Television viewing and hypertension in obese children.

BACKGROUND: Television viewing is strongly associated with an increased risk of childhood and adolescent obesity. However, the association between TV viewing and hypertension in children is unknown. This study aimed to identify whether TV watching is associated with hypertension in obese children. METHODS: Children seen for obesity, aged 4 to 17 years, were evaluated at three pediatric centers from 2003 to 2005. In 2006-2007, a logistic regression model estimated the odds of hypertension for hours of daily TV time controlling for race, site, and body mass index (BMI) z-score. RESULTS: A total of 546 subjects, with a mean age of 12 years, were evaluated. The children had a mean BMI of 35.5+/-9.3 kg/m(2) (98.7th+/-0.8 percentile, z-score 2.54+/-0.4). TV time was positively correlated with the severity of obesity. After controlling for race, site, and BMI z-score, both the severity of obesity and daily TV time were significant independent predictors of the presence of hypertension. Children watching 2 to 4 hours of TV had 2.5 times the odds of hypertension compared with children watching 0 to <2 hours. The odds of hypertension for children watching 4 or more hours of TV were 3.3 times greater than for children watching 0 to <2 hours of TV. CONCLUSIONS: In obese children, the amount of time spent watching TV is associated with both hypertension and the severity of obesity. Thus, TV viewing is a potential target for addressing hypertension in obese children.

Use of wireless capsule endoscopy in the management of severe Henoch-Schonlein purpura.

Henoch-Schonlein purpura is a multisystem vasculitis that primarily affects children. Characteristic symptoms include purpura of the lower extremities and buttocks, abdominal pain, arthralgias, and hematuria. Gastrointestinal bleeding occurs in approximately 50% of children and, although often self-limiting, can be significant. Wireless capsule endoscopy has been found to be safe and effective for children over 10 years of age. It is now the preferred imaging modality for evaluating gastrointestinal bleeding from the small intestine. Here we report an unusual case of chronic Henoch-Schonlein purpura vasculitis, primarily affecting the gastrointestinal tract, in which wireless capsule endoscopy was helpful in evaluating and directing treatment options.

Childhood obesity and insulin-resistant syndrome.

Childhood obesity has become a national concern, health threat, and is increasing at an alarming rate. Obesity is associated with many comorbidities that last into adulthood. Insulin-resistant syndrome (IRS) is developing in growing numbers of obese children. Pediatric nurses play a unique and important role in identifying which children are at risk for obesity and IRS. This article gives current information on what tools to use, how to identify those children, and the interventions needed.

Polyethylene glycol for constipation in children younger than eighteen months old.

BACKGROUND: Polyethylene glycol (PEG) is a safe and effective treatment for constipation in children older than 18 months. Data on its safety and efficacy in infants are lacking. The goal of this study was to determine safety, efficacy, and optimal dose of polyethylene glycol powder for treatment of constipation in patients younger than 18 months. METHODS: The authors reviewed the charts of patients younger than 18 months treated with PEG 3350 for constipation. The initial dose, effective maintenance dose, response to therapy, duration of therapy, and side effects were recorded. RESULTS: Twenty-eight patients younger than 18 months of age treated with PEG were identified (3, age 0-5 months; 9, age 6-11 months; 16, age 12-17 months). Mean duration of therapy was 6.2 +/- 5 months (range, 3 weeks-21 months). Mean initial dose was 0.88 g/kg/day (range, 0.26-2.14 g/kg/day). Mean effective maintenance dose was 0.78 g/kg/day (range, 0.26-1.26 g/kg/day). PEG relieved constipation in 97.6% of patients. One infant experienced increased gas per rectum and four others experienced transient diarrhea that resolved after adjusting the dose. CONCLUSION: Oral powdered polyethylene glycol at a maintenance dose of 0.78 g/kg/day is safe and effective for patients younger than 18 months. Dose and safety profiles are similar for those reported in older children.