Journal articles on the topic 'Children Growth Measurement Evaluation'
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Rahmalisa, Uci, and Yulisman Yulisman. "Automatic Height and Weight Measurement Integrated Database System." JURNAL TEKNOLOGI DAN OPEN SOURCE 4, no. 2 (December 20, 2021): 248–53. http://dx.doi.org/10.36378/jtos.v4i2.1792.
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Measurement of height and weight, it is needed especially for school age 5-15 years old. From the results of monitoring height and weight measurements, we can monitor whether the child is underweight or overweight and obese. We can also monitor the growth of elementary school age children. The problem faced is that monitoring the growth of children in schools cannot be carried out effectively. This is because the process of measuring children's height and weight is done manually and of course it takes time for the process, besides that, data on student height and weight are also recorded still manually, so that data processing and utilization is not optimal. The purpose of making this Automatic Height and Weight Measurement Integrated Database System to process of measuring height and weight can be done effectively and efficiently, so it can produce integrated information in Database. The existence of an integrated database will make it easier for related parties to recap and archive children's data and store history of children's growth as material for evaluating and monitoring child growth. The results of this evaluation can be used as a reference for follow-up to be conducted. The resulting output is information in the form of tables and graphs of children's growth. In this research using the prototyping method which aims to get an overview of the tool to be designed and built, then it will be evaluated by the user. The evaluated prototype will be used as a reference to make a tool as the final product as the output of this research.
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Fisberg, Regina Mara, Maria Eugênia da Silva-Fernandes, Benjamim José Schmidt, and Mauro Fisberg. "Nutritional evaluation of children with phenylketonuria." Sao Paulo Medical Journal 117, no. 5 (September 2, 1999): 185–91. http://dx.doi.org/10.1590/s1516-31801999000500002.
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CONTEXT: Dietary phenylalanine (PA) restriction is the most effective form for reducing its excess in the blood and is the only efficient method for treating phenylketonuria. The diet is complex and should be adapted to combine the patients' eating habits, growth and development. It depends basically on the use of industrialized products as substitutes free of PA for proteins that are not fully supplied. OBJECTIVE: To evaluate the nutritional status of children with phenylketonuria (PKU) by anthropometric measurements and food intake. DESIGN: Cross-sectional study. SETTING: Children with PKU attending the Association of Parents and Friends of Handicapped Children (Associação de Pais e Amigos dos Excepcionais - APAE) and normal children attending at municipal day care centers in São Paulo. PARTICIPANTS: 42 children with PKU and 31 normal children aged 1 to 12 of both sexes were assessed in two groups, under and over 7 years of age. MAIN MEASUREMENTS: Weight and height measurements. RESULTS: Children with PKU ingested calories, calcium, iron, zinc, and copper below the recommended values, whereas the protein intake was within the normal range. Food intake in the group of normal children was within normality rates. The height/weight Z-score means for children with PKU were 0.47 for those under 7 years and 1.86 for 7 year-olds and over; in normal children the means were 0.97 <7 years and 1.54 <FONT FACE="Symbol">³</FONT>7 years, with no statistically significant difference. The height/age Z-score means were significantly lower in the PKU children <7 years (-1.23) than in the normal controls (0.91). CONCLUSIONS: The data presented demonstrate the importance of nutritional surveillance in patients with PKU so as to support adequacy of nutrient intake and to guarantee growth within the relevant standards.
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Suharjito, Suharjito, Jimmy Jimmy, and Abba Suganda Girsang. "Mobile Decision Support System to Determine Toddler's Nutrition Using Fuzzy Sugeno." International Journal of Electrical and Computer Engineering (IJECE) 7, no. 6 (December 1, 2017): 3683. http://dx.doi.org/10.11591/ijece.v7i6.pp3683-3691.
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Determination of nutritional status is closely related to the determination of dietary patterns should be given to infants. Nutrition is very important role in mental, physical development, and human productivity. In this study, the system based on android is developed to determine the nutritional status of infants by using Fuzzy Sugeno. Indicator variables are age, height, circle head, and body weight according to the male or female. In this study, the results of measurements of nutritional status of children with Fuzzy Sugenoare tested by comparing the nutritional quality of the data Posyandu toddler by using anthropometric tables. The results of the evaluation measurement accuracy in this application are compared with the results of manual calculation based infant growth charts according to WHO standards. Therefore, these applications can be used to help the community in monitoring the nutritional status of children so that the growth of children is more appropriate in line with expectations.
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Silva, Patrícia Isabel Pereira, and Miriam Perez. "Prenatal Ultrasound Diagnosis of Biometric changes in the Brain of Growth Restricted Fetuses. A Systematic Review of Literature." Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics 43, no. 07 (July 2021): 545–59. http://dx.doi.org/10.1055/s-0041-1730290.
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AbstractFetal growth restriction (FGR) occurs when the fetus does not reach its intrauterine potential for growth and development as a result of compromise in placental function. It is a condition that affects 5 to 10% of pregnancies and is the second most common cause of perinatal morbidity and mortality. Children born with FGR are at risk of impaired neurological and cognitive development and cardiovascular or endocrine diseases in adulthood. The purpose of the present revision is to perform a literature search for evidence on the detection and assessment by ultrasound of brain injury linked to FGR during fetal life. Using a systematic approach and quantitative evaluation as study methodology, we reviewed ultrasound studies of the fetal brain structure of growth-restricted fetuses with objective quality measures. A total of eight studies were identified. High quality studies were identified for measurement of brain volumes; corpus callosum; brain fissure depth measurements, and cavum septi pellucidi width measurement. A low-quality study was available for transverse cerebellar diameter measurement in FGR. Further prospective randomized studies are needed to understand the changes that occur in the brain of fetuses with restricted growth, as well as their correlation with the changes in cognitive development observed.
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Hancock, Caroline, Silvana Bettiol, and Lesley Smith. "Socioeconomic variation in height: analysis of National Child Measurement Programme data for England." Archives of Disease in Childhood 101, no. 5 (September 4, 2015): 422–26. http://dx.doi.org/10.1136/archdischild-2015-308431.
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ObjectiveShort stature is associated with increased risk of ill health and mortality and can negatively impact on an individual's economic opportunity and psychological well-being. The aim of this study was to investigate the association between height and area-level deprivation by ethnic group in children in England.DesignCross-sectional analysis of data gathered from the National Child Measurement Programme 2008/2009 to 2012/2013.Participants/methodsChildren (n=1 213 230) aged 4–5 and 10–11 years attending state-maintained primary schools in England. Mean height SD score (SDS) (based on the British 1990 growth reference) was calculated for children by Income Deprivation Affecting Children Index as a measure of area-level deprivation. Analyses were performed by sex and age group for white British, Asian and black ethnicities.ResultsFor white British children mean height decreased 0.2 SDS between the least and the most deprived quintile. For Asian children the relationship was weaker and varied between 0.08 and 0.18 SDS. For white British boys the magnitude of association was similar across age groups; for Asian boys the magnitude was higher in the age group of 10–11 years and in white British girls aged 10–11 years the association decreased. Height SDS was similar across all levels of deprivation for black children.ConclusionsSocial inequalities were shown in the height of children from white British and Asian ethnic groups. Further evaluation of height in black children is warranted. Action is needed to reduce inequalities in height by addressing the modifiable negative environmental factors that prevent healthy growth and development of children.
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Kemp, Stephen F. "New Treatments for Growth Hormone Deficiency." US Endocrinology 09, no. 01 (2013): 71. http://dx.doi.org/10.17925/use.2013.09.01.71.
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First recognized in the early 20th century, growth hormone deficiency (GHD) has been treated with growth hormone (GH) replacement since 1958. Initial replacement was with cadarevic GH. In 1985, GH therapy with recombinant human GH (rhGH) replaced cadaveric GH, which increased not only safety, but also efficacy (because of increased supply). Improvements in GH dosing and frequency of injection has resulted in adult heights now usually in the normal range. GHD is diagnosed from the clinical picture, along with measurement of serum insulin-like growth factor 1 (IGF-I), IGF binding protein-3, and GH response to provocative stimuli. Several long-acting GH preparations are now under development. There has been a great deal of data from databases that confirms safety of GH administration while patients are taking GH. A recent report of increased mortality risk in adults who were treated with GH as children has not been confirmed by a second similar retrospective evaluation. Additional long-term follow-up studies of adults who took GH as children are needed.
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Ekholuenetale, Michael, Amadou Barrow, Anthony Ike Wegbom, and Amit Arora. "Measuring the Uptake of Growth Monitoring and Nutrition Promotion among under-5 Children: Findings from the Rwanda Population-Based Study." Children 9, no. 11 (November 16, 2022): 1758. http://dx.doi.org/10.3390/children9111758.
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Regular growth monitoring can be used to evaluate the nutritional and physical health of children. Ample evaluation of the reach and quality of nutrition interventions is necessary to increase their effectiveness, but there is little research on improving coverage measurement. The aim of this study was to explore the coverage of growth monitoring, nutrition promotion, and associated factors by Rwandan caregivers of children under the age of five. Data from 2019–2020 Rwanda Demographic and Health Survey with a total of 8092 children under the age of five were used for this study. Prevalence of growth monitoring and nutrition promotion were reported and the factors influencing this were evaluated using multivariable logistic regression model. The prevalence of growth monitoring and nutrition promotion among under-5 children was 33.0% (95%CI: 30.6–35.6%). Older children, caregivers who were native residents, those with a health insurance, in a marital relationship, employed, and residing in rural areas had higher odds to participate in growth monitoring and nutrition promotion compared to their counterparts. Rwanda has a low rate of coverage for growth monitoring and nutrition promotion among children <5 and public health nutrition interventions should prioritize nutritional counseling as well as the availability of growth monitoring and promotion services.
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Rose, Charles E., Jeanne Bertolli, Jacob Elijah Attell, Cynthia A. Moore, Flavio Melo, Kim Kotzky, Nevin Krishna, et al. "Early Growth Parameters as Predictors of Developmental Delay among Children Conceived During the 2015–2016 Zika Virus Outbreak in Northeastern Brazil." Tropical Medicine and Infectious Disease 5, no. 4 (October 1, 2020): 155. http://dx.doi.org/10.3390/tropicalmed5040155.
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Background: Identifying infants with congenital infection for early intervention will likely be challenging in future Zika virus outbreaks. We investigated indicators of risk for developmental delay among children born with and without obvious manifestations of congenital Zika virus infection. Methods: We evaluated 120 children conceived during the 2015−2016 Zika virus outbreak in Paraíba, Brazil. We analyzed data from children at birth; ages 1−7 months and approximately 24 months, using medical records (i.e., anthropometric measurements diagnoses), medical evaluation (i.e., Zika/other laboratory tests, dysmorphic features), and parent report (seizures, developmental delay). We used a Bayesian modeling approach to identify predictors of developmental delay. Results: Head circumference (HC) and length at birth and rates of growth for HC and length at follow-up were consistent across domains of developmental delay; (e.g., for every 1 cm per month decrease in HC growth rate; there was a corresponding decrease in the gross motor z-score). Modeling results indicated that HC and length at birth, and follow-up HC and length rates of growth, were predictive of developmental delay. Conclusion: These findings suggest that accurate measurement and frequent monitoring of HC and length, especially in the first few months of life, may be useful for identifying children possibly congenitally exposed to Zika virus who could benefit from early intervention services.
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Marsh, David R., Helena Pachón, Dirk G. Schroeder, Tran Thu Ha, Kirk Dearden, Tran Thi Lang, Nguyen Dhanh Hien, Doan Anh Tuan, Tran Duc Thach, and David Claussenius. "Design of a Prospective, Randomized Evaluation of an Integrated Nutrition Program in Rural Viet Nam." Food and Nutrition Bulletin 23, no. 4_suppl2 (December 2002): 34–44. http://dx.doi.org/10.1177/15648265020234s206.
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Few prospective studies of child growth and its determinants take place in programmatic contexts. We evaluated the effect of Save the Children's (SC) community empowerment and nutrition program (CENP) on child growth, care, morbidity, empowerment, and behavioral determinants. This paper describes the research methods of this community-based study. We used a longitudinal, prospective, randomized design. We selected 12 impoverished communes with documented child malnutrition, three comparison, and three intervention communes in each of two districts in Phu Tho Province, west of Hanoi. SC taught district trainers in November 1999 to train local health volunteers to implement the 10-month CENP, including situation analysis, positive deviance (PD) inquiry, growth monitoring and promotion, nutrition education and rehabilitation program (NERP), deworming, and monitoring. PD inquiries aim to discover successful care practices in poor households that likely promote well-nourished children. NERPs are neighborhood-based, facilitated group learning sessions where caregivers of malnourished children learn and practice PD and other healthy behaviors. We dewormed all intervention and comparison children. We weighed all children less than 24 months of age living in the intervention and comparison communes and randomly selected 240 children (120 intervention and 120 comparison). We gathered information on nutritional status, diet, illness, care, behavioral determinants, empowerment, and program quality, monthly for six months with a re-survey at 12 months. We collected most information through maternal interview but also observed hygiene and program quality, and videotaped feedings at home. Some implementation and research limitations will attenuate CENP impact and measurement of its effectiveness.
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Banfi, Gluseppe, Marcello Marinelli, Ermlnla Casari, Michelangelo Murone, and Plerangel Bonini. "Isotopic and nonisotopic assays for measuring somatotropin compared: re-evaluation of cutoff value in provocative tests." Clinical Chemistry 37, no. 2 (February 1, 1991): 273–76. http://dx.doi.org/10.1093/clinchem/37.2.273.
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Abstract Measurement of human growth hormone (hGH; somatotropin) concentrations in serum after provocative tests is crucial for diagnosing deficiencies in production of this hormone. Serum hGH can be measured by various immunoassays, isotopic and nonisotopic, with monoclonal or polyclonal antibodies: a cutoff value of 10 micrograms/L after provocative testing is usually used to distinguish normal from hGH-deficient children. Previous studies demonstrated discrepancies in hGH measurement by different radioisotopic immunoassays. Here we evaluated the responses of six different commercial assays, radioisotopic and nonisotopic, with monoclonal or polyclonal antibodies in a series of 16 provocative tests (stimulation with clonidine) in short children. A wide range of discrepant values was obtained with the different kits. A cutoff of 10 micrograms/L produced discordance of diagnosis among assays for two children, whereas complete agreement was reached for a cutoff value of 7 micrograms/L. Parallelism tests performed with hGH international standard, pure recombinant hGH, and a serum with high hGH content suggest that heterogeneity of the antibodies used by the manufacturers, even among monoclonal antibodies, is the main source of discordant results. Cutoff values and reference values must be established separately for each method proposed for routine use.
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MARQUES, Priscila Francisco, Maria Angela Bellomo BRANDÃO, Gabriel HESSEL, Roberta Vacari ALCANTARA, Marcela Linden FERREIRA, and Elizete Aparecida LOMAZI. "Evaluation of growth and nutritional status in children and adolescents with extrahepatic portal vein obstruction and portal hypertension." Revista de Nutrição 30, no. 4 (August 2017): 455–61. http://dx.doi.org/10.1590/1678-98652017000400005.
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ABSTRACT Objective: This study aims to evaluate dietary intake, nutritional status, and growth rate in children and adolescents with extrahepatic portal vein obstruction and portal hypertension. Methods: Outpatients aged 1-18 years, diagnosed with extrahepatic portal vein obstruction and portal hypertension, who had no associated diseases, and who had not been subjected to a venous shunt were included in this study. Two evaluations were carried out in this study: an initial (evaluation 1) and a final evaluation (evaluation 2), with a three-month minimum interval between them. In each evaluation, dietary intake was analyzed comparing the results with recommended energy intake using the Harris & Benedict equation and participants’ anthropometric data, such as weight, height, mid-arm muscle circumference, weight-for-age, height-for-age, and body mass index-for-age, based on the World Health Organization 2006 standards. Results: A total of 22 patients participated in this study. There was a significant improvement in weight, height, body mass index, and mid-arm muscle circumference measurements (p<0.001; p<0.001; p<0.017; p=0.0018 respectively) and in the relationship between dietary intake and energy recommended energy intake, according to the Harris & Benedict equation (p=0.0001) from the first and second evaluation. Conclusion: Extrahepatic portal vein obstruction and portal hypertension were not shown to be factors predisposing to malnourishment.
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Koca, Serkan Bilge, and Aysegul Bukulmez. "Evaluation of metabolic factors affecting the presence of hepatosteatosis and the effect of insulin like growth factor-1 level in overweight and obese children." Volume 1, Issue 3 1, no. 3 (October 15, 2021): 119–27. http://dx.doi.org/10.26900/hsq.1.3.05.
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Although previous studies related to non-alcoholic fatty liver disease (NAFLD) in childhood were predominantly ALT and uric acid level, the number of studies that have been handled in terms of insulin like growth factor-1 (IGF-1) level or IGF-1 standard deviation score (SDS) is limited. In this study, all factors that may affect NAFLD, including IGF-1 level and IGF-1 SDS, were evaluated in two groups of children who were not statistically different from each other in terms of age, gender, weight, height, body mass index and puberty. This study was a cross sectional study. 36 children with evidence of fatty liver disease on ultrasound imaging and 38 children without it were included in the study. Anthropometric data, laboratory measurements and radiological results of all participants were evaluated. All factors that could affect NAFLD were evaluated by binary logistic regression analysis. Weight, weight SDS, body mass index (BMI) SDS, homeostasis model assessment of insulin resistance (HOMA-IR), AST, ALT, GGT, uric acid, triglyceride, HDLcholesterol, IGF-1, IGF-1 SDS were evaluated in this model to predict NAFLD. In the statistical model, the percentage of predicting those with NAFLD, that is, the sensitivity, was 88.9%, while the detection rate of those without NAFLD, that is, the specificity, was 94.7%. IGF-1 level was found to be significantly lower in the group with NAFLD (p: 0.04), but there was no significant difference between the groups in terms of IGF-1 SDS (p: 0.10). There are conflicting results in studies examining the relationship between IGF-1 SDS and NAFLD. This may be due to ethnicity, regional differences, kit-specific laboratory reference ranges, or method of measurement. Laboratory measurements including appropriate parameters with a detailed physical examination can be used to predict the presence of NAFLD without the need for radiological examination.
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Leidman, Eva, Shannon Doocy, Iris Bollemeijer, Muhammad Jatoi, and Jennifer Majer. "Accuracy of Fully Automated 3D Imaging System for Child Anthropometry in a Low-Resource Setting: An Effectiveness Evaluation in South Sudan." Current Developments in Nutrition 6, Supplement_1 (June 2022): 919. http://dx.doi.org/10.1093/cdn/nzac067.039.
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Abstract Objectives To evaluate accuracy of child stature (height/length) and mid-upper arm circumference (MUAC) measurements produced by the AutoAnthro 3D imaging system developed by Body Surface Technology Inc following improvements to the software algorithm to improve accuracy and support automated processing, and hardware changes aimed to reduce cost. Methods A two-stage cluster survey in Malakal Protection of Civilians (PoC) in South Sudan between September 27 and October 2, 2021. All children aged 6–59 months within selected households were eligible. For each child, manual measurements were obtained by two anthropometrists following the protocol used for the 2006 WHO Child Growth Standards (CGS) study. Scans were then captured by a different enumerator using a Samsung Galaxy 8 phone loaded with a custom software, AutoAnthro, and an Intel RealSense 3D scanner. Scans were processed using a fully automated algorithm. A multivariate logistic regression was fit to evaluate adjusted odds of achieving a successful scan. Accuracy of measurements were visually assessed using Bland-Altman (BA) plots and quantified using average bias, technical error of measurement (TEM), limits of agreement (LoA), and the 95% precision interval for individual differences. Results Manual measurements were obtained for 539 age eligible children, from which scan derived measurements were successfully processed for 234 (43.4%) of children. Caregivers for at least 56 children (10.4%) refused consent for scan capture; additional scans were unsuccessfully transmitted to the server. Neither demographic characteristics of the children (age and sex), stature, nor MUAC were associated with availability of scan derived measurements (P > 0.05); team was significantly associated (P < 0.001). The average bias of measurements in cm was −0.5 (95% confidence interval (CI): −2.0, 1.0) for stature and + 0.7 (CI: 0.4, 1.0) for MUAC. For stature, 95% LoA was −23.9 to 22.9 cm. For MUAC, the 95% LoA was −4.0 to 5.4 cm. The TEM was 8.4 cm for stature and 1.8 cm for MUAC. All metrics of accuracy varied considerably by team. Conclusions Scan derived measurements were not of sufficient accuracy for widespread adoption. Differences in accuracy by team provide evidence that investments in training may be able to improve performance. Funding Sources USAID's Bureau for Humanitarian Affairs and Grand Challenges Canada.
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Muhardi, Leilani, Leilani Muhardi, Eline M. Van der Beek, Marieke Abrahamse-Berkeveld, Hamid Jan B. Jan Mohamed, Ngee Lek, Wendy Oddy, and V. P. Wickramasinghe. "Early detection of childhood obesity through extended routine growth monitoring of children below two years of age in the Asia Pacific region." World Nutrition Journal 2, no. 1 (August 23, 2018): 22. http://dx.doi.org/10.25220/wnj.v02.i1.0004.
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Introduction Increased body fat deposition during early life predisposes to higher obesity and metabolic disorder risks in later life. This is particularly relevant in the Asia Pacific region where historically prevalent under-nutrition is now been paralleled or even overruled by over-nutrition over the last few decades. This overview aims to evaluate the potential of early detection of obesity (risk) among experts through addition of specific growth monitoring assessments in children during the first two years of life. Methods A discussion among experts from Malaysia, Singapore, Sri Lanka and Australia on infant growth and a qualitative evaluation of current practice highlighted the need to measure body composition to assess the quality of growth. Current tools are mainly directed towards simple anthropometric measures such as body weight, length and head circumference which do not adequately reflect concurrent changes in body composition to detect early life adiposity development. Recent findings have shown benefits of measurement such as the sum of four skinfold thickness (S4SFT) during the first two years of life for risk assessment of later overweight/obesity. We recommend this assessment for routine practice as a proxy for fat deposition in young children. Further studies to understand implementation hurdles and cost-effectiveness of S4SFT and health outcomes in young children in the Asia Pacific region are necessary. Conclusion Inclusion of four skinfold thickness measurements as part of routine growth monitoring assessment, in addition to weight and height, could be recommended to assess adiposity development in early life allowing identification of infants at risk for obesity.
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Zoller, Thomas, Maria Antonia Prioli, Maria Clemente, Mara Pilati, Camilla Sandrini, Giovanni Battista Luciani, Marco Deganello Saccomani, et al. "Congenital Heart Disease: Growth Evaluation and Sport Activity in a Paediatric Population." Children 9, no. 6 (June 14, 2022): 884. http://dx.doi.org/10.3390/children9060884.
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(1) Objective: To evaluate: (i) the associations of age and disease severity with anthropometric indices and weight status, (ii) the difference in the frequency of sports activity among different levels of disease severity in paediatric patients with congenital heart disease (CHD). (2) Methods: Clinical data of Caucasian children (aged 2–18 years) diagnosed with CHD (2005–2018) were retrospectively collected from the electronic register of outpatient visits. Of the 475 children with CHD, 368 children and their 1690 complete anthropometric measurements were eligible for inclusion in our analysis. (3) Results: Significant increase with age was observed for weight z-score [beta (95%CI): 0.03 (0.02, 0.05) for one-unit of age] and BMI z-score [0.06 (0.03, 0.08)] but not for height z-score. The probability of being underweight and overweight/obese increased and decreased with disease severity, respectively. The obesity probability of patients with mild CHD (0.06 [95%CI: 0.03, 0.08]) was not statistically distinguishable from that of patients with moderate CHD (0.03 [95%CI: 0.02, 0.05]), whereas it was lower in patients with severe CHD (0.004 [95%CI: 0.0, 0.009]). No obese patients with a univentricular heart defect were observed. Days spent in sport activities were equal to 1.9 [95%CI: 1.6, 2.2] days/week, 1.9 [1.5, 2.2], 1.4 [1.1, 1.7] and 0.7 [0.1, 1.3] in patients with mild, moderate, severe and univentricular CHD, respectively. (4) Conclusions: The risk of being overweight and obese should not be underestimated in paediatric patients diagnosed with CHD, especially in children with mild or moderate heart defects. It could be prevented or reduced by promoting a healthy lifestyle.
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Rosenfeld, Ron G. "Pharmacogenomics and pharmacoproteomics in the evaluation and management of short stature." European Journal of Endocrinology 157, suppl_1 (August 2007): S27—S31. http://dx.doi.org/10.1530/eje-07-0186.
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It has long been recognized that growth failure encompasses a diverse spectrum of underlying pathophysiological processes, a characteristic that has significantly impacted both the diagnosis and management of growth disorders. This problem is exacerbated by inherent difficulty in distinguishing the borders between the ‘normal range’ for stature and defined abnormal growth. Evaluation of GH secretion has proven problematic, both diagnostically and prognostically, except in cases of unequivocal GH deficiency. Measurement of serum concentrations of IGF-I, IGFBP-3, and ALS have proven useful in the assessment of GH responsiveness and have contributed to the concept of primary and secondary ‘IGF deficiency’. Nevertheless, there is great need for biochemical and/or molecular biomarkers that could: i) predict short- and long-term responsiveness to various therapeutic modalities, such as GH and IGF-I, and ii) predict potential risk for adverse effects of therapy. Candidate proteins and genes identified to date, and worthy of further evaluation, include IGF-I, IGF-I receptor, GH receptor and its variants (such as exon 3-deleted GHR), STAT5b and short stature homeobox. Proteomic analysis of serum samples pre- and post-treatment and correlation with clinical responsiveness should provide additional candidate biomarkers. Molecular studies to consider include: i) sequencing and mutation analysis of known genetic components of the GH–IGF axis; ii) evaluation of single nucleotide polymorphisms of candidate genes; and iii) identification of new candidate genes. It is proposed that the major target population to study is that of children currently labeled as idiopathic short stature (ISS). These children can be divided into those with: i) primary IGFD, where the focus should be on genes related to GHR, GHR signaling, and IGF-I gene expression, or ii) no IGFD (i.e. ‘true ISS’), where the focus should be on genes related to IGFR, IGF signaling and epiphyseal growth.
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Witkowska-Sędek, Ewelina, Małgorzata Rumińska, Anna Stelmaszczyk-Emmel, Anna Majcher, and Beata Pyrżak. "The associations between the growth hormone/insulin-like growth factor-1 axis, adiponectin, resistin and metabolic profile in children with growth hormone deficiency before and during growth hormone treatment." Acta Biochimica Polonica 65, no. 2 (July 8, 2018): 333–40. http://dx.doi.org/10.18388/abp.2018_2601.
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The study investigated the associations between the growth hormone/insulin-like growth factor-1 (GH/IGF-1) axis, adiponectin, resistin and metabolic profile in 47 GH-deficient children before and during 12 months of GH treatment. 23 short age-matched children without growth hormone deficiency (GHD) or any genetic or chronic disorders were recruited as controls at baseline. Metabolic evaluation included measurements of adiponectin, resistin, IGF-1, total cholesterol (total-C), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), glucose, insulin, glycated hemoglobin (HbA1c), thyroid stimulating hormone (TSH) and free thyroxine (free T4) concentrations. The GH-deficient children had significantly higher adiponectin (p<0.05) and total cholesterol (p<0.05) and significantly lower resistin (p<0.05) than the controls. Resistin at 6 months of GH treatment correlated significantly with changes in height SDSin that period (r=0.35) and with fasting insulin (r=0.50), the HOMA-IR (r=0.56) and the QUICKI (r= - 0.53) at 12 months of therapy. Adiponectin at 12 months of GH treatment was significantly associated with changes in HDL-C within the first 6 months (r=0.73) and also within 12 months (r=0.56) of therapy, while resistin correlated significantly with an increment in IGF-1 within 12 months of treatment (r=0.49) and with total-C at 12 months (r=0.56). Untreated GH-deficient children had higher adiponectin and lower resistin than healthy short children without GHD. Adiponectin and resistin did not change significantly during the first 12 months of GH therapy. Good responders to GH treatment had a tendency for higher resistin during GH therapy, which correlates positively with insulin resistance parameters.
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Clemmons, David R. "Consensus Statement on the Standardization and Evaluation of Growth Hormone and Insulin-like Growth Factor Assays." Clinical Chemistry 57, no. 4 (April 1, 2011): 555–59. http://dx.doi.org/10.1373/clinchem.2010.150631.
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Abstract Growth hormone (GH) and insulin-like growth factor I (IGF-I) measurements are widely used in the diagnosis of disorders of GH secretion, evaluation of children with short stature from multiple causes, management of disorders that lead to nutritional insufficiency or catabolism, and monitoring both GH and IGF-I replacement therapy. Therefore, there is an ongoing need for accurate and precise measurements of these 2 peptide hormones. Representatives of the Growth Hormone Research Society, the IGF Society, and the IFCC convened an international workshop to review assay standardization, requirements for improving assay comparability, variables that affect assay interpretation, technical factors affecting assay performance, assay validation criteria, and the development and use of normative data. Special attention was given to preanalytical conditions, the use of international commutable reference standards, antibody specificity, matrix requirements, QC analysis, and interference by binding proteins. Recommendations for each of these variables were made for measurements of each peptide. Additionally, specific criteria for IGF-I were recommended for age ranges of normative data, consideration of Tanner staging, and consideration of the effect of body mass index. The consensus statement concludes that major improvements are necessary in the areas of assay performance and comparability. This group recommends that a commutable standard for each assay be implemented for worldwide use and that its recommendations be applied to accomplish the task of providing reliable and clinically useful results.
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KOÇAK, Betül, and Hande ÖNGÜN YILMAZ. "EVALUATION OF NUTRITIONAL STATUS AND RELATED FACTORS IN PRESCHOOL CHILDREN ADMITTED TO HOSPITAL DUE TO INFECTION." INTERNATIONAL REFEREED ACADEMIC JOURNAL OF SPORTS, no. 38 (2021): 0. http://dx.doi.org/10.17363/sstb.2020/abc8985/.38.4.
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Aim: In this study, it was aimed to evaluate the nutritional status of preschool children who were admitted to the hospital due to infection, and to determine the relationship between the frequency of infection and their growth and development. Method: This descriptive cross-sectional study was conducted with a total of 110 children aged between 3 and 6 years who applied due to infection to a hospital in Istanbul. Data collection was made with face to face interviews with a questionnaire form including questions about the child's age, gender, health status, infection frequency, cleaning habits, anthropometric measurements, and food consumption frequency. Results: According to body mass index (BMI) Z scores, 8.1% of the children were severely thin, 9.1% thin, 44.5% normal, 21.8% overweight, and 16.4% obese. While 36.4% of the children having infection 1-3 times a year, 63.6% having infection 4 and more times a year. Children whose rooms were cleaned frequently had more infections (p<0.05). There was no relationship between the children's daily energy and nutrient consumption and the infection frequency (p>0.05) except vitamin D. Children who consumed less vitamin D had 4 or more infections yearly (p<0.05). Conclusion: Frequent infectious diseases during childhood affect growth and development. Due to the bilateral relationship between infection and malnutrition, the nutritional status and growth developments of children with frequent infections should be followed closely.
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Himes, John H., Alex F. Roche, David Thissen, and William M. Moore. "Parent-Specific Adjustments for Evaluation of Recumbent Length and Stature of Children." Pediatrics 75, no. 2 (February 1, 1985): 304–13. http://dx.doi.org/10.1542/peds.75.2.304.
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A clinical "parent-specific" method for evaluating recumbent length and stature of children, allowing for the stature of parents, is presented. This method uses midparent stature and allows adjustment of recumbent length (birth to 3 years) and stature (3 to 18 years) of US children relative to National Center for Health Statistics growth charts. The method is based on parent-child relationships for 586 midparent-child pairs participating in the Fels Longitudinal Study, and on more than 16,000 serial measurements of recumbent length and stature. The method provides a clinical tool to separate the normal genetic contribution of parental stature to stature of children from other factors that affect stature such as malnutrition or disease.
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Hasegawa, Yukihiro, Tomonobu Hasegawa, Makoto Takada, and Yutaka Tsuchiya. "Plasma free insulin-like growth factor I concentrations in growth hormone deficiency in children and adolescents." European Journal of Endocrinology 134, no. 2 (February 1996): 184–89. http://dx.doi.org/10.1530/eje.0.1340184.
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Hasegawa Y, Hasegawa T, Takada M, Tsuchiya Y. Plasma free insulin-like growth factor I concentrations in growth hormone deficiency in children and adolescents. Eur J Endocrinol 1996;134:184–9. ISSN 0804–4643. Serum levels of total insulin-like growth factor I (IGF-I) correlate with growth hormone (GH) secretory status and are a useful parameter in the diagnostic evaluation of GH deficiency. Serum total IGF-I levels represent the combined quantity of free or unbound IGF-I and IGF-I that is bound to specific IGF binding proteins. Free IGF-I (fIGF-I), which is postulated to be the bioactive fraction, accounts for only a small fraction of the total amount. We have recently developed a new immunoradiometric assay (IRMA) for plasma fIGF-I and have investigated fIGF-I in relation to GH status. The simple, non-extraction assay procedure involves the capture of unbound IGF-I by anti-IGF-I antibody coated to polystyrene beads and detection by a radiolabelled anti-IGF-I antibody directed to a separate epitope. Preliminary studies demonstrated that the f IGF-I IRMA does not measure IGF-I that is complexed to IGF-binding proteins and that the equilibrium between the free and bound fractions is not disturbed during the assay. Free IGF-I levels were compared to total IGF-I levels measured in the same IRMA after acid–ethanol extraction of the samples. Normal levels of fIGF-I from infancy through adulthood were found to have a close correlation with total IGF-I levels, with the lowest levels occurring in infancy and peak levels during puberty. Patients with complete GH deficiency had low levels of both fIGF-I and total IGF-I, with 94% and 100% of the levels below the 5th percentile for age, respectively. On the other hand, approximately 90% of patients with normal IGF binding protein-3 levels among partial GH deficiency and normal short children had free and total IGF-I levels above the 5th percentile for age. These data indicate that the clinical utility of plasma fIGF-I measurements is similar to measurements of total IGF-I in the evaluation of childhood GH deficiency. Yukihiro Hasegawa, Division of Endocrinology and Metabolism, Tokyo Metropolitan Kiyose Children's Hospital, 1-3-1 Urnezono Kiyose, Tokyo 204, Japan
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de Bie, Prim, Annemieke C. Heijboer, and Martine M. L. Deckers. "Impact of IGF-1 Normative Datasets on Indication and Outcome of Growth Hormone Stimulation Testing." Journal of the Endocrine Society 5, Supplement_1 (May 1, 2021): A678—A679. http://dx.doi.org/10.1210/jendso/bvab048.1383.
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Abstract In the Netherlands, the diagnosis of growth hormone deficiency in children follows the Dutch national guidelines for Triage and Diagnosis of Growth Disorders in Children. Initial biochemical evaluation includes an IGF-1 measurement as screening parameter for growth hormone deficiency. Based on the clinical probability of growth hormone deficiency and the IGF-1 Z-score, a growth hormone stimulation test is performed if serum IGF-1 Z-score is < 0 SD in case of a high probability and if serum IGF-1 Z-score is < -1 SD in case of low probability. An IGF-1 Z-score > 0 SD virtually excludes a growth hormone deficiency disorder. The interpretation of growth hormone stimulation testing is dependent on both the peak growth hormone concentration, but also on the baseline IGF-1 Z-score, particularly in cases of partial deficiency. Although, nation wide, Dutch laboratories have harmonized their measurement for IGF-1 (as was previously done for growth hormone), a Dutch harmonized normative data set has not been widely adopted. Moreover a clinical evaluation of the implementation of this dataset based on dynamic testing has not been published. To assess the impact of choice of a particular normative dataset on the diagnosis of growth hormone deficiency we recalculated Z-scores of IGF-1 measurements between 2016 and 2019, using our home reference values based on de normative dataset by Elmlinger (E)1, and using the normative datasets defined by Bidlingmaier (B)2 and by the Dutch IGF-1 harmonization program (NL). Based on these three Z-scores, the outcomes of growth hormone stimulation tests performed in this period (n=86) were reassessed according to the interpretation described in the Dutch guideline. Using all three normative datasets the same 4 patients were identified as likely to have a growth hormone deficiency, whereas 10(E), 10(B), or 8(NL) patients were identified as possible partial growth hormone deficiency. In 70(E), 66(B) or 72(NL) patients the growth hormone stimulation test was unaffected. Using normative dataset B, 6 patients displayed a pattern associated with a possible growth hormone resistance, or of bio-inactive growth hormone syndromes, which based on its incidence would be unlikely for a secondary care setting. A striking observation was however, that of all patients with a normal stimulation test 9 (E)/16 (B) or 30 (NL) had a IGF-1 Z-score of > 0 SD. This implies that, for the diagnosis of growth hormone deficiency, it is safe to implement the Dutch harmonized dataset, which in addition could result in a reduction in the number of growth hormone stimulation tests that have to be performed. References: 1. Elmlinger MW et al. Clin Chem Lab Med. 2004;42(6):654-64. 2. Bidlingmaier M et al. J Clin Endocrinol Metab. 2014 May;99(5):1712-21.
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Zaki, Ibnu, Farida Farida, and Hesti Permata Sari. "Peningkatan Kapasitas Kader Posyandu Melalui Pelatihan Pemantauan Status Gizi Balita." Jurnal Pengabdian kepada Masyarakat (Indonesian Journal of Community Engagement) 3, no. 2 (June 5, 2018): 169–77. http://dx.doi.org/10.22146/jpkm.28595.
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Early childhood represents the stage of golden period during children development. Nutritional status monitoring at this period is very important to prevent growth disorders. The monitoring process is conducted monthly through posyandu. Posyandu cadres are the spearhead of successful nutritional status monitoring for children under five years old, therefore increasing cadres’ capability is necessary. This activity aims to improve posyandu cadres’ capability including knowledge and skills for nutritional status monitoring of children under five years old. This activities were carried out at Posyandu Mawar VI Karangsalam Kidul, Kedungbanteng Sub-District, Banyumas District, Central Java. This series of activities are conducted for four months, from May to August, 2017. The activity method was training with simulation with seven cadres participated in this activity. The evaluation resulted in increase of knowledge and skill level of cadre in nutritional status monitoring. The increase of knowledge scoring before and after training equal to 1.88 points. The increase of skill showed by almost every measurements are conducted properly, such as weighing standing toddler, weighing baby weight less than two years old, height measurement of toddler, and plotting KMS. Whereas, cadres are still having difficulties in measuring the length of the baby. It can be concluded that there is an increase in knowledge and skills of posyandu cadres in nutritional status monitoring of children after training.
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Effert, Josephine, Simone Uhlig, Cornelia Wiechers, Mirja Quante, Christian F. Poets, Matthias C. Schulz, Siegmar Reinert, Michael Krimmel, Bernd Koos, and Christina Weise. "Prospective Evaluation of Children with Robin Sequence Following Tübingen Palatal Plate Therapy." Journal of Clinical Medicine 12, no. 2 (January 5, 2023): 448. http://dx.doi.org/10.3390/jcm12020448.
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Background: To assess the long-term functional orthodontic outcome of the Tübingen palatal plate (TPP) in children with Robin sequence (RS) in comparison to age- and sex-matched healthy controls. Methods: Between 09/2019 and 10/2020, we performed orthodontic assessments in 41 children at our Department of Orthodontics. Included were patients with RS (17 non-syndromic; four syndromic) and healthy controls (n = 22, average age in both groups 9.9 y). Facial analyses of 2D images, digital study casts and cephalometric measurements were made. Results: The orthodontic examinations showed no statistically significant group differences regarding functional extraoral, intraoral and pharyngeal parameters, or in skeletal patterns. The relationship between the upper and lower incisors was significantly increased (overjet 4 (2–10) vs. 3 (0–9) mm; p = 0.01) with a significant deficit in the lower face proportions (Jaw Index 4.15 (1.9–9.6) vs. 2.98 (0–9); p = 0.02; Facial convexity angle 157 (149–173) vs. 159 (149–170); p = 0.01). Conclusion: Children with RS treated with the TPP showed normal long-term functional orthodontic outcomes, thanks to the functional adaption of the stomatognathic system. However, soft tissue growth did not completely match skeletal growth, resulting in a more convex facial profile.
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Chowdhury, Fahmida, Mujibul Hoque, Md Manajjir Ali, and Md Anisul Hossain. "Comparison of Growth in Children with Cyanotic and Acyanotic Congenital Heart Disease in a Tertiary Care Hospital." Journal of Bangladesh College of Physicians and Surgeons 36, no. 2 (May 10, 2018): 64–69. http://dx.doi.org/10.3329/jbcps.v36i2.36068.
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Background: Congenital heart disease (CHD) is the commonest of all congenital lesions and is the most common type of heart diseases among children. Anthropometric evaluation is very important for early recognition of growth failure in children with cyanotic and acyanotic congenital heart diseases.Methods: This comparative cross sectional study was undertaken with the objective to compare the growth of children with cyanotic and acyanotic congenital heart disease using anthropometric measurement in Department of Paediatrics, Sylhet MAG Osmani Medical College Hospital from March, 2014 to September, 2014. Sixty children aged 6 months to 60 months with CHD, were included in this study, where 30 children with cyanotic and 30 children with acyanotic CHD, confirmed by Echocardiogram.Results: All the children (100%) with cyanotic congenital heart disease were underweight (Weight for age Z score). Among them, 23.33% had moderate and 76.67% had severe underweight. In children with acyanotic congenital heart disease, 93.33% had underweight. Among them, 20% had moderate and 73.33% had severe underweight. The p-value was 0.35008. In cyanotic congenital heart disease, 96.67% children had stunting. Among them, 13.33% had moderate and 83.33% had severe stunting. In acyanotic congenital heart disease, 43.33% children had stunting. Among them, 33.33% had moderate and 10% had severe stunting. There was significant statistical deference in between the two groups, (pvalue was <0.0001). In cyanotic congenital heart disease, 43.33% children had wasting. Among them, 30% had moderate and 13.33% had severe wasting. In acyanotic congenital heart disease, 76.67% children had wasting. Among them, 30% had moderate and 46.67% had severe wasting. There was significant deference in the groups (p value was 0.0077).Conclusion: Growth failure was common in children with both cyanotic and acyanotic congenital heart disease. There was no significant difference in weight for age Z score (WAZ) of patients with cyanotic and acyanotic CHD but stunting was significantly higher in patients with cyanotic CHD and wasting was significantly higher in patients with acyanotic CHD.J Bangladesh Coll Phys Surg 2018; 36(2): 64-69
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Beatty, E., L. Audette, A. Paré, D. Simonyan, V. Dion, S. Berthelot, and M. Parent. "LO82: Normal bedside ultrasound of growth plates in healthy children." CJEM 20, S1 (May 2018): S36. http://dx.doi.org/10.1017/cem.2018.144.
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Introduction: The diagnosis of Salter-Harris Type 1 fractures in the Emergency Department (ED) is primarily clinical, as radiographs are usually unrevealing. We hypothesize that bilateral asymmetry of the growth plate, detected using bedside ultrasound (US), could improve the accuracy of this diagnosis in the ED. This study seeks to determine growth plate size according to age, and to establish normal variation in bilateral symmetry of growth plate cartilage, for the ulna, radius, tibia, and fibula, using bedside US in normal healthy children. Methods: This prospective observational study was conducted in a convenience sample of children ages 0-17 during planned visits to an elementary school, high school, and an outpatient pediatric clinic. A sample size of 177 was determined with a linear regression model using previously published data on the subject. The study was approved by the hospital and universitys ethics board. After a medical questionnaire with a research nurse, the participants underwent ultrasound evaluation of bilateral ulnae, radii, fibulae, and tibiae, to obtain still images of the physes from two orthogonal views. The evaluations were performed by 3 medical residents, 1 medical student, and by the supervising emergency physician. All ultrasonographers were EDE1 certified and specifically trained for growth plate imagery. The still images were evaluated ulteriorly and measurements taken of the physeal cartilage. Ten percent of the patients had their images re-evaluated by the supervising physician to determine inter-rater reliability. Results: A total of 227 patients were recruited. The median age was 8 years old with an interquartile range of (3;14). Mean growth plate size by age was determined, confirming decreasing growth plate size with advancing age for all articulations. The percentage of absolute difference between right and left, for all growth plates together, was a mean of 17% with a 95% CI of 16-19%. The overall inter-rater reliability was excellent at 0.84. Conclusion: This study establishes a reproducible technique of measuring growth plates with ultrasound. We suspect that increased asymmetry at the growth plate, beyond this established normal variation, may signify a physis widening or hematoma consistent with a Salter-Harris Type 1 fracture; this will be evaluated in a second study.
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Choi, Kyunghwa, Misun Kim, Koeun Lee, Okhyung Nam, Hyo-seol Lee, Sungchul Choi, and Kwangchul Kim. "Accuracy and Precision of Three-dimensional Imaging System of Children’s Facial Soft Tissue." JOURNAL OF THE KOREAN ACADEMY OF PEDTATRIC DENTISTRY 47, no. 1 (February 29, 2020): 17–24. http://dx.doi.org/10.5933/jkapd.2020.47.1.17.
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The purpose of this study was to evaluate the accuracy and precision of the three-dimensional (3D) imaging system of children’s facial soft tissue by comparing linear measurements. The subjects of the study were 15 children between the ages of 7 and 12. Twenty-three landmarks were pointed on the face of each subject and 16 linear measurements were directly obtained 2 times using an electronic caliper. Two sets of 3D facial images were made by the 3D scanner. The same 16 measurements were obtained on each 3D image. In the accuracy test, the total average difference was 0.9 mm. The precision of 3D photogrammetry was almost equivalent to that of direct measurement. Thus, 3D photogrammetry by the 3D scanner in children had sufficient accuracy and precision to be used in clinical setting. However, the 3D imaging system requires the subject’s compliance for exact images. If the clinicians provide specific instructions to children while obtaining 3D images, the 3D device is useful for investigating children’s facial growth and development. Also the device can be a valuable tool for evaluating the results of orthodontic and orthopedic treatments.
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Titova, O. N., N. N. Taran, T. V. Strokova, I. A. Matinyan, A. V. Keleynikoba, and E. V. Pavlovskaya. "Evaluation of the efficacy of using a mixture based on whey protein hydrolysate for nutritional supplementation of children with cerebral palsy." Russian Medical Inquiry 4, no. 5 (2020): 282–89. http://dx.doi.org/10.32364/2587-6821-2020-4-5-282-289.
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Aim: to evaluate the efficacy of using a semi-element mixture for nutritional supplementation of children with cerebral palsy (CP) and a body mass deficit with gastrointestinal symptoms. Patients and Methods: 27 children with CP aged from 2 to 18 years were examined. All children underwent the following tests: anthropometry (measurement of body weight and linear growth), measurement of the triceps and biceps skinfold thickness, shoulder circumference measurement, body composition estimation by Bioelectrical Impedance Analysis, calculation of basic energy demand indicators. A semi-elemental mixture based on whey protein hydrolysate with a high content of medium-chain triglycerides was used as nutritional supplementation. The diet therapy efficacy was evaluated after 6 months based on the analysis of the dynamics of anthropometric indicators and gastrointestinal symptoms. Results: all children had a body mass deficit, in the structure of which the severe body mass deficit was 48.2%. The study of body composition components revealed a deficit of lean body mass, active cell mass, absolute and relative amounts of body fat mass, total and intracellular fluid. Gastrointestinal symptoms were mainly represented by disorders of bowel habit in the form of constipation (70.4% of cases), changes in appetite (reduced/selective hunger; 63% of cases) and flatulence (51.8%). When re-examined after 6 months, 44.4% of children’s body weight indicators reached the age norm during nutritional supplementation with a semi-elemental mixture. Body mass deficit of various degrees persisted in 15 (55.6%) patients, while severe body mass deficit — only in 6 (22.2%). The range of weight gain was from 0.5 to 8.4 kg. An increase in the shoulder muscles circumference indicates an increase in the somatic protein pool, which is confirmed by the analysis of the body component composition. An increase in the estimated value of the basic energy demand was registered. Gastrointestinal symptoms were stopped in 44.4% of cases, while constipation persisted in 15 (55.6%) children. Conclusion: the high efficiency of nutritional supplementation with the semi-elemental mixture in children with CP, body mass deficit and gastrointestinal symptoms is confirmed by the positive dynamics of anthropometric indicators and a decrease in the frequency of gastrointestinal manifestations. KEYWORDS: cerebral palsy, body mass deficit, anthropometry, bioelectrical impedance analysis, gastrointestinal symptoms, nutritional supplementation, diet therapy, cow’s milk protein hydrolysate, semi-elemental mixture. FOR CITATION: Titova O.N., Taran N.N., Strokova T.V. et al. Evaluation of the efficacy of using a mixture based on whey protein hydrolysate for nutritional supplementation of children with cerebral palsy. Russian Medical Inquiry. 2020;4(5):282–289. DOI: 10.32364/2587-6821- 2020-4-5-282-289.
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Hussein, Almontaser, Hekma Farghaly, Eman Askar, Kotb Metwalley, Khaled Saad, Asmaa Zahran, and Hisham A. Othman. "Etiological factors of short stature in children and adolescents: experience at a tertiary care hospital in Egypt." Therapeutic Advances in Endocrinology and Metabolism 8, no. 5 (May 2017): 75–80. http://dx.doi.org/10.1177/2042018817707464.
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Background: Accurate anthropometric measurements and critical analysis of growth data allow the clinician to promptly recognize children with short stature. The aim of this study was to determine the frequency of etiological factors causing short stature among children referred to the pediatric endocrinology clinic of Assiut University Children’s Hospital, the main tertiary care center in Upper Egypt. Methods: We conducted this descriptive observational study from May 2012 to December 2015, to analyze 637 children (boys 354, girls 283) with short stature. Evaluation included: detailed medical history, physical examination, laboratory tests, bone age and chromosomal analysis. Results: Endocrinological causes accounted for 26% of short stature [of them, 11.8% had growth hormone deficiency (GHD)], 63.6% had normal variants of growth [of them, 42% had familial short stature (FSS), 15.8% had constitutional growth delay (CGD) and 5.5% a combination of both]. Interestingly, celiac disease (CD) constituted 6.6% of children with short stature in our cohort. Conclusions: Although potentially treatable causes such as GHD, hypothyroidism and CD accounted for a considerable percentage of short stature in our study, the majority of short stature in children had normal variations of growth. Growth hormone treatment in children, however, should be promptly initiated with specific clinical indications. CD is a not uncommon cause of short stature.
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Mitrovic, Katarina, Tatjana Milenkovic, Sladjana Todorovic, Rade Vukovic, Ivana Rakocevic, and Dragan Zdravkovic. "Etiology of growth hormone deficiency in children and adolescents." Srpski arhiv za celokupno lekarstvo 141, no. 1-2 (2013): 35–40. http://dx.doi.org/10.2298/sarh1302035m.
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Introduction. Growth hormone deficiency (GHD) can be isolated or associated with deficiency of other pituitary gland hormones. According to age at diagnosis, causes of GHD are divided into congenital or acquired, and according to etiology into recognized and unknown. Objective. We analyzed etiology and prevalence of GHD, demographic data at birth, age, body height (BH) and bone age at diagnosis as well as the frequency of other pituitary hormone deficiencies. Methods. The study involved 164 patients (109 male). The main criterion for the diagnosis of GHD was inadequate response of GH after two stimulation tests. The patients were classified into three groups: idiopathic, congenital and acquired GHD. Results. Idiopathic GHD was confirmed in 57.9% of patients, congenital in 11.6% and acquired in 30.5%. The mean age at diagnosis of GHD was 10.1?4.5 years. The patients with congenital GHD had most severe growth retardation (-3.4?1.4 SDS), while the patients with idiopathic GHD showed most prominent bone delay (-3.6?2.3 SDS). The prevalence of multiple pituitary hormone deficiency was 56.1%, in the group with congenital GHD 73.7%, acquired GHD 54.0% and idiopathic GHD 53.7%. The frequency of thyrotropin deficiency ranged from 88.2-100%, of adrenocorticotrophin 57.1-68.8% and of gonadotrophins deficiency 57.1- 63.0%, while deficiency of antidiuretic hormone was 2.0-25.0%. Conclusion. Although regular BH measurements enable early recognition of growth retardation, patients? mean age and degree of growth retardation indicate that GHD is still diagnosed relatively late. A high incidence of other pituitary hormone deficiencies requires a detailed investigation of the etiology of disorders and evaluation of all pituitary functions in each child with confirmed GHD.
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Nunes Jr, Walter Ribeiro, David Gozal, and Renata C. Di Francesco. "Cephalometric and Pharyngometric Evaluation in Snoring Children with Sleep-Disordered Breathing and Adenotonsillar Hypertrophy Under an Orthodontic or Orthopedic Treatment." Journal of Child Science 09, no. 01 (January 2019): e68-e74. http://dx.doi.org/10.1055/s-0039-1692987.
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AbstractAltered craniofacial growth has been implicated in sleep-disordered breathing (SDB) in children. The authors aimed to evaluate the cephalometric measurements and pharyngeal dimensions related to SDB in snoring children with adenotonsillar hypertrophy (ATH) treated with an orthodontic and orthopedic oral appliance (OOA). Forty habitually snoring children, 6 to 9 years old with evidence of grade 3 to 4 ATH, maxillary constriction, and class II dental malocclusion were enrolled, with 24 children being treated with OOA, and 16 remaining untreated children as controls. All children underwent a cephalometric X-ray and acoustic pharyngometry for airway measurements at the start and 6 months after. Cephalometric measurements related to SDB reduced in the treated group (p < 0.01) as follows: maxillary–mandibular relationship: –2.2 ± 1.70°; maxillary–mandibular planes angle: –2.4 ± 3.80°; and hyoid bone position: –4 ± 3.8 mm (p < 0.001). OOA treatment revealed improvements in pharyngeal minimum cross-section area (MCA) (0.2 ± 0.2 cm2) and volume (V) (3.15 ± 2.5 cm3), while reductions in MCA (–0.2 ± 0.3 cm2) and in V (–1.25 ± 1.3 cm3) occurred in controls (p < 0.001 vs. OOA). Six months of OOA treatment in snoring children with SDB promotes enlargement of the pharyngeal dimensions and beneficial cephalometric changes.
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Bapuraj, Jayapalli Rajiv, Amy K. Bruzek, Jamaal K. Tarpeh, Lindsey Pelissier, Hugh J. L. Garton, Richard C. E. Anderson, Bin Nan, Tianwen Ma, and Cormac O. Maher. "Morphometric changes at the craniocervical junction during childhood." Journal of Neurosurgery: Pediatrics 24, no. 3 (September 2019): 227–35. http://dx.doi.org/10.3171/2019.4.peds1968.
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OBJECTIVECurrent understanding of how the pediatric craniocervical junction develops remains incomplete. Measurements of anatomical relationships at the craniocervical junction can influence clinical and surgical decision-making. The purpose of this analysis was to quantitatively define clinically relevant craniocervical junction measurements in a population of children with CT scans that show normal anatomy.METHODSA total of 1458 eligible patients were identified from children between 1 and 18 years of age who underwent cervical spine CT scanning at a single institution. Patients were separated by both sex and age in years into 34 groups. Following this, patients within each group were randomly selected for inclusion until a target of 15 patients in each group had been reached. Each patient underwent measurement of the occipital condyle–C1 interval (CCI), pB–C2, atlantodental interval (ADI), basion-dens interval (BDI), basion-opisthion diameter (BOD), basion-axial interval (BAI), dens angulation, and canal diameter at C1. Mean values were calculated in each group. Each measurement was performed by two teams and compared for intraclass correlation coefficient (ICC).RESULTSThe data showed that CCI, ADI, BDI, and dens angulation decrease in magnitude throughout childhood, while pB–C2, PADI, BAI, and BOD increase throughout childhood, with an ICC of fair to good (range 0.413–0.912). Notably, CCI decreases continuously on coronal CT scans, whereas on parasagittal CT scans, CCI does not decrease until after age 9, when it shows a continuous decline similar to measurements on coronal CT scans.CONCLUSIONSThese morphometric analyses establish parameters for normal pediatric craniocervical spine growth for each year of life up to 18 years. The data should be considered when evaluating children for potential surgical intervention.
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Barros, Fernando C., Sharon R. A. Huttly, Cesar C. Victora, Betty R. Kirkwood, and J. Patrick Vaughan. "Comparison of the Causes and Consequences of Prematurity and Intrauterine Growth Retardation: A Longitudinal Study in Southern Brazil." Pediatrics 90, no. 2 (August 1, 1992): 238–44. http://dx.doi.org/10.1542/peds.90.2.238.
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A cohort of 5914 liveborns (99% of the city births) was followed up to the age of 4 years in Pelotas, southern Brazil. Besides the perinatal evaluation, the cohort children were examined again at mean ages of 11, 23, and 47 months. During each visit the children were weighed and measured and information on morbidity was collected. Also, multiple sources of information were used for monitoring mortality throughout the study. Of the babies with known gestational age, 9.0% were classified as intrauterine growth-retarded and 6.3% as preterm. Excluding those of unknown gestational age, 62% of low birth weight babies were intrauterine growth-retarded and 36% were preterm. Intrauterine growth retardation was statistically associated with maternal height, prepregnancy weight birth interval, and smoking, whereas preterm births were associated with maternal prepregnancy weight and maternal age. Preterm babies had a perinatal mortality rate 13 times higher than that of babies of appropriate birth weight and gestational age and 2 times higher than that of intrauterine growth-retarded babies. Infant mortality rates presented a similar pattern, with the differentials being more pronounced during the neonatal than in the postneonatal period. In the first 2 years of life intrauterine growth-retarded children were at almost twice the risk of being hospitalized for diarrhea compared with appropriate birth weight, term children, while preterm children experienced only a slightly greater risk. For pneumonia, however, both groups of children were hospitalized significantly more than appropriate birth weight, term children. In terms of growth, despite their earlier disadvantage, preterm children gradually caught up with their appropriate birth weight, term counterparts. This catch-up occurred primarily between mean ages 23 and 47 months. Intrauterine growth-retarded children, however, exhibited no such catch-up. Indeed, their average monthly growth rates between measurements were always lower than those of children in the other two groups.
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Lidia, Man, Pitea Ana Maria, Chinceșan Mihaela Ioana, Man A, Mărginean Oana, and Baghiu Maria Despina. "Evaluation of Anthropometric and Biochemical Status in Children with Nutritional Deficiency." Acta Medica Marisiensis 59, no. 6 (December 1, 2013): 293–97. http://dx.doi.org/10.2478/amma-2013-0067.
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Abstract Objective: To evaluate the anthropometric and biochemical status of children with nutritional deficiency. Methods: We have conducted a prospective study on 226 children admitted in Pediatric Clinic I, divided into two groups: one group of 49 children with nutritional deficiency (body-mass-index < -2SD) and one control group (177 children). We have followed demographic data, anthropometric indices evaluated as standard deviations (weight, height, middle upper-arm circumference, tricipital skinfold), biochemical proteic status (Insulin-like Growth Factor 1 IGF-1, albumin, total proteins). We also followed parameters of general nutritional biochemistry. Results: The mean age for underweight children was 5.8 years, lower than in the control group. The weight of the nutritional-deficient group was significantly lower than in the control group, unlike the height (p <0.001). We have also found significant differences in body-mass-index, middle upper-arm circumference and tricipital skinfold, all of them with low SDs in children with nutritional deficiency. Regarding the biochemical markers, we have found significantly higher values of transaminases (p <0.001) and lower IGF-1 (p = 0.02) and total proteins (p = 0.013) in nutritional-deficient group. Most IGF-1 values were in normal range in both groups, but with a higher percent of low values in nutritional deficient children (37.5% vs 14.2%, p = 0.0046). There were no significant differences in height, albumin, cholesterol, triglyceride and glucose levels between the two groups. Conclusions: The anthropometric measurements are the most precise methods in evaluating the nutritional status. Among the studied biochemical markers, IGF-1, total proteins and transaminases are correlated with nutritional deficiencies
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Kindler, K. E., G. P. Douglas, T. M. Mtonga, E. Katsalira, M. Lungu, J. B. Newton, M. Meyer, and T. C. Castillo. "Developing a portable field unit to improve well-child care." Public Health Action 12, no. 1 (March 21, 2022): 24–27. http://dx.doi.org/10.5588/pha.21.0062.
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BACKGROUND: Pediatric growth tracking has been identified as a top priority by international health agencies to assess the severity of malnutrition and stunting. However, remote low-resource settings often lack the necessary infrastructure for longitudinal analysis of growth for the purposes of early identification and immediate intervention of stunting.METHODS: To address this gap, we developed a portable field unit (PFU) capable of identifying a child over the course of multiple visits, each time adding new anthropomorphic measurements. We conducted a preliminary field evaluation of the PFU by using the unit on two distinct visits to three schools in the area surrounding a medical clinic in rural San Jose, Honduras. The unit was used to assess children at each school as part of the community outreach.RESULTS: Community outreaches to three schools were conducted by two distinct teams, where they used the device to assess 210 children. Of the 180 children registered during the first visit, 112 were re-identified and assessed on the subsequent visit. Twenty-four instances of moderate-to-severe malnutrition were identified and referred for further evaluation to the central clinic.CONCLUSION: This initial assessment suggests that the PFU could be an effective means of identifying at-risk children.
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Mendonça, Marcos Rogério de, Osmar Aparecido Cuoghi, and Ana Paula Veloso de Linhares. "Evaluation of the mesio-distal positioning of the maxillary first permanent molar in individuals with ectopic eruption." Research, Society and Development 10, no. 7 (June 24, 2021): e36310716188. http://dx.doi.org/10.33448/rsd-v10i7.16188.
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Objective: To evaluate the mesial-distal positioning of the maxillary first permanent molar in children who present with ectopic eruption of the maxillary first permanent molar (PFMEE). Methods: panoramic radiographs and lateral cephalometric radiographs 12 children of both genders were evaluated. The study group was composed of 12 children with PFMEE and the control group was composed of 12 children with normal occlusion with the first upper permanent molar in occlusion. After selecting the exams from both groups and performing the anatomical tracings, linear and angular measurements were performed. In the lateral cephalometric radiographs the following angles were evaluated: SNGo.GN, SN.GN, SNA, SNB, ANB, 6mx.Palatal Plane and the 6mx.PTV distance. In the panoramic radiograph the angles 6mx.Infraorbital Plane and 6mx.Occlusal Plane were evaluated. Results: PFMEE can occur in individuals regardless of their skeletal pattern. The control group showed much greater angular measurements 6mx.Palatal Plane and 6mx.Infraorbital Plane. Conclusion: There is no relationship between PFMEE and craniofacial growth pattern, there is no direct relationship with the anteroposterior relationship of the apical bases and in cases of PFMEE the mesial angulation is reduced, representing lack of space for eruption of the first permanent molars.
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Nagaeva, Elena V., Tatiana Y. Shiryaeva, Valentina A. Peterkova, Olga B. Bezlepkina, Anatoly N. Tiulpakov, N. A. Strebkova, Alexey V. Kiiaev, et al. "Russian national consensus. Diagnostics and treatment of hypopituitarism in children and adolescences." Problems of Endocrinology 64, no. 6 (April 1, 2019): 402–11. http://dx.doi.org/10.14341/probl10091.
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The materials of the National Consensus reflect the modern domestic and international experience on this issue.
Before conducting a specialized endocrinological examination of a short child, all other causes of short stature should be excluded: severe somatic diseases in a state of decompensation that can affect growth velocity, congenital systemic skeletal diseases, syndromic short stature (all girls with growth retardation require a mandatory study of karyotype, depending on the presence or absence of phenotypic signs of Turner syndrome), endocrine diseases in decompensation.
A specialized examination of the state of GH-IGF-I axis is carried out when the proportionally folded child has pronounced short stature: if the child’s height is < –2.0 SDS, if the difference between the child’s height SDS and child’s midparental height SDS exceeds 1.5 SDS and/or a low growth velocity.
The consensus reflects clear criteria for the diagnosis of GH-deficiency, central hypothyroidism, central hypocorticosolism, central hypogonadism, diabetes insipidus, hypoprolactinemia, and also the criteria for their compensation.
The dose of somatropin with GH-deficiency in children and adolescents is 0.025–0.033 mg/kg/day. With total somatotropic insufficiency, especially in young children, it is advisable to start therapy with somatropin from lower doses: 25–50% of the substitution, gradually increasing it within 3–6 months to optimal. In children with a growth deficit when entering puberty, the dose may be increased to 0.045–0.05 mg/kg/day.
With the development of side effects, the dose of somatropin can be reduced (by 30–50%), or temporarily canceled (depending on the severity of the clinical picture) until the complete disappearance of undesirable symptoms. With swelling of the optic nerve, treatment is temporarily stopped until the picture of the fundus of the eye fully normalizes. If therapy has been temporarily discontinued, treatment is resumed in smaller doses (50% of the initial) with a gradual (within 1–3 months) return to the optimum.
GH treatment at pediatric doses not continue beyond attainment of a growth velocity below 2–2.5 cm/year, closure of the epiphyseal growth zones, or earlier, when: the achievement of genetically predicted height, but not more than 170 cm in girls, 180 cm in boys, the patient’s desire and his parents / legal representatives satisfied with the achieved result of the final height.
Re-evaluation of the somatotropic axis is carried out after reaching the adult height, after 1–3 months GH therapy will be discontinued. Patients with isolated GH-deficiency or patients with 1 (besides GH) pituitary hormone deficiencies in the presence of a normal IGF-1 level (against the background of somatropin withdrawal) and not having molecular genetic confirmation of the diagnosis need re- evaluation. Patients with two or more (besides GH) pituitary hormone deficiencies, acquired hypothalamic-pituitary lesions due to operations on the pituitary and irradiation of the hypothalamic-pituitary area (if the IGF-1 level is low against somatropin withdrawal), specific pituitary/ hypothalamic structural defect on MRI, gene defects of the GH-IGF-I system do not need re- evaluation.
If GH deficiency is confirmed, treatment with somatropin is resumed at metabolic doses of 0.01—0.003 mg/kg/day under the control of the IGF-I level in the blood (measurement 1 time in 6 months), the indicator should not exceed the upper limit of the reference value for the corresponding age and floor.
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Setiyorini, Erni, and Yeni Kartika Sari. "Cadres Empowerment in the Application, Socialization Early Detection of Development Children and Anticipatory Guidance in Wonodadi District." Jurnal Ners dan Kebidanan (Journal of Ners and Midwifery) 2, no. 3 (August 1, 2015): 270–75. http://dx.doi.org/10.26699/jnk.v2i3.art.p270-275.
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In Indonesia, the number of infants reach 10% of the population, in which the prevalence ofdevelopment disorder 12,8%–16% and we need to screening development of children. The mortality ofchildrens high due to accident, poisoning and trauma recorded 7,3% and one of top five lead childdeaths in 1992. Based on interviews with some kader posyandu, we know that the kader had neverreceived training related to early detection growth and development and anticipatory guidance inchildren. The purpose of this science and technology activity for society was to empower kader in theapplication, the socialization of children’s early detection growing and development Method for thisactivity was to team up with 2 partners i.e. Midwife of Kebonagung Village with number of kader of 25people and the midwife of Wonodadi village with number of cadres of as many as 30 people. The methodof this activity was to provide a pre test training before, children’s early detection growth and developmentwith method of lecture, discussion, simulation and applications of valuation DDTK in kindergarten,mentoring and evaluation of training activities and the activities of the posyandu. The results of theevaluation of the training process showed improved knowledge on average level of good on both ofkader and partner, most cadres is skilled, whereas the evaluation of the activities of mentoring atposyandu activities, most of posyandu already documenting the measurement of height, weight, nutritionalstatus, while for childrens’s early detection growing and development with developmental screeningassessment card but not complete. In order for the assessment, documentation, socialization ofchildrens’s early detection growing and development activities and anticipatory guidance fluently,then the expected partner, the Councilor and head of the Clinic Wonodadi made a commitment in themonitoring activities.
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Dundar, Ismail, Nurdan Ciftci, Aysehan Akinci, Emine Camtosun, Leman Kayas, Ahmet Sigirci, and Fatma Yagin. "Evaluation of endocrine functions before and after enzyme replacement therapy in children with mucopolysaccharidosis." Medicine Science | International Medical Journal 11, no. 3 (2022): 1184. http://dx.doi.org/10.5455/medscience.2022.03.053.
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There is a scarcity of data concerning endocrine function and the effects of enzyme replacement therapy (ERT) on growth and other endocrine functions in patients with mucopolysaccharidosis (MPS). This study retrospectively evaluated height increase, bone mineral density (BMD), and other endocrine functions in MPS patients who received ERT for at least two years in our clinic. The clinical findings, hormonal analysis (TSH, fT4, ACTH, cortisol, FSH, LH, testosterone, estradiol, prolactin, GH, IGF-1, IGFBP-3), and BMD measurements of 10 MPS patients, aged 0-18 years, before and after ERT were recorded and compared retrospectively. Four patients were MPS Type-2, five were MPS Type-4, and one was MPS Type-6. Nine of the patients were male, and one was female. The mean treatment onset age was 7.6 years. The mean ± standard deviation of the patients' height SDS was -4.61±3.01 before treatment and -5.65±2.42 after treatment. While the mean BMD Z-score of the patients was -2.33±1.77 before treatment, it was -0.94±1.52 after treatment. Apart from growth retardation (one of the most prominent disease features), no severe dysfunction was detected in other endocrine organs in our patients with MPS. Severe short stature was evident at the time of diagnosis in MPS patients, and their height SDS worsened, despite ERT. However, osteoporotic BMD Z-scores at diagnosis improved after ERT. No serious dysfunction was seen in other endocrine organs.
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Siemensma, Mark F., Christiaan van Bergen, Eline van Es, Joost W. Colaris, and Denise Eygendaal. "Indications and Timing of Guided Growth Techniques for Pediatric Upper Extremity Deformities: A Literature Review." Children 10, no. 2 (January 20, 2023): 195. http://dx.doi.org/10.3390/children10020195.
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Osseous deformities in children arise due to progressive angular growth or complete physeal arrest. Clinical and radiological alignment measurements help to provide an impression of the deformity, which can be corrected using guided growth techniques. However, little is known about timing and techniques for the upper extremity. Treatment options for deformity correction include monitoring of the deformity, (hemi-)epiphysiodesis, physeal bar resection, and correction osteotomy. Treatment is dependent on the extent and location of the deformity, physeal involvement, presence of a physeal bar, patient age, and predicted length inequality at skeletal maturity. An accurate estimation of the projected limb or bone length inequality is crucial for optimal timing of the intervention. The Paley multiplier method remains the most accurate and simple method for calculating limb growth. While the multiplier method is accurate for calculating growth prior to the growth spurt, measuring peak height velocity (PHV) is superior to chronological age after the onset of the growth spurt. PHV is closely related to skeletal age in children. The Sauvegrain method of skeletal age assessment using elbow radiographs is possibly a simpler and more reliable method than the method by Greulich and Pyle using hand radiographs. PHV-derived multipliers need to be developed for the Sauvegrain method for a more accurate calculation of limb growth during the growth spurt. This paper provides a review of the current literature on the clinical and radiological evaluation of normal upper extremity alignment and aims to provide state-of-the-art directions on deformity evaluation, treatment options, and optimal timing of these options during growth.
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Hasegawa, Yukihiro, Tomonobu Hasegawa, and Yutaka Tsuchiya. "Clinical Utility of Total Insulin-like Growth Factor-I and Insulin-like Growth Factor Binding Protein-3 Measurements in the Evaluation of Short Children." Clinical Pediatric Endocrinology 4, no. 2 (1995): 103–13. http://dx.doi.org/10.1297/cpe.4.103.
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Ekim, Mesiha, Aydan Ikinciogullari, Betul Ulukol, Sevcan A. Bakkaloglu, Nuray Ozkaya, Tanil Kendirli, Pelin Adiyaman, Emel Babacan, and Gonul Ocal. "Evaluation of Nutritional Status and Factors Related to Malnutrition in Children on CAPD." Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis 23, no. 6 (November 2003): 557–62. http://dx.doi.org/10.1177/089686080302300607.
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Objective The aim of this study was to investigate the nutritional status of children on continuous ambulatory peritoneal dialysis (CAPD) and to relate it to the dose of dialysis and serum levels of inflammatory cytokines and insulin-like growth factor-1 (IGF-1). Patients 17 CAPD patients (8 girls, 9 boys; mean age 13.1 ± 3.5 years, median 15 years) were included in the study. Anthropometric measurements and serum albumin levels were used in the evaluation of nutritional status. Serum interleukin (IL)-1β, IL-6, tumor necrosis factor α, and IGF-1 levels were determined in all CAPD patients and in a healthy control group. Weekly Kt/V and creatinine clearance (CCr) were measured to determine adequacy of dialysis. Results The mean dialysis period was 23.7 ± 15.2 months (median 23 months). Anthropometric measurements and serum albumin level were as follows: height 130.2 ± 15.6 cm, height standard deviation score (HtSDS) -4.2 ± 2.4, body mass index (BMI) 16.3 ± 1.6 kg/m2, body mass index standard deviation score (BMISDS) -0.8 ± 0.9, triceps skinfold thickness (TST) 4.2 ± 1.4 mm, midarm circumference (MAC) 16.21 ± 2.3 cm, upper arm muscle area (AMA) 1799.1 ± 535.7 mm2, upper arm fat area (AFA) 334.5 ± 143 mm2, and serum albumin 3.1 ± 0.7 g/dL. The BMI was above the fifth percentile in all patients; TST and MAC were below the fifth percentile in 14 patients (82.4%) and 10 patients (58.8%) respectively. The AMA was below the fifth percentile in 8 patients; however, the AFA was below the fifth percentile in all patients. Mean serum albumin level was under 3.5 g/dL in 70.5% of the children. We found significant positive correlations between BMI and Kt/V ( r = 0.69, p < 0.01), CCr ( r = 0.64, p < 0.05), and IL-6 ( r = 0.61, p < 0.01). There was an inverse correlation between BMISDS and dialysis period ( r = -0.58, p < 0.05); and between IL-6 and serum albumin ( r = -0.49, p < 0.05). A significant positive correlation between BMISDS and serum IGF-1 level ( r = 0.62, p < 0.01) was noted. We also found a significant positive correlation between serum IGF-1 level and both HtSDS ( r = 0.57, p < 0.05) and TST ( r = 0.52, p < 0.05). Significant positive correlations between AFA and CCr and IGF-1 were also noted (both r = 0.56, p < 0.05). Conclusion Although many factors may be responsible for malnutrition and growth retardation, we found that prolonged period of dialysis, inadequate dialysis, and low IGF-1 levels are the most important risk factors in CAPD patients.
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Daskalogiannakis, John, and R. Bruce Ross. "Effect of Alveolar Bone Grafting in the Mixed Dentition on Maxillary Growth in Complete Unilateral Cleft Lip and Palate Patients." Cleft Palate-Craniofacial Journal 34, no. 5 (September 1997): 455–58. http://dx.doi.org/10.1597/1545-1569_1997_034_0455_eoabgi_2.3.co_2.
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Objective: This study was conducted to evaluate the effects on facial growth of alveolar bone grafting in the mixed dentition for patients with UCLP. Design: Retrospective cephalometric study. Setting: Craniofacial Treatment and Research Centre, The Hospital for Sick Children, Toronto, Ontario, Canada. Patients: The 58 patients participating in the study had a history of complete unilateral cleft lip and palate, all of which were repaired by the same plastic surgeon. Interventions: Twenty-one patients received an iliac-crest alveolar bone graft at a mean age of 10.3 years, while 37 did not receive an alveolar bone graft. Lateral cephalometric radiographs were obtained on all patients at two different times: at a mean age of 9.4 years (prior to bone grafting in the grafted group) and at a mean age of 15.2 years. Main Outcome Measures: All radiographs were traced and digitized by the same person, using cephalometric computer software. Superimposition and cephalometric analysis was undertaken to investigate the differences between the two groups in the 5.6-year experimental period. A two-way analysis of covariance was used for evaluation of the statistical significance of the results. Results: No statistically significant differences were found in 14 of the 15 cephalometric measurements performed. Harvold's maxillary unit length was statistically significantly shorter in the grafted group, although a lack of correlation with angular measurements and inherent problems with this specific measurement raise doubts in this finding. Conclusion: Mixed dentition bone grafting does not affect subsequent vertical and A-P development of the maxilla in complete unilateral cleft lip and palate patients during the first several postoperative years.
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Goyal, Suresh, Kavita Tiwari, Pradeep Meena, Sunny Malviya, and Mohd Asif. "Cobalamin and folate status in malnourished children." International Journal of Contemporary Pediatrics 4, no. 4 (June 21, 2017): 1480. http://dx.doi.org/10.18203/2349-3291.ijcp20172690.
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Background: Vitamin B12 and folate are essential micronutrients which are critical especially during infancy and early childhood as these are periods of rapid growth, development, and increased demand. Malnutrition further increases the risk of these micronutrient deficiency due to poor socioeconomic status, inadequate intake and poor absorption. Aim of present work was to study the cobalamin and folate status in malnourished children.Methods: A hospital based observational study on 80 children suffering from severe acute malnutrition (SAM) aged 6-60 months. Detailed socio-economic, feeding and development history with complete anthropometric evaluation was done. Blood samples sent for measurement of plasma vitamin B12 and serum folate levels. Statistical analysis was done using SPSS version 20.0.Results: Mean age of SAM children was 17.25±12.60 months. 30 (37.5%) had vitamin B12 deficiency (vitamin B12 levels<100pg/ml) and 9 (11.25%) had borderline vitamin B12 levels (100-200pg/ml). Folate deficiency was found in only 7 (8.75%) children. Mean vitamin B12 and folate levels were found to be 353.65±330.76pg/ml, 11.18±4.17ng/ml respectively. Among vitamin B12 deficient children, majority (26, 86.66%) belong to lower socio-economic status, 17 (56.66%) were still predominantly on breast feeding and 11 (36.66%) had delayed introduction of complementary feeding. Among B12 deficient children 23 (76.66%) had delayed development (DQ <70). 100% of B12 deficient children were anemic with majority (21,70%) having severe anemia. 17 (56.66%) B12 deficient children also had associated thrombocytopenia (PC <1.5 lakh/cumm).Conclusions: There was a high prevalence of vitamin B12 deficiency among malnourished children. Folate deficiency was found only in few. Efforts should be directed to prevent its deficiency in pregnant and breastfeeding women and their infants with special attention on malnourished children.
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Pradeep, Celia, Marcel Abouassaly, Zarina Assis, Melanie Finkbeiner, and Lucie Lafay-Cousin. "NFB-12. Effect of trametinib on leg length discrepancy in a child with NF1 related plexiform neurofibroma." Neuro-Oncology 24, Supplement_1 (June 1, 2022): i130. http://dx.doi.org/10.1093/neuonc/noac079.474.
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Abstract INTRODUCTION: Plexiform neurofibroma(PN) is a challenging benign tumor. Recently, MEK inhibitors (MEKi) showed encouraging tumor response. We report the observed effect of Trametinib on leg length discrepancy (LLD) in a child with NF1. CASE DESCRIPTION: A 4 year old girl with sporadic NF1, developed progressive bilateral L1-L5 paraspinal PN extending to the left thigh resulting in hypertrophy of left leg and associated with LLD. At 33 months of age, length difference of 2.8 cm between both femurs was described on scanogram with a projected LLD of at 6.1- 6.2 cm LLD at bone maturity using the multiplier method, a common method of predicting LLD. At 36 months of age, treatment with Trametinib was initiated for her large PN. Ten months into therapy, parents reported impression of decrease swelling of her left thigh enlargement. MRI evaluation showed stable measurement of PN using the RECIST criteria. Repeat measurement on scanogram at 46 months of age disclosed a stable difference of 2.8 cm between both femurs, with a LLD projected at 5.2-5.3 cm at maturity by multiplier method. Bone age at study entry and at 11 months into therapy (Greulich-Pyle) was reported normal for chronologic age. DISCUSSION/CONCLUSION: LLD has not been commonly described in association with NF1 related PN. Given the PN involved mainly the left thigh in our patient, it is reasonable to suggest common underlying mechanism for the PN and faster growth of her left femur. Although with limited time point’s measurements, the early observation of stabilization of the LLD, 10 months into Trametinib therapy suggesting a final discrepancy in femurs length less than initially predicted, is encouraging. Further evaluation at completion of treatment and on follow-up are needed. Larger case series will be useful to explore this unexpected and possible clinical effect of MEKi in NF1 children.
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Boguszewski, Cesar L., Lars Hynsjö, Gudmundur Johannsson, Bengt-Åke Bengtsson, and Lena MS Carlsson. "22-kD Growth hormone exclusion assay: a new approach to measurement of non-22-kD growth hormone isoforms in human blood." European Journal of Endocrinology 135, no. 5 (November 1996): 573–82. http://dx.doi.org/10.1530/eje.0.1350573.
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Boguszewski CL, Hynsjö L, Johansson G, Bengtsson B-Å, Carlsson LMS. 22-kD Growth hormone exclusion assay: a new approach to measurement of non-22-kD growth hormone isoforms in human blood. Eur J Endocrinol 1996;135:573–82. ISSN 0804–4643 Human growth hormone (GH) exists in a variety of isoforms. In the pituitary, the most abundant isoform is 22-kD GH (22 K GH), while other isoforms (non-22 K GH) are present in variable amounts. In human plasma, the GH heterogeneity contributes to the wide variability in GH levels measured by different immunoassays. The physiological role of the non-22 K GH isoforms is poorly understood, but they may represent a spectrum of agonists or antagonists of the GH receptor. It is possible that increased amounts of non-22 K GH isoforms in the circulation contribute to the growth failure observed in some short children and may be involved in the pathophysiology of acromegaly and other unrelated diseases. Currently, there is no method available to evaluate the ratio of non-22 K GH isoforms to total GH in large sets of serum samples. In this report, a novel assay procedure is described in which monomeric and dimeric isoforms of 22 K GH are removed from serum and non-22 K GH isoforms are quantitated. The 22 K GH exclusion assay (22 K GHEA) was established as a screening method to identify conditions in which the ratio of non-22 K GH isoforms to total GH in human blood is altered. A 22 K GH-speciflc monoclonal antibody (MCB) is used for binding to 22 K GH in serum. Magnetic beads coated with rat anti-mouse immunoglobulin G and a magnetic device are used to remove the 22 K GH-MCB complexes from serum. The non-22 K GH isoforms are measured by a polyclonal antibody-based immunoradiometric assay (GH-IRMA). The assay procedure was optimized systematically by statistical experimental designs. In serum spiked with monomeric or dimeric 22 K GH, the 22 K GH extraction was efficient at GH levels up to 100 μg/l (range 96.3–100%). The intra- and interassay precision for non-22 K GH levels of 3.9 μg/l were 2.6% and 8.7%, respectively, while for levels of 0.6 μg/l, which were very close to the detection limits of the assay, the coefficients were 17.0% and 21.6%, respectively. The percentage of non-22 K GH isoforms determined in serum samples from three different groups of subjects showed clearly distinctive values. The 22 K GHEA is a new method for evaluation of non-22 K GH isoforms in human blood under different physiological and pathophysiological conditions. Cesar L Boguszewski, RCEM, Sahlgrenska University Hospital, Bruna Stråket, 16 S-413 45 Göteborg, Sweden
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Panda, Mayadhar, Sikata Nanda, Mangala Charan Murmu, Rama Chandra Giri, and Lila Lalantika Debi. "Evaluation of the performance of a nutrition rehabilitation centre in a tertiary care hospital in Eastern India." International Journal Of Community Medicine And Public Health 6, no. 4 (March 27, 2019): 1728. http://dx.doi.org/10.18203/2394-6040.ijcmph20191428.
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Background: Severe acute malnutrition (SAM) places extraordinary challenges in the way of survival, growth and development of the child under five years of age. Our aim was to evaluate the functioning and performance of facility based management of SAM children admitted in the nutrition rehabilitation centre (NRC) and to identify the existing bottlenecks in the NRC.Methods: Children above 1 month and less than 5 years of age with severe acute malnutrition were included during the study period. Demographic details of the SAM children, clinical features during admission were recorded. Anthropometric measurements like MUAC, weight, height/length and WHZ scores were taken at admission and compared with the findings at discharge. Statistical analysis: the data after collection, compilation was analysed by SPSS.Results: Majority 277 (78.47%) of them belonged to rural areas. 300 (85%) SAM children were referred by medical officers. Bilateral oedema was recorded in 12 (17.9%) admitted children during 2014-2015, 22 (17.9%) children in 2015-2016 and in 37 (22.7%) children during 2016-2017. There was significant improvement in the mean weight (kg) and mean MUAC (cm) at discharge was in comparison to the weight and MUAC of the children at admission and this difference in increase in the mean weight and MUAC were found to be statistically significant.Conclusions: Implementation of WHO feeding guidelines resulted in adequate weight gain of inpatient malnourished children, however the frontline workers in the community and health care providers of PHCs should be trained and given hands on training for early identification and referral of SAM cases.
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Galadanci, Najibah Aliyu, Maira Sohail, Oluwasegun Philip Akinyelure, Akinyemi I. Ojesina, and Julie Kanter. "Effect of Sickle Cell Related Therapies on Growth in Children with Sickle Cell Disease: Evidence from the Displace Study." Blood 136, Supplement 1 (November 5, 2020): 21. http://dx.doi.org/10.1182/blood-2020-140582.
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Introduction Reduced growth and delayed maturation have been previously described in children with sickle cell disease (SCD) due to multifactorial causes including chronic anemia and increased hemolysis. Interventions that decrease anemia and inflammation may have a beneficial effect on growth in children with SCD. Previous studies have demonstrated that children with SCD treated with hydroxyurea (HU) and chronic red cell transfusion therapy (CRCT) experience linear growth and increase in body mass index (BMI) compared to their counterparts not on therapy. Unfortunately, most of these studies were limited due to small sample size, cross-sectional study design or were conducted from single or a few center(s). DISPLACE (Dissemination and Implementation of Stroke Prevention Looking at the Care Environment) is a large, NHLBI (National Heart, Lung, and Blood Institute) funded consortium to improve stroke prevention implementation in SCD. DISPLACE includes the largest database of children with SCD from 28 different centers in the US. These data allow for an optimal assessment of growth in children with SCD on different disease modifying therapies. Using the DISPLACE database, we conducted a cross-sectional sub-study to evaluate how HU and CRCT affect growth in children over time. Methods The DISPLACE study collected data on 5,247 children aged 2-19 years with SCD from 28 centers in the US between 2012-2016. The majority of children have data collected from at least five years of continuous care. At baseline and annually thereafter, all children had routine standard of care anthropometric measurements including height and weight, vital signs, laboratory tests including complete blood count and chemistries and SCD-related therapies including chronic blood transfusion therapy and hydroxyurea therapy. Body mass index was converted to z-scores (zBMI) based on the Centers for Disease Control guide for age and sex. Children were categorized based on the zBMI score as underweight, normal, and overweight/obese. Our inclusion criteria included children with documented results of weight, height, vital signs, clinical and laboratory tests at baseline. Children who do not have sufficient data for evaluation (at least one missing anthropometric measurement or laboratory value) were excluded. Results Of the 3,305 children included in the study, 19.8%, 66.1%, 14.2% were underweight, normal, and overweight/obese at their initial (baseline) visit respectively. Children who were overweight/obese had a significantly higher hemoglobin level (p<0.0001) and significantly lower reticulocyte count (p = 0.0334) at baseline than normal and underweight children. Children who are overweight/obese had a significantly higher systolic and diastolic blood pressure compared to those who are normal or underweight (p = 0.0079 and p = 0.0003 respectively). A higher proportion of children who were overweight/obese were on CRCT at baseline compared to children with normal or underweight zBMI (p = 0.0002). The proportion of children on HU therapy at baseline was similar across zBMI categories (p = 0.2412). The multivariable adjusted model showed that the baseline hemoglobin levels were associated with the odds of being underweight (OR 0.93, 95% CI: 0.86 - 0.99), or overweight/obese (OR: 1.26, 95% CI: 1.17 - 1.36) compared with normal zBMI. At baseline, blood transfusion was associated with being overweight/obese versus normal (OR: 1.85, 95% CI: 1.31 - 2.60). After two years of therapy, there was a statistically significant increase in median zBMI from baseline among children initiating blood transfusion versus controls, (p = 0.0481), but the zBMI difference in hydroxyurea therapy versus controls remain same. (p=0.3925). Conclusion In our US-based study, the majority of children with SCD (70%) had normal zBMI. As baseline hemoglobin is associated with zBMI, that may predict who is at risk for being underweight or overweight. In addition, patients treated with CRCT are more likely to be overweight and have higher blood pressure. These findings suggest that individuals on CRCT should be monitored and may need lower calories than those not on disease modifying therapies. Disclosures Kanter: bluebird bio, inc: Consultancy, Honoraria; Novartis: Consultancy; Sanofi: Consultancy; Medscape: Honoraria; Guidepoint Global: Honoraria; GLG: Honoraria; Jeffries: Honoraria; Cowen: Honoraria; Wells Fargo: Honoraria; NHLBI Sickle Cell Advisory Board: Membership on an entity's Board of Directors or advisory committees; SCDAA Medical and Research Advisory Board: Membership on an entity's Board of Directors or advisory committees; AGIOS: Membership on an entity's Board of Directors or advisory committees; BEAM: Membership on an entity's Board of Directors or advisory committees.
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Brady, Keri J. S., Gabrielle G. Grant, Frederick J. Stoddard, Walter J. Meyer, Kathleen S. Romanowski, Philip H. Chang, Lynda E. Painting, et al. "Measuring the Impact of Burn Injury on the Parent-Reported Health Outcomes of Children 1 to 5 Years: A Conceptual Framework for Development of the Preschool Life Impact Burn Recovery Evaluation Profile CAT." Journal of Burn Care & Research 41, no. 1 (June 21, 2019): 84–94. http://dx.doi.org/10.1093/jbcr/irz110.
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AbstractDue to the rapid developmental growth in preschool-aged children, more precise measurement of the effects of burns on child health outcomes is needed. Expanding upon the Shriners Hospitals for Children/American Burn Association Burn Outcome Questionnaire 0 to 5 (BOQ0–5), we developed a conceptual framework describing domains important in assessing recovery from burn injury among preschool-aged children (1–5 years). We developed a working conceptual framework based on the BOQ0–5, the National Research Council and Institute of Medicine’s Model of Child Health, and the World Health Organization’s International Classification of Functioning, Disability, and Health for Children and Youth. We iteratively refined our framework based on a literature review, focus groups, interviews, and expert consensus meetings. Data were qualitatively analyzed using methods informed by grounded theory. We reviewed 95 pediatric assessments, conducted two clinician focus groups and six parent interviews, and consulted with 23 clinician experts. Three child health outcome domains emerged from our analysis: symptoms, functioning, and family. The symptoms domain describes parents’ perceptions of their child’s pain, skin-related discomfort, and fatigue. The functioning domain describes children’s physical functioning (gross and fine motor function), psychological functioning (internalizing, externalizing, and dysregulation behavior; trauma; toileting; resilience), communication and language development (receiving and producing meaning), and social functioning (connecting with family/peers, friendships, and play). The family domain describes family psychological and routine functioning outcomes.
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Muslimova, Elena, Josep Maria De Bergua, Ravi Savarirayan, Paul Arundel, Helen McDevitt, Valerie Cormier-Daire, Vrinda Saraff, et al. "PSAT106 Infigratinib in Children with Achondroplasia: Design of the PROPEL, PROPEL2 and PROPEL OLE Studies." Journal of the Endocrine Society 6, Supplement_1 (November 1, 2022): A633. http://dx.doi.org/10.1210/jendso/bvac150.1311.
Full textAbstract:
Abstract Background Achondroplasia (ACH), the most common non-lethal form of skeletal dysplasia, is characterized by defective endochondral ossification resulting from gain-of-function mutations in the fibroblast growth factor receptor 3 (FGFR3) gene, a negative regulator of endochondral bone formation. Infigratinib, a selective, orally bioavailable FGFR1–3 tyrosine kinase inhibitor, has been shown to reverse established growth arrest in chondrocytes and improve foramen magnum and long bone length in Fgfr3Y367C/+ mice. Infigratinib is being investigated for the treatment of ACH in the PROPEL program of three clinical trials: 1) PROPEL, designed to collect information on the natural history of ACH; 2) PROPEL2, designed to obtain preliminary evidence of efficacy and safety and to identify the dose of infigratinib to investigate further; 3) PROPEL OLE, which is designed to evaluate the long-term efficacy and safety of infigratinib in children with ACH. Methods PROPEL (NCT04035811) is a non-interventional clinical assessment study designed to characterize the natural history of up to 200 children aged 2.5–10 years with ACH over a 6−24-month period. The primary objective is to collect baseline height velocity measurements in children who may participate in an interventional study with infigratinib. The primary endpoint is the annualized growth velocity (AGV). Further objectives are to collect other baseline growth measurements, evaluate exploratory biomarker indicators of growth, and assess ACH-related medical events reported as medical history, or non-treatment adverse events (AEs). PROPEL2 (NCT04265651) is a phase 2, open-label study of infigratinib in children aged 3−11 years with ACH who completed ≥6 months observation in PROPEL. PROPEL2 includes dose-escalation with an extended dose-finding treatment phase (n≈40), a pharmacokinetics sub-study (n≈18), followed by a dose-expansion phase (n≈20) in which children receive infigratinib for 12 months to confirm the selected dose and provide evidence of efficacy. Primary endpoints are treatment-emergent AEs, change from baseline in AGV, and infigratinib pharmacokinetics. Secondary endpoints include safety/tolerability of infigratinib and changes from baseline in anthropometric parameters, including body proportions. Exploratory outcomes include changes in QoL and other parameters of disease burden. PROPEL OLE (NCT05145010) is a phase 2, open-label extension study in up to 230 children who completed an interventional study with infigratinib and, potentially, in ≤50 who are infigratinib-naive. The primary objectives are to evaluate safety, tolerability, and efficacy of long-term daily doses of infigratinib. Secondary objectives include evaluation of changes in other indicators of growth and development, and evaluation of QoL and disease burden. Children will receive infigratinib until they reach final/near final height. Summary PROPEL, PROPEL2, and PROPEL OLE are currently ongoing. Together, these studies are intended to provide key evidence on the safety and efficacy of oral infigratinib in children with ACH and will inform the design of future studies in this setting. Presentation: Saturday, June 11, 2022 1:00 p.m. - 3:00 p.m.