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Diet intervention on obese children with hypertension in China
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Yan-Ping Wan, Ren-Ying Xu, Ying-Jie Wu, Zhi-Qi Chen, Wei Cai |
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Author Affiliations: Department of Clinical Nutrition, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China (Wan YP, Xu RY, Wu YJ, Chen ZQ); Clinical Nutrition Center, Xin Hua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China (Cai W)
Corresponding Author: Yan-Ping Wan, Department of Clinical Nutrition, 145 Shan Dong Middle Road, Shanghai 200001, China (Tel: +86-21-53882227; Fax: +86-21-68383318; Email: wanyp204@yahoo.com.cn)
doi:10.1007/s12519-009-0051-0
Background: Obesity has made obesity-related diseases a worldwide problem. This study was undertaken to evaluate the effects of diet-oriented intervention on obese children with hypertension in China and to determine the relationship between anthropometric indexes and hypertension.
Methods: A total of 469 obese children, aged 6 to 18 years, were evaluated between January 2001 and December 2005; 184 of them were diagnosed with hypertension. Hypertensive children were provided with individual diet-oriented intervention for more than 6 months. Physical exercises were recommended for obese children at least 30 minutes per day. Height, body weight, waist circumference, systolic blood pressure, and diastolic blood pressure were taken for each subject before and after intervention.
Results: Of the 184 children enrolled, 139 (75.5%; 86 boys) completed the study. Weight, body mass index (BMI), waist circumference, and hip circumference all decreased after a 6-month intervention, despite a 2.1 cm increase in height. Systolic and diastolic pressures decreased by 16.6 and 13.3 mmHg compared with baseline levels. Of the 139 children, 103 (74.1%) who had blood pressure in the normal range (<90th percentile for age and sex) were taken as a response group. The other 36 children who remained hypertensive showed no obvious differences in anthropometric measurements and were taken as a non-response group. Weight, BMI, BMI%, waist circumference, hip circumference and blood pressure in the 139 children showed significant differences after the intervention compared with baseline values. Weight, BMI, BMI%, waist circumference, and hip circumference were positively correlated with both systolic and diastolic blood pressures; they were correlated more strongly with systolic pressure than with diastolic pressure.
Conclusions: Diet-oriented intervention can decrease blood pressure in most obese children with hypertension. Weight, height, BMI, BMI%, waist circumference, and hip circumference are closely associated with blood pressure.
Key words: body mass index; children; diet intervention; hypertension; obesity
World J Pediatr 2009;5(4):269-274 |
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[Abstract] [Full Text] [PDF]
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Co-assessment of iron, vitamin A and growth status to investigate anemia in preschool children in suburb Chongqing, China
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Ke Chen, Xuan Zhang, Ting-Yu Li, Li Chen, Ping Qu, You-Xue Liu |
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Author Affiliations: Child Health Care, Children's Hospital, Chongqing Medical University, Chongqing, China (Chen K, Zhang X, Li TY, Chen L, Qu P, Liu YX); Chengdu Maternal and Child Health Care Hospital, Chengdu, China (Chen K)
Corresponding Author: Ting-Yu Li, Child Health Care, Children's Hospital, Chongqing Medical University, 136 Second Zhongshan Road, Chongqing 400014, China (Tel: +86 23 6362 3604; Fax: +86 23 6362 4479; Email: tyli@vip.sina.com)
doi:10.1007/s12519-009-0052-z
Background: Anemia is a widespread public health problem, which is due to many factors, nutritional or non-nutritional. Iron, vitamin A and growth status were assessed to investigate anemia of preschool children in suburb Chongqing, China.
Methods: A descriptive, cross-sectional survey was performed on 459 preschool children aged 2 to 7 years randomly chosen from the kindergartens in 6 suburban districts of Chongqing. Weight and height levels, hemoglobin, erythrocyte protoporphyrin, serum retinol, and ferritin concentrations were measured to evaluate the anthropometric and nutritional status.
Results: The rates of stunt, underweight, overweight, wasting, obesity, anemia, iron deficiency, vitamin A deficiency (VAD), and marginal VAD were 6.3%, 3.9%, 3.7%, 1.5%, 3.1%, 23.5%, 15.0%, 6.3% and 25.9%, respectively. Serum retinol concentration was significantly lower in children with anemia than in those without anemia (P=0.003), and the retinol concentration was associated with hemoglobin (Pearson's correlation coefficient, r=0.22, P<0.01). Children with VAD had a significantly increased risk for anemia (odds ratio, 2.56; 95% confident interval, 1.15-5.70). In all 108 children with anemia, only 42 were related to VAD and 12 related to iron deficiency, suggesting that almost half of the anemia children cannot be explained solely by iron deficiency or VAD.
Conclusions: Vitamin A and iron deficiency are still public health problems in some localities of China. Public health interventions in anemia control should be used to eliminate deficiencies of vitamin A, iron, and other micronutrients by deliberate supplementation. Attention must be paid to such deficiencies in high-risk groups, especially in preschool children.
Key words: anemia; iron; micronutrient deficiency; preschool children; vitamin A
World J Pediatr 2009;5(4):275-281 |
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[Abstract] [Full Text] [PDF]
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Celiac disease in 87 children with typical and atypical symptoms in Black Sea region of Turkey
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Gönül Dinler, Erdal Atalay, Ayhan Gazi Kalaycı |
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Author Affiliations: Unit of Pediatric Gastroenterology Hepatology and Nutrition (Dinler G, Kalaycı AG) and Department of Pediatrics (Atalay E), Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
Corresponding Author: Gönül Dinler, Pediatric Gastroenterology Hepatology and Nutrition Department, Ondokuz Mayıs University Faculty of Medicine, Samsun 55139, Turkey (Tel: +90 3623121919-3734; Fax: +90 3624576041; Email: gdinler@omu.edu.tr)
doi:10.1007/s12519-009-0053-y
Background: Celiac disease presents with a spectrum of clinical disorders. The variety of clinical presentations largely depends on age and extraintestinal findings. This study aimed to determine typical and atypical cases according to presenting symptoms and to evaluate their biochemical and pathological parameters.
Methods: Eighty-seven patients with celiac disease in our unit between 2000 and 2007 were reviewed. Their diagnosis was made by serological and histological examination. The patients were divided into two groups according to their typical or atypical symptoms.
Results: The mean age of the patients at diagnosis was 8.2 years (range, 1-18 years), but patients presenting with typical symptoms were younger than those presenting with atypical symptoms. The patients in the two groups did not differ significantly in sex, weight and height Z scores except age. Diarrhea (96.3%), abdominal distention (65.4%) and failure to thrive (60%) were the most common clinical presentations in the typical group, and short stature (62.5%) and anemia (31.2%) were the most common in the atypical group. Total/subtotal villous atrophy was significantly higher in the typical group than in the atypical group.
Conclusions: Many children with celiac disease show an atypical form. The understanding of presentations of celiac disease may prevent delayed diagnosis. Celiac disease should be specially investigated in patients with recurrent iron deficiency anemia, short stature and autoimmune disorders.
Key words: atypical presentation; celiac disease; child; iron deficiency anemia; short stature
World J Pediatr 2009;5(4):282-286 |
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[Abstract] [Full Text] [PDF]
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Congenital rubella syndrome: pattern and presentation in a southern Nigerian tertiary hospital
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Innocent Ocheyana George, Angela Ine Frank-Briggs, Raphael Sonny Oruamabo |
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Author Affiliations: Department of Pediatrics and Child Health, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria (George IO, Frank-Briggs AI); College of Health Sciences, Niger Delta University Wilberforce Island, Bayelsa State, Nigeria (Oruamabo RS)
Corresponding Author: I. O. George, Department of Pediatrics and Child Health, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria (Email: geonosdemed@yahoo.com)
doi:10.1007/s12519-009-0054-x
Background: Congenital rubella syndrome (CRS) resulting from maternal rubella infection can result in miscarriages, still birth and rubella infection of the infant. The aim of this study was to evaluate the pattern and presentation of CRS over an 8-year period as seen in the University of Port-Harcourt Teaching Hospital (UPTH), Nigeria.
Methods: The medical records of all cases of CRS presenting to the Pediatric Department of UPTH from January 2000 to December 2007 were reviewed.
Results: There were 16 394 babies delivered in UPTH from January 2000 to December 2007. Of these babies, 19 were clinically diagnosed as having CRS, but none had laboratory confirmation. They had a mean age of 5.1±3.2 months (range: 1-11 months). Seventy-five percent of their mothers had presumed rubella infection during the first trimester of pregnancy. Cataract was noticed to be the most prominent systemic manifestation in 18 of the 19 babies. Other common manifestations included hearing impairment (n=14), microcephaly (n=13), patent ductus arteriosus (n=11), and low birth weight (n=10). A surge was observed in the number of babies with CRS from 2004 to 2007; however, this was not statistically significant (χ2=8.68, P=0.28). Unfortunately, long-term outcome of the 19 babies was not available.
Conclusion: CRS is commonly diagnosed at our center. Thus, mounting effective surveillance for CRS and considering the inclusion of rubella vaccine in Nigeria are of extreme importance.
Key words: congenital rubella syndrome; maternal infection; national program on immunization
World J Pediatr 2009;5(4):287-291 |
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[Abstract] [Full Text] [PDF]
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Nuss operation for pectus excavatum: a single-institution experience
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Yong-Zhong Mao, Shao-Tao Tang, Yong Wang, Qiang-Song Tong, Qing-Lan Ruan |
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Background: The Nuss procedure for repair of pectus excavatum (PE) has been accepted worldwide because of minimal invasiveness and excellent cosmetic results. We summarized our experience with the treatment of 115 patients aged 2.7-18 years.
Methods: All the 115 patients underwent the Nuss procedure successfully from July 2003 to February 2008. They were divided into two groups: children group (below 12 years) and adolescents group (aged 12-18 years).
Results: The rate of complications was 14.7% and 37.5% in the children and adolescents groups, respectively (P<0.05). There was significant difference in operation time, length of hospital stay, and analgesic time between the two groups (P<0.05). The initial results of Nuss procedure were excellent.
Conclusions: The Nuss procedure can be performed with excellent early results in children. We suggest that children with PE should accept the Nuss procedure as early as possible when they are over 5 years old. Key words: adolescents; children; complication; Nuss procedure; pectus excavatum |
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[Abstract] [Full Text] [PDF]
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Interventional occlusion of congenital vascular malformations
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Chun-Hong Xie, Cheng-Sen Xia, Fang-Qi Gong, Yin-Bao Zhou, Wei-Hua Zhu |
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Background: New materials and devices have been used in the management of cardiac malformations. In this paper, we present our experience with interventional occlusion of congenital vascular malformations.
Methods: Between January 1997 and December 2005, 139 patients with congenital vascular malformations who had undergone interventional occlusion in the Children's Hospital, Zhejiang University School of Medicine were studied. The clinical data of the patients were retrospectively reviewed including pre-operative evaluation, surgical procedures, immediate complete closure rate, short-term complications, and short-term outcome.
Results: Of the 139 patients, 126 had patent ductus arteriosus, and successful deployment was achieved in 121 of the 126 patients (96%, 121/126). Six patients had coronary artery fistula and 14 different coils were used for embolization; the immediate complete closure rate was 83.3%, and the complete closure rate after one month was 100%. The abnormal vessels of 3 patients with pulmonary sequestration were completely occluded using four 0.038-inch Gianturco coils. In 3 patients with aortopulmonary collaterals, 14 abnormal vessel branches were occluded with sixteen 0.038-inch Gianturco coils, reaching a closure rate of 100%. One patient with pulmonary arteriovenous fistula was occluded successfully with two 0.038-inch Gianturco coils.
Conclusions: Transcatheter closure using coils is a safe and effective alternative to surgical ligation in the management of congenital vascular malformations in children. Selection of appropriate coils is important to achieve a better outcome.
Key words: embolization; patent ductus arteriosus; transcatheter; vascular malformations
World J Pediatr 2009;5(4):296-299 |
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[Abstract] [Full Text] [PDF]
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Effect of melatonin on proliferation of neonatal cord blood mononuclear cells
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Wei Zhou, Ping Wang, Li Tao |
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Author Affiliations: Department of Neonatology, Guangzhou Children's Hospital, Guangzhou Medical College, Guangzhou 510120, China (Zhou W, Wang P, Tao L)
Corresponding Author: Wei Zhou, MD, Department of Neonatology, Guangzhou Children's Hospital, Guangzhou Medical College, Guangzhou 510120, China (Tel: +86-20-81330577; Fax: +86-20-81861650; Email: zhouwei_pu002@126.com)
doi:10.1007/s12519-009-0057-7
Background: Pineal melatonin (MLT) is a neuroendocrine hormone that possesses a wide variety of biological effects. MLT regulation of the immune system has been studied in recent years. But very little is known about MLT interaction with neonatal cord blood mononuclear cells (CBMCs) and the lymphocyte immune system in neonates. This study was designed to investigate the proliferative effects of MLT on CBMCs and peripheral blood mononuclear cells (PBMCs).
Methods: Cord blood samples were collected from 10 normal full-term infants at the Guangzhou Maternal and Infant Hospital, China. Ten samples of adult peripheral blood were also collected from healthy volunteers. 3H-thymidine (3H-TdR) incorporation was used to analyze the influence of MLT on proliferation of CBMCs. The effects of MLT on proliferation of CBMCs and PBMCs were compared.
Results: 3H-TdR incorporation increased in a dose-dependent manner with varying MLT concentrations (50 pg/ml-50 ng/ml), but peaked at 5 ng/ml. After incubation with MLT (5 ng/ml), interleukin-2 (IL-2, 50 ng/ml), MLT+phytohemagglutinin (PHA, 5 μg/ml), and MLT+IL-2, respectively in CBMCs media, 3H-TdR incorporation rates were 114 327±52 863, 16 087±9006, 118 360±59 207, and 17 682±7391. Compared to the control cell suspension (14 133±8688), 3H-TdR incorporation rates of the MLT and MLT+PHA groups were significantly increased (t=5.9143, P<0.001; t=5.5078, P<0.001). 3H-TdR incorporation was not different between the IL-2 and MLT+IL-2 groups (t=0.4983, P>0.05; t=0.9839, P>0.05). PHA treatment (110 397±48 663) presented no difference in 3H-TdR incorporation compared to the MLT or MLT+PHA groups (t=0.1730, P>0.05; t=0.3286, P>0.05). 3H-TdR incorporation was significantly greater in CBMCs than in PBMCs cultures after addition of various stimulators to the culture media.
Conclusions: MLT promoted proliferation of PBMCs and also enhanced proliferation of CBMCs. The proliferative effects of MLT were greater on CBMCs than on PBMCs.
Key words: cell proliferation; cord blood; melatonin; mononuclear cell; neonate
World J Pediatr 2009;5(4):300-303 |
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[Abstract] [Full Text] [PDF]
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Risk factors and laser therapy for retinopathy of prematurity in neonatal intensive care unit
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Li Liu, Tian Tian, Chong-Xun Zheng, Vatavu Ileana, Anca Ioana, Ciomartan Tatiana, Racovitan Oana |
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Author Affiliations: Department of Neonatology, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, China (Liu L, Tian T); Biomedical Engineering Institute of Xi'an Jiaotong University, Xi'an 710061, China (Zheng CX); Institute for Mother and Child Care (IOMC) of Bucharest Medical University, Sector 2, 72309, Romania (Ileana V, Ioana A, Tatiana C, Oana R)
Corresponding Author: Li Liu, MD, Department of Neonatology, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, China (Tel: 86-29-85323829; Fax: 86-29-85263190; Email: nellie918@yahoo.com.cn)
doi:10.1007/s12519-009-0058-6
Background: With the increasing survival rates of preterm infants, the incidence of retinopathy of prematurity (ROP) is also increasing. This study aimed to investigate the risk factors for ROP in Neonatal Intensive Care Unit, and the effects of laser therapy.
Methods: Thirty-five premature infants with various other diseases were studied. Data were collected including gender, gestational age, birth weight, maternal gravidity, Apgar score, antenatal and postnatal hypoxia, anemia, jaundice, infection, pregnancy complications, and head ultrasound manifestations. All patients were subjected to fundus examinations at a postmenstrual age of 34 weeks using an indirect ophthalmoscope. The infants were divided into ROP group and non-ROP group. Infants with ROP received laser treatment. The data of the infants were analyzed using univariate analysis and the logistic regression model.
Results: Twenty-seven (77.1%) of the 35 infants had ROP and 21 of them also had plus diseases. The recovery rates were 74.1% and 92.6% at 2 weeks and 3 months after laser therapy, respectively. The birth weight and gestational age in the ROP group were significantly lower than those in the non-ROP group (P<0.01). The lower the gestational age and birth weight, the higher the incidence of ROP. There was a significant difference in the incidence of ROP with postnatal hypoxia (P=0.013), anemia (P=0.012) and gravidity two (P<0.05), analyzed with the Fisher's exact probability test (P<0.05). The gestational age was significantly lower in the plus disease group than in the non-plus disease group (P<0.05).
Conclusions: The incidence of ROP is high in premature infants with various other diseases and is correlated with birth weight, gestational age, postnatal hypoxia, anemia and maternal gravidity. Laser therapy shows good outcomes.
Key words: laser therapy; premature infant; retinopathy of prematurity; risk factor
World J Pediatr 2009;5(4):304-307 |
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[Abstract] [Full Text] [PDF]
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Drugs controlling proteinuria of patients with Alport syndrome
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Jian-Guo Li, Jie Ding, Fang Wang, Hong-Wen Zhang |
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Author Affiliations: Department of Pediatrics, Peking University First Hospital, Beijing 100034, China (Li JG, Ding J, Wang F, Zhang HW)
Corresponding Author: Jie Ding, MD, PhD, Department of Pediatrics, Peking University First Hospital, No. 1, Xianmen Dajie, Beijing 100034, China (Tel: 8610 66551122 ext 3236; Fax: 8610 66134261; Email: djnc_5855@126.com).
doi:10.1007/s12519-009-0059-5
Background: Proteinuria is one of the risk factors for the progression of renal diseases including Alport syndrome (AS), a hereditary glomerular renal disease. This study aimed to evaluate the efficacy of angiotensin converting enzyme inhibitors (ACEIs) and/or tripterygium, a Chinese herbal medicine widely used in Chinese patients with hematuria and proteinuria, on proteinuria in patients with AS.
Methods: Twenty-nine children were enrolled into this retrospective study. Patients were divided into 3 therapy groups: ACEI group, tripterygium group, and ACEI plus tripterygium group.
Results: In the 29 children, 23 were male and 6 female. In the ACEI group and the tripterygium group, the effective rate was 87.5% and 25.0%, respectively and in the ACEI plus tripterygium group was 42.9%.
Conclusions: ACEI is effective in controlling proteinuria of AS patients. Tripterygium should be carefully administered in controlling proteinuria of AS patients.
Key words: Alport syndrome; angiotensin converting enzyme inhibitor; herbal medicine; tripterygium
World J Pediatr 2009;5(4):308-311 |
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[Abstract] [Full Text] [PDF]
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