Paediatric obesity

BACKGROUND AND AIMS: Studies in the paediatric population have shown inconsistent associations between cardiorespiratory fitness and inflammation independently of adiposity. The purpose of this study was (i) to analyse the combined association of cardiorespiratory fitness and adiposity with high-sensitivity C-reactive protein (hs-CRP), and (ii) to determine whether adiposity acts as a mediator on the association between cardiorespiratory fitness and hs-CRP in children and adolescents...

There is a need for more flexible treatment strategies to help patients reach relevant treatment outcomes and adhere better to treatment. The aim of this study was to evaluate the long-term efficacy, in terms of patients' weight status, of replacing usual care (UC) physical visits with more frequent but shorter telephone coaching (TC) sessions as part of a structured childhood obesity treatment. In this controlled study, patients aged 5-14 years from the Södertälje outpatient clinic, Sweden were randomized to either UC or TC over an 18-month period after participating in an initial standard obesity treatment programme...

The majority of marketed drugs remain understudied in some patient populations such as pregnant women, paediatrics, the obese, the critically-ill, and the elderly. As a consequence, currently used dosing regimens may not assure optimal efficacy or minimal toxicity in these patients. Given the vulnerability of some subpopulations and the challenges and costs of performing clinical studies in these populations, cutting-edge approaches are needed to effectively develop evidence-based and individualized drug dosing regimens...

BACKGROUND: The aim of this study is to determine values of insulinaemia, homeostasis model assessment (HOMA) index and quantitative insulin sensitivity check index (QUICKI) among a population of prepubertal Caucasian children, to analyse factors associated with insulin resistance (IR), and to study its association with cardiovascular risk factors. MATERIALS AND METHODS: Population-based study conducted on a randomly selected sample of prepubescent Caucasian subjects aged 2...

OBJECTIVES: To evaluate efficacy of nutrition and physical activity interventions in the clinical management of paediatric non-alcoholic fatty liver disease (NAFLD). The prevalence of paediatric NAFLD continues to rise alongside childhood obesity. Weight loss through lifestyle modification is currently first-line treatment, although supplementation of specific dietary components may be beneficial. METHODS: Medline, CINAHL, EMBASE, Scopus and Cochrane Libraries were systematically searched to identify randomised controlled trials (RCTs) assessing nutritional and physical activity interventions...

BACKGROUND: Advances in juvenile idiopathic arthritis (JIA) treatment is promoting free disease survival. Cardiovascular disease (CVD) may emerge as an important cause of morbidity and mortality. Pulse wave velocity (PWV), a surrogate marker of arterial stiffness, and telomere length (TL) are considered as potential predictors of CVD and its outcomes. The study aim was to assess PWV, TL in a JIA population and to test its correlation. In a cross sectional study, 24 JIA patients, 21 controls for TL and 20 controls for PWV were included...

To study the effect of patient size, anatomical location and modulation strength (MS) on image-quality and delivered dose of CT scans acquired with automatic-exposure-control system (AEC). Four anthropomorphic phantoms (three paediatric and one thin adult) were studied, and normal and obese adults were simulated by placing bolus plates around the adult phantom. Thorax and abdomen-pelvis CT were performed using an AEC system equipped with five possible MS. Modulated tube current (mAsmod) was compared to Reference mAs and image-noise was assessed...

INTRODUCTION: The onset of obesity at young ages is strongly associated with the early development of type 2diabetes (T2D). The shape of the curves of glucose and insulin curves during an oral glucose tolerance test (OGTT) could predict the risk of developing T2D. OBJECTIVE: To analyse the morphology of the OGTT and determine T2D risk factors in a mainly Caucasian population of children and adolescents. METHODS: Observational retrospective study including 588 patients (309 males, 279 females) with a mean age of 11...

BACKGROUND: Whilst still rare, the incidence of paediatric stone disease is increasing in developed countries and it is important to evaluate the aetiology. We set up a dedicated renal stone service for children combining medical and surgical expertise in 1993 and now have a large case series of children to investigate the epidemiology. METHODS: A retrospective hospital note review of children presenting with kidney stones during the last 22 years (1993-2015) was conducted...

BACKGROUND: Intracranial lesions may affect the hypothalamo-hypophyseal axis and lead to some neuro-endocrinological dysfunctions (hyperphagia, sleep disorders and hormonal dysfunctions). There is a very limited number of studies about childhood obesity and intracranial lesions. AIMS: To evaluate the incidence of intracranial lesions and its role in clinical symptoms and aetiology in cases with morbid obesity who have been admitted to the paediatric endocrinology department with this complaint...

OBJECTIVES: To identify the unanswered research questions in paediatric preventive care that are most important to parents and clinicians, and to explore how questions from parents and clinicians may differ. DESIGN: Iterative mixed methods research priority setting process. SETTING: Toronto, Ontario, Canada. PARTICIPANTS: Parents of children aged 0-5 years enrolled in a research network in Toronto, and clinicians practising in Toronto, Ontario, Canada...

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A four-year-old girl was referred to a paediatric department with low height, obesity and hypothyroidism. Her paraclinical tests were characteristic with elevated P-parathyroid hormone concentration, hypothyroidism, growth hormone deficiency, abnormal phenotype with brachydactyly, tooth problems and mental retardation, which led to a suspicion of Albright's hereditary osteodystrophy (AHO). The diagnosis was verified by molecular genetic testing. Less than 1% of children with obesity have an endocrine disorder, and AHO is one of them...

As childhood obesity increases, it is becoming important to understand the complications of obesity in children and develop novel biomarkers. Evidence indicates that microRNAs (miRNA) are dys-regulated in obesity and may serve as sensitive and specific circulating biomarkers. Non-alcoholic fatty liver disease (NAFLD) is a complication of obesity that ultimately requires a liver biopsy to determine disease severity. While studies have been conducted in adults, no study to date has examined circulating miRNAs in children with obesity and NAFLD...

AIM: To investigate the epidemiology, clinical profile and risk factors of pseudotumor cerebri syndrome (PTCS) in children aged 1-16 years. METHODS: A national prospective population-based cohort study over 25 months. Newly diagnosed PTCS cases notified via British Paediatric Surveillance Unit were ascertained using classical diagnostic criteria and categorised according to 2013 revised diagnostic criteria. We derived national age, sex and weight-specific annual incidence rates and assessed effects of sex and weight categories...

Data on paediatric pulmonary embolism (PE) are scarce. We sought to systematically review the current literature on childhood PE and conducted a search on paediatric PE via PubMed (1946-2013) and Embase (1980-2013). There was significant heterogeneity in reported data. Two patterns were noted: classic thromboembolic PE (TE-PE) and in situ pulmonary artery thrombosis (ISPAT). Mean age of presentation for TE-PE was 14.86 years, and 51 % of cases were males. The commonest method for diagnosis of TE-PE was contrast CT with angiography (74 % of patients)...

AIM: To determine vitamin D deficiency risk and other lifestyle factors in children aged 2-17 years presenting with an acute fracture to Sunshine Hospital. METHODS: A prospective observational study was undertaken using a convenience sample data collected from children aged 2-17 years of age presenting with an acute fracture. Recruitment was undertaken over a 3-month period from February to May 2014. Risk factors for vitamin D deficiency (skin pigmentation, hours spent outdoors, sunscreen use and obesity) were identified...

There is a growing need to curb paediatric obesity. The aim of this study is to untangle associations between video-game-use attributes and obesity as a first step towards identifying and examining possible interventions. Cross-sectional time-lagged cohort study was employed using parent-child surveys (t1) and objective physical activity and physiological measures (t2) from 125 children/adolescents (mean age = 13.06, 9-17-year-olds) who play video games, recruited from two clinics at a Canadian academic children's hospital...

We compared anthropometry, cardiometabolic risk and aerobic fitness among obese youth in weight management who were diagnosed with one or more psychiatric disorders (PD), with (PD+M) or without (PD-M) a prescribed psychotropic medication with those with no PD (NPD). Physical measures were evaluated at baseline, and psychiatric diagnoses and related medications were identified from medical records. Of 99 patients 64 (65%) had a diagnosed PD, and of those, 23 (36%) had a related medication (PD+M). Compared to NPD, PD-M had a higher body mass index (BMI) (P = 0...

AIM: To provide a systematic review and meta-analyses investigating the association between overweight/obesity as defined by Body Mass Index (BMI) and periodontal disease in terms of clinical periodontal outcomes. MATERIALS AND METHODS: A systematic search of the literature was conducted by two authors (SR and SD) independently in the Cochrane Library, PubMed, Web of Science (ISI), Scopus, Scielo, Lilacs and System for Information on Grey Literature in Europe (SIGLE) for full articles published until September 2015...