Are the Classical Symptoms of Hypertension in Children Still Sensitive Enough?

The available literature is scarce on the initial symptoms of arterial hypertension in children. Our study aimed to analyze the initial clinical profile of patients referred to the hospital with suspected hypertension and those diagnosed with hypertension for the first time during a hospitalization for other reasons. This study was a retrospective analysis of medical records in 471 patients. More than half of the patients showed no symptoms. The most common symptom reported was a headache-28% (132) of patients. The diagnosis of elevated blood pressure or hypertension was more frequent in asymptomatic patients (P = 0.001). Headaches were seen more often in healthy patients than in patients with hypertension. Newly diagnosed hypertension is mainly diagnosed in asymptomatic children. Moreover, the symptoms previously described in the literature as the most common did not prove to be predictive of hypertension in our study.

Lipid Profile in Children Born Small for Gestational Age.

BACKGROUND: Lipid disorders are one of the risk factors for cardiovascular diseases. The aim of the study was to estimate the lipid profile in early childhood in the population of Polish children born small for gestational age (SGA). MATERIALS AND METHODS: The study included 140 patients (93 SGA children and 47 controls) aged 5 to 11 years. All the subjects underwent a physical examination and blood laboratory tests for the glucose and lipid profiles. The SGA group was divided into subgroups, i.e., symmetrical and asymmetrical intrauterine growth restriction (IUGR). RESULTS: Blood sample analysis revealed higher levels of total cholesterol (SGA group 190.61 ± 24.66 mg/dL vs. controls 143.23 ± 23.90; p < 0.001). The analysis of particular cholesterol fractions showed significantly higher mean values of triglycerides and LDL cholesterol as well as lower mean values of HDL cholesterol in SGA children. Children in both groups did not differ significantly in terms of weight or body mass index. A statistically significantly higher glucose concentration was observed in SGA patients with the symmetrical type of IUGR. Analyzing the differences regarding metabolic factors, we obtained a statistically significant difference only in fasting glucose concentration (asymmetrical IUGR = 90.56 ± 10.21 vs. symmetrical IUGR = 98.95 ± 14.79; p < 0.001). CONCLUSIONS: Children born SGA, even those not suffering from overweight or obesity in their early childhood, have an abnormal lipid profile, which may contribute to the development of cardiovascular diseases in adulthood.

Assessment of Cardiovascular Risk Factors in Patients with Juvenile Idiopathic Arthritis.

INTRODUCTION: The aim of this study was to assess the exposure to cardiovascular disease (CVD) risk factors in patients with juvenile idiopathic arthritis (JIA). Intima-media complex thickness (IMT), selected metabolic parameters and health behaviors were assessed in the course of the study. METHODS: The study included study group, which consisted of 45 patients with JIA and 37 healthy age- and sex-matched children in the control group. Analyses in both groups included anthropometric parameters, laboratory tests, IMT and a questionnaire on exposure to modifiable CVD risk factors. RESULTS: The study confirmed that CVD risk factors were present in both groups of patients. Significantly more children with JIA had abnormal BMI (p = 0.006) compared to the control group. Children in the study group were more likely to consume fruit regularly (p = 0.021) and less likely to consume fast food (p = 0.011) and sweetened beverages (p = 0.042) than children in the control group. Only 1 patient with JIA met criteria for ideal cardiovascular health. Dietary habits were not associated with IMT values, BMI, presence of joint pain or biochemical parameters in the study group. CONCLUSIONS: Patients with JIA are exposed to cardiovascular risk factors equally to their healthy peers. Ideal cardiovascular health should be pursued in the pediatric population with particular attention paid to patients with chronic diseases (i.e., JIA). The application of carotid artery IMT measurement in the assessment of CVD risk requires studies on a larger group of patients.

Why and How Should We Assess the Cardiovascular Risk in Patients with Juvenile Idiopathic Arthritis? A Single-Centre Experience with Carotid Intima-Media Measurements.

BACKGROUND: Children diagnosed with juvenile idiopathic arthritis (JIA) are thought to be more likely to develop cardiovascular disease in adulthood. The factors modulating the cardiovascular risk, involving exposure to secondhand smoking, sedentary lifestyle and abnormal body mass index, might have had a stronger impact during the COVID-19 pandemic. The lack of reliable prognostic markers for a higher probability of cardiovascular events might be solved by carotid intima-media thickness (cIMT) measurement. The paramount goal of the study was to assess its usefulness in JIA patients. MATERIALS AND METHODS: The results of cIMT measured by a single physician in 45 children diagnosed with JIA were compared to 37 age- and sex-matched healthy counterparts. The analysis also involved anthropometric parameters, laboratory tests, and a survey regarding lifestyle-related factors. RESULTS: Four JIA patients appeared to have cIMT above the 94th percentile. A positive correlation between erythrocytes sedimentation rate (ESR) and right carotid artery percentiles was found. Passive smoking increased the cardiovascular risk regardless of JIA. Doubling the daily screen time during the pandemic led to a significant reduction in children's physical activity. However, the number of enrolled subjects was not enough to make significant recommendations. CONCLUSIONS: cIMT measurements remain an interesting perspective for future cardiovascular screening of children with JIA. It has yet to be determined whether it should be considered in all JIA patients on a reliable basis.

Serum Adipocytokines Profile in Children Born Small and Appropriate for Gestational Age-A Comparative Study.

BACKGROUND: Adipose tissue is not only a storage place for fat, but also an endocrine organ, secreting bioactive molecules which influence body metabolism. Such molecules are known as adipocytokines. In the past years the coincidence between adipocytokines and fetal growth restriction disorders was found. The aim of the study was to estimate serum levels of adiponectin, leptin and resistin in children born small for gestational age, compared to children born at an appropriate size for gestational age. METHODS: The study consisted of 35 children aged seven to nine years, born SGA (small for gestational age) on term and 25 healthy children (14 girls, 11 boys), born with proper birthweight (AGA-appropriate for gestational age)-control group. RESULTS: Adiponectin and leptin levels were significantly higher in the SGA group compared to the AGA group (p = 0.023, p = 0.018 respectively). The resistin values were comparable in both groups of patients. There was a positive correlation between serum leptin concentration and current body weight in SGA group (r = 0.28; p = 0.108). In turn, adiponectin levels in this group of patients negatively correlated with actual body weight (r = -0.51; p = 0.002). The negative correlation between body mass index and plasma adiponectin levels was found only in children born SGA. SGA children had significantly higher values of diastolic blood pressure. There was negative correlation between serum adiponectin level and systolic blood pressure in SGA children. In the SGA group the phenomenon of catch-up growth was observed in 32 children. CONCLUSIONS: Children born SGA have abnormal adipose tissue biomarkers profiles.

Evaluation of Health-Promoting Behaviors in the Prevention of Cardiovascular Diseases in the Preschool Children of Polish Health Care Professionals.

BACKGROUND: The aim of the study was to evaluate the health-promoting behavior of the preschool children (aged 3-6 y) of Polish health care professionals (HCPs). METHODS: The study was conducted by means of quantitative research on a group of 386 individuals, using an Internet-based survey. RESULTS: The ideal cardiovascular health model was determined in the case of 22 children (5.6%). The collected data revealed that, when regarding the recommended level of physical activity, children from HCP families meet the American Heart Association criteria much more often than their peers from other study populations (56.5% vs. 16.6%). In our study, more girls than boys participated in organized activities (60.2% vs. 50.3%, p = 0.05). There was no correlation between achieving adequate levels of physical activity and the BMI (p > 0.1). Overweight children had a more balanced diet than children with a normal body weight (p = 0.009). CONCLUSIONS: The obtained results allowed us to make the conclusion that there is a need to implement educational and preventive measures on a large scale, while some health-promoting behaviors, especially those concerning proper nutrition, require major modifications, even in HCP families.

Stokes velocity generated by a point force in various geometries.

In this short review, we visualize the fluid velocity generated by a point force close to a plane free surface or a plane rigid wall. We present separately contributions from all the multipoles which form the corresponding classical systems of images. Such graphical images might be useful in the theoretical and numerical modeling of the dynamics of micro-objects moving close to an interface.

Periodic and quasiperiodic motions of many particles falling in a viscous fluid.

The dynamics of regular clusters of many nontouching particles falling under gravity in a viscous fluid at low Reynolds number are analyzed within the point-particle model. The evolution of two families of particle configurations is determined: two or four regular horizontal polygons (called "rings") centered above or below each other. Two rings fall together and periodically oscillate. Four rings usually separate from each other with chaotic scattering. For hundreds of thousands of initial configurations, a map of the cluster lifetime is evaluated in which the long-lasting clusters are centered around periodic solutions for the relative motions, and they are surrounded by regions of chaotic scattering in a similar way to what was observed by Janosi et al. [Phys. Rev. E. 56, 2858 (1997)] for three particles only. These findings suggest that we should consider the existence of periodic orbits as a possible physical mechanism of the existence of unstable clusters of particles falling under gravity in a viscous fluid.

Ethnomedicinal survey and in vitro anti-plasmodial activity of the palm Borassus aethiopum Mart.

ETHNOPHARMACOLOGICAL RELEVANCE: Malaria remains a major global health threat, with the heaviest burden of disease in sub-Saharan Africa. Effective treatment is not available in many affected areas, and the Plasmodium falciparum parasite is becoming resistant to existing drugs. Alternative therapies are necessary to overcome these challenges. Borassus aethiopum is the third most used palm species in traditional medicines in Africa. Yet, there is only limited information substantiating medicinal properties of the palm. The objective of this study was to document medicinal uses of B. aethiopum and investigate anti-plasmodial activity of the palm extracts used in traditional medicine to treat malaria. MATERIALS AND METHODS: The fieldwork and collection of samples was done in Ghana in the Greater Accra, Brong Ahafo, and Volta regions. Our ethnomedicinal survey did not specifically focus on medicinal uses against malaria; any medicinal application of B. aethiopum was of interest. Data collection employed a structured questionnaire, open-ended questions, and group discussion. The experimental extraction of samples was carried out using three common solvents: distilled water, absolute ethanol, and dichloromethane (CH2Cl2). Anti-plasmodial activity of compounds was determined against erythrocytic stages of the FCR3 strain of P. falciparum by a [3H]-hypoxanthine incorporation assay. RESULTS: A total of 37 use records were documented regarding the medicinal uses of B. aethiopum for the management of 24 different disorders. The highest medicinal use value was recorded for the use of B. aethiopum against malaria, and a subsequent laboratory investigation focused on evaluating anti-plasmodial activity of the palm. Several root and leaf extracts displayed anti-plasmodial activity, with the highest (78% at 50 µg/mL) elicited by one of the dichloromethane root extracts. CONCLUSION: Our results demonstrate the value of integrating ethnobotanical and pharmacological research in the study of beneficial effects of palm products on human health. While the high inhibitory activity found in dichloromethane extracts cannot validate the ethnomedicinal use, the anti-plasmodial effect observed cannot be nullified. We brought preliminary evidence that this palm is a promising source of alternative medicines that could contribute to improving health conditions in malaria endemic areas of sub-Saharan Africa.

African palm ethno-medicine.

ETHNOPHARMACOLOGICAL RELEVANCE: This study is the first to demonstrate the breadth and patterns of the medicinal applications of African palms. It sheds light on species with the potential to provide new therapeutic agents for use in biomedicine; and links the gap between traditional use of palms and pharmacological evaluation for the beneficial effects of palm products on human health. Last but not least, the study provides recommendations for the areas that should be targeted in future ethno-botanical surveys. AIM OF THE STUDY: The primary objective of this survey was to assemble all available ethno-medicinal data on African palms, and investigate patterns of palm uses in traditional medicine; and highlight possible under-investigated areas. MATERIALS AND METHODS: References were found through bibliographic searches using several sources including PubMed, Embase, and Google Scholar and search engines of the State and University Libraries of Aarhus, National Library of Denmark and Copenhagen University Libraries, Harvard University Libraries, and the Mertz Library. Information about ethno-medicinal uses of palms was extracted and digitized in a database. Additionally, we used an African palm distribution database to compute the proportion of palm species that have been used for medicinal purposes in each country. RESULTS: We found 782 medicinal uses mentioned in 156 references. At least 23 different palm species (some remained unidentified) were used medicinally in 35 out of Africa's 48 countries. The most commonly used species were Elaeis guineensis, Phoenix dactylifera, Cocos nucifera, and Borassus aethiopum. Medicinal uses were in 25 different use categories of which the most common ones were Infections/Infestations and Digestive System Disorders. Twenty-four different parts of the palms were used in traditional medicine, with most of the uses related to fruit (and palm oil), root, seed and leaf. Palms were used in traditional medicine mostly without being mixed with other plants, and less commonly in mixtures, sometimes in mixture with products of animal origin. Future ethno-botanical surveys should be directed at the central African region, because palm species richness (and plant species richness in general) is particularly high in this area, and only few ethno-botanical studies available have focused on this region. CONCLUSION: The wide time span covered by our database (3500 years) shows that African palms have been used medicinally by many societies across the continent from time immemorial until today. Most medicinal use records for African palms were found in two categories that relate to most prevailing diseases and disorders in the region. By analyzing ethno-medicinal studies in one database we were able to demonstrate the value of palms in traditional medicine, and provide recommendations for the areas that should be targeted in future ethno-botanical surveys.

Ritual uses of palms in traditional medicine in sub-Saharan Africa: a review.

Palms (Arecaceae) are prominent elements in African traditional medicines. It is, however, a challenge to find detailed information on the ritual use of palms, which are an inextricable part of African medicinal and spiritual systems. This work reviews ritual uses of palms within African ethnomedicine. We studied over 200 publications on uses of African palms and found information about ritual uses in 26 of them. At least 12 palm species in sub-Saharan Africa are involved in various ritual practices: Borassus aethiopum, Cocos nucifera, Dypsis canaliculata, D. fibrosa, D. pinnatifrons, Elaeis guineensis, Hyphaene coriacea, H. petersiana, Phoenix reclinata, Raphia farinifera, R. hookeri, and R. vinifera. In some rituals, palms play a central role as sacred objects, for example the seeds accompany oracles and palm leaves are used in offerings. In other cases, palms are added as a support to other powerful ingredients, for example palm oil used as a medium to blend and make coherent the healing mixture. A better understanding of the cultural context of medicinal use of palms is needed in order to obtain a more accurate and complete insight into palm-based traditional medicines.

New categories for traditional medicine in the Economic Botany Data Collection Standard.

The Economic Botany Data Collection Standard (EBDCS) has been successfully followed by ethnobotanists investigating plant uses in many parts of the world. However, we have encountered some cases in our study of traditional medicine where the standard seems incomplete and inaccurate when it is applied to plant uses of rural or indigenous societies in developing countries. We propose two categories to be added to the EBDCS: Cultural Diseases and Disorders, and Ritual/Magical Uses. Adding these categories, we believe will give a more accurate insight into traditional medicine and will contribute to developing an integrative ethnomedicinal data collection protocol, which will make ethnomedicinal studies more comparable.