ABSTRACT
OBJECTIVES: There is a theoretical risk for neonatal hypothyroidism after prenatal exposure to iodinated contrast media. Current recommendations are in favour of neonatal thyroid function assessment. Our aim was to check if recommendations were observed, and if neonatal evaluation demonstrated anomalies. METHODS: Over the period from 01/01/2010 to 01/08/2015, maternal and newborn records were retrospectively reviewed. All pregnant women who underwent a computed tomography and their newborns were included. We collected thyroid-stimulating hormone (TSH), thyroxine (T4) and tri-iodothyronine (T3) levels. RESULTS: A total of 101 maternal and newborn records were reviewed. Mean gestational age at CT scan was 29.3±7.2 weeks. The mean dose of total iodine administered was 82.6±19.1mL. Only 21 newborns had a biological analysis (20.8%). All newborns had normal TSH and T4 levels at birth. Only 7 newborns had a T3 level above the upper threshold value, but according to expert opinion none have been considered pathological. CONCLUSION: Our study revealed that recommendations for neonatal thyroid function assessment after prenatal exposure to iodinated contrast media were not observed. This exposure seemed unlikely to have an important effect on thyroid function at birth.
Subject(s)
Congenital Hypothyroidism/diagnosis , Contrast Media/chemistry , Infant, Newborn/blood , Iodine/adverse effects , Neonatal Screening/methods , Congenital Hypothyroidism/blood , Congenital Hypothyroidism/chemically induced , Female , Gestational Age , Humans , Iodine/administration & dosage , Maternal-Fetal Exchange , Pregnancy , Prenatal Exposure Delayed Effects , Retrospective Studies , Thyrotropin/blood , Thyroxine/blood , Tomography, X-Ray Computed , Triiodothyronine/bloodABSTRACT
The literature contains a substantial amount of information about factors that adversely influence the linear growth in up to 85% of patients undergoing haematopoietic SCT (HSCT) with TBI and/or cranial irradiation (CI) for acute leukaemia (AL). By contrast, only a few studies have evaluated the impact of growth hormone (GH) therapy on growth rate and final height (FH) in these children. We evaluated growth rates during the pre- and post-transplant periods to FH in a group of 25 children treated with HSCT (n=22), TBI (n=21) or/and CI (n=8) for AL and receiving GH therapy. At the start of GH treatment, the median height Z-score was -2.19 (-3.95 to 0.02), significantly lower than at AL diagnosis (P<0.001). Overall height gain from start of GH treatment to FH was 0.59Z (-2.72 to 2.93) with a median height Z-score at FH of -1.35 (-5.35 to 0.27). This overall height gain effect was greater in girls than in boys (P=0.04). The number of children with heights in the reference population range was greater after than before GH therapy (P=0.07). At FH the GVHD and GH treatments lasting <2 years were associated with shorter FH (P=0.02 and 0.05). We found a measurable beneficial effect of GH treatment on growth up to FH.
Subject(s)
Body Height/drug effects , Body Height/radiation effects , Cranial Irradiation/adverse effects , Hematopoietic Stem Cell Transplantation/adverse effects , Human Growth Hormone/administration & dosage , Leukemia, Myeloid, Acute/therapy , Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy , Whole-Body Irradiation/adverse effects , Child , Child, Preschool , Female , Follow-Up Studies , Human Growth Hormone/deficiency , Humans , Infant , Male , Retrospective StudiesABSTRACT
The management of immune diseases in children remains challenging, although significant advances have been made. In addition to pharmacological approaches, extracorporeal photochemotherapy (ECP) is distinctive in its ability to provide immunomodulation without immune suppression or toxicity. However, in practice, this therapy is not widely used because of logistical issues and the lack of robust clinical pediatric studies. Here, we discuss the potential clinical applications of ECP in children and emphasize the need for a rigorous and specifically pediatric clinical evaluation of ECP.
Subject(s)
Autoimmune Diseases/therapy , Graft vs Host Disease/therapy , Immunosuppression Therapy/methods , Photopheresis , Child , Evidence-Based Medicine , Humans , Treatment OutcomeABSTRACT
PURPOSE: The aim of this retrospective study was to describe the prevalence of metabolic abnormalities among obese children. PATIENTS AND METHODS: Two hundred and forty-four obese children were referred in our center between 2003 and 2007. The frequency of metabolic syndrome (MS) was assessed with the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) criteria. Insulin resistance was defined as a Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) greater than the 75th percentile. RESULTS: Around 95.9% of the children had abdominal obesity, 38.1% had systolic hypertension, 19.3% diastolic hypertension, 12.3% hypertriglyceridemia, and 4.1% hypoHDLemia. Insulin resistance was present in 69.6% of children; 11.5% of children met the criteria for MS. Both the Z-score of the body mass index and the prevalence of metabolic abnormalities were higher in the group of the youngest children. CONCLUSION: The prevalence of metabolic abnormalities is high among overweight children, particularly in the youngest children. However, the management of obesity but not metabolic-specific intervention remains the priority.
