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1.
PLoS Negl Trop Dis ; 14(8): e0008435, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32817617

RESUMO

Noma is an orofacial gangrene affecting primarily children living in extreme poverty in remote parts of subtropical and tropical countries. Mortality and disability are high, and survivors often have physical and functional deformities resulting in stigma and isolation. Many healthcare professionals and primary healthcare workers where noma risk factors exist have no knowledge about noma and its implications. Public health measures to improve nutrition, immunizations, sanitation, and access to healthcare and measures to eliminate extreme poverty can lead to the eradication of noma. Research allocation has been insufficient to study the epidemiology, treatment, and prevention of noma. In a recent editorial by Hotez and colleagues in PLOS Neglected Tropical Diseases (NTDs), "What constitutes an NTD?" Noma is not included. The exclusion of noma from NTDs constitutes this preventable childhood disease as a neglected neglected disease. The purpose of this article is the inclusion of noma with the PLOS NTDs. Increased awareness and attention to noma can lead to the eradication of this disease affecting the world's most vulnerable.


Assuntos
Transtornos da Nutrição Infantil/complicações , Doenças Negligenciadas , Noma , Criança , Humanos , Pobreza , Fatores de Risco
2.
Medicine (Baltimore) ; 99(18): e19595, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32358344

RESUMO

To evaluate the effect of chronic malnutrition on the oral health of children aged 1 to 5 years.An observational, analytical, cross-sectional study was conducted and involved 82 children (12-71 months of age). Nutritional status was evaluated using anthropometric indicators and oral health status/caries prevalence was measured. Non-stimulated saliva was collected and flow rate and buffering capacity was measured.The mean dmft index was 1.38 for the adequately nourished children, 3.04 for those with mild malnutrition, 2.5 for those with moderate malnutrition and 2.4 for those with severe malnutrition. 69 of the 82 children had low to very low buffering capacity. No significant differences among the groups were found between malnutrition and age, buffering capacity or the dmft index (P > .05). However, significant differences in salivary flow were found among the different malnutrition categories (P < .05). Spearman correlation coefficient revealed a weak negative correlation between nutrition and salivary flow (r = -0.267).Malnutrition exerts a negative impact on the oral cavity of children and a reduction in salivary flow rate was observed with the increase in malnutrition. Diagnosing the effects of malnutrition in oral environment of children is important because it could improve the quality of life and give them an adequate treatment.


Assuntos
Transtornos da Nutrição Infantil/fisiopatologia , Cárie Dentária/epidemiologia , Saúde Bucal , Transtornos da Nutrição Infantil/complicações , Pré-Escolar , Doença Crônica , Estudos Transversais , Cárie Dentária/etiologia , Feminino , Humanos , Lactente , Masculino , Estado Nutricional , Prevalência , Saliva/metabolismo
5.
Glob Health Action ; 12(1): 1626184, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31232215

RESUMO

Background: Little is known about the long-term effects of early childhood undernutrition on adolescent cardiovascular disease risk and educational performance in low-income countries. We examined this in a rural Ugandan population. Objective: To investigate if stunting or wasting among children aged 2-5 years is associated with cardiovascular disease risk or educational achievement during adolescence. Methods: We conducted analyses using data from a cohort of children followed from early childhood to adolescence. Weight and height were measured in 1999-2000 when the children were 2-5 years of age and repeated in 2004/2005 and 2011. We compared cardiovascular disease risk parameters (mean blood pressure, lipids, HbA1c) and schooling years achieved in 2011 among 1054 adolescents categorised into four groups: those who experienced stunting or wasting throughout follow-up; those who recovered from stunting or wasting; those who were normal but later became stunted or wasted; and those who never experienced stunting or wasting from childhood up to adolescence. We controlled for possible confounding using multiple generalised linear regression models along with Generalised Estimating Equations to account for clustering of children within households. Results: Wasting was negatively associated with systolic blood pressure (-7.90 95%CI [-14.52,-1.28], p = 0.02) and diastolic blood pressure (-3.92, 95%CI [-7.42, -0.38], p = 0.03). Stunting had borderline negative association with systolic blood pressure (-2.90, 95%CI [-6.41, 0.61] p = 0.10). Recovery from wasting was positively associated with diastolic blood pressure (1.93, 95%CI [0.11, 3.74] p = 0.04). Stunting or wasting was associated with fewer schooling years. Conclusion: Recovery from wasting rather than just an episode in early childhood is associated with a rise in blood pressure while educational achievement is compromised regardless of whether recovery from undernutrition happens. These findings are relevant to children exposed to undernutrition in low-income settings.


Assuntos
Doenças Cardiovasculares/etiologia , Transtornos da Nutrição Infantil/complicações , Escolaridade , Transtornos do Crescimento/complicações , Nível de Saúde , Pobreza/estatística & dados numéricos , População Rural/estatística & dados numéricos , Adolescente , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Masculino , Estudos Retrospectivos , Fatores de Risco , Uganda
6.
Arch Argent Pediatr ; 117(3): e211-e217, 2019 06 01.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31063303

RESUMO

Introduction: Children with congenital heart diseases (CHDs) suffer from malnutrition because of nutritional deficiencies, being short stature the possible long-term consequence. Objective: To describe the presence of short stature among children undergoing cardiac surgery for CHDs. Population and methods: Retrospective study. Children undergoing cardiac surgery with cardiopulmonary bypass pump between 2009 and 2013 were included. Preterm infants, carriers of genetic syndromes or other disease with nutritional compromise were excluded. Demographic data, type of CHD, admission surgery and anthropometric assessment using the WHO standards were studied. Short stature was defined as lenght/height for age Z score < -2 standard deviations, by sex. Results: A total of 640 children were studied; 361 (56.4 %) were boys; median age: 8 months (IQR: 1.9; 34.6); 66 children underwent > 1 surgery; 27 of them (40.9 %) had hypoplasia of the left ventricle. There were 358 (55.9 %) infants with cyanotic CHDs, 196 (30.6 %) with univentricular physiology. The median HAZ was -0.9 (IQR: -1.9; -0.1); 135 (21.1 %) had a short stature, 11 % of newborn infants and 24.1 % of older than one month old. A higher frequency of short stature was observed in 4 out of 6 children who underwent complete repair of the atrioventricular canal, in 15 out of 39 infants with repair of tetralogy of Fallot, in 8 out of 25 infants with hypoplasia of the left ventricle subjected to Glenn procedure, and in 34 out of 103 with closure of the ventricular septal defect. No association or statistically significant difference was found between short stature and cyanosis or univentricular physiology. Conclusions: There is a high frequency of short stature among children with CHDs, with differences according to the type of CHD and cardiac surgery performed.


Assuntos
Procedimentos Cirúrgicos Cardíacos/métodos , Transtornos do Crescimento/epidemiologia , Cardiopatias Congênitas/cirurgia , Comunicação Interventricular/cirurgia , Estatura , Transtornos da Nutrição Infantil/complicações , Pré-Escolar , Feminino , Transtornos do Crescimento/etiologia , Cardiopatias Congênitas/fisiopatologia , Comunicação Interventricular/epidemiologia , Humanos , Lactente , Transtornos da Nutrição do Lactente/complicações , Recém-Nascido , Masculino , Estudos Retrospectivos
7.
Am J Trop Med Hyg ; 101(1): 242-252, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31074407

RESUMO

Anemia is known to impact a child's growth and development, but not all anemias are caused by iron deficiency, and the CDC and WHO have emphasized investigating other contributors to anemia. This cross-sectional sub-study of a 2012-2016 maternal-child cohort in coastal Kenya evaluated 244 children and found 185 (76%) to have been anemic on at least one time point since birth. At the time of assessment in 2016, evaluation included a complete blood count, nutritional assessment, and testing for parasitic infections, focusing on the primary outcome of anemia, defined as hemoglobin (Hb) < 11 g/dL. The average age at assessment was 20.5 ± 7 months. Ninety-five percent had a lifetime average Hb in the anemic range. Adjusting for age and gender, prior or current malaria infection (prior: Hb ß = -0.99, 95% CI: -1.49 to -0.49, P = 0.01), or having any current infection with hookworm, Trichuris, Strongyloides, Ascaris, and/or malaria (ß = -0.84, 95% CI: -1.36 to -0.33, P = 0.01) was associated with decreased current Hb. Nutritional evaluation revealed that children with a declining Hb ate fewer vitamin-A-rich vegetables per week (P = 0.01) or eggs (P = 0.01), drank more milk (P = 0.07), and ate more bread (P = 0.01), and were more likely to live in a household that experienced food shortage (P = 0.05). The high prevalence of anemia, polyparasitism, and dietary insufficiency among children in rural coastal Kenya suggests that remedial interventions will need to address both diet and parasitic infections to effectively combat this significant health threat.


Assuntos
Anemia/epidemiologia , Anemia/etiologia , Transtornos da Nutrição Infantil/complicações , Helmintíase/complicações , Malária/complicações , Pré-Escolar , Estudos de Coortes , Estudos Transversais , Feminino , Helmintíase/epidemiologia , Humanos , Lactente , Quênia/epidemiologia , Malária/epidemiologia , Masculino , Estado Nutricional , Prevalência , Fatores Socioeconômicos
8.
J Pak Med Assoc ; 69(5): 722-724, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31105296

RESUMO

A 12-year-old boy who underwent gastric wedge resection was transferred to our hospital because of vomiting, growth failure, and weight loss in January, 2016. We tried to restore his general condition by maintaining additional nutritional supply through peripheral parenteral nutrition (PN). However, continuous vomiting, weight loss, and superior mesenteric artery syndrome persisted because of low treatment compliance. The findings of hyponatraemia and bicytopenia did not improve. Bone marrow biopsy was performed, and it revealed copper deficiency. PN with additional micronutrient agents, including copper, were administered. In particular, invasive diagnosis and treatment, and adequate education improved the treatment compliance of the child. His copper deficiency and bicytopenia improved, and his weight and dietary intake also increased. We confirmed that treatment compliance is important in paediatric patients with malnutrition. In chronic malnutrition, attention should also be paid to deficiency of micronutrients such as copper, which can lead to haematologic problems.


Assuntos
Anemia/etiologia , Transtornos da Nutrição Infantil/complicações , Cobre/deficiência , Deficiências Nutricionais/complicações , Leucopenia/etiologia , Anorexia , Criança , Transtornos da Nutrição Infantil/terapia , Doença Crônica , Deficiências Nutricionais/terapia , Suplementos Nutricionais , Nutrição Enteral , Gastrectomia , Humanos , Ileostomia , Masculino , Nutrição Parenteral , Cooperação do Paciente , Síndrome da Artéria Mesentérica Superior , Vômito , Perda de Peso
9.
Int J Pediatr Otorhinolaryngol ; 122: 105-110, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30999158

RESUMO

INTRODUCTION: The age-based formula is commonly used to predict tracheal tube (TT) sizes although its inaccuracy has been reported to reach as high as 60%. We aim to determine a practical formula using age in months and weight in kilograms to predict uncuffed tracheal tube (TT) size in children and infants. METHODS: A retrospective cross-sectional study was conducted on data obtained from a prospective study on children aged less than 9 years who came for elective surgery and received general anesthesia with oroendotracheal tube intubation at Songklanagarind Hospital between September 2008 and December 2012. The uncuffed TT sizes were based on the age-based formulae and the discretion of the attending anesthesiologist. The age (in months), weight (in kg), and final TT size were measured. Univariate and multivariate linear regression analyses were used to find potential predictors of final uncuffed TT size and therefore the best formula. The correlation coefficient (r) for each model was calculated. The kappa statistic was used to measure the agreement between predicted and actual TT size. RESULTS: A total of 668 patients were recruited. The age/weight formulae for infants aged ≤12 months and children aged >12 months were 3.15 + (age [months] × 0.05) + (weight [kg] × 0.05) with r value of 0.75 (n = 216) and 3.83 + (age [months] × 0.017) + (weight [kg] × 0.017) with r value of 0.85 (n = 452), respectively. The formulae correctly predicted 69.0% and 65.0% of actual TT sizes for infants and children, respectively (both p < 0.001). The formulae for malnourished infants and children whose weights were less than the 3rd percentile for age were 2.70 + (weight [kg] × 0.21) (n = 43) and 3.59 + (age [months] × 0.012) + (weight [kg] × 0.056) (n = 105) with r values of 0.81 and 0.87, respectively. CONCLUSION: The age/weight formula can be used to estimate TT size in infants and children. In failure to thrive children, our formula for malnourished children and infants provided high correlation with final TT sizes.


Assuntos
Peso Corporal , Intubação Intratraqueal/instrumentação , Fatores Etários , Anestesia Geral , Criança , Transtornos da Nutrição Infantil/complicações , Pré-Escolar , Estudos Transversais , Procedimentos Cirúrgicos Eletivos , Feminino , Humanos , Lactente , Transtornos da Nutrição do Lactente/complicações , Masculino , Conceitos Matemáticos , Estudos Retrospectivos
10.
Dev Med Child Neurol ; 61(10): 1175-1181, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-30937885

RESUMO

AIM: To develop and validate a screening tool for feeding/swallowing difficulties and/or undernutrition in children with cerebral palsy (CP). METHOD: This cross-sectional, observational study included 89 children with CP (63 males, 26 females; median age 6y 0mo; interquartile range 4y 0mo-8y 11mo), across all Gross Motor Function Classification System levels. Children with feeding tubes were excluded. Children were classified as well-nourished or moderately to severely undernourished, using the paediatric Subjective Global Nutrition Assessment. Eating and drinking abilities were classified using the Eating and Drinking Ability Classification System (EDACS) from mealtime observation and videofluoroscopic swallow studies when indicated. Parents/caregivers answered 33 screening questions regarding their child's feeding/swallowing abilities and nutritional status. The diagnostic ability of each question for identifying children with feeding/swallowing difficulties and undernutrition was calculated and the combination of questions with the highest sensitivity and specificity identified. RESULTS: Feeding difficulties impacted on swallow safety in 26 children (29%) and 26 children (29%) were moderately or severely undernourished. The 4-item final tool had high sensitivity and specificity for identifying children with feeding/swallowing difficulties (81% and 79% respectively) and undernutrition (72% and 75% respectively). The tool successfully identified 100 per cent of children with severe undernutrition and 100 per cent of those classified as EDACS level IV or V. INTERPRETATION: Screening for feeding/swallowing difficulties and undernutrition will enable early identification, assessment, and management for those children in need. WHAT THIS PAPER ADDS: A screening tool with high sensitivities and specificities for identifying children with feeding/swallowing difficulties and undernutrition. The tool identified 100 per cent of children with severe undernutrition. The tool identified 100 per cent of children in Eating and Drinking Ability Classification System levels IV or V.


Assuntos
Paralisia Cerebral/diagnóstico , Transtornos da Nutrição Infantil/diagnóstico , Transtornos de Deglutição/diagnóstico , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Inquéritos e Questionários/normas , Paralisia Cerebral/complicações , Criança , Transtornos da Nutrição Infantil/complicações , Pré-Escolar , Estudos Transversais , Transtornos de Deglutição/complicações , Avaliação da Deficiência , Transtornos da Alimentação e da Ingestão de Alimentos/complicações , Feminino , Humanos , Masculino , Estudos Prospectivos , Sensibilidade e Especificidade
11.
Dev Med Child Neurol ; 61(10): 1168-1174, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-30927269

RESUMO

AIM: To evaluate the diagnostic performance of anthropometric indicators to identify undernutrition in children with cerebral palsy (CP). METHOD: The present study was a monocentric retrospective analysis of prospectively collected data among children and adolescents with CP participating in a rehabilitation program. Undernutrition was defined as a z-score for dual-energy X-ray absorptiometry (DXA) determined body fat percentage less or equal to -2.0. The cut-off values for body mass index (BMI) of the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC), and the cut-off values for BMI and height for age of the Robert Koch Institut (RKI) were evaluated. RESULTS: In total, 329 children with CP (181 males, 148 females, Gross Motor Function Classification System levels I-V) were eligible for analysis. The mean age was 12 years 4 months (SD 2y 9mo). The BMI cut-off values showed the following sensitivities and specificities: WHO, sensitivity of 0.474 (95% confidence interval [CI] 0.244-0.711), specificity of 0.897 (95% CI: 0.857-0.928); CDC, sensitivity of 0.632 (95% CI: 0.384-0.837), specificity of 0.819 (95% CI: 0.772-0.861); RKI, sensitivity of 0.789 (95% CI: 0.544-0.939), specificity of 0.732 (95% CI: 0.679-0.781); and for height for age, sensitivity of 0.263 (95% CI: 0.091-0.512), specificity of 0.668 (95% CI: 0.612-0.720). INTERPRETATION: BMI had a high specificity but very low sensitivity in identifying undernutrition in children with CP. Z-scores for height for age had even lower specificity and sensitivity and seemed not to be appropriate for predicting undernutrition in children with CP. WHAT THIS PAPER ADDS: Body mass index (BMI) z-scores had a high specificity but very low sensitivity in identifying undernutrition in children with cerebral palsy (CP). Height z-scores were not appropriate for predicting undernutrition in children with CP. Undernutrition assessed by BMI was overestimated in children with CP versus when assessed by dual-energy X-ray absorptiometry (DXA).


Assuntos
Paralisia Cerebral/complicações , Transtornos da Nutrição Infantil/diagnóstico , Antropometria , Índice de Massa Corporal , Criança , Transtornos da Nutrição Infantil/complicações , Feminino , Humanos , Masculino , Estudos Retrospectivos , Sensibilidade e Especificidade
12.
Nutr Clin Pract ; 34(4): 581-588, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30644589

RESUMO

OBJECTIVES AND STUDY: Failure to thrive (FTT) is an interruption in the normal pattern of growth. We aimed to evaluate the clinical characteristics, underlying etiologies, diagnostic workup, and frequency of micronutrient deficiencies (MDs) in children with FTT. METHODS: This retrospective study was done with 729 children (319 male, mean age 6.8 ± 5.5 years) with FTT (weight for age <3rd percentile) who had visited the Pediatric Gastroenterology outpatient clinic between 2011 and 2016. Children who had previously known chronic diseases, inadequate intake, or inadequate absorption were excluded. Acute malnutrition was considered if weight-for-age z-scores were below -2 and height-for-age z-scores were above -2, and chronic malnutrition was defined if height-for-age z-scores were below -2. RESULTS: The malnutrition rate was 57.1% (acute: 37.8%, chronic: 19.3%). Of children, 98.7% had laboratory evaluation. We found that 1.1% of laboratory tests, 0.4% of imaging studies, 27% of endoscopic findings, and biopsy results led to a specific diagnosis, equating to a total of 1.3% of diagnostic workup leading to a diagnosis related to FTT. The causes of FTT were inadequate nutrition (61.4%), psychiatric and behavioral disorders (17.2%), endocrinologic disorders (9%), recurrent infections (6.4%), gastrointestinal diseases (1.9%), and cardiac disorders (0.1%). Vitamin A and D deficiencies were the most common MD. CONCLUSION: We showed that the most common cause of FTT is "purely nutrition" FFT because of inadequate caloric intake, and extensive diagnostic workup is rarely helpful to reveal the etiology. These results implicate the importance of clinical evaluation and anthropometry to evaluate a child with FTT.


Assuntos
Transtornos da Nutrição Infantil/diagnóstico , Insuficiência de Crescimento/diagnóstico , Gastroenteropatias/diagnóstico , Micronutrientes/deficiência , Criança , Transtornos da Nutrição Infantil/complicações , Pré-Escolar , Diagnóstico Diferencial , Insuficiência de Crescimento/etiologia , Feminino , Gastroenteropatias/etiologia , Humanos , Masculino , Estudos Retrospectivos
13.
Public Health Nutr ; 22(5): 862-871, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30501655

RESUMO

OBJECTIVE: To investigate whether children with concurrent wasting and stunting require therapeutic feeding and to better understand whether multiple diagnostic criteria are needed to identify children with a high risk of death and in need of treatment. DESIGN: Community-based cohort study, following 5751 children through time. Each child was visited up to four times at 6-month intervals. Anthropometric measurements were taken at each visit. Survival was monitored using a demographic surveillance system operating in the study villages. SETTING: Niakhar, a rural area of the Fatick region of central Senegal.ParticipantsChildren aged 6-59 months living in thirty villages in the study area. RESULTS: Weight-for-age Z-score (WAZ) and mid-upper arm circumference (MUAC) were independently associated with near-term mortality. The lowest WAZ threshold that, in combination with MUAC, detected all deaths associated with severe wasting or concurrent wasting and stunting was WAZ <-2·8. Performance for detecting deaths was best when only WAZ and MUAC were used. Additional criteria did not improve performance. Risk ratios for near-term death in children identified using WAZ and MUAC suggest that children identified by WAZ <-2·8 but with MUAC≥115 mm may require lower-intensity treatment than children identified using MUAC <115 mm. CONCLUSIONS: A combination of MUAC and WAZ detected all near-term deaths associated with severe anthropometric deficits including concurrent wasting and stunting. Therapeutic feeding programmes may achieve higher impact if WAZ and MUAC admission criteria are used.


Assuntos
Transtornos da Nutrição Infantil/diagnóstico , Transtornos do Crescimento/mortalidade , Desnutrição/diagnóstico , Programas de Rastreamento/métodos , População Rural , Síndrome de Emaciação/mortalidade , Antropometria , Braço , Estatura , Peso Corporal , Transtornos da Nutrição Infantil/complicações , Transtornos da Nutrição Infantil/mortalidade , Pré-Escolar , Estudos de Coortes , Feminino , Transtornos do Crescimento/complicações , Humanos , Lactente , Masculino , Desnutrição/complicações , Desnutrição/mortalidade , Medição de Risco , Fatores de Risco , Senegal , Síndrome de Emaciação/complicações
14.
Nutrition ; 57: 46-51, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30149240

RESUMO

OBJECTIVE: The aim of this study was to assess whether the nutritional status of children with cancer is influenced by variations in cytokine concentrations observed during chemotherapy. We also evaluated whether this relationship could be modified by nutritional status at diagnosis and type of cancer. METHODS: Mexican children with lymphoma or solid tumors were evaluated at diagnosis and at 2- and 6-mo follow-up visits. Blood samples were obtained to determine serum prealbumin, tumor necrosis factor (TNF)-α, interleukin (IL)-6, leptin concentrations, and hemoglobin. Children were classified as undernourished (UN) or well nourished (WN), according to prealbumin concentration. The influence of each cytokine on prealbumin concentration was analyzed by time-series regression model. RESULTS: Fifty patients (ages 2-17 y) were enrolled. There were 17 children with lymphomas and 33 with solid tumors. At baseline, 56% were UN and 26% presented anemia; the frequencies of UN children were higher for those with lymphoma than for those with a solid tumor (P = 0.003). By nutritional status, UN children presented lower leptin (P = 0.002) but higher IL-6 concentrations (P = 0.009) than the WN group. Children with lymphoma presented lower prealbumin (P = 0.003), but higher TNF-α (P = 0.001) and IL-6 (P = 0.011) concentrations than those with solid tumors. At follow-up, the concentration of prealbumin increased and IL-6 decreased in children with lymphoma. Multivariate analysis demonstrated that decreases in prealbumin concentration at the end of follow-up were associated with increases in IL-6 and TNF-α concentration during chemotherapy. CONCLUSIONS: These results suggest that the cytokine responses during chemotherapy are related to nutritional status at the end of 6 mo of treatment regardless of the initial nutritional status and the type of cancer.


Assuntos
Transtornos da Nutrição Infantil/sangue , Transtornos da Nutrição Infantil/complicações , Citocinas/sangue , Neoplasias/sangue , Neoplasias/tratamento farmacológico , Estado Nutricional , Adolescente , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Masculino , México , Neoplasias/complicações
15.
Head Neck Pathol ; 13(4): 722-726, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30120720

RESUMO

Smooth muscle tumors associated with Epstein-Barr virus infections (EBV-SMT) of laryngeal origin are exceedingly rare and have been reported in few adult patients, but not in children. This reported case describes a lesion found in the larynx of an 8-year-old Guatemalan undernourished girl. Microscopically, the lesion showed a highly cellular mesenchymal spindle cell tumor, containing frequent lymphocytes. The immunohistochemical analysis revealed positivity for α-smooth muscle actin and h-caldesmon. In addition, most of the tumor cells were positive for EBV by in situ hybridization. To the best of the author's knowledge, this is the first literature-reported case of laryngeal EBV-SMT occurring in an undernourished child.


Assuntos
Transtornos da Nutrição Infantil/complicações , Neoplasias Laríngeas/patologia , Neoplasias Laríngeas/virologia , Tumor de Músculo Liso/patologia , Tumor de Músculo Liso/virologia , Criança , Infecções por Vírus Epstein-Barr/complicações , Feminino , Humanos
17.
Pan Afr Med J ; 34: 145, 2019.
Artigo em Francês | MEDLINE | ID: mdl-32110264

RESUMO

Introduction: The consequences of severe acute malnutrition are measured in terms of health and survival, but also of cognitive development, its productivity and the overall national economy. Its management requires enormous financial resources. The purpose of this study was to assess the effectiveness of treating severe acute malnutrition versus cost of treatment of severe acute malnutrition in children. Methods: We conducted a retrospective study of 199 children aged 0-59 months admitted to the Centre for Nutritional Recovery and Education in Kaya, Burkina Faso, from January to December 2014. The cost of treatment, the length of stay in the Centre for Nutritional Recovery and Education, daily weight gain and the speed of recovery were analyzed based on the standards calculation methods. Mann-Whitney test and Kruskall-Wallis test were used to compare the medians (0.05 threshold). Results: As expected, children aged 6-23 months were the most affected (51.8%) and acute respiratory infections were the most associated diseases (57.9%). The median length of stay in the Centre for Nutritional Recovery and Education was 9.0 (7.0-13.0) days, the mean speed of recovery was 100.0 (65.8 - 143.3) g/day and the average daily weight gain was 18.1 (11.6 - 27.7) g/kg/day. The average cost of treatment in a malnourished child is estimated to be 15 715,3 FCFA (25.2 USD). Conclusion: The cost of treatment is hardly affordable by the parents of malnourished children; hence the necessity for government and development partners interventions.


Assuntos
Transtornos da Nutrição Infantil/terapia , Hospitalização/estatística & dados numéricos , Transtornos da Nutrição do Lactente/terapia , Desnutrição Aguda Grave/terapia , Burkina Faso/epidemiologia , Transtornos da Nutrição Infantil/complicações , Transtornos da Nutrição Infantil/economia , Pré-Escolar , Feminino , Custos Hospitalares , Humanos , Lactente , Transtornos da Nutrição do Lactente/complicações , Transtornos da Nutrição do Lactente/economia , Recém-Nascido , Tempo de Internação , Masculino , Estudos Retrospectivos , Desnutrição Aguda Grave/complicações , Desnutrição Aguda Grave/economia , Ganho de Peso
18.
Pediatr Ann ; 47(11): e465-e469, 2018 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-30423190

RESUMO

Traditionally, nutritional risk has been defined by growth failure, with clinical intervention indicated when a child falls below the third to fifth percentile on growth charts. Although the velocity of linear growth and weight gain during the first years are unparalleled at any other time of life, this period is also unique for other reasons. Nutrition not only supports increased bone length, muscle mass, and tissue growth, but also continued development of several highly metabolic organs such as the gastrointestinal tract, the immune system, the cardiorespiratory system, the kidneys, and the central nervous system. Just as growth depends on consistent nutrients, so too does organ development, especially the brain. The undernourished child may exhibit compromised optimal development and future cognitive performance, irrespective of weight status. It is often challenging in early childhood to ensure that a child is receiving high-quality nutrition. Primary care clinicians are positioned to identify the child with potential nutritional risk and design an appropriate intervention that promotes optimal development. [Pediatr Ann. 2018;47(11):e465-e469.].


Assuntos
Desenvolvimento Infantil/fisiologia , Transtornos da Nutrição Infantil/diagnóstico , Insuficiência de Crescimento/diagnóstico , Atenção Primária à Saúde/métodos , Transtornos da Nutrição Infantil/complicações , Pré-Escolar , Insuficiência de Crescimento/etiologia , Gráficos de Crescimento , Humanos , Lactente , Fenômenos Fisiológicos da Nutrição do Lactente , Necessidades Nutricionais , Estado Nutricional , Medição de Risco/métodos
19.
PLoS One ; 13(10): e0200435, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30286087

RESUMO

INTRODUCTION: Human immunodeficiency virus and protein energy malnutrition are still prevalent in Nigeria and the occurrence of the two conditions together confers a poor prognosis. The aim of this study was to determine the current categories of malnutrition amongst under-5 children in Lagos, document their HIV status and determine any peculiarities in the clinical features, haematological and some biochemical profile in these children. METHODS: The study was a cross-sectional study conducted at the Paediatric departments of the Lagos University Teaching Hospital and the Massey Street Children's Hospital, both in Lagos, over a 6-month period. All the subjects had anthropometry, HIV testing, full blood count and serum proteins done. The factors associated with HIV status were determined with the logistic regression analysis. RESULTS: Two hundred and fourteen (214) malnourished children ≤5 years, including 25 (11.7%) with HIV were recruited in the study. Among the study participants, 150 (70.1%) and 54 (29.9%) had moderate and severe malnutrition, respectively. Fever, cough and diarrhea were the most common symptoms in the study participants. The haematological indices were comparable in the two groups, the serum globulin levels though higher in the HIV infected group was not statistically significantly different from the non-infected group.(p = 0.66). None of the factors explored on multivariate analysis was able to predict the occurrence of the infection in this cohort. CONCLUSION: Malnourished children remain a high risk group for HIV infection and the prevalence of the infection obtained in this group of children is still unacceptably high. Discriminatory features between malnutrition and HIV remains difficult. The presence of hyperglobulinaemia on laboratory analysis in a malnourished child may heighten the suspicion of possible underlying associated HIV infection. Screening of malnourished children for HIV infection and further longitudinal studies on malnourished children with HIV is advocated.


Assuntos
Transtornos da Nutrição Infantil/complicações , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Antropometria , Pré-Escolar , Estudos Transversais , Feminino , Soropositividade para HIV/complicações , Soropositividade para HIV/epidemiologia , Hospitais Pediátricos , Humanos , Lactente , Recém-Nascido , Masculino , Nigéria/epidemiologia , Prevalência , Prognóstico , Análise de Regressão , Centros de Atenção Terciária
20.
Arch. argent. pediatr ; 116(5): 684-687, oct. 2018. ilus
Artigo em Inglês, Espanhol | LILACS, BINACIS | ID: biblio-973674

RESUMO

Actualmente, el escorbuto es una entidad infrecuente en pediatría. Se han publicado reportes de casos que describen la enfermedad en lactantes alimentados con leche hervida, en pacientes con sobrecarga de hierro por enfermedades hematológicas y en niños con restricciones alimentarias por trastornos del neurodesarrollo. Se reporta el caso de un paciente masculino de 4 años con diagnóstico de trastorno del espectro autista que desarrolló la enfermedad por un hábito alimentario selectivo de larga evolución, sin ingesta de frutas ni verduras. La importancia del reporte radica en informar al pediatra y a otros profesionales dedicados a la atención primaria de salud acerca del desarrollo de escorbuto como potencial consecuencia de las dietas restrictivas en niños con trastornos del neurodesarrollo y de la trascendencia de la anamnesis alimentaria en pacientes con patología para evitar enfermedades asociadas a micronutrientes.


Scurvy is a very uncommon entity in pediatric population. Some case reports have been published in infants fed with boiled milk, in patients with iron overload secondary to hematological diseases and in children with food restrictions secondary to neurodevelopmental disorders. We report a case of a 4-year-old male patient with a diagnosis of autism spectrum disorder, which developed scurvy secondary to a long-term selective eating habit without fruit or vegetable intake. The objective of this case report is to announce the pediatrician and other professionals dedicated to primary health care about scurvy as a potential consequence of restrictive diets in children with autism spectrum disorders as well as the importance of dietary history in sick patients to prevent associated micronutrient deficiencies.


Assuntos
Humanos , Masculino , Pré-Escolar , Escorbuto/diagnóstico , Transtornos da Nutrição Infantil/complicações , Comportamento Alimentar , Transtorno do Espectro Autista/psicologia , Escorbuto/etiologia , Transtornos da Nutrição Infantil/etiologia , Transtorno do Espectro Autista/complicações
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