Report on advances for pediatricians in 2018: allergy, cardiology, critical care, endocrinology, hereditary metabolic diseases, gastroenterology, infectious diseases, neonatology, nutrition, respiratory tract disorders and surgery.

This review reported notable advances in pediatrics that have been published in 2018. We have highlighted progresses in allergy, cardiology, critical care, endocrinology, hereditary metabolic diseases, gastroenterology, infectious diseases, neonatology, nutrition, respiratory tract disorders and surgery. Many studies have informed on epidemiologic observations. Promising outcomes in prevention, diagnosis and treatment have been reported. We think that advances realized in 2018 can now be utilized to ameliorate patient car

Addressing the double burden of malnutrition in Egypt: do conditional cash transfers have a role?

Many developing countries are undergoing rapid socio-economic changes that impact on health and its social distribution. These changes can occur so rapidly that there is a resulting co-existence of diseases of affluence and diseases of poverty. Priority setting for nutritional programs has focused on the alleviation of undernutrition in low income settings. However, evidence shows that in many Low-and-Middle Income Countries the prevalence of obesity among women is increasing and can coexist with childhood stunting. This dual burden of poor nutrition contributes to worsening health inequity between the poor and the rich. Global and national policy makers are looking for novel programs to replace social protection mechanisms deemed inefficient. Conditional Cash Transfer (CCT) programs have emerged as an increasingly popular poverty alleviation strategy with some positive results. However, there is evidence they may have a negative impact if the complexity of transition settings is not taken into account. In this paper, we review the nutritional situation in Egypt and compare two CCT programs (Mexico and Colombia) in an attempt to identify features that would address both child undernutrition and adult overnutrition. We conclude with suggestions for design of an Egyptian CCT program that would help maximise benefit to its beneficiaries

Enhanced post-natal growth is associated with elevated blood pressure in young Senegalese adults

Background Evidence suggests that intrauterine growth restriction followed by rapid post-natal growth is associated with high blood pressure. We assessed the effect of early size and post-natal growth on blood pressure in a population from West Africa, where fetal growth retardation and childhood malnutrition are common. Methods A total of 1288 Senegalese subjects were followed from infancy to young adulthood (mean age 17.9 years). Adult systolic blood pressure (SBP) was regressed on infant and adult anthropometric characteristics. Results In unadjusted analyses, infant size was positively associated with adult SBP (1.1 +/- 03; P = 0.001 for weight; 0.7 +/- 0.3; P = 0.04 for length). With adjustment for current size, the regression coefficients for infant size were reversed (-0.2 +/- 0.3; P = 0.51 for weight; -0.3 +/- 0.3; P = 0.35 for length). SBP increased by 4.1 and 2.9 mmHg for 1 standard deviation (SD) increase in current weight or height, respectively. No interaction between infant size and current size was found in the overall models (P = 0.11 for weight, P = 0.95 for height), but this term interacted with sex for weight effect. A negative interaction was found in males (-0.9 +/- 0.4; P = 0.02) but not in females (0.3 +/- 0.4; P = 0.46). The association of current weight with SBP was stronger in lighter weight male infants. Conclusions These findings support the hypothesis that subjects who were small in early life and experienced enhanced post-natal growth have higher levels of SBP, even in low-income settings

The life cycle of malnutrition: IFPRI 1999-2000 Annual Report Essay

This year some 30 million babies in the developing world—around 82,000 every day—will be born with impaired growth due to poor nutrition during fetal life. term. The authors examine each stage of the life cycle, from birth and infancy to childhood, adolescence, adulthood, and old age. In developing countries the main direct causes of intrauterine growth retardation (IUGR) are nutritional. IUGR infants are more likely to become stunted children. Data on the nutritional status of school-age children are increasingly being collected, as evidence mounts linking malnutrition or hunger with poor school attendance, performance, and learning. The economic livelihood of populations depends on the health and nutritional well-being of adults. Recent multicountry studies have shown significant malnutrition among older adults. Vicious circles—such as the life cycle of malnutrition—based as they are on mutually reinforcing processes, can be transformed into virtuous circles by more consistently and effectively applying our growing knowledge of what works, and where, in combating malnutrition. While preventing fetal and early childhood malnutrition deserves particular attention, the life cycle dynamics of cause and consequence demand a holistic, inclusive approach to malnutrition. Adequate nutrition is a human right for all people, and intervening at each point in the life cycle will accelerate and consolidate positive change.Malnutrition Prevention., Nutrition Research.,

Secular Trends in Physiological Capital: Implications for Equity in Health Care

Over the past three centuries there has been a rapid accumulation of physiological capital in OECD countries. Enhanced physiological capital is tied to long-term reduction in environmental hazards and to the conquest of chronic malnutrition. Data on heights and birth weights suggests that physiological capital has become more equally distributed, thereby reducing socioeconomic disparities in the burden of disease. Implications for health care policy are: (1) enhanced physiological capital has done more to reduce inequities in health status than has wider access to health care; (2) the main contribution of more advanced medical treatment so far has been to retard depreciation in individuals' physiological capital; (3) prenatal and early childhood care and environmental issues are key for interventions aimed at enhancing physiological capital and at affecting its rate of depreciation; (4) lifestyle change is the most important issue affecting health equity in rich countries; and (5) greater access to clinical care should be promoted through aggressive outreach, since expanded insurance coverage by itself is inadequate.