METABOLIC EMERGENCIES – PART II

Metabolic disorders can manifest especially in the neonatal and infant period by: hypoglycemia, heart failure, primary hyperlactacidemia, liver failure, untreatable convulsions, neurologic damage. The authors present the main manifestations of metabolic emergencies and their emergency treatment

Effect of the Lights4Violence intervention on the sexism of adolescents in European countries

Background: Sexism results in a number of attitudes and behaviors that contribute to gender inequalities in social structure and interpersonal relationships. The objective of this study was to evaluate the effectiveness of Lights4Violence, an intervention program based on promoting health assets to reduce sexist attitudes in young European people. Methods: We carried out a quasi-experimental study in a non-probabilistic population of 1146 students, aged 12–17 years. The dependent variables were the difference in the wave 1 and wave 2 values in the subscales of the Ambivalent Sexism Inventory: benevolent sexism (BS) and hostile sexism (HS). The effect of the intervention was evaluated through linear regression analyses stratified by sex. The models were adjusted by baseline subscales scores, socio-demographic and psychological variables. Results: In girls, we observed a decrease in BS in the intervention group compared to the control group (β = − 0.101; p = 0.006). In the wave2,, BS decreased more in the intervention group compared to the control group in girls with mothers with a low level of education (β = − 0.338; p = 0.001), with a high level of social support (β = − 0.251; p < 0.001), with greater capacity for conflict resolution (β = − 0.201; p < 0.001) and lower levels of aggressiveness (β = − 0.232, p < 0.001). In boys, the mean levels of HS and BH decreased in wave 2 in both the control and intervention groups. The changes observed after the wave 2 were the same in the control group and in the intervention group. No significant differences were identified between both groups. Conclusions: The implementation of the Lights4Violence was associated with a significant reduction in BS in girls, which highlights the potential of interventions aimed at supporting the personal competencies and social support. It is necessary to reinforce the inclusion of educational contents that promote reflection among boys about the role of gender and the meaning of the attributes of masculinity. Trial registration: Clinicaltrials.gov : NCT03411564. Unique Protocol ID: 776905. Date registered: 26-01-2018.The project “Lights, Camera and Action against Dating Violence” (Ligts4Violence) was funded by the European Commission Directorate-General Justice and Consumers Rights, Equality and Citizen Violence Against Women Program 2016 for the period 2017–2019 to promote healthy dating relationship assets among secondary school students from different European countries, under grant agreement No. 776905. It was also co-supported by the CIBER of Epidemiology and Public Health of Spain for its aid to the Gender-based Violence and Youth Research Program

METABOLIC EMERGENCIES – PART I

Often, patients with metabolic conditions (diseases caused by electrolytic unbalances, endocrine dysfunctions, inborn errors of metabolism) have symptoms similar to other emergencies, particularly as newborns and infants. The authors present the main emergencies: electrolytic unbalances – hypoglycemia, hyponatremia, metabolic acidosis and neonatal hypocalcemia; endocrine dysfunctions – suprarenal insuffi ciency and neonatal hypopituitarism; inborn metabolic diseases – acidosis, hyperglycemia/ hypoglycemia, hyperammoniemia, clinical symptoms associated to them, and recommended treatment

ETYHICAL ISSUES IN CYSTIC FIBROSIS

In recent decades, the rapid advances in the diagnosis and treatment of cystic fibrosis led to the emergence of ethical issues related to neonatal screening, gene therapy, organ transplantation, and fertility. Also, transition of patients with cystic fibrosis from pediatric to adult care is not only a professional but also an ethical issue. Understanding the ethical issues related to this condition is crucial to providing optimal care

NEWBORN SCREENING FOR RARE DISEASES IN THE NORTH-EAST PART OF ROMANIA: RESULTS OF THE NEWBORN SCREENING PROGRAM 2009-2012

Objective. To evaluate the Newborn Screening Program for rare diseases – congenital hypothyroidism (CH) and phenylketonuria (PKU) – in the north-east part of Romania from 2009 to 2012. Methods. To realize the transversal descriptive study, we studied the cohorts formed by the babies who were borne between 2009-2012 in the maternities situated in the north-east part of the country. The screening was performed for two diseases: phenylketonuria (PKU) and congenital hypothyroidism (CH). Thyroid stimulating hormone (TSH) and phenylalanine (Phe) were tested by fl uorometric assay. Newborns with abnormal screening results (TSH > 9 μIU/L, Phe > 3 mg/dl) were re-examined. Results. A total of 76,308 newborns were screened. From these, were detected 9 cases with CH and 5 cases with PKU. The incidence of CH was 1: 8,478 and of PKU1: 15,261, for the whole period. Conclusions. Newborn screening programme represent an important public health programme that allows early diagnosis and prevention of severe consequences for PKU and CH

THE ROLE OF NUTRITION IN BRAIN DEVELOPMENT

The brain is an organ that functions harmoniously special only through a balanced intake of biologically active substances. The phrase “food for brain” expresses the important role of nutrition in the development and energy supply of the brain. There is a brief presentation of data on the development of the brain, the existence and functionality of the microbiome-gut-brain axis and the impact of the key nutrients in these complex processes. The authors concluded that nutritional assistance to the pregnant woman since the onset of pregnancy, the prophylaxis of prematurity, the early prevention of the gut microbiome of infant through encouragement of natural birth and breast-feeding are necessary conditions for the development of the brain

ORAL MANIFESTATIONS IN CELIAC DISEASE CHILDREN

Celiac disease is a gluten-sensitive enteropathy induced by dietary wheat gliadin and related proteins in genetically susceptible individuals. About 50% of patients with celiac disease present atypical symptoms, one of them being oral manifestations represented by: dental enamel defects, recurrent aphthous ulcers, delayed eruption, cheilosis, oral lichen planus, atrophic glossitis, xerostomia. Dental enamel defects and recurrent aphthous stomatitis, atrophic glossitis, dry mouth syndrome are the most common oral manifestations of celiac disease. All these oral signs could help to early diagnosis of CD

VEGETARIAN DIET IN CHILDREN

Vegetarianism may have implications on the growth of children and adolescents. There are different types of vegetarian diets: some may be suitable for children, other defi cient in essential nutrients. If a vegetarian diet is done properly and includes fortifi ed foods it can promote health and reduce risk for major chronic diseases. Restriction or exclusion of products of animal nature can lead to low intake of essential nutrients

POLYMORPHISM OF THE CLINICAL SIGNS OF CELIAC DISEASE IN CHILDREN

Celiac disease (CD) is an autoimmune systemic condition caused by sensitivity to gluten in genetically predisposed patients. The clinical signs of CD are extremely diverse, ranging from the typical intestinal malabsorption syndrome (characterized by chronic diarrhea, abdominal distension and malnutrition) to atypical symptoms that may involve any system or organ: chronic constipation, increased level of liver enzymes, iron deficiency anemia, recurrent abdominal pain, neurological conditions, tooth enamel erosion. The authors report four pediatric cases diagnosed with various atypical forms of celiac disease: the form associated with recurrent abdominal pain and increased level of liver enzymes, and the form associated with chronic constipation, all accompanied by failure to thrive and one case of type I diabetes mellitus associated with celiac disease. To conclude with, pediatricians, gastroenterologists and general practitioners should be familiar with all the clinical forms of coeliac disease in order to be able to diagnose this childhood disease and thus prevent long-term complications like osteoporosis, infertility and intestinal lymphoma

CYSTIC FIBROSIS-RELATED DIABETES

Cystic fi brosis-related diabetes is an entity distinct from diabetes mellitus type 1 and 2, but with symptoms characteristic to them. Along with the extension of the life expectancy, the prevalence of diabetes increased in association with a more severe decline of the lung function and a poorer nutritional status in comparison to that of people with cystic fi brosis but without diabetes. The authors present current data regarding the prevalence and physiopathology of the disease, the clinical picture, and the useful examinations in establishing the diagnosis, the therapeutic possibilities and disease prognostic. We conclude that the early diagnosis and appropriate therapeutic interventions may diminish the negative impact of diabetes on the lung function and the nutritional status in cystic fi brosis