Cardiometabolic Risk Profile and its Relation with the Waist Circumference to Height Ratio in Turkish School-Age Children

Background: Obesity, cardiovascular diseases and diabetes have been rapidly increasing in pediatric age group all around the world. Therefore, cardiometabolic risk factors (CMRF) should be carefully screened beginning from the school ages. The aim of this study was to define the CMRF and to determine their correlations with the weight for height ratios (WHtR) in Turkish school-age children. Methods: 6-12 year-old, 310 overweight children (150 females, 160 males) evaluated in the pediatry outpatient clinic of Kartal Koşuyolu Research and Training Hospital between January, 2016-February, 2017 were enrolled in this cross-sectional study. Their weights, heights, waist circumferences (WC) and blood pressures were recorded; body mass indices (BMI) and WHtR were calculated; blood glucose, cholesterol and triglyceride levels were analyzed. Children with BMI ≥ 85th percentile were accepted as overweight. The correlations between the CMRF, age and gender of children and their WHtR were analyzed statistically. Results: Dyslipidemia, increased BMI and WC were more common CMRF than hypertension and hyperglycemia in Turkish school-age children. CMRF had quite significant relationship with gender and moderately significant relation with age. Male children had higher lipid, glucose and blood pressure levels than females. Moreover, a significant association was demonstrated between the CMRF and WHtR in both gender. (p values <0.05). Conclusion: Male children carry higher cardiometabolic risk than their female counterparts. WHtR can be used to detect children with increased CMRF in pediatric outpatient clinics. It is important to take measures to prevent morbidity and mortality due to metabolic syndrome in adult life

Safety of hospital discharge before return of bowel function after elective colorectal surgery

Background: Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function.Methods: A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien-Dindo classification system.Results: A total of 3288 patients were included in the analysis, of whom 301 (9.2 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4-7) and 7 (6-8) days respectively (P &lt; 0.001). There were no significant differences in rates of readmission between these groups (6.6 versus 8.0 per cent; P = 0.499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0.90, 95 per cent c.i. 0.55 to 1.46; P = 0.659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34.7 versus 39.5 per cent; major 3.3 versus 3.4 per cent; P = 0.110).Conclusion: Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients