Risk factors that affect metabolic health status in obese children

BACKGROUND:While some obese children are metabolically healthy (MHO), some have additional health problems, such as hypertension, dyslipidemia, insulin resistance, and hepatosteatosis, which increase mortality and morbidity related to cardiovascular diseases (CVD) during adulthood. These children are metabolically unhealthy obese (MUO) children. In this study we assessed the factors that affect metabolic health in obesity and the clinical and laboratory findings that distinguish between MHO and MUO children.METHODS:In total, 1085 patients aged 6-18 years, with age- and sex-matched BMI exceeding the 95th percentile were included in the study (mean 11.1&plusmn;2.9 years, 57.6% female, 59.7% pubertal). Patients without dyslipidemia, insulin resistance, hepatosteatosis, or hypertension were considered as MHO. Dyslipidemia was defined as total cholesterol level over 200 mg/dL, triglyceride over 150 mg/dL, LDL over 130 mg/dL, or HDL under 40 mg/dL. Insulin resistance was calculated using the homeostasis model of assesment for insulin resistance (HOMA-IR) index. Hepatosteatosis was evaluated with abdominal ultrasound. Duration of obesity, physical activity and nutritional habits, screen time, and parental obesity were questioned. Thyroid and liver function tests were performed.RESULTS:Six hundred and forty-two cases (59.2%) were MUO. Older age, male sex, increased BMI-SDS, and sedentary lifestyle were associated with MUO. Excessive junk food consumption was associated with MUO particularly among the prepubertal obese patients.CONCLUSIONS:Our results revealed that the most important factors that affect metabolic health in obesity are age and BMI. Positive effects of an active lifestyle and healthy eating habits are prominent in the prepubertal period and these habits should be formed earlier in life.</p

Turkish Neonatal Society Guideline on fluid and electrolyte balance in the newborn

WOS: 000484450300006PubMed ID: 31236019Fluid and electrolyte balance and acid-base homeostasis are essential components of normal cellular and organ functions, both in the intrauterine and postnatal developmental period. Knowledge of physiologic changes and appropriate management are important aspects of neonatal intensive care. The aim is to ensure successful transition from the fetal to neonatal period and maintain a normal fluid-electrolyte and acid-base balance. In this paper, fluid and electrolyte requirements in the neonate, treatment of sodium and acid-base disorders on which some controversy exists, and also perioperative fluid-electrolyte management are reviewed

Turkish Neonatal Society Guideline on fluid and electrolyte balance in the newborn

Fluid and electrolyte balance and acid-base homeostasis are essential components of normal cellular and organ functions, both in the intrauterine and postnatal developmental period. Knowledge of physiologic changes and appropriate management are important aspects of neonatal intensive care. The aim is to ensure successful transition from the fetal to neonatal period and maintain a normal fluid-electrolyte and acid-base balance. In this paper, fluid and electrolyte requirements in the neonate, treatment of sodium and acid-base disorders on which some controversy exists, and also perioperative fluid-electrolyte management are reviewed

The role of FEV6 in the detection of airway obstruction

AbstractObjectives: There are recent reports regarding the use of forced expiratory volume in 6s (FEV6) in place of forced expiratory vital capacity (FVC) in the detection of airway obstruction. We aimed to investigate the role of FEV6 in comparison with FVC in the evaluation of airway obstruction.Methods: The pulmonary function tests (PFT) results of all 5114 patients, who had been tested in the pulmonary function laboratory between 1998 and 2003, were retrospectively analyzed to investigate the relationship between FEV6 and FVC.Results: We have found a mean difference of 95.35±121.7 (min=0, max=1050)ml (3.37%) when FVC and FEV6 values (FVC–FEV6) of all cases were compared. This difference was found to be higher (180ml, 7.3%) in patients with airway obstruction. When FEV1/FVC is taken as the gold standard, FEV1/FEV6 had negative predictive value of 92.24% and a sensitivity of 86.09% in the detection of airway obstruction.Conclusions: Although it is easier to use FEV6 in place of FVC, relatively low sensitivity in that setting may result in the underestimation of airway obstruction. This drawback should be kept in mind when FEV6 is utilized to detect airway obstruction

Hypertrophic Cardiomyopathy After a Single Dose of Dexamethasone in a Preterm Infant

Dexamethasone is widely used in preterm infants with severe pulmonary disease. Hypertrophic cardiomyopathy (HCM) is a transient side effect observed after multiple doses of dexamethasone. We report a preterm infant with myocardial hypertrophy after a single dose of dexamethasone (0.5 mg/kg) used to treat laryngeal edema secondary to prolonged intubation. A benign course was observed without left ventricular outflow tract obstruction and with recovery within 4 weeks. Myocardial effects of dexamethasone may be independent of dose and duration of treatment. The risk/benefit ratio must be carefully considered before using even a single dose of dexamethasone in preterm infants