UNDERNUTRITION AND OBESITY IN PEDIATRIC PATIENTS ADMITTED IN A ROMANIAN HOSPITAL

Aims. The determinants of children nutrition status varies around the globe in relation with socio-economic particularities, dietary habits and family lifestyle. The present study attempted to evaluate the changes and determinants of nutritional status of a representative children population from South Romania. Materials and methods. A prospective cross section study was performed in Grigore Alexandrescu Emergency Children’s Hospital from Bucharest between December 2010-February 2011. We enrolled 1529 children and anthropometric, dietary assessment and interview schedule were used for all the participants. Study design was similar with the one used in 2005, on similar condition (timing and participants). The population was divided in 2 age groups: 0-2 years and 2-18 years. Data analyze used SPSS software and the Data Analysis module of MICROSOFT EXCEL 2007. Chi-Squared Test was performed for hypothesis testing involving nominal variables (categorical), non-parametric Wilcoxon-Mann-Whitney Test for comparing values of two independent cohorts, Independent Sample T Test for comparing average values of two independent cohorts, and the ‘Correlate’ function /Pearson coefficient for proving associations between the parameters being considered. Results. The overall rate of undernutrition was 11% while 13% subjects were obese/overweight. Half of subjects with undernutrition came from low-income families. Compared to non-obese children, obese subjects regularly consume sweets and hyper caloric drinks (p<0.001), spend more time watching TV and less time doing physical activity (p<0.001). Comparing data 2005/2011 we revealed that there is a decreasing level of malnutrition for both age groups and there is a warring prevalence of overweight/obese children. Conclusions. Almost a quarter of subject had nutritional status modifi cations. Inappropriate dietary habits (hypercaloric, hyperglucidic) and sedentary lifestyle were the main determinants of overweight/ obesity. This study provides data for national database and it represents an important argue in order to establish children nutritional diseases prevention programs

SWEAT CONDUCTIVITY IN THE DIAGNOSIS OF CYSTIC FIBROSIS – THE EXPERIENCE OF THE REGIONAL CENTRE “GRIGORE ALEXANDRESCU” EMERGENCY CHILDREN’S HOSPITAL

Introduction. The sweat test is the standard method for the diagnosis of cystic fibrosis (CF). The sweat conductivity represents an alternative not yet accepted as a diagnosis method, in spite of its good correlation with chloride (Cl-) titration. The aim of this paper is twofold: to highlight the reference values for this method, as they differ from those used in the case of the Gibson-Cooke method, and also to test the capacity of the conductivity method to discriminate patients with and without CF. Methods. Sweat conductivity was determined for 2,180 patients admitted to the Pulmonology Department of “Grigore Alexandrescu” Emergency Children’s Hospital, in Bucharest, between January 2000 and June 2015. The CF diagnosis was determined on the basis of suggestive clinical manifestations, associated with two positive sweat tests (ST) and/or genetic testing. The sweat test was considered positive if the result was higher than 75 mmol/L, as recommended by the producer of the used technology (Wescor). The patients were divided in three groups: the first group – the patients with values ≤45 mmol/L NaCl, the second group – the patients with values between 46 and 65 mmol/L, and the third group – the patients with tested values > 65 mmol/L. The ROC curve was used to determine the threshold value that discriminated patients with and without CF. Results. No patient was determined to suffer from CF in the first category. In the second group, there was one patient with the diagnosis of atypical CF. Eighty patients suffering from CF had values > 65 mmol/L, and among these 80 patients, 79 had values > 75mmol/L. The threshold value for the optimum prediction of the CF diagnosis was thus determined to be 76 mmol/l, with an area under the curve of 0.999, p<0.000, which makes the method excellent in identifying the patients with CF with a sensitivity and specificity of 97%. Conclusion. the values of sweat conductivity are higher than those obtained through Cl- titration, Cl- titration being necessary and compulsory in equivocal cases

SUBNUTRIŢIA ŞI OBEZITATEA LA PACIENŢII PEDIATRICI INTERNAŢI ÎNTR-UN SPITAL DIN ROMÂNIA

Obiective. Condiţiile socio-economice, obiceiurile alimentare şi comportamentale sunt citate ca factori cu rol determinant în infl uenţarea stării de nutriţie, mai ales în populaţia pediatrică, în întreaga lume. Studiul de faţă îşi propune evaluarea schimbărilor într-un interval de 5 ani a stării de nutriţie şi a factorilor externi specifi ci care le-au infl uenţat, pe un eşantion semnifi cativ de copii din zona de sud a României. Material şi metodă. Studiul prospectiv cross-section a fost realizat în cadrul Spitalului Clinic de Urgenţă pentru Copii „Grigore Alexandrescu“ din Bucureşti, în perioada decembrie 2010-februarie 2011. Au fost înrolaţi 1.529 de pacienţi şi evaluaţi antropometric şi din punct de vedere al obiceiurilor alimentare pe baza completării unui chestionar. Protocolul de studiu a fost cel aplicat în anul 2005, în acelaşi interval de timp pe un lot asemănător numeric. Loturile de studiu s-au alcătuit pe criteriul vârstă: 0-2 ani şi 2-18 ani. S-a aplicat pentru prelucrare statis tică programul SPSS, specializat în calcule statistice ştiinţifi ce, produs de fi rma SPSS şi modulul Data Analysis al programului MICROSOFT EXCEL 2007. S-au utilizat: testul lui Chi pătrat aplicat pentru testarea ipo tezelor cu privire la variabile nominale (categoriale), testul non-parametric Wilcoxon-Mann-Whitney pentru compararea valorilor a două eşantioane independente, Independent Sample T Test pentru testarea egalităţii mediilor a două eşantioane independente; de asemenea, am utilizat funcţia „Correlate” cu coefi cientul Pearson pentru a demonstra dacă există asocieri între diverşi parametri studiaţi. Rezultate. Rata globală a malnutriţiei a fost de 11% şi a obezităţii de 13%. Jumătate dintre pacienţii cu malnutriţie provin din familiile cu venituri scăzute. Comparativ cu populaţia cu greutate normală, pacienţii obezi consumă frecvent dulciuri, băuturi hipercalorice (p<0,001), petrec mai mult timp în faţa televizorului şi mai puţin timp efectuând activitate fi zică (p<0,001). Comparând datele între cele două studii 2005/2011, se constată o scădere a procentului de copii cu malnutriţie şi o creştere a celor cu suprapondere/obezitate. Concluzii. Aproximativ un sfert dintre subiecţi au tulburări ale stării de nutriţie, predominând obezitatea. Creşterea frecvenţei obezităţii s-a corelat semnifi cativ cu dieta dezechilibrată (hipercalorică, exces de hidrocarbonate) şi sedentarismul. Studiul prezentat poate servi drept bază de date pentru studii viitoare în ţara noastră şi este un argument convingător pentru introducerea unui program naţional de prevenţie a bolilor de nutriţie la copii