18 research outputs found
The efficacy of iron chelator regimes in reducing cardiac and hepatic iron in patients with thalassaemia major: a clinical observational study
<p>Abstract</p> <p>Background</p> <p>Available iron chelation regimes in thalassaemia may achieve different changes in cardiac and hepatic iron as assessed by MR. The aim of this study was to assess the efficacy of four available iron chelator regimes in 232 thalassaemia major patients by assessing the rate of change in repeated measurements of cardiac and hepatic MR.</p> <p>Results</p> <p>For the heart, deferiprone and the combination of deferiprone and deferoxamine significantly reduced cardiac iron at all levels of iron loading. As patients were on deferasirox for a shorter time, a second analysis ("Initial interval analysis") assessing the change between the first two recorded MR results for both cardiac and hepatic iron (minimum interval 12 months) was made. Combination therapy achieved the most rapid fall in cardiac iron load at all levels and deferiprone alone was significantly effective with moderate and mild iron load. In the liver, deferasirox effected significant falls in iron load and combination therapy resulted in the most rapid decline.</p> <p>Conclusion</p> <p>With the knowledge of the efficacy of the different available regimes and the specific iron load in the heart and the liver, appropriate tailoring of chelation therapy should allow clearance of iron. Combination therapy is best in reducing both cardiac and hepatic iron, while monotherapy with deferiprone or deferasirox are effective in the heart and liver respectively. The outcomes of this study may be useful to physicians as to the chelation they should prescribe according to the levels of iron load found in the heart and liver by MR.</p
Lifestyle Changes and Determinants of Childrenās and Adolescentsā Body Weight Increase during the First COVID-19 Lockdown in Greece: The COV-EAT Study
Previous studies showed that the coronavirus disease 2019 (COVID-19) lockdown imposed changes in adultsā lifestyle behaviors; however, there is limited information regarding the effects on youth. The COV-EAT study aimed to report changes in childrenās and adolescentsā lifestyle habits during the first COVID-19 lockdown and explore potential associations between changes of participantsā lifestyle behaviors and body weight. An online survey among 397 children/adolescents and their parents across 63 municipalities in Greece was conducted in AprilāMay 2020. Parents self-reported changes of their childrenās lifestyle habits and body weight, as well as sociodemographic data of their family. The present study shows that during the lockdown, childrenās/adolescentsā sleep duration and screen time increased, while their physical activity decreased. Their consumption of fruits and fresh fruit juices, vegetables, dairy products, pasta, sweets, total snacks, and breakfast increased, while fast-food consumption decreased. Body weight increased in 35% of children/adolescents. A multiple regression analysis showed that the body weight increase was associated with increased consumption of breakfast, salty snacks, and total snacks and with decreased physical activity. The COV-EAT study revealed changes in childrenās and adolescentsā lifestyle behaviors during the first COVID-19 lockdown in Greece. Effective strategies are needed to prevent excessive body weight gain in future COVID-19 lockdowns
Do Children and Adolescents with Overweight or Obesity Adhere to the National Food-Based Dietary Guidelines in Greece?
Childhood obesity increases the risk for metabolic disorders, but is also related to nutritional deficiencies, such as anemia and hypovitaminosis D. Although children/adolescents with overweight/obesity may have higher energy intake, their diet quality and diversity may be low. The present study aimed to evaluate the consumption of foods against the national food-based dietary guidelines in children and adolescents with overweight or obesity in Greece. Sociodemographic, anthropometric and lifestyle data were collected from a sample of 1467 children 2ā18 years old (962 obese, 505 overweight, 51.2% females) in 2014ā2017. The results of this study show that the consumption of dairy products, fruit, vegetables, legumes and fish by children/adolescents with overweight or obesity was lower than the national recommendations (ranging from a minimum of 39.5% for fish, to a maximum of 75.5% for cereal/potato/rice). Only the consumption of meat/poultry was found to exceed the national recommendation (estimated coverage of 131.3%). Moreover, a large proportion of participants regularly consumed various unhealthy foods/beverages. The present findings indicate that the majority of children/adolescents with overweight/obesity do not comply with the national food-based dietary guidelines in Greece. The implementation of new strategies to promote healthy diets among children/adolescents with overweight/obesity are urgently required
Natural and vaccine-induced immunity to Neisseria meningitidis serogroup C in asplenic patients with beta-thalassemia
Natural and vaccine-induced immunity to meningococcus C (MenC) was
evaluated in asplenic adolescents and adults with beta-thalassemia. At
baseline 19.3% of patients and 22.8% age-matched controls had positive
(> 2 mu g/ml) naturally acquired Men C- specific IgG antibodies;
patients had a lower probability of having protective SBA compared to
controls (OR =21, p = 0.012). MenC conjugate vaccine (MCC) induced
protective IgG concentrations in 63% of patients and 90.1% of
controls. SBA increased significantly post vaccination and there were no
differences between patients and controls; however patients had
significantly lower IgG concentrations post vaccination compared to
controls (4.52 vs 10.94 mu g/ml. p < 0.001, respectively). A second dose
of MCC given to 11 patients who had received MCC in the past induced
higher IgG compared to primary response (p =, 0.001). Naturally- and
vaccine-induced immunity to MenC is impaired in asplenic
beta-thalassemics; a second dose of MCC improves vaccine immunogenicity
and is essential for their optimal protection. (C) 2011 Elsevier Ltd.
All rights reserved
CARDIAC MAGNETIC RESONANCE IN TRANSFUSION DEPENDENT THALASSAEMIA: ASSESSMENT OF IRON LOAD AND RELATION TO LEFT VENTRICULAR EJECTION FRACTION
International audienceCardiac Magnetic Resonance (CMR) has replaced all other surrogate measurements in the determination of transfusional cardiac iron overload in patients with thalassaemia major. We aimed to determine the diagnostic value of CMR T2* with respect to cardiac dysfunction (CD) as determined by CMR-derived left ventricular ejection fraction (LVEF). Cardiac T2* values and LVEF measured by CMR were recorded in 303 patients with thalassaemia major, at the time of their first CMR. T2* was correlated with LVEF (regression coefficient: 0.57, p 8ms and ā¤14 ms and reduced to 9.1% in patients with T2* between 14-20 ms. As the probability of CD is progressively, and not suddenly, reduced with increasing values of T2*, CMR has a limited diagnostic value for cardiac dysfunction (ROC Analysis, AUC = 0.68). Patients with cardiac T2* ā¤ 8 ms require careful and intensive management. This risk decreases with increasing values of T2* but even in mildly loaded patients the probability of impaired LVEF is not negligible
Age, beta thalassaemia trait, and iron-deficient anaemia significantly affect reticulocyte indices in pre-school children
Reticulocyte indices are easy to obtain, low cost parameters and have
gained interest in the field of diagnosing anaemias of childhood.
We assessed distribution, age and gender variation, relation to indices
of iron metabolism and diagnostic performance of reticulocyte
haemoglobin content (CHr), percentage of microcytic reticulocytes
(micro_r), percentage of hypochromic reticulocytes (hypo_r), and
percentage of reticulocytes with low CHr (low_CHr) in 386 pre-school
children classified in four groups: healthy, iron deficiency (ID), iron
deficiency anaemia (IDA), and beta-thalassaemia carriers (beta-thal).
Age had a positive effect in CHr (Spearmanās rho = 0.21) and a negative
effect in hypo_r (Spearmanās rho = -0.2) in healthy children. CHr and
low_CHr were related to ferritin in the IDA group (Spearmanās rho 0.55
and -0.53, respectively). In the beta-thal group, HbA(2) is strongly
related to all reticulocyte indices. micro_r and CHr performed best in
discriminating between IDA and beta-thal heterozygosity (ROC analysis,
area under the curve (AUC): 0.76 and 0.74, respectively). CHr achieved
the best AUC (0.58) in identifying ID among children without anaemia.
Age, IDA and beta-thal significantly affect reticulocyte indices. CHr
and micro_r may have a role as screening tools in discriminating
between IDA and beta-thal heterozygosity
Increased Serum Concentrations of High Mobility Group Box 1 (HMGB1) Protein in Children with Autism Spectrum Disorder
High mobility group box 1 protein (HMGB1) has been suggested to be involved in the immune dysfunction and inflammation reported in autism spectrum disorder (ASD). We aimed to assess HMGB1 serum concentrations (SCs) in high-functioning ASD children compared to typically developing (TD) controls and to explore their associations with the autism spectrum quotient (AQ), the empathy quotient (EQ), and the systemizing quotient (SQ). The study involved 42 ASD children and 38 TD children, all-male, aged between 6.1 and 13.3 years old. HMGB1 SCs were measured by enzyme-linked immunosorbent assay (ELISA). Groups were comparable regarding age, general IQ, birth weight, and maternal age at birth. ASD children showed significantly higher HMGB1 SCs compared to TD children (1.25 Ā± 0.84 ng/mL versus 1.13 Ā± 0.79 ng/mL, respectively, p = 0.039). The Spearmanās rho revealed that HMGB1 SCs were positively correlated with the AQ attention to detail subscale (rs = 0.46, p = 0.045) and with the SQ total score (rs = 0.42, p = 0.04) in the ASD group. These results show that HMGB1 serum concentrations are altered in ASD children, and suggest that inflammatory processes mediated by HMGB1 may be associated with specific cognitive features observed in ASD