Erratum to: Serum cystatin C levels in children with sickle cell disease

In the introduction, the expanded form of CSSCD should read Cooperative Study of Sickle Cell Disease (CSSCD) and not Comprehensive Study of Sickle Cell Disease

Serum cystatin C levels in children with sickle cell disease

Patients with sickle cell disease (SCD) may develop kidney dysfunction from childhood. The purpose of this study was to examine the value of serum cystatin C as a marker for glomerular filtration rate (GFR) in children with SCD, as compared to serum creatinine and creatinine clearance (CrCl). Twenty children (ages 9–21, ten males) with SCD with and without albuminuria were studied. The mean serum cystatin for the whole group was 0.89 mg/l (0.5–1.7 mg/l). Mean serum cystatin C was significantly different among the children with proteinuria (n=4), microalbuminuria (n=5), and without albuminuria (n=11) (1.25 mg/l, 0.84 mg/l, and 0.78 mg/l, respectively). The mean GFR derived from serum cystatin was significantly different among these subgroups, becoming abnormal in the proteinuric cohort (63 ml/min per 1.73 m2), in contrast to 94 for the microalbuminuric, and 103 for the normal subgroups. Serum creatinine (mean: 0.58 mg/dl, range: 0.3–1.1) did not change significantly with the level of albuminuria. Mean CrCl remained normal to increased within the subgroups, (133 ml/min per 1.73 m2 for those with proteinuria, 144 for those with microalbuminuria, and 163 for the normal subgroup). We conclude that serum cystatin C correlates with the level of albuminuria and may be a reliable method to measure renal function in SCD

Catheter survival and comparison of catheter exchange methods in children on hemodialysis

This retrospective study was done to compare the infection-free and overall survival of first and subsequent tunneled cuffed hemodialysis catheters in children. Subsequent catheters were exchanged by two different methods (a) removal and replacement (R&R), or (b) wire-guided exchange (WGE) using the same tunnel and vessel. The study involved 59 children (27 male, 32 female; mean age 13.9 ± 4.6 years) undergoing maintenance hemodialysis in a pediatric unit over a period of 60 months. From a total of 175 catheters (57 first catheters, 81 WGE, 37 R&R) and 38,888 catheter days, 74/175 (42%) catheters were exchanged because of catheter-related bacteremia (CRB) and 43/175 (25%) for malfunction or cuff extrusion. One-year survival rates for first and consecutive catheters was 26% and 21%, respectively. The overall survival of first catheters, and those exchanged by WGE and R&R for both infectious and non-infectious reasons, was not statistically different. However, infection-free survival of first catheters was significantly prolonged in comparison with that of subsequent catheters (P 10 years. There was a significant association between gram-negative and polymicrobial CRB and requirement for R&R (P < 0.02). Our findings suggest that WGE is safe in a clinically stable child if the tunnel and the exit site are not infected and has the potential benefit of preserving the vascular access site. The shorter infection-free survival in subsequent catheters suggests a cumulative disadvantage with prolonged catheter use

Effect of a child care center-based obesity prevention program on body mass index and nutrition practices among preschool-aged children

This study examined the effect of an early childhood obesity prevention program on changes in Body Mass Index (BMI) z-score and nutrition practices. Eight child care centers were randomly assigned to an intervention or attention control arm. Participants were a multiethnic sample of children aged 2 to 5 years old (N = 307). Intervention centers received healthy menu changes and family-based education focused on increased physical activity and fresh produce intake, decreased intake of simple carbohydrate snacks, and decreased screen time. Control centers received an attention control program. Height, weight, and nutrition data were collected at baseline and at 3, 6, and 12 months. Analysis examined height, weight, and BMI z-score change by intervention condition (at baseline and at 3, 6, and 12 months). Pearson correlation analysis examined relationships among BMI z-scores and home activities and nutrition patterns in the intervention group. Child BMI z-score was significantly negatively correlated with the number of home activities completed at 6-month post intervention among intervention participants. Similarly, intervention children consumed less junk food, ate more fresh fruits and vegetables, drank less juice, and drank more 1% milk compared to children at control sites at 6 months post baseline. Ninety-seven percent of those children who were normal weight at baseline were still normal weight 12 months later. Findings support child care centers as a promising setting to implement childhood obesity prevention programs in this age group

Effect of a Two-Year Obesity Prevention Intervention on Percentile Changes in Body Mass Index and Academic Performance in Low-Income Elementary School Children

Objectives. We assessed the effects of a school-based obesity prevention intervention that included dietary, curricula, and physical activity components on body mass index (BMI) percentiles and academic performance among low-income elementary school children

Relationship between aminotransferases levels and components of the metabolic syndrome among multiethnic adolescents

Data evaluating the frequency of elevated aminotransferases (as a surrogate for non-alcoholic fatty liver disease [NAFLD]) and metabolic syndrome (MS) components among overweight multiethnic children/adolescents originating predominantly from South/Central America and the Caribbean are limited. A sample (N = 284) of multiethnic (75% Latino, 25% Afro Caribbean/non-Hispanic black) overweight children/ adolescents' (mean age 12.24 +/- 3.48) overnight fasting insulin and glucose, systolic/diastolic blood pressure, HDL/LDL/total cholesterol, triglyceride, aspartate aminotransferase (AST) and alanine aminostransferase (ALT) were analyzed. A total of 22% of the sample had elevated ALT (> or = 30 U/L; mean 25.94 U/L for Hispanics, 23.05 U/L for blacks) and 8% had elevated AST (> or = 35 U/L; mean 23.05 U/L for Hispanics, 24.68 U/L for blacks). AST and ALT were significantly correlated with triglycerides (r = 0.23, P < .01; r = 0.18, P < .05, respectively) for the overall sample. Among overweight adolescents, MS components are associated with NALFD in subgroups of major ethnic groups suggesting that AST and ALT as surrogate markers for NAFLD should be included in addition to the standard cardio metabolic tests

Caregiver's Country of Birth Is a Significant Determinant of Accurate Perception of Preschool-Age Children's Weight

One in four preschool-age children in the United States are currently overweight or obese. Previous studies have shown that caregivers of this age group often have difficulty accurately recognizing their child's weight status. The purpose of this study was to examine factors associated with accurate/inaccurate perception of child body mass index (BMI) among a multicultural sample of caregivers who were predominantly low-income and foreign-born. A total of 980 caregivers (72% Hispanic, 71% born outside of the United States) of preschool-age children (N= 1,105) were asked if their child was normal weight, overweight, or obese. Answers were compared to actual child BMI percentile category via chi-square analysis. Logistic regression analysis was performed to assess predictors of accurate perception of child BMI percentile category. More than one third of preschoolers were either overweight (18.4%) or obese (16.5%). The majority (92%) of caregivers of an overweight/obese child inaccurately perceived that their child was in a normal BMI category. Overall, foreign-born caregivers were significantly less likely to accurately perceive their child's BMI percentile category versus U.S.-born caregivers (odds ratio [OR] = 0.65, 95% confidence interval [CI] = 0.48-0.88). Specifically, those born in South America (OR = 0.59, 95% CI = 0.36-0.98), Central America/Mexico (OR = 0.59, 95% CI = 0.41-0.85), and Caribbean Hispanic nations (OR = 0.54, 95% CI = 0.35-0.83) were significantly less likely to accurately perceive their child's BMI category versus U.S.-born caregivers. The results of this study suggest that foreign-born caregivers of U.S. preschool-age overweight/obese children in particular do not accurately perceive their child's BMI status. Health care professionals serving foreign-born caregivers may consider additional culturally appropriate healthy weight counseling for these families