24 research outputs found
Obesity in Children: Recent Insights and Therapeutic Options
Obesity in children, including adolescents, is nowadays, in the light of the COVID-19 pandemic, an even more pressing problem than before it, leading to increased prevalence of obesity and its comorbidities at young age. A simple and correct approach to diagnosis is essential, and some new insights in epidemiology, pathophysiology, and diagnosis are currently under investigation. Obesity in preschool children and metabolically healthy obesity are new entities that are recently being defined and written about. Additionally, several new factors that might influence obesity development are being researched, such as pollutants, sleep duration, and gut microbiota. In this chapter, we briefly present them as possible therapeutic targets in the future along with current therapeutic options in the pediatric population, namely lifestyle change, pharmaceutical options, and surgery. A child is always significantly affected by his/her family lifestyle, home, and social environment, which has to be considered in childhood obesity management
The Role of Cardiorespiratory Fitness in Children with Cardiovascular Risk
Cardiorespiratory fitness is an outcome of physical activity, enabling the transport of oxygen from the atmosphere to the mitochondria to perform physical work and therefore reflects the overall capacity of the cardiovascular and respiratory systems to perform the prolonged exercise. In recent decades, it has declined in the paediatric population. Cardiovascular fitness measurement has yet to be standardised in children but is a powerful marker of health in youth and is strongly associated with inflammation and inversely associated with cardiovascular risk factors, especially obesity. Notably, youth with low cardiorespiratory fitness levels have a higher risk of developing cardiovascular diseases during adulthood. Lowered cardiorespiratory fitness has been demonstrated most often in children with obesity and associated cardiovascular comorbidities, however, these can be associated with cardiorespiratory fitness independently to body mass index. The benefits of physical activity on health have been well demonstrated during growth and it should be encouraged in children with cardiovascular risk to prevent further reduction of cardiorespiratory fitness and the development of other comorbidities. Along with appropriate physical exercise and diet in childhood, breastfeeding in the first year of life is recommended
Cardiovascular Risk Factors in Children
Cardiovascular morbidity and mortality are still increasing in developed countries with emphasis on the obesity epidemic. Children and young adults are no exception. With modern lifestyle, traditional cardiovascular risk factors, such as hypertension, obesity, dyslipidemia, insulin resistance, kidney damage, are increasingly present in children leading to premature cardiovascular events in adult life. Cardiovascular risk factor can accelerate naturally progressing atherosclerosis, which should be prevented to facilitate quality and longevity of life. Primary and primordial prevention in the pediatric population are of utmost importance. However, if a cardiovascular risk factor is already present, frequent monitoring of possible development of other cardiovascular risk factors and evaluation of end organ damage should be implemented to intervene in time
Henoch–Schönlein purpura - obravnava in zdravljenje pediatričnih bolnikov severovzhodnega dela Slovenije
Ultrasound Elastography in Children
Ultrasound elastography is a novel ultrasound technique, being extensively researched in children in the last decade. It measures tissue elasticity with the observation of tissue response after an external stimulus. From research to clinical practice, ultrasound elastography has evolved significantly in liver fibrosis evaluation in children; however, several other applications of the technique are available in both clinical practice and research environments. Practically, in children any organ can be assessed, including the brain in early ages, along with muscle and connective tissue elasticity evaluation, spleen, kidney, skin, lymphatic tissue, etc. The elastography method, age, body mass index and technical points should be considered when performing ultrasound elastography. This review highlights its vast potential as a diagnostic tool in the pediatric population, where ultrasound is a dominant imaging tool; however, the indications and exam protocol for its clinical use in several fields in pediatrics have yet to be elucidated
Current Knowledge of Selected Cardiovascular Biomarkers in Pediatrics: Kidney Injury Molecule-1, Salusin-α and -β, Uromodulin, and Adropin
Cardiovascular diseases are the leading cause of morbidity and mortality in the modern world. Their common denominator is atherosclerosis, a process beginning in childhood. In pediatrics, the aim of preventive measures is to recognize children and adolescents at risk for accelerated atherosclerosis and possible premature cardiovascular events in adulthood. Several diagnostic procedures and biomarkers are available for cardiovascular risk assessment in adults. However, reliable markers in pediatrics are still insufficiently studied. In this contribution, we discuss five potential biomarkers of particular interest: kidney injury molecule-1, salusin-α and -β, uromodulin, and adropin. Studies regarding the pediatric population are scarce, but they support the evidence from studies in the adult population. These markers might entail both a prognostic and a therapeutic interest
Novel Biomarkers of Heart Failure in Pediatrics
Novel biomarkers of heart failure are the subject of numerous studies. Biomarkers of heart failure can be determined in the blood and in the urine. Seven groups of biomarkers of heart failure based on pathophysiological mechanisms are presented in this review, namely biomarkers of myocardial stretch, myocyte injury, myocardial remodeling, biomarkers of inflammation, renal dysfunction, neurohumoral activation, and oxidative stress. Studies of biomarkers in the pediatric population are scarce, therefore, further investigation is needed for reliable prognostic and therapeutic implications. The future of biomarker use is in multimarker panels that include a combination of biomarkers with different pathophysiological mechanisms in order to improve their diagnostic and prognostic predictive value
Obesogens in Children—An Uncharted Territory
Obesogens are exogenous chemicals belonging to the group of endocrine-disrupting chemicals and are believed to interfere in obesity development. In children, several chemicals are under investigation, most commonly bisphenol A, phthalates, perfluorinated alkyl substances, and persistent organic pollutants, including organochlorinated pesticides, tributyltin, polychlorinated biphenyls and dioxins. Several associations have been studied between chemical exposure in utero and postnatally. Current opinion among researchers indicates that the obesogen theory is very likely; however, limited published studies show inconsistent support for the obesogenic effects of most substances in children and are limited by difficulty in providing the exact mechanisms of action, nor is their mutual effect in humans known, let alone in children. Existing data indicate that we have only scratched the surface and have much more to learn about obesogens. Hopefully, in the future, more information will provide an opportunity for policy makers to take action and protect public health