CARDIOVASCULAR SUFFERING IN CHILDHOOD OBESITY

Obesity-related cardiovascular disease is becoming more prevalent in conjunction with the rise in childhood obesity. Children with obesity may exhibit early signs of cardiovascular dysfunction: increased arterial stiffness, early atherosclerosis, changes in the myocardial structure and function. These are the result of their excess adiposity, often independent of other obesity-related comorbidities such as dyslipidemia and insulin resistance. Obesity in childhood predisposes to an increased risk of morbidity and cardiovascular mortality in adult. This review is to highlight the importance and need of programs for early detection, diagnosis, treatment and prevention of childhood obesity in order to decrease the incidence of the cardiovascular pathology in adults

Eating habits in school-age children

University of Medicine and Pharmacy „Grigore T. Popa”, Iasi, RomaniaAdopting a healthy lifestyle at childhood would reduce a number of conditions with a great influence on the quality of life, as we can recall obesity and malnutrition. Diet can be both a primary cause of a disease and a protective factor against it. The school-age child can be very easily influenced in one direction by class, teacher, family or media. That is why the education and advice received at this age are very important, as they can „cut off the roots” the possible health problems that could change the whole life course. In view of these considerations, we have focused on the analysis of the nutrition of the school-age children in order to identify non-healthy eating habits and their influence on the nutritional status. Methods: We evaluated the eating habits on a cohort of 270 children aged 7 to 15 from an urban school in Romania. We applied KIDMED questionnaire, by Serra-Majem et al. (2004), comprised of 16 questions with dichotomous response possibilities (YES / NO). Results: Of the study group, 91.48% responded that they consume fresh fruit or fresh fruit juice daily, while 8.51% responded negatively. At second item of the questionnaire, ‘’if they eat more than a fruit by day’’, only 68.51% of the children gave a positive answer. Answer to the question „if they eat once a day a vegetable was positive in 82.59% of cases and negative in 17.40%, but only 57.50 % of the study group eats more than one vegetable by day. From the study group 42.22% of children are not eating breakfast. 66.29% of children eat cereals/cereals products at breakfast, 61.11% of them are eating milk/milk based products at breakfast and 23.70% are eating pastry at breakfast. 36.66% of the study group eats more than once a week fast-food and 52.96% of them eat more than once a day sugar and sweets. 52.59 % of children declared that they eat olive oil at home. Conclusions: A high number of children have unhealthy habits in schools. School-based programs can play an important role in promoting lifelong healthy eating

SEVERE EXTRAPULMONARY COMPLICATIONS IN MYCOPLASMA PNEUMONIAE INFECTION – CASE STUDY

Mycoplasma infection is a common pathology in childhood. The most common involvement known is pulmonary, and the course of the illness is typically mild. Extra-pulmonary involvement include an extremely wide range of manifestations (neurological, cardiac, dermatological, hematological, musculoskeletal, gastrointestinal, renal, uro-genital, ocular), more frequently than we know, with an high incidence, up to 50%. We report two cases of life-threatening extra-pulmoary manifestations caused by Mycoplasma pneumoniae in children. First case is a 17 year old teenager with severe and rapidly progressive form of hemolytic anemia without any anterior respiratory manifestation. Investigations revealed Mycoplasma pneumoniae as etiologic agent. Second case a 3 years old child of with severe sepsis, multi-organ failure, including hematological, in the context of extremely rare co-infection by Mycoplasma pneumoniae and Hantavirus. The onset of illness was with minor respiratory symptoms, but the evolution was rapidly progressive, ultimately leading to the child’s death. Both cases have imposed a wide range of investigations for diagnostic and to monitor the treatment. Therapeutic difficulties are presented and discussed

THE THROMBOEMBOLIC DISEASE IN CHILDREN (II) (TREATMENT AND MANAGEMENT)

Thrombosis is the result of an imbalance between two complex systems: hemostasis and fibrinolysis. Although the incidence of thromboembolism is lower in children than in adults, the associated morbidity is clinically relevant. This paper summarizes the main risk factors, important to define effective strategies for primary thromboprophylaxis in children at risk, the diagnostic criteria and the optimal therapeutic approach, which, until now, have mostly been extrapolated from the adult’s recommendations

THROMBOEMBOLIC DISEASE IN CHILDREN (EPIDEMIOLOGY, ETIOPATHOGENY AND DIAGNOSIS) (I)

Thrombosis is the result of an imbalance between two complex systems: hemostasis and fibrinolysis. Although the incidence of thromboembolism is lower in children than in adults, the associated morbidity is clinically relevant. This paper summarizes the main risk factors – important in defining effective strategies for primary thromboprophylaxis in children at risk, the diagnostic criteria and the optimal therapeutic approach, which have mostly been extrapolated from the adult’s recommendations until now

CONCOMITANT INGESTION OF ETHYLENE GLYCOL AND ETHANOL: A DIAGNOSIS TRAP?

Ethylene glycol is one of the most toxic alcohols; it may be accidentally or intentionally consumed as a substitute for ethanol or related to suicidal attempts. Ingestion of ethylene glycol causes a severe metabolic acidosis with increased anion and osmotic gap due to its toxic metabolites, leading to a clinical picture of central nervous system depression, cardiovascular and renal impairment. A 16-year-old boy was admitted with clinical and biological signs of ethylene glycol poisoning after simultaneous ingestion of antifreeze and ethanol. The patient had mild anion gap metabolic acidosis only at the debut, rapidly corrected with one dose of sodium bicarbonate; further evaluation did not reveal acidosis, even if the subsequent evolution included acute renal failure requiring hemodialysis. Due to the absence of a positive history and of a persistent metabolic acidosis, the diagnosis of ethylene glycol poisoning was delayed until it was confi rmed by serum toxicological test. Conclusions: concomitant ingestion of ethanol may mask the symptoms of ethylene glycol poisoning; the absence of persistent metabolic acidosis does not rule out the diagnosis

Tackling Dyslipidemia in Obesity from a Nanotechnology Perspective

Obesity and dyslipidemia are the main features of metabolic syndrome, expressed mainly by adipose tissue dysfunction and connected by similar pathways and pharmacotherapy. Conventional drugs used in these two associated disorders are limited due to poor drug efficiency, non-specificity, and toxic side effects. Therefore, novel solutions for tackling obesity-associated diseases and providing insights into the development of innovative or improved therapies are necessary. Targeted nanotherapy is a revolutionary technology, offering a promising solution for combatting the disadvantages of currently available therapies for treating obesity and dyslipidemia due to its superior features, which include specific cell targeting, the protection of drugs against physiological degradation, and sustained drug release. This review presents a brief assessment of obesity and dyslipidemia, their impacts on human health, current treatment, and limitations, and the role and potential use of nanotechnology coupled with targeted drug delivery and nutraceuticals as emerging therapies. To the best of our knowledge, this paper presents, for the first time in the literature, a comparison between obesity and dyslipidemia nano-formulations based on drugs and/or natural extracts applied in experimental studies

The Impact of Chronic Suppurative Otitis Media with and without Cholesteatoma in Patients from Northeastern Romania

Quality of life is a widely used concept that tends to become an important part of clinical management. The present study performs an analysis of the impact of suppurative chronic otitis media with and without cholesteatoma on quality of life, using the COMQ-12 questionnaire. It was applied to a group of 40 healthy people and to 40 patients before surgery, and the answers to the questions were analyzed and correlated with socioeconomic factors. After the confirmation of the diagnosis based on clinical and imaging information, the patients completed the COMQ-12 questionnaire. It was observed that the chronic ear problems had negative impacts of varying degrees on daily and long-term activities. The evaluation and analysis of information can be used in setting therapeutic targets

Pediatric endocarditis - a stone left after the pandemic cascade

Infective endocarditis is a rare disease in children. The etiology is mainly bacterial. However, viral infective endocarditis, possibly related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has also been reported. The pathophysiological principle of the connection between the two entities seems to be attributed to the transient immune deficiency of the body during the infection. Additionally, SARS-CoV-2 is reported in the literature as a direct cardiopathic virus. Therefore, the new coronavirus seems to have the ability to affect both the intact cardiac tissue and the previously damaged one both during the acute episode and at a distance from it. Consequently, we propose to review the main pathophysiological aspects of pediatric cardiac damage caused by SARS-CoV-2. The ultimate goal is to deepen existing knowledge, broaden the horizon of understanding and analysis regarding the systemic damage induced by viral infections, and strengthen an information base from which to start a meta-analysis. Next, we performed a non-systematized screening of the specialized literature with reference to cases of endocarditis in the pediatric population, reported in the period 2020–2023. From the total of articles found, we chose to include in the review a number of 6 case reports, including a number of 7 patients (5 children and 2 adolescents). Analysis of reports suggests that SARS-CoV-2 infection could play a role in the development of endocarditis, either directly through active infection or indirectly through a post-infectious immune response. Also, pre-existing conditions and complex medical history predispose to an increased risk of developing a severe, complicated form of endocarditis. Also, the lack of data on the vaccination history and the failure to categorize the infection depending on the type of antibodies (IgM or IgG) in some studies represent a major bias in the reports. The latter make it difficult to evaluate the influence of vaccination and the impact of acute versus chronic infection on the course of cases