Inflammation-Induced Atherosclerosis as a Target for Prevention of Cardiovascular Diseases from Early Life

Atherogenesis starts from the fetal life, and its natural course consists of interrelations between traditional risk factors and inflammatory, immune, and endothelial biomarkers. Even the early-stages of atherosclerotic lesions, i.e. fatty streaks present the features of chronic inflammation. Markers of inflammation are associated with insulin resistance and major atherosclerosis risk factors. Several studies have confirmed a relationship between surrogate markers of future cardiovascular disease with childhood obesity, notably abdominal obesity, as well as with the degree of obesity. Moreover, functional and structural changes are documented in arteries of children with a familial predisposition to atherosclerotic diseases; these changes are associated with clusters of inflammatory factors and markers of oxidation. In addition to the development of atheromatous plaques, inflammation also plays an essential role in the destabilization of artery plaques, and in turn in the occurrence of acute thrombo-embolic disorders. Markers of inflammation can provide predictive clinical information about outcomes of patients with acute coronary syndromes, independent of the extent of myocardial damage. Moreover, serum levels of the inflammatory markers might add prognostic information provided by traditional risk factors. Platelets have an important role in vascular inflammation and atherosclerosis and in the formation of mural thrombi. As lifestyle modification trials have been successful in decreasing endothelial dysfunction and the level of markers of inflammation among children and adolescents, it is suggested that in addition to expanding pharmacological therapies considered for secondary prevention of atherosclerotic diseases aiming to control the inflammatory process, the importance of primordial/primary prevention of atherosclerosis should be underscored

Obesity and Air Pollution: Global Risk Factors for Pediatric Non-alcoholic Fatty Liver Disease

Non-alcoholic fatty liver disease (NAFLD) is becoming as an important health problem in the pediatric age group. In addition to the well-documented role of obesity on the fatty changes in liver, there is a growing body of evidence about the role of environmental factors, such as smoking and air pollution, in NAFLD. Given that excess body fat and exposure to air pollutants is accompanied by systemic low-grade inflammation, oxidative stress, as well as alterations in insulin/insulin-like growth factor and insulin resistance, all of which are etiological factors related to NAFLD, an escalating trend in the incidence of pediatric NAFLD can be expected in the near future. This review focuses on the current knowledge regarding the epidemiology, diagnosis and pathogenesis of pediatric NAFLD. The review also highlights the importance of studying the underlying mechanisms of pediatric NAFLD and the need for broadening efforts in prevention and control of the main risk factors. The two main universal risk factors for N LD, obesity and air pollution, have broad adverse health effects, and reducing their prevalence will help abate the serious health problems associated with pediatric NAFLD

Zinc and copper status in children with high family risk of premature cardiovascular disease

Background: Zinc and copper are beneficial to health, growth and development, and also for the prevention of cardiovascular disease (CVD) with regards to improved dietary habits as a preliminary step in CVD prevention. This study was conducted among 2-18-year-old children with high family risk of premature CVD in comparison to controls. Subjects and Methods: One hundred randomly selected children whose parents had premature myocardial infarction were included in the study. The controls were 100 individuals randomly selected from the case group's neighbors and matched for age, sex and socioeconomic status. A four-day food record questionnaire was used to assess zinc and copper intakes, and their serum levels were determined using Flame-Atomic Absorption Spectrophotometry. The data were analyzed by SPSS/Windows V6 software, using the Student's t and Mantel-Hanzel tests. Significance of differences was considered at P<0.05. Results: The daily zinc intake was significantly lower in the case than control group (6.89±2.97 vs. 8.30±2.45 mg, P=0.047). The mean serum zinc level was not significantly different between both groups (82.12±14.1 vs. 92.26±23.7 µg/dL, P>0.05). Zinc deficiency was more prevalent among the case in boys than their controls (58% vs. 18%, P=0.04). This difference was not significant in girls (44% vs. 40%). The daily intake and serum level of copper were not significantly different between the case and control groups. No case of copper deficiency was found. The mean systolic blood pressure was not significantly different between the zinc-deficient and zinc-sufficient subjects. Although the mean diastolic blood pressure of the former was higher than the latter, there was no statistically significant difference. About 23.7% of all studied sample had mild-to-moderate degrees of failure to thrive, with significantly lower daily intake and serum zinc level than other subjects (5.41±1.06 mg, 82.09±12.74 µg/dL vs. 6.89±2.14 mg, 99.25±27.15 µg/dL, respectively, P<0.05). Conclusion: It is recommended that emphasis be placed on the consumption of food rich in zinc by children, especially those with high family risk of premature CVD. Ann Saudi Med 2002;22(5-6):291-294

Role of Environmental Chemicals in Obesity: A Systematic Review on the Current Evidence

The purpose of this paper is to systematically review the experimental and human studies on obesogenic chemicals and their mechanisms of action to provide a comprehensive view on the multifactorial aspects of obesity. The literatures were searched in available databases. The relevant papers were selected in three phases. After quality assessment, two reviewers extracted the data while another checked their extracted data. In this review, we summarized information regarding environmental chemicals that can be associated with obesity. Most evidence comes from experimental and laboratory studies; however a growing number of human studies also support the role of obesogenic chemicals. The current evidence proposes that the systemic responses to exposure to environmental factors could potentially increase the risk of excess weight. The effects of exposure to these chemicals are of crucial importance during developmental phases of life, when preprogramming for an adipogenic outcome may occur. By considering the adverse transgenerational effects of obesogen chemicals on human health, the global obesity epidemic should be considered as a multifactorial complex disorder necessitating the emphasis of public health interventions for environmental protection

Nosocomial Infection due to Rotavirus in Infants in Alzahra Hospital, Isfahan, Iran

Rotavirus is one of the most common causes of acute diarrhoea during infancy, and the spread of this infection due to rotavirus in paediatric wards can cause acute diarrhoea during hospitalization, and, in turn, prolong hospitalization or rehospitalization. It is, therefore, important to evaluate the problem and to find an appropriate approach to decrease the rate of infection. The incidence of nosocomial infection due to rotavirus was studied in 80 children aged 3-24 months from November 2003 to April 2004 in the Alzahra Hospital, Isfahan, Iran. Rotavirus antigen was detected by latex aggulutation in stool samples obtained during hospitalization and up to 72 hours after discharge from the hospital. The prevalence of nosocomial infection due to rotavirus was 26.25%, which is a considerable prevalence compared to similar studies which reported a prevalence of 27.7%, 19.4%, and 14.6%. Overall, 15% of the 21 children with positive rotavirus antigen in their stools had acute diarrhoea during hospitalization and up to 72 hours after discharge (symptomatic nosocomial infection), and 11.25% of all children (n=80) studied had asymptomatic nosocomial infection. Regarding the low frequency of nosocomial infection due to rotavirus in other studies which have only studied symptomatic cases during hospitalization and reported a prevalence of 3.3 and 9%, it is suggested that the real estimation of nosocomial infection due to rotavirus in asymptomatic cases that might become symptomatic after discharge from hospital should also be considered. Due to the relatively high frequency of nosocomial infection in the Alzahra Hospital, it is necessary to follow stricter health issues, e.g. isolation of patients with diarrhoea and hand-washing before and after the examination of every patient