Weight Deficit Research Articles

Peculiarities of length-weight somatometric indices in school-age children of the industrial center

Introduction. Children’s health is of particular value, being a medical, biological and social and labour potential for any state. Objective and informative health indices include parameters of the physical development. The aim of the study is to assess length-weight somatometric indices in children studying in general educational institutions of Ulan-Ude. Materials and methods. The sample of respondents included nine hundred thirty two school-age children. Variables were sampled for length and weight, body mass index was calculated and compared with WHO criteria. Descriptive statistics are expressed as mean and standard deviation, Student’s t-test was used to compare means. Results. Among children of the industrial center, persons with harmonious physical development predominate (51.9±2.6%). Among the variants of disharmonious physical development in boys and girls, excessive body weight (27.3±2.3% and 22.9±1.9) and high height (12.6±1.7% and 14±1.6%, respectively) prevailed. The proportion of other variants of disharmony (low length, body weight deficit and their combination) is small. The phenomena of sexual dimorphism are quite pronounced in children – acceleration of growth differed from the general patterns earlier by 2–3 years. Limitations. The results of the study have limitations in relation to children with various health disorders. Given the small number of age groups, as well as the fact that children of one industrial center were examined, the diagnostic significance of the data obtained may be less objective. Conclusion. Regional features of growth-weight somatometric indices are important to timely identify children with disharmonious development as early as possible to prevent long-term consequences.

Is There Still a Role for Peritoneal Drains in Neonatal Pneumoperitoneum? A Single-Center Experience

IntroductionAlthough pneumoperitoneum from necrotizing enterocolitis or spontaneous intestinal perforation is a surgical emergency, risk stratification to determine which neonates benefit from initial peritoneal drainage (PD) is lacking. MethodsUsing a single-center retrospective review of very low birth weight neonates under 1500 g who underwent PD for pneumoperitoneum (January 2015 to December 2023) from necrotizing enterocolitis or spontaneous intestinal perforation, two cohorts were created: drain “responders” (patients managed definitively with PD; includes placement of a second drain) and “nonresponders” (patients who underwent subsequent laparotomy or died after PD). Antenatal/postnatal characteristics, periprocedural clinical data, and hospital outcomes were compared between responders and nonresponders using Student’s t-test, chi-squared test, or Kruskal–Wallis test as appropriate, with P < 0.05 considered significant. ResultsFifty-six neonates were included: 31 (55%) drain responders and 25 (45%) nonresponders. Birth weight, gestational age, sex, ethnicity, use of postnatal steroids, and enteral feeds were similar between the cohorts. Nonresponders had higher base deficits (−3.4 versus −5.0, P = 0.032) and FiO2 (0.25 versus 0.52, P = 0.001) after drain placement. Drain responders had significantly shorter lengths of stay (89 versus 148 days, P = 0.014) and lower mortality (6.4% versus 56%, P < 0.001). A subgroup analysis of the nonresponders showed no differences in birth weight, vasopressor requirement, FiO2, or postdrain base deficit between nonresponders who had a drain alone versus laparotomy following drain placement. ConclusionsPD remains a viable initial therapy for pneumoperitoneum in premature very low birth weight neonates (< 1500 g), demonstrating clinical response in more than half. Ongoing clinical assessment and judgment is imperative after drain placement to ensure continued clinical improvement.

Hippocampal Serotonin and Responses to Immobilization Stress in Rats Treated with Metformin

Background: Stress-related illnesses and depression are rising in modern society. Selective serotonin reuptake inhibitors as well as other antidepressants, are also not very effective and commonly exhibit partial remission, suggesting the need for novel therapeutic agents for treating anxiety and depression. Objective: The present study was designed to investigate serotonergic mechanisms in the potential anxiolytic and stress-reducing effects of metformin. Method: In the first experiment, rats were given two doses (50 and 100mg/kg) of metformin to monitor the effects of repeated administration on motor activity, anxiety, and 5-HT-1A receptor expression in the hippocampus and raphe nuclei. The second experiment was conducted in 2 parts, in 2a. experiment, control, and metformin (50 mg/kg) treated rats were immobilized for 2 hours for 5 consecutive days. Food intake and body weight were monitored daily and anxiety-like behavior was monitored on days 2 and 6. On day 6, rats were again immobilized for 2 hours, and after termination of stress rats were sacrificed to collect the hippocampus for HPLC-EC analysis of serotonin (5-hydroxytryptamine; 5-HT) and 5-hydroxy indole acetic acid (5-HIAA). In 2b. experiment, control, and metformin (50 mg/kg) treated rats were immobilized for 2 hours, and after 2 hours rats were sacrificed to collect the hippocampus for HPLC-EC analysis of 5-HT and 5-HIAA. Results: We found that metformin treatment exhibited anxiety reduction associated with greater expression of 5-HT-1A receptor in the hippocampus and reduced expression in the raphe nuclei. Immobilization stress-induced food intake and body weight deficits were comparable in control and metformin-treated rats, but the anxiogenic effects of stress were smaller in the metformintreated group. Stress-induced decreases of hippocampal 5-HT were smaller in metformin-treated than in control rats. Conclusion: Metformin can reduce stress-induced anxiety mediated via an increase in hippocampal 5-HT levels and 5-HT-1A heteroreceptor expression.

Energy, Protein, Fat and Carbohydrate Intakes in Children with Wasting Syndrome at SDN 2 Tlanak Kedungpring, Lamongan District

In school-age children, the body will later need energy and macronutrients for growth, physical activity and other skills. The purpose of this study was to describe the energy, protein, fat and carbohydrate intakes in children with wasting syndrome at SDN 2 Tlanak Kedungpring, Lamongan Regency. The research design used is descriptive observational. The sample consisted of 30 respondents. The technique used was 2 x 24-hour food recall interviews. The research time starts from October 2022-March 2023. The analysis technique used is univariate or descriptive. The results of this study showed that 20 respondents (66.6%) had energy consumption levels in the severe deficit category, 28 respondents (93.3%) had carbohydrate consumption levels in the severe deficit category, 13 respondents (43.4%) had protein consumption in the category of weight deficit and as many as 13 respondents (43.4%) had a level of fat consumption in the normal category. The conclusion of the study was that most children with wasting syndrome had normal levels of energy, carbohydrate and protein intake, deficits in weight and fat. The hope of this study is to provide an impetus for parents and the school to pay attention to children's food so that nutritional needs can be met.

Pollination deficits and their relation with insect pollinator visitation are cultivar-dependent in an entomophilous crop

Insects contribute considerably to global crop pollination, with pollination deficits being documented for multiple entomophilous or pollinator-dependent crops. Different cultivars of crops are being cultivated within and across production regions, so it is essential to understand the cultivar variability of pollination deficits. Here, we used a dataset from 286 sites from multiple production regions to develop a synthesis on pollination deficits in two widely cultivated highbush blueberry cultivars, ‘Bluecrop’ and ‘Duke’. Additionally, we determined if bee visitation or bee richness reduces pollination deficits in these cultivars. On average, neither cultivar showed pollination deficits regarding fruit set. However, for ‘Bluecrop’ we found pollination deficits for berry weight and seed set, which was not the case for ‘Duke’. Increasing total bee visitation reduced pollination deficits of both berry weight and seed set for ‘Bluecrop’. More specifically, a non-linear, negative exponential model best predicted this relation between bee visitation and pollination deficits. Our results highlight that pollination deficits and responses to pollinator visitation are variable between different cultivars of a single crop, which suggests opportunities to use certain cultivars that are less dependent on insect-mediated pollination in landscapes and regions where pollination services have been compromised. In addition, the non-linear response between bee visitation and pollination deficits suggests that optimal bee visitation rates need to be determined to improve pollination management and crop yield and to support accurate economic valuations of pollination services.

Experimental analysis of the effect of low water temperature on oogenesis of juvenile chum salmon

The state of gonads is examined for juvenile chum salmon exposed for two weeks at low water temperature, for different stages of their embryonic-larval development. The transfer of the embryos and larvae from the water with temperature of 10.0–12.0 о C to the water with temperature of 1.3–1.8 о C slowed both somatic growth of the fish and development of their germ cells in all cases. The deficit in body weight and ovarian weight of experimental fish was not compensated later. However, the gonad weight was decreased in the somatic component and did not affect the fund of germ cells, in the medium term. The state of ovaries did not differ between the control and experimental groups of fish 50 days after the end of exposure, regardless of the initial condition of gonads in the experiment.

Growth patterns of preterm and small for gestational age children during the first 10 years of life.

Preterm and small for gestational age (SGA) remain significant public health concerns worldwide. Yet limited evidence exists on their growth patterns during childhood from low-or middle-income countries. We investigated the postnatal growth patterns of preterm and SGA compared to term appropriate for gestational age (AGA) children from birth to 10-11y, and examined the impact of birth status on child nutritional status during the school age years. Children born to women who participated in a double-blinded randomized controlled trial of preconception micronutrient supplementation in Vietnam were classified into three groups: preterm AGA (n = 130), full-term SGA (n = 165) and full-term AGA (n = 1,072). Anthropometric data (weight and height) were collected prospectively at birth, 3, 6, 12, 18, 24 months and at 6-7 and 10-11y. We used ANOVA and multiple regression models to examine the differences in growth patterns from birth to 10-11y as well as child undernutrition and overnutrition by birth status. Children who were born preterm exhibited rapid postnatal growth, but still had lower HAZ at 1y and 2y and showed catch up to the AGA group at 6y. Compared to those born AGA, SGA infants had higher risk of thinness (BMIZ < -2) at 2y and 6y (adjusted Odds Ratio, AOR [95% CI] 2.5 [1.0, 6.1] and 2.6 [1.4, 4.6], respectively); this risk reduced at 10-11y (1.6 [0.9, 2.8]). The risk of stunting (HAZ < -2) was also 2.4 [1.5, 3.8] and 2.3 times [1.2, 4.1] higher in SGA than AGA group at ages 2y and 6-7y, respectively, with no differences at 10y. Although preterm children had higher rates of thinness and stunting at 2y compared to AGA children, these differences were not statistically significant. No associations were found between preterm or SGA and overweight /obesity at age 10-11y. Children who were born term-SGA continued to demonstrate deficits in weight and height during childhood whereas those born preterm showed catch-up growth by age 6-7y. Additional efforts to reduce the burden of these conditions are needed, particularly during school-age and early adolescents when children are exposed to challenging environments and have higher demands for nutrition.

Оценка пищевого статуса у детей с атопическим дерматитом, ассоциированным с пищевой аллергией

Aim. To assess the nutritional status and body composition of children with atopic dermatitis (AD) and food allergy (FA). Design. Prospective comparative observational study. Materials and methods. We observed 129 children: 59 participants in the main group with AD, the exacerbations of which are associated with FA, and 70 children in the comparison group. Age — from 1 year to 6 years (mean age — 3.44 ± 1.61 years). In the main group, there were 32 (54.2%) boys and 27 (45.8%) girls. Mild AD was observed in 12 (20.3%), moderate — in 36 (61.1%), severe — in 11 (18.6%) children. All patients followed elimination diets. A comprehensive clinical, laboratory, instrumental, allergological (for specific IgE antibodies to food allergens) examination was conducted, as well as measuring the height and body weight of patients. Body composition was determined by bioimpedancemetry. Results. Assessment of nutritional status showed that Z-score indicators were normal in 24 (40.7%) patients of the main group and in 54 (77.1%) children from the comparison group. Mild and moderate body weight deficit was observed only in the main group — in 31 (52.5%) children. In the main group and in the comparison group, children with overweight and obesity were identified (6.8 and 22.9%, respectively, p = 0.0003). Anthropometric indicators according to Z-score corresponded to the parameters of body component composition. A detailed analysis of the body component composition showed that children with mild to moderate underweight had disorders in the form of decreased lean, fat, skeletal muscle and active cell mass, which most accurately reflects the nutritional status of these patients. Etiologically significant allergens were egg (47.5%) and cow's milk (35.6%), as well as soy (16.9%), cod (13.6%), and wheat (13.6%). Conclusion. Most children with AD and PA had nutritional deficiencies associated with alimentary factors (deficiency of nutrients due to long-term elimination diets). Some children, on the contrary, were overweight and obese, which is an alarming sign. The type of diet therapy in such patients should be selected depending on the nutritional status and body component composition. Keywords: children, atopic dermatitis, food allergy, nutritional deficiencies, body component composition.

Hubungan Asupan Zat Gizi Makro dengan Status Gizi Berdasarkan LILA pada Remaja Putri di SMA Negeri 2 dan 4 Kecamatan Tuban

Problem: Chronic energy deficiency is a condition in which a person experiences a long-lasting and chronic lack of energy and protein. This condition can be determined through the measurement of MUAC (Upper Arm Circumference) as one of the indicators of nutritional status measurement. with a threshold of 23.5 cm. Objective: This study is to determine the relationship between macronutrient intake, iron and physical activity with nutritional status based on MUAC in SMA Negeri 2 and 4 Tuban District. Method : Analytical research method with a cross sectional approach. The sample of adolescents in SMA Negeri 2 and 4 Tuban Sub-district amounted to 237 respondents, determined by cluster random sampling technique. Analysis of the study using spearman correlation statistical test. Result: showed that adolescent girls with weight deficit energy intake had Chronic energy deficiency nutritional status with a percentage (93.5%), protein (76.5%), fat (76.6%), carbohydrates (86.2%). The results of statistical tests found a significant relationship between macronutrient intake and Chronic energy deficiency (p-value = 0.000). Conclusion: of this study is that macronutrients can affect the incidence of Chronic energy deficiency in adolescents. The lower the intake of macronutrients, the more adolescent girls are at risk of chronic energy deficiency

Assessment of the Economic Profitability of Fattening Selected Chicken Genotypes in an Organic Farm

The aim of this study was to evaluate whether production costs can be reduced and whether the profitability of organic chicken fattening can be increased by selecting the appropriate genotypes. Rhode Island Red (K-11) and Sussex (S-66) conservative chicken genotypes, as well as modern chicken genotypes such as slow-growing Hubbard JA 957 hybrids and fast-growing Ross 308 hybrids, were selected for the study. One hundred and sixty chickens were used in the experiment (forty birds per group). The birds were fed commercial organic complete feed up to 52 days of age and organic farm-made feed (to reduce costs) between 53 and 81 days of age. Population distribution was determined using the Kolmogorov–Smirnov test. The results were analyzed statistically using one-way analysis of variance (ANOVA) with multiple comparisons and the post hoc Tukey test at a significance level of p &lt; 0.05. The 81-day fattening period (the minimum recommended period in organic farming) led to considerable weight deficits in Rhode Island Red and S-66 chickens and excessive slaughter/trade weights in Hubbard JA 957 and Ross 308 chickens. The feed conversion ratio was high in Rhode Island Red (K-11) and Sussex (S-66) chickens at 4.19 and 4.50, respectively, and much lower in Hubbard JA 957 and Ross 308 chickens at 2.79 and 2.53, respectively. The choice of chicken genotypes had a major impact on the profitability of organic farming, and the total costs of feed and other ingredients per kg of body weight were determined at EUR 3.83 for Rhode Island Red (K-11), EUR 3.90 for Sussex (S-66), EUR 6.57 for Hubbard JA 957, and EUR 6.62 for Ross 308 genotypes. The profitability of organic farming can be increased by selecting modern, meat-type, slow-growing chicken genotypes.

Quantifying Bone Strength Deficits in Young Adults Born Extremely Preterm or Extremely Low Birth Weight.

The long-term bone health of young adults born extremely preterm (EP; <28 weeks' gestation) or extremely low birth weight (ELBW; <1000 g birth weight) in the post-surfactant era (since the early 1990s) is unclear. This study investigated their bone structure and estimated bone strength using peripheral quantitative computed tomography (pQCT)-based finite element modeling (pQCT-FEM). Results using this technique have been associated with bone fragility in several clinical settings. Participants comprised 161 EP/ELBW survivors (46.0% male) and 122 contemporaneous term-born (44.3% male), normal birth weight controls born in Victoria, Australia, during 1991-1992. At age 25 years, participants underwent pQCT at 4% and 66% of tibia and radius length, which was analyzed using pQCT-FEM. Groups were compared using linear regression and adjusted for height and weight. An interaction term between group and sex was added to assess group differences between sexes. Parameters measured included compressive stiffness (kcomp ), torsional stiffness (ktorsion ), and bending stiffness (kbend ). EP/ELBW survivors were shorter than the controls, but their weights were similar. Several unadjusted tibial pQCT-FEM parameters were lower in the EP/ELBW group. Height- and weight-adjusted ktorsion at 66% tibia remained lower in EP/ELBW (mean difference [95% confidence interval] -180 [-352, -8] Nm/deg). The evidence for group differences in ktorsion and kbend at 66% tibia was stronger among males than females (pinteractions <0.05). There was little evidence for group differences in adjusted radial models. Lower height- and weight-adjusted pQCT-FEM measures in EP/ELBW compared with controls suggest a clinically relevant increase in predicted long-term fracture risk in EP/ELBW survivors, particularly males. Future pQCT-FEM studies should utilize the tibial pQCT images because of the greater variability in the radius possibly related to lower measurement precision. © 2023 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).

241 Increased Inflammatory Tone and Impaired Skeletal Muscle Growth in Intrauterine Growth-Restricted Neonatal Lambs Is Improved By Daily Supplementation of ω-3 Polyunsaturated Fatty Acid Ca2+ Salts

Abstract Low birthweight due to fetal intrauterine growth restriction (IUGR) often results from maternofetal heat stress. IUGR fetuses exhibit enhanced inflammatory tone, which persists after birth and impacts body composition, skeletal muscle growth, and metabolic function. Therefore, our objective was to determine whether daily oral supplementation of Ca2+ salts of ω-3 polyunsaturated fatty acids (ω-3 PUFA) to IUGR-born neonatal lambs improved inflammatory tone, body composition, and growth metrics. Pregnant ewes were exposed to heat stress (40°C, 35% humidity, THI = 85) from d 40 to 95 of gestation to induce IUGR. Lambs were weaned at birth and hand-reared on milk replacer. Daily oral boluses of 0.5 mL molasses containing 0 or 0.42 g/kg bodyweight of ω-3 PUFA (Virtus Nutrition) were administered. Femoral catheters were placed at d 24 and lambs were necropsied at d 30. At birth, IUGR lambs (n = 8; 3.12 ± 0.34 kg) and IUGR+ω-3 lambs (n = 7; 3.67 ± 0.32 kg) were lighter (P &amp;lt; 0.05) than controls (n = 12; 4.28 ± 0.15 kg). Plasma TNFα concentrations were greater (P &amp;lt; 0.05) at birth for IUGR (557 ± 121 pg/mL) and IUGR+ω-3 lambs (437 ± 82 pg/mL) than for controls (213 ± 78 pg/mL). Plasma TNFα concentrations remained increased (P &amp;lt; 0.05) for IUGR lambs but not for IUGR+ω-3 compared with controls at 2, 3, and 4 wk of age. Adjusted 30-d bodyweights were lighter (P &amp;lt; 0.05) for IUGR lambs (9.83 ± 0.6 kg) but not for IUGR+ω-3 lambs (11.59 ± 0.4 kg) than for controls (12.35 ± 0.2 kg). Heart and brain weights were 17% and 6% lighter (P &amp;lt; 0.05), respectively, for IUGR lambs than for controls. Brain weight deficits were resolved in IUGR+ω3 lambs, but heart weights did not differ between IUGR and IUGR+ω-3 IUGR lambs. Crown circumference/ bodyweight, abdominal circumference/ bodyweight, and cannon bone length/ bodyweight (indicators of asymmetric body composition) were 11% to 15% greater (P &amp;lt; 0.05) for IUGR lambs than for IUGR+ω-3 lambs or controls. At necropsy, IUGR lambs had lighter (P &amp;lt; 0.05) whole hindlimbs (29%) and flexor digitorum superficialis (24%), soleus (36%), biceps femoris (25%), semitendinosus (24%), gastrocnemius (29%), and longissimus dorsi (26%) muscles compared with controls. Weight deficits were partially or fully resolved in IUGR+ω-3 lambs for whole hindlimbs and for all muscles but the soleus, which did not differ from IUGR lambs. These findings demonstrate that daily oral supplementation of Ca2+ salts of ω-3 PUFA reduced the enhanced inflammatory tone observed in IUGR-born offspring, which coincided with improved skeletal muscle growth and indicators of symmetrical body composition.

76 Follow-up of the Therapeutic Effects of Integrative Neuropsychological Training Model for Executive Functions Deficits in School-age Children Born Very Low Birth Weight with Normal Early Development-A Preliminary Report

Objective:The preschool children born very low birth weight(VLBW) still have executive functions(EFs) deficits even with normal early development(Ni, Huang, &amp; Guo, 2011). Consequently, early intervention might be more important than expected. This study aims to investigate the follow-up outcome of the therapeutic effects of integrative neuropsychological training model(INTM) focused on EFs for school-age VLBW children with EFs deficits.Participants and Methods:The VLBW children, recruited from the Regional Cohort Network for premature infants who were admitted to neonatal intensive care units, had normal scores in Bayley and Wechsler Intelligence systems before 6 years old. They also received follow-up neuropsychological assessment for EFs at 6 or 8-year-old. The deficits of EFs were defined from the result of Digit Span Subtest of WISC-IV, Knox's Cube Test(KCT), Tower of London(ToL), Wisconsin Card Sorting Test(WCST), and Comprehensive Nonverbal Attention Test Battery(CNAT). A total of 8 VLBW children with EFs deficits were recruited and received EFs training at 6 or 8-year-old. The INTM combined with Comprehensive Memory Training System(CMTS), Executive FUNction Training(EFT), and multi-ecological materials focused on enhancing the four aspects of EFs, including working memory, planning, cognitive flexibility, and inhibition ability. Then, they received follow-up neuropsychological assessment for EFs at 8 or 10-year-old.Results:The results showed that all children got benefits from 20 hours of INTM and most of the EF aspects remained improved at follow-up. A total of 8 VLBW children with an average of 3.4 aspects EFs deficits had an average of 1.4 aspects of EFs deficits left at the follow-up. More precisely, 5 of them had 1 aspects of EFs deficits and 3 of them had 2 aspects of EFs deficits.Conclusions:This study revealed that such a short-term INTM had long-term effects in enhancing the EFs of those VLBW children who had normal early development but later grew into EFs deficits at school-age. Besides, their EFs are still improving even after two years of intervention. Further study on more subjects with longer follow-up might help VLBW children to achieve better neuropsychological function.

The impact of in utero cannabis exposure on fetal growth.

The goal of this study was to examine if in utero cannabis exposure predicted reduced birth size and if these effects were evident in specific growth parameters as early as the second trimester. Eligible women had an initial prenatal visit between January 1, 2010, and March 31, 2020, completed an anatomy ultrasound between 18-24 weeks' gestation, and had no self-reported alcohol, tobacco, or other biochemically verified drug use. The two primary study groups were cannabis users (n = 109) identified through self-report and urine toxicology screens, and a randomly selected control group of non-substance users (n = 171). Medical records were manually reviewed for background and medical information, anatomy ultrasound results, and birth size parameters. After controlling for significant confounders, regression results indicated significant (p < .05) deficits in birth weight associated with cannabis exposure, with a trend for increasing weight effects beginning in the second trimester. A significant decrease in head circumference was evident as early as the second trimester, with differences remaining significant until birth. Significant overall length and specific bone length deficits were not predicted by cannabis exposure, at birth or earlier in gestation, after control for confounding. Cannabis exposure predicted growth deficits at birth, with some effects evident as early as the second trimester. The biggest and earliest effects were seen for cranial size, with an adjusted deficit of more than 14 percentile points by birth. Overall weight was not impacted until at or near delivery.

FRI247 Case Of Metabolic Resolution Of Non-classic Congenital Adrenal Hyperplasia Post Roux-En-Y Gastric Bypass

Abstract Disclosure: K.G. Romo: None. S. Shu: None. M. Gabriel: None. S. Bhamre: None. Q.Z. Iqbal: None. A.A. Noor: None. G.I. Uwaifo: None. Background: Non-classic congenital adrenal hyperplasia (NCCAH) is an autosomal recessive disorder resulting from loss of function mutations of the 21-hydroxylase gene. It is characterized by mild cortisol deficiency, excess ACTH production, and androgen excess, often with various features of dysmetabolic syndrome. Elective bariatric surgery is one of the most effective long-term management strategies for morbid and complicated obesity. This case presents a woman with NCCAH and complicated morbid obesity who s/p Roux-en-Y Gastric Bypass (RYGB) had metabolic resolution of NCCAH and no longer required glucocorticoid (GC) therapy. Clinical Case: A 34-year-old G1P1 woman with NCCAH on glucocorticoid therapy, treated hypothyroidism with thyroid nodular disease, dyslipidemia, and morbid obesity (pre-RYGB BMI 60-69.9) initially presented to endocrinology on account of hirsutism and secondary amenorrhea attributed to PCOS. Work-up then confirmed diagnosis of NCCAH with 21-hydroxylase genetic testing showing deletion of one copy of CYP21A2 and the pathogenic variant p.V282L in the remaining copy. Outside the peripartum period, she was managed with OCP therapy, spironolactone, and metformin. She was additionally prescribed GC therapy of hydrocortisone 10mg TID following her diagnosis of NCCAH. She subsequently became pregnant unexpectedly. Post-partum course was complicated by significant weight gain, which led her to seek elective bariatric surgery for long-term weight management. At 5 months post-op, she had a weight deficit of ∼100lbs. Although she self-discontinued GC therapy due to fear of weight gain, her amenorrhea resolved, her hirsutism significantly improved, and lab testing revealed normalization of all NCCAH markers, including ACTH, 17-OHP, and androstenedione. Thus, GC therapy was not restarted. At 11 months post-op and still off GC therapy, she had a total weight deficit of ∼160lbs and continued metabolic resolution of NCCAH markers. Conclusions: This case presents a patient with NCCAH and morbid obesity who no longer required GC therapy post-RYGB. Presently, GC therapy remains the only available treatment for CAH; however, long-term GC therapy has the potential for myriad possible complications and side effects. Our case presents elective bariatric surgery as a potential and unique treatment option for patients with classic or non-classic CAH who have associated morbid obesity. The exact pathophysiologic basis for this effect and its potential role in long-term management of appropriate CAH patients requires further in-depth study. Presentation: Friday, June 16, 2023

Трансформація цінностей дівчаток-підлітків під впливом комплексної оздоровчої програми

The study on the impact of a health program using the means of health fitness, motivational training, and psychocorrective activities on the transformation of value orientations of underweight teenage schoolgirls is relevant. The aim of the study is to investigate the impact of a comprehensive health program on the transformation of value orientations and school anxiety of underweight adolescent girls. The study involved 69 underweight adolescent girls (among them 54 12-yearold girls and 15 13-year-old girls). Methods. To assess value orientations, the M. Rokych’s methodology was used. The Phillips test was used to assess the level and nature of school anxiety in teenage girls. The factor structure of value orientations and school anxiety of 12-13-year-old girls with body weight deficiency was studied using factor analysis. Results. Based on the factor analysis, the transformation of the girls’ instrumental values, as well as the positive dynamics of the decrease in their school anxiety indicators, were accepted as criteria for the effectiveness of the health program. The program was designed for 9 months of duration and included psychocorrective activities, motivational training, and health-enhancing recreational physical activity. After the study, the value of health increased by 2 points and was in the top three most important values, and the value of knowledge rose by 6 units in the ranking of values. Among the positive changes, it should be noted that the rating of such a value as “Sensitivity” increased by 7 points and “Intolerance to shortcomings in oneself and others” decreased by 9 points. After participation in the program, there was a decrease in school anxiety indicators (frustration of the need to achieve success, which is expressed in an unfavorable mental background that does not allow the child to achieve a high result and fear of self-expression, which is manifested in negative emotional experiences of situations related to the need t present myself to others). Conclusions. The proposed program had a positive effect on the transformation of value orientations, the reduction of school anxiety indicators of 12–13-year-old girls with a body weight deficit.

Decreased myelin-related gene expression in the nucleus accumbens during spontaneous neonatal opioid withdrawal in the absence of long-term behavioral effects in adult outbred CFW mice

Prenatal opioid exposure is a major health concern in the United States, with the incidence of neonatal opioid withdrawal syndrome (NOWS) escalating in recent years. NOWS occurs upon cessation of in utero opioid exposure and is characterized by increased irritability, disrupted sleep patterns, high-pitched crying, and dysregulated feeding. The main pharmacological strategy for alleviating symptoms is treatment with replacement opioids. The neural mechanisms mediating NOWS and the long-term neurobehavioral effects are poorly understood. We used a third trimester-approximate model in which neonatal outbred pups (Carworth Farms White; CFW) were administered once-daily morphine (15 mg/kg, s.c.) from postnatal day (P) day 1 through P14 and were then assessed for behavioral and transcriptomic adaptations within the nucleus accumbens (NAc) on P15. We also investigated the long-term effects of perinatal morphine exposure on adult learning and reward sensitivity. We observed significant weight deficits, spontaneous thermal hyperalgesia, and altered ultrasonic vocalization (USV) profiles following repeated morphine and during spontaneous withdrawal. Transcriptome analysis of NAc from opioid-withdrawn P15 neonates via bulk mRNA sequencing identified an enrichment profile consistent with downregulation of myelin-associated transcripts. Despite the neonatal behavioral and molecular effects, there were no significant long-term effects of perinatal morphine exposure on adult spatial memory function in the Barnes Maze, emotional learning in fear conditioning, or in baseline or methamphetamine-potentiated reward sensitivity as measured via intracranial self-stimulation. Thus, the once daily third trimester-approximate exposure regimen, while inducing NOWS model traits and significant transcriptomic effects in neonates, had no significant long-term effects on adult behaviors.

Effects of family-based treatment on adolescent outpatients treated for anorexia nervosa in the Eating Disorder Unit of Helsinki University Hospital

BackgroundFamily therapy for adolescent anorexia nervosa (AN) has stronger evidence of efficacy in comparison with individual therapy, and family-based treatment (FBT) is the most evaluated in numerous randomized clinical trials. However, few studies have focused on how FBT performs outside of research settings. The current study is the first to assess clinical outcomes of FBT for adolescent AN in Finland, in a specialized outpatient clinic.AimThe naturalistic outcome of outpatient FBT for adolescent AN was investigated.MethodsFifty-two female patients and their families who received FBT at a tertiary eating disorders unit participated in the study. Data on their pre-treatment parameters, treatment details, and condition at the end of treatment (EOT) was collected from their medical records.ResultsAt EOT, a majority (61.5%) had achieved a full weight restoration [percentage of expected body weight (%EBW) ≥ 95%]. Participants with an %EBW ≥ 95 at EOT had a significantly higher pre-treatment %EBW than those with an EBW < 95% at EOT. Participants with an EBW ≥ 95% at EOT showed significantly higher total weight gain during the treatment period, a higher rate of regular menstrual periods at EOT, significantly lower rates of dietary restrictions, and less cognitive or behavioral symptoms of the eating disorder overall, compared to participants who did not achieve a normal body weight. In 22 cases (42.3%), there was no need for further treatment at the end of FBT. Participants who needed further treatment after FBT, compared to those who did not, showed significantly higher rates of psychiatric comorbidity, history of mental health treatment, and need for psychopharmacological treatment.ConclusionsIn this naturalistic study, and in line with previous studies, FBT for AN appeared to be an effective and sometimes sufficient intervention, especially for patients with milder weight deficit and less severe psychiatric comorbidities. The results show that FBT can be successfully implemented in Finland and suggest that training more ED clinicians in FBT would be beneficial.Trial registration: The study was retrospectively registered on February 8th, 2023, in ClinicalTrials.gov Protocol Registration and Results System, identifier: NCT05734573.

Evaluasi Konsumsi Makan dan Kepatuhan Konsumsi TTD terhadap Tingkat Kecukupan Zat Besi pada Remaja Putri di SMKN 1 Salatiga

Background: Anemia is a nutritional problem, the 2018 Riskesdas data shows 48.9% of adolescent girls experience iron deficiency anemia. The government has made efforts to overcome the problem of anemia in adolescent girls through the provision of blood-supplementation tablets (TTD).Methods: This research used is descriptive with a quantitative approach, using a 2x24 hour instrument record, and the SQ-FFQ form. This study assesses the level of iron adequacy by looking at the data from the evaluation of food consumption which is expressed by the value of MAR (Mean Adequacy Ratio).Result: The results showed that respondents in consuming iron tablets were in the non-adherent category as much as 65%, the level of iron adequacy in the very poor category was 42.5%, the level of macronutrient intake in 42.5% of respondents experienced a severe level of deficit and the food intake of respondents was less varied.Conclusion : The conclusion of this study is an evaluation of food consumption average has a weight deficit, the food consumed does not vary, iron intake is not sufficient according to the AKG, and is not obedient in consuming TTD.

Anthropometric characteristics of patients suffering from chronic cystitis

Introduction. With a depressingly high prevalence of chronic cystitis (it is believed that half of women suffer from acute cystitis at least once in their lives), there is still no clarity on this disease. We were unable to find any studies on the anthropometric characteristics of patients with chronic cystitis either in the domestic or in the English literature.Objective. To assess the anthropometric characteristics of patients with chronic recurrent cystitis.Material &amp; methods. A prospective multicenter cohort study included 91 patients with symptoms of acute cystitis. All underwent anthropometric measurements, analyzed complaints, studied anamnesis morbi et vitae, performed a study on a gynecological chair; urine was sent for general analysis and bacteriological examination for nonspecific microflora with the determination of the sensitivity of the isolated pathogen to antimicrobial drugs. The patients answered questions about the Russian version of the Acute Cystitis Symptom Score (ACSS). A urethra and cervical canal smear was studied using the polymerase chain reaction method to identify the causative agents of sexually transmitted infections. The diagnosis was considered confirmed in the presence of leukocyturia, bacteriuria, and the sum of symptoms on the ACSS scale was 6 or more.Results. The duration of chronic recurrent cystitis was averaged at 7.1 ± 4.2 years. The age of the patients ranged from 18 to 49 years, averaging 28.9 ± 3.9 years. The height ranged from 150 cm to 178 cm, on average 165.9 ± 7.1 cm. The average weight was within the normal range: 64.2 ± 6.1 kg. However, the spread in the cohort by body weight was two-fold: from 42 to 86 kg. Overweight was found in five (5.5%) patients; two patients (2.2%), on the contrary, had a body weight deficit. When analyzing anthropometric indicators, along with the obvious ones (direct dependence of the duration of the disease on the age of the patient; direct dependence of the quality of life on the severity of symptoms), other statistically significant correlations were established: a positive relationship between age and weight, weight and duration of the disease.Conclusion. The analysis showed that overweight women respond to treatment worse, they have a longer history of cystitis. Neither typical symptoms nor ACSS score correlated with any of the anthropometric measures.