Healthy Preschool Children Research Articles

Stereoacuity and Related Factors in Healthy Preschool Children: The Nanjing Eye Study

ABSTRACT Purpose To assess the distribution of stereoacuity and related factors in healthy preschool children aged 48–60 months in eastern China. Methods This cross-sectional study was part of the Nanjing Eye Study, a longitudinal population-based cohort study. In 2016, preschool children without any neurological problems or ophthalmological abnormalities completed comprehensive eye examinations, including visual acuity, ocular alignment and movements, cycloplegic refraction, axial length, interpupillary distance, Titmus stereotest, anterior segment, and fundus examination. Multivariate linear regression model was used to determine the factors associated with stereoacuity score, and logistic regression model was used to determine the factors associated with subnormal stereoacuity (worse than 40 arc-seconds). Results Among 942 healthy preschool children (mean age = 55 months), the mean (SD) stereoacuity was 81 (2.3) arc-seconds with majority (76.5%) worse than 40 arc-seconds. In the multivariate analysis, older age (p = 0.001) and better presenting visual acuity (PVA) (p = 0.01) were independently associated with better stereoacuity score. Older age was also associated with low risk of subnormal stereoacuity (odds ratio = 0.37,p < 0.001 for age 57–60 months compared to age 48–51 months). Conclusions The maturation of stereopsis has not completed by the age of 48–60 months. Age and PVA should be taken into account when evaluating stereopsis in healthy preschoolers. The significant associations of age and PVA with stereoacuity provide valuable insights into possible intervention for healthy preschool children with poor stereoacuity.

70 High Dose Vitamin D for the Prevention of Wheezing in Preschoolers: A Secondary Analysis of a Randomized Clinical Trial

Wheeze is a common condition affecting nearly one in three preschool children with few effective preventive interventions. Observational studies have suggested that vitamin D may improve lung function in children and adults, though no trial has examined whether a high dose of vitamin D supplementation can prevent wheezing in healthy preschool children. This study aimed to determine whether high dose vitamin D supplementation could reduce wheezing in young healthy children compared to a standard dose of vitamin D supplementation. This study was a prespecified secondary analysis of a 1:1 parallel, multicenter, superiority randomized clinical trial. The trial was conducted through a large primary care research network in Toronto, ON. Children with health conditions affecting growth, chronic condition(s) except for asthma, severe developmental delays, and children with gestational age < 32 weeks were excluded. Healthy children age 1 to 5 years were randomized to either ‘standard-dose’ (400IU/day) or ‘high-dose’ (2000IU/day) orally supplemented vitamin D. Parents administered 1 drop/day of the assigned formulation (Kids Ddrops containing vitamin D3) to their child between time of enrolment (September-November) until follow-up (April-June). The outcome for this prespecified secondary analysis was one or more wheezing episode ascertained monthly by telephone. A binomial regression model was used to obtain the relative risk of one or more wheezing episodes in the high-dose group compared to the standard-dose group with 95% confidence intervals. Between September 2011 and June 2015, 703 children were recruited of which 631 (89.6%) provided data on wheezing. Mean age was 2.03 years and 57% were male. At baseline, 17 % of children in the high-dose group and 15 % of children in the standard-dose group had serum 25-hydroxyvitamin D levels below 75 nmol/L. Wheezing in the past was reported at baseline by 22% in the high-dose group and 20% in the standard-dose group. One or more wheezing episodes occurred in 16% of participants in the high-dose group and 12% of participants in the standard-dose group over the winter season which was not statistically different (RR=1.38, 95% CI: 0.93, 2.07, p=0.12). In this randomized clinical trial of healthy young children, the risk of wheezing was not reduced by high-dose vitamin D compared to standard-dose supplementation. These results are consistent with several observational studies of vitamin D supplementation and wheeze in childhood. The trial was conducted across multiple sites, enhancing the generalizability of results. This study was limited by parent-reported outcomes, though gold standard tests for wheeze (e.g. spirometry) are challenging to perform in young children.

The Association of Physical Activity and Sedentary Behaviors with Upper Respiratory Tract Infections and Sleep Duration in Preschool Children-Study Protocol.

Currently, there is no consensus regarding the benefits of physical activity in terms of upper respiratory tract infections (URTIs) among different age groups of children. The number of school students avoiding physical education is on the rise. Children of all ages spend more time on sedentary behavior, eat less nutritious food and spend less time sleeping. All of these concomitant aspects adversely affect the immune system. A coexisting problem of a growing society is a large number of URTIs which is the main reason for general practitioner intervention. The aim of this study is to determine whether there is a correlation between the frequency of respiratory tract infections and the level of physical exercise in a cohort of pre-school children. This will be a cross-sectional, short-term study conducted on a single study population. We aim to recruit four-, to seven-year-old children who will be receiving activity monitoring devices for 24 h a day for 40 days. Daily step count, mean intensity of physical exercise and sleep duration will be measured. Simultaneously, their parents will receive a series of 60 questionnaires, one questionnaire per day, for the daily assessment of upper respiratory infection (URI) symptoms. Our study conducted on a cohort of healthy pre-school children using uniform tools, aims to scientifically establish and quantify the relationship between physical activity and health outcomes over a specified period of time.

Feasibility study and reference values of FibroScan 502 with M probe in healthy preschool children aged 5\u2009years

BackgroundTransient elastography (TE) using FibroScan with M probe has been widely used in adults for controlled attenuation parameter (CAP) and liver stiffness measurement (LSM). In this study, we aimed to assess the feasibility of this approach and reference values of CAP and LSM in healthy preschool children aged 5 years.MethodsFibroScan-502 with M probe (Echosens, Paris, France) and bioelectrical impedance analysis (InBody 720, Biospace, South Korea) were prospectively conducted in healthy children aged 5 years from the Shanghai Prenatal Cohort Study. Linear regression models and piece-wise linear regression models were used to explore the factors associated with CAP and LSM.ResultsThe success rate of a valid TE measurement was 96.5% in 452 healthy preschool children aged 5 years, and 436 children with 236 boys were included for further study. The median, inter quartile range (IQR) and the 5th–95th percentiles of CAP values were 171.50, 162.07–188.13 and 154.21–214.53 dB/m, respectively. The median, mean ± standard deviation and the 5th–95th percentiles of LSM were 3.20, 3.28 ± 0.86 and 2.00–4.78 kPa, respectively. In multivariate linear regression analyses, the CAP but not the LSM value was significantly positively correlated with such anthropometric index as body weight, body mass index, waist circumference, body fat content and body fat percentage.ConclusionsFibroScan-502 with M-probe can be used to measure CAP and LSM in preschool children aged 5 years. The 95th percentiles of CAP values and LSM were 214.53 dB/m and 4.78 kPa, respectively. Further study should be performed to explore the cut-off values of CAP and LSM for diagnosis of hepatic steatosis and fibrosis in children.

Spirometric values in healthy preschool children.

Spirometry is the most commonly used test to evaluate lung function. Foreign refe rence standards are currently available for preschool children. 1. To measure spirometric variables in healthy Chilean preschool children, 2. To compare these results with predictive ones according to GLI (Global Lung Initiative), Eigen (USA) and França (Brazil), and 3. If there is a sig nificant difference with these, to develop reference equations. Questionnaires were distributed to parents in several schools and kindergartens in Santiago. Children with a history of prematurity, asthmatic symptoms, chronic lung disease (including asthma), and chronic non respiratory disease were excluded. Spirometry was performed according to ATS/ERS 2007 guideli nes, with MedGraphics equipment, USA. Family and environmental background, weight and height were recorded, as well as values obtained in forced vital capacity (FVC), forced expiratory volume in 0.5, 0.75 and 1 second (FEV0.5, FEV0.75, and FEV1, respectively). 276 spirometries were performed, 202 met acceptability criteria, 112 girls, average age 5.01 ± 0.57 years, height 108.7 ± 5.6 cm. When comparing by gender, there was only a significant difference in FVC, which was higher in boys. The average values obtained in the total group were: FVC 1.22 ± 0.22 liters, FEV1 1.16 ± 0.18 liters, FEV0.75 1.07 ± 0.17 liters. These parameters were higher in percentage than the predictive ones according to GLI, Eigen, and França, except FVC with Eigen, therefore, predictive equations were de veloped. Spirometric values of preschoolers living in Santiago were higher than foreign reference values. We proposed these reference standards to be used in our country.

Impulse oscillometry reference values and correlation with predictors in Turkish preschool children.

Er İ, Günlemez A, Baydemir C, Kılıçbay F, Ersu R, Uyan ZS. Impulse oscillometry reference values and correlation with predictors in Turkish preschool children. Turk J Pediatr 2019; 61: 560-567. Impulse oscillometry (IOS) is a noninvasive, rapid technique requiring passive cooperation that allows for evaluation of lung function through the measurement of airway resistance and reactance. There are no available reference values for Turkish children. This study is aimed to determine the reference values of IOS parameters and to study their correlation with height, weight, body mass index, and age as predictors in healthy Turkish preschool children. Healthy children between 3-7 years of age who were selected according to ERS/ATS criteria and followed at Kocaeli University outpatient clinic performed IOS. The correlation between the anthropometric predictor variables and resistance and reactance at 5-20 hertz (R5-R20 and X5-X20), the respiratory impedance at 5 hertz (Z5), resistance area (AX) and resonance frequency (Fres) were assessed by regression analysis and stepwise method. 151 children (93 female) with the mean age of 67.9±16.2 months participated in the study. Multilinear regression analysis for IOS values of all children revealed that resistance was significantly correlated with height and reactance was significantly correlated with age (p < 0.05). For girls, height had a negative effect on R5-20, Z5, AX values, while age had a positive effect on X5-20 and a negative effect on Fres (p < 0.05). For boys, weight had a negative effect on R5- 20, Z5 values, while age had a positive effect on X15-20 and a negative effect on AX, Fres (p < 0,05). This study provided reference values of IOS in healthy Turkish children that would be a useful guide for diagnosing and following respiratory diseases in preschool children.

Iron deficiency anemia among preschool children belonging to affluent families in Kerala, India

Context: Anemia leads to impaired cognitive function, growth, and psychomotor development. Zeroing in on a specific socioeconomic or demographic group and a specific type of anemia, may help in better planning of resources in our battle against anemia. Aims: The aim of this study is to determine the prevalence, severity, risk factors (age, gender, and nutrition status) of iron deficiency anemia (IDA) in apparently healthy preschool children (6–59 months) belonging to affluent families. Settings and Design: A cross-sectional study conducted in a private teaching hospital. Subjects and Methods: A total of 160 children aged 6–59 months, belonging to the upper middle class, who came to the pediatric outpatient department for routine visits over a period of 1 year were evaluated. Sociodemographic data with hemoglobin, red cell indices and iron studies of blood samples were estimated. Statistical Analysis Used: Continuous data were described as mean and standard deviation. Odds ratio with 95% confidence interval was calculated using multiple logistics regression. Results: Among the 160 children evaluated, 48 (30%) were anemic, of which 41 (85.4%) had IDA. Equal proportion (P = 0.84) of boys (25.0%) and girls (26.4%) and equal proportion (P = 0.75) of well-nourished (26.2%) and moderately nourished (23.3%) had IDA. A higher proportion (P Conclusions: A high prevalence among apparently healthy children from affluent families is an indicator that the general population rates will be even higher. This study highlights the need to plan further intervention trials with either iron-rich or iron-fortified foods or iron supplementation, especially among children below the age of 2.

Vitamin D Status and Analysis of Specific Correlates in Preschool Children: A Cross-Sectional Study in Southern Croatia.

Vitamin D deficiency is a globally important problem, particularly in children, but there is a lack of information regarding this deficiency in preschool children from southeastern Europe. This study aimed to establish the levels of 25-hydroxyvitamin D (25(OH)D) and associations of gender, time spent outdoors, physical activity (PA), and body mass index (as predictors) with the 25(OH)D level (outcome) in healthy preschool children. The participants were preschoolers (all 5–6 years of age) from southern Croatia. All the participants were tested during their mandatory medical examination 6–7 months prior to school enrollment. The PA was obtained using the preschool-age physical activity questionnaire (Pre-PAQ), which categorizes PA into five levels (from sedentary to vigorous PA). The prevalence of 25(OH)D deficiency was high: 58% of the children had 25(OH)D levels of <50 nmol/L (deficiency), and an additional 29% had an insufficient level of 25(OH)D (50–75 nmol/L). Boys had higher levels of 25(OH)D than girls. A multinomial regression using 25(OH)D categories as the outcome and a sufficient level (>75 nmol/L) as the reference value identified gender as the only significant predictor of 25(OH)D status, with boys being at lower risk for 25(OH)D deficiency than girls. These results showed a high prevalence of 25(OH)D deficiency in preschoolers from the southern part of Croatia, which is additionally alarming based on the geographical position of the studied region (42° N) and its high number of sunshine hours (>2600 h per year). Future studies examining other potential correlates of 25(OH)D in the region are warranted.

Prevalence and Predictors of Behavioral Problems in Healthy Swiss Preschool Children Over a One Year Period.

Behavioral problems impair children's health but prevalence rates are scarce and persistence rates vary due to divergence in age ranges, assessment methods and varying environmental factors. The aim of this study was to assess prevalence rates of behavioral problems, their persistence over a 1-year period, and the impact of child- and parent-related factors on behavioral problems. 555 2-6-year-old healthy preschool children were assessed at baseline and 382 of the initial sample at 1-year follow-up. Assessment included questionnaires concerning behavioral problems and their potential predictors (e.g. socio-economic status or parenting style). Altogether, nearly 7% of these children showed clinically relevant behavioral problems, and 3% showed persistent symptoms. Low SES, inconsistent parenting and corporal punishment were positively associated with behavioral problems. The prevalence rates of behavioral problems in Swiss preschoolers are similar to other European countries, but persistence is still rather low within preschool age. These findings need further confirmation in longitudinal studies.

Case presentation: persistent adenovirus B3 infections associated with bronchiolitis obliterans treated with cidofovir in a child with mosaic tetrasomy 9p

BackgroundAdenoviruses (AdV) are non-enveloped, double-stranded DNA viruses with multiple serotypes, which cause a variety of end-organ disease in both immunocompetent and immunocompromised individuals. Some adenoviruses can become latent in the mucosa-associated lymphoid tissue (e.g. adenoids and tonsils), with the potential to reactivate sporadically, leading to upper or lower respiratory tract infection and disease. Bronchiolitis Obliterans (BO) is a rare chronic lung disorder which usually follows a severe insult to the respiratory tract. In children, it is a complication of severe infections (as post-infectious BO), typically manifesting after a severe respiratory infection, in previously healthy pre-school children. Symptoms and signs of air trapping (hyperinflated chest, expiratory wheeze) with persistent oxygen requirement are characteristic. The presence of the unusual mosaic tetrasomy 9p genotype in this case, despite standard cidofovir therapy for persistent or chronic adenovirus infection, may have impacted on the child’s long-term clinical outcomes.Case presentationWe present a case of persistent AdV B3 infection in a 14-month old boy with mosaic tetrasomy 9p, which persisted for 10 weeks, resulting in radiologically-confirmed BO, requiring cidofovir to control the persistent AdV B3 infection and standard therapy with pulsed steroids. We argue that in the presence of the mosaic tetrasomy 9p, earlier antiviral therapy may have decreased the severity of BO, as this mutation is known to be associated with some degree of immune dysregulation.ConclusionsAdenovirus infections are common in children and may persist as latent infections, with subsequent reactivations during loss of immune control, related to systemic illness arising from other causes. In chronic, reactivated AdV infection with pneumonia, BO is a recognised complication. However, in this case, with the presence of the mosaic tetrasomy 9p mutation, earlier antiviral therapy may have reduced such longer term complications, due to the immune dysregulatory nature of this mutation.

Asthma control in preschool children with small airway function as measured by IOS and fractional exhaled nitric oxide.

This study investigated the accuracy of impulse oscillometry (IOS) combined with fractional exhaled nitric oxide (FeNO) to assess asthma control among preschool children. A total of 79 preschool children(3-6 year old) with asthma and 25 healthy preschool children who visited a paediatrician were enrolled in this study. All of the children were tested for allergens, respiratory system resistance (at 5 and 20 Hz [R5, R20]), respiratory system reactance (at 5 Hz [X5]), the resonant frequency of reactance (Fres), and the area under the reactance curve (between 5 Hz and Fres (reactance area [AX]) using IOS and FeNO. A paediatric respiratory specialist who was unaware of the IOS and FeNO results assigned children with asthma to either the asthma-controlled group (n = 27) or the asthma-uncontrolled group (n = 52) based on the Global Initiative for Asthma (GINA) criteria. A healthy control group (n = 25) was also included. The relationships between the FeNO and IOS values as well as the asthma control of the three groups were analysed, and the areas under the curve (AUCs) were calculated for each measure. (1) During the controlled group, means±standard deviations of AX, R5-20, R5, X5 and FeNO were 26.15 ± 7.534, 3.52 ± 1.311,9.97 ± 1.576,-3.85 ± 0.572,-3.85 ± 0.572. During the uncontrolled group, means±standard deviations of AX,R5-20,R5,X5 and FeNO were 38.34 ± 13.563,5.36 ± 1.545,11.41 ± 2.029,-5.07 ± 1.554,36.40 ± 21.07. Among preschool children, significant differences were observed between the controlled and uncontrolled group with regard to the small airway functional parameters (AX, R5-20, R5, and X5) and FeNO(P <0.05).(2) A receiver operating characteristic (ROC) analysis showed that the AUCs were 0.786 for FeNO alone, 0.751 for X5 alone, and 0.866 for X5 combined with FeNO (cut-off value: 27 ppb). FeNO combined with the small airway function parameter X5 accurately assessed asthma control among preschool children.

Comparative analysis of inhibitory processes of healthy preschool children and children with the autistic spectrum disorder

Comparative analysis of inhibitory processes of healthy preschool children and children with the autistic spectrum disorder

Comparative analysis of inhibitory processes of healthy preschool children and children with the autistic spectrum disorder

Understanding the processes that create inhibitory demands is central to understanding the role of inhibitory control in all aspects of development. The processes that create inhibitory demands on most developmental tasks seem clear and well understood. However, there is one inhibitory task that appears substantially easier than the others: the Reverse Categorization task, in which children are asked to “reverse sort” items (e.g., put large items in a small box and put small items in a large box). This finding is both surprising and problematic because it cannot be explained by any existing account of inhibitory development. Four experiments with 3- and 4-year-olds sought to explain why the Reverse Categorization task is easy. Two experiments (N = 64) investigated the hypothesis that children conceptualize the task in a way that reduces its inhibitory demands; and two experiments (N = 56) tested the hypothesis that the task is easier because children sort items slowly. The data indicate that children spontaneously respond more slowly on the Reverse Categorization task than on other inhibitory tasks and that this slowing reduces the task’s cognitive demands. The way in which slowed responding works, and its relation to other inhibition-reducing interventions, is discussed.

Physiological stress measures in preschool children and their relationship with body composition and behavioral problems.

The relationship between physiological stress measures and body composition or behavioral problems in older children remains controversial, and data in young children are lacking. The aim of the study was to investigate this relationship in predominantly healthy preschool children. Physiological stress measures were assessed using diurnal salivary alpha-amylase (sAA) and salivary cortisol, nail cortisol and parasympathetic activation (PNS) by overnight heart rate variability, and body composition (body mass index, skinfold thickness) and behavior problems (using the Strengths and Difficulties Questionnaire) in 324 children aged 2-6years of the SPLASHY study. Parasympathetic nervous system was inversely related to body fat, to emotional, and to peer problems. Diurnal sAA was related to hyperactivity problems and moderated the relationship of cortisol and hyperactivity problems. Cortisol was not related to any other health problems. The relationship of PNS with body composition and behavioral problems might highlight the protective role of the parasympathetic system early in life.

El Niño Altered Gut Microbiota of Children: A New Insight on Weather-Gut Interactions and Protective Effects of Probiotic.

Changes in weather often trigger a myriad of negative impacts on the environment, which eventually affect human health. During the early months of 2016, Malaysia experienced El Niño, with an extremely dry season of almost zero rainfall. At the same time, an increase of more than twofold in fecal secretary immunoglobulin-A (SIgA) levels of healthy preschool children aged 2-6 years was observed, accompanied by an increase in phylum Bacteroidetes, predominantly attributed to genus Bacteroides and Odoribacter, which also positively correlated with fecal SIgA levels. Here, we present evidence to illustrate the detrimental effects of weather change on a microscopic "environment," the human gut ecosystem. We also discuss the protective effects of probiotic against dysbiosis as induced by weather change. The increase in Bacteroidetes was at an expense of decreased genus Faecalibacterium and Veillonella (phylum Firmicutes), whereas children consuming probiotic had a decrease in genus Collinsella, Atopobium, and Eggerthella (phylum Actinobacteria) instead.

Optimizing diagnostic biomarkers of iron deficiency anemia in community-dwelling Indian women and preschool children.

The detection of iron deficiency anemia is challenged by the paucity of diagnostic tests demonstrating high sensitivity and specificity. Using two biomarkers, zinc-protoporphyrin/heme and hepcidin, we established the diagnostic cut-off values for iron deficiency anemia in preschool children and women. We randomly selected non-anemic individuals (n=190; women=90, children=100) and individuals with iron deficiency anemia (n=200; women=100, children=100) from a preexisting cohort of healthy preschool children and their mothers. The diagnostic performance of these biomarkers was estimated by analyzing receiver operating characteristic curves. Diagnostic cut-offs with a high predictive value for iron deficiency anemia were selected. Median zinc-protoporphyrin/heme and hepcidin values in non-anemic children were 49 μmol/mol heme and 42 ng/mL, respectively, and in non-anemic women these values were 66 μmol/mol heme and 17.7ng/mL, respectively. Children and women with iron deficiency anemia had higher zinc-protoporphyrin/heme ratios (children=151 μmol/mol heme and women=155 μmol/mol heme) and lower hepcidin levels (children=1.2ng/mL and women=0.6ng/mL). A zinc-protoporphyrin/heme ratio cut-off >90 μmole/mole heme in children and >107 μmole/mole heme in women was associated with a high diagnostic likelihood for iron deficiency anemia (children, likelihood ratio=20.2: women, likelihood ratio=10.8). Hepcidin cut-off values of ≤6.8ng/mL in children and ≤4.5ng/mL in women were associated with a high diagnostic likelihood for iron deficiency anemia (children, likelihood ratio=14.3: women, likelihood ratio=16.2). The reference ranges and cut-off values identified in this study provide clinicians with guidance for applying these tests to detect iron deficiency anemia. Erythrocyte zinc-protoporphyrin/heme ratio is a valid point-of-care biomarker to diagnose iron deficiency anemia.

Análisis tiempo-frecuencia del Potencial de disparidad (MMN) en niños preescolares mexicanos saludables

Análisis tiempo-frecuencia del Potencial de disparidad (MMN) en niños preescolares mexicanos saludables

URINARY EXCRETION OF WATER-SOLUBLE VITAMINS (C, B1, B2, AND B6) IN HEALTHY CHILDREN OF PRESCHOOL AND SCHOOL AGE: A CROSS-SECTIONAL STUDY

Background . Children of preschool and school age are at risk of developing vitamin deficiency. Screening of the vitamin provision of children remains an urgent problem of pediatrics. Objective. Our aim was to determine the prevalence of low excretion of watersoluble vitamins among healthy preschool and school-age children. Methods. The study was conducted in March-April 2017. We determined the urinary excretion (fasting morning portion collected during 30–120 min after night-time urination) of metabolites of vitamins C, B 1 , B 2 , and B 6 in healthy children. Riboflavin (vitamin B 2 metabolite) was determined spectrophotometrically by titration with a riboflavin-binding apoprotein; 4-pyridoxyl acid (vitamin B 6 metabolite) and thiamine (vitamin B 1 metabolite) — by fluorescent method, ascorbic acid (vitamin C metabolite) — by visual titration with Tillman’s reagent. The excretion considered to be low (equivalent to vitamin deficiency) when thiamine excretion was < 7, 10, 11, and 12 μg/h and riboflavin < 6, 9, 10, and 13 μg/h in children aged 3–5, 6–8, 9–11, and above 12 years, respectively; 4-pyridoxylic acid — < 40, 60, and 70 μg/h in children aged 3–5, 6–8, and ≥ 9 years, ascorbic acid — < 0.2 and 0.4 mg/h in children aged 3–11 and ≥ 12 years, respectively. Results. Metabolites were excreted in 39 children (20 girls), 14 of them aged 4–6 years and 25 children aged 7–14 years. A low level of ascorbic acid excretion was found in 13 (33%) children, of thiamine — in 24 (62%), of riboflavin — in 16 (41%), of 4-pyridoxyl acid — in 26 (67%). Low excretion of at least one vitamin metabolite was detected in 30 (77%) children, of 3 or more metabolites simultaneously — in 15 (39%). Conclusion. A low level of urinary excretion of metabolites of at least one water-soluble vitamin (C, B 1 , B 2 , and B ≥ ) occurs in most preschool and schoolage children.

Comparison of facemask and mouthpiece interfaces for multiple breath washout measurements

BackgroundDifferent interfaces (mouthpiece/nose clip vs. facemask) are used during multiple breath washout (MBW) tests in young children. MethodsWe investigated the effect of interface choice and breathing modalities on MBW outcomes in healthy adults and preschool children. ResultsIn adults (n = 26) facemask breathing significantly increased LCI, compared to mouthpiece use (mean difference (95% CI) 0.4 (0.2; 0.6)), with results generalizable across sites and different equipment. Exclusively nasal breathing within the facemask increased LCI, as compared to oral breathing. In preschoolers (2–6 years, n = 46), no significant inter-test difference was observed across interfaces for LCI or FRC. Feasibility and breathing stability were significantly greater with facemask (incorporating dead space volume minimization), vs. mouthpiece. This was more pronounced in subjects <4 years of age. ConclusionBoth nasal vs. oral breathing and mouthpiece vs. facemask affect LCI measurements in adults. This effect was minimal in preschool children, where switching between interfaces is most likely to occur.

Ultrasound calcaneus bone measurement in healthy preschool children: correlation with muscular fitness and weight status

Ultrasound calcaneus bone measurement in healthy preschool children: correlation with muscular fitness and weight status