Imbalance In Children Research Articles

Anthropometric indices growth references (length, Weight and Head Circumferences) of children aged 0–24 months in North-East of Iran by GAMLSS

BackgroundGrowth references play a crucial role in the screening, evaluation, and surveillance of children, aiding in the early identification of the requirement for diverse growth-promoting interventions. Variations in human growth across distinct ethnic cohorts arise from genetic disparities, lifestyle variances, nutritional diversity, and diverse social and environmental contexts. Consequently, the selection of growth references markedly influences the prevalence of developmental disorders and nutritional imbalances in children. The study aims to assess the growth percentile of children in the north-east of Iran and establish population-specific reference charts for length, weight, and head circumference spanning from birth to 24 months.MethodsThis cross-sectional population-based research conducted in the north-east of Iran, from 2016 to 2023. The Data extracted from the electronic health records of Mashhad University of Medical Sciences. All apparently healthy children aged from birth to 24 months who were measured at least once by health staff at the ages of birth,1,2,4,6,7,9,12,15,18,24 months were included. The target population of the study were 479,089 children (96.21%), encompassing 233,565 girls (48.75%) and 245,524 boys (51.25%). Gender-specific percentile curves for length, weight, and head circumference concerning age, as well as weight concerning length, were derived using the GAMLSS approach.ResultsFrom the anthropometric information of 479,089 children (245,524 boys and 233,565 girls), growth charts were constructed. In comparison to the standard WHO chart, Iranian neonates displayed lower weight across all percentiles during the first month after birth, exhibited decreased head circumference at the 3rd percentile, and boys showed reduced length across all percentiles. After this age, Iranian children demonstrated increased weight, length, and head circumference.ConclusionsThis research introduces the inaugural large-scale endeavor for indigenous reference charts. Through the noted distinctions from the international reference, the utilization of this novel resource offers the potential to enhance the surveillance of children’s growth within the area. Moreover, by accurately assessing growth anomalies such as underweight, stunting, and wasting, it expands the domain of impactful policies in this sphere. Simultaneously, it enables the exploration of the secular trend of children’s growth in the forthcoming years.

Production of Mandarin and Fuzhou lexical tones in six- to seven-year-old Mandarin-Fuzhou bilingual children

AbstractThis study investigated the production of Mandarin and Fuzhou lexical tones by Mandarin-Fuzhou bilingual children. Forty children aged 6;11 to 7;6 and two groups of adults (Mandarin speakers and Fuzhou speakers) were asked to produce pre-selected familiar monosyllabic words. Adult judges' perceptual judgments and acoustic analysis showed that: (1) overall, these children's production performance of Mandarin tones was similar to adults', with very high accuracy; (2) children did not reach adult-like production competence in Fuzhou tones by age 7;6; and (3) there was an imbalance in children's development of the seven lexical tones in Fuzhou. Children's late and unbalanced development of Fuzhou tones could be ascribed to their unbalanced Mandarin-Fuzhou exposure, and it is argued that children might transfer the characteristics of the Mandarin tonal system to their production of Fuzhou tones.

Exploring Nutritional Status and Metabolic Imbalances in Children with FASD: A Cross-Sectional Study.

Malnutrition is a significant concern in paediatric populations, particularly among children with neurodevelopmental disorders such as foetal alcohol spectrum disorder (FASD). This study aimed to examine macronutrient and micronutrient imbalances and assess the nutritional status of a group of patients with FASD. This study involved an analysis of the serum levels of key nutrients in a group of children diagnosed with FASD. Macronutrients and micronutrients were measured to identify any imbalances, including vitamin D, B12, E, A, albumin, and serum protein, among others. The study found a high prevalence of vitamin D deficiency among the patients. Additionally, elevated serum concentrations of micronutrients such as vitamin B12, E, and A were observed in 8%, 7%, and 19% of patients, respectively. Macronutrient imbalances were noted, including high levels of albumin and serum protein, indicating a possible metabolic disturbance. Unexpectedly, high rates of hypercholesterolemia were observed, raising concerns about an increased risk of metabolic syndrome in this population. These findings suggest that the principal issue among patients with FASD is an altered metabolism rather than nutritional deficiencies. Potential causes of these abnormalities could include oxidative stress and changes in body composition. The results underline the need for further research to better understand the unique nutritional challenges in children with FASD and to guide the development of targeted therapeutic strategies.

Prevalence of and factors associated with Na + /K + imbalances in a population of children hospitalized with febrile urinary tract infection

We aimed to assess the prevalence of and factors associated with Na + /K + imbalances in children hospitalized for febrile urinary tract infection (fUTI). This retrospective Italian multicenter study included children aged 18 years or younger (median age = 0.5 years) who were discharged with a primary diagnosis of fUTI. Na + /K + imbalances were classified as hyponatremia (sodium < 135 mEq/L), hypernatremia (sodium > 145 mEq/L), hypokalemia (potassium < 3.5 mEq/L), hyperkalemia (potassium > 5.5 mEq/L), and concurrent hyponatremia and hyperkalemia, in the absence of evidence of hemolyzed blood samples. Among the 849 enrolled children, 23% had hyponatremia, 6.4% had hyperkalemia, 2.9% had concurrent hyponatremia and hyperkalemia, 0.7% had hypokalemia, and 0.4% had hypernatremia. In the multiple logistic regression analysis, after applying the Bonferroni correction, only C-reactive protein (C-RP) levels were significantly associated with hyponatremia (OR = 1.04; 95% CI: 1.02–1.06; p < 0.001), only age was significantly associated with hyperkalemia (OR = 1.7; 95% CI: 1.1–2.7; p = 0.01), and only CAKUT was significantly associated with concurrent hyponatremia and hyperkalemia (OR = 4.3; 95% CI: 1.7–10.8; p = 0.002). Even after adjusting for the presence of kidney hypoplasia, abnormal renal echogenicity, pelvi-caliceal dilation, ureteral dilation, uroepithelial thickening of the renal pelvis, bladder abnormalities, pathogen other than E. coli, concurrent hyponatremia and hyperkalemia persisted significantly associated with CAKUT (OR = 3.6; 95% CI: 1.2–10.9; p = 0.02).Conclusion: Hyponatremia was the most common Na + /K + imbalance in children hospitalized for fUTI, followed by hyperkalemia and concurrent hyponatremia and hyperkalemia. C-RP levels were most strongly associated with hyponatremia, age with hyperkalemia, and CAKUT with concurrent hyponatremia and hyperkalemia (suggestive of transient secondary pseudo-hypoaldosteronism). Therefore, in children who develop concurrent hyponatremia and hyperkalemia during the course of a fUTI, an underlying CAKUT could be suspected.What is known:• Na+ and K+ abnormalities can occur in patients hospitalized for febrile urinary tract infection (fUTI).• Concurrent hyponatremia and hyperkalemia during fUTI may suggest transient secondary pseudo-hypoaldosteronism (TPHA), for which limited data on prevalence are available.What is new:• The most common Na+/K+ imbalance in children hospitalized with fUTI was hyponatremia (23%), followed by hyperkalemia (6.4%), concurrent hyponatremia and hyperkalemia (2.9%), hypokalemia (0.7%), and hypernatremia (0.4%).• Concurrent hyponatremia and hyperkalemia were mainly associated with CAKUT, while hyponatremia alone correlated with high C-reactive protein and hyperkalemia alone with younger age. In cases of concurrent hyponatremia and hyperkalemia during fUTI, an underlying CAKUT should be suspected.

“Assessment Of Cardiac Autonomic Dysfunction In Children With Cerebral Palsy Using Heart Rate Variability”

Background: Cardiac autonomic imbalance in children with CP might be due to primary brain insult, vary with different levels of Gross Motor Functional Classification System or may alter with multimodal therapies in various types of cerebral palsy (1,2) . It is important to understand and to create awareness that autonomic impairment in children with CP is in part due to sedentary lifestyle (3).HRV(Heart Rate Variability) in cerebral palsy is recognized as an important tool for monitoring cardiovascular health, in which autonomic imbalance is characterized by reduced HRV (i.e. regarded as increased cardiac sympathetic activity and decreased vagal modulation) (4,5) . Of the research that does exist, each study discusses only very few parameters of the autonomic nervous system, thus providing opportunities for further research and hence the need for the study. Materials and Methods: This is a cross-sectional case control study of 51 children with Cerebral Palsy (CP) and 51 normal children, conducted at District Early Intervention Centre (DEIC) in the Department of Paediatrics, Vani Vilas hospital. These 51 cases were assessed and classified based on their demographic features, etiology, type of CP, GMFCS scale and with the objectives of assessing the heart rate variability (HRV) in children with cerebral palsy and compare it with controls in both supine position and after a stress test, and also to correlate the obtained parameters with GMFCS level, type of CP using a systematically designed proforma. Results: Results of the study showed that of the children with CP studied, 62% were male children, and majority of were between 6-8 years of age (58%), and it was found that the most common etiology for CP in our study was due to perinatal asphyxia (43%), and 80% of the children had history of NICU admission. Of the 51 cerebral palsy children studied 72% were in GMFCS levels 3 and 4, regarding the topographical classification majority had spastic quadriplegia (58.8%) followed by spastic diplegia (15.7%). Study revealed that cerebral palsy children had significantly lower HRV, higher sympathetic activity, autonomic response deficit to stress test, and higher autonomic dysfunction when compared to normal children. Among cases, HRV was lowest with spastic quadriplegia and triplegic CP, in functional classification HRV was lowest among GMFCS 4 and 3. Conclusion: Cerebral palsy children had significantly higher sympathetic activity and less cardiac vagal modulation compared to normal children in supine position and there was existence of autonomic response deficit in cerebral palsy children after stress test, higher the motor impairment, higher was the sympathetic activity

Prevalence and Patterns of Electrolyte Imbalance in Children Diagnosed with Acute Severe Malnutrition at a Nutritional Stabilization Center

Malnutrition accounts for around 35% of all fatalities in Pakistan among children under five, making it the primary cause of childhood mortality in that country. The most severe type of malnutrition, known as severe acute malnutrition (SAM), was frequently linked to electrolyte abnormalities. The purpose of this study was to ascertain how frequently electrolyte imbalance occurred in children with SAM who were admitted to a tertiary care facility. Objective: To Determine the Prevalence and Patterns of Electrolyte Imbalance in Children Diagnosed with Acute Severe Malnutrition at a Nutritional Stabilization Center”. Methods: A cross-sectional study was carried out in Nawabshah at the Department of Pediatrics, Peoples University of Medical and Health Sciences, from May 16 to August 15, 2024. This study comprised 92 patients with severe acute malnutrition, ranging in age from 2 to 60 months. Non purposive sampling technique was used for data collection. Children with secondary causes of wasting were excluded, including those with congenital heart disease, chronic renal or liver illness, TB, cancer, and hemolytic anaemia. Weight-for-height was calculated using measurements of weight, length, and height. When the weight-for-height ratio fell below the -3 standard deviation (SD), children were diagnosed with SAM. The lab received blood samples that were taken for serum electrolytes. The chi-square test was used for stratification, and descriptive statistics were computed. Results: Participants' average ages ranged from 23.63± 12.71 months. A total of 85 (93.4%) of the 92 SAM patients had an electrolyte imbalance. The prevalence of hypokalemia (70.08%), hypocalcemia (56.52%), hyponatremia (32.60%), and hypomagnesemia (28.26%), respectively. Conclusions: Children with SAM experience dyselectrolytemia both with and without problems. In all cases of SAM, serum electrolyte levels may need to be assessed in order to identify hyponatremia and hypokalemia in the absence of symptoms. This will facilitate the inpatient treatment triage process for patients with asymptomatic hyponatremia and hypokalemia.

Correction of microecological imbalance in children who have suffered from multisystem inflammatory syndrome associated with SARS‐CoV‐2 in the post‐rehabilitation period

To conduct a study of the quality of life of children who have suffered from multisystem inflammatory syndrome (MIS‐C) associated with SARSCoV‐2 in the post‐rehabilitation period against the background of correction of microecological imbalance.The study involved 49 children aged 2 to 12 years who underwent MIS‐C associated with SARS‐CoV‐2 and received treatment in a hospital (DGKB No. 3 in Novosibirsk), and then underwent rehabilitation on an outpatient basis. The duration of rehabilitation was 7–8 weeks. All children were prescribed a course of additional rehabilitation for 30 days in order to correct microecological imbalance, which included: Biovestin, a dietary supplement in liquid form, containing bifidobacteria of the Bifidobacterium longum MC‐42 strain; the official drug, Kudesan, (active ingredient Coenzyme Q10); and the official drug, Succinic Acid. The assessment of physical, social, educational, emotional and psychological functioning, as well as quality of life as an integrating indicator before and after a comprehensive rehabilitation course using the parental form of the Reds OL Generic Core Scales questionnaire (Russian version) was carried out.After the rehabilitation course, children who underwent MIS‐C associated with SARS‐CoV‐2 showed signs of dysfunction of various organs and systems, which may be the result of an imbalance in the microbial ecosystem and requires mandatory correction. The introduction of a probiotic product and drugs affecting metabolic processes into the rehabilitation course led to a decrease in inflammatory reactions, as well as normalisation of metabolic processes and increased oxygenation, which improved the condition of the children and their quality of life.Federal Research Center for Fundamental and Translational Medicine (FRC FTM), Siberian Branch, Russian Academy of Sciences

Oral Mucositis and Nutritional Status in Children Who Underwent Hematopoietic Cell Transplantation: AComparison Between Nonmalignant and Malignant Primary Diseases.

There is a lack of studies analyzing the association between oral mucositis (OM) and nutritional imbalance in children during hematopoietic stem cell transplantation (HSCT). The aim of this study was to compare the risk factors for OM and nutritional imbalance during HSCT in pediatric patients with nonmalignant diseases (NMD) and malignant diseases (MD). Data on age, sex, primary disease, transplantation type, conditioning regimen, GVHD prophylaxis, gastrointestinal toxicity, OM, percent body weight loss or gain, nutritional repositioning, and overall survival (OS) were retrospectively collected from the 132 medical records. The data were then compared between patients with NMD (n = 70) and MD (n = 62). OM had a similar severity between the groups. The primary risk factor for OM in the NMD group was the conditioning regimen with busulfan, while in the MD group it was GVHD prophylaxis with cyclosporin and methotrexate. OM did not have an impact on body weight loss or gain in any of the groups. In the NMD, body weight gain due to fluid overload was more pronounced and associated with a lower age range. OS was similar between the groups and was not affected by OM. OM pattern was similar in pediatric patients with or without MD, but the factors that determined these oral lesions were different. There were disparities in body weight changes between the two groups, and these changes were not associated to OM.

Indicators of Blood Glucose Imbalance in Children with Beta-thalassemia Major

Children diagnosed with beta-thalassemia major have a significantly increased likelihood of developing an imbalance in their blood glucose levels. It is essential to do screenings for diabetes and prediabetes in children, and to maintain a high degree of suspicion for abnormalities in blood glucose levels, since this is important for their management. Additionally, it is crucial to acknowledge other markers of blood glucose imbalance, including the glycated hemoglobin level, the fructosamine level, and the occurrence of hypoglycemic crises. Implementing preventive measures and closely monitoring one's health can effectively hinder the path towards diabetes. Thalassemia is a prevalent hereditary blood condition. The need for frequent blood transfusions in thalassemia leads to an excess of iron in the body, which has a role in the development of several disorders, including those affecting insulin production and function. This review examines the several markers of blood glucose dysregulation in children diagnosed with beta-thalassemia major. It also explores the impact of iron overload and other factors, such as the effects of desferioxamine and deferasirox. The review also discusses strategies for preventing diabetes and emphasizes the significance of a multidisciplinary team in caring for these youngsters

Peripheral Binocular Imbalance in Anisometropic and Strabismic Amblyopia.

Individuals with amblyopia experience central vision deficits, including loss of visual acuity, binocular vision, and stereopsis. In this study, we examine the differences in peripheral binocular imbalance in children with anisometropic amblyopia, strabismic amblyopia, and typical binocular vision to determine if there are systematic patterns of deficits across the visual field. This prospective cohort study recruited 12 participants with anisometropic amblyopia, 10 with strabismic amblyopia, and 10 typically sighted controls (age range, 5-18years). Binocular imbalance was tested at 0°, 4°, and 8° eccentricities (4 angular locations each) using band-pass filtered Auckland optotypes (5 cycles per optotype) dichoptically presented with differing contrast to each eye. The interocular contrast ratio was adjusted until the participant reported each optotype with equal frequency. Participants with anisometropic and strabismic amblyopia had a more balanced contrast ratio, or decreased binocular imbalance, at 4° and 8° eccentricities as compared with central vision. Participants with strabismic amblyopia had significantly more binocular imbalance in the periphery as compared with individuals with anisometropic amblyopia or controls. A linear mixed effects model showed a main effect for strabismic amblyopia and eccentricity on binocular imbalance across the visual field. There is evidence of decreased binocularity deficits, or interocular suppression, in the periphery in anisometropic and strabismic amblyopia as compared with controls. Notably, those with strabismic amblyopia exhibited more significant peripheral binocular imbalance. These variations in binocularity across the visual field among different amblyopia subtypes may necessitate tailored approaches for dichoptic treatment.

Application of array comparative genomic hybridization in clinical diagnostics of intellectual disability/developmental delay in children

Background: This study was designed to analyze and evaluate the potential pathogenic genomic imbalance in children with unexplained intellectual disability (ID) and/or developmental delay (DD) and its association with phenotypes, and to investigate the value of array-based comparative genomic hybridization (array-CGH). Methods: A total of 72 Children with ID/DD were evaluated by array-CGH for detection of genomic copy number variations (CNVs). Results: The results of the array-CGH revealed that 10(14%) of the 72 patients had pathogenic CNVs, in that six cases had pathogenic CNV in a single chromosome, 2 cases had multiple microdeletions and 2 cases had combined microdeletion and microduplication, 2 cases had pathogenic CNVs in chromosome 1p36 and Xq28 region. One case had variation of unknown significance in chromosome region 15q11.2. Large bands of copy neutral loss of heterozygosity were detected in 2 cases comprising more than 10% of genome. Conclusions: Array-CGH being a high-throughput and rapid tool, allows for the etiological diagnosis in some of the children with unexplained ID/DD.

Qualitative Study of Utilization of Local Food for the Nutritional Needs of Stunted Children in Indonesia

Introduction: Stunting is a national problem in Indonesia due to an imbalance in children's nutritional intake. Diversity in balanced food consumption is one of the efforts to prevent stunting. Objectives: Exploring the potential of various types of food ingredients, utilization, equipment, capabilities, and expectations of the community in utilizing local food to fulfill stunting children's nutrition. Methods: Qualitative studies use a phenomenological approach. Research informants 15 people. Data were collected through Focus Group Discussion activities. ATLAS.Ti22 software is used to analyze data from focus group discussions. Results: It was found that the theme of ability and expectation has the highest co-occurrence value of 0.76, meaning that hope is very strongly related to the ability of the community. The theme of ability and availability of food ingredients has a co-occurrence value of 0.58, meaning that the ability to process local food ingredients is strongly related to the availability of food ingredients. Utilization and ability co-occurrence value of 0.16 means that the use of local food ingredients is weakly related to the ability to process food. Conclusion: Diversity in food consumption is related to food availability, utilization, and ability to process food. Suggestion: local food processing assistance is needed for the stunting target group to increase the community's ability to process local food. Inter-agency collaboration is needed in specific nutrition intervention programs by utilizing local food ingredients.

Magnitude of Pulse Pressure Variation is Associated with Qp:Qs Imbalance during Pediatric Cardiac Surgery: A Two-Center Retrospective Study.

Pulse pressure variation (PPV) is based on heart-lung interaction and its association with the imbalance between pulmonary and systemic blood flow (Qp:Qs) has been understudied. We hypothesized that (1) baseline PPV (after induction of anesthesia) is different in a mixed congenital heart disease population with different Qp:Qs, (2) baseline PPV is different between a pooled group with high Qp:Qs and one with low Qp:Qs, and (3) a systemic-pulmonary shunt procedure results in reduced PPV compared to baseline. We retrospectively reviewed the medical charts of children who presented to the operating room for cardiac surgery between 2010 and 2018. General patient characteristics, PPV, and other hemodynamic parameters following the induction of general anesthesia were retrieved. Patients were grouped according to the type of congenital heart disease, and whether the Qp:Qs ratio was higher or lower than 1. We also identified patients who received a systemic-pulmonary shunt in order to evaluate changes in PPV. A total of 1253 patients were included in the study. Baseline PPV differed significantly according to the type of congenital heart disease, with atrial septal defect showing the lowest PPV (9.5 5.6%) and tricuspid valve malformation the highest (21.8 14.1%). The high Qp:Qs group (n = 932) had significantly lower PPV compared to the low Qp:Qs group (n = 321; 11.8 5.7% vs. 14.9 7.9%, respectively; p 0.001). PPV decreased significantly following systemic-pulmonary shunt. PPV was associated with Qp:Qs imbalance in children undergoing general anesthesia for cardiac surgery. A lower PPV was associated with increased Qp:Qs. Clinicians should take this into account when using PPV to evaluate volume status and when conducting clinical trials in a mixed population of patients with congenital heart disease.

The Effectiveness of Technology-Based Daily Food Recording in Increasing Children's Daily Intake: Literature Review

The technology-based daily recording of children's dietary is expected to be able to provide an easier overview of children nutritional status. So, it will reduce the number of nutritional imbalances in children. This research aimed to know determine the effectiveness of children's daily dietary recording with an application to estimate children's nutritional needs. The research method was used a literature review study. Result: From the results of the study, it was concluded that the use of food recording applications, either use photos or not, provide increased information on children's daily nutrition. The application allows an estimation of the food portion and nutrition of children's diet. It may become a benchmark for parents or health workers in providing children's diets. The dietary assessment application can be used both in the community and in hospitals to monitor children nutrition status. It is recommended that further research to include food waste in the calculation so that the daily energy estimate is more accurate.

Cytokine network imbalance in children with B-cell acute lymphoblastic leukemia at diagnosis

Immune imbalance has been proved to be involved in the pathogenesis of hematologic neoplasm. However, little research has been reported altered cytokine network in childhood B-cell acute lymphoblastic leukemia (B-ALL) at diagnosis. Our study aimed to evaluate the cytokine network in peripheral blood of newly diagnosed pediatric patients with B-ALL. Serum levels of interleukin (IL)-2, IL-4, IL-6, IL-10, tumor necrosis factor (TNF), interferon (IFN)-γ, and IL-17A in 45 children with B-ALL and 37 healthy control children were measured by cytometric bead array, while the level of transforming growth factor-β1 (TGF-β1) in the serum was measured by enzyme-linked immunosorbent assay. Patients showed a significant increase in IL-6 (p < 0.001), IL-10 (p < 0.001), IFN-γ (p = 0.023) and a significant reduction in TGF-β1 (p = 0.001). The levels of IL-2, IL-4, TNF and IL-17A were similar in the two groups. Higher concentrations of pro-inflammatory cytokines were associated with febrile in patients without apparent infection by using unsupervised machine learning algorithms. In conclusion, our results indicated a critical role for aberrant cytokine expression profiles in the progression of childhood B-ALL. Distinct cytokine subgroups with different clinical features and immune response have been identified in patients with B-ALL at the time of diagnosis.

IMMUNE-INFLAMMATORY-ENDOCRINE REGULATION DISORDERS IN CHILDREN WITH CORONAVIRUS INFECTION.

The aim: To study the of homeostasis links desorder and indicators imbalance in children with Coronavirus infection. Materials and methods: A clinical and laboratory study was conducted in children (50 persons) with Coronavirus infection. The children were used outpatient treatment. Results: It was found that Direct bilirubin was increased in 3 times (10.55±7.67 vs. 3.63±0.49 μmol/l, p<0.01), Alanine aminotransferase - in 1.7 times (37,02±20.53 vs. 21.90±1.82 IU/l, p<0.01). An levels increassng of Ig G - in 12.3 times, Ig E - in 4.6 times, Ig M - in 3.4 times was observed. The CRP level was increased in 3.1 times (8.76 ± 2.16 vs. 2.54 ± 0.53 mg/l, p< 0.01), C-peptide (4.65±1.67 vs. 1.23±0.08 ng/ml, p<0.01) - in 3.8 times. Negative correlations of T3 with Procalcitonin (r=-0.30) and Creatinine (r=-34) were revealed. T4 values are correlated with Total cholesterol (r=-0.65) and Creatinine (r=0.29). Leptin was presented positive correlations with Alanine aminotransferase (r=0.48) and with C-peptide (r=0.39). Conclusions: There was an increase in the Ig G levels in 12.3 times, Ig E - in 4.6 times, and the Ig M level - in 3.4 times. The Thyroid stimulating hormone level was significantly lower (in 4.7 times). An increase in the C-reactive protein levels (in 3.1 times) and C-peptide (in 3.8 times) was observed. It should be noted that the strongest negative correlation between T4 and Total cholesterol (r=-0.65) and the highest positive correlation between Leptin and Alanine aminotransferase (r=0.48) and C-peptide (r=0. 39).

The occurence of postural disorders and muscular imbalance in children from urban and rural environment

Background. Postural examination is considered to be one of the most important parts of the general examination and is therefore the basis for correct diagnosis and determining preventive measures or appropriate treatment procedures. Objective. The aim of the study was to evaluate the functional status of school-aged children. Methods: The study was carried out at selected primary schools in Slovakia, we examined 453 children. We assessed the quality of the postural system according to Thomas Klein´s evaluation, modified by Mayer, the presence of shortened and weakened muscles according to Janda. The following measurements were used to assess the range of motion of the spine: Otto’s inclination and reclination distance, Schober’s distance, Stibor’s distance and Thomayer’s distance. Results. A statistically significant difference was found in the examination of gluteal muscles strength l.dx. (p = 0.03), gluteal muscles l.sin. (p ≤ 0.001), with the children from urban environment having, on average, lower muscle strength. Statistically significant differences were found in the evaluation of m. trapesiusl.dx. at significance level p = 0.04, m. trapesiusl.sin. at the level of significance p ≤ 0,001, with higher average values found in children from the urban environment. Conclusion. Children from countryside show better postural outcomes and exhibit fewer postural disturbances than children from city backgrounds.

Assessment of postural control in children

The relevance of the study is due to the high incidence of postural control impairment in patients with neurological diseases and lack of common approaches to their diagnosing in children. In this article we show the main stages in the formation of postural control and mechanisms of balance maintaining in childhood. We assessed the information content of existing clinical scales used to study components of postural balance in children in clinical practice. Also, we studied the diagnostic significance of functional methods for assessing postural control. Particular attention we paid to the study of the diagnostic significance of computer posturography (stabilometry) and accelerometry. We identified the main clinical and functional diagnostic markers of postural imbalance in children of different age and nosological groups. Further research in this area will make it possible to develop the most objective criteria for impaired postural control in childhood, which will increase the effectiveness of treatment and rehabilitation measures.

Nutritional Imbalances in Polish Children with Coeliac Disease on a Strict Gluten-Free Diet.

Currently, the only treatment for coeliac disease (CD) is a strict, lifelong gluten-free diet (GFD); however, their completeness with regard to energy and macro- and micronutrients remains poorly understood. Paediatric studies are often limited by a low quality and a lack of controls, and their findings should be interpreted with caution. The aim of the present study was to evaluate nutritional imbalances in children with CD on a strict GFD. Methods: A single-centre prospective cohort study was conducted. A total of 48 children with CD (33 girls, mean age 11.8 ± 3.68 years) on a strict GFD (mean duration 5.02 ± 3.87 years) were compared with 50 non-coeliac subjects (26 girls, mean age 10.2 ± 3.97 years). In both groups, anthropometric measurements (body height, weight and BMI) and laboratory tests (haemoglobin level, calcium and magnesium serum concentration, folic acid, vitamin B1, B2, B6 and B12 level) were checked. Additionally, in coeliac subjects, a 3-day food record for energy and macro- and micronutrient intake assessment were determined, and the values were compared to those in non-CD participants and the dietary reference intake (DRI) standards. Results: The CD children were more likely to demonstrate significantly lower serum vitamin B1 and folic acid levels compared to controls (p = 0.01 and p = 0.002, respectively). Although mean serum calcium values were within normal ranges, they were significantly lower in CD subjects than controls (p = 0.01). Mean calcium, folic acid and vitamin D intake was below the dietary recommendations in the CD group (69.9%, 71.2% and 68.9% DRI, respectively) but did not differ significantly between CD and non-coeliac subjects. In turn, the mean supply of proteins and carbohydrates in the CD group substantially exceeded the recommended levels (190.3% and 189.4% DRI, respectively) but was similar to controls. A significantly higher number of CD children were classified as underweight, and a significantly lower number as overweight or obese, compared with controls (p < 0.001). Conclusion: Although children with CD receive nutritional education at diagnosis, a GFD often does not provide a balanced set of macro- and micronutrients. This is mainly due to unhealthy dietary habits, as commonly observed in the general population. Children with CD should be informed that while their diet should be free of gluten, it should nevertheless cover all their nutrition requirements in the long term.

Early Signs of Autonomic Nervous System Imbalance in Children with High Cardiometabolic Risk

Objective:Autonomic nervous system is involved in many disorders, and changes in its modulation are the known risk factors for cardiovascular diseases. Its role in metabolic disarrangements in children at high cardio-metabolic risk is not known. Aim of the study is to analyze the relation between clinical-metabolic parameters and autonomic nervous system in children.Materials and Methods:Children affected by type 1 diabetes (group 1), obesity (group 2), and control group (group 3) were enrolled. Autonomic nervous system functionality was assessed with dynamic tests (The Expiration to Inspiration indexes—E/I delta and ratio, 30:15 Ratio Test, Systolic blood pressure response to standing—deltaPA), and ultrasonography was performed to evaluate Intima Media Thickness (cIMT). Clinical parameters were recorded.Results:The study popultaion had a total of 75 children with mean age of 12.5 ± 2.8 years: 26 in group 1, 28 in group 2, 21 in group 3. Obese children had higher cIMT z-score (P < .001). Diabetic patients had lower EI delta values (P < .001) and 30:15 ratio test (P = .01). There was an inverse correlation between E/I delta and microalbuminuria levels (rho −0.955, P < .001) and 30:15 ratio test and microalbuminuria (rho −0.936, P < .001) in group 1, even after adjustment for age. DeltaPA was higher in obese (P = .032) and correlated with BMI z-score and homeostatic model assessment.Conclusion:Our results highlight imbalances in sutonomic nervous system function in children at high metabolic risk, in particular with involvement of parasympathetic function in type 1 Diabetes Mellitus and sympathetic one in obesity. An early screening could lead to a prompt identification of these alterations and could have a predictive role on cardio-metabolic risk.