Pressure In Children Research Articles

Tongue pressure in children and adolescents with osteogenesis imperfecta

RESUMO Objetivo Investigar e correlacionar a pressão lingual da região anterior e posterior em contração isométrica e durante deglutição de saliva de indivíduos com osteogênese imperfeita. Métodos Estudo transversal observacional, do qual participaram 22 sujeitos, com média de idade de 12,09 anos, divididos em osteogênese imperfeita leve (tipo 1) (n=15) e osteogênese imperfeita moderada-grave (tipos 3, 4 e 5) (n=7). O Iowa Oral Pressure Instrument foi utilizado e foi aferida a pressão em isometria de língua da região anterior, da região posterior e durante deglutição. As análises estatísticas foram realizadas no programa SPSS, por meio dos testes Mann Whitney, correlação de Spearman e modelo de regressão linear simples. O nível de significância de p<0,05 foi utilizado. Resultados A pressão em isometria de língua foi maior na região anterior do que na região posterior na amostra total e no grupo com osteogênese imperfeita moderada-grave. A pressão da região anterior durante deglutição de saliva foi maior no grupo com osteogênese imperfeita leve. Também foi observada maior pressão de língua da região posterior nesse grupo. Conclusão Maior pressão da região anterior de língua correlaciona-se à maior pressão da região posterior de língua, porém, não há correlação significativa entre a capacidade isométrica de língua e a pressão de língua durante a função de deglutição de saliva.

Effect of Inhaled Sevoflurane on Pediatric Cerebrospinal Fluid Pressure During Lumbar Puncture; Implications for Intracranial Hypertension.

Objective: To determine influence of sevoflurane on changes in cerebrospinal fluid pressure in children presenting for lumbar puncture. Methods: Cerebrospinal fluid pressure, end tidal carbon dioxide, and end tidal sevoflurane concentration measurements were obtained at 2-minute intervals for a total of 10 minutes (T0 to T5). Because of concerns regarding patient safety and comfort, the study measurements were completed at the end of the lumbar procedure, starting with the closing pressure and when sevoflurane was stopped. Results: As end tidal sevoflurane concentration decreased, cerebrospinal fluid pressure initially increased up to T2 before decreasing back to around the initial point. There was no significant correlation between sevoflurane level and cerebrospinal fluid pressure. Both weight status and presence or absence of optic edema did not have a significant impact on pressure over time. However, there was a statistically significant difference in the cerebrospinal fluid pressure over time between those with spontaneous respirations compared to those without. Conclusions: There was no significant correlation between the end tidal sevoflurane concentration and cerebrospinal fluid pressure. Assisted ventilation did produce a statistically significant increase in cerebrospinal fluid pressure and suggests that the most accurate measurements are in those with spontaneous respirations.

Transorbital point-of-care ultrasound versus fundoscopic papilledema to support treatment indication for potentially elevated intracranial pressure in children

PurposeTo compare transorbital point-of-care ultrasound techniques —optic nerve sheath diameter (US-ONSD) and optic disc elevation (US-ODE)— with fundoscopic papilledema to detect potentially raised intracranial pressure (ICP) with treatment indication in children.MethodsIn a prospective study, 72 symptomatic children were included, 50 with later proven disease associated with raised ICP (e.g. pseudotumour cerebri, brain tumour, hydrocephalus) and 22 with pathology excluded. Bilateral US-ONSD and US-ODE were quantified by US using a 12-MHz-linear-array transducer. This was compared to fundoscopic optic disc findings (existence of papilledema) and, in 28 cases, invasively measured ICP values.ResultsThe sensitivity and specificity of a cut-off value of US-ONSD (5.73 mm) to detect treatment indication for diseases associated with increased ICP was 92% and 86.4%, respectively, compared to US-ODE (0.43 mm) with sensitivity: 72%, specificity: 77.3%. Fundoscopic papilledema had a sensitivity of 46% and a specificity of 100% in this context. Repeatability and observer-reliability of US-ODE examination was eminent (Cronbach’s α = 0.978–0.989). Papilledema was detected fundoscopically only when US-ODE was > 0.67 mm; a US-ODE > 0.43 mm had a positive predictive value of 90% for potentially increased ICP.ConclusionIn our cohort, transorbital point-of-care US-ONSD and US-ODE detected potentially elevated ICP requiring treatment in children more reliably than fundoscopy. US-ONSD and US-ODE indicated the decrease in ICP after treatment earlier and more reliably than fundoscopy. The established cut-off values for US-ONSD and US-ODE and a newly developed US-based grading of ODE can be used as an ideal first-line screening tool to detect or exclude conditions with potentially elevated ICP in children.

Non-linear relationship between sleep duration and blood pressure in children with short stature.

Evidence regarding the relationship between sleep duration and blood pressure is controversial. Therefore, the aim of this study was to investigate the relationship between sleep duration and blood pressure in children with short stature. A total of 1,085 participants with short stature were enrolled from the Affiliated Hospital of Jining Medical University in China. The variables involved in this study included sleep duration, anthropometric indicators and biochemical parameters. Sleep duration was evaluated in a face-to-face interview. The average age of the 1,085 selected participants was 10.2 ± 3.5 years old, and approximately 763 (70.32%) of them were male. The results of adjusted linear regression showed that sleep duration was negatively associated with systolic blood pressure z scores (SBP-Z) and diastolic blood pressure z scores (DBP-Z) after adjusting for confounders (β -0.07, 95% CI -0.13, -0.01 P = 0.038; β -0.05, 95% CI -0.10, -0.01 P = 0.035, respectively). A nonlinear relationship was detected between sleep duration and blood pressure, including SBP-Z, DBP-Z and mean arterial pressure z scores (MAP-Z). The inflection point of the nonlinear relationship between sleep duration and SBP-Z is 10 h, and the inflection point of DBP-Z and MAP-Z is 8 h. This study revealed a nonlinear relationship between sleep duration and blood pressure in children with short stature. The findings suggest that the optimal sleep duration in children with short stature was 8-10 h, and sleep durations either too short or too long were associated with increased blood pressure levels.

Machine learning models to predict post-dialysis blood pressure in children and young adults on maintenance hemodialysis

Hypertension is associated with significant cardiovascular morbidity. Blood pressure (BP) control on maintenance hemodialysis (HD) is strongly impacted by volume status. The objective of this study was to assess whether machine learning (ML) is effective in predicting post-HD BP in children and young adults on HD. We collected data on BP, IDWG, pulse, and weights for patients on maintenance HD (> 3 months). Input features included DW, pre-post weight difference, IDWG and pre-HD BP. Seven models were trained and tuned using open-source libraries. Model performance was evaluated using time-series cross-validation on a rolling basis (3–12 month training, 1-day testing). Various regression scores were compared between models. Data for 35 patients (14,375 HD sessions) were analyzed. Extreme gradient boosting (XGB) and vector autoregression with exogenous regressors (VARX) achieved better accuracy in predicting post-dialysis systolic BP than K-nearest neighbor, support vector regression (SVR) with radial basis function kernel and random forest (p < 0.001 for each). The differences in accuracy between XGB, VARX, SVR with linear kernel, random forest and linear regression were not significant. Using clinical parameters, ML models may be useful in predicting post-HD BP, which may help guide DW adjustment and optimizing BP control for maintenance HD patients.

The impact of dietary and sleep rhythms on blood pressure in children and adolescents: a cross-sectional study.

Evidence about the relationship between meal and sleep time and CVD in children is scarce. The aims of this study were to describe the association between life rhythm patterns and blood pressure in children. This research was conducted among 5,608 children aged 6 to 15 years old in Chongqing and Sichuan provinces in 2021 and 2022. Dietary and sleep rhythms information was collected. The time of the first meal and last meal, and sleep time, were obtained. The mean age was 10.48 ± 2.24 years old, with 2958 (52.75%) male participants. The mean feeding window on weekdays was 11.69 h, 12.42 h, and 13.23 h for participants aged 6-7 years old, 8-12 years old and 13-15 years old, respectively. Weekday feeding window and last mealtime were positively correlated with blood pressure levels. And the changes in the feeding window between weekdays and weekends were significantly correlated with BP. Sleep duration and change in wake time were significantly correlated with SBP. Based on these results, this study identified the optimal combination of dietary and sleep rhythm interventions for children younger than 12 years of age and aged 12 and older, respectively. Disorder dietary and sleep rhythms disorders may correlate with elevated blood pressure levels, suggesting developing optimal dietary and sleep rhythm patterns could prevent the incidence of CVDs in children. The optimal dietary rhythm was defined by the indexes of breakfast time, dinner time and daily feeding window. As good meal patterns are defined as satisfied the following three items: for children younger than 12 years should have breakfast after 7:30 am; aged 12 years and over should have breakfast after 7 am; having dinner before 6 pm; daily feeding window less than 12.5 h. And less optimal dietary rhythm should satisfy any condition or eat dinner between 6 pm and 8 pm; and poor dietary rhythm should not satisfy any of the three criteria and eat dinner after 8 pm. Children with optimal dietary rhythm (in group A) had lower SBP (P < 0.001), DBP (P = 0.002) and MAP (P < 0.001) than those in group C.

Validation of Multiple Office Blood Pressure Measurement: A Novel Tool for Evaluating Blood Pressure in Children

Validation of Multiple Office Blood Pressure Measurement: A Novel Tool for Evaluating Blood Pressure in Children

Pre-hypertension genes in the avon longitudinal study of parents and children (ALSPAC) predict higher systolic blood pressure in children from the manchester babyGRO study

Pre-hypertension genes in the avon longitudinal study of parents and children (ALSPAC) predict higher systolic blood pressure in children from the manchester babyGRO study

Central Corneal Thickness and Intraocular Pressure in Children with Type I Diabetes Mellitus.

The aim of this study is to determine the mean central corneal thickness (CCT) and mean intraocular pressure (IOP) in children with type 1 diabetes mellitus (T1DM) and to determine the relationship between CCT and IOP on the one hand and age, gender, retinopathy hemoglobin A1c (HbA1c), and duration of diabetes on the other. This is a case-control, hospital-based study conducted at Hospital ___________ between January and November 2022. Thirty-eight children with T1DM were recruited as cases, and 38 healthy children were recruited as controls. The cases and controls then underwent ophthalmic examination, IOP measurement, and CCT measurement using optical coherence tomography (OCT) of the right eye. The IOP measurements were adjusted for CCT for further analysis. The means CCT and IOP values were significantly higher in the T1DM group than in the control group (p-value<0.02 respectively). The mean CCT was 542.18 ± 20.40 µm in the T1DM group, and 529.52 ± 26.17 µm in the control group. The mean IOP was 14.68 ± 1.98 mmHg in the T1DM group, and 13.52 ± 1.66 mmHg in the control group. The mean HbA1c was 10.68 ± 2.49% in the T1DM group. Age and duration of diabetes mellitus (DM) were found to have a significant association with CCT in children with T1DM. The duration of DM was also found to be significantly associated with the IOP. Gender and HbA1c levels were found to have no significant relationship with either CCT or IOP. Children with T1DM have significantly higher CCT and IOP than the average child. The duration of DM is a significant factor that impacts both CCT and IOP. In addition, age is another factor that affects CCT in children with T1DM.

The interdependence of happiness and filial piety within the family: a study in Vietnam.

Filial piety is one of the most important values in Vietnam, as it is in a number of East Asian countries. It is an expression of children's respect, gratitude, and care for their parents. While filial piety may bring joy to parents and is a personal duty for offspring, it can also be a pressure for children. Hence, in recent years, some studies have considered filial piety as two dimensions instead of one dimension.Participants And Procedure This study focused on clarifying the relationship between filial piety and perceived family happiness with 385 adult offspring who lived in Vietnam at the time of the study. The Dual Filial Piety Scale (DFPS) and the Interdependent Happiness Scale (IHS) were used. The results showed that participants regularly engaged in aspects of filial piety and there was no contradiction between authoritarian filial piety (AFP) and reciprocal filial piety (RFP). Filial piety can predict family happiness at a fairly high level. These results, besides showing the importance and value to the family, also give a multi-dimensional and comprehensive view of filial piety. At the social level, upholding the value of filial piety is the basis for building family happiness as well as making an important contribution to the implementation of social security in the family.

Role of muscle mass in the association between handgrip strength and blood pressure in children and adolescents.

Studies have reported conflicting results on the association between handgrip strength (HGS) and blood pressure during childhood and adolescence. High multicollinearity involving somatic components that influence both HGS and blood pressure might be an important source of bias. This study sought to investigate the independent effects of HGS and muscle mass on blood pressure levels in children and adolescents. Muscle mass and fat mass (Multifrequency Electrical Bioimpedance) and systolic (SBP) and diastolic (DBP) blood pressure (Automatic oscillometric device) were assessed in 833 volunteers aged 6-18 years, of both sexes. Handgrip strength-for-age quartiles were calculated and participants were assigned to groups by HGS quartiles. Analysis of covariance was conducted to address the linear association between HGS and SBP adjusted for height, muscle mass, and fat mass. To test for linear trend, contrast analysis was conducted. Partial eta-squared was used to confirm or rule out a small significant effect of the independent variables on SBP. The effect size of HGS on SBP was not significant in both sexes. In girls, 1.7% of the between-groups variance in SBP was accounted for by muscle mass (P = 0.016). In boys, 2.3% and 1.8% of the between-groups variance in SBP was accounted for by muscle mass (P = 0.001) and height (P = 0.005), respectively. In conclusion, children with a more advanced physical maturity for their age, that is, who are taller, stronger, and have greater fat-free mass, may be nearly reaching the physiological parameters of adulthood, and consequently have higher systolic blood pressure.

Evaluation of Blood Pressure in Children Treated with Ceftriaxone: A Case-Control Study

Background: In children, high blood pressure can develop into hypertension and its consequences during puberty and adulthood. High blood pressure in children is often secondary to other causes, including renal diseases. Nephrolithiasis is one of the causes of secondary hypertension. The extensive use of cephalosporins in hospitals, particularly ceftriaxone, can result in nephrolithiasis. Therefore, the purpose of this study was to assess the relationship between ceftriaxone treatment and elevated blood pressure in children. Method: The research was conducted as a case-control study over an 18-month period from 2018 to 2019. In this study, blood pressure was measured in 111 children aged 3-13 years who were hospitalized at Amir Kabir Hospital in Arak and received ceftriaxone for at least 48 hours. As a control group, 111 children who did not receive ceftriaxone had their blood pressure measured. The blood pressure levels and percentiles of children in the two groups were then compared. Result: In the case and control groups, the mean age was 5.1±1.61 and 6.04±2.4 years, and the mean height was 109.17±10.71 and 114.86±12.95 cm, respectively. A slightly higher mean systolic blood pressure percentile was observed in the case group (65.59±18.17) than in the control group (65.28±14.51) (P=0.112), and the mean diastolic blood pressure percentile was also slightly higher in the case group (58.89±18.88) than in the control group (54.85±19.28) (P=0.317). The difference in diastolic blood pressure was greater than in systolic blood pressure. However, these detected differences were slight and not statistically significant. Conclusion: This study showed no association between blood pressure levels and ceftriaxone treatment in children older than three years who received the medicine for at least 48 hours. However, additional research is suggested, focusing on the effects of the medicine at higher doses and over a longer period of time following administration.

Evaluation of Pre and Post-operative Pulmonary Artery Pressures in Children with Adenotonsillar Hypertrophy and Correlation with Chronicity: A Prospective Study on 50 Children.

Children with grade III or IV of adenotonsillar hypertrophy especially of a longer duration, may show cardiovascular changes due to mouth breathing. These changes can be detected on doppler echocardiocardiography which can be used as a screening tool. Fifty paediatric patients of grade 3 and 4 adenotonsillar hypertrophy underwent adenotonsillar resection after a pre-operative work up which included doppler echocardiography to measure pulmonary artery pressures. A post-operative doppler echocardiography was done after three months. 11 children (22%) showed deranged pulmonary artery pressure values with increased mean pulmonary artery pressure (MPAP) and pulmonary artery systolic pressure (PSAP) on preoperative doppler echocardiography, and 2 out of these 11 children had Pulmonary Artery Hypertension. A significant (p < 0.001) improvement was noted in pulmonary artery pressure values (MPAP and PSAP returned to normal) after adenotonsillectomy in 3-month postoperative echocardiography. Also, a statistically significant correlation was obtained between chronicity of symptoms and raised pulmonary artery pressures. Our study concluded that these children with chronic untreated upper airway obstructive symptoms get predisposed to potential cardiac complications. And these grave consequences can be easily prevented by a timely intervention.

Captopril Polyvinyl Alcohol/Sodium Alginate/Gelatin-Based Oral Dispersible Films (ODFs) with Modified Release and Advanced Oral Bioavailability for the Treatment of Pediatric Hypertension.

Hypertension can begin in childhood; elevated blood pressure in children is known as pediatric hypertension. Contrary to adult hypertension, there is a scarcity of commercial medications suitable for the treatment of pediatric hypertension. The aim of this study was to develop orally dispersible films (ODFs) loaded with captopril for the treatment of hypertension in children. Captopril-loaded ODFs were composed of different blends of synthetic polymers, such as polyvinyl alcohol (PVA) and polyvinyl pyrrolidone, and natural polymers, such as sodium alginate (SA) and gelatin. The ODFs were characterized based on their mechanical and thermal properties, drug content, surface morphology, in vitro disintegration, in vitro release, and bioavailability. A novel HPLC method with precolumn derivatization was developed to precisely and selectively determine captopril levels in plasma. A low concentration of PVA and a high concentration of SA generated ODFs with faster hydration and disintegration rates. SA-based films exhibited fast disintegration properties (1-2 min). The optimized modified-release film (F2) showed significant (p < 0.05) enhancement in bioavailability (AUC = 1000 ng min/mL), with a value 1.43 times that of Capoten® tablets (701 ng min/mL). While the plasma concentration peaking was in favor of the immediate-release tablet, Tmax was significantly prolonged by 5.4 times for the optimized ODF (3.59 h) compared with that of the tablets (0.66 h). These findings indicate uniform and sustained plasma concentrations, as opposed to the pulsatile and rapid plasma peaking of captopril from the immediate-release tablets. These findings suggest that the modified release of oral films could offer more favorable plasma profiles and better control of hypertension than the conventional release tablets.

Are the Reference Equations for Maximal Respiratory Pressure in Children Adequately Predicting Their Value?

Are the Reference Equations for Maximal Respiratory Pressure in Children Adequately Predicting Their Value?

LSS rs2254524 Increases the Risk of Hypertension in Children and Adolescents with Obesity.

Childhood obesity and its related comorbidities have become major health issues over the last century. Among these comorbidities, cardiovascular diseases, especially hypertension, are the most significant. Recently, a polymorphism affecting the activity of lanosterol synthase has been associated with an increased risk of hypertension in adolescents. In this study, we aimed to investigate the effect of LSS rs2254524 polymorphism on blood pressure in children and adolescents with obesity. We enrolled 828 obese children aged 6-17 years. Subjects carrying the A allele showed higher rates of systolic and diastolic stage I hypertension and stage II hypertension. Carriers of the A allele showed a 2.4-fold (95% C.I. 1.5-4.7, p = 0.01) higher risk for stage II hypertension and a 1.9-fold higher risk for stage I hypertension (95% C.I. 1.4-2.6, p < 0.0001). The risk was independent of confounding factors. In conclusion, LSS rs2254524 worsens the cardiovascular health of children and adolescents with obesity, increasing their blood pressure.

Blood Pressure in Children in the 21st Century: What Do We Know and Where Do We Go From Here?

The association between hypertension in adulthood and cardiovascular morbidity and death is well known. Based on that association, a diagnosis of elevated blood pressure in children has been clinically interpreted as early cardiovascular disease. The objective of this review is to discuss historical data and new research on the relationship between elevated blood pressure and early preclinical and later adult cardiovascular disease. After summarizing the evidence, we will address the gaps in knowledge around Pediatric hypertension in an effort to stimulate research into the important role that control of blood pressure in youth may play in preventing adult cardiovascular disease.

Cardiovascular disease risk factors and their association with peripheral and central blood pressures in children and adolescents

Cardiovascular disease risk factors and their association with peripheral and central blood pressures in children and adolescents

Correlation between electronic wrist blood pressure with auscultatory blood pressure in children.

The increasing prevalence of obesity in children and adolescents has turned hypertension into an important public health issue. In the current literature, auscultatory blood pressure measurement is recommended for the diagnosis of hypertension. The number of studies comparing electronic blood pressure measurement and auscultatory blood pressure measurement is limited. This study aimed to compare auscultatory blood pressure measurement with electronic blood pressure measurement in the children population group aged 5-15 years. A total of 72 patients aged between 5-15 years without chronic disease were included in the study. Anthropometric measurements (height, weight, body mass index, wrist circumference, mid-upper arm circumference) were performed. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were first measured electronically from the wrist using an Omron Rs7 Intelli It HEM-6232T device, and then auscultatory measurements were performed. Each type of measurement was performed 3 times intermittently. The mean wrist circumference was 14.43±0.22 cm and the mean mid-upper arm circumference was 21.43±0.55 cm. Mean SBP, DBP and MAP measured electronically on the wrist were 104.1±1.5, 65.6±1.3 and 78.1±1.3 mmHg, respectively, and mean SBP, DBP and MAP measured via auscultation were 99.3±1, 61.4±0.7 and 73.6±0.7 mmHg, respectively. Electronically-measured wrist MAP had significantly moderate correlations with mid-upper arm and wrist circumference (r:0.547, r:0.559, p<0.01). Since the differences were less than 4 mmHg in both systolic and diastolic pressures between electronic wrist blood pressure (EWBP) measurement and auscultatory measurement, it appears that electronic measurement may be important in first line of blood pressure screening. Since it is easy and practical to use in the early period, it may be an alternative approach to auscultatory measurement among non-critical pediatric patients.

Prevalence of hypertension and its associations with body composition across Chinese and American children and adolescents.

The age of onset of hypertension (HTN) is decreasing, and obesity is a significant risk factor. The prevalence and racial disparities in pediatric HTN and the association between body composition and blood pressure are insufficiently studied. This study aimed to evaluate the prevalence of HTN in Chinese and American children and adolescents and to assess the relationship between various body composition indices and HTN. Seven thousand, five hundred and seventy-three Chinese and 6239 American children and adolescents aged 8-18years from the 2013-2015 China Child and Adolescent Cardiovascular Health study and the 2011-2018 National Health and Nutrition Examination Surveys were analyzed. Blood pressure and body composition (fat and muscle) were measured by trained staff. The crude prevalence and age-standardized prevalence rate (ASPR) of primary HTN and its subtypes [isolated systolic hypertension (ISH) and isolated diastolic hypertension (IDH)] were calculated based on 2017 American Academy of Pediatrics guidelines. Multivariable-adjusted linear regression coefficients and odds ratios (ORs) were calculated to assess the associations of body composition indicators with HTN, ISH and IDH. The ASPR of HTN was 18.5% in China (CN) and 4.6% in the United States (US), whereas the obesity prevalence was 7.4% and 18.6%, and the population attributable risk of HTN caused by overweight and obesity was higher in the US than in CN. Increased fat mass, muscle mass and body fat percentage mass were associated with a higher risk of HTN in both countries. The percent of muscle body mass had a protective effect on HTN and ISH in both countries [HTN (CN: OR= 0.83, 95% CI =0.78-0.88; US: OR= 0.72, 95% CI= 0.64-0.81); ISH (CN: OR= 0.87, 95% CI= 0.80-0.94; US: OR= 0.71, 95% CI= 0.62-0.81)], and the protective effect was more common among children and adolescents with high levels of physical activity. The burden of HTN in Chinese children and adolescents was substantial and much greater than that in the US, and the contribution of obesity to HTN was higher in the US than in CN. Augmenting the proportion of muscle mass in body composition has a protective effect against HTN in both populations. Optimizing body composition positively influences blood pressure in children and adolescents, particularly those with high-level physical activity. Video abstract (MP4 149982 KB).