Childhood Types Research Articles

The association between emotional abuse in childhood and healthcare utilization in adulthood among sami and non-sami: the SAMINOR 2 questionnaire survey

BackgroundEmotional abuse in childhood is the most common type of childhood abuse worldwide and is associated with a variety of somatic and mental health issues. However, globally and in indigenous contexts, research on the associations between emotional abuse in childhood and somatic and mental specialist healthcare utilization in adulthood is sparse.AimThe main aim of this study was to investigate the association between emotional abuse in childhood and somatic and mental specialist healthcare utilization in adulthood in Sami and non-Sami populations, and to examine whether this association differs between the two ethnic groups.MethodThis study used cross-sectional data from the SAMINOR 2 Questionnaire Survey - a population-based study on health and living conditions in areas with Sami and non-Sami populations in Middle and Northern Norway. In total, 11 600 individuals participated in SAMINOR 2. Logistic regression was used to present the association between emotional abuse in childhood and somatic and mental specialist healthcare utilization.ResultsEmotional abuse in childhood was significantly associated with somatic specialist healthcare utilization in adulthood (fully adjusted odds ratio [OR] 1.31, 95% confidence interval [CI] 1.15–1.49), with no differences observed between ethnic groups. Emotional abuse in childhood was also associated with mental specialist healthcare utilization (fully adjusted OR 3.99, 95% CI 3.09–5.14), however this association was weaker among Sami (crude OR 2.38, 95% CI 1.37–4.13) compared with non-Sami (crude OR 5.40, 95% Cl 4.07–7.15) participants.ConclusionsEmotional abuse in childhood is associated with somatic and mental specialist healthcare utilization in adulthood, with a stronger association to mental healthcare utilization. The association between emotional abuse in childhood and mental specialist healthcare utilization was weaker among Sami than non-Sami participants. Future studies should investigate the reason for this ethnic difference. Our results highlight the need to strengthen efforts to prevent childhood abuse and develop strategies to reduce its societal and personal burden.

Childhood Mediterranean Diet Adherence Is Associated with Lower Prevalence of Childhood Obesity, Specific Sociodemographic, and Lifestyle Factors: A Cross-Sectional Study in Pre-School Children.

The Mediterranean diet (MD) has been related with a decreased probability of overweight/obesity as well as central obesity at all stages of the human life, decreasing the risk of diverse disease states and improving quality of life. Over the last few years, the prevalence of childhood overweight/obesity and especially abdominal obesity has highly increased worldwide, being associated with a higher likelihood of overweight/obesity as well as central obesity at the next stages of the life during adulthood. The purpose of the present study was to explore the relationship of MD compliance with sociodemographic, anthropometry and lifestyle features in pre-school children aged 2-5 years old. This is a cross-sectional study, which includes 5188 pre-school children from diverse regions of Greece. Relevant questionnaires were applied to evaluate the sociodemographic features of the enrolled children. Anthropometric parameters were measured by relevant techniques. Qualified questionnaires were utilized for assessing several lifestyle factors such as physical activity, quality of life, breastfeeding practices, MD adherence, as well as the prevalence of childhood asthma and diabetes mellitus type I. Of the enrolled children, 41.7% showed low MD compliance and 36.4% of them indicated moderated compliance, while only 21.9% of them showed a high MD adherence. Overweight/obesity was noted in 24.2% of the assigned children, while abdominal obesity was noticed in 18.2% of them. Higher MD compliance was related with an elevated prevalence of sex (boys, p = 0.0005), Greek nationality (p = 0.0088), rural type of residence (p = 0.0099), childhood overweight/obesity (p < 0.0001) and abdominal obesity (p < 0.0001), lower childbirth weight (p < 0.0001), increased physical activity (p = 0.0041), improved quality of life (p = 0.0008), exclusive breastfeeding (p < 0.0001), childhood asthma (p = 0.0001) and diabetes mellitus type 1 (p = 0.0002). A higher MD adherence is associated with specific sociodemographic, better anthropometric, and beneficial lifestyle factors in pre-school children. However, MD compliance remains low or moderate in the vast majority of children aged 2-5 years old. Thus, future public strategies and policies should be performed to inform parents of the potential beneficial effects of MD against obesity and related chronic diseases at the next stage of their children's lives.

Factors That Influence the Relationship Between Childhood Abuse and Adulthood Depression

Major depressive disorder (MDD) is a global problem which brings bad effects to physical and mental health. Childhood abuse experience also brings severe outcomes for adulthood physical health and psychological health, especially depression. Research shows that childhood abuse predicts adult depression symptoms directly and indirectly through factors like personality, allostatic load and genes. Other factors like psychological resilience, gender, family environment, type of childhood maltreatment (CM), culture differences are also effective. In this paper, these are classified into internal factors (personality, allostatic load, psychological resilience, gender, self-acceptance and self-esteem, genes) and external factors (family environment, type of childhood maltreatment, culture difference). Personality, allostatic load, psychological resilience, self-acceptance and self-esteem, genes, family environment and type of childhood abuse all have effective influence on relationship between CM and MDD. There is something special with gender and culture difference. There still doesnt have enough literature to support the effective function of the two with significant statistics, but both of them have influence on childhood abuse and depression. Some researchers believe that childhood abuse could predict depression through a number of factors changed by gender or culture. Therefore, further studies are needed for the effects of gender or culture difference.

Association between adverse childhood experiences and the number of suicide attempts in lifetime

IntroductionAdverse childhood experiences (ACEs), defined as abuse, neglect, or a dysfunctional household in childhood, have been associated with suicidality (Fjeldsted et al., 2020). Every type of ACE has a direct impact on suicide ideation, self-harm and/or suicide attempt (Angelakis et al., 2019).ObjectivesWe aim to quantify the association between types of ACEs (including emotional, physical, sexual abuse, and emotional and physical neglect) and the number of suicide attempts in lifetime.MethodsWe included 748 patients who attempted suicide at least once. They were asked to complete the Columbia-Suicide Severity Rating Scale (CSSRS), and the Childhood Trauma Questionnaire-Short Form (CTQ-SF). Logistic regression models were run to assess the association between each ACE type and the number of suicide attempts.ResultsPoisson univariate regression analyses show a linear trend in the relationship between having a higher number of suicide attempts and having suffered every ACE type in childhood (p&lt;0.05). Our results show a lower percentage of previous suicide attempts among participants without ACEs, and an increasing tendency among patients with various types of ACEs. The rate of ACEs types is significantly higher in the group with previous suicide attempts than in the first-attempt group (p=0.000).Image:Image 2:ConclusionsThis study contributes to clarify the role of childhood trauma in the number of suicide attempts in lifetime. This has important implications for reducing suicide rates, and preventing future re-attempts. Further studies analysing every construct of childhood trauma may contribute to the detection of suicidal behaviour.FundingsThis work was supported by the Instituto de Salud Carlos III (grant number: PI19/00941 SURVIVE) and co-funded by the European Union (grant numbers: COV20/00988, PI17/00768), the European Union’s Horizon 2020 research and innovation programme Societal Challenges (grant number: 101016127), and the Fundación Española de Psiquiatría y Salud MentalAcknowledgementsSURVIVE project (PI19/00941)KeywordsSuicide attempt, Adverse Childhood ExperiencesReferencesAngelakis, I., Gillespie, E. L., &amp; Panagioti, M. (2019). Childhood maltreatment and adult suicidality: A comprehensive systematic review with meta-analysis. Psychological Medicine, 49(7), 1057-1078. https://doi.org/10.1017/S0033291718003823Fjeldsted, R., Teasdale, T. W., &amp; Bach, B. (2020). Childhood trauma, stressful life events, and suicidality in Danish psychiatric outpatients. Nordic Journal of Psychiatry, 74(4), 280-286. https://doi.org/10.1080/08039488.2019.1702096Disclosure of InterestNone Declared

Mechanics of the Left Ventricle in Children Born Prematurely

An increase in the birth rate of premature and low birth weight children at the current level of medical development requires the development of fundamental ideas about the physiology of the cardiovascular system in a history of preterm birth from the point of view of pre- and postnatal ontogenesis. Practicing neonatologists, pediatricians, therapists, cardiologists, reproductologists, etc. it is necessary to improve the traditional ideas about the mechanisms of damage to the cardiovascular system in this category of patients. Because it is established that this clinical subgroup is characterized by increased risks of early onset of pathology of the heart and blood vessels, as well as a high mortality rate in adulthood. Pathological changes of the cardiovascular system in conditions of prematurity can occur at various levels of integration of the body (molecular, subcellular, cellular, organ, functional systems, organismal). The use of modern non-invasive technology “spot trace” makes it possible to study the features of segmental deformation and the variety of forms of LV torsion mechanics during postnatal growth and development in prematurely born children. Optimization of research and diagnostic processes in the field of mechanics of the infant heart in the prenatal and postnatal periods from the point of view of progressive data on anatomy, histology, clinical biochemistry allows us to study the nature of various contractile-rotational models, as well as reasonably assume the contribution of the fibrous skeleton of the infant heart to the formation of “childhood types” of left ventricular twisting. The search and development of informative criteria for the early diagnosis of latent subclinical heart dysfunction in childhood, taking into account the possibilities of non-invasive ultrasound technology “spot trace” (analysis of types of rotational movement, determination of areas of reduced longitudinal deformation of the left ventricle), based on the current provisions of evidence-based medicine, have become quite possible in modern conditions and are demonstrated by the authors in this review. The information offered to the readers will allow to expand the understanding of the physiology and pathophysiology of the infant heart with a history of premature birth, bearing in mind the fact that prematurity is considered a chronic condition.

Çocuklarda priapizme yaklaşım

Priapism is defined as a persistent erection that prolongs for more than 4 to 6 hours regardless of sexual stimulation. It is rare in pediatdrc population and might be frequently due to sickle cell anemia, hematologic disorders, toxins, malignancy and drugs. Ischemic subtype is the most common type in childhood. It is still challenging for clinicians to manage pediatric age patients with priapism in consequence of lack of well established data. In this review, the literature is searched in order to understand and manage properly the clinical classification, etiology, pathology and novel treatment modalities. Keywords: priapism, priapism in childhood, prolonged erection

Psikolojik Dayanıklılığın Yordayıcıları: Çocukluk Çağı Travma Yaşantıları ve Affetme

Psychological resilience enables the person to come out of this situation in a strong way without being harmed after traumatic events. In our study, the relationship between experiencing childhood traumas, types of forgiveness and psychological resilience was examined. In addition, it was also investigated how childhood traumatic experiences and types of forgiveness (forgiving oneself, forgiving the situation, forgiving others) predict psychological resilience. In this study, which was conducted with the relational screening model, the relationships between the dependent variable “Psychological Resilience” and the independent variables “Childhood Traumas” and “Forgiveness” were examined by multiple linear regression analysis Enter method. Data were collected from a total of 366 participants, 236 of whom were women (64.5%) and 130 (35.5%) were men, living in the province of Istanbul. The Personal Information Form, Childhood Trauma Scale [CTS], Adult Resilience Scale [PDS] and Heartland Forgiveness Scale [HAS] were applied to the individuals in the sample. In the study, the relationships between the variables mentioned first were examined, the relationship was determined, and according to the results of the multiple linear regression analysis, it was determined that childhood traumas, self-forgiveness and forgiveness of the situation predicted psychological resilience, while forgiveness of others had no predictive effect. In the study, it was concluded that childhood trauma experiences negatively predicted psychological resilience, while self-forgiveness and forgiving the situation variables predicted it positively. It is thought that it is very important to study self-forgiveness, especially when working with childhood traumas in psychological trauma-based interventions and psychotherapy processes.

The Association Between Living Area in Childhood and Respiratory Disease Mortality in Adulthood.

Objective: No studies have examined the association between characteristics of urban areas and future respiratory disease mortality. We examined whether the type of living area during childhood was associated with all-cause and respiratory disease mortality in adulthood. Methods: A total of 81,413 Japanese participants aged 40–79 years old completed a lifestyle questionnaire including the type of childhood living areas. The Cox proportional hazards regression model was used to calculate the multivariable hazard ratios (HRs) with 95% confidence intervals (CIs) of all-cause and respiratory disease mortality. Results: Living in large city areas in childhood was associated with a higher risk of all-cause mortality [HR = 1.05 (95% CI, 1.01–1.10)], but not with respiratory disease mortality [HR = 1.04 (95% CI, 0.92–1.18)] compared to rural and remote areas. The excess risk of all-cause and respiratory disease mortality was primarily found in industrial areas among men; the respective multivariable HRs were 1.28 (95% CI, 1.00–1.64) and 1.90 (95% CI: 1.10–3.29). Conclusion: Eliminating childhood health hazards associated with living in industrial areas suggested to reduce the risk of mortality from respiratory diseases in adulthood.

Study of the role of etiological factors on the likelihood of organic personality disorder

Objective: to study the influence of etiological factors on the possibility of the formation of organic personality disorder. Materials and methods: 80 patients with organic personality disorder were examined. The control group was represented by 82 healthy volunteers. Research methods: anamnestic, clinical, and statistical. Results: it was established that heredity aggravated by mental illness, alcoholization and drug addiction of relatives of different kinship lines, perinatal pathology factors associated with the child, diseases suffered in childhood (infectious diseases, etc.), which resulted in severe outcomes in the early stages of treatment in the form of hospitalizations or other complications in the form of pneumonia, bronchitis, etc., convulsive conditions, traumatic brain injuries received in childhood, reveal a reliably significant probability for the occurrence of organic personality disorder. The effect factor of operative interventions performed under general anesthesia in childhood did not show a statistically significant effect. Conclusions: heredity, perinatal pathology, some diseases suffered in childhood, convulsive states and various types of traumatic brain injury significantly increase the likelihood of organic personality disorder.

The Role of Milk on Children's Weight Status: An Epidemiological Study among Preadolescents in Greece.

Milk consumption contributes greatly to children’s diet, playing a pivotal role in the development and structure of bones and the functioning of the musculoskeletal system and the heart. This study investigated the association between the type of milk and childhood overweight/obesity. In the school period 2014–2016, 1728 students aged 10–12 years and their parents participated. The measurement and classification of their weight status were performed through the criteria of the International Obesity Task Force. Among others, the type of milk consumption was recorded. Four categories of the type of milk children consumed were classified (white milk, chocolate milk, both types of milk, and no milk at all). Children consuming only white milk were 33.1% less likely to be overweight/obese in comparison with children who were not consuming milk at all [OR (95% CI): 0.669 (0.516, 0.867), p = 0.002]. The consumption of chocolate milk showed a protective role against childhood overweight/obesity although its association was not consistently significant. This study highlights the significant contribution of milk (and particularly of white milk) consumption to weight management, and thus its promotion should be consistently encouraged. More studies are needed to shed light on the effects of different dairy foods on weight status in childhood.

Differences in Community Stakeholders’ Perceived Barriers and Needs to Improve Food Security for Families With Children Under 3 Years Before and During COVID-19

ObjectivesTo explore the perceived barriers and needs of different types of community stakeholders regarding services and resources to improve food security for families with children under 3 years before and during COVID-19. MethodsCommunity stakeholders (n = 32) working with low-income families with children ages 0–3 years in Florida participated in a 60-minute interview via Zoom. Participants included those working in healthcare (n = 7), community/policy development (n = 6), emergency food assistance (n = 6), early childhood development (n = 7), and nutrition education (n = 6). Trained researchers conducted interviews using a semi-structured script based on the PRECEDE component of the PRECEDE-PROCEED model. Interviews were audio-recorded, transcribed verbatim, and analyzed using an inductive thematic approach. Crosstab qualitative analysis was used to compare data across different types of stakeholders. ResultsOverall barriers to providing resources and services to improve food security in families with children under 3 years included community individuals’ lack of knowledge of available resources and the stigma associated with applying for benefits. When further exploring these barriers by type of stakeholder, before COVID-19, early childhood and nutrition educators reported a lack of social marketing and community engagement as key barriers to providing resources and services while emergency food assistance providers stated limited funding restrictions. Community/policy development providers also expressed lack of community buy-in and motivation as their primary barriers. Stakeholders stated that while existing barriers remained, new challenges emerged due to COVID-19. Early childhood and nutrition education providers reported individuals’ lack of knowledge and access to technology as the main barrier, while healthcare and community/policy development providers reported fear of COVID-19 exposure and new safety protocols. Emergency food providers reported a lack of knowledge in accessing resources or services. ConclusionsUnderstanding pre-existing and emerging barriers to improving food security in households with young children can guide the development of effective policies and practices relevant to different types of stakeholders. Funding SourcesNone.

Assessment of miR-1179 As a Potential Biomarker in Juvenile Myoclonic Epilepsy

Objective: Juvenile myoclonic epilepsy (JME) is one of the most common childhood types of epilepsy and comprises 5-10% of all epilepsies. Altered expression levels of microRNAs (miRNAs) have been reported in epilepsy as in many diseases. As is known, miRNAs regulate gene expression post-transcriptionally and have potential as diagnostic biomarkers due to their stability in clinical samples. Herein, this study aimed to evaluate miR-1179 levels of JME patients and assess the potential of miR-1179 as a diagnostic biomarker. Material and Method: Twenty patients and 20 healthy controls were recruited in this study and total RNA was extracted from peripheral blood samples of participants. Quantitative real-time polymerase chain reaction (qRT-PCR) was performed to calculate the relative expression level of miR-1179. Additionally, receiver operating characteristic (ROC) curve was conducted to evaluate the diagnostic value of miR-1179 in JME. Results: Expression levels of miR-1179 were statistically significantly increased in patients with JME compared to healthy controls (p&lt;0.0001). ROC analysis revealed that miR-1179 is a well diagnostic biomarker with an area under the curve (AUC) of 0.89. Conclusion: miR-1179 may be considered a remarkable biomarker in the diagnosis of JME. The interaction between miR-1179 and its target Calmodulin 1 (CALM1) should be reinforced through functional studies. Further research in larger cohorts will help to enlighten the etiopathogenesis of JME.

Vicious Infants: Dangerous Childhoods In Antebellum US Literature by Laura Soderberg

Reviewed by: Vicious Infants: Dangerous Childhoods In Antebellum US Literature by Laura Soderberg Paige Gray Vicious Infants: Dangerous Childhoods in Antebellum US Literature. By Laura Soderberg. Amherst and Boston: University of Massachusetts Press, 2021. x + 200 pp. Paper $27.95, cloth $90. at an early point in Vicious Infants, an adept exploration of early American literary childhoods existing outside the idealized narratives perpetuated and normalized by white supremacy, author Laura Soderberg centers on the common practice of youth indenture as depicted in Harriet Wilson’s Our Nig (1859) and William Apess’s A Son of the Forest (1829). Here, she posits that, taken together, these texts help us “reframe how unfree labor connects child bodies to the public sphere and . . . subsequently shapes their relationship to the social [End Page 343] world as adults” (20). Soderberg’s ability to seamlessly incorporate legal and historical texts—as she does in this particular section by examining what indenture contracts suggest regarding the consent and autonomy of children who were Black, brown, or poor—helps make Vicious Infants a significant scholarly contribution to childhood studies, as well as, of course, nineteenth-century American literature and culture. Though there are places where the book’s momentum occasionally gets weighed down by dense language or academic jargon, and while there are other places where the discussion could have been fleshed out (for example, a section on Freud in the second chapter), these are slight criticisms. For in her skillful erosion of any presumed barriers between the literary and the historical via her shrewd close readings throughout the book, Soderberg reinforces the discursive nature of childhood through her impressive, important research. The book’s captivating title is more than just a catchy phrase underscoring the myth of childhood innocence. It is a nineteenth-century criminal designation. “An early alternative for the [legal] category of the minor,” Soderberg explains, “the term infant was generally used to classify subjects under the age of eighteen or twenty-one years old as holding different rights and duties than adult subjects” (24). Thus, “vicious infants,” as a phrase, also encapsulates the ways in which language predetermines the experience of childhood. Derived from the Latin in-fans, or “non-speaking,” “infant” works to “name an imposed silence, a declaration that the speech of a minor could not properly be recognized in court as the sign of intention or testimony” (25). Those young people unrecognized or marginalized because of antebellum legal and literary strictures shape Vicious Infants. The study’s unifying argument “pushes against any singular type of antebellum childhood, to which one is either admitted or refused” and instead advocates for “a broader vocabulary of multiple childhoods that each have their own relationship to civic and social life” (4). Now, to most childhood studies scholars, this notion may not be revelatory—the idea of varying models of childhood across time and space has been part of academic discussion since the publication of Philippe Ariès’s Centuries of Childhood (1960; 1962 English trans.). Yet each chapter’s specific engagement with the ways in which early American rhetoric of the white middle-and upper-class imagination codified and essentialized childhood rewards readers in its revisionary recasting of nineteenth-century childhood in the United States, which it accomplishes through considering textual gaps and silences—the textual in-fans. Following the strong opening chapter on indenture and social contracts, Soderberg turns to “the incorrigible child” and juvenile delinquency, unpacking the textual implications of domestic child-rearing manuals (from [End Page 344] well-known figures including Amos Bronson Alcott and Lydia Maria Childs) and institutional records from facilities such as the New York House of Refuge. In what may be the most compelling chapter, Soderberg brings to light the nineteenth-century racialized understanding of “prodigy” in antebellum medical discourse—that is, the “white tendency to treat Blackness as unpredictable and . . . as existing outside of genealogy,” which functioned “as a means of denying Black futurity” (83, 86). In her discussion of Susan Paul’s The Memoir of James Jackson, the Attentive and Obedient Scholar, Who Died in Boston, October 31, 1833, Aged Six Years and Eleven Months, which many argue is the first work of African American...

Особливості ендокринного статусу в дітей з ожирінням та поліморфізмами гена лактази

Актуальність. Ожиріння — це дисбаланс імуноцитокінової та нейроендокринної регуляції енергетичного обміну з надлишковим накопиченням жирової тканини в організмі, пов’язаний з формуванням хронічної прозапальної імунної відповіді, асоційованої з генотипом С/С 13910 гена лактази. Мета дослідження: визначити особливості тиреоїдного, статевого гормонального статусу, жирового обміну та формування лептинорезистентності в дітей з ожирінням та поліморфізмами (SNP) гена лактази (LCT). Матеріали та методи. Проведено комплексне обстеження згідно з діючим протоколом зі спеціальності «дитяча ендокринологія» 76 дітей віком 6–18 років з ожирінням та SNP LCT. Першу групу (n = 36) становили діти з генотипом С/С 13910, що асоціюється з лактазною недостатністю дорослого типу. До другої групи (n = 40) увійшли фенотипово схожі діти з генотипами С/Т та Т/Т 13910, що асоціюються з лактазною персистенцією. Визначення порушень жирового обміну проводили методом біоімпедансометрії на електронних вагах Tefal Bodysignal (Франція). Дослідження ендокринного статусу виконували за допомогою імунохімічного методу тестування з електрохемілюмінісцентною детекцією (ECLIA), генотипування гену лактази — за допомогою полімеразної ланцюгової реакції в режимі реального часу. Результати. У дітей з генотипом С/С 13910 виявляються статистично значимі відмінності в ендокринному статусі, пов’язані з підвищенням інсулінорезистентності у хлопчиків до 6,79 ± 1,12 за індексом НОМА проти 3,29 ± 0,99 у хлопчиків з генотипами С/Т та Т/Т 13910 при р = 0,028. У дівчаток з генотипом С/С 13910 відмічається відносне, в межах фізіологічної норми, зниження вільного естрадіолу до 40,10 ± 0,05 пг/мл порівняно з рівнем у дівчаток з генотипами С/Т та Т/Т 13910 — 75,61 ± 4,6 пг/мл при р &lt; 0,01, з одночасним патологічним підвищенням в 3,5 раза дегідроепіандростерону сульфату у віці 15–18 років до 594,50 ± 8,81 мкг/дл відносно рівня у дівчаток з генотипами С/Т та Т/Т 13910 — 167,06 ± 12,80 мкг/дл при р &lt; 0,01. Для дівчаток з генотипом С/С 13910 характерне статистично значиме (р &lt; 0,05) підвищення рівня лептину до 47,84 ± 4,40 нг/мл порівняно з дівчатками з генотипами С/Т та Т/Т 13910 — 32,54 ± 4,30 нг/мл. Порушення жирового обміну асоціюються з більш високим рівнем жирової маси тіла (ЖМТ) у хлопчиків та дівчат з генотипом С/С 13910 відносно дітей з генотипами С/Т та Т/Т 13910, а саме: у хлопчиків з генотипом С/С 13910 середній рівень ЖМТ становив 35,46 ± 2,52 %, тоді як у хлопчиків з генотипами С/Т та Т/Т 13910 — 25,04 ± 2,14 %. У дівчаток з генотипом С/С 13910 середній рівень ЖМТ становив 38,19 ± 2,25 %, тоді як у дівчат з генотипами С/T та Т/Т 13910 середній рівень ЖМТ — 28,99 ± 0,76 % при р &lt; 0,001. Висновки. Фактором ризику ожиріння в дітей є генотип С/С 13910 гена лактази, що асоціюється з лактазною недостатністю дорослого типу. Хлопчики 6–18 років, хворі на ожиріння, носії даного генотипу, мають в 1,5 раза вищий ризик формування інсулінорезистентності. Дівчата 15–18 років з генотипом С/С 13910, хворі на ожиріння, мають в 1,5 раза вищий ризик виникнення лептинорезистентності та в 3,5 раза вищий ризик інвертованого перебігу пубертатного періоду за рахунок гіперандрогенії надниркового генезу.

Hyperglycemia and hyponatremia in predicting the recurrence of febrile convulsions

Aim: The most common seizure type in childhood is febrile convulsion, which is likely to recur due to many risk factors. This study aimed to evaluate serum sodium and glucose levels in patients who had a febrile convulsion and investigate the relationship between these values and recurrent seizures.Materials and Methods: The medical records of patients presenting to our hospital with the diagnosis of febrile convulsion between 2013 and 2018 were investigated. Patients with high-risk factors for recurrence were excluded. According to the reference ranges of our laboratory, for glucose, 101-149 mg/dl as mild-to-moderate stress hyperglycemia, above 150 mg/dl as severe stress hyperglycemia; for sodium, below 134 mmol/L as hyponatremic.Results: Of the 90 patients, 51 were boys, and 39 were girls. Without recurrent convulsions with recurrent convulsions (first-last): The mean age was 27.2±12.7 months / 27.4 ± 11.3 months-30.5±12.4; the mean serum glucose level was 129.1±37 mg/dl/130 ±37.5 mg/dl-124 ± 34 mg/dl; the mean serum sodium level was 134.07±3.05 mmol/L 134.4 ± 2.6 mmol/L-133.8 ± 2.9mmol/L. The glucose level was 60-100 mg/dl in 14/5 cases, 101-149 mg/dl in 39/10 cases, and above 150 mg/dl in 16/6 cases; the sodium level was 135-150 mmol/L in 29/10 cases, 135 mmol/L in 40/11 cases.Conclusion: Febrile convulsion is in most cases present with hyponatremia and hyperglycemia, but this cannot be a predictive marker of seizure recurrence.

Eradicating Illiteracy in the Rural Masses during the Great War

This study analyses a unique Italian publication linked to a wider project aimed at eradicating the illiteracy of the rural masses. Il Piccolissimo (1917–1919), a magazine written for children in the agricultural area around Rome, informed them about the Great War and educated them about better values and the importance of making savings. This cultural project, conceived and edited by Giovanni Cena and other intellectuals of the time, also envisaged the establishment and management of rural schools and infirmaries to provide children with a better and healthier life. In Italy, during those years, the magazine Il Corriere dei Piccoli was published to entertain and educate children of the middle and upper classes, while Il Piccolissimo sought to develop an awareness of social responsibility in the poor and hardworking children of the countryside. By examining its contents, graphic layout, iconic language, and educational aims we intend to highlight how the type of childhood it targeted acquired unprecedented social visibility in Italy.

Contornos das políticas sociais (assistência-educação) à infância desvalida portuguesa (séculos XIX e XX)

A problemática da assistência e educação às crianças pobres, abandonadas ou desvalidas, designadas por ‘Outra infância’, apresentou diferentes enfoques de análise e diferentes discursos, que tiveram respostas sociais (políticas), segundo o período histórico abordado (século XIX e parte do século XX). O propósito historiográfico norteia-se pela assistência educativa e protetiva àquele tipo de infância. Recorremos a fontes documentais, à imprensa, a legislação, a teses e monografias de instituições, etc., que permitiram elaborar a argumentação, de índole hermenêutica, que é um método cujo campo de atuação envolve a compreensão e a profundidade dos aspetos subjetivos e objetivos de pesquisa. O quadro teórico-conceptual assenta numa base ampla de referências à proteção e assistência social, à economia social, aos dispositivos jurídicos, ao papel das instituições asilares de internamento, etc. A estrutura do estudo divide-se em 3 pontos: a representação social da infância e respetivas construções sociais; a assistência social regulada pelos dispositivos administrativos locais e a perspetiva das instituições de internação à infância desvalida.

Diagnostic delay in ADHD: Duration of untreated illness and its socio-demographic and clinical predictors in a sample of adult outpatients.

To investigate the Duration of Untreated Illness (DUI) and its socio-demographic and clinical predictors in a sample of adult ADHD outpatients. The DUI of 150 adult outpatients with a confirmed diagnosis of DSM-IV ADHD was calculated. Non-parametric tests were used to evaluate differences in DUI among subgroups and to build a correlation matrix. Subsequently, a multiple linear regression model was performed. The median DUI was 17 years (interquartile range [IQR]=14). DUI was longer in employed patients, those with a family history of ADHD, those with a history of major depressive disorder and those who had predominantly inattentive ADHD in childhood. The current age, age at administration of the first proper treatment and education level were correlated with DUI. Current age (63.3% of total variance), family history of ADHD and the presence of a predominantly inattentive type in childhood (together, 2.6% of total variance) were all predictors of DUI. Information programmes for caregivers and training for health care professionals should be promoted to foster the early recognition of covert inattentive symptoms and shorten DUI.

Experiencia y hallazgos en el manejo de la dieta cetogénica en niños con epilepsia refractaria, estudio de 10 casos

Refractory epilepsy is due to that drug-resistant epilepsy in which there is no improvement after the applica-tion of various antiepileptic drugs (AEDs). The Telethon Children's Rehabilitation Center cares for a large population of children with some type of epilepsy. Recently, the application of the home intervention proto-col for the ketogenic diet (DC) has increased. A few years ago, DC was only attended with extreme surveil-lance in a hospital center under rigid schemes. With this background, the objective of this study was to describe the experience and findings of a series of 10 cases of children with refractory epilepsy treated with this DC protocol over the course of at least 1 year. All the cases of children (n = 10) attended at the Telethon Children's Rehabilitation Center, Aguascalientes, Mexico, who were treated with the ketogenic diet between the dates of February 2010 and June 2015, were reviewed by means of an electronic clinical record criteria for refractory epilepsy, as well as surveillance for pediatric neurology and nutrition. The DC home interven-tion protocol was established under the criteria of Lambruschini-Nilo & Gutierrez-Sanchez, where it started with a classic type DC with a 2: 1 ratio during the first week of adaptation and then went on to the 3: 1 or 4 ratio: 1 corresponding according to patient tolerance. The reduction in the number of crises was measured at 3 months and one year after surgery. A one-way ANOVA general linear model with repeated measures was applied to measure the efficacy at 3 months and one year of treatment, finding statistical significance when comparing the results means of the number of epileptic events before the diet (p = <0.006). . The most frequent type of epilepsy was West Syndrome in 4 patients, Lennox Gastaut Syndrome in 3 patients, Severe Myoclonic Epilepsy of Childhood and other types of epilepsy, 3 patients. The most common side effects were constipation in 60% of the population, and the least common were hypoalphalipoproteinemia-like dyslipidemia in 30%, reflux in 20%, and kidney stones in 10%.

Genotype-phenotype variable correlation in Wilson disease: clinical history of two sisters with the similar genotype

BackgroundWilson disease (WD) is an Autosomal-Recessive disorder due to mutations of ATP7B gene on chromosome 13q14.3. Inadequate protein function leads to low ceruloplasmin blood levels and copper accumulation in liver, basal ganglia and chornea. Main clinical manifestations are hypertransaminasemia, tremors, dysarthria, dystonia and psychiatric symptoms. The phenotypic variability in WD is considerable and its onset can be heterogeneous: the most common type in childhood is the hepatic involvement, followed by the neurological one or others. The presence of a genotype-phenotype correlation has not yet been fully demonstrated. The phenotypic variability may be explained by the intervention of other modifier genes regulating copper metabolism in the presence of mutations ATP7B.Case presentationA streaking phenotypic variability was observed in two Sicilian sisters carrying the same genotype for ATB7B gene [c.3207C > A / c.3904-2A > G]. Although both started to present signs at age 10 years, onset was characterized by neurological signs in the first (tremors, motor incoordination, language and cognitive impairment), while liver involvement has been the only sign in the other. They started the same chelation therapy. After a 20-year follow-up the former is severely affected (MRI evidence of basal ganglia copper deposits and hyperchogenic liver, thrombocytopenia), while the latter presents only a moderate liver enlargement. In literature, the splice mutation c.3904-2A > G is also reported in Egypt population, associated with acute liver failure or chronic hepatic disease, and it could be typical of Mediterranean area, not being reported in other geographical zones.ConclusionBased on our clinical experience in Eastern Sicily, there is a considerable phenotypic variability in WD, even in the presence of an identical genotype. The mutation c.3904-2A > G could be associated with this phenotypic variability in Mediterranean population, but further studies should be conducted. This condition could be explained by the intervention of modifier genes regulating copper metabolism in the presence of defective ATP7B protein function. Further investigations on their role by Next Generation Sequencing or Whole Exome Analysis might have a profound impact on patients’ management and in particular on therapy.