Acquired cysts of the kidneys in children with chronic renal failure

The study aimed at evaluating an incidence of the acquired cysts of the kidneys in children with chronic renal failure. The study involved 33 children with renal failure treated conservatively with continuous peritoneal dialysis under ambulatory conditions and hemodialyses. CT tomography and sonography were carried out in all patients. The acquired cysts of the kidney were diagnosed in one out of 33 examined patients (3.03%) by ultrasound. This result was confirmed by CT-scanning. It is worth following the development of the cyst in his child waiting for kidney transplantation and further following all dialysed patients with ultrasound performed once per three months and CT-scans in some patients.     

Radiodiagnosis of traumatic injuries of the kidneys in children

Altogether 35 children (21 boys and 14 girls) with traumatic renal lesions ages 5 to 14 were examined, of them 23 were subjected to operation 2-13 h after injury, 12 patients received conservative therapy. The patients were divided into 3 groups with relation to a degree of severity of injury: mild (12 patients), moderate (20 patients) and grave (3 patients). All the children were given combined clinical, x-ray and radiological examination. Normally the most informative diagnostic method was excretory urography, particularly its infusion variant. Renography, renoscanning or dynamic renoscintigraphy were employed for observation over time to reduce radiation exposure.     

Hyperuricemia and metabolic syndrome in children with overweight and obesity

ObjectiveTo study the prevalence of hyperuricemia in children with overweight or obesity and analyze the relation with metabolic syndrome and the diseases that define it.Materials and methodsThis is a cross-sectional prevalence study in 148 children recruited from pediatric endocrinology consultation, with overweight or obesity (12 ± 3 years, 48% boys, BMI 31.8 ± 6.1). We measured BMI, waist-height, waist circumference, blood pressure with standard instrumentation and glucose (fasting and after overload with 75 g), insulin resistance, cholesterol HDL, triglycerides and uric acid.ResultsThe prevalence of hyperuricemia was 53%. Patients with hyperuricemia had greater BMI (33.9 vs 30.6, p = 0.003), plus waist circumference (101.4 vs 91.1 cm, p < 0.001), higher blood pressure: systolic (123.4 vs 111.9 mm Hg, p < 0.001), diastolic (78.2 vs 68.7 mm Hg, p < 0.001). They presented greater blood glucose after overload oral glucose (107.5 vs 100.7 mg/dl, p = 0.03), insulin was higher (29.2 vs 20.7 mg/dl, p = 0.001) as well as HOMA IR (6.5 vs 4.4, p < 0.001) and HDL levels were lower (49.5 vs 54.4 mg/dl, p = 0.02).Uric acid's level which most is the likely diagnosis of metabolic syndrome corresponds to 5.4 mg/dl in our sample (sensitivity: 64% and specificity 62%).ConclusionThe prevalence of hyperuricemia in children with overweight and obesity is high. In the group of patients with obesity and hyperuricemia, we found out that the parameters measured to diagnose with metabolic syndrome were less favorable. Uric acid's level from where there is a higher possibility to see metabolic syndrome is 5.4 mg/dl.     

Assessment of the character and incidence of electrocardiographic changes in children with simple obesity

The studied group comprised 82 children with simple obesity. In the group the character and frequency of ECG changes in 12 conventional leads were analyzed. A correlation was established between the character and frequency of these changes and the degree of overweight and obesity duration. In children with simple obesity a considerable prevalence was observed of disturbances of sinus rhythm, impairment of intraventricular conduction and signs of left ventricular hypertrophy. The observed changes were more frequent in children with over 5 years of obesity duration. No correlation was demonstrated between the incidence of these changes and the degree of overweight.     

Altered macrophage-like functions of preadipocytes in inflammation and genetic obesity

We recently demonstrated that preadipocytes exhibit functional features of macrophages, such as phagocytosis and anti-microbial activity, suggesting that preadipose cells could play a role in the inflammatory process or immune response. The aim of this study was to compare these functions of both macrophages and cells from stroma-vascular fraction (SVF) of the adipose tissue in two different situations, obesity and inflammation, characterized by alterations in immune responsiveness. We demonstrated that ob/ob mice exhibited strong decrease in antimicrobial activity of both macrophages and SVF. This defect is compensated in SVF, at least in part, by an enhancement of phagocytosis that does not seem to be due to an increased macrophage number. In vitro leptin treatment of SVF and macrophages from obese mice did not restore their immune defects. Thioglycollate treatment of lean and obese mice induced an inflammatory process that led to an increase in macrophage activity in both strains. This stimulation also observed in SVF from lean mice is not present in obese ones. This work demonstrated that SVF immune functions could be modified in different pathological situations such as inflammation and obesity and sustained the new physiological role of preadipocytes in these processes.     

Thyroid function and obesity in children and adolescents

The aim of this retrospective study was to investigate the frequency of thyroid dysfunction as assessed by TSH, T3 and T4 in a large cohort of 290 obese and 280 healthy children. In addition, thyroid autoantibodies were measured in random subgroups of 123 obese and 80 control children, iodine excretion in 50 and thyroid volume in 23 of the obese children. Elevated TSH levels (>4 U/l) were found in 22 obese children (7.5%), but only in one control (0.3%). The medians of TSH and T3 concentrations were normal, but significantly higher in the obese group than in the controls, while T4 levels did not differ. The prevalence of positive thyroid autoantibodies was increased in the obese children, for the most part in those with elevated TSH. There was no evidence for iodine deficiency as a cause of the average increase of TSH. We conclude that in childhood obesity TSH and T3 levels are significantly increased; in most cases, however, these increases are not accounted for by thyroid autoimmunity or iodine deficiency. As a consequence, TSH elevations with normal thyroid hormone levels in obese children don't need any thyroxine treatment, if thyroid disorders were definitely excluded beforehand.     

Social inequality and obesity in Czech school children

This study uses logistic regressions to consider the effect of social factors, physical activity, meal frequency and BMI of parents on children's body mass index (BMI) values. Three thousand three hundred and sixty-two children aged 7-11 years were examined in 38 schools in the Czech Republic. Six anthropometric characteristics were assessed in 1999-2000. Most important factors influencing children's BMI values were: obesity of both or at least one of the parents, being an only child, residence in small communities, and irregular breakfasts.     

Measuring social-cognitive functions in children with somatotropic axis dysfunction

Growth hormone (GH) and insulin-like growth factor I (IGF-I) are expressed in specific regions of the central nervous system during early human development. They may consequently influence aspects of cognition, or emotional and behavioural adjustment from childhood to adulthood, in conditions associated with abnormalities of the somatotropic axis. GH receptors are relatively common within hippocampal and perihippocampal regions that are primarily involved in declarative memory for facts and events. They are also located in structures (e.g. the putamen) that are involved in the processing of social perceptions. IGF-I receptors have been discovered in the amygdala and prefrontal cortex, which contribute to the neural circuits known as the 'social brain'. The evaluation of emotional, social and behavioural adjustment among children who have deficiencies in GH or IGF-I functional integrity requires the objective assessment of their social-cognitive competence. We describe a computerized test battery, the Schedules for the Assessment of Social Intelligence (SASI), which has been shown to possess excellent psychometric properties in terms of reliability and validity. The SASI, which can be used by both children and adults, may provide new evidence for deficits and treatment effects of GH/IGF-I on emotional, behavioural and cognitive functions.     

Investigation on hyperuricemia in children with obesity or various pediatric disorders

The present study aims at investigating the frequency and characteristics of hyperuricemia in both obese and sick children. First, we established our own reference values for serum uric acid (UA), since UA values are highly dependent upon age. In the analysis of 328 samples consisting of six different age groups: <1, 1-3, 4-6, 7-9, 10-12, and 13-15 years, the mean values for UA were found to increase significantly with an increase of age. A significant sex difference was observed only in the age group of 13-15 years. Hyperuricemia was defined as the values over the mean value plus 2 standard deviations for each age group. Next, we examined the frequency of hyperuricemia in 1,687 obese children aged 6-15 years and its relation to metabolic syndrome (MetS). A total of 328 children (19.4%) were found to have hyperuricemia. Among them, 98 children (29.9%) had MetS, whereas 197 (14.5%) out of 1,359 children without hyperuricemia had MetS. Finally, the frequency of hyperuricemia in sick patients was investigated using 13,675 samples from 9,405 patients. Hyperuricemia was seen in 348 (3.7%) patients after excluding redundant samples. The number of patients with hyperuricemia was higher in males than in females. The most common disorder causing hyperuricemia was gastroenteritis, followed by respiratory tract infection and cardiac diseases. This first comprehensive study of childhood hyperuricemia is useful for considering its relationship with hyperuricemia and life-style-related disorders occurring in adulthood.     

An attempt to characterize certain parameters of the radiorenographic curve in children with intact kidneys and urine passages.

The authors evaluated 48 curves for the right and left kidney of 24 children free from any disorder of the uropoietic system, in whom radiorenography formed part of a general examination. In the recordings they evaluated the "secretory" (ta) and "excretory" (td) parts of the curves and percentual differences in the recordings for times ta and td and at 5, 10 and 15 minutes. The percentual differences in the curves were compared with the findings in a group of 64 children with cystopyelonephritis. Times ta and td for the whole group of investigated children were normal. Percentual differences between the curves for the right and left kidney were significantly smaller in the "healthy" group than in the children with cystopyelonephritis. Comparison of the results in the two groups showed that the differences were statiscally significant or highly significant. The drop in the recordings at 5, 10 and 15 minutes corresponded to the normal findings in adults.     

Socioeconomic status, height, and obesity in children

The substantial increase in the prevalence of child obesity over recent decades and its association with a number of negative health and economic outcomes suggests its strong potential as an influence on the lifecourse development of health and productivity. This paper evaluates interactive effects between family socioeconomic status (SES) and height on child obesity in the United States. Using the 1999-2006 National Health and Nutrition Examination Surveys (NHANES), the results of this paper confirm previous findings that taller children exhibit greater propensity towards obesity as measured by body mass index (BMI) and that obesity is inversely related to family SES as measured by poverty status. The analysis adds to the existing literature by showing that the magnitude of the SES-obesity association is larger in taller children. Age and sex patterns are evaluated that suggest the SES-height interaction persists through childhood and adolescence in males but is only evident in females during adolescence. Interaction effects are also shown to be most evident in white males and Hispanic females. Policy implications are discussed and directions for future work are suggested.