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  • ISSN: 2373-9312
    Volume 9, Issue 2
    Research Article
    Geruza Mara Hendges, Elza Daniel de Mello, Maria Lucia Bonfleur, and Claudia Silveira Viera*
    Facing an increase in childhood obesity, it is necessary to investigate the metabolic profile of school-aged children in order to identify earlier lipid and glycemic changes. The objective in this study was to establish the blood pressure, anthropometric and metabolic profile of school-age children born at term or premature in western Paraná. The methodology implemented in this article was a cross-sectional, convenience-type sample of 132 children (five to nine years old), from four municipal schools, 33 children from each school were selected for data collection. Family socioeconomic variables, weight, height, waist circumference, blood pressure, total cholesterol, triglycerides and glucose were analyzed. The schoolchildren were divided into two groups: born at term (GENT), and premature births (GENP). Statistical analysis using XLSTAT. The main results obtained showed that overweight and obesity were observed in the GENT (38.33%), and GENP (41.66%). Statistical difference was observed only in the abdominal circumference in the GENT, of these, 90% had mean systolic blood pressure above the 90th percentile (p<0.001), 65% had clinical criteria for metabolic syndrome. In conclusion, anthropometric profile showed a significant prevalence of obesity in both groups, waist circumference higher than expected for age. Lipid parameters should be routinely evaluated among schoolchildren, looking for changes to propose interventions to reduce the risk of chronic conditions in adulthood.
    Dhiego Sgarbosa Tomin, Daniel Almeida do Valle, Bruno Augusto Telles, Alfredo Lohr Junior, Mara Lúcia S.F.Santos, Tiago dos Santos Bara, and Mara L. Cordeiro*
    Tuberous sclerosis complex (TSC), is rare autosomal dominant genetic disease characterized by the occurrence of benign tumors, including epileptogenic tumors in the brain. Its highly varying phenotypic manifestations can lead to mis- and missed diagnoses. To investigate the main neurological symptoms and clinical course of TSC, we conducted a cross-sectional and observational study with 23 pediatric patients diagnosed with TSC (age range, 0–15 years), who received neurological follow-up care between 2014 and 2020 at our clinic, in the largest children’s hospital in Brazil. We analyzed demographic data, clinical manifestations, diagnosis methods, medications in use, age of onset, and outcomes. The average ages of initial symptom recognition and diagnosis were ~3 months and ~13 months, respectively. The first signs of TSC were recognized before 6 months of age in most cases. The most common first signs of TSC identified were seizures, cardiac rhabdomyomas, and hypochromic macules. The most common medications being used were valproate, vigabatrin, and everolimus. Antenatal detection of a cardiac rhadomyoma should be followed by diagnostic screening for TSC to enable early diagnosis. Early recognition of TSC allows for early intervention, including monitoring for signs of seizure activity. Pre-emptive treatment, including seizure suppression, can enable patients with TSC to have a better quality of life.
    Cristiane Aparecida Moran*, Carolina Batista Antunes, Simone Dal Corso, Simone Nascimento Santos Ribeiro, Bruna Samantha Marchi, Ingrid Guerra Azevedo, and Silvana Alves Pereira
    Objective: Observe the exercise intensity of overweight children, their perceived exertion and the motivational aspect, using an active video game compared to the ergometric treadmill test.
    Methods: Cross-sectional study with children aged 6 to 10 years. The control group consisted of eutrophic (normal-weight) subjects and the experimental group of overweight children. The children were invited to take part in a racing video game and ergometric treadmill protocol. Maximal exercise intensity was assessed by maximum heart rate and perceived exertion by the modified Borg scale. A numerical scale was used to evaluate the motivational aspect.
    Results: The sample consisted of 22 children (11 boys and 11 girls). Maximum heart rate was reached in all the modalities, except for the control group in the treadmill exercise. Perceived exertion was similar between the two groups and both reported to be motivated by the active video game (p < 0.001).
    Conclusion: For overweight children, exercise intensity and motivation are higher in the video game and perceived exertion was similar between the treadmill and the video game.
    Piet Hein Jongbloet*, Hans MM Groenewoud, Bart ALM Kiemeney, Andrė LM Verbeek, and Nel Roeleveld
    Objectives: An intrauterine origin of childhood leukemia has been presumed. The association with specific maternal and child characteristics, such as chromosomal aberrations and monozygotic twinning, compel us to look for aberrant conditions around conception. To study an ab ovo origin, the month of birth was analysed according to the predictions of the seasonally bound preovulatory overripeness ovopathy (SPrOO), hypothesis.
    Materials and methods: The birth distributions of leukemia patients diagnosed under age 15 in three consecutive datasets from the Netherlands (N=233, born 1965-1979; N=1565, born 1958-1986; and N=1962, born 1973-2003), were graphically compared with the corresponding total birth distributions. In addition, patients born in the SPrOO hypothesis-based high-risk months (January/February and June/July), were compared to patients born in low-risk periods (March/April/May), by conventional chi-square analyses with one-sided p-values and by relative risks (RRs), with 95% confidence intervals (95%,CI).
    Results: In the three datasets we found excesses of births during the indicated high-risk months versus deficits during the low-risk months: RR=1.24 (CI 0.87, 1.76), p=0.12; RR=1.14 (CI 0.99, 1.30), p=0.03 and RR=1.13 (CI 1.00, 1.27), p=0.02, respectively. Similar trends were present for the leukemia subtypes ALL and ANLL and for gender. The results appeared to be more pronounced in patients of 0-4 years old, and were waning in the older age groups.
    Conclusions: Seasonally-bound overripeness Ovopathy and causally related aberrant DNA expression by hypo- or hypermethylation may be regarded as initiating causal factor in the etiological pathway of childhood leukemia. It remains unclear whether overripeness ovopathy is sufficient to generate innate susceptibility to agents with leukemogenic potential, or whether it acts as a mediator of subsequent disease which needs an additional environmental “second hit”. This concept elucidates several controversies related to determinants of childhood leukemia, such as maternal and paternal age, socio-economic status and particularly to an allegedly protective effect of some MTHFR polymorphisms.
    Review Article
    Ron Westrum*
    The “Battered Child Syndrome” is today a widely accepted concept in Pediatric Medicine. However, there was an earlier time when this concept was still “in the air” rather than a known quantity. Recognition came slowly, impeded by intellectual, social and organizational hurdles, but aided by courageous individuals willing to make a stand. “Social entrepreneurs” had to conceptualize, fight for, and establish the concept as real and useful. First radiologists, then pediatricians, and finally everybody saw this concept as valuable and important. This case study illustrates the steps by which a “hidden event” becomes a recognized medical syndrome. The narrative shows how advocacy and information flow build on each other and thus combine to shape medical institutions. The information needed to justify special mechanisms for collection (such as protective services), come through the very creation of these same mechanisms. We are more willing to see something clearly once we feel we can do something about it.
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