Vzestup obezity v posledních letech vedl k řadě studií, které se zabývaly vztahy mezi tělesnou hmotností v dětství a dosaženým vzděláním, výší příjmu a jinými socioekonomickými aspekty v dospělosti. Příspěvek navazuje na výzkumy, které byly zaměřeny především na akademickou úspěšnost dětí a dospívajících s nadváhou a obezitou. Tyto výzkumy usilovaly o socioekonomickou, psychosociální a zdravotní analýzu příčin a důsledků školního prospěchu u této části populace. Cílem příspěvku je porovnání a shrnutí výstupů z těchto studií. Úvodní část přináší informace o aktuálním výskytu nadměrné tělesné hmotnosti u dětské i dospělé populace ve světě a v naší zemi. Epidemie nadváhy a obezity a její posun do nižšího věku je spojován s větším ohrožením zdraví a s přidruženými vývojovými komplikacemi u současné i u budoucích generací: z uvedených důvodů nejde o okrajové téma. Akademickou úspěšnost dětí a dospívajících s nadváhou a obezitou nelze zkoumat bez znalostí faktorů, které jsou pro rozvoj dětské nadměrné hmotnosti významné. Poznatky o časté a výsledné podobě socioekonomických a vzdělanostních výsledků u populace s nadváhou a obezitou v dospělém věku jsou samy o sobě vysvětlením toho, z jakých důvodů je nutné se zabývat výsledky podobně zaměřených výzkumů z předcházejících vývojových období. Závěrečné shrnutí je doplněno o náměty, jichž by bylo vhodné využít v tematicky navazujících studiích. and The rise of obesity in recent years has led to a number of studies about relationship between weight in childhood and the reached level of education, income and other socio-economic aspects in adulthood. This article follows previous researches which were focused mostly on the academic success of children and adolescents with overweight and obesity. These researches aimed for the socio-economic, psychosocial and health analysis of causes and consequences of school success rate within this part of population. The aim of this article is to compare and summarize the outputs of these studies.
The introductory part brings information about current occurrence of overweight in children and adults population in the world and in our country. The epidemic of overweight and obesity and its movement to a lower age is connected with greater risks for health and associated developmental complications for current and future generations, therefore this is not a marginal issue.
The academic success of children and adolescents with overweight and obesity cannot be studied without the knowledge of factors, which are significant for the development of children obesity. Findings about common and final form of socioeconomic and educational results within the population with overweight and obesity are themselves the explanation of why it is important to address the outputs of similarly focused researches form previous developmental periods. The final summary is supplemented by suggested topics, which should be used in thematically following studies.
Hemolytic uremic syndrome (HUS) is a type of thrombotic microangiopathy, in the course of which some patients may develop chronic kidney disease (CKD). It is clinically important to investigate the markers of a poor prognosis. The levels of angiotensinogen (AGT) and interleukin-18 (IL-18) in serum and urine were evaluated. Study was conducted in 29 children with a history of HUS. Serum and urine AGT concentration was significantly higher in children after HUS as compared to the control group. No differences depending on the type of HUS and gender were noted. The serum concentration of IL-18 in children after HUS was significantly lower, whereas in urine did not differ significantly between the sick and healthy children. A negative correlation between the concentration of AGT in serum and albuminuria in patients after HUS was detected. The results indicate that the concentration of AGT in serum and urine in children after HUS increases, which may indicate the activation of the intrarenal renin-angiotensin-aldosterone system. The statement, that AGT may be a good biomarker of CKD after acute kidney injury due to HUS requires prospective studies with follow-up from the acute phase of the disease on a larger group of patients. Reduced IL-18 serum concentration in children after HUS with no difference in its urine concentration may indicate a loss of the protective effects of this cytokine on renal function due to previously occurred HUS., K. Lipiec, P. Adamczyk, E. Świętochowska, K. Ziora, M. Szczepańska., and Obsahuje bibliografii
A recently discussed cardiovascular risk factor, asymmetric dimethylarginine (ADMA), is known to act as an endogenous inhibitor of endothelial nitric oxide synthase. The aim of this study was to establish 1) the relationship between ADMA and ultrasonographically or biochemically determined endothelial dysfunction in children, and 2) the effect of folate supplementation on these parameters. The study cohort included 32 children with familial hypercholesterolemia (FH), 30 with diabetes mellitus type 1 (DM1) and 30 age-matched healthy children as the control group. Furthermore, twenty-eight randomly selected FH and DM1 children were re-examined after 3-months supplementation with folic acid. Baseline levels of ADMA and oxidized low density lipoproteins (oxLDL) were significantly higher in FH group than in DM1 and healthy children. Children in DM1 group had significantly lower concentration of homocysteine, but ADMA levels were normal. Folic acid supplementation significantly lowered homocysteine and hsCRP levels in both FH and DM1 group; however, ADMA and oxLDL concentrations remained unaltered. In conclusion, ADMA and oxLDL appear to be associated with endothelial dysfunction in children with FH. Administration of folic acid did not influence these markers in both FH and DM1 children., P. Jehlička ... [et al.]., and Obsahuje seznam literatury
Individual studies have suggested the utility of fractional exhaled nitric oxide (FeNO) measurement in detecting cough-variant asthma and eosinophilic bronchitis in patients with chronic cough. The aim of this study was to clarify a correlation of cough reflex sensitivity and fractional exhaled nitric oxide in asthmatic children. 25 children with asthma and 15 controls were submitted to cough reflex sensitivity measurement – capsaicin aerosol in doubling concentrations (from 0.61 to 1250 µmol/l) was inhaled by a single breath method. Concentrations of capsaicin causing two (C2) and five coughs (C5) were reported. Fractional exhaled nitric oxide (FeNO) measurement was included. Asthmatic children (11 boys and 14 girls, mean age 9±1 years) and control group (unconfirmed diagnosis of asthma) (6 boys and 9 girls, mean age 8±1 years) were included into the study. FeNO vs. C2 in asthma (Spearman´s rank correlation: -0.146, p=0.49); FENO vs. C5 in asthma (Spearman´s rank correlation: -0.777, p=0.71). We found that there is no correlation between cough reflex sensitivity and fractional exhaled nitric oxide either in children with asthma or in the control group.
New knowledge about the neural aspects of cough has revealed
a complex network of pathways that initiate cough. The effect of
inflammation on cough neural processing occurs at multiple
peripheral and central sites within the nervous system. Evidence
exists that direct or indirect neuroimmune interaction induces
a complex response, which can be altered by mediators released
by the sensory or parasympathetic neurons and vice versa. The
aim of this study was to clarify changes of cough reflex sensitivity
– the activity of airway afferent nerve endings - in asthmatic
children. 25 children with asthma and 15 controls were submitted
to cough reflex sensitivity measurement - capsaicin aerosol in
doubling concentrations (from 0.61 to 1250 µmol/l) was inhaled
by a single breath method. Concentrations of capsaicin causing
two (C2) and five coughs (C5) were reported. Asthmatic children'
(11 boys and 14 girls, mean age 9 ± 1 yrs) cough reflex sensitivity
(geometric mean, with the 95 % CI) for C2 was 4.25 (2.25-8.03)
µmol/l vs. control C2 (6 boys and 9 girls, mean age 8 ± 1 yrs) was
10.61 (5.28-21.32) µmol/l (p=0.024). Asthmatic children' C5 was
100.27 (49.30-203.93) µmol/l vs. control C5 56.53 (19.69-162.35)
µmol/l (p=0.348). There was a statistically significant decrease of
C2 (cough threshold) in the asthmatic patients relative to controls
(p-value for the two-sample t-test of log(C2) for the one-sided
alternative, p-value = 0.024). The 95 % confidence interval for the
difference of the mean C2 in asthma vs. control, [1.004, 6.207].
For C5, the difference was not statistically significant (p-value =
0.348). There was a statistically significant decrease of cough
reflex sensitivity (the activity of airway afferent nerve endings) -
C2 value in the asthmatic children relative to controls.
The SARS-CoV-2 pandemic has indeed been one of the most significant problems facing the world in the last decade. It has affected (directly or indirectly) the entire population and all age groups. Children have accounted for 1.7 % to 2 % of the diagnosed cases of COVID-19. COVID-19 in children is usually associated with a mild course of the disease and a better survival rate than in adults. In this review, we investigate the different mechanisms which underlie this observation. Generally, we can say that the innate immune response of children is strong because they have a trained immunity, allowing the early control of infection at the site of entry. Suppressed adaptive immunity and a dysfunctional innate immune response is seen in adult patients with severe infections but not in children. This may relate to immunosenescence in the elderly. Another proposed factor is the different receptors for SARS-CoV-2 and their differences in expression between these age groups. In infants and toddlers, effective immune response to viral particles can be modulated by the pre-existing non-specific effect of live attenuated vaccines on innate immunity and vitamin D prophylaxis. However, all the proposed mechanisms require verification in larger cohorts of patients. Our knowledge about SARS-CoV-2 is still developing.
Cardiovascular disease is a major cause of morbidity and mortality in young adults with end-stage renal disease (ESRD), but its basis is still not well understood. We therefore evaluated the determinants of atherosclerosis in children with ESRD. A total of 37 children with ESRD (with 31 who had undergone transplantation) were examined and compared to a control group comprising 22 healthy children. The common carotid intimamedia thickness (CIMT) was measured by ultrasound as a marker of preclinical atherosclerosis. The association of CIMT with anthropometrical data, blood pressure, plasma lipid levels, and other biochemical parameters potentially related to cardiovascular disease was evaluated. Children with ESRD had significantly higher CIMT, blood pressure, and levels of lipoprotein (a), urea, creatinine, ferritin, homocysteine, and serum uric acid as well as significantly lower values of apolipoprotein A. The atherogenic index of plasma (log(triglycerides/HDL cholesterol)) was also higher in patients with ESRD; however, this difference reached only borderline significance. In addition, a negative correlation was found between CIMT and serum albumin and bilirubin in the ESRD group, and this correlation was independent of age and body mass index. In the control group, a significant positive correlation was observed between CIMT and ferritin levels. Factors other than traditional cardiovascular properties, such as the antioxidative capacity of circulating blood, may be of importance during the early stages of atherosclerosis in children with endstage renal disease., H. M. Dvořáková ... [et al.]., and Obsahuje seznam literatury
Předkládaná studie se věnuje specifikům dětské výpovědi. Mapuje možné zdroje její nespolehlivosti (nízká schopnost zapamatovat si a vybavit si události, vysoká sugestibilita, snadnost vzniku falešných vzpomínek, neporozumění pro procesy a interakce v okolí, možnost záměrného lhaní). Jsou uvedeny některé postupy, které mohou pomoci zkvalitnit, nebo naopak znehodnotit informace, podané dítětem. Schopnost dítěte porozumět své vlastní motivaci, prožívání a chování, stejně tak jako chování a prožívání jiných lidí je často zpochybňována. Ukazuje se však, že dětský úhel pohledu na události, které zažívá, a na sociální interakce, kterým je vystaveno, je obohacující. Přináší smysluplné informace, je jedinečný a přispívá jak k pochopení prožívání a chování dítěte a jeho aktuálních potíží, tak ke hlubšímu porozumění rodinným vztahům a jiným skutečnostem., The present study maps the possible sources of unreliability of child,s testimony (lower ability to remember and recall events, high suggestibility, easier formation of false memories, misunderstanding of the processes and interactions in surroundings, probability of deliberate lying) as well as its potential benefits in research and counselling practices. There are some procedures that can help improve or conversely depreciate information given by child. Child,s ability to understand their own motivation, experience and behaviour as well as behaviour and feelings of others are often questioned. But despite all mentioned risks, child,s testimony is very useful not only in judicial proceedings in which the child may be the only witness to the events but also in psychological research and counselling. It turns out that a child is more sensitive to some aspects of family life (conflicts) than an adult and gives even more accurate information than its parents. Child,s view of family life is important for understanding its behaviour and experience., Xenie Uholyeva., and Obsahuje seznam literatury