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.
Akutní lymfoblastická leukemie (ALL) tvoří jednu čtvrtinu dětských nádorů a je tak nejčastějším maligním nádorovým onemocněním v dětském věku. Jedná se o heterogenní onemocnění, jehož biologie je odlišná od ALL dospělých. Medián věku při diagnóze dětské ALL je 5 let, nejčastějšími chromozomálními abnormitami jsou fúzní gen TEL-AML a hyperdiploidie nad 50 chromozomů. Pravděpodobnost přežití bez selhání (EFS) je při aplikaci kombinované chemoterapie lišící se dle rizika nepříznivého průběhu více než 75 % a pravděpodobnost vyléčení je 85 %. Relaps postihuje 15–20 % dětí s ALL a v jeho léčbě hraje významnou roli transplantace kostní dřeně. Akutní myeloidní leukemie (AML) tvoří 15 % leukemií v dětství. Nejčastějším genetickým podtypem AML je monocytární leukemie s přestavbou MLL genu na dlouhém raménku 11. chromozomu (20–25 % dětí s AML), která má intermediární prognózu. Prognosticky příznivé podtypy akutní promyelocytární leukemie s t (15; 17), myeloidní leukemie s t (8; 21) a myelomonocytární leukemie s inv (16) se nachází u 30–40 % dětí s AML s šancí na vyléčení 70 %. Celkové výsledky léčby AML se u dětí stále zlepšují s šancí na dosažení remise více než 90 % a pravděpodobností přežití více než 60 %., Acute lymphoblastic leukemia (ALL) represents 25 % of childhood tumors being the most frequent childhood cancer. ALL is a heterogeneous disease, biologically different from the same disease in adults. Median age at diagnosis is 5 years, the most frequent chromosomal abnormalities are fusion gene TEL-AML1 and hyperdiploidy over 50 chromosomes. Event-free-survival is over 75 % and overall survival 85 % in children treated with combined chemotherapy intensified according to the risk group. The incidence of relapse is 15–20 % and bone marrow transplantation is the important treatment modality in such situation. Acute myeloid leukemia (AML) represents 15 % of childhood leukemias. The most frequent genetic subtype is monocytic leukemia with MLL rearrangement at the long arm of chromosome 11 (11q23) (20–25 % of all AML) with intermediate prognosis. Subtypes with good prognosis – acute promyelocytic leukemia with t (15; 17), myeloid leukemia with t (8; 21) and myelomonocytic leukemia with inv (16) represent 30–40 % of AML with overall survival 70 %. Total treatment results are steadily improving with a chance to achieve remission over 90 % and overall survival over 60 %., Jan Starý, and Lit.: 20
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
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
The aims of our study were to evaluate plasma levels of gut hormones in children with Type 1 diabetes mellitus (T1DM) in comparison with healthy contro ls and to corr elate plasma concentrations of gut hormones with blood biochemistry, markers of metabolic control and with anthropometric parameters. We measured postprandial levels of specific gut peptide hormones in T1DM children. Amylin, glucos e-dependent insulinotropic polypeptide (GIP), glucagon-like peptide 1 (GLP-1), ghrelin, leptin, pancreatic polypeptide (PP), and polypeptide YY (PYY) were assessed in 19 T1DM children and 21 healthy reference controls. Multiplex assay kit (LINCOplex®) was used for determination of the defined plasma hormone levels. T1DM subjects had significantly reduce d amylin (p<0.001) and ghrelin (p<0.05) levels, whereas GIP (p<0.05) was elevated when compared with healthy controls. Pl asma levels of other measured hormones did not differ statistically between the studied groups. Further analysis of T1DM patien ts demonstrated an association between body mass index and GL P-1 (r=0.4642; p<0.05), leptin (r=0.5151; p<0.05), and amylin (r=0.5193; p<0.05). Ghrelin levels positively correlated with serum HDL cholesterol (r=0.4760; p<0.05). An inverse co rrelation was demonstrated with triglycerides (TG) (r=-0. 5674; p<0.01), insulin dosage (r= -0.5366; p<0.05), and HbA1c% (r= -0.6864; p<0.01). Leptin was inversely correlated with TG (r= -0.6351; p<0.01). Stepwise regression analysis was performed to enlighten the predictive variables. Our study demonstrated an altered secretion pattern of gut peptide hormones in T1DM children. A close correlation was revealed between these peptides as well as with blood biochemistry, markers of me tabolic control and with anthropometric parameters. Further studies are essential to explore this issue in T1DM children., M. Huml ... [et al.]., and Obsahuje bibliografii a bibliografické odkazy
Obesity in children is accompanied by increased circulating leptin concentrations. Girls have higher leptin concentrations than boys. The aim of our study was to compare serum leptin levels before and after a five-week weight reduction program and to study the relationship of leptin levels, serum total cholesterol, and androgens (testosterone, dehydroepiandrosterone, dehydroepiandrosterone sulphate) in 33 obese boys (age: 12.71.97 years, BMI: 30.46±4.54) and 66 obese girls (age: 12.7±2.51 years, BMI: 29.31±4.62). We found that serum leptin concentrations in obese children were significantly decreased after a weight reduction program (before 20.79±9.61 ng/ml, after 13.50±8.65 ng/ml in girls; before 12.25±10.09 ng/ml and after 5.18±3.56 ng/ml in boys, p<0.0001 in both genders). Leptin levels correlated positively with the body mass index before and after weight reduction. There was a positive association in obese boys and a negative one in obese girls between leptin levels and the WHR (waist to hip circumference ratio). Serum leptin also shows a strong relationship to fat distribution (p = 0.02 in boys, p<0.0001 in girls). No significant correlation was found between leptin concentrations and total cholesterol or androgens. We confirmed that leptin is a sensitive parameter of body composition and weight reduction in obese children., R. Pilcová, J. Šulcová, M. Hill, P. Bláha, L. Lisá., and Obsahuje bibliografii
The most common etiology of non- syndromic monogenic obesity are mutations in gene for the Melanocortin -4 receptor ( MC485 ) with variable prevalence in different countries (1.2 -6.3 % of obese children). The aim of our study was 1 ) to search for MC4R mutations in obese children in Slovakia and compare their prevalence with other European countries, and 2 ) to describe the phenotype of the mutation carriers. DNA analysis by direct Sanger sequencing of the coding exons and intron/exon boundaries of the MC4R gene was performed in 268 unrelated Slovak children and adolescents with body mass index above the 97 th percentile for age and sex and obesity onset up to 11 years (mean 4.3±2.8 years). Two different previously described heterozygous loss of function MC4R variants (i.e. p.Ser19Alafs*34, p.Ser127Leu) were identified in two obese probands, and one obese (p.Ser19Alafs*34), and one lean (p.Ser127Leu) adult family relatives. No loss of function variants were found in lean controls. The prevalence of loss -of-function MC4R variants in obese Slovak children was 0.7 %, what is one of the lowest frequencies in Europe., D. Stanikova, M. Surova, L. Ticha, M. Petrasova, D. Virgova, M. Huckova, M. Skopkova, D. Lobotkova, L. Valentinova, M. Mokan, J. Stanik, I. Klimes, D. Gasperikova., and Obsahuje bibliografii
Midazolam is a short acting sedative with small number of adverse effects. Administered orally, it is currently the most common form of conscious sedation in children. The objective of this paper is to describe effect of midazolam administered to children during dental treatment on their vital signs, and to monitor changes in children’s behavior. We described values of vital signs and behavior in 418 sedations conducted in 272 children between 1-12 years of age. To achieve the following results, we used data from 272 all first-time sedations. After administration of midazolam arterial blood pressure and blood oxygen saturation decreased by values which were not clinically significant. The heart rate increased, with values staying within the limits of physiological range. The speed of onset of midazolam’s clinical effects depends on age and dose. The lower age and dose correlated with the higher behavior score. The effectiveness of midazolam treatment is 97.8 %. Unwillingness of child to receive midazolam is predictor for disruptive behavior during sedation. 1.8 % of all sedation cases showed paradoxical reactions. The administration of midazolam in dose of 0.5 mg per 1 kg of child’s body weight is safe and could be recommended for dental treatment in pediatric dentistry., Jana Vasakova, Jana Duskova, Jitka Lunackova, Klara Drapalova, Lucie Zuzankova, Luboslav Starka, Michaela Duskova, Zdenek Broukal., and Obsahuje bibliografii