[Show abstract][Hide abstract] ABSTRACT: The authors present a case of a 6-year-old boy operated on in the 4th week of life because of adrenal abscess. The diagnosis of an adrenal abscess in the neonatal period is challenging due to its rare occurrence and non-specific signs. Adrenal abscesses can develop via two mechanisms: as a result of a hematogenic infection and a spread of bacteria to "normal" adrenal glands or, which is much more common, a complication of an adrenal hematoma. Early and accurate diagnosis is crucial for appropriate therapeutic management. Imaging, including ultrasound, can be problematic. The final diagnosis is frequently established on the basis of a histological examination of a surgical specimen.
[Show abstract][Hide abstract] ABSTRACT: The aim of the study was to analyze cardiometabolic risk factors and carotid intima-media thickness (IMT) in obese children. We studied 122 obese children fulfilling the criteria of the International Obesity Task Force and 58 non-obese children. Anthropometric parameters, blood pressure, lipid profile, C-reactive protein, and adiponectin were assessed in all children. Glucose and insulin during the oral glucose tolerance test were assessed in obese children. The IMT was determined using ultrasound B-mode imaging in 81 obese and 32 non-obese children. We found that obese children had significantly higher levels of lipid and other non-lipid atherogenic indicators, but lower levels of adiponectin compared with non-obese children. The difference in the mean carotid IMT was insignificant in the two groups. Taking the combined groups, the level of adiponectin correlated negatively with body mass index and lipid atherogenic indicators. The IMT strongly correlated with systolic blood pressure in obese children. In the children fulfilling the criteria of metabolic syndrome, 17 out of the 84 obese children older than 10 years of age, IMT was greater than in those who did not fulfil these criteria. We conclude that the coexistence of abdominal obesity with abnormal lipid profile and hypertension leads to the early development of atherosclerosis accompanied by increased carotid intima-media thickness. Obesity initiates the atherosclerotic processes in early childhood.
No preview · Article · Oct 2015 · Advances in Experimental Medicine and Biology
[Show abstract][Hide abstract] ABSTRACT: In pathogenesis of obesity an important role is played by environmental, genetic and socio-cultural factors. In recent years major attention is paid to genetic factors in obesity. Many studies have proven that genetic factors are of poly-gene nature. This means that obesity is a sum of malfunctions of genes which are responsible for fat accumulation and metabolism and thus for maintaining the correct body weight. It is assumed that the structure and expression of genes which generate obesity may be affected by the nutrients supplied in the daily diet and that the gene-nutrient interactions may occur on various levels. Among the nutrients which influence the pathogenesis of obesity there are folic acid, B vitamins, calcium, vitamin D, antioxidant vitamins (vitamin A, E, C) and polyunsaturated fatty acids from the omega 3 group (mainly eicosapentaenoic and docosahexaenoic acids). It is suggested that shortages of these components may contribute to the excessive accumulation of body fat.
No preview · Article · Jun 2014 · Pediatria polska
[Show abstract][Hide abstract] ABSTRACT: Meningitis due to group A streptococci (GAS) is an uncommon manifestation of invasive streptococcal disease. Meningitis is associated with infectious foci of the upper respiratory tract, mainly otitis media. In children without acute infection Streptococcus pyogenes often colonize nosopharynx. The antibiotic of choice for the treatment of streptoccocal meningitis is penicillin. We present the case of a 5-year-old boy with GAS meningitis. His history presented recurrent otitis media. From throat and cerebrospinal fluid cultures was isolated the same GAS, which belongs to M1 serotype, the most prevalent in Poland. Treatment with cefotaxim and penicillin was given. The patient recovered, without any neurological deficiency.
No preview · Article · May 2014 · Pediatria polska
[Show abstract][Hide abstract] ABSTRACT: IntroductionNon-HDL cholesterol (non-HDL) is recommended by NCEP ATP III (2005), its value correlates with level of apolipoprotein B and reflects the levels of all atherogenic lipid fraction. Non-HDL cholesterol is defined as the difference between the total cholesterol and the high-density lipoprotein cholesterol. Non-HDL cholesterol is better than LDL-Ch at predicting cardiovascular risk.
No preview · Article · Feb 2010 · Pediatria polska
[Show abstract][Hide abstract] ABSTRACT: The spread of overweight and obesity is alarming in the face of metabolic syndrome development and its consequences. As obesity becomes a social norm, a lack of adequate attention seems to be noticed. In the development of obesity special attention is focused on preschool and pubertal periods, as they are considered as critical in the development of obesity and its persistence into adulthood. We have analyzed anthropological parameters of 302 overweight and obese children, patients of the Department of Pediatrics and Endocrinology between 2004-2007. Children were at the age from 1.5 y to 18.25 y. Overweight was diagnosed when BMI > or =1 SDS, obesity when BMI > or =2 SDS. 77% of boys and 86% of girls were obese. The mean value of BMI, expressed as SDS BMI, was +4.3 SDS (girls) and +4.5 SDS (boys) in children under 6 yrs, +3.03 SDS (girls) and +2.95 SDS (boys) in children between 6-14 yrs, +3.95 SDS (girls) and +4.08 (boys) in children above 14 yrs. The youngest group (i.e. under 6 yrs), although comparatively most obese, was sparse: 7% of all girls and 5.6% of all boys. The oldest group (i.e.above 14 yrs) was plentiful (45.6% of all girls and 27.8% of all boys) and comparatively very obese. Data of parents' weight status were completed in 56% of cases: 31.2% of mothers and 41.5% of fathers were overweight, 33.3% of mothers and 50.8% of fathers were obese. These observations can suggest that overweight and obesity can be underestimated and/or ignored/ disregarded in preschool and pubertal children. It seems to be alarming as these two periods of life are critical in the development of obesity. Special attention should be applied in the field of prevention of obesity, especially in younger children, and early identification of overweight small children and/ or children at risk of obesity.
No preview · Article · Feb 2009 · Przegla̧d lekarski
[Show abstract][Hide abstract] ABSTRACT: High dietary calcium intake has an impact on reduction of adipose tissue, as in prevention and treatment of obesity and metabolic syndrome (MS). The aim of the study was to evaluate the influence of dietary calcium on appearance MS in children and adolescents.
The study included 150 patients in the age range of 7-18 years with obesity. In each child, the bioelectrical impedance analysis, waist circumference, blood pressure, lipids (enzymatic method), Oral Glucose Tolerance Test (OGTT) with marking of glucose, insulin blood levels (RIA method), and estimation of nutritional status had been made. The standard deviation score of body mass index (SDS BMI), waist to hip ratio (WHR), insulin resistance (HOMA-IR) was calculated. MS was recognized according Cook criteria.
All patients had waist circumference greater than the 90 percentile. Boys had more often an abnormal lipids profile than girls. Both, high blood pressure and HOMA-IR >3 were found in over half of studied patients. The diet of many patients had too much fat and saccharose intaking. Only 20% of children consumed normal value of calcium. The observed intaking more than 20 mg of calcium per ideal body mass (i.b.m) per 24 hours had higher % FAT, SDS BMI, waist circumference, HOMA-IR, and insulin. MS was recognized more often in this group.
Insufficient dietary calcium intake could have an effect on some parameters of metabolic syndrome.
No preview · Article · Feb 2008 · Pediatric endocrinology
[Show abstract][Hide abstract] ABSTRACT: Prenatal and neonatal adrenal haemorrhage is being increasingly frequently reported. We present a group of 13 neonates with adrenal haemorrhage, hospitalised in the Department of Paediatrics and Endocrinology of Warsaw Medical University from 2003 to 2007.
of this study was to analyse: the perinatal history, haemorrhage predisposing factors, its size, localization and progress estimated by ultrasonography, as well as clinical, biochemical and hormonal findings indicating adrenal insufficiency.
the study group comprised 13 neonates hospitalised in the Department of Paediatrics and Endocrinology, Warsaw Medical University, from 2003 to 2007, due to adrenal haemorrhage diagnosed by ultrasonography in the first week of life.
all neonates were born at term, there was a male predominance. Twelve neonates had risk factors such as: birth trauma, intrauterine infection, perinatal asphyxia. No risk factors were found only in 1 neonate. One neonate had bilateral adrenal haemorrhage, others were unilateral - predominantly right-sided. In the study group clinical presentation was asymptomatic in 3 neonates, 1 of the patients had anaemia, 9 persistent jaundice, 2 bluish discoloration of the scrotum. Only one patient with bilateral adrenal haemorrhage showed sings of adrenal insufficiency and supplementation with glyco- and mineralcorticoids was necessary. Complete resolution of adrenal haemorrhage was reported after an average time of 3.5 months of observation.
1. Adrenal haemorrhage in neonates rarely leads to development of adrenal insufficiency. 2. In neonates with bilateral adrenal haemorrhage an extended hormonal diagnosis is required. 3. All patients require a systematic clinical and sonographic follow-up. Unilateral haemorrhage should be differentiated from neuroblastoma. 4. Scrotal haematoma may be a symptom of adrenal haemorrhage.
No preview · Article · Jan 2008 · Medycyna wieku rozwojowego