scholarly journals Impact of the 2017 American Academy of Pediatrics Guideline on Hypertension Prevalence Compared With the Fourth Report in an International Cohort

Hypertension ◽  
2019 ◽  
Vol 74 (6) ◽  
pp. 1343-1348 ◽  
Author(s):  
Liu Yang ◽  
Roya Kelishadi ◽  
Young Mi Hong ◽  
Anuradha Khadilkar ◽  
Tadeusz Nawarycz ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
American Academy ◽  
Pediatric Population ◽  
Fasting Blood Glucose ◽  
Laboratory Data ◽  
American Academy Of Pediatrics ◽  
Fourth Report ◽  
The Difference ◽  
Stage 1 ◽  
Control Study

In 2017, the American Academy of Pediatrics (AAP) updated the clinical practice guideline for high blood pressure (BP) in the pediatric population. In this study, we compared the difference in prevalence of elevated and hypertensive BP values defined by the 2017 AAP guideline and the 2004 Fourth Report and estimated the cardiovascular risk associated with the reclassification of BP status defined by the AAP guideline. A total of 47 200 children and adolescents aged 6 to 17 years from 6 countries (China, India, Iran, Korea, Poland, and Tunisia) were included in this study. Elevated BP and hypertension were defined according to 2 guidelines. In addition, 1606 children from China, Iran, and Korea who were reclassified upward by the AAP guideline compared with the Fourth Report and for whom laboratory data were available were 1:1 matched with children from the same countries who were normotensive by both guidelines. Compared with the Fourth Report, the prevalence of elevated BP defined by the AAP guideline was lower (14.9% versus 8.6%), whereas the prevalence of stages 1 and 2 hypertension was higher (stage 1, 6.6% versus 14.5%; stage 2, 0.4% versus 1.7%). Additionally, comparison of laboratory data in the case-control study showed that children who were reclassified upward were more likely to have adverse lipid profiles and high fasting blood glucose compared with normotensive children. In conclusion, the prevalence of elevated BP and hypertension varied significantly between both guidelines. Applying the new AAP guideline could identify more children with hypertension who are at increased cardiovascular risk.

Tuberculin Testing in the Pediatric Office and Clinic

PEDIATRICS ◽  
1979 ◽  
Vol 64 (6) ◽  
pp. 965-966
Author(s):  
Edwin L. Kendig
Keyword(s):  
American Academy ◽  
Disease Control ◽  
School Children ◽  
Tuberculin Test ◽  
Pediatric Clinic ◽  
American Academy Of Pediatrics ◽  
Tuberculin Testing ◽  
The Difference ◽  
Low Rate

Another article in this issue of Pediatrics, "Assessment of Tuberculin Screening in an Urban Pediatric Clinic," (p 856) again focuses attention on a weighty question: Is routine use of the tuberculin test important? The authors have pointed out the difference in philosophy of the Center for Disease Control, and the American Academy of Pediatrics. The Center for Disease Control recommends that routine tuberculin testing for school children and other similar programs be abandoned if the yield of positive tuberculin reactions is less than 1%1; this recommendation is based on the assumption that discovery of cases at this low rate will not have epidemiologic impact (italics added).

scholarly journals The American Academy of Pediatrics hypertension guidelines identify obese youth at high cardiovascular risk among individuals non-hypertensive by the European Society of Hypertension guidelines

2019 ◽  
Vol 27 (1) ◽  
pp. 8-15 ◽  
Author(s):  
Procolo Di Bonito ◽  
Maria Rosaria Licenziati ◽  
Marco G Baroni ◽  
Claudio Maffeis ◽  
Anita Morandi ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Young People ◽  
American Academy ◽  
Left Ventricular Mass Index ◽  
Left Ventricular ◽  
American Academy Of Pediatrics ◽  
Hypertension Guidelines ◽  
Obese Youth

Background Two different systems for the screening and diagnosis of hypertension (HTN) in children currently coexist, namely, the guidelines of the 2017 American Academy of Pediatrics (AAP) and the 2016 European Society for Hypertension (ESH). The two systems differ in the lowered cut-offs proposed by the AAP versus ESH. Objectives We evaluated whether the reclassification of hypertension by the AAP guidelines in young people who were defined non-hypertensive by the ESH criteria would classify differently overweight/obese youth in relation to their cardiovascular risk profile. Methods A sample of 2929 overweight/obese young people (6–16 years) defined non-hypertensive by ESH (ESH–) was analysed. Echocardiographic data were available in 438 youth. Results Using the AAP criteria, 327/2929 (11%) young people were categorized as hypertensive (ESH–/AAP+). These youth were older, exhibited higher body mass index, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), triglycerides, total cholesterol to high-density lipoprotein cholesterol (TC/HDL-C) ratio, blood pressure, left ventricular mass index and lower HDL-C ( p <0.025–0.0001) compared with ESH–/AAP–. The ESH–/AAP+ group showed a higher proportion of insulin resistance (i.e. HOMA-IR ≥3.9 in boys and 4.2 in girls) 35% vs. 25% ( p <0.0001), high TC/HDL-C ratio (≥3.8 mg/dl) 35% vs. 26% ( p = 0.001) and left ventricular hypertrophy (left ventricular mass index ≥45 g/h2.16) 67% vs. 45% ( p = 0.008) as compared with ESH–/AAP–. Conclusions The reclassification of hypertension by the AAP guidelines in young people overweight/obese defined non-hypertensive by the ESH criteria identified a significant number of individuals with high blood pressure and abnormal cardiovascular risk. Our data support the need of a revision of the ESH criteria.

AMERICAN ACADEMY OF PEDIATRICS, INC. PROCEEDINGS AND REPORTS

PEDIATRICS ◽  
1955 ◽  
Vol 15 (2) ◽  
pp. 221-230
Author(s):  
C. Henry Kempe
Keyword(s):  
American Academy ◽  
Daily Practice ◽  
Polymyxin B ◽  
Sulfa Drugs ◽  
Antimicrobial Drugs ◽  
Gram Negative ◽  
American Academy Of Pediatrics ◽  
The Difference ◽  
Related Compounds ◽  
Antibacterial Spectrum

THE SCOPE of the topic is such that one must present many simplifications in a positive manner. As an aid to memory in classifying the ever-increasing number of antibiotics and their antibacterial spectra and dosages, 2 charts have been prepared which are self-explanatory (Tables I and II). In all types of oversimplification one may quarrel with 1 or more points, but the material presented can be of practical value in daily practice. CHOICE AND DOSAGE OF COMMON ANTIBIOTICS Antimicrobial drugs are classified as bacteriocidal (those which kill bacterial organisms) or bacteriostatic (those which primarily inhibit bacterial multiplication which, however, resumes upon the removal of the bacteriostatic drug). Bacteriocidal agents actually differ from bacteriostatic agents only in the fact that their action is irreversible. The difference between bacteriostatic and bacteriocidal action appears to be a quantitative rather than qualitative one. Agents may be bacteriostatic at a given concentration and for a given exposure, while increasing concentration or exposure may cause a progressive shift toward bacteriocidal action. Primarily bacteriocidal agents in current use are penicillin, streptomycin, polymyxin B, bacitracin, and neomycin. Primarily bacteriostatic agents are tetracycline and all related compounds, chloramphenicol, erythromycin, and all sulfa drugs. The dosages of these drugs are given in Table I. A simple way to recall the antibacterial spectrum of antibiotics: pathogens are divided into rods (most of which are gram negative) and cocci (most of which are gram positive). Bacteriocidal agents which kill rods only are streptomycin and polymyxin B; bacteriocidal agents killing cocci only are penicillin and bacitracin; neomycin is bacteriocidal for a wide variety of rods and cocci.

scholarly journals Hepatic dysfunction in asphyxiated neonates: a prospective case: control study

2021 ◽  
Vol 8 (10) ◽  
pp. 1695
Author(s):  
Rajiv Prasad ◽  
Vibhuti Vaghela ◽  
Radhika Iyer ◽  
Siddharth Verma ◽  
Jigar Anadkat
Keyword(s):  
Liver Function ◽  
Case Control Study ◽  
Perinatal Asphyxia ◽  
Birth Asphyxia ◽  
Case Control ◽  
Full Term ◽  
Term Neonates ◽  
The Difference ◽  
Stage 1 ◽  
Control Study

Background: Birth asphyxia can lead to hypoxic damage to liver at cellular level which leads to release of liver enzymes in blood as well as altered liver function. This study aimed to study the alteration of hepatic function in birth asphyxia and correlate it with different stages of hypoxic ischemic encephalopathy (HIE).Method: A case control study was conducted at SMIMER Surat which involved 115 cases and 115 controls. Cases were full term neonates admitted in the NICU with an APGAR score of 6 or less at 1 minute of birth while controls were those neonates with an APGAR score of 7 or more. Blood samples were taken at 72 hours of life and liver function tests of the 2 groups were compared.Results: The difference in aspartate transferase (AST), alanine transferase (ALT), lactate dehydrogenase (LDH), alkaline phosphatase (ALP) levels of the cases and controls were statistically significant (p<0.05). However, difference in total protein and total bilirubin in between the 2 groups was statistically insignificant. The study also found that the difference in AST, ALT and LDH was statistically significant between HIE stage 1 and stage 2 (p<0.5), between HIE stage 1 and stage 3 (p<0.5) but insignificant between HIE stage 2 and stage 3 (p>0.5).Conclusions: The present study showed that the serum levels of hepatic enzymes were higher in full term neonates with perinatal asphyxia than full term neonates without perinatal asphyxia at the age of 72 hours. The enzyme levels showed an increasing trend with increasing severity of HIE.

scholarly journals Obesity-Related Hypertension in Pediatrics, the Impact of American Academy of Pediatrics Guidelines

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2586
Author(s):  
Irene Rutigliano ◽  
Gianpaolo De Filippo ◽  
Luigi Pastore ◽  
Giovanni Messina ◽  
Carlo Agostoni ◽  
...  
Keyword(s):  
Blood Pressure ◽  
American Academy ◽  
Hepatic Steatosis ◽  
Laboratory Data ◽  
Age Groups ◽  
Positive Association ◽  
Obese Children ◽  
American Academy Of Pediatrics ◽  
The Impact ◽  
Diagnosis Of Hypertension

The prevalence of primary hypertension in pediatric patients is increasing, especially as a result of the increased prevalence of obesity in children. New diagnostic guidelines for blood pressure were published by the American Academy of Pediatrics (AAP) in 2017 to better define classes of hypertension in children. The aim of our study is to evaluate the impact of new guidelines on diagnosis of hypertension in pediatrics and their capacity to identify the presence of cardiovascular and metabolic risk. Methods: Retrospective clinical and laboratory data from 489 overweight and obese children and adolescents were reviewed. Children were classified according to the 2004 and 2017 AAP guidelines for systolic and diastolic blood pressure. Lipid profile and glucose metabolism data were recorded; triglyceride/HDL ratio (TG/HDL) was calculated as an index of endothelial dysfunction. Hepatic steatosis was detected using the ultrasonographic steatosis score. Results: Children with elevated blood pressure increased from 12.5% with the 2004 AAP to 23.1% with the 2017 AAP criteria (p < 0.001). There was a statistically significant increase in children with high blood pressure in all age groups according to the new cut-off values. Notably, the diagnosis of hypertension according to 2017 AAP criteria had a greater positive association with Hepatic Steatosis (rho 0.2, p < 0.001) and TG/HDL ratio (rho 0.125, p = 0.025). Conclusions: The 2017 AAP tables offer the opportunity to better identify overweight and obese children at risk for organ damage, allowing an earlier and more impactful prevention strategy to be designed.

scholarly journals Prevalence of Hypertension in Children

Hypertension ◽  
2019 ◽  
Vol 73 (1) ◽  
pp. 148-152 ◽  
Author(s):  
Cynthia S. Bell ◽  
Joyce P. Samuel ◽  
Joshua A. Samuels
Keyword(s):  
Blood Pressure ◽  
American Academy ◽  
Screening Program ◽  
Elevated Blood Pressure ◽  
Elevated Blood ◽  
Older Children ◽  
American Academy Of Pediatrics ◽  
Fourth Report ◽  
Prevalence Estimates ◽  
Hypertension In Children

In 2017, the American Academy of Pediatrics issued a new clinical practice guideline for defining hypertension in children as an update to the previous Fourth Report guidelines issued in 2004. Prevalence of confirmed pediatric hypertension in children has ranged from 2% to 4% based on previous guidelines yet it is unknown what the prevalence is under the new guideline. We estimated the prevalence of elevated blood pressure, stage 1, and stage 2 hypertension by the new American Academy of Pediatrics guideline in our school-based blood pressure screening program. New prevalence estimates were compared with Fourth Report prevalence estimates in the same population by sex, age, and height factors. In 22 224 students aged 10 to 17 years screened in school as part of the Houston Pediatric and Hypertension Program at the University of Texas McGovern Medical School, the prevalence of elevated blood pressure (previously called prehypertension) increased from 14.8% by Fourth Report to 16.3% by the new American Academy of Pediatrics guideline. This increase in elevated blood pressure resulted from differential classification changes in younger and older children. Prevalence of confirmed hypertension remains at 2% to 4% in this population, however shorter children <13 years old and taller, older children 13+ years old are systematically more likely to be diagnosed with hypertension by new guidelines.

scholarly journals Recombinant interleukin-2 stimulates lymphocyte recovery in severe patients with COVID-19

2020 ◽  
Author(s):  
Meng‘en Zhu ◽  
Qian Wang ◽  
Shaoqiong Zhou ◽  
Bin Wang ◽  
Li Ke ◽  
...  
Keyword(s):  
Interleukin 2 ◽  
Laboratory Data ◽  
Control Group ◽  
Regular Treatment ◽  
Reactive Protein ◽  
Significant Difference ◽  
Before And After ◽  
Recombinant Interleukin 2 ◽  
The Difference ◽  
Control Study

Abstract Object: A recently developing pneumonia called COVID-19 which caused by SARS-CoV-2 has quickly spread across the world. Lymphopenia and a proinflammatory cytokine storm frequently happened in severe COVID-19 patients. But no specific immunomodulate therapy on COVID-19 had been reported. In this retrospect case control study, we observed the potential therapeutic effect of recombinant human interleukin-2 (rIL-2) on severe COVID-19 patients in a hospital in Wuhan, China. Methods: Fifty nine severe cases with COVID-19 admitted in hospital from January 29, 2020 to February 29, 2020 were included in this study. Twenty patients received a one-week to 10 days subcutaneous injection of the recombinant human interleulin-2 1 million IU per day other than regular treatment were classified as rIL-2 group. Twenty from thirty nine patients with regular treatment without intervention of rIL-2 were matched as the control group. Clinical characteristic such as age, gender, symptoms, signs, laboratory data and comorbidities were paired in these two groups. Changes of lymphocytes counts, IL-6 and C- reactive protein (CRP) before and after rIL-2 treatment and differences between rIL-2 group and non-rIL-2 group were analyzed.Results: There were a clearly visible increasing in lymphocyte counts and a decreasing in CRP level in non rIL-2 group and rIL-2 group. The difference of the change of lymphocyte counts were significant in rIL-2 group and non-rIL-2 group (p<0.01). Though CRP decreased more in rIL-2 group, it did not show a significant difference between the two groups (p>0.05).Conclusion: RIL-2 might be a prospective adjuvant therapy for severe COVID-19 patients by increasing lymphocytes number.

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