How to approach childhood obesity

2021 ◽  
pp. 175573802110598
Author(s):  
Rosemarie Patterson ◽  
Sangeetha Sornalingam ◽  
Romanie Hannah ◽  
Max Cooper
Keyword(s):  
Childhood Obesity ◽  
Psychological Consequences ◽  
Significant Morbidity ◽  
Contributing Factors ◽  
Socioeconomic Groups ◽  
Lower Socioeconomic ◽  
Need Support ◽  
Ongoing Support ◽  
Rule Out

Childhood obesity has a rising prevalence and is associated with significant morbidity, social and psychological consequences. In England, 21% of children aged between 10 and 11 are obese, with the highest rates being among children from lower socioeconomic groups. Primary care is responsible for managing most children who are overweight or obese. Consultations should generate positive conversations about childhood obesity and rule out underlying conditions and co-morbidities. Families may need support to recognise contributing factors and should be encouraged to identify simple, achievable strategies to promote healthier choices. Follow-up is essential, and families should be referred on to appropriate services for ongoing support.

scholarly journals Smoking Cessation and Socioeconomic Status: An Update of Existing Evidence from a National Evaluation of English Stop Smoking Services

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Rosemary Hiscock ◽  
Fiona Dobbie ◽  
Linda Bauld
Keyword(s):  
Smoking Cessation ◽  
Odds Ratio ◽  
Smoking Status ◽  
Socioeconomic Groups ◽  
Design Variables ◽  
Lower Socioeconomic ◽  
Routine Monitoring ◽  
Stop Smoking Services ◽  
Human And Social Capital

Smokers from lower socioeconomic groups are less likely to be successful in stopping smoking than more affluent smokers, even after accessing cessation programmes. Data were analysed from 3057 clients of nine services. Routine monitoring data were expanded with CO validated smoking status at 52-week follow-up. Backwards logistic regression modelling was used to consider which factors were most important in explaining the relationship between SES and quitting. The odds ratio of stopping smoking among more affluent clients, compared with more disadvantaged clients, after taking into account design variables only, was 1.85 (95% CI 1.44 to 2.37) which declined to 1.44 (1.11 to 1.87) when all controls were included. The factors that explained more than 10% of the decline in the odds ratio were age, proportion of friends and family who smoked, nicotine dependence, and taking varenicline. A range of factors contribute to lower cessation rates for disadvantaged smokers. Some of these can be modified by improved smoking cessation service provision, but others require contributions from wider efforts to improve material, human, and social capital.

scholarly journals COVID-19-associated rhino-orbital mucormycosis (CAROM)—a case report

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Humsheer Singh Sethi ◽  
Kamal Kumar Sen ◽  
Sudhansu Sekhar Mohanty ◽  
Sangram Panda ◽  
Kolluru Radha Krishna ◽  
...  
Keyword(s):  
Case Report ◽  
Health Care Professionals ◽  
Opportunistic Infections ◽  
Fungal Spores ◽  
Nasal Discharge ◽  
Contributing Factors ◽  
Post Discharge ◽  
Pulmonary Mucormycosis ◽  
The Right

Abstract Background There has been a rapid rise in the number of COVID-19-associated rhino-orbital mucormycosis (CAROM) cases especially in South Asian countries, to an extent that it has been considered an epidemic among the COVID-19 patients in India. As of May 13, 2021, 101 CAROM cases have been reported, of which 82 cases were from India and 19 from the rest of the world. On the other hand, pulmonary mucormycosis associated with COVID-19 has a much lesser reported incidence of only 7% of the total COVID-19-associated mucormycosis cases (Singh AK, Singh R, Joshi SR, Misra A, Diab Metab Syndr: Clin Res Rev, 2021). This case report attempts to familiarize the health care professionals and radiologists with the imaging findings that should alarm for follow-up and treatment in the lines of CAROM. Case presentation Rhino-orbital mucormycosis (ROM) is a manifestation of mucormycosis that is thought to be acquired by inhalation of fungal spores into the paranasal sinuses. Here, we describe a 55-year-old male, post COVID-19 status with long standing diabetes who received steroids and ventilator therapy for the management of the viral infection. Post discharge from the COVID-19 isolation ICU, the patient complained of grayish discharge from the right nostril and was readmitted to the hospital for the nasal discharge. After thorough radiological and pathological investigation, the patient was diagnosed with CAROM and managed. Conclusion Uncontrolled diabetes and imprudent use of steroids are both contributing factors in the increased number of CAROM cases. Our report emphasizes on the radiological aspect of CAROM and reinforces the importance of follow-up imaging in post COVID-19 infection cases with a strong suspicion of opportunistic infections.

scholarly journals Prevalence and Contributing Factors Associated With Postoperative Pain in Pediatric Patients: A Cross-Sectional Follow-up Study

2021 ◽  
Vol 23 ◽  
pp. 100159
Author(s):  
Zemenay Ayinie Mekonnen ◽  
Debas Yaregal Melesse ◽  
Habitamu Getinet Kassahun ◽  
Tesera Dereje Flatie ◽  
Misganaw Mengie Workie ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pediatric Patients ◽  
Contributing Factors ◽  
Cross Sectional ◽  
Factors Associated ◽  
Follow Up Study

scholarly journals Physical inactivity and health inequality during coronavirus: a novel opportunity or total lockdown?

2020 ◽  
Vol 6 (1) ◽  
pp. e000903
Author(s):  
Natalie F Shur ◽  
David Johns ◽  
Stefan Kluzek ◽  
Nicholas Peirce
Keyword(s):  
Public Health ◽  
Health Inequality ◽  
Physical Inactivity ◽  
The Elderly ◽  
Restricted Movement ◽  
Socioeconomic Groups ◽  
Lower Socioeconomic ◽  
The World ◽  
Additional Burden ◽  
Public Health Promotion

Government-restricted movement during the coronavirus pandemic in various countries around the world has led to rapid and fundamental changes in our health behaviour. As well as being at a higher risk of contracting and being hospitalised with COVID-19, the elderly, those with chronic disease and lower socioeconomic groups are also disproportionately affected by restriction of movement, further widening the physical activity health inequality. In this viewpoint we discuss the physiological sequelae of physical inactivity, and the additional burden of ageing and inflammation. We provide recommendations for public health promotion and interventions to try to mitigate the detrimental effects of physical inactivity and rebalance the health inequality.

scholarly journals Myopericytoma in the Antitragus of the Auricle: A Rare Tumor

2020 ◽  
pp. 014556132098457
Author(s):  
Tae Seong Eo ◽  
Jeong Hae Kie ◽  
Hyun Seung Choi ◽  
Junhui Jeong
Keyword(s):  
Large Firm ◽  
Rare Tumor ◽  
Long Term Follow Up ◽  
Slow Growing ◽  
Rule Out

A myopericytoma in the auricle is rare. If an auricle contains a large, firm, red-brown mass, excision should be considered because the mass may be a myopericytoma. After excision, histopathological and immunohistochemical diagnoses are essential to rule out malignancy. Long-term follow-up is required because the tumor is slow-growing.

scholarly journals New screening approach to detecting congenital syphilis in China: a retrospective cohort study

2020 ◽  
pp. archdischild-2020-320549
Author(s):  
Fang Hu ◽  
Shuai-Jun Guo ◽  
Jian-Jun Lu ◽  
Ning-Xuan Hua ◽  
Yan-Yan Song ◽  
...  
Keyword(s):  
Predictive Value ◽  
Congenital Syphilis ◽  
Area Under The Curve ◽  
Diagnostic Tools ◽  
Operating Characteristics ◽  
Loss To Follow Up ◽  
Sensitivity Specificity ◽  
Mother To Child ◽  
Rule Out

BackgroundDiagnosis of congenital syphilis (CS) is not straightforward and can be challenging. This study aimed to evaluate the validity of an algorithm using timing of maternal antisyphilis treatment and titres of non-treponemal antibody as predictors of CS.MethodsConfirmed CS cases and those where CS was excluded were obtained from the Guangzhou Prevention of Mother-to-Child Transmission of syphilis programme between 2011 and 2019. We calculated sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) using receiver operating characteristics (ROC) in two situations: (1) receiving antisyphilis treatment or no-treatment during pregnancy and (2) initiating treatment before 28 gestational weeks (GWs), initiating after 28 GWs or receiving no treatment for syphilis seropositive women.ResultsAmong 1558 syphilis-exposed children, 39 had confirmed CS. Area under the curve, sensitivity and specificity of maternal non-treponemal titres before treatment and treatment during pregnancy were 0.80, 76.9%, 78.7% and 0.79, 69.2%, 88.7%, respectively, for children with CS. For the algorithm, ROC results showed that PPV and NPV for predicting CS were 37.3% and 96.4% (non-treponemal titres cut-off value 1:8 and no antisyphilis treatment), 9.4% and 100% (non-treponemal titres cut-off value 1:16 and treatment after 28 GWs), 4.2% and 99.5% (non-treponemal titres cut-off value 1:32 and treatment before 28 GWs), respectively.ConclusionsAn algorithm using maternal non-treponemal titres and timing of treatment during pregnancy could be an effective strategy to diagnose or rule out CS, especially when the rate of loss to follow-up is high or there are no straightforward diagnostic tools.

Association between early antibiotic exposure and risk of childhood weight gain and obesity: a systematic review and meta-analysis

2019 ◽  
Vol 32 (5) ◽  
pp. 439-445 ◽  
Author(s):  
Mohammad Aghaali ◽  
Seyed Saeed Hashemi-Nazari
Keyword(s):  
Systematic Review ◽  
Weight Gain ◽  
Childhood Obesity ◽  
Early Life ◽  
Meta Analysis ◽  
Healthy Children ◽  
Antibiotic Exposure ◽  
Statistical Estimates ◽  
Childhood Weight

Abstract Background Recent studies have shown that antibiotic exposure during infancy is associated with increased body mass in healthy children. This study was performed to investigate the association between early-life antibiotic exposure and risk of childhood obesity. Methods A systematic review and meta-analysis was performed to comprehensively and quantitatively determine the association between early antibiotic exposure and risk of childhood obesity. Various databases such as PubMed, Embase, Scopus, Web of Science, ProQuest, Cochrane and Google Scholar were searched. A random-effects meta-analysis was performed to pool the statistical estimates. Additionally, a subgroup analysis was performed based on the time of follow-up. Results Nineteen studies involving at least 671,681 participants were finally included. Antibiotic exposure in early life was significantly associated with risk of childhood weight gain and obesity (odds ratio [OR]: 1.05, 95% confidence interval [CI]: 1.04–1.06). Conclusions Antibiotic exposure in early life significantly increases the risk of childhood weight gain and obesity.

scholarly journals Prospective Evaluation of Serum β-Glucan Testing in Patients With Probable or Proven Fungal Diseases

2016 ◽  
Vol 3 (3) ◽  
Author(s):  
Cécile Angebault ◽  
Fanny Lanternier ◽  
Frédéric Dalle ◽  
Cécile Schrimpf ◽  
Anne-Laure Roupie ◽  
...  
Keyword(s):  
Clinical Utility ◽  
Clinical Suspicion ◽  
Fungal Diseases ◽  
Prospective Evaluation ◽  
Invasive Fungal Diseases ◽  
Undetectable Serum ◽  
Antifungal Use ◽  
Kinetics Of ◽  
Rule Out

Abstract Background.  Early diagnosis and treatment are crucial in invasive fungal diseases (IFD). Serum (1-3)-β-d-glucan (BG) is believed to be an early IFD marker, but its diagnostic performance has been ambiguous, with insufficient data regarding sensitivity at the time of IFD diagnosis (TOD) and according to outcome. Whether its clinical utility is equivalent for all types of IFD remains unknown. Methods.  We included 143 patients with proven or probable IFD (49 invasive candidiasis, 45 invasive aspergillosis [IA], and 49 rare IFD) and analyzed serum BG (Fungitell) at TOD and during treatment. Results.  (1-3)-β-d-glucan was undetectable at TOD in 36% and 48% of patients with candidemia and IA, respectively; there was no correlation between negative BG results at TOD and patients' characteristics, localization of infection, or prior antifungal use. Nevertheless, patients with candidemia due to Candida albicans were more likely to test positive for BG at TOD (odds ratio = 25.4, P = .01) than patients infected with other Candida species. In 70% of the patients with a follow-up, BG negativation occurred in >1 month for candidemia and >3 months for IA. A slower BG decrease in patients with candidemia was associated with deep-seated localizations (P = .04). Thirty-nine percent of patients with rare IFD had undetectable BG at TOD; nonetheless, all patients with chronic subcutaneous IFD tested positive at TOD. Conclusions.  Undetectable serum BG does not rule out an early IFD, when the clinical suspicion is high. After IFD diagnostic, kinetics of serum BG are difficult to relate to clinical outcome.

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