AMERICAN BOARD OF PEDIATRICS

PEDIATRICS ◽  
1967 ◽  
Vol 40 (4) ◽  
pp. 685-687
Keyword(s):  
Early Life ◽  
Metabolic Disorders ◽  
Electrolyte Balance ◽  
School Problems ◽  
Genetic Theory ◽  
Respiratory Problems ◽  
Health Measures ◽  
Written Examination ◽  
Malabsorption Syndromes ◽  
Vitamin Requirements

CHANGES IN THE WRITTEN EXAMINATION IN ORDER to provide candidates with a knowledge of specific areas of strength or weakness in their training, the American Board of Pediatrics will make the following changes in the written examination to be offered in January 1968 and subsequent years: The length of the examination will be increased from 3 hours to 6 hours, i.e., two 3-hour sessions with a luncheon break between. Questions of the morning session must be completed and turned in before the luncheon break; a second set of questions will be issued for the afternoon portion of the examination. Candidates' examinations will be graded on the full performance, but will also be scored in the following subdivisions of pediatric knowledge, including diagnosis and treatment: I. The Newborn To include prenatal care and obstetric practices as they relate to the offspring; embryology, physiology, and pathology of the fetus and newborn; infant feeding; vitamin requirements and deficiencies; infections and metabolic disorders peculiar to the newborn; anomalies and other disorders which require attention in early life. II. Metabolic Disorders Principles of fluid and electrolyte balance and management; inborn and acquired errors of metabolism; molecular and chemical disorders; endocrinology; renal and genitourinary disease; malabsorption syndromes. III. Growth and Development General genetic theory; physical, mental, and behavioral development; neurology, psychology and psychiatry; school problems; adolescence; family medicine; mental retardation, perceptual handicaps. IV. Infectious Disease, Immunology, and Allergy Bacterial, viral, fungal, and protozoal disease; infectious and inflammatory disease of uncertain origin; "autoimmune" diseases; principles of immunity; immunization; public health measures; allergy; mechanical respiratory problems; dermatology.

scholarly journals Maternal Obesity and Developmental Programming of Metabolic Disorders in Offspring: Evidence from Animal Models

2011 ◽  
Vol 2011 ◽  
pp. 1-9 ◽  
Author(s):  
M. Li ◽  
D. M. Sloboda ◽  
M. H. Vickers
Keyword(s):  
Animal Models ◽  
Early Life ◽  
Metabolic Disorders ◽  
Maternal Obesity ◽  
Maternal Weight ◽  
Critical Window ◽  
Obesity Epidemic ◽  
Obesity And Overweight ◽  
Increased Risk ◽  
Maternal Overnutrition

The incidence of obesity and overweight has reached epidemic proportions in the developed world as well as in those countries transitioning to first world economies, and this represents a major global health problem. Concern is rising over the rapid increases in childhood obesity and metabolic disease that will translate into later adult obesity. Although an obesogenic nutritional environment and increasingly sedentary lifestyle contribute to our risk of developing obesity, a growing body of evidence links early life nutritional adversity to the development of long-term metabolic disorders. In particular, the increasing prevalence of maternal obesity and excess maternal weight gain has been associated with a heightened risk of obesity development in offspring in addition to an increased risk of pregnancy-related complications. The mechanisms that link maternal obesity to obesity in offspring and the level of gene-environment interactions are not well understood, but the early life environment may represent a critical window for which intervention strategies could be developed to curb the current obesity epidemic. This paper will discuss the various animal models of maternal overnutrition and their importance in our understanding of the mechanisms underlying altered obesity risk in offspring.

Drug-Induced Metabolic Disorders and Parenteral Nutrition in the Intensive Care Unit: A Pharmaceutical and Metabolic Perspective

DICP ◽  
1989 ◽  
Vol 23 (5) ◽  
pp. 363-371 ◽  
Author(s):  
Joseph F. Dasta ◽  
David F. Driscoll
Keyword(s):  
Critical Care ◽  
Parenteral Nutrition ◽  
Metabolic Disorders ◽  
Care Setting ◽  
Critical Role ◽  
Critical Care Setting ◽  
Nutrition Support ◽  
Sensitive Period ◽  
Electrolyte Balance ◽  
Drug Induced

Since its inception, the field of parenteral nutrition has continued to evolve requiring the expertise of several health care disciplines. This feature has made nutrition support unique among clinical subspecialties. As a member of this team, the pharmacist plays a critical role in the provision of sterile admixtures, compatible nutritional formulations, and cost-effective, therapeutically equivalent strategies. The pharmacist has become more involved in the clinical care of the patient, with particular emphasis on the development of drug-induced metabolic disorders. The multitude of drugs prescribed to hospitalized patients increases the potential for serious metabolic disturbances. This is especially true in the critical care setting where sudden changes in metabolism (e.g., acid-base homeostasis, fluid and electrolyte balance) may result in profoundly negative effects. The critical care setting also represents the most sensitive period of hospitalization where even subtle changes in metabolic homeostasis may assume major clinical significance. Early recognition of offending agents and the institution of appropriate intervention may avert serious iatrogenic diseases. The nutrition support team is in a unique position to address many such disorders through selective manipulation of the various components in the parenteral nutrient admixture. The ability of the pharmacist to recognize the development of drug-induced metabolic disorders lends further support for clinical pharmacy in nutrition support services.

Endocrine and metabolic emergencies

2016 ◽  
Keyword(s):  
Adrenal Gland ◽  
Glucose Control ◽  
Metabolic Disorders ◽  
Electrolyte Balance ◽  
Acid Base Balance ◽  
Acid Base ◽  
Nursing Assessment ◽  
Base Balance

This chapter covers common metabolic disorders, principally disorders of glucose control, acid–base balance, and electrolyte balance. The nursing assessment and management of thyroid and adrenal gland emergencies are also covered.

scholarly journals Nutritional genomics: a practical approach by early life conditioning with dietary phosphorus

2010 ◽  
Vol 39 (suppl spe) ◽  
pp. 268-278 ◽  
Author(s):  
Christopher M. Ashwell ◽  
Roselina Angel
Keyword(s):  
Early Life ◽  
Metabolic Disorders ◽  
Epidemiological Data ◽  
Dietary Manipulation ◽  
Fetal Origins ◽  
Fetal Origins Hypothesis ◽  
Dietary Phosphorus ◽  
In Utero Environment ◽  
Nutritional Genomics

The recent technologies that have led to the new field of functional genomics (how the genome of an organism regulates homeostasis and responds to stimuli) are providing a clearer understanding of how organisms interact with their environment and in particular their diet. We are beginning to learn how the diet may have long-term influence on performance and health. A form of epigenetic regulation has been recently described called fetal "programming". Fueled by epidemiological data the "fetal origins" hypothesis suggests that a poor in utero environment resulting from maternal dietary or placental insufficiency may "program" susceptibility in the fetus to cardiovascular or metabolic disorders. We have observed similar apparent programming by dietary manipulation in the chicken. When birds are challenged with a diet low in phosphorus (P) for 90 hours post-hatch they obtain the ability to better utilize P later in life. This increased retention of P from the diet can partially be explained by an enduring increase in the expression of the intestine-specific Na/P cotransporter (NaPcoT) gene during programming as well as later in life when fed P restricted diets. The resulting data provide the first evidence for neonatal programming of gene expression in an oviparous species.

scholarly journals Butyrate producing Clostridiales utilize distinct human milk oligosaccharides correlating to early colonization and prevalence in the human gut

2020 ◽  
Author(s):  
Michael Jakob Pichler ◽  
Chihaya Yamada ◽  
Bashar Shuoker ◽  
Maria Camila Alvarez-Silva ◽  
Aina Gotoh ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Human Milk ◽  
Early Life ◽  
Metabolic Disorders ◽  
Human Milk Oligosaccharides ◽  
Human Gut ◽  
Milk Oligosaccharides ◽  
Diet Analyses ◽  
Early Establishment

AbstractThe early life human gut microbiota exerts life-long health effects on the host, but the mechanisms underpinning its assembly remain elusive. Particularly, the early colonization of Clostridiales from the Roseburia-Eubacterium group, associated with protection from colorectal cancer, immune- and metabolic disorders is enigmatic. Here we unveil the growth of Roseburia and Eubacterium members on human milk oligosaccharides (HMOs) using an unprecedented catabolic apparatus. The described HMO pathways and additional glycan utilization loci confer co-growth with Akkermansia muciniphilia via cross-feeding and access to mucin O-glycans. Strikingly, both, HMO and xylooligosaccharide pathways, were active simultaneously attesting an adaptation to a mixed HMO-solid food diet. Analyses of 4599 Roseburia genomes underscored the preponderance of HMO pathways and highlighted different HMO utilization phylotypes. Our revelations provide a possible rationale for the early establishment and resilience of butyrate producing Clostridiales and expand the role of specific HMOs in the assembly of the early life microbiota.

scholarly journals Identification of blood cell transcriptome‐based biomarkers in adulthood predictive of increased risk to develop metabolic disorders using early life intervention rat models

2020 ◽  
Vol 34 (7) ◽  
pp. 9003-9017 ◽  
Author(s):  
Nara Szostaczuk ◽  
Evert M. Schothorst ◽  
Juana Sánchez ◽  
Teresa Priego ◽  
Mariona Palou ◽  
...  
Keyword(s):  
Blood Cell ◽  
Early Life ◽  
Metabolic Disorders ◽  
Rat Models ◽  
Increased Risk ◽  
Cell Transcriptome

scholarly journals Maternal N-Acetyl Cysteine Intake Improved Glucose Tolerance in Obese Mice Offspring

2020 ◽  
Vol 21 (6) ◽  
pp. 1981
Author(s):  
Michal Michlin ◽  
Lital Argaev-Frenkel ◽  
Liza Weinstein-Fudim ◽  
Asher Ornoy ◽  
Tovit Rosenzweig
Keyword(s):  
Environmental Factors ◽  
Glucose Tolerance ◽  
High Fat Diet ◽  
Early Life ◽  
Metabolic Disorders ◽  
Obese Mice ◽  
High Fat ◽  
Pregnancy And Lactation ◽  
Glucose Stimulated Insulin Secretion

Exposure to certain environmental factors during the early stages of development was found to affect health in adulthood. Among other environmental factors, oxidative stress has been suggested to be involved in fetal programming, leading to elevated risk for metabolic disorders, including type 2 diabetes; however, the possibility that antioxidant consumption during early life may affect the development of diabetes has scarcely been studied. The aim of this study was to investigate the effects of N-acetyl-l-cysteine (NAC) given during pregnancy and lactation on the susceptibility of offspring to develop glucose intolerance at adulthood. C57bl6/J mice were given NAC during pregnancy and lactation. High fat diet (HFD) was given to offspring at an age of 6 weeks for an additional 9 weeks, till the end of the study. Isolated islets of NAC-treated offspring (6 weeks old, before HFD feeding) had an increased efficacy of glucose-stimulated insulin secretion and a higher resistance to oxidative damage. Following HFD feeding, glucose tolerance and insulin sensitivity of NAC-treated offspring were improved. In addition, islet diameter was lower in male offspring of NAC-treated mice compared to their HFD-fed littermates. NAC consumption during early life improves glucose tolerance in adulthood in mice.

scholarly journals The role of oxytocin and vasopressin in the pathophysiology of heart failure in pregnancy and in fetal and neonatal life

2020 ◽  
Vol 318 (3) ◽  
pp. H639-H651 ◽  
Author(s):  
E. Szczepanska-Sadowska ◽  
A. Cudnoch-Jedrzejewska ◽  
A. Wsol
Keyword(s):  
Heart Failure ◽  
Cardiovascular System ◽  
Early Life ◽  
Severe Heart Failure ◽  
Cardiovascular Responses ◽  
Electrolyte Balance ◽  
Negative Consequences ◽  
Pregnant Mother ◽  
Negative Effects ◽  
Mother And Child

Pregnancy and early life create specific psychosomatic challenges for the mother and child, such as changes in hemodynamics, resetting of the water-electrolyte balance, hypoxia, pain, and stress, that all play an important role in the regulation of the release of oxytocin and vasopressin. Both of these hormones regulate the water-electrolyte balance and cardiovascular functions, maturation of the cardiovascular system, and cardiovascular responses to stress. These aspects may be of particular importance in a state of emergency, such as hypertension in the mother or severe heart failure in the child. In this review, we draw attention to a broad spectrum of actions exerted by oxytocin and vasopressin in the pregnant mother and the offspring during early life. To this end, we discuss the following topics: 1) regulation of the secretion of oxytocin and vasopressin and expression of their receptors in the pregnant mother and child, 2) direct and indirect effects of oxytocin and vasopressin on the cardiovascular system in the healthy mother and fetus, and 3) positive and negative consequences of altered secretion of oxytocin and vasopressin in the mother with cardiovascular pathology and in the progeny with heart failure. The present survey provides evidence that moderate stimulation of the oxytocin and vasopressin receptors plays a beneficial role in the healthy pregnant mother and fetus; however, under pathophysiological conditions the inappropriate action of these hormones exerts several negative effects on the cardiovascular system of the mother and progeny and may potentially contribute to the pathophysiology of heart failure in early life.

scholarly journals SUN-643 Potential Contributions of Gut Microbiota-Liver Axis to the Transgenerational Metabolic Reprogramming of Maternal Exercise

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Liyuan Zhou ◽  
Xinhua Xiao ◽  
Qian Zhang ◽  
Ming Li ◽  
Miao Yu
Keyword(s):  
Fatty Acid ◽  
Gut Microbiota ◽  
High Fat Diet ◽  
Early Life ◽  
Metabolic Disorders ◽  
Male Offspring ◽  
Metabolic Reprogramming ◽  
Adult Offspring ◽  
High Fat ◽  
Maternal Exercise

Abstract Background: Early-life overnutrition programs increased risks of metabolic disorders in adulthood. Regular exercise is widely accepted to be an effective measure to maintain metabolic health. However, the transgenerational effects of maternal exercise and the specific mechanism are largely unclear. Aims: Our objective was to investigate whether maternal exercise could alleviate the metabolic disturbances induced by early-life overnutrition in both dams and offspring and to explore the role of gut microbiota-liver axis in mediating the transgenerational metabolic reprogramming. Methods: C57BL/6 females were randomly divided into three groups 3 weeks before mating and during pregnancy: the control group, high-fat group, and high-fat with exercise group (voluntary wheel running training). They received their original diets during lactation. The male offspring had ad libitum access to chow diet from weaning to 24 weeks of age. Glucose tolerance test and serum biochemical parameters were detected. The cecal contents from dams at weaning and 8-week and 24 week of offspring were collected for 16s rDNA sequencing. Hepatic HE staining and transcriptome were performed in adult offspring. Results: The results showed that perinatal high-fat diet resulted in significant glucose intolerance, insulin resistance and lipid profiles disorders in both dams and offspring. Maternal exercise markedly improved insulin sensitivity in dams and metabolic disorders in offspring from young into adulthood, especially the hepatic steatosis. The decrease in harmful bacteria and the persistent enrichment of short chain fatty acid producers from mothers to adult offspring, particularly the genus Odoribacter, were all associated with improvement in metabolism by maternal exercise. In addition, maternal exercise significant upregulated FGF21 and genes involved in the fatty acid oxidation and TCA cycle in adult offspring, which were down-regulated by perinatal high-fat diet and were significantly correlated with the altered microbial species. Conclusion: Overall, maternal exercise could significantly mitigate the detrimental effects of perinatal high-fat diet on metabolism in both dams and male offspring. The continuous alterations in gut microbiota and reprogramming hepatic metabolism might be critical factors in deciphering the transgenerational metabolic benefits of maternal exercise, which provides some novel evidence and targets for combating the metabolic diseases.

Magnesium in pregnancy and breastfeeding

2015 ◽  
Author(s):  
Sir Peter Gluckman ◽  
Mark Hanson ◽  
Chong Yap Seng ◽  
Anne Bardsley
Keyword(s):  
Metabolic Disorders ◽  
Preterm Labour ◽  
Magnesium Deficiency ◽  
Current Evidence ◽  
Uterine Contractility ◽  
Magnesium Supplementation ◽  
Low Magnesium ◽  
Physiological Processes ◽  
Malabsorption Syndromes ◽  
In Pregnancy

Magnesium in important for a wide variety of physiological processes; prominent among them is the control of muscle contractions, cardiac function, and carbohydrate metabolism. In pregnancy, low magnesium status is associated with hypertension, pre-eclampsia, gestational diabetes, leg cramping, and preterm labour. Magnesium has been used extensively in obstetrics to reduce uterine contractility in threatened preterm labour. Although current evidence does not support a requirement for magnesium supplementation for most pregnant women, those who are overweight, have risk factors for hypertensive or metabolic disorders or malabsorption syndromes, or who are carrying multiple fetuses, should pay particular attention to their diets and should be monitored for signs of magnesium deficiency. Consuming a magnesium-rich diet throughout pregnancy is recommended.

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