Disturbed eating attitudes and behaviors among elementary school children were evaluated using the Children’s Eating Attitude Test. Our findings demonstrate that students in early adolescence have ...disturbed eating attitudes and behaviors. We recommend screening for eating disorders in this group in order to provide primary and secondary prevention.
Objective. It has been suggested that the incidence of inflammatory bowel disease (IBD), which includes ulcerative colitis (UC) and Crohn's disease (CD), is higher in northern than in southern ...Europe. Recent epidemiological studies showed the loss of the previously described geographical north-south gradient. The aim of this study was to investigate the incidence of UC and CD in Primorsko-goranska County, Croatia. Material and methods. In the period 1 January 2000 to 31 December 2004 (5 years) all new patients diagnosed with IBD were prospectively identified according to a standard protocol for case ascertainment and definition. A total of 178 residents (81 F, 97 M) were newly diagnosed as having IBD during the study period. Of these, 70 had UC and 100 CD. Eight patients had indeterminate IBD. The data on patients were collected using a data form completed by gastroenterologists. Results. Annual age-standardized incidence rates were 4.3/105 (95% CI 2.6-6.0) for UC and 7.0/105 (95% CI 3.4-10.6) for CD. The highest incidence rate was observed in the age group 35-44 years for UC and the 25-34 years age group for CD. The incidence of IBD was higher in the urban than in the rural population, with the exception of on the islands. Conclusions. The incidence of IBD was higher than previously observed in Croatia. Our results suggest that CD incidence rates in the northern coastal part of Croatia are currently comparable with those reported in northern Europe.
The Pediatric Quality of Life Inventory™ Family Impact Module (PedsQL™ FIM) is a health-related quality of life and family functioning questionnaire for parents of children with chronic conditions. ...The aim of this study was to develop the Croatian version of the PedsQL™ FIM and to evaluate its psychometric properties. The study included 212 parents of children with chronic gastrointestinal disorders (GID) and those of healthy children. All parents completed the PedsQL™ FIM, PedsQL™ 4.0 Generic Core Scales (PedsQL), and World Health Organization Quality of Life-BREF questionnaire (WHOQOL-BREF). The Croatian version of the PedsQL™ FIM was developed following strict procedures for the translation and cross-cultural adaptation process (i.e. forward translation, reconciliation, backward translation, and pre-testing). Psychometric analyses included testing internal consistency reliability (Cronbach’s coefficient) and aspects of construct validity (Spearman’s correlation coefficients, known-groups comparison method, and exploratory factor analysis—EFA). Cronbach’s α of 0.7 and above were found for all scales. Parents of healthy children reported significantly higher all PedsQL™ FIM scores than parents of children with GID. Correlations between the PedsQL™ FIM and WHOQOL-BREF scales ranged 0.07–0.56. The EFA found 6 factors to explain 73.79 % of the total variance. Finally, the PedsQL™ FIM correlated moderate to high (range 0.46–0.64) to all PedsQL™ scores. The measure is feasible, short, and easily scored. It has appropriate internal consistency reliability and acceptable construct validity. However, more studies about validity are needed that will include other children with chronic conditions considering that a questionnaire validation is an iterative process.
ABSTRACT
Objective:
Dipeptidyl peptidase IV (DPP IV/CD26) is involved in the degradation of proline‐rich proteins such as gliadin and in modulation of the immune response. The aim of this study was ...to examine the possible causal connection between DPP IV enzyme activities and celiac disease (CD) in children.
Patients and Methods:
Intestinal mucosal biopsy specimens were obtained from 97 patients. The patients were divided into 3 groups: patients with active CD (n = 38), patients with malabsorption syndrome (MS) of other causes (n = 37), and control patients (n = 22). In addition, blood samples were collected from 48 patients with active CD and 50 control patients without gastrointestinal diseases. DPP IV enzyme activity was measured in the intestinal mucosal biopsy specimens and in the serum samples.
Results:
DPP IV activity in the small intestine correlated inversely with the grade of mucosal damage in the CD (r = −0.92, P < 0.001) and MS groups (r = −0.90, P < 0.001). Intestinal DPP IV activity was statistically significantly lower in the CD and MS groups than in the control group (P < 0.001). By contrast, serum DPP IV activity was not significantly different between the CD and control groups.
Conclusions:
Our results suggest that the decrease in intestinal DPP IV activity is not specific to CD because it correlates with the level of mucosal damage in both patients with CD and those with MS. In addition, it seems that serum DPP IV activity cannot be used as a specific noninvasive diagnostic or prognostic marker of CD.
A case of 16-year-old female with secondary psoas abscess as the complication of the Crohn’s disease was analysed. Her pre-hospital, long lasting, non-specific symptoms led to ultrasound (US) and ...radiologic imaging confirming the diagnosis. The antibiotic treatment was insufficient and worsening of the patient’s condition required surgical treatment including descendent colectomy, abscess drainage and negative pressure wound therapy (NPWT). In spite of numerous complications the condition of the child gradually improved and she was discharged from the hospital on the 71st postoperative day. Two years after the colectomy, the occlusion of her colostomy was performed.
Chronic intussusception (CI) is defined as an intussusception lasting for 14 days or more. Because the clinical manifestations are non-specific, the diagnosis is usually delayed. Symptoms include ...intermittent abdominal pain, sometimes an abdominal mass is palpable and there is a marked weight loss. Diagnosis is based on typical features revealed by ultrasound or barium enema and CT investigations. Therapy is surgical with obligatory exclusion of possible underlying lesions. We report a case of a 3.5-year-old girl with chronic intussusception. Laboratory blood findings revealed sideropenic anemia and stools positive for Ascaris lumbricoides. Anti-parasitic therapy with mebendazole was repeatedly administered with early improvements but soon after symptoms relapsed. During surgery an ileocolic chronic intussusception extending to hepatic flexure was found. Postoperative control examinations proved complete healing. We suspected that Ascaris lumbricoides infestation was an etiologic factor for the development of chronic intussusception in the child.
Nasljedna nepodnošljivost fruktoze ili fruktozemija je autosomno recesivno nasljedni poremećaj koji nastaje zbog nedostatne aktiv- nosti enzima fruktoza-1-fosfat aldolaze (aldolaze B). Bolest se ...klinički, u dotad naizgled zdravog dojenčeta, očituje nakon uvođenja namirnica koje sadrže fruktozu, saharozu ili sorbitol. Najčešći simptomi bolesti su povraćanje, bljedilo, drhtavica, somnolencija, a katkad i konvulzije (većinom kao posljedica hipoglikemije, odnosno neuroglikopenije). Može se razviti i akutno zatajenje jetre, a ako se dijete pravilno ne zbrine, takva kriza može završiti smrću. Pošto se fruktoza, saharoza i sorbitol isključe iz prehrane, simptomi bolesti se brzo i spontano povlače. Ako bolest ostane neprepoznata, dugoročno može uzrokovati ponavljajuće bolove u trbuhu, povraćanje, kroničnu bolest jetre, tubulopatiju, rahitis te zaostajanje u rastu i razvoju. Anamnestički podatci o pojavi simptoma nakon uvođenja voća i povrća u dohranu i/ili odbojnost prema slatkoj hrani ključni su za postavljanje sumnje na ovu bolest. Labo- ratorijski nalazi koji podupiru dijagnozu, a česti su u akutnom pogoršanju, su hipoglikemija, hipofosfatemija, hiperuricemija, meta- bolička acidoza i povišene aktivnosti aminotransferaza. Dijagnoza se potvrđuje nalazom bialelnih patogenih mutacija gena ALDOB ili mjerenjem aktivnosti enzima u tkivu jetre ili crijeva, što se danas rjeđe primjenjuje. Pravodobno postavljanje dijagnoze ključno je za dobar ishod. Ako se spriječi unos fruktoze u organizam, prognoza je izvrsna. Cilj ovog rada je predočiti klinička obilježja nasljedne nepodnošljivosti fruktoze prikazom dvoje bolesnika, jednog s akutnim, a drugog sa subakutnim kliničkim tijekom, te tako upozoriti na ovu rijetku, a lječivu nasljednu metaboličku bolest.
Glucocorticoids may be useful as short-term palliative therapy for acute exacerbations of Crohn disease. When glucocorticoids are used for longer than brief periods, even in moderate dosages, they ...can produce a variety of adverse effects, including steroid diabetes. Two boys were treated with methylprednisolone due to acute exacerbations of Crohn disease. After five and six weeks of continuous oral administration of methylprednisolone, the boys developed steroid diabetes. Diabetic symptoms dominated the clinical presentation but there was no tendency towards diabetic ketoacidosis. Reduction of methylprednisolone dosage rather than insulin therapy resulted in better control of glycemia. Frequent blood glucose monitoring is recommended in children on prolonged therapy with glucocorticoids. Steroid diabetes experienced by the reported cases may be a marker for the onset of diabetes in their adulthood.
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