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Introduction. One of the urgent issues in the first stage of nursing premature infants is acute kidney injury. The incidence of neonatal acute kidney injury in developing countries is 3.9/1000 live births, with 34.5/1000 among neonatal intensive care patients.The aim of the study was to establish echographic signs of acute kidney injury in deeply premature infants in the neonatal period.Materials and methods. 24 children with clinical and laboratory signs of acute kidney injury “AKI+” and 76 children without signs of acute kidney injury “AKI-“. All the children included in the study were born with a body weight of less than 1500 g and a gestation period of less than 32 weeks and were in the neonatal intensive care unit. To clarify the nature of the detected changes, a scientific analysis of the results of pathoanatomic studies of 55 deceased preterm infants was carried out.Results. In all children from the “AKI+” group, there was a pronounced diffuse-uneven increase in the echogenicity of the parenchyma, there was a depletion of the vascular pattern in the subcapsular zone and/or in the cortical layer of the parenchyma, in 25% of patients on the 5th-15th day of life, anechogenic formations without signs of blood flow, with a diameter of 1-3 mm in the cortical layer were noted. The changes had a bilateral nature of the lesion, with further observation they were gradually reduced and by 3 ± 2 months of life they were not determined during ultrasound of the kidneys.Discussion. Acute kidney injury is an urgent problem of preterm infants born with very low and extremely low body weight. The article presents the results of ultrasound examination of the kidneys in comparison with clinical and laboratory indicators and the results of pathomorphological studies. As a result of the study, the most characteristic ultrasound signs of acute kidney injury were identified, which are an uneven diffuse increase in the echogenicity of the renal parenchyma, small anechoic avascular inclusions (cysts) of the parenchyma, depletion of renal blood flow.Conclusions. Renal ultrasonography is an informative method, but echographic changes may be labile depending on the clinical course of the disease, and the absence of anechogenic masses in the parenchyma may be due to technical limitations of the ultrasonography method. It requires further monitoring and continued vigilance of the pediatrician and pediatric nephrologist.

The aim was to review the compliance, side effects and effectiveness of subcutaneous immunoglobulin (SCIG) supplementation in patients with primary immunodeficiencies (PID) who had previously received intravenous immunoglobulin (IVIG) therapy and subsequently switched to SCIG, as well as to compare these parameters in patients while considering body weight. Demographic data, clinical and laboratory findings, SCIG dose, and side effects of 87 patients were retrospectively obtained from patient files. In patients who first received IVIG and then SCIG, the monthly SCIG dose was calculated by multiplying the IVIG dose by 1.37. The total monthly SCIG dose was distributed via injection across three or four doses per month, thus every 7 or 10 days. Of the 87 patients aged between one and 22 years, 50 were male (57.5%) and 37 were female (42.5%). The serum IgG levels of the SCIG group were higher and more stable than those of the IVIG group. The number of hospitalizations and infections decreased significantly after initiation of SCIG. Thirteen patients (14.9%) had low body weight (LBW) for their age, seven of whom were male (53.8%). Serum IgG levels of the LBW cohort were significantly elevated and more stable during the SCIG period than the IVIG period. Mild, local side effects were detected in 153 administrations (3.3%) in 30 patients with normal body weight, while no local reactions were recorded in the patients with LBW. SCIG supplementation is an effective treatment for pediatric patients with PID. The preliminary data from the present study suggest that such treatment is also safe for LBW children. The numbers of patient hospitalizations and family visits to clinics were reduced, allowing our patients and their parents to live more normal lives.

The study and monitoring of international indicators of the health status of premature infants is the current vector of scientific research in neonatology.Objective. To assess the effectiveness of the nursing technologies of premature babies in the Republic of Belarus based on the analysis of long-term indicators of morbidity, mortality and survival of the infants with extremely low body weight.Material and methods. Statistical reports data were used for a retrospective analysis of epidemiological indicators for the period of 2002–2018.Results. The proportion of premature infants in the Republic of Belarus was stabilized at 4,2–4,5% increase in the absolute numbers, including those born weighing less than 1500 g. The ratio of the absolute number of alive and stillborn infants with extremely low body weight is many times higher than the initial values (p up to 1 year increased 2 times to the maximum level in 2018 (81,5%). There was an increase in the overall incidence of premature children in 2002–2010 (p the perinatal period (p of congenital pneumonia for the period 2002–2009 increased to a maximum level of 263,4 ‰ (p 2018. The republican mortality rate of premature babies was stabilized at the level of 0,95 ‰ in the last 9 years, while the indicator was decreased 5 times among children weighing 500–999 g.Conclusion. The assessment of the long-term dynamics of the main indicators of the health status of premature infants in the Republic of Belarus testified to the effectiveness of a complex of organizational and medical measures for their nursing.

Összefoglaló. A divatiparra vonatkozó egészségvédelmi szabályozások hiányosak. A karcsúság elérését célzó szociokulturális nyomás a divatiparon belül fokozott, a divatmodelleket gyakran késztetik kórosan alacsony testsúly elérésére, ami pszichológiai abúzusnak felel meg. Ezért a modellek közt az evészavarok prevalenciája magasabb az átlagpopulációhoz képest. A divatvilág veszélyei között ezeken túl a szexuális abúzus, a financiális visszaélések, illetve a fiatalkorúak foglalkoztatásával kapcsolatos szabályozatlanság említendő. A kockázatok csökkentése érdekében fontos volna nemzetközi szabályozásokat bevezetni a divatszakmában. Az erre irányuló kezdeményezések először 2006-ban jelentek meg Spanyolországban: a modellek foglalkoztatásának feltétele volt az egészséges tápláltsági állapot alsó határától minimálisan elmaradó testtömegindex (18,0) elérése. Később Franciaországban az evészavarok gyakoriságának mérséklésére törvénybe foglalták a modellek kötelező egészségügyi vizsgálatát, illetve az utólagosan módosított divatfotók megjelölését. E szabályozások azonban könnyen kijátszhatók. A törvényhozás mellett különböző szervezetek alkottak olyan irányelveket, amelyek a modellek egészségvédelmét szolgálták. Ezek az iránymutatások elsősorban a biztonságos munkavégzésre, a fiatalkorúak foglalkoztatásának korlátozására és az emberi méltóság megtartására irányulnak. A divatszakmában előforduló feszültségek vezettek továbbá olyan nonprofit szervezetek megalakulásához, amelyek a modellek érdekvédelméért dolgoznak. A divatmodellek egészségvédelmét célzó jogi szabályozás a mai kultúrában domináns karcsúságideál megváltoztatását is szolgálná, mert a szociális tanulás révén a divatot követő átlagnépesség utánozza a modelleket. A divatmodellek egészségének védelme tehát népegészségügyi vonatkozással is bír. Orv Hetil. 2021; 162(23): 905–910. Summary. The fashion industry is lacking sufficient health protective regulations. There is an increased sociocultural pressure to be thin. Fashion models are often forced to reach abnormally low body weight, which can be regarded as psychological abuse. This leads to a higher prevalence of eating disorders among models compared with the general population. Some of the other dangers associated with the fashion industry are sexual harassment, financial exploitation, and unregulated minor labour force. To reduce these risks, it is crucial to introduce international regulations in the fashion industry. The first initiative for such regulations took place in Spain in 2006 when the condition for models’ employment was for their body mass index (BMI) not to drop below 18.0, which is close to the low end of healthy BMI. Later in France, to decrease the prevalence of eating disorders, a legislation on compulsory medical examination for models was made. Also, retouching of photos had to be disclosed. Regulations like these, however, can easily be eluded. Different organisations implemented guidelines, such as establishing safe working conditions, limiting underage labour force, and maintaining dignity to protect models’ health. Tension within the fashion industry led to the formation of non-profit organisations seeking the protection of models’ interest. Regulations protecting models’ health in the fashion industry would encourage society to adjust its predominant ideal for thinness. Just as the general population tends to follow fashion trends portrayed by fashion models, so would they likely imitate the new look of models. Hence, the protection of models’ health goes beyond the fashion industry. It has public health implications as well. Orv Hetil. 2021; 162(23): 905–910.

Although direct oral anticoagulants are effective and safe in preventing stroke in atrial fibrillation (AF) patients with low body weight, data remain limited in AF patients with extremely low body weight ( 60 kg (n = 1019, 33.7%), 50–60 kg (n = 1126, 37.2%), and

The article presents the literature data and the results of the authors’ observations of preterm children in the postnatal period, born with extremely low and very low body weight, with the definition of the leading psycho-neurological disorders, which cause disabling conditions in this group of patients. The authors highlight the difficulties of predicting the neuropsychological development of deeply premature and extremely premature children. The scientists note the importance of a comprehensive assessment of their health status. They justify the necessity of improving the system of medical support for such children at all stages of nursing, rehabilitation and the introduction of a personalized approach to clinical practice with the development of differentiated programs of medical supervision and habilitation.

There is a paucity of data on the influence of low body weight on clinical outcomes in patients with acute venous thromboembolism (VTE).The COMMAND VTE registry is a multicenter cohort study enrolling 3027 consecutive patients with acute symptomatic VTE. The current study population consisted of 2778 patients with available body weight value, who were divided into 2 groups; 1705 patients with lower body weight (≤60 kg) and 1073 patients with higher body weight (60 kg).Patients with lower body weight were older (70.8 versus 60.9 years, P 0.001), and more often women (75% versus 38%, P 0.001), and more often had active cancer (27% versus 19%, P 0.001) than those with higher body weight. The cumulative 5-year incidence of recurrent VTE was not significantly different between the 2 groups (10.6% versus 10.7%, P = 0.51). The cumulative 5-year incidences of major bleeding and all-cause death were significantly higher in patients with lower body weight than in those with higher body weight (14.6% versus 9.6%, P 0.001, and 35.8% versus 19.8%, P 0.001, respectively). The excess adjusted risk of patients with lower body weight relative to those with higher body weight remained significant for major bleeding and all-cause death (HR 1.57, 95%CI: 1.16-2.12, P = 0.003, and HR 1.50, 95%CI: 1.24-1.81, P 0.001, respectively).In the current Japanese real-world registry, there were a high proportion of patients with low body weight, who had a higher risk for major bleeding and mortality without significant excess risk for recurrent VTE.

Purpose: Oral anticoagulants are crucial for preventing systemic thromboembolism in atrial fibrillation (AF), with guidelines preferring non-vitamin K antagonist oral anticoagulants (NOACs) over vitamin K antagonists (VKAs) in the general AF population. However, as NOACs are administered in fixed doses, concerns of unintentional underdosing in morbidly obese patients and unintentional overdosing in underweight patients have emerged. Therefore, a critical appraisal of the benefit-risk profile of NOACs in AF patients across the body weight spectrum is needed. Methods and results: After searching Medline, this systematic review discusses the impact of body weight on the risk-benefit profile of NOACs versus VKAs. The meta-analysis demonstrated that NOAC use in obese and class III obese AF patients (body mass index (BMI) ≥ 30 and ≥ 40 kg/m2, respectively) was associated with significantly lower stroke/systemic embolism (stroke/SE) risks (RR 0.82, 95%CI [0.71-0.96] and RR 0.75, 95%CI [0.64-0.87], respectively), similar to lower major bleeding risks (RR 0.83, 95%CI [0.69-1.00] and RR 0.74, 95%CI [0.57-0.95], respectively) and similar mortality risks (RR 0.92, 95%CI [0.73-1.15] and RR 1.17, 95%CI [0.83-1.64], respectively) compared to VKAs. In AF patients ≤ 60 kg, significantly lower stroke/SE (RR 0.63, 95%CI [0.56-0.71]) and major bleeding risks (RR 0.71, 95%CI [0.62-0.80]), but similar mortality risks (RR 0.68, 95%CI [0.42-1.10]), were observed for NOAC- versus VKA-treated patients. Conclusion: The benefit-risk profile of NOACs seems preserved in (morbidly) obese AF patients and patients with low body weight. However, more data are needed on underweight AF patients (BMI < 18.5 kg/m2) and on differences between NOACs in these patients.

Objectives: Low body weight is an easily assessable cause of Raynaud’s phenomenon (RP), and is frequently overlooked by clinicians. We aim to investigate the association of low body weight (body mass index 2), involuntary weight loss, and nutritional restrictions with the presence of RP. Method: Participants from the Lifelines Cohort completed a validated self-administered connective tissue disease questionnaire. Subjects who reported cold-sensitive fingers and biphasic or triphasic colour changes were considered to suffer from RP. Patient characteristics, anthropometric measurements, and nutritional habits were collected. Statistical analyses was stratified for gender. Results: Altogether, 93 935 participants completed the questionnaire. The prevalence of RP was 4.2% [95% confidence interval (CI) 4.1–4.4%], and was three-fold higher in women than in men (5.7% vs 2.1%, p

In recent publications, positive results have been reported with the use of glasses with red protective filters in prematurely born infants with low body weight, which were presumably associated with a decrease in the levels of illumination of the environment of the child. However, to date, it has not been proven that a decrease in the amount of light reaching the retina of the newborn affects the frequency and severity of retinopathy of prematurity (RP). The analysis of the literature on the therapeutic effect of various modes of red and near infrared radiation on the retina is presented, which allowed a different look at the protective mechanisms of glasses-filters in premature babies. It has been suggested and substantiated that the observed effect may relate to the phenomenon of pre-conditioning photostimulation, which reduces the risk of developing RP and reduces the severity of the disease due to the induction of adaptive plastic reactions in the retina.

The aim of the study was to evaluate the types of left ventricular (LV) rotation depending on the nature of feeding during the first year of life in oneto five-year-old children born with very low and extremely low body weight.Material and Methods. The study included 88 children aged one to five years, born deeply premature with very low and extremely low body weight. The comparison group consisted of 46 healthy children of the same age, born full-term. TheLV mechanics was studied based on the assessment ofLV rotation at the levels of the mitral valve, papillary muscles, and apex andLV twist using two-dimensional echocardiography and two-dimensional speckle-tracking strain imaging.Results.Differences between the types ofLV twist and the nature of feeding during the first year of life in oneto five-year-old children born with very low and extremely low body weight were identified. In children with natural feeding, the first (“adult”) type ofLV twist was registered in 75% of cases; the fourth type ofLV twist was detected in 12.5% of cases. In children with bottle-feeding during the first year of life, the “adult” type ofLV twist was registered in 34.38% of cases; fourth type ofLV twist was detected in 40.63% of children born deeply premature. In children with mixed feeding during the first year of life, the ratio ofLV twist types was as follows: 40.63% of patients had the first “adult” type; “child” types were present in 18.75% and 18.75% of children, respectively; fourth type of twist was detected in 21.88%.

Annually, more than 1 million premature infants die of infectious diseases due to the failure of the mechanisms of antiviral and antibacterial protection. In this regard, immune build up with timely vaccination to prevent severe infections is a particularly important factor. This study presents a retrospective analysis of the results of vaccination of extremely premature infants. The results of immunization were analyzed, and the vaccination scheme for children born with very low and extremely low body weight are presented.

Shumna T. Ye., Levchuk-Vorontsova T. O. Diagnostic possibilities of determination of osteogenesis disorders in children born with low body weight. Journal of Education, Health and Sport. 2020;10(9):937-951. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2020.10.09.114 https://apcz.umk.pl/czasopisma/index.php/JEHS/article/view/JEHS.2020.10.09.114 https://zenodo.org/record/4064924 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2020; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 20.08.2020. Revised: 01.09.2020. Accepted: 30.09.2020. UDК 616.71-053.2-06:616-056.25]-07 DIAGNOSTIC POSSIBILITIES OF DETERMINATION OF OSTEOGENESIS DISORDERS IN CHILDREN BORN WITH LOW BODY WEIGHT T. Ye. Shumna, T. O. Levchuk-Vorontsova Zaporizhzhia State Medical University, Zaporizhzhia, Ukraine Shumna T. Yе., MD, PhD, DSc, Professor of the Department of Faculty Pediatry, Zaporizhzhia State Medical University, Ukraine; 28А, Novgorodskaia street, Zaporizhzhia, 69076; Tel .:+380978541809, e-mail: tshumnaya72@gmail.com ID orcid 0000-0003-4926-1271 Levchuk-Vorontsova T.O., MD, Assistant of the Department of Children Diseases, Zaporizhzhia State Medical University, Ukraine; 28А, Novgorodskaia street, Zaporizhzhia, 69076; Tel .: +380674352467, e-mail: tatyana0702@gmail.com ID orcid 0000-0003-0557-6714 Abstract The work aims at studying the bone tissue mineral density in children born with low body weight, taking into account the dependence on the nature of feeding and polymorphism of the C/A gene polymorphism of COL1A1_1 collagen gene (rs1107946). Materials and methods. The study involved 74 children. Of these, 29 children born with the body weight of 1500-1999 g were in the observation group I; 25 children weighing 2000-2499 g - group II; 20 children with the body weight at birth of 2500 g - group III (control group). All children were under inpatient treatment at the Municipal Non-Profit Enterprise "City Children Hospital no. 5" of Zaporizhia City Council. Data on the type of breastfeeding of a child aged under 1 year were analyzed for all children. The study of bone tissue mineral density was performed at the age of 12-15 months using an ultrasonic bone sonometer (densitometer) Sunlight MINIOMNI) BeamMed Ltd., Israel. The examination was conducted at the Department of Faculty Pediatrics of the Zaporizhia State Medical University. Analysis of the results was performed by non-parametric statistics methods using the Statistica 13 software package. Ordinal descriptive statistics was used to calculate the average Z-score indicators. The non-parametric statistical method "2 × 2 Table", the Chi-square (df = 1) was used to compare the frequencies of desitometry indicators in different groups. Results. In general, among the examined children according to densitometry data, there were no changes in the skeletal system (Z-score 0.48 ± 1.20) in 64.86% of cases, but there were osteopenia (Z-score -1.8 ± 0 , 53) in 27.03% and osteoporosis (Z-score -3.5 ± 0.96) in 8.11%. But in the further analysis by groups, the average Z-score indicator in children of the group I was 0.37 ± 2.06, in children of the group II - -0.08 ± 1.59 and in children of the group III - 0.47 ± 1, 69. But in children of the group I with body weight at birth 1500-1999g, osteopenia was registered in 34.48% of cases; the group II (2000-24999 g) - in 28.00% of cases; the group III (2500 g and more) - in 15.00% of cases. Osteoporosis was found only among children of the groups I and II. Children of the group I mainly received artificial and mixed feeding. Children of the group II received approximately the same amount of natural and artificial feeding, much less often mixed one, and 50% of children of the group III were on natural feeding. The Z-score indicators less than -1SD were found in children with AA and CA genotypes. Osteopenia was significantly less common in children with the AA genotype of the C/A gene polymorphism of COL1A1_1 collagen gene (rs1107946), who received natural or mixed feeding than in children who were exclusively on artificial feeding (p˂0.05). Among children with the AA genotype who were breastfed, there were changes in bone tissue (63.64% of children had osteopenia and 22.73% had osteoporosis). Among heterozygotes who were on artificial feeding, osteoporosis was found in 12.5%. Children with the CA genotype on mixed feeding had a decrease in bone tissue density (osteopenia) in 33.33% of cases. Children with AA genotype who were breastfed and had osteopenia, these were children weighing up to 2500 g (groups I and II). Children with osteopenia on mixed breastfeeding weighed at birth up to 2000 g. Osteopenia in children receiving artificial feeding was found in children of all 3 groups: 50.00% - group I, 28.57% - group II and 21, 43% - group III. Osteoporosis in breastfed children was found only among children of the groups I and II. Conclusions. According to densitometry data, among all examined children, there were no changes in the skeletal system (Z-score 0.48 ± 1.20) in 64.86%, osteopenia was registered (Z-score - 1.8 ± 0.53) in 27.03% and osteoporosis (Z-score -3.5 ± 0.96) was registered in 8.11%. But in children of the group I with body weight at birth of 1500-1999g, osteopenia was registered in 34.48% of cases; in the group II (2000-24999) in 28.00% of cases; in the group III (2500 g and more) in 15.00% of cases. Osteoporosis was found only among children born weighing up to 2500 g. Children of the group I mainly received artificial (62.07%) and mixed (34.48%) feeding. Children of the group II received approximately the same amount of natural (40.00%) and artificial (44.00%) feeding, much less often mixed one. In the control group III, 50% of children were breastfed. Regardless of the type of feeding, no changes in bone tissue were detected in children with the CC genotype of the C/A gene polymorphism of COL1A1_1 collagen gene (rs1107946). The Z-scores indicators less than -1 SD were found in children with the AA and CA genotypes, and only among children with the AA genotype of polymorphism, who received natural or mixed feeding, osteopenia occurred significantly less frequently (30.00%) than among children who had exclusively artificial feeding (63.64%). Osteoporosis was detected only in children with the AA genotype (12.5%) who were on artificial feeding. Key words: children born with low body weight; premature babies; densitometry; osteoporosis; osteopenia; breastfeeding; artificial feeding; mixed feeding; C/A gene polymorphism of COL1A1_1 collagen gene (rs1107946).

Hyponatremia is a potentially dangerous side effect of antidepressants. Almost every antidepressant can cause hyponatremia. Duloxetine-induced hyponatremia is a side effect that is usually seen in older women. In addition to advanced age and female sex; low body weight, presence of comorbid diseases are other important risk factors for the development of hyponatremia. In this case report we present a patient with depressive disorder who developed hyponatremia with duloxetine treatment which resolved immediately after the cessation of the medication with supportive electrolyte treatment. In our case, the resolution of hyponatremia with supportive electrolyte treatment in addition to the cessation of duloxetine reminds us about the importance of monitoring sodium levels both before and after antidepressant treatment in geriatric populations., Hiponatremi, antidepresanların potansiyel olarak tehlikeli bir yan etkisidir. Hemen hemen her antidepresan hiponatremiye neden olabilir. Duloksetin kaynaklı hiponatremi genellikle yaşlı kadınlarda görülen bir yan etkidir. İleri yaş ve kadın cinsiyetine ek olarak; düşük vücut ağırlığı, komorbid hastalıkların varlığı hiponatremi gelişimi için diğer önemli risk faktörleridir. Bu olgu sunumunda, ilacın kesilmesinden hemen sonra düzelen duloksetin tedavisi ile hiponatremi gelişen depresif bozukluğu olan bir hasta sunulmaktadır. Bizim olgumuzda, duloksetin kesilmesine ek olarak, hiponatreminin destekleyici elektrolit tedavisi ile çözülmesi bize geriatrik popülasyonlarda antidepresan tedavisinden önce ve sonra sodyum seviyelerinin izlenmesinin önemini hatırlatmaktadır.

The authors analyzed the Russian legislation, scientific literature and law enforcement practice on the nursing of newborns with extremely low body weight. They used the normative legal acts, scientific articles and court decisions on this topic. There were identified the problems of legal regulation of medical care to newborns with extremely low body weight, as well as the facts of infringement of the rights of doctors in cases of mortality of such children. The authors concluded that the legal regulation of medical care for children with extremely low body weight requires further improvement, careful analysis by medical specialists, since from a legal point of view there is no balance between the interests of children born with extremely low body weight, their parents and doctors.

The immune system of a premature newborn is characterized by quantitative and functional features that do not allow it to respond optimally to numerous pathogenic microorganisms against which during contact and during the first hours after birth they come into contact with a huge number of exogenous antigens of a viral, bacterial and fungal nature that were not previously known to him. This proves the relevance of the search for new directions for the effective prevention of mortality and severe morbidity in premature infants by changing the approach to the complex treatment of children with extremely low and very low body weight. Objective. To evaluate the effectiveness and safety of enriched intravenous immunoglobulins (IVIG) in children with extremely low body weight and very low birth weight in infants with lung infections in adjuvant therapy. Material and methods. A retrospective study and statistical analysis of the primary medical documentation “History of the development of the newborn” and “History of childbirth” of 49 preterm infants born with extremely low and very low body weight with intrauterine and neonatal pneumonia was carried out, the second group consisted of 66 children with a similar pathology, in the treatment of which enriched immunoglobulin therapy was not used. The collection of retrospective material was carried out from January 1st to December 31st, 2019 on the basis of the perinatal center of the Karasai central district hospital of the Almaty region. Results and discussion. We analyzed 49 stories of the development of newborn children with intrauterine and neonatal pneumonia, all children received a standard treatment package, including antibacterial, infusion and symptomatic therapy. As an immunomodulatory therapy, children received the Pentoglobin drug, which was registered and allowed from 0 months. The use of intravenous immunoglobulins has been studied as a method of treating intrauterine pneumonia and preventing the death of newborns children. The criteria for prescribing the drug were a sepsis clinic, a septiclike condition, pneumonia that did not give rise to initial antibiotic therapy, progressing according to the X-ray picture, laboratory changes (leukopenia, leukocytosis, neutropenia in combination with high CRP). Conclusions. The clinical efficacy of the use of an immunomodulating drug from the groups of enriched intravenous immunoglobulins in 49 premature infants with extremely low and very low body weight, with severe intrauterine and neonatal pneumonia was shown. It has been established that the inclusion of enriched intravenous immunoglobulin in the complex therapy of patients with severe neonatal pneumonia leads to a relief of clinical manifestations, a decrease in the risk of resistance of microorganisms to antibiotics and the risk of death. Keywords: premature infants, extremely low body weight, very low body weight, neonatal pneumonia, enriched intravenous immunoglobulins.

Annually more than 15 million children are born prematurely in the world. The clinical case illustrates the importance of an integrated approach for follow-up observation of children from 0 to 36 months old, born with very low and extremely low body weight. We studied the effectiveness of the Rehabilitation Center for children born with very low and extremely low body weight on the basis of a large multidisciplinary Bashlyaeva children’s hospital in Moscow 2012–2018. This center is necessary for a comprehensive assessment of the health status of children born with very low and extremely low body weight, as well as for the dynamic and timely diagnostics and the application of optimal treatment of revealed pathological changes. The development of differentiated programs for medical examination and rehabilitation of this group of children should include an optimal protocol of dynamic monitoring. It will reduce both the rate of incidence and disability, and improve the quality of life and social adaptation of children.

This article is devoted to the issue of nursing and further monitoring of children born with very low and extremely low body weight. The article presents the data of international statistics and seven-year experience of the Rehabilitation Center for children born with very low and extremely low body weight, based on a large multidisciplinary children’s hospital. The authors pay particular attention to improvement of medical care of children born with very low and extremely low body weight.

Purpose of the study. Study the indicators of nutritional status(hemoglobin, total protein, albumin, creatinine, urea, glucose in blood plasma)at birth, in dynamics on the 10th, 20th, 30th day of life in premature newbornswith very low and low birth weight at birth. Various types of feeding (breast milk,breast milk in combination with a fortifier and artificial feeding) to assess theongoing measures for successful feeding and the quality of nursing.Materials and methods. A survey of 118 children aged from birth to 1 monthof life, who were divided into groups depending on the type of feeding.Conclusion. The study made it possible to present laboratory parameters(hemoglobin, total protein, albumin, creatinine, urea, blood glucose in bloodplasma) that characterize the nutritional status of premature infants with very low and low birth weight on various types of feeding (breast milk, breast milk incombination with a fortifier and artificial feeding) and propose measures aimed atoptimizing feeding in the neonatal period.

Breakfast skipping (BS) has been considered to be associated with obesity, particularly among younger generations. However, few studies have addressed this issue in a middle-aged population considering sex and the conditions prior to breakfast. Therefore, we investigated clinical parameters, self-reported BS, late-night dinner (LND) eating, and late-night snacking (LNS) in ten body mass index (BMI) categories in a cross-sectional study of 892,578 non-diabetic people aged 40–74 years old who underwent a checkup. BS and LND were more prevalent in men (20.7% and 40.5%, respectively) than women (10.9% and 17.4%), whereas LNS was more prevalent in women (15.0%) than men (12.2%; all p < 0.0001). The overall prevalence of BS increased linearly with increasing BMI. However, when subjects were divided into men and women, the prevalence of BS showed a U-shaped relationship with BMI in men (n = 479,203). When male subjects were restricted to those in their 40s or those reporting LND, the prevalence of BS further increased, maintaining a U-shaped form. Logistic regression analysis also showed a U-shaped relationship in the adjusted odds ratios of BMI categories for BS in men and a J-shaped curve in women. In conclusion, our study revealed an unexpectedly high prevalence of BS in middle-aged low-body-weight men.

Emerging data indicate that acute kidney injury (AKI) may contribute to a worse prognosis in the infant population. Kidney replacement therapy (KRT) can be used to treat patients with AKI; however, this technique is challenging in patients in the neonatal intensive care units (NICUs) due to the low body weights and blood volumes in this population. Peritoneal dialysis (PD) is a potential modality since it is technically less challenging. However, PD has been associated with several disadvantages, including poor fluid status control, catheter-associated leakage, and peritonitis. Unfortunately, these complications can cause the temporary cessation of PD. Continuous kidney replacement therapy (CKRT) may represent a suitable alternative for PD. CKRT may be technically feasible in infants; however, little is known about the application of CKRT in neonates with low body weights. In this report, we discuss three cases of CKRT who were treated in the NICU at a tertiary medical center in southern Taiwan. We selected an adequate catheter diameter and achieved vascular access via an internal jugular vein or umbilical vein. The prescription of an appropriate dose of heparin was then used to prolong the circuit life of the CKRT. The maintenance of circuit durability in neonates with low body weight remains problematic. We hope that our experience can assist with the future clinical management of CKRT in neonates with low body weight.

BackgroundKidney transplantation from donors who weigh ≤5 kg is performed at only a few transplant centers owing to the high complication and low graft survival rates associated with this approach.MethodsWe retrospectively compared the results of kidney transplantation at our center between January 2015 and December 2019 based on the following pediatric donor criteria: donor body weight ≤5 kg (n=32), 5 kg< donor weight ≤20 kg (n=143), and donor weight >20 kg (n=110). We also perform subgroup analysis of kidney transplantation outcomes from ≤5 kg donors, using conventional (dual separate and classic en-bloc KTx)/novel (en-bloc KTx with outflow tract) surgical methods and allocating to adult/pediatric recipients.ResultsThe death-censored graft survival rates from extremely low body weight ≤5kg at 1 month, and 1, 3, and 5 years were 90.6%, 80.9%, 77.5%, and 73.9%, respectively, which were significantly lower than that from larger body weight pediatric donors. However, the 3-, and 5-year post-transplantation eGFRs were not significantly different between the pediatric and adult recipient group. The thrombosis (18.8%) and urinary leakage (18.8%) rates were significantly higher in the donor weight ≤5 kg group. Compared with 5 kg< donor weight ≤20 kg group, donor weight ≤5kg group was at elevated risk of graft loss due to thrombosis (OR: 13.4) and acute rejection (OR: 6.7). No significant difference on the outcomes of extremely low body weight donor kidney transplantation was observed between adults and pediatric recipients. Urinary leakage rate is significantly lower in the novel operation (8.7%) than in the conventional operation group (44.4%).ConclusionsAlthough the outcomes of donor body weight ≤5kg kidney transplantation is inferior to that from donors with large body weight, it can be improved through technical improvement. Donors with body weight ≤5 kg can be considered as an useful source to expand the donor pool.

A qualitative improvement in the management of pregnancy and delivery, optimization of General care and provision of intensive care for children born prematurely, particularly with low and extremely low body weight, significantly reduced the risk of damage to the nervous system of perinatal hypoxic-ischemic genesis. At the same time, there is a significant number of children born at low gestational age, with a significant violation of intellectual, cognitive development and behavior change. One of the assumptions about cause of improper maturation of the brain is the role of unbalanced chromosomal and genomic micro anomalies. There is provided the data on the survey of 22 children with approximately the same clinic of developmental disorders, 19 of which revealed various structural micro-damages of genesis, but their interpretation is difficult today. The algorithm of selection of children for the extended genetic examination is given.

The aim of this study was to evaluate the efficacy of non-invasive respiratory therapy using the method of dual positive airway pressure (DuoPAP) via nasal prongs performed in the intensive care unit and neonatal intensive care unit in premature newborns with extremely low body weight and respiratory distress syndrome in the early neonatal period. We conducted a retrospective analysis of 55 medical records of premature newborns treated in the intensive care unit of the Perinatal Center at S.S. Yudin City Clinical Hospital during the first 7 days of their life. We included patients treated between January 2018 and December 2019. All newborns had extremely low body weight (850 ± 149 g); mean gestational age was 28 ± 4 weeks; Apgar score at the first minute of life varied between 3 and 6; Silverman Anderson score (severity of respiratory disorders) was between 3 and 5 s. Standard examination was performed in accordance with current protocols developed by Russian and foreign specialists in neonatal medicine. A specially developed clinical protocol of the study was approved by the local ethics committee. Study participants were divided into 3 groups according to their type of spontaneous respiratory efforts, target level of preductal saturation, and Silverman Anderson score. Patients in Group I received synchronized intermittent mandatory ventilation (SIMV); patients in Group II received ventilation using DuoPAP via nasal prongs (if it was ineffective, we considered SIMV via tube); patients in group III received ventilation using DuoPAP only. In this study, we have identified indications and contraindications for initial and prolonged respiratory therapy with DuoPAP and developed main practical recommendations for effective and safe application of DuoPAP. The efficacy and safety of non-invasive respiratory therapy with DuoPAP via nasal prongs in extremely premature infants with respiratory distress syndrome in the early neonatal period is primarily determined by the newborn’s readiness for active spontaneous and productive respiratory movements, but not only by the compensated parameters of the acid-base state and gas composition of the capillary blood. The assessment of feasibility and limitations of non-invasive respiratory therapy with DuoPAP is an important step towards developing a clinical protocol for respiratory therapy in the early neonatal period in a neonatal intensive care unit; it will help to reduce the use of invasive lung ventilation. Key words: premature newborns, non-invasive respiratory therapy, respiratory distress syndrome, extremely low body weight

Introduction: The safety of prasugrel in elderly and/or low body weight Japanese patients with ischemic stroke who have a relatively high bleeding risk with antiplatelet therapy remains unknown. Objective: We aimed to investigate the safety and efficacy of long-term prasugrel monotherapy for stroke prevention compared with clopidogrel in elderly and/or low body weight Japanese patients with non-cardioembolic ischemic stroke. Methods: In this randomized, double-blind, comparative, phase III study, elderly (age ≥75 years) and/or low body weight (≤50 kg) Japanese patients with a previous history of non-cardioembolic ischemic stroke were assigned to a prasugrel 3.75 mg (PRA3.75) group, a prasugrel 2.5 mg (PRA2.5) group, or a clopidogrel 50 mg (CLO50) group and followed up for 48 weeks. The primary safety endpoint was the combined incidence of primary safety events, defined as life-threatening, major, and other clinically relevant bleeding. The efficacy endpoint was a composite of ischemic stroke, myocardial infarction, and death from other vascular causes. Results: A total of 654 patients (age 76.4 ± 7.3 years, body weight 55.6 ± 9.3 kg, women 43.9%) from 74 medical institutions within Japan were enrolled. The combined incidence (95% CI) of primary safety events was 4.2% (1.9–7.8%), 1.9% (0.5–4.7%), and 3.6% (1.6–6.9%) in the PRA3.75 group (n = 216), PRA2.5 group (n = 215), and CLO50 group (n = 223), respectively (hazard ratios [HR] PRA3.75/CLO50, 1.13 [0.44–2.93]; PRA2.5/CLO50, 0.51 [0.15–1.69]). The incidences of bleeding leading to treatment discontinuation (95% CI) were 2.3% (0.8–5.3%), 0.9% (0.1–3.3%), and 2.2% (0.7–5.2%) in the PRA3.75, PRA2.5, and CLO50 groups, respectively (HRs PRA3.75/CLO50, 1.01 [0.29–3.48]; PRA2.5/CLO50, 0.41 [0.08–2.12]). There was no significant difference in all bleeding events between groups. The incidence of ischemic stroke, myocardial infarction, and death from other vascular causes was lower, but not significantly so, in patients treated with prasugrel than in patients treated with clopidogrel: PRA3.75, 0.0% (0/216); PRA2.5, 3.3% (7/215); and CLO50, 3.6% (8/223; HRs PRA3.75/CLO50, 0.00 [0.00–0.00]; PRA2.5/CLO50, 0.90 [0.32–2.47]). Conclusions: Elderly and/or low body weight ­Japanese patients with previous non-cardioembolic ischemic stroke who received PRA3.75 showed similar results in terms of primary safety endpoint, and a numerically lower incidence of ischemic stroke, myocardial infarction, and death from other vascular causes, compared with those who received CLO50.

It was found that children born as a result of early preterm birth are characterized by nephronogenesis, characterized by atypical increase in size, variability of nephron components, and recapitulation of mesonephronogenesis. The kidneys of premature infants with extremely low body weight are characterized by a peculiar structure, which is manifested in a reduced number of nephrons at birth, a pronounced glomerular-tubular imbalance – the structural and functional predominance of the glomerular component over the tubular part of the nephron. The concept of a new period of human ontogenesis is proposed – metanatal, which is understood as the period of life of a person born with extremely low and very low body weight as a result of early and early preterm birth, during 22–36 weeks of postconceptual age. The concept is based on the uniqueness of the structure-forming processes that occur in organs, which can not be evaluated as either embryo-fetal or postnatal ontogenesis processes after physiological delivery of 37–40 weeks of gestational age. Probably, these processes should be designated as postconceptual morphogenesis.

The article presents the data of our own observations of children born with extremely low and very low body weight. The leading pathological conditions in the digestive tract have been determined and the need for an early start of rehabilitation effects aimed at preventing and correcting these conditions has been substantiated. The paper highlights the difficulties in assessing the physical development of deeply premature babies. The necessity of improving the system of medical support for such children at all stages of nursing and the introduction into widespread practice of a personalized approach to rehabilitation is substantiated.

Background: Stunting or short was failed condition to grow of the baby (0-11 months old) and toodler (12-59 months old) impacted of the cronic malnutrition especially in the first 1.000 days of life its effecting the children to be too short. LBW is a factor that most dominant risk against stunting on child. Purpose : This research was to know the Correlation between history of low body weight of birth with the genesis stunting of the toodler aged 6-59 months in Mataram Ilir Village Seputih Surabaya Central Lampung 2019. Methods: This type of research is analysis observation with cross sectional design with purposive sampling as the sampling technique and Chi Square test as the bivariate analysis. Results: The results of the analysis showed that the frequency distribution of children with a history of LBW was 85 (35%), and the proportion of respondents with a history of normal weight birth was 152 (64.1%). While the frequency of the incidence of infants with normal height was 141 (59.5%), and the frequency of genesis stunting was 96 (40.5%). The results showed that the p-value was 0.005 and OR was 2.282 (95% CI: 1.29 - 3.8). Conclusion: There was a significant relationship between history of LBW and genesis stunting.

Background Vorapaxar inhibits the thrombin-mediated activation of platelets, reduces thrombotic events in patients with myocardial infarction or peripheral arterial disease while increasing bleeding. In the TRA 2°P-TIMI 50 trial, we observed a nominally significant interaction between low body weight and the reduced efficacy of vorapaxar. Methods We investigated the relationship between body weight and the efficacy and safety of vorapaxar within a multinational, randomized, double-blind, placebo-controlled trial of vorapaxar in patients with atherosclerosis. This analysis was performed among 20,138 patients with a clinical indication for vorapaxar. Results Compared with patients weighing 60 kg or more, patients weighing less than 60 kg were older, more frequently women, Asian and had renal insufficiency (each P0.05). Conclusions Vorapaxar reduced vascular events and improved net clinical outcome regardless of body weight in younger patients. Elderly patients with low weight may not be good candidates for aggressive secondary prevention with vorapaxar added to standard therapy. Clinical Trial Registration URL: http://www.clinicaltrials.gov Unique identifier: NCT00526474

Introduccion : Los trastornos de la imagen corporal y alimentarios, asi como conductas de control de peso riesgosas para la salud, son mas frecuentes en los deportistas que practican deportes con enfasis en la estetica, la delgadez y un bajo peso especifico. Objetivo : Comparar la imagen corporal (insatisfaccion y alteracion) y el riesgo de trastornos alimenticios en una muestra de adolescentes gimnastas versus un grupo control de adolescentes no gimnastas con un IMC similar. Material y metodos : Se selecciono un muestreo no probabilistico por conveniencia de 56 participantes mujeres y hombres clasificados como gimnastas elite, gimnastas regulares y grupo control. La imagen corporal y trastornos alimenticios fueron valorados con la Escala de Factores de Riesgo de Trastornos Alimentarios (EFRATA). Resultados : Al realizar una prueba ANOVA de dos factores, la insatisfaccion con la imagen corporal, presento diferencias estadisticamente significativas por sexo (F (1, 55) =17.41, p ≤ 0.001) y grupo (F (2, 55) = 3.66, p = 0.033), mostrando un mayor grado de insatisfaccion los hombres (M= -0.54) respecto a las mujeres (M = 0.43). El riesgo de anorexia mostro diferencias significativas por sexo (F (1, 55) = 10.69, p = 0.002) y grupo (F (2, 55) = 7.97, p ≤ 0.001). Conclusion : Los gimnastas presentaron un mayor grado de insatisfaccion corporal al desear una silueta mas gruesa o musculosa para el caso de los varones, mientras que las mujeres quieren ser mas delgadas respecto al grupo control. De igual forma los gimnastas reportaron un mayor riesgo de anorexia en comparacion con el grupo control. Abstract. Introduction : Body image and eating disorders, as well as risky weight management behaviors are more frequent in athletes who practice sports with an emphasis on aesthetics, thinness and a specific low body weight. Objective : to compare body image (dissatisfaction and alteration) and the risk of eating disorders in a sample of adolescent gymnasts versus a control group of non-gymnastics adolescents with similar BMI. Material and methods : A convenient non-probabilistic sample of 56 female and male participants classified as elite, regular gymnasts and control group with a BMI similar to that of gymnasts. The instrument used to assess body image and eating disorders was the Scale of Risk Factors for Eating Disorders. Results : When performing an inferential analysis using a two-way ANOVA, dissatisfaction with body image showed statistically significant gender (F (1, 55) = 17.41, p ≤ 0.001) and group (F (2 , 55) = 3.66, p = 0.033) differences, males displaying higher degree of dissatisfaction (M = -0.54) than females (M = 0.43). The risk of anorexia showed significant differences by sex (F (1, 55) = 10.69, p = 0.002) and group (F (2,55) = 7,97, p ≤ 0.001). Conclusion : Gymnasts showed greater body dissatisfaction, with males desiring a more muscular silhouette whilst females a leaner figure compared to the control group. Likewise, gymnasts reported an increased risk of anorexia compared to the control group.

Objectives Body mass index (BMI) is used to assess adiposity worldwide. However, additional adjustment for waist circumference (WC), a surrogate marker of abdominal fat, may be capable of revealing a latent relationship between low body weight and glycated hemoglobin (A1C) concentration. Here, we investigated the relationship between A1C and BMI in young adults, adjusting for WC. Methods We reviewed A1C, BMI, WC and other clinical data in a cross-sectional study of 26,475 apparently healthy Japanese people 20 to 39 years of age who were undergoing health check-ups. Results Although the values of most serum parameters were high in subjects with a high BMI in both younger (20 to 29 years of age, n=10,810) and older subjects (30 to 39 years of age, n=15,665), A1C had a J-shaped relationship with BMI category in younger subjects, regardless of sex. A traditional linear model via a generalized linear model showed that in younger subjects, an inverse association of A1C level with BMI category (19 to 26.9 kg/m2 vs. ≤18.9 kg/m2) was identified after adjustment for WC. This indicates positive associations between A1C and BMI categories of ≤18.9 (beta=0.06; p Conclusions Additional adjustment of BMI for WC revealed a latent U-shaped association between A1C concentration and BMI, particularly in young adults; this deserves further investigation.

The aim of this study was to describe femoral neck (FN) geometry among eumenorrheic underweight women around the age of peak bone mass. Proximal femur geometry and body composition were assessed in 12 underweight women and in 24 healthy controls using dual-energy X-ray absorptiometry. The Hip Structural Analysis program was used to determine bone geometry at the FN. The cross-sectional area (CSA) and the cross-sectional moment of inertia (CSMI) were significantly lower in underweight women than in controls (p 0.05). There was a trend toward lower sectional modulus (Z) and strength index in underweight women (p 0.15). Body weight, body mass index, and lean mass (LM) were positively correlated with CSA, CSMI, Z, and neck-shaft angle (r = 0.428-0.611, p 0.05). After controlling for body weight, body mass index, and LM, the differences in CSA, CSMI, Z, and neck-shaft angle were no more statistically significant between the 2 groups. The multivariate analysis retained LM as the main predictor of CSA, CSMI, and Z in the whole population. The present study suggests that thinness is associated with low resistance to axial forces (CSA) and bending load (Z and CSMI) in adult eumenorrheic women. LM seems to be a key determinant of FN geometry in underweight women.

To study the health status of children of the first 12 months of life born after in vitro fertilization from single and multiple pregnancies, the authors analyzed obstetric and gynecological anamnesis of mothers, peculiarities of the procedure of extracorporal fertilization, the results of a prospective clinical observation of children under 1 year with the assessment of physical, neuro-psychological development, morbidity and disability. It was found that multiple pregnancy due after in vitro fertilization is a risk factor for preterm birth, birth of children with low body weight and the formation of perinatal pathology. Children born from a single pregnancy after in vitro fertilization, at the age of 1 year did not differ from children born from spontaneous pregnancy, in terms of physical and neuropsychological development parameters, and absence of disability. Morbidity, disability, physical and neuropsychic development of children with a birth weight of less than 1,500 g from multiple pregnancies after in vitro fertilization did not differ from children from multiple natural pregnancies in the first 12 months of life. The procedure of in vitro fertilization is not a negative factor for the formation of the health of children born from single and multiple pregnancies. In this regard, the multiple pregnancy and the associated prematurity is the main factor affecting the health of children born after in vitro fertilization.

Aim. To establish the clinical and genetic determinants of the formation of delayed speech development in infants with very low and extremely low birth weight and to develop a prediction algorithm for this condition. Materials and methods. A cohort prospective study was conducted, which included 155 infant with very low and extremely low birth weight. Their speech development in 6, 12, 18, 24 and 36 months of life was studied and determinants determined. Results. It was found that 30.9% of children at the adjusted age of 24 months and almost 25% of children born with low and extremely low body weight at the age of 36 months have delayed speech. Important factors that promote delayed speech turned out to be severe intraventricular hemorrhages, postponed anemia in the first year of life, physical development and socio-economic status of the family. Forcasting model for delayed speech in early age for children born with low and extremely low body weight is devised. Conclusion: proposed model has high specificity (84.88%) and restrained sensitivity (55.88%) that testifies about ability to use it in practical medicine.

Purpose Although direct oral anticoagulants are effective and safe in preventing stroke in atrial fibrillation (AF) patients with low body weight, data remain limited in AF patients with extremely low body weight (60 kg (n = 1,019, 33.7 %), 50–60 kg (n = 1,126, 37.2 %), and P = 0.60); 1.37, 1.73 and 2.73 for bleeding requiring hospitalization (P = 0.154); 2.02, 2.67 and 4.92 for total death (P = 0.003); and 0.73, 0.95 and 1.23 for cardiovascular death (P = 0.57), respectively. After adjusting for confounders by Cox regression analysis, body weight

В останні роки наявна тенденція до збільшення кількості передчасних пологів. Увесь світ «захоплений» виходжування немовлят з екстремально малою масою тіла. Менша увага приділяється «пізнім недоношеним». Частота народження дітей в термінах гестації 34-36 тижнів різниться в різних країнах.«Пізні недоношені» є досить проблемною групою новонароджених і потребують особливої уваги, оскільки більше третини з них потребують проведення комплексної інтенсивної терапії; більш ніж половина немовлят цієї групи потребують медичного виходжування в умовах спеціалізованого стаціонару.

Background: Pathophysiological changes such as extreme body weights in critically ill patients with severe infections may alter the pharmacokinetics (PK) of antimicrobials, leading to treatment failure or toxicity. There are almost no PK data on meropenem in critically ill patients with low body weight (LwBW) and therefore information is lacking on the most appropriate dosing regimens, especially when administered by extended infusion. Objectives: To assess if the current administered doses of meropenem could lead to supratherapeutic concentrations in LwBW patients and to identify the factors independently associated with overexposure. Methods: A matched case-control 1:1 study of surgical critically ill patients treated with meropenem administered by extended or continuous infusion and undergoing therapeutic drug monitoring was conducted. Cases (patients with LwBW (body mass index (BMI) < 18.5 kg/m2)) were matched with normal body weight controls (NBW) (patients with BMI ≥ 18.5 kg/m2 and ≤30 kg/m2)) by age, gender, baseline renal function and severity status (APACHE II score). A 100% fT > MIC was considered an optimal pharmacokinetic/pharmacodynamic (PK/PD) target and 100% fT > 10 × MIC as supratherapeutic exposure. Results: Thirty-six patients (18 cases and 18 controls) were included (median (range) age, 57.5 (26–75) years; 20 (55.6% male)). Meropenem was administered by 6 h (extended) or 8 h (continuous) infusion at a median (range) daily dose of 5 (1–6) g/day. Similar median meropenem trough plasma concentrations (Cmin,ss), measured pre-dose on day three to four of treatment) were observed in the two groups (19.9 (22.2) mg/L vs 22.4 (25.8) mg/L, p > 0.999). No differences in the proportion of patients with an optimal or a supratherapeutic PKPD target between cases and controls were observed. A baseline estimated glomerular filtration rate (eGFR) < 90 mL/min was the only factor independently associated with a supratherapeutic PK/PD target. Conclusions: LwBW seems not to be a risk factor for achieving a supratherapeutic PK/PD target in critically ill patients receiving meropenem at standard doses by extended or continuous infusion.

Eating disorders (EDs) are psychiatric disorders associated with both physical and psychosocial morbidity and severe medical complications. Low bone mineral density (BMD) is common in young women with anorexia nervosa, and evidence suggests that other ED diagnoses are also associated with poor bone health outcomes and increased fracture risk. This chapter summarizes current methods used to assess bone health in individuals with EDs, including novel techniques, factors related to the development of low BMD in individuals with EDs, and recommendations for its management. It also sheds light on the challenges faced by clinicians when treating EDs. Overall, the chapter aims to improve the readers’ understanding of bone health in individuals with EDs and the complex interplay between low body weight, altered body composition, and adaptive endocrine alterations that contribute to the development and maintenance of osteoporosis.

Initial body weight may affect animal performance. This study investigated the effect of divergent selection based on body weight and betaine supplementation on performance of quails in the tropical environment. In total, 900 7-day-old female Japanese quails were divided into 30 cages of 30 birds in a 3×2 factorial design. The first factor was body weight (Random, High, and Low), and the second factor was betaine supplementation (0% and 0.14%), resulting in 6 treatments. Performance data were collected for 2 periods of 28 days during the laying phase. The variables observed included feed consumption, egg production, egg weight, and feed conversion. The data were analyzed using analysis of variance and continued with Duncan’s Test for significant results. The results showed that there was no interaction between body weight and betaine supplementation on quails’ performance. Random body weight produced more eggs and the highest feed efficiency than Low body weight (P

We aimed to determine if low body weight (LBW) status (&lt, 50 kg) is independently associated with increased risk of ischemic stroke and bleeding in Thai patients with non-valvular atrial fibrillation (NVAF). (1) Background: It has been unclear whether LBW influence clinical outcome of patients with NVAF. (2) Methods: This prospective multicenter cohort study included patients enrolled in the COOL-AF Registry. The following data were collected: demographic data, medical history, risk factors and comorbid conditions, laboratory and investigation data, and medications. Follow-up data were collected every 6 months. Clinical events during follow-up were confirmed by the adjudication committee. (3) Results: A total of 3367 patients were enrolled. The mean age was 67.2 &plusmn, 11.2 years. LBW was present in 338 patients (11.3%). Anticoagulant and antiplatelet was prescribed in 75.3% and 26.2% of patients, respectively. Ischemic stroke, major bleeding, intracerebral hemorrhage (ICH), and death occurred during follow-up in 2.9%, 4.4%, 1.4%, and 7.7% of patients, respectively, during 25.7 months follow-up. LBW was an independent predictor of ischemic stroke, major bleeding, ICH, and death, with a hazard ratio of 2.40, 1.79, 2.37, and 2.65, respectively. (4) Conclusions: LBW was independently associated with increased risk of adverse outcomes in Thai patients with NVAF. This should be carefully considered when balancing the risks and benefits of stroke prevention among patients with different body weights.

Background: Fixed-dose 2.5 mg of fondaparinux subcutaneous injection once daily has been recommended in treatment of non-ST-segment elevation acute coronary syndrome (NSTE-ACS) irrespective of body weight (BW). However, data on anti–factor Xa (anti-FXa) activity of fondaparinux are scarce in low-BW patients. Objective: We aimed to assess anti-FXa activity of fondaparinux in low-BW patients (BW < 50 kg) compared with normal-BW patients (BW ≥ 50 kg) who presented with NSTE-ACS. Methods: This is a prospective cohort study of patients with NSTE-ACS receiving fondaparinux. Anti-FXa activity was measured 4 hours after 2.5 mg subcutaneous injection of fondaparinux after the first 2 doses. Results: Among 87 enrolled patients, 18 (21%) had BW Conclusion and Relevance: Anti-FXa activity of the second dose of fondaparinux was higher in low-BW patients but still within the expected range.

Tandem and/or diffuse calcific coronary stenoses can present significant challenges during percutaneous coronary intervention (PCI). Often, these long lesions require treatment with multiple stents of different calibers. However, this approach can result in unfavorable outcomes. We report here a case of tandem calcific right coronary artery stenoses in a low body weight elderly lady successfully treated via the radial approach using a sheathless guide with 50 mm tapered Biomime Morph stent aided by intravascular ultrasound and rotablation.