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Obesity, the current pandemic, is associated with alarming rises among children and adolescents, and the forecasts for the near future are worrying. The present paper aims to draw attention to the short-term effects of the excess adipose tissue in the presence of a viral infection, which can be life-threatening for pediatric patients, given that the course of viral infections is often severe, if not critical. The COVID-19 pandemic has been the basis of these statements, which opened the door to the study of the repercussions of obesity in the presence of a viral infection. Since 2003, with the discovery of SARS-CoV-1, interest in the study of coronaviruses has steadily increased, with a peak during the pandemic. Thus, obesity has been identified as an independent risk factor for COVID-19 infection and is correlated with a heightened risk of severe outcomes in pediatric patients. We sought to determine the main mechanisms through which obesity is responsible for the unfavorable evolution in the presence of a viral infection, with emphasis on the disease caused by SARS-CoV-2, in the hope that future studies will further elucidate this aspect, enabling prompt and effective intervention in obese patients with viral infections, whose clinical progression is likely to be favorable. [ABSTRACT FROM AUTHOR]

Introduction: Antimicrobial resistance (AMR) is currently a growing concern among healthcare providers, underscoring the importance of describing the regional susceptibility profile for common microorganisms that are associated with urinary tract infections (UTIs). This knowledge serves as the foundation for proper empirical therapeutic recommendations tailored to local susceptibility patterns. Results: We found a high prevalence of ESBL-producing strains (36.9%), with Escherichia coli and Klebsiella spp. being the most prevalent isolated bacteria. Among the catheterized patients, Klebsiella spp. emerged as the primary etiology, with a significant correlation between catheterization and Proteus spp. (p = 0.02) and Providencia stuartii (p < 0.0001). We observed significant correlations between urinary catheterization and older age (68.9 ± 13.7 years vs. 64.2 ± 18.1 years in non-catheterized patients, p = 0.026) and with the presence of an isolate with extensive drug resistance (p < 0.0001) or even pandrug resistance (p < 0.0001). Susceptibility rates significantly decreased for almost all the tested antibiotics during the study period. Notably, susceptibility was markedly lower among catheterized patients, with the most pronounced differences observed for carbapenems (59.6% versus 83.4%, p < 0.0001) and aminoglycosides (37.1% versus 46.9%, p = 0.0001). Materials and Methods: We conducted a retrospective study analyzing the susceptibility profiles of 724 extended-spectrum beta-lactamases (ESBL)-producing Enterobacterales isolated from urine cultures. Our focus was on highlighting susceptibility profiles among isolates associated with urinary catheterization and assessing the shifts in the susceptibility rates over time. Conclusions: The constant rise in AMR rates among Enterobacterales presents significant challenges in treating severe infections, particularly among urinary catheterized patients. This trend leaves clinicians with limited or no effective treatment options. Consequently, the development and implementation of personalized treatment protocols are imperative to ensure efficient empirical therapies. [ABSTRACT FROM AUTHOR]

Gangliosidosis (ORPHA: 79255) is an autosomal recessive lysosomal storage disease (LSD) with a variable phenotype and an incidence of 1:200000 live births. The underlying genotype is comprised GLB1 mutations that lead to β-galactosidase deficiency and subsequently to the accumulation of monosialotetrahexosylganglioside (GM1) in the brain and other organs. In total, two diseases have been linked to this gene mutation: Morquio type B and Gangliosidosis. The most frequent clinical manifestations include dysmorphic facial features, nervous and skeletal systems abnormalities, hepatosplenomegaly, and cardiomyopathies. The correct diagnosis of GM1 is a challenge due to the overlapping clinical manifestation between this disease and others, especially in infants. Therefore, in the current study we present the case of a 3-month-old male infant, admitted with signs and symptoms of respiratory distress alongside rapid progressive heart failure, with minimal neurologic and skeletal abnormalities, but with cardiovascular structural malformations. The atypical clinical presentation raised great difficulties for our diagnostic team. Unfortunately, the diagnostic of GM1 was made postmortem based on the DBS test and we were able to correlate the genotype with the unusual phenotypic findings. [ABSTRACT FROM AUTHOR]

Background and Objectives: The aim of this research was to assess the spread of SARS-CoV-2 infection; the study was motivated by parental hesitancy regarding child vaccination, and the potential passive immunity of infants acquired through breastfeeding from mothers vaccinated against COVID-19 or infected with SARS-CoV-2. Materials and Methods: We quantified the anti-SARS-CoV-2 immunoglobulin G (IgG) titer in the serum of 743 children under 5 years old, hospitalized between 1 August 2022, and 15 September 2023. Results: Among the participants, 52.76% had an anti-SARS-CoV-2 IgG titer that exceeded the reactivity threshold of the kit used, with an average of 1558.01 U/mL across the entire group. By age-specific categories, SARS-CoV-2 antibody prevalence was 43.04% for 0–12 months, 42.22% for 12–24 months, 61.67% for 24–36 months, 65.17% for 36–48 months, and 68.55% for 48–59 months. Gender analysis revealed 55.32% male participants, with a 52.07% seropositivity rate. Notably, IgG titer correlated positively with the child's age. Gender, admission diagnosis, and emergency department presentation were not variation factors of the IgG titer. Conclusions: The majority of children in the study group demonstrated IgG against SARS-CoV-2, and this rate increased with the child's age. Also, the IgG titer increased with the child's age. [ABSTRACT FROM AUTHOR]

Among the factors incriminated in the appearance of eating disorders, intestinal microbiota has recently been implicated. Now there is evidence that the composition of gut microbiota is different in anorexia nervosa. We gathered many surveys on the changes in the profile of gut microbiota in patients with anorexia nervosa. This review comprehensively examines the contemporary experimental evidence concerning the bidirectional communication between gut microbiota and the brain. Drawing from recent breakthroughs in this area of research, we propose that the gut microbiota significantly contributes to the intricate interplay between the body and the brain, thereby contributing to overall healthy homeostasis while concurrently impacting disease risk, including anxiety and mood disorders. Particular attention is devoted to elucidating the structure and functional relevance of the gut microbiota in the context of Anorexia Nervosa. [ABSTRACT FROM AUTHOR]

This paper delineates several aspects of cystic fibrosis-related diabetes (CFRD)—a common complication of cystic fibrosis (CF). CFRD exhibits a predilection for older individuals with CF, yet it also extends its influence on children and adolescents. Scientific insights postulate a potential link between CFRD and the aberrant mucus production within the pancreas, thereby culminating in pancreatic insufficiency. This, in turn, perturbs the synthesis of insulin, a pivotal endocrine hormone responsible for the regulation of glycemic levels. Standardized protocols advocate for the systematic screening of CFRD among all individuals with CF, commencing at the age of 10 years using the oral glucose tolerance test (OGTT). Therapeutic modalities encompass insulin therapy, dietary adjustments, and the vigilant monitoring of glycemic parameters. The overarching objective is to maintain blood glucose levels within a targeted range to mitigate the advent of diabetic complications. Untreated or sub-optimally managed CFRD can precipitate a spectrum of deleterious health ramifications, encompassing cardiovascular afflictions, neuropathy, renal dysfunction, and ocular complications. [ABSTRACT FROM AUTHOR]

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The aim of the study is to identify the level of depression among parents of children diagnosed with a rare disease. Materials and methods: a number of 29 parents were included in the research. Parents had to complete the items of Beck Depression Inventory. A number of twelve questions were address and socio-demographic data were also registered. Data were processed using IBM SPSS Statistics, version 23. Results and discussion: parents have a minimal depression (M=8.27 ± 11.70). Marital status and child's age were identified to relate with the level of depression. Parents who have children aged between 6 and 12 years old score higher on BDI compared to the groups 0-6 years old or of those older than 12. Parents who registered higher scores on depression were more frequently involved in psychological or psychiatric consultations. Parents who believe the mother is more involved have higher scores on BDI. Conclusion: The support for parents having a child diagnosed with a rare disease must be offered by a multidisciplinary team and the psychological care of both children and parents must be considered. [ABSTRACT FROM AUTHOR]

Introduction: Acute otitis media (AOM) is the most frequent diagnosis of the sick children visiting clinicians' offices and the most common reason for administration of antibiotics. Method: The study included 104 patients discharged from Pediatric Clinic III - "Saint Mary's" Children's Clinical Emergency Hospital of Iasi from January 2015 to January 2017, diagnosed with "Acute otitis media". Objective: On this batch we performed a retrospective study based on the data found in the children's medical charts, by observing the risk factors to which they were exposed and that favor the illness, and also the connection between the risk factors and the occurrence of complications. Results: The risk factors for acute otitis media that we identified in this group were the cold season, male gender, premature birth, low birth weight, artificial alimentation in the first year of life, incorrect dietary diversification, child's becoming a community member, higher number of siblings, association of respiratory tract infections, of chronic diseases or immune deficiencies, allergic status, exposure to pollutants. To prevent premature and late complications, it is important to accurately specify the diagnosis and establish individualized therapy according to guidelines. It is also essential to follow up and ensure directly observed therapy for children through the collaboration of a pediatrician with the family doctor and the ENT specialist. [ABSTRACT FROM AUTHOR]

Cystic fibrosis (CF) is a very complex disease that raises significant health and social problems, being considered internationally an important public health problem. Known as a multi-organ disease that affects the following organs: salivary glands, lung, digestive tube, liver, pancreas, kidneys, reproductive organs, CF also has an impact on the oral health (structural abnormalities, abnormalities of the teeth eruption, damage to the enamel, accumulation of tartar, gingivitis, cavities, malocclusions, oropharyngeal candidiasis). The authors show the main implications of the disease at teeth level. [ABSTRACT FROM AUTHOR]

Osteo-articular disorder in cystic fibrosis is considered a common complication of this pathology. The most efficient strategies used for bone health maintenance in patients with cystic fibrosis are early recognition, prevention and correct treatment. The purpose of this study was the clinical and paraclinical evaluation of patients hospitalized in the 3rd Clinic of Pediatrics, “Sf. Maria” Children's Emergency Hospital Iasi, diagnosed with cystic fibrosis that exhibited also symptoms of osteo-articular manifestation. The results from this study support the idea that the association of treatment, calcium, multimineral supplements with appropriate hygienic-dietary regimen and with the background therapy of the disease can contribute significantly to better healthand wellbeing. Also, non-compliance to treatment among patients and their families significantly contributes to early installation of the complications, including the osteo-articular ones (even from the age of 6 years). [ABSTRACT FROM AUTHOR]

Helicobacter pylori infection is the most frequent bacterian infection and the main cause of duodenal ulcerations. The prevalence in patients with cysic fibrosis is controversial. The paper present generale data about Helicobacter pylori and the particularities of this infection in cystic fibrosis (cystic fibrosis paradox). The authors concluded that although the prevalence of Helicobacter pylori and its role in gastroduodenal disease in cystic fibrosis are controversial, however, its role should not be underestimated. [ABSTRACT FROM AUTHOR]

Cytomegalovirus infection is a major public health problem, because annually there are born increasingly more children with this infection. Numerous studies have shown that cytomegalovirus infection is an important cause of hearing loss. Cytomegalovirus infection specific symptoms present at birth are a strong predictor for hearing loss, even in populations with low maternal seroprevalence rate. The severity of deafness due to cytomegalovirus infection is variable. Pathophysiology of deafness caused by cytomegalovirus infection is not well known, the mechanisms possible involved being impaired endolymphatic structures, cytopathic effect of the virus and the host response to the inner ear structures. The relationship between viral load and increased likelihood of deafness in infants supports the role of antiviral therapy in decreasing the incidence and the severity of deafness caused by cytomegalovirus. We consider that monitoring children with congenital cytomegalovirus infection should include also hearing monitoring. [ABSTRACT FROM AUTHOR]

The aim of this paper was to discusse patient support in celiac disease, with a more attention to children. We point the physical and psychological problems related to this chronic disease and the fact that a proper medical surveillance of the patient should be doubled by strong psychological and educational guidance. Family support increases the adherence to gluten-free-diet and also assures a better quality of life. Some data also indicate that psychological stress may be involved in the development of celiac disease and primary stress and secondary stress should be taken into account regarding the therapy for this disease. Successful management of celiac disease both from the medical and the psychological aspects requires proper education of patients and their families and use the most efficient coping mechanism. Even if quality of life of these patients is relatively positive comparing to other chronic disease, patients should be empowered regarding the fact that not all symptoms will vanish after diagnosis and glutenfree-diet. [ABSTRACT FROM AUTHOR]

Frecvent, bolnavii cu afecţiuni metabolice (boli datorate dezechilibrelor electrolitice, disfuncţii endocrine, boli înnăscute de metabolism) prezintă simptome similare cu ale altor urgenţe, în particular în perioada de nounăscut şi sugar. Autorii prezintǎ principalele urgenţe: în cazul dezechilibrelor electrolitice - hipoglicemia, hiponatremia, acidoza metabolicǎ şi hipocalcemia neonatalǎ; în cazul disfuncţiilor endocrine - insufi cienţa suprarenalianǎ şi criza hipopituitarǎ neonatalǎ; în bolile înnăscute de metabolism - acidoza, hiperglicemia/ hipoglicemia, hiperamoniemia, simptomele clinice asociate acestora şi tratamentul recomandat. [ABSTRACT FROM AUTHOR]

Vegetarianismul poate avea implicații asupra creşterii copiilor şi adolescenților. Există diferite tipuri de diete vegetariene: unele pot fi adecvate pentru copii, altele deficitare în nutrienți esențiali. Dacă o dietă vegetariană este realizată adecvat şi include alimente fortifiate, poate promova starea de sănătate şi reduce riscul de boli cronice majore. Restricția sau excluderea produselor de natură animală poate conduce la aport scăzut de nutrienți esențiali. [ABSTRACT FROM AUTHOR]

Diabetul asociat fibrozei chistice este o entitate distinctă comparativ cu diabetul zaharat tip 1 şi 2, dar care are şi simptome caracteristice acestora. Odată cu prelungirea speranței de viață, şi prevalența diabetului a crescut, asociindu-se cu un declin mai sever al funcției pulmonare şi cu stare nutrițională mai precară comparativ cu ale paciențilorcu fibroză chistică, darfără diabet. Autorii prezintă date actuale cu privire la prevalența şi fiziopatologia bolii, tabloul clinic, examenele utile în stabilirea diagnosticului, posibilitățile terapeutice şi prognosticul bolii. Concluzionăm că diagnosticarea precoce şi intervențiile terapeutice adecvate pot diminua impactul negativ al diabetului asupra funcției pulmonare şi satusului nutrițional în FC. [ABSTRACT FROM AUTHOR]

Scop. Evaluarea rezultatelor Programului național de sănătate de screening neonatal pentru boli rare în partea de nord-esta României, pentru perioada 2009-2012. Metodologie. în acest studiu descriptiv transversal au fost cuprinse cohortele de nou-născuți înregistrați în perioada 2009-2012 în maternitățile din regiunea de nord-est a României. Screeningul a fost realizat pentru două boli: hipotiroidism congenital (HC) şi fenilcetonurie (PKU). Determinarea hormonului stimulant tiroidian (TSH) şi a fenilalaninei (Phe) a fost realizată prin metodă fluorimetrică. Nou-născuții la care s-au înregistrat rezultate pozitive la testele de screening (TSH peste 9 µlU/L, Phe peste 3 mg/dl) au fost supuşi retestării. Rezultate. în perioada menționată au fost incluşi în screening 76.308 nou-născuți. Au fost detectate 9 cazuri cu HC şi 5 cazuri cu PKU. Incidența HC a fost de 1: 8.478, iar pentru PKU de 1: 15.261, pentru întreaga perioadă studiată. Concluzii. Screeningul neonatal reprezintă un program important de sănătate publică care permite diagnosticarea precoce şi prevenirea consecințelor severe ale HC şi PKU. [ABSTRACT FROM AUTHOR]

Phenylketonuria has long been an incurable disease. In the last decades, early detection by newborn screening and the introduction of phenylalanine-free diet have positively influenced the neuro-psychological development of these patients. The pathogenesis of cognitive dysfunction is still unknown although there has been significant progress in understanding the disease. In literature, the emphasis is on increased concentrations of phenylalanine in the brain, as pathological substrate of mental retardation. However, in addition to phenylalanine neurotoxicity, a defi cit in neutral amino acids in the brain may be an important factor that affects cognitive function in phenylketonuria. Mental development depends on when the treatment is initiated and its continuation. In children with phenylketonuria treated early and continuously, intelligence quotient is normal, but below the average for the general population. In conclusion, the pathogenetic cascade of brain dysfunction in phenylketonuria starts with the effect of the high blood Phe concentration on metabolite transport through blood-brain barrier associated with a defi cit of neutral amine acids in the brain. Dietary phenylalanine restriction remains the treatment of choice, especially during childhood. [ABSTRACT FROM AUTHOR]

The incidence of urinary tract infections (UTIs) caused by Klebsiella pneumoniae has exhibited an increasing trend and has become a high burden for many public health systems, especially in hospital settings. Multidrug resistance associated with the production of extended-spectrum β-lactamases (ESBL) among K. pneumoniae isolates is endemic in Southeastern Europe. We retrospectively analyzed 75 cases admitted to 'St. Parascheva' Clinical Hospital of Infectious Diseases in Iasi, Romania, during the first 6 months of 2019 (January 1 to June 30), who had a confirmed diagnosis of K. pneumoniae UTI at discharge. From a total of 75 patients, 34 (45.3%) presented ESBL+K. pneumoniae. The mean age was 66 years (70.1 for the ESBL+ patients vs. 62.6 for the ESBL- patients, P=0.0365). There was a symmetrical sex distribution (37 men vs. 38 women). Of these, 22 men had ESBL+K. pneumoniae UTIs, compared to only 15 with an ESBL- strain, P=0.0087. Another risk factor for ESBL+K. pneumoniae UTIs was the presence of hospitalization in the past 6 months; 20 (58.82%) patients with ESBL+ infections were previously hospitalized, compared to only 5 (12.19%) patients with ESBL- strains, P<0.0001. The urinary catheter carriers presented an increased prevalence of ESBL+ infections (15/34 vs. 5/41, P=0.0012). Regarding mortality, ESBL+ infections caused 6 fatalities, compared to only 1 death in the ESBL- group, P=0.0166. ESBL+K. pneumoniae strains represent an important cause of healthcare-related UTIs, with a significantly higher mortality rate compared to ESBL- strains. Early identification and adequate management of the risk factors incriminated in ESBL+ UTIs should be a priority for physicians in order to limit the dissemination of the ESBL-producing strains and thus to improve the outcome of these patients. [ABSTRACT FROM AUTHOR]

Calciul reprezintă un nutriment esențial în homeostazia organismului uman, îndeosebi pentru obținerea unei mase osoase normale. El se găseşte în proporție de 99% în oase şi dinți. Cantitatea osoasă de calciu este de aproximativ 450 g la vârsta de 9-10 ani şi ajunge la 600-700 g între 18-20 ani. În prezent, este o relație clară între densitatea osoasă obținută în adolescență şi apariția la vârste tinere (nefiziologice) a osteoporozei, susținându-se că aceasta devine o afecțiune pediatrică. [ABSTRACT FROM AUTHOR]

Calcium represents an essential nutrient in the homeostasis of human body, especially for obtaining a normal bone mass. It is found in 99% in the bones and teeth. Amount of the bone calcium is approximately of 450 g at the age of 9-10 years and reach to 600-700 g between 18-20 years. Currently, it is a clear relationship between bone density obtained in adolescence and the appearance of osteoporosis at young age (non-physiological), arguing that it becomes a pediatric disease. [ABSTRACT FROM AUTHOR]

Calciul, cel mai important mineral al organismului, este un adevărat nutriment. Homeostazia acestuia este asigurată în principal de parathormon, nivelul seric al vitaminei D, de receptorii de calciu membranari şi de receptorii osoşi pentru vitamina D. Autorii prezintă date legate de aportul de calciu şi vitamina D la sugar, copil şi adolescent, precum şi factorii nutriţionali care conduc la pierderi fecale şi urinare de calciu: excesul de grăsimi, sare, oxalaţi, fi taţi, carne, cacao, cafea. Factorul genetic reprezentat prin receptorii de vitamina D de la nivel osos infl uenţează prin polimorfi smul numeric şi fenotipic în procent de 70-80% densitatea osoasă a individului, chiar sub un aport dietetic de calciu normal. [ABSTRACT FROM AUTHOR]

Fenilcetonuria (PKU) a fost mult timp o boală incurabilă. În ultimele decade, diagnosticul precoce prin screening neonatal şi introducerea dietei fără fenilalanină au infl uenţat pozitiv dezvoltarea neurologică a acestor pacienţi. Patogenia disfuncţiei cognitive este încă necunoscută, deşi s-au realizat progrese importante în cunoaşterea acestei boli. În literatură, accentul se pune pe infl uenţa concentraţiilor crescute ale fenilalaninei din creier ca substrat patologic al retardului mintal. În afara neurotoxicităţii fenilalaninei, un factor important poate fi şi defi citul aminoacizilor neutri în creier, care afectează funcţia cognitivă în fenilcetonurie. Dezvoltarea mintală depinde de momentul începerii tratamentului şi de respectarea acestuia. Copiii cu PKU trataţi precoce şi continuu vor avea coefi cientul de inteligenţă normal, dar sub media pentru populaţia generală. În concluzie, cascada patogenezei disfuncţiei cerebrale în fenilcetonurie începe cu efectul concentraţiilor sanguine crescute ale Phe asupra transportului metaboliţilor prin bariera hemato-encefalică, la care se adaugă defi citul cerebral de aminoacizi neutri. Dieta fără fenilalanină rămâne tratamentul de primă intenţie în prevenirea retardului neuropsihic. [ABSTRACT FROM AUTHOR]

First described in 1964, deafness caused by congenital cytomegalovirus infection - a major problem of public health - is today the most frequent cause of sensorineural deafness in children. The prevalence of congenital cytomegalovirus infection is between 0.2-5% worldwide, and for the sensorineural deafness is 22-41% in children with clinical symptomatic infection and 6-16% in those with asymptomatic infection. Diagnosis of congenital cytomegalovirus infection is possible if the virus is isolated during the first 3 weeks of life or if the serum IgM antibodies are found at birth or shortly after birth. After this period, the congenital infection can't be differentiated from the acquired infection, which does not associate sensorineural deafness and does not affect the cochlea. In 50% of cases the neonatal hearing screening can't detect hearing impairment because, usually, the onset of deafness is belated. Deafness caused by cytomegalovirus infection can be progressive or with late onset (at preschoolers or in the first years of school), requiring more frequent audiology monitoring (at birth, at 3, 6, 9, 12, 18, 24, 30, and 36 months and annually until school age) in order to detect and to treat deafness. Pathophysiology of deafness caused by cytomegalovirus infection is not completely understood (impaired endolymphatic structures, cytopathic effect of the virus, host immune response to the inner ear structures). Hearing loss can be unilateral (frequency of 4-8 kHz) or bilateral, and varies from medium to severe. Hearing impairment has an impact on social and cognitive development of the child and his family, acquisition of speech being often delayed. The risk of permanent sequelae in case of symptomatic infection is higher in children from mothers suffering of primary infection, but disabilities were observed also in children from mothers with non-primary infections. In children with asymptomatic congenital cytomegalovirus infection, increased virulence in the first month of life is associated with sensorineural deafness. Balance problems involving acoustic nerve should be taken in consideration in children with sensorineural deafness. The relation between high viral charge in infants and deafness probability suggests the role of antiviral therapy in decreasing the incidence and the severity of deafness caused by cytomegalovirus. Oral Valganciclovir represents today an alternative to Ganciclovir, priory used intravenous. Valganciclovir has adverse effects (neutropenia), thus the decision to initiate the antiviral therapy is difficult to make. Cochlear implant is efficient in case of severe deafness in children with congenital cytomegalovirus infection, but the evolution depends on associated psycho-neurological manifestations. [ABSTRACT FROM AUTHOR]

Obezitatea şi depresia reprezintă două probleme fundamentale de sănătate publică la nivel mondial, obezitatea pediatrică fiind alarmantă atât per se, cât şi prin riscul menținerii statutului de obez la vârsta adultă şi implicit a continuării expunerii la comorbidități. Pe de altă parte, depresia la copil este o veritabilă provocare diagnostică, dată fiind simptomatologia clinică mascată a acesteia, şi o necesitate date fiind consecințele severe ale acesteia şi, în particular, modificările patologice asupra comportamentului alimentar. Lucrarea de față îşi propune realizarea unei sinteze a literaturii de specialitate actuale cu privire la resorturile comorbidității obezitate - depresie la copil vizând interrelația şi originea etiopatogenică comună. [ABSTRACT FROM AUTHOR]

Primary obesity in children, one of the most common nutrition diseases in the world, shows particularities depending on the age regarding the risk factors, prevention and treatment. The aim of the study was the assessment of preschool patients diagnosed with primary obesity in the 3rd Clinic of Pediatrics, “Sf. Maria” Children's Emergency Hospital Iasi, in order to identify the onset of overweight/obesity and the prenatal and postnatal risk factors from the first 6 years of life involved in causing obesity. We conclude that in order to combat obesity the emphasis should be on prevention, particularly important being the measures that promote healthy eating and combat sedentariness. [ABSTRACT FROM AUTHOR]

Currently, chronic hepatitis C (HCV) is a major global problem with high impact on patients and their families. The liver influences the nutritional status through his role in the intermediary metabolism of macronutrients and micronutrients. Hepatitis C infection affect digestion and nutrient absorption, storage and metabolism, which can lead to deficiencies of vitamins, minerals and malnutrition. The authors present nutritional recommendations for children with HCV, a balanced diet of these patients containing all the nutrients is an important component of health, influencing treatment response and side effects. [ABSTRACT FROM AUTHOR]

Schizofrenia cu debut precoce şi foarte precoce, mai specific, manifestă înainte de 18, respectiv 13 ani, constituie o entitate nosologică încă insuficient explorată, ce aduce cu sine o veritabilă provocare diagnostică dată de specificităţile vârstei timpurii la care apare. Totodată, schizofrenia cu debut în copilărie şi adolescenţă se întrepătrunde cu o serie de tulburări ale dezvoltării neurocognitive, având şi o importantă susceptibilitate genetică. Întregul context de apariţie a acesteia, dificultatea detectării simptomelor psihoproductive în copilăria mică, severitatea simptomelor şi cronicizarea, impun o conduită diagnostică riguroasă şi o abordare multidisciplinară în vederea realizării terapiei optime de lungă durată şi integrării socio-familiale a pacienţilor. Lucrarea de faţă îsi propune sintetizarea datelor din litaratura de specialitate în vederea realizării unui precursor pentru cercetări viitoare ample, care să conducă la crearea unor ghiduri de abordare specifică a schizofreniei la copil şi adolescent. [ABSTRACT FROM AUTHOR]

Liver disease is an early complication in children with cystic fibrosis (CF). The clinical manifestations in hepatobiliary disease of CF include neonatal cholestasis, liver steatosis, liver fibrosis, biliary lithiasis, focal biliary cirrhosis and multilobular cirrhosis, with or without portal hypertension. Changes in the tests evaluating the liver function are inconsistent and are not correlated with the severity of the liver lesions. The diagnosis of liver disease in CF requires the presence of at least two of the following four diagnosis criteria: clinical manifestations, pathologic liver function tests, ultrasound and histologic changes. The annual follow-up to evaluate the liver function is s recommended for diagnosis of asymptomatic liver disease and early initiation of treatment with ursodeoxycholic acid. The improvement of the liver function influences life quality and increases the survival rate in patients with CF. [ABSTRACT FROM AUTHOR]

Afectarea hepatică reprezintă o manifestare precoce la copiii cu fibroză chistică (FC). Spectrul manifestărilor clinice în afectarea hepato-biliară din FC cuprinde colestaza neonatală, steatoza hepatică, fibroza hepatică, litiaza biliară, ciroza biliară focală şi ciroza multilobulară, cu sau fără hipertensiune portală. Modificarea testelor de evaluare a funcției hepatice este inconstantă şi nu se corelează cu severitatea leziunilor hepatice. Diagnosticarea bolii hepatice în FC necesită prezența a cel puțin două din cele patru criterii de diagnostic: manifestări clinice, modificarea testelor funcționale hepatice, ecografice şi anatomopatologice. Screeningul anual pentru suferința hepatică este recomandat pentru diagnosticarea bolii asimptomatice şi inițierea precoce a tratamentului cu acid ursodeoxicholic. Ameliorarea funcției hepatice influențează calitatea vieții şi creşte rata supraviețuirii la pacienții cu FC. [ABSTRACT FROM AUTHOR]

Among the factors incriminated in the appearance of eating disorders, intestinal microbiota has recently been implicated. Now there is evidence that the composition of gut microbiota is different in anorexia nervosa. We gathered many surveys on the changes in the profile of gut microbiota in patients with anorexia nervosa. This review comprehensively examines the contemporary experimental evidence concerning the bidirectional communication between gut microbiota and the brain. Drawing from recent breakthroughs in this area of research, we propose that the gut microbiota significantly contributes to the intricate interplay between the body and the brain, thereby contributing to overall healthy homeostasis while concurrently impacting disease risk, including anxiety and mood disorders. Particular attention is devoted to elucidating the structure and functional relevance of the gut microbiota in the context of Anorexia Nervosa., Competing Interests: The authors declare no conflict of interest.

Obesity is a medical and social problem with a dramatically increasing prevalence. It is important to take action since childhood to prevent and treat obesity and metabolic syndrome. Infantile obesity affects all body systems starting in childhood and continuing to adulthood. Understanding the impact of stressors on weight status may be especially important for preventing obesity. The relationship between stress, eating behavior and obesity is not fully understood. However, there is evidence that stress causes disorders in hypothalamic-pituitary-adrenal (HPA) axis, system that regulates both stress and feeding responses. Also, the response is different depending on the type of stressors. Chronic stress, especially when people live in a palatable food environment, induces HPA stimulation, excess glucocorticoids, insulin resistance, which lead to inhibition of lipid mobilization, accumulation of triglyceride and retention of abdominal fat.

Congenital duodenal stenosis is one of the most common causes of neonatal obstruction, which is frequently associated with annular pancreas and Down syndrome. Ectopic pancreas is defined as an abnormally situated pancreatic mass that lacks contact with normal pancreas. Although the association between duodenal stenosis and annular pancreas is very common, the presence of an ectopic island of pancreas in such cases is very rare. We present a case of unusual association of duodenal stenosis, jejunal ectopic pancreas in a neonate with Down syndrome.