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Introduction: The factors that predict recurrence of fever following defervescence (DS) during febrile neutropenia (FN) episode have not been studied. The objective was to estimate the incidence and risk factors for recurrent fever (RF) in children with FN during the intensive phase of acute lymphoblastic leukemia (ALL) treatment. Methods: The study included 113 consecutive patients diagnosed with ALL. Total of 256 FN episodes in these patients between January 2016 and June 2017 were analysed retrospectively. RF was defined as recurrent febrile event with absolute neutrophil count

Necrotising enterocolitis (NEC) is often managed with a temporary enterostomy. Neonates with enterostomy are at risk of growth retardation during critical neurodevelopment. We examined their growth using z-score. We identified all patients with enterostomy from NEC in two neonatal surgical units (NSU) during January 2012-December 2016. Weight-for-age z-score was calculated at birth, stoma formation and closure, noting severely underweight as z < - 3. We compared those kept in NSU until stoma closure with those discharged to local units or home (LU/H) with a stoma. A total of 74 patients were included. By stoma closure, 66 (89%) had deteriorated in z-score with 31 (42%) being severely underweight. There was no difference in z-score at stoma closure between NSU and LU/H despite babies sent to LU/H having a more distal stoma, higher birth weight and gestational age. Babies in LU/H spent a much shorter period on parenteral nutrition while living with their stoma for longer, many needing readmission.Conclusion: Growth failure is a common and severe problem in babies living with enterostomy following NEC. z-score allowed growth trajectory to be accounted for in nutrition prescription and timing of stoma closure. Care during this period should be focused on minimising harm.What is Known:• Necrotising enterocolitis (NEC) is a life-threatening condition affecting predominately premature and very low birth weight neonates. Emergency treatment with temporary enterostomy often leads to growth failure.• There is no consensus on the optimal timing for stoma reversal, hence prolonging impact on growth during crucial developmental periods. Both malnutrition and surgical NEC are independently associated with poor neurodevelopment outcome.What is New:• Our study found growth in 89% of babies deteriorated while living with a stoma, with 42% having a weight-for-age z-score < - 3, meeting the WHO criteria of being severely underweight, despite judicial use of parenteral nutrition. Applying z-score to weight measurements will allow growth trajectory to be accounted for in clinical decisions, including nutrition prescription (both enteral and parenteral), and guide timing of stoma closure.• Surgeons who target stoma closure at a certain weight risk waiting for an indefinite period of time, during which babies' growth may falter. [ABSTRACT FROM AUTHOR]

Background: National Family Health Survey (NFHS) documented that nearly 5.8 million children (6.4%) are undernourished in India which is l/3rd of the world's share. Objective: i) To assess the concomitant prevalence of severe wasting, severe stunting and severe underweight among children 6-59 months in a rural population of Northern India. Methods: A cross-sectional study was conducted in 2 blocks of district Meerut, Uttar Pradesh during 2013-2015. A total of 70 villages were included and all children in the age group of 6-59 months were covered by house to house visits. Data on socio-demographic profile and anthropometry was collected utilizing standards methods and equipment's. The Z-scores for weight-for-height (WFH), height-for-age (HFA), and weight-for-age (WFA) were calculated using WHO child growth standards. Results: A total of 19449 children in the age group of 6-59 months from house to house survey were approached. Out of 19449 children, 464 children were excluded due to erroneous age estimation; knock knees; physically handicapped and spinal deformities. Thus, 18985 children were enrolled for the present study. The weight, height and age were available for 18474, 18595 and 18983 children. The prevalence of severe wasting, severe stunting and severe underweight was found to be 2.2%, 16.2% and 12.2%, respectively. Concomitant presence of severe wasting, severe stunting and severe underweight was found in 0.9% (171/18,463) children. Conclusion: High prevalence of severe wasting, severe stunting and severe underweight was found in children from district Meerut indicating poor nutritional status. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Relatively little has been written about the outcomes of medical stabilization, analyzed specifically across the age spectrum, in adults with severe anorexia nervosa (AN). Method We retrospectively evaluated clinical parameters relevant to acuity of illness and outcomes of early refeeding in 142 adults with severe AN, admitted for definitive inpatient medical stabilization from October 1, 2008 to December 31, 2012. Patients were categorized into three age groups: 17 to 29, 30 to 40, and 41+ years. Results The study included 142 patients with median age of 28 years old (range 17-65 years). Fifty-four percent ( n = 78) were under 30 years old, 23% ( n = 32) between 30 and 40 years old, and 23% ( n = 32) were over 40 years old. Average admission BMI did not differ among age groups, ranging from 12.7 to 13.2 kg/m2. Of the admission parameters, only low serum albumin levels (more prevalent in older patients), high international normalized ratio (INR) levels (more prevalent in younger patients), and neutropenia (more prevalent in the <30 age group) varied with age. During hospitalization, rates of bradycardia, hypoglycemia, liver dysfunction, very low %IBW, refeeding hypophosphatemia, refeeding edema, length of stay, and discharge BMI did not differ with age. Age group was associated with rate of weekly weight gain only in patients with AN-binge purge subtype. Discussion Results demonstrate medical abnormalities and response to medical stabilization in severely ill AN patients during hospitalization were mostly similar across the age span. This information should allay fears that the effect of age will make medical stabilization more difficult. © 2015 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:378-385). [ABSTRACT FROM AUTHOR]

Objective. We sought to estimate the association between severity of maternal pre-pregnancy underweight and feto-infant morbidity outcomes. Methods. Missouri maternally linked cohort records from 1989 to 1997 inclusive were analysed. Using pre-pregnancy maternal body mass index (BMI), we classified study participants into: Normal (18.5-24.9) [referent group], mild thinness (17.0-18.5), moderate thinness (16.0-16.9) and severe thinness (<16.0). We estimated the association between pre-pregnancy underweight, underweight subtypes and feto-infant morbidity outcomes using adjusted odds ratios to approximate relative risks with correction for intra-cluster correlations. Results. Fetal growth curve trajectories for the two groups became divergent as from 30 gestational weeks. Underweight mothers were at increased risk for low birthweight (OR = 1.82; 95% CI = 1.77-1.88), very low birthweight (OR = 1.41; 95% CI = 1.31-1.51), small for gestational age (OR = 1.80; 95% CI = 1.76-1.84), preterm (OR = 1.37; 95% CI = 1.33-1.40) and very preterm (OR = 1.42; 95% CI = 1.34-1.50). These risk estimates increased in a dose-effect fashion with increasing severity of underweight status except for very preterm (p for trend < 0.01). Conclusion. Pre-pregnancy underweight is a risk factor for a spectrum of feto-infant morbidity outcomes, with risk estimates being most pronounced among extremely underweight mothers. [ABSTRACT FROM AUTHOR]