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Children with congenital heart defects (CHD) are often short/lightweight relative to peers. Limited growth, particularly height, may reflect energy deficits impacting physical activity. Latent class analyses of growth from birth and Bruce treadmill exercise data retrospectively identified for height, weight, and body mass index z-scores growth trajectories. Linear regression models examined exercise parameters by growth trajectory, adjusting for age/sex/CHD severity. A total of 213 children with CHD (39% female, 12.1 ± 2.9 years) achieved 85.8 ± 10.1% of the predicted peak heart rate. Peak heart rate among children whose height was consistently below average (class 1) was 15.2 ± 4.9 beats/min lower than children with other height trajectories. These children also attained a lower percentage of predicted peak heart rate. Children whose weight ( p = 0.03) or body mass index ( p < 0.001) z-score increased throughout childhood had significantly lower exercise duration (mean difference 1-2 min) than children whose growth trajectories were stable or declined. Children with above-average weight or an increasing body mass index also used a higher percentage of their heart rate reserve at each submaximal exercise stage. A very low height z-score trajectory is associated with decreased exercise capacity that may increase the risk for morbidities associated with a sedentary lifestyle. Future studies should examine potential mechanisms for the observed height deficits, such as an inadequate energy supply that could impact physical activity participation, congestive heart failure, cyanosis, pubertal stage, supplemental feeding history, or familial growth patterns. Prospective studies examining growth in relation to objective measures of daily physical activity are required.

Objectives: Vitamin D affects many aspects of cartilage and skeletal development. Inconsistent findings currently exist regarding the impact of vitamin D deficiency on childhood growth. This study aims to evaluate the impact of vitamin D deficiency on childhood skeletal development by exploring long bone growth in children with healed and active rickets. Materials and methods: Forty‐four known‐age children (2 months to 12 years) with rickets and 99 without rickets were compared with modern reference data from North America. Diaphyseal lengths of children with active rickets (34.1%, 15/44), healed rickets (65.9%, 29/44), and without rickets (99/143, 69.2%) were expressed as a percentage of expected length and an average percentage value was calculated across all available long bones. Results: Combined data for all six long bones revealed that children with active rickets had achieved only 75.3% of their expected size whereas, on average, children with healed rickets had achieved 81.6% of their expected size. On average, children without skeletal evidence of rickets had achieved 83.7% of their expected size. Children with severe skeletal manifestations of active rickets had a lower average percentage of expected size (70.4%) than the remainder of children affected by the condition. Discussion Pronounced growth faltering existed in children with active rickets and affected the upper and lower limb, indicating systemic growth failures during the deficiency. Poor maternal health, early weaning and inadequate infant feeding, and lack of sunlight exposure likely contributed to the development of rickets. Complex interactions between pathological conditions, nutritional deficiencies and vitamin D deficiency may have exacerbated growth impacts. [ABSTRACT FROM AUTHOR]

Scop: evaluarea nivelelor serice de micronutrienţi la copii cu tulburări de nutriţie, şi aprecierea corelaţiei dintre acestea şi măsurătorile antropometrice. Material şi metode: Studiul a fost realizat pe 125 copii (0-18 ani); lotul de lucru a constat în copii cu scoruri Z < -2 deviaţii standard pentru cel puţin o măsurare antropometrică, copii fără tulburări de creştere fiind consideraţi lot de control. Astfel, pentru fiecare măsurare antropometrică am avut diferite loturi de lucru/control, folosite pentru evaluarea corelaţiei cu rezultatele de laborator. Am urmărit opt parametri antropometrici şi relaţia lor cu cinci micronutrienţi (Ca, Mg, Fe, Zn şi Cu). Rezultate: nu s-au găsit diferenţe semnificative între nivelurile serice de micronutrienţi nici în funcţie de sex, nici în funcţie de mediul de provenienţă. Cel mai frecvent, nivelurile serice medii de micronutrienţi au fost mici la copiii cu scoruri Z < -2 deviaţii standard (cu excepția Cu). Mg şi Ca s-au corelat pozitiv cu majoritatea măsurătorilor antropometrice. Pentru Fe, Zn şi Cu nu am găsit nici o corelaţie, cu niciuna dintre măsurile antropometrice. Diferenţe între nivelurile serice medii au fost găsite pentru Mg, cu valori mai scăzute la copii cu greutate scăzută pentru vârstă şi pliu tricipital redus, respectiv pentru Cu, cu niveluri mai ridicate la copii pliu tricipital redus. Indicii eritrocitari au fost corelaţi pozitiv cu nivelurile de Fe şi Zn. Concluzii: corelaţii între nivelul seric de micronutrienţi şi scorurile de evaluare antropometrică au fost găsite pentru Mg şi Ca, dar nu pentru Fe şi Zn, care în schimb s-au corelat direct cu indicii eritrocitari. Mg, Fe şi Zn tind să prezinte valori serice mici la copiii cu deficite de creştere. Având în vedere costurile, evaluarea de rutină a nivelurilor serice de Zn şi Cu la copii cu suspiciune de tulburări de creştere nu este justificată în zona noastră geografică.

The hypothesis that stimulant medications may cause growth deficits in children with attention deficit hyperactivity disorder (ADHD) was reevaluated in 124 children and adolescents with ADHD and 109 controls at the Massachusetts General Hospital, Boston, MA.

Skeletal abnormalities are an early and prominent feature of most mucopolysaccharide (MPS) disorders, with the degree of skeletal involvement varying between and within MPS subtypes. Most patients exhibit a constellation of radiographic abnormalities known as dysostosis multiplex, consisting of abnormally shaped vertebrae and ribs, enlarged skull, spatulate ribs, hypoplastic epiphyses, thickened diaphyses and bullet-shaped metacarpals. Thoracolumbar kyphosis or the gibbus deformity is often a key diagnostic clue. Also common are hip dysplasia, genu valgum and, later in the course of the disease, spinal cord compression, which can be life-threatening. Short stature is ubiquitous. Treatment of skeletal manifestations usually involves surgical intervention. All patients with MPS should be considered at high risk for surgical intervention requiring anaesthesia because of airway and cardiac disease manifestations. Regular imaging of the cervical, thoracic and lumbar spine, the hips and the lower extremities is recommended for patients with MPS. [ABSTRACT FROM PUBLISHER]