Journal of Pediatric Biochemistry - Volume 1, issue 4

Authors: Lopez, Luis C.

Article Type: Other

DOI: 10.3233/JPB-2011-0033

Citation: Journal of Pediatric Biochemistry, vol. 1, no. 4, pp. 277-278, 2011

Authors: Zahran, Samer M. | Hamed, Enas A. | Awean, Galia Z.A. | Abdel-Hafez, Nagla M. | Hassan, Youssef S.

Article Type: Research Article

Abstract: Burn is an injury which is not only devastating for the patients but also puts a great burden on the society by consuming enormous health care resources. Despite improvements in burn wound care and treatment, understanding the role of key pro-/anti-inflammatory cytokines in pathogenesis of burn injury, sepsis and survival requires clarification. This work aimed at measuring plasma levels of the following cytokines: leptin, tumor necrosis factor (TNF)-α, interleukin (IL)-6, transforming growth factor …(TGF)-α, and basic fibroblast growth factor (bFGF), procalcitonin (PCT) and C-reactive protein (CRP) in children with thermal burn (n=42; 22 males and 20 females with an age range of two months up to 7 years) vs. sex and age matched healthy controls (n=26; 12 males and 14 females with an age range of six months up to 8 years). The venous samples were drawn from patients at 2nd and 8th day postinjury. The relationship between measured plasma cytokines with length of hospital stay, total burn surface area (TBSA), sepsis, survival and complete blood count were investigated. The fatality rate was 28.6% (n=12). At the 2nd day of postinjury, burn cases showed significantly higher values of WBC, CRP, PCT, TNF-α, IL-6, leptin, bFGF, and TGF-α than healthy controls. At the 8th day of postinjury, sepsis caused further significant elevations of WBC, CRP, PCT, TNF-α and IL-6 levels but significantly lower TGF-α levels than cases without sepsis. At the 8th day of postinjury, patients with larger TBSA (> 30%) demonstrated significantly higher values of WBC, CRP, PCT, TNF-α, and IL-6, but significantly lower levels of bFGF and TGF-α than cases with smaller TBSA (⩽30%). At the 8th day of postinjury, non-survivors showed significantly higher levels of WBC, CRP, PCT, TNF-α and IL-6, but significantly lower levels of leptin, bFGF, and TGF-α than survivors. Correlation studies showed significant positive correlation between TBSA and each of IL-6, TNF-α and leptin levels. Except for bFGF and TGF-α levels that were reduced, the increases in other parameters (PCT, TNF-α and IL-6) were directly proportionate to the burn severity, sepsis and fatality. Both bFGF and TGF-α correlated with poor prognostic burn healing in severe septic cases. PCT and/or IL-6 are valuable biomarkers for early detection of burn infections. TGF-α, bFGF and leptin being immuno- and angiogenic modulators might reduce inflammation and post-burn immune dysfunction and enhance burn healing. Show more

Keywords: Pediatric thermal burns, sepsis, C-reactive protein, transforming growth factor-α, tumor necrosis factor-α, interleukin-6, leptin, procalcitonin, basic fibroblast growth factor

DOI: 10.3233/JPB-2011-0029

Citation: Journal of Pediatric Biochemistry, vol. 1, no. 4, pp. 279-288, 2011

Authors: Matarazzo, Patrizia | Tuli, Gerdi | Verna, Francesca | Tessaris, Daniele | Fiore, Ludovica | Mussa, Alessandro | Repici, Marialia | Lala, Roberto

Article Type: Research Article

Abstract: Hyponatremia and hypernatremia, common electrolyte abnormalities in children hospitalized for intracranial diseases, are life-threatening events. Diagnosis and adequate treatment of hypo- and hypernatremia are mandatory to prevent neurological sequelae. We report ante-and post-hypophyseal dysfunctions, disabilities and acute sodium metabolism derangements in 16 children affected by hypothalamic-hypophyseal tumors treated by neurosurgery and/or chemotherapy during a long-lasting follow-up. We compare acute hypo- and hypernatremic episodes during surgery between these patients, treated with a …specific hormonal and infusive protocol (protocol A), and a previous cohort of patients, affected by similar tumors, treated with a previously published protocol (protocol B). All patients showed multiple or isolated pituitary dysfunctions and disabilities before chemotherapy and/or surgical treatment that worsened during the follow-up period. We found a statistical significant decrease of hyponatremic intra-operative acute events in children treated with protocol A. Sodium metabolism derangements complicating the course of hypothalamic-hypophyseal tumors can be partially prevented with specific per-operative protocols. Aim of this study is to present a new sodium metabolism derangements management in children treated for hypothalamic-hypophyseal tumors and to compare this with a previous one. Show more

Keywords: Sodium metabolism derangements, diabetes insipidus, SIADH, children, hypothalamic-hypophyseal tumors

DOI: 10.3233/JPB-2011-0030

Citation: Journal of Pediatric Biochemistry, vol. 1, no. 4, pp. 289-296, 2011

Authors: Dhelaria, Anshoo | Commondoor, Raghuram | Kar, Ananya | Eisenhut, Michael

Article Type: Research Article

Abstract: Objectives of this study were to investigate the characteristics of metabolic acidosis associated with rotavirus gastroenteritis and to explore them as a tool in the management of dehydration. The study was retrospective, case record based and conducted in a secondary level District General Hospital. Included study population were 133 children who were admitted to the Paediatric Unit with rotavirus gastroenteritis. Degree of dehydration, result of blood gas analysis, C-reactive protein level, urinary ketones, renal function tests, …fluid management and duration of hospitalization were recorded and results compared between patients with and without severe metabolic acidosis (serum bicarbonate < 17 mmol/L). Out of 133 patients, blood gas analysis was obtained in 78 (59%) and 73 (94%) of those showed metabolic acidosis (bicarbonate < 22 mmol/L). Thirty five patients developed severe metabolic acidosis. Patients with severe metabolic acidosis showed signs of dehydration more commonly (97% vs. 74%, p< 0.05) and required intravenous rehydration more frequently (94% vs. 63%, p< 0.05) than those who were not severely acidotic. With respect to gender ratio, initial temperature, serum levels of C-reactive protein, chloride, anion-gap, lactate and ketonuria, there were no significant differences between the severely acidotic patients and those who were not. Urea and creatinine levels were higher (46.6 (11.7) versus 37.8 (11.9) micromole/L for creatinine and 5.5 (1.9) versus 4.2 (2.1) mmol/L for urea, p< 0.05) in patients with severe metabolic acidosis and correlated significantly negatively (for both: r=− 0.29, p=0.02) with serum bicarbonate levels. We concluded that the majority of children attending hospital with rotavirus gastroenteritis had a metabolic acidosis. Severe metabolic acidosis was associated with more severe dehydration and higher urea and creatinine levels and increased requirement for intravenous fluid boluses and intravenous rehydration. A bicarbonate level of > 17 mmol/L excluded severe clinical dehydration and below this level a degree of dehydration was very likely. Show more

Keywords: Metabolic acidosis, rotavirus, dehydration, gastroenteritis

DOI: 10.3233/JPB-2011-0032

Citation: Journal of Pediatric Biochemistry, vol. 1, no. 4, pp. 297-301, 2011

Authors: Tungtrongchitr, Rungsunn | Phonrat, Benjaluck | Yamborisut, Uruwan | Popruk, Supaluk | Tungtrongchitr, Anchalee

Article Type: Research Article

Abstract: In order to evaluate the mechanism of disturbance of melanocortin signaling in different groups of Thai children and adolescents classified according to body mass index (BMI) percentile for age by The Centers for Disease Control and Prevention (CDC) growth charts, and α-melanocortin stimulating hormone (α-MSH), soluble leptin receptor and melanocortin −4 receptor (MC4R) polymorphism were studied. 149 male and 127 female children and adolescent Thai subjects with age range between 5–19 years were selected. Statistically …significant difference of serum leptin receptor concentration between under weight (< 5th percentile), possible at risk for underweight (between 5th and 15th percentile), probably healthy (between 15th and 85th percentile); at risk for overweight (between the 85th and 95th percentile) and overweight (over the 95th percentile) were found. The levels of α-MSH were not significantly different when comparing the groups. Heterozygous of MC4R polymorphism (Val103Ile) were found in underweight, possible at risk for underweight and probably healthy group which might have been the cause of lower BMI for age even they have had normal serum α-MSH concentration. Using the logistic regression analysis, the group of risk for being overweight and overweight was statistically significant with α-MSH. This study supported a positive correlation between α-MSH and BMI with ages of Thai children and adolescents group. Show more

Keywords: α-melanocortin stimulating hormone, soluble leptin receptor, melanocortin -4 receptor, body mass index

DOI: 10.3233/JPB-2011-0034

Citation: Journal of Pediatric Biochemistry, vol. 1, no. 4, pp. 303-308, 2011

Authors: Miller, Jr, Robert R.

Article Type: Research Article

Abstract: As the incidence of both type-1 and type-2 diabetes increases, more diabetes-related complications are being observed in pediatric patients. However, some diabetes-related issues in pediatric patients may be a carry-over or consequence of gestational or fetal diabetes. Elevated maternal glucose levels have been associated with increased incidence of spontaneous abortions, perinatal mortality, stillbirths, and congenital malformations. A few of these congenital malformations (embryopathy) in both humans and animals include skin discoloration; webbed …toes; cleft lips and palates; congenital heart defects; and neural tube defects. While neural tube defects and congenital heart defects are the most frequent consequence of embryonic / fetal hyperglycemia, hyperglycemia-induced hepatic and renal developmental problems are also known. Hyperglycemia-induced embryopathy has been associated with reduced cell proliferation, oxidative-stress, increased rates of lipid peroxidation coupled with increased homocysteine levels, and apoptosis. Consequently, this review discusses embryonic hyperglycemia-induced reduced embryo viability, increased rates of oxidative-stress, increased lipid peroxidation rates coupled with elevated homocysteine levels, and increased apoptosis rates. Show more

Keywords: Hyperglycemia, diabetes, embryopathy, oxidative-stress, lipid peroxidation, homocysteine, apoptosis

DOI: 10.3233/JPB-2011-0027

Citation: Journal of Pediatric Biochemistry, vol. 1, no. 4, pp. 309-324, 2011

Authors: Anil, Nidhi | Singh, Meenu

Article Type: Research Article

Abstract: Nitric oxide (NO) is a ubiquitous messenger molecule with multiple roles in cellular physiology and signaling. Recent studies have indicated the role of NO as an inflammatory mediator and as a potential non invasive biomarker. The current review focuses on the role of nitric oxide and its derivatives including nitrites as potential non invasive biomarkers for assessing airway inflammation in respiratory disorders including asthma, bronchiectasis, cystic fibrosis and chronic obstructive pulmonary disease.

Keywords: Nitric oxide, nitrite, biomarkers, airway inflammation

DOI: 10.3233/JPB-2011-0028

Citation: Journal of Pediatric Biochemistry, vol. 1, no. 4, pp. 325-329, 2011

Authors: Rehman, Abdul

Article Type: Research Article

Abstract: Hepatitis C virus infection (HCV) in children is not similar to that in adults in many ways. The knowledge of the disease in children is scanty. This review discusses the disease in children.

Keywords: Route of infection, perinatal infection, histopathology, clinical outcome, autoimmunity, liver biopsy

DOI: 10.3233/JPB-2011-0031

Citation: Journal of Pediatric Biochemistry, vol. 1, no. 4, pp. 331-338, 2011