Background: Exposure to cigarette smoke is causing health problems, its components are known to possess carcinogenic, mutagenic, cytotoxic or irritant properties. Prevalence of smoking in pregnant women is between 17% and 35% worldwide. Passive smoking is identified as a factor with negative impact on health, and children are especially vulnerable. Children raised in families with smokers have a higher incidence of respiratory infections, recurrent wheezing, bronchitis, nocturnal cough and asthma. The aim of this study was determination of sensitization to various allergens in children exposed to cigarette smoke compared with children not exposed to cigarette smoke.
Material and method: One-hundred eighty children treated in Pediatric Clinic 1 of Tîrgu Mureș were included in the study between 2008- 2011. The patients were divided into two groups: 50 children exposed to cigarette smoke and 130 children not exposed. Measurement of lung function was performed in children over 4 years using a spirometer. Serum specific IgE was analyzed to inhalatory and food allergens. Wheezing phenotype was determined in children younger than 4 years and exposure to cigarette smoke was evaluated based on parents' responses to questionnaires.
Results: There was a significantly greater likelihood of developing sensitivity in children exposed to tobacco smoke than in those not exposed to dermatophagoides pteronissimus, dermatophagoides farinae, milk and grass pollen.
Conclusions: During early childhood both pre- and postnatal tobacco smoke exposure has an adjuvant effect on allergic sensitization inhalatory and food allergens.
Introduction: The international literature gives us very variable data regarding sleep disorders and the complaints related to this pathology. However, interpreting these data is difficult because of the ethnical and cultural differences and the numerous possibilities of the assessments. In this paper the authors examined and evaluated the main parameters which characterize the sleep habits of a group of children in Romania, as well as the complaints related to it, which could influence the quality of sleeping.
Material and method: Distributing questionnaires amongst children in Tîrgu Mureș. We used different questionnaires, based on the Epworth and Conner’s scores, for children between 11-14 and 15-18 years and for their parents.
Results: The gender ratio was approximately equal, the height and weight of the children was within the framework of Romanian standards. The most frequent nocturnal complaints were: problems with falling asleep, agitation, awakenings during the night. The most frequent daytime complaints: fatigue when in school, difficulty waking up in the morning and mood swings. The results showed significant differences between weekday sleeping hours and weekend sleep time (p = 0.0022).
Conclusion: Sleep habits change with age, which is a physiological effect. Other factors that modify sleeping habits in a negative way and reduce the time spent sleeping, play a crucial role in the occurrence of persistent fatigue, reduced quality school performance and even of a depraved life quality.
Objective: To evaluate the anthropometric and biochemical status of children with nutritional deficiency. Methods: We have conducted a prospective study on 226 children admitted in Pediatric Clinic I, divided into two groups: one group of 49 children with nutritional deficiency (body-mass-index < -2SD) and one control group (177 children). We have followed demographic data, anthropometric indices evaluated as standard deviations (weight, height, middle upper-arm circumference, tricipital skinfold), biochemical proteic status (Insulin-like Growth Factor 1 IGF-1, albumin, total proteins). We also followed parameters of general nutritional biochemistry. Results: The mean age for underweight children was 5.8 years, lower than in the control group. The weight of the nutritional-deficient group was significantly lower than in the control group, unlike the height (p <0.001). We have also found significant differences in body-mass-index, middle upper-arm circumference and tricipital skinfold, all of them with low SDs in children with nutritional deficiency. Regarding the biochemical markers, we have found significantly higher values of transaminases (p <0.001) and lower IGF-1 (p = 0.02) and total proteins (p = 0.013) in nutritional-deficient group. Most IGF-1 values were in normal range in both groups, but with a higher percent of low values in nutritional deficient children (37.5% vs 14.2%, p = 0.0046). There were no significant differences in height, albumin, cholesterol, triglyceride and glucose levels between the two groups. Conclusions: The anthropometric measurements are the most precise methods in evaluating the nutritional status. Among the studied biochemical markers, IGF-1, total proteins and transaminases are correlated with nutritional deficiencies
Introduction: Most children with fever without source will have a self limited viral infection though a small percent will develop a serious bacterial infection (SBI) like urinary tract infection, pneumonia, bacteraemia, meningitis or sepsis. The challenge facing practitioners is to distinguish between these two groups and currently biomarkers, like C-reactive protein (CRP) and Procalcitonin (PCT), are available for this purpose. The aim of the current study was to identify SBI in infants with fever without an identifiable cause using the recently introduced “Lab-score” combining C-reactive protein, procalcitonin and urine dipstick results.
Methods: This survey is part of an observational study aimed at identifying children with fever without source at risk of SBI. Patients were recruited from the Emergency Department of Tirgu Mures Emergency Clinical County Hospital, Romania, during 2013. SBI diagnosis was based on urine, blood and cerebrospinal fluid cultures and chest radiographs. For infants, aged 7 days to 12 months, CRP and PCT were determined and the “Lab-score” was calculated. Positive and negative likelihood ratios and post test probabilities were calculated for each parameter and score.
Results: Of the ninety infants included in the study, SBI was diagnosed in nineteen (21.11%). Ten had a urinary tract infection, seven had pneumonia, one had a urinary tract infection and bacteraemia, and one had sepsis. Positive and negative likelihood ratios for CRP (.40.0 mg/L) and PCT (.0.5 ng/mL) were 10.27/0.45 and 7.07/0.24 and post-test probabilities 73%/65%. For a “Lab-score1” (.3), positive and negative likelihood ratios were 10.43/0.28, and the posttest probability was 73%.
Conclusions: In our survey the “Lab-score” proved a strong predictor for the identification of febrile infants at risk of SBI, but showed no significant difference compared with CRP and PCT which both proved equally good predictors for SBI.
Purpose: to evaluate the serum levels of micronutrients in children with nutritional disorders, and to find if there is a direct correlation between them and the anthropometric measurements. Materials and methods: the study was conducted on 125 children (0-18 years); the working group consisted in children with Z-score < -2 standard deviations for at least one anthropometric measurement, while the children without growth disorders were considered as controls. Thus, for each anthropometric measurement, we had different working/control groups that were used for the assessment of correlation with laboratory findings. We followed eight anthropometric parameters and their relation with five of the micronutrients (Ca, Mg, Fe, Zn and Cu). Results: no statistical differences were found in micronutrients serum levels between genders or provenance. Most mean serum levels of micronutrients were lower in the children with Z-scores < -2 standard deviations (except Cu). Mg and Ca were positively correlated with most of the anthropometric measurements. For Fe, Zn and Cu, we found no correlation with any of the anthropometric measures. Differences in mean serum levels were found for Mg, with lower values in children with low weight-forage and triceps-skinfold-thickness, and for Cu, with higher levels in children with low triceps-skinfold-thickness. The red blood cell indices were positively associated with Fe and Zn levels. Conclusions: correlations between the serum level of micronutrients and anthropometric evaluation scores were found for Mg and Ca, but not for Fe and Zn, which were instead directly correlated with red blood cells indices. Mg, Fe and Zn tend to present small serum values in children with growth deficits. Considering the costs, the routine evaluation of Zn and Cu serum levels in growth disorder suspicion is not justified in our geographic area.
Objectives: Our study aimed to evaluate and compare the accuracy of C-reactive protein, Procalcitonin and Interleukine-6 in identifying serious bacterial infections (SBI) in children with fever without source.
Methods: 139 children, aged 7 days to 36 months, addressing the Emergency Department from a Romanian university hospital, were prospectively enrolled during 2013. C-reactive protein, Procalcitonin and Interleukin-6 were determined for every patient. SBI diagnosis was based on cultures results and chest radiographs.
Results: 31 patients (22.3%) had SBI. C-reactive protein [AUC: 0.87 (95%CI: 0.81-0.92)] and Procalcitonin [AUC: 0.83 (95%CI: 0.76-0.89)] proved strong prediction value for SBI and performed better than Interleukin-6 [AUC: 0.77 (95%CI: 0.69-0.84)]. For the group of children with the duration of fever less than 8 hours, Interleukin- 6 was the best predictor [AUC: 0.88 (0.76-0.95)].
Conclusions: Both C-reactive protein and Procalcitonin are strong and similar predictors for SBI, and Interleukin- 6 might be a better SBI screening tool for children with shorter duration of fever.