Inverse correlation between Helicobacter pylori colonization and obesity in a cohort of inner city children.

Background: Recently, publications in adults and children have documented a potential role of Helicobacter pylori (H. pylori) in decreasing the likelihood of obesity. The present study compares the prevalence of H.

Pilot validation of objective malnutrition-inflammation scores in pediatric and adolescent cohort on chronic maintenance dialysis.

Background: In recognition of the challenges inherent with the use of single-item indices for the diagnosis of malnutrition-inflammation morbidity in pediatric dialysis patients, to enhance accuracy, we validated a composite scoring system in a pilot study. The objective malnutrition-inflammation score seeks to validate the use of a composite scoring system as a tool for assessing malnutrition-inflammation burden in a pediatric dialysis population.

Methods: We enrolled 20 patients on hemodialysis (n = 14) and peritoneal dialysis (n = 6) over a period of 12 months.

Albuminuria and diabetic nephropathy.

Albuminuria is characterized clinically as an early predictor for progression of diabetic nephropathy (DN). Proteinuria (macroalbuminuria) is the universal finding in progressive renal disease, and is viewed as a measure of the severity and determinant for diabetic renal disease progression. Albuminuria is a marker for early DN, an independent predictor for mortality, and is associated with renal and cardiovascular risks.

Ventricular tachycardia in acute fulminant myocarditis: medical management and follow-up.

The combination of ventricular tachycardia (VT) and severe left ventricular dysfunction presents a serious challenge in management of acute fulminant myocarditis (AFM). We report a case of a 17-month-old girl with AFM, presented with hypotension and VT, successfully treated with respiratory and inotropic support, high-dose intravenous immunoglobulin, and amiodarone. The myocardial function improved significantly within 2 weeks of treatment.

The Downstart Program: a hospital-based pediatric healthy lifestyle program for obese and morbidly obese minority youth.

Although obesity affects all cultures, ethnic groups and social strata, this disorder affects African Americans, Hispanics and the poor at a disproportionate rate. The Downstart Pediatric Healthy Lifestyle Program was developed to provide a multi-disciplinary behavioral modification program for inner city families in Brooklyn, New York interested in leading a healthier, more active lifestyle. The Downstart Program uses a four-pronged approach of medical evaluation, exercise, nutritional education and lifestyle modification.

The prevalence of metabolic syndrome in inner city obese African-American youth.

Background: In children and adolescents, obesity increases the risk of metabolic syndrome (MS).

Objective: We examined the prevalence of MS among obese and morbidly obese children and adolescents referred to an obesity clinic in a university-based hospital center.

Design/methods: A total of 194 obese (BMI > 95%) children and adolescents were evaluated.

Management of metabolic syndrome in morbidly obese children and adolescents.

The main goal in managing metabolic syndrome (MS) in children and adolescents is to prevent Type 2 DM and reduce the risk of future cardiovascular disease. Although frustrating and challenging for both patients and healthcare providers, the best strategy for managing MS is preventing obesity through promotion of lifestyle modifications that include weight reduction, prevention of excessive weight gain and increase physical activity. Different therapeutic options and medications for MS are discussed including side effects of each drug.

Pancreatic beta-cell hyperactivity in morbidly obese adolescents.

beta-cell hyperactivity, with increased beta-cell mass in the pancreas, contributes to insulin oversecretion in response to insulin resistance. beta-cell mass expansion, also known as "endocrine pancreas plasticity", is an adaptation to variations in insulin demand, is generally observed in obese persons and in women during late pregnancy. In obese persons, increased free fatty acids contribute to beta-cell growth.

Atrial flutter in a premature infant with a structurally normal heart.

Isolated postnatal atrial flutter (AF) with a structurally normal heart is rare in the neonatal period. Central lines have their inherent risks and are frequently used in the management of growing premature newborns. Some new antimicrobial agents do have pro-arrhythmic effects, proven in adults but with limited data available for the newborn.

Career Decision-Making among Pediatric Residents.

Background: Knowledge of the timing and process of residents' career decisionmaking could improve mentoring, career counseling and subspecialty recruitment efforts. However, knowledge about the timing of career decisions made by pediatric residents is lacking.

Objective: To examine the timing of career decision-making among pediatric residents.

Management of a large organized intraatrial catheter-tip thrombus in a child with acquired immunodeficiency syndrome using escalating tissue plasminogen activator infusions.

Objectives: To describe the dissolution of a large organized intraatrial catheter-tip thrombus using a novel aggressive dose escalation of tissue plasminogen activator infusion.

Design: Case report.

Setting: A six-bed pediatric intensive care unit (ICU) at a university hospital.

Physician assistants as physician extenders in the pediatric intensive care unit setting-A 5-year experience.

Objective: To describe the scope of practice and complementary role of physician assistants as physician extenders in the pediatric intensive care unit.

Design: Descriptive report of a 5-yr experience using a physician assistant-resident staffing model in comparison to the traditional resident-only coverage.

Setting: Six-bed pediatric intensive care unit at a tertiary care center subject to longstanding New York Hospital Code 405 restrictions on resident work hours.

Treatment of acute lymphoblastic leukemia-induced extreme hypercalcemia with pamidronate and calcitonin.

Objective: To describe extreme hypercalcemia as the presenting feature of acute lymphoblastic leukemia in an 8-yr-old girl and the combined use of pamidronate and calcitonin for its treatment.

Design: Case report.

Setting: Pediatric intensive care unit.