RESUMO
Allograft function and metabolic effects of four treatment regimens, namely, methylprednisone (MP) standard dose (MP-STD), deflazacort (DFZ), MP-late steroid withdrawal (MP-LSW), and MP-very low dose (MP-VLD), were evaluated in prepubertal patients. MP was decreased by month 4 post-transplantation to 0.2 mg/kg/day in MP-STD and DFZ patients and to <0.1 mg/kg/day in MP-LSW and MP-VLD patients. Starting in month 16 post-transplant, MP was switched to DFZ in the DFZ group and totally withdrawn in the MP-LSW group. Creatinine clearance diminished in the MP-STD and MP-LSW groups from 77 +/- 6 to 63 +/- 6 ml/min/1.73 m(2)and from 103 +/- 5 to 78 +/- 3 ml/min/1.73 m(2), respectively (p < 0.01 and p < 0.001, respectively). Height increased >0.5 SDS only in the MP-LSW and MP-VLD groups. The body mass index and fat body mass for height-age increased only in the MP-STD patients (p < 0.05 and p < 0.01, respectively). Fat body mass decreased in the DFZ group (p < 0.05), total cholesterol and LDL-cholesterol increased in the MP-STD group, while LDL-cholesterol and total cholesterol/HDL-cholesterol ratio decreased in the DFZ group (p < 0.01). Lumbar spine bone mineral density (BMD) for height-age showed an increase in the MP-LSW and MP-VLD groups (p < 0.01). Our data suggest that MP-LSW and MP-VLD strategies improve linear growth, BMD, the peripheral distribution of fat, and preservation of the bone-muscle unit and maintain the normal lipid profile. The MP-LSW patients had a concerning rate of acute rejections and graft function deterioration in prepubertal patients.
Assuntos
Composição Corporal/fisiologia , Transtornos do Crescimento/prevenção & controle , Crescimento/fisiologia , Transplante de Rim/efeitos adversos , Densidade Óssea/efeitos dos fármacos , Densidade Óssea/fisiologia , Criança , Pré-Escolar , Relação Dose-Resposta a Droga , Esquema de Medicação , Feminino , Rejeição de Enxerto/induzido quimicamente , Transtornos do Crescimento/fisiopatologia , Transtornos do Crescimento/reabilitação , Humanos , Imunossupressores/uso terapêutico , Transplante de Rim/reabilitação , Vértebras Lombares/efeitos dos fármacos , Vértebras Lombares/metabolismo , Masculino , Metilprednisolona/uso terapêutico , Complicações Pós-Operatórias/prevenção & controle , Complicações Pós-Operatórias/reabilitação , Pregnenodionas/uso terapêuticoRESUMO
El crecimiento en el niño y en el adolecente es un buen indicador de salud, pero el hipocrecimiento o talla baja - y se debe insistir en ello - no es una enfermedad. Durante los últimos años se ha venido incrementando la consulta por la talla baja o corta estatura y muchas veces son los padres quienes alimentan en sus hijos las expectativas de ser más altos. Existe la creencia de que la estatura alta es sinónimo de grandeza, de éxito, o de mejor proyección social.Cuando se estudia un paciente por talla baja, el objetivo final es establecer la diferencia entre la talla baja normal y la patológica. El crecimiento estatural del niño refleja su estado de salud, sus condiciones de vida y potencial genético.
Assuntos
Humanos , Transtornos do Crescimento/diagnóstico , Transtornos do Crescimento/etiologia , Transtornos do Crescimento/fisiopatologia , Transtornos do Crescimento/reabilitação , Peso-Estatura/fisiologiaRESUMO
Este artigo apresenta uma revisäo de literatura sobre métodos de tratamento (cirúrgico ou conservador) de fraturas de côndilo mandibular em crianças e suas conseqüências (anquilose e/ou assimetria), com apresentaçäo de dois casos clínicos tratados conservadoramente com aparelhos ortopédicos funcionais
Assuntos
Humanos , Criança , Côndilo Mandibular , Fraturas Mandibulares , Ortopedia , Pediatria , Assimetria Facial , Transtornos do Crescimento/reabilitação , Fraturas MaxilomandibularesRESUMO
The benefits of nutritional supplementation, with or without psychosocial stimulation, on the growth of stunted children were evaluated. Children aged 9-24 mo with lengths less than -2 SD of the National Center for Health Statistics references (n = 129) were randomly assigned to four groups: control, nutritional supplementation, stimulation, and both interventions. A fifth group with lengths greater than -1 SD was also enrolled. Length, weight, head and arm circumferences, and triceps and subscapular skinfold thicknesses were measured on enrollment and 6 and 12 mo later. Multiple-regression analysis was used to determine the effects of the interventions in which age, sex, initial status, initial dietary intake, and several socioeconomic variables were controlled for. Stimulation had no effect on growth and there was no interaction between the interventions. After 12 mo supplemented children had significantly increased length, weight, and head circumference (all P less than 0.01). The effects of supplementation were not cumulative but occurred in the first 6 mo.
Assuntos
Alimentos Fortificados , Transtornos do Crescimento/dietoterapia , Terapia Ocupacional , Ludoterapia , Feminino , Transtornos do Crescimento/reabilitação , Humanos , Lactente , Jamaica , Masculino , Distribuição Aleatória , Análise de RegressãoRESUMO
The benefits of nutritional supplementation, with or without psychosocial stimulation, on the growth of stunted children were evaluated. Children aged 9-24 mo with lengths < -2 SD of the National Center of Health Statistics references (n = 129) were randomly assigned to four groups: control, nutritional supplementation, stimulation, and both interventions. A fifth group with lengths > -1 SD was also enrolled. Length, weight, head and arm circumferences, and triceps and subscapular skinfold thicknesses were measured on enrollment and 6 and 12 mo later. Multiple-regression analysis was used to determine the effects of the interventions in which age, sex, initial status, initial dietary intake, and several socioeconomic variables were controlled for. Stimulation had no effect on growth and there was no interaction between the interventions. After 12 mo supplemented children had significantly increased length, weight, and head circumference (all P < 0.01). The effects of supplementation were not cumulative but occurred in the first 6 mo.(AU)