1
|
Andrews SM, Panjwani AA, Potter SN, Hamrick LR, Wheeler AC, Kelleher BL. Specificity of Early Childhood Hyperphagia Profiles in Neurogenetic Conditions. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2024; 129:175-190. [PMID: 38657964 DOI: 10.1352/1944-7558-129.3.175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 10/10/2023] [Indexed: 04/26/2024]
Abstract
Hyperphagia is highly penetrant in Prader-Willi syndrome (PWS) and has increasingly been reported in other neurogenetic conditions (NGC). The Hyperphagia Questionnaire (HQ) was completed by caregivers of 4-8-year-olds with PWS (n = 17), Angelman syndrome (AS; n = 22), Williams syndrome (WS; n = 25), or low-risk controls (LRC; n = 35). All NGC groups were significantly elevated in HQ Total and Behavior scores compared to LRC. Only AS and WS were significantly elevated in the Drive domain, and only PWS in the Severity domain. After controlling for externalizing behavior, HQ Total scores were higher for PWS relative to other groups. Hyperphagic symptoms may not differentiate PWS from other NGCs in early childhood. However, hyperphagic phenotypes may be most severe in PWS. Further investigation of these profiles may inform etiology and syndrome-specific treatments.
Collapse
|
2
|
Zorn S, von Schnurbein J, Schirmer M, Brandt S, Wabitsch M. Measuring hyperphagia in patients with monogenic and syndromic obesity. Appetite 2022; 178:106161. [PMID: 35809703 DOI: 10.1016/j.appet.2022.106161] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 06/07/2022] [Accepted: 07/03/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND Hyperphagia is a key symptom in patients with monogenic obesity, but the assessment is challenging. OBJECTIVES We aimed to investigate the applicability of Dykens' Hyperphagia Questionnaire in patients with monogenic and syndromic obesity to assess the quality and severity of hyperphagia, and to compare our results with those reported in the literature. METHODS Patients with biallelic leptin receptor variants (LEPR, n = 8), heterozygous melanocortin-4 receptor variants (MC4R, n = 7) and 16p11.2 deletions, leading to a deletion of the Src homology 2B adaptor protein gene (n = 5) were included in the study. Hyperphagia was assessed by the parent-based, 13-item hyperphagia questionnaire from Dykens et al. (2007). A literature research was performed to identify published hyperphagia scores assessed by Dykens' Hyperphagia Questionnaire. RESULTS The total hyperphagia scores were similar in patients with biallelic LEPR and monoallelic MC4R variants (32.0 ± 9.3 vs. 31.4 ± 5.4), but significantly lower in patients with 16p11.2 deletions (21.4 ± 5.5, p < 0.05). Compared to patients with syndromic obesity (27.6 ± 9.0) from the literature, patients with LEPR and MC4R variants had higher total hyperphagia scores. Total hyperphagia scores in patients with 16p11.2 deletions were lower than for patients with other syndromic obesity forms (21.4 ± 5.5 vs. 24.6 ± 8.1), but similar to those for individuals with obesity without a genetic cause (22.9 ± 7.2). CONCLUSIONS Dykens' Hyperphagia Questionnaire seems to be a useful tool to assess hyperphagic behaviour in patients with monogenic and syndromic obesity.
Collapse
Affiliation(s)
- Stefanie Zorn
- Center for Rare Endocrine Diseases, Division of Paediatric Endocrinology and Diabetes, Department of Paediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm, Germany
| | - Julia von Schnurbein
- Center for Rare Endocrine Diseases, Division of Paediatric Endocrinology and Diabetes, Department of Paediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm, Germany
| | - Melanie Schirmer
- Center for Rare Endocrine Diseases, Division of Paediatric Endocrinology and Diabetes, Department of Paediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm, Germany
| | - Stephanie Brandt
- Center for Rare Endocrine Diseases, Division of Paediatric Endocrinology and Diabetes, Department of Paediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm, Germany
| | - Martin Wabitsch
- Center for Rare Endocrine Diseases, Division of Paediatric Endocrinology and Diabetes, Department of Paediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm, Germany.
| |
Collapse
|
3
|
Gupta M, Phan TLT, Bunnell HT, Beheshti R. Obesity Prediction with EHR Data: A deep learning approach with interpretable elements. ACM TRANSACTIONS ON COMPUTING FOR HEALTHCARE 2022; 3:32. [PMID: 35756858 PMCID: PMC9221869 DOI: 10.1145/3506719] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Accepted: 12/01/2021] [Indexed: 06/07/2023]
Abstract
Childhood obesity is a major public health challenge. Early prediction and identification of the children at an elevated risk of developing childhood obesity may help in engaging earlier and more effective interventions to prevent and manage obesity. Most existing predictive tools for childhood obesity primarily rely on traditional regression-type methods using only a few hand-picked features and without exploiting longitudinal patterns of children's data. Deep learning methods allow the use of high-dimensional longitudinal datasets. In this paper, we present a deep learning model designed for predicting future obesity patterns from generally available items on children's medical history. To do this, we use a large unaugmented electronic health records dataset from a large pediatric health system in the US. We adopt a general LSTM network architecture and train our proposed model using both static and dynamic EHR data. To add interpretability, we have additionally included an attention layer to calculate the attention scores for the timestamps and rank features of each timestamp. Our model is used to predict obesity for ages between 3-20 years using the data from 1-3 years in advance. We compare the performance of our LSTM model with a series of existing studies in the literature and show it outperforms their performance in most age ranges.
Collapse
|
4
|
Wernio E, Kłosowska A, Kuchta A, Ćwiklińska A, Sałaga-Zaleska K, Jankowski M, Kłosowski P, Wiśniewski P, Wierzba J, Małgorzewicz S. Analysis of Dietary Habits and Nutritional Status of Children with Down Syndrome in the Context of Lipid and Oxidative Stress Parameters. Nutrients 2022; 14:nu14122390. [PMID: 35745122 PMCID: PMC9231028 DOI: 10.3390/nu14122390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/06/2022] [Accepted: 06/06/2022] [Indexed: 01/21/2023] Open
Abstract
Introduction: The risk of obesity in children with Down syndrome is high. Undoubtedly, proper nutrition plays an important role in the prevention of excess body weight and is associated with a reduction of metabolic complications. The aim of the study was to assess the problem of disturbances in the nutritional status and eating habits of children with DS. Methods: A total of 39 patients were included in the study. The nutritional status was assessed by anthropometric tests and Dual X-ray Absorptiometry. Eating habits were assessed using the Child Eating Behavior Questionnaire and the Food Frequency Questionnaire. Blood samples were taken to determine the oxidative stress and lipid parameters. Results: Obesity was recognized in 15% of subjects and 23% were overweight. Children that were overweight were characterized by higher levels of triglycerides, atherogenic index of plasma, and apoA2 and apoE levels. Fat mass, fat mass/height2 index, and visceral fat mass correlated with thiobarbituric acid reactive substances and advanced oxidative protein product level. The analysis of the Child Eating Behavior Questionnaire showed that children struggling with being overweight were more interested in food compared to those with normal body weight. A positive correlation was identified between waist circumference and food interest categories. Insufficient consumption of dairy products, vegetables, whole grain products, as well as fruits, seeds, nuts, and fatty fish was noted. Patients were less likely to consume products that are a good source of mono- and polyunsaturated fatty acids. Conclusions: In children with Down syndrome and obesity, disturbances in lipid and oxidative stress parameters are observed. Abnormal eating habits in all children with Down syndrome regardless of their nutritional status were noted. Proper nutritional education, nutritional control, and management of metabolic problems are essential in this group of patients.
Collapse
Affiliation(s)
- Edyta Wernio
- Department of Clinical Nutrition, Medical University of Gdansk, 80-211 Gdansk, Poland;
- Correspondence:
| | - Anna Kłosowska
- Department of Pediatrics, Hematology and Oncology, Medical University of Gdansk, 80-211 Gdansk, Poland;
| | - Agnieszka Kuchta
- Department of Clinical Chemistry, Medical University of Gdansk, 80-211 Gdansk, Poland; (A.K.); (A.Ć.); (K.S.-Z.); (M.J.)
| | - Agnieszka Ćwiklińska
- Department of Clinical Chemistry, Medical University of Gdansk, 80-211 Gdansk, Poland; (A.K.); (A.Ć.); (K.S.-Z.); (M.J.)
| | - Kornelia Sałaga-Zaleska
- Department of Clinical Chemistry, Medical University of Gdansk, 80-211 Gdansk, Poland; (A.K.); (A.Ć.); (K.S.-Z.); (M.J.)
| | - Maciej Jankowski
- Department of Clinical Chemistry, Medical University of Gdansk, 80-211 Gdansk, Poland; (A.K.); (A.Ć.); (K.S.-Z.); (M.J.)
| | - Przemysław Kłosowski
- Department of Endocrinology and Internal Medicine, Medical University of Gdansk, 80-211 Gdansk, Poland; (P.K.); (P.W.)
| | - Piotr Wiśniewski
- Department of Endocrinology and Internal Medicine, Medical University of Gdansk, 80-211 Gdansk, Poland; (P.K.); (P.W.)
| | - Jolanta Wierzba
- Department of Internal and Pediatric Nursing, Institute of Nursing and Midwifery, Medical University of Gdansk, 80-211 Gdansk, Poland;
| | - Sylwia Małgorzewicz
- Department of Clinical Nutrition, Medical University of Gdansk, 80-211 Gdansk, Poland;
| |
Collapse
|
5
|
Chaves E, Reddy SD, Cadieux A, Tomasula J, Reynolds K. The Continued Impact of the COVID-19 Pandemic on Pediatric Obesity: A Commentary on the Return to a Healthy New "Normal". INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5597. [PMID: 35564991 PMCID: PMC9103242 DOI: 10.3390/ijerph19095597] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/24/2022] [Accepted: 04/26/2022] [Indexed: 12/04/2022]
Abstract
Two years into this pandemic, mental health symptoms are more prevalent in children and adolescents, routine wellness visits have decreased, individuals and families are experiencing increased stress, and food and nutrition insecurity are on the rise. Pediatric overweight and obesity are yet another health condition that has been impacted by the pandemic. The current commentary aims to (a) summarize a variety of factors contributing to worsening obesity and healthy lifestyle choices in youth throughout the pandemic and to (b) provide recommendations for healthcare providers on navigating this challenge. Specific health behaviors, such as increased sedentary behavior, decreased physical activity, a change to families' home-food environments, and an increase in sleep dysregulation have contributed to increased weight gain in children and adolescents. As uncertainty continues with the advent of various COVID-19 variants, it remains important to consider how the pandemic has impacted pediatric overweight and obesity.
Collapse
Affiliation(s)
- Eileen Chaves
- Nationwide Children’s Hospital, The Ohio State University, Columbus, OH 43205, USA
| | - Sheethal D. Reddy
- Children’s Pediatric Institute, Emory University, Atlanta, GA 30322, USA;
| | - Adelle Cadieux
- Helen DeVos Children’s Hospital, Michigan State University, Grand Rapids, MI 49503, USA;
| | | | - Kimberly Reynolds
- Institute on Development and Disability, Oregon Health & Science University, Portland, OR 97239, USA;
| |
Collapse
|
6
|
Yuan Y, Ding J, Wang C, Zhang S, Wang Y, Liu Y, Liu J. The after-school sedentary behavior status among children and adolescents with intellectual disabilities. Front Psychiatry 2022; 13:1049180. [PMID: 36532201 PMCID: PMC9751425 DOI: 10.3389/fpsyt.2022.1049180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 11/17/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND There is evidence that the after-school period plays an essential role in accumulating sedentary behavior (SB) among children and adolescents, as well as implementing potential interventions. However, relatively little is known regarding SB status of children and adolescents with intellectual disabilities (ID) during the after-school period. The purpose of this study was to investigate the total level and specific pattern of the after-school SB among children and adolescents with ID. METHODS The after-school SB status among 325 children and adolescents with ID was evaluated by the parent-reported Children's Leisure Activities Study Survey-Chinese edition questionnaire. RESULTS Parents of children and adolescents with ID reported approximately 204 min/day of after-school SB. Specifically, the longest time of the after-school period was spent performing the screen-based SB (84 mins/d). This was followed by recreational SB and educational SB (50 and 30 mins/d, respectively). The children aged 6-12 years old engaged more time in recreational SB than adolescents aged 16-18 years old (p < 0.05) during the after-school period. Further, the data indicated that 37.5% of children and adolescents with ID achieved the guideline limitation of 2-h-maximum screen-based SB during the after-school hour. CONCLUSION Children and adolescents with ID spent a large portion of the after-school period in SB, particularly engaged in more time on after-school screen-based SB. Future efforts should focus on developing and implementing period-specific interventions designed to reduce after-school SB in the segment of this population.
Collapse
Affiliation(s)
- Yaqing Yuan
- Division of Sports Science and Physical Education, Tsinghua University, Beijing, China.,College of Sports and Health, Shandong Sport University, Jinan, Shandong, China
| | - Jianing Ding
- Department of Physical Education, Fujian Agriculture and Forestry University, Fuzhou, Fujian, China
| | - Chao Wang
- Department of Health Management, Yongan Prison of Fujian Province, Yongan, Fujian, China
| | - Shaohua Zhang
- Department of Physical Education, China Disabled Persons' Federation, Beijing, China
| | - Yinping Wang
- Beijing Tongzhou Nationalities Primary School, Beijing, China
| | - Yang Liu
- Department of Physical Education, Shandong Jianzhu University, Jinan, Shandong, China
| | - Jingmin Liu
- Division of Sports Science and Physical Education, Tsinghua University, Beijing, China
| |
Collapse
|
7
|
Distinct Basal Metabolism in Three Mouse Models of Neurodevelopmental Disorders. eNeuro 2021; 8:ENEURO.0292-20.2021. [PMID: 33820803 PMCID: PMC8174051 DOI: 10.1523/eneuro.0292-20.2021] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 02/27/2021] [Accepted: 03/15/2021] [Indexed: 02/06/2023] Open
Abstract
Prevalence of metabolic disturbances is higher among individuals with neurodevelopmental disorders (NDDs), yet this association has been largely overlooked. Investigation into human disease remains challenging, as a complete pathophysiological understanding relies on accurate modeling and highly controlled variables. Genetically engineered mouse models are widely used to gain insight into the biology of human NDDs, but research focus has been on behavioral and neurophysiological abnormalities. Such models not only allow for evaluating usefulness in reproducing human features, including similarities and discrepancies with rodent phenotypes, but they also represent a unique opportunity to observe and quantify novel anomalies. Here, we present the first characterization and comparison of basal metabolism in three mouse models of NDDs, namely, Down syndrome (DS; Dp(16)Yey/+ mice), 16p11.2 deletion syndrome (16pDel; 16p11.2df/+ mice), and fragile X syndrome [FXS; Fmr1 knock-out (KO) mice] and their wild-type (WT) counterparts. Using the Comprehensive Lab Animal Monitoring System (CLAMS) coupled to EchoMRI, as well as quantification of key plasma metabolites by liquid chromatography mass spectrometry (LC-MS), our in vivo study reveals that each mouse model expresses a unique metabolic signature that is sex-specific, independent of the amount of food consumed and minimally influenced by physical activity. In particular, we identify striking differences in body composition, respiratory exchange ratio (RER), caloric expenditure (CE), and concentrations of circulating plasma metabolites related to mitochondrial function. Providing novel insight into NDD-associated metabolic alterations is an essential prerequisite for future preclinical and clinical interventions.
Collapse
|
8
|
Hendrix JA, Amon A, Abbeduto L, Agiovlasitis S, Alsaied T, Anderson HA, Bain LJ, Baumer N, Bhattacharyya A, Bogunovic D, Botteron KN, Capone G, Chandan P, Chase I, Chicoine B, Cieuta-Walti C, DeRuisseau LR, Durand S, Esbensen A, Fortea J, Giménez S, Granholm AC, Hahn LJ, Head E, Hillerstrom H, Jacola LM, Janicki MP, Jasien JM, Kamer AR, Kent RD, Khor B, Lawrence JB, Lemonnier C, Lewanda AF, Mobley W, Moore PE, Nelson LP, Oreskovic NM, Osorio RS, Patterson D, Rasmussen SA, Reeves RH, Roizen N, Santoro S, Sherman SL, Talib N, Tapia IE, Walsh KM, Warren SF, White AN, Wong GW, Yi JS. Opportunities, barriers, and recommendations in down syndrome research. TRANSLATIONAL SCIENCE OF RARE DISEASES 2021; 5:99-129. [PMID: 34268067 PMCID: PMC8279178 DOI: 10.3233/trd-200090] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Recent advances in medical care have increased life expectancy and improved the quality of life for people with Down syndrome (DS). These advances are the result of both pre-clinical and clinical research but much about DS is still poorly understood. In 2020, the NIH announced their plan to update their DS research plan and requested input from the scientific and advocacy community. OBJECTIVE The National Down Syndrome Society (NDSS) and the LuMind IDSC Foundation worked together with scientific and medical experts to develop recommendations for the NIH research plan. METHODS NDSS and LuMind IDSC assembled over 50 experts across multiple disciplines and organized them in eleven working groups focused on specific issues for people with DS. RESULTS This review article summarizes the research gaps and recommendations that have the potential to improve the health and quality of life for people with DS within the next decade. CONCLUSIONS This review highlights many of the scientific gaps that exist in DS research. Based on these gaps, a multidisciplinary group of DS experts has made recommendations to advance DS research. This paper may also aid policymakers and the DS community to build a comprehensive national DS research strategy.
Collapse
Affiliation(s)
| | - Angelika Amon
- Deceased. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA; Department of Biology, Massachusetts Institute of Technology, Cambridge, MA, USA; Howard Hughes Medical Institute, Chevy Chase, MD, USA
| | - Leonard Abbeduto
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA, USA; MIND Institute, University of California, Davis, CA, USA
| | | | - Tarek Alsaied
- Heart Institute Department of Pediatrics Cincinnati Children’s Hospital Medical Center University of Cincinnati, Cincinnati, OH, USA
| | | | | | - Nicole Baumer
- Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA; Down Syndrome Program, Developmental Medicine Center, Boston Children’s Hospital, Boston, MA, USA
| | - Anita Bhattacharyya
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
- Department of Cell and Regenerative Biology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Dusan Bogunovic
- Department of Microbiology, Icahn School of Medicine at Mt. Sinai, New York, NY, USA; Department of Pediatrics, Icahn School of Medicine at Mt. Sinai, New York, NY; Precision Immunology Institute, Icahn School of Medicine at Mt. Sinai, New York, NY, USA; Mindich Child Health and Development Institute, Icahn School of Medicine at Mt. Sinai, New York, NY, USA
| | - Kelly N. Botteron
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | | | - Priya Chandan
- Department of Neurosurgery, Division of Physical Medicine and Rehabilitation, University of Louisville School of Medicine, Louisville, KY, USA
| | - Isabelle Chase
- Department of Pediatric Dentistry, Boston Children’s Hospital, Boston, MA, USA
| | - Brian Chicoine
- Advocate Medical Group Adult Down Syndrome Center, Park Ridge, IL, USA
| | | | | | | | - Anna Esbensen
- Department of Pediatrics, University of Cincinnati College of Medicine & Division of Developmental and Behavioral Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Juan Fortea
- Barcelona Down Medical Center, Fundació Catalana de Síndrome de Down, Barcelona, Spain; Sant Pau Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain; Center of Biomedical Investigation Network for Neurodegenerative Diseases, Madrid, Spain
| | - Sandra Giménez
- Multidisciplinary Sleep Unit, Respiratory Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Ann-Charlotte Granholm
- Knoebel Institute for Healthy Aging, University of Denver, Denver, CO, USA
- Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
| | - Laura J. Hahn
- Department of Speech and Hearing Science, University of Illinois Urbana Champaign, Champaign, IL, USA
| | - Elizabeth Head
- Department of Pathology and Laboratory Medicine, UC Irvine School of Medicine, Orange, CA, USA
| | | | - Lisa M. Jacola
- Department of Psychology, St Jude Children’s Research Hospital, Memphis, TN, USA
| | | | - Joan M. Jasien
- Division of Pediatric Neurology, Duke University Health System, Durham, NC, USA
| | - Angela R. Kamer
- Department of Periodontology and Implant Dentistry, New York University, College of Dentistry, New York, NY, USA
| | - Raymond D. Kent
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Bernard Khor
- Benaroy Research Institute at Virginia Mason, Seattle, WA, USA
| | - Jeanne B. Lawrence
- Department of Neurology, University of Massachusetts Medical School, Worcester, MA, USA; Department of Pediatrics, University of Massachusetts Medical School, Worcester, MA, USA
| | | | - Amy Feldman Lewanda
- Children s National Rare Disease Institute, Children’s National Health System, Washington, DC., USA
| | - William Mobley
- Department of Neurosciences, University of California, San Diego, CA, USA
| | - Paul E. Moore
- Division of Allergy, Immunology, and Pulmonology, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Nicolas M. Oreskovic
- Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA; Department of Internal Medicine, Massachusetts General Hospital, Boston, Mass
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Ricardo S. Osorio
- Center for Brain Health, Department of Psychiatry, NYU Langone Medical Center, New York, NY, USA
| | - David Patterson
- Knoebel Institute for Healthy Aging, University of Denver, Denver, CO, USA
- Eleanor Roosevelt Institute, University of Denver, Denver, CO, USA; Department of Biological Sciences, University of Denver, Denver, CO, USA; Molecular and Cellular Biophysics Program, University of Denver, Denver, CO, USA
| | - Sonja A. Rasmussen
- Department of Pediatrics, University of Florida College of Medicine, Gainesville, FL; Department of Epidemiology, University of Florida College of Public Health and Health Professions and College of Medicine, Gainesville, FL
| | - Roger H. Reeves
- Department of Physiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nancy Roizen
- Department of Pediatrics, UH/Rainbow Babies and Children’s Hospital and Department of Pediatrics, Case Western Reserve University, Cleveland, OH, USA
| | - Stephanie Santoro
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
- Down Syndrome Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA
| | - Stephanie L. Sherman
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, USA
| | - Nasreen Talib
- Division of General Pediatrics, Children’s Mercy Kansas City, 2401 Gillham Road, Kansas City, MO, USA
| | - Ignacio E. Tapia
- Sleep Center, Division of Pulmonary Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Kyle M. Walsh
- Division of Neuro-epidemiology, Department of Neurosurgery, Duke University, Durham, NC, USA
| | - Steven F. Warren
- Institute for Life Span Studies, University of Kansas, Lawrence, KS, USA
| | - A. Nicole White
- Research Foundation, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Guang William Wong
- Department of Physiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Center for Metabolism and Obesity Research, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - John S. Yi
- Division of Surgical Sciences, Department of Surgery, Duke University Medical Center, Durham, NC, USA
| |
Collapse
|
9
|
Active Parents-Active Children-A Study among Families with Children and Adolescents with Down Syndrome. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020660. [PMID: 33466714 PMCID: PMC7828765 DOI: 10.3390/ijerph18020660] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/08/2021] [Accepted: 01/09/2021] [Indexed: 11/16/2022]
Abstract
From a public health perspective, it is important that children with Down syndrome (DS) lay the foundations of physical activity (PA) early in life to keep active in school, as teenagers and as adults. The aims were to investigate PA patterns in children and adolescents with DS, as well as their parents’ and siblings’ PA patterns. Methods: A survey was performed among 310 families with children with DS (54% boys and 46% girls) aged 8–18 years (mean 14.04, SD 3.18) in Sweden. Chi-squared tests and multiple logistic regression were carried out. Results: Nineteen percent of children and adolescents with DS and 34% of the parents were active three or more times per week. The child’s PA level was significantly associated with parents’ PA (OR = 5.5), siblings’ PA (OR = 5.1) and the child’s locomotion ability (OR = 3.5). Physically active parents had active children to a greater extent than inactive parents (59% vs. 29%; p < 0.001). Conclusions: Physically active parents have active children. To promote PA among children and adolescents with DS, it is important to promote and pay attention to the parents’ and siblings’ PA behavior, as children with DS are dependent on support from the family.
Collapse
|
10
|
Beltrán Romero L, García Puig J. Hemodynamics in Down syndrome. Rev Clin Esp 2020. [DOI: 10.1016/j.rceng.2019.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
11
|
Beltrán Romero L, García Puig J. Hemodinámica en el síndrome de Down. Rev Clin Esp 2020; 220:292-293. [DOI: 10.1016/j.rce.2019.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 11/11/2019] [Accepted: 11/17/2019] [Indexed: 10/25/2022]
|
12
|
Xicota L, Rodríguez J, Langohr K, Fitó M, Dierssen M, de la Torre R. Effect of epigallocatechin gallate on the body composition and lipid profile of down syndrome individuals: Implications for clinical management. Clin Nutr 2020; 39:1292-1300. [DOI: 10.1016/j.clnu.2019.05.028] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 05/24/2019] [Accepted: 05/29/2019] [Indexed: 12/29/2022]
|
13
|
Ganz F, Hammam N, Pritchard L. Sedentary behavior and children with physical disabilities: a scoping review. Disabil Rehabil 2020; 43:2963-2975. [DOI: 10.1080/09638288.2020.1723720] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Felipe Ganz
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Nevin Hammam
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
- Department of Rheumatology and Rehabilitation, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Lesley Pritchard
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| |
Collapse
|
14
|
Agiovlasitis S, Choi P, Allred AT, Xu J, Motl RW. Systematic review of sedentary behaviour in people with Down syndrome across the lifespan: A clarion call. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2019; 33:146-159. [PMID: 31441571 DOI: 10.1111/jar.12659] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 06/16/2019] [Accepted: 07/31/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Individuals with Down syndrome (DS) experience health disparities possibly associated with high levels of sedentary behaviour (SB). We systematically reviewed SB measurement, levels, patterns, correlates, consequences and interventions in people with DS across the lifespan. METHOD We searched these databases: Embase; PubMed; Web of Science; Scopus; CINAHL; PsycINFO; SPORTDiscus; and Cochrane Library. We included quantitative studies published in English since 1 January 1990. RESULTS We identified 17 eligible articles. Across studies, accelerometer-determined sedentary time was 552 min/day (median: 542; range 392-680 min/day). Sedentary time appeared higher than previously reported values in the general population, especially for youth with DS. Multivariate SB correlates were primarily familial and environmental. Sedentary behaviour consequences have not been exclusively studied. Motor skills training reduced SB in youth with DS. CONCLUSIONS Sedentary behaviour research in this population is in early stages. Individuals with DS have high levels of SB that may be responsive to interventions.
Collapse
Affiliation(s)
| | - Poram Choi
- Department of Kinesiology, Mississippi State University, Mississippi State, MS, USA
| | - Anthony T Allred
- Department of Kinesiology, Mississippi State University, Mississippi State, MS, USA
| | - Jian Xu
- Department of Kinesiology, Mississippi State University, Mississippi State, MS, USA
| | - Robert W Motl
- Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL, USA
| |
Collapse
|
15
|
Bermudez BEBV, de Oliveira CM, de Lima Cat MN, Magdalena NIR, Celli A. Gastrointestinal disorders in Down syndrome. Am J Med Genet A 2019; 179:1426-1431. [PMID: 31183986 DOI: 10.1002/ajmg.a.61258] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 03/05/2019] [Accepted: 05/21/2019] [Indexed: 12/12/2022]
Abstract
Down syndrome is the most common human chromosomal disorder. Among clinical findings, one constant concern is the high prevalence of gastrointestinal system alterations. The aim of this study was to determine the prevalence of gastrointestinal disorders at a Down syndrome outpatient clinic during a 10-year follow-up period. Data from medical files were retrospectively reviewed from 1,207 patients. Gastrointestinal changes occurred in 612 (50.7%). The most prevalent disorder was chronic intestinal constipation. Intestinal parasite occurred in 22% (mainly giardiasis), gastroesophageal reflux disease in 14%, digestive tract malformations occurred in 5%: 13 cases of duodenal atresia, 8 of imperforate anus, 4 annular pancreases, 2 congenital megacolon, 2 esophageal atresias, 2 esophageal compression by anomalous subclavian and 1 case of duodenal membrane. We had 38/1,207 (3.1%) patients with difficulty in sucking and only three with dysphagia that resolved before the second year of life. Peptic ulcer disease, celiac disease, and biliary lithiasis were less prevalent with 3% each. Awareness of the high prevalence of gastrointestinal disorders promotes outstanding clinical follow-up as well as adequate development and greater quality of life for patients with Down syndrome and their families.
Collapse
Affiliation(s)
- Beatriz E B V Bermudez
- Down Syndrome Outpatient Clinic, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - Camila M de Oliveira
- Preventive Medicine & Epidemiology, Boston University School of Medicine, Boston, Massachusetts
| | - Mônica N de Lima Cat
- Down Syndrome Outpatient Clinic, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - Neiva I R Magdalena
- Down Syndrome Outpatient Clinic, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - Adriane Celli
- Down Syndrome Outpatient Clinic, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| |
Collapse
|
16
|
Kelly A, Gidding SS, Walega R, Cochrane C, Clauss S, Townsend RR, Xanthopoulos M, Pipan ME, Zemel BS, Magge SN, Cohen MS. Relationships of Body Composition to Cardiac Structure and Function in Adolescents With Down Syndrome are Different than in Adolescents Without Down Syndrome. Pediatr Cardiol 2019; 40:421-430. [PMID: 30386863 PMCID: PMC6399030 DOI: 10.1007/s00246-018-2014-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 10/19/2018] [Indexed: 12/14/2022]
Abstract
Median survival in Down syndrome (DS) is 60 years, but cardiovascular disease risk and its markers such as left ventricular mass (LVM) have received limited attention. In youth, LVM is typically scaled to height2.7 as a surrogate for lean body mass (LBM), the strongest predictor of LVM, but whether this algorithm applies to DS, a condition which features short stature, is unknown. To examine the relationships of LVM and function with height, LBM, and moderate-to-vigorous physical activity(MVPA) in DS, DS youth aged 10-20 years, and age-, sex-, BMI-, race-matched nonDS controls underwent echocardiography for LVM, ejection fraction (EF), and left ventricular diastolic function (measured as E/E'); dual-energy X-ray absorptiometry (DXA)-measured LBM; accelerometry for MVPA. (DS vs. nonDS median [min-max]): DS had lower height (cm) (144.5 [116.7-170.3] vs. 163.3 [134.8-186.7]; p < 0.0001); LBM (kg) (33.48 [14.5-62.3] vs 41.8 [18.07-72.46], p < 0.0001); and LVM (g) (68.3 [32.1-135] vs 94.0 [43.9-164.6], p < 0.0001); similar EF (%) (65 [54-77] vs 64 [53-77], p = 0.59); and higher E/E' (8.41 [5.54-21.4] vs 5.81 [3.44-9.56], p < 0.0001). In height2.7-adjusted models, LVM was lower in DS (β = - 7.7, p = 0.02). With adjustment for LBM, LVM was even lower in DS (β = - 15.1, p < 0.0001), a finding not explained by MVPA. E/E' remained higher in DS after adjustment for age, height, HR, SBP, and BMI (β = 2.6, p < 0.0001). DS was associated with stiffer left ventricles and lower LVM, the latter magnified with LBM adjustment. Scaling to height2.7, the traditional approach for assessing LVM in youth, may underestimate LVM differences in DS. Whether lower LVM and diastolic function are intrinsic to DS, pathologic, or protective remains unknown.Clinical Trial Registration: NCT01821300.
Collapse
Affiliation(s)
- Andrea Kelly
- Division of Endocrinology & Diabetes, The Children's Hospital of Philadelphia, Philadelphia, PA, USA. .,Department of Pediatrics, Perelman School of Medicine of University of Pennsylvania, Philadelphia, PA, USA. .,Division of Endocrinology & Diabetes, Roberts Center for Pediatric Research, Room 14363, 2716 South Street, Philadelphia, PA, 19146, USA.
| | - Samuel S. Gidding
- Samuel S. Gidding M.D., Familial Hypercholesterolemia Foundation, Pasadena, CA
| | - Rachel Walega
- Division of Endocrinology and Diabetes, Center for Translational Science, Children’s National Health System, Washington, D.C
| | - Claire Cochrane
- Division of Endocrinology & Diabetes, The Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Sarah Clauss
- Division of Cardiology, Children’s National Health System, Washington, D.C
| | - Ray R. Townsend
- Department of Medicine, Perelman School of Medicine of University of Pennsylvania, Philadelphia, PA
| | - Melissa Xanthopoulos
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Mary E. Pipan
- Department of Pediatrics, Perelman School of Medicine of University of Pennsylvania, Philadelphia, PA,Division of Behavioral Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Babette S. Zemel
- Department of Pediatrics, Perelman School of Medicine of University of Pennsylvania, Philadelphia, PA,Division of Gastroenterology, Hepatology, & Nutrition, The Children’s Hospital of Philadelphia
| | - Sheela N. Magge
- Division of Endocrinology and Diabetes, Center for Translational Science, Children’s National Health System, Washington, D.C
| | - Meryl S. Cohen
- Department of Pediatrics, Perelman School of Medicine of University of Pennsylvania, Philadelphia, PA,Division of Cardiology, The Children’s Hospital of Philadelphia, Philadelphia, PA
| |
Collapse
|
17
|
Yaribeygi H, Butler AE, Sahebkar A. Aerobic exercise can modulate the underlying mechanisms involved in the development of diabetic complications. J Cell Physiol 2019; 234:12508-12515. [PMID: 30623433 DOI: 10.1002/jcp.28110] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Accepted: 12/07/2018] [Indexed: 12/20/2022]
Abstract
Diabetes mellitus is a highly prevalent metabolic disorder that affects many molecular pathways, causing a shift from a physiologic to a pathophysiologic state. Alterations in the molecular pathways promote diabetic complications and, thus, many medical and nonmedical therapies have been directed at preventing these complications. Despite the beneficial effects on moderating glycemic control, medical therapies may also have unfavorable side effects. This makes nonmedical therapeutic approaches more attractive due to lower pharmacological side effects of these strategies compared to medical agents. Aerobic exercise is now considered as a major nonmedical strategy that can promote beneficial and protective effects to counteract the development of diabetic complications via attenuation of the major molecular mechanisms involved in diabetes.
Collapse
Affiliation(s)
- Habib Yaribeygi
- Chronic Kidney Disease Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alexandra E Butler
- Diabetes Research Center, Qatar Biomedical Research Institute, Doha, Qatar
| | - Amirhossein Sahebkar
- Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.,School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| |
Collapse
|
18
|
Clairman H, Dettmer E, Buchholz A, Cordeiro K, Ibrahim Q, Maximova K, Toulany A, Taylor VH, Katzman DK, Morrison KM, Hamilton J, Ball G, Chanoine JP, Ho J, Legault L, Mackie P, Thabane L, Zenlea I. Pathways to eating in children and adolescents with obesity. Int J Obes (Lond) 2018; 43:1193-1201. [PMID: 30568266 DOI: 10.1038/s41366-018-0271-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 09/09/2018] [Accepted: 09/19/2018] [Indexed: 01/13/2023]
Abstract
BACKGROUND Paediatric obesity management remains generalised to dietary and exercise modifications with an underappreciation for the contributions of eating behaviours and appetitive traits in the development of obesity. OBJECTIVES To determine whether treatment-seeking children and adolescents with obesity cluster into phenotypes based on known eating behaviours and appetitive traits ("eating correlates") and how socio-demographic and clinical characteristics associate with different phenotypes. METHODS A cross-sectional, multi-centre questionnaire was administered between November 2015 and March 2017 examining correlates of eating in children and adolescents attending weight-management programmes in Canada. Latent profile analysis was used to cluster participants based on seven eating correlate scores obtained from questionnaires. Analysis of variance (ANOVA) was used to determine phenotype differences on socio-demographic and clinical characteristics. Multinomial logistic regression models assessed relative risk of specific characteristics associating with a disordered eating phenotype. RESULTS Participants were 247 children and adolescents (45.3% male, mean BMI z-score = 3.4 ± 1.0 kg/m2) from six paediatric weight management centres in Canada. Seven eating correlates clustered into three distinct phenotypes: (1) loss of control eating, emotional eating, external eating, hyperphagia, impulsivity ("Mixed-Severe"; n = 42, 17%), (2) loss of control eating, emotional eating, external eating, hyperphagia ("Mixed-Moderate"; n = 138, 55.9%), and (3) impulsivity ("Impulsive"; n = 67; 27.1%). Social functioning scores and body esteem were significantly different across groups, with the Mixed-Severe participants having the poorest social functioning and lowest body esteem. Low body esteem indicated a greater risk of being in a multi-correlate group compared to the Impulsive group, while poor social function had a greater risk of clustering in the Mixed-Severe than Impulsive phenotype. CONCLUSIONS Distinct eating phenotypes were found in treatment-seeking children and adolescents with obesity. Empirical evidence is needed, but these data suggest that tailored treatment approaches could be informed by these classifications to improve weight-management outcomes.
Collapse
Affiliation(s)
- Hayyah Clairman
- Institute of Medical Science, University of Toronto, Toronto, Canada.,Department of Pediatrics, University of Alberta, Alberta, Canada
| | - Elizabeth Dettmer
- Department of Psychology, The Hospital for Sick Children, Toronto, Canada
| | | | | | - Quazi Ibrahim
- Population Health Research Institute, McMaster University, Hamilton, Canada
| | | | - Alene Toulany
- Division of Adolescent Medicine, Department of Pediatrics, The Hospital for Sick Children, Toronto, Canada
| | - Valerie H Taylor
- Department of Psychiatry, Women's College Hospital, Toronto, Canada
| | - Debra K Katzman
- Institute of Medical Science, University of Toronto, Toronto, Canada.,Division of Adolescent Medicine, Department of Pediatrics, The Hospital for Sick Children, Toronto, Canada
| | - Katherine M Morrison
- Division of Endocrinology, Department of Pediatrics, McMaster Children's Hospital, McMaster University, Hamilton, Canada
| | - Jill Hamilton
- Institute of Medical Science, University of Toronto, Toronto, Canada. .,Division of Endocrinology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Canada.
| | | | - Geoff Ball
- Department of Pediatrics, University of Alberta, Alberta, Canada
| | | | - Josephine Ho
- Department of Pediatrics, University of Calgary, Calgary, Canada
| | - Laurent Legault
- Department of Pediatrics, McGill University, Montreal, Canada
| | - Pam Mackie
- Population Health Research Institute, McMaster University, Hamilton, Canada
| | - Lehana Thabane
- Population Health Research Institute, McMaster University, Hamilton, Canada.,Department of Pediatrics, McMaster University, Hamilton, Canada
| | - Ian Zenlea
- Credit Valley Hospital, Toronto, ON, Canada.,Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
19
|
Cazzo E, Gestic MA, Utrini MP, Chaim FDM, Cândido EC, Jarolavsky LBDS, de Almeida AMN, Pareja JC, Chaim EA. Bariatric surgery in individuals with severe cognitive impairment: report of two cases. SAO PAULO MED J 2018; 136:84-88. [PMID: 28443951 PMCID: PMC9924171 DOI: 10.1590/1516-3180.2016.0299071216] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 12/07/2016] [Indexed: 11/22/2022] Open
Abstract
CONTEXT Bariatric surgery has become the gold-standard treatment for refractory morbid obesity. Obesity is frequently associated with certain syndromes that include coexisting cognitive deficits. However, the outcomes from bariatric surgery in this group of individuals remain incompletely determined. CASE REPORT A 25-year-old male with Prader-Willi syndrome, whose intelligence quotient (IQ) was 54, was admitted with a body mass index (BMI) of 55 kg/m2, associated with glucose intolerance. He underwent the Scopinaro procedure for biliopancreatic diversion, with uneventful postoperative evolution, and presented a 55% loss of excess weight one year after the surgery, with resolution of glucose intolerance, and without any manifestation of protein-calorie malnutrition. A 28-year-old male with Down syndrome, whose IQ was 68, was admitted with BMI of 41.5 kg/m2, associated with hypertension. He underwent Roux-en-Y gastric bypass, with uneventful postoperative evolution. He presented a 90% loss of excess weight one year after the surgery, with resolution of the hypertension. CONCLUSION Bariatric surgery among individuals with intellectual impairment is a controversial topic. There is a tendency among these individuals to present significant weight loss and comorbidity control, but less than what is observed in the general obese population. The severity of the intellectual impairment may be taken into consideration in the decision-making process regarding the most appropriate surgical technique. Bariatric surgery is feasible and safe among these individuals, but further research is necessary to deepen these observations.
Collapse
Affiliation(s)
- Everton Cazzo
- MD, MSc, PhD. Assistant Lecturer, Department of Surgery, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-UNICAMP), Campinas (SP), Brazil.
| | - Martinho Antonio Gestic
- MD, MSc. Assistant Lecturer, Department of Surgery, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-UNICAMP), Campinas (SP), Brazil.
| | - Murillo Pimentel Utrini
- MD. Assistant Lecturer, Department of Surgery, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-Unicamp), Campinas (SP), Brazil.
| | - Felipe David Mendonça Chaim
- MD, MSc. Attending Physician, Department of Surgery, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-UNICAMP), Campinas (SP), Brazil.
| | - Elaine Cristina Cândido
- BSc. Attending Nurse, Bariatric Surgery Outpatient Service, Hospital de Clínicas da Universidade Estadual de Campinas (HC-UNICAMP), Campinas (SP), Brazil.
| | - Luciana Bueno da Silveira Jarolavsky
- BSc. Head Nurse, Bariatric Surgery Outpatient Service, Hospital de Clínicas da Universidade Estadual de Campinas (HC-UNICAMP), Campinas (SP), Brazil.
| | - Ana Maria Neder de Almeida
- BSc. Attending Psychologist, Bariatric Surgery Outpatient Service, Hospital de Clínicas da Universidade Estadual de Campinas (HC-UNICAMP), Campinas (SP), Brazil.
| | - José Carlos Pareja
- MD, PhD. Associate Professor, Department of Surgery, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-UNICAMP), Campinas (SP), Brazil.
| | - Elinton Adami Chaim
- MD, MSc, PhD. Full Professor, Department of Surgery, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-UNICAMP), Campinas (SP), Brazil.
| |
Collapse
|
20
|
Capone GT, Chicoine B, Bulova P, Stephens M, Hart S, Crissman B, Videlefsky A, Myers K, Roizen N, Esbensen A, Peterson M, Santoro S, Woodward J, Martin B, Smith D. Co-occurring medical conditions in adults with Down syndrome: A systematic review toward the development of health care guidelines. Am J Med Genet A 2017; 176:116-133. [PMID: 29130597 DOI: 10.1002/ajmg.a.38512] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 08/30/2017] [Accepted: 09/26/2017] [Indexed: 11/06/2022]
Abstract
Adults with Down syndrome (DS) represent a unique population who are in need of clinical guidelines to address their medical care. The United States Preventive Service Task Force (USPSTF) has developed criteria for prioritizing conditions of public health importance with the potential for providing screening recommendations to improve clinical care. The quality of existing evidence needed to inform clinical guidelines has not been previously reviewed. Using the National Library of Medicine (NLM) database PubMed, we first identified 18 peer reviewed articles that addressed co-occurring medical conditions in adults with DS. Those conditions discussed in over half of the articles were prioritized for further review. Second, we performed detailed literature searches on these specific conditions. To inform the search strategy and review process a series of key questions were formulated a priori. The quality of available evidence was then graded and knowledge gaps were identified. The number of participating adults and the design of clinical studies varied by condition and were often inadequate for answering all of our key questions. We provide data on thyroid disease, cervical spine disease, hearing impairment, overweight-obesity, sleep apnea, congenital heart disease, and osteopenia-osteoporosis. Minimal evidence demonstrates massive gaps in our clinical knowledge that compromises clinical decision-making and management of these medically complex individuals. The development of evidence-based clinical guidance will require an expanded clinical knowledge-base in order to move forward.
Collapse
Affiliation(s)
- George T Capone
- Kennedy Krieger Institute, Down Syndrome Clinic & Research Center, Baltimore, Maryland
| | - Brian Chicoine
- Advocate Adult Down Syndrome Center, Park Ridge, Illinois
| | - Peter Bulova
- Montefiore Hospital, Adult Down Syndrome Clinic, Pittsburgh, Pennsylvania
| | - Mary Stephens
- Christiana Care Health System, Adult Down Syndrome Clinic, Wilmington, Delaware
| | - Sarah Hart
- Duke University Medical Center, Durham, North Carolina
| | | | - Andrea Videlefsky
- The Adult Disability Medical Home, Urban Family Practice, Marietta, Georgia
| | | | - Nancy Roizen
- Rainbow Babies and Children's Hospital, Cleveland, Ohio
| | - Anna Esbensen
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Jane and Richard Thomas Center for Down Syndrome, Cincinnati, Ohio
| | - Moya Peterson
- University of Kansas Medical Center, Adults with Down Syndrome Specialty Clinic, Kansas City, Kansas
| | | | - Jason Woodward
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Jane and Richard Thomas Center for Down Syndrome, Cincinnati, Ohio
| | - Barry Martin
- Division of General Internal Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - David Smith
- Children's Hospital of Wisconsin, Down Syndrome Clinic of Wisconsin, Milwaukee, Wisconsin
| | | |
Collapse
|
21
|
De Matteo A, Vajro P. Down Syndrome and Pediatric Nonalcoholic Fatty Liver Disease: A Causal or Casual Relationship? J Pediatr 2017; 189:11-13. [PMID: 28751123 DOI: 10.1016/j.jpeds.2017.07.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 07/06/2017] [Indexed: 12/20/2022]
Affiliation(s)
- Antonia De Matteo
- Pediatrics Section Department of Medicine, Surgery, and Dentistry "Scuola Medica Salernitana" University of Salerno Baronissi, SA, Italy
| | - Pietro Vajro
- Pediatrics Section Department of Medicine, Surgery, and Dentistry "Scuola Medica Salernitana" University of Salerno Baronissi, SA, Italy.
| |
Collapse
|
22
|
Abstract
PURPOSE Individuals with Down syndrome (DS) are at greater risk for obesity than their peers who are developing typically. One factor contributing to an early onset of obesity is low levels of physical activity (PA). However, there is little known regarding PA patterns during infancy. METHODS The purpose of this study was to examine the daily PA patterns in 22 infants developing typically and 11 infants with Down syndrome (aged 1-12 months) using Actigraph GT3X+ (wrist and ankle). RESULTS No significant differences between groups were identified in PA counts at the ankle. Both groups produced significantly more PA at the wrist than at the ankle and PA counts increased across months in age. CONCLUSION This study represents an important first step in establishing baseline PA patterns during infancy.
Collapse
|