Ten per cent of the world’s school-aged children are estimated to be carrying excess body fat (Fig. 1), with an increased risk for developing chronic disease. Of these overweight children, a quarter are obese, with a significant likelihood of some having multiple risk factors for type 2 diabetes, heart disease and a variety of other co-morbidities before or during early adulthood. The prevalence of overweight is dramatically higher in economically developed regions, but is rising significantly in most parts of the world. In many countries the problem of childhood obesity is worsening at a dramatic rate. Surveys during the 1990s show that in Brazil and the USA, an additional 0.5% of the entire child population became overweight each year. In Canada, Australia and parts of Europe the rates were higher, with an additional 1% of all children becoming overweight each year. The burden upon the health services cannot yet be estimated. Although childhood obesity brings a number of additional problems in its train – hyperinsulinaemia, poor glucose tolerance and a raised risk of type 2 diabetes, hypertension, sleep apnoea, social exclusion and depression – the greatest health problems will be seen in the next generation of adults as the present childhood obesity epidemic passes through to adulthood. Greatly increased rates of heart disease, diabetes, certain cancers, gall bladder disease, osteoarthritis, endocrine disorders and other obesityrelated conditions will be found in young adult populations, and their need for medical treatment may last for their remaining life-times. The costs to the health services, the losses to society and the burdens carried by the individuals involved will be great. The present report has been written to focus attention on the issue and to urge policy-makers to consider taking action before it is too late. Specifically, the report:

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1467-789X.2004.00133.x

Obesity in children and young people: a crisis in public health.

Fetal nutrition and cardiovascular disease in adult life

Jaundice occurs in most newborn infants. Most jaundice is benign, but because of the potential toxicity of bilirubin, newborn infants must be monitored to identify those who might develop severe hyperbilirubinemia and, in rare cases, acute bilirubin encephalopathy or kernicterus. The focus of this guideline is to reduce the incidence of severe hyperbilirubinemia and bilirubin encephalopathy while minimizing the risks of unintended harm such as maternal anxiety, decreased breastfeeding, and unnecessary costs or treatment. Although kernicterus should almost always be preventable, cases continue to occur. These guidelines provide a framework for the prevention and management of hyperbilirubinemia in newborn infants of 35 or more weeks of gestation. In every infant, we recommend that clinicians 1) promote and support successful breastfeeding; 2) perform a systematic assessment before discharge for the risk of severe hyperbilirubinemia; 3) provide early and focused follow-up based on the risk assessment; and 4) when indicated, treat newborns with phototherapy or exchange transfusion to prevent the development of severe hyperbilirubinemia and, possibly, bilirubin encephalopathy (kernicterus).

/pdf/management-of-hyperbilirubinemia-in-the-newborn-infant-35-or-479p0jffqq.pdf

Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation

Sponsors asked the IOM's Food and Nutrition Board and the Division of Behavioral and Social Sciences and Education Board on Children, Youth, and Families to review and update the IOM (1990) recommendations for weight gain during pregnancy and recommend ways to encourage their adoption through consumer education, strategies to assist practitioners, and public health strategies.The committee was asked to address the following tasks: 1. Review evidence on the relationship between weight gain patterns before, during, and after pregnancy and maternal and child health outcomes, with particular attention to the prevalence of maternal obesity racial/ethnic and age differences, components of GWG, and implications of weight during pregnancy on postpartum weight retention, maternal and child obesity, and later child health. 2. Within a life-stage framework consider factors in relation to GWG that are associated with maternal health outcomes such as lactation performance, postpartum weight retention, cardiovascular disease, metabolic processes including glucose and insulin-related issues, and risk of other chronic diseases; for infants and children, in addition to low birth weight, consider early developmental impacts and obesity-related consequences (e.g., mental health, diabetes). 3. Recommend revisions to the existing guidelines, where necessary, including the need for specific pregnancy weight guidelines for underweight, normal weight, and overweight and obese women and adolescents and women carrying twins or higher-order multiples. 4. Consider a range of approaches to promote appropriate weight gain, including: individual (behavior), psychosocial, community, health care, and health systems; timing and components of interventions; and ways to enhance awareness and adoption of the guidelines, including interdisciplinary approaches, consumer education to men and women, strategies to assist practitioners to use the guidelines, and public health strategies. 5. Identify gaps in knowledge and recommend research priorities.

/pdf/weight-gain-during-pregnancy-reexamining-the-guidelines-54naat6auf.pdf

Weight Gain During Pregnancy: Reexamining the Guidelines

Ancient missense mutations in a new member of the RoRet gene family are likely to cause familial Mediterranean fever

Sensorineural hearing impairment is a lesser known feature of hypoparathyroidism The hearing of 20 patients with idiopathic hypoparathyroidism was investigated by pure-tone audiometry Bilateral sensorineural hearing loss was found in three (15%) Sensorineural hearing loss is considered to be associated with a prolonged low calcium level in the inner ear fluid and is a possible complication of hypoparathyroidism

Hearing impairment in idiopathic hypoparathyroidism and pseudohypoparathyroidism.

227 Allergic reaction to measles-mumps-rubella (MMR) vaccine in a girl tolerant to egg-protein

Smallpox revaccination of 21 000 first responders in Israel: lessons learned

We studied the prevalence of myopia in 17-year-old Israeli military recruits with neurofibromatosis type 1 (NF1). Twenty-four percent of the youngsters with neurofibromatosis had myopia, compared to 19% of the controls; this difference was statistically significant (P < 0.03). The recruits with NF1 had a slightly lower IQ, fewer years of education, and lower height and weight than the controls. Thus, these factors, which have been reported to be associated with myopia, did not significantly influence the high prevalence of myopia in the neurofibromatosis subjects. A high prevalence of myopia seems to be an additional feature of NF1.

Myopia in neurofibromatosis type 1.

Seven infants aged 2 to 6 months presented with vomiting, diarrhea, apathy, and shocklike state up to 2 hours after ingesting 100 to 200 mL of soy-based formula. The reasons for the administration of soy-based formula were atopic family history, atopic dermatitis, constipation, acute gastroenteritis, and Jewish dietary (Kashrut) laws; in only one patient was soybased formula given because of cow milk allergy. Three of the patients had a similar reaction on repeated inadvertent exposure to soy-based formula. Five infants tolerated humanized milk formula without any adverse events. In one infant an allergic reaction to humanized milk formula (generalized urticaria and vomiting) developed at age 8 months, up to which time he had been exclusively breast fed. Only one infant had a positive skin test to soybean. The two cow milk-allergic infants had a positive skin test to cow milk. Five infants underwent oral soybean challenges at age 12 to 24 months, all of which were negative. We conclude that soybean allerg...

Yehuda L. Danon

Papers

Hearing impairment in idiopathic hypoparathyroidism and pseudohypoparathyroidism.

227 Allergic reaction to measles-mumps-rubella (MMR) vaccine in a girl tolerant to egg-protein

Smallpox revaccination of 21 000 first responders in Israel: lessons learned

Myopia in neurofibromatosis type 1.

Soybean allergy in cow milk-tolerant infants