Abstract:
:Childhood obesity may be seen as a marker for high-risk dietary and physical inactivity practices. Recent increases in the prevalence of overweight and obesity among American children are not limited to one age, gender, or ethnic group, which suggests that unique behaviors of the members of various racial or ethnic subgroups of the population are unlikely to be the major contributing factors. Rather, it seems that environmental changes promoting increased energy intake and decreased energy output are occurring and have widespread impact on children from various backgrounds. Although no ethnic group is immune from the current shift in energy balance, differential rates of overweight seem to exist among ethnic groups. National probability samples of African-American, Hispanic, and white children in the United States provide clear evidence that white children are at lower risk for childhood overweight than are African-American or Hispanic children. Of concern is the lack of national data on the prevalence of overweight and obesity for Native-American and Asian-American groups. Also of concern is the aggregation of racial and ethnic subgroups, which may render prevalence rates meaningless. This possibility is clearly true with some surveys of weight status that combine diverse populations, such as Asians and Pacific Islanders, into one group. The high rates of obesity in African-American, Hispanic, and Native-American children are of concern. Although parental SES is associated inversely with childhood obesity among whites, higher SES does not seem to protect African-American and Hispanic children against obesity. In these groups, childhood obesity does not seem to be associated significantly with parental income and education. Health consequences of childhood obesity include a higher prevalence of type 2 diabetes and an increased risk for adverse levels of lipids, lipoproteins, and blood pressure. The effects of recently reported unprecedented levels of childhood overweight on subsequent risk for obesity in middle age are not known until future longitudinal data can be collected. It seems likely, however, that future health consequences of current early and severe childhood obesity will be staggering. Funding for adult follow-up of longitudinal studies of high-risk African American, Hispanic, and Native-American children is needed urgently to provide information on the long-term effects of childhood obesity. Halting the obesity epidemic is a formidable task, but the success in recent decades of drastically reducing childhood undernutrition offers hope and should spur similar action and leadership efforts. Promotion of efforts to reduce excess caloric intake with efforts to increase energy expenditure should receive paramount attention in the design of health programs. Given the relatively few published obesity-prevention and treatment studies that are designed to address specific cultural issues, it is important to promote the development of culturally appropriate intervention strategies that are shown to be effective among youth of diverse backgrounds. Although the dietary and activity goals will be similar, parental, family, and community messages and techniques grounded in cultural traditions and norms will be different for each ethnic group. This approach is crucial in the United States, a country with an increasingly diverse population.
journal_name
Pediatr Clin North Amjournal_title
Pediatric clinics of North Americaauthors
Crawford PB,Story M,Wang MC,Ritchie LD,Sabry ZIdoi
10.1016/s0031-3955(05)70345-xsubject
Has Abstractpub_date
2001-08-01 00:00:00pages
855-78issue
4eissn
0031-3955issn
1557-8240pii
S0031-3955(05)70345-Xjournal_volume
48pub_type
杂志文章,评审abstract::Auricular reconstruction of microtia is available and is extremely satisfying for the patient, family, and care givers. The patient can look forward to a realistic pinna. With current research activity, auricular reconstruction could evolve even further. The pediatrician is an extremely important member of this effort...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0031-3955(05)70516-2
更新日期:1996-12-01 00:00:00
abstract::In this article, I have attempted to summarize the concept of intestinal permeability to antigens such as ingested food proteins, bacterial breakdown products, endotoxins, and enzymes. The mature gut retains the capacity to absorb macromolecules by a pinocytotic mechanism which is more pronounced during the neonatal p...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章
doi:10.1016/s0031-3955(16)33204-7
更新日期:1975-11-01 00:00:00
abstract::In hyperinsulinemic hypoglycemia (HH) there is dysregulation of insulin secretion from pancreatic β-cells. Insulin secretion becomes inappropriate for the level of blood glucose leading to severe hypoglycemia. HH is associated with a high risk of brain injury because insulin inhibits lipolysis and ketogenesis thus pre...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.pcl.2015.04.010
更新日期:2015-08-01 00:00:00
abstract::The risk of rheumatic fever in childhood continues to be high in the United States, especially where crowded living conditions promote epidemic spread of streptococcal pharyngitis. Early identification and appropriate penicillin therapy shorten the acute streptococcal illness and greatly reduce the occurrence of seque...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章
doi:10.1016/s0031-3955(16)32528-7
更新日期:1971-02-01 00:00:00
abstract::The author enumerates the objectives of nutritional instruction and therapy for the child with diabetes mellitus and examines some of the principles upon which this therapy is based. Also discussed are the methods used to formulate meal plans, stressing the fact that instruction and counseling in nutritional principle...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章
doi:10.1016/s0031-3955(16)34623-5
更新日期:1984-06-01 00:00:00
abstract::Hyperthyroidism in infants and children usually is caused by Graves' disease; however, several other diseases can also produce hyperthyroidism in these age groups. Because the pathophysiology and clinical course of these conditions differ, optimal treatment depends on precise diagnosis. ...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0031-3955(16)37011-0
更新日期:1990-12-01 00:00:00
abstract::Emergency medicine requires diagnosing unfamiliar patients with undifferentiated acute presentations. This requires hypothesis generation and questioning, examination, and testing. Balancing patient load, care across the severity spectrum, and frequent interruptions create time pressures that predispose humans to fast...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.pcl.2018.07.003
更新日期:2018-12-01 00:00:00
abstract::Spinal deformity is a relatively common disorder, particularly in teenage girls. Early detection is possible by a simple, quick visual inspection that should be a standard part of the routine examination of all preteen and teenage patients. Follow-up observation will reveal those curvatures that are progressive and pe...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章
doi:10.1016/s0031-3955(16)36155-7
更新日期:1986-12-01 00:00:00
abstract::Septic shock remains the major cause of childhood morbidity and mortality worldwide. Although early sepsis recognition, fluid resuscitation, timely administration of antimicrobials, and vasoactive-inotropic drug infusions are all key to achieving good sepsis outcomes, therapy using various steroid drug classes remains...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.pcl.2017.06.010
更新日期:2017-10-01 00:00:00
abstract::Duchenne muscular dystrophy is the second most common lethal genetic disorder in humans. With the advent of molecular genetic technology, the definition of this disease has been modified to include an abnormality of dystrophin in muscle--a dystrophinopathy. Accurate genetic counseling is possible using methods of dele...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0031-3955(16)38379-1
更新日期:1992-08-01 00:00:00
abstract::The benefits and possible detriment of resistance training have been noted extensively in the literature. Although the benefits of resistance training are well known, many professionals fail to heed scientific advice or follow appropriate recommendations for resistance training in adolescents. When developing a resist...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.pcl.2010.02.009
更新日期:2010-06-01 00:00:00
abstract::In this article we reviewed some of the important concepts and techniques of molecular biology applied to the study of lymphoid malignancies. Molecular biology is a tool for addressing certain basic research and clinical questions. It is also a key to the development of a new perspective in biology and medicine. For t...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0031-3955(16)36506-3
更新日期:1988-08-01 00:00:00
abstract::When a child presents with high-anion gap metabolic acidosis, the pediatrician can proceed with confidence by recalling some basic principles. Defects of organic acid, pyruvate, and ketone body metabolism that present with acute acidosis are reviewed. Flowcharts for identifying the underlying cause and initiating life...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.pcl.2017.11.003
更新日期:2018-04-01 00:00:00
abstract::Untreated sleep disturbances and sleep disorders pose significant adverse daytime consequences and place children at considerable risk for poor health outcomes. Sleep disturbances occur at a greater frequency in children with acute and chronic medical conditions compared with otherwise healthy peers. Sleep disturbance...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.pcl.2011.03.012
更新日期:2011-06-01 00:00:00
abstract::Interprofessional collaborative practice (IPCP) is a service delivery approach that seeks to improve health care outcomes and the patient experience while simultaneously decreasing health care costs. The current article reviews the core competencies and current trends associated with IPCP, including challenges faced b...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.pcl.2017.08.017
更新日期:2018-02-01 00:00:00
abstract::Fluid homeostasis requires adequate water intake, regulated by an intact thirst mechanism and appropriate free water excretion by the kidneys, mediated by appropriate secretion of arginine vasopressin (AVP, also known as antidiuretic hormone). AVP exerts its antidiuretic action by binding to the X chromosome-encoded V...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章
doi:10.1016/j.pcl.2011.07.013
更新日期:2011-10-01 00:00:00
abstract::Many pediatric patients and their families use dietary supplements and homeopathy. They do not always disclose this information to their health care practitioners. It is important that health care practitioners are aware of the research available in these areas and discuss the use of these products openly with their p...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.pcl.2007.10.005
更新日期:2007-12-01 00:00:00
abstract::Premature and unexpected death, especially in children, is tragic and very unacceptable. Effective treatments for sudden death of pediatric patients continue to emerge. Modern cardiopulmonary resuscitation function began with the widespread introduction of closed-chest cardiac massage in 1960; however, despite 35 year...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0031-3955(16)38867-8
更新日期:1994-12-01 00:00:00
abstract::This article covers several aspects of the clinical management of neonatal hypoglycemia that have recently evolved, reviewing the evidence informing these recommended changes in practice. Topics covered include use of buccal dextrose gel, rationale for avoiding the traditional "mini dextrose bolus," and benefits of di...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.pcl.2018.12.004
更新日期:2019-04-01 00:00:00
abstract::There are many conditions that produce chronic arthritis in childhood, including JRA. The pitfalls associated with proper diagnosis involve underrecognition, misrecognition, and overrecognition of symptoms and signs. ...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章
doi:10.1016/s0031-3955(16)36106-5
更新日期:1986-10-01 00:00:00
abstract::Disorders of sodium and water homeostasis are common occurrences in pediatric practice. They reflect distinct problems in the regulation of total body sodium balance and water distribution, respectively. Each of these groups of disorders has separate afferent and efferent mechanisms that are activated during disease s...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0031-3955(16)40088-x
更新日期:1995-12-01 00:00:00
abstract::Feeding problems in infants and young children are common. In healthy children who are developing and growing normally, feeding problems are usually not serious and can be managed conservatively by reassuring the family and providing them with anticipatory guidance and follow-up. A majority of serious childhood feedin...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.pcl.2017.08.021
更新日期:2018-02-01 00:00:00
abstract::Sexual activity is a common practice among young adolescents, placing them at high risk for STDs, many of which have long-term consequences. Early diagnosis and treatment are essential to limit both the consequences and the spread of these infections. The clinician has a responsibility to the adolescent patient to rec...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0031-3955(05)70567-8
更新日期:1997-12-01 00:00:00
abstract::Renal arteriography remains the only study to identify and define correctly both location and extent of renal artery stenosis. Because other studies do not adequately identify all children who have renal artery disease, it is reasonable to perform renal arteriography in those children with severe hypertension who do n...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0031-3955(16)38485-1
更新日期:1993-02-01 00:00:00
abstract::Herpes simplex encephalitis (HSE) is an uncommon disease, yet 25 to 30 per cent of cases involve children. The initial clinical findings are nonspecific (fever, altered mental status), but most cases evolve to demonstrate focal neurologic signs and symptoms. The CSF is abnormal in over 90 per cent of cases. The EEG, C...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0031-3955(16)36466-5
更新日期:1988-06-01 00:00:00
abstract::In an otherwise healthy child with acute dehydration known to be due to diarrhea or vomiting, the amount of deficit can best be estimated by accurate weight. Total serum protein and hematocrit provide a rough estimate of reduction in circulating blood volume, but calculation from these data will usually underestimate ...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章
doi:10.1016/s0031-3955(16)32538-x
更新日期:1971-02-01 00:00:00
abstract::Community-acquired pneumonia (CAP) occurs more often in early childhood than at almost any other age. Many microorganisms are associated with pneumonia, but individual pathogens are difficult to identify, which poses problems in antibiotic management. This article reviews the common as well as new, emerging pathogens,...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.pcl.2012.12.009
更新日期:2013-04-01 00:00:00
abstract::Injury is the most important threat to the health of children in the United States and the leading cause of death after the first year of life. Injuries must be viewed as diseases that can be prevented by using principles of epidemiology, engineering, biomechanics, and health education. Effective preventative strategi...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章
doi:10.1016/s0031-3955(16)38666-7
更新日期:1993-12-01 00:00:00
abstract::This article provides an overview of the composition of human milk, its variation, and its clinical relevance. The composition of human milk is the biological norm for infant nutrition. Human milk also contains many hundreds to thousands of distinct bioactive molecules that protect against infection and inflammation a...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.pcl.2012.10.002
更新日期:2013-02-01 00:00:00
abstract::As new therapies for pediatric asthma are approved by the Food and Drug Administration, clinicians should be aware of their benefits and limitations. Accompanying these therapies are potential obstacles, including the delivery of inhaled therapies and age-specific issues regarding implementation and adherence. New ins...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.pcl.2017.08.001
更新日期:2017-12-01 00:00:00