PURPOSE: Childhood obesity is an increasing public health issue worldwide. We examined dietary patterns among adolescents in a dormitory school, identified obese adolescents and tried to intervene to improve food habits and physical activity. METHODS: We conducted an experimental prospective longitudinal study based on 36 obese (body mass index [BMI]> or =95th percentile) adolescents (aged 12-18 years) compared with controls (healthy children: normal age-appropriate BMI (BMI< or =85th percentile). Six months' intervention included lifestyle-modification counseling (once a week by a clinical dietician), and an exercise regimen twice a week, 60 minutes each time, instructed by a professional pediatric trainer). Both groups underwent baseline measurements at the beginning of the study and 6 months later (arterial stiffness, blood pressure, pulse, weight and height, hemoglobin, creatinine, liver enzymes, highly sensitive C-reactive protein and complete lipid profile). RESULTS: Twenty-one participants completed the study. Low compliance from participants, school staff and parents was observed (participation in planned meetings; 71%-83%). BMI significantly decreased from 32.46+/-3.93 kg/m2 to 30.32+/-3.4 kg/m2 (P=0.002) in the study group. Arterial stiffness was not significantly different between the 2 groups and did not change significantly after 6 months' intervention (P=0.494). No significant changes in CRP and lipid profile were observed after the intervention. CONCLUSION: Making lifestyle modifications among adolescents in a dormitory school is a complex task. Active intervention indeed ameliorates BMI parameters. However, in order to maximize the beneficial effects, a multidisciplinary well-trained team is needed, with emphasis on integrating parents and the school environment.
Adolescent* ; Blood Pressure ; C-Reactive Protein ; Child ; Compliance ; Counseling ; Creatinine ; Food Habits ; Humans ; Life Style* ; Liver ; Longitudinal Studies ; Motor Activity ; Obesity ; Parents ; Pediatric Obesity ; Prospective Studies ; Public Health ; Vascular Stiffness

BACKGROUND AND OBJECTIVES: Reports on the incidence of intracardiac thrombi (ICT) have increased over the last few decades, but ICT are still relatively rare among children. Left ventricular systolic dysfunction and dilatation may contribute to the formation of ICT, especially when a hypercoagulable state exists. The aim of this study was to describe the incidence of ICT in children suffering from cardiac failure with left ventricular dysfunction and to identify risk factors on admission for developing ICT. SUBJECTS AND METHODS: We conducted a retrospective chart review of children up to 18 years of age admitted to the Pediatric Intensive Care Unit due to cardiac failure with left ventricular dysfunction between January 1, 2003 and December 31, 2008. RESULTS: Twenty-one patients were admitted with clinical signs of cardiac failure and echocardiographic findings compatible with dilated cardiomyopathy or acute myocarditis. Dilated cardiomyopathy was diagnosed in 11 patients (52%). Adenoviruses and enteroviruses were suspected to be the cause of acute myocarditis in 5 cases. The personal or family history of hypercoagulable states were obtained from 19 out of 21 patients (90%). Among patients with a hypercoagulable state, 3 out of 7 developed ICT compared with none out of 12 among patients without hypercoagulability (p=0.043). Two of these 3 patients experienced an embolic event. CONCLUSION: Cardiac failure with left ventricular dysfunction may predispose the patient to ICT and increase the risk of thromboembolism, especially when an underlying hypercoagulable state exists. The hypercoagulable state must be carefully evaluated on admission in these patients.
Adenoviridae ; Cardiomyopathy, Dilated ; Child ; Dilatation ; Enterovirus ; Heart Failure ; Humans ; Incidence ; Intensive Care Units ; Myocarditis ; Retrospective Studies ; Risk Factors ; Stress, Psychological ; Thromboembolism ; Thrombophilia ; Ventricular Dysfunction, Left