The Relationship of Psychosocial Dysfunction and Stunting of Adolescents in Suburban, Indonesia

The purpose of this study was to investigate the psychosocial dysfunction of adolescents with stunted and normal height. This was a cross-sectional study using pediatric symptom checklist-17 (PSC-17), subjected to adolescents (age: 11 to 14 years) in Suburban, West Java Indonesia. Two variables of the subjects’ characteristics (sex and body height) were included in the multivariate analysis because the p was <0.25 (p = 0.22, p = 0.07). It was found that 53 subjects had psychosocial dysfunction (25 stunted, 4 severely stunted, and 24 normal heights) with significant comparing proportion between severely stunted and normal height (p = 0.04). In severely stunted adolescents, the risk of psychosocial dysfunction is 6.33 more than in normal stature group. Examination was done on those 53 adolescents resulted in several psychosocial disorders: 12 psychosocially low self-esteem, 12 family problems, and others ranging from other several aspect problems. Forty-one from the 53 adolescents were with psychopathology symptoms. There was psychosocial dysfunction just in adolescents with severely stunted.

Evaluation and management of the child with hypothyroidism

Background Thyroid hormones are critical for early neurocognitive development as well as growth and development throughout childhood.Prompt recognition and treatment of hypothyroidism is,therefore,of utmost importance to optimize physical and neurodevelopmental outcomes.Data sources A PubMed search was completed in Clinical Queries using the key terms 'hypothyroidism'.Results Hypothyroidism may be present at birth (congenital hypothyroidism) or develop later in life (acquired hypothyroidism).Thyroid dysgenesis and dyshormonogenesis account for approximately 85% and 15% of permanent cases of congenital primary hypothyroidism,respectively.More than 95% of infants with congenital hypothyroidism have few,if any,clinical manifestations of hypothyroidism.Newborn screening programs allow early detection of congenital hypothyroidism.In developed countries,Hashimoto thyroiditis is the most common cause of goiter and acquired hypothyroidism in children and adolescents.Globally,iodine deficiency associated with goiter is the most common cause of hypothyroidism.Central hypothyroidism is uncommon and may be associated with other congenital syndromes and deficiencies of other pituitary hormones.Familiarity of the clinical features would allow prompt diagnosis and institution of treatment.Conclusions To optimize neurocognitive outcome in infants with congenital hypothyroidism,treatment with levothyroxine should be started as soon as possible,preferably within the first 2 weeks of life.Children with acquired hypothyroidism should also be treated early to ensure normal growth and development as well as cognitive outcome.The target is to keep serum TSH < 5 mIU/L and to maintain serum free T4 or total T4 within the upper half of the age-specific reference range,with elimination of all symptoms and signs of hypothyroidism.

Mitogen-activated protein kinase signal pathways play an important role in right ventricular hypertrophy of tetralogy of Fallot

Background Tetralogy of Fallot （TOF） is the most common malformation of children with an incidence of approximately 10% of congenital heart disease patients. There can be a wide spectrum to the severity of the anatomic defects, which include ventricular septal defect, aortic override, right ventricular outflow tract obstruction, and right ventricular hypertrophy. We examined the relationship between right ventricular hypertrophy in patients with TOF and the gene expression of factors in the mitogen-activated protein kinase （MAPK） signal pathway. Methods To gain insight into the characteristic gene（s） involved in molecular mechanisms of right ventricular hypertrophy in TOF, differential mRNA and micro RNA expression profiles were assessed using expression-based micro array technology on right ventricular biopsies from young TOF patients who underwent primary correction and on normal heart tissue. We then analyzed the gene expression of the MAPK signal pathway using reverse transcription-polymerase chain reaction （RT-PCR） in normals and TOF patients. Results Using the micro RNA chip V3.0 and human whole genome oligonucleotide microarray VI.0 to detect the gene expression, we found 1068 genes showing altered expression of at least two-fold in TOF patients compared to the normal hearts, and 47 micro RNAs that showed a significant difference of at least two-fold in TOF patients. We then analyzed these mRNAs and micro RNAs by target gene predicting software Microcosm Targets version 5.0, and determined those mRNA highly relevant to the right ventricular hypertrophy by RT-PCR method. There were obvious differences in the gene expression of factors in the MAPK signal pathway when using RT-PCR, which was consistent to the results of the cDNA microarray.Conclusion The upregulation of genes in the MAPK signal pathway may be the key events that contribute to right ventricular hypertrophy and stunted angiogenesis in patients with TOF.