Search Results (4)

Background: Functional gastrointestinal disorders (FGIDs) are highly prevalent among infants. Exclusive breastfeeding has been consistently associated with better gastrointestinal health. However, current evidence regarding the associations between early feeding practices and infant gastrointestinal development remains limited. Objectives: To examine the associations between early feeding practices at 1 month of age and gastrointestinal symptoms and overall gastrointestinal burden in infants during the first 12 months of life. Methods: In this multicenter prospective cohort study, 669 healthy mother–infant pairs were finally included. According to feeding practices at 1 month of age, infants were categorized into three groups: exclusive direct breastfeeding (EDB, n = 236, 35.28%), bottle-fed expressed breastmilk (EBB, n = 150, 22.42%), and mixed feeding (MF, n = 283, 42.30%). Gastrointestinal (GI) symptoms were assessed using the Infant Gastrointestinal Symptom Questionnaire (IGSQ) and symptom items from the PedsQL™ Infant Scales. Generalized estimating equations (GEEs) were used to assess the associations. Results: Infants in the EDB group had the lowest incidence of GI symptoms and lower IGSQ scores throughout the follow-up period. Compared with EDB, the MF group showed higher IGSQ scores (β = 0.95, p = 0.002) and higher odds of constipation (OR = 1.64, p < 0.001), vomiting (OR = 1.70, p < 0.001), and swallowing difficulty (OR = 1.79, p = 0.002); these associations remained robust across multiple sensitivity analyses. The EBB group showed higher odds of certain symptoms in the main analysis, but sensitivity analyses (e.g., time-varying exposure) indicated that these associations were not robust, except for bloating (OR = 1.31, p = 0.042). Conclusions: The EDB is the optimal strategy for infant gastrointestinal health and should be prioritized. The MF is robustly associated with increased odds of constipation, vomiting, swallowing difficulty, and overall gastrointestinal burden. The EBB may slightly increase the odds of bloating, which can be mitigated by paced feeding and adequate burping. Full article

Introduction: Chronic kidney disease and kidney failure are associated with a decline in physical abilities resulting in severe health-related complications. Existing systematic reviews and meta-analyses show that exercise interventions in patients on haemodialysis enhance physical functioning, cardiovascular health, muscle strength, and overall quality of life. However, the available literature mostly stem from adult cohorts outside Africa. Thus, this scoping review aims to evaluate existing literature on the impact of exercise programs on paediatric patients undergoing haemodialysis in Africa. Methods: A systematic search of electronic databases, including CINAHL, EBSCO, Medline, PubMed, and Scopus, was conducted following the Arksey and O’Malley methodological framework for scoping reviews and complied with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) reporting guidelines. The inclusion criteria was applied to identify peer-reviewed articles published between 2015 and 2025, focusing on the effects, impact, and benefits of exercises and physical activity programs in paediatric patients undergoing haemodialysis aged up to 18 years. The selection process was done by two researchers pertaining to importing search results, removing duplicates, screening titles and abstracts, and analysis the reference lists of selected studies to ensure comprehensive coverage. Results: Two exercise-based intervention studies were eligible in the final review. In both studies, the duration of the intervention was about two months, and they included sample sizes of 60 and 50 participants. The first study, using the Paediatric Quality of Life Inventory (PedsQL-I), reported significant improvements across all dimensions in quality-of-life following muscle stretching and isometric exercises. The second study, employing the Paediatric Quality of Life Multidimensional Fatigue Scale (PedsQL-MFS) and the Depression Anxiety Stress Scale (DASS), found reductions in fatigue and psychological distress, and positive biochemical changes. A notable omission was the lack of detail regarding contraindications and precautionary measures. These are essential for informing clinical decision-making and ensuring exercises are safe. Discussion: The findings underscore the importance of incorporating exercise into the standard care of paediatric patients undergoing haemodialysis to facilitate better health outcomes. The fact that only two relevant studies were found highlights a narrow regional scope within Africa as both studies originated from a single country. Further research is needed to develop and implement effective exercise interventions tailored to other countries in Africa. Full article

Objective: To characterize debilitating fatigue in children and adults across inactive auto-inflammatory diseases (AID), identifying distinct disease-specific fatigue phenotypes and modifiable risk factors is necessary for optimal care. Methods: A single-center cohort of consecutive patients with inactive AID between 2007 and 2024 was performed. Demographics, clinical and laboratory features, and treatment were captured. Fatigue was characterized and quantified using the PedsQL-MFS and VAS; the CES-D/CESD-R was applied to assess depression risk. Comparisons were made using non-parametric methods, multivariable regression identified risk factors of fatigue in inactive disease. Results: 66 patients were included: 39 (59%) were children; the median age at symptom onset was 4 years, at treatment start was 8 years, and study follow-up was 7 years. All patients had inactive disease at the last visit. Patients with cryopyrin-associated periodic syndromes (CAPS) had the highest Cognitive Fatigue scores (p = 0.04). Univariate analyses identified higher fatigue scores (1) in adults across all domains except Sleep/Rest (all p ≤ 0.002), (2) in patients with pathogenic/likely pathogenic variants, and (3) for disease duration ≥10 years except Sleep/Rest (all p ≤ 0.01). Depression was the single most important factor associated with fatigue in all domains (p < 0.001). In multivariable analysis, depression remained the strongest predictor of fatigue even when accounting for age, gene variant, disease duration, and treatment delay. Conclusions: Fatigue remains the major burden in AID despite the availability of effective anti-inflammatory therapies. Depression was identified as the strongest determinant of debilitating fatigue in inactive AID. Systematic screening and integrated approaches addressing both psychological and inflammatory domains are essential for optimal care. Full article

Although fatigue is a frequently occurring symptom in young patients with obesity, relatively few studies have assessed their perception of fatigue and its impact on their quality of life so far. Comparisons between the reports of fatigue in children/adolescents with obesity and their parents were assessed using the Pediatric Quality of Life Inventory-Multidimensional Fatigue Scale (PedsQL-MFS). One hundred Italian children/adolescents (36 males; 64 females), aged between 11 and 17 (mean age = 15.3; SD = 1.61) with severe obesity [mean Body Mass Index (BMI: kg/m²) = 38; SD = 5.48] and their caregivers were enrolled. Perception of fatigue did not change by sex and rates of obesity in adolescents, while there was a difference (p = 0.040) in parents’ reports of cognitive fatigue between parents of children/adolescents of Group 1 (BMI SDS 2–2.99) and Group 2 (BMI SDS > 3), with a higher perception of fatigue in parents of the less heavy obese children. Significant differences in reports of general fatigue subscale were found between children/adolescents and their parents, being higher in their parents than in the young subjects with obesity (p < 0.001). Significant moderate correlations between all the subscales of PedsQL-MFS for children and parents were found with Pearson’s coefficients ranging from 0.529 to 0.571 (p < 0.001). The perception of fatigue measured with the PedsQL-MFS was comparable between obese children and their parents, thus indicating that this symptom is not hidden by children and is clearly perceived by their parents. Full article