Mirjam Močnik

By Mirjam Močnik and Nataša Marčun Varda

Cardiovascular morbidity and mortality are still increasing in developed countries with emphasis on the obesity epidemic. Children and young adults are no exception. With modern lifestyle, traditional cardiovascular risk factors, such as hypertension, obesity, dyslipidemia, insulin resistance, kidney damage, are increasingly present in children leading to premature cardiovascular events in adult life. Cardiovascular risk factor can accelerate naturally progressing atherosclerosis, which should be prevented to facilitate quality and longevity of life. Primary and primordial prevention in the pediatric population are of utmost importance. However, if a cardiovascular risk factor is already present, frequent monitoring of possible development of other cardiovascular risk factors and evaluation of end organ damage should be implemented to intervene in time.

Part of the book: Risk Factors for Cardiovascular Disease

By Mirjam Močnik and Nataša Marčun Varda

Cardiorespiratory fitness is an outcome of physical activity, enabling the transport of oxygen from the atmosphere to the mitochondria to perform physical work and therefore reflects the overall capacity of the cardiovascular and respiratory systems to perform the prolonged exercise. In recent decades, it has declined in the paediatric population. Cardiovascular fitness measurement has yet to be standardised in children but is a powerful marker of health in youth and is strongly associated with inflammation and inversely associated with cardiovascular risk factors, especially obesity. Notably, youth with low cardiorespiratory fitness levels have a higher risk of developing cardiovascular diseases during adulthood. Lowered cardiorespiratory fitness has been demonstrated most often in children with obesity and associated cardiovascular comorbidities, however, these can be associated with cardiorespiratory fitness independently to body mass index. The benefits of physical activity on health have been well demonstrated during growth and it should be encouraged in children with cardiovascular risk to prevent further reduction of cardiorespiratory fitness and the development of other comorbidities. Along with appropriate physical exercise and diet in childhood, breastfeeding in the first year of life is recommended.

Part of the book: Cardiorespiratory Fitness

By Mirjam Močnik and Nataša Marčun Varda

Obesity in children, including adolescents, is nowadays, in the light of the COVID-19 pandemic, an even more pressing problem than before it, leading to increased prevalence of obesity and its comorbidities at young age. A simple and correct approach to diagnosis is essential, and some new insights in epidemiology, pathophysiology, and diagnosis are currently under investigation. Obesity in preschool children and metabolically healthy obesity are new entities that are recently being defined and written about. Additionally, several new factors that might influence obesity development are being researched, such as pollutants, sleep duration, and gut microbiota. In this chapter, we briefly present them as possible therapeutic targets in the future along with current therapeutic options in the pediatric population, namely lifestyle change, pharmaceutical options, and surgery. A child is always significantly affected by his/her family lifestyle, home, and social environment, which has to be considered in childhood obesity management.

Part of the book: Obesity

By Mirjam Močnik and Nataša Marčun Varda

Paediatric nephrology is frequently seen as a challenging aspect of paediatric care and necessitating specialised expertise. Nevertheless, the typical issues encountered in paediatric nephrology, such as urinary tract infections and mild micturition disorders, often do not require the attention of a paediatric nephrologist and can be managed effectively by a general practitioner. Urinary tract infections frequently present to emergency centres. They commonly include acute pyelonephritis and uncomplicated cystitis, differentiated upon clinical presentation. Urinalysis, urine culture, acute phase reactants, and renal and bladder ultrasound are the mainstay for the diagnosis. Except for asymptomatic bacteriuria, antibiotic treatment is necessary in the management. Micturition disorders are more common in nephrological outpatient clinics and encompass a wide range of urinary issues, with primary nocturnal enuresis and various forms of daytime micturition problems being the most prevalent. These disorders can be classified as primary or secondary, as well as monosymptomatic or non-monosymptomatic. The diagnosis is based on history and voiding diary and supplemented with imaging and functional diagnostic procedures, as needed. The management primarily involves urotherapy, complemented with medications, if necessary.

Part of the book: Common Childhood Diseases - Diagnosis, Prevention and Management [Working title]