RESUMO
Gestational weight gain is an important indicator for monitoring nutritional status during pregnancy. However, there are no gestational weight gain references created for adolescents or national datasets to enable the construction of such graphs up to date. This manuscript aims to describe the creation of a Latin American dataset to construct gestational weight gain references for adolescents aged 10-19 years old. Gestational weight gain data from studies conducted in nine countries (Argentina, Brazil, Chile, Colombia, Mexico, Panama, Paraguay, Peru, and Uruguay) collected between 2003 and 2021 were harmonized. Data on height, weight, and gestational age in at least two gestational trimesters were included. Pregnant adolescents should be free of diseases that could affect weight, and newborns should weigh between 2,500-4,000 g and be free of congenital malformations. The final dataset included 6,414 individuals after data cleaning. Heterogeneity between the countries was assessed by calculating standardized site differences for GWG and z scores of height-for-age. Several imputation procedures were tested, and approximately 10% of the first-trimester weights were imputed. The prevalence of individuals with underweight (1.5%) and obesity (5.3%) was low, which may lead to problems when modeling the curves for such BMI categories. Maternal height and gestational weight gain did not show significant differences by country, according to the standardized site differences. A harmonized dataset of nine countries with imputed data in the first trimester of pregnancy was prepared to construct Latin American gestational weight gain curves for adolescents.
Assuntos
Ganho de Peso na Gestação , Gravidez , Feminino , Recém-Nascido , Humanos , Adolescente , Criança , Adulto Jovem , Adulto , Aumento de Peso , América Latina/epidemiologia , Índice de Massa Corporal , Obesidade/epidemiologiaRESUMO
Monitoring gestational weight gain (GWG) throughout pregnancy among adolescents is important for detecting individuals at risk and timely intervention. However, there are no specific tools or guidelines for GWG monitoring of this group. We aimed to construct GWG charts for pregnant adolescents (10-19 years old) according to pre-pregnancy body mass index (BMI) using a pooled dataset from nine Latin American countries. Datasets from Argentina, Brazil, Chile, Colombia, Mexico, Panama, Paraguay, Peru, and Uruguay collected between 2003 and 2021 were combined after data cleaning and harmonization. Adolescents free of diseases that could affect GWG and who gave birth to newborns weighing between 2,500-4,000 g and free of congenital malformations were included. Multiple imputation techniques were applied to increase the sample size available for underweight and obesity categories. Generalized Additive Models for Location, Scale, and Shape were used to construct the charts of GWG according to gestational age. Internal and external validation procedures were performed to ensure that models were not over-adjusted to the data. The cohort included 6,414 individuals and 29,414 measurements to construct the charts and 1,684 individuals and 8,879 measurements for external validation. The medians (and interquartile ranges) for GWG at 40 weeks according to pre-pregnancy BMI were: underweight, 14.9 (11.9-18.6); normal weight, 14.0 (10.6-17.7); overweight, 11.6 (7.7-15.6); obesity, 10.6 kg (6.7-14.3). Internal and external validation showed that the percentages above/below selected percentiles were close to those expected, except for underweight adolescents. These charts describe the GWG throughout pregnancy among Latin American adolescents and represent a significant contribution to the prenatal care of this group. GWG cut-offs based on values associated with lower risks of unfavorable outcomes for the mother-child binomial should be determined before implementing the charts in clinical practice.
Assuntos
Ganho de Peso na Gestação , Complicações na Gravidez , Gravidez , Feminino , Recém-Nascido , Adolescente , Humanos , Criança , Adulto Jovem , Adulto , Resultado da Gravidez , Magreza/epidemiologia , Magreza/complicações , América Latina , Obesidade/epidemiologia , Obesidade/complicações , Sobrepeso/epidemiologia , Sobrepeso/complicações , Índice de Massa CorporalRESUMO
Introducción: El equilibrio postural conforma parte de la evaluación funcional para riesgo de caída en adultos mayores. El Ministerio de Salud Chileno aplica el Test Estación Unipodal para valora la estabilidad unipodal estática como herramienta de prevención en salud. Objetivo: Determinar la concordancia o equivalencia diagnóstica entre el Test Estación Unipodal y el Test unipodal para estabilidad corporal estática, en modalidad ojos abiertos. Métodos: Estudio de concordancia diagnóstica, de tipo transversal; aplicado en 60 adultos mayores autovalentes pertenecientes a talleres deportivos del Gimnasio Olímpico de San Miguel, Región Metropolitana, Chile, quienes voluntariamente ejecutaron dos pruebas de estabilidad unipodal estática y respondieron un instrumento de consulta al final de la evaluación referida al Test unipodal para estabilidad corporal estática. Resultados: Entre las dos pruebas de estabilidad unipodal, en modalidad ojos abiertos, se presentó una concordancia significativa al evaluar buena o deficiente estabilidad (p = 0,0005). Los adultos mayores evaluados percibieron el Test unipodal para estabilidad corporal estática como prueba de fácil aplicación, bajo nivel de riesgo físico y cansancio, declarando intención de volver a realizarla si se requiere valorar nuevamente su estabilidad. Conclusión: Ambos métodos, Test Estación Unipodal y Test unipodal para estabilidad corporal estática, en modalidad ojos abiertos, fueron capaces de clasificar correctamente buena estabilidad o estabilidad deficiente en los adultos mayores evaluados. Por lo tanto, resultan equivalentes y concordantes para el diagnóstico de la estabilidad estática con apoyo unipodal(AU)
Introduction: Postural balance is part of the functional assessment for risk of falling in aged adults. The Chilean Ministry of Health applies the Unipodal Station Test to assess static unipodal stability as a health prevention tool. Objective: To determine concordance or diagnostic equivalence between the Unipodal Station Test and the Unipodal Test for static body stability, in the open eyes modality. Methods: Cross-sectional study of diagnostic concordance applied in sixty self-supporting aged adults belonging to sports workshops of the Olympic Gymnasium of San Miguel, in the Metropolitan Region of Chile, who voluntarily completed two static unipodal stability tests and answered a consultation instrument at the end of the assessment concerning the Unipodal Test for static body stability. Results: Between the two unipodal stability tests, in the open eyes modality, a significant concordance was present upon assessing good or poor stability (p = 0.0005). The aged adults who underwent assessment perceived the Unipodal Test for static body stability as a test of easy application and low level of physical risk and fatigue, as well as declared their intention to complete it again if their stability needed to be reassessed. Conclusion: Both the Unipodal Station Test and the Unipodal Test for static body stability, in the open eyes modality, were effective methods to classify good stability or poor stability correctly in the aged adults who underwent assessment. Therefore, they are equivalent and concordant for the diagnosis of static stability with unipodal support(AU)
Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Acidentes por Quedas/prevenção & controle , Idoso , Fatores de Risco , Chile , Estudos TransversaisRESUMO
Dihydroxynaphthyl aryl ketones 1-5 have been evaluated for their abilities to inhibit microtubule assembly and the binding to tubulin. Compounds 3, 4 and 5 displayed competitive inhibition against colchicine binding, and docking analysis showed that they bind to the tubulin colchicine-binding pocket inducing sheets instead of microtubules. Remarkable differences in biological activity observed among the assayed compounds seem to be related to the structure and position of the aryl substituent bonded to the carbonyl group. Compounds 2, 3 and 4, which contain a heterocyclic ring, presented higher affinity for tubulin compared to the carbocyclic analogue 5. Compound 4 showed the best affinity of the series, with an IC50 value of 2.1 µM for microtubule polymerization inhibition and a tubulin dissociation constant of 1.0 ± 0.2 µM, as determined by thermophoresis. Compound 4 was more efficacious in disrupting microtubule assembly in vitro than compound 5 although it contains the trimethoxyphenyl ring present in colchicine. Hydrogen bonds with Asn101 of α-tubulin seem to be responsible for the higher affinity of compound 4 respects to the others.