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PURPOSE: This study investigated the prognostic potential of baseline C-reactive protein (CRP) levels and early CRP kinetics in a real-world cohort of patients with metastatic renal cell carcinoma (mRCC) under first-line (1L) therapy with immune checkpoint inhibitors (CPI). METHODS/PATIENTS: Analyses were performed retrospectively in a cohort of 61 mRCC patients under CPI-based 1L therapy. Patients were stratified based on baseline CRP (< 10 vs ≥ 10 mg/l) and CRP change within the initial three months of CPI therapy (normal: baseline < 10 mg/l, normalized: baseline ≥ 10 mg/l and nadir < 10 mg/l, non-normalized: baseline and nadir ≥ 10 mg/l). Finally, the association of baseline CRP and CRP change with progression-free (PFS) and overall survival (OS) was evaluated. RESULTS: Baseline CRP was not significantly associated with both PFS (p = 0.666) and OS (p = 0.143). Following stratification according to early CRP kinetics, 23, 25 and 13 patients exhibited normal, normalized and non-normalized CRP levels, respectively. Patients with normal and normalized CRP had a markedly prolonged PFS (p = 0.091) and OS (p = 0.008) compared to patients with non-normalized CRP. Consequently, significantly better PFS (p = 0.031) and OS (p = 0.002) were observed for the combined normal-normalized group. In multivariate analysis including ECOG and IMDC risk, normalized CRP kinetics alone or in combination with the normal group was identified as significant independent risk factor for OS, whereas a statistical trend was observed for PFS. CONCLUSIONS: The present study emphasizes the prognostic potential of early CRP kinetics in CPI-treated mRCC. As a standard laboratory parameter, CRP can be easily implemented into clinical routine to facilitate therapy monitoring.
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OBJECTIVES: To test whether preschool academic skills were associated with educational attainment in adolescence and whether associations differed between individuals born preterm and at full term. STUDY DESIGN: This prospective cohort study comprised 6924 individuals, including n = 444 (6.4%) adolescents born preterm (<37 weeks of gestation) from the Avon Longitudinal Study of Parents and Children. Preschool academic (mathematics and literacy) skills were rated by teachers at 4-5 years. Educational attainment at 16 years was informed by attaining a General Certificate of Secondary Education (GCSE) in key subjects mathematics and English. Logistic regressions assessed the association between preterm birth, preschool mathematics, and GCSE Mathematics and between preterm birth, preschool literacy, and GCSE English. RESULTS: Similar numbers of adolescents born preterm and at term achieved a GCSE in mathematics and English (53.6 % vs 57.4% and 59.5% vs 63.9%, respectively; P values > .05). Higher preschool academic skill scores in mathematics were associated with greater odds of attaining GCSE Mathematics and preschool literacy skills were associated with GCSE English. Adolescents born preterm with higher preschool mathematics (OR: 1.51, CI: 1.14, 2.00) and literacy skills (OR: 1.57, CI: 1.10, 2.25) were more likely to attain GCSEs in the respective subject than their term-born counterparts with equal levels of preschool skills. CONCLUSIONS: Preschool academic skills in mathematics and literacy are associated with educational attainment of preterm and term-born individuals in adolescence. Children born prematurely may benefit more from preschool mathematics and literacy skills for academic and educational success into adolescence than term-born individuals.
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Alfabetização , Nascimento Prematuro , Criança , Feminino , Humanos , Recém-Nascido , Pré-Escolar , Adolescente , Estudos Longitudinais , Estudos Prospectivos , Escolaridade , MatemáticaRESUMO
Coronavirus disease 2019 (COVID-19) has been shown to affect the vasculature, including placental changes. Insults to the placenta, especially in the first and second trimester, can affect placental functionality with a resultant impact on fetal growth and wellbeing. Thus, we explored the relationship between antenatally acquired maternal COVID-19 infection and neonatal birth characteristics. A retrospective chart review was completed using the University of New Mexico electronic medical record system. ICD-10 codes were used to identify individuals that had a positive pregnancy test and positive COVID-19 screening test between 1 March 2020 to 24 March 2021. Chi-square and nonparametric Wilcoxon analyses were used, with p < 0.05 considered significant. A total of 487 dyad charts was analyzed, with 76 (16%) individuals identified as being COVID-19-positive (CovPos) during pregnancy. CovPos mothers were significantly more likely to deliver via a cesarean section compared to CovNeg mothers (33% vs. 20%, p < 0.01). There was a significant difference in gestational age at delivery, with infants born to CovPos individuals born at an earlier gestational age than those born to CovNeg individuals (37.6 vs. 38.5 weeks; p < 0.01). Our findings showed differences in maternal and infant characteristics following COVID-19 infection during pregnancy. Additional investigations are required to further delineate these relationships with a focus on potential long-term impacts on the neonate.
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Myzus persicae is a cosmopolitan aphid that is highly polyphagous and an important agricultural pest. The subspecies M. persicae nicotianae has been described for highly specialized phenotypes adapted to tobacco (Nicotiana tabacum). In Chile, the population of M. persicae nicotianae was originally composed of a single red genotype that did not possess insecticide resistance mutations. However, in the last decade, variation in the colour of tobacco aphids has been observed in the field. To determine whether this variation stems from the presence of new genotypes, sampling was carried out across the entire distribution of tobacco cultivation regions in Chile. The aphids collected were genotyped, and the frequency of kdr (L1014F), super-kdr (M918T), modification of acetylcholinesterase (MACE) and nicotinic acetylcholine receptor ß subunit (nAChRß) mutations associated with insecticide resistance was determined. A total of 16 new genotypes of M. persicae nicotianae were detected in Chile: four of them possessed the MACE mutation, and none of them possessed the kdr, super-kdr or nAChRß mutation. The previously described red genotype was not detected in any of the sampled fields over two seasons. These results raise questions about the mechanisms underlying changes in the genetic structure of M. persicae nicotianae populations in Chile. Future research aimed at addressing these questions could provide new insight into aphid evolution and agricultural practices.
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AIMS Rosuvastatin (10 mg per day) compared with placebo reduced major adverse cardiovascular (CV) events by 24% in 12 705 participants at intermediate CV risk after 5.6 years. There was no benefit of blood pressure (BP) lowering treatment in the overall group, but a reduction in events in the third of participants with elevated systolic BP. After cessation of all the trial medications, we examined whether the benefits observed during the active treatment phase were sustained, enhanced, or attenuated. METHODS AND RESULTS After the randomized treatment period (5.6 years), participants were invited to participate in 3.1 further years of observation (total 8.7 years). The first co-primary outcome for the entire length of follow-up was the composite of myocardial infarction, stroke, or CV death [major adverse cardiovascular event (MACE)-1], and the second was MACE-1 plus resuscitated cardiac arrest, heart failure, or coronary revascularization (MACE-2). In total, 9326 (78%) of 11 994 surviving Heart Outcomes Prevention Evaluation (HOPE)-3 subjects consented to participate in extended follow-up. During 3.1 years of post-trial observation (total follow-up of 8.7 years), participants originally randomized to rosuvastatin compared with placebo had a 20% additional reduction in MACE-1 [95% confidence interval (CI), 0.640.99] and a 17% additional reduction in MACE-2 (95% CI 0.681.01). Therefore, over the 8.7 years of follow-up, there was a 21% reduction in MACE-1 (95% CI 0.690.90, P = 0.005) and 21% reduction in MACE-2 (95% CI 0.690.89, P = 0.002). There was no benefit of BP lowering in the overall study either during the active or post-trial observation period, however, a 24% reduction in MACE-1 was observed over 8.7 years. CONCLUSION The CV benefits of rosuvastatin, and BP lowering in those with elevated systolic BP, compared with placebo continue to accrue for at least 3 years after cessation of randomized treatment in individuals without cardiovascular disease indicating a legacy effect.
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Humanos , Doenças Cardiovasculares/prevenção & controle , Infarto do Miocárdio , Pressão Sanguínea , ColesterolRESUMO
Human mesenchymal stromal cells (MSC) are an important tool for basic and translational research. Large amounts of MSC are required for in vitro and in vivo studies, however, the limited life-span and differentiation ability in vitro hamper their optimal use. Here we report that 1:1 mixture of L15 and mTeSR1 culture media increased the life-span of IPI-SA3-C4, a normal non-immortalized human subcutaneous preadipocyte strain by 20% while retaining their adipogenic capacity and stable karyotype. The increased proliferative capacity was accompanied by increased expression of the stem markers POU5F1, SOX2, MYC and hTERT, and inhibition of hTERT activity abolished the growth advantage of L15-mTeSR1. Consequently, the described MSC culture would considerably enhance the utility of MSC for in vitro studies.
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Adipócitos/citologia , Adipogenia , Proliferação de Células , Telomerase/metabolismo , Adipócitos/metabolismo , Técnicas de Cultura de Células , Linhagem Celular , Sobrevivência Celular , HumanosRESUMO
Background: Auto-polymerized acrylic resins are commonly used in many applications in dentistry including in maxillofacial rehabilitation such as interim prostheses, denture repair, reline, orthodontic appliances, record base, among others. These substances, however, have some negative aspects such as poor mechanical properties. Aim: The objective of the current study was to evaluate the effect of incorporating zinc oxide nanoparticles to auto-polymerized acrylic resins on their flexural strength. Materials and methods: Thirty specimens were made from auto-polymerized acrylic resins, divided into three main groups (1 control and 2 experimental). Each group had ten specimens. The two experimental groups comprised the zinc oxide powder at 1% and 2% concentrations, respectively. Acrylic specimens were fabricated with the dimension of 65mm length, 10mm width and 2.5mm thickness according to ISO 1567 specification 1999. Each specimen was subjected to the flexural strength test by a universal testing machine. The crosshead speed for the flexural strength test was 5mm/min until fracture occurred. The SPSS version 16 was utilized for the statistical analysis. The ANOVA and Tukey were used for the comparison among all groups. Results: there was a significant increase (p<0.001) in the flexural strength of the acrylic resins following the addition of zinc oxide particles (control group: 133.27 SD 1.73, ZnO 1%: 154.28 SD 2.90, ZnO 2%: 176.45 SD 0.94). Conclusions: The incorporation of zinc oxide nanoparticles has a significant effect on the flexural strength of auto-polymerized acrylic resins.
Antecedentes: Las resinas acrílicas autopolimerizadas se usan comúnmente en muchas aplicaciones en odontología, incluyendo la rehabilitación maxilofacial, en prótesis provisionales, reparación de prótesis, revestimientos, en aparatos de ortodoncia, bases de registro, entre otros. Estas sustancias, sin embargo, tienen algunos aspectos negativos tales como propiedades mecánicas deficientes. Objetivo: el objetivo del presente estudio fue evaluar el efecto de la incorporación de nanopartículas de óxido de zinc en la resistencia a la flexión de resinas acrílicas autopolimerizadas. Materiales y métodos: Treinta muestras de resinas acrílicas autopolimerizadas fueron hechas, divididas en tres grupos principales (un grupo control y dos experimentales), cada grupo con diez especímenes. Se incorporó polvo de óxido de zinc en los dos grupos experimentales, en concentraciones de 1% y 2%, respectivamente. Las muestras de acrílico se fabricaron con una dimensión de 65mm de longitud, 10mm de ancho y 2,5mm de espesor según la especificación ISO 1567 1999. Cada muestra se sometió a la prueba de resistencia a la flexión mediante una máquina de prueba universal. La velocidad de la cruceta para la prueba de resistencia a la flexión fue de 5mm/min hasta que se produjo la fractura. Se utilizó la versión SPSS 16 para el análisis estadístico. El ANOVA y Tukey se utilizaron para la comparación entre todos los grupos. Resultados: Se observó un aumento significativo (p<0.0 01) en la resistencia a la flexión de las resinas acrílicas luego de la adición de partículas de óxido de zinc (grupo de control: 133,27 SD 1,73 MPa, ZnO 1%: 154,28 SD 2,90 MPa, ZnO 2%: 176,45 SD 0,94 MPa). Conclusiones: La incorporación de nanopartículas de óxido de zinc tiene un efecto significativo en la resistencia a la flexión de las resinas acrílicas autopolimerizadas.
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Humanos , Óxido de Zinco , Resinas Acrílicas/química , Materiais Dentários/química , Nanopartículas/química , Avaliação de Resultados em Cuidados de Saúde , Resistência à FlexãoRESUMO
Objetivo. Determinar los conocimientos y condiciones de autocuidado de pacientes con Diabetes Mellitus tipo 2. Materiales y métodos. Estudio descriptivo, transversal, cuantitativo, la muestra estuvo conformada por 41 pacientes con Diabetes Mellitus tipo 2 de una IPS de Montería, Colombia. Resultados. Mayoría de participantes estuvieron entre 48 a 77 años; nivel educativo primario y bachillerato, 20% analfabeta; 88% reside en zona urbana y 73% son femeninos. Los pacientes manifestaron conocer los cuidados básicos, sin embargo, 46% desconocen en que consiste su enfermedad y las complicaciones de la misma. La medicación, ejercicio y alimentación son los temas educativos que con mayor frecuencia les brindan en los controles; con relación al automonitoreo sólo la reciben aquellos pacientes que se administran insulina; más de la mitad de los pacientes manifestaron haber presentado complicaciones agudas o crónicas como hipertensión arterial, hipoglicemia, retinopatía y neuropatía. Conclusiones: Se evidencio deficiente conocimiento sobre la enfermedad y su autocuidado en los participantes del estudio, por lo que se hace necesario desarrollar estrategias e intervenciones de apoyo educativo teniendo en cuenta las características sociodemográficas, necesidades e individualidades de los pacientes que permitan apropiarse de los conocimientos para alcanzar un adecuado autocuidado y metas terapéuticas.
Objective. To determine the knowledge and self-care conditions of patients with Type 2 Diabetes Mellitus. Materials and methods. Descriptive, cross-sectional, quantitative study. The sample consisted of 41 patients with Type 2 Diabetes Mellitus from an IPS in Monteria, Colombia. Results. Most participants were between 48 to 77 years old; primary education level and baccalaureate, 20% illiterate; 88% reside in urban areas and 73% are female. The patients said they know the basic care, however, 46% do not know what their illness consists of and the complications of it. The medication, exercise and feeding are the educational subjects that most frequently give them in the controls; in relation to self-monitoring, only those patients who administer insulin receive it; More than half of the patients reported having acute or chronic complications such as high blood pressure, hypoglycemia, retinopathy and neuropathy. Conclusions. Deficient knowledge about the disease and its self-care in the study participants was evidenced, so it is necessary to develop strategies and educational support interventions taking into account the sociodemographic characteristics, needs and individualities of the patients that allow them to appropriate the knowledge to achieve adequate self-care and therapeutic goals
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Humanos , Adulto , Diabetes Mellitus Tipo 2 , Autocuidado , ConhecimentoRESUMO
OBJECTIVES: To assess differences relating to circadian preference in objectively measured sleep patterns from childhood to adolescence over a 9-year period. We hypothesized there is developmental continuity in sleep timing and duration according to circadian preference. STUDY DESIGN: Young participants (N = 111, 65% girls) from a community-based birth cohort underwent sleep actigraphy at mean ages 8.1 (SD = 0.3), 12.3 (SD = 0.5), and 16.9 (SD = 0.1) years. A short version of Morningness-Eveningness Questionnaire was administered in late adolescence. At each follow-up, sleep midpoint, duration, wake after sleep onset, sleep efficiency, and weekend catch-up sleep were compared between those reporting morning, intermediate, and evening preferences in late adolescence. RESULTS: Mixed model analyses indicated that sleep timing was significantly earlier among morning types compared with evening types at all ages (P values < .04). The mean differences in sleep midpoint between morning and evening types increased from a mean of 19 minutes (age 8), 36 minutes (age 12), to 89 minutes (age 17). The largest change occurred from age 12 to 17 years. Sleep duration, wake after sleep onset, sleep efficiency, and catch-up sleep did not differ according to circadian preference. CONCLUSIONS: This study found significant continuity in sleep timing from childhood to adolescence over 9 years, indicating that late circadian preference reported in late adolescence begins to manifest in middle childhood. Further studies are needed to establish whether sleep timing has its origins at an even earlier age.
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Ritmo Circadiano/fisiologia , Sono/fisiologia , Actigrafia/métodos , Adolescente , Criança , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Masculino , Inquéritos e Questionários , Fatores de TempoRESUMO
ABSTRACT Objectives: The present study was aim to evaluate the safety and efficacy of Mini-PNL to treat kidney stones in patients aged <3 years. This is the one of the largest series in the literature in this age group of patients. Material and methods: From May 2012 to April 2016, the medical records of 74 infant patients who underwent mini-PNL for renal stones were reviewed retrospectively. All infants were evaluated with the plain abdominal radiograph, urinary ultrasound, non-contrast computerized tomography and/or intravenous urogram. Pre-operative, intraoperative and post-operative data were analyzed. Results: A total of 74 infant (42 male, 32 female) with a mean age 21.5±8.2 (10-36) months were included in this study. The mean size of the stones was 22.0±5.9 (14-45) mm. A 17 Fr rigid pediatric nephroscope with a pneumatic intracorporeal lithotripsy were used through 20-22 Fr access sheath. The stone-free rate was 84.7% at 1 month after the operation. Mean operative time was 74.0 (40-140) min. Mean fluoroscopy screening time was as 4.3(3.1-8.6) min. Average hospitalization time was 3.8 (2-9) day. Auxiliary procedures were performed to 11(15.3%) patients (7 extracorporeal shock wave lithotripsy, 3 re- percutaneous nephrolitotomy, 1 retrograde intrarenal surgery). No major complication classified as Clavien IV-V observed in study group. Conclusions: Mini-PNL with pneumatic intracorporeal lithotripsy can be performed safely and effectively to manage kidney stones in infants with high stone free rate and low complications.
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Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Nefrostomia Percutânea/métodos , Nefrolitíase/cirurgia , Índice de Gravidade de Doença , Estudos Retrospectivos , Resultado do TratamentoRESUMO
OBJECTIVES: The present study was aim to evaluate the safety and efficacy of Mini-PNL to treat kidney stones in patients aged <3 years. This is the one of the largest series in the literature in this age group of patients. MATERIAL AND METHODS: From May 2012 to April 2016, the medical records of 74 infant patients who underwent mini-PNL for renal stones were reviewed retrospectively. All infants were evaluated with the plain abdominal radiograph, urinary ultrasound, noncontrast computerized tomography and/or intravenous urogram. Pre-operative, intraoperative and post-operative data were analyzed. RESULTS: A total of 74 infant (42 male, 32 female) with a mean age 21.5±8.2 (10-36) months were included in this study. The mean size of the stones was 22.0±5.9 (14-45) mm. A 17 Fr rigid pediatric nephroscope with a pneumatic intracorporeal lithotripsy were used through 20-22 Fr access sheath. The stone-free rate was 84.7% at 1 month after the operation. Mean operative time was 74.0 (40-140) min. Mean fluoroscopy screening time was as 4.3(3.1-8.6) min. Average hospitalization time was 3.8 (2-9) day. Auxiliary procedures were performed to 11(15.3%) patients (7 extracorporeal shock wave lithotripsy, 3 re- percutaneous nephrolitotomy, 1 retrograde intrarenal surgery). No major complication classified as Clavien IV-V observed in study group. CONCLUSIONS: Mini-PNL with pneumatic intracorporeal lithotripsy can be performed safely and effectively to manage kidney stones in infants with high stone free rate and low complications.
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Nefrolitíase/cirurgia , Nefrostomia Percutânea/métodos , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Estudos Retrospectivos , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
ABSTRACT Objective To evaluate laparoscopic skills of third-year Gynecology and Obstetrics residents after training at a training and surgical experimentation center. Methods Use of a prospective questionnaire analyzing demographic data, medical residency, skills, competences, and training in a box trainer and in pigs. Results After the training, there was significant improvement in laparoscopic skills according to the residents (before 1.3/after 2.7; p=0.000) and preceptors (before 2.1/after 4.8; p=0.000). There was also significant improvement in the feeling of competence in surgeries with level 1 and 2 of difficulty. All residents approved the training. Conclusion The training was distributed into 12 hours in the box trainer and 20 hours in animals, and led to better laparoscopic skills and a feeling of more surgical competence in laparoscopic surgery levels 1 and 2.
RESUMO Objetivo Avaliar a habilidade laparoscópica dos residentes do terceiro ano de residência médica em Ginecologia e Obstetrícia após treinamento em um centro de treinamento e experimentação cirúrgica. Métodos Aplicação de questionário de forma prospectiva analisando dados demográficos, da residência médica, da habilidade, da competência e do treinamento em caixa preta e em porcas. Resultados Após o treinamento, houve melhora da habilidade em laparoscopia de forma significativa na avaliação dos residentes (antes 1,3/depois 2,7; p=0,000) e preceptores (antes 2,1/depois 4,8; p=0,000). Houve melhora significativa na sensação de competência em cirurgias de níveis 1 e 2 de dificuldade. Todos os residentes aprovaram o treinamento. Conclusão O treinamento dividido em 12 horas de caixa preta e 20 horas em animais trouxe melhora na habilidade em laparoscopia e na sensação de melhora na competência cirúrgica em cirurgias laparoscópicas de níveis 1 e 2.
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Humanos , Animais , Adulto , Competência Clínica , Laparoscopia/normas , Ginecologia/normas , Internato e Residência , Obstetrícia/educação , Suínos , Ensino , Avaliação de Programas e Projetos de Saúde , Inquéritos e Questionários , Laparoscopia/educação , Modelos Animais , Ginecologia/educaçãoRESUMO
OBJECTIVE: To evaluate laparoscopic skills of third-year Gynecology and Obstetrics residents after training at a training and surgical experimentation center. METHODS: Use of a prospective questionnaire analyzing demographic data, medical residency, skills, competences, and training in a box trainer and in pigs. RESULTS: After the training, there was significant improvement in laparoscopic skills according to the residents (before 1.3/after 2.7; p=0.000) and preceptors (before 2.1/after 4.8; p=0.000). There was also significant improvement in the feeling of competence in surgeries with level 1 and 2 of difficulty. All residents approved the training. CONCLUSION: The training was distributed into 12 hours in the box trainer and 20 hours in animals, and led to better laparoscopic skills and a feeling of more surgical competence in laparoscopic surgery levels 1 and 2. OBJETIVO: Avaliar a habilidade laparoscópica dos residentes do terceiro ano de residência médica em Ginecologia e Obstetrícia após treinamento em um centro de treinamento e experimentação cirúrgica. MÉTODOS: Aplicação de questionário de forma prospectiva analisando dados demográficos, da residência médica, da habilidade, da competência e do treinamento em caixa preta e em porcas. RESULTADOS: Após o treinamento, houve melhora da habilidade em laparoscopia de forma significativa na avaliação dos residentes (antes 1,3/depois 2,7; p=0,000) e preceptores (antes 2,1/depois 4,8; p=0,000). Houve melhora significativa na sensação de competência em cirurgias de níveis 1 e 2 de dificuldade. Todos os residentes aprovaram o treinamento. CONCLUSÃO: O treinamento dividido em 12 horas de caixa preta e 20 horas em animais trouxe melhora na habilidade em laparoscopia e na sensação de melhora na competência cirúrgica em cirurgias laparoscópicas de níveis 1 e 2.
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Competência Clínica , Ginecologia/normas , Internato e Residência , Laparoscopia/normas , Obstetrícia/educação , Adulto , Animais , Ginecologia/educação , Humanos , Laparoscopia/educação , Modelos Animais , Avaliação de Programas e Projetos de Saúde , Inquéritos e Questionários , Suínos , EnsinoRESUMO
OBJECTIVES: To examine whether faster growth from birth to term (40 postmenstrual weeks) and during the first year thereafter was associated with better neurocognitive abilities in adults born preterm with very low birth weight (VLBW; <1500 g). STUDY DESIGN: Weight, length, and head circumference data of 103 VLBW participants of the Helsinki Study of Very Low Birth Weight Adults were collected from records. Measures at term and at 12 months of corrected age were interpolated. The participants underwent tests of general neurocognitive ability, executive functioning, attention, and visual memory at mean age of 25.0 years. RESULTS: Faster growth from birth to term was associated with better general neurocognitive abilities, executive functioning, and visual memory in young adulthood. Effect sizes in SD units ranged from 0.23-0.43 per each SD faster growth in weight, length, or head circumference (95% CI 0.003-0.64; P values <.05). After controlling for neonatal complications, faster growth in head circumference remained more clearly associated with neurocognitive abilities than weight or length did. Growth during the first year after term was not consistently associated with neurocognitive abilities. CONCLUSIONS: Within a VLBW group with high variability in early growth, faster growth from birth to term is associated with better neurocognitive abilities in young adulthood. Neurocognitive outcomes were predicted, in particular, by early postnatal head growth.
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Transtornos Cognitivos/epidemiologia , Recém-Nascido Prematuro/crescimento & desenvolvimento , Atenção , Dano Encefálico Crônico/epidemiologia , Cefalometria , Função Executiva , Feminino , Cabeça/crescimento & desenvolvimento , Humanos , Lactente , Recém-Nascido , Recém-Nascido de muito Baixo Peso , Modelos Lineares , Estudos Longitudinais , Masculino , Memória , Nascimento a Termo/fisiologiaRESUMO
OBJECTIVES: Market integration is an important source of cultural change exposing indigenous populations to epidemiologic and nutrition transitions. As children and adolescents are biologically sensitive to the health effects of market integration, we examine community variation of anthropometric indicators of nutritional status and growth among a cross-cultural sample of Kichwa, Shuar, Huaorani, and Cofán indigenous groups in the northern Ecuadorian Amazon. METHODS: We measured height, weight, body mass index (BMI), upper arm circumference, and triceps skinfolds of 186 children and adolescents aged 2 to 18 years from seven communities. Anthropometric z-scores were calculated based on the National Health and Nutritional Examination Survey. Comparisons were made with this US reference group, along with between community differences to contextually explore the impacts of varying degrees of market integration. RESULTS: We found a high prevalence of stunting in both boys (40%) and girls (34%). Adiposity increased with age and 40% of girls between 15 and 18 years old were overweight. There were large sex differences in body composition with higher BMI, arm circumference, and triceps skinfolds in adolescent girls. The Kichwa demonstrated the poorest growth outcomes and nutritional stress followed by the Huaorani and Shuar; yet distinctions in under- and over-nutrition were evident within groups. CONCLUSION: Market integration is a major factor influencing the developmental and lifestyle mismatch associated with the epidemiologic and nutrition transition in general, and the dual burden pattern of high rates of stunting yet adequate to above average short-term nutritional status indicators found among indigenous Amazonian populations.
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Comparação Transcultural , Distúrbios Nutricionais/etnologia , Estado Nutricional , Mudança Social , Adiposidade , Adolescente , Pesos e Medidas Corporais , Criança , Pré-Escolar , Equador/epidemiologia , Feminino , Humanos , Indígenas Sul-Americanos , Masculino , Inquéritos Nutricionais , Fatores SexuaisRESUMO
We studied whether physical activity, measured by wrist-worn accelerometers, is associated with mother- and teacher-rated psychiatric problems in 8-year-old children (n = 199). Higher overall physical activity and more time spent in more intense physical activity were associated with lower odds for psychiatric problems in emotional, social, and behavioral domains.
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Transtornos Mentais/epidemiologia , Atividade Motora , Criança , Docentes , Feminino , Humanos , Relações Interpessoais , Masculino , Relações Mãe-FilhoRESUMO
OBJECTIVE: To determine the prevalence of vertebral fractures as a complication of juvenile idiopathic arthritis (JIA). STUDY DESIGN: This cross-sectional study evaluated the prevalence and characteristics of spinal abnormalities in 50 children (aged 7.0-18.7 years) with treatment-resistant JIA by magnetic resonance imaging. Vertebral deformities, endplate irregularities, intervertebral disc involvement, spinal canal, neural foramina, and back muscles were analyzed and correlated with clinical characteristics and bone mineral density. RESULTS: Magnetic resonance imaging revealed various abnormalities in 31 patients (62%). Vertebral compression was seen in 28%, disc degeneration in 46%, protrusions in 14%, prolapses in 4%, endplate changes in 26%, and anterior vertebral corner lesions in 16%. Two patients (4%) had mild spinal canal narrowing without medullar involvement; none had neural root compression. Six patients (12%) had mild back muscle atrophy. No correlation was observed between spinal fractures or other vertebral changes and disease activity or duration, pain or bone mineral density; patients with spinal fractures tended to have a higher recent glucocorticoid exposure (P=.086). CONCLUSION: Children with severe JIA have a high prevalence of compression fractures and other vertebral, endplate, and disc abnormalities in the thoracic and lumbar spine.