RESUMO
BACKGROUND: To evaluate the influence of previous physical activity (PA) during childhood, adolescence, and current PA practice on the production of antibodies and inflammatory response between the first and second doses of the COVID-19 vaccine. METHODS: Fifty-nine men and 56 women were evaluated before the first vaccine, and 12 weeks later, blood samples were taken to quantify production of anti-severe acute respiratory syndrome coronavirus-2 immunoglobulin G antibodies and cytokines. Previous PA during childhood and adolescence was self-referred, and current PA was assessed using the International Physical Activity Questionnaire. RESULTS: A positive and significant association was observed only between PA practice during adolescence and an increase in antibody production in adulthood (ß = 2012.077, 95% confidence interval, 257.7953-3766.358, P = .025). Individuals who practiced PA during adolescence showed higher production of antibodies between the first and second vaccine dose compared to nonpractitioners (P = .025) and those that accumulated ≥150 minutes per week of current moderate-vigorous PA (MVPA), and presented higher antibody production in relation to who did <150 minutes per week of MVPA (P = .046). Individuals that were practitioners during childhood produced higher G-CSF (P = .047), and those that accumulated ≥150 minutes per week of current MVPA demonstrated lower IP-10 levels (P = .033). However, PA practitioners during adolescence presented higher G-CSF (P = .025), IL-17 (P = .038), IL-1RA (P = .005), IL-1ß (P = .020), and IL-2 (P = .026) levels. CONCLUSION: Our results suggest that adults that accumulated at least 150 minutes of MVPA per week or practiced PA during adolescence developed an improved immune and inflammatory response against COVID-19 vaccination.
Assuntos
Anticorpos Antivirais , COVID-19 , Exercício Físico , SARS-CoV-2 , Humanos , Masculino , Feminino , COVID-19/prevenção & controle , COVID-19/imunologia , Adulto , Adolescente , Anticorpos Antivirais/sangue , SARS-CoV-2/imunologia , Vacinas contra COVID-19/imunologia , Vacinas contra COVID-19/administração & dosagem , Imunoglobulina G/sangue , Imunoglobulina G/imunologia , Citocinas/sangue , Criança , Pessoa de Meia-Idade , Adulto Jovem , Inflamação/imunologia , Fatores EtáriosRESUMO
Phase angle, obtained by bioelectrical impedance, is an indicator of cellular integrity and has been proposed as a prognostic parameter in patients who are critically ill. This systematic review aimed to evaluate the association between phase angle and adverse clinical outcomes in hospitalized patients with coronavirus disease-2019 (COVID-19). An extensive literature search was performed in the MEDLINE/PubMed, Embase, and Web of Science databases, with interest in observational studies evaluating the association between phase angle and adverse clinical outcomes in individuals aged ≥18 years hospitalized with COVID-19. Studies were independently selected by two reviewers, according to eligibility criteria. Subsequently, data were extracted and presented in a qualitative synthesis. The evaluation of the quality of the studies was performed according to the Newcastle-Ottawa scale. The full methodology was published in PROSPERO (ID CRD42022306177). A total of 392 articles were identified, resulting in seven selected studies, of which six were prospective cohorts and one was retrospective. In the quality assessment, six studies obtained scores equal to or greater than seven, indicating a low risk of bias. A total of 750 participants composed the samples of the selected studies. Five studies reported an independent association between phase angle and adverse clinical outcomes during hospitalization for COVID-19, with emphasis on prolonged hospitalization and mechanical ventilation and higher mortality in patients with a lower phase angle. Thus, phase angle measurement can be useful in the early identification of risks in patients hospitalized with COVID-19, for the purpose of adequacy of clinical management.
Assuntos
COVID-19 , Adolescente , Adulto , COVID-19/terapia , Estado Terminal/terapia , Humanos , Estudos Prospectivos , Respiração Artificial , Estudos RetrospectivosRESUMO
AIM: To compare pubertal development in age-matched healthy girls born with low birth weight (LBW) or appropriate birth weight for gestational age (AGA). SUBJECTS AND METHODS: Girls with breast in Tanner stage II and normal body mass index were followed for 3 years with a complete physical exam, bone age, pelvic ultrasound, and measurement of gonadal hormones using a leuprolide test. RESULTS: Forty-one girls (AGA 25/LBW 16) were followed up for 3 years. By 3 years, they had similar bone age, adjusted height, and body composition. In LBW girls, breast Tanner stage advanced faster during the first 2 years of follow-up, which was associated with higher serum androgens. Hirsutism score, ovarian volume, and number of follicles between AGA and LBW were not different nor was age of menarche. By the third year, basal and poststimulated levels of gonadotropins and androgens anti-Müllerian hormone and inhibin B were similar in both groups and did not show differences related to birth weight or degree of catch-up growth. CONCLUSION: LBW recruits showed a slightly faster breast development but no differences in androgen excess signs, internal genitalia, and gonadal hormonal patterns.
Assuntos
Recém-Nascido de Baixo Peso/fisiologia , Ovário/crescimento & desenvolvimento , Ovário/fisiologia , Puberdade/fisiologia , Androgênios/sangue , Hormônio Antimülleriano/sangue , Peso ao Nascer/fisiologia , Mama/crescimento & desenvolvimento , Criança , Pré-Escolar , Feminino , Seguimentos , Hormônios Esteroides Gonadais/sangue , Gonadotropinas/sangue , Humanos , Recém-Nascido , Inibinas/sangue , Estimativa de Kaplan-Meier , Menarca/fisiologia , Estudos ProspectivosRESUMO
BACKGROUND: STAT5, which plays an important role in GH signal transduction, has been studied extensively in children with growth retardation, but there is scarce information regarding STAT3. AIM: We determined total and phosphorylated STAT3 after GH stimulation in fibroblasts from children with idiopathic short stature (ISS) and control children with normal stature. SUBJECTS AND METHODS: We studied 15 prepubertal children (age 7.6 ± 0.4 years) with short stature (height -2.8 ± 0.2 SDS), decreased growth velocity (
Assuntos
Núcleo Celular/metabolismo , Citoplasma/metabolismo , Transtornos do Crescimento/metabolismo , Hormônio do Crescimento Humano/metabolismo , Fator de Transcrição STAT3/metabolismo , Algoritmos , Células Cultivadas , Criança , Pré-Escolar , Regulação para Baixo , Feminino , Fibroblastos/metabolismo , Humanos , Masculino , Fosforilação , Transporte Proteico , Proteínas Recombinantes , Transdução de Sinais , Pele/citologia , Pele/metabolismo , Fatores de TempoRESUMO
AIM: We investigated whether the insulin-like growth factor (IGF)-I response to growth hormone (GH) is regulated by body mass index (BMI) in short children with normal weight. METHODS: We studied 37 prepubertal children with idiopathic short stature (ISS), comparing children with high-normal BMI (standard deviation scores, SDS 1.23 +/- 0.11, n = 20) and low-normal BMI (SDS -0.93 +/- 0.12, n = 17). The IGF-I response to GH was determined with an abbreviated IGF-I generation test, by measuring serum IGF-I concentrations at baseline and 24 h after the administration of GH (0.033 mg/kg). RESULTS: Children with high- and low-normal BMI had similar age (8.5 +/- 0.7 vs. 8.7 +/- 0.7 years) and height (-2.0 +/- 0.1 vs. -2.2 +/- 0.2 SDS). However, children with high-normal BMI exhibited higher mean basal IGF-I (191 +/- 15 vs. 139 +/- 11 ng/ml, p < 0.05), higher mean IGF-I levels 24 h after GH administration (261 +/- 22 vs. 164 +/- 14 ng/ml, p < 0.05) and a higher IGF-I percent increase after GH administration (37 +/- 5 vs. 17 +/- 4%, p < 0.05) compared with children with normal-low BMI. CONCLUSION: BMI modulates the IGF-I response to GH, suggesting that GH sensitivity may be influenced by the nutritional status in children with ISS and normal body weight.
Assuntos
Índice de Massa Corporal , Hormônio do Crescimento Humano/uso terapêutico , Fator de Crescimento Insulin-Like I/metabolismo , Composição Corporal , Criança , Feminino , Humanos , MasculinoRESUMO
Small size at birth may result from fetal undernutrition which may occur at different times during gestation. Early postnatal catch-up growth and excess childhood weight gain are associated with an increased risk of adult cardiovascular disease and type 2 diabetes mellitus. The aim of this study was to assess the relative contributions of body composition and energy expenditure on fasting insulin sensitivity during late childhood. We took advantage of two previously described prospective cohorts of children born either at term or prematurely, with a wide range of birth weights adjusted for gestational age. Seventy-one prepubertal children (mean age 7.5 +/- 0.3 years) were examined: 23 term SGA (8 M, 15 F), 12 preterm SGA (7 M, 5 F), 16 term AGA (8 M, 8 F), and 20 preterm AGA (9 M, 11 F). Mean height SDS was -0.18 +/- 0.11 and mean BMI SDS was 0.27 +/- 0.03. Change in weight SDS was significantly higher in children born SGA compared to their AGA counterparts (p < 0.001). Change in weight SDS was highly correlated with fasting insulin (p < 0.03) and leptin (p < 0.001). Fasting insulin correlated only with serum leptin levels. Body composition appeared to be the main determinant of fasting leptin levels. No differences in lipid profile were observed between the different groups. There was a clear tendency to higher insulin and leptin levels in children born SGA compared with their AGA counterparts. IGF-I levels were significantly higher only in SGA term compared to AGA term. Resting energy expenditure (REE) was lower in SGA born at term and higher in SGA born preterm compared to their AGA counterparts. In conclusion, fasting insulin sensitivity is mainly determined by leptin levels which in turn are determined by body composition. IGF-I and REE showed a divergent pattern in SGA term compared to SGA preterm groups. IGF-I levels were determined only by weight change from birth to age 2 years, which may not be as pronounced in VLBW children compared to SGA term and thus may preclude a difference in IGF-I levels in the group of preterm children. The divergent effect in REE in SGA born at term compared to SGA born preterm compared to their AGA counterparts may explain the divergent effects on IGF-I. This difference might be a consequence of different timing in the exposure to intrauterine nutritional deficiency.
Assuntos
Composição Corporal/fisiologia , Metabolismo Energético/fisiologia , Recém-Nascido de Baixo Peso/fisiologia , Nascimento Prematuro/fisiopatologia , Nascimento a Termo/fisiologia , Densidade Óssea , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Insulina/sangue , Resistência à Insulina , Leptina/sangue , MasculinoRESUMO
BACKGROUND: Insulin-like growth factor-I (IGF-I) and insulin are structurally related proteins with similar receptors and signal transduction systems. AIM: We postulate that some low birth weight (LBW) children may have decreased sensitivity to both insulin and IGF-I. METHODS: We studied 48 prepubertal LBW children aged 7.6 +/- 2.4 years. Insulin sensitivity was determined using an oral glucose tolerance test, and IGF-I sensitivity was assessed by determining nocturnal GH concentrations at baseline and after administration of recombinant human IGF-I/IGFBP-3 complex. RESULTS: Children were classified into quartiles of insulin sensitivity based on their glucose AUC/insulin AUC index. Children in the lowest quartile of insulin sensitivity exhibited a lower IGF-I sensitivity after administration of the rhIGF-I/rhIGFBP-3 complex compared to children in the highest quartile of insulin sensitivity (percent change in GH AUC: -44.2 +/- 5.7 vs. -21.6 +/- 6.8, p < 0.05). CONCLUSION: LBW children in the lowest quartile of insulin sensitivity exhibited a lower pituitary GH response to the administration of rhIGF-I/rhIGFBP-3. Our findings suggest that reduced sensitivity to insulin and IGF-I may coexist in some prepubertal LBW children.
Assuntos
Recém-Nascido de Baixo Peso/fisiologia , Resistência à Insulina/fisiologia , Fator de Crescimento Insulin-Like I/fisiologia , Criança , Pré-Escolar , Feminino , Teste de Tolerância a Glucose , Transtornos do Crescimento/etiologia , Hormônio do Crescimento Humano/sangue , Humanos , Recém-Nascido , Proteína 3 de Ligação a Fator de Crescimento Semelhante à Insulina , Proteínas de Ligação a Fator de Crescimento Semelhante a Insulina , Masculino , Proteínas RecombinantesRESUMO
Mutations in the GH receptor gene have been identified as the cause of growth hormone insensitivity syndrome (GHIS), a rare autosomal recessive disorder. We studied the clinical and biochemical characteristics and the coding sequence and intron-exon boundaries of the GH receptor gene in a consanguineous family with severe short stature which consisted of two patients, their parents and five siblings. The two adolescents had heights of -4.7 and -5.5 SDS, respectively, with elevated growth hormone associated with low IGF-I, IGFBP-3 and GHBP concentrations. Molecular analysis of the GH receptor gene revealed a mutation in exon 6, present in both patients This mutation, E180 splice, has been previously described in an Ecuadorian cohort, and in one Israeli and six Brazilian patients. We determined the GH receptor haplotypes based on six polymorphic sites in intron 9. Co-segregation of the E180splice mutation with haplotype I was found in this family, compatible with a common Mediterranean ancestor, as shown for previous cases with the E180splice mutation described to date.
Assuntos
Síndrome de Laron/etnologia , Síndrome de Laron/genética , Mutação/genética , Receptores da Somatotropina/genética , População Branca/genética , Adolescente , Adulto , Estatura/genética , Criança , Chile , Éxons/genética , Feminino , Haplótipos/genética , Humanos , Masculino , Região do Mediterrâneo/etnologia , Pessoa de Meia-Idade , Linhagem , FenótipoRESUMO
Growth hormone may help to increase final height in patients with short stature, but its efficacy is variable. It has been recently reported that the isoform of the GH receptor (GHR) that lacks exon 3 (d3-GHR) is associated with a greater growth response to GH therapy. We hypothesized that nocturnal growth hormone concentrations, basal IGF-I and IGFBP-3 levels, and insulin sensitivity might show variations among individuals depending on their GHR allelic variant. To test this hypothesis, we studied 38 prepubertal LBW children with nocturnal GH concentrations, IGF-I and IGFBP-3 levels and insulin sensitivity during OGTT and Insulin test. The GHR allelic variant was analyzed through multiplex PCR analysis in DNA from peripheral leukocytes. Characteristics of the overnight GH secretion [(mean GH: 6.8 +/- 0.6 vs. 6.2 +/- 0.5 ng/ml), (AUC: 3,227 +/- 280 vs. 2,908 +/- 212 ng/ml.min), (peak number: 4.4 +/- 0.3 vs. 4.4 +/- 0.2), (amplitude: 12 +/- 1.1 vs. 10.8 +/- 1.1 ng/ml)] did not differ between groups (f1/f1 vs. f1/d3 plus d3/d3). In addition, we did not observe any significant differences in serum IGF-I SDS (-0.49 +/- 0.26 vs. -0.40 +/- 0.35) or IGFBP-3 SDS (-1.21 +/- 0.24 vs. -0.89 +/- 0.21) nor in insulin sensitivity (WIBSI: 12 +/- 1.2 vs. 10.8 +/- 1.1) in LBW children with full length GHR compared to children carrying at least one GHRd3 allele. The distribution of the f1/f1 allelic variant and fi/d3 or d3/d3 was similar in the LBW children with or without catch-up growth. These results suggest that the GHR allelic variant does not play a significant role in the regulation of GH-IGF-I/BP3 axis or in insulin sensitivity in prepubertal LBW children.
Assuntos
Proteínas de Transporte/genética , Hormônio do Crescimento Humano/sangue , Recém-Nascido Pequeno para a Idade Gestacional/metabolismo , Resistência à Insulina/fisiologia , Proteínas de Ligação a Fator de Crescimento Semelhante a Insulina/sangue , Fator de Crescimento Insulin-Like I/metabolismo , Criança , Ritmo Circadiano , Feminino , Variação Genética , Teste de Tolerância a Glucose , Humanos , Recém-Nascido , Proteína 3 de Ligação a Fator de Crescimento Semelhante à Insulina , MasculinoRESUMO
OBJECTIVE: There is limited information regarding the effects of IGF-I and/or IGFBP-3 on circulating ghrelin concentrations. To determine the effects of IGF-I on GH and ghrelin concentrations, we examined the GH and ghrelin nocturnal profiles before and after the administration of the IGF-I/-IGFBP-3 complex (Iplex) to low birth weight children. DESIGN: The children were studied on two separate occasions, the first under basal conditions, and the second time after the sc administration of 1 mg/kg of Iplex at 2100 h. Blood samples for determination of GH and ghrelin were obtained every 20 min between 2300 h and 0700 h, while the children were sleeping. In each patient, we calculated the mean GH and ghrelin area under the curve (GH AUC and GHR AUC), both under basal conditions and after the administration of the IGF-I/IGFBP-3 complex. SETTING: The study was performed at a University Research Centre located at a General Hospital in Santiago, Chile. PATIENTS: Twenty prepubertal children (11 boys and 9 girls), born after a full-term pregnancy with a birth weight below 2.8 kg were studied at a mean +/- SEM age of 7.3 +/- 0.5 years (range 4-11 years). Their mean height was -1.8 +/- 0.3 standard deviation score (SDS) and their mean BMI was 0.1 +/- 0.2 SDS at the time of the study. MAIN OUTCOME AND RESULTS: Mean nocturnal GH AUC exhibited a significant decrease (2903 +/- 185 vs 1860 +/- 122 ng/ml min, P < 0.01), whereas mean GHR AUC showed a significant increase after administration of the IGF-I/IGFBP-3 complex (68 +/- 16 vs 288 +/- 36 ng/ml min, P < 0.01). CONCLUSIONS: These findings indicate that the IGF-I/IGFBP-3 complex appears to have opposite effects on circulating GH and ghrelin concentrations in low birth weight children, suggesting that, in addition to its known negative feed-back effect on GH, IGF-I and/or IGFBP-3 may have a positive feed-back effect on ghrelin.
Assuntos
Transtornos do Crescimento/metabolismo , Hormônio do Crescimento/sangue , Recém-Nascido de Baixo Peso/metabolismo , Proteína 3 de Ligação a Fator de Crescimento Semelhante à Insulina/farmacologia , Fator de Crescimento Insulin-Like I/farmacologia , Complexos Multiproteicos/farmacologia , Hormônios Peptídicos/sangue , Área Sob a Curva , Criança , Seguimentos , Grelina , Humanos , Recém-Nascido , Taxa Secretória , Estatísticas não ParamétricasRESUMO
INTRODUCTION: Insulin resistance (IR) develops as early as age 1 to 3 yr in small for gestational age (SGA) infants who show rapid catch-up postnatal weight gain. In contrast, greater insulin secretion is related to infancy height gains. We hypothesized that IGF-I levels could be differentially related to gains in length and weight and also differentially related to IR and insulin secretion. METHODS: In a prospective study of 50 SGA (birth weight < 5th percentile) and 14 normal birth weight [appropriate for gestational age (AGA)] newborns, we measured serum IGF-I levels at birth, 1 yr, and 3 yr. IR (by homeostasis model assessment) and insulin secretion (by short iv glucose tolerance test) were also measured at 1 yr and 3 yr. RESULTS: SGA infants had similar mean length and weight at 3 yr compared with AGA infants. SGA infants had lower IGF-I levels at birth (P < 0.0001), but conversely they had higher IGF-I levels at 3 yr (P = 0.003) than AGA infants. Within the SGA group, at 1 yr IGF-I was associated with length gain from birth and insulin secretion (P < 0.0001); in contrast at 3 yr IGF-I was positively related to weight, body mass index, and IR. CONCLUSIONS: IGF-I levels increased rapidly from birth in SGA, but not AGA children. During the key first-year growth period, IGF-I levels were related to beta-cell function and longitudinal growth. In contrast, by 3 yr, when catch-up growth was completed, IGF-I levels were related to body mass index and IR, and these higher IGF-I levels in SGA infants might indicate the presence of relative IGF-I resistance.
Assuntos
Recém-Nascido Pequeno para a Idade Gestacional/sangue , Resistência à Insulina , Fator de Crescimento Insulin-Like I/análise , Insulina/sangue , Insulina/metabolismo , Peso ao Nascer , Estudos de Casos e Controles , Desenvolvimento Infantil , Pré-Escolar , Teste de Tolerância a Glucose , Humanos , Lactente , Recém-Nascido de Baixo Peso/sangue , Recém-Nascido , Secreção de Insulina , Estudos ProspectivosRESUMO
Adiponectin, a novel adipocytokine with insulin sensitizing properties, is inversely related to obesity and insulin resistance in adults. We recently reported large variations in weight gain and insulin sensitivity during the first year in infants born small for gestational age (SGA) or appropriate for gestational age (AGA). We now determined whether adiponectin levels were related to postnatal growth and insulin sensitivity in a prospective cohort followed from birth to two years old (n = 85) (55 female/30 male, 65 SGA/20 AGA). Serum adiponectin levels at one year and two years were higher compared to reported levels in adults and older children, and decreased from one year (21.6 +/- 0.6 microg/ml) to two years (15.7 +/- 0.7 microg/ml) (p < 0.05). At two years adiponectin levels were lower in females (15.3 +/- 0.4 microg/ml) than males (16.4 +/- 0.6 microg/ml) (p < 0.05), but no gender difference was seen in leptin or insulin levels. No differences in adiponectin levels were seen between SGA and AGA infants at one or two years. However, in SGA infants changes in adiponectin between one to two years old were inversely related to weight gain (r = -0.310, p < 0.05). Changes in leptin levels between one to two years were positively related to weight gain in both SGA and AGA infants (r = 0.450 and r = 0.500 respectively, both p < 0.05). Adiponectin levels were unrelated to insulin levels at one or two years, nor to change in insulin levels between one to two years. In multiple regression analysis, adiponectin levels were related only to postnatal age; omitting age from the model, the determinants of higher adiponectin levels were male gender (p = 0.03), lower postnatal body weight (p < 0.001), and higher birth weight SD score (p = 0.004). In conclusion, fall in serum adiponectin levels during the first two years of life were related to increasing age and greater weight gain SGA infants, but were unrelated to insulin sensitivity.
Assuntos
Resistência à Insulina , Peptídeos e Proteínas de Sinalização Intercelular/sangue , Leptina/sangue , Aumento de Peso , Adiponectina , Estudos de Coortes , Feminino , Humanos , Lactente , Recém-Nascido , Recém-Nascido Pequeno para a Idade Gestacional , Insulina/sangue , Masculino , Estudos ProspectivosRESUMO
Strong associations between low birth weight and insulin resistance have been described. However, most of these studies have been retrospective. We aimed to determine whether infants born small for gestational age (SGA: birth weight <5th percentile for gestational age) have decreased insulin sensitivity, compared with appropriate for gestational age (AGA: birth weight >10th percentile) at 1 yr of age. We studied blood lipids, fasting insulin levels, other markers of insulin sensitivity, and insulin secretion during an iv glucose tolerance test in a cohort of 85 SGA and 23 AGA 1-yr-old infants. In addition, SGA infants were stratified according to catch-up growth (CUG) in weight (WCUG) or length (LCUG) during the first year of life. At 1 yr, SGA infants had a clear tendency to higher triglycerides. Fasting insulin was significantly higher in SGA infants with WCUG, compared with those who did not catch up and AGA infants (mean +/- SEM, 32.6 +/- 4.6 vs. 14.9 +/- 2.3 vs. 21.4 +/- 3.3 pM, respectively; P < 0.05). Length increment (in SD score) was the principal determinant of postload insulin secretion (R(2) = 0.1, P < 0.01). We conclude that insulin secretion and sensitivity are closely linked to patterns of rapid WCUG and LCUG during early postnatal life. Fasting insulin sensitivity is more related to WCUG and current body mass index, whereas insulin secretion seems to be directly related to LCUG.
Assuntos
Crescimento/fisiologia , Recém-Nascido Pequeno para a Idade Gestacional/crescimento & desenvolvimento , Resistência à Insulina/fisiologia , Insulina/metabolismo , Glicemia/metabolismo , Estatura/fisiologia , Peso Corporal/fisiologia , Estudos de Coortes , Feminino , Teste de Tolerância a Glucose , Humanos , Lactente , Recém-Nascido , Insulina/sangue , Secreção de Insulina , Masculino , Estudos ProspectivosRESUMO
OBJECTIVE: To study the consequences of low birth weight on glucose and lipid metabolism 48 hours after delivery. METHODS: We studied 136 small for gestational age (SGA) and 34 appropriate for gestational age (AGA) term neonates who were born in Santiago, Chile. Prefeeding venous blood was obtained 48 hours after birth for determination of glucose, free fatty acids, beta-hydroxy butyrate, insulin, C-peptide, leptin, sex hormone-binding globulin, insulin-like growth factor-binding protein-1 (IGFBP-1), and cortisol. RESULTS: SGA newborns had lower glucose (SGA versus AGA, median [interquartile range]: 3.6 mmol/L [2.9-4.1 mmol/L] vs 3.9 mmol/L [3.6-4.6 mmol/L]) and insulin levels (31.3 pmol/L [20.8-47.9 pmol/L] vs 62.5 pmol/L [53.5-154.9]) than AGA infants, and they had higher glucose/insulin ratios (13.9 mg/dL/uIU/mL [8.6-19.1 mg/dL/uIU/mL] vs 8.2 mg/dL/uIU/mL [4.6-14.1 mg/dL/uIU/mL]). SGA infants also had higher levels of IGFBP-1 (5.1 nmol/L [4.4-6.7 nmol/L] vs 2.9 nmol/l [1.4-4.2 nmol/L]), free fatty acids (0.72 mEq/L [0.43-1.00 mEq/L] vs 0.33 mEq/L [0.26-0.54 mEq/L]) and beta-hydroxy butyrate (0.41 mEq/L [0.15-0.91 mEq/L] vs 0.09 mEq/L [0.05-0.13 mEq/L]). Sex-hormone binding globulin levels were not significantly different between the 2 groups. CONCLUSIONS: In early postnatal life, SGA infants display an increased insulin sensitivity with respect to glucose disposal but not with respect to suppression of lipolysis, ketogenesis, and hepatic production of IGFBP-1. It will be important to determine how these differential sensitivities to insulin vary with increasing age.
Assuntos
Glucose/metabolismo , Recém-Nascido Pequeno para a Idade Gestacional/metabolismo , Metabolismo dos Lipídeos , Ácido 3-Hidroxibutírico/sangue , Glicemia , Peptídeo C/metabolismo , Feminino , Humanos , Hidrocortisona/sangue , Recém-Nascido , Recém-Nascido Pequeno para a Idade Gestacional/sangue , Insulina/sangue , Proteína 1 de Ligação a Fator de Crescimento Semelhante à Insulina/sangue , Leptina/sangue , Lipídeos/sangue , Masculino , Globulina de Ligação a Hormônio Sexual/metabolismoRESUMO
El Servicio de Emergencia del Hospital de Niños Baca Ortíz, es una unidad técnico administrativa que brinda atención inmediata, eficaz y ágil al usuario que por cualquier situación de accidente o enfermedad acude en busca de tratamiento y recuperación de salud. La atención que se proporciona a todos los pacientes se lo hace sin distinción de raza, credo, posición económica o nacionalidad, considerando al individuo como un ser Bio-Psico-Social. En el Servicio de Emergencia se procede a la recepción del paciente, valoración, recolección de muestras, instauración de vías intravenosas, cateterización, procedimientos que por la inadecuada aplicación de técnicas de asepsia aumentan los riesgos de infección. Otra inquietud que ha motivado a las estudiantes de Post-grado a realizar esta investigación, es porque se ha observado que en este Servicio no existe un adecuado manejo de equipos además, se comparte la medicación, soluciones, entre las diferentes subáreas del Servicio de Emergencia, por otra parte existe una inadecuada aplicación de técnicas de asepsia y antisepsia por parte del personal Médico y de Enfermería. En el marco teórico se describe la Reseña Histórica del Hospita de Niños Baca Ortíz, su organización y en especial en el Servicio de Emergencia donde se realizó el estudio. Se contempla además los aspectos epidemiológicos, la organización de los Comités de Infecciones Intrahospitalarias y sus funciones. Se describe el proceso infeccioso y los eslabones de la cadena epidemiológica. Se utilizaron algunas técnicas para recolección de datos como: La aplicación de encuestas al personal del Servicio de Emergencia, como son: Médicos, Enfermeras, Personal, Auxiliar de Enfermería y Auxiliares Administrativos, con el objetivo de recabar información sobre el conocimiento y aplicación de técnicas de asepsia y antisepsia. Se aplicó también una guía de observación dirigida a todo el personal, sobre la aplicación de las técnicas de asepsia y antisepsia durante la atención al usuario. Se realizó un mapeo bacteriológico de las manos del personal, material y equipos que se utiliza en el Servicio. Para el desarrollo de la investigación, surgen hipótesis que están dirigidas a la incorrecta aplicación de las técnicas de asepsia y antisepsia. La demanda excesiva, la diversidad de patologías, la falta de disponibilidad de material y equipos, implica el uso incorrecto de técnicas de asepsia y antisepsia por parte del personal del Servicio de Emergencia...
Assuntos
Humanos , Antissepsia , Assepsia , Atenção à Saúde , Equador , Pessoal de Saúde , Departamentos Hospitalares , Hospitais Pediátricos/históriaRESUMO
"En un mundo de grandes conglomerados en que la distancia que separa a los países industrializados de los sub-desarrollados, es cada vez mayor, las posibilidades de un camino autónomo de desarrollo de tornan cada vez más complejas". (1). "Si a esto añadimos que el trágico impacto de la crisis económica de la presente década, está incidiendo sobre 1.800 millones de niños de edad inferios a los 15 años, que representan al 40 por ciento de los 4.500 millones de habitantes de la tierra, dos quintas partes de la población mundial aún carecen de una vivienda adecuada y una tercera parte de los trabajadores están sin empleo o bién no se utilizan debidamente su capacidad". (2). "Las condiciones de vida son tan hostíles en los países en vías de desarrollo que la mortalidad infantil es diez veces mayor que en los países industrializados". (3). Siendo el Ecuador un país de vías de desarrollo está inmerso dentro de esta pronlemática mundial, en donde las condiciones socio-económicas generan una población expuesta a riesgo de enfermar o morir, lo que impacta especialmente en los niños. Debido a los bajos ingresos económicos la mayoría de familiar no pueden satisfacer sus necesidades básicas, situación que se agrava con el nacimiento de un niño prematuro, ya que él implica muchos gastos y requiere de los cuidados oportunos de la madre y de las personas que le rodean para poder subsistir. Si ella no le acerca al seno, si no le dá abrigo, le asea y le evita traumatismos el ni o morirá inevitablemente de frío, hambre o accidentes múltiples debido a los malos cuidados. Considerando prematuro al niño que nace antes de las 37 semanas de gestación; independientemente de su peso al nacimiento. (1) Hurtado Oswaldo, el poder político en el Ecuador, Ed. Planeta, Quinta Ed. pág. 304. (2) American Academy of Pediatrics, Publicación sumultánea. Ed. Española, vol 18 N-2 Cap. 23, Pág. 81 (3) IBID
Assuntos
Recém-Nascido , Recém-Nascido Prematuro , Pais , Crescimento , Fatores SocioeconômicosRESUMO
"En un mundo de grandes conglomerados en que la distancia que separa a los países industrializados de los sub-desarrollados, es cada vez mayor, las posibilidades de un camino autónomo de desarrollo se tornan cada vez complejas". "Si a esto añadimos que el trágico impacto de la crisis económica de la presente década, está incidiendo sobre 1.800 millones de niños de edad inferior a los 15 años, que representan al 40 por ciento de los 4.500 millones de habitantes de la tierra, dos quintas partes de la población mundial aún carecen de una vivienda adecuada y una tercera parte de los trabajadores están sin empleo o bién no se utilizan debidamente su capacidad". "Las condiciones de vida son tan hostíles en los países en vías de desarrollo que la mortalidad infantíl en diez veces mayor que en los países industrializados". Siendo el Ecuador un país de vías de desarrollo está inmerso dentro de esta problemática mundial, en donde las condiciones socio-.economicas generan una población expuesta a riesgo de enfermar o morir, lo que impacta especialmente en los niños. Debido a los bajos ingresos económicos la mayoría de familias no pueden satisfacer ni siquiera sus necesidades básicas, situación que se agrava con el nacimiento de un niños prematuro, ya que él implica muchos gastos y requiere de los cuidados oportunos de la madre u de las personas que lo rodean para poder subsistir. Si ella no le acerca al seno, sino le dá abrigo, le asea y le evita traumatismos el niño morirá inevitablemente de frío, hambre o accidentes múltiples debido a los malos cuidados. Considerando prematuro al niño que nace antes de las 37 semanas de gestación; independientemente de su peso al nacimiento...