RESUMO
BACKGROUND: Iron deficiency (ID) in infancy is related to subsequent behavior problems. The effects of micronutrient status in middle childhood are uncertain. OBJECTIVE: The aim of the study was to examine the associations of micronutrient status biomarkers in middle childhood with externalizing and internalizing behavior problems in adolescence. METHODS: We assessed whether ID (ferritin <15 µg/L), anemia (hemoglobin <12.7 g/dL), or blood concentrations of zinc, vitamins A and B-12, and folate at ages 5-12 y were associated with externalizing or internalizing behavior problems in adolescence in 1042 schoolchildren from Bogotá, Colombia. Behavior problems were assessed with the Youth Self-Report questionnaire after a median 6.2 y of follow-up. Mean problem score differences with 95% CIs were estimated between categories of micronutrient status biomarkers with the use of multivariable linear regression. RESULTS: Mean ± SD externalizing and internalizing problems scores were 52.6 ± 9.6 and 53.8 ± 9.9, respectively. Among boys, middle-childhood ID, anemia, and low plasma vitamin B-12 were associated with 5.9 (95% CI: 1.0, 10.7), 6.6 (95% CI: 1.9, 11.3), and 2.7 (95% CI: 0.4, 4.9) units higher mean externalizing problems scores in adolescence, respectively-after adjustment for baseline age, time spent watching television or playing video games, mother's height, and socioeconomic status. Also in boys, ID was related to an adjusted 6.4 (95% CI: 1.2, 11.6) units higher mean internalizing problems score. There were no associations among girls. Other micronutrient status biomarkers were not associated with behavior problems. CONCLUSIONS: ID, anemia, and low vitamin B-12 in middle childhood are related to behavior problems in adolescent boys.This study was registered at clinicaltrials.gov as NCT03297970.
Assuntos
Comportamento do Adolescente/fisiologia , Anemia/psicologia , Deficiências de Ferro , Transtornos Mentais/sangue , Transtornos Mentais/etiologia , Deficiência de Vitamina B 12/psicologia , Adolescente , Comportamento do Adolescente/psicologia , Anemia/sangue , Biomarcadores/sangue , Criança , Colômbia , Feminino , Ferritinas/sangue , Ácido Fólico/sangue , Humanos , Ferro/sangue , Modelos Lineares , Masculino , Transtornos Mentais/psicologia , Micronutrientes/sangue , Estado Nutricional , Autorrelato , Estudantes/psicologia , Vitamina A/sangue , Vitamina B 12/sangue , Zinco/sangueRESUMO
Chronic kidney disease is associated with a high prevalence of depression, which increases inversely with the glomerular filtration rate. This paper aims to evaluate the factors associated with a low quality of life and depression in patients on haemodialysis. Two hundred patients undergoing haemodialysis answered the Medical Outcomes Study 36 - Item Short - Form Health Survey (SF-36) and Beck Depression Inventory (BDI). Clinical and laboratory variables were analysed and correlated with these two tools. The prevalence of depression was 29%. Anaemia and hypoalbuminemia were independent risk factors for depression. All SF-36 domains showed worse results in patients with depression, and the pain domain presented the highest correlation. Our findings provide evidence that patients on haemodialysis have a low quality of life and a high prevalence of depression. A greater number of comorbidities, an excessive number of medications, diabetes mellitus, anaemia and hypoalbuminemia were associated with a reduced quality of life.
Assuntos
Depressão/epidemiologia , Transtorno Depressivo/epidemiologia , Falência Renal Crônica/terapia , Qualidade de Vida , Adulto , Anemia/epidemiologia , Anemia/psicologia , Antidepressivos/uso terapêutico , Brasil/epidemiologia , Comorbidade , Estudos Transversais , Depressão/psicologia , Transtorno Depressivo/tratamento farmacológico , Transtorno Depressivo/psicologia , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/psicologia , Feminino , Humanos , Hipoalbuminemia/epidemiologia , Hipoalbuminemia/psicologia , Falência Renal Crônica/psicologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Dor , Polimedicação , Prevalência , Escalas de Graduação Psiquiátrica , Diálise Renal/psicologia , Fatores de RiscoRESUMO
OBJECTIVES: to analyse the prevalence and factors associated with anaemia in children from Rio Branco, Acre. METHODS: the study included 610 children between 6 and 59 months old. A questionnaire was issued with questions on characteristics of the mother, feeding practices and antecedent morbidity. The anaemia diagnosis was based on haemoglobin levels at 110 g/l. Multiple Poisson regression was used to analyse the associated factors with variables entered into hierarchical blocks. RESULTS: the anaemia prevalence was 51.8 percent. The factors associated with anaemia were the following: age below 24 months (prevalence ratio [PR]: 1.51 and 95 percent confidence interval [95 percent CI]: 1.17 to 1.95); years of formal education for the mother between 5-8 years (PR: 1.34 and 95 percent CI: 1.13 to 1.58) and less than or equal to 4 years (PR: 1.32 and 95 percent CI: 1.05 to 1.65); anaemia in the mother (PR: 1.28 and 95 percent CI: 1.08 to 1.51); and consumption frequency less than once a week for meats (PR: 1.35 and 95 percent CI: 1.03 to 1.77) and fruits (PR: 1.28 and 95 percent CI: 1.09 to 1.52). CONCLUSIONS: the prevalence of anaemia among children in Rio Branco is a serious public health problem. The results highlight the need to strengthen policies on family health care and provide mothers with counselling on feeding practices.(AU)
OBJETIVOS: Analisar a prevalência e os fatores associados à anemia em crianças de Rio Branco, Acre. MÉTODO: Participaram do estudo 610 crianças de 6 a 59 meses. Foi aplicado um questionário com questões sobre as características da mãe, práticas alimentares e morbidades preessas. O diagnóstico de anemia baseou-se no valor de hemoglobina de 110 g/l. Na análise dos fatores associados foi utilizada a reessão de Poisson múltipla, com entrada das variáveis em blocos hierarquizados. RESULTADOS: A prevalência de anemia foi de 51,8 por cento. Os fatores associados &aave; anemia foram: idade abaixo de 24 meses: (razão de prevalência [RP]: 1,51; intervalo de confiança em 95 por cento [IC95 por cento]: 1,17-1,95); anos de estudo da mãe entre 5-8 anos (RP: 1,34; IC95 por cento: 1,13-1,58) e igual ou inferior a 4 anos (RP: 1,32; IC95 por cento: 1,05-1,65); situação de anemia da mãe (RP: 1,28; IC95 por cento: 1,08-1,51); freqüência de consumo em menos de uma vez por semana de carnes (RP: 1,35; IC95 por cento: 1,03-1,77) e frutas (RP: 1,28; IC95 por cento: 1,09-1,52). CONCLUSÕES: A prevalência de anemia em crianças de Rio Branco é um problema ave em saúde pública. Destaca-se a necessidade do fortalecimento de políticas em atenção &aave; saúde da família e ao aconselhamento sobre as práticas alimentares voltadas a mãe (AU)
Assuntos
Anemia/psicologia , Estado Nutricional , Saúde da Criança , Fatores Epidemiológicos , Estudos TransversaisRESUMO
Biological and psychosocial factors affect child development and behavior. Whereas biological underpinnings behind the neurotoxic effects of lead are studied extensively, the effects of psychosocial factors contributing to poor behavioral outcomes in lead-exposed children are not well understood. Parental attributes and practices may moderate or mediate the effects of lead on children's behavioral outcomes. We investigated the hypothesis that maternal and child lead and hemoglobin levels are associated with maternal perceptions of their parenting. Specifically, we hypothesized that children with higher blood lead (BLL) and lower hemoglobin concentrations would be associated with poorer maternal self-assessments of their parenting skills or the mother-child relationship. Children aged 13-55 months and their mothers (n=109) were recruited from among the participants of a previous lead and anemia screening study and from preschools in Montevideo, Uruguay. The mother-child pair attended two study visits: one to collect biological samples and answer demographic and child questionnaires, including statements regarding parenting; and a second to evaluate maternal IQ, depression and stress, and child development. Of the children, 51.6% had blood lead concentrations (BLLs) ≥ 5 µg/dL, 18.0% had anemia, and 8% had both conditions. Among mothers, 48.4% had BLLs ≥ 5 µg/dL, 16.0% had anemia, and 11% had both. BLLs ≥ 5 µg/dL in mother or child were associated with lower maternal perceptions of being skilled at discipline (p<0.05). Maternal anemia was associated with lower likelihood that mothers would let their children explore and play (p<0.05), whereas child anemia was associated with maternal perception of lower emotional support (p<0.01). In addition to shared environmental exposures, parenting and family interactions need to be considered as potentially contributing factors to poorer outcomes in lead-exposed children.
Assuntos
Comportamento Infantil , Desenvolvimento Infantil , Poluentes Ambientais/sangue , Hemoglobinas/análise , Intoxicação do Sistema Nervoso por Chumbo em Adultos/psicologia , Intoxicação do Sistema Nervoso por Chumbo na Infância/psicologia , Chumbo/sangue , Comportamento Materno , Mães/psicologia , Poder Familiar , Percepção , Adulto , Anemia/sangue , Anemia/psicologia , Biomarcadores/sangue , Pré-Escolar , Depressão/sangue , Depressão/psicologia , Emoções , Poluentes Ambientais/efeitos adversos , Comportamento Exploratório , Análise Fatorial , Feminino , Humanos , Lactente , Chumbo/efeitos adversos , Intoxicação do Sistema Nervoso por Chumbo em Adultos/sangue , Intoxicação do Sistema Nervoso por Chumbo em Adultos/diagnóstico , Intoxicação do Sistema Nervoso por Chumbo na Infância/sangue , Intoxicação do Sistema Nervoso por Chumbo na Infância/diagnóstico , Masculino , Relações Mãe-Filho , Análise Multivariada , Testes Neuropsicológicos , Jogos e Brinquedos , Medição de Risco , Fatores de Risco , Estresse Psicológico/sangue , Estresse Psicológico/psicologia , Inquéritos e Questionários , Uruguai , Adulto JovemRESUMO
OBJECTIVE: To assess the presence of emotional distress in patients with chronic kidney disease (CKD), and the effect of kidney transplant on these symptoms. MATERIAL AND METHODS: This was a two-part study. Part one was cross-sectional, observational, and descriptive, where 75 patients with CKD were evaluated for emotional distress with the Hospital Anxiety and Depression Scale (HAD) and the Symptom Checklist 90 (SCL-90). In part two, we longitudinally followed 19% of the study cohort to examine symptomatological changes after their kidney transplantation. RESULTS: The results of the HAD indicated that 30.7% of the study cohort with End-Stage Renal Disease (ESRD) showed anxious symptoms, and 25.3% showed depressive symptoms. The change in the HAD total score before and after kidney transplant was not significant. However, a significant decrease in total score on the SCL-90 was observed before and after transplantation. CONCLUSION: Improvement on emotional distress was found after kidney transplantation.
Assuntos
Falência Renal Crônica/psicologia , Transplante de Rim/psicologia , Estresse Psicológico/diagnóstico , Adulto , Anemia/complicações , Anemia/psicologia , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/etiologia , Transtornos de Ansiedade/psicologia , Lista de Checagem , Estudos Transversais , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/etiologia , Transtorno Depressivo/psicologia , Feminino , Seguimentos , Humanos , Hipertensão/complicações , Hipertensão/psicologia , Falência Renal Crônica/complicações , Falência Renal Crônica/cirurgia , Falência Renal Crônica/terapia , Masculino , México , Pessoa de Meia-Idade , Diálise Peritoneal/psicologia , Estudos Prospectivos , Diálise Renal/psicologia , Índice de Gravidade de Doença , Estresse Psicológico/etiologia , Estresse Psicológico/psicologia , Avaliação de Sintomas , Adulto JovemRESUMO
Basándose en una nosografía de doce casos Jean Bernard describe en 1967 un síndrome raro que bautiza con el nombre de la heroína de una novela del siglo XIX de Barbey dAurevilly. Se trata de una anemia microcítica provocada por hemorragias a repetición que los pacientes (en general mujeres muy jóvenes) se autoprovocan en secreto, desarrollando un cuadro misterioso que causa perplejidad en los médicos que son consultados. El autor describe las características de este cuadro poniéndolo en relación con las anorexias y, en general con un abanico sintomatológico que se expresa en el cuerpo y que forma parte de la nebulosa definición de las patologías límites. En este sentido resulta interesante discutir la relación con la histeria y con la concepción de Joyce McDougall acerca de lo que ella denomina la histeria arcaica en la que prevalece una dimensión de carencia del objeto primario. La descripción del análisis de la paciente que se presenta como ejemplo clínico pone de manifiesto la importancia de la vivencia contratransferencial como instrumento activador del marco representacional del analista en su trabajo interpretativo.
Based on a nosography of 12 cases Jean Bernard describes in 1967 a strange syndrome that he baptizes with the name of a heroine of Barbey dAurevillys 19th century novel. The question is about a microcytic anemia caused by repeated bleedings that the patients (in general very young women) provoke themselves privately, developing a mysterious picture that leaves the doctors who are consulted utterly astonished. The author compares this syndrome with the anorexias and, in general with a range of symptoms expressed in the body that are part of the nebulous definition of the borderlines pathologies. Thereby its interesting to discuss the relation with the hysteria and with Joyce McDougalls conception of what she names the "archaic hysterics" in which it prevails a dimension of lack of the primary object. The description of the analysis of the patient, who is presented as clinical example, reveals the importance of the countertransferencial experience as instrument activator of the frame representational of the analyst in his interpretive work.
Assuntos
Humanos , Feminino , Adolescente , Relações Mãe-Filho , Psicanálise , Psicopatologia , Anemia/psicologia , Comportamento Autodestrutivo/psicologia , Síncope/etiologiaRESUMO
Basándose en una nosografía de doce casos Jean Bernard describe en 1967 un síndrome raro que bautiza con el nombre de la heroína de una novela del siglo XIX de Barbey dAurevilly. Se trata de una anemia microcítica provocada por hemorragias a repetición que los pacientes (en general mujeres muy jóvenes) se autoprovocan en secreto, desarrollando un cuadro misterioso que causa perplejidad en los médicos que son consultados. El autor describe las características de este cuadro poniéndolo en relación con las anorexias y, en general con un abanico sintomatológico que se expresa en el cuerpo y que forma parte de la nebulosa definición de las patologías límites. En este sentido resulta interesante discutir la relación con la histeria y con la concepción de Joyce McDougall acerca de lo que ella denomina la ¶histeria arcaica÷ en la que prevalece una dimensión de carencia del objeto primario. La descripción del análisis de la paciente que se presenta como ejemplo clínico pone de manifiesto la importancia de la vivencia contratransferencial como instrumento activador del marco representacional del analista en su trabajo interpretativo.(AU)
Based on a nosography of 12 cases Jean Bernard describes in 1967 a strange syndrome that he baptizes with the name of a heroine of Barbey dAurevillys 19th century novel. The question is about a microcytic anemia caused by repeated bleedings that the patients (in general very young women) provoke themselves privately, developing a mysterious picture that leaves the doctors who are consulted utterly astonished. The author compares this syndrome with the anorexias and, in general with a range of symptoms expressed in the body that are part of the nebulous definition of the borderlines pathologies. Thereby its interesting to discuss the relation with the hysteria and with Joyce McDougalls conception of what she names the "archaic hysterics" in which it prevails a dimension of lack of the primary object. The description of the analysis of the patient, who is presented as clinical example, reveals the importance of the countertransferencial experience as instrument activator of the frame representational of the analyst in his interpretive work.(AU)