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1.
J Pediatr Gastroenterol Nutr ; 63(1): 106-12, 2016 07.
Artigo em Inglês | MEDLINE | ID: mdl-27336592

RESUMO

OBJECTIVES: Improving self-esteem, dietary habits, and physical activity is essential for long-term success in childhood obesity prevention. The aim is to evaluate the effects of a healthy living promotion program, Healthy Kids-Houston, on BMI, dietary habits, self-esteem, and physical activity among minority children. METHODS: The after-school program was implemented at community centers in low-income neighborhoods with close proximity to public schools. The program consisted of 3 6-week sessions. Each week, children attended 2 2-hour sessions. Each 2-hour session in the intervention included 90 minutes of structured physical activities and 30 minutes of nutrition and healthy habit lessons. The control group received typical enrichment programs. Outcomes were measured before the intervention and at the end of each 6-week session. RESULTS: We enrolled 877 children (age 10.2 ±â€Š0.1 years (mean ±â€ŠSE); body mass index z score: 1.49 ±â€Š0.1; 52.0% boys; 72.6% Hispanic) in the program with 524 children received the intervention at 14 community centers and 353 children served as control at 10 community centers. The intervention led to no improvements in BMI z score (P = 0.78) and dietary habits (P = 0.46). Significant improvements (P ≤ 0.02) were detected in the amount of exercise that a child perceived to be required to offset a large meal and in several key self-esteem scores. No improvements were detected in physical activities (P ≥ 0.21). CONCLUSIONS: The improvement in some key self-esteem scores and nutrition knowledge may act as a mediator to motivate these children to adopt a healthier lifestyle in the future.


Assuntos
Serviços de Saúde Comunitária , Dieta , Promoção da Saúde , Autoimagem , Índice de Massa Corporal , Criança , Serviços de Saúde da Criança , Fenômenos Fisiológicos da Nutrição Infantil , Exercício Físico , Feminino , Humanos , Masculino , Grupos Minoritários , Necessidades Nutricionais , Pobreza , Serviços de Saúde Escolar
2.
J Clin Gastroenterol ; 48(3): 248-52, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24129407

RESUMO

BACKGROUND: Infliximab (IFX) is an established treatment modality for moderate to severe pediatric ulcerative colitis (UC). The purpose of this study was to identify clinical and laboratory parameters, which predict response to IFX in pediatric UC defined by colectomy as the primary outcome measure. Postsurgical complications were examined as well. METHODS: A retrospective chart review was performed on children younger than 19 years who received IFX therapy at Texas Children's Hospital, Houston, Texas for the treatment of UC from January 2005 to April 2012. Demographics, laboratory data, clinical subtype, duration of disease, transfusion requirement, number of IFX infusions, concurrent medications, and postoperative complication with regard to IFX exposure were examined. RESULTS: Forty-seven patients (22 male and 25 female; average age at diagnosis: 11.4 y) received IFX. Twenty-six (55.3%) required colectomy, 20 (42.6%) of which occurred within a year of therapy initiation. Disease duration <20 months before IFX initiation, increased the likelihood of a colectomy within a year [OR: 3.8 (95% CI, 1.6-13.3), P=0.044]. Blood transfusion requirement before IFX was associated with higher rates of colectomy within a year [OR: 9.78 (95% CI, 2.2-43.3), P=0.0028]. Preoperative exposure to IFX within 8 weeks did not significantly increase postoperative complications (P=0.26). Serum albumin levels at diagnosis did not predict colectomy. CONCLUSIONS: Shorter disease duration and need for blood transfusion may be useful indicators of limited response to IFX in pediatric UC.


Assuntos
Anti-Inflamatórios/uso terapêutico , Anticorpos Monoclonais/uso terapêutico , Colite Ulcerativa/tratamento farmacológico , Fármacos Gastrointestinais/uso terapêutico , Adolescente , Fatores Etários , Anti-Inflamatórios/efeitos adversos , Anticorpos Monoclonais/efeitos adversos , Criança , Colectomia/efeitos adversos , Colite Ulcerativa/diagnóstico , Colite Ulcerativa/cirurgia , Intervalo Livre de Doença , Feminino , Fármacos Gastrointestinais/efeitos adversos , Hospitais Pediátricos , Humanos , Infliximab , Modelos Logísticos , Masculino , Razão de Chances , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Texas , Fatores de Tempo , Reação Transfusional , Resultado do Tratamento
3.
Menopause ; 20(4): 443-7, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23211877

RESUMO

OBJECTIVE: The purpose of this study was to assess the effect of soy isoflavone supplementation on quality of life in postmenopausal women. METHODS: A multicenter, randomized, double-blind, placebo-controlled 24-month trial was conducted to assess the effect of 80 or 120 mg of daily aglycone hypocotyl soy isoflavone supplementation on quality of life in 403 postmenopausal women using a validated Menopause-Specific Quality of Life questionnaire. RESULTS: Menopause-Specific Quality of Life domain scores at 1 year and 2 years were similar to baseline. There were no differences in domain scores among treatment groups. CONCLUSIONS: Soy isoflavone supplementation offers no benefit to quality of life in postmenopausal women.


Assuntos
Isoflavonas/administração & dosagem , Menopausa , Qualidade de Vida , beta-Glucanas/administração & dosagem , Adulto , Suplementos Nutricionais , Método Duplo-Cego , Endométrio/diagnóstico por imagem , Feminino , Humanos , Isoflavonas/efeitos adversos , Pessoa de Meia-Idade , Placebos , Inquéritos e Questionários , Resultado do Tratamento , Ultrassonografia , beta-Glucanas/efeitos adversos
4.
Pediatrics ; 116(2): 400-6, 2005 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-16061595

RESUMO

OBJECTIVE: Compared with preterm formula (PF), mother's milk (MM) is associated with lower rates of late-onset sepsis (LOS) and necrotizing enterocolitis (NEC) among premature infants. Because not all mothers of premature infants produce sufficient milk to supply their infants throughout hospitalization, we reasoned that pasteurized donor human milk (DM) would be a suitable alternative. METHODS: Extremely premature infants (<30 weeks of gestation) whose mothers intended to breastfeed were assigned randomly to receive either pasteurized DM or PF if the supply of their own MM became insufficient during the study (birth to 90 days of age or hospital discharge). Infection-related events (LOS, NEC, meningitis, presumed sepsis, or urinary tract infection) that occurred after the attainment of a milk intake of 50 mL/kg, dietary intake, growth, skin-to-skin contact, and duration of hospital stay were compared. The primary analysis compared groups DM and PF on an intent-to-treat basis. If no differences were noted, then these groups were combined and compared with the reference group, group MM. If differences were noted, then the subsequent analyses compared each group with group MM. RESULTS: Of 243 infants, 70 (29%) received only MM; group DM included 81 infants and group PF included 92 infants. Because of poor weight gain, 17 infants (21%), all in group DM, were switched to PF. There were no differences in birth weight, gestational age, multiple births, and age at attainment of feeding of 50 mL/kg among groups. There were no differences between group DM and group PF in LOS and/or NEC, other infection-related events, hospital stay, or number of deaths. Group DM received a greater intake of milk and more nutritional supplements but had a slower rate of weight gain, compared with group PF. Compared with groups DM and PF, group MM had fewer episodes of LOS and/or NEC and total infection-related events and a shorter duration of hospital stay. Group MM also had fewer Gram-negative organisms isolated from blood cultures than did the other groups. CONCLUSIONS: In this randomized, blinded trial of feeding of extremely premature infants, we found that, as a substitute for MM, DM offered little observed short-term advantage over PF for feeding extremely premature infants. Advantages to an exclusive diet of MM were observed in terms of fewer infection-related events and shorter hospital stays.


Assuntos
Fórmulas Infantis , Recém-Nascido Prematuro , Bancos de Leite Humano , Leite Humano , Método Duplo-Cego , Enterocolite Necrosante/prevenção & controle , Idade Gestacional , Humanos , Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido , Doenças do Prematuro/prevenção & controle , Sepse/prevenção & controle
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