ABSTRACT
This research presents theoretical arguments of a new approach called Technique "K," which aims to reduce student's anxiety before a cognitive challenge. Through a randomized, controlled clinical trial, we evaluate the Beck Anxiety Inventory and salivary cortisol. We compared the results in the last year of high school, who were facing school tests, before and after the application of the "K" technique (intervention group) and placebo (control group). Statistical analyses consisted of using the Chisquare, Spearman and the Wilcoxon test. The principal component analysis observed in the case group, - 10.50 (-18.25; -4.75), was statistically higher than the control group, -6.00 (-8.75; -1.25). It is not possible to identify statistical significance (p = 0.462) in the variation of salivary cortisol concentration. The results suggest the effectiveness of the "K" technique in managing anxiety in high school students. Although, future research is needed to extend the preliminary data obtained in this study
Esta pesquisa apresenta argumentos teóricos de uma nova abordagem denominada Técnica "K", visando reduzir a ansiedade do aluno diante de um desafio cognitivo. Por meio de um ensaio clínico randomizado e controlado, avaliamos o Inventário de Ansiedade de Beck e o cortisol salivar. Comparamos os resultados dos alunos, que estavam enfrentando provas escolares, antes e após a aplicação da técnica "K" (grupo intervenção) e placebo (grupo controle). As análises estatísticas consistiram na utilização do Qui-quadrado, Spearman e teste de Wilcoxon. A análise de componentes principais observada no grupo caso, -10,50 (-18,25; -4,75), foi estatisticamente superior ao grupo controle, -6,00 (-8,75; -1,25). Não é possível identificar significância estatística (p = 0,462) na variação da concentração de cortisol salivar. Os resultados sugerem a eficácia da técnica "K" no manejo da ansiedade em estudantes do ensino médio. No entanto, pesquisas futuras são necessárias para estender os dados preliminares obtidos neste estudo
Esta investigación presenta argumentos teóricos para un nuevo enfoque denominado Técnica "K", con el objetivo de reducir la ansiedad de los estudiantes frente a un desafío cognitivo. A través de un ensayo clínico aleatorizado y controlado, evaluamos el Inventario de Ansiedad de Beck y el cortisol salival. Comparamos los resultados de los estudiantes, que se enfrentaban a pruebas escolares, antes y después de la aplicación de la técnica "K" (grupo de intervención) y placebo (grupo control). Los análisis estadísticos consistieron en utilizar la prueba de Chicuadrado, Spearman y Wilcoxon. El análisis de componentes principales observado en el grupo de casos, -10,50 (-18,25; -4,75), fue estadísticamente superior al grupo control, -6,00 (-8,75; -1,25). No es posible identificar significación estadística (p = 0,462) en la variación de la concentración de cortisol salival. Los resultados sugieren la efectividad de la técnica "K" en el manejo de la ansiedad en estudiantes de secundaria. Sin embargo, se necesitan futuras investigaciones para ampliar los datos preliminares obtenidos en este estudio
Subject(s)
Adolescent , AdolescentABSTRACT
BACKGROUND: Phenylketonuria (PKU) is characterized by phenylalanine (Phe) accumulation to toxic levels due to the low activity of phenylalanine-hydroxylase. PKU patients must follow a Phe-restricted diet, which may put them in risk of nutritional disturbances. Therefore, we aimed to characterize body composition parameters and nutritional status in Brazilian PKU patients also considering their metabolic control. METHODS: Twenty-seven treated PKU patients older than 5 years, and 27 age- and gender-matched controls, were analyzed for anthropometric features and body composition by bioelectrical impedance (BIA). Patients' metabolic control was assessed by historical Phe levels. RESULTS: There was no effect of PKU type, time of diagnosis, or metabolic control for any analyzed parameter. About 75% of patients and controls were eutrophic, according to their BMI values. There were no difference between groups regarding body composition and other BIA-derived parameters. CONCLUSIONS: Brazilian PKU patients do not show differences in body composition and nutritional status in comparison with controls, regardless metabolic control. Although similar to controls, PKU patients may be in risk of disturbed nutritional and metabolic markers as seen for the general population.
ABSTRACT
OBJECTIVE: Differentiating constitutional delay of growth and puberty from hypogonadotropic hypogonadism is still a problem in clinical practice. Our previous study demonstrated that the peak/basal ratio of the free alpha-subunit of the glycoprotein hormones is higher in normal prepubertal boys than in male adults with hypogonadotropic hypogonadism. The objective of this study was to assess the performance of this ratio in normal male patients at different ages and levels of pubertal development, and in patients with hypogonadotropic hypogonadism, both isolated and combined with other pituitary hormone deficiencies. DESIGN: Cohort study. PATIENTS: Twenty-eight normal prepubertal males between 6 and 8 years; 20 normal prepubertal males between 9 and 13 years; 18 males with constitutional delay of growth and puberty; 26 normal pubertal males; 13 adult men with isolated hypogonadotropic hypogonadism; 21 adult men with complete hypogonadotropic hypogonadism combined with other hormone deficiencies; and 11 adult men with partial hypogonadotropic hypogonadism combined with other hormone deficiencies. MEASUREMENTS: Serum levels of free alpha-subunit immediately before (basal), and 30 and 60 min after 100 micro g intravenous GnRH were measured by immunofluorimetry. Median and P25-P75 range of the peak/basal ratio of the free alpha-subunit was determined for each group. A receiver operating characteristics curve was calculated. Results were compared using the Kruskal-Wallis test. RESULTS: The peak/basal ratio of the free alpha-subunit was higher in patients with constitutional delay of growth and puberty (7.46) than in those with isolated hypogonadotropic hypogonadism (2.73), complete combined hypogonadotropic hypogonadism (1.58), and partial combined hypogonadotropic hypogonadism (2.61; P < 0.001). A peak/basal ratio < 3.26 identified hypogonadotropic hypogonadism with 93.2% sensitivity and 94.4% specificity when compared to constitutional delay of growth and puberty. There was no statistical difference between the peak/basal ratio of prepubertal patients between 6 and 8 years (7.20), patients between 8 and 13 years (8.71), normal pubertal males (8.10) and those with constitutional delay of growth and puberty (7.46). In a group of boys with delayed puberty, a cut-off point of 3.69 defined hypogonadotropic hypogonadism with 95.6% sensitivity and 94.4% specificity. A cut-off point of 4.81 gave 100% sensitivity (88.9% specificity), and 3.09 gave 100% specificity (86.7% sensitivity). CONCLUSIONS: The peak/basal ratio of the free alpha-subunit can be used for the differential diagnosis of constitutional delay of growth and puberty and hypogonadotropic hypogonadism, irrespective of age. This distinction allows early investigation and treatment of patients with hypogonadotropic hypogonadism and reassurance for those with constitutional delay of growth and puberty.
