ABSTRACT
BACKGROUND: Previous studies have shown that women with coronary artery disease (CAD) are less likely to undergo angiography and have less favorable outcomes after percutaneous coronary intervention (PCI). OBJECTIVES: Assess the outcomes of women with acute coronary syndrome (ACS) and stable CAD (lesion>50%) treated with contemporary PCI using DES. METHODS: Observational, longitudinal cohort study with prospective follow-up included all female patients ≥ 18 years admitted at a tertiary public cardiovascular center in Brazil from January 2019 to December 2020. The level of significance adopted in the statistical analysis was 5%. RESULTS: 1146 women (average age 65 years) underwent guideline-recommended PCI. Risk factors were frequent (hypertension: 88%, dyslipidemia: 85%, diabetes: 47.5%), and 69% were admitted due to ACS. Radial access was used in 59% of patients; 1516 vessels were treated with 1725 stents implanted (1.5 stents/patient). PCI was successful in 97.7%, in-hospital death occurred in 1.2%, peri-procedural MI in 3.6%, and TIA in 0.4%. Predictors of in-hospital major adverse cardiac and cerebrovascular events (MACCE): previous stroke (OR: 2.97; CI: 1.06-7.15; p= 0.023), CKD (OR: 3.11; CI: 1.49-6.20; p= 0.002), and at least one procedural failure during PCI (OR: 10.2; CI: 1.17-5.9; p<0.001). The average follow-up was 576.2 days in 1047 patients. All-cause mortality occurred in 5.3%, cardiac death in 3.5%, recurrent ACS in 8%, and additional revascularization procedures in 5.5%. The predictors for MACCE during FU were hospital admission for ACS for the index PCI (OR: 1.58; HR: 1.06-2.35; p=0.023) and the presence of MACCE during hospitalization (OR: 6.66; HR: 2.42- 18.3; p< 0.001). CONCLUSION: In this pioneering study involving 1146 patients treated by contemporary PCI and followed for almost 2 years, we obtained very encouraging in-hospital and mid-term results.
FUNDAMENTO: Estudos prévios demonstram que mulheres com doença arterial coronariana (DAC) são menos submetidas a angiografia e apresentam resultados menos favoráveis após intervenção coronariana percutânea (ICP). OBJETIVOS: Avaliar os resultados de mulheres com síndrome coronariana aguda (SCA) e DAC estável (lesão>50%) tratadas com ICP contemporânea usando stents liberadores de drogas. MÉTODOS: Estudo de coorte observacional, longitudinal, com acompanhamento prospectivo, que incluiu todas as pacientes do sexo feminino > 18 anos admitidas em centro cardiológico público terciário no Brasil, no período de janeiro de 2019 a dezembro de 2020. RESULTADOS: 1146 mulheres (idade média de 65 anos) foram submetidas à ICP recomendada pela diretriz. Os fatores de risco foram frequentes (hipertensão: 88%, dislipidemia: 85%, diabetes: 47,5%) e 69% foram internadas devido à SCA. O acesso radial foi usado em 59% das pacientes; 1516 vasos foram tratados com 1725 stents implantados (1,5 stents/paciente). A ICP foi bem-sucedida em 97,7%, a morte intra-hospitalar ocorreu em 1,2%, IM periprocedimento em 3,6% e ataque isquêmico transitório em 0,4%. Preditores de eventos adversos cardíacos e cerebrovasculares maiores (ECCAM) intra-hospitalares: acidente vascular cerebral prévio (OR: 2,97; IC: 1,06-7,15; p = 0,023), DRC (OR: 3,11; IC: 1,49-6,20; p = 0,002) e pelo menos uma falha de procedimento durante ICP (OR: 10,2; IC: 1,17-5,9; p < 0,001). O acompanhamento médio foi de 576,2 dias em 1.047 pacientes. Mortalidade por todas as causas ocorreu em 5,3%, morte cardíaca em 3,5%, nova SCA em 8% e necessidade de nova revascularização em 5,5%. Os preditores de ECCM durante o seguimento foram admissão por SCA (retirar índice ICP) e a presença de ECCM durante a hospitalização (OR: 6,66; HR: 2,42-18,3; p< 0,001). CONCLUSÃO: Neste estudo pioneiro envolvendo 1146 pacientes tratados por ICP contemporânea e acompanhados por quase 2 anos, obtivemos resultados hospitalares e de médio prazo muito encorajadores.
Subject(s)
Coronary Artery Disease , Percutaneous Coronary Intervention , Humans , Female , Aged , Longitudinal Studies , Middle Aged , Coronary Artery Disease/surgery , Risk Factors , Treatment Outcome , Acute Coronary Syndrome/therapy , Acute Coronary Syndrome/surgery , Prospective Studies , Brazil , Practice Guidelines as Topic , Hospital Mortality , Drug-Eluting StentsABSTRACT
BACKGROUND: Screen use has become nearly universal, especially in children. Therefore, it is important not only to comprehend its effects on health but also to understand its patterns of use. We aim to describe screen use patterns among children assessed at 2, 4, and 6-7 years, based on device, period of the day, and child/family characteristics. METHODS: Longitudinal study, with participants of the 2015 Pelotas (Brazil) Birth Cohort, a population-based study including all living newborns in the city of Pelotas between 1 January and 31 December 2015. Child/family characteristics used in the study were sex, skin color, family income, and maternal education. Screen time at 2 years was evaluated by TV time. At age 4, TV time and other screens (computer and videogames) was assesed. At 6-7 years, screen use was collected for each device (TV, smartphone, tablet/iPad, computer, and videogames). RESULTS: At 2, 4, and 6-7 years, 1420, 3963, and 3857 had valid screen time data, respectively. Mean total screen time ranged from ~ 2.5 h per day at age 2 to ~ 5.5 h per day at age 6-7. At 2 years, no difference in screen time was found according to child/family characteristics. In general, boys presented higher screen time values at 4 and 6-7 years. No differences for ethnicity were observed. For family income and maternal education, the extreme groups presented higher use. Higher values of screen time were also observed during the evening and for children who did not attend school nor had home activities during the Covid-19 pandemic. CONCLUSIONS: The results suggest that children are exceeding current screen time guidelines, with different patterns of use according to child/family characteristics. The high use of screens and more concentrated use during the evenings raise concern considering its possible negative effects on health.
Subject(s)
Screen Time , Humans , Brazil/epidemiology , Female , Male , Child, Preschool , Child , Prospective Studies , Longitudinal Studies , Television/statistics & numerical data , Video Games/statistics & numerical data , Child Behavior , COVID-19/epidemiology , Computers/statistics & numerical data , Socioeconomic FactorsABSTRACT
BACKGROUND: Bullying has been identified as a risk factor for many issues among adolescents. Although it was already considered a public health issue in Brazil before the COVID-19 pandemic, little is known about how the pandemic and associated public health measures have affected bullying behavior. OBJECTIVE: To explore changes in bullying victimization and perpetration among Brazilian high school students from 2019 to 2022. METHODS: This study utilizes data from the Longitudinal Study of Adolescent Lifestyle (ELEVA), employing a repeated cross-sectional with a nested cohort design. Adolescents (n = 1.987, 50.2% female, mean age 16.4 years) answered a questionnaire and bullying-related information were extracted from two different questions for victims and perpetrators. Multilevel logistic regression models were used. RESULTS: Bullying victimization decreased from 46% (95% CI: 40-52%) in 2019 to 30% (95% CI: 24-36%) in 2022 (OR: 0.46, 95% CI: 0.30-0.69, p < 0.05) in the longitudinal sample. Stable prevalences of bullying victimization (44% in 2019, 40% in 2022, p = 0.090) and perpetration (9.7% in 2019. 8.7% in 2022, p = 0.5) were observed within the repeated cross-sectional sample. CONCLUSION: This study found a significant decrease in bullying victimization among Brazilian high school students from 2019 to 2022 in the longitudinal sample, which coincides with the decrease in bullying behavior associated with getting older. However, the prevalence of bullying victimization and perpetration remained relatively stable and high in the repeated cross-sectional sample. These findings highlight the need for effective policies and interventions to prevent bullying among high school students. Additionally, providing resources and support for students experiencing bullying could be beneficial.
Subject(s)
Bullying , COVID-19 , Crime Victims , Humans , Adolescent , Bullying/statistics & numerical data , Bullying/psychology , Female , Male , Cross-Sectional Studies , COVID-19/epidemiology , COVID-19/psychology , COVID-19/prevention & control , Brazil/epidemiology , Crime Victims/statistics & numerical data , Crime Victims/psychology , Prospective Studies , Longitudinal Studies , Students/psychology , Students/statistics & numerical data , Adolescent Behavior/psychology , Surveys and Questionnaires , PandemicsABSTRACT
OBJECTIVE: Allergic rhinitis (AR) is highly prevalent worldwide. Good patient adherence ensures successful treatment. This study aimed to identify the association between the intranasal aerosol technique and symptom improvement. METHODS: This is an analytical, prospective, and longitudinal study that included 36 patients diagnosed with AR. The Rhinitis Control Assessment Test (RCAT) questionnaire was administered to both an experimental population and a control group. The 11 steps of the intranasal aerosol technique were explained to the experimental group, and performance was graded using a pamphlet for patient follow-up in subsequent controls. RESULTS: Of the participants, 63.9% were women and 36.1% were men, with a median age of 30 years (IQR 24-42) and an age range from 18 to 69 years. An average RCAT percentage of 55.6% was observed in both groups during the first consultation. On the second visit, a difference in disease control was noted. In the experimental group, 83.3% had controlled symptoms, whereas only 61.1% of the control group did. At the third visit, 76.5% of the experimental group had controlled symptoms, compared to 58.8% of the control group. In the experimental group, 52.9% of patients demonstrated good technique, while only 5.9% in the control group did (p=0.004). CONCLUSIONS: Patient education and training, compared to an untrained group, benefit the patient by aiding in the remission of symptoms and improving quality of life.
Subject(s)
Administration, Intranasal , Rhinitis, Allergic , Humans , Female , Male , Adult , Middle Aged , Rhinitis, Allergic/diagnosis , Young Adult , Adolescent , Prospective Studies , Aged , Longitudinal Studies , Surveys and Questionnaires , Nasal Sprays , Aerosols , Treatment OutcomeABSTRACT
BACKGROUND: Psoriasis requires a comprehensive assessment of concomitant diseases to make better therapeutic decisions. This study examined the differences in the onset and progression of associated cardiometabolic comorbidities in psoriasis patients based on their treatments. METHODS: A retrospective longitudinal study was conducted on patients aged over 13 years with psoriasis seen at a Northern Mexican Hospital between 2012 and 2023. Patients were categorized into three groups according on the type of treatment received: topical, systemic, and biologic. A logistic regression analysis was performed to identify predictors of comorbidity development. RESULTS: 197 patients were included; 52.8% were women, with a mean (SD) age of 54.45 (16.91) years, divided into topical [n = 90 (45.7%)], systemic [n = 57 (29.1%)], and biologic [n = 50 (25.5%)] groups, metabolic dysfunction-associated steatotic liver disease (MASLD) was significantly more prevalent in the biologic group [22 (44%)], p < 0.001. The logistic regression showed that type 2 diabetes mellitus, biological treatments (OR = 5.798, p = 0.001), and body mass index (OR = 1.144, p = 0.002), predicted the development of MASLD with a Nagelkerke's R2 of 0.400. CONCLUSIONS: Psoriasis patients using biological therapies have a greater predisposition to MASLD. These patients should receive a comprehensive approach to identify metabolic conditions, and screening tests for MASLD are recommended.
Subject(s)
Psoriasis , Humans , Psoriasis/epidemiology , Psoriasis/drug therapy , Psoriasis/diagnosis , Psoriasis/complications , Female , Male , Middle Aged , Retrospective Studies , Adult , Aged , Longitudinal Studies , Diabetes Mellitus, Type 2/epidemiology , Diabetes Mellitus, Type 2/drug therapy , Diabetes Mellitus, Type 2/complications , Mexico/epidemiology , Fatty Liver/epidemiology , Fatty Liver/diagnosis , Body Mass Index , Biological Therapy/methods , Biological Therapy/adverse effects , Biological Products/therapeutic use , Comorbidity , PrevalenceABSTRACT
Narrative accounts have documented the potential for suffering to degrade a person's well-being by undermining their sense of meaning in life, but few studies have investigated this among nonclinical samples living in non-Western contexts of the Global South. Leveraging data from a set of three-wave longitudinal studies with younger Indonesian (Study 1: Wave 1 [December 2020], Wave 2 [January 2021], Wave 3 [February 2021]; N = 620) and Colombian adults (Study 2: Wave 1 [August/September 2021], Wave 2 [October/November 2021], Wave 3 [February 2022]; N = 2626), the present research used causal mediation methods within a counterfactual framework to examine whether the associations between suffering (Wave 1) and subsequent anxiety symptoms, depression symptoms, and general mental health (Wave 3) are mediated by meaning in life (Wave 2). Mediation analyses in both studies provided some evidence indicating that overall suffering (Wave 1) is indirectly associated with worse subsequent mental well-being on all three outcomes (Wave 3) via lower meaning in life (Wave 2). Results were generally consistent with those found for overall suffering when the aspects of suffering were considered individually, although in Study 1 the evidence in support of mediation was stronger and more consistent for some aspects of suffering compared to others. Over both shorter (Study 1) and longer (Study 2) time lags, the findings suggest that meaning in life may be one of the mechanisms by which suffering degrades mental well-being. Practical implications for mitigating and transcending the deleterious effects of suffering on mental well-being are discussed.
Subject(s)
Anxiety , Depression , Humans , Female , Male , Indonesia , Adult , Longitudinal Studies , Depression/psychology , Anxiety/psychology , Colombia , Young Adult , Middle Aged , Stress, Psychological/psychology , Mental Health , AdolescentABSTRACT
To evaluate the accuracy of the lung ultrasound score (LUS) in predicting ventilatory weaning failure during neonatal hospitalization in the NICU and to identify factors associated with weaning failure, including corrected gestational age (CGA). This prospective, longitudinal, pragmatic and observational cohort study included neonates on mechanical ventilation for at least 48 h. The primary outcome was the accuracy of lung ultrasound in predicting 3-day weaning failure, with the ROC curve used to determine the best LUS cutoff (sensitivity and specificity). Among 55 neonates, the pre-extubation LUS did not show statistical significance in predicting weaning failure (AUC 0.61; 95% CI: 0.46-0.76, p = 0,169). In the subgroup analysis, a score ≥ 4 suggests the need for ventilatory support after extubation (area under the curve [AUC] = 0.91, 95% CI: 0.80-1.0, p < 0.001) in neonates with GA ≥ 28 weeks. In extremely preterm infants, the pre-extubation LUS was not statistically significant in predicting weaning failure (AUC = 0.38, 95% CI: 0-0.77, p = 0.535). In contrast, CGA ≥ 28.7 weeks at extubation was predictor of successful weaning within 3 days (AUC = 0.95, 95% CI: 0.85-1.0, p < 0.001). CONCLUSION: LUS show promise in predicting weaning failure, though its accuracy may be limited in extremely preterm infants, highlighting the need for further well-powered studies. CGA at extubation also emerges as a key consideration in this population, warranting confirmation through robust future research. WHAT IS KNOWN: ⢠Identifying the optimal timing for extubation is crucial, as both prolonged mechanical ventilation and failed extubation are linked to increased morbidity. ⢠Lung ultrasound plays a well-established role in diagnosing various neonatal lung pathologies, allowing clinicians to make rapid, bedside decisions for the treatment of newborns. WHAT IS NEW: ⢠LUS appears to be accurate in predicting weaning failure, though its accuracy may be lower in extremely preterm infants. ⢠In extremely preterm infants, CGA may play an important role in extubation decision-making. ⢠These findings are hypothesis-generating and warrant further investigation in future studies.
Subject(s)
Airway Extubation , Gestational Age , Intensive Care Units, Neonatal , Lung , Ultrasonography , Ventilator Weaning , Humans , Infant, Newborn , Ventilator Weaning/methods , Female , Male , Prospective Studies , Ultrasonography/methods , Lung/diagnostic imaging , Treatment Failure , Longitudinal Studies , Infant, Extremely Premature , Predictive Value of Tests , ROC Curve , Infant, PrematureABSTRACT
OBJECTIVE: To assess the outcomes of three surgical techniques in the management of simple gastroschisis. MATERIALS AND METHODS: An observational, descriptive, retrospective, longitudinal study was carried out. Medical records of patients diagnosed with simple gastroschisis and treated with different surgical techniques -Simil-Exit, primary closure, and deferred closure- were reviewed. RESULTS: 38 gastroschisis patients undergoing either the Simil-Exit (n= 10), the primary closure (n= 11), or the deferred closure (n= 17) techniques were analyzed. The Simil-Exit technique involved a shorter operating time than primary closure and deferred closure. Both Simil-Exit and primary closure patients required a shorter mechanical ventilation time, fewer days of parenteral nutrition, shorter time to oral feeding initiation, and a shorter hospital stay than deferred closure patients. The deferred closure technique had more frequent complications, such as sepsis. CONCLUSIONS: The Simil-Exit and the primary closure techniques demonstrated favorable outcomes in patients with simple gastroschisis. In addition, the former involved shorter operating times, it required less exposure of the small bowel loops to the environment, it was easily reproducible, and it provided a better cosmetic result.
OBJETIVOS: Evaluar los resultados de tres técnicas quirúrgicas para la resolución de gastrosquisis simple. MATERIAL Y METODOS: Se realizó un estudio observacional, descriptivo, retrospectivo y longitudinal. Fueron revisados los expedientes clínicos de pacientes con diagnóstico de gastrosquisis simple tratados con diferentes técnicas quirúrgicas, Símil-Exit, cierre de pared primario y cierre de pared diferido. RESULTADOS: Se analizaron los datos de 38 pacientes con gastrosquisis que fueron intervenidos quirúrgicamente con técnica Símil-Exit (n= 10), con cierre de pared primario (n= 11) y con cierre de pared diferido (n= 17). La técnica Símil-Exit mostró menor tiempo quirúrgico que el cierre de pared primario y que el cierre de pared diferido; tanto los pacientes intervenidos con Símil Exit como los de cierre de pared primario, con respecto a los de cierre de pared diferido, requirieron menor tiempo de ventilación mecánica, menor número de días de apoyo con nutrición parenteral, menor intervalo de tiempo para el inicio de alimentación oral y menor tiempo de estancia hospitalaria. La técnica de cierre diferido de pared presentó con mayor frecuencia complicaciones como sepsis. CONCLUSIONES: La técnica Símil-Exit y el cierre de pared primario mostraron resultados favorables en pacientes con gastrosquisis simple; la primera, además, requirió de menor tiempo quirúrgico, menor exposición de asas intestinales al medio ambiente, fácilmente reproducible y mejor resultado estético.
Subject(s)
Gastroschisis , Length of Stay , Gastroschisis/surgery , Humans , Retrospective Studies , Female , Male , Infant, Newborn , Treatment Outcome , Length of Stay/statistics & numerical data , Longitudinal Studies , Operative Time , Respiration, Artificial/statistics & numerical data , Parenteral Nutrition/methodsABSTRACT
OBJECTIVES: To compare the impact of COVID-19 on the clinical status and psychological distress of patients with immune-mediated rheumatic disease (IMRD) caused by SARS-CoV-2 infection with that of noninfected IMRD controls during a 6-month follow-up period. METHODS: The ReumaCoV Brazil is a longitudinal study designed to follow IMRD patients for 6 months after COVID-19 (patients) compared with IMRD patients without COVID-19 (controls). Clinical data, disease activity measurements and current treatments regarding IMRD and COVID-19 outcomes were evaluated in all patients. Disease activity was assessed through validated tools at inclusion and at 3 and 6 months post-COVID-19. Fatigue, using FACIT-F (Functional Assessment of Chronic Illness Therapy) and psychological distress, using DASS 21 (Depression, Anxiety and Stress Scale - 21 Items), used to evaluated psychological distress, were evaluated at 6 months after COVID-19 in both groups. The significance level was set as p < 0.05, with a 95% confidence interval. RESULTS: A total of 601 patients were evaluated-321 patients (IMRD COVID-19 + patients) and 280 controls (IMRD COVID-19- patients)-who were predominantly female with similar median ages. Disease activity assessment over a 6-month follow-up showed no significant difference between cases and controls. Although the mean activity scores did not differ significantly, some patients reported worsened disease activity post-COVID-19, particularly in rheumatoid arthritis (RA) (32.2%) and systemic lupus erythematosus (SLE) patients (23.3%). Post-COVID-19 worsening in RA patients correlated with medical global assessment (MGA) and CDAI scores, with a moderate to large effect size. Diabetes mellitus showed a positive association (OR = 7.15), while TNF inhibitors had a protective effect (OR = 0.51). Fatigue, depression, anxiety, and stress were significantly greater in patients than in controls. Worse disease activity post-COVID-19 correlated with worse FACIT-F and DASS-21 scores in RA patients. No significant associations were found between COVID-19 outcomes and post-COVID-19 disease activity, FACIT-F or DASS-21. CONCLUSIONS: Post-COVID-19 IMRD patients exhibited significant fatigue, depression, anxiety, and stress, which can be mistaken for disease activity, despite having similar disease activity scores. The variability in reports on IMRD flares and the potential triggering of SARS-CoV-2 for autoimmune manifestations underscore the need for detailed clinical assessment and a comprehensive approach to managing them.
Subject(s)
COVID-19 , Fatigue , Psychological Distress , Rheumatic Diseases , Humans , COVID-19/psychology , Fatigue/etiology , Female , Male , Middle Aged , Rheumatic Diseases/psychology , Longitudinal Studies , Brazil/epidemiology , Adult , Arthritis, Rheumatoid/psychology , SARS-CoV-2 , Severity of Illness Index , Lupus Erythematosus, Systemic/psychology , Lupus Erythematosus, Systemic/complications , Stress, Psychological , AnxietyABSTRACT
INTRODUCTION: total hip arthroplasty (THA) is a successful surgical intervention for end-stage hip arthritis, however, it is not extent for complications. The risk of instability after THA with conventional design is up to 7% for primary procedures and 5-20% for revisions. The purpose of this study is to document the complications that occur with the double mobility prosthetic design. MATERIALS AND METHODS: observational, longitudinal, retrospective and descriptive study. A sample of 542 patients undergoing primary THA using a double mobility design was included, complications occurring from December 1, 2015 to December 31, 2021 were recorded. RESULTS: the complications that occurred were: 13 (2.39%) patients with postoperative dislocation, five (0.92%) with periprosthetic fracture, five (0.92%) with transient neuropraxia of the sciatic nerve, three (0.55%) with periprosthetic infection, one (0.18%) with chronic pain and one (0.18%) with pulmonary thromboembolism. CONCLUSIONS: the double mobility design is an appropriate option to reduce the risk of prosthetic dislocation in patients undergoing total hip arthroplasty.
INTRODUCCIÓN: la artroplastía total de la cadera (ATC) es una intervención quirúrgica exitosa para la coxartrosis en estadios avanzados; sin embargo, no está exenta de complicaciones. El riesgo de inestabilidad después de la ATC con diseño convencional es de hasta 7% para procedimientos primarios y de 5-20% para revisiones. El propósito de este estudio es documentar las complicaciones ocurridas en las ATC con el diseño protésico de doble movilidad. MATERIALES Y MÉTODOS: estudio observacional, longitudinal, retrospectivo y descriptivo. Se incluyó una muestra de 542 pacientes sometidos a ATC primaria utilizando un diseño de doble movilidad. Se registraron las complicaciones ocurridas del 1 de Diciembre de 2015 al 31 de Diciembre de 2021. RESULTADOS: las complicaciones que se presentaron fueron: 13 (2.39%) pacientes con luxación postoperatoria, cinco (0.92%) con fractura periprotésica, cinco (0.92%) con neuropraxia transitoria del nervio ciático (0.92%), tres (0.55%) con infección periprotésica, uno (0.18%) con dolor crónico y uno (0.18%) con tromboembolia pulmonar. CONCLUSIONES: el diseño de doble movilidad es una opción adecuada para disminuir el riesgo de luxación protésica en pacientes operados de artroplastía total de cadera.
Subject(s)
Arthroplasty, Replacement, Hip , Hip Prosthesis , Postoperative Complications , Prosthesis Design , Humans , Arthroplasty, Replacement, Hip/adverse effects , Arthroplasty, Replacement, Hip/methods , Retrospective Studies , Male , Female , Aged , Middle Aged , Hip Prosthesis/adverse effects , Postoperative Complications/etiology , Postoperative Complications/epidemiology , Postoperative Complications/prevention & control , Longitudinal Studies , Tertiary Care Centers , Aged, 80 and over , Hip Dislocation/etiology , Hip Dislocation/prevention & control , Periprosthetic Fractures/etiology , Adult , Prosthesis-Related Infections/etiology , Prosthesis-Related Infections/prevention & control , Pulmonary Embolism/etiology , Pulmonary Embolism/prevention & control , Pulmonary Embolism/epidemiologyABSTRACT
INTRODUCTION: Glomerular diseases can be associated with solid or hematopoietic malignancies. The prevalence of these associations varies according to the studied glomerular disease. This study aimed to evaluate the frequency and type of neoplasms in patients with glomerular diseases as well as their clinical, laboratory, and histopathological features and the relationship with immunosuppressive therapy. METHODS: This was a retrospective, descriptive, observational, longitudinal study that reviewed 4,820 medical records and included 95 patients with glomerular disease and neoplasms. Demographic, clinical, laboratory, and histologic data were collected. RESULTS: The prevalence of neoplasms was 1.97% (95 patients; 81 [85.3%] malignant, 14 [14.7%] benign). Hematologic malignancies (35.8%) showed the highest prevalence, followed by colon, rectal, and gynecologic tumors. The glomerulopathy with the highest frequency was membranous glomerulopathy (MGN, 25 patients, 35.7%). The dose of the immunosuppressive agents among patients with neoplasms before or after immunosuppression was not statistically different. Neoplasm was diagnosed before glomerulopathy in 53% of patients. Among cases in which neoplasms were diagnosed after glomerulopathy, 43% were diagnosed in the first year of follow-up of the renal disease. The predominant syndrome at presentation was nephrotic syndrome. Progression to chronic kidney disease stage 5 at the end of follow-up occurred in 8.4% of the cases. CONCLUSIONS: Neoplasms manifested before or, less frequently, after the diagnosis of glomerular diseases. As neoplasms diagnosed after presentation of glomerulopathy often appeared early after this diagnosis, it is necessary to be aware of neoplasms during the first year of follow-up of glomerulopathies, especially in patients with nephrotic syndrome, and MGN.
Subject(s)
Paraneoplastic Syndromes , Humans , Retrospective Studies , Female , Male , Brazil/epidemiology , Middle Aged , Longitudinal Studies , Adult , Paraneoplastic Syndromes/epidemiology , Paraneoplastic Syndromes/etiology , Aged , Prevalence , Glomerulonephritis/epidemiology , Glomerulonephritis/complications , Young Adult , Glomerulonephritis, Membranous/epidemiology , Glomerulonephritis, Membranous/etiology , Adolescent , Immunosuppressive Agents/therapeutic useABSTRACT
This study aims to examine the prevalence of abdominal obesity-dynapenia phenotype, identified by the presence of abdominal obesity and dynapenia, and understand its associated factors with a representative sample of the Brazilian population. Data were collected from the baseline of the Brazilian Longitudinal Study of Aging (ELSI-Brasil) 2015-2016. Abdominal obesity was determined by a waist-to-height ratio ≥ 0.55cm, while dynapenia was identified by evidence of low handgrip strength assessed via dynamometry, according to cutoff points proposed for the Brazilian population. The dependent variable was the coexistence of both conditions (abdominal obesity and dynapenia), and its association with independent variables (sociodemographic characteristics, behavior and health conditions, chronic diseases, and place of residence by Brazilian region) was analyzed using Poisson regression to obtain crude and adjusted prevalence ratios by sex, age, and education level. The prevalence of isolated abdominal obesity was 57.8%, isolated dynapenia was 5.7%, and abdominal obesity-dynapenia was 12.3%. In the adjusted model, significant associations were found with smoking (0.7; 95%CI: 0.5-0.9), alcohol consumption (0.7; 95%CI: 0.5-0.9), physical activity (0.6; 95%CI: 0.5-0.8), poor self-rated health (1.7; 95%CI: 1.4-2.2), multimorbidity (1.3; 95%CI: 1.1-1.6), and regions of residence. These factors indicate key points for the development of prevention and treatment strategies for abdominal obesity associated with low muscle strength, and we suggest that methodologies discussed here for abdominal obesity diagnosis be used as a reliable and practical means to identify this condition in older adults.
O objetivo do estudo é examinar a prevalência do fenótipo da obesidade abdominal dinapênica, identificado pela presença de obesidade abdominal e dinapenia, e conhecer seus fatores associados em uma amostra representativa da população brasileira. Foram usados dados da linha do base Estudo Longitudinal da Saúde dos Idosos Brasileiros (ELSI-Brasil) 2015-2016. A obesidade abdominal foi determinada pela razão cintura-estatura ≥ 0,55cm, e dinapenia foi identificada pela presença de baixa força de preensão palmar, por meio da dinamometria, segundo pontos de corte propostos para brasileiros. A variável dependente foi a coexistência de ambas as condições (obesidade abdominal e dinapenia), e analisou-se sua associação entre as variáveis independentes (características sociodemográficas, comportamento e condições de saúde, doenças crônicas e local de moradia segundo regiões do Brasil), utilizando-se regressão de Poisson para obter razões de prevalência brutas e ajustadas por sexo, idade e escolaridade. A prevalência de obesidade abdominal foi de 57,8%, 5,7% de dinapenia isolada e 12,3% de obesidade abdominal-dinapênica. No modelo ajustado, foram significativas as associações com tabagismo (0,7; IC95%: 0,5-0,9), consumo de álcool (0,7; IC95%: 0,5-0,9), prática de atividade física (0,6; IC95%: 0,5-0,8), autoavaliação da saúde ruim (1,7; IC95%: 1,4-2,2), multimorbidade (1,3; IC95%: 1,1-1,6), e regiões de residência. Esses fatores indicam pontos-chave para o desenvolvimento de estratégias de prevenção e tratamento da obesidade abdominal associada à baixa força muscular, e sugere-se que as metodologias aqui abordadas para seu diagnóstico sejam usadas como forma de identificação dessa condição em pessoas idosas, por sua confiabilidade e praticidade.
El objetivo del estudio es examinar la prevalencia del fenotipo de obesidad abdominal dinapénica, identificado por la presencia de obesidad abdominal y dinapenia, y comprender sus factores asociados en una muestra representativa de la población brasileña. Se utilizaron datos de la línea de base del Estudio Longitudinal de Salud de los Ancianos Brasileños (ELSI-Brasil) 2015-2016. La obesidad abdominal se determinó por la relación cintura-estatura ≥ 0,55cm y la dinapenia se identificó por la presencia de baja fuerza de prensión manual, mediante dinamometría, según puntos de corte propuestos para los brasileños. La variable dependiente fue la coexistencia de ambas condiciones (obesidad abdominal y dinapenia), y se analizó su asociación entre variables independientes (características sociodemográficas, comportamiento y estado de salud, enfermedades crónicas y lugar de residencia según regiones de Brasil), mediante regresión de Poisson para tasas de prevalencia crudas y ajustadas por sexo, edad y educación. La prevalencia de obesidad abdominal aislada fue del 57,8%, la de dinapenia aislada del 5,7% y la de obesidad abdominal dinapénica del 12,3%. En el modelo ajustado, se observaron asociaciones significativas con el tabaquismo (0,7; IC95%: 0,5-0,9), el consumo de alcohol (0,7; IC95%: 0,5-0,9), la actividad física (0,6; IC95%: 0,5-0,8) y la mala autoevaluación de la salud (1,7; IC95%: 1,4-2,2), multimorbilidad (1,3; IC95%: 1,1-1,6) y regiones de residencia. Estos factores indican puntos claves para el desarrollo de estrategias de prevención y tratamiento de la obesidad abdominal asociada a baja fuerza muscular, y se sugiere que las metodologías aquí abordadas para su diagnóstico se utilicen como una forma de identificar esta condición en personas mayores, debido a su confiabilidad y practicidad.
Subject(s)
Hand Strength , Obesity, Abdominal , Phenotype , Socioeconomic Factors , Humans , Brazil/epidemiology , Female , Male , Obesity, Abdominal/epidemiology , Middle Aged , Longitudinal Studies , Aged , Prevalence , Hand Strength/physiology , Sociodemographic Factors , Risk Factors , Sarcopenia/epidemiology , Sarcopenia/diagnosis , Sarcopenia/physiopathology , Aging/physiology , Aged, 80 and overABSTRACT
BACKGROUND: The mental health consequences of exposure to childhood trauma have been little studied among adolescents in low-income and-middle-income countries (LMICs), despite a relatively high burden of trauma in LMIC populations. We investigated associations between trauma and adolescent psychiatric disorders in the 2004 Pelotas Birth Cohort, Brazil. METHODS: In the 2004 Pelotas Birth Cohort, current psychiatric diagnoses (anxiety, mood, attention-hyperactivity, and conduct-oppositional disorders) were assessed at age 15 years (caregiver-report Development and Well-being Assessment), and age 18 years (self-report Mini-International Neuropsychiatric Interview). Lifetime cumulative trauma was assessed via caregiver report up to age 11 years and combined self-report and caregiver-report thereafter. Exposure to 12 trauma types were assessed (serious accident, fire, other disaster, attack or threat, physical abuse, sexual abuse, witnessed domestic violence, witnessed attack, witnessed accident, heard about attack, heard about accident, and parental death). Due to the high prevalence of trauma exposure in the sample, the number of different types of trauma exposure reported was extracted as a proxy for cumulative trauma load. We assessed both cross-sectional and longitudinal associations between cumulative trauma load and psychiatric disorders during adolescence using logistic regression, adjusting for confounders and pre-existing child psychopathology at 48 months. We also computed population attributable fractions (PAFs) for trauma-mental health associations at age 18 years. FINDINGS: 4229 adolescents (51·9% male, 48·1% female) were included in logistic regression analyses based on imputed data. Trauma exposure affected 81·2% of adolescents by age 18 years. At age 15 years, the odds of any disorder (adjusted odds ratio [aOR] 1·19 [95% CI 1·03-1·38]), anxiety disorders (1·45 [1·21-1·75]), and conduct-oppositional disorders (1·60 [1·13-2·27]) increased for each category increase in cumulative trauma, but mood and attention-hyperactivity disorders were not related to cumulative trauma. At age 18 years, the odds of any disorder (1·34 [1·24-1·44]), anxiety disorders (1·23 [1·13-1·34]), mood disorders (1·33 [1·22-1·46]), attention-hyperactivity disorders (1·24 [1·09-1·41]), and conduct-oppositional disorders (1·59 [1·36-1·86]) all increased for each category increase in cumulative trauma. In longitudinal analyses, each category increase in cumulative trauma by age 11 years was associated with an increased odds of any disorder (aOR 1·26 [95% CI 1·11-1·44]), anxiety disorders (1·27 [1·04-1·56]), and conduct-oppositional disorders (1·43 [1·04-1·97]) at 15 years; and trauma up to age 15 years was associated with increased odds of any disorder (1·32 [1·21-1·45]), anxiety disorders (1·27 [1·14-1·40]), mood disorders (1·26 [1·12-1·41]), and conduct-oppositional disorders (1·52 [1·24-1·87]) at age 18 years. Trauma up to age 11 years was not predictive of disorders at age 18 years, and there were no longitudinal associations between trauma and attention-hyperactivity disorders. PAF estimates indicated that trauma exposure accounted for 30·6% (95% CI 21·2-38·7) of psychiatric disorders at age 18 years. INTERPRETATION: Increasing exposure to trauma is associated with mental disorders among Brazilian adolescents. Given the high prevalence of trauma in LMIC populations, strategies to reduce exposure, identify those at greatest risk of mental disorders following trauma, and mitigate the consequences are crucial. FUNDING: Wellcome Trust, WHO, National Support Program for Centers of Excellence, Brazilian National Research Council, Brazilian Ministry of Health, Children's Pastorate, São Paulo Research Foundation, Rio Grande do Sul Research Foundation, L'Oréal-Unesco-ABC Program for Women in Science in Brazil-2020, All for Health Institute, University of Bath, Economic and Social Sciences Research Council. TRANSLATION: For the Portuguese translation of the abstract see Supplementary Materials section.
Subject(s)
Mental Disorders , Humans , Brazil/epidemiology , Adolescent , Male , Female , Longitudinal Studies , Mental Disorders/epidemiology , Child , Birth Cohort , Adverse Childhood Experiences/statistics & numerical data , Cross-Sectional StudiesABSTRACT
The scope of this study was to determine the diagnostic performance of ABSI for obesity and sarcopenic obesity, compared to the results of bioimpedance analysis (BIA) and BMI, by sex and age group. It involved a cross-sectional study with 12,793 participants in the second round of ELSA-Brasil (Longitudinal Study of Adult Health in Brazil), which obtained measurements of body fat percentage using BIA and anthropometry, verifying the performance of the diagnostic tests in order to compare the indices. The results showed that for obesity in men in all three age groups, the sensitivity was below 49%. Specificity ranged from 73% to 93%, with a higher percentage in the 65 to 79 age group. The same pattern was found for women, with sensitivity lower than 42%, and specificity ranged from 85% to 92%, and was higher in older women. With respect to sarcopenic obesity, the sensitivity and specificity among men in the three age groups were 72% was 99%, respectively. Among women, sensitivity was around 95% and specificity around 70% in all age groups. ABSI, compared to BIA, showed a reduced ability to identify obesity. However, it proved to be a good marker of sarcopenic obesity.
Objetivou-se determinar o desempenho diagnóstico do ABSI para obesidade e obesidade sarcopênica, comparados aos resultados da bioimpedância (BIA) e do IMC, por sexo e faixa etária. Trata-se de um estudo seccional com 12.793 participantes da segunda onda do ELSA-Brasil, que obteve medidas de percentual de gordura corporal utilizando BIA e antropometria, verificando-se a performance dos testes diagnósticos para comparar os índices. Os resultados mostraram que, para obesidade, em homens nas três faixas etárias, a sensibilidade foi abaixo de 49%. A especificidade variou de 73% a 93%, sendo maior na faixa etária de 65 a 79 anos. Esse padrão foi encontrado para as mulheres, sendo a sensibilidade inferior a 42%; a especificidade variou entre 85% e 92%, sendo maior nas idosas. Quanto à obesidade sarcopênica, a sensibilidade e a especificidade entre os homens nas três faixas etárias foram de 72% e 99%, respectivamente. Entre as mulheres, a sensibilidade foi de aproximadamente 95%, e a especificidade em torno de 70% em todas as faixas etárias. O ABSI, comparado à BIA, mostrou reduzida capacidade de discriminar obesidade, mas mostrou-se bom marcador de obesidade sarcopênica.
Este artículo tuvo como objetivo determinar el rendimiento diagnóstico del ABSI para obesidad y obesidad sarcopénica, comparado con los resultados del análisis de bioimpedancia (BIA) e IMC, por sexo y grupo de edad. Se trata de un estudio transversal con 12.793 participantes de la onda 2 de ELSA-Brasil, que obtuvieron mediciones del porcentaje de grasa corporal mediante BIA y antropometría, verificando la realización de las pruebas diagnósticas para comparar los índices. Los resultados mostraron que, para la obesidad, en los hombres de los tres grupos de edad, la sensibilidad estaba por debajo del 49%. La especificidad osciló entre 73% y 93%, siendo mayor en el grupo de edad de 65 a 79 años. Este patrón se encontró en mujeres, con una sensibilidad inferior al 42%; la especificidad varió entre 85% y 92%, siendo mayor en mujeres de edad avanzada. En cuanto a la obesidad sarcopénica, la sensibilidad y especificidad entre los hombres de los tres grupos de edad fueron del 72% y el 99%, respectivamente. La sensibilidad fue aproximadamente del 95% y la especificidad de alrededor del 70% en todos los grupos de edad entre las mujeres. El ABSI, en comparación con el BIA, mostró una capacidad reducida para discriminar la obesidad. Sin embargo, demostró ser un buen marcador de obesidad sarcopénica.
Subject(s)
Body Mass Index , Electric Impedance , Obesity , Sarcopenia , Sensitivity and Specificity , Humans , Male , Female , Cross-Sectional Studies , Obesity/complications , Obesity/epidemiology , Obesity/physiopathology , Sarcopenia/diagnosis , Sarcopenia/epidemiology , Aged , Middle Aged , Brazil/epidemiology , Adult , Age Factors , Sex Factors , Longitudinal Studies , Anthropometry/methodsABSTRACT
The scope of this article is to analyze the correlation between alcohol consumption and abdominal obesity in participants of the ELSA-Brasil cohort after a follow-up period of nine years. A longitudinal analysis was performed with baseline and follow-up data from ELSA-Brasil. At baseline, 15,105 civil servants were enrolled. After exclusions, the final sample consisted of 3,591 participants. Anthropometric and lifestyle data were collected, and abdominal obesity was diagnosed in accordance with the World Health Organization parameters. The t-test and chi-square test were applied, and crude and adjusted Poisson models were assessed. The results revealed that more than 70% of the sample reported alcohol use. In nine years, an increase in abdominal obesity and alcohol consumption was observed among men and women. A total of 1,588 new cases of abdominal obesity were identified. Higher alcohol consumption increased the risk of abdominal obesity in men (1.15, 95%CI 1.01-1.31, p < 0.001). The conclusion drawn was that after a follow-up period of 9 years, the highest risk of abdominal obesity was observed only in men who increased their alcohol consumption.
O objetivo é analisar a relação entre o consumo de álcool e obesidade abdominal em participantes da coorte ELSA-Brasil após nove anos de acompanhamento. Análise longitudinal a com dados da linha de base e follow-up do ELSA-Brasil. Na linha de base foram arrolados 15.105 servidores públicos. Após exclusões, a amostra final foi composta por 3.591 participantes. Dados antropométricos e de hábitos de vida foram coletados. Obesidade abdominal foi diagnosticada, segundo a Organização Mundial de Saúde. Foram utilizados teste t e qui-quadrado e testados modelos de Poisson bruto e ajustado. Mais de 70% da amostra relatou uso de bebida alcoólica. Em nove anos, foi observado aumento da obesidade abdominal e do consumo de álcool entre homens e mulheres. Foram identificados 1.588 novos casos de obesidade abdominal. O maior consumo de bebidas alcoólicas elevou o risco de obesidade abdominal em homens (1,15, IC95% 1,01-1,31, p < 0,001). Em nove anos de seguimento, o maior risco de obesidade abdominal foi observado apenas em homens que aumentaram o seu consumo de álcool.
El objetivo es analizar la relación entre el consumo de alcohol y la obesidad abdominal en participantes de la cohorte ELSA-Brasil tras nueve años de seguimiento. Análisis longitudinal realizado con datos de la línea de base y de seguimiento de ELSA-Brasil. En la línea de base se encontraban inscritos 15.105 servidores públicos. Tras las exclusiones, la muestra final estuvo compuesta por 3.591 participantes. Se recogieron datos antropométricos y de estilo de vida. Se diagnosticó obesidad abdominal, según la Organización Mundial de la Salud, se utilizaron las pruebas t y chi-cuadrado y se probaron modelos de Poisson crudos y ajustados. Más del 70% de la muestra refirió consumir alcohol. En nueve años se observó un aumento de la obesidad abdominal y del consumo de alcohol entre hombres y mujeres. Se identificaron 1.588 nuevos casos de obesidad abdominal. El mayor consumo de bebidas alcohólicas incrementó el riesgo de obesidad abdominal en los hombres (1,15, IC95% 1,01-1,31, p < 0,001). En 9 años de seguimiento, el mayor riesgo de obesidad abdominal se observó sólo en los hombres que aumentaron su consumo de alcohol.
Subject(s)
Alcohol Drinking , Obesity, Abdominal , Humans , Male , Obesity, Abdominal/epidemiology , Female , Alcohol Drinking/epidemiology , Alcohol Drinking/adverse effects , Middle Aged , Brazil/epidemiology , Follow-Up Studies , Longitudinal Studies , Adult , Incidence , Cohort Studies , Sex Factors , Risk Factors , Aged , Life Style , Time FactorsABSTRACT
OBJECTIVE: To analyze the temporal and territorial relationship between health system financing fragmentation and maternal mortality in the last two decades in Mexico. METHODS: We conducted an ecological-longitudinal study of the maternal mortality ratio (MMR) in the 32 states of Mexico during the period 2000-2022. Annual MMRs were estimated at the national and state levels according to health insurance. We compared the distribution of individual attributes and place of residence between deceased women with and without social security to identify overrepresented demographic profiles. Finally, we mapped state disparities in MMR by health insurance for the last four political administrations. FINDINGS: MMR in Mexico decreased from 59.3 maternal deaths per hundred thousand live births in 2000 to 47.3 in 2018. However, from 2019 onwards, MMR increased from 48.7 in 2019 to 72.4 in 2022. Seven out of ten maternal deaths occurred in the population without social security from 2000 to 2018, then decreasing to six out of ten from 2020. Maternal deaths in the population without social security were more frequent among younger women, with less schooling, unmarried, and residing in rural areas, with higher Indigenous presence and greater social marginalization. From 2019 onwards, the MMR was higher in the population with social security. CONCLUSION: The results of this study confirm the close relationship between maternal mortality and social inequalities, and suggest that affiliation with social security has ceased to be a differentiating factor in recent years. Understanding the evolution of maternal mortality between the population with and without social security in Mexico allows us to quantify the gap in maternal deaths attributed to inequalities in access to maternal health services, which can contribute to the design of policies that mitigate these gaps.
Subject(s)
Maternal Mortality , Humans , Maternal Mortality/trends , Female , Mexico/epidemiology , Adult , Longitudinal Studies , Social Security/statistics & numerical data , Healthcare Financing , Young Adult , Pregnancy , Insurance, Health/statistics & numerical data , Adolescent , Maternal Health Services/economics , Maternal Health Services/statistics & numerical data , Middle AgedABSTRACT
BACKGROUND: Low back pain (LBP) is a leading cause of years lived with disability. However, the association of non-chronic LBP with levels of daily physical activity (PA) remains poorly explored. This study investigated the association between previous and current non-chronic LBP with daily PA and compliance with PA recommendations in middle and older-aged adults. METHODS: This is a cross-sectional analysis including volunteers from the Baltimore Longitudinal Study of Aging who answered questions about LBP and wore an Actiheart accelerometer for 7days. Generalized linear models and logistic models were used and adjusted for potential confounders. RESULTS: 662 volunteers were included (50.8% women, 68.1% white), aged 68.0 (± 11.4) years. Previous non-chronic LBP was reported by 240 (36.3%) participants with mean pain intensity of 3.5 ± 2.0 (ranging from 0 to 10). Current non-chronic LBP was reported by 5.7% (n = 38) with mean pain intensity of 4.1 ± 2.3. Participants reporting current non-chronic LBP had lower levels of total (ß -0.18, 95% CI -0.34 to -0.02) and vigorous (ß -0.29, 95% CI -0.56 to -0.007) daily PA and lower odds of meeting PA recommendations (OR 0.20, 95% CI 0.05 to 0.92) compared to those reporting no LBP. No association was observed for LBP intensity. Conversely, previous non-chronic LBP showed no statistically significant association with daily PA levels. CONCLUSION: The presence of current non-chronic LBP seems to be negatively associated with PA levels driven mainly by lower engagement in vigorous PA. No association was observed for pain intensity.
Subject(s)
Low Back Pain , Humans , Low Back Pain/epidemiology , Female , Male , Aged , Cross-Sectional Studies , Middle Aged , Baltimore/epidemiology , Longitudinal Studies , Exercise , Motor Activity , Accelerometry , Aged, 80 and overABSTRACT
Piscine orthoreovirus (PRV) is a virus that is widely distributed among global aquaculture populations of salmonid species. The coho salmon (Oncorhynchus kisutch) is a species of increasing productive and economic importance in Chile. The presence of PRV has generated concern about its impact on the health and welfare of this species. The objective of this study was to comparatively describe the clinical manifestations, pathological changes, and pathogenesis associated with PRV infection in two different farms of farmed coho salmon in Chile through a prospective longitudinal descriptive observational study. The results demonstrated that PRV-1b and PRV-3a are independently associated with the same clinical and pathological presentation in farmed coho salmon. Microscopic pathology of the disease associated with PRV-1b and PRV-3a was primarily characterized by degenerative and inflammatory findings in the heart and liver. Hematological and blood biochemistry biomarkers in fish exhibited alterations, manifesting as hemolytic anemia and prehepatic jaundice likely due to indirect hyperbilirubinemia. Pathogenesis of infection associated with both PRV-1b and PRV-3a would indicate a specific tropism for erythrocytes and cardiomyocytes of the spongy myocardium. It is noteworthy that despite a notable reduction in viral load of both PRV subgroups in tissues, the frequency of macroscopic lesions increased during the final phase of the study. In conclusion, the results indicate a strong correlation between infection by both PRV subgroups and the proposed orthoreoviral cardiomyopathy and hemolytic jaundice (OCHJ) disease. Further research on the pathogenesis and surveillance of PRV-1b and PRV-3a subgroups is pivotal to develop effective strategies for the control of OCHJ in farmed coho salmon.
Subject(s)
Cardiomyopathies , Fish Diseases , Oncorhynchus kisutch , Orthoreovirus , Reoviridae Infections , Animals , Fish Diseases/virology , Orthoreovirus/physiology , Orthoreovirus/genetics , Reoviridae Infections/veterinary , Reoviridae Infections/virology , Oncorhynchus kisutch/virology , Chile/epidemiology , Cardiomyopathies/veterinary , Cardiomyopathies/virology , Prospective Studies , Aquaculture , Longitudinal StudiesABSTRACT
BACKGROUND: Few studies have evaluated the impact of branched-chain amino acid (BCAA) intake on the risk of obesity in adults. The results are contradictory, and the causality has not been explored. This study assessed the association between BCAA intake and obesity incidence among Brazilian adults and investigated the potential moderating role of the plant-based index (PDI) in this relationship. METHODS: A longitudinal study was conducted between 2016 and 2022, with 3090 participants (2043 women, 1047 men; mean age 34 years) from the Cohort of Universities of Minas Gerais (CUME) Study. Data were collected through an online questionnaire. The relationship between BCAA intake and obesity incidence was assessed using crude and adjusted Cox regression models. Restricted cubic spline analysis (RCS) was used to estimate the nonlinearity. The multiplicative interaction with PDI was tested. RESULTS: The overall incidence of obesity was 192 cases (6.21%). The incidence was 16.4/1000 person-years in females; 21.8/1000 person-years in males; and 18.3/1000 person-years total, with a mean follow-up period of 3.4 years. Compared to the first tertile, the highest intake tertiles for BCAA (HR = 1.50, 95% CI = 1.03-2.18), isoleucine (HR = 1.52, 95% CI = 1.04-2.22), and leucine (HR = 1.51, 95% CI = 1.03-2.20) were independently associated with obesity risk. BCAA intake above 16 g/day increases the risk of obesity. CONCLUSIONS: There was a positive association between the intake of BCAA, isoleucine, and leucine with the risk of obesity. The PDI accentuated the association between BCAA intake and obesity in both the lowest and highest quintiles.
Subject(s)
Amino Acids, Branched-Chain , Obesity , Humans , Amino Acids, Branched-Chain/administration & dosage , Male , Female , Adult , Brazil/epidemiology , Obesity/epidemiology , Incidence , Follow-Up Studies , Longitudinal Studies , Diet, Vegetarian/statistics & numerical data , Risk Factors , Middle Aged , Diet, Plant-BasedABSTRACT
This study aim was to evaluate the need for orthodontic treatment of mixed to permanent dentition using the Dental Aesthetic Index (DAI) in a 4-year follow-up. A longitudinal study was conducted with 353 children in the stages from mixed (T1) to permanent (T2) dentition. The need for orthodontic treatment was assessed using the DAI categorized into: DAI 1 (absence of malocclusion and orthodontic treatment need; DAI ≤ 25); DAI 2 (malocclusion is defined and elective orthodontic treatment is needed; DAI = 26 to 30); DAI 3 (severe malocclusion and a desirable orthodontic treatment need; DAI = 31 to 35) and DAI 4 (severe malocclusion and a mandatory orthodontic treatment need; DAI ≥ 36). The Bowker symmetry test was used to determine agreement in the categorization of DAI at T1 and T2, with a significance level of 5%. The results showed a significant disagreement in the need for orthodontic treatment between T1 and T2 (p<0.05). In 34.6% of children evaluated in T1, the same need for orthodontic treatment was maintained in T2. According to the DAI, in 60.8% of the children, the need decreased, and in 39.2% their need for orthodontic treatment increased. This preliminary longitudinal study using DAI, showed a decrease in malocclusion and need for orthodontic treatment as the dentition transitioned from mixed to permanent occurred. This finding has valuable implications for epidemiological data in orthodontics.