ABSTRACT
AIMS: Pannexin-1 (PANX1) is a hemichannel that releases ATP upon opening, initiating inflammation, cell proliferation, and migration. However, the role of PANX1 channels in colon cancer remains poorly understood, thus constituting the focus of this study. MAIN METHODS: PANX1 mRNA expression was analyzed using multiple cancer databases. PANX1 protein expression and distribution were evaluated by immunohistochemistry on primary tumor tissue and non-tumor colonic mucosa from colon cancer patients. PANX1 inhibitors (probenecid or 10Panx) were used to assess colon cancer cell lines viability. To study the role of PANX1 in vivo, a subcutaneous xenograft model using HCT116 cells was performed in BALB/c NOD/SCID immunodeficient mice to evaluate tumor growth under PANX1 inhibition using probenecid. KEY FINDINGS: PANX1 mRNA was upregulated in colon cancer tissue compared to non-tumor colonic mucosa. Elevated PANX1 mRNA expression in tumors correlated with worse disease-free survival. PANX1 protein abundance was increased on tumor cells compared to epithelial cells in paired samples, in a cancer stage-dependent manner. In vitro and in vivo experiments indicated that blocking PANX1 reduced cell viability and tumor growth. SIGNIFICANCE: PANX1 can be used as a biomarker of colon cancer progression and blocking PANX1 channel opening could be used as a potential therapeutic strategy against this disease.
Subject(s)
Colonic Neoplasms , Connexins , Disease Progression , Nerve Tissue Proteins , Animals , Female , Humans , Male , Mice , Biomarkers, Tumor/metabolism , Biomarkers, Tumor/genetics , Cell Line, Tumor , Cell Proliferation , Cell Survival , Colonic Neoplasms/pathology , Colonic Neoplasms/metabolism , Colonic Neoplasms/genetics , Connexins/metabolism , Connexins/genetics , Gene Expression Regulation, Neoplastic , HCT116 Cells , Mice, Inbred BALB C , Mice, Inbred NOD , Mice, SCID , Nerve Tissue Proteins/metabolism , Nerve Tissue Proteins/genetics , Probenecid/pharmacology , Xenograft Model Antitumor AssaysABSTRACT
El adecuado manejo perioperatorio del dolor agudo y la elección de la técnica anestésica influyen en la incidencia de complicaciones a corto, mediano y largo plazo, encontrándose en este grupo el desarrollo de dolor crónico no oncológico (DCNO). debido al aumento de la prevalencia de dolor crónico no oncológico y su relación con un manejo inadecuado o insuficiente del dolor agudo en el periodo perioperatorio, hemos realizado una revisión de su fisiopatología, los factores de riesgo y las técnicas preventivas que permitirían mitigar y/o disminuir su incidencia.
The adequate perioperative management of acute pain and the correct choice of the anesthetic technique influence the incidence of complications in the short, medium and long term, being in this group the development of chronic non-oncological pain (CNOP). due to the increase in the prevalence of non-oncological chronic pain and its relation with an inadequate or insufficient management of acute pain in the perioperative period, we have carried out a review of its pathophysiology, risk factors and preventive techniques that would allow mitigating and/or decrease its incidence.
Subject(s)
Humans , Acute Pain/drug therapy , Chronic Pain/prevention & control , Chronic Pain/epidemiology , Pain Management/methods , Anesthesia/methods , Preoperative Care , Incidence , Risk Factors , Chronic Pain/physiopathologyABSTRACT
Prader-Willi syndrome (PWS) is a genetic disorder frequently characterized by obesity, growth hormone deficiency, genital abnormalities, and hypogonadotropic hypogonadism. Incomplete or delayed pubertal development as well as premature adrenarche are usually found in PWS, whereas central precocious puberty (CPP) is very rare. This study aimed to report the clinical and biochemical follow-up of a PWS boy with CPP and to discuss the management of pubertal growth. By the age of 6, he had obesity, short stature, and many clinical criteria of PWS diagnosis, which was confirmed by DNA methylation test. Therapy with recombinant human growth hormone (rhGH) replacement (0.15 IU/kg/day) was started. Later, he presented psychomotor agitation, aggressive behavior, and increased testicular volume. Laboratory analyses were consistent with the diagnosis of CPP (gonadorelin-stimulated LH peak 15.8 IU/L, testosterone 54.7 ng/dL). The patient was then treated with gonadotropin-releasing hormone analog (GnRHa). Hypothalamic dysfunctions have been implicated in hormonal disturbances related to pubertal development, but no morphologic abnormalities were detected in the present case. Additional methylation analysis (MS-MLPA) of the chromosome 15q11 locus confirmed PWS diagnosis. We presented the fifth case of CPP in a genetically-confirmed PWS male. Combined therapy with GnRHa and rhGH may be beneficial in this rare condition of precocious pubertal development in PWS.
Subject(s)
Gonadotropin-Releasing Hormone/therapeutic use , Human Growth Hormone/therapeutic use , Prader-Willi Syndrome/drug therapy , Puberty, Precocious/drug therapy , Child , DNA Methylation , Hormone Replacement Therapy/methods , Humans , Male , Prader-Willi Syndrome/diagnosis , Prader-Willi Syndrome/genetics , Puberty, Precocious/complications , Recombinant Proteins/adverse effects , Recombinant Proteins/therapeutic useABSTRACT
SUMMARY Prader-Willi syndrome (PWS) is a genetic disorder frequently characterized by obesity, growth hormone deficiency, genital abnormalities, and hypogonadotropic hypogonadism. Incomplete or delayed pubertal development as well as premature adrenarche are usually found in PWS, whereas central precocious puberty (CPP) is very rare. This study aimed to report the clinical and biochemical follow-up of a PWS boy with CPP and to discuss the management of pubertal growth. By the age of 6, he had obesity, short stature, and many clinical criteria of PWS diagnosis, which was confirmed by DNA methylation test. Therapy with recombinant human growth hormone (rhGH) replacement (0.15 IU/kg/day) was started. Later, he presented psychomotor agitation, aggressive behavior, and increased testicular volume. Laboratory analyses were consistent with the diagnosis of CPP (gonadorelin-stimulated LH peak 15.8 IU/L, testosterone 54.7 ng/dL). The patient was then treated with gonadotropin-releasing hormone analog (GnRHa). Hypothalamic dysfunctions have been implicated in hormonal disturbances related to pubertal development, but no morphologic abnormalities were detected in the present case. Additional methylation analysis (MS-MLPA) of the chromosome 15q11 locus confirmed PWS diagnosis. We presented the fifth case of CPP in a genetically-confirmed PWS male. Combined therapy with GnRHa and rhGH may be beneficial in this rare condition of precocious pubertal development in PWS.
Subject(s)
Humans , Male , Child , Prader-Willi Syndrome/drug therapy , Puberty, Precocious/drug therapy , Gonadotropin-Releasing Hormone/therapeutic use , Human Growth Hormone/therapeutic use , Prader-Willi Syndrome/diagnosis , Prader-Willi Syndrome/genetics , Puberty, Precocious/complications , Recombinant Proteins/adverse effects , Recombinant Proteins/therapeutic use , DNA Methylation , Hormone Replacement Therapy/methodsABSTRACT
Background. Disparities in acute myocardial infarction (AMI) care for women and minorities have been extensively reported in United States but with limited information on Hispanics. Methods. Medical records of 287 (62%) Hispanic and 176 (38%) non-Hispanic white (NHW) patients and 245 women (53%) admitted with suspected AMI to a southern California nonprofit community hospital with a large Hispanic patient and provider representation were reviewed. Baseline characteristics, outcomes (mortality, CATH, PCI, CABG, and use of pertinent drug therapy), and medical insurance were analyzed according to gender, Hispanic and NHW race/ethnicity when AMI was confirmed. For categorical variables, 2 × 2 chi-square analysis was conducted. Odds ratio and 95% confidence interval for outcomes adjusted for gender, race/ethnicity, cardiovascular risk factors, and insurance were obtained. Results. Women and Hispanics had similar drug therapy, CATH, PCI, and mortality as men and NHW when AMI was confirmed (n = 387). Hispanics had less private insurance than NHW (31.4% versus 56.3%, P < 0.001); no significant differences were found according to gender. Conclusions. No differences in quality measures and outcomes were found for women and between Hispanic and NHW in AMI patients admitted to a facility with a large Hispanic representation. Disparities in medical insurance showed no influence on these findings.
ABSTRACT
Objectives. To examine trends in the prevalence and disparities of traditional cardiovascular disease (CVD) risk factors among the major race/ethnic groups in the USA: non-Hispanic Whites (NHWs), non-Hispanic Blacks (NHBs), and Mexican Americans (MAs). Methods. We used cross-sectional trend analysis in women and men aged 25-84 years participating in the NHANES surveys, years 1988-1994 (n = 14,341) and 1999-2004 (n = 12,360). Results. The prevalence of obesity and hypertension increased significantly in NHW and NHB, both in men and women; NHB had the highest prevalence of obesity and hypertension in each time period. Diabetes prevalence showed a nonsignificant increasing trend in all groups and was higher in MA in both periods. Smoking significantly decreased in NHW men and NHB, the latter with the largest decline although the highest prevalence in each period; no changes were noted in MA, who had the lowest prevalence in both periods. Race/ethnic CVD risk factors disparities widened for obesity and hypercholesterolemia, remained unchanged for diabetes and hypertension, and narrowed for smoking. Conclusions. The increasing prevalence of obesity and hypertension underscores the need for better preventive measures, particularly in the NHB group that exhibits the worst trends. The decline in smoking rates may offset some of these unfavorable trends.
ABSTRACT
BACKGROUND: The aim of this study was to assess the main factors related to maternal mortality reduction in large time series available in Chile in context of the United Nations' Millennium Development Goals (MDGs). METHODS: Time series of maternal mortality ratio (MMR) from official data (National Institute of Statistics, 1957-2007) along with parallel time series of education years, income per capita, fertility rate (TFR), birth order, clean water, sanitary sewer, and delivery by skilled attendants were analysed using autoregressive models (ARIMA). Historical changes on the mortality trend including the effect of different educational and maternal health policies implemented in 1965, and legislation that prohibited abortion in 1989 were assessed utilizing segmented regression techniques. RESULTS: During the 50-year study period, the MMR decreased from 293.7 to 18.2/100,000 live births, a decrease of 93.8%. Women's education level modulated the effects of TFR, birth order, delivery by skilled attendants, clean water, and sanitary sewer access. In the fully adjusted model, for every additional year of maternal education there was a corresponding decrease in the MMR of 29.3/100,000 live births. A rapid phase of decline between 1965 and 1981 (-13.29/100,000 live births each year) and a slow phase between 1981 and 2007 (-1.59/100,000 live births each year) were identified. After abortion was prohibited, the MMR decreased from 41.3 to 12.7 per 100,000 live births (-69.2%). The slope of the MMR did not appear to be altered by the change in abortion law. CONCLUSION: Increasing education level appears to favourably impact the downward trend in the MMR, modulating other key factors such as access and utilization of maternal health facilities, changes in women's reproductive behaviour and improvements of the sanitary system. Consequently, different MDGs can act synergistically to improve maternal health. The reduction in the MMR is not related to the legal status of abortion.
Subject(s)
Abortion, Induced/legislation & jurisprudence , Educational Status , Maternal Health Services/statistics & numerical data , Maternal Mortality/trends , Adolescent , Adult , Chile/epidemiology , Female , Humans , Middle Aged , Models, Statistical , Pregnancy , Regression Analysis , Time Factors , Young AdultABSTRACT
OBJECTIVES: To test whether foreign-born status confers a protective effect against low birth weight (LBW) outcomes among Mexican-origin women in Colorado. METHODS: Retrospective cohort study utilizing Colorado birth records from 1989-2004 for multivariate logistic regression analysis. The study population was 66,422 U.S.-born women of Mexican origin (USB) and 85,000 Mexican-born (MB) women with singleton births. RESULTS: Mexican-born women had 24.9% lower odds of LBW (OR 0.751 95% CI 0.782) than USB women. Mexican-born women had a higher prevalence of risk factors for LBW than their USB counterparts (anemia, cardiac disease, hypertension, inadequate prenatal care, less than high school education). After adjusting for these risk factors, MB women had 22.5% lower odds of having LBW infants than USB women (OR 0.775, 95% CI 0.73-0.81). CONCLUSIONS: This study supports the epidemiologic paradox of LBW; despite higher prevalence of risk factors, foreign-born status confers an overall protective effect against low birth weight outcomes.
Subject(s)
Causality , Infant, Low Birth Weight/physiology , Mexican Americans , Adolescent , Adult , Colorado/epidemiology , Emigrants and Immigrants , Female , Health Status Disparities , Humans , Infant, Newborn , Logistic Models , Pregnancy , Pregnancy Complications/epidemiology , Registries , Retrospective Studies , Risk Factors , Young AdultABSTRACT
Antecedentes: Una relación inversa entre estatura y riesgo de mortalidad ha sido establecida en estudios prospectivos de países desarrollados. Sin embargo, dicha asociación prácticamente permanece inexplorada en sociedades latinoamericanas en rápida transición económica y epidemiológica. Diseño: De un universo de 11.600 adultos viviendo en el centro urbano de Mostazal, Chile, se realizó un estudio de cohorte prospectivo de una muestra aleatoria ponderada de 795 sujetos seguidos durante 8 años. Método: Desde 1997 a 1999 se evaluó la estatura (percentiles 50 y 75 por sexo), hipertensión, diabetes, dislipidemia, obesidad, tabaquismo, consumo de alcohol y antecedentes hereditarios de enfermedad cardiovascular. El riesgo relativo de mortalidad por cualquier causa fue estimado a través de modelos de regresión de Cox ajustando por edad, sexo, factores de riesgo, educación e ingreso. Resultados: Se observó una relación inversa entre la estatura adulta y los factores de riesgo cardiovascular. En el modelo completamente ajustado el riesgo de mortalidad por cualquier causa asociado a la estatura fue 0,75 (IC 95 por ciento 0,66 - 0,85; p tendencia <0,001). Los factores de riesgo cardiovascular tradicionales solo explicaron 22 por ciento de la asociación inversa establecida entre estatura y mortalidad. Conclusión: En sociedades en transición económica como Chile, la estatura aparece como un factor de riesgo independiente de mortalidad. En esta cohorte de adultos chilenos, los factores de riesgo cardiovascular tradicionales solo explicaron parcialmente la relación inversa entre estatura y mortalidad.
Background: The inverse relationship between height and mortality risk has been well established in developed countries, but remains practically unexplored in Latin American societies. Setting: Chile, 11,600 adults living in the urban centre of Mostazal. Design: Prospective cohort study of a weighted random sample of 795 subjects followed during 8 years. Methods: Height (percentiles 50 and 75 by sex) along hypertension, diabetes, dyslipidemia, obesity, smoking, alcohol consumption and hereditary cardiovascular disease were assessed at baseline. Relative risks of all-cause mortality with 95% confidence intervals were computed in Cox regression models adjusting for age, gender, cardiovascular risk factors and joint-effects of other socioeconomic measures. Results: A significant inverse relationship between cardiovascular risk factors and height was observed. The risk of all cause mortality was 0.75 (95 percent CI 0.66 - 0.85; p-for trend <0.001) after full adjustments. Traditional cardiovascular risk factors explained only 22 percent of the association for height with mortality risk. Conclusions: In this adult cohort, traditional cardiovascular risk factors only explained partially the inverse relationship between height and all-cause mortality. Similar to developed countries, in economic transitioning societies such as Chile, height is an independent risk factor, likely reflecting different early exposure patterns that influence the health status during the life course.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Body Height , Cardiovascular Diseases/mortality , Analysis of Variance , Chile , Cohort Studies , Developing Countries , Cardiovascular Diseases/epidemiology , Follow-Up Studies , Risk Assessment , Risk Factors , Socioeconomic Factors , Survival AnalysisABSTRACT
OBJECTIVE: Nutritional, immunological and psychological benefits of exclusive breastfeeding for the first 6 months of life are unequivocally recognized. However, mothers should also be aware of the importance of breastfeeding for promoting adequate oral development. This study evaluated the association between breastfeeding and non-nutritive sucking patterns and the prevalence of anterior open bite in primary dentition. MATERIAL AND METHODS: Infant feeding and non-nutritive sucking were investigated in a 3-6 year-old sample of 1,377 children, from São Paulo city, Brazil. Children were grouped according to breastfeeding duration: G1--non-breastfed, G2--shorter than 6 months, G3--interruption between 6 and 12 months, and G4--longer than 12 months. Three calibrated dentists performed clinical examinations and classified overbite into 3 categories: normal, anterior open bite and deep bite. Chi-square tests (p<0.05) with odds ratio (OR) calculation were used for intergroup comparisons. The impact of breastfeeding and non-nutritive sucking on the prevalence of anterior open bite was analyzed using binary logistic regression. RESULTS: The prevalence estimates of anterior open bite were: 31.9% (G1), 26.1% (G2), 22.1% (G3), and 6.2% (G4). G1 would have significantly more chances of having anterior open bite compared with G4; in the total sample (OR=7.1) and in the subgroup without history of non-nutritive sucking (OR=9.3). Prolonging breastfeeding for 12 months was associated with a 3.7 times lower chance of having anterior open bite. In each year of persistence with non-nutritive sucking habits, the chance of developing this malocclusion increased in 2.38 times. CONCLUSIONS: Breastfeeding and non-nutritive sucking durations demonstrated opposite effects on the prediction of anterior open bite. Non-breastfed children presented significantly greater chances of having anterior open bite compared with those who were breastfed for periods longer than 12 months, demonstrating the beneficial influence of breastfeeding on dental occlusion.
Subject(s)
Breast Feeding , Open Bite/epidemiology , Sucking Behavior , Brazil/epidemiology , Breast Feeding/adverse effects , Child , Child, Preschool , Cross-Sectional Studies , Female , Fingersucking/adverse effects , Humans , Logistic Models , Male , Open Bite/etiology , Pacifiers/adverse effects , Prevalence , Time Factors , Tooth, DeciduousABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Cardiovascular Diseases/prevention & control , Socioeconomic Factors , Risk Factors , Drug Costs/trends , Patient Care/trends , Patient Education as Topic/trends , Economic Indexes , Costs and Cost Analysis/economics , Continuity of Patient Care/standardsABSTRACT
OBJECTIVE: Nutritional, immunological and psychological benefts of exclusive breastfeeding for the frst 6 months of life are unequivocally recognized. However, mothers should also be aware of the importance of breastfeeding for promoting adequate oral development. This study evaluated the association between breastfeeding and non-nutritive sucking patterns and the prevalence of anterior open bite in primary dentition. MATERIAL AND METHODS: Infant feeding and non-nutritive sucking were investigated in a 3-6 year-old sample of 1,377 children, from São Paulo city, Brazil. Children were grouped according to breastfeeding duration: G1 - non-breastfed, G2 - shorter than 6 months, G3 - interruption between 6 and 12 months, and G4 - longer than 12 months. Three calibrated dentists performed clinical examinations and classifed overbite into 3 categories: normal, anterior open bite and deep bite. Chi-square tests (p<0.05) with odds ratio (OR) calculation were used for intergroup comparisons. The impact of breastfeeding and non-nutritive sucking on the prevalence of anterior open bite was analyzed using binary logistic regression. RESULTS: The prevalence estimates of anterior open bite were: 31.9 percent (G1), 26.1 percent (G2), 22.1 percent (G3), and 6.2 percent (G4). G1 would have signifcantly more chances of having anterior open bite compared with G4; in the total sample (OR=7.1) and in the subgroup without history of non-nutritive sucking (OR=9.3). Prolonging breastfeeding for 12 months was associated with a 3.7 times lower chance of having anterior open bite. In each year of persistence with non-nutritive sucking habits, the chance of developing this malocclusion increased in 2.38 times. CONCLUSIONS: Breastfeeding and non-nutritive sucking durations demonstrated opposite effects on the prediction of anterior open bite. Non-breastfed children presented signifcantly greater chances of having anterior open bite compared with those who were breastfed for periods longer than 12 months, demonstrating the benefcial infuence of breastfeeding on dental occlusion.
Subject(s)
Child , Child, Preschool , Female , Humans , Male , Breast Feeding , Open Bite/epidemiology , Sucking Behavior , Brazil/epidemiology , Breast Feeding/adverse effects , Cross-Sectional Studies , Fingersucking/adverse effects , Logistic Models , Open Bite/etiology , Prevalence , Pacifiers/adverse effects , Time Factors , Tooth, DeciduousABSTRACT
Recently it has been suggested that the decline in cardiovascular mortality observed over the last 50 years may be coming to an end. This alarming trend, which has been noted mainly in younger adults from lower socioeconomic strata, may be linked to other changes, namely the increasing prevalence of modifiable risk factors, the most important of which is obesity. In contrast, our ability to predict cardiovascular risk continues to improve steadily, although it is unclear which will be its ability in designing more effective global preventive measures. Coronary heart disease appears to develop through multiple pathways, whose association with cardiovascular risk is mediated by complex processes involving numerous factors ranging from genetic predisposition to unfavorable socioeconomic circumstances. Although some attention has been paid to the latter, more effort has been put into controlling isolated risk factors. For example, numerous large studies have involved looking at the effect of single-drug therapies aimed at specific targets rather than examining more comprehensive approaches to managing multiple risk factors. In conclusion, an effective strategy for controlling modifiable risk factors in both individuals and populations must address this complex scenario and should consider significant socioeconomic factors such as education, income and the built environment. The unfavorable trend observed in cardiovascular health makes it essential that current preventive strategies are reassessed.
Subject(s)
Cardiovascular Diseases/prevention & control , Cardiovascular Diseases/epidemiology , Humans , Risk Factors , Socioeconomic FactorsABSTRACT
La prevalencia, creciente en la última década, de los factores de riesgo cardiovascular en todo el mundo y el estancamiento de la reducción de la mortalidad cardiovascular (dependiente de la enfermedad coronaria sobre todo) en adultos jóvenes de baja posición socioeconómica son tendencias alarmantes que indican que la disminución de la mortalidad cardiovascular observada en los últimos 50 años podría estar llegando a su término. La obesidad, que ha alcanzado proporciones epidémicas en el mundo, ocupa un lugar central en esta tendencia. La enfermedad coronaria se desarrolla a través de un proceso que involucra múltiples vías causales. La expresión de los factores de riesgo cardiovascular parece estar determinada por características que incluyen desde el código genético hasta factores socioeconómicos desfavorables. El control del riesgo cardiovascular hasta ahora se ha centrado predominantemente en el manejo farmacológico de factores de riesgo aislados, en detrimento de otros factores participantes, en especial los socioeconómicos. Estrategias más efectivas en el control del riesgo cardiovascular tanto en individuos como en las poblaciones deberían considerar este complejo escenario, que incluye características socioeconómicas como la educación, los ingresos y el medio ambiente construido. Las tendencias desfavorables señaladas más arriba enfatizan la necesidad de redirigir las actuales estrategias preventivas del riesgo cardiovascular (AU)
Recently it has been suggested that the decline in cardiovascular mortality observed over the last 50 years may be coming to an end. This alarming trend, which has been noted mainly in younger adults from lower socioeconomic strata, may be linked to other changes, namely the increasing prevalence of modifiable risk factors, the most important of which is obesity. In contrast, our ability to predict cardiovascular risk continues to improve steadily, although it is unclear which will be its ability in designing more effective global preventive measures. Coronary heart disease appears to develop through multiple pathways, whose association with cardiovascular risk is mediated by complex processes involving numerous factors ranging from genetic predisposition to unfavorable socioeconomic circumstances. Although some attention has been paid to the latter, more effort has been put into controlling isolated risk factors. For example, numerous large studies have involved looking at the effect of singledrug therapies aimed at specific targets rather than examining more comprehensive approaches to managing multiple risk factors. In conclusion, an effective strategy for controlling modifiable risk factors in both individuals and populations must address this complex scenario and should consider significant socioeconomic factors such as education, income and the built environment. The unfavorable trend observed in cardiovascular health makes it essential that current preventive strategies are reassessed (AU)
Subject(s)
Humans , Male , Female , Middle Aged , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/prevention & control , Socioeconomic Factors , Economic Indexes , Risk FactorsABSTRACT
PURPOSE: The inverse relationship between early life and adult socioeconomic measures and mortality risk has been well established in developed countries, but remains practically unexplored in Latin American societies. The setting was Chile; the study included 11,600 adults living in the urban center of San Francisco de Mostazal. This was a prospective cohort study of a weighted random sample of 795 subjects followed up during 8 years. METHODS: Education (elementary, high school and college), height (percentiles 50 and 75), and income (population quartiles) were assessed at baseline. Relative risks of all-cause mortality were computed in Cox regression models adjusting for age, gender, body mass index, smoking status, and joint effects of the socioeconomic measures. RESULTS: A graded inverse relationship with all-cause mortality was observed for education (risk: 1.0, 0.67, and 0.30, p for trend < 0.01) and height (risk: 1.0, 0.75, and 0.56, p for trend < 0.01), but not for income (p for trend = 0.94). CONCLUSIONS: These findings suggest a 'pauper rich' paradox in transitioning Latin American economies. Income level does not seem sufficient to improve survival in cohorts exposed to adverse early life influences reflected by education and height.
Subject(s)
Health Status Disparities , Mortality/trends , Poverty/statistics & numerical data , Adult , Age Factors , Aged , Aged, 80 and over , Body Mass Index , Chile/epidemiology , Cohort Studies , Developing Countries , Educational Status , Humans , Income/statistics & numerical data , Kaplan-Meier Estimate , Middle Aged , Multivariate Analysis , Proportional Hazards Models , Prospective Studies , Risk , Risk Assessment , Risk Factors , Socioeconomic Factors , Surveys and QuestionnairesABSTRACT
Introdução - Este estudo epidemiológico tem por objetivo determinar a prevalência das características relativas ao espaçamento anterior na dentadura decídua, associando as variantes oclusais aos fatores idade e sexo. Métodos - A amostra foi constituída por 388 crianças de ambos os sexos, na faixa etária dos 3 aos 6 anos, regularmente matriculadas em três pré-escolas de São Paulo - SP. Os exames clínicos foram realizados por um cirurgião-dentista previamente calibrado. O espaçamento interdental nos arcos superior e inferior foi classificado em quatro categorias: ausente, espaços primatas, generalizado e apinhamento. Os dados foram submetidos à análise estatística descritiva. Além disso, as características oclusais foram comparadas segundo a idade e o sexo por meio do teste Qui-Quadrado (P<0,05). Resultados - A presença de espaços generalizados foi a característica mais prevalente nos arcos superior e inferior (60,31 por cento e 58,25 por cento, respectivamente). A freqüência de crianças que possuíam somente os espaços primatas bilaterais no arco superior foi maior em relação ao inferior (21,91 por cento versus 10,82 por cento). A prevalência de arcos com ausência de espaços, porém sem apinhamento, foi de aproximadamente 15 por cento na amostra. O apinhamento foi mais freqüente no arco inferior do que no superior (14,69 por cento versus 2,06 por cento). Para o arco inferior, a prevalência de apinhamento foi significativamente maior nas crianças com 6 anos, em comparação às de 3-4 anos e 5 anos de idade (P[;0,001). O dimorfismo sexual não foi demonstrado. Conclusão - Os resultados evidenciaram que o espaçamento anterior é uma característica comum na dentadura decídua e o apinhamento é mais freqüente no arco inferior.
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Dental Occlusion , Diastema , Tooth, Deciduous , Epidemiologic Studies , PrevalenceABSTRACT
Introdução - Este estudo epidemiológico tem por objetivo determinar a prevalência das características relativas ao espaçamento anterior na dentadura decídua, associando as variantes oclusais aos fatores idade e sexo. Métodos - A amostra foi constituída por 388 crianças de ambos os sexos, na faixa etária dos 3 aos 6 anos, regularmente matriculadas em três pré-escolas de São Paulo - SP. Os exames clínicos foram realizados por um cirurgião-dentista previamente calibrado. O espaçamento interdental nos arcos superior e inferior foi classificado em quatro categorias: ausente, espaços primatas, generalizado e apinhamento. Os dados foram submetidos à análise estatística descritiva. Além disso, as características oclusais foram comparadas segundo a idade e o sexo por meio do teste Qui-Quadrado (P<0,05). Resultados - A presença de espaços generalizados foi a característica mais prevalente nos arcos superior e inferior (60,31 por cento e 58,25 por cento, respectivamente). A freqüência de crianças que possuíam somente os espaços primatas bilaterais no arco superior foi maior em relação ao inferior (21,91 por cento versus 10,82 por cento). A prevalência de arcos com ausência de espaços, porém sem apinhamento, foi de aproximadamente 15 por cento na amostra. O apinhamento foi mais freqüente no arco inferior do que no superior (14,69 por cento versus 2,06 por cento). Para o arco inferior, a prevalência de apinhamento foi significativamente maior nas crianças com 6 anos, em comparação às de 3-4 anos e 5 anos de idade (P[;0,001). O dimorfismo sexual não foi demonstrado. Conclusão - Os resultados evidenciaram que o espaçamento anterior é uma característica comum na dentadura decídua e o apinhamento é mais freqüente no arco inferior.