The impact of excess body fat on bone remodeling in adolescents.

The impact of excess body fat on bone remodeling was evaluated in overweight, obese, and extremely obese adolescents. In adolescents with excess weight, it was observed that the higher the bone mineral content and bone mineral density values, the lower the levels of the biomarkers. Nutritional imbalances by excess had a negative effect on bone formation in this stage of life. INTRODUCTION: The aim of this study was to investigate the impact of excess body fat on bone remodeling in adolescents. METHODS: Body weight, height, and body mass index were determined in 391 adolescents classified as normal weight, overweight, obese, and extremely obese. Bone age was obtained and bone mineral content and bone mineral density were evaluated in the lumbar spine, proximal femur, and total and subtotal body. Blood samples were collected for evaluation of the following bone biomarkers: osteocalcin, bone alkaline phosphatase (BAP), and serum carboxy-terminal telopeptide (S-CTx). The data were analyzed according to nutritional status and age. RESULTS: In girls with excess weight, the biomarkers were higher in the 10 to 13-year age group and no significant differences were observed between groups according to nutritional status. In boys, the levels were higher in those aged 13 to 15 years. According to nutritional status, significant differences were only observed in mean S-CTx for the age groups of 10-15 years, with higher levels between overweight and obese adolescents aged 10-12 years and between obese and extremely obese adolescents aged 13-15 years. In girls, significant negative correlations were observed between lean mass, fat mass, and fat percentage and each of the three bone markers studied. There was no correlation between lean mass or fat mass and the three biomarkers in boys. The biomarker trends demonstrated across the age groups follow the age trends for growth velocity. CONCLUSIONS: The higher the fat percentage and fat mass in girls, the lower the levels of the biomarkers, indicating that excess body fat has a negative effect on the evolution of these markers during adolescence.

[Relations among arm, arm muscle, arm fat areas and menarche in adolescents in the municipality of Botucatu]. / Relação entre área do braço, área do músculo, área de gordura do braço e a menarca em adolescentes do município de Botucatu.

The authors show the relations among arm circumference, arm muscle and arm fat areas with or without menarche, by carrying out an anthropometric study in 717 adolescents in the municipality of Botucatu. It must be emphasized that those adolescents who had already menstruated presented significantly higher nutritional indicators than those who had not menstruated yet. There was an increase in fat tissue and lean body mass in those adolescents who had already menstruated. Body changes might be expressed by calculating muscle and arm fat areas using triceps skinfold and arm circumference.

[Evaluation of the psychoaffective development of adolescents aged 15-18. A study on adolescents in the town of Botucatu, SP-aspects of sexuality]. / Avaliação do desenvolvimento afetivo-social do adolescente na faixa etária dos 15 aos 18 anos.Estudo com adolescentes do município de Botucatu, SP - Aspectos da sexualidade.

The authors present data obtained from the analysis of a questionnaire regarding sexuality among 1,437 adolescent students in the Botucatu municipal district. The student's age varied from 15 to 19 years. The results demonstrate the evolving characteristics of the student's sexuality and suggest that sexual orientation and guidance should be part of the child and adolescent educational process. The authors pointed out that the members of Health care team should stimulate the discussion of sexuality while providing medical advice.

Nutritional management and weight changes during hospitalization of Brazilian infants with diarrhoea: primary reliance on oral feeding or continuous nasogastric drip with locally made, modulated minced chicken formula.

The nutritional management of infants admitted with diarrhoea to the University Hospital of Botucatu includes a change from bolus feeding of a modulated minced-chicken formula to a continuous nasogastric drip (NGD) feeding, whenever the required calorie intake is not achieved or the diarrhoea does not subside. To evaluate this approach, the clinical course and weight changes of 63 children, aged 1-20 months, were reviewed; most (81 per cent) were below the third percentile for weight at admission and 76 per cent had a total duration of diarrhoea greater than or equal to 10 days. Associated infections, mainly systemic, were present at or after admission in 70 per cent of them. Twenty-five survivors needed nutritional support (NS), predominantly NGD, for a median duration of 30 per cent of their admission time, and were compared to 31 survivors managed without NS. Those who necessitated NS lost weight for a significantly longer median time (12 x 4 days, p less than 0.005), but their total weight loss was similar (5 x 4 per cent) as well as diarrhoea's duration (8 x 7 days). There was a tendency for a longer hospitalization (21 x 16 days 0.05 less than P less than 0.10) and a longer span to begin weight gain after diarrhoea's end for the group with NS (p less than 0.05), but subsequent growth quotient and daily weight gain during admission were similar for both groups. Both groups of survivors received similar amounts of energy, although the initial increase was delayed for those who needed the NGD.(ABSTRACT TRUNCATED AT 250 WORDS)

[Planning and execution of a course in puericulture in an ambulatory service]. / Planejmento e execução de curso de puericultura em ambulatório.

With a population of which 42.6% is under 14 years old, Brazil is especially in need of general practitioners with a good gourding in pediatrics. The fourth year of premedical training at the Botucatu Medical School at São Paulo, Brazil, includes a course in child care designed to help fill this need by giving the students their first contact with the problems of children. The course lasts 12 weeks and is given in the pediatric outpatient ward of the School's teaching hospital; its purpose is to accustom the student to dealing with members of the families of young patients while learning important aspects of clinical care at the early stages of his training, and using, in his contacts with patients, a vocabulary that the latter can understand. The course is designed to given the student not only theoretical knowledge, but also training for future practice, under the constant guidance of their instructors. A weekly evaluation of the progress of the course, in which the students participate, yields information for the ongoing improvement of the program, which has been conducted for almost ten years.

Planejamento e execuçào de curso de puericultura em ambulatório / Planning and execution of a course in puericulture in an ambulatory service

With a population of which 42.6 per cent is under 14 years old, Brazil is especially in need of general practitioners with a good gourding in pediatrics. The fourth year of premedical training at the Botucatu Medical School at Sào Paulo, Brazil, includes a course in child care designed to help fill this need by giving the students their first contact with the problems of children. The course lasts 12 weeks and is given in the pediatric outpatient ward of the School's teaching hospital; its purpose is to accustom the student to dealing with members of the families of young patients while learning important aspects of clinical care at the early stages of his training, and using, in his contacts with patients, a vocabulary that the latter can understand. The course is designed to given the student not only theoretical knowledge, but also training for future practice, under the constant guidance of their instructors. A weekly evaluation of the progress of the course, in which the students participate, yields information for the ongoing improvement of the program, which has been conducted for almost ten years (Au)

Planejamento e execucao de curso de puericultura em ambulatorio. / The planning and conduct of a course in child care in an outpatient ward

Com 42,6% da sua populacao com menos de 14 anos de idade, o Brasil tem especial necessidade de medicos gerais que tenham bons fundamentos de Pediatria. A inclusao de um curso de puericultura no quarto ano da graduacao medica da Faculdade de Medicina de Botucatu (Sao Paulo, Brasil), visa facilitar o atendimento dessa necessidade ao proporcionar aos alunos o primeiro contato com os problemas da crianca. O curso, que tem doze semanas de duracao, e desenvolvido no ambulatorio de Pediatria do hospital de ensino daquela faculdade, e tem por finalidade, entre outras, acostumar o aluno ao contato com os familiares de pacientes menores, absorvendo aspectos do atendimento clinico relevantes na fase inicial do aprendizado e utilizando, no trato com os pacientes, um vocabulario que lhes seja acessivel. O curso empenha-se em dar ao aluno nao apenas conhecimentos teoricos, mas tambem capacitacao para a pratica futura, com a constante orientacao dos docentes. Uma avaliacao semanal do andamento do curso, realizada com a participacao dos alunos, proporciona subsidios para o constante apefeicoamento do programa, que vem sendo aplicado ha cerca de dez anos