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1.
Osteoporos Int ; 30(8): 1645-1654, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31143990

RESUMO

Diet is thought to modulate inflammation. This study shows no relationships between the dietary inflammatory index (DII) and biomarkers of inflammation or bone after adjusting for covariates. Monocyte chemoattractant protein-1 was inversely associated with peripheral tibia cortical thickness and prospective childhood studies should be conducted to better understand this relationship and to determine if there are long-term consequences in adulthood. INTRODUCTION: Examine the relationships between the DII-scores and bone and biomarkers of inflammation in 290 adolescents, ages 9-13 years. METHODS: DII-scores were calculated from 3-day diet records and categorized into tertiles, low (< - 1.34), medium (- 1.34 to 1.41), and high (> 1.41) inflammation. Radius and tibia bone were assessed via peripheral quantitative computed tomography (Stratec XCT 2000) at the 66% site relative to the distal growth plate. Fasting serum was measured for tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6), vascular endothelial growth factor (VEGF), and monocyte chemoattractant protein-1 (MCP-1). The relationships between DII-scores and bone and biomarkers of inflammation were assessed using bivariate and partial correlations adjusting for sexual maturation, sex, race, muscle cross-sectional area, and height. ANOVA/ANCOVA models were used to compare DII-tertiles with dependent variables. RESULTS: DII-scores were negatively associated with tibia trabecular area (TtAr; r = - .141, P = .019), periosteal perimeter (PsPM; r = - .145, P = .016), endosteal perimeter (r = - .145, P = .016), strength strain index (SSI; r = - .129, P = .032), and radius TtAr (r = - .140, P = .020), PsPM (r = -.138, P = .027) and SSI (r = -.131, P = .036) but nullified when adjusting for covariates. Tibia PsPM was higher in the low DII group compared to the medium (P = .050) and high (P = .046) groups but nullified after controlling for covariates. DII-scores were not associated with TNF-α, VEGF, or IL-6, but were associated with MCP-1 only in the unadjusted model (r = .125, P = .042). In the adjusted model, MCP-1 was inversely associated with tibia cortical thickness (r = -.150 P = .030). CONCLUSION: The DII-scores were not related to biomarkers of inflammation or bone; however, the biomarker of inflammation, MCP-1 was negatively associated with tibia CtTh. Future prospective pediatric studies should be conducted to better understand this relationship and determine if there are long-term implications in adulthood.


Assuntos
Fenômenos Fisiológicos da Nutrição do Adolescente/fisiologia , Osso Cortical/fisiopatologia , Dieta , Inflamação/fisiopatologia , Adolescente , Antropometria/métodos , Biomarcadores/sangue , Composição Corporal/fisiologia , Densidade Óssea/fisiologia , Quimiocina CCL2/sangue , Criança , Osso Cortical/patologia , Estudos Transversais , Feminino , Humanos , Inflamação/sangue , Mediadores da Inflamação/análise , Masculino , Avaliação Nutricional , Tíbia/patologia , Tíbia/fisiopatologia , Tomografia Computadorizada por Raios X/métodos
2.
Osteoporos Int ; 29(8): 1783-1791, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29713797

RESUMO

Eggs contain bioactive compounds thought to benefit pediatric bone. This cross-sectional study shows a positive link between childhood egg intake and radius cortical bone. If randomized trials confirm our findings, incorporating eggs into children's diets could have a significant impact in preventing childhood fractures and reducing the risk of osteoporosis. INTRODUCTION: This study examined the relationships between egg consumption and cortical bone in children. METHODS: The cross-sectional study design included 294 9-13-year-old black and white males and females. Three-day diet records determined daily egg consumption. Peripheral quantitative computed tomography measured radius and tibia cortical bone. Body composition and biomarkers of bone turnover were assessed using dual-energy X-ray absorptiometry and ELISA, respectively. RESULTS: Egg intake was positively correlated with radius and tibia cortical bone mineral content (Ct.BMC), total bone area, cortical area, cortical thickness, periosteal circumference, and polar strength strain index in unadjusted models (r = 0.144-0.224, all P < 0.050). After adjusting for differences in race, sex, maturation, fat-free soft tissue mass (FFST), and protein intakes, tibia relationships were nullified; however, egg intake remained positively correlated with radius Ct.BMC (r = 0.138, P = 0.031). Egg intake positively correlated with total body bone mineral density, BMC, and bone area in the unadjusted models only (r = 0.119-0.224; all P < 0.050). After adjusting for covariates, egg intake was a positive predictor of radius FFST (ß = 0.113, P < 0.050) and FFST was a positive predictor of Ct.BMC (ß = 0.556, P < 0.050) in path analyses. There was a direct influence of egg on radius Ct.BMC (ß = 0.099, P = 0.035), even after adjusting for the mediator, FFST (ß = 0.137, P = 0.020). Egg intake was positively correlated with osteocalcin in both the unadjusted (P = 0.005) and adjusted (P = 0.049) models. CONCLUSION: If the positive influence of eggs on Ct.BMC observed in this study is confirmed through future randomized controlled trials, whole eggs may represent a viable strategy to promote pediatric bone development and prevent fractures.


Assuntos
Densidade Óssea/fisiologia , Fenômenos Fisiológicos da Nutrição Infantil/fisiologia , Osso Cortical/fisiologia , Ovos/estatística & dados numéricos , Absorciometria de Fóton , Adolescente , Antropometria/métodos , Biomarcadores/sangue , Desenvolvimento Ósseo/fisiologia , Remodelação Óssea/fisiologia , Criança , Estudos Transversais , Dieta/estatística & dados numéricos , Comportamento Alimentar/fisiologia , Feminino , Humanos , Masculino , Rádio (Anatomia)/fisiologia , Maturidade Sexual/fisiologia , Tíbia/fisiologia , Tomografia Computadorizada por Raios X/métodos
3.
J Clin Endocrinol Metab ; 101(1): 199-205, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26574958

RESUMO

CONTEXT: IGF-1 promotes bone growth directly and indirectly through its effects on skeletal muscle. Insulin and IGF-1 share a common cellular signaling process; thus, insulin resistance may influence the IGF-1-muscle-bone relationship. OBJECTIVE: We sought to determine the effect of insulin resistance on the muscle-dependent relationship between IGF-1 and bone mass in premenarcheal girls. DESIGN, SETTING, AND PARTICIPANTS: This was a cross-sectional study conducted at a university research center involving 147 girls ages 9 to 11 years. MAIN OUTCOME MEASURES: Glucose, insulin, and IGF-1 were measured from fasting blood samples. Homeostasis model assessment of insulin resistance (HOMA-IR) was calculated from glucose and insulin. Fat-free soft tissue (FFST) mass and bone mineral content (BMC) were measured by dual-energy x-ray absorptiometry. Our primary outcome was BMC/height. RESULTS: In our path model, IGF-1 predicted FFST mass (b = 0.018; P = .001), which in turn predicted BMC/height (b = 0.960; P < .001). IGF-1 predicted BMC/height (b = 0.001; P = .002), but not after accounting for the mediator of this relationship, FFST mass. The HOMA-IR by IGF-1 interaction negatively predicted FFST mass (b = -0.044; P = .034). HOMA-IR had a significant and negative effect on the muscle-dependent relationship between IGF-1 and BMC/height (b = -0.151; P = .047). CONCLUSIONS: Lean body mass is an important intermediary factor in the IGF-1-bone relationship. For this reason, bone development may be compromised indirectly via suboptimal IGF-1-dependent muscle development in insulin-resistant children.


Assuntos
Densidade Óssea/fisiologia , Resistência à Insulina/fisiologia , Fator de Crescimento Insulin-Like I/metabolismo , Músculo Esquelético/fisiologia , Absorciometria de Fóton , Glicemia/metabolismo , Composição Corporal/fisiologia , Estatura , Criança , Estudos Transversais , Método Duplo-Cego , Feminino , Humanos , Insulina/sangue , Fator de Crescimento Insulin-Like I/genética , Menarca , Músculo Esquelético/anatomia & histologia
4.
J Clin Endocrinol Metab ; 99(9): 3240-6, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24926952

RESUMO

CONTEXT: Although animal studies suggest that adenovirus 36 (Ad36) infection is linked to obesity and systemic inflammation, human data are scant and equivocal. OBJECTIVE: Associations of Ad36 infection with total body adiposity and inflammatory-related markers were determined in 291 children aged 9-13 years (50% female, 49% black). DESIGN: Fasting blood samples were measured for presence of Ad36-specific antibodies and TNF-α, IL-6, vascular endothelial growth factor (VEGF), and monocyte chemoattractant protein-1 (MCP-1). Fat mass and fat-free soft tissue mass were measured by dual-energy X-ray absorptiometry. RESULTS: The overall prevalence of Ad36 seropositivity [Ad36(+)] was 42%. There was a higher percentage of Ad36(+) children in the highest tertiles of TNF-α and IL-6 compared with their respective middle and lowest tertiles (both P < .03). There was also a trend toward a higher prevalence of Ad36(+) children in the highest tertile of VEGF compared with tertiles 1 and 2 (P = .05). Multinomial logistic regression, adjusting for age, race, sex, and fat-free soft tissue mass, revealed that compared with children with the lowest TNF-α, IL-6, and VEGF levels (tertile 1), the adjusted odds ratios for Ad36(+) were 2.2 [95% confidence interval (CI) 1.2-4.0], 2.4 (95% CI 1.4-4.0), and 1.8 (95% CI 1.0-3.3), respectively, for those in the highest TNF-α, IL-6, and VEGF levels (tertile 3). No association was observed between Ad36(+) and greater levels of fat mass or MCP-1 (all P > .05). CONCLUSIONS: In children, our data suggest that Ad36(+) may be associated with biomarkers implicated in inflammation but not with greater levels of fat mass.


Assuntos
Adenoviridae/imunologia , Infecções por Adenovirus Humanos/epidemiologia , Infecções por Adenovirus Humanos/imunologia , Adiposidade/imunologia , Inflamação/epidemiologia , Inflamação/imunologia , Adolescente , Anticorpos Antivirais/sangue , Biomarcadores/sangue , Quimiocina CCL2/sangue , Criança , Feminino , Humanos , Interleucina-6/sangue , Masculino , Razão de Chances , Prevalência , Estudos Soroepidemiológicos , Fator de Necrose Tumoral alfa/sangue , Fator A de Crescimento do Endotélio Vascular/sangue
5.
Proc Math Phys Eng Sci ; 469(2159): 20130323, 2013 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-24204184

RESUMO

We describe a fast algorithm to propagate, for any user-specified accuracy, a time-harmonic electromagnetic field between two parallel planes separated by a linear, isotropic and homogeneous medium. The analytical formulation of this problem (ca 1897) requires the evaluation of the so-called Rayleigh-Sommerfeld integral. If the distance between the planes is small, this integral can be accurately evaluated in the Fourier domain; if the distance is very large, it can be accurately approximated by asymptotic methods. In the large intermediate region of practical interest, where the oscillatory Rayleigh-Sommerfeld kernel must be applied directly, current numerical methods can be highly inaccurate without indicating this fact to the user. In our approach, for any user-specified accuracy ϵ>0, we approximate the kernel by a short sum of Gaussians with complex-valued exponents, and then efficiently apply the result to the input data using the unequally spaced fast Fourier transform. The resulting algorithm has computational complexity [Formula: see text], where we evaluate the solution on an N×N grid of output points given an M×M grid of input samples. Our algorithm maintains its accuracy throughout the computational domain.

6.
J Clin Endocrinol Metab ; 98(12): 4816-25, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24092833

RESUMO

CONTEXT: Changes in serum vitamin D metabolites and calcium absorption with varying doses of oral vitamin D3 in healthy children are unknown. OBJECTIVE: Our objective was to examine the dose-response effects of supplemental vitamin D3 on serum vitamin D metabolites and calcium absorption in children living at two U.S. latitudes. DESIGN: Black and white children (n = 323) participated in a multisite (U.S. latitudes 34° N and 40° N), triple-masked trial. Children were randomized to receive oral vitamin D3 (0, 400, 1000, 2000, and 4000 IU/d) and were sampled over 12 weeks in winter. Serum 25-hydroxyvitamin D (25(OH)D) and 1,25-dihydroxyvitamin D (1,25(OH)2D) were measured using RIA and intact PTH (iPTH) by immunoradiometric assay. Fractional calcium absorption was determined from an oral stable isotope 44Ca (5 mg) in a 150-mg calcium meal. Nonlinear and linear regression models were fit for vitamin D metabolites, iPTH, and calcium absorption. RESULTS: The mean baseline 25(OH)D value for the entire sample was 70.0 nmol/L. Increases in 25(OH)D depended on dose with 12-week changes ranging from -10 nmol/L for placebo to 76 nmol/L for 4000 IU. Larger 25(OH)D gains were observed for whites vs blacks at the highest dose (P < .01). Gains for 1,25(OH)2D were not significant (P = .07), and decreases in iPTH were not dose-dependent. There was no dose effect of vitamin D on fractional calcium absorption when adjusted for pill compliance, race, sex, or baseline 25(OH)D. CONCLUSION: Large increases in serum 25(OH)D with vitamin D3 supplementation did not increase calcium absorption in healthy children living at 2 different latitudes. Supplementation with 400 IU/d was sufficient to maintain wintertime 25(OH)D concentrations in healthy black, but not white, children.


Assuntos
Cálcio da Dieta/metabolismo , Desenvolvimento Infantil , Colecalciferol/administração & dosagem , Suplementos Nutricionais , Absorção Intestinal , Modelos Biológicos , Deficiência de Vitamina D/prevenção & controle , Adolescente , Negro ou Afro-Americano , Calcifediol/sangue , Calcifediol/metabolismo , Calcitriol/sangue , Calcitriol/metabolismo , Criança , Colecalciferol/efeitos adversos , Colecalciferol/metabolismo , Colecalciferol/uso terapêutico , Suplementos Nutricionais/efeitos adversos , Método Duplo-Cego , Feminino , Georgia , Humanos , Indiana , Absorção Intestinal/etnologia , Masculino , Hormônio Paratireóideo/sangue , Hormônio Paratireóideo/metabolismo , Estações do Ano , Luz Solar , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/etnologia , Deficiência de Vitamina D/metabolismo , População Branca
7.
Osteoporos Int ; 24(6): 1869-79, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23093348

RESUMO

UNLABELLED: Osteoporotic fracture rates differ according to race with Blacks having up to half the rate of Whites. The current study demonstrates that racial divergence in cortical bone properties develops in early childhood despite lower serum 25-hydroxyvitamin D in Blacks. INTRODUCTION: Racial differences in bone structure likely have roots in childhood as bone size develops predominantly during growth. This study aimed to compare cortical bone health within the tibial diaphysis of Black and White children in the early stages of puberty and explore the contributions of biochemical variables in explaining racial variation in cortical bone properties. METHODS: A cross-sectional study was performed comparing peripheral quantitative computed tomography-derived cortical bone measures of the tibial diaphysis and biochemical variables in 314 participants (n = 155 males; n = 164 Blacks) in the early stages of puberty. RESULTS: Blacks had greater cortical volumetric bone mineral density, mass, and size compared to Whites (all p < 0.01), contributing to Blacks having 17.0 % greater tibial strength (polar strength-strain index (SSIP)) (p < 0.001). Turnover markers indicated that Blacks had higher bone formation (osteocalcin (OC) and bone-specific alkaline phosphatase) and lower bone resorption (N-terminal telopeptide) than Whites (all p < 0.01). Blacks also had lower 25-hydroxyvitamin D (25(OH)D) and higher 1,25-dihydroxyvitamin D (1,25(OH)2D) and parathyroid hormone (PTH) (all p < 0.05). There were no correlations between tibial bone properties and 25(OH)D and PTH in Whites (all p ≥ 0.10); however, SSIP was negatively and positively correlated with 25(OH)D and PTH in Blacks, respectively (all p ≤ 0.02). Variation in bone cross-sectional area and SSIP attributable to race was partially explained by tibial length, 25(OH)D/PTH, and OC. CONCLUSIONS: Divergence in tibial cortical bone properties between Blacks and Whites is established by the early stages of puberty with the enhanced cortical bone properties in Black children possibly being explained by higher PTH and OC.


Assuntos
População Negra/estatística & dados numéricos , Densidade Óssea/fisiologia , Puberdade/etnologia , Tíbia/fisiologia , População Branca/estatística & dados numéricos , Adolescente , Antropometria/métodos , Composição Corporal , Criança , Estudos Transversais , Diáfises/diagnóstico por imagem , Diáfises/fisiologia , Feminino , Humanos , Masculino , Osteocalcina/sangue , Hormônio Paratireóideo/sangue , Puberdade/sangue , Puberdade/fisiologia , Tíbia/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Vitamina D/análogos & derivados , Vitamina D/sangue
8.
J Clin Endocrinol Metab ; 96(1): E89-98, 2011 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-20962027

RESUMO

CONTEXT: The extent to which 25-hydroxyvitamin D [25(OH)D] and IGF-I influence bone mineral content (BMC) accrual from early to mid-puberty is unclear. OBJECTIVE, SETTING, AND PARTICIPANTS: This study sought to determine relationships among 25(OH)D, IGF-I, and BMC in community-dwelling prepubertal females (n = 76; aged 4-8 yr at baseline) over a period of up to 9 yr. DESIGN: The hypothesis that changes in IGF-I vs. 25(OH)D are more strongly associated with BMC accrual was formulated after data collection. 25(OH)D and IGF-I were log-transformed and further adjusted using two-way ANOVA for differences in season and race. Linear mixed modeling (including a random subject-specific intercept and a random subject-specific slope on age) was employed to analyze the proportion of variance the transformed 25(OH)D and IGF-I variables explained for the bone outcomes. RESULTS: IGF-I was more strongly associated with BMC accrual than 25(OH)D at the total body (R(2) = 0.874 vs. 0.809), proximal femur (R(2) = 0.847 vs. 0.771), radius (R(2) = 0.812 vs. 0.759), and lumbar spine (R(2) = 0.759 vs. 0.698). The rate of BMC accrual was positively associated with changes in IGF-I but negatively associated with 25(OH)D. When IGF-I and 25(OH)D were included in the same regression equation, 25(OH)D did not have a significant predictive effect on BMC accrual above and beyond that of IGF-I. CONCLUSIONS: These prospective data in early adolescent females indicate that both 25(OH)D and IGF-I have a significant impact on bone mineral accrual; however, the positive association of IGF-I and BMC accrual is greater than the negative association of 25(OH)D and BMC accrual.


Assuntos
Densidade Óssea/fisiologia , Calcificação Fisiológica/fisiologia , Fator de Crescimento Insulin-Like I/metabolismo , Vitamina D/análogos & derivados , Análise de Variância , Composição Corporal , Criança , Pré-Escolar , Dieta , Feminino , Humanos , Modelos Lineares , Estudos Prospectivos , Vitamina D/sangue
9.
Osteoporos Int ; 22(2): 655-65, 2011 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-20449571

RESUMO

UNLABELLED: Despite adolescent black females experiencing the highest rates of obesity, the effect of excess fat mass on bone structure and strength in this population is unknown. Our findings in postadolescent black females suggest that excess weight in the form of fat mass may adversely influence cortical bone structure and strength. INTRODUCTION: Although adolescent obesity has been associated with reduced bone structure and strength in white females, this relationship has not been studied in adolescent black females, a population experiencing the highest rates of obesity. Our objective was to compare bone structure and strength between postadolescent black females with normal and high levels of adiposity. METHODS: Black females with ≤ 32% body fat were classified as normal body fat (NF; n = 33, aged 19.3 ± 1.3 years); females exceeding this cutoff were classified as high body fat (HF; n = 15, aged 19.0 ± 1.1 years). Using peripheral quantitative computed tomography, tibial and radial bones were scanned at the 4% (trabecular) and 20% (cortical) sites from the distal metaphyses. Fat-free soft-tissue mass (FFST) and %body fat were assessed by dual-energy X-ray absorptiometry. RESULTS: After controlling for either FFST or body weight, the HF vs. NF group had lower total cross-sectional area (CSA; 9-17%), cortical CSA (6-15%), and strength-strain index (SSI; 13-24%) at the cortical site of the tibia (all p < 0.05). At the cortical site of the radius, the HF vs. NF group had lower total CSA (14%, p = 0.03), cortical CSA (9%, p = 0.04), and SSI (15%, p = 0.07) after control for body weight. There were no group differences in either the FFST-adjusted cortical bone values at the radius or in the trabecular bone parameters (body weight- or FFST-adjusted) at the tibia and radius. CONCLUSIONS: Consistent with our adiposity and bone data in late-adolescent white females, our findings in black females entering adulthood also suggest that obesity may adversely influence cortical bone strength.


Assuntos
Tecido Adiposo/diagnóstico por imagem , Densidade Óssea/fisiologia , Rádio (Anatomia)/diagnóstico por imagem , Tíbia/diagnóstico por imagem , Absorciometria de Fóton , Adolescente , Negro ou Afro-Americano , Estudos de Casos e Controles , Feminino , Humanos , Imageamento Tridimensional , Obesidade/complicações , Tomografia Computadorizada por Raios X/métodos , Adulto Jovem
10.
Osteoporos Int ; 17(11): 1691-7, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-16874441

RESUMO

INTRODUCTION: If higher bone gains acquired from weight-bearing sports during growth persist into old age, the residual benefits could delay or even prevent osteoporotic fractures. The purpose of this study was to determine if the higher areal bone mineral density (aBMD) observed 15 years after competitive training and competition in former female college artistic gymnasts (GYM) compared with controls (CON) is maintained nine years later in this same cohort approaching menopause. In this 9-year follow-up, aBMD changes were also compared between GYM (n=16; aged 45.3+/-3.3 years) and CON (n=13; aged 45.4+/-3.8 years). METHODS: Total body, lumbar spine, proximal femur, femoral neck, leg, and arm aBMD were assessed at baseline and follow-up using dual-energy X-ray absorptiometry (DXA), (Hologic QDR-1000W). GYM had higher aBMD at all sites at follow-up (P<0.05; eta (2)>0.14). RESULTS: While there were no significant differences between groups for percent changes in aBMD at the total body, lumbar spine, total proximal femur, femoral neck, and arm, the change in leg aBMD was significantly different between GYM and CON (P=0.05; eta (2)=0.14). CONCLUSIONS: Former female college artistic gymnasts maintained significantly higher aBMD than controls 24 years after retirement from gymnastics training and competition. This study provides greater insight into the effects of past athletic participation on skeletal health in women approaching menopause.


Assuntos
Envelhecimento/fisiologia , Densidade Óssea/fisiologia , Ginástica/fisiologia , Absorciometria de Fóton , Adulto , Antropometria , Composição Corporal/fisiologia , Dieta , Ingestão de Energia/fisiologia , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Atividade Motora/fisiologia
11.
J Trauma ; 55(6): 1162-7, 2003 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-14676666

RESUMO

BACKGROUND: Morbidity and mortality from venous thromboembolism (VTE) remains a significant problem for hospitalized patients. Despite the ample prospective literature defining the prevalence of VTE in hospitalized patient populations, the prevalence of VTE in the thermally injured population remains largely unknown. METHODS: We prospectively studied 148 thermally injured patients with hospital stays of greater than 3 days with lower extremity duplex ultrasonograms obtained at admission and discharge. RESULTS: Nine patients experienced VTE (6.08%). Eight of the nine deep venous thromboses were proximal. One of the two pulmonary embolisms was fatal. Treatment risk factors that were associated with VTE were the presence of a central venous line (p = 0.020) and transfusion of more than 4 units of packed red blood cells (p = 0.023). These treatment factors were significantly related to each other (p < 0.0001), to body surface area burned, and to intervention. CONCLUSION: The prevalence of VTE in burn patients is similar to that of moderate- to high-risk general surgical patients for whom VTE prophylaxis is recommended. VTE prophylaxis of burn patients, especially those requiring central venous lines and more than 4 units of packed red blood cells, should be considered.


Assuntos
Queimaduras/complicações , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/epidemiologia , Tromboembolia/diagnóstico por imagem , Tromboembolia/epidemiologia , Ultrassonografia Doppler Dupla , Trombose Venosa/diagnóstico por imagem , Trombose Venosa/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Superfície Corporal , Queimaduras/cirurgia , Cateterismo Venoso Central/efeitos adversos , Feminino , Humanos , Iowa/epidemiologia , Tempo de Internação/estatística & dados numéricos , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Prevalência , Estudos Prospectivos , Fatores de Risco , Distribuição por Sexo , Tromboembolia/etiologia , Tromboembolia/prevenção & controle , Reação Transfusional , Ultrassonografia Doppler Dupla/métodos , Trombose Venosa/etiologia , Trombose Venosa/prevenção & controle
12.
Osteoporos Int ; 14(2): 116-22, 2003 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-12730781

RESUMO

Low body weight is associated with increased risk for fractures, whereas higher body weight has been shown to be protective against osteoporosis. This study evaluated whether body weight plays a role regulating bone turnover and mass in normal-weight (body mass index (BMI) <25 kg/m2), overweight (BMI 25-29.9 kg/m2) and obese (BMI> or =30 kg/m2) postmenopausal women who were either receiving hormone replacement therapy [HRT(+)] or not [HRT(-)] (total of six groups). Body weight, BMI, total body bone mineral content (TBBMC), and markers of bone formation (serum osteocalcin) and bone resorption (urinary pyridinoline (PYD) and deoxypyridinoline) were retrospectively analyzed in 210 postmenopausal women. The mean age was 67+/-6 years, with mean body weight of 70.8+/-14.2 kg, ranging from 45.0 to 115.5 kg. Body weight was positively correlated with TBBMC ( r=0.50, p<0.0001). There was a lower TBBMC and higher bone formation rate in normal-weight than obese HRT(-) women, but in women taking HRT there were no differences between BMI categories. In addition, in normal-weight HRT(-) women only, PYD and body weight showed a negative correlation (r=-0.39, p=0.01). Among normal-weight, but not overweight or obese subjects, we observed higher TBBMC and lower bone turnover in the HRT(+) compared with the HRT(-) group. Regression models explained 36% of the variance in TBBMC, mainly through body weight. Additional models could only explain 11-15% of the variance in bone turnover. Taken together, these data suggest that among normal-weight but not obese postmenopausal women, higher bone turnover is associated with lower bone mass, and that only normal-weight women show a different bone turnover profile with HRT treatment. Body weight should be considered an important factor in bone metabolism with relevant clinical implications.


Assuntos
Índice de Massa Corporal , Peso Corporal/fisiologia , Reabsorção Óssea/fisiopatologia , Osso e Ossos/fisiologia , Pós-Menopausa/fisiologia , Idoso , Estatura , Densidade Óssea/fisiologia , Desenvolvimento Ósseo/fisiologia , Osso e Ossos/metabolismo , Terapia de Reposição de Estrogênios , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos
13.
Amsterdam; Elsevier; 3. ed; 2002. 560 p. tab.
Monografia em Inglês | Coleciona SUS | ID: biblio-935159
14.
SADJ ; 56(4): 178-81, 2001 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-11436232

RESUMO

A chalk-based antimicrobial dentifrice was developed and has undergone in vitro testing to determine antimicrobial efficacy by kill-time studies, and in vivo clinical studies to determine anti-plaque build-up properties. The antimicrobial efficacy of the formulation is attributable to the following components; sodium lauryl sulphate, sodium monofluorophosphate, flavouring oils, triclosan, and low water activity. In vitro kill-time testing showed the dentifrice to have good activity against organisms associated with plaque, showing at least 99% reductions in the numbers of each organism. In vivo clinical results showed the dentifrice to protect against the build-up of plaque when compared to water alone. These results demonstrate that this dentifrice is effective in controlling plaque, and can thus be expected to promote good oral hygiene.


Assuntos
Anti-Infecciosos Locais/uso terapêutico , Carbonato de Cálcio/uso terapêutico , Placa Dentária/prevenção & controle , Dentifrícios/química , Dentifrícios/uso terapêutico , Análise de Variância , Anti-Infecciosos Locais/farmacologia , Bactérias/efeitos dos fármacos , Carbonato de Cálcio/farmacologia , Contagem de Colônia Microbiana , Estudos Cross-Over , Placa Dentária/microbiologia , Dentifrícios/farmacologia , Fluoretos/farmacologia , Fluoretos/uso terapêutico , Humanos , Testes de Sensibilidade Microbiana , Fosfatos/farmacologia , Fosfatos/uso terapêutico , Método Simples-Cego , Dodecilsulfato de Sódio/farmacologia , Dodecilsulfato de Sódio/uso terapêutico , Tensoativos/farmacologia , Tensoativos/uso terapêutico , Triclosan/farmacologia , Triclosan/uso terapêutico
15.
J Appl Physiol (1985) ; 90(4): 1523-31, 2001 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-11247955

RESUMO

The purpose of this study was to use estimates of body composition from a four-component model to determine whether the density of the fat-free mass (D(FFM)) is affected by muscularity or musculoskeletal development in a heterogenous group of athletes and nonathletes. Measures of body density by hydrostatic weighing, body water by deuterium dilution, bone mineral by whole body dual-energy X-ray absorptiometry (DXA), total body skeletal muscle estimated from DXA, and musculoskeletal development as measured by the mesomorphy rating from the Heath-Carter anthropometric somatotype were obtained in 111 collegiate athletes (67 men and 44 women) and 61 nonathletes (24 men and 37 women). In the entire group, D(FFM) varied from 1.075 to 1.127 g/cm3 and was strongly related to the water and protein fractions of the fat-free mass (FFM; r = -0.96 and 0.89) and moderately related to the mineral fraction of the FFM (r = 0.65). Skeletal muscle (%FFM) varied from 40 to 68%, and mesomorphy varied from 1.6 to 9.6, but neither was significantly related to D(FFM) (r = 0.11 and -0.14) or to the difference between percent fat estimated from the four-component model and from densitometry (r = 0.09 and -0.16). We conclude that, in a heterogeneous group of young adult athletes and nonathletes, D(FFM) and the accuracy of estimates of body composition from body density using the Siri equation are not related to muscularity or musculoskeletal development. Athletes in selected sports may have systematic deviations in D(FFM) from the value of 1.1 g/cm3 assumed in the Siri equation, resulting in group mean errors in estimation of percent fat from densitometry of 2-5% body mass, but the cause of these deviations is complex and not simply a reflection of differences in muscularity or musculoskeletal development.


Assuntos
Composição Corporal/fisiologia , Músculo Esquelético/fisiologia , Esportes/fisiologia , Tecido Adiposo/anatomia & histologia , Tecido Adiposo/fisiologia , Adulto , Água Corporal/fisiologia , Densidade Óssea , DNA/química , DNA/genética , Densitometria , Feminino , Humanos , Masculino , Modelos Biológicos , Músculo Esquelético/anatomia & histologia
16.
Phys Med Biol ; 45(7): 1755-64, 2000 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-10943917

RESUMO

Radiotherapy treatments are becoming more complex, often requiring the dose to be calculated in three dimensions and sometimes involving the application of non-coplanar beams. The ability of treatment planning systems to accurately calculate dose under a range of these and other irradiation conditions requires evaluation. Practical assessment of such arrangements can be problematical, especially when a heterogeneous medium is used. This work describes the use of Monte Carlo computation as a benchmarking tool to assess the dose distribution of external photon beam plans obtained in a simple heterogeneous phantom by several commercially available 3D and 2D treatment planning system algorithms. For comparison, practical measurements were undertaken using film dosimetry. The dose distributions were calculated for a variety of irradiation conditions designed to show the effects of surface obliquity, inhomogeneities and missing tissue above tangential beams. The results show maximum dose differences of 47% between some planning algorithms and film at a point 1 mm below a tangentially irradiated surface. Overall, the dose distribution obtained from film was most faithfully reproduced by the Monte Carlo N-Particle results illustrating the potential of Monte Carlo computation in evaluating treatment planning system algorithms.


Assuntos
Método de Monte Carlo , Radiometria/métodos , Planejamento da Radioterapia Assistida por Computador/métodos , Radioterapia Conformacional/métodos , Algoritmos , Neoplasias Ósseas/radioterapia , Osso e Ossos/efeitos da radiação , Dosimetria Fotográfica/métodos , Humanos , Pulmão/efeitos da radiação , Neoplasias Pulmonares/radioterapia , Imagens de Fantasmas , Fótons
17.
Genet Res ; 75(3): 257-67, 2000 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-10893862

RESUMO

We have isolated a homologue of the period (per) gene from the Australian sheep blow fly, Lucilia cuprina, as part of a comparative approach to the analysis of dipteran circadian systems. Sequence analysis of the 4 kb per cDNA revealed the conservation of three functional domains, namely the PAS dimerization motif, and the nuclear and cytoplasmic localization domains. A fourth domain, the threonine-glycine (TG) repeat region, is also conserved in L. cuprina per but has been severely truncated. No length variation was found in the TG repeat of L. cuprina or L. sericata collected from several different latitudinal zones. Expression analysis indicated a diel oscillation in per mRNA in LD 12:12 with a period of 24 h and a peak at Zt 12. PER-immunoreactive protein oscillations were also demonstrated, with peak immunoreactivity lagging approximately 3 h behind peak mRNA levels. These results show the existence of a Drosophila-like circadian system in a calliphorid fly. They also provide evidence for the conservation of per function across the Diptera, and confirm the relevance of the Drosophila system as a model for fly circadian rhythms.


Assuntos
Relógios Biológicos , Ritmo Circadiano , Dípteros/genética , Genes de Insetos , Proteínas de Insetos/genética , Sequência de Aminoácidos , Aminoácidos , Animais , Sequência de Bases , DNA Complementar , Proteínas de Drosophila , Glicina , Proteínas de Insetos/classificação , Proteínas de Insetos/metabolismo , Dados de Sequência Molecular , Proteínas Nucleares , Proteínas Circadianas Period , Filogenia , RNA Mensageiro/metabolismo , Sequências Repetitivas de Aminoácidos , Ovinos/parasitologia , Treonina , Fatores de Tempo
18.
Environ Res ; 83(2): 174-9, 2000 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-10856190

RESUMO

Dust wipe samples collected in the field were tested by nondestructive X-ray fluorescence (XRF) followed by laboratory analysis with flame atomic absorption spectrophotometry (FAAS). Data were analyzed for precision and accuracy of measurement. Replicate samples with the XRF show high precision with an intraclass correlation coefficient (ICC) of 0.97 (P<0.0001) and an overall coefficient of variation of 11.6%. Paired comparison indicates no statistical difference (P=0.272) between XRF and FAAS analysis. Paired samples are highly correlated with an R(2) ranging between 0.89 for samples that contain paint chips and 0.93 for samples that do not contain paint chips. The ICC for absolute agreement between XRF and laboratory results was 0.95 (P<0.0001). The relative error over the concentration range of 25 to 14,200 microgram Pb is -12% (95% CI, -18 to -5). The XRF appears to be an excellent method for rapid on-site evaluation of dust wipes for clearance and risk assessment purposes, although there are indications of some confounding when paint chips are present.


Assuntos
Poluição do Ar em Ambientes Fechados/análise , Chumbo/análise , Poeira , Desenho de Equipamento , Habitação , Pintura , Medição de Risco , Sensibilidade e Especificidade , Manejo de Espécimes , Espectrometria por Raios X/instrumentação
19.
Appl Occup Environ Hyg ; 15(2): 217-27, 2000 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-10675980

RESUMO

An environmental-justice (equity) grant program was used to make accessible an existing lead-training program to minority persons and residents of low-income communities. The purpose of the program was to enhance the knowledge base within the communities concerning lead hazards and intervention strategies and expand possibilities for employment in the lead abatement industry. Barriers to attendance were anticipated and addressed, and included transportation, meals, license application fees, reminders of course date and location, and day care. The program was evaluated through measures of recruitment rates, pre- and post-testing scores, and change in perception of confidence at pre-test, post-test, and at four-month follow-up. Fee-paying registrants over the same time period were used as a comparison group. First day attendance rates for individuals recruited into the equity-grant was 59 percent, of these 94 percent completed all days. Equity and fee-paying groups had similar scores on the pre-test (p = .209), while mean scores on the final exam differed significantly (p < .001) between the groups and were 77 percent and 85 percent, respectively. After adjusting for demographic and course type attended, perceptions of self-efficacy (benefit) and outcome-effectiveness (confidence) increased significantly from pre- to post-tests for both groups and remained at post-course levels at four months follow-up. Lessons learned include: (1) Lead abatement and other related activities can be successfully taught through traditional training methods; (2) A necessary element for delivery of educational services to minority groups is forming workable ties with local community groups, but eligibility requirements must be maintained; (3) Once barriers to first-day attendance are overcome, the information necessary to perform specific work skills can be taught; (4) Positive changes in belief are not dependent on minority status, income, or education levels; (5) Training and education increased confidence in ability to perform learned skills, and belief that there will be a beneficial outcome when performed for themselves, their families, and communities; and, (6) A consensus regarding applicability of regulations must be achieved among federal, state, and local communities.


Assuntos
Educação , Saúde Ambiental , Conhecimentos, Atitudes e Prática em Saúde , Intoxicação por Chumbo/prevenção & controle , Gestão da Segurança , Adulto , Negro ou Afro-Americano , Idoso , Demografia , Poluentes Ambientais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Projetos Piloto , Pobreza , Avaliação de Programas e Projetos de Saúde
20.
Chronobiol Int ; 17(1): 29-41, 2000 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-10672431

RESUMO

In constant conditions (constant darkness DD[, 20 degrees C), the sand beach isopod Cirolana cookii exhibits spontaneous rhythmic swimming activity with an average free-running period of 12.5 h. The rhythms are seen as temporal adaptations to a complex interidal environment. These results support a dual circalunidian clock model for tidal rhythms in which two components of the rhythm have characteristic periods and active phase lengths and are hypothesized to be controlled by separate circalunidian clocks. A quantitative model successfully simulates many of the properties of endogenous swimming rhythms of C. cookii, including free-running behavior, entrainment, and phase-response curves (PRCs).


Assuntos
Relógios Biológicos , Crustáceos/fisiologia , Modelos Biológicos , Animais , Lua , Atividade Motora , Periodicidade , Água do Mar , Natação
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