Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 22.526
Filtrar
1.
Beijing Da Xue Xue Bao Yi Xue Ban ; 51(6): 1085-1090, 2019 Dec 18.
Artigo em Chinês | MEDLINE | ID: mdl-31848509

RESUMO

OBJECTIVE: To explore the screening value of osteoporosis self-assessment tool for Asians (OSTA) and the optimal cut-off value in Chinese healthy physical examination population. METHODS: We selected a healthy physical examination population for bone mineral density screening at the Health Examination Center in Peking University Third Hospital from 2013 to 2016. Quantitative ultrasound (QUS) results were used as the gold standard, and T value ≤-2.5 was defined as osteoporosis patients. Diagnostic test methods were used to analyze the sensitivity, specificity, likelihood ratio and area under curve (AUC) of different cut points of OSTA. The screening accuracy of OSTA at different cut points was compared and the optimal cut-point value determined. RESULTS: A total of 5 833 subjects were included in the study, with an average age of (48.3±17.5) years and 2 594 women (44.5%). The QUS test showed 403 patients with osteoporosis (6.9% of the total population), 343 female osteoporosis patients (13.22% of the female population). In the whole age group, AUC at the international routine cut-off value (OSTA ≤-1) screening for osteoporosis was 0.815 (95%CI: 0.804-0.825), and screening accuracy was higher in the women (AUC=0.837, 95%CI: 0.823-0.851) than that in the men (AUC=0.767, 95%CI: 0.752-0.781; P<0.05). In the whole age group, when the optimal cut-off value was 0, its AUC 0.842 (95%CI: 0.832-0.851) was significantly higher than that when the cut-off value was -1 (P<0.01), and net reclassification improvement (NRI) increased by 5.5%. In the 40 to 65-year-old group, when OSTA cut-off value ≤0, the screening accuracy was significantly higher (NRI=19.5%, P=0.003) than that when it was -1. CONCLUSION: The OSTA screening tool had good osteoporosis screening value in healthy people, and the screening accuracy in women is higher than that in men. Increasing the screening cut-off value of OSTA would be helpful to improve the screening accuracy in the whole and 40 to 65-year-old population. There may be different optimal cut-off values for different age group population.


Assuntos
Osteoporose , Autoavaliação , Absorciometria de Fóton , Adulto , Idoso , Grupo com Ancestrais do Continente Asiático , Densidade Óssea , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Exame Físico , Medição de Risco , Sensibilidade e Especificidade
2.
Beijing Da Xue Xue Bao Yi Xue Ban ; 51(6): 1115-1118, 2019 Dec 18.
Artigo em Chinês | MEDLINE | ID: mdl-31848514

RESUMO

OBJECTIVE: To explore the relationships of periodontal parameters, cortical width on mental foramen and osteoporotic condition in postmenopausal women. METHODS: Ninetyeight postmenopausal women between 50 to 65 years old were recruited. General conditions, such as age, menopausal age, duration of menopause, and body mass index (BMI) were recorded. Periodontal parameters were examined, including oral hygiene index simplified (OHI-S), probing depth (PD), clinical attachment loss (CAL), gingival recession (GR) and bleeding on probing (BOP). Panoramic radiograph was taken and the cortical width (CW) of mental foramen was measured on images. The examiner was celebrated. Bone mass density (BMD) of left hip and lumbar spine was assessed using standardized dual energy X-ray absorptiometry. According to World Health Organization, based on the T-score of BMD (difference of the measured BMD and the mean value of young white women in terms of standard deviations), the subjects were divided into osteoporotic group (T-score<-2.5) and non-osteoporotic group (T-score≥-2.5). These parameters were compared between the groups. RESULTS: The number of osteoporotic group was 47 (47.96%). Ages and duration of menopause were significantly different between the groups. Osteoporotic group presented older ages [(59.64±4.58) years vs. (56.94 ± 4.26) years, P<0.05], and longer duration of menopause [(10.17± 5.37) years vs. (6.02 ±4.48) years, P<0.05]. There was no significant difference in menopausal age and BMI between the groups. BOP% was statistically significantly higher in osteoporotic group (29.43±21.12) than in non-osteoporotic group (21.43±17.09), with a P-value of 0.046. The other periodontal parameters, including OHI-S, PD, CAL, and GR were not statistically significantly different in the groups. The CWs were statistically significantly lower in osteoporotic group compared with non-osteoporotic group, with a P-value of 0.001. The mean values of CWs were (3.61±1.04) mm (osteoporotic group) and (4.25±0.77) mm (non-osteoporotic group), respectively. CONCLUSION: The study demonstrated absence of a significant association between periodontal parameters and BMD. However, the CWs were found to be related with the BMD, which may be used to detect BMD abnormal in maxillofacial imaging. The dentists should pay attention not only to the oral health, but also to the general bone mass density, which may be detected on panoramic images.


Assuntos
Osteoporose Pós-Menopausa , Periodontite , Absorciometria de Fóton , Idoso , Densidade Óssea , Feminino , Humanos , Pessoa de Meia-Idade , Pós-Menopausa
3.
Zhonghua Yi Xue Za Zhi ; 99(42): 3345-3349, 2019 Nov 12.
Artigo em Chinês | MEDLINE | ID: mdl-31715673

RESUMO

Objective: The aim is to analyze the fracture risk in rheumatic patients by fracture risk assessment tool (FRAX), which is recommended by World Health Organization (WHO), so that we can prevent the occurrence of osteoporotic fracture earlier. Methods: Totally 617 participants, 204 out-patients with rheumatism, 204 in-patients with rheumatism and 209 healthy controls, from March to October in 2018 of Fourth Medical Center of PLA General Hospital, Jishuitan Hospital and China-Japan Friendship Hospital, were enrolled in this study. The probability of hip fracture (PHF) and major osteoporotic fracture (PMOF) in 10 years with FRAX were compared, and the differences between taking sleroids or not and with or without bone mass density (BMD) of femoral neck were evaluated. Correlation analysis was conducted between PHF, PMOF and clinical information, including age, disease duration, gender, steroid usage, osteocalcin, P1NP and ß-crosslaps. Results: There was no significant difference in PMOF within 10 years (3.455±2.690 vs 2.973±2.149 vs 3.323±1.828) among the three groups (P>0.05), but the PHF (0.986±1.619 vs 0.515±0.873 vs 0.149±0.311) was different (P<0.05). PHF and PMOF increased gradually with age. PMOF of patients without glucocorticoid therapy in 10 years was lower than that of patients with glucocorticoid (3.554±2.584 vs 2.857±2.238, P<0.05). There is no difference between the results of FRAX calculated with BMD or not (3.012±2.231 vs 3.207±2.601, P>0.05). PHF and PMOF were positively correlated with age, course of disease, glucocorticoid use and osteocalcin level, while PHF was negatively correlated with TP1NP among in-patients. Conclusion: The prevalence of 10-year hip fracture calculated by FRAX in rheumatism patients is higher than that of healthy group. FRAX can be used to calculate fracture risk without BMD. Combination of FRAX and bone turnover markers may be more effective in prediction of osteoporotic fracture in rheumatic patients.


Assuntos
Fraturas do Quadril , Fraturas por Osteoporose , Doenças Reumáticas , Absorciometria de Fóton , Densidade Óssea , China , Humanos , Medição de Risco , Fatores de Risco
4.
Zhonghua Wei Chang Wai Ke Za Zhi ; 22(10): 977-983, 2019 Oct 25.
Artigo em Chinês | MEDLINE | ID: mdl-31630497

RESUMO

Objective: To explore the value of dual-energy CT-based volumetric iodine-uptake (VIU) in the evaluation of chemotherapy efficacy in advanced gastric cancer. Methods: Inclusion criteria of subjects: (1) without previous systematic therapy; (2) with complete clinical information before and after chemotherapy; (3) without contraindications of chemotherapy. Exclusion criteria of subjects: (1) unfinished duration and times of chemotherapy; (2) unmeasurable primary lesions; (3) poor imaging quality or poor gastric filling. Clinical and image data of 52 patients with advanced gastric cancer who were diagnosed by pathology from gastroscopic biopsy, and needed chemotherapy evaluated by imaging and clinical information in the First Affiliated Hospital of Wenzhou Medical University from February 2017 to February 2018 were collected and analyzed. Of 52 patients, 38 were male and 14 were female with the median age of 65 (31-88) years old. All the patients underwent a dual-energy, dual phase-enhanced CT scanning before chemotherapy and after the third chemotherapy session. The parameters of the lesions measured before and after chemotherapy in portal vein phase were as follows: the maximum diameter (the largest diameter among those measured in the cross-sectional, coronal, and sagittal planes), average CT value (the regions of interest were manually pinpointed under cross-sectional planes with largest diameter of the tumor, which did not include regions less than 2 mm to the edge of the tumor) and VIU (lesion volume × iodine concentration). The change rates of maximum lesion diameter, average CT value and VIU before and after chemotherapy were calculated [(post-chemotherapy parameters-pre-chemotherapy parameters)/ pre-chemotherapy parameters]. The efficacy of chemotherapy was evaluated by RECIST 1.1 (the change of maximum tumor diameter after chemotherapy), Choi (the change of average CT value after chemotherapy) and VIU (the change of VIU after chemotherapy), respectively, which was categorized by complete response (CR), partial response (PR), stable disease (SD) and progressive disease (PD). Patients with CR, PR, and SD were assigned to the effective group, while those with PD were classified as the ineffective group. Paired t - test or Wilcoxon signed ranks test was used to compare the changes of parameters before and after chemotherapy, whereas Spearman correlation analysis and Kappa test were used for the correlation analysis and the consistency test between the three evaluation criteria (Kappa≥0.75 indicated good consistency). Results: After chemotherapy, the average CT value [(74.01±16.75) HU vs. (81.06±15.87) HU, t=2.202, P=0.030] and median VIU (668.53×10(2) µg vs. 272.52×10(2) µg, Z=4.761, P<0.001) decreased significantly, while the difference of the maximum diameter was not statistically significant [(66.71±34.49) mm vs. (78.45±35.62) mm, t=1.708, P=0.091]. The median change rate of VIU (-53.33%) was greater than that of CT values (-5.75%) with significant difference (Z=-5.408, P<0.001). According to the RECIST 1.1 criteria, 47 patients (90.4%, including 19 with PR and 28 with SD) were effective and 5 patients (9.6%) were ineffective. According to the Choi criteria, 45 patients (86.5%, including 37 with PR and 8 with SD) were effective and 7 patients (13.5%) were ineffective. According to the VIU criteria, 46 patients (88.5%, including 41 with PR and 5 with SD) were effective and 6 patients (11.5%) were ineffective. Efficacy comparison among these three criteria showed no significant difference (χ(2)=0.377, P=0.828). As compared to RECIST 1.1 evaluation, the proportion of PR evaluated by Choi and VIU was significantly higher (χ(2)=16.861, P<0.001), whereas the proportion of SD was significantly lower (χ(2)=24.089, P<0.001). There was no significant difference in the proportions of PR and SD between VIU and Choi criteria (χ(2)=0.887, P=0.346). Consistency and correlation analysis showed that the VIU and Choi evaluation criteria presented the highest consistency and correlation (Kappa=0.912, P<0.001; r=0.916, P<0.001). Conclusion: VIU is a feasible parameter for the evaluation of chemotherapy efficacy in advanced gastric cancer, and may be more sensitive than the evaluation criteria based on maximum diameter or change of CT value in the tumor.


Assuntos
Neoplasias Gástricas/diagnóstico por imagem , Neoplasias Gástricas/tratamento farmacológico , Tomografia Computadorizada por Raios X/métodos , Absorciometria de Fóton , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Radioisótopos do Iodo/farmacologia , Masculino , Pessoa de Meia-Idade , Compostos Radiofarmacêuticos/farmacologia , Indução de Remissão , Neoplasias Gástricas/patologia , Resultado do Tratamento
5.
J Indian Soc Pedod Prev Dent ; 37(3): 282-285, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31584029

RESUMO

Aim: The objective was to evaluate the bone mineral density (BMD) and bone mineral content (BMC) in children affected with molar incisor hypomineralization (MIH) using dual-energy X-ray absorptiometry (DEXA) scan. Materials and Methods: The study comprised a total of 30 children aged 6-10 years. Fifteen children were affected with MIH (moderate and severe variety) diagnosed using the European Academy of Paediatric Dentistry 2003 criteria, and remaining 15 children not affected with MIH serve as a control group. DEXA scan was done in all the selected children under standard conditions. Results: A positive association was seen between childhood illness and MIH. The mean subtotal BMC (grams) in MIH and control group was 633 ± 80.05 and 670.33 ± 166.41, respectively, whereas mean subtotal BMD (g/m2) was 1.00 and 0.87 ± 0.35, respectively, with no statistically significant difference between two groups. BMD and BMC at the lumbar spine and thoracic spine locations were also did not vary significantly between MIH-affected children and controls. Conclusion: Childhood illnesses were more common in MIH-affected children compared to controls. Bone maturation parameters (BMD, BMC) do not differ between MIH affected and control children.


Assuntos
Densidade Óssea , Hipoplasia do Esmalte Dentário , Absorciometria de Fóton , Criança , Humanos , Incisivo , Dente Molar , Projetos Piloto
6.
Nutr. hosp ; 36(5): 1074-1080, sept.-oct. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-184629

RESUMO

Antecedentes: la definición y metodología recomendadas para diagnosticar sarcopenia ha ido evolucionando. El consenso más utilizado es el del Grupo Europeo de Trabajo en Sarcopenia en Personas Mayores publicado en 2010 (EWGSOP1), que ha sido actualizado en 2019 (EWGSOP2). Objetivos: determinar la prevalencia de sarcopenia en personas mayores institucionalizadas usando el algoritmo del EWGSOP2 y comparar dichos resultados con los obtenidos en el Granada Sarcopenia Study al aplicar el algoritmo del EWGSOP1. Métodos: para evaluar la sarcopenia se midieron la masa muscular con un impedanciómetro, la fuerza muscular con un dinamómetro y la velocidad de la marcha en un recorrido de cuatro metros. Para la comparación de los resultados se realizó un análisis de sensibilidad y especificidad utilizando la versión 20 de SPSS. Resultados: según el EWGSOP2, el 60,1% tenía sarcopenia y el 58,1% tenía sarcopenia grave, resultados sin diferencias estadísticamente significativas al compararlos con los obtenidos según el EWGSOP1 (63% tenía sarcopenia y 61,2%, sarcopenia grave). Tampoco se hallaron diferencias significativas al comparar los sujetos con baja masa muscular según las fórmulas propuestas en uno y otro consenso, mientras que sí las hubo al comparar los sujetos con baja fuerza muscular debido a la variación en los puntos de corte. Conclusiones: la prevalencia de sarcopenia en personas mayores institucionalizadas es alta, destacando una gran mayoría de sujetos con baja fuerza muscular y bajo rendimiento físico. La utilización de la metodología propuesta por el EWGSOP2 no influyó en los resultados de prevalencia de sarcopenia obtenidos al aplicar el EWGSOP1


Background: the definition and methodology recommended for the diagnosis of sarcopenia has been changing. The mostly applied consensus is the one published by the European Working Group in Older People in 2010 (EWGSOP1), which was updated in 2019 (EWGSOP2). Objectives: assessing the prevalence of sarcopenia in institutionalized older adults using the EWGSOP2 algorithm and comparing these results with the EWGSOP1 algorithm results. Methods: in order to diagnose sarcopenia, muscle mass was assessed using an impedanciometer, muscle strength with a dynamometer and walking speed over a four-meter course. For the comparison of the results, a sensitivity and specificity analysis were performed with the version 20 of SPSS. Results: according to the EWGSOP2, 60.1% of the participants had sarcopenia and 58.1% had severe sarcopenia, results with no statistical differences when they are compared to the results according to the EWGSOP1 (63% had sarcopenia and 61.2%, severe sarcopenia). Neither were statistical differences found when comparing subjects with low muscle mass according to the formulas suggested by both consensus, while there were differences when comparing subjects with low muscle strength due to the variation of cut-off points. Conclusions: the prevalence of sarcopenia in institutionalized older adults is high, being remarkable that the majority of the participants had low muscle strength and low physical performance. The utilization of the methodology proposed by the EWGSOP2 did not have influence in the results of prevalence of sarcopenia obtained when the EWGSOP1 recommendations were applied


Assuntos
Humanos , Idoso , Idoso de 80 Anos ou mais , Sarcopenia/diagnóstico , Sarcopenia/epidemiologia , Instituição de Longa Permanência para Idosos/estatística & dados numéricos , Consenso , Índice de Massa Corporal , Algoritmos , Força Muscular , Absorciometria de Fóton , Estudos Transversais , Antropometria , Desempenho Físico Funcional , Repertório de Barthel
7.
Nutr. hosp ; 36(5): 1189-1195, sept.-oct. 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-184644

RESUMO

High altitude mountaineering is characterized by high energetic requirements due to the environment in which the activity is developed: negative energy balance, extreme cold, high altitude and the assumption of potential risks can be found during the practice of this sport. High altitude mountaineering, as a result of the previous factors, induces changes in body composition which have never been studied previously in a systematic review. A search within four different databases (PubMed, SportDiscus, Scopus and Medline) was performed using the thesaurus terms "Mountaineering" and "Body composition". A second search was performed using the following terms "Altitude" and "Body composition". The selection criteria included studies with healthy adults which evaluated the effects of at least 14 days of uninterrupted stays at altitudes above 4,000 m. The studies included in the review assessed body composition through different methods such as anthropometry, bioimpedance, dual energy x-ray absorptiometry, hydrostatic weighing and air displacement plethysmography. The search was performed up to and including December 1st 2018. Eleven observational studies met the inclusion criteria. All studies reported weight loss, of which five reported significant reductions in lean mass and six reported reductions in fat mass. Also, three studies reported reductions in both fat mass and lean mass. Current evidence is limited to observational studies with important confounding factors affecting the final conclusions. Longitudinal studies with a better methodological design and control groups are needed in order to verify these results


El alpinismo a grandes altitudes se caracteriza por elevados requerimientos energéticos debido al ambiente en el que se desarrolla la actividad: los balances energéticos negativos, el frío extremo, la exposición a la altitud o niveles de estrés elevados se pueden observar en la práctica de este deporte. Debido a estos factores, el alpinismo de altitud induce cambios en la composición corporal que no se han estudiado previamente en una revisión sistemática. Se realizó una búsqueda en cuatro bases de datos (PubMed, SportDiscus, Scopus and Medline) con los términos Mesh "Mountaineering" y "Body composition". Una segunda búsqueda se realizó usando los términos "Altitude" y "Body composition". Los criterios de selección incluyeron estudios con adultos sanos que evaluaron los efectos de estancias de al menos 14 días ininterrumpidos en altitudes superiores a los 4.000 m. La composición corporal se analizó con diferentes métodos como antropometría, bioimpedancia, absorciometría dual de rayos x, pesada hidrostática y pletismografía por desplazamiento de aire. La búsqueda se realizó incluyendo estudios fechados hasta el 1 de diciembre de 2018. Once estudios observacionales cumplieron con los criterios de inclusión. Todos los estudios reportaron pérdida de peso, de los cuales cinco reportaron reducciones en masa magra; seis, reducciones en masa grasa; y tres, reducciones en ambas. La evidencia actual se limita a estudios observacionales con factores de confusión importantes que afectan a los resultados finales. Se necesitan estudios longitudinales con mejor diseño metodológico y grupo control para verificar estos resultados


Assuntos
Humanos , Montanhismo/fisiologia , Composição Corporal/fisiologia , Altitude , Necessidade Energética/fisiologia , Antropometria , Absorciometria de Fóton , Pletismografia , Necessidades Nutricionais , Análise Qualitativa
8.
J Int Soc Sports Nutr ; 16(1): 39, 2019 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-31500646

RESUMO

BACKGROUND: Enzymatically modified isoquercitrin (EMIQ), a water-soluble quercetin, has been shown to intensify muscle hypertrophy in mice. We investigated the effect of EMIQ in supplementary protein powder on athlete body composition. METHODS: Forty Japanese males who played American football (age: 19.8 ± 1.4 years; body height: 174.1 ± 6.0 cm; body mass: 75.5 ± 10.7 kg) were assigned to a randomized, placebo-controlled, double-blind trial of parallel group. Participants received either EMIQ in whey protein (EW, n = 19) or contrast whey protein (W, n = 20) 6 days per week over 4 months. Body composition was assessed using dual-energy X-ray absorptiometry. Markers of oxidative stress, derivatives of reactive oxygen metabolites (d-ROMs) and biological antioxidant potential (BAP), were assessed using a free radical analytical system. Data were analyzed using a univariate and repeated measures general model statistics. RESULTS: After 4 months, changes in lower limb fat-free mass and muscle mass were significantly greater in the EW group than in the W group (mean change ±95% CI; W: 324.1 ± 284.3, EW: 950.3 ± 473.2, p = 0.031, W: 255.7 ± 288.6, EW: 930.9 ± 471.5, p = 0.021, respectively). Moreover, the EW group exhibited a significantly higher BAP/d-ROMs ratio, antioxidation index, than the W group after 4 months (mean change ± SD; W: 8.8 ± 1.1, EW: 10.3 ± 2.8; p = 0.028). No significant differences in body mass, lean body mass, fat mass, or lower limb fat mass were observed between the groups. CONCLUSION: Ingestion of EMIQ in supplementary protein powder for 4 months exerts antioxidant effects and increases muscle mass among American football players. TRIAL REGISTRATION: University Hospital Medical Information Network Clinical Trial Registry, UMIN000036036 . Retrospectively registered in 2019.


Assuntos
Composição Corporal , Suplementos Nutricionais , Músculo Esquelético/crescimento & desenvolvimento , Quercetina/análogos & derivados , Absorciometria de Fóton , Adolescente , Atletas , Proteínas na Dieta/administração & dosagem , Método Duplo-Cego , Futebol Americano , Humanos , Masculino , Quercetina/administração & dosagem , Fenômenos Fisiológicos da Nutrição Esportiva , Adulto Jovem
10.
BMC Infect Dis ; 19(1): 820, 2019 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-31533648

RESUMO

BACKGROUND: The aim of this study was to establish the prevalence of lipodystrophy and its association to cumulative exposure to antiretroviral drugs. METHOD: We conducted a cross sectional study in all HIV- infected patients attending the HIV clinic in the Centre hospitalier universitaire de Montréal (CHUM) with DEXA scan. Lipodystrophy was defined as a trunk/limb fat ratio ≥ 1.5. Association between cumulative exposure to antiretroviral (measured in years of use) with trunk/limb fat ratio (coded as a continuous variable) was assessed using univariate and multivariate linear regression for each antiretroviral drug with at least 40 exposed patients. RESULTS: One hundred sixty-six patients were included. Seventy-five percent were male, median age was 56 years, 67% were Caucasian. Overall, prevalence of lipodystrophy was 47%, with a mean trunk/limb fat ratio of 1.87, SD = 1.03, min = 0.6 and max = 5.87. Each 10-year increase in age and HIV infection duration was associated with an average increase of 0.24 and 0.34 for the trunk/limb fat ratio respectively. (p = 0.003, p = 0.002, respectively) Patients classified as lipodystrophic were more likely to be diabetic (50 vs. 28%, p = 0.07) and to have dyslipidemia (47 vs. 19%, p = 0.01). According to viral load at DEXA test, each one log increase was associated with less probability (0.7) of lipodystrophy. (p = 0.01) Among ARV drugs tested, there was an association between years of use of d4T, ritonavir and raltegravir and higher trunk/limb fat ratio (indicating more lipodystrophy) (p < 0.05). CONCLUSION: Lipodystrophy is very common in HIV infected patients and is correlated with duration of some new antiretroviral drugs.


Assuntos
Antirretrovirais/uso terapêutico , Infecções por HIV/tratamento farmacológico , Síndrome de Lipodistrofia Associada ao HIV/diagnóstico , Absorciometria de Fóton , Adulto , Idoso , Estudos Transversais , Dislipidemias/diagnóstico , Dislipidemias/etiologia , Feminino , Síndrome de Lipodistrofia Associada ao HIV/epidemiologia , Síndrome de Lipodistrofia Associada ao HIV/etiologia , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Carga Viral
11.
Vet Clin North Am Exot Anim Pract ; 22(3): 397-417, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31395322

RESUMO

Diagnostic imaging relies on interpretation of interactions between the body tissue and various energies, such as x-rays, ultrasound, and magnetic or nuclear energies, to differentiate normal from abnormal tissues. Major technological improvements regarding emission and detection of the energetic waves, as well as reconstruction and interpretation of the images, have occurred. These advances made possible visualization of smaller structures, quantitative evaluation of functional processes, and development of unique imaging-guided procedures. This article reviews the technological advances that allowed development of cone beam computed tomography, dual-energy x-ray absorptiometry, and contrast-enhanced ultrasonography, which all could have applications in exotic pet medicine.


Assuntos
Animais Exóticos , Diagnóstico por Imagem/veterinária , Medicina Veterinária/tendências , Absorciometria de Fóton/instrumentação , Absorciometria de Fóton/métodos , Absorciometria de Fóton/tendências , Absorciometria de Fóton/veterinária , Animais , Tomografia Computadorizada de Feixe Cônico/instrumentação , Tomografia Computadorizada de Feixe Cônico/métodos , Tomografia Computadorizada de Feixe Cônico/tendências , Tomografia Computadorizada de Feixe Cônico/veterinária , Diagnóstico por Imagem/instrumentação , Diagnóstico por Imagem/métodos , Diagnóstico por Imagem/tendências , Humanos , Ultrassonografia/instrumentação , Ultrassonografia/métodos , Ultrassonografia/tendências , Ultrassonografia/veterinária , Medicina Veterinária/instrumentação , Medicina Veterinária/métodos
12.
Aging Clin Exp Res ; 31(10): 1375-1389, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31422565

RESUMO

PURPOSE: The purpose of this paper was to review the available approaches for bone strength assessment, osteoporosis diagnosis and fracture risk prediction, and to provide insights into radiofrequency echographic multi spectrometry (REMS), a non-ionizing axial skeleton technique. METHODS: A working group convened by the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis met to review the current image-based methods for bone strength assessment and fracture risk estimation, and to discuss the clinical perspectives of REMS. RESULTS: Areal bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA) is the consolidated indicator for osteoporosis diagnosis and fracture risk assessment. A more reliable fracture risk estimation would actually require an improved assessment of bone strength, integrating also bone quality information. Several different approaches have been proposed, including additional DXA-based parameters, quantitative computed tomography, and quantitative ultrasound. Although each of them showed a somewhat improved clinical performance, none satisfied all the requirements for a widespread routine employment, which was typically hindered by unclear clinical usefulness, radiation doses, limited accessibility, or inapplicability to spine and hip, therefore leaving several clinical needs still unmet. REMS is a clinically available technology for osteoporosis diagnosis and fracture risk assessment through the estimation of BMD on the axial skeleton reference sites. Its automatic processing of unfiltered ultrasound signals provides accurate BMD values in view of fracture risk assessment. CONCLUSIONS: New approaches for improved bone strength and fracture risk estimations are needed for a better management of osteoporotic patients. In this context, REMS represents a valuable approach for osteoporosis diagnosis and fracture risk prediction.


Assuntos
Osteoporose/diagnóstico , Absorciometria de Fóton/métodos , Densidade Óssea , Osso e Ossos , Consenso , Feminino , Fraturas Ósseas , Humanos , Osteoartrite , Medição de Risco , Análise Espectral , Ultrassonografia
13.
JAMA ; 322(8): 736-745, 2019 08 27.
Artigo em Inglês | MEDLINE | ID: mdl-31454046

RESUMO

Importance: Few studies have assessed the effects of daily vitamin D doses at or above the tolerable upper intake level for 12 months or greater, yet 3% of US adults report vitamin D intakes of at least 4000 IU per day. Objective: To assess the dose-dependent effect of vitamin D supplementation on volumetric bone mineral density (BMD) and strength. Design, Setting, and Participants: Three-year, double-blind, randomized clinical trial conducted in a single center in Calgary, Canada, from August 2013 to December 2017, including 311 community-dwelling healthy adults without osteoporosis, aged 55 to 70 years, with baseline levels of 25-hydroxyvitamin D (25[OH]D) of 30 to 125 nmol/L. Interventions: Daily doses of vitamin D3 for 3 years at 400 IU (n = 109), 4000 IU (n = 100), or 10 000 IU (n = 102). Calcium supplementation was provided to participants with dietary intake of less than 1200 mg per day. Main Outcomes and Measures: Co-primary outcomes were total volumetric BMD at radius and tibia, assessed with high resolution peripheral quantitative computed tomography, and bone strength (failure load) at radius and tibia estimated by finite element analysis. Results: Of 311 participants who were randomized (53% men; mean [SD] age, 62.2 [4.2] years), 287 (92%) completed the study. Baseline, 3-month, and 3-year levels of 25(OH)D were 76.3, 76.7, and 77.4 nmol/L for the 400-IU group; 81.3, 115.3, and 132.2 for the 4000-IU group; and 78.4, 188.0, and 144.4 for the 10 000-IU group. There were significant group × time interactions for volumetric BMD. At trial end, radial volumetric BMD was lower for the 4000 IU group (-3.9 mg HA/cm3 [95% CI, -6.5 to -1.3]) and 10 000 IU group (-7.5 mg HA/cm3 [95% CI, -10.1 to -5.0]) compared with the 400 IU group with mean percent change in volumetric BMD of -1.2% (400 IU group), -2.4% (4000 IU group), and -3.5% (10 000 IU group). Tibial volumetric BMD differences from the 400 IU group were -1.8 mg HA/cm3 (95% CI, -3.7 to 0.1) in the 4000 IU group and -4.1 mg HA/cm3 in the 10 000 IU group (95% CI, -6.0 to -2.2), with mean percent change values of -0.4% (400 IU), -1.0% (4000 IU), and -1.7% (10 000 IU). There were no significant differences for changes in failure load (radius, P = .06; tibia, P = .12). Conclusions and Relevance: Among healthy adults, treatment with vitamin D for 3 years at a dose of 4000 IU per day or 10 000 IU per day, compared with 400 IU per day, resulted in statistically significant lower radial BMD; tibial BMD was significantly lower only with the 10 000 IU per day dose. There were no significant differences in bone strength at either the radius or tibia. These findings do not support a benefit of high-dose vitamin D supplementation for bone health; further research would be needed to determine whether it is harmful. Trial Registration: ClinicalTrials.gov Identifier: NCT01900860.


Assuntos
Densidade Óssea/efeitos dos fármacos , Colecalciferol/administração & dosagem , Suplementos Nutricionais , Vitaminas/administração & dosagem , Absorciometria de Fóton , Administração Oral , Idoso , Relação Dose-Resposta a Droga , Método Duplo-Cego , Feminino , Análise de Elementos Finitos , Resistência à Flexão , Humanos , Masculino , Pessoa de Meia-Idade , Rádio (Anatomia)/anatomia & histologia , Rádio (Anatomia)/diagnóstico por imagem , Tíbia/anatomia & histologia , Tíbia/diagnóstico por imagem , Falha de Tratamento , Vitamina D/análogos & derivados , Vitamina D/sangue
14.
Int J Sports Med ; 40(10): 619-624, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31365945

RESUMO

Based on the high financial and logistical costs associated with the assessment of body composition with dual-energy X-ray absorptiometry (DXA), this study determined which field method has the best correlation with DXA data, and developed an equation to estimate fat-free mass (FFM) using the field anthropometric data in international soccer players. A total of 17 international soccer players participated in this study. DXA values provided a criterion measure of FFM. Correlation coefficients, biases, limits of agreement, and differences were used as validity measures, and regression analyses were used to develop the prediction equation. All field methods used to obtain FFM data showed positive correlations (r from 0.90-0.96) with DXA. Only the equation developed by Deurenberg et al. [6] showed no differences from DXA with a low bias. The main strength of this study was providing a valid and accurate equation to estimate FFM specifically in international soccer players.


Assuntos
Adiposidade , Atletas , Composição Corporal , Absorciometria de Fóton , Adulto , Estudos Transversais , Impedância Elétrica , Humanos , Masculino , Análise de Regressão , Pregas Cutâneas , Futebol
15.
Transplant Proc ; 51(7): 2324-2329, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31402249

RESUMO

PURPOSE: In this study, we evaluated the relationship between serum homocysteine level and proteinuria, parathyroid hormone, vitamin D, and bone mineral density in kidney transplant recipients (KTR). MATERIALS AND METHODS: A total of 117 stable KTR older than 18 years was followed in our outpatient clinic. Demographic data were recorded. Simultaneously biochemical parameters, including glucose, blood urea nitrogenous, creatinine, calcium, phosphorus, sodium, potassium, albumin, parathormone, vitamin D3, homocysteine, vitamin B12, folate, and 24-hour urine protein, and bone mineral density of the femoral neck and spine by dual-energy x-ray absorptiometry (DEXA) were measured. RESULTS: DEXA measurements were normal, osteoporotic, and osteopenic (12.3%, 36.3%, and 51.3%, respectively). There was a relationship between the serum homocysteine and usage of rapamycin (P = .05), statins (P = .057), and beta blockers (P = .01), DEXA measurements were not related with serum homocysteine levels and immunosuppressive drugs used. Serum homocysteine levels correlated negatively with blood urea nitrogen (P = .002), creatinine (P = .001), vitamin B12 (P < .001), and a positively daily proteinuria (rho = 0.203, P = .031). There was a negative relationship between proteinuria and serum level of vitamin D. CONCLUSIONS: The bone mineral density decreased in more than 87% of our KTR. We did not find any relationship between DEXA measurements and levels of homocysteine, vitamin D, parathormone, and immunosuppressive drugs. It should be noted that some drugs used may affect serum homocysteine levels. Interestingly, there was a relationship between proteinuria and serum levels of homocysteine and vitamin D. Therefore, serum levels of homocysteine and vitamin D should be evaluated for preventing renal damage in KTR.


Assuntos
Densidade Óssea/efeitos dos fármacos , Homocisteína/sangue , Transplante de Rim , Absorciometria de Fóton , Densidade Óssea/fisiologia , Inibidores de Calcineurina/uso terapêutico , Colecalciferol/sangue , Feminino , Humanos , Imunossupressores/uso terapêutico , Masculino , Pessoa de Meia-Idade , Hormônio Paratireóideo/sangue , Proteinúria
16.
Medicine (Baltimore) ; 98(31): e16628, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31374030

RESUMO

To investigate the differences in bone mineral density between patients with liver cirrhosis and healthy control, and to analyze the risk factors of hepatic osteoporosis in patients with HBV related liver cirrhosis.A total of 189 patients with liver cirrhosis and 207 health controls were enrolled. The bone mineral density of lumbar spine and femoral neck was examined by dual energy X-ray absorptiometry. -2.0

Assuntos
Hepatite B/complicações , Cirrose Hepática/epidemiologia , Cirrose Hepática/etiologia , Osteoporose/epidemiologia , Absorciometria de Fóton , Adulto , Fatores Etários , Idoso , Peso Corporal , Densidade Óssea , Doenças Ósseas Metabólicas/epidemiologia , Fibrose , Humanos , Cirrose Hepática/patologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais
17.
Nutr. hosp ; 36(4): 792-798, jul.-ago. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-184702

RESUMO

Introducción: los pacientes con enfermedad renal crónica (ERC) deben ser considerados como un grupo de alto riesgo cardiovascular, ya que existen múltiples factores que incrementan la presencia de dislipidemia. Objetivo: determinar si el cociente androide/ginecoide (CA/G) tiene utilidad como factor cardiometabólico para dislipidemia en pacientes pediátricos con insuficiencia renal crónica Materiales y métodos: estudio de una cohorte. Se incluyeron pacientes con ERC terminal en diálisis peritoneal y hemodiálisis. A cada paciente se le realizó determinación de la composición corporal, índice de masa corporal (IMC) y perfil de lípidos. Posteriormente, se realizó somatometría y perfil de lípidos a los 6 y 12 meses de seguimiento. Análisis estadístico: para identificar la diferencia entre las variables somatométricas y bioquímicas iniciales, a los 6 y 12 meses se aplicó la prueba de Friedman. El coeficiente de Spearman determinó la correlación de variables corporales y bioquímicas. Resultados: se analizaron 21 pacientes. Las concentraciones séricas de los triglicéridos a 12 meses de seguimiento aumentaron significativamente (6 vs. 12 meses; p = 0,05), sin evidencia de un incremento en el score Z del IMC (p = 0,98) o colesterol total (p = 0,49). La grasa corporal, su porcentaje y score Z del IMC no se correlacionaron con los cambios en los niveles del colesterol y triglicéridos a los 6 y 12 meses; sin embargo, el CA/G presentó una asociación estadísticamente significativa con la modificación en las concentraciones séricas de los triglicéridos a los 6 (r = 0,65, p = 0,003) y 12 meses de seguimiento (r = 0,54, p = 0,02). Conclusiones: el CA/G mostró asociación al incremento en la concentración sérica de triglicéridos a 12 meses de seguimiento


Background: there are multiple factors that increase the presence of dyslipidemia in chronic kidney disease (CKD). Objective: to determine if the android/gynecoid ratio (A/GR) has utility as a cardiometabolic factor for dyslipidemia in pediatric patients with chronic renal failure. Materials and methods: cohort study. Patients with terminal CKD in peritoneal dialysis and hemodialysis were included. Determinations of body composition, body mass index (BMI), and lipid profile were assessed for each patient. Subsequently, somatometry and lipid profile were performed at 6 and 12 months of follow-up. Statistical analysis: to identify the difference between the initial somatic and biochemical variables, and at 6 and 12 months, the Friedman test was applied. The Spearman coefficient determined the correlation of bodily and biochemical variables. Results: twenty-one patients were analyzed. Triglycerides (TGL) serum at 12 months of follow-up increased significantly (6 vs 12 months, p = 0.05), without evidence of an increase in the Z score of the BMI (p = 0.98) or total cholesterol (p = 0.49). Body fat, fat percentage and Z score BMI did not correlate with changes in cholesterol and triglyceride levels at 6 and 12 months; however, the A/GI presented a statistically significant association with the change in serum concentrations of TGL at 6 (r = 0.65, p = 0.003) and 12 months of follow-up (r = 0.54, p = 0.02). Conclusions: the A/GI showed an association with the increase in the serum concentration of TGL at 12 months of follow-up


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Dislipidemias/diagnóstico , Prognóstico , Insuficiência Renal Crônica/complicações , Estudos de Coortes , Diálise Renal , Estado Nutricional , Avaliação Nutricional , Absorciometria de Fóton , Composição Corporal , Índice de Massa Corporal , Análise Estatística , Triglicerídeos/análise , Antropometria , Análise Multivariada
18.
Nutr. hosp ; 36(4): 919-925, jul.-ago. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-184719

RESUMO

Introducción: el índice de masa corporal (IMC) es una medida subrogada de la adiposidad corporal, por lo que puede infradiagnosticar sobrepeso y obesidad, lo que hace necesario definir variables más adecuadas para su correcto diagnóstico. Objetivo: comparar la categorización de sobrepeso y obesidad según el porcentaje de grasa medido con absorciometría de rayos X de energía dual (DEXA) con el IMC y la fórmula Clínica Universidad de Navarra - Body Adiposity Estimator (CUN-BAE), así como su relación con la adherencia a la dieta mediterránea, la actividad física y la satisfacción con la imagen corporal. Sujetos y métodos: estudio descriptivo transversal llevado a cabo en una muestra de 64 estudiantes de Medicina. Se determinaron peso, talla, perímetro de cintura, porcentaje de grasa medido con DEXA, adherencia a la dieta mediterránea, nivel de actividad física y satisfacción con la imagen corporal. Resultados: el IMC infradiagnostica sobrepeso respecto al porcentaje de grasa medido por DEXA mientras que la ecuación CUN-BAE presenta una buena correlación. El porcentaje de grasa se asocia inversamente con la satisfacción con la imagen corporal con mayor fuerza que el IMC. Conclusión: se necesitan nuevas herramientas capaces de distinguir los casos con IMC normal cuyo porcentaje de grasa corporal está elevado. Sería útil estudiar si el empleo de un cuestionario de satisfacción con la imagen corporal en personas clasificadas como normopeso podría distinguir a aquellas con una mayor probabilidad de exceso de grasa y así emplear estudios más exhaustivos en este colectivo


Introduction: body mass index (BMI) can under-diagnose overweight and obesity as it is a surrogate measure of central adiposity, making it necessary to define more adequate variables for its correct diagnosis. Objective: to compare the categorization of overweight and obesity according to the percentage of fat measured with dual-energy X-ray absorptiometry (DEXA) with the BMI and the Clínica Universidad de Navarra - Body Adiposity Estimator (CUN-BAE) formula, as well as their relationship with adherence to the Mediterranean diet, physical activity and satisfaction with body image. Subjects and methods: cross-sectional study conducted in 64 medical students. We determined weight, height, waist circumference, percentage of fat measured with DEXA, adherence to the Mediterranean diet, level of physical activity and degree of satisfaction with body image. Results: BMI underdiagnoses overweight with respect to the percentage of fat measured by DEXA while CUN-BAE has a good correlation. Percentage of fat is inversely associated with satisfaction with body image more strongly than the BMI. Conclusion: the limitations of BMI to diagnose excess body fat pose the need for new tools to distinguish patients with normal BMI whose percentage of body fat is high. It would be useful to assess whether the use of a questionnaire of satisfaction with body image in people classified as normal weight could distinguish individuals with a higher probability of excess of fat, and thus, employ more accurate study methods in this group


Assuntos
Humanos , Masculino , Feminino , Adulto , Composição Corporal/fisiologia , Estilo de Vida , Imagem Corporal , Estudantes de Medicina/estatística & dados numéricos , Absorciometria de Fóton/métodos , Absorciometria de Fóton/instrumentação , Dieta Mediterrânea , Índice de Massa Corporal , Estudos Transversais , Sobrepeso , Obesidade , Inquéritos e Questionários , Antropometria , Atividade Motora
19.
Cancer Radiother ; 23(5): 408-415, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31331841

RESUMO

PURPOSE: Radiotherapy is a treatment method performed using ionizing radiation on cancer patients either alone or with surgery and/or chemotherapy. Although modern radiotherapy techniques provide a significant advantage in protecting healthy tissues, it is inevitable that normal tissues are also located in the areas targeted by radiations. In this study, we aimed to examine the bone mineral density changes in bone structures commonly included in the irradiated area such as, L5 vertebra, sacrum, and femur heads, in patients who have received pelvic radiotherapy; and the relationship between these changes with radiation dose. MATERIAL AND METHODS: Patients included in the study had been previously diagnosed with rectal cancer, which were operated or not. Preoperative or postoperative pelvic radiotherapy was planned for all patients. In terms of convenience when comparing with future scans, all densitometry and CT scans were performed with the same devices. Fifteen patients were included in the study. In order to determine the dose of radiation each identified area had taken after radiotherapy, the sacrum, L5 vertebra, bilateral femoral heads, and L1 regions were contoured in the CT scans in which treatment planning was done. Sagittal cross-sectional images were taken advantage of while these regions were being contoured. RESULTS: Bone mineral density was evaluated with CT and dual-energy X-ray absorptiometry before and after the treatment. The regions that have theoretically been exposed to irradiation, such as L5, sacrum, left to right femur were found to have significant difference in terms of bone density. According to CT evaluation, there was a significant decrease in bone intensity of L5, sacrum, left and right femurs. Dual-energy X-ray absorptiometry assessment revealed that the whole of the left femoral head, left femur neck and Ward's region were significantly affected by radiotherapy. However, there was no significant difference in the sacrum and L5 vertebra before and after radiotherapy. CONCLUSION: More accurate results could be achieved if the same study was conducted on a larger patient population, with a longer follow-up period. When the reduction in bone density is at maximum or a cure is likely in a long-term period, bone mineral density could be determined by measurements performed at regular intervals.


Assuntos
Densidade Óssea , Cabeça do Fêmur/efeitos da radiação , Vértebras Lombares/efeitos da radiação , Órgãos em Risco/efeitos da radiação , Radioterapia Conformacional/efeitos adversos , Neoplasias Retais/radioterapia , Sacro/efeitos da radiação , Absorciometria de Fóton , Adulto , Idoso , Doenças Ósseas Metabólicas/diagnóstico por imagem , Doenças Ósseas Metabólicas/etiologia , Terapia Combinada , Estudos Transversais , Feminino , Cabeça do Fêmur/diagnóstico por imagem , Cabeça do Fêmur/patologia , Seguimentos , Humanos , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/patologia , Masculino , Órgãos em Risco/diagnóstico por imagem , Órgãos em Risco/patologia , Neoplasias Retais/cirurgia , Sacro/diagnóstico por imagem , Sacro/patologia , Tomografia Computadorizada por Raios X
20.
Sports Health ; 11(5): 453-460, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31348720

RESUMO

BACKGROUND: Body composition assessment is frequently used in sports medicine and athletic performance environments to assess change in response to strength training and nutrition programs. However, to effectively do so requires knowledge regarding expected body composition values relative to sport and sex. Dual-energy x-ray absorptiometry (DXA) is widely used to evaluate body composition, although its utility in relationship to specific sports, performance, or rehabilitation is not clearly defined. HYPOTHESIS: Body composition metrics and distribution of National Collegiate Athletic Association Division I collegiate athletes will vary based on sport and sex. LEVEL OF EVIDENCE: Level 4. STUDY DESIGN: Cross-sectional study. METHODS: A convenience sample of 337 athletes (229 men and 108 women) participating in football, wrestling, soccer, hockey, basketball, golf, softball, or volleyball was evaluated. DXA-measured total body composition, including bone mineral density (BMD), % lean mass, % fat, and regional distribution, were compared by sex, sport, and with an age-matched National Health and Nutrition Examination Survey (NHANES) population. RESULTS: Men had higher BMD, lower % fat (16.4% vs 25.2%) and higher % lean mass (79.2% vs 70.6%) (P < 0.001). Regional composition varied by sport and sex, with women having a greater proportion of lean mass at the trunk and men in their arms (P < 0.0001). Leg lean mass was distributed similarly between sexes (35%). Overall, the normative group (NHANES) had lower BMD and higher percentage fat. CONCLUSION: DXA-measured body composition and lean mass distribution varies by sport and sex in Division I athletes. The observed difference to the NHANES population emphasizes challenges in identifying appropriate comparison populations, reinforcing the need to compare athletes with their own baseline. CLINICAL RELEVANCE: These findings establish a framework to investigate the relevance of these variances and determine the utility of body composition analysis in elite athletes.


Assuntos
Absorciometria de Fóton , Atletas , Composição Corporal , Adolescente , Adulto , Densidade Óssea , Estudos Transversais , Feminino , Humanos , Masculino , Inquéritos Nutricionais , Esportes , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA