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Blood Press ; 27(1): 25-31, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-28830245


BACKGROUND: The association between elevated blood pressure (BP) and childhood obesity has been documented in several studies. However, little is known the difference in BP levels among children and adolescents with different patterns of fat distribution. The present study examined the association of subcutaneous fat distributional pattern with obesity and elevated BP among children and adolescents. METHODS: A total of 38,687 students (19,386 boys and 19,301 girls) aged 7-17 years participated in the study. Body mass index (BMI) cutoff points recommended by the International Obesity Task Force (IOTF) were used to define overweight and general obesity. Abdominal obesity was defined as waist-to-height ratio (WHtR) ≥ 0.5. Relatively high BP (RHBP) status was defined as systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) ≥ 95th percentile for age and gender. All individuals were classified into four groups (Q1-Q4) according to the age and sex-specific quartiles of subscapular to triceps skinfold thickness ratio (STR), the prevalence rates of overweight, general obesity, abdominal obesity and RHBP among the four groups were compared. RESULTS: In both boys and girls, significant differences in the prevalence rates of overweight, general obesity, abdominal obesity and RHBP were observed among the four groups, an increasing trend was observed from the Q1 (STR <25 th) group to the Q4 (STR ≥ 75th) group (p < 0.01). Children and adolescents with high STR had higher prevalence of overweight, obesity and RHBP than their counterparts with low STR (p < 0.01). CONCLUSION: Truncal pattern of subcutaneous fat distribution is associated with obesity and elevated BP among children and adolescents. Public health attention should not only focus on the amount of body fat, but also on the distributional pattern of body fat.

Determinação da Pressão Arterial/métodos , Pressão Sanguínea/fisiologia , Obesidade/complicações , Gordura Subcutânea/anormalidades , Adolescente , Criança , Feminino , Humanos , Masculino , Prevalência
Am J Clin Dermatol ; 16(4): 295-301, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25943075


Poland's syndrome is a rare congenital condition characterized by absence of the pectoralis major muscle and a wide spectrum of associated ipsilateral chest wall and upper extremity anomalies. Associated dermatologic anomalies classically include pectoral and axillary alopecia, anhidrosis due to the absence of sweat glands, and deficiency in subcutaneous fat. Functional limitations are minimal, and thus surgical correction is primarily indicated for aesthetic purposes. Chest wall reconstruction typically involves transposition of a latissimus dorsi myocutaneous flap with or without a temporary subcutaneous tissue expander prior to surgical reconstruction. Using the PubMed database, a literature review was done on Poland's syndrome. We summarize the key features of Poland's syndrome, including the epidemiology, clinical presentation, pathogenesis, and management, and highlight the dermatologic associations reported in the literature.

Síndrome de Poland/fisiopatologia , Dermatopatias/etiologia , Alopecia/etiologia , Humanos , Hipo-Hidrose/etiologia , Síndrome de Poland/epidemiologia , Síndrome de Poland/cirurgia , Dermatopatias/patologia , Gordura Subcutânea/anormalidades , Parede Torácica/anormalidades , Parede Torácica/cirurgia
PLoS One ; 8(5): e61638, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23650502


We studied the relation between prostaglandin analogue use and ocular adnexal features. We used a prospective, cross-sectional study involving 157 current, 15 past, and 171 never users of prostaglandin analogues. Patients 50 years of age or older and without conditions affecting ocular adnexal anatomy underwent glaucoma medication use history, external digital photography and systematic external adnexal exam. Two masked readers assessed the digital photos for upper lid dermatochalasis and lower lid steatoblepharon using a validated grading scheme. Another masked clinical examiner also assessed upper lid ptosis, levator muscle function, and inferior scleral show. We performed ordinal logistic regression analysis accounting for multiple covariates to assess the relation between prostaglandin analogue use and adnexal features. Multivariable analyses indicated there was a 230-fold increased risk of incremental involution of dermatochalasis (odds ratio (OR) = 2.30; 95% confidence interval (CI) 1.43-3.69; p = 5.44E-04) and a 249-fold increased risk of incremental loss of lower lid steatoblepharon (OR = 2.49; 95% CI, 1.54-4.03; p= 1.98E-04) associated with current prostaglandin analogue use (bimatoprost 0.03%, travoprost 0.005%, or latanoprost 0.004%) versus prostaglandin analogue never or past users. Upper lid ptosis (OR = 4.04; 95% CI, 2.43-6.72; p = 7.37E-08), levator dysfunction (OR = 7.51; 95% CI, 3.39-16.65; p = 6.74E-07) and lower lid retraction (OR = 2.60; 95% CI, 1.58-4.28; p = 1.72E-04) were highly associated with current prostaglandin analogue use versus prostaglandin analogue never or past users. The associations between prostaglandin analogue use and deepening of the upper lid sulci and between prostaglandin analogue use and loss of inferior periorbital fat are confirmed in this multivariable analysis. The associations between prostaglandin analogue use and levator muscle dysfunction and between prostaglandin analogue use and upper lid ptosis represent significant side effects that could impact visual function in glaucoma patients.

Glaucoma/tratamento farmacológico , Prostaglandinas Sintéticas/uso terapêutico , Anormalidades da Pele/induzido quimicamente , Amidas/efeitos adversos , Amidas/uso terapêutico , Bimatoprost , Cloprostenol/efeitos adversos , Cloprostenol/análogos & derivados , Cloprostenol/uso terapêutico , Estudos Transversais , Pálpebras/anormalidades , Pálpebras/efeitos dos fármacos , Humanos , Latanoprosta , Análise Multivariada , Estudos Prospectivos , Prostaglandinas F Sintéticas/efeitos adversos , Prostaglandinas F Sintéticas/uso terapêutico , Prostaglandinas Sintéticas/efeitos adversos , Gordura Subcutânea/anormalidades , Gordura Subcutânea/efeitos dos fármacos , Travoprost
Clin Orthop Relat Res ; 469(5): 1442-9, 2011 May.
Artigo em Inglês | MEDLINE | ID: mdl-21042891


BACKGROUND: Lower extremity vascular anomalies have been described for patients with clubfoot but few imaging studies have investigated effects on soft tissues such as fat and muscle. To make these assessments we need noninvasive, noncontrast agents to more safely image children. QUESTIONS/PURPOSES: We describe a novel noninvasive imaging protocol to identify vascular and soft tissue abnormalities in the lower limbs of patients with clubfoot and determine whether these abnormalities are present in patients who had recurrent clubfoot. PATIENTS AND METHODS: Three-dimensional noncontrast-enhanced MR angiography was used to identify vascular, bone, and soft tissue abnormalities in patients with clubfoot. We determined whether these abnormalities were more common in patients who had experienced recurrent clubfoot. RESULTS: Four patients with isolated unilateral clubfoot had arterial anomalies in the clubfoot limb. All patients had less muscle volume in the affected limb, and nine of 11 patients (82%) had less subcutaneous fat, with a mean difference of 0.56 cm(3) ± 0.36 cm(3) (range, 0.08-1.12 cm(3)). Vascular anomalies and decreased fat and muscle volumes were present in all three patients with recurrent clubfoot. CONCLUSIONS: We found a high frequency of vascular and soft tissue anomalies in the affected limbs of patients with unilateral clubfoot that may correlate with response to treatment.

Pé Torto Equinovaro/patologia , Extremidade Inferior/irrigação sanguínea , Angiografia por Ressonância Magnética , Músculo Esquelético/patologia , Gordura Subcutânea/patologia , Malformações Vasculares/patologia , Adulto , Criança , Pé Torto Equinovaro/complicações , Pé Torto Equinovaro/cirurgia , Feminino , Humanos , Imagem Tridimensional , Masculino , Pessoa de Meia-Idade , Missouri , Músculo Esquelético/anormalidades , Procedimentos Ortopédicos , Recidiva , Gordura Subcutânea/anormalidades , Resultado do Tratamento , Malformações Vasculares/complicações