Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 23.435
Filtrar
1.
Coluna/Columna ; 20(3): 165-168, July-Sept. 2021. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1339742

RESUMO

ABSTRACT Objective To evaluate the intra- and interobserver reproducibility of the classification of proximal humeral ossification in patients with idiopathic scoliosis. Methods Observational, descriptive, cross-sectional study. Radiographs (anteroposterior) of 29 patients diagnosed with idiopathic scoliosis were chosen and investigated at the Spine Surgery Outpatient Clinic of the Department of Orthopedics and Traumatology of the Hospital Getúlio Vargas, Recife, Pernambuco. These radiographs were evaluated and classified by 9 spinal orthopedic surgeons at two moments, with a minimum interval of 30 days, for analysis of the intraobserver and interobserver reproducibility of the classification of proximal humeral ossification used as a predictor of peak growth velocity. Results Intraobserver reproducibility achieved moderate to substantial concordance with the kappa index. In the analysis of interobserver reproducibility using the Fleiss' kappa method, a reasonable to moderate concordance was observed, except for in stage 5, in which concordance ranged from substantial to almost perfect. Conclusion In this study, the reproducibility of the Li classification in most of the stages was reasonable to moderate for the interobserver assessment and moderate to substantial for the intraobserver assessment, which differs from the current literature. Level of evidence III; Diagnostic studies - Investigation of a diagnostic test.


RESUMO Objetivo Avaliar a reprodutibilidade intra e interobservadores da classificação de ossificação do úmero proximal em pacientes portadores de escoliose idiopática. Métodos Estudo observacional, descritivo e transversal. Foram selecionadas radiografias (anteroposteriores) de 29 pacientes com diagnóstico de escoliose idiopática acompanhados no Ambulatório de Cirurgia da Coluna do Departamento de Ortopedia do Hospital Getúlio Vargas, Recife, Pernambuco. Essas radiografias foram avaliadas e classificadas por nove cirurgiões ortopedistas de coluna em dois momentos, com intervalo mínimo de 30 dias, para análise da reprodutibilidade intraobservador e interobservador da classificação de ossificação do úmero proximal utilizada como preditor do pico de velocidade de crescimento. Resultados A reprodutibilidade intraobservador com o índice Kappa atingiu concordância moderada a substancial. Já na análise da reprodutibilidade interobservador com o método de kappa de Fleiss constatou-se concordância de razoável a moderada, exceto no estágio 5, no qual a concordância variou de substancial a quase perfeita. Conclusões Neste estudo, a reprodutibilidade da classificação de Li, na maioria dos estágios foi razoável a moderada na avaliação interobservador e moderada à substancial na avaliação intraobservador, o que diverge da literatura atual. Nível de evidência III; Estudos diagnósticos - Investigação de um exame para diagnóstico.


RESUMEN Objetivo Evaluar la reproducibilidad intra e interobservador de la clasificación de osificación del húmero proximal en pacientes con escoliosis idiopática. Métodos Estudio observacional, descriptivo y transversal. Se seleccionaron radiografías (anteroposteriores) de 29 pacientes con diagnóstico de escoliosis idiopática en la Clínica de Cuidados Ambulatorios de Cirugía de Columna del Departamento de Ortopedia del Hospital Getúlio Vargas, Recife, Pernambuco. Estas radiografías fueron evaluadas y clasificadas por nueve cirujanos ortopedistas de columna, en dos momentos, con un intervalo mínimo de 30 días, para analizar la reproducibilidad intraobservador e interobservador de la clasificación de osificación del húmero proximal utilizada como predictor de la velocidad máxima de crecimiento. Resultados La reproducibilidad intraobservador con el índice Kappa alcanzó concordancia de moderada a sustancial de la reproducibilidad intraobservador. En el análisis de la reproducibilidad interobservador con el método de kappa de Fleiss, se encontró concordancia de razonable a moderada, excepto en la etapa 5, en que la concordancia varió de sustancial a casi perfecta. Conclusiones En este estudio, la reproducibilidad de la clasificación de Li en la mayoría de las etapas fue de razonable a moderada en la evaluación interobservador y de moderada a sustancial en la evaluación intraobservador, lo que difiere de la literatura actual. Nivel de Evidencia III; Estudios de Diagnóstico - Investigación de una prueba de diagnóstico.


Assuntos
Humanos , Escoliose , Reprodutibilidade dos Testes , Crescimento
2.
Lima; Perú. Acuerdo Nacional; 20210800. 36 p. ilus.
Monografia em Espanhol | MINSAPERÚ | ID: biblio-1284235

RESUMO

El Acuerdo Nacional contiene lineamientos prioritarios para el corto y mediano plazo en los temas de Salud, Educación, Lucha contra la Pobreza y Pobreza Extrema, Crecimiento Económico Sostenible con Empleo Digno, Reforma Política y Reforma del Sistema de Administración de Justicia. En tal sentido, son considerados como desarrollos de las políticas de Estado, y apuntan hacia la consecución de la Visión del Perú al 2050 y de los Objetivos de Desarrollo Sostenible que el Perú se ha comprometido a adoptar como Estado miembro de la Organización de las Naciones Unidas.


Assuntos
Pobreza , Nações Unidas , Saúde , Estado , Política Nacional de Ciência, Tecnologia e Inovação , Política de Inovação e Desenvolvimento , Políticas , Desenvolvimento Sustentável , Crescimento
3.
Eur J Epidemiol ; 36(8): 861-872, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34420151

RESUMO

Human health effects of airborne lower-chlorinated polychlorinated biphenyls (LC-PCBs) are largely unexplored. Since PCBs may cross the placenta, maternal exposure could potentially have negative consequences for fetal development. We aimed to determine if exposure to airborne PCB during pregnancy was associated with adverse birth outcomes. In this cohort study, exposed women had lived in PCB contaminated apartments at least one year during the 3.6 years before conception or the entire first trimester of pregnancy. The women and their children were followed for birth outcomes in Danish health registers. Logistic regression was performed to estimate odds ratios (OR) for changes in secondary sex ratio, preterm birth, major congenital malformations, cryptorchidism, and being born small for gestational age. We performed linear regression to estimate difference in birth weight among children of exposed and unexposed mothers. All models were adjusted for maternal age, educational level, ethnicity, and calendar time. We identified 885 exposed pregnancies and 3327 unexposed pregnancies. Relative to unexposed women, exposed women had OR 0.97 (95% CI 0.82, 1.15) for secondary sex ratio, OR 1.13 (95% CI 0.76, 1.67) for preterm birth, OR 1.28 (95% CI 0.81, 2.01) for having a child with major malformations, OR 1.73 (95% CI 1.01, 2.95) for cryptorchidism and OR 1.23 (95% CI 0.88, 1.72) for giving birth to a child born small for gestational age. The difference in birth weight for children of exposed compared to unexposed women was - 32 g (95% CI-79, 14). We observed an increased risk of cryptorchidism among boys after maternal airborne LC-PCB exposure, but due to the proxy measure of exposure, inability to perform dose-response analyses, and the lack of comparable literature, larger cohort studies with direct measures of exposure are needed to investigate the safety of airborne LC-PCB exposure during pregnancy.


Assuntos
Poluentes Atmosféricos/toxicidade , Anormalidades Congênitas/etiologia , Exposição Ambiental/efeitos adversos , Crescimento/efeitos dos fármacos , Exposição Materna/efeitos adversos , Bifenilos Policlorados/efeitos adversos , Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente , Adulto , Estudos de Coortes , Anormalidades Congênitas/epidemiologia , Dinamarca/epidemiologia , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Recém-Nascido Pequeno para a Idade Gestacional , Bifenilos Policlorados/análise , Gravidez , Resultado da Gravidez , Nascimento Prematuro , Efeitos Tardios da Exposição Pré-Natal/epidemiologia
4.
Res Vet Sci ; 139: 11-17, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34229106

RESUMO

To determine if Cu injection during late gestation can affect fetal and postnatal growth, hematology and immune function of progeny, 70 multiparous pregnant Angus cows, at 219 ± 15 d of gestation, were ranked by BW and BCS and randomly assigned to one of two treatments: Cu + (n = 35) in total 160 mg of Cu were administered subcutaneously in two moments (80 mg per moment) at 64 ± 15 d and 54 ± 15 d prepartum; and Cu- (n = 35), in total of 16 ml of sterile NaCl solution (9 g / l) were administered subcutaneously in two moments (8 ml per moment) at 64 ± 15 d and 54 ± 15 d prepartum. Calves from both treatments were weaned at 260 ± 15 d of age, male calves were separated from female calves and stockered on natural pastures until 690 ± 15 d of age, then placed into a feedlot for 104 d before slaughter. At the beginning of the experiment, cows Cu serum concentration was similar (P = 0.34) between treatments and these reflected a severe Cu deficiency (Cu + = 24.2 ± 1.5 µg/dl; Cu- = 22.2 ± 1.4 µg/dl). At calving, Cu serum concentration was greater (P < 0.01) in Cu + cows than Cu- cows. Copper serum concentration in calves from Cu + cows was greater at birth (P = 0.02) and 75 ± 15 d of age (P < 0.01) and tended (P = 0.07) to be greater at 160 ± 15 d of age compared to calves from Cu- cows. Calf BW at birth did not differ (P > 0.10) between treatments, however, calf BW adjusted at 75 d of age tended to be greater (P = 0.10) in calves from Cu + cows compared to calves from Cu- cows. Calf ADG from birth to 75 d of age was greater (P = 0.04) in calves from Cu + cows compared to calves from Cu- cows. Calf hematological parameters and titers of neutralizing antibodies against BHV-1 after primary and secondary vaccination against respiratory diseases did not differ (P > 0.10) between treatments. During finishing period, steers BW, 12th rib fat thickness and LM area were not affected (P > 0.10) by treatments. In summary, inorganic Cu injection during late gestation in Cu deficient beef cows allows to increase Cu serum concentration in calves from birth to 160 d of age. This event was associated with an increase in ADG and a tendency to increase BW during the first 75 days of life. After 75 days of age, any effect on the offspring performance was not observed.


Assuntos
Ração Animal , Cobre , Suplementos Nutricionais , Desenvolvimento Fetal , Ração Animal/análise , Animais , Bovinos , Dieta , Feminino , Desenvolvimento Fetal/efeitos dos fármacos , Crescimento/efeitos dos fármacos , Imunidade/efeitos dos fármacos , Masculino , Parto , Gravidez
5.
Ann Hum Biol ; 48(2): 101-109, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34097548

RESUMO

BACKGROUND: The assessment of biological maturity status plays an important role in talent identification and development programs. AIM: To compare age at predicted adult height and BAUS skeletal age as indicators of biological maturity status in youth soccer players using a construct-validity approach. SUBJECTS AND METHODS: Participants were 114 players from the U12 to U17 age groups of a professional youth soccer academy. Maturity status was determined via percentage of predicted adult height based upon the Khamis-Roche method (somatic maturity) and assessed via the SonicBone BAUSTM system (skeletal maturity). Convergent and known-groups validity were evaluated between maturity assessment methods and by comparing maturity-related selection biases across age groups. RESULTS: Although maturity status indicators were largely interrelated (r = .94, 95%CL 0.91-0.96), concordance (κ = 0.31 to 0.39) and Spearman's rank-order correlations (ρ = 0.45-0.52) of classification methods were moderate. A selection bias towards early maturing players emerged in the U14 age group which remained relatively consistent through to the U17 age group. CONCLUSIONS: Results confirm the construct-validity of both methods to assess biological maturity status although further validation relative to established indicators of biological maturity is needed. Furthermore, caution is also warranted when interpreting maturity status classification methods interchangeably given the poor concordance between classification methods.


Assuntos
Antropometria/instrumentação , Atletas/estatística & dados numéricos , Estatura , Crescimento , Software , Adolescente , Determinação da Idade pelo Esqueleto , Criança , Alemanha , Humanos , Masculino , Futebol
6.
Sci Rep ; 11(1): 12738, 2021 06 17.
Artigo em Inglês | MEDLINE | ID: mdl-34140589

RESUMO

Both Campylobacter- and Shigella-induced invasive enteritis are common in under-5 Bangladeshi children. Our study aimed to determine the factors associated with Campylobacter and Shigella enteritis among under-5 children, the post-infection worsening growth, and the household cost of invasive enteritis. Data of children having Shigella (591/803) and Campylobacter (246/1148) isolated from the fecal specimen in Bangladesh were extracted from the Global Enteric Multicenter Study (GEMS) for the period December 2007 to March 2011. In multiple logistic regression analysis, fever was observed more frequently among shigellosis cases [adjusted OR 2.21; (95% CI 1.58, 3.09)]. Breastfeeding [aOR 0.55; (95% CI 0.37, 0.81)] was found to be protective against Shigella. The generalized estimating equations multivariable model identified a negative association between Shigella and weight-for-height z score [aOR - 0.11; (95% CI - 0.21, - 0.001)]; a positive association between symptomatic Campylobacter and weight-for-age z score [aOR 0.22; (95% CI 0.06, 0.37)] and weight-for-height z score [aOR 0.22; (95% CI 0.08, 0.37)]. Total costs incurred by households were more in shigellosis children than Campylobacter-induced enteritis ($4.27 vs. $3.49). Households with low-level maternal education tended to incur less cost in case of their shigellosis children. Our findings underscore the need for preventive strategies targeting Shigella infection, which could potentially reduce the disease burden, associated household costs, and child growth faltering.


Assuntos
Efeitos Psicossociais da Doença , Enterite/epidemiologia , Crescimento , Bangladesh/epidemiologia , Campylobacter jejuni/isolamento & purificação , Pré-Escolar , Enterite/economia , Enterite/microbiologia , Fezes/microbiologia , Humanos , Fatores de Risco , Índice de Gravidade de Doença , Shigella flexneri/isolamento & purificação , Shigella sonnei/isolamento & purificação
7.
Semina cienc. biol. saude ; 42(2): 179-186, jun./dez. 2021. Ilus, Tab
Artigo em Português | LILACS | ID: biblio-1293120

RESUMO

Objetivo: comparar o crescimento pondo-estatural dos lactentes aos seis meses de vida em aleitamento materno exclusivo e aleitamento complementar ou misto. Método: estudo transversal, com 38 mães e lactentes entre o quinto e o sexto mês de vida, cuja coleta de dados ocorreu em unidades de saúde de um município no Oeste do estado do Paraná, Brasil. Os dados foram analisados por estatística descritiva. Resultados: a prevalência do aleitamento materno exclusivo foi de 21% (n=8) da amostra. As variáveis antropométricas (peso, altura e perímetro cefálico - PC) dos lactentes em aleitamento materno exclusivo apresentaram médias inferiores àqueles em aleitamento materno predominante e/ou com uso de fórmula. Conclusão: o crescimento pondo-estatural dos lactentes aos seis meses de vida em aleitamento materno exclusivo e em aleitamento complementar ou misto estava dentro do esperado para a idade. Contudo, evidenciou-se baixa prevalência de aleitamento materno exclusivo. Palavras-chave: Aleitamento materno; Alimentação artificial; Desmame precoce; Crescimento; Lactente.


Objective: compare the weight-height growth of the infants at six months of life in exclusive breastfeeding and complementary or mixed breastfeeding. Method: transversal study, with 38 mothers and infants between the fifth and the sixty months of life, whose data collect occurred in primary health care units of a city in the West of the state of Paraná, Brazil. The data was analyzed by descriptive statistics. Results: the prevalence of exclusive breastfeeding was of 21% (n=8) of the sample. The anthropometrics variables (weight, height and head circumference - HC) of the infants in exclusive breastfeeding show lower averages to those in predominant breastfeeding and/or with use of formula. Conclusion: the weight-height growth of the infants at six months of life in exclusive breastfeeding and in complementary or mixed breastfeeding was inside of the expected for age. However, was evidenced low prevalence of exclusive breastfeeding.


Assuntos
Recém-Nascido , Lactente , Desmame , Alimentação Artificial , Aleitamento Materno , Crescimento , Lactente
8.
Rev. cuba. pediatr ; 93(2): e1126, fig
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1280368

RESUMO

Introducción: El nevo melanocítico congénito es una lesión pigmentada melanocítica, que está generalmente presente en el momento del nacimiento. La dermatoscopia es una técnica útil en el diagnóstico de los nevos. Objetivo: Examinar las características clínicas y dermatoscópicas de pacientes pediátricos con nevos melanocíticos congénitos. Métodos: Investigación de tipo descriptivo transversal. La población incluyó 340 pacientes pediátricos que asistieron a la consulta de dermatoscopia del Hospital Pediátrico Universitario "José Luis Miranda", Santa Clara, entre abril 2016- abril de 2017. La muestra quedó constituida por 128 pacientes con diagnóstico de nevos melanocíticos congénitos. Los datos obtenidos se analizaron a través del paquete estadístico SPSS 21.0. Se emplearon los métodos de la estadística descriptiva. Resultados: El cambio clínico más frecuente fue el crecimiento en 76 (47,8 por ciento) nevos. La localización más comprometida fue en los miembros superiores con 28 (17,6 por ciento) nevos. Existió una relación estadísticamente significativa (p< 0,05) entre el tamaño de los nevos y la localización en zonas fotoexpuestas con la presencia de cambios clínicos. El patrón en empedrado (27,7 por ciento) fue el más frecuente; sin embargo, el patrón globular (24,5 por ciento) se observó en todas las localizaciones. Ninguno de los nevos detectados empeoró hacia el melanoma maligno. Conclusiones: La mayoría de los nevos melanocíticos congénitos en este trabajo aparecieron desde el nacimiento. La presencia de cambios clínicos fue más evidente en las regiones fotoexpuestas. No se observó ningún nevo con estructuras o patrones dermatoscópicos relacionados con malignidad(AU)


Introduction: Congenital melanocytic nevi is a melanocytic pigmented lesion, which is usually present at birth. Dermatoscopy is a useful technique in the diagnosis of nevi. Objective: To examine the clinical and dermatoscopic characteristics of pediatric patients with congenital melanocytic nevi. Methods: Cross-sectional descriptive type research. The data obtained were analyzed through the SPSS 21.0 statistical package. The methods of descriptive statistics were used. Results: The most common clinical change was growth, in 76 (47.8 percent) nevi. The most compromised location was in the upper members with 28 (17.6 percent) nevi. There was a statistically significant relation (p< 0.05) among the size of the nevi and the location in photoexposed areas with the presence of clinical changes. The cobbled pattern (27.7 percent) was the most common; however, the globular pattern (24.5 percent) was observed in all locations. None of the detected nevi worsen towards malignant melanoma. Conclusions: Most congenital melanocytic nevi are shown from birth. The presence of clinical changes was most evident in photoexposed regions. No nevi was observed with dermatoscopic structures or patterns related to malignancy(AU)


Assuntos
Humanos , Encaminhamento e Consulta , Crescimento , Melanoma , Nevo Pigmentado
9.
Sci Rep ; 11(1): 9716, 2021 05 06.
Artigo em Inglês | MEDLINE | ID: mdl-33958675

RESUMO

Adipose tissue represents not only an important energy storage tissue but also a major endocrine organ within the body, influencing many biochemical systems including metabolic status, immune function and energy homeostasis. The objective of this study was to evaluate the effect of an enhanced dietary intake during the early calfhood period on the transcriptome of visceral adipose tissue. Artificially reared Angus × Holstein-Friesian heifer calves were offered either a high (HI, n = 15) or moderate (MOD, n = 15) plane of nutrition from 3 to 21 weeks of life. At 21 weeks of age all calves were euthanized, visceral adipose harvested and samples subsequently subjected to mRNA sequencing. Plane of nutrition resulted in the differential expression of 1214 genes within visceral adipose tissue (adj. p < 0.05; fold change > 1.5). Differentially expressed genes were involved in processes related to metabolism and energy production. Biochemical pathways including Sirtuin signalling (adj. p < 0.0001) and the adipogenesis pathways (adj. p = 0.009) were also significantly enriched, indicating greater metabolic processing and adipogenesis in the calves on the high plane of nutrition. Results from this study identify novel genes regulating the molecular response of visceral adipose tissue to an improved plane of nutrition during early calfhood.


Assuntos
Fenômenos Fisiológicos da Nutrição Animal , Gordura Intra-Abdominal/metabolismo , Transcriptoma , Animais , Bovinos , Biologia Computacional , Feminino , Crescimento , Análise de Sequência de RNA/métodos , Transdução de Sinais
10.
Environ Health Prev Med ; 26(1): 59, 2021 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-34022817

RESUMO

BACKGROUND: The Hokkaido Study on Environment and Children's Health is an ongoing study consisting of two birth cohorts of different population sizes: the Sapporo cohort and the Hokkaido cohort. Our primary objectives are to (1) examine the effects that low-level environmental chemical exposures have on birth outcomes, including birth defects and growth retardation; (2) follow the development of allergies, infectious diseases, and neurobehavioral developmental disorders, as well as perform a longitudinal observation of child development; (3) identify high-risk groups based on genetic susceptibility to environmental chemicals; and (4) identify the additive effects of various chemicals, including tobacco. METHODS: The purpose of this report is to provide an update on the progress of the Hokkaido Study, summarize recent results, and suggest future directions. In particular, this report provides the latest details from questionnaire surveys, face-to-face examinations, and a collection of biological specimens from children and measurements of their chemical exposures. RESULTS: The latest findings indicate different risk factors of parental characteristics on birth outcomes and the mediating effect between socioeconomic status and children that are small for the gestational age. Maternal serum folate was not associated with birth defects. Prenatal chemical exposure and smoking were associated with birth size and growth, as well as cord blood biomarkers, such as adiponectin, leptin, thyroid, and reproductive hormones. We also found significant associations between the chemical levels and neuro development, asthma, and allergies. CONCLUSIONS: Chemical exposure to children can occur both before and after birth. Longer follow-up for children is crucial in birth cohort studies to reinforce the Developmental Origins of Health and Disease hypothesis. In contrast, considering shifts in the exposure levels due to regulation is also essential, which may also change the association to health outcomes. This study found that individual susceptibility to adverse health effects depends on the genotype. Epigenome modification of DNA methylation was also discovered, indicating the necessity of examining molecular biology perspectives. International collaborations can add a new dimension to the current knowledge and provide novel discoveries in the future.


Assuntos
Saúde da Criança , Poluentes Ambientais/efeitos adversos , Hipersensibilidade/epidemiologia , Transtornos do Neurodesenvolvimento/epidemiologia , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Fumar/efeitos adversos , Biomarcadores/sangue , Criança , Pré-Escolar , Estudos de Coortes , Exposição Ambiental/efeitos adversos , Saúde Ambiental , Feminino , Sangue Fetal/química , Seguimentos , Crescimento/efeitos dos fármacos , Humanos , Hipersensibilidade/etiologia , Lactente , Japão/epidemiologia , Masculino , Transtornos do Neurodesenvolvimento/etiologia , Gravidez , Efeitos Tardios da Exposição Pré-Natal/etiologia , Prevalência
11.
Pediatrics ; 147(5)2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33888567

RESUMO

BACKGROUND AND OBJECTIVES: Breastfeeding is an evidence-based recommendation for all countries, but breastfeeding rates have been declining in many middle-income settings. One reason behind this decline is the perception that breastfeeding may not be necessary in modern urban settings, where clean water is available and alternative foods are abundant. We investigate the importance of breastfeeding for early childhood development in the modern urban context of São Paulo, Brazil. METHODS: In our study, we used data from the ongoing prospective Western Region Birth cohort in São Paulo, Brazil. Children were recruited at birth and managed for 3 years. Durations of exclusive and mixed breastfeeding were our primary independent variables. Our secondary independent variable was an indicator for compliance with World Health Organization (WHO) breastfeeding recommendations. Our primary outcomes of interest were indicators of children's physical, cognitive, language, and social-emotional development at 3 years of age. Adjusted estimates and 95% confidence intervals were calculated by using linear and logistic regression. RESULTS: Complying with WHO recommendations to exclusively breastfeed for 6 months followed by complementary feeding until 2 years of age was associated with a 0.4-SD increase in overall child development (ß: .38; confidence limit = 0.23 to 0.53), a 0.6-SD increase in height-for-age z score (ß: .55; confidence limit = 0.31 to 0.79), and a 67% decrease in the odds of stunting (odds ratio = 0.33; 95% confidence interval = 0.20 to 0.54). CONCLUSIONS: Our results suggest that even in settings with easy access to complementary foods, complying with WHO breastfeeding recommendations is important for healthy physical growth and cognitive development.


Assuntos
Aleitamento Materno , Desenvolvimento Infantil , Cognição , Crescimento , Brasil , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Estudos Prospectivos , Saúde da População Urbana
12.
N Engl J Med ; 384(16): 1517-1528, 2021 04 22.
Artigo em Inglês | MEDLINE | ID: mdl-33826814

RESUMO

BACKGROUND: More than 30 million children worldwide have moderate acute malnutrition. Current treatments have limited effectiveness, and much remains unknown about the pathogenesis of this condition. Children with moderate acute malnutrition have perturbed development of their gut microbiota. METHODS: In this study, we provided a microbiota-directed complementary food prototype (MDCF-2) or a ready-to-use supplementary food (RUSF) to 123 slum-dwelling Bangladeshi children with moderate acute malnutrition between the ages of 12 months and 18 months. The supplementation was given twice daily for 3 months, followed by 1 month of monitoring. We obtained weight-for-length, weight-for-age, and length-for-age z scores and mid-upper-arm circumference values at baseline and every 2 weeks during the intervention period and at 4 months. We compared the rate of change of these related phenotypes between baseline and 3 months and between baseline and 4 months. We also measured levels of 4977 proteins in plasma and 209 bacterial taxa in fecal samples. RESULTS: A total of 118 children (59 in each study group) completed the intervention. The rates of change in the weight-for-length and weight-for-age z scores are consistent with a benefit of MDCF-2 on growth over the course of the study, including the 1-month follow-up. Receipt of MDCF-2 was linked to the magnitude of change in levels of 70 plasma proteins and of 21 associated bacterial taxa that were positively correlated with the weight-for-length z score (P<0.001 for comparisons of both protein and bacterial taxa). These proteins included mediators of bone growth and neurodevelopment. CONCLUSIONS: These findings provide support for MDCF-2 as a dietary supplement for young children with moderate acute malnutrition and provide insight into mechanisms by which this targeted manipulation of microbiota components may be linked to growth. (Supported by the Bill and Melinda Gates Foundation and the National Institutes of Health; ClinicalTrials.gov number, NCT04015999.).


Assuntos
Suplementos Nutricionais , Alimentos Formulados , Microbioma Gastrointestinal , Fenômenos Fisiológicos da Nutrição do Lactente , Desnutrição/dietoterapia , Antropometria , Bangladesh , Proteínas Sanguíneas/análise , Peso Corporal , Fezes/microbiologia , Feminino , Crescimento , Humanos , Lactente , Masculino , Desnutrição/microbiologia , Proteoma , Ganho de Peso
13.
Nutrients ; 13(4)2021 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-33923714

RESUMO

Protein quality and quantity are important factors in determining lean body (muscle) mass (LBM). In phenylketonuria (PKU), protein substitutes provide most of the nitrogen, either as amino acids (AA) or glycomacropeptide with supplementary amino acids (CGMP-AA). Body composition and growth are important indicators of long-term health. In a 3-year prospective study comparing the impact of AA and CGMP-AA on body composition and growth in PKU, 48 children were recruited. N = 19 (median age 11.1 years, range 5-15 years) took AA only, n = 16 (median age 7.3 years, range 5-15 years) took a combination of CGMP-AA and AA, (CGMP50) and 13 children (median age 9.2 years, range 5-16 years) took CGMP-AA only (CGMP100). A dual energy X-ray absorptiometry (DXA) scan at enrolment and 36 months measured LBM, % body fat (%BF) and fat mass (FM). Height was measured at enrolment, 12, 24 and 36 months. No correlation or statistically significant differences (after adjusting for age, gender, puberty and phenylalanine blood concentrations) were found between the three groups for LBM, %BF, FM and height. The change in height z scores, (AA 0, CGMP50 +0.4 and CGMP100 +0.7) showed a trend that children in the CGMP100 group were taller, had improved LBM with decreased FM and % BF but this was not statistically significant. There appeared to be no advantage of CGMP-AA compared to AA on body composition after 3-years of follow-up. Although statistically significant differences were not reached, a trend towards improved body composition was observed with CGMP-AA when it provided the entire protein substitute requirement.


Assuntos
Aminoácidos/administração & dosagem , Composição Corporal/efeitos dos fármacos , Caseínas/administração & dosagem , Proteínas na Dieta/administração & dosagem , Fragmentos de Peptídeos/administração & dosagem , Fenilcetonúrias/fisiopatologia , Absorciometria de Fóton , Adolescente , Estatura , Criança , Pré-Escolar , Suplementos Nutricionais , Feminino , Crescimento/efeitos dos fármacos , Humanos , Estudos Longitudinais , Masculino , Fenilalanina/sangue , Fenilcetonúrias/sangue , Fenilcetonúrias/dietoterapia , Estudos Prospectivos , Resultado do Tratamento
14.
J Sci Med Sport ; 24(9): 881-885, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33752967

RESUMO

OBJECTIVE: To identify the causal relation between growth velocity and injury in elite-level youth football players, and to assess the mediating effects of motor performance in this causal pathway. DESIGN: Prospective cohort study. METHODS: We measured the body height of 378 male elite-level football players of the U13 to U15 age categories three to four months before and at the start of the competitive season. At the start of the season, players also performed a motor performance test battery, including motor coordination (Körperkoordinationstest für Kinder), muscular performance (standing broad jump, counter movement jump), flexibility (sit and reach), and endurance measures (YoYo intermittent recovery test). Injuries were continuously registered by the academies' medical staff during the first two months of the season. Based on the causal directed acyclic graph (DAG) that identified our assumptions about causal relations between growth velocity (standardized to cm/y), injuries, and motor performance, the causal effect of growth velocity on injury was obtained by conditioning on maturity offset. We determined the natural indirect effects of growth velocity on injury mediated through motor performance. RESULTS: In total, 105 players sustained an injury. Odds ratios (OR) showed a 15% increase in injury risk per centimetre/year of growth velocity (1.15, 95%CI: 1.05-1.26). There was no causal effect of growth on injury through the motor performance mediated pathways (all ORs were close to 1.0 with narrow 95%CIs). CONCLUSIONS: Growth velocity is causally related to injury risk in elite-level youth football players, but motor performance does not mediate this relation.


Assuntos
Atletas , Crescimento/fisiologia , Atividade Motora/fisiologia , Futebol/lesões , Adolescente , Estatura , Criança , Humanos , Masculino , Movimento/fisiologia , Razão de Chances , Estudos Prospectivos , Desempenho Psicomotor/fisiologia , Medição de Risco , Futebol/fisiologia , Futebol/estatística & dados numéricos , Fatores de Tempo
15.
Poult Sci ; 100(3): 100962, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33652522

RESUMO

Total replacement of dietary inorganic phosphate (Pi) by a novel consensus bacterial 6-phytase variant (PhyG) in phytate-rich diets (>0.3% phytate-P) was investigated in 2 trials using growth performance and bone quality as outcome measures. Both trials utilized a completely randomized design with 5 dietary treatments across 4 phases: starter (0-10 d), grower (10-21 d), finisher 1 (21-35 d), and finisher 2 (35-42 d). Treatments comprised a nutritionally adequate positive control (PC) diet containing monocalcium phosphate and 4 experimental diets (IPF1, IPF2, IPF3, and IPF4), all containing no added Pi and reduced in Ca by 0.2 to 0.3% units vs. PC. IPF1contained PhyG at 1,000 FTU/kg (all phases); IPF2 contained PhyG at 1,000 FTU/kg (all phases) and was additionally reduced in digestible AA, ME, and sodium (-0.2 to -0.4% points, -74 kcal/kg, -0.04% points, respectively, vs. PC); IPF3 contained PhyG at 3,000 FTU/kg in starter, 2,000 FTU/kg in grower, and 1,000 FTU/kg in finisher phases; and IPF4 contained xylanase (2,000 U/kg) and PhyG (2,000 FTU/kg in starter, 1,500 FTU/kg in grower, and 1,000 FTU/kg in finisher phases) and was additionally reduced in ME (-71 kcal/kg vs. PC). Ross 308 broilers were used (trial 1: n = 1,200 mixed sex; 24 birds per pen × 10 replicates; trial 2: n = 1,300 males; 26 birds × 10 replicates). During all phases in both trials, all IPF treatments maintained or improved BW, ADG, ADFI, FCR and BW-corrected FCRc and bone quality parameters vs. PC. vs. PC, treatment IPF3 increased ADG during starter phase (+10.8%) and reduced overall FCRc (-12 points, P < 0.05) in Trial 1, and increased overall ADG (+4.4%), day 35 and day 42 BW (+3.5%, +4.9%), and reduced overall FCRc (-11 points) in Trial 2 (P < 0.05). IPF4 produced equivalent performance to IPF3 (both trials). These are the first data to demonstrate total replacement of Pi by microbial phytase during an entire growth cycle in broiler diets.


Assuntos
6-Fitase , Fenômenos Fisiológicos da Nutrição Animal , Osso e Ossos , Galinhas , Suplementos Nutricionais , Crescimento , 6-Fitase/farmacologia , Fenômenos Fisiológicos da Nutrição Animal/efeitos dos fármacos , Animais , Osso e Ossos/efeitos dos fármacos , Galinhas/crescimento & desenvolvimento , Dieta/veterinária , Digestão/efeitos dos fármacos , Crescimento/efeitos dos fármacos , Masculino , Distribuição Aleatória
16.
Poult Sci ; 100(3): 100964, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33652533

RESUMO

The effects of early heat conditioning on the acute heat stress response in broilers were investigated via the growth performance, dopamine, serotonin, and corticosterone and the expression of heat shock proteins (HSP) and heat shock factors. One-day-old chicks (n = 144) were divided into 3 groups in a 35-d experiment (48 chicks per each group). Group 1 (C) was treated with an optimum temperature, group 2 (CH) was treated with 40°C ± 1°C on day 35 (5 h), and group 3 (HH) was treated with 40°C ± 1°C on day 5 (24 h) and day 35 (5 h). On day 7, the body weight gain was lower (P < 0.05) in HH than in C and CH. On day 35, the heat-treated groups (CH and HH) had lower weight gains than the C group (P < 0.05), whereas the feed conversion ratio was lower in HH (P < 0.05). Serum corticosterone was higher in CH than in C, but HH and C did not differ (P < 0.05). Liver HSP70 protein expression was higher in CH than HH and C (P < 0.05), which did not differ, and HSP40 protein expression was higher in CH than C (P < 0.05). These results suggest that early heat conditioning may reduce acute heat stress on broiler.


Assuntos
Galinhas , Regulação da Expressão Gênica , Crescimento , Proteínas de Choque Térmico , Resposta ao Choque Térmico , Animais , Galinhas/sangue , Galinhas/genética , Galinhas/crescimento & desenvolvimento , Regulação da Expressão Gênica/fisiologia , Crescimento/fisiologia , Proteínas de Choque Térmico HSP70/genética , Proteínas de Choque Térmico/genética , Resposta ao Choque Térmico/genética , Temperatura Alta , Ganho de Peso/fisiologia
17.
Ann Hum Biol ; 48(1): 8-14, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33533281

RESUMO

Background: Children with achondroplasia (ACH) appear to lack a pubertal growth spurt in height.Aim To explore the growth spurt in height and its segments sitting height and leg length, in a large sample of ACH cases using growth curve modelling.Subjects and methods: Height and sitting height were measured longitudinally in ACH children, and the data were analysed using the SITAR (SuperImposition by Translation and Rotation) growth model, which estimates a mean growth curve and random effects for individuals defining differences in size, pubertal timing and intensity.Results: Out of 402 ACH children, 85 boys and 75 girls aged 7-20 years had respectively 529 and 454 measurements of height and sitting height, with leg length calculated by difference. SITAR analysis identified peaks in mean height velocity at 13.3 and 11.3 years in boys and girls, with peak velocities of 4.3 and 4.4 cm/year. Mean peak velocity for sitting height was 3.0 cm/year, but leg length showed no peak. The SITAR models explained 92% to 99% of the cross-sectional variance.Conclusion: ACH children do experience a growth spurt in puberty, but only half that of control children. The spurt is due entirely to sitting height, with no leg length spurt.


Assuntos
Acondroplasia/fisiopatologia , Estatura/fisiologia , Crescimento , Perna (Membro)/fisiologia , Puberdade , Postura Sentada , Adolescente , Argentina , Criança , Feminino , Humanos , Masculino
18.
Nutrients ; 13(2)2021 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-33562750

RESUMO

BACKGROUND: Vitamin D deficiency during pregnancy or infancy is associated with adverse growth in children. No systematic review has been conducted to summarize available evidence on the effect of vitamin D supplementation in pregnancy and infancy on growth and body composition in children. OBJECTIVE: We aim to summarize the available evidence on the effect of vitamin D supplementation in pregnancy and infancy on child growth and body composition. METHOD: A systematic review and meta-analysis were performed on the effects of vitamin D supplementation during early life on children's growth and body composition (bone, lean and fat). A literature search of randomized controlled trials (RCTs) was conducted to identify relevant studies on the effects of vitamin D supplementation during pregnancy and infancy on children's body composition (bone, lean and fat) in PubMed, EMBASE and Cochrane Library from inception to 31 December 2020. A Cochrane Risk Assessment Tool was used for quality assessment. The comparison was vitamin D supplementation vs. placebo or standard care. Random-effects and fixed-effect meta-analyses were conducted. The effects are presented as mean differences (MDs) or risk ratios (RRs) with 95% confidence intervals (CIs). RESULTS: A total of 3960 participants from eleven randomized controlled trials were eligible for inclusion. Vitamin D supplementation during pregnancy was associated with higher triceps skinfold thickness (mm) (MD 0.33, 95% CI, 0.12, 0.54; I2 = 34%) in neonates. Vitamin D supplementation during pregnancy or infancy was associated with significantly increased length for age z-score in infants at 1 year of age (MD 0.29, 95% CI, 0.03, 0.54; I2 = 0%), and was associated with lower body mass index (BMI) (kg/m2) (MD -0.19, 95% CI -0.34, -0.04; I2 = 0%) and body mass index z-score (BMIZ) (MD -0.12, 95% CI -0.21, -0.04; I2 = 0%) in offspring at 3-6 years of age. Vitamin D supplementation during early life was not observed to be associated with children's bone, lean or fat mass. CONCLUSION: Vitamin D supplementation during pregnancy or infancy may be associated with reduced adiposity in childhood. Further large clinical trials of the effects of vitamin D supplementation on childhood body composition are warranted.


Assuntos
Composição Corporal/fisiologia , Crescimento/fisiologia , Vitamina D/administração & dosagem , Vitaminas/administração & dosagem , Adiposidade , Viés , Estatura , Índice de Massa Corporal , Peso Corporal , Densidade Óssea , Intervalos de Confiança , Feminino , Humanos , Lactente , Recém-Nascido , Razão de Chances , Placebos/administração & dosagem , Gravidez , Ensaios Clínicos Controlados Aleatórios como Assunto , Pregas Cutâneas , Vitamina D/fisiologia
19.
Nutr Hosp ; 38(2): 410-417, 2021 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-33624504

RESUMO

Introduction: Introduction: in children with cleft lip and/or palate nutritional status and growth may be impaired due to early life feeding difficulties. Objective: to review the existing literature on the nutritional prognosis during childhood of patients undergoing surgery for cleft lip and/or palate (CLP), their body composition and growth patterns from 2 to 10 years of age, and the possible effects of their early nutritional status on the long-term onset of overweight. Methods: a systematic search of growth and body composition parameters in 2-10 year-old CLP children, including cross-sectional and longitudinal studies, and using the Pubmed and Scopus databases. From the 2,983 retrieved articles, 6 were finally included. Results: two studies out of 6 were longitudinal and the other 4 were cross-sectional, including very heterogeneous samples. Weight and height were used as growth parameters in 2 studies; 2 studies used body mass index (BMI); and the remaining 2 used indexes of nutritional status derived from anthropometric measures. The studies showed discrepancies among results: 3 of them found growth differences between children with CLP and their counterparts, whereas the other 3 did not. The two longitudinal studies did not show any significant differences between the mean BMI z-scores or growth curves of cleft patients and their counterparts. When differences existed, the most affected group was that under 5 years, syndromic children, and adopted children with CL/P. Conclusions: the literature is scarce comparing growth patterns between children with CLP and controls, and results cannot confirm that children with CLP aged 2-10 years, excluding those with syndromes or belonging to vulnerable populations, have different growth patterns or a worse nutritional status than their counterparts.


Assuntos
Composição Corporal , Fenda Labial/fisiopatologia , Fissura Palatina/fisiopatologia , Crescimento/fisiologia , Estatura , Índice de Massa Corporal , Peso Corporal , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Estudos Longitudinais , Masculino , Estado Nutricional , Prognóstico , Fatores Socioeconômicos
20.
Neurotoxicol Teratol ; 84: 106956, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33524508

RESUMO

Two developmental stressors were compared in preweaning rats exposed to either one stressor or both. Stressors were barren cage rearing or maternal separation (pup isolation). 40 gravid Sprague-Dawley CD/IGS rats were randomly assigned to two cage conditions: standard (Std) cage or barren cage (Bar), 20 litters/condition throughout gestation and lactation. After delivery, litters were randomly culled to 4 males and 4 females. The second stressor was maternal separation: Two male/female pairs per litter were isolated from their dam 4 h/day (Iso) and two pairs were not (Norm). Hence, there were 4 conditions: Std-Norm, Std-Iso, Bar-Norm, and Bar-Iso. One pair/litter/stress condition received the following: elevated zero-maze (EZM), open-field, swim channel, Cincinnati water maze, conditioned fear, and open-field with methamphetamine challenge. The second pair/litter/condition received the light-dark test, swim channel, Morris water maze, forced swim, and EZM with diazepam challenge. Barren rearing reduced EZM time-in-open, whereas isolation rearing reduced open-field activity in males and increased it in females. Effects on straight channel swimming were minor. In the Cincinnati water maze test of egocentric learning, isolation rearing increased errors whereas barren cage housing reduced errors in combination with normal rearing. Barren cage with maternal separation (pup isolation) increased Cincinnati water maze escape latency but not errors. Barren cage housing reduced hyperactivity in response to methamphetamine. Isolation rearing increased time in open in the EZM after diazepam challenge. Trends were seen in the Morris water maze. These suggested that barren cage and isolation rearing in combination reduced latency on acquisition on days 1 and 2 in males, whereas females had increased latency on days 2 and 3. Combined exposure to two developmental stressors did not induce additive or synergistic effects, however the data show that these stressors had long-term effects with some evidence that the combination of both caused effects when either stressor alone did not, but synergism was not observed.


Assuntos
Comportamento Animal/efeitos dos fármacos , Meio Ambiente , Isolamento Social , Estresse Psicológico/psicologia , Animais , Animais Recém-Nascidos , Ansiedade de Separação/psicologia , Estimulantes do Sistema Nervoso Central/farmacologia , Medo/psicologia , Feminino , Crescimento/efeitos dos fármacos , Masculino , Privação Materna , Aprendizagem em Labirinto/efeitos dos fármacos , Metanfetamina/farmacologia , Atividade Motora/efeitos dos fármacos , Ratos , Ratos Sprague-Dawley , Natação/psicologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...