RESUMEN
BACKGROUND: Males have higher weight and length at birth than females. AIM: To verify the influence of the Y chromosome and the action of intrauterine androgens on weight and length at birth of children with Disorders of Sex Development (DSD). SUBJECTS AND METHODS: A cross-sectional and retrospective study. Patients with Turner syndrome (TS), complete (XX and XY), mixed (45,X/46,XY) and partial (XY) gonadal dysgenesis (GD), complete (CAIS) and partial (PAIS) androgen insensitivity syndromes and XX and XY congenital adrenal hyperplasia (CAH) were included. Weight and length at birth were evaluated. RESULTS: Weight and length at birth were lower in TS and mixed GD when compared to XY and XX DSD cases. In turn, patients with increased androgen action (117 cases) had higher weight and length at birth when compared to those with absent (108 cases) and decreased (68 cases) production/action. In birthweight, there was a negative influence of the 45,X/46,XY karyotype and a positive influence of increased androgen and gestational age. In birth length, there was a negative influence of the 45,X and 45,X/46,XY karyotypes and also a positive influence of increased androgen and gestational age. CONCLUSIONS: The sex dimorphism of weight and length at birth could possibly be influenced by intrauterine androgenic action.
Asunto(s)
Síndrome de Resistencia Androgénica , Andrógenos , Masculino , Niño , Recién Nacido , Femenino , Humanos , Estudios Retrospectivos , Caracteres Sexuales , Estudios TransversalesRESUMEN
BACKGROUND: Secular trends of increasing weight and height over past centuries are well documented in developed countries. However, these data are still scarce in developing countries such as Brazil. AIM: To verify the secular trends of height, weight and body mass index (BMI) of military students from Brazilian Army schools who were born between the 1920s and 1990s. SAMPLE AND METHODS: A retrospective study was performed, which included a survey of data from the files of two Army schools. The sample was composed of subjects aged between 18-20 years old. RESULTS: The study analysed 2169 heights and 1741 weights and BMIs. During the evaluation period, height increased 7.3 cm, weight 9.8 kg and BMI 1.8 kg/m(2). The most significant gains were observed in subjects born from the 1920s to the 1940s and the 1960s to the 1970s. CONCLUSION: Secular trends of growth in military students born in the 20th century were positive in Brazil, although increases were not constant decade-by-decade.
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Estatura , Índice de Masa Corporal , Peso Corporal , Adolescente , Brasil , Humanos , Masculino , Personal Militar , Estudios Retrospectivos , Estaciones del Año , Estudiantes , Factores de Tiempo , Adulto JovenRESUMEN
PURPOSE: The abuse of cocaine and its derivatives presents a likely risk factor for injury. Trauma incurred by cocaine and derivative abusers may be more severe than that incurred by non-users. OBJECTIVES: To ascertain the presence of cocaine and its derivatives in trauma patients and to correlate RTS (Revised Trauma Score) and ISS (Injury Severity Score) with the presence of cocaine and its derivatives in blood and urine samples. METHODS: All trauma victims treated in an emergency unit between November 11, 2012 and September 15, 2013 were included in the study. Blood and urine samples were collected on admission to hospital. RTS and ISS scores were then compared with the presence or absence of cocaine and its derivatives in the samples. The associations between RTS < 7.84 and ISS > 16 and the independent variables were evaluated by the gross odds ratio values, determined by univariate logistic regression. Multivariate analysis was performed using multivariate logistic regression. RESULTS: Of 453 patients (83.7% male) included in the study, 28.6% presented ISS > 16 and 33.6% presented RTS < 7.84. A total of 435 samples were collected, and 86 (19.8%) provided positive samples for cocaine, 48 (11%) for crack and 69 (15.9%) for cocaethylene. Compared to other patients, drug users showed a greater probability of RTS < 7.84 (2.18 times greater) and a greater probability of ISS > 16 (1.76 times greater). CONCLUSION: For the trauma patients included in our study, the use of cocaine and its derivatives was shown to be associated with more severe traumas, as demonstrated by their RTS and ISS scores.
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Cocaína/sangre , Cocaína/orina , Detección de Abuso de Sustancias/métodos , Heridas y Lesiones/sangre , Heridas y Lesiones/orina , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Brasil , Estudios Transversales , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Factores de Riesgo , Índices de Gravedad del TraumaRESUMEN
Sex ambiguity may be due to several disorders of gonadal differentiation, including true hermaphroditism (TH), as well as male and female pseudohermaphroditism. Although TH is a rare cause of intersex in Europe and North America, in Africa it presents one of the highest frequencies. The 46,XX karyotype has been found in the majority of the reported patients (70.6%), and aberrations in the sex chromosomes have been observed in about 22% of the cases. The 46,XY karyotype has been described as less frequent. Herein we describe ten cases of TH which have been diagnosed over the last 7 years, six lateral TH, two unilateral TH, and two cases of ovotestes with absent contralateral gonad. From a total of 18 gonads analyzed, there were 8 testes, 6 ovaries and 4 ovotestes. Nine subjects had originally a male sex assignment, and in three cases this was reverted to female. Four cases had a 46,XY karyotype. Additional sex chromosome aberrations had been found in four different cases [two 46,XX/46,XY, one 45,X/47,XYY, one 46,X,del(Yq)]. A 46,XX karyotype was found in only two individuals, and both were SRY negative. Our preliminary data, especially on the constitution of chromosomes and gonads, indicate marked differences from those in the literature.
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Trastornos del Desarrollo Sexual/genética , Ovario/anomalías , Testículo/anomalías , Adolescente , Brasil , Diferenciación Celular/fisiología , Niño , Preescolar , Trastornos del Desarrollo Sexual/patología , Femenino , Humanos , Lactante , Cariotipificación , Masculino , Estudios RetrospectivosRESUMEN
To study the growth of 566 children (273 males and 293 females) from fourteen day care centers of Paulínia (São Paulo, Brazil), with ages ranging from 3 months to 3 years, admitted from March 1st to May 31st, 1993, the authors analyzed the z-score distribution of height for age and weight for height in relation to age group, per capita family income, social class levels, mothers education level and child birth weight. The Kruskal-Wallis test and the Multiple Comparison test were used in the statistical analysis. The children with less than 24 months or with birth weight less than 3000 g as the children with mothers education level less than four years, presented left deviated distribution in the height for age z-score. The weight for height score was less satisfactory in the group with per capita income less than one salary, in the group with birth weight less than 3000 g, and in the group with ages superior to 18 months.Therefore, institutional actions concerning the children and their parents are recommended in order to attenuate these factors.
RESUMEN
BACKGROUND: the purpose of this study is to evaluate the nutritional status of children and teenagers with chronic renal (CRF) failure using anthropometric measurements. MATERIAL AND METHODS: 41 children and adolescents with (CRF) (creatinine "clearance" < 50 ml/min/1,73m(2)) followed at the Pediatric Nephrology Unit (HC-UNICAMP), between January 1995 and November 1996, were evaluated by the assessment of anthropometric measurements, mid upper arm circunference (MUAC) and triceps skinfold (TSF). With these measurements, mid arm fat area (MUAFA) and arm muscle area (AMA) were calculated and its z-scores. These measurements were performed twice at least, ranging from 0.21 to 1.3 years (0.88 +/- 0.04). RESULTS: all the z-scores (MUAC, TSF, MUAFA and AMA) were very low, and only the AMA z-score was statistically significant (p= 0,03 Wilcoxon test). The patients were divided in to groups, according to their treatment, and the MAC z-score for the renal transplantation group was statistically significant (p= 0,02 Wilcoxon test). CONCLUSIONS: these data demonstrate a compromised nutritional status from both muscle and fat stores, with an improvement in muscle stores.
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Fallo Renal Crónico/complicaciones , Trastornos Nutricionales/etiología , Estado Nutricional , Adolescente , Adulto , Antropometría , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Lactante , Masculino , Evaluación Nutricional , Trastornos Nutricionales/diagnóstico , Estadísticas no ParamétricasRESUMEN
This cross-sectional study aimed to compare growth, nutritional status and body composition outcomes between a group of 94 HIV-infected children and adolescents on antiretroviral therapy (ART) and 364 healthy controls, and to evaluate their association with clinical and lifestyle variables within the HIV-infected group. When compared with the control group, HIV patients had higher risk of stunting (odds ratio [OR] 5.33, 95% confidence interval [CI]: 2.83-10.04) and thinness (OR 4.7, 95% CI: 2.44-9.06), higher waist-to-hip ratios (medians 0.89 versus 0.82 for boys and 0.90 versus 0.77 for girls, P < 0.001), and lower prevalence of overweight or obesity (OR 0.33, 95% CI: 0.14-0.78). Protease inhibitor usage was associated with thinness (OR 3.51, 95% CI 1.07-11.44) and lipoatrophy (OR 3.5, 95% CI 1.37-8.95). HIV-infected children on ART showed significant nutritional status and body composition abnormalities, consistent with the severity of vertical HIV infection and the consequences of prolonged ART.
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Fármacos Anti-VIH/uso terapéutico , Composición Corporal , Trastornos del Crecimiento/virología , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/metabolismo , Estado Nutricional , Adolescente , Fármacos Anti-VIH/efectos adversos , Estudios de Casos y Controles , Niño , Trastornos de la Nutrición del Niño/inducido químicamente , Trastornos de la Nutrición del Niño/metabolismo , Trastornos de la Nutrición del Niño/virología , Preescolar , Estudios Transversales , Femenino , Trastornos del Crecimiento/inducido químicamente , Trastornos del Crecimiento/metabolismo , Infecciones por VIH/patología , Síndrome de Lipodistrofia Asociada a VIH/metabolismo , Humanos , Lactante , Masculino , Análisis Multivariante , Oportunidad Relativa , Análisis de RegresiónRESUMEN
This randomized, prospective, non-inferiority study aimed to quantify anti-HBs titers induced by recombinant Hepatitis B vaccine from healthy infants vaccinated with combined Hepatitis B and Bacillus Calmette-Guérin (BCG) vaccines (HbsAg 10 microg plus BCG suspension 0.1mg) and compare them to titers obtained with separated vaccines. Infants were immunized at birth either with combined intradermal (ID) BCG and Hepatitis B or ID BCG alone and intramuscular (IM) Hepatitis B. Both groups received IM Hepatitis B at 1 and 6 months of age. After the third dose anti-HBs titers > or =10 IU/mL were observed in 99% of vaccinees and > or =1000 IU/mL in 71%. There were no adverse events in both groups. Combination of HbsAg with BCG as first dose did not modify the profile of the humoral immune response for Hepatitis B indicating safety and immunogenicity of this vaccine in newborn.
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Vacuna BCG/administración & dosificación , Anticuerpos contra la Hepatitis B/sangre , Vacunas contra Hepatitis B/administración & dosificación , Vacunas contra Hepatitis B/inmunología , Virus de la Hepatitis B/inmunología , Hepatitis B/inmunología , Vacunación , Femenino , Hepatitis B/sangre , Antígenos de Superficie de la Hepatitis B/inmunología , Vacunas contra Hepatitis B/efectos adversos , Humanos , Esquemas de Inmunización , Recién Nacido , Inyecciones Intradérmicas , Masculino , Estudios Prospectivos , Vacunas Combinadas/administración & dosificación , Vacunas Combinadas/efectos adversos , Vacunas Combinadas/inmunología , Vacunas Sintéticas/administración & dosificación , Vacunas Sintéticas/efectos adversos , Vacunas Sintéticas/inmunologíaRESUMEN
Cell-mediated immune responses to BCG vaccine were evaluated in 7-month-old infants vaccinated with intradermal combined BCG and Hepatitis B or intradermal BCG and intramuscular Hepatitis B at birth. Peripheral blood mononuclear cell cultures from both groups showed CD4(+), CD8(+) and remarkable gammadelta(+) T cell BCG-specific proliferation, without significant differences. Also, IL-10, IL-12, IFN-gamma and TNF-alpha concentrations in culture supernatants, measured by ELISA, were similar. The results suggested that the combined BCG and Hepatitis B vaccine was as immunogenic as BCG separated from Hepatitis B vaccine.
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Vacuna BCG/inmunología , Vacunas contra Hepatitis B/inmunología , Receptores de Antígenos de Linfocitos T gamma-delta/análisis , Linfocitos T/inmunología , Estudios Transversales , Citocinas/biosíntesis , Femenino , Humanos , Inmunización , Lactante , Recién Nacido , Activación de Linfocitos , Masculino , Vacunas Combinadas/inmunologíaAsunto(s)
Cognición/fisiología , Destreza Motora/fisiología , Desempeño Psicomotor/fisiología , Brasil , Niño , Preescolar , Educación , Escolaridad , Femenino , Humanos , Masculino , Pruebas NeuropsicológicasRESUMEN
No disponible
No disponible
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Humanos , Trastornos de la Destreza Motora/fisiopatología , Trastornos del Conocimiento/fisiopatología , Destreza Motora/fisiología , Cognición/fisiologíaRESUMEN
A desnutriçäo está freqüentemente relacionada com doenças crônicas. O diagnóstico precoce realizado por técnicas práticas e simples favorece o tratamento, minimizando as complicaçöes. OBJETIVO: avaliar a situaçäo nutricional de crianças e adolescentes com insuficiência renal crônica (IRC) utilizando parâmetros antropométricos. MÉTODOS: Foram avaliadas 41 crianças e adolescentes com IRC ("clearance" de creatinina abaixo de 50 ml/min/1,73m2) acompanhadas no Ambulatório de Nefrologia Pediátrica do HC-Unicamp, de janeiro de 1995 a novembro de 1996, pelas medidas do perímetro braquial (PB) e da prega cutânea tricipital (PCT), com as quais calculou-se a área de gordura braquial (AGB) e área muscular braquial (AMB) e os respectivos escores z. Estas medidas foram realizadas pelo menos duas vezes, com intervalo de 0,21 a 1,3 anos (0,88 ± 0,04). RESULTADOS: Os escores z obtidos tanto para PB, como para PCT, AGB e AMB apresentaram valores muito baixos, sendo que, na evoluçäo, apenas o escore z de AMB apresentou melhora estatisticamente significativa (p= 0,03 teste de Wilcoxon). Quando selecionados quanto ao tratamento de substituiçäo renal, apenas os transplantados renais apresentaram melhora estatisticamente significativa para o escore z de PB (p= 0,02 teste de Wilcoxon). CONCLUSÄO: Estes dados mostram uma situaçäo nutricional comprometida tanto em relaçäo à reserva de gordura, quanto de músculo, com melhora no acompanhamento apenas em relaçäo à área muscular
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Humanos , Masculino , Femenino , Lactante , Preescolar , Niño , Adolescente , Adulto , Estado Nutricional , Fallo Renal Crónico , Trastornos Nutricionales , Evaluación Nutricional , Antropometría , Estudios Transversales , Estadísticas no Paramétricas , Trastornos NutricionalesRESUMEN
Os autores estudaram 11 lactentes com desnutricao calorica-proteica que tinham na autopsia o diagnostico de doenca de inclusao citomegalica generalizada.A historia clinica e os preparados histologicos de cada caso foram revistos. Os sinais e sintomas mais frequentes que poderiam estar relacionados ao CMV eram respiratorios: tosse, taquipneia, dispneia e estertores. Na maioria dos casos a duracao dos sintomas foi longa, frequentemente afebril, podendo porem ter curso tao rapido como dois dias. Na autopsia os orgaos mais acometidos eram: pulmao, rim, figado e timo.A pneumonia interticial foi a principal doenca em tres casos