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1.
Rev. bras. med. esporte ; 28(3): 213-216, May-June 2022. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1365719

ABSTRACT

ABSTRACT Introduction: Physical activity is accomplished by the coordination of various organ systems of the human body, and physical exercise can positively impact the activities of many of these systems. Because the impact of high-intensity sports on human organs is different according to the environmental temperature and exercise intensity, we must make more detailed observations and discussions. Objective: To analyze the changes in the body shape, function, and organ function of middle school students before and after high-intensity physical exercise through the study of human movement. Methods: Through the experimental research on the characteristics of metabolic gas exchanges in high-intensity incremental load exercise of college students. Results: There were statistically significant differences in the incidence of physiological reactions shown by the students who underwent high-intensity incremental load exercise, such as abdominal pain, dyspnea, tachycardia, nausea, dizziness, and muscle aches (P<0.05). Hypothermia was accompanied by a decrease in heart rate during exercise. Conclusion: Carrying out overload training can effectively mediate physiological functions. It is an important, in improving sports performance, to carry out warm-up activities in a low-temperature environment to increase body temperature. Level of evidence II; Therapeutic studies - investigation of treatment results.


RESUMO Introdução: A atividade física acontece por meio coordenação de vários sistemas de órgãos do corpo humano, e os exercícios físicos podem ter impacto positivo nas atividades de vários desses sistemas. Uma vez que o impacto de esportes de alta intensidade nos órgãos humanos é diferente de acordo com a temperatura do ambiente e com a intensidade do exercício, é necessário realizar observações e discussões mais detalhadas. Objetivo: Analisar as mudanças de forma e função do corpo, e das funções dos órgãos de alunos universitários antes e depois de atividade física de alta intensidade, através do estudo do movimento humano. Métodos: Pesquisa experimental sobre as características da troca gasosa em exercícios de alta intensidade com aumento gradual de carga em alunos universitários. Resultados: Houve diferenças estatísticas significativas na incidência de reações fisiológicas dos estudantes que passaram pela atividade de alta intensidade com aumento gradual de carga, incluindo dores abdominais, dispneia, taquicardia, náusea, tonturas, e dores musculares (p<0,05). Na presença de hipotermia havia uma queda na frequência cardíaca durante os exercícios. Conclusão: Exercícios de sobrecarga podem mediar funções fisiológicas eficientemente. Para melhorar a performance esportiva em ambientes de baixa temperatura é importante realizar exercícios de aquecimento para aumentar a temperatura do corpo. Nível de evidência II; Estudos terapêuticos - investigação de resultados de tratamento.


RESUMEN Introducción: La actividad física ocurre por medio de la coordinación de varios sistemas de órganos del cuerpo humano y los ejercicios físicos pueden tener impacto positivo en las actividades de varios de estos sistemas. Dado que el impacto de deportes de alta intensidad en los órganos humanos es diferente de acuerdo con la temperatura del ambiente y con la intensidad del ejercicio, es necesario realizar observaciones y discusiones más detalladas. Objetivo: Analizar los cambios de forma y función del cuerpo, y de las funciones de los órganos de alumnos universitarios antes y después de la actividad física de alta intensidad, a través del estudio del movimiento humano. Métodos: Investigación experimental sobre las características del intercambio de gases en ejercicios de alta intensidad con aumento gradual de carga en alumnos universitarios. Resultados: Hubo diferencias estadísticas significativas en la incidencia de reacciones fisiológicas de los estudiantes que pasaron por la actividad de alta intensidad con aumento gradual de carga, incluyendo dolores abdominales, disnea, taquicardia, náuseas, mareos y dolor muscular (p<0,05). En la presencia de hipotermia se produjo un descenso cardíaco durante los ejercicios. Conclusión: Los ejercicios de sobrecarga pueden mediar las funciones fisiológicas eficientemente. Para mejorar el rendimiento deportivo en ambientes de baja temperatura es importante realizar ejercicios de calentamiento para aumentar la temperatura corporal. Nivel de evidencia II; Estudios terapéuticos - investigación de resultados de tratamiento.

2.
Radiol. bras ; 55(2): 113-119, mar.-abr. 2022. graf
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1365294

ABSTRACT

Resumo As doenças neurometabólicas hereditárias representam um desafio diagnóstico e precisam de classificações eficientes para sua compreensão. São um grupo de doenças raras, mas atingem pelo menos um a cada mil nascimentos. Algumas têm possibilidade terapêutica. Os quadros clínico e radiológico são variáveis e, às vezes, superponíveis, a depender da fase da doença. Por isso, observam-se na literatura vários tipos de classificações, algumas de difícil aplicação prática. O objetivo deste estudo é ilustrar a classificação das doenças neurometabólicas hereditárias baseada exclusivamente em achados radiológicos. Trata-se de um estudo retrospectivo a partir de exames de imagem do sistema nervoso central, particularmente de crianças, realizados em uma rede de hospitais. Todos os casos foram estudados por tomografia computadorizada multidetectores e/ou ressonância magnética, tendo sido avaliados por dois neurorradiologistas. Consideraram-se os casos com diagnóstico definitivo. A classificação propõe 10 subgrupos, de acordo com os achados radiológicos. Todos os casos estudados apresentaram, pelo menos, um desses achados. Na maioria dos casos observou-se mais de um achado, o que aumentou a especificidade e restringiu os diagnósticos diferenciais. Após avaliar os dados de literatura e os deste estudo, demonstra-se que é possível classificar as doenças neurometabólicas hereditárias pelo aspecto radiológico, o que favorece um diagnóstico definitivo.


Abstract Inherited neurometabolic disorders represent a diagnostic challenge, and an efficient classification system is needed in order to improve the understanding of these diseases. Although they constitute a group of rare diseases, they have a collective incidence of at least one case per 1,000 live births. Some inherited neurometabolic disorders are treatable. The clinical and radiological presentations are variable and sometimes overlap, depending on the stage of the disease. Therefore, a number of classification systems have been devised, some of which are difficult to apply in practice. The aim of this study was to illustrate a classification system for inherited neurometabolic disorders, based exclusively on radiological findings. This was a retrospective study of imaging examinations of the central nervous system, particularly of children, performed in a network of hospitals. All of the cases were studied by multidetector computed tomography, magnetic resonance imaging, or both, the images having been obtained by two neuroradiologists. We included only cases in which a definitive diagnosis was made. The classification system separates the relevant radiological findings into 10 categories. All of the cases studied presented at least one of those findings. In most of the cases, more than one finding was observed, which increased specificity and narrowed the differential diagnosis. Data from the literature and from this study demonstrate that it is possible to classify inherited neurometabolic disorders by their radiological aspects, which favors a definitive diagnosis.

3.
Arch. argent. pediatr ; 120(1): e25-e28, feb 2022. ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1353751

ABSTRACT

La enfermedad de Tay-Sachs es una enfermedad metabólica hereditaria neurodegenerativa. Existen cuatro tipos según el inicio de los síntomas clínicos: infantil, infantil de inicio tardío, juvenil y adulto. El tipo infantil tiene el peor pronóstico. Recientemente, se describieron diferentes anomalías que acompañan a los trastornos metabólicos e influyen en el pronóstico. Presentamos el caso de un lactante con enfermedad de Tay-Sachs junto con coartación aórtica y reflujo vesicoureteral bilateral (RVU) de grado V. Se realizó el seguimiento del paciente en el consultorio externo de Cardiología Pediátrica. En la ecografía abdominal, se observó ectasia pielocalicial, y se detectó reflujo vesicoureteral bilateral de grado V en la cistouretrografía miccional. No se ha informado previamente la coexistencia de estas anomalías. Este caso pone de manifiesto que no se deben subestimar las anomalías del examen neurológico en los pacientes con una cirugía cardíaca reciente, porque podría perderse la oportunidad de diagnosticar enzimopatías congénitas.


Tay-Sachs disease is a neurodegenerative inherited metabolic disease. There are four forms classified by the time of first clinical symptoms: infantile, late infantile, juvenile and adult. Infantile form has the poorest prognosis. Lately, different abnormalities which accompany metabolic disorders and affect the prognosis have been described. We present an infant with Tay-Sachs disease accompanied by coarctation of the aorta and bilateral grade V vesicoureteral reflux (VUR). The patient was followed up in the outpatient clinic of Pediatric Cardiology. The abdominal ultrasonography showed pelvicalyceal ectasia; bilateral grade V VUR in voiding cystourethrography was found. This coexistence has not been previously reported. This case emphasizes that abnormalities in the neurological examination of cardiac postsurgical patients should not be underestimated because the opportunity to diagnose inborn errors of metabolism could be missed.


Subject(s)
Humans , Male , Infant , Aortic Coarctation/complications , Aortic Coarctation/diagnosis , Tay-Sachs Disease/diagnosis , Vesico-Ureteral Reflux/complications , Vesico-Ureteral Reflux/diagnosis
4.
Arq. bras. cardiol ; 118(1): 33-40, jan. 2022. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1360114

ABSTRACT

Resumo Fundamento A ação do peptídeo natriurético atrial (ANP) na natriurese, diurese e vasodilatação, resistência à insulina, fígado, rim e tecido adiposo pode contribuir para o desenvolvimento metabólico e cardiovascular saudável. Embora o nível circulante de ANP seja reduzido em pacientes com obesidade, sua resposta à perda de peso ainda é pouco explorada em populações pediátricas. Objetivo Avaliar os efeitos das variações do ANP em resposta à intervenção interdisciplinar para perda de peso na Síndrome Metabólica (SMet) e nos riscos cardiometabólicos em adolescentes com obesidade. Métodos 73 adolescentes com obesidade participaram de uma terapia interdisciplinar para perda de peso de 20 semanas, incluindo uma abordagem clínica, nutricional, psicológica e de exercícios físicos. A composição corporal, análises bioquímicas e pressão sanguínea foram avaliadas. A SMet foi classificada de acordo com a Federação Internacional de Diabetes (IDF) (2007). Após o tratamento, os voluntários foram divididos de acordo com os níveis de plasma do ANP aumento (n=31) ou ANP redução (n=19). Resultados Ambos os grupos apresentaram redução significativa de peso corporal, índice de massa corporal (IMC) e circunferências de cintura, pescoço e quadril (CC, CP e CQ, respectivamente), e aumento da massa livre de gordura (MLG). É interessante observar que houve uma redução significativa na gordura corporal, na razão de TG/HDL-c e na prevalência de SMet (de 23% para 6%) somente no grupo com ANP aumento. Conclusão Este estudo sugere que o aumento nos níveis séricos de ANP após a terapia para perda de peso pode estar associado a melhorias nos riscos cardiometabólicos e na prevalência reduzida de SMet em adolescentes com obesidade.


Abstract Background The action of atrial natriuretic peptide (ANP) on natriuresis, diuresis and vasodilatation, insulin resistance, liver, kidney, and adipose tissue may contribute to the healthy metabolic and cardiovascular development. Even though the circulating level of ANP is reduced in patients with obesity, its response to weight loss remains poorly explored in pediatric populations. Objective To evaluate the effects of ANP variations in response to interdisciplinary weight loss intervention on metabolic syndrome (MetS) and cardiometabolic risks in adolescents with obesity. Methods 73 adolescents with obesity attended a 20-week clinical interdisciplinary weight loss therapy including clinical, nutritional, psychological and exercise training approach. Body composition, biochemical analyses and blood pressure were evaluated. MetS was classified according to the International Diabetes Federation (IDF) (2007). After the treatment, volunteers were divided according to Increasing (n=31) or Decreasing (n=19) ANP plasma levels. Results Both groups present significant reduction of body weight, Body Mass Index (BMI), waist, neck and hip circumferences (WC, NC and HC, respectively) and increasing fat-free mass (FFM). Interestingly, a significant reduction in body fat, TG/HDL-c ratio and MetS prevalence (from 23% to 6%) was observed in the Increased ANP group only. Conclusion This study suggests that an increase in ANP serum levels after weight loss therapy could be associated with improvements in cardiometabolic risks and the reduced prevalence of MetS in adolescents with obesity.


Subject(s)
Humans , Child , Adolescent , Cardiovascular Diseases/etiology , Cardiovascular Diseases/prevention & control , Metabolic Syndrome/epidemiology , Pediatric Obesity/therapy , Body Composition , Weight Loss/physiology , Body Mass Index , Atrial Natriuretic Factor/metabolism
5.
Hematol., Transfus. Cell Ther. (Impr.) ; 44(1): 95-99, Jan.-Mar. 2022. tab
Article in English | LILACS | ID: biblio-1364881

ABSTRACT

Abstract Hemochromatosis is currently characterized by the iron overload caused by hepcidin deficiency. Large advances in the knowledge on the hemochromatosis pathophysiology have occurred due to a better understanding of the protein of the iron metabolism, the genetic basis of hemochromatosis and of other iron overload diseases or conditions which can lead to this phenotype. In the present review, the main aims are to show updates on hemochromatosis and to report a practical set of therapeutic recommendations for the human factors engineering protein (HFE) hemochromatosis for the p.Cys282Tyr (C282Y/C282Y) homozygous genotype, elaborated by the Haemochromatosis International Taskforce.


Subject(s)
Humans , Male , Female , Iron Metabolism Disorders , Hemochromatosis/diagnosis , Hemochromatosis/therapy , Phlebotomy , Iron Overload , Hepcidins/deficiency , Hemochromatosis Protein
6.
Journal of Clinical Hepatology ; (12): 439-442, 2022.
Article in Chinese | WPRIM | ID: wpr-920908

ABSTRACT

Nonalcoholic fatty liver disease is a common chronic liver disease with the risk of progression to nonalcoholic hepatitis, liver fibrosis, and hepatocellular carcinoma. Nonalcoholic fatty liver disease has various pathogeneses, among which abnormal metabolism of branched-chain amino acids can induce oxidative stress, autophagy, and mitochondrial dysfunction in hepatocytes and is the most important mechanism in the development and progression of nonalcoholic fatty liver disease. This article reviews related research advances and analyzes the possible role of abnormal metabolism of branched-chain amino acids in the development and progression of nonalcoholic fatty liver disease, in order to improve clinical awareness and diagnosis.

7.
Journal of Preventive Medicine ; (12): 240-243, 2022.
Article in Chinese | WPRIM | ID: wpr-920759

ABSTRACT

Objective@#To investigate the value of serum hepcidin in assessment of liver inflammation activity among patients with chronic hepatitis B ( CHB ), so as to provide insights into the assessment of liver inflammation activity among CHB patients.@*Methods@#A total of 79 CHB patients who were admitted to the Affiliated Hospital of Hangzhou Normal University were selected as the experimental group, while 40 healthy volunteers were randomly sampled as controls. Subjects'demographic data, liver function tests and iron metabolism parameters were collected from medical records, and serum hepcidin was measured using enzyme-linked immunosorbent assay ( ELISA ). In addition, ultrasound-guided liver biopsy was performed in CHB patients, and mild and moderate-to-severe CHB were classified according to liver inflammation activity and degree of liver fibrosis. Serum hepcidin levels were compared between the experimental and control groups and between patients with mild and moderate-to-severe CHB. The value of serum hepcidin in assessment of liver inflammation activity was examined among CHB patients using the receiver operating characteristic ( ROC ) curve analysis.@*Results@#Subjects in the experimental group included 54 men ( 68.35% ) and had a mean age of ( 39.06±10.67 ) years, while the controls included 24 men (60.00%) and had a mean age of ( 42.43±11.44 ) years. Lower hepcidin levels were measured in the experimental group than in the control group [( 11.70±5.64 ) vs. ( 17.82±3.63 ) μg/L; P<0.05 ]. There were 54 patients with mild CHB ( 68.35% ) and 25 cases with moderate-to-severe CHB ( 31.65% ), and lower hepcidin levels were detected in patients with moderate-to-severe CHB than in those with mild CHB [ ( 6.92±2.21 ) vs. ( 13.95±5.36 ) μg/L; P<0.05 ]. The area under the ROC curve, optimal cut-off, sensitivity and specificity of serum hepcidin were 0.903 ( P<0.05 ), 10.365 μg/L, 100.0% and 72.2% for assessment of moderate-to-severe CHB, respectively.@*Conclusion@#Serum hepcidin is feasible to evaluate the liver inflammatory activity among patients with CHB.

8.
Article in Chinese | WPRIM | ID: wpr-920542

ABSTRACT

Objective To explore the effects of different dietary induction models of inulin, resistant starch RS3 and their complexes on the body weight and intestinal flora in mice. Methods A total of 64 C57BL/6 mice were randomly divided into low-fat control group, low-fat inulin group, low-fat resistant starch RS3 group, low-fat composite group and high-fat control group, high-fat inulin group, high-fat resistant starch RS3 group and high-fat composite group for dietary intervention. The mice were weighed and fresh feces were collected weekly. Diet intervention was continued until the weight of the high-fat control group was more than 14% higher than that of the low-fat control group. The mice were then sacrificed after overnight fasting. Liver and epididymal fat were weighed, and the colon contents were collected for 16S amplicon sequencing analysis. Results In low-fat diet fed mice, the combined induction of inulin and resistant starch RS3 caused a significant decrease in body weight gain. In high-fat diet fed mice, inulin alone and the combined induction both caused a significant reduction in weight gain, and there was no significant difference between the two methods. In the high-fat diet groups, inulin, resistant starch RS3, and the compound could be distinguished by Bacteroides, Bifidobacterium and Alloprevotella respectively. In the low-fat diet groups, inulin, resistant starch RS3, and the composite groups could be distinguished by Coriobacteriaceae_UCG_002, Bacteroides and Helicobacter, respectively. Conclusion Inulin and resistant starch RS3 diet induction can significantly reduce the weight gain of C57BL/6 mice, change the structure of intestinal flora, and show the difference between high-fat and low-fat diets. Inulin and resistant starch RS3 may reduce body weight and promote fat metabolism by changing the structure of intestinal flora.

9.
Article in Japanese | WPRIM | ID: wpr-913209

ABSTRACT

This cross-sectional study examines the association between coping with past ankle sprain, and current physical activity levels and sedentary times. It included a total of 1,464 male soccer players, who participated in the 6th Senior Soccer Festival in Shizuoka in 2017. A self-administered questionnaire was conducted on the day of the festival and 567 subjects responded (38.7% response rate). Participants answered questions regarding the coping with past ankle sprain, such as whether they had first aid treatment (yes/no), the type of initial treatment facilities (6 categories), and their most frequented facilities (5 categories). Additionally, the International Physical Activity Questionnaire Short Form was used to obtain information on current physical activity level and sedentary time. We compared the mean values of physical activity levels and sedentary times with the first aid treatment, initial treatment facilities and most frequented facilities answers, respectively. The mean age was 64.7 years. Physical activity level was associated with first aid treatment (yes: 3860.3 Metabolic equivalents (METs)/min/week; no: 3082.0 METs/min/week) (p=0.033). Sedentary time was also associated with first aid treatment (yes: 265.4 min/day; no: 321.3 min/day) (p=0.014). Initial treatment facilities and most frequented facilities were not associated with physical activity levels or sedentary times. Our study showed that those who had received first aid treatment had high physical activity levels and low sedentary time.

10.
Article in Japanese | WPRIM | ID: wpr-913207

ABSTRACT

Sedentary behavior is ubiquitous in modern lifestyles and defined as any waking behavior with an energy expenditure of ≤ 1.5 metabolic equivalents while sitting, reclining, or lying. Epidemiological evidence suggests that high volumes of sedentary behavior are independently associated with an elevated risk of cardiometabolic disease and all-cause mortality. By contrast, a growing body of experimental evidence showing the potential benefits for cardiometabolic risks of reducing and breaking up sedentary time. Therefore, recent physical activity guidelines indicate the importance of reducing and regularly interrupting prolonged sitting. In this narrative review, we summarize the findings from experimental studies that investigated the acute impacts of prolonged, uninterrupted sitting and interrupting sitting on several cardiometabolic risk factors, including vascular function, blood pressure, and glucose metabolism. Here, we highlight experimental evidence from controlled laboratory trials that may lead to a better understanding of biological plausibility, the causal structure of relationships, and potential mechanistic insight on linking sedentary behavior with adverse cardiometabolic outcomes. Our literature review collectively suggests that in addition to increasing moderate- to vigorous-intensity physical activity, reducing sedentary time may contribute to cardiometabolic health. However, the recent evidence remains limited and inconclusive, thus future studies are needed to develop a deeper causal and mechanistic understanding of the biological pathways through which prolonged sitting can adversely influence cardiometabolic health outcomes.

11.
Journal of Clinical Hepatology ; (12): 703-707, 2022.
Article in Chinese | WPRIM | ID: wpr-922985

ABSTRACT

The liver is the main place for metabolism in human body, and when severe liver injury is induced by various factors, there will be disorders in the functions of synthesis, metabolism, and biological conversion. This article summarizes the features of the metabolism of nutrients such as glucose, amino acids, and lipids in the presence of liver failure, as well as the assessment of malnutrition and clinical interventions. For patients with liver failure, it is of great importance to identify and correct malnutrition in a timely manner, so as to improve energy metabolism and inflammation and increase survival rate.

12.
Acta Pharmaceutica Sinica ; (12): 303-312, 2022.
Article in Chinese | WPRIM | ID: wpr-922934

ABSTRACT

Cytochrome P450s (CYP450) is a superfamily of phase I metabolic enzymes, which participates in more than 90% of drug oxidation. The induction or inhibition of CYP450s is the main mechanism of drug-drug interaction. In recent years, in vitro metabolism studies conducted through isolated organs, cells, or enzyme systems have developed rapidly, due to their precision and simplicity. Therefore, profiles of the in vitro metabolism studies of traditional Chinese medicines can infer the possible metabolic pathways of drugs, predict the potential drug interactions, and may enhance the rational use of drugs in clinic. This article reviews the in vitro inhibitory effects of traditional Chinese medicine, ingredients, and extracts on the activities of CYP450 enzymes in the liver microsomes, which can provide a reference for further researches on the interaction between Chinese medicine and chemical medicine.

13.
Article in English | WPRIM | ID: wpr-922572

ABSTRACT

OBJECTIVE@#To explore the mechanisms of Dangua Recipe (DGR) in improving glycolipid metabolism based on transcriptomics.@*METHODS@#Sprague-Dawley rats with normal glucose level were divided into 3 groups according to a random number table, including a conventional diet group (Group A), a DGR group (Group B, high-calorie diet + 20.5 g DGR), and a high-calorie fodder model group (Group C). After 12 weeks of intervention, the liver tissue of rats was taken. Gene sequence and transcriptional analysis were performed to identify the key genes related to glycolipid metabolism reflecting DGR efficacy, and then gene or protein validation of liver tissue were performed. Nicotinamide phosphoribosyl transferase (Nampt) and phosphoenolpyruvate carboxykinase (PEPCK) proteins in liver tissues were detected by enzyme linked immunosorbent assay, fatty acid synthase (FASN) protein was detected by Western blot, and fatty acid binding protein 5 (FABP5)-mRNA was detected by quantitative real-time polymerase chain reaction. Furthermore, the functional verification was performed on the diabetic model rats by Nampt blocker (GEN-617) injected in vivo. Hemoglobin A@*RESULTS@#Totally, 257 differential-dominant genes of Group A vs. Group C and 392 differential-dominant genes of Group B vs. Group C were found. Moreover, 11 Gene Ontology molecular function terms and 7 Kyoto Encyclopedia of Genes and Genomes enrichment pathways owned by both Group A vs. Group C and Group C vs. Group B were confirmed. The liver tissue target validation showed that Nampt, FASN, PEPCK protein and FABP5-mRNA had the same changes consistent with transcriptome. The in vivo functional tests showed that GEN-617 increased body weight, HbA@*CONCLUSION@#Nampt activation was one of the mechanisms about DGR regulating glycolipid metabolism.


Subject(s)
Animals , Diabetes Mellitus, Experimental , Drugs, Chinese Herbal , Glycolipids , Liver , Metabolic Diseases , Rats , Rats, Sprague-Dawley , Transcriptome/genetics
14.
Hematol., Transfus. Cell Ther. (Impr.) ; 43(4): 389-395, Oct.-Dec. 2021. tab, graf
Article in English | LILACS | ID: biblio-1350802

ABSTRACT

ABSTRACT Introduction: Children and adolescents with cancer are particularly vulnerable to malnutrition and require special attention on nutritional assessment. An adequate nutritional status during treatment is essential in reducing morbidity and mortality, being a modifiable risk factor for clinical outcomes. This study aims to determine the nutritional status of pediatric patients with cancer assessed by the nutrition team at diagnosis and evaluate its association with the overall survival. Method: This is a retrospective cross-sectional study of patients at the time of cancer diagnosis who had nutritional assessments when hospitalized or referred to the nutrition outpatient clinic. Nutritional status was classified by the mid-upper arm circumference (MUAC) and body mass index for age z-score (zBMI/A). The Cox regression analysis was used to determine the association between the nutritional status and overall survival, adjusting for gender, tumor group and age. Results: The study included 366 patients. The prevalence of undernutrition varied from 8 to 23% and overweight, from 5 to 20%. The MUAC identified more children as undernourished than the zBMI/A in patients with solid and hematological tumors. There was no significant difference in the overall survival by malnutrition classified by the zBMI/A (p = 0.1507) or MUAC (p = 0.8135). When adjusted for gender, tumor group and age, the nutritional status classification by the zBMI/A (hazard ratio [HR], 1.27; 95% confidence interval [CI], 0.88-1.83; p = 0.209) and MUAC (HR, 0.94; 95% CI, 0.61-1.44; p = 0.773) did not impact overall survival. Conclusion: The nutritional status at diagnosis did not significantly impact the overall survival, which suggests there may have been a protective effect by successful nutritional intervention during the subsequent care.


Subject(s)
Male , Female , Child , Nutritional Status , Neoplasms/metabolism , Brazil , Child , Adolescent
15.
J. pediatr. (Rio J.) ; 97(6): 595-602, Nov.-Dec. 2021. tab, graf
Article in English | LILACS | ID: biblio-1350976

ABSTRACT

Abstract Objective: To discuss the approach to patients diagnosed with growth hormone deficiency (GHD) in childhood during the transition period from puberty to adulthood, focusing on the following: (1) physiology; (2) effects of recombinant human GH (rhGH) interruption/reinstitution after adult height achievement; (3) re-evaluation of somatrotropic axis; (4) management of rhGH reinstitution, when necessary. Source of data: Narrative review of the literature published at PubMed/MEDLINE until September 2020 including original and review articles, systematic reviews and meta-analyses. Synthesis of data: Growth hormone is crucial for the attainment of normal growth and for adequate somatic development, which does not end concomitantly with linear growth. Retesting adolescents who already meet the criteria that predict adult GHD with high specificity is not necessary. Patients with isolated GHD have a high likelihood of normal response to GH testing after puberty. Adolescents with confirmed GHD upon retesting should restart rhGH replacement and be monitored according to IGF-I levels, clinical parameters, and complementary exams. Conclusion: Patients with isolated idiopathic GHD in childhood are a special group who must be reevaluated for GHD as many of them have normal GH provocative tests upon retesting after puberty. Patients who confirm the persistence of GHD in the transition period should maintain rhGH replacement in order to reach an ideal peak bone mass, satisfactory body composition, lipid and glucose profiles, and quality of life.


Subject(s)
Humans , Child , Adolescent , Adult , Human Growth Hormone , Transition to Adult Care , Quality of Life , Insulin-Like Growth Factor I , Growth Hormone , Puberty
19.
Rev. colomb. reumatol ; 28(3): 171-177, jul.-set. 2021. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1357267

ABSTRACT

RESUMEN Introducción: Las espondiloartritis son un grupo de enfermedades inflamatorias crónicas con afectación principalmente del esqueleto axial y también de articulaciones periféricas. En cuanto al metabolismo óseo de estos pacientes, se ha observado en algunos estudios que existen niveles más bajos de vitamina D en pacientes con espondiloartritis. Objetivo: Estimar la prevalencia de déficit/insuficiencia de vitamina D, el metabolismo fosfocálcico y sus implicaciones en una cohorte de pacientes con espondiloartritis. Metodología: Estudio observacional, descriptivo y transversal. Se llevó a cabo una revisión retrospectiva de la base de datos de pacientes con espondiloartritis que fueron atendidos en las consultas externas del Servicio de Reumatología del Hospital General Universitario de Ciudad Real entre junio del 2018 y junio del 2019. Las variables se describieron usando medidas de frecuencia o medidas de tendencia central/dispersión según correspondiera. Resultados: Se analizaron 115 pacientes, de los cuales 64 fueron hombres y 51 mujeres, con una edad media de 45,97 años (± 13,41 DE). Del total de los pacientes, 59 presentaron espon dilitis anquilosante, 24 artropatía psoriásica, 9 artritis asociada a enfermedad inflamatoria intestinal, 12 espondiloartritis axial no radiográfica y 11 artritis reactiva. Los niveles de vitamina D fueron de 23,81 ng/ml (±10,5 DE), con un 77,4% de los pacientes con cifras de déficit/insuficiencia de vitamina D. Agrupados por el subtipo de espondiloartritis y según las cifras de déficit/insuficiencia de vitamina D, 45 pacientes tenían espondilitis anquilo sante, 19 artropatía psoriásica, 9 artritis asociada a enfermedad inflamatoria intestinal, 7 espondiloartritis axiales no radiográficas y 9 artritis reactivas. Además, el déficit de vita mina D (< 20 ng/ml) se presentaba la mayoría de las veces en las estaciones de primavera e invierno, con 31 y 26 pacientes respectivamente. Conclusiones: Una optimización de los niveles de vitamina D puede implicar una mejoría en la situación clínica del paciente, medida tanto por BASDAI y DAPSA como por PCR y VSG. En consecuencia, se recomienda la monitorización y suplementación de vitamina D en pacientes con hipovitaminosis D.


ABSTRACT Introduction: Spondyloarthritis is a group of chronic inflammatory diseases that mainly affect the axial skeleton, and also the peripheral joints. In bone metabolism studies on these patients, it has been observed that there are lower levels of vitamin D in patients with spondyloarthritis. Objective: To estimate the prevalence of vitamin D deficiency / insufficiency, as well as calcium/ phosphate metabolism and their implications in a cohort of patients with spondyloarthritis. Methodology: Observational, descriptive, and cross-sectional study. A retrospective review of the databases was carried out on patients with spondyloarthritis who were treated in the outpatient clinics of the Rheumatology Department of the General University Hospital of Ciudad Real between June 2018 and June 2019. Variables are described using frequency and central tendency / dispersion measurements as appropriate. Results: The study included 115 patients, of whom 64 were men and 51 women, with a mean age of 45.97 years (± 13.41 SD). They included 59 patients with ankylosing spondylitis, 24 with psoriatic arthropathy, 9 arthritis associated with inflammatory bowel disease, 12 non-radiographic axial spondylarthritis, and 11 reactive arthritis. Vitamin D levels were 23.81 ng/ml (± 10.5 SD), with 77.4% of patients with vitamin D deficiency / insufficiency levels. Grouped by the spondylarthritis subtype, and according to vitamin D deficiency / insufficiency, 45 patients had ankylosing spondylitis, 19 psoriatic arthropathy, 9 arthritis associated with inflammatory bowel disease, 7 non-radiographic axial spondyloarthritis, and 9 reactive arthritis. Furthermore, vitamin D deficiency (< 20 ng/ml) mainly occurred in the spring and winter seasons, with 31 and 26 patients, respectively. Conclusions: An optimization of vitamin D levels may lead to an improvement in the clinical situation of the patients, as measured by both BASDAI and DAPSA, as well as by PCR and ESR. Therefore, vitamin D monitoring and supplementation is recommended in patients with vitamin D deficiency.

20.
Arq. bras. oftalmol ; 84(4): 324-329, July-Aug. 2021. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1285298

ABSTRACT

ABSTRACT Purpose: Keratoconus presents certain specificities in pediatric patients compared with adults. The greatest challenge is because the disease is typically more severe and progresses faster in children. This retrospective study aimed to report crosslinking procedure in patients under 18 years of age and their follow-up for at least 24 months after the procedure. Methods: Overall, 12 eyes from 10 patients were studied and data, such as visual acuity with and without correction, maximum keratometry, corneal thickness, foveal thickness, and endothelial microscopy, were assessed at both preoperative and postoperative visits. Corneal crosslinking was performed in all patients. Results: A tendency toward reduced Kmax and improved Corrected Distance Visual Acuity at all postoperative moments. Only one of the 12 eyes exhibited increased Kmax of more than 1 D during a time frame longer than 12 months. Regarding pachymetry, a tendency for corneal thinning was observed in the first four months after surgery. Conclusion: Encouraging results were obtained regarding the stabilization of the disease, progression, and procedural safety, corroborating to other authors' findings. The significance of early diagnosis and short-term follow-up were highlighted.


RESUMO Objetivo: O ceratocone na população pediátrica apresenta algumas particularidades em relação à população adulta. O maior desafio é devido à doença ser geralmente mais severa e rapidamente progressiva em crianças. Métodos: Este artigo utiliza uma análise retrospectiva para relatar o uso do crosslinking em jovens menores de 18 anos e sua evolução pelo menos 24 meses após o procedimento. Foram estudados 12 olhos de 10 pacientes, e dados como acuidade visual com e sem correção, ceratometria máxima, espessura corneana, espessura foveal e microscopia endotelial avaliados no pré e pós-operatórios. O crosslinking corneano foi realizado em todos os pacientes pelo mesmo cirurgião. Resultados: Observou-se uma tendência de redução do valor do Kmax e melhora da acuidade visual corrigida em todos os momentos de pós operatório. Com relação à paquimetria, observou-se afinamento corneano do ponto mais fino, nos primeiros quatro meses de pós-operatório. Conclusão: Resultados encorajadores foram obtidos com relação à estabilização da doença, progressão e segurança do procedimento, corroborando com as conclusões de outros autores. A importância do diagnóstico precoce e do acompanhamento a curto prazo do paciente deve ser destacada.

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