ABSTRACT
OBJECTIVE: To assess the validity of a food frequency questionnaire (FFQ) by applying it to children and adolescents living in Salvador, Bahia. METHODS: The validity of this FFQ with 98 food items was investigated among 108 children and adolescents who were selected from a sample of 1445 that had been planned for a study on the risk factors for asthma and other allergic diseases. The adults responsible for these children and adolescents gave responses for a 24-hour recall (R24h) and an FFQ. The average energy and nutrient values from the FFQ were compared with those from the R24h by means of the paired t test and Pearson correlation coefficients. The concordance was evaluated using the Bland-Altman method and kappa statistics. RESULTS: The energy and nutrient intake estimated using the FFQ was significantly higher than what was obtained using the R24h. The correlation coefficients adjusted for energy were statistically significant for protein, fat, vitamin C and zinc. The weighted kappa values ranged from 0.06 for vitamin A (p = 0.24) to 0.34 for energy (p < 0.00). The results from the Bland-Altman plots for lipid, protein and zinc showed the most significant validity parameters, and zinc was found to show the best concordance. CONCLUSION: The results suggest that the FFQ showed satisfactory validity for use in studies involving children and adolescents.
Subject(s)
Feeding Behavior , Surveys and Questionnaires , Adolescent , Brazil/epidemiology , Child , Child, Preschool , Data Interpretation, Statistical , Diet Surveys , Eating , Female , Humans , Male , Reproducibility of ResultsABSTRACT
Objective: To assess the validity of a food frequency questionnaire (FFQ) by applying it to children and adolescents living in Salvador, Bahia. Methods: The validity of this FFQ with 98 food items was investigated among 108 children and adolescents who were selected from a sample of 1445 that had been planned for a study on the risk factors for asthma and other allergic diseases. The adults responsible for these children and adolescents gave responses for a 24-hour recall (R24h) and an FFQ. The average energy and nutrient values from the FFQ were compared with those from the R24h by means of the paired t test and Pearson correlation coefficients. The concordance was evaluated using the Bland-Altman method and kappa statistics. Results: The energy and nutrient intake estimated using the FFQ was significantly higher than what was obtained using the R24h. The correlation coefficients adjusted for energy were statistically significant for protein, fat, vitamin C and zinc. The weighted kappa values ranged from 0.06 for vitamin A (p = 0.24) to 0.34 for energy (p < 0.00). The results from the Bland-Altman plots for lipid, protein and zinc showed the most significant validity parameters, and zinc was found to show the best concordance. Conclusion: The results suggest that the FFQ showed satisfactory validity for use in studies involving children and adolescents (AU)
Objetivo: Evaluar la validez de un cuestionario de frecuencia de alimentos (QFA) aplicándolo a niños y adolescentes residentes en Salvador, Bahía. Métodos: Se investigó la validez de este QFA con 98 ítems de alimentos en 108 niños y adolescentes seleccionados a partir de una muestra de 1.445 planificados para un estudio sobre los factores de riesgo para asma y otras enfermedades alérgicas. Los adultos responsables de estos niños y adolescentes proporcionaron respuestas para un recuerdo de 24 horas (R24h) y el QFA. Los valores promedio de energía y nutrientes procedentes del QFA se compararon con los del R24h mediante una prueba t de student y los coeficientes de correlación de Pearson. La concordancia se evaluó usando el método de Bland-Altman y el estadístico kappa. Resultados: El consumo estimado de energía y nutrientes usando el QFA fue significativamente superior que el obtenido usando el R24h. Los coeficientes de correlación ajustados para la energía fueron estadísticamente significativos para proteínas, grasas, vitamina C y cinc. Los valores ponderados por kappa variaron desde 0,06 para la vitamina A (p = 0,24) hasta 0,34 para la energía (p < 0,00). Los resultados de las gráficas de Bland-Altman para los lípidos, proteínas y cinc mostraron los parámetros más significativos para la validez y se halló que el cinc tenía la mejor concordancia. Conclusión: Los resultados sugieren que el QFA mostró una validez satisfactoria para ser usado en estudios con niños y adolescentes (AU)
Subject(s)
Humans , Male , Female , Child , Adolescent , Nutrition Surveys/methods , Feeding Behavior , Nutrients/analysis , Feeding Behavior , Surveys and QuestionnairesABSTRACT
The amount of copies of HCV-RNA and count of CD8(+) lymphocytes was retrospectively evaluated in 326 patients: sampling was performed in basal condition, during treatment with alpha-IFN (n=232) and post-treatment follow-up, and at the same time points in untreated patients (n=94). In the treated group the difference between CD8(+) lymphocytes in the patients successfully treated (n=65) and those with an unfavourable outcome (n=176) is statistically significant (898+/-172 vs., 440+/-176 CD8(+) lymphocytes per mm(3) P<0.005 ANOVA). Also, in the untreated patients the average count of CD8(+) cells is statistically higher in patients with a favourable outcome (P<0.01 ANOVA). The present data show that the count of CD8(+) lymphocyte is of clinical value in order to predict the outcome of HCV infection and may be used together with the viral load and genotype, already established predictors.
ABSTRACT
Finding one major hepatotropic virus may not be enough to identify the aetiology of liver disease when risk factors are present, particularly in patients with past or present infection with other viral agents, or chronic liver disease. The pathogenic process in these cases is often complex. In the five cases we report, acute hepatitis (initiated by halothane, cytomegalovirus or Epstein-Barr virus) preceded the reactivation of hepatitis B infection, and these events occurred in patients with chronic hepatitis C infection. Each case demonstrates how several viruses can be implicated in the development of hepatitis, either as single agents or via cross-activation of T cells. The nosography of hepatitis, therefore, and the optimum therapeutic choices, can puzzle the clinical team.
Subject(s)
Hepatitis, Viral, Human/classification , Hepatitis, Viral, Human/diagnosis , Adult , Female , Hepatitis, Viral, Human/virology , Humans , Male , Middle Aged , RNA, Viral/isolation & purificationABSTRACT
OBJECTIVE: Infection with hepatotropic viruses is associated with a variable degree of liver disease, and there is evidence that more severe lesions are related to the association with another viral infection. The aim of this investigation is to establish the relationship between different viral infections occurring in the same individual and the presence and progression of liver disease. DESIGN: The study population comprises 754 intravenous (IV) drug abusers exposed to hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV) or cytomegalovirus (CMV). All individuals were followed for an average of 2 years. Liver disease was assessed by liver function tests, 99m-technetium (99mTc) liver scintigraphy, and also by liver biopsy in a subset (n = 136) of patients. The different viral patterns and presence of disease were analysed by logistic regression, and the risk factors were calculated. Contingency tables of patients with single or associated infections were drawn up to evaluate progression of liver disease. RESULTS: Association of HIV with at least one other viral infection was constant. Surface antigens of HBV (HBsAg) were always associated with HIV (n = 19); in this group, 18 patients had signs of liver disease. A past infection with HBV, as revealed by the presence of at least antibodies against the surface antigen (HBsAb) and antibodies against the core antigen of HBV (HBcAb), was detected in 463 patients (61.4%). The overall prevalence of HCV antibodies was 63.91% (n = 482). In 96.8% of the 406 patients tested, HCV-RNA was detected by reverse transcriptase polymerase chain reaction (RT-PCR). The majority of patients with high alanine transaminase (ALT) had anti-HBV antibodies in the presence of HCV (56.1%). At the end of follow-up, all of these patients showed signs of active liver disease, and scoring was significantly worse than in patients with either HBV or HCV alone. An infection/reactivation of CMV was found in patients previously exposed to HBV and with increased ALT values. CONCLUSIONS: Data emerging from this study reveal the association of HCV or CMV, or both, with a previous HBV infection, as demonstrated by HBsAb and HBcAb, and rapid progression of the disease in this group of patients. A previous HBV infection therefore appears to be an important risk factor for subsequent viral-related liver disease.
