Ingesta de nutrientes y estado nutricional de niños peruanos entre 6 a 35 meses / Nutrient intake and nutritional status of peruvian children from 6 to 35 months old

Introducción: La ingesta de nutrientes influye en la malnutrición, la niñez constituye una ventana de oportunidades para el desarrollo de intervenciones que contribuyan a mejorar el estado nutricional de los niños. Objetivos: Determinar la ingesta de nutrientes y estado nutricional de niños peruanos. Materiales y métodos: Estudio transversal que incluyó 1296 niños entre 6 a 35 meses. El muestreo fue probabilístico, estratificado y multietápico. La ingesta de nutrientes se calculó por recordatorio de 24 h. Se consideró porcentaje de ingesta muy deficiente (2 y ≤3 z score) y obesidad (P/T>3 z score). El procesamiento se realizó mediante muestras complejas ajustado por ponderación. Se calcularon porcentajes, chi cuadrado e intervalo de confianza al 95%. Resultados: La ingesta adecuada fueron: 15,2% de energía, 2,4% proteína total, 15,3% grasa 6,9% hierro, 5,8% vitamina A y 11,1% zinc (p<0.001). Se encontró diferencias significativas entre el estado nutricional y la energía (p=0.007), proteína total (p<0.001), grasa (p=0.013), vitamina A (p=0.001) y zinc (p=0.008), excepto en hierro (p=0.593). Discusión: Los resultados muestran que la mayoría de los niños presentan deficiente o excesiva ingesta de nutrientes e influyen en el estado nutricional de los niños. Conclusiones: Existen diferencias significativas entre la ingesta de nutrientes y el estado nutricional del niño, excepto en hierro (AU)

Introduction: Nutrient intake influences malnutrition, childhood is a window of opportunity for the development of interventions that contribute to improve the nutritional status of children. Objectives: Determine the nutrient intake according to nutritional status of Peruvian children. Materials and methods: Cross-sectional study included 1296 children between 6 to 35 months of age. The sampling was probabilistic, stratified and multistage. Nutrient intake was calculated by reminder of 24 h according to patterns of the FAO/WHO/UNU, ideal weight, breastfeeding included in the analysis. It was considered percentage of intake very poor (<70%), poor (≥ 70 to <90), adequate (≥90% to2; z score ≤3) and obesity (W/H> 3 z score). The processing was performed with complex samples adjusted by weighting. Percentages, chi square and confidence interval were calculated at 95%. Results: Adequate intake was 15.2% energy, 2.4% total protein, 15.3% fat, 6.9% iron, 5.8% vitamin A and zinc 11.1% (p< 0.001). Significant differences between nutritional status and energy were found (p=0.007), total protein (p<0.001), fat (p=0.013), vitamin A (p=0.001) and zinc (p=0.008) except iron (p=0.593). Discussion: The results show that the majority of children present deficient or excessive nutrient intake and influence the nutritional status of children. Conclusions: There are significant differences between the intake of nutrients according to the nutritional status of the child, except iron (AU)

Diversidad alimentaria en los niños peruanos de 6 a 35 meses / Peruvian household dietary diversity in children between 6 to 35 months

Introducción. La diversidad alimentaria estima la calidad de la dieta del niño. Objetivo. Determinar la diversidad alimentaria (DA) y la desnutrición crónica (DC) en niños peruanos. Diseño. Se realizó un estudio transversal, durante el 2012-2013. Lugar. Instituto Nacional de Salud, Lima, Perú. Participantes. Niños entre 6 a 35 meses que residen en los hogares peruanos. Intervenciones. Muestreo probabilístico, estratificado y multietápico. La muestra incluyó 13216 viviendas, que incluyó 1 315 niños. Se definió DA: ingesta de 4 a 7 grupos de alimentos durante el día anterior, según criterios de la Organización Mundial de la Salud (OMS). El procesamiento se realizó mediante muestras complejas, ajustado por ponderación. Se calculó porcentajes, chi cuadrado y regresión logística. Se solicitó el consentimiento informado escrito de los padres. Principales medidas de resultados. Diversidad alimentaria. Resultados. EI75,5% de los niños tuvieron DA. Los niños (78,5%) tuvieron mayor DA que las niñas (72,5%). Los niños que habitan en el área urbana (76,5%) y pobres (80,2%) tuvieron mayor DA. La carne fue el cuarto grupo de alimento consumido. La DA estuvo asociada a la DC (p>0,05). La edad entre 6 a 11 meses fue un factor protector de DC. El sexo femenino, el área rural, vivir en la sierra, selva, el nivel educativo primario del jefe del hogar, la pobreza estuvieron asociados a la DC. Conclusiones. Las tres cuartas partes de los niños peruanos entre 6 a 35 meses tuvieron diversidad alimentaria adecuada. La DA se asoció a la desnutrición crónica, aunque no fue significativa esta asociación.

Introduction. Household dietary diversity is key element in the quality of the diet in children. Objective. To estimate household dietary diversity and chronic malnutrition (CM) in Peruvian children. Design. A cross-sectional study was conducted during 2012-2013. Setting. National Institute of Health, Lima, Peru. Participants. Children between 6 to 35 months living in Peruvian households. Interventions. Probabilistic, stratified and multistage sampling. The sample included 13216 households with 1 315 children. Dietary diversity (DO) was defined as 4-7 intake of food groups during the previous day by the World Health Organization (WHO) standard. An analysis of complex samples was made in SPSS and the weighting factor was adjusted. Percentages, chi square and OR were calculated. Written informed consent of the parents was requested. Main outcome measures. Dietary diversity. Results. 75.5% of children received from 4 to more food groups. Children (78.5%) had higher frequency of DO than girls (72.5%). Children living in urban areas had increased DO. Poor children had high DO (80.2%). Meat consumption was fourth in the order of most foods consumed by children. The DO was associated with the OC (p> 0.05). Age 6-11 was protective factor of OC. The girls, rural areas, children living in the mountains, jungle, the primary education level, poverty were associated with OC. Conclusions. Three quarters of Peruvian children age 6-35 months had adequate household dietary diversity. The DO was associated with CM although the association was not significant.

Leptina e anorexia nervosa / Leptin and anorexia nervosa

Estudos recentes comprovam a importância da leptina no comportamento alimentar. A diminuição das concentrações séricas desse hormônio está diretamente relacionada com a variação da taxa de gordura corporal e provoca alterações em eixos neuroendócrinos, levando à amenorreia e à hiperatividade, entre outras consequências. Neste trabalho estamos apresentando uma revisão bibliográfica dos principais focos de estudo que relacionam a LEP com a ANN, bem como dos efeitos do excesso e da deficiência desse hormônio sobre o comportamento alimentar. Trata-se de um esforço para converter uma grande gama de conhecimentos obtidos da literatura em um texto, objetivando prover uma visão de como a LEP, funcionando como um sinal periférico de disponibilidade de energia, pode influenciar a atividade de circuitos neuronais que controlam mecanismos associados à regulação da homeostasia energética.

Recent studies demonstrate the importance of leptin in feeding behavior. The decreasing of the serum concentration of this hormone is directly related to the body fatty amount and provokes alterations in neuroendocrine axis, causing amenorrhea and hyperactivity, among others consequences. In this paper, a review of the main aspects interconnecting leptin and anorexia nervosa is made, as well as of the effects of excess and deficiency of this hormone on feeding disease. It was an effort to convert a large amount of knowledge obtained from literature into a condensed text, aiming to provide an updated view, how leptin functioning as a peripheral signal of energy availability to central nervous system influences on the neural activity involved in regulation of body weight and energy homeostasis.

Leptina e anorexia nervosa / Leptin and anorexia nervosa

Estudos recentes comprovam a importância da leptina no comportamento alimentar. A diminuição das concentrações séricas desse hormônio está diretamente relacionada com a variação da taxa de gordura corporal e provoca alterações em eixos neuroendócrinos, levando à amenorreia e à hiperatividade, entre outras consequências. Neste trabalho estamos apresentando uma revisão bibliográfica dos principais focos de estudo que relacionam a LEP com a ANN, bem como dos efeitos do excesso e da deficiência desse hormônio sobre o comportamento alimentar. Trata-se de um esforço para converter uma grande gama de conhecimentos obtidos da literatura em um texto, objetivando prover uma visão de como a LEP, funcionando como um sinal periférico de disponibilidade de energia, pode influenciar a atividade de circuitos neuronais que controlam mecanismos associados à regulação da homeostasia energética.(AU)

Recent studies demonstrate the importance of leptin in feeding behavior. The decreasing of the serum concentration of this hormone is directly related to the body fatty amount and provokes alterations in neuroendocrine axis, causing amenorrhea and hyperactivity, among others consequences. In this paper, a review of the main aspects interconnecting leptin and anorexia nervosa is made, as well as of the effects of excess and deficiency of this hormone on feeding disease. It was an effort to convert a large amount of knowledge obtained from literature into a condensed text, aiming to provide an updated view, how leptin functioning as a peripheral signal of energy availability to central nervous system influences on the neural activity involved in regulation of body weight and energy homeostasis.(AU)

A História do estudo urodinâmico / The Urodynamic studies history

O estudo urodinâmico é definido pela Sociedade Internacional de Continência como a avaliação morfológica, fisiológica, bioquímica e hidrodinâmica do trasmporte urinário. São vários os parâmetros avaliados durante a fase de enchimento ou esvaziamento vesical. O estudo é indispensável para o diagnóstico das disfunções vesicais, pois muitas vezes os sintomas urinários são similares, mesmo quando as etiologias são diferentes. Este artigo revê a história do estudo urodinâmico, cujo primeiro registro de medida da pressão vesical ocorreu de forma acidental, em 1882. Ao longo dos anos, observamos uma tendência à padronização da terminologia do trato urinário inferior, e dos parâmetros do estudo urodinâmico. Os equipamentos também evoluíram e atualmente a videourodinâmica e a urodinâmica ambulatorial são instrumentos importantes no estabelecimento de diagnósticos mais precisos.

[Effect of an urodynamic study on women with urinary incontinence]. / Impacto do estudo urodinâmico em mulheres com incontinência urinária.

OBJECTIVE: The purpose was to evaluate tolerance of patients with urinary incontinence undergoing an urodynamic study. METHODS: Forty nine patients with lower urinary tract symptoms submitted to an urodynamic study were evaluated... Prior to and immediately after the procedure each patient completed a self-administered questionnaire about several emotional variables, including anxiety, pain and shame. Answers about pain were given on a visual analog scale. Mean values of continuous variables were compared using a paired t-test, whereas categorical variables were compared using the chi-square test. RESULTS: The mean age was 49.5 (23-84) years. Pain score pre-procedure was 4.29 +/-3 and after procedure was 2.7+/-2.9 (p=0.001). CONCLUSION: The urodynamic study is well tolerated by female patients and a low morbidity was found. Previous orientation can decrease anxiety.

Trato urinário, assoalho pélvico e ciclo gravídico-puerperal / Lower urinary tract, pelvic floor and pregnancy-puerperium cycle

Os autores realizaram revisão da literatura na base de dados Medline. Este artigo sintetiza as informações disponíveis com relação aos danos obstétricos imediatos e tardios ao trato urinário e assoalho pélvico feminino, enfatizando suas implicações na incontinência urinária. O parto vaginal causa vários graus de lesão muscular, neuromuscular e ao tecido conectivo. Estes danos podem resultar em incontinência urinária e/ou prolapso genital. A episiotomia mediana aumenta o risco de lacerações perineais e a médio-lateral, quando praticada rotineiramente, não previne a incontinência urinária. A prevenção do ganho excesivo de peso, bem como a prática de exercícios perineais antes e depois do parto, podem reduzir o risco de incontinência urinária no pós-parto

Impacto do estudo urodinâmico em mulheres com incontinência urinária / Effect of an urodynamic study on women with urinary incontinence

OBJETIVO: Avaliar a tolerabilidade das pacientes com incontinência urinária submetidas ao estudo urodinâmico (EUD). MÉTODOS: Foram avaliadas 49 pacientes com queixas do trato urinário inferior submetidas ao estudo urodinâmico. Por meio de um questionário, as pacientes respondiam sobre seus anseios em relação ao exame a que iriam se submeter (medo, vergonha, ansiedade) e a expectativa de dor, por meio de uma escala visual analógica. Imediatamente após o estudo, as mesmas perguntas eram repetidas. Os resultados foram comparados antes e após a realização do EUD. A análise estatística das variáveis contínuas foi feita pelo teste t pareado, e as variáveis qualitativas foram comparadas pelo teste do Qui-quadrado. Fixou-se em 5 por cento a hipótese de nulidade. RESULTADOS: A média de idade foi de 49,5 (23-84) anos, sendo que 55 por cento estavam no menacme e 45 por cento na pós-menopausa. O principal sentimento antes do exame foi ansiedade, presente em 28 pacientes. A expectativa de dor foi de 4,29 ± 3 (antes do exame) e 2,7 ± 2,9 (após a realização do EUD) (p=0,001). CONCLUSÃO: O EUD apresenta baixa morbidade e desconforto psíquico. A informação prévia ao exame pode diminuir a ansiedade.

OBJECTIVE: The purpose was to evaluate tolerance of patients with urinary incontinence undergoing an urodynamic study. METHODS: Forty nine patients with lower urinary tract symptoms submitted to an urodynamic study were evaluated... Prior to and immediately after the procedure each patient completed a self-administered questionnaire about several emotional variables, including anxiety, pain and shame. Answers about pain were given on a visual analog scale. Mean values of continuous variables were compared using a paired t-test, whereas categorical variables were compared using the chi-square test. RESULTS: The mean age was 49.5 (23-84) years. Pain score pre-procedure was 4.29 ± 3 and after procedure was 2.7 ± 2.9 (p=0.001). CONCLUSION: The urodynamic study is well tolerated by female patients and a low morbidity was found. Previous orientation can decrease anxiety.

Cellular aspects of elastogenesis in the elastic tendon of the chicken wing.

Morphological, immunocytochemical and ultrastructural methods were used to investigate the role of cells during elastogenesis in the elastic tendon of the chicken wing. Intimate contact of the cell processes with elastic fibers was observed in adult birds. During development there was a sequential appearance of microfibril bundles that became progressively impregnated with amorphous elastin, which eventually predominated in fully developed elastic fibers. The growing elastic fibers were usually enveloped by recesses of the cell surface. The tendon cells were polarized in their association with fibrous components of the extracellular matrix. This arrangement suggests that these cells secrete and organize elastic and collagen fibers to different extracellular compartments. These results show that cells are intimately involved in producing components of different extracellular matrix fibers, in controlling their assembly, and in defining their borders and associations during development.

The development of fibrocartilage in the elastic tendon of the chicken wing.

The elastic tendon of the chicken wing has five morphologically distinct regions. One of these regions is a distally located fibrocartilage from which fibrous connections extend to the capsule of the distal radius. In adult birds, this region shows the characteristics of a tendon-compressed fibrocartilage, with an accumulation of proteoglycans between thick collagen bundles arranged in a basket-weave formation. Here we study the development of this fibrocartilage in order to of compare it with other tendon fibrocartilages and try to identify the factors involved in fibrocartilage differentiation. This fibrocartilage initially developed by cell enlargement and accumulation of vimentin, with simultaneous deposition of proteoglycans in the extracellular matrix and an increase in the amount and thickness of collagen bundles. Elastic fibers were minor components associated with the collagen bundles. Cells could be classified into two main types. One was typically fibrocartilaginous and the other was fibroblast-like, the latter occurring in close association with the collagen bundles. These results establish the steps in the development of the elastic tendon fibrocartilage and provide a basis for future studies.