Final height of adults with childhood-onset steroid-responsive idiopathic nephrotic syndrome

The aim of this study was to evaluate the final stature of adults with childhood-onset steroid-responsive idiopathic nephrotic syndrome (INS) and the influence of disease-related issues on the achievement of their target heights. We analyzed 60 (41 male) patients and/or their records, with a minimum age of 19 years or at a Tanner`s pubertal stage 4 for boys or status postmenarche for girls, and normal glomerular filtration rate. Mean age at first and last consultation was 5.3 +/- 2.4 years and 20.5 +/- 3.1 years, respectively. Mean follow-up period was 15.10 years. Mean cumulative dose of prednisone was 1254 +/- 831.40 mg/kg. Mean initial and final height Z scores (HtZ) were, respectively, -0.60 +/- 1.0 and -0.64 +/- 0.92 (p = 0.72). The final HtZ showed a significant correlation only with the initial HtZ and the target HtZ (THZ). Six patients achieved a final HtZ below -2, which in male patients correlated strongly to the initial HtZ and THZ. A strong correlation was demonstrated between final HtZ, initial HtZ, and THZ. INS-related issues did not prevent the final stature to reach the predicted target height.

Expression profiles of the glucose-dependent insulinotropic peptide receptor and LHCGR in sporadic adrenocortical tumors

Glucose-dependent insulinotropic peptide receptor (GIPR) and LHCGR are G-protein-coupled receptors with a wide tissue expression pattern. Aberrant expression of these receptors has rarely been demonstrated in adult sporadic adrenocortical tumors with a lack of data on pediatric tumors. We quantified the GIPR and LHCGR expression in a large cohort of 55 patients (25 children and 30 adults) with functioning and non-functioning sporadic adrenocortical tumors. Thirty-eight tumors were classified as adenomas whereas 17 were carcinomas. GIPR, and LHCGR expression were analyzed by real-time PCR and normal human pancreatic and testicular tissue samples were used as positive controls. Mean expression values were determined by fold increase in comparison with a normal adrenal pool. GIPR mRNA levels were significantly higher in adrenocortical carcinomas than in adenomas from both pediatric and adult groups. LHCGR expression was similar in both carcinomas and adenomas from the pediatric group but significantly lower in carcinomas than in adenomas from the adult group (median 0.06 and 2.3 respectively, P<0.001). GIPR was detected by immunohistochemistry in both pediatric and adult tumors. Staining and real-time PCR results correlated positively only when GIPR in RN A levels were increased at least two-fold in comparison with normal adrenal expression levels. In Conclusion, GIPR overexpression was observed in pediatric and adult adrenocortical tumors and very low levels of LHCGR expression were found in all adult adrenocortical carcinomas.

The role of nutritional profile in the orexigenic neuropeptide secretion in nonalcoholic fatty liver disease obese adolescents

Background Little progress has been made to identify the central neuroendocrine pathway involved in the energy intake control in nonalcoholic fatty liver disease (NAFLD) patients. Objective To assess the influence of orexigenic neuropeptides in the nutritional aspects of NAFLD obese adolescents submitted to a long-term interdisciplinary approach. Methods Fifty adolescents aged 15-19 years, with body mass index at least 95th percentile, consisting of 25 patients without NAFLD and 25 with NAFLD. The NAFLD diagnosis was determined by ultrasonography. Blood samples were collected to analyze glycemia, hepatic transaminases, and lipid profile. Insulin resistance was estimated by Homeostasis Model Assessment Insulin Resistance Index. Neuropeptide Y (NPY) and agouti related protein concentrations were measured by enzyme-linked immunosorbent assay. Analyses of food intake were made by 3 days recordatory inquiry. Results At baseline conditions, the patients with NAFLD had significantly higher values of body mass, body mass index, visceral fat, triglycerides, VLDL-C, and hepatic transaminases. After the long-term intervention, they presented a significant reduction in these parameters. In both the groups, it was observed a significant decrease in energy intake, macronutrients and dietetic cholesterol. Only the patients with NAFLD presented a positive correlation between the saturated fatty acids intake and the orexigenic neuropeptides NPY and agouti related protein, and carbohydrate with NPY. Indeed, it was observed a positive correlation between energy intake, lipid (%) and saturated fatty acids with visceral fat accumulation. Conclusion Our findings showed an important influence of diet composition in the orexigenic system, being essential consider that the excessive saturated fatty acids intake could be a determinant factor to increase nonalcoholic fatty liver disease. Eur J Gastroenterol Hepatol 22:557-563 (C) 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Inflammation and Overweight in Peritoneal Dialysis: Is There an Association?

More than 30% of the patients on peritoneal dialysis show chronic systemic inflammatory activity with high levels of C-reactive protein. The purpose of this cross-sectional study was to investigate the influence of the inflammatory state on clinical and nutritional markers in patients on peritoneal dialysis. Twenty-seven patients were included: mean age was 57.6 +/- 19 years, 48% were male, and median time on peritoneal dialysis was 16.0 (8.3; 35.8) months. Clinical, dialytic, laboratory, anthropometric and electric bioimpedance data were collected with the sample stratified for C-reactive protein. In patients, the levels of Interleukin-6 and tumor necrosis factor-a were higher, while adiponectin levels were lower than in healthy individuals (p <= 0.001), indicating the presence of inflammatory activity in the sample. When compared to patients with C-reactive protein < 1 mg/dL, those with = 1mg/dL showed higher body mass index (29.4 +/- 6.1 vs. 24.4 +/- 4.5 kg/m(2); p = 0.009), percent of standard body weight (124.5 +/- 25.4 vs. 106.8 +/- 17.9 %; p = 0.012), and percent of body fat as assessed by both anthropometry (31.3 +/- 9.9 vs. 23.9 +/- 9.1%; p = 0.056) and bioimpedance (38.9 +/- 6.3 vs. 26.2 +/- 12.6 %; p < 0.001). Patients with C-reactive protein = 1mg/dL also exhibited higher levels of ferritin (701 +/- 568 vs. 532 +/- 356 ng/mL; p = 0.054) and lower total lymphocyte count (median 1838 vs. 1638 mm(3); p = 0.001). In conclusion, higher body mass index and body fat markers were associated with C-reactive protein = 1mg/dL, and higher C-reactive protein was associated with immunocompetence impairment evidenced by the lower total lymphocyte count. Our findings confirm the relationship between inflammation, body fat, and immunocompetence, which may be superimposed potentializing the inflammatory status.

Prevalence and risk factors of metabolic syndrome in Brazilian and Italian obese adolescents: a comparison study

Background: Metabolic syndrome (MS) prevalence between different populations in obese adolescents is scanty to date. Objective: To compare the MS prevalence and related risk factors in Brazilian and Italian obese adolescents. Methods: A total of 509 adolescents (110 Brazilian, 399 Italian), aged 15-19 years. Anthropometric characteristics, triglycerides (TG), total, low-density lipoprotein (LDL)-, high-density lipoprotein (HDL)-cholesterol, fasting plasma glucose (FPG), insulin, homeostasis model assessment of insulin resistance (HOMA-IR) and blood pressure were measured. Results: Age, body mass index (BMI) and BMI z-score were not significantly different between the two subgroups. BMI z-score, TG, FPG, HOMA-IR and systolic blood pressure (SBP) were significantly higher in boys than in girls both in Brazilian and Italian adolescents, while HDL-cholesterol levels were lower in boys than in girls. No significant differences were observed in BMI, LDL and total-cholesterol and DBP in two genders and groups. Insulin, FPG, HOMA-IR and TG were significantly higher, while LDL-cholesterol and SBP were significantly lower in Brazilian than in Italian subjects, both in males and females. HDL and total-cholesterol and diastolic blood pressure (DBP) were not significantly different between the two subgroups and genders. MS prevalence was higher in Brazilian than in Italian obese boys (34.8 vs. 23.6%, p < 0.001) and girls (15.6 vs. 12.5%, p < 0.01). The most frequently altered parameter was HOMA-IR both in subjects with MS (100% in Brazilian and 81.8% in Italian) and without MS (42.9% and 11.7%). Conclusion: Metabolic syndrome represents a worldwide emerging health problem in different ethnical populations, the alterations of the risk factors related to MS (different in their prevalence between different subgroups) being strictly linked to the degree of obesity.

The Developing Left Superior Cervical Ganglion of Pacas (Agouti Paca)

In this study the main question investigated was the number and size of both binucleate and mononucleate superior cervical ganglion (SCG) neurons and, whether post-natal development would affect these parameters. Twenty left SCGs from 20 male pacas were used. Four different ages were investigated, that is newborn (4 days), young (45 days), adult (2 years), and aged animals (7 years). By using design-based stereo-logical methods, that is the Cavalieri principle and a physical disector combined with serial sectioning, the total volume of ganglion and total number of mononucleate and binucleate neurons were estimated. Furthermore, the mean perikaryal (somal) volume of mononucleate and binucleate neurons was estimated using the vertical nucleator. The main findings of this study were a 154% increase in the SCG volume, a 95% increase in the total number of mononucleate SCG neurons and a 50% increase in the total volume of SCG neurons. In conclusion, apart from neuron number, different adaptive mechanisms may coexist in the autonomic nervous system to guarantee a functional homeostasis during ageing, which is not always associated with neuron losses. Anat Rec, 292:966-975, 2009. (C) 2009 Wiley-Liss, Inc.

Relating body mass index to figural stimuli: population-based normative data for Caucasians

OBJECTIVE: To establish body mass index (BMI) norms for standard figural stimuli using a large Caucasian population-based sample. In addition, we sought to determine the effectiveness of the figural stimuli to identify individuals as obese or thin. DESIGN: All Caucasian twins born in Virginia between 1915 and 1971 were identified by public birth record. In addition, 3347 individual twins responded to a letter published in the newsletter of the American Association of Retired Persons (AARP). All adult twins (aged 18 and over) from both of these sources and their family members were mailed a 16 page 'Health and Lifestyle' questionnaire. SUBJECTS: BMI and silhouette data were available on 16 728 females and 11 366 males ranging in age from 18- 100. MEASUREMENTS: Self-report information on height-weight, current body size, desired body size and a discrepancy score using standard figural stimuli. RESULTS: Gender- and age-specific norms are presented linking BMI to each of the figural stimuli. Additional norms for desired body size and discrepancy scores are also presented. Receiver operating curves (ROC) indicate that the figural stimuli are effective in classifying individuals as obese or thin. CONCLUSIONS: With the establishment of these norms, the silhouettes used in standard body image assessment can now be linked to BMI. Differences were observed between women and men in terms of desired body size and discrepancy scores, with women preferring smaller sizes. The figural stimuli are a robust technique for classifying individuals as obese or thin.

Melanoma in adolescents: A case-control study of risk factors in Queensland, Australia

The incidence of melanoma increases markedly in the second decade of life but almost nothing is known of the causes of melanoma in this age group. We report on the first population-based case-control study of risk factors for melanoma in adolescents (15-19 years). Data were collected through personal interviews with cases, controls and parents. A single examiner conducted full-body nevus counts and blood samples were collected from cases for analysis of the CDKN2A melanoma predisposition gene. A total of 201 (80%) of the 250 adolescents with melanoma diagnosed between 1987 and 1994 and registered with the Queensland Cancer Registry and 205 (79%) of 258 age-, gender- and location-matched controls who were contacted agreed to participate. The strongest risk factor associated with melanoma in adolescents in a multivariate model was the presence of more than 100 nevi 2 mm or more in diameter (odds ratio [OR] = 46.5, 95% confidence interval [Cl] = 11.4-190.8). Other risk factors were red hair (OR = 5.4, 95%Cl = 1.0-28.4); blue eyes (OR = 4.5, 95%Cl = 1.5- 13.6); inability to tan after prolonged sun exposure (OR = 4.7, 95%Cl = 0.9-24.6); heavy facial freckling (OR = 3.2, 95% Cl = 0.9-12.3); and family history of melanoma (OR = 4.0, 95%Cl = 0.8-18.9). Only 2 of 147 cases tested had germline variants or mutations in CDKN2A. There was no association with sunscreen use overall, however, never/rare use of sunscreen at home under the age of 5 years was associated with increased risk (OR = 2.2, 95%Cl = 0.7-7.1). There was no difference between cases and controls in cumulative sun exposure in this high-exposure environment. Factors indicating genetic susceptibility to melanoma, in particular, the propensity to develop nevi and freckles, red hair, blue eyes, inability to tan and a family history of the disease are the primary determinants of melanoma among adolescents in this high solar radiation environment. Lack of association with reported sun exposure is consistent with the high genetic susceptibility in this group. (C) 2002 Wiley-Liss, Inc.

A curious experiment: the paradigm switch from observation and speculation to experimentation, in the understanding of neuromuscular function and disease

The four-link chain of the motor unit represents the contemporary end-point of some two millennia of evolving knowledge in neuroscience. The paradigm shift in neuromuscular epistemology occurred in the mid-17th century. In 1666, the newly graduated Dutch doctor, Jan Swammerdam (1637-1680) published his former investigations of dissected nerve-muscle preparations. These experiments comprised the quantum leap from observation and speculation, to that of experimentation in the field of neuroanatomy and neurophysiology. In what he termed 'A Curious Experiment' he also described the phenomenon of intrinsic muscle excitability - I cannot observe that the muscle in the living animal ever absolutely ceases from all motion. Eighty years later (1752), von Haller demonstrated experimentally that irritability (contractility) was an intrinsic property of all muscular tissue; and distinguished between the sensibility of nerve impulses and the irritability of muscular contraction. This experimental progression from Swammerdam to von Haller culminated in 1850, when Claude Bernard's studies in experimental pharmacology confirmed that muscle was a functional unit, independent of any electrical innervation via its supplying nerve. This account comprises an audit of Swammerdam's work in the perspective of neuromuscular knowledge. (C) 2002 Elsevier Science B.V. All rights reserved.

Idades e crescimento da cioba, Ocyururs chrysurus, da Costa Central do Brasil

A idade e o crescimento da cioba da costa central do Brasil foram estudados a partir de leituras de ot��litos obtidos em amostragens mensais de desembarques comerciais, realizados nas cidades de Vit��ria e Vila Velha, entre os anos de 1998 e 1999. Atrav��s da an��lise do incremento marginal, foi verificada a forma����o anual de uma zona transl��cida a partir do final do outono e durante o inverno. Foram observadas ciobas de 2 a 19 anos. Os comprimentos furcais (CF) m��dios retrocalculados variaram de 108 mm para idade 1 a 524 mm para idade 19. A equa����o de Von Bertalanffy ajustada aos CF m��dios retrocalculados foi CFt = 567,1 (1 - e -0.130 (t + 0.773)). A rela����o comprimento peso foi P = 2,68x10-5CF2.914, onde P = peso total em gramas. O crescimento �� lento, com os incrementos anuais em peso aumentando gradativamente at�� atingir o m��ximo de 164 g entre as idades 7 e 8 anos. Os resultados deste trabalho indicam que a cioba tem longa expectativa de vida e baixas taxas de crescimento som��tico, caracter��sticas das esp��cies mais sens��veis �� explora����o pesqueira.

Concilia����o entre forma����o esportiva e forma����o escolar : um estudo das sele����es brasileiras masculinas de basquetebol de base

A pesquisa se caracteriza pela abordagem plurimetodol��gica do tipo qualitativa/quantitativa, e tem como objetivo investigar de que maneira se constroem as estrat��gias de concilia����o entre a forma����o esportiva e escolar em atletas de elite que servem ��s sele����es brasileiras masculinas de basquetebol Sub 17 e Sub 19. O estudo se organizou em tr��s cap��tulos. Do tipo ���estado do conhecimento���, o primeiro cap��tulo tem por objetivo mapear as produ����es acad��micas que tratam da concilia����o entre forma����o escolar e forma����o esportiva. Utiliza como fonte a base de dados Scielo para busca nacional e o Portal Peri��dicos Capes para busca internacional. Foram encontrados 17 artigos distribu��dos em 13 peri��dicos. Os dados foram classificados/analisados por meio de indicadores bibliom��tricos, como distribui����o anual, distribui����o por revista, rela����o autoral e origem demogr��fica. Para an��lise tamb��m foram levados em considera����o uma tese de doutorado, tr��s disserta����es de mestrado e tr��s trabalhos apresentados em congresso, al��m de um n��mero especial de peri��dico, n��o localizado nas bases escolhidas. Mostra que a preocupa����o com o tema surge na Europa e nos Estados Unidos, na d��cada de 70, e que, no Brasil, essa quest��o passa a ser abordada nos anos 2000. Demonstra tentativas de concilia����o entre as forma����es realizadas em pa��ses da Europa, Estados Unidos e Brasil, al��m da import��ncia da fam��lia e do pertencimento de classes sociais na possibilidade de prioriza����o a uma das forma����es envolvidas. O segundo cap��tulo, de natureza quali-quantitativa, investiga as estrat��gias utilizadas pelos atletas convocados em 2013 para as sele����es brasileiras de basquetebol masculinas de base Sub 17 e Sub 19 anos, quanto ��s poss��veis concilia����es entre forma����o esportiva e escolar. Busca, ainda, compreender a influ��ncia das convoca����es para as sele����es nacionais nos ��ndices de escolaridade desses atletas de elite, como abandono, atraso e repet��ncia escolar. A pesquisa mostra que esse grupo de atletas de elite apresenta m��dias de repet��ncia, abandono e atraso escolar maiores que as m��dias nacionais. O terceiro cap��tulo analisa o entendimento desse grupo de jovens atletas em rela����o �� forma����o escolar ou, ainda, se um poss��vel desinteresse do grupo pelo modelo atual de escola se daria apenas pelo fato de serem esportistas de elite. Para isso, recorre ��s possibilidades de investiga����o oriundas da segunda metade do question��rio utilizado como instrumento para adotar uma metodologia de livre associa����o de palavras direcionadas a partir de quatro palavras indutoras (estruturas sem��nticas), a saber: ���treinar���, ���estudar���, ���ir a escola��� e ���competir���. Essa associa����o livre �� usualmente utilizada como suporte te��rico/metodol��gico em pesquisas que investigam representa����o social (ACOSTA, 2005). Ao dar visibilidade a essas quest��es nota-se que a posi����o desses atletas, em rela����o �� escola, n��o difere das encontradas em outras pesquisas que tratam de jovens inseridos no ensino m��dio. A falta de significado do que se aprende na escola em rela����o ao que eles desejam desenvolver como atividade laboral, faz com que a escola seja entendida como mon��tona, mas, ao mesmo tempo, necess��ria, caso seus projetos de forma����o esportiva n��o aconte��am.

Detec����o e caracteriza����o de patotipos diarreiog��nicos de Escherichia coli por m��todos fenot��picos e genot��picos em indiv��duos de todas as idades atendidos nas unidades de sa��de de Vit��ria-ES

A diarreia �� a segunda causa de mortalidade em <5 anos e �� respons��vel pela diminui����o da produtividade na popula����o economicamente ativa. Dentre os agentes infecciosos envolvidos, seis patotipos diarreiog��nicos de Escherichia coli (DEC) merecem destaque: E. coli enteropatog��nica (EPEC), E.coli enteroinvasora (EIEC), E. coli enterotoxig��nica (ETEC), E. coli enteroemorr��gica ou produtora de toxina de Shiga (EHEC/STEC), E. coli enteroagregativa (EAEC) e E. coli de ader��ncia difusa (DAEC). O objetivo deste estudo foi determinar a frequ��ncia dos patotipos de DEC e caracterizar fenot��pica e genotipicamente EAEC, DAEC, aEPEC e E. coli chain-like adhesion (CLA) isolados de fezes indiv��duos de todas as idades atendidos nas Unidades de Sa��de do munic��pio de Vit��ria, ES, entre janeiro de 2008 e junho de 2011. Os isolados de E. coli foram submetidos ��: (i) PCR para detec����o dos genes eae, bfpA, aat, lt, st, ipaH, stx1 e stx2; (ii) hibridiza����o de col��nia com as sondas eae, aat e daaC; (iii) ades��o em cultura de c��lulas HEp-2 para evidenciar padr��o de ader��ncia agregativa (AA), difusa (DA) e chain-like adhesion (CLA). PCR para detec����o de genes de virul��ncia foi realizado em isolados de EAEC, CLA, DAEC e aEPEC. Isolados de EAEC e CLA, foram submetidos a testes de forma����o de biofilme e de pel��cula. Foram obtidos 328 esp��cimes fecais e E. coli foi isolada de 85,7%. Os seguintes patotipos foram identificados: EAEC (18,3%), DAEC (11%), aEPEC (2,6%), ETEC (0,7%). CLA foi identificada em 4,9% e EIEC, tEPEC e STEC n��o foram detectados. Dos 60 isolados de EAEC (AA) (25% aat+ por PCR e 35% por hibridiza����o), f��mbrias de ader��ncia agregativa foram evidenciadas em baixa frequ��ncia (aggA- 1,7%, aafA- 0%, agg3A- 11,7%, hdA- 8,3%). EAEC t��pica correspondeu a 31,7% dos isolados de EAEC (aggR+), e foram significantes nestas a forma����o de biofilme, escore 3+ de produ����o de pel��cula e presen��a dos genes aat, agg3A, hdA, aap, sat, pet, set1A e iucA. Todos os isolados CLA apresentaram o gene pet, 87,5%, foram aggR-, formaram pel��cula e nenhum produziu biofilme. Dentre dos 42 isolados de DAEC (DA), a sonda daaC detectou 52,4%. PCR evidenciou adesinas afa/Dr (daaD e afa) em 59,5% e adesina AIDA-I n��o foi encontrada, sugerindo que outras adesinas estejam envolvidas na ades��o da DAEC. Isolados de DAEC afa/Dr + foram estatisticamente mais isolados de <5 anos. Em aEPEC, os genes da ilha de patogenicidade OI-122 pesquisados, nleE, efa1/lifA e paa foram evidenciados em 30% dos isolados, todos provenientes de <5 anos. Caracter��sticas de virul��ncia de tEAEC e DAEC Afa/Dr sugerem que sejam subpopula����es relacionadas com diarreia. CLA n��o parece ser variante de EAEC.

Occupational accidents among middle and high school students of the state of S��o Paulo, Brazil

OBJECTIVES: To estimate the prevalence of occupational injuries and identify their risk factors among students in two municipalities. METHODS: A cross-sectional survey was conducted in public schools of the municipalities of Santo Antonio do Pinhal and Monteiro Lobato, Brazil. A stratified probabilistic sample was drawn from public middle and high schools of the study municipalities. A total of 781 students aged 11 to 19 years participated in the study. Students attending middle and high school answered a comprehensive questionnaire on living and working conditions, as well as aspects of work injuries, and health conditions. Multiple logistic regression models were fitted to estimate risk factors of previous and present occupational injuries. RESULTS: Of 781 students, 604 previously had or currently have jobs and 47% reported previous injuries. Among current workers (n=555), 38% reported injuries on their current job. Risk factors for work injuries with statistically significant odds ratio >2.0 included attending evening school, working as a housekeeper, waiter or brickmaker, and with potentially dangerous machines. CONCLUSIONS: The study results reinforce the need of restricting adolescent work and support communities to implement social promotion programs.

Intergenerational interaction in health promotion: a qualitative study in Brazil

OBJECTIVE: In 1994 a pilot intergenerational project was started in the city of Taguatinga, Brazil, to promote the well-being of both elderly and adolescent populations using reminiscence processes as a means of interaction. The purpose of the study is to evaluate the project from the participants' viewpoint and to improve the contribution of those age groups in building up social capital. METHODS: From November 1999 to April 2000 a qualitative study using focus groups technique was conducted. Using a discussion guide, 9 groups of students, ranging in age from 13 to 19 years old, and 3 groups of elderly aged 60 years and over were interviewed to collect data regarding their interaction before and after an intergenerational program. RESULTS: The main findings suggested a change in attitude of young people toward old age and elderly people. Participating elderly people reported improvement in their health status. For both age groups the findings suggested a better understanding between generations. CONCLUSIONS: It seems that reminiscence intergenerational activity contributes to building up mutual trust and reciprocity. These results seem to indicate this is an alternative for investing in social capital and improving participants' well-being. However, further work is needed to support these findings.

Plataforma de gest��o de incidentes

Mestrado em Engenharia Electrot��cnica e de Computadores. ��rea de Especializa����o de Telecomunica����es.