Altered Body Mass Index Research Articles

Caffeic Acid, Chlorogenic Acid, Garlic Acid, and Protocatechuic Acid as Hypolipidemic Agents

As the pathophysiology of dyslipidemias is clarified, one system is likely to emerge in which the underlying mechanism explains the phenotypic pattern observed on lipoprotein analysis. Every day, millions of vials of blood are drawn to assess patients’ risk for the disease. These tests measure three biomarkers, or factors in the blood known to be associated with CAD: low-density lipoproteins (LDL cholesterol), high-density lipoproteins (HDL cholesterol), and triglycerides. All three biomarkers are lipids – water-insoluble molecules that are among the structural and functional building blocks of living cells. Highly altered Body Mass Index (BMI) and hypertension are independent and reversible determinants for coronary artery disease. Hypolipidemia can prevent hyperlipidemic patients to be victim of coronary artery disease. This study was conducted to compare hypolipidemic effects of Niacin and Jujube fruit in primary as well as secondary hyperlipidemic patients. Study was conducted in 2023 at Jinnah Hospital Lahore, Pakistan. Sixty participants were enrolled of both gender male and female hyperlipidemic patients age range from 20 to 70 years. Written and explained consent was taken from all patients. They were divided in two groups. Group-I was advised to take two grams Niacin in divided doses for the period of two months. Group-II was advised to take 500 grams of fruit Jujube daily for the period of two months. Their baseline LDL and HDL cholesterol was determined by conventional method of measuring Lipid Profile. After two months therapy, their post treatment lipid profile was measured and mean values with ± SEM were analyzed biostatistically. Group-I which was on Niacin their LDL cholesterol decreased significantly and HDL cholesterol was increased significantly. In group-II patients LDL cholesterol was decreased significantly but HDL increase was not significant with p-value of >0.05. It was concluded from the research work that Niacin is potent in lowering LDL and increasing HDL cholesterol, while Jujube has significant effect as LDL cholesterol lowering agent, but it does not increase HDL cholesterol significantly.

Health profile of people living in the Gare Palma mining area of Tamnar block, Raigarh, Chhattisgarh, India.

A community-based health survey was conducted in Tamnar block, Raigarh district of Chhattisgarh, India. A total of 909 individuals (adults) were selected from 909 households from 33 sampled villages from March 2019 to February 2020. All individuals were clinically examined, and observations were recorded. Among adults older than 18 years, hypertension was observed in 21.7%. Type II diabetes was observed in only 4.0% of individuals. Tuberculosis was seen in 23 (2.5%) individuals. Common morbidities were similar in tribal and non-tribal communities living in the same area. For communicable diseases, being male, having nutritional deficiencies, and smoking were independent risk factors. For non-communicable diseases, the independent significant risk factors identified were being male, an altered body mass index, disturbed sleep, smoking, and nutritional deficiencies.

A comparative study on the efficacy of pranayama and dietary restriction on altered body mass index and thyroid-stimulating hormone in middle-aged women with subclinical hypothyroidism

Background: Among the various thyroidrelated diseases hypothyroidism, is one of the prevalent thyroid disorders, which is more common in women than in men. The prevalence among the general population ranges between 0.2% and 5.3% in Europe and 0.3% and 3.7% in the USA. Aim and Objectives: Therefore, the current study was designed and carried out to determine the efficacy of yoga on the treatment of subclinical hypothyroidism with reference to lipid profiles of women suffering from hypothyroidism. Materials and Methods: The recruited subjects were randomly assigned into three groups namely: Group 1: Control group (15 patients) did not instruct to follow any intervention; Group 2: Patients were trained and instructed to follow the yogic practice 60 min a day, 6 days/week for 8 weeks; and Group 3: Patients were instructed to follow the dietary restriction for the same 8week period. Body mass index (BMI) of the study subjects and the blood thyroidstimulating hormone (TSH) levels were assessed before and after the intervention periods. Results: The results observed in the current study; it can be concluded that our study findings are in line with the theme that a decrease in the levels of TSH, along BMI with are showing the evidence of decreased severity of hypothyroidism in patients under the interventions with more specific to the yogic intervention than the dietary intervention. Conclusion: It can be concluded that our study findings are in line with the theme that decrease in the BMI along with the levels of TSH are showing the evidence of decreased severity of hypothyroidism in patients under the interventions with more specific to the yogic intervention than the dietary intervention.

P.188 Early growth and metabolic abnormalities in zebrafish and cellular models of SELENON-related myopathy

SELENON-Related Myopathy (SELENON-RM) is a rare genetic disease caused by recessive mutations of the <i>SELENON</i> gene. It is characterized by the development of rigid spine, axial muscle weakness, and respiratory insufficiency. The most common histopathological feature in SELENON-RM patients is the presence of minicores in skeletal muscle biopsies, which are concentrated areas of mitochondrial depletion within fibers. Natural history data suggest that insulin-resistance as well as altered body mass index (BMI) are correlated with SELENON-RM prognosis. There is no cure or effective treatment for SELENON-RM. The <i>SELENON</i> gene encodes selenoprotein-N, an endoplasmic reticulum (ER) membrane glycoprotein with reducing catalytic activity. Selenoprotein-N has been shown to activate SERCA channels by reducing it at low Ca²⁺ concentrations in the ER. Additionally, it has also been shown to colocalize with Mitochondrial Associated Membranes (MAM), which are vital for mitochondrial function. However, the molecular mechanism(s) by which selenoprotein-N deficiency causes SELENON-RM is still unclear. A particular challenge has been the lack of cellular or animal models that exhibit readily assayable phenotypes. In this project, we aim to identify cellular and animal models suited for high throughput drug screening while elucidating the molecular mechanism of the disease. To do so, we tested selenoprotein-N deficient cells and zebrafish selenon-null models. Using different measures of metabolism, we found that Selenon-KO C2C12 cells and primary myoblasts isolated from Selenon-KO mice were metabolically impaired. We also assessed several phenotyping outcomes in zebrafish models, from embryonic development to adulthood. Our results showed muscle weakness during early development as well as reduced growth during the larval stage. Together, these data establish the potential for selenoprotein-N deficient cells and zebrafish as models for the discovery of therapeutic targets for SELENON-RM.

Erratum: Correction of Figures. Association between the Blautia/Bacteroides Ratio and Altered Body Mass Index after Bariatric Surgery

Erratum: Correction of Figures. Association between the Blautia/Bacteroides Ratio and Altered Body Mass Index after Bariatric Surgery

Механізми ремоделювання кісткової тканини у осіб молодого віку з остеоартритом, що протікає на фоні ожиріння

The purpose of the study was to determine the content of osteoprotegerin in the blood serum of patients with osteoarthritis, based on the stage of obesity and the state of bone mineral density. Materials and methods. Under surveillance there were 75 patients with osteoarthritis, which proceeded against the background of an altered body mass index. The comparison group consisted of 50 patients with osteoarthritis and normal body weight. The age of patients in both groups was comparable, and gender balance was observed between groups. The osteoprotegerin index (pg/ml) was studied in fasting blood serum by enzyme immunoassay (ELISA) using of the FineTest EH0247 reagents, China. The prevalence of osteoporotic conditions was assessed using dual-energy x-ray absorptiometry (DEXA), HOLOGIC Explorer QDR W Series Bone Densitometer (USA). Statistical analysis was performed using the software package Statistics 10.0 and Excel 2010. Cardinal and ordinal changes were compared using the Mann-Whitney test. Correlation was calculated using Spearman's rank correlations. In all statistical analysis procedures, the level of significance p was taken equal to or less than 0.05 (p &lt;0.05). Based on body mass index, all patients in the main group were divided into 3 subgroups. Thus, changes in body weight were recorded in 75 patients with osteoarthritis (main group). 1st stage of obesity was found in 31 patients (42%); 2nd – 22 patients (29%) and 22 patients (29%) with osteoarthritis were overweight. Results and discussion. When studying the content of osteoprotegerin in the examined patients, it was found that both in the isolated course of osteoarthritis (92.29±1.68 pg/ml) and in its combination with obesity (124.03±3.2 pg/ml), there was an increase in this indicator when compared with the results of patients in the control group (65.64±0.64, p &lt;0.05). In order to study the state of bone mineral density in patients with osteoarthritis, a densitometric study was performed using double energy X-ray absorptiometry – DEHA (device "Expert 1188", Lunar, USA), which allowed to diagnose osteoporotic conditions. Thus, signs of osteopenia were found in 11 patients (15%) of the main and 8 people (16%) of the comparison group. Manifestations of osteoporosis were found in 18 (24%) and 5 people (10%), respectively. In patients of the main group with osteopenia, the content of osteoprotegerin in the blood serum corresponded to 108.43±0.48 pg/ml, in the comparison group – 84.86±0.87 pg/ml. With the development of osteoporosis, this value exceeded the control values, however, it was somewhat lower than with osteopenia: 99.94±1.1 and 73.57±1.66 pg/ml, respectively. Conclusion. The course of osteoarthritis is accompanied by an increase in the production of osteoprotegerin, which indicates a violation of bone tissue remodeling through increased processes of its resorption. The level of blood serum osteoprotegerin in patients with osteoarthritis has a significant increase with weight gain and its maximum value is observed in patients with 2nd stage of obesity. In patients with osteoarthritis, the formation of osteoporotic conditions (osteopenia or osteoporosis) is observed, one of the markers of which can be considered an increase in the content of osteoprotogerin glycoprotein – cytokine, which is characterized by inhibition of osteoclast production

Association between the Blautia/Bacteroides Ratio and Altered Body Mass Index after Bariatric Surgery.

BackgroundCurrent evidence support that the gut microbiota plays a potential role in obesity. Bariatric surgery can reduce excess weight and decrease the risk of life-threatening weight-related health problems and may also influence gut microbiota. In this study, we aimed to investigate the changes in gut microbiota before and after bariatric surgery and evaluate the association of the gut microbial shift and altered body mass index (BMI) after bariatric surgery.MethodsBetween January 2019 and July 2020, stools from 58 patients scheduled for bariatric surgery were collected. Six months after bariatric surgery, stools from 22 of these patients were re-collected, and the changes in gut microbiota before and after bariatric surgery were evaluated. In addition, the differences in gut microbiota between patients with severe obesity (BMI >35 kg/m2, n=42) and healthy volunteers with normal BMI (18.8 to 22.8 kg/m2, n=41) were investigated.ResultsThe gut microbiota of patients who underwent bariatric surgery showed increased α-diversity and differed β-diversity compared with those before surgery. Interestingly, Blautia was decreased and Bacteriodes was increased at the genus level after bariatric surgery. Further, the Blautia/Bacteroides ratio showed a positive correlation with BMI. To validate these results, we compared the gut microbiota from severely obese patients with high BMI with those from healthy volunteers and demonstrated that the Blautia/Bacteroides ratio correlated positively with BMI.ConclusionIn the gut microbial analysis of patients who underwent bariatric surgery, we presented that the Blautia/Bacteroides ratio had changed after bariatric surgery and showed a positive correlation with BMI.

Erectile and sexual dysfunction in male and female patients with celiac disease: A cross-sectional observational study.

IntroductionSexual function is often impaired in patients with chronic illnesses. Several patients with chronic gastrointestinal and liver disorders have been shown to suffer from sexual dysfunction, and celiac disease is a highly prevalent gastroenterological disorder.AimThe aim of this study was to investigate the sexual function incidence and the risk factors for sexual dysfunction in both male and female celiac disease patients.MethodsTwo hundred and eighty‐four patients (170 females, 114 males) participated in this cross‐sectional observational study in an anonymous manner. Female sexual function was assessed through the Female Sexual Function Index questionnaire. Male sexual function was assessed through the International Index of Erectile Function‐5 questionnaire. Clinical‐demographic variables were recorded. We investigated differences in the patient‐reported outcomes among the different subgroups and whether there were clinical‐demographic predictors of sexual dysfunction in our setting.Main outcome measuresPrevalence and assessment of sexual dysfunction in celiac disease patients.ResultsIn the female group, 85 subjects (50%) had a total score compatible with sexual dysfunction: 43 (61.42%) showed low desire, 79 (46.47%) showed arousal disorder, 66 (38.82%) lubrication disorder, and 84 (49.41%) inability of obtaining an orgasm. Also, a large proportion of our female patients, 161 (94.70%), showed sexual discomfort during intercourse. In the male group, 79 patients (62.2%) showed scores compatible with normal erectile function, eight (7.01%) had mild erectile dysfunction, 24 (21.05%) mild to moderate erectile dysfunction, and three (2.63%) presented severe erectile dysfunction. Altered body mass index was significantly associated with sexual dysfunction both in male and female patients. Early age at diagnosis was a significant predictor of sexual dysfunction in male celiac disease patients.ConclusionsA significant proportion of celiac disease patients present sexual dysfunction. Early age at diagnosis and high body mass index seem to predict sexual dysfunction in this clinical setting. Assessment of sexual function should be part of the initial evaluation of celiac disease patients in order to establish a prompt diagnosis and early treatment.

Risk factors associated with hypertension among inmates in southern Brazil

Objective: To identify the association between risk factors for systemic arterial hypertension and blood pressure levels in prisoners under a closed regime. Materials and methods: Cross-sectional study conducted with prisoners under a closed regime between February and September 2019. A total of 240 men from a penitentiary complex in southern Brazil participated in the study. A semi-structured instrument based on the national guidelines for cardiovascular diseases was used for data collection. Results: Univariate analysis allowed us to identify that physical exercise was negatively associated with the development of systemic arterial hypertension (p = 0.034). However, body mass index and abdominal circumference were positively associated with cardiovascular risk and systemic arterial hypertension (p = 0.000). Through multivariate analysis, we noted the statistical significance of the body mass index when controlled for all other variables in the model (adjusted OR = 2.33). Conclusions: Risk factors for the development of systemic arterial hypertension are present in the prison environment to a similar degree as in the general population; particularly the absence ofphysical exercise and altered body mass index and abdominal circumference. It is worth mentioning that the body mass index was the variable of greater statistical significance, since, when altered, it increased 2.33 times the chance of inmates to develop systemic arterial hypertension.

BLOOD PRESSURE VARIABILITY IN TWO CONSECUTIVE BLOOD PRESSURE MEASUREMENTS IN HYPERTENSIVE AND NON-HYPERTENSIVE PATIENTS

Objective: The aim of this study was to compare blood pressure variability (BPV) in two consecutive blood pressure measurements in hypertensive and non-hypertensive patients. Design and method: A total of 92 patients from an outpatient clinic underwent two consecutive blood pressure measurements. The first one was using a calibrated aneroid sphygmomanometer and the second the HBP-1100 automatic blood pressure monitor. Auscultatory measurement was simultaneously performed by two trained observers using a dual-head teaching stethoscope and one supervisor who checked if differences between observers were less than or equal to 4 mmHg. Interval between measurements was at least 30 and at most 60 seconds. Blood pressure variability was defined as the standard deviation around the mean of the two systolic blood pressure (SBP) and diastolic blood pressure (DBP) readings. The paired sample t-test was used to determine whether there is a difference between the mean SBP and DBP variability in two observation sets, defined as hypertensive and non-hypertensive patients. Results: A total population of 92 from an outpatient clinic [66.3% female; mean age: 39.18 years; 32.61% hypertensives] underwent two consecutive blood pressure measurements in different methods. 184 valid blood pressure measurements were performed. Mean auscultatory SBP and DBP was 114.13 ± 17.95/ 69.48 ± 14.08 mmHg, respectively. Using the oscillometric method, mean SBP and DBP was 119.26 ± 16.94/71.89 ± 14.047 mmHg. Mean SBP difference between the two measurements was 5.13 ± 8.57 and 2.402 ± 6.85. SBP variability in hypertensive patients is statistically significantly higher (p = 0.01), whereas for DBP there is no significant difference (p = .0.78). Blood pressure variability in hypertensive patients with altered body mass index (BMI) was not statistically different (p = 0.30 and p = 0.56 for SBP and DBP, respectively). Conclusions: Increased SBP variability between two measurements was identified in hypertensive patients, regardless of BMI. As blood pressure variability is a recognized risk factor for cardiovascular events, its investigation should be included in the management of hypertensive care even in the interval between two blood pressure measurements.

Content Analysis of the Diagnostic Proposition Risk of Excessive Fluid Volume in Hemodialysis Patients.

To analyze the content of the diagnostic proposition risk of excessive fluid volume in patients undergoing hemodialysis. Content validity study, with 48 judges who assessed the content of the diagnostic proposition risk of excessive fluid volume, using an electronic data collection instrument. The judges' answers were analyzed through the calculation of the Content Validity Index and the T test. The risk of excessive fluid volume was considered adequate, containing 23 risk factors: increased sodium concentration in the dialysate; missing hemodialysis sessions; insufficient water; low self-efficacy for fluid restriction; deficient knowledge; altered body mass index; excessive intake of fluids, proteins and sodium; lower kt/v index; inadequate removal of fluids in hemodialysis; thirst; xerostomia; older people; comorbidities; renal function decline; decreased urinary volume; inflammatory status; hospitalization; low serum level of albumin and lymphocytes, and high level of phosphorus; and use of antihypertensive drugs. The content of the diagnostic proposition risk of excessive fluid volume was considered adequate by the judges.

Riesgo cardiovascular y factores asociados en docentes de una institución universitaria

ObjectiveThe aim of this study was to identify the factors associated with cardiovascular risk in teachers in a private university in Colombia. Materials and methodsWe performed a descriptive cross-sectional study with an analytical phase. Probabilistic sampling was performed by proportional fixation with 104 full-time teachers who met the inclusion criteria. ResultsThere were 55 women (52.9%) and 49 men (47.1%). A statistically significant relationship was found with age (p=.001) with an OR 0.351, and with body mass index (p=.000) with an OR 6.071, establishing that altered body mass index conferred a 6-fold increased risk of cardiovascular disease. ConclusionBody mass index is a constant variable in terms of the relationship with the occurrence of cardiovascular disease, which reflects individuals’ lifestyle.

A prática de atividade física em pessoas com Diabetes Mellitus tipo 2 – estudo transversal

Objetivou-se identificar a associação entre características sociodemográficas e clínicas com a prática de atividade física em momentos de lazer de pessoas com Diabetes Mellitus Tipo 2. Estudo transversal, quantitativo, realizado com pessoas com Diabetes Mellitus Tipo 2, cadastradas junto a Equipes de Estratégia da Saúde da Família de um município de Minas Gerais. Realizou-se entrevista e avaliação clínica entre fevereiro e novembro de 2017, aplicando-se instrumento elaborado pelos autores. Para análise dos dados autorreferidos utilizou-se estatística descritiva e regressão logística, com nível de significância de 5% (α = 0,05). Participaram 558 pessoas, predominando: mulheres (66,8%), ≥ 60 anos (66,3%), tempo de doença &lt;10 anos (63,8%), Índice de Massa Corpórea alterado (69,2%) e prática de atividade física reduzida (73,1%). Identificou-se associação entre menor prática de atividade física e sexo, renda, glicemia e comorbidades. Conclui-se que existe associação entre características sociodemográficas, condições clínicas dos participantes com a menor prática de atividade física.

Evaluation of cardiovascular risk factors in people living with HIV in São Paulo, Brazil.

HIV infection as a chronic disease has emerged from treatment advances over the past three decades. From this perspective, the diseases associated with AIDS are not a main threat for patients who use Antiretroviral Therapy (ART). A new set of HIV associated complications have emerged resulting in comorbidities related to aging and ART exposure as cardiovascular disease (CVD). This study aimed to evaluate the cardiovascular risk factors in people living with HIV (PLWH) in Brazil. This was a cross-sectional study carried out at all Specialized Care Services for people living with HIV in the Southeast of Brazil. A sociodemographic and clinical questionnaire was used and cardiovascular risk assessed through the Framingham Score. Data analysis was performed by Chi-square, Fisher's exact test and logistic regression. The majority were male, over 40 years old and they showed a mean age of 44 years. Current hypertension, diabetes, altered body mass index, presence of metabolic syndrome and altered abdominal circumference were also associated with cardiovascular risk. After regression analysis, male sex, older age, smoking, diabetes, hypertension and metabolic syndrome were related as predictive factors for a higher cardiovascular risk. The results demonstrate that combination of the prevention of modifiable risk factors with considerable changes in lifestyle are determining factors for success in the therapeutic of PLWH. High levels of motivation are essential for behavioral changes, and nurses are ideally position to provide safe care with nonpharmacological strategies for CVD risk reduction.

Caracterización de la exposición prenatal de un grupo de niños de 0 a 5 años con cardiopatía congénita atendidos en Cali, Colombia. La importancia del ácido fólico

Introducción. Con una prevalencia estimada de 4 a 9 casos por cada 1 000 nacimientos, las cardiopatías congénitas (CC) tienen gran impacto en la morbimortalidad pediátrica. La variabilidad de prevalencia se ha atribuido a diferencias regionales en cuanto a factores genéticos, ambientales, entre otros.Objetivo. Obtener datos sobre variables de exposición prenatales de pacientes con CC atendidos en Cali, Colombia.Materiales y métodos. Se aplicó una encuesta a las madres de 30 pacientes de 0 a 5 años con CC atendidos en 2 clínicas de alta complejidad (tercer y cuarto nivel) de Cali. La encuesta estaba orientada a múltiples variables de exposición y la información recolectada fue digitalizada en una base de datos en el programa Microsoft Excel para hacer un análisis estadístico descriptivo.Resultados. Se evidenciaron varias exposiciones potencialmente asociadas a CC, tales como índice de masa corporal alterado, administración inadecuada de suplementos de ácido fólico y exposición a vitamina A, rayos X, alcohol y cigarrillo.Conclusión. El consumo insuficiente o inoportuno de ácido fólico podría facilitar la generación de efectos teratogénicos de sustancias oxidantes. Por lo tanto, se debe educar a las mujeres de Cali sobre la importancia de una ingesta adecuada de ácido fólico y sobre los riesgos de la exposición a agentes teratogénicos durante el embarazo para reducir las tasas de incidencia de CC en esta ciudad.

Risk assessment for perioperative pressure injuries.

ABSTRACTObjectives:to evaluate and classify patients according to the Risk Assessment Scale for Perioperative Pressure Injuries; verify the association between sociodemographic and clinical variables and the risk score; and identify the occurrence of pressure injuries due to surgical positioning. Method:observational, longitudinal, prospective and quantitative study carried out in a teaching hospital with 278 patients submitted to elective surgeries. A sociodemographic and clinical characterization questionnaire and the Risk Assessment Scale for Perioperative Pressure Injuries were used. Descriptive, bivariate and logistic regression analyses were applied. Results:the majority of patients (56.5%) presented a high risk for perioperative pressure injury. Female sex, elderly group, and altered body mass index values were statistically significant (p < 0.05) for a higher risk of pressure injuries. In 77% of the patients, there were perioperative pressure injuries. Conclusion:most of the participants presented a high risk for development of perioperative decubitus ulcers. The female sex, elderly group, and altered body mass index were significant factors for increased risk. The Risk Assessment Scale for Perioperative Pressure Injuries allows the early identification of risk of injury, subsidizing the adoption of preventive strategies to ensure the quality of perioperative care.

Low Adherence To Nutritional Recommendations In Patients With Cirrhosis: A Prospective Observational Study

AIM: The aim of the study was to evaluate patients’ adherence to the current nutritional recommendations adapted to the individual clinical status. MATERIALS AND METHODS: 192 outpatients with cirrhosis were prospectively evaluated. 161 were considered at risk of impaired nutrition as they present at least one of the following factors: altered body mass index score, non-volitional body weight changes, ascites, peripheral edema, hepatic encephalopathy, or diabetes.Patients at risk were offered a nutritional assessment by a nutritionist, including a 3-days food diary and hand-grip strength (HGS) test. Only 78 patients returned the diaries properly filled in. RESULTS: The analysis of food diaries showed a low-level adherence to the nutritional recommendations: caloric intake was insufficient, in excess or adequate in 75%, 13% and 12% of cases, respectively. An appropriate consumption of carbohydrates, protein and fibers was found only in 10-15% of cases, while the intake of simple sugars, lipids, and water resulted adequate in up to 55%. The protein intake was more frequently insufficient in patients with more advanced disease. HGS test was altered in 49% of patients. 27 subjects (17%) refused the nutritional assessment: these patients presented a significantly less severe disease and a lower number of risk factors. CONCLUSIONS: Patients with cirrhosis have inadequate nutritional intake and poor adherence to the recommendations provided during the normal path of care. Therefore, a multidisciplinary approach with a nutritionist should be recommended, starting in the early stage of the disease when the awareness of patients regarding the importance of nutrition appears to be lower.

Impact of continuous low-dose antibiotic prophylaxis on growth in children with vesicoureteral reflux

Continuous antibiotic prophylaxis (CAP) is a mainstay of treatment for children with vesicoureteral reflux (VUR). There has been an increasing focus on the effect of antibiotics on gut microbiota and subsequent repercussions on growth. Continuous antibiotic prophylaxis is generally considered safe; however, its impact on growth in children with VUR remains unknown. This objective of this study was to determine whether CAP altered height, weight, or body mass index (BMI) in children with VUR. Children diagnosed with primary VUR were identified. Demographics including weight and height percentiles, BMI and BMI percentiles, age, gender, antibiotic class, prior antibiotic use, urinary tract infectionhistory, and breakthrough infections were tested in univariate and multivariate analyses. Primary outcome was change in BMIas well as weight, height, and BMI percentiles. One hundred eighty patients (146 girls, 34 boys) were prescribed CAP at mean age of 29.2±26.2 months. Mean follow-up on CAP was 4.1±3.3 years, with median follow-up of 3.08 years. Mean increase in weight percentile was 1.49 (2.02 males, 1.37 females; P=0.46). Mean decrease in height percentile was -4.44 (-2.18 males, -4.95 females; P=0.51). Age at diagnosis (P=0.004) and history of prior treatment courses of antibiotics (P=0.007) were associated with a significant BMI increase (Fig.1). Body mass index percentile increased from 58.4 to 66.5; however, this increase was only significant in children aged above 1 year(P<0.0001). Of note, children above 1 year of age were significantly more likely to have a history of prior treatment courses of antibiotics (58% vs32%; P<0.0001), and when controlling for prior antibiotic use, the increase in BMI percentile in those over 1 year of age did not reach significance. The use of antibiotics has been associated with alterations in pediatric growth parameters in both animal models and clinical studies. However, little information exists on the impact of prophylactic-dosed antibiotics on growth. While this study is limited by the retrospective analysis and small sample size, it was found that the use of CAP did impact growth parameters, with a stronger effect seen in children who had received prior treatment courses of antibiotics before the infection leading to the initiation of CAP. Continuous antibiotic prophylaxis was correlated with significant increase in BMI in children with prior antibiotic usage and a significant increase in BMI percentile in children aged above 1 year. Continuous antibiotic prophylaxis was also associated with decreased height percentiles, particularly in patients aged less than 1 year, though it did not reach statistical significance. Further analysis is needed to investigate whether these effects on weight, height, and BMI are persistent and clinically significant.

Impact of obesity on autoimmune arthritis and its cardiovascular complications.

Obesity can instigate and sustain a systemic low-grade inflammatory environment that can amplify autoimmune disorders and their associated comorbidities. Metabolic changes and inflammatory factors produced by the adipose tissue have been reported to aggravate autoimmunity and predispose the patient to cardiovascular disease (CVD) and metabolic comorbidities. Rheumatoid arthritis (RA) and psoriatic arthritis (PsA) are autoimmune arthritic diseases, often linked with altered body mass index (BMI). Severe joint inflammation and bone destruction have a debilitating impact on the patient's life; there is also a staggering risk of cardiovascular morbidity and mortality. Furthermore, these patients are at risk of developing metabolic symptoms, including insulin resistance resulting in type 2 diabetes mellitus (T2DM). In addition, arthritis severity, progression and response to therapy can be markedly affected by the patient's BMI. Hence, a complex integrative pathogenesis interconnects autoimmunity with metabolic and cardiovascular disorders. This review aims to shed light on the network that connects obesity with RA, PsA, systemic lupus erythematosus and Sjӧgren's syndrome. We have focused on clarifying the mechanism by which obesity affects different cell types, inflammatory factors and traditional therapies in these autoimmune disorders. We conclude that to further optimize arthritis therapy and to prevent CVD, it is imperative to uncover the intricate relation between obesity and arthritis pathology.

Síndrome metabólico, hipotiroidismo y riesgo cardiovascular en licenciadas y auxiliares de enfermería, Hospital Escuela Universitario octubre-noviembre 2016

Background and objectiveThyroid dysfunction in the population has significant consequences for numerous health problems, including cardiovascular diseases and metabolic syndrome. The objective of this study was to analyse the relationship between cardiovascular risk, hypothyroidism, and metabolic syndrome in nurses of the Hospital Escuela Universitario from October to November 2016. Patients and methodsA descriptive, cross-sectional study was conducted on a stratified sample consisting of 150 auxiliary nurses and 50 registered nurses, all females. The interview technique was used in the data collection process, using a questionnaire consisting of 20 closed questions. The results were tabulated using the statistical software EPI-INFO version 7.2.0.1 and Microsoft Office Excel 2013. Univariate and bivariate analyses were performed. ResultsThe study showed that 94 (47%) had neither non-metabolic syndrome nor sub-clinical hypothyroidism. The metabolic syndrome criteria was fulfilled by 82 (41%), 12 (6%) were only diagnosed with subclinical hypothyroidism, and 12 (6%) had both pathologies. The two main criteria for metabolic syndrome fulfilled by the study group were: 159 (79.5%) with central obesity and 151 (75.5%) with an HDL-cholesterol<50mg/dL. The most important metabolic syndrome criteria found in this study group was triglycerides≥150mg/dL, with a score of 16. As regards cardiovascular risk, 194 (97%) nurses had a low risk. ConclusionsMost of the study group had an altered body mass index and some associated dyslipidaemia. The prevalence of sub-clinical hypothyroidism in the nursing staff was similar to that found in other studies, and the prevalence of metabolic syndrome was higher than the reported worldwide (20-25%) and nationally (23%).