World Health Organization Reference Research Articles

Fluoride Exposure and Thyroid Function among Iodine Deficient Adults in Canada

Background: Fluoride exposure has the potential to disrupt thyroid functioning, though adequate iodine intake may mitigate this effect. This study is the first population-based study to examine the impact of chronic low-level fluoride exposure on thyroid function, while considering iodine status.Objective: This study used weighted population-based data from Cycle 3 (2012-2013) of the Canadian Health Measures Survey (CMHS), a cross-sectional survey designed to collect health and wellness data and biological specimens on Canadians.Methods: The weighted sample represented 7,543,966 adults aged 18-79 who were not taking any thyroid-related medication. Urinary fluoride concentrations were measured in spot samples using an ion selective electrode and adjusted for specific gravity (UFSG) and creatinine (UFCR). Serum TSH levels provided a measure of thyroid function. Multivariable regression analyses examined the relationship between adjusted levels of urinary fluoride and TSH, controlling for covariates. We tested whether TSH levels were more strongly related to urinary fluoride levels in adults who were moderately-to-severely iodine deficient than in adults who were iodine sufficient, according to World Health Organization reference standardsResults: The mean (SD) age of the sample was 46.6 (15.8) years and approximately 17.8% fell in the moderately-to-severely iodine deficient range. Median UFSG and UFCR concentrations were 0.74 mg/L and 0.46 mg/g, respectively. Among iodine deficient adults, a 1 mg/L increase in UFSG was associated with a 0.36 mIU/L increase in TSH [95% CI: -0.03, 0.75; p = 0.03], and a 1 mg/g increase in UFCR was associated with a 0.61 mIU/L increase in TSH [95% CI: 0.22, 0.99; p < 0.01].Conclusion: Adults living in Canada who have moderate-to-severe iodine deficiencies and higher levels of urinary fluoride may be at an increased risk for underactive thyroid gland activity.

Prevalence of underweight, overweight and obesity among children and adolescents in Germany. KiGGS Wave 2 results according to international reference systems.

In Germany, the reference system according to Kromeyer-Hauschild is usually used to define underweight, overweight and obesity in children and adolescents. International classification systems to describe prevalence are the reference systems of the World Health Organization (WHO) and the International Obesity Task Force (IOTF). This article reports underweight, overweight and obesity prevalences among children and adolescents according to WHO and IOTF criteria using data from the second wave of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS Wave 2, 2014-2017). According to the WHO reference system, the prevalence of underweight among 5- to 17-year-olds is 1.6%, the prevalence of overweight is 26.3% (including obesity) and the prevalence of obesity is 8.8%. According to IOTF, the prevalence of underweight among 3- to 17-year-olds is 10.0%. The prevalence of overweight (including obesity) is 19.3% and the prevalence of obesity is 4.7%. From a public health point of view, underweight as an indicator of malnutrition plays a rather minor role in Germany. The prevalence of overweight according to WHO is three quarters higher and one quarter higher according to IOTF than the national reference. When comparing the international reference systems, the WHO prevalence is one third higher than IOTF prevalence. According to national and international reference systems, no further increase in the prevalence of overweight and obesity is observed, but the prevalence remain at a high level.

Red blood cell counts and indices in the elderly German population

AbstractBackgroundData on peripheral blood cell values in older subjects are rare. While hemoglobin (Hb) values are supposed to change with rising age, little is known about reference values for other erythrocytic blood cell counts. This cross-sectional study was initiated to analyze hematologic laboratory parameters among subjects aged ≥60 years.MethodsThis was a retrospective cross-sectional study of outpatient laboratory data between January 1stand December 31st, 2015 originating from a German countrywide laboratory group; inclusion criteria: age ≥60 years, normal C-reactive protein (CRP), transferrin saturation, reticulocytes, lactate dehydrogenase, haptoglobin and soluble transferrin receptor; exclusion criteria: glomerular filtration rate (GFR)<60 mL/min, lack of inclusion criteria; primary objective: assessment of the mean Hb value; secondary objective: assessment of mean values of red blood cell (RBC) counts.ResultsOf 30,611 subjects ≥60 years, 4641 met the inclusion criteria and were thus considered hematologically healthy; the following age groups were formed: 60–69 years (2094), 70–79 years (2171), 80–89 years (360), >90 years (16); median values for male/female subjects were: Hb 15.2/14.0 g/dL, RBC 5.0/4.6/μL, mean cellular volume (MCV) 89/89/fl, mean corpuscular hemoglobin (MCH) 31/30 pg/RBC, mean corpuscular hemoglobin concentration (MCHC) 34/34 g/dL, hematocrit (hct) 44/41%. Statistical evaluation revealed a slight but significant decrease in values over age decades for all parameters except for MCH. However, all values remained within the recommended German Society of Hematology and Oncology (DGHO) reference ranges. Hb values remained above the recommended World Health Organization (WHO) cut-offs for definition of anemia.ConclusionsThe results confirm the WHO reference values and are in accordance with the recommended DGHO reference values and previous results of other study cohorts outside Germany. There seems to be no need for establishing age-specific RBC or erythrocytic reference ranges for subjects >60 years.

INSIGHT Study Maternal Return to Work and Infant Weight Outcomes

ObjectiveMaternal return to work within 12 weeks of delivery is associated with poor child health and development. However, little is known about the impact of return to work on the risk of child obesity. We examined whether timing of maternal return to work is associated with rapid infant weight gain from 0 to 6 months and weight-for-length at 1 year. MethodsSecondary data analysis of 279 mother-newborn dyads from the Intervention Nurses Start Infants Growing on Healthy Trajectories Study, a randomized controlled trial evaluating a responsive parenting (RP) intervention. Rapid infant weight gain from 0 to 6 months was assessed using conditional weight gain (CWG) scores. Infant weight-for-length was calculated using World Health Organization reference values. Analysis of variance (ANOVA) examined whether infant weight outcomes differed by timing of maternal return to work (≤12 weeks vs >12 weeks after delivery). Moderation by study group (RP intervention vs safety control) and mediation by breastmilk feeding were examined in ANOVA models. ResultsAmong 261 mothers, approximately one half (n = 130) returned to work within 12 weeks. Compared with infants of mothers who returned to work after 12 weeks, infants of mothers who returned to work within 12 weeks had greater CWG scores from 0 to 6 months (P = .006) and were heavier at 1 year (P = .05). These associations were not moderated by study group or mediated by breastmilk feeding. ConclusionsMaternal return to work within 12 weeks was associated with rapid infant weight gain in the first 6 months and greater weight-for-length at 1 year, although the mechanisms to explain our findings are unclear.

Increased Adiposity as a Potential Risk Factor for Lower Academic Performance: A Cross-Sectional Study in Chilean Adolescents from Low-to-Middle Socioeconomic Background.

We explored the association between excess body fat and academic performance in high school students from Santiago, Chile. In 632 16-year-olds (51% males) from low-to-middle socioeconomic status (SES), height, weight, and waist circumference were measured. Body-mass index (BMI) and BMI for age and sex were calculated. Weight status was evaluated with 2007 World Health Organization (WHO) references. Abdominal obesity was diagnosed with International Diabetes Federation (IDF) references. Total fat mass (TFM) was measured with dual-energy X-ray absorptiometry (DXA). TFM values ≥25% in males and ≥35% in females were considered high adiposity. School grades were obtained from administrative records. Analysis of covariance examined the association of fatness measures with academic performance, accounting for the effect of diet and physical activity, and controlling SES background and educational confounders. We found that: (1) having obesity, abdominal obesity, or high adiposity was associated with lower school performance alone or in combination with unhealthy dietary habits or reduced time allocation for exercise; (2) high adiposity and abdominal obesity were more clearly related with lower school grades compared to obesity; (3) the association of increased fatness with lower school grades was more salient in males compared to females.

High Blood Pressure Is a Highly Prevalent but Unrecognised Condition in Primary Infertile Men: Results of a Cross-sectional Study

BackgroundAlthough most of the components related to metabolic syndrome were shown to have a detrimental effect on male fertility, the effects of high blood pressure (HBP) have been partially analysed. ObjectiveTo investigate the prevalence and impact of hypertension on clinical and semen parameters in a cohort of white European men presenting for couple’s infertility at a single tertiary referral academic centre. Design, setting, and participantsA cross-sectional study was performed including analysis of data from 2185 primary infertile men. Comorbidities were scored with Charlson Comorbidity Index (CCI; categorised 0 vs ≥1). HBP was defined as blood pressure ≥140/90mmHg. Semen analyses followed the 2010 World Health Organization reference criteria. Outcome measurements and statistical analysisDescriptive statistics and logistic regression analyses tested the association among semen parameters, clinical characteristics, and HBP. Results and limitationsOverall, HBP was found in 6.8% of infertile patients and in 3.6% of age-comparable men without known fertility problems. Of 148 patients, 85 (58%) were either unaware of their HBP or not adequately medically-controlled. +HBP men were older (median age [interquartile range], 37 [33–40] vs 39 [36–44] yr; p<0.001), had higher CCI scores (X2=25.6; p<0.001), higher BMI (25.1 [23.3–27.3] vs 26.8 [24.9–29.4]; p<0.001), and a waist circumference >102cm in a greater proportion of individuals (41% vs 23%; X2=4.68 p<0.05) than −HBP men. Hypertensive and normotensive men did not differ in terms of hormonal milieu and semen parameters. Patients did not differ in terms of HPB rates according to oligozoospermia, asthenozoospermia, and teratozoospermia status. The lack of a real control group represents the main limitation of the study. ConclusionsHypertension and unrecognised or not adequately controlled HBP are highly prevalent among white European primary infertile men. Hypertension per se did not have an impact on hormonal and semen parameters. Patient summaryBecause of its effects in terms of overall prospective men’s health, high blood pressure must be comprehensively considered over the basic work-up of every infertile man in the outpatient clinic setting.

The Availability and Quality of Continuous Positive Airway Pressure (CPAP) for Neonatal Care in Public Health Facilities in India: A Cross- Sectional Cluster Survey

Background: Continuous Positive Airway Pressure (CPAP) is increasingly used in low- and middle-income setting to manage respiratory distress in neonates. Methods: National cross-sectional cluster survey of neonatal care units (SNCU) in 79 medical colleges (MC) and 63 district hospitals (DH) to assess availability, use, and, outcomes of CPAP. Findings: 68·3% of MC and 36·6% of DH used CPAP. Basic infrastructure was widely available. Air-oxygen blenders were available in 50·7% (95%CI 41·4,60·9) of hospitals. Equipment needed for monitoring and/or the detection and management of complications was not always in place; screening for retinopathy in 89·9%(77·2,95·9) MC and 60·3%(44·0,75·6) DH, treatment for retinopathy in 44·3%(30·9,58·5) MC and 7·9%(2·9,20·0) DH, screening for bronchopulmonary dysplasia in 62·0%(49·0,73·5) MC and 22·2%(12·5,36·3) DH, management of pneumothorax in 63·3%(49·8,74·9) of MC and 20·6%(9·8,38·3) of DH. Medical staff trained in the use of CPAP was available in 56·0%(45·8,65·8) of hospitals. The nurse:patient ratio was 7·3(95% CI 6·4-8·5) in MC and 6·6 (5·5-8·3) in DH. 72% MC and 59·3% DH used an upper oxygen saturation limit of above 94%. Respiratory circuits were reused in 52·8% of hospitals. Case Fatality Rates for neonates admitted to a SNCU were 11·5%(9·7,13·3) [13·2%(10·7,15·7) at MC and 7·4%(5·7,9·1) at DC] and 21·4%(16·6,26·2) for neonates receiving CPAP [19·8%(14·6,24·9) MC; 26·3%(15·7,37·0) DH]. Complication rates ranged from 27·9%(21·2,34·5) for rescue mechanical ventilation and 0·7%(0·2,1·2) for pneumothorax. Interpretation: Further support to infrastructure, training, and revision of current guidelines is urgently needed to improve the quality of care and ensure successful scale up of CPAP. Funding Statement: World Health Organization (Reference:2016/613341-0) Declaration of Interests: The authors have no competing interests to declare. Ethics Approval Statement: The study was approved by the Ministry of Health and Family Welfare of India (Child Health Division) and by the Liverpool School of Tropical Medicine’s Research and Ethics Committee (Research protocol 15·032).

Are birthweight and postnatal weight gain in childhood associated with blood pressure in early adolescence? Results from a Ugandan birth cohort.

BackgroundIn Africa, where low birthweight (LBW), malnutrition and high blood pressure (BP) are prevalent, the relationships between birthweight (BW), weight gain and BP later in life remain uncertain. We examined the effects of early life growth on BP among Ugandan adolescents.MethodsData were collected prenatally from women and their offspring were followed from birth, with BP measured following standard protocols in early adolescence. Weight-for-age Z-scores (WAZ) were computed using World Health Organization references. Linear regression was used to relate BW, and changes in WAZ between birth and 5 years, to adolescents’ BP, adjusting for confounders.ResultsAmong 2345 live offspring, BP was measured in 1119 (47.7%) adolescents, with mean systolic BP 105.9 mmHg and mean diastolic BP 65.2 mmHg. There was little evidence of association between BW and systolic [regression coefficient β = 0.14, 95% confidence interval (CI) (-1.00, 1.27)] or diastolic [β = 0.43, 95% CI (-0.57, 1.43)] BP. Accelerated weight gain between birth and 5 years was associated with increased BP: systolic β = 1.17, 95% CI (0.69, 1.66) and diastolic β = 1.03, 95% CI (0.59, 1.47). Between birth and 6 months of age, effects of accelerated weight gain on adolescent BP were strongest among the LBW (both premature and small-for-gestational-age) children [BW < 2.5 kg: β = 2.64, 95% CI (0.91, 4.37), BW≥2.5 kg: β = 0.58, 95% CI (0.01, 1.14), interaction P-value = 0.024].ConclusionsFindings from this large tropical birth cohort in Uganda suggest that postnatal weight gain rather than BW is important in the developmental programming of BP, with fast-growing LBW children at particular risk. Efforts to control BP should adopt a life course approach.

English

Organochlorine pesticides belong to the class of persistent organic pollutants (POPs). They are deeply involved in environmental issues and represent a real threat for human health. The aim of this study was to assess the level of organochlorine pesticides contamination in human milk through two studies of POPs biomonitoring performed in 2010 and 2015 in Cote d'Ivoire. Primiparous breastfeeding mothers were selected from maternal and child healthcare centers in the district of Abidjan. A grouped human milk sample was prepared from individual sample collected from each mother. The grouped sample was frozen at -20°C, packaged and shipped to a World Health Organization (WHO) reference laboratory in Germany for the determination of persistent organic pollutants. Analysis of samples from both studies revealed the presence of several organochlorine pesticides such as dichlorodiphenyltrichlorethane (DDT), hexachlorocyclohexane (HCH), dieldrin, chlordane, heptachlor and heptachlorobenzene. Some organochlorine pesticides such as DDT (1073 to 491 ng/g) (54.24%), chlordane (5.7 to 3.6 ng/g) (36.84%), heptachlor (4 to 2 ng/g) (50%) and dieldrin (4.6 to 3.3 ng/g) showed an outstanding decrease. However, HCH and heptachlorobenzene increased in human milk from 2010 to 2015. Values increased from 13.8 to 18.2 ng/g for HCH and from 2.6 to 3.4 ng/g for heptachlorobenzene. Despite their ban, humans are still subject to a long term exposure to organochlorine pesticides. Key words:Organochlorine pesticides, human milk, biomonitoring.

Patterns of early life body mass index and childhood overweight and obesity status at eight years of age

BackgroundExcess weight gain in infancy and childhood is associated with increased risk of subsequent obesity. Identifying patterns of infancy and childhood weight gain associated with subsequent obesity or overweight status could help identify children at highest risk. Thus, we examined patterns of infancy and early childhood BMI in relation to mid-childhood overweight and obesity status.MethodsIn a prospective cohort of 215 children from Cincinnati, OH (born: 2003–2006), we measured weight and length or height at ages 4 weeks and 1, 2, 3, 4, 5, and 8 years. We calculated BMI z-scores using World Health Organization references. Using linear fixed effect models, we estimated mean BMI at each age and rates of change in BMI between ages 4 weeks and 5 years by children’s overweight and obesity status at age 8 years, assessed with BMI z-scores or bioelectric impedance analysis (BIA).ResultsChildren who became overweight (BMI, n = 51 and BIA, n = 37) or obese (BMI, n = 22 and BIA, n = 29) at age 8 years had greater BMI at all ages compared to normal weightchildren. Children who were overweight had similar rates of change in BMI as children who were lean. Children who were obese had greater gains in BMI between age 4 weeks and 5 years, with the most rapid gains in the first 2 years.ConclusionsResults from this study of modest sample size, suggest that adiposity patterns in the first 5 years of life are related to subsequent childhood overweight and obesity risk.

Substantial variation across geographic regions in the obesity prevalence among 6\u20138\xa0years old Hungarian children (COSI Hungary 2016)

BackgroundThere have been previous representative nutritional status surveys conducted in Hungary, but this is the first one that examines overweight and obesity prevalence according to the level of urbanization and in different geographic regions among 6–8-year-old children. We also assessed whether these variations were different by sex.MethodsThis survey was part of the fourth data collection round of World Health Organization (WHO) Childhood Obesity Surveillance Initiative which took place during the academic year 2016/2017. The representative sample was determined by two-stage cluster sampling. A total of 5332 children (48.4% boys; age 7.54 ± 0.64 years) were measured from all seven geographic regions including urban (at least 500 inhabitants per square kilometer; n = 1598), semi-urban (100 to 500 inhabitants per square kilometer; n = 1932) and rural (less than 100 inhabitants per square kilometer; n = 1802) areas.ResultsUsing the WHO reference, prevalence of overweight and obesity within the whole sample were 14.2, and 12.7%, respectively. According to the International Obesity Task Force (IOTF) reference, rates were 12.6 and 8.6%. Northern Hungary and Southern Transdanubia were the regions with the highest obesity prevalence of 11.0 and 12.0%, while Central Hungary was the one with the lowest obesity rate (6.1%). The prevalence of overweight and obesity tended to be higher in rural areas (13.0 and 9.8%) than in urban areas (11.9 and 7.0%). Concerning differences in sex, girls had higher obesity risk in rural areas (OR = 2.0) but boys did not. Odds ratios were 2.0–3.4 in different regions for obesity compared to Central Hungary, but only among boys.ConclusionsOverweight and obesity are emerging problems in Hungary. Remarkable differences were observed in the prevalence of obesity by geographic regions. These variations can only be partly explained by geographic characteristics.Trial registrationStudy protocol was approved by the Scientific and Research Ethics Committee of the Medical Research Council (61158–2/2016/EKU).

Identifying Overweight and Obesity in Brazilian Schoolchildren, 2014.

For any intervention in a population, we need to understand population characteristics and needs. The School Health Program (PSE) is a Brazilian national proposal for the improvement of schoolchildren's quality of life by integrating health and education areas to address vulnerabilities that affect the development of students from public schools. To describe the prevalence of overweight and obesity in school-aged children and adolescents and to expound methods to evaluate the nutritional status deviation. Cross-sectional study. Schools in Itatiba, Sao Paulo, Brazil, participating in PSE. A total of 6829 schoolchildren aged 6 month to 15 years. Nutritional status and standard percentile curves for body mass index (BMI) for gender. In children younger than 5 years, the prevalence of being overweight was 13.9%; for those between 5 years or older and younger than 10 years, it was 33.9%; and for those 10 years or older, it was 34.0%. In males, obesity and severe obesity were more present (10.7% and 3.7%, respectively) than in girls (9.5% and 1.9%, respectively). Regarding location, it was found that the region with the highest income showed a higher prevalence of overweight children. Compared with the World Health Organization reference BMI curves, our reference percentile curve showed a higher standard for the cutoff points between normal range and overweight. From our results, we found that age and measures of weight and height in schoolchildren could contribute, in a cheap and simple way, to the assessment of nutritional status in a region. This is helpful in providing health monitoring and assisting in making public health decisions, as well as serving in comparison with other scientific studies. Partnership between education and health systems can facilitate and improve the quality of health management among schoolchildren.

A World Health Organization Human Hepatitis E Virus Reference Strain Related to Similar Strains Isolated from Rabbits.

ABSTRACTWe report here the genome sequence of a hepatitis E virus (HEV) strain from a chronically infected immunodeficient patient. Full-length sequence analysis revealed a distinct HEV strain, of a tentative new subgenotype, clustering with viruses from rabbits. It is a World Health Organization reference strain for validation of nucleic acid testing.

Radon Levels in Indoor Environments of the University Hospital in Bari-Apulia Region Southern Italy.

Since 1988, the International Agency for Research on Cancer (IARC) has classified radon among the compounds for which there is scientific evidence of carcinogenicity for humans (group 1). The World Health Organization (WHO) recommends a reference radon level between 100 and 300 Bq/m3 for homes. The objective of this study is to measure the radon concentrations in 401 workplaces, different from the patient rooms, in 28 different buildings of the university hospital in Bari (Apulia region, Southern Italy) to evaluate the exposure of health care workers. Radon environmental sampling is performed over two consecutive six-month periods via the use of passive dosimeters of the CR-39 type. We find an average annual radon concentration expressed as median value of 48.0 Bq/m3 (range 6.5–388.0 Bq/m3) with a significant difference between the two six-month periods (median value: February/July 41.0 Bq/m3 vs. August/January 55.0 Bq/m3). An average concentration of radon lower than the WHO reference level (100 Bq/m3) is detected in 76.1% of monitored environments, while higher than 300 Bq/m3 only in the 0.9%. Most workplaces report radon concentrations within the WHO reference level, therefore, the risk to workers’ health deriving from occupational exposure to radon can be considered to be low. Nevertheless, the goal is to achieve near-zero exposures to protect workers’ health.

MP60-13 WHEN TO PERFORM SEMEN CULTURE IN ASYMPTOMATIC INFERTILE MEN? HINTS FROM A CROSS SECTIONAL STUDY

You have accessJournal of UrologyInfertility: Basic Research & Pathophysiology1 Apr 2018MP60-13 WHEN TO PERFORM SEMEN CULTURE IN ASYMPTOMATIC INFERTILE MEN? HINTS FROM A CROSS SECTIONAL STUDY Eugenio Ventimiglia, Filippo Pederzoli, Paolo Capogrosso, Walter Cazzaniga, Nicola Frego, Francesco Chierigo, Edoardo Pozzi, Luca Boeri, Massimo Alfano, Federico Dehò, Emanuele Montanari, Franco Gaboardi, Vincenzo Mirone, Francesco Montorsi, and Andrea Salonia Eugenio VentimigliaEugenio Ventimiglia More articles by this author , Filippo PederzoliFilippo Pederzoli More articles by this author , Paolo CapogrossoPaolo Capogrosso More articles by this author , Walter CazzanigaWalter Cazzaniga More articles by this author , Nicola FregoNicola Frego More articles by this author , Francesco ChierigoFrancesco Chierigo More articles by this author , Edoardo PozziEdoardo Pozzi More articles by this author , Luca BoeriLuca Boeri More articles by this author , Massimo AlfanoMassimo Alfano More articles by this author , Federico DehòFederico Dehò More articles by this author , Emanuele MontanariEmanuele Montanari More articles by this author , Franco GaboardiFranco Gaboardi More articles by this author , Vincenzo MironeVincenzo Mirone More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , and Andrea SaloniaAndrea Salonia More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1905AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The EAU guidelines suggest performing semen culture in case of increased leukocytes in semen. However, the clinical significance of an increased concentration of leukocytes in the ejaculate is controversial. Although leukocytospermia is a sign of inflammation, it is not necessarily associated with bacterial or viral infections. We aimed to retrospectively validate this recommendation in a cohort of Caucasian-European men seeking medical help for male factor couple's infertility. METHODS Complete socio-demographic, clinical and hormonal data from 547 consecutive infertile men seeking medical help for coupls's infertility and asymptomatic for genital infections were analysed. Health-significant comorbidities were scored with the Charlson Comorbidity Index (CCI; categorized 0 vs 1 vs ≥2). Semen culture was obtained from every man after exclusion of urethritis and bladder infection. Polymerase chain reaction (PCR) DNA was used to identify Chlamydia trachomatis and Ureaplasma urealyticum in the semen. A concentration of >10ˆ3 cfu/mL urinary tract pathogens in the ejaculate was considered suggestive for significant bacteriospermia. Semen analysis values were assessed based on 2010 World Health Organization reference criteria. EAU guidelines for semen culture (leukocytospermia >106 WBCs/mL, according to WHO classification) were used to predict positive semen culture in our cohort and thus validated. Moreover, we tested the predictive performance and accuracy of several clinical parameters and compared them to EAU guidelines RESULTS Overall, a positive semen culture was found in 56 (10%) men. The most commonly identified pathogens belonged to the Enterobacteriaceae family (15% of all positive examinations). Of all, 141 (26%) patients had leukocytospermia >106 WBCs/mL and would have therefore deserved semen culture testing according to EAU guidelines; of them, 12 (9%) actually displayed a positive semen culture. Conversely, 44 (79%) out of 56 patients with positive semen culture would have been missed. Overall predictive accuracy, sensibility, and specificity of EAU guidelines were 48%, 21%, and 74% respectively. No further clinical parameter was significantly associated with positive sperm culture and could be therefore used as a predictor, except for increased serum neutrophil-to-lymphocyte (NRL) ratio (predictive accuracy 60%, p=0.03 vs. EAU guidelines). CONCLUSIONS The vast majority (79%) of asymptomatic infertile men with a positive sperm culture may miss a proper diagnostic assessment when relying on EAU guidelines. Of clinical importance, not a single parameter, except for NLR, can assist medical decision making. Therefore, a semen culture should be offered to every infertile man. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e794-e795 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Eugenio Ventimiglia More articles by this author Filippo Pederzoli More articles by this author Paolo Capogrosso More articles by this author Walter Cazzaniga More articles by this author Nicola Frego More articles by this author Francesco Chierigo More articles by this author Edoardo Pozzi More articles by this author Luca Boeri More articles by this author Massimo Alfano More articles by this author Federico Dehò More articles by this author Emanuele Montanari More articles by this author Franco Gaboardi More articles by this author Vincenzo Mirone More articles by this author Francesco Montorsi More articles by this author Andrea Salonia More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Thresholds of physical activity associated with obesity by level of sedentary behaviour in children

It is unknown whether moderate-to-vigorous physical activity (MVPA) thresholds for obesity should be adapted depending on level of sedentary behaviour in children. The objective of the study is to determine the MVPA thresholds that best discriminate between obese and non-obese children, by level of screen time and total sedentary time in 12 countries. This multinational, cross-sectional study included 6522 children 9-11years of age. MVPA and sedentary time were assessed using waist-worn accelerometry, while screen time was self-reported. Obesity was defined according to the World Health Organization reference data. Receiver operating characteristic curve analyses showed that the best thresholds of MVPA to predict obesity ranged from 53.8 to 73.9mind-1 in boys and from 41.7 to 58.7mind-1 in girls, depending on the level of screen time. The MVPA cut-offs to predict obesity ranged from 37.9 to 75.9mind-1 in boys and from 32.5 to 62.7mind-1 in girls, depending on the level of sedentary behaviour. The areas under the curve ranged from 0.57 to 0.73 ('fail' to 'fair' accuracy), and most sensitivity and specificity values were below 85%, similar to MVPA alone. Country-specific analyses provided similar findings. The addition of sedentary behaviour levels to MVPA did not result in a better predictive ability to classify children as obese/non-obese compared with MVPA alone.

The prevalence and risk factors of stunting among primary school children in North Sumatera, Indonesia

Stunting in primary school-aged children is a kind of health and nutrition problem in Indonesia which has an impact on the human quality resources degradation. This research aimed to determine the stunting prevalence and the risk factors associated with stunting in primary school children in North Sumatra Province. This research is an analysis of cross-sectional approach. The total sampleis 400 children aged 8-13 years old were in the study from the Medan city and Langkat regency in July - October 2017. Data collected by using questionnaire and anthropometric assessment. Stunting (<-2 SD of height-for-age Z-score) were defined by using the World Health Organization reference 2007. Chi-square analysis and logistic regression were used toassess the association between risk factors and stunting. The prevalence of stunting in primary school children was 38.87%. The factors associated with stunting school children were theeducation of mother (OR=1.53), income (OR=2.27), work of mother (OR=1.39), energy intake (OR=2.66) and protein intake (OR=2.02). The dominant factor that influences stunting in school children was energy intake. The conclusion of this study is stunting prevalence in school children in NorthSumatra higher.

Investigating Caesarean Section Birth as a Risk Factor for Childhood Overweight.

Caesarean section birth may be associated with overweight in childhood; however, findings to date have been inconsistent. This study explored the association of caesarean section vs. vaginal birth with childhood overweight in Vietnam. This longitudinal cohort study explored the association of delivery mode with overweight, obesity, and overweight/or obesity at 8 years of age in children (n = 1937) across 20 sites in Vietnam, using Young Lives longitudinal cohort study data. Categories were defined using BMI z-scores in relationship to the World Health Organization (WHO) reference median: overweight >1 and <2 standard deviations (SD) above WHO reference median, obese >2 SD, and overweight/or obese >1 SD. Individual questionnaire data collected sociodemographic information and pregnancy/birth information through face-to-face interviews with mothers/caregivers. Anthropometric measurements for mother and child were collected at baseline and at 8 years for children. Adjusted multivariable logistic models revealed a twofold increase in odds at age 8 years of overweight [odds ratio (OR) = 1.8, 95% confidence interval (95% CI) 1.03-3.2, p = 0.039], obese (OR = 2.2, 95% CI 1.2-4.0, p = 0.014), or overweight/or obese (OR = 2.1, 95% CI 1.3-3.3, p = 0.002) for children born through caesarean section compared with vaginal birth. Children born through planned caesarean section (adjusted OR = 2.3, 95% CI 1.2-4.1, p < 0.001) and unplanned caesarean section (adjusted OR = 1.9, 95% CI 1.1-3.5, p = 0.03) had similar increased odds of overweight/or obesity compared with children born through vaginal birth. These findings suggest that there may be an association between caesarean section and childhood overweight even after adjustment for confounders. Further research is needed to explore the underlying mechanisms of this finding.

Impact of dietary nutrient intake and physical activity on body composition and growth in Indian children.

BackgroundTo investigate interrelationships of dietary composition and physical activity (PA) with growth and body composition (BC) in urban Indian school children.MethodsA cross-sectional study was performed in 4,747 Indian school children (2,623 boys) aged 3-18 years. Weight, height, BC by body impedance analyzer, PA and dietary food intakes by questionnaire method were recorded.ResultsMean daily energy and protein intakes as recommended dietary allowance were significantly lower in both boys and girls (P<0.01) above 6 years, with 55% reduction in micronutrient intakes in older children. When compared with World Health Organization references, lower heights in pubertal boys and girls were related to dietary energy and protein intake. Multiple regression analysis showed positive association of height for age z-scores (HAZ) with midparental height z-scores (β=0.45, P=0.0001) and protein density (β=0.103, P=0.014). HAZ was negatively associated with inactivity (β=-0.0001, P=0.049) in boys and girls (R2=0.104, P<0.01). Further, body fat percentage was negatively correlated with moderate or light activity and antioxidant intakes (P<0.01) but not with dietary fat intake. Percentage muscle mass was positively correlated with moderate activity and negatively with inactivity (P<0.05).ConclusionAdequacy of protein and antioxidant intakes, reducing inactivity and increasing moderate activity are essential for optimal growth and body composition in Indian children.

Determinants of nutritional status in children under three years of age in rural Zimbabwe: the case of Shamva and Makoni Districts

Background: Malnutrition contributes significantly to the child health burden in developing countries. Stunting, wasting and underweight are associated with poor physical growth, increased morbidity, mortality and retarded cognitive development.Objective: The main objective of this study was to assess determinants of malnutrition among children under three years of age from rural households.Setting and Design: A cross-sectional study carried out in Shamva and Makoni districts of ZimbabweSubjects: A total of 186 mother-child pairs were randomly selected and an interviewer-administered questionnaire was used to capture socio-demographic data from participants. Scales, wooden height-boards and Mid-Upper Arm Circumference tapes were used to take anthropometric measurements using the WHO guidelines. The Statistical Package for Social Sciences (SPSS) and Emergency Nutrition Assessment for Standardised Monitoring and Assessment of Relief and Transition (ENA for SMART) software packages were used to analyse data. The World Health Organization (2006) reference standards were used to calculate z-scores.Results: Child wasting, underweight and stunting prevalences were 8.6%, 7% and 18% respectively. Overweight was 11.6% among children. Mother's Body Mass Index (p=0.044), marital status (p=0.035), household income (p=0.021), low birth weight (p=0.029) and duration of exclusive breastfeeding (p=0.014) were found to be significant determinants of malnutrition. The prevalence of stunting and underweight was higher among boys compared to girls (p=0.038 and p=0.040) while the risk increased with age (p=0.041).Conclusions: Mother's Body Mass Index (BMI), marital status and household income were determinants of malnutrition. The main individual determinants of malnutrition among under-three children were low birth weight and reduced period of exclusive breastfeeding.