• 【药物洞察: 男性激素避孕的最新进展。】 复制标题 收藏 收藏
    DOI:10.1038/ncpendmet0069 复制DOI
    作者列表:Amory JK,Page ST,Bremner WJ
    BACKGROUND & AIMS: :As there are limitations to current methods of male contraception, research has been undertaken to develop hormonal contraceptives for men, analogous to the methods for women based on estrogen and progestogens. When testosterone is administered to a man, it functions as a contraceptive by suppressing the secretion of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) from the pituitary gland. Since these hormones are the main stimulatory signals for spermatogenesis, low levels of LH and FSH markedly impair sperm production. After 3-4 months of testosterone treatment, 60-70% of men no longer have sperm in their ejaculate, and most other men exhibit markedly diminished sperm counts. Male hormonal contraception is well tolerated, free of serious adverse side effects, and 95% effective in the prevention of pregnancy. Importantly, male hormonal contraception is reversible, with sperm counts usually recovering within 4 months of the discontinuation of hormone treatment. Because exogenous testosterone administration alone does not completely suppress sperm production in all men, researchers have combined testosterone with second agents, such as progestogens or gonadotropin-releasing-hormone antagonists, to further suppress secretion of LH and FSH and improve suppression of spermatogenesis. Recent trials have used combinations of long-acting injectable or implantable forms of testosterone with progestogens, which can be administered orally, by injection or by a long-acting implant. Such combinations suppress spermatogenesis to zero without severe side effects in 80-90% of men, with near-complete suppression in the remainder of individuals. One of these testosterone and progestogen combination regimens might soon bring the promise of male hormonal contraception to fruition.
    背景与目标: : 由于目前男性避孕方法存在局限性,因此已经进行了研究以开发针对男性的激素避孕药,类似于基于雌激素和孕激素的女性避孕方法。当向男性施用睾丸激素时,它通过抑制垂体的促黄体激素 (LH) 和促卵泡激素 (FSH) 的分泌而起到避孕作用。由于这些激素是精子发生的主要刺激信号,因此低水平的LH和FSH明显损害了精子的产生。经过3-4个月的睾酮治疗后,60-70% 的男性射精中不再有精子,大多数其他男性的精子数量明显减少。男性激素避孕耐受性良好,无严重不良副作用,95% 有效预防妊娠。重要的是,男性激素避孕是可逆的,精子数量通常在停止激素治疗后4个月内恢复。由于单独使用外源性睾丸激素并不能完全抑制所有男性的精子产生,因此研究人员已将睾丸激素与第二种药物 (例如孕激素或促性腺激素释放激素拮抗剂) 结合使用,以进一步抑制LH和FSH的分泌并改善精子发生的抑制。最近的试验使用了长效可注射或可植入形式的睾丸激素与孕激素的组合,可以口服,注射或长效植入物给药。在80-90% 的男性中,这种组合将精子发生抑制为零,而没有严重的副作用,在其余个体中几乎完全抑制。这些睾丸激素和孕激素联合疗法之一可能很快就会实现男性激素避孕的希望。
  • 【热应激对雄性小鼠体内和体外生育力的影响。】 复制标题 收藏 收藏
    DOI:10.1071/rd05022 复制DOI
    作者列表:Yaeram J,Setchell BP,Maddocks S
    BACKGROUND & AIMS: :A study was conducted to determine whether following exposure of male mice to high temperatures, the ability of their spermatozoa to fertilise ova was reduced, especially during the period before the males became completely infertile. Male mice placed in a microclimate chamber at 36 degrees C for two periods, each of 12 h on successive days, were less able to fertilise control females in vivo when mated and, even in those females that became pregnant, litter size was reduced. However, these effects were associated with falls in testis weight and numbers of spermatozoa in the testis and epididymis. To determine whether the effect on fertility was a result of the decreased spermatozoa numbers, spermatozoa were collected from the epididymides of heated and control males. Equal numbers of motile spermatozoa from an unselected sample or those subjected to a swim-up procedure to separate those that were motile from the immotile ones in the sample were then mixed in vitro with oocytes from superovulated normal females. Similar numbers of spermatozoa from both control and heated males bound to the zona pellucida but smaller percentages of the oocytes were fertilised by spermatozoa from the heated males and fewer of these spermatozoa penetrated the ova. The effects were first seen 7 days after the heat exposure and became more obvious after 10 or 14 days.
    背景与目标: : 进行了一项研究,以确定雄性小鼠暴露于高温后,其精子受精卵子的能力是否降低,尤其是在雄性完全不育之前。在36摄氏度的小气候室中放置两个周期的雄性小鼠,每次连续12小时,交配时在体内受精对照雌性的能力较小,即使在怀孕的雌性中,产仔数也减少了。然而,这些影响与睾丸重量下降以及睾丸和附睾中精子数量下降有关。为了确定对生育力的影响是否是精子数量减少的结果,从加热和对照男性的附睾中收集了精子。然后将来自未选择样品的等量运动精子或经过游泳程序以将样品中运动的精子与未运动的精子分开的精子与超排卵正常雌性的卵母细胞在体外混合。与透明带结合的对照雄性和受热雄性的精子数量相似,但受热雄性的精子受精的卵母细胞百分比较小,而这些精子穿透卵子的数量较少。这种影响最初是在热暴露后7天看到的,而在10或14天后变得更加明显。
  • 【[非洲男性乳腺癌,与瓦加杜古大学教学医院 (布基纳法索) 的5例病例有关]。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Sano D,Dao B,Lankoandé J,Touré B,Sakandé B,Traoré SS,Wandaogo A,Dakouré R,Sanou A
    BACKGROUND & AIMS: :A retrospective study of male breast cancer was undertaken at Ouagadougou University Teaching Hospital over a 3 year period (1993-1996). Authors report 5 cases representing 4.16% of all breast cancers. The patients' mean age was 61 years. The average duration of signs and symptoms before the diagnosis was 13 months. Clinically all the 5 cases presented advanced cancers (4 T4N2M0, 1 T4N2M1 according to UICC TNM System) with size ranging from 5.5, to 11.5 cm. Histology found: 2 medullary infiltrating carcinoma, 1 canalar infiltrating carcinoma, 1 colloid mucous carcinoma and 1 lobular infiltrating carcinoma. All patients had mastectomy associated with axillary clearance in 4 cases. Radiotherapy, chemotherapy and hormonotherapy were not associated because unavailable in Burkina Faso. Three patients died: the first, 10 days after surgical treatment and the 2 others respectively after 14 and 17 months. We have lost sight 1 patients. The last one is still alive. Authors find that to get better prognosis, it is important to improve medical and technical means, to increase information and to promote early detection.
    背景与目标: : 在瓦加杜古大学教学医院进行了为期3年 (1993-1996年) 的男性乳腺癌回顾性研究。作者报告了5例代表所有乳腺癌4.16% 的病例。患者的平均年龄为61岁。诊断前症状和体征的平均持续时间为13个月。临床上所有5例均表现为晚期癌症 (根据UICC TNM系统,4个T4N2M0,1个T4N2M1),大小从5.5到11.5厘米。组织学发现: 髓质浸润性癌2例,管内浸润性癌1例,胶体粘液性癌1例,小叶浸润性癌1例。所有患者均行乳房切除术伴腋窝清除4例。放疗,化疗和激素治疗不相关,因为在布基纳法索不可用。3例患者死亡: 手术治疗后第1、10天,另外2例分别在14和17个月后死亡。我们已经看不见1个病人了。最后一个还活着。作者发现,要获得更好的预后,必须改善医疗和技术手段,增加信息并促进早期发现。
  • 【田纳西州东部怀孕青少年的生殖器沙眼衣原体感染: 一项为期7年的病例对照研究。】 复制标题 收藏 收藏
    DOI:10.1016/s1083-3188(97)70060-3 复制DOI
    作者列表:Chokephaibulkit K,Patamasucon P,List M,Moore B,Rodriguez H
    BACKGROUND & AIMS: STUDY OBJECTIVE:To examine the prevalence, symptomatology, risk factors, and other infections associated with urogenital chlamydial infection in pregnant teenagers. DESIGN:Retrospective case-control study by medical record review. SETTING:Prenatal care clinic for adolescents at University of Tennessee Medical Center, Knoxville, Tennessee. PARTICIPANTS:Pregnant adolescents younger than 19 years of age who were diagnosed with chlamydial infection on the first prenatal visit from 1988 to 1994 were studied. Pregnant adolescents of similar age and socioeconomic background who came in the same day for the first prenatal visit, but were not infected, made up the control group. INTERVENTION:Routine prenatal questionnaires regarding personal and medical histories, and routine prenatal screening, including pelvic examination with Papanicolaou (PAP) smear and laboratory investigations for common genital infections and sexual transmitted disease (STDs), were obtained. MAIN OUTCOME MEASURES:Analyzed the prevalence of chlamydial infection and compared the infected group to the control group with regard to race, behavioral factors, symptoms, prenatal screening results, other concurrent genital infections, and histories of STDs. RESULTS:Of a total population of 596 pregnant teenagers, 67 (11.24%) were infected with Chlamydia trachomatis. In multivariate analysis, black race (odds ratio [OR] = 4.01; 95% confidence interval [CI] = 1.74-9.23; p = 0.001) and greater gestational age at first prenatal visit (OR = 1.11; 95% CI = 1.04-1.18; p = 0.001) were independently associated with chlamydial infection. Age, marital status, number of pregnancies, smoking, alcohol abuse, drug abuse, age at first intercourse, and multiple sex partners were not associated with the infection. Likewise, the symptom of vaginal discharge (a complaint of > 70% in each group), other genital co-infections (found > 50% in each group, mainly candidiasis and bacterial vaginosis), abnormal PAP smears (found > 60% in each group) and histories of STDs or previous chlamydial infection were not significantly different between case and control groups. Human papillomavirus infection, trichomonal infection, and dysplasia or atypia were found more often in patients infected with chlamydia, but were not statistically significant. CONCLUSION:Pregnant adolescents in east Tennessee were at risk for chlamydial infection as well as for other genital infections and abnormal PAP smears. Routine prenatal chlamydial screening is warranted because of a lack of specific symptoms.
    背景与目标:
  • 【抑郁症状是非洲裔美国青少年和年轻人性风险的预测指标。】 复制标题 收藏 收藏
    DOI:10.1016/j.jadohealth.2006.01.015 复制DOI
    作者列表:Brown LK,Tolou-Shams M,Lescano C,Houck C,Zeidman J,Pugatch D,Lourie KJ,Project SHIELD Study Group.
    BACKGROUND & AIMS: PURPOSE:To understand the prospective relationship between depressive symptoms and sexual risk behavior among a community sample of African American adolescents. METHODS:African American adolescents (n = 415) who participated in a larger multi-site human immunodeficiency virus (HIV) prevention program provided baseline data on demographics, psychosocial context and depressive symptoms. At six-month follow-up, data were collected regarding sexual activity in the past 90 days. Multivariate logistic regression was conducted to determine the prospective relationship between depressive symptoms and proportion of condom use while controlling for relevant demographic and contextual factors. RESULTS:The odds that African American adolescents who reported depressive symptoms at baseline would report inconsistent condom use at six-month follow-up was approximately four times greater than that of their peers who did not report depressive symptoms. Older adolescents and females were less likely to use condoms consistently and certain contextual factors, such as less pleasurable expectations about condom use, and living with a partner also heightened HIV/STI risk. CONCLUSIONS:Clinicians should assess for depression symptoms in African American adolescent patients as an indicator of future sexual risk. Prevention interventions that address depressed mood could have a significant impact on later HIV/STI sexual risk behaviors. Further research is needed to understand the effect of depressive symptoms on sexual risk among adolescents of other race/ethnicities and to examine the potential cultural forces that affect this relationship.
    背景与目标:
  • 【儿童早期铅暴露青少年的伤害趋势。】 复制标题 收藏 收藏
    DOI:10.1016/j.jadohealth.2006.02.008 复制DOI
    作者列表:Kincl LD,Dietrich KN,Bhattacharya A
    BACKGROUND & AIMS: :This pilot study investigated adolescents with well-documented childhood lead burdens to determine the relationship between lead and unintentional injury. Adolescents completed a self-administered injury questionnaire. Results demonstrated that elevated childhood blood lead concentrations were significantly related to injury variables. Further study is necessary to understand adolescent health and safety implications.
    背景与目标: : 这项初步研究调查了有充分记录的儿童铅负担的青少年,以确定铅与意外伤害之间的关系。青少年完成了一份自我管理的伤害问卷。结果表明,儿童血铅浓度升高与损伤变量显着相关。为了了解青少年健康和安全的影响,有必要进行进一步的研究。
  • 【青少年物质使用的升级和启动: 感知到的同伴使用的影响。】 复制标题 收藏 收藏
    DOI:10.1016/j.jadohealth.2006.02.010 复制DOI
    作者列表:D'Amico EJ,McCarthy DM
    BACKGROUND & AIMS: PURPOSE:The middle school years are peak years for substance use initiation. The current study assessed the impact of peer influence on both initiation and escalation of cigarette, alcohol, and marijuana use among sixth, seventh, and eighth graders. METHODS:Youth (n = 974; 45% male) were surveyed twice over an academic year and reported on their personal substance use and their perception of peer substance use. The sample ranged in age from 10 to 15 years at Time 1 (M age = 11.95) and was 44% White, 26% Latino, 7% Asian American/Pacific Islander, 4% African American, and 14% mixed ethnic origin. RESULTS:Hierarchical regressions examined whether personal and perceived peer substance use predicted later substance involvement, and logistic regressions assessed whether Time 1 perceived peer and personal use of other substances discriminated between initiates and noninitiates. After controlling for personal substance use, perceived peer alcohol use predicted both increased alcohol and marijuana use, and perceived peer marijuana use predicted increased alcohol use. Only perceived peer alcohol use was associated with initiation of alcohol, and both perceived peer alcohol and marijuana use predicted onset of marijuana use. CONCLUSIONS:Results highlight the importance of perceived peer use in predicting both onset and escalation of use and suggest utilizing a multifaceted prevention approach that targets multiple substances.
    背景与目标:
  • 【2001-2014年,青少年和年轻人接受丁丙诺啡和纳曲酮治疗阿片类药物使用障碍的趋势。】 复制标题 收藏 收藏
    DOI:10.1001/jamapediatrics.2017.0745 复制DOI
    作者列表:Hadland SE,Wharam JF,Schuster MA,Zhang F,Samet JH,Larochelle MR
    BACKGROUND & AIMS: Importance:Opioid use disorder (OUD) frequently begins in adolescence and young adulthood. Intervening early with pharmacotherapy is recommended by major professional organizations. No prior national studies have examined the extent to which adolescents and young adults (collectively termed youth) with OUD receive pharmacotherapy. Objective:To identify time trends and disparities in receipt of buprenorphine and naltrexone among youth with OUD in the United States. Design, Setting, and Participants:A retrospective cohort study was conducted using deidentified data from a national commercial insurance database. Enrollment and complete health insurance claims of 9.7 million youth, aged 13 to 25 years were analyzed, identifying individuals who received a diagnosis of OUD between January 1, 2001, and June 30, 2014, with final follow-up date December 31, 2014. Analysis was conducted from April 25 to December 31, 2016. Time trends were identified and multivariable logistic regression was used to determine sociodemographic factors associated with medication receipt. Exposures:Sex, age, race/ethnicity, neighborhood education and poverty levels, geographic region, census region, and year of diagnosis. Main Outcomes and Measures:Dispensing of a medication (buprenorphine or naltrexone) within 6 months of first receiving an OUD diagnosis. Results:Among 20 822 youth diagnosed with OUD (0.2% of the 9.7 million sample), 13 698 (65.8%) were male and 17 119 (82.2%) were non-Hispanic white. Mean (SD) age was 21.0 (2.5) years at the first observed diagnosis. The diagnosis rate of OUD increased nearly 6-fold from 2001 to 2014 (from 0.26 per 100 000 person-years to 1.51 per 100 000 person-years). Overall, 5580 (26.8%) youth were dispensed a medication within 6 months of diagnosis, with 4976 (89.2%) of medication-treated youth receiving buprenorphine and 604 (10.8%) receiving naltrexone. Medication receipt increased more than 10-fold, from 3.0% in 2002 (when buprenorphine was introduced) to 31.8% in 2009, but declined in subsequent years (27.5% in 2014). In multivariable analyses, younger individuals were less likely to receive medications, with adjusted probability for age 13 to 15 years, 1.4% (95% CI, 0.4%-2.3%); 16 to 17 years, 9.7% (95% CI, 8.4%-11.1%); 18 to 20 years, 22.0% (95% CI, 21.0%-23.0%); and 21 to 25 years, 30.5% (95% CI, 30.0%-31.5%) (P < .001 for difference). Females (7124 [20.3%]) were less likely than males (13 698 [24.4%]) to receive medications (P < .001), as were non-Hispanic black (105 [14.8%]) and Hispanic (1165 [20.0%]) youth compared with non-Hispanic white (17 119 [23.1%]) youth (P < .001). Conclusions and Relevance:In this first national study of buprenorphine and naltrexone receipt among youth, dispensing increased over time. Nonetheless, only 1 in 4 commercially insured youth with OUD received pharmacotherapy, and disparities based on sex, age, and race/ethnicity were observed.
    背景与目标:
  • 【重度抑郁症儿童和青少年的气质和性格特征: 一项病例对照研究。】 复制标题 收藏 收藏
    DOI:10.1016/j.comppsych.2012.10.009 复制DOI
    作者列表:Zappitelli MC,Bordin IA,Hatch JP,Caetano SC,Zunta-Soares G,Olvera RL,Soares JC
    BACKGROUND & AIMS: OBJECTIVES:To evaluate temperament and character traits using the Junior Temperament and Character Inventory (JTCI) in children and adolescents with major depressive disorder (MDD) in comparison with healthy control subjects (HC), and to verify if comorbidity with disruptive behavioral disorders and being currently depressed influence JTCI scores. METHODS:A case-control study comprising 41 MDD children/adolescents matched to 40 HC by gender and age (8-17years). All participants were assessed diagnostically with the Kiddie Schedule for Affective Disorders and Schizophrenia - Present and Lifetime (K-SADS-PL). Temperament and character traits were measured with the parent and child versions of JTCI, and depression was evaluated with the Children's Depression Rating Scale (CDRS). RESULTS:According to child and parent data, MDD subjects had significantly higher scores on harm avoidance and novelty seeking, and lower scores on reward dependence, persistence, self-directedness and cooperativeness compared with HC. According to parent data only, MDD subjects significantly differed from HC on self-transcendence (lower spirituality scores and higher fantasy scores). Comorbidity with disruptive behavioral disorders exerted influence on almost all dimensions, in general increasing the mean differences between MDD and HC subjects. Also, being currently depressed did not influence the results, except for reward dependence according to parent data. LIMITATIONS:The cross-sectional nature of the study and its limited sample size. CONCLUSIONS:MDD children/adolescents have a different temperament and character profile compared to HC subjects. This study supports previous findings of trait-like characteristics of harm avoidance and self-directedness.
    背景与目标:
  • 【南非城市青少年队列中的居民流动性,社会经济背景和体重指数。】 复制标题 收藏 收藏
    DOI:10.1016/j.healthplace.2012.09.016 复制DOI
    作者列表:Ginsburg C,Griffiths PL,Richter LM,Norris SA
    BACKGROUND & AIMS: :Adolescents who are changing residence, as well as their social and economic circumstances may experience lifestyle changes that have an effect on body composition outcomes such as undernutrition, overweight or obesity. This paper uses data from Birth to Twenty, a birth cohort of South African urban children, to determine the relationship between residential mobility and body mass index (BMI) amongst Black adolescents aged 15 (n=1613), and to examine the role of changes in household socioeconomic status (SES). The prevalence of overweight and obesity in the sample was 25% in females and 8% in males. Amongst the females, a strong positive association between residential mobility and BMI was observed for those who also experienced an increase in household SES between birth and 15 years (β=0.42, SE=0.13), while no effect was identified for males. The study shows the potential for environmental change and increased resources to influence the risk for obesity. It also highlights the value in considering the range of social environmental factors and changes across the early life course that might play a part in evolving nutritional patterns in urban transitioning environments.
    背景与目标: : 改变居住地以及他们的社会和经济环境的青少年可能会经历生活方式的改变,这些改变会影响身体成分的结果,例如营养不足,超重或肥胖。本文使用从出生到20岁的数据 (南非城市儿童的出生队列) 来确定居住流动性与15岁黑人青少年 (n = 1613) 的体重指数 (BMI) 之间的关系,并研究其作用在家庭社会经济地位 (SES) 中的变化。样本中超重和肥胖的患病率在女性中25%,在男性中8%。在女性中,对于那些在出生至15岁之间家庭SES增加的人 (β = 0.42,SE = 0.13),观察到居住流动性与BMI之间存在很强的正相关关系,而对男性则没有发现影响。这项研究显示了环境变化的潜力和增加的资源来影响肥胖的风险。它还强调了在考虑社会环境因素的范围以及整个早期生活过程中可能在城市转型环境中不断变化的营养模式中发挥作用的价值。
  • 【青少年神经性厌食症的增强认知行为疗法: 家庭疗法的替代方法?】 复制标题 收藏 收藏
    DOI:10.1016/j.brat.2012.09.008 复制DOI
    作者列表:Dalle Grave R,Calugi S,Doll HA,Fairburn CG
    BACKGROUND & AIMS: :A specific form of family therapy (family-based treatment) is the leading treatment for adolescents with anorexia nervosa. As this treatment has certain limitations, alternative approaches are needed. "Enhanced" cognitive behaviour therapy (CBT-E) is a potential candidate given its utility as a treatment for adults with eating disorder psychopathology. The aim of the present study was to establish, in a representative cohort of patients with marked anorexia nervosa, the immediate and longer term outcome following CBT-E. Forty-nine adolescent patients were recruited from consecutive referrals to a community-based eating disorder clinic. Each was offered 40 sessions of CBT-E over 40 weeks from a single therapist. Two-thirds completed the full treatment with no additional input. In these patients there was a substantial increase in weight together with a marked decrease in eating disorder psychopathology. Over the 60-week post-treatment follow-up period there was little change despite minimal subsequent treatment. These findings suggest that CBT-E may prove to be a cost-effective alternative to family-based treatment.
    背景与目标: : 一种特殊形式的家庭治疗 (基于家庭的治疗) 是青少年神经性厌食症的主要治疗方法。由于这种治疗有一定的局限性,因此需要其他方法。“增强” 认知行为疗法 (cbt-e) 是一种潜在的候选药物,因为它可用于饮食失调精神病理学的成年人。本研究的目的是在具有明显神经性厌食症的代表性队列中,建立cbt-e后的近期和长期结果。从连续转诊到社区饮食失调诊所招募了49名青少年患者。每位治疗师在40周内接受了40次cbt-e治疗。三分之二的人完成了完整的治疗,没有额外的投入。在这些患者中,体重显着增加,进食障碍心理病理学显着减少。在治疗后60周的随访期内,尽管后续治疗很少,但变化不大。这些发现表明,cbt-e可能被证明是基于家庭的治疗的一种经济有效的替代方法。
  • 【在一组青少年中,肩膀,腋窝和腰部位置的可变性是什么?】 复制标题 收藏 收藏
    DOI:10.1111/joa.12630 复制DOI
    作者列表:Gardner A,Berryman F,Pynsent P
    BACKGROUND & AIMS: :The clinical assessment of scoliosis is based on the recognition of asymmetry. It is not clear what the degree of asymmetry is in a population without scoliosis, which could make the differentiation between abnormal and normal uncertain. This study defines the range of normality in certain parameters of torso shape that are also associated with the clinical assessment of scoliosis. This was done by analysing the surface topography of a group of 195 children serially measured over a 5-year period. The analysis considered both the spinal curvature and the relative position of shoulders, axillae and waist on each side. The bivariate relationships were examined using 95% confidence interval data ellipses. Our results showed that a degree of spinal curvature was seen, either as a main thoracic or main thoracolumbar curve. The distribution of the data about a mean point is illustrated by 95% confidence interval (CI) data ellipses with shoulder, axilla and waist data plotted against spinal curvature. The mean values were close to zero (exact symmetry) for all of the measured parameters, with the ellipses showing little differences in the distributions. We conclude that mild asymmetry of the measured torso parameters is normal. These results define what is normal and beyond what point asymmetry becomes abnormal. This information is of use for those managing and counselling patients with scoliosis both before and after surgery.
    背景与目标: : 脊柱侧弯的临床评估是基于对不对称的认识。目前尚不清楚没有脊柱侧弯的人群的不对称程度,这可能使异常与正常之间的区别不确定。这项研究定义了躯干形状某些参数的正常范围,这些参数也与脊柱侧弯的临床评估有关。这是通过分析在5年内连续测量的一组195名儿童的表面形貌来完成的。分析同时考虑了脊柱曲率以及肩,腋窝和腰部在两侧的相对位置。使用95% 置信区间数据椭圆检查双变量关系。我们的结果表明,可以看到一定程度的脊柱弯曲,无论是主要的胸弯还是主要的胸腰弯。关于平均点的数据分布通过95% 置信区间 (CI) 数据椭圆来说明,其中肩部、腋窝和腰部数据相对于脊柱曲率绘制。所有测量参数的平均值都接近零 (精确对称),椭圆在分布中几乎没有差异。我们得出的结论是,测得的躯干参数的轻度不对称性是正常的。这些结果定义了什么是正常的,以及超过什么点的不对称变得异常。此信息适用于在手术前后对脊柱侧弯患者进行管理和咨询的人员。
  • 【调整肥胖后,自我报告的体育锻炼是否与青少年的高血压有关?】 复制标题 收藏 收藏
    DOI:10.1080/02640414.2012.734631 复制DOI
    作者列表:Barros MV,Ritti-Dias RM,Honda Barros SS,Mota J,Andersen LB
    BACKGROUND & AIMS: :Studies show that both low physical activity (PA) and adiposity are associated with a higher risk of hypertension. However, the relationship between PA and blood pressure in adolescents is controversial and other studies have reported that no association was observed. Of particular interest is the evaluation of whether the association between PA and high blood pressure is independent of adiposity. A sample of 3764 Brazilian adolescents who attend high schools was selected using random cluster sampling. Data were collected using the Global School-based Student Health Survey, anthropometry, and blood pressure readings. The prevalence of high blood pressure was 14.6% (95% Confidence Interval (CI) 13.5-15.7), higher amongst males (20.0%; 95%CI 18.0-22.1) compared with females (10.9%; 95%CI 9.7-12.3). Sixty-six per cent of the adolescents were reported to be insufficiently active. The prevalence of high blood pressure was 12.8% (95%CI 11.0-14.7) amongst active compared with 15.4% (95%CI 14.0-16.9) amongst insufficiently active adolescents. The association between PA and high blood pressure was observed only amongst females after adjusting for waist circumference (odds ratio (OR) 1.67; 95%CI 1.21-2.31) and body mass index (OR 1.71; 95%CI 1.23-2.37). Notwithstanding levels of adiposity, higher PA levels are associated with a lower prevalence of high blood pressure amongst females, although not amongst males.
    背景与目标: : 研究表明,低体力活动 (PA) 和肥胖都与高血压的高风险相关。然而,PA与青少年血压之间的关系存在争议,其他研究报告未观察到关联。特别令人感兴趣的是评估PA与高血压之间的关联是否独立于肥胖。采用随机整群抽样的方法,选取了3764名就读高中的巴西青少年样本。数据是使用全球学校学生健康调查,人体测量学和血压读数收集的。高血压的患病率为14.6% (95% 置信区间 (CI) 13.5-15.7),男性 (20.0%; 95% CI 18.0-22.1) 高于女性 (10.9%; 95% CI 9.7-12.3)。据报告,66% 的青少年活动不足。在活跃的青少年中,高血压的患病率12.8% (95% CI 11.0-14.7),而在不活跃的青少年中,高血压的患病率为15.4% (95% CI 14.0-16.9)。仅在调整腰围 (比值比 (OR) 1.67; 95% CI 1.21-2.31) 和体重指数 (OR 1.71; 95% CI 1.23-2.37) 后,在女性中观察到PA与高血压之间的关联。尽管肥胖程度较高,但女性中PA水平较高与高血压患病率较低有关,尽管男性中并非如此。
  • 【确定基于饮食场合的机会,以改善澳大利亚青少年的整体饮食。】 复制标题 收藏 收藏
    DOI:10.3390/nu9060608 复制DOI
    作者列表:Fayet-Moore F,McConnell A,Kim J,Mathias KC
    BACKGROUND & AIMS: :Adolescents in Australia have a poor dietary intake, leading to large numbers of them being at risk for inadequate intake of micronutrients, and excessive intake of less healthful dietary components. This study examined dietary intakes at multiple eating occasions to identify opportunities for more targeted recommendations and strategies to improve dietary intakes among adolescents. Data from the first 24-h recall of 14-18 years old in the 2011-2012 National Nutrition and Physical Activity Survey were analysed (n = 772). Participant-defined eating occasions were classified as breakfast, lunch, dinner or other eating occasions combined. The mean percent contribution to the total day intake of top shortfall nutrients (calcium, magnesium, vitamin A, iron), discretionary calories, saturated fat, free sugars and sodium, as well as nutrient density, the foods consumed and the percent of consumers at each eating occasion, were calculated. Breakfast had the lowest prevalence of consumers (81%), contributed the least to total daily energy (14.6%) and almost a quarter of daily calcium and iron. Other eating occasions combined contributed 47.5% of free sugars and were top contributors of daily calcium (34.6%) and magnesium (31.7%). Discretionary foods contributed 32.4% of the energy at lunch, and the sodium content at lunch was 415 mg/1000 kJ. Key opportunities identified for adolescents were to increase breakfast consumption, given the high nutrient densities of breakfasts consumed; improve overall lunch quality, particularly the sodium content; promote the intake of milk, fruit and a variety of vegetables at both lunch and dinner; maintain healthful choices at in-between meal eating occasions while focusing on decreasing the intake of discretionary foods.
    背景与目标: : 澳大利亚的青少年饮食摄入不足,导致大量青少年有微量营养素摄入不足的风险,并且摄入过多的健康饮食成分。这项研究检查了多种饮食场合的饮食摄入量,以确定有针对性的建议和策略的机会,以改善青少年的饮食摄入量。分析了2011-2012年全国营养和身体活动调查中14-18岁的第一次24小时回忆的数据 (n = 772)。参与者定义的饮食场合分为早餐,午餐,晚餐或其他饮食场合。最大短缺营养素 (钙,镁,维生素a,铁),可自由支配的卡路里,饱和脂肪,游离糖和钠的平均每日摄入量的百分比,以及营养素密度,所消耗的食物和消费者的百分比在每个饮食场合都被计算。早餐的消费者患病率最低 (81%),对每日总能量 (14.6%) 的贡献最少,几乎每天钙和铁的四分之一。其他饮食场合共同贡献了47.5% 的游离糖,并且是每日钙 (34.6%) 和镁 (31.7%) 的主要贡献者。随意食物在午餐时贡献了32.4% 的能量,午餐时钠含量为415 mg/1000 kJ。考虑到早餐的营养密度高,为青少年确定的主要机会是增加早餐消费; 提高午餐的整体质量,特别是钠含量; 在午餐和晚餐时促进牛奶,水果和各种蔬菜的摄入; 在进餐之间保持健康的选择,同时注重减少随意食物的摄入。
  • 【儿童和青少年肥厚型心肌病的外显率: 一项为期12年的临床筛查和预测基因检测的随访研究。】 复制标题 收藏 收藏
    DOI:10.1161/CIRCULATIONAHA.111.090514 复制DOI
    作者列表:Jensen MK,Havndrup O,Christiansen M,Andersen PS,Diness B,Axelsson A,Skovby F,Køber L,Bundgaard H
    BACKGROUND & AIMS: BACKGROUND:The penetrance of hypertrophic cardiomyopathy (HCM) during childhood and adolescence has been only sparsely described. We studied the penetrance of HCM and the short- and long-term outcomes of clinical screening and predictive genetic testing of child relatives of patients with HCM. METHODS AND RESULTS:Ninety probands and 361 relatives were included in a family screening program for HCM (1994-2001). Eleven sarcomere genes, CRYAB, α-GAL, and titin were screened. Sixty-six relatives and 4 probands were <18 years of age at inclusion. Twelve child relatives were mutation carriers (age, 12 ± 5 years), and 26 had unknown genetic status, ie, relatives from families without identified mutations (n = 21) or not tested (n = 5) (age, 11 ± 5 years). Twenty-eight noncarriers (42%; age, 10 ± 4 years) served as control subjects. Two of 38 child relatives (5%) at risk of developing HCM fulfilled diagnostic criteria for HCM at inclusion. After 12 ± 1 years of follow-up, 2 of the 36 (6%; 95% confidence interval, 2-18) at-risk child relatives who were phenotype negative at inclusion had developed the HCM phenotype at 26 and 28 years of age. During follow-up, none of the child relatives experienced serious cardiac events. Participation in the screening program had no long-term negative psychological impact. CONCLUSIONS:The penetrance of HCM in phenotype-negative child relatives at risk of developing HCM was 6% after 12 years of follow-up. The finding of phenotype conversion in the mid-20s warrants continued screening into adulthood. Forty-two percent of the child relatives were noncarriers, and repeat clinical follow-up could be safely limited to the remaining children.
    背景与目标:

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