Comparison Of Bone Quantity By Ultrasound Measurements Of Phalanges Between White And Black Children Living In Paraná,brazil, With Europeans

The objective of this study was to determine bone quantity by ultrasound measurements of the proximal fnger phalanges (AD-SoS = amplitude-dependent speed of sound) of healthy Brazilian schoolchildren living in Paraná, Brazil, and to compare these values with European populations. The sample was composed of 1356 Brazilian schoolchildren of both genders (660 males, 696 females), aged 6 to 11 years, divided into white (840) and black (516) groups and compared to age- and gender-matched Europeans. AD-SoS of the schoolchildren increased significantly with age for both genders. Significantly higher AD-SoS values were observed for the white children (1916 ± 58) compared to their black counterparts (1898 ± 72) and for the female gender (1920 ± 61) compared to the male gender (1898 ± 66). Overall, the AD-SoS outcomes for females were similar to those of European studies. However, the AD-SoS of the Brazilian schoolchildren of both genders and skin colors was lower than that reported for children in Poland. AD-SoS outcomes for Brazilian schoolboys were similar to those obtained in Italian studies and were lower than those of the Spanish children. In conclusion, Brazilian schoolchildren of both genders and skin colors showed lower bone quantities than Polish children and Spanish males, and levels similar to Italian children and Spanish females.4310976981Mora, S., Gilsanz, V., Establishment of peak bone mass (2003) En-docrinol Metab Clin North Am, 32, pp. 39-63Silva, C.C., Goldberg, T.B., Teixeira, A.S., Dalmas, J.C., Bone mineralization among male adolescents: Critical years for bone mass gain (2004) J Pediatr, 80, pp. 461-467Habicht, J.P., Martorell, R., Yarbrough, C., Malina, R.M., Klein, R.E., Height and weight standards for preschool children. How relevant are ethnic differences in growth potential? (1974) Lancet, 1, pp. 611-614WHO Working Group (1986) Bull World Health Organ, 64, pp. 929-941. , Use and interpretation of anthropometric indicators of nutri-tional statusCauley, J.A., Lui, L.Y., Stone, K.L., Hillier, T.A., Zmuda, J.M., Hochberg, M., Longitudinal study of changes in hip bone mineral density in Caucasian and African-American women (2005) J Am Geriatr Soc, 53, pp. 183-189Neuner, J.M., Zhang, X., Sparapani, R., Laud, P.W., Nattinger, A.B., Racial and socioeconomic disparities in bone density testing before and after hip fracture (2007) J Gen Intern Med, 22, pp. 1239-1245Leder, B.Z., Araujo, A.B., Travison, T.G., McKinlay, J.B., Racial and ethnic differences in bone turnover markers in men (2007) J Clin Endocrinol Metab, 92, pp. 3453-3457Travison, T.G., Araujo, A.B., Esche, G.R., McKinlay, J.B., The relationship between body composition and bone mineral content: Threshold effects in a racially and ethnically diverse group of men (2008) Osteoporos Int, 19, pp. 29-38Travison, T.G., Beck, T.J., Esche, G.R., Araujo, A.B., McKinlay, J.B., Age trends in proximal femur geometry in men: Variation by race and ethnicity (2008) Osteoporos Int, 19, pp. 277-287Hill, D.D., Cauley, J.A., Sheu, Y., Bunker, C.H., Patrick, A.L., Baker, C.E., Correlates of bone mineral density in men of African ancestry: The Tobago bone health study (2008) Osteoporos Int, 19, pp. 227-234INEP (Instituto Nacional de Estudos e Pesquisas Edu-cacionais Anísio Teixeira) Mostre Sua Raça, , http://inep.gov.br/imprensa/noticias/censo/escolar/news05_05.htm, declare sua cor, Accessed July 26, 2010Ribeiro, R.R., Guerra-Junior, G., de Barros-Filho, A., Bone mass in schoolchildren in Brazil: The effect of racial miscegenation, pubertal stage, and socioeconomic differences (2009) J Bone Miner Metab, 27, pp. 494-501Baroncelli, G.I., Federico, G., Bertelloni, S., de Terlizzi, F., Cadossi, R., Saggese, G., Bone quality assessment by quantitative ultrasound of proximal phalanxes of the hand in healthy subjects aged 3-21 years (2001) Pediatr Res, 49, pp. 713-718Gimeno, B.J., Azcona San Julián, C., Sierrasesúmaga Ariznabarreta, L., Bone mineral density determination by os-teosonography in healthy children and adolescents: Normal values (2001) An Esp Pediatr, 54, pp. 540-546Vignolo, M., Brignone, A., Mascagni, A., Ravera, G., Biasotti, B., Aicardi, G., Infuence of age, sex, and growth variables on phalangeal quantitative ultrasound measures: A study in healthy children and adolescents (2003) Calcif Tissue Int, 72, pp. 681-688Vignolo, M., Parodi, A., Mascagni, A., Torrisi, C., de Terlizzi, F., Aicardi, G., Longitudinal assessment of bone quality by quantitative ultrasonography in children and adolescents (2006) Ultrasound Med Biol, 32, pp. 1003-1010Halaba, Z.P., Quantitative ultrasound measurements at hand phalanges in children and adolescents: A longitudinal study (2008) Ultrasound Med Biol, 34, pp. 1547-1553Pena, S.D.J., Bortolini, M.C., Pode a genética defnir quem deve se benefciar das cotas universitárias e demais ações afr- mativas? (2004) Estud Av, 18, pp. 31-50Pena, S.D.J., Bastos-Rodrigues, L., Pimenta, J.R., Bydlowski, S.P., DNA tests probe the genomic ancestry of Brazilians (2009) Braz J Med Biol Res, 42, pp. 870-876Telles, E., (2003) Racismo À Brasileira: Uma Nova Perspectiva Soci-ológica, , Rio De Janeiro: Relume Dumará, Fundação FordOliveira, F., Ser negro no Brasil: Alcances e limites (2004) Estud Av, 18, pp. 57-60Gilsanz, V., Skaggs, D.L., Kovanlikaya, A., Sayre, J., Loro, M.L., Kaufman, F., Differential effect of race on the axial and appendicular skeletons of children (1998) J Clin Endocrinol Metab, 83, pp. 1420-1427Nelson, D.A., Simpson, P.M., Johnson, C.C., Barondess, D.A., Kleerekoper, M., The accumulation of whole body skeletal mass in third- and fourth-grade children: Effects of age, gender, ethnicity, and body composition (1997) Bone, 20, pp. 73-78Bell, N.H., Shary, J., Stevens, J., Garza, M., Gordon, L., Edwards, J., Demonstration that bone mass is greater in black than in white children (1991) J Bone Miner Res, 6, pp. 719-723Rupich, R.C., Specker, B.L., Lieuw, A.F., Ho, M., Gender and race differences in bone mass during infancy (1996) Calcif Tissue Int, 58, pp. 395-397Abrams, S.A., O'Brien, K.O., Liang, L.K., Stuff, J.E., Differences in calcium absorption and kinetics between black and white girls aged 5-16 years (1995) J Bone Miner Res, 10, pp. 829-833Bryant, R.J., Wastney, M.E., Martin, B.R., Wood, O., McCabe, G.P., Morshidi, M., Racial differences in bone turnover and calcium metabolism in adolescent females (2003) J Clin Endocrinol Metab, 88, pp. 1043-1047Jaime, P.C., Latorre, M.R., Florindo, A.A., Tanaka, T., Zerbini, C.A., Dietary intake of Brazilian black and white men and its relationship to the bone mineral density of the femoral neck (2006) São Paulo Med J, 124, pp. 267-270Bhattoa, H.P., Bettembuk, P., Ganacharya, S., Balogh, A., Prevalence and seasonal variation of hypovitaminosis D and its relationship to bone metabolism in community dwelling postmenopausal Hungarian women (2004) Osteoporos Int, 15, pp. 447-451Wuster, C., Albanese, C., de Aloysio, D., Duboeuf, F., Gambac-Ciani, M., Gonnelli, S., Phalangeal osteosonogrammetry study: Age-related changes, diagnostic sensitivity, and discrimination power (2000) J Bone Miner Res, 15, pp. 1603-1614. , The Phalangeal Osteosonogrammetry Study Grou

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

When It Was Nutricional Of White And Black Schoolboys Of The South Of The Brasil [estado Nutricional De Escolares Brancos E Negros Do Sul Do Brasil]

OBJECTIVE. To evaluate the nutritional status of pupils from public schools of two cities in the western part of the state of Parana according to socioeconomic status and race. METHODS. 1,443 children (aged 6 - 11 years) of both genders, classified as white or black and with different socioeconomic status were evaluated by weight, height and body mass index, transformed into the z score. A descriptive analysis of the data was performed, and the chi-square test, Fisher's exact test, variance analysis and linear regression with significance of 5% were used. RESULTS. In the low socioeconomic status black pupils were predominant. Black boys presented lower values in weight and height in relation to white boys. When values of the z score lower than -2 were considered, white girls predominated in weight and height and black boys in height. No significant difference was found in values above +2. Low interaction of socioeconomic status and age was observed to predict weight, as well as for socioeconomic status, age and color of the skin, for height. CONCLUSION. Despite socioeconomic and racial differences found, there was no important variation of the nutritional status in the group of schoolchildren evaluated.552121126Laguardia, J., O uso da variável raça na pesquisa em saúde (2004) Physis. (Rio J), 14, pp. 197-234Coimbra Jr., C.E.A., Minorías étnico-raciales, desigualdad y salud: Consideraciones teóricas preliminares (1998) Salud, cambio social e política: Perspectivas desde América Latina, pp. 151-61. , Bronfman MN, Castro R, organizadores. 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Changes in the association between overweight and family income between 1971 and 2002 (2006) Am J Clin Nutr, 84, pp. 707-16Monteiro, C.A., Conde, W.L., Tendência secular da desnutrição e da obesidade na infância na cidade de São Paulo (1974-1996) (2000) Rev Saúde Pública, 34, pp. 52-61Batista Filho, M., Rissin, A., Nutritional transition in Brazil: Geographic and temporal trends (2003) Cad Saúde Pública, 19, pp. 181-91Cigolini, A.A., (1999) A fragmentação do território em unidades político-administrativas: Análise da criação de municípios no Estado do Paraná, , [dissertação].Florianópolis: Universidade Federal de Santa Catarinahttp://urlwww.cdc.gov/growthcharts, NCHS - National Center for Health Statistics. Available fromhttp://www.anep.org.br/mural/anep/04-12-97-cceb.htm, ANEP - Associação Nacional de Empresas de Pesquisa. Critério de Classificação Econômica. Brasil. Disponível emhttp://inep.gov.br/imprensa/noticias/censo/escolar/news05_05.htm, INEP - Instituto Nacional de Estudos e Pesquisas Educacionais Anísio Teixeira. Mostre sua raça, declare sua cor. Disponível emBahr, P.R., Race and nutrition: An investigation of Black-White differences in health-related nutritional behaviours (2007) Sociol Health Illn, 93, pp. 2105-10Haas, J.S., Lee, L.B., Kalpan, C.P., Sonneborn, D., Phillips, K.A., Liang, S.Y., The association of race, socioeconomic status, and health insurance with the prevalence of overweight among children and adolescents (2003) Am J Public Health, 93, pp. 2105-10Habicht, J.P., Martorell, R., Yarbrough, G., Klein, R.E., Malina, R.M., Height and weight standards for preschool children: How relevant are ethnic differences in growth potential? (1974) Lancet, 1, pp. 611-5Use and interpretation of anthropometric indicators of nutritional status (1986) Bull WHO, 64, pp. 929-41. , World Health OrganizationBarros- Filho, A.A., Barros, M.B.A., Maude, G.H., Ross, D.A., Davies, P.S.W., Preece, M.A., Evaluation of the nutritional status of 1 st-year school children in Campinas, Brazil (1990) Ann Trop Paediatr, 10, pp. 75-84Parent, A.S., Teilmann, G., Juul, A., Skakkebaek, N.E., Toparri, J., Bourguignon, J.P., The timing of normal puberty and the age limits of sexual precocity: Variations around the world, secular trends, and changes after migration (2003) Endocr Ver, 24, pp. 668-93Herman-Giddens, M.E., Slora, E.J., Wasserman, R.C., Bourdony, C.J., Bhapkar, M.V., Koch, G.G., Hasemeier, C.M., Secondary sexual characteristics and menses in young girls seen in office practice: A study from the Pediatric Research in Office Settings network (1997) Pediatrics, 99, pp. 505-12Brasil, L.M.P., Fisberg, M., Maranhão, H.S., Excesso de peso de escolares em região do nordeste Brasileiro: Contraste entre as redes de ensino pública eprivada (2007) Rev Bras Saude Mater Infant, 7, pp. 405-12Troncon, J.K., Gomes, J.P., Guerra-Junior, G., Lalli, C.A., Prevalência de obesidade em crianças de uma escola pública e de um ambulatório geral de Pediatria de Hospital universitário (2007) Rev Paul Pediatr, 25, pp. 305-10Sotelo, Y.O.M., Colugnati, F.A.B., Taddei, J.A.A.C., Prevalência de sobrepeso e obesidade entre escolares da rede pública segundo três critérios de diagnóstico antropométrico (2004) Cad Saude Publica, 20, pp. 233-40Silva, G.A.P., Balaban, G., Motta, M.E.F.A., Prevalência de sobrepeso e obesidade em crianças e adolescentes de diferentes condições socioeconômicas (2005) Rev Bras Saúde Matern Infant, 5, pp. 53-9Escrivão, M.A.M.S., Oliveira, F.L., Taddei, J.A.A.C., Lopez, A., Obesidade exógena na infância e na adolescência (2000) J Pediatr. 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