80 research outputs found
BigO: A public health decision support system for measuring obesogenic behaviors of children in relation to their local environment
Obesity is a complex disease and its prevalence depends on multiple factors
related to the local socioeconomic, cultural and urban context of individuals.
Many obesity prevention strategies and policies, however, are horizontal
measures that do not depend on context-specific evidence. In this paper we
present an overview of BigO (http://bigoprogram.eu), a system designed to
collect objective behavioral data from children and adolescent populations as
well as their environment in order to support public health authorities in
formulating effective, context-specific policies and interventions addressing
childhood obesity. We present an overview of the data acquisition, indicator
extraction, data exploration and analysis components of the BigO system, as
well as an account of its preliminary pilot application in 33 schools and 2
clinics in four European countries, involving over 4,200 participants.Comment: Accepted version to be published in 2020, 42nd Annual International
Conference of the IEEE Engineering in Medicine and Biology Society (EMBC),
Montreal, Canad
International Consensus Guideline on Small for Gestational Age (SGA): Etiology and Management from Infancy to Early Adulthood
: This International Consensus Guideline was developed by experts in the field of SGA of 10 pediatric endocrine societies worldwide. A consensus meeting was held and 1300 articles formed the basis for discussions. All experts voted about the strengths of the recommendations. The guideline gives new and clinically relevant insights into the etiology of short stature after SGA birth, including novel knowledge about (epi)genetic causes. Besides, it presents long-term consequences of SGA birth and new treatment options, including treatment with gonadotropin-releasing hormone agonist (GnRHa) in addition to growth hormone (GH) treatment, and the metabolic and cardiovascular health of young adults born SGA after cessation of childhood-GH-treatment in comparison with appropriate control groups. To diagnose SGA, accurate anthropometry and use of national growth charts are recommended. Follow-up in early life is warranted and neurodevelopment evaluation in those at risk. Excessive postnatal weight gain should be avoided, as this is associated with an unfavorable cardio-metabolic health profile in adulthood. Children born SGA with persistent short stature < -2.5 SDS at age 2 years or < -2 SDS at age of 3-4 years, should be referred for diagnostic work-up. In case of dysmorphic features, major malformations, microcephaly, developmental delay, intellectual disability and/or signs of skeletal dysplasia, genetic testing should be considered. Treatment with 0.033-0.067 mg GH/kg/day is recommended in case of persistent short stature at age of 3-4 years. Adding GnRHa treatment could be considered when short adult height is expected at pubertal onset. All young adults born SGA require counseling to adopt a healthy lifestyle
Toward Systems Models for Obesity Prevention: A Big Role for Big Data
The relation among the various causal factors of obesity is not well understood, and there remains a lack of viable data to advance integrated, systems models of its etiology. The collection of big data has begun to allow the exploration of causal associations between behavior, built environment, and obesity-relevant health outcomes. Here, the traditional epidemiologic and emerging big data approaches used in obesity research are compared, describing the research questions, needs, and outcomes of 3 broad research domains: eating behavior, social food environments, and the built environment. Taking tangible steps at the intersection of these domains, the recent European Union project "BigO: Big data against childhood obesity" used a mobile health tool to link objective measurements of health, physical activity, and the built environment. BigO provided learning on the limitations of big data, such as privacy concerns, study sampling, and the balancing of epidemiologic domain expertise with the required technical expertise. Adopting big data approaches will facilitate the exploitation of data concerning obesity-relevant behaviors of a greater variety, which are also processed at speed, facilitated by mobile-based data collection and monitoring systems, citizen science, and artificial intelligence. These approaches will allow the field to expand from causal inference to more complex, systems-level predictive models, stimulating ambitious and effective policy interventions
Starting point for benchmarking outcomes and reporting of pituitary adenoma surgery within the European Reference Network on Rare Endocrine Conditions (Endo-ERN): results from a meta-analysis and survey study
Objective: The European Reference Network on Rare Endocrine Conditions (Endo-ERN) aims to organize high-quality healthcare throughout Europe, inc luding care for pituitary adenoma patients. As surgery is the mainstay of treatment, we aimed to describe the current surgical practice and published surgical outcomes of pi tuitary adenoma within Endo-ERN.
Design and Methods: Systematic review and meta-analysis of studies reporting surgical outcomes of pituitary adenoma patients within Endo-ERN MTG6 pituitary reference centers between 2010 and 2019. A survey was completed by refere nce centers on their current surgical practice.
Results: A total of 18 out of 43 (42%) reference centers located in 7 of the 20 (35%) MTG6- represented countries published 48 articles. Remission rates we re 50% (95% CI: 42–59) for patients with acromegaly, 68% (95% CI: 60–75) for Cushing’s disease, and 53% (95% CI: 39–66%) for prolactinoma. Gross total resection was achieved in 49% (95% CI: 37–61%) of patients and visual improvement in 78% (95% CI: 68–87). Mort ality, hemorrhage, and carotid injury occurred in less than 1% of patients. New-onset hypopituitarism occurred in 16% (95% CI: 11–23), transient diabetes insipidus in 12% (95 % CI: 6–21), permanent diabetes insipidus in 4% (95% CI: 3–6), syndrome of inappropria te secretion of antidiuretic hormone (SIADH) in 9% (95% CI: 5–14), severe epist axis in 2% (95% CI: 0–4), and cerebrospinal fluid leak in 4% (95% CI: 2–6). Thirty-five (81 %) centers completed the survey: 54% were operated endoscopically and 57% were together with an ENT surgeon.
Conclusion: The results of this study could be used as a first benchmark for the outcomes of pituitary adenoma surgery within Endo-ERN. However, the hete rogeneity between studies in the reporting of outcomes hampers comparability and warrants outcome collection through registries
Primary Generalized Glucocorticoid Resistance and Hypersensitivity
Context:The human glucocorticoid receptor (hGR) is a ubiquitously
expressed intracellular, ligand-dependent transcription factor, which
mediates the action of glucocorticoids and influences physiological
functions essential for life. Alterations in the molecular mechanisms of
hGR action impair glucocorticoid signal transduction and alter tissue
sensitivity to glucocorticoids. This review summarizes the
pathophysiology, molecular mechanisms and clinical aspects of primary
generalized glucocorticoid resistance (PGGR) and hypersensitivity
(PGGH). Evidence Acquisition: A systematic review of the published,
peer-reviewed medical literature (PubMed: 1975 through May 2011) was
conducted to identify original articles and reviews on this topic.
Evidence Synthesis: Evidence synthesis was relied upon the experience of
a number of experts in the field, including our extensive personal
experience. Conclusions: The molecular basis of PGGR and PGGH has been
ascribed to mutations in the hGR gene, which alter tissue sensitivity to
glucocorticoids. The stochastic nature of glucocorticoid signaling
pathways in association with the variable effect that hGR gene
mutations/polymorphisms might have on glucocorticoid signal transduction
indicates that alterations in hGR action may have important implications
for many critical biological processes, such as the behavioral and
physiological responses to stress, the immune and inflammatory reaction,
as well as growth and reproduction. Copyright (C) 2011 S. Karger AG,
Base
Primary Generalized Glucocorticoid Resistance and Hypersensitivity: The End-Organ Involvement in the Stress Response
Primary generalized glucocorticoid resistance (PGGR or Chrousos
syndrome) and primary generalized glucocorticoid hypersensitivity (PGGH)
are rare genetic disorders characterized by generalized, partial
target-tissue insensitivity or hypersensitivity to glucocorticoids,
respectively, while also causing compensatory alterations in the
activity of the hypothalamic-pituitary-adrenal axis. The molecular basis
of Chrousos syndrome and PGGH has been ascribed to mutations in the gene
encoding the human glucocorticoid receptor (hGR), which impair
glucocorticoid signal transduction and alter tissue sensitivity to
glucocorticoids. Alterations in hGR action may have important
implications for many critical biological processes, such as the
behavioral and physiologic responses to stress, immune responses,
growth, and reproduction. This Presentation summarizes the
pathophysiology, clinical manifestations, and molecular mechanisms of
the PGGR and PGGH states
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