Secular Change in Growth of Philadelphia Black Adolescents

Secular changes in growth were observed on a USA urban population. In 1977 nearly 900 Black Philadelphia adolescents, IOV2 to 16 years of age were examined and the results were compared with an earlier Philadelphia sample measured in 1956-65. Youths in 1977 were taller and heavier, on average, and had greater sitting heights than youths in 1956-65. Mean log weight relative to mean height was almost unchanged as were skinfold thicknesses. There is some evidence of accelerated skeletal maturation. The general conclusion is that the situation of Black adolescents in Philadelphia has improved over approximately the past twenty years

Improved residual fat malabsorption and growth in children with cystic fibrosis treated with a novel oral structured lipid supplement: A randomized controlled trial.

BACKGROUND:In the primary analysis of a 12-month double-blind randomized active placebo-controlled trial, treatment of children with cystic fibrosis (CF) and pancreatic insufficiency (PI) with a readily absorbable structured lipid (Encala™, Envara Health, Wayne, PA) was safe, well-tolerated and improved dietary fat absorption (stool coefficient of fat absorption [CFA]), growth, and plasma fatty acids (FA). OBJECTIVE:To determine if the Encala™ treatment effect varied by severity of baseline fat malabsorption. METHODS:Subjects (n = 66, 10.5±3.0 yrs, 39% female) with baseline CFA who completed a three-month treatment with Encala™ or a calorie and macronutrient-matched placebo were included in this subgroup analysis. Subjects were categorized by median baseline CFA: low CFA (<88%) and high CFA (≥88%). At baseline and 3-month evaluations, CFA (72-hour stool, weighed food record) and height (HAZ), weight (WAZ) and BMI (BMIZ) Z-scores were calculated. Fasting plasma fatty acid (FA) concentrations were also measured. RESULTS:Subjects in the low CFA subgroup had significantly improved CFA (+7.5±7.2%, mean 86.3±6.7, p = 0.002), and reduced stool fat loss (-5.7±7.2 g/24 hours) following three months of EncalaTM treatment. These subjects also had increased plasma linoleic acid (+20%), α-linolenic acid (+56%), and total FA (+20%) (p≤0.005 for all) concentrations and improvements in HAZ (0.06±0.08), WAZ (0.17±0.16), and BMIZ (0.20±0.25) (p≤0.002 for all). CFA and FA were unchanged with placebo in the low CFA group, with some WAZ increases (0.14±0.24, p = 0.02). High CFA subjects (both placebo and Encala™ groups) had improvements in WAZ and some FA. CONCLUSIONS:Subjects with CF, PI and more severe fat malabsorption experienced greater improvements in CFA, FA and growth after three months of Encala™ treatment. Encala™ was safe, well-tolerated and efficacious in patients with CF and PI with residual fat malabsorption and improved dietary energy absorption, weight gain and FA status in this at-risk group

Vitamin D status, nutrition and growth in HIV-infected mothers and HIV-exposed infants and children in Botswana.

BACKGROUND:Poor vitamin D status is a global health problem and common in patients with human immunodeficiency virus (HIV) in high-income countries. There is less evidence on prevalence of vitamin D deficiency and nutrition and growth in HIV-infected and -exposed children in low- and middle-income countries. OBJECTIVES:To determine the vitamin D status in Batswana HIV-infected mothers and their children, differences among HIV-infected mothers and between HIV-exposed and -infected infants and children, and associations between vitamin D and disease-related outcomes, nutrition, and growth. METHODS:This was a cross-sectional study of HIV+ mothers and HIV-exposed infants and unrelated children (1-7.9 years). Serum 25-hydroxyvitamin D (25(OH)D) was measured, among other nutritional indicators, for mothers, infants and children. Vitamin D status for HIV-infected mothers and children, and an immune panel was assessed. History of HIV anti-retroviral medications and breastfeeding were obtained. Data were collected prior to universal combination antiretroviral therapy in pregnancy. RESULTS:Mothers (n = 36) had a mean serum 25(OH)D of 37.2±12.4ng/mL; 11% had insufficient (<20ng/mL), 17% moderately low (20.0-29.9ng/mL) and 72% sufficient (≥30ng/mL) concentrations. No infants (n = 36) or children (n = 48) were vitamin D insufficient; 22% of HIV- and no HIV+ infants had moderately low concentrations and 78% of HIV- and 100% of HIV+ infants had sufficient status, 8% of HIV- and no HIV+ children had moderately low concentrations and 92% of HIV- and 100% HIV+ children had sufficient concentrations. HIV+ children had significantly lower length/height Z scores compared to HIV- children. Length/height Z score was positively correlated with serum 25(OH)D in all children (r = 0.33, p = 0.023), with a stronger correlation in the HIV+ children (r = 0.47 p = 0.021). In mothers, serum 25(OH)D was positively associated with CD4% (r = 0.40, p = 0.016). CONCLUSIONS:Results showed a low prevalence of vitamin D insufficiency in Botswana. Growth was positively correlated with vitamin D status in HIV-exposed children, and HIV+ children had poorer linear growth than HIV- children

Vitamin D supplementation and antibacterial immune responses in adolescents and young adults with HIV/AIDS

Human monocytes activated by toll-like receptor 2/1 ligand (TLR2/1L) show enhanced expression of the vitamin D receptor (VDR) and the vitamin D-activating enzyme 1α-hydroxylase (CYP27B1). The resulting intracrine conversion of precursor 25-hydroxyvitamin D(3) (25OHD) to active 1,25-dihydroxyvitamin D (1,25(OH)(2)D) can stimulate expression of antibacterial cathelicidin (CAMP). To determine whether this response is functional in HIV-infected subjects (HIV+), serum from HIV+ subjects pre- and post-vitamin D supplementation was utilized in monocyte cultures with or without TLR2/1L. Expression of CYP27B1 and VDR was enhanced following treatment with TLR2/1L, although this effect was lower in HIV+ vs HIV- serum (p<0.05). CAMP was also lower in TLR2/1L-treated monocytes cultured in HIV+ serum (p<0.01). In a dose study, supplementation of HIV+ subjects with 4,000IU or 7,000IU vitamin D/day increased serum 25OHD from 17.3±8.0 and 20.6±6.2 ng/ml (43 nM and 51 nM) at baseline to 41.1±12.0 and 51.9±23.1 ng/ml (103 nM and 130 nM) after 12 wks (both p<0.001). Greater percent change from baseline 25OHD was significantly associated with enhanced TLR2/1L-induced monocyte CAMP adjusted for baseline expression (p = 0.009). In a randomized placebo-controlled trial, 7,000IU vitamin D/day increased serum 25OHD from 18.0±8.6 to 32.7±13.8 ng/ml (45 nM and 82 nM) after 12 wks. Expression of CAMP increased significantly from baseline after 52 wks of vitamin D-supplementation. At this time point, TLR2/1L-induced CAMP was positively associated with percent change from baseline in 25OHD (p = 0.029 overall and 0.002 within vitamin D-supplemented only). These data indicate that vitamin D supplementation in HIV-infected subjects can promote improved antibacterial immunity, but also suggest that longer periods of supplementation are required to achieve this

New Population-Based Reference Values for Spinal Mobility Measures Based on the 2009-2010 National Health and Nutrition Examination Survey

Cilj: Utvrditi karakteristike ličnosti i stupanj empatije studenata prve godine zdravstvenih studija te ispitati doprinos osobina ličnosti u predviđanju empatije. Metode: U istraživanju je sudjelovalo 59 studenata svih pet studijskih smjerova Odjela zdravstvenih studija Sveučilišta u Splitu. Za vrijeme predavanja iz kolegija Komunikacijske vještine primijenjeni su mjerni instrumenti-E-upitnik za ispitivanje empatije i BFQ upitnik za ispitivanje pet osobina ličnosti (ekstraverzije, ugodnosti, savjesnosti, emocionalne stabilnosti i otvorenosti) uz upute za rješavanje testova, te napomenu da će identitet ispitanika biti poznat samo istraživaču te nakon usmenog pristanka ispitanika. Rezultati: Razina empatije kod studenata zdravstvenih studija mjerena E- upitnikom prosječno je ocijenjena ocjenom 2,9 u rasponu od 0 do 4, što ukazuje na visok stupanj empatije ispitanika. Osobine ličnosti mjerene BFQ upitnikom u ovom istraživanju su: ekstraverzija, ugodnost, savjesnost, emocionalna stabilnost i otvorenost. Od navedenih osobina ličnosti najniža razina zabilježena je za emocionalnu stabilnost-2,99, a najviša za savjesnost 3,42 ( u rasponu od 1 do 5 ). Za ekstraverziju, ugodnost i otvorenost zabilježene su sljedeće prosječne vrijednosti: ekstraverzija i ugodnost 3,35, a otvorenost 3,32, što ukazuje na visoku razinu ovih osobina kod ispitanika. Regresijska analiza pokazala je statistički značajnu povezanost između triju od pet ispitivanih osobina ličnosti-ekstraverzije, ugodnosti i savjesnosti, pri čemu je utjecaj ekstraverzije na empatiju negativan, a utjecaj ugodnosti i savjesnosti pozitivan. Najveći utjecaj na empatiju ima ugodnost. Zaključak: Postojanje empatije kao jedne od najvažnijih i najpoželjnijih karakteristika zdravstvenih djelatnika te njezinu razinu moguće je predvidjeti na osnovi ispitivanja glavnih osobina ličnosti ispitanika. Ekstrovertne osobe u prosjeku su manje empatične, dok savjesne i ugodne osobe iskazuju visok stupanj empatije. Utjecaj emocionalne stabilnosti i otvorenosti na empatiju nije zabilježen.Goal: To define the characteristics of personality and the degree of empathy of the first year students of heath study and to research the contribution of personality characteristics on the prediction of empathy. Metods: 59 students of all five study courses of the Health study department of the university of Split participated in the research. During the lecture of Communication skills the following measuring instruments were used: E-questionnaire for the analysis of empathy and BFQ questionnaire for the analysis of five characteristics of personality (extraversion, agreeableness, conscientiousness, emotional stability and openness) together with the instruction on how to solve the tests, and a note containing the information that the identity of the subject will be known only by the researcher after an informed consent of the subject. Results: The level of empathy of health study students measured by an E-questionnaire has had an average grade of 2.9 on the scale from 0 to 4, which indicates a high level of the empathy of subjects. The personality characteristics measured by BFQ questionnaire in this research are: extraversion, agreeableness, conscientiousness, emotional stability and openness. Emotional stability is located on the lowest level of the scale-2.99 and conscientiousness is located on the highest level of the scale-3,42 (on the scale from 1 to 5). Extraversion, agreeableness and openness have the following average values: extraversion and agreeableness 3,35, and openness 3,32, which indicates a high level of personality characteristics of subjects. Regressive analysis has shown a statistically important connection between three out of five analyzed characteristics of personality- extraversion,agreeableness and conscientiousness, with the negative influence of extraversion on the empathy, and the positive influence of agreeableness and conscientiousness. Conclusion: The existence and the level of empathy as one of the most important and desirable characteristics of health professionals is predictable on the basis of the analysis of personality characteristics of subjects. Extrovers are less emphatical , while conscientious and pleasant people show a high degree of empathy. The influence of emotional stability and openness on the empathy hasn't been recorded

Vitamin D₃ Supplementation in Batswana Children and Adults with HIV: A Pilot Double Blind Randomized Controlled Trial

<div><p>Objectives</p><p>Since vitamin D insufficiency is common worldwide in people with HIV, we explored safety and efficacy of high dose cholecalciferol (D₃) in Botswana, and evaluated potential modifiers of serum 25 hydroxy vitamin D change (Δ25D).</p><p>Design</p><p>Prospective randomized double-blind 12-week pilot trial of subjects ages 5.0–50.9 years.</p><p>Methods</p><p>Sixty subjects randomized within five age groups to either 4000 or 7000IU per day of D₃ and evaluated for vitamin D, parathyroid hormone, HIV, safety and growth status. Efficacy was defined as serum 25 hydroxy vitamin D (25D) ≥32ng/mL, and safety as no simultaneous elevation of serum calcium and 25D. Also assessed were HIV plasma viral RNA viral load (VL), CD4%, anti-retroviral therapy (ART) regime, and height-adjusted (HAZ), weight-adjusted (WAZ) and Body Mass Index (BMIZ) Z scores.</p><p>Results</p><p>Subjects were 50% male, age (mean±SD) 19.5±11.8 years, CD4% 31.8±10.4, with baseline VL log₁₀ range of <1.4 to 3.8 and VL detectable (>1.4) in 22%. From baseline to 12 weeks, 25D increased from 36±9ng/ml to 56±18ng/ml (p<0.0001) and 68% and 90% had 25D ≥32ng/ml, respectively (p = 0.02). Δ25D was similar by dose. No subjects had simultaneously increased serum calcium and 25D. WAZ and BMIZ improved by 12 weeks (p<0.04). HAZ and CD4% increased and VL decreased in the 7000IU/d group (p<0.04). Younger (5–13y) and older (30–50y) subjects had greater Δ25D than those 14–29y (26±17 and 28±12 vs. 11±11ng/ml, respectively, p≤0.001). Δ25D was higher with efavirenz or nevirapine compared to protease inhibitor based treatment (22±12, 27±17, vs. 13±10, respectively, p≤0.03).</p><p>Conclusions</p><p>In a pilot study in Botswana, 12-week high dose D₃ supplementation was safe and improved vitamin D, growth and HIV status; age and ART regimen were significant effect modifiers.</p><p>Trial Registration</p><p>ClinicalTrials.gov <a href="https://clinicaltrials.gov/ct2/show/NCT02189902" target="_blank">NCT02189902</a></p></div