Dietary intakes of adolescent girls in relation to weight status

Background: To examine macronutrient and micronutrient intake of adolescent girls of Tehran, capital of Iran to discover any malnutrition in relation to weight status and dieting. Methods: A cross-sectional study was conducted. Four hundred 11- to 17-year-old students were selected by multistage cluster sampling from secondary and high schools of Tehran. The information about dietary intakes was taken by food frequency questionnaire and 24-hour recall form. The students' body mass indices (BMIs) were measured and were classified according to National Center for Health Statistics/Center for Disease Control and Prevention (2000) growth charts. Participants were also questioned about body image and dieting. Results: 6.7 of adolescent girls were classified as being obese, 14.6 overweight, 75.4 normal and 3.2 underweight. Students 11-13 year old, had mean intakes lower than estimated average requirement (EAR) for folic acid, vitamin E, calcium, magnesium, phosphorus, potassium and sodium, and 14-18 year old students had mean intakes lower than EAR for niacin, pyridoxine, folic acid, pantothenic acid, vitamin E, calcium, magnesium, phosphorus, potassium, sodium and zinc. Obese and overweight adolescents had less carbohydrate, thiamin, niacin, iron and selenium intake. The participants, who were dieting, used significantly less amounts of proteins, carbohydrates, thiamin, niacin, iron, selenium, sodium and zinc. Conclusion: Knowing the harmful consequences of nutrient deficiency especially in adolescents, nutrition education must be emphasized in schools to promote nutritional literacy

Impact of comorbid conditions on asthmatic adults and children

Comorbid conditions (comorbidities) can complicate the diagnosis and management of asthma. In different age groups, comorbid conditions can present varying challenges, including diagnostic confusion due to mimicking asthma symptoms, exacerbation of asthma symptoms, therapy for comorbid conditions affecting asthma or therapy for asthma affecting these conditions. This review aims to summarise some common comorbid conditions with asthma, such as rhinitis, vocal cord dysfunction, gastro-oesophageal reflux, psychiatric disorders, obesity and obstructive sleep apnoea, and discuss their prevalence, symptoms, diagnosis and treatment, highlighting any differences in how they impact children and adults. Overall, there is a lack of data on the impact of treating comorbid conditions on asthma outcomes and further studies are needed to guide age-appropriate asthma management in the presence of these conditions.This article is freely available via Open Access. Click on the Publisher URL to access it via the publisher's site.A.K. reports personal fees from AstraZeneca, Behring, Boehringer Ingelheim, GlaxoSmithKline, Griffols, Teva, Novartis, Novo Nordisk, Paladdin, Pfizer, Purdue, Sanofi and Trudel, outside the submitted work. D.M.G.H. reports personal fees from AstraZeneca, Chiesi and Pfizer and grants and personal fees from Boehringer Ingelheim, GlaxoSmithKline and Novartis, outside the submitted work. S.J.S. reports fees from AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, Novartis, Propeller Health, Regeneron and Sanofi, outside the submitted work all paid to the University of Colorado School of Medicinepublished version, accepted version, submitted versio

EFFECTS OF GROWTH HORMONE REPLACEMENT THERAPY ON THYROID FUNCTION TESTS IN GROWTH HORMONE DEFICIENT CHILDREN

"nThere are numerous, often contradictory reports on the effect of growth hormone (GH) therapy on thyroid function. These reports prompted us to evaluate the impact of GH therapy on thyroid function in previously euthyroid children with GH deficiency. Twenty five clinically and biochemically euthyroid children with GH deficiency were studied. A thyroid profile (T4, Free T4, T3 and TSH) was performed at baseline and 3, 6 and 12 months after GH therapy in 21 children with idiopathic growth hormone deficiency (group A) and 4 children with organic GH deficiency (group B). We observed a significant reduction in serum T4 and free T4 concentrations during GH therapy in both groups (P < 0.01). No patient in group A had free T4 levels fell into the hypothyroid range, while in one of four patients in group B, free T4 value fell into the hypothyroid range during GH therapy. In both groups, no significant variation in serum TSH and T3 was recorded at any time. Our data suggest that GH therapy can introduce changes in thyroid function and so confirm the need of a careful monitoring of thyroid function in particular in children with organic GH deficiency during long-term GH therapy

Basophil activation test in the diagnosis and monitoring of mastocytosis patients with wasp venom allergy on immunotherapy

Background There is need for an accurate diagnostic test in mastocytosis patients with wasp venom allergy (WVA) and monitoring of these patients during immunotherapy (IT). In this study, we aimed to evaluate sensitivity and specificity of the Basophil Activation Test (BAT) as a diagnostic and monitoring test in patients with mastocytosis and WVA. Methods Seventeen patients with mastocytosis and WVA and six mastocytosis patients without WVA were included. BAT was performed before the start of IT (first visit) and at 6 weeks (second visit) and 1 year (third visit), after reaching the maintenance dose. Of 17 patients included, 11 completed the third visit. In mastocytosis patients with WVA, dose-dependent wasp-venom induced upregulation of CD63 and CD203c expression on basophils was observed compared with mastocytosis patients without WVA. Serum specific IgE, IgG4, and tryptase levels were measured in all patients. Results BAT had a sensitivity of 87% and specificity of 100% in diagnosing WVA in mastocytosis patients. Basophil allergen threshold sensitivity with respect to CD63 and CD203c was significantly decreased in the second visit compared with the first visit and increased significantly in the third visit compared with the second visit. Specific IgE levels increased significantly in the second visit compared with first and decreased significantly in the third visit compared with the second. Specific IgG4 levels rose significantly in the second visit compared with the first and on the third visit compared with the second. Tryptase levels did not change significantly during the study. Conclusions BAT represents a diagnostic test with 100% specificity in allergic patients with mastocytosis and these patients are better to be monitored for a longer period during IT. (c) 2013 International Clinical Cytometry Societ

Frequency and risk factors of penicillin and amoxicillin allergy in suspected patients with drug allergy

Background: Unconfirmed beta-lactam allergy is a significant public health problem because of the limitations it imposes in drug selection. In this study, we aimed to evaluate patients referred for beta-lactam allergy to determine the frequency of confirmed beta-lactam allergy and identify some risk factors. Methods: In a prospective cohort study, all referred patients to Immunology, Asthma and Allergy Research Institute in Tehran University of Medical Sciences (between 2007 - 2009) who suspected to have beta-lactam allergy were entered into this study based on having the inclusion criteria. Follow-up was performed 6-8 years after the final diagnosis. Diagnosis of beta-lactam allergy relies on thorough history and specific IgE measurements (ImmunoCAP), skin prick testing (SPT), intradermal testing (IDT), patch testing, and oral drug challenge test. Results: Fifty-one patients with mean age of 24.5 (±18.5) years were enrolled in this study. Based on workups, beta-lactam allergy was confirmed in 16 (31.4%) patients, suspicious in 22 (43.1%) patients and ruled out in 13 (25.5%) patients. During the follow-up, 3 patients with suspicious drug allergy consumed the culprit drug with no reaction so allergy was finally ruled out in 16 (31.4%) patients. Age, sex, atopy and family history of drug allergies were not significantly different between the patients with confirmed or ruled-out diagnosis of penicillin and amoxicillin allergy. Conclusion: At least up to one-third of patients with a history of beta-lactam allergy are proven to be safe using the drug. Also, a clear protocol consists ofserum slgE assay and SPT can be helpful to the physicians in the health care system. © 2017, Academy of Medical Sciences of I.R. Iran. All rights reserved

Determinants of non-adherence to anti-TB treatment in high income, low TB incidence settings: a scoping review.

BACKGROUND: Improving adherence to anti-TB treatment is a public health priority in high-income, low incidence (HILI) regions. We conducted a scoping review to identify reported determinants of non-adherence in HILI settings.METHODS: Key terms related to TB, treatment and adherence were used to search MEDLINE, EMBASE, Web of Science, PsycINFO and CINAHL in June 2019. Quantitative studies examining determinants (demographic, clinical, health systems or psychosocial) of non-adherence to anti-TB treatment in HILI settings were included.RESULTS: From 10,801 results, we identified 24 relevant studies from 10 countries. Definitions and methods of assessing adherence were highly variable, as were documented levels of non-adherence (0.9-89%). Demographic factors were assessed in all studies and clinical factors were frequently assessed (23/24). Determinants commonly associated with non-adherence were homelessness, incarceration, and alcohol or drug misuse. Health system (8/24) and psychosocial factors (6/24) were less commonly evaluated.CONCLUSION: Our review identified some key factors associated with non-adherence to anti-TB treatment in HILI settings. Modifiable determinants such as psychosocial factors are under-evidenced and should be further explored, as these may be better targeted by adherence support. There is an urgent need to standardise definitions and measurement of adherence to more accurately identify the strongest determinants