Adiposity and Age Explain Most of the Association between Physical Activity and Fitness in Physically Active Men

BACKGROUND: To determine if there is an association between physical activity assessed by the short version of the International Physical Activity Questionnaire (IPAQ) and cardiorespiratory and muscular fitness. METHODOLOGY/PRINCIPAL FINDINGS: One hundred and eighty-two young males (age range: 20-55 years) completed the short form of the IPAQ to assess physical activity. Body composition (dual-energy X-Ray absorptiometry), muscular fitness (static and dynamic muscle force and power, vertical jump height, running speed [30 m sprint], anaerobic capacity [300 m running test]) and cardiorespiratory fitness (estimated VO(2)max: 20 m shuttle run test) were also determined in all subjects. Activity-related energy expenditure of moderate and vigorous intensity (EEPA(moderate) and EEPA(vigorous), respectively) was inversely associated with indices of adiposity (r = -0.21 to -0.37, P<0.05). Cardiorespiratory fitness (VO(2)max) was positively associated with LogEEPA(moderate) (r = 0.26, P<0.05) and LogEEPA(vigorous) (r = 0.27). However, no association between VO(2)max with LogEEPA(moderate), LogEPPA(vigorous) and LogEEPA(total) was observed after adjusting for the percentage of body fat. Multiple stepwise regression analysis to predict VO(2)max from LogEEPA(walking), LogEEPA(moderate), LogEEPA(vigorous), LogEEPA(total), age and percentage of body fat (%fat) showed that the %fat alone explained 62% of the variance in VO(2)max and that the age added another 10%, while the other variables did not add predictive value to the model [VO(2)max  = 129.6-(25.1× Log %fat) - (34.0× Log age); SEE: 4.3 ml.kg(-1). min(-1); R(2) = 0.72 (P<0.05)]. No positive association between muscular fitness-related variables and physical activity was observed, even after adjusting for body fat or body fat and age. CONCLUSIONS/SIGNIFICANCE: Adiposity and age are the strongest predictors of VO(2)max in healthy men. The energy expended in moderate and vigorous physical activities is inversely associated with adiposity. Muscular fitness does not appear to be associated with physical activity as assessed by the IPAQ

Postural balance, isometric trunk muscle strength and low back symptoms among young adults

Abstract Low back pain (LBP) is a significant health problem in all developed countries. The high prevalence of LBP in youth is a cause of concern because a link has been reported between LBP in adolescence and chronic LBP (CLBP) in adulthood. In order to prevent CLBP in adulthood potential protective factors in youth should be identified. The association between trunk muscle strength and LBP has been widely studied but the results are conflicting. The current knowledge on the role of postural balance in relation to LPB is even more controversial. The aims of the thesis were to evaluate 1) the reproducibility of the inclinometric postural balance and maximal isometric trunk muscle strength measurements, 2) the association of low back symptoms with postural balance, trunk muscle strength, and cross-sectional area and fat content of extensor muscles, and 3) muscular fitness in relation to physical activity and television viewing. The study population belongs to the 1986 Northern Finland Birth Cohort (NFBC 1986), originally consisting of 9,479 children with an expected date of birth between July 1, 1985 and June 30, 1986. A total of 874 subjects completed the physical examination at a mean age of 19 years. Of those who participated in the physical examination 554 subjects took part in magnetic resonance imaging (MRI) of the lumbar spine, including extensor muscles, at a mean age of 21 years. Reproducibility of isometric trunk muscle testing was found to be comparable to other methods that are used to measure trunk muscle function. Low back symptoms were not associated with postural balance or trunk muscle strength. Neither was there an association between LBP and the cross-sectional area or fat content of the lumbar muscles. Trunk muscles were significantly stronger in those who participated in regular physical activity and weaker in those who watched TV more than two hours daily. In conclusion, physical activity has an association with muscular fitness whereas association with TV viewing is negative independently of the level of physical activity. Single measurement of trunk muscle strength, and cross-sectional area or fat content of lumbar extensor muscles has little significance in the evaluation of the severity of low back symptoms in young adults.Tiivistelmä Alaselkäkipu on huomattava kansanterveydellinen ongelma kaikissa kehittyneissä maissa. Erityisen huolestuttavaa on alaselkäkivun yleisyys nuorilla, sillä tällä on todettu olevan yhteyttä krooniseen selkäkipuun aikuisuudessa. Jotta kroonista kipua aikuisiällä voitaisiin ehkäistä, kivulta suojaavat tekijät pitäisi pystyä tunnistamaan jo nuoruudessa. Vartalon lihasvoiman ja alaselkäkivun yhteyttä on tutkittu runsaasti viimeisten vuosikymmenten aikana mutta tulokset ovat ristiriitaisia. Tulokset seisomatasapainon yhteydestä alaselkäkipuun ovat niin ikään ristiriitaisia. Tämän tutkimuksen tavoitteena oli 1) arvioida inklinometrisen tasapainomittauksen ja isometristen lihasvoimamittausten luotettavuutta, 2) arvioida alaselkäoirein yhteyttä vartalon lihasvoimaan, seisomatasapainoon sekä ojentajalihasten rasvoittumiseen ja poikkipinta-alaan ja 3) arvioida lihasvoiman yhteyttä liikunta-aktiivisuuteen ja television katseluun. Tutkimusaineiston perustan muodostavat Pohjois-Suomen 1986 syntymäkohorttiin kuuluvat nuoret Oulun ja Lapin lääneistä, alkuperäiseen kohorttiin kuului 9,479 lasta, joiden laskettu syntymäaika oli heinäkuun 1:n 1986 ja kesäkuun 30:n 1986 välillä. Heistä Oulun Diakonissalaitoksen Liikuntaklinikalla suoritettuihin tutkimuksiin osallistui yhteensä 874 nuorta. Tutkimukseen liittyen Oulun yliopistollisen keskussairaalan radiologian klinikalla suoritettuihin selän magneetti- kuvauksiin osallistui 554 nuorta. Isometrinen lihasvoimatestaus osoittautui luotettavaksi tavaksi mitata vartalon lihasvoimaa. Alaselkäoireilla tai niiden vakavuudella ei todettu olevan yhteyttä vartalon lihasvoimaan tai seisomatasapainoon. Myöskään oireiden ja vartalon ojentajalihasten rasvoittumisen tai poikkipinta-alan välillä ei todettu olevan yhteyttä. Aktiivisemmin liikkuvien lihasvoima oli merkittävästi parempi kuin vähemmän liikkuvilla, toisaalta televisiota runsaasti katsovien lihasvoima oli televisiota vähän katsovia huonompi riippumatta siitä kuinka paljon he harrastivat liikuntaa. Aktiivisella liikunnalla on positiivinen yhteys lihasvoimaan. Toisaalta runsaalla television katsomisella on negatiivinen yhteys lihasvoimaan harrastetun liikunnan määrästä riippumatta. Yksittäisillä mittauksilla, kuten lihaksen poikkipinta-alalla tai vartalon lihasvoimalla ei todettu yhteyttä alaselkäoireiden vakavuuteen nuorilla aikuisilla

Näin diagnosoin ja hoidan lasten virtsatieinfektiot

Tiivistelmä Virtsatieinfektio on pienillä lapsilla yleisin sairaalahoitoon johtava bakteeritulehdus. Virtsankeräystyynyllä tai -pussilla saatu positiivinen tulos kannattaa yleensä varmistaa luotettavammalla menetelmällä. Lentovirtsan saamista imeväiseltä voi nopeuttaa sivelemällä alavatsaa kylmillä nestelapuilla. Hyvävointinen lapsi voidaan hoitaa suun kautta annosteltavilla lääkkeillä avoterveydenhuollossa. Virtsaelinten kaikututkimus on aiheellinen ainakin imeväisillä sekä ensimmäisen munuaistason tulehduksen jälkeen

Effect of point-of-care testing for respiratory pathogens on antibiotic use in children:a randomized clinical trial

Abstract Importance: Limited data are available on the clinical impact of multiplex polymerase chain reaction (PCR) point-of-care testing for respiratory pathogens in acutely ill children. Objective: To evaluate the effect of multiplex PCR point-of-care testing for respiratory pathogens on antibiotic use in acutely ill children. Design, Setting, and Participants: This unblinded, randomized clinical trial was conducted from May 6, 2019, through March 12, 2020. The participants were followed up until hospitalization or discharge from the emergency department (ED) for primary outcome. The study was conducted at the pediatric ED of Oulu University Hospital, Finland. Eligible study participants were children aged 0 to 17 years with fever and/or any respiratory signs or symptoms. Children with underlying medical conditions were included. The statistical analyses were performed between August 11, 2020, and September 14, 2021. Interventions: The participants were randomly assigned in a 2:1 ratio either to undergo multiplex PCR point-of-care testing (18 respiratory viruses and 3 bacteria with results ready within 70 minutes) upon arrival at the ED or to receive routine care. Main Outcomes and Measures: The primary outcome was the proportion of children receiving antibiotic therapy. The secondary outcomes were the numbers of diagnostic tests and radiographic imaging procedures performed and costs. Results: A total of 1417 children were assessed for eligibility. After exclusions, 1243 children (692 boys [56%]) were randomly allocated to either the intervention (829 children) or control (414 children) group. The mean (SD) age of the participants was 3.0 (3.6) years in the intervention group (median [IQR], 1.7 [0.4–4.1] years) and 3.0 (3.5) years (median [IQR], 1.9 [0.4–4.1] years) in the control group. Multiplex PCR point-of-care testing for respiratory pathogens did not reduce the overall prescribing of antibiotics in the emergency department (226 children [27.3%] in the intervention group vs 118 children [28.5%] in the control group; risk ratio, 0.96; 95% CI, 0.79–1.16). Targeted antibiotic therapy was started in 12 children (1.4%) tested with point-of-care multiplex PCR and 2 children (0.5%) in the control group (risk ratio, 3.0; 95% CI, 0.76–11.9). The numbers of diagnostic tests did not differ between the groups, nor did the costs. Conclusions and Relevance: In this randomized clinical trial, point-of-care testing for respiratory pathogens did not reduce the use of antibiotics at the pediatric ED. Testing for respiratory pathogens appears to have a limited impact on clinical decision-making for acutely ill children. Trial Registration: ClinicalTrials.gov Identifier: NCT0393294

Development of gut mycobiome in infants and young children:a prospective cohort study

Abstract Background: The composition of the gut fungal microbiome, mycobiome, is likely associated with human health. Yet, the development of gut mycobiome is poorly understood in infants and children. Here we investigate how perinatal events influence the development of gut mycobiome. Methods: In this prospective cohort study of 140 infants, we used ITS gene sequencing of fecal samples from birth to the age of 18 months. We compared gut mycobiome composition according to delivery mode and exposure to intrapartum antibiotics during vaginal delivery. Results: At birth, gut mycobiome were dominated by the genus Candida, at 6-month stool samples by Malassezia and Cystofilobasidium, and the 18-month stool samples by Trichosporon and unidentified fungi. Perinatal factors altered mycobiome. At 18 months, gut mycobiome of infants born vaginally consisted mostly of Trichosporon (32%) and unidentified fungi (31%), while those born via Cesarean section delivery samples had mycobiome dominated by Saccharomyces (50%). At the age of 18 months, those exposed to intrapartum antibiotics had mycobiome dominated by Trichosporon (66%) not seen in those unexposed to antibiotics. Conclusions: Delivery mode and exposure to intrapartum antibiotic prophylaxis were markedly associated with gut mycobiome composition from birth to 18 months of age. Impact: ● The composition of the gut mycobiome is likely associated with human health. Yet, the development of gut mycobiome is poorly understood in infants and children. ● In this prospective cohort study, delivery mode and exposure to intrapartum antibiotic prophylaxis were markedly associated with gut mycobiome composition from birth to 18 months of age. ● The impact of intrapartum antibiotic prophylaxis on fungal microbiome in vaginally born infants, previously shown to influence gut bacteriome composition, may be explained by the interaction between bacteria and fungi. ● Gut mycobiome composition likely deserves further investigation in relation to gut microbiome and health in children

Diaper-embedded urine test device for the screening of urinary tract infections in children:a cohort study

Abstract Background: There is a need for an easy and sensitive method for screening of urinary tract infections in young children. We set out to test whether a novel diaper-embedded urine test device is feasible and reliable in screening for urinary tract infections. Methods: This prospective cohort study consisted of young children examined due to a suspected acute urinary tract infection at the Pediatric Emergency Department of the Oulu University Hospital, Finland. We analyzed the same urine samples using three different methods: 1) a diaper-embedded test device applied to the urine pad within the diaper, 2) a urine sample aspirated from the urine pad for the conventional point-of-care dipstick test, and 3) a urine sample aspirated from the urine pad and analyzed in the laboratory with an automated urine chemistry analyzer. The gold standard for confirming urinary tract infection was quantitative bacterial culture. Results: Urine samples were available from 565 children. Bacterial culture confirmed urinary tract infection in 143 children. Sensitivity of the positive leukocyte screening of the diaper-embedded urine test device was 93.1% (95% CI: 87.4–96.8) and that of the point-of-care urine dipstick analysis was 95.4% (90.3–98.3) in those with both tests results available (n = 528). The sensitivity of the positive leukocyte test of the diaper-embedded test device was 91.4% (85.4–95.5) and that of the automated analysis was 88.5% (82.0–93.3) in those with both tests available (n = 547). The time to the test result after urination was immediate for the diaper-embedded test, 1–5 min for point-of-care dipstick, and 30–60 min for laboratory-based automated urine chemistry analyzer. Conclusions: In this prospective study, the diaper-embedded urine test device was an easy and sensitive screening method for UTIs in young children. The main clinical benefit of the diaper-embedded urine test device was that the screening test result was available immediately after urination

Delivery mode and perinatal antibiotics influence the infant gut bacteriome and mycobiome:a network analysis

Abstract Both exposure to antibiotics at birth and delivery via Caesarean section influence the gut bacteriome’s development in infants. Using 16S rRNA and internal transcribed spacer sequencing on the Ion Torrent platform, we employed network analysis to investigate the bacterial and fungal interkingdom relationships in the gut microbiome from birth to age 18 months in a prospective cohort study of 140 infants. The gut microbiome at ages six and 18 months revealed distinctive microbial interactions, including both positive and negative associations between bacterial and fungal genera in the gut ecosystem. Perinatal factors, delivery mode and intrapartum antibiotic exposure affected the associations between bacterial and fungal species. In infants exposed and unexposed to perinatal antibiotics, the gut microbiome formed distinct networks for the bacteriome and mycobiome. The fungi Saccharomyces, Trichosporon, Pezoloma, Cystofilobasidium, Rigidoporus and Fomitopsis were strongly associated with exposure to antibiotics at birth. Hyaloscypha, Trichosporon, Fomitopsis and Vishniacozyma were strongly associated with the control group that was not exposed to antibiotics. Five distinct networks were formed according to delivery mode. The present study confirms that bacteria and fungi clearly interact in the infant gut ecosystem. Furthermore, perinatal factors appear to influence the relationships between bacteria and fungi in the developing gut microbiome

Bacterial extracellular vesicles in the microbiome of first-pass meconium in newborn infants

Abstract Background: Bacterial extracellular vesicles (EVs) are more likely to cross biological barriers than whole-cell bacteria. We previously observed EV-sized particles by electron microscopy in the first-pass meconium of newborn infants. We hypothesized that EVs may be of bacterial origin and represent a novel entity in the human microbiome during fetal and perinatal periods. Methods: We extracted EVs from first-pass meconium samples of 17 newborn infants and performed bacterial 16S rRNA gene sequencing of the vesicles. We compared the EV content from the meconium samples of infants based on the delivery mode, and in vaginal delivery samples, based on the usage of intrapartum antibiotics. Results: We found bacterial EVs in all first-pass meconium samples. All EV samples had bacterial RNA. Most of the phyla present in the samples were Firmicutes (62%), Actinobacteriota (18%), Proteobacteria (10%), and Bacteroidota (7.3%). The most abundant genera were Streptococcus (21%) and Staphylococcus (17%). The differences between the delivery mode and exposure to antibiotics were not statistically significant. Conclusions: Bacterial EVs were present in the first-pass meconium of newborn infants. Bacterial EVs may represent an important novel feature of the gut microbiome during fetal and perinatal periods

Delivery mode and perinatal antibiotics influence the predicted metabolic pathways of the gut microbiome

Abstract Delivery mode and perinatal antibiotics influence gut microbiome composition in children. Most microbiome studies have used the sequencing of the bacterial 16S marker gene but have not reported the metabolic function of the gut microbiome, which may mediate biological effects on the host. Here, we used the PICRUSt2 bioinformatics tool to predict the functional profiles of the gut microbiome based on 16S sequencing in two child cohorts. Both Caesarean section and perinatal antibiotics markedly influenced the functional profiles of the gut microbiome at the age of 1 year. In machine learning analysis, bacterial fatty acid, phospholipid, and biotin biosynthesis were the most important pathways that differed according to delivery mode. Proteinogenic amino acid biosynthesis, carbohydrate degradation, pyrimidine deoxyribonucleotide and biotin biosynthesis were the most important pathways differing according to antibiotic exposure. Our study shows that both Caesarean section and perinatal antibiotics markedly influence the predicted metabolic profiles of the gut microbiome at the age of 1 year