33 research outputs found
Microvasculature and Cardiovascular Risk Factors in Childhood
__Abstract__
Cardiovascular disease is the leading cause of mortality, morbidity and hospitalization
worldwide, and is a major public health problem in adult populations. The developmental‐
origins hypothesis suggests that cardiovascular disease might originate from
early life. Adverse exposures, acting in different periods of fetal and early postnatal life
might lead to permanent adaptations in the cardiovascular system, which are beneficial
for short term survival, but increase the susceptibility of cardiovascular disease in later
life. This hypothesis is supported by experimental studies in animals showing that
growth restriction in early life leads to developmental adaptations in cardiovascular
structure and function, which leads to an increase in vulnerability to cardiovascular
disease.
In line with this hypothesis, large observational studies in humans have shown that
fetal growth restriction and rapid infant growth are associated with cardiac and vascular
changes in childhood and an increased risk of cardiovascular disease in adulthood.
Also, observational studies using more detailed adverse exposures during fetal life suggested
that, among other maternal factors, higher maternal blood pressure during
pregnancy and the presence of gestational hypertensive disorders are associated with
increased risks of fetal growth restriction and a higher blood pressure in childhood.
Postnatally, suboptimal infant nutrition and increased adiposity levels throughout childhood
are also shown to be associated with the development of cardiovascular disease in
later life. Thus, previous research suggests that a restricted nutritional in utero environment
and abundant postnatal environment may lead to cardiovascular disease in
later life.
The mechanisms relating adverse maternal, fetal and infant factors with an increased
risk of cardiovascular diseases in later life are not fully understood. Early microvasculature
adaptations, in response to adverse exposures in early life, might be part of the
underlying mechanisms in the development of cardiovascular disease. Animal studies
have shown that alterations in the microvascular structure and, hence, increased peripheral
resistance, precede the development of hypertension. In humans, the microvasculature
can non‐invasively be assessed by using retinal vascular imaging. Several
longitudinal studies among adults have shown that retinal arteriolar narrowing, likely
indicative of increased peripheral vascular resistance, is associated with increased risks
of hypertension and stroke in later life, whereas wider retinal venular caliber is associated
with an increased risk of metabolic syndrome and inflammation. Thus, these
studies suggest that alterations in retinal vessel calibers can be used as early markers of
cardio‐metabolic disease risk.
In summary, cardiovascular disease might already originate in early life. Identifying
risk factors and potential mechanisms influencing the development of cardiovascular
diseases from early life onwards, is important for future preventive strategies that aim
to improve cardiovascular health throughout the life course. Therefore, studies presented
in this thesis were designed to identify maternal, fetal and infant factors associated
with microvasculature alterations and cardiovascular healt
30 Yan-nhanu language documentation and revitalisation
Breastfeeding may have a protective effect on the development of obesity in later life. Not much is known about the effects of infant feeding on more-specific fat measures.We examined associations of breastfeeding duration and exclusiveness and age at the introduction of solid foods with general and abdominal fat outcomes in children.We performed a population-based, prospective cohort study in 5063 children. Information about infant feeding was obtained by using questionnaires. At the median age of 6.0 y (90\% range: 5.7\%, 6.8\%), we measured childhood anthropometric measures, total fat mass and the android:gynoid fat ratio by using dual-energy X-ray absorptiometry and preperitoneal abdominal fat by using ultrasound.We observed that, in the models adjusted for child age, sex, and height only, a shorter breastfeeding duration, nonexclusive breastfeeding, and younger age at the introduction of solid foods were associated with higher childhood general and abdominal fat measures (P-trend < 0.05) but not with higher childhood body mass index. The introduction of solid foods at a younger age but not breastfeeding duration or exclusivity was associated with higher risk of overweight or obesity (OR: 2.05; 95\% CI: 1.41, 2.90). After adjustment for family-based sociodemographic, maternal lifestyle, and childhood factors, the introduction of solid food between 4-4.9 mo of age was associated with higher risks of overweight or obesity, but the overall trend was not significant.Associations of infant breastfeeding and age at the introduction of solid foods with general and abdominal fat outcomes are explained by sociodemographic and lifestyle-related factors. Whether infant dietary composition affects specific fat outcomes at older ages should be further studied
Maternal vomiting during early pregnancy and cardiovascular risk factors at school age: the Generation R Study
Background: Evidence suggests that low birth weight and fetal exposure to extreme maternal
undernutrition is associated with cardiovascular disease in adulthood. Hyperemesis gravidarum, a clinical entity characterized by severe nausea and excess vomiting leading to a suboptimal maternal nutritional status during early pregnancy, is associated with an increased risk of
adverse pregnancy outcomes. Several studies also showed that different measures related to
hyperemesis gravidarum, such as maternal daily vomiting or severe weight loss, are associated
with increased risks of adverse fetal pregnancy outcomes. Not much is known about long-term
offspring consequences of maternal hyperemesis gravidarum and related measures during pregnancy. We examined the associations of maternal daily vomiting during early pregnancy, as a
measure related to hyperemesis gravidarum, with childhood cardiovascular risk factors.
Methods: In a population-based prospective cohort study from early pregnancy onwards among
4,769 mothers and their children in Rotterdam, the Netherlands, we measured childhood body
mass index, total fat mass percentage, android/gynoid fat mass ratio, preperitoneal fat mass area,
blood pressure, lipids, and insulin levels. We used multiple regression analyses to assess the associations of maternal vomiting during early pregnancy with childhood cardiovascular outcomes.
Results: Compared with the children of mothers without daily vomiting during early pregnancy, the children of mothers with daily vomiting during early pregnancy had a higher childhood total body fat mass (difference 0.12 standard deviation score [SDS]; 95% confidence
interval [CI] 0.03–0.20), android/gynoid fat mass ratio (difference 0.13 SDS; 95% CI 0.04–
0.23), and preperitoneal fat mass area (difference 0.10 SDS; 95% CI 0–0.20). These associations
were not explained by birth characteristics but partly explained by higher infant growth.
Maternal daily vomiting during early pregnancy was not associated with childhood blood pressure, lipids, and insulin levels.
Conclusions: Maternal daily vomiting during early pregnancy is associated with higher childhood total body fat mass and abdominal fat mass levels, but not with other cardiovascular risk
factors. Further studies are needed to replicate these findings, to explore the underlying mechanisms and to ass
The influence of phosphorus on the structure and hydrodesulfurization activity of sulfided Fe and Fe-Mo catalysts supported on carbon and alumina
Body mass index, gestational weight gain and fatty acid concentrations during pregnancy: the Generation R Study
Radiation optic neuropathy and retinopathy in patients with presumed benign intraorbital tumours treated with fractionated stereotactic radiotherapy
Purpose: To assess the long-term effects of fractionated stereotactic radiotherapy (fSRT) for the treatment of (presumed) benign intraorbital tumours on visual acuity, visual fields, globe and eyelid position, and complications including radiation retinopathy and deviations of retinal nerve fibre layer (RNFL) on OCT. Methods: Multi-centre retrospective follow-up study of a consecutive series of 25 patients treated in the Rotterdam Orbital Center (collaboration between Erasmus Medical Center and Rotterdam Eye Hospital) between 2002 and 2018. Data on the dose of fSRT, visual acuity, Humphrey field analyser (HFA) perimetry, globe and eyelid position were obtained from the medical records. Results: In this retrospective consecutive series of 25 patients with a median follow-up of 104 months (range 48–215 months), 80.0% of the patients had presumed optic nerve sheath meningioma and 20.0 % presumed cavernous haemangioma with signs suggestive of recent growth. In most patients, a better visual acuity and RNFL thickness were observed after stereotactic radiotherapy. Improvement of the visual field defects was observed after treatment, with a mean deviation of −14.98 dB (12.9 SD) before treatment versus −4.56 dB (10.8 SD) after treatment, respectively. Significant, but small changes in exophthalmometry values were observed with a mean of 14.92 mm (7.9 SD) versus 13.79 mm (7.3 SD) after treatment, respectively. Only 3 patients (15.0%) developed radiation retinopathy after stereotactic radiotherapy. All patients with radiation retinopathy had presumed optic nerve sheath meningioma. Conclusions: Based on our results, fSRT is an effective treatment modality for this subset of orbital tumours with few complications and good long-term visual and cosmetic outcomes. FSRT is non-invasive and safer than surgery for lesions in the posterior orbit or around the optic nerve
Retinal microvasculature and cardiovascular health in childhood
10.1542/peds.2014-3341Pediatrics1354678-68
Establishing triple helix relationships : The case of PEA
This case describes the umbrella organization Printed Electronics Arena (PEA) which is situated in the Norrköping region, Sweden. The strategy of the PEA organization is based on the triple helix model, which is an academic model that promotes regional development through the interaction between academy, public bodies, and industry. The main asset is a new technology – printed electronics (PE) - that the research institute Acreo and Linköping University (LiU) are creating, developing and exploiting. Acreo and LiU in co-operation with regional municipalities, industrial partners, a business incubator and a science park are active stakeholders in PEA. To that end, the PEA organization has three financiers; the Swedish Agency for Innovation Systems (VINNOVA), the Norrköping Regional Development Foundation (NRDF) and Acreo. The case provides an overview from the triple helix level that pinpoints the relationship between actors involved. In addition to that, the case describes PEA from a business perspective, and then goes on to describe new potential business ideas based on PE. The account of the case begins with local politics and the ambitious expansion of LiU in Norrköping. Then, the case describes the efforts of the triple helix actors to attract research resources to Campus Norrköping. Also, the establishment of the research institute Acreo in Norrköping is depicted as well as how the specific PE technology became established at the campus. The case then describes the birth of the umbrella organization PEA and illustrates how it is based on the earlier activities of Acreo. The activities and the result of PEA as well as two illustrating cases finish off the portrayal of the first stages of the PEA project