Estado Nutricional, Hábitos alimentarios, Actividad física y Horas de Sueño en estudiantes de la Patagonia Chilena según las estaciones del año: Estudio Observacional

Introduction:A comparison was made of the nutritional status, eating habits, physical activity and hours of sleep in students from 5th to 8th grade of primary education in a public school in the city of Punta Arenas, Chile, according to the winter and summer seasons, considering the variability weather and sunlight from extreme weather.Materials and methods:Analytical observational study with a quantitative, longitudinal cohort approach. 105 students of both sexes, whose average age was 11.5 years, were followed over a 7-month period. Two measurements of the four variables under study were made (nutritional status, eating habits, physical activity and hours of sleep). Weight and height measurements were made to obtain the Body Mass Index (BMI) to classify the nutritional status according to BMI / age with the growth patterns recommended by the World Health Organization (WHO). Eating and sleeping habits were evaluated with a self-administered questionnaire and sleeping hours were categorized for age according to the National Sleep Foundation. For the evaluation of physical activity in the students, the Physical Activity Questionnaire for Children PAQ-C was used. Data analysis was performed with the SPSSⓇ Version 22 statistical software and the t-student statistical test for related samples.Results: There was no significant difference in the nutritional status by season (p.057). Healthy eating habits and physical activity diminished during summer (p> 0, 05).The hours of sleep did not have significant differences in both seasons with an average of 8.3 hours. Conclusions: Healthy dietary habits and physical activity are altered during the summer. This is possibly associated to school break and there’s no evidence of a direct effect of seasonal nature.Introducción: Se realizó una comparación del estado nutricional, hábitos alimentarios, actividad física y horas de sueño en estudiantes de 5° a 8° grado de educación primaria en una escuela pública de la ciudad Punta Arenas Chile, según las estaciones de invierno y verano considerando la variabilidad climática y de luz solar de un clima extremo.Material y métodos: Estudio observacional analítico de enfoque cuantitativo, longitudinal de cohorte. Se siguieron durante un período de 7 meses a 105 estudiantes de ambos sexos cuya edad promedio fue 11,5 años. Se realizaron dos mediciones de las cuatro variables en estudio (estado nutricional, hábitos alimentarios, actividad física y horas de sueño). Se efectuaron mediciones de peso y talla para la obtención del Índice de Masa Corporal (IMC) para clasificar el estado nutricional según IMC/edad con los patrones de crecimiento recomendados por la Organización Mundial de la Salud (OMS). Los hábitos alimentarios y sueño fueron evaluados con un cuestionario auto administrado y se categorizó las horas de sueño para la edad según National Sleep Foundation. Para la evaluación de la actividad física en los estudiantes se utilizó la Physical Activity Questionnaire for Children PAQ-C. El análisis de datos se realizó con el Software estadístico SPSSⓇ Versión 22 y la prueba estadística t-student para muestras relacionadas. Resultados: No se encontró diferencia significativa en el estado nutricional (p 0,57). Los hábitos alimentarios saludables y la actividad física disminuyen en la estación de verano (p> 0,05). Las horas de sueño no tuvieron diferencias significativas en ambas estaciones con un promedio de 8,3 horas. Conclusiones: Los hábitos alimentarios saludables y de actividad física disminuyen en la estación de verano posiblemente asociados al receso escolar, sin evidenciar un efecto directo de la estación de año sobre las variables estudiadas

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Estado nutricional, hábitos alimentarios, actividad física y horas de sueño en estudiantes de la patagonia chilena según las estaciones del año: Estudio Observacional

Introduction:A comparison was made of the nutritional status, eating habits, physical activity and hours of sleep in students from 5th to 8th grade of primary education in a public school in the city of Punta Arenas, Chile, according to the winter and summer seasons, considering the variability weather and sunlight from extreme weather.Materials and methods:Analytical observational study with a quantitative, longitudinal cohort approach. 105 students of both sexes, whose average age was 11.5 years, were followed over a 7-month period. Two measurements of the four variables under study were made (nutritional status, eating habits, physical activity and hours of sleep). Weight and height measurements were made to obtain the Body Mass Index (BMI) to classify the nutritional status according to BMI / age with the growth patterns recommended by the World Health Organization (WHO). Eating and sleeping habits were evaluated with a self-administered questionnaire and sleeping hours were categorized for age according to the National Sleep Foundation. For the evaluation of physical activity in the students, the Physical Activity Questionnaire for Children PAQ-C was used. Data analysis was performed with the SPSSⓇ Version 22 statistical software and the t-student statistical test for related samples.Results: There was no significant difference in the nutritional status by season (p.057). Healthy eating habits and physical activity diminished during summer (p> 0, 05).The hours of sleep did not have significant differences in both seasons with an average of 8.3 hours. Conclusions: Healthy dietary habits and physical activity are altered during the summer. This is possibly associated to school break and there’s no evidence of a direct effect of seasonal nature.Introducción: Se realizó una comparación del estado nutricional, hábitos alimentarios, actividad física y horas de sueño en estudiantes de 5° a 8° grado de educación primaria en una escuela pública de la ciudad Punta Arenas Chile, según las estaciones de invierno y verano considerando la variabilidad climática y de luz solar de un clima extremo.Material y métodos: Estudio observacional analítico de enfoque cuantitativo, longitudinal de cohorte. Se siguieron durante un período de 7 meses a 105 estudiantes de ambos sexos cuya edad promedio fue 11,5 años. Se realizaron dos mediciones de las cuatro variables en estudio (estado nutricional, hábitos alimentarios, actividad física y horas de sueño). Se efectuaron mediciones de peso y talla para la obtención del Índice de Masa Corporal (IMC) para clasificar el estado nutricional según IMC/edad con los patrones de crecimiento recomendados por la Organización Mundial de la Salud (OMS). Los hábitos alimentarios y sueño fueron evaluados con un cuestionario auto administrado y se categorizó las horas de sueño para la edad según National Sleep Foundation. Para la evaluación de la actividad física en los estudiantes se utilizó la Physical Activity Questionnaire for Children PAQ-C. El análisis de datos se realizó con el Software estadístico SPSSⓇ Versión 22 y la prueba estadística t-student para muestras relacionadas. Resultados: No se encontró diferencia significativa en el estado nutricional (p 0,57). Los hábitos alimentarios saludables y la actividad física disminuyen en la estación de verano (p> 0,05). Las horas de sueño no tuvieron diferencias significativas en ambas estaciones con un promedio de 8,3 horas. Conclusiones: Los hábitos alimentarios saludables y de actividad física disminuyen en la estación de verano posiblemente asociados al receso escolar, sin evidenciar un efecto directo de la estación de año sobre las variables estudiadas

Clinical and genetic characteristics of late-onset Huntington's disease

Background: The frequency of late-onset Huntington's disease (&gt;59 years) is assumed to be low and the clinical course milder. However, previous literature on late-onset disease is scarce and inconclusive. Objective: Our aim is to study clinical characteristics of late-onset compared to common-onset HD patients in a large cohort of HD patients from the Registry database. Methods: Participants with late- and common-onset (30–50 years)were compared for first clinical symptoms, disease progression, CAG repeat size and family history. Participants with a missing CAG repeat size, a repeat size of ≤35 or a UHDRS motor score of ≤5 were excluded. Results: Of 6007 eligible participants, 687 had late-onset (11.4%) and 3216 (53.5%) common-onset HD. Late-onset (n = 577) had significantly more gait and balance problems as first symptom compared to common-onset (n = 2408) (P &lt;.001). Overall motor and cognitive performance (P &lt;.001) were worse, however only disease motor progression was slower (coefficient, −0.58; SE 0.16; P &lt;.001) compared to the common-onset group. Repeat size was significantly lower in the late-onset (n = 40.8; SD 1.6) compared to common-onset (n = 44.4; SD 2.8) (P &lt;.001). Fewer late-onset patients (n = 451) had a positive family history compared to common-onset (n = 2940) (P &lt;.001). Conclusions: Late-onset patients present more frequently with gait and balance problems as first symptom, and disease progression is not milder compared to common-onset HD patients apart from motor progression. The family history is likely to be negative, which might make diagnosing HD more difficult in this population. However, the balance and gait problems might be helpful in diagnosing HD in elderly patients