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Sadarangani KP, Schuch FB, De Roia G, Martínez-Gomez D, Chávez R, Lobo P, Cristi-Montero C, Werneck AO, Alzahrani H, Ferrari G, Ibanez A, Silva DR, Von Oetinger A, Matias TS, Grabovac I, Meyer J. Exchanging screen for non-screen sitting time or physical activity might attenuate depression and anxiety: A cross-sectional isotemporal analysis during early pandemics in South America. J Sci Med Sport 2023:S1440-2440(23)00076-2. [PMID: 37210319 DOI: 10.1016/j.jsams.2023.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 03/21/2023] [Accepted: 04/17/2023] [Indexed: 05/22/2023]
Abstract
OBJECTIVES To examine the theoretical substitutions of screen exposure, non-screen sitting time, moderate and vigorous physical activity with depressive and anxiety symptoms in South American adults during the COVID-19 pandemic. DESIGN A cross-sectional study during the first months of the COVID-19 pandemic with data from 1981 adults from Chile, Argentina, and Brazil. METHODS Depressive and anxiety symptoms were assessed using the Beck Depression and Anxiety Inventories. Participants also reported physical activity, sitting time, screen exposure, sociodemographic, and tobacco use data. Isotemporal substitution models were created using multivariable linear regression methods. RESULTS Vigorous physical activity, moderate physical activity, and screen exposure were independently associated with depression and anxiety symptoms. In adjusted isotemporal substitution models, replacing 10 min/day of either screen exposure or non-screen sitting time with any intensity of physical activity was associated with lower levels of depressive symptoms. Improvements in anxiety symptoms were found when reallocating either screen exposure or non-screen sitting time to moderate physical activity. Furthermore, replacing 10 min/day of screen exposure with non-screen sitting time was beneficially associated with anxiety (B = -0.033; 95 % CI = -0.059, -0.006) and depression (B = -0.026; 95 % CI = -0.050, -0.002). CONCLUSIONS Replacement of screen exposure with any intensity of physical activity or non-screen sitting time could improve mental health symptoms. Strategies aiming to reduce depressive and anxiety symptoms highlight physical activity promotion. However, future interventions should explore specific sedentary behaviors as some will relate positively while others negatively.
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Affiliation(s)
- Kabir P Sadarangani
- Universidad Autónoma de Chile, Chile; Escuela de Kinesiología, Facultad de Salud y Odontología, Universidad Diego Portales, Chile.
| | - Felipe Barreto Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Brazil; Faculty of Health Sciences, Universidad Autónoma de Chile, Providencia, Chile
| | - Gabriela De Roia
- Laboratorio de Estudios en Actividad Física (LEAF), Universidad de Flores (UFLO), Argentina
| | - David Martínez-Gomez
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and IdiPaz, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Spain; IMDEA Food Institute, Campus de Excelencia Internacional UAM + CSIC, Spain
| | - Róbinson Chávez
- Instituto de Salud Pública Andrés Bello, Universidad Andrés Bello, Chile
| | - Pablo Lobo
- Laboratorio de Estudios en Actividad Física (LEAF), Universidad de Flores (UFLO), Argentina
| | - Carlos Cristi-Montero
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Chile
| | - André O Werneck
- Department of Nutrition, School of Public Health, University of São Paulo (USP), Brazil
| | - Hosam Alzahrani
- Department of Physical Therapy, College of Applied Medical Sciences, Taif University, Saudi Arabia
| | - Gerson Ferrari
- Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile (USACH), Chile
| | - Agustin Ibanez
- Global Brain Health Institute, University of California, USA; Trinity College Dublin, Ireland; Cognitive Neuroscience Center (CNC), Universidad San Andres, Argentina; National Scientific and Technical Research Council (CONICET), Argentina; Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibanez, Chile
| | - Danilo R Silva
- Federal University of Sergipe - UFS São Cristóvão Brazil Federal University of Sergipe - UFS, Brazil; Department of Sports and Computer Science, Universidad Pablo de Olavide (UPO), 41013 Seville, Spain
| | - Astrid Von Oetinger
- Escuela de Kinesiología, Facultad de Salud y Odontología, Universidad Diego Portales, Chile; Universidad Mayor, Facultad de Ciencias, Dirección de Postgrado, Chile
| | - Thiago S Matias
- Department of Physical Education, Federal University of Santa Catarina, Brazil
| | - Igor Grabovac
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Austria
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Kittelson DB, Swanson J, Aldridge M, Giannelli RA, Kinsey JS, Stevens JA, Liscinsky DS, Hagen D, Leggett C, Stephens K, Hoffman B, Howard R, Frazee RW, Silvis W, McArthur T, Lobo P, Achterberg S, Trueblood M, Thomson K, Wolff L, Cerully K, Onasch T, Miake-Lye R, Freedman A, Bachalo W, Payne G. Experimental verification of principal losses in a regulatory particulate matter emissions sampling system for aircraft turbine engines. Aerosol Sci Technol 2021; 56:63-74. [PMID: 35602286 PMCID: PMC9118390 DOI: 10.1080/02786826.2021.1971152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 07/07/2021] [Accepted: 07/30/2021] [Indexed: 06/15/2023]
Abstract
A sampling system for measuring emissions of nonvolatile particulate matter (nvPM) from aircraft gas turbine engines has been developed to replace the use of smoke number and is used for international regulatory purposes. This sampling system can be up to 35 m in length. The sampling system length in addition to the volatile particle remover (VPR) and other sampling system components lead to substantial particle losses, which are a function of the particle size distribution, ranging from 50 to 90% for particle number concentrations and 10-50% for particle mass concentrations. The particle size distribution is dependent on engine technology, operating point, and fuel composition. Any nvPM emissions measurement bias caused by the sampling system will lead to unrepresentative emissions measurements which limit the method as a universal metric. Hence, a method to estimate size dependent sampling system losses using the system parameters and the measured mass and number concentrations was also developed (SAE 2017; SAE 2019). An assessment of the particle losses in two principal components used in ARP6481 (SAE 2019) was conducted during the VAriable Response In Aircraft nvPM Testing (VARIAnT) 2 campaign. Measurements were made on the 25-meter sample line portion of the system using multiple, well characterized particle sizing instruments to obtain the penetration efficiencies. An agreement of ± 15% was obtained between the measured and the ARP6481 method penetrations for the 25-meter sample line portion of the system. Measurements of VPR penetration efficiency were also made to verify its performance for aviation nvPM number. The research also demonstrated the difficulty of making system loss measurements and substantiates the E-31 decision to predict rather than measure system losses.
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Affiliation(s)
- D. B. Kittelson
- Department of Mechanical Engineering, University of Minnesota, Minneapolis, Minnesota, USA
| | - J. Swanson
- Department of Mechanical Engineering, University of Minnesota, Minneapolis, Minnesota, USA
| | - M. Aldridge
- National Vehicle and Fuels Emissions Laboratory, Office of Transportation and Air Quality, U. S. Environmental Protection Agency, Ann Arbor, Michigan, USA
| | - R. A. Giannelli
- National Vehicle and Fuels Emissions Laboratory, Office of Transportation and Air Quality, U. S. Environmental Protection Agency, Ann Arbor, Michigan, USA
| | - J. S. Kinsey
- Office of Research and Development, U. S. Environmental Protection Agency, Research Triangle Park, North Carolina, USA
| | - J. A. Stevens
- National Vehicle and Fuels Emissions Laboratory, Office of Transportation and Air Quality, U. S. Environmental Protection Agency, Ann Arbor, Michigan, USA
| | - D. S. Liscinsky
- Formerly United Technologies Research Center, East Hartford, Connecticut, USA (retired)
| | - D. Hagen
- Center for Excellence for Aerospace Particulate Emissions Reduction Research, Missouri University of Science and Technology, Rolla, Missouri, USA
| | - C. Leggett
- National Vehicle and Fuels Emissions Laboratory, Office of Transportation and Air Quality, U. S. Environmental Protection Agency, Ann Arbor, Michigan, USA
| | - K. Stephens
- Aerospace Testing Alliance, Arnold Engineering Development Complex, Arnold Air Force Base, Tennessee, USA
| | - B. Hoffman
- Aerospace Testing Alliance, Arnold Engineering Development Complex, Arnold Air Force Base, Tennessee, USA
| | - R. Howard
- Aerospace Testing Alliance, Arnold Engineering Development Complex, Arnold Air Force Base, Tennessee, USA
| | | | - W. Silvis
- AVL-North America, Plymouth, Michigan, USA
| | | | - P. Lobo
- Center for Excellence for Aerospace Particulate Emissions Reduction Research, Missouri University of Science and Technology, Rolla, Missouri, USA
| | - S. Achterberg
- Center for Excellence for Aerospace Particulate Emissions Reduction Research, Missouri University of Science and Technology, Rolla, Missouri, USA
| | - M. Trueblood
- Center for Excellence for Aerospace Particulate Emissions Reduction Research, Missouri University of Science and Technology, Rolla, Missouri, USA
| | - K. Thomson
- National Research Council-Canada, Ottawa, Canada
| | - L. Wolff
- Boston College, Chestnut Hill, Massachusetts, USA
| | | | - T. Onasch
- Aerodyne Research, Inc, Billerica, Massachusetts, USA
| | - R. Miake-Lye
- Aerodyne Research, Inc, Billerica, Massachusetts, USA
| | - A. Freedman
- Aerodyne Research, Inc, Billerica, Massachusetts, USA
| | - W. Bachalo
- Artium Technologies, Sunnyvale, California, USA
| | - G. Payne
- Artium Technologies, Sunnyvale, California, USA
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3
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Sadarangani KP, De Roia GF, Lobo P, Chavez R, Meyer J, Cristi-Montero C, Martinez-Gomez D, Ferrari G, Schuch FB, Gil-Salmerón A, Solmi M, Veronese N, Alzahrani H, Grabovac I, Caperchione CM, Tully MA, Smith L. Changes in Sitting Time, Screen Exposure and Physical Activity during COVID-19 Lockdown in South American Adults: A Cross-Sectional Study. Int J Environ Res Public Health 2021; 18:5239. [PMID: 34069124 PMCID: PMC8156285 DOI: 10.3390/ijerph18105239] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 04/21/2021] [Accepted: 04/27/2021] [Indexed: 12/17/2022]
Abstract
The worldwide prevalence of insufficient physical activity (PA) and prolonged sedentary behavior (SB) were high before the coronavirus (COVID-19) pandemic. Measures that were taken by governments (such as home confinement) to control the spread of COVID-19 may have affected levels of PA and SB. This cross-sectional study among South American adults during the first months of COVID-19 aims to (i) compare sitting time (ST), screen exposure, moderate PA (MPA), vigorous PA (VPA), and moderate-to-vigorous PA (MVPA) before and during lockdown to sociodemographic correlates and (ii) to assess the impact of lockdown on combinations of groups reporting meeting/not-meeting PA recommendations and engaging/not-engaging excessive ST (≥7 h/day). Bivariate associations, effect sizes, and multivariable linear regressions were used. Adults from Argentina (n = 575) and Chile (n = 730) completed an online survey with questions regarding demographics, lifestyle factors, and chronic diseases. Mean reductions of 42.7 and 22.0 min./day were shown in MPA and VPA, respectively; while increases of 212.4 and 164.3 min./day were observed in screen and ST, respectively. Those who met PA recommendations and spent <7 h/day of ST experienced greatest changes, reporting greater than 3 h/day higher ST and more than 1.5 h/day lower MVPA. Findings from the present study suggest that efforts to promote PA to South American adults during and after COVID-19 restrictions are needed.
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Affiliation(s)
- Kabir P. Sadarangani
- Escuela de Kinesiología, Facultad de Salud y Odontología, Universidad Diego Portales, Santiago 8370179, Chile
- Department of Kinesiology, Universidad Autónoma de Chile, Santiago 7500912, Chile
| | - Gabriela F. De Roia
- Laboratorio de Estudios en Actividad Física (LEAF), Universidad de Flores (UFLO), Buenos Aires C1406, Argentina; (G.F.D.R.); (P.L.)
| | - Pablo Lobo
- Laboratorio de Estudios en Actividad Física (LEAF), Universidad de Flores (UFLO), Buenos Aires C1406, Argentina; (G.F.D.R.); (P.L.)
| | - Robinson Chavez
- Instituto de Salud Pública Andrés Bello, Universidad Andrés Bello, Santiago 8370149, Chile;
| | - Jacob Meyer
- Department of Kinesiology, Iowa State University, Ames, IA 50011, USA;
| | - Carlos Cristi-Montero
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso 2530388, Chile;
| | - David Martinez-Gomez
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and IdiPaz, 28049 Madrid, Spain;
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- IMDEA Food Institute, Campus de Excelencia Internacional UAM + CSIC, 28049 Madrid, Spain
| | - Gerson Ferrari
- Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile (USACH), Santiago 7500618, Chile;
| | - Felipe B. Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria 97105-900, RS, Brazil;
| | | | - Marco Solmi
- Department of Neurosciences, Padua Neurosciences Center, University of Padua, 35122 Padua, Italy;
| | - Nicola Veronese
- Geriatrics Section, Department of Medicine (DIMED), University of Padova, 35122 Padova, Italy;
- Institute of Clinical Research and Education in Medicine (IREM), 35122 Padova, Italy
| | - Hosam Alzahrani
- Department of Physical Therapy, College of Applied Medical Sciences, Taif University, Taif 21944, Saudi Arabia;
| | - Igor Grabovac
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, 1090 Wien, Austria;
| | - Cristina M. Caperchione
- Human Performance Research Centre, School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Sydney, NSW 2007, Australia;
| | - Mark A. Tully
- Institute of Mental Health Sciences, School of Health Sciences, Ulster University, Newtownabbey BT37 0QB, UK;
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge CB1 1PT, UK;
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4
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Jones DG, Taylor AM, Enkiri SA, Lobo P, Brayman KL, Keeley EC, Lipson LC, Gimple LW, Ragosta M. Extent and severity of coronary disease and mortality in patients with end-stage renal failure evaluated for renal transplantation. Am J Transplant 2009; 9:1846-52. [PMID: 19538490 PMCID: PMC2850065 DOI: 10.1111/j.1600-6143.2009.02703.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The purpose of this study is to explore the relationship between coronary artery disease (CAD), transplantation status and subsequent mortality in end-stage renal disease (ESRD) patients undergoing evaluation for renal transplantation. Two hundred fifty-three ESRD patients at high risk for CAD underwent coronary angiography as part of a renal transplant evaluation. The cohort was divided into three groups: Group 1 (n = 127) had no vessels with >or=50% stenosis, Group 2 (n = 56) had one vessel with >or=50% stenosis and Group 3 (n = 70) had two or more vessels with >or=50% stenosis. Long-term survival was determined; median follow-up was 3.3 years. The baseline characteristics were similar except for older age and higher proportion of diabetes mellitus, dyslipidemia and peripheral vascular disease in Groups 2 and 3 patients as compared to Group 1. Survival was worse in Group 3 compared to Group 1 (p < 0.0001). Each of the three subgroups had better survival with renal transplantation than those who did not undergo transplantation (p < 0.0001). Although the degree of CAD is related to subsequent mortality, transplantation is associated with better survival regardless of the extent and severity of CAD. Thus, the presence of CAD should not exclude ESRD patients from consideration for this therapy.
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Affiliation(s)
- D. G. Jones
- Cardiovascular Division, Department of Medicine, University of Virginia, Charlottesville, VA
| | - A. M. Taylor
- Cardiovascular Division, Department of Medicine, University of Virginia, Charlottesville, VA
| | - S. A. Enkiri
- Department of Medicine, University of Virginia, Charlottesville, VA
| | - P. Lobo
- Division of Nephrology, Department of Medicine, University of Virginia, Charlottesville, VA
| | - K. L. Brayman
- Division of Transplantation, Department of Surgery, University of Virginia, Charlottesville, VA
| | - E. C. Keeley
- Cardiovascular Division, Department of Medicine, University of Virginia, Charlottesville, VA
| | - L. C. Lipson
- Cardiovascular Division, Department of Medicine, University of Virginia, Charlottesville, VA
| | - L. W. Gimple
- Cardiovascular Division, Department of Medicine, University of Virginia, Charlottesville, VA
| | - M. Ragosta
- Cardiovascular Division, Department of Medicine, University of Virginia, Charlottesville, VA
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5
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Jones DG, Taylor AM, Enkiri SA, Lobo P, Brayman KL, Keeley EC, Lipson LC, Gimple LW, Ragosta M. Extent and severity of coronary disease and mortality in patients with end-stage renal failure evaluated for renal transplantation. Am J Transplant 2009. [PMID: 19538490 DOI: 10.1111/j.1600-6143.2000.02703.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The purpose of this study is to explore the relationship between coronary artery disease (CAD), transplantation status and subsequent mortality in end-stage renal disease (ESRD) patients undergoing evaluation for renal transplantation. Two hundred fifty-three ESRD patients at high risk for CAD underwent coronary angiography as part of a renal transplant evaluation. The cohort was divided into three groups: Group 1 (n = 127) had no vessels with >or=50% stenosis, Group 2 (n = 56) had one vessel with >or=50% stenosis and Group 3 (n = 70) had two or more vessels with >or=50% stenosis. Long-term survival was determined; median follow-up was 3.3 years. The baseline characteristics were similar except for older age and higher proportion of diabetes mellitus, dyslipidemia and peripheral vascular disease in Groups 2 and 3 patients as compared to Group 1. Survival was worse in Group 3 compared to Group 1 (p < 0.0001). Each of the three subgroups had better survival with renal transplantation than those who did not undergo transplantation (p < 0.0001). Although the degree of CAD is related to subsequent mortality, transplantation is associated with better survival regardless of the extent and severity of CAD. Thus, the presence of CAD should not exclude ESRD patients from consideration for this therapy.
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Affiliation(s)
- D G Jones
- Cardiovascular Division, Department of Medicine, University of Virginia, Charlottesville, VA, USA
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6
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Flohr T, Bonatti H, Frierson H, Harmon RC, Berg C, Sifri CD, Lobo P, Schmitt T, Sawyer R, Pruett T, Brayman K. Herpes simplex virus hepatitis after renal transplantation. Transpl Infect Dis 2008; 10:377-8. [PMID: 18844865 DOI: 10.1111/j.1399-3062.2008.00309.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
MESH Headings
- Abnormalities, Multiple/therapy
- Acute Disease
- Acyclovir/analogs & derivatives
- Acyclovir/therapeutic use
- Antiviral Agents/therapeutic use
- Drug Therapy, Combination
- False Negative Reactions
- Female
- Hepatitis, Viral, Human/diagnosis
- Hepatitis, Viral, Human/drug therapy
- Hepatitis, Viral, Human/pathology
- Hepatitis, Viral, Human/virology
- Humans
- Immunohistochemistry
- Injections, Intravenous
- Kidney Transplantation/adverse effects
- Liver/pathology
- Liver/virology
- Polymerase Chain Reaction
- Simplexvirus/isolation & purification
- Syndrome
- Urogenital Abnormalities/therapy
- Valacyclovir
- Valine/analogs & derivatives
- Valine/therapeutic use
- Young Adult
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7
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Amaya-Castellanos D, Viloria-Castejón H, Ortega P, Gómez G, Urrieta JR, Lobo P, Estévez J. [Vitamin A deficiency and the anthropometric nutritional status of urban and rural marginalized children in the state of Zulia, Venezuela]. Invest Clin 2002; 43:89-105. [PMID: 12108030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
The present transversal study was carried out to estimate the prevalence of both vitamin A deficiency (VAD) and protein-energy malnutrition among children (24 to 85 months) from three urban slums (n = 173) in Maracaibo city, Zulia State, Venezuela and a rural slum area (n = 34), vieinal to Maracaibo, by measuring serum retinol and z score of anthropometric indices Height//Age (H//AZ); Weight//Age (W//AZ) and Weight//Height (W//HZ), compared to NCHS-WHO reference values. The Graffar's methodology adapted to Venezuela by Méndez Castellano (1986) confirmed the underprivileged socio-economic condition of the children population. For serum retinol analysis, peripheral venous blood was drawn and serum was treated according to the Bieri et al. (1979) technique and HPLC procedure. Values were recorded in microgram/dL. Statistical analysis was done by using Epi Info 2000, release 1.0 and SAS release 6.0 (1996) computer programs. The prevalence of VAD (serum retinol < 20 micrograms/dL) in the total children population (n = 207) was 22.2%, being higher in urban children than in rural children (22.5% vs 20.5%). No clinical signs of VAD were detected in the children. The nutritional status analysed by Z score of anthropometric indices revealed that 27.4% of children suffered from undernutrition (Z score = -2 to > -3 SD), being 15.4% stunted, 9.6% wasted and 2.6% with acute protein-energy malnutrition. Neither severe malnutrition nor overweight were detected. According with the H//AZ index, 54.6% of children had adequate nutrition. However 23% of them suffered from VAD. In children at risk of developing undernutrition (Z score = -1 to > -2 SD), 20.9% had VAD and of the stunted children, 21.9% presented VAD. With W//AZ, 60.3%, 29.9% and 9.1% of children were with adequate nutrition, at risk, or wasted respectively; of each group, 25.6%, 17.7% and 15%, respectively had serum retinol values below 20 micrograms/dL. The Z score of W//HZ indicator revealed that 87.4%, 10.4% and 2.4% of children were in good nutrition, at risk, or with acute protein-energy malnutrition, respectively. In the three groups 22.1%, 23.8% and 20%, respectively were affected by VAD. These results indicate that VAD coexists indistinctly in healthy, adequately nourished children, as in those malnourished ones. Our VAD prevalence results and others from Venezuela, are higher than the criteria laid down by WHO and PAHO which warrant wide community intervention. This public health problem becomes more significant because children are apparently healthy and, if timely vitamin A supplementation is not given, any intercurrent infection is likely to worsen the vitamin A status, increasing the widely known consequences.
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Affiliation(s)
- Daisy Amaya-Castellanos
- Laboratorio de Investigación en Desnutrición Infantil, Instituto de Investigaciones Biológicas e Instituto de Investigaciones Clínicas, Universidad del Zulia, Apartado 526, Maracibo,
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8
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Mancini MJ, Connors AF, Wang XQ, Nock S, Spencer C, Mccullough C, Lobo P, Isaacs R. HLA matching for simultaneous pancreas-kidney transplantation in the United States: a multivariable analysis of the UNOS data. Clin Nephrol 2002; 57:27-37. [PMID: 11837799 DOI: 10.5414/cnp57027] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND As the incidence of diabetic nephropathy increases, especially in minority populations, more simultaneous pancreas-kidney (SPK) transplants are being performed both in the United States and worldwide. The role of matching on SPK outcomes and organ allocation remains controversial. The purpose of this analysis was to determine the influence of HLA matching using currently employed criteria on 5-year SPK graft survival. METHODS We performed an analysis of all 3,316 SPK transplants performed in the United States reported to the United Network for Organ Sharing (UNOS) between December 31, 1988 and December 31, 1994. Kaplan-Meier unadjusted 1- and 5-year graft survival with log rank comparisons and Cox multivariable regression models that adjusted for 12 confounding variables were used to analyze the influence of HLA matching on outcomes. RESULTS Despite low-grade HLA or DR matching or high levels of common reactive groups (CREG) mismatching, 1- and 5-year allograft survival rates were 90% and 78% for kidney, and 85% and 75% for pancreas transplantation. CONCLUSIONS SPK transplantation is associated with excellent outcomes independent of the level of HLA matching. These data support the hypothesis that SPK transplants need not be allocated based on matching criteria, thus minimizing organ ischemia time and promoting a more racially equitable allocation for SPKs in the US today.
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Affiliation(s)
- M J Mancini
- Department of Medicine, The University of Virginia Health System, Charlottesville 22908, USA.
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9
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Abstract
BACKGROUND A successful kidney transplant from a living-related donor (LRD) remains the most effective renal replacement therapy for children with end-stage renal failure. The use of LRD kidneys results in decreased time on dialysis, increased graft survival, and better function compared with kidneys transplanted from cadaver donors. We retrospectively analyzed data from the United Network of Organ Sharing (UNOS) Scientific Renal Transplant Registry to determine risk factors for graft loss in children who received an LRD kidney. METHODS Data was obtained from the UNOS Scientific Renal Transplant Registry on 2418 children ranging in age from 0 to 18 years who underwent an LRD kidney transplantation between January 1988 and December 1994. Multivariate analysis of graft survival was performed using Kaplan-Meier and Cox regression models. RESULTS The effects of age, pretransplantation dialysis, early rejection, and race were found to significantly affect graft survival. Gender, peak panel-reactive antibody, and ABO blood type were not found to be significant risk factors. Infants <2 years of age initially had the worst graft survival; however, over time their results stabilized, and at 7 years estimated graft survival was good (71%). Adolescents ranging in age from 13-18 years had the best initial graft survival, but as time went on graft survival worsened (55%). Patients who underwent pretransplantation dialysis had a relative risk for graft loss of 1.77 (P<0.001), whereas those who had an early rejection had a relative risk for graft loss of 1.41 (P<0.002). African-Americans had a significantly higher relative risk for graft loss than either Caucasians (1.57, P<0.0005) or Hispanics (2.01, P<0.0003). CONCLUSIONS Predictors of graft survival for children who receive LRD kidney transplants include age at transplantation, pretransplantation dialysis, early rejection, and race. Over time, adolescents and African-Americans seem to have the lowest graft survival.
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Affiliation(s)
- M Ishitani
- Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA
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10
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Isaacs RB, Conners A, Nock S, Spencer C, Lobo P. Noncompliance in living-related donor renal transplantation: the United Network of Organ Sharing experience. Transplant Proc 1999; 31:19S-20S. [PMID: 10372037 DOI: 10.1016/s0041-1345(99)00117-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- R B Isaacs
- University of Virginia Department of Medicine, Charlottesville 22908, USA
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11
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Abstract
Nitric oxide (NO) is a novel chemical messenger that mediates a variety of biological actions. This study was undertaken to investigate the effects of NO on parietal cell function. The rate of [3H]arginine conversion to [3H]citrulline, a parameter of NO synthase activity, and NO formation (as NO2-), were inhibited by the NO synthase inhibitor, NG-nitro-L-arginine methyl ester (L-NAME), in a concentration-dependent manner in the non-stimulated toad gastric mucosa. This range of concentrations of L-NAME provoked stimulation of H+ secretion in a similar fashion, which was blocked by L-arginine but not by D-arginine. Pre-treatment with carbachol plus ethylene glycol-bis(beta-aminoethyl ether)-N,N,N',N'-tetra-acetic acid (EGTA) prevented the effect of L-NAME on H+ secretion and drastically reduced NO synthase activity. L-arginine had an inhibitory effect on H+ secretion in non-stimulated and carbachol-stimulated gastric mucosa, which was reversed by L-NAME. Carbachol and pentagastrin, but not histamine, significantly increased NO formation in the toad gastric mucosa. The results suggest that changes in NO synthesis in the gastric mucosa may modulate parietal cell function and that a calcium-dependent mechanism may be involved.
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Affiliation(s)
- M Molero
- Laboratorio de Investigaciones Gastrointestinales, Facultad de Medicina, Universidad del Zulia, Venezuela
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12
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Sanfey H, Haussman G, Isaacs I, Ishitani M, Lobo P, McCullough C, Pruett T. Steroid withdrawal in kidney transplant recipients: is it a safe option? Clin Transplant 1997; 11:500-4. [PMID: 9361950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The long-term side effects of lifelong steroid immunosuppression are well documented, therefore, steroid withdrawal (SW) if safe would clearly be of benefit. From 1987-1996, 470 kidney transplants were performed at our institution. During this time period, steroid withdrawal was offered to a select group of patients (n = 43) who were at least 1 year post transplant (27.6 +/- 12.0 months, 15-64 months), had stable graft function and had experienced only mild episodes of rejection in the postoperative period. Informed consent was obtained from all participants. Twenty-five patients were male and 18 were female. The mean age at time of transplantation was 42.4 +/- 14.1 years (17-65 years). There were 28 cadaveric renal transplants (CRT), 10 living related kidney transplants (LRT) and 5 simultaneous kidney-pancreas transplants (SPK). Maintenance immunosuppression in all patients consisted of CSA 3-5 mg/kg, and AZA 1-2 mg/kg. Twenty-nine patients (67%) have remained off steroids with good renal function for 13-59 months (38.3 +/- 11.0). Steroids were restarted in 14/43 (32%) patients 1-36 months post SW (13.3 +/- 11.0 months). Eight of these 14 patients had a rise in creatinine and biopsy proven rejection, 5 of whom responded to reinstitution of steroid immunosuppression, and have stable renal function (CR = 2.0 +/- 0.4) 41-53 months (45 +/- 4.0 months) post SW. Three (7%) patients lost their allograft. One was a SPK recipient who retained good pancreatic function and subsequently received a successful 2nd kidney transplant. The other 2 patients died awaiting retransplantation. Steroids were recommenced in 6/14 patients who did not develop rejection for inability to tolerate CSA/AZA (2), anxiety (2) or recurrent disease (2). In the majority of our patients, (93%) SW did not result in immunologic graft loss. A graft loss of 7% (3) is not significantly different from the expected graft loss in a kidney transplant recipient population over a time period of 9 years. Therefore, we feel that with careful monitoring steroid withdrawal can be safely accomplished in select patients.
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Affiliation(s)
- H Sanfey
- Transplant Division, University of Virginia Health Sciences Center, Charlottesville 22908, USA
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13
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Erasmus RT, Kusnir J, Stevenson WC, Lobo P, Herman MM, Wills MR, Savory J. Hyperaluminemia associated with liver transplantation and acute renal failure. Clin Transplant 1995; 9:307-11. [PMID: 7579738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Iatrogenic aluminium toxicity is reported in a patient who underwent an orthotopic liver transplant and who had concomitant renal failure requiring hemodialysis. Following transplantation the patient developed a metabolic encephalopathy with only mildly elevated blood ammonia concentrations. During the period following transplantation the patient received massive infusions of albumin and was on oral feeding (vivonexten), both of which contained aluminium, as did the dialysis fluid. Hyperaluminemia and profoundly elevated liver tissue aluminium concentrations were observed. Treatment with desferrioxamine, a trivalent ion chelator, decreased the plasma aluminium concentrations with an improvement in the patient's mental status.
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Affiliation(s)
- R T Erasmus
- Department of Pathology, University of Virginia Health Sciences Center, Charlottesville 22908, USA
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14
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Stevenson W, Gaffey M, Ishitani M, McCullough C, Dickson R, Caldwell S, Lobo P, Pruett T. Clinical course of four patients receiving the experimental antiviral agent fialuridine for the treatment of chronic hepatitis B infection. Transplant Proc 1995; 27:1219-21. [PMID: 7878856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- W Stevenson
- Department of Surgery, University of Virginia Health Science Center, Charlottesville 22908
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15
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Chacín J, Cárdenas P, Lobo P, Hernández I. Secretory and metabolic effects of ethanol in the isolated amphibian gastric mucosa. Gastroenterology 1991; 100:1288-95. [PMID: 1901555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
The effects of pure ethanol and some alcoholic beverages on acid secretion and metabolism were examined in the isolated toad gastric mucosa. Pure ethanol applied to the luminal side or to the submucosal side at low concentrations (2%-10%) was a potent stimulant of acid secretion, whereas high concentrations (greater than or equal to 20%) were inhibitory. Cimetidine and calcium-free solutions did not abolish the secretory effect of ethanol. Beer and wine, but not rum and whisky, caused a significant stimulation of acid secretion. Respiration was progressively increased by ethanol at concentrations between 2% and 20%. This effect was not affected by cimetidine or by SCH 28080, an inhibitor of the gastric hydrogen-potassium-stimulated adenosine triphosphatase. Ethanol (10%) significantly increased by 46% the tissue lactate-pyruvate ratio. The oxidations of glucose, butyrate, and acetate were progressively reduced by low concentrations of ethanol (5% and 10%). The results indicate that (a) low concentrations of ethanol and alcoholic beverages with low ethanol content are direct stimulants of acid secretion and (b) the secretory and metabolic effects of low concentrations of ethanol seem to be mediated via its oxidation.
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Affiliation(s)
- J Chacín
- Laboratorio de Investigaciones Gastrointestinales, Facultad de Medicina, Universidad del Zulia, Maracaibo, Venezuela
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16
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Subero O, Lobo P, Chacín J. Ca2+ requirement for metabolic effects of secretagogues in the amphibian gastric mucosa. Am J Physiol 1989; 257:G969-76. [PMID: 2514602 DOI: 10.1152/ajpgi.1989.257.6.g969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The role of extracellular Ca2+ in metabolic effects induced by theophylline and histamine was investigated in the isolated toad gastric mucosa. Primary and secondary effects on metabolism were differentiated by using K(+)-free solutions, which blocked the secretory responses but not the metabolic ones. The stimulation of respiration induced by theophylline and histamine was dose dependent and was significantly decreased by Ca2(+)-free solutions. In the presence of 1.8 mM Ca2+, the rate of glycogen breakdown was increased by theophylline in a dose-dependent manner and the dose-response curve was somewhat similar to that obtained with oxygen uptake. This effect was inhibited by incubation in Ca2(+)-free solutions. Ca2+ stimulated the rate of glycogen utilization in a concentration-dependent manner. The rates of oxidation of exogenous glucose and pyruvate were significantly inhibited by Ca2(+)-free solutions in theophylline- and histamine-stimulated mucosa, whereas the rates of oxidation of butyrate and acetate were not significantly affected. The Ca2+ ionophore A23187 significantly stimulated the rate of oxygen uptake and this response was not blocked by omeprazole and Sch 28080, two specific inhibitors of gastric H(+)-K(+)-ATPase. The results indicate that Ca2+ is required for optimal stimulation of carbohydrate catabolism in the toad gastric mucosa.
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Affiliation(s)
- O Subero
- Laboratorio de Investigaciones Gastrointestinales, Facultad de Medicina, Universidad del Zulia, Maracaibo, Venezuela
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17
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Chacín J, Cárdenas P, Lobo P, Subero O. Role of calcium in secretory and metabolic effects of substrates in the gastric mucosa. Am J Physiol 1986; 251:G161-8. [PMID: 3090895 DOI: 10.1152/ajpgi.1986.251.2.g161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The role of extracellular Ca2+ in the effects and oxidation of metabolic substrates was investigated in the isolated toad gastric mucosa. In the presence of lipoate, the stimulating effect of 10 mM glucose on spontaneous acid secretion was significantly reduced by 76% in Ca2+-free solutions. The inhibition was overcome by addition of 5 mM Ca2+. The increment in respiration induced by glucose was also blocked in the absence of external Ca2+. The effect of 10 mM pyruvate on acid secretion was inhibited by 37% in Ca2+-free solutions. The secretory responses induced by 10 mM butyrate and 10 mM octanoate were not significantly affected by Ca2+-free solutions. The rates of oxidation of [14C]-glucose and [14C]pyruvate were significantly reduced by incubating in Ca2+-free solutions containing 0.1 mM of EGTA. When O2 uptake and glucose oxidation were measured simultaneously in the same preparation, the increment in the rate of glucose oxidation accounted for by 43% of the total increase of respiration observed in the presence of Ca2+. The rates of oxidation of [14C]butyrate and [14C]acetate were not significantly affected by Ca2+-free solutions. The rate of oxidation of [14C]glucose exhibited saturation kinetics versus concentration and was lower in the absence of external Ca2+ under a range of glucose concentrations. Similar results were observed when the experiments were performed in the absence of external potassium to block the acid secretory process. Ca2+ stimulated the rate of glucose oxidation in a dose-dependent manner. The kinetics of 45Ca2+ efflux and 45Ca2+ uptake were not significantly affected by glucose and butyrate.(ABSTRACT TRUNCATED AT 250 WORDS)
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Haddad E, Le Bourgeois JP, Kuentz M, Lobo P. Liver complications in lymphomas treated with a combination of chemotherapy and radiotherapy: preliminary results. Int J Radiat Oncol Biol Phys 1983; 9:1313-9. [PMID: 6885544 DOI: 10.1016/0360-3016(83)90262-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
From May 1978 to May 1981, a total of 20 patients (18 patients with Non Hodgkin Lymphomas + 2 patients with Stage IV Hodgkin's disease) were treated with chemotherapy and whole or upper abdominal radiotherapy. All the patients were in complete remission at the time of irradiation. Shielding of the kidneys was effected at the start of treatment and the right lobe of the liver was shielded after a dose of 20 Gy was delivered. As of January 1982, 17 of the patients were alive and free of disease with a follow-up ranging from 6 to 32 months (mean follow-up of 18.5 months). Two patients were dead from their disease. Alterations in liver chemistry were observed in 5 patients, clinical jaundice or transient hepatomegaly along with changes in liver chemistry in 4 patients, classical veno-occlusive disease in 2 patients and 7 of the patients did not develop any complication. No death from complications were observed. The contribution of the following factors such as radiotherapy dose to the liver, drugs, nutritional status and associated medical conditions, towards the development of complications have been analyzed in detail.
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Kanji AM, Chao JH, Liebner EJ, Lobo P, Thakrar HV. Extrinsic compression of superior vena cava an analysis of 41 patients. Int J Radiat Oncol Biol Phys 1980; 6:213-5. [PMID: 6248494 DOI: 10.1016/0360-3016(80)90040-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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20
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Munube GM, Babigumira J, Henderson BE, Lobo P, Soneji AD. Association of an enterovirus infection with a respiratory-enteric disease in an orphanage in Kampala, Uganda. East Afr Med J 1970; 47:258-64. [PMID: 4319702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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