Community-acquired pneumonia (CAP) is amongst the leading causes of death worldwide. As inflammatory markers, cytokines can predict outcomes, if interpreted together with clinical data and scoring ...systems such as CURB-65, CRB, and Acute Physiology and Chronic Health Evaluation II (APACHE II). The aim of this study was to determine the impact of inflammatory biomarkers on the early mortality of hospitalized CAP patients. Twenty-seven CAP patients needing hospitalization were enrolled for the study and samples of interleukin-1 (IL-1) and interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), C-reactive protein (CRP), and homocystein were collected at the time of admission (day 1) as well as on the seventh day of the treatment. There was a significant reduction in the levels of IL-6 between the first and the second collections. Median IL-6 values decreased from 24 pg/mL (day 1) to 8 pg/mL (day 7) (P=0.016). The median levels of TNF-α were higher in patients: i) with acute kidney injury (AKI) (P=0.045), ii) requiring mechanical ventilation (P=0.040), iii) with short hospital stays (P=0.009), iv) admitted to the intensive care unit (ICU) (P=0.040), v) who died early (P=0.003), and vi) with worse CRB scores (P=0.013). In summary, IL-6 and TNF-α levels were associated with early mortality of CAP patients. Longer admission levels demonstrated greater likelihood of early death and overall mortality, necessity of mechanical ventilation, and AKI.
The present study reviews the possible role of Se status during pregnancy regarding adverse pregnancy outcomes, with emphasis on those related to diminished antioxidant activity and increased ...oxidative stress. Studies have reported that Se could play an important role in adverse outcomes such as miscarriages, neural tube defects, diaphragmatic hernia, premature birth, low birth weight, pre-eclampsia, glucose intolerance and gestational diabetes. Also, low Se status has been associated with adverse outcomes among HIV-infected pregnant women and their offspring. Nevertheless, the function of Se in the aetiology of pregnancy complications is yet to be elucidated. Available evidence presents the following limitations: most study designs do not allow conclusions about causal relationships; study populations, selection of subjects, research setting, procedures for defining sample size and analytical methods are often poorly described; many studies fail to adjust for important confounding variables. In addition, population studies assessing the relationship between Se intake during pregnancy and health outcomes are scarce. Further research is still needed to clarify the role of Se status in adverse pregnancy outcomes, especially those related to augmented oxidative stress.
OBJECTIVE: To assess the reliability of the Lista de Atividades Fisicas (Brazilian version of the Physical Activity Checklist Interview) in children. METHODS: The study is part of a cross-cultural ...adaptation of the Physical Activity Checklist Interview, conducted with 83 school children aged between seven and ten years, enrolled between the 2nd and 5th grades of primary education in the city of Sao Paulo, Southeastern Brazil, in 2008. The questionnaire was responded by children through individual interviews. It is comprised of a list of 21 moderate to vigorous physical activities performed on the previous day, it is divided into periods (before, during and after school) and it has a section for interview assessment. This questionnaire enables the quantification of time spent in physical and sedentary activities and the total and weighed metabolic costs. Reliability was assessed by comparing two interviews conducted with a mean interval of three hours. For the interview assessment, data from the first interview and those from an external evaluator were compared. Bland-Altman's proposal, the intraclass correlation coefficient and Lin's concordance correlation coefficient were used to assess reliability. RESULTS: The intraclass correlation coefficient lower limits for the outcomes analyzed varied from 0.84 to 0.96. Precision and agreement varied between 0.83 and 0.97 and between 0.99 and 1, respectively. The line estimated from the pairs of values obtained in both interviews indicates high data precision. The interview item showing the poorest result was the ability to estimate time (fair in 27.7% of interviews). Interview assessment items showed intraclass correlation coefficients between 0.60 and 0.70, except for level of cooperation (0.46). CONCLUSIONS: The Brazilian version of the Physical Activity Checklist Interview shows high reliability to assess physical and sedentary activity on the previous day in children.Original Abstract: OBJETIVO: Avaliar a confiabilidade do questionario Lista de Atividades Fisicas em criancas. METODOS: O estudo e parte da adaptacao transcultural do questionario, realizado com 83 escolares de sete a dez anos, matriculados do segundo ao quinto ano do ensino fundamental da cidade de Sao Paulo, SP, em 2008. O questionario foi respondido pela crianca por meio de entrevista individual, apresenta lista com 21 atividades fisicas moderadas a vigorosas realizadas no dia anterior, e dividido em periodos (antes, durante e apos a escola) e possui secao de avaliacao da entrevista. O questionario permite quantificar: tempo em atividades fisicas e sedentarias; e custos metabolicos total e ponderado. A confiabilidade foi avaliada comparando-se duas entrevistas realizadas com intervalo medio de tres horas. Para a secao C (avaliacao da entrevista), compararam-se dados da primeira entrevista e de um avaliador externo. Utilizaram-se a proposta de Bland & Altman e os coeficientes de correlacao intraclasse e de correlacao de concordancia de Lin na avaliacao da confiabilidade. RESULTADOS: Os limites inferiores dos coeficientes de correlacao intraclasse para os desfechos analisados variaram de 0,84 a 0,96. Aprecisao e concordancia variaram, respectivamente, de 0,83 a 0,97 e de 0,99 a 1, A reta estimada a partir de pares de valores obtidos nas duas aplicacoes para atividade fisica indica elevada precisao dos dados. O item da entrevista com pior resultado foi a habilidade em estimar tempo (regular em 27,7% das entrevistas). Os itens da secao C apresentaram coeficientes de correlacao intraclasse entre 0,60 e 0,70, exceto o nivel de cooperacao (0,46). CONCLUSOES: A Lista de Atividades Fisicas apresenta alta confiabilidade para aferir atividade fisica e sedentaria do dia anterior em criancas.
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