生物标志物的联合检测对矽肺早期辅助诊断的价值

目的：探讨联合检测生物标志物应用于矽肺早期辅助诊断的灵敏度和特异性。方法：采用立意抽样法，选取65例男性矽肺患者为病例组，以70例接触游离二氧化硅的在岗作业人员为对照组。清晨空腹采集外周血并分离血清，采用比色法测定对照人群和矽肺患者血清中超氧化物歧化酶（SOD）和丙二醛（MDA）水平；酶联免疫吸附法测定白细胞介素-6（IL-6）及肿瘤坏死因子-α（TNF-α）水平，以矽肺I期患者血清中有显著性变化的生物标志物（MDA、IL-6和TNF-α）检测数据为数据集，绘制受试者工作特征曲线（ROC）并建立Logistic回归模型，评估联合检测上述生物标志物对矽肺早期辅助诊断的价值。结果：与对照组相比，矽肺患者血清中SOD表达水平无显著变化（P > 0.05）；矽肺I期及Ⅱ期患者血清中MDA及IL-6表达水平显著升高（P < 0.05）；矽肺I期患者血清中TNF-α表达水平显著升高（P < 0.05）。回归模型结果显示，ROC曲线下面积排序为：3个指标联合检测（0.89） > IL-6（0.86） > MDA（0.81） > TNF-α（0.65）。结论：IL-6、TNF-α和MDA的联合检测可以提高矽肺早期辅助诊断的灵敏度和特异性。     

Patterns and Correlates of Self-Reported Physical Activity in a Cohort of Racially Diverse Pregnant Adolescents

Study ObjectiveRegular physical activity (PA) during pregnancy decreases the risk of gestational hypertension and preeclampsia. Currently, little is known about the PA of pregnant adolescents. Our intent was to characterize the PA behaviors of a group of racially diverse, low-income pregnant teens and to identify potential determinants of PA.Design, Setting, Participants, and InterventionsA cohort of 157 racially diverse pregnant adolescents (13-18 years of age) completed up to 3 previous day PA recalls as part of a larger prospective longitudinal study on determinants of maternal and fetal bone health. Subjects self-reported activities from 7 AM to 11:30 PM, choosing from a list of 37 activities including a category for “other.” Subjects recorded activities in 30-minute intervals.Main Outcome MeasuresEstimated metabolic equivalent task (MET) values were assigned to each activity and summed for a measure of total daily PA in MET min/d. Determinants of PA were evaluated using a stepwise linear mixed effect model.ResultsThe average calculated MET min/d was 1478 ± 130. Significant determinants of MET min/d included race (P = .007), maternal age at conception (P = .042), gestational age (P = .002), and attending school (P < .001). Black teens were less physically active than white teens, and older teens were more active than younger teens; activity decreased throughout gestation, and teens currently attending school were more active.ConclusionPA is low across gestation and pregnant teens spent more than half of their monitored time in sedentary activities. Targeted interventions are needed to achieve current PA goals in this pediatric obstetric population.     

Talon cusp in the temporary dentition of a patient with Kabuki syndrome: Case report with a two‐year follow‐up

The presence of dental abnormalities in the same individual may be related to syndromic cases and occur through associated systemic changes. Kabuki syndrome presents well‐defined systemic changes, but its clinical characteristics related to the oral cavity have not been fully explained. This study aimed to report the dental changes in a child diagnosed with Kabuki syndrome. A male brown patient aged 2 years and 7 months, accompanied by his mother to the dental visit, they main complaint was the presented of an additional tooth behind upper right central incisor. Anamnesis, intra‐ and extraoral examinations, and dental X‐rays were performed, revealing a talon cusp. Considering the dental clinical findings, the patient was referred to a medical geneticist who additionally requested cardiological and genetic examinations, which established the Kabuki syndrome. The caregivers were advised that the talon cusp would not cause any injury to the natural exfoliation of the tooth and that oral hygiene should be performed carefully. Abnormalities in the oral cavity and developmental delay may be associated with a potential undiagnosed syndrome. The medical evaluation becomes decisive for investigation, diagnosis, and final conduct of the case.     

Objective and subjective measures of the neighbourhood environment: Associations with frailty levels

ObjectivesThe aim of this study was to investigate whether perceptions of the neighbourhood environment (NE) and objective measures of the NE were associated with frailty in older adults.MethodsA cross-sectional study in Adelaide, Australia, recruited a sample of 115 community-dwelling adults aged ≥60 years. Respondents’ perceptions of their NEs were assessed using the Neighbourhood Environment Walkability Scale (NEWS). An objective assessment of these NEWS survey questions was conducted using seven variables: residential density, land use mix diversity, street connectivity, accessibility, seasonal persistent green cover, road crash density and crime rate. Frailty was evaluated using the FRAIL (fatigue, resistance, ambulation, illnesses and loss of weight) scale. Multivariable linear regression analyses were employed to assess the associations between NEWS and frailty, and to assess the associations between objective neighbourhood variables and frailty.ResultsFrail and pre-frail older adults were more likely to live in areas with lower residential density, lower density of road crashes, and higher accessibility than robust participants. Additionally, a poorer perception of the overall environment, worse land-use mix and accessibility and worse crime safety were associated with frailty and pre-frailty after adjustment of covariates and objective GIS variables.DiscussionNeighbourhood characteristics, both objective and perceived, are associated with frailty levels in older adults, and that strategies to tackle frailty must consider the impact of the neighbourhood environment.     

Assessment of postural stability in women with hip osteoarthritis: A case–control study

Objective

The aim of the study was to assessment the impact of hip osteoarthritis on postural stability.