scholarly journals Growth in early life and physical and intellectual development at school age: a cohort study

2019 ◽  
Vol 121 (8) ◽  
pp. 866-876 ◽  
Author(s):  
Chao Li ◽  
Lingxia Zeng ◽  
Duolao Wang ◽  
Stephen Allen ◽  
Shabbar Jaffar ◽  
...  
Keyword(s):  
Weight Gain ◽  
Nutritional Status ◽  
Early Life ◽  
Intellectual Development ◽  
Controlled Trial ◽  
Intellectual Function ◽  
Full Scale Intelligence Quotient ◽  
Height Gain ◽  
Randomised Controlled ◽  
Perceptual Reasoning

AbstractThe associations between growth during early life and subsequent cognitive development and physical outcomes are not widely known in low-resource settings. We examined postnatal weight and height gain through early life and related these measurements to the nutritional status and intellectual development of the same children when they were between 7 and 9 years old. Mothers had enrolled in an randomised controlled trial to evaluate the effect of prenatal micronutrient supplementation on birth weight. Their children were born in 2004, their height and weight were measured at 6, 12, 18 and 24 months of age and were followed up between October 2012 and September 2013 (at ages 7–9 years, n 650). Height-for-age, weight-for-age and BMI-for-age were used to describe the nutritional status, and the Wechsler Intelligence Scale for Children fourth edition was used to measure the intellectual function. Multilevel linear and logistic modelling was used to estimate the association between early growth and subsequent growth and intellectual function. After adjustment, weight gain from 6 to 12 months of age was associated with Full-scale Intelligence Quotient, Verbal Comprehension Index, Working Memory Index and Perceptual Reasoning Index. Weight gain during early life was associated with subsequent nutritional status. For every 1 kg increase in weight during the 0- to 6-month period, the OR for underweight, thinness and stunting at 7–9 years of age were 0·19 (95 % CI 0·09, 0·37), 0·34 (95 % CI 0·19, 0·59) and 0·40 (95 % CI 0·19, 0·83), respectively. Weight gain during the periods of 6–12 months of age and 18–24 months of age was also associated with a lower risk of being underweight. Weight gain during early life was associated with better growth outcomes and improved intellectual development in young school-aged children.

scholarly journals Metformin reduces 12-month change in body weight among people newly commenced on clozapine: a retrospective naturalistic cohort study

2021 ◽  
Vol 11 ◽  
pp. 204512532110006
Author(s):  
Jessica Spokes ◽  
Samantha Hollingworth ◽  
Karl Winckel ◽  
Steve Kisely ◽  
Andrea Baker ◽  
...  
Keyword(s):  
Cohort Study ◽  
Weight Gain ◽  
Tobacco Smoking ◽  
Digital Health ◽  
Controlled Trial ◽  
Bodyweight Gain ◽  
Metabolic Effects ◽  
Secondary Outcome ◽  
Standard Clinical Practice ◽  
Randomised Controlled

Background: People with schizophrenia have a 15–20-year reduction in life expectancy, driven in part by the metabolic effects of antipsychotics. Clozapine is associated with the highest rates of weight gain. As clozapine remains the most effective antipsychotic for treatment-resistant schizophrenia (TRS), identifying treatments to ameliorate clozapine-induced weight gain (CIWG) is urgently needed to reduce this morality gap. Methods: We retrospectively analysed digital health records of patients with TRS aged 18–65 newly initiated on clozapine at four tertiary hospitals in south-east Queensland from 1 March 2017 to 30 June 2019. Our primary outcome was the effect of metformin on change in percentage bodyweight at 12 months after clozapine initiation, with secondary outcome being proportion with >5% or >7% bodyweight change. We also explored impact on bodyweight change of other variables including sex, tobacco smoking, type 2 diabetes (T2DM), age, clozapine level and dose and clozapine/norclozapine ratio. Results: Among 90 patients initiated on clozapine, metformin use ( n = 48) was associated with a smaller increase in percentage bodyweight (1.32% versus 5.95%, p = 0.031), lower rates of >7% gain in bodyweight (37.8% versus 63.0%, p = 0.025) but not >5% gain in bodyweight. Age below the median (32.0 years) was associated with greater bodyweight gain (5.55% versus 1.22%, p = 0.046). Sex, tobacco smoking, T2DM, clozapine dose and level and clozapine/norclozapine ratio were not associated with differences in change in bodyweight. Conclusion: In this small retrospective cohort study, use of metformin within 12-months of clozapine initiation was associated with a statistically and clinically significant reduction in CIWG. Although there is increasing evidence for the role of metformin to ameliorate bodyweight gain at time of clozapine initiation, our findings need replication and testing in a randomised controlled trial before recommending metformin co-commencement with clozapine as standard clinical practice.

scholarly journals Mediterranean Diet Implementation to Protect against Advanced Lung Cancer Index (ALI) Rise: Study Design and Preliminary Results of a Randomised Controlled Trial

2021 ◽  
Vol 18 (7) ◽  
pp. 3700
Author(s):  
Aristea Gioxari ◽  
Dimitrios Tzanos ◽  
Christina Kostara ◽  
Panos Papandreou ◽  
Giannis Mountzios ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Randomised Controlled Trial ◽  
Nutritional Status ◽  
Mediterranean Diet ◽  
Controlled Trial ◽  
Small Cell ◽  
Advanced Lung Cancer ◽  
Study Endpoint ◽  
Preliminary Results ◽  
Randomised Controlled

The Mediterranean diet (MD) has been inversely associated with lung cancer (LC) risk. Hereby we show the preliminary results of our prospective randomised controlled trial in inflammatory and nutritional status of LC patients after 3-month implementation of MD. In total, 30 patients with small-cell or non-small-cell LC (stages III–IV) were enrolled. They were randomly assigned either to Control group, receiving general nutritional guidelines, or the MD group, in which a personalised MD plan was provided. Medical and dietary history, anthropometrics, blood biomarkers, and circulating antioxidant vitamins were assessed. The main outcome was a significantly higher advanced lung cancer inflammation index (ALI) in patients of the control arm than those following MD (p = 0.003). In the MD group, platelets were significantly reduced at the study endpoint (p = 0.044). BMI and body fat mass remained unchanged in both arms, but serum glucose was significantly higher in control compared to MD group (p = 0.017). In conclusion, we showed for the first time that implementing a personalised MD for 3 months is promising to regulate prognostic biomarkers in advanced LC. The final results of our on-going trial will shed a light on the inflammatory, antioxidant and nutritional status of LC patients following MD.

scholarly journals RARE-04. INTELLECTUAL DEVELOPMENT IN CHILDREN WITH PEDIATRIC CRANIOPHARYNGIOMA AFTER TUMOR REMOVAL

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii442-iii442
Author(s):  
Tatsuki Oyoshi ◽  
Shingo Fujio ◽  
Nayuta Higa ◽  
Hajime Yonezawa ◽  
Koji Yoshimoto
Keyword(s):  
Intellectual Development ◽  
Mean Value ◽  
University Hospital ◽  
Electrolyte Imbalance ◽  
Surgical Removal ◽  
Tumor Removal ◽  
Full Scale Intelligence Quotient ◽  
Verbal Comprehension Index ◽  
The Mean ◽  
Perceptual Reasoning

Abstract INTRODUCTION Intellectual assessment in children with craniopharyngioma after tumor removal is still unknown. We assessed intellectual development in children who underwent microsurgical resection in our institute over the last twelve years. MATERIALS AND METHODS Ten children among 41 patients with craniopharyngioma treated and followed at Kagoshima University Hospital between 2007 and 2019 were reviewed. We also assessed intellectual development in 10 years or younger children with craniopharyngioma one year after tumor removal. Intelligence was assessed using the Wechsler Intelligence Scale for Children-Fourth Edition (WISC-Ⅳ). RESULTS Ten children underwent microsurgical tumor removal. The mean age at surgery was 5.8 (range 1–10) years. Transcranial approach was performed in 8 children, transsphenoidal approach in two children. The mean follow up period was 110 months. Gamma knife surgery (GKS) was performed in 6 children less than 6 months after first surgery. Regional recurrences occurred in 5 children, and additional GKS was performed in four children, second microsurgical removal in one child. Severe obesity with a transient electrolyte imbalance occurred in one child. Eight children with GH deficiency underwent GH replacement therapy. Eight children were assessed working memory index (WMI), processing speed index (PSI), Perceptual reasoning index (PRI), and verbal comprehension index (VCI) using WISC 4. Each mean value of WMI, PSI, and PRI was lower than VCI, except for 2 children with normal full scale intelligence quotient. CONCLUSION WMI, PSI and PRI in children with intellectual disabilities were lower tendency than VCI after surgical removal of craniopharyngiomas in the present study.

scholarly journals Highlights of this issue

2013 ◽  
Vol 203 (6) ◽  
pp. A22-A22
Author(s):  
Kimberlie Dean
Keyword(s):  
Eating Disorders ◽  
Randomised Controlled Trial ◽  
Anxiety Disorders ◽  
Early Life ◽  
Controlled Trial ◽  
Childhood Anxiety ◽  
Childhood Anxiety Disorders ◽  
Low Intensity ◽  
Randomised Controlled ◽  
Diagnostic Outcomes

Interventions throughout early life - antenatally, in childhood and in adolescenceTwo papers in the Journal this month describe trials of interventions targeting young people – one focused on treating anxiety disorders in childhood and another on preventing eating disorders in adolescence. While CBT for childhood anxiety disorders is known to be effective, its availability is limited. Thirlwall et al (pp. 436–444) conducted a randomised controlled trial of low-intensity guided parent-delivered CBT in a sample of children with anxiety disorders referred by primary or secondary care to a specialist clinic. Compared with waiting-list controls, the children receiving the full intervention demonstrated superior diagnostic outcomes, whereas those receiving a brief version of the intervention showed no improvements. In a linked editorial, Cartwright-Hatton (pp. 401–402) highlights the prevalence of childhood anxiety disorders, the implications of failing to treat them and the evidence supporting their treatability. She also points to the implications of findings from Thirlwall et al indicating that therapists need not be highly trained or experienced to achieve significant results.

scholarly journals In-home fortification with 2.5 mg iron as NaFeEDTA does not reduce anaemia but increases weight gain: a randomised controlled trial in Kenyan infants

2015 ◽  
Vol 11 ◽  
pp. 151-162 ◽  
Author(s):  
Tanja Barth-Jaeggi ◽  
Diego Moretti ◽  
Jane Kvalsvig ◽  
Penny A. Holding ◽  
Jane Njenga ◽  
...  
Keyword(s):  
Weight Gain ◽  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Randomised Controlled ◽  
Home Fortification

scholarly journals CoMET: a protocol for a randomised controlled trial of co-commencement of METformin as an adjunctive treatment to attenuate weight gain and metabolic syndrome in patients with schizophrenia newly commenced on clozapine

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e021000 ◽  
Author(s):  
Dan Siskind ◽  
Nadia Friend ◽  
Anthony Russell ◽  
John J McGrath ◽  
Carmen Lim ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Body Weight ◽  
Weight Gain ◽  
Controlled Trial ◽  
Adjunctive Treatment ◽  
Double Blind ◽  
Human Research Ethics ◽  
Increased Risk ◽  
Point Body ◽  
Randomised Controlled

IntroductionClozapine, while effective in treatment refractory schizophrenia, is associated with significant weight gain, heart disease and increased risk of type 2 diabetes mellitus (T2DM). Although there is evidence for weight loss with metformin for people with obesity who are already taking clozapine, there have been no published trials that have investigated the effect of metformin in attenuating weight gain at the time of clozapine initiation.Methods and analysisA 24-week double-blind placebo-controlled trial of concomitant prescription of metformin at clozapine commencement. Eighty-six people being commenced on clozapine will be randomised to placebo or metformin (variable dose, up to 2 g/day). The primary outcome is comparative end point body weight, between the placebo and metformin groups. Secondary outcomes are comparative rates of conversion to T2DM, alteration of metabolic syndrome parameters, proportion gaining >5% body weight and changes in diet and appetite. We will additionally examine biomarkers associated with change in weight among trial participants.Ethics and disseminationEthics approval was granted by the Metro South Human Research Ethics Committee HREC/17/QPAH/538-SSA/17/QPAH/565. We plan to submit a manuscript of the results to a peer-reviewed journal, and present results at conferences, consumer forums and hospital grand rounds.Trial registration numberACTRN12617001547336; Pre-results.

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