Cross-sectional analysis: clinical presentation of children with persistently low ALP levels

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Oliver Semler ◽  
Carl-Joachim Partsch ◽  
Anibh Martin Das ◽  
Andreas Prechtl ◽  
Corinna Grasemann
Keyword(s):  
Motor Development ◽  
Serum Alkaline Phosphatase ◽  
Body Height ◽  
Patient Records ◽  
Cross Sectional ◽  
Clinical Presentations ◽  
Wide Range ◽  
Z Scores ◽  
Sectional Analysis ◽  
Specific Symptoms

Abstract Objectives Low activity of serum alkaline phosphatase (ALP) is a hallmark of hypophosphatasia (HPP), but low readings of ALP are not always recognized in clinical routine. Understanding the clinical presentations associated with low ALP may contribute to a timelier diagnosis of HPP. Methods Data from paediatric patients with low ALP, excluding patients in intensive care and with oncological/haematological disorders, were analysed. Most recent ALP values, previous diagnoses, medication and relevant symptoms were extracted from patient records at nine specialised centres and analysed descriptively. A relationship between body height and ALP values was scrutinised by linear regression. Results Of 370 children, 15 (4.1%) had a diagnosis of HPP. In the subgroup without a diagnosis of HPP, 241 (67.9%) out of 355 patients had one or more medical conditions known to be associated with low serum ALP. Of those, hypothyroidism, malnutrition and steroid administration were most frequent. Characteristic symptoms, particularly, short stature, muscle weakness and delay of motor development were more frequent and ALP values were lower in patients with documented HPP diagnosis compared to patients without diagnosis of HPP (Ø z-scores: −2.52) (interquartile range [IQR] = 0.20) vs. −1.96 (IQR = 0.87). A weak positive linear relationship between z-scores of ALP and body height was identified (p<0.001). Conclusions This analysis of paediatric patient records elucidates a wide range of disorders associated with low ALP activity. In case of additional specific symptoms, HPP should always be considered as a differential diagnosis.

scholarly journals Characteristics of registered clinical trials assessing treatments for COVID-19: a cross-sectional analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e039978 ◽  
Author(s):  
Hemalkumar B Mehta ◽  
Stephan Ehrhardt ◽  
Thomas J Moore ◽  
Jodi B Segal ◽  
G Caleb Alexander
Keyword(s):  
Clinical Trials ◽  
Clinical Investigation ◽  
Scientific Progress ◽  
Cross Sectional ◽  
Design Elements ◽  
Cross Sectional Analysis ◽  
Therapeutic Benefits ◽  
Wide Range ◽  
The Usa ◽  
Sectional Analysis

ObjectivesThe coronavirus disease 2019 (COVID-19) pandemic has prompted many initiatives to identify safe and efficacious treatments, yet little is known regarding where early efforts have focused. We aimed to characterise registered clinical trials assessing drugs or plasma treatments for COVID-19.Design, setting and participantsCross-sectional analysis of clinical trials for the treatment of COVID-19 that were registered in the USA or in countries contributing to the WHO’s International Clinical Trials Registry Platform. Relevant trial entries of drugs or plasma were downloaded on 26 March 2020, deduplicated, verified with reviews of major medical journals and WHO websites and independently analysed by two reviewers.Main outcome(s)Trial intervention, sponsorship, critical design elements and specified outcomesResultsOverall, 201 clinical trials were registered for testing the therapeutic benefits of 92 drugs or plasma, including 64 in monotherapy and 28 different combinations. Only eight (8.7%) products or combinations involved new molecular entities. The other test therapies had a wide range of prior medical uses, including as antivirals, antimalarials, immunosuppressants and oncology treatments. In 152 trials (75.7%), patients were randomised to treatment or comparator, including 55 trials with some form of blinding and 97 open-label studies. The 49 (24.4%) of trials without a randomised design included 29 single armed studies and 20 trials with some comparison group. Most trial designs featured multiple endpoints. Clinical endpoints were identified in 134 (66.7%) of trials and included COVID-19 symptoms, death, recovery, required intensive care and hospital discharge. Clinical scales were being used in 33 (16.4%) trials, most often measures of oxygenation and critical illness. Surrogate endpoints or biomarkers were studied in 88 (42.3%) of trials, primarily assays of viral load. Although the trials were initiated in more than 17 countries or regions, 100 (49.8%) were registered in China and 78 (37.8%) in the USA. Registered trials increased rapidly, with the number of registered trials doubling from 1 March to 26 March 2020.ConclusionsWhile accelerating morbidity and mortality from the COVID-19 pandemic has been paralleled by early and rapid clinical investigation, many trials lack features to optimise their scientific value. Global coordination and increased funding of high-quality research may help to maximise scientific progress in rapidly discovering safe and effective treatments.

scholarly journals Motor development in non-microcephalic infants born to mothers with Zika Virus infection during pregnancy

2020 ◽  
Vol 27 (2) ◽  
pp. 174-179
Author(s):  
Laís Rodrigues Gerzson ◽  
Carla Skilhan de Almeida ◽  
Juliana Herrero da Silva ◽  
Lavinia Schüler-Faccini
Keyword(s):  
Motor Development ◽  
Cross Sectional Study ◽  
Control Group ◽  
Cross Sectional ◽  
Gross Motor ◽  
Gross Motor Development ◽  
Significant Difference ◽  
Z Scores ◽  
And Control ◽  
Normal Head

ABSTRACT This cross-sectional study sought to evaluate motor development in infants exposed to ZIKV born with normal head circumference (HC). Thirty one children, distributed into two groups, participated in the study: 15 whose mothers were infected by ZIKV during pregnancy, born with HC from −1.9 to +2 Z-scores, adjusted for sex and gestational age (exposed group); and 16 randomly selected infants without known prenatal exposure to ZIKV, paired by sex and age (control group). Alberta Infant Motor Scale (AIMS) was used to evaluate gross motor development. We found no significant difference between the exposed and control groups. However, considering that AIMS is a screening test that assesses only the gross motor development and the small size of our sample, infants exposed to ZIKV during pregnancy should be continuously evaluated for different aspects of their development.

scholarly journals Factors associated with risk of developmental delay in preschool children in a setting with high rates of malnutrition: a cross-sectional analysis of data from the IHOPE study, Madagascar

2020 ◽  
Author(s):  
Ann Miller ◽  
Andres Garchitorena ◽  
Faramalala Rabemananjara ◽  
Laura Cordier ◽  
Marius Randriamanambintsoa ◽  
...  
Keyword(s):  
At Risk ◽  
Developmental Delay ◽  
Action Plan ◽  
International Norms ◽  
Cross Sectional ◽  
Severe Stunting ◽  
Factors Associated ◽  
Cross Sectional Analysis ◽  
Z Scores ◽  
Sectional Analysis

Abstract Background: 50% of Malagasy children have moderate to severe stunting. In 2016, a new 10-year National Nutrition Action Plan (PNAN III) was initiated to help address stunting and developmental delay. We report factors associated with risk of developmental delay in 3 and 4 year olds in the rural district of Ifanadiana in southeastern Madagascar in 2016. Methods: The data are from a cross-sectional analysis of the 2016 wave of IHOPE panel data (a population-representative cohort study begun in 2014). We interviewed women ages 15-49 using the MICS Early Child Development Indicator (ECDI) module, which includes questions for physical, socio-emotional, learning and literacy/numeracy domains. We analyzed ECDI data using standardized z scores for relative relationships for 2 outcomes: at-risk-for-delay vs. an international standard, and lower-development-than-peers if ECDI z scores were >1 standard deviation below study mean. Covariates included demographics, adult involvement, household environment, and selected child health factors. Variables significant at alpha of 0.1 were included a multivariable model; final models used backward stepwise regression, clustered at the sampling level. Results: Of 432 children ages 3 and 4 years, 173 (40%) were at risk for delay compared to international norms and 68 children (16.0%) had lower-development than peers. This was driven mostly by the literacy/numeracy domain, with only 7% of children considered developmentally on track in that domain. 50.5% of children had moderate to severe stunting. 76 (17.6%) had >=4 stimulation activities in past 3 days. Greater paternal engagement (OR 1.59(1.13, 2.21)) was associated with increased delay vs. international norms. Adolescent motherhood (OR3.89 (1.32, 11.48)) decreased children’s development vs. peers. Engagement from a non-parental adult reduced odds of delay for both outcomes (OR(95%CI =0.76 (0.61, 0.93) & 0.28(0.16, 0.50) respectively). Stunting was not associated with delay risk (1.33 (0.83, 2.14) or low development (0.91(0.47, 1.74)) when controlling for other factors. Conclusions: In this setting of high child malnutrition, stunting is not independently associated with developmental risk. A low proportion of children receive developmentally supportive stimulation from adults, but non-parent adults provide more stimulation in general than either mother or father. Stimulation from non-parent adults is associated with lower odds of delay

scholarly journals Annual Observation of Changes in the Angle of Trunk Rotation. Trunk Asymmetry Predictors. A Study from a Scoliosis Screening in School Adolescents

2020 ◽  
Vol 17 (6) ◽  
pp. 1899
Author(s):  
Katarzyna Adamczewska ◽  
Marzena Wiernicka ◽  
Ewa Kamińska ◽  
Joanna Małecka ◽  
Agata Dąbrowska ◽  
...  
Keyword(s):  
Body Mass ◽  
Stepwise Regression ◽  
Body Height ◽  
Stepwise Multiple Regression ◽  
Trunk Rotation ◽  
Primary School Students ◽  
School Students ◽  
Cross Sectional ◽  
Sectional Analysis ◽  
Scoliosis Screening

Adolescent forms of idiopathic scoliosis are commonly encountered deformities of the thoracic and lumbar spine. They affect a significant number of adolescents, yet their cause is still unknown. The presented research is a cross-sectional analysis of 3933 volunteers (2131 girls and 1802 boys). The participants were primary school students aged 9 to 13 years old. This study determined a relationship between predictors such as: body mass, body height and body mass index (BMI) (independent variables) and angle of trunk rotation (ATR) value (dependent variable). Moreover, a stepwise multiple regression with backward selection was conducted to determine to what extent the dependent variable is explained by body mass, body height and BMI. In the group of 11,12,13-year-old girls, the analyzed results of multiple stepwise regression were statistically significant. Among the all studied predictors, it has been shown that body mass in the 11-year-old girls and body height in 12- and 13-year-old girls are major correlates of a 1-year ATR increase in proximal and main thoracic spine levels.

scholarly journals Correction: Ethnic Differences in Arterial Wave Reflection Are Mostly Explained by Differences in Body Height—Cross-Sectional Analysis of the HELIUS Study

PLoS ONE ◽  
2016 ◽  
Vol 11 (12) ◽  
pp. e0168620
Author(s):  
Daan W. Eeftinck Schattenkerk ◽  
Jacqueline van Gorp ◽  
Marieke B. Snijder ◽  
Aeilko H. Zwinderman ◽  
Charles O. Agyemang ◽  
...  
Keyword(s):  
Ethnic Differences ◽  
Wave Reflection ◽  
Body Height ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Helius Study ◽  
Sectional Analysis ◽  
Arterial Wave Reflection

Abstract P339: Glycemic Excursions and Cognitive Function in Older Adults With Diabetes

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Andreea Rawlings ◽  
A. Richey Sharrett ◽  
Nisa Maruthur ◽  
Christina Parrinello ◽  
Casey Rebholz ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
Glycemic Control ◽  
Cross Sectional ◽  
Cognitive Domains ◽  
Z Scores ◽  
The Mean ◽  
Sectional Analysis ◽  
Blood Glucose Concentrations ◽  
Physician Diagnosis

Introduction: The association between glucose excursions and cognitive function in older adults with diabetes is not well described. 1,5-anhydroglucitol (1,5-AG) is a novel biomarker of hyperglycemic excursions. Low 1,5-AG levels reflect blood glucose concentrations exceeding the renal filtration threshold (~180 mg/dl) over the prior 1-2 weeks. Our aim was to test the hypothesis that glucose excursions, as measured by 1,5-AG, were associated with lower cognitive function in older adults with diabetes. Methods: We conducted a cross-sectional analysis of 2000 participants with diabetes from ARIC visit 5 (2011-2013). Diabetes was defined based on self-reported physician diagnosis, diabetes medication use, or HbA1c ≥6.5%. Eleven neuropsychological tests were summarized using Z scores and were grouped into three cognitive domains representing memory, executive function, and language; a global measure of cognitive function was also calculated by averaging and standardizing scores from all tests. 1,5-AG was dichotomized at 10 μg/mL, with values <10 μg/mL reflecting glycemic excursions. Participants were categorized into one of four groups based on 1,5-AG categories and glycemic control (HbA1c <7% vs ≥7%). We used linear regression and adjusted for demographic and clinical characteristics. Results: The mean age of participants was 75 years, 57% were female, and 78% were white. For persons with HbA1c ≥7%, the adjusted differences in cognitive scores comparing 1,5-AG <10 to 1,5-AG ≥10 ug/mL were significantly lower in all domains except memory (Figure). For persons with HbA1c <7%, there were no significant differences in cognitive scores between 1,5-AG categories. Conclusions: Short-term glucose excursions are independently associated with lower cognitive scores in older adults with diabetes and with poor glycemic control (HbA1c ≥7%). Prospective studies are needed to determine if targeting hyperglycemic excursions can improve cognitive function in older adults with diabetes.

Failure Analysis of Automotive Ultrasonic Parking Sensors

2016 ◽  
Author(s):  
Miguel Angel Neri Flores ◽  
Alberto Martinez Villafañe ◽  
Caleb Carreño
Keyword(s):  
Computed Tomography ◽  
Copper Wire ◽  
Internal Defects ◽  
Cross Sectional ◽  
X Ray ◽  
Soldering Process ◽  
Computer Image Processing ◽  
Wide Range ◽  
Silver Paint ◽  
Sectional Analysis

Abstract Automotive ultrasonic parking sensors were analyzed using X- ray computed tomography (XCT or microtomography), in order to determine if there were internal failures generated on the soldering process between copper wires and piezoelectric ceramic on these sensors. This paper reports the use of X-ray radiography and computer image processing for the study of internal defects. By using X-ray tomography technique, pores, cracks, holes, solder balling, insufficient solder, lead related defects, device related defects, and solder bridging may be identified (1-2). When coupled with a real time radiographic detector and image processor, X-ray technology allows instantaneous radiographic imaging and semi-automatic or totally automatic inspection. Analysis was conducted on six produced test samples showing that the application of XCT as a method of quality control of specimens produced by electronic packaging offers a wide range of possibilities to detect defects within materials. There were determined that five sensors contain internal defects on the soldered joints, between the copper wire, and the piezo electric ceramic covered with silver paint, as shown on the computed tomography. Accuracy of XCT method strongly depends on the size of the samples analyzed, but the possibility of obtaining information in 3D nondestructively shows considerable advantages of XCT method over traditional metallographic cross-sectional analysis.

scholarly journals Gender Differences in Clinicoepidemiological Features of Vitiligo: A Cross-Sectional Analysis

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Sharmila Patil ◽  
Manjyot Gautam ◽  
Nitin Nadkarni ◽  
Neha Saboo ◽  
Kiran Godse ◽  
...  
Keyword(s):  
Social Consequences ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Factors Associated ◽  
Cross Sectional Analysis ◽  
Clinical Presentations ◽  
History Of ◽  
Duration Of Disease ◽  
Males And Females ◽  
Sectional Analysis

Background. Vitiligo has important clinical and social consequences particularly in the pigmented skin. The present study was conducted to assess the differences in clinicoepidemiological presentation of vitiligo in males and females and to understand the factors associated with spread of vitiligo in them. Methods. This is a cross-sectional analysis of secondary clinical data of 168 vitiligo patients at a tertiary medical centre at Navi Mumbai. We used logistic regression models to estimate the association between gender and clinical characteristics of vitiligo and to evaluate the factors associated with spread of vitiligo. Results. There were no significant differences between the mean ages of males and females; however, males reported a longer duration of disease (6.9 (10.4) years) compared with females (4.9 (7.4) years). Males were significantly more likely to report a family history of vitiligo compared with females (adjusted OR (aOR): 16.87, 95% CI: 2.16 to 131.69). Even though females were more likely to report spread of lesions, the association was not statistically significant (OR: 1.21, 95% CI: 0.62 to 2.36). Discussion. The differences in the clinical presentations between genders highlight the need to understand the different factors (possibly genetic) that may play a part in the pathogenesis of this multifactorial disease in males and females.

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