scholarly journals Breastfeeding: what changed after a decade?

2017 ◽  
Vol 25 (0) ◽  
Author(s):  
Áurea Tamami Minagawa Toryiama ◽  
Elizabeth Fujimori ◽  
Claudia Nery Teixeira Palombo ◽  
Luciane Simões Duarte ◽  
Ana Luiza Vilela Borges ◽  
...  
Keyword(s):  
Median Duration ◽  
Cox Regression ◽  
Small City ◽  
Cross Sectional ◽  
Significance Level ◽  
Paulo State ◽  
Kaplan Meier ◽  
Duration Of Breastfeeding ◽  
Method Analysis ◽  
Pacifier Use

ABSTRACT Objective: to analyze the changes in prevalence, median duration and correlates of breastfeeding in a small city in São Paulo state, Brazil. Method: analysis of two cross-sectional studies, conducted at intervals of one decade, with 261 and 302 children younger than two years, respectively. We used Kaplan-Meier survival analysis for calculation of the median duration of breastfeeding, and Cox regression for correlates analysis, with significance level of 5%. Results: an increase of 33.4% in the prevalence of exclusive breastfeeding and 20.9% in breastfeeding was identified. Regarding the latter, the median duration increased from 7.2 to 12 months. In the most recent study, the median duration was lower in first-born children who used pacifiers, and it was not associated with breastfeeding incentive actions. Conclusions: advances in the prevalence and duration of breastfeeding were observed during the 10 year-period, however, pacifier use still remains associated to a shorter median duration of breastfeeding. Our findings contribute to highlighting the need for intensification of nursing actions in the promotion of breastfeeding, and discouragement regarding the use of pacifiers.

scholarly journals Sarcopenia in elderly major trauma; A single centre retrospective analysis of psoas and masseter muscle groups

2020 ◽  
Author(s):  
Surabhi Varma ◽  
Michael SJ Wilson ◽  
Mitesh Naik ◽  
Amandeep Sandhu ◽  
Helen Chidera Uchenna Ota ◽  
...  
Keyword(s):  
Major Trauma ◽  
Cox Regression ◽  
Psoas Muscle ◽  
Trauma Patients ◽  
Cross Sectional ◽  
Traumatic Injuries ◽  
Regression Methods ◽  
Kaplan Meier ◽  
Pelvic Imaging ◽  
Muscle Groups

Abstract Background There is an emerging role for the radiological evaluation of the psoas muscle as a marker of sarcopenia, and as a prognostic discriminant in elderly patients with traumatic injuries. Older trauma patients are more likely to undergo cranial than abdomino-pelvic imaging. Identifying sarcopenia using masseter cross sectional area (M-CSA) has shown correlation with mortality. We sought to determine the correlation between psoas: lumbar vertebral index (PLVI) and the M-CSA, and their association with health outcomes. Methods Patients aged 65 or above, who presented as a trauma call over a 1 year period were included if they underwent cranial or abdominal CT imaging. Images were retrospectively analyzed to obtain PLVI and mean M-CSA measurements. Electronic records were abstracted for demographics and outcomes. Logistic regression methods, log scale analyses, Cox regression model and Kaplan-Meier plots were used to determine association of sarcopenia with outcomes. Results There were 155 eligible patients in the M-CSA group and 204 patients in the PLVI group. Sarcopenia was defined as the lowest quartile in each group. Both PLVI and M-CSA measurements were available in 142 patients. Pearson’s correlation indicated a weakly positive linear relationship (r = 0.35, p < 0.001) between these. There was no statistical association between M-CSA sarcopenia status and any measured outcomes. Those with PLVI sarcopenia were more likely to die in hospital (adjusted OR 3.38, 95% CI 1.47–9.73, p = 0.006) and at 2-years (adjusted HR 1.90, 95% CI 1.11–3.25, p = 0.02). Only 29% patients with PLVI sarcopenia were discharged home, compared with 58% without sarcopenia (p = 0.001). Conclusion Sarcopenia, defined by PLVI, is predictive of increased in-patient and 2- year mortality. Our study did not support prognostic relevance of M-CSA. Further research should be directed at improving the validity of masseter measurements or identifying alternative radiological determinants of sarcopenia on cranial imaging.

scholarly journals Estimation of the Distribution of Duration of Breastfeeding from Cross-Sectional Data: Some Methodological Issue

2021 ◽  
Author(s):  
Anup Kumar ◽  
Sachin Kumar ◽  
Jai Kishun ◽  
Uttam Singh ◽  
Pushpraj .
Keyword(s):  
Life Table ◽  
Current Status Data ◽  
Current Status ◽  
Life Table Analysis ◽  
Cross Sectional ◽  
Kaplan Meier ◽  
Table Analysis ◽  
Duration Of Breastfeeding ◽  
Status Data ◽  
The Impact

Background: Duration of breastfeeding is an important health indicator of mother and child. There are various indirect epidemiological methods available to estimate the duration of breastfeeding from cross sectional data. Objective: To estimate the distribution of duration of breastfeeding at national level cross sectional data and compare various available technique. The impact of the sampling frame (ascertain of the individual understudy) is also evaluated. Method: National Family Health Survey (NFHS-IV) data is used. Duration of breastfeeding of only those children who were born before 60 months from survey date were included in the study. The technique of Current Status Data, Life Table Analysis, and Kaplan Meier (KM) estimator is applied to assess the distribution of duration of breastfeeding. Result: The mean estimate is 32.84, 33.14 and 33.64 months by Kaplan Maier Estimator, Current Status Data and Life Table Analysis respectively. The Current Status and Life Table method are better than Kaplan Meier Estimator as it is doesn’t based on recall data and heaping present in the data. Conclusion: One must be very cautions while estimating the various epidemiological parameters from cross section data set. The assumptions of the methodology as per data available should be evaluate. If such data is not available, the available methodology may be modified. Regression analysis based on Current Status data technique may be used to assess the impact of various clinical and epidemiological factors (such as nutrition of mother, health status of mother etc.) on duration of breastfeeding

scholarly journals Prevalence and Maternal Concerns of Exclusive Breast Feeding in Libyan Women in Albaida City

2019 ◽  
Vol 34 (2) ◽  
pp. 105-111
Author(s):  
Mohamed Thabet Ali ◽  
Faiza M. Ali
Keyword(s):  
Median Duration ◽  
Outpatient Clinic ◽  
Optimal Growth ◽  
Cross Sectional Study ◽  
World Health ◽  
Affecting Factors ◽  
Cross Sectional ◽  
Negative Perceptions ◽  
Health Organization ◽  
Duration Of Breastfeeding

Exclusive breastfeeding (EBF) is strongly recommended by the World Health Organization, United Nation Children's Fund (UNICEF), and American Academy of Pediatrics during the first six months of life. Breastfeeding should continue up to two years for optimal growth and development while it is suggested to start supplementary foods beginning from the seventh month. The study aimed to determine the frequency and examine the affecting factors of EBF in infants who attended the pediatrics outpatient clinic in Althawra Hospital in Albaida city, Libya. A cross-sectional study was conducted in eight months period among 223 breastfeeding mothers, with infants aged 6-24 months, who attended the pediatrics Outpatient clinic. Mothers’ perceptions about breastfeeding, complementary feeding practices, and demographic characteristics were collected by interviews with them. EBF periods were 1-45 weeks, Median week was 17 weeks. Six months EBF rate was 32,28%. Younger mother (≤ 20) or older (≥35) ages, and mothers having chronic diseases had a shorter median week of EBF. The median duration of breastfeeding was 9 months (0-24 months). The most frequent reason of the early interruption of EBF was, according to mother’s perceptions, for having inadequate breast milk (50.3 %). The study indicates that the frequency of 6 months EBF (32,28%) and the median duration of breastfeeding (17 weeks) are low in Albaida. A local strategy must be developed to overcome mothers negative perceptions about EBF in the first 6 months of age.

scholarly journals Pacifier use as a risk factor for reduction in breastfeeding duration: a systematic review

2008 ◽  
Vol 8 (4) ◽  
pp. 377-389 ◽  
Author(s):  
Edson Theodoro dos Santos Neto ◽  
Adauto Emmerich Oliveira ◽  
Eliana Zandonade ◽  
Maria del Carmem Bisi Molina
Keyword(s):  
Systematic Review ◽  
Risk Factor ◽  
Breastfeeding Duration ◽  
Specific Population ◽  
Cross Sectional ◽  
Degree Of Association ◽  
Duration Of Breastfeeding ◽  
Experienced Difficulty ◽  
Pacifier Use

This systematic review of literature proposes to establish whether pacifier use is a risk factor for a reduction in the duration of breastfeeding. A search of the Medline and Lilacs databases was carried out for articles published between 1996 and 2006 using the following descriptors: "breastfeeding" and "pacifier". Articles were excluded if they: had no open access abstracts; did not contain estimators testing the degree of association between breastfeeding duration and pacifier use; involved a follow-up loss of greater than 20%; were written in languages other than Portuguese, English and Spanish; covered specific population categories, such as pre-term babies or mothers who experienced difficulty breastfeeding; or were based on information provided by the mother or a health care professional. Nineteen articles were chosen according to the criteria outlined above; of these, one was a randomized clinical trial, eleven were prospective cohort studies and seven were cross sectional studies. The review concludes that pacifier use is a risk factor for breastfeeding duration, although the performance mechanism remains obscure. Other risk factors relate to the children, their parents and the hospital care they receive regarding the early interruption of breastfeeding. There is a need to standardize the methodology for investigating the association between pacifier use and breastfeeding duration, in order to provide scientific knowledge on this subject.

scholarly journals Enthesitis Related Arthritis in a Longitudinal Southeast Asian Registry: High Prevalence of HLA-B27, Different Sacroiliitis Risk Factors and Less Common Drug-Free Remission

2021 ◽  
Vol 10 (4) ◽  
pp. 568
Author(s):  
Thaschawee Arkachaisri ◽  
Kai Liang Teh ◽  
Yun Xin Book ◽  
Sook Fun Hoh ◽  
Xiaocong Gao ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Cox Regression ◽  
Age At Onset ◽  
Human Leukocyte ◽  
Common Disease ◽  
Hla B27 ◽  
Significance Level ◽  
Enthesitis Related Arthritis ◽  
Joint Deformity ◽  
Kaplan Meier

Objective. To describe the clinical characteristics, predictors and treatment of children with Enthesitis Related Arthritis (ERA) in a Singapore longitudinal cohort over 11 years. Methods. ERA patients were recruited from our registry (2009–2019). Nonparametric descriptive statistics including median (interquartile range, IQR) were used to describe data. Kaplan–Meier survival and logistic/Cox regression analyses were used to estimate the probabilities and determine predictors of clinical variables, respectively. The significance level was set at <0.05. Results. One hundred and forty-six ERA patients (87% male, 82% Chinese) were included. Median onset age was 11.9 years (IQR 9.4–14.0) and median disease duration was 4.9 years (IQR 2.6–8.3). Family history of Human Leukocyte Antigen (HLA)-B27 associated diseases was positive in 7.5%. Acute uveitis occurred in 3.4%. Oligoarthritis was present in 89.7%. Hip, knee and ankle joints were among the most common joints involved. One-fourth had enthesitis at diagnosis (Achilles tendon entheses, 82.9%). Sacroiliitis occurred in 61%. Probabilities of sacroiliitis development were 0.364, 0.448 and 0.578 at 1, 2 and 5 years after onset, respectively. Negative HLA-B27, female, older age at onset and hip arthritis at diagnosis were associated with shorter time for sacroiliitis development (p = 0.001–0.049). Methotrexate (MTX) remained the most common disease modifying anti-rheumatic drug (DMARD) used (77.4%). However, 77.9% required anti-TNF (aTNF) therapy secondary to MTX failure. Among MTX-treated sacroiliitis patients, 85.3% failed, requiring aTNF, as compared to 63.2%patients without axial disease. Longer duration to diagnosis (p = 0.038) and MTX use (p = 0.007) predicted aTNF therapy. None had joint deformity. Conclusions. This study underscores differences in ERA clinical characteristics, predictors and treatment responses. Our ERA population had many unique findings but good functional outcomes.

scholarly journals Use of Medications by Breastfeeding Women in the 2015 Pelotas (Brazil) Birth Cohort Study

2020 ◽  
Vol 17 (2) ◽  
pp. 568 ◽  
Author(s):  
Bárbara Heather Lutz ◽  
Diego Garcia Bassani ◽  
Vanessa Iribarrem Avena Miranda ◽  
Marysabel Pinto Telis Silveira ◽  
Sotero Serrate Mengue ◽  
...  
Keyword(s):  
Regression Models ◽  
Cox Regression ◽  
Medication Use ◽  
Population Based ◽  
Birth Cohort Study ◽  
Ministry Of Health ◽  
Adverse Side Effects ◽  
Kaplan Meier ◽  
Duration Of Breastfeeding ◽  
Risk Categories

Background: This study describes medication use by women up to 3 months postpartum and evaluates the association between medication use by women who were still breastfeeding at 3 months postpartum and weaning at 6 and 12 months. Methods: Population-based cohort, including women who breastfed (n = 3988). Medications were classified according to Hale’s lactation risk categories and Brazilian Ministry of Health criteria. Duration of breastfeeding was analysed using Cox regression models and Kaplan-Meier curves, including only women who were still breastfeeding at three months postpartum. Results: Medication use with some risk for lactation was frequent (79.6% regarding Hale’s risk categories and 12.3% regarding Brazilian Ministry of Health criteria). We did not find statistically significant differences for weaning at 6 or 12 months between the group who did not use medication or used only compatible medications and the group who used medications with some risk for lactation, according to both criteria. Conclusions: Our study found no association between weaning rates across the different breastfeeding safety categories of medications in women who were still breastfeeding at three months postpartum. Therefore, women who took medications and stopped breastfeeding in the first three months postpartum because of adverse side-effects associated with medications could not be addressed in this analysis.

scholarly journals The Associations of Psoas and Masseter Muscles With Sarcopenia and Related Adverse Outcomes in Older Trauma Patients- A Retrospective Study

2020 ◽  
Author(s):  
Surabhi Varma ◽  
Michael SJ Wilson ◽  
Mitesh Naik ◽  
Amandeep Sandhu ◽  
Helen Chidera Uchenna Ota ◽  
...  
Keyword(s):  
Cox Regression ◽  
Psoas Muscle ◽  
Adverse Outcomes ◽  
Trauma Patients ◽  
Cross Sectional ◽  
Traumatic Injuries ◽  
Regression Methods ◽  
Kaplan Meier ◽  
Pelvic Imaging ◽  
Masseter Muscles

Abstract Background: There is an emerging role for the radiological evaluation of the psoas muscle as a marker of sarcopenia, and as a prognostic discriminant in elderly patients with traumatic injuries. Older trauma patients are more likely to undergo cranial than abdomino-pelvic imaging. Identifying sarcopenia using masseter cross sectional area (M-CSA) has shown correlation with mortality. We sought to determine the correlation between psoas: lumbar vertebral index (PLVI) and the M-CSA, and their association with health outcomes. Methods: Patients aged 65 or above, who presented as a trauma call over a 1 year period were included if they underwent cranial or abdominal CT imaging. Images were retrospectively analyzed to obtain PLVI and mean M-CSA measurements. Electronic records were abstracted for demographics and outcomes. Logistic regression methods, log scale analyses, Cox regression model and Kaplan-Meier plots were used to determine association of sarcopenia with outcomes. Results: There were 155 eligible patients in the M-CSA group and 204 patients in the PLVI group. Sarcopenia was defined as the lowest quartile in each group. Both PLVI and M-CSA measurements were available in 142 patients. Pearson’s correlation indicated a weakly positive linear relationship (r=0.35, p<0.001) between these. There was no statistical association between M-CSA sarcopenia status and any measured outcomes. Those with PLVI sarcopenia were more likely to die in hospital (adjusted OR 3.38, 95% CI 1.47-9.73, p=0.006) and at 2-years (adjusted HR 1.90, 95% CI 1.11-3.25, p=0.02). Only 29% patients with PLVI sarcopenia were discharged home, compared with 58% without sarcopenia (p=0.001).Conclusion: Sarcopenia, defined by PLVI, is predictive of increased in-patient and 2- year mortality. Our study did not support prognostic relevance of M-CSA. Further research should be directed at improving the validity of masseter measurements or identifying alternative radiological determinants of sarcopenia on cranial imaging.

scholarly journals Sarcopenia in Elderly Major Trauma; A Single Centre Retrospective Analysis of Psoas and Masseter Muscle Groups

2020 ◽  
Author(s):  
Surabhi Varma ◽  
Michael SJ Wilson ◽  
Mitesh Naik ◽  
Amandeep Sandhu ◽  
Helen Chidera Uchenna Ota ◽  
...  
Keyword(s):  
Major Trauma ◽  
Cox Regression ◽  
Psoas Muscle ◽  
Trauma Patients ◽  
Cross Sectional ◽  
Traumatic Injuries ◽  
Regression Methods ◽  
Kaplan Meier ◽  
Pelvic Imaging ◽  
Muscle Groups

Abstract Background: There is an emerging role for the radiological evaluation of the psoas muscle as a marker of sarcopenia, and as a prognostic discriminant in elderly patients with traumatic injuries. Older trauma patients are more likely to undergo cranial than abdomino-pelvic imaging. Identifying sarcopenia using masseter cross sectional area (M-CSA) has shown correlation with mortality. We sought to determine the correlation between psoas: lumbar vertebral index (PLVI) and the M-CSA, and their association with health outcomes. Methods: Patients aged 65 or above, who presented as a trauma call over a 1 year period were included if they underwent cranial or abdominal CT imaging. Images were retrospectively analyzed to obtain PLVI and mean M-CSA measurements. Electronic records were abstracted for demographics and outcomes. Logistic regression methods, log scale analyses, Cox regression model and Kaplan-Meier plots were used to determine association of sarcopenia with outcomes. Results: There were 155 eligible patients in the M-CSA group and 204 patients in the PLVI group. Sarcopenia was defined as the lowest quartile in each group. Both PLVI and M-CSA measurements were available in 142 patients. Pearson’s correlation indicated a weakly positive linear relationship (r=0.35, p<0.001) between these. There was no statistical association between M-CSA sarcopenia status and any measured outcomes. Those with PLVI sarcopenia were more likely to die in hospital (adjusted OR 3.38, 95% CI 1.47-9.73, p=0.006) and at 2-years (adjusted HR 1.90, 95% CI 1.11-3.25, p=0.02). Only 29% patients with PLVI sarcopenia were discharged home, compared with 58% without sarcopenia (p=0.001).Conclusion: Sarcopenia, defined by PLVI, is predictive of increased in-patient and 2- year mortality. Our study did not support prognostic relevance of M-CSA. Further research should be directed at improving the validity of masseter measurements or identifying alternative radiological determinants of sarcopenia on cranial imaging.

Associations of homocysteine metabolism with the risk of spinal osteoarthritis progression in postmenopausal women

2021 ◽  
Author(s):  
Masaki Nakano ◽  
Yukio Nakamura ◽  
Tomohiko Urano ◽  
Akiko Miyazaki ◽  
Takako Suzuki ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Cohort Study ◽  
Cox Regression ◽  
Mthfr C677t ◽  
C677t Polymorphism ◽  
Prevalence Odds Ratio ◽  
Cross Sectional ◽  
Mthfr C677t Polymorphism ◽  
Cox Regression Analysis ◽  
Kaplan Meier

Abstract Purpose Although homocysteine accumulation is a reported risk factor for several age-related disorders, little is known on its relationship with osteoarthritis (OA). We therefore investigated for associations of homocysteine and C677T polymorphism in methylenetetrahydrofolate reductase (MTHFR), which is involved in homocysteine clearance, with the development and progression of spinal OA, through a combined cross-sectional and longitudinal cohort study. Methods A total of 1306 Japanese postmenopausal outpatients participating in the Nagano Cohort Study were followed for a 9.7-year mean period. Cross-sectional multiple logistic regression for spinal OA prevalence at registration by serum homocysteine level was performed with adjustment for confounders. In addition to Kaplan–Meier analysis, multivariate Cox regression was employed to examine the independent risk of MTHFR C677T variant for spinal OA progression. Results Multivariate regression analysis revealed a significant association between homocysteine and spinal OA prevalence (odds ratio 1.38; 95% confidence interval [CI] 1.14–1.68). Kaplan–Meier curves showed a gene dosage effect of the T allele in MTHFR C677T polymorphism on the accelerated progression of spinal OA severity (P = 0.003). A statistically significant independent risk of the T allele for spinal OA advancement was validated by Cox regression analysis. Respective adjusted hazard ratios for the CT/TT and TT genotypes were 1.68 (95% CI 1.16–2.42) and 1.67 (95% CI 1.23–2.28). Conclusions Circulating homocysteine and C677T variant in MTHFR are associated with the prevalence rate and ensuing progression, respectively, of spinal OA. These factors may represent potential interventional targets to prevent OA development and improve clinical outcomes.

Does chemotherapy work in reversal of malignant obstruction due to gastric cancer?

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21676-e21676
Author(s):  
Vanessa Montes Santos ◽  
Renata Gondim Meira Velame Azevedo ◽  
Rossana Veronica Mendoza Lopez ◽  
Paulo Marcelo Hoff ◽  
Jorge Sabbaga ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Cox Regression ◽  
Metastatic Gastric Cancer ◽  
Rank Test ◽  
Anticholinergic Drugs ◽  
Significance Level ◽  
Malignant Obstruction ◽  
Kaplan Meier ◽  
Clinical Measures

e21676 Background: Malignant obstruction (MO) is a common complication in patients with gastric cancer. Although palliative chemotherapy has already shown beneficial for overall survival in advanced cases, its value for MO reversal is still unknown. Methods: Inthis retrospective study we analyzed all consecutive patients with metastatic gastric cancer admitted with MO at the Instituto do Câncer do Estado de São Paulo (ICESP) from 2008 to 2016. The primary and secondary endpoints were overall survival and obstruction reversal rate respectively. Clinical measures other than chemotherapy and alimentary pause included the use of octreotide 0.1 mg, 3 times a day, steroids, antiemetics and anticholinergic drugs. Survival curves were calculated by Kaplan-Meier and log-rank test was used to compare them. The Cox regression model was used to evaluate risk factors for overall survival and the hazard ratio (HR) was calculated with its respective 95% confidence intervals. The analysis was performed in SPSS v.18 for Windows statistical software, and the significance level was 5%. Results: One hundred and eighteen(118)patients were included. Median overall survival was 11.2 months and survival time after the MO was 3.6 months for the whole group. Median time of use of octreotide was 3 days. Reversal of obstruction was seen in 16 of 36 patients (38.4%) in which chemotherapy was used and only in 22 of the 92 patients (24%) treated with exclusive clinical measures. In spite of these figures a significant better overall survival (p 0.002) was achieved in the group of patients that reached obstruction reversal without chemotherapy (13.6 months vs. 11.6 months for the clinical treatment group). Conclusions: This study suggests that chemotherapy even when reversing MO, has no impact in patients overall survival. These finding is particularly relevant for cost contingency in settings with limited resources. .

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