Category: Nevin Manimala

Endokrynol Pol. 2021 Aug 11. doi: 10.5603/EP.a2021.0070. Online ahead of print.

ABSTRACT

BACKGROUND: Gynecomastia (GM) is benign unilateral or bilateral proliferation of the glandular tissue of breast in males. Its development during adolescence is usually considered a physiologic phenomenon and is expected to resolve within months. Sometimes however it is due to pathologic conditions or diseases and it is not uncommon these not to be recognized on time. The present study aims to investigate the causes of prepubertal and pathologic pubertal GM, its association with obesity, age of appearance and whether GM has a psychological impact on boys and adolescents admitted at endocrine department.

MATERIAL AND METHODS: A total of 157 boys and adolescents with GM were included in a cross-sectional retrospective study in a single tertiary center for endocrine diseases. Patients were evaluated by anthropometric measurements, serum hormonal levels and a questionnaire.

RESULTS: For the period 2009-2018 a total of 157 boys and adolescents were diagnosed with GM (76.43 % obese, 3.18%- overweight). Twelve (7.64 %, mean age of GM development -7.53 years) were prepubertal, 5.09%- with primary or secondary testicular damage, 5.73% with hypogonadotropic hypogonadism, 11.48% -with elevated prolactin level and 110 boys (70.06%) with physiologic pubertal GM. A statistically significant difference was found between the age of development of physiologic GM -11.85 years (9.35-16.92) and those due to hypergonadotropic 13.57 years (10-16.25) (p=0.006) and hypogonadotropic 12.77 (10.50-14.0) (p=0.028) hypogonadism. Onset of pubertal GM in normal weight boys was 13.13 years, and in obese/overweight -11.69 years (p <0.001). Eighty four patients (53.5%) confessed a psychological burden of GM, 12.1 % consulted because of its development, in 8.2 % led to cessation of sports and 2.5 % changed their clothes.

CONCLUSIONS: Prepubertal and pubertal GM has a high association with obesity. Excess adipose tissue has an impact on the age of development in both groups. Nearly a quarter of pubertal cases are due to pathologic conditions and those are often diagnosed more than 18 months after the appearance of breast. So although greater number of pubertal GM is physiologic it may be reasonable adolescents to be evaluated within the first 6 months of breast development so not to delay the diagnosis of pathologic ones. Additionally we have found that GM has a complex influence on psychologic state of boys and adolescents.

PMID:34378787 | DOI:10.5603/EP.a2021.0070

Cien Saude Colet. 2021 Aug;26(8):3255-3264. doi: 10.1590/1413-81232021268.06092021. Epub 2021 Apr 28.

ABSTRACT

This study sought to analyze the evidence of the validity of a Brazilian version of the Fear of COVID-19 Scale (FCV-19S), based on indicators relating to: (1) the internal structure; (2) the internal consistency; (3) the relation with external variables; and (4) the content. The instrument was culturally adapted, focusing on semantic and specifically Brazilian linguistic aspects. The Brazilian version of the FCV-19S was then applied, in a virtual environment, to 211 participants (72.98% female) with an average age of 37.07 years (SD=13.03), together with the Self-Perception Questionnaire on Mental Health in Pandemics and the Sociodemographic and Functional Questionnaire. The confirmatory factor analysis revealed one-dimensionality. The internal consistency indices obtained (Cronbach’s alpha =0.921; McDonald’s omega =0.926) can be considered high. The correlation between fear and obsessive thinking of the disease, generalized anxiety, generalized stress, phobic-avoidant behavior and bereavement due to the pandemic was found to be statistically significant. Evidence of the validity related to content, derived from a qualitative approach, were satisfactory. The conclusion drawn is that the Brazilian version of the FCV-19S proved to be adequate regarding the evidence of the expected validity.

PMID:34378713 | DOI:10.1590/1413-81232021268.06092021

Braz J Biol. 2021 Aug 9;83:e246781. doi: 10.1590/1519-6984.246781. eCollection 2021.

ABSTRACT

The agouti (Dasyprocta leporina) is a rodent that is found in the Neo-tropical region. This animal is hunted for its meat but has recently been reared in captivity as a source of meat protein in rural communities. A 20-month experiment was carried out to evaluate the effect of an anthelmintic on the reproductive performance of the agouti (Dasyprocta leporina) reared in captivity. This experiment was conducted in the humid tropics of Trinidad and Tobago. Sixteen animals (15 females, 1 male) placed in each of the two treatment groups in a completely randomized study design. In treatment 1 (T1) animals were given subcutaneous injections of Endovet Ces® (Ivermectin/Praziquantel) at 0.2 mg/kg every three months. Treatment 2 (T2) was the negative control group where animals were not exposed to an anthelmintic. Reproductive data were collected at parturition which included birth weight, litter weight, litter size and gender of offspring. The results showed that there was no statistical difference (p > 0.05) between the treatment groups with respect to birth weight, litter weight, litter size and gender. However, agoutis that were dewormed had a higher birth weight (220.24 g vs 209.1 g) and litter weight (369.8 g vs 343 g). The same values were obtained for the litter size (1.7 vs 1.7) and animals that were dewormed had a higher female offspring to male offspring (2.41:1 vs 1.11:1). This experiment demonstrated that the use of an anthelmintic strategically in the management of captive reared agoutis had no statistical effect (p > 0.05) on the reproductive parameters. Therefore, these animals can be kept in captive conditions without being dewormed and produce efficiently with proper feeding and housing management.

PMID:34378685 | DOI:10.1590/1519-6984.246781

Cien Saude Colet. 2021 Aug;26(8):3135-3145. doi: 10.1590/1413-81232021268.04672020. Epub 2020 Jun 3.

ABSTRACT

The study analyzed and compared the types of food sold in the surroundings of 30 private and 26 public elementary schools in the city of Niterói, Rio de Janeiro. Data were collected by audit using a checklist instrument to characterize establishments (formal or informal) and identify the types of food and beverages sold, which were classified by processing level (fresh, processed, and ultraprocessed). Mann-Whitney statistical tests were used to verify the difference in the type of trade outlets d the categories of food sold between schools. The Kruskal-Wallis test was used to verify the difference in the amount of food traded between the categories. The amount of ultraprocessed food in the surroundings of public and private schools was statistically higher (p=0.0001) than the other categories. Some culinary preparations had a high rate of energy contribution from ultraprocessed foods (above 15%). There was no statistically significant difference (p = 0.478) in the categories of food sold between public and private schools. The sale of ultraprocessed products predominates around public and private schools, favoring the exposure of children to an environment that encourages the consumption of these products.

PMID:34378704 | DOI:10.1590/1413-81232021268.04672020

Cien Saude Colet. 2021 Aug;26(8):3175-3185. doi: 10.1590/1413-81232021268.09182020. Epub 2020 Jun 3.

ABSTRACT

We present results of initial steps of the psychometric evaluation of a proposed modified version of the Brazilian Household Food Insecurity Measurement Scale aimed at assessing adults’ recall of food insecurity at age 12. Data were obtained through self-administered questionnaires from civil servants at university campuses in Rio de Janeiro, who participated in the first and fourth waves of the longitudinal Pró-Saúde Study. We evaluated test-retest reliability (n=58), internal consistency, factor structure, convergent, discriminant validity (n=3,253). Test-retest reliability kappa coefficients were above 0.65; Cronbach’s α coefficient was 0.84. Factor loadings were above 0.800. The composite reliability was above 0.90. The square root values of the Average Variance Extracted were positive and statistically significant. Household food insecurity during childhood was strongly associated with larger family size and several sociodemographic conditions at age 12: female head of household, residence in rural area or small town, worse standard of living, and insufficient food due to lack of money. This initial evaluation suggests good performance. Further investigation should include additional psychometric properties and other population contexts.

PMID:34378707 | DOI:10.1590/1413-81232021268.09182020

Arq Bras Cardiol. 2021 Aug 6:S0066-782X2021005012202. doi: 10.36660/abc.20200600. Online ahead of print.

ABSTRACT

BACKGROUND: Left ventricular hypertrophy (LVH) is an important cardiovascular risk factor, regardless of arterial hypertension. Despite the evolution of imaging tests, the electrocardiogram (ECG) is still the most used in the initial evaluation, however, with low sensitivity.

OBJECTIVE: To evaluate the performance of the main electrocardiographic criteria for LVH in elderly and very elderly hypertensive individuals.

METHODS: In a cohort of hypertensive patients, ECGs and doppler echocardiographies (ECHO) were performed and separated into three age groups: <60 years, Group I; 60-79 years Group II; and ≥80 years, Group III. The most used electrocardiographic criteria were applied for the diagnosis of LVH: Perugia; Pegaro-Lo Presti; Gubner-Ungerleider; Narita; (Rm+Sm) x duration; Cornell voltage; Cornell voltage duration; Sokolow-Lyon voltage; R of aVL ≥11 mm; RaVL duration. In evaluating the performance of these criteria, in addition to sensitivity (Sen) and specificity (Esp), the “Diagnostic Odds Ratios” (DOR) were analyzed. We considered p-value <0.05 for the analyses, with two-tailed tests.

RESULTS: In 2,458 patients, LVH was present by ECHO in 781 (31.7%). In Groups I and II, the best performances were for the criteria of Narita, Perugia, (Rm+Sm) x duration, with no statistical differences between them. In Group III (very elderly) the Perugia criteria and (Rm+Sm) x duration had the best performances: Perugia [44,7/89.3; (Sen/Esp)] and (Rm+Sm) duration [39.4%/91.3%; (Sen/Esp), p<0.05)], with the best PAIN results:6.8. This suggests that in this very elderly population, these criteria have greater discriminatory power to separate patients with LVH.

CONCLUSION: In very elderly hypertensive patients, the Perugia electrocardiographic criteria and (Rm+Sm) x duration showed the best diagnostic performance for LVH.

PMID:34378674 | DOI:10.36660/abc.20200600

Braz J Med Biol Res. 2021 Aug 6;54(10):e11035. doi: 10.1590/1414-431X2021e11035. eCollection 2021.

ABSTRACT

In this eight-year retrospective study, we evaluated the associations between climatic variations and the biological rhythms in plasma lipids and lipoproteins in a large population of Campinas, São Paulo state, Brazil, as well as temporal changes of outcomes of cardiovascular hospitalizations. Climatic variables were obtained at the Center for Meteorological and Climatic Research Applied to Agriculture (University of Campinas – Unicamp, Brazil). The plasma lipid databases surveyed were from 27,543 individuals who had their lipid profiles assessed at the state university referral hospital in Campinas (Unicamp). The frequency of hospitalizations was obtained from the Brazilian Public Health database (DATASUS). Temporal statistical analyses were performed using the methods Cosinor or Friedman (ARIMA) and the temporal series were compared by cross-correlation functions. In normolipidemic cases (n=11,892), significantly different rhythmicity was observed in low-density lipoprotein (LDL)- and high-density lipoprotein (HDL)-cholesterol (C) both higher in winter and lower in summer. Dyslipidemia (n=15,651) increased the number and amplitude of lipid rhythms: LDL-C and HDL-C were higher in winter and lower in summer, and the opposite occurred with triglycerides. The number of hospitalizations showed maximum and minimum frequencies in winter and in summer, respectively. A coincident rhythmicity was observed of lower temperature and humidity rates with higher plasma LDL-C, and their temporal series were inversely cross-correlated. This study shows for the first time that variations of temperature, humidity, and daylight length were strongly associated with LDL-C and HDL-C seasonality, but moderately to lowly associated with rhythmicity of atherosclerotic outcomes. It also indicates unfavorable cardiovascular-related changes during wintertime.

PMID:34378675 | DOI:10.1590/1414-431X2021e11035

J Obstet Gynaecol Res. 2021 Aug 10. doi: 10.1111/jog.14980. Online ahead of print.

ABSTRACT

OBJECTIVE: To examine the prevalence of female sexual dysfunction (FSD) in gynecologic cancer survivors.

METHODS: A cross-sectional observation survey recruited women aged 18-65 years old who were diagnosed with gynecologic cancers and underwent surgery, radiation, chemotherapy, or combined modalities. Data were collected from September 2019 to March 2020 by the Thai version of the female sexual function index questionnaire to define FSD. The survey contained six domains: desire, arousal, lubrication, orgasm, satisfaction, and pain.

RESULTS: Of the 98 women included in the study, the mean age was 48.7 ± 10.6 years old. Two-third (67.3%) of the participants was premenopausal, had been diagnosed with ovarian cancer, and had early-stage gynecologic cancers. Fifty-eight of 98 (59.2%) participants were sexually active in the past 4 weeks before the survey. Among those, 89.6% had FSD. The median scores in the FSD group were significantly lower than those in the non-FSD group in all six domains, namely, desire, arousal, lubrication, orgasm, satisfaction, and pain (p < 0.05). There was no statistically significant difference observed between participants with and without FSD in terms of age group, cancer-related data, or sexual behavior data, except participants who had good/excellent relationships with their partners, which impacted FSD (p = 0.01).

CONCLUSIONS: This study discovered the high prevalence (89.6%) of hidden issue of “female sexual dysfunction” in Thai gynecologic cancer survivors. The good/excellent relationships with their partners affected the FSD who were sexually active in the past 4 weeks before the survey.

PMID:34376017 | DOI:10.1111/jog.14980

Nature. 2021 Aug 10. doi: 10.1038/s41586-021-03855-y. Online ahead of print.

ABSTRACT

Genome-wide association studies have uncovered thousands of common variants associated with human disease, but the contribution of rare variation to common disease remains relatively unexplored. The UK Biobank (UKB) contains detailed phenotypic data linked to medical records for approximately 500,000 participants, offering an unprecedented opportunity to evaluate the impact of rare variation on a broad collection of traits^1,2. Here, we studied the relationships between rare protein-coding variants and 17,361 binary and 1,419 quantitative phenotypes using exome sequencing data from 269,171 UKB participants of European ancestry. Gene-based collapsing analyses revealed 1,703 statistically significant gene-phenotype associations for binary traits, with a median odds ratio of 12.4. Furthermore, 83% of these associations were undetectable via single variant association tests, emphasizing the power of gene-based collapsing analysis in the setting of high allelic heterogeneity. Gene-phenotype associations were also significantly enriched for loss-of-function-mediated traits and approved drug targets. Finally, we performed ancestry-specific and pan-ancestry collapsing analyses using exome sequencing data from 11,933 UKB participants of African, East Asian, or South Asian ancestry. Together, our results highlight a significant contribution of rare variants to common disease. Summary statistics are publicly available through an interactive portal ( http://azphewas.com/ ).

PMID:34375979 | DOI:10.1038/s41586-021-03855-y

Econ Hum Biol. 2021 Jul 30;43:101050. doi: 10.1016/j.ehb.2021.101050. Online ahead of print.

ABSTRACT

Hiring discrimination towards (former) burnout patients has been extensively documented in the literature. To tackle this problem, it is important to understand the underlying mechanisms of such unequal hiring opportunities. Therefore, we conducted a vignette experiment with 425 genuine recruiters and jointly tested the potential stigma against job candidates with a history of burnout that were mentioned earlier in the literature. We found candidates revealing a history of burnout elicit perceptions of requiring work adaptations, likely having more unpleasant collaborations with others as well as diminished health, autonomy, ability to work under pressure, leadership capacity, manageability, and learning ability, when compared to candidates with a comparable gap in working history due to physical injury. Led by perceptions of a reduced ability to work under pressure, the tested perceptions jointly explained over 90 % of the effect of revealing burnout on the probability of being invited to a job interview. In addition, the negative effect on interview probability of revealing burnout was stronger when the job vacancy required higher stress tolerance. In contrast, the negative impact of revealing burnout on interview probability appeared weaker when recruiters were women and when recruiters had previously had personal encounters with burnout.

PMID:34375926 | DOI:10.1016/j.ehb.2021.101050