Global ETD Search

11	Avaliação da função renal pelo Clearance de Creatinina, dos pacientes vítimas de acidente ofídico no Hospital de Referência de Porto Nacional Tocantins (2013-2014) / Renal function assessment by Creatinine Clearance on patients victims of ophidic accident at Referral Hospital in Porto Nacional, Tocantins State (2013-2014) Magalhães Filho, Asterio Souza 18 December 2015 (has links) O Hospital de Referência de Porto Nacional no estado do Tocantins é responsável pelo atendimento da população desta cidade e de mais treze municípios circunvizinhos que compreendem a Regional de Saúde Amor Perfeito pela SESAU TO. Totalizando aproximadamente 180.000 habitantes, grande parte dessa população reside na zonal rural e mesmo os habitantes das zonas urbanas frequentam ambientes selvagens como beira de rios e matas, o que os expõe ao contato com animais peçonhentos. Os acidentes ofídicos ocorridos nesta região são atendidos, quase que exclusivamente, nesta unidade hospitalar e a disfunção renal é uma das mais temíveis complicações nesses casos. Esse estudo epidemiológico visa realizar diagnóstico de disfunção renal em pacientes vítimas de acidente ofídico, e acompanhamento evolutivo do quadro clínico pela mensuração do clearance de creatinina com o método indireto utilizando a Fórmula de Cockroft e Gault. Foi realizado o acompanhamento clínico de todos os pacientes atendidos no Hospital de Referência de Porto Nacional vítimas de acidente ofídico de qualquer gênero no período de janeiro de 2013 a dezembro de 2014. A mensuração do clearance de creatinina foi realizada no momento do primeiro atendimento e posteriormente em acompanhamento diário da Taxa de Filtração Glomerular usando a Fórmula de Cockroft e Gault (140-Peso-kg) x Idade em anos / 72 x creatinina plasmática. Durante o período estudado foram atendidos neste hospital 78 casos de acidente ofídico, dos quais 88,4% classificados como acidente Botrópico e 6,4% como Crotálico. O clearance de creatinina ficou abaixo de 60 ml/min/m², o que comprova disfunção renal, em 12 pacientes, demonstrando uma incidência geral de 15,4%. A incidência de acidente Botrópico foi de 15,9 % enquanto que a do tipo Crotálico foi de 20%. Todos os pacientes restabeleceram a função renal normal após término do tratamento. A maioria dos casos ocorreu nos meses de janeiro, fevereiro, novembro e dezembro, onde ocorrem as maiores incidências de chuvas. Fatores como idade do paciente e o tempo entre o acidente e o início da terapia específica, com soro adequado, contribuíram para o surgimento da Insuficiência Renal Aguda pós-acidente ofídico. O conhecimento do perfil epidemiológico de cada região aliado ao estudo das taxas de incidência, prevalência e complicações desta entidade clínica, bem como o início precoce da terapêutica adequada interferem no surgimento de lesões renais com pior prognóstico. / The Referral Hospital in Porto Nacional, Tocantins state, is responsible for serving the population of this city and thirteen surrounding municipalities that comprise the Regional Health Office called \"Perfect Love\" administrated by SESAU-TO healthy authority. With approximately 180,000 inhabitants in total, much of this population lives in the rural zone, and even the urban dwellers attend wild environments such as river banks and forests, which is putting them in contact with venomous animals. The ophidic accidents occurred in this region are treated almost exclusively in this hospital unite and renal dysfunction is one of the most feared complications in these cases. This epidemiological study aims at performing diagnosis of renal dysfunction in patients suffering from ophidic accident, and the monitoring evolution of the clinical picture by measuring creatinine clearance with an indirect method by using the Cockroft and Gault formula. Clinical follow-ups were performed in all patients treated at the Referral Hospital in Porto Nacional city, Tocantins state, which were victims of any kind of ophidic accident from January 2013 to December 2014. The measurement of creatinine clearance was done at the first doctor visit and later in a daily basis for monitoring glomerular filtration rate using the formula of Cockroft and Gault (140-kg-weight) x Age in years / 72 x plasmatic creatinine. During the study period, 78 cases of ophidic accidents were treated. 88.4% were classified as Bothropic accident and 6.4% Crotalic one. The creatinine clearance level was below 60 ml / min / m², which proves renal dysfunction in 12 patients, leading to an overall incidence of 15.4%. When separated by type of accident, the incidence for Bothropic accident was 15.9% while the Crotalic type was 20%. All patients restored normal renal function after the end of treatment. Most cases occurred in January, February, November and December, when the highest incidence of rainfall occurs. Factors such as patient age, time between the accident and early specific therapy with appropriate serum contributed to the emergence of acute renal failure in the post-ophidic accident period. The knowledge of the epidemiological profile of each region together with the study of incidence rates, prevalence and complications of this clinical entity, as well as the early initiation of appropriate therapy interferes with the appearance of renal lesions with poor prognosis. acidente ofídico Clearance de creatinina Cockroft and Gault creatinine clearance função renal Hospital de Referência ophidic accidents Porto Nacional de Tocantins
12	Clovis Lithic Debitage from Excavation Area 8 at the Gault Site (41BL323), Texas: Form and Function Pevny, Charlotte D. 2009 May 1900 (has links) This dissertation focuses on two portions of the Clovis lithic assemblage recovered from Excavation Area 8 at the Gault site (41BL323) located in central Texas. Gault is a quarry-camp visited by hunter-gatherer groups for at least 13,000 years, with Paleoindian, Archaic, and Late Prehistoric occupations. Freshwater seep springs, a diverse array of floral and faunal resources, and an abundant outcrop of high-quality toolstone at the site created an ideal location for people who lived a mobile hunting-andgathering way of life. The site is currently the only locale with two stratigraphically separate Clovis components-a lower geologic unit designated 3a and an upper unit designated 3b. Both are represented in Excavation Area 8 where, in the spring of 2000, Texas A&M University (TAMU) excavated 22 1-m2 contiguous units. For this research, 3375 complete flakes were analyzed individually to characterize Clovis debitage as represented at Excavation Area 8 and to establish if there are technological differences between the debitage assemblages recovered from Units 3a and 3b. The two Clovis components are quite similar from a technological standpoint. Minor differences appear to be related to site formation processes and intensity of site use. The second objective was to determine if Clovis debitage has diagnostic technological traits that allow confident assignment to the Clovis era. To test whether Clovis debitage is distinctive, it was compared to debitage recovered from later cultural components at the site. No evidence of a true blade technology was observed in the post- Clovis Paleoindian or Early Archaic debitage assemblages, although biface manufacture continued through time. Technologically, few differences were observed between the Clovis, post-Clovis Paleoindian, and Early Archaic debitage related to biface reduction. While overshot flakes may be diagnostic of Clovis biface technology, biface thinning flakes and other non-distinctive debitage showed few differences between components. During debitage analysis pieces were selected in an attempt to identify edgemodified tools. Low- and high-power usewear analysis was employed to make determinations concerning the cultural modification or use of flakes. This study concluded post-depositional damage affected most of the collection and there was minimal usewear-or minimal observable usewear-on flakes. Taphonomic processes interfered to a great extent with drawing firm inferences on tool use and possibly hindered the identification of tools. Of the 3375 pieces of Clovis debitage originally analyzed, 26 specimens were classified as tools based mainly on invasive, patterned flaking with less reliance on microscopic use indicators. Of these, inference of use was assigned to nine tools. Archaeology Clovis Gault site quarry workshop blade technology projectile point manufacture lithic debitage usewear edge-modified tools taphonomic processes trampling
13	Avaliação da função renal pelo Clearance de Creatinina, dos pacientes vítimas de acidente ofídico no Hospital de Referência de Porto Nacional Tocantins (2013-2014) / Renal function assessment by Creatinine Clearance on patients victims of ophidic accident at Referral Hospital in Porto Nacional, Tocantins State (2013-2014) Asterio Souza Magalhães Filho 18 December 2015 (has links) O Hospital de Referência de Porto Nacional no estado do Tocantins é responsável pelo atendimento da população desta cidade e de mais treze municípios circunvizinhos que compreendem a Regional de Saúde Amor Perfeito pela SESAU TO. Totalizando aproximadamente 180.000 habitantes, grande parte dessa população reside na zonal rural e mesmo os habitantes das zonas urbanas frequentam ambientes selvagens como beira de rios e matas, o que os expõe ao contato com animais peçonhentos. Os acidentes ofídicos ocorridos nesta região são atendidos, quase que exclusivamente, nesta unidade hospitalar e a disfunção renal é uma das mais temíveis complicações nesses casos. Esse estudo epidemiológico visa realizar diagnóstico de disfunção renal em pacientes vítimas de acidente ofídico, e acompanhamento evolutivo do quadro clínico pela mensuração do clearance de creatinina com o método indireto utilizando a Fórmula de Cockroft e Gault. Foi realizado o acompanhamento clínico de todos os pacientes atendidos no Hospital de Referência de Porto Nacional vítimas de acidente ofídico de qualquer gênero no período de janeiro de 2013 a dezembro de 2014. A mensuração do clearance de creatinina foi realizada no momento do primeiro atendimento e posteriormente em acompanhamento diário da Taxa de Filtração Glomerular usando a Fórmula de Cockroft e Gault (140-Peso-kg) x Idade em anos / 72 x creatinina plasmática. Durante o período estudado foram atendidos neste hospital 78 casos de acidente ofídico, dos quais 88,4% classificados como acidente Botrópico e 6,4% como Crotálico. O clearance de creatinina ficou abaixo de 60 ml/min/m², o que comprova disfunção renal, em 12 pacientes, demonstrando uma incidência geral de 15,4%. A incidência de acidente Botrópico foi de 15,9 % enquanto que a do tipo Crotálico foi de 20%. Todos os pacientes restabeleceram a função renal normal após término do tratamento. A maioria dos casos ocorreu nos meses de janeiro, fevereiro, novembro e dezembro, onde ocorrem as maiores incidências de chuvas. Fatores como idade do paciente e o tempo entre o acidente e o início da terapia específica, com soro adequado, contribuíram para o surgimento da Insuficiência Renal Aguda pós-acidente ofídico. O conhecimento do perfil epidemiológico de cada região aliado ao estudo das taxas de incidência, prevalência e complicações desta entidade clínica, bem como o início precoce da terapêutica adequada interferem no surgimento de lesões renais com pior prognóstico. / The Referral Hospital in Porto Nacional, Tocantins state, is responsible for serving the population of this city and thirteen surrounding municipalities that comprise the Regional Health Office called \"Perfect Love\" administrated by SESAU-TO healthy authority. With approximately 180,000 inhabitants in total, much of this population lives in the rural zone, and even the urban dwellers attend wild environments such as river banks and forests, which is putting them in contact with venomous animals. The ophidic accidents occurred in this region are treated almost exclusively in this hospital unite and renal dysfunction is one of the most feared complications in these cases. This epidemiological study aims at performing diagnosis of renal dysfunction in patients suffering from ophidic accident, and the monitoring evolution of the clinical picture by measuring creatinine clearance with an indirect method by using the Cockroft and Gault formula. Clinical follow-ups were performed in all patients treated at the Referral Hospital in Porto Nacional city, Tocantins state, which were victims of any kind of ophidic accident from January 2013 to December 2014. The measurement of creatinine clearance was done at the first doctor visit and later in a daily basis for monitoring glomerular filtration rate using the formula of Cockroft and Gault (140-kg-weight) x Age in years / 72 x plasmatic creatinine. During the study period, 78 cases of ophidic accidents were treated. 88.4% were classified as Bothropic accident and 6.4% Crotalic one. The creatinine clearance level was below 60 ml / min / m², which proves renal dysfunction in 12 patients, leading to an overall incidence of 15.4%. When separated by type of accident, the incidence for Bothropic accident was 15.9% while the Crotalic type was 20%. All patients restored normal renal function after the end of treatment. Most cases occurred in January, February, November and December, when the highest incidence of rainfall occurs. Factors such as patient age, time between the accident and early specific therapy with appropriate serum contributed to the emergence of acute renal failure in the post-ophidic accident period. The knowledge of the epidemiological profile of each region together with the study of incidence rates, prevalence and complications of this clinical entity, as well as the early initiation of appropriate therapy interferes with the appearance of renal lesions with poor prognosis. acidente ofídico Clearance de creatinina função renal Hospital de Referência Porto Nacional de Tocantins Cockroft and Gault creatinine clearance ophidic accidents
14	Birth of a Regiment, Princess Patricia's Canadian Light Infantry 1914-1919 Kempling, James S. 05 December 2011 (has links) This thesis uses a web site as its primary format. Readers are invited to visit www.birthofaregiment.com. Financed by a wealthy Montreal businessman, the original regiment was very British in its make-up. The Patricia’s were recruited and trained separate from the Canadian Expeditionary Force. For the first year of the war, they fought in a British brigade, under British officers using British weapons. By 1919, the PPCLI were distinctly Canadian. The Patricia’s became the best known Canadian regiment and one of three retained in the permanent force. This thesis examines that remarkable transition, the changes wrought by the war and the mechanisms used to reinforce the unique image of the Patricia’s. It also tests several myths embodied in the histories of the Regiment against a database of over five thousand files of soldiers who served with the Patricia’s during the First World War. / Graduate PPCLI World War One First World War Canada Hamilton Gault Farquhar Frezenberg Mount Sorrel Vimy Ridge Passchendaele Canal du Nord Weapons
15	Site Formation Processes at the Buttermilk Creek Site (41BL1239), Bell County, Texas Keene, Joshua L. 2009 August 1900 (has links) The archaeological literature warns against trusting the context of artifacts found within a vertisol due to the constant mixing of sediments caused by the shrink/swell properties of clays. These churning processes were thought to be the defining characteristic of vertisols until only the past few decades. It is now apparent that vertisols vary drastically based on a wide spectrum of variables and are fully capable of forming without churning processes. The Buttermilk Creek Site, Block A represents a prime example of a minimally developed vertisol. In addition, the site itself is a heavily occupied lithic quarry that has been almost continuously inhabited since Clovis and possibly Pre-Clovis times. This thesis takes a detailed look at the sediments and distribution of lithic artifacts from Block A of the Buttermilk Creek site to address the two following research objectives: 1) to determine if the archaeological context within the floodplain sediments at Block A has been disturbed by post-depositional processes, and 2) to identify discrete occupation surfaces within the vertic floodplain sediments at the site. These objectives are addressed using a variety of methods, including: 1) plotting the stratigraphic position of diagnostic artifacts, 2) determining the size distribution of debitage and artifact quantities throughout the floodplain deposits, 3) examining the distribution of cultural versus non-cultural lithic material, 4) recording the presence or absence of heat alteration in the deposits, 5) creating maps showing the degree of fissuring across the site, 6) analyzing differences in patination on artifacts, and 7) analyzing the presence of calcium carbonate on artifacts from all levels. Results from these analyses show that, despite the classification of sediments at Block A as a vertisol, vertical displacement of artifacts is largely absent. Chronologically ordered diagnostic points, consistently size sorted artifacts, and a lack of constant mixing of calcium carbonate throughout the profile suggest that artifacts found as deep as 20 cm below the Clovis-aged horizon represent intact cultural horizons. These oldest components found in Block A may represent some of the earliest known evidence of people in the New World. Buttermilk Creek vertisol pedoturbation archaeology lithics size sorting Clovis pre-clovis site formation argilliturbation clay cracks slickenside Gault geoarchaeology 41BL1239 grumusol edwards plateau gilgai folsom golondrina angostura pleistocene holocene transition
16	BIRTHWEIGHT AND SUSCEPTIBILITY TO CHRONIC DISEASE Issa Al Salmi Unknown Date (has links) The thesis examines the relationship of birthweight to risk factors and markers, such as proteinuria and glomerular filtration rate, for chronic disease in postnatal life. It made use of the Australian Diabetes, Obesity and Lifestyle Study (AusDiab). The AusDiab study is a cross sectional study where baseline data on 11,247 participants were collected in 1999-2000. Participants were recruited from a stratified sample of Australians aged ≥ 25 years, residing in 42 randomly selected urban and non-urban areas (Census Collector Districts) of the six states of Australia and the Northern Territory. The AusDiab study collected an enormous amount of clinical and laboratory data. During the 2004-05 follow-up AusDiab survey, questions about birthweight were included. Participants were asked to state their birthweight, the likely accuracy of the stated birthweight and the source of their stated birthweight. Four hundred and twelve chronic kidney disease (CKD) patients were approached, and 339 agreed to participate in the study. The patients completed the same questionnaire. Medical records were reviewed to check the diagnoses, causes of kidney trouble and SCr levels. Two control subjects, matched for gender and age, were selected for each CKD patient from participants in the AusDiab study who reported their birthweight. Among 7,157 AusDiab participants who responded to the questionnaire, 4,502 reported their birthweights, with a mean (standard deviation) of 3.4 (0.7) kg. The benefit and disadvantages of these data are discussed in chapter three. The data were analysed for the relationship between birthweight and adult body size and composition, disorders of glucose regulation, blood pressure, lipid abnormalities, cardiovascular diseases and glomerular filtration rate. Low birthweight was associated with smaller body build and lower lean mass and total body water in both females and males. In addition low birthweight was associated with central obesity and higher body fat percentage in females, even after taking into account current physical activity and socioeconomic status. Fasting plasma glucose, post load glucose and glycosylated haemoglobin were strongly and inversely correlated with birthweight. In those with low birthweight (< 2.5 kg), the risks for having impaired fasting glucose, impaired glucose tolerance, diabetes and all abnormalities combined were increased by 1.75, 2.22, 2.76 and 2.28 for females and by 1.40, 1.32, 1.98 and 1.49 for males compared to those with normal birthweight (≥ 2.5 kg), respectively. Low birthweight individuals were at higher risk for having high blood pressure ≥ 140/90 mmHg and ≥ 130/85 mmHg compared to those with normal birthweight. People with low birthweight showed a trend towards increased risk for high cholesterol (≥ 5.5 mmol/l) compared to those of normal birthweight. Females with low birthweight had increased risk for high low density lipoprotein cholesterol (≥ 3.5 mmol/l) and triglyceride levels (≥ 1.7 mmol/l) when compared to those with normal birthweight. Males with low birthweight exhibited increased risk for low levels of high density lipoprotein cholesterol (<0.9 mmol/l) than those with normal birthweight. Females with low birthweight were at least 1.39, 1.40, 2.30 and 1.47 times more likely to have angina, coronary artery disease, stroke and overall cardiovascular diseases respectively, compared to those ≥ 2.5 kg. Similarly, males with low birthweight were 1.76, 1.48, 3.34 and 1.70 times more likely to have angina, coronary artery disease, stroke and overall cardiovascular diseases compared to those ≥ 2.5 kg, respectively. The estimated glomerular filtration rate was strongly and positively associated with birthweight, with a predicted increase of 2.6 ml/min (CI 2.1, 3.2) and 3.8 (3.0, 4.5) for each kg of birthweight for females and males, respectively. The odd ratio (95% confidence interval) for low glomerular filtration rate (<61.0 ml/min for female and < 87.4 male) in people of low birthweight compared with those of normal birthweight was 2.04 (1.45, 2.88) for female and 3.4 (2.11, 5.36) for male. One hundred and eighty-nineCKD patients reported their birthweight; 106 were male. Their age was 60.3(15) years. Their birthweight was 3.27 (0.62) kg, vs 3.46 (0.6) kg for their AusDiab controls, p<0.001 and the proportions with birthweight<2.5 kg were 12.17% and 4.44%, p<0.001. Among CKD patients, 22.8%, 21.7%, 18% and 37.6% were in CKD stages 2, 3, 4 and 5 respectively. Birthweights by CKD stage and their AusDiab controls were as follows: 3.38 (0.52) vs 3.49 (0.52), p=0.251 for CKD2; 3.28 (0.54) vs 3.44 (0.54), p=0.121 for CKD3; 3.19 (0.72) vs 3.43 (0.56), p= 0.112 for CKD4 and 3.09 (0.65) vs 3.47 (0.67), p<0.001 for CKD5. The results demonstrate that in an affluent Western country with a good adult health profile, low birthweight people were predisposed to higher rates of glycaemic dysregulation, high blood pressure, dyslipidaemia, cardiovascular diseases and lower glomerular filtration rate in adult life. In all instances it would be prudent to adopt policies of intensified whole of life surveillance of lower birthweight people, anticipating this risk. The general public awareness of the effect of low birthweight on development of chronic diseases in later life is of vital importance. The general public, in addition to the awareness of people in medical practice of the role of low birthweight, will lead to a better management of this group of our population that is increasingly surviving into adulthood. birth weight birthweight birth weight and renal volume BIRTH WEIGHT QUESTIONNAIRE chronic disease Barker Hypothesis Foetal development DOHaD gestational age Anthropometric Characteristics body composition Height weight body mass index Waist Circumference hip circumference Waist-hip Ratio obesity Central Obesity Fatness Lean Body Mass Lean Mass Fat Mass body fat mass Body Fat Percentage body fatness Body Surface Area diabetes Fasting Glucose fasting insulin level glucose tolerance Impaired Fasting Glucose Impaired Glucose Tolerance Glycosylated Hemoglobin HbA1c IFG glucose control glycaemic control Metabolic Syndrome Syndrome X blood pressure Systolic Blood-pressure Diastolic Blood-pressure Systolic Hypertension high blood pressure Hypertension Dyslipidaemia Dyslipidemia Total Cholesterol Triglyceride Low Density Lipoprotein Cholesterol Ldl Cholesterol High Density Lipoprotein Hdl Cholesterol Fibrinogen angina Angina-pectoris Stroke coronary artery disease cardiovascular disease Framingham Framingham Heart Study Framingham Score coronary heart disease Glomerular Filtration glomerular filtration rate Glomerular Hyperfiltration Glomerular Injury Glomerular Number Nephrogenesis Nephron Endowment Nephron Number NKF-K/DQQI Classification Chronic Kidney Disease (ckd) Chronic Kidney Failure Kidney Failure CKD STAGES end-stage renal disease (ESRD) end-stage renal failure Cockcroft-gault MDRD formula Serum Creatinine Urinary Creatinine albuminuria Albuminuria:creatinine Ratio Kidney Development Kidney dysfunction low birth weight low birth weight Pre-term Birth AusDiab Study case control longitudinal observational study
17	BIRTHWEIGHT AND SUSCEPTIBILITY TO CHRONIC DISEASE Issa Al Salmi Unknown Date (has links) The thesis examines the relationship of birthweight to risk factors and markers, such as proteinuria and glomerular filtration rate, for chronic disease in postnatal life. It made use of the Australian Diabetes, Obesity and Lifestyle Study (AusDiab). The AusDiab study is a cross sectional study where baseline data on 11,247 participants were collected in 1999-2000. Participants were recruited from a stratified sample of Australians aged ≥ 25 years, residing in 42 randomly selected urban and non-urban areas (Census Collector Districts) of the six states of Australia and the Northern Territory. The AusDiab study collected an enormous amount of clinical and laboratory data. During the 2004-05 follow-up AusDiab survey, questions about birthweight were included. Participants were asked to state their birthweight, the likely accuracy of the stated birthweight and the source of their stated birthweight. Four hundred and twelve chronic kidney disease (CKD) patients were approached, and 339 agreed to participate in the study. The patients completed the same questionnaire. Medical records were reviewed to check the diagnoses, causes of kidney trouble and SCr levels. Two control subjects, matched for gender and age, were selected for each CKD patient from participants in the AusDiab study who reported their birthweight. Among 7,157 AusDiab participants who responded to the questionnaire, 4,502 reported their birthweights, with a mean (standard deviation) of 3.4 (0.7) kg. The benefit and disadvantages of these data are discussed in chapter three. The data were analysed for the relationship between birthweight and adult body size and composition, disorders of glucose regulation, blood pressure, lipid abnormalities, cardiovascular diseases and glomerular filtration rate. Low birthweight was associated with smaller body build and lower lean mass and total body water in both females and males. In addition low birthweight was associated with central obesity and higher body fat percentage in females, even after taking into account current physical activity and socioeconomic status. Fasting plasma glucose, post load glucose and glycosylated haemoglobin were strongly and inversely correlated with birthweight. In those with low birthweight (< 2.5 kg), the risks for having impaired fasting glucose, impaired glucose tolerance, diabetes and all abnormalities combined were increased by 1.75, 2.22, 2.76 and 2.28 for females and by 1.40, 1.32, 1.98 and 1.49 for males compared to those with normal birthweight (≥ 2.5 kg), respectively. Low birthweight individuals were at higher risk for having high blood pressure ≥ 140/90 mmHg and ≥ 130/85 mmHg compared to those with normal birthweight. People with low birthweight showed a trend towards increased risk for high cholesterol (≥ 5.5 mmol/l) compared to those of normal birthweight. Females with low birthweight had increased risk for high low density lipoprotein cholesterol (≥ 3.5 mmol/l) and triglyceride levels (≥ 1.7 mmol/l) when compared to those with normal birthweight. Males with low birthweight exhibited increased risk for low levels of high density lipoprotein cholesterol (<0.9 mmol/l) than those with normal birthweight. Females with low birthweight were at least 1.39, 1.40, 2.30 and 1.47 times more likely to have angina, coronary artery disease, stroke and overall cardiovascular diseases respectively, compared to those ≥ 2.5 kg. Similarly, males with low birthweight were 1.76, 1.48, 3.34 and 1.70 times more likely to have angina, coronary artery disease, stroke and overall cardiovascular diseases compared to those ≥ 2.5 kg, respectively. The estimated glomerular filtration rate was strongly and positively associated with birthweight, with a predicted increase of 2.6 ml/min (CI 2.1, 3.2) and 3.8 (3.0, 4.5) for each kg of birthweight for females and males, respectively. The odd ratio (95% confidence interval) for low glomerular filtration rate (<61.0 ml/min for female and < 87.4 male) in people of low birthweight compared with those of normal birthweight was 2.04 (1.45, 2.88) for female and 3.4 (2.11, 5.36) for male. One hundred and eighty-nineCKD patients reported their birthweight; 106 were male. Their age was 60.3(15) years. Their birthweight was 3.27 (0.62) kg, vs 3.46 (0.6) kg for their AusDiab controls, p<0.001 and the proportions with birthweight<2.5 kg were 12.17% and 4.44%, p<0.001. Among CKD patients, 22.8%, 21.7%, 18% and 37.6% were in CKD stages 2, 3, 4 and 5 respectively. Birthweights by CKD stage and their AusDiab controls were as follows: 3.38 (0.52) vs 3.49 (0.52), p=0.251 for CKD2; 3.28 (0.54) vs 3.44 (0.54), p=0.121 for CKD3; 3.19 (0.72) vs 3.43 (0.56), p= 0.112 for CKD4 and 3.09 (0.65) vs 3.47 (0.67), p<0.001 for CKD5. The results demonstrate that in an affluent Western country with a good adult health profile, low birthweight people were predisposed to higher rates of glycaemic dysregulation, high blood pressure, dyslipidaemia, cardiovascular diseases and lower glomerular filtration rate in adult life. In all instances it would be prudent to adopt policies of intensified whole of life surveillance of lower birthweight people, anticipating this risk. The general public awareness of the effect of low birthweight on development of chronic diseases in later life is of vital importance. The general public, in addition to the awareness of people in medical practice of the role of low birthweight, will lead to a better management of this group of our population that is increasingly surviving into adulthood. birth weight birthweight birth weight and renal volume BIRTH WEIGHT QUESTIONNAIRE chronic disease Barker Hypothesis Foetal development DOHaD gestational age Anthropometric Characteristics body composition Height weight body mass index Waist Circumference hip circumference Waist-hip Ratio obesity Central Obesity Fatness Lean Body Mass Lean Mass Fat Mass body fat mass Body Fat Percentage body fatness Body Surface Area diabetes Fasting Glucose fasting insulin level glucose tolerance Impaired Fasting Glucose Impaired Glucose Tolerance Glycosylated Hemoglobin HbA1c IFG glucose control glycaemic control Metabolic Syndrome Syndrome X blood pressure Systolic Blood-pressure Diastolic Blood-pressure Systolic Hypertension high blood pressure Hypertension Dyslipidaemia Dyslipidemia Total Cholesterol Triglyceride Low Density Lipoprotein Cholesterol Ldl Cholesterol High Density Lipoprotein Hdl Cholesterol Fibrinogen angina Angina-pectoris Stroke coronary artery disease cardiovascular disease Framingham Framingham Heart Study Framingham Score coronary heart disease Glomerular Filtration glomerular filtration rate Glomerular Hyperfiltration Glomerular Injury Glomerular Number Nephrogenesis Nephron Endowment Nephron Number NKF-K/DQQI Classification Chronic Kidney Disease (ckd) Chronic Kidney Failure Kidney Failure CKD STAGES end-stage renal disease (ESRD) end-stage renal failure Cockcroft-gault MDRD formula Serum Creatinine Urinary Creatinine albuminuria Albuminuria:creatinine Ratio Kidney Development Kidney dysfunction low birth weight low birth weight Pre-term Birth AusDiab Study case control longitudinal observational study
18	BIRTHWEIGHT AND SUSCEPTIBILITY TO CHRONIC DISEASE Issa Al Salmi Unknown Date (has links) The thesis examines the relationship of birthweight to risk factors and markers, such as proteinuria and glomerular filtration rate, for chronic disease in postnatal life. It made use of the Australian Diabetes, Obesity and Lifestyle Study (AusDiab). The AusDiab study is a cross sectional study where baseline data on 11,247 participants were collected in 1999-2000. Participants were recruited from a stratified sample of Australians aged ≥ 25 years, residing in 42 randomly selected urban and non-urban areas (Census Collector Districts) of the six states of Australia and the Northern Territory. The AusDiab study collected an enormous amount of clinical and laboratory data. During the 2004-05 follow-up AusDiab survey, questions about birthweight were included. Participants were asked to state their birthweight, the likely accuracy of the stated birthweight and the source of their stated birthweight. Four hundred and twelve chronic kidney disease (CKD) patients were approached, and 339 agreed to participate in the study. The patients completed the same questionnaire. Medical records were reviewed to check the diagnoses, causes of kidney trouble and SCr levels. Two control subjects, matched for gender and age, were selected for each CKD patient from participants in the AusDiab study who reported their birthweight. Among 7,157 AusDiab participants who responded to the questionnaire, 4,502 reported their birthweights, with a mean (standard deviation) of 3.4 (0.7) kg. The benefit and disadvantages of these data are discussed in chapter three. The data were analysed for the relationship between birthweight and adult body size and composition, disorders of glucose regulation, blood pressure, lipid abnormalities, cardiovascular diseases and glomerular filtration rate. Low birthweight was associated with smaller body build and lower lean mass and total body water in both females and males. In addition low birthweight was associated with central obesity and higher body fat percentage in females, even after taking into account current physical activity and socioeconomic status. Fasting plasma glucose, post load glucose and glycosylated haemoglobin were strongly and inversely correlated with birthweight. In those with low birthweight (< 2.5 kg), the risks for having impaired fasting glucose, impaired glucose tolerance, diabetes and all abnormalities combined were increased by 1.75, 2.22, 2.76 and 2.28 for females and by 1.40, 1.32, 1.98 and 1.49 for males compared to those with normal birthweight (≥ 2.5 kg), respectively. Low birthweight individuals were at higher risk for having high blood pressure ≥ 140/90 mmHg and ≥ 130/85 mmHg compared to those with normal birthweight. People with low birthweight showed a trend towards increased risk for high cholesterol (≥ 5.5 mmol/l) compared to those of normal birthweight. Females with low birthweight had increased risk for high low density lipoprotein cholesterol (≥ 3.5 mmol/l) and triglyceride levels (≥ 1.7 mmol/l) when compared to those with normal birthweight. Males with low birthweight exhibited increased risk for low levels of high density lipoprotein cholesterol (<0.9 mmol/l) than those with normal birthweight. Females with low birthweight were at least 1.39, 1.40, 2.30 and 1.47 times more likely to have angina, coronary artery disease, stroke and overall cardiovascular diseases respectively, compared to those ≥ 2.5 kg. Similarly, males with low birthweight were 1.76, 1.48, 3.34 and 1.70 times more likely to have angina, coronary artery disease, stroke and overall cardiovascular diseases compared to those ≥ 2.5 kg, respectively. The estimated glomerular filtration rate was strongly and positively associated with birthweight, with a predicted increase of 2.6 ml/min (CI 2.1, 3.2) and 3.8 (3.0, 4.5) for each kg of birthweight for females and males, respectively. The odd ratio (95% confidence interval) for low glomerular filtration rate (<61.0 ml/min for female and < 87.4 male) in people of low birthweight compared with those of normal birthweight was 2.04 (1.45, 2.88) for female and 3.4 (2.11, 5.36) for male. One hundred and eighty-nineCKD patients reported their birthweight; 106 were male. Their age was 60.3(15) years. Their birthweight was 3.27 (0.62) kg, vs 3.46 (0.6) kg for their AusDiab controls, p<0.001 and the proportions with birthweight<2.5 kg were 12.17% and 4.44%, p<0.001. Among CKD patients, 22.8%, 21.7%, 18% and 37.6% were in CKD stages 2, 3, 4 and 5 respectively. Birthweights by CKD stage and their AusDiab controls were as follows: 3.38 (0.52) vs 3.49 (0.52), p=0.251 for CKD2; 3.28 (0.54) vs 3.44 (0.54), p=0.121 for CKD3; 3.19 (0.72) vs 3.43 (0.56), p= 0.112 for CKD4 and 3.09 (0.65) vs 3.47 (0.67), p<0.001 for CKD5. The results demonstrate that in an affluent Western country with a good adult health profile, low birthweight people were predisposed to higher rates of glycaemic dysregulation, high blood pressure, dyslipidaemia, cardiovascular diseases and lower glomerular filtration rate in adult life. In all instances it would be prudent to adopt policies of intensified whole of life surveillance of lower birthweight people, anticipating this risk. The general public awareness of the effect of low birthweight on development of chronic diseases in later life is of vital importance. The general public, in addition to the awareness of people in medical practice of the role of low birthweight, will lead to a better management of this group of our population that is increasingly surviving into adulthood. birth weight birthweight birth weight and renal volume BIRTH WEIGHT QUESTIONNAIRE chronic disease Barker Hypothesis Foetal development DOHaD gestational age Anthropometric Characteristics body composition Height weight body mass index Waist Circumference hip circumference Waist-hip Ratio obesity Central Obesity Fatness Lean Body Mass Lean Mass Fat Mass body fat mass Body Fat Percentage body fatness Body Surface Area diabetes Fasting Glucose fasting insulin level glucose tolerance Impaired Fasting Glucose Impaired Glucose Tolerance Glycosylated Hemoglobin HbA1c IFG glucose control glycaemic control Metabolic Syndrome Syndrome X blood pressure Systolic Blood-pressure Diastolic Blood-pressure Systolic Hypertension high blood pressure Hypertension Dyslipidaemia Dyslipidemia Total Cholesterol Triglyceride Low Density Lipoprotein Cholesterol Ldl Cholesterol High Density Lipoprotein Hdl Cholesterol Fibrinogen angina Angina-pectoris Stroke coronary artery disease cardiovascular disease Framingham Framingham Heart Study Framingham Score coronary heart disease Glomerular Filtration glomerular filtration rate Glomerular Hyperfiltration Glomerular Injury Glomerular Number Nephrogenesis Nephron Endowment Nephron Number NKF-K/DQQI Classification Chronic Kidney Disease (ckd) Chronic Kidney Failure Kidney Failure CKD STAGES end-stage renal disease (ESRD) end-stage renal failure Cockcroft-gault MDRD formula Serum Creatinine Urinary Creatinine albuminuria Albuminuria:creatinine Ratio Kidney Development Kidney dysfunction low birth weight low birth weight Pre-term Birth AusDiab Study case control longitudinal observational study

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