Feeding practices and dietary intake in Brazilian children with Down syndrome: A cross-sectional study

BACKGROUND

Studies investigating the quality of the diet and dietary intake of children with Down syndrome (DS) are required because the features attributed to the syndrome can affect growth, development and quality of life.

METHODS

This cross-sectional study was conducted with 77 Brazilian children with DS between 5 and 36 months of age receiving care at the multidisciplinary outpatient clinic of the University Hospital. Participants' sociodemographic, dietary and anthropometric data were collected from the care protocols. Dietary data were collected from 24-h recalls and dietary practices were assessed according to the WHO dietary guidelines. Associations between inadequate feeding practices and demographic variables were assessed using logistic regression models.

RESULTS

Fruits, milk or infant formula, vegetables, beans and meat were among the five most consumed foods by the children investigated. Overall, we observed a high number of cases of early weaning (50.6%), low minimum dietary diversity (MDD; 40.3%), inadequate consistency for age (64.9%), early presence of ultra-processed foods (76.6%), sugars and sweets (33.8%) in the diet of the children with DS. In the associations of inadequate feeding practices by age group, low MDD [odds ratio (OR): 18.6; 95% confidence interval (CI): 3.4; 57.1] and inadequate consistency (OR: 6.65; 95% CI: 1.8; 24.7) were more frequent among children aged below 12 months while this relationship was inverse for early introduction of sugar and sweets (OR: 0.04; 95% CI: 0.01; 0.29).

CONCLUSION

Our findings showed a high number of cases of inadequate dietary practices in children with DS investigated, which could adversely affect the long-term health of this population.

Development and validation of the ABC2-SPH risk score for in-hospital mortality in COVID-19 patients

Introduction

Fast and efficient assessment of prognosis of coronavirus disease 19 (COVID-19) is needed to optimize the allocation of health care and human resources, to empower early identification and intervention of patients at higher risk of poor outcome. A proper assessment tool may guide decision making, to develop an appropriate plan of care for each patient. Although different scores have been proposed, the majority of them are limited due to high risk of bias, and there is a lack of reliable prognostic prediction models.

Purpose

To develop and validate an easy applicable rapid scoring system that employs routinely available clinical and laboratory data at hospital presentation, to predict in-hospital mortality in patients with COVID-19, able to discriminate high vs non-high risk patients. Additionally, we aimed to compare this score with other existing ones.

Method

Cohort study, conducted in 36 Brazilian hospitals in 17 cities. Consecutive symptomatic patients (≥18 years old) with laboratory confirmed COVID-19 admitted to participating hospitals. Primary outcome was in-hospital mortality. Logistic regression analysis was performed to develop a prediction model for in-hospital mortality, based on the 3978 patients that were admitted between March-July, 2020. The model was then validated in the 1054 patients admitted during August-September, as well as in an external cohort of 474 Spanish patients.

Results

Median (25th-75th percentile) age of the model-derivation cohort was 60 (48–72) years, 53.8% were men, in-hospital mortality was 20.3%. The validation cohorts had similar age distribution and in-hospital mortality. From 20 potential predictors, seven significant variables were included in the in-hospital mortality risk score: age, blood urea nitrogen, number of comorbidities, C-reactive protein, SpO2/FiO2 ratio, platelet count and heart rate. The model had high discriminatory value (AUROC 0.844, 95% CI 0.829 to 0.859), which was confirmed in the Brazilian (0.859) and Spanish (0.899) validation cohorts. Our ABC2-SPH score showed good calibration in both Brazilian cohorts, but, in the Spanish cohort, mortality was somewhat underestimated in patients with very high (>25%) risk. The ABC2-SPH score is implemented in a freely available online risk calculator.

Conclusions

We designed and validated an easy-to-use rapid scoring system based on characteristics of COVID-19 patients commonly available at hospital presentation, for early stratification for in-hospital mortality risk of patients with COVID-19.

Funding Acknowledgement

Type of funding sources: Foundation. Main funding source(s): Minas Gerais State Agency for Research and Development (Fundação de Amparo à Pesquisa do Estado de Minas Gerais - FAPEMIG) [grant number APQ-00208-20], National Institute of Science and Technology for Health Technology Assessment (Instituto de Avaliação de Tecnologias em Saúde – IATS)/ National Council for Scientific and Technological Development (Conselho Nacional de Desenvolvimento Científico e Tecnolόgico - CNPq) [grant number 465518/2014-1]

High Diversity of Drosophilidae in High-Altitude Wet Forests in Northeastern Brazil

The high-altitude wet forests of northeastern Brazil, locally known as "Brejos de Altitude," are enclaves of the Atlantic Forest situated above 500 m, surrounded by dryland vegetation, the Caatinga. The aim of this study was to characterize drosophilid communities in these upland forests, since few ecological studies on drosophilid communities have been conducted in northeastern Brazil. Four sites were investigated in three different times of the year throughout standardized traps. The results reveal the presence of 55 different species in a total of 13,064 specimens collected. The data were evaluated using ecological diversity measurements and compared with those obtained for other environments in the same geographic region. As for species composition, the Bonito upland forest, in a boundary forest location, stood out as having high species richness.

Prognostic significance of CD44v6, p63, podoplanin and MMP-9 in oral squamous cell carcinomas

OBJECTIVES

To analyse the expression of the CD44v6, p63, podoplanin and MMP-9, and their prognostic significance in patients with oral squamous cell carcinomas (OSCC).

MATERIAL AND METHODS

Immunohistochemistry technique was performed on 60 OSCC for detection of CD44v6, p63, podoplanin and MMP-9 proteins. Extent and intensity of staining were evaluated in tumour cells and were compared with patients' clinical-pathological characteristics and survival.

RESULTS

CD44v6 expression was detected at the membrane of tumour cells of 94% cases. Nuclear expression of p63 protein was present in 96.5%. Podoplanin was observed at the membrane of tumour cells of 94% cases. MMP-9 was found in the cytoplasm of tumour cells in 83.7% cases. A high level of expression (67%-89%) in all four proteins was noted. Podoplanin was associated with the expression of MMP-9 (P = 0.010) and both were associated with lymph node metastasis (P = 0.011 and P = 0.018, respectively). Co-expression of podoplanin/MMP-9 was an adverse independent prognostic factor for cancer-specific survival (P = 0.008) and recurrence-free survival (P = 0.042).

CONCLUSION

Podoplanin and MMP-9 together could contribute to tumour progression and dissemination of OSCC. Their combined overexpression showed an adverse effect on survival, suggesting that they could be regarded as important prognostic biomarkers in OSCC.

Clinicopathologic significance of BubR1 and Mad2 overexpression in oral cancer

OBJECTIVES

BubR1 and Mad2 are central components of the mitotic checkpoint complex that inhibits anaphase onset until all chromosomes are correctly aligned at the metaphase plate. We propose to analyse the combined expression of BubR1 and Mad2 and assess its significance to oral squamous cell carcinoma (OSCC) diagnosis and prognosis.

MATERIALS AND METHODS

BubR1 and Mad2 expression was assessed by real-time PCR in OSCC cell lines and in normal human oral keratinocytes, and by immunohistochemistry in 65 patients with OSCC. The results were compared regarding clinicopathological parameters, proliferative activity and survival.

RESULTS

BubR1 and Mad2 transcripts were overexpressed in OSCC cell lines which also exhibited attenuated spindle assembly checkpoint activity. BubR1 and Mad2 were also overexpressed in patients with OSCC. BubR1 expression was associated with advanced stages and larger tumour size in univariate analysis, and with shorter overall survival both in univariate and multivariate analysis. Mad2 overexpression was associated with that of BubR1 and, importantly, high expression of Mad2 and BubR1 was associated with increased cellular proliferation.

CONCLUSION

Our data propose a role for BubR1 and Mad2 in OSCC cellular proliferation, progression and prognosis.

Synthesis of bis-amino acid derivatives by Suzuki cross-coupling, Michael addition and substitution reactions

Several bis-amino acids were prepared using a bis-Suzuki coupling (compounds 4-8, 10), a sequential Michael addition and bis-Suzuki coupling (compounds 12, 13) and a Michael addition followed by a substitution reaction (compounds 18, 19). Thus, the pure stereoisomer of the methyl esters of N-(tert-butoxycarbonyl)-beta-bromodehydroaminobutyric acid and dehydrophenylalanine and of N-benzyloxycarbonyl-beta-bromodehydroaminobutyric acid were reacted with 1,4-phenylene-bis-boronic acid or 9,9-dioctyl-9H-fluorene-2,7-bis-boronic acid using modified Suzuki coupling conditions. The corresponding bis-dehydroamino acid derivatives were obtained in good to high yields maintaining the stereochemistry of the starting materials. This reaction was also applied successfully to a brominated dehydrodipeptide and 1,4-phenylene-bis-boronic acid showing that it could be used to create cross-links in peptide chains. An N,N-diacyldehydroalanine derivative was used in a sequential Michael addition and bis-Suzuki coupling giving a p-terphenyl bis-amino acid and a fluorenyl bis-amino acid in good yields. Two bis-alpha,beta-diamino acids were obtained by a Michael addition of 1,2,4-triazole to the methyl esters of N-(4-toluenesulfonyl), N-(tert-butoxycarbonyl) dehydroamino acids followed by treatment with ethylenediamine.

Enhancing reductive cleavage of aromatic carboxamides

[reaction: see text] A set of aromatic and especially heteroaromatic N-benzyl carboxamides, derived from naphthalene, pyridine, pyrazine, and quinoline, and the corresponding tert-butyl acylcarbamates have been synthesized and studied by cyclic voltammetry with respect to facilitated reduction. The latter undergo regiospecific cleavage of their C(O)-N bonds under very mild reductive conditions with formation of Boc-protected (benzyl)amine in most cases in nearly quantitative yields. Examples of preparative cleavage by controlled potential electrolysis, activated aluminum, and NaBH(4) are given.

Effects of prenatal cocaine exposure on postnatal growth patterns of male Wistar rats

The purpose of this study was to investigate basic parameters regarding the postnatal effects of prenatal exposure to cocaine. Timed-pregnant Wistar rats were injected SC with 60 mg/kg body weight/day of cocaine from gestational day 8 to 22. Control females were nonmanipulated and given food and lib; saline females received saline injections and pair-fed received saline and were nutritionally controlled to the cocaine-treated rats. Litters were restricted to 8 pups, weighed every other day until postnatal day (PND) 30 and every week from PND 30 to PND 90. The rats were perfused at PND 14, 30, and 90. The adequacy of adjustment of the logistic and Gompertz models to the body weights of the offspring was tested for the whole experimental period. The results from the Gompertz curve showed a higher growth rate and less time to reach 37% of expected mature body mass for the offspring of cocaine and pair-fed dams as compared with that of control and saline dams. No significant differences in the estimated adult weight were found among the experimental groups. The allometric relationship between forebrain and body weight is described by two postnatal growth phases with a first phase of rapid growth between PND 14 and 30 and a decelerating phase between PND 30 and 90. This relationship was not different among the experimental groups; however, the cocaine and pair-fed offspring showed a constant deficit in the forebrain weight as compared with the control and saline offspring.(ABSTRACT TRUNCATED AT 250 WORDS)