PubMed · 7191915
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S Nazari, R Dionigi, P Dionigi, A Bonoldi. A multivariable pattern for nutritional assessment.. https://doi.org/10.1177/014860718000400512
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BACKGROUND: Evaluation of the negative impact of active smoking on lipid and lipoprotein serum levels and the relationship with body mass index (BMI) and waist/hip ratio (WHR). METHODS AND RESULTS: The group was formed by 178 (77 men and 101 women), mean age 54 years (SD 6.2 attending the lipid out-patient department at the Third Medical Clinic, First Medical Faculty, Charles University Prague. Attention was paid to whether the patients were treated with hypolipidaemic agents or not. A statistically significant difference (p < 0.05) was found between smokers and non-smokers as regards total cholesterol (mean values and SD) in the group of 80 treated women (smokers 7.84 mmol/l, SD 1.21). Significantly higher values of LDL cholesterol in smokers as compared with non-smokers (6.00 mmol/l SD 2.08 vs. 4.8 mmol/l, SD 1.26) were recorded in the group of treated women. Other results were also to the disadvantage of smokers (with the exception of non-treated women), though the difference was not statistically significant: non-treated female smokers had a higher LDL cholesterol (4.24 mmol/l, SD 1.42) as compared with non-treated non-smokers (5.3 mmol/1, SD 0.60). In treated men the LDL cholesterol value in smokers (5.20 mmol/l SD 1.20) were also higher than in non-smokers (4.54, SD, 1.15). Triacylglycerols in women (smokers vs. non-smokers): in the group of treated women 3.11 mmol/l, SD 4.86 vs 1.94 mmol/l SD 1.08, in the group of non-treated women 3.74 mmol/l, SD 4.77 vs. 1.94 mmol/l, SD 0.74. Triacyglycerols in men (smokers vs. non-smokers): in the treated men 3.87 mmol/l SD 3.54 vs. 2.62 mmol/l, SD 1.63, in the non-treated men 10.62 mmol/l, SD 9.86 vs. 2.86 mmol/l, SD 1.63. HDL-cholesterol in women (smokers vs. non-smokers): in the treated group 1.24 mmol/l SD 0.46 vs. 1.39 mmol/l, SD 0.35, in the group of non-treated men 1.54 mmol/l, SD 0.37, vs. 2.86 mmol/l, SD 1.64. HDL cholesterol in men (smokers vs. non-smokers): in the treated group 1.15 mmol/l, SD 0.30 vs. 1.27 mmol/l, SD 0.31, in the non-treated group 1.09 mmol/l, SD 0.40 vs. 1.15 mmol, SD 0.28. In female smokers treated and non treated and in non-treated male smokers the WHR values were higher, in treated smokers lower despite the surprisingly higher BMI. CONCLUSION: Active smoking has an adverse impact on serum lipid and lipoprotein levels in patients with familial combined hyperlipidaemia.
PURPOSE: The objectives of this study are: (1) to investigate the dosimetric differences of the different treatment planning systems (TPS) in breast irradiation with tangential fields, and (2) to study the effect of beam characteristics on dose distributions in tangential breast irradiation with 6 MV linear accelerators from different manufacturers. METHODS AND MATERIALS: Nine commercial and two university-based TPS are evaluated in this study. The computed tomographic scan of three representative patients, labeled as "small", "medium" and "large" based on their respective chest wall separations in the central axis plane (CAX) were used. For each patient, the tangential fields were set up in each TPS. The CAX distribution was optimized separately with lung correction, for each TPS based on the same set of optimization conditions. The isodose distributions in two other off-axis planes, one 6 cm cephalic and the other 6 cm caudal to the CAX plane were also computed. To investigate the effect of beam characteristics on dose distributions, a three-dimensional TPS was used to calculate the isodose distributions for three different linear accelerators, the Varian Clinac 6/100, the Siemens MD2 and the Philips SL/7 for the three patients. In addition, dose distributions obtained with 6 MV X-rays from two different accelerators, the Varian Clinac 6/100 and the Varian 2100C, were compared. RESULTS: For all TPS, the dose distributions in all three planes agreed qualitatively to within +/- 5% for the "small" and the "medium" patients. For the "large" patient, all TPS agreed to within +/- 4% on the CAX plane. The isodose distributions in the caudal plane differed by +/- 5% among all TPS. In the cephalic plane in which the patient separation is much larger than that in the CAX plane, six TPS correctly calculated the dose distribution showing a cold spot in the center of the breast contour. The other five TPS showed that the center of the breast received adequate dose. Isodose distributions for 6 MV X-rays from three different accelerators differed by about +/- 3% for the "small" patient and more than +/- 5% for the "large" patient. For two different 6 MV machines of the same manufacturer, the isodose distribution agreed to within +/- 2% for all three planes for the "large" patient. CONCLUSION: The differences observed among the various TPS in this study were within +/- 5% for both the "small" and the "medium" patients while doses at the hot spot exhibit a larger variation. The large discrepancy observed in the off-axis plane for the "large" patient is largely due to the inability of most TPS to incorporate the collimator angles in the dose calculation. Only six systems involved agreed to within +/- 5% for all three patients in all calculation planes. The difference in dose distributions obtained with three accelerators from different manufacturers is probably due to the difference in beam profiles. On the other hand, the 6 MV X-rays from two different models of linear accelerators from the same manufacturer have similar beam characteristics and the dose distributions are within +/- 2% of each other throughout the breast volume. In general, multi-institutional breast treatment data can be compared within a +/- 5% accuracy.
The aim of the study was to identify at birth, in infants showing intra-uterine growth retardation (IUGR), any parameters correlative with the increase in height SDS during the first 2 years of life and with short stature at 2 years of age, and to determine whether the sensitivity and specificity of such parameters would permit their use as predictors of short stature at 2 years of age. Two cohorts of children born with IUGR with birth weight < 3rd percentile, were studied. In the first group of 317 children selected at birth, 224 were effectively followed up to 2 years of age (group 1) and the second group of 48 children was evaluated at 2 years of age for short stature related to IUGR (group 2). Perinatal history, auxological data at birth and parental height were monitored in a prospective study for the group 1 children and in a retrospective study for the group 2 children. By 2 years of age, 8% of the 224 children followed (group 1), presented short stature (< or = 2 SDS). In a multiple linear regression model, gestational age, birth length (SDS), target height (SDS) and maternal tobacco consumption were found to be the strongest predictors of the magnitude of the height gain (SDS) during the first 2 years of life. Using these parameters 47% of the variability of the height gain (SDS) during the first 2 years of life could be explained at birth. Moreover, logistic regression analysis showed three risk factors at birth for short stature by 2 years of age: reduced gestational age due to premature birth (adjusted odd ratio (O.R.) = 2.10; 95% C.I. = 1.06-4.14), the greater the difference (for each S.D.) between birth length (SDS) and target height (SDS) (O.R. = 1.93; 95% C.I. = 1.40-2.66) and although as a borderline significant factor, maternal tobacco consumption (O.R. = 1.58; C.I. 95% = 0.81-3.07). Non-parametric discriminant analysis was used to investigate whether short (< or = -2 SDS) or normal stature (> -2 SDS) at 2 years could be predicted at birth using gestational age (weeks), birth length (SDS), target height (SDS) and maternal tobacco consumption as discriminant variables. We found that this discriminant model correctly predicted at birth the short stature of 57 of 59 children at 2 years of age (sensitivity 97%) and the normal stature of 142 of 159 children at 2 years of age (specificity 89%). In conclusion, an accurate prediction of short stature by 2 years of age is feasible at birth in the IUGR neonate.