Vectores de impedancia bioeléctrica en la población universitaria colombiana / Bioelectrical impedance vectors in the Colombian university population

Introducción: el análisis de la composición corporal (CC) es un elemento esencial en la práctica clínica nutricional. La impedancia bioeléctrica es una de las técnicas más utilizadas para estimar la CC. Se han planteado diversos enfoques para disminuir el margen de error que presenta, asegurando su aplicación en todas las poblaciones. Uno de ellos es el uso de vectores de impedancia, mediante el empleo de elipses de tolerancia. Objetivo: comparar los vectores de la muestra con la población italiana y determinar elipses de tolerancia específicas para población universitaria colombiana. Materiales y métodos: estudio observacional de corte transversal en 608 universitarios. La participación fue a conveniencia y voluntaria, entre febrero de 2022 y marzo de 2023. El software BIVA 2002 fue usado para calcular las elipses de tolerancia y BIVA Confidence para comparar los vectores de las elipses con la población italiana a partir de la prueba T2 de Hotelling, que se consideró significativa con p < 0,05. Resultados: las medidas de R/Hy Xc/H fueron mayores en mujeres (420,75 ± 56,012 Ω/m vs. 308,7508 ± 41,81 Ω/m) y (46,15 ± 5,79 Ω/m vs. 39,44 ± 5,01 Ω/m), respectivamente. Los vectores de impedancia se posicionaron sobre los cuadrantes superiores del gráfico RXc, evidenciando diferencias significativas en la distribución de los vectores de composición entre las muestras. Conclusiones: los vectores de los universitarios colombianos fueron diferentes a la población de referencia, por lo que fue necesario determinar las elipses específicas.(AU)

Introduction: body composition (BC) analysis is an essential element in clinical nutritional practice. Bioelectrical impedance is one of the most widely used techniques for estimating BC. Several approaches have been proposed to reduce the margin of error it presents, ensuring its appli- cation in all populations. One of them is the use of impedance vectors, using tolerance ellipses.Objective: to compare the sample vectors with the Italian population and to determine specific tolerance ellipses for the Colombian university population. Materials and methods: observational cross-sectional study in 608 university students. Participation was at convenience and voluntary, betweenFebruary 2022 and March 2023. BIVA 2002 software was used to calculate the tolerance ellipses and BIVA confi dence to compare the vectorsof the ellipses with the Italian population using Hotelling’s T2 test, which was considered as significant at p < 0.05. Results: R/H and Xc/H measurements were higher in females (420.75 ± 56.012 Ω/m vs 308.7508 ± 41.81 Ω/m) and (46.15 ± 5.79 Ω/m vs 39.44 ± 5.01 Ω/m), respectively. The impedance vectors were positioned over the upper quadrants of the RXc plot, evidencing significant differences in the distribution of the composition vectors between samples. Conclusions: the vectors of the Colombian university students were different from the reference population, so it was necessary to determinethe specific ellipses.

Características antropométricas, capacidad de salto vertical y resistencia de carrera de bomberos, en servicio activo, con relación a la edad / Anthropometric characteristics, vertical jumping capacity and running endurance, in active-duty firefighters, in relation to age

El objetivo de este estudio fue establecer relaciones entre las variables de rendimiento físico e índices antropométricos según la edad de bomberos adultos chilenos, en servicio activo, provenientes de la región de Valparaíso. Participaron 68 bomberos, hombres, sanos, en servicio activo, que fueron divididos en dos grupos según edad; 30 años (n = 32; 40,6 ± 8,5 años). Se evaluaron las variables antropométricas de masa corporal (MC), estatura, perímetro de cintura (PC), índice de masa corporal (IMC] = Peso /estatura2 [m]) e índice cintura-estatura (ICE). La capacidad de salto vertical fue evaluada con los protocolos de Squat Jump, Countermovement Jump y Abalakov Jump. La resistencia en carrera fue estimada con la prueba de Course Navette y se calculó indirectamente el consumo de oxígeno (VO2). Las variables antropométricas para el grupo > 30 años fueron mayores en comparación al grupo de menor edad en MC (p = 0.027), IMC (p = 0.015), PC (p 0.05) entre ambos grupos. Existió una correlación significativa positiva entre la edad y las variables de MC (r = 0,252), IMC (r = 0,307), ICE (r = 0,431) y PC (r= 0,401). Al comparar ambos grupos de edad hubo diferencias antropométricas, pero no en la condición física. Se sugiere reforzar programas de entrenamiento para optimizar la composición corporal y capacidad física de bomberos en servicio activo para responder a las exigentes tareas que demanda este ámbito laboral.

SUMMARY: The aim of this study was 1) to compare anthropometric characteristics, jumping ability, and running endurance according to age and 2) to determine the relationship between age and physical performance parameters in Chilean adult firefighters in active service from the Valparaíso region. Sixty-eight healthy male firefighters, in active service, were divided into two groups according to age; 30 years (n = 32; 40.6 ± 8.5 years) participated. The anthropometric variables of body mass (BM), height, waist circumference (WC), body mass index (BMI = weight/height2 [m]) and waist-to-height ratio (WHR) were evaluated. Vertical jumping ability was assessed with the Squat Jump, Countermovement Jump and Abalakov Jump protocols. Running endurance was estimated with the Course Navette test and oxygen consumption (VO2) was calculated indirectly. Anthropometric variables for the > 30 years group were higher compared to the younger age group in BM (p = 0.027), BMI (p = 0.015), WC (p 0.05). There was a significant positive correlation between age and the variables of BM (r = 0.252), BMI (r = 0.307), WHR (r = 0.431) y WC (r= 0.401). When comparing both age groups, there were anthropometric differences, but not in physical condition. It is suggested to reinforce training programs to optimize the body composition and physical capacity of firefighters in active service in order to respond to the demanding tasks demanded by this work environment.

Cord Blood Levels of Spexin, Leptin, and Visfatin in Term Infants Born Small, Appropriate, and Large for Gestational Age and Their Association with Newborn Anthropometric Measurements

Objective: Children born small for gestational age (SGA) are at risk of future obesity and associated comorbidities. Therefore the identification of risk factors and novel biomarkers which are associated with this risk are needed for early detection and to improve preventive strategies. Spexin (SPX), a novel neuropeptide that is involved in the regulation of obesity and fat metabolism, is a candidate biomarker for predicting obesity and related comorbidities at an early age. The aim of this study was to investigate serum levels of SPX in term infants born small, appropriate, and large for gestational age (LGA) and its association with newborn anthropometric measurements. Methods: One hundred and twenty term newborn babies classified as SGA, appropriate for gestational age (AGA), or LGA and their mothers were included. SPX, leptin and visfatin were measured in cord blood and maternal serum by enzyme-linked immunosorbent assay. Results: Fifty-six (46.7%) neonates were girls and 64 (53.3%) were boys. The mean birth weight was 3170.70±663 g, birth length was 48.9±2.79 cm, and head circumference was 34.5±1.67 cm. Birth weights, lengths, and head circumferences of the neonates in the SGA, AGA, and LGA groups were significantly different. Cord blood SPX and leptin levels in the SGA groups were significantly lower than those of both the LGA and AGA groups. Cord blood visfatin levels were significantly lower in the AGA group than the LGA and SGA groups. Maternal SPX levels of SGA babies were significantly lower than those of the mothers in both the LGA and AGA groups, but no significant difference was observed between the SGA and LGA groups. Maternal visfatin levels of the AGA babies were significantly higher than the maternal levels of SGA and LGA groups. There was no difference in terms of maternal leptin levels. Cord blood SPX and leptin levels were positively correlated with birth weight, length and head circumference. Birth weight increased significantly in line with maternal pregestational body mass index. Conclusion: The lowest SPX levels were found in the SGA babies and cord SPX level was significantly correlated with newborn length, weight, and head circumference.

Τhe anthropometric and biochemical profile of pediatric non-alcoholic fatty liver disease: A systematic review and a meta-analysis.

BACKGROUND & AIMS: Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in children and one of the leading indications for liver transplantation in adults. However, current screening methods are inadequate and are accompanied by several disadvantages. This meta-analysis aims to identify the anthropometrical and biochemical characteristics most commonly appearing in pediatric NAFLD that could contribute to the diagnosis of the disease in the every-day clinical setting. METHODS: A systematic search was conducted in major electronic databases (MEDLINE, Scopus and Embase) up to 15th of August 2021. Primary outcome was the comparison of the anthropometric characteristics, whereas secondary outcomes were the comparisons of biochemical profile, lipid profile, and metabolic parameters in children with NAFLD compared with age-matched healthy controls. Quality assessment was performed with Newcastle-Ottawa Scale (NOS) and results were expressed as mean differences with 95% confidence intervals. RESULTS: Sixty-four studies were included. Two different comparisons were designed regarding the body mass status. Statistically significant differences were demonstrated by comparing children with NAFLD vs lean/normal weighted controls in body weight (23.0 kg, 95% CI: 14.0-31.8, P < 0.00001), height (3.07 cm, 95% CI: 0.21-5.94, P = 0.04), ΒΜΙ (10 kg/m2, 95% CI: 8.36-11.7, P < 0.00001) and waist circumference 25.8 cm (95% CI: 20.6-30.9, P < 0.00001) and by comparing children with NAFLD vs overweight/obese controls in weight (6.81 kg, 95% CI: 3.81-9.81), height (3.18 cm, 95% CI: 1.24 to 5.13, P = 0.001), BMI (2.19 kg/m2, 95% CI: 1.76-2.62, P < 0.00001) and WC (7.35 cm, 95% CI: 6.20-8.49, P < 0.00001). CONCLUSIONS: Anthropometrical and biochemical characteristics of children and adolescents with NAFLD are statistically significantly different compared to age-matched controls; these characteristics could be used to identify individuals at risk of developing NAFLD and related comorbidities.

Fatores de Risco Cardiovascular em Cardiologistas Especialistas pela Sociedade Brasileira de Cardiologia / Cardiovascular Risk Factors in Cardiology Specialists from the Brazilian Society of Cardiology

Resumo Fundamento: Principal causa de morte em todo o mundo, as doenças cardiovasculares (DCV) e sua prevalência nos médicos cardiologistas são pouco conhecidas. Objetivos: Descrever os hábitos de vida e os fatores de risco cardiovascular e verificar a prevalência de diagnóstico, conhecimento e controle dos fatores de risco cardiovasculares (FRCV) de médicos cardiologistas associados e especialistas pela Sociedade Brasileira de Cardiologia. Métodos: Estudo multicêntrico nacional transversal que avaliou cardiologistas brasileiros por meio de questionário sobre hábitos de vida, doenças preexistentes, medicações em uso, medidas antropométricas, pressão arterial e dosagens de glicose e lípideos sanguíneos. Resultados: Foram avaliados 555 cardiologistas, 67,9% do sexo masculino, média de idade de 47,2±11,7 anos. A maioria era não tabagista (88,7%), fisicamente ativa (77,1%), consumia bebida alcóolica (78,2%), com circunferência abdominal normal (51,7%) e excesso de peso (56,1%). As prevalências de hipertensão arterial sistêmica (HAS), diabetes mellitus (DM) e dislipidemia (DLP) foram de 32,4%, 5,9% e 49,7%, respectivamente e, destes, apenas 57,2%, 45,5% e 49,6% sabiam ter as doenças. Conclusões: Os cardiologistas brasileiros participantes do estudo apresentaram prevalências significativas de HAS, DM e DLP, mas apenas a metade dos participantes sabia ser portador dessas condições e, entre eles, as taxas de controle eram baixas para HAS e DLP, apesar de os cardiologistas serem profissionais detentores de conhecimento diferenciado sobre esses FRCV. Os achados representam um alerta para a abordagem dos FRCV em cardiologistas brasileiros e estimulam a realização de estudos futuros.

Abstract Background: A major cause of death worldwide, cardiovascular diseases and their prevalence in cardiologists are little known. Objectives: To describe life habits and cardiovascular risk factors (CVRF) and to investigate the prevalence of diagnosis, awareness, and control of these CVRF among cardiologists members affiliated to and specialists from the Brazilian Society of Cardiology. Methods: National multicenter cross-sectional study to assess Brazilian cardiologists using a questionnaire on life habits, preexisting diseases, current medications, anthropometric measurements, blood pressure, and levels of glucose and lipids. Results: A total of 555 cardiologists were evaluated, of which 67.9% were male, with a mean age of 47.2±11.7 years. Most were non-smoker (88.7%) and physically active (77.1%), consumed alcohol (78.2%), had normal weight circumference (51.7%), and were overweight (56.1%). The prevalence of systemic arterial hypertension (SAH), diabetes mellitus (DM), and dyslipidemia (DLP) were 32.4%, 5.9%, and 49.7%, respectively, of which only 57.2%, 45.5%, and 49.6%, respectively, were aware of the diseases. Conclusions: The Brazilian cardiologists participating in the study had a high prevalence of SAH, DM and DLP, but only a half of participants were aware of these conditions and, among these, the rates of controlled disease were low for SAH and DLP, although cardiologists are professionals with great knowledge about these CVRF. These findings represent a warning sign for the approach of CVRF in Brazilian cardiologists and encourage the conduction of future studies.

Forward functional stability indicator (FFSI) as a reliable measure of limits of stability.

Functional stability has been studied in diverse populations, yet the possibility to compare the results across them and the knowledge about actual performance referenced to the maximum capacity is limited. Our aim was to improve the functional limits of stability testing and introduced Forward Functional Stability Indicator (FFSI) as a reliable measure of functional stability. The study participants were not able to cross the projected forward anatomical stability limit (FASL). It is located at the level of first metatarsophalangeal joints and should be considered a mechanical limit of the maximal voluntary centre of foot pressure (COP) excursion (MVE). It was only true when the whole feet were in contact with the ground. There were statistically significant differences in limits of stability (LOS) test results in the conditions when the heels were raised and the toes muscles were contracted isometrically. The proposed forward functional stability indicator (FFSI) is a highly reliable measure of functional stability, which provides information about the actual performance with reference to maximum capacity and is easy to compare across normal and clinical populations. •The proposed forward functional stability indicator (FFSI) is a highly reliable measure of functional stability.•FFSI provides information about the actual performance with reference to maximum capacity and is easy to compare across normal and clinical populations.•The forward anatomical stability limit (FASL) is located at the level of first metatarsophalangeal joints and should be considered a mechanical limit of the maximal voluntary centre of pressure (COP) excursion when certain measurement criteria are met.

Características clínicas de los pacientes con apneas obstructivas del sueño: diferencias según género / Clinical features in patients with obstructive sleep apnea syndrome: differences by gender

INTRODUCCIÓN: El síndrome de apnea obstructiva del sueño (SAHOS) es más prevalente en hombres, los estudios poblacionales muestran una relación de 2:1, sin embargo, en los estudios clínicos la frecuencia llega a ser de hasta de 6:1. Estas diferencias en el ambiente clínico puede ser consecuencia de variaciones en el reporte de síntomas en hombres comparados con mujeres. OBJETIVO: Evaluar las diferencias de género en la presentación clínica de apnea obstructiva de sueño. Pacientes: Estudio transversal de pacientes sometidos a una poligrafía respiratoria (PR) con sospecha clínica de SAHOS. Se recolectaron datos demográficos, antropométricos, comorbilidades y las variables de la PR. Se realizó estudio t de student, Mann-Whitney y chi-cuadrado según correspondiera. RESULTADOS: Se incluyeron 1.044 pacientes: edad promedio 53,2 ± 14 años, 76% hombres. Las mujeres con SAHOS poseen mayor IMC (32,2 ± 6,1 vs 30,8 ± 5,0; p=0,002) y edad (61,4 ± 12,2 vs 52,6 ± 13,9; p < 0,001), pero menor circunferencia de cuello (CC) (38,1 ± 3,6 vs 43,2 ± 3,3; p < 0,001), además, presentan menor IA/H y menor duración de las apneas. No hubo diferencias en los síntomas clásicos de apneas presenciada y somnolencia diurna, sin embargo, describen más frecuentemente insomnio, cefalea matinal, depresión y uso de fármacos hipnóticos. CONCLUSIONES: Las mujeres al momento del diagnóstico son de mayor edad y más obesas, aunque presentan una CC menor, presentan una enfermedad más leve, pero refieren más fatiga, cansancio, cefalea e insomnio. Debemos estar alerta en la presentación clínica diferente de las mujeres para mejorar la sospecha diagnóstica.

INTRODUCTION: Obstructive sleep apnea (OSA) is more prevalent in men, population studies show a ratio of 2:1, however in clinical studies the frequency is as high as 6:1. These differences in the clinical setting may be a consequence of variations in the reporting of symptoms in men compared to women. OBJECTIVE: To evaluate gender differences between women and men with recent diagnosis of OSA. Patients: A cross-sectional, study of patients undergoing home sleep apnea testing (HSAT) with clinical suspicion of OSA. Demographic, anthropometric, comorbidities and HSAT variables were collected. We performed t student analysis, Mann-Whitney test or chi square test as appropriate. RESULTS: 1,044 patients were included: mean age 53.2 ± 14 years, 76% men. Women with OSA have a higher BMI (32.2 ± 6.1 vs 30.8 ± 5.0, p = 0.002), were older (61.4 ± 12.2 vs 52.6 ± 13.9, p <0.001), but have a lower neck circumference (NC) (38.1 ± 3.6 vs. 43.2 ± 3.3, p <0.001). The women presented lower AHI and shorter duration of apneas. Although the classic symptoms of apnea and daytime sleepiness showed no differences, women reported more frequently insomnia, morning headache, depression and use of hypnotic drugs. CONCLUSIONS:: Clinical differences between gender are present at time of diagnosis. Woman are older and more obese, although they have a lower NC. They have a milder disease, but they refer to be more tired, headache, insomnia and depression. We must be alert in the different clinical presentation of women to improve the diagnostic suspicion.

Effect of long-term Helicobacter pylori infection on growth of children: a cohort study.

BACKGROUND: The effects of Helicobacter pylori (H. pylori) infection on growth are a controversial issue. We investigated the effects of long-term H. pylori infection on height and weight in children. METHODS: A total of 200 children of 7-18 years old suffering from dyspeptic complaints were classified into two groups: H. pylori positive and negative groups, respectively. Whether the infection was impoved was followed up while performing urea breath test, and according to exposure time to the infection, the children were further divided into group 1 (≤1.5 months), group 2 (>1.5-≤6 months) and group 3 (>6 months). Antropometric measurements were obtained and repeated every six months. RESULTS: Mean growth velocity scores in the H. pylori positive and negative groups were 0.49±3.85 [95% confidence interval (CI): -0.21-1.18] and 1.98±4.42 (95% CI: 1-2.96), respectively. The difference between both groups was statistically significant (P=0.012). Mean growth velocity scores in groups 1, 2 and 3 were 0.96±3.84, 0.16±4.51 and -0.85±3.09, respectively. Mean growth velocity scores of group 3 were significantly lower than those of groups 0 and 1 (P=0.005 and P=0.041). The mean weight scores in group 3 were similar to those in group 2, but the scores in group 3 were significantly lower than those in group 1 (-1.75±1.05, -1.21±1.37 and -0.88±1.49, respectively). CONCLUSION: As the duration of exposure is prolonged in children with H. pylori infection, the negative effect of the infection on both height and weight is evident.

Gasto energético e medidas antropométricas de novas usuárias do contraceptivo injetável trimestral de acetato de medroxiprogesterona de depósito / Energy expenditure and anthropometric measurements in new users of depot medroxyprogesterone acetate

Objetivo:Avaliar o gasto energético e as medidas antropométricas de mulheres durante o primeiro ano de uso do método contraceptivo de acetato de medroxiprogesterona de depósito.Métodos:Estudo prospectivo com grupo de comparação. Foram incluídas mulheres saudáveis, não obesas, nunca usuárias de acetato de medroxiprogesterona de depósito e sem antecedentes que pudessem contribuir para a variação do peso corporal; foram distribuídas em dois grupos, 28 usuárias de acetato de medroxiprogesterona e 24 usuárias de dispositivo intrauterino de cobre, pareadas por idade (±1 ano) e índice de massa corporal (kg/m2). As variáveis estudadas foram sociodemográficas (idade, etnia, tabagismo, etilismo, atividade física, classe econômica e escolaridade), peso (kg), índice de massa corporal, gasto energético basal e total, medidas de circunferência de cintura e quadril (cm) e relação cintura-quadril.Resultados:A idade das mulheres variou de 20-39 anos. As médias de idade/índice de massa corporal foram 29,6 (DP=±5,2) anos/23,9 (±3,6 kg/m2), no grupo de acetato de medroxiprogesterona de depósito, e de 28,6 (DP=±5,2) anos/ 24,5 (±2,7 kg/m2), no grupo de dispositivo intrauterino de cobre. Após análise de variância para medidas repetidas, as usuárias de acetato de medroxiprogesterona de depósito apresentaram ganho de 2,2 kg no peso corporal e de -0,2 kg no grupo do dispositivo intrauterino de cobre, sem diferença estatisticamente significativa entre eles. Não houve discrepância nas demais variáveis estudadas.Conclusão:Mulheres saudáveis e jovens não apresentaram mudança no peso, nas medidas e nos gastos energéticos durante o primeiro ano de uso do contraceptivo acetato de medroxiprogesterona. A orientação em relação aos hábitos saudáveis de vida e o monitoramento de medidas são importantes para o controle do peso corporal em usuárias de métodos contraceptivos.

Objective:The objective of this study was to assess energy expenditure and the anthropometric profile of women during the first year of use of depot medroxyprogesterone acetate contraception.Methods:This prospective study included healthy non-obese women who had never used depot-medroxyprogesterone acetate and did not have a history of weight fluctuations. The women were divided into two groups composed of 28 depot medroxyprogesterone acetate users and 24 copper intrauterine device (TCu380A) users. They were paired for age (+1 year) and body mass index (+1 kg/m2). The following variables were used: sociodemographic characteristics (age, ethnicity, smoking status, alcohol consumption, physical activity, economic class, and education level), weight (kg), body max index, resting and total energy expenditure, waist and hip circumferences (cm), and waist-to-hip ratio.Results:The age of the women studied ranged from 20-39 years. The mean values of age/body mass index ratio were 29.6 (SD=+5.2) years/23.9 (+3.6 kg/m2) in the depot medroxyprogesterone acetate group and 28.6 (SD=+5.2) years/24.5 (+2.7 kg/m2) in the intrauterine device group. After conducting repeated measures analysis of variance, the users of depot medroxyprogesterone acetate showed weight gain of 2.2 kg, and those in the intrauterine device group showed weight loss of 0.2 kg without statistically significant difference between the groups. There were no significant differences between the other variables.Conclusion:There were no changes in weight, anthropometric measurements, and energy expenditure in the young and healthy women during the first year of use of depot medroxyprogesterone acetate contraception. Guidelines and recommendations for a healthy lifestyle to avoid changes in the anthropometric measurements are important for weight control in users of contraceptive methods.

Características faciais, palatinas e erupção dentária em crianças pré-termo com idades entre 12 e 24 meses que receberam assistência respiratória / Facial and palate characteristics and tooth eruption in preterm children aged 12-24 months who have received mechanical ventilation

INTRODUÇÃO: As crianças pré-termo, principalmente aquelas de muito baixo peso (MBP) podem apresentar alterações no seu padrão craniofacial, no desenvolvimento da cavidade bucal e no padrão eruptivo dental. Este estudo teve como objetivos descrever as características faciais, palatinas e a erupção dentária em crianças pré-termo que receberam assistência respiratória; comparar os efeitos da ventilação mecânica invasiva (VMI) e do CPAP sobre as mesmas variáveis; observar o impacto do aleitamento, uso de chupeta e presença de displasia brocopulmonar em crianças pré-termo com idades entre 12 e 24 meses. MÉTODOS: Participaram deste estudo crianças pré-termo, procedentes do Ambulatório de Seguimento de Recém- Nascidos Pré-Termo do Hospital Universitário da Universidade de São Paulo e do Ambulatório de Seguimento dos Prematuros A5 RN 002 do Instituto da Criança do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, com peso ao nascimento inferior a 2000g. Foram constituídos dois grupos a partir dos dados sociodemográficos coletados dos prontuários de internação neonatal das crianças participantes. O Grupo 1 (G1) constituise de 34 crianças pré-termo que receberam VMI por intubação orotraqueal (IOT) por um período igual ou maior que 7 dias, e o Grupo 2 (G2) é composto por 34 crianças pré-termo que receberam CPAP por um período de tempo igual ou maior que 72 horas. Foi realizada entrevista com a mãe ou responsável pela criança, com objetivo de obter as informações relativas à duração do aleitamento, uso da chupeta, presença/ausência de displasia broncopulmonar como sequela da prematuridade. As crianças foram submetidas a um exame de inspeção da cavidade bucal para detectar a presença de alterações no rebordo ou palato, para classificar o formato do palato (quadrado, estreito e ovoide) e para visualizar a erupção dos dentes decíduos, classificada em atrasada, normal ou adiantada para a idade. Foram realizadas medidas faciais, com...

INTRODUCTION: Preterm children, especially those of very low birth weight, (VLBW), may show changes in the craniofacial pattern in the development of the oral cavity and tooth eruption pattern. This study aimed to describe the facial and palate characteristics as well as tooth eruption in preterm infants who have receiving mechanical ventilation; compare the effects of invasive mechanical ventilation (IMV) and CPAP on the same variables; observe the impact of breastfeeding, use of pacifier and presence of bronchopulmonary dysplasia in preterm children aged 12-24 months. METHODS: The study included preterm infants, coming from the Pre-Term Newborn Follow-up Clinic of the University Hospital at University of São Paulo and from the Preterm Follow-up Clinic A5 RN 002 of the Children's Institute of the Medical School of the University of São Paulo, weighting less than 2000g at birth. Based on the sociodemographic data collected from newborn hospital records of participating children, two groups were divided. Group 1 (G1) consisted of 34 preterm infants who received IMV by tracheal intubation (TI) for a period equal to or greater than 7 days and Group 2 (G2) consisted of 34 preterm infants who received CPAP for a period of time equal to or greater than 72 hours. An interview was conducted with the mother or the child's guardian in order to obtain information on breastfeeding duration, nursing nipple use, presence/absence of bronchopulmonary dysplasia as prematurity-related sequelae. The children underwent an oral cavity inspection to detect the presence of changes in alveolar ridge or palate, so as to sort palate shape (square, narrow, oval) and to view the eruption of primary teeth, classified as delayed, average or early for the age. Facial measures were taken with the use of a caliper on anthropometric points, such as facial and mandibular width, upper, middle and lower thirds of faces, facial height and facial index. A descriptive...

Crescimento de prematuros com muito baixo peso internados em UTI neonatal no estado do Pará / Growth of preterm birth infants with very low weight admitted to neonatal icu in the state of Pará

OBJETIVO: analisar o ganho de peso e o crescimento do perímetro cefálico de recém-nascidos prematuros, de muito baixo peso, na Fundação Santa Casa de Misericórdia do Pará. MÉTODO: avaliação antropométrica semanal e classificação segundo a condição da mãe e administração da dieta de recém nascidos prematuros de muito baixo peso, nascidos no período de 15 de abril a 15 de outubro de 2007, na Fundação Santa Casa de Misericórdia do Pará. RESULTADO: em nenhuma das semanas estudadas, o ganho de peso médio alcançou o mínimo esperado. Não houve influência significativa da condição de acompanhamento da mãe e da via de administração da dieta na média de ganho de peso e no crescimento do perímetro cefálico. A dieta no seio materno foi à única que atingiu o valor de ganho de peso considerado adequado pela Academia Americana de Pediatria. O crescimento médio do perímetro cefálico apresentou crescimento satisfatório em todas as análises. CONCLUSÃO: apesar de não interferirem diretamente no ganho de peso e crescimento do perímetro cefálico, a presença da mãe e a via de administração da dieta são fatores que podem colaborar para o crescimento adequado dos pacientes. É imprescindível a adoção de medidas que assegurem a evolução satisfatória dos pacientes.

Objective: to analyze the weight gains and cephalic perimeter growth of very low weight pre-mature new-born. Method: anthropometric evaluation of pre-mature new-born babies with very low weights during the period of between 15th April to 15th October 2007admitted at the neonatal ICU of the (FSCMPA) in the period between 15th April and 15th October 2007. Result: there were no significant influence of mothers conditions or in the administration of diet on the mean weight gains among the pre-mature new-born babies. The breast-feeding had a influence on the weight gains. The aver-age cephalic perimeter growth was not a significant factor among these patients. Conclusion: it is necessary to develop more studies of this kind in order to improve the weight gains among the new-born.

The natural history of HIV-associated lipodystrophy in the changing scenario of HIV infection.

OBJECTIVES: In long-term HIV-infected patients, peripheral lipoatrophy (LA) and central lipohypertrophy (LH) appear to be related to the same insults (virus and antiretroviral drugs), but are likely to be associated with different fat depot physiologies. The objective of this study was to describe the natural history of lipodystrophy assessed using dual energy X-ray absorptiometry (DEXA) and computed tomography (CT) in a large HIV out-patients metabolic clinic. METHODS: An observational retrospective study was carried out including HIV-infected patients recruited at the Metabolic Clinic of Modena, Modena, Italy, who were assessed for lipodystrophy and had at least two anthropometric evaluations using DEXA for leg fat per cent mass and abdominal CT for visceral adipose tissue (VAT). Factors associated with leg fat per cent and VAT changes were analysed using multivariable generalized estimating equation (GEE) regression models. RESULTS: A total of 6789 DEXAs and 7566 CT scans were evaluated in the observation period. A total of 1840 patients were included; the mean age was 45.2 ± 7.2 (standard deviation) years, 621 (34%) were women, and the median HIV infection duration was 176 (interquartile range 121-232) years. According to the GEE multivariable regression analysis, leg fat per cent evaluated with DEXA appeared to increase over calendar years (ß = 0.92; P < 0.001); moreover, a progressive increase in VAT was observed in the cohort (ß = 5.69; P < 0.001). No association with antiretroviral drugs was found. CONCLUSIONS: In our study, neither LA nor LH appeared to be associated with antiretroviral drug exposure. We observed a progressive increase in LH in HIV-infected patients over calendar years. This anthropometric change, together with loss of appendicular lean mass, could describe a physiological aging process in HIV-infected patients.

Avaliação nutricional dos profissionais do serviço de nutrição e dietética de um hospital terciário de Porto Alegre / Nutritional evaluation of employees on a nutritional and dietary service of a tertiary hospital in Porto Alegre

Este estudo objetivou identificar o perfil antropométrico e bioquímico e analisar a evolução do ganho de peso dos profissionais do Serviço de Nutrição e Dietética (SND) do Hospital de Clínicas de Porto Alegre (HCPA). Estudo de caráter longitudinal retrospectivo, com 190 funcionários. Aplicou-se questionário estruturado e foram realizadas análises bioquímicas e avaliação antropométrica. Observou-se excesso de peso em 60,8% dos funcionários. O ganho de peso encontrou-se associado ao tempo de serviço, turno de trabalho e prática de atividade física. O estudo demonstrou que 1 ano a mais de trabalho esteve associado ao ganho de peso médio de 500 g, o turno de trabalho com ganho de peso médio de 4 kg e a prática de atividade física com perda de peso médio de 3,3 kg. A associação entre ganho de peso, tempo e turno de trabalho em colaboradores de serviços de nutrição remete à necessidade de criação de programas de educação nutricional que promovam hábitos alimentares saudáveis.

This study aimed to identify anthropometric and biochemical status and to analyze the weight gain of collaborators of nutrition and dietetics services of Hospital de Clínicas de Porto Alegre (HCPA). This was a retrospective longitudinal study enrolled 190 employees. Nutritional assessment and clinical analysis was measurement. A structured questionnaire was applied all employees. The prevalence of excess weight was 60.8%. Weight gain was significantly associated to length of service, working shift and physical activity. The study showed that an additional year of work was associated with weight gain around 500 g, the shift in average gain of 4 kg and physical activity with average weight loss of 3.3 kg. The association between weight gain, working time and working shift in employees refers to the need to create nutrition intervention program aiming to promote healthy eating habits.

Anthropometry and cardiovascular disease risk factors among retirees and non-retirees in Ile-Ife, Nigeria: A comparative study.

BACKGROUND: Increasing affluence in low-income countries has been associated with lifestyle-related conditions, which may afford some people the opportunity to retire from gainful employment. This study examined the relationship between selected anthropometric variables and cardiovascular disease risk factors among age-matched retirees and non-retirees in Ile-Ife, Nigeria. MATERIALS AND METHODS: Self-reported healthy adults (104 retirees and 99 age-matched non-retirees) were purposively recruited. Weight, height, waist circumference, systolic blood pressure and diastolic blood pressure were measured with standard equipment and procedures. An established questionnaire was used to classify the subjects into high, medium and low cardiovascular disease risk categories. The data were analysed with basic description and inferential statistics. RESULTS: Mean ages for the retirees and non-retirees were 64.8 ± 7.0 years and 63.8 ± 4.5 years, respectively. The mean systolic blood pressure, diastolic blood pressure and waist circumference were higher for the retirees than for the non-retirees (all P < 0.01) as were the mean cardiovascular disease risk factors scores (P < 0.01). CONCLUSION: The study concludes that retirees have a higher risk for cardiovascular disease than non-retirees and weight and Body Mass Index are the major determinants. Studies are needed to explain the differences in body composition indices and cardiovascular disease risk factors between retirees and age-matched non-retirees.

Análisis biomecánico (antropométrico y cinemático) en niños con parálisis cerebral espástica / Biomechanical analysis (anthropometric and kinematic) in children with spastic cerebral palsy

La Parálisis Cerebral Infantil involucra una cantidad de síndromes caracterizados por alteraciones del movimiento y de la postura causados por un daño no progresivo en el cerebro inmaduro, es relevante, reconocer e identificar a través de estudios de análisis de movimiento humano con sistemas computarizados, las diferentes alteraciones del control postural y sus implicaciones biomecánicas, como predictores de la función de la extremidad superior, durante la fase de alcance de objetos en la posición sedente en niños con parálisis cerebral. Objetivo. Establecer el análisis biomecánico en los componentes antropométrico y cinemático de los niños entre 5 y 12 años con parálisis cerebral espástica y sanos que realizan el movimiento de alcance de un objeto frontal desde la posición sedente. Sujetos y métodos. Estudio descriptivo, comparativo enmarcado dentro de una investigación de casos con una muestra de 20 niños. Resultados. En el desarrollo de las tres fases del patrón del alcance los ángulos de inclinación pélvica, tronco relativo y la distancia resultante de la mano fueron estadísticamente significativos. Conclusiones. El comportamiento de las 31 variables cinemáticas indica en forma general que para el grupo PC fueron muy heterogéneas en su magnitud en contraste con aquellas del grupo control donde existe una tendencia a ser más homogéneas.

The Infantile Cerebral Paralysis involves an amount of syndromes characterized by alterations of the movement and of the position caused by a nonprogressive damage in the immature brain, he is excellent, to recognize and to identify through studies of analysis of human movement with systems computerized, the different alterations from the postural control and their biomechanic implications, like predicting of the function of the superior extremity, during the phase of reach of objects in the sedente position in children with cerebral paralysis. Objective. To establish the biomechanic analysis in the components anthropometric and kinematic of the children between 5 and 12 years with healthy espástica cerebral paralysis and that makes the movement of reach of a frontal object from the sedente position. Subjects and methods. Descriptive, comparative study framed within an investigation of cases with a sample of 20 children. Results. In the development of the three phases of the pattern of the reach the pelvic rakes, relative trunk and the resulting distance of the hand were statistically significant. Conclusions. The behavior of the 31 variable kinematics indicates in general form that for group PC they are very heterogenous in his magnitude in contrast to those of the group control where exists a tendency to be more homogenous.

Diferentes aferições do diâmetro abdominal sagital e do perímetro da cintura na predição do HOMA-IR / Different measurements of the sagittal abdominal diameter and waist perimeter in the prediction of HOMA-IR / Mediciones distintas del diámetro abdominal sagital y del perímetro de la cintura en la predicción del HOMA-IR

FUNDAMENTO: A correlação entre aumento de gordura visceral e de resistência à insulina coloca o diâmetro abdominal sagital e o perímetro da cintura como instrumentos potenciais para a predição de resistência à insulina. OBJETIVO: Avaliar a reprodutibilidade de diferentes aferições do diâmetro abdominal sagital e do perímetro da cintura e analisar o poder discriminante dos mesmos para predizer resistência à insulina. MÉTODOS: Foram avaliados 190 homens adultos. O diâmetro abdominal sagital (menor cintura, maior diâmetro abdominal, nível umbilical e ponto médio entre as cristas ilíacas) e o perímetro da cintura (nível umbilical, menor cintura, imediatamente acima da crista ilíaca e ponto médio entre a crista ilíaca e a última costela) foram aferidos em quatro locais diferentes. A resistência à insulina foi avaliada pelo índice HOMA-IR. RESULTADOS: Todas as medidas apresentaram correlação intraclasse de 0,986-0,999. Tanto o diâmetro abdominal sagital aferido na menor cintura (r=0,482 e AUC=0,739±0,049) como o perímetro da cintura aferido no ponto médio entre a última costela e a crista ilíaca (r=0,464 e AUC=0,746±0,05) apresentaram maiores correlações com o HOMA-IR, bem como um melhor poder discriminante para o HOMA-IR segundo a análise ROC (p<0,001). CONCLUSÃO: O diâmetro abdominal sagital e o perímetro da cintura mostraram-se altamente reprodutíveis. O diâmetro abdominal sagital (menor cintura) e o perímetro da cintura (ponto médio crista ilíaca e última costela) apresentaram melhor desempenho em predizer o HOMA-IR. Investigações em outros grupos da população brasileira devem ser realizadas para viabilizar a utilização desses indicadores de resistência à insulina na população como um todo de forma padronizada.

BACKGROUND: The correlation between the increase in visceral fat and insulin resistance makes the sagittal abdominal diameter and the waist perimeter as potential tools for the prediction of insulin resistance. OBJECTIVE: To assess the reproducibility of different measurements of the sagittal abdominal diameter and the waist perimeter and analyze the discriminating power of the measurements when predicting insulin resistance. METHODS: A total of 190 adult males were studied. The sagittal abdominal diameter (smallest girth, larger abdominal diameter, umbilical level and midpoint between the iliac crests) and the waist perimeter (umbilical level, smallest girth, immediately above the iliac crest and midpoint between the iliac crest and the last rib) were measured at four different sites. Insulin resistance was assessed by the homeostasis model of assessment-insulin resistance (HOMA-IR) index. RESULTS: All measurements presented an intraclass correlation of 0.986-0.999. The sagittal abdominal diameter measured at the smallest girth (r=0.482 and AUC=0.739±0.049) and the waist perimeter measured at the midpoint between the last rib and the iliac crest (r=0.464 and AUC=0.746±0.05) presented the highest correlations with the HOMA-IR and the best discriminating power for HOMA-IR according to the ROC analysis (p<0.001). CONCLUSION: The sagittal abdominal diameter and waist perimeter showed to be highly reproducible and the sagittal abdominal diameter (smallest girth) and waist perimeter (midpoint between the iliac crest and the last rib) presented the best performance when predicting HOMA-IR. Further studies in other groups of the Brazilian population must be carried out to allow the use of these indicators of insulin resistance in the population as a whole, following standardized procedures.

FUNDAMENTO: La correlación entre aumento de la grasa visceral y de la resistencia a la insulina pone el diámetro abdominal sagital y el perímetro de la cintura como los instrumentos potenciales para la predicción de resistencia a la insulina. OBJETIVO: Evaluar la reproductibilidad de distintas mediciones del diámetro abdominal sagital y del perímetro de la cintura y analizar el poder discriminante de las mismas para predecir resistencia a la insulina. MÉTODOS: Se evaluaron a 190 varones adultos. El diámetro abdominal sagital (menor cintura, mayor diámetro abdominal, nivel umbilical y punto promedio entre las crestas ilíacas) y el perímetro de la cintura (nivel umbilical, menor cintura, inmediatamente superior a la cresta ilíaca y punto promedio entre la cresta ilíaca y la última costilla) se calcularon en cuatro locales diferentes. La resistencia a la insulina se evaluó por el índice HOMA-IR. RESULTADOS: Todas las mediciones presentaron correlación intraclase de 0,986-0,999. Tanto el diámetro abdominal sagital calculado en la menor cintura (r=0,482 y AUC=0,739±0,049) como el perímetro de la cintura calculado en el punto promedio entre la última costilla y la cresta ilíaca (r=0,464 e AUC=0,746±0,05) presentaron mayores correlaciones con el HOMA-IR, así como un mejor poder discriminante para el HOMA-IR según el análisis ROC (p<0,001). CONCLUSIONES: El diámetro abdominal sagital y el perímetro de la cintura se evidenciaron altamente reproductibles. El diámetro abdominal sagital (menor cintura) y el perímetro de la cintura (punto promedio la cresta ilíaca y última costilla) presentaron mejor desempeño en predecir el HOMA-IR. Investigaciones en otros grupos de la población brasileña se deben realizar para viabilizar la utilización de estos indicadores de resistencia a la insulina en la población como un todo de forma estandarizada.

Descripción del somatotipo e IMC en una muestra de adolescentes de colegios municipalizados de la ciudad de Temuco - Chile / Description of somatotype and BMI the adolescent's sample to public school of the Temuco - Chile

La mal nutrición en el mundo se ha convertido en un problema de salud pública, similar situación ocurre en Chile. Los estudios del índice de masa corporal (IMC), de la composición corporal, estado nutricional, de la población, son los parámetros recomendados por la OMS (Organización Mundial de la Salud), para conocer el estado nutricional. Realizamos este estudio para describir la realidad nutricional de los adolescentes de los colegios municipalizados de la ciudad de Temuco. Evaluamos 993 adolescentes de ambos sexos, 543 hombres (54,7 por ciento) y 450 mujeres (45,3 por ciento), entre 6 y 14 años de edad, alumnos de diferentes colegios urbanos municipalizados. Para obtener el somatotipo utilizamos el método antropométrico descrito por Heath & Cárter, efectuándose la evaluación y clasificación del IMC de acuerdo a las normas de la OMS. Los hombres, fueron más mesomórficos que las mujeres, siendo esta diferencia estadísticamente significativa. p<= 0,05. Al comparar los componentes Ectomorfía y Mesomorfía del somatotipo en relación al sexo presentaron valores estadísticamente significativos a favor de los varones, pero el valor de Endomorfía fue estadísticamente significativo a favor de las mujeres. El 19,4 por ciento del total de la muestra eran obesos, y un 23,1 por ciento presentaron sobrepeso. En los hombres el 19,3 por ciento fueron obesos y un 23,9 por ciento presentaron sobrepeso, en las mujeres el 22,0 por ciento sobrepeso y un 19.6 por ciento obesidad. Observamos un predominio del componente endomesomórfico en las mujeres y mesoendomórficos en los varones. Los probables factores son la modificación de estilo de vida, alimentación y efecto del sedentarismo que en la Novena Región alcanza un 96,4 por ciento de la población.

Bad nutrition has become a public health problem, similar situation had happened in Chile studies on body composition, nutritional state, and body mass index (BMI), are parameters recommended by the WHO for determining human beings' nutritional state. This study has been carried out to describe the adolescent nutritional situation of the urban public schools in Temuco - Chile. Nine thousands and ninety nine subjects were evaluated, 543 men (54.7 percent) and 450 women (46.3 percent), between 6 and 14 years old, all students at urban public schools. In order to obtain the Somatotype the anthropometric Heath & Carter method was used, classifying BMI according to the WHO norms. Men were more endomorphic than women, this difference was statistically significant (p=0.005). To compare the ectomorphic and mesomorphic components of somatotopic in relation to sex, this value were statistic statistically significant to men, but the endomorphic value was statistically significant was to women. Regarding to the total sample, 19.4 percent was obese and 23.1 percent was overweight. Then, according to men, 19.3 percent were obese and a 23.9 percent were overweight, and women had a 22.0 percent of overweight and a 19.6 percent were obese. It was observed a prevalence of the endomesomorphic component in women and mesoendomorphic in men. These results show an obesity prevalence of 19.4 percent and an overweight of 23.1 percent within the evaluated population getting closer to the national standards of the adult population, which corresponds to a 50 percent according to the a survey given by the Chilean Ministry of Health (MINSAL), the probable factors are the modification of lifestyle, food and sedentary effect that in the Chilean ninth region reaches a 96.4 percent out of the population.

Obesidade e intervenção coronariana: devemos continuar valorizando o Índice de Massa Corpórea? / Obesity and coronary intervention: should we continue to use Body Mass Index as a risk factor?

FUNDAMENTO: Para discriminar risco coronariano elevado, indicadores de obesidade central são melhores do que o Índice de Massa Corpórea (IMC), que é ainda o índice antropométrico (IA) mais utilizado para seguimento após intervenção coronariana percutânea (ICP). OBJETIVO: Reconhecer, entre os índices antropométricos (IA), os que melhor se correlacionam com ocorrência de desfechos após intervenção coronariana percutânea (ICP). MÉTODOS: Foram considerados 308 pacientes (p), idade média de 61,92±11,06 anos, 60,7 por cento do sexo masculino, submetidos a ICP com stent. Após seis meses, pesquisaram-se os desfechos: óbito, reintervenção por ICP ou cirurgia cardíaca, exame não-invasivo alterado por isquemia ou sintomas anginosos. Os p foram divididos em: Grupo 1 (com desfechos, n=91; 29,5 por cento) e Grupo 2 (sem desfechos, n=217; 70,45 por cento). No sexo masculino e feminino, os IA estudados e seus respectivos pontos de corte foram: circunferência abdominal (CA) > 90/80 cm, relação cintura-quadril (RCQ) > 0,90/0,80cm, índice de conicidade (IC) >1,25/1,18 e índice de massa corpórea (IMC) >30 para ambos os sexos. RESULTADOS: Os grupos diferiram quanto à maior ocorrência de histórico familiar e infarto prévio no Grupo 2. No sexo masculino, CA > 90 cm (p=0,0498) foi, em análise multivariada, preditor independente de desfechos. IMC não foi preditor de eventos. No Grupo 1, a probabilidade de ocorrência de IMC alterada é significativamente menor do que a ocorrência dos outros IA estudados (p<0,0001). CONCLUSÃO: CA anormal comportou-se como preditor independente de ocorrência de desfechos no sexo masculino dessa população pós-ICP. IMC elevado não foi preditor de desfechos e foi o índice antropométrico menos prevalente em pacientes com eventos.

BACKGROUND: Central anthropometric indexes are better than the body mass index to discriminate elevated coronary risk. However, the Body Mass Index (BMI) is still the most frequently studied anthropometric index on outcomes of patients undergoing percutaneous coronary angioplasty (PCI). OBJECTIVE: To recognize, among several anthropometric indexes of obesity, which one best discriminates MACE (Major Adverse Cardiac Events) after PCI. METHODS: Subjects were 308 patients (mean age 61.92±11.06 years, 60.7 percent of them men) who had undergone successful coronary angioplasties. Six months after the procedure, patients were contacted for clinical follow-up. Major Adverse Cardiac Events included death, acute myocardial infarction, cardiac surgery, reintervention, angina, or evidence of myocardial ischemia on a non-invasive test. Patients were divided into 2 groups: Group 1 (with MACE, n=91, 29.5 percent), Group 2 (with no MACE, n= 217; 70.45 percent). For men and women, the anthropometric indexes studied and their respective cut-off points were waist circumference >90/80 cm, Waist-Hip Ratio > 0.90/0.80cm, Conicity Index > 1.25/1.18, and Body Mass Index > 30. RESULTS: There were more cases of familial history and previous infarct in Group 2. For men, waist circumference >90cm (p=0.0498) in multivariate analyses was an independent predictor of MACE. BMI was not related to MACE. In Group 1, the prevalence of an elevated BMI was significantly different compared to the other anthropometric indexes studied (p<0.0001). CONCLUSION: Waist circumference was an independent predictor of MACE in men. Body Mass Index was not related to MACE and was the least frequent anthropometric index in the MACE group.

Avaliação das medidas do comprimento peniano de crianças e adolescentes / Penile anthropometry in Brazilian child and adolescent

OBJETIVO: Classicamente, o pênis tem duas funções: permitir a fertilização interna e direcionar o jato miccional. Entretanto, alterações objetivas do tamanho peniano podem levar ao diagnóstico de doenças. Além disso, é motivo comum de consulta médica a busca por parâmetros de normalidade do tamanho do pênis. Contudo, a antropometria do pênis da criança e do adolescente brasileiros ainda não foi devidamente estudada. O objetivo do estudo é realizar a antropometria do pênis de crianças e adolescentes brasileiros, estabelecendo referências para aplicação clínica. MÉTODOS: Foi realizado um estudo transversal, envolvendo 2.010 pacientes com idades variando entre 0 e 18 anos. Foram obtidas cinco medidas penianas: diâmetro da haste peniana; comprimento aparente e real do pênis flácido; comprimento aparente e real (CRTmax) do pênis flácido sob tração máxima. O desenvolvimento puberal foi caracterizado pelos critérios de Tanner. RESULTADOS: De todas as medidas penianas, o CRTmax foi a única que não apresentou variação significativa interpesquisador em todas as faixas etárias analisadas (p = 0,255). Os resultados foram distribuídos em tabelas com a média do CRTmax e os valores do que se considera micropênis (média - 2,5 desvio padrão) de acordo com as diferentes faixas etárias e com os diferentes graus de maturação sexual de Tanner. Foi desenvolvido um gráfico com a distribuição dos valores do CRTmax distribuído por percentis 10, 25, 50, 75 e 90 por faixa etária. CONCLUSÕES: De todas as medidas antropométricas penianas, o CRTmax é a única clinicamente útil. Recomendamos nossos resultados como referência de antropometria peniana para crianças e adolescentes brasileiros.

OBJECTIVE: Classically, the penis has two functions: to make internal fertilization possible and to direct the urine stream. However, objective abnormalities in penis size can lead to diseases being diagnosed. Furthermore, many medical consultations are the result of patients seeking parameters for normal penis size. Additionally, the penile anthropometry of Brazilian children and adolescents has not yet been properly studied. The objective of this study is to carry out penile anthropometry of Brazilian children and adolescents, establishing references for clinical use. METHODS: A cross-sectional study was carried out of 2,010 patients with ages varying from 0 to 18 years. Five penile measurements were taken: diameter of penile shaft; apparent and real length of flaccid penis; apparent and real (RSLmax) length of flaccid penis fully stretched. Pubertal development was defined according to Tanner's criteria. RESULTS: Only RSLmax, out of all of the penile measurements, did not exhibit significant interobserver variation at all ages analyzed (p = 0.255). Results were tabulated with mean RSLmax and the values that define micropenis (mean - 2.5 standard deviations) by age and by Tanner sexual maturity stages. A graph was plotted of the distribution of RSLmax results by the 10th, 25th, 50th, 75th and 90th percentiles and by age. CONCLUSIONS: Out of all of the penile anthropometric measurements, only RSLmax is clinically useful. We recommend our results as a reference standard for penile anthropometry of Brazilian children and adolescents.

Estudo Antropométrico de pré-escolares da calha do Rio Negro, Amazonas, Brasil. II- Barcelos

A cross-sectional study was carried out in the municipal district of Barcelos (Amazonas State, Brazil) in 1995, involving 240 pre-school children in the urban area and 43 in the interior, in order to evaluate their nutritional status according to antropometric indicators. According to the Gomez classification, in the urban area 41,7% of the children presented some degree of malnutrition, with the mild form DI predominanting (32,1%) and affecting all age-groups indiscrimanately; the prevalence of the severe form DIII was 2,5%. In the interior 37,2% of the children presented some degree of malnutrition, but the prevalence of the more severe forms was lower. According to the criteria of the WHO, 31,1% of the children presented a height for age ratio indicative of chronic undernourishiment, less frequent in the first year of life (10,2%). Weight for height ratios indicative of acute undernutrition were detected in 4,2% of the sample, mainly in children under 12 months old. These results are an indication of the precarious state of health and nutrition of the study population.

Foi realizado no município de Barcelos (1995) estudo transversal, onde avaliou-se o estado nutricional de 240 pré-escolares da área urbana e 43 na área rural, por meio de avaliação antropométrica, adotando-se a classificação de Gomez e os critérios propostos pela OMS. Constatou-se pela classificação de Gomez, que 41,7% das crianças da área urbana apresentavam algum grau de desnutrição, predominando a forma leve- (DI) 32,1%, acometendo indistintamente todas as faixas etárias, sendo de apenas 2,5% a ocorrência da forma grave (DIII). Na área rural, o quadro registrado não difere muito quanto a intensidade (37,2%), contudo, mostra-se mais atenuado em relação a gravidade da desnutrição. Segundo os critérios da OMS, 31,1% das crianças do município apresentavam inadequação no indicador altura/idade (desnutrição crônica), constatando-se uma relativa proteção nas crianças no primeiro ano de vida (10,2%). A inadequação no indicador peso/altura (desnutrição aguda), foi constatada em apenas 4,2% dos pré-escolares do município, acometendo principalmente as crianças no primeiro ano de vida. Estes resultados evidenciam as precárias condições de saúde e nutrição da referida população.