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1.
PLoS One ; 19(3): e0301208, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38547211

RESUMO

Undernutrition in children with cancer is associated with complications during cancer therapy. The study objective was to determine the association between specific anthropometric parameters and short-term chemotherapy-related complications and mortality. This was a hospital-based, prospective cohort study of children, age ≤12 years, with a new cancer diagnosis at the Paediatric Oncology Unit, Korle Bu Teaching Hospital, Ghana. Socio-demographic information, cancer characteristics and anthropometric measurements were obtained at enrolment. Participants were followed up for twelve weeks from commencement of chemotherapy and selected treatment-related complications such as anaemia and thrombocytopenia requiring transfusions, prolonged neutropenia resulting in treatment delays, febrile neutropenia, mucositis and death were recorded. A total of 133 participants were recruited with a median age of 4.5 years. Eighty-one (60.9%) were diagnosed with solid tumours, 31 (23.3%) had leukaemias and 21 (15.8%) had lymphomas. Of the anthropometric parameters assessed, only arm anthropometry using upper arm muscle area (UAMA) and mid-upper arm circumference (MUAC) were associated with complications. Participants with wasting were more likely to develop anaemia and mucositis. However, the incidence of prolonged neutropenia was significantly higher among participants with average UAMA (p = 0.043) and low average UAMA (p = 0.049) compared to those with low UAMA. Risk of neutropenia was also significantly less among those with wasting by MUAC compared to those well-nourished (p = 0.045). Twenty-three participants (17.3%) died with a greater proportion (11/44; 25%) occurring in those who were wasted using MUAC. These findings underscore the need for nutritional surveillance at diagnosis and during chemotherapy, particularly where co-morbid disease is prevalent.


Assuntos
Anemia , Desnutrição , Mucosite , Neoplasias , Neutropenia , Humanos , Criança , Pré-Escolar , Estudos Prospectivos , Gana/epidemiologia , Desnutrição/complicações , Desnutrição/epidemiologia , Desnutrição/diagnóstico , Hospitais de Ensino , Antropometria/métodos , Neoplasias/complicações , Neoplasias/tratamento farmacológico , Braço/anatomia & histologia , Anemia/induzido quimicamente , Anemia/epidemiologia , Neutropenia/induzido quimicamente , Neutropenia/epidemiologia
2.
Surg Radiol Anat ; 46(4): 463-472, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38446211

RESUMO

BACKGROUND: The biceps brachii (BB) is a fusiform muscle comprising of two muscular bellies located in the anterior compartment of the arm. Its primary function includes elbow flexion and forearm supination. PURPOSE: The study aimed to examine the morphometric parameters of the BB in adult cadaveric specimens. METHODS: This dissection-based study examined the anatomy of the BB in 40 arms taken from 20 Thiel embalmed European cadavers, including 13 males with an average age of 81 years and seven females with an average age of 84 years. The investigation included an observational inspection of the BB morphology and collected 19 parameters, comprising the lengths and widths of the short and long head tendons and muscle bellies. RESULTS: The observation analysis showed that the anatomy of the BB consisted mainly of two muscle bellies: a short head and a long head. An additional third humeral head, originating from the anteromedial aspect of the mid of the humerus and inserted into the common biceps tendon, was observed in four (10%) specimens. The average lengths of the short head and long head were 35.98 ± 3.44 cm and 38.90 ± 3.40 cm, respectively. There was no difference in the BB parameters according to the arm sides. However, the male specimens showed greater BB parameters than the female specimens. CONCLUSION: The short head had a greater muscle belly, while the long head had a longer origin and insertion tendons. The BB parameters were correlated positively with the humerus length.


Assuntos
Braço , Músculo Esquelético , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Braço/anatomia & histologia , Cadáver , Cabeça do Úmero , Músculo Esquelético/anatomia & histologia , Tendões
3.
Sci Rep ; 14(1): 6551, 2024 03 19.
Artigo em Inglês | MEDLINE | ID: mdl-38504109

RESUMO

World Athletics use maximum allowable standing height (MASH) equations for para-athletes with bilateral lower extremity amputations to estimate stature and limit prosthesis length since longer prostheses can provide running performance advantages. The equations were developed using a white Spanish population; however, validation for other races and geographical groups is limited. This study aimed to determine the validity of the MASH equations for Black and white Americans and whether bias errors between calculated and measured stature were similar between these populations. Sitting height, thigh length, upper arm length, forearm length, and arm span of 1899 male and 1127 female Black and white Americans from the Anthropometric Survey of US Army Personnel database were input into the 6 sex-specific MASH equations to enable comparisons of calculated and measured statures within and between Black and white groups. Two of 12 MASH equations validly calculated stature for Black Americans and 3 of 12 equations were valid for white Americans. Bias errors indicated greater underestimation or lesser overestimation of calculated statures in 10 equations for Black compared to white Americans and in 2 equations for white compared to Black Americans. This study illustrates that race and geography impact the validity of MASH equations.


Assuntos
Estatura , Paratletas , Esportes , Feminino , Humanos , Masculino , Antropometria , Braço/anatomia & histologia , Negro ou Afro-Americano , Amputação Cirúrgica , Próteses e Implantes , Brancos
4.
Nutrients ; 16(5)2024 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-38474805

RESUMO

(1) Background: High blood pressure (HBP) and obesity are significant and growing public health issues worldwide. Our study aimed to evaluate the associations of neck circumference (NC), mid-upper arm circumference (MUAC), and wrist circumference (WrC) with HBP among Lithuanian children and adolescents aged 7-17 years. (2) Methods: In this cross-sectional study, data on BP and anthropometric measurements were analysed in 3688 children and adolescents aged 7-17 years. Multivariate logistic regression analysis was used to estimate the associations between anthropometric indices and HBP. (3) Results: Overall, the prevalence rates of elevated BP and hypertension were 13.7% and 12.9%, respectively. After adjustment for age, BMI, and WC, statistically significant elevated aORs were observed for associations between greater NC, MUAC, WrC, and HBP in boys (aORs: 2.13, 2.46, and 2.48, respectively) and in girls (aORs: 2.01, 2.36, and 2.09, respectively). Moreover, per-unit increase in NC, MUAC, and WrC was also associated with greater odds of HBP in boys (aORs: 1.20, 1.21, and 1.37, respectively) and in girls (aORs: 1.10, 1.10, and 1.21, respectively). The analysed anthropometric indices presented higher area under the curve values for predicting HBP in boys than in girls. (4) Conclusions: This study suggests that higher NC, MUAC, and WrC are associated with increased odds of HBP in Lithuanian children and adolescents.


Assuntos
Hipertensão , Punho , Masculino , Feminino , Criança , Humanos , Adolescente , Estudos Transversais , Braço/anatomia & histologia , Lituânia/epidemiologia , Índice de Massa Corporal , Hipertensão/epidemiologia , Pressão Sanguínea/fisiologia , Circunferência da Cintura
5.
Pediatr Obes ; 19(5): e13107, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38318985

RESUMO

BACKGROUND: Mid-upper arm circumference (MUAC) was recommended for screening of adolescents with obesity, although its diagnostic performance with respect to high-precision assessment of body composition remains unknown. OBJECTIVE: To evaluate the diagnostic performance of MUAC in identifying obesity and metabolic syndrome in U.S. adolescents. METHODS: A cross-sectional study was conducted using National Health and Nutrition Examination Survey (NHANES) data (2011-2018) of adolescents aged 12-19. We calculated the area under the receiver operating characteristic curve, sensitivity, specificity, positive and negative predictive values and likelihood ratios of MUAC in identifying obesity and metabolic syndrome. RESULTS: In our study, data of 5496 adolescents, including 2665 females, were analysed. The prevalence of obesity was higher in boys (14%) than girls (10%), whilst metabolic syndrome was more common in males (2.6%) than females (1.7%). The area under the curve (AUC) of MUAC in identifying obesity was 0.69 in boys and 0.86 in girls, whilst the AUC of MUAC in identifying metabolic syndrome was 0.91 in boys and 0.87 in girls. The optimal MUAC cut-off for identifying adolescents with obesity was 28.3 cm in boys (sensitivity: 64.8%, specificity: 85.5%) and 30.8 cm in girls (sensitivity: 67.9%, specificity: 90.1%). CONCLUSIONS: MUAC was a good indicator of both obesity and metabolic syndrome, with higher accuracy in girls.


Assuntos
Síndrome Metabólica , Obesidade Pediátrica , Masculino , Feminino , Adolescente , Humanos , Obesidade Pediátrica/diagnóstico , Obesidade Pediátrica/epidemiologia , Inquéritos Nutricionais , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/epidemiologia , Estudos Transversais , Braço/anatomia & histologia , Antropometria/métodos
6.
Public Health Nutr ; 27(1): e52, 2024 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-38282033

RESUMO

OBJECTIVE: To describe the food consumption, nutrition knowledge and nutritional assessment of childbearing age women and their children, living in rural villages in Madagascar. The results presented are related to the Tany Vao research study. DESIGN: A cross-sectional pilot study. SETTING: The study was carried out in Ampanitosoha village on Nosy Mitsio island in Madagascar. PARTICIPANTS: 32 women (14-49 years) and 36 children and adolescents (2-17 years). RESULTS: 70 % of the women lacked nutrition knowledge and did not reach the Minimum Dietary Diversity Index for Women cut-off. The median BMI was 21·1 kg/m2 but 55·2 % of the women exceeded the cut-off for waist-to-hip ratio, 51·7 % for waist-to-height ratio and 81·2 % for mid-upper arm circumference (MUAC). Almost all had adequate intake of energy, protein and carbohydrates, while 27·6 % had excessive fat intake and 75·9 % of added sugars. Over half of the women did not meet the micronutrients Reference Daily Intake (RDI). For children, the MUAC z-score was lower for boys than for girls (P-value = 0·041). CONCLUSIONS: These results underline the importance of increasing women's nutritional knowledge to promote healthy pregnancy and lactation. Moreover, it is fundamental to provide people living in rural areas with sustainable tools to improve dietary diversity and support long-term health.


Assuntos
Dieta , Estado Nutricional , Masculino , Criança , Gravidez , Humanos , Feminino , Adolescente , Madagáscar , Estudos Transversais , Projetos Piloto , Antropometria/métodos , Braço/anatomia & histologia
7.
Surg Radiol Anat ; 46(1): 81-84, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37934299

RESUMO

The coracobrachialis muscle (CB) represents one of the anterior arm compartment muscles. It has been defined by classic anatomy textbooks and old papers, as a muscle of one belly arising from the coracoid process tip and partially from the tendon of the biceps brachii short head, and inserted into the humeral shaft, above the bone's midpoint. However, recent cadaveric studies have confirmed that in the majority of cases, the CB is a two-headed muscle consisting of a superficial and a deep head. This finding has caused confusion regarding the terminology of CB's morphology. Typical CB morphology, according to recent data should not be considered the muscle of one belly, but the two-headed muscle. In particular, the musculocutaneous nerve's (MCN) course plays an important role in defining the CB morphological characteristics. If the MCN courses medially to the CB, with no signs of penetration after dissection, it can be concluded, that the CB is composed of one head; otherwise, if the muscle is composed of two or more heads, the MCN will courses between the CB bellies. In conclusion, it is of paramount importance to adopt common-universal terminology. Hence, considering recent findings, if the CB origin and/or the insertion differs from the typical anatomy, an "atypical CB" is the proper definition of the muscle, while if this "atypical CB" coexists with a typical CB, the terminology "accessory CB" may be used.


Assuntos
Braço , Nervo Musculocutâneo , Humanos , Braço/anatomia & histologia , Nervo Musculocutâneo/anatomia & histologia , Músculo Esquelético/anatomia & histologia , Tendões , Dissecação , Cadáver
8.
Ann Afr Med ; 22(3): 359-364, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37417026

RESUMO

Background: Biceps brachii is an elongated two-headed fusiform muscle of the anterior compartment of the arm which crosses the shoulder as well as the elbow joint. It assists in flexion of the shoulder joint and elbow joint and powerful supinator of the forearm. It also assists in the abduction of the shoulder joint. Accessory heads of biceps brachii muscle not only give additional strength to the joints, at the same time, they may also simulate soft-tissue tumors that can result in neurovascular compression. Aims and Objectives: Accordingly, the aim of this study was designed to evaluate the prevalence of accessory heads of biceps brachii muscle in human cadavers. Materials and Methods: This study was conducted on 107 formalin embalmed human cadavers (male 62 and 45 female), and dissections were performed in accordance with the institutional ethical standards and the Indian Anatomy Act. Results: Out of 107 cadavers, three-headed biceps brachii was noted in 18 cadavers (16.82%) associated with the unusual course of musculocutaneous nerve. Rare and unusual unilateral five-headed biceps brachii was noted in one male cadaver (0.93%). All accessory heads noted in this study were supplied by the separate branches of musculocutaneous nerve except the humeral head of five-headed biceps, which was supplied by the radial nerve. Conclusion: Awareness of these anatomical variations, knowledge is necessary for radiologists, anesthetists, physiotherapists, and orthopedic surgeons to avoid complications during various radiodiagnostic procedures or surgeries of flexor deformities of the upper arm and forearm.


Résumé Contexte: Le biceps brachial est un muscle allongé fusiforme à deux têtes de la loge antérieure du bras qui traverse l'épaule ainsi que l'articulation du coude. Il aide à la flexion de l'articulation de l'épaule et du coude et supinateur puissant de l'avant-bras. Il aide également à l'abduction de l'articulation de l'épaule. Les têtes accessoires du muscle biceps brachial donnent non seulement une force supplémentaire aux articulations, en même temps, ils peuvent également simuler des tumeurs des tissus mous pouvant entraîner une compression neurovasculaire. Buts et objectifs: En conséquence, le but de ce étude a été conçue pour évaluer la prévalence des têtes accessoires du muscle biceps brachial chez les cadavres humains. Matériels et méthodes: ce étude a été menée sur 107 cadavres humains embaumés au formol (hommes 62 et 45 femmes), et des dissections ont été réalisées dans conformément aux normes éthiques institutionnelles et à la loi sur l'anatomie indienne. Résultats: Sur 107 cadavres, biceps brachial à trois têtes a été notée sur 18 cadavres (16,82 %) associée à l'évolution inhabituelle du nerf musculo-cutané. Unilatérale rare et inhabituelle Un biceps brachial à cinq têtes a été noté sur un cadavre masculin (0,93 %). Toutes les têtes accessoires notées dans cette étude ont été fournies par le branches du nerf musculo-cutané à l'exception de la tête humérale du biceps à cinq têtes, qui était alimentée par le nerf radial. Conclusion: Conscience de ces variations anatomiques, une connaissance est nécessaire aux radiologues, anesthésistes, kinésithérapeutes, et chirurgiens orthopédistes pour éviter les complications lors de diverses procédures de radiodiagnostic ou de chirurgies des déformations des fléchisseurs de la partie supérieure bras et avant-bras. Mots-clés: Asymétrie, tumeurs dermoïdes, hypertrophie et lipome, névralgie mandibulaire.


Assuntos
Braço , Músculo Esquelético , Feminino , Humanos , Masculino , Braço/anatomia & histologia , Cadáver , Desenvolvimento Embrionário , Músculo Esquelético/anormalidades , Músculo Esquelético/anatomia & histologia
9.
Surg Radiol Anat ; 45(9): 1089-1095, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37452194

RESUMO

OBJECTIVE: To study the anatomy and biometry of the radial artery and to report the implications of this study for daily practice in Cardiac Surgery. METHOD: Radial arteries from 45 human cadavers (28 males and 17 females, average age 79.2 (92) fixed in 10% formalin were dissected. The proximal and distal internal calibers and lengths of these radial arteries were measured. RESULTS: Our results showed the presence of a single radial artery variation in 2.3% of the entire sample (1.1% of the 90 dissected upper limbs). The distance between the epicondyle and the emergence of the radial artery was 32.4 (6.67) mm in men and 30.7 (9.00) mm in women, with an average of 31.8 (7.58) mm. For the right upper limb, the mean proximal internal caliber of the radial artery was 3.16 (0.56) mm and its mean distal internal caliber was 2.62 (0.66) mm. For the left upper limb, the mean proximal internal caliber of the radial artery was 3.17 (0.59) mm and its mean distal internal caliber was 2.64 (0.68) mm. The mean length of the left radial artery was 197.0 (17) mm. The mean length of the right radial artery was 201.0 (33) mm. CONCLUSION: It is very important to be aware of the possible anatomical variation of the radial artery. Despite its rarity, this knowledge may ensure a better safety and reliability of the harvesting technique for use as a graft.


Assuntos
Braço , Artéria Radial , Masculino , Humanos , Feminino , Idoso , Artéria Radial/anatomia & histologia , Reprodutibilidade dos Testes , Braço/anatomia & histologia , Cadáver , Biometria
10.
Medicina (Kaunas) ; 59(6)2023 May 23.
Artigo em Inglês | MEDLINE | ID: mdl-37374205

RESUMO

To compare mid-upper arm circumference (MUAC) with body mass index (BMI) and propose MUAC cut-off points corresponding to BMIs of <18.5 kg/m2 (underweight) and ≥30.0 kg/m2 (obesity) for pregnant Sudanese women, a cross-sectional community-based study was conducted in the city of New Halfa, Sudan. Healthy pregnant women were recruited. Body parameters such as height, weight, and MUAC were measured. The MUAC (cm) cut-off values for underweight and obesity were determined using receiver operating characteristic (ROC) curve analysis. Of 688 pregnant women, 437 were in early pregnancy (<20 weeks of gestation) and 251 were in late pregnancy (≥20 weeks of gestation). There was a significant positive correlation between BMI and MUAC among women in both early pregnancy (r = 0.734) and late pregnancy (r = 0.703). The cut-off points of MUAC for detecting underweight and obesity were found to be 24.0 cm and 29.0 cm, respectively, for women in early pregnancy, with good predictive values. For women in late pregnancy, the cut-off points for detecting underweight and obesity were 23.0 cm and 28.0 cm, respectively. We concluded that for Sudanese pregnant women, the MUAC cut-off points identified in the study for diagnosing underweight and obesity are both sensitive and specific.


Assuntos
Estado Nutricional , Magreza , Feminino , Humanos , Gravidez , Índice de Massa Corporal , Estudos Transversais , Magreza/diagnóstico , Gestantes , Braço/anatomia & histologia , Antropometria , Obesidade/diagnóstico
11.
Adv Clin Exp Med ; 32(12): 1369-1375, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37140016

RESUMO

BACKGROUND: Malnutrition rates in pediatric celiac disease (CD) patients range from 20.2% to 67.3%. OBJECTIVES: To investigate the prevalence of malnutrition in pediatric CD patients in Turkey using different anthropometric measurements, including mid-upper arm circumference (MUAC). MATERIAL AND METHODS: This prospective study included 124 patients aged 1-18 years with a diagnosis of CD, admitted to the Pediatric Gastroenterology Outpatient Clinic of Adana City Training and Research Hospital, Turkey. The anthropometric measurements, including weight-for-age (WFA) Z-score, height-for-age (HFA) Z-score, body mass index (BMI)-for-age Z-score, MUAC [cm], and MUAC Z-score were calculated. RESULTS: The study analyzed 75 female (60.5%) and 49 male (39.5%) patients with a mean age of 9.83 ±4.1 years. While 44 patients (35.5%) had malnutrition according to their BMI Z-scores, 60 patients (48.4%) had malnutrition based on their MUAC Z-scores. The number of patients with stunting (HFA value below -2) was 24 (19.4%), and the WFA value was below -2 in 27 (21.8%) patients. Furthermore, the BMI Z-score failed to identify chronic malnutrition in 70.9% of patients. There was a positive linear correlation (r = 0.396) between the BMI value and the MUAC value (p < 0.001). However, the degree of agreement between the BMI Z-scores and MUAC Z-scores was weak (κ: 0.300). CONCLUSIONS: The MUAC Z-score successfully detected acute and chronic malnutrition and should be included in standard anthropometric measurements at follow-up nutritional assessments in CD patients.


Assuntos
Doença Celíaca , Desnutrição , Humanos , Masculino , Criança , Feminino , Pré-Escolar , Adolescente , Estudos Prospectivos , Antropometria , Braço/anatomia & histologia , Doença Celíaca/complicações , Doença Celíaca/diagnóstico , Doença Celíaca/epidemiologia , Desnutrição/diagnóstico , Desnutrição/epidemiologia , Desnutrição/etiologia , Peso Corporal
12.
Public Health Nutr ; 26(6): 1210-1221, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-36722310

RESUMO

OBJECTIVE: To compare the prognostic value of mid-upper arm circumference (MUAC), weight-for-height Z-score (WHZ) and weight-for-age Z-score (WAZ) for predicting death over periods of 1, 3 and 6 months follow-up in children. DESIGN: Pooled analysis of twelve prospective studies examining survival after anthropometric assessment. Sensitivity and false-positive ratios to predict death within 1, 3 and 6 months were compared for three individual anthropometric indices and their combinations. SETTING: Community-based, prospective studies from twelve countries in Africa and Asia. PARTICIPANTS: Children aged 6-59 months living in the study areas. RESULTS: For all anthropometric indices, the receiver operating characteristic curves were higher for shorter than for longer durations of follow-up. Sensitivity was higher for death with 1-month follow-up compared with 6 months by 49 % (95 % CI (30, 69)) for MUAC < 115 mm (P < 0·001), 48 % (95 % CI (9·4, 87)) for WHZ < -3 (P < 0·01) and 28 % (95 % CI (7·6, 42)) for WAZ < -3 (P < 0·005). This was accompanied by an increase in false positives of only 3 % or less. For all durations of follow-up, WAZ < -3 identified more children who died and were not identified by WHZ < -3 or by MUAC < 115 mm, 120 mm or 125 mm, but the use of WAZ < -3 led to an increased false-positive ratio up to 16·4 % (95 % CI (12·0, 20·9)) compared with 3·5 % (95 % CI (0·4, 6·5)) for MUAC < 115 mm alone. CONCLUSIONS: Frequent anthropometric measurements significantly improve the identification of malnourished children with a high risk of death without markedly increasing false positives. Combining two indices increases sensitivity but also increases false positives among children meeting case definitions.


Assuntos
Braço , Estatura , Humanos , Criança , Lactente , Pré-Escolar , Peso Corporal , Estudos Prospectivos , Prognóstico , Antropometria , Braço/anatomia & histologia
13.
Arch Pediatr ; 30(2): 118-125, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36710238

RESUMO

BACKGROUND: In emergency settings, medication dosages are primarily determined based on the child's weight; however, the healthcare personnel sometimes may have to make the first intervention without knowing the patient's weight, which may result in an underdose or overdose of the medication. We aimed to find a reliable method to estimate children's bodyweight, including the obese and malnourished. METHODS: We conducted the study with children between the ages of 3 and 17 years. We measured the children's bodyweight, right foot length, and mid-upper arm circumference in centimeters during their examination. We created a concise formula through regression analysis to estimate the patients' weight based on the right foot length and mid-upper arm circumference. Finally, we compared this formula to other conventional formulae. RESULTS: The study included 741 patients whose average age was 8.4±3.9 (3-17) years. A high correlation was found between the patients' foot length, arm circumference, and bodyweight (R: 0.866, p<0.001 and R: 0.910, p<0.001, respectively). A single formula was created by regression analysis based on foot length and the mid-upper arm circumference without including sex and age in the calculation to make a more straightforward and faster calculation in emergency cases. CONCLUSION: The formula created may be advantageous for reliably and easily estimating the weight of children aged 3-17 of any sex and body habitus in emergency settings without special equipment. This newly developed formula may enable a low-cost optimal level of weight estimation without the need for special equipment.


Assuntos
Braço , Desnutrição , Humanos , Criança , Pré-Escolar , Adolescente , Braço/anatomia & histologia , Antropometria/métodos , Obesidade , Peso Corporal
14.
Int J Gynaecol Obstet ; 161(2): 462-469, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-36263879

RESUMO

OBJECTIVE: To compare the performance of mid upper arm circumference (MUAC) and body mass index (BMI) for prediction of small for gestational age (SGA) in Zambia. METHODS: This is a secondary analysis of an ongoing clinical cohort that included women with a single gestation and MUAC measured before 24 weeks of pregnancy. We assessed relationships between maternal MUAC and birth weight centile using regression. The performance of MUAC and BMI to predict SGA was compared using receiver operating characteristic curves and the effect of maternal HIV was investigated in sub-group analyses. RESULTS: Of 1117 participants, 847 (75%) were HIV-negative (HIV-) and 270 (24%) were HIV-positive (HIV+). Seventy-four (7%) delivered severe SGA infants (<3rd centile), of whom 56 (76%) were HIV- and 18 (24%) were HIV+ (odds ratio [OR] 1.01, 95% confidence interval [CI] 0.58-1.75). MUAC was associated with higher birth weight centile (+1.2 centile points, 95% CI 0.7-1.6; P < 0.001); this relationship was stronger among HIV+ women (+1.7 centile points, 95% CI 0.8-2.6; P < 0.001) than HIV- women (+0.9 centile points, 95% CI 0.4-1.4; P = 0.001). The discriminatory power was similar, albeit poor (area under the curve [AUC] < 0.7), between MUAC and BMI for the prediction of SGA. In stratified analysis, MUAC and BMI showed excellent discrimination predicting severe SGA among HIV+ (AUC 0.83 and 0.81, respectively) but not among HIV- women (AUC 0.64 and 0.63, respectively). CONCLUSION: Maternal HIV infection increased the discrimination of both early pregnancy MUAC and BMI for prediction of severe SGA in Zambia. CLINICAL TRIAL NUMBER: ClinicalTrials.gov (NCT02738892).


Assuntos
Infecções por HIV , Doenças do Recém-Nascido , Feminino , Humanos , Lactente , Recém-Nascido , Gravidez , Antropometria , Braço/anatomia & histologia , Peso ao Nascer , Retardo do Crescimento Fetal , Idade Gestacional , Infecções por HIV/complicações , Zâmbia
15.
Hand Surg Rehabil ; 42(1): 24-27, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36402286

RESUMO

Biceps brachii (BB) tendon rupture is frequent in young males and may require surgical repair. Non-anatomic reinsertion leads to loss of strength in supination. The main aim of the present study was to describe the anatomy of the osseous footprint of the distal BB tendon. The dimensions of the footprint of the distal BB insertion were analyzed in 100 dry cadaver radii, using MicroScribe 3D software. Insertion area, assimilated to an ellipse, was calculated from 4 points (medial, lateral, cranial and caudal) determining the two axes of the ellipse. Mean footprint length, width and area were 18 mm (range, 7-24 mm), 9 mm (range, 4-15 mm), and 129 mm2 (range, 46-266 mm²), respectively. Intra- and inter-observer correlation coefficients were satisfactory: κ = 0.75 and κ = 0.7, respectively. The present study reported BB footprint dimensions in 100 radii, providing a basis to guide surgical treatment of distal BB tendon rupture. Non-anatomical restoration of the BB tendon footprint leads to poorer clinical and biomechanical results; precise knowledge of the footprint is necessary for anatomical repair.


Assuntos
Músculo Esquelético , Traumatismos dos Tendões , Masculino , Humanos , Músculo Esquelético/cirurgia , Braço/anatomia & histologia , Rádio (Anatomia) , Tendões/cirurgia , Tendões/anatomia & histologia , Traumatismos dos Tendões/cirurgia
16.
Am J Hum Biol ; 35(3): e23837, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36382876

RESUMO

OBJECTIVES: The Middle Upper Arm Circumference (MUAC) bracelet is a widely used instrument in public health assessments and humanitarian assistance projects. The WHO guidelines present a universal cut-off point of 115 mm to determine whether a child has severe acute malnutrition. The objective of this study is to analyze the existing differences in the MUAC for boys and girls aged between 6 and 59 months, from 22 countries distributed in three different continents, in contrast to the use of this single cut-off point. In addition, the creation of MUAC growth charts is presented for reference use. MATERIALS AND METHODS: This study was carried out with a database developed by Action Against Hunger, composed, after the data pre-processing phase, of 97 921 individuals without anthropometric failure from African, Asian, and American continents. MUAC measurements were compared between countries, dividing by sex and age groups. A k-means method was used to create country clusters to allow comparisons and the variability was resumed using a Principal Component Analysis. For each cluster, growth curves were created and smoothed using the LOESS method. RESULTS: Our research has revealed the existence of differences in the MUAC between countries in both, males and females, although with different trends. The evidence was confirmed with the creation of two clusters using the k-means method, which, when graphically represented by the Principal Component Analysis, showed that the MUAC was clearly different. There were also differences between males and females within each cluster, where growth curves did not overlap in any age group. CONCLUSIONS: All statistical analysis indicate that there are differences in the MUAC values for children without anthropometric failure between countries, but also between sexes. With this research, a new reference is proposed that consider the existing variability between human populations to improve the precision in the determination of severe acute malnutrition in children.


Assuntos
Braço , Desnutrição Aguda Grave , Masculino , Feminino , Criança , Humanos , Lactente , Pré-Escolar , Braço/anatomia & histologia , Países em Desenvolvimento , Antropometria/métodos , Inquéritos Nutricionais
17.
Nutrients ; 14(21)2022 Oct 27.
Artigo em Inglês | MEDLINE | ID: mdl-36364777

RESUMO

This study aimed to (i) characterise the body composition of professional and semi-professional male futsal players, (ii) assess the validity of commonly used equations to estimate FM%, (iii) develop and cross-validate a futsal-specific FM% prediction equation. In a cross-sectional design, 78 adult male futsal players were assessed for body mass, stature, skinfolds, and girths as per the International Society for the Advancement of Kinanthropometry protocol and completed a dual-energy X-ray absorptiometry (DXA) scan for reference body composition data. Using paired-sample t-tests, the FM% from the DXA and nine published equations were compared. New sport-specific models were developed by stepwise multiple regression. Existing equations were cross-validated using the least squares regression, concordance correlation coefficient, and the Bland−Altman analyses. New equations were further cross-validated using the PRESS approach. None of the existing equations accurately predicted the DXA-derived FM% (p < 0.001; R2 ≤ 0.76, SEE ≥ 1.59; CCC ≤ 0.83; bias = −8.2% to −1.3%, limited agreement, and varying trends). The novel Bettery® equation: −0.620 + (0.159 ∗ Σ4SKF [triceps, abdominal, iliac crest, and front thigh (mm)]) + (0.120 ∗ waist girth (cm)), demonstrated a high accuracy (R2 = 0.85, SEE = 1.32%), a moderate strength of agreement (CCC = 0.92), no bias (0.2%), good agreement (±2.5%), and no trend (r = −0.157; p = 0.170) against the DXA. The Bettery® equation is the first to allow for a valid and sport-specific assessment of FM% in male futsal players.


Assuntos
Braço , Composição Corporal , Adulto , Humanos , Masculino , Estudos Transversais , Antropometria/métodos , Absorciometria de Fóton , Braço/anatomia & histologia , Impedância Elétrica
18.
BMC Public Health ; 22(1): 2056, 2022 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-36357916

RESUMO

BACKGROUND: Body mass index (BMI) remains the most used indicator of nutritional status despite the presence of a potentially credible alternative. Mid-upper arm circumference (MUAC) is an anthropometric measure that requires simple equipment and minimal training. The aim of this study was to compare MUAC with BMI and propose a MUAC cut-off point corresponding to a BMI of < 18.5 kg/m2 (underweight) and ≥ 30.0 kg/m2 (obesity) among Sudanese adults. METHODS: A cross-sectional study using multistage cluster sampling was conducted in New-Halfa, eastern Sudan. Participants' age and sex were recorded and their MUAC, weight and height were measured using the standard procedures. The MUAC (cm) cut-offs corresponding to < 18.5 kg/m2 and ≥ 30.0 kg/m2 were calculated and determined using receiver operating characteristic (ROC) curve analysis RESULTS: Five hundreds and fifty-two adults were enrolled in the study. The median (interquartile range, IQR) of the participants age was 31.0 (24.0 ̶ 40.0) years and 331 (60.0%) of them were females. The medians (IQR) of BMI and MUAC were 22.4 (19.1 ̶ 26.3) kg/m2 and 25.0 (23.0 ̶ 28.0) cm, respectively. There was a significant positive correlation between MUAC and BMI (r = 0.673, p < 0.001). Of the 552 enrolled participants, 104 (18.8%), 282 (51.1%), 89 (16.1%) and 77 (13.9%) were normal weight, underweight, overweight and obese, respectively. Best statistically derived MUAC cut-off corresponding to a BMI < 18.5 kg/m2 (underweight) was ≤ 25.5 cm in both males and females (Youden's Index, YI = 0.51; sensitivity = 96.0%; specificity = 54.0%), with a good predictive value (AUROCC = 0.82). Best statistically derived MUAC cut-off corresponding to a BMI ≥ 30.0 kg/m2 (obesity) was ≥ 29.5 cm in both males and females (YI = 0.62, sensitivity = 70.3%, specificity = 92.0%), with a good predictive value (AUROCC = 0.86, 95.0% CI = 0.76 - 0.95). CONCLUSION: The results suggest that the cut-offs based on MUAC can be used for community-based screening of underweight and obesity.


Assuntos
Estado Nutricional , Magreza , Adulto , Masculino , Feminino , Humanos , Índice de Massa Corporal , Magreza/diagnóstico , Magreza/epidemiologia , Braço/anatomia & histologia , Estudos Transversais , Sudão/epidemiologia , Antropometria/métodos , Obesidade/diagnóstico , Obesidade/epidemiologia
19.
J Nutr Sci ; 11: e101, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36405092

RESUMO

Mid-upper arm circumference (MUAC) is simple to use and inexpensive in Ethiopia; both MUAC and target weight are employed, although the time to cure for MUAC is not indicated. The present study is aimed to determine cure time of MUAC for children in outpatient therapeutic program. A prospective cohort study was conducted among 414 severe acute malnourished under-five children admitted to selected health twenty-two posts from 1 February to 30 July 2021, in Oromia, Ethiopia. Data were coded, entered to Ep-data version 4.2 software, and transferred to SPSS for windows version 25 software for analysis. The Multivariate Cox Proportional Hazards model was used to fit independent determinants of time to cure. All tests were two-sided and statistical implications at P-values < 0⋅05. In the present study, the minimum week for a cure was 4 weeks, the maximum was 16 weeks and the overall time to cure severe acute malnutrition as measured by MUAC is judged to be 10 at 95 % CI (9⋅65-10⋅35). Families with six or more members are 2⋅16 times more at risk, children from homes with the lowest wealth index are at 1⋅4 times more risk, and children from food insecure families were 2⋅61 times more likely to require long-term treatment for MUAC. In the present study, the time to cure severe acute malnutrition by MUAC is determined as 10 weeks. Moreover, family size, low wealth index, and household food insecurity were risks to delay in cure time MUAC.


Assuntos
Braço , Alta do Paciente , Desnutrição Aguda Grave , Humanos , Braço/anatomia & histologia , Etiópia , Pacientes Ambulatoriais , Estudos Prospectivos , Desnutrição Aguda Grave/terapia , Pré-Escolar
20.
Curr Biol ; 32(14): 3195-3202.e5, 2022 07 25.
Artigo em Inglês | MEDLINE | ID: mdl-35803271

RESUMO

Giant carnivorous dinosaurs such as Tyrannosaurus rex and abelisaurids are characterized by highly reduced forelimbs that stand in contrast to their huge dimensions, massive skulls, and obligate bipedalism.1,2 Another group that follows this pattern, yet is still poorly known, is the Carcharodontosauridae: dominant predators that inhabited most continents during the Early Cretaceous3-5 and reached their largest sizes in Aptian-Cenomanian times.6-10 Despite many discoveries over the last three decades, aspects of their anatomy, especially with regard to the skull, forearm, and feet, remain poorly known. Here we report a new carcharodontosaurid, Meraxes gigas, gen. et sp. nov., based on a specimen recovered from the Upper Cretaceous Huincul Formation of northern Patagonia, Argentina. Phylogenetic analysis places Meraxes among derived Carcharodontosauridae, in a clade with other massive South American species. Meraxes preserves novel anatomical information for derived carcharodontosaurids, including an almost complete forelimb that provides evidence for convergent allometric trends in forelimb reduction among three lineages of large-bodied, megapredatory non-avian theropods, including a remarkable degree of parallelism between the latest-diverging tyrannosaurids and carcharodontosaurids. This trend, coupled with a likely lower bound on forelimb reduction, hypothesized to be about 0.4 forelimb/femur length, combined to produce this short-armed pattern in theropods. The almost complete cranium of Meraxes permits new estimates of skull length in Giganotosaurus, which is among the longest for theropods. Meraxes also provides further evidence that carchardontosaurids reached peak diversity shortly before their extinction with high rates of trait evolution in facial ornamentation possibly linked to a social signaling role.


Assuntos
Dinossauros , Animais , Braço/anatomia & histologia , Evolução Biológica , Dinossauros/anatomia & histologia , Fósseis , Filogenia , Crânio/anatomia & histologia
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