Thigh-hip ratio is significantly associated with all-cause mortality among Japanese community-dwelling men.

Anthropometric evaluation is a simple yet essential indicator of muscle and fat mass when studying life prognosis in aging. This study aimed to investigate the contributions of anthropometric measurements, independent of body mass index, to measures of all-cause mortality. We examined data for 1,704 participants from the 2014 Nomura Cohort Study who attended follow-ups for the subsequent eight years (follow-up rate: 93.0%). Of these, 765 were male (aged 69 ± 11 years) and 939 were female (aged 69 ± 9 years). The Japanese Basic Resident Registry provided data on adjusted relative hazards for all-cause mortality. The data were subjected to a Cox regression analysis, wherein the time variable was age and the risk factors were gender, age, anthropometric index, smoking habits, drinking habits, exercise habits, cardiovascular history, hypertension, lipid levels, diabetes, renal function, and serum uric acid. Of the total number of participants, 158 (9.3%) were confirmed to have died, and of these, 92 were male (12.0% of all male participants) and 66 were female (7.0% of all female participants). The multivariable Cox regression analysis revealed that a smaller thigh-hip ratio predicted eight-year all-cause mortality in male participants, but only baseline body mass index was associated with all-cause mortality in female participants. Thigh-hip ratio is a useful predictor of death in Japanese community-dwelling men.

Is there no beauty in sexually dimorphic eyes? Facial attractiveness and White Europeans ocular morphology-Brief communication.

The link between human ocular morphology and attractiveness, especially in the context of its potential adaptive function, is an underexplored area of research. In our study, we examined the association between facial attractiveness and three sexually dimorphic measures of ocular morphology in White Europeans: the sclera size index, width-to-height ratio, and relative iris luminance. Sixty participants (30 women) assessed the attractiveness of the opposite-sex photographs of 50 men and 50 women. Our results show that in both men and women, none of the three measures was linked to the opposite sex ratings of facial attractiveness. We conclude that those ocular morphology measures may play a limited role in human mate preferences.

Invention and Clinical Application of an Oversleeve for Measuring Limb Volume in Postoperative Breast Cancer Patients.

BACKGROUND: Lymphedema is a common complication of breast cancer treatment, affecting 1/5 of breast cancer survivors, but there is no reliable way to detect subclinical lymphedema. OBJECTIVE: The purpose of this study was to determine the feasibility and reliability of using an oversleeve as a postoperative limb volume measurement tool in breast cancer patients. METHODS: Fifty patients were analyzed based on inclusion criteria. A body volume measurement kit was designed based on the drainage volume method and the circumference measurement method. Twenty-two normal healthy people were measured by the drainage volume (LV) and oversleeve measuring limb volume (OMLV) methods, so as to verify the accuracy of OMLV. Twenty-eight patients with lymphedema diagnosed by the circumdiameter measurement (CDM) method were measured with OMLV for comparison. The difference in measurements between OMLV and CDM was compared in 50 patients with early lymphedema diagnosed by the LV method. RESULTS: There was no significant difference between the sleeve method and the drainage volume method in the normal population (P = 0.74). All patients with lymphedema diagnosed by CDM met the diagnostic criteria by the OMLV method. In patients with early lymphedema diagnosed by LV, the diagnostic rate with OMLV was significantly higher than that with CDM (P = 0.008). CONCLUSION: Similar to LV in the diagnosis of lymphedema, OMLV can effectively improve the diagnostic rate of early lymphedema, providing a new option for the diagnosis and treatment of lymphedema.

Ovine ELOVL5 and FASN genes polymorphisms and their correlations with sheep tail fat deposition.

Reducing tail fat deposition can increase the economic value of a carcass and improve feed efficiency. This study aimed to explore ELOVL5 and FASN polymorphisms associated with tail fat deposition and their expression levels of sheep. Association analysis showed that ELOVL5 synonymous mutation g.62534 C > T was associated with tail width, tail fat weight, and relative tail fat weight (P < 0.05). FASN synonymous mutation g.12694 A > G was associated with tail length and width (P < 0.05). Combined effect analyses indicated significant differences between the combined genotypes and tail fat deposition. Quantitative real-time reverse transcription PCR indicated that the ELOVL5 and FASN expression levels were significantly higher in tail fat than in other tissues (P < 0.05). ELOVL5 expression levels in tail-fat tissue of big-tail sheep was significantly higher than that in small-tail sheep (P < 0.01). FASN expression levels were significantly higher in tail-fat tissue of small-tail sheep than in that of big-tail sheep (P < 0.05). During development, ELOVL5 tail fat expression increased significantly from 0 to 6 months old (P < 0.05), and FASN expression at 3 months old was significantly higher than that at 0 (minimum) and 6 months old (P < 0.05). Therefore, ELOVL5 and FASN polymorphisms could represent new candidate molecular markers and targets to reduce tail fat deposition in sheep.

¿Cómo se pesa al paciente con trastorno de la conducta alimentaria? Revisión del abordaje del peso en los tratamientos / How is the patient with Eating Disorders weighed? Review of weight approach in treatments

Introducción: la excesiva preocupación por el peso y la forma corporal en los Trastornos de la Conducta Alimentaria (TCA) conducen a conductas obsesivas de chequeo y/o evitación corporal. Existe consenso que el peso es un elemento fundamental en el tratamiento de los TCA, sin embargo, en el pesaje conviven enfoques múltiples. Objetivo: describir cómo se aborda el pesaje en el tratamiento de los pacientes con TCA. Materiales y método: el estudio consiste en una revisión de bibliografía, descriptiva. Se incluyeron publicaciones científicas mediante la búsqueda actualizada en base de datos: Scielo, Lilacs y Pubmed, desde 2010 hasta el 2020. Los descriptores de la búsqueda fueron: "pesaje y trastornos alimentarios/desórdenes alimentarios" y "tratamiento, trastornos alimentarios y pesaje". Resultados: de la búsqueda bibliográfica quedaron incluidos 14 artículos internacionales de diseño descriptivo. Los estudios fueron diversos, en estudiantes, atletas, pacientes, grupo control y profesionales, el tamaño muestral fue desde 24 instituciones especializadas en TCA hasta una población de 2287 participantes. Ningún estudio identificó cuál es el profesional encargado de pesar al paciente. El 75% de los artículos que describieron la modalidad de pesaje eligieron pesaje ciego en el comienzo del tratamiento y el resto optó por pesaje abierto, utilizándolo como terapia de exposición. Todos los profesionales modificaron la modalidad de pesaje según el nivel de ansiedad del paciente y el tiempo del tratamiento. Los pacientes prefirieron el pesaje ciego como beneficioso para sus tratamientos. El 90% de los estudios mostraron que los individuos que se autopesaban con mayor frecuencia, iniciaron más tempranamente atracones y conductas compensatorias. Conclusión: los tratamientos basados en evidencia no abordan la modalidad del pesaje de manera consensuada y las recomendaciones varían dentro de las terapias, y a lo largo del tiempo. La utilidad terapéutica del pesaje en los TCA es fundamental para evaluar el riesgo, alertar sobre los cambios en la ingesta alimentaria y para reducir la ansiedad. Sin embargo, es necesario abordarlo con profesionalismo e interdisciplina para disminuir el impacto sobre las conductas perjudiciales para la salud y la psicopatología. Se recomiendan más estudios que ayuden a construir criterios comunes y guías de consenso regional para mejorar el tratamiento de los TCA(AU).

Introduction: excessive concern about weight and body shape in Eating Disorders (ED) lead to obsessive checking and/or body avoidance behaviors. There is consensus that weight is a fundamental element in the treatment of eating disorders, however multiple approaches coexist in weighing. Objectives: to describe how weighing is addressed in the treatment of patients with ED Materials and method: the study consists of a descriptive bibliographic review. Scientific publications were included through the updated database search: Scielo, Lilacs and Pubmed, from 2010 to 2020. Search descriptors were: "body weight and eating disorders/eating disorders" and "treatment, eating disorders and body weight". Results: out of the bibliographic search, 14 international articles of descriptive design were included. The sample groups of the studies were diverse, including students, athletes, patients, control group and professionals, with a sample size of 2287 participants and 24 institutions specialized in eating disorders. No study identified the professional in charge of weighing the patient. 75% of the articles that described the weighing modality chose blind weighing at the beginning of the treatment and the rest opted for open weighing, using it as exposure therapy. All the professionals modified the weighing modality according to the patient's anxiety level and the treatment time. Patients preferred blind weighing as beneficial for their treatment. 90% of the studies showed that individuals who self-weighed more frequently initiated binge eating and compensatory behaviors earlier. Conclusion: evidence-based treatments do not consensually address how the patient is weighed, and the recommendations vary according to therapies and time period. The therapeutic utility of ED weighing is essential to assess risk, alert to changes in food intake, and to reduce anxiety. However, it is necessary to approach it with professionalism and interdiscipline to reduce the impact on behaviors harmful to health and psychopathology. More studies are recommended to help build common criteria and regional consensus guidelines to improve the treatment of ED(AU).

Consumption of ultra-processed foods and anthropometric indicators in adolescents, adults, and the elderly in a capital city in northeastern Brazil / Consumo de alimentos ultraprocessados e indicadores antropométricos em adolescentes, adultos e idosos de uma capital do Nordeste do Brasil

ABSTRACT Objective To evaluate the consumption of ultra-processed foods and associate it with anthropometric indicators in adolescents, adults, and the elderly. Methods Cross-sectional, domiciliary, population-based study, comprising adolescents aged 10-19 years, adults aged 20-59 years, and elderly people aged 60 or older, residents of the urban area of the city of Teresina, Piauí. Demographic, socioeconomic, lifestyle, food consumption, and anthropometric data were collected. The analysis of variance test was used along with the Bonferroni post-hoc test and crude and adjusted linear regression with a 95% confidence interval (95% CI). The level of significance adopted was 5%. Results There was no significant association between the consumption of ultra-processed foods and anthropometric variables in adults and the elderly. However, among adolescents, the results showed an inverse association, thus signaling a reduction in anthropometric indicators as the consumption of ultra-processed foods increases. Conclusion There was no association between the consumption of ultra-processed foods and anthropometric indicators in adults and the elderly; however, among adolescents, the results showed an inverse association, which encourages the development of new studies, especially longitudinal ones.

RESUMO Objetivo Avaliar o consumo de alimentos ultraprocessados e associá-lo a indicadores antropométricos em adolescentes, adultos e idosos Métodos Estudo transversal, domiciliar, de base populacional, compreendendo adolescentes de 10-19 anos, adultos de 2059 anos e idosos de 60 anos ou mais, residentes na zona urbana da cidade de Teresina, Piauí. Foram coletados dados demográficos, socioeconômicos, de estilo de vida, consumo alimentar e antropométrico. O teste de análise de variância foi utilizado juntamente com o teste post-hoc de Bonferroni e regressão linear bruta e ajustada com intervalo de confiança de 95% (IC95%). O nível de significância adotado foi de 5%. Resultados Não houve associação significativa entre o consumo de alimentos ultraprocessados e indicadores antropométricos em adultos e idosos, entretanto, entre os adolescentes, os resultados demonstraram uma associação inversa, sinalizando redução dos indicadores antropométricos à medida que se aumenta o consumo de ultraprocessados. Conclusão Não houve associação entre o consumo de alimentos ultraprocessados e indicadores antropométricos em adultos e idosos, entretanto, entre os adolescentes, os resultados demonstraram uma associação inversa, o que incentiva o desenvolvimento de novos estudos, especialmente, longitudinais.

Effects of nutrition education given to persons with multiple sclerosis and their families on diet quality and anthropometric and biochemical measurements / Efeito da educação nutricional dada a pessoas com esclerose múltipla e suas famílias em relação a qualidade da dieta, medidas antropométricas e bioquímicas

ABSTRACT Objective: In this study, it was aimed to investigate the effects of nutrition education given to persons with multiple sclerosis and their families on anthropometric and biochemical measurements and diet quality. Methods: Data from 51 persons with multiple sclerosis were analysed in this intervention study. The study was conducted with 3 groups. The education group consisted of only persons with multiple sclerosis, the family education group consisted of persons with multiple sclerosis and a family member living with them, and the control group consisted of persons with multiple sclerosis who had not received an education. Anthropometric and biochemical measurements and dietary quality assessments were made before (T1) and immediately after education (T2) and also 3 months after education (follow-up, T3). Results: The distribution of family education group diet quality scores showed a significant increase from "poor" to "needs improvement" at T3 compared to T1. The upper middle arm circumference measurements of the female control group were decreased at T2 and T3 [from 29.0 (23-34) cm to 28.0 (22-31) cm and to 27.5 (22-31) cm]. Women in family education group, levels of serum haemoglobin and haematocrit were higher than in control group at T2 and T3. Also, men in family education group, levels of alanine aminotransferase were lower than those in education group at follow up. Levels of total cholesterol and low-density lipoprotein cholesterol in education group were higher than those control group at T1, T2, and T3. Conclusion: This study indicates that nutrition education affects some biochemical and anthropometric measurements in persons with multiple sclerosis. Diet quality improved when receiving education together with families.

RESUMO Objetivo: Objetivou-se investigar os efeitos da educação nutricional dada a pessoas com esclerose múltipla e seus familiares, avaliação de medidas antropométricas, bioquímicas e da qualidade da dieta. Métodos: Dados de 51 participantes com esclerose múltipla foram analisados neste estudo de intervenção. O estudo foi dividido em 3 grupos, sendo o primeiro composto por indivíduos que obtiveram educação nutricional, o segundo, composto por indivíduos mais um membro da família que morava com eles e obtiveram educação nutricional, e o terceiro, grupo controle, composto por indivíduos que não obtiveram educação nutricional. Medidas antropométricas, bioquímicas e avaliações da qualidade da dieta foram feitas antes (T1) imediatamente após a educação nutricional (T2) e também 3 meses após a educação nutricional (T3). Resultados: A distribuição dos escores de qualidade da dieta do grupo de educação familiar mostrou um aumento significativo de "ruim" para "precisa melhorar" no T3 em comparação ao T1. As medidas da circunferência do braço médio do grupo controle feminino foram menores em T2 e T3 [de 29,0 (23-34) cm para 28,0 (22-31) cm e para 27,5 (22-31) cm]. Nas mulheres do grupo família, os níveis séricos de hemoglobina e hematocrito foram maiores do que no grupo controle em T2 e T3. Também nos homens do grupo família, os níveis de alanina aminotransferasa foram mais baixos do que os do grupo educação no seguimento. Os níveis de CT e LDL-C no grupo educação foram superiores aos do grupo controle em T1, T2 e T3. Conclusão: Este estudo observou que a educação nutricional afeta algumas medidas bioquímicas antropométricas em pessoas com esclerose múltipla. A qualidade da dieta melhorou quando recebeu educação junto com as famílias.

Anthropometric, biochemical, and nutritional risk factors for osteoporosis in Korean adults based on a large cross-sectional study.

BACKGROUND: Osteoporosis a common bone disorder characterized by decreases in bone mass, tension, and strength. Although many previous studies worldwide have sought to identify the risk factors for osteoporosis, studies that simultaneously examine a variety of factors, such as biochemical, anthropometric and nutritional components, are very rare. Therefore, the objective of this study was to simultaneously examine the association of osteoporosis with biochemical profiles, anthropometric factors, and nutritional components in a large-scale cross-sectional study. METHOD: This cross-sectional study was based on data from the Korea National Health and Nutrition Examination Survey (KNHANES VI-VII) from 2015 to 2018. Based on data from 16,454 participants, logistic regression was used to examine the association between various parameters in a crude analysis and in models adjusted for confounders. RESULTS: In men, osteoporosis was significantly associated with the anthropometric variables height and weight; the biochemical components hemoglobin, hematocrit, urea nitrogen and urine pH and creatinine; and the nutritional components total food intake, energy, water, protein, phosphorus, and kalium. However, these associations disappeared in adjusted model 2. In women, osteoporosis was significantly related to the anthropometric measures height, weight, and systolic blood pressure; the biochemical components hemoglobin, hematocrit and urine pH; and the nutritional components total food intake, water, calcium, phosphorus, and kalium. Most of these associations were maintained in the adjusted models. CONCLUSION: Osteoporosis was linked to various anthropometric, biochemical and urine and nutritional components in Korean women, but the association between osteoporosis and risk factors differed according to sex.

Morphological Measurement of the Femoral Anterior Bow in Chinese Population Based on Three-Dimensional Computed Tomography.

PURPOSE: The femoral anterior bow is an important factor in matching a femoral implant to a femur. However, its morphology in the Chinese population has rarely been reported. In this study, a three-dimensional measurement approach was adopted to provide accurate data. The aim was to supply a reference for designing a long-stemmed femoral prosthesis that is more suitable for Chinese people. METHODS: Computed tomography data were collected from both lower limbs of 96 normal volunteers and reconstructed into a three-dimensional model using Mimics software. The parameters of the femoral anterior bow were measured using medical image analysis software. Statistical analysis was conducted using independent-samples and paired-samples t-tests with SPSS software. RESULTS: All the indexes showed significant sexual difference (P < 0.05). The minimum cross-sectional area of the femoral medullary cavity was larger in men (10.77 ± 1.53 mm) than in women (9.79 ± 1.27 mm). The distance from the position of the maximum curvature to the lower edge of the lesser trochanter was also larger in men (60.93 ± 5.81 mm) than in women (56.31 ± 2.80 mm). However, the curvature of the femoral medullary cavity centerline was larger in women (883.57 ± 249.74 mm) than in men (958.79 ± 266.61 mm). The femoral anterior bow morphological indexes of Chinese subjects were different from the published data for other populations. There were no significant differences between left and right femoral anterior bows in either sex (P > 0.05). CONCLUSION: The three-dimensional measurement approach adopted in this study is more convenient and accurate than previous conventional methods, with high repeatability. The morphological indexes of the femoral anterior bow in this research suggest that population characteristics should be taken into account. This study will provide references for the design of long-stemmed femoral prostheses in the Chinese population.

Relationship between obesity-related anthropometric indicators and cognitive function in Chinese suburb-dwelling older adults.

BACKGROUND: Studies relating obesity to cognition in older people show conflicting results, which may be explained by the choice of obesity indicators. OBJECTIVES: This study aimed to investigate the relationship between obesity-related indicators and cognitive impairment, especially between different age or gender subgroups, and explore whether obesity-related indicators were related to specific cognitive domains. METHODS: This was a cross-sectional study on 1753 participants aged ≥ 60 years (41.0% men; aged 71.36 ± 5.96 years). Obesity-related indicators included body mass index (BMI), waist circumference (WC), calf circumference (CC), waist to hip ratio (WHR), waist to calf circumstance ratio (WCR), fat to fat-free mass ratio (FM/FFM). The Mini-Mental State Examination scale (MMSE) was used to assess cognitive function. Cognitive impairment was defined as a score ≤ 17 for illiterates, ≤ 20 for participants with primary school education, and ≤ 24 for those with junior high school degrees or above. Multiple logistic regression analysis was used to estimate multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Restricted cubic splines were used to analyze and visualize the linear relationships. RESULTS: The prevalence of cognitive impairment was 18.77%. In the fully adjusted model, CC was negatively associated with cognitive impairment (OR = 0.94, 95% CI: 0.90-0.98). Further analysis showed that CC correlated positively with recall and place orientation. A higher FM/FFM was found to be associated with a higher prevalence of cognitive impairment (OR: 1.44, 95%CI: 0.88-2.35, P for trend = 0.029); this association was notable in women (P for trend = 0.002) and the oldest (P for trend = 0.009), and so did the potential effect of BMI on cognitive impairment (70-80 years: P for trend = 0.011; ≥ 80 years: P for trend = 0.013). No statistically significant association was found between cognitive impairment and WC, WHR, or WCR. CONCLUSION: CC and FM/FFM were associated with cognitive impairment in older people. Future research needs to distinguish the effects of fat and muscle mass on cognitive function, with special attention to different ages and genders.

Neck Circumference as a Predictor of Metabolic Syndrome in Koreans: A Cross-Sectional Study.

Metabolic syndrome (MetS) is a complex metabolic disorder and a high-risk condition for type 2 diabetes and cardiovascular disease. Rapid screening of at-risk individuals using accurate and time-saving tools is effective in disease management. Using the Korea National Health and Nutrition Examination Survey (KNHANES) data, we collected data from 2234 participants suitable for the study design, of which 974 (43.6%) were men and 1260 (56.4%) were women. We used receiver operating characteristic (ROC) curve analysis to estimate the optimal sex-specific neck circumference (NC) cut-off point to predict the MetS risk. To analyze the risk of MetS according to the estimated NC, logistic regression analysis was performed to identify the confounding factors. The result of the ROC analysis showed that the optimal neck cut-off points for predicting the risk of MetS were 38.25 cm (AUC: 0.759, 95% CI: 0.729-0.790) in men and 33.65 cm (AUC: 0.811, 95% CI: 0.782-0.840) in women. In the upper NC cut-off point compared to the lower NC cut-off point, NC was associated with an increased MetS risk by 2.014-fold (p = 0.010) in men and 3.650-fold (p < 0.001) in women, after adjustments. The current study supports NC as an effective anthropometric indicator for predicting the risk of MetS. It is suggested that more studies should be conducted to analyze the disease prediction effect of the combined application of anthropometric indicators currently in use and NC.

Chest conformation spuriously influences strain parameters of myocardial contractile function in healthy pregnant women.

AIMS: Left ventricular (LV) contractility during noncomplicated pregnancy has been previously investigated by two-dimensional speckle-tracking echocardiography (2D-STE), with conflicting results. Chest abnormalities might affect myocardial strain parameters, yet this issue has not been previously investigated during pregnancy. We evaluated the influence of chest conformation on myocardial strain parameters in healthy pregnant women. METHODS: Between October 2019 and February 2020, 50 healthy pregnant women (32.3 ±â€Š4.0 years old) were consecutively studied. They underwent obstetric visit, assessment of chest shape by modified Haller index (MHI; chest transverse diameter over the distance between sternum and spine) and transthoracic echocardiography implemented with 2D-STE analysis of all myocardial strain parameters in the first trimester (12-14 weeks), third trimester (36-38 weeks) and 6-9 weeks after delivery. RESULTS: LV ejection fraction remained substantially unchanged (P = 0.13), while on the average all myocardial strain parameters showed a small but significant decrease during pregnancy, and recovered postpartum (all P < 0.001). Women with concave-shaped chest wall (MHI > 2.5, n = 29), and those with normal chest conformation (MHI ≤ 2.5, n = 21) were then separately analyzed. Pregnant women with MHI above 2.5, but not those with MHI 2.5 or less, showed a progressive but reversible decrease in all myocardial strain parameters (all P < 0.001). MHI was strongly correlated with LV global longitudinal strain (r = -0.87) and LV global circumferential strain (r = -0.83) in the third trimester of pregnancy. CONCLUSION: Myocardial strain impairment during healthy pregnancy may not reflect intrinsic myocardial dysfunction but rather intraventricular dyssynchrony related to a narrow antero-posterior chest diameter and rise in the diaphragm, with consequent extrinsic myocardial compression.

Fenton vs. Intergrowth-21st: Postnatal Growth Assessment and Prediction of Neurodevelopment in Preterm Infants.

Although the survival rate of preterm infants has improved over the years, growth failure and associated impaired neurodevelopmental outcome remains a significant morbidity. Optimal nutrition plays an important role in achieving adequate postnatal growth. Accurate growth monitoring of preterm infants is critical in guiding nutritional protocols. Currently, there is no consensus regarding which growth assessment tool is suitable for monitoring postnatal growth of preterm infants to foster optimal neurodevelopmental outcomes while avoiding future consequences of aggressive nutritional approaches including increased risk for cardiovascular disease and metabolic syndrome. A retrospective single center cohort study was conducted to compare the performance of two growth-assessment tools, Fenton and Intergrowth-21st (IG-21st) in the classification of size at birth, identification of impaired growth and predicting neurodevelopment. A total of 340 infants with mean gestational age of 30 weeks were included. Proportion of agreement between the two tools for identification of small for gestational age (SGA) was high 0.94 (0.87, 0.1) however, agreement for classification of postnatal growth failure at discharge was moderate 0.6 (0.52, 0.69). Growth failure at discharge was less prevalent using IG-21st. There was significant association between weight-based growth failure and poor neurodevelopmental outcomes at 12 and 24 months of age.

Preoperative measurement of the hiatal surface with MDCT: impact on surgical planning.

OBJECTIVE: To evaluate the accuracy and reproducibility of hiatal surface area (HSA) measurement on dedicated multidetector computed tomography (MDCT) acquisition, in patients, previously subjected to laparoscopic sleeve gastrectomy (LSG), and affected by gastroesophageal reflux disease (GERD). Intraoperative HSA measurement was considered the reference standard. METHODS: Fifty-two candidates for laparoscopic hiatal hernia repair were prospectively included in the study. MDCT images were acquired during swallowing of oral iodinated contrast media and during strain. Measurements were performed by nine readers divided into three groups according to their experience. Results were compared with intraoperative measurements by means of Spearman correlation coefficient. Reproducibility was evaluated with intra- and interreader agreement by means of weighted Cohen's kappa and intraclass correlation coefficient (ICC). RESULTS: Significant differences between MDCT and intraoperative HSA measurements were observed for swallowing imaging for less experienced readers (p = 0.037, 0.025, 0.028 and 0.019). No other statistically significant differences were observed (p > 0.05). The correlation between HSA measured intraoperatively and on MDCT was higher for strain imaging compared to swallowing (r = 0.94-0.92 vs 0.94-0.89). The overall reproducibility of MDCT HSA measurement was excellent (ICC of 0.95; 95% CI 0,8993 to 0,9840) independently of reader's experience CONCLUSION: HSA can be accurately measured on MDCT images. This method is reproducible and minimally influenced by reader experience. The preoperative measurement of HSA has potential advantages for surgeons in terms of correct approach to hiatal defects in obese patient.

Assessment of peritoneal thickness using CT in relation to dialysis adequacy in peritoneal dialysis patients.

Studies assessing peritoneal thickness by CT in peritoneal dialysis (PD) patients are lacking. In this study, we aimed to investigate the association between peritoneal thickness as measured by CT and dialysis adequacy with peritoneal membrane characteristics in PD patients. Ninety-four PD patients were enrolled. Peritoneal thickness was measured by CT. Patients with and without a decrease in Kt/V of at least 0.3 over time were classified as Group 1 and Group 2, respectively. An increase of 0.1 unit of dialysate/plasma (D/P) creatinine over time were considered significant. The relationship between peritoneal membrane thickness, change in Kt/V, and peritoneal membrane characteristics were investigated. There were 31 (33.0%) patients in Group 1. The duration of PD (86.0 ± 64.1 vs. 59.6 ± 45.2 months, p: 0.023), peritoneal thickness (1.02 ± 0.37 vs. 0.87 ± 0.21 mm, p: 0.015), peritoneal calcification (7 [22.6%] vs. 3 [4.8%] patients, p: 0.013], increased D/P creatinine ratio (14 [45.2%] vs. 14 [22.2%] patients, p: 0.031) and CRP (13.9 ± 11.2 vs. 7.1 ± 4.8 mg/L, p: 0.045) were significantly higher in Group 1, whereas albumin (3.6 ± 0.5 vs. 3.8 ± 0.6 g/dL, p: 0.047) and parathyroid hormone (355.2 ± 260.2 vs. 532.1 ± 332.9 ng/L, p: 0.015) levels were significantly lower. Peritoneal thickness was significantly correlated with duration of PD (r: 0.775, p < 0.001) and CRP (r: 0.282, p: 0.006). Regression analysis showed that peritoneal thickness (Exp (B) [95% CI]: 0.029 [0.003-0.253], p: 0.001) was independent predictor of decreased Kt/V in PD patients. In conclusion, prolonged PD duration and increased peritoneal thickness are associated with a decrease in Kt/V over time. CT may be an alternative and noninvasive method instead of peritoneal biopsy for determining the structural changes of the peritoneal membrane .

Transvaginal two-dimensional ultrasound measurement of cervical volume to predict the outcome of the induction of labour: a prospective observational study.

BACKGROUND: Assessing the likelihood of success of induction of labour using ultrasonically measured cervical volume is an important research question. METHOD: A prospective observational study was carried out at North Colombo Teaching Hospital, Ragama, Sri Lanka. Pre-induction digital cervical assessment, transvaginal cervical length, and cervical volume measurements were performed. Inductions with singleton pregnancies at term were included. Basic demographic and clinical details, independent variables (Bishop score, cervical length and cervical volume), and dependent variables (frequency of delivery within 24 h and induction to delivery interval) were recorded. Vaginal delivery within 24 h was the primary outcome. RESULTS: We studied 100 pregnant women who had induction of labour. Median (IQR) Bishop score was 5 (3-6), mean (SD) cervical length was 3.6 (0.7) cm, and mean (SD) cervical volume was 27.5 (10.4) cm3. Cervical length was the best predictor for predicting the likelihood of vaginal delivery within 24 h [aOR - 12.12 (3.44, 42.71); < 0.001], and cervical volume also appeared to be a significant potential predictor [aOR-1.10 (1.01, 1.17); 0.01]. Cervical length was found to have the highest AUC (0.83) followed by the cervical volume (0.74). The best cut-off value for cervical volume in predicting the likelihood of vaginal delivery within 24 h was less than 28.5 cm3 with a sensitivity of 72% and specificity of 74%. CONCLUSIONS: Transvaginal sonographic measurement of cervical volume appears to be a potential novel predictor for the likelihood of vaginal delivery within 24 h of induction of labour. Cervical length is still more superior to cervical volume in predicting the likelihood of vaginal delivery. Bishop score was not a significant predictor in this context.

Comparison of outcomes between gap balancing and measured resection techniques for total knee arthroplasty: A prospective, randomized, controlled trial.

OBJECTIVE: The aim of this study was to compare the effect of Gap Balancing (GB) versus Measured Resection (MR) techniques on the early clinical and radiological results of Total Knee Arthroplasty (TKA). METHODS: In this prospective study, 99 patients (99 knees) who underwent unilateral TKA between March 2018 and January 2019 were randomly allocated to one of two groups: The GP group, TKA with GB technique (19 male, 31 female; mean age = 55.9 ±16.5) and the MR group, TKA with MR technique (19 male, 30 female; mean age = 54.2 ± 18.7). Patients in both groups were comparable in terms of the demographic and clinical data. The angle of cutting block to PCA and Cutting Thickness of the Medial and Lateral Condyle (CTMC, CTLC) were intraoperatively measured. In radiographic analysis, Preoperative Mechanical Femorotibial Angle (Pre-mFTA), Postoperative Mechanical Femorotibial Angle (Post-mFTA), and joint line changes were examined. Femoral component Rotation Angle (FCRA) was also measured by computed tomography. In gait analysis, the spatiotemporal parameters (walking speed, step length, and single support time) and kinematics parameters (flexion angle, extension angle, and transversal rotation) were collected at 12 months postoperatively. Furthermore, Western Ontario and McMaster Universities Arthritis Index (WOMAC) were performed at 12 months after surgery. RESULTS: CTMC and CTLC were both significantly higher in GB group than in the MR group (9.8±2.0 mm vs 8.5 ± 1.2 mm; 7.9 ± 1.8mm vs 6.8 ± 1.4mm; P = 0.001, P = 0.002, respectively). Angle of cutting block to PCA was statistically lower in GB group than in the MR group (1.7 ± 1.5° vs 3.1 ± 0.5 °; P < 0.001). FCRA is greater in the GB group compared to the MR group, but the difference did not reach statistical significance (1.2 ± 2.8 ° vs 0.7 ± 2.0 °; P > 0.05). Although post-mFTA significantly improved compared with pre-mFTA in both groups, no significant difference was observed in the changes of post-mFTA between the two groups (0.9 ± 1.7° vs 0.3 ± 1.8°, P > 0.05). No significant differences were determined between the two groups in spatiotemporal gait parameters including walking speed, step length, and single support time. The sagittal max knee flexion range was significantly larger in the GB group than in the MR group (49.27 ± 5.24 ° vs 45.99 ± 8.21 °, P < 0.05). The flexion range did not reach the level of the control group. There was no significant difference between the two groups in WOMAC at 12 months follow-up (P > 0.05). CONCLUSION: Evidence from this study has revealed GB and MR techniques have both little effect on early clinical results of TKA. Nonetheless, GB technique can provide better knee flexion in the early postoperative gait status compared with MR technique. LEVEL OF EVIDENCE: Level I, Therapeutic Study.

Are adults just big kids? Can the newer paediatric weight estimation systems be used in adults?

BACKGROUND: The weight of a patient is an important variable that impacts on their medical care. Although some drugs are prescribed on a so-called 'adult dose' basis, we know that adults come in all shapes and sizes - a 'one-dose-fits-all' approach is not necessarily appropriate. As a measured weight may not always be available, an alternative method of accurately estimating weight is required. OBJECTIVES: To assess and compare the accuracy of weight estimations in adults by patient self-estimation, the Mercy method, Buckley method, Broca index and PAWPER XL-MAC (paediatric advanced weight prediction in the emergency room eXtra length/eXtra large mid-arm circumference) method. METHODS: This was a prospective, cross-sectional study conducted at a tertiary academic hospital in a metropolitan area of Johannesburg, South Africa. Anthropometric variables of height, abdominal circumference, thigh circumference, mid-arm circumference and humeral length were measured. These variables were then applied to the various weight estimation methods and compared with the patient's actual weight. RESULTS: There were 188 adult patients included in the study. None of the methodologies evaluated in this study achieved the recommended >70% of weight estimations within 10% of the patient's actual weight (PW10). The Mercy method was the closest to achieving greater than the recommended 95% for weight estimation falling within 20% of the patient's actual weight (PW20). The PW20 for the Mercy method was 91.5%. The PAWPER XL-MAC and patient self-estimate methods achieved a PW20 of 85.1% and 86.1%, respectively. The Broca and Buckley methods performed poorly overall. CONCLUSIONS: None of the evaluated weight estimation methodologies was accurate enough for use in adult weight estimation. The Mercy and PAWPER XL-MAC methodologies both showed significant promise for use in adult weight estimation, but need further refinement. Although patient self-estimates were similarly accurate to those found in previous studies, they were not an accurate option; self-estimations would remain the first choice if the patient was able to provide such an estimation. The Broca index and Buckley method cannot be recommended owing to their poor performance.