ABSTRACT
Estimation of thickness of subcutabeous folds (SqF) is a simple way to estimate body composition in children, although it has its limitations. Double photon densitometry (DXA) is considered a new standard. Objective: To compare the precision of estimation of body fat by SqF and DXA in a population of Chilean children. Patients and Methods: Body fat was estimated in 128 eutrophic healthy children (70 females, 58 males), between 2 and 18 y.o. through SqF equations and DXA. Differences between both methods were evaluated through the Bland and Altman method and Lin concordance coefficient. Results: Most SqF equations had poor concordance with DXA. There was better concordance if the Westrate and Deurenberg equation was used among prepuberal and children of all ages (average difference of 2,96 +/- 1,20 percent and 4,92 +/- 0,98 percent and Lin concordance index of 0,50 +/- 0,22 and 0,43 +/- 0,88, respectively). Conclusions: Body fat estimated through subcutaneous fold measurements is poorly correlated with double photon densitometry among Chilean children. However, until more precise equations are developed, Westrate and Deurenberg for all ages, and Westrate/Deurenberg specific for pre-puberal age can be used.
La estimación del grosor de pliegues subcutáneos (PS) es una manera simple de estimar composición corporal en niños, sin embargo, tiene limitaciones. La densitometría de doble fotón (DXA) es considerada como el nuevo estándar de referencia. Objetivo: Comparar la precisión de la estimación del porcentaje de masa grasa por PS con la obtenida por DXA en población infantil chilena. Pacientes y Método: Se estimó el porcentaje de masa grasa en 128 niños (70 mujeres y 58 hombres) sanos, eutróficos, entre 2 y 18 años, por diversas ecuaciones de PS y se comparó con DXA. La diferencia entre ambos mediciones fue evaluada mediante el método de Bland y Altman y el coeficiente de concordancia de Lin. Resultados: La mayoría de las ecuaciones de PS tuvieron un pobre nivel de concordancia con DXA. Sin embargo, existe una mejor concordancia entre lo calculado según PS y DXA tanto en niños pre-puberales con la fórmula específica de Westrate y Deurenberg y en niños de todas las edades, con la ecuación general de Westrate y Deurenberg (diferencia promedio de 2,96 +/- 1,20 por ciento y 4,92 +/- 0,98 por ciento e índice de concordancia de Lin de 0,50 +/- 0,22 y 0,43 +/- 0,88, respectivamente) Conclusiones: La estimación del porcentaje de masa grasa a partir de los PS, tiene una baja concordancia, sin embargo, mientras no se desarrollen ecuaciones con una precisión más alta se podrían utilizar las ecuaciones de Westrate y Deurenberg a todas las edades y la de Westrate y Deurenberg específica para la edad pre-puberal.
Subject(s)
Humans , Male , Adolescent , Female , Child, Preschool , Child , Absorptiometry, Photon , Body Composition , Skinfold Thickness , Adiposity , Anthropometry , Body Mass Index , ChileABSTRACT
Background: Maps have played a critical role in public health since 1855, when John Snow associated a cholera outbreak with contaminated water source in London. After cardiovascular diseases, cancer is the second leading cause of death in Chile. Cancer was responsible for 22.7 percent of all deaths in 1997-2004 period. Aim To describe the geographical distribution of stomach, trachea, bronchi and lung cancer mortality. Material and methods: Mortality statistics for the years 1997-2004, published by the National Statistics Institute and Chilean Ministry of Health, were used. The standardized mortality ratio (SMR) for sex and age quinquennium was calculated for 341 counties in the country. A hierarchical Bayesian analysis of Poisson regression models for SMR was performed. The maps were developed using adjusted SMR (or smoothed) by the Poisson model. Results: There is an excess mortality caused by stomach cancer in south central Chile, from Teno to Valdivia. There is an excess mortality caused by trachea, bronchi and lung cancer in northern Chile, from Copiapó to Iquique. Conclusions: The geographical analysis of mortality caused by cancer shows cluster of counties with an excess risk. These areas should be considered for health care decision making and resource allocation.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Neoplasms/mortality , Bayes Theorem , Bronchial Neoplasms/mortality , Cause of Death , Chile/epidemiology , Lung Neoplasms/mortality , Poisson Distribution , Stomach Neoplasms/mortality , Tracheal Neoplasms/mortalityABSTRACT
Background: Death certification is the basis for the study of mortality patterns and the identification of leading causes of death. These data are used for planning health policies and prevention programs. Aim: To evaluate the quality of mortality statistics in Chile from 1997 and 2003. Material and methods: Mortality data from 1997 to 2003 available at the Chilean Ministry of Health was used. Quality of information was evaluated using the percentage of certifications done by physicians and ill-defined causes of death according to rural or urban residence, medical services, age and gender. Results: Death certification done by physicians increased from 97.6 percent to 99.0 percent in the studied period. The greatest increase was observed in rural areas, from 89.9 percent to 94,8 percent. There was a steady reduction in the percentage of ill-defined causes of deaths, from 4.7 percent in 1997 to 2.8 percent in 2003. The percentage of ill-defined causes had a great variation among the different medical services. The variation went from 1.5 percent in Magallanes to 13.7 percent in Araucania Sur. There was an inverse linear correlation between death certification by physicians and ill-defined conditions. Conclusions: Quality of Chilean mortality statistics has improved over time. Nevertheless, there is still space for enhancement for the appropriate use of this information.