Menarquia en adolescentes de zona urbana y periurbana de encarnación y su asociación con estado nutricional y menarquia materna. Año 2022

Introducción: La menarquia es un indicador de maduración sexual que se produce entre los 10-15 años. Factores genéticos y ambientales intervienen en la edad de aparición de la menarquia. Objetivos: Determinar la edad de menarquia y su asociación con el estado nutricional y la menarquia materna en adolescentes del 6° grado de instituciones educativas seleccionadas de zona urbana y periurbana de Encarnación. Materiales y métodos: Estudio observacional, descriptivo con componente analítico en adolescentes sin patología endócrina de base, con consentimiento escrito. Se evaluó presencia de menarquia, edad de inicio, estado nutricional, circunferencia abdominal (CA), menarca materna. Resultados: Fueron incluidas 112 adolescentes (urbana 51, periurbana 61), edad promedio 12 años. El 77,7%(n=87) refirió menarca, más frecuente en zona urbana (90,2%, vs 67%c2 p=0,003). Edad promedio de menarquia fue 11,1±0,7 años (urbana 11,4±0,5 vs 10,7±0,8, p=0,0001) y fue menor que la materna con 12,8±1,4 años (p=0,0001). El 16,1% tenía obesidad (23% en zona periurbana versus 7,8% en urbana c2 p=0,002), el 0,9% tuvo desnutrición y un 30,4% sobrepeso. Las adolescentes con obesidad tuvieron menarca a los 10,6±0,9 años vs 11,1±0,7 años en el resto (T Student p=0,03). El 13,4%(n=15) tuvo CA aumentada, y en ellas la edad de menarca fue menor (10,6±0,7 años, p=0,03). Conclusión: Dos tercios de las adolescentes refirió menarquia, aquellas de zona periurbana, con obesidad o circunferencia abdominal aumentada mostraron menor promedio de edad de inicio.

Introduction: Menarche is an indicator of sexual maturation that occurs between 10-15 years of age. Genetic and environmental factors affect the age of onset of menarche. Objectives: To determine the age of menarche and its association with nutritional status and maternal menarche in 6th grade adolescents from selected educational institutions in urban and peri-urban areas of Encarnación. Materials and methods: This was an observational, descriptive study with an analytical component in adolescents without underlying endocrine pathology; written consent was obtained. The presence of menarche, age at onset, nutritional status, abdominal circumference (AC), and maternal menarche were evaluated. Results: 112 adolescents (51 urban, 61 peri-urban) were included, the average age 12 years. 77.7% (n=87) reported menarche, more frequently in urban areas (90.2%, vs 67%, p=0.003). Mean age at menarche was 11.1 ± 0.7 years (urban 11.4 ± 0.5 vs 10.7 ± 0.8, p = 0.0001) and was lower than the maternal age with 12.8 ± 1, 4 years (p=0.0001). 16.1% were obese (23% in peri-urban areas versus 7.8% in urban areas, p=0.002), 0.9% were undernourished and 30.4% were overweight. Adolescents with obesity had menarche at 10.6±0.9 years vs. 11.1±0.7 years in the rest (Student's T, p=0.03). 13.4% (n=15) had increased AC, and in these, the age of menarche was lower (10.6±0.7 years, p=0.03). Conclusion: Two thirds of the adolescents reported menarche, those from the peri-urban area, with obesity or increased abdominal circumference, showed a lower average age of onset.

Progresión de los componentes de la presión arterial y la correlación con las medidas antropométricas y laboratoriales en adultos jóvenes / Progression of blood pressure components and correlation with anthropometric and laboratory measurements in young adults

Introducción: La presencia de hipertensión arterial en población joven aumenta el riesgo de eventos cardiovasculares en la mediana edad y como consecuencia una morbimortalidad prematura. El propósito de este estudio es evaluar la progresión de los componentes de la presión arterial y la correlación con las medidas antropométricas y laboratoriales en estudiantes de la Universidad Nacional de Asunción- Paraguay. Materiales y métodos: Se realizó un estudio descriptivo correlacional, longitudinal, prospectivo, desde el año 2013 hasta el año 2017 evaluando al inicio 284 universitarios y 240 al final de las carreras. Se midieron variables sociodemográficas, antropométricas, presión arterial, determinaciones bioquímicas. La progresión de los componentes de la presión arterial, de las variables antropométricas y clínicas se calcularon mediante la prueba T de muestras relacionadas. La correlación de la presión arterial sistólica y presión arterial diastólica con las variables antropométricas y laboratoriales con la correlación de Pearson. Resultados: La progresión de los componentes de la presión arterial presentó una diferencia estadísticamente significativa en la presión arterial sistólica, presión arterial diastólica y presión de pulso. En relación con las características antropométricas y clínicas de los estudiantes se encontró una diferencia estadísticamente significativa entre la medición inicial y final en el peso, perímetro abdominal, glicemia, insulina, colesterol total, colesterol de alta densidad, colesterol de baja densidad, triglicéridos y proteína C reactiva. La correlación más importante encontrada entre las medidas antropométricas con la presión arterial sistólica y presión arterial diastólica fue la circunferencia abdominal. Conclusión: Se encontró aumento de la tendencia de la presión arterial y de otros factores de riesgo cardiovascular en universitarios.

Introduction: The presence of arterial hypertension in young population increases the risk of cardiovascular events in middle age and as a consequence premature morbimortality. The purpose of this study was to evaluate the progression of blood pressure components and the correlation with anthropometric and laboratory measurements in students of the National University of Asuncion, Paraguay. Materials and methods: A descriptive correlational, longitudinal, prospective, descriptive study was conducted from 2013 to 2017 evaluating at the beginning 284 undergraduates and 240 at the end of the careers. Sociodemographic variables, anthropometric variables, blood pressure, biochemical determinations were measured. The progression of blood pressure components, anthropometric and clinical variables were calculated using the related samples t-test. The correlation of systolic blood pressure and diastolic blood pressure with anthropometric and laboratory variables was correlated with Pearson's correlation. Results: The progression of blood pressure components presented a statistically significant difference in systolic blood pressure, diastolic blood pressure and pulse pressure. In relation to the anthropometric and clinical characteristics of the students, a statistically significant difference was found between the initial and final measurements in weight, abdominal perimeter, glycemia, insulin, total cholesterol, high-density cholesterol, low-density cholesterol, triglycerides, and C-reactive protein. The most important correlation found between anthropometric measurements with systolic blood pressure and diastolic blood pressure was abdominal circumference. Conclusion: An increase in the trend of blood pressure and other cardiovascular risk factors was found in university students.

Relación del consumo de calcio con el síndrome metabólico en adultos de la Amazonía Ecuatoriana / Relationship of calcium consumption with metabolic syndrome in adults from the Ecuadorian Amazon

Introducción. El Síndrome Metabólico (SM) comprende un conjunto de factores de riesgo cardiometabólico representado por obesidad central, dislipidemia, hipertensión arterial y glucosa alterada, se ha evidenciado que el consumo adecuado de calcio representa una disminución del riesgo para este síndrome. Objetivo. Analizar la relación entre el consumo de calcio total, de origen animal y vegetal con el SM y sus indicadores. Materiales y métodos. Estudio transversal de eje correlacional, con una muestra de 100 adultos de la región amazónica ecuatoriana, durante el último trimestre del 2020. La ingesta dietética de calcio se determinó mediante un recordatorio de 24 horas y el SM según los criterios de Adult Treatment Panel-IV (ATP-IV). Resultados. La población estuvo conformada por adultos maduros (40 a 60 años) que evidenciaron una ingesta de calcio deficiente (182,50 mg y 228,60 mg en mujeres y hombres respectivamente). Se evidenció, además, una relación directamente proporcional entre la circunferencia abdominal (r=0,391 ­ p=0,000), presión arterial sistólica (r=0,290 ­ p=0,000) y glucosa en ayuno (r=0,326 ­ p=0,000) con la edad. La ingesta de calcio total se relacionó positivamente con los triglicéridos, (r=0,221 ­ p=0,027). Conclusiones. La ingesta dietética de calcio en ambos sexos no alcanza el requerimiento diario y se relaciona positivamente con los triglicéridos(AU)

Introduction. The Metabolic Syndrome (MS) comprises a set of cardiometabolic risk factors represented by central obesity, dyslipidemia, high blood pressure and altered glucose, it has been shown that adequate calcium intake represents a decreased risk for this syndrome. Objective. To analyze the relationship between the consumption of total calcium, animal and vegetable origin, with MS and its indicators. Materials and methods. Cross-sectional study of correlational axis, with a sample of 100 adults from the Ecuadorian Amazon region, during the last quarter of 2020. Dietary calcium intake was determined through a 24-hour recall and the diagnosis of MS according to the Adult Treatment Panel- IV (ATP-IV) criteria. Results. The population consisted of mature adults (40 to 60 years) who showed a deficient calcium intake in both sexes (182.50 mg and 228.60 mg in women and men respectively). There is also evidence of a directly proportional relationship between abdominal circumference (r=0.391 - p=0.000), systolic blood pressure (r=0.290 - p=0.000) and fasting glucose (r=0.326 - p=0.000) with age. Total calcium intake was positively related to triglycerides (r=0.221 ­ p=0.027). Conclusions. Calcium dietary intake in both sexes does not reach the daily requirement and is positively related to triglycerides(AU)

Evaluation of ultrasonographic approaches aimed at determining distinct abdominal adipose tissue depots

ABSTRACT Objective: To analyze different anatomical sites in the abdominal region, in order to determine the positional parameter that identifies a higher level of visceral adipose tissue (VAT) and confers a greater cardiometabolic risk. Materials and methods: This is a methodological study in which VAT was evaluated by ultrasonography (USG) in three anatomical sites in the abdomen, while the abdominal circumference (AC) was measured using seven different protocols. Additionally, the glycemic and lipid profile, C-reactive protein, and the presence of systemic arterial hypertension were evaluated. Results: One hundred and six individuals with an average age of 42 (36.8-46.2) years were included. The evaluation of the calibration of the ultrasound procedure for the analysis of VAT by intra- and inter-evaluators showed high reproducibility. The pattern of abdominal fat distribution differed between sexes, with higher mean VAT in males (p < 0.05) and higher mean SAT (subcutaneous adipose tissue) in females (p < 0.005). In the abdominal scan applied to women, higher levels of VAT and lower levels of SAT were observed in the narrower waist region, between the iliac crest and the last rib (p < 0.001). In males, the profile of adipose disposition along the abdomen was uniform (p > 0.05). Correlations between VAT measured by USG and cardiometabolic parameters were relatively stronger in the upper abdomen (p < 0.05). Conclusion: Women accumulate more VAT in the narrower waist region, while men accumulate VAT uniformly across the abdomen. There was relative superiority in predicting cardiometabolic risk in the upper abdomen for both sexes.

Avaliação Nutricional de Pacientes com Esquizofrenia dos Centros de Atenção Psicossocial do Extremo Sul Catarinense: Uma Série de Casos / Nutritional Assessment of Patients with Schizophrenia from Psychosocial Care Centers in the Extreme South of Santa Catarina State: a Case Series

Introdução: Análises corporais mais específicas mostram que pacientes com esquizofrenia também apresentam uma porcentagem de gordura mais elevada quando comparado a indivíduos saudáveis. O objetivo deste trabalho foi caracterizar os pacientes de acordo com as variáveis sociodemográficas e clínicas, estado nutricional e risco cardiovascular de pacientes com esquizofrenia. Métodos: Estudo transversal com 26 pacientes com diagnóstico de esquizofrenia nos Centros de Atenção Psicossocial das cidades de Criciúma/SC, e de Siderópolis/ SC, e com os pacientes com esquizofrenia da Farmácia Escola da Universidade do Extremo Sul Catarinense. Verificaram-se variráveis sociodemográficas, clínicas, medidas antropométricas (peso, estatura, circunferência abdominal, razão cintura-quadril, avaliação combinada, percentual de gordura corporal) e a classificação da pressão arterial. A amostra constituiu-se de 26 indivíduos, 50% homens e 50% mulheres, e a idade média foi de 42,4 anos. Cerca de 50% utilizavam antipsicóticos de primeira geração, 23,1%, antipsicóticos de segunda geração e 26,9%, ambos. A maior parte dos indivíduos encontrava-se com estado nutricional alterado, sendo que 42,3% com obesidade pelo Índice de Massa Corporal e 61,5% com a circunferência abdominal acima do desejado. Os resultados da razão cintura-quadril mostraram que 76,9% dos indivíduos estavam com risco aumentado para doenças cardiovasculares e obesidade, e 73,1% apresentaram excesso de gordura corporal. Parâmetros de estado nutricional e risco cardiovascular estiveram associados, indicando a necessidade do uso destes de forma conjunta. Conclusão: Faz-se necessário monitorar a situação nutricional e de saúde desses indivíduos para melhoria dos cuidados prestados, com promoção de atenção nutricional em um contexto multiprofissional.

Introduction: More specific body analyses show that patients with schizophrenia also have a higher fat percentage when compared to healthy individuals. This study aimed to characterize patients according to sociodemographic and clinical variables, nutritional status, and cardiovascular risk of patients with schizophrenia. Methods: Cross-sectional study with 26 patients diagnosed with schizophrenia in the Psychosocial Care Centers of the cities of Criciúma and Siderópolis and with patients with schizophrenia from the Pharmacy School of the Universidade do Extremo Sul Catarinense. We verified sociodemographic and clinical variables, anthropometric measurements (weight, height, abdominal circumference, waist-to-hip ratio, combined assessment, body fat percentage), and blood pressure classification. The sample consisted of 26 individuals, 50% male and 50% female, and the mean age was 42.4 years. About 50% used first-generation antipsychotics, 23.1% second-generation antipsychotics, and 26.9% both. Most individuals had altered nutritional status, 42.3% were obese according to the Body Mass Index, and 61.5% had abdominal circumference above the desired range. The results of the waist-to-hip ratio showed that 76.9% of the individuals were at increased risk for cardiovascular diseases and obesity, and 73.1% had excess body fat. Parameters of nutritional status and cardiovascular risk were associated, indicating the need to use them together. Conclusion: It is necessary to monitor the nutritional and health status of these individuals to improve the care provided, promoting nutritional care in a multidisciplinary context,

Risk Factors for Intrapartum Cesarean Section Delivery in Low-risk Multiparous Women Following at Least a Prior Vaginal Birth (Robson Classification 3 and 4)

Abstract Objective The aim of the present study was to evaluate the risk factors for cesarean section (C-section) in low-risk multiparous women with a history of vaginal birth. Methods The present retrospective study included low-risk multiparous women with a history of vaginal birth who gave birth at between 37 and 42 gestational weeks. The subjects were divided into 2 groups according to the mode of delivery, as C-section Group and vaginal delivery Group. Risk factors for C-section such as demographic characteristics, ultrasonographic measurements, smoking, weight gain during pregnancy (WGDP), interval time between prior birth, history of macrosomic birth, and cervical dilatation at the admission to the hospital were obtained fromthe charts of the patients. Obstetric and neonatal outcomes were compared between groups. Results The most common C-section indications were fetal distress and macrosomia (33.9% [n=77 and 20.7% [n=47] respectively). A bivariate correlation analysis demonstrated that mothers aged>30 years old (odds ratio [OR]: 2.09; 95% confidence interval [CI]: 1.30-3.34; p=0.002), parity >1 (OR: 1.81; 95%CI: 1.18-2.71; p=0.006), fetal abdominal circumference (FAC) measurement>360mm (OR: 34.20; 95%CI: 8.04 -145.56; p<0.001)) and<345mm (OR: 3.06; 95%CI: 1.88-5; p<0.001), presence of large for gestational age (LGA) fetus (OR: 5.09; 95%CI: 1.35-19.21; p=0.016), premature rupture of membranes (PROM) (OR: 1.52; 95%CI: 1-2.33; p=0.041), and cervical dilatation<5cm at admission (OR: 2.12; 95%CI: 1.34-3.34; p=0.001) were associated with the group requiring a C-section. Conclusion This is the first study evaluating the risk factors for C-section in low-risk multiparous women with a history of vaginal birth according to the Robson classification 3 and 4. Fetal distress and suspected fetal macrosomia constituted most of the Csection indications.

Cardiovascular Risk Factors in Patients with Chronic Kidney Disease Under Conservative Treatment

Abstract Background Cardiovascular disease (CVD) is commonly associated with chronic kidney disease (CKD). These diseases have a significant impact on life expectancy. Individuals with CKD are more likely to die from CVD than to progress to end-stage kidney disease. Objective To assess cardiovascular risk factors of patients with CKD under conservative treatment. Methods This was an observational, cross-sectional study. Socioeconomic, anthropometric, biochemical, and physical inactivity data were assessed, and 10-year risk for CVD were estimated using the Framingham Score in patients with CKD under conservative treatment. For statistical analysis, the Student's t-test and Pearson's chi-square test were performed. Results A total of 172 individuals were evaluated, 57% of whom were male, with an average age of 68.85 ± 11.41 years. The prevalence of hypertension and diabetes were 87.2% and 53.5%, respectively; 62.2% were physically inactive; 9.9% of men were smokers and 12.8% consumed alcohol. According to BMI, 82.4% of adults <60 years old and 60.6% of those older than 60 years were overweight. High waist circumference and a high waist-hip ratio were highly prevalent in females (91.9% and 83.8%, respectively) and males (64.3% and 39.8%, respectively); 92.4% had a high body fat percentage and 73.3% high uric acid levels. According to the Framingham score, 57% have a medium or high risk of developing CVD in 10 years. Conclusion There was a high prevalence of cardiovascular risk factors in the population studied. The assessment of cardiovascular risk factors in patients with CKD makes it possible to guide the conduct of health professionals to prevent mortality from cardiovascular causes. Int J Cardiovasc Sci. 2020; [online].ahead print, PP.0-0

Use of biometrics in the prediction of body weight in crossbred lambs / [Uso da biometria na predição do peso corporal de cordeiros mestiços]

O objetivo deste trabalho foi propor um modelo matemático para predição do peso corporal de cordeiros com base nas medidas biométricas. Foram utilizados dados de 51 cordeiros, com composição genética de pelo menos 50% da raça Santa Inês. O peso corporal (PC) dos animais foi acompanhado durante 91 dias por meio de pesagens semanais. Após as pesagens, foram tomadas as medidas: altura anterior (AA); altura posterior (AP); comprimento corporal (CC); largura de peito (LP); largura de garupa (LG); perímetro torácico (PT) e perímetro de barril (PB). Essas medidas foram utilizadas como variáveis de entrada do modelo. Foi observado correlações positivas e significativas (P<0,05) entre todas as variáveis biométricas com o PC. No entanto, o PC apresentou uma alta correlação com o PT (0,836), seguido do PB (0,818) e AP (0,740). Dessa forma, essas três medidas foram significativas para estimativa do PC. Portanto, o modelo para predizer o PC dos cordeiros foi: Peso (kg)=0,4455* PT - 0,5794 * PB + 0,0019 * AP2 + 0.0053* PB2. O perímetro torácico, perímetro de barril e altura de posterior podem ser utilizados como variáveis preditoras do peso corporal em ovinos mestiços, independente do sexo.(AU)

Agreement analysis between sonographic estimates and birth weight, by the WHO and intergrowth-21st tables, in newborns of diabetic mothers / Análise de concordância entre estimativas ultrassonográficas e peso ao nascer, pelas tabelas da OMS e Intergrowth-21st, em recém-nascidos de mães diabéticas

Abstract Objective To analyze the agreement, in relation to the 90th percentile, of ultrasound measurements of abdominal circumference (AC) and estimated fetal weight (EFW), between the World Health Organization (WHO) and the International Fetal and Newborn Growth Consortium for the 21st Century (intergrowth-21st) tables, as well as regarding birth weight in fetuses/newborns of diabetic mothers. Methods Retrospective study with data from medical records of 171 diabetic pregnant women, single pregnancies, followed between January 2017 and June 2018. Abdominal circumference and EFW data at admission (from 22 weeks) and predelivery (up to 3 weeks) were analyzed. These measures were classified in relation to the 90th percentile. The Kappa coefficient was used to analyze the agreement of these ultrasound variables between the WHO and intergrowth-21st tables, as well as, by reference table, these measurements and birth weight. Results The WHO study reported 21.6% large-for-gestational-age (LGA) newborns while the intergrowth-21st reported 32.2%. Both tables had strong concordances in the assessment of initial AC, final AC, and initial EFW (Kappa = 0.66, 0.72 and 0.63, respectively) and almost perfect concordance in relation to final EFW (Kappa = 0.91). Regarding birth weight, the best concordances were found for initial AC (WHO: Kappa = 0.35; intergrowth-21st: Kappa= 0.42) and with the final EFW (WHO: Kappa = 0.33; intergrowth- 21st: Kappa = 0.35). Conclusion The initial AC and final EFW were the parameters of best agreement regarding birth weight classification. The WHO and intergrowth-21st tables showed high agreement in the classification of ultrasound measurements in relation to the 90th

Resumo Objetivo Analisar a concordância, em relação ao percentil 90, das medidas ultrassonográficas da circunferência abdominal (CA) e peso fetal estimado (PFE), entre as tabelas da Organização Mundial de Saúde (OMS) e do International Fetal and Newborn Growth Consortium for the 21st Century integrowth-21st, bem como em relação ao peso ao nascer em fetos/recém-nascidos de mães diabéticas. Métodos Estudo retrospectivo com dados de prontuários de 171 gestantes diabéticas, com gestações únicas, seguidas entre Janeiro de 2017 e Junho de 2018. Foram analisados dados da CA e do PFE na admissão (a partir de 22 semanas) e no pré-parto (até 3 semanas). Essas medidas foram classificadas em relação ao percentil 90. O coeficiente Kappa foi utilizado para analisar a concordância entre as tabelas da OMS e Intergrowth-21st, assim como, por tabela de referência, entre as medidas e o peso ao nascer. Resultados O estudo da OMS relatou 21,6% dos recém nascidos grandes para a idade gestacional (GIG) enquanto que o estudo do intergrowth-21st relatou 32,2%. Ambas as tabelas tiveram fortes concordâncias na avaliação da CA inicial e final e PFE inicial (Kappa= 0,66, 0,72 e 0,63, respectivamente) e concordância quase perfeita em relação ao PFE final (Kappa= 0,91).Emrelação ao peso ao nascer, asmelhores concordâncias foram encontradas para aCAinicial (OMS: Kappa= 0,35; intergrowth-21st: Kappa= 0,42) e como PFE final (OMS: Kappa = 0,33; intergrowth-21st: Kappa= 0,35). Conclusão A CA inicial e o PFE final foram os parâmetros de melhor concordância em relação à classificação do peso ao nascer. As tabelas da OMS e intergrowth-21st mostraram alta concordância na classificação das medidas ultrassonográficas em relação ao percentil 90. Estudos são necessários para confirmar se alguma dessas tabelas é superior na previsão de resultados negativos a curto e longo prazo no grupo GIG.

Prevalencia de acantosis nigricans y factores asociados con el síndrome metabólico en Nobsa (Boyacá, Colombia) / Prevalence of Acanthosis Nigricans and Associated Factors to Metabolic Syndrome in Nobsa (Boyacá, Colombia) / Prevalência de acantose nigricans e fatores associados com a síndrome metabólica em Nobsa (Boyacá, Colômbia)

Introducción: El síndrome metabólico es un conjunto de anormalidades fisiológicas que manifiestan resistencia a la insulina, de la que se derivan complicaciones micro y macrovasculares de alto costo en salud. Objetivo: Estimar la prevalencia de la acantosis nigricans y los factores sociodemográficos asociados en una pobla-ción con síndrome metabólico del municipio de Nobsa (Boyacá, Colombia) en el periodo agosto de 2017-agosto de 2018. Método: Estudio transversal analítico en una muestra de 82 pacientes del programa de crónicos del municipio de Nobsa. Se recolectó información sobre la presencia o ausencia de acantosis nigricans en la exploración física, junto con medidas antropométricas, fototipo de piel y presión arterial; así como concentración sérica de glucosa en ayuno, creatinina y perfil lipídico. Los datos se analizaron mediante la prueba de chi cuadrado. Resultados: En una muestra de 82 pacientes con edad media de 62 años, de los cuales el 91 % fueron mujeres, se encontró una prevalencia de acantosis nigricans del 41,5 % con asociación estadísticamente significativa para niveles elevados de glucosa (p = 0,008) y un odds ratio de 3,75 (IC95 %: 1,3-10,2). Para las demás variables en estudio no se evidenció asociación con significancia estadística. Conclusiones: la acantosis nigricans es un signo clínico indicador de resistencia a la insulina y de niveles alterados de glucemia

Introduction: The metabolic syndrome is a set of physiological abnormalities that manifest insulin resistance, from which high cost micro- and macrovascular complications in health derive. Objective: To estimate the prevalence of acanthosis nigricans and the sociodemographic factors asso-ciated with the population with metabolic syndrome in the municipality of Nobsa (Boyacá, Colombia), from August 2017 to August 2018. Method: Analytical cross-sectional study in a sample of 82 patients from the Nobsa municipality chronic program. Information was collected on the presence or absence of acanthosis nigricans in the physical examination together with anthropometric measurements, skin phototype and blood pres-sure, as well as serum concentration of fasting glucose, creatinine, and lipid profile. The data were analyzed using the Chi square test. Results: In a sample of 82 patients with a mean age of 62 years, of which 91% were women, a pre-valence of acanthosis nigricans of 41.5% was found with a statistically significant association for high glucose levels (p = 0.008) and an Odds Ratio of 3.75 (95% CI: 1.3-10.2). For the other variables under study, no association with statistical significance was evidenced. Conclusions: Acanthosis nigricans is a clinical sign of insulin resistance and altered blood glucose levels

Introdução: A síndrome metabólica é um conjunto de anomalias fisiológicas que manifestam resis-tência à insulina, da qual derivam complicações micro e macro vasculares de alto custo em saúde. Objetivo: Estimar a prevalecia de acantose nigricans e os fatores sociodemográficos associados, a uma população com síndrome metabólica no município de Nobsa (Boyacá, Colômbia) no período de Agosto de 2017 ­ Agosto de 2018. Método: Estudo analítico transversal com uma amostra de 82 pacientes do Programa de crónicos no município de Nobsa. Foram recolhidas informações sobre a presença ou ausência de acantose nigri-cans no exame físico, juntamente com medições antropométricas, fotótipo de pele e pressão sanguí-nea; bem como a concentração sérica da glicose em jejum, creatinina e perfil lipídico. Os dados foram analisados utilizando o teste do qui-quadrado. Resultados: Uma amostra de 82 pacientes com idade meia de 62 anos, 91 % dos quais eram mulhe-res, foi identificada uma prevalência de acantose nigricans de 41,5 % com associação estatisticamente significativa para níveis elevadas de glicose (p = 0,008) e um odds ratio de 3,75 (IC95 %: 1,3-10,2). Para as outras variáveis em estudo, não foi evidenciada associação estatisticamente significativa. Conclusões: A acantose nigricans é um sinal clinico indicador de resistência à insulina e níveis eleva-dos de glicose no sangue

Waist Circumference Above 80 cm Predicts Increased Systolic Blood Pressure in Healthy Young Adult Women

Abstract Background: Among anthropometric measures for assessing adiposity-related risk, waist circumference (WC) is simple and fast to perform. Cut-off values for WC proposed by the International Diabetes Federation (IDF), and the Adult Treatment Panel III of the National Cholesterol Education Program (NCEP-ATP III) are categorized by gender and are not age-specific. Objective: To analyze the association between WC and cardiometabolic risk factors in adult women. Methods: A total of 164 healthy adult women were grouped by WC according to IDF and NCEP-ATP III cutoff values. Continuous variables were described as mean ± standard deviation or median (interquartile range). The Shapiro-Wilk test was used to assess the normality of data. Variables were analyzed by unpaired Student's t-test, Mann-Whitney U and Kruskal-Wallis tests. The correlation of WC categories with systolic (SBP) and diastolic (DBP) blood pressure, fasting blood glucose, high-density lipoprotein cholesterol (HDL-c), and triglycerides were examined by Spearman's rho correlation coefficient and linear regression analysis. A p value < 0.05 was considered statistically significant. Results: Increased WC showed a significant correlation with SBP, DBP, glucose, HDL-c, and triglycerides. In bivariate linear regression, approximately 63.0 % of the variability of SBP (≥ 130 mmHg) among the age group 20-40 years was predicted by increased WC according to both criteria. Conclusion: A WC above 80 cm in women aged 20-40 years strongly predicted variability in SBP, calling attention to the importance of measuring WC for the monitoring and prevention of cardiovascular and metabolic diseases in women in this age group.

Variáveis antropométricas em pacientes hipertensos e/ou diabéticos cadastrados em um programa hiperdia / Anthropometric variables in hypertensive and/or diabetic patients registered in a hyperdia program

Objetivo: Analisar o Índice de Massa Corporal (IMC) e Circunferência Abdominal (CA) em pacientes cadastrados no Programa Hiperdia de uma Unidade Básica de Saúde no município de Santarém ­ PA. Metodologia: Estudo quantitativo, descritivo e analítico em uma Unidade Básica de Saúde da Família de Santarém-Pará. Foram coletados dados antropométricos (altura, peso e circunferência abdominal) de 66 pacientes atendidos pelo programa Hiperdia no período de 10 a 17 de Outubro de 2017 após aprovação pelo Comitê de Ética. A análise estatística foi feita por meio do software Bioestat 5.3®. Resultados: Os resultados demonstraram prevalência do gênero feminino (72,7%) e de idosos (54,5%). 65,2% estavam com sobrepeso ou obesidade pela análise do IMC. Foi constatado, também, que 75,8% dos pacientes apresentaram uma circunferência abdominal inadequada. A análise estatística revelou associação significativa entre idade e IMC, sendo os pacientes abaixo de 60 anos com maior risco de sobrepeso e obesidade, e entre gênero e circunferência abdominal inadequada, sendo as mulheres mais susceptíveis. Conclusão: Maior parte da população estudada apresenta anormalidades nas variáveis antropométricas. Ocorreu, portanto, educação em saúde orientando a respeito do alto risco advindo das doenças crônicas não transmissíveis e a sua associação com o excesso de peso.

Objective: to analyze Body Mass Index (BMI) and Abdominal Circumference (AC) in patients registered in Hyperdia program of the Family Health Unit - Uruará in the city of Santarém ­ PA. Methodology: it is a quantitative, descriptive and analytical study in a Family Health Unit in Santarém-Pará. Anthropometric data (height, weight and waist circumference) were collected from 66 patients treated by the Hiperdia program from October 10 to 17, 2017 after approval by the Ethics Committee. Statistical analysis was performed using the Bioestat 5.3® software. Results: The result analysis a prevalence of women (72,7%) and a higher percentage of elderly (54,5%). 65,2% of the patients have overweight or obesity by the BMI analysis. It was also found that 75,8% of patients have an inappropriate AC. Statistical analysis showed significant association between age and BMI, in which Patients under 60 years old have more chances to be in an inappropriate BMI, and between genre and AC, which women tend to be in an inappropriate AC classification. Conclusion: Most of the studied population has abnormalities in anthropometric variables. Therefore, health education took place advising on the high risk that comes from non-transmissible chronical diseases and its association with overweight.

Índice cintura talla un marcador de obesidad visceral relacionado a cistitis no complicada / Index Waist Size A Visceral Obesity Marker Related To Non-Complicated Cystitis

Objetivo: Determinar la relación entre el índice cintura-talla y la presencia de cistitis no complicada en los pacientes de consulta externa en un centro de atención primaria de Lima en el año 2018. Métodos: Se realizó un diseño observacional analítico, tipo casos y controles. Con una muestra de 131 casos y 131 controles, por muestreo aleatorio simple, sometidos a criterios de selección. Se revisó historias clínicas para la obtención retrospectiva de los datos. Se calculó el Odds Ratio como medida de asociación. Resultados: La media del índice cintura talla para cistitis no complicada fue de 61,91 ± 6.39 para los casos y 58.12 ± 3.87 para los controles. Se encontró asociación estadísticamente significativa entre la presencia de cistitis y el índice- cintura talla (OR 5,27; IC95% 3,10 ­ 8,95; p <0,001). Asimismo, se encontró asociación con el perímetro abdominal (OR 2,11 IC 95% 1,26 ­ 3,55; p=0,005) e IMC (OR 2,02; IC95% 1,20 ­ 3,37; p=0,007). Conclusión: El índice cintura talla tuvo una fuerte asociación con la presencia de cistitis no complicada. Se sugieren estudios prospectivos para corroborar la asociación entre marcadores de obesidad visceral y el desarrollo de infección de tracto urinario.

Objective: The aim of this study was to determine the association between waist to height ratio and uncomplicated cystitis in a primary health care center in Lima, during the year 2018. Methods: We conducted an observational, analytical, case-control study, in which a total of 131 cases and 131 controls were obtained by simple random sample, applying exclusion and inclusion criteria. Retrospective recollection of the data was performed using the medical record of each selected patient. Odds ratio was calculated to measure the strength of association. Results: the waist to height ratio mean for uncomplicated cystitis was 61,9 ± 6.39 and 58.12 ± 3.87 for the controls. We found an statistical significant association between uncomplicated cystitis and waist to height ratio (OR 5,27; 95%CI 3,10 ­ 8,95; p <0,001). Waist circumference (OR 2,11 95%CI;1,26 ­ 3,55; p=0,005) and body mass index (OR 2,02; 95%CI 1,20 ­ 3,37; p=0,007) were also associated. Conclusion: we found a strong association between waist to height ratio and uncomplicated cystitis, prospective studies are suggested to confirm the association between visceral obesity and the appearance of urinary tract infections

Evaluación del dolor y la distensión abdominal según el agente insuflante (CO 2 frente al aire) en una unidad de endoscopia digestiva avanzada de Manizales, Colombia / Comparison of abdominal pain and distention due to insufflation with CO 2 versus insufflation with air in an advanced digestive endoscopy unit in Manizales, Colombia

Resumen Objetivo: comparar la magnitud del dolor y el perímetro abdominal; la incidencia del dolor y la distensión abdominal, y las complicaciones según el agente insuflante utilizado. Pacientes y método: estudio prospectivo analítico de cohorte. Se recolectaron datos de 43 colangiopancreatografías retrógradas endoscópicas (CPRE) y 20 colonoscopias insufladas con dióxido de carbono (CO2); para cada una se buscó un examen control con aire ambiente. En total, se sumaron 86 CPRE y 40 colonoscopias. Además, se realizó una caracterización clínica, un análisis bivariado y multivariado. Resultados: el procedimiento más doloroso fue la colonoscopia; sin embargo, el 60 % de los pacientes de colonoscopia, y el 70 % de aquellos de CPRE, no presentaron dolor 15 minutos después de haber despertado luego del examen. Asimismo, no se hallaron diferencias estadísticamente significativas según la indicación del examen, la presencia o intensidad de dolor al momento del procedimiento, la edad, el sexo o el diagnóstico. El riesgo relativo (RR) de dolor inmediato fue 4,8 veces superior, cuando la insuflación se realizó con aire en vez de CO2 (RR = 4,8; intervalo de confianza [IC], 95 %: 2,3 a 9,2; p <0,001). Entre tanto, el riesgo de distensión abdominal en el grupo con aire fue 2,6 veces superior, en comparación con el grupo insuflado con CO2 (RR = 2,6; IC, 95 %: 1,8 a 3,9; p <0,001). El CO2 redujo la probabilidad y la magnitud de la distensión abdominal y de los dolores inmediatos, posteriores a la colonoscopia o a la CPRE. No hubo complicaciones en ninguno de los 126 pacientes. Conclusiones: el dolor y la distensión abdominal se presentan con menor frecuencia e intensidad cuando se usa CO2 como agente insuflante. Ninguno de los procedimientos presentó complicaciones mayores.

Abstract Objective: This study compares the incidence of abdominal pain and distension, the magnitude of pain, abdominal perimeter, and related complications related to two different insufflating agents. Patients and Method: Prospective analytical cohort study. Data were collected from 43 performances of endoscopic retrograde cholangiopancreatography (ERCPs) and 20 colonoscopies in which patients were insufflated with CO2. A control examination using ambient air for insufflation was performed for each patient. In total, 86 ERCPs and 40 colonoscopies were performed. The study includes clinical characterizations, bivariate analysis and multivariate analysis. Results: The most painful procedure was colonoscopy, but 60% of colonoscopy patients and 70% of ERCP patients had no pain 15 minutes after waking up following their examinations. No statistically significant differences related to reasons for examination, presence or intensity of pain at the time of the procedure, age, sex or diagnosis were found. The relative risk (RR) of immediate pain is 4.8 times higher when insufflation is done with air instead of CO2 (RR = 4.8; 95% CI: 2.3 to 9.2; p <0.001). The risk of abdominal distension in the air group was 2.6 times higher than that of the group insufflated with CO2 (RR = 2.6; 95% CI: 1.8 to 3.9; p <0.001). CO2 reduces the likelihood and extent of abdominal distension and immediate post colonoscopy or ERCP pain. There were no complications in any of the 126 patients. Conclusions: Abdominal pain and bloating occur less frequently and less intensely when CO2 is used as an insufflating agent. None of the procedures presented major complications.

Fetal growth in low-risk Indian population at a tertiary centre and its comparison with INTERGROWTH-21 standards: a prospective cohort study

Background: The objective of this study was to compare the fetal growth pattern in low risk Indian population with the INTERGROWTH-21 standards.Methods: Low risk women were enrolled at 10 to 20 weeks of gestation and followed up until delivery. An experienced operator performed abdominal ultrasound every 5±1 week and measured biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur length (FL) of the fetus. Newborn anthropometric measurements were taken within 12 hours of childbirth.Results: A total of 126 healthy women, enrolled at mean gestation of 16.8±1.6 weeks, completed the follow up until delivery. None of the participants developed any major obstetric or medical morbidity. The study subjects showed lower mean z scores for BPD (-0.7±1.3), HC (-0.4±1.3) and AC (-0.4±1.3) but a higher mean z-score for FL (0.3±1.7) as compared to INTERGROWTH-21 standards. From 1st through 5th visit, the z scores for BPD and HC improved whereas declined for AC and FL.Conclusions: The fetal growth in non-affluent healthy Indian women had a lower fetal growth compared to INTERGROWTH-21 standards.

Medidas abdominais adicionais são uma ferramenta útil para avaliar a composição corporal em mulheres obesas / Additional abdominal measurements are a useful tool to evaluate body composition in obese women

ABSTRACT BACKGROUND: During weight gain, most of the excess adipose tissue accumulates in the trunk. This alters the body shape and makes collection of anthropometric measurements, especially waist circumference (WC), difficult. OBJECTIVE: To evaluate the sensitivity and applicability of additional abdominal measurements in order to assess body composition of obese women. METHODS: A total of 30 women between 20 and 50 years of age and BMI above 30 kg/m² were assessed. Three WC measurements, were performed: at the umbilical scar designated as WC1 and at 8 and 16 cm above the umbilical scar, designated as WC2, and WC3 respectively. The correlation (r) between these anthropometric measurements and their sum was assessed against the parameters fat mass (FM), free fat mass (FFM), body fat percentage (%BF), and trunk fat percentage (%TF), obtained by total and trunk segmental bioelectric impedance analysis (BIA) as well as by the golden standard total and trunk dual energy X-ray absorptiometry (DXA). RESULTS: The measurements WC1, WC2, WC3, and their sum correlated strongly and moderately with the parameters FM, FFM, and %BF in total BIA and in both total DXA and trunk DXA. CONCLUSION: The results demonstrated a robust correlation between the sum of the three WC measurements and total and trunk DXA in obese women suggesting that such measurements may be a good indicator of body and trunk fat in women, actually superior to BIA results. The use of these three measurements may be an alternative for the assessment of body and trunk fat, in those cases in which the body shape due to adipose tissue trunk accumulation makes accurate classical measurement (WC1) difficult.

RESUMO CONTEXTO: O acúmulo de tecido adiposo excessivo no ganho de peso se dá em maior proporção no segmento do tronco, leva à alteração dos formatos corporais dificultando a tomada de medidas antropométricas, em especial a circunferência abdominal (CA). OBJETIVO: Avaliar a sensibilidade de medidas adicionais na região abdominal, considerando cada medida individualmente e sua somatória, e a aplicabilidade dessas medidas na avaliação da composição corporal de mulheres obesas. MÉTODOS: Foram avaliadas 30 mulheres com idade entre 20 e 50 anos e IMC acima de 30 kg/m² com a realização de três medidas de CA denominadas: CA1 padronizada na cicatriz umbilical, CA2 a 8 cm acima da cicatriz umbilical e CA3 a 16 cm acima da cicatriz umbilical. Foi avaliada a correlação (r) destas medidas antropométricas e de sua somatória com os parâmetros massa gorda (MG), massa livre de gordura (MLG), porcentagem de gordura corporal (%GC) e do tronco (%GT) obtidos por impedância bioelétrica (BIA) total e segmentar do tronco e por absorciometria de raios-X de dupla energia (DXA) total e do tronco, como padrão ouro. RESULTADOS: As medidas CA1, CA2, CA3 e a somatória das três tiveram correlação forte e moderada com os parâmetros MG, MLG e %GC tanto para BIA total como para DXA total e DXA do tronco. CONCLUSÃO: Os resultados deste estudo mostram forte correlação entre a soma das medidas de três pontos no abdome com DXA de tronco e total, em mulheres obesas, sugerindo serem estas medidas, um bom indicador de gordura corporal e de gordura da região do tronco, superior aos resultados obtidos por BIA. O uso dessas três medidas pode ser um indicador alternativo de avaliação da gordura corporal e de tronco, nos casos em que o formato corporal de acúmulo de gordura na região do tronco, dificultar a acurácia da medida clássica (CA1).

Estimation of gingival blood glucose using a sensitive self-monitoring device in periodontitis patients

Background: Diabetes Mellitus is a complex disease with varying degree of systemic and oral complications. The prognosis is quite favorable if a disease is diagnosed in early stages. Since a large number of patients seek dental treatment routinely, screening procedures for early detection of subclinical cases can help in diagnosis of asymptomatic diabetes. Aim: The present study was undertaken to evaluate if gingival crevicular blood can be used for the estimation of blood glucose levels in periodontitis patients. Material and Methods: A prospective study was carried out comprising 150 patients Group A comprised of 75 subjects with gingivitis and group B comprised of 75 subjects with periodontitis. For gingival crevicular blood glucose (GCBG) level estimation, the blood was drawn onto the glucometer strip after gently probing the gingival sulcus and the readings were recorded. At the same time, blood Vijayendra Pandey, Akhilesh Chandra, Deepak Kumar, Anup Kumar Singh, Priyankesh, Alok Kumar Gupta. Estimation of gingival blood glucose using a sensitive self-monitoring device in periodontitis patients. IAIM, 2019; 6(6): 51-56. Page 52 was also collected from the index finger onto the glucometer strip for the capillary finger-prick blood glucose (CFBG) sample. Both the values were compared and statistical analysis of data was performed. Results: The mean GCBGL and CFBGL in group A was 98.43 mg/dl ± 18.62 and 103.48 mg/dl ± 13.90 respectively, while in group B it was 136.37 mg/dl ± 36.95 and 141.62 mg/dl ± 51.84, respectively. There was no statistically significant difference (p> 0.05) between the two values in both the groups. Conclusion: It can be concluded that GCBG levels are positively correlated with CFBG levels. Therefore, clearly indicating that gingival crevicular blood collected during diagnostic periodontal examination may be an excellent source of blood sample for glucometric analysis.