Evaluación de la condición física en poblaciones de 6 a 14 años de México y Cuba

El presente estudio constituye un trabajo trascendente en el área del conocimiento de la condición física y representa el resultado de investigaciones realizadas en la República de Cuba y en los Estados Unidos Mexicanos como respuesta a la solicitud de ambos países. Fue diseñado estadísticamente, para representar datos oficiales y altamente confiables, con el objetivo de conocer el estado de la condición física de las dos naciones y valorar así, el efecto de los programas de Educación Física que se aplican. Se contó con el apoyo de las organizaciones deportivas y de cultura física al conformar los estudios, cuidadosamente tratados en el diseño de muestra, para ello se contó con un equipo de estadísticos especialistas que tuvieron a su cargo el procesamiento de la información. Los datos de este estudio se consideraron limitados para la publicación y una vez desclasificados se dan conocer. Se utilizaron iguales metodologías en su aplicación, lo que resulta una información valiosa para el perfeccionamiento de los planes y programas que en el campo de la Licenciatura en Cultura Física y se brinda una información que, en su comparación, llama a la reflexión de los especialistas de Educación Física, para continuar el perfeccionamiento de estas especialidades, en general.

O presente estudo constitui um trabalho transcendental na área do conhecimento da aptidão física e representa o resultado de uma pesquisa realizada na República de Cuba e nos Estados Unidos Mexicanos em resposta à solicitação de ambos os países. Foi projetado estatisticamente para representar dados oficiais e altamente confiáveis, com o objetivo de conhecer o estado da aptidão física em ambos os países e, assim, avaliar o efeito dos programas de Educação Física aplicados. As organizações esportivas e de cultura física foram apoiadas na elaboração dos estudos, cuidadosamente tratadas no desenho da amostra, com a ajuda de uma equipe de estatísticos especializados que foram responsáveis pelo processamento das informações. Os dados deste estudo foram considerados limitados para publicação e, uma vez desclassificados, são tornados públicos. Foram utilizadas as mesmas metodologias em sua aplicação, o que resulta em informações valiosas para o aprimoramento dos planos e programas no campo da cultura física e fornece informações que, em sua comparação, exigem a reflexão dos especialistas em educação física, a fim de continuar o aprimoramento dessas especialidades em geral.

The present study constitutes a transcendent work in the area of knowledge of physical condition and represents the result of research carried out in the Republic of Cuba and in the United Mexican States in response to the request of both countries. It was designed statistically, to represent official and highly reliable data, with the objective of knowing the state of the physical condition of the two nations and thus evaluating the effect of the Physical Education programs that are applied. It was had the support of sports and physical culture organizations when forming the studies, carefully treated in the sample design, for this it was had a team of specialist statisticians who were in charge of processing the information. The data from this study was considered limited for publication and will be released once declassified. The same methodologies were used in its application, which is valuable information for the improvement of plans and programs in the field of the Bachelor's Degree in Physical Culture and information is provided that, in comparison, calls for reflection by specialists. of Physical Education, to continue the improvement of these specialties, in general.

Presión arterial en recién nacidos sanos de término y pretérmino tardío en la Ciudad de México / Blood pressure in healthy term and late preterm newborns in Mexico City

Resumen Objetivo: Describir medidas de presión arterial sistólica (PAS), diastólica (PAD) y media (PAM) en recién nacidos sanos de término y pretérmino tardío para establecer parámetros de normalidad. Método: Estudio transversal realizado en el cunero fisiológico del Hospital Español, Ciudad de México. Se incluyeron 551 pacientes recién nacidos sanos. Las tomas de PA fueron realizadas dentro de las primeras 48 horas de vida con método oscilométrico. Posterior a la evaluación de normalidad, se realizó un análisis descriptivo de la población y cálculo de percentiles (25, 50 y 75) específicos para cada semana de gestación. Todos los análisis fueron realizados en STATA v14.2. Resultados: Los recién nacidos de sexo masculino tuvieron un valor medio de PAS de 64.6 mmHg en la semana 35 de gestación, este valor aumentó a 69.8 mmHg en la semana 40. El valor de la PAD fue de 42.6 mmHg en la semana 35 de gestación, disminuyendo a 40.8 mmHg para la semana 40. Los valores medios de PAS en los recién nacidos de sexo femenino fueron de 65.5 mmHg en la semana 35, teniendo un incremento a 73.5 mmHg en la semana 40. El valor de la PAD en la semana 35 de gestación fue 38 mmHg, incrementando a 41.3 mmHg en la semana 40. Conclusiones: Los valores de PA en recién nacidos sanos se modifican con la edad gestacional y el sexo. Estos resultados pueden servir como referencia para otros médicos ubicados en países o ciudades con alturas similares a la Ciudad de México.

Abstract Objective: Describe the measurements of systolic, diastolic and mean blood pressure in healthy term and late preterm newborns to establish normal values. Methods: Cross-sectional study carried out in the nursery of the Hospital Español, located in Mexico City. A sample of 551 healthy newborns were included in the study. Blood pressure (BP) measurements were taken within the first 48 hours of life with the oscillometric method. After the evaluation of normality, a descriptive analysis of the population and calculation of percentiles (25, 50 and 75) specific for each week of gestation was performed. All analyzes were performed in STATA v14.2. Results: Male newborns had a mean SBP value of 64.6 mmHg at week 35 of gestation, this value increased to 69.8 mmHg at week 40; the systolic blood pressure (SBP) value was 42.6 mmHg at week 35 of gestation, which decreased to 40.8 mmHg at week 40. The mean SBP values in female newborns were 65.5 mmHg at week 35, increasing to 73.5 mmHg at week 40; the diastolic blood pressure (DBP) value at week 35 of gestation was 38 mmHg, increasing to 41.3 mmHg at week 40. Conclusions: The BP values in healthy newborns are modified by the gestational age and sex of the patients. These results can serve as a reference for other physicians located in countries or cities with a similar altitude than the one in Mexico City.

Detection of ocular hypertelorism among Indian children

Background & objectives: Ocular hypertelorism constitutes an important component of many clinical syndromes. It is typically recommended to use inter-pupillary distance (IPD) for objective evaluation of ocular hypo/hypertelorism. Barring infancy, there is a scarcity of data on this anthropometric parameter relating to the ocular apparatus. This study aims to study auxological dynamics of IPD in children of Indian origin. Methods: A total of 3622 ( 2239 males and, 1383 females) normal, healthy Indian children of North-western origin, aged one month to 14 yr comprised the sample for this study. Inner and outer-canthal distance were measured using standardized anthropometric techniques. None of the children who participated in this study had craniofacial dysmorphism or any body deformity. Mean (standard deviation SD) and percentiles were calculated for IPD in male and female subjects at different age levels. Results: IPD increased from 4.68±0.21 to 6.19±0.36 cm in males and from 4.59±0.26 to 6.08±0.25 cm in females between one month and 14 yr of age. Boys in general, possessed larger IPD than girls, however, the gender differences became significant (P?0.05) at 10, 11, 16-18 and 22-24 months, respectively, and five and 10 yr of age, respectively. Interpretation & conclusions: The results of this study suggest that the patients having IPD less than the 3rd percentile should be treated as cases of hypotelorism while, those exceeding 97th percentile as cases of hypertelorism. The use of percentile grids presented for IPD may be used to detect ocular hypotelorism and hypertelorism in male and female children to corroborate diagnosis of different syndromes

Situación nutricional entre los percentiles ecuatorianos y la OMS en adolescentes del 12 años / Nutritional situation between ecuadorian and who percentile in 12-year-old adolescents

Se trata de la recopilación de información sobre estudios que reflejan la situación nutricional en Ecuador, y las comparaciones entre los percentiles ecuatorianos y los que sugiere la Organización Mundial de la Salud (OMS). Estudios refieren que este tipo de comparación difiere de las realidades de un país pues presenta diferente ubicación geográfica y por sus rasgos culturales, que difieren ancestralmente se presentan divergencias entre la alimentación, estilos de vida, bases socioeconómicas, rasgos antropométricos y otras variables que influyen y que han obligado a crear sus propios estándares de comparaciones. Objetivo: Describir la situación nutricional entre los percentiles ecuatorianos y la OMS en adolescentes de 12 años. Materiales y método: Es del tipo cualitativa, descriptiva, donde se recopila información relevante vinculada al descriptor en estudio, por eso la modalidad es tipo documental y descriptiva, transversal y observacional porque se le y observa información relevante de momento y se describe y señalan procedimientos como modelos para otras investigaciones. Resultados: Ecuador como país latinoamericano refleja una situación alimentaria y nutricional de amplio potencial productivo, de grandes oportunidades y capacidades socioeconómicas, necesarios para dar respuestas a las exigencias nutricionales de su población. Sin embargo, la información sobre el estado nutricional de la población infantil refleja el desarrollo del país, con una reducción significativa de la prevalencia de retardo de crecimiento, que prevalecen mucho más en grupos indígenas, por problemas sociales: mortalidad infantil, pobreza, indigencia y analfabetismo. Conclusiones: Estimar valores de desnutrición y sobrepeso a través de comparaciones por los percentiles internacionales (WHO) y los de Estados Unidos no reflejan la realidad de una población que difiere en todo con la de esos estándares comparativos. Por ello el esfuerzo de estudios por crear sus propios estándares nacionales es loable y muestra las realidades de una población(AU)

This is the collection of information on studies that reflect the nutritional situation in Ecuador, and comparisons between Ecuadorian percentiles and those suggested by the World Health Organization (WHO). Studies report that this type of comparison differs from the realities of a country because it has different geographical location and its cultural features, which differ ancestrally, there are divergences between food, lifestyles, socioeconomic bases, anthropometric traits and other variables that influence and that have forced to create their own standards of comparisons. Objective: To describe the nutritional situation between the Ecuadorian and WHO percentiles in 12-year-old adolescents Materials and methods: It is of the qualitative, descriptive type, where relevant information linked to the descriptor in study is collected, so the modality is documentary and descriptive, transversal and observational because relevant information is observed at the moment and procedures are described and indicated as models for another research. Results: Ecuador as a Latin American country reflects a food and nutritional situation with ample productive potential, great opportunities and socioeconomic capacities, necessary to respond to the nutritional demands of its population. However, information on the nutritional status of the child population reflects the development of the country, with a significant reduction in the prevalence of growth retardation, which is much more prevalent in indigenous groups, due to social problems: infant mortality, poverty, indigence and illiteracy. Conclusions: Estimating values of malnutrition and overweight through comparisons by the international percentiles (WHO) and those of the United States do not reflect the reality of a population that differs in everything with that of these comparative standards. That is why the effort of studies to create their own national standards is laudable and shows the realities of a population(AU)

Ultrasound reference values for the calcaneus of children and adolescents at moderate altitudes in Peru

Abstract Objective: a) Establish reference values for bone parameters by using the speed of sound (SOS, m/s) of broadband ultrasound attenuation (BUA, dB/MHz) and establish a bone quality index (BQI = αSOS + βBUA) for children and adolescents living in a region of moderate altitude, b) compare bone parameters with an international standard (with different ethnic, socio-economic, and lifestyle backgrounds) by using ultrasound of the calcaneus (heel bone) (QUS). Methods: A descriptive cross-sectional study was carried out with children and adolescents between the ages of 6.0 and 16.9 years old. The sample was selected randomly. A total of 1322 subjects were studied. Weight, height, and bone parameters, using ultrasound of the calcaneus, were evaluated SOS, BUA, and BQI. Body Mass Index BMI was calculated. Results: The average age of males was 11.44 ± 0.35 years old, and for females, it was 11.43 ± 0.35 years old. The students in this research showed slightly higher values of SOS, BUA, and BQI for both sexes when compared with the international reference (the 50th percentile). Percentiles were generated (P3, P10, P25, P50, P75, P90, and P97) using the LMS method [median (M), standard deviation (S), and power of the Box-Cox transformation (L)] by age and sex. Conclusion: The students living at a moderate altitude showed slightly higher values in bone parameters in relation to the international reference. This pattern depicted a population with a better state of bone health. The proposed percentiles may be used to categorize adequate to at risk bone parameters based on age and sex.

Local references for ultrasound-estimated fetal weight based on 2, 211 singleton pregnancies in the City of Curitiba, south of Brazil / Referências locais para o peso fetal estimado por ultrassom baseado em 2. 211 gestações únicas na cidade de Curitiba, Sul do Brasil

Abstract Objective To develop reference curves of estimated fetal weight for a local population in Curitiba, South of Brazil, and compare them with the curves established for other populations. Methods An observational, cross-sectional, retrospective study was conducted. A reference model for estimated fetal weight was developed using a local sample of 2,211 singleton pregnancies with low risk of growth disorders and well-defined gestational age. This model was compared graphically with the Hadlock and Intergrowth 21st curves. Results Reference curves for estimated fetal weight were developed for a local population. The coefficient of determination was R2 = 99.11%, indicating that 99.11% of the fetal weight variations were explained by the model. Compared with Hadlock curves, the 50th, 90th, and 97th percentiles in this model were lower, whereas the 10th percentile nearly overlapped, and the 3rd percentile was slightly higher in the proposed model. The percentiles were higher in the proposed model compared with the Intergrowth 21st curves, particularly for the 3rd, 10th, and 50th percentiles. Conclusion We provide a local reference curve for estimated fetal weight. The proposed model was different from other models, and these differences might be due to the use of different populations for model construction.

Resumo Objetivo Desenvolver curvas de referência para o peso fetal estimado em uma população de Curitiba, Sul do Brasil, e compará-las com curvas estabelecidas para outras populações. Métodos Foi realizado um estudo observacional, transversal e retrospectivo. Um modelo de referência para o peso fetal estimado foi desenvolvido usando uma amostra local de 2.211 gestações únicas de baixo risco de distúrbios do crescimento e idade gestacional bem definida. Este modelo foi comparado graficamente com as curvas de Hadlock e Intergrowth 21st. Resultados As curvas de referência para o peso fetal estimado foram desenvolvidas para uma população local. O coeficiente de determinação foi de R2 = 99,11%, indicando que 99,11% das variações do peso fetal foram explicadas pelo modelo. Em comparação com as curvas de Hadlock, os percentis 50, 90, e 97 neste modelo foram inferiores, enquanto o percentil 10 quase se sobrepôs, e o percentil 3 foi ligeiramente superior no modelo proposto. Os percentis foram maiores no modelo proposto em comparação com as curvas do Intergrowth 21st, particularmente para os percentis 3, 10, e 50. Conclusão Fornecemos uma curva de referência local para o peso fetal estimado. O modelo proposto foi diferente de outros modelos, e essas diferenças podem ser devido ao uso de diferentes populações para a construção do modelo.

Electrocardiographic Parameters in Indian Newborns

Objective: To generate data of electrocardiogram (ECG) parameters according to gestationalage in Indian newborns. Methods: An observational study was carried out over 7 months inneonatology unit of a tertiary care teaching hospital. Following auscultation, ECG parameterswere recorded simultaneously in 12 leads, on third day of life, in hemodynamically stableneonates. Data from 364 babies were analyzed, keeping at least 30 records for eachgestational age between 30 to 42 weeks. Results: There was no difference in mean heart raterecorded through auscultation and ECG traces. The mean (SD) values recorded were: Pwave duration 0.04 (0.01) s, P wave amplitude 1.3 (0.4) mm, T wave duration 0.07 (0.02) s, Twave amplitude 1.1 (0.6) mm, PR interval 0.09 (0.02) s, QRS duration 0.04 (0.01) s, QTinterval 0.26 (0.02) s, QTc 0.4 (0.03) s and QRS axis 127 (22) degree. Gestation age-wisepercentile charts of different ECG parameters were generated. Conclusion: Thesegestational age-wise percentile charts of different ECG parameters for Indian newborns canbe used as reference for neonatal ECG

A study of anthropometric parameters of school children: a cross sectional study in Rajasthan

Background: The ongoing research in the school health domain is necessary to understand the secular trends in anthropometric parameters. Our study is an attempt to analyze the cross sectional findings and comparison with national reference studies to draw a conclusion on changing attributes of anthropometric parameters with time.Methods: The present study was adapted as a school based, cross sectional, observational epidemiological study design. We have analyzed the data generated out of assessment of height and weight (anthropometric analysis) along with other evaluation as a part of comprehensive health examination.Results: We evaluated, a total of 995 students, aged 5-16 years of which, 569 (57.2%) were boys and 426 (42.8%) were girls. BMI percentiles were calculated for both schoolboys and schoolgirls. Comparisons of the present height and weight curves with earlier data from India and multi country data from WHO was done. In this study prevalence of overweight was 10.35% which indicates the rising trends of childhood overweight and obesity.Conclusions: The trends of changing anthropometric measurements as evident in our study indicate the schoolchildren are growing taller and heavier. With increase in BMI, the prevalence of childhood overweight is on high level but level of underweight and under nutrition per say is low, probably due to quality food availability and increased buying capacity of families.

Patrones de actividad física de adolescentes escolares: validez, confiabilidad y propuesta de percentiles para su evaluación / Physical activity patterns of school adolescents: Validity, reliability and percentiles proposal for their evaluation

La actividad física (AF) regular durante la infancia y adolescencia es importante para prevenir las enfermedades no transmisibles y sus factores de riesgo. Objetivos: Validar un cuestionario que mide patrones de AF, su fiabilidad, comparar los niveles de AF alineados por edad cronológica y biológica y desarrollar curvas percentílicas para valorar los niveles de AF en función de la maduración biológica. Sujetos y Método: Estudio descriptivo, transversal, de una muestra no probabilística por cuotas, de 3.176 adolescentes (1.685 hombre y 1.491 mujeres) chilenos con edades entre 10,0 y 18,9 años. Se evaluó el peso y la estatura de pie y sentada. Se determinó la edad biológica a través de los años de pico de velocidad de crecimiento y la edad cronológica en años. Se calculó el índice de masa corporal y se aplicó una encuesta de AF. Se utilizó el método LMS para desarrollar percentiles. Resultados: Los valores para el análisis confirmatorio mostraron saturaciones entre 0,517 y 0,653, el valor de adecuación de Kaiser-Meyer-Olkin (KMO) fue de 0,879 y el porcentaje de la varianza explicó el 70,8%. Los valores de alpha de Cronbach oscilaron entre 0,81 y 0,86. Hubo diferencias de AF entre ambos géneros cuando se alineó por edad cronológica y no hubo diferencias por edad biológica. Se proponen percentiles para clasificar la AF de adolescentes de ambos géneros de acuerdo a la edad biológica y al sexo. Conclusión: El cuestionario fue válido y confiable; la AF debe ser evaluada por la edad biológica. Estos hallazgos dieron origen al desarrollo de percentiles para valorar AF de acuerdo a la edad biológica y al género.

Regular physical activity (PA) during childhood and adolescence is important for the prevention of non-communicable diseases and their risk factors. Objectives: To validate a questionnaire for measuring patterns of PA, verify the reliability, comparing the levels of PA aligned with chronological and biological age, and to develop percentile curves to assess PA levels depending on biological maturation. Subjects and Method: Descriptive cross-sectional study was performed on a sample non-probabilistic quota of 3,176 Chilean adolescents (1685 males and 1491 females), with a mean age range from 10.0 to 18.9 years. An analysis was performed on, weight, standing and sitting height. The biological age through the years of peak growth rate and chronological age in years was determined. Body Mass Index was calculated and a survey of PA was applied. The LMS method was used to develop percentiles. Results: The values for the confirmatory analysis showed saturations between 0.517 and 0.653. The value of adequacy of Kaiser-Meyer-Olkin (KMO) was 0.879 and with 70.8% of the variance explained. The Cronbach alpha values ranged from 0.81 to 0.86. There were differences between the genders when aligned chronological age. There were no differences when aligned by biological age. Percentiles are proposed to classify the PA of adolescents of both genders according to biological age and sex. Conclusion: The questionnaire used was valid and reliable, plus the PA should be evaluated by biological age. These findings led to the development of percentiles to assess PA according to biological age and gender.

Inducen cambios relevantes en las estimaciones de la talla los nuevos procedimientos de construcción de curvas de crecimiento / Do new procedures for estimating growth curves introduce outstanding changes in height estimates

Introducción: El uso de curvas de crecimiento para supervisar el desarrollo físico de los niños es esencial en la práctica pediátrica. Las normas cubanas de talla se elaboraron en la década de los 70 siguiendo procedimientos recomendados en ese momento. En los últimos años se han obtenido métodos estadísticos automatizados capaces de modelar correctamente el proceso del crecimiento. La OMS, en su Estudio Multicéntrico, utilizó el método Box-Cox PowerExponential (BCPE). Es importante determinar si introducir este nuevo procedimiento para construir curvas induce modificaciones en los valores de los perpercentiles que habitualmente se estiman. Objetivo: evaluar las discrepancias entre los valores de los perpercentiles estimados por ambos procedimientos. Material y Métodos: se usaron los datos de longitud en decúbito supino y estatura, de sujetos cubanos menores de 20 años medidos en el primer Estudio Nacional de Crecimiento y Desarrollo (ENCD). Se construyeron curvas usando el método BCPE implementado en el paquete GAMLSS de R. Las diferencias se evaluaron comparando los valores de los perpercentiles suavizados obtenidos por ambos métodos. Resultados: los modelos que mejor ajustaron fueron: para la longitud en decúbito supino, sexo femenino NO (GLµ=10;GLÏ­=5;edad0.001); sexo masculino NO(GLlµ=14;GLÏ­=6;edad0.006); para estatura, sexo femenino NO(GLµ=16;GLÏ­=10;edad0.544); sexo masculino NO(GLµ=16;GLÏ­=12;edad0.117). Las estimaciones de los perpercentiles de estatura fueron muy similares con ambos procedimientos. En los perpercentiles extremos de la longitud en decúbito supino se detectaron diferencias, debidas muy probablemente a correcciones introducidas en el cómputo de la desviación estándar durante el procesamiento del ENCD. Conclusiones: para la longitud en decúbito supino se detectaron diferencias, no así en la estatura. Se recomienda el uso del procedimiento automatizado pues disminuye considerablemente la carga subjetiva presente en el método anterior(AU)

Introduction: The use of growth curves to monitor physical development in children is essential for pediatric health care. Cuban height charts were created during the seventies decade following technics recommended at that time. In the last years, statistical methods based computational technics have been obtained a better model pattern for growth process. In particular WHO in the Multicenter Growth Study used the Box-Cox Power Exponential (BCPE) method. It is important to determine whether the application of such procedure in drawing curves introduce changes in the percentiles' estimates commonly used. Objective: To evaluate discrepancies between percentiles' estimates from both methods. Material and methods: supine-decubitus length data and height from Cubans under 20 years old from the first National Growth and Development Study (ENCD) were examined. Perpercentiles were estimated viEl método BCPE a the BCPE method implemented in GAMLSS' package supported in R language. Comparison of smoothed percentiles obtained from both procedures were plotted to evaluate discrepancies. Results: The best fitted models were: for female supine-decubitus lengths the NO (DFµ=10;DFÏ­=5;age0.001) and NO(DFµ=14;DFÏ­=6;age0.006) for male respectively and NO(DFµ=16;DFÏ­=10;age0.544) and NO(DFµ=16;DFÏ­=12;age0.117) for female and male height. Height percentiles estimates were closely enough using either method. Some differences were detected for length percentiles, possibly due to computational corrections done while calculating standard deviations of ENCD. Conclusions: Some differences were detected for length percentiles estimations but not for the height. The use of computational procedure is recommended because its considerable reduction of the subjective charge as compare with the method used before(AU)

Construction of National Standards of Growth Curves of Height and Weight for Children Using Cross-sectional Data.

Objectives: Growth curves are the most important tools for the assessment of growth of children, which could further helps to develop preventive interventions. Geographical and physical differences necessitate using national growth curves. This study aims to construct growth curves using anthropometric measurements namely weight and height for Indian children using cross-sectional data from National Family and Health Surveys. Materials and Methods: Box- Cox power exponential, a flexible distribution, was used that offers to adjust kurtosis and improves the estimation of extreme percentiles. LMS-methods that fit skewed data adequately and generate fitted curves that follow closely the empirical data, with maximum penalized likelihood, Akaike information criteria (AIC) and generalized AIC with penalty 3 were used to construct the growth curves. Before fittings this model factors which influence the nutritional status of children were examined, similar to World Health Organization (WHO) (2006) factors, namely standard infant feeding practices, sanitation, non-smoking mothers additionally poverty (household consumable assets based). Results: Model fitted in LMS-model and standard based on height and weight for children aged 0–60 months was obtained after iteration for degrees of freedom for the parameters. Growth curves for mean Z-scores and percentiles were constructed for both sexes and significant lower values were noticeably found to be set as growth-standard compared to WHO-standards. Conclusion: Study showed the prospect of constructing regional/national growth curve and their need for the assessment of children’s growth, which could help to identify undernourished-children at national level. There is an urgent need to collect longitudinal data of children to fit the growth curve of children in India.

Demystifying LMS and BCPE Methods of Centile Estimation for Growth and Other Health Parameters.

Lambda-Mu-Sigma and Box-Cox Power Exponential are popular methods for constructing centile curves but are difficult to understand for medical professionals. As a result, the methods are used by experts only. Non-experts use software as a blackbox that can lead to wrong curves. This article explains these methods in a simple non-mathematical language so that medical professionals can use them correctly and confidently.

Relación talla sentada/talla de pie del nacimiento a la adultez en niños españoles / Sitting height/standing height ratio in a spanish population from birth to adulthood

Introducción. Para el diagnóstico de los pacientes con trastornos del crecimiento, la inspección visual y la medida de los segmentos corporales pueden proporcionar una importante información. El método más utilizado es la evaluación de la relación entre la talla sentada y la talla de pie (TS/TP) y su comparación con los referentes según la edad. Objetivo. Determinar los valores de normalidad de la relación talla sentada/talla de pie en una población normal aragonesa, desde el nacimiento hasta los 18 años. Población y métodos. Estudio longitudinal desde el nacimiento hasta los 18 años. Se registró la longitud (hasta los 3 años), la talla de pie vertical (desde los 2 años) y la talla sentada. Se determinaron los percentiles de la relación talla sentada/talla de pie. Resultados. Se incluyeron 165 varones y 167 mujeres. La relación talla sentada/talla de pie desciende desde el nacimiento en los niños y las niñas (0,656 y 0,647 respectivamente) hasta el inicio de la pubertad (0,514 y 0,519); más tarde aumenta levemente hasta alcanzar la relación defnitiva del adulto (0,52 y 0,53). Conclusión. Se presentan los valores de la relación talla sentada/talla de pie, en niños y niñas normales, hasta los 18 años. Esta relación disminuye desde el nacimiento hasta la pubertad y luego aumenta levemente hasta alcanzar la relación defnitiva del adulto.

Introduction. For the diagnosis of patients with growth disorders, visual inspection and the measurement of body segments may provide important information. The most commonly used method is the assessmentof the sitting/standing height (SH/SH) ratio and its comparison to aged matched controls. Objective. To establish the normal values of the sitting/standing height ratio in a normal Aragonese population from birth to 18 years old. Population and Methods.Longitudinal study from birth to 18 years old. Length (up to 3 years old), standing height (as of 2 years old) and sit-ting height were recorded. Percentiles for sitting/ standing height ratio were determined. Results. The study included 165 male children and 167 female children. The values of the sitting/standing height ratio decrease from birth both in males and females (0.656 and 0.647, respectively) until the onset of puberty (0.514 and 0.519); and later start to slightly increase until reaching the defnitive adult ratio (0.52 and 0.53, respectively). Conclusion. Sitting/standing height ratio values are presented in normal male and female children up to 18 years old. This ratio decreases from birth to puberty and then slightly increases until reaching the fnal adult ratio.

Escala Argentina de Inteligencia Sensorio-Motriz (EAIS): Percentiles nacionales / Argentine Scale of Sensor Motor Intelligence: National percentiles

El estudio del desarrollo psicomotor de niños menores de 3 años permite observar que algunas veces, el área intelectual no es considerada en su real dimensión, como un logro específico de los niños en ese período. La Escala Argentina de Inteligencia Sensorio-motriz (EAIS) es el primer instrumento creado en Argentina para la evaluación del desarrollo cognitivo en bebés de 6 a 30 meses. Dado que no se contaba con percentiles nacionales en niños argentinos, se propuso como objetivo la realización de una validación nacional de la EAIS. La muestra estuvo conformada por niños nacidos a término, sin patología y con un desarrollo psicomotor normal, provenientes de 10 provincias argentinas. Se conformaron grupos interdisciplinarios de trabajo en las provincias participantes para la evaluación del desarrollo cognitivo mediante la administración de la EAIS. Se logró una muestra total de 800 niños. Se construyeron tablas de percentiles nacionales para la EAIS a partir del estadío mediano obtenido en la prueba y para cada una de las series que la conforman. Los resultados permiten observar que el 72.25% de los niños obtuvieron percentiles normales, el 27.75% restante obtuvo percentiles de riesgo y retraso en la inteligencia sensorio-motriz. A partir de estos resultados se encuentra una progresión de la inteligencia gradual y cuasi-continua: ella no evoluciona más por saltos, y hacia delante, sino como una rampa con períodos de mesetas y vuelta atrás de falsos pasos.

The psychomotor development assessment in children younger than 3 years old allow us to realize that, sometimes, the intellectual area of development is not considered as it should be; i.e., as a specific achievement during that period of development. The Argentine Scale of Sensor Motor Intelligence (EAIS) is the first scale to assess cognitive development from Argentina. Until now we did not have national percentiles, so we decided to perform a study focusing on the national validation of the EAIS. The national validation of the Argentine Scale of Sensor motor Intelligence was performed with the aim of determining national percentiles for Argentinean children from 6 to 30 month old. The sample consisted of full-term infants (> 37 weeks of gestation), without any pathology and with a normal psychomotor development. The sample was collected from 10 Argentine provinces: Buenos Aires, Córdoba, Santa Fe, Entre Ríos, Salta, Misiones, Chaco, Río Negro, Santa Cruz, and Mendoza. We organized interdisciplinary working groups in each of the ten provinces, in order to evaluate infant cognitive development in children from each Argentinean provinces through administration of the EAIS, and to perform national percentiles for the EAIS. The procedure for the realization of this work consisted in four stages: The first stage of this work consisted in the call, invitation and training to professional staff from different provinces of Argentina, to participate of the present research. A total of 30 professionals from 10 provinces decided to participate. During the second stage we proceeded to the administration of the EAIS by each of the staff of trained professionals in each of the provinces. In the third stage we achieved to collect a total sample of 800 infants from 10 Argentine provinces. Fourth stage: the realization of national percentiles tables for the EAIS and the transfer of results to scientific community is the principal aim of the present paper. We evaluated a total sampleof 800 children from 6 to 30 month old. To assess the psychomotor development, the Prueba Nacional de Pesquisa (PRUNAPE) was applied to the whole sample of 800 children. Then, we evaluated the cognitive development through administration of the EAIS, to each child that had obtained a normal psychomotor development in the PRUNAPE. We then performed national percentiles for the EAIS from the results of this analysis. Results show us that from a total of 800 children, 578 (72.25%) obtained normal cognitive development (percentile 50 or higher), 112 children (14%) obtained risk percentiles (percentile 25) and the 110 remaining children (13.75%) obtained results within delay percentiles (10 percentile or less). In conclusion, the 27.75% of children achieved a sensor motor intelligence development below that expected in relation to the age. That percentage was similar to what we have found in previous research. We didn’t find significant differences between provinces in relation to children’s cognitive development. In previous research we found that only the 20% of 24-month-old children had completed VI stage of sensor motor intelligence. We consider by this study an important aim was to investigate at what age Argentinean children usually complete this stage. We prove that Argentinean children usually complete VI stage of sensor motor intelligence about 30-month-old, unlike Jean Piaget´s postulations. He considered that children often complete VI stage of sensor motor intelligence around the 24-month-old. From the results, we suggest that there is a gradual and quasi-continuous progression of the intelligence, i.e., intelligence does not seem to evolve by leaps according to the ladder model instead it develops as a ramp with some retrogression and missteps.

Peso al nacer de los niños y niñas derechohabientes del Instituto Mexicano del Seguro Social / Birth weight of male and female infants born in hospitals affiliated with the Instituto Mexicano del Seguro Social

Introducción. El peso al nacer es un indicador fundamental para evaluar la salud de los niños. Sin embargo, para decir si el peso alcanzado es o no apropiado, debe compararse con patrones de referencia de acuerdo con la edad gestacional y sexo. El objetivo de este trabajo fue conocer el peso al nacer en función de la edad gestacional de niños y niñas que nacieron en hospitales del Instituto Mexicano del Seguro Social. Métodos. De junio de 2000 a marzo de 2002, en 33 hospitales del Instituto Mexicano del Seguro Social de las regiones norte, centro, sur y Ciudad de México, se pesaron 24,627 recién nacidos (12,701 niños y 11,926 niñas) con una báscula electrónica; todos de gestación única, íntegros y sin complicaciones. Con SPSS para Windows 11.5 se analizó el peso de los niños y niñas de las semanas 28 a 42, obteniéndose el peso de los siguientes percentiles: 10, 25, 50, 75 y 90, así como el promedio y la desviación estándar. Estos mismos valores se obtuvieron para cada región solamente para las semanas 35 a 42. Resultados. El peso de los recién nacidos se presenta por sexo, por semanas de gestación y por percentiles, además del peso promedio y desviación estándar. Los niños tienen un mayor peso que las niñas; asimismo, pesan más los recién nacidos de la región norte. En relación con reportes previos se observó que, después de la semana 37, el peso al nacer de los niños en el percentil 50 ha aumentado alrededor de 100 g por semana, en tanto que en el percentil 10 ha aumentado en promedio 139 g por semana. Conclusiones. Se presentan los datos del peso de recién nacidos, obtenidos de una muestra poblacional, que se proponen como un referente para evaluar el peso al nacer de niños mexicanos.

Background. Birth weight is a fundamental indicator for evaluating the health of children. In order to determine whether or not an infant's birth weight is appropriate, we compared the reference standards in accordance with gestational age and gender in newborns from hospitals affiliated with the Mexican Social Security Institute, using a population-based design. Methods. From June 2000 to March 2002, from 33 hospitals affiliated with the Mexican Social Security Institute, the weight of 24,627 newborns (12,701 males and 11,926 females) was evaluated with an electronic scale. Infants were from the following regions of Mexico: northern, central, Mexico City and southern. Using SPSS v.11.5 for Windows, the weight of the total sample was analyzed from weeks 28 to 42 to build the following percentiles: 10th, 25th, 50th, 75th and 90th, as well as the average and standard deviation. The same values were obtained for each of the above-mentioned regions but only for those infants with 35-42 weeks of gestational age. Results. Male newborns are heavier than females. The weight of newborns from northern Mexico is higher than the birth weight of newborns from other regions of Mexico. Newborns from southern Mexico have the lowest birth weight. Comparing these values with other Mexican studies, it is considered that the birth weight of newborns increased per week ~100 g after 37 weeks of gestation for the 50th percentile and ~139 g per week for the 10th percentile. Conclusions. Growth data of infants from a sample population is proposed as a benchmark to evaluate the birth weight of Mexican newborns.

Curvas de crecimiento de la circunferencia de la cintura en niños y adolescentes habaneros / Growth curves of waist circumference in Havana children and adolescents

INTRODUCCIÓN. En los últimos decenios, el sobrepeso y la obesidad han aumentado en los niños y adolescentes cubanos, por lo que son necesarios instrumentos sencillos que permitan analizar en la práctica asistencial las características y evolución de la obesidad. Por esta razón, se decidió desarrollar curvas de crecimiento de la circunferencia de la cintura en niños y adolescentes habaneros, dimensión que muestra una alta correlación con la masa grasa intraabdominal y, por ende, con un perfil lipídico aterogénico. MÉTODOS. Se estimaron valores de percentiles de esta circunferencia según grupos de edad y sexo, utilizando el método de transformación de potencia de tipo Box-Cox (BCPE), en 4 360 niños y adolescentes entre 7,5 y 19,0 años, que integraron las muestras de los estudios transversales de crecimiento y desarrollo efectuados en La Habana durante los años 1998 y 2005. RESULTADOS. La circunferencia de la cintura aumentó de forma significativa con la edad en uno y otro sexo. Los niños mostraron cifras superiores a las de las niñas y los valores que se obtuvieron tienden a ser inferiores a los reportados en otros estudios. CONCLUSIONES. Estas curvas podrían usarse provisionalmente con propósitos clínicos y epidemiológicos hasta que se disponga de referencias de carácter nacional para la identificación de niños escolares y adolescentes con riesgo de desarrollar trastornos relacionados con la adiposidad visceral

INTRODUCTION. In past decades, the excess weight and obesity have increased in Cuban children and adolescents, thus, are necessaries simple tools allowing analyzing in health practice the characteristics and evolution of obesity. By this reason, we decide to develop growth curves of waist circumference in Havanan children and adolescents, a dimension showing a high correlation with the intra-abdominal fatty mass and consequently, with an atherogenic lipid profile. METHODS. Authors estimated the percentile values according to the age groups and the sex, using the potency transformation method type Box-Cox (BCPE) in 4 360 children and adolescents aged between 7,5 and 19,0 included in the sample of cross-sectional studies of growth and development conducted in La Habana in 1998 and 2005. RESULTS. The waist circumference increased in a significant way with age in both sexes. Boys showed figures higher than that of girls and the values obtained trend to be lower than those reported in other studies. CONCLUSIONS. These curves could be used provisionally with clinical and epidemiologic objectives until be available national references to identify the schoolboys and adolescents with a risk to develop disorders related to visceral adiposity

Primeras curvas de percentiles de la circunferencia de cintura en un grupo de adolescentes del Estado Lara Venezuela / First percentile curves of waist circumference in a group of teenagers Lara State Venezuela

Desarrollar curvas de percentiles (P) de la circunferencia de la cintura (CC) en adolescentes según edad, sexo y sitio de medición de la CC. Estudio descriptivo transversal con 7.230 adolescentes sanos (3.935 mujeres), de 10 a 19 años de edad, todas las clases sociales, seleccionados aleatoriamente en 27 instituciones educativas, urbanas y rurales, públicas y privadas de 8 parroquias de Iribarren. Se midió la CC en tres sitios anatómicos. Se construyeron curvas suavizadas para P3, P10, P25, P50, P75, P90 y P97 con el método LMS Pro. Para el sitio anatómico (1), mujeres entre 12 y 15 años superaron a los hombres. Entre 16 y 19 años los resultados se invirtieron. A los 19 años, el P90 no parece demostrar continuidad con el criterio diagnóstico de obesidad central de mujeres adultas, según el ATP III. Para el sitio anatómico (2), el P90 de hombres tampoco parece tener continuidad con el criterio diagnóstico de la Federación Internacional de Diabetes para adultos. En los sitios anatómicos (2) y (3), los percentiles siempre fueron superiores en varones. Todos los percentiles difirieron de poblaciones extranjeras. Se confirma la necesidad de desarrollar curvas de percentiles propias, con sus puntos de corte para diagnosticar obesidad central

To develop percentile curves (P) of waist circumference (WC) in adolescents according to age, sex and measurement site of WC. A representative cross-sectional study of 7230 healthy adolescents (3,935 women) aged 10-19 years, of all social classes, randomly selected from 27 urban and rural, public and private, educational institutions, in the state Lara, Venezuela was done. WC was measured at three anatomical sites. Smoothed curves were constructed for P3, P10, P25, P50, P75, P90 and P97 using the LMS Pro method. For the anatomical site (1), the women’s values, aged 12-15 years, were higher than male’s ones. For ages 16-19 years the results were reversed. In 19-year-old women, the P90 does not appear to show continuity with the diagnosticcriteria of central obesity of ATP II in adult women. For the anatomical site (2), P90 male does not seem to have continuity with the diagnostic criteria of the International Diabetes Federation among adult men. For anatomical sites (2) and (3), the percentiles were always higher in males. All percentiles differed from foreign populations. This confirms the need to develop our own percentile curves, with their cutoff points for central obesity diagnosis

Distribución percentilar del índice energía proteína en edades pediátricas / Percentile distribution of the energy-protein index in paediatric ages

Se analizó la distribución percentilar del índice energía proteína (E/P) en niños y niñas de 3 meses a 9 años, para optimizar la identificación de alteraciones nutricionales incipientes. El calculó se hizo en 5.212 niños con estado nutricional y talla normales, sanos, provenientes de una comunidad urbana marginal, atendidos en el Centro de Atención Nutricional Infantil Antímano (CANIA) en el período enero 1999 a diciembre 2007. Se excluyeron niños con antecedentes de prematuridad, inicio de estirón puberal y patologías crónicas definidas o en estudio. La circunferencia muscular del brazo y el índice Energía/Proteína se calcularon a partir del pliegue tricipital y circunferencia media del brazo, medidas por antropometristas estandarizadas con control de calidad cuatrimestral, aplicando las normas recomendadas por el Programa Biológico Internacional y el Centro Internacional de la Infancia. Se obtuvieron los estadísticos descriptivos del índice y de las variables utilizadas en su cálculo, así como los percentiles 3, 10, 25, 50, 75, 90 y 97 del índice. Se aplicó el test de Kolmogorov-Smirnoff, Anova de una vía, Chi cuadrado, test de Tukey y correlaciones bivariadas. El comportamiento del índice evidenció valores mayores en el sexo femenino que fueron decreciendo con la edad en ambos sexos en rangos de 1,78 a 1,53 en el sexo femenino y de 1,68 a 1,42 en el masculino. Se encontraron diferencias estadísticamente significativas por edad y sexo. El comportamiento del índice permite concluir la necesidad de aplicar la distribución percentilar de sus valores en la evaluación nutricional en edades pediátricas, debiéndose validar su efectividad.

The aim of this study was to analyze the percentile distribution of the Energy-Protein index (E/P) in boys and girls aged 3 months to 9 years in order to better identify incipient nutritional alterations. This index was calculated in 5212 healthy children with normal nutritional status and stature from a poor urban community at Centro de Atención Nutricional Infantil Antímano (CANIA), within the period between January 1999 and December 2007. Children with prematurity backgrounds, pubertal growth spurts, or with chronic pathologies, were excluded. Calculations of arm muscle circumference and E/P index were based on the anthropometric variables: triceps skinfold thickness, and mid-arm circumference measured by standardized anthropometrists, with quality control every 4 months as recommended by international standard of the International Biological Program and the International Center for Infancy. The descriptive statistics of the Energy/Protein index and the variables used for their calculation were obtained, as well as the index percentiles 3, 10, 25, 50, 75, 90, and 97. Tests applied included Kolmogorov-Smirnoff, Anova one-way, Chi Square, Tukey and bivariated correlations. The E/P index behavior exhibited higher values in the girls, decreasing with age in both sexes, ranging from 1.78 to 1.53 in girls and from 1.68 to 1.42 in boys. Statistically significant differences were found for each age and sex. The E/P index behavior allows us to conclude that its percentile distribution should be applied to nutritional assessments in pediatric ages. These values should be validated and their effectiveness should be studied.

Curvas de crecimiento intrauterino a nivel del mar / Growth intrauterine curves at sea level

Introducción. Objetivo: determinar las curvas de crecimiento intrauterino a nivel del mar. Material y métodos. Estudio descriptivo y transversal realizado a 1 626 recién nacidos en el puerto de Veracruz. Se obtuvo somatometría en relación a edad gestacional y sexo. Resultados. El grupo de mayor frecuencia fue de 38 a 40 semanas de gestación (65%), y el de menor fue de 41 a 43 semanas (9%). La mitad fue de sexo masculino. No se encontró diferencia significativa (P > 0.05) entre ambos sexos respecto a peso, talla y perímetro cefálico. Los resultados se expresaron en gráficas percentilares y tablas de valor promedio con medias de dispersión. Conclusión. Las curvas de crecimiento intrauterino a nivel del mar tuvieron un comportamiento distintivo al compararlas con patrones de referencia utilizados en el hospital, lo que justifica el uso de percentilas propias.

Introduction. Objective: To determine the growth intrauterine curves at the sea level. Material and methods. This is a descriptive cross-sectional study performed in 1 626 newborns in Veracruz, Mexico. A somatometric evaluation was achieved in relation to gestational age and sex. Results. The largest frequency group was from 38 to 40 gestation weeks (65%), and the fewer frequency group was from 41 to 43 weeks (9%). Half of them were male. No significant difference (P > 0.05) was found between both sexes in accordance to weight, size, and cephalic perimeter. Results were presented by percentile graphics and average value boards with means of dispersion. Conclusion. The intrauterine growth curves at the sea level behave differently from reference standards used in our hospital, which justifies the elaboration and use of local reference standards.

Percentiles peso, talla y perímetro cefálico en recién nacidos a término, obtenidos por parto y cesárea, en el hospital Materno Infantil del Guasmo; 1 de enero al 31 de mayo de 2002 / Weight, size and cephalic perimeter percentiles in newborns to term, obtained by childbirth and caesarean in the Maternal – Infantile Hospital of Guasmo, January 1st and 31 May 2002

Tipo de estudio: prospectivo, analítico.Objetivo: Crear curvas de percentiles de peso, talla y perímetro cefálico de recién nacidos a término en el hospital materno-infantil del Guasmo, para que otras unidades hospitalarias las realicen y podamos tener una curva acorde con la realidad nacional.Diseño metodológico: Se estudiaron de enero 1° al 31 de mayo de 2002, 1054 recién nacidos a término obtenidos por parto o cesárea. Se evalúa edad gestacional por esquema de Ballard, y se procedía a pesar, medir talla y perímetro cefálico.Resultados: Los niños obtenidos por parto son más pequeños 3205.42 gramos que los de cesárea 3275 gramos; la paridad es un factor importante ya que las primíparas tuvieron productos más pequeños que las multíparas; de igual forma los varones son más grandes 3250g, que las mujeres 3200g y las madres adolescentes tuvieron niños más pequeños 2206.81g en comparación con el resto de edades.Conclusión: El peso promedio del RN de esta institución (3250 gramos) está considerado entre los parámetros ideales al compararlo con niveles internacionales.

Type of study: prospective, analytic.Objective: To create curves of weight, size and cephalic perimeter percentiles of newborn full term in the hospital materno-infantil of Guasmo, so that other hospital units carry out them and we can have an in agreement curve to out national reality.Methodological design: were studied between January 1 to 31 May of 2002, with a universe of 1054 newborns full term obtained by childbirth or caesarean operation. Gestational age is valued by Ballard’s outline and we proceeded to weigh, to measure size and cephalic perimeter.Results: the children obtained by childbirth are smaller 3205.42 grams than caesarean 3275 grams; the parity is an important factor: primiparas had smaller products those multiparas; the males are bigger 3250g that the women 3200g and the adolescent mothers had smaller children 2206.81g in comparison with the rest age.Conclusion: the weight average of newborn of this institution (3250 grams) it is the one considered as ideal weight to international grade.