Gender differences and the role of parental education, school types and migration on the body mass index of 2930 Austrian school children : A cross-sectional study.

BACKGROUND: Austria faces increasing numbers of childhood overweight and obesity. Despite increasing numbers of studies, associations between parental body mass index (BMI) and education and the school type on overweight/obesity in students have not been reported. The objective of this study was to evaluate the influence of these parameters on the genesis of overweight/obesity in a large cohort representative of youth in Upper Austrian. METHODS: A cross-sectional analysis of data from 2930 children and adolescents aged 10, 14 or 17 years from 11 different state school types was conducted. Students and their parents completed a questionnaire and heights and weights were measured. RESULTS: Of the students 16.9% fulfilled the criteria for overweight and 5.6% for obesity, with the highest rates in the 10-year-olds (19.6% and 5.8%, respectively). While no gender differences were present in the youngest age group, the body mass index (BMI) during adolescence remained higher in boys but decreased significantly in girls. Male gender remained a risk factor through all calculations. Boys were overrepresented in schools with lower education levels and more often had BMIs ≥ 85th and ≥95th percentile. Higher parental education levels and lower parental BMIs were associated with lower BMIs of their offspring. Migration was an additional association factor for BMIs ≥ 85th percentile. CONCLUSION: Low parental education levels, higher parental BMIs and migration background were associated with overweight and obesity in 10-year-olds. In adolescence, male gender and higher parental BMIs remained risk factors.

Geographic Atrophy and Foveal-Sparing Changes Related to Visual Acuity in Patients With Dry Age-Related Macular Degeneration Over Time.

PURPOSE: To correlate the area of geographic atrophy (GA) and residual foveal sparing (FS), and to identify the minimum FS and maximum GA area allowing sufficient visual acuity (VA) for daily tasks. DESIGN: Prospective cohort study. METHODS: Thirty-six eyes of 25 patients with GA and FS were followed for 18 months using spectral-domain optical coherence tomography and VA tests. Volume scans were imported into software enabling grading of areas in B-scans and computing of planimetric measurements in complete volume scans. Correlation of areas 1 (complete atrophy), 2 (FS in the central millimeter), and 3 (FS in the central 3 mm) with each other and with best-corrected VA (BCVA) were evaluated. RESULTS: Baseline means of areas 1, 2, and 3 were 6.15 mm2, 0.49 mm2, and 3.08 mm2, respectively. At 1 year, area 1 increased by a mean of 1.33 mm2, while areas 2 and 3 were decreased by 0.12 mm2 and 0.65 mm2, respectively. From baseline to 18 months and from visit to visit, all areas and BCVA changed progressively (P < .001). Significant thresholds in GA size and FS for achieving a BCVA ≥ 70 ETDRS letters were detected (area 1: ≤6 mm2; area 2: ≥0.48 mm2; and area 3: ≥3.28 mm2). CONCLUSION: GA and FS changed inversely over time. In general, FS highly correlated with BCVA, while GA progression correlated with the central 3-mm FS regression, but not with BCVA. A threshold in GA and FS area could be determined for BCVA necessary for daily activity.

Using concept hierarchies to improve calculation of patient similarity.

OBJECTIVE: We introduce a new distance measure that is better suited than traditional methods at detecting similarities in patient records by referring to a concept hierarchy. MATERIALS AND METHODS: The new distance measure improves on distance measures for categorical values by taking the path distance between concepts in a hierarchy into account. We evaluate and compare the new measure on a data set of 836 patients. RESULTS: The new measure shows marked improvements over the standard measures, both qualitatively and quantitatively. Using the new measure for clustering patient data reveals structure that is otherwise not visible. Statistical comparisons of distances within patient groups with similar diagnoses shows that the new measure is significantly better at detecting these similarities than the standard measures. CONCLUSION: The new distance measure is an improvement over the current standard whenever a hierarchical arrangement of categorical values is available.

Prospective analysis on brain magnetic resonance imaging in children.

BACKGROUND: Previous studies have addressed the prevalence of incidental findings in adult populations. There are few studies following paediatric patients, most of data were retrieved retrospectively. We conducted a prospective study to determine the prevalence of incidental, pathologic and normal findings in a symptomatic paediatric population. METHODS: The subjects of this prospective single centre study are 436 children aged 0-18 years with clinical symptoms and subsequent first brain MRI. Normal, incidental as well as pathologic MRI findings are documented in association with age, gender, neurological examination and previous investigations (CCT, EEG). Secondary outcome parameters are defined as MRI results and their implications. Two board-certified radiologists prospectively analysed MR images without knowing the result from each other. RESULTS: The 436 patients with brain MRI were categorized into three groups as follows: 155 (35.5%) patients had normal findings, 163 (37.4%) had incidental findings and 118 (27.1%) had pathological findings in brain MRI. When adding patients with pathologic and incidental findings we report even more (47.9%). We analysed the correlation between neurologic examination and MRI result and it was significant (p-value 0.0008). The p-value for concordance of both radiology reports was <0.001 and therefore highly significant. CONCLUSION: To our knowledge this is the first prospective paediatric study reporting the prevalence of normal, pathologic and incidental findings in brain MRI in symptomatic children. Incidental findings are common in paediatric patients but we report the highest prevalence. Our data may help guiding management decision in a consistent and clinically appropriate manner.