Sensitivity for palpating lumbopelvic soft- tissues and bony landmarks and its associated factors: A single-blinded diagnostic accuracy study.

BACKGROUND: Evidence on the diagnostic performance of palpatory methods and possible confounding factors is scarce. OBJECTIVES: To examine the sensitivity of palpatory methods for location of lumbopelvic landmarks and to assess its association with personal characteristics. METHODS: Eighty-three participants (41 men, 55.6 (16.5) years, 25.9 (4.8) kg/m2 [mean (SD)]) were enrolled in this single-blinded study. Fourteen body and softy-tissue landmarks were sequentially palpated from the spinous process of L4 to the ischial tuberosity. CT-scan images were used to assess what landmark was located. RESULTS: Sensitivity for location was in range 22-86% for soft-tissues and 26-69% for bony landmarks. Reduction in sensitivity was observed from the quadratus lumborum to the inferior and lateral angle of the sacrum (86-26% and 75-33%, left and right sides, respectively). Palpations of L4 and L5 spinous processes were systematically more cephalic than other landmarks. Gender was weakly correlated to almost all landmarks (rp⁢b= 0.333 or weaker). Body mass index was weakly correlated to the accurate location of ILAS and quadratus lumborum, great trochanter, PSIS, and piriformis (rp⁢b=-0.307 or weaker). CONCLUSIONS: Systematic and propagation errors were present using sequential palpatory methods. Palpation in men was more sensitive and higher BMI was associated with lower sensitivity for lumbopelvic landmarks.

Abdominal subcutaneous and visceral fat thickness in newborns: correlation with anthropometric and metabolic profile.

OBJECTIVE: To correlate abdominal subcutaneous and visceral fat thickness with anthropometric data and metabolic profile in newborns. STUDY DESIGN: A cross-sectional study with 99 newborns was performed at Instituto de Medicina Integral Professor Fernando Figueira, Brazil. Abdominal subcutaneous and visceral thickness were measured by ultrasound. Glucose, insulin, homeostatic model assessment-insulin resistance (HOMA-IR), total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, very-low-density lipoprotein cholesterol and triglycerides were determined. Pearson correlation coefficients were calculated. RESULT: Abdominal subcutaneous fat thickness was positively correlated with birth weight (r=0.31; P<0.001), height (r=0.27; P<0.001) and abdominal circumference (r=0.26; P<0.001), but not with metabolic profile. Abdominal visceral fat thickness was correlated with abdominal circumference (r=0.23; P=0.01), insulin (r=0.21; P=0.04) and HOMA (r=0.24; P=0.02). The results remained the same among males and females. CONCLUSION: Abdominal fat distribution in newborns has a different correlation with anthropometric and metabolic profile. Abdominal subcutaneous fat thickness is positively correlated with anthropometric data whereas abdominal visceral fat thickness is correlated with insulin and HOMA-IR.