Coexistence of Non-Lower Body Mass Index and Exercise Habits Reduce Readmission in Older Patients With Heart Failure.

Objective: To investigate the impact of body mass index (BMI) and exercise habits on readmission rates among older patients with heart failure. Methods: Ninety-seven older patients admitted for heart failure (median age: 81 years; 57.7% male) were included in the study. Patients were categorized into four groups based on the presence or absence of lower BMI and/or the absence of exercise habits. Lower BMI was defined as BMI<20.3 kg/m2 at discharge and exercise habits were defined as engaging in 30 or more minutes of moderate or vigorous exercise at least once a week. The primary outcome was all-cause readmission during the 1-year follow-up period. Results: The patients were distributed across four groups: lower BMI/non-exerciser (n=24, 24.7%), lower BMI/exerciser (n=22, 22.7%), non-lower BMI/non-exerciser (n=21, 21.6%), and non-lower BMI/exerciser (n=30, 30.9%). Forty-six patients (47.4%) experienced readmission during the 1-year follow-up period. In a cox proportional hazard analysis, non-lower BMI/exerciser remained an independent prognostic factor even after adjusting for confounding factors (non-lower BMI/exerciser vs. lower BMI/non-exerciser: hazard ratio, 0.26; 95% confidence interval, 0.08-0.83; p=0.022). Conclusion: The coexistence of non-lower BMI and regular exercise habits may reduce readmission during the 1-year in older patients with heart failure. Therefore, it is imperative to conduct appropriate nutritional assessments for patients with lower BMI at discharge. Additionally, promoting and monitoring sustained physical activity after discharge is crucial for older patients with heart failure.

EXPRESS: CT-BASED SARCOPENIA ASSESSMENT: PREDICTING OUTCOMES IN ACUTE INFECTION PATIENTS.

OBJECTIVES: In this retrospective cohort study, we investigated the prognostic value of sarcopenia evaluated by CT-based indices for adverse hospitalization outcomes in patients with acute infections. METHODS: We analyzed data from 225 patients admitted to the hospital for acute infections between 2019 and 2020. Patients who had undergone an abdominal CT scan either up to one month before or within the first 3 days of hospitalization were included. Computed tomography image analysis was used to evaluate skeletal muscle mass (by skeletal muscle index- SMI) and muscle quality (by psoas muscle density, pMD). RESULTS: Low pMD was associated with higher in-hospital mortality (31% vs. 11.4% p<0.001) as well as higher longer-term mortality rates (p=0.008 for 30 days and <0.001 for 90- and 1-year mortality). Low pMD remained an independent poor prognostic factor after controlling for confounders, with an adjusted odds ratio (aOR) of 2.74, (95% CI 1.33-5.67, p=0.006) for 1-year mortality, and aOR of 2.61, (95% CI 1.23-5.55) for prolonged hospital stay. Low SMI was associated with adverse outcomes, although this association was not independent after controlling for confounders. Notably, patients with both low SMI and pMD exhibited the poorest hospitalization outcomes: aOR for 1-year mortality 5.015 (95% CI 1.767-14.23, p=0.002), and prolonged LOS aOR 3.197, (95% CI 1.159-8.821, p=0.025). CONCLUSIONS: CT-based muscle indices serve as independent prognostic factors in medical patients admitted with acute infection. Incorporating radiological assessments of sarcopenia into routine care for hospitalized patients with acute infection may enable risk stratification and early intervention in reversible conditions.

Life-period associations of body mass index with adult carotid intima-media thickness: The Bogalusa Heart Study and the Cardiovascular Risk in Young Finns Study.

OBJECTIVE: Child and adult body mass index (BMI) associates with adult carotid artery intima-media thickness (cIMT). However, the relative contribution of BMI at different life-periods on adult cIMT has not been quantified. This study aimed to determine the life-course model that best explains the relative contribution of BMI at different life-periods (childhood, adolescence, and young-adulthood) on cIMT in adulthood. METHODS: BMI was calculated from direct measurements of height and weight at up to seven time-points from childhood to adulthood (1973-2007) among 2485 participants of the Cardiovascular Risk in Young Finns Study (YFS) and 1271 participants in the Bogalusa Heart Study (BHS). BMI measures at three ages representative of childhood (9-years), adolescence (18 years) and young-adulthood (30 years) life-periods were used. B-mode ultrasound was used to measure common cIMT in adulthood (>30 years). Associations were evaluated using the Bayesian relative life-course exposure model. RESULTS: In both cohorts, cumulative exposure to higher levels of BMI across the life-course was associated with greater cIMT. Of the examined life-periods, BMI in young-adulthood provided the greatest relative contribution towards the development of adult cIMT for YFS (49.9 %, 95 % CrI = 34-68 %) and white BHS participants (48.6 %, 95 % CrI = 9-86 %), whereas BMI in childhood had the greatest relative contribution for black BHS participants (54.0 %, 95 % CrI = 8-89 %). CONCLUSION: Although our data suggest sensitive periods in the life-course where prevention and intervention aimed at reducing BMI might provide most benefit in limiting the effects of BMI on cIMT, maintaining lower BMI across the life-course appears to be optimal.

Implementation of a lifestyle and life-skills intervention to prevent weight-gain and cardiometabolic abnormalities in young people with first-episode psychosis as part of routine care: The Keeping the Body in Mind program.

OBJECTIVES: In 2013, a cluster-controlled pilot study found the 12-week Keeping the Body in Mind (KBIM) lifestyle and life skills intervention was able to prevent weight gain in a small sample of youth experiencing first-episode psychosis (FEP) with fewer than 4 weeks of antipsychotic exposure. This study aims to evaluate the effectiveness of KBIM as routine care on anthropometry and metabolic biochemistry in a larger sample of youth with FEP across three community mental health services. METHOD: This retrospective chart audit was conducted on youth with FEP, prescribed a therapeutic dose of antipsychotic medication, and who engaged with KBIM between 2015 and 2019. Primary outcomes were weight and waist circumference. Secondary outcomes were blood pressure, blood glucose, and blood lipids. Outcomes were collected in at baseline and at 12 weeks. Data on program engagement were obtained from the participant's medical file. RESULTS: One-hundred and eighty-two people met inclusion criteria, and up to 134 people had baseline and 12-week data on one or more outcome. Mean number of sessions attended was 11.1 (SD = 7.3). Increases in weight and waist circumference were limited to 1.5 kg (SD = 5.3, t(133) = 3.2, p = .002) and 0.7 cm (SD = 5.8, t(109) = 1.2, p = .23) respectively. Eighty-one percent of participants did not experience clinically significant weight gain (>7% of baseline weight). There were no significant changes in blood pressure or metabolic biochemistry. CONCLUSION: The prevention of substantial gains in weight and waist circumference observed in the initial pilot study was maintained with implementation of KBIM as part of routine clinical care for youth with FEP.

Comparison of nutritional status and growth curves of children and adolescents in the city of Goiânia, Goiás: cross-sectional study

ABSTRACT BACKGROUND: Nutritional status and growth curves can affect cognitive development, increase the risk of infection, and contribute to the development of chronic diseases. Its etiology is related to food, socioeconomic, and maternal conditions. However, to date, no data on these parameters exist in the state of Goiás, Brazil. OBJECTIVE: To compare the nutritional status and growth curves of children and adolescents in the city of Goiânia, Goiás, Brazil. DESIGN AND SETTING: This was a cross-sectional study. A total of 529 individuals were recruited from a primary health center in the municipality. METHODS: To assess nutritional status, the sample was divided into three categories: 3-4, 5-10, and 11-19 years, with z-score classification considering body mass index for age. The classification of growth curves was performed considering the median height values for age, assuming two references: (a) young Brazilian population and (b) one recommended for international use. The independent sample T-test was used to compare anthropometric variables. RESULTS: The results showed that the classification of eutrophics represents a predominant percentage between both sexes (men: 03-04 = 55.4%; 05-10 = 57.6%; 11-19 = 53.5 % and women: 03-04 = 53.5%; 05-10 = 63.9%; 11-19 = 56.9%), and growth curves showed differences in specific periods in both sexes. CONCLUSIONS: It can be concluded that children and adolescents from the city of Goiânia present as predominance the eutrophic nutritional status, followed by the risk of overweight, underweight, obesity, and malnutrition of both sexes.

Growth charts of Brazilian youngs: 20-years data of 95,000 children and adolescents from "Projeto Esporte Brasil" / Curvas de crescimento de jovens brasileiros: dados de 20 anos com 95.000 crianças e adolescentes do "Projeto Esporte Brasil"

Abstract This article aims to present growth curves for height, weight, and BMI of 95,000 Brazilian youths aged 6 to 17 years, including the five regions of the country, the Amazon region, and indigenous populations, and compare them with the World Health Organization (WHO) growth references. The final sample consisted of 52,729 boys and 42,731 girls from the "Projeto Esporte Brasil" database. Body mass and height information were used to derive the curves. The generalized additive model for location, scale, and shape was employed. In this study, we present smoothed weight-for-age, height-for-age, and BMI-for-age curves for boys and girls. Differences were observed between the results of the Brazilian curves and the WHO growth references. The developed curves will be valuable for professionals in medicine, public health, nutrition, physical education, and other related fields, regarding the assessment of physical growth in Brazilian children and adolescents and monitoring the nutritional status of this population. Additionally, these curves will facilitate the identification of individuals or subgroups at risk of diseases and delayed growth, with a greater focus on specific country-related factors.

Resumo O objetivo do artigo é apresentar curvas de crescimento de altura, peso e IMC de 95.000 jovens brasileiros com idades entre 6 e 17 anos, incluindo as cinco regiões do país, a região da Amazônia e os povos indígenas, e comparar com as referências de crescimento da Organização Mundial da Saúde (OMS). A amostra final foi composta por 52.729 meninos e 42.731 meninas provenientes do banco de dados do "Projeto Esporte Brasil". As informações de massa corporal e estatura foram utilizadas para derivar as curvas. O modelo aditivo generalizado para localização, escala e forma foi usado. neste estudo, apresentamos as curvas suavizadas de peso-idade, altura-idade e IMC-idade para meninos e meninas. Foram observadas diferenças entre os resultados das curvas brasileiras e as referências de crescimento da OMS. As curvas desenvolvidas serão úteis para profissionais da medicina, saúde pública, nutrição, educação física, entre outros, no que diz respeito a avaliação do crescimento físico de crianças e adolescentes brasileiros e para monitorar o estado nutricional desta população. Além disso, essas curvas permitirão a detecção de indivíduos ou subgrupos em risco de doenças e crescimento retardado, com um foco maior em fatores específicos do país.

Comparison of the effect of dietary and herbal supplements on anthropometric, metabolic and androgenic profiles of women with polycystic ovary syndrome: a systematic review and network meta-analysis protocol.

Polycystic ovarian syndrome (PCOS) is characterized by obesity, glucose intolerance, dyslipidemia, and hyperandrogenemia. Although several, placebo-controlled 2x2 factorial design, randomized controlled trials have tested the efficacy of dietary and herbal supplements in controlling these parameters in PCOS patients, these studies are not suitable for a comparative efficacy assessment across these supplements. Herein, a protocol for systematic review and network meta-analysis (NMA) is presented to make such a comparison. PubMed, Embase, and Scopus, were interrogated to identify relevant trials, published in English, factors to be investigated will include dietary factors, micronutrients, choline, essential fatty acids, and herbal extracts. Other factors to be considered include trial design, population characteristics, interventions compared, and outcomes of interest. The revised Cochrane tool was used for the appraisal of eligible trials. NMA (frequentist method) will be used for respective outcomes to compare effect sizes (weighted or standardized mean difference) among the interventions. Both logical and statistical (inconsistency assessment) approaches will be used to minimize intransitivity risk. The surface under the cumulative ranking curve values will be used to gauge the best intervention for outcomes with a statistically significant effect size suggesting a favorable outcome. Additionally, the exploration of interrelation among interventions and the small study effect in respective NMA models will be investigated using network maps and comparison-adjusted funnel plots, respectively. Statistical significance is assumed at p<0.05 with 95% confidence interval. Stata statistical software (v16) was used for analysis. The study was registered with PROSPERO, registration number: CRD42022301530.

Laser-Based 3D Body Scanning Reveals a Higher Prevalence of Abdominal Obesity than Tape Measurements: Results from a Population-Based Sample.

BACKGROUND: The global obesity epidemic is a major public health concern, and accurate diagnosis is essential for identifying at-risk individuals. Three-dimensional (3D) body scanning technology offers several advantages over the standard practice of tape measurements for diagnosing obesity. This study was conducted to validate body scan data from a German population-based cohort and explore clinical implications of this technology in the context of metabolic syndrome. METHODS: We performed a cross-sectional analysis of 354 participants from the Study of Health in Pomerania that completed a 3D body scanning examination. The agreement of anthropometric data obtained from 3D body scanning with manual tape measurements was analyzed using correlation analysis and Bland-Altman plots. Classification agreement regarding abdominal obesity based on IDF guidelines was assessed using Cohen's kappa. The association of body scan measures with metabolic syndrome components was explored using correlation analysis. RESULTS: Three-dimensional body scanning showed excellent validity with slightly larger values that presumably reflect the true circumferences more accurately. Metabolic syndrome was highly prevalent in the sample (31%) and showed strong associations with central obesity. Using body scan vs. tape measurements of waist circumference for classification resulted in a 16% relative increase in the prevalence of abdominal obesity (61.3% vs. 52.8%). CONCLUSIONS: These results suggest that the prevalence of obesity may be underestimated using the standard method of tape measurements, highlighting the need for more accurate approaches.

Deep Learning for Automated Measurement of Patellofemoral Anatomic Landmarks.

BACKGROUND: Patellofemoral anatomy has not been well characterized. Applying deep learning to automatically measure knee anatomy can provide a better understanding of anatomy, which can be a key factor in improving outcomes. METHODS: 483 total patients with knee CT imaging (April 2017-May 2022) from 6 centers were selected from a cohort scheduled for knee arthroplasty and a cohort with healthy knee anatomy. A total of 7 patellofemoral landmarks were annotated on 14,652 images and approved by a senior musculoskeletal radiologist. A two-stage deep learning model was trained to predict landmark coordinates using a modified ResNet50 architecture initialized with self-supervised learning pretrained weights on RadImageNet. Landmark predictions were evaluated with mean absolute error, and derived patellofemoral measurements were analyzed with Bland-Altman plots. Statistical significance of measurements was assessed by paired t-tests. RESULTS: Mean absolute error between predicted and ground truth landmark coordinates was 0.20/0.26 cm in the healthy/arthroplasty cohort. Four knee parameters were calculated, including transepicondylar axis length, transepicondylar-posterior femur axis angle, trochlear medial asymmetry, and sulcus angle. There were no statistically significant parameter differences (p > 0.05) between predicted and ground truth measurements in both cohorts, except for the healthy cohort sulcus angle. CONCLUSION: Our model accurately identifies key trochlear landmarks with ~0.20-0.26 cm accuracy and produces human-comparable measurements on both healthy and pathological knees. This work represents the first deep learning regression model for automated patellofemoral annotation trained on both physiologic and pathologic CT imaging at this scale. This novel model can enhance our ability to analyze the anatomy of the patellofemoral compartment at scale.

Effects of Dairy Intake on Markers of Cardiometabolic Health in Adults: A Systematic Review with Network Meta-Analysis.

The health effects of dairy products are still a matter of scientific debate owing to inconsistent findings across trials. Therefore, this systematic review and network meta-analysis (NMA) aimed to compare the effects of different dairy products on markers of cardiometabolic health. A systematic search was conducted in 3 electronic databases [MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science; search date: 23 September 2022]. This study included randomized controlled trials (RCTs) with a ≥12-wk intervention comparing any 2 of the eligible interventions [e.g., high dairy (≥3 servings/d or equal amount in grams per day), full-fat dairy, low-fat dairy, naturally fermented milk products, and low dairy/control (0-2 servings/d or usual diet)]. A pairwise meta-analysis and NMA using random-effects model was performed in the frequentist framework for 10 outcomes [body weight, BMI, fat mass, waist circumference, low-density lipoprotein cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, fasting glucose, glycated hemoglobin, and systolic blood pressure]. Continuous outcome data were pooled using mean differences (MDs) and dairy interventions ranked using the surface under the cumulative ranking curve. Nineteen RCTs with 1427 participants were included. High-dairy intake (irrespective of fat content) showed no detrimental effects on anthropometric outcomes, blood lipids, and blood pressure. Both low-fat and full-fat dairy improved systolic blood pressure (MD: -5.22 to -7.60 mm Hg; low certainty) but, concomitantly, may impair glycemic control (fasting glucose-MD: 0.31-0.43 mmol/L; glycated hemoglobin-MD: 0.37%-0.47%). Full-fat dairy may increase HDL cholesterol compared with a control diet (MD: 0.26 mmol/L; 95% CI: 0.03, 0.49 mmol/L). Yogurt improved waist circumference (MD: -3.47 cm; 95% CI: -6.92, -0.02 cm; low certainty), triglycerides (MD: -0.38 mmol/L; 95% CI: -0.73, -0.03 mmol/L; low certainty), and HDL cholesterol (MD: 0.19 mmol/L; 95% CI: 0.00, 0.38 mmol/L) compared with milk. In conclusion, our findings indicate that there is little robust evidence that a higher dairy intake has detrimental effects on markers of cardiometabolic health. This review was registered at PROSPERO as CRD42022303198.

Concordância entre as medidas aferidas de peso, altura e IMC e autorrelatadas pela internet em participantes da coorte de nascimentos de Pelotas de 1993: estudo transversal de validação / Agreement between measured weight, height and BMI and Web-based self-reported data in participants of the 1993 Pelotas Birth Cohort, Brazil: a cross-sectional validation study / Concordancia entre medidas de peso, talla e IMC autoinformadas en internet en participantes de la Cohorte de Nascimiento de Pelotas de 1993, Brasil: estudio de validación transversal

Objetivo: avaliar a concordância entre altura, peso e índice de massa corporal (IMC) aferidos durante o acompanhamento dos 22 anos da coorte de nascimentos de Pelotas, Rio Grande do Sul, Brasil, de 1993, e dados autorrelatados durante o acompanhamento online da coortesnaweb. Métodos: estudo transversal de validação; a concordância foi avaliada pelos coeficientes de correlação de Lin para medidas contínuas e de Kappa ponderado para o estado nutricional; utilizou-se a correlação de Spearman para estimar a correlação entre as medidas. Resultados: 783 participantes foram incluídos; observou-se alta correlação e alta concordância entre as medidas de altura (r = 0,966; ρ = 0,966), peso (r = 0,934; ρ = 0,928) e IMC (r = 0,903; ρ = 0,910) aferidas e as autorrelatadas via internet; não houve correlação entre as diferenças médias e o intervalo de tempo entre as medidas. Conclusão: utilizar a internet para coletar medidas antropométricas autorrelatadas é um método válido, comparado ao método tradicional.

Objective: to evaluate the agreement between measured height, weight, and body mass index (BMI) during the 22-year follow-up of the 1993 Pelotas Birth Cohort, state of Rio Grande do Sul, Brazil, and self-reported data during the online follow-up of the coortesnaweb. Methods: this was a cross-sectional validation study; agreement was assessed by means of Lin's concordance correlation coefficient for continuous measures and weighted Kappa for nutritional status; Spearman's rank correlation coefficient was used to estimate the correlation between measurements. Results: a total of 783 participants were included; it could be seen high correlation and high agreement between the measured height (r = 0.966; ρ = 0.966), weight (r = 0.934; ρ = 0.928), and BMI (r = 0.903; ρ = 0.910) and Web-based self-reported data; there was no correlation between mean difference and the time interval between measurements. Conclusion: using the Internet to collect self-reported anthropometric measurements is as valid as the traditional method.

Objetivo: evaluar la concordancia entre la altura, el peso y el índice de masa corporal (IMC) medidos durante el acompañamiento de 22 años de la cohorte de nacimientos de Pelotas de 1993 y autoinformado durante el seguimiento en línea de la coortesnaweb. Métodos: estudio metodológico de validación. Se utilizó el coeficiente de correlación de Lin para medidas continuas, y de Kappa ponderado para el estado nutricional y la correlación de Spearman para la correlación entre medidas. Resultados: se incluyeron 783 participantes, con alta correlación y concordancia entre las medidas de talla (r = 0,966; ρ = 0,966), peso (r = 0,934; ρ = 0,928) e IMC (r = 0,903; ρ = 0,910) medidos y autoinformados vía web. No hubo correlación entre las diferencias de medidas y el intervalo de tiempo entre las mediciones. Conclusión: el uso de internet para recopilar variables antropométricas autoinformadas es válido en comparación con el método tradicional.

Are sociodemographic and anthropometric variables effective in screening probable and confirmed sarcopenia in community-dwelling older adults? A cross-sectional study

ABSTRACT BACKGROUND: Screening for probable and confirmed sarcopenia using sociodemographic and anthropometric indicators can be a practical, cheap, and effective strategy to identify and treat older people susceptible to this condition. OBJECTIVES: To identify cutoff points for sociodemographic and anthropometric variables in screening probable and confirmed sarcopenia in community-dwelling older adults. DESIGN AND SETTING: This was a cross-sectional study of community-dwelling older adults in Araranguá, Santa Catarina, Brazil. METHODS: Sociodemographic (age, education) and anthropometric (weight, height, body mass index [BMI], waist circumference [WC], and dominant calf circumference [DCC]) factors were considered as predictors. The outcomes were probable sarcopenia (reduction in muscle strength assessed by time ≥ 15 s in the five-time sit-to-stand test) and confirmed sarcopenia (reduction in strength and muscle mass). Receiver operating characteristic curve analysis was used to analyze the ability to track sociodemographic and anthropometric variables for sarcopenia. RESULTS: In 308 older adults, WC > 91 cm in women and age > 69 years in men were useful in screening for probable sarcopenia. The variables age, weight, BMI, WC, and DCC can be used to screen for sarcopenia in older women and men. CONCLUSION: Sociodemographic and anthropometric variables are simple and accessible tools for sarcopenia screening in older adults.

Weighty Matters: A Real-World Comparison of the Handtevy and Broselow Methods of Prehospital Weight Estimation.

INTRODUCTION: The majority of pediatric medications are dosed according to weight and therefore accurate weight assessment is essential. However, this can be difficult in the unpredictable and peripatetic prehospital care setting, and medication errors are common. The Handtevy method and the Broselow tape are two systems designed to guide Emergency Medical Services (EMS) providers in both pediatric patient weight estimation and medication dosing. The accuracy of the Handtevy method of weight estimation as practiced in the field by EMS has not been previously examined. STUDY OBJECTIVE: The primary objective of this study was to examine the field performance of the Handtevy method and the Broselow tape with respect to prehospital patient weight estimation. METHODS: This was a retrospective chart review of trauma and non-trauma patients transported by EMS to the emergency department (ED) of a quaternary care children's hospital from January 1, 2021 through June 30, 2021. Demographic data, ED visit information, prehospital weight estimation, and medication dosing were collected and analyzed. Scale-based weight from the ED was used as the standard for comparison. RESULTS: A total of 509 patients <13 years of age were included in this study. The EMS providers using the Broselow method estimated patient weight to within +/-10% of ED scale weight in 51.3% of patients. When using the Handtevy method, the EMS providers estimated patient weight to within +/-10% of ED scale weight in 43.7% of patients. When comparing the Handtevy versus Broselow method of prehospital weight estimation, there was no significant association between method and categorized weight discrepancy (over, under, or accurate estimates - defined as within 10% of ED scale weight; P = .25) or percent weight discrepancy (P = .75). On average, prehospital weight estimation was 6.33% lower than ED weight with use of the Handtevy method and 6.94% lower with use of the Broselow method. CONCLUSION: This study demonstrated no statistically significant difference between the use of the Handtevy or Broselow methods with respect to prehospital weight estimation. While further research is necessary, these results suggest similar field performance of the Broselow and Handtevy methods.

Bloqueadores do Receptor de Angiotensina Avaliados por Medida de Consultório e Residencial da Pressão Arterial. Estudo TeleMRPA / Angiotensin Receptor Blockers Evaluated by Office and Home Blood Pressure Measurements. TeleHBPM Study

Resumo Fundamento O tratamento adequado e a obtenção das metas na hipertensão arterial são importantes na redução dos desfechos cardiovasculares. Objetivos Descrever os bloqueadores do receptor de angiotensina (BRA) em monoterapia ou combinação dupla e a taxa de controle da hipertensão arterial. Métodos Estudo transversal que avaliou pacientes em uso de BRA entre 2017 e 2020. Foram excluídos aqueles em uso de três ou mais anti-hipertensivos. As variáveis analisadas foram: sexo, idade, índice de massa corporal, medidas válidas da medida residencial da pressão arterial (MRPA); pressão arterial sistólica (PAS) e diastólica (PAD) obtidas pela MRPA e de forma casual; variabilidade pressórica; classe dos anti-hipertensivos e dos BRAs. Foram utilizados testes de t pareado, qui-quadrado e Fisher, além de sobreposição dos intervalos de confiança de 95% com nível de significância de 5% (p < 0,05). Resultados Foram selecionados 17.013 pacientes; destes, 12.813 preencheram os critérios, dos quais 62,1% eram do sexo feminino. O número médio de medidas válidas foi de 23,3 (±2,0), com médias para a PAS de 126,8±15,8 mmHg e 133,5±20,1 mmHg (p < 0,001) e para a PAD de 79,1±9,7 mmHg e 83,6±11,9 mmHg (p < 0,001) pela MRPA e medida casual, respectivamente. Losartana foi o BRA mais utilizado e o que apresentou comportamentos mais elevados da pressão arterial. As combinações de BRA com diuréticos ou com antagonistas de canal de cálcio tiveram menores valores de pressão arterial. Conclusões Losartana foi utilizada em mais da metade dos pacientes, apesar de ser a menos eficiente na redução e no controle da pressão arterial.

Abstract Background Adequate treatment of arterial hypertension and achieving arterial hypertension goals in are important in reducing cardiovascular outcomes. Objectives To describe angiotensin receptor blockers in monotherapy or double combination therapy and the rate of arterial hypertension control. Methods This cross-sectional study evaluated patients who were using angiotensin receptor blockers between 2017 and 2020. Those using three or more antihypertensive drugs were excluded. The analyzed variables included sex, age, body mass index, valid home blood pressure monitoring (HBPM) measurements, casual and HBPM systolic and diastolic blood pressure measurements, blood pressure variability, and antihypertensive and angiotensin receptor blocker class. Paired t, chi-square, and Fisher's exact tests were used, as well as overlapping 95% confidence intervals and a significance level of 5% (p < 0.05). Results Of 17,013 patients, 12,813 met the inclusion criteria, 62.1% of whom were female. The mean number of valid measurements was 23.3 (SD, 2.0). The mean HBPM and casual measurements for systolic blood pressure were 126.8 (SD, 15.8) mmHg and 133.5 (SD, 20.1) mmHg (p <0.001), respectively, while those for diastolic blood pressure were 79.1 (SD, 9.7 mmHg) and 83.6 (SD, 11.9) mmHg (p <0.001), respectively. Losartan was the most common angiotensin receptor blocker and resulted in the highest blood pressure values. Combinations of angiotensin receptor blockers with diuretics or calcium channel antagonists resulted in lower blood pressure values. Conclusions More than half of the patients used losartan, although it was the least efficient drug for reducing and controlling blood pressure.

Simulation of 3D Body Shapes for Pregnant and Postpartum Women.

Several studies have reported that pre-pregnant women's body mass index (BMI) affects women's weight gain with complications during pregnancy and the postpartum weight retention. It is important to control the BMI before, during and after pregnancy. Our objectives are to develop a technique that can compute and visualize 3D body shapes of women during pregnancy and postpartum in various gestational ages, BMI, and postpartum durations. Body changes data from 98 pregnant and 83 postpartum women were collected, tracked for six months, and analyzed to create 3D model shapes. This study allows users to simulate their 3D body shapes in real-time and online, based on weight, height, and gestational age, using multiple linear regression and morphing techniques. To evaluate the results, precision tests were performed on simulated 3D pregnant and postpartum women's shapes. Additionally, a satisfaction test on the application was conducted on new 149 mothers. The accuracy of the simulation was tested on 75 pregnant and 74 postpartum volunteers in terms of relationships between statistical calculation, simulated 3D models and actual tape measurement of chest, waist, hip, and inseam. Our results can predict accurately the body proportions of pregnant and postpartum women.

Relationship between tube voltage kV value for head and neck CT angiography and body weight / 中国基层医药

Objective:To investigate the relationship between tube voltage kV value for head and neck CT angiography and body weight.Methods:A total of 120 patients with suspected vascular disease of the head and neck who underwent CT angiography of the head and neck in Beihai People's Hospital from January 2020 to May 2022 were included in this study. Patients were divided into three groups according to different tube voltages: group A (tube voltage 120 kV, n = 45), group B (tube voltage 100 kV, n = 45) and group C (tube voltage 80 kV, n = 30). Patients in group A were divided into group A1 (< 70 kg, n = 15), group A2 (70-85 kg, n = 15) and group A3 (> 85 kg, n = 15) according to different body weights. Patients in group B were divided into group B1 (< 70 kg, n = 15), group B2 (70-85 kg, n = 15) and group B3 (> 85 kg, n = 15) according to different body weights. Patients in group C were divided into group C1 (< 70 kg, n = 15) and group C2 (70-85 kg, n = 15) according to different body weights. Group C3 was not used. The contrast medium used was Loversol. The CT value, image noise, signal-to-noise ratio, contrast to noise ratio, and effective radiation dose of arterial vessels in each group were measured. The images were subjectively evaluated by two physicians who had senior professional titles using a 5-point rating scale. Results:Subjective score of image quality was all ≥ 3 grade in each group. There was no significant difference in image quality rating between groups A1 and A2 and groups B1, B2, and C1. There was a remarkable difference in image quality rating between groups A3, B3, and C2 and the other groups. There was a significant difference in the CT value of blood vessels at four different levels between groups A1, B1 and C1 ( F = 76.82, 64.62, 98.79, 71.85, all P < 0.001). There was a significant difference in CT value of blood vessels at four different levels between groups A2, B2 and C2 ( F = 159.82, 112.33, 108.22, 135.18, all P < 0.001). There was a significant difference in CT value of blood vessels at four different levels between groups A3 and B3 ( t = 4.40, 4.27, 3.91, 3.59, all P < 0.05). In groups B3 and C2, the image noise was remarkably increased, signal to noise ratio and contrast to noise ratio were remarkably decreased compared with those in the other groups. The effective radiation dose of arterial vessels in group B1 was 47% lower than that in group A1 and the effective radiation dose of arterial vessels in group C1 was 73% lower than that in group A1 ( F = 116.18, P < 0.001). The effective radiation dose of arterial vessels in group B2 was 49% lower than that in group A2, and the effective radiation dose of arterial vessels in group C2 was 66% lower than that in group A2 ( H = 35.40, P < 0.001). The effective radiation dose in group B3 was 35% lower than that in group A3 ( t = 3.59, P < 0.05). Conclusion:In CT angiography of the head and neck, the selection of tube voltage kV value is related to body weight. Tube voltage 80 kV is suitable for patients with a body weight < 70 kg, tube voltage 100 kV for patients with a body weight of 70-85 kg, and tube voltage 120 kV for patients with a body weight > 85 kg. These tube voltages can decrease effective radiation dose and ensure image quality, meeting the requirement for clinical diagnosis.

Medidas antropométricas orofaciais de recém-nascidos e sua relação com sexo, peso e altura / Anthropometric orofacial measures of newborns and their relationship with sex, weight and height

RESUMO Objetivo Comparar as medidas antropométricas orofaciais, com peso, altura e sexo de recém-nascidos. Método Estudo transversal observacional realizado com 130 recém-nascidos em aleitamento materno exclusivo. A coleta de dados foi realizada por fonoaudiólogas devidamente treinadas e calibradas. As medidas orofaciais dos recém-nascidos foram realizadas com uma régua maleável e transparente de 10 cm de comprimento, nos seguintes segmentos: alturas do terço superior (tr-g), do terço médio (g-sn) e do terço inferior da face (sn-gn); altura do filtro (sn-Is); distância entre o canto do olho e a comissura labial do lado direito e esquerdo (ex-ch). A medida do peso e da altura foram coletadas nos prontuários dos recém-nascidos. Os dados foram submetidos à análise estatística, sendo aplicado o teste de Mann-Whitney, adotando nível de significância de 5%. Resultados Dos 130 recém-nascidos, 61 eram do sexo masculino e 69 do sexo feminino. A mediana do peso foi de 3,3 kg e da altura de 49 cm. Houve diferença significativa entre o peso e a medida da distância entre o canto do olho e a comissura labial do lado direito e esquerdo (ex-ch). Não foi encontrada diferença significativa das medidas orofaciais com sexo e altura. Conclusão Não houve diferença nas medidas antropométricas orofaciais de recém-nascidos a termo quando comparadas com sexo e altura; porém, quando comparadas com peso, há diferença nas medidas da distância entre o canto do olho e a comissura labial do lado direito e esquerdo.

ABSTRACT Purpose To compare orofacial anthropometric measurements, with weight, height and sex of newborns. Methods Observational cross-sectional study carried out with 130 newborns on exclusive breastfeeding. Data collection was performed by properly trained and calibrated speech therapists. The orofacial measurements of the newborns were performed with flexible and transparent ruler 10 cm long, in the following segments: heights of the upper third(tr-g), the middle third(g-sn) and the lower third on the face (sn-gn); filter height (sn-Is), distance between the corner of the eye and the labial commissure on the right and left side (ex-ch). Weight and height measurements were collected from the newborns' medical records. The data were submitted to statistical analysis, using the Mann-Whitney test, adopting a significance level of 5%. Results Of the 130 newborns, 61 were male and 69 female. The median weight was 3.3 kg and the median height was 49 cm. There was significant difference between weight and measurement distance between the corner of the eye and the left and right labial commissure (ex-ch). There was no significant difference in orofacial measurements with sex and height. Conclusion There was no difference in orofacial anthropometric measurements of full-term newborns when compared with sex and height; however, when compared to weight, there is a difference in the measurements of the distance between the corner of the eye and the labial commissure on the right and left side.

Anthropometric Measures and Risk of Cardiovascular Disease: Is there an Opportunity for Non-Traditional Anthropometric Assessment? A Review.

Background: Several anthropometric measurements are used to assess cardiovascular risk and progress during clinical treatment. Most commonly used anthropometric measurements include total body weight and body mass index (BMI), with several other simple anthropometric measures typically underused in clinical practice. Herein, we review the evidence on the relationship between different anthropometric measurements and cardiovascular risk in patients with and without cardiovascular disease (CVD). Methods: Data for this review were identified by searches in PubMed, the Web of Science, Google Scholar, and references from relevant articles by using appropriate and related terms. The last search was performed on June 22, 2022. Articles published in English and Spanish were reviewed and included, if appropriate. We included studies detailing the relationship between skinfolds thickness, waist-to-hip ratio (WHR) and Conicity index with cardiovascular risk in adults with/without CVD. Results: In patients from the general population, elevated subscapular and triceps skinfolds showed a positive relationship with the development of hypertension, diabetes mellitus, hypercholesterolemia, cardiovascular mortality, and all-cause mortality. A higher subscapular skinfold was also associated with increased risk of coronary artery disease and stroke. A higher WHR, as well as other less common anthropometric measurements such as the Conicity index, was associated with an increased risk of myocardial infarction, incident CVD, major adverse cardiovascular events, and mortality in both patients with and without previous CVD. Conclusions: Non-traditional anthropometric measurements including skinfolds and WHR seem to improve the prediction of cardiovascular risk in the general population, and recurrent events in patients with previous CVD. Use of additional anthropometric techniques according to an objective and standardized method, may aid cardiovascular risk stratification in patients from the general population and the evaluation of therapeutic interventions for patients with CVD.

The effect of probiotics on lipid profile & anthropometric indices in diabetic nephropathy; a systematic review and meta-analysis of clinical trials.

PURPOSE: Recent trials have demonstrated the possible improvements in lipid profile & anthropometric indices after probiotics supplementation. We aimed to reanalyze the related literature to explore the efficacy of probiotics in Diabetic Nephropathy (DN) patients. METHODS: PubMed, Embase, Web of science, google scholar, Scopus, and Cochrane Library databases were systematically searched to find the related data on diabetic nephropathy population. All Randomized controlled trials (RCTs) that investigated the effect of probiotics on serum lipid markers (High-Density Lipoprotein [HDL], Triglyceride, Total Cholesterol, TC-to-HDL ratio, Low-Density Lipoprotein, Very Low-Density Lipoprotein) and anthropometric indices (Body Weight, Body Mass Index, waist-to-hip ratio) were included (PROSPERO No.CRD42020186189). Meta-analysis was performed using the random-effect model. RESULTS: Of 156 studies, seven were eligible for inclusion. Lipid biomarkers had a marginal reduction (except for HDL; WMD = 2.59 mg/dl; 95% CI = -0.28, 5.47; P = 0.077); whereas anthropometric indices increased in a non-significant manner. CONCLUSION: There is limited evidence to support the efficacy of probiotics for the modulation of lipid profile and anthropometric indices in DN patients. GRAPHICAL ABSTRACT: Probiotics did not beneficial effect on lipid profile & anthropometric markers in Diabetic Nephropathy; anyway, more trials should be conducted. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40200-021-00765-8.