Variaciones fisiológicas y antropométricas en trabajadores según su residencia en tres altitudes geográficas del Perú / Physiological and anthropometric variations in workers due to their residence in three geographic altitudes in Peru

Introducción: El organismo se adapta al lugar donde reside, pero este tema no ha sido estudiado en la población laboral peruana. Objetivo: Determinar las variaciones fisiológicas y antropométricas en trabajadores según su residencia en tres altitudes geográficas del Perú. Métodos: Se realizó una investigación transversal analítica, con los datos fisiológicos (6 parámetros de laboratorio) y antropométricos (peso y talla) de 7500 trabajadores en 3 altitudes diferentes: Lima (nivel del mar), Arequipa (2500 m sobre el nivel del mar) y Cerro de Pasco (4300 m sobre el nivel del mar). Estas mediciones fueron estándares, realizadas por clínicas ocupacionales con certificaciones de calidad. Se obtuvo los coeficientes y valores p para las diferencias según cada altitud y ajustados por el sexo y la edad de cada participante. Resultados: Todos los parámetros fisio-antropométricos variaron según la altitud de residencia (todos los valores p fueron menores a 0,005). Los que se incrementaron a mayor altitud fueron la hemoglobina, el colesterol total y el colesterol HDL; en cambio, disminuyeron a mayor altitud el peso y la glucosa en ayunas. En los hombres aumentaron todas las variables menos en el colesterol HDL (que disminuyó significativamente) y el colesterol LDL (que no tuvo variación estadística), en comparación con las mujeres. Conclusiones: Son evidentes las variaciones en las mediciones de los trabajadores según el lugar donde residían, lo que muestra que no se debe tomar parámetros fijos para su valoración laboral. Esto debe servir a los médicos del trabajo y las autoridades, para tener en cuenta al momento de la valoración de la aptitud médica y luego para la vigilancia ocupacional(AU)

Introduction: The human body adapts to its place of residence, but this topic has not been studied in the Peruvian working population. Objective: Determine physiological and anthropometric variations in workers due to their residence in three geographic altitudes in Peru. Methods: An analytical cross-sectional study was conducted of physiological data (6 laboratory parameters) and anthropometric data (weight and height) of 7 500 workers from three different altitudes: Lima (sea level), Arequipa (2 500 m above sea level) and Cerro de Pasco (4 300 m above sea level). The measures were standard and taken by occupational clinics with quality certifications. Coefficients and p values for differences between the altitudes were obtained and adjusted according to the sex and age of participants. Results: All the physio-anthropometric parameters varied with the altitude of the place of residence (all p values were under 0.005). The parameters which increased at a higher altitude were hemoglobin, total cholesterol and HDL cholesterol, whereas the ones which decreased at a higher altitude were weight and fasting glucose. Among men all variables increased except for HDL cholesterol (which decreased significantly) and LDL cholesterol (which did not show any statistical variation), in comparison with women. Conclusions: Variations in measurements taken from workers from different places of residence are obvious, which shows that fixed parameters should not be used for their labor assessment. This should be taken into account by occupational doctors and authorities for medical attitude assessment and occupational surveillance(AU)

Risk Factors for Tibial Component Oversizing in Total Knee Arthroplasty among African Americans.

Incidences and risk factors for tibial component oversizing in total knee arthroplasty (TKA) have been well described, predominantly in Caucasian samples. Component oversizing has been linked to variations in proximal tibial shape and morphology, which has been found to be objectively different in African Americans compared with Caucasians. These anthropometric differences may affect the conformity of modern TKA systems to the anatomy of African Americans undergoing TKA. We sought to investigate the incidence and risk factors for tibial baseplate oversizing in an exclusively African American population undergoing TKA with a symmetric tibial baseplate. We reviewed the records of self-reported African American patients who had undergone a primary TKA at a single academic institution between 2005 and 2016. The primary outcome was incidence of tibial baseplate oversizing in the coronal and sagittal planes as determined by a single set of appropriately rotated postoperative orthogonal radiographs. Logistic regression models identified trends in oversizing within the population based on age, sex, body mass index (BMI), and TKA model. Among all 525 knees being evaluated, the occurrences of medial and lateral overhang were 14.2 and 15.2%, respectively. Increase in age was associated with lower risk of medial tibial overhang (odds ratio = 0.97 for each 1-year increase in age). Simple linear regression models described a linear relationship between BMI and overhang, with every one-unit increase in BMI, medial tibial overhang is 0.031 mm higher and posterior tibial overhang is 0.062 mm higher. Mediolateral oversizing was approximately twice more likely in females than males. Among TKA models used, the Stryker Triathlon had the least risk for mediolateral oversizing and the P.F.C. SIGMA demonstrated the least propensity for anteroposterior oversizing. To conclude, incidence of mediolateral tibial oversizing in this population was common. Previously identified variables affecting proximal tibial morphology, including age, body morphotype, and gender, may be equally applicable to the conformity of tibial baseplates in this population. Surgeons must pay particular attention to avoid mediolateral tibial oversizing in this population, especially in obese and older patients.

Perineal length among Vietnamese women.

OBJECTIVE: Vietnamese clinicians routinely perform episiotomies in the belief that 3rd-4th degree tears may be prevented, based partly on the view that Vietnamese women have a short perineal length that puts them at increased risk of tears. However, there is no evidence to suggest Vietnamese women have a short perineum compared with other populations. We aimed to determine the mean perineal length among Vietnamese women in early labor and in the second stage, and to compare this to findings from similar studies in other populations. MATERIALS AND METHODS: We undertook an observational study in a tertiary obstetric hospital in Vietnam from October 2014 to June 2015. Pregnant women who presented in early labor with a live singleton cephalic presentation at ≥37 weeks gestation were eligible. Perineal length was measured early in the 1st stage of labor (≤4 cm dilation) and in 2nd stage of labor (10 cm dilation). Mean perineal length was compared to other populations using t-tests. RESULTS: Of 395 women, 159 (40.3%) were nulliparous and 236 (59.8%) multiparous. Overall the mean perineal length in early labor was 3.4 cm (±0.4), and did not differ by parity. Mean perineal length among Vietnamese women was significantly shorter (P < 0.001) than other populations (means 3.8-4.6 cm). Among 365 women who reached 2nd stage the mean perineal length was 4.3 cm (±0.6). CONCLUSION: The perception that Vietnamese women have a relatively shorter perineal length appears to have some basis and outcomes reported from episiotomy trials may not be generalizable to Vietnamese women.

Relação espacial entre a falange distal e o estojo córneo em éguas Campolinas jovens com e sem sinais de obesidade / Spatial relationship between the distal phalanx and the hoof capsule in young Campolina mares with and without obesity

Estudos prévios têm demonstrado alterações radiográficas em cascos de equinos obesos. Os objetivos foram estudar, com avaliação radiográfica, a relação espacial entre estojo córneo e falange distal de éguas jovens da raça Campolina com e sem obesidade. Foram utilizadas 22 éguas entre três e cinco anos de idade, sendo analisadas varáveis de adiposidade e medidas radiográficas dos cascos dos membros torácicos de éguas com escore corporal de 5 a 7/9 (Grupo Controle) e de 8 a 9 (Grupo Obeso). Foram feitas comparações entre os grupos e correlacionaram-se as variáveis de adiposidade entre si, variáveis adiposidade com variáveis casco e variáveis de casco entre si. Utilizou-se o teste t de Student para variáveis paramétricas e o teste Mann-Whitney para as não-paramétricas, para as medidas de correlação, utilizou o teste de Pearson para duas amostras paramétricas e o teste de Spearman para comparações que envolvam pelo menos uma variável não paramétrica (P<0,05). Os resultados demonstraram que éguas Campolinas obesas, ainda jovens, já apresentam indícios de alteração na relação espacial entre estojo córneo e falange distal.(AU)

Previous studies have demonstrated radiographic changes in the hoof of obese horses. The objective was to study through radiographic evaluation the spatial relationship between the hoof capsule and the distal phalanx of Campolina mares with and without obesity. Twenty-two Campolina mares 3 to 5 years old were used. We analyzed adiposity variables and radiographic measurements of the hoof of both forelimbs of mares with body condition score from 5 to 7/9 (Control group) and from 8 to 9 (Obese group). Comparisons were made between groups using the Student t test for parametric variables and the Mann-Whitney test for the nonparametric ones. Pearson or Spearman tests were used to evaluate the correlation among parametric and nonparametric variables respectively (P<0.05). Evidences of changes in the spatial relationship between the hoof capsule and the distal phalanx were observed in obese Campolina young mares.(AU)

Joint effects of physical activity, body mass index, waist circumference, and waist-to-hip ratio on the risk of heart failure.

BACKGROUND: Obesity increases heart failure (HF) risk; however, the independent effect of physical activity and the joint effect of physical activity and adiposity on HF risk are not established. We evaluated the single and joint associations of physical activity and different indicators of adiposity (body mass index, waist circumference, and waist-to-hip ratio) with HF risk. METHODS AND RESULTS: Study cohorts included 59 178 Finnish participants who were 25 to 74 years of age and free of HF at baseline. During a mean follow-up of 18.4 years, 1921 men and 1693 women developed HF. The multivariable-adjusted hazard ratios of HF associated with low, moderate, and high physical activity were 1.00, 0.79, and 0.69 (P(trend)<0.001) for men and 1.00, 0.86, and 0.68 (P(trend)<0.001) for women, respectively. The multivariable-adjusted hazard ratios of HF at different levels of body mass index (<25, 25 to 29.9, and >or=30 kg/m(2)) were 1.00, 1.25, and 1.99 (P(trend)<0.001) for men and 1.00, 1.33, and 2.06 (P(trend)<0.001) for women, respectively. Abdominal adiposity, measured by waist circumference or waist-to-hip ratio, was associated with a greater risk of HF among both men and women (all P(trend)<0.01). In joint analyses, the protective effect of physical activity was consistent in subjects at all levels of body mass index. CONCLUSIONS: General overweight and general and abdominal obesity are independently associated with an increased risk of HF, whereas moderate or high levels of physical activity are associated with a reduced risk of HF. The protective effect of physical activity on HF risk is observed at all levels of body mass index.