Geometric indices of femur bone strength in female handball players.

The practice of sports during the growth phase has a positive influence on bone mineral accrual. However, the effects of different sports are still not fully understood. The aim of this study was to evaluate the bone geometry in adolescent handball players. This is a cross-sectional study in which 53 female adolescents (12-17 years old) were divided into two groups: handball players (HG: n = 26), who must have had at least six months of participation in official competitions, and a control group (CG: n = 27). Bone geometry properties, such as cross-sectional area (CSA), cross-sectional moment of inertia (CSMI), section modulus (Z), and femoral strength index (FSI) were measured using DXA. Tanner's sexual maturity, menarche, peak height velocity, sun exposure, and calcium intake were assessed. An unpaired Student's t test or the Mann-Whitney test and multivariate analyzes were used to compare variables differences between groups. The HG group showed a significantly higher body mass index, weight and lean mass (LST), CSA, CSMI, Z, and FSI than the CG group. When the values were adjusted for LST, the differences disappeared. The LST has been shown to be relevant to the strength and bone stiffness of the femurs of female adolescents, and the competitive practice in handball may have contributed to its increase.

Tratamento de queimaduras de segundo grau profundo em abdômen, coxas e genitália: uso da pele de tilápia como um xenoenxerto / Treatment of deep second-degree burns on the abdomen, thighs, and genitalia: use of tilapia skin as a xenograft

A pele de tilápia possui microbiota não infecciosa e estrutura morfológica semelhante à pele humana. Estudos clínicos fase II, ainda não publicados, mostraram resultados promissores na sua utilização para tratamento de queimaduras. Nos protocolos destes estudos, pacientes com lesões em áreas de dobras de pele, como genitais e região inguinal, foram excluídos, pois achava-se que o biomaterial não aderiria apropriadamente, resultando em um grau de cicatrização inferior. Relato de caso de paciente do sexo feminino, 18 anos, sem comorbidades, com queimaduras de segundo grau profundo em abdômen, região inguinal, parte da genitália e metade superior de ambas as coxas, envolvendo 13,5% da área total da superfície corporal. A pele de tilápia foi aplicada nas lesões levando a uma reepitelização completa com 16 dias de tratamento. Não foram observados efeitos colaterais. A pele de tilápia traz, portanto, a promessa de um produto inovador, de fácil aplicação e alta disponibilidade, que pode se tornar a primeira pele animal nacionalmente estudada e registrada pela Agência Nacional de Vigilância Sanitária, para uso no tratamento de queimaduras. Este relato de caso contribui para reduzir as limitações em relação às áreas anatômicas apropriadas para a aplicação da pele de tilápia, uma vez que, mesmo com a necessidade de reposição de pele, foram obtidos bons resultados com aplicação na genitália e região inguinal.

Tilapia skin has a non-infectious microbiota and a morphological structure similar to human skin. Phase II clinical studies, not yet published, have shown promising results in their use for the treatment of burns. In the protocols of these studies, patients with lesions in areas of skin folds, such as genitals and inguinal regions, were excluded, as it was thought that the biomaterial would not adhere properly, resulting in a lower degree of healing. Case report of a female patient, 18 years old, without comorbidities, with deep second-degree burns in the abdomen, inguinal region, part of the genitalia and upper half of both thighs, involving 13.5% of the total body surface area. Tilapia skin was applied to the lesions leading to a complete re-epithelialization with 16 days of treatment. No side effects were observed. Tilapia skin, therefore, brings the promise of an innovative product, easy to apply, and highly available, which can become the first animal skin nationally studied and registered by the Agência Nacional de Vigilância Sanitária, for use in the treatment of burns. This case report contributes to reduce the limitations concerning the anatomical areas appropriate for the application of tilapia skin, since, even with the need for skin replacement, good results were obtained with application to the genitalia and inguinal region.

Análise do exercício agachamento com e sem o uso de physioball e banda elástica em diferentes intensidades / Analysis of the squat exercise with and without physioball and elastic band in different intensities

RESUMO O objetivo do presente estudo foi analisar a atividade mioelétrica (EMG), o tempo sob tensão (TST) e a projeção dos joelhos no exercício agachamento sem o uso de implementos (SI) e com o uso de physioball (PH) e banda elástica (BE) em diferentes intensidades de esforço. Dez homens realizaram o exercício nos três protocolos com a intensidade de 50 e 100% de 10 RM. A distância entre joelhos no protocolo controle (51,25cm) foi menor quando comparada com o SI 50% (84,38cm; p < 0,001), com o SI 100% (88,80cm; p < 0,001) e com BE 100% (67,41cm; p = 0,014). A distância entre os joelhos também foi menor para os protocolos PH 100% (53,10cm; p < 0,001) e BE 100% (67,41cm; p < 0,001) comparada ao SI 100% (88,80cm). O Vasto Medial Oblíquo (VMO) apresentou maior ativação nos protocolos SI 50% (p = 0,035) e PH 50% (p = 0,028) quando comparados ao protocolo BE 50%. A realização do agachamento com cargas submáximas parece aumentar e diminuir a ativação do VMO quando realizado com PH e BE, respectivamente.

ABSTRACT The objective of the present study was to analyze the myoelectric activity (EMG), the time under tension (TST) and the knee projection in the squat exercise without the use of implements (SI) and with the use of physioball (PH) and elastic band (EB) at different intensities of effort. Ten men performed the exercise in the three protocols with the intensity of 50 and 100% of 10 RM. The distance between knees in the control protocol (51.25 cm) was lower when compared to SI 50% (84.38 cm, p <0.001), with SI 100% (88.80 cm, p <0.001) and with EB 100% (67.41cm, p = 0.014). The distance between the knees was also lower for the protocols PH 100% (53.10cm, p <0.001) and EB 100% (67.41, p <0.001) compared to the SI 100% (88.80 cm) protocols. The Vasto Medial Oblique (VMO) presented greater activation in the SI 50% protocols (p = 0.035) and PH 50% (p = 0.028) when compared to the EB 50% protocol. The accomplishment of squatting with submaximal loads seems to increase and decrease the activation of VMO when performed with physioball and BE, respectively.

Very low-calorie diet in candidates for bariatric surgery: change in body composition during rapid weight loss.

OBJECTIVE: To analyze the changes in the body composition of morbidly obese patients induced by a very low-calorie diet. METHODS: We evaluated 120 patients selected from a university hospital. Body composition was assessed before and after the diet provided during hospitalization, and changes in weight, body mass index, and neck, waist and hip circumferences were analyzed. Bioimpedance was used to obtain body fat and fat-free mass values. The data were categorized by gender, age, body mass index and diabetes diagnosis. RESULTS: The patients consumed the diet for 8 days. They presented a 5% weight loss (without significant difference among groups), which represented an 85% reduction in body fat. All changes in body circumference were statistically significant. There was greater weight loss and a greater reduction of body fat in men, but the elderly showed a significantly higher percentage of weight loss and greater reductions in body fat and fat-free mass. Greater reductions in body fat and fat-free mass were also observed in superobese patients. The changes in the diabetic participants did not differ significantly from those of the non-diabetic participants. CONCLUSIONS: The use of a VLCD before bariatric surgery led to a loss of weight at the expense of body fat over a short period, with no significant differences in the alteration of body composition according to gender, age, body mass index and diabetes status.

Very low-calorie diet in candidates for bariatric surgery: change in body composition during rapid weight loss

OBJECTIVE: To analyze the changes in the body composition of morbidly obese patients induced by a very low-calorie diet. METHODS: We evaluated 120 patients selected from a university hospital. Body composition was assessed before and after the diet provided during hospitalization, and changes in weight, body mass index, and neck, waist and hip circumferences were analyzed. Bioimpedance was used to obtain body fat and fat-free mass values. The data were categorized by gender, age, body mass index and diabetes diagnosis. RESULTS: The patients consumed the diet for 8 days. They presented a 5% weight loss (without significant difference among groups), which represented an 85% reduction in body fat. All changes in body circumference were statistically significant. There was greater weight loss and a greater reduction of body fat in men, but the elderly showed a significantly higher percentage of weight loss and greater reductions in body fat and fat-free mass. Greater reductions in body fat and fat-free mass were also observed in superobese patients. The changes in the diabetic participants did not differ significantly from those of the non-diabetic participants. CONCLUSIONS: The use of a VLCD before bariatric surgery led to a loss of weight at the expense of body fat over a short period, with no significant differences in the alteration of body composition according to gender, age, body mass index and diabetes status.

Bases anatomofuncionales de la articulación de la cadera y su relación con la fractura / Anatomic-functional bases of the hip joint and its relation with the fracture

Introducción: la sobrecarga en la epífisis proximal del fémur genera fuerzas deformantes sobre las características anatómicas, que junto a la pérdida de la masa mineral ósea resultan en la ocurrencia de fracturas. Existe un aumento de la evidencia de que la anatomía de la cadera juega un importante papel en la etiología de la fractura. Objetivo: sistematizar los conocimientos referentes a las características anatomofuncionales de la articulación de la cadera y su relación con la fractura desde el punto de vista radiológico. Materiales y métodos: se realizó una investigación documental, cuyo objeto de estudio fueron los textos clásicos de anatomía humana, ortopedia y traumatología, radiología, así como los artículos científicos publicados en las bases de datos informáticas. Desarrollo: desde hace más de 20 años se estudian las relaciones entre la anatomía imagenológica de la cadera y la ocurrencia de fracturas en esta región. Los estudios que se han realizado sobre las características de los componentes estructurales del hueso, tanto en su configuración interna como externa, demuestran que existe relación entre la anatomía de la articulación de la cadera y la fractura de la misma. Conclusiones: el conocimiento sobre la estructura anatómica, sus características funcionales y la relación de sus dimensiones con el riesgo de padecer de fractura provee de una base sólida para el entendimiento de los mecanismos de producción de las mismas y el diseño de futuras acciones de intervención para su prevención y tratamiento (AU).

Introduction: the overload of the femur proximal epiphysis generates deforming forces on the anatomic characteristics that together with the loss of bone mineral mass result in fractures´ occurrence. There is an increase of the evidence that hip anatomy plays an important role in the fracture etiology. Objective: to systematize current knowledge on the anatomic-functional characteristics of the hip joint and their relation with the fracture from the radiological point of view. Materials and methods: a documental research was carried; the objective of study were the classical handbooks of Human Anatomy, Orthopedics and Trauma, and Radiology, and also the scientific articles published in medical databases. Development: the relationship between the hip imaging anatomy and the occurrence of fractures in this anatomical region have been studied for more than 20 years. The studies carried out on the characteristics of the bone structural components, both in their internal configuration as in the external one, showed that there is a relationship between the hip join anatomy and its fracture. Conclusions: knowledge on the anatomic structure, its functional characteristics, and the relationship of its dimensions with the risk of suffering a fracture, provides a solid basis for understanding the mechanisms of their occurrence and for the design of future intervention actions to prevent and treat them (AU).

Bases anatomofuncionales de la articulación de la cadera y su relación con la fractura / Anatomic-functional bases of the hip joint and its relation with the fracture

Introducción: la sobrecarga en la epífisis proximal del fémur genera fuerzas deformantes sobre las características anatómicas, que junto a la pérdida de la masa mineral ósea resultan en la ocurrencia de fracturas. Existe un aumento de la evidencia de que la anatomía de la cadera juega un importante papel en la etiología de la fractura. Objetivo: sistematizar los conocimientos referentes a las características anatomofuncionales de la articulación de la cadera y su relación con la fractura desde el punto de vista radiológico. Materiales y métodos: se realizó una investigación documental, cuyo objeto de estudio fueron los textos clásicos de anatomía humana, ortopedia y traumatología, radiología, así como los artículos científicos publicados en las bases de datos informáticas. Desarrollo: desde hace más de 20 años se estudian las relaciones entre la anatomía imagenológica de la cadera y la ocurrencia de fracturas en esta región. Los estudios que se han realizado sobre las características de los componentes estructurales del hueso, tanto en su configuración interna como externa, demuestran que existe relación entre la anatomía de la articulación de la cadera y la fractura de la misma. Conclusiones: el conocimiento sobre la estructura anatómica, sus características funcionales y la relación de sus dimensiones con el riesgo de padecer de fractura provee de una base sólida para el entendimiento de los mecanismos de producción de las mismas y el diseño de futuras acciones de intervención para su prevención y tratamiento (AU).

Introduction: the overload of the femur proximal epiphysis generates deforming forces on the anatomic characteristics that together with the loss of bone mineral mass result in fractures´ occurrence. There is an increase of the evidence that hip anatomy plays an important role in the fracture etiology. Objective: to systematize current knowledge on the anatomic-functional characteristics of the hip joint and their relation with the fracture from the radiological point of view. Materials and methods: a documental research was carried; the objective of study were the classical handbooks of Human Anatomy, Orthopedics and Trauma, and Radiology, and also the scientific articles published in medical databases. Development: the relationship between the hip imaging anatomy and the occurrence of fractures in this anatomical region have been studied for more than 20 years. The studies carried out on the characteristics of the bone structural components, both in their internal configuration as in the external one, showed that there is a relationship between the hip join anatomy and its fracture. Conclusions: knowledge on the anatomic structure, its functional characteristics, and the relationship of its dimensions with the risk of suffering a fracture, provides a solid basis for understanding the mechanisms of their occurrence and for the design of future intervention actions to prevent and treat them (AU).

Anatomia óssea e muscular da coxa de Tapirus terrestris (Perissodactyla, Taperidae) / Bone and muscular anatomy of the thigh leg of Tapirus terrestris (Perissodactyla, Taperidae)

Tapirus terrestris (Linnaeus, 1758) é conhecida como anta brasileira é um mamífero da ordem Perissodactyla, o único dessa ordemque ocorre de forma endêmica no Brasil, sendo considerado maior mamífero brasileiro. Existem poucos estudos relacionados àsua morfologia. Objetivou-se descrever os ossos e os músculos da coxa de T. terrestris. Foram utilizados quatro exemplares de T.terrestris fixados em formaldeído a 10%. Para a descrição osteológica, os ossos foram macerados, limpos e secos, identificados edescritos. Para a descrição muscular, os músculos foram dissecados, segundo as técnicas usuais em anatomia macroscópica. Oesqueleto da região glútea de T. terrestris é constituído pelo osso do quadril, a coxa é constituída e pelo osso fêmur.. Os músculos(M.) que compõe a coxa são o M. Tensor da fáscia lata, M. Bíceps femoral, M. Semitendíneo, M. Semimembranáceo, M. Grácil, M.Pectíneo, M. Quadríceps femoral, M. Adutor, M. Sartório, M. quadrado profundo, M. piriforme, M. gêmeos e M. obturador interno.Conclui-se que T. terrestris possuem características osteológicas e musculares semelhantes a dos equinos, Entretanto, algumasdiferenças morfológicas são evidenciadas.

The species Tapirus terrestris (Linnaeus, 1758) is known as Brazilian tapir is a mammal of the order Perissodactyla, the only order that which occurs endemic in Brazil, considered largest mammal Brazilian. There are few studies related to their morphology. The study aimed to describe the bones and muscles of the thigh T. terrestris. We used four specimens of T. terrestris fixed in 3.7% formaldehyde. For osteological description, the bones were macerated, cleaned and dried, identified and described. For a description of muscle, the muscles were dissected according to the usual techniques in gross anatomy. For the histological description samples were collected every muscle they have been processed and applied stains hematoxylin and eosin, Massons trichrome, and Orcein Reticulin, followed by analysis by light microscopy. The skeleton of the gluteal region of T.s terrestris consists of hip bone, thigh bone that is formed by the femur. The muscles (M.) that makes up the thigh are M. Tensor fascia lata, M. Biceps femoris, M. Semitendinosus, M. Semimembranosus, M. Gracilis, M. Pectineus, M. Quadriceps femoris, M. Adductor,M. Sartorius and M. quadratus profundus, M. piriformis, M. gemelis e M. obturator internus. Histologically muscles showed striated muscle fibers, collagen fibers, elastic and reticular fibers. We conclude that the T. terrestris have characteristics similar to osteological and muscle of horses, however, some differences were evident fact that can be corroborated by locomotor patterns acquired by the species due to its habitat.(AU)

Acoustic wave therapy for cellulite, body shaping and fat reduction.

BACKGROUND: Cellulite is a common aesthetic condition that affects almost every woman. OBJECTIVE: To evaluate the efficacy of acoustic wave therapy (AWT) for cellulite and body shaping. METHODS: In this open-label, single-centre trial, 30 women presenting moderate or severe cellulite underwent 12 sessions of AWT on the gluteus and back of the thighs, over six weeks. The following assessments were performed at baseline, and up to 12 weeks after treatment: Cellulite Severity Scale (CSS), body circumference measurements, subcutaneous fat thickness by magnetic resonance imaging (MRI), quality of life related by Celluqol® and a satisfaction questionnaire. RESULTS: The treatment reduced cellulite severity from baseline up to 12 weeks after the last treatment session (subjects presenting severe cellulite: 60% to 38%). The mean CSS shifted from 11.1 to 9.5 (p < 0.001). Hips circumferences reduced from 99.7 and 103.2 cm to 96.2 and 100.3 cm (respectively, p < 0.001). The average thickness of the subcutaneous fat tissue also decreased (28.3 ± 6.5 mm to 26.7 ± 6.1mm; p < 0.001). The treatment also improved quality of life. More than 90% of the subjects would undergo the treatment again and 89% were satisfied with the results. No serious adverse events were reported. CONCLUSIONS: AWT is a safe treatment to improve cellulite appearance and reduce body circumferences.

Femoroacetabular impingement / Impacto femoroacetabular

ABSTRACT The femoroacetabular impingement (FAI) is as condition recently characterized that results from the abnormal anatomic and functional relation between the proximal femur and the acetabular border, associated with repetitive movements, which lead labrum and acetabular cartilage injuries. Such alterations result from anatomical variations such as acetabular retroversion or decrease of the femoroacetabular offset. In addition, FAI may result from acquired conditions as malunited femoral neck fractures, or retroverted acetabulum after pelvic osteotomies. These anomalies lead to pathological femoroacetabular contact, which in turn create impact and shear forces during hip movements. As a result, there is early labrum injury and acetabulum cartilage degeneration. The diagnosis is based on the typical clinical findings and images. Treatment is based on the correction of the anatomic anomalies, labrum debridement or repair, and degenerate articular cartilage removal. However, the natural evolution of the condition, as well as the outcome from long-term treatment, demand a better understanding, mainly in the asymptomatic individuals.

RESUMO O impacto femoroacetabular (FAI) é condição de caracterização relativamente recente; decorre de relações anatômico-funcionais anormais entre a região proximal do fêmur e o acetábulo, associadas a movimentos de repetição, que acarretam lesões no labrum e na cartilagem acetabular. As alterações são representadas pela retroversão acetabular ou diminuição da altura entre a borda lateral da cabeça e o colo femoral. Além disso, o impacto femoroacetabular pode ser secundário a fraturas do colo do fêmur com consolidação viciosa ou decorrer de osteotomias pélvicas que provocam o retrodirecionamento do acetábulo. Essas anomalias levam ao contato femoroacetabular patológico que origina forças de impacto e cisalhamento durante os movimentos do quadril. Em consequência, há lesão labral e artrose precoce. O diagnóstico é feito pela sintomatologia típica, sinais radiográficos e ressonância magnética. O tratamento fundamenta-se na correção das anomalias anatômicas, reparo do labrum e remoção da cartilagem lesada. Entretanto, há necessidade de conhecer melhor a evolução natural da afecção, principalmente nos indivíduos assintomáticos, bem como resultados do tratamento em longo prazo.

Neurovascular structures at risk during anterolateral and medial arthroscopic approaches of the hip / Estructuras neurovasculares en riesgo durante abordajes artroscopicos anterolaterales y mediales de la cadera

To describe the safety areas for placement of 5 anterolateral portals (anterior, anterior lateral, posterior lateral, proximal anterior medial and distal anterior medial portals) and 3 recently described medial portals (anterior medial, posterior medial and distal posterior medial portals) to provide topographical description of the safety of each. A descriptive, observational and cross-sectional study in which femoral triangle dissection was performed in 12 hips. 5 lateral portals and the 3 medial portals were placed. Clinically relevant neurovascular structures associated with each portal, were identified measured and documented. The lateral portal with the highest risk of injury to a nearby neurovascular structure was the anterior portal, the most adjacent to the femoral cutaneous nerve, 1.42 cm (±0.85) lateral to the portal. In the medial portals, the anterior medial portal has the narrowest margin in relation to the femoral artery, 2.14 cm (±0.35) lateral to the portal and medial to the obturator nerve by 0.87 cm (±0.62). The lateral portals have a higher safety margin; the portal with the most proximity to a neurovascular structure is the anterior portal, associated laterally with the femoral cutaneous nerve, presenting a higher risk of injury. Medial portals have a higher risk of injuring the femoral neurovascular bundle as well as the obturator nerve.

El objetivo fue describir las áreas de seguridad para la colocación de 5 portales estándar (portal anterior, anterolateral, posterolateral, portal anterior proximal medial y portal anterior distal medial) y 3 portales mediales emergentes (antero medial, portal posteromedial y posteromedial distal) para proporcionar una descripción topográfica de la seguridad de cada portal. Se realizó un estudio descriptivo, observacional y transversal, en la que se disecó el triángulo femoral de 12 caderas. Se colocaron los 5 portales laterales y los 3 portales mediales. Se documentó la medición de cada estructura neurovascular de relevancia clínica en relación a cada uno de los portales evaluados. En cuanto al portal de mayor riesgo entre los laterales, se encontró el portal anterior con mayor cercanía al nervio cutáneo femoral lateral (1,42±0,85 cm), ubicado lateral al portal. En los portales mediales el portal anterior medial tiene el margen más estrecho respecto a la arteria femoral (2,14±0,35 cm) lateral al portal, y medial el nervio obturador (0,87±0,62 cm). Los portales laterales tienen un amplio margen de seguridad, el portal con el margen más reducido es el portal anterior en relación al nervio cutáneo femoral lateral, presentando un elevado riesgo de lesionarlo, los portales mediales tienen un alto riesgo de lesionar las estructuras neurovasculares femorales y el nervio obturador.

Movement anatomy of the gluteal region and thigh of the giant anteater Myrmecophaga tridactyla (Myrmecophagidae: Pilosa) / Anatomia do movimento da região glútea e coxa de Myrmecophaga tridactyla tamanduá-bandeira (Myrmecophagidae: pilosa)

Locomotion reveals the displacement and behavior manner of the species in their daily needs. According to different needs of the several species, different locomotor patterns are adopted. The shapes and attachment points of muscles are important determinants of the movements performed and consequently, the locomotion and motion patterns of living beings. It was aimed to associate anatomical, kinesiology and biomechanics aspects of the gluteal region and thigh of the giant anteater to its moving characteristics and locomotor habits. It was used three specimens of Myrmecophaga tridactyla, settled in formaldehyde aqueous solution at 10% and subsequently, dissected using usual techniques in gross anatomy. The morphological characteristics of the gluteal region and thigh that influence the patterns of movement and locomotion of animals, were analyzed and discussed in light of literature. All muscles of the gluteal region and thigh of giant anteater show parallel arrangement of the muscular fibers, being flat or fusiform. These muscles are formed in the joint which the interpotent type biolever act. These morphological characteristics indicate a greater predominance of amplitude and movement speed at the expense of strength. On the other hand, features such as osteometric index and the observation of giant anteater motion indicate the opposite, what reflects this animal lack of expertise in locomotor habits and shows the need of future realization of more detailed studies in this subject.(AU)

A locomoção revela o modo de deslocamento e comportamento das espécies nas suas necessidades diárias. De acordo com as diferentes necessidades das diversas espécies, diferentes padrões locomotores são adotados. As formas e pontos de fixação dos músculos são importantes determinantes dos movimentos realizados e, por conseguinte, dos padrões de locomoção e movimentação dos seres vivos. Objetivou-se associar aspectos anatômicos, cinesiológicos e biomecânicos da região glútea e coxa do tamanduá bandeira às suas características de movimentação e hábitos locomotores. Utilizaram-se três espécimes de Myrmecophaga tridactyla, fixados em solução aquosa de formaldeído a 10% e posteriormente, dissecados usando as técnicas usuais em anatomia macroscópica. As características morfológicas da região glútea e coxa que influenciam os padrões de movimento e locomoção dos animais foram analisadas e discutidas à luz da literatura. Todos os músculos da região glútea e coxa do tamanduá bandeira apresentam disposição paralela das fibras musculares, sendo planos ou fusiformes. Esses músculos formam nas articulações sobre as quais agem bioalavancas do tipo interpotente. Essas características morfológicas indicam maior predominância de amplitude e velocidade de movimento em detrimento da força. Por outro lado, características como os índices osteométricos e a observação da movimentação do tamanduá bandeira indicam o oposto, o que reflete a falta de especialização desse animal quanto aos hábitos locomotores e sinaliza a necessidade da realização futura de estudos mais detalhados a esse respeito.(AU)

Reference curves of the body fat index in adolescents and their association with anthropometric variables / Curvas de referência do índice de adiposidade corporal de adolescentes e sua relação com variáveis antropométricas

OBJECTIVES: To develop reference curves for the body fat index (BFI) in the pediatric population, in adolescents from the city of São Paulo, Brazil, and verify their association with body mass index and body fat percentage. METHODS: The study is part of the research project "Nutritional Profile of Adolescents from Public and Private Schools of São Paulo" that was performed in 2004-2005. A total of 4,686 adolescents (2,130 boys and 2,556 girls) aged 10-15 years were divided into two groups: 10-12 and 13-15 years of age. Body mass, height, body mass index, hip circumference, body fat percentage, body fat index, and sexual maturation performed by the self-assessment method (prepubertal, pubertal, and postpubertal) were analyzed. ANOVA was performed, as well as percentile distribution, Pearson's correlation, and Bland-Altman plot. RESULTS: In boys, there was an increase in body mass, height, body mass index, and hip circumference with advancing age and Tanner stage. In girls, there was an increase in body fat index and body fat percentage with advancing age and stage of sexual maturation. An association was found between body fat index and body mass index (r = 0.67 in boys and 0.80 in girls, p < 0.001) and body fat percentage (r = 0.71 in boys and 0.68 in girls, p < 0.001). CONCLUSION: The body fat index seems to reflect well the phenomena of sexual dimorphism in adolescence, is easy to perform, and represents a method that should be used in population samples. .

OBJETIVOS: Desenvolver curvas de referência do índice de adiposidade corporal para população pediátrica, em adolescentes da cidade de São Paulo, Brasil, e verificar a sua relação com o índice de massa corporal e percentual de gordura corporal. MÉTODOS: O estudo faz parte do projeto de pesquisa "Perfil Nutricional de Adolescentes de escolas Públicas e Privadas de São Paulo" realizado em 2004/2005. 4.686 adolescentes (2.130 meninos e 2.556 meninas) de 10-15 anos foram divididos em dois grupos: 10-12 e 13-15 anos. Massa corporal, estatura, índice de massa corporal, circunferência de quadril, porcentagem de gordura corporal, índice de adiposidade corporal e maturação sexual realizada pelo método de autoavaliação (pré-púbere, púbere e pós-púbere) foram analisadas. Foi feito ANOVA, distribuição percentilar, correlação de Pearson e o gráfico de Bland-Altman. RESULTADOS: Nos meninos, ocorreu aumento da massa corporal, estatura, índice de massa corporal e circunferência do quadril com o avanço da idade e estágio de Tanner. Nas meninas, ocorreu aumento do índice de adiposidade corporal e do percentual de gordura corporal com o avanço da idade e estágio de maturação. Foi encontrada uma associação entre o índice de adiposidade corporal com o índice de massa corporal (r = 0,67 nos meninos e 0,80 nas meninas; p < 0,001) e com o percentual de gordura (r = 0,71 nos meninos e 0,68 nas meninas; p < 0,001). CONCLUSÃO: O índice de adiposidade corporal parece refletir bem os fenômenos do dismorfismo sexual na adolescência, sendo um método de fácil realização que deveria ser mais utilizado em amostras populacionais. .

Reference curves of the body fat index in adolescents and their association with anthropometric variables.

OBJECTIVES: To develop reference curves for the body fat index (BFI) in the pediatric population, in adolescents from the city of São Paulo, Brazil, and verify their association with body mass index and body fat percentage. METHODS: The study is part of the research project "Nutritional Profile of Adolescents from Public and Private Schools of São Paulo" that was performed in 2004-2005. A total of 4,686 adolescents (2,130 boys and 2,556 girls) aged 10-15 years were divided into two groups: 10-12 and 13-15 years of age. Body mass, height, body mass index, hip circumference, body fat percentage, body fat index, and sexual maturation performed by the self-assessment method (prepubertal, pubertal, and postpubertal) were analyzed. ANOVA was performed, as well as percentile distribution, Pearson's correlation, and Bland-Altman plot. RESULTS: In boys, there was an increase in body mass, height, body mass index, and hip circumference with advancing age and Tanner stage. In girls, there was an increase in body fat index and body fat percentage with advancing age and stage of sexual maturation. An association was found between body fat index and body mass index (r = 0.67 in boys and 0.80 in girls, p < 0.001) and body fat percentage (r = 0.71 in boys and 0.68 in girls, p<0.001). CONCLUSION: The body fat index seems to reflect well the phenomena of sexual dimorphism in adolescence, is easy to perform, and represents a method that should be used in population samples.

Morfología de la cadera y media de contracción muscular en bipedestación en la parálisis cerebral / Morphologie de la hanche et moyenne de contraction musculaire en position bipède dans la paralysie cérébrale / Hip morphology and average muscle contraction when standing in cerebral palsy

Introducción: en la parálisis cerebral la articulación de la cadera es una de las más afectadas; sus alteraciones conllevan complicaciones importantes. Aunque su desarrollo se relaciona con trastorno del tono muscular y desequilibrio entre el grupo abductor y el adductor no existen datos objetivos que permitan cuantificar la proporción exacta entre las contracciones de ambos grupos musculares, a partir de la cual esta articulación se encuentra en riesgo. Objetivos: mostrar en una población con parálisis cerebral la media global del porcentaje de contracción de los grupos abductores (µ por ciento Abd) y adductores (µ por ciento Add) de cadera en bipedestación y compararla con los distintos grados de alteración de dicha articulación. Métodos: se midió la actividad muscular en bipedestación de los grupos abductor y adductor en 19 caderas, de 10 sujetos con parálisis cerebral utilizando un electromiógrafo de superficie. Los resultados se expresaron en porcentaje respecto a la contracción máxima isométrica obtenida previamente en los mismos grupos musculares. Las caderas se valoraron utilizando estudios radiológicos. Resultados: la media del porcentaje de contracción del grupo adductor supera a la del grupo abductor en las caderas subluxadas y luxadas. En el estudio por casos, al comparar resultados individuales con la media global para nuestra población no se consigue una asociación significativa. Conclusiones: se intuye que aunque el grupo adductor es un factor importante en el desarrollo de la patología coxofemoral, no es útil como indicador del estado articular aun utilizando medias de población con alteraciones neurológicas(AU)

Introduction: the hip joint is one of the most affected joint in cerebral palsy and its alterations are one of the most important complications. Although its development is related to muscle tone disorder and imbalance between abductor and adductor groups, there are no objective data that allow us to quantify the exact proportion between contractions of both muscle groups from which this joint is at risk. Objective: show, in a population with cerebral palsy, the mean of contraction percentage of hip abductors (µ pecent Abd) and adductors (µ percent Add) groups when standing and compare it with the different degrees of alteration of this joint. Methods: muscle activity of the abductors and adductors groups when standing was measured in 19 hips of 10 subjects with cerebral palsy using a surface electromyography. Results were expressed in percentage regarding the maximum isometric contraction previously obtained in the same muscle groups. Hips were assessed using radiological studies. Results: the mean percentage of contraction of the adductor group exceeds the adductor group in subluxated and luxated hips. In these case studies, a significant association when comparing individual results with the overall mean for our population is not achieved. Conclusions: although the adductor group is an important step in the development of hip pathology factor, it is not useful as an indicator of this joint stage, even using population means suffering neurological disorders(AU)

Introduction: l'articulation de la hanche est l'une des structures les plus souvent touchées dans la paralysie cérébrale; son altération provoque des complications importantes. Bien que son évolution soit associée à un trouble du tonus musculaire et de l'équilibre entre le groupe abducteur et le groupe adducteur, il n`y a pas de données objectives permettant de calculer la proportion exacte entre les contractions de tous ces deux groupes musculaires, à partir de laquelle cette articulation est en risque. Objectifs: le but de ce travail est de montrer la moyenne totale du pourcentage de contractions du groupe abducteur (µ pourcent Add) de la hanche en position bipède dans une population atteinte de paralysie cérébrale, et de la comparer avec les différents grades d'altération de cette articulation. Méthodes: on a mesuré l'activité musculaire en position bipède des groupes abducteur et adducteur de 10 patients (19 hanches), atteints de paralysie cérébrale, en utilisant un électromyographe de surface. Les résultats sont exprimés en pourcentage par rapport à la contraction maximale isométrique obtenue préalablement dans les mêmes groupes musculaires. On a évalué les hanches en faisant des examens radiologiques. Résultats: la moyenne du pourcentage de contraction du groupe adducteur supère celle du groupe abducteur dans les hanches subluxées et luxées. Dans l'étude des cas, on n'a pas obtenu une association significative en comparant les résultats individuels avec la moyenne totale de notre population. Conclusions: bien que le groupe adducteur soit un facteur clé dans l'évolution de la pathologie coxofémorale, il n'est pas utile comme indicateur de l'état articulaire, même en utilisant des moyennes de populations atteintes d'altérations neurologiques.

Anthropometry, silhouette trajectory, and risk of breast cancer in Mexican women.

BACKGROUND: Obesity has been associated with breast cancer risk in the Caucasian population but the association remains unclear in the Hispanics. Previous studies conducted among Hispanics in the U.S. have shown inconsistent results. PURPOSE: The association between anthropometry, body shape evolution across lifetime, and the risk of breast cancer was assessed using a multi-center population-based case-control study conducted in Mexico. METHODS: One thousand incident cases and 1074 matched control women aged 35-69 years were recruited between 2004 and 2007, and analyzed in 2011-2012. Conditional logistic regression models were used. RESULTS: Height was related to an increased risk of breast cancer in both premenopausal (p trend=0.03) and postmenopausal women (p trend=0.002). In premenopausal women, increase in BMI; waist circumference (WC); hip circumference (HC); and waist-hip ratio (WHR) were inversely associated with breast cancer risk (p trends<0.001 for BMI and WC, 0.003 for HC, and 0.016 for WHR). In postmenopausal women, decreased risks were observed for increased WC (p trend=0.004) and HC (p trend=0.009) among women with time since menopause <10 years. Further analysis of body shape evolution throughout life showed strong and significant increase in risk of breast cancer among women with increasing silhouettes size over time compared to women with no or limited increase. CONCLUSIONS: These findings suggest that anthropometric factors may have different associations with breast cancer risk in Hispanic women than in Caucasian women. This study also shows the importance of considering the evolution of body shape throughout life.

Geometric morphometrics for the study of hemicoxae sexual dimorphism in a local domestic equine breed / Morfometría geométrica para el estudio del dimorfismo sexual hemicoxae en una raza equina doméstica local

Twenty-eight skeletonized hemicoxae from young animals (yearlings, 13 males and 15 females) belonging to the "Cavall Pirinenc Català" horse (Catalan Pyrenean Horse) breed were studied by means of geometric morphometric (GM) methods. Morphometric analysis was based on coordinates of 16 landmarks of the ilium and ischiopubic regions that were digitized on 2D photographic images. Sexes did not appear separated either by size or shape, the latter being independent of the former. K-means clustering of shape variables were used in order to classify individuals by sex and an average accuracy of 57.1 percent was achieved. Males were misclassified more frequently than females. For the iliac landmarks, which contributed to the total variance of shape with the higher degree, the value obtained increased to 60.7 percent for k-means. The ischiopubic complex contributed less to sex differentiation according to shape. It is concluded that the use of GM and multivariate statistics is not a reliable method to quantify pelvic shape and size differences between the sexes for equine yearlings. This is the first known study to apply GM to the hip of an equine breed.

Fueron estudiados mediante morfometría geométrica (MG) 28 hemicoxales esqueletizados de animales jóvenes (potrillos, 13 machos y 15 hembras) pertenecientes a la raza de caballos "Cavall Pirinenc Català" (caballo Pirineo Catalán). El análisis morfométrico se basó en las coordenadas de 16 puntos de interés de las regiones isquiopúbica e ilíaca, que fueron digitalizadas mediante imágenes fotográficas en 2D. Los sexos no aparecen separados, ya sea por tamaño o forma, siendo esta última independiente de la primera. Se utilizó el análisis cluster de las K medias en las variables de forma con el fin de clasificar a los individuos por sexo y se logró una precisión media del 57,1 por ciento Los machos fueron mal clasificados con más frecuencia que las hembras. Para los puntos de referencia ilíacos, lo que contribuyó a la varianza total de la forma con el grado más alto, el valor obtenido se incrementó a 60.7 por ciento de K medias. El complejo isquiopúbico contribuyó menos a la diferenciación sexual de acuerdo a la forma. Se concluye que el uso de MG y estadística multivariada no es un método fiable para cuantificar la forma de la pelvis y las diferencias de tamaño entre los sexos para primales equinos. Este es el primer estudio conocido para aplicar MG en la cadera de una raza equina.

Descrição anatômica do terço proximal da artéria circunflexa femoral medial: estudo em cadáver / Anatomical description of the proximal third of the medial femoral circumflex artery: a cadaveric study

OBJETIVO: Descrever através de estudo em cadáver a disposição anatômica do terço proximal da artéria cincunflexa femoral medial (ACFM). MÉTODOS: Foi avaliada a disposição anatômica do terço proximal da ACFM, através de dissecção em 12 quadris de cadáver, que após terem sua altura aferida em metros (M), foram determinados alguns parâmetros: Ângulo de lateralização da ACFM (Â), Profundidade da ACFM em relação a origem superomedial do músculo quadrado femoral (P), distância da ACFM em relação a inserção superolateral do músculo quadrado femoral (D). RESULTADOS: Quando comparamos a média dos parâmetros entre os sexos notamos: Masculino Â= 43.6 graus, feminino Â= 38.3 graus. Masculino D= 6mm, feminino D= 9.5mm. Masculino P= 20.8 mm, feminino P= 18.3mm. A média dos parametros  e P são menores no sexo feminino porém o parâmetro D no sexo feminino é maior. CONCLUSÃO: Devemos ter como parâmetro superficial de segurança para o terço proximal da ACFM o ponto de inserção superolateral do músculo quadrado femoral. Que o parâmetro D da ACFM no sexo feminino é maior do que no sexo masculino. Que desinserir o músculo quadrado femoral em sua origem no ísquio pode oferecer maior segurança a ACFM do que faze-lo em sua inserção femural. Nível de evidência IV, série de casos.

OBJECTIVE: To describe, in a cadaver study, the anatomical arrangement of the proximal third medial femoral circumflex artery (ACFM). METHODS: We evaluated the anatomic arrangement of the proximal third of the ACFM through dissection in 12 cadaver hips. After measuring their height in meters (M), several parameters were determined: angle of lateralization of ACFM (Â), Depth ACFM in relation to the superomedial origin of the quadratus femoris muscle (P), and distance of ACFM from the superolateral insertion of the muscle quadratus femoris (D). RESULTS: In the comparison of mean parameters between the sexes, it was noted that: Male  = 43.6 degrees, female  = 38.3 degrees. Male D = 6mm, female D = 9.5mm. Male P = 20.8 mm, female P = 18.3mm. The average for parameters A and P were lower in females, but parameter D was higher in females. CONCLUSION: We should use, as the secure surface parameter for the proximal third of the ACFM, the superolateral insertion point of the quadratus femoris muscle. The fact that the parameter D of ACFM is greater in females than in males. Disconnecting the quadratus femoris muscle at its point of origin in the isquio may offer greater security to ACFM than doing it at the point of femoral insertion. Level of Evidence.