RESUMO
Poor measurement quality has set back the utility of anthropometry in defining childhood malnutrition, prompting calls for alternative measurement techniques. This study aimed to assess the reliability of anthropometric measurements using a digital height board in comparison to an analog height board in Namibian children under 5 years of age. A cross-sectional, descriptive study was conducted (n = 425) between the age of 6 and 59 months, using anthropometric measurements of weight, height and mid-upper arm circumference. Two trained enumerators each collected four height measurements of each child: two using an analog height board and two using a digi-board. The repeated height measurements between and within the enumerators were used to determine intra- and interobserver reliability. Reliability of the digi-board was assessed using the technical error of measurement (TEM), relative TEM (%TEM), intraclass correlation and a Bland-Altman analysis to assess the agreement between the two methods. In all these assessments, the analog height board was considered as the gold standard and used for comparison. The digi-board showed superiority to the analog height board in terms of reliability (analog TEM = 0.22, digi-board TEM = 0.16). Although the digi-board has potential to improve child anthropometry, further clinical and large survey studies are needed to validate the used of this tool in routine population-based surveys.
Assuntos
Atenção à Saúde , Arterite de Células Gigantes/terapia , Guias de Prática Clínica como Assunto , Reumatologia , Especialização , Padrão de Cuidado , Medicina Baseada em Evidências , Mapeamento Geográfico , Acessibilidade aos Serviços de Saúde , Humanos , Equipe de Assistência ao Paciente , Medicina Estatal , Reino UnidoRESUMO
Liver failure, whether arising directly from acute liver failure or from decompensated chronic liver disease is an increasing problem worldwide and results in many deaths. In the UK only 10% of individuals requiring a liver transplant receive one. Thus the need for alternative treatments is paramount. A BioArtificial Liver machine could temporarily replace the functions of the liver, buying time for the patient's liver to repair and regenerate. We have designed, implemented and tested a clinical-scale BioArtificial Liver machine containing a biomass derived from a hepatoblastoma cell-line cultured as three dimensional organoids, using a fluidised bed bioreactor, together with single-use bioprocessing equipment, with complete control of nutrient provision with feedback BioXpert recipe processes, and yielding good phenotypic liver functions. The methodology has been designed to meet specifications for GMP production, required for manufacture of advanced therapy medicinal products (ATMPs). In a porcine model of severe liver failure, damage was assured in all animals by surgical ischaemia in pigs with human sized livers (1.2-1.6 kg liver weights). The BioArtificial liver (UCLBAL) improved important prognostic clinical liver-related parameters, eg, a significant improvement in coagulation, reduction in vasopressor requirements, improvement in blood pH and in parameters of intracranial pressure (ICP) and oxygenation.
