RESUMO
OBJECTIVE: Validation of body adiposity index (BAI) in a paediatrics sample; and to develop, if necessary, a valid BAI for paediatrics (i.e. BAIp). METHODS: A total of 1615 children (52% boys) aged 5-12 years underwent anthropometry. Their body composition was assessed using a foot-to-foot bioimpedance. The validity of BAI = (Hip circumference/Height(1.5)) - 18 was tested by combining correlation and agreement statistics. Then, the sample was split into two sub-samples for the construction of BAIp. A regression was used to compute the prediction equation for BAIp-based percentage of body fat (%BF). RESULTS: The initial BAI over-estimated the %BF of children by 49% (29.6 ± 4.2% versus 19.8 ± 6.8%; p < 0.0001). The original methodology led to a BAIp = (Hip circumference/Height(0.8)) - 38 in children. When compared to BAI, BAIp showed both better correlation (r = 0.57; p < 0.01 versus r = 0.74; p < 0.0001) and agreement (ICC = 0.34; [95% CI = -0.19-0.65] versus ICC = 0.83; [95% CI = 0.81-0.84]). However, there were some systematic biases between the two values of %BF as exemplified by the large 95% limit of agreement [-9.1%; 8.8%] obtained. CONCLUSION: BAI over-estimates the %BF in children. In contrast, BAIp appears as a new index for children's body fatness, with acceptable accuracy. In its current form, this index is valid only for large-scale studies.
Assuntos
Adiposidade , Antropometria/métodos , Impedância Elétrica , Composição Corporal , Índice de Massa Corporal , Criança , Pré-Escolar , Estudos Transversais , Feminino , França , Humanos , Masculino , Análise de RegressãoRESUMO
Results of a retrospective study of 674 frozen sections in thyroid surgery, demonstrated on over all reliability of 98.2%, when compared with final pathological findings, with 651 confirmation in 674 cases. False negatives of malignancy represented 1.6% of lesions thought to be benign, while false positives were obtained in 4.8% of lesions thought to be malignant on frozen sections. Prior to frozen sections, 221 patients had needle punctures and cytological smears studies of the thyroid lesion. When comparing the results after using the two methods, no false positive for malignancy, assessed by cytology, was found on frozen sections, which also corrected but two false negatives of malignancy given by the 177 smears affirmative of benignancy, but reduced the number of equivocal results of cytology from 36 to 1. Both pre-operative cytological examination by needle puncture and intra-operative frozen sections appear, therefore, to be very reliable methods for studying thyroid lesions. Frozen sections are complementary to cytological studies. These results suggest that, in surgical thyroid diseases, frozen sections, need perhaps not to be systematically conducted, but should be selective and reserved for cases in which pre-operative needle cytology affirms malignancy, or raises suspicion.
Assuntos
Neoplasias da Glândula Tireoide/patologia , Biópsia por Agulha , Reações Falso-Negativas , Reações Falso-Positivas , Secções Congeladas , Humanos , Cuidados Pré-Operatórios , Estudos Retrospectivos , Neoplasias da Glândula Tireoide/cirurgiaRESUMO
Thyroidectomy for different thyroid disorders was conducted in 422 patients during 1978, after normal pre-operative laryngoscopy findings. Dissection of the recurrent laryngeal nerve was employed systematically in all patients except those having isthmectomy or enucleation operations, with a total number of 556 nerves dissected. Pre-and post-operative laryngoscopic examinations in the alert patient was conducted in all cases. After one year, 8% of the patients with abnormal post-operative laryngoscopic findings had not returned for follow-up. The known rate of recurrent nerve paralysis after one year was 0.7% of the nerves exposed, the maximum rate being 2% if patients not followed-up are included. These results confirm the value of systematic recurrent nerve dissection during thyroid surgery.
