低体重儿"游泳"(水疗)临床应用研究

目的探讨低体重儿"游泳"(水疗)在住院期间的部分指标变化的临床意义.方法检测出生体重＞1 800 g＜2 500 g的低出生体重儿73人,随机分为游泳组与对照组.游泳组35人,对照组38人的体重增加、NBNA评分、胃肠功能紊乱等方面的情况.结果两组间在每天体重增加,游泳前后NBNA(新生儿神经行为测定)评分及胃肠功能紊乱(便秘、溢奶、腹胀)的发生率等方面有明显统计学差异,而两组在血常规及肝功能方面则无明显统计学差异,两组新生儿脐部均无感染.结论低体重儿游泳可不失时机地促进其早期全方位的生长与发育.     

Weight Status of Persons with Intellectual Disabilities

Background The aim was to study the weight and weight status of the study group in 2002 and 2007, and to study the differences in weight and weight status between 2002 and 2007 and the risk groups for (becoming) overweight/obese. Materials and Methods The Body Mass Index (BMI) of 336 clients of a Dutch service provider for persons with intellectual disabilities was calculated in 2002 and 2007. Results The mean increase in BMI between 2002 and 2007 was 0.8 (2.2 kg). In 2002, 36% of the study group was overweight/obese; this was higher in 2007: 45%. The expected relationship between increase in BMI and the change in living circumstances could not be confirmed. Conclusions Further research into health‐control programmes, weight status, food‐intake and physical exercise is recommended.     

Helping Individuals Achieve a Healthy Weight Gain During Pregnancy: A Multipronged Approach

Approximately half of pregnant individuals in the United States exceed recommendations for gestational weight gain (GWG). Excessive GWG is associated with negative outcomes for maternal and infant health. In this article, we provide guidance to nurses who counsel patients about GWG. Because of negative bias toward persons with obesity, nurses need to understand their own attitudes toward obesity to provide supportive GWG counseling. The use of words such as weight is preferred to obese, and recommended GWG goals should be consistent with established guidelines. The setting of specific, measurable, attainable, realistic, and trackable behavioral goals can help translate a goal for GWG into practical actions in daily living. Mobile phone apps, if carefully chosen, may help individuals learn about and track GWG.     

External validation of the Best Guess formulae for paediatric weight estimation

Objective: A new method for estimation of weight in children based on their age has been proposed. The present study aims to validate the Best Guess formulae in a new population of children. Methods: This was a secondary analysis of a database collected for a prospective, observational, cohort study conducted in the Paediatric ED of Sunshine Hospital. Children aged 1–11 years who presented to the ED between 18 August 2005 and 25 February 2006 were included. Actual weight, height, age and ethnicity were obtained. Agreement between estimated weight using the Best Guess formulae and measured weight is reported using mean bias, 95% limits of agreement and proportion within 20% of actual weight. Results: A total of 410 cases were included in the present study. Forty‐six per cent were female and median age was 4 years. The mean bias in the 1–5 year group was 0.9 kg, with 95% limits of agreement ?3.5 to +5.3 kg. Seventy‐six per cent of estimations were within 20% of measured weight. The mean bias in the 5–11 year group was 0.4 kg, with 95% limits of agreement ?14.4 to +15.2 kg. In this group, 64% of estimations were within 20% of measured weight. Conclusion: The Best Guess formulae performed moderately well in estimating children's weight, but had a tendency to overestimate weight, particularly in children with lower body mass index.     

The Use of Body Habitus Reference Images Improves the Ability of Novices to Accurately Estimate Children's Weight Using the PAWPER XL Tape System

Background

The original methodology of the PAWPER (Pediatric Advanced Weight Prediction in the Emergency Room) tape relies on a gestalt visual assessment of a child's body habitus to adjust a length-based weight estimation. This assessment is dependent on the user's subjective opinion, which may result in aberrations in accuracy between users and populations. With the development of the second-generation PAWPER XL tape, a more objective method of habitus evaluation was desired.

Ultrasound Fetal Weight Estimation: How Accurate Are We Now Under Emergency Conditions?

The primary aim of this study was to evaluate the accuracy of sonographic estimation of fetal weight when performed at due date by first-line sonographers. This was a prospective study including 500 singleton pregnancies. Ultrasound examinations were performed by residents on delivery day. Estimated fetal weights (EFWs) were calculated and compared with the corresponding birth weights. The median absolute difference between EFW and birth weight was 200 g (100–330). This difference was within ±10% in 75.2% of the cases. The median absolute percentage error was 5.53% (2.70%–10.03%). Linear regression analysis revealed a good correlation between EFW and birth weight (r = 0.79, p < 0.0001). According to Bland–Altman analysis, bias was −85.06 g (95% limits of agreement: −663.33 to 494.21). In conclusion, EFWs calculated by residents were as accurate as those calculated by experienced sonographers. Nevertheless, predictive performance remains limited, with a low sensitivity in the diagnosis of macrosomia.     

东营市13461例正常出生儿体重统计分析

目的：为统计分析东营市正常出生儿体重。方法：对我国胜利油田所在地东营市从１９９０年至１９９４年出生的正常足月新生儿１３４６１例出生体重进行统计分析。结果：男婴６７１１例，平均体重３４３０±４３６ｇ，女婴６７５０例，平均体重３３０６±４２５ｇ，Ｐ＞０．０５，无明显差异。职工子女体重大于农民子女，Ｐ＜０．０５，有显著差异。本组低出生体重儿占１．６％，巨大儿占７．０％，较文献报道５．３％高。同时发现低出生儿孕周３９±２周，女婴明显多于男婴，农民发病率（２．４％）高于职工（１．５％）。巨大儿孕周４０±１周，职工（７．２％）高于农民（４％）。男婴明显多于女婴，Ｐ＜０．０５，有显著差异。结论：说明改善营养对增加新生儿体重的重要性。本组体重高于美国、新加坡、上海、武钢等新生儿体重，与油田职工营养、生活条件较好有关     

乳腺癌患者体质量管理的证据总结

目的 总结乳腺癌患者体质量管理的最佳证据,为医护人员指导乳腺癌患者进行体质量管理提供依据。方法 采用主题词结合自由词系统检索UpToDate、Clinicalkey、BMJ最佳临床实践、Cochrane Library、CINAHL、PubMed、EMbase等数据库中关于乳腺癌患者体质量管理的最佳临床实践、指南、专家共识、系统评价。结果 共纳入相关文献14篇,其中指南8篇、专家共识2篇、系统评价4篇。最终形成34条证据,包括体质量管理的必要性、目标、评估及策略。结论 该研究总结了乳腺癌患者体质量管理的最佳证据,可为开展乳腺癌患者体质量管理提供循证依据。     

超声预测巨大胎儿体重公式准确性研究

目的： 求出较为准确的预测巨大胎儿体重公式。方法： 通过超声测量 １４２ 例胎儿头围 （ＨＣ）、腹围（ＡＣ）、股骨径 （ＦＬ） 及胎儿腿部皮下脂肪厚度 （ＦＴＨ）, 根据各生理参数计算出ＨＣ、ＡＣ、ＦＬ、ＦＴＨ 分别与胎儿体重的直线回归方程以及以上４ 参数与胎儿体重的多元线性回归方程, 并进行比较。结果： 应用多元线性回归方程预测巨大胎儿体重较直线回归方程准确。结论：多元线性回归方程考虑到了影响胎儿体重的各个因素,因此其准确性较高。     

超声测定甲状腺重量准确性研究

目的:研究超声法测定甲状腺重量(w(?))的准确性并分析使W_E产生误差的原因。方法:应用超声法测定了22例正常人和63例甲状腺机能亢进症(甲亢)病人甲状腺重量,并将甲亢组按X-CT测值(W(?))分四组对照分析结果:除W(?)≥70克组,W(?)与W_L间无相关关系外(γ=0.183,P＞0.05),其余各组,W(?)与W(?)间无差异(P＞0.05,并呈良好相关(γ=0.704~0.929,P均＜0.005),但尚存在一定的误差,51例小于70克甲亢病例误差率为(0.03±13.5%结论:B超可作为甲状腺重量测定的一种方法,它具有准确、简便、重复性好等优点,但当甲状腺重量≥70克时,超声测值偏小。     

Weight loss methods and changes in eating habits among successful weight losers

Background Changes in several lifestyle related factors are required for successful long-term weight loss. Identification of these factors is of major importance from a public health point of view.

Methods/subjects This study was based upon findings from the Finnish Weight Control Registry (FWCR), a web-based registry. In total, 316 people were recruited and 184 met the study inclusion criteria. The aims of this study were to assess means and typical changes in eating habits associated with successful long-term weight loss.

Results Half of the participants (48%) reported that they lost weight slowly primarily with dietary changes. Self-weighing frequency was high, 92% was weighing themselves at least once a week during the weight loss phase, and 75% during the maintenance phase. Dietary aspects associated with successful weight loss and weight maintenance included an increase in intake of vegetables, a reduction in frequency of eating candies and fast food, regular meal frequency and application of the Plate model.

Conclusions Both slow and fast weight loss may lead to successful long-term results and weight maintenance. A decrease in energy intake was achieved by reducing intake of energy-dense food, applying the Plate model and by regular meal frequency.

• Key messages

• Successful long-term weight loss is associated with a reduction in intake of energy-dense food. A more regular meal frequency and a high frequency of self-weighing seem to be helpful.

     

Development of individual growth standards for estimated fetal weight: II. Weight prediction during the third trimester and at birth

Using a weight estimation procedure based of the Rossavik growth model, we have evaluated the possibility of establishing individual growth curve standards for fetal weight estimates and of predicting birth weights in the second trimester. In 20 normal fetuses delivered at term, 95% of the weight estimates obtained after 26 weeks' menstrual age (MA) were within +/- 22% of the predicted weight estimates. In these same fetuses the mean difference between birth weight estimates based on growth patterns before 26 weeks, MA, and actual birth weights was 1.2%, with 95% of the percent deviations being between 13.3% and - 8.8%. In a similar prospective study, the mean percent difference was -1.7%, with a range of 9.6% to -13.6%. Direct comparison of weight estimates obtained during the last week before delivery with birth weight projections indicated that birth weight estimates obtained 14 weeks before delivery had smaller systematic and random errors than those obtained within a week of delivery. These results indicate that individual growth curve standards for fetal weight estimates and the growth potential of individual fetuses can be determined from growth patterns in the second trimester.