Frequent diarrhoeas in early childhood have sustained effects on the height, weight and head circumference of children in East Bhutan

Episodes of diarrhoea and nutritional status of 113 children in East Bhutan were recorded monthly from 7 to 36 months of age. A re-examination was carried out 20 months later. The load of diarrhoeal diseases in early childhood was negatively associated with the parameters of children's long-term nutritional status 20 months later. Also, when early nutritional status and socioeconomic factors are included in the model, the diarrhoea variable explains a significant part of the variation in height for age ( p =0.04, delta R²=0.035), weight for age ( p =0.03, delta R²=0.030) and head circumference ( p = 0.0007, delta R²= 0.077). This is not so for the variation in weight for height or mid-upper arm circumference (p > 0.1, delta R² < 0.005). Stunting is widespread in the area, and the erects of diarrhoea on nutritional status are more likely to be sustained in settings where dietary intake is marginal.     

Fetal abdominal protuberance ratio throughout pregnancy

We defined ``fetal abdominal protuberance ratio' as the ratio between the abdominal circumference (AC) and the distance between the anterior border of the fetal aorta and the posterior surface of the fetal skin (AO-P) and measured it in a total of 358 fetuses between 13 and 40 weeks. The AC and AO-P diameters both grew with gestational age but the increment was steeper for the AC which means a higher protuberance ratio with advancing gestational age. Received: 7 June 1995 / Accepted: 29 May 1996     

STUDIES ON MATURITY IN NEWBORN INFANTS

Five anthropometric measurements, birth weight, crown-heel length, head circumference, occipito-frontal diameter, and bi-parietal diameter were recorded in a group of 174 newborn infants of various gestational ages. The material was selected to contain a relatively large number of infants with extreme birth weights and/or gestational ages. Head circumference was better correlated to gestational age than were the other four measurements. Birth weight and crown-heel length had the same degree of correlation to gestational age. The two skull diameters showed significantly lower correlations to gestational age. The confidence limits for estimating gestational age on the basis of the mean value for head circumference were ±26.1 days in this material. In SGA infants, crown-heel length and head circumference were not significantly greater than in pre-term infants of the same birth weight.     

Relationship between changes in neck circumference and cardiovascular risk factors

OBJECTIVE: Neck circumference (NC) is a simple screening measure for identifying overweight and obese patients. The main aim of the present study was to determine the relationship between changes in NC and changes in cardiovascular risk factors by evaluating some components of the metabolic syndrome. METHODS: The present longitudinal cohort study included 364 subjects (155 men and 209 women) with no known major medical conditions and who were not receiving any medication. Main indicators included NC, waist circumference, waist-to-hip ratio, body mass index, and fasting lipoprotein, glucose and uric acid levels. RESULTS: Pearson's correlation coefficients indicated a significant association between changes in NC and changes in body mass index (men, r=0.67; women, r=0.69; each, P<0.0001), waist circumference (men, r=0.69; women, r=0.56; each, P<0.0001), waist-to-hip ratio (men, r=0.27; women, r=0.33; each, P<0.0001), and total cholesterol (men, r=0.68; women, r=0.64; each, P<0.0001), low density lipoprotein cholesterol (men, r=0.58; women, r=0.59; each, P<0.0001), triglyceride (men, r=0.48; women, r=0.44; each, P<0.0001), glucose (men, r=0.51; women, r=0.44; each, P<0.0001) and uric acid (men, r=0.42; women, r=0.47; each, P<0.0001) levels. The relative changes in NC contributed to independent significant changes in total cholesterol (8% for men and 1% for women), low density lipoprotein cholesterol (1% for men and 1% for women) and triglycerides (23% for men); it did not significantly contribute to changes in high density lipoprotein cholesterol, glucose or uric acid levels. CONCLUSION: Changes in NC are positively correlated with changes in some factors of the metabolic syndrome and, therefore, are correlated with changes in the risk of cardiovascular disease.     

脂肪分布与男性高血压病关系的病例对照研究

以在男性人群现患调查中发现的高血压病患者为病例组，非高血压病患者为对照组，以腰臀比值为指标，进行脂肪分布与男性高血压病关系的病例对照研究。结果显示，病例组腰臀比阳性暴露率（７４．６３％）显著高于对照组（４８．２０％），ｃＯＲ＝３．２（Ｐ＜０．０１）。齐同了年龄、性别、高血压家族史并调整了肥胖等因素后，ａＯＲ＝２．２（Ｐ＜０．０５）。病例组腰臀比均值高于对照组（Ｐ＜０．０１）。脂肪集中分布于腹部，可能与高血压病有关。     

Socioeconomic deprivation and waist circumference in men and women: The Scottish MONICA surveys 1989 –1995

Socioeconomic deprivation and waist circumference were measured in three Scottish MONICA cross-sectional surveys of 2233 men and 2516 women aged 25–64 years in 1989–1995. Means of waist circumference, waist/hip ratio (WHR) and body mass index (BMI) increased with level of deprivation (measured by the Carstairs index) more significantly in women than in men, and more significantly in non-smokers than in current-smokers. Their obesity cases defined by conventional cut-points showed similar patterns of relation to deprivation. There appeared to be more obviously consistent and significant increases in the prevalence of large waist circumference with deprivation for both sexes than in the prevalence of WHR and BMI above the 90th centile. Also there was a more significant trend of increase in waist circumference over time than there was in WHR and BMI for both sexes. Residual case–control analysis, controlling for height, showed a dose–response relationship between deprivation and waist circumference. Compared to the most affluent (the first tertile of the Carstairs score), odds ratio for men in the middle group (the second tertile) adjusted for age, survey year and smoking status was 1.37 (95%CI 1.10–1.70) and in the most deprived (the third tertile) 1.46 (1.17–1.82); and for women 1.22 (0.99–1.50) and 1.81 (1.47–2.23). The study suggests that large waist circumference, increasingly prevalent, is directly related to socio-economic deprivation, and greater attention should be paid to increasing girth in the socially deprived.This revised was published online in April 2005. In the previous version the article category was missing.     

Prediction of growth discordance in twins with the use of abdominal circumference ratios

OBJECTIVE: The purpose of this study was to assess the accuracy of sonographic prediction of twin birth weight discordance using the abdominal circumference ratio. STUDY DESIGN: This was a prospective cohort of diamniotic twin gestations that underwent serial ultrasound examinations every 2 to 4 weeks from 11 to 38 weeks of gestation. Birth weight discordance was defined as > or =25% difference in birth weight, relative to the larger twin. The sensitivity, specificity, and predictive values for the abdominal circumference ratio were assessed for the prediction of growth discordance. RESULTS: Of 503 diamniotic twin pregnancies, 64 pregnancies (12.7%) had discordant fetal growth. The abdominal circumference ratio could be measured consistently throughout gestation in 100% of twin pairs. Receiver operating curve analysis showed that the abdominal circumference ratio was a good predictor of birth weight discordance (area under the curve = 0.80). An abdominal circumference ratio cutoff of 0.93 yielded a sensitivity and specificity of 61% and 84%, respectively. CONCLUSION: Twin birth weight discordance may be predicted at any gestational age with an abdominal circumference ratio <0.93.     

Reference Values for Valve Circumferences and Ventricular Wall Thicknesses of Fetal and Neonatal Hearts

To evaluate valvular stenosis, cardiac dilation, and/or cardiac hypertrophy, measurements of valve circumference and ventricular wall thickness are of importance. To establish reference values in fetuses and neonates, we reviewed pathology reports at Women and Infants Hospital from 1978 through 2002 and found measurements in 776 cases that were suitable for analysis. Gestational ages (GA) ranged from 15 to 42 wk. The tabulated data include the mean, standard deviation, and 10th and 90th percentile values for foot length, body weight, body length, heart weight, valve measurements, and ventricular wall thicknesses for each week of GA. In cases in which clinical dating is not reliable, we estimated the GA by the mean value nearest that of the observed foot length. All linear measurements increased in a linear fashion throughout the second and third trimesters of development. The circumferences of cardiac valves at all ages, in descending order of magnitude, are: tricuspid, mitral, pulmonary, and aortic. Mean left ventricular (LV) wall thickness is greater than mean right ventricular (RV) wall thickness throughout gestation. The tables offer a means of determining valvular stenosis, or cardiac dilation and/or hypertrophy, based on various gestational ages.     

Measurement of the abdominal circumference for the detection of intra-abdominal hemorrhage has no diagnostic value

BACKGROUND: Measuring the circumference of the abdomen is still commonly used when treating a patient with suspicion of intra-abdominal bleeding. In the present study the usefulness of this method for a diagnostic purpose is questioned because of the assumed method-related interindividual variation. METHODS: The study group consisted of 34 end-stage renal failure (ERSF) patients treated with peritoneal dialysis. Each patient was measured by the same nurse at the level of the umbilicus and the level of the iliac crest both before and after an infusion of 2000 ml of peritoneal dialysis fluid into the peritoneal cavity. One healthy female served as a control. Her abdominal circumference was measured at the level of the umbilicus by 10 different emergency medical technicians (EMTs), each of whom performed the measurement three times. The measuring tape was blank and the place of the first measurement was marked as performed in clinical practice. RESULTS: The mean abdominal circumference at the level of the umbilicus before an infusion of peritoneal fluid was 93.2 +/- 9.5 cm (SD), and after filling the peritoneal cavity 96.3 +/- 9.5 cm (difference 3.1 +/- 1.7 cm). These figures at the level of the iliac crest were 96 +/- 8.3 and 97.2 +/- 8.4 cm (difference 1.2 +/- 1.4 cm) (P < 0.0001), respectively. The mean value between the smallest and largest values when measuring the circumference of a healthy control person was 1.85 +/- 1.11 (P < 0.0005). The mean difference in circumference in the peritoneal dialysis patients was smaller than the largest difference among the three measurements taken by the same EMT. CONCLUSION: Measuring the abdominal circumference should not be used as a diagnostic tool when intra-abdominal bleeding is suspected.