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PubMed1989

Rapidly developing overweight in school children as an indicator of psychosocial stress.

From a cohort of 971 Swedish children followed up from birth through 15 years of age, all the children who had shown an increment in relative weight of more than 15% (measured weight in % of standard weight for height) between the ages of 7 and 10 years (group A, n = 25), 10 and 13 years (group B, n = 23), and 7 and 13 years (group C, n = 22) were selected for the present study. For each case a control matched for sex and relative weight at 7 (groups A and C) or 10 years (group B) was selected. The degree of psychosocial stress was estimated by two raters on the basis of all the accumulated data in the school health records and of the personal knowledge of the school nurses. There was good agreement between the raters. A significant difference in the degree of psychosocial stress was found between cases and controls. An analysis of specific items revealed differences with respect not only to soft data, but also to objective facts (continuation of school after completion of the nine years of compulsory school). It is concluded that a rapid weight gain during school years may be an indicator of psychosocial problems.

Adolescent↗

PubMed2003

Analyses of growth curves of nellore cattle by multiple-trait and random regression models.

The purpose of this study was to compare estimates of genetic parameters for sequential growth of beef cattle using two models and two data sets. Growth curves of Nellore cattle were analyzed using body weights measured at ages 1 (birth weight) to 733 d. Two data samples were created, one with 71,867 records sampled from all herds (MISS), and the other with 74,601 records sampled from herds with no missing traits (NMISS). Records preadjusted to a fixed age were analyzed by a multiple-trait model (MTM), which included the effects of contemporary group, age of dam class, additive direct, additive maternal, and maternal permanent environment. Analyses were by REML, with five traits at a time. The random regression model (RRM) included the effects of age of animal, contemporary group, age of dam class, additive direct, additive maternal, permanent environment, and maternal permanent environment. All effects were modeled as cubic Legendre polynomials. These analyses were also by REML. Shapes of estimates of variances by MTM were mostly similar for both data sets for all except late ages, where estimates for MISS were less regular, and for birth weight with MISS. Genetic correlations among ages for the direct and maternal effects were less smooth with MISS. Genetic correlations between direct and maternal effects were more negative for NMISS, where few sires were maternal grandsires. Parameter estimates with RRM were similar to MTM cept that estimates of variances showed more artifacts for MISS; the estimates of additive direct-maternal correlations were more negative with both data sets and approached -1.0 for some ages with NMISS. When parameters of a growth model obtained by used for genetic evaluation, these parameters should be examined for consistency with parameters from MTM and prior information, and adjustments may be required to eliminate artifacts.

Age Factors↗

PubMed1984

Intracranial and systemic effects of osmotic and oncotic therapy in experimental cerebral edema.

Experiments were carried out to compare the effectiveness of oncotic and osmotic therapy in dogs with experimental cerebral edema caused by a left parietal cold lesion. Animals were divided into five groups and treated for 6 hours with either crystalloid (control group), or mannitol, albumin, furosemide, or albumin/furosemide (treatment groups). The cerebral effects of therapy were evaluated by intracranial pressure (ICP) measurements and by postmortem evaluations of water content, using computerized tomography (CT) density measurements and wet-dry weight measurements. The ICP was significantly reduced by all treatments except albumin alone, and was reduced equally by mannitol, furosemide, and albumin/furosemide. The CT density of the lesion area was significantly increased by all treatments. The density of the contralateral nonlesioned hemisphere was significantly increased by all treatments except albumin. The water content of the lesion area was significantly decreased by all treatments; water content of the opposite hemisphere was not significantly reduced. The systemic effects of therapy were evaluated by measuring net fluid balance, wedge pressures, hematocrits, free water clearance, and vasopressin. Negative fluid balance without an increase in hematocrit or in vasopressin secretion occurred only in dogs treated with albumin/furosemide. Such oncodiuretic therapy seems to cause normovolemic dehydration and to have cerebral effects similar to mannitol and furosemide, without their undesirable systemic effects.

Albumins↗

PubMed2005

Long-term cholinergic treatment is not associated with greater risk of weight loss during Alzheimer's disease: data from the French REAL.FR cohort.

BACKGROUND: An increased incidence of weight loss has been reported in patients with Alzheimer's disease (AD) treated with higher doses of acetylcholinesterase inhibitors (AChEI) compared with placebo patients in several clinical trials. The proportion of patients losing weight is extremely variable from one study to another and further analysis is necessary to reach a conclusion on the association of weight loss and AChEI. OBJECTIVE: This observational study was designed to investigate the potential effects of AChEI use on weight loss during AD. DESIGN: 486 patients with AD were followed for one year (initial mean age 77.3 +/- 77 years; initial mean MMS score 20.3 +/- 4.2). Comprehensive geriatric and neuropsychological assessment was conducted every 6 months. Cholinergic treatment was recorded at each visit, as well as any concomitant medication for dementia, psychotropic and other medications. We defined clinically significant weight loss as > or = 4% of the subject's initial weight based on the last measured weight. The data were initially evaluated categorically to identify those who had lost > or = 4% of their initial weight or had remained stable. RESULTS: Eighty-nine per cent of AD patients were treated with AchEI during the first year of follow-up. Twenty-one per cent experienced clinically significant weight loss during this period. Weight loss was associated with more rapid deterioration of cognitive function (Delta MMSE -2.62 +/- 3.99 versus -1.72 +/- 3.64, P = 0.014) and loss of independence in instrumental activities of daily living (Delta IADL -1.45 +/- 1.50 versus - 0.88 +/- 1.43, P = 0.002). The frequency of weight loss was similar whether AD patients were treated with AChEI or not (respectively 21.1 and 19.5%, P = 0.81). In multivariate analysis, the risk of weight loss was significantly decreased in patients taking AChEI for more than 3 months compared (OR = 0.25, 95% CI = 0.11-0.56, P = 0.0007). CONCLUSIONS: Our data suggest that long-term cholinergic treatment is not associated with greater risk of weight loss during AD and may be a protective factor. Further analysis is necessary to confirm this relation. It is obvious that the benefit observed might also be partly related to the organised non-pharmacological management provided for our patients, which included a specific care plan for each individual and facilitated response to nutritional problems as they occurred. Global care of AD patients must associate regular pluridisciplinary management with AChEI treatment.

Activities of Daily Living↗

PubMedDate not supplied

Body Mass Index (BMI), BMI change and mortality in community-dwelling seniors without dementia.

UNLABELLED: Recently Canada adopted the World Health Organization's (WHO)Weight Classification system for Body Mass Index (BMI). To date, there has been minimal investigation on the predictive ability of BMI on mortality in seniors. This study investigates the predictive ability of the BMI categories identified in this Weight Classification System and change in BMI on mortality in Canadian seniors. METHODS: Canadian Study of Health and Aging (CSHA) participants who completed clinical examination (including body weight measurements) in 1991 (CSHA1) and 1996 (CSHA2) were included (n = 539). BMI change (CSHA1 to CSHA2) was categorized as no change/mild increase (0 to < 2.0 units), mild decrease (-0.1 to < -2.0 units), or significant increase/decrease (> or = +/-2.0 units). The outcome was subsequent 5-year-mortality, i.e. death between CSHA2 and CSHA3 (2001). Logistic regression controlled for age, gender, education level, marital status, smoking and cognitive status. RESULTS: BMI at CSHA1 was not a significant predictor of all-cause mortality between CSHA2 and CSHA3. A significant decrease in BMI regardless of BMI category predicted death (OR 2.10 95% CI 1.17, 3.80). Other factors predictive of death were age and cognitive impairment without dementia. CONCLUSION: A static measure of BMI is a less useful measure of mortality risk than weight change in older adults. Weight change, especially weight loss resulting in a BMI change of at least 2.0 units, is predictive of mortality and should be considered a warning sign.

Aged↗

PubMed1988

Accuracy, continuity, and pattern of flow from five macrorate infusion pumps.

The accuracy, continuity, and pattern of flow from five commercially available macrorate infusion pumps were evaluated in vitro. Intravenous fluid was run through each infusion device at 5, 10, and 50 mL/hr. The weight of the fluid was measured serially after flow periods of 5, 10, and 15 sec for each device at each flow rate using a computerized gravimetric technique. The influence of the type of pump, flow rate, and sample-collection time on flow continuity was determined. Flow continuity (variation in flow) was expressed as the coefficient of variance of the measured weights. All of the infusion devices had flow rates within 5% of the desired rates of 5, 10, and 50 mL/hr. Flow continuity was significantly affected by the type of pump used but not by either flow rate or sample-collection time. All five devices had unique flow patterns attributable to their respective pump-operating mechanisms. The method of drug delivery and, in particular, the pump-operating mechanism of a given infusion device may affect flow continuity; therefore, alterations in clinical response to a continuous drug infusion must not be attributed exclusively to the drug or the clinical condition of the patient. Further in vitro and in vivo evaluations are needed to define the clinical importance of these data.

Infusions, Intravenous↗

PubMedDate not supplied

Twin pregnancy: the distribution of maternal weight gain of non-smoking normal weight women.

We documented the pattern and distribution of weight gain through twin pregnancies of healthy non-smoking women with good birth outcomes. The mean birthweight was 2621 g and the mean gestational age at delivery was 37.6 weeks. As few of the women were weighed after 34 weeks, the weight gain graph was drawn to this point. The sample was separated into subgroups based on birthweights and gender of the infants. Weight gains, parity, income, first measured weight, BMI and Apgars were not different between the subgroups. The only difference between those with infants that were small for gestational age (SGA), over 3 kg, or intermediate in weight was gestational age. For the groups divided by infant gender, the only differences were maternal age and infant birthweight. The mean, median and 80% confidence limits for weight gain at 34 weeks were 14.1, 13.6, and between 8.5 and 19.4 kg, respectively. There was a wide range of weight gained by these women carrying twin pregnancies.

Adult↗

PubMed1996

Weight change in Alzheimer's disease.

PURPOSE: To determine the natural history of weight change and the occurrence of clinically significant weight loss in subjects with Alzheimer's disease (AD). PATIENTS AND METHODS: Subjects with AD and cognitively normal older controls were recruited from 21 U.S. university medical centers that were participating in the Consortium to Establish a Registry for Alzheimer's Disease (CERAD). Annual assessments were performed. Subjects with AD (n = 362) and controls (n = 317) with two or more weight measurements taken a year or more apart were included in this analysis. The average period of follow-up was > 2 years for both subjects with AD and controls. Four variables describing different aspects of weight change were defined: >/= 5% weigh loss, percent weight change/year, maximum percent weight loss over 1 year, and standard deviation of measurements/subject. RESULTS: Nearly twice as many subjects with AD experienced a weight loss of 5% or more when compared with controls (men P = .003 women P = .001). Surprisingly, a weight gain of 5% or more was also more common among AD cases. Overall, there was a tendency toward weight loss for both subjects with AD and controls, as measured by percent weight change/year. When other possible causes of weight loss were controlled using a multivariate model, a diagnosis of AD remained a significant predictor of >/= 5% weigh loss (P << .001), maximum percent weight loss over 1 year (P << .001), and standard deviation of measurements/subject (P << .001). A trend toward significance was noted for percent weight change/year (P = .07). Other than AD, very few of the possible confounders of this association remained significant predictors of weight change. In bivariate analysis, the severity of AD at entry correlated with percent weight change/year and standard deviation of measurements/subject. Additionally, the functional status of subjects with AD correlated with all four measures of weight change. CONCLUSION: Clinically important weight loss occurs more frequently among patients with AD than among cognitively normal control subjects. Instances of weight gain, periods of acute weight loss, and greater fluctuations in weight suggest that the natural history of weight change in AD may be characterized by dysfunction in body weight regulation. Further analysis is warranted regarding the relationship of severity of dementia, functional status, and other specific aspects of AD to weight change.

Activities of Daily Living↗

PubMed1994

Evidence of radiation-induced reduction of height and body weight from repeated measurements of adults exposed in childhood to the atomic bombs.

Reduction of growth from exposure to atomic bomb radiation has been examined using individuals under 10 years old at the time of the bombing (ATB) and a growth curve analysis based on measurements of height and weight made in the course of the 4th-7th cycles of the Adult Health Study examinations (1964-1972). As expected, the largest difference in growth to emerge is between males and females. However, a highly significant reduction of growth associated with dose (DS86) was observed among those survivors for whom four repeated measurements of height and weight were available. Longitudinal analysis of a more extended data set (n = 821), using expected values based on simple linear regression models fitted to the three available sets of measurements of height and weight on the 254 individuals with a missing measurement, also indicates a significant radiation-related growth reduction. The possible contribution of such factors as poor nutrition and disruption of normal family life in the years immediately after the war is difficult to evaluate, but the effects of socioeconomic factors on the analysis of these data are discussed.

Adult↗

PubMed1997

Intra- and interexaminer reliability of anthropometric measurements of term infants.

BACKGROUND: The reliability of anthropometric measurements of term infants has not been studied sufficiently to determine if these measurements are reliable enough to be used in clinical practice and research. This study described the intra- and interexaminer reliability of the following anthropometric measurements: weight (WT), head circumference (HC), chest circumference (CC), abdominal circumference (AC), mid-arm circumference (MAC), and length. METHODS: A convenience sample of 50 clinically stable term infants was studied. Two examiners obtained the six measurements twice using blank tape measures. The order of examiners was randomized and the examiners were masked to their own and the other examiners' measurements. RESULTS: The intraexaminer mean absolute differences were as follows: WT = 1.88, 3.28 g; HC = 0.29, 0.29 cm; CC = 0.50, 0.78 cm; AC = 0.71, 0.77 cm; MAC = 0.36, 0.39 cm; length = 0.92, 1.18 cm. The interexaminer mean absolute differences were as follows: WT = 1.94, 1.66 g; HC = 0.37, 0.36 cm; CC = 0.59, 0.72 cm; AC = 0.99, 0.77 cm; MAC = 0.41, 0.57 cm; length = 1.57, 1.47 cm. CONCLUSIONS: These findings indicate that intraexaminer differences tended to be smaller than interexaminer differences for all measures except weight, which remained stable for intra- and interexaminer comparisons. These findings also suggest that weight and head circumference were the most reliable measures, whereas length and mid-arm circumference were the least reliable measures.

Abdomen↗

PubMed1993

Advanced pubertal development and eating disturbance in early adolescent girls.

This study assessed the hypothesis that early adolescent girls with advanced pubertal development would be at increased risk for eating disturbance compared with less-advanced peers. Sixth-grade girls differing in levels of pubertal development responded to the Eating Disorder Inventory (EDI); to questions about weight-related concerns and dieting; and to measures of body image and appearance satisfaction. Body mass index (BMI) was calculated from measured weights and heights, and used as a measure of body fatness. Also assessed were the relative contributions of physical variables (e.g., body fatness) and psychological variables (e.g., body image) to eating- and weight-related concerns. Results supported the hypothesis that more advanced pubertal development was associated with an elevated level of eating disturbance. Analyses suggested that although normal pubertal increases in fatness and weight initially might induce eating-related concerns, it is the psychological response to these changes, in the form of more negative body image, that ultimately becomes more important for promoting eating disturbance.

Age Factors↗

PubMed1999

Treatment of hypopituitarism in infancy. Effect on head circumference growth.

BACKGROUND: Head circumference of children with multiple pituitary-hormone deficiency (MPHD) may be subnormal for age. Moreover it is known that linear growth in infancy is growth-hormone (GH) dependent. Therefore, aim of the study has been to compare head circumference measurements in children with hypopituitarism after L-thyroxine (L-T4) therapy alone, before therapy with GH, and after GH was added to the therapy. METHODS: Five infants (2 girls, 3 boys) with MPHD, diagnosed and treated before the age of 2 years and whose auxological parameters records during L-T4 therapy alone were available, were retrospectively studied. Head circumference and length measurements were expressed as standard deviation score (SDS). Weight measurements were expressed as weight for length ratio percentage. RESULTS: Initially treated with L-T4 alone for a mean period of 4, 5 months, there were neither positive effects on head circumference nor on linear growth. A significant catch-up growth was observed only employing GH therapy in addition to L-T4: mean head circumference SDS and length SDS increased respectively from -2.20 to -0.89 SDS and from -4.16 to -0.87 SDS after a mean period of 18 months of combined GH and L-T4 therapy. CONCLUSIONS: Therefore, head circumference growth, in infancy, is growth hormone dependent as well as linear growth, and during GH treatment, monitoring head circumference growth is important as much as monitoring linear growth.

Adolescent↗

PubMedDate not supplied

Treatment of hypopituitarism in infancy. Effect on head circumference growth.

Drug Therapy, Combination↗

PubMed1981

Bone mineral analysis of the rat femur by direct photon absorptiometry.

This report describes a method using direct photon absorptiometry (DPA) for determination in vivo of the bone mineral content to bone width ratio (BMC/W) in the rat femur. A significant correlation was noted between measurements by DPA and whole femur dry weight and ash weight. Measurements were reproducible within repeated determinations of both the same and successive days. Soft tissue, rotation of the femur, or slight differences in the longitudinal positioning of the femur did not significantly affect usefulness of the measurements. A significant positive correlation was seen between body weight and the femur BMC/W, indicating that the method accurately reflected expected physiological changes in bone mineral. The method is suitable for the rapid, simple, accurate, and reproducible measurement of bone mineral in the anesthetized rat and is applicable to serial measurements.

Animals↗

PubMed1982

Comparison of stated and measured patient heights and weights.

Stated and measured patient heights and weights were compared, and the clinical importance of any differences was determined. A total of 112 health-clinic patients were interviewed for height and weight determinations. They were divided into four groups: men 21-35 years old; men 65 years and older; women 21-35 years old; and women 65 years and older. The stated and the actual heights and weights were analyzed for significant differences. Calculations of body surface area (BSA) and basal energy expenditure (BEE) were used to determine the clinical impact of any discrepancies. Patients in all groups tended to overestimate their height, but only the estimates of men differed significantly from the measured values. Differences between stated and measured heights for older women showed statistical differences from younger men and women but not from older men. All groups except young men overestimated their weight. Older men showed the greatest tendency towards overestimation of weight. In elderly men, the calculations of BSA and BEE were significantly different (p less than 0.002) when stated versus measured values were used. These differences were not considered clinically important. Overall, patients in all groups were well aware of their heights and weights.

Adult↗

PubMedDate not supplied

Agreement between paramedic-estimated weights and subsequent hospital measurements in adults with out-of-hospital cardiac arrest.

OBJECTIVE: To assess the accuracy of paramedic estimates of adult body weights in cardiac arrest cases. HYPOTHESIS: Paramedics could accurately estimate the weights of out-of-hospital cardiac arrest patients. DESIGN: Retrospective data analysis of a 15-month, multicenter study involving nontraumatic out-of-hospital cardiac arrest patients. Paramedic estimates of body weights were compared to weights measured in the hospital. Patients were included in the analysis only if both a paramedic weight and a measured in-hospital weight were recorded. SETTING: Six urban emergency medical services systems. PARTICIPANTS: The study population included adults with return of spontaneous circulation who subsequently were admitted to the hospital. MEASUREMENTS: Pearson correlation analysis of paramedic-estimated weights and measured weights. RESULTS: Among the 133 study patients, the correlation coefficient (R) for paramedic estimates and the actual measured weight was 0.93. Paramedic estimates of weight were within 10% of the measured weights in 74% of the patients, and within 20% of measured weights in 93% of the patients. CONCLUSION: Paramedic weight estimates correlated well with measured weights.

Adult↗

PubMed1999

Weight, weight change, mortality in a random sample of older community-dwelling women.

OBJECTIVE: To evaluate the relationship between measured weight, weight change, and 6-year mortality risk in a random sample of 648 community-dwelling women aged 65 and older from Baltimore, Maryland. MEASUREMENTS: Data were collected using a standardized questionnaire and administered in person by trained interviewers. Questionnaires were completed annually from 1984 to 1986, and body weight was measured at each interview. Weight was defined as body mass index (BMI) of low (< 23 kg/m2), average (> or = 23 kg/m2 to < or = 28 kg/m2), and high (> 28 kg/m2). Four mutually exclusive categories of weight change of at least 4.5% in BMI over the three annual interviews were developed to describe all possible weight change patterns: weight gain, weight loss, no change, and weight cycling. RESULTS: During the follow-up period, 106 women (16%) died. Women with low baseline BMI, regardless of weight change, and those who lost weight, regardless of baseline BMI had increased mortality risk. Women with average baseline BMI and weight loss had a very high mortality risk (hazard ratio (HR) 3.84, 95% Confidence interval (CI) 2.14-6.89). Women who weight cycled had increased mortality risk at low and high baseline weights, and a nonsignificant increased risk at average baseline weight (P = .069). Analyses were adjusted for age, education, smoking, alcohol usage, and pre-existing illness and included an interaction between weight change and baseline BMI. CONCLUSIONS: These results suggest that white, older, community-dwelling women are at an increased risk of mortality if they are underweight, lose weight, or weight cycle.

Aged↗

PubMed1997

The impact of hormone replacement therapy on quality of life and willingness to pay.

OBJECTIVE: To measure the gain in quality of life due to hormone replacement therapy for women with mild and severe menopausal symptoms. DESIGN: Prospective study where data on quality of life and willingness to pay were collected by interview. SETTING: Department of Gynaecology at Södertälje Hospital near Stockholm. PARTICIPANTS: One hundred and four women aged 45 to 65 years treated for menopausal symptoms for at least one month. METHODS: Quality of life was measured by the time tradeoff and rating scale methods. The willingness to pay for hormone replacement therapy was investigated using the contingent valuation method. MAIN OUTCOME MEASURES: The quality adjusted life year weight measured with the rating scale and time tradeoff methods, and willingness to pay. RESULTS: The increase in the quality adjusted life year weight due to hormone replacement therapy for women with mild symptoms was 0.26 according to the rating scale method and 0.18 according to the time tradeoff method. For women with severe symptoms the quality adjusted life year weight increased by 0.50 according to the rating scale method and by 0.42 according to the time tradeoff method. The mean willingness to pay for hormone replacement therapy per month was 2300 Swedish krone for women with mild symptoms and 4800 Swedish krone for women with severe symptoms (Pounds 1 = 10.3 Swedish krone). CONCLUSIONS: Hormone replacement therapy leads to a major improvement in quality of life for women with menopausal symptoms. Both for women with mild and severe menopausal symptoms the willingness to pay for the treatment also greatly exceeds the costs, indicating that hormone replacement therapy is economically beneficial for women with menopausal symptoms.

Aged↗