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The effects of electrical stimulation on denervated muscle using implantable electrodes.

This experimental study investigated the effects of continuous electrical stimulation on denervated muscle. The canine peroneal nerve was severed and repaired microsurgically, and the denervated extensor muscle group of the leg was stimulated continuously with an implantable electrode and pulse generator. EMG study, muscle force measurement, muscle weight measurement, histology, and histochemistry were performed to study the effect at eight weeks after the operation. Continuous electrical stimulation (pulse frequency 130 pps, burst rate approximately 1 train/min) was effective in decreasing muscle atrophy and in improving muscle force. These findings may have broader clinical applications.

Animals↗

Predictive models of carpal tunnel syndrome causation among VDT operators.

Carpal tunnel syndrome (CTS), a cumulative trauma disorder of the hand and wrist, is one of the most common disabling injuries experienced by video-display terminal (VDT) operators. The purpose of this study was to develop a theoretically based operational quantitative predictive model of the risk of work-related CTS among VDT operators. A total of 100 female VDT operators, who performed a variety of office functions, were studied at a major midwestern university. Data were collected on job exposure, anthropometry and posture factors using questionnaires, direct observation and video-recording. Discriminant analysis and logistic regression were performed to develop the operational models. The results of the study indicated the following: (1) percentage of workday working with a VDT was the most significant factor and accounted for 60% of the variance explaining the causation of musculoskeletal discomforts associated with CTS; (2) discriminant function with six variables (i.e. work duration, trunk incline, wrist extension, wrist ulnar deviation, overall anthropometric measure, weighted anthropometric measure) correctly classified 73% of the CTS group and 72% of the non-CTS group; (3) using the logistic regression model, the probabilities associated with changes in the predictive variables as affecting CTS risk are presented such that increasing the daily work duration from 1 h to 4 h increases the probability of CTS risk from 0.45 to 0.92. The results of the study suggest that the main causation of CTS is job design, the secondary (and lesser cause) is posture associated with the workplace design and the least contributing factor to CTS causation is the individual's anthropometric make-up.

Analysis of Variance↗

The interobserver reproducibility of bioelectrical impedance analysis measurements in infants and toddlers.

Although nomograms to convert readings of resistance (R) and reactance (Xc) into estimates of body composition have begun to emerge for children as well as adults, there has been reluctance to use bioelectrical impedance analysis (BIA) in very young children due to the irritability of children, measurement instability, positioning of electrodes, and, of course, reproducibility of measurements. The precision of completely independent measurements of BIA indices was evaluated by two observers by comparing a series of 40 measurements of R and Xc and 36 measurements for weight in four malnourished children on 10 different days during the course of their nutritional recuperation. For weight, the CV (coefficient of variation) was 3.5% for observer A and 3.8% for observer B. There were no differences in the means across observers with respect to weight, R, and Xc. The results obtained in this study illustrate that properly trained observers following the same standards can produce equivalent data for BIA and weight measurements even in sick children.

Body Composition↗

Indications of disordered eating behaviour in adolescent patients with idiopathic scoliosis.

We have investigated whether patients with adolescent-onset idiopathic scoliosis (AIS) are more likely to have a low body-weight. Measurements of weight, height and body mass index (BMI) were made in 44 young women with AIS and compared with age- and gender-adjusted normative data. The body mass criteria of the International Classification of Diseases for eating disorders was used to determine how many patients were within the range considered to be 'eating disordered'. Compared with the normative data, the AIS group did not differ significantly in terms of height, (p = 0.646), but they were significantly lighter (p < 0.001) and had significantly lower BMI scores (p < 0.001); 25% of the series had BMI scores which were within the range considered to be anorexic. The relationship between a diagnosis of AIS and low body-weight may indicate disordered eating and is thus a cause for concern, particularly in the light of the well-established relationship between eating psychopathology and osteoporosis. Aspects of organic health may need to be considered in addition to the cosmetic deformity.

Adolescent↗

Screening for tuberculosis prior to isoniazid preventive therapy among HIV-infected gold miners in South Africa.

SETTING: Human immunodeficiency virus (HIV) clinic for employees of a gold mine, Free State, South Africa. OBJECTIVE: To evaluate the process of screening for active tuberculosis (TB) prior to commencing TB preventive therapy in HIV-infected individuals. DESIGN: Cross-sectional study comparing performance of various combinations of screening tests for TB against a gold standard diagnosis of TB based on symptoms, chest radiograph (CXR), sputum microscopy and culture. RESULTS: Of 899 individuals, 44 (4.9%) had TB. The most sensitive symptom combination (59.1%) was any of night sweats, new or worsening cough or reported weight loss; measured weight loss > 5% or abnormal CXR increased sensitivity to 90.9%. Sputum microscopy did not increase sensitivity further, but including World Health Organization HIV clinical staging or CD4 count did. As the specificity of all these combinations was low, many individuals required further investigation to rule out TB. TB prevalence was high (11.7%) among individuals with a CD4 count < 200/mm3. CONCLUSION: CXR greatly increased the sensitivity of screening for TB in this population. Sputum microscopy conferred no additional benefit among asymptomatic patients with a normal CXR. The high prevalence of TB amongst those with a low CD4 count underlines the importance of screening for active TB prior to commencing TB preventive therapy, and before antiretroviral therapy.

Adult↗

Fatal fatty liver-kidney syndrome in obese monkeys.

A fatal syndrome associated with brief periods of anorexia or acute weight loss was noted in monkeys. Affected monkeys died unexpectedly or after a very short illness. Consistent gross findings at necropsy were enlarged, pale yellow livers, pale tan to yellow kidneys, abundant deposits of body fat and empty gastrointestinal tracts. Fatty change of the liver and kidney was the predominant and characteristic lesion found microscopically. Most of the monkeys were female Macaca fascicularis greater than 8 years of age. However, monkeys of other species and ages, and one male also died of this syndrome. Affected monkeys generally had losses of 8-33% of body weight (last measured weight--weight at death). In some animals, this syndrome was associated with a location change forcing new social interactions. A common clinical pathologic finding was azotemia. These findings suggest that obese monkeys may be prone to a fatal syndrome characterized by fatty change of the liver and kidney, and weight loss.

Animals↗

Can self-reported body weight be used to evaluate long-term follow-up of a weight-loss program?

The purpose of this study was to determine whether former participants in weight-control programs would provide valid weight data by self-report in telephone interviews. Participants were 39 women and 107 men (aged 28 to 63 years) who were in year 4 or 5 post-treatment. These represented 95% of participants who had completed all annual clinic visits. Self-reported body weights obtained by telephone interview were validated against weight measured directly in a university clinic. Overall, self-reported weight was 5.9 lb (2.7 kg) (standard deviation = 7.0 lb) (2.9%) lower than the measured weight. Using regression analysis, the strongest predictor of measured weight was reported weight, for both men and women. The bias in self-report of weight seen here is of about the same magnitude and direction as that seen in population studies. We conclude that the use of self-reported weight is not adequate for the assessment of long-term weight-loss maintenance unless the magnitude of discrepancy is adjusted for.

Adult↗

Lung weight in vivo measured with computed tomography and rebreathing of soluble gases.

In nine anesthetized dogs, accuracy of noninvasive measurements of lung weight (W) and gas volume in vivo was determined from volume and density determined by computed tomography (CT) and by rebreathing helium and the soluble gases dimethyl ether (WDME) and acetylene (WC2H2). Reference standards were obtained from the postmortem scale weight of the frozen lungs (Wscale) and compared with the CT lung weights measured in the living dog (WCT-38) and the frozen carcass (WCT-cold). WCT-cold did not significantly differ from Wscale [-2 +/- 9% (SD), P = 0.7]. WCT-cold was 10% greater than WCT-38 (0.10 greater than P greater than 0.05), suggesting an increase in lung weight despite immediately commencing freezing after death. WDME measured 64 +/- 6% and WC2H2 56 +/- 12% of WCT-38. Serial multiple measurements in three dogs over 14 wk showed a coefficient of variation (CV) of 10 +/- 2% for WDME, 18 +/- 2% for WC2H2, 4.1 +/- 0.9% for WCT, 2.6 +/- 0.8% for CT density, and 3.5 +/- 1.6% for functional residual capacity (FRC) by CT. FRC calculated from CT consistently underestimated FRC measured by rebreathing helium by 18 +/- 8% (P less than 0.005). This error, despite good agreement between WCT and Wscale, was explained by underestimation of CT total lung volume and overestimation of lung density by factors known to affect CT readings, such as partial volume effects, beam hardening, and limited number of input signals. These data show that CT scanning can provide serial measurement of the mass, density, and volume of the lungs with a CV in the order of 5%, but the rebreathing of soluble gases gives more than double this variability. Measurements of WDME performed on the same day had a CV of 3 +/- 1%, so that WDME provides a precise noninvasive means to measure lung weight in acute studies.

Acetylene↗

Accuracy of child growth-monitoring weights obtained by commune volunteers in Phu Tho Province, Vietnam.

BACKGROUND: Weight-for-age is a commonly used indicator of the health of children and communities. We determined the accuracy of health volunteers' weight measurements in a nutrition project in Vietnam. OBJECTIVE: To report the accuracy of the volunteers' weight measurements and to assess the likely effect of any inaccuracies. METHODS: Save the Children /USA trained health volunteers to weigh children (6-36 months old) every other month from December 1999 to August 2000. Trained researchers randomly rechecked 257 weights (range, 24-114 per session). We computed nondirectional and directional differences between the weights measured by volunteers and those measured by researchers. RESULTS: The weights recorded by volunteers were lower than those recorded by researchers by an average of 30 g (p < .05). Almost all of the error occurred during the first weighing session, at which the average weight recorded by volunteers was 280 g below that recorded by researchers (p = .01). The error at subsequent weighings was minimal (< 20 g below reference at each session). CONCLUSIONS: One-time directional error suggests bias. Perhaps some communities (or families) influenced the volunteers to report weights lower than those actually observed to justify the programmatic food supplements or to give the impression at subsequent weighings that the level of malnutrition had been successfully reduced from that at the first session. Careful supervision of measurements of weight at baseline is essential.

Body Weight↗

A portable monitoring system for measuring weight-bearing during tibial fracture healing.

An ambulatory monitoring system has been developed to measure the weight-bearing achieved by a patient on their fractured leg. The system is lightweight, portable, and can monitor weight-bearing continuously over an extended period of time. In addition to mean weight-bearing, the system can also determine temporal parameters associated with the patients' gait. This system was used to measure the weight-bearing achieved during the course of fracture healing in a small number of patients being treated by a variety of fixation methods for a tibial fracture. In general, weight-bearing was observed to increase with time post fracture, and the fixation method employed appeared to influence the rate of increase of loading of the fractured limb, more rigid methods of fixation enabling full-weight-bearing to be achieved sooner.

Adolescent↗

The body image detection device versus subjective measures of weight dissatisfaction: a validity comparison.

Several procedures have been developed to measure body image distortion. A recently developed device is the Body Image Detection Device (BIDD), which includes a measure of perceptual size distortion (BPI) and subjective ratings of relative weight (SRI). Initial studies have supported the validity and reliability of the BIDD BPI and SRI in mainly bulimic patients, though studies which question the validity of the BIDD (especially the BPI) have appeared. One purpose of the present study was to examine the BIDD's validity in anorectic as well as bulimic patients and to compare both to a psychiatric control group. A second purpose of the study was to compare the validity of the BIDD to alternative measures. Thus, this study also compared the BIDD indices with simple measures of body weight dissatisfaction. The results did not support the validity of the BIDD BPI as a measure of body image disturbance, moderately supported the SRI, and did support the measures of weight dissatisfaction.

Adult↗