The number of obese children has increased with almost 100 % in a few decades. Deceases like insulin-resistance and type-2 diabetes often comes with overweight and worldwide research to prevent and cure these complications is constantly approaching. This study provides with greater knowledge of what correlations there are between anthropometric measurements, insulin resistance and respiratory quotient.For this study, data from 83 children and teenagers was included. The medical records from their first visit to the pediatric science unit at Uppsala University Hospital was used. To measure basal metabolic rate (BMR), indirect respiratory calorimetrics was used to measure the respiratory ratio at rest and fasting (RQ-BMR), and blood samples were collected to analyze fs-(fasting) insulin. The anthropometric measurements that were taken were waist, waist-height-ratio (WtHR), waist-hip ratio (WHR), waist-hip-height ratio (WHtR), waist circumference (AC), waist circumference-height ratio (ACHR), sagittal abdominal diameter (SAD) and Sagittal abdominal diameter-height ratio (SADHR).Correlations between fs-insulin and WHtR, WCHR, SAD and SADHR was found for the whole group of participators in this study. The strongest correlation was to WHtR for boys and SAD for girls. The RQ-BMR correlated the best with SADHR and ACHR. No correlations between RQ-BMR were found specifically for boys or girls.

O Diâmetro Abdominal Sagital (DAS) é uma medida antropométrica relacionada com a gordura visceral e empregada para avaliar a obesidade abdominal, uma variável associada à síndrome metabólica. Sua utilização é indicada na prática clínica para avaliação de risco cardiometabólico em adolescentes obesos. OBJETIVO: Verificar a concordância entre o DAS e a circunferência abdominal (CA) na avaliação da obesidade central e sua associação com os critérios da Síndrome Metabólica e HOMA-IR em adolescentes obesos. CASUÍSTICA E MÉTODOS: Estudo de corte transversal constituído por 83 adolescentes obesos entre 14 e 18 anos, (46 do sexo feminino e 37 do sexo masculino) matriculados no Instituto da Criança do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, nos ambulatórios das Unidades de Endocrinologia Pediátrica e de Adolescentes. Foram submetidos a avaliações antropométricas (IMC, Escore Z do IMC, percentual de gordura corporal, circunferência abdominal, diâmetro abdominal sagital), laboratoriais (HDL-c, triglicérides (TG), glicemia (GLIS) e insulina para o cálculo do HOMA-IR) e de pressão arterial sistólica (PAS) e diastólica (PAD), utilizadas para classificação dos critérios da SM. RESULTADOS: Todos os adolescentes apresentaram valores elevados de IMC (36,9±6,7 kg/m2), Z-IMC (+3,27±0,94) e 91,6% da casuística tiveram valores alterados no percentual de gordura corporal (41,4% para o grupo feminino e 36% para o grupo masculino), confirmando a obesidade grave do grupo. Considerando o percentil >=90 do Center for Disease Control and Prevention (CDC), no National Health and Nutrition Examination Survey (NHANES 2011-2014), 85,5% dos adolescentes apresentaram valores elevados de CA (117,7 ± 14,7) e 89,2% valores alterados no DAS (26,9±3,7). Quanto às variáveis laboratoriais, 32,5% dos pacientes apresentaram diminuição de HDL-c e níveis aumentados de: TG (10,8%); GLIS (3,6%); PAS (32,5%,); PAD (21,7%) e HOMA-IR (79,5%), considerando toda a amostra. De acordo com os critérios utilizados pelo International Diabetes Federation, 27,7% da casuística apresentou SM. O DAS demonstrou estar significantemente correlacionado com as variáveis PAS (r=0,489 p < 0,001), PAD(r=0,277 p 0,011) e HOMA-IR (r=0,462 p < 0,001) nos grupos geral, feminino, masculino, com e sem SM. A correlação encontrada entre as medidas do DAS e CA no grupo geral e feminino foi de r = 0,91 (p 0,000) e, no grupo masculino, de r = 0,93 (p 0,000). A concordância entre a CA e o DAS é significante (Kappa k = 0.511; p < 0,001). Nos grupos geral, feminino e masculino com SM, a concordância é mais expressiva (Kappa k = 1,00; p < 0,001.). Esses resultados mostram que os adolescentes apresentavam risco cardiometabólico aumentado e expressiva obesidade central, identificada pelo DAS e CA, apesar de 73,5% deles estarem medicados. O DAS oferece vantagem metodológica na sua mensuração. CONCLUSÕES: Nas condições deste estudo, conclui-se que: as medidas antropométricas CA e DAS se equivalem para o grupo de adolescentes avaliados na classificação da SM; O DAS é preditor de PAS, PAD e HOMA-IR e forte indicador de risco cardiometabólico em adolescentes obesos / The sagittal abdominal diameter (SAD) is an anthropometric measure related to visceral fat and used to evaluate abdominal obesity, a variable associated with the metabolic syndrome. Studies have suggested its employment in the clinical practice for estimating cardiometabolic risk of obese adolescents. OBJECTIVE: To verify the concordance between SAD and abdominal circumference in the assessment of central obesity and its association with the Metabolic Syndrome cluster and with HOMA-IR in obese adolescents. CASUISTICS AND METHODS: In a cross-sectional study, 83 obese adolescents between 14 and 18 years (46 females and 37males) with body mass index (BMI) of 36.9 ± 6.7 kg/m2, followed at the Pediatric Endocrinology Unit and at the Adolescent Unit of the Children\'s Institute, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo were submitted to anthropometric (BMI, BMI Z Score, body fat percentage, abdominal circumference, sagittal abdominal diameter), laboratory (HDL-c, triglycerides, glycemia and insulin for calculating HOMA-IR) and systolic and diastolic blood pressure assessments aimed for classification of metabolic syndrome. Previous consentment was given by all patients and their families. RESULTS: All adolescents presented elevated BMI and Z-BMI, and high body fat percentage was displayed by 91.6% of the patients (41.4% for the female group and 36% for the male group), confirming severe obesity. Considering the >= 90 percentile cut-off values as provided by the Anthropometric Reference Data for Children and Adults: United States 2011-2014 for abdominal circumference and SAD, 85.5% of the patients presented high abdominal circumference values (117.7±14.7) and 89.2% presented elevated values of SAD (26.9±3.7). With regard to laboratory variables, 32.5% of the patients displayed decreased HDL-c and increased values of: triglycerides (10.8%); glycemia (3.6%); systolic blood pressure (32.5%); diastolic blood pressure (21.7%) and HOMA-IR (79.5%). According to the criteria of the International Diabetes Federation (IDF), 27.7% of patients presented metabolic syndrome. SAD was significantly correlated with systolic (r=0.489 p < 0.001) and diastolic (r=0.277 p 0.011) blood pressures and HOMA-IR (r=0.462 p < 0.001) in the general, female and male groups, with and without metabolic syndrome. The correlation between SAD and abdominal circumference in the general and female groups was r = 0.91(p 0.000) and in the male group was r = 0.93 (p 0.000). The concordance between SAD and abdominal circumference was significant (Kappa coefficient k = 0.511; p < 0.001). In the general, male and female groups with metabolic syndrome, the concordance was more expressive (Kappa coefficient; k = 1.00 and p < 0.001). These results show that the adolescents presented increased cardiometabolic risk and significant central obesity identified by SAD and abdominal circumference although 73.5% of the studied patients were maintained under medication for clinical metabolic syndrome symptoms. SAD displayed methodological advantages concerning its measurement. CONCLUSIONS: Under the conditions of this study, it is concluded that: the anthropometric measurements of SAD and abdominal circumference are equivalent for metabolic syndrome classification of the studied adolescents; that SAD is a predictor of systolic and diastolic blood pressures and HOMA-IR and is a strong indicator of cardiometabolic risk in obese adolescents

O Diâmetro Abdominal Sagital (DAS) é uma medida antropométrica relacionada com a gordura visceral e empregada para avaliar a obesidade abdominal, uma variável associada à síndrome metabólica. Sua utilização é indicada na prática clínica para avaliação de risco cardiometabólico em adolescentes obesos. OBJETIVO: Verificar a concordância entre o DAS e a circunferência abdominal (CA) na avaliação da obesidade central e sua associação com os critérios da Síndrome Metabólica e HOMA-IR em adolescentes obesos. CASUÍSTICA E MÉTODOS: Estudo de corte transversal constituído por 83 adolescentes obesos entre 14 e 18 anos, (46 do sexo feminino e 37 do sexo masculino) matriculados no Instituto da Criança do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, nos ambulatórios das Unidades de Endocrinologia Pediátrica e de Adolescentes. Foram submetidos a avaliações antropométricas (IMC, Escore Z do IMC, percentual de gordura corporal, circunferência abdominal, diâmetro abdominal sagital), laboratoriais (HDL-c, triglicérides (TG), glicemia (GLIS) e insulina para o cálculo do HOMA-IR) e de pressão arterial sistólica (PAS) e diastólica (PAD), utilizadas para classificação dos critérios da SM. RESULTADOS: Todos os adolescentes apresentaram valores elevados de IMC (36,9±6,7 kg/m2), Z-IMC (+3,27±0,94) e 91,6% da casuística tiveram valores alterados no percentual de gordura corporal (41,4% para o grupo feminino e 36% para o grupo masculino), confirmando a obesidade grave do grupo. Considerando o percentil >=90 do Center for Disease Control and Prevention (CDC), no National Health and Nutrition Examination Survey (NHANES 2011-2014), 85,5% dos adolescentes apresentaram valores elevados de CA (117,7 ± 14,7) e 89,2% valores alterados no DAS (26,9±3,7). Quanto às variáveis laboratoriais, 32,5% dos pacientes apresentaram diminuição de HDL-c e níveis aumentados de: TG (10,8%); GLIS (3,6%); PAS (32,5%,); PAD (21,7%) e HOMA-IR (79,5%), considerando toda a amostra. De acordo com os critérios utilizados pelo International Diabetes Federation, 27,7% da casuística apresentou SM. O DAS demonstrou estar significantemente correlacionado com as variáveis PAS (r=0,489 p < 0,001), PAD(r=0,277 p 0,011) e HOMA-IR (r=0,462 p < 0,001) nos grupos geral, feminino, masculino, com e sem SM. A correlação encontrada entre as medidas do DAS e CA no grupo geral e feminino foi de r = 0,91 (p 0,000) e, no grupo masculino, de r = 0,93 (p 0,000). A concordância entre a CA e o DAS é significante (Kappa k = 0.511; p < 0,001). Nos grupos geral, feminino e masculino com SM, a concordância é mais expressiva (Kappa k = 1,00; p < 0,001.). Esses resultados mostram que os adolescentes apresentavam risco cardiometabólico aumentado e expressiva obesidade central, identificada pelo DAS e CA, apesar de 73,5% deles estarem medicados. O DAS oferece vantagem metodológica na sua mensuração. CONCLUSÕES: Nas condições deste estudo, conclui-se que: as medidas antropométricas CA e DAS se equivalem para o grupo de adolescentes avaliados na classificação da SM; O DAS é preditor de PAS, PAD e HOMA-IR e forte indicador de risco cardiometabólico em adolescentes obesos / The sagittal abdominal diameter (SAD) is an anthropometric measure related to visceral fat and used to evaluate abdominal obesity, a variable associated with the metabolic syndrome. Studies have suggested its employment in the clinical practice for estimating cardiometabolic risk of obese adolescents. OBJECTIVE: To verify the concordance between SAD and abdominal circumference in the assessment of central obesity and its association with the Metabolic Syndrome cluster and with HOMA-IR in obese adolescents. CASUISTICS AND METHODS: In a cross-sectional study, 83 obese adolescents between 14 and 18 years (46 females and 37males) with body mass index (BMI) of 36.9 ± 6.7 kg/m2, followed at the Pediatric Endocrinology Unit and at the Adolescent Unit of the Children\'s Institute, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo were submitted to anthropometric (BMI, BMI Z Score, body fat percentage, abdominal circumference, sagittal abdominal diameter), laboratory (HDL-c, triglycerides, glycemia and insulin for calculating HOMA-IR) and systolic and diastolic blood pressure assessments aimed for classification of metabolic syndrome. Previous consentment was given by all patients and their families. RESULTS: All adolescents presented elevated BMI and Z-BMI, and high body fat percentage was displayed by 91.6% of the patients (41.4% for the female group and 36% for the male group), confirming severe obesity. Considering the >= 90 percentile cut-off values as provided by the Anthropometric Reference Data for Children and Adults: United States 2011-2014 for abdominal circumference and SAD, 85.5% of the patients presented high abdominal circumference values (117.7±14.7) and 89.2% presented elevated values of SAD (26.9±3.7). With regard to laboratory variables, 32.5% of the patients displayed decreased HDL-c and increased values of: triglycerides (10.8%); glycemia (3.6%); systolic blood pressure (32.5%); diastolic blood pressure (21.7%) and HOMA-IR (79.5%). According to the criteria of the International Diabetes Federation (IDF), 27.7% of patients presented metabolic syndrome. SAD was significantly correlated with systolic (r=0.489 p < 0.001) and diastolic (r=0.277 p 0.011) blood pressures and HOMA-IR (r=0.462 p < 0.001) in the general, female and male groups, with and without metabolic syndrome. The correlation between SAD and abdominal circumference in the general and female groups was r = 0.91(p 0.000) and in the male group was r = 0.93 (p 0.000). The concordance between SAD and abdominal circumference was significant (Kappa coefficient k = 0.511; p < 0.001). In the general, male and female groups with metabolic syndrome, the concordance was more expressive (Kappa coefficient; k = 1.00 and p < 0.001). These results show that the adolescents presented increased cardiometabolic risk and significant central obesity identified by SAD and abdominal circumference although 73.5% of the studied patients were maintained under medication for clinical metabolic syndrome symptoms. SAD displayed methodological advantages concerning its measurement. CONCLUSIONS: Under the conditions of this study, it is concluded that: the anthropometric measurements of SAD and abdominal circumference are equivalent for metabolic syndrome classification of the studied adolescents; that SAD is a predictor of systolic and diastolic blood pressures and HOMA-IR and is a strong indicator of cardiometabolic risk in obese adolescents

No description available.

Einleitung: In der zahnärztlichen Literatur findet man klinische Studien, welche die Modifikation der sagittalen Kompensationskurve (SKK) aufgrund ihrer Entstehung, ihres Verhaltens während des Wachstums oder in Abhängigkeit von anderen Faktoren untersuchen. Zahlreichen Veränderungen und Variationen der SKK während des Zahnwechsels bzw. im Laufe des Lebens unterliegen dem Einfluss von Wachstum, kraniofazialer Morphologie, Kaukraft, Frontzahnmorphologie, Ausprägung der Okklusion und der relativen Lage der Kiefergelenke zur Mandibula sowie von weiteren Faktoren. Ziel: Das Ziel dieser Studie war eine Untersuchung der Variation der SKK in erneut aufgestellten Gipsmodellen von Doktorandin (D) und Studenten (S) in Neutralverzahnung. Im Rahmen der Überlegungen zur Biomechanik erhob sich die Frage, ob und gegebenenfalls wie sich die Ausprägung der SKK bei wiederholter Aufstellung in Neutralverzahnung trotz identischer Anatomie der Zähne verändert. Nach Überlegungen zur Okklusion und Morphologie ist bei der Verwendung von identischen Zähnen und idealer Aufstellung in Neutralverzahnung theoretisch nur eine Variante der Zahnbogenform und somit der SKK möglich. Es sollte untersucht werden, ob die Ausprägung der Kurve mit anderen Elementen wie Länge, Breite und Symmetrie des Zahnbogens korreliert. Es sollten Durchschnittstiefe beider Kieferseiten, die Position der tiefsten Stelle sowie Minimal- und Maximalwerte der SKK ermittelt werden. Modelle der Doktorandin (D) und Studenten (S) sollten verglichen werden. Material und Methoden: Das Ober- und Unterkiefer-Gipsmodell eines ausgesuchten Patientenfalls (Urmodell, Abschlussmodell nach kieferorthopädischer Behandlung, Neutralverzahnung) wurde 65-mal dubliert und die Zähne vom Zahnkranz separiert, so dass ein Puzzle der Okklusion erneut erstellt werden musste. Die Doktorandin stellte 20 Modelle und 45 Studenten jeweils ein Modell in Neutralverzahnung auf. Von den 65 so entstandenen Modellen wurden 58 ausgewertet. Vermessen wurden die Ausprägung der SKK, Zahnbogenbreite, Zahnbogenlänge sowie Symmetrie des Zahnbogens anhand Messschieber, Millimeterfolie sowie einer individuellen Messapparatur. Zur statistischen Auswertung wurden Korrelationsberechnungen, Hypothesentests (T-Test/ Welch-Test) sowie Boxplotdiagramme zur grafischen Darstellung erstellt. Ergebnisse: Es wurde eine negative Korrelation (r= -0,61) der Zahnbogenbreite mit der Zahnbogenlänge ermittelt. Es bestanden keine weiteren Korrelationen der SKK mit den übrigen Messwerten größer als r =0,6 oder kleiner als r= -0,6. Die S-Modelle waren breiter aufgestellt als die D-Modelle. Die SKK der D-Modelle waren in beiden Quadranten deutlich tiefer. Die Gesamtheit aller Modelle wies im 4. Quadranten tiefere Kurven als im 3. Quadranten auf. Durchschnittlich wiesen alle Modelle einen kürzeren dritten Quadranten auf. Aus der Horizontalebene betrachtet, verlief der Zahnbogen im vierten Quadranten steiler. Der tiefste Punkt der SKK ist der mesio-bukkale Höcker des ersten Molaren beidseits. Schlussfolgerung: Es konnte keine signifikante Abhängigkeit der Ausprägung der SKK von übrigen Messgrößen nachgewiesen werden. Betrachtet man die erstellten Modelle einzeln, so entstanden unterschiedlichste Ausprägungen der SKK, Zahnbogenbreiten und –längen bei funktioneller Okklusion. Die Mittelwerte aller vermessenen Modelle (Zahnbogenbreite und –länge) sind fast identisch mit denen des Urmodells ( 1,0mm). Das bestätigt zum Teil die Theorie, dass die Zahnbogenform durch die Zahnform vorgegeben ist. Die Mittelwerte schwanken um die Morphologie des Urmodells. Das Spiel für die Anordnung der Morphologie und Streubreite der Zahnbogenform ist größer als vorerst vermutet. Es müssen weitere Studien auf diesem Gebiet erfolgen, um den Sachverhalt genau zu prüfen. Als ein Ziel der kieferorthopädischen Behandlung wird das Abflachen einer ausgeprägten SKK empfohlen, um eine Neutralverzahnung weitestgehend einzustellen. Der Behandler sollte ausreichende Kenntnis über den idealen Verlauf der SKK besitzen, damit beim Gebrauch von starren Bögen während der terminalen Behandlung mit Straight-Wire-Technik eine Neutralverzahnung im Molarbereich gewährleistet bleibt.

Syfte och frågeställningar Syftet med den här studien har varit att undersöka och jämföra kvinnor och män i åldersgrupperna 30-39 år respektive 40-49 år avseende antropometriska mått samt prestation på GIH:s hälsotester. En vidare målsättning var att undersöka om det förekom några skillnader mellan två separata testtillfällen. Frågeställningarna har varit om resultaten på hälsotesterna skiljer sig mellan könen, åldersgrupperna samt mellan två separata testtillfällen. Metod Totalt fullföljde 41 deltagare GIH:s hälsotester, av dem var 20 kvinnor och 21 män mellan 30-49 år. Det enda som krävdes för att delta var att man uppfattade sig själv som frisk. Personer som tidigare haft stroke, hjärtinfarkt eller opererats på grund av hjärtproblem har inte inkluderats, ej heller gravida och personer med ledbesvär. Testerna utfördes på LTIV (Laboratoriet för tillämpad idrottsvetenskap) mellan februari och mars 2016. Resultat Signifikanta skillnader mellan de två separata testtillfällena noterades för några av styrketesterna framför allt hos männen: axelpressar, handgrip och stolresningar. Mellan könen sågs signifikanta skillnader i de antropometriska måtten, samt i flera konditions- och styrketester. Bland dessa kunde signifikant högre värden ses för kvinnorna än för männen i ryggstyrketestet.  Signifikanta skillnader mellan åldersgrupperna 30-39 år och 40-49 år sågs näst intill endast för kvinnor. De yngre jämfört med de äldre kvinnorna presterade bättre i flera av testerna, de vägde mindre och hade mindre kroppsmått. Slutsats Det framkom vanligtvis inte några signifikanta skillnader mellan det första och andra testtillfället, med enstaka undantag. När så är fallet behövs bara ett test utföras initialt inför en period med exempelvis fysisk aktivitet som senare kanske ska följas upp med ett återtest. Skillnader mellan könen och olika åldersgrupper framkom i vissa tester men inte i alla. Resultaten i denna studie beror bland annat på urvalet av individer. Eftersom att syftet med den här studien har varit att endast utföra de tester som ingår i GIH:s hälsotester har inga tester lagts till eller exkluderats. I arbetet diskuteras bland annat hur optimala testerna är som ett mått på hälsa. För att effektivisera hälsotestundersökningar framöver behöver nödvändigtvis inte alla tester utföras.

Orthognatic surgery deals with congenital and acquired dentoalveolar or skeletal deformities of the face. An unfavourable downward rotation of a mandible and posterior vertical maxillary excess cause an anterior open bite, which is characterized by excessive anterior facial height in the lower third, a gap between the incisors in maximal occlusion and a large mandibular angle. Osteotomy (mainly Le Fort I osteotomy or bilateral sagittal split osteotomy of the mandibular ramus - BSSO), ostectomy or distraction osteogenesis are performed to correct the orthognatic deformities. Osteosynthetic materials based on titanium or bioresorbable materials are used in the form of miniplates with monocortical screws, or bicortical screws are utilized to fix the bony fragments. Stability of the new jaws position is the main criterion for success. Relapse causes a loss of occlusion and consequently functional and aesthetic disorders. Relapse consists of skeletal and dental factors. Skeletal relapse is usually divided into early and long-term relapse. BSSO with counter-clockwise (CCW) rotation of the occlusal plane alone was traditionally considered to be the least stable treatment method. Some authors suggest the use of two miniplates on each side of the osteotomy, but we have not found scientific proof of the...

Orthognatic surgery deals with congenital and acquired dentoalveolar or skeletal deformities of the face. An unfavourable downward rotation of a mandible and posterior vertical maxillary excess cause an anterior open bite, which is characterized by excessive anterior facial height in the lower third, a gap between the incisors in maximal occlusion and a large mandibular angle. Osteotomy (mainly Le Fort I osteotomy or bilateral sagittal split osteotomy of the mandibular ramus - BSSO), ostectomy or distraction osteogenesis are performed to correct the orthognatic deformities. Osteosynthetic materials based on titanium or bioresorbable materials are used in the form of miniplates with monocortical screws, or bicortical screws are utilized to fix the bony fragments. Stability of the new jaws position is the main criterion for success. Relapse causes a loss of occlusion and consequently functional and aesthetic disorders. Relapse consists of skeletal and dental factors. Skeletal relapse is usually divided into early and long-term relapse. BSSO with counter-clockwise (CCW) rotation of the occlusal plane alone was traditionally considered to be the least stable treatment method. Some authors suggest the use of two miniplates on each side of the osteotomy, but we have not found scientific proof of the...