Introduction:Excess body fat is linked to higher risks for metabolic syndrome, type 2 diabetes mellitus (T2DM), and cardiovascular disease (CV), among other health conditions. However, it is not only the level but also the distribution of body fat that contributes to increased disease risks. For example, an increased level of abdominal fat, or visceral adipose tissue (VAT), is associated with a higher risk of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH).Methods: A review of the most relevant primary and secondary sources on body composition from the last 25 years was conducted. Relevant articles were identified using PUBMED and Google Scholar. Narrative synthesis was performed as statistical pooling was not possible due to the heterogeneous nature of the studies. Results:The body mass index (BMI) is commonly used as a proxy measure of body fatness. However, BMI does not reflect the level and distribution of body fat. Other anthropometric methods such as waist circumference measurement and waist-hip ratio, as well as methodologies like hydro densitometry, bioelectrical impedance, and isotope dilution are also limited in their ability to determine body fat distribution.Imaging techniques to define body composition have greatly improved performance over traditional approaches. Ultrasound (US), computed tomography (CT), dualenergy X-ray absorptiometry (DXA), magnetic resonance imaging (MRI), are now commonly used in clinical research. Of these, MRI can provide the most accurate and high-resolution measure of body composition. In addition, MRI techniques are considered the best for the determination of fat at the organ level. On the other hand, imaging modalities require specialized, often expensive equipment and expert operation.Conclusions: Anthropometric methods are suitable for rapid, high-volume screening of subjects but do not provide information on body fat distribution. Imaging techniques are more accurate but are expensive and do not lend themselves for high throughput. Therefore, successful trial strategies require a tiered approach in which subjects are first screened using anthropometric methods followed by more sophisticated modalities during the execution of the trial.
Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/InbQzt-H3KgObjective: This study evaluated patterns of utilization and costs of emergency transport among women with a diagnosis of preterm labor in the US. Methods: The IBM ® Treatment Pathways ® tool was used to interrogate a cohort randomly selected from the IBM's MarketScan ® dataset. Differences in costs and utilization patterns were assessed by the type of emergency transport service and geography.Results: A cohort of 12,995 women between the ages of 16 and 45 met the inclusion criteria. About 1,029 (7.9%) of these women had evidence of emergency transport within a day of the preterm labor diagnosis. In this cohort, the median cost of emergency ground transportation was US$834; air transport had a median cost of US$22,922. Additionally, 3.1% ( 284) women out of a cohort of 8,728 women ages of 16 and 45 with a diagnosis of false labor required emergency transport within 7 days suggesting that they were discharged too soon. Discussion: The prevalence of emergency transport for preterm labor in rural areas is significantly higher compared to non-rural areas. In addition, the disproportionate use of air transport in rural areas increases the costs of the preterm labor event. Moreover, disparities in both utilization rates and costs were identified for different parts of the country.
The medication expenditures for detection of one single IMD patient was RMB$952,405.04. Overall the cost is huge. Conclusions: Neonatal screening for IMD using MS/MS in common neonates may not be cost-effective, this needs to be confirmed using data on observed mortality and disability reduction.The results prompt the need of prudent consideration for nationwide promotion of IMD neonatal screening using MS/MS.
Pathogenic variants in the BRCA1 and BRCA2 genes have been recognized as major contributors to breast and ovarian cancer risk since the mid-1990s. While the prevalence of BRCA1 and BRCA2 mutations in the general population is estimated at 1:400, the prevalence in the Hispanic population has not been established. However, the significantly earlier age of breast cancer onset and the higher prevalence of triple-negative breast tumors compared to non-Hispanic White women are consistent with a high prevalence of BRCA1/2 mutations in the Hispanic population. Recent studies have shown that a handful of highly recurrent BRCA1/2 mutations are responsible for most of the hereditary risk of breast and ovarian cancer in Hispanic women. Two mutations in particular, BRCA1 185delAG and BRCA1 exon9-12 del, are the most prevalent and can be traced back to Spanish and Amerindian founder populations respectively.
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