University Cl~ildret~'~ Ilospital. Ilci(lc~lhc~r,y, Gcrrtlro~y /F.S., ;\I.G., K.S../ ut~d hr~rcI.ar Rcscw-ch Coltrc~.Kurl.tr~rlrc, Gcrr)lunjv [..I .%.I ABSTRACT. Despite the increasing use of tetrapolar TBK, total body potassium whole-body bioelectric impedance (BI) analysis in the as-CV, coefficient of variation sessment of body composition, its usefulness in estimating RhISE, root mean square error fat-free mass (FFR.1) has not been evaluated in comparison with conventional skinfold anthropometry in children. We therefore compared I) the intraobserver and interobserver reproducibility of BI and skinfold measurements and the Within the past few years, BI analysis has gained wide use in derived FFhl estimates, and 2) the predictability of FFhI the assessment of body composition. The method appears para s calculated from measurements of total body potassium ticularly suitable for use in children, because the measurements (TBK) using ' "K spectrometry by equations based on either are fast, noninvasive, painless, and require little subject cooper-BI or skinfold measurements in 112 healthy children, ation. The BI technique is based on the difference in specific adolescents, and young adults aged 3.9 to 19.3 y. best-resistance to an electrical current between aqueous and nonfitting equation to predict TBK-derived FFhl from BI and aqueous compartments within the body. Validation studies have other potential independent predictors was developed and shown the accuracy and precision of the technique to be at least cross validated in two randomly selected subgroups of the comparable with conventional anthropometric methods such as study population by stepwise multiple regression analysis. skinfold thickness measurements in both adults and children Although the technical error associated with BI measure-(1-4). ments was much smaller than that of skinfold measure-The few studies performed so far in children suggest that the mcnts, the reproducibility of BI-derived FFhl estimates changing proportions of body fluid compartments during child-(intraobserver coefficient of variation [CV], 0.39%; inter-hood may require the use of specific pediatric prediction equaobserver CV, 1.2370) was only slightly better than that of tions (4-7). However, the validation methods used so far are FFhI estimates obtained by use of weight and two skinfold difficult to apply in smaller children or rely on a number of measurements (0.62% and 1.39%, respectively). 'l'he cross unverifiable assumptions. Densitometric underwater weighing validation procedure yielded the following best-fitting pre-and respirometric assessment of residual lung volume require diction equation: FFhI = 0.65. (height2/impedance) + full subject cooperation. In addition, the specific density of the 0.68.age + 0.15 (Rz = 0.975, root mean square error = FFM seems to change during childhood; variable-density FFM 1.98 kg, CV = 5.8%, 95% limits of agreement = -1 1.1% models have been applied but are hypothetical (4, 8). Isotope to +12.470). Conventional anthropometry, using publi...
OBJECTIVE: To provide reference data for obesity indices in Mid-European schoolchildren and adolescents, to evaluate the usefulness of body mass index (BMI) as an indicator of obesity in children, and to analyse the patterns of fat accumulation during childhood. DESIGN: Cross-sectional observational study in 2554 healthy schoolchildren and adolescents (age, 6±19 y) living in Heidelberg, Germany in 1989a1990. Centile charts for BMI and skinfold-derived percentage body fat mass (PFM) were constructed using Cole's LMS method for normalised growth standards. RESULTS: The BMI centile values of German children ranged higher than French, lower than North American and Italian, and similar to Swedish and British children. While BMI steadily increased with age, PFM was markedly lower in peripubertal than in pre-and postpubertal boys. BMI predicted PFM with reasonable precision in girls (r 0.84), and in obese boys (r 0.58), but not in the leaner two thirds of the male population (r 0.01, NS). The 75th BMI percentile was the most appropriate cutoff value to screen for the 15% most obese patients by PFM (sensitivity: 82%, speci®city: 85%). The pattern of the trunk-to-extremity skinfold ratio across childhood suggested that the typical adult distribution of central and peripheral fat is achieved in mid puberty in girls, but not before the end of adolescence in boys. CONCLUSIONS: The major differences observed between BMI charts obtained in different countries underline the need for population-speci®c reference data. BMI is of limited usefulness in predicting relative fat mass in individual children. The developmental pattern of fat accumulation and distribution during adolescence is highly dynamic and gender-speci®c.
Filaroides hirthi lungworm infection was diagnosed by the recovery of 1st-stage larvae from the faeces of dogs with heavy, artificially induced infections using zinc sulphate flotation. Diagnosis of low-grade natural infections was infrequently achieved. Zinc sulphate flotation was demonstrated to be about 100 times as efficient as the Baermann technique in concentrating F. hirthi larvae from dog faeces. Larvae recovered from faeces proved to be infective when fed to a pup and it was concluded that F. hirthi infection can be transmitted directly and immediately by fresh faecal contamination. Mongrel dogs of diverse ancestry were readily infected by feeding 1st-stage larvae from lung tissue. This, F. hirthi infection was shown not to be limited to the Beagle breed by biological restrictions. The observations that 1st-stage larvae pass through the alimentary tract on their way out of the body and that larvae are found in the mesenteric lymph modes long after a single exposure to infection support the hypothesis that there is an autogenous re-infection of the host by a proportion of these larvae.
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