Anthropometric Indices and the Incidence of Hypertension: A Comparative Analysis

Objective: To investigate the association between several anthropometric measurements of obesity with the incidence of hypertension. Research Methods and Procedures: Participants were 592 individuals free of hypertension, selected at random from the community. In the baseline evaluation, they were submitted to completed measures of demographics, anthropometrics, blood pressure, and other risk factors for hypertension. Incident hypertension was defined by blood pressure equal or higher than 140/90 mm Hg or use of blood pressure‐lowering drugs. Results: During a mean follow‐up time of 5.6 ± 1.1 years, 127 developed hypertension. The hazard ratios for the development of hypertension, adjusted for age, baseline blood pressure, gender, and alcohol consumption, were 1.042 (p = 0.091) for BMI, 1.023 (p = 0.028) for waist circumference, 1.042 (p = 0.013) for waist‐to‐height ratio, 1.061 (p = 0.014) for waist‐to‐height² index, 1.079 (p = 0.022) for waist‐to‐height³ index, and 1.033 (p = 0.006) for the waist‐to‐hip ratio. Discussion: The correction of the circumference of waist for stature or hip circumference improves its performance in the prediction of the incidence of hypertension.     

Relationship of Serum Adiponectin and Leptin Concentrations with Body Fat Distribution in Humans

Objective: We investigated whether serum concentrations of adiponectin are determined by body fat distribution and compared the findings with leptin. Research Methods and Procedures: Serum concentrations of adiponectin and leptin were measured by radioimmunoassay (n = 394) and analyzed for correlation with sex, age, and body fat distribution, i.e., waist‐to‐hip ratio, waist and hip circumference, and subcutaneous adipose tissue area of the lower leg as assessed by magnetic resonance imaging. Results: After adjusting for sex and percentage of body fat, adiponectin was negatively (r = ?0.17, p < 0.001) and leptin was positively (r = 0.22, p < 0.001) correlated with waist‐to‐hip ratio. Leptin, but not adiponectin, correlated with both waist (r = 0.49, p < 0.001) and hip circumference (r = 0.46, p < 0.001). Furthermore, leptin, but not adiponectin, correlated with the proportion of subcutaneous fat of the lower leg cross‐sectional area (r = 0.37, p < 0.001). Discussion: These data suggest that both adipocytokines are associated with central body fat distribution, and serum adiponectin concentrations are determined predominantly by the visceral fat compartment.     

术中静脉不向剂量右美托咪啶对全髋置换术患者术后患者芬太尼静脉自控镇痛效果的影响

目的：观察气管内全身麻醉下行全髋置换术患者,术中静脉应用不同剂量右美托咪定对术后芬太尼静脉自控镇痛效果的影响及相关不良反应发生的情况。方法：选择择期在气管内全麻下行全髋置换术的患者60 例,ASA Ⅰ ～Ⅱ级,年龄47～78 岁,体重42～79 kg。患者随机分组法分为3 组（n=20）：C 组（盐水对照组）、D1 组（右美托咪定0.5 μg/kg 组）和D2 组（右美托咪定1 μg/kg组）,在手术结束前约1 小时按分组分别给予生理盐水和右美托咪啶,术后镇痛使用芬太尼静脉自控镇痛24 h。记录患者术后2h、2～6 h、6～12 h、12～24 h芬太尼的用量;VAS 评分法评估患者术前、术后2 h、6 h、12 h、24 h 时的疼痛程度;记录镇痛期间恶心呕吐、皮肤瘙痒及过度镇静等不良反应发生的情况。结果：术后2h 和术后2～6 h芬太尼用量D1组和D2 组较C 组减少（P＜0.05）,但D1组和D2 组之间比较无差异（P＞0.05）;而术后6～12 和12～24 h三组患者芬太尼用量无差异（P＞0.05）。术后2 h、2～6 hVAS评分D1 组和D2 组较C组减少（P＜0.05）,而D1组和D2 组之间比较无差异（P＞0.05）;术后6～12、12～24 h三组患者VAS 评分无差异（P＞0.05）。与C 组比较,D1 组和D2 组镇痛期间恶心呕吐发生率降低（P＜0.05）,余不良反应各组之间比较无差异（P＞0.05）。结论：气管内全身麻醉下行全髋置换术的患者,术中静脉应用右美托咪啶可在术后6 h内增强芬太尼镇痛的效果减少芬太尼的用量,但增大剂量效果并不增加而作用时间也不延长。     

人工髋关节置换术在320 例股骨头缺血性坏死中的治疗体会

目的：探讨人工髋关节置换术在治疗股骨头缺血性坏死（ANFH）中的临床疗效。方法：选择2007 年2 月-2011 年2 月我院收 治的320 例（340 髋）股骨头缺血性坏死患者,均采用人工髋关节置换术对患者进行治疗,其中160 例（172 髋）患者应用骨水泥型 假体进行治疗,另外160 例（168）患者采用非骨水泥型假体进行治疗。采用Harris评分对患者手术前后的髋关节功能情况进行评 价,并比较骨水泥治疗组和非骨水泥治疗组的临床疗效。结果：患者均获得随访,随访时间为3～18 个月。全部患者手术后的 Harris评分明显高于手术前,差异有统计学意义（P<0.05）。骨水泥治疗组和非骨水泥治疗组在术后出血量、术后Harris 评分及住 院时间方面的差异无统计学意义（P>0.05）,但非骨水泥治疗组的并发症发生率明显低于骨水泥治疗组（P<0.05）。结论：采用人工 髋关节置换术治疗ANFH疗效显著,能明显改善患者的生活质量,骨水泥型假体与非骨水泥型假体的治疗效果相当,应根据患者 的具体情况进行合理的选择。     

术中静脉不同剂量右美托咪啶对全髋置换术患者术后患者芬太尼静脉自控镇痛效果的影响

目的:观察气管内全身麻醉下行全髋置换术患者,术中静脉应用不同剂量右美托咪定对术后芬太尼静脉自控镇痛效果的影响及相关不良反应发生的情况。方法:选择择期在气管内全麻下行全髋置换术的患者60例,ASA I~Ⅱ级,年龄47~78岁,体重42~79 kg。患者随机分组法分为3组(n=20):C组(盐水对照组)、D1组(右美托咪定0.5μg/kg组)和D2组(右美托咪定1μg/kg组),在手术结束前约1小时按分组分别给予生理盐水和右美托咪啶,术后镇痛使用芬太尼静脉自控镇痛24 h。记录患者术后2h、2~6 h、6~12 h、12~24 h芬太尼的用量;VAS评分法评估患者术前、术后2 h、6 h、12 h、24 h时的疼痛程度;记录镇痛期间恶心呕吐、皮肤瘙痒及过度镇静等不良反应发生的情况。结果:术后2h和术后2~6 h芬太尼用量D1组和D2组较C组减少(P0.05),但D1组和D2组之间比较无差异(P0.05);而术后6~12和12~24 h三组患者芬太尼用量无差异(P0.05)。术后2 h、2~6 hVAS评分D1组和D2组较C组减少(P0.05),而D1组和D2组之间比较无差异(P0.05);术后6~12、12~24 h三组患者VAS评分无差异(P0.05)。与C组比较,D1组和D2组镇痛期间恶心呕吐发生率降低(P0.05),余不良反应各组之间比较无差异(P0.05)。结论:气管内全身麻醉下行全髋置换术的患者,术中静脉应用右美托咪啶可在术后6 h内增强芬太尼镇痛的效果减少芬太尼的用量,但增大剂量效果并不增加而作用时间也不延长。     

Quantitative trait loci mapping for canine hip dysplasia and its related traits in UK Labrador Retrievers

Background

Canine hip dysplasia (CHD) is characterised by a malformation of the hip joint, leading to osteoarthritis and lameness. Current breeding schemes against CHD have resulted in measurable but moderate responses. The application of marker-assisted selection, incorporating specific markers associated with the disease, or genomic selection, incorporating genome-wide markers, has the potential to dramatically improve results of breeding schemes. Our aims were to identify regions associated with hip dysplasia or its related traits using genome and chromosome-wide analysis, study the linkage disequilibrium (LD) in these regions and provide plausible gene candidates. This study is focused on the UK Labrador Retriever population, which has a high prevalence of the disease and participates in a recording program led by the British Veterinary Association (BVA) and The Kennel Club (KC).

Results

Two genome-wide and several chromosome-wide QTLs affecting CHD and its related traits were identified, indicating regions related to hip dysplasia.

Conclusion

Consistent with previous studies, the genetic architecture of CHD appears to be based on many genes with small or moderate effect, suggesting that genomic selection rather than marker-assisted selection may be an appropriate strategy for reducing this disease.

Electronic supplementary material

The online version of this article (doi:10.1186/1471-2164-15-833) contains supplementary material, which is available to authorized users.     

Numerical simulation of the insertion process of an uncemented hip prosthesis in order to evaluate the influence of residual stress and contact distribution on the stem initial stability

The long-term success of a cementless total hip arthroplasty depends on the implant geometry and interface bonding characteristics (fit, coating and ingrowth) and on stem stiffness. This study evaluates the influence of stem geometry and fitting conditions on the evolution and distribution of the bone–stem contact, stress and strain during and after the hip stem insertion, by means of dynamic finite element techniques. Next, the influence of the mechanical state (bone–stem contact, stress and strain) resulted from the insertion process on the stem initial resistance to subsidence is investigated. In addition, a study on the influence of bone–stem interface conditions (friction) on the insertion process and on the initial stem stability under physiological loading is performed. The results indicate that for a stem with tapered shape the contact in the proximal part of the stem was improved, but contact in the calcar region was achieved only when extra press-fit conditions were considered. Changes in stem geometry towards a more tapered shape and extra press fit and variation in the bone–stem interface conditions (contact amount and high friction) led to a raise in the total insertion force. A direct positive relationship was found between the stem resistance to subsidence and stem geometry (tapering and press fit), bone–stem interface conditions (bone–stem contact and friction interface) and the mechanical status at the end of the insertion (residual stress and strain). Therefore, further studies on evaluating the initial performance of different stem types should consider the parameters describing the bone–stem interface conditions and the mechanical state resulted from the insertion process.     

Deformation of uncemented metal acetabular cups following impaction: experimental and finite element study

Predicting failure following the implantation of acetabular cups used in hip replacements is important in ensuring robust component designs. This study has developed 3D explicit dynamics finite element (FE) models to investigate the deformation of press-fit metal cups following insertion in the acetabular cavity. The cup deformation following insertion is clearly influenced by the forces encountered during insertion, the initial position of the cup in the cavity, the support provided by the underlying bone and the geometry of the cup itself. Experimentally validated explicit dynamics FE models were used to allow a physiologically relevant simulation of the impaction of cups, which is encountered in clinical practice, in comparison to previous studies that have used unrealistically high static forces to simulate a static press-fit insertion. Diametrical cup deformations were twice as large when the cup was tilted at 5° with respect to the cavity compared to when the poles of the cup and the cavity were aligned. The introduction of a non-uniform support to the cup increased deformations further by a factor of approximately 2.5. The greatest deformations established in the model were between 80 and 150 μm similar to typical cup–femoral head clearances. Increasing the thickness at the pole of the cup and reducing the cup diameter resulted in significantly smaller deformations being generated. These results suggest that small cup misalignments, which may not be noticeable in a clinical situation, may produce significant deformations after insertion especially when coupled with the non-uniform support found in the pelvis.     

Patient-specific acetabular shape modelling: comparison among sphere,ellipsoid and conchoid parameterisations

The shape of the human acetabular cup was commonly represented as a hemisphere, but different geometries and patient-specific shapes have been recently proposed in the literature. Our aim was to test the limits of the sphericity assumption by comparing three different parameterisations, namely the sphere, the ellipsoid and the rotational conchoid. Models of hip surfaces, reconstructed from CT scans taken from Caucasian race cadavers and patients, were automatically processed to extract the acetabular surface. Two separate analyses were carried out on the overall acetabular shape, including both the acetabular fossa and the lunate surface (case A) and acetabular cup represented by the lunate surface only (case B). Nonlinear gradient-based and evolutionary computation approaches were implemented for the fitting process. Minor differences from the three idealised geometries were detected (median values of the fitting errors < 1 mm). Nonetheless, the sphere fitting was found to be statistically different from both the ellipsoid (p < 2.50e ? 10) and the conchoid (p < 1.07e ? 09), whereas no statistical difference was detected between the ellipsoid and the conchoid for case A. Significance of the difference between ellipsoid and sphere (p < 4.55e ? 12) and between conchoid and sphere (p < 1.93e ? 11) was found for case B as well. Interestingly, for case B statistical difference was detected between the ellipsoid and the conchoid. In conclusion, we synthesise that the morphology of the overall acetabular cup can be parameterised both with an ellipsoid shape and with a conchoid shape as well with superior quality than the simple sphere. Differently, if one considers just the lunate surface, better fitting results are expected when using the ellipsoid.     

Does Isolated Unilateral Hip or Knee Osteoarthritis Lead to Adverse Changes in Extremity Composition?

BackgroundWhile muscle atrophy is a function of normal aging, loss of muscle in the setting of hip and knee osteoarthritis (OA) has been observed using radiographic studies. There is limited data available regarding changes in extremity composition using bioimpedance (BIA). The purpose of this study was to assess the changes in extremity composition in patients with isolated, unilateral hip or knee OA using BIA.MethodsPatients presenting to our institution’s adult reconstruction clinic from February 2020 to April 2021 were retrospectively reviewed to identify those with isolated, unilateral hip and knee OA. The InBody 770 Body Composition Analyzer (InBody USA, Cerritos, California) was used to perform a complete body composition assessment, per protocol. Lean extremity mass (LEM), fat mass (FM), intracellular water (ICW), extremity body water (EBW = ICW + extracellular water (ECW)) and phase angle (PA) were determined. Differences between the affected (OA) and unaffected (no OA) extremities were compared using t-tests.Results38 patients had isolated hip OA. The mean age was 60.8 (±11.7) years, mean BMI was 31.7 (±6.8) kg/m2, and 39.5% were female. LEM, FM, EBW, ICW, and PA were significantly decreased in the hip OA extremity (LEM: 20.0 vs. 20.4 kg, p=0.0008, FM: 8.8 vs. 8.9 kg, p=0.0049, EBW: 15.7 vs 16.0, p=0.0011, ICW: 9.5 vs. 9.7 L, p=0.0004, PA: 4.5 vs 4.9º, p<0.0001). There were 25 patients with isolated knee OA. Mean age was 62.8 (±11.3) years, mean BMI was 33.6 (±6.9) kg/m2, and 52.0% were female. FM and PA were significantly lower in the knee OA extremity (11.3 vs 11.4 kg, p=0.0291, 4.5 vs 4.9º, p<0.0001). There were no significant differences in LEM, EBW, and ICW between the knee OA extremity and the unaffected extremity.ConclusionPatients with isolated, unilateral hip OA had decreased LEM, FM, EBW, and ICW in the affected extremity. Both unilateral hip and knee OA was associated with decreased PA, suggestive of greater underlying dysfunction in muscle or cellular performance. Further study is needed to better define when these abnormalities develop, how they progress over time, and the impact of targeted interventions in reversing these changes. Level of Evidence: III