Centile Charts Research Articles

Neck Circumference as A Screening Tool for Obesity in Pre- and Primary School Children in Puducherry India – A Cross-Sectional Study

Introduction: Obesity has become the 21st Century’s greatest challenge and threat. Around 50% of the obese children become obese adolescents, of which 80% become obese adults. Methodology: Cross-sectional analytical study was done on 930 pre- and primary school children. Neck circumference, weight, height, waist and hip circumference was recorded. Overweight/obese identified according to WHO standards. Age-specific percentile charts for boys and girls were drawn with data from the apparently normal children in the study population. Results: The Neck Circumference measurements ranged from 23.64(±1.16) to 28.49(±2.87) in boys and 23.59(±1.63) to 27.6(±2.67) in girls. ROC analysis derived cut-offs for overweight and obesity in each age group/gender were found to have high sensitivity (80-100%) and specificity (60-95.9%). Using the reference percentile data/curves, and the cut –offs obtained by ROC analysis, a neck circumference above the 75th percentile for age and gender can be regarded as overweight and above the 90th percentile as obese in both boys and girls. Conclusion: The study concludes that the Neck circumference is a valid and effective screening tool for overweight/obesity in pre and primary school children.

Streamlining pediatric vital sign assessment: innovations and insights

Accurate assessment of pediatric vital signs is critical for detecting abnormalities and guiding medical interventions, but interpretation is challenging due to age-dependent physiological variations. Therefore, this study aimed to develop age-specific centile curves for blood pressure, heart rate, and respiratory rate in pediatric patients and create a user-friendly web-based application for easy access to these data. We conducted a retrospective cross-sectional observational study analyzing 3,779,482 records from the National Emergency Department Information System of Korea, focusing on patients under 15 years old admitted between January 2016 and December 2017. After applying exclusion criteria to minimize the impact of patients’ symptoms on vital signs, 1,369,608 records were used for final analysis. The box–cox power exponential distribution and Lambda–Mu–Sigma (LMS) method were used to generate blood pressure centile charts, while heart rate and respiratory rate values were drawn from previously collected LMS values. We developed comprehensive age-specific centile curves for systolic, diastolic, and mean blood pressure, heart rate, and respiratory rate. These were integrated into a web-based application (http://centile.research.or.kr), allowing users to input patient data and promptly obtain centile and z-score information for vital signs. Our study provides an accessible system for pediatric vital sign evaluation, addressing previous limitations and offering a practical solution for clinical assessment. Future research should validate these centile curves in diverse populations.

Determination of the Normative Value of Fetal Left Brachiocephalic Vein Diameter Using Ultrasound in a Tertiary Care Hospital in Eastern India.

Fetal ultrasound plays a vital role in prenatal care by offering key insights into fetal growth and facilitating the early identification of congenital abnormalities. Among various anatomical structures, the fetal left brachiocephalic vein (FLBCV) plays a significant role in fetal circulation, yet normative data for FLBCV dimensions are limited, particularly in diverse populations. This study aims to establish normative values for FLBCV diameter in fetuses between 18 and 23 weeks of gestation in a tertiary care hospital in Eastern India. Such data are essential for accurate clinical assessment and early diagnosis of potential congenital anomalies. This descriptive study was conducted at the College of Medicine and Sagore Dutta Hospital, Kolkata, India, from January to December 2022. The study included 287 singleton pregnancies between 18 and 23 weeks of gestation, excluding cases with maternal or fetal conditions that could affect the measurements. LBCV diameter was measured using transabdominal ultrasound, and the normative values were established using percentile charts. Correlation analyses were performed to assess the relationship between FLBCV diameter and various fetal and maternal parameters. Linear regression analysis was done to identify significant predictors of FLBCV diameter. FLBCV diameter showed a consistent increase with gestational age, ranging from a median of 1.87 mm at 18 completed weeks to 2.27 mm at 22 completed weeks. The 95th percentile values exhibited more pronounced growth, particularly between 18 and 20 weeks. Significant positive correlations were observed between FLBCV diameter and fetal biometric parameters such as biparietal diameter, head circumference, abdominal circumference, and femur length. Head circumference emerged as the most significant predictor (p=0.007) of FLBCV diameter in the linear regression model. This study provides essential normative data on FLBCV diameter for the Indian population, offering a valuable reference for clinicians in prenatal diagnostics. The incorporation of FLBCV measurement in basic fetal echocardiography, which is a part of the second-trimester fetal anomaly scan, could enhance the detection of congenital anomalies, contributing to improved prenatal care.

Reference ranges of peripheral-muscle oxygenation in term neonates delivered by Caesarean section during immediate transition after birth.

To establish reference ranges of peripheral-muscle regional oxygen saturation (prSO2) and peripheral fractional tissue oxygen extraction (pFTOE) during the first 15 min after birth in stable term neonates. Secondary outcome parameters of prospective observational studies in healthy term neonates delivered by Caesarean section were analysed. prSO2 was measured on the right forearm using the INVOS 5100C monitor. pFTOE was calculated out of prSO2 and arterial oxygen saturation (SpO2). Centile charts (10th-90th) of prSO2 and pFTOE were defined during the first 15 min after birth. Three-hundred-five term neonates with a mean gestational age and birth weight of 39.0 ± 0.9 weeks and 3321 ± 454 g, respectively, were included. The 50th centiles of prSO2 were 39% (minute two), 52% (minute five), 71% (minute 10), and 73% (minute 15). The 50th centiles of pFTOE were 0.529 (minute two), 0.378 (minute five), 0.237 (minute 10), and 0.231 (minute 15). Reference ranges of prSO2 and pFTOE were established for term neonates delivered by Caesarean section during the immediate transition after birth. These reference ranges increase knowledge of physiological processes taking place immediately after birth and are necessary for possible future clinical applications.

Normal Values for the fT3/fT4 Ratio: Centile Charts (0-29 Years) and Their Application for the Differential Diagnosis of Children with Developmental Delay.

Primary congenital hypothyroidism is easily diagnosed on the basis of elevated plasma levels of thyroid-stimulating hormone (TSH). In contrast, in the rare disorders of thyroid hormone resistance, TSH and, in mild cases, also thyroid hormone levels are within the normal range. Thyroid hormone resistance is caused by defects in hormone metabolism, transport, or receptor activation and can have the same serious consequences for child development as congenital hypothyroidism. A total of n = 23,522 data points from a large cohort of children and young adults were used to generate normal values and sex-specific percentiles for the ratio of free triiodothyronine (T3) to free thyroxine (T4), the fT3/fT4 ratio. The aim was to determine whether individuals with developmental delay and genetically confirmed thyroid hormone resistance, carrying defects in Monocarboxylate Transporter 8 (MCT8), Thyroid Hormone Receptor alpha (THRα), and Selenocysteine Insertion Sequence-Binding Protein 2 (SECISBP2), had abnormal fT3/fT4 ratios. Indeed, we were able to demonstrate a clear separation of patient values for the fT3/fT4 ratio from normal and pathological controls (e.g., children with severe cerebral palsy). We therefore recommend using the fT3/fT4 ratio as a readily available screening parameter in children with developmental delay for the identification of thyroid hormone resistance syndromes. The fT3/fT4 ratio can be easily plotted on centile charts using our free online tool, which accepts various SI and non-SI units for fT3, fT4, and TSH.

Enhanced lake elevation mapping using a zone-based method

Abstract Inland lakes play a crucial role in monitoring global climate change and managing responses to extreme weather events, with lake elevation being critical for assessing their regulatory capacities. However, due to the limited temporal resolution of current altimetry satellites, obtaining high-frequency, high-precision elevation data for water bodies remains challenging. Consequently, most studies utilize elevation-area (E-A) models constructed from historical elevation and area records, integrated with area observations from high-temporal resolution optical satellites to infer precise water levels. Yet, the construction of the E-A model often assumes a uniform water level across the lake, thus overlooking potential segmentation during dry periods. To address this, our study implemented a zone-based approach, utilizing hydrological connectivity principles to ensure that elevation data within E-A models are confined to appropriate zonal regions. This method effectively minimized uncertainties by preventing errors from zonal discrepancies, significantly improving accuracy compared to traditional methods. It reduced root mean square errors (RMSE) by 0.71–1.73 m during the dry season, achieving RMSEs of 0.35, 0.64, and 0.37 m across three segments. Furthermore, this method ensures water level data are confined to specific zones, preventing the inconsistencies typically caused by averaging data across multiple stations or selecting data from varying elevations. This consistent domain definition reduces extrapolation errors during the model prediction and inversion. Moreover, the method compensates for time information losses often incurred by relying on multi-year percentile charts, thereby enabling more precise aquatic boundary delineation than traditional regional boundaries.

A meta-analysis of Chinese men's penile size in a global context.

Penile size is a topic of significant interest among men and healthcare professionals. However, data on adult male penile dimensions in China are scarce, hindering clinical counseling and research. This study aimed to establish normative data for Chinese penile size and compare it with a global reference population. We conducted a meta-analysis of published studies on penile size, focusing on Chinese and international data. Studies from East and Southeast Asia were excluded to minimize regional confounding factors. The analysis included 23 Chinese studies encompassing 34,060 men aged 16-57 years, and 19 international studies encompassing 15,216 men aged 16-91 years. Penile length and circumference were assessed in both flaccid and erect states. This study established the first nomogram and percentile distribution chart for adult male penile size in China. The mean flaccid length was 7.42cm (standard deviation [SD]±0.95cm), and the mean flaccid circumference was 8.54cm (SD±0.62cm). The mean erect length was 12.42cm (SD±1.63cm), and the mean erect circumference was 10.75cm (SD±1.34cm). Compared with the global reference population (flaccid length: 9.09cm±1.51cm, flaccid circumference: 9.12cm±0.93cm; p<0.05 for both), Chinese men exhibited statistically significant shorter flaccid lengths and circumferences. No significant differences were observed in erect length or circumference between Chinese men and the global reference population (p>0.05 for both). Notably, the growth coefficient during erection (defined as the percentage increase from flaccid length to erect length) was significantly higher in Chinese men (67.39%) compared with the global average (43.45%; p<0.05), supporting the hypothesis of a proportionally greater increase in shorter penises. This study provides novel and comprehensive data on penile size in Chinese men. Compared with a global reference population, Chinese men exhibited shorter flaccid penises but a higher proportional increase upon erection. These findings may be of value for clinical counseling and future research on penile size variations. The newly developed nomogram and percentile chart can serve as a valuable tool for both patients and healthcare professionals.

Causes and effects of childhood obesity

Abstract Background Childhood and adolescent obesity and overweight is a major public health crisis nationally and internationally.. Obesity in childhood increases the risk of cardiovascular diseases, hypertension, lipid and carbohydrate metabolism disorders, including type 2 diabetes, abnormalities resulting from posture defects, and furthermore obesity in adulthood. Excessive body weight is also the cause of many emotional disorders related with lack of acceptance by oneself, family and peers. An analysis of the prevalence of obesity among children hospitalized in the Department of Rehabilitation was conducted in 2020-2023. Excessive body weight occurred in 23% of the examined patients. Purpose The aim of the study is to show the incidence of obesity and overweight among children hospitalized in the Department of Rehabilitation, to determine the cause of the disease based on the author's survey, which took into account the lifestyle of the examined patients, and to examine the relationship between body weight and elevated blood pressure values. The results were subjected to statistical analysis. Methods The clinical trial was conducted on 1,283 pediatric patients. The data were analyzed: weight, height, BMI, blood pressure and then the obtained values were placed on percentile charts. An original questionnaire was also conducted - took into account the age, gender, lifestyle, eating habits and physical activity of the respondents. Results 23% of hospitalized patients indicated excessive body weight. 10% of patients were obese and 13% were overweight. Back pain was the reason for hospitalization in 76% of overweight and obese children. Among children with excessive body weight, 25% indicated higher blood pressure values, while in the control group, this problem affected only 1% of respondents. A relationship has been shown between lack of physical activity, excessive body weight and problems with the locomotor system - 72% of overweight and obese children didn’t engage in any regular physical activity. After school, children spent their time mainly in a sitting or semi-reclining position. Moreover, 60% of parents reported that they don’t know what their child's diet looks like. Most teenagers admitted to eating meals irregularly, snacking between meals, and drinking sweetened drinks and leaving home without breakfast. Conclusions Obesity and overweight among children and adolescents is a significant public health problem in both medical and social dimensions. Counteracting obesity should start in early childhood and should be based on the lifestyle that includes proper nutrition and physical activity. Factors contributing to overweight and obesity include: lack of daily physical activity, avoiding exercise during physical education classes, spending many hours in a sitting position and inappropriate eating habits.

Prediction Model for Chronological Weight Loss After Bariatric Surgery in Korean Patients.

This study aimed to develop a predictive model for monitoring chronological weight loss during the early postoperative period following bariatric surgery in Korean patients with morbid obesity. The baseline characteristics and postoperative weight loss outcomes were collected for up to 24 months after surgery in patients who underwent sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB). The factors influencing weight loss outcomes were analyzed, and longitudinal percentile charts were plotted using quantile regression models adjusted for the identified independent factors. The analysis included 491 and 274 patients who underwent SG and RYGB, respectively, of whom 225 (29.4%) were men. A positive association was found between the maximum percentage of total weight loss (%TWL) and female sex, body mass index (BMI) ≥40, and age <40 years. Among patients who reached nadir BMI or had at least 12 months of follow-up data (n=304), 7.6% exhibited inadequate weight loss (TWL <20%). The predictors of insufficient weight loss were older age (>40 years), male sex, and psychological problems. Centile charts were generated for the entire cohort, incorporating age, sex, and the type of procedure as covariates. The percentile charts proposed in the present study can assist surgeons and healthcare providers in gauging patients' progress toward their weight loss goals and determining the timing of adjunctive intervention in poor responders during early postoperative follow-up.

Reference Ranges for Arterial Oxygen Saturation, Heart Rate, and Cerebral Oxygen Saturation during Immediate Postnatal Transition in Neonates Born Extremely or Very Preterm

ObjectiveTo define percentile charts for arterial oxygen saturation (SpO2), heart rate (HR), and cerebral oxygen saturation (crSO2) during the first 15 minutes after birth in neonates born very or extremely preterm and with favorable outcome. Study designWe conducted a secondary-outcome analysis of preterm neonates included in the COSGOD III trial with visible cerebral oximetry measurements and with favorable outcome, defined as survival without cerebral injuries until term age. We excluded infants with inflammatory morbidities within the first week after birth. SpO2 was obtained by pulse oximetry, and electrocardiogram or pulse oximetry were used for measurement of HR. CrSO2 was assessed with near-infrared spectroscopy. Measurements were performed during the first 15 minutes after birth. Percentile charts (10th to 90th centile) were defined for each minute. ResultsA total of 207 preterm neonates with a gestational age of 29.7 (23.9-31.9) weeks and a birth weight of 1200 (378-2320) grams were eligible for analyses. The 10th percentile of SpO2 at minute two, five, ten and 15 was 32%, 52%, 83% and 85%, respectively. The 10th percentile of HR at minute two, five, ten and 15 was 70bpm, 109bpm, 126bpm and 134bpm, respectively. The 10th percentile of crSO2 at minute two, five, ten and 15 was 15%, 27%, 59% and 63%, respectively. ConclusionsThis study provides new centile charts for SpO2, HR, and crSO2 for extremely preterm neonates with favorable outcome. Implementing these centiles in guiding interventions during the stabilization process after birth might help to more accurately target oxygenation during postnatal transition period.

Age- and Sex-Dynamic Fluctuations and Reference Intervals for Alkaline Phosphatase Among the Spanish Population.

Interpretation of alkaline phosphatase (ALP) activity is essential for the diagnosis of certain diseases. ALP changes during life and may vary between different populations. To establish reference intervals (RIs) and percentile charts for ALP activity in the Spanish population through a multicentric observational study and to compare the RIs to those defined in other countries. A total of 662 350 ALP measurements from individuals ages 0 to 99 years from 9 Spanish tertiary care centers collected between 2020 and 2022 were analyzed. This study is the largest published in the literature to date. Continuous percentile charts for ALP according to sex and age were established which can be used as RIs. Higher levels are reached during the first weeks of life. In puberty, a differential evolution is observed in both sexes, reaching a peak at 10 to 13 years of age in boys and remaining stable in girls at this age. Significant differences were also observed in adults, higher in men between ages 20 and 49 years and between ages 50 and 79 years in women, as reported in some countries. ALP activity follows an age- and sex-dependent fluctuation with geographic differences. It is important to have appropriate reference values for each population in order to allow for a correct diagnostic interpretation and early diagnosis of diseases related to ALP abnormalities.

Disparities with global standards about growth references of mid-upper arm circumference-for-age for Pakistani children aged 6-60 months.

Growth reference values about mid-upper arm circumference (MUAC) are vital for assessing children's nutritional status. However, Pakistan lacks these reference values and growth charts. This study aims to develop these for children aged 6-60 months and compare them with global standards. The data were acquired from the 2018 National Nutrition Survey of Pakistan, which was conducted by the United Nations Children's Fund (UNICEF) during 2018-2019. The final study cohort comprised 57 285 children, with 51% being boys. Percentile values and charts for MUAC-for-age were developed using generalised additive models for location, scale and shape with the Box-Cox power exponential distribution. The mean MUAC was 14.21 cm (±2.07 cm) and 14.13 cm (±2.12 cm) for the boys and girls, respectively. At 60 months of age, the P3 and P97 percentiles for girls were slightly higher than those for boys. The median percentiles of Pakistani children were smaller than the World Health Organisation 2007 standards and with international references. We observed disparities in MUAC-for-age growth references among Pakistani children compared to global standards, highlighting regional, age and gender variations. This underscores the need for developing countries like Pakistan to establish their growth references.

Abstract 08: Blood Pressure Percentile Charts Better Identify High Risk Young Adults: The Coronary Artery Risk Development in Young Adults (CARDIA) Study

Introduction: Current guidelines set a static threshold for diagnosis of hypertension based on absolute blood pressure (BP) levels for all ages. However, BP generally increases with age and relative levels tend to track within individuals from young adulthood on. We aimed to determine whether BP percentiles , compared to the current AHA/ACC clinical thresholds for hypertension, are better able to identify young adults at higher risk for future CVD events. Methods: Among 5,115 CARDIA participants (ppts; mean age 25 yrs; 54% female; 51% Black), we used baseline BP level and over 35 years of follow-up for fatal and non-fatal CVD events. We calculated normative BP percentiles for adults aged 18 and older using NHANES by estimating underlying BP among treated individuals combined with observed BP for untreated individuals (Figure). Using these BP Percentile Charts, we calculated the baseline BP percentile for each ppt. Adjusted survival analyses examined the association between BP percentile (in deciles) and incident CVD events over 30 years. C statistics for models using BP percentiles vs those using current guideline-recommended thresholds were compared to determine relative accuracy. Results: At baseline, mean S/DBP was 112/70 mmHg and &lt;1% were on antihypertensive medications. Adjusted HRs for BP percentile decile demonstrated a dose-response effect with increasing risk associated with higher deciles of SBP. Compared to the 5 th decile young adults with SBPs in the highest decile 90-100% (SBP ≥127 for men and ≥120 for women) had a HR of 1.76 (95% CI 1.10-2.83). C statistics for models using BP percentiles were higher than for models using guideline-recommended thresholds (0.724 vs 0.713). No significant association was seen with DBP deciles. Conclusion: BP percentiles are better able to predict future CVD risk in young adults as compared to current age-invariant thresholds. These methods may help to risk stratify young adults and more accurately identify higher risk individuals for early prevention efforts.

Which fetal growth charts should be used in France? Position of the French College of Obstetricians and Gynecologists (CNGOF).

To assess which fetal growth charts best describe intrauterine growth in France defined as the ability to classify 10% of fetuses below the 10th percentile (small for gestational age [SGA]) and above the 90th percentile (large for gestational age [LGA]) in the second and third trimesters. We analyzed five studies on fetal ultrasound measurements using three French data sources. Two studies used second and third trimester ultrasound data from a nationwide birth cohort in 2011 (the ELFE study, N = 13 197 and N = 7747); one study used third trimester ultrasound data from on a nationwide cross-sectional study (the 2016 French National Perinatal Survey, N = 9940); and the last two studies were from the "Flash study" 2014 which prospectively collected ultrasound data from routine visits in the second and third trimesters (N = 4858 and N = 3522). For each study, we reported the percentage of measurements below the 10th percentile or above the 90th percentile, using French, Hadlock's, WHO and Intergrowth (IG) charts. WHO classified 4.7% and 16.3% of fetuses as having an estimated fetal weight (EFW) <10th and >90th percentiles in the second trimester compared to 3.3% and 34.7% with IG. The percentage of fetuses in the third trimester with an EFW <10th and >90th percentiles, ranged from 9.1% to 9.4% and from 8.0% to 11.1%, respectively, for WHO, and from 3.9% to 4.1% and from 17.3% to 21.6%, respectively, for IG. The WHO and IG charts for head circumference were very similar and performed well. Compared to the WHO charts, the French and Hadlock's charts deviated more frequently from the target percentiles values for EFW and biometric measures. It is recommended to use the WHO charts for the assessment of EFW and ultrasound biometric measurements in France (strong recommendation; low quality of evidence).

'Age specific variations in ovarian reserves in healthy fertile and infertile women: A cross sectional study.

Ovarian reserve tests are valuable for evaluation of female fertility, and to formulate appropriate treatment strategies for infertile women. Antral follicle count (AFC) and Anti-Mullerian hormone (AMH) are most reliable markers of ovarian reserve which are related inversely to age. There are many factors that affect ovarian reserve like race, ethnicity, fertility status, BMI or any chronic illness. We conducted this study to find outage specific nomograms for AMH and AFC among fertile and Infertile Indian women, to find out any variations between fertile and Infertile ovarian reserves at various centiles, to define the age cut-off of decline in AMH and AFC among fertile and Infertile Indian women and to find correlation between AMH and AFC. It was a prospective cross sectional single centre study conducted at a tertiary hospital of northern India from March 2017 to February 2022. Fertile healthy women were recruited from family planning clinic, oocyte donors and subfertile women from Gynaecology and ART clinic. AMH was done using ELISA, Beckmann Coulter Gen II assay and AFC was done using TVS with high frequency probe (9.0 MHZ, Voluson,S-6, GE Healthcare, USA) by trained personnel. R Statistical Programming Language was used for statistical modelling and visualization. Age-specific AFC centile chart and AMH centile chart were generated using GAMLSS (Generalized Additive Models for Location Scale and Shape) package available in R Statistical Computing Language. A Non-linear decline in ovarian reserves among fertile, while linear among infertile women was seen. Centiles defined for both groups with a faster decline in infertile women. Age cut off for decline in AMH and AFC in fertile women approximately 31 years using ROC analysis and Age cut off for decline in AMH and AFC in infertile women is approximately 34 years. There seems to be a good correlation between AFC and AMH. We need to counsel women to consider child bearing well before ovarian reserves decline (31-34 years).

Radius-Stage-Adjusted Height-for-Age and Weight-for-Age Percentile Charts for Chinese Children and Adolescents

Radius-Stage-Adjusted Height-for-Age and Weight-for-Age Percentile Charts for Chinese Children and Adolescents

Use of kidney trajectory charts as an adjunct to chronic kidney disease guidelines- a qualitative study of general practitioners.

Chronic kidney disease (CKD) affects up to 11% of the population. General practice is at the forefront of the identification of patients with declining kidney function, and appropriate monitoring and management of patients with CKD. An individualized and patient-centred approach is currently recommended in guidelines, but would be enhanced by more detailed guidance on how this should be applied to different age groups, such as use of a kidney trajectory chart. We explored the opinion of general practitioners (GPs) about the potential utility of kidney trajectory charts. Qualitative study interviewing 27 Australian GPs about their management of chronic kidney disease. GPs were presented with charts that plotted percentiles of kidney function (eGFR) with age and discussed how they would use the charts manage to patients with declining kidney function. GPs' opinion was sought as to how useful these charts might be in clinical practice. Most GPs were positive about the use of kidney trajectory charts to assist them with recognition and management of declining kidney function in general practice: e.g, comments included a "valuable tool", "a bit of an eye opener"," will help me explain to the patients", "I'll stick it on my wall.". GPs responded that the charts could help monitor patients, trigger early recognition of a younger patient at risk, and assist with older patients to determine when treatment may not be warranted. GPs also thought that charts could also be useful to motivate patients and help them monitor their own condition. Use of percentile charts in conjunction with the current CKD guidelines help support a patient-centred model of care. Kidney trajectory charts can help patients to understand their risk of further kidney damage or decline. Research on the use of these charts in clinical practice should be undertaken to further develop their use.

СLINICAL CHARACTERISTICS OF CHILDREN AND ADOLESCENTS WITH METABOLIC SYNDROME IN KYIV

This study aimed to clinically evaluate children and adolescents with metabolic syndrome (MetS) in order to identify and diagnose the condition at an early stage and prevent possible complications.&#x0D; Materials and Methods. A comprehensive examination of 105 children aged 10 to 17 years with MetS was conducted at the Rheumatology and Cardiology Department of Children's Clinical Hospital No. 6 in Kyiv. The International Diabetes Federation (IDF) criteria were used to establish MetS. Anthropometric assessments included calculation of body mass index, evaluation of waist circumference using age-specific percentile charts, determination of waist-to-height ratio (WHtR), and measurement of neck circumference in lying and standing positions. Ambulatory blood pressure monitoring was performed using the ABM-04 device (Meditech, Hungary), and laboratory investigations (glucose, insulin, lipid profile) were conducted using the Cobas 6000 analyzer and test system (Roche Diagnostics). The EZR version 1.61 (November 11, 2022) package was used for statistical analysis of the obtained data.&#x0D; Results and Discussion. In terms of heredity analysis, the presence of hypertension in the father of children, maternal grandmother, and mother was the most common, indicating the importance of genetic influence on the development of this condition. Among the most common complaints were elevated blood pressure, headaches, anxiety, and palpitations. The logistic regression model demonstrated that daytime sleepiness was associated with symptoms such as sweating, morning hoarseness, tinnitus, weather sensitivity, and fatigue. There was no statistically significant difference between the manifestations of acanthosis nigricans and purple stretch marks in girls and boys, but a higher tendency was observed in males.&#x0D; Conclusions. Metabolic syndrome in children and adolescents is associated with a high risk of complications, as most of them have a high WHtR value. Cardiovascular diseases showed the highest hereditary dependency in close relatives of children with MetS. Cardiovascular symptoms are the most common among children with MetS, but girls had significantly higher frequencies of emotional and psychological symptoms.

Kidney trajectory charts improve GP management of patients with reduced kidney function: a randomised controlled vignette study.

The stages of chronic kidney disease (CKD) and estimated glomerular filtration rate (eGFR) reference ranges are currently determined without considering age. To determine whether a chart that graphs age with eGFR helps GPs make better decisions about managing patients with declining eGFR. A randomised controlled vignette study among Australian GPs using a percentile chart plotting the trajectory of eGFR by age. Three hundred and seventy-three GPs received two case studies of patients with declining renal function. They were randomised to receive the cases with the chart or without the chart, and asked a series of questions about how they would manage the cases. In an older female patient with stable but reduced kidney function, use of the chart was associated with GPs in the study recommending a longer follow-up period, and longer time until repeat pathology testing. In a younger male First Nations patient with normal but decreasing kidney function, use of the chart was associated with GPs in the study recommending a shorter follow-up period, shorter time to repeat pathology testing, increased management of blood pressure and lifestyle, and avoidance of nephrotoxic medications. This represents more appropriate care in both cases. Having access to a chart of percentile eGFR by age was associated with more appropriate management review periods of patients with reduced kidney function, either by greater compliance with current guidelines or greater awareness of a clinically relevant kidney problem.

Weight Reduction Percentile Charts: 2-Year Follow-up Results of OAGB and RYGB Post Bariatric Surgery.

Using a single percentile chart provides us with high standards for the evaluation and accurate investigation of sufficient weight loss after bariatric surgery, counseling, and treating patients in an evidence-based way. Creating percentile charts of weight loss for gastric bypass is the aim of this study. This retrospective study was based on data from patients who underwent RYGB or OAGB from February 2008 to February 2020. The lambda-mu-sigma (LMS) method was used to estimate the reduction in body mass index (BMI) and six other metrics measured throughout post-operative follow-up. Percentile charts for various metrics have been presented for the first 2years' post-surgery. We applied a bootstrap sampling method to evaluate percentile validity. We recruited 2579 and 1943 patients who underwent OAGB (75% female) and RYGB (84% female) and were between the ages of 18 and 70years. The preoperative BMI of patients in the OAGB group was higher than in the RYGB group. Concerning RYGB weight reduction results, the maximum percentage of excess weight loss (%EWL) occurs 18months after surgery and is steady at 24months. Far above 50%, EWL is achieved after 6months. OAGB weight loss follows the same trend as RYGB; at 6months, the %EWL values are slightly higher than RYGB. We present the first bariatric weight loss percentile chart for OAGB. It allows evaluation of sufficient and insufficient weight loss at any post-operative point in a visual aspect. Furthermore, it predicts prospective outcomes and guides patient monitoring.