Medial Calf Research Articles

Adolescents' chronotype and its association with obesity-related outcomes: The EHDLA study.

This study aimed to assess associations between chronotype and obesity-related indicators in a sample of Spanish adolescents. This cross-sectional study used data from The Eating Healthy and Daily Life Activities (EHDLA) Study, which included a representative sample of adolescents from Spain. A total of 820 adolescents (54.7% girls) aged 12-17 years were included in the analyses. The adolescents' chronotype was determined using the Morningness/Eveningness Scale in Children. Obesity-related indicators included body mass index, waist circumference, waist-to-height ratio, triceps and medial calf skinfolds, sum of skinfolds, and body fat percentage. Generalized linear models were used to examine the relationship between the Morningness-Eveningness score and chronotype status and the above-mentioned obesity-related indicators in adolescents. All analyses were adjusted for sex, age, socioeconomic status, sleep duration, physical activity, sedentary behaviour, adherence to the Mediterranean diet, and energy intake. The morningness chronotype was associated with higher abdominal obesity (odds ratio [OR] = 1.67, 95% confidence interval (CI) 1.12 to 2.50; p = 0.001), waist-to-height ratio (unstandardized beta coefficient [B] = 0.01, 95% CI 0.01 to 0.05; p = 0.029) and skinfold calves (B = 1.04 95% CI 0.24 to 1.94; p = 0.011), compared with the intermediate chronotype. Adolescents with a morningness chronotype may be more prone to abdominal obesity than their counterparts with an intermediate chronotype. Effective intervention-related approaches can be applied to those with a morningness chronotype.

Examining the Relationship between Foot Medial Arch Height and Short and Medium Distance Running Performances and Some Variables in Athletes

In this study, the relationship between foot medial arch height, age, height, body weight, body mass index (BMI), calf and thigh thickness and 100-meter and 3000-meter running performances in athletes was investigated. 28 athletes competing in national competitions, with an average age of 18.29±5.68 years, were included in the study on a voluntary basis. The right foot medial arch heights, heights, body weights, calf and thigh thicknesses of the participants were determined. BMI's were calculated. Also, 100 m and 3000 m. running times were determined. Data analyzes were performed using descriptive statistics and correlation tests. As a result of the analysis, 100 m running performance had a negative relationship with the values of height (r= -.377), body weight (r= -.466), BMI (r= -.428) and thigh circumference (r= -.433). It was observed that there was a relationship with the calf circumference measurement value (-.496) at the p<0.01 level. On the other hand, it was determined that the relationship between foot medial arch height (r= -.178) was not significant (p>0.05). On the other hand, 3000 m running performance was negatively affected by height (r= -.493), body weight (r= -.641), BMI (r= -.625) and calf girth thickness (r= -.623). It was determined that it showed significance at the p<0.01 level. It was also determined that there was a significant relationship with medial arch height in a negative direction (r = -.404) and at p < 0.05. As a result, it can be said that foot medial arch height, height, body weight, BMI, thigh and calf circumference thickness values are effective on short and medium distance running performances.

Application of flow-through flaps for replantation after traumatic limb amputation according to the angiosome concept.

This study was performed to explore the treatment of the injury caused by traumatic limb amputation. From October 2002 to October 2021, 30 cases were enrolled in the present study. The reasons for injury were as follows: 8 cases with single hydraulic column crush injury, 12 cases with gear and wire rope stranding, 6 cases with belt avulsion injury, and 4 cases with carbon block smash injury. The present study application of a free or small saphenous vein bypass to reconstruct the injured artery and vein according to the concept of the angiosome model. The defective vessels were bridged with the axial vessels of a flow-through flap, such as a medial calf flap or anterolateral femoral flap, to construct an additional blood supply and drainage vein for the severed limb. The clinical data of 30 cases with traumatic limb amputation of the lower leg and ankle were retrospectively analyzed. In all 30 cases of traumatic limb amputation, the replantation via the adoption of a flow-through flap was successful, and 85.6% of the patients remained in good postoperative condition. There were no symptoms of ischemia in the marginal segment after blood supply reconstruction of the transected limb by axial vascular bridging within the flap. Via the adoption of microsurgical techniques, the blood supply to the transected limb can be reconstructed by bridging the defective vessels with the adoption of the axial vessels of the flow-through flap is a feasible and advanced treatment option.

Relationship between perceived physical literacy and obesity-related outcomes in adolescents: the EHDLA study.

The aim of the present study was to examine the relationship between perceived physical literacy and obesity-related outcomes among adolescents from Spain. This is a secondary cross-sectional analysis including a total sample of 845 Spanish adolescents (55.3% girls) aged 12-17 years from the Valle de Ricote (Region of Murcia) from the Eating Healthy and Daily Life Activities (EHDLA) project. Physical literacy was evaluated using the Spanish Perceived Physical Literacy Instrument for adolescents (S-PPLI). Body mass index was computed by taking the participants' body weight in kilograms and dividing it by the square of their height in meters, and body mass index (z score) and overweight/obesity and obesity were computed by the World Health Organization age- and sex-specific thresholds. Waist circumference was measured using a constant tension tape. Moreover, the waist-to-height ratio was calculated, and therefore, abdominal obesity was determined. Skinfold measurements were taken at the triceps and medial calf using calibrated steel calipers. In general, the overall trend was downward (i.e., the higher the PPLI score the lower the obesity-related indicators), with the approximate significance of smooth terms being statistically significant for all models examined (p < 0.001). Adolescents with lower perceived physical literacy (PPL) showed the highest estimated marginal means of body mass index, body mass index z score, waist circumference, waist-to-height ratio, and skinfold (triceps and calf) and predictive probabilities of having excess weight, obesity, and abdominal obesity, while their counterparts with high PPL had the lowest. In addition, significant differences were observed for all the obesity-related indications between adolescents with low PPL and those with medium PPL (p-adjusted < 0.05 for all indicators), as well as with those with high PPL (p-adjusted < 0.05 for all indicators). Moreover, these significant differences were also shown for most indicators between adolescents with medium PPL and those with high PPL (except for obesity). Physical literacy could play a crucial role in maintaining more desirable obesity-related outcomes in adolescents. Adolescents with high perceived physical literacy showed lower obesity-related indicators (i.e., body mass index, body mass index z score, waist circumference, waist-to-height ratio, skinfolds), as well as a lower probability of having excess weight, obesity, and abdominal obesity.

Efficacy of Airbo·Wave in Nighttime Compression for Leg Lymphedema.

Objectives: This study aimed to clarify the efficacy of Airbo·Wave EV1 in nighttime compression therapy as part of complex decongestive therapy (CDT) for leg lymphedema. Patients and Methods: We retrospectively reviewed 33 patients with leg lymphedema who used Airbo·Wave EV1 between April 2021 and September 2022. In these patients, the changes in leg volume and skin hardness were assessed using a scale ranging from 1 (softest) to 7 (hardest), and dermal thickness before and after the use of Airbo·Wave EV1 was evaluated. Results: Twenty-two patients used Airbo·Wave EV1 for nighttime compression in CDT. Their skin hardness in the lower calf decreased mildly (mean scale: before, 3.9; after, 3.6 [p <0.05]), but the leg volume and skin thickness were unchanged. Eleven patients who were nonadherent could restart compression therapy by using Airbo·Wave EV1. Their skin hardness in the medial lower calf (before, 5.1; after, 4.3 [p <0.05]), leg volume (before, 8412 mL; after, 8191 mL [p <0.01]), and skin thickness in the medial and lateral lower leg were reduced. Conclusion: Airbo·Wave EV1 could improve skin hardness in the calf area. Moreover, it is a safe procedure for the nonadherent while reducing leg volume reasonably.

Common sports injuries and physical treatments

Physiotherapy is a non-invasive and non-pharmaceutical application of artificial physical factors and natural physical factors to the human body through the body's neurological, humoral, endocrine, immune and other physiological regulatory mechanisms to achieve the purpose of treatment and rehabilitation. With the widespread popularity and popularity of sports, more people are participating in sports in which injuries become common at different levels of sports from daily recreation to high intensity competitive levels. Physical therapy is considered the first choice for sports people to treat sports injuries and is becoming common and mainstream in the field of sports injury treatment and rehabilitation. Physiotherapy has become critical as a primary treatment or secondary intervention after a sports injury and make sense in the rehabilitation of sports injuries. This article focuses on the physiotherapy treatment of common sports injuries in different sports. Common sports injuries in basketball include ankle sprains, meniscus tears, Achilles tendon ruptures, and patellar tendonitis. Common sports injuries in rugby include groin injuries and shoulder dislocations. Common sports injuries in baseball include ulnar collateral ligament injuries and rotator cuff injuries. Common sports injuries in tennis include epicondylitis of the elbow joint. Common injuries in soccer include medial collateral ligament sprains and calf strains. This article analyzes the anatomical structure of the above-mentioned common injury sites, the physical means of intervention and the different roles of physiotherapy in different sports injuries. The results of the article found that physiotherapy is available for all the sports mentioned above. However, depending on the injury in a sport, physiotherapy has a different proportion of the conventional treatment modalities.

Lower extremity lymphedema and vascularized lymph node transfer recipient sites: a review of the current literature

Vascularized lymph node transfer is a surgical treatment for lower extremity lymphedema aimed at restoring physiological lymphatic flow. Much variation exists in determining the appropriate donor site from which to harvest lymph nodes as well as the optimal recipient site to anastomose the new lymph nodes. This article reviews the underlying principles of free vascularized lymph node transfer and discusses patient-specific, disease-specific and surgery-specific factors in considering recipient sites from the proximal, middle, and distal lower extremity. The clinical outcomes of published studies in lymphatic surgery for lower extremity lymphedema are presented. An omental flap to the middle lower extremity (mid-thigh, popliteal fossa, or medial calf) is then recommended due to the abundance of lymphatic tissue, proximity to pooled lymph fluid, and avoidance of added bulk or poor cosmesis of the distal lower extremity. However, additional clinical outcomes studies are needed and represent an area of further investigation.

Stocking-only versus additional eccentric compression after below-the-knee truncal vein sclerotherapy: A SOVAECS prospective randomized within-person trial

ObjectiveAfter foam sclerotherapy in the truncal saphenous vein, the clinical effects of additional eccentric compression has not yet been explored. MethodsBetween April 2020 and February 2021, we enrolled 42 patients (84 limbs) who underwent bilateral endovenous combined therapy for great saphenous vein (GSV) reflux. Each patient received the same type of endovenous ablation in both above-the-knee GSVs (laser, radiofrequency, cyanoacrylate glue), and combined foam sclerotherapy was performed on both below-the-knee GSVs. Subsequently, we conducted a prospective randomized, single-blind, within-person study in which each patient's bilateral truncal saphenous vein of the calves underwent two different compression therapies: wearing of a regular class II compression stocking on one side (RC group) and additional eccentric compression on the other side (AC group). The primary end point was the occlusion range (score, 0-10) of the below-the-knee truncal GSV after foam sclerotherapy. The secondary outcomes were the pain score (visual analog scale score range, 0-10) of the paired limb, the required number of additional foam sclerotherapy sessions, compliance with compression therapy, and procedure-related complications. ResultsFor the above-the-knee GSV, endovenous laser treatment (n = 44), endovenous radiofrequency ablation (n = 14), and endovenous cyanoacrylate glue ablation (n = 26) were performed. The mean subcompression pressure of the medial calf in the supine and standing positions were 16.7 ± 2.34 mm Hg and 24.5 ± 6.6 mm Hg in the RC group and 38.5 ± 5.5 mm Hg and 45.3 ± 8.2 mm Hg in the AC group, respectively (P = .000). The secondary outcomes of pain score, number of additional foam sclerotherapy sessions, and pigmentation were not significantly different statistically between the two groups. The patient-reported satisfaction scores (range, 0-10) on compression at 24 hours postoperatively were 8.03 ± 1.9 for the AC group and 7.98 ± 1.9 for the RC group (P = .317; Wilcoxon signed ranks test). In both groups, the closure rate of the above-the-knee GSV at 1 month postoperatively was 100%. No procedure-related complications were identified within 1 month postoperatively, including no deep vein thrombosis, numbness, or skin necrosis requiring additional medical attention. ConclusionsThe 24 hours of additional eccentric compression on the truncal GSV compared with the use of a conventional knee-level stocking only did not yield any clinical advantages in terms of the occlusion range, postoperative pain, need for additional sclerotherapy, or skin pigmentation after foam sclerotherapy. The decision on which type of compression therapy to perform after foam sclerotherapy in the truncal vein should be comprehensively determined.

A NOVEL TECHNIQUE FOR MANAGEMENT OF A CRITICALLY-SIZED BONE DEFECT IN THE OPEN PROXIMAL TIBIAL FRACTURE: EMPLOYING THE CAPANNA TECHNIQUE IN TRAUMA

A NOVEL TECHNIQUE FOR MANAGEMENT OF A CRITICALLY-SIZED BONE DEFECT IN THE OPEN PROXIMAL TIBIAL FRACTURE: EMPLOYING THE CAPANNA TECHNIQUE IN TRAUMA

The athlete's vein: venous adaptations in the lower limbs of endurance athletes.

Endurance exercise induces cardiovascular adaptations; the athletic phenotypes of the heart and arteries are well characterized, but few studies have investigated the effects of chronic exercise on the venous system. The aim of this study was to describe the anatomy and function of lower-limb deep and superficial veins in athletes compared with controls. Endurance-trained athletes and untrained controls (13 males, 7 females per group) were examined using ultrasound to measure vein diameter and flow, and air plethysmography to assess calf venous volume dynamics and muscle pump function at rest, during a single step, ambulation (10 steps) and after acute treadmill exercise (30 min ∼80% age-predicted heart rate maximum). Diameters of three of the seven deep veins assessed were larger in athletes (P ≤ 0.0167) and more medial calf perforators were detectable (5 vs. 3, P = 0.0039). Calf venous volume was 22% larger in athletes (P = 0.0057), and calf muscle pump ejection volume and ambulatory venous volume after 10 steps were both greater in athletes (20 and 46% respectively, P ≤ 0.0482). Following acute exercise, flow recovery profiles in deep and superficial veins draining the leg were not different between groups, despite athletes performing approximately four times more work. After exercise, venous volume and ejection volume were reduced by ∼20% in athletes with no change in controls (interaction, P ≤ 0.0372) and although ambulatory venous volume reduced, this remained greater in athletes. These findings highlight venous adaptations that compensate for the demands of regular endurance exercise, all of which are suited to enhance flow through the lower-limb venous system.NEW & NOTEWORTHY Although much literature exists describing adaptations to the heart and arteries in response to endurance exercise training, less is known about the effects on the venous system. Characteristics of "the athlete's vein" described here include deep and perforator vein remodeling, improved drainage, and greater calf venous volume at rest and on calf muscle pump activation. Following exercise, athletes demonstrated prompt flow recovery and appropriate volume reductions, and veins beneficially adapt to better tolerate the demands of regular physical activity.

The relationship between the degree of subcutaneous fluid accumulation and the lymphatic diameter

The relationship between the fluid accumulation in the subcutaneous tissue and the lymphatic degeneration in the lymphedematous limbs has not been elucidated, and we have evaluated it in the current study. Twenty-five patients (50 limbs) were included in this retrospective study. We performed lymphatic ultrasound by separating the limbs into four lymphosomes: the saphenous (medial) thigh, saphenous (medial) calf, lateral thigh, and lateral calf. In each lymphosome, the lymphatic diameter, the degree of lymphatic degeneration, and the fluid accumulation in the subcutaneous tissue were evaluated. The lymphatic vessels were detected based on the index of D-CUPS (Doppler, Crossing, Uncollapsibe, Parallel, and Superficial fascia). Lymphatic degeneration was diagnosed based on the NECST (Normal, Ectasis, Contraction, and Sclerosis Type) classification. All patients were women with a mean age of 62.7 years. Lymphatic vessels were detected using lymphatic ultrasonography in 50 saphenous (medial) thigh lymphosomes, 43 saphenous (medial) calf lymphosomes, 34 lateral thigh lymphosomes, and 22 lateral calf lymphosomes. The fluid accumulation tended to be more acute in the more severe stages of lymphedema. As for the NECST classification, the normal type was observed only in the areas without fluid accumulation. Among the other areas, the percentage of contraction type was the largest in the area with slight edema and decreased in the areas with severe edema. The lymphatic vessels were dilated to a greater extent in legs with more severe fluid accumulation. Therefore, there is no hesitation needed to perform lymphaticovenous anastomosis because of severe lymphedema.

Functionality of lower limb with exposed bone using VAC® negative pressure wound therapy vs. medial calf flap

Functionality of lower limb with exposed bone using VAC® negative pressure wound therapy vs. medial calf flap

Appendicular Skeletal Muscle Mass Prediction in People Living With HIV: A Cross-sectional Study.

People living with HIV (PWH) experience an accelerated aging process. There is no anthropometric predictive model for appendicular skeletal muscle mass (ASM) in PWH. This study develops anthropometric models to predict and validate ASM measured by dual energy x-ray absorptiometry (DXA) in PWH; DXA scans were obtained for 125 PWH (male = 74; age >18 years) on antiretroviral therapy. Fat mass ratio was used for lipodystrophy diagnosis. A multiple stepwise linear regression considered ASM DXA as the dependent variable and validated by PRESS method. A high power of determination and low standard estimate error were found for ASM DXA -predicted (adjusted r2 = 0.84 to 0.87, standard estimate error = 1.7-1.6 kg) and high PRESS validation coefficients (Q 2PRESS = 0.84-0.86, S PRESS = 1.7-1.6 kg). The variables included were lipodystrophy diagnosis, medial calf circumference, sex, and total body weight. We present novel, reliable, and validated anthropometric models to predict ASM DXA in PWH.

Estimativa da massa gorda em adolescentes do sexo feminino do sul do Brasil: desenvolvimento e validação de modelos matemáticos

abstract This study aimed to develop and validate the first mathematical models, based on anthropometric properties, to estimate fat mass (FM) in a heterogeneous sample of female adolescents. A cross-sectional and quantitative study conducted with 196 individuals aged 12 to 17 years from the metropolitan region of Curitiba, Paraná, Brazil. The participants were randomly divided into two groups: regression sample (n = 169) and validation sample (n = 27). Dual-energy X-ray absorptiometry (DXA) was used as the reference method to determine body fat in relative and absolute values. Stature, body mass, waist girth and triceps, subscapular, biceps, iliac crest, abdominal, front thigh and medial calf skinfold thickness were defined as independent variables and measured according to an international technical protocol. Statistical analyzes used the Ordinary Least Square (OLS) regression model, paired t test and Pearson correlation. Four multivariate mathematical models with high determination coefficients (R2 ≥90%) and low estimated standard errors (SEE = ≤2.02 kg) were developed. Model 4 stands out for its low number of independent variables and significant statistical performance (R2 = 90%; SEE = 1.92 kg). It is concluded that the four mathematical models developed are valid for estimating FM in female adolescents in southern Brazil.

Agreement and validity between body fat estimated by skinfold measurement and air displacement plethysmography in adolescents

Objective: Assess the agreement and validity between relative body fat percentages estimated using anthropometric measurements and air displacement plethysmography (ADP). Methods: A cross-sectional study was conducted on 118 adolescents (60 females) aged 10 to 14 years (x̄=12.19, sd=1.18). Adolescents were classified as eutrophic or with overweight according to body mass index (body weight/height2) (x̄=20,12, sd=3,56). Measurements of skinfold thickness (triceps and medial calf) were collected and used to estimate relative body fat by the Slaughter equation. ADP was used as a reference method for the estimation of relative body fat. Agreement between body fat measurement methods (anthropometry × ADP) was analyzed by the Bland–Altman method. The mean error (ME) was calculated by subtracting the body fat percentage estimated by the Slaughter equation from the body fat percentage estimated by ADP. Validity was tested with the concordance correlation coefficient (CCC). Results: There was no agreement between the methods, regardless of sex and weight status. For boys with overweight (ME = 4.52; p = 0.007), eutrophic girls (ME = 6.37; p &lt; 0.001), and girls with overweight (ME = 5.55; p &lt; 0.001), the Slaughter equation resulted in overestimation of body fat compared with ADP. Skinfold equations did not demonstrate validity when compared with ADP. Conclusion: Slaughter's skinfold equations did not demonstrate agreement and validity compared with ADP in either sex or weight status. Skinfold equations should be used with caution and, whenever possible, in combination with other body composition indicators.

Prediction and validation of total and regional skeletal muscle volume by using anthropometric measurements in prepubertal Japanese children.

It is difficult to easily estimate skeletal muscle (SM) volume in children. We aimed to develop regression-based prediction equations to estimate the total body and regional SM volume using calliper measurements of skinfold thickness and limb circumference and to investigate the validity of these equations. In total, 142 healthy, prepubertal, Japanese children, aged 6-12 years, were divided into two groups: the model development group (sixty boys, thirty-eight girls) and the validation group (twenty-six boys, eighteen girls). Contiguous magnetic resonance images were obtained from the first cervical vertebra to the ankle joints as reference data. SM volume was calculated from the summation of the digitised cross-sectional areas. Limb and waist circumferences were measured at mid-upper arm, mid-thigh, maximal calf and at the level of umbilicus. Each girth was corrected for subcutaneous adipose tissue thickness, as estimated by skinfold thickness measurements. Skinfold thickness was measured at the posterior upper arm, anterior thigh, medial calf and lateral to the umbilicus, using callipers. Significant correlations were observed between the site-matched SM volume, measured by MRI, and each corrected girth × standing height value in the model development group. When these SM volume prediction equations were applied to the validation group, the measured total body and regional SM volume were similar to the predicted values. These results suggest that the anthropometric prediction equations developed in this study provide reliable information about the total and regional SM volume in prepubertal Japanese children, with varying degrees of estimation accuracy for each region.

The local physiological effects of a single-use topical negative pressure device in healthy volunteers: the PICO-1 study.

This study aimed to investigate the effects of a single-use negative pressure wound therapy (sNPWT) device on tissue perfusion, oxygenation and pressure in the intact skin of healthy volunteers. Healthy volunteers wore a PICO sNPWT device (Smith+Nephew, UK) on their right medial calf for one week. Perfusion, tissue oxygenation and tissue pressure were recorded in superficial and deep tissues over a period of seven days. At the baseline visit, measurements were recorded before and after dressing application without activation. Macrovascular flow and transduced needle pressure measures were recorded at 0 minutes, 30 minutes and 60 minutes after device activation. Superficial tissue perfusion and both oxygenation measures were recorded continuously over the hour following activation. All outcome measures were repeated at 24 hours and again after seven days, both with the dressing and following dressing removal. The device was associated with a measurable increase in perfusion of the limb in 12 healthy volunteers. Superficial tissue oxygenation adjacent to the dressing was reduced during wear, while deeper tissue demonstrated an increase in oxygenation levels. Superficial skin perfusion was observed to differ between skin overlying muscle and that overlying bone. Pressure in tissue underneath the dressing pad was increased throughout dressing wear and returned to baseline levels on dressing removal. sNPWT produced measurable changes in local physiology in healthy volunteers with intact skin, despite the absence of a wound. Effects may differ according to anatomical site and the composition of underlying tissues. Other factors that promote healing were not explored in this study. This study was funded by Smith+Nephew investigator-initiated grant IIS 684. The funder had no input into study design, conduct, analysis, manuscript preparation or dissemination. The authors have no conflicts of interest to declare.

The lower limb perforator veins in normal subjects

ObjectiveWith the developments in vascular ultrasound technology, the opportunity has arisen to examine in greater detail the distribution and behavior of the perforators in normal lower limbs and the implications in understanding their normal role. MethodsThe lower limbs of 20 healthy participants free of any cardiovascular or venous disease were examined. The anatomical characteristics and distribution as well as the functional features of all ultrasound-detectable lower limb venous perforators were evaluated in these normal limbs. Perforator flow was tested at rest, supine, sitting, standing, and with exercise. Comparisons were made between standard augmentation and isometric foot plantar flexion. ResultsTwenty individuals (13 females, 7 males; mean age, 36.9 ± 12 years) participated in the study. On average each limb had 14.2 (range, 8-21) perforators identified by ultrasound examination, with an average size of 1.3 ± 0.56 mm (range, 0.4-3.5 mm), most in the medial calf and those in the lower third were larger. On ultrasound examination, the valves were observed only within these larger direct perforators (17%; 18/105). All maneuvers resulted in flow which was only from superficial to the deep system and no two-way flow was observed. Spontaneous flow at rest occurred in a small proportion, but treadmill walking led to the recruitment of most perforators with spontaneous pulsatile flow at greatly increased velocities. The estimated total perforator volume flow could be increased by up to five-fold and accounting for as much as 80 mL/min in a leg. Isometric foot plantar flexion stopped any spontaneous flow and, on relaxation, resulted in a reproduceable short burst of inflow in the calf perforators. Augmentation by calf or foot cuff compression produced a brief variable inward, flow but this flow did not correlate with the perforator flow, with the more physiological maneuvers of isometric foot plantar flexion and exercise. ConclusionsThis study has shown that normal perforator veins in the leg are unidirectional from superficial to deep veins. Although few perforators have spontaneous flow at rest, most are recruited with exercise to substantially increase spontaneous perforator flow secondary to the increased skin blood flow. The augmentation maneuver is not comparable with more physiological activity. These normal features should be taken into account in the assessment of the abnormal perforator.

Fat tissue on the march: secular trend of body circumferences and skinfold thicknesses in Slovenia over the 70 years period.

Introduction: The prevalence of overweight and obesity among young adults has increased dramatically in recent decades. The survey examined anthropometric indicators of fat tissue amount in the population of adult males and females from Slovenia from 1950 to 2019. Methods: From a large anthropometric database body height, body mass, seven circumferences (C: waist, hip, relaxed and flexed upper arm, forearm, middle thigh, medial calf) and seven skinfold thicknesses (SFT: triceps, biceps, subscapular, iliac crest, supraspinale, front thigh and medial calf) were obtained in different combinations for more than 3400 males and almost 4600 females of age 18 to 29 years, measured in the years between 1950 and 2019. To evaluate the secular trend, data were classified into 10-year periods and compared with ANOVA. Results: Body mass, waist-to-height ratio, waist-to-hip ratio, waist C, relaxed and flexed upper arm C, calf C, Triceps/subscapular ratio, biceps SFT, supraspinale SFT, front thigh SFT, and medial calf SFT increased (p < 0.001) over the last 70 years, however, thigh C decreased (p < 0.001) over the last 30 years. Body mass index and forearm C increased in males and decreased in females. Triceps and subscapular SFT`s increased till 2009 and then decreased in next decade in both sexes. Body fat % increased over the 70-years observed period from 12% to almost 15% in males and from 24% to more than 26% in females. Conclusion: From 1950 to 2009 or even to 2019, large amount of body fat clearly became more prevalent in young adults from Slovenia, which mostly is in line with secular trend in fat tissue in other parts of the world; however, in many measurements this trend slows down or even reverses after 2009 in Slovenia. Slovenian population appears to be leaner compared to other populations.

Genetic association of anthropometric traits with type 2 diabetes in ethnically endogamous Sindhi families.

BackgroundEthnically endogamous populations can shed light on the genetics of type 2 diabetes. Such studies are lacking in India. We conducted this study to determine the genetic and environmental contributions of anthropometric traits to type 2 diabetes risk in the Sindhi families in central India.MethodsWe conducted a family study in Indian Sindhi families with at least one case of type 2 diabetes. Variance components methods were used to quantify the genetic association of 18 anthropometric traits with eight type 2 diabetes related traits. Univariate and bivariate polygenic models were used to determine the heritability, genetic and environmental correlation of anthropometric traits with type 2 diabetes related traits.ResultsWe included 1,152 individuals from 112 phenotyped families. The ascertainment-bias corrected prevalence of type 2 diabetes was 35%. Waist circumference, hip circumference and the biceps, triceps, subscapular and medial calf skinfold thicknesses were polygenically and significantly associated with type 2 diabetes. The range of heritability of the anthropometric traits and type 2 diabetes related traits was 0.27–0.73 and 0.00–0.39, respectively. Heritability of type 2 diabetes as a discrete trait was 0.35. Heritability curves demonstrated a substantial local influence of type 2 diabetes related traits. Bivariate trait analyses showed that biceps and abdominal skinfold thickness and all waist-containing indexes were strongly genetically correlated with type 2 diabetes.ConclusionsIn this first study of Sindhi families, we found evidence for genetic and environmental concordance of anthropometric traits with type 2 diabetes. Future studies need to probe into the genetics of type 2 diabetes in this population.