Incidence of variations in human cadaveric renal vessels

Background: Awareness of discrepancies of renal vasculature is crucial for some medical procedures. The present study investigated origin and course of aberrant and accessory renal vessels and any associated variations. Materials and methods: Renal blood vessels of 63 cadavers were examined. Number of renal veins and arteries, arrangement, location where the vasculature attached to the kidneys, and presence of variations were recorded. Incidence of renal vasculature variations was determined, and associations were tested with age at death, sex, and cause of death and whether variations were more common on a specific side. Results: Variations were found in 7 (11%; 95% confidence interval [CI] 5–22%) cadavers. For renal veins, double, triple, and quadruple veins unilaterally (5; 8%) and veins that drained the superior pole (1; 2%) or inferior pole only (5; 8%) were found. For renal arteries, double and triple arteries unilaterally (3; 5%) and arteries attached to the superior pole only (1; 2%) or inferior pole only (2; 3%) were found. Other variations (polycystic kidney, variations in the common iliac or gonadal veins) were observed. Only renal failure as a cause of death was different between those with or without variations (4/7 [57%] vs. 1/56 [2%]; p < 0.001). Conclusions: The present study found many variations in renal vasculature. Awareness of such variations may be useful for physicians concerned with this region

Perceptions of body size, obesity threat and the willingness to lose weight among black South African adults: a qualitative study

BACKGROUND: The obesity epidemic is associated with rising rates of cardiovascular disease (CVD) among adults, particularly in countries undergoing rapid urbanisation and nutrition transition. This study explored the perceptions of body size, obesity risk awareness, and the willingness to lose weight among adults in a resource-limited urban community to inform appropriate community-based interventions for the prevention of obesity. METHOD: This is a descriptive qualitative study. Semi-structured focus group discussions were conducted with purposively selected black men and women aged 35–70 years living in an urban South African township. Weight and height measurements were taken, and the participants were classified into optimal weight, overweight and obese groups based on their body mass index (Kg/m2). Participants were asked to discuss on perceived obesity threat and risk of cardiovascular disease. Information on body image perceptions and the willingness to lose excess body weight were also discussed. Discussions were conducted in the local language (isiXhosa), transcribed and translated into English. Data was analysed using the thematic analysis approach. RESULTS: Participants generally believed that obesity could lead to health conditions such as heart attack, stroke, diabetes, and hypertension. However, severity of obesity was perceived differently in the groups. Men in all groups and women in the obese and optimal weight groups perceived obesity to be a serious threat to their health, whereas the overweight women did not. Obese participants who had experienced chronic disease conditions indicated strong perceptions of risk of obesity and cardiovascular disease. Obese participants, particularly men, expressed willingness to lose weight, compared to the men and women who were overweight. The belief that overweight is ‘normal’ and not a disease, subjective norms, and inaccessibility to physical activity facilities, negatively influenced participants’ readiness to lose weight. CONCLUSION: Low perception of threat of obesity to health particularly among overweight women in this community indicates a considerable challenge to obesity control. Community health education and promotion programmes that increase awareness about the risk associated with overweight, and improve the motivation for physical activity and maintenance of optimal body weight are needed.IS

Nutritional characterisation of low-income households of Nairobi: socioeconomic, livestock and gender considerations and predictors of malnutrition from a cross-sectional survey

Background: In sub-Saharan Africa, urban informal settlements are rapidly expanding, leading to overcrowding and constituting challenging environments for food and water supplies, health and nutrition. The study objectives were to characterise and compare two low-income areas of Nairobi according to socioeconomic (including livestock and gender) indicators and the nutritional status of non-pregnant women of reproductive age and 1 to 3 year-old children; and to investigate socioeconomic predictors of malnutrition in these areas. Methods: In this cross-sectional survey 205 low-income households in deprived areas of Dagoretti and Korogocho (Nairobi) were randomly selected. Socioeconomic data were collected via an interviewer-administered questionnaire. Maternal and child dietary data were collected by a 24-h dietary recall. Maternal and child anthropometric and haemoglobin measurements were taken. Chi-square, t-test and Wilcoxon-Mann–Whitney test were used to compare groups and multivariable linear regression to assess predictors of malnutrition. Results: Dagoretti consistently showed better socioeconomic indicators including: income, education and occupation of household head, land ownership, housing quality and domestic asset ownership. Animal ownership was more than twice as high in Dagoretti as in Korogocho (53.0 % vs 22.9 % of households; p-value < 0.0001). A double burden of malnutrition existed: 41.5 % of children were stunted, and 29.0 % of women were overweight. In addition, 74.0 % of the children and 25.9 % of the women were anaemic, and were at risk of inadequate intakes for a number of micronutrients. Nutritional status and nutrient intakes were consistently better in Dagoretti than Korogocho; height-for-age (0.47 Z-scores higher; p-value = 0.004), the minimum dietary diversity (80.0 % vs 57.7 % in children, p-value = 0.001) and intakes of several nutrients were significantly higher. Positive predictors of maternal nutritional status were income, age and not having a premature delivery. Positive predictors of child nutritional status were area, household head education, mother not being married, female animal ownership and child’s sex (female). Conclusions: Malnutrition is prevalent in these settings, which could be partly due to low nutrient intakes, and to socioeconomic factors (including poverty), thus requiring comprehensive approaches that include increased accessibility and affordability of nutrient-dense foods. This study indicates that differences among low-income areas may need consideration for prioritisation and design of interventions