85 resultados para Obesidade Fatores de risco
Resumo:
A sndrome dos ovrios policsticos (SOP) a desordem endcrina mais comum em mulheres com idade reprodutiva. Seu diagnstico firmado atravs do consenso de Rotterdam na presena de dois dos seguintes critrios: anovulao crnica, sinais clnicos e/ou bioqumicos de hiperandrogenismo e presena de micropolicistos nos ovrios. Na SOP, alm das caractersticas especficas da sndrome comum a presena de marcadores de risco cardiovascular aumentado como dislipidemia, hipertenso arterial, resistncia insulina e obesidade central Objetivos: Analisar a acurcia diagnstica da circunferncia da cintura (CC), relao cintura-estatura (RCEst), razo cintura-quadril (RCQ) e ndice de conicidade (ndice C) para deteco de fatores de risco cardiovascular (FRCV) e sndrome metablica (SM) em mulheres com sndrome dos ovrios policsticos (SOP). Metodologia: Foi realizado estudo transversal envolvendo 108 mulheres na faixa etria de 20-34 anos, com diagnstico de SOP de acordo com o consenso de Rotterdam. Foram considerados parmetros clnicos, antropomtricos e bioqumicos de avaliao do risco cardiovascular. A anlise dos dados foi desenvolvida em duas etapas, conforme descrito a seguir. Fase 1: anlise da acurcia dos pontos de corte previamente determinados na literatura nacional para CC, RCEst, RCQ e ndice C, para predio de FRCV; Fase 2: determinao de pontos de corte dos ndices antropomtricos supracitados, especficos para mulheres com SOP, para discriminao de SM, atravs da anlise da curva ROC (Receiver Operating Characteristic). Resultados: Com base nos achados da fase 1 do estudo, a RCEst foi o marcador que apresentou correlaes positivas significativas com o xi maior nmero de FRCV (presso arterial, triglicerdeos e glicemia aps teste oral de tolerncia glicose), alm de correlao negativa com HDL-colesterol. Os demais marcadores antropomtricos se correlacionaram positivamente com presso arterial, enquanto CC e RCQ apresentaram correlao positiva tambm com triglicerdeos. Todos os indicadores antropomtricos apresentaram taxas de sensibilidade superiores a 60%, com destaque para a RCEst que apresentou sensibilidade superior a 70%. Na fase 2 da pesquisa observamos que a CC, RCEst e RCQ apresentaram desempenho semelhante na predio de SM, sendo superiores ao ndice C. Os valores de ponto de corte dos ndices antropomtricos para discriminar SM foram: CC = 95 cm; RCEst = 0,59; RCQ = 0,88; e ndice C = 1,25. Utilizando esses pontos de corte as taxas de sensibilidade e especificidade da CC e RCEst foram superiores s observadas para RCQ e ndice C. Concluses: Nossos dados enfatizam a importncia da avaliao antropomtrica no rastreamento do risco cardiovascular em mulheres com SOP, destacando-se a relevncia da RCEst na predio de FRCV clssicos e a necessidade de considerar pontos de corte especficos para mulheres com SOP para discriminao de SM
Resumo:
Fundamento: A obesidade abdominal apresenta elevada prevalncia em mulheres com sndrome dos ovrios policsticos (SOP) e est associada a um aumento do risco cardiovascular. Objetivo: Verificar a acurcia da circunferncia da cintura (CC), da relao cintura-quadril (RCQ), da relao cinturaestatura (RCEST) e do ndice de conicidade (ndice C), no que se refere deteco de fatores de risco cardiovascular (FRCV) em mulheres com SOP. Mtodos: Por meio de estudo transversal, foram alocadas 102 mulheres (26,5 5 anos) com diagnstico de SOP, de acordo com o consenso de Rotterdam. O colesterol total (CT), os triglicerdeos (TG), o LDL-colesterol (LDL-C), o HDLcolesterol (HDL-C), a glicemia de jejum, a glicemia aps teste oral de tolerncia glicose (TOTG) e a presso arterial (PA) foram avaliados em todas as pacientes, alm das variveis antropomtricas. Resultados: A relao cintura-estatura foi o marcador que apresentou correlaes positivas significativas com o maior nmero de FRCV (PA, TG e glicemia aps TOTG), destacando-se ainda a correlao negativa com HDL-C. Todos os marcadores antropomtricos avaliados se correlacionaram positivamente com PA, enquanto CC e RCQ apresentaram correlao positiva tambm com TG. No tocante acurcia para deteco de FRCV, os indicadores antropomtricos considerados apresentaram taxas de sensibilidade superiores a 60%, com destaque para a RCEST, que apresentou sensibilidade superior a 70%. Concluso: A RCEST demonstrou ser o indicador antropomtrico com a melhor acurcia para a predio de FRCV. Nesse sentido, prope-se a incluso desse parmetro de fcil mensurao na avaliao clnica para o rastreamento de mulheres com SOP e FRCV----------------------ABSTRACT Background: Women with polycystic ovary syndrome (PCOS) present a high prevalence of abdominal obesity, which is associated with an increased cardiovascular risk. Objective: To verify the accuracy of the waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and the conicity index (CI) in the detection of cardiovascular risk factors (CVRF) in women with PCOS. Methods: The present transversal study allocated 102 women (26.5 5 years) with a diagnosis of PCOS, according to the Rotterdam criteria. Total cholesterol (TC), triglycerides (TG), LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C), fasting glucose, glucose after the oral glucose tolerance test (OGTT) and blood pressure (BP) were evaluated in all patients, in addition to the anthropometric variables. Results: The WHtR was the marker that presented significant positive correlations with the highest number of CVRF (BP, TG and post-OGTT glucose), whereas there was a negative correlation with HDL-C. All the evaluated anthropometric markers were positively correlated with BP, whereas WC and WHR also presented a positive correlation with TG. Regarding the accuracy for the detection of CVRF, the anthropometric markers presented a sensibility > 60%, especially the WHtR, which had a sensibility > 70%. Conclusion: The WHtR showed to be the most accurate anthropometric indicator for the prediction of CVRF. In this sense, we propose the inclusion of this easily-measured parameter in the clinical assessment for the screening of women with PCOS and CVRF
Resumo:
Fundamento: A obesidade abdominal apresenta elevada prevalncia em mulheres com sndrome dos ovrios policsticos (SOP) e est associada a um aumento do risco cardiovascular. Objetivo: Verificar a acurcia da circunferncia da cintura (CC), da relao cintura-quadril (RCQ), da relao cinturaestatura (RCEST) e do ndice de conicidade (ndice C), no que se refere deteco de fatores de risco cardiovascular (FRCV) em mulheres com SOP. Mtodos: Por meio de estudo transversal, foram alocadas 102 mulheres (26,5 5 anos) com diagnstico de SOP, de acordo com o consenso de Rotterdam. O colesterol total (CT), os triglicerdeos (TG), o LDL-colesterol (LDL-C), o HDLcolesterol (HDL-C), a glicemia de jejum, a glicemia aps teste oral de tolerncia glicose (TOTG) e a presso arterial (PA) foram avaliados em todas as pacientes, alm das variveis antropomtricas. Resultados: A relao cintura-estatura foi o marcador que apresentou correlaes positivas significativas com o maior nmero de FRCV (PA, TG e glicemia aps TOTG), destacando-se ainda a correlao negativa com HDL-C. Todos os marcadores antropomtricos avaliados se correlacionaram positivamente com PA, enquanto CC e RCQ apresentaram correlao positiva tambm com TG. No tocante acurcia para deteco de FRCV, os indicadores antropomtricos considerados apresentaram taxas de sensibilidade superiores a 60%, com destaque para a RCEST, que apresentou sensibilidade superior a 70%. Concluso: A RCEST demonstrou ser o indicador antropomtrico com a melhor acurcia para a predio de FRCV. Nesse sentido, prope-se a incluso desse parmetro de fcil mensurao na avaliao clnica para o rastreamento de mulheres com SOP e FRCV----------------------ABSTRACT Background: Women with polycystic ovary syndrome (PCOS) present a high prevalence of abdominal obesity, which is associated with an increased cardiovascular risk. Objective: To verify the accuracy of the waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and the conicity index (CI) in the detection of cardiovascular risk factors (CVRF) in women with PCOS. Methods: The present transversal study allocated 102 women (26.5 5 years) with a diagnosis of PCOS, according to the Rotterdam criteria. Total cholesterol (TC), triglycerides (TG), LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C), fasting glucose, glucose after the oral glucose tolerance test (OGTT) and blood pressure (BP) were evaluated in all patients, in addition to the anthropometric variables. Results: The WHtR was the marker that presented significant positive correlations with the highest number of CVRF (BP, TG and post-OGTT glucose), whereas there was a negative correlation with HDL-C. All the evaluated anthropometric markers were positively correlated with BP, whereas WC and WHR also presented a positive correlation with TG. Regarding the accuracy for the detection of CVRF, the anthropometric markers presented a sensibility > 60%, especially the WHtR, which had a sensibility > 70%. Conclusion: The WHtR showed to be the most accurate anthropometric indicator for the prediction of CVRF. In this sense, we propose the inclusion of this easily-measured parameter in the clinical assessment for the screening of women with PCOS and CVRF
Resumo:
The dyslipidemia and excess weight in adolescents, when combined, suggest a progression of risk factors for cardiovascular disease (CVD). Besides these, the dietary habits and lifestyle have also been considered unsuitable impacting the development of chronic diseases. The study objectives were: (1) estimate the prevalence of lipid profile and correlate with body mass index (BMI), waist circumference (WC) and waist / height ratio (WHR) in adolescents, considering the maturation sexual, (2) know the sources of variance in the diet and the number of days needed to estimate the usual diet of adolescents and (3) describe the dietary patterns and lifestyle of adolescents, family history of CVD and age correlates them with the patterns of risk for CVD, adjusted for sexual maturation. A cross-sectional study was performed with 432 adolescents, aged 10-19 years from public schools of the Natal city, Brazil. The dyslipidemias were evaluated considering the lipid profile, the index of I Castelli (TC / HDL) and II (LDL / HDL) and non-HDL cholesterol. Anthropometric indicators were BMI, WC and WHR. The intake of energy, nutrients including fiber, fatty acids and cholesterol was estimated from two 24-hour recalls (24HR). The variables of lipid profile, anthropometric and clinical data were used in the models of Pearson correlation and linear regression, considering the sexual maturation. The variance ratio of the diet was calculated from the component-person variance, determined by analysis of variance (ANOVA). The definition of the number of days to estimate the usual intake of each nutrient was obtained by taking the hypothetical correlation (r) ≥ 0.9, between nutrient intake and the true observed. We used the principal component analysis as a method of extracting factors that 129 accounted for the dependent variables and known cardiovascular risk obtained from the lipid profile, the index for Castelli I and II, non-HDL cholesterol, BMI, and WC the WHR. Dietary patterns and lifestyle were obtained from the independent variables, based on nutrients consumed and physical activity weekly. In the study of principal component analysis (PCA) was investigated associations between the patterns of cardiovascular risk factors in dietary patterns and lifestyle, age and positive family history of CVD, through bivariate and multiple logistic regression adjusted for sexual maturation. The low HDL-C dyslipidemia was most prevalent (50.5%) for adolescents. Significant correlations were observed between hypercholesterolemia and positive family history of CVD (r = 0.19, p <0.01) and hypertriglyceridemia with BMI (r = 0.30, p <0.01), with the CC (r = 0.32, p <0.01) and WHR (r = 0.33, p <0.01). The linear model constructed with sexual maturation, age and BMI explained about 1 to 10.4% of the variation in the lipid profile. The sources of variance between individuals were greater for all nutrients in both sexes. The reasons for variances were  1 for all nutrients were higher in females. The results suggest that to assess the diet of adolescents with greater precision, 2 days would be enough to R24h consumption of energy, carbohydrates, fiber, saturated and monounsaturated fatty acids. In contrast, 3 days would be recommended for protein, lipid, polyunsaturated fatty acids and cholesterol. Two cardiovascular risk factors as have been extracted in the ACP, referring to the dependent variables: the standard lipid profile (HDL-C and non-HDL cholesterol) and "standard anthropometric index (BMI, WC, WHR) with a power explaining 75% of the variance of the original data. The factors are representative of two independent variables led to dietary patterns, "pattern 130 western diet" and "pattern protein diet", and one on the lifestyle, "pattern energy balance". Together, these patterns provide an explanation power of 67%. Made adjustment for sexual maturation in males remained significant variables: the associations between puberty and be pattern anthropometric indicator (OR = 3.32, CI 1.34 to 8.17%), and between family history of CVD and the pattern lipid profile (OR = 2.62, CI 1.20 to 5.72%). In females adolescents, associations were identified between age after the first stage of puberty with anthropometric pattern (OR = 3.59, CI 1.58 to 8.17%) and lipid profile (OR = 0.33, CI 0.15 to 0.75%). Conclusions: The low HDL-C was the most prevalent dyslipidemia independent of sex and nutritional status of adolescents. Hypercholesterolemia was influenced by family history of CVD and sexual maturation, in turn, hypertriglyceridemia was closely associated with anthropometric indicators. The variance between the diets was greater for all nutrients. This fact reflected in a variance ratio less than 1 and consequently in a lower number of days requerid to estimate the usual diet of adolescents considering gender. The two dietary patterns were extracted and the pattern considered unhealthy lifestyle as healthy. The associations were found between the patterns of CVD risk with age and family history of CVD in the studied adolescents
Resumo:
investiga a prevalncia de nveis pressricos elevados e avaliar a correlao entre nveis de presso arterial (PA) e outros fatores de risco cardiovascular em pacientes com sndrome dos ovrios policsticos (SOP).Por meio de estudo transversal foram comparados os nveis de PA e parmetros antropomtricos e bioqumicos de risco cardiovascular em 113 mulheres com SOP (idade 26,24,3 anos) e num grupo controle constitudo por 242 mulheres saudveis da populao geral (26,85,0 anos). o grupo SOP apresentou prevalncia de PA alterada (≥130/85 mmHg) significativamente superior ao grupo controle (18,6% vs. 9,9%, respectivamente; p<0,05). Mulheres com SOP apresentaram valores mdios superiores de PA sistlica, ndice de massa corporal (IMC), circunferncia da cintura (CC), triglicerdeos e glicemia de jejum, alm de nveis inferiores de HDL - colesterol, em comparao ao grupo controle (p<0,01). No grupo SOP, os valores de PA sistlica e diastlica apresentaram correlao positiva significativa com a idade, IMC, CC e triglicerdeos (p<0,05). A freqncia de mulheres com valores de PA acima do limite da normalidade foi significativamente maior no grupo SOP, em relao ao grupo controle. Adicionalmente, os valores de PA se correlacionaram positivamente com outros fatores de risco cardiovascular como obesidade e nveis de triglicerdeos. Esses achados alertam para a relevncia de estratgias preventivas em mulheres com SOP, no sentido de evitar eventos mrbidos relacionados ao sistema cardiovascular
Resumo:
Nas ltimas dcadas, houve grande aumento da prevalncia de obesidade, inclusive na faixa etria peditrica. Com isso, aumentou o nmero de crianas e adolescentes afetados por sndrome metablica (SM), diabetes tipo 2 (DM2) e doenas cardiovasculares (DCV), doenas anteriormente consideradas quase exclusivas de adultos. Os objetivos do estudo foram identificar e correlacionar marcadores antropomtricos (IMC- ndice de massa corprea, CA- circunferncia abdominal, RCQ- razo cintura/quadril, RCArazo cintura altura e PSE- prega subescapular), PAS e PAD- presso arterial sistlica e diastlica, respectivamente, e laboratoriais (CT- colesterol total, HDL, LDL, TGL- triglicrides, I/G- razo insulina glicose, HOMA- homeostatic model assessment for insulin resistance) de risco para o desenvolvimento de SM e observar a sua prevalncia em crianas e adolescentes com excesso de peso. Foi conduzido estudo transversal, em amostra aleatria, de convenincia, onde foram avaliadas 60 crianas e adolescentes com excesso de peso, atendidas no ambulatrio de endocrinologia peditrica do Hospital de Pediatria da Universidade Federal do Rio Grande do Norte (UFRN) com idade mnima e mxima de 7 e 15 anos, de maio de 2009 a abril de 2010. Foram admitidos os indivduos que apresentavam sobrepeso (IMC P > 85 e < 95) ou obesidade (IMC P > 95) (CDC, 2000) e histria familiar positiva para DM2 em parentes de primeiro ou segundo grau ou algum dos sinais de resistncia insulnica (acantose, hipertenso arterial, dislipidemia, sndrome de ovrios policsticos). 2 O componente individual para SM mais prevalente foi o percentil da CA ≥ 90 (58,3%), seguido de HDL ≤ 40 mg/dl (36,6%). Na regresso linear simples, observaram-se as variaes para mais nos parmetros laboratoriais e de PA para cada unidade de aumento de IMC, CA, RCA, RCQ e PSE, sendo significantes as seguintes correlaes: CA com TGL, HOMA IR, I/G, PAS e PAD; RCQ com TGL, HOMA, I/G, LDL e glicemia; RCA com TGL; PSE com TGL, HOMA-IR, I/G e PAS; e IMC com HOMA IR, I/G, PAS e PAD. De acordo com os critrios da IDF (Federao Internacional de Diabetes International Diabetes Federation) 2007, o diagnstico de SM foi encontrado em seis indivduos (10%). Do total, oito (13,3%), estavam em situao de sobrepeso e 52 (86,6%), obesos. As evidncias de correlao CA e RCQ, medidas de obesidade centrpeta, com vrios marcadores como TGL e HOMA, j sabidamente relacionados SM, chamam ateno para a necessidade de utilizao dessas medidas de forma mais rotineira na prtica peditrica, por serem de fcil obteno, baixo custo e mtodo no invasivo. Os valores de CA, RCQ, RCA e PSE, quando elevados devem justificar maior detalhamento na avaliao laboratorial de possvel resistncia insulnica. importante a identificao de crianas e adolescentes que preencham os requisitos para o diagnstico da SM, pois so indivduos de maior risco metablico e devem ser adequadamente acompanhados.
Resumo:
Objetivos: Estimar a prevalncia de alteraes do filme lacrimal e da doena do olho seco (DOS), comparar as mudanas na presso intraocular (PIO) e comparar as espessuras macular e da camada de fibras nervosas da retina (CFNR), entre mulheres com sndrome dos ovrios policsticos (SOP) e mulheres saudveis, estratificando-as em condies clnicas, metablicas e inflamatrias. Metodologia: O estudo incluiu 45 mulheres com SOP e 47 mulheres saudveis ovulatrias submetidas a avaliaes clnico-ginecolgicas e oftalmolgicas, incluindo propeduticas para a avaliao do filme lacrimal e medida da PIO, e medio da espessura macular, da CFNR e parmetros do disco ptico usando tomografia de coerncia ptica. Resultados: Tempo de ruptura do filme lacrimal (TRFL; p=0.001) e impregnao por fluorescena (p=0.006) apresentaram diferenas estatisticamente significantes entre os grupos estudados. A prevalncia de DOS foi de 44,4% nas portadoras de SOP. Houve reduo estatisticamente significativa do TRFL na presena de SOP (p=0.001). Alm disso, houve efeito estatisticamente significativo de intolerncia glicose e sndrome metablica/inflamao na impregnao por fluoresceina (p=0.004; p=0.015, respectivamente). A PIO encontrou-se estatisticamente mais elevada no grupo SOP que no grupo controle (p=0.011). Houve um aumento na mdia do IPC (ndice presso-crnea) com a associao entre SOP e da sndrome metablica (p = 0.005); A mdia da espessura da CNFR superior ao redor do nervo ptico foi estatisticamente mais espessa nas voluntrias com SOP que nas voluntrias saudveis (p=0.036); Aps estratificao pela presena de resistncia insulnica, as mdias dos subcampos das espessuras maculares macular interno temporal, macular interno inferior, macular interno nasal e macular externo nasal, foram mais espessas no grupo SOP que no grupo controle (p<0.05); Houve associao significativa entre obesidade e resistncia insulnica (p=0.037), e intolerncia glicose (p=0.001), com aumento mdio do componente principal 1 (CP1), e, na presena de sndrome metablica (p<0.0001), com aumento mdio do componente principal 2 (CP2), respectivamente, em relao espessura macular total. Na presena de obesidade e inflamao, houve reduo no escore mdio da CP2 (p=0.034), em relao espessura da CFNR na mcula. xviii Concluses: H uma associao da SOP, suas alteraes metablicas e inflamatrias com alteraes do filme lacrimal e com mudanas na PIO. A diminuio na espessura da CFNR macular e aumento da espessura total macular esto possivelmente associadas s alteraes metablicas, e, o aumento na espessura da CFNR ao redor do nervo ptico esto provavelmente associadas s alteraes hormonais, inerentes SOP.
Resumo:
A associao entre fatores de risco cardiovascular (FRCV) na psmenopausa e o antecedente de irregularidade menstrual no menacme foi avaliado em estudo caso-controle envolvendo 414 mulheres na psmenopausa com idade de 60,4 5,5 anos e IMC de 25,3 4,7 kg/m2. As variveis consideradas foram: caracterizao do ciclo menstrual entre 20 e 35 anos (independente) e relato atual sobre ocorrncia de hipertenso arterial, dislipidemia, diabetes mellitus e doena arterial coronariana (dependentes). Utilizou-se o teste qui-quadrado e modelos de regresso logstica, ajustados para outras variveis implicadas no risco para doenas CV, com nvel de significncia 5%. Observou-se que mulheres que relataram irregularidade menstrual prvia estiveram associadas com risco aumentado para ocorrncia de algum FRCV [odds ratio ajustado (OR)= 2,14; IC-95%= 1,024,48], quando comparadas quelas com ciclos regulares. Anlise estratificada demonstrou as seguintes associaes significativas com o antecedente de irregularidade menstrual: hipertenso arterial (OR= 2,4; 95% IC= 1,395,41), hipercolesterolemia (OR= 2,32; 95% IC= 1,174,59), hipertrigliceridemia (OR= 2,09; 95% IC= 1,104,33) e angioplastia coronariana (OR= 6,82; 95% IC= 1,4432,18). Os dados sugerem que o antecedente de irregularidade menstrual, indicativo da ocorrncia da sndrome dos ovrios policsticos na idade reprodutiva, pode estar relacionado com aumento do risco para doenas CV na ps-menopausa __________________________________________________ABSTRACT Menstrual Cycle Irregularity as a Marker of Cardiovascular Risk Factors at Postmenopausal Years.To evaluate the association between cardiovascular risk factors (CVRF)during postmenopausal years and previous menstrual irregularity during reproductive years, we performed a case-control study in 414 postmenopausal women (mean age 60.4 5.5 years; BMI 25.3 4.7 kg/m2). The variables assessed were: menstrual cycle characteristics at age 2035y (independent) and records of arterial hypertension, dyslipidemia, diabetes mellitus, and coronary heart disease (dependent). Statistical analysis used the chi-square test and logistic regression, adjusting for potential confounders for cardiovascular risk, with significance set at 5%. Women reporting previous menstrual irregularity were associated with increased risk for some CVRF [adjusted odds ratio (OR) 2.14; CI-95%= 1.024.48], when compared with those reporting regular menstrual cycles. Stratified analysis demonstrated significant associations of previous menstrual irregularity with: arterial hypertension [OR= 2.74; CI-95%= 1.395.41), hypercholesterolemia (OR= 2.32; CI-95%= 1.174.59), hypertriglyceridemia (OR= 2.09; CI-95%=1.104.33), and coronary angioplasty (OR= 6.82; CI-95%= 1.4432.18). These data suggest that a prior history of menstrual irregularity, as indicative of polycystic ovary syndrome, may be related to increased risk for CVD during postmenopausal years
Resumo:
Estudar a incidncia e fatores de risco (tempo de doena e presena de hipertenso arterial sistmica) para retinopatia diabtica em 1002 pacientes encaminhados pelo Programa de Diabetes do Hospital Universitrio Onofre Lopes no perodo de 1992 1995. Mtodos: Estudo retrospectivo de pacientes com diagnstico de diabetes mellitus encaminhados ao Setor de Retina do Departamento de Oftalmologia pelo Programa de Diabetes do Hospital Universitrio e submetido, sob a superviso do autor, a exame oftalmolgico, incluindo medida da acuidade visual corrigida (tabela de Snellen), biomicroscopia do segmento anterior e posterior, tonometria de aplanao e oftalmoscopia binocular indireta sob midrase(tropicamida 1% + fenilefrina 10%). Foi realizada anlise dos pronturios referente ao tempo de doenas e diagnostico clnico de hipertenso arterial sistmica. Resultados: Dos 1002 diabticos examinados (em 24 deles a fundoscopia foi invivel), 978 foram separados em 4 grupos: sem retinopatia diabtica (SRD), 675 casos (69,01%); com retinopatia diabtica no proliferativa (RDNP), 207 casos (21,16%); com retinopatia diabtica proliferativa (RDP), 70 casos (7,15%); e pacientes j fotocoagulados (JFC), 26 casos (2,65%). Do total, 291 eram do sexo masculino (29%) e 711 do sexo feminino (71%). Os 4 grupos foram ainda avaliados quanto ao sexo, a faixa etria, a acuidade visual, tempo de doena, presena de catarata e hipertenso arterial sistmica e comparados entre si. Com relao ao tipo de diabetes, 95 eram do tipo I (9,4%), 870 pacientes eram do tipo II (86,8%), e em 37 casos(3,7%) o tipo de diabetes no foi determinado. Concluses: Comprovou-se que os pacientes com maior tempo de doena tinham maior probabilidade de desenvolver retinopatia diabtica, e que a hipertenso arterial sistmica no constituiu fator de risco em relao diminuio da acuidade visual nos pacientes hipertensos
Resumo:
The aims of this study were to analyze the access of dental services by child population, to determine the prevalence of dental caries, gingivitis and malocclusion in resident children from the municipal district of Sobral Cear and to evaluate the incidence of the dental decay in adolescents associated with the factors related to socioeconomic condition, access to health services and self-perception. This study had as main factor the multidisciplinary represented by the participation of health professional (doctors, dentists, nurses) in the development of the survey's initial reference; student from Human Sciences area to apply the structured questionnaire in domiciliary visits; statistics professionals in the orientation of the analysis to be held and family health team (community health agents, dentists and dental clinic assistants) in the scheduling of domiciliary visits and the accomplishment of oral exam. The sample was determined from the domicile record that included children born between 1990 and 1994 to develop the research Children health conditions in the municipal district of Sobral Cear . The first sample comprised 3425 parents of children from 5 to 9 years old, living in the urban area at the municipal district of Sobral Cear, aiming at identifying the most important factors associated to the access to dental service. From this sample, 1021 children were selected in a systematic way, for the accomplishment to the epidemiological study of decay, gingivitis and malocclusion. In the study's third phase, in order to arrange the group to be followed, 688 adolescents were examined and interviewed, by means of the active search from the 1021 individuals that had been previously examined. It was observed that 50.9% of the children had access to dental service at least once in a lifetime. Of this total, 65.3% accomplished it during the last year, and 85.4% of these did in public services, what allows to identify the importance of this sector in the access to dental services. It was observed that the factors that most affected the access to dental 129 services were related to socioeconomic condition, such as the access to health plan, the possession of toothbrush, garbage collecting, mother s schooling, sewerage treatment and malnutrition. In relation to oral diseases, an increase in the DMF-T index according the age was observed, from 0.10 in five years old to 1.66 in the nine years old, while with the dmf-t index, the inverse happened, since the index decreased from 3.59 in five years old to 2.69 in nine years old. In relation to gingivitis, an average 32.7% of the children presented gum bleeding. In what concerns malocclusion, it was observed that 60.3% of the children didn't present any problem, 30.17% had light malocclusion and 9.5% severe malocclusion. The average incidence of dental caries was 1.86 teeth per youngster. Among the studied variables, tooth pain in the last six months, mother's income and school snack, adjusted by the perception about the need of treatment, the mother's schooling and the dentist's appointment at least once in a lifetime, were the variables that presented positive relationship with the high incidence of dental caries on this population by logistic regression. Variables of socioeconomic nature, related to the access to health services and behavior and biological variables presented a relationship with the high caries incidence. The study point out to the need of developing health actions in a humanized way, by an oral health team effectively bound to the population's interest, with the great objective to provide, with the public health services managers, adequate conditions to improve oral health
Resumo:
Alterations in the neuropsychomotor development of children are not rare and can manifest themselves with varying intensity at different stages of their development. In this context, maternal risk factors may contribute to the appearance of these alterations. A number of studies have reported that neuropsychomotor development diagnosis is not an easy task, especially in the basic public health network. Diagnosis requires effective, low-cost, and easy - to-apply procedures. The Denver Developmental Screening Test, first published in 1967, is currently used in several countries. It has been revised and renamed as the Denver II Test and meets the aforementioned criteria. Accordingly, the aim of this study was to apply the Denver II Test in order to verify the prevalence of suspected neuropsychomotor development delay in children between the ages of 0 and 12 months and correlate it with the following maternal risk factors: family income, schooling, age at pregnancy, drug use during pregnancy, gestational age, gestational problems, type of delivery and the desire to have children. For data collection, performed during the first 6 months of 2004, a clinical assessment was made of 398 children selected by pediatricians and the nursing team of each public health unit. Later, the parents or guardians were asked to complete a structured questionnaire to determine possible risk indicators of neuropsychomotor development delay. Finally the Denver II Developmental Screening Test (DDST) was applied. The data were analyzed together, using Statistical Package for Social Science (SPSS) software, version 6.1. The confidence interval was set at 95%. The Denver II Test yielded normal and questionable results. This suggests compromised neuropsychomotor development in the children examined and deserves further investigation. The correlation of the results with preestablished maternal risk variables (family income, mother s schooling, age at pregnancy, drug use during the pregnancy and gestational age) was strongly significant. The other maternal risk variables (gestational problems, type of delivery and desire to have children) were not significant. Using an adjusted logistic regression model, we obtained the estimate of the greater likelihood of a child having suspected neuropsychomotor development delay: a mother with _75 4 years of schooling, chronological age less than 20 years and a drug user during pregnancy. This study produced two manuscripts, one published in Acta Cirrgica Brasileira , in which an analysis was performed of children with suspected neuropsychomotor development delay in the city of Natal, Brazil. The other paper (to be published) analyzed the magnitude of the independent variable maternal schooling associated to neuropsychomotor development delay, every 3 months during the first twelve months of life of the children selected.. The results of the present study reinforce the multifactorial characteristic of development and the cumulative effect of maternal risk factors, and show the need for a regional policy that promotes low-cost programs for the community, involving children at risk of neuropsychomotor development delay. Moreover, they suggest the need for better qualified health professionals in terms of monitoring child development. This was an inter- and multidisciplinary study with the integrated participation of doctors, nurses, nursing assistants and professionals from other areas, such as statisticians and information technology professionals, who met all the requirements of the Postgraduate Program in Health Sciences of the Federal University of Rio Grande do Norte
Resumo:
Body image is the figure of our bodies built in our minds and the degree of dissatisfaction is often associated with risk factors identified by anthropometric measures. The purpose of this descriptive study was to evaluate the risk factors associated to morphological and functional variables associate to the perception of auto-image in middle-aged walkers of the south zone of the city of Natal. A hundred and thirty volunteers had been evaluated in four groups in function of the gender and age group. As measurement evaluations were used an auto-image perception questionnaire proposed by Stunkart of nine silhouettes numbered for both gender was applied; a weighing machine equipped with stadiometer for the body mass (kg) and stature (m) and the body mass index (kg/m2) that was calculated with base in measures of the body weight and stature and classified according to norms of the National Institute of Health (2000) as well as the systolic and diastolic blood pressure by a electronic digital device (DIGITRONIC). A metal anthropometric tape was used for the waist to hip ratio (WHR). It was used Analyses of variance (ANOVA) one-way, post hoc of Tukey and correlation of Spearman for the nonparametric data adopting the level of ρ≤ 0,05 for rejection of the null hypothesis. The body mass index indicated high factors of risk in the consisting groups. In all the groups were registered the desire to reduce their silhouettes. The body weight shows reduced when compared with the younger group in the male group of superior age group, while in the female group the inverse one occurs. The autoimage perception is associated with the classification of the waist to hip ratio in the female gender in the age group of the 50 to the 59 years and in the classification of the body mass index of all constituted groups. Significant associations had not been found for classification of the systolic and diastolic blood pressure in relation to the auto-image 41 perception. This thesis presents relation of interdisciplinarity and its contents have application in the fields of Physical Education, Medicine, Physiotherapy and Nursing
Resumo:
Preeclampsia is a spectral disease, with different clinical forms which can evolve with severe multisystemic complications. This present study aimed to determine the risk factors associated with preeclampsia (PE); to validate the existence of aggregation of hypertensive disease in families of women with preeclampsia and verify the existence of association between polymorphisms in the VEGF gene and level of VEGF and its soluble receptor (sFlt1). A case-control study was performed (n = 851). Genotyping of VEGF was performed and serum levels of VEGF and sFlt1 were measured by ELISA. It was observed that 38% of mothers (173, 455) of a case of preeclampsia and 30.8% (78 of 361) of controls had history of hypertension (p <0.0001). Similarly, when examining the history of maternal preeclampsia, we observed that 14.6% (48 of 328) of mothers of women with preeclampsia and 9.6% (12 of 294) of mothers of controls had a history of preeclampsia (p = 0.0001). As for maternal history of preeclampsia, we found that 5.1% (15 of 295) of cases and 3.6% (7 of 314) of controls had a history of preeclampsia (p = 0.0568). Sisters of women with preeclampsia also had a history of hypertensive disease in 9% (41 of 455) versus 6.6% (13 of 361), p = 0.002. Similarly when examining the history of preeclampsia in sisters, it was observed that 22.7% (57 of 251) of a sister of case versus 11.4% (26 of 228) of controls had a history of preeclampsia (P = 0.0011). We observed a decrease in free VEGF in the serum of patients (P <0.05) and increased soluble VEGF receptor. There was no association between polymorphisms in the VEGF gene and preeclampsia. The data obtained in this work validate that hypertensive disease in mothers and sisters with preeclampsia are risk factors for preeclampsia. The risk of illness in the family is higher according to disease severity. High incidence of preeclampsia can be assumed by the high incidence of this disease among the controls. Significant differences between the frequency of preeclampsia in mothers of cases and controls indicate familial factors. Work is being conducted with the to eventually perform genome wide association studies to identify susceptibility loci
Resumo:
Resilience consists of a capacity to adapt and overcome situations of risk, from the aid of protective factors. This construct constitutes a process of preventive and multidimensional present in all stages of human development. During this development, it has been immersed in the elderly biopsychosocial changes resulting from the aging process. In this sense, there was a need for a multidisciplinary study, combining psychology, medicine, nursing, social work and gerontology in order to check the resilience, its risk factors, such as life events and health, and protection, such as self-esteem and social support. For this, we performed a descriptive exploratory study of cross-sectional nature, along with a convenience sample consisting of 65 elderly users of the public health of the district east of the city of Natal/RN, Brazil. This research allowed the collection of socio-demographic, economic, relational, physical, biological and psychological in understanding the aging process. It is observed that the studied sample socio-economic status and chronic health conditions in their own lives and their families, that demand for care and attention every day, are resilient, have faced significant losses, have positive self-esteem and social support perceived as external satisfactory. Given this multidimensional nature, the aging process deserves the attention of many professionals and health policies, seeking provide to the elderly a better living conditions and mechanisms that promote well-being and health
Resumo:
Post-menarche patients with clinical signs of vulvovaginitis were analyzed in this study, whose aims were the following: identify the frequency of C. albicans and non C. albicans species and negative results, correlate the vaginal culture for yeast with risk factors and symptomatology; compare positive and negative results for yeast in the vaginal and anal cultures; compare the positive results for C. albicans with other results found in the vaginal and anal cultures; and compare concomitant positivity for C. albicans and non C. albicans in the vaginal and anal cultures. Sample selection occurred between May, 2003 and May, 2005, and included 99 patients from Natal, Brazil. The laboratory methods used consisted of CHROMagar Candida culture medium, thermotolerance test at 42-45C and hypertonic NaCL, in addition to the classic methods of carbohydrate assimilation and fermentation. We used absolute numbers, percentages, means of central tendency, chi-squared test (χ2) with Yates correction, Fisher s exact test and odds ratio for statistical analysis. The most frequent species was C. albicans in 69% of the cases. The positivity for Candida spp showed an association with the use of tight-fitting intimate clothing and/or synthetics, allergic diseases and the occurrence of itching, leukorrhea and erythema. Anal colonization increased the likelihood of vaginal contamination by 2.8 and 4.9 times, respectively, for Candida spp and C. albicans. When compared to the other species, C. albicans-positive anal colonization increased by 3.7 times the likelihood of vaginal positivity. These data suggest likely vaginal contamination originating in the anus
