Estado nutricional antropom��trico, composi����o corporal e pressão arterial em adolescentes

Os objetivos deste trabalho foram: (1) estimar as preval��ncias de excesso de peso e de gordura corporal, obesidade central e pressão arterial elevada (PAE) em adolescentes benefici��rios do Programa Nacional de Alimenta����o Escolar (PNAE) da rede municipal de ensino de Natal-RN; (2) verificar a associa����o entre vari��veis antropom��tricas e de composi����o corporal com a pressão arterial, a matura����o sexual e a hist��ria familiar positiva de fatores de risco para doen��a cardiovascular (FRDCV); (3) comparar dois padr��es de refer��ncia para classifica����o do excesso de peso em adolescentes; e (4) propor equa����es preditivas de massa gorda (MG) e massa livre de gordura (MLG) baseadas nos per��metros corporais. Trata-se de um estudo transversal, com 526 adolescentes benefici��rios do PNAE, em Natal, Brasil. O tamanho da popula����o de estudo foi definido por amostragem aleat��ria, em dois est��gios, e ponderada segundo n��mero de alunos de cada escola. No primeiro estudo, o excesso de peso foi determinado por ��ndice de Massa Corporal (IMC), a gordura corporal estimada por dobras cut��neas e a obesidade central por per��metro abdominal. A pressão arterial elevada foi classificada conforme a American Academy of Pediatrics. As preval��ncias foram apresentadas em valores relativos e efeito do desenho. Realizou-se uma an��lise fatorial para sintetizar o conjunto de vari��veis antropom��tricas visando identificar fatores comuns. Extra��ram-se dois fatores: (1) padr��o excesso de adiposidade e (2) padr��o adiposidade central elevada. Para avaliar a associa����o entre os padr��es de adiposidade corporal com pressão arterial elevada, faixa et��ria, matura����o sexual e hist��ria familiar de FRDCV utilizou-se a Raz��o de Chances e respectivo intervalo de confian��a de 95% e regress��o log��stica. No segundo estudo, calculou-se a sensibilidade e a especificidade do excesso de peso classificado segundo o IOTF e a World Health Organization WHO em rela����o ao excesso de adiposidade corporal; e a estat��stica Kappa para medir a concord��ncia entre os dois padr��es de refer��ncia. No terceiro estudo, foram elaborados modelos preditivos de MG e MLG com base em nove per��metros corporais, utilizando a bioimped��ncia Byodinamics 450 como padr��o de refer��ncia. Para tanto foram selecionados 218 adolescentes eutr��ficos, segundo o IMC a partir do estudo transversal. As equa����es foram estimadas por regress��o linear m��ltipla, considerando a idade e os per��metros corporais. Os resultados apontaram que 14,1% dos meninos e 15,7% das meninas tinham excesso de peso; 15,3% dos meninos e 11,6% das meninas tinham excesso de gordura corporal e dentre os meninos 14,3% tinham pressão arterial elevada e as meninas, 21,4%. Todos os efeitos do desenho foram inferiores a 2,5%. Nos meninos, o padr��o excesso de adiposidade foi associado �� hist��ria familiar positiva de FRDCV (ORajust=2,60; 1,09-6,22), matura����o sexual (ORajust=2,92; 1,04-8,22) e PAE (ORajust=3,66; 1,34-9,94). Os meninos com 12 anos e mais apresentaram 6,1 vezes mais chance de apresentar padr��o adiposidade central elevada do que os adolescentes com 10 a 11 anos (IC95% 2,32-16,04), assim como os p��beres apresentaram 3,2 vezes este mesmo padr��o em rela����o aos pr��-p��beres (IC95%1,14-8,85). A partir da compara����o entre os dois padr��es de referencia de classifica����o do excesso de peso por meio do IMC, observou-se que a sensibilidade foi de 79,3% para o crit��rio IOTF e de 88,9% para WHO e a especificidade foi de 94,7% e 89,9%, respectivamente. O n��vel de concord��ncia foi maior para o crit��rio IOTF (Kappa=0,70 x Kappa=0,64). Em rela����o �� constru����o das equa����es preditivas de gordura corporal, do total de 106 meninos e 112 meninas, foram desenvolvidas duas equa����es para estimar MG e duas para MLG, considerando o sexo. No sexo masculino, a equa����o para estimar a MG incluiu as vari��veis idade, punho, quadril e per��metro abdominal (R2=0,552; AIC=416,04) e MLG, idade, punho e antebra��o (R2=0,869; AIC=578,24). Enquanto que no feminino, MG foi estimada pelas vari��veis punho, per��metro do abd��men, do quadril, da coxa proximal e da panturrilha (R2=0,838; AIC=415,36); e a MLG por idade, punho, per��metro do abd��men, do quadril e da panturrilha (R2=0,878; AIC=512,48). Conclui-se que os adolescentes tinham elevada preval��ncia de excesso de adiposidade corporal e de pressão arterial elevada. Tanto o padr��o excesso de adiposidade quanto adiposidade central elevada constituem-se em padr��es de risco. O padr��o excesso de adiposidade foi associado �� pressão arterial, hist��ria familiar positiva de FRDCV e matura����o sexual em meninos. O crit��rio IOTF mostrou-se menos sens��vel, mais espec��fico, com maior n��vel de concord��ncia e maior probabilidade de identificar corretamente o excesso de gordura corporal nos adolescentes avaliados. Quatro equa����es foram desenvolvidas para a estimativa da MG e MLG em adolescentes. As equa����es desenvolvidas para estimar a MG no sexo feminino e MLG para ambos os sexos apresentaram valores elevados de coeficiente de determina����o ajustados e, portanto, s��o as preferenciais. Este estudo foi realizado com a participa����o de equipe multidisciplinar composta por professores da ��rea de Nutri����o, Endocrinologia Pedi��trica, Estat��stica, Educa����o F��sica, discentes do Curso de Gradua����o em Nutri����o e residentes em Pediatria

Associa����o da frequ��ncia al��lica dos polimorfismos dos genes do sistema renina angiotensina com a for��a muscular e pressão arterial de idosas

Physiological changes induced by the aging process is dynamic and progressive, reducing the adaptability and independence of older people and may be influenced by genetic and environmental factors. Thus the aim of this thesis was to investigate the association between polymorphism of the ACE gene ID and the phenotypes of muscular strength and blood pressure of 62 elderly Brazilian (67.35 �� 5.66 years) during a 16-week program of supervised training. The elderly women were stratified by age, with the group 1 (G1, n = 34) <70 years and group 2 (G2 n = 28) &#8805; 70 years, and in three groups by ACE, ACE-II (n = 8) ACE- DD (n = 35) and ACE-ID (n = 19). The level of muscle strength was evaluated by the method of maximum repetitions and measures of blood pressure (BP) were measured before and after training (PAPr��1 and PAP��s1) and before and after each training session (PAPre2 and PAP��s2), in place of training. DNA samples were isolated from peripheral blood leukocytes polymorphism and insertion / deletion (ID) of the ACE gene (rs1800795) was genotyped by polymerase chain reaction (PCR) plus PCR-confirmatory. The genotype distribution of the polymorphism ID attended the prerogatives of Hardy-Weit��herg. There was variation in power levels before and after training and the age between groups (t-test) and the ACE polymorphism (ANOVA) (p <0.05). Depending on the results it was concluded that resistance training helps to reduce SBP and increased muscle strength of upper and lower limbs when considering the age and ACE polymorphism. In this study the Elderly carriers of the D allele were more reactive to changes in BP resistance training. This study was multidisciplinary project involving researchers in the areas Medical, Physical Education, Pharmacy, Nutrition, Gerontology and Statistics. This fulfilled the requirements of the multidisciplinary Graduate Program in Health Sciences

Valida����o de instrumentos para avalia����o da habilidade e do conhecimento acerca da medida da pressão arterial

This study aimed to validate tools for evaluating the ability and knowledge about blood pressure (BP) among nursing students. It is a cross-sectional, descriptive, quantitative and methodological study accomplished at the Universidade Federal do Rio Grande do Norte (UFRN), Universidade do Estado do Rio Grande do Norte (UERN) and a private university of the state. The sample consisted of 27 judges of research selected from the inclusion criteria: nursing, teachers of the semiology and/or semiotics discipline, with at least 1 year of experience, being from UFRN, EEN, UERN and private university of the state and and agree to participate voluntarily with the signing of the consent form. The research was development in three stages: construction of two instruments based on the scientific literature, resulting in a structured checklist consists of 28 items and a knowledge questionnaire with 12 questions; submission of the instruments to the judges, in the period from June to September 2012, which should evaluate each item in appropriate , appropriate with changes and inappropriate , addition to making an overall assessment of each instrument based on 10 requirements; validation and verification to the level of agreement among the judges, through the application of Kappa and Content Validity Index (CVI). Was used the consensus level greater than 0.61 (good) to the Kappa index and greater than 0.75 for CVI. Was approved by the Ethics in Research / HUOL. After being coded and tabulated, the data were analyzed using descriptive statistics. Of the 27 judges who evaluated the instrument, 77.8% are female, with a mean age of 36.6 (�� 9.0) years, 63.0% worked in UFRN, 74.1% had academic master and 63.0% worked exclusively on teaching. Average length of teaching experience was 7.9 (�� 8.0) years and in the semiology and/or semiotics discipline of 5.5 (�� 6.7) years. In the judgment of structured checklist and questionnaire of knowledge about blood pressure mensurement any item/question was considered inappropriate since all obtained level of agreement within the indices established (CVI> 0,75 E Kappa> 0.61). In relation to structured checklist, of those 28 items present, 9 showed perfect concordance index (CVI = 1.00, Kappa = 1.00) and another 19 were considered appropriate with changes, especially with regard to clarity and vocabulary. In the questionnaire of knowledge, among the 12 questions that comprised, 7 had perfect concordance index and the others were considered appropriate with changes as requirements as clarity, vocabulary, and feasible sequence of instructional topics. In terms of a overall evaluating of instruments, the structured checklist got CVI of 0.94 and Kappa of 0.89 and the knowledge questionnaire, CVI of 0.97 and a kappa of 0.94. Both instruments proved to be valid as to their content, configuring it as clear and objective tools of assessment of knowledge and ability on blood pressure, being of nursing students as well as others students and health professionals, since the use of valid measures seeking to reduce the risk of distorting the results

Controlador preditivo generalizado multi-modelo aplicado ao controle de pressão arterial

Postsurgical complication of hypertension may occur in cardiac patients. To decrease the chances of complication it is necessary to reduce elevated blood pressure as soon as possible. Continuous infusion of vasodilator drugs, such as sodium nitroprusside (Nipride), would quickly lower the blood pressure in most patients. However, each patient has a different sensitivity to infusion of Nipride. The parameters and the time delays of the system are initially unknown. Moreover, the parameters of the transfer function associated with a particular patient are time varying. the objective of the study is to develop a procedure for blood pressure control i the presence of uncertainty of parameters and considerable time delays. So, a methodology was developed multi-model, and for each such model a Preditive Controller can be a priori designed. An adaptive mechanism is then needed for deciding which controller should be dominant for a given plant

Implementa����o de um sistema embarcado aplicado ao controle de pressão arterial

Hypertension is a dangerous disease that can cause serious harm to a patient health. In some situations the necessity to control this pressure is even greater, as in surgical procedures and post-surgical patients. To decrease the chances of a complication, it is necessary to reduce blood pressure as soon as possible. Continuous infusion of vasodilators drugs, such as sodium nitroprusside (SNP), rapidly decreased blood pressure in most patients, avoiding major problems. Maintaining the desired blood pressure requires constant monitoring of arterial blood pressure and frequently adjusting the drug infusion rate. Manual control of arterial blood pressure by clinical personnel is very demanding, time consuming and, as a result, sometimes of poor quality. Thus, the aim of this work is the design and implementation of a database of tuned controllers based on patients models, in order to find a suitable PID to be embedded in a Programmable Integrated Circuit (PIC), which has a smaller cost, smaller size and lower power consumption. For best results in controlling the blood pressure and choosing the adequate controller, tuning algorithms, system identification techniques and Smith predictor are used. This work also introduces a monitoring system to assist in detecting anomalies and optimize the process of patient care.

Efeito do treinamento resistido na pressão arterial e capacidade funcional de idosas hipertensas

The results of studies about the ideal resistance training intensity for reduction of resting blood pressure levels, as well as this type of training to increase the functional capacity of hypertensive older women are still unclear, since the few investigations usually analyze young individuals normotensive, and the literature lacks precise information in elderly hypertensive subjects. Objectives: To determine the effect of two resistance training intensities on resting blood pressure and the effect of resistance training on functional capacity in elderly women with systemic arterial hypertension, analyzing these variables before and after eight weeks of intervention. Methods: Patients underwent eight weeks of resistance training, with a frequency of three times per week on alternate days, in the afternoon. The exercises performed were: leg press, bench press, knee extension, lat pull-down, knee flexion, shoulder abduction, standing cable hip abduction and biceps curl. Results: It was found that patients who underwent training with moderate resistance, showed a reduction on resting values of diastolic blood pressure (DBP) p<0.03 and of mean arterial pressure (MAP) p<0.03. Patients who underwent mild resistance training showed reduction in resting values of MAP (p<0.03) and a tendency to decrease in DBP (p<0.06). With regard to functional capacity, the results showed significant increase in the strength of arms and legs, agility and aerobic endurance (p<0.001) and maintaining flexibility (p>0.05). Conclusion: The data indicated that both mild and moderate resistance training, even when started in old age, promoted cardiovascular benefits and also improve the functional capacity of hypertensive older women.

Influ��ncia das medidas antropom��tricas sobre a pressão arterial sist��mica de hipertensos cadastrados nas unidades de sa��de da fam��lia no munic��pio de Jo��o Pessoa - PB

Este trabalho objetiva avaliar a influ��ncia das medidas antropom��tricas sobre a pressão arterial sist��mica de uma coorte de hipertensos atendidos nas Unidades de Sa��de da Fam��lia (USF) no munic��pio de Jo��o Pessoa-PB durante o per��odo de 2008 a 2011. Para verificar as diferen��as de n��veis press��ricos entre as medidas realizadas nas consultas referentes ao cadastro, e a ultima pressão obtida no per��odo de acompanhamento foram utilizadas informa����es sobre a identifica����o, dados cl��nicos do paciente, fatores de risco e doen��as concomitantes. Testes estat��sticos de comparabilidade entre grupos foram empregados. Para investigar os padr��es de associa����o dos fatores de risco das vari��veis antropom��tricas e sociodemogr��ficas com a hipertens��o dos pacientes, foi empregado o Modelo de Regress��o Log��stica. Foram encontradas associa����es significativas (p<0,005) da hipertens��o com a obesidade e o sedentarismo. Com os resultados desta pesquisa pretende-se: fornecer indicadores sobre a efetividade da Estrat��gia Sa��de da Fam��lia; avaliar a qualidade das informa����es antropom��tricas; contribuir para a defini����o de estrat��gias que garantam o melhoramento dos acompanhamentos dos hipertensos e fornecer elementos cient��ficos de apoio para outras USF e institui����es governamentais.

Hipertens��o arterial e fatores de risco em servidores atendidos pelo departamento de assist��ncia da Universidade Federal do Rio Grande do Norte

Systemic arterial hypertension is a multifactorial disease that contributes to the country��s high cardiovascular morbi-mortality rates. Considering that hypertension affects individuals in their most productive age while facing work and living risk factors, it is important to investigate its occurrence and predisposing factors in different occupational segments. The objective of this study was to identify the prevalence of hypertension among workers attended to in a medical service of a public university, their hypertension levels, the risk factors present, and their knowledge of the factors that influence the arterial pressure. The epidemiologic study was conducted in the Health Department of the Federal University of Rio Grande do Norte with 102 workers that sought care in the medical clinic during the months of March to May 2009. Data were collected by means of a questionnaire and measurements of systolic and diastolic arterial pressure (SAP and DAP) that were classified in stages according to the Brazilian Society of Hypertension and the degree of risk for cardiovascular events according to the criteria of the Brazilian Society for Cardiology. Data were analyzed using descriptive statistics. The workers were, on average, 54 years of age; the majority (67%) was male and had primary or middle educational level; they worked mainly in supplemental units and deanship offices conducting different functions such as security guards, administrative assistants, health auxiliaries and constructions workers; 48 (47%) of the workers identified themselves as hypertensive for 8 years on average, with the majority executing hard labor and administrative functions. Among the workers with hypertension, the number of the pressure levels classified as pre-hypertensive, stage I and II were: (12% in the SAP and 20% in the DAP); (16% in the SAP and 9% in the DAP); and (15% in the SAP and 5% in the DAP), respectively. The workers that did not identify themselves as hypertensive presented classifications with greater frequencies were: normal (16% in the SAP and 30% in the DAP); and pre-hypertensive (21% in the SAP and 16% in the DAP). The risk factors identified in more than 50% of the workers were: tobacco smoking, alcohol consumption and indices of being overweight, although physical activities are also present. Of the 48 workers diagnosed as hypertensive, those that had 5 risk factors present and limitrophic pressure levels (12%), in stage I hypertension (16%) and stage II hypertension (15��%) were categorized as being in high risk for vascular events. The number of workers that indicated they had knowledge of the factors that influence their hypertension was less than 39% for each factor. It is concluded that there is a high prevalence of systemic arterial hypertension in the university workers, even amongst those already under treatment. They constitute a population at risk considering their age group, their work functions, and their inadequate life habits. Health care of these hypertensive workers that seek attention in the Health Department is an important aspect of the internal workers health policy in the institution. Educational interventions are recommended for the improvement of quality of life and of work in these workers

Preval��ncia de doen��a arterial obstrutiva perif��rica (DAOP) e altera����es sensoriais em pacientes diab��ticos tipo 2: impacto da DAOP sobre a qualidade de vida, n��vel de atividade f��sica e composi����o corporal

Diabetes Mellitus (DM) affected approximately 171 million people in the world in the year 2000 as described by the World Health Organization (WHO). Because DM is a multisystem disease it can cause several complications especially those related to the cardiovascular system. The Peripheral Arterial Disease (PAD) of the lower limbs and the Diabetic Distal Symmetric Polyneuropathy (DDSP) can affect the DM patient causing consequences as the diabetic foot and eventually amputations. The main objective of this study was to determine the prevalence of PAD and sensorial impairment in 73 type 2 DM (DM2) patients and also assess the impact of PAD on quality of life, level of physical activity and body composition. For clinical assessment it was used: the ankle-brachial index (ABI); quantitative sensorial test for tactile sensibility (ST), pain (SD), vibration (SV); Achilles tendon reflex (RA); quality of life questionnaire (SF-36); modified Baecke physical activity questionnaire and bioelectric impedance. Prevalence of PAD in the studied population was 13.7%. ABI was inversely correlated to age (p=0,03; rh��= -0,26), diabetes duration (p=0,02; rh��= -0,28) and blood pressure (p= 0,0007; rh��= -0,33). There were lower scores for physical health summary on the SF-36 in DM2 patients; however, the presence of PAD predominantly mild did not significantly impact quality of life, body composition or physical activity level assessed by questionnaire. Fourteen patients (19.2%) present bilateral and symmetrical alterations in two or more sensorial tests compatible to DPN diagnosis. Abnormalities in ST, SD and SV were present in 27.3%, 24.6% and 8.2%; respectively. There was association of results from ST abnormalities with RA and mainly with SD, suggesting the importance of 10g monofilament use in DM2 routine assessment. In conclusion, the prevalence of PAD in subclinical DM2 was slightly higher compared to the general population and in agreement to previously published data in DM patients. The PAD severity was predominantly mild and still without repercussion on quality of life and body composition. Our study demonstrated a significant prevalence of both PAD and DPN in DM2 without previous diagnosis of these complications and indicates the necessity of early preventive and therapeutic interventions for this population

Caminhos e descaminhos da ades��o ao tratamento anti-hipertensivo :um estudo com usu��rios do Pacha (Programa de Assist��ncia e Cuidado da Hipertens��o Arterial) do Hospital Universit��rio Onofre Lopes

The high blood pressure is a multifactorial chronic disease which possesses emotional and social features in the illness appearance and evolution and in the adherence to the treatment which involves a decision-making through patient so that he or she process the necessary changes on harmful living habits. Adhesion, traditionally, it is referred to the patient to answer to the doctor orientations or of other health professional, about the appearance to the appointment with a doctor, about the use of medicine or lifestyle changes and maintaining this adhesion is the main problem to be overcame. It is expected the adhesion will ever be a continual, stable and satisfactory action, disregarding the complexity of subjectivity processes which permeate the sicken. This research aimed to investigate the difficulties which the person with high blood pressure has to adhere to the treatment, from the signification processes which give sense to the actions dealing with the adhesion. The study was carried out with 48 users of assistance program to the high blood pressure patient from Hospital Universit��rio from Natal RN, between 40-65 age. The answers were submitted to a double analysis process: 1) answer systematization in categories and codes and admission in statistical program SPSS (Statistical Package of Social Science), for generation of descriptive statistics; 2) Sense and signification analysis which permeated the deepener statement and interpretatively. The greater difficulties found are present on low-salt and law-calorie diets, in the dealing with everyday feeling and stress, being these factors cited as direct motive to the high blood pressure, regardless of interviewee s sex. It is observed there is not adhesion, but adhering, as an experienced everyday process. This work contributes with its results, assessing the used strategies by program with the aim of increasing the adhesion rates

��ndices de obesidade central e fatores de risco cardiovascular na s��ndrome dos ov��rios polic��sticos

Fundamento: A obesidade abdominal apresenta elevada preval��ncia em mulheres com s��ndrome dos ov��rios polic��sticos (SOP) e est�� associada a um aumento do risco cardiovascular. Objetivo: Verificar a acur��cia da circunfer��ncia da cintura (CC), da rela����o cintura-quadril (RCQ), da rela����o cinturaestatura (RCEST) e do ��ndice de conicidade (��ndice C), no que se refere �� detec����o de fatores de risco cardiovascular (FRCV) em mulheres com SOP. M��todos: Por meio de estudo transversal, foram alocadas 102 mulheres (26,5 �� 5 anos) com diagn��stico de SOP, de acordo com o consenso de Rotterdam. O colesterol total (CT), os triglicer��deos (TG), o LDL-colesterol (LDL-C), o HDLcolesterol (HDL-C), a glicemia de jejum, a glicemia ap��s teste oral de toler��ncia �� glicose (TOTG) e a pressão arterial (PA) foram avaliados em todas as pacientes, al��m das vari��veis antropom��tricas. Resultados: A rela����o cintura-estatura foi o marcador que apresentou correla����es positivas significativas com o maior n��mero de FRCV (PA, TG e glicemia ap��s TOTG), destacando-se ainda a correla����o negativa com HDL-C. Todos os marcadores antropom��tricos avaliados se correlacionaram positivamente com PA, enquanto CC e RCQ apresentaram correla����o positiva tamb��m com TG. No tocante �� acur��cia para detec����o de FRCV, os indicadores antropom��tricos considerados apresentaram taxas de sensibilidade superiores a 60%, com destaque para a RCEST, que apresentou sensibilidade superior a 70%. Conclus��o: A RCEST demonstrou ser o indicador antropom��trico com a melhor acur��cia para a predi����o de FRCV. Nesse sentido, prop��e-se a inclus��o desse par��metro de f��cil mensura����o na avalia����o cl��nica 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

Fun����o auton��mica em pacientes portadores de lipodistrofia generalizada cong��nita - sindrome de berardinelli - SEIP

A S��ndrome de Berardinelli-Seip ou Lipodistrofia Generalizada Cong��nita (LGC) �� uma doen��a rara, com transmiss��o autoss��mica recessiva, caracterizada principalmente pela aus��ncia quase total de tecido adiposo. Os pacientes afetados apresentam resist��ncia a insulina, dislipidemia e hipertens��o arterial. Estudos t��m evidenciado que estas altera����es metab��licas interferem na modula����o auton��mica para o n�� sinusal. O principal objetivo deste estudo foi investigar a modula����o auton��mica em pacientes portadores de LGC, atrav��s da variabilidade de freq����ncia card��aca (VFC), pelo m��todo linear de dom��nio de tempo na Eletrocardiografia Din��mica de 24 horas e estabelecer um crit��rio relativamente simples, n��o invasivo, para diagn��stico de disfun����o auton��mica nestes pacientes. Participou voluntariamente deste estudo transversal, um grupo de pacientes portadores de LGC (n=18) na faixa et��ria de 9,3 a 39,8 anos (21,3 �� 8,3) cuja variabilidade de freq����ncia card��aca foi comparada com um grupo de pacientes controles (n=19) com idade de 9,3 a 39,1 anos (21,4 �� 7,8). Todos os volunt��rios foram submetidos �� avalia����o cl��nica, laboratorial, antropom��trica e an��lise de VFC no dom��nio de tempo atrav��s de eletrocardiografia din��mica de 24 horas. Para an��lise dos dados relativos aos ��ndices temporais de VFC foram utilizados o MeanRR, SSDN e rMSSD. Pacientes com LGC apresentavam aumento da pressão arterial comparados com indiv��duos do grupo controle (sist��lica, 131,1 vs 106,3 mmHg, p<0,05); diast��lica, 85,0 vs 68,2 mmHg, p<0,05) e 10 tinham crit��rios para diagn��stico de Hipertens��o Arterial e Hipertrofia do Ventr��culo Esquerdo. Os n��veis de glicose, triglicer��deos, colesterol e HOMA-R eram elevados e 12 pacientes tinham crit��rios para diabetes mellitus tipo 2. Comparado com os controles, pacientes com LGC tinham diminui����o dos ��ndices MeanRR (639,8 vs 780,5 ms, p<0,001), SDNN (79,2 vs 168,5 ms, p<0,001), e rMSSD (15,8 vs 59,6 ms, p<0,001). Em pacientes com LGC, a redu����o da VFC foi independente de dist��rbios metab��licos e hemodin��micos. Os resultados de nosso experimento indicam que pacientes com LGC apresentavam modula����o auton��mica anormal caracterizada pelo aumento da freq����ncia card��aca e pronunciada redu����o da VFC, independente de dist��rbios metab��licos e hemodin��micos observados nesta s��ndrome. O car��ter multidisciplinar desse estudo fica contemplado pela intera����o de profissionais de diversas ��reas como: cardiologia, endocrinologia, metabolismo, neurologia, nutri����o, etc

Imagem corporal e fatores de risco em praticantes de caminhada da cidade do Natal-RN

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 &#961;&#8804; 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

S��ndrome metab��lica e risco cardiovascular na p��s- menopausa: avalia����o por diferentes crit��rios diagn��sticos e influ��ncia de fatores s��cio-econ��micos

The metabolic syndrome (MetS) involves a group of risk factors and is associated with a significantly higher risk of developing cardiovascular diseases (CVD) and type 2 diabetes. Recent studies have shown the importance of preventing CVD through early diagnosis and treatment of patients with MetS. The objective of our study was to determine the prevalence of MetS by different diagnostic criteria in postmenopausal women and analyze the influence of socioeconomic factors on cardiovascular risk in this sample of the population. A cross-sectional study involving 127 postmenopausal women (45 to 64 years) from Natal and Mossor��, Brazil. The study was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte. The experimental protocol consisted of applying structured interview, clinical examination and implementation of dosages blood. The diagnosis of MetS was based on NCEP-ATP III (National Cholesterol Education Program-Adult Treatment Panel III) and IDF (International Diabetes Federation) criteria. The research was accomplished with the participation of an interdisciplinary team in their several phases. The result of the sample studied had mean age of 53.9 �� 4.6 years and per capita income of 54.5 dollars. The prevalence of MetS, according to NCEP-ATP III and IDF criteria, was 52.8% and 61.4$, respectively. The agreement rate between NCEP-ATP III and IDF criteria was 81.9%, with a kappa value of 0.63 (CI 95%, 0.49-0.76), indicating good agreement between the two definitions. The most prevalent cardiovascular risk factor was HDL < 50 mg/dl, observed in 96.1% of the women analyzed, followed by increased waist circumference (&#8805; 80 cm) in 78.0%, elevated blood pressure in 51.2%, triglycerides &#8805; 150 mg/dl in 40.9% and glycemia &#8805; 100 mg/dl in 37.0% of the women. The occurrence of MetS was significantly associated with schooling and body mass index (BMI). High blood pressure was significantly associated with low family income, low schooling and weight gain. There was no significant association between the intensity of climacteric symptomatology and the occurrence of MetS. The conclusions of the research were that MetS and its individual components show a high prevalence in postmenopausal Brazilian women, and significant associations with weight gain and low socioeconomic indicators. The data point to the need for an interdisciplinary approach at the basic health care level, directed toward the early identification of risk factors and the promotion of cardiovascular health of climacteric women.

Acur��cia dos ��ndices antropom��tricos de obesidade central na determina����o de s��ndrome metab��lica e fatores de risco cardiovascular em mulheres com s��ndrome dos ov��rios polic��sticos

A s��ndrome dos ov��rios polic��sticos (SOP) �� a desordem end��crina mais comum em mulheres com idade reprodutiva. Seu diagn��stico �� firmado atrav��s do consenso de Rotterdam na presen��a de dois dos seguintes crit��rios: anovula����o cr��nica, sinais cl��nicos e/ou bioqu��micos de hiperandrogenismo e presen��a de micropolicistos nos ov��rios. Na SOP, al��m das caracter��sticas espec��ficas da s��ndrome �� comum a presen��a de marcadores de risco cardiovascular aumentado como dislipidemia, hipertens��o arterial, resist��ncia �� insulina e obesidade central Objetivos: Analisar a acur��cia diagn��stica da circunfer��ncia da cintura (CC), rela����o cintura-estatura (RCEst), raz��o cintura-quadril (RCQ) e ��ndice de conicidade (��ndice C) para detec����o de fatores de risco cardiovascular (FRCV) e s��ndrome metab��lica (SM) em mulheres com s��ndrome dos ov��rios polic��sticos (SOP). Metodologia: Foi realizado estudo transversal envolvendo 108 mulheres na faixa et��ria de 20-34 anos, com diagn��stico de SOP de acordo com o consenso de Rotterdam. Foram considerados par��metros cl��nicos, antropom��tricos e bioqu��micos de avalia����o do risco cardiovascular. A an��lise dos dados foi desenvolvida em duas etapas, conforme descrito a seguir. Fase 1: an��lise da acur��cia dos pontos de corte previamente determinados na literatura nacional para CC, RCEst, RCQ e ��ndice C, para predi����o de FRCV; Fase 2: determina����o de pontos de corte dos ��ndices antropom��tricos supracitados, espec��ficos para mulheres com SOP, para discrimina����o de SM, atrav��s da an��lise da curva ROC (Receiver Operating Characteristic). Resultados: Com base nos achados da fase 1 do estudo, a RCEst foi o marcador que apresentou correla����es positivas significativas com o xi maior n��mero de FRCV (pressão arterial, triglicer��deos e glicemia ap��s teste oral de toler��ncia �� glicose), al��m de correla����o negativa com HDL-colesterol. Os demais marcadores antropom��tricos se correlacionaram positivamente com pressão arterial, enquanto CC e RCQ apresentaram correla����o positiva tamb��m com triglicer��deos. Todos os indicadores antropom��tricos 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 predi����o de SM, sendo superiores ao ��ndice C. Os valores de ponto de corte dos ��ndices antropom��tricos 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. Conclus��es: Nossos dados enfatizam a import��ncia da avalia����o antropom��trica no rastreamento do risco cardiovascular em mulheres com SOP, destacando-se a relev��ncia da RCEst na predi����o de FRCV cl��ssicos e a necessidade de considerar pontos de corte espec��ficos para mulheres com SOP para discrimina����o de SM