Correlation of habitual physical activity levels with flow mediated dilation of the brachial artery in 5-10 year old children

Endothelial dysfunction is an early key event of atherogenesis. Both fitness level and exercise intervention have been shown to positively influence endothelial function. In a cross-sectional study of 47 children, the relationship between habitual physical activity and flow-mediated dilation (FMD) of the brachial artery was explored. Habitual physical activity levels (PALs) were assessed using a validated stable isotope technique, and FMD of the brachial artery was measured via high-resolution ultrasound. The results showed that habitual physical activity significantly correlated with FMD (r=0.39, P=0.007), and remained the most influential variable on dilation in multivariate analysis. Although both fitness level and exercise intervention have previously been shown to positively influence FMD, this is the first time that a relationship with normal PALs has been investigated, especially, at such a young age. These data support the concept that physical activity exerts its protective effect on cardiovascular health via the endothelium and add further emphasis to the importance of physical activity in childhood.

Habitual physical activity and physical activity intensity: their relation to body composition in 5.0-10.5 year old children

Background: Concerns of a decrease in physical activity levels (PALs) of children and a concurrent increase in childhood obesity exist worldwide. The exact relation between these two parameters however has as yet to be fully defined in children. Objective: This study examined the relation in 47 children, aged 5–10.5 y (mean age 8.4plusminus0.9 y) between habitual physical activity, minutes spent in moderate, vigorous and hard intensity activity and body composition parameters. Design: Total energy expenditure (TEE) was calculated using the doubly labelled water technique and basal metabolic rate (BMR) was predicted from Schofield's equations. PAL was determined by PAL=TEE/BMR. Time spent in moderate, vigorous and hard intensity activity was determined by accelerometry, using the Tritrac-R3D. Body fatness and body mass index (BMI) were used as the two measures of body composition. Results: Body fat and BMI were significantly inversely correlated with PAL (r=-0.43, P=0.002 and r=-0.45, P=0.001). Times spent in vigorous activity and hard activity were significantly correlated to percentage body fat (r=-0.44, P=0.004 and r=-0.39, P=0.014), but not BMI. Children who were in the top tertiles for both vigorous activity and hard activity had significantly lower body fat percentages than those in the middle and lowest tertiles. Moderate intensity activity was not correlated with measures of body composition. Conclusions: As well as showing a significant relation between PAL and body composition, these data intimate that there may be a threshold of intensity of physical activity that is influential on body fatness. In light of world trends showing increasing childhood obesity, this study supports the need to further investigate the importance of physical activity for children.

Densidade do ferro biodisponível em uma dieta habitual no Estado de São Paulo

O conhecimento do potencial de biodisponibilidade de ferro da dieta de uma população é imprescindível na implantação de um programa de fortificação com esse mineral. A quantificação da capacidade de absorção do ferro dietético foi efetuada em três refeições, habituais entre os paulistas: desjejum (pão, margarina, café com açúcar), almoço (arroz, feijão, carne e café com açúcar) e jantar (arroz, feijão, ovo frito, café com açúcar), servidas a 28 indivíduos adultos, de ambos os sexos, aparentemente sadios. As densidades do ferro biodisponível (dFeB) nas refeições estudadas foram: desjejum dFeB = 0,23; almoço dFeB = 0,73 e jantar dFeB = 0,28. Os valores encontrados, bastante inferiores aos adequados para suprir o requerimento de ferro da mulher, sugerem que a fortificação não é estratégia efetiva no controle da anemia ferropriva, quando aplicada às refeições de composição igual àquelas estudadas.

Dieta habitual e fatores de risco para doenças cardiovasculares

INTRODUÇÃO: Estudo descritivo por amostragem em munícípio do Estado de São Paulo, Brasil, em 1990, com objetivo de analisar, mediante entrevistas domiciliares, a dieta habitual e fatores de risco para doenças cardiovasculares em indivíduos maiores de 20 anos. METODOLOGIA: Foram entrevistados 557 indivíduos, de idade entre 20 e 88 anos, que fazem parte de subamostra de um estudo global na região. A dieta habitual, identificada pelo histórico alimentar foi comparada às recomendações da OMS e os fatores de risco estudados (obesidade, dislipidemias, diabetes melito) diagnosticados pelo Índice de Massa Corpórea e dosagens bioquímicas. RESULTADOS E CONCLUSÕES: Observou-se que 60% da população consome dieta com energia total abaixo da estimativa das necessidades e que a contribuição calórica dos carboidratos foi de 56%, dos lipídios de 29% e das proteínas de 15%. Entretanto, na análise por percentil, a contribuição calórica dos lipídios e das proteínas encontra-se muito acima dos padrões recomendados em detrimento dos carboidratos. A energia, distribuição calórica e quantidade de colesterol foi adequada em apenas 5% das dietas. Dentre os fatores de risco para doenças cardiovasculares estudados observou-se a prevalência de obesidade em 38% dos indivíduos, de dislipidemias em 26% e de diabetes melito em 5%. A atividade física leve preponderante com dieta inadequada, tanto em termos de qualitativos quanto quantitativos, agravam ainda mais esse quadro.

Metodologia para a avaliação da atividade física habitual em homens com 50 anos ou mais

OBJETIVO: Descrever a metodologia de avaliação da atividade física habitual, utilizanda em uma pesquisa em população masculina, por meio de um questionário já validado. MÉTODOS: O questionário de atividade física habitual de Baecke, traduzido para a língua portuguesa e, a seguir, foi realizado o back translation. Em sua versão final o questionário foi aplicado em estudo epidemiológico transversal, realizado com 326 homens com idade igual ou superior a 50 anos. A consistência interna entre as questões foi analisada pelo a de Cronbach e foram calculados os coeficientes de correlação de Spearman entre os escores de atividade física habitual, bem como os coeficientes de correlação parcial, ajustados por idade, índice de massa corporal e escolaridade. RESULTADOS: A consistência interna mostrou-se satisfatória nas magnitudes de atividade física ocupacional e exercícios físicos no lazer. Foram obtidas correlações significativas entre todos os escores de atividades físicas com o escore total de atividade física habitual, independente da idade, escolaridade e índice de massa corporal. CONCLUSÕES: O questionário Baecke mostrou-se um instrumento prático para avaliar a atividade física habitual, aliando rapidez na aplicabilidade e facilidade no entendimento para as respostas, sendo indicado para estudos epidemiológicos no Brasil.

Ronco habitual e apnéia obstrutiva observada em adultos: estudo de base populacional, Pelotas, RS

OBJETIVO: Estimar a prevalência de ronco habitual e apnéia obstrutiva observada e fatores associados. MÉTODOS: Estudo transversal com amostra representativa de 3.136 adultos, com 20 anos ou mais, residentes em Pelotas, Rio Grande do Sul, em 2005. Informações sobre os desfechos e variáveis demográficas, socioeconômicas, comportamentais e antropométricas foram coletadas por meio de questionário. A análise estatística bruta e ajustada foi realizada utilizando-se teste exato de Fisher ou qui-quadrado de tendência linear e regressão de Poisson, respectivamente. RESULTADOS: A prevalência encontrada de ronco habitual foi de 50,5% (IC 95%: 48,1;52,8) e de apnéia obstrutiva de 9,9% (IC 95%: 8,7;11,2). Na análise ajustada, o relato de ronco foi maior nos homens (Razão de Prevalências - RP=1,25; IC 95%: 1,16;1,34), nos idosos (RP=1,62; IC 95%: 1,46;1,80), nos tabagistas (RP=1,15; IC 95%: 1,07;1,25), nos alcoolistas (RP=1,17; IC 95%: 1,03;1,31) e nos obesos (RP 1,71, IC95% 1,55;1,88). O relato de apnéia obstrutiva foi maior nos homens (RP=2,05; IC 95%: 1,67;2,52), nos idosos (RP=2,23; IC 95%: 1,64;3,03), nos tabagistas (RP=1,60; IC 95%: 1,25;2,05) e nos obesos (RP=2,61; IC 95%: 1,97;3,47). CONCLUSÕES: Ronco habitual e apnéia obstrutiva foram sintomas comuns na população estudada. Fatores de risco conhecidos como sexo masculino e idade entre quarta e quinta décadas de vida não são modificáveis. Entretanto, tabagismo, alcoolismo e obesidade também associados aos desfechos, devem ser identificados e tratados na população geral.

Incidence of anti-toxoplasma antibodies in women with high-risk pregnancy and habitual abortions

Toxoplasmosis is a zoonosis caused by Toxoplasma gondii, an obligate intracellular parasite. In pregnant women on the worldwide scale, there are seroprevalences from 7% to 51.3% and in women with abnormal pregnancies and abortions the seroprevalences vary from 17.5% to 52.3%. In Mexico, seropositivity has been found to vary from 18.2% to 44.8% in women with abnormal deliveries or abortions. This study's aim was to determine the incidence oflgG and IgM anti-Toxoplasma antibodies in women at the Gineco-Obstetrics Hospital of the Western Medical Center of the Mexican Social Security Institute. Three hundred and fifty women with high-risk pregnancies were studied, and 122 (34.9%) were found to be IgG seropositive and 76 (20.7%) were IgM positive. In one group of women with habitual abortions there were 48 (44.9%) with the preseiwe of IgG antibodies and 33 (33-3%) were IgM seropositive. Seropositivity was analyzed according to age, occupation, socio-economic level, eating raw or poorly cooked meat, and living with cats.

Nutrición enteral en el paciente neurológico: ¿es suficiente el contenido en vitamina D en las fórmulas de uso habitual?

INTRODUCTION Vitamin D deficiency produces inadequate bone mineralization, proximal muscle weakness, abnormal gait and increased risk of falls and fractures. Moreover, in epidemiological studies, has been associated with increased risk of cancer, autoimmune diseases, type 1 and 2 diabetes, rheumatoid arthritis, multiple sclerosis, infectious diseases, cardiovascular diseases and depression. When synthesis through the skin by sun exposure is not possible and the patient can not eat by mouth, as in the advanced stages of various neurological diseases, the supply of vitamin D has to be done by enteral nutrition. OBJECTIVES The aim of this study is to review the role of vitamin D in a common group of neurological conditions that often require artificial nutrition and analyze whether the vitamin D of different enteral nutrition formulas is adequate to meet the needs of this group of patients. RESULTS Numerous studies have shown the association between vitamin D deficiency and increased incidence of dementia, stroke and other neurodegenerative diseases. Interventions aimed to increase levels of vit. D and its effects on functional (falls, pain, quality of life) and cardiovascular goals (cardiovascular death, stroke, myocardial infarction, cardiovascular risk factors) have obtained as highlight data a clear reduction of falls and fractures, while the evidence for the other parameters studied is still limited and inconsistent. The content of calcium and vitamin D of enteral formulas is legislated in our country. The total amount of vitamin D for a daily intake of 1,500-2,000 kcal ranges between 300 and 1,600 IU/d (mean ± SD: 32.9 ± 8.5 mg/100 kcal) in the complete formulas for enteral nutrition most commonly used. 50% of the diets studied, for an intake of 2,000 kcal/d, and 90% for an intake of 1,500 kcal/d, provide less than 600 IU/d of vitamin D. DISCUSSION Some revised recently guidelines published recommendations of daily intake of vitamin D. The document published by the U.S. Institute of Medicine recommended for adults between 19 and 70 years, 600 IU/d and up from 70, proposes 800 IU/d of vitamin D. These amounts are deemed insufficient by other scientific societies to state that to achieve blood levels of 25 (OH) D equal or greater than 30 ng/ml may be required a daily intake of 1,500-2,000 IU and a number two or three times higher if previous deficiency exists. CONCLUSIONS Further controlled studies are needed to ascertain which is the appropriate dose of vitamin D in advanced stages of neurological disease, where sun exposure is difficult and unlikely. We suggest that the vitamin D content should probably be reconsidered in enteral nutrition formulas, which, in light of recent publications appear as clearly insufficient for standard energy intakes (1,500-2,000 kcal).

Utilitat del holter de 72 hores a la pràctica clínica habitual

Objectiu: Estudiar les diferències d’augmentar el temps de registre de 24 a 72 hores en holters Material i mètodes: Estudi de cohorts retrospectiu. S’analitzen les dades de 56 pacients consecutius de març del 2009 fins al desembre del 2011. Resultats i Conclusions: Allargar el temps de registre fins les 72 hores augmenta el nombre de diagnòstics en un 17,8%. En la sospita de fibril•lació auricular allargar el temps de registre resulta útil en un 42,9% dels estudis; en el mareig en un 20% i en la síncope en un 14,3%. Els nous diagnòstics detectats són potencialment greus

Recessive multiple epiphyseal dysplasia (rMED) with homozygosity for C653S mutation in the DTDST gene - phenotype, molecular diagnosis and surgical treatment of habitual dislocation of multilayered patella: case report.

BACKGROUND: Multiple epiphyseal dysplasia (MED) is one of the more common generalised skeletal dysplasias. Due to its clinical heterogeneity diagnosis may be difficult. Mutations of at least six separate genes can cause MED. Joint deformities, joint pain and gait disorders are common symptoms. CASE PRESENTATION: We report on a 27-year-old male patient suffering from clinical symptoms of autosomal recessive MED with habitual dislocation of a multilayered patella on both sides, on the surgical treatment and on short-term clinical outcome. Clinical findings were: bilateral hip and knee pain, instability of femorotibial and patellofemoral joints with habitual patella dislocation on both sides, contractures of hip, elbow and second metacarpophalangeal joints. Main radiographic findings were: bilateral dislocated multilayered patella, dysplastic medial tibial plateaus, deformity of both femoral heads and osteoarthritis of the hip joints, and deformity of both radial heads. In the molecular genetic analysis, the DTDST mutation g.1984T > A (p.C653S) was found at the homozygote state. Carrier status was confirmed in the DNA of the patient's parents. The mutation could be considered to be the reason for the patient's disease. Surgical treatment of habitual patella dislocation with medialisation of the tibial tuberosity led to an excellent clinical outcome. CONCLUSIONS: The knowledge of different phenotypes of skeletal dysplasias helps to select genes for genetic analysis. Compared to other DTDST mutations, this is a rather mild phenotype. Molecular diagnosis is important for genetic counselling and for an accurate prognosis. Even in case of a multilayered patella in MED, habitual patella dislocation could be managed successfully by medialisation of the tibial tuberosity.

Práctica Habitual de la Puntualidad en las Actividades Laborales del IMARPE y Cumplimiento de Horario de Atención al Público

Promover en todas las dependencias del IMARPE de la Sede Central y de las Sedes Regionales, la práctica de la cultura de la puntualidad, como deber ciudadano esencial y como valor fundamental de respeto a los demás y convivencia en sociedad.

Irish English habitual do be revisited

This article describes similarities of the Irish Gaelic present habitual aspect and traditional Irish English dialects. These observations are contrasted with differences in the Scots Gaelic aspectual system and an explanation for the deviances in present habitual marking in Scottish English and Irish English is suggested, based on differences in the Gaelic contact varieties.