Angélica Lemos Debs Diniz

The effects of aerobic, resistance, and combined exercise on metabolic control, inflammatory markers, adipocytokines, and muscle insulin signaling in patients with type 2 diabetes mellitus

The purpose of this study was to compare the effects of 3 different modalities of exercise on metabolic control, insulin resistance, inflammatory markers, adipocytokines, and tissue expression of insulin receptor substrate (IRS)-1 after 12 weeks of training among patients with type 2 diabetes mellitus. Forty-eight patients with type 2 diabetes mellitus were randomly assigned to 4 groups of training (3 times a week, 60 minutes per session): aerobic group (n = 12), resistance group (n = 12), combined (aerobic and resistance) group (n = 12), and control group (n = 12). Fasting and postprandial blood glucose, glycated hemoglobin, lipid profile, insulin resistance index (homeostasis model assessment of insulin resistance), adipocytokines (adiponectin, visfatin, and resistin), tumor necrosis factor, interleukin, and high-sensitivity C-reactive protein (hs-CRP) were measured at baseline and at the end of the study. Patients also underwent a muscle microbiopsy before and after training to quantify IRS-1 expression. All 4 groups displayed decreases in blood pressure, fasting plasma glucose, postprandial plasma glucose, lipid profile, and hs-CRP (P < .05); and there was no difference across the groups. After training, the IRS-1 expression increased by 65% in the resistance group (P < .05) and by 90% in the combined group (P < .01). Exercise training favorably affects glycemic parameters, lipid profile, blood pressure, and hs-CRP. In addition, resistance and combined training can increase IRS-1 expression.

Ophthalmic artery Doppler as a measure of severe pre-eclampsia

To identify differences in orbital flow behavior in mild and severe pre‐eclamptic women compared with healthy pregnant women, demonstrated by ophthalmic artery Doppler indexes.

Ophthalmic artery Doppler velocimetry in healthy pregnancy

To establish normative data for ophthalmic artery Doppler parameters throughout a healthy pregnancy, to investigate the possible correlation between these Doppler measurements and gestational age, and to test intraobserver variability.

Fatores associados à duração do aleitamento materno em crianças menores de seis meses

PURPOSE To describe the characteristics of mothers and children and to evaluate the factors associated with discontinuation of exclusive breastfeeding. METHODS A cross-sectional study on infants under six months of age who attended the vaccination campaign in 2008. In the sample design, vaccination units were selected by drawing lots and infants were similarly selected later at each unit systematically. A semi-structured instrument was used for data collection, containing questions about childrens nutrition and socio-demographic characteristics. We used Odds Ratio and the χ² test for data analysis, accepting as the critical level p<0.05. RESULTS The prevalence of breastfeeding for infants under 120 and 180 days of age was 89.5 and 85% respectively, and exclusive breastfeeding was 50.6 and 39.7% for infants less than 120 and 180 days of age, respectively. The factors most related to the abandonment of exclusive breastfeeding in infants under six months were maternal employment outside the home (OR=2.73; 95%CI=1.74-4.29) and use of pacifiers (OR=4.26; 95%CI=2.85-6.38). The mother being multiparous (OR=0.57; 95%CI=0.40-0.81) and receiving postpartum care in the public health care network (OR=0.55; 95%CI=0.39-0.79) represented protective factors against the practice of early cessation of breastfeeding. CONCLUSIONS The prevalence of breastfeeding and exclusive breastfeeding in the municipality of Uberlândia is among the highest in the country and the factors most often associated with the practice of early weaning were maternal employment outside the home, offering pacifiers to the infants, receiving postpartum care in the private health sector, and primiparity.

Avaliação da reprodutibilidade ultrassonográfica como método para medida da gordura abdominal e visceral

OBJETIVO: O objetivo deste estudo e avaliar a variabilidade interobservador do metodo ultrassonografico para medida da gordura subcutânea, visceral e perirrenal por meio de tecnica padronizada. MATERIAIS E METODOS: Foram avaliados 50 pacientes entre novembro de 2006 e janeiro de 2007. A medida da espessura subcutânea foi realizada com transdutor linear de 7,5 MHz posicionado transversalmente a 1 cm acima da cicatriz umbilical. Para a gordura visceral foi utilizado transdutor de 3,5 MHz posicionado 1 cm acima da cicatriz umbilical, considerando-se a medida entre a face interna do musculo reto abdominal e a parede posterior da aorta na linha media do abdome. A gordura perirrenal foi medida no terco medio do rim direito, com transdutor posicionado na linha axilar media. RESULTADOS: A reprodutibilidade interobservador foi analisada por meio do teste t de Student, com significância de 95%. Nao houve diferenca significativa entre as medias das medidas das gorduras subcutânea, visceral e perirrenal, com p = 0,7141, 0,7286 e 0,6368, respectivamente. As medias encontradas, com seus respectivos desvios-padrao, foram: 2,64 ± 1,37 para a espessura subcutânea, 6,84 ± 2,38 para a espessura visceral e 4,89 ± 2,6 para a espessura perirrenal. CONCLUSAO: A ultrassonografia apresentou boa reprodutibilidade interobservador para avaliacao da gordura abdominal por meio das medidas das espessuras subcutânea, visceral e perirrenal. Unitermos: Gordura abdominal; Ultrassom; Sindrome metabolica.

Sonographic hepatorenal ratio: A noninvasive method to diagnose nonalcoholic steatosis

To evaluate the accuracy of the sonographic hepatorenal ratio (HRR) in the diagnosis and grading of nonalcoholic steatosis, using biopsy as the reference.

Doplervelocimetria das artérias oftálmica e central da retina em gestantes normais

OBJETIVOS: avaliar os padroes dos indices doplervelocimetricos das arterias oftalmica e central da retina durante o segundo e terceiro trimestres da gestacao normal e comparar os valores obtidos do olho direito e esquerdo das gestantes. METODOS: estudo transversal no qual se avaliaram seis indices doplervelocimetricos das arterias central da retina e oftalmica em 51 gestantes normais, com idades gestacionais entre a 20a e a 38a semana. As variaveis analisadas foram os indices de resistencia e pulsatilidade (IR, IP), os picos de velocidade sistolica e diastolica (PVS, PVD) e a razao entre picos de velocidade (RPV). A analise dos indices doplervelocimetricos dos olhos direito e esquerdo foi realizada utilizando-se a mediana dos valores. Para a comparacao dos valores dos indices entre os dois olhos das gestantes, utilizou-se o teste t de Student para dados pareados. A associacao entre a idade gestacional e os indices foi testada empregando-se o coeficiente de correlacao linear de Pearson. Adotou-se o nivel de significância de 5% para os testes estatisticos. RESULTADOS: a mediana dos indices doplervelocimetricos das arterias oftalmica e central da retina foram, respectivamente: IP=1,83; IR=0,78; PVS=34,20; PVD=6,80; RPV=0,48 e IP=1,34; IR=0,70; PVS=7,40; PVD=2,10. Nao houve diferencas na analise comparativa dos indices doplervelocimetricos entre os olhos direito e esquerdo das gestantes normais. O coeficiente de correlacao linear entre a idade gestacional e os indices de ambas as arterias nao mostrou diferenca significante durante a gestacao normal. CONCLUSAO: e factivel a analise unilateral dos indices doplervelocimetricos das arterias oftalmica e central da retina no estudo de doencas maternas sistemicas. Nao ha mudanca significativa dos indices doplervelocimetricos das arterias oftalmica e central da retina ao longo da gestacao normal entre a 20a e a 38a semana.

Abdominal Obesity and Association With Atherosclerosis Risk Factors: The Uberlândia Heart Study

AbstractEctopic visceral fat (VF) and subcutaneous fat (SCF) are associated with cardiovascular risk factors. Gender differences in the correlations of cardiovascular disease risk factors and ectopic fat in the Brazilian population still lacking.Cross-sectional study with 101 volunteers (50.49% men; mean age 56.5 ± 18, range 19–74 years) drawn from the Uberlândia Heart Study underwent ultrasonography assessment of abdominal visceral adipose tissue with convex transducer of 3.5 MHz of frequency. The thickness of VF was ultrasonographically measured by the distance between the inner face of the abdominal muscle and the posterior face of abdominal aorta, 1 cm above the umbilicus. The SCF thickness was measured with a 7.5 MHz linear transducer transversely positioned 1 cm above the umbilical scar. The exams were always performed by the same examiner. Ectopic fat volumes were examined in relation to waist circumference, blood pressure, and metabolic risk factors.The VF was significantly associated with the levels of triglycerides (P < 0.01, r = 0.10), HDL cholesterol (P < 0.005, r = 0.15), total cholesterol (P < 0.01, r = 0.10), waist circumference (P < 0.0001, r = 0.43), systolic blood pressure (P < 0.001, r = 0.41), and diastolic blood pressure (P < 0.001, r = 0.32) in women, and with the levels of triglycerides (P < 0.002, r = 0,14), HDL cholesterol (P < 0.032, r = 0.07), glucose (P < 0.001, r = 0.15), alanine aminotransferase (ALT) (P < 0.008, r = 0.12), gamma-GT (P < 0.001, r = 0.30), waist circumference (P < 0.001, r = 0.52), systolic blood pressure (P < 0.001, r = 0.32), and diastolic blood pressure (P < 0.001, r = 0.26) in men. SCF was significantly associated with the levels of triglycerides (P < 0.01, r = 0.34), LDL cholesterol (P < 0.001, r = 0.36), total cholesterol (P < 0.05, r = 0.36), waist circumference (P < 0.0001, r = 0.62), systolic and diastolic blood pressure (P < 0.05, r = 0.34) in women, and with the waist circumference (P < 0.001, r = 0.065)), and MetS (P < 0.05, r = 0.11) in men.The VF and SCF were correlated with most cardiovascular risk factors in both genders but our findings support the idea that there are gender differences in the correlations between ectopic fat deposition and the cardiovascular risk factors.

Dopplerfluxometria da veia hepática em pacientes com esteatose não alcoólica

OBJECTIVE: To evaluate the correlation between right hepatic vein Doppler flowmetry and degree of steatosis, inflammation and fibrosis at biopsy in nonalcoholic fatty liver disease. MATERIALS AND METHODS: Doppler ultrasonography was performed in 80 patients divided into two groups as follows: 40 patients diagnosed with nonalcoholic fatty liver disease and also submitted to biopsy, and a control group including 40 healthy adults with no risk factor for nonalcoholic fatty liver disease. The Doppler waveform patterns of right hepatic vein were classified into triphasic, biphasic and monophasic. Biopsy specimens were classified according to the degree of steatosis, inflammation and fibrosis. RESULTS: Triphasic flow was observed in 38 (95%) patients of the control group and in nine (56%) patients with mild steatosis, whereas in patients with severe steatosis, the pattern was monophasic in 60%. A statistically significant difference was observed in the distribution of Doppler patterns (p < 0.01). A significant negative correlation between the Doppler waveform pattern of right hepatic vein and steatosis degree was observed (r = 0.57; p < 0.01). CONCLUSION: An abnormal Doppler waveform pattern of right hepatic vein in patients with nonalcoholic fatty liver disease may suggest the presence of decreased vascular compliance caused by fatty infiltration.

Prevalência de bócio e nódulos tiroideanos detectados através de ultra-som em população com mais de 50 anos

The aim of this study was to determine the prevalence of goiter and thyroid nodules in a population aged 50 years and older, matching with a younger control group, their offspring. We studied 101 subjects (19M/82F), 51 to 85 years and 65 offspring (18M / 47F), 14 to 50 years of age. Ultrasound was used to identify goiter and thyroid nodules, but all thyroids were also evaluated by palpation. The prevalence of goiter and thyroid nodules were higher in the older group (15.8% and 18.8%, respectively) as compared to their offspring (3.1% and 7,7%, respectively). No correlation was found between thyroid volume and age. Thyroid palpation has poor sensitivity but high specificity in identifying goiter and nodules. We conclude that goiter and nodules are more prevalent in the elderly, with no correlation between thyroid volume and age. Ultrasound was better than thyroid palpation to detect goiter and nodules.