Maria Alayde Mendonça da Silva

Prevalência de pressão arterial elevada em escolares e adolescentes de Maceió

OBJECTIVES: To define the prevalence of high blood pressure in a representative sample of children and adolescents from the city of Maceio, state of Alagoas, Brazil, and to investigate the association of high blood pressure with age, sex and nutritional status. METHODS: This cross-sectional study was carried out from May 2000 to September 2002. Individuals between 7 and 17 years of age were selected among all the 185,702 students from public and private schools. The size of the sample was defined based on the expected prevalence of hypertension for the age group. After randomization, data were collected through a questionnaire. Blood pressure was measured twice. Weight and height were also measured. High blood pressure was defined as systolic and/or diastolic blood pressure over the 95th percentile in one or in both measures. RESULTS: The final sample included 1,253 students (706 females). One hundred and eighteen students had high blood pressure (mean age 13 years; 44% males). Risk of being overweight and excess weight were identified, respectively, in 9.3 and 4.5% of the students. These variables were significantly associated with high blood pressure. CONCLUSIONS: The prevalence of high blood pressure was 9.4%. High blood pressure was significantly more frequent among overweight students and among those at risk for being overweight.

Prevalência e variáveis associadas ao hábito de fumar em crianças e adolescentes

OBJETIVO: Identificar a prevalencia do habito de fumar e a ocorrencia de variaveis associadas ao habito em criancas e adolescentes de 7 a 17 anos, de ambos os sexos e provenientes da cidade de Maceio. METODOS: Estudo epidemiologico transversal, baseado na populacao de alunos da rede de ensino publico e privada, niveis fundamental e medio. Calculo da amostra baseado na menor prevalencia esperada de inumeras variaveis, incluindo tabagismo. Amostragem por conglomerados. Questionario sobre o habito de fumar; entrevista individual com cada estudante. Considerado fumante atual aquele que admitiu ter fumado em 1 ou mais dias nos ultimos 30 dias. Variaveis analisadas: relacionadas ao estudante (idade, sexo, experimentacao previa de cigarros e trabalho remunerado), a sua condicao na escola (publica/privada, turno, nivel e repetencia) e a familia (classificacao economica, pais fumantes e pais separados). RESULTADOS: Foram avaliados 1.253 estudantes (547 do sexo masculino, media de idade 12,4±2,9 anos). Identificou-se uma prevalencia de tabagismo de 2,4%. A analise estatistica multivariada demonstrou associacao significante do habito de fumar com: maior idade (odds ratio de 1,31); experimentacao previa de cigarros (odds ratio de 33,96); estudar no periodo noturno (odds ratio de 5,43). Observou-se que 286 estudantes (22,8%) admitiram haver experimentado cigarros (9% de 7 a 9 anos; 21% de 10 a 14 anos; 36% de 15 a 17 anos). CONCLUSOES: A prevalencia de tabagismo em criancas e adolescentes da rede de ensino da cidade de Maceio e de 2,4%, sendo mais frequente em estudantes de 15 a 17 anos, do curso noturno. Estudantes que experimentaram cigarros apresentam 34 vezes mais chances de se tornarem fumantes.

Relação da obesidade com a pressão arterial elevada em crianças e adolescentes

FUNDAMENTO: Excessos de peso e de gordura corporal sao atualmente reconhecidos como os maiores determinantes da elevacao da pressao arterial em criancas e adolescentes. OBJETIVO: Identificar associacao e correlacao entre obesidade - identificada por meio da circunferencia da cintura (CC), da prega cutânea do triceps (PCT) e do indice de massa corporal (IMC) - pressao arterial elevada (PAE) em criancas e adolescentes. METODOS: Estudo epidemiologico transversal, de base populacional escolar, em criancas e adolescentes de ambos os sexos, com idades entre 7 e 17 anos, selecionados aleatoriamente. Protocolo: questionario estruturado; medidas de peso, altura, espessura da prega tricipital, circunferencia da cintura, pressao arterial; diagnostico de obesidade por meio de IMC, PCT e CC; diagnostico de PAE. Analise estatistica: qui-quadrado. RESULTADOS: Foram avaliados 1.253 estudantes (547 do sexo masculino, media de idade 12,4 ± 2,9 anos), e identificou-se uma prevalencia de obesidade (IMC, PCT, CC), respectivamente, de 13,7%, 14,8% e 9,3%. A PAE foi identificada em 7,7% dos jovens. Houve associacao significante de obesidade (IMC, PCT, CC) com PAE (*p < 0,0001). Observou-se correlacao forte (*p < 0,01) entre CC e IMC; moderada entre CC e PCT, CC e PAS, IMC e PAS (*p < 0,01); fraca entre PAD e CC, PCT e IMC, e entre PAS e PCT (*p < 0,05). CONCLUSAO: A associacao e correlacao significantes entre PAE e excesso de gordura corporal por qualquer dos metodos utilizados estabelecem a importância de sua utilizacao na avaliacao de criancas e adolescentes, com vistas a prevencao da HAS nessa faixa etaria, sugerindo-se, para isso, a utilizacao do IMC associado a, pelo menos, um outro metodo antropometrico.

Obesity and lung function: a systematic review

ABSTRACT Obesity is a chronic disease characterized by the excessive accumulation of body fat that is harmful to the individuals. Respiratory disorders are among the comorbidities associated with obesity. This study had the objective of investigating the alterations in respiratory function that affect obese individuals. A systematic review was performed, by selecting publications in the science databases MEDLINE and LILACS, using PubMed and SciELO. The articles that assessed pulmonary function by plethysmography and/or spirometry in obese individuals aged under 18 years were included. The results demonstrated that the obese individuals presented with a reduction in lung volume and capacity as compared to healthy individuals. Reduction of total lung capacity and reduction of forced vital capacity, accompanied by reduction of the forced expiratory volume after one second were the most representative findings in the samples. The articles analyzed proved the presence of a restrictive respiratory pattern associated with obesity.

Cardiopatia congênita no recém-nascido: da solicitação do pediatra à avaliação do cardiologista

OBJECTIVE To analyze the importance of symptoms as a reason for referral to pediatric cardiologists in the diagnosis of congenital heart diseases (CHD) in the newborn (NB). METHODS Prospective study on live NB referred for cardiac evaluation, with performance of electrocardiogram, chest radiography and echocardiography. Cardiology consultation was requested by means of a multiple-choice form including signs and symptoms suggestive of CHD. Patent ductus arteriosus (PDA) without clinical and/or hemodynamic consequences was not considered a heart disease. RESULTS From 1999 to 2002, 358 out of 3716 NB were studied, and 49 cases of CHD and 128 of PDA were found. The prevalence of CHD was 13.2:1000 NB. The main reason for referral to the cardiologist was heart murmur in 256 (72%) NB, of which 39 (15%) had CHD, and in 91% of the 128 cases of PDA. In 14 (4%) NB, the reason for referral was cyanosis, and eight of these patients (57%) had a CHD. Heart failure was the reason for referral in 37 (10%) NB, of whom 17 (46%) had CHD. Arrhythmia, associated congenital malformations, or chromosome disorders were the reasons for referral in 14% of the cases. CONCLUSION The main reason for referral was detection of a heart murmur on cardiac auscultation. Although cyanosis and heart failure were uncommon reasons for referral, their presence indicated a high probability of the diagnosis of heart disease. Pediatric screening plays a key role in this diagnosis.

Prevalence of overweight and obesity in children and adolescents from the city of Maceió (AL)

OBJECTIVE To establish prevalence of overweight and obesity in children and adolescents from the city of Maceió, Alagoas, Brazil, and investigate the association of risk of overweight and obesity with gender, age and type of school. METHODS This was a cross-sectional study. Students between 7 and 17 years of age were selected from 396 public and private schools of Maceió. After randomization, data were collected by questionnaire. Weight and height were measured (body mass index = weight:height2). Overweight and obesity were defined, respectively, as body mass index greater than the 85th percentile and equal or greater than the 95th percentile for age and gender. RESULTS The final sample included 1253 students (706 females). One hundred sixteen students were overweight and fifty six students were obese. Obesity was significantly associated with students between 7 and 9 years of age, when compared to the 10 and 13 year olds (p<0.04) and the 14 and 17 year olds (p<0.02). Private school students were more likely to be overweight (OR=2.2; CI95%:1.36 - 3.32) and more likely to be obese (OR=4.7; CI95%:2.32 - 9.34) than students CONCLUSION The prevalence of overweight and obesity were, respectively, 9.3% and 4.5%. Overweight and obesity were significantly more frequent among private school students.

Markers of redox imbalance in the blood of hypertensive patients of a community in Northeastern Brazil

BACKGROUND Recent studies describe the participation of reactive oxygen and nitrogen species in hypertension. OBJECTIVE To identify the redox imbalance in the blood of hypertensive. METHODS Superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), glutathione (GSH), vitamin C, transferrin, ceruloplasmin, malondialdehyde (MDA) and carbonyl group were quantified in the blood of 20 hypertensives and 21 controls. The individuals had a Body Mass Index of ≥ 18.5 and ≤ 30 kg/m(2), glycemia ≤ 100 mg/dL, serum cholesterol ≤ 200 mg/dL, and were nonsmokers, non-pregnant and non-lactating women, non-users of alopurinol and probucol, with hypertensives on antihypertensive medication. All individuals underwent a preparatory period of 4 weeks without alcohol, vitamin supplements, dexamethasone and paracetamol. RESULTS Reduced levels of CAT (p 0.013), GSH (p 0.003) and MDA (p 0.014), and high levels of GPx (p 0.001) and ceruloplasmin (p 0.015) were obtained in the hypertensive group compared with controls. A positive correlation between systolic pressure and MDA in hypertensive and diastolic pressure and CAT in controls was obtained. CONCLUSION The data obtained suggest that the hypertensives were in redox imbalance, despite the possibly attenuating effect of their antihypertensive medication.BACKGROUND: Recent studies describe the participation of reactive oxygen and nitrogen species in hypertension. OBJECTIVE: To identify the redox imbalance in the blood of hypertensive. METHODS: Superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), glutathione (GSH), vitamin C, transferrin, ceruloplasmin, malondialdehyde (MDA) and carbonyl group were quantified in the blood of 20 hypertensives and 21 controls. The individuals had a Body Mass Index of > 18.5 and < 30 kg/m2, glycemia < 100 mg/dL, serum cholesterol < 200 mg/dL, and were nonsmokers, non-pregnant and non-lactating women, non-users of alopurinol and probucol, with hypertensives on antihypertensive medication. All individuals underwent a preparatory period of 4 weeks without alcohol, vitamin supplements, dexamethasone and paracetamol. RESULTS: Reduced levels of CAT (p 0.013), GSH (p 0.003) and MDA (p 0.014), and high levels of GPx (p 0.001) and ceruloplasmin (p 0.015) were obtained in the hypertensive group compared with controls. A positive correlation between systolic pressure and MDA in hypertensive and diastolic pressure and CAT in controls was obtained. CONCLUSION: The data obtained suggest that the hypertensives were in redox imbalance, despite the possibly attenuating effect of their antihypertensive medication.Sandra Mary Lima Vasconcelos1,2,4, Marília Oliveira Fonseca Goulart1,2, Maria Alayde Mendonça da Silva1,5, Vanusa Manfredini6, Mara da Silveira Benfato6, Luiza Antas Rabelo1,3, Gilberto Fontes1,3 Universidade Federal de Alagoas-UFAL1, Instituto de Química e Biotecnologia-IQB2, Instituto de Ciências Biológicas e da Saúde-ICBS3, Faculdade de Nutrição-FANUT4, Faculdade de Medicina-FAMED5; Maceió, AL-Brasil. Universidade Federal do Rio Grande do Sul-UFRGS6; Porto Alegre, RS-Brasil.

Marcadores de desequilíbrio redox em sangue de pacientes hipertensos de uma comunidade no Nordeste do Brasil

BACKGROUND Recent studies describe the participation of reactive oxygen and nitrogen species in hypertension. OBJECTIVE To identify the redox imbalance in the blood of hypertensive. METHODS Superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), glutathione (GSH), vitamin C, transferrin, ceruloplasmin, malondialdehyde (MDA) and carbonyl group were quantified in the blood of 20 hypertensives and 21 controls. The individuals had a Body Mass Index of ≥ 18.5 and ≤ 30 kg/m(2), glycemia ≤ 100 mg/dL, serum cholesterol ≤ 200 mg/dL, and were nonsmokers, non-pregnant and non-lactating women, non-users of alopurinol and probucol, with hypertensives on antihypertensive medication. All individuals underwent a preparatory period of 4 weeks without alcohol, vitamin supplements, dexamethasone and paracetamol. RESULTS Reduced levels of CAT (p 0.013), GSH (p 0.003) and MDA (p 0.014), and high levels of GPx (p 0.001) and ceruloplasmin (p 0.015) were obtained in the hypertensive group compared with controls. A positive correlation between systolic pressure and MDA in hypertensive and diastolic pressure and CAT in controls was obtained. CONCLUSION The data obtained suggest that the hypertensives were in redox imbalance, despite the possibly attenuating effect of their antihypertensive medication.BACKGROUND: Recent studies describe the participation of reactive oxygen and nitrogen species in hypertension. OBJECTIVE: To identify the redox imbalance in the blood of hypertensive. METHODS: Superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), glutathione (GSH), vitamin C, transferrin, ceruloplasmin, malondialdehyde (MDA) and carbonyl group were quantified in the blood of 20 hypertensives and 21 controls. The individuals had a Body Mass Index of > 18.5 and < 30 kg/m2, glycemia < 100 mg/dL, serum cholesterol < 200 mg/dL, and were nonsmokers, non-pregnant and non-lactating women, non-users of alopurinol and probucol, with hypertensives on antihypertensive medication. All individuals underwent a preparatory period of 4 weeks without alcohol, vitamin supplements, dexamethasone and paracetamol. RESULTS: Reduced levels of CAT (p 0.013), GSH (p 0.003) and MDA (p 0.014), and high levels of GPx (p 0.001) and ceruloplasmin (p 0.015) were obtained in the hypertensive group compared with controls. A positive correlation between systolic pressure and MDA in hypertensive and diastolic pressure and CAT in controls was obtained. CONCLUSION: The data obtained suggest that the hypertensives were in redox imbalance, despite the possibly attenuating effect of their antihypertensive medication.Sandra Mary Lima Vasconcelos1,2,4, Marília Oliveira Fonseca Goulart1,2, Maria Alayde Mendonça da Silva1,5, Vanusa Manfredini6, Mara da Silveira Benfato6, Luiza Antas Rabelo1,3, Gilberto Fontes1,3 Universidade Federal de Alagoas-UFAL1, Instituto de Química e Biotecnologia-IQB2, Instituto de Ciências Biológicas e da Saúde-ICBS3, Faculdade de Nutrição-FANUT4, Faculdade de Medicina-FAMED5; Maceió, AL-Brasil. Universidade Federal do Rio Grande do Sul-UFRGS6; Porto Alegre, RS-Brasil.

Frequência de fatores de risco cardiovascular antes e 6 e 12 meses após gastroplastia

OBJECTIVE To compare the frequency of cardiovascular risk factors (CVRFs) in obese patients of the Brazilian Unified Health System (Sistema Único de Saúde - SUS) with indication of bariatric surgery during the preoperative period and after the sixth month and the first year of the procedure. METHODS An observational, longitudinal, prospective, and analytical study was performed, with consecutive selection of obese patients with indication for surgery referred to preoperative cardiac evaluation. The protocol consisted of: medical history, physical examination, electrocardiogram, echocardiogram, and biochemical analysis. This study analyzed the following variables: weight, body mass index (BMI), waist circumference (WC), systemic arterial hypertension (SAH), diabetes mellitus type 2(DM), dyslipidemia (high LDL cholesterol; low HDL cholesterol; hypertriglyceridemia), and metabolic syndrome (MS). The chi-squared test and the Tukey-Kramer method were used for statistical analysis. RESULTS The sample was composed of 96 obese people, among which 86 were women, aged between 18 and 58 years old (median 35 years old). At the end of six months, significant reductions of 88%, 95%, 71%, 89%, and 80% in the frequency of SAH, high LDL cholesterol, hypertriglyceridemia, DM, and MS could already be observed. A significant and small reduction in the frequency of low HDL cholesterol (24%) and abnormal WC (31%) was observed only at the end of 12 months. After six months and one year, weight and BMI experienced reductions of 33.4kg and 44.3kg, and 13.1kg/m(2) and 17.2kg/m(2), respectively. CONCLUSION The positive impact on weight loss and the reduction in BMI, WC, and in the frequency of CVRFs are already extremely significant after six months and remain so one year after bariatric surgery.

Trombo em trânsito no interior do átrio direito: relato de caso e revisão da literatura

Emboli in transit in right atrium are rare. When they occur, they are associated to high rate of pulmonary embolism and mortality. This is a case report on an embolus in transit in right chambers, with clinical suspicion of pulmonary thromboembolism. Diagnosis was obtained through transesophageal echocardiography. The patient had a positive response post-anticoagulation. The team discussed presentation forms, treatment and condition development.Emboli in transit in right atrium are rare. When they occur, they are associated to high rate of pulmonary embolism and mortality. This is a case report on an embolus in transit in right chambers, with clinical suspicion of pulmonary thromboembolism. Diagnosis was obtained through transesophageal echocardiography. The patient had a positive response post-anticoagulation. The team discussed presentation forms, treatment and condition development.