Poliana Cristina de Almeida Fonsêca

Associação entre fatores de risco cardiovascular e indicadores antropométricos de obesidade em universitários de São Luís, Maranhão, Brasil

The article aims to evaluate the relation between cardiovascular risk factors (CVRF) and anthropometric indicators in a sample of university students from Sao Luis-MA, Brazil. It is a cross-sectional study conducted with 968 university students, with median age of 22. Glycemia, triglycerides, HDL-c, smoking, alcohol consumption, physical inactivity, metabolic syndrome (Joint Interim Statement criteria) and insulin resistance (IR), were associated and correlated with anthropometric indicators such as BMI, WC, WHR and WHtR. Associations were found between TGL, SH, SM and higher values of all anthropometric variables. The RI was associated with higher BMI values and WHtR in men and women. The low HDL-c was associated with higher values of all anthropometric variables in women. Consumption of alcohol was associated with higher values of BMI and WC in women and WHR in men and WHtR. Smoking was associated with higher values of WHtR in both sexes. Physical inactivity was associated with higher values of WHR in men only. The highest correlations were established for women between TGL and BMI CC, WHR and WHtR. The indicators most associated with CVRF were BMI, WC and WHtR in females and WHR and WHtR in men.The article aims to evaluate the relation between cardiovascular risk factors (CVRF) and anthropometric indicators in a sample of university students from São Luís-MA, Brazil. It is a cross-sectional study conducted with 968 university students, with median age of 22. Glycemia, triglycerides, HDL-c, smoking, alcohol consumption, physical inactivity, metabolic syndrome (Joint Interim Statement criteria) and insulin resistance (IR), were associated and correlated with anthropometric indicators such as BMI, WC, WHR and WHtR. Associations were found between TGL, SH, SM and higher values of all anthropometric variables. The RI was associated with higher BMI values and WHtR in men and women. The low HDL-c was associated with higher values of all anthropometric variables in women. Consumption of alcohol was associated with higher values of BMI and WC in women and WHR in men and WHtR. Smoking was associated with higher values of WHtR in both sexes. Physical inactivity was associated with higher values of WHR in men only. The highest correlations were established for women between TGL and BMI CC, WHR and WHtR. The indicators most associated with CVRF were BMI, WC and WHtR in females and WHR and WHtR in men.

Metodologias de identificação de padrões alimentares a posteriori em crianças brasileiras: revisão sistemática

The objective of this study is to provide guidance for identifying dietary patterns using the a posteriori approach, and analyze the methodological aspects of the studies conducted in Brazil that identified the dietary patterns of children. Articles were selected from the Latin American and Caribbean Literature on Health Sciences, Scientific Electronic Library Online and Pubmed databases. The key words were: Dietary pattern; Food pattern; Principal Components Analysis; Factor analysis; Cluster analysis; Reduced rank regression. We included studies that identified dietary patterns of children using the a posteriori approach. Seven studies published between 2007 and 2014 were selected, six of which were cross-sectional and one cohort, Five studies used the food frequency questionnaire for dietary assessment; one used a 24-hour dietary recall and the other a food list. The method of exploratory approach used in most publications was principal components factor analysis, followed by cluster analysis. The sample size of the studies ranged from 232 to 4231, the values of the Kaiser-Meyer-Olkin test from 0.524 to 0.873, and Cronbachs alpha from 0.51 to 0.69. Few Brazilian studies identified dietary patterns of children using the a posteriori approach and principal components factor analysis was the technique most used.

Neural complications and physical disabilities in leprosy in a capital of northeastern Brazil with high endemicity

INTRODUCTION Leprosy is an infectious disease whose etiologic agent is Mycobacterium leprae, manifested by dermatological and neurological signs and symptoms. OBJECTIVE To investigate neural changes and the degree of physical disability in the eyes, hands and feet before and after treatment, as well as sociodemographic and clinical profile of patients affected by leprosy. METHOD A longitudinal epidemiological study comprising 155 patients with leprosy, from a spontaneous demand, diagnosed between March 2010 and February 2011, and treated with multidrug therapy (MDT) between March 2010 and July 2012 in a program for leprosy eradication in São Luis (MA), Brazil. RESULTS Before treatment, 46.5% of patients were considered as borderline, 51.6% had some alteration in the eyes and 52.3% in the feet, and the radial nerve (18.7%) was the most affected. There was a statistically significant difference between the changes in the radial nerve at the beginning of and after treatment. CONCLUSIONS The analysis points to late diagnosis, as some patients have had abnormal neural and physical disabilities before treatment.

Factors associated with neural alterations and physical disabilities in patients with leprosy in São Luis, State of Maranhão, Brazil

INTRODUCTION Leprosy is a chronic infectious disease that is caused by Mycobacterium leprae. The objective of this study was to evaluate the risk factors that are associated with neural alterations and physical disabilities in leprosy patients at the time of diagnosis. METHODS A prospective cross-sectional study was conducted on 155 leprosy patients who participated in a program that aimed to eliminate leprosy from São Luis, State of Maranhão. RESULTS Patients who were 31-45 years of age, were older than 60 years of age or had a partner were more likely to have a disability. Patients with partners were 1.14 times more likely (p = 0.025) to have disabilities of the hands. The frequency of disabilities in the feet among the patients with different clinical forms of leprosy was statistically significant. CONCLUSIONS The identification of risk factors that are associated with neural alterations and physical disabilities in leprosy patients is important for diagnosing the disease because this approach enables physicians to plan and prioritize actions for the treatment and monitoring of patients.

Consumo de energia e macronutrientes no lanche escolar de adolescentes de São Luís, Maranhão, Brasil

Objective:This report evaluated nutritional composition of school lunch consumed by teenagers at two schools in Sao Luis (MA).Methods:Cross-sectional study setting a sample of 200 teenagers aged 15-17 years from two schools, one public and one private. There were undertaken dietary recalls of school lunch of the last three days the teenagers were at school. These dietary data were analyzed according to the Brazilian Table of Food Composition. Carbohydrates, lipids and proteins consumption were compared to the Dietary Reference Intakes (DRI) recommendations. Statistical analysis was performed using Stata 10.0. For comparisons, there were used Students t-test and χ2. The significance level was set at 5%.Results:The school lunch consumption was reported by 69.5% of adolescents. Most acquired this snack canteens of schools: private (76.0%) and public (51.0%). Adolescents from public schools had higher energy consumption (338.7 versus 286.3 kcal, p = 0.043) and carbohydrates (52.5 vs. 39.3 g, p = 0.006). The adequacy of macronutrients appeared in half of the sample: carbohydrates (43.9%), protein (43.2%) and lipids (49.6%). Almost the half (43.9%) of teenagers had appropriate carbohydrate intake. This adequacy of carbohydrate was higher between public school students (p<0.001) as well as the adequacy of lipid (p<0.001). Boys had higher adequacy of protein (55.6 versus 32.9%; p=0.007), whereas girls had higher adequacy of carbohydrate (52.6% versus 33.3%; p=0.005) and lipid (61.8 versus 34.9%; p=0.006).Conclusions:The inadequacy of macronutrients was high in the sample, suggesting the low quality of school lunch consumed by these teenagers.

A pressão arterial está associada a indicadores de adiposidade corporal em crianças de quatro a sete anos

INTRODUCTION AND OBJECTIVE Studies in adults have shown an association between increased adiposity and hypertension, but few studies have analyzed this association in childhood. The aim of this study was to investigate the association between blood pressure (BP) and body adiposity indicators in children, controlling for the variables of birth conditions, sociodemographics, lifestyle and diet. METHODS In this cross-sectional study of 399 children aged 4 to 7 years, the dependent variable was BP, measured according to the protocol established by the 7th Brazilian Guidelines on Hypertension. The explanatory variables of the study were waist-to-height ratio (WHtR) and body mass index (BMI). Multiple linear regression was used to assess the independent association between adiposity and BP indicators adjusted for the variables of birth conditions, sociodemographics, lifestyle and diet. Statistical significance was set as α=5%. RESULTS BMI for age and WHtR correlated positively with systolic (SBP) and diastolic blood pressure (DBP). After multivariate analysis, higher values of BMI (model 1) and WHtR (model 2) were associated with increased SBP and DBP. CONCLUSION Increased body adiposity, as assessed by BMI and WHtR, was associated with increased SBP and DBP among the children studied. Thus, we suggest the use of BMI and WHtR in the nutritional assessment of children to detect changes in BP and other cardiometabolic risk factors in this population.

The TyG index cutoff point and its association with body adiposity and lifestyle in children

OBJECTIVE To investigate the factors associated with insulin resistance in children aged 4-7 years, and to identify the cutoff point of the triglyceride-glucose index for the prediction of insulin resistance in this population. METHODS A cross-sectional study was conducted with 403 children from a retrospective cohort. Insulin resistance was also evaluated in a sub-sample using the HOMA index. Four indicators of body adiposity were assessed: body mass index, waist-to-height ratio, and the percentages of total and central body fat. Food habits were evaluated by the identification of dietary patterns, using principal component analysis. Information was also collected on lifestyle, socioeconomic status, and breastfeeding time. RESULTS The median index observed in the sample was 7.77, which did not differ between the genders. The shorter the time spent in active activities, the higher the triglyceride-glucose value; and increase in the values of body adiposity indicators was positively associated with triglyceride-glucose. The cutoff point with the best balance between sensitivity and specificity values was 7.88 (AUC=0.63, 95% CI: 0.51-0.74). CONCLUSION The present study identified that total and central body adiposity and shorter time spent in lively activities was positively associated with insulin resistance, evaluated through the triglyceride-glucose index. The cutoff point of 7.88 may be used in this population for insulin resistance risk screening, but caution is required when using it in other populations.

Application of kinesiotherapy and electrothermotherapy in the treatment of elderly with knee osteoarthrosis: a comparative study

Introducao Dentre as modalidades de tratamento na Osteoartrose, destacam-se a forma cirurgica e conservadora atraves dos recursos fisioterapeuticos como a eletrotermoterapia e a cinesioterapia. Objetivo Verificar os efeitos de dois protocolos terapeuticos em mulheres idosas com Osteoartrose de joelho. Metodos Realizou-se um estudo do tipo ensaio clinico nao controlado com delineamento pre-teste e pos-teste, onde foram selecionadas para a pesquisa 30 pacientes do sexo feminino, com idade entre 61 a 80 anos, com diagnostico de Osteoartrose de joelho primaria, atendidas em um Centro de Referencia Integral a Saude do Idoso (CAISI), que foram divididas em 2 grupos de 15 pessoas para cada modalidade de terapias: o grupo I foi tratado com a cinesioterapia, e o grupo II foi tratado com eletrotermoterapia. Pacientes de ambos os grupos realizaram 36 atendimentos fisioterapeuticos durante 12 semanas. Para a coleta dos dados foi utilizada ficha protocolo contendo dados socio-demograficos, indice de massa corporal (IMC), escala visual analogica (EVA) e medida da amplitude do movimento (ADM). Para analise estatistica, foram utilizados os testes nao parametricos de Mann-Whitney e Wilcoxon, o teste parametrico t de Student para amostras independentes e para verificar as associacoes o teste qui-quadrado. Resultados Os tratamentos realizados nos dois grupos contribuiram para a reducao do nivel de dor. Houveram diferencas nos grupo I e II quanto ao aumento da ADM, exceto na flexao do joelho esquerdo no grupo II. Conclusoes Conclui-se que ambas as modalidades de terapias demonstraram respostas terapeuticas pela reducao da dor e melhora da ADM, porem o grupo que foi tratado pela cinesioterapia obteve uma melhora mais acentuada.

Prevalência e fatores associados à anemia ferropriva e hipovitaminose A em crianças menores de um ano

Objective To assess the iron deficiency anemia and vitamin A deficiency prevalence and associated factors in children under one year. Methods Cross-sectional study with a sample of 93 children. Children with hemoglobin <11 g/dL were considered anemic. The cutoff point used for the classification of low levels of vitamin A was < 0.70 mMol/L and to characterize disability < 0.35 mmol/L. Statistical analyzes were carried out using Stata 10.0 software. Variables were presented in simple frequency and the association among the factors and deficiencies of iron and vitamin A was performed by the Pearson chi- square test. Mean hemoglobin and vitamin A were compared using the Student t test for parametric variables and Mann-Whitney test for nonparametric. Results The prevalence of anemia and vitamin A deficiency was 29.03% and 19.10%, respectively. It was found also low vitamin A values in 90.32% of children. The presence of iron deficiency anemia was associated to low maternal age and education. Low values of vitamin Awere significant in non-white mothers. The prevalence of inadequate iron intake and vitamin A was 23.66% and 22.58%, respectively. Conclusion This study evidences the high prevalence of these diseases, highlighting the importance of adopting preventive measures.