Prevalence of central obesity in a large sample of adolescents from public schools in Recife, Brazil / Prevalência de obesidade central em grande amostra de adolescentes de escolas públicas em Recife, Brasil

OBJECTIVE: To determine the prevalence and association of central obesity (CO) and hypertension and its associations with alcohol intake, smoking and physical activity in adolescents. SUBJECTS AND METHODS: Cross sectional study in 1,824 students from 29 public schools in Recife. RESULTS: 89.6 percent were normal weight, 6.7 percent overweight and 3.7 percent obese; 77.2 percent were normotensive, 5.9 percent prehypertensive and 16.9 percent hypertensive; CO was 10.2 percent when the 90th percentile was used as cutoff and 25.2 percent when the 75th percentile was used. There was a higher likelihood of central obesity among students aged 18 to 20 years, smoking and alcohol intake. The probability of hypertension increases if the subject is male, has a waist circumference (WC) > 90, WC > 75 and does not practice physical activity. CONCLUSIONS: A high prevalence of CO and hypertension was found in adolescents. CO was more frequent in students aged 18 to 20 years, smokers and with alcohol intake and hypertension was associated with male, CO and no physical activity.

OBJETIVO: Determinar a prevalência e a associação de obesidade central (CO) e hipertensão e suas associações com consumo de álcool, fumo e atividade física em adolescentes. SUJEITOS E MÉTODOS: Estudo de corte transversal em 1.824 estudantes de 29 escolas públicas em Recife. RESULTADOS: 89,6 por cento com peso normal, 6,7 por cento sobrepeso e 3,7 por cento obesidade; 77,2 por cento normotensos, 5,9 por cento pré-hipertensos e 16,9 por cento hipertensos; 10,2 por cento de CO quando utilizado percentil 90 como ponto de corte e de 25,2 por cento quando utilizado percentil 75. Houve maior probabilidade de CO entre os estudantes com 18 a 20 anos, fumantes e consumo de álcool. A probabilidade de hipertensão aumenta nos homens, com WC (waist circumference) > 90, WC > 75 e sem atividade física. CONCLUSÕES: Elevada prevalência de CO e hipertensão foi encontrada em adolescentes. CO foi mais frequente nos estudantes com 18 a 20 anos, fumantes, e consumo de álcool e hipertensão foram associados com sexo masculino, CO e ausência de atividade física.

The tunica vaginalis dorsal graft urethroplasty: initial experience

INTRODUCTION: Nowadays, buccal mucosa grafts are the most successful method to reconstruct bulbar urethral strictures. Dorsal placement of the graft has been recently proposed, allowing the graft to be spread fixed on the tunica albuginea of the corporal bodies overlying the stricture. The dorsal graft is ingenious and represents a useful addition to the surgical armamentarium, since it offers a better chance for graft take than does the spongiosum when the urethra is diseased and poorly vascularized. We developed an additional reconstructive option using tunica vaginalis grafts, placed dorsally, for the treatment of anterior urethral strictures. SURGICAL TECHNIQUE: A total of 11 patients with anterior urethral strictures were treated with a tunica vaginalis graft urethroplasty. The surgical technique was done as described by Barbagli. The urethra was dissected from the corpora cavernosa and rotated 180 degrees. The dorsal urethral surface was exposed and fully opened. Both the distal and proximal lumina were calibrated. The tunica vaginalis graft was sutured, splayed and quilted over the corpora cavernosa using 6-0 PDS running stitches. The left side of the urethral mucosa was sutured to the graft using 6-0 PDS sutures. A 18F silicone Foley catheter was inserted at this point. The urethra was rotated back to its original position and sutured laterally to the right side of the graft. At the end of the procedure, the graft was completely covered by the urethra. With a follow-up ranging from 7 weeks to 5 months, all patients were voiding well (uroflowmetry > 14 mL per second). CONCLUSION: This initial experience in 11 patients indicates that tunica vaginalis dorsal graft urethroplasty may be considered within the reconstructive armamentarium of genitourinary surgeons.