Respiratory muscle strength and lung function in the stages of Parkinson's disease / Força muscular respiratória e função pulmonar nos estágios da doença de Parkinson

ABSTRACT Objective: To investigate parameters of lung function and respiratory muscle strength in different stages of Parkinson's disease (PD), as well as to determine their correlation with motor function and quality of life. Methods: This was a cross-sectional study conducted at a referral center for PD in the city of Recife, Brazil. Respiratory muscle strength and lung function, as well as their relationship with motor function and quality of life, were evaluated in patients with PD, stratified by the level of severity, and were compared with the data obtained for a control group. After confirming the normality of data distribution, we performed one-way ANOVA with a post hoc t-test. Results: The sample comprised 66 individuals, in two groups: PD (n = 49) and control (n = 17). All of the parameters investigated showed inverse correlations with PD severity, and there were significant differences among the levels of severity, as well as between the PD and control groups, in terms of the MIP, MEP, FVC, FEV1, and FEF25-75%. The lung function parameters also showed moderate to weak inverse correlations with bradykinesia and rigidity. On a quality of life questionnaire, the total score and mobility domain score both presented a moderate inverse correlation with FVC, FEV1, PEF, and MEP. Conclusions: Respiratory muscle strength and some lung function parameters are impaired from the early stages of PD onward, bradykinesia and rigidity being the cardinal signs that correlate most strongly with impairment of those parameters. Such alterations negatively affect the quality of life of patients with PD.

RESUMO Objetivo: Investigar a repercussão de parâmetros de função pulmonar e de força muscular respiratória nos diversos estágios da doença de Parkinson (DP) e suas correlações com a funcionalidade e a qualidade de vida desses pacientes. Métodos: Estudo de corte transversal realizado em um serviço de referência para DP em Recife (PE). Foram avaliadas a força muscular respiratória e a função pulmonar, assim como suas relações com a funcionalidade e a qualidade de vida, em pacientes com DP estratificados por gravidade da DP e comparados a um grupo controle. Após a verificação da normalidade da amostra, foi realizada one-way ANOVA e teste t post hoc. Resultados: A amostra foi composta por 66 indivíduos, sendo 49 no grupo DP e 17 no grupo controle. Houve reduções nos parâmetros investigados com a progressão da doença, em comparação com o grupo controle, sendo encontradas diferenças significativas em PImáx, PEmáx, CVF, VEF1 e FEF25-75% em todos os estágios da DP. Houve correlações inversas (de fraca a moderada) de alguns parâmetros estudados com bradicinesia e rigidez. Os escores totais do questionário de qualidade de vida e de seu domínio mobilidade apresentaram moderada correlação inversa com CVF, VEF1, PFE e PEmáx. Conclusões: A força muscular respiratória e alguns parâmetros de função pulmonar encontram-se reduzidos desde os estágios iniciais da DP, sendo a bradicinesia e a rigidez os sinais cardinais mais correlacionados ao prejuízo desses parâmetros. Essas alterações repercutem negativamente na qualidade de vida desses pacientes.

ABSI is a poor predictor of insulin resistance in Chinese adults and elderly without diabetes

ABSTRACT Objective: Recently, a new obesity index (A Body Shape Index, ABSI) based on waist circumference (WC) was developed, and high ABSI corresponds to a more central concentration of body volume. It is well known that central obesity is closely linked with insulin resistance (IR). Therefore, our study aimed to examine the discriminatory power of ABSI for IR in Chinese adults and elderly without diabetes. Subjects and methods: In 2007, a cross-sectional study was made. In this study, 570 individuals without diabetes were available for analysis (male: 56.1%, mean age: 62.3 ± 6.5 years). Insulin resistance was assessed by homeostasis model assessment (HOMA-IR). Areas under the receiver operating characteristic (ROC) curves were determined to identify variables/models that could predict insulin resistance. Results: ABSI was associated with IR, the cut-off points was 0.0785 m11/6kg-2/3 to identifying IR and the area under the ROC (AUC) curve was 0.618 (95%CI: 0.561-0.675), which was not better than body mass index BMI (AUC = 0.753; 95%CI: 0.706-0.801), WC (AUC = 0.749; 95%CI: 0.700-0.797), and fasting plasma glucose (FPG, AUC = 0.752; 95%CI: 0.705-0.799). Furthermore, combination with ABSI could improve the discriminatory power of other variables for IR. The AUC curve increased from 0.753 to 0.771for BMI, 0.749 to 0.754 for WC, 0.752 to 0.769 for FPG, respectively. Conclusions: ABSI is associated with IR in the general Chinese adults and elderly without diabetes, but the discriminatory power for IR is poor. It is recommended that ABSI be used in combination with other variables.

Water temperature, body mass and fasting heat production of pacu (Piaractus mesopotamicus)

ABSTRACT Knowledge on fasting heat production (HEf) of fish is key to develop bioenergetics models thus improving feeding management of farmed species. The core of knowledge on HEf of farmed, neotropical fish is scarce. This study assessed the effect of body mass and water temperature on standard metabolism and fasting heat production of pacu, Piaractus mesopotamicus, an omnivore, Neotropical fresh water characin important for farming and fisheries industries all through South American continent. An automated, intermittent flow respirometry system was used to measure standard metabolic rate (SMR) of pacu (17 - 1,050 g) at five water temperatures: 19, 23, 26, 29 and 33 °C. Mass specific SMR increased with increasing water temperature but decreased as function of body mass. The allometric exponent for scaling HEf was 0.788, and lied in the range recorded for all studied warm-water fish. The recorded van't Hoff factor (Q10) for pacu (2.06) shows the species low response to temperature increases. The model HEf = 0.04643×W0.7882×T1.837 allows to predict HEf (kJ d-1) from body mass (W, kg) and water temperature (T, °C), and can be used in bioenergetical models for the species.

Cardiac remodeling indicators in adolescent athletes / Indicadores de remodelagem cardíaca em atletas adolescentes

Summary Objective: The idea that different sports and physical training type results in different cardiac adaptations has been widely accepted. However, this remodelling process among different sport modalities is still not fully understood. Thus, the current study aims to investigate the heart morphology variation associated with a set of different modalities characterized by distinct models of preparation and different methods and demands of training and completion. Method: The sample comprises 42 basketball players, 73 roller hockey players, 28 judo athletes and 21 swimmers. Anthropometry was assessed by a single and experienced anthropometrist and the same technician performed the echocardiographic exams. Analysis of variance was used to study age, body size and echocardiograph parameters as well as different sport athlete's comparison. Results: Basketball players are taller (F=23.448; p<0.001; ES-r=0.553), heavier (F=6.702; p<0.001; ES-r=0.334) and have a greater body surface area (F=11.896; p<0.001; ES-r=0.427). Basketball and hockey players have larger left auricle diameters compared with judo athletes (F=3.865; p=0.011; ES-r=0.316). Interventricular end-diastolic septal thickness (F=7.287; p<0.001; ES-r=0.347) and left ventricular posterior wall thickness (F=8.038; p<0.001; ES-r=0.362) of the judokas are smaller compared to the mean values of other sports participants. In addition, relative left parietal ventricular wall thickness is lower among swimmers compared with judokas (F=4.127; p=0.008; ES-r=0.268). Conclusion: The major contributors to changes in heart morphology are for the most part associated with sport-specific training and competition and the specific dynamics and adaptive mechanisms imposed by each sport.

Resumo Objetivo: Os efeitos decorrentes da prática de diferentes modalidades desportivas resultam em padrões divergentes de adaptação cardíaca. A presente pesquisa procura estudar a variação da morfologia do coração associada a um conjunto de modalidades desportivas distintas quanto à natureza do esforço e aos modelos de preparação, incluindo metodologias de treino e sistemas de competição. Método: Foram estudados 42 basquetebolistas, 73 hoquistas, 28 judocas e 21 nadadores. A antropometria foi avaliada por um único e experiente antropometrista e os exames ecocardiográficos foram realizados pelo mesmo operador. Recorreu-se à análise da variância para estudar a variação associada a idade, medidas de tamanho corporal e parâmetros ecocardiográficos, bem como para a comparação entre os atletas de diferentes modalidades desportivas. Resultados: Os basquetebolistas são os atletas mais altos (F=23,448; p<0,001; ES-r=0,553), mais pesados (F=6,702; p<0,001; ES-r=0,334), com maior superfície corporal (F=11,896; p<0,001; ES-r=0,427) e, com os hoquistas, apresentam um diâmetro da aurícula esquerda superior ao dos judocas (F=3,865; p=0,011; ES-r=0,316). A espessura telediastólica do septo interventricular (F=7,287; p<0,001; ES-r=0,347) e da parede posterior do ventrículo esquerdo (F=8,038; p<0,001; ES-r=0,362) dos judocas é inferior à dos outros atletas, mesmo quando controlado para o tamanho corporal. Os nadadores apresentam uma espessura parietal relativa do ventrículo esquerdo superior à dos judocas (F=4,127; p=0,008; ES-r=0,268). Conclusão: As diferentes fontes de variação da morfologia cardíaca prendem-se com as dinâmicas do processo de treino, competição e correspondentemente com os mecanismos adaptativos, sobrepondo-se ao processo de formação desportiva a longo prazo.

Preliminary assessment of neck circumference in benign prostatic hyperplasia in patients with metabolic syndrome

ABSTRACT Objectives To investigate the impact of neck circumference (NC) in the treatment of bening prostatic hyperplasia (BPH) patients with metabolic syndrome (MtS). Additionally, we determined dose response to alpha-blockers and cut-off values for NC and waist circumference (WC), in these patients. Materials and Methods Non-randomized, open-labelled, and multi-centre study was conducted between March 2014 and September 2015. The BPH patients were enrolled and were divided into 2 groups: with MtS (Group 1; n=94) and without MtS (Group 2; n=103). Demographic data, anthropometric measurements, blood analyses, uroflowmetric parameters, post voiding residual urine (PVR), prostate volume, quality of life (QoL) index, NC and WC were recorded. Both groups were administered oral alpha-blockers and response to treatment was evaluated. Receiver-operating characteristic (ROC) curves were obtained and significant p was p<0.05 . Results In total, 197 patients were enrolled with mean age of 60.5±8.1 years. Mean NC and WC were higher in MtS patients (p<0.001). Uroflowmetry parameters and QoL indexes were comparable between groups before treatment. International prostate symptom score, uroflowmetry parameters, and QoL significant improved in Group 2 than Group 1, at 1 st and 6 th months of treatment with alpha-blockers. Success rate of treatment was significant higher in Group 2 than Group 1 (p<0.001). Cut-off values were 42.5cm and 113.5cm for NC and WC respectively, for response to alpha-blockers in BPH patients with MtS. Conclusions MtS can be related with BPH and can negatively affect the response to alpha-blocker treatment. NC can be used for predicting response to alpha-blocker treatment in BPH patients with MtS.

Cutoffs and cardiovascular risk factors associated with neck circumference among community-dwelling elderly adults: a cross-sectional study / Pontos de corte e fatores de risco cardiovascular associados com a circunferência do pescoço em idosos da comunidade: um estudo transversal

ABSTRACT CONTEXT AND OBJECTIVE: In elderly people, measurement of several anthropometric parameters may present complications. Although neck circumference measurements seem to avoid these issues, the cutoffs and cardiovascular risk factors associated with this parameter among elderly people remain unknown. This study was developed to identify the cutoff values and cardiovascular risk factors associated with neck circumference measurements among elderly people. DESIGN AND SETTING: Cross-sectional study conducted in two community centers for elderly people. METHODS: 435 elderly adults (371 women and 64 men) were recruited. These volunteers underwent morphological evaluations (body mass index and waist, hip, and neck circumferences) and hemodynamic evaluations (blood pressure values and heart rate). Receiver operating characteristic curve analyses were used to determine the predictive validity of cutoff values for neck circumference, for identifying overweight/obesity. Multivariate analysis was used to identify cardiovascular risk factors associated with large neck circumference. RESULTS: Cutoff values for neck circumference (men = 40.5 cm and women = 35.7 cm), for detection of obese older adults according to body mass index, were identified. After a second analysis, large neck circumference was shown to be associated with elevated body mass index in men; and elevated body mass index, blood pressure values, prevalence of type 2 diabetes and hypertension in women. CONCLUSION: The data indicate that neck circumference can be used as a screening tool to identify overweight/obesity in older people. Moreover, large neck circumference values may be associated with cardiovascular risk factors.

RESUMO CONTEXTO E OBJETIVO: Em idosos, diversas ferramentas antropométricas podem apresentar complicações durante a mensuração. Embora a circunferência do pescoço pareça evitar tais problemas, os pontos de corte e fatores de risco cardiovascular associados a essa ferramenta em idosos permanecem desconhecidos. Este estudo foi desenvolvido para identificar os valores de ponto de corte e fatores de risco cardiovascular associados à circunferência do pescoço em idosos. DESENHO E LOCAL: Estudo transversal, realizado em dois centros comunitários para idosos. MÉTODOS: 435 idosos (371 mulheres e 64 homens) foram recrutados. Os voluntários foram submetidos a avaliação morfológica (índice de massa corporal e cintura, quadril, e circunferência do pescoço) e hemodinâmica (valores da pressão arterial e frequência cardíaca). A análise pela curva receiver operating characteristic foi usada para determinar o valor preditivo dos valores de ponto de corte da circunferência do pescoço para identificação de sobrepeso/obesidade. Análise multivariada foi usada para identificar os fatores de risco cardiovascular associados com circunferência do pescoço larga. RESULTADOS: Os valores de corte para circunferência do pescoço (homens = 40,5 cm e mulheres = 35,7 cm) para detectar adultos idosos obesos, de acordo com o índice de massa corporal, foram identificados. Depois da segunda análise, circunferência do pescoço larga foi associada com elevado índice de massa corporal em homens e mulheres e elevados valores de pressão arterial, prevalência de diabetes mellitus tipo II e hipertensão em mulheres. CONCLUSÃO: Os dados indicam que a circunferência do pescoço pode ser utilizada como ferramenta de rastreio para identificar sobrepeso/obesidade em idosos. Ademais, altos valores de circunferência do pescoço podem estar associados com fatores de risco cardiovascular.

Relationship Between Neck Circumference and Epicardial Fat Thickness in a Healthy Male Population / Relação Entre Circunferência do Pescoço e Espessura da Gordura Epicárdica em Uma População de Homens Saudáveis

Abstract Background: Epicardial fat is an upper body visceral fat depot that may play a significant role in the development of adverse metabolic and cardiovascular risk profiles. There is a significant direct relationship between the amount of epicardial fat and general body adiposity (body mass index, BMI), but data regarding subcutaneous adiposity is limited. Objective: We conducted a study to determine the association between neck circumference and epicardial fat thickness in healthy young male individuals, and assess their individual correlations with general body adiposity and cardiometabolic risk factors. Methods: One hundred consecutive male patients aged 18 years or older with no known major medical conditions were included in the study. All participants underwent detailed physical examination including measurement of blood pressure, weight, height, waist/hip ratio, and neck circumference. Blood was collected to determine fasting glucose and lipid parameters. A standard echocardiographic examination was performed with additional epicardial fat thickness determination. Results: Among 100 study participants, neck circumference correlated significantly with weight, waist circumference, BMI, blood glucose, serum total cholesterol, low-density (LDL)-cholesterol, and triglycerides levels. No significant correlation was found between neck circumference and high-density lipoprotein (HDL)-cholesterol levels. Neck circumference correlated moderately and positively with echocardiographic epicardial fat thickness. Conclusion: Among patients with low cardiometabolic risk, increased neck circumference was associated with increased epicardial fat thickness.

Resumo Fundamentos: A gordura epicárdica é um depósito de gordura visceral na parte superior do organismo que pode desempenhar um papel importante no desenvolvimento de perfis cardiovasculares e metabólicos adversos. Há uma relação direta significativa entre a quantidade de gordura epicárdica e a adiposidade corporal geral (índice de massa corporal, IMC), mas dados sobre a adiposidade subcutânea são limitados. Objetivos: Realizamos um estudo para determinar a associação entre a circunferência do pescoço e a espessura da gordura epicárdica em jovens saudáveis do sexo masculino, além de avaliar as suas correlações individuais com a adiposidade corporal geral e fatores de risco cardiometabólicos. Métodos: Cem pacientes consecutivos do sexo masculino com idade igual ou superior a 18 anos e sem nenhuma condição médica importante e conhecida foram incluídos no estudo. Todos os participantes foram submetidos a um exame físico detalhado que incluiu medida da pressão arterial, peso, altura, razão cintura/quadril e circunferência do pescoço. Sangue foi coletado para determinação da glicemia de jejum e parâmetros lipídicos. Um exame ecocardiográfico padrão foi realizado com determinação adicional da espessura da gordura epicárdica. Resultados: Entre os 100 participantes do estudo, a circunferência do pescoço mostrou correlação significativa com o peso, circunferência de cintura, IMC, glicemia e níveis séricos de colesterol total, lipoproteína de baixa densidade (LDL-colesterol) e triglicerídeos. Não foi observada correlação significativa entre a circunferência do pescoço e níveis de colesterol de alta densidade (HDL-colesterol). A circunferência do pescoço correlacionou moderadamente e positivamente com a espessura da gordura epicárdica à ecocardiografia. Conclusão: Entre pacientes com baixo risco cardiometabólico, o aumento da circunferência do pescoço foi associado a um aumento da espessura da gordura epicárdica.

Maternal 75-g OGTT glucose levels as predictive factors for large-for-gestational age newborns in women with gestational diabetes mellitus

ABSTRACT Objective Our goal was to investigate which glucose measurement from the 75-g oral glucose tolerance test (OGTT) has more capability of predicting large for-gestational-age (LGA) newborns of mothers with gestational diabetes mellitus (GDM). Subjects and methods The study group consisted of 118 consecutively pregnant women with singleton pregnancy, patients of Outpatients Department of the Endocrinology, Diabetes, and Metabolic Disorders Clinic. All were prospectively screened for GDM between 24th and 28th week of pregnancy and followed to delivery. Outcome measures included: patients’ ages, pre-pregnancy BMI, BMI before delivery, FPG, 1 and 2 hour OGTT glucose values, haemoglobin A1c at third trimester, gestational week of delivery, mode of delivery and baby birth weight. Results From 118 pregnancies, 78 (66.1%) women were with GDM, and 40 (33.9%) without GDM. There were statistically significant differences (30.7 versus 5.0%, p < 0.01) between LGA newborns from GDM and control group, respectively. Gestation week of delivery and fasting glucose levels were independent predictors for LGA (Beta = 0.58 and Beta = 0.37 respectively, p < 0.01). Areas under the receiver operator characteristic curve (AUC) were compared for the prediction of LGA (0.782 (0.685-0.861) for fasting, 0.719 (0.607-0.815) for 1-hour and 0.51 (0.392-0.626) for 2-hour OGTT plasma glucose levels). Conclusion Fasting and 1-hour plasma glucose levels from OGTT may predict LGA babies in GDM pregnancies.

Allometric relationships among body mass, MUZZLE-tail length, and tibia length during the growth of Wistar rats1

PURPOSE : To investigate allometric relationships among body mass (BM), muzzle-tail length (MTL), and tibia length (TL) in Wistar rats and establish their growth rate change parameters. METHODS : Eighteen male and 18 female Wistar rats were studied from the 3rd to the 21st week of age. BM, MTL, and TL were measured daily, and relative growth was compared using allometry. RESULTS : A positive correlation between BM and MTL (p<0.05) and BM and TL (p<0.05) was observed. Males and females showed comparable curves; however, females had turning points at a younger age. The allometric relationship between BM and MTL presented a regular increase until reaching a mass of 351 g (males) and 405 g (females). BM and TL showed an initial increase until 185 g (males) and 182 g (females), and then reached a plateau that finished at 412 g (males) and 334 g (females), to display another increase. CONCLUSIONS : The allometric relationship of body mass with animal length and tibia length was comparable for male and female rats, with female rats maturing earlier. Animal longitudinal growth occurred in a single stage. In contrast, tibia length depicted two stages of accelerated growth with an intermediate period of deceleration.

Perceptions about penis size among supposedly healthy 40 to 60-year-old Brazilian men: a cross-sectional pilot study / Percepções sobre o tamanho do pênis em homens brasileiros supostamente saudáveis de 40 a 60 anos: um estudo piloto transversal

CONTEXT AND OBJECTIVE: Many men seek medical treatments complaining that their penises are too small (short) when in fact they are not (they are not cases of micropenis). The objective of the present study was to evaluate men's satisfaction with their own bodies and sex life and the prevalence of erectile dysfunction, among men who were not seeking medical or psychological advice. DESIGN AND SETTING: Cross-sectional study in a private, philanthropic hospital in São Paulo, Brazil. METHODS: In this study, 300 male blood donors aged between 40 and 60 years old answered a questionnaire, in privacy, about their sex life and their satisfaction with their own bodies. They were also screened for erectile dysfunction by means of the International Index of Erectile Function questionnaire. RESULTS: Seven men (2.3%) reported that they were dissatisfied with their penis size (they thought that it was small), and among these, one was found to have mild erectile dysfunction. However, none of them had sought medical attention. Among these seven, only two had normal body mass index; the other five were overweight (three) or obese (two). CONCLUSION: The prevalence of dissatisfaction with penis size was low. Among the seven dissatisfied men, only one had erectile dysfunction, of mild type, and all of them felt potent. .

CONTEXTO E OBJETIVO: Muitos homens buscam tratamento médico com a queixa de que seus pênis são muito pequenos (curtos), quando na verdade não são (não são casos de micropênis). O objetivo do presente estudo foi avaliar a satisfação com o próprio corpo e vida sexual e a prevalência de disfunção erétil entre homens que não estavam buscando aconselhamento médico ou psicológico. TIPO DE ESTUDO E LOCAL: Estudo transversal, em um hospital privado filantrópico em São Paulo, Brasil. MÉTODOS: Neste estudo, 300 homens doadores de sangue, com idade entre 40 e 60 anos, responderam um questionário, em privacidade, sobre sua vida sexual e satisfação com o próprio corpo. Eles também foram rastreados para disfunção erétil por meio do questionário International Index of Erectile Function. RESULTADOS: Sete homens (2,3%) disseram estar insatisfeitos com o tamanho de seus pênis (achavam que era pequeno), e entre estes, um tinha disfunção erétil leve. Entretanto, nenhum deles procurou aten-dimento médico. Entre esses sete, somente dois estavam com índice de massa corporal normal, três estavam com sobrepeso e dois eram obesos. CONCLUSÃO: A prevalência de insatisfação com o tamanho do pênis foi pequena. Entre os sete homens insatisfeitos, apenas um tinha disfunção erétil, leve, e todos se sentiam potentes. .

She’s a femme fatale: low-density larval development produces good disease vectors

Two hypotheses for how conditions for larval mosquitoes affect vectorial capacity make opposite predictions about the relationship of adult size and frequency of infection with vector-borne pathogens. Competition among larvae produces small adult females. The competition-susceptibility hypothesis postulates that small females are more susceptible to infection and predicts frequency of infection should decrease with size. The competition-longevity hypothesis postulates that small females have lower longevity and lower probability of becoming competent to transmit the pathogen and thus predicts frequency of infection should increase with size. We tested these hypotheses for Aedes aegypti in Rio de Janeiro, Brazil, during a dengue outbreak. In the laboratory, longevity increases with size, then decreases at the largest sizes. For field-collected females, generalised linear mixed model comparisons showed that a model with a linear increase of frequency of dengue with size produced the best Akaike’s information criterion with a correction for small sample sizes (AICc). Consensus prediction of three competing models indicated that frequency of infection increases monotonically with female size, consistent with the competition-longevity hypothesis. Site frequency of infection was not significantly related to site mean size of females. Thus, our data indicate that uncrowded, low competition conditions for larvae produce the females that are most likely to be important vectors of dengue. More generally, ecological conditions, particularly crowding and intraspecific competition among larvae, are likely to affect vector-borne pathogen transmission in nature, in this case via effects on longevity of resulting adults. Heterogeneity among individual vectors in likelihood of infection is a generally important outcome of ecological conditions impacting vectors as larvae.

Antigos e novos indicadores antropométricos como preditores de resistência à insulina em adolescentes / Old and new anthropometric indices as insulin resistance predictors in adolescents

Objetivo Apesar da importância da resistência à insulina (RI) no desenvolvimento de doenças crônicas, seu diagnóstico envolve demandas invasivas. Assim, faz-se necessário o desenvolvimento de métodos alternativos para predizer RI na prática clínica, sendo os indicadores antropométricos uma alternativa. Portanto, o objetivo deste estudo é avaliar o comportamento desses indicadores com relação ao HOMA-IR (Homeostasis Model Assessment of Insulin Resistance). Materiais e métodos: Coletaram-se peso, altura e circunferência da cintura de 148 adolescentes. A partir destes, calcularam-se índice de massa corporal (IMC), índice de massa corporal invertido (IMCi), relação cintura-estatura (RCE) e índice de conicidade (IC). Coletaram-se ainda dados de composição corporal (percentual de gordura corporal – %GC), por meio de bioimpedância elétrica, e dados bioquímicos (glicemia e insulinemia de jejum) empregados no cálculo do HOMA-IR. O ponto de corte para o HOMA-IR adotado foi de 2,39±1,93. A análise estatística envolveu a correlação de Spearman, a construção de modelos de regressão linear múltiplos e curvas ROC (Receiver Operating Characteristic), com IC de 95%. Utilizou-se o pacote estatístico SPSS v.18.0, considerando p<0,05 como nível de significância. Resultados Todos os indicadores antropométricos estavam estatisticamente correlacionados de forma positiva ao HOMA-IR. A curva ROC mostrou que CC, RCE e IC, nesta ordem, apresentaram-se mais eficazes em predizer RI. Conclusão Entre os indicadores estudados, aqueles relacionados ao acúmulo de gordura central parecem os mais indicados para predizer RI. .

Objective Despite the importance of insulin resistance (IR) on chronic diseases development, its diagnosis remains invasive. Thus, it’s necessary to develop alternative methods to predict IR on clinical practice, and the anthropometric indices are a good alternative to it. Given that, this study’s purpose is to evaluate these indices behavior in relation to HOMA-IR (Homeostasis Model Assessment of Insulin Resistance). Materials and methods: We collected weight, height and waist circumference from 148 adolescents. Through these indices, we calculated the body mass index (BMI), inverted body mass index (iBMI), waist-to-height ratio (WHtR) and conicity index (C index). We also collected data from body composition (body fat percentage – %BF), through electric impedance, and biochemical data (fasting glucose and insulin levels) employed on the HOMA-IR calculation. The HOMA-IR cutoff adopted was of 2.39±1.93. The statistical analysis involved the Spearman correlation analysis, multiple linear regression models and ROC (Receiver Operating Characteristic) curves construction, using 95% CI. We used the statistic pack SPSS v.18, considering p<0.05 as the significance level. Results All anthropometric indices were statistically and positively correlated to HOMA-IR. The ROC curve showed that WC, WHtR and C index, in this order, were the most efficient to predict IR. Conclusion Among the indicators studied, those related to central fat accumulation seem the most suitable for predicting IR. .

Evidence of underdiagnosis and markers of high blood pressure risk in children aged 6 to 13 years / Evidências de subdiagnóstico e marcadores de risco de pressão arterial elevada em crianças de 6 a 13 anos

OBJECTIVE: To estimate the prevalence of high blood pressure (BP) in school children, as well as the reported frequency of previous measurements of BP in these children, and to identify high BP risk markers in the sample. METHODS: This was a cross-sectional study involving 794 children aged 6 to 13 years, enrolled in public elementary schools. A questionnaire was given to parents/guardians, consisting of perinatal, socioeconomic data, and information on previous measurements of BP in these children. Anthropometric measurements included weight, height, waist, hip, and arm and neck circumference, in addition to the three BP measurements. Classification of BP levels was carried out according to current international recommendations, established in 2004. RESULTS: The prevalence of high BP (hypertension or prehypertension) was 7%. Only 21.7% of children had previously undergone BP measurements. The odds ratio of high BP among children with and without overweight was 2.9 (95% CI = 1.7 to 5.0, p < 0.001). None of the anthropometric measurements was superior to the Z-score of BMI as a predictor of high BP. History of hypertension during pregnancy (p < 0.001), prematurity (p = 0.006), maternal hypertension (p = 0.01), and paternal hypertension (p = 0.008) were also correlated with the presence of high BP in children. CONCLUSIONS: Overweight and family history constitute the main risk markers of high BP in children. The low frequency of BP measurement in children observed in this municipality contributes to the underdiagnosis of the disease, with irreversible consequences for these individuals. .

OBJETIVO: Estimar a prevalência de pressão arterial (PA) elevada em escolares, assim como a frequência relatada de aferição prévia da PA nessas crianças. Identificar marcadores de risco de PA elevada na amostra. MÉTODOS: Estudo transversal envolvendo 794 crianças de 6 a 13 anos, matriculadas no ensino público fundamental. Questionário entregue aos pais, com informações perinatais, sócio-econômicas e sobre aferição prévia da PA nas crianças. Avaliação antropométrica: peso, altura, circunferências abdominal, de quadril, braquial e cervical, além das três aferições da pressão arterial. Classificação dos níveis pressóricos conforme as recomendações internacionais atuais, estabelecidas em 2004. RESULTADOS: A prevalência de PA elevada (hipertensão ou pré-hipertensão) foi de 7%. Apenas 21,7% das crianças haviam sido previamente submetidas a aferições de PA. A razão de chances de PA elevada entre crianças com e sem excesso de peso foi de 2,9 (IC 95% = 1,7 a 5,0, p < 0,001). Nenhuma das medidas antropométricas foi superior ao Z de IMC como preditor de PA elevada. Histórico de hipertensão na gestação (p < 0,001), de prematuridade (p = 0,006), hipertensão materna (p = 0,01) e hipertensão paterna (p = 0,008) também se correlacionaram à presença de PA elevada nas crianças. CONCLUSÕES: Excesso de peso e história familiar configuram como principais marcadores de risco de PA elevada em crianças. A baixa frequencia de aferição da PA observada em crianças deste município contribui para o subdiagnóstico da doença, com consequências futuras irreversíveis para esses indivíduos. .

Diabetes mellitus and impaired glucose tolerance in urban adult population / Diabete melito e tolerância diminuída à glicose em população adulta urbana

Objective: Estimating the prevalence of diabetes mellitus (DM) and impaired glucose tolerance (IGT) in the urban population aged between 30 and 69 years in the municipality of Campo Grande, state of Mato Grosso do Sul, Brazil. Methods: Population-based cross-sectional study conducted between October/2009 and February/2011. The investigation included the determination of fasting glucose and participants with blood glucose ≥ 200 mg/dL were considered diabetic. Nondiabetic patients, which showed blood glucose ≥ 100 mg/dL and < 200 mg/dL, underwent an oral glucose tolerance test (OGTT) to investigate whether they had DM or IGT. Results: 1.429 individuals participated in this investigation. The general prevalence, adjusted for sex and age, were: 12.3% for DM (95%CI: 10.5 to 13.9%) and 7.1% for IGT (95%CI: 5.7 to 8.4%). There was a higher prevalence of DM with increasing age in people with low educational level, family history of diabetes, overweight, obesity and central obesity. Among diabetic patients (n = 195), 25% were unaware they had the disease and were diagnosed through investigation. Among patients who already knew they had DM (n = 146), 37% were unaware of the potential chronic complications. Conclusion: This study confirms the increased prevalence of DM in Brazil and emphasizes the need for early diagnosis, as well as the importance of strict adherence to medical treatment in order to prevent its much feared complications. .

Objetivo: estimar a prevalência de diabete melito (DM) e a tolerância diminuída à glicose (TDG) na população urbana de idade entre 30 e 69 anos do município de Campo Grande/MS. Métodos: estudo transversal de base populacional realizado entre 10/2009 e 2/2011. Na investigação, foi realizada a dosagem da glicemia capilar em jejum e os participantes com glicemia ≥ 200 mg/dL foram considerados diabéticos. Os não diabéticos, que apresentaram glicemia ≥ 100 mg/dL e < 200 mg/dL, foram submetidos a um teste oral de tolerância à glicose (TOTG) para investigar se tinham DM ou TDG. Resultados: nesta investigação, participaram 1.429 indivíduos. As prevalências gerais, ajustadas por sexo e faixa etária, foram: para DM de 12,3% (IC95%: 10,5 a 13,9%) e para TDG de 7,1% (IC95%: 5,7 a 8,4%). Houve maior prevalência de DM com o aumento da idade, em pessoas com baixa escolaridade, histórico de diabete na família, sobrepeso, obesidade e obesidade central. Do total de diabéticos (n= 195), 25% não sabiam que tinham a doença e obtiveram o diagnóstico por meio da investigação. Dos pacientes que já sabiam ter DM (n= 146), 37% desconheciam as potenciais complicações crônicas. Conclusão: este estudo corrobora o aumento da prevalência de DM no Brasil e enfatiza a necessidade de sua constatação precoce, bem como da importância da adesão rigorosa ao tratamento médico com o intuito de prevenir suas temíveis complicações. .

Crescimento e composição corporal de uma coorte de crianças e adolescentes com diabetes tipo 1 / Growth and body composition of a cohort of children and adolescents with type 1 diabetes

OBJETIVO: Avaliar o crescimento e a composição corporal de crianças e adolescentes com diabetes tipo 1 (DM1). SUJEITOS E MÉTODOS: Estudo de uma coorte de 44 pacientes com DM1 acompanhados em média por quatro anos, comparados a um grupo controle. Avaliaram-se peso, estatura, índice de massa corporal (IMC), porcentagem de massa gorda (%MG), índice de massa gorda, cintura e razão cintura/estatura. RESULTADOS: No sexo feminino, na primeira avaliação a %MG das pacientes foi menor, enquanto na segunda avaliação a média da cintura das pacientes foi maior que a dos controles. No sexo masculino, a estatura dos pacientes foi menor na primeira avaliação, enquanto o IMC foi maior na segunda. Não foram observadas diferenças entre as variações dos escores z de estatura, peso e IMC e da %MG ou na distribuição desses escores entre as duas avaliações em ambos os grupos. A análise multivariada mostrou diferença no IMC e na razão cintura/estatura dos dois sexos e também na cintura das meninas. CONCLUSÃO: Os pacientes apresentaram crescimento adequado, porém diferiram na composição corporal durante o período do estudo.

OBJECTIVE: To evaluate the growth and body composition of children and adolescents with type 1 diabetes mellitus (T1DM). SUBJECTS AND METHODS: A cohort of 44 patients with T1DM were followed up for approximately four years and compared with a control group. Weight, height, body mass index (BMI), body fat percentage (BF%), fat mass index, waist circumference (WC) and waist-height ratio were determined. RESULTS: In females, in the first evaluation, BF% was lower in patients than in controls, while in the second evaluation, mean WC was higher in patients than in controls. In males, height of the patients was lower in the first evaluation, while body mass index (BMI) was higher in the second one. We did not find any differences among the changes in height, weight and BMI z-scores and BF% or in the distribution of those z-scores between the two evaluations, in both groups. Multiple regression analysis found differences in BMI and waist-height ratio in both sexes and also in WC in females. CONCLUSION: The patients had adequate growth but showed discrepancy in their body composition during the study.

Body size and longitudinal body weight changes do not increase mortality in incident peritoneal dialysis patients of the Brazilian peritoneal dialysis multicenter study

OBJECTIVES: To determine the roles of body size and longitudinal body weight changes in the survival of incident peritoneal dialysis patients. PATIENTS AND METHODS: Patients (n = 1911) older than 18 years of age recruited from 114 dialysis centers (Dec/ 2004-Oct/2007) and participating in the Brazilian Peritoneal Dialysis Multicenter Cohort Study were included. Clinical and laboratory data were collected monthly (except if the patient received a transplant, recovered renal function, was transferred to hemodialysis, or died). RESULTS: Survival analyses were performed using Kaplan-Meier survival curves and Cox proportional hazards. Total follow-up was 34 months. The mean age was 59 years (54% female). The weight category percentages were as follows: underweight: 8%; normal: 51%; overweight: 29%; and obese 12%. The multivariate model showed a higher risk of death for a body mass index <18.5 kg/m², a neutral risk between 25 and 29.9 kg/m² and a protective effect for an index >30 kg/m². Patients were divided into five categories according to quintiles of body weight changes during the first year of dialysis: <-3.1%, -3.1 to+0.12%, +0.12 to <+3.1% (reference category), +3.1 to +7.1% and >+7.1%. Patients in the lowest quintile had significantly higher mortality, whereas no negative impact was observed in the other quintiles. CONCLUSION: These findings suggest that overweight/obesity and a positive body weight variation during the first year of peritoneal dialysis therapy do not increase mortality in incident dialysis patients in Brazil.

Análise vetorial de impedância bioelétrica (BIVA) em recém-nascidos pré-termo estáveis / Bioelectrical impedance vector analysis (BIVA) in stable preterm newborns

OBJETIVO: Observar o comportamento dos vetores ponteados no gráfico de resistência e de reactância corrigidos pelo comprimento corporal (RXc) através da análise vetorial de impedância bioelétrica (BIVA) e os valores de ângulo de fase (AF) em recém-nascidos (RNs) pré-termo estáveis, considerando a hipótese que o RN pré-termo apresenta o seu comportamento vetorial na BIVA sugestivo de menor quantidade de água e de tecidos moles corporais, comparativamente à referência do RN a termo. MÉTODOS: Foi realizado estudo de corte transversal em RNs pré-termo, de ambos os sexos, que se encontravam em uma unidade de cuidados intermediários de um hospital terciário. Coletaram-se dados relacionados ao nascimento e à alimentação, bem como dados de bioimpedância elétrica (800 mA, 50 kHz). Os gráficos e as análises vetoriais foram realizados através do BIVA software. RESULTADOS: Um total de 108 RNs pré-termo foram estudados, separados por faixa etária (< 7 dias e > 7 dias). A maioria dos RNs pré-termo encontrou-se fora da normalidade (acima dos intervalos de tolerância de 95%) existentes na literatura para RNs a termo, e observou-se uma tendência para a dispersão dos pontos no quadrante superior direito no gráfico RXc. O AF dos RNs < 7 dias foi de 4,92° (±2,18), e a dos RNs > 7 dias, de 4,34° (±2,37). CONCLUSÃO: Os RNs pré-termo se comportam de maneira semelhante entre si. A maioria deles possui menor quantidade absoluta de água corporal e apresenta menor quantidade tanto de massa livre de gordura quanto de massa gorda, em valores absolutos, quando comparados com os RNs a termo.

OBJECTIVE: To observe the behavior of the plotted vectors on the RXc (R - resistance - and Xc - reactance corrected for body height/length) graph through bioelectrical impedance analysis (BIVA) and phase angle (PA) values in stable premature infants, considering the hypothesis that preterm infants present vector behavior on BIVA suggestive of less total body water and soft tissues, compared to reference data for term infants. METHODS: Cross-sectional study, including preterm neonates of both genders, in-patients admitted to an intermediate care unit at a tertiary care hospital. Data on delivery, diet and bioelectrical impedance (800 mA, 50 kHz) were collected. The graphs and vector analysis were performed with the BIVA software. RESULTS: A total of 108 preterm infants were studied, separated according to age (< 7 days and > 7 days). Most of the premature babies were without the normal range (above the 95% tolerance intervals) existing in literature for term newborn infants and there was a tendency to dispersion of the points in the upper right quadrant, RXc plan. The PA was 4.92° (±2.18) for newborns < 7 days and 4.34° (±2.37) for newborns > 7 days. CONCLUSION: Premature infants behave similarly in terms of BIVA and most of them have less absolute body water, presenting less fat free mass and fat mass in absolute values, compared to term newborn infants.

Obese elderly women exhibit low postural stability: a novel three-dimensional evaluation system

OBJECTIVE: The aim of this study was to evaluate the multisegmental static postural balance of active eutrophic and obese elderly women using a three-dimensional system under different sensory conditions. METHODS: A cross-sectional study was conducted on 31 elderly women (16 eutrophic and 15 obese) aged 65 to 75 years. The following anthropometric measurements were obtained: weight, height, waist and hip circumference, and handgrip strength. The physical activity level was evaluated using the International Physical Activity Questionnaire. Body composition was measured using the deuterium oxide dilution technique. The Polhemus® Patriot (three-dimensional) equipment was used to measure the parameters of postural balance along the anteroposterior and laterolateral axes. The data acquisition involved one trial of 60 s to test the limit of stability and four trials of 90 s each under the following conditions: (1) eyes open, stable surface; (2) eyes closed, stable surface; (3) eyes open, unstable surface; and (4) eyes closed, unstable surface. RESULTS: For the limit of stability, significant differences were observed in the maximum anteroposterior and laterolateral displacement (p<0.01) and in the parameter maximum anteroposterior displacement in the eyes closed stable surface condition (p<0.01) and maximum anteroposterior and laterolateral displacement in the eyes open unstable surface (p<0.01 and p = 0.03) and eyes closed unstable surface (p<0.01 and p<0.01) conditions. CONCLUSIONS: Obese elderly women exhibited a lower stability limit (lower sway area) compared with eutrophic women, leaving them more vulnerable to falls.

Diet and feeding strategy of the dusky grouper Mycteroperca marginata (Actinopterygii: Epinephelidae) in a man-made rocky habitat in southern Brazil

A garoupa-verdadeira (Mycteroperca marginata) é uma espécie marinha geralmente associada a fundos rochosos e recifes. O presente trabalho investiga a dieta e estratégia alimentar de uma população da garoupa-verdadeira que habita um longo (4,5 km) par de molhes de pedra na desembocadura do estuário da laguna dos Patos, sul do Brasil. Não há trabalhos anteriores realizados nesse tipo de habitat construído pelo homem e este trabalho fornece uma base de comparação com estudos de dieta de outras populações da garoupa-verdadeira ocorrendo em habitats naturais. De modo similar ao encontrado em estudos prévios realizados em substratos naturais, caranguejos e peixes foram as principais categorias de alimento consumidas (%IRI = 85,1 e %IRI = 12,6, respectivamente), enquanto camarões e moluscos tiveram menor importância na dieta (%IRI = 1,9 e %IRI = 0,4, respectivamente). Como reportado anteriormente para populações de garoupa-verdadeira que habitam recifes e fundos rochosos, o presente trabalho revelou marcadas mudanças na dieta em função do tamanho da espécie. Siri-azul e peixes tornam-se gradativamente mais importantes na dieta de indivíduos maiores (> 500 mm de comprimento total, CT). Finalmente, foi observado que a população de garoupa-verdadeira teve uma estratégia alimentar generalista com uma elevada variação entre indivíduos no consumo de presas. Essa estratégia permaneceu similar ao longo do aumento em tamanho da espécie. Os resultados do presente trabalho sugerem que substratos rochosos estabelecidos pelo homem propiciam locais de alimentação adequados para a garoupa-verdadeira no sul do Brasil e que poderiam ser usados como ferramentas adicionais nos esforços de conservação dessa espécie ameaçada.

The dusky grouper (Mycteroperca marginata) is a marine species usually associated with rocky bottoms and reefs. The present work investigated the diet and feeding strategy of a dusky grouper population inhabiting a 4.5 km long pair of rocky jetties located in the mouth of Patos Lagoon estuary. No prior research has been conducted in such man-made habitat and the current study provides a basis for comparative studies on the diet of the dusky grouper populations inhabiting natural vs. manmade rocky habitats. Similarly with previous studies on natural substrates, crabs and fishes were the main food categories consumed (%IRI = 85.1 and %IRI = 12.6, respectively), whereas shrimps and mollusks had lower importance in the diet (%IRI = 1.9 and 0.4, respectively). As previously reported for dusky grouper populations inhabiting reefs and rocky bottoms, the present work revealed conspicuous size related dietary shifts. Blue crabs and fishes become increasingly important food itemsin the diet of larger individuals (> 500 mm, TL). Finally, it was found that the studied dusky population has a generalist feeding strategy with a high between-individual variation in prey consumption. Such strategy remained similar across the size increment of the species. Our findings suggest that man-made rocky substrates provide suitable feeding grounds for the dusky grouper in southern Brazil and could be used as an additional tool in the conservation efforts of this endangered species.

Weight-length relationship, condition factor and blood parameters of farmed Cichla temensis Humboldt, 1821 (Cichlidae) in central Amazon

A criação de peixes carnívoros nativos vem recebendo grande atenção devido ao promissor uso na aquicultura. Entre estes peixes destacam-se os tucunarés do gênero Cichla, de grande interesse para a pesca esportiva e a indústria de peixes ornamentais da Amazônia. O presente estudo descreve a relação peso-comprimento, fator de condição relativo (Kn) e parâmetros sanguíneos do tucunaré Cichla temensis Humboldt, 1821 cultivado na Amazônia central. Os peixes submetidos a treinamento alimentar na alevinagem receberam ração extrusada contendo 45% de proteína bruta na engorda e tiveram Kn variando de 0,925-1,199, indicando boas condições de higidez no cultivo. A equação obtida da relação peso-comprimento foi P = 0,0073.Ct3,1435, indicando crescimento do tipo isométrico, que é o mais desejável para peixes em uma piscicultura. O número de eritrócitos, trombócitos e leucócitos totais, hematócrito, concentração de hemoglobina, volume corpuscular médio (VCM), concentração da hemoglobina corpuscular média (CHCM), linfócitos, monócitos e neutrófilos mostrou variação intra-específica. Foi observada correlação positiva significativa (p<0,001) do número de eritrócitos totais com a concentração de hemoglobina e o hematócrito. Estes foram os primeiros resultados sobre parâmetros sanguíneos de C. temensis e poderão ser usados como referência para comparação em estudos futuros para avaliar o estado de saúde deste peixe em diferentes ambientes, pois a medida destes parâmetros pode ser usada como ferramenta rápida para diagnóstico de doenças, estresse ou desnutrição.

Farming of native carnivore fish species has drawn attention due to their promising use in aquaculture. Among these species, tucunaré of the genus Cichla stand out, them being of high economical interest for sport fishing and Amazon’s industry of ornamental fish. The present study describes the weight-length relationship (WLR), relative condition factor (Kn), red blood cell parameters, thrombocytes and leukocytes count of Cichla temensis Humboldt, 1821, farmed in central Amazon. Fish that underwent food training during fingerling culture received extruded ration containing 45% of crude protein during fattening, and had Kn with values from 0.925-1.199, which indicated good health condition during the culture. The equation obtained from the WLR was W = 0.0073Lt3.1435, indicating an isometric growth, which is the desirable for fish of fish farm. Red blood cell counts, total thrombocyte and leukocyte counts, hematocrit, hemoglobin concentration, mean corpuscular volume (MCV), concentration of mean corpuscular hemoglobin (MCHC), lymphocytes, monocytes and neutrophils had intra-specific variation. A significant (p<0.001) positive correlation of the red blood cells number with the hemoglobin concentration and hematocrit was found. These are the first sets of blood parameters for C. temensis and could be used as reference for comparison in further studies to evaluate the health status of this fish in different environments, because assessment of these parameters may be used as quick tool for diagnosing diseases, stress and malnutrition.