Tuberculosis in the colombian-venezuelan border: geospatial distribution. / Tuberculosis en la frontera colombo-venezolana: distribución geoespacial.

The geospatial distribution of pulmonary and extrapulmonary tuberculosis (TB) morbidity in the municipality of Cúcuta in 2019 and 2020 was described by the Kulldorff method using the geographic location and reporting date of incident TB cases. The unit of analysis was the event reported to the National Epidemiological Surveillance System (SIVIGILA). A total of 607 cases were identified in 392 neighborhoods distributed in ten communes. Most cases of pulmonary TB were reported in the northern commune, with the El Salado neighborhood being the most affected repeatedly. Incident cases of extrapulmonary TB did not show patterns of repetition in the distribution between spatial and temporal units. Strategies to mitigate and control the spread of pulmonary infection should prioritize the western region.

La distribución geoespacial de la morbilidad por tuberculosis (TB) pulmonar y extrapulmonar en el municipio de Cúcuta en los años 2019 y 2020 se describió utilizando el método de Kulldorff usando la ubicación geográfica y la fecha de reporte de los casos incidentes de TB. La unidad de análisis fue el evento reportado al Sistema Nacional de Vigilancia Epidemiológica (SIVIGILA). Se identificaron 392 barrios distribuidos en diez comunas, donde se ubicaron 607 casos. En la distribución de la TB pulmonar, la comuna norte fue la que más casos reportó, siendo el barrio El Salado el más afectado de manera repetitiva. Los casos incidentes de TB extrapulmonar no mostraron patrones de repetición en la distribución entre las unidades espaciales y temporales. Se debe priorizar la región occidental dentro de las estrategias de mitigación y control de la propagación de la infección pulmonar del territorio.

Plan de egreso: herramienta del cuidado - diada con enfermedad crónica / Discharge Plan: A Care Tool - Chronic Disease Dyad / Plano de saída: ferramenta de cuidados - diácono com doença crônica. Estudo pseudo-experimental

Introducción: La OMS reporta incremento de las enfermedades crónicas no trasmisibles, dada su complejidad, los pacientes presentan constantes hospitalizaciones, por lo cual es necesario fortalecer la competencia del cuidado de la enfermedad tanto del paciente como del cuidador en el hogar a través del programa plan de egreso. Objetivo: determinar el cambio en la competencia para el cuidado posterior a la implementación de herramienta plan de egreso para el cuidado en el hogar de la diada persona-cuidador familiar en situación de cronicidad en una institución de segundo nivel de atención. Materiales y métodos: Estudio de abordaje cuantitativo, seudo-experimental, con diseño de pruebas pre-test y pos-test, aplicando los instrumentos de "caracterización diada paciente-cuidador" y "Cuidar". La población correspondió a 62 diadas. Muestreo no probabilístico a conveniencia. Se calculó del delta pre-post y se utilizó t-Student pareada para comparar. Resultados: el programa plan de egreso aumentó en el paciente las dimensiones de Conocimiento con un delta de 3.2 y Unicidad de 3,0 y competencia de cuidado global en 10,3; mientras que las competencias del cuidador familiar mejoraron en las dimensiones de Conocimiento con un delta de 3.34, Unicidad con delta 1.5, la dimensión de Disfrute con 1.7 y la de Reciprocidad ­Relación con un delta de 1.61 para un total en la competencia de 9.2. Discusión y conclusiones: Estos hallazgos sugieren fortalecer el programa plan de egreso, durante la hospitalización y alta con el propósito de mejorar la competencia para cuidar en el hogar tanto del paciente como su cuidador familiar en situación de cronicidad.

Introduction: The WHO reports an increase in chronic non-communicable diseases. Given the complexity of these diseases, patients are constantly hospitalized; therefore, it is necessary to strengthen the competence of both patients and caregivers at home to take care of the disease using the program "discharge plan." Objective: To determine the change in care competency following the implementation of the tool "discharge plan" in a second-level care facility for in-home care of the chronically ill person and family caregiver dyad. Materials and Methods: Quantitative, quasi-experimental study, with pre-test and post-test design, using the "Characterization of the patient-caregiver dyad" form and the "CUIDAR" instrument. The population consisted of 62 dyads. Non-probabilistic convenience sampling was used. Pre- and post-delta was calculated, and paired Student t-test was used for comparison. Results: The "discharge plan" program increased the patients' dimensions of Knowledge by a delta of 3.2, Uniqueness by 3.0, and total care competency by 10.3. Family caregivers' competencies improved in the dimensions of Knowledge by a delta of 3.34, Uniqueness by 1.5, Enjoyment by 1.7, and Reciprocity-relationship by 1.61, for a total competency score of 9.2. Discussion and conclusions: These findings suggest that the discharge plan program must be strengthened during hospitalization and discharge to improve the homecare competency of chronically ill patients and their family caregivers.

Introdução: A OMS relata um aumento nas doenças crônicas não transmissíveis, dada sua complexidade, os pacientes apresentam hospitalizações constantes, razão pela qual é necessário reforçar a competência de atendimento tanto do paciente quanto do cuidador em casa através do programa do plano de alta. Objetivo: determinar a mudança na competência de prestação de cuidados após a implementação de uma ferramenta de plano de alta para o cuidado domiciliar da díade pessoa-família cuidadora em uma instituição de cuidados de segundo nível. Materiais e Métodos: Um estudo de abordagem quantitativa, pseudo-experimental, com um projeto pré-teste e pós-teste, aplicando os instrumentos "caracterização da díade paciente-cuidador" e "Cuidar". A população correspondia a 62 díades. Amostragem de conveniência não-probabilística. O delta pré-post foi calculado e foi utilizado o par t-Student para comparação. Resultados: o programa do plano de alta hospitalar aumentou as dimensões do Conhecimento do paciente com um delta de 3,2 e a exclusividade de 3,0 e a competência global de prestação de cuidados em 10,3; enquanto as competências dos cuidadores familiares melhoraram nas dimensões do Conhecimento com um delta de 3,34, a exclusividade com delta 1,5, a dimensão de prazer com 1,7 e a relação de reciprocidade com um delta de 1,61 para uma competência total de 9,2. Discussão e conclusões: Estas descobertas sugerem o fortalecimento do programa do plano de alta, durante a hospitalização e alta com o objetivo de melhorar a competência para cuidar em casa tanto do paciente quanto de seu cuidador familiar em uma situação de cronicidade.

Tuberculosis en la frontera colombo-venezolana: distribución geoespacial / Tuberculosis in the colombian-venezuelan border: geospatial distribution

RESUMEN La distribución geoespacial de la morbilidad por tuberculosis (TB) pulmonar y extrapulmonar en el municipio de Cúcuta en los años 2019 y 2020 se describió utilizando el método de Kulldorff usando la ubicación geográfica y la fecha de reporte de los casos incidentes de TB. La unidad de análisis fue el evento reportado al Sistema Nacional de Vigilancia Epidemiológica (SIVIGILA). Se identificaron 392 barrios distribuidos en diez comunas, donde se ubicaron 607 casos. En la distribución de la TB pulmonar, la comuna norte fue la que más casos reportó, siendo el barrio El Salado el más afectado de manera repetitiva. Los casos incidentes de TB extrapulmonar no mostraron patrones de repetición en la distribución entre las unidades espaciales y temporales. Se debe priorizar la región occidental dentro de las estrategias de mitigación y control de la propagación de la infección pulmonar del territorio.

ABSTRACT The geospatial distribution of pulmonary and extrapulmonary tuberculosis (TB) morbidity in the municipality of Cúcuta in 2019 and 2020 was described by the Kulldorff method using the geographic location and reporting date of incident TB cases. The unit of analysis was the event reported to the National Epidemiological Surveillance System (SIVIGILA). A total of 607 cases were identified in 392 neighborhoods distributed in ten communes. Most cases of pulmonary TB were reported in the northern commune, with the El Salado neighborhood being the most affected repeatedly. Incident cases of extrapulmonary TB did not show patterns of repetition in the distribution between spatial and temporal units. Strategies to mitigate and control the spread of pulmonary infection should prioritize the western region.

Relación entre bienestar psicológico y la percepción de calidad de vida en pacientes en hemodiálisis / Relationship between psychological well-being and perception of quality of life in hemodialysis patients

Introducción: La hemodiálisis es la alternativa terapéutica más empleada en los pacientes con enfermedad renal cró-nica; sin embargo, no se han establecido de forma multi-dimensional las condiciones de bienestar psicológico y la calidad de vida de estos pacientes. Objetivo: Analizar el perfil de bienestar psicológico y per-cepción de calidad de vida de pacientes en hemodiálisis, así como diferenciar e identificar la relación entre estas varia-bles. Material y método: Estudio observacional descriptivo trans-versal realizado a 173 pacientes en hemodiálisis. Se emplea-ron los cuestionarios PGWBI para evaluar el bienestar psi-cológico y el WHOQOL-BREF para la calidad de vida.Resultados: Pacientes con ERC en tratamiento con HD con un promedio de 57,59±13,31 años, predominantemente de género masculino (n=110; 63,58%). Se encontraron altos índices de bienestar psicológico (78,61%) y percepciones moderadas de calidad de vida (54,91%), acompañadas de sintomatología depresiva (97,11%) y ansiosa (97,11%). La edad, nivel educativo, condición laboral, ingresos económicos, tener Diabetes Mellitus y concentraciones sanguíneas inadecuadas de hemoglobina, potasio y fósforo, mostraron diferencias en los dominios y categorías (p<0,01). El análisis correlacional encontró una estrecha relación lineal entre las dos variables estudiadas (r=0,81; p=0,0001). Conclusiones: Los participantes del estudio mostraron altas percepciones de bienestar psicológico y moderadas apreciaciones de calidad de vida a expensas de elevadas valoraciones de positividad, autocontrol, vitalidad y percepciones de salud física, psicológica y relaciones sociales. El bienestar psicológico desde sus diferentes categorías influencia directamente la percepción de calidad de vida de los pacientes en hemodiálisis. (AU)

Introduction: Hemodialysis is the most widely used therapeutic alternative in patients with chronic kidney disease; however, the conditions of psychological well-being and quality of life of these patients have not been established in a multidimensional way. Objective: To analyse the profile of psychological well-being and perception of quality of life of hemodialysis patients, as well as to differentiate and identify the relationship between these variables. Material and method: Cross-sectional descriptive observatio-nal study carried out on 173 hemodialysis patients. The PGW-BI questionnaires were used to assess psychological well-be-ing and the WHOQOL-BREF for quality of life. Results: Patients with CKD on hemodialysis with an average age of 57.59±13.31 years, predominantly male (n=110; 63.58%). High indices of psychological well-being (78.61%) and moderate perceptions of quality of life (54.91%) were found, accompanied by depressive (97.11%) and anxious (97.11%) symptomatology. Age, educational level, employment status, income, having diabetes mellitus and inadequate blood concentrations of haemoglobin, potassium and phosphorus showed differences in the domains and categories (p<0.01). Correlational analysis found a strong linear relationship between the two variables studied (r=0.81; p=0.0001). Conclusions: Study participants showed high perceptions of psychological well-being and moderate appreciations of qua-lity of life at the expense of high ratings of positivity, self-con-trol, vitality and perceptions of physical health, psychological health and social relationships. Psychological well-being ac-cording to different categories directly influences the percei-ved quality of life of hemodialysis patients. (AU)

Bienestar psicológico en enfermeras que realizan terapia de reemplazo renal en tiempos de COVID-19 / Psychological well-being in nurses performing renal replacement therapy in times of COVID-19 pandemic

Introducción: La pandemia por COVID-19 ha generado deterioro de la salud mental en los profesionales del sector salud, siendo desconocida su situación en las enfermeras al cuidado de pacientes con enfermedad renal crónica.Objetivo: Identificar el bienestar psicológico y sus diferencias de acuerdo a las variables demográficas y profesionales en enfermeras que realizan hemodiálisis en tiempos de COVID-19.Material y Método: Estudio cuantitativo, descriptivo transversal, realizado en 52 enfermeras que realizan terapia de reemplazo renal en unidades de cuidado intensivo y de terapia renal en tiempos de COVID-19. Fueron obtenidas variables de tipo sociodemográfico, académico, laboral y se empleó la escala PGWBI para establecer los niveles de bienestar psicológico. Se utilizó el test de Mann-Whitney y Kruskall-Wallis realizando el post test de Dunn para comparar diferencias entre las variables estudiadas.Resultados: La edad promedio fue de 36,56±6,95 años. Los niveles de bienestar psicológico fueron positivos en todas las categorías de la escala, con excepción de la ansiedad y la depresión. De igual forma, se encontró que las variables género, estado civil, estabilidad, antigüedad laboral, remuneración salarial y formación académica, muestran comportamiento diferenciado en las categorías que evalúa el instrumento.Conclusiones: Se identificaron altos niveles de bienestar psicológico en enfermeras que prestan cuidados en pacientes en terapia de reemplazo renal en tiempos de pandemia por COVID-19, donde factores como el estado civil, formación post gradual y tener estabilidad laboral con mejores ingresos salariales, influencian positivamente las categorías que contribuyeron a los resultados de bienestar psicológico de las enfermeras evaluadas. (AU)

Introduction: The COVID-19 pandemic has led to deterioration of mental health in health care professionals, and the situation of nurses caring for patients with chronic kidney disease is currently unknown.Objective: To identify psychological well-being and differences according to demographic and professional variables in nurses performing haemodialysis in times of the COVID-19 pandemic.Method: Quantitative, descriptive, cross-sectional study carried out on 52 nurses performing renal replacement therapy in intensive care and renal therapy units in COVID-19 times, who gave their consent. Sociodemographic, academic and work-related variables were obtained and the PGWBI scale was used to establish levels of psychological well-being. The Mann-Whitney and Kruskall-Wallis tests were used, and Dunn’s post-test was performed to compare differences between the variables studied.Results: The mean age of the nurses studied was 36.56±6.95 years. The levels of psychological well-being were positive in all the categories of the scale, with the exception of anxiety and depression. Similarly, it was found that the variables gender, marital status, job stability, length of service, salary remuneration and academic training showed differential behaviour in the categories assessed by the instrument.Conclusions: High levels of psychological well-being were identified in nurses providing care in renal replacement therapy patients in times of COVID-19 pandemic, where factors such as marital status, post-graduate training and having job stability with better salary income positively influence the categories that contributed to the psychological well-being scores of the nurses assessed. (AU)

Panorama de la automedicación en estudiantes de educación superior: una mirada global / Overview of self-medication in higher education students: a global view / Panorama da automedicação em estudantes do ensino superior: uma visão global

Introducción: La automedicación es una práctica que llevan a cabo especialmente los jóvenes universitarios, al percibirse inmunes a enfermedades, sin tener en cuenta los efectos sobre el uso de fármacos sin prescripción. Objetivo: Analizar los hallazgos de la literatura existente sobre la automedicación en estudiantes de educación superior. Materiales y métodos: Se em-pleó la metodología Scoping Review, utilizando los términos DeCS y MeSH en español, in-glés y portugués en cuanto a: "automedicación", "estudiantes", "educación superior", "COV-ID-19". A continuación, se articularon las ecuaciones de búsqueda empleando los operadores booleanos AND y OR, en las bases de datos: IBECS, Scielo, BVS, Google Scholar, LILACS, Science Direct y Pubmed. Al respecto se limitó el tiempo de publicación entre 2016 ­ 2021. Resultados: Se obtuvieron 23 artículos, consolidando seis núcleos temáticos: motivos para automedicarse; grupos farmacológicos que se consumen; fuentes de recomendación; factores sociodemográficos; semestres y programas académicos; y, conocimientos sobre los riesgos de la automedicación. Los analgésicos son los medicamentos que más se consumen, siendo el principal motivo de uso el dolor de cabeza. Los farmacéuticos junto con los medios de comunicación suelen ser fuentes de recomendación. Predominaron bajos niveles de cono-cimiento acerca de los riesgos de la automedicación. Conclusiones: La literatura indica que este problema de salud pública es cada vez mayor y evidencia la necesidad de abordarlo con estrategias eficaces

Introduction: Self-medication is a practice carried out especially by university students, be-cause they perceive themselves to be immune to effects on their health as a result of the use of non-prescription drugs. Objective: To analyze the findings of the existing literature on self-medication in higher education students. Materials and Methods: The Scoping Review methodology was used, using the DeCS and MeSH terms in Spanish, English and Portuguese "self-medication", "students", "higher education", "COVID-19", articulating them by creat-ing search equations using Boolean operators. AND and OR, in the databases: IBECS, Scielo, VHL, Google Scholar, LILACS, Science Direct and Pubmed, limiting the publication time between 2016 - 2021. Results: 23 articles were obtained, consolidating six thematic nuclei: reasons for self-medicate; pharmacological groups consumed; recommendation sources; so-ciodemographic factors; semesters and academic programs; and, knowledge about the risks of self-medication. Analgesics are the most consumed medications, with headaches being the main reason for use. Pharmacists along with the media are often sources of recommendation. Low levels of knowledge about the risks of self-medication prevailed. Conclusions: The literature indicates that this public health problem is increasing and evidences the need to address it with effective strategies.

Introdução: A automedicação é uma prática realizada principalmente por estudantes uni-versitários, pois se percebem imunes aos efeitos sobre sua saúde decorrentes do uso de me-dicamentos isentos de prescrição. Objetivo: Analisar os achados da literatura existente so-bre automedicação em estudantes do ensino superior. Materiais e Métodos: Foi utilizada a metodologia Scoping Review, utilizando os termos DeCS e MeSH em espanhol, inglês e português "automedicação", "alunos", "ensino superior", "COVID-19", articulando-os através da criação de equações de busca utilizando operadores booleanos AND e OR, nas bases de dados: IBECS, Scielo, BVS, Google Acadêmico, LILACS, Science Direct e Pu-bmed, limitando o tempo de publicação entre 2016 - 2021. Resultados: Obtiveram-se 23 artigos, consolidando seis núcleos temáticos: motivos para automedicação; grupos farma-cológicos consumidos; fontes de recomendação; fatores sociodemográficos; semestres e pro-gramas acadêmicos; e, conhecimento sobre os riscos da automedicação. Os analgésicos são os medicamentos mais consumidos, sendo as dores de cabeça o principal motivo de uso. Os farmacêuticos junto com a mídia são muitas vezes fontes de recomendação. Predominaram baixos níveis de conhecimento sobre os riscos da automedicação. Conclusões: A literatura in-dica que este problema de saúde pública é crescente e evidencia a necessidade de enfrentá-lo com estratégias eficazes

Restricted feeding modulates peripheral clocks and nutrient sensing pathways in rats.

OBJECTIVE: Feeding restriction in rats alters the oscillators in suprachiasmatic, paraventricular, and arcuate nuclei, hypothalamic areas involved in food intake. In the present study, using the same animals and experimental protocol, we aimed to analyze if food restriction could reset clock genes (Clock, Bmal1) and genes involved in lipid metabolism (Pgc1a, Pparg, Ucp2) through nutrient-sensing pathways (Sirt1, Ampk, Nampt) in peripheral tissues. METHODS: Rats were grouped according to food access: Control group (CG, food ad libitum), Restricted night-fed (RF-n, food access during 2 h at night), Restricted day-fed (RF-d, food access during 2 h in the daytime), and Day-fed (DF, food access during 12 h in the daytime). After 21 days, rats were decapitated at ZT3 (0900-1000 h), ZT11 (1700-1800 h), or ZT17 (2300-2400 h). Blood, liver, brown (BAT) and peri-epididymal (PAT) adipose tissues were collected. Plasma corticosterone and gene expression were evaluated by radioimmunoassay and qPCR, respectively. RESULTS: In the liver, the expression pattern of Clock and Bmal1 shifted when food access was dissociated from rat nocturnal activity; this phenomenon was attenuated in adipose tissues. Daytime feeding also inverted the profile of energy-sensing and lipid metabolism-related genes in the liver, whereas calorie restriction induced a pre-feeding increased expression of these genes. In adipose tissues, Sirt1 expression was modified by daytime feeding and calorie restriction, with concomitant expression of Pgc1a, Pparg, and Ucp2 but not Ampk and Nampt. CONCLUSION: Feeding restriction reset clock genes and genes involved in lipid metabolism through nutrient-sensing-related genes in rat liver, brown, and peri-epididymal adipose tissues.

Restricted feeding modulates peripheral clocks and nutrient sensing pathways in rats

ABSTRACT Objective: Feeding restriction in rats alters the oscillators in suprachiasmatic, paraventricular, and arcuate nuclei, hypothalamic areas involved in food intake. In the present study, using the same animals and experimental protocol, we aimed to analyze if food restriction could reset clock genes ( Clock, Bmal1 ) and genes involved in lipid metabolism ( Pgc1a, Pparg, Ucp2 ) through nutrient-sensing pathways ( Sirt1, Ampk, Nampt ) in peripheral tissues. Materials and methods: Rats were grouped according to food access: Control group (CG, food ad libitum ), Restricted night-fed (RF-n, food access during 2 h at night), Restricted day-fed (RF-d, food access during 2 h in the daytime), and Day-fed (DF, food access during 12 h in the daytime). After 21 days, rats were decapitated at ZT3 (0900-1000 h), ZT11 (1700-1800 h), or ZT17 (2300-2400 h). Blood, liver, brown (BAT) and peri-epididymal (PAT) adipose tissues were collected. Plasma corticosterone and gene expression were evaluated by radioimmunoassay and qPCR, respectively. Results: In the liver, the expression pattern of Clock and Bmal1 shifted when food access was dissociated from rat nocturnal activity; this phenomenon was attenuated in adipose tissues. Daytime feeding also inverted the profile of energy-sensing and lipid metabolism-related genes in the liver, whereas calorie restriction induced a pre-feeding increased expression of these genes. In adipose tissues, Sirt1 expression was modified by daytime feeding and calorie restriction, with concomitant expression of Pgc1a , Pparg , and Ucp2 but not Ampk and Nampt . Conclusion: Feeding restriction reset clock genes and genes involved in lipid metabolism through nutrient-sensing-related genes in rat liver, brown, and peri-epididymal adipose tissues.

Jóvenes universitarios estilos de vida y biología humana: ¿Predisponen al desarrollo de enfermedad cardiovascular? / Young university students: lifestyles and human biology: ¿Do they predispose to the development of cardiovascular disease? / Jovens estudantes universitários: estilos de vida e biologia humana: ¿Eles predispõem ao desenvolvimento de doenças cardiovasculares?

INTRODUCCIÓN: Las enfermedades cardiovasculares han despertado interés en los últimos años por su alta incidencia a nivel mundial, generando 17,9 millones de muertes a nivel global, a pesar de que estas patológicas tienen poca prevalencia en poblaciones jóvenes, se sabe que desde edades tempranas se van produciendo cambios estructurales y funcionales en la red vascular y cardiaca derivados de conductas inadecuadas en salud relacionadas al estilo vida y aspectos biológicos propios de cada individuo. OBJETIVO: La investigación tiene como objetivo determinar los estilos de vida y los aspectos biológicos de los estudiantes de enfermería que pueden influir en el desarrollo de enfermedad cardiovascular. Metodología: Investigación cuantitativa descriptiva de corte transversal, con un muestreo a conveniencia donde participaron 100 estudiantes, se utilizaron instrumentos validados y estandarizados como el CEVJU-II, SISCO-SV-21 y datos de valoración física y bioquímica sanguínea. RESULTADOS: La edad promedio de los estudiantes fue de 21 años, en su mayoría población femenina. Los estudiantes presentaron conductas no saludables en los estilos de vida: actividad física, alimentación, sueño, consumo de alcohol, cigarro y drogas ilegales, y estrés moderado. El principal antecedente familiar fue la hipertensión arterial, sin embargo, las alteraciones antropométricas, presión arterial, lípidos y glucosa sanguínea no tuvieron altas prevalencias. CONCLUSIONES: Se concluye que a pesar de que la mayoría de los jóvenes universitarios mantienen conductas no saludables en los estilos de vida, estos comportamientos a edades tempranas no se manifestaban en cambios antropométricos y bioquímicos, lo que reduce el riesgo de presentar enfermedades cardiovasculares a futuro.

INTRODUCTION: Cardiovascular diseases have aroused interest in recent years due to their high incidence worldwide, generating 17.9 million deaths globally. Even though these pathological diseases have a slightprevalence in young populations, it is known that they are producing structural and functional changes in the vascular and cardiac network from an early age. These arederived from inappropriate health behaviors related to the lifestyle and biological aspects of everyone. AIM:The research aims to determine nursing students' lifestyles and biological elements that can influence the development of cardiovascular disease. METHODOLOGY: a cross-sectional descriptive quantitative studywas carried out, with a convenience sampling where 100 students participated, validated and standardized instruments such as CEVJU-II, SISCO-SV-21,and blood physical and biochemical assessment data were used. Results:The average age of the students was 21 years old, mostly female population. The students presented unhealthy behaviors intheir lifestyles: physical activity, eating, sleeping, consumption of alcohol, cigarettes,and illegal drugs, and moderate stress. The main family history was arterial hypertension;however, anthropometric alterations, blood pressure, lipids,and blood glucose did not have a high prevalence. CONCLUSIONS:This allows us to conclude that even though most young university students maintain unhealthy lifestyles, these behaviors at an early age were not manifested in anthropometric and biochemical changes, which reduces the risk of developing cardiovascular diseases in the future.

INTRODUÇÃO: As doenças cardiovasculares têm despertado interesse nos últimos anos devido à sua alta incidência mundial, gerando 17,9 milhões de mortes globalmente, apesar de essas doenças patológicas terem pouca prevalência em populações jovens, sabe-se que desde cedo estão produzindo alterações estruturais e funcionais na rede vascular e cardíaca derivada de comportamentos inadequados à saúde relacionados ao estilo de vida e aspectos biológicos de cada indivíduo. OBJETIVO: A pesquisa tem por objetivodeterminar os estilos de vida e aspectos biológicos de estudantes de enfermagem que podem influenciar no desenvolvimento de doenças cardiovasculares. METODOLOGIA: pesquisa quantitativa, descritiva transversal, com uma amostra de conveniência em que participaram 100 alunos, foram utilizados instrumentos validados e padronizados como o CEVJU-II, SISCO-SV-21 e dados de avaliação física e bioquímica do sangue. RESULTADOS: A idade média dos alunos era de 21 anos, em sua maioria população feminina. Os alunos apresentaram comportamentos não saudáveis no estilo de vida: atividade física, alimentação, sono, consumo de álcool, cigarro e drogas ilícitas e estresse moderado. Oprincipal antecedentefamiliar foihipertensão arterial, porém alterações antropométricas, pressão arterial, lipídios e glicemia não tiveram prevalências elevadas. CONCLUSÕES: Isso nos permite concluir que apesar de a maioria dos jovens universitários manter comportamentos não saudáveis em seus estilos de vida, esses comportamentos em uma idade precoce não se manifestaram em alterações antropométricas e bioquímicas, o que reduz o risco de desenvolver doenças cardiovasculares no futuro.

Peripheral clock system circadian abnormalities in Cushing's disease.

In Cushing's syndrome, the cortisol rhythm is impaired and can be associated with the disruption in the rhythmic expression of clock genes. In this study, we evaluated the expression of CLOCK, BMAL1, CRY1, CRY2, PER1, PER2, PER3 genes in peripheral blood leukocytes of healthy individuals (n = 13) and Cushing's disease (CD) patients (n = 12). Participants underwent salivary cortisol measurement at 0900 h and 2300 h. Peripheral blood samples were obtained at 0900 h, 1300 h, 1700 h, and 2300 h for assessing clock gene expression by qPCR. Gene expression circadian variations were evaluated by the Cosinor method. In healthy controls, a circadian variation in the expression of CLOCK, BMAL1, CRY1, PER2, and PER3 was observed, whereas the expression of PER1 and CRY2 followed no specific pattern. The expression of PER2 and PER3 in healthy leukocytes presented a late afternoon acrophase, similarly to CLOCK, whereas CRY1 showed night acrophase, similarly to BMAL1. In CD patients, the circadian variation in the expression of clock genes was lost, along with the abolition of cortisol circadian rhythm. However, CRY2 exhibited a circadian variation with acrophase during the dark phase in patients. In conclusion, our data suggest that Cushing's disease, which is characterized by hypercortisolism, is associated with abnormalities in the circadian pattern of clock genes. Higher expression of CRY2 at night outlines its putative role in the cortisol circadian rhythm disruption.

Postnatal Ontogeny of the Circadian Expression of the Adrenal Clock Genes and Corticosterone Rhythm in Male Rats.

The postnatal synchronization of the circadian variation of the adrenal clock genes in mammals remains unknown. We evaluated the postnatal ontogeny of daily variation of clock genes (Clock/Bmal1/Per1/Per2/Per3/Cry1/Cry2/Rorα/Rev-Erbα) and steroidogenesis-related genes (Star and Mc2r) in rat adrenals and its relationship with the emergence of plasma corticosterone rhythm using cosinor analysis. Plasma corticosterone circadian rhythm was detected from postnatal day (P)1, with morning acrophase, between zeitgeber time (ZT)0 and ZT2. From P14, there was a nocturnal acrophase of corticosterone at ZT20, which was associated with pups' eye opening. From P3 there was a circadian variation of the mRNA expression of Bmal1, Per2, Per3, and Cry1 genes with morning acrophase, whereas Rev-Erbα had nocturnal acrophase. From P14, Bmal1, Per2, Per3, and Cry1 acrophases advanced by approximately 10 hours, as compared with early neonatal days, becoming vespertine-nocturnal. In all postnatal ages, Per2 and Cry1 circadian profiles were synchronized in phase with the circadian rhythm of plasma corticosterone, whereas Bmal1 was in antiphase. An adult-like Star circadian rhythm profile was observed only from P21. In conclusion, our original data demonstrated a progressive postnatal maturation of the circadian variation of the adrenal clock genes in synchrony with the development of the corticosterone circadian rhythm in rats.

Restricted Feeding Schedules Modulate in a Different Manner the Expression of Clock Genes in Rat Hypothalamic Nuclei.

Food access restriction is associated to changes in gene expression of the circadian clock system. However, there are only a few studies investigating the effects of non-photic synchronizers, such as food entrainment, on the expression of clock genes in the central oscillators. We hypothesized that different feeding restriction patterns could modulate the expression of clock genes in the suprachiasmatic nucleus (SCN) "master" clock and in extra-SCN oscillators such as the paraventricular (PVN) and arcuate (ARC) hypothalamic nuclei. Wistar rats were divided into four groups: Control group (CG; food available ad libitum), Restricted night-fed (RF-n; food access during 2 h at night), Restricted day-fed (RF-d; food access during 2 h at daytime), Day-fed (DF; food access during 12 h at daytime). After 21 days, rats were decapitated between ZT2-ZT3 (0800-0900 h); ZT11-ZT12 (1700-1800 h), or ZT17-18 (2300-2400 h). Plasma corticosterone was measured by radioimmunoassay (RIA). The expression of Clock, Bmal1, Per1, Per2, Per3, Cry1, Cry2, Rev-erbα, and Rorα were assessed in SCN, PVN, and ARC hypothalamic nuclei by RT-PCR and calculated by the 2[-DeltaDeltaCT(Cyclethreshold)](2-ΔΔCT) method. Restricted food availability during few h led to decreased body weight in RF-n and RF-d groups compared to controls and DF group. We also observed an anticipatory corticosterone peak before food availability in RF-n and RF-d groups. Furthermore, the pattern of clock gene expression in response to RF-n, RF-d, and DF schedules was affected differently in the SCN, PVN, and ARC hypothalamic nuclei. In conclusion, the master oscillator in SCN as well as the oscillator in PVN and ARC, all brain areas involved in food intake, responds in a tissue-specific manner to feeding restriction.

The cortisol awakening response is blunted in patients with active Cushing's disease.

INTRODUCTION: Cortisol awakening response (CAR) is a rapid increase of cortisol levels within 30-45 min after awakening. OBJECTIVE: This study evaluates CAR compared with cortisol circadian rhythm in active and in remission Cushing's disease (CD). MATERIALS AND METHODS: We evaluated healthy controls (HC, n=19), obese (OB, n=10), in remission (n=08), and active CD patients (n=10). Salivary free cortisol (SF) was determined at 0800, 1100, 1700, 2000, and 2300 h on the first day. CAR was obtained the next morning immediately upon awakening and at 15, 30, 45, and 60-min post-wake up. RESULTS: We observed differences in SF levels throughout the day in HC, OB, and in remission CD (ANOVA P=0.0001) but not in active CD (P=0.2). We demonstrated SF increment after awakening in HC, OB, and in remission CD (ANOVA P=0.007), with no effect of time on SF in active CD. The relative increment of SF obtained at the peak after awakening (CARi%) in the active CD (67±57%) was lower than in HC (154±107%), OB (240±188%), and in remission CD (186±184%) patients (P=0.009). There was a negative correlation between the SF at awakening and the CARi% in HC (r=-0.8), OB (r=-0.78), and in remission CD (r=-0.74) but not in active CD (r=-0.35; P=0.31). CONCLUSION: This study originally described a blunted CAR in active CD in contrast to its presence in HC, OB, and in remission CD. This subtle dysfunction of the hypothalamus-pituitary-adrenal axis may represent a distinct and additional physiopathological phenomenon superimposing the dysregulated cortisol circadian rhythm in this disease.