Fatores associados com o desempenho de jovens atletas de atletismo / Factors associated with performance in young track and field athletes

O presente estudo teve objetivo de verificar os fatores sociais e comportamentais associados com o desempenho na competição de atletas adolescentes de Atletismo de Santa Catarina. Participaram deste estudo 74 atletas adolescentes de 15 a 19 anos com me diana de idade de 17,0 (16,0-18,0) anos. Os participantes responderam questões sociodemográficas (sexo, idade e classe social), questões sobre a frequênci a e duração das sessões de treinamento, experiência no esporte, experiência na competição, incentivo finan ceiro (Bolsa-Atleta) e status social subjetivo na equipe. Além disso, desempenho na competição foi obtido a partir da consulta de registros dos resultados oficiais da principal competição esportiva para adolescentes do Estado de Santa Catarina. O teste de correlação de Spearman foi utilizado para verificar correlação entre as variáveis. Para comparação entre os grupos foi utilizado o teste U de Mann Whitney. Verificou-se que os medalhistas eram os atletas que apresentaram maior experiência no esporte (p=0,033) e na competição (p=0,011) e maior duração das sessões de treinamento (p=0,002), comparados aos não medalhistas da competição. Além disso, foram observadas correlações significativas entre o desempenho e as variáveis de experiência no esporte (rho = -0,298; p = 0,011), status social subjetivo na equipe (rho = -0,316; p = 0,006), experiência na competição (rho = -0,377; p = 0,001) e média da duração dos treinos (rho = -0,316; p = 0,006). Por último, observaram-se melhores desempenhos os atletas que receberam Bolsa-Atleta comparados aos atletas que não receberam o benefício (p<0,001). Conclui-se que além das variáveis de treinamento no Atletismo apresentarem grande relevância para o resultado na competição, o status social e políticas públicas de incentivo ao esporte também apresentam parcela de contribuição para o sucesso no resultado da competição.(AU)

Abstract: The present study aimed to verify the social and behavioural factors associated with the performance in the competition of adolescent track and field athletes from Santa Catarina. 74 adolescent athletes aged 15 to 19 years participated in this study with a median age of 17.0 (16.0-18.0) years. Participants answered sociodemographic questions (gender, age and social class), questions about the frequency and duration of training sessions, sports experience, competition experience, financial incentive (Bolsa-Atleta) and subjective social status in the team. In addition, performance in the competition was obtained by consulting the records of the official results of the main sports competition for adolescents in the State of Santa Catarina. Spearman's correlation test was used to verify correlation between variables. Mann Whitney U test was used to compare the groups. It was found that the medalists were the athletes who had more experience in sport (p = 0.033) and competition (p = 0.011) and longer training sessions (p = 0.002), compared to non-medalists in the competition. In addition, significant correlations were observed between performance and sport experience variables (rho = -0.298; p = 0.011), subjective social status in the team (rho = -0.316; p = 0.006), experience in competition (rho = -0.377; p = 0.001) and average training duration (rho = -0.316; p = 0.006). Finally, athletes who received Bolsa-Atleta improved performance compared to athletes who did not receive the benefit (p <0.001). It is concluded that in addition to the variables of training in Athletics present great relevance for the result in the competition, the social status and public policies of incentive to the sport also present part of contribution for the success in the result of the competition.(AU)

Xanthelasma palpebrarum after hyaluronic acid injection in the lower eyelid: A case report and review of the literature.

BACKGROUND: Hyaluronic acid filler treatments are a very popular nonsurgical procedure worldwide, most wanted to create a more attractive profile and correct facial aging. Since its usage has expanded, more complications have been seen. AIMS: To report a probably new adverse effect related to injectable fillers. PATIENT: A 38-year-old white woman who underwent hyaluronic acid filling in the periorbital area and presented twelve months after with two symmetrically yellowish plaque lesions on the lower eyelids, with no edema or nodules. RESULTS: The lesion appeared to be xanthelasma, in a patient with no history of hyperlipidemia. Histological analysis showed unspecific findings with rare histiocytes present in the papillary dermis. The patient was treated with hyaluronidase infiltration in both lower eyelid areas as an attempt to minimize the appearance of the lesions, with a satisfactory response. CONCLUSIONS: As hyaluronic acid fillings are becoming more popular, all physicians have to be aware of its complications. The xanthelasma-like reaction is probably a new adverse effect related to injectable fillers and it is important to be alert to this possibility.

Fatores preditores de maior número de estágios na cirurgia de Mohs: estudo de 256 casos / Predictive factors for the highest number of stages in Mohs surgery: a study of 256 cases

Introdução: a cirurgia micrográfica de Mohs (CMM) é capaz de alcançar altas taxas de cura no tratamento do câncer de pele e remover o mínimo possível de tecido saudável. Objetivos: caracterizar os pacientes submetidos à cirurgia micrográfica de Mohs e estudar fatores preditores de maior número de fases cirúrgicas. Métodos: estudo observacional, transversal, retrospectivo e descritivo realizado em serviço de referência para cirurgia micrográfica no período de 2013 a 2019. Foram revisados os prontuários de 230 pacientes (256 lesões). Resultados: lesões com recidiva tiveram significativamente mais número de fases que lesões sem recidiva (1,69 vs 1,31 fase). Tumores acima de 2cm tiveram maior número de fases que os de tamanho menor de 1cm e que aqueles entre 1,1 e 2,2cm (2,0 vs 1,08 e 1,22, respectivamente). Quando comparadas as localizações das lesões com o número de fases, não houve diferença significativa. Em relação aos subtipos histológicos pré-operatórios, houve diferença significativa: carcinomas basocelulares (CBC) agressivos precisaram de maior número de fases que os CBCs não agressivos. Conclusões: nosso estudo demonstra, corroborando dados da literatura, que os fatores de risco descritos estão diretamente relacionados a um maior número de estágios da cirurgia micrográfica de Mohs

Introduction: Mohs micrographic surgery (MMS) can achieve high cure rates in skin cancer treatment and remove as little healthy tissue as possible. Objective: This study aims to characterize patients undergoing Mohs micrographic surgery and to assess predictive factors for a higher number of surgical phases. Methods: Observational, cross-sectional, retrospective, and descriptive study conducted in a reference service for micrographic surgery from 2013 to 2019. The medical records of 230 patients (256 lesions) were reviewed. Results: Injuries with recurrence had significantly more stages than injuries without recurrence (1.69 stages versus 1.31 stages). Tumors greater than 2 cm had a greater number of phases than those smaller than 1 cm and between 1.1 and 2.2 cm (2.0 versus 1.08 and 1.22, respectively). When comparing the locations of the lesions with the number of phases, there was no significant difference. There was a considerable difference regarding the preoperative histological subtypes: aggressive basal cell carcinomas (BCC) required a higher number of phases than non-aggressive BCCs. Conclusions: Our study demonstrates, corroborating data from the literature, that the risk factors described are directly related to a greater number of stages of Mohs micrographic surgery.

Low linolenic and linoleic acid consumption are associated with chronic kidney disease in patients with type 2 diabetes.

AIM: This cross-sectional study aimed to assess the association of the fat content in the diet with Diabetic Kidney Disease (DKD) in patients with type 2 diabetes. METHODOLOGY: Patients from the Diabetes research clinic at Hospital de Clínicas de Porto Alegre (Brazil) were consecutively recruited. The inclusion criterion was the diagnosis of type 2 diabetes. The exclusion criteria were as follows: body mass index >40 kg/m2, heart failure, gastroparesis, diabetic diarrhea, dietary counseling by a registered dietitian during the previous 12 months, and inability to perform the weighed diet records (WDR). The dietary fatty acids (saturated, monounsaturated and polyunsaturated) consumption was estimated by 3-day WDR. Compliance with the WDR technique was assessed by comparison of protein intake estimated from the 3-day WDR and from the 24-h urinary nitrogen output performed on the third day of the WDR period. The presence of DKD was defined as urinary albumin excretion (UAE) ≥ 30 mg / 24 h or/and glomerular filtration rate (eGFR) <60 ml/min/1.73 m2. Urinary albumin was measured twice and eGFR was estimated by using the CKD-EPI equation. RESULTS: A total of 366 patients were evaluated; of these, 33% (n = 121) had DKD. Multivariate analysis showed that the intake of linolenic acid was negatively associated with DKD (OR = 0.57; 95% CI 0.35-0.93; P = 0.024), adjusted for gender, smoking, cardiovascular disease, ACE inhibitors and/or angiotensin receptor blocker use, systolic blood pressure, fasting plasma glucose and HDL cholesterol. In a separate model, similar results were observed for linoleic acid, adjusting to the same co-variables (OR = 0.95; 95% CI 0.91-0.99; P = 0.006). CONCLUSION: The lower intake of polyunsaturated fatty acids, especially linolenic and linoleic acid, is associated with chronic kidney disease in patients with type 2 diabetes.

Capacity of Objective Measures of Physical Activity to Predict Brazilian Children's Low Motor Proficiency.

This study analyzed the associations between physical activity (PA) and motor proficiency (MP) to determine what level of moderate PA might help avoid low MP in 8-10-year-old Brazilian children. We assessed MP of 98 children using the Bruininks-Oseretsky Motor Proficiency, Second Edition Short Form (BOT-2 SF), and we assessed PA using the GT3X + accelerometer. We analyzed data using means, standard deviations, frequency distribution, spearman correlation coefficients, Mann-Whitney U test, and the Receiver Operating Characteristics curve. There was a difference between groups of children with adequate or better versus low MP in minutes/day of moderate PA (defined as 2,296-4,011 accelerometer counts/minute; U = 666.0, p = .045) such that those with less time engaged in moderate PA had lower MP scores than peers with adequate MP. There was also a positive correlation between moderate PA and the strength and agility MP domain ( rs = .226; p = .025). In addition, minutes/day of moderate PA less than or equal to 142.56 minutes showed predictive capacity for low MP (area under the curve = 0.635; p = .027). Thus, objective measures of PA were able to predict low MP in 8-10-year-old Brazilian children, with an approximate guideline of about 2.5 hours per day of moderate PA needed to protect against low MP.

Status social subjetivo na escola e nas aulas de educação física / Subjective social status in school and in physical education classes / Nivel social subjetivo en el colegio y en las clases de educación física

Resumo Objetivo Identificar os fatores associados à percepção do status social subjetivo na escola e nas aulas de educação física em escolares de uma escola de Florianópolis (SC). Método A amostra foi composta por 312 estudantes (53,2% meninas), de 10 a 16 anos, do ensino fundamental de uma escola da rede pública municipal de Florianópolis (SC). Foram investigadas questões de qualidade de vida, atividade física, comportamento sedentário, índice de massa corporal (IMC), características sociodemográficas e status social subjetivo na escola e nas aulas de educação física. Resultados A percepção do status social na escola foi superior nas meninas (p = 0,003), enquanto a percepção do status social nas aulas de educação física foi superior nos meninos (p = 0,015). A percepção de status social nas aulas de educação física apresentou correlações negativas com o IMC (r = −0,202; p = 0,001) e tempo sentado durante a semana (r = −0,127; p = 0,026) e correlação positiva com a atividade física (r = 0,372; p < 0,001). Maior escolaridade dos pais indicou maior status social subjetivo dos adolescentes na escola (p ≤ 0,001). Além disso, maior percepção de status social, tanto na escola como nas aulas educação física, apresentou correlações positivas com melhor percepção da qualidade de vida geral (r = 0,264; p < 0,001 e r = 0,222; p < 0,001 respectivamente). Conclusão O presente estudo indicou relações importantes do status social subjetivo na educação física com a qualidade de vida, IMC, tempo sentado e atividade física dos adolescentes.

Abstract Objective The objective of the study was identify factors associated with the subjective social status perception at school and in physical education classes in a school of Florianopolis - SC. Method The sample consisted of 312 students, of both sexes, aged 10 to 16 years, regularly enrolled in elementary school 5th to 8th year of a municipal public school of Florianopolis - SC. Were investigated quality of life issues, physical activity, sedentary behavior, body mass index (BMI), sociodemographic characteristics and subjective social status at school and in physical education classes. Results The perception of social status at school was higher in girls (p = 0.003), while the perception of social status in physical education classes was higher in boys (p = 0.015). The perception of social status in physical education classes showed negative correlations with BMI (r = −0.202; p = 0.001) and time sitting during the week (r = −0.127; p = 0.026) and positively correlated with physical activity (r = 0.372; p <0.001). Furthermore, higher educational level of parents indicated higher subjective social status of adolescents at school (p≤0,001). Moreover, higher perceived social status, both in school and in physical education classes showed positive correlations with better perception of general quality of life (r = 0.264, p <0.001 and r = 0.222, p <0.001, respectively). Conclusion School with lower perceived social status in physical education have higher BMI and lower levels of physical activity and quality of life.

Resumen Objetivo El objetivo de este estudio fue identificar los factores asociados con la percepción del nivel social subjetivo en el colegio y en las clases de educación física en estudiantes de una escuela de Florianópolis, SC. Método La muestra estuvo formada por 312 estudiantes (el 53,2% eran niñas), entre 10 y 16 años de educación primaria en una escuela de la red pública municipal de Florianópolis, SC. Se analizó la calidad de vida, la actividad física, el comportamiento sedentario, el índice de masa corporal (IMC), las características sociodemográficas y el nivel social subjetivo en el colegio y en las clases de educación física. Resultados La percepción del nivel social en el colegio fue mayor en las mujeres (p= 0,003) mientras que la percepción del nivel social en las clases de educación física fue mayor en los varones (p= 0,015). La percepción del nivel social en clases de educación física mostró una correlación negativa con el índice de masa corporal (r = −0,202; p= 0,001) y el tiempo sentado durante la semana (r = −0,127; p= 0,026) y se correlacionó positivamente con la actividad física (r = 0,372; p<0,001). La educación superior de los padres indicaba mayor nivel social subjetivo de los adolescentes en la escuela (p≤0,001). Además, mayor percepción del nivel social, en el colegio y en las clases de educación física mostraron correlaciones positivas con una mejor percepción de la calidad de vida en general (r = 0,264; p<0,001 y r = 0,222; p<0,001, respectivamente). Conclusión Este estudio mostró relaciones importantes del nivel social subjetivo en la educación física con la calidad de vida, el índice de masa corporal, el tiempo sentado y la actividad física de los adolescentes.

Assessment of sleep in subjects with visual impairment: Comparison using subjective and objective methods.

The objective of the present study was to verify the agreement between objective and subjective measures of sleep in people with and without visual impairment. Thirty-seven subjects with visual impairment participated in the study (19 blind without light perception and 18 low-vision), as well as 34 subjects with normal vision, with paired age and gender characteristics. For the subjective sleep evaluation, we used the Sleep Quality Index-PSQI and for the objective evaluation we used the ActiGraph GT3X+. Among the three analyzed groups, the blind was the only ones who presented differences between subjective and objective sleep duration (p = 0.021). Furthermore, the concordance between subjective and objective sleep duration (ICC = 0.388; p = 0.108) was not observed in blind subjects, and a greater variability of differences in sleep duration between the two methods was observed by the Bland Altman scatter plot. We concluded that the sleep duration obtained by PSQI did not show agreement for the objective sleep duration in blind subjects without light perception.

Factors associated with sleep duration in Brazilian high school students.

The aim of this study was to investigate the factors associated with short sleep duration on southern Brazilian high school students. Our study was comprised of 1,132 adolescents aged 14 to 19 years, enrolled in public high schools in São José, Brazil. The students answered a questionnaire about working (work and workload), health perception, smoking, school schedule, sleep (duration and daytime sleepiness), and socio-demographics data. The results showed that more than two thirds of adolescent workers had short sleep duration (76.7%), and those with a higher workload (more than 20 hours) had a shorter sleep duration (7.07 hours) compared to non-workers (7.83 hours). In the analysis of factors associated with short sleep duration, adolescents who worked (OR = 2.12, 95% CI 1.53 to 2.95) were more likely to have short sleep duration compared to those who did not work. In addition, older adolescents (17-19 years) and students with poor sleep quality were 40% and 55% more likely to have short sleep duration compared to younger adolescents (14-16 years) and students with good sleep quality, respectively. Adolescents with daytime sleepiness were more likely to have short sleep duration (OR = 1.49, 95% CI 1.06 to 2.07) compared to those without excessive daytime sleepiness. In addition students of the morning shift (OR = 6.02, 95% CI 4.23 to 8.57) and evening shift (OR = 2.16, 95% CI 1.45 to 3.22) were more likely to have short sleep duration compared to adolescents of the afternoon shift. Thereby adolescents who are workers, older, attended morning and evening classes and have excessive daytime sleepiness showed risk factors for short sleep duration. In this sense, it is pointed out the importance of raising awareness of these risk factors for short sleep duration of students from public schools from São José, located in southern Brazil.

Análise Epistemológica de Teses e Dissertações de Dois Programas de Pós-graduação Stricto Sensu da Educação Física Sobre Pessoas com deficiência / Epistemological Analysis of Theses and Dissertations in Two Brazilian Physical Education Stricto Sensu Graduate Courses on Persons With Disabilities

RESUMO: o presente estudo teve como objetivo identificar as abordagens metodológicas e pressupostos epistemológicos adotados pelos autores das teses e dissertações sobre pessoas com deficiência dos dois mais conceituados programas de pós-graduação stricto sensu de Educação Física do Brasil dos últimos 10 anos. Os estudos foram classificados de acordo com as abordagens metodológicas empírico-analítica, fenomenológica-hermenêutica e crítico-dialética. A análise epistemológica baseou-se em critérios de validação científica, concepção de causalidade e concepção de ciência. Foram identificados que 66,7% dos estudos utilizaram a abordagem empírico-analítica e 33,3% a fenomenológica-hermenêutica. Não foram encontrados estudos que utilizaram a abordagem críticadialética. Com isto sugere-se que os caminhos da formação dos pesquisadores dos cursos de Pós-Graduação de Educação Física que tratam da temática pessoas com deficiência se diversifiquem com escolhas metodológicas; que se fundamentem em pressupostos epistemológicos sob perspectivas filosóficas do conhecimento e não só busquem a objetividade e a neutralidade científica.

ABSTRACT: This study aimed to identify the methodological approaches and epistemological assumptions adopted by the authors of theses and dissertations on people with disabilities of the two best-ranked stricto sensu graduate programs of Physical Education in Brazil over the last 10 years. The studies were classified according to empirical-analytic, phenomenological-hermeneutic and critical-dialectic methodological approaches. The epistemological analysis was based at scientific validation criteria, conception of causality and conception of science. The investigation identified that 66.7% of the studies used empirical-analytic approach, and 33.3% used phenomenological hermeneutic approach. No studies were found using critical-dialectical approach. It is suggested that researchers' training in Graduate Physical Education courses, which address the theme people with disabilities, diversify the methodological choices; be based on epistemological assumptions under philosophical perspectives of knowledge, and seek not only objectivity and scientific neutrality.

Aspectos biopsicossociais em escolares com atraso no desenvolvimento motor: um estudo longitudinal / Biopsychosocial factors contributing to delayed motor development in children: a longitudinal study

INTRODUCTION: Biopsychosocial conditions may influence childhood motor skill acquisition. OBJECTIVE: To analyse the biopsychosocial profiles of children with delayed motor development. METHODS: Employ quantitative descriptive research under longitudinal analysis. Seventeen students with motor development classified as lower than expected after two evaluations were investigated. A biopsychosocial questionnaire was applied to analyse risk factors in the form of an interview for the parents, and the Motor Development Scale (MDS) was applied to evaluate subject motor patterns. RESULTS: Biological and environmental risk factors, such as difficulties in school learning and low socioeconomic status may have contributed to delays in motor development. CONCLUSION: Childhood motor development may be influenced by biological and environmental risk factors such as gestational age at birth, type of birth, family socioeconomic status, and parental education level.

INTRODUÇÃO: Condições biopsicossociais podem influenciar a aquisição de habilidades motoras na infância. OBJETIVO: analisar o perfil biopsicossocial de escolares com atraso no desenvolvimento motor. MÉTODO: trata-se de uma pesquisa descritiva quantitativa sob análise longitudinal. Foram investigados dezessete escolares que tiveram na segunda avaliação seu desenvolvimento motor classificado como inferior ao esperado. Para análise dos fatores de risco utilizou-se um questionário biopsicossocial em forma de entrevista com os pais das crianças e a Escala de Desenvolvimento Motor (EDM) para avaliação do padrão motor da criança. RESULTADOS: fatores de risco biológico e ambientais, como dificuldades na aprendizagem escolar e baixo nível socioeconômico podem ter contribuído para o atraso no desenvolvimento moto.r CONCLUSÃO: o desenvolvimento motor pode ser influenciado por fatores de risco tanto biológico como ambiental, tais como: tempo de gestação, tipo de parto, condição socioeconômica da família, nível de escolaridade dos pais.

Hábitos e problemas relacionados ao sono em crianças dos seis aos dez anos / Habits and problems of sleeping in children six to ten years old

Sono é extremamente importante na vida dos seres vivos, sendo uma necessidade vital e biológica essencial ao crescimento, desenvolvimento e saúde da criança e um sono com pouca duração ou qualidade pode interferir de forma negativa nesse processo. Objetivo: apresentar uma análise descritiva das questões do Questionário de Hábitos de Sono das Crianças (CSHQ) de crianças de 6 aos 10 anos e verificar possíveis diferenças nestas questões do 1º ao 4º ano escolar. Métodos: participaram do estudo 61 crianças com idade de 6 a 10 anos, sendo 33 do sexo masculino. Foram avaliadas questões sobre o sono, por meio da versão em português do CSHQ (Children`s Sleep Habits Questionnaire) preenchido pelos pais. Resultados: em relação às questões do CSHQ, a maioria das respostas obtidas apresentaram prevalência alta na frequência de 2 a 4 vezes (às vezes) por semana. Quanto as questões sobre a hora de dormir, algumas questões como "tem medo de dormir no escuro", tem medo de dormir sozinha", "adormece a ver televisão", tiveram prevalências maiores e próximas de 50 por cento, com a frequência de 5 a 7 vezes (habitualmente) por semana. As "parassonias" foram mais frequentes nas crianças do 1º ano, diminuindo com a troca de turma, ou seja, com o aumento da idade. A "perturbação respiratória do sono" e a "sonolência" apresentaram escores maiores para as crianças do 1º ano. Conclusão: observou-se que as crianças do 1º ano apresentaram maiores pontuações em grande parte das sub-escalas do CSHQ, o que pode ser explicado pela entrada na escola, em que, surgem novas rotinas e compromisso escolares exigindo adaptação das crianças a este novo meio, inclusive adequação aos horários de acordar e dormir...

Sleeping is quite important to human beings and a vital need to the growth, development and health of children. Poor quality and short sleeping can be harmful to this process. Objective: to present a descriptive analysis of Sleep Children Habits Questionnaire (CSHQ) questions of children aged 6 to 10 years and possible differences from 1st to 4th school year. Methods: the study included 61 children aged 6-10 years, 33 male. Sleep questions were evaluated the Portuguese version of CSHQ completed by parents. Results: in relation of CSHQ questions, most of the responses showed a high prevalence rate in 2-4 times (sometimes) a week. In questions about bedtime, some questions as "afraid to sleep in the dark," "afraid to sleep alone", "falls asleep watching TV", had higher prevalence and near 50 percent, at the rate of 5-7 times (usually) a week. The "parasomnias" were more frequent in children of first year, reducing the exchange of class, that is, with increasing age. The "respiratory sleep disturbance" and "drowsiness" had higher scores for children from first year. Conclusion: it was observed that the children of first year showed higher scores in most of sub CSHQ, which can be explained by the entry in school, where there are new routines and school commitment requiring adaptation of children to this new place, including adaptation to the times of wakingand sleeping...

Contrasting effects of preexisting hyperglycemia and higher body size on hospital mortality in critically ill patients: a prospective cohort study.

BACKGROUND: Obesity and diabetes mellitus are well-defined risk factors for cardiovascular mortality. The impact of antecedent hyperglycemia and body size on mortality in critical ill patients in intensive care units (ICUs) may vary across their range of values. Therefore, we prospectively analyzed the relationship between in-hospital mortality and preexisting hyperglycemia and body size in critically ill ICU patients to understand how mortality varied among normal, overweight, and obese patients and those with low, intermediate, and high glycated hemoglobin (HbA1c) levels. METHODS: Medical history, weight, height, physiologic variables, and HbA1c were obtained during the first 24 h for patients who were consecutively admitted to the high complexity ICU of Hospital de Clínicas de Porto Alegre, Brazil, from April to August 2011. The relationships between mortality and obesity and antecedent hyperglycemia were prospectively analyzed by cubic spline analysis and a Cox proportional hazards model. RESULTS: The study comprised 199 patients. The overall hospital mortality rate was 43.2% during a median 16 (8-28) days of follow-up. There was a progressive risk of in-hospital mortality with higher HbA1c levels, with the relationship becoming significant at HbA1c >9.3% compared with lower levels (hazard ratio 1.74; 95% confidence interval with Bonferroni correction 1.49-2.80). In contrast, mean body mass index (BMI) was higher in survivors than in nonsurvivors (27.2 kg/m2 ± 7.3 vs. 24.7 kg/m2 ± 5.0 P = 0.031, respectively). Cubic spline analysis showed that these relationships differed nonlinearly through the spectrum of BMI values. In a Cox proportional hazards model adjusted for Acute Physiology and Chronic Health Evaluation II score and HbA1c, the risk of in-hospital mortality progressively decreased with increasing BMI (BMI <20 vs. 20-23.9 kg/m2, P = 0.032; BMI <20 vs. 24-34.9 kg/m2, P = 0.010; BMI <20 vs. ≥35 kg/m2, P = 0.032). CONCLUSIONS: Our findings suggest that significant hyperglycemia prior to ICU admission is a risk factor for in-hospital mortality. Conversely, increasing BMI may confer an advantageous effect against mortality in critical illness independently of previous glycemic control.

[Assessment and treatment of hyperglycemia in critically ill patients]. / Avaliação e tratamento da hiperglicemia em pacientes graves.

Hyperglycemia is a commonly encountered issue in critically ill patients in the intensive care setting. The presence of hyperglycemia is associated with increased morbidity and mortality, regardless of the reason for admission (e.g., acute myocardial infarction, status post-cardiovascular surgery, stroke, sepsis). However, the pathophysiology and, in particular, the treatment of hyperglycemia in the critically ill patient remain controversial. In clinical practice, several aspects must be taken into account in the management of these patients, including blood glucose targets, history of diabetes mellitus, the route of nutrition (enteral or parenteral), and available monitoring equipment, which substantially increases the workload of providers involved in the patients' care. This review describes the epidemiology, pathophysiology, management, and monitoring of hyperglycemia in the critically ill adult patient.

Avaliação e tratamento da hiperglicemia em pacientes graves / Assessment and treatment of hyperglycemia in critically ill patients

A hiperglicemia é um problema frequentemente encontrado em pacientes graves em ambiente de terapia intensiva. Sua presença se associa ao aumento da morbidade e da mortalidade, independentemente da causa da admissão (infarto agudo do miocárdio, condição após cirurgia cardiovascular, acidente vascular cerebral e sepse). Entretanto, permanecem muitas dúvidas com relação à fisiopatologia e, particularmente, em relação ao tratamento da hiperglicemia no paciente graves. Na prática clínica, devem ser levados em consideração diversos aspectos para o controle desses pacientes, inclusive os alvos de glicemia, o histórico de diabetes mellitus, a via de nutrição (enteral ou parenteral) e o equipamento de monitoramento disponível, o que aumenta substancialmente a carga de trabalho dos profissionais envolvidos nesse tratamento. Esta revisão descreveu a epidemiologia, a fisiopatologia, o tratamento e o monitoramento da hiperglicemia no paciente adulto grave.

Hyperglycemia is a commonly encountered issue in critically ill patients in the intensive care setting. The presence of hyperglycemia is associated with increased morbidity and mortality, regardless of the reason for admission (e.g., acute myocardial infarction, status post-cardiovascular surgery, stroke, sepsis). However, the pathophysiology and, in particular, the treatment of hyperglycemia in the critically ill patient remain controversial. In clinical practice, several aspects must be taken into account in the management of these patients, including blood glucose targets, history of diabetes mellitus, the route of nutrition (enteral or parenteral), and available monitoring equipment, which substantially increases the workload of providers involved in the patients' care. This review describes the epidemiology, pathophysiology, management, and monitoring of hyperglycemia in the critically ill adult patient.

Consulta coletiva para usuários tabagistas nas unidades de saúde da zona rural

O tabagismo é uma doença crônica caracterizada pela dependência física e psicológica do consumo de nicotina, substância presente no tabaco. É responsável por um número considerável de doenças e é uma importante causa de mortalidade no Brasil e no mundo. Considerando que o risco para os fumantes se relaciona com quantidade e tempo de exposição, um atendimento linear de qualidade é fundamental para o sucesso da mudança de hábito do paciente. Este projeto de intervenção é uma proposta de trabalhar com usuários tabagistas e ex-tabagistas cadastrados nas Unidades Básicas da zona rural sul de Cachoeira do Sul, através de grupos de consultas coletivas, com o objetivo de realizar o atendimento e acompanhamento destes pacientes que sofrem com a elevada demanda nas Unidades de Saúde e o difícil acesso. Espera-se vincular os pacientes aos profissionais de referência de sua área, buscando um atendimento de qualidade que reduza o número de fumantes na zona rural, e, por conseguinte, os malefícios do tabagismo a médio e longo prazo