Avaliação de indicadores antropométricos de obesidade e a presença de comorbidades em participantes das ações do NASF do município de Candói, Paraná, Brasil / Evaluation of anthropometric indicators of obesity and the presence of comorbidities in participants of NASF actions in the city of Candói, Paraná, Brazil

Introdução: alguns indicadores antropométricos se caracterizam por serem facilmente aplicados e amplamente utilizados para a avaliação da obesidade e distribuição da gordura corporal, constituindo um dos primeiros passos para identificar risco inicial à saúde. Objetivo: avaliar e identificar a frequência de obesidade geral e abdominal por meio de indicadores antropométricos e verificar a presença de comorbidades em indivíduos que participaram das reuniões educativas e atividades do NASF do Município de Candói, Paraná. Metodologia: trata-se de um estudo quantitativo e transversal, com aplicação de questionário para conhecer as comorbidades e caracterizar a amostra por meio da aferição de peso, estatura e circunferência da cintura (CC), além da determinação do índice de massa corporal (IMC) e relação cintura-estatura (RCE). Nas análises de associação, utilizou-se o teste de qui-quadrado seguido do cálculo das razões de chance (RC). Resultados: a maior parte da amostra foi classificada como sobrepeso/obesidade (69,2%), com base no IMC, e apresentou elevados índices de obesidade abdominal pela CC e RCE. Os valores de CC aumentados foram observados em 83,01% dos pacientes. Em relação a RCE, o valor adequado foi verificado em apenas 14,5% dos participantes. As associações entre os índices antropométricos e as demais variáveis mostraram diferenças estatisticamente significativas em relação à idade dos participantes, revelando maior frequência de RCE aumentada em pacientes com 60 anos ou mais (RC = 8,53, p = 0,01). Dentre as comorbidades, o destaque foi a presença da hipertensão arterial sistêmica. Conclusão: além das elevadas frequências de obesidade geral, obesidade abdominal e da presença de comorbidades, como a hipertensão arterial sistêmica, a RCE foi o índice antropométrico capaz de sugerir risco cardiometabólico aumentado em idosos. Neste sentido, este estudo mostra a capacidade de caracterizar os usuários do sistema público de saúde com potencial para o desenvolvimento de doença cardiovascular através do uso de ferramentas antropométricas de baixo custo, e assim, poder dar suporte para ações corretivas a nível de políticas públicas municipais.

Introduction: some anthropometric indicators are characterized by being easily applied and widely used to assess obesity and body fat distribution, constituting one of the first steps to identify initial health risk. Objective: to assess and identify the frequency of general and abdominal obesity using anthropometric indicators and to verify the presence of comorbidities in individuals who participated in the NASF educational meetings and activities in the city of Candói, Paraná. Methodology: this is a quantitative and cross-sectional study, with the application of a questionnaire to find out about comorbidities and to characterize the sample by measuring weight, height and waist circumference (WC), in addition to determining the body mass index (BMI) and waist-height ratio (RCE). In the association analyzes, the chi-square test was used followed by the calculation of the odds ratios (CR). Results: most of the sample was classified as overweight/obesity (69.2%), based on BMI, and showed high rates of abdominal obesity by WC and WHR. The increased WC values were observed in 83.01% of the patients. Regarding CER, the adequate value was verified in only 14.5% of the participants. The associations between the anthropometric indices and the other variables showed statistically significant differences in relation to the age of the participants, revealing a higher frequency of increased CER in patients aged 60 years or older (RC = 8.53, p = 0.01). Among the comorbidities, the highlight was the presence of systemic arterial hypertension. Conclusion: in addition to the high frequencies of general obesity, abdominal obesity and the presence of comorbidities, such as systemic arterial hypertension, the CER was the anthropometric index capable of suggesting increased cardiometabolic risk in the elderly. In this sense, this study shows the ability to characterize users of the public health system with the potential for the development of cardiovascular disease through the use of low-cost anthropometric tools, and thus be able to support corrective actions at the level of municipal public policies. .

Evidence on Human Exposure to Pesticides and the Occurrence of Health Hazards in the Brazilian Population: A Systematic Review.

Brazil is among the biggest pesticide consumers in the world, with its population severely exposed to tons of such substances, both because of environmental contamination and occupational use. The health consequences of pesticide exposure are well-documented, but still sparse regarding Brazilian population. This study systematically reviewed the Brazilian studies published that address the relationship between exposure to pesticides and health problems in the Brazilian population. Also, information about pesticide use in Brazil is provided. The included studies showed that exposure to pesticides has a relevant impact on the health of the Brazilian population, regardless of age and gender, and on workers in rural areas or not. Most poisoning events seem to result from the continuous use of pesticides, whether occupationally or environmentally, characterizing a public health problem. The major consequences reported in literature were damage to the central nervous system, cancer, deleterious effects on rural workers' health, intoxications, malformations, and endocrine changes. These findings point out the need to understand the impact of chronic exposure to pesticides on severely exposed people and highlight the importance of creating public policies to protect them and avoid disease occurrence.

Critical review of cancer mortality using hospital records and potential years of life lost.

Objective To determine and discuss cancer mortality rates in southern Brazil between 1988 and 2012. Methods This was a critical review of literature based on analysis of data concerning incidence and mortality of prostate cancer, breast cancer, bronchial and lung cancer, and uterine and ovarian cancer. Data were collected from the online database of the Brazil Instituto Nacional de Câncer José Alencar Gomes da Silva. Results The southern Brazil is the leading region of cancer incidence and mortality. Data on the cancer profile of this population are scarce especially in the States of Santa Catarina and Paraná. We observed inconsistency between data from hospital registers and death recorded. Conclusion Both cancer incidence and the mortality are high in Brazil. In addition, Brazil has great numbers of registers and deaths for cancer compared to worldwide rates. Regional risk factors might explain the high cancer rates.

Critical review of cancer mortality using hospital records and potential years of life lost / Revisão crítica da mortalidade por câncer usando registros hospitalares e anos potenciais de vida perdidos

ABSTRACT Objective To determine and discuss cancer mortality rates in southern Brazil between 1988 and 2012. Methods This was a critical review of literature based on analysis of data concerning incidence and mortality of prostate cancer, breast cancer, bronchial and lung cancer, and uterine and ovarian cancer. Data were collected from the online database of the Brazil Instituto Nacional de Câncer José Alencar Gomes da Silva. Results The southern Brazil is the leading region of cancer incidence and mortality. Data on the cancer profile of this population are scarce especially in the States of Santa Catarina and Paraná. We observed inconsistency between data from hospital registers and death recorded. Conclusion Both cancer incidence and the mortality are high in Brazil. In addition, Brazil has great numbers of registers and deaths for cancer compared to worldwide rates. Regional risk factors might explain the high cancer rates.

RESUMO Objetivo Investigar e discutir os indicadores de mortalidade por câncer na Região Sul do Brasil entre 1988 e 2012. Métodos Revisão crítica da literatura baseada na análise de dados referentes às estimativas de incidência e mortalidade dos cânceres de próstata, mama feminina, brônquios e pulmões, colo de útero e ovário, realizada por meio de consulta na base de dados online do Instituto Nacional de Câncer José Alencar Gomes da Silva. Resultados A Região Sul lidera no país a incidência e a mortalidade das neoplasias estudadas. Há escassez de dados sobre o perfil do câncer nesta população, especialmente nos Estados de Santa Catarina e Paraná. Notou-se, ainda, incoerência entre os dados de registros hospitalares e registros de óbito no período estudado. Conclusão Tanto a incidência quanto a mortalidade decorrentes dos cânceres estudados ainda são muito elevadas no Brasil, com significante número de registros da doença e de óbitos, quando comparado às taxas mundiais. Fatores de risco regionais podem explicar as elevadas taxas.

Does l-glutamine-supplemented diet extenuate NO-mediated damage on myenteric plexus of Walker 256 tumor-bearing rats?

This study was designed to appraise the relationship between enteric neuropathy and oxidative stress in cancer cachexia under l-glutamine-supplemented diet. Total and nitrergic neuronal populations were investigated in jejunum and ileum in four experimental groups: control (C); control l-glutamine-supplemented diet (CG); Walker-256 tumor (TW); and Walker-256 tumor supplemented with l-glutamine (TWG). In addition, local oxidative stress, neuronal nitric oxide synthase (nNOS) enzyme and nitric oxide (NO) levels were evaluated. Neuronal density and somatic area of the total and nitrergic populations were reduced in TW rats, which was accompanied by high oxidative stress, NO and nNOS levels. l-glutamine supplementation prevented neuronal atrophy, changes in pan neuronal density and nNOS overexpression (ileum), and restored total antioxidant capacity. Nevertheless, the oxidative stress was partially mitigated and no effect was observed on the reduction of nitrergic population and NO levels. l-glutamine-supplemented diet extenuates NO-mediated damage on the myenteric plexus although has a small benefit on oxidative stress.

l-Glutamine supplementation promotes an improved energetic balance in Walker-256 tumor-bearing rats.

We evaluated the effects of supplementation with oral l-glutamine in Walker-256 tumor-bearing rats. A total of 32 male Wistar rats aged 54 days were randomly divided into four groups: rats without Walker-256 tumor, that is, control rats (C group); control rats supplemented with l-glutamine (CG group); Walker-256 tumor rats without l-glutamine supplementation (WT group); and WT rats supplemented with l-glutamine (WTG group). l-Glutamine was incorporated into standard food at a proportion of 2 g/100 g (2%). After 10 days of the experimental period, the jejunum and duodenum were removed and processed. Protein expression levels of key enzymes of gluconeogenesis, that is, phosphoenolpyruvate carboxykinase and glucose-6-phosphatase, were analyzed by western blot and immunohistochemical techniques. In addition, plasma corticosterone, glucose, insulin, and urea levels were evaluated. The WTG group showed significantly increased plasma glucose and insulin levels ( p < 0.05); however, plasma corticosterone and urea remained unchanged. Moreover, the WTG group showed increased immunoreactive staining for jejunal phosphoenolpyruvate carboxykinase and increased expression of duodenal glucose-6-phosphatase. Furthermore, the WTG group presented with less intense cancer cachexia and slower tumor growth. These results could be attributed, at least partly, to increased intestinal gluconeogenesis and insulinemia, and better glycemia maintenance during fasting in Walker-256 tumor rats on a diet supplemented with l-glutamine.

Supplementation with L-glutamine prevents tumor growth and cancer-induced cachexia as well as restores cell proliferation of intestinal mucosa of Walker-256 tumor-bearing rats.

This study aimed to evaluate the intestinal mucosa of the duodenum and jejunum of Walker-256 tumor-bearing rats supplemented with L-glutamine. Thirty-two male 50-day-old Wistar rats (Rattus norvegicus) were randomly divided into four groups: control (C), control supplemented with 2 % L-glutamine (GC), Walker-256 tumor (WT), and Walker-256 tumor supplemented with 2 % L-glutamine (TWG). Walker-256 tumor was induced by inoculation viable tumor cells in the right rear flank. After 10 days, celiotomy was performed and duodenal and jejunal tissues were removed and processed. We evaluated the cachexia index, proliferation index, villus height, crypt depth, total height of the intestinal wall, and number of goblet cells by the technique of periodic acid-Schiff (PAS). Induction of Walker-256 tumor promoted a reduction of metaphase index in the TW group animals, which was accompanied by a reduction in the villous height and crypt depths, resulting in atrophy of the intestinal wall as well as increased PAS-positive goblet cells. Supplementation with L-glutamine reduced the tumor growth and inhibited the development of the cachectic syndrome in animals of the TWG group. Furthermore, amino acid supplementation promoted beneficial effects on the intestinal mucosa in the TWG animals through restoration of the number of PAS-positive goblet cells. Therefore, supplementation with 2 % L-glutamine exhibited a promising role in the prevention of tumor growth and cancer-associated cachexia as well as restoring the intestinal mucosa in the duodenum and jejunum of Walker-256 tumor-bearing rats.

Prevalência de fatores de risco cardiovascular em diabéticos tipo 2 no município de Paranavaí-PR / Prevalence of cardiovascular risk factors in patients withtype 2 diabetes melittus in the city of Paranavaí-PR

As doenças cardiovasculares têm apresentado grande importância dentro da saúde pública, frente ao seu enorme impacto social e econômico. Os fatores de risco para estas doenças tem acompanhado o portador do Diabetes Mellitus, representando a principal causa de morbimortalidade nesta população. O presente trabalho teve como finalidade levantar a prevalência dos fatores de risco das complicações do Diabetes, que podem levar a doenças cardiovasculares. O estudo avaliou um grupo de 53 diabéticos (tipo 2) atendidos por uma equipe do Programa Saúde da Família (PSF) em Paranavaí, Paraná. A avaliação incluiu avaliação socioeconômica, antropométrica, pressórica e bioquímica. O estudo demonstrou uma elevada prevalência de vários fatores de risco, como pressão arterial, dislipidemias, hiperglicemia e excesso de peso, tanto em homens, quanto em mulheres. Considerando a coexistência de fatores de risco, foi possível identificar uma alta prevalência de portadores da síndrome metabólica. Desta forma, o estudo reforça a necessidade da melhoria do acompanhamento destes pacientes, visando ao controle metabólico e à redução da distribuição de gordura corporal, buscando evitar as complicações que acompanham o diabetes, assim como a implantação de programas de intervenção e educação através do PSF, com finalidade de reduzir o ônus do sistema público.

Cardiovascular diseases have shown great importance within public health as a result of its enormous social and economic impact. The risk factors for such diseases have followed the patients with type 2 diabetes Mellitus, representing the major cause of their morbimortality. This paper studies the prevalence of the consequences of Diabetes which can lead to cardiovascular diseases. This study evaluates a group of 53 patients with type 2 diabetes Mellitus assisted by a team of the Health Family Program in Paranavaí, Paraná, Brazil. The evaluation included socioeconomic conditions, anthropometric, biochemical and blood pressure levels. The study showed high prevalence of several risk factors such as blood pressure, dyslipidemia, hyperglycemia and weight excess for both genders. Considering the coexistence of risk factors, we identified wide prevalence of patients with metabolic syndrome. Thus, this study suggests the need for improved monitoring of patients in order to control their metabolic parameters and reduce their body fat distribution to avoid the complications from diabetes. This paper still suggests the need for interventions and educational programs through the Health Family Program to reduce the expenses of the public system.

Automedicação em adultos na cidade de Guairaçá - PR / Self-medication in adults in the city of Guairaçá, estate of Paraná-Brazil

A prática da automedicação tem preocupado os vários setores da saúde pública no Brasil. Diversos fatores têm contribuído para este fato. As ações em beneficio de sua prevenção serão possíveis somente por meio de diagnósticos regionais, direcionando os programas que visem ao seu controle. Neste sentido, este trabalho teve por objetivo promover um levantamento da prevalêcia da prática da automedicação e traçar suas características na cidade de Guairaçá-PR. Este estudo transversal de base populacional utilizou 360 moradores,entre 20 e 80 anos, de ambos os sexos e de diferentes níveis sociais. O estudo identificou a prática da automedicação em 74,72% da população igualmente distribuída em ambos os sexos, com maior prevalência abaixo dos 50 anos de idade. A principal forma de escolha do medicamento foi a autoprescrição (52%). O trabalho revelou um panorama que pode ser variado em relação a outros estudos, porém mostra uma realidade preocupante com altos índices de automedicação, o grau de instrução como fator determinante, uso abusivo de analgésicos não-opióides, devido a distúrbios relacionados à dor, e uma alta prevalência de usuários do SUS praticando automedicação, revelando a necessidade de programas educativos e evidenciando a falta de uma atuação mais ativa dos profissionais ligados ao uso de medicamentos.

The self-medication practice has worried the several sectors of the health public in Brazil. Diverse factors had been the responsible for this fact. The actions that promote its prevention will be possible only through the regional diagnostic directing the programs to privilege its control. In this direction, this work had the purpose to evaluate the prevalence of the self-medication and their characteristics in the city of Guairaçá-PR. This transversal study of population base used 360 adult persons, between 20-80 years, of both sex and different social levels and instruction degree to evaluate the profile of the drug utilization without medical prescription. The study identifi ed theself-medication practice in 74.72% of the population equally distributed in both between men and women, with the most prevalence tothe people less than 50 years. The main type of choice of the medicine was self-prescription (52%). The work showed a survey that can be varied in relation to other studies, however shows a preoccupying reality with the great prevalent index of self-medication, instruction degree as factor to practice self-medication, the abusive use of analgesics (AINS) due pain disturbs, and a great number of SUS users that practice self-medication. These dates suggest the necessity of educative programs and evidencing the lack of a more active performance of the professionals that work with drugs.