Health in early adulthood: the contribution of the 1978/79 Ribeirão Preto birth cohort.

The increase in non-communicable chronic diseases of adults is due to demographic changes and changes in the risk factors related to physical activity, smoking habits and nutrition. We describe the methodology for the evaluation of persons at 23/25 years of age of a cohort of individuals born in Ribeirão Preto in 1978/79. We present their socioeconomic characteristics and the profile of some risk factors for chronic diseases. A total of 2063 participants were evaluated by means of blood collection, standardized questionnaires, anthropometric and blood pressure measurements, and methacholine bronchoprovocation tests. The sexes were compared by the chi-square test, with alpha = 0.05. Obesity was similar among men and women (12.8 and 11.1%); overweight was almost double in men (30.3 vs 17.7%). Weight deficit was higher among women than among men (8.6 and 2.6%). Women were more sedentary and consumed less alcohol and tobacco. Dietary fat consumption was similar between sexes, with 63% consuming large amounts (30 to 39.9 g/day). Metabolic syndrome was twice more frequent among men than women (10.7 vs 4.8%), hypertension was six times more frequent (40.9 vs 6.4%); altered triglyceride (16.1 vs 9.8%) and LDL proportions (5.4 vs 2.7%) were also higher in men, while women had a higher percentage of low HDL (44.7 vs 39.5%). Asthma and bronchial hyper-responsiveness were 1.7 and 1.5 times more frequent, respectively, among women. The high prevalence of some risk factors for chronic diseases among young adults supports the need for investments in their prevention.

Health in early adulthood: the contribution of the 1978/79 Ribeirão Preto birth cohort

The increase in non-communicable chronic diseases of adults is due to demographic changes and changes in the risk factors related to physical activity, smoking habits and nutrition. We describe the methodology for the evaluation of persons at 23/25 years of age of a cohort of individuals born in Ribeirão Preto in 1978/79. We present their socioeconomic characteristics and the profile of some risk factors for chronic diseases. A total of 2063 participants were evaluated by means of blood collection, standardized questionnaires, anthropometric and blood pressure measurements, and methacholine bronchoprovocation tests. The sexes were compared by the chi-square test, with alpha = 0.05. Obesity was similar among men and women (12.8 and 11.1 percent); overweight was almost double in men (30.3 vs 17.7 percent). Weight deficit was higher among women than among men (8.6 and 2.6 percent). Women were more sedentary and consumed less alcohol and tobacco. Dietary fat consumption was similar between sexes, with 63 percent consuming large amounts (30 to 39.9 g/day). Metabolic syndrome was twice more frequent among men than women (10.7 vs 4.8 percent), hypertension was six times more frequent (40.9 vs 6.4 percent); altered triglyceride (16.1 vs 9.8 percent) and LDL proportions (5.4 vs 2.7 percent) were also higher in men, while women had a higher percentage of low HDL (44.7 vs 39.5 percent). Asthma and bronchial hyper-responsiveness were 1.7 and 1.5 times more frequent, respectively, among women. The high prevalence of some risk factors for chronic diseases among young adults supports the need for investments in their prevention.

Resposta a administracao de corticosteroide em pacientes portadores de doenca pulmonar obstrutiva cronica e asma / Response to administration of corticosteroids in patients with chronic obstructive lung disease and asthma

Realizamos estudo espirometrico avaliando a resposta a adminisatracao de 200 mcg de salbutamol via inalatoria, antes e apos a administracao diaria de 8 mg de triancinolona, via oral, por um periodo de em media duas semanas, em 21 pacientes portadores de doenca pulmonar obstrutiva cronica (DPOC) ou asma. Onze pacientes responderam com aumento significante da CVF ou "VEF IND. 1" ou "FEF IND. 25-75 por cento", apos o uso de corticosteroides. Dez pacientes nao responderam. Houve em media aumento significante da CVF e "VEF IND. 1" (p < 0,01) e do "FEF IND. 25-75 por cento" (p < 0,05), apos o uso de corticosteroide. Nao houve diferenca significante entre os respondedores e nao respondedores ao uso de corticosteroide quanto a idade, a CVF, "VEF IND. 1" e "FEF IND. 25-75 por cento" iniciais (percentagem do predito). O grupo dos pacientes respondedores ao uso de corticosteroide, tambem respondeu ao uso do broncodilatador, quanto ao "FEF IND. 25-75 por cento", deferindo significativamente do grupo dos nao respondedores (p < 0,02). Houve correlacao negativa significante entre a intensidade da resposta ao corticosteroide e ao broncodilatador, avaliada pelo delta "FEF IND. 25-75 por cento" (p < 0,05). A administracao do corticoide nao modificou a resposta ao broncodilatador.

Tuberculose ganglionar em adultos / Lymph node tuberculosis in adults

A linfadenite e uma importante forma de acometimento tuberculoso extra-pulmonar que contribui com 8,4 por cento do total de casos de tuberculose nos adultos tratados em nosso Servico. A exerese ganglionar com exame histologico do fragmento, propiciou o diagnostico em 77,8 por cento dos casos. A boa evolucao clinica e a alta porcentagem de reatores ao PPD (84,2 por cento) faz-nos supor a predominancia de M. tuberculosis como o agente etiologico da linfadenite na nossa serie. Houve boa resposta em 75 por cento dos pacientes submetidos ao esquema quimioterapico com seis meses de duracao.

Estenose bronquica de etiologia tuberculosa: patogenia e tratamento / Bronchial stenosis of tuberculous etiology: pathogenesis and treatment

Descrevemos quatro casos de estenose bronquica, uma complicacao rara de tuberculose pulmonar. No primeiro caso, uma mulher de 18 anos, sem tratamento previo para tuberculose, apresentou estenose bronquica como resultado da cicatrizacao de complexo primario. Nao havia lesao de parenquima ao raio X. Nos outros tres pacientes a estenose bronquica foi atribuida a tuberculose ativa com pesquisa positiva para bacilo alcool-acido resistente em escarro. Estes receberam tratamento para tuberculose. Em um deles isto foi suficiente para a resolucao da estenose, mas nos outros dois pacientes ocorreu estenose bronquica devido a fibrose.

Involvement of lymphocytes in non-immune inflammation: dual effect of glucocorticoids.

Leucopenia induced by the administration of methotrexate reduced the volume of inflammatory exudate and the number of cells entering the pleural cavity during a 4-h carrageenin pleurisy when compared with that of non-leucopenic controls. The depressed response was partially but markedly restored when leucopenic animals were intravenously injected, immediately before the initiation of pleurisy, with spleen lymphocytes (or their products) obtained from normal, adrenal-demedullated or mock-operated rats. In contrast spleen lymphocytes (or their products) obtained from adrenalectomized rats or from rats receiving metyrapone, an inhibitor of adrenal glucocorticoid biosynthesis, were completely inactive. It is concluded that in physiologic concentrations glucocorticoids are essential for the production of lymphocyte-derived factors involved in the development of acute, non-immune inflammation. In pharmacologic concentrations, however, glucocorticoids suppress the release of such pro-inflammatory factors.