Family History of Hypertension: Impact on Blood Pressure, Anthropometric Measurements and Physical Activity Level in Schoolchildren

Abstract Background: A family history of arterial hypertension (AH), combined with environmental risk factors, is directly related to the development of AH. Objectives: To evaluate the frequency of AH, anthropometric indicators and level of physical activity and their association with a family history (FH) of AH in school children. Methods: Cross-sectional study with 118 students, aged between 11 and 17 years, of both sexes. Waist circumference (WC), weight, height, level of physical activity and FH of HA were collected. Body mass index z score (BMI-z) and waist-to-height ratio (WHtR) were calculated. Binary logistic regression model was used to verify the chance risk, with significance p <0.05. Results: Of the 118 parents who answered the questionnaire, 34.7% had a positive FH of AH. Girls with a positive FH had higher means of WC (p= 0,004), BMI (p=0,020), and systolic blood pressure (SBP) (p=0,006) than boys, and a higher risk of being overweight (OR=4,48; 95%CI:1,55-12,94), and having elevated WHtR (OR=5.98; 95%CI:1.66- 21.47) and SBP (OR=3,07; 95%CI:1,03-9,13) than girls without a FH, but they practice more vigorours moderate physical activity (MVPA) (p=0,039). On the other hand, no differences in these parameters were observed between boys with and without a FM of AH. Conclusion: Overweight and a FH of hypertension were associated with an increased risk for AH in girls. This was not observed among boys, perhaps due to more active lifestyle.

Reconstrucción de herida compleja de tórax posterior a resección agresiva por cáncer de mama avanzado / Complex chest wound reconstruction following aggressive resection for advanced breast cancer

Los grandes defectos torácicos requieren generalmente procedimientos complejos para su reparación; en la mayoría de los casos es necesaria la combinación de tejidos autólogos y materiales protésicos, por lo que constituye un desafío para el cirujano plástico. En nuestra experiencia se presenta una herida compleja de la pared torácica secundaria a exéresis tumoral. En general se dispone de varias opciones reconstructivas para cubrir los defectos resultantes de las amplias escisiones y poder aportar colgajos vascularizados, amplios y voluminosos. A pesar de no disponer en nuestro caso con los tejidos regionales más comúnmente usados, hemos podido dar cobertura a todo el defecto y se ha garantizado una adecuada estabilidad de la pared torácica. Se tuvo como objetivo mostrar la forma en que se realizó la reconstrucción inmediata con la combinación de colgajo de rotación y material protésico. En este artículo se revisa el hemicolgajo dermograso abdominal, la técnica de elevación y sus ventajas e inconvenientes. Se trata de una técnica de gran seguridad, versátil, con pocas secuelas en la zona donante, de tiempo quirúrgico relativamente corto.

Large thoracic defects require complex procedures for repair, in most cases it requires the combination of autologous tissues and prosthetic materials. A complex wound secondary to tumor exeresis was presented in our service. Among the multiple reconstructive options, a rotation and advancement abdominal dermofat hemicolgajo was chosen. Resulting in a technique of great safety, versatile, with little sequel in the donor area, and short surgical time

Relação entre o perfil de adesão e as barreiras para a permanência no programa de extensão "yoga: awaken one" / Relationship between the membership profile and the barriers to stay in the "yoga: awaken one" extension program

Objetivo: Investigar a relação entre o perfil de adesão e barreiras percebidas por estudantes universitários para permanência no Programa de Extensão "Yoga: Awaken ONE". Métodos: Foram realizados dois cortes transversais com universitários da Universidade Federal do Recôncavo da Bahia. O primeiro foi composto por 16 indivíduos e investigou o perfil demográfico, socioeconômico, antropométrico, da aptidão física e da qualidade de vida dos universitários que ingressaram no Programa de Extensão. O segundo visou identificar as barreiras para permanência de 13 estudantes (dentre os 16 iniciais) que haviam se afastado do Programa após quatro meses do início. Resultados: Houve predominância de indivíduos do sexo feminino, dos cursos de graduação em Educação Física e Pedagogia e da classe socioeconômica C. A maioria dos participantes estava com indicadores adequados de gordura corporal. Observou-se grande proporção de indivíduos com indicadores baixos de flexibilidade e força muscular. Para a qualidade de vida, a menor mediana foi observada para o domínio meio ambiente e a maior para o domínio relações sociais. As principais barreiras percebidas para a prática de yoga pelos universitários foram "jornada de estudos extensa" e "jornada de trabalho extensa". Observou-se correlação do perfil sociodemográfico, indicadores de obesidade, variáveis hemodinâmicas, flexibilidade, força muscular e qualidade de vida com barreiras percebidas para permanência no Programa de Extensão universitária "Yoga: Awaken ONE". Conclusões: Estes achados sugerem que o perfil do público universitário pode ser determinante para a permanência ou evasão de programas de promoção de exercícios físicos e precisa ser considerado em propostas de programas de extensão universitária.

Objective: Investigate the relationship between the member adherence profile and barriers perceived by university students to remain in the "Yoga: Awaken ONE" Extension Program. Methods: Two cross-sections were carried out with university students from the Federal University of Recôncavo da Bahia. The first was composed of 16 individuals and investigated the demographic, socioeconomic, anthropometric, physical fitness, and quality of life profile of university students joining the Extension Program. The second aimed at identifying the barriers to remain in the program faced by 13 students (out of the initial 16) who had withdrawn from the Program four months after the beginning. Results: There was a predominance of female individuals, from undergraduate courses in Physical Education and Pedagogy, and from the C socioeconomic class. Most participants had adequate body fat indexes. There was a large proportion of individuals with low flexibility and muscle strength. For quality of life, the lowest median was observed for the environment domain, while the highest could be noted for the social relationship domain. The main barriers perceived for the practice of yoga by university students were "long study hours" and "long work hours". There was a correlation between sociodemographic profile, obesity indicators, hemodynamic variables, flexibility, muscle strength, and QOL with the perceived barriers to stay in the "Yoga: Awaken ONE" university extension program. Conclusions: These findings suggest that the profile of the university audience can be a determinant for the permanence or dropout of programs that promote physical exercise and therefore, it should be taken into consideration in proposals for university extension programs.

Quality of life and its relationship with different anthropometric indicators in adults with obesity / Qualidade de vida e sua relação com diferentes indicadores antropométricos em adultos com obesidade

Abtract Introduction: Obesity compromises the quality of life. However, few studies have investigated the influence of different anthropometric indicators on the quality of life of this population. Objective: We aimed to correlate the physical and mental components of quality of life and verify its association with different anthropometric indicators in adults with obesity. Methods: A cross-sectional study was conducted in adults with obesity [body mass index (BMI) ≥ 30 kg/m²]. The quality of life was investigated using the SF-36 questionnaire, with scores ranging from 0 (worst-case scenario) to 100 (best scenario for the outcome). The anthropometric indicators used were BMI, waist circumference, waist/height ratio (WHR), and lean and fat body mass. For analysis, Spearman's correlation and crude and adjusted linear regression for sociodemographic variables were used. Results: A total of 75 subjects (nfemales = 47; µage= 34.8 ± 7.1 years) were included, and their means of the physical and mental components were 64.5 ± 15.9 and 50.8 ± 21.3 points, respectively. The social functioning domain presented a strong positive correlation (r = 0.760) with the mental health domain, and eight moderate correlations (0.400 ≤ r ≥ 0.699) were found between the different domains of the questionnaire. The functional capacity domain and the physical component presented a moderate negative correlation with the WHR (r = -0.402 and r = -0.407, respectively). After adjustment, the WHR was inversely associated with the physical component (β = -1.197; p = 0.002). Conclusion: In adults with obesity, important correlations were observed between the physical and mental components of quality of life, and the waist/height ratio was the only anthropometric indicator correlated and associated with the physical component of the outcome.

Resumo Introdução: A obesidade compromete a qualidade de vida física e mental em função do excesso de peso corporal. Entretanto poucos estudos se propuseram a compreender a influência dos diferentes indicadores antropométricos na qualidade de vida dessa população. Objetivo: Correlacionar os componentes físico e mental da qualidade de vida e verificar a sua associação com diferentes indicadores antropométricos em adultos com obesidade. Métodos: Realizou-se um estudo transversal com adultos com obesidade (índice de massa corporal [IMC] ≥ 30kg/m²). A qualidade de vida foi investigada pelo questionário SF-36, com amplitude de escores de zero (pior cenário) a 100 (melhor cenário para o desfecho). Os indicadores antropométricos foram: IMC, perímetro de cintura, razão cintura/estatura (RCE), massa corporal magra e gorda. Na estatística, empregou-se correlação de Spearman e regressão linear bruta e ajustada para variáveis sociodemográficas. Resultados: Nos 75 sujeitos (nmulheres = 47; µidade = 34,8 ± 7,1 anos), o componente físico apresentou média de 64,5 ± 15,9 pontos e mental de 50,8 ± 21,3 pontos. O domínio de aspecto social apresentou forte correlação positiva (r = 0,760) com o domínio da saúde mental e foram encontradas oito correlações moderadas (0,400 ≤ r ≥ 0,699) entre os distintos domínios do questionário. O domínio capacidade funcional e o componente físico apresentaram moderada correlação negativa com a RCE (r = -0,402 e r = -0,407, respectivamente). Na análise ajustada, a RCE apresentou uma associação inversa com o componente físico (β = -1,197; p = 0,002). Conclusão: Em adultos com obesidade, observou-se importantes correlações entre os componentes físico e mental da qualidade de vida e a razão cintura/estatura foi o único indicador antropométrico correlacionado e associado ao componente físico do desfecho.

Carboxiterapia associada à drenagem linfática manual na adiposidade abdominal / Carboxytherapy associated with manual lymphatic drainage in abdominal adiposity

Introdução: A lipodistrofia localizada em flancos está entre os problemas estéticos mais procurados para tratamento. Dentre os procedimentos utilizados para tratar esta condição, destaca-se a utilização da carboxiterapia e a drenagem linfática. Objetivo: Avaliar a associação da carboxiterapia com a drenagem linfática manual na gordura abdominal, em mulheres não sedentárias. Métodos: Foi realizado um estudo do tipo exploratório, analítico, com abordagem quantitativa. A amostra caracterizou-se como não probabilística por conveniência, e foi aplicada tanto no gênero feminino, quanto masculino. A pesquisa foi realizada em um laboratório de saúde, de uma faculdade privada, localizada em Vitória da Conquista/BA. Os instrumentos utilizados foram um questionário com dados sociodemográficos, uma ficha de anamnese, uma escala likert de satisfação, além dos registros fotográficos. Foram realizadas 8 sessões de carboxiterapia associada à drenagem linfática manual, realizadas 2 vezes na semana, com duração de 50 minutos. Resultados: A análise do comprimento da circunferência abdominal mostrou que o procedimento realizado promove redução em sua média, no qual se observou um resultado satisfatório da redução de medidas através da perimetria. Conclusão: O tratamento com a carboxiterapia associado à drenagem linfática manual apresentou resultados significativos e favoráveis, quanto a redução de medidas e na satisfação. (AU)

Introduction: Flank localized lipodystrophy is one of the most aesthetic problems for treatment. Among the procedures used to treat this condition, the use of carboxytherapy and lymphatic drainage stands out. Objective: To evaluate the association of carboxytherapy with manual lymphatic drainage in abdominal fat in non-sedentary women. Methods: An exploratory study, analytical, with quantitative approach was performed. The sample was characterized as nonprobabilistic for convenience and was applied to both females and males. The research was conducted in a health laboratory of a private college, located in Vitória da Conquista in the state of Bahia. The instruments were a questionnaire with sociodemographic data, an anamnesis form, a likert satisfaction scale, and photographic records. Eight sessions of carboxytherapy associated with manual lymphatic drainage were performed twice a week, lasting 50 minutes. Results: The analysis of the abdominal circumference length showed that the procedure promotes a satisfactory result of the reduction of measurements. Conclusion: The treatment with carboxytherapy associated with manual lymphatic drainage showed significant and favorable results regarding the reduction of measurements and satisfaction. (AU)

Trigliceridos/colesterol HDL: utilidad en la deteccion de sujetos obesos con riesgo para diabetes mellitus tipo 2 y enfermedad cardiovascular / Triglycerides/HDL cholesterol: utility for the detection of obese subjects with risk for diabetes mellitus type 2 and cardiovascular diseases / Triglicerideos/colesterol HDL: utilidade na deteccao de sujeitos obesos com risco para a diabetes mellitus tipo 2 e doenca cardiovascular

En la Republica Argentina, la prevalencia de obesidad se ha incrementado considerablemente y la de diabetes mellitus tipo 2 (DMT2) alcanza 12,7%. La obesidad presenta heterogeneidad y el aumento de la grasa abdominal puede incluir hipertrigliceridemia, hiperglucemia, disminucion de C-HDL, aumentos de apolipoproteina B (Apo B), aumento de lipoproteinas LDL pequenas y densas, hiperinsulinemia, insulino-resistencia (IR), estado inflamatorio cronico, estado protrombotico y otras alteraciones metabolicas, que se han reunido en el llamado sindrome metabolico con prevalencia del 20 al 40%. La resistencia a la insulina (IR) esta presente en 10 al 25% de la poblacion y se asocia con esas alteraciones. La determinacion de IR es compleja, necesita de internacion en clinicas y debe ser realizada por especialistas. En el laboratorio se puede estimar a traves del dosaje de insulina, pero no esta estandarizado, por lo que es necesario disponer de tecnicas sencillas y accesibles. La relacion trigliceridos (TG)/colesterol HDL (C-HDL) puede ser una opcion utilizando como valores de corte TG/C-HDL ≥2,5 en mujeres y ≥3,5 en varones. Se asocia significativamente con IR y enfermedad cardiovascular (ECV), tiene buena especificidad aunque bajo poder discriminador por lo cual cuando esta presente y existe riesgo de DMT2 o ECV deberia complementarse con el calculo del colesterol-no-HDL o Apo B y el colesterol remanente. Teniendo en cuenta la pandemia de obesidad y DMT2 y la elevada frecuencia de ECV, la relacion TG/C-HDL podria ser un marcador que deberia ser informado por el laboratorio bioquimico-clinico.

In Argentina, the prevalence of obesity has increased considerably and type 2 diabetes mellitus (DMT2) reaches 12.7%. Obesity presents heterogeneity and the increase in abdominal fat may include hypertriglyceridemia, hyperglycemia, decrease in HDL-C, increases in apolipoprotein B (Apo B), increase in small and dense LDL lipoproteins, hyperinsulinemia, insulin resistance (IR), chronic inflammatory state, prothrombotic state and other metabolic alterations, which have been included in the so-called metabolic syndrome with 20 to 40% prevalence. Insulin resistance is present in 10 to 25% of the population and is associated with these alterations. The determination of IR is complex; it needs hospitalization and must be performed by specialists. In the laboratory, it can be estimated through insulin dosing, but it is not standardized, so it is necessary to have simple and accessible techniques. The triglycerides (TG)/HDL cholesterol (HDL-C) ratio can be an option using TG/C-HDL cutoff values ≥2.5 in women and ≥3.5 in men. It is significantly associated with IR and CVD and has good specificity but low discriminating power. So when it is present and there is a risk of T2DM or cardiovascular disease, CVD should be complemented with the calculation of non-HDL cholesterol or Apo B and the remaining cholesterol. Considering the pandemic of obesity and DMT2 and the high frequency of CVD, the TG/C-HDL ratio marker should be reported by the biochemical-clinical laboratory.

Na Republica Argentina, a prevalencia de obesidade aumentou em forma consideravel e a de diabetes mellitus tipo 2 (DMT2) atinge 12,7%. A obesidade apresenta heterogeneidade e o aumento da gordura abdominal pode incluir hipertrigliceridemia, hiperglicemia, diminuicao do HDL-C, aumentos da apolipoproteina B (Apo B), aumento das lipoproteinas LDL pequenas e densas, hiperinsulinemia, resistencia a insulina, estado inflamatorio cronico, estado pro-trombotico e outras alteracoes metabolicas, que se encontraram na chamada sindrome metabolica, com prevalencia de 20 a 40%. A resistencia a insulina (RI) esta presente em 10 a 25% da populacao e esta associada a essas alteracoes. A determinacao da RI e complexa, precisa da hospitalizacao em clinicas e deve ser realizada por especialistas. No laboratorio, isso pode ser estimado atraves da dosagem de insulina, mas nao e padronizado, portanto e necessario ter tecnicas simples e acessiveis. A relacao triglicerideos (TG)/colesterol HDL (C-HDL) pode ser uma opcao usando como valores de corte TG/C-HDL ≥2,5 em mulheres e ≥3,5 em homens. Esta significativamente associado a RI e a doenca cardiovascular (DCV), possui boa especificidade, embora apresente baixo poder discriminador; portanto, quando esta presente e ha risco de DMT2 ou DCV, deveria ser complementado com o calculo do colesterol nao-HDL ou Apo B e o restante colesterol. Considerando a pandemia de obesidade e DMT2 e a alta frequencia de DCV, a relacao TG/C-HDL poderia ser um marcador que deveria ser relatado pelo laboratorio bioquimico-clinico.

Immunohistochemical expression of plasminogen activator inhibitor-1 in subcutaneous versus omental adipose tissue in patients after elective abdominal surgery

Plasminogen activator inhibitor-1 (PAI-1) is a biomarker of thrombosis. Adipose and vascular tissues are among the major sources of PAI-1 production. Previous studies indicated that fat deposits mediate increased cardiovascular risk among obese individuals. We investigated the immunohistochemical (IHC) expression of PAI-1 in adipose and vascular tissues from the omentum and the subcutaneous tissue. The pathology samples were selected from 37 random patients who underwent elective abdominal surgery between 2008-2009. PAI-1 expression was semi-quantitatively scored and compared between the groups. Significant differences were noted in the IHC expression of PAI-1 between the omental and the subcutaneous adipose tissues (1.1 ± 0.8 versus 0.8 ± 0.6, respectively (p=0.05)). Adipose tissue displayed higher IHC expression of PAI-1 compared to vascular wall tissue in both omentum and subcutaneous sections (1.1 ± 0.8 versus 0.5 ± 0.9 (p=0.004), and 0.8 ± 0.6 versus 0.4 ± 0.6 (p=0.003), respectively). In conclusion, our study compared PAI-1 expression in the omentum versus the subcutaneous tissue and adipose versus vascular tissues. IHC expression of PAI-1 level was significantly higher in the omental adipose tissue compared to the subcutaneous adipose tissue. Adipose tissue displayed significantly higher PAI-1 expression than vascular tissue. The study elucidates the biological differences of adipose and vascular tissue from subcutaneous versus omental sections.

Medidas abdominais adicionais são uma ferramenta útil para avaliar a composição corporal em mulheres obesas / Additional abdominal measurements are a useful tool to evaluate body composition in obese women

ABSTRACT BACKGROUND: During weight gain, most of the excess adipose tissue accumulates in the trunk. This alters the body shape and makes collection of anthropometric measurements, especially waist circumference (WC), difficult. OBJECTIVE: To evaluate the sensitivity and applicability of additional abdominal measurements in order to assess body composition of obese women. METHODS: A total of 30 women between 20 and 50 years of age and BMI above 30 kg/m² were assessed. Three WC measurements, were performed: at the umbilical scar designated as WC1 and at 8 and 16 cm above the umbilical scar, designated as WC2, and WC3 respectively. The correlation (r) between these anthropometric measurements and their sum was assessed against the parameters fat mass (FM), free fat mass (FFM), body fat percentage (%BF), and trunk fat percentage (%TF), obtained by total and trunk segmental bioelectric impedance analysis (BIA) as well as by the golden standard total and trunk dual energy X-ray absorptiometry (DXA). RESULTS: The measurements WC1, WC2, WC3, and their sum correlated strongly and moderately with the parameters FM, FFM, and %BF in total BIA and in both total DXA and trunk DXA. CONCLUSION: The results demonstrated a robust correlation between the sum of the three WC measurements and total and trunk DXA in obese women suggesting that such measurements may be a good indicator of body and trunk fat in women, actually superior to BIA results. The use of these three measurements may be an alternative for the assessment of body and trunk fat, in those cases in which the body shape due to adipose tissue trunk accumulation makes accurate classical measurement (WC1) difficult.

RESUMO CONTEXTO: O acúmulo de tecido adiposo excessivo no ganho de peso se dá em maior proporção no segmento do tronco, leva à alteração dos formatos corporais dificultando a tomada de medidas antropométricas, em especial a circunferência abdominal (CA). OBJETIVO: Avaliar a sensibilidade de medidas adicionais na região abdominal, considerando cada medida individualmente e sua somatória, e a aplicabilidade dessas medidas na avaliação da composição corporal de mulheres obesas. MÉTODOS: Foram avaliadas 30 mulheres com idade entre 20 e 50 anos e IMC acima de 30 kg/m² com a realização de três medidas de CA denominadas: CA1 padronizada na cicatriz umbilical, CA2 a 8 cm acima da cicatriz umbilical e CA3 a 16 cm acima da cicatriz umbilical. Foi avaliada a correlação (r) destas medidas antropométricas e de sua somatória com os parâmetros massa gorda (MG), massa livre de gordura (MLG), porcentagem de gordura corporal (%GC) e do tronco (%GT) obtidos por impedância bioelétrica (BIA) total e segmentar do tronco e por absorciometria de raios-X de dupla energia (DXA) total e do tronco, como padrão ouro. RESULTADOS: As medidas CA1, CA2, CA3 e a somatória das três tiveram correlação forte e moderada com os parâmetros MG, MLG e %GC tanto para BIA total como para DXA total e DXA do tronco. CONCLUSÃO: Os resultados deste estudo mostram forte correlação entre a soma das medidas de três pontos no abdome com DXA de tronco e total, em mulheres obesas, sugerindo serem estas medidas, um bom indicador de gordura corporal e de gordura da região do tronco, superior aos resultados obtidos por BIA. O uso dessas três medidas pode ser um indicador alternativo de avaliação da gordura corporal e de tronco, nos casos em que o formato corporal de acúmulo de gordura na região do tronco, dificultar a acurácia da medida clássica (CA1).

Relación de los índices de masa corporal y cintura-cadera con la capacidad residual funcional pulmonar en niños chilenos obesos versus normopeso: un estudio transversal / Relation among body mass index, waist-hip ratio, and pulmonary functional residual capacity in normal weight versus obese Chilean children: A cross-sectional study

Introducción. La obesidad está asociada a un descenso acelerado de la función ventilatoria. Las formas más frecuentes de evaluar el estado nutricional y medir la grasa abdominal y las caderas son el índice de masa corporal (IMC) y el índice cintura-cadera (ICC). Existe escasa evidencia que sugiera su relación con la capacidad residual funcional (CRF). Nuestro objetivo fue determinar la relación entre el IMC, el ICC y la CRF en niños obesos de la ciudad de Talca, Chile. Población y métodos. Se reclutaron niños de ambos sexos (6-12 años). Se evaluaron peso, talla, IMC, ICC y función pulmonar a través de pletismografía corporal. Dependiendo de la distribución de los datos, se utilizó la prueba t de Student o U de Mann-Whitney para muestras independientes y, la prueba r de Pearson o Spearman para establecer la correlación entre ICC y CRF. Resultados. Los niños se dividieron en normopeso (n= 18) y obesos (n= 18). Se reportó una disminución significativa de la CRF (p= 0,025) en niños obesos y una relación inversa entre ICC y CRF, la cual fue moderada en niños normopeso (s= -0,489; p= 0,03) y alta en obesos (r= -0,681; p= 0,001). Conclusiones. Los niños obesos mostraron una menor CRF respecto de los normopeso, que, a su vez, se relacionó con el ICC. Estos resultados indican efectos sistémicos que produce la obesidad en la función ventilatoria en niños y la necesidad de incorporar indicadores de distribución de grasa corporal a temprana edad.

Introduction. Obesity is associated with a rapid decrease in ventilatory function. The most common way of assessing nutritional status and measuring abdominal fat and hips are the body mass index (BMI) and the waist-hip ratio (WHR). There is scarce evidence suggesting their relation to functional residual capacity (FRC). Our objective was to determine the relation among BMI, WHR, and FRC in obese children in the city of Talca, Chile. Population and methods. Male and female children were recruited (6-12 years). Weight, height, BMI, WHR, and pulmonary function were assessed; the latter with body plethysmography. Depending on data distribution, Student's t test or the Mann-Whitney U test were used for independent samples, while Pearson's or Spearman's r test was used to establish the correlation between WHR and FRC. Results. Children were divided into normal weight (n = 18) and obese (n = 18). A significant reduction in FRC (p = 0.025) was reported in obese children, while a reverse association was observed between WHR and FRC, which was moderate in normal weight children (s = -0.489; p = 0.03) and high in obese children (r = -0.681; p = 0.001). Conclusions. Obese children showed a lower FRC compared to normal weight children, which, in turn, was associated with WHR. These results are indicative of the systemic effects caused by obesity on children's ventilatory function and the need to use body fat distribution indicators at an early age.

Indicadores antropométricos associados à demência em idosos de Florianópolis - SC, Brasil: Estudo EpiFloripa Idoso / Anthropometric indicators associated with dementia in the elderly from Florianópolis - SC, Brazil: EpiFloripa Ageing Study

Resumo O objetivo deste artigo é investigar a associação entre demência e indicadores antropométricos em idosos de Florianópolis. Estudo transversal, de base populacional, realizado com 1.197 idosos (≥ 60 anos) em 2013/2014. A demência foi considerada como a presença conjunta de escore baixo no Miniexame do Estado Mental (MEEM) e a incapacidade funcional moderada/grave nas atividades de vida diária (AVD). As variáveis independentes avaliadas foram: índice de massa corporal (IMC), perímetro da cintura (PC), índice de conicidade e relação cintura/estatura (RCEst). A regressão logística (bruta e ajustada) foi utilizada para identificar os fatores associados. A prevalência estimada de demência foi de 15,1%. Após ajustes para características sociodemográficas, estilo de vida e sintomas depressivos, a demência foi positivamente associada aos tercis superiores do IMC (OR: 2,32; IC95%: 1,26-4,25), PC (OR: 2,22; IC95%: 1,20-4,11) e RCEst. (OR: 2,30; IC95%: 1,19-4,43). De acordo com os resultados, tanto a obesidade quanto a gordura abdominal foram associados ao desfecho, sugerindo que o IMC, o PC e a RCEst. devam ser considerados na investigação dessa relação.

Abstract Objective To investigate the association between dementia and anthropometric indicators in the elderly from Florianópolis. Method This is a cross-sectional population-based survey performed with 1,197 elderly (≥ 60 years) in 2013/2014. Dementia was defined as the combined evidence of low MMSE (Mini-Mental State Examination) score and moderate/severe disability in the activities of daily living. The independent variables were body mass index (BMI), waist circumference (WC), conicity index and waist-to-height ratio (WHtR). Logistic regression (crude and adjusted) was performed to identify associated factors. Results Dementia prevalence was estimated at 15.1%. After adjustment for sociodemographic characteristics, lifestyle and depressive symptoms, dementia was positively associated with the upper tertiles of the BMI (OR: 2.32; CI95%: 1.26-4.25), WC (OR: 2.22; CI95%: 1.20-4.11) and WHtR (OR: 2.30; CI95%: 1.19-4.43). Conclusion Results have shown that both obesity and abdominal fat were associated with the outcome, suggesting that BMI, WC and WHtR should be considered in the investigation of this relationship.

Perfil nutricional e percepção da imagem corporal em adolescentes de escolas públicas e privadas de município mineiro / Nutritional profile and perception of body image in adolescents of public and private schools in the city of minas gerais

Introdução: A caracterização do perfil nutricional da população de adolescentes, assim como o diagnóstico de sobrepeso e obesidade, é de suma importância para auxiliar a elaboração de medidas de controle e reversão do quadro, possibilitando melhora na qualidade de vida e a prevenção das doenças crônicas não transmissíveis (DCNTs). Objetivo: Traçar o perfil nutricional e fatores associados (gênero, tipo de escola, idade e percepção da imagem corporal) em adolescentes de município de Minas Gerais. Material eMétodos: Estudo transversal, desenvolvido com estudantes de ambos os gêneros do ensino fundamental 2, com idade entre dez a dezesseis anos, matriculados em escolas públicas e privadas. Foram coletados dados antropométricos de 576 indivíduos, incluindo peso, altura e circunferência da cintura, padronizados de acordo com as orientações do Ministério da Saúde. Também foram coletados dados referentes ao hábito alimentar e a percepção da imagem corporal dos indivíduos, através de questionários semi-estruturados e auto preenchidos. Resultados: Dos adolescentes estudados, 58,7% pertenciam à rede pública de ensino, 64,9% do gênero feminino e a mediana de idade foi de 13 anos. Em relação ao estado nutricional, 1,5% da amostra encontrava-se com a estatura inadequada para a idade, 30,93% apresentavam excesso de gordura abdominal e 34,4% excesso de peso. Em relação a imagem corporal, observou-se que os indivíduos obesos e com sobrepeso apresentaram maior insatisfação com sua imagem corporal, quando comparados ao grupo dos indivíduos eutróficos. Em relação aos hábitos alimentares, 37,1% dos adolescentes relataram nunca realizar o café da manhã, mas em relação as outras refeições (almoço e janta) a maioria relatou consumir sempre. Em relação aos alimentos ultraprocessados, 41,2% dos adolescentes relataram consumir guloseimas diariamente e 33,2%, refrigerantes ou suco em pó. Conclusão: São necessárias medidas que promovam a alimentação saudável, visando a prevenção da obesidade, sobrepeso e das doenças crônicas não transmissíveis em adolescentes.

Introduction: The characterization of the nutritional profile of the adolescent population, as well as the diagnosis of overweight and obesity, is of paramount importance to help the elaboration of measures of control and reversion of the picture, allowing improvement in the quality of life and the prevention of chronic diseases noncommunicable diseases (NCDs). Objective: To describe the nutritional profile and associated factors (gender, school type, age and perception of body image) in adolescents from Minas Gerais. Material and Methods: A cross-sectional study, developed with students from both genders of elementary school 2, aged between ten and sixteen, enrolled in public and private schools. Anthropometric data were collected from 576 individuals, including weight, height and waist circumference, standardized according to the guidelines of the Ministry of Health. Data were also collected regarding dietary habits and body image perception of the individuals through semi- structured and self-filled. Results: Of the adolescents studied, 58.7% belonged to the public school system, 64.9% were female, and the median age was 13 years. Regarding nutritional status, 1.5% of the sample was inadequate for height, 30.93% had abdominal fat excess and 34.4% were overweight. Regarding body image, it was observed that obese and overweight individuals showed greater dissatisfaction with their body image, when compared to the group of eutrophic individuals. Regarding eating habits, 37.1% of adolescents reported never having breakfast, but in relation to other meals (lunch and dinner) the majority reported consuming always. In relation to ultraprocessed foods, 41.2% of adolescents reported consuming daily goodies and 33.2%, soft drinks or juice powder. Conclusion: Measures to promote healthy eating are needed to prevent obesity, overweight and chronic noncommunicable diseases in adolescents.

Associação entre maus-tratos familiares e excesso de peso e de gordura em escolares do município do Rio de Janeiro/RJ, Brasil / Association between domestic maltreatment and excess weight and fat among students of the city/state of Rio de Janeiro, Brazil

Resumo O objetivo deste estudo foi investigar a relação entre maus-tratos na família e excesso de peso, de gordura corporal e de gordura abdominal dos adolescentes da rede pública de ensino de município do Rio de Janeiro - Brasil. Trata-se de um estudo transversal que utiliza dados do Sistema de Vigilância de Fatores de Risco e Proteção à Saúde de Adolescentes, realizado em 2007, pelo município do Rio de Janeiro. A amostra foi composta por 1.628 escolares de 13 a 19 anos, de ambos os sexos, cursando o 9˚ ano do ensino fundamental. O excesso de peso, de gordura corporal e de gordura abdominal (desfechos) e os maus-tratos familiares (a agressão física e verbal) foram avaliados. A associação entre os maus-tratos e os desfechos foi realizada via modelos de regressão logística. Os maus-tratos apresentaram uma relação inversa com o excesso de peso e o de gordura para as meninas, mas somente a agressão física se associou significativamente com o excesso de peso (RC = 0,499; IC = 0,212-0,951). Já para os meninos, os resultados apontaram para o excesso de peso e de gordura mas sem significância estatística. Políticas de saúde devem considerar as diferenças existentes entre os gêneros no enfrentamento às experiências de violência que possam influenciar a saúde e o bem-estar do adolescente.

Abstract This study sought to investigate the relationship between domestic maltreatment and excess weight, body fat and abdominal fat among adolescents from the public schools in the city of Rio de Janeiro - Brazil. It involved a cross-sectional study using data from the Risk Factor Surveillance System and Protection of Health of Adolescents, held in 2007 by the municipality of Rio de Janeiro. The sample consisted of 1628 students aged 13 to 19 years, of both sexes, in the 9th year of school. Excess weight, body fat and abdominal fat (outcome variables) and domestic maltreatment (physical and verbal aggression) were evaluated. The association between domestic maltreatment and outcome variables was conducted via logistic regression models. Domestic maltreatment showed an inverse relationship to excess weight and fat for girls, but only physical aggression was significantly associated with excess weight (OR = 0.499, CI = 0.212 to 0.951). As for the boys, the results pointed to excess weight and fat but without statistical significance. Health policies must consider the differences between the genders in coping with experiences of violence that may influence the health and well-being of adolescents.

A propósito de un caso de lipoma retroperitoneal / Retroperitoneal Lipoma: A case report

Los lipomas retroperitoneales son infrecuentes y suelen representar el 2.9% de los tumores primarios de origen en retroperitoneo1 . Pueden alcanzar gran tamaño y el diagnóstico diferencial debe hacer con el liposarcoma bien diferenciado, aunque es muy difícil de realizar en el preoperatorio2 . Se presenta el caso de un paciente con lipoma retroperitoneal cuyo diagnóstico se realizó por tomografía axial computada (TAC) y que fue extirpado en su totalidad.

Retroperitoneal lipomas are infrequent and can represent a 2.9 % of the primary tumors originated in the retroperitoneum. They can reach a great size and the differential diagnosis must be performed with the well differentiated liposarcoma, even though it is very difficult to establish it during the preoperative time. We describe herein a case of a patient with a retroperitoneal lipoma. The diagnosis was established with a computed axial tomography (CAT) and it was totally surgically removed.

Razón entre grasa visceral y subcutánea como predictor de alteraciones cardiometabólicas / Ratio of visceral to subcutaneous fat as a predictor of cardiometabolic risk

RESUMEN La grasa visceral es una importante medida predictora de riesgo cardiometabólico, sin embargo, se ha sugerido que la razón entre los componentes visceral y subcutáneo (TAV/TAS ≥ 0,4) puede ser un indicador más apropiado para evaluar la predisposición para acumular grasa visceral (GV) y las alteraciones cardio-metabólicas. Objetivo: Evaluar la predisposición para acumular GV y su asociación con alteraciones cardio-metabólicas. Métodos: Estudio transversal con 147 individuos atendidos en un ambulatorio de un hospital en el Nordeste brasileño. Se evaluaron el TAV y el TAS por tomografía computarizada y se investigaron variables demgráficas, clínicas, antropométricas y factores de riesgo cardiometabólico. Resultados: El promedio de edad fue 52,7±13,2 años y se observó una elevada razón TAV/TAS de 0,79±0,29 en hombres y 0,54±0,22 en mujeres. Se correlacionó la razón TAV/TAS con perfil glucídico y puntuacion de calcio coronariano (PCC) (p< 0,05), mientras que el TAV aislado presentó correlación directa con colesterol no-HDL, triglicéridos (TG), razón TG/HDL, glicemia, hemoglobina glicosilada y PCC (p<0,05) e inversa con HDL-c (p= 0,001). Conclusiones: Se observó una elevada predisposición para la acumulación de TAV. La razón TAV/TAS presentó correlación con alteraciones cardiometabólicas, pero la concentración de TAV aislada se correlacionó con un número superior de parámetros, siendo en esta investigación un predictor más potente que la razón TAV/TAS para indicar esas alteraciones.

ABSTRACT Visceral fat is an important predictor of cardiometabolic risk, but evidence suggests that the ratio between visceral and subcutaneous fat (≥0.4) may be a more appropriate indicator to assess individual predisposition to accumulate visceral fat (VF) and predict cardiometabolic alterations. Objective: To evaluate the predisposition to accumulate VF and its association with cardiometabolic alterations. Methods: A cross-sectional study was conducted with 147 patients seen at a hospital in Northeast Brazil. VF and subcutaneous fat (SF) were evaluated by computed tomography and anthropometric and cardiometabolic risk factors were investigated. Results: The mean age was 52.7±13.2 years. Mean VF/SF ratio was high: 0.79±0.29 for men and 0.54±0.22 for women and was correlated with the glucose profile and coronary calcium score (CCA) (p< 0.05). VF was directly correlation with non-HDL cholesterol, triglycerides (TG), TG/HDL ratio, glycemia, glycated hemoglobin and CCA (p< 0.05) and inversely with HDL-c (p= 0.001). Conclusions: A high predisposition to VF accumulation was observed in the population. VF/SF ratio correlated with cardiometabolic alterations, but the concentration of isolated VF correlated with a higher number of parameters. In this investigation, VF alone was a more powerful predictor of cardiometabolic alterations than the ratio of VF/SF.

Diabetes mellitus referida: incidência e determinantes, em coorte de idosos do município de São Paulo, Brasil, Estudo SABE - Saúde, Bem-Estar e Envelhecimento / Reported diabetes mellitus: incidence and determinants in cohort of community dwelling elderly people in São Paulo City, Brazil: SABE study, health, wellness and aging

Resumo Verificar a associação da incidência de diabetes melito (DM) e variáveis determinantes em coorte de idosos. Foram analisados idosos, participantes do Estudo SABE - Saúde, Bem-Estar e Envelhecimento, realizado no município de São Paulo, em 2000 (2.143 idosos), e em 2006 (1.115 idosos). As variáveis de estudo foram: DM; sociodemográficas (sexo, grupo etário, escolaridade, companhia no domicílio), estado nutricional (risco para obesidade, obesidade e gordura abdominal), clínicas (número de doenças referidas) e de estilo de vida (ingestão de bebida alcoólica, hábito de fumar, ingestão de carnes e de frutas, legumes e verduras). Utilizou-se regressão logística múltipla para verificar a associação entre variáveis de estudo, utilizando o programa Stata/SE 10.0. Em 2006, 914 idosos, sobreviventes de 2000, foram analisados, dos quais 72 constituíram os novos casos de DM (incidência de 7,7/1.000 pessoas-ano). Verificou-se associação (p < 0,000) entre incidência de DM com obesidade corporal (OR = 1,67; IC = 1,00-2,81) e gordura abdominal elevada (OR = 2,32; IC = 1,47-3,67). Concluiu-se que a obesidade corporal e a gordura abdominal elevada foram as variáveis que contribuem para o desenvolvimento da DM em idosos.

Abstract To verify the association between the incidence of DM and predictors, in a cohort of elderly people. Elderly people (≥ 60 y) were analyzed, of both genders, participants of the SABE Survey, carried out in the city of São Paulo, Brazil, in 2000 (n = 2,143) and 2006 (n = 1,115). The study variables were: DM; demographic (gender, age group, education level, companionship in the residence), nutritional status (risk for obesity, body obesity, and high abdominal fat), clinical (number of reported diseases), and lifestyle (alcohol consumption, smoking, intake of meat and fruit and vegetables). Multiple logistic regression (p < 0.05) was used to verify the association between variables of this study, with the statistical software Stata/SE 10.1. In 2006, 914 subjects, survivors of 2000, were analyzed and 72 were identified as new cases of DM (7.7/1.000 person-years). It was found that body obesity (OR = 1.67, CI = 1.00 to 2.81) and high abdominal fat (OR = 2.32, CI = 1.47 to 3.67) were predictors of the incidence of DM in the elderly (p < 0.000). It was concluded that body obesity and abdominal fat are the variables which contribute to the development of DM in the elderly.

The role of moderate-to-vigorous physical activity in mediating the relationship between central adiposity and immunometabolic profile in postmenopausal women

ABSTRACT Objectives To analyze the role of moderate-to-vigorous physical activity (MVPA) in mediating the relationship between central adiposity and immune and metabolic profile in postmenopausal women. Materials and methods Cross-sectional study comprising 49 postmenopausal women (aged 59.26 ± 8.32 years) without regular physical exercise practice. Body composition was measured by dual-energy X-ray absorptiometry. Fasting blood samples were collected for assessment of nonesterified fatty acids, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), adiponectin, insulin and estimation of insulin resistance (HOMA-IR). Physical activity level was assessed with an accelerometer (Actigraph GTX3x) and reported as a percentage of time spent in sedentary behavior and MVPA. All analyses were performed using the software SPSS 17.0, with a significance level set at 5%. Results Sedentary women had a positive relationship between trunk fat and IL-6 (rho = 0.471; p = 0.020), and trunk fat and HOMA-IR (rho = 0.418; p = 0.042). Adiponectin and fat mass (%) were only positively correlated in physically active women (rho = 0.441; p = 0.027). Physically active women with normal trunk fat values presented a 14.7% lower chance of having increased HOMA-IR levels (β [95%CI] = 0.147 [0.027; 0.811]). Conclusions The practice of sufficient levels of MVPA was a protective factor against immunometabolic disorders in postmenopausal women.

Terapia combinada associada à drenagem linfática reduz lipodistrofia localizada no abdômen de mulheres jovens / Combined therapy associated with lymphatic drainage reduce lipodystrophy located on abdomen of young women

Introdução: A Lipodistrofia localizada (LL) é o excesso de tecido adiposo em locais do corpo. A terapia combinada (TC) e a drenagem linfática manual (DLM) podem agir na redução da LL. Objetivo: Verificar o efeito da TC associada à DLM sobre a LL no abdômen de mulheres jovens e o grau de satisfação da imagem corporal. Método: Estudo clínico cego, no qual participaram 12 mulheres com LL no abdômen. As participantes realizaram 10 sessões de TC associado a DLM. As mulheres foram avaliadas antes e após o tratamento, através da aferição do peso e altura; perimetria abdominal; adipometria; registro fotográfico; e aplicação da Escala de Satisfação com a Imagem Corporal. Resultados: Redução da perimetria, da dobra cutânea na região, da porcentagem de gordura corporal e melhora da satisfação da imagem corporal dos indivíduos. Conclusão: O tratamento apresentou resultados rápidos e satisfatórios na redução da LL no abdômen de mulheres. (AU)

Introduction: Localized Lipodystrophy (LL) is the excess of adipose tissue at body sites. Combination therapy (CT) and manual lymphatic drainage (DLM) may act to reduce LL. Objective: To verify the effect of CT associated with DLM on the LL in the abdomen of young women and the degree of body image satisfaction. Method: Blind clinical study, in which 12 women with LL participated in the abdomen. Participants underwent 10 CT sessions associated with DLM. The women were evaluated before and after treatment by measuring the weight and height; abdominal circumference; plicometry; photographic record; and application of Satisfaction Scale with Body Image. Results: We observed reduction in abdominal circumference, skinfold thickness, reducing the percentage of body fat and improved body image satisfaction of individuals. Conclusion: The treatment presented fast and satisfactory results in the reduction of LL in the abdomen of women. (AU)

Frecuencia de síndrome metabólico en niños y adolescentes del Paraguay / Frequency of metabolic syndrome in children and adolescents in Paraguay

La intención de la elección del tema de Síndrome Metabólico surge a raíz de la epidemia mundial de obesidad en la infancia y adolescencia observada en las últimas décadas, y que ha supuesto la aparición en pediatría de alteraciones hasta ahora más propias de la edad adulta, como el Síndrome Metabólico (SM) y que generen día a día numerosas complicaciones de salud como las Enfermedades Cardiovasculares (ECV) y Diabetes tipo 2. Se tienen como objetivo determinar la frecuencia de SM en niños y adolescentes del Paraguay y sus componentes. Se ha encontrado que el sobrepeso y la obesidad abdominal son los factores principales que contribuyen a las manifestaciones del Síndrome Metabólico en niños y adolescentes del Paraguay, por ese motivo corren mayor riesgo de sufrir enfermedades cardiovasculares y diabetes tipo 2 en el futuro y de forma más precoz. Se ha visto en estudios realizados en América que los componentes más prevalentes fueron la obesidad y la dislipidemia, mientras que; alrededor del 7% con hiperglucemia y síndrome metabólico de manera general. Según estudios realizados en Paraguay, se vio que la frecuencia de sobrepeso y obesidad es muy alta al igual que la incidencia del síndrome metabólico

The purpose of the choice of the Metabolic Syndrome issue arises from the worldwide epidemic of obesity in infancy and adolescence observed in the last decades, and which has led to the appearance in pediatrics of alterations that have hitherto been more typical of adulthood, Such as Metabolic Syndrome (MS) and that generate daily complications of health such as Cardiovascular Diseases (CVD) and Type 2 Diabetes. Its objective is to determine the frequency of MS in children and adolescents in Paraguay and its components. It has been found that overweight and abdominal obesity are the main factors that contribute to the manifestations of the Metabolic Syndrome in children and adolescents of Paraguay, for that reason they are at greater risk of suffering cardiovascular diseases and type 2 diabetes in the future and in a more early. It has been seen in studies carried out in America that the most prevalent components were obesity and dyslipidemia, whereas; around 7% with hyperglycemia and metabolic syndrome in general. According to studies in Paraguay, it was found that the frequency of overweight and obesity is very high, as is the incidence of the metabolic syndrome