Relação entre estilo de vida e a etiologia da doença de Parkinson em pacientes do Município de Jequié ­ BA / Relationship between lifestyle and etiology of Parkinson disease in patients of Jequié ­ Municipality

A doença de Parkinson (DP) consiste de uma alteração neurológica decorrente da destruição generalizada de parte da substantia nigra, dos gânglios basais, onde se localizam os neurônios dopaminérgicos, que por fatores ainda não muito esclarecidos se degeneram. É considerada uma moléstia idiopática, possivelmente multifatorial, e de incidência relativamente alta, justificando mais estudos sobre esse assunto. OBJETIVO: analisar a relação entre o estilo de vida e a etiologia da Doença de Parkinson em pacientes do município de Jequié - BA, correlacionando o estilo de vida desses indivíduos com o desenvolvimento da Doença de Parkinson. MÉTODOS: Trata-se de um estudo do tipo caso-controle, com um desenho observacional, analítico e transversal de base populacional, que envolveu a identificação de indivíduos portadores (casos) e não portadores (controles) da Doença de Parkinson. Uma amostra de 38 participantes, tendo por casos 17 indivíduos diagnosticados com DP casos e 21 controles. O estilo de vida foi avaliado, relacionando com possíveis fatores de risco e proteção. RESULTADOS: Verificamos diferenças estatisticamente significativas para a exposição à praguicidas (p = 0,03), consumo de água de poço (p < 0,0001), uso continuado de medicamentos (p = 0,02), ao consumo de carne vermelha (p = 0,01), ao histórico familiar de DP (p = 0,004), todos apontados como fatores de risco, enquanto que apenas a carga tabágica de 50 cigarros/ano/dia mostrou diferença estaticamente significativa (p = 0,0002), sendo associada como fator protetor. CONCLUSÃO: Esses resultados parecem consistentes com a literatura atual, que sugere um modelo multifatorial para etiologia da DP.

Parkinson's disease (PD) consists of a neurological alteration resulting from the widespread destruction of part of the substantia nigra, of the basal ganglia, where dopaminergic neurons are located, which, due to factors not yet well understood, degenerate. It is considered an idiopathic disease, possibly multifactorial, and of relatively high incidence, justifying further studies on this subject. OBJECTIVE: to analyze the relationship between lifestyle and the etiology of Parkinson's Disease in patients from the municipality of Jequié - BA, correlating the lifestyle of these individuals with the development of Parkinson's Disease. METHODS: This is a case-control study with an observational, analytical, cross-sectional population-based design that involved the identification of individuals (cases) and non-carriers (controls) of Parkinson's Disease. A sample of 38 participants, having 17 cases diagnosed with PD cases and 21 controls. Lifestyle was assessed, relating to possible risk factors and protection. RESULTS: We found statistically significant differences for pesticide exposure (p = 0.03), well water consumption (p <0.0001), continued use of medications (p =0.02), and red meat consumption ( p = 0.01), the family history of PD (p = 0.004), all of which were identified as risk factors, whereas only the tabacic load of 50 cigarettes / year / day showed a statistically significant difference (p = 0.0002), being associated as a protective factor. CONCLUSION: These results seem consistent with the current literature, which suggests a multifactorial model for the etiology of PD.

Assessment of cardiovascular risk of patients with arterial hypertension of a public health unit.

OBJECTIVE: To assess the cardiovascular risk, using the Framingham risk score, in a sample of hypertensive individuals coming from a public primary care unit. METHODS: The caseload comprised hypertensive individuals according to criteria established by the JNC VII, 2003, of 2003, among 1601 patients followed up in 1999, at the Cardiology and Arterial Hypertension Outpatients Clinic of the Teaching Primary Care Unit, at the Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. The patients were selected by draw, aged over 20 years, both genders, excluding pregnant women. It was a descriptive, cross-sectional, observational study. The Framingham risk score was used to stratify cardiovascular risk of developing coronary artery disease (death or non-fatal acute myocardial infarction). RESULTS: Age range of 27-79 years (x = 63.2 +/- 9.58). Out of 382 individuals studied, 270 (70.7%) were female and 139 (36.4%) were characterized as high cardiovascular risk for presenting diabetes mellitus, atherosclerosis documented by event or procedure. Out of 243 stratified patients, 127 (52.3%) had HDL-C < 50 mg/dL; 210 (86.4%) had systolic blood pressure > or = 120 mmHg; 46 (18.9%) were smokers; 33 (13.6%) had a high cardiovascular risk. Those added to 139 enrolled directly as high cardiovascular risk, totaled up 172 (45%); 77 (20.2%) of medium cardiovascular risk and 133 (34.8%) of low risk. The highest percentage of high cardiovascular risk individuals was aged over 70 years; those of medium risk were aged over 60 years; and the low risk patients were aged 50 to 69 years. CONCLUSION: The significant number of high and medium cardiovascular risk individuals indicates the need to closely follow them up.

Assessment of cardiovascular risk of patients with arterial hypertension of a public health unit / Avaliação do risco cardiovascular de indivíduos portadores de hipertensão arterial de uma unidade pública de saúde

Objective: To assess the cardiovascular risk, using the Framingham risk score, in a sample of hypertensive individuals coming from a public primary care unit. Methods: The caseload comprised hypertensive individuals according to criteria established by the JNC VII, 2003, of 2003, among 1601 patients followed up in 1999, at the Cardiology and Arterial Hypertension Outpatients Clinic of the Teaching Primary Care Unit, at the Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. The patients were selected by draw, aged over 20 years, both genders, excluding pregnant women. It was a descriptive, crosssectional, observational study. The Framingham risk score was used to stratify cardiovascular risk of developing coronary artery disease (death or non-fatal acute myocardial infarction). Results: Age range of 27-79 years (x = 63.2 ± 9.58). Out of 382 individuals studied, 270 (70.7%) were female and 139 (36.4%) were characterized as high cardiovascular risk for presenting diabetes mellitus, atherosclerosis documented by event or procedure. Out of 243 stratified patients, 127 (52.3%) had HDL-C < 50 mg/dL; 210 (86.4%) had systolic blood pressure greater than or equal to 120 mmHg; 46 (18.9%) were smokers; 33 (13.6%) had a high cardiovascular risk. Those added to 139 enrolled directly as high cardiovascular risk, totaled up 172 (45%); 77 (20.2%) of medium cardiovascular risk and 133 (34.8%) of low risk. The highest percentage of high cardiovascular risk individuals was aged over 70 years; those of medium risk were aged over 60 years; and the low risk patients were aged 50 to 69 years. Conclusion: The significant number of high and medium cardiovascular risk individuals indicates the need to closely follow them up.

Objetivo: Identificar o risco cardiovascular, por meio do escore de risco de Framinghan, em uma amostra de hipertensos de uma unidade pública de saúde. Métodos: A casuística foi constituída por hipertensos, segundo critérios do JNC VII, 2003, de 2003, dentre 1.601 acompanhados no ano de 1999 no Ambulatório de Cardiologia e Hipertensão Arterial do Centro Saúde Escola da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo. Os pacientes foram selecionados por sorteio, com idade acima de 20 anos, ambos os gêneros, excluindo-se as gestantes. Tratou-se de estudo observacional descritivo e transversal. Utilizou-se o Escore de Risco de Framinghan para estratificação do risco cardiovascular para desenvolvimento de doença arterial coronária (morte ou infarto agudo do miocárdio - não fatal). Resultados: A idade variou de 27 a 79 anos (x = 63,2 ± 9,58). Dos 382 indivíduos estudados, 270 (70,7%) eram mulheres e 139 (36,4%) foram caracterizados como de alto risco cardiovascular por apresentarem diabetes mellitus, aterosclerose documentada por evento ou procedimento. Dos 243 estratificados, 127 (52,3%) apresentaram HDL-C < 50 mg/dL; 210 (86,4%) apresentaram pressão arterial sistólica maior ou igual a 120 mmHg; 46 (18,9%) eram fumantes; 33 (13,6%) eram de alto risco cardiovascular - que somados aos 139 incluídos diretamente como alto risco cardiovascular, totalizaram 172 (45%); 77 (20,2%) eram de médio risco cardiovascular e 133 (34,8%) de baixo risco. O maior percentual de indivíduos de alto risco cardiovascular situou-se acima 70 anos; de médio risco, acima de 60 anos; e de baixo risco entre 50 e 69 anos. Conclusão: O número significativo de indivíduos de alto e médio risco cardiovascular indica a necessidade de um acompanhamento mais próximo dos mesmos.