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Background.Anecdotal reports are appearing in the scientific literature about cases of brain tumors in interventional physicians who are exposed to ionizing radiation. In response to this alarm, several designs of leaded caps have been made commercially available. However, the results reported on their efficacy are discordant.Objective.To synthesize, by means of a systematic review of the literature, the capacity of decreasing radiation levels conferred by radiation attenuating devices (RADs) at the cerebral level of interventional physicians.Methodology.A systematic review was performed including the following databases: MEDLINE, SCOPUS, EBSCO, Science Direct, Cochrane Controlled Trials Register (CENTRAL), WOS, WHO International Clinical Trials Register, Scielo and Google Scholar, considering original studies that evaluated the efficacy of RAD in experimental or clinical contexts from January 1990 to May 2023. Data selection and extraction were performed in triplicate, with a fourth author resolving discrepancies.Results.Twenty articles were included in the review from a total of 373 studies initially selected from the databases. From these, twelve studies were performed under clinical conditions encompassing 3801 fluoroscopically guided procedures, ten studies were performed under experimental conditions with phantoms, with a total of 88 procedures, four studies were performed using numerical calculations with a total of 63 procedures. The attenuation and effectiveness of provided by the caps analyzed in the present review varying from 12.3% to 99.9%, and 4.9% to 91% respectively.Conclusion.RAD were found to potentially provide radiation protection, but a high heterogeneity in the shielding afforded was found. This indicates the need for local assessment of cap efficiency according to the practice.
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Exposição Ocupacional , Doses de Radiação , Proteção Radiológica , Humanos , Exposição Ocupacional/análise , Exposição Ocupacional/prevenção & controleRESUMO
Cardiovascular diseases represent the leading cause of death worldwide. Thus, cardiovascular rehabilitation programs are crucial to mitigate the deaths caused by this condition each year, mainly in patients with coronary artery disease. COVID-19 was not only a challenge in this area but also an opportunity to open remote or hybrid versions of these programs, potentially reducing the number of patients who leave rehabilitation programs due to geographical/time barriers. This paper presents a method for building a cardiovascular rehabilitation prediction model using retrospective and prospective data with different features using stacked machine learning, transfer feature learning, and the joint distribution adaptation tool to address this problem. We illustrate the method over a Chilean rehabilitation center, where the prediction performance results obtained for 10-fold cross-validation achieved error levels with an NMSE of 0.03±0.013 and an R2 of 63±19%, where the best-achieved performance was an error level with a normalized mean squared error of 0.008 and an R2 up to 92%. The results are encouraging for remote cardiovascular rehabilitation programs because these models could support the prioritization of remote patients needing more help to succeed in the current rehabilitation phase.
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There is a significant risk of injury in sports and intense competition due to the demanding physical and psychological requirements. Hamstring strain injuries (HSIs) are the most prevalent type of injury among professional soccer players and are the leading cause of missed days in the sport. These injuries stem from a combination of factors, making it challenging to pinpoint the most crucial risk factors and their interactions, let alone find effective prevention strategies. Recently, there has been growing recognition of the potential of tools provided by artificial intelligence (AI). However, current studies primarily concentrate on enhancing the performance of complex machine learning models, often overlooking their explanatory capabilities. Consequently, medical teams have difficulty interpreting these models and are hesitant to trust them fully. In light of this, there is an increasing need for advanced injury detection and prediction models that can aid doctors in diagnosing or detecting injuries earlier and with greater accuracy. Accordingly, this study aims to identify the biomarkers of muscle injuries in professional soccer players through biomechanical analysis, employing several ML algorithms such as decision tree (DT) methods, discriminant methods, logistic regression, naive Bayes, support vector machine (SVM), K-nearest neighbor (KNN), ensemble methods, boosted and bagged trees, artificial neural networks (ANNs), and XGBoost. In particular, XGBoost is also used to obtain the most important features. The findings highlight that the variables that most effectively differentiate the groups and could serve as reliable predictors for injury prevention are the maximum muscle strength of the hamstrings and the stiffness of the same muscle. With regard to the 35 techniques employed, a precision of up to 78% was achieved with XGBoost, indicating that by considering scientific evidence, suggestions based on various data sources, and expert opinions, it is possible to attain good precision, thus enhancing the reliability of the results for doctors and trainers. Furthermore, the obtained results strongly align with the existing literature, although further specific studies about this sport are necessary to draw a definitive conclusion.
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Futebol , Humanos , Inteligência Artificial , Teorema de Bayes , Reprodutibilidade dos Testes , Aprendizado de Máquina , MúsculosRESUMO
The evaluation of white blood cells is essential to assess the quality of the human immune system; however, the assessment of the blood smear depends on the pathologist's expertise. Most machine learning tools make a one-level classification for white blood cell classification. This work presents a two-stage hybrid multi-level scheme that efficiently classifies four cell groups: lymphocytes and monocytes (mononuclear) and segmented neutrophils and eosinophils (polymorphonuclear). At the first level, a Faster R-CNN network is applied for the identification of the region of interest of white blood cells, together with the separation of mononuclear cells from polymorphonuclear cells. Once separated, two parallel convolutional neural networks with the MobileNet structure are used to recognize the subclasses in the second level. The results obtained using Monte Carlo cross-validation show that the proposed model has a performance metric of around 98.4% (accuracy, recall, precision, and F1-score). The proposed model represents a good alternative for computer-aided diagnosis (CAD) tools for supporting the pathologist in the clinical laboratory in assessing white blood cells from blood smear images.
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Abstract Introduction: Serological tests are used to confirm Trypanosoma cruzi infection and their discriminatory accuracy depends on the established decision threshold. Both, the standard methodology and the receiver operating characteristic (ROC) curve methodology allow obtaining such threshold. Objective: To compare the discriminatory accuracy of the standard methodology and the ROC curve methodology regarding serological tests for confirming T. cruzi infection. Materials and methods: A set of anti-T. cruzi antibodies values from subjects previously classified as healthy or as having Chagas disease were used, and computer simulations were performed under homoscedasticity and heteroscedasticity conditions. Sensitivity, specificity, 100% sensitivity, 100% specificity, and perfect-decision were calculated. Results: The discriminatory accuracy obtained with the standard methodology favored specificity (98.22% to 99.56%) over sensitivity (67.25% to 87.14%), while in the ROC curve methodology a balance between sensitivity (94.56% and 96.44%) and specificity (90.35% and 92.11%) was observed. Also, in the ROC curve methodology a greater perfect-decision ratio was observed, which, under homoscedasticity conditions, was >90%. Decisions thresholds were affected by het-eroscedasticity conditions. Conclusion: The ROC curve methodology showed better discriminatory accuracy, therefore its use for calculating decision thresholds in serological tests for detecting Chagas disease is recommended.
Resumen Introducción. Las pruebas serológicas se utilizan para detectar infección por Trypanosoma cruzi y su precisión discriminatoria depende del umbral de decisión establecido. La metodología estándar y la de curva característica operativa del receptor (COR) permiten obtener tal umbral. Objetivo. Comparar la precisión discriminatoria de la metodología estándar y la metodología de curva COR en lo que respecta a pruebas serológicas para detectar infección por T. cruzi. Materiales y métodos. Se utilizó un conjunto de valores de anticuerpos contra T. cruzi de individuos clasificados como chagásicos o sanos y se realizaron simulaciones computarizadas en condiciones homocedásticas y heterocedásticas. Se calculó sensibilidad, especificidad, sensibilidad = 100%, especificidad = 100% y decisión-perfecta. Resultados. La precisión discriminatoria de la metodología estándar favoreció la especificidad (98.22% a 99.56%) sobre la sensibilidad (67.25% a 87.14%), mientras que la de la curva COR mostró un equilibrio entre sensibilidad (94.56% y 96.44%) y especificidad (90.35% y 92.11%). Esta última metodología también evidenció una mayor proporción de decisión-perfecta, la cual llegó a ser >90% en condiciones de homocedasticidad. Los umbrales de decisión fueron afectados por las condiciones de heterocedasticidad. Conclusión. La metodología de la curva COR mostró una mejor precisión discriminatoria, por lo que se recomienda su uso para el cálculo de umbrales de decisión en pruebas serológicas para la enfermedad de Chagas.
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El ácido úrico (producto final del metabolismo de las purinas) ha sido asociado con la enfermedad cardiovascular, aún y cuando no se ha considerado como un factor independiente de la misma. Esta molécula posee acciones paradójicas, pues su elevación contribuye a la capacidad antioxidante en plasma. En vista de que el ejercicio físico contribuye a incrementos en la concentración de este marcador, el objetivo de este estudio fue evaluar sus niveles séricos y su relación con factores de riesgo cardiovascular en adultos con actividad física regular y su comparación con individuos sedentarios. Fueron evaluados 94 individuos, 51 sedentarios y 43 físicamente activos, a los cuales se les determinó índice de masa corporal, circunferencia de cintura, ácido úrico, glicemia, triglicéridos y colesterol total y fraccionado. No se observaron diferencias estadísticamente significativas en los niveles de ácido úrico entre los grupos en estudio, pero sí se observó una frecuencia baja de hiperuricemia (<20%). En ambos grupos, el ácido úrico se relacionó positivamente con el índice de masa corporal y la circunferencia abdominal, mientras que en el grupo sedentario se obtuvo, además, relación con las concentraciones de glicemia y triglicéridos. No se observaron diferencias en cuanto a la frecuencia de las alteraciones bioquímicas y antropométricas evaluadas según los niveles de ácido úrico. En conclusión, los niveles de ácido úrico y su asociación con los factores clásicos de riesgo cardiovascular son similares tanto en individuos sedentarios como con actividad física regular, lo que sugiere la realización de nuevos estudios que involucren otros marcadores cardiometabólicos.
Uric acid (final product of purine metabolism) has been associated with cardiovascular disease, even if it was not considered an independent factor. This molecule has paradoxical actions since its increase contributes to plasma antioxidant capacity. Given that physical exercise contributes to a rise in the concentration of this marker, the aim of this study was to evaluate serum levels and their relation to cardiovascular risk factors in adults with regular physical activity and compared to sedentary individuals. A total of 94 individuals were evaluated, 51 of them being sedentary and 43 physically active, to which body mass index, waist circumference, uric acid, glucose, triglycerides and total and fractionated cholesterol were determined. No statistically significant differences in the levels of uric acid between the study groups were found and a low frequency of hyperuricemia (<20%) was observed. In both groups, uric acid was positively associated to body mass index and abdominal circumference, while in the sedentary group there was also an association regarding serum glucose and triglycerides. No differences in the frequency of anthropometric and biochemical alterations evaluated according to uric acid levels were observed. In conclusion, the levels of uric acid and their association with traditional cardiovascular risk factors are similar in both sedentary individuals and in those with regular physical activity, suggesting further studies involving other cardiometabolic markers.
O ácido úrico (produto final do metabolismo das purinas) tem sido associada com a doença cardiovascular, mesmo quando não foi considerada como um fator independente dela. Esta molécula tem acções paradoxais porque a sua elevação contribui para a capacidade antioxidante em plasma. Dado que o exercício físico contribui para aumentar a concentração deste marcador, o objetivo deste estudo foi avaliar seus níveis séricos e sua relação com fatores de risco cardiovascular em adultos com atividade física regular e comparada com indivíduos sedentários. Foram avaliados 94 indivíduos, 51 sedentários e 43 fisicamente ativos, aos quais lhes foi determinado índice de massa corporal, circunferência da cintura, ácido úrico, glicemia, triglicérides e colesterol total e fracionado. Não foram observadas diferenças estatisticamente significativas nos níveis de ácido úrico entre os grupos de estudo, além de uma baixa freqüência de hiperuricemia (<20%). Em ambos os grupos, o ácido úrico foi positivamente associado com o índice de massa corporal e circunferência abdominal, enquanto que o grupo sedentário também foi obtida relação com as concentrações de glicemia e triglicérides. Não houve diferença na frequência das alterações antropométricas e bioquímicas avaliadas de acordo com os níveis de ácido úrico Em conclusão, os níveis de ácido úrico e sua associação com os fatores clássicos de risco cardiovascular são similares tanto em indivíduos sedentários quanto em aqueles com atividade física regular, sugerindo mais estudos que envolvam outros marcadores cardiometabólicos.
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Adulto , Pessoa de Meia-Idade , Idoso , Doenças Cardiovasculares/etiologia , Ácido Úrico , Estilo de Vida Saudável , Comportamento SedentárioRESUMO
La hipertensión arterial (HTA) representa uno de los factores de riesgo que más contribuye a la enfermedad cardiovascular y actualmente se desarrollan modelos de predicción de riesgo a padecerla. El objetivo de esta investigación fue evaluar la reproducibilidad de un modelo de regresión logística en una población del estado Carabobo, Venezuela, así como la introducción de nuevas variables que mejoren dicho modelo. A 202 pacientes se les evaluó distintos factores de riesgo de HTA con los cuales se evaluó la reproducibilidad de un modelo ya planteado. Posteriormente se evaluó la introducción de nuevas variables al modelo que pudieran mejorar el mismo, utilizando el método del paso a paso de regresión logística. El modelo de predicción de riesgo que sirve como base a este estudio incorpora 3 variables: Presión arterial sistólica (PAS), edad e índice de masa corporal (IMC), de los cuales en este trabajo sólo edad e IMC resultaron significativas (p <0,000 y p <0,012 respectivamente). Una segunda regresión logística adicional, evaluó la introducción de nuevas variables al estudio, donde solo el fenotipo de cintura hipertrigliceridemia (CHT) contribuye a mejorar el modelo predictivo de la HTA. Por tanto, se encontró reproducibilidad parcial del modelo de predicción de riesgo de HTA, además de mejorar el mismo, al añadir la variable fenotipo de CHT. Se recomienda realizar nuevas investigaciones en otras poblaciones venezolanas así como estudios que involucren otras covariables clínicas.
High blood pressure (hypertension) is one of the risk factors that contribute most to cardiovascular disease. Adequate risk prediction models are needed to address prevention. The objective of this research was to evaluate the reproducibility of a logistic regression model in a population of Carabobo, Venezuela, and the introduction of new variables to improve the model. A total of 202 patients were assessed various risk factors of hypertension with which the reproducibility of an already proposed model was evaluated. Later, the introduction of new variables to the model that could improve it by using the stepwise logistic regression method was evaluated. The model risk prediction that serves as the basis of this study incorporates three variables: systolic blood pressure (SBP), age and body mass index (BMI), from which, in this work, only age and BMI were significant (p-value <0.000 and p <0.012 respectively). A second additional logistic regression assessed the introduction of new variables to the study, where only hypertriglyceridemic waist (HTW) phenotype helps to improve the predictive model of hypertension. Therefore, partial reproducibility of risk prediction model of hypertension was found, in addition to improving it by adding the variable HTW phenotype. We recommend further research in other Venezuelan populations and studies involving other clinical covariates.
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Objetivo: Evaluar la frecuencia del nivel de actividad física y su asociación con factores clásicos de riesgo cardiovascular en una comunidad rural del Municipio San Diego, Carabobo, Venezuela. Métodos: Se evaluaron 95 individuos mayores de 18 años. Se les determinó peso, talla, circunferencia de cintura, presión arterial así como glucosa, triglicéridos, colesterol total, LDLc y HDLc en suero. Se aplicó una encuesta para medir antecedentes personales de enfermedad cardiovascular (ECV) y estilo de vida, mientras que el nivel de actividad física fue medido a través del Cuestionario Internacional de Actividad Física (IPAQ) en su versión corta. Resultados: El 54% de los evaluados eran físicamente inactivos, mientras que los regularmente activos no superaron el 35%. Se encontró una elevada proporción de individuos con HDLc baja (85%), seguido de las alteraciones de la masa corporal (68%), así como de obesidad abdominal (57%). Las cifras de hipertensos se ubicaron por debajo del 30%. No se encontraron diferencias estadísticamente significativas en las alteraciones bioquímicas entre los individuos evaluados según su nivel de actividad física. Conclusiones: En la comunidad rural evaluada se encontró una baja frecuencia de actividad física y una alta frecuencia de factores de riesgo cardiovascular, por lo que se recomienda establecer estrategias de promoción en salud que involucren a comunidades rurales.
Objective: To evaluate the frequency of physical activity level and its association with cardiovascular risk factors in a rural community from San Diego, Carabobo, Venezuela. Methods: Ninety-five individuals older than 18 years were evaluated. It was determined weight, height, waist circumference, blood pressure and glucose, triglycerides, total cholesterol, LDLc and HDLc in serum. A survey was conducted to measure personal history of cardiovascular disease and lifestyle, while physical activity level was measured by International Physical Activity Questionnaire (IPAQ), in its short form. Results: Fifty-four percent of individuals were inactive physically, while those active regularly no exceeded 35%. A high frequency of individuals with low HDLc (85%) followed by body mass alterations (68%) as well as abdominal obesity (57%) was found. The hypertensive people were less than 30%. No statistically significant differences in biochemical alterations between individuals evaluated according to their level of physical activity were found. Conclusions: In the rural community evaluated a low frequency of physical activity and a high frequency of cardiovascular risk factors were found, so it is recommended to establish health promotion strategies involving rural communities.
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La Enfermedad de Alzheimer (EA) es una patología neurodegenerativa frecuente en la población senil. Clínicamente se caracteriza por la pérdida progresiva de la memoria y otras habilidades cognitivas. Se han propuesto diversas causas como desencadenantes de la EA, entre las cuales se encuentran factores ambientales como malnutrición, lesiones a nivel craneal y exposición al aluminio (Al), debido a que este metal es una sustancia neurotóxica. El objetivo del presente estudio fue evaluar los niveles de aluminio sérico en pacientes con enfermedad de Alzheimer, internados en un geriátrico en el municipio Veroes, Estado Yaracuy, durante el período mayo-junio de 2013. La muestra estuvo conformada por 22 pacientes con EA, y el grupo control estuvo representado por 12 pacientes sin EA. Las concentraciones de aluminio sérico fueron determinadas por Espectrofotometría de Absorción Atómica Electrotérmica (ETAAS) con horno de grafito. Se obtuvieron valores de la mediana de aluminio sérico de 2,15 mg/L, con un máximo de elevación de 3,0 mg/L para el grupo con EA, mientras que el control fue de 1,60 mg/L, con un máximo de 3,30 mg/L. Ninguno de los pacientes presentaron niveles de Al sérico por encima del límite permisible. Se observaron cifras superiores de este metal en los pacientes con EA en comparación con el grupo control, además de ser significativamente mayores en el género femenino y en aquellos que consumían antiácidos.
Alzheimer's disease (AD) is a common neurodegenerative disorder in the elderly population. It is clinically characterized by progressive loss of memory and other cognitive skills. There are several proposed AD causes as triggers, among which are environmental factors including malnutrition, cranial injuries and exposure level aluminum (Al), because this metal is a neurotoxic substance. The aim of this study was to evaluate serum aluminum levels in patients with Alzheimer's disease, institutionalized in Veroes town, Yaracuy state during May-June 2013 period. The sample consisted of 22 patients with AD and the control group was represented by 12 patients without AD. Serum aluminum concentrations were determined by Electrothermal Atomic Absorption Spectrophotometry (ETAAS) with graphite furnace. Median values of serum aluminum of 2.15 mg/L, with a maximum height of 3.0 mg/L for the AD group were obtained, while the control was 1.60 mg/L, with a maximum of 3.30 mg/L. None of the patients had serum Al levels above the allowable limit. Higher figures of this metal were observed in patients with AD compared with the control group, as well as being significantly higher in females and in those eating antacids.
A doença de Alzheimer (DA) é uma desordem neurodegenerativa frequente na população idosa. Clinicamente caracteriza-se pela perda progressiva da memória e outras habilidades cognitivas. Várias causas têm sido propostas como gatilhos para DA, incluindo fatores ambientais tais como a desnutrição, lesões cranianas e exposição de alumínio (Al), devido a que este metal é uma substância neurotóxica. O objetivo deste estudo foi avaliar os níveis de alumínio sérico em pacientes com doença de Alzheimer, hospitalizados na cidade Veroes, Estado Yaracuy, durante o período maio-junho de 2013. A mostra consistiu de 22 pacientes com DA e o grupo controle foi representado por 12 pacientes sem DA. Concentrações de alumínio sérico foram determinadas por Espectrofotometria de Absorção Atômica Eletrotérmica (ETAAS) com forno de grafite. Os valores da mediana de alumínio sérico de 2,15 mg/L, com uma altura máxima de 3,0 mg/L para o grupo DA foram obtidos, enquanto que para o grupo controle foi de 1,60 mg/L, com um máximo de 3,30 mg/L. Nenhum dos pacientes tinha níveis séricos de Al acima do limite permitido. Foram observados valores mais elevados deste metal nos pacientes com DA em comparação com o grupo controle, além de ser significativamente maior no sexo feminino e nas pessoas que consumiam antiácidos.
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Humanos , Alumínio , Doença de Alzheimer , Meio Ambiente , Fatores DesencadeantesRESUMO
Objetivo: Evaluar la frecuencia de circunferencia hipertrigliceridémica (CHT) y resistencia a la insulina (RI), y su asociación con otros factores de riesgo cardiovascular, en una comunidad rural y una urbana de Tinaquillo, Estado Cojedes, Venezuela. Métodos: Se evaluaron 89 individuos mayores de 18 años (45 pertenecientes a la comunidad rural y 44 a la comunidad urbana) a los cuales se les determinó peso, talla, circunferencia de cintura, presión arterial así como glucosa, insulina, triglicéridos, colesterol total, LDLc y HDLc en suero. Además, se aplicó una encuesta para medir antecedentes personales de enfermedad cardiovascular (ECV) y estilo de vida. Resultados: Se encontró una baja frecuencia de CHT (9%). Caso contrario, resultó la RI (51%), siendo elevada en ambas comunidades pero significativamente mayor en la comunidad urbana. La CHT en el grupo total se asoció estadísticamente con la presencia de insulinorresistencia y obesidad. Por su parte, la insulinorresistencia tuvo asociación estadística con obesidad y obesidad abdominal, tanto en el grupo total como en las comunidades evaluadas por separado. Conclusiones: Los resultados confirman que las comunidades próximas a la industrialización tienen un riesgo mayor a padecer ECV. No obstante, la comunidad rural mostró un cifra importante de RI, lo que indica que ésta población es igualmente propensa al riesgo cardiovascular, sugiriendo que los programas de promoción en salud emergentes deben tener alcance hasta las comunidades rurales y no limitarse a las comunidades urbanas.
Objective: To evaluate the frequency of hypertriglyceridemic waist (HTW) and insulin resistance (IR) and its association with cardiovascular risk factors in a rural community and an urban community Tinaquillo, Cojedes State, Venezuela. Methods: Eighty-nine individuals older than 18 years (45 belonging to the rural community and 44 from the urban community) were evaluated. Weight, height, waist circumference, blood pressure were measured, and glucose, insulin, triglycerides, total cholesterol, LDLc and HDLc in serum were determined. In addition, a questionnaire was applied to know personal history of cardiovascular disease (CVD) and lifestyle. Results: A low frequency of HTW (9%) was found. By contrast, the frequency of IR was high (51%), which was high in both communities but significantly higher in urban community. HTW was statistically associated with the presence of IR and obesity in the total group. The IR was statistically significant with obesity and abdominal obesity in both the total group and in the communities evaluated separately. Conclusions: The results confirm that the upcoming industrialization communities are at increased risk for cardiovascular disease. However, the rural community showed a significant frequency of IR, indicating that this population is also prone to cardiovascular risk, suggesting that emerging programs in health promotion should be reach to rural communities and not just urban communities.
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La epimastigogénesis de Trypanosoma cruzi es la transformación del tripomastigota sanguícola en epimastigota que ocurre en la porción anterior del tracto intestinal del insecto vector. Se ha reportado la activación de cisteín proteasas durante la epimastigogénesis in vitro en condiciones axénicas, sugiriendo la utilización de aminoácidos como fuente de carbono para la obtención de energía. El objetivo del presente trabajo fue estudiar a través de indicadores los cambios metabólicos producidos durante la diferenciación tripomastigota-epimastigota. Se partió de un 100% de tripomastigotas sobrenadantes de células Vero, incubados en medio LITB a 27ºC en condiciones de alta (epimastigogénesis horizontal) y baja (epimastigogénesis vertical) tensión de oxígeno. Se realizó contaje de parásitos (Cámara de Neubauer) y recuento diferencial (Giemsa) a diferentes tiempos de incubación (0, 1, 2, 4, 6, 8, 11 y 12 días). A cada tiempo se determinó en los sobrenadantes del medio de cultivo las concentraciones de glucosa y amoníaco, así como los valores de pH. Los resultados mostraron que: 1) Independientemente de la tensión de oxígeno se evidenció formas en diferenciación y amastigotas durante el proceso, siendo la aparición de epimastigotas más tardía en alta tensión de oxígeno; 2) El incremento poblacional fue significativamente mayor en condiciones de alta tensión de oxígeno, registrándose alta mortalidad de amastigotas durante los primeros días de incubación en la epimastigogénesis vertical; 3) El consumo de glucosa fue concomitante con la aparición de epimastigotas en ambas condiciones, siendo mayor en alta tensión de oxígeno; 4) No se registró liberación de amoníaco en ninguno de los casos estudiados; 5) Los valores de pH fueron similares hasta el sexto día en ambas condiciones, evidenciándose una acidificación gradual del medio de cultivo en alta tensión de oxígeno. Todo parece sugerir que durante la epimastigogénesis de T. cruzi, los parásitos involucrados en los procesos de diferenciación no muestran activación de las diferentes rutas metabólicas.
The epimastigogenesis of Trypanosoma cruzi is the transformation from bloodstream trypomastigote to epimastigote that occurs in the anterior portion of the intestinal tract of the insect vector. It has been reported cysteine proteases activation during axenic epimastigogenesis in vitro, suggesting the use of amino acids as a carbon source for the production of energy. The aim of this work was to study through indicators metabolic changes produced during the trypomastigote-epimastigote differentiation. We started with a 100% trypomastigotes derived from Vero cell supernatants, incubated in LITB medium at 27°C under high (horizontal epimastigogenesis) and low (vertical epimastigogenesis) oxygen tension. We estimated parasites number (Neubauer chamber) and differential morphology (Giemsa) at different incubation times (0, 1, 2, 4, 6, 8, 11 and 12 days). Each time was determined in the supernatants of the culture medium glucose and ammonia concentrations as well as the pH values. The results showed that: 1) Regardless of the oxygen tension it was evidenced differentiation forms and amastigote during the process, with the later occurrence of epimastigotes in high oxygen tension; 2) Population growth was significantly greater in high oxygen tension, registering high mortality of amastigotes during the firsts incubation days in the vertical epimastigogenesis; 3) Glucose consumption was concomitant with the appearance of epimastigotes in both conditions, being higher in high oxygen tension; 4) There was no ammonia release in any of the cases studied; 5) The pH values were similar to the sixth day in both conditions, showing gradual acidification of the culture medium at high oxygen tension. Everything seems to suggest that during the epimastigogenesis of T. cruzi parasites involved in differentiation processes show no activation of different metabolic pathways.
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En los últimos años se ha reportado en Venezuela una nueva realidad de la enfermedad de Chagas, con múltiples brotes de transmisión oral y vectorial, con participación de triatominos considerados antiguamente como silvestres que han colonizado zonas urbanas próximas a vegetaciones. El Municipio San Diego del Estado Carabobo se ha caracterizado por un gran crecimiento demográfico con expansión habitacional hacia zonas boscosas, y en donde se ha reportado la captura de triatominos domiciliarios y peridomicilarios. En este estudio se evaluó los factores de riesgo y nivel de conocimiento de la enfermedad de Chagas, así como determinación de infección por Trypanosoma cruzi en el Sector A del mencionado Municipio. A través de pruebas serológicas, se obtuvo una seroprevalencia de 5,6% de un total de 90 individuos evaluados. Haciendo uso de un cuestionario, se encontró baja frecuencia de los factores de riesgo clásicos (condiciones de vivienda y presencia de chipos); no obstante, se obtuvo un porcentaje elevado de presencia de animales en el intra o peridomicilio (74%), así como de vegetación abundante próxima al hogar (82%). En cuanto al nivel de conocimiento, aproximadamente la mitad de los encuestados (46%) mostró un nivel intermedio, seguido de una considerable proporción de participantes con nociones bajas (34%). Los conocimientos más elevados correspondieron a la definición sobre la enfermedad de Chagas y sintomatología más frecuente (60%) e insecto vector (72%). Por otro lado, se obtuvo baja frecuencia en cuanto a los mecanismos de transmisión y reservorios del parásito. Los resultados sugieren la necesidad de ampliar los mecanismos de acción en la lucha contra la enfermedad de Chagas, promoviendo estrategias educativas que aumenten el conocimiento en la comunidad.
In recent years it has been Venezuela reported in Venezuela a new reality of Chagas disease, with multiple outbreaks of oral and vectorial transmission, involving formerly considered as wild triatomines that have colonized urban areas near vegetation. The San Diego County Carabobo state was characterized by a high population growth with residential expansion into forested areas, and where it has been reported domiciliary and peridomiciliary triatomine capture. In this study we evaluated the risk factors and level of knowledge of Chagas disease, as well to identify Trypanosoma cruzi infection in Sector A of the said municipality. Through serological tests yielded a seroprevalence of 5.6 % of a total of 90 individuals tested. Using a questionnaire, we found low frequency of traditional risk factors (housing conditions and presence of triatomines), however, we obtained a high percentage of animals in the presence of intra-or peri (74 %) and abundant vegetation close to home (82 %). Regarding the level of knowledge, about half of respondents (46 %) showed an intermediate level, followed by a considerable proportion of participants with low notions (34 %). Knowledge was highest in the definition of Chagas disease and most common symptom (60 %) and insect vector (72 %). On the other hand, it was obtained a low frequency transmission mechanisms and reservoirs of parasite. The results suggest the need to broaden the mechanisms of action in the fight against Chagas disease, promoting educational strategies that increase community awareness.
RESUMO
Entre los efectos no clásicos de la Vitamina D destaca su asociación con el sistema cardiovascular y su disminución, se relaciona con factores de riesgo que definen al Síndrome Metabólico (SM). Es por ello que el objetivo de este estudio fue evaluar los niveles de Vitamina D en pacientes con SM y relacionarlos con sus componentes. Fueron estudiados 31 individuos con SM que acudieron a consultas de medicina interna en el Instituto Venezolano de Seguro Social Dr. Luis Guada Lacau y el Ambulatorio Urbano Dr. Miguel Franco del Municipio Naguanagua, Edo. Carabobo durante el primer trimestre del año 2011. A los mismos les fueron medidos los niveles de 25-(OH)-Vitamina D, circunferencia abdominal, presión arterial, perfil lipídico y glicemia, así como los índices aterogénicos y la relación TG/HDL-c. 54% de los participantes presentó niveles insuficientes de Vitamina D, asociándose estadísticamente a LDL-c elevado (chi-cuadrado=3,77; p-valor=0,052), mostrando además una correlación media y positiva con los valores de esta lipoproteína (r=0.3813; p-valor=0.0350) y con la relación LDL-c/HDL-c (r=0.3820; p-valor=0,0340). No se encontraron diferencias estadísticamente significativas entre los parámetros evaluados al dividir la muestra según la presencia o no de insuficiencia de vitamina D (prueba t de Student y Prueba de Wilcoxon-U-Mann Whitney). Los resultados obtenidos confirman la hipótesis de que la hipovitaminosis D puede ser considerada como un factor de riesgo para desarrollar SM, sugiriendo la realización de futuras investigaciones que contribuyan a profundizar la participación de la insuficiencia de esta vitamina y su posible interacción con otros factores no clásicos de riesgo cardiovascular(AU)
Among the nonclassical effects of vitamin D highlights its association with cardiovascular system, strongly associating your decline to risk factors that define the metabolic syndrome (MS). That is why the aim of this study was to assess vitamin D levels in patients with MS and link components. Was study 31 subjects with MS attending internal medicine clinics at the Venezuelan Institute of Social Security, Dr. Luis Guada Lacau and the Ambulatory Urban Dr. Miguel Franco of Naguanagua, Edo. Carabobo during the first quarter of 2011. At the same they were measured the levels of 25 - (OH)-vitamin D, waist circumference, blood pressure, lipid profile and glucose, and the atherogenic index and the ratio TG/HDL-c. 54% of participants had insufficient levels of Vitamin D, associated statistically elevated LDL-c (chi-square=3.77, p-value=0.052), also showing average and positive correlation with the values of this lipoprotein (r=0.3813, p-value=0.0350) and LDL-C/HDL-C relationship (r=0.3820, p-value=0.0340). No statistically significant differences were found between the parameters evaluated by dividing the sample according to the presence or absence of vitamin D insufficiency (Students t and Wilcoxon- U Mann-Whitney test). The results confirm the hypothesis that vitamin D deficiency may be considered a risk factor for developing MS, suggesting future conducting research that contributes to deepen the involvement of the failure of this vitamin and its possible interaction with other factors nonclassical cardiovascular risk(AU)
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Vitamina D/análise , Deficiência de Vitamina D/complicações , Linfócitos B/ultraestrutura , Doenças Cardiovasculares/fisiopatologia , Síndrome Metabólica/fisiopatologia , Endopeptidases , Resistência à Insulina , Gordura Abdominal , Doenças MetabólicasRESUMO
Las dislipidemias constituyen un factor de riesgo cardiovascular esencial en el desarrollo de la aterosclerosis, teniendo una elevada incidencia en la actualidad y es uno de los focos de acción principales en el control clínico metabólico de la población susceptible, incluyendo individuos aparentemente sanos. Es por ello que el objetivo del presente estudio fue evaluar la frecuencia de dislipidemias en un grupo de individuos aparentemente sanos con la finalidad de aportar datos que sirvan para la promoción del diagnóstico temprano y tratamiento oportuno los factores de riesgo para ECV. Se evaluaron 100 pacientes con edades comprendidas entre 18 y 50 años, a los cuales se les determinó Triglicéridos, colesterol total, HDL-colesterol (HDL-c), LDL-colesterol (LDL-c) e índices aterogénicos de Castelli I y II. La dislipidemia aislada más común en el grupo estudiado fue la hipercolesterolemia (43%), seguida de la hipertrigliceridemia (32%) y niveles disminuidos de HDL-c (31%). Se evidenció una baja frecuencia en el aumento de los índices aterogénicos y dislipidemias mixtas (18%). En conclusión, el porcentaje de dislipidemia reportado sugiere reforzar el diseño y aplicación de programas preventivos que disminuyan la incidencia no sólo de estas alteraciones bioquímicas sino también del resto de los factores de riesgo modificables que conducen a una enfermedad cardiovascular.
Dyslipidemias are an essential cardiovascular risk factor in the development of atherosclerosis, taking a high incidence at the moment and it is one of the main centers of action in clinical metabolic control of the susceptible subjects, including apparently healthy individuals. It was raised, the aim of this study was to evaluate the frequency of dyslipidemias in a group of apparently healthy individuals in order to provide data for the promotion of early diagnosis and timely treatment of risk factors for CVD. We evaluated 100 patients with ages between 18 and 50 years old, whom they found triglycerides, total cholesterol, HDL-cholesterol (HDL-c), LDL-cholesterol (LDL-c) and atherogenic index of Castelli I and II. The dyslipidemia more common in the studied group was hypercholesterolemia (43%), followed by hypertriglyceridemia (32%), and decreased levels of HDL-c (31%). It was observed a low frequency in the increase in the atherogenic index and mixed dyslipidemia (18%). In conclusion, the reported percentage of dyslipidemia suggests to strengthen the design and implementation of preventive programmes to reduce the incidence of not only these biochemical alterations but also the rest of modifiable risk factors leading to cardiovascular disease.
RESUMO
Objetivo: evaluar la frecuencia de sueño o descanso insuficiente y su asociación con la edad y factores de riesgo cardiometabólico (RCM) en mujeres carabobeñas de estrato socioeconómico (ESE) bajo. Métodos: se estudiaron 85 mujeres adultas (21-65 años) aparentemente sanas, de ESE bajo (según método de Graffar modificado), que asistieron a un centro ambulatorio de salud del Edo. Carabobo entre marzo-junio 2011. La frecuencia de sueño o descanso insuficiente se evaluó mediante la pregunta: "¿Durante los últimos 30 días, cuantos días Ud. ha sentido que no duerme o descansa suficiente?". Se determinaron peso, talla, circunferencia de cintura, presión arterial así como glucosa, triglicéridos, colesterol total, LDLc y HDLc en suero. Se calcularon índices de riesgo aterogénico e índice de masa corporal (IMC). Se estableció síndrome metabólico (SM) según criterios ATPIII. Resultados: 24,6% de las mujeres reportaron ≥14 días de sueño insuficiente en el último mes. El sueño insuficiente se asoció significativamente a edad > 40 años, exceso de peso, obesidad central, hipertrigliceridemia, relación colesterol total/HDLc elevada, relación triglicéridos/HDLc elevada y SM. El riesgo de SM en las mujeres que reportaron ≥14 días de sueño o descanso insuficiente fue 5,68 veces mayor respecto de aquellas que no manifestaron tal alteración (p=0,015), independientemente de su edad, IMC y antecedentes familiares de enfermedad cardiovascular y diabetes mellitus. Conclusiones: el sueño o descanso insuficiente fue frecuente y se asoció significativamente a elevado RCM en las mujeres estudiadas. Los resultados sugieren que el despistaje de sueño insuficiente debe integrarse a la evaluación de la salud cardiometabólica.
Objective: to assess the frequency of perceived insufficient rest or sleep and their association with age and cardiometabolic risk factors in a group of low income women. Methods: we studied 85 low income women (21-65 years), apparently healthy, who attended an health center in Carabobo State, Venezuela, between March to June 2011. The frequency of insufficient rest or sleep was assessed using the question: "During the past 30 days, for about how many days have you felt you did not get enough rest or sleep?". Weight, height, waist circumference, blood pressure and serum glucose, triglycerides, total cholesterol, LDL cholesterol and HDL cholesterol were measured. Atherogenic indexes and body mass index (BMI) were calculated. Metabolic syndrome (MS) was established according to ATPIII criteria. Results: 24.6% women reported ≥ 14 days of insufficient rest o sleep in the last month. Perceived insufficient rest or sleep was significantly associated with age > 40 years, overweight, central obesity, hypertriglyceridemia, high total cholesterol/HDL cholesterol ratio, high triglyceride/HDL cholesterol ratio and MS. The risk of MS in women who reported ≥ 14 days of insufficient sleep or rest was 5.68 times higher than in those that showed no such alteration (p= 0.015), independently of age, BMI and first-degree family history of cardiovascular disease and diabetes mellitus. Conclusions: perceived insufficient rest or sleep was common and significantly associated to high cardiometabolic risk in the studied women. The results suggest that insufficient sleep screening should be integrated into the assessment of cardiometabolic health.
RESUMO
Tomando en cuenta que aún no existe una metodología estándar de rutina para la determinación del colesterol de lipoproteínas de baja densidad (LDL-c) se decidió evaluar su determinación analítica utilizando tres técnicas: determinación enzimática homogénea, precipitación con sulfato de polivinilo y fórmula de Friedewald. Fueron procesadas 98 muestras de suero a las cuales se les determinó triglicéridos (TG), colesterol total (CT), colesterol de lipoproteínas de alta densidad (HDL-c) y colesterol de lipoproteínas de baja densidad (LDL-c). Los valores promedio de CT fueron 194,46 ± 43,54 mg/dL, HDL-c 51,12 ± 12,36 mg/dL y TG 132,88 ± 76,93 mg/dL. Aun cuando el análisis de regresión mostró una buena correlación entre los valores de LDL-c, los resultados indicaron una diferencia estadísticamente significativa en los mismos cuando los niveles de TG superaron los 200 mg/dL. La misma se observó principalmente entre el método de precipitación y la fórmula de Friedewald, siendo los valores significativamente más bajos en esta última (LDL-c por precipitación: 141,3 ± 26,2 mg/dL; LDL-c por fórmula de Friedewald: 110,1 ± 35,4 mg/dL). De la misma manera se vio afectada la proporción de individuos clasificados según su riesgo coronario. Es necesario comparar las técnicas aplicadas en este estudio con la cuantificación beta para evaluar cuál tiene un mayor nivel de exactitud.
Considering that there is still no standard methodology for routine determination of low density lipoprotein (LDL-c) it was decided to evaluate their analytical determination using three techniques: homogeneous enzymatic determination, polyvinyl sulphate precipitation and Friedewald formula. Ninety-eight serum samples were processed; triglycerides (TG), total cholesterol (TC), high-density lipoprotein (HDL-c) and LDL-c were determined. Mean total cholesterol was 194.46 ± 43.54 mg/dL, HDL-C was 51.12 ± 12.36 mg/dL and TG was 132.88 ± 76.93 mg/dL. Although regression analysis showed a good correlation between LDL-c, the results showed a statistically significative difference in them when TG levels exceeded 200 mg/dL. It was mainly observed in the precipitation method and the Friedewald formula, the latter values being significantly lower (LDL-C by precipitation: 141.3 ± 26.2 mg/dL, LDL-C by the Friedewald formula: 110, 1 ± 35.4 mg/dL). Moreover, this difference affected the proportion of individuals classified according to their coronary risk. It is necessary to compare the techniques applied in this study with beta quantification to assess which has a higher level of accuracy.
Levando em consideragao que ainda nao existe uma metodologia padrao de rotina para a determinagao do colesterol de lipoproteínas de baixa densidade (LDL-c) se decidiu avaliar sua determinagao analítica utilizando tres técnicas: determinagao enzimática homogénea, precipitagao com sulfato de polivinil e fórmula de Friedewald. Foram processadas 98 amostras de soro as quais lhes foi determinado triglicerídeos (TG), colesterol total (CT), colesterol de lipoproteínas de alta densidade (HDL-c) e colesterol de lipoproteínas de baixa densidade (LDL-c). Os valores médios de CT foram 194,46 ± 43,54 mg/dL, HDL-c 51,12 ± 12,36 mg/dL e TG 132,88 ± 76,93 mg/dL. Inclusive quando a análise de regressao mostrou uma boa correlagao entre os valores de LDL-c, os resultados indicaram uma diferenga estatisticamente significativa nos mesmos quando os niveis de TG superaram os 200 mg/dL. A mesma se observou principalmente entre o método de precipitagao e a fórmula de Friedewald, sendo os valores significativamente mais baixos nesta última (LDL-c por precipitagao: 141,3 ± 26,2 mg/dL; LDL-c por fórmula de Friedewald: 110,1 ± 35,4 mg/dL). Da mesma maneira se viu afetada a proporgao de indivíduos classificados conforme seu risco coronariano. É necessário comparar as técnicas aplicadas neste estudo com a quantificagao beta para avaliar qual é que tem maior nível de exatidao.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Métodos de Análise Laboratorial e de Campo/métodos , LDL-Colesterol/análise , LDL-Colesterol/sangue , HDL-Colesterol/análise , Enzimas/sangue , Equipamentos de Medição de Riscos , Triglicerídeos/sangueRESUMO
El objetivo de esta investigación fue relacionar la concentración de mercurio urinario de 100 residentes de la comunidad Boca de Yaracuy (zona costera del Estado Carabobo-Venezuela) con los niveles mercuriales encontrados en pescado, agua y sedimento provenientes del Caño El Alpargatón. Durante el estudio fueron captados 4 peces, 2 muestras de agua y tres de sedimento y analizadas por absorción atómica. La media de los niveles de mercurio en la orina de los individuos analizados fue de 3,62 ± 1,09 µg/g creatinina, ubicandose por debajo del valor límites establecido por la Agencia para sustancias tóxicas y registro de enfermedades, Conferencia americana de higienistas industriales gubernamentales y la Organización Mundial de la Salud, además de las Gacetas oficiales venezolanas N° 5382 y 5021. En las muestras ambientales provenientes del Caño. El Alpargatón, no se encontraron niveles elevados de mercurio, así como ausencia de intoxicación por mercurio en sus habitantes. Se requieren de nuevas investigaciones que abarquen un mayor número de elementos que faciliten un mejor abordaje de la contaminación mercurial.
The aim study was to relate the concentration of urinary mercury than 100 residents of the Community Boca Yaracuy (Carabobo state coastal-Venezuela) with mercury levels found in fish, water and sediment from the Caño Alpargatón. During the study were caught 4 fish, 2 samples of water and three samples of sedimentand, analyzed by atomic absorption. The average mercury levels in urine of individuals analyzed was 3,62 ± 1.09 mg/g creatinine, ranking below the limits set by the Agency for toxic substance and disease registry, American conference of gubernamental industrial hygienists, the World Health Organization and the Venezuela Official Gazettes N°5382 and 5021. In environmental samples from the Caño Alpargaton not were found elevanted levels of mercury and mercury poisoning absence of its inhabitants. Further investigations are needed to cover a larger number of elements to be a better approach to mercury pollution.
Assuntos
Humanos , Masculino , Adolescente , Adulto , Feminino , Adulto Jovem , Creatinina/toxicidade , Creatinina/urina , Intoxicação por Mercúrio/complicações , Metais/efeitos adversos , Exposição por Inalação/análise , Pesqueiros/métodos , População RuralRESUMO
Objetivo Evaluar el nivel de conocimiento de los factores de riesgo cardiovascular y asociarlo con alteraciones de los marcadores clínicos, antropométricos y bioquímicos de riesgo cardiovascular en una comunidad del Municipio Naguanagua, Venezuela. Métodos Se evaluaron 205 pacientes con edades comprendidas entre 18 y 77 años, a los cuales se les determinó peso, talla, circunferencia abdominal, presión arterial, glicemia y perfil lipídico. Se aplicó una encuesta para medir el nivel de conocimiento de los factores de riesgo cardiovascular. Resultados Se evidenció una alta frecuencia de obesidad abdominal (67 %) sobrepeso y obesidad (38 %) e Hipertensión (26 %). Casi 60 % de los participantes afirmó conocer los factores de riesgo cardiovascular, pero sólo 14,7 % reconocieron los once factores que se consideraron para definir el nivel de conocimiento. Más de la mitad de los participantes mostraron un bajo nivel de conocimiento de factores de riesgo cardiovasculares cuyos niveles promedio de colesterol total, LDL colesterol y triglicéridos fueron significativamente menores a los del grupo de alto nivel de conocimiento. Conclusión Se encontró un porcentaje elevado de individuos con bajo nivel de conocimiento de los factores de riesgo cardiovascular y una frecuencia de alteraciones de los parámetros clínicos, antropométricos y bioquímicos mayor entre los participantes con alto nivel de conocimiento, confirmando la necesidad de ejecutar estrategias que no sólo eleven el nivel de conocimiento de las comunidades venezolanas, sino también motiven efectivamente a la adopción de un estilo de vida asociado a la reducción de los factores de riesgo cardiovascular y al autocuidado de la salud.
Objective Associating the level of awareness concerning cardiovascular risk factors related to changes in clinical, anthropometric and biochemical markers regarding cardiovascular risk in people living in Naguanagua, Venezuela. Method 205 patients aged 18 to 77 years were evaluated; weight, height, waist circumference, blood pressure, glucose and serum lipid profile were measured. A survey assessed the patients' level of awareness regarding cardiovascular risk factors. Results A high frequency of abdominal obesity (67 %), being overweight and obese (38 %) and suffering from hypertension (26 %) was observed. Nearly 60 % of respondents claimed to know about cardiovascular risk factors, but only 14.7 % of them recognized the eleven factors considered to define such level of knowledge. More than half of the participants showed a low level of awareness concerning cardiovascular risk factors; average levels of total cholesterol, cholesterol LDL and triglycerides were significantly lower in the group having a high level of knowledge concerning cardiovascular risk factors. Conclusions Extremely low levels of awareness regarding cardiovascular risk factor prevalence and high frequency concerning changes in clinical, anthropometric and biochemical markers for cardiovascular risk were higher in the group having a high level of knowledge of cardiovascular risk factors, thereby confirming the need for implementing strategies for raising Venezuelan communities' level of knowledge regarding cardiovascular risk factors and also encouraging them to adopt a lifestyle associated with reduced cardiovascular risk factors and self-care.
Assuntos
Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Doenças Cardiovasculares/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Consumo de Bebidas Alcoólicas/epidemiologia , Antropometria , Glicemia/análise , Doenças Cardiovasculares/epidemiologia , Diabetes Mellitus/epidemiologia , Dieta , Dislipidemias/epidemiologia , Comportamentos Relacionados com a Saúde , Hipertensão/epidemiologia , Lipídeos/sangue , Sobrepeso/epidemiologia , Fatores de Risco , Fumar/epidemiologia , Fatores Socioeconômicos , Venezuela/epidemiologiaRESUMO
OBJECTIVE: Associating the level of awareness concerning cardiovascular risk factors related to changes in clinical, anthropometric and biochemical markers regarding cardiovascular risk in people living in Naguanagua, Venezuela. METHOD: 205 patients aged 18 to 77 years were evaluated; weight, height, waist circumference, blood pressure, glucose and serum lipid profile were measured. A survey assessed the patients' level of awareness regarding cardiovascular risk factors. RESULTS: A high frequency of abdominal obesity (67 %), being overweight and obese (38 %) and suffering from hypertension (26 %) was observed. Nearly 60 % of respondents claimed to know about cardiovascular risk factors, but only 14.7 % of them recognized the eleven factors considered to define such level of knowledge. More than half of the participants showed a low level of awareness concerning cardiovascular risk factors; average levels of total cholesterol, cholesterol LDL and triglycerides were significantly lower in the group having a high level of knowledge concerning cardiovascular risk factors. CONCLUSIONS: Extremely low levels of awareness regarding cardiovascular risk factor prevalence and high frequency concerning changes in clinical, anthropometric and biochemical markers for cardiovascular risk were higher in the group having a high level of knowledge of cardiovascular risk factors, thereby confirming the need for implementing strategies for raising Venezuelan communities' level of knowledge regarding cardiovascular risk factors and also encouraging them to adopt a lifestyle associated with reduced cardiovascular risk factors and self-care.
Assuntos
Doenças Cardiovasculares/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Adolescente , Adulto , Idoso , Consumo de Bebidas Alcoólicas/epidemiologia , Antropometria , Glicemia/análise , Doenças Cardiovasculares/epidemiologia , Diabetes Mellitus/epidemiologia , Dieta , Dislipidemias/epidemiologia , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Hipertensão/epidemiologia , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Sobrepeso/epidemiologia , Fatores de Risco , Fumar/epidemiologia , Fatores Socioeconômicos , Venezuela/epidemiologia , Adulto JovemRESUMO
Vitamin D has an essential role in calcium metabolism and bone health. Vitamin D3 or cholecalciferol is synthesized from 7-dehydrocholesterol or provitamin D3, by sunlight ultraviolet radiation to the skin. 7-dehydrocholesterol is subsequently hydroxylated in the liver and then in the kidney to produce 1,25-(OH)2D3, the active metabolite that binds to specific receptors (VDR) in target tissues, mainly bone and intestine. Other tissues, such as the immune and cardiovascular system, have also VDR. Vitamin D deficiency can induce rickets in children and osteomalacia and osteoporosis in adults. A possible inverse association between vitamin D levels and the prevalence of metabolic syndrome has been proposed. Vitamin D deficiency increases the risk of type 1 diabetes, insulin resistance, and hypertension, key components of this syndrome. However, other studies have not confirmed this association. Further clinical and experimental studies are needed to ascertain the role of vitamin D in metabolic syndrome.