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1.
Cancers (Basel) ; 15(7)2023 Mar 29.
Artículo en Inglés | MEDLINE | ID: mdl-37046686

RESUMEN

Hemangiosarcoma is a mesenchymal neoplasm originating in the endothelial cells of blood vessels; they can be classified as non-visceral and visceral types. Non-visceral hemangiosarcomas can affect the skin, subcutaneous tissues, and muscle tissues; visceral hemangiosarcomas can affect the spleen, liver, heart, lungs, kidneys, oral cavity, bones, bladder, uterus, tongue, and retroperitoneum. Among domestic species, dogs are most affected by cutaneous HSA. Cutaneous HSA represents approximately 14% of all HSA diagnosed in this species and less than 5% of dermal tumors, according to North American studies. However, Brazilian epidemiological data demonstrate a higher prevalence, which may represent 27 to 80% of all canine HSAs and 13.9% of all skin neoplasms diagnosed in this species. Cutaneous HSA most commonly affects middle-aged to elderly dogs (between 8 and 15 years old), with no gender predisposition for either the actinic or non-actinic forms. The higher prevalence of cutaneous HSA in some canine breeds is related to lower protection from solar radiation, as low skin pigmentation and hair coverage lead to greater sun exposure. Actinic changes, such as solar dermatosis, are frequent in these patients, confirming the influence of solar radiation on the development of this neoplasm. There are multiple clinical manifestations of hemangiosarcoma in canines. The diagnostic approach and staging classification of cutaneous HSAs are similar between the different subtypes. The definitive diagnosis is obtained through histopathological analysis of incisional or excisional biopsies. Cytology can be used as a presurgical screening test; however, it has little diagnostic utility in cases of HSA because there is a high risk of blood contamination and sample hemodilution. Surgery is generally the treatment of choice for dogs with localized non-visceral HSA without evidence of metastatic disease. Recently, electrochemotherapy (ECT) has emerged as an alternative therapy for the local ablative treatment of different neoplastic types; the use of radiotherapy for the treatment of dogs with cutaneous HSA is uncommon. There is greater consensus in the literature regarding the indications for adjuvant chemotherapy in subcutaneous and muscular HSA; doxorubicin is the most frequently used antineoplastic agent for subcutaneous and muscular subtypes and can be administered alone or in combination with other drugs. Other therapies include antiangiogenic therapy, photodynamic therapy, the association of chemotherapy with the metronomic dose, targeted therapies, and natural products. The benefits of these therapies are presented and discussed. In general, the prognosis of splenic and cardiac HSA is unfavorable. As a challenging neoplasm, studies of new protocols and treatment modalities are necessary to control this aggressive disease.

2.
Clin Chim Acta ; 528: 56-64, 2022 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-35092724

RESUMEN

BACKGROUND: Automated, technically simple analytical methods offering objective results are highly valued in clinical laboratories. Kappa free light chains (KFLC) in cerebrospinal fluid (CSF) are promising multiple sclerosis (MS) biomarkers, particularly kappa (K) index. METHODS: KFLC were determined in CSF and serum samples of patients diagnosed with MS, clinically/radiologically isolated syndrome (N, 39), and controls (N, 152; inflammatory and non-inflammatory neurological disorders). Diagnostic performance of several KFLC parameters, previously determined oligoclonal band (OCB) testing, and IgG index, was assessed. A K index decision threshold for sample screening was identified and reduction in performed OCB analyses estimated accordingly. RESULTS: Higher KFLC parameters were detected in the MS group and K index performed best among them (AUC 0.92). At a 7.25 cut-off it showed better sensitivity (85% vs. 77%) though less specificity (88% vs. 91%) than OCBs. Comparatively, IgG index's performance was inferior (AUC 0.83). A decision K index threshold of 2.55 (97% sensitivity) would reduce OCB testing by 52% in the studied population. CONCLUSIONS: The proposed 7.25 cut-off could assist MS diagnostics and identify some false negative cases from OCB studies. Sequential algorithms using K index for the decision to perform OCB detection would improve laboratory efficiency and substantially reduce costs.


Asunto(s)
Esclerosis Múltiple , Biomarcadores , Humanos , Cadenas kappa de Inmunoglobulina/líquido cefalorraquídeo , Laboratorios Clínicos , Esclerosis Múltiple/líquido cefalorraquídeo , Bandas Oligoclonales/líquido cefalorraquídeo
4.
Cureus ; 13(11): e19286, 2021 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-34900469

RESUMEN

Endometrial cancer (EC) is the second most frequent gynecological malignancy worldwide with an overall favorable prognosis. However, there is a subgroup of patients with a higher rate of recurrence and worse prognosis who benefit from a specific pre- and post-treatment radiological evaluation that allows the adjustment of the therapeutic attitude towards the biology of the tumor. The main factors that determine high-risk disease are non-endometrioid tumor histology, histopathological grade 3, lymphovascular space invasion (LVSI), myometrial invasion ≥50%, and cervical stroma involvement. Radiological evaluation helps identify high-risk cases prior to surgical staging and is an important tool both in pre-treatment and in case of clinical recurrence suspicion. As for imaging techniques, both transvaginal ultrasound and MRI can assess local tumor extent while CT and positron emission tomography/CT (PET/CT) help assess lymph nodes and distant metastases. The central purpose of this article is to review the specific factors that determine high-risk endometrial cancer, and the main specificities in the pre-treatment and follow-up evaluation according to the most recent international guidelines.

5.
BMJ Case Rep ; 14(12)2021 Dec 30.
Artículo en Inglés | MEDLINE | ID: mdl-34969801

RESUMEN

A healthy 38-year-old woman, with no significant medical or surgical history, was referred to the gynaecology emergency department with acute low quadrant abdominal pain and nausea. On examination, painful palpation of right iliac fossa, abdominal guarding and positive Blumberg's sign were noted. An abdominal-pelvic CT scan showed a hypodense tubular structure with peripheral enhancement to the right of the inferior vena cava, suggestive of thrombosis of the right ovarian vein. The only risk factor identified was the use of the combined contraceptive pill.


Asunto(s)
Ovario , Trombosis , Dolor Abdominal/etiología , Adulto , Femenino , Humanos , Ovario/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Vena Cava Inferior/diagnóstico por imagen
6.
Int Ophthalmol ; 41(10): 3419-3425, 2021 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-34050855

RESUMEN

INTRODUCTION: Glaucoma is a progressive optic neuropathy that requires continuous monitoring. The purpose of the study was to develop and evaluate the usability of a mobile application, for iOS and Android platforms, containing functionalities to improve patients' knowledge about glaucoma and facilitate their treatment. METHODS: The application was developed by a multidisciplinary team using an adapted version of a co-design methodology. Volunteers were selected, among patients and patients' relatives, from the Instituto Cearense de Oftalmologia, chosen by rational choice sampling, to answer the system usability scale after having prior orientation. The results extracted from the questionnaire were analyzed quantitatively. After grouping by age, a proportions test (z-test) was performed. RESULTS: It was possible to develop an application for mobile devices named "GlaucoCheck." Of the 36 interviewees, the average age was 51 (22-69) years old, 56% were women, and 30.5% had a university degree. The average APP score for usability in the SUS questionnaire was 75.6 (95% CI 74.1-77.2). CONCLUSION: There was an appropriate acceptance of patients to the "GlaucoCheck", as it was considered easy to handle, exhibiting interactive and uncomplicated layout. It was possible to develop an application and to register a positive acceptance by the users, encompassing functions that permits better adherence to treatments and additional knowledge about glaucoma.


Asunto(s)
Glaucoma , Aplicaciones Móviles , Adulto , Anciano , Femenino , Glaucoma/diagnóstico , Humanos , Persona de Mediana Edad , Encuestas y Cuestionarios , Adulto Joven
8.
Percept Mot Skills ; 128(4): 1530-1548, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-33818161

RESUMEN

The purpose of this study was to verify the effectiveness of the rate of perceived exertion threshold (RPET) for predicting young competitive swimmers' lactate threshold (LT) during incremental testing. We enrolled 13 male athletes (M age = 16, SD = 0.6 years) in an incremental test protocol consisting of eight repetitions of a 100-meter crawl with 2-minute intervals between each repetition. We collected data for blood lactate concentration ([La]) and Borg scale rate of perceived exertion (RPE) at the end of each repetition. The results obtained were: M RPET = 4.98, SD = 1.12 arbitrary units (A.U.) and M lactate threshold = 4.24, SD = 1.12 mmol.L-1, with [La] and RPE identified by the maximal deviation (Dmax) method without a significant difference (p > 0.05) and large correlations between DmaxLa and DmaxRPE at variables for time (r = 0.64), velocity (r = 0.67) and percentage of personal best time (PB) (r = 0.60). These results suggest that RPET is a good predictor of LT in young competitive swimmers.


Asunto(s)
Ácido Láctico , Esfuerzo Físico , Adolescente , Frecuencia Cardíaca , Humanos , Masculino
9.
Florianópolis; Secretaria de Estado da Saúde; 1. ed. rev. e atual; 2021. 93 p. Tab, graf.
Monografía en Portugués | LILACS, CONASS, CNS-BR, ColecionaSUS, SES-SC | ID: biblio-1355058

RESUMEN

O Sistema Único de Saúde (SUS) tem papel fundamental no auxílio às pessoas que desejam parar de fumar. Para tanto, é muito importante que os profissionais atuantes na atenção básica e assistência à saúde estejam preparados para oferecer esse auxílio. Considerando esse contexto, a Diretoria de Vigilância Epidemiológica da Secretaria de Estado da Saúde de Santa Catarina (DIVE/SES/SC), por meio de sua Gerência de Análises Epidemiológicas e Doenças e Agravos Não Transmissíveis (GADNT) e a Escola de Saúde Pública de Santa Catarina (ESPSC) disponibilizam o curso "Abordagem e Tratamento do Tabagismo".


Asunto(s)
Humanos , Masculino , Femenino , Tabaquismo/terapia , Prevención del Hábito de Fumar/métodos , Programas Nacionales de Salud , Servicios Preventivos de Salud , Tabaquismo/complicaciones , Tabaquismo/epidemiología , Brasil/epidemiología , Prevalencia , Cese del Hábito de Fumar , Cursos de Capacitación
10.
Cornea ; 39(9): 1132-1138, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32558730

RESUMEN

PURPOSE: To develop a mobile app that allows photographs to be captured and edited under the overlay of images and projection of a protractor with 360 degrees axis markings, which enables the surgeon to accurately visualize the programmed and marked alignment where the intrastromal corneal ring segments (ICRS) will be implanted, detecting possible marking errors. METHODS: A codesign methodology was chosen to develop the Eye Axis Check application. After app development, measurements were obtained, and comparisons were made between manual marks and ICRS alignment with and without the app in 13 eyes that had undergone ICRS implantation for keratoconus. The mobile app was made available to 15 ophthalmic surgeons in different cities to assess its usability. RESULTS: The users approved the developed application for ease of use and utility. No difference was found between the markings made manually and those made with the app, and the mean difference between ICRS centralization and assessment made by the app was 4.84 degrees (95% confidence interval: -5.32 to 15.01; P = 0.3193). On comparison of the agreement between app measurements and manual measurements for the ICRS centration, no significant differences were found, and excellent concordance (0.991) and a strong positive linear correlation (0.984) were observed. CONCLUSIONS: A mobile app for preoperative planning and intraoperative ICRS alignment was developed and revealed to be useful and easy to use, allowing the surgeon to visualize the programmed alignment where the ICRS will be implanted.


Asunto(s)
Sustancia Propia/cirugía , Queratocono/cirugía , Aplicaciones Móviles , Prótesis e Implantes , Implantación de Prótesis/métodos , Refracción Ocular/fisiología , Agudeza Visual , Sustancia Propia/patología , Topografía de la Córnea , Humanos , Periodo Intraoperatorio , Queratocono/diagnóstico , Queratocono/fisiopatología , Periodo Preoperatorio
11.
Rev. bras. oftalmol ; 79(2): 114-117, Mar.-Apr. 2020. tab, graf
Artículo en Inglés | LILACS | ID: biblio-1137947

RESUMEN

Abstract Purpose: To outline the epidemiological profile of clinical treatments for glaucoma provided by the Brazilian Unified Health System (SUS, acronym in Portuguese) between January 2012 and December 2018. Methods: A quantitative and descriptive study was conducted using available data based on the outpatient information system from SUS (SIA/SUS, acronym in Portuguese). The variables were monocular treatment with first, second, and third-line drugs; monocular treatment with combinations of two drugs and three drugs from different lines; binocular treatment with first, second, and third-line drugs; and binocular treatment with combinations of two drugs and three drugs from different lines. Results: During the analysis period, the prevalence of clinical therapies for glaucoma increased from 2012 to 2017 and decreased from 2017 to 2018. Of the clinically treated patients, 96% were carriers of binocular glaucoma. Among the regions of Brazil, the Northeast had the highest prevalence of binocular glaucoma (about 60% of the number of cases), and the most common therapy was combinations of two drugs from different lines. The Southeast region had the highest concentration of monocular glaucoma (53% of cases), and the predominant therapy was combinations of three drugs from different lines. The Midwest region had the lowest prevalence of monocular-treatments for glaucoma (less than 6%). Conclusion: In Brazil, the highest number of treatments offered by the public health system was in the Northeast and Southeast regions. There is a high national prevalence and potential for the morbidity of this disease. Therefore, it is necessary to strengthen programs aimed at early diagnosis and appropriate treatment to reduce adverse outcomes.


Resumo Objetivo: Traçar o perfil epidemiológico do tratamento clínico para o glaucoma no Brasil fornecido pelo Sistema Único de Saúde (SUS), no período de janeiro de 2012 a dezembro de 2018. Métodos: Estudo quantitativo e descritivo, utilizando a base de dados disponível no Sistema de Informações Ambulatoriais do SUS (SIA/SUS). As variáveis utilizadas foram: tratamento monocular com drogas de primeira, de segunda e de terceira linha; tratamento monocular com combinações de duas drogas e de três drogas de diferentes linhas; tratamento binocular com drogas de primeira, de segunda e de terceira linha; e tratamento binocular com combinações de duas drogas e de três drogas de diferentes linhas. Resultados: Durante o período analisado, a prevalência de terapias clínicas para o glaucoma aumentou entre 2012 e 2017 e diminuiu entre 2017 e 2018. Dos pacientes tratados clinicamente, 96% eram portadores de glaucoma binocular. Entre as regiões do Brasil, o Nordeste teve a maior prevalência de glaucoma binocular (cerca de 60% do número de casos), e a terapia mais comum foi a combinação de duas drogas de diferentes linhas. A região Sudeste teve a maior concentração de glaucoma monocular (53% dos casos), e a terapia predominante foi a combinação de três drogas de diferentes linhas. A região Centro-Oeste apresentou a menor prevalência de tratamentos monoculares para o glaucoma (menos de 6%). Conclusão: No Brasil, o maior número de tratamentos oferecidos pelo sistema público de saúde foi nas regiões Nordeste e Sudeste. Existe uma alta prevalência nacional e um alto potencial para morbidade desta doença. Portanto, é necessário fortalecer programas voltados para o diagnóstico precoce e para o tratamento adequado a fim de reduzir os resultados adversos.


Asunto(s)
Humanos , Sistema Único de Salud , Glaucoma/tratamiento farmacológico , Glaucoma/epidemiología , Farmacoepidemiología/métodos , Presión Intraocular , Brasil , Epidemiología Descriptiva , Estudios de Evaluación como Asunto
12.
Urology ; 137: e6-e7, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31887350

RESUMEN

Jackstone calculus is a rare bladder stone with a unique appearance, presenting a stippled and spiculated contour. Correct diagnosis is important because it may have therapeutic implications, as this distinctive shape correlates with a specific mineral composition of calcium oxalate dihydrate, which tend to be easily fragmented by lithotripsy, allowing to attempt an endoscopic treatment instead of surgery in larger stones. We present the case of a 77-year-old male where a 2 cm bladder calculus was incidentally found on CT, with features that allowed to make straightforward the diagnosis of a jackstone calculus.


Asunto(s)
Cálculos de la Vejiga Urinaria/patología , Anciano , Oxalato de Calcio/análisis , Humanos , Hallazgos Incidentales , Masculino , Tomografía Computarizada por Rayos X , Cálculos de la Vejiga Urinaria/química , Cálculos de la Vejiga Urinaria/diagnóstico por imagen
13.
Insights Imaging ; 10(1): 38, 2019 Mar 21.
Artículo en Inglés | MEDLINE | ID: mdl-30900187

RESUMEN

The portal vein (PV) is the main vessel of the portal venous system (PVS), which drains the blood from the gastrointestinal tract, gallbladder, pancreas, and spleen to the liver. There are several variants affecting the PV, and quite a number of congenital and acquired pathologies.In this pictorial review, we assess the embryological development and normal anatomy of the PVS, displaying selected cases consisting of normal variants, congenital anomalies, and a large and heterogeneous group of acquired conditions that may affect the PV.

14.
J Feline Med Surg ; 21(4): 314-321, 2019 04.
Artículo en Inglés | MEDLINE | ID: mdl-29788832

RESUMEN

OBJECTIVES: Feline injection site sarcoma (FISS) is a rapid growing locally aggressive tumor with a low metastatic rate. Its histologic features are clearly defined, but there are few studies regarding its immunohistochemical characteristics. The present study investigated the immunohistochemical characteristics of 21 cases of FISS. METHODS: FISSs from 12 male and nine female cats, 20 mixed-breed and one Siamese, were included in the study. After histopathological diagnosis, additional histologic sections were immunostained for vimentin, cytokeratin, desmin, S100 protein, viral feline leukemia virus (FeLV) particles, cyclooxygenase 2 (COX-2) and c-KIT. Positive and negative controls were adopted accordingly. Immunostainings were classified as positive or negative according to the number of positive cells from a total of 1000 cells per tumor section. RESULTS: Histopathologic diagnosis of the tumors revealed 18 (85.7%) fibrosarcomas and three (14.3%) other sarcomas; four fibrosarcomas (22.2%) were grade III, five (27.8%) were grade II and nine (50.0%) were grade I. Two sarcomas were grade III and one was grade II. Seventeen (81%) tumors were negative for desmin. All samples were positive for vimentin. Twenty tumors (95.2%) were positive for S-100 protein. Positivity for c-KIT was observed in four (19%) samples; COX-2 was positive in 13 (61.9%) and FeLV viral particles were positive in nine (42.9%) FISSs. CONCLUSIONS AND RELEVANCE: Immunohistochemical findings of FISSs revealed positive immunostainings for desmin, vimentin, S-100 protein, c-KIT, COX-2 and FeLV viral particles.


Asunto(s)
Enfermedades de los Gatos , Reacción en el Punto de Inyección , Sarcoma , Animales , Enfermedades de los Gatos/diagnóstico , Enfermedades de los Gatos/patología , Gatos , Femenino , Inmunohistoquímica , Reacción en el Punto de Inyección/diagnóstico , Reacción en el Punto de Inyección/patología , Reacción en el Punto de Inyección/veterinaria , Masculino , Sarcoma/química , Sarcoma/diagnóstico , Sarcoma/patología , Neoplasias de los Tejidos Blandos/química , Neoplasias de los Tejidos Blandos/diagnóstico , Neoplasias de los Tejidos Blandos/patología
15.
PLoS One ; 13(7): e0200075, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29975756

RESUMEN

Multiple cardiovascular risk factors are directly related to the severity of atherosclerosis, even in children and adolescents. In this context accurate assessment of risk factors at the individual level play a decisive role in cardiovascular disease (CVD) prevention. The objective of this study was to estimate the prevalence of cardiovascular risk factors, the frequency of their coexistence in individuals, and identify possible determinants associated with this coexistence in Brazilian adolescents. A cross-sectional study with 1170 students (12-17 years) from public and private schools of a large city was conducted. In addition to family history, modifiable cardiovascular risk factors were assessed including: tobacco use, alcohol consumption, sedentary lifestyle, overweight/obesity, increased waist circumference, and high blood pressure (office and home). We built a linear regression model to identify determinants associated with increasing number of modifiable risk factors. Mean study population age was 14.7±1.6 years, 67% were enrolled in public schools and 33% in private ones. The majority of the adolescents had at least two risk factors (68.9%), more than 10% had more than 4 risk factors, and in only 6.7% of the sample no risk factor was identified. Family history of CVD (ß-coefficient = 1.20; 95%CI 1.07-1.34; p<0.001), increasing age (ß-coefficient = 0.08; 95%CI 0.04-0.11; p<0.001), and being enrolled in private schools (ß-coefficient = 0.16; 95%CI 0.02-0.30; p = 0.023) were directly associated with the modifiable CV risk factors. In conclusion, the prevalence of multiple cardiovascular risk factors was high in the population of adolescents studied. School based interventions should be addressed to change this scenario.


Asunto(s)
Enfermedades Cardiovasculares/epidemiología , Adolescente , Brasil/epidemiología , Femenino , Humanos , Masculino , Prevalencia , Factores de Riesgo , Instituciones Académicas
16.
J. pediatr. (Rio J.) ; 94(2): 184-191, Mar.-Apr. 2018. tab, graf
Artículo en Inglés | LILACS | ID: biblio-894115

RESUMEN

Abstract Objective The management of children with low birth weight is not the same in countries with different resources. The authors assessed the association of birth weight with blood pressure and nutritional status in a representative sample of adolescents from a Brazilian state, aiming to identify possible consequences of these differences. Methods A cross-sectional school-based study was conducted with adolescents (12-18 years) enrolled in public and private schools. Birth weight, office blood pressure, home blood pressure measurements, and nutritional status (body mass index, height z-score for the age, and waist circumference) were assessed. The association of birth weight with the outcomes (blood pressure, height, body mass index, and waist circumference) was studied through univariate and multivariable linear regression models. Results A total of 829 adolescents with a mean age of 14.6 ± 1.62 years were included; 43.3% were male, and 37.0% from private schools. The prevalence of low birth weight was 8.7%. Mild low height prevalence was higher among those adolescents with low/insufficient birth weight when compared to those with normal/high birth weight (11.7 vs. 4.2%; p < 0.001). In the multiple linear regression analysis, for each increase of 100 g in birth weight, height increased by 0.28 cm (95% CI: 0.18-0.37; p < 0.01). Birth weight did not influence office blood pressure and home blood pressure, body mass index, or waist circumference of adolescents. Conclusions Birth weight was directly associated to height, but not associated to blood pressure, body mass index, and waist circumference in adolescents from an urban area of a developing country.


Resumo Objetivo O manejo de crianças com baixo peso ao nascer não é o mesmo em países com diferentes recursos. Investigamos a associação do peso ao nascer com a pressão arterial e o estado nutricional em uma amostra representativa de adolescentes de uma capital brasileira com o objetivo de identificar possíveis consequências destas diferenças. Métodos Estudo transversal de base escolar conduzido com adolescentes (12-18 anos) matriculados em escolas públicas e privadas. Investigou-se o peso ao nascer, a pressão arterial, e o estado nutricional, por meio do índice de massa corporal, do escore z de estatura para idade e da circunferência da cintura. Resultados Um total de 829 adolescentes com uma idade média 14.6 ± 1.62 anos foram incluídos, 43.3% do sexo feminino e 37.0% de escolas privadas. A prevalência de baixo peso ao nascer foi 8.7%. Baixa estatura leve foi mais prevalente nos adolescentes com peso ao nascer baixo/insuficiente (11.7 × 4.2% - p < 0.001). Na análise de regressão linear múltipla, para cada aumento de 100 g no peso ao nascer, a estatura aumentou em 0.28 cm (IC 95% = 0.18-0.37; p < 0.01). O peso ao nascer não influenciou a pressão arterial (casual e residencial), o índice de massa corporal e a circunferência da cintura dos adolescentes. Conclusões O peso ao nascer esteve diretamente associado à altura, mas não associado à pressão arterial, índice de massa corporal e circunferência da cintura em adolescentes de uma área urbana de um país em desenvolvimento.


Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Peso al Nacer/fisiología , Índice de Masa Corporal , Estado Nutricional/fisiología , Hipertensión/fisiopatología , Factores Socioeconómicos , Presión Sanguínea/fisiología , Estudios Transversales , Circunferencia de la Cintura , Hipertensión/diagnóstico
17.
Blood Press ; 27(3): 151-157, 2018 06.
Artículo en Inglés | MEDLINE | ID: mdl-29302991

RESUMEN

PURPOSE: Population-based studies estimating prevalence's of white-coat, masked and sustained hypertension in non-European adolescents are needed, particularly in developing countries. Aiming to determine these estimates and, additionally identify factors associated to these conditions this study was conducted. MATERIALS AND METHODS: Cross-sectional study with a representative sample of secondary school students from a Brazilian state capital. Office measurements were performed with validated semi-automatic devices. Home BP (blood pressure) monitoring protocol included two day-time and two evening-time measurements over 6 days. Adolescents' were classified as: normotensives (office and home BP <95th percentile); sustained hypertensives (office and home BP ≥95th percentile); white-coat hypertensives (office BP ≥95th percentile and home BP <95th percentile) and masked hypertensives (office BP <95th percentile and home BP ≥95th percentile). Logistic regression models were built to identify if sex, age, BMI and family history of HTN were independently associated with white-coat, masked and sustained hypertension. RESULTS: In a sample of 1024 adolescents, prevalence of white-coat, masked and sustained hypertension was 7.5%, 2.2% and 1.7%, respectively. Male sex was positively associated with white-coat hypertension (OR 2.68; 95%CI 1.58-4.54; p < 0.001). BMI was positively associated with both white-coat (OR 1.23; 95%CI 1.16-1.30; p < 0.001) and sustained hypertension (OR 1.19; 95%CI 1.11-1.29; p < 0.001). None of the independent variables were associated with masked hypertension in this population. CONCLUSION: The estimated prevalence of white-coat hypertension, masked and sustained hypertension in a population of non-European adolescents assessed by home BP monitoring was 7.5%, 2.2% and 1.7% respectively. Male sex was positively associated with white-coat hypertension in these adolescents while BMI was positively associated with both white-coat and sustained hypertension.


Asunto(s)
Monitoreo Ambulatorio de la Presión Arterial/métodos , Hipertensión de la Bata Blanca/epidemiología , Adolescente , Índice de Masa Corporal , Brasil , Estudios Transversales , Femenino , Humanos , Hipertensión/etiología , Modelos Logísticos , Masculino , Prevalencia , Factores de Riesgo , Factores Sexuales , Hipertensión de la Bata Blanca/etiología
18.
J Hypertens ; 36(1): 61-68, 2018 01.
Artículo en Inglés | MEDLINE | ID: mdl-28763343

RESUMEN

OBJECTIVE: Evidence on normal range of home blood pressure (BP) in adolescents relies on only one European study. This study aims to investigate the normal range of home BP in a healthy non-European population of adolescents. METHODS: Cross-sectional study with a representative sample of secondary school students (12-17 years) from a Brazilian state capital. Adolescents' heights were classified in percentiles according to age and sex. Height percentiles were divided in 50th or less or more than 50th percentile. The home BP protocol included two day-time and two evening-time measurements over 6 days. Exams were considered valid with at least 12 measurements. RESULTS: A total of 1024 adolescents were included, mean age 15.21 ±â€Š1.61 years, mostly women (52.4%), from public schools (68.4%) and nonwhite (51.3%). The 50th (midpoint of distribution) and the 95th percentile (upper normal limit) for home SBP and DBP in adolescents are provided by sex, age and height percentiles. There was a marked increase in the estimated 95th percentile for home SBP with increasing age in men for both height percentiles examined (16 mmHg for ≤50th percentile and 14.5 mmHg for >50th percentile) and less so for home DBP (1 and 5 mmHg, respectively). In women, the 95th percentile increase with age was less significant for SBP and similar for DBP when compared with men in the two height percentiles evaluated (6/2 mmHg for ≤50th percentile and 4/4 mmHg for >50th percentile). CONCLUSION: Reference values for home BP by height percentiles for age and sex in a non-European population of adolescents are provided.


Asunto(s)
Presión Sanguínea , Adolescente , Determinación de la Presión Sanguínea , Estatura , Brasil , Estudios Transversales , Femenino , Humanos , Masculino , Valores de Referencia , Instituciones Académicas
19.
J Pediatr (Rio J) ; 94(2): 184-191, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-28843059

RESUMEN

OBJECTIVE: The management of children with low birth weight is not the same in countries with different resources. The authors assessed the association of birth weight with blood pressure and nutritional status in a representative sample of adolescents from a Brazilian state, aiming to identify possible consequences of these differences. METHODS: A cross-sectional school-based study was conducted with adolescents (12-18 years) enrolled in public and private schools. Birth weight, office blood pressure, home blood pressure measurements, and nutritional status (body mass index, height z-score for the age, and waist circumference) were assessed. The association of birth weight with the outcomes (blood pressure, height, body mass index, and waist circumference) was studied through univariate and multivariable linear regression models. RESULTS: A total of 829 adolescents with a mean age of 14.6±1.62 years were included; 43.3% were male, and 37.0% from private schools. The prevalence of low birth weight was 8.7%. Mild low height prevalence was higher among those adolescents with low/insufficient birth weight when compared to those with normal/high birth weight (11.7 vs. 4.2%; p<0.001). In the multiple linear regression analysis, for each increase of 100g in birth weight, height increased by 0.28cm (95% CI: 0.18-0.37; p<0.01). Birth weight did not influence office blood pressure and home blood pressure, body mass index, or waist circumference of adolescents. CONCLUSIONS: Birth weight was directly associated to height, but not associated to blood pressure, body mass index, and waist circumference in adolescents from an urban area of a developing country.


Asunto(s)
Peso al Nacer/fisiología , Índice de Masa Corporal , Hipertensión/fisiopatología , Estado Nutricional/fisiología , Adolescente , Presión Sanguínea/fisiología , Niño , Estudios Transversales , Femenino , Humanos , Hipertensión/diagnóstico , Masculino , Factores Socioeconómicos , Circunferencia de la Cintura
20.
Motriz (Online) ; 24(1): e1018140, 2018. tab, ilus
Artículo en Inglés | LILACS | ID: biblio-895045

RESUMEN

AIMS: To compare the internal and external load and the recovery by playing position and the match outcome (wins, losses or draws) in professional soccer. METHODS: 23 male professional soccer athletes from a team of the first division of the Brazilian Championship took part into the study (age 26.1 ± 3.8 years old, weight 77.5 ± 5.0 kg, height 177.6 ± 5.1 cm). During the games, athletes were monitored by GPS and the variables of external loads were taken. Additionally, the session rating of perceived exertion (session RPE) and the perceived recovery scale (PRS) were collected 30 minutes and 40h after the end of the matches, respectively. RESULTS: The external load was greater on full-backs and defense midfielders (p<0.05). The full-backs cover higher total distances compared to attackers, and, compared to all the others positions, they have more stimuli > 20 km/h, covering higher distances >20 km/h; these stimuli makes them to perceive less recovered than defenders, defense and attack midfielders (p<0.05). Moreover, the defenders are those who cover lower distances by the minute and the defense midfielders are those who present the lower Peak Velocity (p<0.05). There were no significant differences between GPS variables, internal load and recovery. In addition, it was found a correlation between the external and the internal load (r=0.66; p=0.001). CONCLUSIONS: The GPS variables and the perceived recovery are influenced by the playing position, but not by the match outcome.(AU)


Asunto(s)
Humanos , Masculino , Adulto , Atletas , Rendimiento Atlético/fisiología , Fatiga , Fuerza Muscular , Fútbol/fisiología
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