RESUMEN
RESUMEN: Objetivo: esta investigación descriptiva hace un análisis de distintos factores del entorno escolar asociados al estado nutricional, específicamente al sobrepeso y obesidad, de estudiantes matriculados en diez escuelas públicas de La Unión de Cartago, Costa Rica, durante el 2015-2016. Metodología: se determinó el estado nutricional y características del estilo de vida de 1268 estudiantes, se evaluaron las meriendas, la alimentación del comedor estudiantil y las ventas de alimentos dentro de los centros educativos. Además, se utilizó un Sistema de Información Geográfica (SIG) para ubicar puntos de venta de alimentos y de recreación en un radio de 400 m alrededor de las escuelas. Resultados: el 35% de la muestra tenía exceso de peso. Los alimentos de las meriendas y aquellos vendidos dentro y fuera de las escuelas eran altamente energéticos y de bajo valor nutricional. En los comedores estudiantiles los tamaños de porción no eran adecuados y se servía en exceso alimentos fuente de carbohidratos. El 47% de estudiantes utilizaba juegos electrónicos más de tres veces por semana, el 65% no participaba en actividades deportivas y había desaprovechamiento de las clases de educación física. Solo tres escuelas tenían áreas de recreación disponibles y sus alrededores en buenas condiciones. Conclusión: diversos factores del entorno escolar pertenecientes al microsistema promueven la sobrealimentación y el sedentarismo, por lo que podrían estar contribuyendo con el exceso de peso en la población infantil.
ABSTRACT: Objective: this descriptive investigation makes an analysis of different school environment factors associated with nutritional status, specifically overweight and obesity, of students enrolled in ten public schools in La Union de Cartago, Costa Rica, during 2015-2016. Methodology: The study determinates the nutritional status and characteristics of the lifestyle of 1268 children. Also snacks taken by students, school meals and food sales within schools were evaluated. In addition, a Geographic Information System (GIS) was used to locate food points of sale and recreation areas within a radius of 400 m around the schools. Results: 35% of the children were overweight. Foods from snacks and those sold inside and outside of schools provide high amounts of energy and low nutritional value. Regarding meals provided in the school's cafeteria, the portion sizes were not adequate, and an excess of foods containing carbohydrate was served. 47% of the children played electronic games more than three times a week, 65% did not participate in sports activities and there was a lack of physical education classes. Only three schools had recreation areas available and their surroundings in good condition. Conclusion: several factors of the school environment belonging to the microsystem promote overfeeding and sedentary lifestyle, which could be contributing to excess bodyweight in children's population.
Asunto(s)
Humanos , Alimentación Escolar , Manejo de la Obesidad , Educación Alimentaria y Nutricional , Costa RicaRESUMEN
Background - Discovery and incorporation of biomarker panels to cancer studies enabled the understanding of genetic variation and its interference in carcinogenesis at molecular level. The potential association between single nucleotide polymorphism (SNP) 309 and increased development of tumors, such as hepatocellular carcinoma, has been subject to several studies. This is the first study on this association conducted in Brazil. Methods - 62 cases of cirrhotic patients with hepatocellular carcinoma surgically treated by partial hepatectomy (HPT) or by liver transplantation (LTX) from 2000 to 2009 at Santa Casa Hospital Complex, in the city of Porto Alegre, were retrospectively analyzed. Tumor samples from surgical specimen were collected and prepared for study in paraffin blocks. Results - Overall survival was 26.7 months in the HPT group and 62.4 months in the LTX group (P <0.01). Overall tumor recurrence was 66.7% in the HPT group (10/15) and 17% in the LTX group (8/47) (X²=13.602, P <0.01). Alpha-fetoprotein levels >200ng/mL, microvascular invasion and histological grade were associated with tumor recurrence (P <0.01). Recurrence rates in each surgical group and analysis of factors associated with tumor recurrence, when stratified for each genotypic pattern, were both not statistically significant. Conclusion - G/G genotype was not associated with tumor recurrence after surgical treatment and it did not show any correlation with other prognostic factors.
Contexto - A descoberta e incorporação de painéis de biomarcadores aos estudos do câncer permitiram o conhecimento de variações genéticas e sua interferência no processo de carcinogênese. A possibilidade de associação do polimorfismo de nucleotídeo simples T309G do gene MDM2 com o aumento da formação de tumores, dentre eles o hepatocarcinoma, tem sido alvo de diversos estudos. Objetivo - Analisar a influência do polimorfismo T309G do gene MDM2 na recidiva tumoral de pacientes cirróticos com hepatocarcinoma submetidos a tratamento cirúrgico. Métodos - Foram analisados retrospectivamente pacientes cirróticos com carcinoma hepatocelular submetidos a tratamento cirúrgico (hepatectomia parcial ou transplante hepático) no período de 2000 a 2009, na Santa Casa Hospital Complex in Porto Alegre, South Brazil. Foram coletadas amostras de fragmentos tumorais da peça operatória (fígado explantado ou segmento hepático), as quais foram preparadas para estudo em bloco parafinado. Resultados - A sobrevida global foi de 26,7 meses para o grupo hepatectomias e 62,4 meses para o grupo transplante hepático (P <0,01), havendo 66,7% de recidiva global no grupo hepatectomias (10/15), e 17% no grupo transplante hepático (8/47) (X²=13,602, P <0.01). Níveis de AFP>200ng/mL correlacionaram-se com a recidiva tumoral em ambos os subgrupos cirúrgicos. Observou-se que 83,3% dos pacientes com recidiva também apresentaram invasão microvascular ao exame anátomo-patológico (P <0,01). Não houve significância estatística quando a recidiva neoplásica foi avaliada para os diferentes genótipos e analisada para cada subgrupo cirúrgico. A análise dos fatores prognósticos relacionados à recidiva do hepatocarcinoma, quando estratificada para cada padrão genotípico, também não se mostrou significante. Conclusão - O nosso estudo revelou que o genótipo G/G não esteve associado à recidiva tumoral após o tratamento cirúrgico, seja nas hepatectomias parciais ou transplante hepático. Além disso, a presença desse genótipo não mostrou correlação com os fatores prognósticos estudados.