Evaluation of self-care with feet among patients with diabetes mellitus.

BACKGROUND: The diabetic foot is a complication of diabetes mellitus (DM) and is the most common cause of lower limb amputation. OBJECTIVES: To assess foot self-care practices by sex and educational level in DM patients from the Northeast of Brazil, state of Bahia. METHODS: This was a quantitative, cross-sectional, observational, analytical study with 88 DM patients seen at routine consultations from February to March of 2020. Data were collected using questionnaires on socioeconomic data and self-care of feet (knowledge about the diabetic foot, habits related to care/inspection of feet, and visits to the Healthcare Center when changes to foot health are detected). RESULTS: 58% of the sample did not know the term "diabetic foot", but a majority did perform minimum adequate foot care practices, such as inspecting feet (60.2%), moisturizing feet (65.9%), avoiding walking barefoot (81.8%), and trimming toenails (92%), although 90.9% did not wear footwear considered appropriate. There was a relationship between lower educational level and worse performance in questions relating to walking barefoot, moisturizing feet, trimming toenails, wearing appropriate footwear, and identifying mycoses (p < 0.05), but there was no association between performing self-care activities and sex. CONCLUSIONS: Interviewed patients with DM did not perform all foot self-care activities and did not know what the term "diabetic foot" means. There was an association between lower educational level and reduced capacity to perform these activities, which suggests that health literacy is important to improve self-care of feet, contributing to reduce complications and foot amputations.

Avaliação do autocuidado com os pés entre pacientes portadores de diabetes melito / Evaluation of self-care with feet among patients with diabetes mellitus

Resumo Contexto O pé diabético é uma complicação do diabetes melito (DM), sendo a maior causa de amputação dos membros inferiores. Objetivos Avaliar a prática de medidas de autocuidado com os pés, segundo sexo e escolaridade, em pacientes portadores de DM na região nordeste no estado da Bahia. Métodos Estudo quantitativo, observacional, analítico, transversal, realizado com 88 pacientes portadores de DM, em consulta de rotina, de fevereiro a março de 2020. A coleta de dados foi executada através da aplicação de questionários socioeconômico e do autocuidado com os pés (conhecimento sobre pé diabético, hábitos de cuidado/inspeção dos pés e procura pela Unidade de Saúde na presença de alterações com a saúde dos pés). Resultados Do total, 58% dos indivíduos desconhecia o termo "pé diabético", porém possuíam cuidados mínimos adequados com os pés, como inspecioná-los (60,2%), hidratá-los (65,9%), não andar descalço (81,8%) e cortar as unhas (92%), apesar de 90,9% não utilizar sapatos considerados adequados. Houve relação entre menor nível de escolaridade e pior desempenho nas questões referentes a andar descalço, hidratar os pés, cortar as unhas, usar calçados adequados e identificar micoses (p < 0,05), porém não houve associação da realização das medidas de autocuidado e sexo. Conclusão Os portadores de DM entrevistados não realizaram todas as medidas de autocuidado com os pés e desconheciam o termo "pé diabético". Houve associação entre menor escolaridade e menor capacidade de realização dessas medidas, o que sugere que o letramento em saúde seria importante para melhoria desse autocuidado, contribuindo para diminuição de complicações e amputações dos pés.

Abstract Background The diabetic foot is a complication of diabetes mellitus (DM) and is the most common cause of lower limb amputation. Objectives To assess foot self-care practices by sex and educational level in DM patients from the Northeast of Brazil, state of Bahia. Methods This was a quantitative, cross-sectional, observational, analytical study with 88 DM patients seen at routine consultations from February to March of 2020. Data were collected using questionnaires on socioeconomic data and self-care of feet (knowledge about the diabetic foot, habits related to care/inspection of feet, and visits to the Healthcare Center when changes to foot health are detected). Results 58% of the sample did not know the term "diabetic foot", but a majority did perform minimum adequate foot care practices, such as inspecting feet (60.2%), moisturizing feet (65.9%), avoiding walking barefoot (81.8%), and trimming toenails (92%), although 90.9% did not wear footwear considered appropriate. There was a relationship between lower educational level and worse performance in questions relating to walking barefoot, moisturizing feet, trimming toenails, wearing appropriate footwear, and identifying mycoses (p < 0.05), but there was no association between performing self-care activities and sex. Conclusions Interviewed patientswith DM did not perform all foot self-care activities and did not know what the term "diabetic foot" means. There was an association between lower educational level and reduced capacity to perform these activities, which suggests that health literacy is important to improve self-care of feet, contributing to reduce complications and foot amputations.

Correlação entre o estado nutricional e a prevalência de enteroparasitoses em crianças de uma comunidade quilombola da cidade de Caetés, Pernambuco / Correlation between nutritional status and the prevalence of enteroparasitosis in children from a quilombola community in the city of Caetés, Pernambuco

As parasitoses intestinais afetam grande parte da população mundial, sobretudo, em países subdesenvolvidos que apresentam precárias condições de vida. O Brasil apresenta uma alta taxa de prevalência e elevado número de mortes representando uma grande problemática na saúde das crianças, pois pode levar a um estado de subnutrição com consequente comprometimento do desenvolvimento físico e intelectual. Verificar a associação entre as parasitoses intestinais e o estado nutricional de crianças da comunidade quilombola Atoleiro na cidade de Caetés-PE. Tratou-se de um estudo transversal, de cunho quantitativo, com a participação de 155 crianças, realizado no período entre abril a outubro de 2019. Os dados obtidos foram avaliados estatisticamente através do teste qui-quadrado x2 de Pearson com o objetivo de obter a correlação de crianças com presença ou ausência de protozoários e helmintos, tendo o valor significativo do (valor p < 0,05) ou marginalmente significativas (valor p < 0,10). Os responsáveis foram questionados sobre as condições socioeconômicos em que viviam. Foi realizado exame parasitológico de fezes a partir das técnicas de Hoffmann e Kato-Katz e o estado nutricional foi avaliado através de um estadiômetro portátil e balança digital e classificado a partir dos indicadores peso/idade, estatura/ idade, peso/estatura e índice de massa corpórea/idade de acordo com Ministério da Saúde. A maioria das crianças foram do sexo feminino 80 (52%) e média geral de ±5 anos. Ao todo foram 110 (70,97%) análises parasitológicas positivas. Destes resultados, 77 crianças (70%) apresentaram algum tipo de protozoário, 32 (29,09%) helmintos e 1 criança (0,91%) poliparasitismo. Percebeu-se ainda que a maioria das crianças obtiveram uma estatura adequada quando comparado a idade 110 (70,97%). Foi elaborado um livreto e um vídeo em forma de cordel com o objetivo de levar para a comunidade informações sobre a prevenção e a promoção em saúde. Evidenciou-se que há grandes problemas relacionados às condições sanitárias da comunidade, sendo estes um dos fatores que contribuíram para o surgimento das infecções parasitárias. A alta prevalência de crianças parasitadas esteve associada aos determinantes socioeconômicos, culturais e ambientais. Percebeu-se que os achados nutricionais como magreza e magreza acentuada foram expressivos, sendo a carência nutricional um agravo expressivo, mesmo não havendo associação estatisticamente significante entre o estado nutricional e as crianças parasitadas.

Intestinal parasitic infections affect a large part of the world population, especially in underdeveloped countries that have precarious living conditions. Brazil has a high prevalence rate and a high number of deaths, representing a major problem in children's health, as it can lead to a state of malnutrition with consequential impairment of physical and intellectual development. The objective of this study was to verify the association between intestinal parasitosis and the nutritional status of children from the Atoleiro quilombola community in the city of Caetés-PE. This was a cross-sectional study, of a quantitative nature, with the participation of 155 children, carried out between April and October 2019. The data obtained were statistically evaluated using Pearson's chi-square (X2) test in order to obtain correlation of children with the presence or absence of protozoa and helminths, reporting significant (p-value <0.05) or marginally significant (p-value <0.10) values. Those responsible were asked about the socioeconomic conditions in which they lived. Parasitological examination of feces was carried out using the techniques of Hoffmann and Kato-Katz and the nutritional status was assessed using a portable stadiometer and digital scale and classified using the weight/age, height/age, weight/height, and body mass index/age according to the Ministry of Health. Most of the children were female (n=80; 52%) and the general mean was ±5 years old. Altogether there were 110 (70.97%) positive parasitological analyses. Of these results, 77 children (70%) presented some type of protozoan, 32 (29.09%) helminths, and 1 child had polyparasitism (0.91%). It was also noticed that most children obtained an adequate height when compared to age (n=110; 70.97%). A booklet and a video in the form of a string were created with the aim of bringing information about prevention and health promotion to the community. It became evident that there are major problems related to the health conditions of the community, which is one of the factors that contributed to the emergence of parasitic infections. The high prevalence of parasitized children was associated with socioeconomic, cultural, and environmental determinants. It was noticed that the nutritional findings, such as thinness and substantial thinness, were significant, with nutritional deficiencies being a significant problem; even though there was no statistically significant association between nutritional status and parasitized children.

Agreement of body adiposity index (BAI) and paediatric body adiposity index (BAIp) in determining body fat in Brazilian children and adolescents.

OBJECTIVE: To evaluate agreement of the body adiposity index (BAI) and paediatric body adiposity index (BAIp) in estimating body fat compared with dual-energy X-ray absorptiometry (DXA) and to propose cut-off points for these indices to classify excess adiposity in Brazilian children and adolescents. DESIGN: Cross-sectional study. Measures of weight, height, hip circumference, BMI and body fat percentage (%BF) assessed by DXA were taken, and BAI and BAIp were calculated. The Bland-Altman plot was used to estimate agreement between the methods, and the receiver-operating characteristic curve to determine the cut-off points for BAI and BAIp per age and sex in comparison with DXA. SETTING: Viçosa, Minas Gerais, Brazil. SUBJECTS: Children and adolescents aged 8-19 years (n 1049). RESULTS: Of the children and adolescents, 52·4 % were girls. BAI and BAIp had satisfactory performance by the receiver-operating characteristic curve, except for the 18-19 years age group, whose BAIp had better predictive capacity than BAI. The agreement analysis showed that BAI overestimated %BF by 2·64 %, on average, using DXA; while BAIp underestimated %BF by 3·37 %. CONCLUSIONS: BAI and BAIp showed low agreement with the body fat obtained by DXA, requiring caution when interpreting body composition data in children and adolescents.

Overweight and Body Image Perception in Adolescents with Triage of Eating Disorders.

PURPOSE: To verify the influence of overweight and alteration in the perception of the corporal image during the triage of eating disorders. METHOD: A food disorder triage was performed in adolescents with 10 to 19 years of age using the Eating Attitudes Test (EAT-26), Children's Eating Attitudes Test (ChEAT), and Bulimic Investigatory Test Edinburgh (BITE), as well as a nutritional status evaluation. The perception of body image was evaluated in a subsample of adolescents with 10 to 14 years of age, using the Brazilian Silhouette Scale. The project was approved by the Human Research Ethics Committee of the Federal University of Viçosa, Minas Gerais, Brazil. RESULTS: The prevalence of eating disorder triage was 11.4% (n = 242) for the 2,123 adolescents evaluated. Overweight was present in 21.1% (n = 447) of the students, being more prevalent in the early adolescence phase, which presented levels of distortion of 56.9% (n = 740) and dissatisfaction of 79.3% (n = 1031). Body dissatisfaction was considered as a risk factor, increasing by more than 13 times the chance of TA screening. CONCLUSION: Overweight was correlated with the ED triage and body dissatisfaction was considered as a risk factor, increasing the chances of these disorders by more than 13 times.

Anthropometric profile, body composition and body image perception of adolescents with positive screening for eating disorders / Perfil antropométrico, composición corporal y percepción de la imagen corporal en adolescentes con detección positiva para los trastornos alimentarios

ABSTRACT Our aim was to associate anthropometric profile, body composition and body image perception with a positive screening for eating disorders in adolescents aged 10 to 14 years. The screening for eating disorders was carried out using the Eating Attitudes Test (EAT-26), Children's Eating Attitudes Test (ChEAT) and Bulimic Investigatory Test Edinburgh (BITE). Weight, height and percentage of body fat were measured, the latter by a vertical bipolar bioimpedance. Body image perception was assessed using the Brazilian Silhouette Scale. The project was approved by the Ethics Committee for Human Research of the Federal University of Viçosa, Minas Gerais, Brazil. 1,300 adolescents were evaluated. The prevalence of screening for eating disorders was 5.5% (n= 71), overweight was 26.1% (n= 339) and high body fat percentage was 38.5% (n= 500). Body distortion was present in 56.9% (n= 740) of adolescents and body dissatisfaction was 79.3% (n= 1,031). Body Mass Index, the percentage of body fat and body dissatisfaction were considered risk factors for positive screening for eating disorders. It is important to evaluate the physical changes in adolescence and their implications on body dissatisfaction, the main risk factor for the development of eating disorders.

RESUMEN El objetivo de ese estudio fue asociar el perfil antropométrico, la composición corporal y la percepción de la imagen corporal con un screening positivo de los trastornos alimentarios en adolescentes de 10 a 14 años. Se realizó la aplicación del Eating Attitudes Test (EAT-26), Children's Eating Attitudes Test (ChEAT) y Bulimic Investigatory Test Edinburg (BITE) para evaluar la detección de trastornos alimentarios. Se midió el peso, la talla, porcentaje de grasa corporal y la percepción de la imagen corporal. El proyecto fue aprobado por el Comité de Ética para la Investigación Humana de la Universidad Federal de Viçosa, Minas Gerais, Brasil. Se evaluó a 1.300 adolescentes y la prevalencia de detección de trastornos alimentarios fue del 5,5% (n= 71). La prevalencia de sobrepeso fue de 26,1% (n= 339) y porcentaje de grasa corporal alto fue 38,5% (n= 500). La distorsión corporal estuvo presente en el 56,9% (n= 740) de los adolescentes, y la insatisfacción corporal fue de 79,3% (n= 1,031). El Índice de Masa Corporal real, el porcentaje de grasa corporal y la insatisfacción corporal fueron considerados factores de riesgo para la detección positiva de trastornos alimentarios. Es importante evaluar los cambios físicos en la adolescencia y sus implicaciones en la insatisfacción corporal, factor de riesgo para el desarrollo de trastornos alimentarios.

Síndrome do ovário policístico e fatores relacionados em adolescentes de 15 a 18 anos / Polycystic ovary syndrome and intervening factors in adolescents from 15 to 18 years old

OBJETIVO: Avaliar os fatores relacionados à presença da síndrome do ovário policístico (SOP) em adolescentes. MÉTODOS: Estudo transversal, com adolescentes do sexo feminino de 15 a 18 anos, divididas em grupo 1 (com diagnóstico médico de SOP) e grupo 2 (sem diagnóstico da síndrome). Utilizou-se o índice estatura para idade e índice de massa corporal para classificação do estado nutricional, e aplicou-se questionário semiestruturado. Foram aplicados testes de Mann-Whitney, Exato de Fisher, correlação de Spearman e regressão logística. RESULTADOS: Foram avaliados 485 adolescentes, com idade média de 16,3 ± 0,9 anos. A prevalência de SOP foi de 6,2%. Não se encontrou diferença entre os grupos quanto aos parâmetros antropométricos e tempo de uso de anticoncepcionais, porém houve diferença quanto à idade da menarca (p < 0,004), e a mais tardia foi fator de proteção para síndrome. CONCLUSÃO: verificou-se associação entre a ocorrência da menarca mais cedo e o desenvolvimento da SOP em adolescentes.

OBJECTIVE: To assess the factors related to the presence of polycystic ovary syndrome (PCOS) in adolescents. METHODS: This was a cross-sectional study, with female adolescents from 15 to 18 years old, divided into: group 1 (with a medical diagnosis of PCOS) and group 2 (not diagnosed with PCOS). The height-for-age index and the body mass index were used for classifying the nutritional status, and a semi-structured questionnaire was applied. The Mann-Whitney test, Fisher's exact test, Spearman correlation coefficients, and logistic regressionwere used. RESULTS: This study evaluated 485 adolescents with an average age of 16.3 ± 0.9 years old. The prevalence of PCOS was 6.2%. No difference was found between the groups regarding anthropometric parameters and period of contraceptive use; however, there were differences regarding the age at menarche (p < 0.004). Older age at menarche was a protection factor against the syndrome. CONCLUSION: An association was found between younger age at menarche and the development of the PCOS in adolescents.

Polycystic ovary syndrome and intervening factors in adolescents from 15 to 18 years old.

OBJECTIVE: To assess the factors related to the presence of polycystic ovary syndrome (PCOS) in adolescents. METHODS: This was a cross-sectional study, with female adolescents from 15 to 18 years old, divided into: group 1 (with a medical diagnosis of PCOS) and group 2 (not diagnosed with PCOS). The height-for-age index and the body mass index were used for classifying the nutritional status, and a semi-structured questionnaire was applied. The Mann-Whitney test, Fisher's exact test, Spearman correlation coefficients, and logistic regression were used. RESULTS: This study evaluated 485 adolescents with an average age of 16.3 ± 0.9 years old. The prevalence of PCOS was 6.2%. No difference was found between the groups regarding anthropometric parameters and period of contraceptive use; however, there were differences regarding the age at menarche (p < 0.004). Older age at menarche was a protection factor against the syndrome. CONCLUSION: An association was found between younger age at menarche and the development of the PCOS in adolescents.

Body fat equations and electrical bioimpedance values in prediction of cardiovascular risk factors in eutrophic and overweight adolescents.

The aim of this study was to analyze body fat anthropometric equations and electrical bioimpedance analysis (BIA) in the prediction of cardiovascular risk factors in eutrophic and overweight adolescents. 210 adolescents were divided into eutrophic group (G1) and overweight group (G2). The percentage of body fat (% BF) was estimated using 10 body fat anthropometric equations and 2 BIA. We measured lipid profiles, uric acid, insulin, fasting glucose, homeostasis model assessment-insulin resistance (HOMA-IR), and blood pressure. We found that 76.7% of the adolescents exhibited inadequacy of at least one biochemical parameter or clinical cardiovascular risk. Higher values of triglycerides (TG) (P = 0.001), insulin, and HOMA-IR (P < 0.001) were observed in the G2 adolescents. In multivariate linear regression analysis, the % BF from equation (5) was associated with TG, diastolic blood pressure, and insulin in G1. Among the G2 adolescents, the % BF estimated by (5) and (9) was associated with LDL, TG, insulin, and the HOMA-IR. Body fat anthropometric equations were associated with cardiovascular risk factors and should be used to assess the nutritional status of adolescents. In this study, equation (5) was associated with a higher number of cardiovascular risk factors independent of the nutritional status of adolescents.