Fatores de risco associados à hipertensão arterial em adolescentes / Risk factors associated with arterial hypertension in adolescents

OBJETIVO: Investigar os fatores de risco associados à hipertensão arterial primária em adolescentes. MÉTODOS: Estudo caso-controle de base ambulatorial com adolescentes, de 12 a 20 anos incompletos, todos provenientes do Núcleo de Estudos da Saúde do Adolescente da Universidade Estadual do Rio de Janeiro. O estado nutricional foi avaliado através do índice de massa corporal. Obteve-se ainda a medida da circunferência abdominal, estatura, história familiar de hipertensão arterial, peso ao nascer e desenvolvimento puberal. A análise foi elaborada através de regressão logística não condicional. RESULTADOS: Participaram 91 casos e 182 controles. O índice de massa corporal mostrou-se associado à hipertensão. A estatura mostrou associação positiva com hipertensão apenas em meninas. Não se evidenciou associação entre desenvolvimento puberal e peso ao nascer com hipertensão arterial na adolescência. Por outro lado, a história familiar, principalmente quando ambos os pais são hipertensos, apresentou forte associação, tanto em meninos (OR = 13,32; IC95 por cento 2,25-78,94), como em meninas (OR = 11,35; IC95 por cento 1,42-90,21). CONCLUSÕES: Em nosso estudo, sobrepeso, obesidade e história familiar de hipertensão (pai e mãe hipertensos) foram os principais fatores de risco para o desenvolvimento de hipertensão arterial em adolescentes.

OBJECTIVE: To investigate the risk factors associated with essential arterial hypertension in adolescents. METHODS: A case-control, outpatients-based study of adolescents, aged 11 to 19 years, all treated at the Center for Studies into Adolescent Health (Núcleo de Estudos da Saúde do Adolescente) at Universidade Estadual do Rio de Janeiro. Nutritional status was assessed by means of body mass index. Data were also obtained on waist circumference, height, family history of arterial hypertension, birth weight and pubertal development. The analysis was performed using unconditional logistic regression. RESULTS: The study investigated 91 cases and 182 controls. Body mass index was associated with hypertension. Height had a positive association with hypertension only among the girls. There was no evidence of an association between pubertal development or birth weight with arterial hypertension in adolescence. In contrast, family history, particularly when both parents had hypertension, exhibited a robust association, both among the boys (OR = 13.32; 95 percentCI 2.25-78.94), and the girls (OR = 11.35; 95 percentCI 1.42-90.21). CONCLUSIONS: In our study, overweight, obesity and family history of hypertension (father and mother with hypertension) were the principal risk factors for arterial hypertension in adolescents.

Risk factors associated with arterial hypertension in adolescents.

OBJECTIVE: To investigate the risk factors associated with essential arterial hypertension in adolescents. METHOD: A case-control, outpatient-based study of adolescents aged 11 to 19 years treated at the Center for Studies into Adolescent Health (Núcleo de Estudos da Saúde do Adolescente) at the Universidade Estadual do Rio de Janeiro. Nutritional status was assessed by means of body mass index. Data were also obtained on waist circumference, height, family history of arterial hypertension, birth weight and pubertal development. The analysis was performed using unconditional logistic regression. RESULTS: The study investigated 91 cases and 182 controls. Body mass index was associated with hypertension. Height had a positive association with hypertension only among the girls. There was no evidence of an association between pubertal development or birth weight with arterial hypertension in adolescence. In contrast, family history, particularly when both parents had hypertension, exhibited a robust association, both among the boys (OR = 13.32; 95%CI 2.25-78.94), and the girls (OR = 11.35; 95%CI 1.42-90.21). CONCLUSIONS: In our study, overweight, obesity and family history of hypertension (father and mother with hypertension) were the principal risk factors for arterial hypertension in adolescents.

Neurological manifestations in HTLV-I-infected blood donors.

The human T-cell lymphotropic virus type 1 (HTLV-I) causes a neurological disease known as HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP) in a minority of infected individuals. Although other neurological outcomes have been described their prevalence is presently unknown. To evaluate the frequency and characteristics of neurological involvement in a population of HTLV-I-infected blood donors we investigated 196 HTLV-I positive and 196 negative blood donors from a blood center of Rio de Janeiro, Brazil. Individuals with abnormalities at the neurological examination were examined by three neurologists, and when pertinent, additional neurological investigations were performed. Descriptive analysis, Student's t-test and chi2 test were employed for statistical analysis. Neurological abnormalities were found in 71 (36.2%) of the HTLV-I positive blood donors and in only 29 (14.8%) of the HTLV-I negative donors (OR = 2.54, 95% CI = 1.67-3.59, p = 0.000002). Cases of myelopathy, motor neuron disease and myopathy were only found in the HTLV-I positive group. In addition, peripheral neuropathy (PN) was significantly more frequent in the positive group (p = 0.015). In summary, our data suggest that HTLV-I-infected individuals exhibit a wide variety of neurological manifestations apart from the classical picture of HAM/TSP.

TP53 mutations in breast cancer tumors of patients from Rio de Janeiro, Brazil: association with risk factors and tumor characteristics.

Somatic mutations in the TP53 gene are the most frequently observed genetic alterations in human malignancies, including breast cancer, which is one of the leading causes of death among women in Brazil. In our study, we determined the frequency and the pattern of TP53 mutations in malignant breast tumors from 120 patients living in Rio de Janeiro, Brazil. TP53 mutations were found in 20% of the tumors, which contained a diversity of mutation types: missense (62.5%), nonsense (8.3%), silent (4.2%), intronic (12.5%), insertion (4.2%) and deletion (8.3%). Of a total of 15 missense mutations, 4 were observed at Arg248 and 2 at Cys242, which are directly involved in DNA binding and in zinc binding, respectively. A subgroup of 51 patients was analyzed with respect to the relation between the presence of TP53 mutations and classical risk factors and with tumor and patient characteristics. For this analysis, we used logistic regression and, in order to obtain more precise confidence intervals, they were recalculated using a bootstrap resampling technique. Our results demonstrate that these mutations are not statistically associated with the risk factors or the patients' characteristics. However, the presence of TP53 mutations is strongly associated with the aggressiveness of the tumors, measured by Elston classification (OR = 11.97 and 95% CI of 2.24-307.05). This finding is in agreement with previous studies, which report the presence of TP53 mutations in tumors with poor prognosis. This correlation between tumor aggressiveness and TP53 mutations could be a crucial variable for the treatment and prognosis of breast cancer.

Doencas cronicas nao-transmissiveis no Brasil: dos fatores de risco ao impacto social / Noncommunicable chronic diseases in Brazil: from risk factors to social impact

Atualmente o perfil epidemiologico do Brasil acha-se representado pelo das doencas do subdesenvolvimento versus as da modernidade. Consequentemente, o pais enfrenta dificuldades no direcionamento simultaneo de acoes para a promocao da saude que contemplem controle, tanto das doencas transmissiveis quanto das doencas cronicas naotransmissiveis (DCNT). O presente trabalho objetivou descrever a situacao epidemiologica da saude do adulto brasileiro no que tange as DCNT e apresentar dados disponiveis sobre a qualidade assistencial e o impacto social destas doencas. Para isto realizou-se uma revisao da literatura desde que foi iniciada a producao e a divulgacao de dados sobre doencas cardiovasculares, cancer e diabetes (1964-1995). Foram leventadas 153 referencias bibliograficas e usadas 97. As autoras apontam as investigacoes basicas que poderiam ser realizadas em todas as regioes do pais para subsidiar o planejamento e a administracao de estrategias populacionais para fatores de risco e para tratamento e controle das doencas cronicas naotransmissiveis no Brasil (AU)

Diet and mortality from common cancers in Brazil: an ecological study

Realizou-se um estudo ecológico com base em dados de 10 capitais brasileiras e, através de análise de regressäo linear, examinou-se a associaçäo entre dieta e as taxas de mortalidade para as principais localizaçöes de câncer, entre adultos com 30 anos ou mais. As taxas de mortalidade ajustadas por idade variavam de 2,4 a 3,3 vezes entre as capitais. Consumo de energia associou-se positivamente com câncer de colon, pulmäo e esôfago (p menor ou igual 0,02 em cada associaçäo). Mortalidade por câncer de colon associou-se positivamente com o consumo de gordura, ovos, álcool, mate, cereais e vegetais (p menor ou igual 0,01); câncer de pulmäo associou-se ao consumo de mate e cereias (p menor ou igual 0,05); câncer de estômago associou-se positivamente com ovos (p=0,04) e, negativamente , com o consumo de fibras, frutas e vitaminas A e C (p menor ou igual 0,05). Câncer de esôfago foi positivamente associado com consumo de gordura e mate (p menor ou igual 0,05) e, negativamente, com vitamina A (p=0,02); câncer de próstata associou-se negativamente com vitamina C (p=0,007). Câncer de mama näo se associou a nenhum dos fatores estudados. A importante variaçäo nas taxas de mortalidade por câncer no Brasil podem ser parcialmente associadas as variaçöes em componentes da dietas ou a fatores a ale associados.

Doencas cronicas nao-transmissiveis no Brasil: dos fatores de risco ao impacto social / Noncommunicable chronic diseases in Brazil: from risk factors to social impact

Atualmente o perfil epidemiologico do Brasil acha-se representado pelo das doencas do subdesenvolvimento versus as da modernidade. Consequentemente, o pais enfrenta dificuldades no direcionamento simultaneo de acoes para a promocao da saude que contemplem controle, tanto das doencas transmissiveis quanto das doencas cronicas naotransmissiveis (DCNT). O presente trabalho objetivou descrever a situacao epidemiologica da saude do adulto brasileiro no que tange as DCNT e apresentar dados disponiveis sobre a qualidade assistencial e o impacto social destas doencas. Para isto realizou-se uma revisao da literatura desde que foi iniciada a producao e a divulgacao de dados sobre doencas cardiovasculares, cancer e diabetes (1964-1995). Foram leventadas 153 referencias bibliograficas e usadas 97. As autoras apontam as investigacoes basicas que poderiam ser realizadas em todas as regioes do pais para subsidiar o planejamento e a administracao de estrategias populacionais para fatores de risco e para tratamento e controle das doencas cronicas naotransmissiveis no Brasil (AU)