Tri-ponderal mass index as a tool for insulin resistance prediction in overweight adolescents: A cross-sectional study.

OBJECTIVE: The aims of this study were to assess the capacity of tri-ponderal mass index (TMI) to screen and predict insulin resistance (IR) in overweight Brazilian adolescents, comparing it with body mass index (BMI) predictive capacity; and to verify the IR predictive capacity of other assessment tools such as waist circumference (WC), and waist-to-height ratio (WHR). METHODS: A cross-sectional study was carried out with 217 overweight adolescents, from both sexes, between 12 and 18 y of age. The participants were classified as having IR according to a previous established cutoff point of ≤3.16. IR was determined by the homeostasis model assessment of insulin resistance. The other assessment tools were measured with standard protocols. RESULTS: There was no difference between TMI and BMI to explain the presence of IR. In girls, BMI presented a slightly better predictive capacity to explain IR than TMI. Moreover, WC was reported to be the most effective IR screening methods for girls. Receiver operating characteristic curves showed that TMI and BMI presented similar values of sensibility and specificity for boys. Nevertheless, BMI had a better sensibility and TMI had a better specificity for girls. Interestingly, WC demonstrated a strong sensibility for both sexes. CONCLUSIONS: TMI did not present a superior predictive accuracy for IR screening in overweight Brazilian adolescents when compared with BMI. TMI and BMI presented similar values of sensitivity and specificity for boys and WC a slightly superior IR predictive capacity for girls.

Triglyceride/glucose index is a reliable alternative marker for insulin resistance in South American overweight and obese children and adolescents.

Background The aim of the present study was to investigate the correlation between the triglyceride/glucose index (TyG index) and homeostasis model assessment of insulin resistance (HOMA-IR). Additionally, we compared the ability of the TyG index and triglycerides/high-density lipoprotein cholesterol (TG/HDL-c) index and the combination of these two indices (TyG index plus TG/HDL-c) to predict insulin resistance (IR) in South American overweight and obese children and adolescents. Methods A cross-sectional study was carried out in 345 overweight adolescents aged 10-18 years, from both the sexes. The TyG index was calculated as Ln (fasting triglycerides [mg/dL] × fasting glucose [mg/dL])/2, while the TG/HDL-c index was calculated by the division of TG (mg/dL) by HDL-c (mg/dL). HOMA-IR was calculated with the formula: fasting insulin (FI) (U/mL) × fasting glucose (mmol/L)/22.5. The cut-off point used to determine the presence of IR was HOMA-IR ≥ 3.16. Results The TyG index showed a positive correlation with HOMA-IR. The area under the receiver operating characteristic (ROC) curve of the TyG index was 0.74, indicating good sensitivity (75.7%) and specificity (67.4%). Furthermore, the TyG index cut-off point of >4.44 was established for IR prediction in this population. Conclusions The TyG index is a simple and cost-effective surrogate marker of IR in South American overweight children and adolescents. Moreover, due to its good accessibility, it can be used in large epidemiological studies.

Intestinal parasitosis and environmental contamination with helminths and protozoa in a Quilombola community of southeast Brazil / Parasitismo intestinal y contaminación ambiental con helmintos y protozoarios en una comunidad quilombola del sudeste de Brasil

Introduction: Intestinal parasitosis by helminths and protozoa is still today a global public health problem mainly affecting people living in conditions of social vulnerability, including rural communities. Objective: Describe human intestinal parasitosis and environmental contamination with helminths and protozoa in the Quilombola community of Quartel do Indaiá (of African descent) in the State of Minas Gerais, Brazil. Methods: A cross-sectional study was conducted of stool and soil samples by spontaneous sedimentation, and of plant samples by centrifugation sedimentation, to detect intestinal helminths and protozoa. Water samples were analyzed for total and fecal coliforms. Results: Helminths and protozoa were found in 45.5 percent of the people (n = 66). The species detected were Ascaris lumbricoides (18.2 percent), Entamoeba coli (18.2 percent), Endolimax nana (18.2 percent), ancylostoma (6.1 percent, Iodamoeba butschlii (4.6 percent), Giardia duodenalis (3 percent) and Trichuris trichiura (1.5 percent). More than one species were present in 19.7 percent of the samples. In 18 of the 39 sites sampled, the soil was contaminated with E. coli, E. nana, A. lumbricoides, I. butschlii and/or Enterobius vermicularis. Vegetables (n = 135) were contaminated in 75 samples with 7 of the 8 species analyzed. The contaminants were E. coli cysts, A. lumbricoides eggs and ancylostoma. All water samples were contaminated with total and fecal coliforms. Conclusions: The Quilombola community of Quartel do Indaiá had high levels of human infection and high environmental contamination with intestinal parasites or protozoa, probably due to lack of appropriate sanitary conditions. It is necessary to improve the access to treated water and sanitation(AU)

Introducción: El parasitismo intestinal por helmintos y protozoarios todavía es un problema de salud pública mundial, que afecta sobre todo personas en condiciones de vulnerabilidad social, incluso las comunidades rurales. Objectivo: Describir la infección humana y la contaminación ambiental por parásitos/comensales intestinales en una comunidade 'quilombola' Quartel do Indaiá (descendentes de esclavos) del Estado de Minas Gerais, Brasil. Métodos: Estudio de corte transversal con análisis de muestras fecales y de tierra por sedimentación espontánea, y de vegetales por sedimentación con centrifugación para detección de parásitos o comensales intestinales. Se analizaron muestras de agua para detección de coliformes totales y fecales. Resultados: Se observó la ocurrencia de parásitos o comensales en 45.5 por ciento de las personas (n = 66). Las especies detectadas fueron Ascaris lumbricoides (18,2 por ciento), Entamoeba coli (18,2 por ciento), Endolimax nana (18,2 por ciento), anquilostomas (6.1 por ciento), Iodamoeba butschlii (4,6 por ciento), Giardia duodenalis (3 por ciento), and Trichuris trichiura (1,5 por ciento). Para 19,7 por ciento de las muestras se detectaron más de una especie. El suelo estuvo contaminado en 18 de los 39 sitios muestreados, con presencia de E. coli, E. nana, A. lumbricoides, I. butschlii y/o Enterobius vermicularis. Los vegetales (n = 135) presentaron contaminación en 75 muestras de 7, entre 8 especies analizadas. Sus contaminantes fueron quistos de E. coli y huevos de A. lumbricoides y anquilostoma. Todas las muestras de agua estaban contaminadas por coliformes totales y fecales. Conclusiones: La comunidad 'quilombola' Quartel do Indaiá presentó alta infección humana y alta contaminación ambiental por parásitos o comensales intestinales, lo que se debe probablemente a la falta de condiciones sanitarias. Se necesita mejorar el acceso para agua tratada y estructuras de saneamiento(AU)

Multidisciplinary obesity treatment program improved health-related quality of life and positively correlated with anthropometric and body composition but not with cardiorespiratory fitness parameters in adolescents.

PURPOSE: The aim of the present study was to verify the effects of a 16-week multidisciplinary obesity treatment program (MOTP) on health-related quality of life (HRQoL) in adolescents with weight excess. In addition, we verified a possible association between changes on HRQoL and anthropometric, body composition, and cardiorespiratory fitness (CRF) parameters. METHODS: Two hundred four adolescents aged from 15 to 18 years were distributed in control group (CG) and intervention group (IG). They underwent a 16-week MOTP composed by nutritional, psychological, and health-related physical activity group sessions. Moreover, they performed physical exercise sessions three times per week during the whole 16-week program. Data on HRQoL, body composition, CRF and anthropometry were collected using standard protocols and validated questionnaires. RESULTS: The MOTP promoted significant enhancements in all HRQoL domains, except for the school domain in IG. Furthermore, positive correlations between HRQoL and body weight (BW), body fat (BF), waist circumference (WC), and body mass index (BMI) z-score were verified. Higher scores of HRQoL might be achieved by improving these variables. CONCLUSIONS: The 16-week MOTP was effective to improve HRQoL in adolescents with weight excess. This improvement has a positive correlation with enhancements in BW, BMI z-score, WC, and BF. Nevertheless, these findings have not reached a consensus on literature and still need to be further enlightened.

DETECTION OF INTESTINAL PARASITES IN THE ENVIRONMENTS OF A PUBLIC SCHOOL IN THE TOWN OF DIAMANTINA , MINAS GERAIS STATE, BRAZIL.

Intestinal parasites are a major public health problem in developing countries, most prevalent in areas where sanitation is poor and the population's hygiene is inadequate. They affect people of all ages, although school-age children are the most susceptible. In this study, we investigated the presence of intestinal parasites in the shared environments of a public school in the town of Diamantina, Minas Gerais State. From December 2012 to February 2013, samples were collected for three months (once a month) by using the Graham method (1941), in duplicate, by affixing a 6 x 5 cm clear tape, six times in each collection site, in a space of about 30 cm2. Then, each tape was positioned longitudinally on a microscope slide and the identification of the biological forms of the parasites was performed with the aid of a 40X objective from an optical microscope. Eleven sites were selected for sampling. Cysts of Entamoeba coli were the most frequently found in this study (50%), followed by Hymenolepis diminuta eggs (27.6%), Iodamoeba butschllii cysts (5.6%), Ascaris lumbricoides eggs (5.6%), Taenia species eggs (5.6%) and hookworm eggs (5.6%). The highest positivity rates were found in the samples drawn from the cafeteria's eating table. The results have indicated the need to improve the cleaning in the school environments, as well as the development of educational practices that may help in the preservation of public health.

[Evaluation of image parameters of pelvic adnexal masses in tele-echography]. / Avaliação dos parâmetros de imagens de massas anexiais pélvicas em tele-ecografia.

PURPOSE: To evaluate the sonographic parameters related to morphological characteristics of pelvic adnexal masses by obtaining two-dimensional images by an observer presence, forwarded electronically (via tele-ultrasound) in static and dynamic modes observers do not face (distance) for comparative analyzes inter intraobserver and to the validation of a second opinion. METHODS: From March to August 2010 were selected 50 patients with adnexal mass viewing of the pelvic ultrasound. They were subjected to ultrasound for abdominal and transvaginal routes. The images were captured in static and dynamic modes, electronically forwarded for evaluation of non-presence and two examiners evaluated according to morphological ultrasonographic parameters previously determined. RESULTS: The evaluators did not face in static and dynamic modes obtained almost perfect agreement for all morphological parameters with Kappa values between 0.6 and 0.8. There was no difference between the methods employed, except for the morphological parameter papillary projection in the static mode, in which the agreement was almost perfect (0.8) while in dynamic mode was substantial (0.6). CONCLUSIONS: The sonographic parameters of the features of adnexal masses pelvic sent by tele-ultrasound are capable of being validated for issuing a second opinion. There were no significant differences in the methodology used in the issue of tele-ultrasound images (static or dynamic) to characterize the composition of pelvic adnexal masses.