Analysis of the association between anxiety, depression and obesity in individuals with metabolic syndrome.

Objective. The aim of this study was to verify the association between anxiety, depression, and obesity in metabolic syndrome (MetS) patients. Methods. It is a retrospective study with 142 volunteers with MetS of both genders and age ≥20 years. Every subject responded to the hospital anxiety and depression scale (HADS). Data are shown as absolute and relative frequencies for categorical variables and a Pearson's chi-square test was performed to verify the association between anxiety or depression and body mass index (BMI). The value of p≤0.05 was considered to be statistically significant. Results. The frequency of anxiety and depression was 18.3% (n=26) and 12% (n=17), respectively. There was no significant association between anxiety or depression and BMI (p=0.481 and 0.079, respectively) in individuals with MetS. Conclusions. Although no association among anxiety, depression and obesity was found, the psychological factors should be added to the MetS treatment contributing to a more effective health care in order to find answers to manage and adhere to the conducts carried out from a more humanized and transdisciplinary perspective. The data also indicate that large sample and case-control methodology are required to obtain a more specific evaluation of this association.

Efeito da dieta hipocalórica na pressão arterial e demais cofatores da síndrome metabólica / Effect of hypocaloric diet on blood pressure and other cofactors of metabolic syndrome

Introdução: a hipertensão arterial sistêmica (HAS) está associada a fatores de risco metabólicos e pode ser definida como uma doença crônica multifatorial, com valores persistentes de pressão arterial sistólica (PAS) e (ou) pressão arterial diastólica (PAD) maiores ou iguais a 140 mmHg x 90 mmHg, respectivamente. A HAS é um dos fatores que compõem a síndrome metabólica (SM) juntamente com a hiperglicemia, dislipidemia e (ou) obesidade central. Modificações no estilo de vida, como a alimentação e perda de peso, demonstraram melhorar os parâmetros cardiometabólicos nos pacientes com HAS e SM. Objetivo: verificar o efeito de uma dieta hipocalórica na antropometria, na pressão arterial e em outros cofatores da síndrome metabólica. Metodologia: trata-se de um ensaio clínico não randomizado, retrospectivo, com dados secundários, em que o mesmo grupo foi de "intervenção" e "comparador", e cujos dados foram coletados antes (baseline) e após a intervenção. A pesquisa foi realizada com 84 pacientes, adultos, com síndrome metabólica, de ambos os sexos. Os pacientes seguiram dieta com restrição calórica de 200 a 500kcal/dia, com cálculo energético em torno de 20kcal/kg de peso, valor energético total não inferior a 1200kcal, durante um período de dois meses. Foi utilizada estatística descritiva e o teste t pareado ou Wilcoxon-Sign-Rank intragrupo para analisar as variações ao longo do tempo (p < 0,05). Resultado:houve uma redução na antropometria (índice de massa corporal, circunferência da cintura, circunferência do braço e circunferência do quadril), PAS e PAD, glicemia de jejum e triglicerídeos com p< 0,05 dos pacientes após a intervenção, mas não houve melhora no HDL (p > 0,05). Conclusão: a dieta hipocalórica reduziu as medidas antropométricas, a pressão arterial e os demais cofatores da SM nos pacientes avaliados após o acompanhamento de dois meses.

Introduction: systemic arterial hypertension (SAH) is associated with metabolic risk factors and can be defined as a multifactorial chronic disease, with persistent values of systolic blood pressure (SBP) and (or) diastolic blood pressure (DBP) greater than or equal to 140 mmHg x 90 mmHg, respectively. SAH is one of the factors that make up the metabolic syndrome (MS) along with hyperglycemia, dyslipidemia and (or) central obesity. Lifestyle modifications, such as diet and weight loss, have been shown to improve cardiometabolic parameters in patients with SAH and MS. Objective: to verify the effect of a hypocaloric diet on anthropometry, blood pressure and other cofactors of the metabolic syndrome. Methodology: this is a non-randomized, retrospective clinical trial, with secondary data, in which the same group was "intervention" and "comparator", and whose data were collected before (baseline) and after the intervention. Research was carried out with 84 patients, adults, with metabolic syndrome, of both sexes. Patients followed a calorie-restricted diet of 200 to 500kcal/day, with energy calculation around 20kcal/kg of weight, total energy value not less than 1200kcal, during a period of two months. Descriptive statistics and the paired t test or intragroup Wilcoxon-Sign-Rank were used to analyze variations over time (p < 0.05). Result: there was a reduction in anthropometry (body mass index, waist circumference, arm circumference and hip circumference), SBP and DBP, fasting glucose and triglycerides with p<0.05 of patients after the intervention, but there was no improvement in HDL (p > 0.05). Conclusion: the hypocaloric diet reduced anthropometric measurements, blood pressure and other MS cofactors in the patients evaluated after a two-month follow-up.

Associação entre a atividade física regular e qualidade de vida em estudantes de medicina de uma instituição de ensino privad / Association between regular physical activity and quality of life in medicine students in a private educational institution

A qualidade de vida (QV) abrange várias dimensões na vida do indivíduo. Muitos estudos retratam que ela é baixa nos estudantes de medicina, porém poucos abordam meios de como melhorá-la. O exércicio físico é apontado, com fortes evidências, como benéfico para QV, logo, é importante analisar se existe uma possível associação entre atividade física regular e a QV nesses estudantes. Metodologia: foi aplicado questionário online, pelo Microsoft Forms, sendo incluidos na pesquisa 362 estudantes de medicina de uma instituição de ensino privada, para avaliar a QV foi utilizado o Questionário de QV abreviado da Organização Mundial da Saúde (WHOQOL-BREF) e incluído perguntas sobre prática de exercício físico, visando analisar o tempo gasto com esta prática semanalmente. A análise de todos os dados foi realizada no Programa IBM ® SPSS ® Statistics 22, foram ainda utilizados na pesquisa os seguintes testes: Kolmogorov-Smirnova, Análise de Variância (ANOVA) One-Way, Teste T de Student e teste de Kruskal­Wallis. Resultados: dentre os participantes da pesquisa, 231 (63,9%) relataram a prática regular de atividade física e que o tempo gasto era maior entre os participantes do ciclo clínico. A pesquisa mostrou uma associação estatisticamente significativa entre a prática de atividade física e melhor QV em todos os domínios do WHOQOL-BREF (p<0,05), principalmente no psicológico (p<0,001). Conclusão: foi encontrada uma associação positiva entre a prática regular de atividade física no tempo de lazer e todos os domínios QV, independente do tempo de atividade física, sexo, idade ou período do curso.

Quality of life (QoL) encompasses several dimensions in an individual's life. Many studies show that it is low in medical students, but few address ways to improve it. Physical exercise is pointed out, with strong evidence, as beneficial for QOL, so it is important to analyze whether there is a possible association between regular physical activity and QOL in these students. Methodology: an online questionnaire was applied using Microsoft Forms, 362 medical students from a private educational institution were included; to evaluate the QoL, was used the abbreviated Quality of Life Questionnaire of World Health Organization (WHOQOL-BREF) and were included questions about physical exercise in order to analyze the time spent with this practice weekly. The analysis of all data was performed using the IBM ® SPSS ® Statistics 22 program, the following tests were also used in the research: Kolmogorov-Smirnova, One-Way Analysis of Variance (ANOVA), Student's T Test and Kruskal­Wallis test. Results: among the research participants, 231 (63,9%) reported regular physical activity and that the time spent was greater among participants in the clinical cycle. The research showed a statistically significant association between the practice of physical activity and better QoL in all domains of the WHOQOL-BREF (p<0.05), especially in the psychological (p<0.001). Conclusion: we found a positive association between the regular practice of physical activity in leisure time and all domains of QoL, regardless of the physical activity time, gender, age, or period of the course

Omega-3 supplementation in the treatment of polycystic ovary syndrome (PCOS) - a review of clinical trials and cohort.

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women associated with cardiovascular disease and obesity. The possible benefits of omega-3 supplementation in this syndrome have been discussed much. This study is aimed to verify, based on the scientific data published, if there are any benefits in the omega-3 supplementation in the treatment of PCOS and to indicate its possible dosages for the treatment of polycystic ovary. The work consists of a systematic review of clinical trials and cohort of the MEDLINE/PubMed database from 2009 to October 2019. All studies that analyzed the omega-3 supplementation in women with PCOS were included. Cross-sectional studies, review articles, systematic reviews, meta-analysis, duplicates, studies in animals or cell culture, studies with omega-3 supplementation via food or associated with other supplementations were not included, except those involving vitamin E. In total, 21 articles were selected. Despite the heterogeneity of the studies selected, indirect benefits were observed mainly regarding the glycemic profile, such as insulin resistance reduction, lipid profile modulation (i.e. decrease in total cholesterol, triglycerides, and elevation of high-density lipoprotein), and the regulation of the androgenic profile. As for the anthropometric profile, the studies were scarce and most of them had no significant meaning. Regarding the antioxidant profile and inflammatory biomarkers, the findings differ among studies, but promising results were observed with different doses over 12 weeks of use, such as C-reactive protein (CRP) reduction. Thus, omega-3 fatty acids promote indirect benefits in the treating of women with PCOS. However, to reveal well-defined standards for dosage and supplementation time, further studies are needed.

Nutrition management of Niemann Pick disease type C: A case report.

Objectives. We aim to report the clinical repercussions of a nutritional approach in a patient diagnosed with Niemann Pick disease type C (NPC) using miglustat as pharmacological therapy. Case report. A 33-year-old woman diagnosed with NPC using miglustat was instructed to look for a dietary management at our nutrition service. Patient's symptoms were weight loss and important gastrointestinal alterations. Our nutritional prescription was a high-calorie and high-protein, lactose- and sucrose-free diet, as well as a daily supplementation of L-glutamine, probiotics, omega 3, and coenzyme Q10. After two months, the patient had weight gain and improvement in the intestinal health. Conclusions. We found that nutritional prescription aided in the treatment of NPC and revealed that nutritional care represents an important strategy in the management of rare genetic diseases.

Duração do sono, ingestão de energia e macronutrientes em indivíduos com síndrome metabólica / Sleep duration, energy and macronutrient intake in individuals with Metabolic syndrome

Introdução: a duração do sono tem sido associada à síndrome metabólica e o principal mediador entre tais fatores parece ser a dieta, pois a ingestão de quilocalorias e macronutrientes pode variar conforme as horas dormidas. Objetivo: avaliar se existe associação entre duração do sono e o consumo de energia e de macronutrientes em indivíduos com síndrome metabólica. Metodologia: trata-se de um estudo retrospectivo, transversal, com dados secundários de prontuários de pacientes adultos, atendidos entre os anos de 013-2020. A duração do sono foi categorizada em: curta para ≤6 horas por noite; adequada para 7-8 horas por noite; e longa para ≥9 horas por noite; já os dados dietéticos foram obtidos por meio da aplicação e cálculo de recordatórios alimentares de 24 horas. Após ajustes para idade e sexo, as variáveis foram avaliadas por meio do teste Qui-Quadrado, sendo considerados significativos valores de p< 0,05. Resultados: das 375 pessoas avaliadas, quase metade relatou uma curta duração de sono; entretanto, não foram encontradas associações estatisticamente significativas entre a duração do sono e o consumo calórico (p=0,957), de carboidratos (p=0,975), proteínas (p=0,865) e lipídios (p=0,382). Discussão: a maior prevalência encontrada de curta duração do sono pode estar associada a algumas características sociodemográficas da população estudada, como o sexo feminino, o sedentarismo, o aumento da idade, a baixa renda e a ocupação ativa no mercado de trabalho. Conclusão: indivíduos com síndrome metabólica parecem ter menor tempo de sono, contudo, a associação do sono com o consumo alimentar ainda requer maiores investigações.

Introduction: Sleep duration has been associated with metabolic syndrome and the main mediator between these factors seems to be diet, as the ingestion of kilocalories and macronutrients can vary according to the hours of sleep. Objective: to assess whether there is an association between sleep duration and energy and macronutrient intake in individuals with metabolic syndrome. Methods: this is a retrospective, cross-sectional study, with secondary data from medical records of adult patients, treated between the years 2013- 2020. Sleep duration was categorized into: short for ≤6 hours per night; suitable for 7-8 hours per night; and long for ≥9 hours per night; dietary data were obtained through the application and calculation of 24-hour dietary recalls. After adjustments for age and sex, the variables were evaluated using the Chi-Square test, with values p<0.05 being considered significant. Results: of the 375 people surveyed, nearly half reported a short sleep duration; however, no statistically significant associations were found between sleep duration and caloric intake (p=0.957), carbohydrates (p=0.975), proteins (p=0.865) and lipids (p=0.382). Discussion: the higher prevalence of short sleep duration found may be associated with some sociodemographic characteristics of the studied population, such as female gender, sedentary lifestyle, increasing age, low income and active occupation in the labor market. Conclusion: Individuals with metabolic syndrome seem to have less sleep time; however, the association of sleep with food consumption still requires further investigation.

Effects of Beta-Hydroxy-Beta-Methylbutyrate Supplementation on Elderly Body Composition and Muscle Strength: A Review of Clinical Trials.

BACKGROUND: The aging process has great impact on body composition, such as the increase of adipose tissue in abdominal region, and the decrease of lean body mass, due to skeletal muscle loss. A reduction in muscle mass is associated to high risk of fractures and falls, loss of mobility, and increased number of hospitalizations. Beta-hydroxy-beta-methylbutyrate (HMB) is a biological substance derived from leucine metabolism, with anabolic and anticatabolic properties. Some HMB effects are tissue repair stimulation and protein anabolism. AIMS: We aimed to evaluate the effects of HMB supplementation on body composition and muscle strength in elderly, as well as to identify the efficient dosages to reach these effects. METHODS: This review included studies that evaluated muscle mass and muscle strength, associated or not with physical exercise and diet in elderly people. Only studies published from 2008 to 2019 were selected for analysis. RESULTS: Six articles were included in the review. The used doses varied from 1.5 to 3 g. In 5 studies, HMB supplementation was associated with calcium; only 1 study did not use the oral administration route. Two studies used 4 g of maltodextrin as a vehicle; 1 used HMB with a hypercaloric and hyperproteic supplement; 1 associated HMB with lysine and arginine; and 1 with arginine and glutamine. Supplementation of 3 g of HMB has shown to be most beneficial in improving strength and body composition in people over 65 years, especially in bed rest and untrained conditions. CONCLUSION: Our findings suggest that HMB has a positive effect on body composition and strength, especially in bedridden or sedentary elderly, due to its anticatabolic properties.

Prevalência de morbidade hospitalar por doenças crônicas não transmissíveis em Salvador (BA): dados DATASUS / Prevalence of hospital morbidity due to chronic non-communicable diseases in Salvador (BA): Datasus data

Introdução: as doenças crônicas não transmissíveis (DCNT) são consideradas como um dos maiores problemas globais de saúde pública da atualidade. Entre elas, podem-se destacar o diabetes mellitus (DM), a hipertensão arterial sistêmica (HAS) e a obesidade. As DCNT causam agravos à saúde e altas taxas de internação e óbitos, quando observadas isoladamente. Além disso, quando associadas, tendem a elevar o grau de morbidade, causando grandes prejuízos aos cofres públicos. Objetivo: Verificar a prevalência de internações e óbitos por DM, HAS e obesidade na população de Salvador. Metodologia: trata-se de um estudo descritivo, com base em dados do Departamento de Informação e Informática do SUS (DATASUS), sobre internações e óbitos ocorridos no período de janeiro a novembro de 2019, no município de Salvador (BA). A coleta dos dados eletrônicos foi realizada no mês de janeiro de 2020 e eles foram apresentados em forma de prevalência. Resultado: das internações registradas em Salvador, 0,63% foram associadas a DM, 0,03% à obesidade e 0,85% a HAS como causa principal. Em relação aos óbitos, 0,80% foram associados a DM e 0,56% a HAS. Não foram registrados óbitos associados à obesidade como causa principal, nesse período. Conclusão: houve maior prevalência de mulheres e idosos nas internações e óbitos por HAS e DM. O uso dos dados do DATASUS foi de extrema importância para a identificação do perfil de morbidade hospitalar. No entanto, a fim de garantir a consistência e a qualidade dos dados, é necessária uma padronização no modo de coleta.

Introduction: chronic non-communicable diseases (NCDs) are considered to be one of the biggest global public health problems today. Among them, diabetes mellitus (DM), systemic arterial hypertension (SAH) and obesity can be highlighted. NCDs cause health problems and high rates of hospitalization and deaths, when observed in isolation. In addition, when associated, they tend to increase the degree of morbidity, causing great damage to public coffers. Objective: to verify the prevalence of hospitalizations and deaths due to DM, SAH and obesity in the population of Salvador. Methods: this is a descriptive study, based on data from the Department of Information and Informatics of SUS (DATASUS), on hospitalizations and deaths from January to November 2019, in the city of Salvador (BA). The collection of electronic data was carried out in January 2020 and they were presented as prevalence. Results ­ Of the hospitalizations registered in Salvador, 0.63% were associated with DM, 0.03% with obesity and 0.85% with SAH as the main cause. Regarding deaths, 0.80% was associated with DM and 0.56% with SAH. There were no deaths associated with obesity as the main cause during this period. Conclusion: there was a higher prevalence of women and the elderly in hospitalizations and deaths due to SAH and DM. The use of DATASUS data was extremely important for the identification of the hospital morbidity profile. However, in order to guarantee the consistency and quality of the data, it is necessary to standardize the mode of collection.

Metabolic Syndrome Among Primary Health Care Nursing Professionals: A Cross-Sectional Population-Based Study.

This research aims at evaluating prevalence and factors associated with metabolic syndrome (MS) in primary health care (PHC) nursing professionals. A multicenter, population-based and cross-sectional study was conducted in a team-tested sample of 1125 PHC nurses in the state of Bahia, Brazil. Sociodemographic, labor, lifestyle and human biology variables were investigated by mean of anamnesis. MS was evaluated according to the criteria of the first Brazilian Guideline for Metabolic Syndrome, which fully adopts the criteria of the National Cholesterol Education Program's Adult Treatment Panel III. MS-associated factors were tested by using robust Poisson Regression. The prevalence of MS found was 24.4%; low High Density Lipoprotein (HDL) cholesterol was the most prevalent component of the syndrome. In the multivariate analysis, physical inactivity (PR = 1.25, 95% CI = 1.02-1.53), alcohol use (PR = 1.84, 95% CI = 1.22-2.77), acanthosis nigricans (PR = 3.23, 95% CI = 2.65-3.92), burnout syndrome (PR = 1.45, 95% CI = 1.17-1.81), (PR = 1.37, 95% CI = 1.12-1.69), working as a nursing technician (PR = 1.43, 95% CI = 1.14-1.80), were associated to MS. It was found that the prevalence of MS was high, which evidences the need for interventions in the PHC environment, improvement of working conditions, monitoring of worker safety and health, diet programs and physical activity.

Genetic and Oral Tests for the Diagnosis of Lactose Intolerance in Mixed-Ancestry Brazilians with Metabolic Syndrome.

BACKGROUND/AIMS: Metabolic syndrome (MetS) comprises a cluster of physiological and anthropometric abnormalities. MetS has been linked to lactose intolerance (LI). The aim of this study was to compare the sensitivity and specificity to detect LI using 2 different tests: (1) a genetic test and (2) an oral lactose tolerance test (OLTT). METHODS: Two hundred and fifty-four MetS patients, ≥20 years of age, of both genders, were recruited for this comparative study. Nine single nucleotide polymorphisms (SNPs) were selected for genetic investigation: rs182549and rs4988235(both considered "gold standard"); rs56064699; rs148142676; rs562211644; rs59533246; rs3754689; rs2278544,and rs10552864(as potential novel SNPs). Sensitivity and specificity, as well as positive and negative predictive values, were calculated for each genotype using WINPEPI version 11.65. Differences between positive and negative OLTT groups were considered statistically significant when p ≤ 0.05. RESULTS: Among the selected SNPs, only rs182549(p < 0.001) and rs4988235(p < 0.001) gave similar results compared to an OLTT. The sensitivity of both SNPs to detect LI was 87 and 86%, and specificity was 83 and 82.5%, respectively. CONCLUSION: Genetic tests using rs182549and rs4988235SNPs showed high agreement with OLTT. These genetic tests may be a good option to replace OLTT in MetS patients.

Biodisponibilidad de minerales que lados y no que lados: una revisión sistemática / Bioavailability of chelated and non-chelated minerals: a systematic review

RESUMEN Los minerales son elementos esenciales para la vida y su equilibrio es imprescindible para múltiples procesos fisiológicos, bioquímicos y metabólicos. La forma en que son ingeridos determina su funcionalidad. Se sugiere que los minerales quelados tienen mejor biodisponibilidad. El objetivo del trabajo fue realizar una revisión sistemática para verificar si los minerales quelados (MQ) son más biodisponibles que los no quelados (MNQ). Se revisaron publicaciones en el período entre 2007 y 2017 en las bases de datos Pubmed, Lilacs y Cochrane Library en los idiomas portugués e inglés, y con las palabras clave: "mineral chelates", "micronutrient chelate", "bioavailability micronutrient chelate", organic mineral, "iron chelate", "zinc chelate", "magnesium chelate", "copper chelate" y "chelate" y sus respectivas traducciones en portugués (idioma original de este artículo). Se seleccionaron 446 artículos, quedando 24 trabajos pendientes de aplicación de criterios de inclusión/exclusión, siendo 15 de ellos en animales (manganeso, zinc, cobre, hierro, cromo, cobalto y selenio) y 9 en humanos, sólo con hierro y calcio. Los estudios demostraron mayor absorción, transporte y biodisponibilidad para los MQ en comparación con los MNQ. Sin embargo, serían necesarios más estudios en humanos, abordando la biodisponibilidad de otros minerales, así como la estandarización de las dosificaciones de estos micronutrientes.

ABSTRACT Minerals are essential elements for life and their balance is important for multiple physiological, biochemical and metabolic processes. The way they are ingested determines their functionality. It has been suggested that chelated minerals have better bioavailability. The objective of this work was to perform a systematic review of published articles to verify if chelated minerals are more bioavailable than non-chelated minerals. Publications were reviewed in the period between 2007 and 2017 in Pubmed, Lilacs and Cochrane Library databases in Portuguese and English with the keywords: "mineral chelates", "micronutrient chelate", "bioavailability micronutrient chelate", organic mineral, "iron chelate", "zinc chelate", "magnesium chelate", "copper chelate" and "chelate" and their respective translations in Portuguese (the original language of this article). 446 articles were selected and 24 papers were left after the application of inclusion / exclusion criteria. Of these, 15 were in animals (manganese, zinc, copper, iron, chromium, cobalt and selenium) and 9 in humans, and focused on iron and calcium. The studies showed greater absorption, transport and bioavailability for chelated compared to non-chelated minerals. More human studies, however, are necessary to address the bioavailability of other minerals, as well as the standardization of the dosajes of these micronutrients.

Internações por fraturas ósseas pelo SUS em idosos do município de Salvador (BA): um estudo descritivo do ano de 2015 / Elderly hospitalizations for bone fractures by Unified Health System in Salvador (BA): a descriptive study of 2015

Introdução: as fraturas ósseas são os casos mais frequentes de internações hospitalares relacionadas a lesões por causas externas, gerando alto impacto econômico ao Sistema Único de Saúde brasileiro (SUS). A população idosa apresenta grande risco de fraturas devido à pré-existência de condições clínicas de fragilidade e de osteoporose. Objetivo: este estudo visa a analisar as internações hospitalares por fraturas ósseas pelo SUS em idosos residentes de Salvador (BA), seus custos correspondentes, a média de permanência hospitalar e o número de óbitos no ano de 2015. Metodologia: foi realizado um estudo com dados do Sistema de Informação Hospitalar, disponibilizados pelo Departamento de Informática do SUS (SIH/SUS). As categorias de fraturas desse sistema são: crânio e ossos da face, pescoço, tórax e pelve, fêmur, outros ossos dos membros e fraturas envolvendo múltiplos ossos. As variáveis estudadas foram: sexo, faixa etária, autorização de internação hospitalar, valor total, média de dias de permanência e número de óbitos. Resultados: as fraturas de outros ossos dos membros foram as mais frequentes em idosos internados por fraturas ósseas (43,7%), enquanto as mais frequentes em idosas internadas foram as de fêmur (41,3%) e de outros ossos dos membros (40,4%). Em ambos os sexos, a média de custo das internações por fraturas de fêmur foram as mais altas (≈R$3.000,00), além de demandarem mais tempo de internamento (≈12 dias). Por outro lado, a média de custo das internações por fraturas de outros ossos dos membros e sua média de dias de permanência hospitalar ficaram entre as mais baixas. Independentemente do sexo, não houve correlação importante entre os dias de permanência e a média de custo hospitalar. A taxa de mortalidade por fraturas de fêmur, no grupo de indivíduos do sexo masculino, foi discretamente maior do que no feminino (5 óbitos/100.000 e 3/100.000, respectivamente). O tipo de fratura que mais levou a óbito, no sexo feminino, foram as fraturas envolvendo múltiplos ossos, com taxa de 6 óbitos/100.000 idosas. Conclusão: os resultados apresentados neste estudo reforçam a importância do planejamento de estratégias a serem implementadas nos programas de atenção à saúde do idoso. Ao reduzir fatores de risco envolvidos com a ocorrência de fraturas, haverá redução de gastos públicos com o tratamento desse tipo de lesão e, logo, consequente melhora da utilização dos recursos financeiros em outros setores da saúde em prol da população.

Introduction: bone fractures are the most frequent cause of hospitalization regarding injury by external causes, leading to high economic impact to Brazilian Unified System (SUS). Elderly population is under great risk of fracture occurrences because of the preexisting clinical conditions of frailty and osteoporosis. Objective: this study aims to analyze hospitalizations due to bone fractures by SUS in Salvador's elderly population, their respective costs, days of hospitalization and numbers of deaths in the year of 2015. Metodology: this being investigated data from the Hospital Information System provided by the IT Department of SUS. The fracture categories available in SIH/SUS are: 'skull and facial bones'; 'neck, thorax and pelvis'; 'femoral bone'; 'other bones of the limbs'; and 'fractures involving multiple bones'. The studied variables were: biological sex, age range, number of approved hospitalizations, total cost, average duration of hospital stay, and number of deaths. Results: fractures of 'other bones of the limbs' were the most frequent in male elderly patients hospitalized for bone fractures (43.7%), whereas in female elders, 'femoral fractures' (41.3%) and 'fractures of other bones of the limbs' (40, 4%) were the most frequent. In both sexes, the average cost of hospitalizations due to 'femoral fractures' was the highest (≈R$ 3,000.00), and they required longer hospitalization period (≈12 days). The average cost of hospitalizations for 'fractures of other bones of the limbs' and their average duration of hospital stay were among the lowest. Regardless of sex, there was no significant correlation between the days of hospitalization and average hospitalization cost. Mortality due to 'femoral fractures' in males was slightly higher than in females, with rates of 5 deaths per 100,000 male elders and 3 death per 100,000 female elders. The kind of fracture that most led to death in female elders was 'fractures involving multiple bones' with a rate of 6 deaths per 100,000 elderly women. Conclusion: the results presented in this study reinforce the importance of planning strategies to be implemented in elderly health care programs in order to improve the functional status of the elderly body systems, reducing the risk factors involved in the occurrence of fractures.

Tempo de trânsito intestinal de indivíduos portadores de síndrome metabólica pela escala de bristol / Intestinal transit time of individuals with metabolic syndrome by the bristol scale

Introdução: a síndrome Metabólica (SM) é um transtorno de origem multifatorial que envolve a elevação da circunferência da cintura, da glicemia, da pressão arterial e dos triglicerídeos e redução do HDL-colesterol. Na etiopatogenia deste transtorno, diversos fatores genéticos e ambientais estão envolvidos, dentre eles, a alteração da microbiota intestinal pode ser um dos agentes causais deste distúrbio. Devido aos elevados custos para analisar este ecossistema, e à sua impossibilidade na prática clínica, ferramentas podem ser utilizadas com a intenção de monitorar o funcionamento intestinal, a exemplo da Escala de Bristol. Metodologia: foram avaliados indivíduos adultos e idosos com Síndrome Metabólica atendidos entre fevereiro de 2015 e maio de 2017. A síndrome metabólica foi definida de acordo com o preconizado pela Federação Internacional de Diabetes. Foi realizada anamnese com informações a respeito da consistência das fezes e coleta de medidas clínicas e antropométricas. Foi realizada análise estatística descritiva. Resultados: foram incluídos neste estudo 186 pacientes, com predominância do sexo feminino (83,9%) e indivíduos adultos (55,1%). Dentre os critérios da SM, o mais presente foi a pressão arterial elevada (95,1%), e a maior parte dos indivíduos apresentaram ritmo intestinal normal pela Escala de Bristol (54,8%). Em relação à idade entre os grupos, o que apresentou ritmo lento, teve maior média de idade (69 anos) em relação aos grupos com ritmo normal e ritmo rápido (57 e 54 anos, respectivamente). Por sua vez, indivíduos com ritmo intestinal rápido, apresentaram maiores médias de índice de massa corporal. Conclusão: indivíduos com Síndrome Metabólica parecem possuir tempo de trânsito intestinal adequado segundo a Escala de Bristol.

Introduction: metabolic syndrome (MS) is a multifactorial disorder that involves elevation of waist circumference, blood glucose, blood pressure and triglycerides, and reduction of HDL-cholesterol. In the etiopathogenesis of this disorder, intestinal health plays an important role, especially in the composition of the microbiota. Due to the high costs to analyze this ecosystem, and the impossibility in clinical practice, other tools can be used with the intention of monitoring the state of health of the microbiota such as the Bristol Scale. Metodology: adult and elderly individuals attended at the Núcleo de Pesquisa e Extensão em Genômica Nutricional e Disfunções Metabólicas of Universidade do Estado da Bahia between February 2015 and May 2017 were evaluated. Anamnesis was performed with information about the consistency of feces and Collection of clinical and anthropometric measurements. The metabolic syndrome was defined according to the International Diabetes Federation. Data were analyzed descriptively. Results: a total of 186 patients were analyzed during the study period, with a predominance of females (83.9%) and adults (55.1%). Among the criteria of MS, the most present was high blood pressure (95.1%), and most of the individuals presented normal bowel rhythm by the Bristol Scale (54.8%). In relation to the age between the groups, which presented a slow rhythm, the mean age (69 years) was higher in relation to the groups with normal rhythm and fast rhythm (57 and 54 years, respectively). In turn, individuals with fast bowel rhythm presented higher mean body mass index. Conclusion: individuals with Metabolic Syndrome seem to have intestinal transit time according to the Bristol Scale.

Associação entre níveis séricos de vitamina D e componentes da síndrome metabólica em pacientes atendidos no centro de estudos e atendimento dietoterápico da Universidade do Estado da Bahia / Association between serum levels of vitamin D and components of the metabolic syndrome in patients attended at the Center for Studies and Diet Therapy at the State University of Bahia

Introdução: a síndrome metabólica é um conjunto de disfunções que ocorre no metabolismo. Por sua vez, as disfunções endocrinometabólicas, incluindo componentes da síndrome, tais como obesidade, diabetes mellitus, elevação da pressão arterial e dislipidemias, têm sido associadas a baixos níveis séricos de vitamina D. A Hipovitaminose D tem atingido altas prevalências em diferentes populações mundiais, sobretudo em portadores desta síndrome. Metodologia: estudo observacional analítico, descritivo, de corte transversal. Os pacientes foram diagnosticados com síndrome metabólica a partir das recomendações da IDF, 2006. A coleta de dados foi realizada no período de agosto de 2015 a julho de 2016 e para determinação da concentração sérica de 25-hidroxivitamina D foi utilizado o método de quimioluminescência. Resultados: a hipovitaminose D foi observada em 77,6% dos pacientes. Dentre os componentes da SM a hipertensão arterial foi o mais prevalente. A análise de dados evidenciou correlação inversamente proporcional entre os níveis séricos de 25(OH)D, com as medidas de circunferência da cintura (r= ­ 0,245; pvalor= 0,013), com níveis séricos de triglicerídeos (r= ­ 1,54; pvalor= 0,030) e também com valores de Índice de Massa Corporal (r= ­ 0,225; pvalor= 0,023). Conclusão: neste estudo foi observado alta prevalência de hipovitaminose D e evidenciada correlação inversa entre os níveis séricos de vitamina D e as medidas de Circunferência da Cintura, de níveis séricos de triglicerídeos e valores de IMC.

Introduction: metabolic syndrome is a condition in which the individual manifests a set of metabolic dysfunctions. Endocrine-metabolic dysfunctions, including components of the syndrome, such as diabetes mellitus, elevated blood pressure and dyslipidemias, have been associated with low serum levels of vitamin D. Hypovitaminosis D has reached high prevalence in different world populations, Patients with this syndrome. Metodology: descriptive, cross-sectional observational study. Patients were diagnosed with metabolic syndrome from the recommendations of the IDF, 2006. Data collection was performed from August 2015 to July 2016 and for determination of the serum concentration of 25-hydroxyvitamin D was used the chemiluminescence method. Results: hypovitaminosis D was observed in 77.6% of the patients. Among the components of MS, arterial hypertension was the most prevalent. Data analysis showed an inversely proportional correlation between 25 (OH) D serum levels and waist circumference (r = ­ 0.245; pvalor = 0.013), with serum triglyceride levels (r = ­ 1.54; pvalor = 0.030) and also with values of Body Mass Index (r = ­ 0.225, pvalor = 0.023). Conclusion: in this study, a high prevalence of D-hypovitaminosis was observed and an inverse correlation was found between serum vitamin D levels and Waist Circumference, serum triglyceride levels and BMI values.