Assessment of sedentary behaviour in individuals with COPD: how many days are necessary?

Objective: The objective of the present study was to define the minimum number of monitoring days required for the adequate cross-sectional assessment of sedentary behaviour in individuals with chronic obstructive pulmonary disease (COPD). Methods: In this cross-sectional study, the sedentary behaviour of individuals with COPD was assessed using two physical activity monitors during awake time for seven consecutive days. Time spent per day in activities requiring ≤1.5 metabolic equivalents (METs) and in sitting, lying and sitting+lying positions was calculated taking into account the average of 7 days (as a reference in all analyses) and of all 119 possible combinations of 2---6 days. Intraclass correlation coefficients (ICCs) and linear regression analyses were performed for all combinations. Results: 91 individuals were analysed (47 female, 66±9 years, forced expiratory volume in 1 s 50±15% predicted). For the variables time spent per day in activities ≤1.5METs and sitting, the average of any combination of at least four assessment days was sufficient to adequately reflect the average of 7 days (adjusted R2≥0.929, ICC≥0.962, p<0.0001 for all). For time spent per day lying and sitting+lying, only two assessment days were enough (adjusted R2≥0.937, ICC≥0.968, p<0.0001 for all). Results were maintained independently of patient sex, disease severity, day of the week, daylight time or daytime naps. Conclusions: The average of 4 days of objective monitoring was sufficient to adequately reflect the results of a 1-week assessment of the main outcomes related to sedentary behaviour in individuals with moderate to very severe COPD, regardless of sex, disease severity, day of the week, daylight time and occurrence of daytime naps.

Effects of Chloramine T on zebrafish embryos malformations associated with cardiotoxicity and neurotoxicity.

Chloramine T, a sodium p-toluene sulfonchloramide, is known to possess a wide spectrum of biocidal activity and is employed as a disinfectant in fish farms to treat bacterial infections. Although Chloramine T may effectively combat pathogens, the sublethal and lethal effects and changes in acetylcholinesterase (AChE) activity remain poorly elucidated using Danio rerio (zebrafish) embryos. Zebrafish is considered a model organism for toxicant screening research and exhibits mammalian-like physiological responses when exposed to environmental pollutants. The aim of this study was to (1) determine LC50 of Chloramine T after 96 hr exposure, (2) verify disinfectant effects on developmental morphology, and (3) evaluate the disinfectant effects on AChE activity in zebrafish embryos. Chloramine T exposure was performed using 16, 32, 64, 128, or 256 mg/L concentrations. The mortality LC50 values were 143.05 ± 3.11 and 130.97 ± 7.4 mg/L at 24 and 96 hr, respectively. Data demonstrated delayed hatching, reduced heartbeats, cardiac edema, and equilibrium disruption of hatched larvae throughout embryonic development. In addition, Chloramine T inhibited AChE activity at 64 or 128 mg/L after 96 hr treatment, corroborating the sub-lethality results observed in zebrafish embryo development and demonstrating an equilibrium disruption in zebrafish larvae.

Energy expenditure per minute in different activities and body positions and its association with the classification as physically active or inactive in daily life in individuals with COPD.

Objective: To describe and compare energy expenditure (EE)/minute walking and in different body postures in individuals with COPD; and to investigate if EE/minute walking is a predictor of their classification as physically active or inactive. Methods: Physical activity (PA) in daily life was objectively assessed using two PA monitors for 7 days and data were analyzed on a minute-by-minute basis. Predominant minutes were separated into walking, standing, sitting, and reclined, and EE/minute (a reflection of PA intensity) was then calculated in each of these four activities and postures. Participants were classified as active and inactive according to the criteria proposed by the American College of Sports Medicine (ACSM). Results: 43 individuals were evaluated (65±8 years; FEV1 50±14% predicted). A binary logistic regression model yielded that, regardless of the time spent walking/day, EE/minute walking was a significant predictor of the classification as physically active (OR=18.2 [2 - 165]; p=0.01), together with BMI (OR=0.68 [0.5 - 0.9]; p=0.008) (model: Chi-square = 22.431, p< 0.05; R2 [Nagelkerke] = 0.556). In the active group, significantly higher EE/minute was observed for walking and standing in comparison both to sitting and reclined. However, in the inactive group, there were significant differences in EE/minute only when comparing walking versus reclined and standing versus reclined. Conclusion: In individuals, with COPD, EE/minute walking is a significant predictor of being classified as physically active, independently of the time spent walking/day. Each additional kilocalorie/minute spent walking increases in 18 times the chances to be classified as physically active in daily life.

Are the Effects of High-Intensity Exercise Training Different in Patients with COPD Versus COPD+Asthma Overlap?

PURPOSE: This study aimed to investigate whether patients with chronic obstructive pulmonary disease (COPD) presenting asthma overlap (ACO) benefit similarly in comparison to patients with only COPD after a 12-week high-intensity exercise training (ET) program. METHODS: Subjects with a diagnosis of COPD alone or ACO were evaluated and compared before and after a high-intensity ET program composed of walking and cycling plus strengthening exercises of the upper and lower limbs (3 days/week, 3 months, 36 sessions). Assessments included spirometry, bioelectrical impedance, 6-min walk test (6MWT), London Chest Activity of Daily Living Scale (LCADL), Hospital anxiety and depression Scale, modified Medical Research Council Scale (mMRC), Saint George Respiratory Questionnaire (SGRQ), and respiratory and peripheral muscle strength [manovacuometry and 1-repetition maximum test (quadriceps femoris, biceps and triceps brachialis), respectively]. ACO was defined according to Sin et al. (Eur Respir J 48(3):664-673, 2016). RESULTS: The sample was composed of 74 subjects (57% male, age 67 ± 8 years, BMI 26 (21-32) kg/m2, FEV1 47 ± 17%predicted), and 12 (16%) of them were classified as presenting ACO. Both groups improved pulmonary function, 6MWT, peripheral and inspiratory muscle strength, LCADL, and SGRQ after ET (p < 0.005 for all). There were no significant interactions between ACO and COPD on ET effects (p > 0.05 for all). Likewise, there was no difference in the proportion of patients achieving the minimum clinical important difference for 6MWT and mMRC. CONCLUSION: High-intensity exercise training generates similar benefits in patients with COPD regardless of whether presenting asthma overlap or not.

Perfil dos pacientes com DPOC que melhoram a capacidade de exercício após treinamento / Profile of patients with COPD who improve exercise capacity after training

Introdução: Fatores associados à melhora no incremental shuttle walking test (ISWT), em pacientes com DPOC não estão claros. Objetivo: Identificar o perfil dos pacientes com melhor desempenho no ISWT após treinamento físico. Métodos: Quarenta e dois pacientes com DPOC foram separados em dois grupos: melhora (GM) no ISWT (≥20 metros) e não melhora (GNM). Foram avaliados: espirometria, ISWT, teste da caminhada de seis minutos (TC6min), sensação de dispneia, dados antropométricos e de gravidade da doença. Resultados: Após treinamento, houve melhora na distância do ISWT (P=0,03). O GM apresentou pior desempenho no ISWT (P<0,0001) e maior sensação de dispneia (P=0,04) antes do treinamento. Os integrantes do GM e do GNM não apresentaram diferenças em relação aos dados antropométricos, bem como de gravidade da doença. Conclusões: Pacientes com mais sintomas e pior desempenho no ISWT inicial parecem ser os que mais melhoram sua capacidade máxima de exercício após treinamento físico.

Introduction: Factors associated with improvement in the incremental shuttle walking test (ISWT), in COPD patients, are not clear. Objective: To identify the profile of patients with better performance in the ISWT after physical training. Methods: Forty-two patients with COPD were separated into two groups: improvement (IG) in the ISWT (≥20 meters), and no improvement (NIG). Spirometry, ISWT, six-minute walk test (6MWT), sensations of dyspnea, anthropometric data and disease severity were evaluated. Results: After training, there was an improvement in the ISWT (P = 0.03). Patients from the IG showed poorer performance in the ISWT (P <0.0001) and greater sensation of dyspnea (P = 0.04) before training. Participants in the IG and NIG did not show any differences in anthropometric data and disease severity. Conclusions: Patients with more symptoms and poorer performance on the initial ISWT seem to be the ones who improve more after physical training.

Aptidão física relacionada à saúde em escolares de município de pequeno porte do interior do Brasil / Health-related physical fitness among school children in a small city in the interior of Brazil

Esse estudo objetivou determinar a aptidão física relacionada à saúde em escolares de um município de pequeno porte do interior do Brasil. A amostra foi composta por 56 escolares (27 do sexo masculino), regularmente matriculados no ensino fundamental da única escola do município. Foram realizados testes clínicos (pressão arterial e frequência cardíaca), antropométrico (massa corporal, estatura e dobras cutâneas) e motor (flexibilidade, força/resistência abdominal, força de membros superiores e aptidão cardiorrespiratória). Nos escontramos que a idade média foi de 13,10 ± 1,06 anos, e os resultados apontaram diferença entre os sexos apenas nas variáveis de percentual de gordura, sendo maior no sexo feminino (p<0,001). Foram encontradas força abdominal e força de membros superiores maiores no sexo masculino (p<0,001), respectivamente. Em conclusão, o percentual de gordura foi maior nas mulheres e a força abdominal e força de membros superiores foram maiores nos homens. Escolaridade dos pais e renda familiar, não apresentaram diferenças significativas.

This study aimed to determine health-related physical fitness in school children of a small town in the interior of Brazil. The sample was comprised of 56 schools (27 male), enrolled in the elementary school of the city. Were performed clinical trials (arterial pressure and heart rate), anthropometric (body mass, stature and skin folds) and motor (flexibility, strength/endurance, strength of upper abdominal and cardiorespiratory fitness). We found the mean age was 13.10 ± 1.06 years, and the results showed difference between sexes only in body fat percentage variable, being higher in females (p<0.001). Abdominal strength and upper limbs strength were found of higher in males (p<0.001), respectively. In conclusion, the body fat percentage was higher in females and the abdominal strength and upper limb strength were higher in males. No significant differences were observed for parental education and family income.

Relationship between the work developed in maximal and submaximal exercise capacity tests and the degree of airflow obstruction in individuals with Chronic Obstructive Pulmonary Disease / Relación de labor desarrollada en tests máximo y submáximo de capacidad de ejercicio con el grado de obstrucción del flujo aéreo en individuos con Enfermedad Pulmonar Obstructiva Crónica / Relação do trabalho desenvolvido em testes máximo e submáximo de capacidade de exercício com o grau de obstrução ao fluxo aéreo em indivíduos com Doença Pulmonar Obstrutiva Crônica

The aim of this study was to investigate the relationship between the work in two exercise capacity tests, a maximum and a submaximal exercise, and the level of airflow obstruction in patients with Chronic Obstructive Pulmonary Disease (COPD). Fifty-three subjects with COPD (29 men, 70±9 years old, 65±14 kg, forced expiratory volume in the first second [FEV1] 38[31-54]% predicted) had their lung function assessed by spirometry, and maximal and submaximal exercise capacity were evaluated by the Incremental Shuttle Walking test (ISWT) and the 6-Minute Walk Test (6MWT), respectively. The work in the tests was calculated by multiplying the covered distance and the individual's body weight (W). To evaluate the contribution of weight on the developed work, subjects were separated into two groups: higher weight (n=32), and lower weight (n=21). FEV1 correlated with the distance on the ISWT and with the ISWT*W (r=0.43 and r=0.49, respectively; p<0.05 for both). Moreover, the distance on the ISWT correlated with the ISWT*W (r=0.88, p<0.0001). Regarding the 6MWT, it was observed that FEV1 had a weak correlation with the covered distance (r=0.29, p=0.03) and a moderate one with the 6MWT*W (r=0.51, p<0.0001). Moreover, the distance covered in the 6MWT was moderately correlated with the 6MWT*W (r=0.47, p=0.0004). The higher weight group showed worse performance only in the 6MWT compared to the lower weight group (407±85 versus 469±64 meters, respectively; p=0.004). The work on the used exercise tests was similarly related to the level of airflow obstruction. The submaximal test, however, appears to have its performance more influenced by the individuals' body weight...

Este estudio tuvo como objetivo investigar la relación de labor desarrollada en dos tests de capacidad de ejercicio, un máximo y otro submáximo, con el grado de obstrucción del flujo aéreo en individuos con Enfermedad Pulmonar Obstructiva Crónica (EPOC). Los 53 individuos con EPOC (29 hombres, 70±9Años, 65±14kg, volumen espiratorio forzado en el primer segundo [VEF1] 38 [31-54]% previsto) tuvieron evaluadas su función pulmonar, a través de espirometría, y capacidad máxima de ejercicio en por el Incremental Shuttle Walking Test (ISWT), y submáxima, por el test de caminata de seis minutos (TC6min). El trabajo desarrollado en los tests fue calculado por el producto de la distancia recorrida con el peso corporal del individuo (P). Para evaluar la contribución del peso en el rendimiento de los tests, los individuos fueron separados en dos grupos : de alto peso (n=32) y bajo peso (n=21). Se observó una correlación del VEF1 con la distancia recorrida en el ISWT y con el ISWT*P (r=0,43 y r=0,49, respectivamente; P<0,05 para ambos). Además, la distancia recorrida en ISWT se correlacionó con el ISWT*P (r=0,88;P<0,0001). En cuanto al TC6min, se observó que el VEF1 presentó una correlación débil con la distancia recorrida (r=0,29; P=0,03) y moderada a TC6min*P (r=0,51; P<0,0001). Aparte, la distancia recorrida en la TC6min se correlacionó moderadamente con el TC6min*P (r=0,47; P=0,0004). El grupo de alto peso mostró peor desempeño solamente en el TC6min en comparación con el de bajo peso (407±85 vs. 469±64 metros, respectivamente; P=0,004). El trabajo en los tests utilizados se relacionó con el grado de obstrucción del flujo de aire de manera similar en ambos los tests. El test submáximo, sin embargo, tuvo su rendimiento más influenciado por el peso corporal de los individuos...

Objetivou-se investigar a relação do trabalho desenvolvido em dois testes de capacidade de exercício, um máximo e outro submáximo, com o grau de obstrução ao fluxo aéreo em indivíduos com Doença Pulmonar Obstrutiva Crônica (DPOC). 53 indivíduos com DPOC (29 homens, 70±9 anos, 65±14 kg, volume expiratório forçado no primeiro segundo [VEF1] 38[31-54]% previsto) tiveram avaliadas sua função pulmonar, por meio de espirometria, e capacidade de exercício máxima, pelo Incremental Shuttle Walking Test (ISWT), e submáxima, pelo teste de caminhada de seis minutos (TC6min). O trabalho desenvolvido nos testes foi calculado pelo produto da distância percorrida com o peso corporal do indivíduo (P). Para avaliar a contribuição do peso no desempenho dos testes, os indivíduos foram separados em dois grupos: maior peso (n=32), e menor peso (n=21). Observou-se correlação do VEF1 com a distância percorrida no ISWT e com o ISWT*P (r=0,43 e r=0,49, respectivamente; p<0,05 para ambas). Além disso, a distância percorrida no ISWT correlacionou-se com o ISWT*P (r=0,88; p<0,0001). Em relação ao TC6min, observou-se que o VEF1 apresentou correlação fraca com a distância percorrida (r=0,29; p=0,03) e moderada com o TC6min*P (r=0,51; p<0,0001). Além disso, a distância percorrida no TC6min correlacionou-se moderadamente com o TC6min*P (r=0,47; p=0,0004). O grupo maior peso apresentou pior desempenho somente no TC6min comparado ao menor peso (407±85 versus 469±64 metros, respectivamente; p=0,004). O trabalho desenvolvido nos testes utilizados relacionou-se com o grau de obstrução ao fluxo aéreo de forma semelhante nos dois testes. O teste submáximo, contudo, teve seu desempenho mais influenciado pelo peso corporal dos indivíduos...

Fatores de risco coronariano em estudantes de uma universidade privada / Coronary risk factors in students of private university

As doenças cardiovasculares podem ser evitadas através da intervenção nos fatores de risco modificáveis, tais como hipertensão arterial, tabagismo, obesidade e dislipidemia. Determinar e comparar o risco coronariano em estudantes de uma Universidade privada, segundo gênero e curso. Estudo transversal que avaliou 273 estudantes de diversos cursos da Universidade Presidente Antônio Carlos – Campus Ponte Nova, com idade média de 24,43 ± 5,40 anos. Todos os avaliados responderam ao questionário Tabela de Risco Coronariano da Michigan Heart Association (MHA). Procedeu-se, então, a análise descritiva com apresentação dos resultados como média ± desvio padrão. O teste t de student foi utilizado para comparação do risco coronariano entre os gêneros. Utilizou-se o teste ANOVA one way para comparação do risco coronariano entre os cursos. Para todos os tratamentos adotou-se um nível de significância de p<0,05. O risco coronariano dos estudantes foi “abaixo da média” (17,5 ± 4,59 pontos), segundo classificação da MHA. O sexo masculino apresentou risco coronariano maior que as mulheres (p<0,001), sendo que obtiveram classificação de “risco médio”, enquanto o sexo feminino obteve “risco abaixo da média”. Não foram encontradas diferenças estatisticamente significantes para o risco coronariano entre os diferentes cursos (p=0,061). As prevalências de risco coronariano foram: hereditariedade (56,41%), excesso de peso (38,1%), sedentarismo (34,8%), hipercolesterolemia (27,47%), tabagismo (14,65%) e hipertensão (8,43%). O risco coronariano dos estudantes foi classificado como “risco abaixo da média”, sendo maior entre os homens, porém, sem diferenças estatisticamente significantes entre os cursos de graduação.

Cardiovascular diseases can be prevented through intervention in modifiable risk factors such as hypertension, smoking, obesity and dyslipidemia. To determine and compare the coronary risk of private university students, according to gender and undergraduate course. Cross-sectional study that evaluated 273 students from undergraduates courses of Universidade Presidente Antônio Carlos – Campus Ponte Nova, with mean age of 24.43 ± 5.40 years. All individuals responded the Coronary Risk questionnaire proposed by Michigan Heart Association (MHA). Statistical analysis consisted of descriptive analysis. The t Student test was used for comparison of coronary risk between genders. We used ANOVA one-way test for comparison of coronary risk between undergraduates courses. All treatments possessed a significance level of p<0.05. The students’ coronary risk were "below average risk" (17.5 ± 4.59 points), according to MHA. The men coronary risk had higher than women (p <0.001), and were classified as "medium risk", while the females had "below average risk." There were no statistically significant differences in coronary risk among different courses (p =0.061). The prevalence of coronary risk factors are: heredity (56,41%), overweight (38,1%), inactivity (34,8%), hypercholesterolemia (27,47%), smoking (14,65%) and hypertension (8,43%). The students’ coronary risk was classified as "below average risk", being higher among men, but without statistically significant differences between the undergraduate courses.

Eficácia do índice de conicidade e da relação cintura/estatura em predizer o percentual de gordura corporal em crianças / Effectiveness of the conicity index and waist to height ratio to predict the percentage of body fat in children

This study evaluated the effectiveness of conicity index and the waist-to-height ratio to predict the percentage of body fat (%BF) in children, measured by tetrapolar electrical bioimpedance. We evaluated 205 children, both male and female, aged 6 to 9 years. Measures of weight, height and waist circumference were obtained and used to calculate the body mass index, conicity index and the waist-to-height ratio. The body composition was measured by tetrapolar electrical bioimpedance. Cut-off points were calculated for two indices from the ROC curve. In the present study, there was uniformity between the sexes and the mean age was 7.2 ± 1.2 years. There was no statistically significant difference between the sexes for the conicity index and the waist-to-height ratio. For men, the conicity index showed a better correlation (r = 0.64) with %BF. For women, the waist-to-height ratio presented a better correlation (r = 0.61). The areas under the ROC curve were larger for waist-to-height ratio for all ages, for both genders. The cut-off points found in this group present good values of sensitivity and specifi city for both indicators. It must behighlighted that the conicity index and the waist-to-height ratio should not be used alone to predict the body fat excess.

El presente trabajo evaluó la efectividad del índice de conicidad y la relación cintura/talla para predecir el porcentual de grasa corporal(%GC) de los niños, medidos por bioimpedancia eléctrica tetrapolar. Se evaluaron 205 niños de 6 a 9 años de ambos sexos. Fueron tomadasmedidas de peso, talla y circunferencia de la cintura, que se utilizaron para calcular el índice de masa corporal, índice de conicidad y la relación cintura/talla. La composición corporal fue medida por bioimpedanciaeléctrica tetra-polar. Se calcularon los puntos de corte para los dos índices a partir de la curva ROC. En este estudio hubo homogeneidad entre los sexos y la media de edad fue 7,2 ± 1,2 años. No hubo diferencias estadí s ticamentesignificativas entre los sexos, para índice de conicidad y la relación cintura/talla. En varones, el índice de conicidad presentó mejor correlación (r= 0,64) con el %GC, en mujeres fue la relación cintura/talla la que presentó mejor correlación (r=0,61). Las áreas bajo la curva ROC fueron mayores para larelación cintura/talla para todas las edades y sexos. Los puntos de corte encontrados para estapoblación presentaron buenos valores desensibilidad y especificidad para los dos indicadores. Es necesario destacar que elíndice de conicidad y la relación cintura/talla no deben ser utilizados separadamente para predecir el exceso de grasa corporal.

O presente trabalho avaliou a eficácia do índice de conicidade e da relação cintura/estatura em predizer o %GC de crianças, mensurado pela bioimpedância elétrica tetrapolar. Avaliou-se 205 crianças com idade de 6 a 9 anos de ambos os sexos. Foram obtidas medidas de peso, estatura e circunferência da cintura, sendo estes utilizados para cálculo do índice de massa corporal, índice de conicidade e relação cintura/estatura. A composição corporal foi medida pela bioimpedância elétrica tetrapolar. Foram calculados pontos de corte para os dois índices a partir da curva ROC. No presente estudo, houve homogeneidade entre os sexos e a idade média foi de 7,2 ± 1,2 anos. Não houve diferença estatisticamente significante, entre os sexos, para o índice de conicidade e relação cintura/estatura. No sexo masculino, o índice de conicidade apresentou melhor correlação (r = 0,64) com o %GC, no feminino foi a relação cintura/estatura que apresentou melhor correlação (r = 0,61). As áreas sob a curva ROC foram maiores para a relação cintura/estatura para todas as idades e sexos. Os pontos de corte encontrados para esta população apresentam bons valores de sensibilidade e de especificidade para os dois indicadores. Ressalta-se que o índice de conicidade e relação cintura/estaturanão devem ser utilizados isoladamente para predizer o excesso de gordura corporal.

Aptidão para atividade física regular em estudantes de educação física da Universidade Federal de Viçosa / Regular physical activity fitness in physical education?s students at Universidade Federal de Viçosa

Com o objetivo de determinar a inaptidão para prática de atividade física regular (AFR) em estudantes deeducação física da Universidade Federal de Viçosa e sua associação com o gênero, foram avaliados 354 estudantes,com idade média de 22,3 ± 2,4 anos, através do PAR-Q. Para a análise estatística, utilizou-se a razãode prevalência (RP) e razão de chances (OR) entre os gêneros. Dentre os sujeitos avaliados, 90 apresentavam inaptidão para AFR, representando um valor relativo a 25,5%. Destes, 77 (21,8%) tiveram uma resposta positiva,10 (2,8%) duas respostas e três (0,9%), três respostas. A OR indicou que as mulheres têm 2,17 chances (IC=1,29 - 3,66) a mais de apresentar inaptidão para AFR que os homens, bem como uma prevalência 79% maior.Desta forma, aconselha-se um exame clínico antes de submeter-se a um programa de AFR. Os dados apontampara uma prevalência de inaptidão para AFR maior que um quarto da amostra, denotando preocupação, vistoa existência do risco na realização de aulas práticas.

To determine the regular practice of physical activity unfitness (AFR) in physical education students at UFVand their gender association. We evaluated 354 students, with mean age of 22.3 ± 2.4 years, through PAR-Q. For statistical analysis, we used the prevalence ratio (PR) and odds ratio (OR) between genders. Ninety subjectshad to unsuitable AFR, representing a value of 25.5%. Of these, 77 (21.8%) had a positive response, 10 (2.8%)two responses and 3 (0.9%) three responses. The OR indicated that women have 2.17 odds (CI = 1.29 to3.66) over men to present inability to AFR and a 79% of higher prevalence. Therefore, caution is a clinicalexamination before undergoing a program of AFR. The data indicate a prevalence of unfitness for AFR largerthan a sample quarter showing concern, since the existence of risk in practical classes conducting.

Body fat assessment by bioelectrical impedance and its correlation with different anatomical sites used in the measurement of waist circumference in children.

OBJECTIVE: To compare the different anatomical sites used in the measurement of waist circumference, as well as the effectiveness of these landmarks to predict the percentage of body fat by tetrapolar bioelectrical impedance analysis. METHODS: We evaluated 205 children from 6 to 9 years of age of both sexes. Data on weight, height and waist circumference were collected at three different sites: at the lower abdominal curvature, above the navel and at the midpoint between the last rib and the iliac crest. Nutritional status was assessed through the body mass index (BMI)/age as recommended by the World Health Organization. RESULTS: The sample was considered homogeneous in terms of sex, and the mean age was 7.2+/-1.2 years. Regarding nutritional status, 6.3% of the children had low weight, 75.1% were eutrophic, 7.3% were overweight, and 11.2% were obese. Among males, there was no statistical difference between the different sites of measurement; in females, the measurement above the navel was statistically higher. In the correlation analysis, the midpoint measurement showed the best correlation with percentage of body fat, with values of 0.50 in boys and 0.62 in girls. CONCLUSION: Waist circumference measured at the midpoint between the last rib and the iliac crest presented the best correlation with percentage of body fat.

Avaliação de gordura corporal pela bioimpedância elétrica e sua correlação com diferentes pontos anatômicos de medida da circunferência da cintura em crianças / Body fat assessment by bioelectrical impedance and its correlation with different anatomical sites used in the measurement of waist circumference in children

OBJETIVO: Comparar os diferentes pontos anatômicos de medida da circunferência da cintura, bem como a eficácia desses locais em predizer o percentual de gordura corporal mensurado pela bioimpedância elétrica tetrapolar. MÉTODOS: Foram avaliadas 205 crianças de 6 a 9 anos de idade de ambos os sexos. Foram coletados dados de peso, estatura e circunferência da cintura em três locais diferentes: na menor curvatura abdominal, sobre a cicatriz umbilical e no ponto médio entre a última costela e crista ilíaca. A avaliação do estado nutricional foi realizada a partir do índice de massa corporal/idade recomendado pela Organização Mundial de Saúde. RESULTADOS: No presente estudo houve homogeneidade entre os sexos, e a idade média foi de 7,2±1,2 anos. Em relação ao estado nutricional, 6,3 por cento das crianças apresentaram baixo peso, 75,1 por cento eram eutróficas, 7,3 por cento apresentaram sobrepeso e 11,2 por cento obesidade. No sexo masculino não houve diferença estatística entre os diferentes locais de medida. No feminino, a medida sobre a cicatriz umbilical foi estatisticamente maior. Na análise de correlação, a circunferência medida no ponto médio foi a que obteve melhor correlação com o percentual de gordura corporal, com valores de 0,50 nos meninos e 0,62 nas meninas. CONCLUSÃO: A circunferência da cintura medida no ponto médio entre a crista ilíaca e ultima costela foi a que apresentou melhor correlação com o percentual de gordura corporal.

OBJECTIVE: To compare the different anatomical sites used in the measurement of waist circumference, as well as the effectiveness of these landmarks to predict the percentage of body fat by tetrapolar bioelectrical impedance analysis. METHODS: We evaluated 205 children from 6 to 9 years of age of both sexes. Data on weight, height and waist circumference were collected at three different sites: at the lower abdominal curvature, above the navel and at the midpoint between the last rib and the iliac crest. Nutritional status was assessed through the body mass index (BMI)/age as recommended by the World Health Organization. RESULTS: The sample was considered homogeneous in terms of sex, and the mean age was 7.2±1.2 years. Regarding nutritional status, 6.3 percent of the children had low weight, 75.1 percent were eutrophic, 7.3 percent were overweight, and 11.2 percent were obese. Among males, there was no statistical difference between the different sites of measurement; in females, the measurement above the navel was statistically higher. In the correlation analysis, the midpoint measurement showed the best correlation with percentage of body fat, with values of 0.50 in boys and 0.62 in girls. CONCLUSION: Waist circumference measured at the midpoint between the last rib and the iliac crest presented the best correlation with percentage of body fat.

Oral paracoccidioidomycosis: a case without lung manifestations.

AIM: The aim of this article is to present a case of Paracoccidioidomycosis with involvement of the oral cavity but without pulmonary manifestations. BACKGROUND: Paracoccidioidomycosis is a fungal infection caused by Paracoccidioides brasiliensis. It is an endemic disease representing a serious health problem for Latin American countries, especially Brazil. This infection primarily affects the lungs of adult men and is acquired through inhalation or accidental inoculation of the fungus. It can spread to other organs and tissues, mainly the oral cavity. Administration of antifungal medication always resolves the disease. REPORT: A 58-year-old black male presented with three painless, ulcerated, mulberry-like granulomatous lesions located in the floor of the mouth, on the superior alveolar ridge, and on the hard palate, which had evolved over a period of two years. Facial asymmetry was observed due to edema in the lower lip and lymphadenopathy. He had smoked for more than six years but showed no evidence of lung alterations, productive cough, or fever. Panoramic radiography showed no signs of a bone lesion in the jaws. Both a radiograph and a CT scan of the thorax showed no areas of nodular infiltration. Fibrobronchoscopic examination of the entire respiratory tract was normal. Biopsies of the oral lesions were performed, and tissue sections exhibited oral mucosa coated with non-keratinized stratified squamous epithelium with acanthosis and focal areas of exocytosis. The underlying connective tissue showed an intense lymphocytic and polymorphonuclear infiltrate in addition to multinuclear giant cells and coagulation necrosis. A special stain used for fungus (the Grocott-Gomori method) was positive. Pulmonary biopsy exhibited aerial spaces containing macrophages, dark granular hemossiderin, and absence of fungus. This was considered normal. In agreement with the recommendation of pneumologists 400 mg/day of ketoconazole was prescribed for the patient. After two months of treatment, even though the oral lesions had resolved completely, the therapy was maintained for six months more. One year after following treatment the patient was in good health and free of any signs of a recurrent infection. SUMMARY: Based on clinical, radiographic, and histologic findings the differential diagnosis included paracoccidioidomycosis and squamous cell carcinoma. Following clinical and biopsy examinations of the oral lesions and the lungs a final diagnosis of paracoccidioidomycosis was made. This is a prime example of oral manifestations of a systemic disease in which the dentist is the initial health care professional to evaluate the patient due to the location of the lesions.