School Health Education Program "Happy Life, Healthy Heart": A Randomized Clinical Trial

Abstract Background: School interventions based on playful activities have been shown to be good strategies for increasing children's knowledge about health, which may impact healthy habits. Objective: To evaluate whether the school health education program entitled "Happy Life, Healthy Heart" increases health knowledge and causes a change in teachers' and students' lifestyles. Method: Cluster randomized clinical trial including elementary school students and teachers from public schools in the city of Frederico Westphalen, Brazil. The intervention consisted of the training of teachers on topics of health, followed by classes on topics related to cardiovascular health given by these teachers to the students. The students were evaluated for nutritional status and health knowledge using the CARDIOKIDS and DAFA questionnaires, and teachers were assessed for physical activity. The Student's t-test, the chi-square test and the two-way ANOVA test were used for comparisons between groups, and McNemar-Bowker for intra-group comparisons. P values of <0.05 were considered statistically significant. Results: A total of 473 children were included, 211 (44.6%) in the control group (CG) and 262 (55.4%) in the intervention group (IG), and 32 teachers (control = 14, intervention =18). There was no difference in health knowledge of the students after the intervention (CG 10.53 ± 0.11 vs. 11.19 ± 0.09 p = 0.061, IG 10.20 ± 0.12 vs. 11.09 ± 0, 09 p = 0.416), although 57.7% of the children of the IG reported having stopped eating pizza and drinking soft drinks (p <0.001), following the Brazilian Food Guide recommendations. Among teachers of the IG, an increase of 27.9% in physical activity level was observed. Conclusions: The "Happy life, healthy heart" program was able to change students' eating habits and increase physical activity in teachers.

Cardiovascular Risk Factors in Children and Adolescents with Fontan Circulation

Abstract Background: Long-term outcomes of patients with Fontan circulation are uncertain regarding the prevalence and role of risk factors (RFs) such as increased body mass index (BMI), arterial hypertension, and hypercholesterolemia. Objectives: To describe the prevalence of RFs in patients with univentricular heart, with variable follow-up times. Methods: This mixed cohort study was performed with 66 patients, who underwent blood count, fasting blood glucose, C-reactive protein (CRP), and lipid profile tests; systolic/diastolic blood pressure (SBP/DBP) measurements; and anthropometric and sociodemographic data collection. Cardiovascular RFs among first-degree relatives and physical activity habits were also assessed. Prevalence was described using proportions, with a 95% confidence interval. Continuous variables (height, weight, age, SBP, DBP) were described as means and standard deviations (m±SD). Associations between RFs were assessed using chi-squared or Fisher's exact tests. Spearman's correlation was used for analyzing CRP and the presence of 2 or more RFs. The Shapiro-Wilk test was used to check for data normality. Statistical significance considered p<0.05. Results: In our population, 19.7% were overweight, mean SBP was 89.44±37.4, and mean DBP was 60.0±26.08. The most prevalent diseases in the interviewees' families were systemic arterial hypertension (30.3%), obesity (16.7%), and 2 or more cardiovascular RFs among first-degree relatives (13.8%). We observed a trend towards significance between the presence of 2 familial RFs and overweight, as well as a risk profile for cardiovascular disease. There was an association between the BMI percentile, the presence of 2 or more RFs (p<0.05), and CRP (p<0.01). Conclusions: Overweight is common in patients with univentricular heart, being related to more than 2 cardiovascular RFs among first-degree relatives; physical inactivity and changes in lipid profiles are also frequent.

Physical Activity and Cardiovascular Risk Factors in Children: a Meta-Analysis Update

Abstract Background Obesity and overweight in childhood can increase the risk of developing cardiovascular disease throughout live. Objectives This study provides an update of a meta-analysis of randomized clinical trials (RCT) published in 2014, to assess the effects of physical activity interventions on preventing cardiovascular risk factors in childhood. Methods This update combines data from the previous search with new data obtained from June 2013 to June 2020. Searches were performed on PubMed, EMBASE and Cochrane CENTRAL. The RCTs enrolled used interventions with physical activity longer than six months in school children aged 6-12 years, and evaluated body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), triglyceride (TG), and low-density lipoprotein (LDL) and high-density lipoprotein (HDL) levels. Data analysis was performed using a random-effects model and a P value <0.05 was considered statistically significant. Results A total of 28,603 articles were retrieved, and 17 RCTs (11,952 subjects) were included. Physical activity interventions were associated with reduction in SBP [−2.11mmHg (95%CI −3.67, −0.54), I243%], DBP [−2.08mmHg (95%CI −3.68, −0,49), I265%] and TG [-0.08mmol/L (95% CI -0.13, -0.03), I20%], and increase in TC [0.17mmol/L (95%CI 0.04, 0.30), I20%]. However, the interventions were not associated with reductions in BMI [−0.03 kg/m2 (95%CI −0.17, 0.10), I20%]. Conclusion This update confirms and reinforces the beneficial effects of physical activity intervention in reducing systolic and diastolic blood pressure and TG levels.

Family Functioning of Adolescents with Congenital Cardiopathy in a Sample from Public Schools in Porto Alegre - RS

Abstract Background The impact of chronic diseases on the patient and the family ranges from minimal to severe distress. Family functioning has been often investigated as a psychosocial measure having an essential role for social adjustment in chronic diseases. Objectives To compare family functioning among families of adolescents with congenital heart disease (CHD) and healthy controls (H) in relation to cohesion, adaptability, and family risk. Method Cross-sectional exposed-control study with 2 groups of adolescents (12 -18 years). The exposed group included adolescents with congenital heart disease (CHD), from a specialized public health system hospital (SUS), and adolescents from 7 public schools, considered healthy, composed the control group. In the hospital, the data collection was individual, before the medical consultation. In schools, the collection took place in groups. Adolescents and parents responded to the FACES III scale. The following statistical tests were used: Pearson's chi-square, Fisher's test, T-test for independent samples, Poisson multivariate regression analysis with 95% reliability, significance established at 5% and a statistical power at 99% (ß = 0.01). Results A total of 161 (41.6%) adolescents with CHD and 226 (58.4%) healthy adolescents participated. There was greater family cohesion among adolescents with CHD, with a higher frequency of connected families, while among healthy adolescents, there are more families of the disengaged type. Regarding adaptability, a higher proportion of families of the chaotic type were found among healthy adolescents compared to adolescents with CHD. A higher frequency of high-risk families was identified among healthy adolescents (16.8%). Conclusion The families of the adolescents with CHD have a more balanced functioning and low risk when compared to the families of healthy adolescents; with greater cohesion between the members and greater adaptability. Congenital heart disease was not an independent factor for high-risk family. (Int J Cardiovasc Sci. 2020; [online].ahead print, PP.0-0).

Prevalence of symptoms of COVID-19 in the state of Rio Grande do Sul: results of a population-based study with 18,000 participants.

OBJECTIVE: To evaluate the prevalence of reports of symptoms of COVID-19 among individuals with and without antibodies and identify those with greater capability to predict the presence of antibodies against SARS-CoV-2. METHODS: The study uses data collected in phases 5 to 8 of Epicovid-19-RS. The presence of antibodies against SARS-CoV-2 was evaluated by a rapid test. The occurrence of cough, fever, palpitations, sore throat, difficulty breathing, changes in taste and smell, vomiting, diarrhea, body pain, shaking, and headache since March 2020 was also evaluated. Then, the capability to predict the evaluated symptoms concerning the presence of antibodies was calculated. RESULTS: A total of 18,000 individuals were interviewed and 181 had antibodies against COVID-19 in phases 5 to 8. The proportion of asymptomatic individuals was 19.9% among participants with antibodies and 49.7% among those without antibodies. All symptoms were reported more frequently by individuals with antibodies. The division of the prevalence of symptoms among individuals with antibodies by the prevalence among individuals without antibodies showed the following prevalence ratios: for changes in smell or taste (9.1), fever (4.2), tremors (3.9), breathing difficulty (3.2) and cough (2.8 times). Anosmia and fever were the symptoms with a greater capability to predict the presence of antibodies. CONCLUSION: The prevalence of symptoms was higher among individuals with antibodies against SARS-CoV-2. The proportion of asymptomatic individuals was low. Altered smell or taste and fever were the symptoms that most predict the presence of antibodies. These results can help to identify probable cases, contributing to the clinical diagnosis and screening of patients for testing and isolation guidance in positive cases, especially in scenarios of the scarcity of diagnostic COVID-19 tests.

Translation, cross-cultural adaptation, and validation of the Leuven Knowledge Questionnaire for congenital heart disease instrument into Brazilian Portuguese

Abstract Objective To translate the Leuven Knowledge Questionnaire for Congenital Heart Disease into Brazilian Portuguese and to validate its psychometric properties with parents and family caregivers of children with congenital heart disease. Method This was a six-step methodological study, including the translation, synthesis, back-translation, evaluation of the version translated by the committee of experts, pre-testing, and validation, for which two pilot tests were used including the think-aloud protocol. The content validity index and the frequency of socioeconomic data were calculated in a statistical programming environment. Results In content validation, the instrument showed good applicability among experts, with average content validity index of 0.8-1, while kappa agreement analysis was between 0.76 to 1; both results were considered adequate for validation. Conclusions The results suggest reliability among the evaluators, indicating the instrument's accuracy and the possibility of using it to assess the knowledge of parents and family caregivers about congenital heart disease.

Social Distancing, Mask Use, and Transmission of Severe Acute Respiratory Syndrome Coronavirus 2, Brazil, April-June 2020.

We assessed the associations of social distancing and mask use with symptomatic, laboratory-confirmed severe acute respiratory syndrome coronavirus 2 infection in Porto Alegre, Brazil. We conducted a population-based case-control study during April-June 2020. Municipal authorities furnished case-patients, and controls were taken from representative household surveys. In adjusted logistic regression analyses of 271 case-patients and 1,396 controls, those reporting moderate to greatest adherence to social distancing had 59% (odds ratio [OR] 0.41, 95% CI 0.24-0.70) to 75% (OR 0.25, 95% CI 0.15-0.42) lower odds of infection. Lesser out-of-household exposure (vs. going out every day all day) reduced odds from 52% (OR 0.48, 95% CI 0.29-0.77) to 75% (OR 0.25, 95% CI 0.18-0.36). Mask use reduced odds of infection by 87% (OR 0.13, 95% CI 0.04-0.36). In conclusion, social distancing and mask use while outside the house provided major protection against symptomatic infection.

Prevalence of overweight and obesity among Brazilian adolescents over time: a systematic review and meta-analysis.

OBJECTIVE: To estimate the burden of excess weight in Brazilian adolescents. DESIGN: Systematic review with meta-analysis. SETTING: We searched the literature in four databases (MEDLINE/PubMed, EMBASE, SciELO and LILACS). Studies were included if they had cross-sectional or cohort design and enrolled Brazilian adolescents. Studies based on self-reported measures were excluded. Random effect models were used to calculate prevalence estimates and their 95 % CI. PARTICIPANTS: Brazilian adolescents (10 to 19 years old). RESULTS: One hundred and fifty-one studies were included. Trend analyses showed a significant increase in the prevalence of excess weight in the last decades: 8·2 % (95 % CI 7·7, 8·7) until year 2000, 18·9 (95 % CI 14·7, 23·2) from 2000 to 2009, and 25·1 % (95 % CI 23·4, 26·8) in 2010 and after. A similar temporal pattern was observed in the prevalence of overweight and obesity separately. In sensitivity analyses, lower prevalence of excess weight was found in older adolescents and those defined using International Obesity Task Force cut-off points. The Southeast and South regions had the highest prevalence of excess weight, overweight and obesity. No significant difference in prevalence by sex was found, except for studies before the year 2000. CONCLUSIONS: The prevalence of overweight and obesity in Brazilian adolescents is high and continues to rise. Public policies on an individual level and targeting modifications in the obesogenic environment are necessary.

Translation, cross-cultural adaptation, and validation of the Leuven Knowledge Questionnaire for congenital heart disease instrument into Brazilian Portuguese.

OBJECTIVE: To translate the Leuven Knowledge Questionnaire for Congenital Heart Disease into Brazilian Portuguese and to validate its psychometric properties with parents and family caregivers of children with congenital heart disease. METHOD: This was a six-step methodological study, including the translation, synthesis, back-translation, evaluation of the version translated by the committee of experts, pre-testing, and validation, for which two pilot tests were used including the think-aloud protocol. The content validity index and the frequency of socioeconomic data were calculated in a statistical programming environment. RESULTS: In content validation, the instrument showed good applicability among experts, with average content validity index of 0.8-1, while kappa agreement analysis was between 0.76 to 1; both results were considered adequate for validation. CONCLUSIONS: The results suggest reliability among the evaluators, indicating the instrument's accuracy and the possibility of using it to assess the knowledge of parents and family caregivers about congenital heart disease.

Prevalence of symptoms of COVID-19 in the state of Rio Grande do Sul: results of a population-based study with 18,000 participants / Prevalência de sintomas característicos de covid-19 no Rio Grande do Sul: resultados de um estudo de base populacional com 18 mil participantes

ABSTRACT OBJECTIVE To evaluate the prevalence of reports of symptoms of COVID-19 among individuals with and without antibodies and identify those with greater capability to predict the presence of antibodies against SARS-CoV-2. METHODS The study uses data collected in phases 5 to 8 of Epicovid-19-RS. The presence of antibodies against SARS-CoV-2 was evaluated by a rapid test. The occurrence of cough, fever, palpitations, sore throat, difficulty breathing, changes in taste and smell, vomiting, diarrhea, body pain, shaking, and headache since March 2020 was also evaluated. Then, the capability to predict the evaluated symptoms concerning the presence of antibodies was calculated. RESULTS A total of 18,000 individuals were interviewed and 181 had antibodies against COVID-19 in phases 5 to 8. The proportion of asymptomatic individuals was 19.9% among participants with antibodies and 49.7% among those without antibodies. All symptoms were reported more frequently by individuals with antibodies. The division of the prevalence of symptoms among individuals with antibodies by the prevalence among individuals without antibodies showed the following prevalence ratios: for changes in smell or taste (9.1), fever (4.2), tremors (3.9), breathing difficulty (3.2) and cough (2.8 times). Anosmia and fever were the symptoms with a greater capability to predict the presence of antibodies. CONCLUSION The prevalence of symptoms was higher among individuals with antibodies against SARS-CoV-2. The proportion of asymptomatic individuals was low. Altered smell or taste and fever were the symptoms that most predict the presence of antibodies. These results can help to identify probable cases, contributing to the clinical diagnosis and screening of patients for testing and isolation guidance in positive cases, especially in scenarios of the scarcity of diagnostic COVID-19 tests.

RESUMO OBJETIVO Avaliar prevalência de relato de sintomas característicos de covid-19 entre indivíduos com e sem anticorpos e identificar aqueles com maior capacidade de predição da presença de anticorpos contra o SARS-CoV-2. MÉTODOS O presente estudo usa dados coletados nas fases de 5 a 8 do Epicovid-19-RS. A presença de anticorpos contra o SARS-CoV-2 foi avaliada por um teste rápido. Avaliou-se também a ocorrência dos sintomas tosse, febre, palpitações, dor de garganta, dificuldade para respirar, alterações no paladar e olfato, vômito, diarreia, dor no corpo, tremedeira e dor de cabeça, desde março de 2020. Então, calculou-se a capacidade de predição dos sintomas avaliados em relação a presença de anticorpos. RESULTADOS Nas fases de 5 a 8, 18 mil indivíduos foram entrevistados e 181 apresentaram anticorpos contra covid-19. A proporção de indivíduos assintomáticos foi de 19,9% entre participantes com anticorpos e 49,7% entre aqueles sem anticorpos. Todos os sintomas foram relatados com maior frequência por indivíduos com presença de anticorpos. A divisão da prevalência de sintomas entre indivíduos com anticorpos pela prevalência entre indivíduos sem anticorpos evidenciou as seguintes razões de prevalência: para alterações de olfato ou paladar (9,1), febre (4,2), tremedeira (3,9), dificuldade respiratória (3,2) e tosse (2,8 vezes). Anosmia e febre foram os sintomas com maior capacidade de predizer a presença de anticorpos. CONCLUSÃO A prevalência de sintomas foi maior entre indivíduos com anticorpos contra SARS-CoV-2. A proporção de indivíduos assintomáticos foi baixa. Alteração de olfato ou paladar e febre foram os sintomas que mais predizem a presença de anticorpos. Esses resultados podem auxiliar a identificação de casos prováveis, contribuindo para o diagnóstico clínico e triagem de pacientes para testagem e orientação de isolamento em casos positivos, especialmente em cenários de escassez de testes diagnósticos de covid-19.

EPICOVID19 protocol: repeated serological surveys on SARS-CoV-2 antibodies in Brazil.

The first case of COVID-19 was reported in China in December 2019, and, as the virus has spread worldwide, the World Health Organization declared it a pandemic. Estimates on the number of COVID-19 cases do not reflect it real magnitude as testing is limited. Population based data on the proportion of the population with antibodies is relevant for planning public health policies. We aim to assess the prevalence of SARS-CoV-2 antibodies, presence of signs and symptoms of COVID-19, and adherence to isolation measures. A random sample comprising 133 sentinel cities from all states of the country will be selected. Three serological surveys, three weeks apart, will be conducted. The most populous municipality in each intermediate region of the country, defined by the Brazilian Institute of Geography and Statistics, was chosen as sentinel city. In each city, 25 census tracts will be selected, and 10 households will be systematically sampled in each tract, totaling 33,250 participants. In each household, one inhabitant will be randomly selected to be interviewed and tested for antibodies against SARS-CoV-2, using WONDFO SARS-CoV-2 Antibody Test. By evaluating a representative sample of Brazilian sentinel sites, this study will provide essential information for the design of health policies.

Nursing Guidelines on Cardiac Surgery and Parents' Anxiety: Randomized Clinical Trial.

OBJECTIVE: The preparation of parents of children who should undergo cardiac surgery requires special treatment such as the explanations about the event. This study aims to compare the effects of standardized nursing guidelines with routine institutional orientation on the anxiety of parents of children undergoing cardiac surgery. METHODS: Randomized clinical trial. The sample consisted of parents of children who underwent cardiac surgery from December 2010 to April 2011. Twenty-two parents were randomized to the intervention group (IG) and received the standard nursing guidelines and 22 participated in the control group (CG) and received the routine guidelines from the institution. Anxiety was assessed by the State-Trait Anxiety Inventory (STAI) applied in the preoperative period, between 12 and 20 hours before surgery and before receiving standard or institutional guidelines and 48 hours after surgery. The analysis of variance (ANOVA) for repeated measures was performed to evaluate the differences between the variations in STAI scores between the groups during the studied period. The level of significance was 0.05. RESULTS: There were no significant differences in baseline anxiety scores between groups with regard to trait anxiety as well as state anxiety: STAI-trait (CG 42.6±4.9 vs. IG 41.4±6.0, P=0.48); STAI-state (CG 42.3±5.7 vs. IG 45.6±8.3, P=0.18). Likewise, the variation in score after 48 hours was similar between groups (STAI-trait P=0.77; STAI-state P=0.61). CONCLUSION: There were no significant differences in the parents' anxiety levels when comparing the two types of guidelines: the standard nursing and the institutional orientation.

Nursing guidelines on cardiac surgery and parents anxiety: randomized clinical trial

Abstract Objective: The preparation of parents of children who should undergo cardiac surgery requires special treatment such as the explanations about the event. This study aims to compare the effects of standardized nursing guidelines with routine institutional orientation on the anxiety of parents of children undergoing cardiac surgery. Methods: Randomized clinical trial. The sample consisted of parents of children who underwent cardiac surgery from December 2010 to April 2011. Twenty-two parents were randomized to the intervention group (IG) and received the standard nursing guidelines and 22 participated in the control group (CG) and received the routine guidelines from the institution. Anxiety was assessed by the State-Trait Anxiety Inventory (STAI) applied in the preoperative period, between 12 and 20 hours before surgery and before receiving standard or institutional guidelines and 48 hours after surgery. The analysis of variance (ANOVA) for repeated measures was performed to evaluate the differences between the variations in STAI scores between the groups during the studied period. The level of significance was 0.05. Results: There were no significant differences in baseline anxiety scores between groups with regard to trait anxiety as well as state anxiety: STAI-trait (CG 42.6±4.9 vs. IG 41.4±6.0, P=0.48); STAI-state (CG 42.3±5.7 vs. IG 45.6±8.3, P=0.18). Likewise, the variation in score after 48 hours was similar between groups (STAI-trait P=0.77; STAI-state P=0.61). Conclusion: There were no significant differences in the parents' anxiety levels when comparing the two types of guidelines: the standard nursing and the institutional orientation.

Knowledge about the Disease and the Practice of Physical Activity in Children and Adolescents with Congenital Heart Disease. / Conhecimento sobre a Doença e a Prática de Atividade Física em Crianças e Adolescentes com Cardiopatia Congênita.

BACKGROUND: Knowledge about the disease itself can be important for self-care in patients with several problems and comprehends information about the diagnosis up to the most important clinical implications. OBJECTIVE: To identify the level of knowledge of children and adolescents with congenital heart disease (CHD) about their illness, and to analyze the association between the level of knowledge and the practice of physical activity. METHODS: Cross-sectional study with 335 patients with CHD, aged 8 to 13 years, followed at a referral pediatric cardiology service in Southern Brazil. Patients were interviewed regarding their knowledge about CHD and a review of medical records was performed to obtain details on heart disease and procedures. A significance level p<0.05 was used. RESULTS: More than 50% of the children and adolescents did not know how to say the name of their disease or explain it. After adjusted OR (AOR), cyanotic patients in comparison to acyanotic ones (AOR: 2.29; 95%CI: 1.76-6.71; p = 0.019); children with lower level of schooling (AOR: 2.20; 95%CI: 1.81-5.86; p = 0.025); and those who did not practice physical activity (AOR: 1.88; 95%CI: 1.09-3.45; p = 0.011) showed potential for incorrect answers or did not know their disease. CONCLUSION: Cyanotic children and adolescents, with a lower level of schooling and who did not practice physical activity, had little knowledge about their disease. It is necessary to develop educational intervention strategies to increase knowledge and change behavior in physical activity promotion, according to the CHD complexity. (Arq Bras Cardiol. 2020; 114(5):786-792).

FUNDAMENTO: O conhecimento sobre a própria doença pode ser importante para o autocuidado em pacientes com vários problemas e abrange a informação sobre o diagnóstico até as implicações clínicas mais importantes. OBJETIVO: Identificar o nível de conhecimento de crianças e adolescentes com cardiopatia congênita (CC) sobre a sua doença, e analisar a relação entre o nível de conhecimento e a prática de atividade física. MÉTODOS: Estudo transversal com 335 pacientes com CC, de 8 a 13 anos, acompanhados em um serviço de cardiologia pediátrica de referência no Sul do Brasil. Os pacientes foram entrevistados em relação ao seu conhecimento sobre a CC e foi realizada revisão dos prontuários para obtenção de detalhes sobre a cardiopatia e os procedimentos. Foi utilizado o nível de significância p < 0,05. RESULTADOS: Mais de 50% das crianças e adolescentes não sabiam referir o nome de sua doença ou explicá-la. Após OR ajustado (ORaj), mostraram potencial para respostas incorretas ou não saber sua doença os pacientes cianóticos em relação aos acianóticos (ORaj: 2,29; IC95%: 1,76-6,71; p=0,019); crianças com menor nível de escolaridade (ORaj: 2,20; IC95%: 1,81-5,86; p=0,025); e não praticantes de atividade física (ORaj: 1,88; IC95%: 1,09-3,45; p=0,011). CONCLUSÃO: As crianças e adolescentes cianóticos, com menor nível de escolaridade e que não praticavam de atividade física apresentaram pouco conhecimento sobre a sua doença. Há necessidade do desenvolvimento de estratégias de intervenções educativas para aumento do conhecimento e mudança comportamental na promoção da atividade física, de acordo com a complexidade da CC. (Arq Bras Cardiol. 2020; 114(5):786-792).

Conhecimento sobre a Doença e a Prática de Atividade Física em Crianças e Adolescentes com Cardiopatia Congênita / Knowledge about the Disease and the Practice of Physical Activity in Children and Adolescents with Congenital Heart Disease

Resumo Fundamento O conhecimento sobre a própria doença pode ser importante para o autocuidado em pacientes com vários problemas e abrange a informação sobre o diagnóstico até as implicações clínicas mais importantes. Objetivo Identificar o nível de conhecimento de crianças e adolescentes com cardiopatia congênita (CC) sobre a sua doença, e analisar a relação entre o nível de conhecimento e a prática de atividade física. Métodos Estudo transversal com 335 pacientes com CC, de 8 a 13 anos, acompanhados em um serviço de cardiologia pediátrica de referência no Sul do Brasil. Os pacientes foram entrevistados em relação ao seu conhecimento sobre a CC e foi realizada revisão dos prontuários para obtenção de detalhes sobre a cardiopatia e os procedimentos. Foi utilizado o nível de significância p < 0,05. Resultados Mais de 50% das crianças e adolescentes não sabiam referir o nome de sua doença ou explicá-la. Após OR ajustado (ORaj), mostraram potencial para respostas incorretas ou não saber sua doença os pacientes cianóticos em relação aos acianóticos (ORaj: 2,29; IC95%: 1,76-6,71; p=0,019); crianças com menor nível de escolaridade (ORaj: 2,20; IC95%: 1,81-5,86; p=0,025); e não praticantes de atividade física (ORaj: 1,88; IC95%: 1,09-3,45; p=0,011). Conclusão As crianças e adolescentes cianóticos, com menor nível de escolaridade e que não praticavam de atividade física apresentaram pouco conhecimento sobre a sua doença. Há necessidade do desenvolvimento de estratégias de intervenções educativas para aumento do conhecimento e mudança comportamental na promoção da atividade física, de acordo com a complexidade da CC. (Arq Bras Cardiol. 2020; 114(5):786-792)

Abstract Background Knowledge about the disease itself can be important for self-care in patients with several problems and comprehends information about the diagnosis up to the most important clinical implications. Objective To identify the level of knowledge of children and adolescents with congenital heart disease (CHD) about their illness, and to analyze the association between the level of knowledge and the practice of physical activity. Methods Cross-sectional study with 335 patients with CHD, aged 8 to 13 years, followed at a referral pediatric cardiology service in Southern Brazil. Patients were interviewed regarding their knowledge about CHD and a review of medical records was performed to obtain details on heart disease and procedures. A significance level p<0.05 was used. Results More than 50% of the children and adolescents did not know how to say the name of their disease or explain it. After adjusted OR (AOR), cyanotic patients in comparison to acyanotic ones (AOR: 2.29; 95%CI: 1.76-6.71; p = 0.019); children with lower level of schooling (AOR: 2.20; 95%CI: 1.81-5.86; p = 0.025); and those who did not practice physical activity (AOR: 1.88; 95%CI: 1.09-3.45; p = 0.011) showed potential for incorrect answers or did not know their disease. Conclusion Cyanotic children and adolescents, with a lower level of schooling and who did not practice physical activity, had little knowledge about their disease. It is necessary to develop educational intervention strategies to increase knowledge and change behavior in physical activity promotion, according to the CHD complexity. (Arq Bras Cardiol. 2020; 114(5):786-792)

EPICOVID19 protocol: repeated serological surveys on SARS-CoV-2 antibodies in Brazil / Protocolo EPICOVID19: pesquisas sorológicas repetidas de anticorpos SARS-CoV-2 no Brasil

Abstract The first case of COVID-19 was reported in China in December 2019, and, as the virus has spread worldwide, the World Health Organization declared it a pandemic. Estimates on the number of COVID-19 cases do not reflect it real magnitude as testing is limited. Population based data on the proportion of the population with antibodies is relevant for planning public health policies. We aim to assess the prevalence of SARS-CoV-2 antibodies, presence of signs and symptoms of COVID-19, and adherence to isolation measures. A random sample comprising 133 sentinel cities from all states of the country will be selected. Three serological surveys, three weeks apart, will be conducted. The most populous municipality in each intermediate region of the country, defined by the Brazilian Institute of Geography and Statistics, was chosen as sentinel city. In each city, 25 census tracts will be selected, and 10 households will be systematically sampled in each tract, totaling 33,250 participants. In each household, one inhabitant will be randomly selected to be interviewed and tested for antibodies against SARS-CoV-2, using WONDFO SARS-CoV-2 Antibody Test. By evaluating a representative sample of Brazilian sentinel sites, this study will provide essential information for the design of health policies.

Resumo O COVID-19 é causado pelo vírus SARS-CoV-2, sendo o primeiro caso relatado na China em dezembro de 2019. O vírus se espalhou pelo mundo, levando a Organização Mundial da Saúde a declarar uma pandemia. As estimativas do número de casos de COVID-19 não refletem sua magnitude real, pois os testes são limitados em muitos países. Dados populacionais sobre a proporção da população com anticorpos são relevantes para o planejamento de políticas públicas de saúde. Nosso objetivo é avaliar a prevalência de anticorpos SARS-CoV-2, a presença de sinais e de sintomas de COVID-19 e a adesão a medidas de isolamento. Uma amostra aleatória composta por 133 cidades sentinelas de todos os estados do país será selecionada. Serão realizados três levantamentos sorológicos, com três semanas de intervalo. Em cada cidade, serão selecionados 25 setores censitários e 10 famílias serão amostradas aleatoriamente em cada setor. Em cada domicílio, um habitante será selecionado aleatoriamente para ser entrevistado e testado para anticorpos contra SARS-CoV-2, usando o Teste de Anticorpo WONDFO SARS-CoV-2, que foi validado antes do trabalho de campo. Ao avaliar uma amostra representativa dos locais sentinela ao longo do tempo, este estudo fornecerá informações essenciais para o desenho de políticas de saúde.

Stress and Food Consumption Relationship in Hypertensive Patients.

BACKGROUND: Stress is a state of threat to the balance of the organism, which can cause biological and psychological changes. In hypertensive patients, stress can interfere with blood pressure levels, influence on food choices and neglect of the diet. OBJECTIVE: This study aims to describe the relationship between stress and dietary intake of hypertensive patients. METHODS: A transversal study was carried out at the Arterial Hypertension Clinic of the Cardiology Institute of Rio Grande do Sul, Brazil. The participants were aged ≥ 18 years and hypertensive. Blood pressure, food consumption and anthropometric measurements were collected. The variables related to stress were evaluated by the Lipp's Stress Symptoms Inventory (LSSI) for adults. Significance level of 5% has been considered for all analyzed data. RESULTS: The number of participants was 100. There was a higher prevalence of the female sex (67%), the mean age of the study population was 55.87 ± 12.55 years. Among the participants, 86% were classified in some of the stress phases, on which 57% were in the resistance phase. It was observed that there was no correlation between the presence of stress (as well as their actions), pressure levels and food consumption. The consumption of foods rich in lipids and individuals with a prevalence of psychological symptoms of stress displayed a significant association. CONCLUSIONS: Rich in fat dietary has been the first choice in patients with psychological symptoms of stress. Further studies regarding remodeled dietary intake and blood pressure levels in relation to the stress phases are suggested. These findings are important to contribute to the development of prevention and treatment strategies for cardiovascular diseases.