Malignant peripheral nerve sheath tumor (MPNST) and MPNST-like entities are defined by a specific DNA methylation profile in pediatric and juvenile population.

BACKGROUND: Malignant peripheral nerve sheath tumors (MPNSTs) account for 3-10% of pediatric sarcomas, 50% of which occur in neurofibromatosis type 1 (NF1). Sporadic MPNSTs diagnosis may be challenging due to the absence of specific markers, apart from immunohistochemical H3K27me3 loss. DNA methylation (DNAm) profiling is a useful tool for brain and mesenchymal neoplasms categorization, and MPNSTs exhibit a specific DNAm signature. An MPNST-like group has recently been recognized, including pediatric tumors with retained H3K27me3 mark and clinical/histological features not yet well explored. This study aims to characterize the DNAm profile of pediatric/juvenile MPNSTs/MPNST-like entities and its diagnostic/prognostic relevance. RESULTS: We studied 42 tumors from two groups. Group 1 included 32 tumors histologically diagnosed as atypical neurofibroma (ANF) (N = 5) or MPNST (N = 27); group 2 comprised 10 tumors classified as MPNST-like according to Heidelberg sarcoma classifier. We performed further immunohistochemical and molecular tests to reach an integrated diagnosis. In group 1, DNAm profiling was inconclusive for ANF; while, it confirmed the original diagnosis in 12/27 MPNSTs, all occurring in NF1 patients. Five/27 MPNSTs were classified as MPNST-like: Integrated diagnosis confirmed MPNST identity for 3 cases; while, the immunophenotype supported the change to high-grade undifferentiated spindle cell sarcoma in 2 samples. The remaining 10/27 MPNSTs variably classified as schwannoma, osteosarcoma, BCOR-altered sarcoma, rhabdomyosarcoma (RMS)-MYOD1 mutant, RMS-like, and embryonal RMS or did not match with any defined entity. Molecular analysis and histologic review confirmed the diagnoses of BCOR, RMS-MYOD1 mutant, DICER1-syndrome and ERMS. Group 2 samples included 5 high-grade undifferentiated sarcomas/MPNSTs and 5 low-grade mesenchymal neoplasms. Two high-grade and 4 low-grade lesions harbored tyrosine kinase (TRK) gene fusions. By HDBSCAN clustering analysis of the whole cohort we identified two clusters mainly distinguished by H3K27me3 epigenetic signature. Exploring the copy number variation, high-grade tumors showed frequent chromosomal aberrations and CDKN2A/B loss significantly impacted on survival in the MPNSTs cohort. CONCLUSION: DNAm profiling is a useful tool in diagnostic work-up of MPNSTs. Its application in a retrospective series collected during pre-molecular era contributed to classify morphologic mimics. The methylation group MPNST-like is a 'hybrid' category in pediatrics including high-grade and low-grade tumors mainly characterized by TRK alterations.

Mesenchymal PLAG1 Tumor With PCMTD1-PLAG1 Fusion in an Infant: A New Type of "Plagoma".

ABSTRACT: In the past decade, there have been major advances in knowledge related to mesenchymal tumors, and new genetic alterations are being delineated. We report a mesenchymal spindle cell neoplasm harboring a novel gene fusion in an infant. Histopathologically, the neoplasm shared some features with sclerosing perineurioma, but immunohistochemically, EMA was negative, whereas GLUT1, NK1-C3, and BCOR were positive. Next-generation sequencing revealed a PCMTD1-pleomorphic adenoma gene 1 (PLAG1) fusion. PLAG1 contributes to the expression of a variety of genes implicated in regulating cell proliferation, and PCMTD1 has been related to the development of certain carcinomas. Recently, other soft tissue tumors in young children associated with PLAG1 fusion variants have been reported. Perhaps, mesenchymal neoplasms presenting PLAG1 fusions with different genes would confirm a specific group (PLAG mesenchymal tumours or "plagomas") in the near future.

[Identification of risk factors for chronic kidney disease among schoolchildren]. / Identificando fatores de risco para desenvolvimento de Doença Renal Crônica entre escolares.

Aiming at identifying risk factors for chronic kidney disease (CKD) among schoolchildren, a cross-sectional population study was carried out in six municipal schools in Goiânia, Brazil. We investigated: history of birthweight, enuresis, urinary incontinence, mictional urgency, family history of kidney disease, diabetes, arterial hypertension, percentiles of arterial blood pressure, waist circumference and body mass index (BMI). We evaluated 274 children, mean age of 8.06 ± 1.33 years, among which 139 (50.7%) were female. We detected: enuresis in 50 (18.2%); urinary incontinence in 34 (12.4%); mictional urgency in 49 (17.9%); BMI above P85 in 18.8% (45); waist circumference above P90 in 17 (6.9%); arterial blood pressure above P95 in 17 (7.1%). Also, we observed correlation between arterial blood pressure, obesity, and increased waist circumference, (p < 0.05). The study showed high frequency of abnormal voiding habits and increased BMI in this population.

Identificando fatores de risco para desenvolvimento de Doença Renal Crônica entre escolares / Identification of risk factors for chronic kidney disease among schoolchildren

Com o objetivo de avaliar a frequência de fatores de risco para doença renal e suas correlações, foi realizado estudo transversal de base populacional em seis escolas municipais de Goiânia (GO). Nós investigamos a história de baixo peso ao nascer, enurese, incontinência urinária, urgência miccional, antecedente familiar de doença renal, diabete, hipertensão arterial, percentil de pressão arterial, perímetro da cintura e índice de massa corporal (IMC). Foram avaliadas 274 crianças, das quais 139 (50,7%) eram meninas, com idade de 8,06 ± 1,33 anos. Observou-se enurese em 50 (18,2%), incontinência urinária em 34 (12,4%) e urgência em 49 (17,9%). O IMC apresentava-se, em 18,8% (45), acima de P85. Perímetro de cintura acima do percentil 90 em 6,9% (17). Pressão arterial foi detectada acima do P95, em 7,1% (17). Também notamos a presença de correlação da pressão arterial com a obesidade e aumento da circunferência da cintura (p < 0,05). O estudo demonstrou elevada frequência de alterações do hábito miccional e aumento do IMC na população estudada.

Aiming at identifying risk factors for chronic kidney disease (CKD) among schoolchildren, a cross-sectional population study was carried out in six municipal schools in Goiânia, Brazil. We investigated: history of birthweight, enuresis, urinary incontinence, mictional urgency, family history of kidney disease, diabetes, arterial hypertension, percentiles of arterial blood pressure, waist circumference and body mass index (BMI). We evaluated 274 children, mean age of 8.06 ± 1.33 years, among which 139 (50.7%) were female. We detected: enuresis in 50 (18.2%); urinary incontinence in 34 (12.4%); mictional urgency in 49 (17.9%); BMI above P85 in 18.8% (45); waist circumference above P90 in 17 (6.9%); arterial blood pressure above P95 in 17 (7.1%). Also, we observed correlation between arterial blood pressure, obesity, and increased waist circumference, (p < 0.05). The study showed high frequency of abnormal voiding habits and increased BMI in this population.

Hospitalizações por condições cardiovasculares sensíveis à atenção primária em municípios goianos / Hospitalizations due to primary care-sensitive cardiovascular conditions in municipalities of Central-West Brazil / Internaciones por condiciones cardiovasculares sensibles de Atención Primaria en municipios de centro-oeste de Brasil

OBJETIVO: Analisar taxas de hospitalização por condições cardiovasculares sensíveis à atenção primária. MÉTODOS: Estudo ecológico com 237 municípios do Estado de Goiás, de 2000 a 2008, utilizando dados do Sistema de Informação Hospitalar e Sistema de Informação da Atenção Básica. As taxas de hospitalização foram calculadas pela proporção entre o número de hospitalizações por condições cardiovasculares e a população acima de 40 anos. Foram avaliadas em triênios: A (2000-2002), B (2003-2005) e C (2006-2008), segundo sexo, faixa etária, porte populacional, pertencimento à região metropolitana, macrorregião de saúde, distância da capital, Índice de Condições de Vida e Saúde e cobertura de Estratégia Saúde da Família. A cobertura populacional potencial da Saúde da Família foi calculada conforme diretrizes do Ministério da Saúde. A variabilidade das taxas foi avaliada segundo teste t e ANOVA. RESULTADOS: Ocorreram 253.254 internações (17,2 por cento do total) por condições cardiovasculares sensíveis à atenção primária. As taxas de hospitalização diminuíram entre os triênios: A (213,5, dp = 104,6), B (199,7, dp = 96,3) e C (150,2, dp = 76,1), com diferença entre os períodos A-C e B-C (p < 0,001). Porte populacional municipal não influenciou o comportamento das taxas. Municípios próximos à capital e aqueles da região metropolitana apresentaram maiores taxas (p < 0,001). Em todos os percentis do Índice de Condições de Vida e Saúde, houve redução das taxas (p < 0,001), exceto no percentil 1. Redução foi também observada em todas as macrorregiões, exceto na região nordeste do estado. A redução das taxas ocorreu independentemente da cobertura da Saúde da Família. CONCLUSÕES: As taxas de hospitalização por condições cardiovasculares sensíveis à atenção primária diminuíram nesses municípios, independentemente da cobertura da Saúde da Família.

OBJECTIVE: To analyze rates of hospitalization due to primary care-sensitive cardiovascular conditions. METHODS: This ecological study on 237 municipalities in the state of Goiás, Central-West Brazil, between 2000 and 2008, used data from the Hospital Information System and the Primary Care Information System. The hospitalization rates were calculated as the ratio between the number of hospitalizations due to cardiovascular conditions and the population over the age of 40 years. The data were evaluated over the three-year periods A (2000-2002), B (2003-2005) and C (2006-2008), according to sex, age group, population size, whether the individual belonged to the metropolitan region, healthcare macroregion, distance from the state capital, living conditions index and coverage within the Family Health Strategy. The potential population coverage of the Family Health Strategy was calculated in accordance with Ministry of Health guidelines. The variability of the rates was evaluated using the t test and ANOVA. RESULTS: A total of 253,254 hospitalizations (17.2 percent) occurred due to primary care-sensitive cardiovascular conditions. The hospitalization rates diminished between the three-year periods: A (213.5, SD = 104.6), B (199.7, SD = 96.3) and C (150.2, SD = 76.1), with differences from A to C and from B to C (p < 0.001). Municipal population size did not influence the behavior of the rates. Municipalities near the state capital and those in the metropolitan area presented higher rates (p < 0.001). At all percentiles of the Life and Health Conditions Index, there were decreases in the rates (p < 0.001), except at percentile 1. Decreases were also observed in all the macroregions except for the northeastern region of the state. The reduction in rates was independent of the Family Health Strategy coverage. CONCLUSION: The rates of hospitalization due to primary care-sensitive cardiovascular conditions decreased in these municipalities, independent of the Family Health Strategy coverage.

OBJETIVO: Analizar tasas de hospitalización por condiciones cardiovasculares sensibles de atención primaria. MÉTODOS: Estudio ecológico con 237 municipios del estado de Goias (centro-oeste de Brasil) de 2000 a 2008, utilizando datos del Sistema de Información Hospitalario y Sistema de Información de Atención Básica. Las tasas de hospitalización fueron calculadas por la proporción entre el número de hospitalizaciones por condiciones cardiovasculares y la población con más de 40 años. Las tasas fueron evaluadas en trienios: A (2000-2002), B (2003-2005) y C (2006-2008), según sexo, grupo etáreo, porte poblacional, pertenencia a la región metropolitana, macro región de salud, distancia a la capital, índice de Condiciones de Vida y Salud y cobertura de Estrategia Salud de la Familia. La cobertura poblacional potencial de la Salud de la Familia fue calculada conforme a las directrices del Ministerio de la Salud. La variabilidad de las tasas fue evaluada según la prueba de t y ANOVA. RESULTADOS: Ocurrieron 253.254 internaciones (17,2 por ciento del total) por condiciones cardiovasculares sensibles de la atención primaria. Las tasas de hospitalización disminuyeron entre los trienios: A (213,5, de=104,6); B (199,7, de=96,3) y C (150,2, de=76,1), con diferencia entre los períodos A-C y B-C (p<0,001). El porte poblacional municipal no influenció el comportamiento de las tasas. Los municipios próximos a la capital y los de la región metropolitana presentaron mayores tasas (p<0,001). En todos los percentiles del Índice de Condiciones de Vida y Salud, hubo reducción de las tasas (p<0,001), excepto en el percentil 1. También se observó reducción en todas las macro regiones, excepto en la Región Noreste del estado. La reducción de las tasas ocurrió independientemente de la cobertura de la Salud de la Familia. CONCLUSIONES: Las tasas de hospitalización por condiciones cardiovasculares sensibles de la atención primaria disminuyeron en estos municipios, independientemente de la cobertura de la Salud de la Familia.

Hospitalizations due to primary care-sensitive cardiovascular conditions in municipalities of Central-West Brazil.

OBJECTIVE: To analyze rates of hospitalization due to primary care-sensitive cardiovascular conditions. METHODS: This ecological study on 237 municipalities in the state of Goiás, Central-West Brazil, between 2000 and 2008, used data from the Hospital Information System and the Primary Care Information System. The hospitalization rates were calculated as the ratio between the number of hospitalizations due to cardiovascular conditions and the population over the age of 40 years. The data were evaluated over the three-year periods A (2000-2002), B (2003-2005) and C (2006-2008), according to sex, age group, population size, whether the individual belonged to the metropolitan region, healthcare macroregion, distance from the state capital, living conditions index and coverage within the Family Health Strategy. The potential population coverage of the Family Health Strategy was calculated in accordance with Ministry of Health guidelines. The variability of the rates was evaluated using the t test and ANOVA. RESULTS: A total of 253,254 hospitalizations (17.2%) occurred due to primary care-sensitive cardiovascular conditions. The hospitalization rates diminished between the three-year periods: A (213.5, SD = 104.6), B (199.7, SD = 96.3) and C (150.2, SD = 76.1), with differences from A to C and from B to C (p < 0.001). Municipal population size did not influence the behavior of the rates. Municipalities near the state capital and those in the metropolitan area presented higher rates (p < 0.001). At all percentiles of the Life and Health Conditions Index, there were decreases in the rates (p < 0.001), except at percentile 1. Decreases were also observed in all the macroregions except for the northeastern region of the state. The reduction in rates was independent of the Family Health Strategy coverage. CONCLUSION: The rates of hospitalization due to primary care-sensitive cardiovascular conditions decreased in these municipalities, independent of the Family Health Strategy coverage.

Comparação e correlação entre automedida, medida casual e monitorização ambulatorial da pressão arterial / Comparison and correlation between self-measured blood pressure, casual blood pressure measurement and ambulatory blood pressure monitoring / Comparación y correlación entre automedida, medida casual y monitorización ambulatoria de la presión arterial

FUNDAMENTO: A medida casual da pressão arterial (PA) pelos profissionais de saúde está sujeita a uma grande variabilidade, sendo necessário buscar novos métodos que possam superar essa limitação. OBJETIVO: Comparar e avaliar a correlação entre os níveis de PA obtidos por meio da automedida da pressão arterial (AMPA) com a medida casual e com a monitorização ambulatorial da pressão arterial (MAPA). MÉTODOS: Avaliamos hipertensos que realizaram as três metodologias de medida da PA com intervalo menor que 30 dias; as médias das pressões foram utilizadas para comparação e correlação. Foram empregados os aparelhos: OMRON 705 CP (medida casual), OMRON HEM 714 (AMPA) e SPACELABS 9002 (MAPA). RESULTADOS: Foram avaliados 32 pacientes, 50,09 por cento mulheres, idade média 59,7 (± 11,2) anos, média do IMC 26,04 (± 3,3) kg/m². Valores médios de pressão sistólica (PAS) e pressão diastólica (PAD) para a AMPA foram de 134 (± 15,71)mmHg e 79,32 (± 12,38) mmHg. Na medida casual as médias da PAS e PAD foram, respectivamente, 140,84 (± 16,15)mmHg e 85 (± 9,68) mmHg. Os valores médios da MAPA na vigília foram 130,47 (± 13,26) mmHg e 79,84 (± 9,82) mmHg para PAS e PAD, respectivamente. Na análise comparativa, a AMPA apresentou valores semelhantes aos da MAPA (p > 0,05) e diferentes da medida casual (p < 0,05). Na análise de correlação a AMPA foi superior à medida casual, considerando a MAPA como o padrão de referência nas medidas tensionais. CONCLUSÃO: A AMPA apresentou melhor comparação com a MAPA do que a medida casual e também se correlacionou melhor com a aquela, especialmente para a pressão diastólica, devendo ser considerada uma alternativa com baixo custo para o acompanhamento do paciente hipertenso.

BACKGROUND: Casual blood pressure (BP) measurement by healthcare professionals is subject to great variability and new methods are necessary to overcome this limitation. OBJECTIVE: To compare and assess the correlation between the BP levels obtained by self-measured BP (SMBP), casual BP measurement and ambulatory blood pressure monitoring (ABPM). METHODS: We assessed hypertensive individuals submitted to the three methods of BP measurement at an interval < 30 days; the BP means were used for comparison and correlation. The following devices were used: OMRON 705 CP (casual measurement), OMRON HEM 714 (SMBP) and SPACELABS 9002 (ABPM). RESULTS: A total of 32 patients were assessed, of which 50.09 percent were females, with a mean age of 59.7 (± 11.2), BMI mean of 26.04 (± 3.3) kg/m². Mean systolic (SBP) and diastolic blood pressure (DBP) for SMBP were 134 (± 15.71) mmHg and 79.32 (± 12.38) mmHg. The casual measurement means of SBP and DBP were, respectively, 140.84 (± 16.15) mmHg and 85 (± 9.68) mmHg. The mean values of ABPM during the wakefulness period were 130.47 (± 13.26) mmHg and 79.84 (± 9.82) mmHg for SBP and DBP, respectively. At the comparative analysis, the SMBP had similar results to those obtained at ABPM (p > 0.05) and different from the casual measurement (p < 0.05). At the analysis of correlation, SMBP values were higher than the casual measurements, considering ABPM as the reference standard in BP measurements. CONCLUSION: SMBP showed a better correlation with ABPM than the casual measurement and was also better correlated with the latter, especially regarding the DBP and should be considered as a low-cost alternative for the follow-up of the hypertensive patient.

FUNDAMENTO: La medida casual de la presión arterial (PA), por los profesionales de la salud está sujeta a una gran variabilidad, siendo necesario buscar nuevos métodos que puedan superar esa limitación. OBJETIVO: Comparar y evaluar la correlación entre los niveles de PA obtenidos por medio de la automedida de la presión arterial (AMPA) con la medida casual y con la monitorización ambulatoria de la presión arterial (MAPA). MÉTODOS: Evaluamos hipertensos que realizaron las tres metodologías de medida de la PA con un intervalo menor que 30 días. Los promedios de las presiones fueron utilizados para la comparación y la correlación. Fueron usados los aparatos: OMRON 705 CP (medida casual), OMRON HEM 714 (AMPA) y SPACELABS 9002 (MAPA). RESULTADOS: Se evaluaron 32 pacientes, 50,09 por ciento mujeres, edad promedio 59,7(± 11,2) años, promedio del IMC 26,04 (± 3,3) kg/m². Los valores promedios de presión sistólica (PAS) y presión diastólica (PAD) para la AMPA fueron de 134 (± 15,71) mmHg y 79,32(± 12,38) mmHg. En la medida casual los promedios de la PAS y PAD fueron, respectivamente, 140,84 (± 16,15) mmHg y 85 (± 9,68) mmHg. Los valores promedios de la MAPA en la vigilia fueron 130,47 (± 13,26) mmHg y 79,84 (± 9,82) mmHg para PAS y PAD, respectivamente. En el análisis comparativo, la AMPA tuvo valores similares a los de la MAPA (p > 0,05) y diferentes de la medida casual (p < 0,05). En el análisis de correlación la AMPA fue superior a la medida casual, considerando la MAPA como el estándar de referencia en las medidas tensionales. CONCLUSIÓN: La AMPA presentó una mejor comparación con la MAPA que la medida casual y también se correlacionó mejor con aquella, especialmente para la presión diastólica, debiendo ser considerada como una alternativa con bajo coste para el seguimiento del paciente hipertenso.

Comparison and correlation between self-measured blood pressure, casual blood pressure measurement and ambulatory blood pressure monitoring.

BACKGROUND: Casual blood pressure (BP) measurement by healthcare professionals is subject to great variability and new methods are necessary to overcome this limitation. OBJECTIVE: To compare and assess the correlation between the BP levels obtained by self-measured BP (SMBP), casual BP measurement and ambulatory blood pressure monitoring (ABPM). METHODS: We assessed hypertensive individuals submitted to the three methods of BP measurement at an interval < 30 days; the BP means were used for comparison and correlation. The following devices were used: OMRON 705 CP (casual measurement), OMRON HEM 714 (SMBP) and SPACELABS 9002 (ABPM). RESULTS: A total of 32 patients were assessed, of which 50.09% were females, with a mean age of 59.7 (± 11.2), BMI mean of 26.04 (± 3.3) kg/m(2). Mean systolic (SBP) and diastolic blood pressure (DBP) for SMBP were 134 (± 15.71) mmHg and 79.32 (± 12.38) mmHg. The casual measurement means of SBP and DBP were, respectively, 140.84 (± 16.15) mmHg and 85 (± 9.68) mmHg. The mean values of ABPM during the wakefulness period were 130.47 (± 13.26) mmHg and 79.84 (± 9.82) mmHg for SBP and DBP, respectively. At the comparative analysis, the SMBP had similar results to those obtained at ABPM (p > 0.05) and different from the casual measurement (p < 0.05). At the analysis of correlation, SMBP values were higher than the casual measurements, considering ABPM as the reference standard in BP measurements. CONCLUSION: SMBP showed a better correlation with ABPM than the casual measurement and was also better correlated with the latter, especially regarding the DBP and should be considered as a low-cost alternative for the follow-up of the hypertensive patient.

Home blood pressure in children and adolescents: a comparison with office and ambulatory blood pressure measurements.

AIM: To compare BP measurements of children and adolescents using different methods office BP (OBP), ambulatory BP monitoring (ABPM) and home BP measurement (HBPM) and to study their correlations. METHOD: Individuals were evaluated between 5 and 15 years of age who had been referred because of a previous high BP. OBP was measured with the OMRON-705CP. Three measurements were carried out at 5-min intervals. HBPM were taken using the same device, two measurements at 5-min intervals in the morning and in the evening during 7 days. ABPM was performed using the SpaceLabs 90207 monitors. RESULTS: A total of 109 children and adolescents were evaluated (9.82 ± 2.63 years), 52.3% boys, 56.9% non-white. The office systolic BP (SBP) was lower than in daytime ABPM (p < 0.001) but similar HBPM (p = 0.294), and the office diastolic BP (DBP) was lower than daytime ABPM (p < 0.001) and in HBPM (p = 0.035). The SBP and DBP at HBPM was lower than daytime ABPM (p < 0.001). Daytime ambulatory BP was more closely associated with home readings (SBP r = 0.731 and DBP r = 0.616) than with office's readings (SBP r = 0.653 and DBP r = 0.394). CONCLUSION: The BP of children and adolescents varies depending on the place and manner of measurement. ABPM presents better correlation with HBPM than with the office measurements.

Fatores de risco associados à infecção e mortalidade por Staphylococcus aureus resistentes a oxacilina em um hospital de referência para doenças infectocontagiosas de Goiânia-GO, Brasil / Risk factors associated to infection and mortality by oxacillin-resistantStaphylococcus aureus (ORSA) in a hospital of reference for infecto-contagious diseases de Goiânia-GO, Brazil / Factores de riesgo asociados a la infección y a la mortalidad por Staphylococcus aureus resistente a oxacilina (orsa) en un hospital de referencia para molestias infecto-contagiosas de Goiânia-GO, el Brasil

Os Staphylococcus aureus são importantes agentes causadores de Infecções relacionadas à Assistência à Saúde, especialmente infecções primárias da corrente sanguínea. Os objetivos deste estudo foram: identificar os fatores de riso para infecção por SARO e os fatoresde risco associados à mortaliadade por SARO; descrever o perfil de susceptibilidade aos antimicrobianos. Foram avaliados 44 prontuários depacientes com diagnóstico de infecção hospitalar por Staphylococcus aureus resistente a oxacilina (SARO) no período de Abril de 2005 a Julhode 2008. O estudo foi tipo caso controle. Os fatores de risco independentes para infecção e mortalidade foram definidos após análise univariada e multivariada. Os fatores de risco independentes para infecção por SARO foram o uso de antibióticos nos últimos 15 dias que precedem o isolamento do SARO e a utilização de nutrição parenteral total. O fator de risco independente associado ao óbito foi o uso de ventilação mecânica. Os sítios mais frequentes de isolamento de SARO foram: no sangue e as secreções. As doenças de base que mais frequentemente acometeram os pacientes que contraíram infecção por SARO foram AIDS, infecção de corrente sanguínea e pneumonia.

Staphylococcus aureus are important agents of hospital infections, especially bloodstream primary infections. The objectives of this study were to identify risk factors for infection by ORSA and risk factors associated to ORSA mortality, and to describe the profileof susceptibility to antimicrobiotic substances. We did a case control study with 44 medical registers of patients diagnosed with hospital infection by ORSA from April 2005 to July 2008. Independent risk factors for infection and mortality were defined after univariate and multivariate analysis. Independent risk factors for infection by ORSA were the use of antibiotics in the last 15 days preceding the isolationof ORSA and the use of total parenteral nutrition. The independent risk factor for death was the use of mechanical ventilation. The most frequent places for ORSA isolation were the blood and secretions. The more frequent base diseases of patients infected by SARO were AIDS, bloodstream infection and pneumonia.

Staphylococcus aureus son agentes importantes de las infecciones hospitalarias, especialmente infecciones primarias de la circulaciónsanguínea. Los objetivos de este estudio fueran identificar los factores de riesgo para infección por ORSA y los factores de riesgo se asociaron a la mortalidad de la ORSA, y describir el perfil de la susceptibilidad a las substancias antimicrobioticas. Hicimos un estudio de control de caso con 44 registros médicos de pacientes diagnosticados con infección hospitalaria por ORSA desde abril 2005 hasta julio 2008. Los factores de riesgo independientes para la infección y la mortalidad fueron definidos después de análisis univariante y multivariante. Losfactores de riesgo independientes para la infección por a ORSA fueran el uso de antibióticos en los 15 días precedentes al aislamiento de ORSA y el uso de la nutrición parenteral total. El factor de riesgo independiente para la muerte fue el uso de ventilación mecánica. Los lugares más frecuentes para el aislamiento de ORSA fueran la sangre y las secreciones. Las enfermedades primarias más frecuentes de los pacientes infectados por ORSA fueran SIDA, infección de la circulación sanguínea y pulmonía.

Fatores de risco cardiovasculares em coorte de profissionais da área médica: 15 anos de evolução / Cardiovascular risk factors in a cohort of healthcare professionals: 15 years of evolution / Factores de riesgo cardiovasculares en cohorte de profesionales del área médica: 15 años de evolución

FUNDAMENTO: Segundo a Organização Mundial de Saúde (OMS), as doenças cardiovasculares (DCV) são responsáveis por 16,7 milhões de mortes/ano. Evidências mostram que as DCV resultam da interação entre fatores de risco variados, presentes desde a infância. OBJETIVO: Verificar, em profissionais da área médica, a presença e evolução de alguns fatores de risco cardiovasculares (FRCV) em um intervalo de 15 anos. MÉTODOS: Analisamos um grupo de indivíduos ao ingressar na faculdade de medicina e repetimos a análise 15 anos depois, comparando os dados encontrados. Utilizamos questionários sobre FRCV (hipertensão arterial sistêmica (HAS), diabete melito (DM), dislipidemia e história familiar de DCV precoce, tabagismo, etilismo e sedentarismo). O colesterol, a glicemia, a PA, o peso, a altura, o índice de massa corpórea (IMC) foram determinados. RESULTADOS: Comparamos 100 indivíduos (sendo 64,0 por cento homens com idade média de 19,9 anos), com os 72 (sendo 62,5 por cento homens, 34,8 anos) incluídos 15 anos após. Houve aumento na prevalência de HAS (6,0 por cento vs 16,7 por cento, p = 0,024), excesso de peso (9,0 por cento vs 26,4 por cento, p = 0,002) e dislipidemia (4,0 por cento vs 19,14 por cento, p = 0,002). Os demais FRCV não se modificaram. Na análise dos valores de pressão arterial sistólica (PAS), pressão arterial diastólica (PAD), colesterol, glicemia e IMC, encontramos elevação na média de todas variáveis (p < 0,05). Houve correlação positiva entre valores de PAS, PAD, IMC e glicemia no intervalo de tempo avaliado (p < 0,05). CONCLUSÃO: Em profissionais da área médica, encontramos elevação na PAS, PAD, glicemia, IMC e colesterol em 15 anos. Na análise da prevalência de FRCV, houve aumento de hipertensão arterial, excesso de peso e dislipidemia.

BACKGROUND: According to the World Health Organization (WHO), cardiovascular diseases (CVD) account for 16.7 million deaths per year. Evidence shows that CVD result from the interaction of multiple risk factors that are present from childhood. OBJECTIVE: To evaluate the presence and evolution of several cardiovascular risk factors (CVRF) among medical professionals, in a period of 15 years. METHODS: We analyzed a group of individuals when they entered medical school, and repeated the analysis after 15 years, comparing the data found. We used CVRF questionnaires (systemic arterial hypertension (SAH); diabetes mellitus (DM); dyslipidemia and family history of premature CVD; smoking habit; alcoholism; and sedentary lifestyle). Cholesterol, blood glucose, BP, weight, height, body mass index (BMI) values were determined. RESULTS: We compared 100 subjects (64.0 percent men with a mean age of 19.9 years) with a total of 72 subjects (62.5 percent men, 34.8 years) that were included in the study 15 years later. There was an increase in the prevalence of hypertension (6.0 percent vs 16.7 percent, p = 0.024), overweight (9.0 percent vs 26.4 percent, p = 0.002), and dyslipidemia (4.0 percent vs 19.14 percent, p = 0.002). The other CVRF remained unchanged. Analyzing the values of systolic blood pressure (SBP); diastolic blood pressure (DBP); cholesterol; glucose; and BMI, we found an increase in the mean values of all variables (p < 0.05). We observed a positive correlation between the values of SBP, DBP, BMI, and blood glucose measured in the time interval (p < 0.05). CONCLUSION: Among medical professionals, there was an elevation in SBP, DBP, glucose, BMI, and cholesterol values in 15 years. In the CVRF prevalence analysis, we found an increase in the prevalence of hypertension, overweight, and dyslipidemia.

FUNDAMENTO: Según la Organización Mundial de Salud (OMS), las enfermedades cardiovasculares (ECV) son responsables de 16,7 millones de muertes/año. Evidencias muestran que las ECV resultan de la interacción entre factores de riesgo variados, presentes desde la infancia. OBJETIVO: Verificar, en profesionales del área médica, la presencia y evolución de algunos factores de riesgo cardiovasculares (FRCV) en un intervalo de 15 años. MÉTODOS: Analizamos a un grupo de individuos al ingresar en la facultad de medicina y hemos repetido el análisis tras 15 años, comparando los datos encontrados. Utilizamos cuestionarios sobre FRCV (hipertensión arterial sistémica (HAS), diabetes melito (DM), dislipidemia e historia familiar de ECV precoz, tabaquismo, etilismo y sedentarismo). El colesterol, la glucemia, el PA, el peso, la altura, el índice de masa corpórea (IMC) fueron determinados. RESULTADOS: Comparamos a 100 individuos (siendo el 64 por ciento varones con edad promedio de 19,9 años), con los 72 (siendo un 62,5 por ciento varones, 34,8 años) incluidos 15 años después. Hubo un aumento en la prevalencia de HAS (6,0 por ciento vs 16,7 por ciento, p = 0,024), exceso de peso (9,0 por ciento vs 26,4 por ciento, p = 0,002) y dislipidemia (4,0 por ciento vs 19,14 por ciento, p = 0,002). Los demás FRCV no se modificaron. En el análisis de los valores de presión arterial sistólica (PAS), presión arterial diastólica (PAD), colesterol, glucemia e IMC, encontramos elevación en el promedio de todas las variables (p < 0,05). Hubo correlación positiva entre valores de PAS, PAD, IMC y glucemia en el intervalo de tiempo evaluado (p < 0,05). CONCLUSIÓN: En profesionales del área médica, encontramos elevación en la PAS, PAD, glucemia, IMC y colesterol en 15 años. En el análisis de la prevalencia de FRCV, hubo aumento de hipertensión arterial, exceso de peso y dislipidemia.

Cardiovascular risk factors in a cohort of healthcare professionals: 15 years of evolution.

BACKGROUND: According to the World Health Organization (WHO), cardiovascular diseases (CVD) account for 16.7 million deaths per year. Evidence shows that CVD result from the interaction of multiple risk factors that are present from childhood. OBJECTIVE: To evaluate the presence and evolution of several cardiovascular risk factors (CVRF) among medical professionals, in a period of 15 years. METHODS: We analyzed a group of individuals when they entered medical school, and repeated the analysis after 15 years, comparing the data found. We used CVRF questionnaires (systemic arterial hypertension (SAH); diabetes mellitus (DM); dyslipidemia and family history of premature CVD; smoking habit; alcoholism; and sedentary lifestyle). Cholesterol, blood glucose, BP, weight, height, body mass index (BMI) values were determined. RESULTS: We compared 100 subjects (64.0% men with a mean age of 19.9 years) with a total of 72 subjects (62.5% men, 34.8 years) that were included in the study 15 years later. There was an increase in the prevalence of hypertension (6.0% vs 16.7%, p = 0.024), overweight (9.0% vs 26.4%, p = 0.002), and dyslipidemia (4.0% vs 19.14%, p = 0.002). The other CVRF remained unchanged. Analyzing the values of systolic blood pressure (SBP); diastolic blood pressure (DBP); cholesterol; glucose; and BMI, we found an increase in the mean values of all variables (p < 0.05). We observed a positive correlation between the values of SBP, DBP, BMI, and blood glucose measured in the time interval (p < 0.05). CONCLUSION: Among medical professionals, there was an elevation in SBP, DBP, glucose, BMI, and cholesterol values in 15 years. In the CVRF prevalence analysis, we found an increase in the prevalence of hypertension, overweight, and dyslipidemia.

[Evaluation of risk and protection factors associated with high blood pressure in children]. / Avaliação dos fatores de risco e proteção associados à elevação da pressão arterial em crianças.

BACKGROUND: Epidemiological studies have shown an increased prevalence of high blood pressure in pediatric patients. Today we know that risk factors can be detected during childhood and may help in preventing the disease. OBJECTIVE: To evaluate risk and protection factors related to high blood pressure in childhood. METHODS: We evaluated children aged 3 to 10 years, residing in the east and southwest sanitary districts of the City of Goiânia, Goiás, and obtained the following data: birth weight, breastfeeding, family history of high blood pressure and obesity, weight, height, body mass index (BMI), and blood pressure. We applied the Mann-Whitney U-test to these variables in order to compare pressure variation. RESULTS: In this sample, 519 children were evaluated, and 246 (47.4%) of them were male. The BMI assessment identified 109 (21%) overweight children, of which 53 (10.3%) were obese. Predominant and/or exclusive breastfeeding for less than 6 months was found in 242 (51.2%). The mean systolic pressure was significantly higher in children with exclusive and/or predominant breastfeeding for less than 6 months (p = 0.04), and in children with family history of high blood pressure (p = 0.05), and in overweight children (p <0.0001). These data were confirmed in multivariate analysis. CONCLUSION: In this sample, we observed that overweight and hereditary factors may be associated with elevated blood pressure, and that breastfeeding for more than 6 months seems to offer a protective effect.

Avaliação dos fatores de risco e proteção associados à elevação da pressão arterial em crianças / Evaluation of risk and protection factors associated with high blood pressure in children

FUNDAMENTO: Estudos epidemiológicos têm mostrado um aumento da prevalência da hipertensão arterial na faixa etária pediátrica. Hoje se sabe que os fatores de risco poderiam ter sido detectados na infância, o que auxiliaria na prevenção da doença. OBJETIVO: Avaliar fatores de risco e de proteção relacionados à elevação da pressão arterial na infância. MÉTODOS: Foram avaliadas crianças de 3 a 10 anos moradoras dos distritos sanitários leste e sudoeste de Goiânia, Goiás. Obtiveram-se os seguintes dados: peso ao nascer, aleitamento materno, história familiar de hipertensão e obesidade, peso, estatura, índice de massa corporal (IMC) e pressão arterial. Utilizaram-se os testes de U de Mann-Whitney para comparar a variação da pressão arterial quanto às variáveis descritas. RESULTADOS: Na amostra estudada, 519 crianças foram avaliadas, 246 (47,4 por cento) do sexo masculino. Avaliação do IMC identificou 109 (21 por cento) com excesso de peso, das quais 53 (10,3 por cento) eram obesas. O aleitamento materno predominante e/ou exclusivo por tempo inferior a 6 meses foi encontrado em 242 (51,2 por cento). As médias da pressão sistólica se encontraram significativamente mais elevadas naquelas crianças com aleitamento materno exclusivo e/ou predominante por tempo inferior a 6 meses (p = 0,04), história familiar positiva para hipertensão (p = 0,05) e excesso de peso (p < 0,0001). Esses dados foram confirmados na análise multivariada. CONCLUSÃO: Na amostra estudada, excesso de peso e fatores hereditários podem estar associados à elevação da pressão arterial, e o tempo em aleitamento materno superior a 6 meses parece conferir um efeito protetor.

BACKGROUND: Epidemiological studies have shown an increased prevalence of high blood pressure in pediatric patients. Today we know that risk factors can be detected during childhood and may help in preventing the disease. OBJECTIVE: To evaluate risk and protection factors related to high blood pressure in childhood. METHODS: We evaluated children aged 3 to10 years, residing in the east and southwest sanitary districts of the City of Goiânia, Goiás, and obtained the following data: birth weight, breastfeeding, family history of high blood pressure and obesity, weight, height, body mass index (BMI), and blood pressure. We applied the Mann-Whitney U-test to these variables in order to compare pressure variation. RESULTS: In this sample, 519 children were evaluated, and 246 (47.4 percent) of them were male. The BMI assessment identified 109 (21 percent) overweight children, of which 53 (10.3 percent) were obese. Predominant and/or exclusive breastfeeding for less than 6 months was found in 242 (51.2 percent). The mean systolic pressure was significantly higher in children with exclusive and/or predominant breastfeeding for less than 6 months (p = 0.04), and in children with family history of high blood pressure (p = 0.05), and in overweight children (p <0.0001). These data were confirmed in multivariate analysis. CONCLUSION: In this sample, we observed that overweight and hereditary factors may be associated with elevated blood pressure, and that breastfeeding for more than 6 months seems to offer a protective effect.

O efeito da musicoterapia na qualidade de vida e na pressão arterial do paciente hipertenso / Music therapy effects on the quality of life and the blood pressure of hypertensive patients / El efecto de la musicoterapia en la calidad de vida y en la presión arterial del paciente hipertenso

FUNDAMENTO: A hipertensão arterial (HA) é uma doença de massa, com conseqüências para o aparelho cardiocirculatório, pois suas complicações elevam as taxas de morbi-mortalidade. Controlar a pressão arterial (PA) diminui complicações e pode preservar a qualidade de vida (QV) dos pacientes. Estudos mostram os efeitos positivos da música como coadjuvante no tratamento de diversas patologias. OBJETIVO: Avaliar o efeito da musicoterapia na QV e no controle da PA de pacientes hipertensos. MÉTODOS: Realizou-se um ensaio clínico controlado que avaliou pacientes de ambos os sexos, maiores que 50 anos, HA estágio 1, em uso de medicação, matriculados em serviço multiprofissional para tratamento da HA. Divididos em grupos experimental (GE) e controle (GC). O GE, além do tratamento convencional, participou de sessões musicoterápicas semanais por doze semanas. O GC permaneceu sob tratamento padrão do serviço. Antes e após a intervenção foi aplicado nos dois grupos o questionário SF-36 e verificada a PA. A voz, importante elemento da comunicação, reflexo do estado físico, psíquico e emocional, foi o principal recurso utilizado. Estatística: testes t-Student e Wilcoxon (significantes p<0,05). RESULTADOS: Os grupos eram inicialmente semelhantes quanto a sexo, idade, escolaridade e QV avaliada. Na comparação inicial e final dos pacientes do GE observamos melhora significativa na QV (p<0,05) e no controle da PA (p<0,05). Sem modificações na adesão. CONCLUSÕES: A musicoterapia contribuiu para a melhora da QV e do controle da PA, sinalizando que essa atividade pode representar um reforço na abordagem terapêutica em programas de atendimento multidisciplinar ao paciente hipertenso.

BACKGROUND: Arterial Hypertension (AH) is a mass disease, with consequences for the cardiocirculatory system, since its complications raise the rates of morbidity and mortality. Controlling blood pressure (BP) reduces complications and may preserve the quality of life (QOL) of patients. Studies show positive effects of music therapy as an adjuvant in the treatment of several diseases. OBJECTIVE: to evaluate the effect of music therapy on the QOL and BP control of hypertensive patients. METHODS: This was a controlled clinical study that evaluated patients of both genders, aged over 50 years, with stage 1 hypertension, in use of medication and enrolled in multidisciplinary service for treatment of hypertension. They were divided into an experimental group (EG) and a control group (CG). The EG, in addition to the conventional treatment, participated in weekly music therapy sessions for twelve weeks. The CG received the standard treatment of the service. Before and after the intervention, the SF-36 questionnaire was applied in both groups, and the BP of each patient was measured. The voice, an important element of communication, reflecting the patient's physical, mental and emotional state, was the main resource used. Statistics: Student T-test and Wilcoxon test were considered significant at p <0.05. RESULSTS: The groups were initially similar in gender, age, education, and the assessed QOL. In the initial and final comparison of EG patients, we observed a significant improvement on the QOL (p <0.05) and BP control (p <0.05), with no change in adhesion. CONCLUSIONS: Music therapy has contributed to an improvement on the QOL and BP control of patients, suggesting that this activity may represent a therapeutic approach to help strengthen the programs of multidisciplinary care of hypertensive patients.

FUNDAMENTO: La hipertensión arterial (HA) es una enfermedad de masa, con consecuencias para el aparato circulatorio, pues sus complicaciones elevan las tasas de morbilidad y mortalidad. Controlar la presión arterial (PA) disminuye complicaciones y puede preservar la calidad de vida (CV) de los pacientes. Estudios muestran los efectos positivos de la música como coadyuvante en el tratamiento de diversas patologías. OBJETIVO: Evaluar el efecto de la musicoterapia en la CV y en el control de la PA de pacientes hipertensos. MÉTODOS: Se realizó un ensayo clínico controlado que evaluó pacientes de ambos sexos, mayores de 50 años, HA estado 1, en uso de medicación, matriculados en servicio multiprofesional para tratamiento de la HA. Se dividieron en grupos experimental (GE) y control (GC). El GE, además del tratamiento convencional, participó en sesiones musicoterápicas semanales por doce semanas. El GC permaneció bajo tratamiento estándar del servicio. Antes y después de la intervención se aplicó en los dos grupos el cuestionario SF-36 y se verificó la PA. La voz, importante elemento de comunicación, reflejo del estado físico, psíquico y emocional, fue el principal recurso utilizado. Estadística: tests t-Student y Wilcoxon (significantes p<0,05). RESULTADOS: Los grupos eran inicialmente similares en cuanto a sexto, edad, escolaridad y CV evaluada. En la comparación inicial y final de los pacientes del GE observamos una mejora significativa en la CV (p<0,05) y en el control de la PA (p<0,05). Sin modificaciones en la adhesión. CONCLUSÕES: La musicoterapia contribuyó para la mejora de la CV y del control de la PA, señalando que esta actividad puede representar un refuerzo en el abordaje terapéutico en programas de atención multidisciplinaria al paciente hipertenso.

Low birth weight as a marker of changes in ambulatory blood pressure monitoring.

BACKGROUND: Low birth weight (LBW) is associated with increased incidence of high blood pressure (BP) and cardiovascular diseases in adulthood. OBJECTIVE: To evaluate possible changes in Ambulatory Blood Pressure Monitoring (ABPM) in LBW children. METHODS: The birth weight (BW) of 1049 school children (ages 8 to 11) living in Goiânia was assessed. Children with low birth weight (BW or= 3.0 Kg). Information on birth weight was obtained from each child's health card. Casual BP and ABPM were measured. Height and weight measurements were obtained to calculate the body mass index (BMI), and sexual maturity was assessed according to Tanner's criteria (those at Tanner stage >or= 2 were excluded). RESULTS: Thirty-four children had low birth weight (LBW) and 34 had normal birth weight (NBW). Both groups were similar regarding age, gender, race, body weight, height, BMI, and family history of hypertension. Low-birth-weight children had higher casual systolic blood pressure (SBP) (p = 0.007). ABPM recordings showed that these children had higher 24-hour diastolic blood pressure (DBP) (p = 0.009), daytime DBP (p = 0.002), night-time DBP and SBP (p = 0.005 and p = 0.001), and reduced nocturnal dip in SBP and DBP (p = 0.001) than those born with normal weight. Birth weight was positively correlated with nocturnal dip in SBP (p = 0.022) and negatively correlated with sleep SBP (p = 0.032). CONCLUSION: Low-birth-weight children have higher BP and changes in circadian rhythm of blood pressure, with reduced nocturnal dipping. These findings may reflect increased risk of adult hypertension and cardiovascular diseases.

Baixo peso ao nascer como marcador de alterações na monitorização ambulatorial da pressão arterial / Bajo peso al nacer como marcador de alteraciones en el monitoreo ambulatorio de la presión arterial / Low birth weight as a marker of changes in ambulatory blood pressure monitoring

FUNDAMENTO: O baixo peso ao nascimento (BPN) está associado com aumento da pressão arterial (PA) e de doenças cardiovasculares no adulto. OBJETIVO: Avaliar as possíveis alterações na monitorização ambulatorial da pressão arterial (MAPA) em crianças com BPN. MÉTODOS: Avaliou-se o peso ao nascimento (PN) de 1.049 crianças, entre 8 e 11 anos, em escolas de Goiânia. Aquelas com BPN (PN < 2,5 kg) foram comparadas com crianças com peso ao nascimento normal - PNN (PN > 3,0 kg). O PN foi obtido no cartão da criança. Avaliaram-se PA casual e MAPA. Após a obtenção do peso e da estatura para cálculo do índice de massa corpórea (IMC), realizou-se avaliação da maturação sexual segundo os critérios de Tanner (excluídos Tanner >2). RESULTADOS: Obtiveram-se 34 crianças com BPN e 34 com PNN. Os grupos foram semelhantes quanto a idade, sexo, raça, peso, estatura, IMC e história familiar de hipertensão. As crianças com BPN apresentaram maior pressão sistólica (PS) casual (p = 0,007). Na MAPA, apresentaram maior pressão diastólica (PD) nas 24 horas (p = 0,009), maior PD de vigília (p = 0,002), maiores PS e PD no sono (p = 0,005 e p = 0,001) e menor descenso noturno da PS e PD (p = 0,001) do que as com PNN. Observou-se uma correlação positiva do PN com o descenso noturno da PS (p = 0,022) e negativa com a PS no sono (p = 0,032). CONCLUSÃO: As crianças com BPN apresentaram PA mais elevada e alteração do ritmo circadiano da pressão arterial, com atenuação do descenso noturno. Esses achados podem representar um risco aumentado para a hipertensão arterial e doença cardiovascular no adulto.

BACKGROUND: Low birth weight (LBW) is associated with increased incidence of high blood pressure (BP) and cardiovascular diseases in adulthood. OBJECTIVE: To evaluate possible changes in Ambulatory Blood Pressure Monitoring (ABPM) in LBW children. METHODS: The birth weight (BW) of 1049 school children (ages 8 to 11) living in Goiânia was assessed. Children with low birth weight (BW < 2.5 Kg) were compared with those of normal birth weight (BW > 3.0 Kg). Information on birth weight was obtained from each child's health card. Casual BP and ABPM were measured. Height and weight measurements were obtained to calculate the body mass index (BMI), and sexual maturity was assessed according to Tanner's criteria (those at Tanner stage > 2 were excluded). RESULTS: Thirty-four children had low birth weight (LBW) and 34 had normal birth weight (NBW). Both groups were similar regarding age, gender, race, body weight, height, BMI, and family history of hypertension. Low-birth-weight children had higher casual systolic blood pressure (SBP) (p = 0.007). ABPM recordings showed that these children had higher 24-hour diastolic blood pressure (DBP) (p = 0.009), daytime DBP (p = 0.002), night-time DBP and SBP (p = 0.005 and p = 0.001), and reduced nocturnal dip in SBP and DBP (p = 0.001) than those born with normal weight. Birth weight was positively correlated with nocturnal dip in SBP (p = 0.022) and negatively correlated with sleep SBP (p = 0.032). CONCLUSION: Low-birth-weight children have higher BP and changes in circadian rhythm of blood pressure, with reduced nocturnal dipping. These findings may reflect increased risk of adult hypertension and cardiovascular diseases.

FUNDAMENTO: El bajo peso al nacer (BPN) está asociado al aumento de la presión arterial (PA) y de enfermedades cardiovasculares en el adulto. OBJETIVO: Evaluar las posibles alteraciones en el monitoreo ambulatorio de la presión arterial (MAPA) en niños con BPN. MÉTODOS: Se evaluó el peso al nacer (PN) de 1.049 niños, entre 8 y 11 años, en escuelas de la ciudad de Goiânia. Aquellos con BPN (PN < 2,5 kg) se compararon con niños con peso normal al nacer - PNN (PN > 3,0 kg). El PN se obtuvo en la tarjeta del niño. Se evaluaron la PA casual y el MAPA. Tras la medición del peso y de la estatura para cálculo del índice de masa corpórea (IMC), se evaluó la maduración sexual según los criterios de Tanner (excluidos Tanner >2). RESULTADOS: Se obtuvo un total de 34 niños con BPN y 34 con PNN. Los grupos fueron semejantes relación a la edad, sexo, raza, peso, estatura, IMC e historia familiar de hipertensión. Los niños con BPN presentaron mayor presión sistólica (PS) casual (p = 0,007). En el MAPA, presentaron mayor presión diastólica (PD) en las 24 horas (p = 0,009), mayor PD de vigilia (p = 0,002), mayores PS y PD en el sueño (p = 0,005 y p = 0,001) y menor descenso nocturno de la PS y PD (p = 0,001) que las con PNN. Se observó una correlación positiva del PN con el descenso nocturno de la PS (p = 0,022) y negativa con la PS en el sueño (p = 0,032). CONCLUSIÓN: Los niños con BPN presentaron PA más elevada y cambio del ritmo circadiano de la presión arterial, con atenuación del descenso nocturno. Esos hallazgos pueden representar un riesgo aumentado para la hipertensión arterial y enfermedad cardiovascular en el adulto.

Music therapy effects on the quality of life and the blood pressure of hypertensive patients.

BACKGROUND: Arterial Hypertension (AH) is a mass disease, with consequences for the cardiocirculatory system, since its complications raise the rates of morbidity and mortality. Controlling blood pressure (BP) reduces complications and may preserve the quality of life (QOL) of patients. Studies show positive effects of music therapy as an adjuvant in the treatment of several diseases. OBJECTIVE: to evaluate the effect of music therapy on the QOL and BP control of hypertensive patients. METHODS: This was a controlled clinical study that evaluated patients of both genders, aged over 50 years, with stage 1 hypertension, in use of medication and enrolled in multidisciplinary service for treatment of hypertension. They were divided into an experimental group (EG) and a control group (CG). The EG, in addition to the conventional treatment, participated in weekly music therapy sessions for twelve weeks. The CG received the standard treatment of the service. Before and after the intervention, the SF-36 questionnaire was applied in both groups, and the BP of each patient was measured. The voice, an important element of communication, reflecting the patient's physical, mental and emotional state, was the main resource used. STATISTICS: Student T-test and Wilcoxon test were considered significant at p <0.05. RESULTS: The groups were initially similar in gender, age, education, and the assessed QOL. In the initial and final comparison of EG patients, we observed a significant improvement on the QOL (p <0.05) and BP control (p <0.05), with no change in adhesion. CONCLUSIONS: Music therapy has contributed to an improvement on the QOL and BP control of patients, suggesting that this activity may represent a therapeutic approach to help strengthen the programs of multidisciplinary care of hypertensive patients.

O uso do corticóide altera o crescimento estatural na síndrome nefrótica primária? / Can steroid use change linear growth of children with primary nephrotic syndrome?

Objetivo: Avaliar, a médio prazo, o efeito do uso de corticóides sobre o crescimento linear de crianças portadoras de síndrome nefrótica primária (SNP).Métodos: Análise retrospectiva de crianças entre 2 e 8 anos portadoras de SNP em tratamento no serviço de Nefrologia Pediátrica do HC-FM-UFGo, que estavam em uso de prednisona por um período mínimo de um ano. Estudaram-se as variações anuais da velocidade do crescimento durante cinco anos de acompanhamento, individualizando-se os períodos com e sem uso de corticóide. O teste t-Student foi utilizado para avaliar as correlações das variáveis com o uso do corticóide. Resultados: Foram avaliadas 29 crianças, com média de idade de 63,4 + 36,4 meses. A velocidade de crescimento anual no período do uso de corticóide variou de 2,5 -18,1 cm, com média de 7,0+ 3,2, e na ausência do uso de corticóide variou de 1,31 - 13,9 cm, com média de 6,8 + 2,8. A comparação dos grupos pelo teste T-student não demonstrou diferença estatisticamente significante (p=0,81). Conclusão: O uso da prednisona em doses terapêuticas não demonstrou alterações na velocidade de crescimento em médio prazo nesse grupo de crianças.

[Arterial hypertension in childhood]. / Hipertensão arterial na infância.

OBJECTIVE: To critically review recent medical literature, focusing on practical features that are relevant for diagnosis and outpatient treatment of pediatric hypertension. SOURCES: Classic articles and systematic review of recent literature through electronic search of Medline and Lilacs databases over the last 10 years, using the key words arterial hypertension, newborns, infants, preschool, children and adolescents. Those articles containing relevant information were selected. SUMMARY OF THE FINDINGS: Arterial hypertension and obesity are public health problems all over the world. Essential arterial hypertension in adults begins in childhood and can also be secondary to several diseases. Pediatricians must measure the arterial pressure of the patients in a proper manner. When arterial hypertension is detected, it must be investigated in order to be adequately treated. The investigation depends on the age and the rising degree of the arterial pressure, taking into consideration the cause of hypertension, as well as its effects on target organs. CONCLUSIONS: The early recognition of an abnormal arterial pressure followed by adequate investigation and treatment are required to reduce the cardiovascular and renal morbidity/mortality.