Waist-to-height ratio and dynapenic abdominal obesity in users of hemodialysis services.

BACKGROUND AND AIMS: Abdominal obesity and decreased muscle strength are risk factors for individuals on hemodialysis. Thus, the combination of these two factors known as dynapenic abdominal obesity acts as an important marker of the nutritional status of this population. Therefore, the objective of the work was to investigate the association between abdominal obesity, dynapenia, and sociodemographic, clinical, and nutritional factors in individuals with chronic kidney disease undergoing hemodialysis. METHODS AND RESULTS: Cross-sectional study with 940 individuals undergoing hemodialysis in southeastern Brazil. Dynapenic abdominal obesity was defined by the combination of the presence of abdominal obesity, indicated by the waist-to-height ratio, and the reduction in muscle strength, measured by handgrip strength. Binary logistic regression was performed to calculate the odds ratio (OR) and the respective confidence intervals (95% CI). Dynapenic abdominal obesity was present in 45.42% of the study population. We found that being 18-59 years (OR: 3.17; 95% CI 2.35-4.28; p < 0.001) and being overweight (OR: 2.58; 95% CI 1.92-3.47; p < 0.001) increased the chances for the presence of dynapenic abdominal obesity; however, the habit of consuming meals away from home (OR: 0.63; 95% CI 0.47-0.85; p = 0.003) and having preserved behavioral adductor muscle thickness (OR: 0.52; 95% CI 0.38-0.71; p < 0.001) are considered protective factors. CONCLUSION: Dynapenic abdominal obesity, present in individuals on hemodialysis, may represent a valid nutritional tool for assessing cardiovascular risk and mortality in this population, in order to implement the most effective preventive and/or therapeutic intervention possible.

Estudo sobre alterações craniofaciais em crianças atópicas e/ou asmáticas, Hospital Universitário Cassiano Antônio Moraes, Vitória-ES, Brasil / Study about craniofacialalterations in asthmatic and/or allergic children, UniversityHospital Cassiano AntônioMoraes, Vitória- ES, Brazil

Objetivos: Este estudo avalia a relação entre o comprometimentorespiratório em crianças com idades de três a seis anos, atópicas e/ou asmáticas, eo seu efeito sobre as características faciais, oclusais e funções oronasofaringianas.Métodos: O estudo consistiu de 33 crianças de ambos os sexos compondo grupoexperimental, com história clínica de atopia e/ou asma e respiradoras bucaiscomprovada por laudo do médico alergista, atendidas na Clínica Pediátrica. Paracompor o grupo controle, 49 crianças de ambos os sexos, com ausência de respiraçãobucal, sem atopia e/ou asma e ausência de tratamento ortodôntico, foramaleatoriamente selecionadas na Clínica de Odontopediatria. Resultados: A probabilidadede desenvolver alterações oclusais e oronasofaringianas, conseqüentesde atopia e/ou asma, foi avaliada pelo teste de Odds Ratio (OR), mostrandosignificância para as variáveis: sobressaliência aumentada, OR= 16,48 (IC=95%:14,72 ? 61,21); mordida aberta OR= 52,50 (IC=95%: 6,05-1177,8); obstruçãonasal OR = 27,43 (IC=95%: 3,30-601,4); deglutição atípica OR= 35,37 (IC 95%:4,29-771,4); fonação atípica OR= 5,97 (IC= 95%: 1,79-20,81); e tipo facial longoOR= 4,61 (95%: 1,66-12,76). Conclusões: Os resultados encontrados evidenciaramque a respiração bucal e a atopia e/ou asma estão positivamente associadascom o risco de desenvolvimento de alterações faciais, oclusais e oronasofaringianase que a intervenção multidisciplinar se torna necessária.

Objectives: The purpose of the study isto evaluate the relationship between compromisedbreathing in asthmatic and/or atopic mouth breatherchildren ranging in age from 3 to 6 years, and the itseffects that condition has on occlusal and facial characteristicsand on oronasalpharyngeal functions relatedto speech and swallowing patterns. Methods: Theexperimental group consisted of thirty-three childrenof both sex, coming to Pediatric Clinic for asthmaand/or atopy treatment and mouth breathing patternconfirmed by exams. Forty-nine children of bothsex, free from respiratory diseases, nose breathers ,and with no history of orthodontic treatment wererandomly selected at Pediatric Dentistry Clinic to bethe control group. Results: The probability of developingocclusal and oronasalpharyngeal alterations,as a consequence of asthma and/or atopy, analyzedthrough odds ratio values (OR), showed the followingsignificant variables: increased overjet, OR = 16.48(CI = 95%: 14.72-61.21); open bite, OR =52.50 (CI = 95%: 6.05-1177.8); nasal airwayobstruction OR = 27.43 (CI= 95%: 3.30-601.4);atypical swallowing pattern, OR = 35.37 (CI =95%: 4.29-771.4); atypical speech pattern, OR =5.97 (CI = 95%: 1.79-20.81); and long facial typeOR = 4.61 (CI = 95%: 1.66-12.76). Conclusions:The results of this research show evidencethat mouth breathing and asthma and/or atopy arepositively associated with the risk of facial, occlusaland oronasalpharyngeal development alterations andthat multidisciplinary intervention become necessary.