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1.
Arq Bras Cardiol ; 109(2 Supl 1): 1-76, 2017 Jul.
Artigo em Português | MEDLINE | ID: mdl-28813069
2.
Faludi, André Arpad; Izar, Maria Cristina de Oliveira; Saraiva, José Francisco Kerr; Chacra, Ana Paula Marte; Bianco, Henrique Tria; Afiune Neto, Abrahão; Bertolami, Adriana; Pereira, Alexandre C.; Lottenberg, Ana Maria; Sposito, Andrei C.; Chagas, Antonio Carlos Palandri; Casella Filho, Antonio; Simão, Antônio Felipe; Alencar Filho, Aristóteles Comte de; Caramelli, Bruno; Magalhães, Carlos Costa; Negrão, Carlos Eduardo; Ferreira, Carlos Eduardo dos Santos; Scherr, Carlos; Feio, Claudine Maria Alves; Kovacs, Cristiane; Araújo, Daniel Branco de; Magnoni, Daniel; Calderaro, Daniela; Gualandro, Danielle Menosi; Mello Junior, Edgard Pessoa de; Alexandre, Elizabeth Regina Giunco; Sato, Emília Inoue; Moriguchi, Emilio Hideyuki; Rached, Fabiana Hanna; Santos, Fábio César dos; Cesena, Fernando Henpin Yue; Fonseca, Francisco Antonio Helfenstein; Fonseca, Henrique Andrade Rodrigues da; Xavier, Hermes Toros; Mota, Isabela Cardoso Pimentel; Giuliano, Isabela de Carlos Back; Issa, Jaqueline Scholz; Diament, Jayme; Pesquero, João Bosco; Santos, José Ernesto dos; Faria Neto, José Rocha; Melo Filho, José Xavier de; Kato, Juliana Tieko; Torres, Kerginaldo Paulo; Bertolami, Marcelo Chiara; Assad, Marcelo Heitor Vieira; Miname, Márcio Hiroshi; Scartezini, Marileia; Forti, Neusa Assumpta; Coelho, Otávio Rizzi; Maranhão, Raul Cavalcante; Santos Filho, Raul Dias dos; Alves, Renato Jorge; Cassani, Roberta Lara; Betti, Roberto Tadeu Barcellos; Carvalho, Tales de; Martinez, Tânia Leme da Rocha; Giraldez, Viviane Zorzanelli Rocha; Salgado Filho, Wilson.
Arq. bras. cardiol ; 109(2,supl.1): 1-76, ago. 2017. tab, graf
Artigo em Português | LILACS-Express | ID: biblio-887919
3.
Int J Med Educ ; 7: 149-53, 2016 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-27213505

RESUMO

OBJECTIVE: We have conducted this study to assess medical students' empathy and to examine empathy differences by students' socio-demographic characteristics, including gender, and specialty preference. METHODS: We have conducted a cross-sectional and descriptive research. Among 595 medical students registered at the Federal University of Santa Catarina (Brazil) in 2012, we have selected a sample of 320 enrolled in the first, third, fifth, seventh, ninth, eleventh, and in the last semester of the course. The response rate obtained was 70.6% (n=226). Data was collected by using a self-report questionnaire, and the variables analyzed included course semester, socio-demographic characteristics (such as age, gender, household monthly income and parents level of education), students' specialty preference, and empathy assessed by the Jefferson Scale of Empathy. We have used descriptive statistics, 95% Confidence Interval for percentages, Student's t-test, and Analysis of Variance to analyze the data. RESULTS: Mean empathy among students was (M=119.7, SD=9.9), with no difference by according to semester (F=1.5, p=.2). Empathy means were higher among females (M=118.3, SD=10.6) than among males (M=121.0, SD=9.3, t=-2.1, p=.032). Students who preferred a people-oriented specialty obtained significantly higher mean scores (M=121.5, SD=8.1) in comparison to students who preferred technology-oriented specialties (M=118.0, SD=11.3, t=2.4, p=.02). CONCLUSIONS: Our study has found consistently high scores of empathy among medical students enrolled in all levels of training at the Federal University of Santa Catarina, and higher empathy among women and students who intend to pursue a people-oriented specialty. Conclusions on higher empathy among medical students require further study.


Assuntos
Escolha da Profissão , Empatia , Medicina/estatística & dados numéricos , Estudantes de Medicina , Adulto , Brasil/epidemiologia , Estudos Transversais , Educação de Graduação em Medicina , Feminino , Humanos , Masculino , Personalidade , Fatores Sexuais , Estudantes de Medicina/psicologia , Estudantes de Medicina/estatística & dados numéricos , Inquéritos e Questionários , Adulto Jovem
4.
J Biomed Inform ; 52: 222-30, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25017250

RESUMO

One of the main reasons that leads to a low adoption rate of telemedicine systems is poor usability. An aspect that influences usability during the reporting of findings is the input mode, e.g., if a free-text (FT) or a structured report (SR) interface is employed. The objective of our study is to compare the usability of FT and ST telemedicine systems, specifically in terms of user satisfaction, efficiency and general usability. We comparatively evaluate the usability of these two input modes in a telecardiology system for issuing electrocardiography reports in the context of a statewide telemedicine system in Brazil with more than 350.000 performed tele-electrocardiography examinations. We adopted a multiple method research strategy, applying three different kinds of usability evaluations: user satisfaction was evaluated through interviews with seven medical professionals using the System Usability Scale (SUS) questionnaire and specific questions related to adequacy and user experience. Efficiency was evaluated by estimating execution time using the Keystroke-Level Model (KLM). General usability was assessed based on the conformity of the systems to a set of e-health specific usability heuristics. The results of this comparison provide a first indication that a structured report (SR) input mode for such a system is more satisfactory and efficient with a larger conformity to usability heuristics than free-text (FT) input. User satisfaction using the SUS questionnaire has been scored in average with 58.8 and 77.5 points for the FT and SR system, respectively, which means that the SR system was rated 18.65 points higher than the FT system. In terms of efficiency, the completion of a findings report using the SR mode is estimated to take 8.5s, 3.74 times faster than using the FT system (31.8s). The SR system also demonstrated less violations to usability heuristics (8 points) in comparison to 14 points observed in the FT system. These results provide a first indication that the usage of structured reporting as an input mode in telecardiology systems may enhance usability. This also seems to confirm the advantages of the usage of structured reporting, as already described in the literature for other areas such as teleradiology.


Assuntos
Eficiência , Modelos Teóricos , Telemedicina , Interface Usuário-Computador , Estudos de Avaliação como Assunto , Pessoal de Saúde/psicologia , Pessoal de Saúde/estatística & dados numéricos , Humanos
5.
Radiol. bras ; 47(3): 149-153, May-Jun/2014. tab, graf
Artigo em Português | LILACS-Express | ID: lil-713645

RESUMO

Objetivo: Avaliar as medidas ultrassonográficas da gordura visceral e subcutânea em crianças e testar se a gordura pré-peritoneal (GPP) e o índice de gordura da parede abdominal (IGPA) são parâmetros úteis para determinar a gordura visceral e a presença de doença hepática gordurosa não alcoólica (DHGNA) em crianças obesas. Materiais e Métodos: Estudo tipo caso-controle, com uma amostra de 44 crianças, sendo 22 casos e 22 controles, pareados conforme sexo e idade. Os resultados foram analisados de forma descritiva e bivariada, com teste t de Student e teste exato de Fischer. Resultados: Os parâmetros ultrassonográficos avaliados - tecido celular subcutâneo, GPP e gorduras intraperitoneais, e DHGNA - obtiveram elevada associação estatística com o índice de massa corpórea. A DHGNA foi observada em oito pacientes obesos (36,36%), sendo que a GPP e o IGPA foram as variáveis com maior significância estatística, com valor de p < 0,0001. Conclusão: A ultrassonografia permite diferenciar e quantificar a gordura visceral e subcutânea nas crianças. As medidas da GPP e do IGPA são úteis para a avaliação da gordura visceral e DHGNA em crianças obesas. .


Objective: To evaluate sonographic measurements of visceral and subcutaneous fat in children, and to investigate the usefulness of preperitoneal fat (PF) and the abdominal wall fat index (AFI) as parameters to determine visceral fat and presence of nonalcoholic fatty liver disease (NAFLD) in obese children. Materials and Methods: A case-control study of a sample including 44 children (22 cases and 22 controls) matched by sex and age. The Student t test and the Fisher exact test were utilized in the descriptive and bivariate analysis. Results: The sonographic parameters evaluated - subcutaneous cell tissue, PF and intraperitoneal fat, and NAFLD - presented high statistical association with body mass index. NAFLD was observed in eight obese patients (36.36%), and PF and AFI were the variables with highest statistical significance, with p < 0.0001. Conclusion: Ultrasonography is useful tool in the differentiation and quantification of visceral and subcutaneous fat in children. The measures of PF and AFI are useful in the assessment of visceral fat and NAFLD in obese children. .

6.
Radiol Bras ; 47(3): 149-53, 2014 May-Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25741071

RESUMO

OBJECTIVE: To evaluate sonographic measurements of visceral and subcutaneous fat in children, and to investigate the usefulness of preperitoneal fat (PF) and the abdominal wall fat index (AFI) as parameters to determine visceral fat and presence of nonalcoholic fatty liver disease (NAFLD) in obese children. MATERIALS AND METHODS: A case-control study of a sample including 44 children (22 cases and 22 controls) matched by sex and age. The Student t test and the Fisher exact test were utilized in the descriptive and bivariate analysis. RESULTS: The sonographic parameters evaluated - subcutaneous cell tissue, PF and intraperitoneal fat, and NAFLD - presented high statistical association with body mass index. NAFLD was observed in eight obese patients (36.36%), and PF and AFI were the variables with highest statistical significance, with p < 0.0001. CONCLUSION: Ultrasonography is useful tool in the differentiation and quantification of visceral and subcutaneous fat in children. The measures of PF and AFI are useful in the assessment of visceral fat and NAFLD in obese children.

7.
J. pediatr. (Rio J.) ; 89(5): 499-504, set.-out. 2013. tab
Artigo em Português | LILACS | ID: lil-690075

RESUMO

OBJETIVO: Verificar os efeitos de um programa de intervenção com exercício físico, atividades recreativas e orientação nutricional na qualidade de vida relacionada à saúde de crianças obesas. MÉTODOS: Trata-se de um ensaio clínico controlado. A população inicial do estudo envolveu crianças com idades entre oito e 11 anos e com índice de massa corporal acima de 97 percentil por idade e sexo, conforme os critérios da Organização Mundial de Saúde, totalizando 44 crianças pareadas em sexo e idade, sendo: grupo caso (n = 22) e grupo controle (n = 22). Determinou-se, antes e após 12 semanas de intervenção (três vezes semanais), o índice de massa corporal e a qualidade de vida relacionada à saúde autor-relatada pelo questionário PedsQL. O grupo controle não participou da intervenção. RESULTADOS: Completaram o estudo 32 crianças (16 em cada). O grupo caso apresentou redução significativa do índice de massa corporal (p = 0,001) e melhorou a qualidade de vida nos domínios físico (p = 0,001), emocional (p = 0,014), social (p = 0,004), psicossocial (p = 0,002) e qualidade de vida geral (p = 0,001), o que não foi observado no grupo controle. CONCLUSÃO: O programa foi efetivo na melhora da saúde e da qualidade de vida de crianças obesas.


OBJECTIVE: To verify the effects of an intervention program including physical exercise and recreational activities, as well as nutritional counseling, on the health-related quality of life of obese children. METHODS: This was a controlled clinical trial. The initial study population included children aged eight to 11 years with a body mass index (BMI) > 97th percentile for age and gender, according to the criteria of the World Health Organization, totaling 44 children matched by gender and age, as case (n = 22) and control groups (n = 22). BMI and self-reported health-related quality of life by Pediatric Quality of Life Inventory were measured before and after 12 weeks of intervention (three times weekly). The control group did not participate in the intervention. RESULTS: Thirty-two children completed the study (16 in each group). The case group showed significant reduction in BMI (p = 0.001) and improved quality of life in the physical (p = 0.001), emotional (p = 0.014), social (p = 0.004), and psychosocial (p = 0.002) domains, as well as in overall quality of life (p = 0.001), which was not observed in the control group. CONCLUSION: The program was effective in improving the health and quality of life of obese children.


Assuntos
Criança , Feminino , Humanos , Masculino , Aconselhamento/métodos , Exercício/fisiologia , Educação em Saúde/métodos , Obesidade/prevenção & controle , Qualidade de Vida , Recreação/psicologia , Índice de Massa Corporal , Estudos de Casos e Controles , Guias como Assunto , Valor Nutritivo/fisiologia , Fatores Socioeconômicos , Inquéritos e Questionários
8.
J Pediatr (Rio J) ; 89(5): 499-504, 2013 Sep-Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23850111

RESUMO

OBJECTIVE: To verify the effects of an intervention program including physical exercise and recreational activities, as well as nutritional counseling, on the health-related quality of life of obese children. METHODS: This was a controlled clinical trial. The initial study population included children aged eight to 11 years with a body mass index (BMI) > 97th percentile for age and gender, according to the criteria of the World Health Organization, totaling 44 children matched by gender and age, as case (n = 22) and control groups (n = 22). BMI and self-reported health-related quality of life by Pediatric Quality of Life Inventory were measured before and after 12 weeks of intervention (three times weekly). The control group did not participate in the intervention. RESULTS: Thirty-two children completed the study (16 in each group). The case group showed significant reduction in BMI (p = 0.001) and improved quality of life in the physical (p = 0.001), emotional (p = 0.014), social (p = 0.004), and psychosocial (p = 0.002) domains, as well as in overall quality of life (p = 0.001), which was not observed in the control group. CONCLUSION: The program was effective in improving the health and quality of life of obese children.


Assuntos
Aconselhamento/métodos , Exercício/fisiologia , Educação em Saúde/métodos , Obesidade/prevenção & controle , Qualidade de Vida , Recreação/psicologia , Índice de Massa Corporal , Estudos de Casos e Controles , Criança , Feminino , Guias como Assunto , Humanos , Masculino , Valor Nutritivo/fisiologia , Fatores Socioeconômicos , Inquéritos e Questionários
9.
Telemed J E Health ; 19(7): 535-41, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23837517

RESUMO

INTRODUCTION: Large-scale asynchronous telemedicine networks can offer a unique opportunity for the acquisition of detailed epidemiological information if the data are acquired and handled in an appropriate way. In this work, an approach is presented for the integration of medical reports in the Digital Imaging and Communications in Medicine (DICOM) Structured Reporting standard in telemedicine networks using structured vocabularies. MATERIALS AND METHODS: The use of these structured vocabularies is extended beyond radiology, and a case study in telecardiology is presented. The approach was applied in the context of a real-world statewide public telemedicine network; nowadays on average 470 written electrocardiographic structured reports daily are being performed. Cardiologists provided more than 220,000 written structured reports, and these reports are stored into a central database. RESULTS: This study was performed during a 12-month period, and it was possible to examine possible associations between a list of co-morbidities and cardiac risk factors with a diagnosis that indicates the presence of cardiac ischemia, cardiac injury, or possible necrosis by using DICOM Structured Reporting. Our application is responsible for coordinating the process of issuance of reports through various technologies and devices. The system works as a library in an HTTP server, which accesses information from studies in DICOM format from the database and from structured vocabularies. CONCLUSIONS: Results indicate that traceability of morbidity, diagnoses, and patient clinical information can be achieved, resulting in an efficient data mining-friendly framework. A multidevice application for Web-based and smartphone-based platforms showed that it is a viable solution for applying the DICOM Structured Reporting standard in telemedicine networks.


Assuntos
Redes de Comunicação de Computadores , Eletrocardiografia/normas , Registros Médicos/normas , Telemedicina/organização & administração , Terminologia como Assunto , Brasil , Cardiologia/normas , Desenvolvimento de Programas , Saúde Pública , Sistemas de Informação em Radiologia , Integração de Sistemas , Telecomunicações , Vocabulário Controlado
10.
J. pediatr. (Rio J.) ; 89(3): 243-249, maio-jun. 2013. tab
Artigo em Português | LILACS | ID: lil-679303

RESUMO

OBJETIVO: Investigar a relação entre pressão arterial e índice de massa corporal, circunferência abdominal, razão cintura/estatura e dobra cutânea tricipital em crianças e adolescentes. MÉTODOS: Estudo epidemiológico transversal, do qual participaram 1.441 escolares de 10 a 16 anos de idade (655 meninos e 786 meninas), selecionados por amostragem aleatória sistemática. Avaliaram-se a massa corporal, a estatura, a circunferência abdominal, a espessura da dobra cutânea tricipital, as pressões arteriais - sistólica e diastólica - o estágio maturacional e a classe econômica. Utilizaram-se os testes de correlação parcial de Pearson e a regressão logística multivariada, considerando-se p < 0,05. RESULTADOS: Todos os indicadores antropométricos demonstraram fracas correlações com os níveis sistólicos e diastólicos, com coeficientes (r) variando de 0,18 a 0,28 (p < 0,001). Na análise multivariada, os únicos preditores antropométricos associados ao risco de pressão arterial elevada foram o índice de massa corporal (OR = 2,9; IC 95%: 1,9-4,5) e a dobra cutânea tricipital (OR = 1,9; IC 95%: 1,3-3,1), independentes da adiposidade abdominal, maturação sexual e nível econômico. CONCLUSÃO: Nesta faixa etária, a adiposidade corporal total parece ser melhor determinante do risco de elevação da pressão arterial do que a adiposidade abdominal.


OBJECTIVE: To investigate the association of blood pressure and body mass index, waist circumference, waist-to-height ratio and triceps skinfold, in children and adolescents in Curitiba, state of Paraná, Brazil. METHODS: Cross-sectional study with a random sample of 1,441 students from public schools, aged from10 to 16 years (655 boys and 786 girls). The following indicators were assessed: weight, height, waist circumference, triceps skinfold, systolic and diastolic blood pressures, pubertal stage, and socioeconomic status. Pearson correlation tests and multivariate logistic regression were used, considering p < 0.05. RESULTS: We found weak correlations among all the anthropometric parameters and systolic and diastolic levels, with coefficients values ranging from 0.18 to 0.28 (p < 0.001). In multivariate analysis, only body mass index [odds ratio (OR) = 2.9; 95% confidence interval (95%CI) 1.9-4.5] and triceps skinfold (OR = 1.9; 95%CI 1.3-3.1) were found as predictors of high blood pressure, regardless of abdominal adiposity, sexual maturation and socioeconomic status. CONCLUSION: Total body adiposity seems to be a better predictor of high blood pressure risk than abdominal fat in this population.


Assuntos
Adolescente , Criança , Feminino , Humanos , Masculino , Adiposidade/fisiologia , Antropometria/métodos , Pressão Sanguínea/fisiologia , Hipertensão/prevenção & controle , Gordura Abdominal/fisiologia , Índice de Massa Corporal , Métodos Epidemiológicos , Fatores de Risco , Medição de Risco/normas , Fatores Sexuais , Pregas Cutâneas
11.
J Pediatr (Rio J) ; 89(3): 243-9, 2013 May-Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23684458

RESUMO

OBJECTIVE: To investigate the association of blood pressure and body mass index, waist circumference, waist-to-height ratio and triceps skinfold, in children and adolescents in Curitiba, state of Paraná, Brazil. METHODS: Cross-sectional study with a random sample of 1,441 students from public schools, aged from 10 to 16 years (655 boys and 786 girls). The following indicators were assessed: weight, height, waist circumference, triceps skinfold, systolic and diastolic blood pressures, pubertal stage, and socioeconomic status. Pearson correlation tests and multivariate logistic regression were used, considering p<0.05. RESULTS: We found weak correlations among all the anthropometric parameters and systolic and diastolic levels, with coefficients values ranging from 0.18 to 0.28 (p<0.001). In multivariate analysis, only body mass index [odds ratio (OR)=2.9; 95% confidence interval (95%CI) 1.9-4.5] and triceps skinfold (OR=1.9; 95%CI 1.3-3.1) were found as predictors of high blood pressure, regardless of abdominal adiposity, sexual maturation and socioeconomic status. CONCLUSION: Total body adiposity seems to be a better predictor of high blood pressure risk than abdominal fat in this population.


Assuntos
Adiposidade/fisiologia , Antropometria/métodos , Pressão Sanguínea/fisiologia , Hipertensão/prevenção & controle , Gordura Abdominal/fisiologia , Adolescente , Índice de Massa Corporal , Criança , Métodos Epidemiológicos , Feminino , Humanos , Masculino , Medição de Risco/normas , Fatores de Risco , Fatores Sexuais , Pregas Cutâneas
13.
J Pediatr (Rio J) ; 89(1): 91-9, 2013 Jan-Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23544816

RESUMO

OBJECTIVE: To describe bone mineral density (BMD) and bone mineral content (BMC) in children and adolescents infected with the human immunodeficiency virus (HIV), and to compare them with data from the National Health and Nutrition Examination Survey IV (NHANES IV). METHOD: The study included 48 children and adolescents (7 to 17 years old) infected with HIV through vertical transmission. BMC and BMD were measured by dual energy absorptiometry X-ray, by calculating z-scores based on data from NHANES IV. The information on clinical and laboratory parameters of infection by HIV was obtained from medical records. Physical activity, calcium intake, and skeletal maturation were also assessed. Descriptive and inferential statistical procedures were used, with levels of significance set at 5%. RESULTS: Seropositive patients presented lower values compared to data from NHANES IV in all z-scores of bone mass (mean=-0.52 to -1.22, SD=0.91 and 0.84, respectively). Based on the subtotal z-BMD, there was a prevalence of 16.7% of children and adolescents with low bone mass for age. Individuals using protease inhibitors presented a lower total z-BMD when compared to the group that did not use (-1.31 vs. -0.79, p=0.02). There were no bone mass differences in relation to physical activity and calcium intake. CONCLUSIONS: In the present sample children and adolescents living with HIV have low bone mass for age, and the use of protease inhibitors appears to be related to such decreases.


Assuntos
Densidade Óssea/fisiologia , Infecções por HIV/fisiopatologia , Inibidores de Proteases/uso terapêutico , Absorciometria de Fóton/métodos , Adolescente , Tamanho Corporal , Relação CD4-CD8 , Cálcio na Dieta/administração & dosagem , Estudos de Casos e Controles , Distribuição de Qui-Quadrado , Criança , Ingestão de Alimentos , Exercício , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/transmissão , Humanos , Transmissão Vertical de Doença Infecciosa , Masculino , Distribuição por Sexo , Fatores Sexuais , Fatores Socioeconômicos
14.
Rev Assoc Med Bras (1992) ; 59(1): 56-63, 2013 Jan-Feb.
Artigo em Inglês, Português | MEDLINE | ID: mdl-23440143

RESUMO

OBJECTIVE: To analyze the effects of a supervised physical exercise and nutritional guidance program, conducted with a playful basis, on the cardiovascular risk profile of obese children. METHODS: Forty-four children aged between 8 and 11 years, divided into two groups, were paired by gender and age: intervention group (n = 22) and control group (n = 22). The following parameters were measured before and after the intervention: body mass, height, waist circumference, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, fasting glucose, high-sensitive C-reactive protein, blood pressure, and carotid intima-media thickness. Both groups continued their traditional medical treatment. The case group exercised with recreational activities three times a week during 12 weeks, and participated in a weekly nutritional guidance session. The control group did not participate in the intervention described. Descriptive statistics, paired and unpaired Student's t-test, Mann-Whitney's U test, and the Wilcoxon test were used, with a significance level of p < 0.05. RESULTS: 32 children concluded the study (16 in each group). At the end of the study, the case group showed a significant reduction in the body mass index (BMI) (p = 0.001), total cholesterol (p = 0.001), LDL cholesterol (p = 0.001), diastolic blood pressure (p = 0.010), and average (p = 0.003) and maximum (p = 0.002) carotid intima-media thickness. The control group showed a significant increase in waist circumference (p = 0.001), blood glucose (p = 0.025), C-reactive protein (p = 0.016), a reduction of HDL cholesterol (p = 0.012) and total cholesterol (p = 0.042), and an increase in the average (p = 0.012) and maximum (p = 0.024) carotid intima-media thickness. CONCLUSION: The program proved effective in the reduction of obesity indicators and of the intima-media thickness, a direct and early signal of atherosclerosis.


Assuntos
Índice de Massa Corporal , Doenças Cardiovasculares/prevenção & controle , Espessura Intima-Media Carotídea , Colesterol/sangue , Exercício/fisiologia , Comportamento Alimentar , Educação em Saúde/normas , Obesidade/patologia , Pressão Sanguínea/fisiologia , Doenças Cardiovasculares/patologia , Criança , Feminino , Educação em Saúde/métodos , Humanos , Masculino , Obesidade/sangue , Fatores de Risco , Estatísticas não Paramétricas
15.
Rev. Assoc. Med. Bras. (1992) ; 59(1): 56-63, jan.-fev. 2013. tab
Artigo em Português | LILACS | ID: lil-666239

RESUMO

OBJETIVO: Analisar os efeitos de um programa de exercício físico e orientação nutricional supervisionado, de caráter lúdico, no perfil de risco cardiovascular de crianças obesas. MÉTODOS: Quarenta e quatro crianças com idades entre 8 e 11 anos divididas em dois grupos pareados em sexo e idade: grupo intervenção (n = 22) e controle (n = 22). Mensurou-se, antes e após a intervenção, a massa corporal, estatura, perímetro abdominal, colesterol total, HDL-colesterol, LDL-colesterol, triglicérides, glicemia de jejum, proteína C reativa ultrassensível, pressão arterial e espessura médio-intimal carotídea. Ambos os grupos continuaram com acompanhamento médico tradicional. O grupo caso participou de 12 semanas de exercício físico, com atividades recreativas em três sessões semanais e uma sessão semanal de orientação nutricional. O grupo controle não participou da intervenção descrita. Na análise foram utilizados a estatística descritiva, o teste t pareado e o teste não pareado, o teste U de Mann Whitney e o teste do Wilcoxon, adotando-se nível de significância p > 0,05. RESULTADOS: Trinta e duas crianças completaram o estudo (16 em cada grupo). Ao final, o grupo caso apresentou redução significativa no índice de massa corporal (IMC) (p = 0,001), colesterol total (p = 0,001) e LDL-colesterol (p = 0,001), pressão arterial diastólica (p = 0,010) e espessura médio-intimal média (p = 0,003) e máxima (p = 0,002). O grupo controle apresentou aumento significativo no perímetro abdominal (p = 0,001), glicemia (p = 0,025), proteína C reativa (p = 0,016) e redução do HDL-colesterol (p = 0,012) e colesterol total (p = 0,042) e aumento na espessura médio-intimal média (p = 0,012) e máxima (p = 0,024). CONCLUSÃO: O programa foi efetivo na redução dos indicadores de obesidade e na diminuição da espessura médio-intimal, um sinal indireto e precoce da aterosclerose.


OBJECTIVE: To analyze the effects of a supervised physical exercise and nutritional guidance program, conducted with a playful basis, on the cardiovascular risk profile of obese children. METHODS: Forty-four children aged between 8 and 11 years, divided into two groups, were paired by gender and age: intervention group (n = 22) and control group (n = 22). The following parameters were measured before and after the intervention: body mass, height, waist circumference, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, fasting glucose, high-sensitive C-reactive protein, blood pressure, and carotid intimamedia thickness. Both groups continued their traditional medical treatment. The case group exercised with recreational activities three times a week during 12 weeks, and participated in a weekly nutritional guidance session. The control group did not participate in the intervention described. Descriptive statistics, paired and unpaired Student's t-test, Mann-Whitney's U test, and the Wilcoxon test were used, with a significance level of p < 0.05. RESULTS: 32 children concluded the study (16 in each group). At the end of the study, the case group showed a significant reduction in the body mass index (BMI) (p = 0.001), total cholesterol (p = 0.001), LDL cholesterol (p = 0.001), diastolic blood pressure (p = 0.010), and average (p = 0.003) and maximum (p = 0.002) carotid intima-media thickness. The control group showed a significant increase in waist circumference (p = 0.001), blood glucose (p = 0.025), C-reactive protein (p = 0.016), a reduction of HDL cholesterol (p = 0.012) and total cholesterol (p = 0.042), and an increase in the average (p = 0.012) and maximum (p = 0.024) carotid intima-media thickness. CONCLUSION: The program proved effective in the reduction of obesity indicators and of the intima-media thickness, a direct and early signal of atherosclerosis.


Assuntos
Criança , Feminino , Humanos , Masculino , Índice de Massa Corporal , Espessura Intima-Media Carotídea , Doenças Cardiovasculares/prevenção & controle , Colesterol/sangue , Exercício/fisiologia , Comportamento Alimentar , Educação em Saúde/normas , Obesidade/patologia , Pressão Sanguínea/fisiologia , Doenças Cardiovasculares/patologia , Educação em Saúde/métodos , Obesidade/sangue , Fatores de Risco , Estatísticas não Paramétricas
16.
J. pediatr. (Rio J.) ; 89(1): 91-99, jan.-fev. 2013. tab
Artigo em Português | LILACS | ID: lil-668831

RESUMO

OBJETIVO: Descrever a densidade mineral óssea (DMO) e conteúdo mineral ósseo (CMO) de crianças e adolescentes que vivem com o vírus da imunodeficiência humana e comparar com os dados do National Health and Nutrition Examination Survey IV (NHANES IV). MÉTODO: Participaram do estudo48 crianças e adolescentes (sete a 17 anos de idade) com infecção pelo vírus da imunodeficiência humana adquirida por transmissão vertical. A DMO e o CMO foram mensurados pela absorciometria por dupla emissão de raios-X, calculando-se escores-z com base nos dados do NHANES IV. Nos prontuários médicos foram obtidas as informações dos parâmetros clínicos e laboratoriais da infecção pelo vírus da imunodeficiência humana. Foram ainda avaliada a atividade física, a ingestão de cálcio e a maturação esquelética. Utilizaram-se procedimentos da estatística descritiva e inferencial, estabelecendo níveis de significância de 5%. RESULTADOS :Os pacientes soropositivos demonstraram valores inferiores comparados aos dados do NHANES IV em todos os escores-z da massa óssea (média = -0,52 a -1,22, dp = 0,91 e 0,84, respectivamente). Com base no z-DMOsubtotal, há uma prevalência de 16,7% de crianças e adolescentes com massa óssea reduzida para a idade. Indivíduos que utilizaram inibidores de protease apresentaram um z-DMOtotal inferior, comparado ao grupo que não utilizou (-1,31 vs. -0,79; p = 0,02). Não foram encontradas diferenças na massa óssea em relação ao nível de atividade física e ingestão de cálcio. CONCLUSÕES: Na presente amostra, crianças e adolescentes que vivem com o vírus da imuno deficiência humana possuem baixa massa óssea para idade, e o uso de inibidores de protease parece estar relacionado a tais reduções.


OBJECTIVE: To describe bone mineral density (BMD) and bone mineral content (BMC) in children and adolescents infected with the human immunodeficiency virus (HIV), and to compare them with data from the National Health and Nutrition Examination Survey IV (NHANES IV). METHOD: The study included 48 children and adolescents (7 to 17 years old) infected with HIV through vertical transmission. BMC and BMD were measured by dual energy absorptiometry X-ray, by calculating z-scores based on data from NHANES IV. The information on clinical and laboratory parameters of infection by HIV was obtained from medical records. Physical activity, calcium intake, and skeletal maturation were also assessed. Descriptive and inferential statistical procedures were used, with levels of significance set at 5%. RESULTS: Seropositive patients presented lower values compared to data from NHANES IV in all z-scores of bone mass (mean = -0.52 to -1.22, SD = 0.91 and 0.84, respectively). Based on the subtotal z-BMD, there was a prevalence of 16.7% of children and adolescents with low bone mass for age. Individuals using protease inhibitors presented a lower total z-BMD when compared to the group that did not use (-1.31 vs. -0.79, p = 0.02). There were no bone mass differences in relation to physical activity and calcium intake. CONCLUSIONS: In the present sample children and adolescents living with HIV have low bone mass for age, and the use of protease inhibitors appears to be related to such decreases.


Assuntos
Adolescente , Criança , Feminino , Humanos , Masculino , Densidade Óssea/fisiologia , Infecções por HIV/fisiopatologia , Inibidores de Proteases/uso terapêutico , Absorciometria de Fóton/métodos , Tamanho Corporal , Estudos de Casos e Controles , Distribuição de Qui-Quadrado , Cálcio na Dieta/administração & dosagem , Ingestão de Alimentos , Exercício , Infecções por HIV/tratamento farmacológico , Infecções por HIV/transmissão , Transmissão Vertical de Doença Infecciosa , Distribuição por Sexo , Fatores Sexuais , Fatores Socioeconômicos
17.
Eur J Prev Cardiol ; 20(2): 301-9, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22345689

RESUMO

AIM: To evaluate whether a multidisciplinary educational program (EP) in cardiovascular prevention (CVP) for children could improve the Framingham cardiovascular risk (FCR) of their parents after one year. METHODS AND RESULTS: This was a prospective community-based study in Brazil during 2010 that randomized students aged 6 to 10 years old to two different approaches to receiving healthy lifestyle information. The control group received written educational material (EM) for their parents about healthy lifestyle. The intervention group received the same EM for parents, and children were exposed to a weekly EP in CVP with a multidisciplinary health team. At onset and end of the study, we collected data from parents and children (weight, height, arterial blood pressure, and laboratory tests). We studied 197 children and 323 parents. Analyzing the parents' FCR we found that 9.3% of the control group and 6.8% of the intervention group had more than a 10% year risk of cardiovascular heart disease (CHD) over the next 10 years. After the children's EP for the year, the intervention group had a reduction of 91% in the intermediate/high FCR group compared with a 13% reduction in the control group, p = 0.002). In the same way, analyzing the FCR of all parents, there was a reduction of the average risk in the intervention group (3.6% to 2.8% respectively, p < 0.001) compared with the control group (4.4% to 4.4%, p = 0.98). CONCLUSION: An educational program in cardiovascular prevention directed at school-age children can reduce the FCR risk of their parents, especially in the intermediate/high risk categories.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Comportamento Infantil , Comportamentos Relacionados com a Saúde , Educação em Saúde , Conhecimentos, Atitudes e Prática em Saúde , Relações Pais-Filho , Prevenção Primária/métodos , Comportamento de Redução do Risco , Adulto , Análise de Variância , Pressão Arterial , Biomarcadores/sangue , Peso Corporal , Brasil/epidemiologia , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/fisiopatologia , Distribuição de Qui-Quadrado , Criança , Dieta/efeitos adversos , Exercício , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Folhetos , Equipe de Assistência ao Paciente , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Abandono do Hábito de Fumar
18.
Arq. bras. cardiol ; 99(5): 1023-1030, nov. 2012. tab
Artigo em Português | LILACS | ID: lil-656635

RESUMO

FUNDAMENTO: Cresce o uso da Telemedicina, especialmente no envio e na avaliação de eletrocardiograma (ECG). É um procedimento de baixo custo, com alto potencial de salvar vidas. OBJETIVO: Descrever a forma de análise sistemática e o perfil do usuário da Rede Catarinense de Telemedicina quando o laudo era emitido de forma livre. MÉTODOS: Estudo observacional, transversal, determinando as associações entre características dos pacientes e diagnósticos eletrocardiográficos emitidos, dentre os usuários da Rede Catarinense de Telemedicina quando o laudo era fornecido de forma livre. Esse sistema estava conectado a 287 cidades de Santa Catarina, os exames eram feitos nos locais de origem e emitidos os laudos em três hospitais terciários. Entre 2005 e 2010, os laudos eram emitidos de forma livre e foi criado um método probabilístico para análise dos dados. Um cardiologista experiente avaliou todos os ECG para aferir a chance de anormalidade. RESULTADOS: Foram avaliados 243.363 ECG. A maioria (58%) foi realizada em pacientes com mais de 50 anos e proveniente da atenção primária (72%). Houve diferenças de frequência por região, parcialmente relacionado com número de cardiologistas/região (r = -0,551), com a distância dos centros terciários e com possíveis diferenças de aceitação do método. Cerca de 53% do ECG foram anormais, com maior frequência quanto maior a idade (r2 = 0,8166), e com diferenças regionais também significantes (p < 0,0001). CONCLUSÃO: Foi construído um sistema de análise dos dados integrando termos prevalentes, análise probabilística e dicionários especializados. O sistema tem atendido uma parcela significativa da população catarinense, principalmente idosos, da rede básica e de regiões remotas do estado.


BACKGROUND: A growing use of telemedicine has been observed, especially as regards the sending and evaluation of electrocardiograms (ECG); this is a low-cost procedure with a high potential to save lives. OBJECTIVES: To describe the form of systematic analysis and user profile of the Telemedicine Network of Santa Catarina during the time when the report was issued freely. METHODS: Observational cross-sectional study determining the associations between patient characteristics and electrocardiographic diagnoses issued among users of the Telemedicine Network of Santa Catarina during the time when the report was issued freely. This system was connected to 287 cities in Santa Catarina; the tests were done in the places of origin and the reports were issued in three tertiary-care hospitals. From 2005 to 2010 the reports were issued freely and a probabilistic method for data analysis was created. An experienced cardiologist evaluated all ECGs to assess the chances of abnormality. RESULTS: 243,363 ECGs were evaluated. The majority (58%) was performed on patients older than 50 years from primary care services (72%). There were differences in the frequency per region; this was partly related to the number of cardiologists/region (r = -0.551), to the distance from tertiary-care centers and potential differences of acceptance of the method. Approximately 53% of the ECGs were abnormal with greater frequency with increasing age (r² = 0.8166) and with significant regional differences (p < 0.0001). CONCLUSIONS: We built a data analysis system integrating prevalent terms, probabilistic analysis and specialized dictionaries. The system has covered a significant portion of the population of Santa Catarina, mainly elderly patients from the network of primary healthcare centers and remote regions of the State.


Assuntos
Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Pessoa de Meia-Idade , Adulto Jovem , Eletrocardiografia/estatística & dados numéricos , Sistemas Computadorizados de Registros Médicos/estatística & dados numéricos , Telemedicina/estatística & dados numéricos , Distribuição por Idade , Brasil , Estudos Transversais , Reprodutibilidade dos Testes , Estudos Retrospectivos
19.
Arq Bras Cardiol ; 99(5): 1023-30, 2012 Nov.
Artigo em Inglês, Português | MEDLINE | ID: mdl-23080222

RESUMO

BACKGROUND: A growing use of telemedicine has been observed, especially as regards the sending and evaluation of electrocardiograms (ECG); this is a low-cost procedure with a high potential to save lives. OBJECTIVES: To describe the form of systematic analysis and user profile of the Telemedicine Network of Santa Catarina during the time when the report was issued freely. METHODS: Observational cross-sectional study determining the associations between patient characteristics and electrocardiographic diagnoses issued among users of the Telemedicine Network of Santa Catarina during the time when the report was issued freely. This system was connected to 287 cities in Santa Catarina; the tests were done in the places of origin and the reports were issued in three tertiary-care hospitals. From 2005 to 2010 the reports were issued freely and a probabilistic method for data analysis was created. An experienced cardiologist evaluated all ECGs to assess the chances of abnormality. RESULTS: 243,363 ECGs were evaluated. The majority (58%) was performed on patients older than 50 years from primary care services (72%). There were differences in the frequency per region; this was partly related to the number of cardiologists/region (r = -0.551), to the distance from tertiary-care centers and potential differences of acceptance of the method. Approximately 53% of the ECGs were abnormal with greater frequency with increasing age (r(2) = 0.8166) and with significant regional differences (p < 0.0001). CONCLUSIONS: We built a data analysis system integrating prevalent terms, probabilistic analysis and specialized dictionaries. The system has covered a significant portion of the population of Santa Catarina, mainly elderly patients from the network of primary healthcare centers and remote regions of the State.


Assuntos
Eletrocardiografia/estatística & dados numéricos , Sistemas Computadorizados de Registros Médicos/estatística & dados numéricos , Telemedicina/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Brasil , Criança , Pré-Escolar , Estudos Transversais , Humanos , Lactente , Recém-Nascido , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estudos Retrospectivos , Adulto Jovem
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