Fatores de risco cardiovascular e distribuição de gordura corporal em brasileiros com 80 anos ou mais

Modelo do estudo: Estudo transversal. Objetivo: Analisar a presença de fatores de risco cardiovascular (FRC) de acordo com o padrão de distribuição de gordura corporal em brasileiros com 80 anos ou mais. Materiais e Método: A amostra foi composta de 113 idosos, com média de idade de 83,4 anos, de ambos os sexos. O percentual de gordura corporal total e abdominal, hipertensão e perfil lipídico foram usados para caracterização dos FRC. O teste qui-quadrado foi utilizado para avaliação das proporções de FRC e o teste Mann-Whitney foi utilizado para comparar os resultados de adiposidade. Resultados: Idosos eutróficos apresentaram baixo triglicerídeos (p=0,017) e colesterol total (p=0,001) além de menores prevalências de hipertensão (p=0,003) e hipertrigliceridemia (p=0,007). Idosos com maior adiposidade abdominal apresentaram maior colesterol total (p=0,026) e prevalência de hipertrigliceridemia (p=0,011) e hipercolesterolemia (p=0,026) quando comparados com os de menor adiposidade abdominal. Aqueles com excesso de gordura (total, ou abdominal ou ambos), com exceção da glicemia (p=0,877), apresentaram alta prevalência de FRC. Aqueles com ambos os excessos de gordura apresentam diferenças, com maior nível de prevalência quando comparados aqueles com apenas um ou nenhum dos excessos. Conclusão: A obesidade, sendo abdominal ou total, é associada, da mesma maneira, com FRC em sujeitos com 80 anos ou maisStudy design: Cross-sectional study. Objective: To analyze the presence of cardiovascular risk factors (CRFs) according to the pattern of body fat distribution, in Brazilians aged 80 years or over. Methods: The sample consisted of 113 subjects, of 83.4 years, of both sexes. The percentages of total and abdominal body fat, hypertension and lipid profile were used for characterization of CRFs. The chisquare test was used to assess proportions of CRFs and the Mann-Whitney test was used to compare the results of adiposity. Results: Eutrophic subjects presented lower triglycerides (p=0.017), total cholesterol (p=0.001) and prevalence of both hypertension (p=0.003) and hypertriglyceridemia (p=0.007). Subjects with higher abdominal adiposity presented higher total cholesterol (p=0.026) and prevalence of hypertriglyceridemia (p=0.011) and hypercholesterolemia (p=0.026) than those with no excess abdominal adiposity. Those with excess fat (total, abdominal or both), with the exception of glucose (p=0.877), presented a high prevalence of CRFs. Those with both types of excess fat presented differences, with a higher prevalence level when compared to those with only one or neither of the excesses. Conclusion: Obesity, whether abdominal or total, is similarly associated with CRFs in subjects aged 80 years and ove

Association between physical activity levels and polypharmacy in hypertensive patients

Background: exercise reduces medication usage in hypertensive people. However, different domains of physical activity (PA) have not been studied in order to analyze their relationship with the use of multiple medications, known as polypharmacy. Purpose: To examine the association between PA in different domains (leisure-time, locomotion and occupational) and polypharmacy in hypertensive patients. Methods: This is a cross-sectional study carried out with 190 hypertensive patients. Polypharmacy was defined as simultaneous use of three or more drugs. The PA domains were the independent variables: Locomotion PA (LPA), Leisure Time PA (LTPA) and Occupational PA (OPA). The multiple logistic regression was performed to analyze the associations. The Mann Whitney test determined whether medications usage differ according to each domain of PA. Results: The total number of drugs used ranged from 0 to 7, which represents an average of 2.35 (±1.6) drugs per person. Scores of LTPA (OR: 3.25; CI95%:1.61-6.54) and LPA (OR: 2.15; CI95%:1.09-4.25) were inversely associated with polypharmacy in hypertensive patients, in the multiple logistic regression analysis (controlled by BMI, chronic diseases, smoking, alcohol consumption and skin color). Conclusions: lower PA in leisure time and locomotion were associated with polypharmacy in hypertensive peopleIntrodução: o exercício reduz o uso de medicamentos em indivíduos hipertensos. Contudo, diferentes domínios de atividade física (AF) não têm sido estudados no intuito de analisar suas relações com o uso de múltiplos medicamentos, conhecido como polifarmácia. Objetivo: analisar a associação entre AF em diferentes domínios (tempo livre, locomoção e ocupação) e polifarmácia em indivíduos hipertensos. Métodos: trata-se de um estudo transversal realizado com 190 hipertensos. Polifarmácia foi definida como o uso simultâneo de três ou mais drogas. As variáveis independentes foram os domínios de AF: Locomoção (AFL); Tempo Livre (AFTL) e Ocupacional (AFO). A regressão logística múltipla foi empregada para analisar as associações. O teste de Mann Whitney foi empregado para comparar se a média de medicamentos usados diferia entre domínios de AF. Resultados: o número total de drogas usadas variou de 0 a 7, com média de 2.35 (±1.6) por pessoa. Escores de AFTL (OR: 3.25; IC95%: 1.61-6.54) e AFL (OR: 2.15; IC95%: 1.09-4.25) foram inversamente associadas à polifarmácia em hipertensos (controlado por IMC, número de doenças crônicas, fumo, consumo de álcool e cor da pele). Conclusão: menor AF no tempo livre e de locomoção foi associada à polifarmácia em indivíduos hipertenso

Factors associated with leisure-time physical activity among patients undergoing hemodialysis

Background End-stage renal disease patients are characterized by low levels of physical activity, especially during leisure time. However, the recognition of variables associated with patterns of physical activity in this population has been little explored. Thus, the objective was to assess factors associated with levels of physical activity during leisure time among patients on haemodialysis. Methods Ninety-eight patients (51.6 ± 15.7 years, 57 M/41 F) from two dialysis centres in São Paulo, Brazil participated in this cross-sectional study. Participants were divided into those who never exercised during leisure-time (inactive) and those who exercised at least once a week (active). The independent factors assessed were: socio-demographic data, comorbidities, personal barriers to exercise and physical activity records from childhood to adulthood (tracking of physical activity). Results Only 27 % of patients were engaged in PA during their leisure time at least once a week. Patients who engaged in regular physical activity during adulthood before the initiation of the hemodialysis treatment (adjusted OR: 7.24 95 % IC: 1.99; 26.50), those who developed the renal disease through diseases other than diabetes or hypertension (adjusted OR: 4.82; 95 % IC: 1.48; 15.68), and those who had no cardiovascular diseases (adjusted OR: 11.33; 95 % IC: 1.23; 103.8) where more likely to be active during their leisure-time. Conclusion Comorbidities such as cardiovascular disease, hypertension and diabetes mellitus as well as the level of physical activity prior to end-stage renal disease could predict leisure-time physical activity among patients receiving hemodialysis therapy

ASSESSING THE NUTRITIONAL CONDITION OF PREGNANT WOMEN IN THE CITY OF SANTO ANDRÉ THROUGH ROSSO’S GRAPH

A falta de vigilancia da condição nutricional da gestante durante o exame pré-natal tem dificultado intervenções adequadas no sentido de prevenir a ocorrência do baixo peso ao nascimento (BP). Foram avaliadas, prospectivamente, 95 gestantes de baixo nível sócio-econômico do Município de Santo André, para realização de exame pré-natal, utilizando-se a curva de Rosso para sua classificação nutricional. O percentual de mãe com baixo peso foi de 36,8%. As mães com mais de duas gestações apresentaram maior ocorrência de sobrepeso ou obesidade e as com menos de duas gestações, percentual significativamente maior de baixo peso. A anemia também se associou de maneira significativa às gestantes de baixo peso. O presente trabalho ressalta a importancia da implantação de instrumento na rede básica de saúde para controlar o ganho de peso da gestante, bem como da vigilancia de outros fatores de risco no intuito de reduzir os elevados percentuais de recém-nascidos com BP.The lack of monitoring ofthenutritional condition of pregnamtwomen during theprenatal exammat^lon has made it difficult for interventions aimir g at the prevention of low weight at birth (BP). 45 pregnmt women of low socio-economic levei registered m the posts of the FOUNDATION for ASSISTANCE to INFANCY (FAISA - Santo André, São Paulo) were evaluated, for accomplishment of prenatal exammation, using Rosso’s Graph for its nutritional classification. The achieved percentage of pregnantwomenwi^th low weightwas 36,8%. Mo^therswi^thmore thamtwo ges^tations and wi^th less than two presented greater occurrence of overweight obesi^ty amd low weight, respectively. Higher percentage of amemia in the pregmant women with low weight was verified. Therefore, it is evident that this instrument should be implemented as routine in ^the prenatal examinabon

Measurement of the cosmic ray spectrum above 4×10184{\times}10^{18} eV using inclined events detected with the Pierre Auger Observatory

A measurement of the cosmic-ray spectrum for energies exceeding $4{\times}10^{18}$ eV is presented, which is based on the analysis of showers with zenith angles greater than $60^{\circ}$ detected with the Pierre Auger Observatory between 1 January 2004 and 31 December 2013. The measured spectrum confirms a flux suppression at the highest energies. Above $5.3{\times}10^{18}$ eV, the "ankle", the flux can be described by a power law $E^{-\gamma}$ with index $\gamma=2.70 \pm 0.02 \,\text{(stat)} \pm 0.1\,\text{(sys)}$ followed by a smooth suppression region. For the energy ($E_\text{s}$) at which the spectral flux has fallen to one-half of its extrapolated value in the absence of suppression, we find $E_\text{s}=(5.12\pm0.25\,\text{(stat)}^{+1.0}_{-1.2}\,\text{(sys)}){\times}10^{19}$ eV.Comment: Replaced with published version. Added journal reference and DO

Energy Estimation of Cosmic Rays with the Engineering Radio Array of the Pierre Auger Observatory

The Auger Engineering Radio Array (AERA) is part of the Pierre Auger Observatory and is used to detect the radio emission of cosmic-ray air showers. These observations are compared to the data of the surface detector stations of the Observatory, which provide well-calibrated information on the cosmic-ray energies and arrival directions. The response of the radio stations in the 30 to 80 MHz regime has been thoroughly calibrated to enable the reconstruction of the incoming electric field. For the latter, the energy deposit per area is determined from the radio pulses at each observer position and is interpolated using a two-dimensional function that takes into account signal asymmetries due to interference between the geomagnetic and charge-excess emission components. The spatial integral over the signal distribution gives a direct measurement of the energy transferred from the primary cosmic ray into radio emission in the AERA frequency range. We measure 15.8 MeV of radiation energy for a 1 EeV air shower arriving perpendicularly to the geomagnetic field. This radiation energy -- corrected for geometrical effects -- is used as a cosmic-ray energy estimator. Performing an absolute energy calibration against the surface-detector information, we observe that this radio-energy estimator scales quadratically with the cosmic-ray energy as expected for coherent emission. We find an energy resolution of the radio reconstruction of 22% for the data set and 17% for a high-quality subset containing only events with at least five radio stations with signal.Comment: Replaced with published version. Added journal reference and DO

Measurement of the Radiation Energy in the Radio Signal of Extensive Air Showers as a Universal Estimator of Cosmic-Ray Energy

We measure the energy emitted by extensive air showers in the form of radio emission in the frequency range from 30 to 80 MHz. Exploiting the accurate energy scale of the Pierre Auger Observatory, we obtain a radiation energy of 15.8 \pm 0.7 (stat) \pm 6.7 (sys) MeV for cosmic rays with an energy of 1 EeV arriving perpendicularly to a geomagnetic field of 0.24 G, scaling quadratically with the cosmic-ray energy. A comparison with predictions from state-of-the-art first-principle calculations shows agreement with our measurement. The radiation energy provides direct access to the calorimetric energy in the electromagnetic cascade of extensive air showers. Comparison with our result thus allows the direct calibration of any cosmic-ray radio detector against the well-established energy scale of the Pierre Auger Observatory.Comment: Replaced with published version. Added journal reference and DOI. Supplemental material in the ancillary file

Nutritional status of pre-school children from low income families

<p>Abstract</p> <p>Background</p> <p>We evaluated growth and nutritional status of preschool children between 2 and 6 years old from low income families from 14 daycare centers.</p> <p>Methods</p> <p>Cross-sectional study with 1544 children from daycare centers of Santo Andre, Brazil. Body weight (W), height (H) and body mass index (BMI) were classified according to the 2000 National Center for Health Statistics (CDC/NCHS). Cutoff points for nutritional disorders: -2 z scores and 2.5 and 10 percentiles for malnutrition risk, 85 to 95 percentile for overweight and above BMI 95 percentile for obesity. Stepwise Forward Regression method was used including age, gender, birth weight, breastfeeding duration, age of mother at birth and period of time they attended the daycare center.</p> <p>Results</p> <p>Children presented mean z scores of H, W and BMI above the median of the CDC/NCHS reference. Girls were taller and heavier than boys, while we observed similar BMI between both genders. The z scores tended to rise with age. A Pearson Coefficient of Correlation of 0.89 for W, 0.93 for H and 0.95 for BMI was documented indicating positive association of age with weight, height and BMI. The frequency of children below -2 z scores was lower than expected: 1.5% for W, 1.75% for H and 0% for BMI, which suggests that there were no malnourished children. The other extremity of the distribution evidenced prevalence of overweight and obesity of 16.8% and 10.8%, respectively.</p> <p>Conclusion</p> <p>Low income preschool children are in an advanced stage of nutritional transition with a high prevalence of overweight.</p