Análise do perfil antropométrico e nível de atividade física de alunos de 6ª e 7ª séries do ensino fundamental de Nova Campina-SP

A obesidade é caracterizada pelo acúmulo de gordura corporal acima dos níveis adequados para saúde, e pode desencadear diversos processos patológicos. É uma patologia que está crescendo de forma considerável tanto em países desenvolvidos como em países em desenvolvimento. Atrelados ao excesso de gordura corporal, vários fatores contribuem para o aumento dessa epidemia entre eles, inatividade física, balanço energético positivo, tecnologia e suas facilidades, fatores genéticos e principalmente condições ambientais. O presente estudo teve como objetivo analisar o perfil antropométrico e nível de atividade física de estudantes do ensino fundamental da rede pública do município de Nova Campina-SP. Foram avaliados 120 adolescentes de escola pública, sendo 60 meninas e 60 meninos, com idade entre 12 a 15 anos. Os voluntários responderam o questionário IPAQ (International Physical Activity Questionaire) sobre nível de atividade física, e foram submetidos à avaliação da composição corporal por antropometria. Entre os 120 adolescentes 23,3% foram classificados como portadores de sobrepeso, enquanto 2,5% dos entrevistados apresentaram baixo peso. Em relação ao nível de atividade física avaliada através do questionário foi constatado que 61,6% dos alunos são considerados ativos, 38,3% são considerados insuficientemente ativos, e não houve índice de sedentarismo. Foi possível verificar que os alunos ativos apresentam peso normal. Estudos com relação à obesidade e sobrepeso, quase em sua totalidade coincidem que a atividade física é uma importante ferramenta não farmacológica na prevenção e tratamento da obesidade, destacando também a importância de estimular essa pratica cada vez mais cedo, pois adolescentes ativos provavelmente serão adultos ativos.ABSTRACTAnalysis of anthropometric profile and level of physical activity of schoolchildren from Nova Campina Obesity is characterized by the accumulation of body fat above the appropriate levels for health and can trigger several pathological processes, including hypertension, diabetes type ii, cardiovascular disease and some cancers. It is a condition that is growing significantly both in developed and developing countries. Linked to excess of body fat, many factors contribute to the increase of this epidemic, including physical inactivity, positive energy balance, technology and its facilities, genetic factors and especially environmental conditions. The present study aims to analyze the anthropometric and physical activity in adolescents students of public elementary schools in  Nova Campina-SP.  Were evaluated 120 adolescents from public schools, male and female. The volunteers answered the ipaq questionnaire about physical activity level, and were submitted to evaluation of body composition by anthropometric methods. The prevalence of overweight was 10 % males and 13 % female, and 89 of this sample with normal weight. It is concluded that studies regarding obesity and overweight, almost entirely agree that physical activity is an important tool in non-pharmacological prevention and treatment of obesity, highlighting as well the importance of encouraging this practice at an earlier age, because sedentary adolescents will probably be sedentary adults

Análise do perfil antropométrico e nível de atividade física de alunos de 6ª e 7ª séries do ensino fundamental de Nova Campina-SP

A obesidade é caracterizada pelo acúmulo de gordura corporal acima dos níveis adequados para saúde, e pode desencadear diversos processos patológicos. É uma patologia que está crescendo de forma considerável tanto em países desenvolvidos como em países em desenvolvimento. Atrelados ao excesso de gordura corporal, vários fatores contribuem para o aumento dessa epidemia entre eles, inatividade física, balanço energético positivo, tecnologia e suas facilidades, fatores genéticos e principalmente condições ambientais. O presente estudo teve como objetivo analisar o perfil antropométrico e nível de atividade física de estudantes do ensino fundamental da rede pública do município de Nova Campina-SP. Foram avaliados 120 adolescentes de escola pública, sendo 60 meninas e 60 meninos, com idade entre 12 a 15 anos. Os voluntários responderam o questionário IPAQ (International Physical Activity Questionaire) sobre nível de atividade física, e foram submetidos à avaliação da composição corporal por antropometria. Entre os 120 adolescentes 23,3% foram classificados como portadores de sobrepeso, enquanto 2,5% dos entrevistados apresentaram baixo peso. Em relação ao nível de atividade física avaliada através do questionário foi constatado que 61,6% dos alunos são considerados ativos, 38,3% são considerados insuficientemente ativos, e não houve índice de sedentarismo. Foi possível verificar que os alunos ativos apresentam peso normal. Estudos com relação à obesidade e sobrepeso, quase em sua totalidade coincidem que a atividade física é uma importante ferramenta não farmacológica na prevenção e tratamento da obesidade, destacando também a importância de estimular essa pratica cada vez mais cedo, pois adolescentes ativos provavelmente serão adultos ativos.ABSTRACTAnalysis of anthropometric profile and level of physical activity of schoolchildren from Nova Campina Obesity is characterized by the accumulation of body fat above the appropriate levels for health and can trigger several pathological processes, including hypertension, diabetes type ii, cardiovascular disease and some cancers. It is a condition that is growing significantly both in developed and developing countries. Linked to excess of body fat, many factors contribute to the increase of this epidemic, including physical inactivity, positive energy balance, technology and its facilities, genetic factors and especially environmental conditions. The present study aims to analyze the anthropometric and physical activity in adolescents students of public elementary schools in  Nova Campina-SP.  Were evaluated 120 adolescents from public schools, male and female. The volunteers answered the ipaq questionnaire about physical activity level, and were submitted to evaluation of body composition by anthropometric methods. The prevalence of overweight was 10 % males and 13 % female, and 89 of this sample with normal weight. It is concluded that studies regarding obesity and overweight, almost entirely agree that physical activity is an important tool in non-pharmacological prevention and treatment of obesity, highlighting as well the importance of encouraging this practice at an earlier age, because sedentary adolescents will probably be sedentary adults

Externado de Medicina Interna - ME212 - 202101

Curso de la carrera de medicina, de carácter teórico-práctico del ciclo 9, en el que los estudiantes presentan una historia clínica con su respectivo plan diagnóstico, terapéutico y de procedimientos en un paciente con una condición médica, a través de la realización de actividades de simulación y metodología activa. El curso del externado de medicina interna busca desarrollar la competencia general de comunicación escrita (nivel 3) y las competencias específicas de práctica clínica-diagnóstico(nivel 3) y profesionalismo-sentido ético y legal y responsabilidad profesional(nivel 3). El externado de medicina al estudiante le permitirá plantear un adecuado tratamiento y plan de trabajo según el diagnóstico de los principales problemas médicos que le servirá en su futura vida profesional

Effect of lung recruitment and titrated Positive End-Expiratory Pressure (PEEP) vs low PEEP on mortality in patients with acute respiratory distress syndrome - A randomized clinical trial

IMPORTANCE: The effects of recruitment maneuvers and positive end-expiratory pressure (PEEP) titration on clinical outcomes in patients with acute respiratory distress syndrome (ARDS) remain uncertain. OBJECTIVE: To determine if lung recruitment associated with PEEP titration according to the best respiratory-system compliance decreases 28-day mortality of patients with moderate to severe ARDS compared with a conventional low-PEEP strategy. DESIGN, SETTING, AND PARTICIPANTS: Multicenter, randomized trial conducted at 120 intensive care units (ICUs) from 9 countries from November 17, 2011, through April 25, 2017, enrolling adults with moderate to severe ARDS. INTERVENTIONS: An experimental strategy with a lung recruitment maneuver and PEEP titration according to the best respiratory-system compliance (n = 501; experimental group) or a control strategy of low PEEP (n = 509). All patients received volume-assist control mode until weaning. MAIN OUTCOMES AND MEASURES: The primary outcome was all-cause mortality until 28 days. Secondary outcomes were length of ICU and hospital stay; ventilator-free days through day 28; pneumothorax requiring drainage within 7 days; barotrauma within 7 days; and ICU, in-hospital, and 6-month mortality. RESULTS: A total of 1010 patients (37.5% female; mean [SD] age, 50.9 [17.4] years) were enrolled and followed up. At 28 days, 277 of 501 patients (55.3%) in the experimental group and 251 of 509 patients (49.3%) in the control group had died (hazard ratio [HR], 1.20; 95% CI, 1.01 to 1.42; P = .041). Compared with the control group, the experimental group strategy increased 6-month mortality (65.3% vs 59.9%; HR, 1.18; 95% CI, 1.01 to 1.38; P = .04), decreased the number of mean ventilator-free days (5.3 vs 6.4; difference, −1.1; 95% CI, −2.1 to −0.1; P = .03), increased the risk of pneumothorax requiring drainage (3.2% vs 1.2%; difference, 2.0%; 95% CI, 0.0% to 4.0%; P = .03), and the risk of barotrauma (5.6% vs 1.6%; difference, 4.0%; 95% CI, 1.5% to 6.5%; P = .001). There were no significant differences in the length of ICU stay, length of hospital stay, ICU mortality, and in-hospital mortality. CONCLUSIONS AND RELEVANCE: In patients with moderate to severe ARDS, a strategy with lung recruitment and titrated PEEP compared with low PEEP increased 28-day all-cause mortality. These findings do not support the routine use of lung recruitment maneuver and PEEP titration in these patients. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01374022

Cardiac myosin activation with omecamtiv mecarbil in systolic heart failure

BACKGROUND The selective cardiac myosin activator omecamtiv mecarbil has been shown to improve cardiac function in patients with heart failure with a reduced ejection fraction. Its effect on cardiovascular outcomes is unknown. METHODS We randomly assigned 8256 patients (inpatients and outpatients) with symptomatic chronic heart failure and an ejection fraction of 35% or less to receive omecamtiv mecarbil (using pharmacokinetic-guided doses of 25 mg, 37.5 mg, or 50 mg twice daily) or placebo, in addition to standard heart-failure therapy. The primary outcome was a composite of a first heart-failure event (hospitalization or urgent visit for heart failure) or death from cardiovascular causes. RESULTS During a median of 21.8 months, a primary-outcome event occurred in 1523 of 4120 patients (37.0%) in the omecamtiv mecarbil group and in 1607 of 4112 patients (39.1%) in the placebo group (hazard ratio, 0.92; 95% confidence interval [CI], 0.86 to 0.99; P = 0.03). A total of 808 patients (19.6%) and 798 patients (19.4%), respectively, died from cardiovascular causes (hazard ratio, 1.01; 95% CI, 0.92 to 1.11). There was no significant difference between groups in the change from baseline on the Kansas City Cardiomyopathy Questionnaire total symptom score. At week 24, the change from baseline for the median N-terminal pro-B-type natriuretic peptide level was 10% lower in the omecamtiv mecarbil group than in the placebo group; the median cardiac troponin I level was 4 ng per liter higher. The frequency of cardiac ischemic and ventricular arrhythmia events was similar in the two groups. CONCLUSIONS Among patients with heart failure and a reduced ejection, those who received omecamtiv mecarbil had a lower incidence of a composite of a heart-failure event or death from cardiovascular causes than those who received placebo. (Funded by Amgen and others; GALACTIC-HF ClinicalTrials.gov number, NCT02929329; EudraCT number, 2016 -002299-28.)

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally

Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

This was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London