Determinantes da pressão arterial em diabéticos tipo 2 com alta ocorrência de controle glicêmico inadequado

Study design: Association studyObjective: To analyze the association between different biological/behavioral risk factors and bloodpressure in a sample of type 2 diabetes mellitus patients with poor glycemic control. Methods: A sampleof 121 type 2 diabetic patients was selected in the Public Healthcare System in a middle size Braziliancity. Blood pressure was measured using an aneroid device, previously calibrated. Six determinants ofblood pressure were taken into count: age, hypoglycemic agents, general obesity, abdominal obesity,eating behaviors and physical activity level. Results: The type 2 diabetic patients presented mean age of60.1±8.9 years-old and, at least, one risk factor. Eating behaviors (ORadj= 0.31 [0.12-0.75]) and sportspractice (ORadj= 0.12 [0.02-0.75]) constituted protective factors associated with lower systolic blood pressure. On the other hand, age was positively associated with high systolic blood pressure (ORadj= 3.81[1.39-10.38]). Patients with 5-6 risk factors, presented higher values of systolic and (F= 3.857; p= 0.011[post hoc with p= 0.039]), diastolic blood pressure (F= 4.158; p= 0.008 [post hoc with p= 0.036]) andincreased occurrence of hypertension (p= 0.010). Conclusion: Our findings indicate that, behavioralvariables were important determinants of blood pressure in type 2 diabetic patients with poor glycemiccontrol and clustering of behavioral and biological risk factors increase the hypertension occurrence.Modelo do estudo: Estudo de associaçãoObjetivo: Analisar a associação entre diferentes fatores de risco biológicos/comportamentais e pressãoarterial in uma amostra de diabéticos do tipo 2 com pobre controle glicêmico. Métodos: Uma amostra de121 diabéticos tipo 2 foi selecionada no sistema público de uma cidade brasileira de porte médio.Pressão arterial foi aferida usando um aparelho aneroide previamente calibrado. Seis determinantes dapressão arterial foram considerados: idade, hipoglicemiantes, obesidade geral, obesidade central, hábitos alimentares e atividade física. Resultados: Os diabéticos apresentaram média de idade de 60,1±8,9anos e ao menos um fator de risco. Hábitos alimentares (ORadj= 0.31 [0.12-0.75]) e prática esportiva(ORadj= 0.12 [0.02-0.75]) constituíram fatores de proteção associados a menor pressão arterial. Poroutro lado, idade foi positivamente associada com alta pressão arterial sistólica (ORadj= 3.81 [1.39-10.38]).Pacientes com 5-6 fatores de risco apresentaram maiores valores sistólicos (F= 3,857; p= 0,011 [post hoccom p= 0,039]) e diastólicos (F= 4,158; p= 0,008 [post hoc com p= 0,036]) e maior ocorrência de hipertensão (p= 0,001). Conclusão: Nossos achados indicam que variáveis comportamentais foram importantesdeterminantes de pressão arterial em pacientes com pobre controle glicêmico e a agregação de fatorescomportamentais e biológicos aumentaram a ocorrência de hipertensão

Associação entre doenças crônicas em adultos e redução dos níveis de atividade física

Type of study:  Prevalence study. Objective: To describe the occurrence of diseases in hypertensive and/or diabetic patients, users of Basic Health Unit (BHU) and to associate the occurrence of both diseaseswith physical activity. Methods: Cross-sectional study involving 222 patients with hypertension and/ordiabetes mellitus, of both sexes and users of two BHU from Bauru, Brazil. Clinical records of the patientswere analyzed to detect the presence of diseases, body weight and height were measured to determinenutritional status, as well as, a questionnaire assessed the physical activity level. Chi-square test identified associations and the binary logistic regression expressed the magnitude of these associations.Significant was set at p < 0.05. Results: The sample had more women (64%), obese (42.3%) andsedentary persons (78.8%). The most frequent diseases among the patients were hypercholesterolemia(31.5%), arthritis / arthrosis (23.8%) and low back pain (23.8%). There was significant association between leisure physical activity (intensity, weekly practice and prior engagement) and lower occurrence ofmetabolic diseases. Independent of confounders, diabetic and diabetics with hypertension had increasedlikelihood to be sedentary. Conclusion: The results suggest that the onset of hypertension and / ordiabetic co-morbidity is associated with high rates of physical inactivity and, consequently, an increasednumber of co-morbidities.Modelo do estudo: Estudo de prevalência. Objetivo: Descrever a ocorrência das doenças mais frequentes que acometem portadores de hipertensão arterial (HAS) e/ou diabetes mellitus (DM), usuários deUnidade Básica de Saúde (UBS) e associar a ocorrência das duas doenças com o nível de atividadefísica. Métodos: Estudo transversal envolvendo 222 indivíduos portadores de hipertensão arterial e/oudiabetes mellitus, de ambos os sexos e usuários de duas UBS da cidade de Bauru/SP. Foram analisados prontuários clínicos dos pacientes para verificação e constatação da ocorrência de doenças. Pesocorporal e estatura foram aferidos para classificação do estado nutricional e foi aplicado questionáriopara verificar o nível de atividade física. O teste qui-quadrado foi utilizado para analisar existência deassociações e a regressão logística binária expressou a magnitude das mesmas. As comparaçõesforam consideradas significativas quando p < 0,05. Resultados: A amostra teve predominância demulheres (64%), pessoas com obesidade (42,3%) e sedentarismo (78,8%). As doenças de maiorocorrência entre os pacientes hipertensos e diabéticos foram a hipercolesterolemia (31,5%), seguidapela artrite/artrose (23,8%) e lombalgia (23.8%). Houve associação significativa entre indicadores deprática de atividades físicas no lazer (intensidade, tempo semanal de prática e engajamento prévio)com menor ocorrência de doenças metabólicas. Independente de variáveis de confusão, indivíduosdiabéticos e diabéticos com hipertensão tiveram chances aumentados de apresentar comportamentosedentário. Conclusão: Os resultados sugerem que o acometimento de pacientes hipertensos e/oudiabéticos por comorbidades está associado às altas taxas de inatividade física e, conseqüentemente,ao aumento do número de agravos associados

Associação entre desordens musculoesqueléticas e gastos com cuidado à saúde entre pacientes do Sistema Único de Saúde

Delineamento: transversal. Objetivos: (i) Identificar a ocorrência de desordens musculoesqueléticas, (ii) identificar seus determinantes e (iii) suas relações com gastos com saúde em adultos atendidos pelo Sistema Único de Saúde. Métodos: Estudo transversal com 963 adultos, com 50 anos e de ambos os sexos tratados em unidades básicas de saúde. Participantes responderam questionários sobre doenças, condição econômica, desordens musculoesqueléticas, atividade ocupacional, consultas de fisioterapia e compra de medicamentos; peso e estatura foram mensurados para calcular o índice de massa corporal. Custos com saúde foram computados retroagindo 12 meses. Resultados: A prevalência de desordens musculoesqueléticas foi 65%, sendo maior em pacientes com doenças do tecido conjuntivo (OR=4,11 [2,98-5,67]) e pessoas que levantam cargas no trabalho (OR=1,45 [1,27-1,66]). Além disso, a ocorrência de desordens musculoesqueléticas nos ombros, região lombar, joelhos e tornozelos/pés foram relacionados a maiores gastos com medicamentos e consultas médicas. Conclusão: A ocorrência de desordens musculoesqueléticas foi elevada entre estes pacientes, é afetada por sexo e atividade ocupacional e positivamente relacionada com gastos com saúde.Study Design: Cross-sectional. Objectives: (i) To identify the prevalence of musculoskeletal disorders, (ii) to identify musculoskeletal disorders correlates and (iii) to identify the existence of relationship between musculoskeletal disorders and healthcare expenditures in adults attended to by the public healthcare system. Methods: Crosssectional study involving 963 adults (over 50 years of age and of both sexes) treated in basic healthcare units (BHU). The participants answered questionnaires about self-reported morbidity, economic condition, musculoskeletal symptoms, occupational activity behavior, physical therapy consultation and prescription drugs purchased. Weight and height were obtained for body mass index computation. Healthcare expenditures in the last 12 months were computed. Results: The prevalence of musculoskeletal symptoms was 65%. Patients diagnosed with musculoskeletal system/connective tissue diseases (OR= 4.11 [2.98 – 5.67]) and people who needed to lift loads at work (OR= 1.45 [1.27 – 1.66]) presented higher likelihood to report the outcome. Moreover, occurrence of musculoskeletal symptoms in shoulders, low back, knees and ankles/feet were positively related to increased prescription drugs used and medical consultations. Conclusion: There is a high occurrence of musculoskeletal symptoms in Brazilian patients, which is affected by sex and occupational activity, and is positively related to increased healthcare expenditures

Low occurrence of musculoskeletal symptoms in swimming? Musculoskeletal symptoms and sports participation in adolescents: cross sectional study (ABCD—Growth study)

The purpose of this paper was to identify the association between the occurrence of musculoskeletal symptoms (MS) and sports participation in adolescents. The sample included 193 adolescents (11 to 17 years of age; 131 boys and 62 girls). For this cross-sectional study, participants were categorized into four groups: “no-sports”, “repetitive non-impact sports”, “high-impact sports”, and “odd-impact sports”. A questionnaire was used, which defined MS as pain or any musculoskeletal complaint that led to restriction of current normal activities. In the entire sample, 112 adolescents reported at least one episode of MS during the recording, representing 58% of the sample. Our findings highlight that adolescents regularly engaged in odd-impact sports, such as martial arts, report a higher occurrence of MS than swimmers and adolescents who do not participate in any physical activity

Inhibition of Spore Germination and Appressorium Formation of Rust Species by Plant and Fungal Metabolites.

Eight fungal and plant metabolites belonging to different classes of naturally occurring compounds, a 24-oxa[14]-cytochalasan as cytochalasin B (1), a trisubstituted isocoumarin as 6-hydroxymellein (2), a tetracyclic pimarane diterpene as sphaeropsidin A (3), a chalcone as cavoxin (4), a pentasubstituted benzofuranone as cyclopaldic acid (5), a bicyclic-sesquiterpene as inuloxin A (6), a epipolythiopiperazine as gliotoxin (7) and a cyclohexene epoxide as epi-epoformin (8), were tested for their effectiveness in reducing early stages of development of several major rust fungi from the genera Puccinia and Uromyces. Spore germination and appressoria formation were assessed on pre-treated detached leaves, under controlled conditions. Among the various metabolites evaluated, compounds 5 and 8 were the most effective in inhibiting fungal germination and penetration of all rust species studied at values comparable with those obtained by fungicide application, while compound 4 was phytotoxic to plant leaves at any concentration tested

Sports practice is related to parasympathetic activity in adolescents

AbstractObjectiveTo analyze the relationship among sports practice, physical education class, habitual physical activity and cardiovascular risk in adolescents.MethodsCross-sectional study with 120 schoolchildren (mean: 11.7±0.7 years old), with no regular use of medicines. Sports practice and physical education classes were assessed through face-to-face interview, while habitual physical activity was assessed by pedometers. Bodyweight, height and height-cephalic trunk were used to estimate maturation. The following variables were measured: body fatness, blood pressure, resting heart rate, blood flow velocity, intima-media thickness (carotid and femoral) and heart rate variability (mean between consecutive heartbeats and statistical index in the time domain that show the autonomic parasympathetic nervous system activity root-mean by the square of differences between adjacent normal R-R intervals in a time interval). Statistical treatment used Spearman correlation adjusted by sex, ethnicity, age, body fatness and maturation.ResultsIndependently of potential confounders, sports practice was positively related to autonomic parasympathetic nervous system activity (β=0.039 [0.01; 0.76]). On the other hand, the relationship between sport practice and mean between consecutive heartbeats (β=0,031 [–0.01; 0.07]) was significantly mediated by biological maturation.ConclusionsSport practice was related to higher heart rate variability at rest

RELAÇÃO ENTRE A PRESENÇA DOS AGENTES COMUNITÁRIOS DE SAÚDE E ADESÃO AO TRATAMENTO DA HIPERTENSÃO ARTERIAL SISTÊMICA

The objective of this study was to compare adherence to the treatment of systemic arterial hypertension among patients attended at a Basic Health Unit and a Family Health Strategy. The study was conducted in the interior of western São Paulo in 2014, with 200 users aged over 50 enrolled in a Family Health Strategy and a Basic Health Unit. Adherence was assessed by the tests of Batalla and Morisky-Green. Statistical analysis was performed using BioStat software. In the Batalla test, adherence in the Family Health Strategy was 31% and in the Basic Health Unit, 40%. In Morisky-Green, it was 64% in the Family Health Strategy and 68% in the Basic Health Unit. We conclude that there was no significant difference in adhesion according to the unit.O objetivo deste estudo foi comparar a adesão ao tratamento da hipertensão arterial sistêmica entre Unidade Básica de Saúde e Estratégia de Saúde da Família. A pesquisa foi realizada no interior do oeste paulista, em 2014, com 200 usuários acima de 50 anos cadastrados em uma Estratégia de Saúde da Família e uma Unidade Básica de Saúde. A adesão foi avaliada pelos testes de Batalla e de Morisky-Green. A análise estatística foi feita no software BioStat. No teste de Batalla, a adesão na Estratégia de Saúde da Família foi de 31% e na Unidade Básica de Saúde, 40%. No de Morisky-Green, ela foi de 64% na Estratégia de Saúde da Família e na Unidade Básica de Saúde, 68%. Concluímos que não houve diferença significativa na adesão segundo a unidade

Combined association of insufficient physical activity and sleep problems with healthcare costs: a longitudinal study

ABSTRACT BACKGROUND: The magnitude of economic losses attributed to sleep problems and insufficient physical activity (PA) remains unclear. This study aimed to investigate the association between insufficient PA, sleep problems, and direct healthcare costs. OBJECTIVE: To investigate the association between insufficient physical activity (PA), sleep problems, and direct healthcare costs among adults. DESIGN AND SETTING: Adults aged ≥ 50 years attended by the Brazilian National Health Service were tracked from 2010 to 2014. METHODS: Direct healthcare costs were assessed using medical records and expressed in US$. Insufficient PA and sleep problems were assessed through face-to-face interviews. Differences were identified using the analysis of covariance and variance for repeated measures. RESULTS: In total, 454 women and 166 men were enrolled. Sleep problems were reported by 28.9$ 4,765.01. CONCLUSION: The combination of sleep problems and insufficient PA plays an important role in increasing direct healthcare costs in adults. Public health stakeholders, policymakers, and health professionals can use these results to reinforce the need for strategies to improve sleep quality and increase PA, especially in nations that finance their National Health Systems

Sedentary behavior, abdominal obesity and healthcare costs in Brazilian adults with cardiovascular diseases: a cross-sectional study

ABSTRACT BACKGROUND: Research on the economic burden of sedentary behavior and abdominal obesity on health expenses associated with cardiovascular diseases is scarce. OBJECTIVE: The objective of this study was to verify whether sedentary behavior, isolated and combined with abdominal obesity, influences the medication expenditure among adults with cardiovascular diseases. DESIGN AND SETTING: This cross-sectional study was conducted in the city of President Prudente, State of São Paulo, Brazil in 2018. METHODS: The study included adults with cardiovascular diseases, aged 30-65 years, who were treated by the Brazilian National Health Services. Sedentary behavior was assessed using a questionnaire. Abdominal obesity was defined by waist circumference. Medication expenditures were verified using the medical records of each patient. RESULTS: The study included a total of 307 adults. Individuals classified in the group with risk factor obesity combined (median [IQ] USD$29.39 [45.77]) or isolated (median [IQ] USD$ 27.17 [59.76]) to sedentary behavior had higher medication expenditures than those belonging to the non-obese with low sedentary behavior group (median [IQ] USD$ 13.51 [31.42]) (P = 0.01). The group with combined obesity and sedentary behavior was 2.4 (95%CI = 1.00; 5.79) times more likely to be hypertensive. CONCLUSION: Abdominal obesity was a determining factor for medication expenses, regardless of sedentary behavior, among adults with cardiovascular diseases

APTIDÃO CARDIORRESPIRATÓRIA E ADIPOSIDADE CORPORAL: 10 MESES DE INTERVENÇÃO COM PRÁTICA DE ATIVIDADES FÍSICAS

O acúmulo de adiposidade, seja total ou central, eleva os fatores de risco de doenças cardiovasculares. Sendo assim, o objetivo do presente estudo foi analisar a relação entre aptidão cardiorrespiratória e adiposidade antes e após 10 meses de prática regular de atividades físicas em mulheres. A amostra foi composta por 59 mulheres atendidas por um plano de saúde privado Após os 10 meses de acompanhamento, o desempenho no TC6M apresentou acréscimo de 5% (p=0,001) e CC (circunferência de cintura) diminuição de 2,2% (p=0,007). Houve relação significativa entre IMC e TC6M no pré (r= -0,31) e no pós (r= -0,45) 10 meses de intervenção, já para a CC houve relação no pós intervenção (r= -0,37). A prática de atividades físicas pode ter proporcionado aumentos no TC6M e diminuição na CC, bem como a relação entre estas variáveis aumentou com a prática de atividades físicas