Nutritional Status Of Schoolchildren Aged 7-10 Years Enrolled In Public And Private Schools Of Cascavel, Paraná, Brazil

Analisar a prevalência de desnutrição, sobrepeso e obesidade em escolares de sete a 10 anos em estudantes de escolas públicas e privadas de Cascavel, Paraná, Brasil. Informações demográficas (sexo, idade e rede de ensino) e medidas antropométricas (massa corporal e estatura) foram obtidas de 2.180 escolares (1.693 de escolas públicas e 487 de privadas). Os valores do Escore-Z do índice de massa corporal foram adotados para a determinação do estado nutricional. As taxas de prevalência de desnutrição, sobrepeso e obesidade foram na ordem de 6,1%, 9,8% e 11,1%, respectivamente. As meninas apresentaram mais chances (15,9 vezes) para o desenvolvimento de desnutrição do que os meninos. Por outro lado, crianças de 10 anos apresentaram mais chances (1,53 vezes) para desenvolverem sobrepeso em relação aos seus pares de sete anos. Adicionalmente, crianças de escolas privadas apresentaram mais chances para o desenvolvimento de sobrepeso (1,63 vezes) ou obesidade (2,88 vezes), em relação aos seus respectivos pares de escolas públicas. As taxas de prevalência de desnutrição e excesso de peso reveladas neste estudo foram elevadas, com as meninas apresentando mais chances para tornarem-se desnutridas do que os meninos. Em contrapartida, tanto o sobrepeso quanto a obesidade foram fenômenos mais frequentemente observados aos 10 anos, em escolares de ambos os sexos e naqueles matriculados na rede privada de ensino.29569970

Combined exercise circuit session acutely attenuates stress-induced blood pressure reactivity in healthy adults

Objective: To investigate the blood pressure (BP) responses to cardiovascular stress test after a combined exercise circuit session at moderate intensity. Method: Twenty individuals (10 male/10 fem; 33.4± 6.9 years; 70.2± 15.8 kg; 170.4± 11.5 cm; 22.3± 6.8% body fat) were randomized in a different days to control session with no exercise or exercise session consisting of 3 laps of the following circuit: knee extension, bench press, knee flexion, rowing in the prone position, squats, shoulder press, and 5 min of aerobic exercise at 75-85% of age-predicted maximum heart rate and/or 13 on the Borg Rating of Perceived Exertion [scale of 6 to 20]. The sets of resistance exercise consisted of 15 repetitions at ~50% of the estimated 1 repetition maximum test. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured at rest and during 1h of recovery in both experimental sessions. After that, blood pressure reactivity (BPR) was evaluated using the Cold Pressor Test. Results: During 1h of exercise recovery, there was a reduction in SBP (3-6 mmHg) and DBP (2-5 mmHg) in relation to pre-session rest (p<0.01), while this reduction was not observed in the control session. A decline in BPR (4-7 mmHg; p<0.01) was observed 1h post-exercise session, but not in the control session. Post-exercise reductions in SBP and DBP were significantly correlated with BPR reductions (r=0.50-0.45; p<0.05). Conclusion: A combined exercise circuit session at moderate intensity promoted subsequent post-exercise hypotension and acutely attenuated BPR in response to a cardiovascular stress test. In addition, the post-exercise BP reduction was correlated with BPR attenuation in healthy adults of both genders

Estado nutricional de escolares de sete a 10 anos de escolas públicas e privadas de Cascavel, Paraná, Brasil

To analyze the prevalence of malnutrition, overweight, and obesity in schoolchildren aged 7-10 years from public and private schools of Cascavel, Paraná, Brazil. Methods: Demographic information (sex, age, and type of school) and anthropometric measurements (body mass and height) were collected from 2,180 students (1,693 from public schools and 487 from private schools). The nutritional status of the children was classified according to their body mass index Z-score. Results: The prevalences of malnutrition, overweight, and obesity were 6.1%, 9.8% and 11.1%, respectively. Girls were 15.9% more likely to be malnourished than boys. As for overweight, 10-year-olds were 1.53 times more likely to be overweight than 7-year-olds. Children from private schools were 1.63 times more likely to be overweight and 2.88 times more likely to be obese than their public school peers. Conclusion: The prevalence of malnutrition and excess weight (overweight and obesity) were high, and girls were more likely to be malnourished. Ten-year-olds and children from private schools were the most affected by overweight and obesity295699708CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQFUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DO AMAZONAS - FAPEAMSem informaçãoSem informaçãoAnalisar a prevalência de desnutrição, sobrepeso e obesidade em escolares de sete a 10 anos em estudantes de escolas públicas e privadas de Cascavel, Paraná, Brasil. Métodos: Informações demográficas (sexo, idade e rede de ensino) e medidas antropométricas (massa corporal e estatura) foram obtidas de 2.180 escolares (1.693 de escolas públicas e 487 de privadas). Os valores do Escore-Z do índice de massa corporal foram adotados para a determinação do estado nutricional. Resultados: As taxas de prevalência de desnutrição, sobrepeso e obesidade foram na ordem de 6,1%, 9,8% e 11,1%, respectivamente. As meninas apresentaram mais chances (15,9 vezes) para o desenvolvimento de desnutrição do que os meninos. Por outro lado, crianças de 10 anos apresentaram mais chances (1,53 vezes) para desenvolverem sobrepeso em relação aos seus pares de sete anos. Adicionalmente, crianças de escolas privadas apresentaram mais chances para o desenvolvimento de sobrepeso (1,63 vezes) ou obesidade (2,88 vezes), em relação aos seus respectivos pares de escolas públicas. Conclusão: As taxas de prevalência de desnutrição e excesso de peso reveladas neste estudo foram elevadas, com as meninas apresentando mais chances para tornarem-se desnutridas do que os meninos. Em contrapartida, tanto o sobrepeso quanto a obesidade foram fenômenos mais frequentemente observados aos 10 anos, em escolares de ambos os sexos e naqueles matriculados na rede privada de ensin

CONVIVENDO COM UMA ESTOMIA INTESTINAL: IMPACTO NO ESTILO DE VIDA, ACEITAÇÃO DA DOENÇA E CUIDADOS

Descrever a percepção do indivíduo estomizado quanto à vivência com a estomia intestinal. Pesquisa qualitativa, realizado em um ambulatório de estomias intestinais, a coleta de dados ocorreu de janeiro a fevereiro de 2022. Foram convidados pacientes com estomas intestinais de eliminação provisória ou definitiva. Foi elaborado um roteiro semiestruturado com perguntas amplas que possibilitaram explorar a percepção do indivíduo estomizado quanto à vivência com a estomiaintestinalParticiparam 14 (100%) indivíduos com estomia intestinal. A análise dos dados possibilitou a identificação de três núcleos temáticos: Impactos da Estomização no Estilo de Vida; Aceitação da Doença e Cuidados com a Ostomização. Conclui-se que esse estudo permitiu conhecer a percepção das pessoas estomizadas e necessidade de uma formação que transcenda o aspecto biológico e valorize as habilidades socioafetivas e as relações terapêuticas entre profissionais da saúde e a pessoa em adoecimento.&nbsp

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure &lt;= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants.

BACKGROUND: Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. METHODS: We used data from 1990 to 2019 on people aged 30-79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. FINDINGS: The number of people aged 30-79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306-359) million women and 317 (292-344) million men in 1990 to 626 (584-668) million women and 652 (604-698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55-62) of women and 49% (46-52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43-51) of women and 38% (35-41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20-27) for women and 18% (16-21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. INTERPRETATION: Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings. FUNDING: WHO