Body fat percentage prediction in older adults: Agreement between anthropometric equations and DXA

BACKGROUND: It is difficult to measure body fat percentage in clinical settings. Equations using anthropometric measures are more feasible and can be used to estimate body fat. However, there is a need to analyze their accuracy in older adults. Our study aims to validate the use of anthropometric equations to estimate body fat percentage in older men and women. METHODS: This study evaluated data from 127 Brazilian individuals aged between 60 and 91 years. Weight, height, skinfold thickness and waist and hip circumferences were measured. Seventeen anthropometric equations were tested using the crossed validity criteria suggested by Lohman and the graph analysis proposed by Bland and Altman and by Lin was also performed. The gold-standard method for comparing the anthropometric equations was the dual-energy absorptiometry X-ray (DXA). RESULTS: The average body fat percentage was 30.2 ± 8.6% in men and 43.4 ± 7.9% in women (p < 0.001). In men, the equations which used skinfold thickness presented amplitude of 11.48%, while in women, amplitude's constant error (CE) was 22.88%. The equations based on circumferences and BMI presented CE variation from -5.3% to 29.68% on the estimation of body fat percentage, which means that a same male individual can have the total body adiposity diagnosed with 34.98% of variation, depending on the selection of the employed equation. For women this CE variation was 12.44%. CONCLUSION: Overall, all the equations yielded different results from the DXA. However, the best equations for male were the one of Lean et al. (1996), which uses the waist circumference, and for women the one of Deurenberg et al. (1991), developed from the body mass index. The need of developing specific equations for older adults still remains, since even the two best equations showed considerable limitations on predicating body fat percentage

Ultrasound Detects Subclinical Joint Inflammation in the Hands and Wrists of Patients With Systemic Lupus Erythematosus Without Musculoskeletal Symptoms

OBJECTIVES: To assess the prevalence and severity of ultrasonographic abnormalities of the hand and wrist of asymptomatic patients with systemic lupus erythematosus (SLE) and compare these findings with those from patients with SLE with musculoskeletal signs or symptoms and healthy controls. METHODS: We conducted a prospective cross-sectional study that evaluated bilaterally, with grey-scale and power Doppler (PD) ultrasound (US), the dorsal hand (2nd to 5th metacarpophalangeal and 2nd to 5th proximal interphalangeal joints) and wrist (radiocarpal, ulnocarpal and intercarpal joints) of 30 asymptomatic patients with SLE, 6 symptomatic patients with SLE and 10 controls. Synovial hypertrophy (SH) and intra-articular PD signal were scored using semiquantitative grading scales (0-3). Individual scores were graded as normal (SH≤1 and PD=0) or abnormal (SH≥2 or PD≥1). Global indexes for SH and PD were also calculated. US findings were correlated with clinical and laboratory data and disease activity indexes. RESULTS: US detected SH (score ≥1) in 77% asymptomatic patients with SLE, mostly graded as minimal (score 1: 63%). 23% of the asymptomatic patients with SLE showed abnormal US PD findings (SH≥2 or PD≥1). SH was present in all symptomatic patients with SLE, mostly graded as moderate (grade 2: 67%), and with associated PD signal (83%). SH (score 1) was identified in 50% of controls, however, none presented abnormal US PD findings. SH index in the asymptomatic SLE group was higher than in the control group (2.0 (0-5) vs 0.5 (0-2), median (range), p=0.01) and lower than in the symptomatic SLE group (7.0 (4-23), median (range), p<0.001). No significant correlation was demonstrated between US PD findings and clinical or laboratory variables and disease activity indexes. CONCLUSION: A small subgroup of asymptomatic patients with SLE may present subclinical joint inflammation. Global US scores and PD signal may be important in disease evaluation and therapeutic monitoring.info:eu-repo/semantics/publishedVersio

Análise do ruído e intervenção fonoaudiológica em ambiente escolar: rede privada e pública de ensino regular

Objetivo : mensurar os níveis de ruído, durante o ano letivo, em duas salas de aula do 1º ano do Ensino Fundamental, sendo uma da rede privada de ensino e outra da rede pública, frequentadas por alunos deficientes auditivos usuários de implante coclear; analisar se os níveis de ruídos encontrados estão de acordo com a Norma Brasileira, NBR 10.152 da ABNT (1990), e discutir com a equipe escolar estratégias que minimizem o impacto do ruído, na aprendizagem dos alunos deficientes auditivos.Métodos : foram realizadas oito mensurações do nível de ruído, empregando um dosímetro, modelo 1444, em cada sala de aula, sendo uma sala da rede privada e outra da rede pública de ensino. Concomitantemente às mensurações de ruído, foram feitas reuniões com os professores e gestores.Resultados : verificou-se que os níveis de ruído presente na rede pública variaram entre 74,3 e 79 dB (A) e que, na rede privada, os níveis de ruído variaram entre 76,1 e 80,9 dB (A). Também foram realizadas 8 reuniões em cada escola.Conclusão : diante dos dados, notaram-se elevados índices de ruído em ambiente escolar, não ocorrendo diferenças estatísticas entre as redes pública e privada de ensino regular. Com relação às reuniões mensais, foi possível observar que os educadores adotaram estratégias que auxiliam a comunicação no ambiente escolar. É evidente a necessidade da aquisição de recurso tecnológico de acessibilidade para alunos deficientes auditivos que utilizam a comunicação oral, o sistema de frequência modulada

The metabolic microenvironment of melanomas: prognostic value of MCT1 and MCT4

BRAF mutations are known drivers of melanoma development and, recently, were also described as players in the Warburg effect, while this reprogramming of energy metabolism has been identified as a possible strategy for treating melanoma patients. Therefore, the aim of this work was to evaluate the expression and prognostic value of a panel of glycolytic metabolism-related proteins in a series of melanomas. The immunohistochemical expression of MCT1, MCT4, GLUT1, and CAIX was evaluated in 356 patients presenting melanoma and 20 patients presenting benign nevi. Samples included 20 benign nevi, 282 primary melanomas, 117 lymph node and 54 distant metastases samples. BRAF mutation was observed in 29/92 (31.5%) melanoma patients and 17/20 (85%) benign nevi samples. NRAS mutation was observed in 4/36 (11.1%) melanoma patients and 1/19 (5.3%) benign nevi samples. MCT4 and GLUT1 expression was significantly increased in metastatic samples, and MCT1, MCT4 and GLUT1 were significantly associated with poor prognostic variables. Importantly, MCT1 and MCT4 were associated with shorter overall survival. In conclusion, the present study brings new insights on metabolic aspects of melanoma, paving the way for the development of new-targeted therapies.This work was supported by FAPESP grant to VLV (2012/04194-1) and CP (2015/25351-6). VMG received a doctoral fellowship (SFRH/BD/51997/2012) from Fundacao para a Ciencia e a Tecnologia (FCT) and ON. 2 SR&TD Integrated Program (NORTE-07-0124-FEDER-000017) co-funded by Programa Operacional Regional do Norte (ON.2- O Novo Norte), Quadro de Referencia Estrategico Nacional (QREN), through Fundo Europeu de Desenvolvimento Regional (FEDER).info:eu-repo/semantics/publishedVersio

Determinants of the organization of diabetes mellitus care in user satisfaction

The objective of the study was analyze user satisfaction determinants of patients with Diabetes Mellitus (DM) regarding the outpatient clinic specialties at the Health Centre of the School. Qualitative cross-sectional study was carried out in outpatient specialty with 20 users with diagnosis of DM. We adopted the method of semi-structured interview using a scripting guide. We used Atlas it software 7.0 to aid in the decoding of speech, and analyzed it by content analysis. The empirical material encoded enabled to observe that the most evident themes are related to organizational accessibility and the relationship between user and service staff in perspective of longitudinality. It was observed the outpatient identifying clinic specialties as a regular source of care and dissatisfaction with regard to service accessibility.O objetivo do estudo foi analisar os determinantes da satisfação do usuário com Diabetes Mellitus (DM) sobre o atendimento no ambulatório de especialidades de um Centro de Saúde Escola. O estudo transversal com abordagem qualitativa foi desenvolvido no ambulatório de especialidades com 20 usuários com diagnóstico de DM. Foram aplicadas entrevistas semiestruturadas por meio de um roteiro norteador. Utilizou-se software Atlas ti 7.0 para auxílio na codificação das falas e técnica de Análise de Conteúdo para análise dos dados. Como resultado, observou-se que os temas mais evidenciados estão relacionados à acessibilidade organizacional e à relação entre usuário, equipe e serviço na perspectiva da longitudinalidade. Observou-se a identificação do ambulatório de especialidade como fonte regular de cuidado e a insatisfação no que se refere à acessibilidade ao serviço.