Birth Weight, Current Anthropometric Markers, and High Sensitivity C-Reactive Protein in Brazilian School Children

Studies have shown associations of birth weight with increased concentrations of high sensitivity C-reactive protein. This study assessed the relationship between birth weight, anthropometric and metabolic parameters during childhood, and high sensitivity C-reactive protein. A total of 612 Brazilian school children aged 5–13 years were included in the study. High sensitivity C-reactive protein was measured by particle-enhanced immunonephelometry. Nutritional status was assessed by body mass index, waist circumference, and skinfolds. Total cholesterol and fractions, triglycerides, and glucose were measured by enzymatic methods. Insulin sensitivity was determined by the homeostasis model assessment method. Statistical analysis included chi-square test, General Linear Model, and General Linear Model for Gamma Distribution. Body mass index, waist circumference, and skinfolds were directly associated with birth weight (P<0.001, P=0.001, and P=0.015, resp.). Large for gestational age children showed higher high sensitivity C-reactive protein levels P<0.001 than small for gestational age. High birth weight is associated with higher levels of high sensitivity C-reactive protein, body mass index, waist circumference, and skinfolds. Large for gestational age altered high sensitivity C-reactive protein and promoted additional risk factor for atherosclerosis in these school children, independent of current nutritional status

Medidas de associação: caso controle e transversal

Estudo dirigido composto de aula em slides e exemplos sobre Medidas de associação: Caso controle e transversal

Medidas de associação: avaliação de risco

Estudo dirigido composto de aula em slides com exemplos sobre Medidas de associação - Avaliação de risco

Critical appraisal, evidence-based medicine and scientific divulgation during the pandemic related to COVID-19 in Brazil

O objetivo do presente texto é refletir sobre o papel da divulgação de evidências científicas e da medicina embasada em evidências no contexto da pandemia relacionada à covid-19 no Brasil e a necessidade de repensar o ensino à luz dessas reflexões. Um dos aspectos em que se observou mais discordância nas mensagens públicas foi em relação às medidas não farmacológicas e ao tratamento. A grande disponibilidade de informação democratiza o conhecimento, mas também gera a necessidade de um letramento científico da população em geral e dos profissionais de saúde para uma seleção adequada e avaliação crítica das evidências, já que a multiplicidade de mensagens sobre as formas de lidar com a epidemia possivelmente tenha contribuído para a dificuldade de controle no país.El objetivo de este texto es reflexionar sobre el papel de la divulgación de la evidencia científica y la medicina basada en evidencias en el contexto de la pandemia de COVID-19 en Brasil y la necesidad de replantear la educación a la luz de estas reflexiones. Uno de los aspectos en los que hubo más discordancia en los mensajes públicos fue con relación a las medidas no farmacológicas y al tratamiento. La amplia disponibilidad de información democratiza el conocimiento, pero también genera la necesidad de alfabetización científica de la población en general y de los profesionales de la salud para una adecuada selección y evaluación crítica de la evidencia, ya que la multiplicidad de mensajes sobre formas de hacer frente a la epidemia posiblemente ha contribuido a la dificultad de control en el país.The objective of this text is to reflect on the role of the dissemination of scientific evidence and evidence-based medicine in the context of the COVID-19-related pandemic in Brazil; and the need to rethink our teaching in light of these reflections. One of the aspects in which there was huge disagreement regarding public messages was related to non-pharmacological measures and treatment. The wide availability of information democratizes knowledge, but also generates the need for scientific literacy of the general population and health professionals for an adequate selection and critical appraisal of the evidence, since the multiplicity of messages about ways to deal with the epidemic possibly contributed to the difficulty of control in Brazil

Medidas de associação: tratamento

Estudo dirigido composto de aula em slides com exemplos sobre Medidas de associação – Tratamento

Birth Weight, Current Anthropometric Markers, and High Sensitivity C-Reactive Protein in Brazilian School Children

Studies have shown associations of birth weight with increased concentrations of high sensitivity C-reactive protein. This study assessed the relationship between birth weight, anthropometric and metabolic parameters during childhood, and high sensitivity C-reactive protein. A total of 612 Brazilian school children aged 5-13 years were included in the study. High sensitivity C-reactive protein was measured by particle-enhanced immunonephelometry. Nutritional status was assessed by body mass index, waist circumference, and skinfolds. Total cholesterol and fractions, triglycerides, and glucose were measured by enzymatic methods. Insulin sensitivity was determined by the homeostasis model assessment method. Statistical analysis included chi-square test, General Linear Model, and General Linear Model for Gamma Distribution. Body mass index, waist circumference, and skinfolds were directly associated with birth weight ( &lt; 0.001, = 0.001, and = 0.015, resp.). Large for gestational age children showed higher high sensitivity C-reactive protein levels ( &lt; 0.001) than small for gestational age. High birth weight is associated with higher levels of high sensitivity C-reactive protein, body mass index, waist circumference, and skinfolds. Large for gestational age altered high sensitivity C-reactive protein and promoted additional risk factor for atherosclerosis in these school children, independent of current nutritional status

C-Reactive protein predicts acute myocardial infarction during high-risk noncardiac and vascular surgery

BACKGROUND: High-sensitivity C-reactive protein predicts cardiovascular events in a wide range of clinical contexts. However, the role of high-sensitivity C-reactive protein as a predictive marker for perioperative acute myocardial infarction during noncardiac surgery is not yet clear. The present study investigated high-sensitivity C-reactive protein levels as predictors of acute myocardial infarction risk in patients undergoing high-risk noncardiac surgery. METHODS: This concurrent cohort study included patients aged >50 years referred for high-risk noncardiac surgery according to American Heart Association/ACC 2002 criteria. Patients with infections were excluded. Electrocardiograms were performed, and biomarkers (Troponin I or T) and/or total creatine phosphokinase and the MB fraction (CPK-T/MB) were evaluated on the first and fourth days after surgery. Patients were followed until discharge. Baseline high-sensitivity C-reactive protein levels were compared between patients with and without acute myocardial infarction. RESULTS: A total of 101 patients undergoing noncardiac surgery, including 33 vascular procedures (17 aortic and 16 peripheral artery revascularizations), were studied. Sixty of the patients were men, and their mean age was 66 years. Baseline levels of high-sensitivity C-reactive protein were higher in the group with perioperative acute myocardial infarction than in the group with non-acute myocardial infarction patients (mean 48.02 vs. 4.50, p = 0.005). All five acute myocardial infarction cases occurred in vascular surgery patients with high CRP levels. CONCLUSIONS: Patients undergoing high-risk noncardiac surgery, especially vascular surgery, and presenting elevated baseline high-sensitivity C-reactive protein levels are at increased risk for perioperative acute myocardial infarction

Positive Psychology and Gratitude Interventions: A Randomized Clinical Trial

Objective: The purpose of this study was to assess the effect of a gratitude intervention on a community sample of adults in relation to aspects involving well-being and mental health.Methods: A randomized clinical trial was conducted with 1,337 participants, composed of an intervention group (Gratitude group, n = 446), and two control groups (Hassles group, n = 444 and Neutral Events group, n = 447). Participants assigned to the intervention condition were asked to write daily gratitude lists for 14 days, listing moments they had been grateful for during the day. The outcomes analyzed were affect, depression, happiness and life satisfaction. Participants completed the positive affect and negative affect schedule (PANAS), center for epidemiological studies depression scale (CES-D), subjective happiness scale (SHS), and satisfaction with life scale (SWLS) three times: pre- and post-intervention and at 14 days after the end of the intervention. Due to attrition, the number of participants analyzed was 410.Results: Before the intervention, the groups did not differ in any of the variables examined, and loss to follow-up was random among the three groups. The gratitude intervention managed to increase positive affect, subjective happiness and life satisfaction, and reduce negative affect and depression symptoms. This change was greater than the changes in the control groups in relation to positive affect. In the other outcomes analyzed, similar changes were observed in the gratitude intervention and the neutral events intervention.Conclusion: Some similarities were found between the Gratitude and the Neutral Events groups probably because participants in the last group usually recorded positive events from their days on the lists, turning it into an activity very similar to that proposed to the gratitude group. Some limitations of the study are discussed, such as the high dropout rate for self-performed online interventions. It is necessary to investigate which characteristics of an intervention ensure better results when the intervention is performed online.Trial Registration: The study is registered in the Brazilian Clinical Trials Registry, under No. RBR-9j9myd. Trial URL: http://www.ensaiosclinicos.gov.br/rg/RBR-9j9myd/

Síndrome coronariana aguda em produtores de tabaco: fatores de risco prevalentes

Objectives: to identify the prevalence of risk factors for arterial coronary disease (ACD) in in-patients from tobacco producing region, who suffered from acute coronary syndrome in intensive care units. Methods: a descriptive, cross-sectional, retrospective study evaluated reports from 2006-2007 of adult in-patients in Vale do Rio Pardo hospitals linked to SUS system. Results: we review 152 reports, of these 80 (52%) patients were male, 70 (46%) live in Santa Cruz do Sul, and in other regions. Age average was 62, 1±13.4 years. 62.5% presented instable angina; 76.3% were smokers; 14.4% presented family history of acute myocardial infarct; 45.5% had dyslipidemia, and 68% with three or more associated RF for ACD. Conclusion: smoking, arterial hypertension and dyslipidemia were the most prevalent of risk factors. Knowledge of local culture allows the establishment of preventive measures for the habitantsObjetivos: Identificar la prevalencia de factores de riesgo para enfermedad arterial coronaria en pacientes internados por síndrome coronaria aguda en unidades intensivas en región productora de tabaco. Métodos: Estudio descriptivo, transversal, retrospectivo que evaluó fichas medicas de pacientes adultos internados entre 2006 hasta 2007 en los Hospitales del Vale do Rio Pardo ligado al sistema SUS. Resultados: Revisadas 152 fichas médicas, de estas el 52% de los pacientes eran de sexo masculino, el 46% residentes en Santa Cruz do Sul y otras regiones. La edad fue de 62,1 ± 13,4 años. Angina instable fue observada en el 62,5% de pacientes, el 76,3 % fumadores, el 14,4% presentaban historia familiar de infarto agudo de miocardio y el 45,5% eran dislipidémicos, y el 68% de los pacientes tenían 3 o más factores de riesgo para EAC. Conclusión: Tabaquismo, hipertensión arterial y dislipidemias fueron más frecuentes.Objetivos: identificar a prevalência dos fatores de risco para doença arterial coronariana (DAC) em pacientes internados por síndrome coronariana aguda nas unidades intensivas de região produtora de fumo. Métodos: estudo descritivo, transversal, retrospectivo que avaliou prontuários de pacientes adultos internados entre 2006 e 2007 nos Hospitais do Vale do Rio Pardo vinculados ao sistema SUS. Resultados: revisados 152 prontuários, destes 80 (52%) eram pacientes do sexo masculino, 70 (46%) residentes em Santa Cruz do Sul, e de outras regiões. A idade média foi de 62,1±13,4 anos. Angina instável esteve presente em 62,5%; 76,3% eram tabagistas, 14,4% apresentavam história familiar de infarto agudo do miocárdio; 45,5% eram dislipidemicos e 68% dos pacientes possuíam três ou mais fatores de risco associados para DAC. Conclusão: tabagismo, hipertensão arterial e dislipidemia foram os fatores de risco prevalentes. O conhecimento da cultura local permite estabelecer medidas preventivas mais efetivas e especialmente dirigidas aos habitantes de cada região