Avaliação de risco cardiometabólico e fatores associados em pessoas idosas diabéticas

To evaluate cardiometabolic risk based on visceral fat indices and associated factors in elderly people with diabetes. Cross-sectional study with an analytical approach, carried out in primary health care. Cardiometabolic risk was estimated from two visceral adiposity indices, the product of lipid accumulation and the visceral adiposity index. Associations were made between cardiometabolic risk and sociodemographic, laboratory and lifestyle variables using the Chi-square test or Fisher's exact test and multivariate analysis using the Poisson model adjusted with robust variance. 202 elderly people with diabetes were evaluated, with a mean age of 67.9 ± 6.7 years. Visceral adiposity indices were related to variables compatible with cardiometabolic risk. Female sex, changes in fasting blood glucose, neck circumference, waist-to-hip ratio and total cholesterol were associated with the visceral adiposity index. While in the lipid accumulation product, the association occurred with an increase in the percentage of fat assessed by body mass index, neck circumference, changes in total cholesterol, fasting blood glucose, glycated hemoglobin and a reduction in HDL. Access to studies was the only sociodemographic variable that was related to the product of lipid accumulation in this population. The lack of association between the studied indices and clinical variables, inflammatory parameters or blood pressure levels suggests that their use as a method of assessing and monitoring cardiometabolic risk should be carried out with caution.Avaliar o risco cardiometabólico a partir dos índices de adiposidade visceral e fatores associados em idosos diabéticos. Estudo transversal com abordagem analítica, realizado na atenção primária de saúde do Recife, Nordeste do Brasil. O risco cardiometabólico foi estimado a partir de dois índices de adiposidade visceral, o produto de acumulação lipídica e o índice de adiposidade visceral. Foram realizadas associações entre o risco cardiometabólico e variáveis sociodemográficas, laboratoriais e de estilo de vida por meio do Teste Qui-quadrado de Independência de Pearson ou Teste Exato de Fisher e análise multivariada pelo modelo de Poisson ajustado com variância robusta. Foram avaliados 202 idosos diabéticos com média de idade de 67,9 ± 6,7 anos. Os índices de adiposidade visceral apresentaram relação com variáveis compatíveis ao risco cardiometabólico. Sexo feminino, alterações na glicemia de jejum, circunferência do pescoço, relação cintura-quadril e colesterol total estiveram associadas ao índice de adiposidade visceral. Enquanto no produto de acumulação lipídica, a associação ocorreu com aumento do percentual de gordura avaliado por índice de massa corporal, circunferência do pescoço, alterações no colesterol total, glicemia de jejum, hemoglobina glicada e com a redução do HDL. O acesso aos estudos foi a única variável sociodemográfica que esteve relacionada ao produto de acumulação lipídica neste público. A ausência de associação dos índices estudados com variáveis clínicas, parâmetros inflamatórios ou com níveis pressóricos, sugere que seu uso como método de avaliação e acompanhamento do risco cardiometabólico seja realizado com cautela

Catálogo Taxonômico da Fauna do Brasil: setting the baseline knowledge on the animal diversity in Brazil

The limited temporal completeness and taxonomic accuracy of species lists, made available in a traditional manner in scientific publications, has always represented a problem. These lists are invariably limited to a few taxonomic groups and do not represent up-to-date knowledge of all species and classifications. In this context, the Brazilian megadiverse fauna is no exception, and the Catálogo Taxonômico da Fauna do Brasil (CTFB) (http://fauna.jbrj.gov.br/), made public in 2015, represents a database on biodiversity anchored on a list of valid and expertly recognized scientific names of animals in Brazil. The CTFB is updated in near real time by a team of more than 800 specialists. By January 1, 2024, the CTFB compiled 133,691 nominal species, with 125,138 that were considered valid. Most of the valid species were arthropods (82.3%, with more than 102,000 species) and chordates (7.69%, with over 11,000 species). These taxa were followed by a cluster composed of Mollusca (3,567 species), Platyhelminthes (2,292 species), Annelida (1,833 species), and Nematoda (1,447 species). All remaining groups had less than 1,000 species reported in Brazil, with Cnidaria (831 species), Porifera (628 species), Rotifera (606 species), and Bryozoa (520 species) representing those with more than 500 species. Analysis of the CTFB database can facilitate and direct efforts towards the discovery of new species in Brazil, but it is also fundamental in providing the best available list of valid nominal species to users, including those in science, health, conservation efforts, and any initiative involving animals. The importance of the CTFB is evidenced by the elevated number of citations in the scientific literature in diverse areas of biology, law, anthropology, education, forensic science, and veterinary science, among others

Aids information among elderly people attending the health family program in Brazil

OBJECTIVE: To asses information level and preventive attitudes toward Aids, as well as the risk perception regarding the disease among elderly people attending the Health Family Program. METHOD: Descriptive cross-sectional study. The sample was composed by 60 individuals, aged 60 years or older attending, and assisted by the Family Health Public Program (PSF) through September 2005 and residents in Ibura, Recife, PE. For data collection a semi-structured questionnaire was applied using the interview technique, with 14 questions, being 5 open questions and 9 closed ones. RESULTS: Most investigated seniors reported some knowledege on Aids and how to protect themselves against the disease; however 100% of the interviewed reported not using any preventive strategy; 83% of the interviewed reported to be aware that an aged person can be contaminated with Aids and 80% of elderly knowed that and apparently healthy individual might be contaminated with the HIV virus. Regarding risk perception, 60% of respondents believed that they were not at risk to be infected by HIV virus and 48% head already been tested for HIV virus. CONCLUSION: The results from this study highligth the need for educational policies towards Aids prevention among elderly people.</p

Factors associated with the practice of physical activity in older diabetic primary care patients

OBJECTIVE: To evaluate the scientific knowledge produced in relation to the factors associated to the practice of physical activity of older diabetic primary care patients in Brazil. METHODS: It involved an on-line research including original articles published between October 2008 and September 2018 in Portuguese, English, and Spanish, from the databases: Medline, Lilacsand Scopus. The keywords used were elderly, diabetes mellitus, exercise, and primary health care. The methodological quality of the articles was evaluated by means of two instruments: Critical Appraisal Skills Programme and Hierarchy of Evidence for Intervention Studies. After analysis, four articles were included. RESULTS: No articles were found with samples consisting only of older people, and only one of them made an exclusive analysis for this age group. There is a need for studies addressing the older diabetic individuals, due to the specificities of this population. None of the articles made use of instruments for physical activity evaluation. CONCLUSION: The practice of physical activity was associated to an improvement in quality of life, self-care, and adherence to treatment for diabetes mellitus, highlighting the importance of professional counseling. Factors such as frequency and type of physical activity were not verified in the studies, which highlights the need for the use of instruments for this evaluation.</p

Frequency of Cardiovascular Involvement in Familial Amyloidotic Polyneuropathy in Brazilian Patients

Background:Familial amyloidotic polyneuropathy (FAP) is a rare disease diagnosed in Brazil and worldwide. The frequency of cardiovascular involvement in Brazilian FAP patients is unknown.Objective:Detect the frequency of cardiovascular involvement and correlate the cardiovascular findings with the modified polyneuropathy disability (PND) score.Methods:In a national reference center, 51 patients were evaluated with clinical examination, electrocardiography (ECG), echocardiography (ECHO), and 24-hour Holter. Patients were classified according to the modified PND score and divided into groups: PND 0, PND I, PND II, and PND > II (which included PND IIIa, IIIb, and IV). We chose the classification tree as the statistical method to analyze the association between findings in cardiac tests with the neurological classification (PND).Results:ECG abnormalities were present in almost 2/3 of the FAP patients, whereas ECHO abnormalities occurred in around 1/3 of them. All patients with abnormal ECHO also had abnormal ECG, but the opposite did not apply. The classification tree identified ECG and ECHO as relevant variables (p < 0.001 and p = 0.08, respectively). The probability of a patient to be allocated to the PND 0 group when having a normal ECG was over 80%. When both ECG and ECHO were abnormal, this probability was null.Conclusions:Brazilian patients with FAP have frequent ECG abnormalities. ECG is an appropriate test to discriminate asymptomatic carriers of the mutation from those who develop the disease, whereas ECHO contributes to this discrimination

Processed and ultra-processed foods are associated with high prevalence of inadequate selenium intake and low prevalence of vitamin B1 and zinc inadequacy in adolescents from public schools in an urban area of northeastern Brazil.

Changes in eating behavior of adolescents are associated with high consumption of processed and ultra-processed foods. This study evaluated the association between these foods and the prevalence of inadequate micronutrient intake in adolescents. A cross-sectional study was conducted with 444 adolescents from public schools in the city of Natal, northeastern Brazil. The adolescents' habitual food consumption was evaluated using two 24-hour dietary recalls. Foods were categorized according to the degree of processing (processed and ultra-processed) and distributed into energy quartiles, using the NOVA classification system. Inadequacies in micronutrient intake were assessed using the estimated average requirement (EAR) as the cutoff point. Multivariate logistic regression models were used to estimate the relationship between energy percentage from processed and ultra-processed foods and prevalence of inadequate micronutrient intake. The mean (Standard Deviation (SD)) consumption of total energy from processed foods ranged from 5.8% (1.7%) in Q1 to 20.6% (2.9%) in Q4, while the mean consumption of total energy from ultra-processed foods ranged from 21.4% (4.9%) in Q1 to 61.5% (11.7%) in Q4. The rates of inadequate intake of vitamin D, vitamin E, folate, calcium, and selenium were above 80% for both sexes across all age groups. Energy consumption from processed foods was associated with higher prevalence of inadequate selenium intake (p < 0.01) and lower prevalence of inadequate vitamin B1 intake (p = 0.04). Energy consumption from ultra-processed foods was associated with lower prevalence of inadequate zinc and vitamin B1 intake (p < 0.01 and p = 0.03, respectively). An increase in the proportion of energy obtained from processed and ultra-processed foods may reflect higher prevalence of inadequate selenium intake and lower prevalence of vitamin B1 and zinc inadequacy

Lack of Association between Inadequate Micronutrient Intake and Prognosis in Outpatients with Heart Failure

Inadequate nutrient intake can lead to worse outcomes in patients with heart failure (HF). This prospective cohort study aimed to assess the prevalence of inadequate micronutrient intake and their association with prognosis in 121 adult and elderly outpatients with HF. Habitual micronutrient intake was evaluated using 24-h dietary recalls (minimum 2 and maximum 6). Participants were grouped into moderate (n = 67) and high (n = 54) micronutrient deficiency groups, according to the individual assessment of each micronutrient intake. Patients’ sociodemographic, clinical, and anthropometric data and clinical outcomes (hospitalization and mortality) within 24 months were collected. Overall and event-free survival rates were calculated using Kaplan–Meier estimates, and curves were compared using the log-rank test. The death risk rate (hazard ratio (HR)) was calculated using Cox’s univariate model. The rate of inadequate intake was 100% for vitamins B1 and D and above 80% for vitamins B2, B9, and E, calcium, magnesium, and copper. No differences in overall survival and event-free survival were observed between groups of HF outpatients with moderate and high micronutrient deficiencies (HR = 0.94 (CI = 0.36–2.48), p = 0.91, and HR = 1.63 (CI = 0.68–3.92), p = 0.26, respectively), as well as when the inadequacy of each micronutrient intake was evaluated alone (all p > 0.05). In conclusion, a high prevalence of inadequate micronutrient intake was observed in outpatients with HF. Inadequate micronutrient intake was not associated with hospitalization and mortality in this group of patients

Parque do Flamengo: projetar a cidade, desenhando patrimônio

Cet article examine le processus qui conduit au classement, en 1965, du parc de Flamengo (Rio de Janeiro) par l’Institut du patrimoine historique et artistique national (Iphan). Ce jardin était né d’un projet de l’architecte Affonso Eduardo Reidy et du paysagiste Roberto Burle Marx, tous deux liés à l’« école carioca » d’architecture moderne. L’analyse des politiques de protection des biensarchitecturaux et paysagers modernes promues par l’Iphan permet d’établir des connexions entre le chemin qui a mené à cette décision et la constitution du champ architectural au Brésil àl’époque des grandes rénovations urbaines mises en œuvre à Rio par Carlos Lacerda, premier gouverneur de l’État de Guanabara, puis dans le contexte politique national tendu du coup d’État et de l’instauration d’un régime autoritaire au Brésil. Cet article aborde en outre les valeurs patrimoniales et sociales convoquées pour défendre la préservation du parc de Flamengo alors que se préparent les grands événements sportifs du début du XXIe siècle et la demanded’inscription de la ville au patrimoine mondial de l’Unesco dans la catégorie « paysage culturel ». Cette réflexion sur le patrimoine et la mise en perspective du conflit traditionnel entre préservation culturelle et spéculation immobilière permettra d’approfondir la thématique du droit à la ville. La documentation empirique privilégiée dans cette recherche a été la procédure d’inscription au patrimoine national du parc de Flamengo et les procès-verbaux des réunions du conseil consultatif de l’Iphan.Trata-se de uma narrativa sobre o processo de patrimonialização do Parque do Flamengo, no Rio de Janeiro, tombado em 1965 pelo Instituto do Patrimônio Histórico e Artístico Nacional - Iphan. O Parque foi projetado pelo arquiteto Affonso Eduardo Reidy e o paisagista Roberto Burle Marx, ligados à “escola carioca” de arquitetura moderna. O artigo estabelece conexões entre esse processo e a constituição do campo arquitetônico no Brasil, abordando as políticas de proteção de bens arquitetônicos e paisagísticos modernos promovidas pelo Iphan. Essas análises estão situadas no bojo do intenso processo de reformas urbanas implementadas na cidade do Rio de Janeiro, no governo de Carlos Lacerda, primeiro governador do estado da Guanabara, no conturbado contexto político nacional de golpe militar e instalação do regime autoritário no Brasil. O artigo explora ainda os valores de patrimônio acionados na preservação do Parque do Flamengo no contexto em que o Rio de Janeiro torna-se palco de grandes eventos esportivos e recebe o título da Unesco de Patrimônio Mundial na categoria de Paisagem Cultural, ao passo que a agenda contemporânea do campo do patrimônio coloca na ordem do dia o debate sobre a sua função social. Espera-se contribuir com reflexões sobre patrimônio na chave do direito à cidade, problematizando o tradicional confronto entre preservação cultural e especulação imobiliária. O material empírico privilegiado foi o processo de tombamento do Parque do Flamengo e as atas do Conselho Consultivo do Iphan relacionadas ao assunto.The article proposes a narrative about the process of heritagization of Parque do Flamengo (Flamengo Park), in Rio de Janeiro, in 1965, by Brazilian National Institute for Heritage (Iphan). The Park was designed by the architect Affonso Eduardo Reidy and the landscape architect Roberto Burle Marx, both linked to the group of Modernist Carioca School. The article makes connections between this process and the constitution of the field of architecture in Brazil, especially the policies aimed at the protection of modern architectural and landscape assets promoted by Iphan. The context is the midst of intense urban reforms in the city of Rio de Janeiro under the government of Carlos Lacerda, first governor of the state of Guanabara, in the troubled national political context of a military coup and the establishment of the authoritarian regime in Brazil. It also explores the ways for preservation of Parque do Flamengo when Rio de Janeiro hosted major sporting events and received the Unesco title of World Heritage Cultural Landscape, while the contemporary agenda of the field is the debate on the social function of heritage. It is hoped to contribute with reflections on heritage in the key of the rights to the city, problematizing the traditional confrontation between preservation and the real estate speculation. The privileged empirical material was the process of registration of Parque do Flamengo as Brazilian Cultural Heritage and the Reports of the Consultative Council of Cultural Heritage Meetings that Parque do Flamengo was under debate