Alimentação, exercício físicio e doença cardiovascular em adolescentes. Conclusões.

Eventos clínicos cardiovasculares decorrentes de Doença Cardiovascular (DCV) estão entre as principais causas de morbilidade e mortalidade nos países industrializados As origens patofisiológicas das lesões responsá- veis, as lesões ateroscleróticas, podem datar de décadas previamente aos eventos clínicos, ou seja, durante a infância e adolescência. A maioria destes eventos clínicos cardiovasculares são determinados por factores de risco sobejamente conhecidos e que incluem necessariamente desequilíbrios dietéticos e sedentarismo. Estes factores de risco podem até já não estar presentes na vida adulta, mas condicionarão sempre a saúde cardiovascular, pelo que é de primordial importância zelar pela saúde do indivíduo desde a sua infância e adolescência A . Estratégias de adopção de estilos de vida saudáveis, focados em alimentação saudável e exercício, têm vindo a demonstrar eficácia na prevenção das DCV B . Neste sentido, o Grupo de Estudos de Risco Cardiovascular em conjunto com o Núcleo de Nutrição em Cardiologia da Sociedade Portuguesa de Cardiologia promoveram, no âmbito da Segunda Reunião Conjunta, um workshop subordinado ao tema “Alimentação, actividade física e DCV em adolescentes”. Desta reunião de trabalho foram retiradas algumas conclusões que serão relatadas de forma objectiva, para que possam servir de recomendações práticas para todos os profissionais de saúde que intervém com adolescentes e suas família

Tumefacção Parotídea Bilateral com Crepitações Subcutâneas

ABSTRACT The presence of air within the parotid gland is called pneumoparotid. This is a rare cause of parotid swelling and is associated to many precipitant factors. A seven -year -old boy was seen at the Emergency Department due to a sudden bilateral parotid swelling. The physical examination revealed a crepitus in the parotid glands. Radiography and ultrasonography suggested the presence of air. This acute episode was self -limited with complete resolution within forty -eight hours. Clinical history revealed that the child had been fi lling up balloons before the symptoms began. An early diagnosis avoids recurrent attacks and is based on the identifi cation of air within the parotid gland associated with the existence of precipitant factors

Portuguese Prevalence of Pediatric Chronic Intestinal Failure

info:eu-repo/semantics/publishedVersio

Alimentação e nutrição do lactente

Os autores apresentam os resultados de uma ampla revisão bibliográfica do conhecimento e práticas relativas à alimentação e nutrição do lactente, tendo por base a evidência científica existente e as recomendações dos principais comités de nutrição pediátrica.É sublinhada a importância do aleitamento materno, se possível de modo exclusivo durante os primeiros 6 meses de vida e é referida a evolução da maturação fisiológica e das preferências alimentares associadas à diversificação alimentar.São apresentados os principais dados relativos ao teor dos alimentos em nutrientes, à idade de início da diversifica-ção e ao modo de progressão da alimentação ao longo do primeiro ano de vida. São feitas considerações específicas em relação a grupos especiais de nutrientes, como é o caso dos micronutrientes, bem como no tocante a componentes com interesse para a saúde da criança, cada vez mais usados na alimentação do lactente, como é o caso dos pré e probióticos.As potenciais repercussões para a saúde da alimentação são também referidas, em particular no tocante à prevenção de alergias, risco cardiovascular e doença celíaca. Finalmente são abordados alguns dos aspectos mais relevantes para a alimentação e saúde do lactente ligados a dietas especiais nomeadamente vegetarianas e macrobióticas

Comparison between CDC and WHO BMI z-score and their relation with metabolic risk markers in Northern Portuguese obese adolescents

Growth-curves are an important tool for evaluating the anthropometric development in pediatrics. The different growth-curves available are based in different populations, what leads to different cut-offs. Pediatric obesity tracks into adulthood and is associated with increased cardiovascular risk. The accurate assessment of a child nutritional status using growth-curves can indicate individuals that are either obese or in risk of becoming obese, allowing an early intervention. Moreover, the association between the data obtained from growth-curves with specific metabolic risk factors further highlights the importance of these charts. This study aimed to evaluate the associations between body mass index z-score (BMIzsc), determined using the growth-curves from the Centre for Disease Control and Prevention (CDC) and from the World Health Organization (WHO), with cardiovascular risk factors, represented here by metabolic syndrome (MS) and insulin resistance (IR) related parameters. The study involved 246 obese adolescents (10-18 years, 122 females). MS was defined according to the International Diabetes Federation. IR was considered for HOMA-IR greater than 2.5

Bilirubin is independently associated with oxidized LDL levels in young obese patients

BACKGROUND: Bilirubin can prevent lipid oxidation in vitro, but the association in vivo with oxidized low-density lipoprotein (Ox-LDL) levels has been poorly explored. Our aim is to the association of Ox-LDL with total bilirubin (TB) levels and with variables related with metabolic syndrome and inflammation, in young obese individuals. FINDINGS: 125 obese patients (13.4 years; 53.6% females) were studied. TB, lipid profile including Ox-LDL, markers of glucose metabolism, and levels of C-reactive protein (CRP) and adiponectin were determined. Anthropometric data was also collected. In all patients, Ox-LDL correlated positively with BMI, total cholesterol, LDLc, triglycerides (TG), CRP, glucose, insulin and HOMAIR; while inversely with TB and HDLc/Total cholesterol ratio (P < 0.05 for all). In multiple linear regression analysis, LDLc, TG, HDLc and TB levels were significantly associated with Ox-LDL (standardized Beta: 0.656, 0.293, -0.283, -0.164, respectively; P < 0.01 for all). After removing TG and HDLc from the analysis, HOMAIR was included in the regression model. In this new model, LDLc remained the best predictor of Ox-LDL levels (β = 0.665, P < 0.001), followed by TB (β = -0.202, P = 0.002) and HOMAIR (β = 0.163, P = 0.010). CONCLUSIONS: Lower bilirubin levels may contribute to increased LDL oxidation in obese children and adolescents, predisposing to increased cardiovascular risk

Body fat percentage is a major determinant of total bilirubin independently of UGT1A1*28 polymorphism in young obese

OBJECTIVES: Bilirubin has potential antioxidant and anti-inflammatory properties. The UGT1A1*28 polymorphism (TA repeats in the promoter region) is a major determinant of bilirubin levels and recent evidence suggests that raised adiposity may also be a contributing factor. We aimed to study the interaction between UGT1A1 polymorphism, hematological and anthropometric variables with total bilirubin levels in young individuals. METHODS: 350 obese (mean age of 11.6 years; 52% females) and 79 controls (mean age of 10.5 years; 59% females) were included. Total bilirubin and C-reactive protein (CRP) plasma levels, hemogram, anthropometric data and UGT1A1 polymorphism were determined. In a subgroup of 74 obese and 40 controls body composition was analyzed by dual-energy X-ray absorptiometry. RESULTS: The UGT1A1 genotype frequencies were 49.9%, 42.7% and 7.5% for 6/6, 6/7 and 7/7 genotypes, respectively. Patients with 7/7 genotype presented the highest total bilirubin levels, followed by 6/7 and 6/6 genotypes. Compared to controls, obese patients presented higher erythrocyte count, hematocrit, hemoglobin and CRP levels, but no differences in bilirubin or in UGT1A1 genotype distribution. Body fat percentage was inversely correlated with bilirubin in obese patients but not in controls. This inverse association was observed either in 6/7 or 6/6 genotype obese patients. UGT1A1 polymorphism and body fat percentage were the main factors affecting bilirubin levels within obese patients (linear regression analysis). CONCLUSION: In obese children and adolescents, body fat composition and UGT1A1 polymorphism are independent determinants of total bilirubin levels. Obese individuals with 6/6 UGT1A1 genotype and higher body fat mass may benefit from a closer clinical follow-up.This work was funded by FEDER funds through the Operational Competitiveness Programme – COMPETE and by National Funds through FCT – Fundação para a Ciência e a Tecnologia under the project FCOMP-01-0124-FEDER-028613 (PTDC/DTP-DES/0393/2012). A PhD grant was attributed to H. Nascimento by FCT (SFRH/BD/48060/2008). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

Morphologic Changes and Clinical Consequences of Wide AAA Necks Treated with 34-36mm Proximal Diameter Evar Devices

Introdução: O tratamento endovascular representa o método de eleição para o tratamento de Aneurismas da Aorta Abdominal (AAA). Existem endopróteses disponíveis com diâmetros do colo proximal até 36mm, que permitem o tratamento de colos proximais até 32 mm. Contudo, a existência de colos largos representa um conhecido preditor de complicações. O objetivo deste estudo é avaliar os resultados a médio-prazo de doentes que requereram endopróteses de 34-36mm. Métodos: Foi realizada uma análise retrospetiva de uma base de dados prospetiva, incluindo todos os pacientes submetidos a EVAR por AAA degenerativo numa instituição terciária na Holanda. Todas as medições foram realizadas em reconstruções center-lumen line em software dedicado. Os pacientes foram classificados como “diâmetro largo” (LD), se a endoprótese implantada tivesse diâmetro superior a 32 mm.. Os restantes pacientes foram classificados como diâmetro normal (ND). O endpoint primário foi complicações relacionadas com o colo (combinação de endoleak tipo IA, migração>5mm ou qualquer intervenção no colo proximal). Alterações morfológicas no colo e sobrevida foram também analisadas. Diferenças entre grupos foram ajustadas por regressão multivariável. Resultados: O estudo incluiu 502 pacientes (90 no grupo LD e 412 no grupo ND). O follow-up mediano foi de 3.5 anos IQR (1.5–6.2) e 4.5 anos IQR (2.1–7.3) para os grupos LD e ND, respetivamente, P=.008. Relativamente às características basais, os doentes no grupo LD, apresentavam maior incidência de hipertensão arterial (83% vs 69.7%, P=.012) e tabagismo (86% vs 84.1%, P=.018). Além de colos mais largos (colo Proximal Ø > 28 mm: 75% vs 3.3%, P45º: 21% vs 9%, P=.002), cónicos (39.8% vs 20.3%, P25%: 42% vs 32.3%, P5 mm ocorreu similarmente entre grupos (7.8% vs 5.1%, P=.32). Reintervenções relacionadas com colo o foram também mais frequentes no grupo LD (13.3% vs 8.7%, P=.027).info:eu-repo/semantics/publishedVersio

Occurrence of polycyclic aromatic hydrocarbons, microplastics and biofilms in Alqueva surface water at touristic spots

Freshwater pollution is a huge concern. A study aiming to evaluate physico chemical characteristics, microbiota, occurrence of two groups of persistent environmental pollutants with similar chemical properties polycyclic aromatic hydrocarbons PAHs and microplastics MPs in Alqueva s surface water was performed during 2021. Water samples were collected at three spots related to touristic activities two beaches and one marina during the Winter, Spring, Summer and Autumn seasons. In addition, the presence of biofilms on plastic and natural materials stone, wood vegetal materials were assessed and compared. Water quality based on physicochemical parameters was acceptable with a low eutrophication level. PAHs concentration levels were lower than the standard limits established for surface waters by international organizations. However, carcinogenic compounds were detected in two sampling locations, which can pose a problem for aquatic ecosystems. PAHs profiles showed significant differences when comparing the dry seasons with the rainy seasons, with a higher number of different compounds detected in Spring. Low molecular weigh compounds, usually associated with the atmospheric deposition and petroleum contamination, were more prevalent. MPs were detected in all samples except one during the Winter season. The polymers detected were poly methyl 2 methylpropenoate , polystyrene, polyethylene terephthalate, polyamide, polypropylene, styrene butadiene, polyvinyl chloride and low high density polyethylene with the last being the most frequent. Biofilms were more often detected on plastics than on natural materials. In addition, biofilms detected on plastics were more complex with higher microbial diversity e.g., bacteria, fungi yeast and phytoplancton organisms and richer in extrapolymeric material. Based on morphological analysis a good agreement between microbiota and microorganism present in the biofilms was found. Among microbiota were identified microorganisms previously linked to plastic and PAHs detoxification suggesting the need for further studies to evaluate the viability of using biofilms as part of a green bioremediation strategy to mitigate water pollutio