"O meu coração bate saudável" - Results from a pilot project for health education in Portuguese children

INTRODUCTION AND OBJECTIVES: Childhood offers an excellent window of opportunity to start interventions to promote behavioral changes before unhealthy lifestyles become established, leading to cardiovascular diseases. The goal of this pilot educational project for children is healthy lifestyle and cardiovascular health promotion. METHODS: This project was implemented in 4th grade children and included teacher-led classroom activities, a lesson given by a Cardiologist and a practical lesson with dietitians. The teacher received a manual containing information on the topics to be discussed in class with the students and the children received a book that addresses cardiovascular risk factors and prevention. The components included were Diet (D), Physical Activity (PA) and Human Body and Heart Awareness (BH). At the beginning and at the end of the school-year, a questionnaire was applied to the children to assess Knowledge (K), Attitudes (A) and Habits (H) on this topics. RESULTS: A total of 73 children from an urban public school in Lisbon, in a low to medium-income area, participated in the project. With the intervention, there was a 9.5% increase in the overall KAH score, mainly driven by the PA component (14.5%) followed by the BH component (12.3%). No improvement was observed for D component. The benefits were also more significant in children from a lower income area, suggesting that socioeconomic status is a determinant in the response obtained. CONCLUSIONS: An educational project for cardiovascular health can be implemented successfully in children aged 9 years, but longer and larger studies are necessary.publishersversionepub_ahead_of_prin

A position paper of the Portuguese Society of Cardiology

Copyright © 2023 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.Global warming is a result of the increased emission of greenhouse gases. This climate change consequence threatens society, biodiversity, food and resource availability. The consequences in health involve the increased risk of cardiovascular (CV) disease and cardiovascular mortality. In this position paper we summarize the data from the main studies that assessed the risks of temperature increase or heat waves in CV events (CV mortality, myocardial infarction, heart failure, stroke, and CV hospitalizations), as well as the data concerning air pollution as an enhancer of temperature-related CV risks. The data currently supports that global warming/heat waves (extreme temperatures) are cardiovascular threats. Achieving the neutrality in the emissions to prevent global warming is essential and it is likely to have an effect in the global health, including the cardiovascular health. Simultaneously, urgent step is required to adapt the society and individual to this new climate context potentially harmful for the cardiovascular health. Multidisciplinary teams should plan and intervene in heat-related healthcare and advocate for environmental health policy change.proofepub_ahead_of_prin

Hipertensão arterial secundária a tumor raro da glândula adrenal

O ganglioneuroma é um tumor do sistema nervoso simpático, podendo estar associado à hipersecreção de substâncias vasoativas responsáveis por sintomas e sinais variados, como a hipertensão arterial. Os autores apresentam um caso de ganglioneuroma e uma revisão da literatura, focando os aspectos mais importantes do diagnóstico e da terapêutica. A paciente apresentava crises hipertensivas sintomáticas recorrentes, tendo realizado estudo imaginológico que detectou uma imagem nodular na adrenal direita. Sendo os tumores neuroblásticos indistinguíveis radiologicamente, procedeu-se à excisão, confirmando-se o diagnóstico pela análise anatomopatológica. Este caso demonstra a variabilidade clínica dos ganglioneuromas, a utilidade da imaginologia e a importância do estudo histológico

Exercise-induced cardiac remodeling in athletes and in special forces

Introdução: A remodelagem cardíaca induzida pelo exercício físico é frequente em atletas. Esta adaptac¸ão manifesta-se a nível estrutural com o aumento das dimensões e massa cardíacas. Os militares também são sujeitos a exercício físico intenso, com especificidades distintas. Objetivo: Comparar a remodelagem cardíaca induzida pelo exercício físico em atletas de competic¸ão e pelo treino militar em militares a frequentar um curso de forc¸as especiais. Metodologia: Estudámos 17 militares (género masculino e caucasianos, idade média 21 ± 3 anos) que ingressaram no curso de Comandos e 17 basquetebolistas (47,3% do género masculino, 64,7% caucasianos, idade média 21 ± 3 anos). A avaliac¸ão incluiu um ecocardiograma transtorácico com análise da mecânica miocárdica. Esta avaliac¸ão foi realizada no início e no final do curso militar e da época desportiva, respetivamente. Resultados: A remodelagem cardíaca teve características distintas: os militares apresentaram um padrão predominantemente excêntrico, com aumento das dimensões do ventrículo esquerdo (49,7 ± 3,2 versus 52,8 ± 3,4 mm; p < 0,01) e da massa (93,1 ± 7,7 versus 100,2 ± 11,4 g/m2; p < 0,01) e diminuic¸ão da espessura relativa das paredes (0,40 ± 0,1 versus 0,36 ± 0,1; p = 0,05); os basquetebolistas apresentaram um padrão concêntrico, com diminuic¸ão das dimensões do ventrículo esquerdo (52,0 ± 4,7 versus 50,4 ± 4,7 mm; p = 0,05) e da espessura relativa das paredes (0,33 ± 0,1 versus 0,36 ± 0,1; p = 0,05). Apesar da deformac¸ão miocárdica global do ventrículo esquerdo não apresentar diferenc¸as significativas entre os grupos, quando analisados em conjunto o seu valor diminuiu (-20,2 ± 1,6% versus -19,4 ± 2,1%; p = 0,03). Conclusão: A remodelagem cardíaca foi frequente, com padrão excêntrico nos militares e con-cêntrico nos atletas. A mecânica miocárdica poderá representar uma adaptac¸ão fisiológicainduzida pelo exercício físico.soldiersAbstractIntroduction: Exercise-induced cardiac remodeling is frequent in athletes. This adaptation isstructurally manifested by an increase in cardiac dimensions and mass. Soldiers are also subjectto intense physical exercise, although with different characteristics.Objective: To compare exercise-induced cardiac remodeling in competitive athletes and insoldiers on a special forces training course.Methods: We studied 17 soldiers (all male and Caucasian, mean age 21 ± 3 years) who comple-ted a special forces course and 17 basketball players (47.3% male, 64.7% Caucasian, mean age21 ± 3 years). Assessment included a transthoracic echocardiogram and analysis of myocardialmechanics. This assessment was performed at the beginning and end of the military course andthe sports season, respectively.Results: Cardiac remodeling was observed in both groups. The soldiers presented a predomi-nantly eccentric pattern, with increased left ventricular (LV) size (49.7 ± 3.2 vs. 52.8 ± 3.4 mm;p < 0.01), increased LV mass (93.1 ± 7.7 vs. 100.2 ± 11.4 g/m2; p < 0.01) and decreased relativewall thickness (0.40 ± 0.1 vs. 0.36 ± 0.1; p = 0.05). The basketball players showed a concentricpattern, with decreased LV size (52.0 ± 4.7 vs. 50.4 ± 4.7 mm; p = 0.05), and increased relativewall thickness (0.33 ± 0.1 vs. 0.36 ± 0.1; p = 0.05). Although there was no significant differencein LV myocardial strain in the groups separately, when compared there was a significant decrease(-20.2 ± 1.6% vs. -19.4 ± 2.1%; p = 0.03).Conclusion: Cardiac remodeling was frequent, with an eccentric pattern in soldiers and a con-centric pattern in basketball players. Myocardial deformation may represent a physiologicaladaptation to physical exercise