Síndrome metabólico y factores asociados en niños y adolescentes de un municipio brasileño

Background: the risk factors associated to metabolic syndrome (MS) have been extensively studied in adults, but in children and adolescents it is poorly explored.Objective: To identify the prevalence of MS and associated factors in children and adolescents.Methods: A cross-sectional study with 540 children and adolescents from 7 to 14 years of age. the socioeconomic, demographic and lifestyle data and the family history of chronic diseases were reported by the individual and/or guardian and recorded in a structured questionnaire. Biochemical tests (fasting blood glucose, triacylglycerols, reduced high-density lipoprotein, very-low-density lipoprotein, homocysteine and cysteine), an anthropometric assessment and a blood pressure measurement were performed. MS was defined according to the criteria of the National Cholesterol Education Program Adult Treatment Panel III adapted by Ferranti. A Poisson regression was used to identify the factors statistically associated with MS.Results: the MS prevalence was 12.8%, in which the most frequent component was a decreased high-density lipoprotein level (58.2%), followed by hypertriglyceridemia (41.8%), elevated blood pressure (29.1%), increased waist circumference (26.7%) and hyperglycemia (7.2%). Associations between metabolic syndrome and overweight [prevalence ratio (PR): 2.2 (1.22-3.95)], father education [PR: 2.19 (1.10-4.37)], serum very low-density lipoprotein concentration [PR: 1.08 (1.04-1.11)] and concomitantly increased serum homocysteine and cysteine concentrations [PR: 2.58(1.32-5.04)] were observed.Conclusions: the MS prevalence is high in children and adolescents and it is increased in patients with overweight, higher father education, increased serum very-low-density lipoprotein concentrations and a concomitant serum homocysteine and cysteine high levels.Fundacao de Amparo a Pesquisa do Espirito Santo (FAPESB)Univ Fed Reconcavo Bahia, Ctr Hlth Sci, Santo Antonio de Jesus, BA, BrazilUniv Fed Bahia, Sch Med Bahia, Salvador, BA, BrazilUniv Fed Bahia, Paediat Gastroenterol & Hepatol Unity, Salvador, BA, BrazilUniv Fed Bahia, Sch Nutr, Salvador, BA, BrazilUniversidade Federal de São Paulo, Dept Psychobiol, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Psychobiol, São Paulo, BrazilFundacao de Amparo a Pesquisa do Espirito Santo (FAPESB): 8814/2006Web of Scienc

Aspectos metodológicos e desafios da Coorte On-line Comportamento Alimentar e Saúde Mental (COCASa) de docentes e discentes universitários durante a pandemia da COVID-19

O distanciamento social adotado para controle da COVID-19 obrigou Instituições de Ensino Superior (IES) a aderirem a novas estratégias para realização das atividades acadêmicas e muitas pesquisas passaram a ser realizadas em ambientes virtuais. O objetivo deste artigo é descrever os aspectos metodológicos e principais desafios enfrentados para a execução do projeto COCASa, um estudo de coorte on-line sobre comportamento alimentar e saúde mental de docentes e discentes de IES do Brasil. O estudo foi iniciado em julho de 2020 e acompanhará os participantes por dois anos. Adotou-se amostragem não probabilística estratificada proporcional com a utilização de escalas, de inquérito alimentar e de questões estruturadas elaboradas pela equipe do projeto. Entre os participantes do baseline, 4.074 discentes e 2.210 docentes iniciaram o questionário e, respectivamente, 76,8% e 85,1% finalizaram o preenchimento. Em ambos os grupos, a maior participação foi de mulheres (docentes: 66,7% e discentes: 76,2%) e residentes nas regiões Nordeste (docentes: 37% e discentes: 50,9%) e Sul (docentes: 27,1% e discentes: 22,5%) do Brasil. A pesquisa on-line amplia a possibilidade de recrutamento de participantes e alcança limites territoriais com menor demanda por financiamento. Durante a pandemia da COVID-19, o uso do ambiente virtual tornou-se uma estratégia viável e acessível para a manutenção das atividades de pesquisa, configurando-se como uma provável tendência a ser adotada pela comunidade científica

Congenital Zika Virus Infection Beyond Neonatal Microcephaly

IMPORTANCE Recent studies have reported an increase in the number of fetuses and neonates with microcephaly whose mothers were infected with the Zika virus (ZIKV) during pregnancy. To our knowledge, most reports to date have focused on select aspects of the maternal or fetal infection and fetal effects. OBJECTIVE To describe the prenatal evolution and perinatal outcomes of 11 neonates who had developmental abnormalities and neurological damage associated with ZIKV infection in Brazil. DESIGN, SETTING, AND PARTICIPANTS We observed 11 infants with congenital ZIKV infection from gestation to 6 monthus in the state of Paraba, Brazil. Ten of 11 women included in this study presented with symptoms of ZIKV infection during the first half of pregnancy, and all 11 had laboratory evidence of the infection in several tissues by serology or polymerase chain reaction. Brain damage was confirmed through intrauterine ultrasonography and was complemented by magnetic resonance imaging. Histopathological analysis was performed on the placenta and brain tissue from infants who died. The ZIKV genome was investigated in several tissues and sequenced for further phylogenetic analysis. MAIN OUTCOMES AND MEASURES Description of the major lesions caused by ZIKV congenital infection. RESULTS Of the 11 infants, 7 (63.6%) were female, and the median (SD) maternal age at delivery was 25 (6) years. Three of 11 neonates died, giving a perinatal mortality rate of 27.3%. The median (SD) cephalic perimeter at birth was 31 (3) cm, a value lower than the limit to consider a microcephaly case. In all patients, neurological impairments were identified, including microcephaly, a reduction in cerebral volume, ventriculomegaly, cerebellar hypoplasia, lissencephaly with hydrocephalus, and fetal akinesia deformation sequence (ie, arthrogryposis). Results of limited testing for other causes of microcephaly, such as genetic disorders and viral and bacterial infections, were negative, and the ZIKV genome was found in both maternal and neonatal tissues (eg, amniotic fluid, cord blood, placenta, and brain). Phylogenetic analyses showed an intrahost virus variation with some polymorphisms in envelope genes associated with different tissues. CONCLUSIONS AND RELEVANCE Combined findings from clinical, laboratory, imaging, and pathological examinations provided a more complete picture of the severe damage and developmental abnormalities caused by ZIKV infection than has been previously reported. The term congenital Zika syndrome is preferable to refer to these cases, as microcephaly is just one of the clinical signs of this congenital malformation disorder.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Prefeitura Municipal de Campina GrandeInst Pesquisa Prof Amorim Neto IPESQ, Campina Grande, Paraiba, BrazilInst Saude Elpidio de Almeida, Campina Grande, Paraiba, BrazilFac Ciencias Med Campina Grande, Campina Grande, Paraiba, BrazilHosp Municipal Pedro I, Campina Grande, Paraiba, BrazilUniv Fed Rio de Janeiro, Inst Biol, Dept Genet, Rio De Janeiro, BrazilUniv Fed Campina Grande, Campina Grande, Paraiba, BrazilTel Aviv Univ, Div Ultrasound Obstet & Gynecol, Lis Matern Hosp, Tel Aviv Sourasky Med Ctr,Sackler Fac Med, Tel Aviv, IsraelFundacao Med Fetal Latino Amer, Sao Paulo, BrazilUniv Fed Sao Paulo, Fundacao Inst Pesquisa & Ensino Diagnost Imagem, Sao Paulo, BrazilUniv Fed Rio de Janeiro, Inst Ciencias Biomed, Rio De Janeiro, BrazilInst DOr Pesquisa & Ensino, Rio De Janeiro, BrazilInst Estadual Cerebro Paulo Niemeyer, Lab Neuropatol, Rio De Janeiro, BrazilFundacao Oswaldo Cruz, Inst Oswaldo Cruz, Lab Flavivirus, Rio De Janeiro, BrazilUniv Fed Sao Paulo, Dept Diagnost Imagem, Sao Paulo, BrazilFundação Instituto de Pesquisa e Ensino de Diagnostico por Imagem, Universidade Federal de São Paulo, São Paulo, BrazilDepartamento de Diagnóstico por Imagem, Universidade Federal de São Paulo, São Paulo, BrazilWeb of Scienc