Hábitos alimentares e risco de doenças cardiovasculares em universitários

Modelo de estudo: Pesquisa descritiva, observacional, transversal. Objetivo: Descrever qualitativamente a frequência de ingestão de determinados alimentos, considerados de risco e de proteção para doenças cardiovasculares (DCV), além de determinar o Escore de Risco de Framingham (ERF) em indivíduos supostamente saudáveis, estudantes de graduação de uma universidade pública brasileira. Metodologia: Participaram 97 estudantes, 45 homens e 52 mulheres, na faixa etária de 18 a 25 anos. Após assinatura do Termo de Consentimento Livre e Esclarecido (TCLE), aprovado pelo Comitê de Ética em Pesquisa, os estudantes preencheram um questionário com os dados da pesquisa. Foram estudados alimentos classificados como de risco e de proteção, conforme sua composição química avaliada por tabelas de alimentos. O teste Qui-quadrado fui utilizado quando as frequências esperadas foram iguais ou superiores a 5. Para os demais parâmetros foi utilizado o teste exato de Fischer. Resultados: Entre os alimentos protetores destacou-se a ingestão diária de legumes (33%), verduras (22%) e frutas (17%) e entre os de risco estão a ingestão diária de café/chás com açúcar (39%), maionese/ margarina/manteiga (34%) e doces (14%). Houve variação de consumo conforme o sexo, para as frequências de 0,1, 2 e 4 vezes por semana para os alimentos: farinha de milho/mandioca, biscoito maisena/caseiro/água e sal, aveia, frango com pele. Houve variação significativa de consumo diário entre os sexos para os alimentos: frutas, doces, maionese/margarina/manteiga, biscoito maisena/caseiro/ água e sal. Conclusões: Este estudo demonstrou que os estudantes universitários apresentaram uma maior frequência diária de ingestão de alimentos considerados de proteção para DCV do que alimentos de risco. Em adição, o ERF calculado demonstrou baixo risco de desenvolvimento de DCV nos indivíduos avaliados.Study Design: Descriptive, observational, cross-sectional. Aims: The aims of this study were to qualitatively describe the frequency of eating certain foods, as risk and protective for cardiovascular disease (CVD), and determine the Framingham Risk Score (FRS) in supposedly healthy individuals, graduate students from a Brazilian public university. Methodology: Participants were 97 students, 45 males and 52 females, 18-25 years. After signing the consent form, approved by the Ethics Committee on Research, students completed a questionnaire survey data. We studied food classified as risk and protection, as assessed by its chemical composition tables. The Chi-square test was used when the expected frequencies greater than or equal to 5. For other parameters we used the Fisher exact test. Results: Among the foods considered protective stood out the daily intake of vegetables (33%), greens (22%) and fruit (17%). Among the foods considered at risk are the daily intake of coffee / tea with sugar (39%), mayonnaise / margarine / butter (34%) and sweets (14%). There was variation in consumption according to sex, for the frequencies of 0, 1, 2 and 4 times a week for food: corn flour / cassava, cornstarch cookie /homemade cookie / water and salt cookie, oats, chicken with skin. There was significant variation in daily consumption between the sexes for food: fruit, sweets, mayonnaise / margarine / butter, cornstarch cookie / homemade cookie / water and salt cookie. Conclusion: This study showed that college students presented higher frequency of daily intake of foods considered protective for CVD than risk food. In addition, the calculated FRS demonstrated low risk of developing CVD in studied individuals

Variations in management of A3 and A4 cervical spine fractures as designated by the AO Spine Subaxial Injury Classification System

OBJECTIVE Optimal management of A3 and A4 cervical spine fractures, as defined by the AO Spine Subaxial Injury Classification System, remains controversial. The objectives of this study were to determine whether significant management variations exist with respect to 1) fracture location across the upper, middle, and lower subaxial cervical spine and 2) geographic region, experience, or specialty. METHODS A survey was internationally distributed to 272 AO Spine members across six geographic regions (North America, South America, Europe, Africa, Asia, and the Middle East). Participants’ management of A3 and A4 subaxial cervical fractures across cervical regions was assessed in four clinical scenarios. Key characteristics considered in the vignettes included degree of neurological deficit, pain severity, cervical spine stability, presence of comorbidities, and fitness for surgery. Respondents were also directly asked about their preferences for operative management and misalignment acceptance across the subaxial cervical spine. RESULTS In total, 155 (57.0%) participants completed the survey. Pooled analysis demonstrated that surgeons were more likely to offer operative intervention for both A3 (p < 0.001) and A4 (p < 0.001) fractures located at the cervicothoracic junction compared with fractures at the upper or middle subaxial cervical regions. There were no significant variations in management for junctional incomplete (p = 0.116) or complete (p = 0.342) burst fractures between geographic regions. Surgeons with more than 10 years of experience were more likely to operatively manage A3 (p < 0.001) and A4 (p < 0.001) fractures than their younger counterparts. Neurosurgeons were more likely to offer surgical stabilization of A3 (p < 0.001) and A4 (p < 0.001) fractures than their orthopedic colleagues. Clinicians from both specialties agreed regarding their preference for fixation of lower junctional A3 (p = 0.866) and A4 (p = 0.368) fractures. Overall, surgical fixation was recommended more often for A4 than A3 fractures in all four scenarios (p < 0.001). CONCLUSIONS The subaxial cervical spine should not be considered a single unified entity. Both A3 and A4 fracture subtypes were more likely to be surgically managed at the cervicothoracic junction than the upper or middle subaxial cervical regions. The authors also determined that treatment strategies for A3 and A4 subaxial cervical spine fractures varied significantly, with the latter demonstrating a greater likelihood of operative management. These findings should be reflected in future subaxial cervical spine trauma algorithms. © 2022 The authors

Global Asthma Network survey suggests more national asthma strategies could reduce burden of asthma

Background Several countries or regions within countries have an effective national asthma strategy resulting in a reduction of the large burden of asthma to individuals and society. There has been no systematic appraisal of the extent of national asthma strategies in the world. Methods The Global Asthma Network (GAN) undertook an email survey of 276 Principal Investigators of GAN centres in 120 countries, in 2013–2014. One of the questions was: “Has a national asthma strategy been developed in your country for the next five years? For children? For adults?”. Results Investigators in 112 (93.3%) countries answered this question. Of these, 26 (23.2%) reported having a national asthma strategy for children and 24 (21.4%) for adults; 22 (19.6%) countries had a strategy for both children and adults; 28 (25%) had a strategy for at least one age group. In countries with a high prevalence of current wheeze, strategies were significantly more common than in low prevalence countries (11/13 (85%) and 7/31 (22.6%) respectively, p &lt; 0.001). Interpretation In 25% countries a national asthma strategy was reported. A large reduction in the global burden of asthma could be potentially achieved if more countries had an effective asthma strategy. © 2017 SEICA