Comparison of glycemic and lipid profiles indicators among obese children and adolescents treated at public or private services from the city of Ribeirão Preto (SP)

Design: Observational cross-sectional. Objectives: To compare the lipid and glycemic profiles of obese children and adolescents, followed at a public or a private health service. Methods: A cross-sectional study involving 113 obese patients, aged 7 to 18 years, conducted at two clinics, one public (n = 51) and the other private ( n = 62). Anthropometric data and blood samples were collected and glucose, insulin, HOMA and lipid profile have been compared between groups. Results: regarding averages, it was observed differences only for HDL, with lower values for public service. The prevalence of indicators outside the normal range, has always been above 45%, with the exception of hyperglycemia witch was rare. Only the prevalence of individuals with low HDL was different between groups, being lower at the private service. Conclusions: there was almost no hyperglycemia, but the prevalence of dyslipidemia and insulin resistance were high in both services. HDL was the only indicator that showed differences between the two groups and, considering that it is the most sensitive to the quality of nutrition and physical activity, it may be suggested that at the public health and on the individual management, these aspects should be better managed in lower income populationsModelo: Observacional transversal. Objetivo: comparar os perfis lipídico e glicêmico de crianças e adolescentes obesos atendidos em serviços de saúde público e privado. Metodologia: estudo transversal, envolvendo 113 indivíduos obesos com idades entre 7 e 18 anos, conduzido em dois ambulatórios, um público (n=51) e outro privado (n=62). Foram colhidos dados antropométricos e amostras de sangue, tendo-se comparado, entre os grupos, glicemia, insulinemia, HOMA e lipidograma. Resultados: em relação às médias, apenas para o HDL houve diferença, sendo os valores inferiores para o serviço público. Quanto à prevalência de indicadores fora da faixa de normalidade, esteve sempre acima de 45%, com exceção da hiperglicemia que se mostrou rara. Apenas a prevalência de indivíduos com HDL baixo foi diferente entre os grupos, sendo inferior para o serviço privado. Conclusões: Não se observou hiperglicemia, mas as prevalências de dislipidemia e resistência insulínica foram elevadas em ambos os serviços. O HDL foi o único indicador que se mostrou diferente entre os dois grupos e, considerando-se que ele é o mais sensível à qualidade da alimentação e à atividades física, pode-se sugerir que, tanto do ponto de vista de saúde pública como individual, esses aspectos devam ser melhor cuidados nas populações de menor rend

Motivation for Brazilian Older Adult Women to Join a Community Physical Activity Program Before COVID-19 Pandemic

Background: Intrinsic and extrinsic motivational factors can affect the levels of adherence of physical activity (PA) during the aging process. Objectives: Investigate the intrinsic and extrinsic aspects and motivation that led older women to enroll in and adhere to a community PA program before the COVID-19 pandemic. Methods: Data were collected via transversal survey before the COVID-19 pandemic. The sample consisted of 21 women, participants of a PA workshop, aged between 60 to 86 years [< 1-year (n = 8) and ≥ 1-year (n = 13) groups]. Motivation was assessed by the Motivation Inventory for Regular Physical Activity Practice (IMPRAF-54), using the 60th percentile to categorize high and low motivation, and two open questions. For qualitative assessment, content analysis was used and the answers were framed into subcategories regarding the motivation factors for adherence and permanence. Results: That adherence to the program was motivated by sociability purposes [total score: 36.0 (6.0), median (interquartile range)] and pleasure [34.0; (6.0)], while the main motivation for permanence was health [40.0 (11.0)]. Differences were noticed between the groups for sociability [38.0 (3.0) P = 0.030] and competitiveness [9.50 (12.0); P = 0.037] highest medians for the < 1 year group. Furthermore, the factors that least motivated older women were competitiveness and aesthetics. Conclusions: Health and sociability were the main motivators for the practice of physical activity among older adult women. Motivation played a fundamental role in the permanence of older adult women in the physical activity program

Hipertensão arterial e óbito em pacientes oncológicos na Covid-19

Introdução: Pacientes com câncer e hipertensão tendem a apresentar pior evolução clínica no contexto da COVID-19.Objetivo: Caracterizar pacientes oncológicos durante a pandemia da COVID-19 e associar a prevalência da hipertensão arterial severa nesta clientela com o desfecho óbito. Método: Coorte retrospectiva, que analisou dados de pacientes com câncer e diagnóstico de COVID-19 em um serviço de referência em oncologia no Rio de Janeiro. O recorte temporal foi entre 11 de março de 2020 e 11 de março de 2021, os quais foram utilizados para análise, totalizando uma amostra de 100 prontuários. As informações foram lançadas em planilha de Excel e analisadas por meio de estatística descritiva. O estudo foi aprovado pelos Comitês de Ética em Pesquisa das instituições envolvidas, pareceres nº: 4.486.636 e 4.509.083. Resultados: Prevaleceram pacientes com idade média de 58,2 anos, gênero feminino (60,6%), raça branca (62%), com o status de performance entre 0 e 1 (42%) na avaliação inicial. O tempo médio de internação foi de 16,9 dias chegando até a 74 dias de internação. O tratamento mais aplicado foi a Quimioterapia (69, %) seguido da cirurgia (46%) e radioterapia com 36%. Observou-se que a HAS foi a comorbidade mais prevalente (49%), seguida da obesidade e DM, ambas com 16%. Doenças cardiovasculares corresponderam a 27% dos pacientes, as quais incluíram insuficiência cardíaca, arritmias, doença arterial coronariana e dislipidemias. A taxa de óbito neste grupo foi de 44% e, dos pacientes hipertensos, 45,83% foi a óbito. Embora seja uma taxa alta, observa-se que este resultado não mostrou associação significativa para o desfecho. Conclusão: O estudo revelou um perfil de paciente suscetível ao agravamento da COVID-19 na clientela estudada, considerando a presença de HAS e doença oncológica concomitantemente. Este resultado norteia o enfermeiro no planejamento do cuidado para complexidade deste paciente. Sugere-se estudos que identifiquem a presença ou não do quadro de agravamento da COVID-19 na clientela estudada e sua associação com o óbitoinfo:eu-repo/semantics/publishedVersio

Evaluation of Depression, Anxiety and Sleep Quality in the Brazilian Population During Social Isolation Due to the New Coronavirus (SARS-CoV-2) pandemic: the DEGAS-CoV Study/ Avaliação da Depressão, Ansiedade e Qualidade do Sono na População Brasileira Durante o Isolamento Social Devido à Nova Pandemia do Coronavírus (SARS-CoV-2): o Estudo DEGAS-CoV

Introduction: The new coronavirus infection (COVID-19) has caused distress and repercussions in mental and physical health of individuals. Depression, anxiety and worsening of sleep quality have been reported in several recent articles that surveyed populations all over the globe. Our work meant to access, through a cross-sectional study, these disorders in the Brazilian population, through the application of an online questionnaire conducted on the second trimester of 2020. Materials and Methods: We applied an online questionnaire, filled with questions regarding social, economic, financial, educational and health status, as well as questions from the Hospital Anxiety and Depression Scale (HAD), and from the Pittsburgh Sleep Quality Index (PSQI).Results: We collected 2,695 valid answers, from April 24th to May 31st, 2020. Age ranged from 18 to 79 years, mean of 31.3. Women were 76.3%, men 23.7%. Symptoms of Anxiety were found in 56.5%, of depression in 46.1%, and of bad sleep in 49.2%. Some groups were more prone than others to one or more of those conditions, such as: younger people, women, mestizos, people with lesser years of education, of lower income or whose income dropped significantly during the pandemic, caregivers, students, sedentary or people practicing less physical activity, people who followed more hours of news of COVID-19 and those less engaged in social and instrumental activities.Conclusion: anxiety, depression and bad sleep quality were significantly high in our survey. Mental and sleep health is heterogeneously affected among individuals, depending on social, economic, financial, educational and health status

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality