Hypovitaminosis D is associated with visceral adiposity, high levels of low-density lipoprotein and triglycerides in alternating shift workers.

Background: Studies suggest that there is a strong association between low vitamin D levels and cardiovascular disease (CVD) and its risk factors (RFs). Hypovitaminosis D (25(OH)D < 30 ng/mL or 75 nmol/L) is a recent public health problem that has reached different populations. The objective of the study was to investigate whether hypovitaminosis D is an additional mechanism to explain the disturbances in the lipid profile as well as the excess of abdominal fat presented by alternating shift workers of a mining company in the region of Inconfidentes, Minas Gerais, Brazil. Methods: A cross-sectional study was conducted in a sample of 391 adult males, aged 20 - 57 years old and working alternating shifts, who had at least one risk criterion for CVD. Demographic, behavioral, clinical, and anthropometric and body composition variables were obtained. A blood sample was drawn for determining 25(OH) D, parathyroid hormone intact molecule, lipid profile, blood glucose, insulin, C-reactive protein, and adipokines. Results: The average age of the 391 study participants was 36.1 ? 7.3 years. The percentage of hypovitaminosis D and dyslipidemia was 73% and 74.2%, respectively. Excess visceral fat was significant in the hypovitaminosis D group, with an odds ratio (OR) of 2.4 (95% confidence interval (CI): 1.1 - 5.2). Dyslipidemia showed 25(OH)D levels significantly lower (OR: 2.7, 95% CI: 1.6 - 4.3) than in individuals with normal levels of cholesterol and fractions, and triglycerides. After adjusted the analysis by age and seasonality, the vitamin levels had a significant inverse association and dose-dependent with lowdensity lipoprotein (OR: 5.9), triglycerides (OR: 2.3) and visceral fat area (OR: 2.4). Conclusion: Hypovitaminosis D and dyslipidemia were found in the majority of our mining company shift workers. Furthermore, excess visceral adiposity, hypertriglyceridemia and high low-density lipoprotein cholesterol levels are strong predictors of hypovitaminosis D

Ability of body mass index to predict abnormal waist circumference : receiving operating characteristics analysis.

Body mass index (BMI) and waist circumference (WC) are the most used anthropometric measures to identify obesity. While BMI is considered to be a simple and accurate estimate of general adiposity, WC is an alternative surrogate measure of visceral obesity. However, WC is subject to significant inter-examiner variation. The aim of the present study was to correlate BMI and WC measures in a group of Brazilian adults to determine the most accurate BMI values for predicting abnormal WC

Indicadores de adiposidade como m?todo de rastreamento para polissonografia em trabalhadores de turno.

Objective: to verify the discriminatory power of adiposity indicators in the prediction of obstructive sleep apnoea (OSA) in shift workers. Methods: a crosssectional study carried out in an iron ore extraction company, in Minas Gerais, Brazil. Anthropometric data were collected and polysomnography (PSG) was performed in 118 male shift workers who owned at least one overall risk factor for cardiovascular disease. Results: the OSA prevalence in the sample was 84.7%. Among the adiposity indicators used to predict OSA (? 5 events/hour), body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), and total body fat (TBF) showed sensitivity values higher than 70%. Visceral fat (VF), neck circumference (NC), and neck-to-height ratio (NHtR) were the most effective in correctly identifying workers without OSA (specificity values higher than 70%). The areas under the receiver operating characteristic (ROC) curves for WC and NHtR were greater than 0.7, which indicated the test was effective in discriminating individuals with OSA. Conclusions: alterations in abdomen and neck adiposity indicators have a significant relationship with the presence of OSA and showed effectiveness as a screening method for PSG. WC and NHtR are considered good indicators for OSA prediction.Objetivo: verificar o potencial discriminat?rio dos indicadores de adiposidade na predi??o da apneia obstrutiva do sono (AOS) em trabalhadores de turnos. M?todos: estudo transversal realizado em uma empresa de extra??o de min?rio de ferro, em Minas Gerais, Brasil. Dados antropom?tricos foram coletados e polissonografia (PSG) foi realizada em 118 trabalhadores de turno do sexo masculino que possu?am ao menos um fator de risco global para doen?a cardiovascular. Resultados: a preval?ncia de AOS na amostra foi de 84,7%. Entre os indicadores de adiposidade usados para predizerem a AOS (? 5 eventos/ hora), o ?ndice de massa corporal (IMC), a circunfer?ncia da cintura (CC), a rela??o cintura/estatura (RCE) e a gordura corporal total (GCT), revelaram valores de sensibilidade acima de 70%. Gordura visceral (GV), circunfer?ncia do pesco?o (CP) e rela??o pesco?o-estatura (RPE) foram as mais efetivas em identificar corretamente trabalhadores sem AOS (valores de especificidade acima de 70%). As ?reas sob a curva de Caracter?stica de Opera??o do Receptor (COR) para CC e RPE foram maiores que 0,7, o que indicou que o teste foi eficaz na discrimina??o de indiv?duos com AOS. Conclus?es: altera??es nos indicadores de adiposidade abdominal e cervical t?m rela??o significativa com a presen?a de AOS e demostraram efic?cia como m?todo de rastreamento para PSG. CC e RPE s?o considerados bons indicadores para predizerem a AOS

Um novo m?todo para aloca??o de unidade em subamostras representativas baseado em covari?veis discretas.

Em estudos experimentais nos quais se deseja verificar a efic?cia de alguma interven??o, ? usual a presen?a de grupos que sofrer?o ou n?o estas interven??es para que compara??es a respeito de fatores relacionados a estas interven??es possam ser medidos. Para garantir que tais compara??es sejam v?lidas, ? necess?rias que os grupos apresentem caracter?sticas o mais semelhantes poss?vel entre si, definidas no in?cio do estudo. Este trabalho apresenta uma nova metodologia de divis?o, dado um conjunto de dados inicial, em k subamostras representativas em rela??o aos dados iniciais, com base em covari?veis que definem as caracter?sticas desta. Os resultados obtidos constatam que a metodologia de aleatoriza??o proposta apresenta resultados satisfat?rios, principalmente se comparados com a t?cnica tradicional de amostragem aleat?ria simples. As subamostras delineadas pelo m?todo apresentam um alto grau de similaridade com a amostra original, o que possibilitar? aos estudos experimentais deste trabalho uma redu??o no vi?s de sele??o, proporcionando resultados mais satisfat?rios.In experimental studies, like clinic trials, where one wants to verify the eficacy of some intervention, the presence of different groups that will suffer the or not the interventions, so one can make future comparisons. To waranty that the comparisons will be valid, it?s necessary that the groups shows the most similar characteristics among them and the original sample. This study brings a new methodology of division of an original sample in k representative sub-samples about the original sample, based in the covariates that defines the original sample characteristics. The results demonstrate that the proposed methodology shows very satisfatory results, mainly if compared to the traditional method, the random sampling. The sub-samples defined by the new method shows a high similarity with the original sample, which will made possible experimental studies with low selection bias and reliable results

Prevalence and risk factors associated with peripheral arterial disease in the hearts of Brazil project

FUNDAMENTO: A doença arterial obstrutiva periférica (DAOP) está associada ao maior índice de risco cardiovascular. No Brasil, faltam dados sobre sua prevalência e fatores de risco. OBJETIVO: Avaliar prevalência e fatores de risco associados à DAOP nas cidades brasileiras com > cem mil habitantes. MÉTODOS: Estudo transversal, multicêntrico, que avaliou 1.170 indivíduos (>18 anos), em 72 centros urbanos, participantes do Projeto Corações do Brasil. O diagnóstico de DAOP baseou-se na medida do índice tornozelo-braquial (ITB) < 0,90. A análise estatística utilizou teste Qui-quadrado (Pearson) corrigido para amostras complexas e intervalos de confiança. P < 0,05 foi considerado significativo. RESULTADOS: A prevalência de DAOP foi de 10,5% e apenas 9% dos portadores da doença apresentaram claudicação. A DAOP esteve associada à presença de diabetes, obesidade total e abdominal, acidente vascular cerebral (AVC) e doença isquêmica do coração (DIC). Houve tendência a maior prevalência de DAOP na presença de hipertensão, insuficiência cardíaca, insuficiência renal dialítica e tabagismo >20 anos/maço. Mulheres coronariopatas apresentaram risco 4,9 vezes maior de ter DAOP, do que aquelas sem coronariopatia e, entre homens diabéticos, o risco de DAOP foi 6,6 maior em comparação aos não diabéticos. CONCLUSÃO: A prevalência de DAOP foi elevada, considerando-se a baixa média de idade da população avaliada (44&plusmn;14,7 anos). A minoria dos portadores apresentava claudicação, o que denota o grande contingente de indivíduos assintomáticos. Os fatores mais fortemente associados à doença foram diabetes, obesidade, AVC e DIC. Os autores concluíram que a medida do ITB deve ser considerada na avaliação de pacientes de moderado e alto risco cardiovascular.BACKGROUND: Peripheral arterial disease (PAD) is associated with increased cardiovascular risk. In Brazil, data on PAD prevalence and risk factors are scarce. OBJECTIVE: To assess prevalence and risk factors related to PAD in Brazilian urban centers with more than 100,000 inhabitants. METHODS: National, multicenter, cross-sectional study of 1,170 individuals (>18 years), from 72 major Brazilian urban centers participating in the "Hearts of Brazil Project". PAD diagnosis was based on ankle-brachial index (ABI) < 0.90. The statistical analysis used the corrected Chi-square (Pearson) test for complex samples and confidence intervals. P< 0.05 was considered statitically significant. RESULTS: PAD prevalence was 10.5%. Intermittent claudication (IC) was present in only 9% of PAD patients. A significant association was found between PAD and the following factors: diabetes, total and abdominal obesity, stroke and ischemic heart disease (IHD). There was a trend of higher PAD prevalence among individuals with hypertension, heart failure, chronic renal failure on dialysis, as well as those who had smoked over 20 pack-years. For females, presence of IHD was associated with a 4.9-fold greater risk of PAD. Among males, a 6.6-fold increased risk of PAD was found for diabetic in comparison to non-diabetic individuals. CONCLUSION: PAD prevalence was markedly high, considering the low mean age of the studied population (44&plusmn;14.7 yrs). IC was detected in a minority of PAD subjects, indicating a considerable number of asymptomatic individuals. Diabetes, obesity, stroke and IHD were the stronger predictors of PAD. The authors concluded that ABI measurement should be considered in the evaluation of moderate to high cardiovascular risk patients.Empresa Libbs Farmacêutic

O perfil semiológico do paciente portador de hemorragia digestiva alta

OBJETIVO: O seguinte estudo objetivou descrever a semiologia do paciente portador de hemorragia digestiva alta, considerando como determinante na avaliação de potencias focos hemorrágicos. METODOLOGIA: Foram realizadas buscas nas plataformas do SciELO, LILACS, PubMed, Scopus e Google Scholar,utilizando os descritores gastrointestinal bleeding, peptic ulcerous disease e varicose hemorrhage, sendo identificados 35 estudos, dos quais foram incluídos 13 artigos completos. Desses estudos, 5 avaliaram as principais etiologias, 2 o surgimento de novos testes diagnósticos, 2 analisaram os aspectos epidemiológicos e 1 a sintomatologia apresentada pelo acometimento da hemorragia digestiva alta. Observou-se inicialmente a abundâncias de informações conceituais sobre o sangramento, como um transtorno clínico comum, acompanhada de inúmeras manifestações, considerando que o foco hemorrágico pode ocorrer em qualquer porção do trato gastrointestinal. Neste estudo, todas as publicações eleitas apresentaram o quadro semiológico composto por algia abdominal, indícios de choque hipovolêmico e taquicardia, alguns exibiram quedas abruptas da pressão arterial, odinofagia, êmese, náuseas e estado ictérico. Os pacientes implicados, cronicamente, já manifestaram ocorrências prévias, devido ao caráter recidivante torna-se essencial investigar a existência de varizes, fístula aorto-entérica, angiodisplasia e doença ulcerosa. CONCLUSÃO: Elucida-se que a hemorragia digestiva alta representa a principal causa de sangramento do trato gastrointestinal, majoritamente manifesta-se como hematêmese ou melena e cursam com o quadro sintomatológico que auxilia na avaliação da gravidade deste e o embasamento de potenciais focos de sangramento e que contribuam para disseminação de informações e intervenções futuras

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost