1
|
Dantas RCDO, Roncalli AG. Reprodutibilidade do protocolo para usuários com hipertensão arterial assistidos na Atenção Básica à Saúde. CIENCIA & SAUDE COLETIVA 2020; 25:3037-3046. [DOI: 10.1590/1413-81232020258.17762018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Accepted: 09/11/2018] [Indexed: 11/21/2022] Open
Abstract
Resumo Os protocolos têm sido adotados como estratégia para melhorar os índices de acompanhamento e controle da Hipertensão Arterial (HA). Objetivou-se verificar a reprodutibilidade de um protocolo para a consulta e o acompanhamento do usuário com HA atendido na Atenção Básica à Saúde (ABS). Tratou-se de estudo metodológico, realizado de janeiro a agosto de 2016, com 160 usuários com HA. A reprodutibilidade se deu nas dimensões indicadoras de saúde, psicossociais, sinais de alterações das cifras pressóricas, ocorrência de complicações e realizações de exames. O protocolo foi aplicado por enfermeiros em dois momentos distintos, com intervalo de acordo com o retorno do participante. A concordância foi avaliada pelos coeficientes Kappa (κ) e de Correlação Intraclasse (CCI), conforme o tipo de variável. O κ intraexaminadores variou de 0,673 a 0,984 e interexaminadores de 0,515 a 0,985. O CCI intraexaminadores pontuou de 0,785 a 0,998 e interexaminadores de 0,845 a 0,999. A média das medidas antropométricas e a das pressões apresentou diferença < 1 entre os examinadores nos tempos 1 e 2. O protocolo apresentou boa reprodutibilidade e alta confiabilidade, podendo ser replicado e utilizado na consulta de acompanhamento do usuário com HA assistido na ABS.
Collapse
|
2
|
Lucchetti BFC, Boaretto N, Lopes FNC, Malvezi AD, Lovo-Martins MI, Tatakihara VLH, Fattori V, Pereira RS, Verri WA, de Almeida Araujo EJ, Pinge-Filho P, Martins-Pinge MC. Metabolic syndrome agravates cardiovascular, oxidative and inflammatory dysfunction during the acute phase of Trypanosoma cruzi infection in mice. Sci Rep 2019; 9:18885. [PMID: 31827186 PMCID: PMC6906468 DOI: 10.1038/s41598-019-55363-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 11/26/2019] [Indexed: 12/20/2022] Open
Abstract
We evaluated the influence of metabolic syndrome (MS) on acute Trypanosoma cruzi infection. Obese Swiss mice, 70 days of age, were subjected to intraperitoneal infection with 5 × 102 trypomastigotes of the Y strain. Cardiovascular, oxidative, inflammatory, and metabolic parameters were evaluated in infected and non-infected mice. We observed higher parasitaemia in the infected obese group (IOG) than in the infected control group (ICG) 13 and 15 days post-infection. All IOG animals died by 19 days post-infection (dpi), whereas 87.5% of the ICG survived to 30 days. Increased plasma nitrite levels in adipose tissue and the aorta were observed in the IOG. Higher INF-γ and MCP-1 concentrations and lower IL-10 concentrations were observed in the IOG compared to those in the ICG. Decreased insulin sensitivity was observed in obese animals, which was accentuated after infection. Higher parasitic loads were found in adipose and hepatic tissue, and increases in oxidative stress in cardiac, hepatic, and adipose tissues were characteristics of the IOG group. Thus, MS exacerbates experimental Chagas disease, resulting in greater damage and decreased survival in infected animals, and might be a warning sign that MS can influence other pathologies.
Collapse
Affiliation(s)
- Bruno Fernando Cruz Lucchetti
- Department of Physiological Sciences, Center of Biological Sciences, State University of Londrina, Londrina, PR, Brazil
- Department of Physiotherapy, University Center of Araguaia Valley, Barra do Garças, MT, Brazil
| | - Natalia Boaretto
- Department of Physiological Sciences, Center of Biological Sciences, State University of Londrina, Londrina, PR, Brazil
| | - Fernanda Novi Cortegoso Lopes
- Department of Physiological Sciences, Center of Biological Sciences, State University of Londrina, Londrina, PR, Brazil
| | - Aparecida Donizette Malvezi
- Department of Pathological Sciences, Center of Biological Sciences, State University of Londrina, Londrina, PR, Brazil
| | - Maria Isabel Lovo-Martins
- Department of Pathological Sciences, Center of Biological Sciences, State University of Londrina, Londrina, PR, Brazil
| | - Vera Lúcia Hideko Tatakihara
- Department of Pathological Sciences, Center of Biological Sciences, State University of Londrina, Londrina, PR, Brazil
| | - Victor Fattori
- Department of Pathological Sciences, Center of Biological Sciences, State University of Londrina, Londrina, PR, Brazil
| | - Rito Santo Pereira
- Department of Pathological Sciences, Center of Biological Sciences, State University of Londrina, Londrina, PR, Brazil
| | - Waldiceu Aparecido Verri
- Department of Pathological Sciences, Center of Biological Sciences, State University of Londrina, Londrina, PR, Brazil
| | | | - Phileno Pinge-Filho
- Department of Pathological Sciences, Center of Biological Sciences, State University of Londrina, Londrina, PR, Brazil
| | - Marli Cardoso Martins-Pinge
- Department of Physiological Sciences, Center of Biological Sciences, State University of Londrina, Londrina, PR, Brazil.
| |
Collapse
|
3
|
Mussi RFDF, Petróski EL. Síndrome metabólica e fatores associados em quilombolas baianos, Brasil. CIENCIA & SAUDE COLETIVA 2019; 24:2481-2490. [DOI: 10.1590/1413-81232018247.13982017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Accepted: 10/21/2017] [Indexed: 12/19/2022] Open
Abstract
Resumo Este estudo buscou analisar a prevalência de Síndrome Metabólica (SM) e os fatores associados em adultos quilombolas. Estudo de base populacional com amostra de 850 adultos de ambos os sexos. A SM foi determinada pelo critério Joint Interim Statement. A regressão de Poisson foi usada para testar as associações, conforme modelo hierarquizado de análise. A prevalência de SM foi de 25,8% (Intervalo de Confiança de 95%: 22,8:28,7). Na análise múltipla permaneceram associados (p < 0,05) sexo, grupo etário, qualidade do sono, Índice de Massa Corporal (IMC) e percentual de gordura (%G). Neste sentido, a presença da SM em adultos quilombolas se associa com o sexo feminino, faixa etária > 40 anos, má qualidade do sono, excesso de peso corporal e obesidade.
Collapse
|
4
|
Mussi RFDF, Petróski EL. Indicadores de obesidade: capacidade preditiva para síndrome metabólica em adultos quilombolas. CIENCIA & SAUDE COLETIVA 2019; 24:2471-2480. [DOI: 10.1590/1413-81232018247.19032017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Accepted: 10/19/2017] [Indexed: 12/15/2022] Open
Abstract
Resumo O objetivo deste estudo foi avaliar a capacidade preditiva da síndrome metabólica (SM) por diferentes indicadores de obesidade (IO) em adultos quilombolas. Estudo transversal com amostra representativa de 850 adultos (18 à 92 anos de idade) quilombolas residentes na microrregião geográfica de Guanambi/Bahia. Foram construídas curvas Receiver Operating Characteristic (ROC) entre os IO (percentual de gordura - %G; índice de adiposidade corporal – IAC; índice de massa corporal – IMC) e a SM. O equilíbrio entre sensibilidade e especificidade definiu os melhores pontos de corte preditores da SM pelos IO. Os três IO apresentaram capacidade preditiva para SM (curva ROC significativamente > 0,5). Entre as mulheres, o %G apresentou área sob a curva ROC (0,69 - IC95%: 0,65:0,73) significativamente maior que os demais IO. Entre os homens as áreas do %G e do IMC foram iguais (0,81 - IC95%: 0,76:0,85) e maiores que a do IAC. Os melhores pontos de corte dos IO para identificar a presença da SM respectivamente em mulheres e homens foram: 24,97 e 25,36 kg/m2 para IMC, 34,30 e 26,14% para IAC e 37,7 e 23,8% para %G. Os IO testados são válidos para rastrear a SM em adultos quilombolas a partir da utilização dos pontos de corte específicos para a população estudada.
Collapse
|
5
|
Dantas RCDO, Roncalli AG. Protocol for hypertensive individuals assisted in Basic Health Care. CIENCIA & SAUDE COLETIVA 2019; 24:295-306. [PMID: 30698262 DOI: 10.1590/1413-81232018241.35362016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 03/01/2017] [Indexed: 11/22/2022] Open
Abstract
Hypertension has low control rate in Brazil and around the World, resulting in social and medical costs; thus there is the need to apply control strategies. This study aimed to create and validate a protocol for consultation and monitoring of hypertensive patients attended in primary health care. It is constituted a methodological research which uses the Delphi method for content validation. The analysis of the protocol by experts was performed in three cycles, using a scale that was not important to extremely important, with a graduation from 1 to 5. The analysis was performed by the Likert scale, percentage of agreement, content validation index, Pearson correlation. The percentage of agreement was 96%. The CVI of 0.98. The Likert scale scored items, at least, as very important. The Pearson correlation was positive for all items ranging from moderate to strong. The protocol is composed of 53 items, divided into seven dimensions. It was concluded that the protocol enables more expressive and systematics monitoring of hypertensive patients and it identifies social and individual conditions that contribute to high blood pressure, so it may be used to guide the consultation, encouraging dialogue between the professional and patient and effective recording of care.
Collapse
Affiliation(s)
- Rosimery Cruz de Oliveira Dantas
- Unidade de Ciências da Vida, Centro de Formação de Professores, Universidade Federal de Campina Grande. R. Aprígio Veloso 882, Universitário. 58429-900 Campina Grande PB Brasil.
| | - Angelo Giuseppe Roncalli
- Departamento de Odontologia, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte. Natal RN Brasil
| |
Collapse
|
6
|
Flor LS, Campos MR. The prevalence of diabetes mellitus and its associated factors in the Brazilian adult population: evidence from a population-based survey. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2018; 20:16-29. [PMID: 28513791 DOI: 10.1590/1980-5497201700010002] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 09/01/2016] [Indexed: 12/20/2022] Open
Abstract
Objective: To estimate the prevalence of self-reported diabetes mellitus (DM) and its associated factors among the Brazilian adult population. Methods: The prevalence of DM was assessed in the Survey on Social Dimensions of Inequalities, a national survey with macro-regions representativeness carried out in 2008. Data were collected by a personal face-to-face interview with 12,423 individuals of both sexes, aged over 20 years. The χ2 test at 5.0% was performed in order to identify associated factors, and logistic regression was used to estimate adjusted odds ratios. Results: The prevalence of DM in Brazil was 7.5%. After adjusting for potential confounders, diabetes remained associated with age (≥ 40 years), education (< 8 years of study), marital status (non-married), obesity, sedentary lifestyle, comorbidity with hypertension and hypercholesterolemia, as well as the demand for health services. Conclusion: Results indicate a high prevalence of DM and its associated preventable factors in Brazil. Thus, they highlight the need for a behavioral change as a strategy for prevention and control of diabetes and its complications.
Collapse
|
7
|
Olivares DEV, Chambi FRV, Chañi EMM, Craig WJ, Pacheco SOS, Pacheco FJ. Risk Factors for Chronic Diseases and Multimorbidity in a Primary Care Context of Central Argentina: A Web-Based Interactive and Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14030251. [PMID: 28257087 PMCID: PMC5369087 DOI: 10.3390/ijerph14030251] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Revised: 02/22/2017] [Accepted: 02/23/2017] [Indexed: 02/08/2023]
Abstract
Global health agencies estimate an increase of chronic diseases in South America. Nevertheless, few studies have investigated chronic diseases and their risk factors in the perspective of multimorbidity. This research aimed to identify these aspects in a primary health care setting of central Argentina. The Pan America version of the STEP wise approach surveillance (STEPS) instrument of the World Health Organization was applied to 1044 participants, 365 men and 679 women, with a mean age of 43 years. High prevalence of overweight (33.5%), obesity (35.2%), central obesity (54%), dyslipidemia (43.5%), metabolic syndrome (21.1%), low intake of fruit and vegetables (91.8%), low levels of physical activity (71.5%), risky alcohol consumption (28%), and smoking (22.5%) were detected. Hypertension and diabetes were the most prevalent chronic conditions and the total prevalence of multimorbidity was 33.1%, with 2, 3, 4, 5 and 6 chronic conditions found in 19.9%, 9.1%, 2.6%, 1.1% and 0.4% of the population, respectively. Multimorbidity affected 6.4% of the young, 31.7% of the adults, and 60.6% of the elderly, and was more prevalent among women, and in participants with lower levels of education. Having multimorbidity was significantly associated with obesity, central obesity, and higher concentrations of total blood cholesterol, low-density lipoprotein cholesterol, triglycerides, and glucose. A website was made available to the participants in order to share the experimental results and health-promoting information.
Collapse
Affiliation(s)
- David E V Olivares
- Center for Health Sciences Research, School of Medicine & Health Sciences, Universidad Adventista del Plata, Libertador San Martín, 25 de Mayo 99, Entre Ríos 3103, Argentina.
| | - Frank R V Chambi
- Center for Health Sciences Research, School of Medicine & Health Sciences, Universidad Adventista del Plata, Libertador San Martín, 25 de Mayo 99, Entre Ríos 3103, Argentina.
| | - Evelyn M M Chañi
- Center for Health Sciences Research, School of Medicine & Health Sciences, Universidad Adventista del Plata, Libertador San Martín, 25 de Mayo 99, Entre Ríos 3103, Argentina.
- Institute for Food Science and Nutrition, Universidad Adventista del Plata, Libertador San Martín, 25 de Mayo 99, Entre Ríos 3103, Argentina.
| | - Winston J Craig
- Institute for Food Science and Nutrition, Universidad Adventista del Plata, Libertador San Martín, 25 de Mayo 99, Entre Ríos 3103, Argentina.
- Department of Public Health, Nutrition and Wellness, School of Health Professions, Andrews University, Berrien Springs, MI 49104, USA.
| | - Sandaly O S Pacheco
- Center for Health Sciences Research, School of Medicine & Health Sciences, Universidad Adventista del Plata, Libertador San Martín, 25 de Mayo 99, Entre Ríos 3103, Argentina.
- Institute for Food Science and Nutrition, Universidad Adventista del Plata, Libertador San Martín, 25 de Mayo 99, Entre Ríos 3103, Argentina.
| | - Fabio J Pacheco
- Center for Health Sciences Research, School of Medicine & Health Sciences, Universidad Adventista del Plata, Libertador San Martín, 25 de Mayo 99, Entre Ríos 3103, Argentina.
- Institute for Food Science and Nutrition, Universidad Adventista del Plata, Libertador San Martín, 25 de Mayo 99, Entre Ríos 3103, Argentina.
| |
Collapse
|
8
|
França SL, Lima SS, Vieira JRDS. Metabolic Syndrome and Associated Factors in Adults of the Amazon Region. PLoS One 2016; 11:e0167320. [PMID: 27936021 PMCID: PMC5147872 DOI: 10.1371/journal.pone.0167320] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Accepted: 11/12/2016] [Indexed: 02/02/2023] Open
Abstract
Metabolic syndrome (MS) plays a key role in the origin of cardiovascular diseases. Studies on the MS in Brazil are recent, and its epidemiology in more isolated regions such as the Amazon is still unknown. The study aimed to estimate the prevalence of MS and associated factors in adults of the Brazilian Amazon. This study was conducted in 2012-2013. It is a cross-sectional population-based study, involving 787 adults randomly selected from the urban area of four cities in the state of Pará, in the Brazilian Eastern Amazon. The participants underwent anthropometric measurements, laboratory examination, and were questioned about their lifestyle. MS was defined by the Joint Interim Statement criteria, using the multiple logistic regression to investigate the potential association of risk factors with the presence of MS. The overall prevalence of MS was 34.1% (95% CI = 30.8-37.4), increasing linearly with the increasing body mass index and age. From 40-49 years of age, MS was observed in about half of the women (46.0%), while men only experienced a high prevalence in the fifth decade of life (43.3%). The low HDL-c (64.4%) and abdominal obesity (58.9%) were higher in women (p < 0.001), while for men, high blood pressure was significantly higher (p < 0.001). Individuals aged 40-59 years old (odds ratio [OR] = 3.35 [95% CI = 2.30-4.90]), ≥ 60 years old (OR = 5.80 [3.63-9.27]), overweight (OR = 4.17 [2.77-6.29]), and obese (OR = 8.82 [5.56-13.98]) were more likely to have MS. The study population experienced high cardiometabolic risk, requiring government efforts to control MS and related risk factors, especially obesity.
Collapse
Affiliation(s)
- Sérgio Lobato França
- Institute of Biological Sciences of the Federal University of Pará, Belém, State of Pará, Brazil
| | - Sandra Souza Lima
- Institute of Biological Sciences of the Federal University of Pará, Belém, State of Pará, Brazil
| | | |
Collapse
|
9
|
Luz RH, Barbosa AR, d'Orsi E. Waist circumference, body mass index and waist-height ratio: Are two indices better than one for identifying hypertension risk in older adults? Prev Med 2016; 93:76-81. [PMID: 27663432 DOI: 10.1016/j.ypmed.2016.09.024] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 09/16/2016] [Accepted: 09/19/2016] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To investigate if the combination of Waist Circumference (WC) and Body Mass Index (BMI) or Waist to Height Ratio (WHtR) and BMI measures is superior to the separate indicators in identifying hypertension risk in older adults from southern Brazil. METHOD This cross-sectional study analyzed data from the second wave (2013/14) of a population- and household-based survey carried out with 1197 older adults (778 women). Hypertension (i.e., outcome) was identified by self-report. The independent variables were body mass index (BMI≥27kg/m2), waist circumference (WC≥88cm for women and WC≥102cm for men), waist/height ratio (WHtR≥0.5), and the combined indexes BMI+WC (BMI≥27kg/m2+WC≥88cm for women and WC≥102cm for men) and BMI+WHtR (BMI≥27kg/m2+WHtR≥0.5). The associations were explored using binary logistic regression. RESULTS The results showed sex differences in all study characteristics. In women, all indicators were associated with the outcome, after adjustments (age, race/color, marital status, schooling, smoking, alcohol consumption, physical activity, and diabetes). WHtR was the indicator most strongly associated with hypertension (OR=2.97; 95% CI 1.58 to 5.59). For men, only BMI and the combined indicators were associated with hypertension. Combined measures of BMI+WHtR showed a stronger association with the outcome (OR=2.68; IC95% 1.62 to 4.44). CONCLUSION The associated indicators differed between the sexes. The combination of BMI+WC and BMI+WHtR using current cut-off points may provide an improved measure of hypertension risk.
Collapse
Affiliation(s)
- Rafaela Haeger Luz
- Programa de Pós Graduação em Nutrição, Universidade Federal de Santa Catarina - SC, Brazil
| | - Aline Rodrigues Barbosa
- Departamento de Educação Física, Centro de Desportos, Universidade Federal de Santa Catarina - SC, Brazil.
| | - Eleonora d'Orsi
- Departamento de Saúde Coletiva, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina - SC, Brazil
| |
Collapse
|
10
|
Lima DBDS, Moreira TMM, Borges JWP, Rodrigues MTP. ASSOCIATION BETWEEN TREATMENT COMPLIANCE AND DIFFERENT TYPES OF CARDIOVASCULAR COMPLICATIONS IN ARTERIAL HYPERTENSION PATIENTS. TEXTO & CONTEXTO ENFERMAGEM 2016. [DOI: 10.1590/0104-07072016000560015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
ABSTRACT: This cross-sectional analytical study was carried out at 23 Family Health Centers in Fortaleza-CE, Brazil. The objective was to verify the link between anti-hypertension treatment compliance and the types of cardiovascular complications present in hypertensive patients. The sample was composed of 182 hypertensive patients registered in the Sistema de Gestão Clínica de Hipertensão Arterial e Diabetes Mellitus da Atenção Básica who accepted to answer and fill in a structured form and an instrument to assess compliance. Among the arterial hypertension patients questioned, 62.0% were women, 66.9% were elderly people, 52.2% were patients with a family income between 1.5 and four monthly minimum wages, 61.2% had between one and eight years of education and 60.4% lived in households with two to four people. The most frequent complications found were cerebrovascular accident (37.9%) followed by acute myocardial infarction (20.3%). Treatment compliance was present in 52.0% of patients and was associated to cerebrovascular accident (p<0.001; OR=3.048; 95%CI=1.633-5.681). The results obtained suggest the need for a behavioral change in hypertensive patients, adopting health promotion measures in order to prevent further cardiovascular complications.
Collapse
|