RESUMEN
BACKGROUND & AIMS: To evaluate the effect of the Brazilian Cardioprotective Diet Program (BALANCE Program) on inflammatory biomarkers, involved in the pathophysiology of the atherosclerosis, on inflammatory biomarkers, cardiovascular risk factors, and on plasma fatty acids in cardiovascular disease secondary prevention patients. METHODS: In this substudy of the BALANCE Program randomized clinical trial, a total of 369 patients aged 45 years or older, who have experienced cardiovascular disease in the previous 10 years, were included. These patients were randomized into two groups and followed up for six months: BALANCE Program group and control group (conventional nutrition advice). In the initial and six-month final visits, anthropometry (body weight, height and waist circumference), food intake evaluation by 24-h dietary recall, plasma inflammatory biomarkers (IL-6, IL-8, IL-10, IL-12, tumor necrosis factor-α, adiponectin, and C-reactive protein levels), blood pressure, glycemia, insulinemia, lipid profile, and plasma fatty acids levels were evaluated. RESULTS: The BALANCE Program group showed increased plasma alpha-linolenic acid levels (P = 0.008), reduction in waist circumference (P = 0.049) and BMI (P = 0.032). No difference was observed among plasma inflammatory biomarkers and clinical data. CONCLUSION: After six months of follow-up, BALANCE Program led to a significant reduction on BMI and waist circumference in individuals in secondary prevention for cardiovascular disease. Although plasmatic alpha-linolenic acid has increased, there was no impact on plasma inflammatory biomarkers. CLINICAL TRIAL REGISTRATION: NCT01620398.
Asunto(s)
Enfermedad de la Arteria Coronaria/dietoterapia , Adiponectina/sangre , Anciano , Biomarcadores/sangre , Brasil , Proteína C-Reactiva/metabolismo , Enfermedad de la Arteria Coronaria/metabolismo , Dieta Mediterránea , Femenino , Humanos , Masculino , Persona de Mediana Edad , Fenómenos Fisiológicos de la Nutrición , Estado Nutricional , Prevención Secundaria , Resultado del TratamientoRESUMEN
BACKGROUND & AIMS: To evaluate the effect of the Brazilian Cardioprotective Diet Program (BALANCE Program) on inflammatory biomarkers, involved in the pathophysiology of the atherosclerosis, on inflammatory biomarkers, cardiovascular risk factors, and on plasma fatty acids in cardiovascular disease secondary prevention patients. METHODS: In this substudy of the BALANCE Program randomized clinical trial, a total of 369 patients aged 45 years or older, who have experienced cardiovascular disease in the previous 10 years, were included. These patients were randomized into two groups and followed up for six months: BALANCE Program group and control group (conventional nutrition advice). In the initial and six-month final visits, anthropometry (body weight, height and waist circumference), food intake evaluation by 24-h dietary recall, plasma inflammatory biomarkers (IL-6, IL-8, IL-10, IL-12, tumor necrosis factor-a, adiponectin, and C-reactive protein levels), blood pressure, glycemia, insulinemia, lipid profile, and plasma fatty acids levels were evaluated. RESULTS: The BALANCE Program group showed increased plasma alpha-linolenic acid levels (P » 0.008), reduction in waist circumference (P » 0.049) and BMI (P » 0.032). No difference was observed among plasma inflammatory biomarkers and clinical data. CONCLUSION: After six months of follow-up, BALANCE Program led to a significant reduction on BMI and waist circumference in individuals in secondary prevention for cardiovascular disease. Although plasmatic alpha-linolenic acid has increased, there was no impact on plasma inflammatory biomarkers. Clinical trial registration: NCT01620398.
Asunto(s)
Humanos , Enfermedades Cardiovasculares , Dieta , Prevención Secundaria , Ácidos Grasos , InflamaciónRESUMEN
AIM: This article reports experiences of Brazilian physicians and nurses caring for women with postpartum depression in primary healthcare settings. BACKGROUND: Prevalence of postpartum depression in Brazil ranges from 12-37%, which fits with international claims about differences in the magnitude of the problem and consistency of screening. DESIGN: Qualitative descriptive. METHOD: This study was situated in health units of the Family Health Strategy in Campina Grande, Brazil. Data were collected from September 2010-January 2011 through open-ended interviews with ten nurses and seven physicians, observations, and field diary records. Inductive content analysis was used to develop categories. FINDINGS: Three categories: (1) Limited professional exposure to postpartum depression; (2) Postpartum depression as the domain of psychiatry; and (3) Challenges dealing with postpartum depression demonstrated that few professionals felt postpartum depression merited their attention. Women, with signs of postpartum depression, were usually identified by family members who noticed behaviours that seemed abnormal. Care providers indicated they had inadequate time and access to screening techniques to identify women with depression attending unit-based pregnancy and postpartum groups. When identified, women were referred directly to psychiatric care. CONCLUSION: Without consistent screening and diagnostic techniques, Brazilian health professionals are insecure about identifying and treating cases of postpartum depression. Referring women to psychiatric units entail more time for women to be diagnosed and treated and increased costs for health services. Primary healthcare professionals require training to screen, identify, and treat postpartum depression in primary healthcare settings.