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The pilot project of pre-anesthetic evaluation through telemedicine at the Pedro Ernesto University Hospital (HUPE) of the State University of Rio de Janeiro (UERJ) is a commendable initiative that aims to address the challenges faced by patients in accessing preoperative care. The objective of this study was to reduce the waiting time between the surgical recommendation and its clinical clearance for the procedure. A service flow was established to enable patients to undergo a comprehensive evaluation, including examination and complementary tests, during a single visit with a general practitioner. Based on the type of surgery and the patient's comorbidities, the Teleconsultants Center assessed the case and provided the necessary guidance. A total of 20 patients were attended to in face-to-face sessions during morning shifts, with the participation of Internal Medicine and Anesthesiology. Subsequently, these patients' evaluations were scheduled for teleconsultation to assess their surgical risk. There has been a significant reduction in the time between the surgical recommendation and the clearance for the procedure with a notable improvement compared to the previous protocol. These initial outcomes demonstrate the project's potential to enhance the efficiency and effectiveness of the preoperative evaluation process through teleassistance.

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Firefighting is associated with high-level physical demands and requires appropriate physical fitness. Considering that obesity has been correlated with decreased cardiorespiratory fitness (CRF) and that the prevalence of obesity may also be elevated within firefighters (FF), we analyzed the association between CRF and body composition (BC) in Brazilian military FF. We assessed 4,237 male FF (18-49 years) who performed a physical fitness test that included BC and CRF. Body composition was assessed by body mass index (BMI), body adiposity index (BAI), body fat percentage (BF%), and waist circumference (WC). CRF was assessed by the 12-minute Cooper test. Comparisons of VO2max between the BC categories were analyzed using the Mann-Whitney test, and the analysis was adjusted for age using the General Linear Model. The Spearman test was used for correlation analysis and the odds ratio (OR) was calculated to assess the odds of the unfit group (≤ 12 metabolic equivalents [METs]) for poor BC. Statistically significant differences were considered when p ≤ 0.05. Considering the BMI categories, 8 volunteers (0.2%) were underweight, 1,306 (30.8%) were normal weight, 2,301 (54.3%) were overweight, and 622 (14.7%) were obese. The VO2max was negatively correlated with age (rs = -0.21), BMI (rs = -0.45), WC (rs = -0.50), and BAI (rs = -0.35) (p < 0.001). Cardiorespiratory fitness was lower in the obese compared with the nonobese for all age categories (-3.8 ml · kg(-1) · min(-1); p < 0.001) and for all BC indices (-4.5 ml · kg(-1) · min(-1); p < 0.001). The OR of the unfit group having poor BC in all indices varied from 2.9 to 8.1 (p < 0.001). Despite the metabolically healthy obesity phenomenon, we found a strong association between CRF and BC irrespective of age and the BC method (BMI, BAI, WC, or BF%). These findings may aid in improving FF training programs with a focus on health and performance.

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A previous genome-wide association study suggested that polymorphisms in the thyrotrophin-releasing hormone receptor (TRHR) gene contribute to fat-free mass (FFM) variation. The aim of the present study was to examine the association between polymorphisms in the TRHR gene with FFM and muscle strength in older women. Volunteers (n = 241; age = 66.65 ± 5.5 years) underwent quadriceps strength assessment using isokinetics and fat-free mass by dual-energy X-ray absorptiometry. TRHR polymorphisms and ancestry-informative markers were genotyped through standard procedures. No significant difference was observed for rs7832552. Regarding the rs16892496, ANCOVA revealed that appendicular fat-free mass (AFFM) and relative AFFM were significantly different between groups (p = 0.04 and p = 0.05, respectively). Individuals carrying A/A and A/C genotypes respectively showed, on average, an extra 1 kg and 900 g of AFFM when compared to C/C genotype carriers. Also, the C/C genotype group presented a significantly higher chance to have reduced muscle strength. The observations presented here provide further evidence that the rs16892496 polymorphism in the TRHR gene may play a role in FFM variation. Moreover, the results bring the novel insight that this genetic variant can present a modest contribution to muscle strength in older women.

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INTRODUÇÃO: O nível de colesterol na infância é um preditor do nível de colesterol na vida adulta. As consequências do colesterol elevado, somadas a outros fatores de risco constituem problema mundial de saúde pública. OBJETIVO: Estimar a prevalência de hipercolesterolemia, hipertrigliceridemia e excesso de peso em estudantes do município de Santa Maria-RS. Métodos: Estudo transversal com 374 crianças de 10 a 12 anos de idade, de escolas das redes pública e privada, realizado no segundo semestre de 2005 na cidade de Santa Maria-RS. Foram determinados os níveis de colesterol total, triglicerídeos e estado nutricional. RESULTADOS: As prevalências de hipercolesterolemia, hipertrigliceridemia e excesso de peso encontradas foram de 4,7 por cento, 8,9 por cento e 20,7 por cento, respectivamente. Não houve diferença significante entre sexo e rede pública e privada. As crianças com excesso de peso apresentaram maior prevalência de alterações lipídicas. CONCLUSÕES: A prevalência de alterações lipídicas pode ser considerada baixa, mas a prevalência de excesso de peso dos estudantes de Santa Maria mostrou-se relativamente alta, alertando à importância de políticas públicas e à necessidade de assistência pediátrica nessa faixa etária, visando o seu diagnóstico precoce e, principalmente, o aconselhamento nutricional e incentivo à prática esportiva, uma vez que as dislipidemias e o excesso de peso têm sido apontados como fatores de risco para as doenças cardiovasculares.

INTRODUCTION: Cholesterol level in childhood is a predictor of cholesterol level in adult life. The consequences of high cholesterol levels summed to other risk factors constitute a worldwide public health problem. OBJECTIVE: To estimate the prevalence of blood lipid abnormalities and overweight among school students of the city of Santa Maria, RS, Brazil. Methods: A cross-sectional study with 374 children, aged between 10 and 12 years, from public and private schools of the city of Santa Maria, RS, conducted on the second semester of 2005. Total cholesterol levels (TC), fractions of cholesterol (HDL- C and LDL- C), triglycerides (TG) and nutritional status were determined. RESULTS: The prevalence of hypercholesterolemia, hypertriglicemia and overweight found were 4.7 percent, 8.9 percent and 20.7 percent, respectively. There was no significant difference between sexes or public and private schools. The overweight children presented higher prevalence of lipid alterations. CONCLUSION: The prevalence of lipid alterations may be considered low, but the prevalence of overweight among the students of Santa Maria was high, demonstrating hence the importance of public policies and the need for pediatric assistance at this age group. The aims here would be early diagnosis, especially for nutritional advising and stimulus for physical activities, since overweight and blood lipid abnormalities have been pointed out as risk factors for cardiovascular diseases.

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BACKGROUND: Obesity is very frequently associated with conditions such as dyslipidemia and diabetes. OBJECTIVE: To verify the diagnostic value of the cut-off points proposed by the International Obesity Task Force (IOTF) and Conde & Monteiro (C&M) for the screening and identification of dyslipidemia in children between 10 and 12 years of age. METHODS: The Body Mass Index (BMI) of 374 children of the school network of the city of Santa Maria-RS was ascertained. The children were selected in a stratified manner from a population of 4,083 children. Lipid levels (reference standard) were determined by means of analysis of total cholesterol (TC), LDL-C, HDL-C and triglycerides (TG). The cut-off points of the IOTF and C&M were used to classify the BMI. Descriptive statistics and analysis of sensitivity and specificity were employed. RESULTS: There was a statistical difference in excess weight prevalence between both proposals (24.7% and 28.6% for IOTF and C&M, respectively). A variation was observed in sensitivity (33% to 83%) and specificity (62% to 80%) between the cut-off points as to the detection of dyslipidemia. The percentage of false negatives was lower than the percentage of false positives. CONCLUSION: The proposals may be used to screen elevated TC and LDL-C in male individuals. Either the IOTF or the C&M classification may be used to identify subjects without dyslipidemia, as these proposals presented high specificity.

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Introdução: A verificação dos níveis lipídicos é feita através de análises laboratoriais, no entanto, existem métodos antropométricos (baixo custo e não invasivos), como o índice de massa corporal (IMC), circunferência da cintura (Ccin) e dobra cutânea Tricipital (TR) que podem ser utilizados como marcadores para as dislipidemias. Objetivo: Sugerir pontos de corte para as medidas antropométricas e testar se valores normativos daspropostas da International Obesity Task Force (IOTF) e de Conde e Monteiro (C&M) podem ser utilizados para triagem na identificação de alterações lipídicas em escolares com idade entre 10 e 12 anos. Metodologia: Determinou-se o IMC, Ccin e TR de 374 escolaresda rede de ensino da cidade de Santa Maria-RS, selecionadas de forma estratificada por rede de ensino e sexo. Os níveis lipídicos (padrão-ouro) foram determinados através da análise do Colesterol Total (CT), Low Density Lipoprotein (LDL-C), High Density Lipoprotein (HDL-C) e Triglicerídeos (TG). Recorreu-se à estatística descritiva, análisede sensibilidade, especificidade, valor preditivo negativo, positivo e Curva ROC com um intervalo de confiança de 95%. Resultados: As prevalências de excesso de peso diferiram estatisticamente entre as propostas de IOTF (24,7%) e C&M (28,6%). Observou-se variada sensibilidade (33% a 83%) e especificidade (62% - 80%) entre os pontos de cortes utilizadospara detecção de dislipidemias. As variáveis antropométricas apresentaram capacidade diagnóstica apenas para TG no sexo feminino, CT e LDL-C no sexo masculino. Conclusão: As propostas da IOTF e C&M podem ser utilizadas para triagem de CT eLDL-C elevados no sexo masculino. Na identificação de sujeitos sem dislipidemia, tanto aclassificação da IOTF como a de C&M podem ser utilizadas, uma vez que apresentaram elevada especificidade. O IMC correspondente a 19,3kg.m-2 é um valor diagnóstico para alterações no TG no sexo feminino e para CT e LDL-C no sexo masculino. As concentrações elevadas de CT e LDL-C, no sexo masculino, também podem ser diagnosticadas a partir valores superiores a 65,7 cm para Ccin e 21,0mm para TR.

Introduction: Investigation of lipid levels is carried out by laboratory analyses, however there are anthropometric methods (noninvasive and of low cost) such as body mass index (BMI), waist circumference (Wcir) and triceps skin fold (TR) that can be used as markers of dyslipidemia.Objective: To suggest cutoff points for these anthropometric measurements and to test whether the reference values recommended by the International Obesity Task Force (IOTF) and Conde and Monteiro (C&M) can be used to screen schoolchildren aged 10 to 12 years forlipid abnormalities. Methodology: The BMI, Wcir and TR were determined for 374 schoolchildren from the public education system of Santa Maria, RS, Brazil. Subjects were selected by stratification by public or private school and by sex. Laboratory analysis (gold standard) was usedto determine Total Cholesterol (TC), Low Density Lipoprotein (LDL-C), High Density Lipoprotein (HDL-C) and Triglycerides (TG). Analysis employed descriptive statistics, calculations of sensitivity, specificity and negative and positive predictive values, and area under the ROC curve with a 95% confidence interval. Results: The prevalence rates of overweight calculated by the two different methods were statistically different, IOTF (24.7%) and C&M (28.6%). Sensitivity (33% - 83%) and specificity (62% - 80%) varied widely between the cutoff points employed toindicate dyslipidemia. The anthropometric variables only exhibited diagnostic capacity for TG among the girls and for CT and LDL-C for the boys. Conclusions: The cutoff points proposed by the IOTF and by C&M can be used to screen for elevated CT and LDL-C among males. Either the IOTF or the C&M cutoffs can be used to identify people without dyslipidemia, since both have high specificity. A BMI of 19.3kg.m-2 is a diagnostic value for abnormal TG levels in females and for abnormal CT and LDL-C among males. Elevated concentrations of CT and LDL-C can also bediagnosed in boys using cut-off values of WCir > 65.7 cm and TSF> 21.0mm.

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FUNDAMENTO: A obesidade associa-se, com grande frequência, a condições como dislipidemias e diabete. OBJETIVO: Verificar valor diagnóstico dos pontos de corte propostos pela International Obesity Task Force (IOTF) e Conde & Monteiro (C&M) para a triagem e identificação de dislipidemias em crianças entre 10 e 12 anos de idade. MÉTODOS: Determinou-se o Índice de Massa Corporal (IMC) de 374 crianças da rede de ensino da cidade de Santa Maria-RS, selecionadas de forma estratificada, de uma população de 4.083 crianças. Os níveis lipídicos (padrão de referência) foram determinados por meio da análise do colesterol total (CT), LDL-C, HDL-C e triglicerídeos (TG). Para classificação do IMC utilizaram-se os pontos de corte da IOTF e de C&M. Utilizou-se a estatística descritiva e análise de sensibilidade e especificidade. RESULTADOS: As prevalências de excesso de peso diferiram estatisticamente entre ambas as propostas (24,7 por cento e 28,6 por cento para IOTF e C&M, respectivamente). Observou-se variada sensibilidade (33 por cento a 83 por cento) e especificidade (62 por cento a 80 por cento) entre os pontos de corte utilizados para detecção de dislipidemias. O porcentual de falso-negativos foi inferior aos de falso-positivos. CONCLUSÃO: As propostas podem ser utilizadas para triagem de CT e LDL-C elevados no sexo masculino. Na identificação de sujeitos sem dislipidemia, tanto a classificação da IOTF como a de C&M podem ser utilizadas, uma vez que apresentaram elevada especificidade.

BACKGROUND: Obesity is very frequently associated with conditions such as dyslipidemia e diabetes. OBJECTIVE: To verify the diagnostic value of the cut-off points proposed by the International Obesity Task Force (IOTF) and Conde & Monteiro (C&M) for the screening and identification of dyslipidemia in children between 10 and 12 years of age. METHODS: The Body Mass Index (BMI) of 374 children of the school network of the city of Santa Maria-RS was ascertained. The children were selected in a stratified manner from a population of 4,083 children. Lipid levels (reference standard) were determined by means of analysis of total cholesterol (TC), LDL-C, HDL-C and triglycerides (TG). The cut-off points of the IOTF and C&M were used to classify the BMI. Descriptive statistics and analysis of sensitivity and specificity were employed. RESULTS: There was a statistical difference in excess weight prevalence between both proposals (24.7 percent and 28.6 percent for IOTF and C&M, respectively). A variation was observed in sensitivity (33 percent to 83 percent) and specificity (62 percent to 80 percent) between the cut-off points as to the detection of dyslipidemia. The percentage of false negatives was lower than the percentage of false positives. CONCLUSION: The proposals may be used to screen elevated TC and LDL-C in male individuals. Either the IOTF or the C&M classification may be used to identify subjects without dyslipidemia, as these proposals presented high specificity.

FUNDAMENTO: La obesidad está asociada, con gran frecuencia, a condiciones como dislipidemias y diabetes. OBJETIVO: Verificar el valor diagnóstico de los puntos de corte propuestos por la International Obesity Task Force (IOTF) y por Conde y Monteiro (C&M) para el triage e identificación de dislipidemias en niños entre 10 y 12 años de edad. MÉTODOS: Se determinó el índice de masa corporal (IMC) de 374 niños del sistema de enseñanza de la ciudad de Santa Maria-RS, seleccionadas de forma estratificada, de una población de 4.083 niños. Los niveles lipídicos (estándar de referencia) se determinaron mediante análisis de colesterol total (CT), LDL-C, HDL-C y de triglicéridos (TG). Para la clasificación del IMC se utilizaron los puntos de corte de la IOTF y de C&M. Se empleó el método de estadística descriptiva y el análisis de sensibilidad y especificidad. RESULTADOS: Las prevalencias de exceso de peso difirieron estadísticamente entre ambas propuestas (un 24,7 por ciento y un 28,6 por ciento para la IOTF y C&M, respectivamente). Se observó que los puntos de corte utilizados para detectar las dislipidemias experimentaron una variación de la sensibilidad (del 33 por ciento al 83 por ciento) y de la especificidad (del 62 por ciento al 80 por ciento). El porcentaje de falsos negativos fue inferior al de falsos positivos. CONCLUSIÓN: Las propuestas se pueden emplear para triage de CT y LDL-C elevados en el sexo masculino. Una vez que presentaron elevada especificidad, en la identificación de los sujetos sin dislipidemia se pueden emplear tanto la clasificación de la IOTF como la de C&M.

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OBJECTIVE: To analyze the predictive capacity of Body Mass Index (BMI), Waist Circumference (WC) and Triceps Skin Folds (TSF) to diagnose of lipid abnormalities and to suggest cutoff points for these measures in order to identify this disease in children. METHODOLOGY: It was measured the BMI, WC, TSF and lipid profiles of 374 schoolchildren (11,25 +/- 0,28 years) from the public education system of Santa Maria, RS, Brazil. Area under the ROC curve (95%CI), sensitivity, specificity and predictive values were analyzed in order to identify the ideal cutoff points. RESULTS: The anthropometric variables only exhibited diagnostic capacity for TG among the girls and CT and LDL-C for the boys. CONCLUSIONS: It was concluded that a BMI of 19.3 kg/m(2) is a diagnostic value for abnormal TG levels in females and for abnormal CT and LDL-C among males. Elevated concentrations of CT and LDL-C can also be diagnosed in boys using cut-off values of WC > 65.7 cm and TSF > 21.0mm.

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OBJETIVO: Analisar a capacidade preditiva do índice de massa corporal (IMC), da circunferência da cintura (Ccin) e da dobra cutânea triciptal (TR) no diagnóstico de alterações lipídicas e sugerir pontos de corte para tais medidas na identificação da doença em crianças. METODOLOGIA: Avaliou-se o IMC, a Ccin, a TR e os níveis lipídicos de 374 escolares (11,25 ± 0,28 anos) da rede de ensino da cidade de Santa Maria, RS. A análise estatística foi realizada por meio da curva ROC (IC95 por cento), da sensibilidade, da especificidade e dos valores preditivos. RESULTADOS: As variáveis antropométricas apresentaram capacidade diagnóstica apenas para TG no sexo feminino, CT e LCL-C no sexo masculino. CONCLUSÃO: Conclui-se que o IMC correspondente a 19,3 kg/m² é um valor diagnóstico para alterações no TG, no sexo feminino, e para CT e LDL-C, no sexo masculino. As concentrações elevadas de CT e LDL-C, no sexo masculino, também podem ser diagnosticadas a partir de valores superiores a 65,7 cm para Ccin e 21 mm para TR.

OBJECTIVE: To analyze the predictive capacity of Body Mass Index (BMI), Waist Circumference (WC) and Triceps Skin Folds (TSF) to diagnose of lipid abnormalities and to suggest cutoff points for these measures in order to identify this disease in children. METHODOLOGY: It was measured the BMI, WC, TSF and lipid profiles of 374 schoolchildren (11,25 ± 0,28 years) from the public education system of Santa Maria, RS, Brazil. Area under the ROC curve (95 percentCI), sensitivity, specificity and predictive values were analyzed in order to identify the ideal cutoff points. RESULTS: The anthropometric variables only exhibited diagnostic capacity for TG among the girls and CT and LDL-C for the boys. CONCLUSIONS: It was concluded that a BMI of 19.3 kg/m² is a diagnostic value for abnormal TG levels in females and for abnormal CT and LDL-C among males. Elevated concentrations of CT and LDL-C can also be diagnosed in boys using cut-off values of WC > 65.7 cm and TSF > 21.0mm.

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Este estudo teve por objetivo verificar se uma sessão de Treinamento Resistido com Pesos (TRP)visando Resistência Muscular Localizada (RML) ou objetivando Aumento de Volume Muscular (AVM) causariam alterações significativas no Peso Hidrostático (PH), Densidade Corporal (DC) e Percentual de Gordura (G).Participaram da amostra nove homens com idade entre 17 e 26 anos que possuíam um nível básico de TRP e eram adaptados ao meio líquido. A coleta do estudo foi realizada em três dias, sendo que no primeiro os sujeitosrealizavam o teste de 1RM em 10 exercícios que fizeram parte do treinamento. Dois dias após, os sujeitosrealizavam a pesagem hidrostática (pré-treinamento), seguido imediatamente de um TRP configurado para AVMe novamente outra pesagem hidrostática (pós-treinamento). Dois dias após realizaram o mesmo processo anterior,no entanto com TRP configurado para RML. O tratamento estatístico mostrou que não houve diferenças significativas (p>0,05) entre os resultados de pré e pós-treinamento nas variáveis PH, DC e G (teste ‘t’ de Student). A interação entre os fatores tipo de treinamento (AVM e RML) e momento da pesagem (pré e pós-treinamento) não foi significativa (ANOVA bifatorial 2x2) sendo que os resultados de PH, DC e G não dependem do treinamento de AVM ou RML. A correlação linear de Pearson mostrou-se significativa (r≥0,94) entre os valores de pré e póstreinamento.Concluiu-se que o TRP não tem efeitos sobre os resultados de PH, DC e G independentemente do tipo de treinamento executado, assim a pesagem hidrostática pode ser realizada antes ou após o TRP sem modificações significativas nos resultados

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