RESUMO
OBJECTIVE: Childhood maltreatment is extremely harmful to health, especially in relation to development of the psychiatric disorders throughout life. The objective of this study was to describe the prevalence and types of maltreatment in a sample of adolescent schoolchildren and to investigate associations between maltreatment types and anxiety and depressive symptoms, sociodemographic variables, and risk behaviors. The study also identified which variables were the greatest predictors of anxiety and depressive symptoms. METHODS: We conducted a cross-sectional study with a sample of 654 school students aged 11 to 17 years. We collected sociodemographic data and administered the Revised Child Anxiety and Depression Scale (RCADS-47) to measure anxiety and depressive symptoms as well as the Childhood Trauma Questionnaire (CTQ) to evaluate maltreatment and adverse experiences such as abuse and negligence during childhood and adolescence. Statistical analyses were conducted to estimate correlations between sociodemographic data, anxiety, depression, and types of maltreatment. A regression analysis was also conducted to identify maltreatment types that predict psychological symptoms. RESULTS: Emotional abuse and emotional neglect were the most prevalent types of maltreatment. Statistically, emotional abuse was the maltreatment type most strongly correlated with depression and anxiety and tended to co-occur with other types of maltreatment. Additionally, emotional and sexual abuse were the greatest predictors of anxiety and depression in adolescents. CONCLUSION: The above results reinforce the findings of previous studies in terms of understanding the effects of maltreatment. They identify emotional abuse as the main predictor of depressive and anxiety symptoms.
Assuntos
Maus-Tratos Infantis , Depressão , Testes Psicológicos , Autorrelato , Humanos , Adolescente , Criança , Depressão/epidemiologia , Estudos Transversais , Inquéritos e Questionários , Ansiedade/epidemiologia , Maus-Tratos Infantis/psicologia , Assunção de RiscosRESUMO
Abstract Objective Childhood maltreatment is extremely harmful to health, especially in relation to development of the psychiatric disorders throughout life. The objective of this study was to describe the prevalence and types of maltreatment in a sample of adolescent schoolchildren and to investigate associations between maltreatment types and anxiety and depressive symptoms, sociodemographic variables, and risk behaviors. The study also identified which variables were the greatest predictors of anxiety and depressive symptoms. Methods We conducted a cross-sectional study with a sample of 654 school students aged 11 to 17 years. We collected sociodemographic data and administered the Revised Child Anxiety and Depression Scale (RCADS-47) to measure anxiety and depressive symptoms as well as the Childhood Trauma Questionnaire (CTQ) to evaluate maltreatment and adverse experiences such as abuse and negligence during childhood and adolescence. Statistical analyses were conducted to estimate correlations between sociodemographic data, anxiety, depression, and types of maltreatment. A regression analysis was also conducted to identify maltreatment types that predict psychological symptoms. Results Emotional abuse and emotional neglect were the most prevalent types of maltreatment. Statistically, emotional abuse was the maltreatment type most strongly correlated with depression and anxiety and tended to co-occur with other types of maltreatment. Additionally, emotional and sexual abuse were the greatest predictors of anxiety and depression in adolescents. Conclusion The above results reinforce the findings of previous studies in terms of understanding the effects of maltreatment. They identify emotional abuse as the main predictor of depressive and anxiety symptoms.
RESUMO
INTRODUCTION: Major depressive disorder (MDD) is a prevalent, debilitating and disabling disorder, and its prevalence is increasing. Antidepressants (AD), cognitive-behavioral therapy (CBT) and behavioral activation (BA) are the main treatments for MDD. Trial-based cognitive therapy (TBCT) addresses and restructures dysfunctional negative core beliefs (CBs) and is a novel and promising approach. OBJECTIVE: The aim of this study was to compare the efficacy of TBCT, BA and treatment as usual (TAU) in the treatment of MDD. METHODS: A total of 76 patients with MDD were randomized into 1 of 3 groups and evaluated at baseline, after 6 weeks and at week 12 (final evaluation). The primary outcome was changing in HAM-D scores, and the secondary outcomes included scores on the BDI, CD-Quest, Sheehan Disability Scale (SDS) and WHOQOL. RESULTS: Both TBCT and BA (which also included AD) were different from TAU (which included antidepressants alone) in reducing the HAM-D and BDI scores and other measures. TBCT and BA were different from TAU in the reduction of disability in SDS and WHOQOL physical domain scores. Besides limited by a small sample size, the dropout rate in the TAU arm was higher, and only 10 patients completed the 3 evaluations. CONCLUSION: This trial provides evidence that TBCT and BA combined with antidepressants were more efficacious than the TAU (drug alone) in reducing the severity of depressive symptoms and disability, showing that this combination can be useful for clinical practice.
Assuntos
Terapia Cognitivo-Comportamental/métodos , Transtorno Depressivo Maior/terapia , Adulto , Antidepressivos/uso terapêutico , Terapia Combinada/métodos , Transtorno Depressivo Maior/tratamento farmacológico , Feminino , Humanos , MasculinoRESUMO
Abstract Although there are international data on the prevalence of behavioral problems through childhood/adolescence, there is still a need to explore emotional/behavioral problems experienced by Brazilian adolescents, especially in situations of extreme social problems or social vulnerability (SV). This is an observational, cross-sectional study, carried out with a convenience sample, to describe emotional/behavioral problems of adolescents living in a high SV scenario in the city of Salvador-BA, from their parents or guardians' point of view. Sociodemographic questionnaire and CBCL/6-18 were applied to a sample of 274 adolescents' parents/guardians. Data analysis found that 20.4% of the sample had problems in the clinical range for CBCL's Total Problems. Sociodemographic variables can impact behavioral problems in adolescence and need to be investigated. This study adds new data on child and youth psychopathologies at the national level and can promote preventive actions and referrals aimed at this population.
Resumo Mesmo diante de dados internacionais sobre prevalência de problemas de comportamento durante a infância/adolescência, ainda há necessidade de explorar problemas emocionais/comportamentais vivenciados pelos adolescentes brasileiros, especialmente em situações de altos problemas sociais ou de vulnerabilidade social (VS). Foi realizado estudo observacional, transversal, com amostra de conveniência, que teve por objetivo descrever os problemas emocionais/comportamentais apresentados por adolescentes que vivem em um contexto de alta VS na cidade de Salvador-BA, a partir do ponto de vista de seus pais ou responsáveis. Foram aplicados questionário sociodemográfico e CBCL/6-18 numa amostra de 274 pais/responsáveis pelos adolescentes. Análises dos dados obtidos indicaram que 20,4% da amostra apresentaram problemas na faixa clínica para escala total do instrumento. Variáveis sociodemográficas podem influenciar os problemas de comportamento na adolescência, necessitando ser investigadas. Este estudo colabora com novos dados sobre psicopatologias infanto-juvenis em âmbito nacional, o que possibilita criar ações preventivas e encaminhamentos voltados para esta população.
Resumen Aún cuando existan datos internacionales sobre la prevalencia de problemas de conducta durante la infancia/adolescencia, aún es necesario explorar los problemas emocionales/de conducta que experimentan los adolescentes brasileños, especialmente en contextos de alta vulnerabilidad social (VS). Se realizó un estudio observacional de conveniencia transversal para describir los problemas emocionales/conductuales presentados por adolescentes, de 11 a 17 años, que viven en un contexto de alta vulnerabilidad social en la ciudad de Salvador-BA, desde el punto de vista de los padres/tutores. Se aplicó un cuestionario sociodemográfico y el CBCL/6-18 a una muestra de 274 padres/tutores de adolescentes. El análisis de los datos indicó que el 20.4% de la muestra tenía problemas en el rango clínico en la escala completa del instrumento. Las variables sociodemográficas pueden influir en los problemas de conducta en la adolescencia y deben investigarse. Este estudio colabora con nuevos datos sobre las psicopatologías infantiles y juveniles en todo el país, lo que permite crear acciones preventivas y referencias dirigidas a esa población.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Pais , Problemas Sociais , Saúde Mental , Estudos Transversais , Inquéritos e Questionários , Comportamento Problema , Transtornos MentaisRESUMO
INTRODUCTION:: Chagas disease currently affects 5.7 million people in Latin America and is emerging in non-endemic countries. There is no consensus concerning the efficacy of trypanocidal therapy for patients with the chronic form of the disease. We evaluated cardiac function and sociodemographic, clinical, and serologic characteristics of a group of asymptomatic Trypanosoma cruzi-seropositive former blood donors, and compared the effects of benznidazole treatment applied for different lengths of time. METHODS:: Blood donors who screened positive for T. cruzi between 1998 and 2002 were recruited 10 years later for follow-up (n = 244); 46 individuals had received treatment. Three subjects had terminated treatment prematurely. The remaining 43 individuals were divided into two groups: individuals who had received benznidazole therapy for 50-60 days (n = 28; BT ≤60 group) or more than 60 days (n = 15; BT >60). Serologic assays, biochemical tests, electrocardiographic, echocardiographic, and clinical examinations were performed on all participants. Parasite loads were determined by qualitative and quantitative polymerase chain reaction. RESULTS:: Parasitemia was significantly reduced in the BT ≤60 and BT >60 groups compared with the untreated group. There were no differences in epidemiologic profiles or clinical, biochemical, electrocardiographic, or echocardiographic data between any of the groups. CONCLUSIONS:: Despite elimination or significant reduction in parasitemia in patients with chronic Chagas disease who received benznidazole, there was no clinical difference between those who were treated for >60 days and those treated for a shorter duration. Furthermore, the adverse effects of benznidazole appear to be less severe than previous reports would suggest.
Assuntos
Doadores de Sangue , Doença de Chagas/tratamento farmacológico , Nitroimidazóis/administração & dosagem , Parasitemia/parasitologia , Tripanossomicidas/administração & dosagem , Adulto , Infecções Assintomáticas , Doença de Chagas/parasitologia , Doença Crônica , Protocolos Clínicos , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Carga Parasitária , Reação em Cadeia da Polimerase , Fatores de Tempo , Resultado do TratamentoRESUMO
Abstract: INTRODUCTION: Chagas disease currently affects 5.7 million people in Latin America and is emerging in non-endemic countries. There is no consensus concerning the efficacy of trypanocidal therapy for patients with the chronic form of the disease. We evaluated cardiac function and sociodemographic, clinical, and serologic characteristics of a group of asymptomatic Trypanosoma cruzi-seropositive former blood donors, and compared the effects of benznidazole treatment applied for different lengths of time. METHODS: Blood donors who screened positive for T. cruzi between 1998 and 2002 were recruited 10 years later for follow-up (n = 244); 46 individuals had received treatment. Three subjects had terminated treatment prematurely. The remaining 43 individuals were divided into two groups: individuals who had received benznidazole therapy for 50-60 days (n = 28; BT ≤60 group) or more than 60 days (n = 15; BT >60). Serologic assays, biochemical tests, electrocardiographic, echocardiographic, and clinical examinations were performed on all participants. Parasite loads were determined by qualitative and quantitative polymerase chain reaction. RESULTS: Parasitemia was significantly reduced in the BT ≤60 and BT >60 groups compared with the untreated group. There were no differences in epidemiologic profiles or clinical, biochemical, electrocardiographic, or echocardiographic data between any of the groups. CONCLUSIONS: Despite elimination or significant reduction in parasitemia in patients with chronic Chagas disease who received benznidazole, there was no clinical difference between those who were treated for >60 days and those treated for a shorter duration. Furthermore, the adverse effects of benznidazole appear to be less severe than previous reports would suggest.
Assuntos
Humanos , Masculino , Feminino , Adulto , Tripanossomicidas/administração & dosagem , Doadores de Sangue , Doença de Chagas/tratamento farmacológico , Parasitemia/parasitologia , Nitroimidazóis/administração & dosagem , Fatores de Tempo , Protocolos Clínicos , Reação em Cadeia da Polimerase , Doença Crônica , Estudos Transversais , Resultado do Tratamento , Doença de Chagas/parasitologia , Infecções Assintomáticas , Carga Parasitária , Pessoa de Meia-IdadeRESUMO
Resumo Descreve-se no estudo o perfil da população idosa e urbana assistida pela Estratégia de Saúde da Família em Teófilo Otoni, MG, e investiga-se fatores associados à prevalência de doenças. Em amostragem aleatória simples, 385 idosos foram entrevistados com base na Ficha A e Ficha do Idoso do Sistema de Informação de Atenção Básica. Dentre os idosos, 83,1% reportaram ter pelo menos uma doença, 69,9% eram hipertensos e 17,7% diabéticos. Análises de regressão de Poisson detectaram que os principais fatores associados à hipertensão e outras doenças foram cor de pele não branca, baixa escolaridade, consumo de medicamentos, uso de prótese dentária e necessidade do serviço público de saúde; já a diabetes foi associada ao sexo feminino e dependência de terceiros. Conclui-se que os idosos da comunidade estudada que apresentam características indicadoras de baixo nível socioeconômico e cultural são mais susceptíveis ao desenvolvimento de doenças, particularmente hipertensão. Embora o índice de diabetes tenha sido mais baixo, essa doença requer controle. Sugere-se investimentos na estruturação da rede de serviços de saúde ofertados para a população de idosos e preparação de profissionais da saúde para que possam atuar efetivamente na melhoria da qualidade de vida do idoso brasileiro.
Abstract The profile of a sample population of elderly receiving treatment under the Family Health Strategy in the municipality of Teófilo Otoni, State of Minas Gerais, Brazil, is described, and the factors associated with diseases prevalence examined. Using simple random sampling, 385 elderly were interviewed using Form A and Elderly Form from the Primary Health Care Information System. The majority of the sample (83.1%) self-reported at least one disease, 69.9% had hypertension, and 17.7% had diabetes. Poisson regression analysis showed that the main factors associated with hypertension and other diseases were being non-white, having a low level of education, medication use, dental prosthesis use, and lack of a private health plan. The prevalence of diabetes was greater among women and individuals who depended on other people to live. It can be concluded that this sample population of elderly has a generally low socioeconomic status and are more susceptible to developing diseases, particularly hypertension. Diabetes should be controlled although had relatively low prevalence. It is suggested investments in structuring the health system network to provide adequate care for the elderly and in training health professionals to play an effective role in improving the quality of life of the elderly in Brazil.
Assuntos
Humanos , Masculino , Feminino , Idoso , Saúde da Família , Doença Crônica/epidemiologia , Atenção Primária à Saúde , Qualidade de Vida , Fatores Socioeconômicos , Brasil/epidemiologiaRESUMO
The profile of a sample population of elderly receiving treatment under the Family Health Strategy in the municipality of Teófilo Otoni, State of Minas Gerais, Brazil, is described, and the factors associated with diseases prevalence examined. Using simple random sampling, 385 elderly were interviewed using Form A and Elderly Form from the Primary Health Care Information System. The majority of the sample (83.1%) self-reported at least one disease, 69.9% had hypertension, and 17.7% had diabetes. Poisson regression analysis showed that the main factors associated with hypertension and other diseases were being non-white, having a low level of education, medication use, dental prosthesis use, and lack of a private health plan. The prevalence of diabetes was greater among women and individuals who depended on other people to live. It can be concluded that this sample population of elderly has a generally low socioeconomic status and are more susceptible to developing diseases, particularly hypertension. Diabetes should be controlled although had relatively low prevalence. It is suggested investments in structuring the health system network to provide adequate care for the elderly and in training health professionals to play an effective role in improving the quality of life of the elderly in Brazil.
Assuntos
Doença Crônica/epidemiologia , Saúde da Família , Idoso , Brasil/epidemiologia , Feminino , Humanos , Masculino , Atenção Primária à Saúde , Qualidade de Vida , Fatores SocioeconômicosRESUMO
OBJECTIVE: In order to support plans and actions that combat the local increasing overweight and obesity prevalence in adolescents, the factors associated to weight excess in public school students from Montes Claros, MG, Southeast Brazil, were studied. METHODS: Cross-sectional study with a sample of adolescents from the public schools of the city. The nutritional status was evaluated and an inquiry was carried out in the schools to determine food consumption and practice of physical activities. Factors associated to weight excess were assessed by bivariate analysis followed by logistic regression. RESULTS: Weight excess prevalence was detected in 18.5% of the 535 adolescents evaluated. The factors associated to weight excess were: per capita income above half minimum wage (OR 1.99; 95%CI 1.01-3.93), candy consumption above two daily portions (OR 1.94; 95%CI 1.13-3.32) and absence of sport activity during leisure time (OR 2.54; 95%CI 1.15-5.59). CONCLUSIONS: The proportion of weight excess in adolescents from public schools is relevant and associated with socioeconomic condition of the family, bad eating habits and sedentary life.
Assuntos
Sobrepeso/epidemiologia , Adolescente , Brasil , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Logradouros Públicos , Setor Público , Fatores de Risco , Instituições AcadêmicasRESUMO
OBJECTIVE: to identify the dietary patterns of adolescents attending public municipal schools in Northern Minas Gerais, Brazil, and to test the association between these patterns and socioeconomic variables and nutritional status of the adolescents. METHODS: this was an analytical, cross-sectional study with randomized sample of 474 adolescents of both genders, between 11 and 17 years of age, attending municipal public schools in the urban area of Montes Claros, MG, Brazil. The parents provided demographic and economic data. The nutritional status (body mass index - BMI) of the adolescents was determined at school, and their dietary habits were assessed though the administration of the Food Frequency Questionnaire for Adolescents (FFQA). Based on 26 categories extracted from FFQA, dietary patterns were determined using principal component analysis (PCA) and associated to anthropometric and socioeconomic factors using multiple regression analysis. RESULTS: the three dietary patterns identified, "junk food," "healthy," and "traditional", explained 23.26%, 6.90%, and 5.24% of data variability, respectively. Adolescents with per capita family income exceeding half a minimum wage were more likely to consume the "junk food" pattern (OR = 1.66; 95% CI = 1.07-2.56), and overweight adolescents had lower chances of eating the "healthy" food pattern (OR = 0.56, 95% CI = 0.35-0.91). CONCLUSIONS: deviations from the "healthy" patterns were not associated to low income, but rather to bad eating habits in the studied population. Overweight adolescents did not adhere to the "healthy" dietary pattern, emphasizing the need for nutritional education among them. .
OBJETIVOS: identificar os padrões de consumo alimentar de adolescentes de escolas públicas do norte de Minas Gerais e testar a associação desses padrões com variáveis socioeconômicas e estado nutricional. MÉTODOS: estudo analítico e transversal com amostra aleatória de 474 adolescentes de ambos os sexos, 11 a 17 anos de idade, matriculados do 6º ao 9º ano de escolas públicas municipais da zona urbana de Montes Claros, MG. Os pais forneceram informações demográficas e econômicas. Nas escolas, avaliou-se o estado nutricional dos adolescentes (índice de massa corporal - IMC) e investigou-se seus hábitos alimentares aplicando-se um Questionário de Frequência Alimentar para Adolescentes (QFAA). Com base em 26 categorias de alimentos extraídas do QFAA, aplicou-se uma análise fatorial de componentes principais (ACP) para identificar os padrões alimentares, que foram associados a fatores antropométricos e socioeconômicos por análise de regressão múltipla. RESULTADOS: os três padrões alimentares identificados, ''junk food'', ''saudável'' e ''tradicional'', explicaram 23,26%, 6,90% e 5,24% da variabilidade dos dados, respectivamente. Adolescentes com renda familiar per capita superior a 1/2 salário mínimo apresentaram maior chance de aderir ao padrão ''junk food'' (OR = 1,66; IC 95% = 1,07-2,56), enquanto aqueles com excesso de peso possuíram menor chance de aderir ao padrão ''saudável'' (OR = 0,56; IC95% = 0,35-0,91). CONCLUSÕES: desvios do padrão alimentar ''saudável'' não estão relacionados à baixa renda, mas sim aos maus hábitos alimentares da população estudada. Adolescentes com sobrepeso não aderiram ao padrão ''saudável'', reforçando a necessidade da implementação ...
Assuntos
Adolescente , Criança , Feminino , Humanos , Masculino , Comportamento Alimentar , Instituições Acadêmicas/estatística & dados numéricos , Estudantes/estatística & dados numéricos , Índice de Massa Corporal , Brasil/epidemiologia , Estudos Transversais , Dieta/efeitos adversos , Dieta/classificação , Análise Fatorial , Estado Nutricional , Obesidade/epidemiologia , Análise de Regressão , Fatores Socioeconômicos , Inquéritos e Questionários , População Urbana/estatística & dados numéricosRESUMO
In order to support plans and actions that combat the local increasing overweight and obesity prevalence in adolescents, the factors associated to weight excess in public school students from Montes Claros, MG, Southeast Brazil, were studied. METHODS: Cross-sectional study with a sample of adolescents from the public schools of the city. The nutritional status was evaluated and an inquiry was carried out in the schools to determine food consumption and practice of physical activities. Factors associated to weight excess were assessed by bivariate analysis followed by logistic regression. RESULTS: Weight excess prevalence was detected in 18.5% of the 535 adolescents evaluated. The factors associated to weight excess were: per capita income above half minimum wage (OR 1.99; 95%CI 1.01-3.93), candy consumption above two daily portions (OR 1.94; 95%CI 1.13-3.32) and absence of sport activity during leisure time (OR 2.54; 95%CI 1.15-5.59). CONCLUSIONS: The proportion of weight excess in adolescents from public schools is relevant and associated with socioeconomic condition of the family, bad eating habits and sedentary life...
A fin de subsidiar planes y acciones de combate local a la creciente prevalencia de sobrepeso y obesidad en adolescentes, se evaluaron los factores asociados al exceso de peso en estudiantes de la red pública de enseñanza en la ciudad de Montes Claros, Minas Gerais. MÉTODOS: Estudio transversal con muestra de adolescentes de la red pública de enseñanza municipal. Se evaluó el estado nutricional y, mediante un cuestionario en ambiente escolar, se determinó el consumo alimentar y la práctica de ejercicios físicos. Para identificar los factores asociados al exceso de peso, se realizaron análisis bivariadas seguidas de regresión logística, adoptándose el nivel de significancia de 5%. RESULTADOS: Se evaluaron 535 adolescentes, en los que la prevalencia de exceso de peso fue de 18,5%. Los factores asociados a la ocurrencia del exceso de peso fueron: ingreso per cápita superior a medio sueldo mínimo (OR 1,99; IC95% 1,01-3,93), consumo de dulces superior a dos porciones diarias (OR 1,94; IC95% 1,13-3,32) y ausencia de práctica de deportes en el tiempo de ocio (OR 2,54; IC95% 1,15-5,59). CONCLUSIONES: El exceso de peso tiene proporción relevante en adolescentes de escuelas públicas, asociándose a la condición socioeconómica de las familias, a los malos hábitos alimentares y al sedentarismo...
OBJETIVO: A fim de subsidiar planos e ações de combate local à crescente prevalência de sobrepeso e obesidade em adolescentes, avaliaram-se os fatores associados ao excesso de peso em estudantes da rede pública de ensino na cidade de Montes Claros, MG. MÉTODOS: Estudo transversal com amostra de adolescentes da rede pública de ensino municipal. Avaliou-se o estado nutricional e, por meio de inquérito em ambiente escolar, determinou-se o consumo alimentar e a prática de exercícios físicos. Para identificar os fatores associados ao excesso de peso, realizaram-se análises bivariadas seguidas de regressão logística. RESULTADOS: Avaliaram-se 535 adolescentes, nos quais a prevalência de excesso de peso foi de 18,5%. Os fatores associados à ocorrência do excesso de peso foram: renda per capita superior a meio salário mínimo (OR 1,99; IC95% 1,01-3,93), consumo de doces superior a duas porções diárias (OR 1,94; IC95% 1,13-3,32) e ausência de prática de esporte no tempo de lazer (OR 2,54; IC95% 1,15-5,59). CONCLUSÕES: O excesso de peso tem proporção relevante em adolescentes de escolas públicas, associando-se à condição socioeconômica das famílias, aos maus hábitos alimentares e ao sedentarismo...
Assuntos
Humanos , Masculino , Feminino , Adolescente , Avaliação Nutricional , Obesidade/epidemiologia , Índice de Massa CorporalRESUMO
The study showed the effectiveness of photodynamic therapy based on methylene blue to treat severe distal and lateral subungual toenail onychomycosis. 22 patients were divided into two groups: group A consisting of 11 patients with severe toenail onychomycosis and group B consisting of 11 patients with mild-to-moderate toenail onychomycosis. All patients had onychomycosis caused by Trichophyton rubrum. The patients were treated with sessions of 2% methylene blue aqueous solution irradiated with light emission diode device with 630 nm and 36 J/cm2 biweekly for six months. The clinical response was significantly better in patients with mild-to-moderate (100%) onychomycosis compared with patients with severe onychomycosis (63.6%).
Assuntos
Dermatoses do Pé/tratamento farmacológico , Azul de Metileno/uso terapêutico , Onicomicose/tratamento farmacológico , Fotoquimioterapia/métodos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Onicomicose/microbiologia , Índice de Gravidade de Doença , Resultado do Tratamento , TrichophytonRESUMO
OBJECTIVE: to identify the dietary patterns of adolescents attending public municipal schools in Northern Minas Gerais, Brazil, and to test the association between these patterns and socioeconomic variables and nutritional status of the adolescents. METHODS: this was an analytical, cross-sectional study with randomized sample of 474 adolescents of both genders, between 11 and 17 years of age, attending municipal public schools in the urban area of Montes Claros, MG, Brazil. The parents provided demographic and economic data. The nutritional status (body mass index - BMI) of the adolescents was determined at school, and their dietary habits were assessed though the administration of the Food Frequency Questionnaire for Adolescents (FFQA). Based on 26 categories extracted from FFQA, dietary patterns were determined using principal component analysis (PCA) and associated to anthropometric and socioeconomic factors using multiple regression analysis. RESULTS: the three dietary patterns identified, "junk food," "healthy," and "traditional", explained 23.26%, 6.90%, and 5.24% of data variability, respectively. Adolescents with per capita family income exceeding half a minimum wage were more likely to consume the "junk food" pattern (OR=1.66; 95% CI=1.07-2.56), and overweight adolescents had lower chances of eating the "healthy" food pattern (OR=0.56, 95% CI=0.35-0.91). CONCLUSIONS: deviations from the "healthy" patterns were not associated to low income, but rather to bad eating habits in the studied population. Overweight adolescents did not adhere to the "healthy" dietary pattern, emphasizing the need for nutritional education among them.
Assuntos
Comportamento Alimentar , Instituições Acadêmicas/estatística & dados numéricos , Estudantes/estatística & dados numéricos , Adolescente , Índice de Massa Corporal , Brasil/epidemiologia , Criança , Estudos Transversais , Dieta/efeitos adversos , Dieta/classificação , Análise Fatorial , Feminino , Humanos , Masculino , Estado Nutricional , Obesidade/epidemiologia , Análise de Regressão , Fatores Socioeconômicos , Inquéritos e Questionários , População Urbana/estatística & dados numéricosRESUMO
This study sought to identify the prevalence of excess weight and food consumption patterns among adolescents attending public schools in northern Minas Gerais state. A cross-sectional study was conducted with a random and representative sample of adolescents. Demographic and economic data were collected. Food consumption was evaluated by applying a semi-quantitative food questionnaire. Body weight and height were measured to assess the nutritional status based on the Body Mass Index (BMI) by Age. The sexes were compared by Student's t test (comparison of samples) and chi-square test (goodness of fit) at a level of significance of p <0.05. 535 adolescents were evaluated and prevalence of excess weight was detected in 18.5% of the group. BMI (p = 0,001) was statistically different between the sexes and higher for girls. The average energy consumption of the group was 3096.30 kcal/day. Fiber consumption was insufficient in 35% of the adolescents, vitamin A and calcium in 80% and unsaturated fats in 100%. Carbohydrate and cholesterol were consumed in excess by 20.6% and 48%, respectively. The prevalence of excess weight and inadequate food consumption is of great concern for the population studied and requires appropriate nutritional intervention.
Assuntos
Ingestão de Alimentos , Sobrepeso/epidemiologia , Adolescente , Pesos e Medidas Corporais , Brasil , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Setor Público , Instituições AcadêmicasRESUMO
Este estudo objetivou identificar a prevalência excesso de peso e o consumo alimentar entre adolescentes de rede pública de ensino ao norte de Minas Gerais. Desenvolveu-se estudo transversal com amostra aleatória e representativa de adolescentes. Foram coletadas informações demográficas e econômicas. O consumo alimentar foi avaliado pela aplicação de questionário semiquantitativo. Aferiu-se peso e altura para avaliação do estado nutricional com base no Índice de Massa Corporal (IMC) por Idade. A comparação entre os gêneros foi conduzida por meio do teste t de Student (médias) ou qui-quadrado (proporções), assumindo-se um nível de significância de p < 0,05. Foram avaliados 535 adolescentes e registrada uma prevalência de excesso de peso para 18,5%. Houve diferença significativa entre os gêneros para o IMC (p = 0,001), maior entre as meninas. O consumo médio de energia foi de 3.096,30kcal/dia. Observou-se consumo insuficiente de fibras em 35% dos adolescentes, de cálcio e vitamina A em 80% e gorduras insaturadas em 100%. Carboidratos e colesterol eram consumidos em excesso por 20,6% e 48%, respectivamente. A prevalência do excesso de peso e o consumo alimentar inadequado mostrou-se preocupante para a população estudada e demandam adequada intervenção nutricional. .
This study sought to identify the prevalence of excess weight and food consumption patterns among adolescents attending public schools in northern Minas Gerais state. A cross-sectional study was conducted with a random and representative sample of adolescents. Demographic and economic data were collected. Food consumption was evaluated by applying a semi-quantitative food questionnaire. Body weight and height were measured to assess the nutritional status based on the Body Mass Index (BMI) by Age. The sexes were compared by Student's t test (comparison of samples) and chi-square test (goodness of fit) at a level of significance of p <0.05. 535 adolescents were evaluated and prevalence of excess weight was detected in 18.5% of the group. BMI (p = 0,001) was statistically different between the sexes and higher for girls. The average energy consumption of the group was 3096.30 kcal/day. Fiber consumption was insufficient in 35% of the adolescents, vitamin A and calcium in 80% and unsaturated fats in 100%. Carbohydrate and cholesterol were consumed in excess by 20.6% and 48%, respectively. The prevalence of excess weight and inadequate food consumption is of great concern for the population studied and requires appropriate nutritional intervention. .
Assuntos
Adolescente , Criança , Feminino , Humanos , Masculino , Ingestão de Alimentos , Sobrepeso/epidemiologia , Pesos e Medidas Corporais , Brasil , Estudos Transversais , Setor Público , Instituições AcadêmicasRESUMO
BACKGROUND: In light of its epidemic proportions in developed and developing countries, obesity is considered a serious public health issue. In order to increase knowledge concerning the ability of health care professionals in caring for obese adolescents and adopt more efficient preventive and control measures, a questionnaire was developed and validated to assess non-dietitian health professionals regarding their Knowledge of Nutrition in Obese Adolescents (KNOA). METHODS: The development and evaluation of a questionnaire to assess the knowledge of primary care practitioners with respect to nutrition in obese adolescents was carried out in five phases, as follows: 1) definition of study dimensions 2) development of 42 questions and preliminary evaluation of the questionnaire by a panel of experts; 3) characterization and selection of primary care practitioners (35 dietitians and 265 non-dietitians) and measurement of questionnaire criteria by contrasting the responses of dietitians and non-dietitians; 4) reliability assessment by question exclusion based on item difficulty (too easy and too difficult for non-dietitian practitioners), item discrimination, internal consistency and reproducibility index determination; and 5) scoring the completed questionnaires. RESULTS: Dietitians obtained higher scores than non-dietitians (Mann-Whitney U test, P < 0.05), confirming the validity of the questionnaire criteria. Items were discriminated by correlating the score for each item with the total score, using a minimum of 0.2 as a correlation coefficient cutoff value. Item difficulty was controlled by excluding questions answered correctly by more than 90% of the non-dietitian subjects (too easy) or by less than 10% of them (too difficult). The final questionnaire contained 26 of the original 42 questions, increasing Cronbach's α value from 0.788 to 0.807. Test-retest agreement between respondents was classified as good to very good (Kappa test, >0.60). CONCLUSION: The KNOA questionnaire developed for primary care practitioners is a valid, consistent and suitable instrument that can be applied over time, making it a promising tool for developing and guiding public health policies.
Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Ciências da Nutrição/educação , Obesidade Infantil/diagnóstico , Médicos de Atenção Primária/psicologia , Inquéritos e Questionários/normas , Adolescente , Adulto , Brasil , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nutricionistas/psicologia , Nutricionistas/estatística & dados numéricos , Cooperação do Paciente , Obesidade Infantil/terapia , Médicos de Atenção Primária/educação , Médicos de Atenção Primária/estatística & dados numéricos , Atenção Primária à Saúde/normas , Análise de Componente Principal , Reprodutibilidade dos TestesRESUMO
BACKGROUND: The histopathology and immune responses of the healing process of leishmaniasis are still poorly studied. OBJECTIVES: This study aimed to examine the histopathological and immunological aspects of lesions of patients with cutaneous leishmaniasis before and after different therapeutic methods. METHODS: We studied 23 individuals grouped according to the treatments: Glucantime, Glucantime + Leishvacin and Glucantime + Leishvacin associated with Bacillus Calmette-Guerin. For analysis of the histopathological changes present in the dermis and epidermis, histological sections were stained with hematoxylin and eosin. The samples were immunostained before and after treatment to analyze the expression of interferon (IFN)-γ, interleukin (IL) 12, IL-10 and IL-4. RESULTS: Before treatment the presence of intense infiltrates of mononuclear cells was noticed and after treatment, even with a diagnosis of clinical cure, the subjects still showed a moderate inflammatory process. In the immunohistochemical analyses, we noticed a difference between the cytokines, with increased expression of cytokines IFN-γ and IL-12 compared to IL 10 and IL-4, both before and after treatment and, comparatively, the difference in this expression was more intense before treatment. However, the cytokine expression analyzed by treatment group showed no statistically significant difference. CONCLUSION: We conclude that a clinical cure does not always coincide with the histopathological one, and that before treatment there is a predominance of Th1 cytokines. In terms of treatment type, there was no difference in the progression of healing for all the three types of treatment, indicating their clinical equivalence.
Assuntos
Antiprotozoários/uso terapêutico , Citocinas/biossíntese , Imunoterapia Ativa/métodos , Leishmaniose , Adjuvantes Imunológicos/uso terapêutico , Adolescente , Adulto , Idoso , Vacina BCG/uso terapêutico , Criança , Feminino , Humanos , Imuno-Histoquímica , Leishmania/imunologia , Leishmaniose/tratamento farmacológico , Leishmaniose/imunologia , Leishmaniose/patologia , Vacinas contra Leishmaniose/uso terapêutico , Masculino , Meglumina/uso terapêutico , Antimoniato de Meglumina , Pessoa de Meia-Idade , Compostos Organometálicos/uso terapêutico , Estudos Retrospectivos , Resultado do Tratamento , Cicatrização/efeitos dos fármacos , Adulto JovemRESUMO
OBJECTIVE: The aim of this study was to evaluate the expression of RAS components and SIRTs enzymes in the adipose tissue of mice fed diets with different macronutrient composition. DESIGN AND METHODS: The body weight, food intake, and energy intake (kcal) were evaluated. Blood parameters (insulin sensitivity, glucose tolerance, total cholesterol, HDL-C triglyceride, and glucose levels) were also assessed. Real-time PCR was performed in epididymal adipose tissue samples to analyze the expression of renin, angiotensinogen (AGT), angiotensin-converting enzyme 1 and 2 (ACE and ACE2), and SIRTs 1-7. Male FVB/N mice were divided into 5 groups (N = 10 each) that were fed with experimental diets for 60 days. Test diets were divided into standard (ST), AIN-93M, high glucose (HG), high protein (HP) and high lipid (HL). RESULTS: The main results showed that HL diet treatment induced reduction in HDL-C and triglyceride plasma levels; increased ACE (Ang II marker) expression and decreased ACE2 (Ang-[1-7] catalyzer) expression in adipose tissue; and also increased SIRT4 expression. CONCLUSION: Diets with high lipid content induced a degenerative state associated with deregulation of adipose tissue enzymes expression.
Assuntos
Tecido Adiposo/metabolismo , Dieta Hiperlipídica/efeitos adversos , Gorduras na Dieta/administração & dosagem , Lipídeos/sangue , Peptidil Dipeptidase A/metabolismo , Sistema Renina-Angiotensina , Sirtuínas/metabolismo , Tecido Adiposo/enzimologia , Angiotensina I/metabolismo , Angiotensina II/metabolismo , Angiotensinogênio/metabolismo , Animais , HDL-Colesterol/sangue , Gorduras na Dieta/sangue , Proteínas Alimentares/administração & dosagem , Sacarose Alimentar/administração & dosagem , Glucose/administração & dosagem , Masculino , Camundongos , Camundongos Endogâmicos , Fragmentos de Peptídeos/metabolismo , Reação em Cadeia da Polimerase em Tempo Real , Renina/metabolismo , Triglicerídeos/sangueRESUMO
Assuntos
Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Antiprotozoários/uso terapêutico , Citocinas/biossíntese , Imunoterapia Ativa/métodos , Leishmaniose , Adjuvantes Imunológicos/uso terapêutico , Vacina BCG/uso terapêutico , Imuno-Histoquímica , Leishmania/imunologia , Vacinas contra Leishmaniose/uso terapêutico , Leishmaniose/tratamento farmacológico , Leishmaniose/imunologia , Leishmaniose/patologia , Meglumina/uso terapêutico , Compostos Organometálicos/uso terapêutico , Estudos Retrospectivos , Resultado do Tratamento , Cicatrização/efeitos dos fármacosRESUMO
This study shows the effectiveness of photodynamic therapy based on methylene blue dye for the treatment of endonyx toenail onychomycosis. Four patients with endonyx onychomycosis caused by Trichophyton rubrum were treated with 2% methylene blue aqueous solution irradiated with light emission diode at 630 nm and an energy density of 36 J/cm2 for 6 months at 2-week intervals. The preliminary study showed the effectiveness of this therapy in the treatment of endonyx onychomycosis, and also indicated that the disease can be caused by T. rubrum.