Objective:To investigate the association between serum uric acid levels and insulin resistance in children and adolescents with obesity.Methods:Cross-sectional study with 245 children and adolescents (134 obese and 111 controls), aged 8-18 years. The anthropometric variables (weight, height and waist circumference), blood pressure and biochemical parameters were collected. The clinical characteristics of the groups were analyzed by t-test or chi-square test. To evaluate the association between uric acid levels and insulin resistance the Pearson's test and logistic regression were applied.Results:The prevalence of insulin resistance was 26.9%. The anthropometric variables, systolic and diastolic blood pressure and biochemical variables were significantly higher in the obese group (p<0.001), except for the high-density-lipoprotein cholesterol. There was a positive and significant correlation between anthropometric variables and uric acid with HOMA-IR in the obese and in the control groups, which was higher in the obese group and in the total sample. The logistic regression model that included age, gender and obesity, showed an odds ratio of uric acid as a variable associated with insulin resistance of 1.91 (95%CI 1.40-2.62; p<−0.001).Conclusions:The increase in serum uric acid showed a positive statistical correlation with insulin resistance and it is associated with and increased risk of insulin resistance in obese children and adolescents.
The living will is a document in which the patients specify their wishes regarding what treatments should be carried out if they are in terminal condition. As it is a new subject, it has been generating doubts in relation to its diffusion, social acceptance and ethical principles. Our study is aimed at verifying the knowledge of healthcare professionals about this document, and analyzing different aspects related to its legal regulation and applicability. A cross-sectional, descriptive and quantitative study was performed in a sample of 351 healthcare professionals, through the application of a survey containing 29 multiple-choice questions, 9 about the sociodemographic profile and 20 about the opinion of the interviewees regarding the document. Among the respondents, 7.98% declared they knew how to write the document, 73.79% felt safer with its regulation, and 61.82% would do it for themselves (p < 0.05). Despite not previously knowing what a living will was, the majority of the sample stated they were in favour of the document and its regulation. This result suggests a need for further discussion and disclosure on the subject in the health sector. Keywords: Advance directives. Bioethics. Critical illness. Professional practice. Resumo Testamento vital: o que pensam profissionais de saúde?O testamento vital é um documento em que os pacientes expõem suas vontades acerca de quais tratamentos serão realizados caso se encontrem em estado terminal. Por ser tema recente, tem gerado dúvidas em relação à sua difusão, aceitação social e princípios éticos. Nosso objetivo foi verificar o grau de conhecimento dos profissionais de saúde a respeito desse documento e analisar aspectos de sua regulamentação legal e aplicabilidade. Tratou-se de pesquisa transversal, descritiva e quantitativa, com 351 profissionais de saúde, mediante entrevista composta de 29 questões de múltipla escolha, 9 abrangendo o perfil sociodemográfico da amostra e 20, a opinião sobre o testamento vital. Entre os entrevistados, 7,98% declararam saber redigi--lo, 73,79% se sentiriam mais seguros com sua regulamentação e 61,82% o fariam para si próprios (p < 0,05). A maioria amostral declarou-se favorável ao documento e à sua regulamentação, apesar de desconhecê-lo previamente, o que sugere a necessidade de maior discussão e divulgação sobre o tema na área de saúde. Palavras-chave: Bioética. Diretivas antecipadas. Estado terminal. Prática profissional. ResumenTestamento vital: ¿lo que piensan profesionales de la salud? El testamento vital es un documento en el cual los pacientes exponen sus deseos acerca de qué tratamientos se realizarán si se encuentran en estado terminal. Por ser un tema reciente, ha generado dudas sobre su difusión, aceptación social y principios éticos. Nuestro objetivo consiste en verificar el grado de conocimiento de los profesionales de la salud sobre este documento y analizar aspectos de su regulación legal y aplicabilidad. Se trata de una investigación transversal, descriptiva y cuantitativa, con 351 profesionales de la sa...
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