Introduction: Inadequate eating habits and physical inactivity directly contribute to changes in nutritional status. Patients with Down syndrome (DS) are more prone to obesity due to genetic and / or environmental factors, which favors cardiovascular diseases with the possibility of complications and reduced life expectancy. Objective: To describe the nutritional status of patients followed up at an outpatient referral center for Down's syndrome in a Brazilian tertiary hospital. Methodology: Retrospective, cross-sectional and descriptive study with analysis of 1,056 medical records of patients with DS, from 2014 to 2016. Food was considered adequate if it consisted of food from all groups in three main meals and one / two snacks and water in breaks. Sedentary lifestyle was considered if the time of physical activity was less than 300 minutes per week. Nutritional status was assessed using the World Health Organization (WHO) body mass index curves, 2007. The data were analyzed using the Excel program. The Pearson's chi-square test was used to compare data from children and adolescents. The level of significance was set at p <0.05. Approved by the Human Research Ethics Committee of the service referred to under number 04542712.3.0000.0096. Results: 517 children (3 to 9 years, 11 months and 29 days) and 539 adolescents (10 to 20 years of age) were evaluated. Food was adequate for 395 (76.4%) children and 336 (62.3%) adolescents (p <0.001). The nutritional status was adequate in 397 (76.8%) children and 371 (68.8%) adolescents, overweight was seen in 40 (8%) children and 64 (12%) adolescents (p <0.01); obesity in 50 (9.7%) children and 96 (17.8%) adolescents (p <0.001) and thinness in 30 (5.8%) children and 8 (1.5%) adolescents (p <0.001). As for physical activity, 39 (7.5%) children and 168 (31.1%) adolescents (p <0.001) were sedentary. Discussion and Conclusion: There was an association of increased body mass index with inadequate diet and physical inactivity with increasing age of patients. Individuals with DS, children and adults, are 30 to 50% susceptible to becoming obese in childhood. According to the classic literature, the presence of hypothyroidism, food error and physical inactivity are associated with overweight and obesity in this population. The prevalence of overweight and obesity in children with intellectual disabilities is almost twice as high as in peers without disabilities. And it is observed that people with DS are less involved in physical activities compared to their siblings. For adolescents, behavioral problems such as impulsiveness, recommendation behavior and disobedience discourage good lifestyle habits. Food inadequacy and physical inactivity were more prevalent in the adolescent population. The body mass index increases the age, therefore the consolidation according to the good practices of life habits requires continuous education of the family and the individual. Multidisciplinary monitoring is essential for the prevention of overweight and obesity.
RESUMO: Objetivo: Descrever e comparar hábito nutricional, prática de atividade física e índice de massa corporal (IMC) de crianças e adolescentes com síndrome de Down acompanhados em ambulatório especializado de um hospital terciário no sul do Brasil. Método: Estudo transversal realizado a partir da análise de prontuário de pacientes com síndrome de Down em idade escolar e adolescentes acompanhados em ambulatório especializado do Complexo Hospital de Clínicas da Universidade Federal do Paraná. A alimentação foi considerada adequada se consistisse em alimentos de todos os grupos nas três refeições principais e um ou dois lanches e água nos intervalos. Sedentarismo foi definido como tempo de atividade física inferior a 300 minutos por semana. O estado nutricional foi avaliado usando as curvas de IMC da Organização Mundial da Saúde, 2007. Resultados: O estudo incluiu 755 pacientes, sendo 236 (31,3%) crianças e 519 (68,7%) adolescentes. Sobrepeso e obesidade foram observados em 10,7% e 14,8% da população, respectivamente, sem diferença significativa entre os gêneros. Alimentação inadequada foi observada em 34,6% e sedentarismo em 23,7% dos pacientes. IMC elevado foi observado em 20,3% das crianças e 27,9% dos adolescentes (p=0,026). Observou-se sedentarismo em 29,5% dos adolescentes e 11% das crianças (p<0,001). Alimentação inadequada também foi mais prevalente em adolescentes, porém sem diferença estatística. Pacientes com IMC elevado, em comparação com eutróficos, tiveram maior prevalência de alimentação inadequada e sedentarismo, com significância estatística. Nesse subgrupo, o sedentarismo foi observado em 25% das crianças e 57,2% dos adolescentes (p<0,001). Conclusão: Adolescentes com síndrome de Down apresentam maiores taxas de IMC elevado e sedentarismo comparados com crianças. Estudos específicos em educação em saúde para essa população são necessários com o objetivo de promover hábitos de vida saudáveis e prevenir a obesidade com efetividade.
Introduction: Skin cancer is the most prevalent cancer in Brazil and responsible for a significant portion of diagnosed malignant tumors. The study of the prevalence of the disease is crucial to a better understanding of its distribution and its impact on the population. Objective: To describe the epidemiology of skin cancer in a tertiary reference hospital for cancer treatment in southern Brazil. Methodology: Observational, descriptive and cross-sectional study carried out from the analysis of the Hospital Cancer Registry of a reference center for cancer in southern Brazil. Qualitative variables were described by absolute and relative frequencies and compared using the Chi-Square test. Epidemiological variables were analysed from a time frame from 2010 to 2014 and the study of survival from a cut from 2005 to 2009. Survival rates were calculated using the Kaplan-Meier method and compared using the Long-Rank test. For all tests, a significance level of 5% was considered. Results: 2224 cases of skin cancer were diagnosed and treated between 2010 and 2014, being 1961 (88.2%) cases of non-melanoma cancer (NMC) and 263 (11.8%) of melanoma cancer (MC). Among men, the age group between 60 and 69 years had the highest proportion of the diagnosis (29.2%), while among women the most affected age group was above 75 years (38.9%). Males accounted for 51.3% of the cases of NMC, but 40.7% of the cases of MC (p < 0.01). The face was the affected site in 70.2% of the cases of NMC and 14.8% of the cases of MC (p < 0.001). Overall survival in the MC was 94.1% in the first year, 85.9% in the second and 71.2% in the fifth (p < 0.001); for NMC, these values were 95.6%, 89.4% and 77.8% respectively (p < 0.001). In the MC, survival among men dropped from 88.5% in the first year to 51.2% in the fifth year, while for women the reduction was from 95.7% to 83.4% (p ≤ 0.001). In the NMC, survival in males decreased from 96.1% to 76.0% from the first to the fifth year, and for women it decreased from 94.8% to 78.7% (p ≤ 0.664). Discussion and Conclusion: According to the prevalence of histological types already established, the proportion of NMC was higher than MC in the sample of this study. The predominant site of involvement of the NMC was the face, while the MC was more prevalent in other parts of the body. In addition, males were more frequent among cases of NMC, while females were more prevalent in MC. Furthermore, the present study showed a difference in survival between the sexes in the MC, which was lower among men, while in the NMC this difference was not significant.
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