Objective: The aim of this study was to analyze the impact of social isolation as a result of the coronavirus-19 disease (COVID-19) pandemic in children and adolescents aged 0–17 years in Southern Brazil. Methods: This is a cross-sectional study in which 542 questionnaires answered by parents or legal guardians of children and adolescents aged 0–17 years residing in the Brazilian South region, through Google Forms®. Questionnaires answered incompletely or from children outside the stipulated age group and from other regions of the country were excluded from the research. The collected data were organized into descriptive and association tables containing absolute and relative frequencies, medians, averages, standard deviations, quartile deviations, average, and proportion estimates in the form of 95% confidence intervals and the result of the chi-square test of independence. Data analysis was fulfilled with the application aid of Microsoft Excel 2016 and Epi Info version 7.2.1.0 of 01/27/2017. Statistically significant associations were considered when p<0.05. Results: There was an increase in the perception of nervousness (62.7%), anxiety (67.7%), and sadness (51.3%) in children and adolescents during the pandemic period. This study evidenced a high prevalence of screens overuse (50.9%) and sedentary lifestyle (39.1%) in this age group during the period. Furthermore, the occurrence of regressive behaviors occurred more frequently in the age group of 3–6 years (57.1%) and between 7 and 10 years (44.6%). Conclusions: It is inferred from this study that one of the implications resulting from the pandemic period is the increase of toxic stress in the pediatric population.

Introdução: As principais causas de morte em transplantados renais são doenças infecciosas e cardiovasculares, ambas muito comuns na realidade brasileira. Além dos fatores de risco convencionais, os fatores de risco específicos podem influenciar o desenvolvimento de doenças cardiovasculares nesses pacientes. Objetivos: Determinar a incidência de eventos cardiovasculares em pacientes pós-transplante renal, analisar os fatores de risco cardiovascular no primeiro, no terceiro e no quinto ano pós-transplante e caracterizar o perfil de pessoas transplantadas deste estudo. Métodos: Estudo observacional de coorte retrospectivo realizado em pacientes acima de 18 anos submetidos a transplante renal, de 2010 a 2016, acompanhados pela Associação Renal Vida, em Blumenau, Santa Catarina, Brasil. Resultados: A amostra totalizou 577 pacientes (392 do sexo masculino e 185 do sexo feminino); faixa etária média de 46,5 anos; e 157 óbitos, sendo 43 causados por doenças cardiovasculares. Observou-se que peso, índice de massa corporal e lipoproteína de alta densidade (HDL) aumentaram no primeiro ano pós-transplante e se estabilizaram após 36 meses. O colesterol aumentou no primeiro ano, manteve-se no terceiro e decaiu no quinto ano. Além disso, houve aumento de 64 pacientes portadores de diabetes mellitus após três anos do transplante, mostrando-se como fator de risco para acidente vascular cerebral, insuficiência cardíaca congestiva (ICC), doença vascular periférica e hipertrofia ventricular esquerda no terceiro ano pós-transplante. Verificou-se obesidade como fator de risco para infarto agudo do miocárdio (IAM), visto que 60% dos pacientes que apresentaram IAM possuíam índice de massa corporal > 30 kg/m2. Em contrapartida, níveis de HDL maiores que 40 parecem ser fator de proteção para hipertrofia ventricular esquerda no terceiro ano e para acidente vascular cerebral no quinto ano. Idade menor que 50 anos também parece ser fator de proteção para IAM, acidente vascular cerebral, ICC e hipertrofia ventricular esquerda nos primeiros 36 meses e para ICC após 60 meses, pois 66,67% dos pacientes com ICC nesse período tinham idade superior a 50 anos. Conclusão: Observou-se que parte dos fatores de risco para as doenças cardiovasculares é modificável. Dessa forma, manutenção de hábitos saudáveis, especialmente acima dos 50 anos, parece ser uma estratégia que pode melhorar o risco cardiovascular e a expectativa de vida pós-transplante renal.

Introduction: The main causes of death in kidney transplant recipients are infectious and cardiovascular diseases, both very common in Brazilian reality. In addition to conventional risk factors, specific risk factors may influence the development of cardiovascular disease in these patients.Objectives:To determine the incidence of cardiovascular events in post-kidney transplant patients, to analyze the cardiovascular risk factors in the first, third and fifth year post-transplant, and to characterize the profile of transplanted people in this study. Methods: Retrospective observational cohort study carried out in patients over 18 years of age who underwent kidney transplantation, from 2010 to 2016, followed up by the Associação Renal Vida, in Blumenau, Santa Catarina state,in Brazil. Results: The sample totaled 577 patients (392 males and 185 females); mean age group of 46.5 years; and 157 deaths, 43 of which were caused by cardiovascular diseases. It was observed that weight, body mass index and high-density lipoprotein (HDL) increased in the first year post-transplantation and stabilized after 36 months. Cholesterol increased in the first year, remained unchanged in the third and decreased in the fifth year. In addition, there was an increase in 64 patients with diabetes mellitus three years after transplantation, which is a risk factor for stroke, congestive heart failure (CHF), peripheral vascular disease and left ventricular hypertrophy in the third year after transplantation. Obesity was found to be a risk factor for acute myocardial infarction (AMI), since 60% of patients who had AMI had a body mass index > 30 kg/m2. In contrast, HDL levels greater than 40 seem to be a protective factor for left ventricular hypertrophy in the third year and for stroke in the fifth year. Age younger than 50 years also seems to be a protective factor for AMI, stroke, CHF and left ventricular hypertrophy in the first 36 months and for CHF after 60 months, as 66.67% of patients with CHF in this period were older than 50 years old. Conclusion: It was observed that part of the risk factors for cardiovascular diseases is modifiable. Thus, maintaining healthy habits, especially over 50 years of age, seems to be a strategy that can improve cardiovascular risk and life expectancy after kidney transplantation.

Introducción: Las principales causas de muerte en transplantados renales son enfermedades infecciosas y cardiovasculares, ambas muy comunes en la realidad brasileña. Además de los factores de riesgo convencionales, los factores de riesgo específicos pueden influenciar el desarrollo de enfermedades cardiovasculares en estos pacientes. Objetivos: Determinar la incidencia de eventos cardiovasculares en pacientes postransplante renal, analizar los factores de riesgo cardiovascular en el primer año, en el tercer año y en el quinto año postransplante y caracterizar el perfil de personas transplantadas de este estudio. Métodos: Estudio observacional de cohorte retrospectivo realizado en pacientes por encima de 18 años sometidos a transplante renal, del 2010 al 2016, seguidos por la Asociación Renal Vida, en Blumenau, Santa Catarina, Brasil. Resultados: La muestra totalizó 577 pacientes (392 del sexo masculino y 185 del sexo femenino); edad media de 46,5 años; y 157 fallecimientos, siendo 43 causados por enfermedades cardiovasculares. Se observó que peso, índice de masa corporal y lipoproteína de alta densidad (HDL) aumentaron en el primer año postransplante y se estabilizaron después de 36 meses. El colesterol aumentó en el primer año, se mantuvo en el tercer año y decayó en el quinto año. Además de esto, hubo un aumento de 64 pacientes portadores de diabetes mellitus después de tres años del transplante, mostrándose como factor de riesgo para accidente vascular cerebral, insuficiencia cardíaca congestiva (ICC), enfermedad vascular periférica e hipertrofia ventricular izquierda en el tercer año postransplante. Se verificó la obesidad como factor de riesgo para infarto agudo de miocardio (IAM), dado que el 60% de los pacientes que presentaron IAM poseían índice de masa corporal > 30 kg/m2. En contrapartida, niveles de HDL mayores que 40 parecen ser un factor de protección para hipertrofia ventricular izquierda en el tercer año y para accidente vascular cerebral en el quinto año. Edad menor que 50 años también parece ser un factor de protección para IAM, accidente vascular cerebral, ICC e hipertrofia ventricular izquierda en los primeros 36 meses y para ICC después de 60 meses, pues el 66,67% de los pacientes con ICC en este período tenían edad superior a 50 años. Conclusión: Se observó que parte de los factores de riesgo para las enfermedades cardiovasculares es modificable. De esta forma, mantenimiento de hábitos saludables, especialmente por encima de los 50 años, parece ser una estrategia que puede mejorar el riesgo cardiovascular y la expectativa de vida postransplante renal.