Objective: The main objective of this systematic review is to assess the effects of obesity on telomere length. Methods: The following databases were searched: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), LILACS, SPORTdiscus, and Web of Science from inception to August 2014. The search was performed using the following combinations of terms: telomere AND "overweight" OR "obesity" OR "adiposity," without language restriction. Results: Sixty-three original studies were included in this systematic review, comprising 119,439 subjects. Thirty-nine studies showed either weak or moderate correlation between obesity and telomere length; however, they showed an important heterogeneity. Conclusions: There is a tendency toward demonstrating negative correlation between obesity and telomere length. The selected studies showed weak to moderate correlation for the main search, and there was an important heterogeneity. For this reason, the causal relationship of obesity and telomere length remains open. Additional controlled longitudinal studies are needed to investigate this issue.

Cystic fibrosis (CF) is an autosomal recessive genetic disorder characterized by dysfunction of the CFTR gene. It is a multisystem disease that most often affects White individuals. In recent decades, various advances in the diagnosis and treatment of CF have drastically changed the scenario, resulting in a significant increase in survival and quality of life. In Brazil, the current neonatal screening program for CF has broad coverage, and most of the Brazilian states have referral centers for the follow-up of individuals with the disease. Previously, CF was limited to the pediatric age group. However, an increase in the number of adult CF patients has been observed, because of the greater number of individuals being diagnosed with atypical forms (with milder phenotypic expression) and because of the increase in life expectancy provided by the new treatments. However, there is still great heterogeneity among the different regions of Brazil in terms of the access of CF patients to diagnostic and therapeutic methods. The objective of these guidelines was to aggregate the main scientific evidence to guide the management of these patients. A group of 18 CF specialists devised 82 relevant clinical questions, divided into five categories: characteristics of a referral center; diagnosis; treatment of respiratory disease; gastrointestinal and nutritional treatment; and other aspects. Various professionals working in the area of CF in Brazil were invited to answer the questions devised by the coordinators. We used the PubMed database to search the available literature based on keywords, in order to find the best answers to these questions.

No abstract

Lifestyle changes lead to significant improvements in BMI, aminotransferase levels and hepatic steatosis in children and adolescents with NAFLD.

Background and AimsComputed tomography, which uses ionizing radiation and expensive software packages for analysis of scans, can be used to quantify abdominal fat. The objective of this study is to measure abdominal fat with 3T MRI using free software for image analysis and to correlate these findings with anthropometric and laboratory parameters in adolescents.MethodsThis prospective observational study included 24 overweight/obese and 33 healthy adolescents (mean age 16.55 years). All participants underwent abdominal MRI exams. Visceral and subcutaneous fat area and percentage were correlated with anthropometric parameters, lipid profile, glucose metabolism, and insulin resistance. Student’s t test and Mann-Whitney’s test was applied. Pearson’s chi-square test was used to compare proportions. To determine associations Pearson’s linear correlation or Spearman’s correlation were used.ResultsIn both groups, waist circumference (WC) was associated with visceral fat area (P = 0.001 and P = 0.01 respectively), and triglycerides were associated with fat percentage (P = 0.046 and P = 0.071 respectively). In obese individuals, total cholesterol/HDL ratio was associated with visceral fat area (P = 0.03) and percentage (P = 0.09), and insulin and HOMA-IR were associated with visceral fat area (P = 0.001) and percentage (P = 0.005).Conclusions3T MRI can provide reliable and good quality images for quantification of visceral and subcutaneous fat by using a free software package. The results demonstrate that WC is a good predictor of visceral fat in obese adolescents and visceral fat area is associated with total cholesterol/HDL ratio, insulin and HOMA-IR.

No abstract

Objectives: Translate and adapt the Breastfeeding Self-Efficacy Scale (BSES) to the cultural reality of Brazil and evaluate the content validity of the Portuguese version, so that it can be used in the Brazilian population. Methods: The study was made in two phases (1-Protocol translation and cultural adaptation, and 2-Validity of Content). Results: The total score ranged from 93 to 162 points (M = 127.03, SD = 19.62). When considering only women who bore many children, the score scale ranged from 106 to 156 (M = 131.66, SD = 15.91). The translated version proved to be easy to understand, showing good consistency and semantic validation. The Index for the Validation of Content was 0.84 and the Cronbach's alpha = 0.90. Conclusions: The findings suggest that the BSES is suitable for screening the maternal confidence in its potentiality to breastfeed. However, it is necessary to evaluate the psychometric properties of this instrument in samples with different social and educational levels, and in other regions of Brazil RESUMO Objetivos: traduzir e adaptar a Breastfeeding Self-Efficacy Scale (BSES), para a realidade cultural do Brasil e avaliar a validade de conteúdo da versão em português, para que possa ser utilizada na população brasileira. Métodos: O estudo envolveu duas fases (1. protocolo de tradução e adaptação cultural e 2. validade de conteúdo). Resultados: O escore total variou de 93 a 162 pontos (M = 127,03; DP = 19,62). Quando considerado apenas as multíparas, a pontuação da escala variou de 106 a 156 (M = 131,66; DP = 15,91). A versão mostrou ser de fácil compreensão, obtendo-se adequada validação semântica e de consistência. O Índice de Validação de Conteúdo foi 0,84 e o coeficiente alfa de Cronbach = 0,90. Conclusões: Os achados sugerem que a BSES é adequada para screening da confiança materna no seu potencial para amamentar. No entanto, é necessário avaliar as propriedades psicométricas deste instrumento em amostra com diferentes níveis sociais e educacionais e em outras regiões do Brasil. Descritores: Auto-eficácia; Aleitamento materno; Estudos de validação RESUMEN Objetivos: traducir y adaptar la escala Breastfeeding Self-Efficacy Scale (BSES), para la realidad cultural de Brasil y evaluar la validez de contenido de la versión en portugués para que pueda ser utilizada en la población brasileña. Métodos: El estudio se realizó en dos fases (1-protocolo de traducción y adaptación cultural, y 2-Validación del contenido). Resultados: El puntaje total varió de 93 a 162 puntos (P = 127,03; DE = 19,62). Cuando fueron consideradas apenas las multíparas, la puntuación de la escala varió de 106 a 156 (P = 131,66; DE = 15,91). La versión mostró ser de fácil comprensión, obteniéndose una adecuada validación semántica y de consistencia. El Índice de Validación de Contenido fue 0,84 y el coeficiente alfa de Cronbach = 0,90. Conclusiones: Los hallazgos sugieren que la BSES es adecuada para detectar la confianza materna en su potencialidad para amamantar. Sin embargo, es necesario evaluar las propiedades psicométr...

No abstract