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  • 1
    In: Brazilian Journal of Nephrology, FapUNIFESP (SciELO)
    Abstract: Abstract Introduction: Obesity is thought to play a role in the disruption of cardiac rhythmicity in obese children, but this is mostly an unexplored field of investigation. We aimed to evaluate the impact of overweight and obesity on circadian and ultradian cardiovascular rhythmicity of prepubertal children, in comparison with normal weight counterparts. Methods: We performed a cross sectional study of 316 children, followed in the birth cohort Generation XXI (Portugal). Anthropometrics and 24-hour ambulatory blood pressure were measured and profiles were examined with Fourier analysis for circadian and ultradian blood pressure (BP) and heart rate (HR) rhythms. Results: Overweight/obese children presented more frequently a non-dipping BP pattern than normal weight counterparts (31.5% vs. 21.6%, p = 0.047). The prevalence of 24-hour mean arterial pressure (MAP) and 8-hour HR rhythmicity was significantly lower in obese children (79.3% vs. 88.0%, p = 0.038 and 33.3% vs. 45.2%, p = 0.031, respectively). The prevalence of the remaining MAP and HR rhythmicity was similar in both groups. No differences were found in the median values of amplitudes and acrophases of MAP and HR rhythms. Discussion: The alterations found in rhythmicity suggest that circadian and ultradian rhythmicity analysis might be sensitive in detecting early cardiovascular dysregulations, but future studies are needed to reinforce our findings and to better understand their long-term implications.
    Type of Medium: Online Resource
    ISSN: 2175-8239 , 0101-2800
    Uniform Title: Cardiovascular rhythmicity in overweight and obese children
    Language: Portuguese , English
    Publisher: FapUNIFESP (SciELO)
    Publication Date: 2023
    detail.hit.zdb_id: 2057873-8
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  • 2
    In: Brazilian Journal of Nephrology, FapUNIFESP (SciELO)
    Abstract: Resumo Introdução: Acredita-se que a obesidade desempenhe um papel na desregulação da ritmicidade cardíaca em crianças obesas, mas esse é um campo de investigação ainda pouco explorado. O objetivo deste trabalho foi avaliar o impacto do sobrepeso e da obesidade na ritmicidade cardiovascular circadiana e ultradiana de crianças pré-púberes, em comparação com crianças com peso normal. Métodos: Realizamos um estudo transversal com 316 crianças, acompanhadas na coorte de nascimentos Geração XXI (Portugal). Foram medidos dados antropométricos e a pressão arterial ambulatorial de 24 horas, e os perfis foram examinados com uma análise de Fourier para ritmos circadianos e ultradianos de pressão arterial (PA) e frequência cardíaca (FC). Resultados: Crianças com sobrepeso/obesidade apresentaram mais frequentemente um padrão de PA não-dipper em comparação com crianças com peso normal (31,5% vs. 21,6%; p = 0,047). A prevalência da pressão arterial média (PAM) de 24 horas e da ritmicidade da FC de 8 horas foi significativamente menor em crianças obesas (79,3% vs. 88,0%; p = 0,038 e 33,3% vs. 45,2%; p = 0,031, respectivamente). A prevalência das restantes ritmicidades da PAM e da FC foi semelhante em ambos os grupos. Não foram encontradas diferenças nos valores medianos das amplitudes e acrofases dos ritmos de PAM e FC. Discussão: As alterações encontradas na ritmicidade sugerem que a análise da ritmicidade circadiana e ultradiana pode ser sensível na detecção de desregulações cardiovasculares precoces, mas são necessários novos estudos para reforçar nossos achados e entender melhor suas implicações a longo prazo.
    Type of Medium: Online Resource
    ISSN: 2175-8239 , 0101-2800
    Uniform Title: Ritmicidade cardiovascular em crianças com sobrepeso e obesidade
    Language: English , Portuguese
    Publisher: FapUNIFESP (SciELO)
    Publication Date: 2023
    detail.hit.zdb_id: 2057873-8
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  • 3
    Online Resource
    Online Resource
    FapUNIFESP (SciELO) ; 2021
    In:  Cadernos Saúde Coletiva Vol. 29, No. 4 ( 2021-12), p. 604-615
    In: Cadernos Saúde Coletiva, FapUNIFESP (SciELO), Vol. 29, No. 4 ( 2021-12), p. 604-615
    Abstract: Abstract Introduction Decentralization of health surveillance required municipalities to reorganize work processes. While bringing the service closer to the territory, it also raised challenges in formulating intervention proposals on health problems. Objective to analyze the work process of professionals who perform health surveillance actions in Brazil. Method This is a literature scoping review study. The search strategy included health databases, Google Scholar, and reference lists for articles published between 2000 and 2016. Searches were conducted in April 2017 by two researchers separately. The sample consists of 38 studies. Results Five categories emerged: decentralization of surveillance actions, health surveillance and networking, educational processes, territorial analysis, and social participation. The decentralized process approached the surveillance of the territory and the community, favoring its anticipatory capacity, the intersectoral work, and the action adjusted to the problems. However, this approach is still a challenge for the construction of the surveillance as a network, based on the primary care through a territorial analysis. The answer to this challenge demands processes of permanent education and the participative compromise of the community and social control. Conclusion The decentralization requires united actions of the professionals of surveillance and attendance, having as focus the territory, intersectoral actions, and social participation.
    Type of Medium: Online Resource
    ISSN: 2358-291X , 1414-462X
    Language: Portuguese
    Publisher: FapUNIFESP (SciELO)
    Publication Date: 2021
    detail.hit.zdb_id: 2617097-8
    SSG: 7,36
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