Orientador: Rosana de Fátima Possobon / Dissertação (mestrado profissional) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-23T08:21:35Z (GMT). No. of bitstreams: 1 Reducino_LucasMiotto_M.pdf: 792145 bytes, checksum: 24b4354e50799af3113ef9c8a6a99dbd (MD5) Previous issue date: 2013 / Resumo: O objetivo deste estudo foi verificar a associação entre o baixo peso ao nascer e o parto prematuro com variáveis independentes nutricionais, obstétricas e socioeconômicas, composto por dois capítulos. Trata-se de um estudo de coorte retrospectiva realizado com dados de 513 crianças e suas respectivas mães, cadastradas em 26 Unidades de Saúde da Família do município de Piracicaba-SP. Para a avaliação de fatores associados, foi utilizada a Análise de Regressão Logística. Foi observada associação significativa entre o baixo peso ao nascer e parto prematuro e também entre o parto prematuro e o Índice de Massa Corporal materno pré gestacional. Não houve associação significativa entre outras variáveis independentes com o peso ao nascer e o parto prematuro. Conclui-se que, nesta amostra, nascer antes de 37 semanas de gestação esteve associado ao peso materno antes do período gestacional e que a prematuridade é fator de risco ao baixo peso ao nascer / Abstract: The aim of this study was to investigate the association between low birth weight and preterm delivery with nutritional, obstetric and socioeconomic variables, comprising two chapters. This is a retrospective cohort with data from 513 children and their mothers were enrolled in the 26 Family Health Units, Piracicaba-SP. For the evaluation of associated factors, we used logistic regression analysis. Significant association was observed between birth weight and prematurity and between prematurity and maternal pre-pregnancy Body Mass Index. There was no significant association between other independent variables with birth weight and premature birth. We conclude that, in this sample, children born before 37 weeks was associated with maternal weight before pregnancy period and the prematurity is a risk factor for low birth weight / Mestrado / Odontologia em Saude Coletiva / Mestre em Odontologia em Saúde Coletiva

Orientador: Carlos Roberto Silveira Correa / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-19T23:23:18Z (GMT). No. of bitstreams: 1 Fialho_PaulaMayaraMatos_M.pdf: 4006179 bytes, checksum: 3811feb02dfa10d8653c3dbcd13e9b40 (MD5) Previous issue date: 2012 / Resumo: A associação entre toxocaríase, asma e aumento de peso ainda não foi estudada. Considerando-se que, provavelmente, haja diferenças entre os diversos fatores de risco para asma, assim como, o aumento de peso e levando-se em consideração que a toxocaríase é uma doença que acomete principalmente crianças, torna-se importante descrever a associação entre essas três variáveis. O objetivo deste trabalho foi estudar a associação entre toxocaríase, prevalência de asma e o sobrepeso e obesidade em crianças adscritas em uma Unidade Básica de Saúde (UBS) do município de Campinas, SP. Os resultados desta dissertação são apresentados no capítulo que engloba o artigo, Associação entre toxocaríase, asma e o índice de massa corporal em crianças, trata-se de um estudo transversal, realizado a partir de uma análise documental feita nos prontuários de 116 crianças atendidas na UBS do Jardim Santa Mônica em Campinas entre os anos 1996 a 1998. As seguintes informações foram obtidas dos prontuários: peso, altura, idade, sexo, presença ou não de asma, resultado do teste sorológico para Toxocara canis, presença ou não de eosinofilia. Para avaliação da antropometria foi usado os escores z. Para o estudo das associações entre presença de sorologia positiva para Toxocara canis, asma e IMC, foi utilizado o teste Wilcoxon para duas amostras. A amplitude da idade foi de 2 a 14 anos. Quanto ao sexo, 57,8% foram do sexo masculino. A prevalência de asma foi de 37,9% e a de crianças com sorologia positiva para infecção por T. canis foi de 54,3%. Comparando-se a distribuição z do IMC das crianças com sorologia positiva para infecção por T. canis com os das não infectadas, observou-se que os escores z mais elevados eram os das crianças com asma e com toxocaríase. Este trabalho aponta para a existência de uma associação entre a infecção por T. canis, asma e aumento do índice de massa corporal em crianças. A infecção por Toxocara tem associação com duas doenças de maior relevância na pediatria, a asma e a obesidade, as quais necessitam da atenção de todos os profissionais da saúde / Abstract: The association between toxocariasis, asthma and weight gain has not been studied. Considering that probably there are differences between the various risk factors for asthma, as well as weight gain and taking into account that toxocariasis is a disease that mainly affects children, it is important to describe the association between these three variables. The objective of this study was to investigate the association between toxocariasis and prevalence of overweight and obesity and asthma in children ascribed in a Health Basic Unit (UBS) in Campinas in São Paulo States. The results of this work are presented in the chapter that includes the article, "Association between toxocariasis, asthma and body mass index in children", it is a cross-sectional study from a documentary analysis made in the clinical reports of 116 children seen at UBS Jardim Santa Mônica in Campinas between the years 1996 to 1998. The following information was obtained from clinical reports: weight, height, age, sex, presence or absence of asthma, the serologic test for Toxocara canis, presence or not of eosinophilia. To evaluate the anthropometric z scores. To study the associations between positive serology for Toxocara canis, asthma and BMI, we used the Wilcoxon test for two samples. The age range was from 2 to 14 years. Regarding gender, 57.8% were male. The prevalence of asthma was 37.9% and children with positive serology for T. canis was 54.3%. Comparing the distribution of BMI z of children with positive serology for T. canis with those not infected, it was observed that the z-scores were higher for children with asthma and toxocariasis. This work points to the existence of an association between infection with T. canis, asthma and increased body mass index in children. Toxocara infection is associated with two diseases of major relevance in pediatrics, asthma and obesity, which require the attention of all health professionals / Mestrado / Epidemiologia / Mestre em Saude Coletiva

Övervikt och fetma bland barn är ett omfattande och komplext problem. BHV-sjuksköterskan har genom sin unika position en betydelsefull roll i det hälsofrämjande samt förebyggande arbetet. En tidig upptäckt främjar barnets hälsa både på kort och lång sikt ur ett folkhälso- samt hållbarhetsperspektiv. Body Mass Index är idag den metod som används inom barnhälsovården för att identifiera barn med övervikt eller fetma. Forskning kring BHV-sjuksköterskan användning av BMI är sparsam. Den här studien beskriver BHV-sjuksköterskans erfarenhet av att använda BMI-kurvan vid de olika hälsokontrollerna på barnavårdscentralen. Tio BHV- sjuksköterskor intervjuades till studien. Dataanalysen har skett genom en kvalitativ innehållsanalys enligt Elo & Kyngäs. Under analysen identifierades tre stycken huvudkategorier med tillhörande 10 stycken subkategorier som beskriver resultatet. De tre huvudkategorierna är ”En naturlig del av besöket”, ”Stöd till vårdande samtal” samt ”Ett användbart instrument”. Resultatdiskussionen lyfter fram att BHV-sjuksköterskan anser att BMI-kurvan utgör ett bra stöd och verktyg för att identifiera barn med övervikt eller fetma. BMI-kurvan beskrivs som tydlig och utifrån kurvan kunde BHV- sjuksköterskan samtala om barnets viktutveckling samt livsstilsfaktorer såsom kost och fysisk aktivitet. I studien framkommer det att BMI-kurvan inte används regelmässigt utan BHV-sjuksköterskan fäster istället stor tilltro till sin egen kliniska blick, vilket även bekräftas i den befintliga forskningen inom ämnet.

Abstract Chlamydia pneumoniae is an obligatory intracellular pathogen that causes upper and lower respiratory tract infections. Like other Chlamydial species, also C. pneumoniae has a tendency to cause persistent infections, which have been associated with different cardiovascular, neurological, and respiratory diseases. In addition, a few studies have reported an association between C. pneumoniae seropositivity and an elevated body mass index (BMI), and it has been shown that C. pneumoniae is capable of infecting preadipocytes and adipocytes. The main aims of this study were to study if certain gene polymorphisms regulate the serum levels of innate immunity and inflammation proteins, and if the polymorphisms are associated with markers of C. pneumoniae infection; to compare different methods in detection of C pneumoniae in atherosclerotic tissue; and to study if serum levels of chlamydial LPS (cLPS) are associated with BMI. The serum levels of inflammatory and innate immunity markers, namely interleukin 6 (IL-6), C-reactive protein (CRP), LPS-binding protein (LBP), and soluble CD14, in apparently healthy individuals were found to correlate with each other and possibly be regulated by the polymorphisms of genes important in inflammation and innate immunity. Especially the serum LBP levels may be regulated by the LBP (rs2232618) and toll-like receptor 4 (rs4986790) polymorphisms. The IL-6 (rs1800795) polymorphism was found to be associated with C. pneumoniae antibody positivity. C. pneumoniae DNA and cLPS could be found from atherosclerotic tissue. A new, cLPS enzyme immunoassay method was developed in this study, and it might provide a standardized, commercial method for the detection of chlamydia in tissue samples, if the sensitivity of the method could be increased e.g. by testing multiple pieces of tissue. In situ hybridization method was found to be complicated by technical problems and the repeatability of polymerase chain reaction was poor. C. pneumoniae IgG positivity and elevated serum cLPS and CRP levels were associated with an elevated BMI. There was also a strong association between cLPS levels and inflammation as measured by CRP levels. The lack of association between serum total endotoxin activity and BMI implies that the association between infection and an elevated BMI may be specific to certain pathogens.

Abstract The aim of this study was to investigate the nature of the association between obesity and periodontal infection and the association of statin medication with periodontal infection. This study was based on the nationally representative Health 2000 Survey, conducted by the National Institute for Health and Welfare (former National Public Health Institute of Finland) in 2000–2001. Article I included 396 dentate, non-diabetic subjects, aged 30–59 years, who had never smoked and who participated in the Follow-up Study on Finnish Adults’ Oral Health about four years later. Article II included 2,784 dentate, non-diabetic subjects, aged 30–49 years. Article III included 425 dentate, non-diabetic, non-rheumatic subjects, aged 45–64 years, who had never smoked and who participated in the in-depth examinations of the Health 2000 Survey. Article IV included 1,297 dentate, non-diabetic subjects, aged 30–49 years, who had never smoked. Article V included 2,032 dentate, non-diabetic, non-rheumatic subjects, aged 40–69 years, who did not smoke. The data used in this study were collected via home-visit interviews, self-administered questionnaires, clinical health examinations and laboratory measurements. In this general population of Finnish adults, high BMI was found to be associated with the incidence of new teeth with pathologically deepened periodontal pockets during four-year follow-up. On the other hand, the presence of teeth with deepened periodontal pockets was found to be associated with obesity in an exposure-response manner. Serum IL-6 levels were found to be associated with the number of teeth with deepened periodontal pockets, but no consistent association was found between serum TNF-α, triglyceride, HDL-C or LDL-C levels and periodontal infection. Statin medication was found to be inversely associated with the number of teeth with deepened periodontal pockets among subjects with visible signs of gingival inflammation, whereas among subjects with no signs of inflammation, statin medication was associated with an increased likelihood of having periodontal infection. The results of this study support the view that obesity could be causally related to the development of periodontal infection, but does not provide evidence that high body weight could be considered a major risk factor. The present study also suggests that a bi-directional association between obesity and periodontal infection is possible. The present study suggests that elevated serum IL-6 could mediate the association of obesity with periodontal infection. The results of this study also suggest that statins could be beneficial as a part of periodontal treatment. / Tiivistelmä Tämän tutkimuksen tarkoituksena oli selvittää lihavuuden ja parodontaali-infektion välisen yhteyden luonnetta sekä statiinien käytön yhteyttä parodontaali-infektioon. Tutkimus perustui kansalliseen Terveys 2000 -tutkimukseen, jonka toteutti Terveyden ja hyvinvoinnin laitos (entinen Kansanterveyslaitos) vuosina 2000 ja 2001. Artikkeli I perustui 396 hampaalliseen henkilöön, jotka olivat ei-diabeetikkoja, 30–59-vuotiaita, eivät koskaan olleet tupakoineet sekä olivat osallistuneet suunterveyden seurantatutkimukseen neljä vuotta myöhemmin. Artikkeli II perustui 2784 hampaalliseen henkilöön, jotka olivat ei-diabeetikkoja, 30–49-vuotiaita eivätkä olleet koskaan tupakoineet. Artikkeli III perustui 425 hampaalliseen henkilöön, joilla ei ollut diabetesta tai reumaa, olivat 45–64-vuotiaita, eivät koskaan olleet tupakoineet ja olivat osallistuneet Terveys 2000 -tutkimuksen täydentäviin tutkimuksiin. Artikkeli IV perustui 1297 hampaalliseen henkilöön, jotka olivat ei-diabeetikkoja, 30–49-vuotiaita eivätkä olleet koskaan tupakoineet. Artikkeli V perustui 2032 hampaalliseen henkilöön, jotka olivat ei-diabeetikkoja, ei-reumaatikkoja, 40–69-vuotiaita, jotka olivat hampaallisia eivätkä tupakoineet. Tutkimuksen aineisto kerättiin kotihaastattelusta, kyselyistä, kliinisestä tutkimuksesta sekä laboratoriomittauksista. Korkean painoindeksin todettiin olevan yhteydessä uusien ientaskuhampaiden ilmaantumiseen seurannan aikana. Toisaalta ientaskuhampaiden esiintymisen todettiin olevan yhteydessä lihavuuteen altistus-vastesuhteen mukaisesti. Seerumin IL-6 pitoisuuden todettiin olevan yhteydessä ientaskuhampaiden lukumäärään, mutta seerumin TNF-α-, triglyseridi-, LDL-kolesteroli- tai HDL-kolesterolipitoisuudella ei todettu yhteyttä ientaskuhampaiden lukumäärään. Statiinien käytön todettiin olevan käänteisesti yhteydessä ientaskuhampaiden lukumäärään henkilöillä, joilla oli näkyviä merkkejä ikenen inflammaatiosta. Henkilöillä, joilla ei ollut näkyviä merkkejä inflammaatiosta, statiinien käyttö oli yhteydessä suurentuneeseen todennäköisyyteen ientaskuhampaiden esiintymiseen. Tämän tutkimuksen tulokset tukevat käsitystä, että lihavuus voi olla kausaalisesti yhteydessä parodontaali-infektion kehittymiseen, mutta ei puolla käsitystä, että sitä voitaisiin pitää merkittävänä riskitekijänä. On myös mahdollista, että lihavuuden ja parodontaali-infektion välillä on kaksisuuntainen yhteys. Tämän tutkimuksen tulosten mukaan on mahdollista, että kohonnut seerumin IL-6 pitoisuus voi välittää lihavuuden yhteyden parodontaali-infektioon. Tutkimuksen tulosten mukaan on myös mahdollista, että statiineista voi olla hyötyä osana parodontaalihoitoa.

Objetivos. Analizar la variación nutricional de los beneficiarios actuales y pasados del Programa de Alimentación y Nutrición al Paciente Ambulatorio con Tuberculosis y Familia (PANTBC). Materiales y métodos. Se realizó un análisis secundario a partir de la valoración antropométrica por medio del índice de masa corporal (IMC) en beneficiarios actuales y pasados del programa PANTBC. Las mediciones se realizaron al inicio, segundo y quinto o sexto mes y se comparó la distribución del estado nutricional al inicio respecto al final (prueba de McNemar-Bowker). Resultados. Se incluyó información de 409 beneficiarios actuales y 110 beneficiarios pasados. Tanto en beneficiarios actuales como pasados se observó disminución progresiva de la condición de bajo peso (IMC<18,5) así como el aumento de la condición de sobrepeso. Los resultados de la tercera medición mostraron que el 57,7% de los beneficiarios actuales que iniciaron con bajo peso terminaron con peso normal, mientras el 20,7% de los que iniciaron con peso normal terminaron con sobrepeso. La comparación del estado nutricional al inicio respecto al final mostró cambios en la distribución (p<0,05). Conclusiones. A lo largo del programa PANTBC existe variación del estado nutricional de los beneficiarios, con la tendencia de pasar de un nivel inferior a otro superior de IMC. / Objectives. Analyze the nutritional changes among current and old beneficiaries of the Food and Nutrition Program for Outpatients with Tuberculosis and their Family (PANTBC, Spanish acronym). Materials and methods. A secondary analysis was conducted based on the anthropometric measurements with the body mass index (BMI) in current and old beneficiaries of the PANTBC program. The measurements were taken at the baseline, second and fifth or sixth month, and the distribution of the nutritional status was analyzed at baseline as compared to the endpoint (McNemar-Bowker test). Results. Information about 409 current beneficiaries and 110 old beneficiaries were included. A progressive decline in low weight as well as an increase in overweight were observed in both current and old beneficiaries (IMC<18.5). The results of the third measurement showed that 57.7% of current beneficiaries who started with low weight ended up with normal weight, while 20.7% of those who started with normal weight ended up with overweight. The analysis of the nutritional status at baseline compared to the endpoint showed changes in distribution (p<0.05). Conclusions. Across the PANTBC program, there is a variation of beneficiaries’ nutritional status, showing a tendency to go from a lower level to a higher level of BMI.

Doctor of Philosophy / Curriculum and Instruction Programs / Michael F. Perl / BeEtta L. Stoney / America is in the midst of an obesity epidemic (Wechsler, McKenna, Lee, & Dietz, 2004). According to Wechsler et al., physical inactivity is a major contributor to this issue. Burnette (1999), reports certain behaviors and instructional strategies help teachers to build stronger teaching/learning relationships with students, and that some specific behaviors may be the most influential. Teacher feedback and teacher proximity are two specific behaviors that are important in a physical education setting. Hastie (1998) and Lund (1990), report that when physical education teachers provide feedback and maintain proximity to students, learning may be enhanced. This study examined the frequency of teacher feedback and teacher proximity in relation to student body mass index (BMI) and student gender. Fifteen Kansas middle school physical education teachers were observed delivering skill based lessons to two classes of students. Event recording, a form of systematic observation, was used in data collection. A multivariate analysis of variance was conducted with independent samples T-tests conducted for specific demographic data. Results indicated no significant differences in the frequency of teacher feedback and teacher proximity in relation to student body mass index (BMI) or student gender. Results of the analysis of various pieces of demographic information showed teachers who use some of the Physical Focus Curriculum activities had a higher rate per minute of teacher feedback than teachers who use none of the curriculum. Analysis also showed that teachers using more individualized skill based activities provided significantly higher rates of feedback and proximity than those conducting large group activities. Further analysis of demographic data revealed those teachers currently coaching a sport provided less feedback and proximity to students in class than those not currently coaching. Membership in the state professional organization did not have any effect upon rates of teacher feedback or proximity. The effects of teacher gender on rates of feedback and proximity showed female teachers are more proximal to all students than male teachers. Recommendations to be considered when conducting further research include increasing the sample size, development of more specific instrumentation to measure rates of feedback and proximity in an activity setting, implementing more control of the type of activity and instruction provided, and including more diversity in the study.

Class of 2016 Abstract / Objectives: The purpose of this study was to evaluate whether overweight/obese children with asthma have different systemic steroid dosing practices and asthma related readmission rates compared to normal/underweight children with asthma. Methods: Medical charts of patients admitted between October 2013 and October 2014 for an acute asthma exacerbation were reviewed retrospectively. The primary objective was to compare the average weight based systemic steroid dose between overweight/obese (Group 1) and normal/underweight (Group 2) with asthma. The secondary objective was to compare asthma-related readmissions between both groups. Data collected included demographic data; 30 day, 90 day and 6-month asthma-related readmissions; asthma medications prior-to-admission, during hospitalization and upon discharge. Results: One hundred fifty nine admissions (147 patients with recorded BMI) were evaluated. There was no significant difference in the proportion of obese, overweight, healthy and underweight patients who had 6-month asthma readmissions (p > 0.05). The mean systemic steroid, including prednisone and methylprednisolone, weight based dosing was similar between Group 1 and Group 2 (p > 0.05). Likewise, the proportion of patients with 6-month readmissions was similar in both groups (p > 0.05). Conclusions: Acute asthma exacerbation pediatric patients whom are overweight/obese were not being dosed differently to normal/underweight patients and were not at risk for increased asthma-related readmission in the following 6 months.

M.Tech. (Homoeopathy) / In South Africa, approximately 61% of the population is believed to be overweight, obese or morbidly obese (Smith, 2010). Risk factors to developing obesity include a sedentary lifestyle, unhealthy diet and poor eating habits, smoking, age, medications such as corticosteroids and other illnesses such as polycystic ovarian syndrome, hypothyroidism and Cushing’s syndrome (Polsdorfer, 2011). Obesity is fast becoming a major problem in all communities in South Africa, not only in regard to the health of individuals but as it continues to increase the costs of health care in the country (Goedecke et al., 2005). The aim of this study is to determine the effect of a herbal formulation consisting of Caffeine, Coffea canephora bean, Coleus forskholii, Camellia sinensis, Evodiamine, Ilex paraguariensis and Phaseolus vulgaris on Body Mass Index and abdominal girth measurements in overweight and obese individuals. Previous studies conducted on the herbal formulation have shown positive results with regard to weight loss, however, the need for a longer trial period was indicated in order to establish long term results as in this study (Baillie, 2011a). The study was a twelve week, double-blind, placebo-controlled study. The participants were males and females between the ages of 18 and 45 years with a BMI between 25 and 35kg/m2. Sixty participants were recruited from the University of Johannesburg, as well as from the public sector, in response to posters posted at the university, local gymnasiums and fitness clubs and given to other Homoeopathic practitioners. Of the sample of sixty participants, thirty participants were placed in the experimental group and thirty in the placebo group according to matched pairing of gender and BMI. The groups received either two capsules of the herbal formulation consisting of Caffeine, Coffea canephora bean, Coleus forskholii, Camellia sinensis, Evodiamine, Ilex paraguariensis and Phaseolus vulgaris or two capsules of a placebo composed of pharmaceutical starch, from Monday to Friday. At the initial consultation, a detailed case history and the vital signs (including blood pressure, respiratory rate, heart rate and temperature) of the participants were taken. Their height and weight was determined and from these measurements, their BMI was calculated. Their abdominal girth was measured three times during each consultation, each time using a standardized method and the average measurement was obtained. The participants then returned for follow-up evaluations in the second, sixth and twelfth week of the study. At each follow-up consultation, the participants’ vital signs and abdominal girth measurements were taken again and their BMI calculated by measuring their weight. The data collected during the study was analysed using statistical techniques including the Shapiro-Wilk test, Friedman Analysis of Variance test, Mann-Whitney test and Wilcoxon Signed-Rank test.

M.Tech. (Chiropractic) / Purpose: Low back pain affects the general population worldwide. Low back pain is a multi-factorial problem with debate as to the exact aetiology of low back pain. Thus, this study examines the relationship between lumbar spine lordosis, body fat percentage, physical activity level, lumbar spine range of motion and the incidence of low back pain. Method: There was a total of one hundred female participants between and including eighteen and thirty-five years of age. These females were symptomatic or asymptomatic of mechanical low back pain. Potential candidates were examined and accepted based on the inclusion and exclusion criteria. Participants were evaluated once. No treatment was administered. Procedure: Subjective responses were acquired through the Visual Analog Scale, the International Physical Activity Questionnaire and an Oswestry Low Back Pain and Disability Questionnaire. The objective evaluation included a physical examination and a lumbar spine regional examination. The participant’s height was measured using a stadiometer. The Bioelectrical Impedance Analysis (BIA) measured the participant’s weight, water content, lean tissue mass and body fat percentage. BMI was calculated from the weight and height recordings. Range of motion of the lumbar spine was measured with a Digital Inclinometer. A flexi curve ruler molded the lumbar spine lordosis of each participant, which was then traced onto a piece of paper to measure the magnitude of lumbar spine lordosis. Results: A clinical relationship did not exist between a hyperlordotic lumbar spine posture, the incidence of low back pain, body fat percentage and lumbar spine range of motion. A clinical relationship was evident between a hyperlordotic lumbar spine posture and the level of physical activity. Conclusion: Given that a clinical relationship exists between a hyperlordotic lumbar spine posture and the level of physical activity, physical activity specifically exercise to strengthen the abdominal muscles should be included in a treatment protocol to reduce the degree of lumbar spine lordosis if the degree is excessive.