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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

Efeito de diferentes interven??es para modifica??o do estilo de vida sobre aspectos cl?nicos e metab?licos envolvidos na s?ndrome metab?lica

Piovesan, Carla Haas 31 March 2015 (has links)
Submitted by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-06-29T14:19:00Z No. of bitstreams: 1 TES_CARLA_HAAS_PIOVESAN_PARCIAL.pdf: 683137 bytes, checksum: 7f0ead503b15c9d9b2d1e6f5476dae34 (MD5) / Approved for entry into archive by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-06-29T14:19:09Z (GMT) No. of bitstreams: 1 TES_CARLA_HAAS_PIOVESAN_PARCIAL.pdf: 683137 bytes, checksum: 7f0ead503b15c9d9b2d1e6f5476dae34 (MD5) / Made available in DSpace on 2017-06-29T14:19:17Z (GMT). No. of bitstreams: 1 TES_CARLA_HAAS_PIOVESAN_PARCIAL.pdf: 683137 bytes, checksum: 7f0ead503b15c9d9b2d1e6f5476dae34 (MD5) Previous issue date: 2015-03-31 / Purpose: The aim was to verify the effects of different interventions for lifestyle modifications on the number of diagnosis criteria and clinical aspects involved in Metabolic Syndrome (MS). Methods: A randomized controlled clinical trial including 125 individuals from 30 to 59 years old with MS was conducted in the Rehabilitation Center of PUCRS. Individuals were randomized into three intervention groups: Standard Intervention (SI) ? nonpharmalogical intervention recommended by the guidelines for clinical management of MS, considered the control group in this trial; Group Intervention (GI) ? group lifestyle change implemented weekly by a multidisciplinary team; Individual Intervention (II) ? outpatient care through weekly individual consultations performed by a multidisciplinary team. The outcomes studied include the modification of the number of diagnosis criteria for MS and other clinical parameters such as cardiovascular risk score, Castelli Index (CI) and insulin resistance index HOMA-IR. Each group was assessed at the beginning and at the end of the interventions (three months). Results: Seventy-two individuals concluded the intervention, among them: SI: 19, GI: 25, and II: 28. Groups GI and II presented significant decrease of body mass index, waist circumference, and systolic arterial pressure after three months. The number of diagnosis criteria for MS decreased significantly ? 40% of the individuals did not meet the criteria for the clinical condition studied at the end of the intervention. The largest reduction occurred within group II, where 52% of the individuals presented less than three criteria. Regarding CI and HOMA-IR, both variables were significantly reduced (p < 0.05) in groups GI and II. Conclusion: The interventions proposed by this study reinforce that nonpharmacological strategies for changing lifestyle impact the reduction of cardiovascular risk factors involved in MS. They are also able to remove the population from this clinical condition by decreasing diagnosis criteria. / Objetivos: O objetivo do estudo foi verificar o efeito de diferentes interven??es para modifica??o do estilo de vida sobre o n?mero de crit?rios de diagn?stico e aspectos cl?nicos envolvidos na S?ndrome Metab?lica (SM). M?todos: Foi realizado um ensaio cl?nico randomizado controlado, o qual incluiu 125 indiv?duos de 30-59 anos com SM, conduzido no Centro de Reabilita??o da PUCRS. Os indiv?duos foram randomizados em tr?s grupos de interven??o: Interven??o Padr?o (IP) - interven??o n?o medicamentosa recomendada nas diretrizes para o manejo cl?nico da SM, considerada nesse estudo grupo controle; Interven??o em Grupo (IG) - a mudan?a do estilo de vida foi trabalhada semanalmente em grupo com equipe multidisciplinar; Interven??o Individual (II) - atendimento ambulatorial com consultas semanais individualizadas realizadas por equipe multidisciplinar. Os desfechos estudados compreendem a modifica??o no n?mero de crit?rios para o diagn?stico da SM e outros par?metros cl?nicos, como o escore de risco cardiovascular ?ndice de Castelli (IC), e ?ndice de resist?ncia ? insulina HOMA-IR. Todos os grupos foram avaliados no in?cio, ao final das interven??es (tr?s meses). Resultados: Conclu?ram a interven??o 72 indiv?duos, sendo: IP: 19, IG: 25 e II: 28. O grupo IG e II promoveram significativa redu??o do ?ndice de massa corporal, circunfer?ncia abdominal, e press?o arterial sist?lica aos tr?s meses. O n?mero de crit?rios para o diagn?stico da SM reduziu de forma significativa, 40% dos indiv?duos n?o preenchiam mais o crit?rio para a condi??o cl?nica estudada ao final da interven??o. A maior redu??o ocorreu no grupo II no qual 52% dos indiv?duos tinham menos de tr?s crit?rios. Em rela??o ao IC e ao HOMA-IR ambas vari?veis reduziram de forma significativa (p<0.05) nos grupos IG e II. Conclus?o: As interven??es propostas neste estudo refor?am que estrat?gias n?o farmacol?gicas de modifica??o do estilo de vida tem impacto na redu??o dos fatores de risco cardiovasculares envolvidos na SM. Tais interven??es demonstraram ser capazes de retirar a popula??o desta condi??o cl?nica por redu??o nos crit?rios de diagn?stico.

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