ACOMPANHAMENTO AMBULATORIAL DE CRIANÇAS E ADOLESCENTES OBESOS E RECOMENDAÇÕES PARA PREVENÇÃO NA ATENÇÃO BÁSICA

Detalhes bibliográficos
Ano de defesa: 2017
Autor(a) principal: Isaia, Heloisa Ataide
Orientador(a): Haeffner, Léris Salete Bonfanti
Banca de defesa: Berlese, Denise Bolzan, Zamberlan, Claudia, Costenaro, Regina Gema Santini
Tipo de documento: Dissertação
Tipo de acesso: Acesso aberto
Idioma: por
Instituição de defesa: Centro Universitário Franciscano
Programa de Pós-Graduação: Mestrado Profissional em Saúde Materno Infantil
Departamento: Saúde Materno Infantil
País: Brasil
Palavras-chave em Português:
Palavras-chave em Inglês:
Área do conhecimento CNPq:
Link de acesso: http://www.tede.universidadefranciscana.edu.br:8080/handle/UFN-BDTD/630
Resumo: Obesity in children and adolescents is worrisome because of its increasing prevalence and risk of associated chronic diseases, with unpostponable preventive and treatment actions. This study aimed to analyze aspects of anthropometry, blood pressure, and laboratory tests at the initial consultation and its evolution in follow-up consultations and to develop a booklet for recommendations and approaches to obesity in primary care. This study collected data from medical records (age, sex, origin, weight, height, blood pressure, laboratory tests) of a cohort of overweight children and adolescents of both sexes between the ages of 2 and 19 that were seen at a specialized outpatient clinic of a tertiary hospital between May 2013 and May 2016. Children were considered to be those younger than 10 years of age. In the initial consultation, 194 patients (51% children) were assessed and 146 patients participated in the follow-up consultation. In the initial consultation, body mass index (BMI), z-score and waist circumference (AC) were significantly higher in adolescents, with severe obesity being more prevalent in children (16.2%). There was no difference between children and adolescents in the mean systolic / diastolic blood pressure percentile. Of the laboratory tests, the only statistically significant difference was the increased total cholesterol level in 48.7% of the adolescents compared with 27% of the children, but HDL was decreased in both. In the follow-up the participants had an average of 5.3 (± 3.4) visits. They showed gains in weight, height and waist circumference. There was a significant decrease in the BMI z-score. There was a decrease in the systolic / diastolic blood pressure percentile, as well as the percentage of patients with abdominal circumference greater than the 90th percentile. The desirable levels of triglycerides, total cholesterol, LDL, and HDL increased significantly between the two evaluations, although 47.4% of the patients still maintained HDL below the desirable level. It was concluded that outpatient follow-up of obese children and adolescents and their families was shown to be positive, at least in the short term, with a reduction of risk factors for cardiovascular diseases, since there was a decrease in waist circumference, tendency for hypertension, hypercholesterolemia and low HDL. As a proposal for prevention and approach to obesity in primary care, the guideline leaflet can contribute. However, when obesity is already established, the specialized service has been shown to be important. It is necessary to evaluate the service offered for more effective actions also in the long term.