RESUMO Objetivo. Avaliar a eficácia de um programa abrangente de controle da pressão arterial (PA) na melhoria de indicadores do estilo de vida, dos níveis de PA e dos resultados de exames laboratoriais entre pessoas que vivem em áreas urbanas de baixa renda no Peru. Métodos. Utilizamos um desenho de estudo prospectivo do tipo pré/pós-intervenção para estudar 1.271 participantes com hipertensão ou pré-hipertensão. A intervenção foi implementada durante 2 anos, de maio de 2015 a abril de 2017, em três centros de saúde em Lima (2 em Comas e 1 em Callao). Comparamos as mudanças nos participantes ao longo do período do estudo. Todos os pacientes participaram de consultas individualizadas, sessões em grupo para educação em saúde e reuniões em grupo regulares para melhorar a autogestão; além disso, receberam mensagens de texto para a educação em saúde. Utilizamos testes t e testes do qui-quadrado pareados para determinar a significância das mudanças nos indicadores antes e após a intervenção. Resultados. Comportamentos relacionados ao estilo de vida, tais como o monitoramento do peso e da pressão arterial, a redução do consumo de sal, o maior consumo de frutas e vegetais e o controle do estresse, melhoraram durante a intervenção (p<0,001). A Escala de Cinco Dimensões EuroQol melhorou (p<0,001), e o índice de massa corporal, a circunferência abdominal e a PA sistólica e diastólica dos participantes diminuíram significativamente (p<0,001). O colesterol de baixa densidade (LDL) e os triglicerídeos diminuíram (p<0,01), e o colesterol de alta densidade (HDL) aumentou. A taxa de filtração glomerular estimada (TFGe) aumentou após o programa (p<0,001). Conclusões. Este programa abrangente de controle da PA foi eficaz na melhoria de indicadores do estilo de vida, dos níveis de PA e dos resultados laboratoriais entre pessoas que vivem em uma área urbana de baixa renda no Peru. O aumento das oportunidades para a medição da PA, a gestão sistemática de pacientes hipertensos e programas comunitários de prevenção e educação são fundamentais para detectar, prevenir e controlar a hipertensão.

ABSTRACT Objective. To assess the effectiveness of a comprehensive blood pressure (BP) control program on improving lifestyle indicators, BP levels, and laboratory examination results among people living in low-income urban areas of Peru. Methods. A prospective before-and-after study design was applied to 1 271 participants with hypertension or pre-hypertension. The intervention was implemented for 2 years, from May 2015 – April 2017, in three health centers in Lima (2 in Comas and 1 in Callao). The changes in participants over the study period were compared. All participants were provided with individualized consultations, group health education sessions, regular group meetings to improve self-management, and text messages providing health education. Paired t- and chi-square tests were used to determine the significance of the changes in indicators before and after the intervention. Results. Lifestyle behaviors, such as weight and blood pressure monitoring, reduced salt consumption, increased fruit and vegetable consumption, and stress control improved during the intervention (P < 0.001). The EuroQol-Five Dimension Scale showed improvement (P < 0.001) and body mass index, waist circumference, and systolic and diastolic BPs of the participants significantly decreased (P < 0.001). Low-density lipoprotein cholesterol (LDL-C) and triglyceride decreased (P < 0.01) and high-density lipoprotein cholesterol (HDL-C) increased. The estimated glomerular filtration rate (eGFR) increased after the program (P < 0.001). Conclusions. This comprehensive BP control program was effective in improving lifestyle indicators, BP levels, and laboratory results among people living in a low-income urban area of Peru. Increasing opportunities for BP measurement, systematic management of hypertensive patients, and community-based prevention and education programs are paramount to hypertension detection, prevention, and control.

RESUMEN Objetivo. Evaluar la efectividad de un programa de control integral de la presión arterial (PA) para mejorar los indicadores relativos al modo de vida, los niveles de PA y los resultados de laboratorio en personas que viven en zonas urbanas de ingresos bajos en Perú. Métodos. Mediante un estudio prospectivo se analizó la situación antes y después de 1.271 personas que presentaban hipertensión arterial y prehipertensión. Esta intervención se llevó a cabo desde mayo del 2015 hasta abril del 2017 en tres centros de salud de Lima (2 en Comas y 1 en Callao), y se compararon los cambios experimentados por las personas durante el estudio. Todos los participantes recibieron consultas personalizadas, reuniones grupales para mejorar el autocuidado y sesiones grupales de educación sobre salud, al igual que mensajes de texto al respecto. Se recurrió a la prueba de la t para datos emparejados y la prueba de la x2 para establecer la significación estadística de los cambios en los indicadores antes y después de la intervención. Resultados. Los comportamientos relativos al modo de vida, como el seguimiento de la presión arterial y del peso, el menor consumo de sal, el mayor consumo de frutas y verduras y el mejor control del nivel de estrés, mejoraron durante la intervención (P < 0,001). El EuroQol-5D (EQ-5D) mostró mejora (P < 0,001), mientras que el índice de masa corporal, el perímetro de la cintura, la presión arterial diastólica y la sistólica de los participantes disminuyeron de manera significativa (P < 0,001). El colesterol de las lipoproteínas de baja densidad (LDL-C) y los triglicéridos disminuyeron (P < 0,001), mientras que el colesterol de las HDL (HDL-C) aumentó. La filtración glomerular estimada (eGFR) aumentó después del programa (P < 0,001). Conclusiones: este programa de control integral de la PA resultó efectivo para mejorar los indicadores relativos al modo de vida, los niveles de PA y los resultados de laboratorio en las personas que viven en zonas urbanas de ingresos bajos en Perú. Aumentar las oportunidades para la medición de la PA, el manejo sistemático de pacientes con hipertensión arterial y los programas de prevención y educación a nivel comunitario son sumamente importantes para detectar, prevenir y controlar la hipertensión arterial.

ABSTRACT OBJECTIVE To assess the prevalence and correlates of insufficient physical activity in adolescents in Peru. METHODS We used a self-administered questionnaire developed from Global school-based Student Health Survey to collect information from secondary school students in North Lima and Callao in 2015. We carried out Poisson regression with robust variance using generalized linear models to estimate the crude and adjusted prevalence ratios (APR) with 95% confidence intervals (95%CI) of insufficient physical activity for its correlates. RESULTS We have found that 78% of the adolescents did not meet the global recommendation of the World Health Organization on physical activity in the last week before the survey. Female respondents (APR = 1.13, 95%CI 1.04–1.21), respondents who perceived themselves as overweight (APR = 1.10, 95%CI 1.03–1.18), and respondents who consumed insufficient vegetables and fruits [no vegetables (APR = 1.30, 95%CI 1.06–1.59), no fruits (APR = 1.15, 95%CI 1.00–1.31) as compared to those who consumed ≥ 2 servings every day in the last seven days] were more likely to report insufficient physical activity. Adolescents who worked after school (APR = 0.92, 95%CI 0.84–0.99), had physical education classes five times per week (APR = 0.94, 95%CI 0.88–0.99), and had parental supervision (APR = 0.92, 95%CI 0.87–0.98) were less likely to report insufficient physical activity. CONCLUSIONS Sex, work after school, perceived body weight, physical education class, parental support, and healthy dietary behaviors were associated with insufficient physical activity. Attempts to improve physical activity should look for ways to enhance leisure-time physical activity, parental support, physical education classes, healthy dietary behaviors, and normal body weight maintenance in adolescents with integrated efforts from the family and school.

ABSTRACT OBJECTIVE To assess the prevalence and correlates of insufficient physical activity in adolescents in Peru. METHODS We used a self-administered questionnaire developed from Global school-based Student Health Survey to collect information from secondary school students in North Lima and Callao in 2015. We carried out Poisson regression with robust variance using generalized linear models to estimate the crude and adjusted prevalence ratios (APR) with 95% confidence intervals (95%CI) of insufficient physical activity for its correlates. RESULTS We have found that 78% of the adolescents did not meet the global recommendation of the World Health Organization on physical activity in the last week before the survey. Female respondents (APR = 1.13, 95%CI 1.04–1.21), respondents who perceived themselves as overweight (APR = 1.10, 95%CI 1.03–1.18), and respondents who consumed insufficient vegetables and fruits [no vegetables (APR = 1.30, 95%CI 1.06–1.59), no fruits (APR = 1.15, 95%CI 1.00–1.31) as compared to those who consumed ≥ 2 servings every day in the last seven days] were more likely to report insufficient physical activity. Adolescents who worked after school (APR = 0.92, 95%CI 0.84–0.99), had physical education classes five times per week (APR = 0.94, 95%CI 0.88–0.99), and had parental supervision (APR = 0.92, 95%CI 0.87–0.98) were less likely to report insufficient physical activity. CONCLUSIONS Sex, work after school, perceived body weight, physical education class, parental support, and healthy dietary behaviors were associated with insufficient physical activity. Attempts to improve physical activity should look for ways to enhance leisure-time physical activity, parental support, physical education classes, healthy dietary behaviors, and normal body weight maintenance in adolescents with integrated efforts from the family and school.

Background Spermatogonial stem cells (SSCs) are important for the production of interspecies germ line chimeras. The interspecies germ cell transfer technique has been suggested as a way to conserve endangered birds. Our objective was to develop a technique for restoring endangered birds by developing interspecies germ line chimeras between pheasant (Phasianus colchicus) and chicken (Gallus gallus) with SSCs. Results SSCs were isolated from the surgically removed testis of a pheasant. Growth conditions for pheasant SSCs were established by co-culturing STO (SIM mouse embryo-derived thioguanine and ouabain resistant) cells and pheasant SSCs. The colony-forming cells divided and proliferated stably to yield an established SSC line. Pheasant SSCs showed strong reactivity for GDNF family receptor alpha1 (GFRa1) marker. Finally, production of germ line chimeras was attempted by transferring pheasant SSCs into recipient embryos. Although final embryo survival was 5.6% (20/354), the initial survival rate was 88% (312/354). To measure the percent transfer of donor SSC to gonads, the pheasant SSCs were labeled with PKH 26 fluorescent dye. We observed 30% donor cells and 9.48% c-kit/CD117-positive cells in the gonads of recipient chickens. Donor SSCs were thus stably engrafted in the recipient gonads. Conclusions This study showed that SSCs can be used as a tool for the conservation of endangered birds and the production of germ line chimeras. Our findings yield insights into how we may use the pheasant spermatogonial stem cell line for efficient production of interspecies germ line chimeras and ultimately, to the restoration of endangered birds.