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OBJECTIVE: To analyze the effects of a supervised physical exercise and nutritional guidance program, conducted with a playful basis, on the cardiovascular risk profile of obese children. METHODS: Forty-four children aged between 8 and 11 years, divided into two groups, were paired by gender and age: intervention group (n = 22) and control group (n = 22). The following parameters were measured before and after the intervention: body mass, height, waist circumference, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, fasting glucose, high-sensitive C-reactive protein, blood pressure, and carotid intima-media thickness. Both groups continued their traditional medical treatment. The case group exercised with recreational activities three times a week during 12 weeks, and participated in a weekly nutritional guidance session. The control group did not participate in the intervention described. Descriptive statistics, paired and unpaired Student's t-test, Mann-Whitney's U test, and the Wilcoxon test were used, with a significance level of p < 0.05. RESULTS: 32 children concluded the study (16 in each group). At the end of the study, the case group showed a significant reduction in the body mass index (BMI) (p = 0.001), total cholesterol (p = 0.001), LDL cholesterol (p = 0.001), diastolic blood pressure (p = 0.010), and average (p = 0.003) and maximum (p = 0.002) carotid intima-media thickness. The control group showed a significant increase in waist circumference (p = 0.001), blood glucose (p = 0.025), C-reactive protein (p = 0.016), a reduction of HDL cholesterol (p = 0.012) and total cholesterol (p = 0.042), and an increase in the average (p = 0.012) and maximum (p = 0.024) carotid intima-media thickness. CONCLUSION: The program proved effective in the reduction of obesity indicators and of the intima-media thickness, a direct and early signal of atherosclerosis.

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OBJETIVO: Analisar os efeitos de um programa de exercício físico e orientação nutricional supervisionado, de caráter lúdico, no perfil de risco cardiovascular de crianças obesas. MÉTODOS: Quarenta e quatro crianças com idades entre 8 e 11 anos divididas em dois grupos pareados em sexo e idade: grupo intervenção (n = 22) e controle (n = 22). Mensurou-se, antes e após a intervenção, a massa corporal, estatura, perímetro abdominal, colesterol total, HDL-colesterol, LDL-colesterol, triglicérides, glicemia de jejum, proteína C reativa ultrassensível, pressão arterial e espessura médio-intimal carotídea. Ambos os grupos continuaram com acompanhamento médico tradicional. O grupo caso participou de 12 semanas de exercício físico, com atividades recreativas em três sessões semanais e uma sessão semanal de orientação nutricional. O grupo controle não participou da intervenção descrita. Na análise foram utilizados a estatística descritiva, o teste t pareado e o teste não pareado, o teste U de Mann Whitney e o teste do Wilcoxon, adotando-se nível de significância p > 0,05. RESULTADOS: Trinta e duas crianças completaram o estudo (16 em cada grupo). Ao final, o grupo caso apresentou redução significativa no índice de massa corporal (IMC) (p = 0,001), colesterol total (p = 0,001) e LDL-colesterol (p = 0,001), pressão arterial diastólica (p = 0,010) e espessura médio-intimal média (p = 0,003) e máxima (p = 0,002). O grupo controle apresentou aumento significativo no perímetro abdominal (p = 0,001), glicemia (p = 0,025), proteína C reativa (p = 0,016) e redução do HDL-colesterol (p = 0,012) e colesterol total (p = 0,042) e aumento na espessura médio-intimal média (p = 0,012) e máxima (p = 0,024). CONCLUSÃO: O programa foi efetivo na redução dos indicadores de obesidade e na diminuição da espessura médio-intimal, um sinal indireto e precoce da aterosclerose.

OBJECTIVE: To analyze the effects of a supervised physical exercise and nutritional guidance program, conducted with a playful basis, on the cardiovascular risk profile of obese children. METHODS: Forty-four children aged between 8 and 11 years, divided into two groups, were paired by gender and age: intervention group (n = 22) and control group (n = 22). The following parameters were measured before and after the intervention: body mass, height, waist circumference, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, fasting glucose, high-sensitive C-reactive protein, blood pressure, and carotid intimamedia thickness. Both groups continued their traditional medical treatment. The case group exercised with recreational activities three times a week during 12 weeks, and participated in a weekly nutritional guidance session. The control group did not participate in the intervention described. Descriptive statistics, paired and unpaired Student's t-test, Mann-Whitney's U test, and the Wilcoxon test were used, with a significance level of p < 0.05. RESULTS: 32 children concluded the study (16 in each group). At the end of the study, the case group showed a significant reduction in the body mass index (BMI) (p = 0.001), total cholesterol (p = 0.001), LDL cholesterol (p = 0.001), diastolic blood pressure (p = 0.010), and average (p = 0.003) and maximum (p = 0.002) carotid intima-media thickness. The control group showed a significant increase in waist circumference (p = 0.001), blood glucose (p = 0.025), C-reactive protein (p = 0.016), a reduction of HDL cholesterol (p = 0.012) and total cholesterol (p = 0.042), and an increase in the average (p = 0.012) and maximum (p = 0.024) carotid intima-media thickness. CONCLUSION: The program proved effective in the reduction of obesity indicators and of the intima-media thickness, a direct and early signal of atherosclerosis.

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Estudam-se dois pacientes com paracoccidioidomicose (blastomicose sul-americana): um com quatro anos de idade acometido pela forma generalizada da doença; o outro com nove anos, portador de forma ganglionar e que já estava em tratamento há cerca de seis anos. Além dos exames específicos e biópsias, os pacientes foram submetidos a estudo imunológico e tratados, o primeiro com a associaçäo de ketoconazole com anfotericina B e o segundo, somente com ketoconazole. A evoluçäo foi ótima nos dois casos. Fazem-se uma revisäo da literatura

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