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de Lima RS, da Silva RN, André SR, Pinheiro AKC, Sousa AI, da Silva IFS, dos Santos J, Nogueira LMV, Zeitoune RCG. Mycobacterium tuberculosis latent infection in healthcare students: systematic review of prevalence. Rev Esc Enferm USP 2024; 58:e20230238. [PMID: 38488508 PMCID: PMC10941757 DOI: 10.1590/1980-220x-reeusp-2023-0238en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 01/12/2024] [Indexed: 03/17/2024] Open
Abstract
OBJECTIVE The aim of this study was to synthesize the evidence on the prevalence of latent Mycobacterium tuberculosis infection (LTBI) among undergraduate health care students. METHODS A systematic review of prevalence with meta-analysis was conducted. Prospective and retrospective cohorts and cross-sectional studies involving probable exposure to M. tuberculosis during undergraduate education, along with the tuberculin skin test (TST) or interferon-γ release assay (IGRA) for investigation of latent tuberculosis were searched. Searches were conducted in MEDLINE, CINAHL, EMBASE, LILACS, Scopus, and Web of Science databases. Independent reviewers were responsible for the selection and inclusion of studies. Data were extracted, critically appraised, and synthesized using the JBI approach. PRISMA was used to report the study. RESULTS Twenty-two studies were analyzed. The overall prevalence in healthcare undergraduate students was 12.53%. CONCLUSION The prevalence of LTBI in undergraduate health students was high for such a highly educated population. Screening with TST and/or IGRA and chemoprophylaxis, when necessary, should be provided to undergraduate health students when in contact with respiratory symptomatic patients.
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Affiliation(s)
- Renata Silva de Lima
- Universidade Federal do Rio de Janeiro, Escola de Enfermagem Anna
Nery, Rio de Janeiro, RJ, Brazil
| | | | - Suzana Rosa André
- Universidade Federal do Rio de Janeiro, Escola de Enfermagem Anna
Nery, Rio de Janeiro, RJ, Brazil
| | | | - Ana Inês Sousa
- Universidade Federal do Rio de Janeiro, Escola de Enfermagem Anna
Nery, Rio de Janeiro, RJ, Brazil
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Calderon-Ocon V, Cueva-Peredo F, Bernabe-Ortiz A. Prevalence, trends, and factors associated with hypertensive crisis among Peruvian adults. CAD SAUDE PUBLICA 2024; 40:e00155123. [PMID: 38381865 PMCID: PMC10877693 DOI: 10.1590/0102-311xen155123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 11/13/2023] [Accepted: 11/16/2023] [Indexed: 02/23/2024] Open
Abstract
There are few studies focused on the epidemiology of hypertensive crisis at the population level in resource-constrained settings. This study aimed to determine the prevalence and trends over time of hypertensive crisis, as well as the factors associated with this condition among adults. A secondary data analysis was carried out using the Peruvian Demographic and Family Health Survey (ENDES). Hypertensive crisis was defined based on the presence of systolic (≥ 180mmHg) or diastolic (≥ 110mmHg) blood pressure, regardless of previous diagnosis or medication use. The factors associated with our outcome were evaluated using multinomial logistic regression, and the trend of hypertensive crisis was evaluated using the Cochrane-Armitage test. Data from 260,167 participants were analyzed, with a mean age of 44.2 (SD: 16.9) years and 55.5% were women. Hypertension prevalence was 23% (95%CI: 22.7-23.4) and, among them, 5.7% (95%CI: 5.4-5.9) had hypertensive crisis, with an overall prevalence of 1.5% (95%CI: 1.4-1.6). From 2014 to 2022, a significant decrease in the prevalence of hypertensive crisis was observed, from 1.7% in 2014 to 1.4% in 2022 (p = 0.001). In the multivariable model, males, increasing age, living in urban areas, high body mass index, and self-reported type 2 diabetes were positively associated with hypertensive crisis, whereas higher educational level, socioeconomic status, and high altitude were inversely associated. There is a need to improve strategies for the diagnosis, treatment, and control of hypertension, especially hypertensive crisis.
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Betti T, Gouveia HG, Gasparin VA, Vieira LB, Strada JKR, Fagherazzi J. Prevalence of risk factors for primary postpartum hemorrhage in a university hospital. Rev Bras Enferm 2023; 76:e20220134. [PMID: 38018607 PMCID: PMC10680393 DOI: 10.1590/0034-7167-2022-0134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 05/07/2023] [Indexed: 11/30/2023] Open
Abstract
OBJECTIVES to identify the risk factors associated with primary postpartum hemorrhage in a university hospital. METHODS a cross-sectional study was conducted with 277 postpartum women who received care during childbirth or cesarean section between June and August 2020. Data were collected using a pre-structured questionnaire administered 24 hours after delivery. Poisson Regression was employed to analyze the factors associated with postpartum hemorrhage. RESULTS postpartum hemorrhage was observed in 30% of the study sample. Shock Index and uterine distension were found to be statistically associated with postpartum hemorrhage. Postpartum women with a Shock Index ≥ 0.9 had a 61% higher prevalence of postpartum hemorrhage (PR=1.61, 95% CI: 1.07 - 2.43), while those with uterine distension had a 134% higher prevalence (PR=2.34, 95% CI: 1.63 - 3.36). CONCLUSIONS recognizing these factors contributes to improvements in clinical practice, as they enable the prediction of their occurrence and call for appropriate management, thereby preventing unfavorable outcomes.
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Affiliation(s)
- Thaís Betti
- Universidade Federal do Rio Grande do Sul. Porto Alegre, Rio Grande do Sul, Brazil
| | | | | | | | | | - Júlia Fagherazzi
- Universidade Federal do Rio Grande do Sul. Porto Alegre, Rio Grande do Sul, Brazil
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Canever JB, Cândido LM, Moreira BDS, Danielewicz AL, Cimarosti HI, Lima-Costa MF, Avelar NCPD. A nationwide study on sleep complaints and associated factors in older adults: ELSI-Brazil. CAD SAUDE PUBLICA 2023; 39:e00061923. [PMID: 38018640 PMCID: PMC10642241 DOI: 10.1590/0102-311xen061923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 06/13/2023] [Accepted: 07/13/2023] [Indexed: 11/30/2023] Open
Abstract
Sleep problems, such as difficulty falling asleep, staying asleep, early awakening with failure to continue sleep, and altered sleep-wake cycle, are common in the general population. This cross-sectional study with 6,929 older adults (≥ 60 years) aimed to estimate the prevalence of different types of sleep problems, their associated factors, and the population-attributable fraction of associated factors among older adults. The outcome variables consisted of self-reported sleep problems: insomnia (initial, intermediate, late, and any type of insomnia), poor sleep quality, and daytime sleepiness. The independent variables were sociodemographic and behavioral characteristics and health conditions. The prevalence proportions were initial insomnia (49.1%), intermediate insomnia (49.2%), late insomnia (45.9%), any type of insomnia (58.6%), poor sleep quality (15.6%), and daytime sleepiness (38.4%). Female sex, presence of two or more chronic diseases, not eating the recommended amount of fruits and vegetables, and regular and bad/very bad self-rated health were positively associated with the sleep problems investigated. Consuming alcohol once a month or more was inversely associated with initial insomnia. Population attributable fraction estimates ranged from 3% to 19% considering two or more chronic diseases, not eating the recommended amount of fruits and vegetables, and regular and bad/very bad self-rated health. High prevalence of self-reported sleep problems was evinced in older adults. These results can be useful to guide public health services in the creation of informational, evaluative, and screening strategies for sleep problems in older Brazilian adults.
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Affiliation(s)
- Jaquelini Betta Canever
- Centro de Ciências, Tecnologias e Saúde do Campus Araranguá, Universidade Federal de Santa Catarina, Araranguá, Brasil
| | - Letícia Martins Cândido
- Centro de Ciências, Tecnologias e Saúde do Campus Araranguá, Universidade Federal de Santa Catarina, Araranguá, Brasil
| | - Bruno de Souza Moreira
- Núcleo de Estudos em Saúde Pública e Envelhecimento, Fundação Oswaldo Cruz/Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | - Ana Lúcia Danielewicz
- Centro de Ciências, Tecnologias e Saúde do Campus Araranguá, Universidade Federal de Santa Catarina, Araranguá, Brasil
| | | | - Maria Fernanda Lima-Costa
- Núcleo de Estudos em Saúde Pública e Envelhecimento, Fundação Oswaldo Cruz/Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
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de Oliveira RA, de Sousa PMP, da Silva JC, Santos LFS, Santos FS, Pascoal LM, Costa ACPDJ, dos Santos LH, Santos M. Leprosy prevalence spatial distribution and trend in a health region in Northeast Brazil, 2008-2017: an ecological study. Epidemiol Serv Saude 2023; 32:e2023522. [PMID: 37729265 PMCID: PMC10510455 DOI: 10.1590/s2237-96222023000200021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 06/15/2023] [Indexed: 09/22/2023] Open
Abstract
MAIN RESULTS A total of 4,029 leprosy cases were notified. Mean prevalence varied between 2.0 and 11.5 cases/10,000 inhab. Spatial distribution of the cases was heterogeneous and there was a falling prevalence trend over the years studied. IMPLICATIONS FOR SERVICES These findings point to the need to strengthen active tracing strategies and expand health actions and services targeting leprosy, with the aim of increasing detection and early treatment of cases. PERSPECTIVES It is important to carry out epidemiological investigations on the spatial distribution and prevalence of leprosy in other health regions in the state, in order to identify other areas with greater vulnerability to leprosy. OBJECTIVE to analyse the spatial distribution and trend of leprosy in municipalities of a health region in a Northeast Brazilian state. METHODS this was an ecological time-series study based on compulsory notification of leprosy cases by the municipalities covered by the Imperatriz-MA Regional Health Management Unit, between 2008 and 2017; prevalence and mean prevalence for the period were calculated; spatial analysis of the area was carried out and maps were generated using ArcGis 10.5. Prais-Winsten regression was used for trend analysis. RESULT 4,029 cases of the disease were identified, and average prevalence ranged from 2.0 to 11.5 cases/10,000 inhabitants-year. The overall trend was downward. Governador Edson Lobão had the highest prevalence, 11.5 cases/10,000 inhabitants, and Lajeado Novo had the lowest prevalence, 2.0 cases/10,000 inhabitants. CONCLUSION spatial distribution of leprosy cases was heterogeneous in the municipalities studied and prevalence had a falling trend.
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Affiliation(s)
- Rayanne Alves de Oliveira
- Universidade Federal do Maranhão, Programa de Pós-Graduação em Saúde e Tecnologia, Imperatriz, MA, Brazil
| | | | - Janiel Conceição da Silva
- Universidade Federal do Maranhão, Programa de Pós-Graduação em Saúde e Tecnologia, Imperatriz, MA, Brazil
| | | | - Floriacy Stabnow Santos
- Universidade Federal do Maranhão, Programa de Pós-Graduação em Saúde e Tecnologia, Imperatriz, MA, Brazil
| | - Lívia Maia Pascoal
- Universidade Federal do Maranhão, Programa de Pós-Graduação em Saúde e Tecnologia, Imperatriz, MA, Brazil
| | | | | | - Marcelino Santos
- Universidade Federal do Maranhão, Programa de Pós-Graduação em Saúde e Tecnologia, Imperatriz, MA, Brazil
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Cabral VP, Moraes CLD, Bastos FI, Abreu AMM, Domingues RMSM. Prevalence of alcohol use during pregnancy, Brazil, 2011-2012. CAD SAUDE PUBLICA 2023; 39:e00232422. [PMID: 37556615 PMCID: PMC10494674 DOI: 10.1590/0102-311xpt232422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 03/20/2023] [Accepted: 04/10/2023] [Indexed: 08/11/2023] Open
Abstract
This is a national cross-sectional, hospital-based study, which interviewed 23,894 postpartum women in 2011-2012 aiming to estimate the prevalence of alcohol use during pregnancy and identifying more vulnerable groups. Alcohol use during pregnancy was identified using the TWEAK scale, and women with a score of ≥ 2 were classified as having a "presumable diagnosis of inadequate alcohol use". The national prevalence of alcohol use and the prevalence in subgroups were calculated according to maternal characteristics, with respective 95% confidence intervals (95%CI). Coexistence of smoking, inadequate prenatal consultations, and alcohol use during pregnancy were graphically identified. The prevalence of alcohol use was 14% (95%CI: 13.3-14.7), with 10% (95%CI: 9.3-10.6) of women presenting presumable diagnosis of inadequate alcohol us during pregnancy. Higher prevalence of alcohol use and presumable diagnosis of inadequate alcohol us was observed in black women, aged 12-19 years, with lower educational level, from a lower economic class, without a partner, without paid work, with more than three previous births, who did not want to get pregnant, with inadequate prenatal care, with previous delivery in public services, and who reported smoking during pregnancy. Among the interviewees, 1.2% presented all three risk factors for negative perinatal outcomes at the same time: smoking, alcohol use, and inadequate prenatal care. The results showed a high prevalence of alcohol use during pregnancy and presumable diagnosis of inadequate alcohol us, especially among women with worse social conditions. These data are relevant for the formulation of public policies to prevent alcohol use and provide support services to help this population stop alcohol use during pregnancy.
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Affiliation(s)
- Vanderlea Poeys Cabral
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Claudia Leite de Moraes
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Francisco I Bastos
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
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Ruiz MT, de Oliveira KF, Azevedo NF, Paschoini MC, Rodrigues WF, de Oliveira CJF, de Oliveira JF, Fonseca LMM, Wernet M. Breastfeeding prevalence in newborns of mothers with COVID-19: a systematic review. Rev Bras Enferm 2023; 76Suppl 1:e20220173. [PMID: 37531480 PMCID: PMC10389650 DOI: 10.1590/0034-7167-2022-0173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 01/17/2023] [Indexed: 08/04/2023] Open
Abstract
OBJECTIVES to compare exclusive breastfeeding prevalence versus artificial feeding in newborns of mothers with COVID-19. METHODS a systematic review of prevalence, according to JBI. Searches in PubMed®, Embase, CINAHL, LILACS and Web of Science™ databases in August 2021. Cross-sectional, longitudinal or cohort studies were selected, without language and time limitations that showed breastfeeding prevalence or that allowed calculation. RESULTS fifteen articles published in 2020 and 2021, cohort (60%) or cross-sectional (40%) were analyzed. The average of exclusive breastfeeding in mothers with COVID-19 was 56.76% (CI=39.90-72.88), and artificial breastfeeding, 43.23% (CI = 30.99 - 55.88), without statistically significant differences. CONCLUSIONS despite the recommendations for maintaining breastfeeding, there was a reduction worldwide, when compared to periods prior to the pandemic. With advances in science, these rates have improved, showing the impact of evidence on practices. As limitations, study sources are cited. It is recommended to carry out new studies. PROSPERO registration CRD42021234486.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Monika Wernet
- Universidade Federal de São Carlos. São Carlos, São Paulo, Brazil
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Pons EDS, Pizzol TDSD, Knauth DR, Mengue SS. Self-medication in children aged 0-12 years in Brazil: a population-based study. Rev Paul Pediatr 2023; 42:e2022137. [PMID: 37436244 PMCID: PMC10332440 DOI: 10.1590/1984-0462/2024/42/2022137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 12/23/2022] [Indexed: 07/13/2023]
Abstract
OBJETIVE Studies have shown that the practice of self-medicating children occurs worldwide and is independent of the country's economic level, medication policies, or access to health services. This study aimed to estimate and characterize the prevalence of self-medication in the Brazilian population of children aged up to 12 years. METHODS We analyzed the data of 7528 children aged up to 12 years whose primary caregivers responded to the National Survey on Access, Use and Promotion of Rational Use of Medicines in Brazil (PNAUM), a cross-sectional population-based study conducted in 245 Brazilian municipalities. The prevalence of self-medication was defined as the use of at least one medication without a doctor's or dentist's indication 15 days before the interview. RESULTS The prevalence of self-medication was 22.2% and was more frequent in older children belonging to poorer families and without health insurance. The acute conditions for which there was a higher frequency of self-medication were pain, fever, and cold/allergic rhinitis. Analgesics/antipyretics stood out among the most used medications for self-medication. CONCLUSIONS The prevalence of self-medication to treat acute conditions was high in Brazilian children sampled in PNAUM, emphasizing the management of common symptoms such as pain, fever, and cold/allergic rhinitis in this age group. These findings reinforce the need for educational actions aimed at parents and caregivers.
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Facin M, Samesima N. The Rare Alternans Pre-Excitation Pattern: Is It a Genuinely Benign Phenomenon? Arq Bras Cardiol 2023; 120:e20220864. [PMID: 36790262 PMCID: PMC10389101 DOI: 10.36660/abc.20220864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Affiliation(s)
- Mirella Facin
- Hospital das ClínicasFaculdade de MedicinaUniversidade de São PauloSão PauloSPBrasilInstituto do Coração (InCor) - Hospital das Clínicas HCFMUSP - Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP – Brasil
| | - Nelson Samesima
- Hospital das ClínicasFaculdade de MedicinaUniversidade de São PauloSão PauloSPBrasilInstituto do Coração (InCor) - Hospital das Clínicas HCFMUSP - Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP – Brasil
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Urrutia-Pereira M, Mocelin LP, Ellwood P, Garcia-Marcos L, Simon L, Rinelli P, Chong-Neto HJ, Solé D. Prevalence of rhinitis and associated factors in adolescents and adults: a Global Asthma Network study. Rev Paul Pediatr 2023; 41:e2021400. [PMID: 36888752 PMCID: PMC9984151 DOI: 10.1590/1984-0462/2023/41/2021400] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 06/26/2022] [Indexed: 03/08/2023]
Abstract
OBJECTIVE To determine the prevalence of allergic rhinitis and associated factors in adolescents and in their parents/guardians. METHODS A cross-sectional study, applying a standardized and validated written questionnaire. Adolescents (13-14 years old; n=1,058) and their parents/guardians (mean age=42.1 years old; n=896) living in the city of Uruguaiana, southern Brazil, responded to the Global Asthma Network standard questionnaires. RESULTS The prevalence of allergic rhinitis in adolescents was 28.0%, allergic rhinoconjunctivitis, 21.3%, and severe forms of allergic rhinitis, 7.8%. In the adults, the prevalence of allergic rhinitis was 31.7%. Some associated factors with allergic rhinitis in adolescents include low physical exercise (OR 2.16; 95%CI 1.15-4.05), having only one older sibling (OR 1.94; 95CI 1.01-3.72) and daily meat consumption (OR 7.43; 95% CI 1.53-36.11). In contrast, consuming sugar (OR 0.34; 95%CI 0.12-0.93) or olive oil (OR 0.33; 95%CI 0.13-0 .81) once or twice a week, and eating vegetables daily (OR 0.39; 95%CI 0.15-0.99) were considered factors negatively associated. In adults, exposure to fungi at home (OR 5.25; 95%CI 1.01-27.22) and consumption of meat once or twice a week (OR 46.45; 95CI 2.12-1020.71) were factors associated with the medical diagnosis of allergic rhinitis, while low education (OR 0.25; 95%CI 0.07-0.92) was found to be a factor negatively associated. CONCLUSIONS The prevalence of allergic rhinitis in adolescents is high, as well as its medical diagnosis in adults living in Uruguaiana. Environmental factors, especially food habits, were associated with findings in both groups.
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Affiliation(s)
| | | | | | | | - Laura Simon
- Universidade Federal do Pampa, Bagé, RS, Brazil
| | | | | | - Dirceu Solé
- Universidade Federal de São Paulo, São Paulo, SP, Brazil
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Cechinel C, Lenardt MH, Rodrigues JAM, Binotto MA, Aristides MM, Kraus R. Frailty and delirium in hospitalized older adults: A systematic review with meta-analysis. Rev Lat Am Enfermagem 2022; 30:e3687. [PMID: 36287400 PMCID: PMC9580989 DOI: 10.1590/1518-8345.6120.3687] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 06/17/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to estimate the prevalence and synthesize diverse evidence about the relationship between frailty and delirium in hospitalized older adults. METHOD a systematic review with meta-analysis in which observational studies conducted with older adults about frailty, delirium and hospitalization, were selected without time of language restrictions. The search was conducted in the MEDLINE, EMBASE, CINAHL, Scopus, Web of Science and CENTRAL databases during August 2021. The precepts set forth by the Joanna Briggs Institute (JBI) - Evidence Synthesis Groups were followed. The meta-analysis model estimated the relative risk corresponding to the prevalence of frailty and delirium. The inverse variance method for proportions was used to estimate the prevalence values and relative risks for binary outcomes. RESULTS initially, 1,244 articles were identified, of which 26 were included in the meta-analysis (n=13,502 participants), with 34% prevalence of frailty (95% CI:0.26-0.42; I 2=99%; t 2=0.7618, p=0) and 21% for delirium (95% CI:0.17-0,25; I 2=95%; t 2=0.3454, p<0.01). The risk for hospitalized older adults to develop delirium was 66% (RR: 1.66; 95% CI:1.23-2.22; I2=92%; t2=0.4154; p<0.01). CONCLUSION 34% prevalence of frailty and 21% of delirium in hospitalized older adults, with frailty being an independent risk factor for developing delirium, with an increased chance of 66% when compared to non-frail individuals.
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Affiliation(s)
- Clovis Cechinel
- Universidade Federal do Paraná, Curitiba, PR, Brazil.,Secretaria Municipal de Saúde, Hospital Municipal do Idoso Zilda Arns, Curitiba, PR, Brazil
| | | | | | - Maria Angélica Binotto
- Universidade Estadual do Centro-Oeste, Departamento de Educação Fisica, Irati, PR, Brazil
| | | | - Rosane Kraus
- Universidade Federal do Paraná, Curitiba, PR, Brazil., Fundação Estatal de Atencão a Saúde, Hospital Municipal do Idoso Zilda Arns, Curitiba, PR, Brazil
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de Paiva KM, Hillesheim D, Rech CR, Delevatti RS, Brown RVS, Gonzáles AI, Haas P. Prevalence and Associated Factors of SARS by Covid-19 in Adults and Aged People with Chronic Cardiovascular Disease. Arq Bras Cardiol 2021; 117:968-975. [PMID: 34161421 PMCID: PMC8682099 DOI: 10.36660/abc.20200955] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/22/2020] [Accepted: 11/11/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The presence of Cardiovascular Disease (CVD) in individuals infected with COVID-19 may imply a worse prognosis. OBJECTIVE To describe the prevalence of Severe Acute Respiratory Syndrome (SARS) by COVID-19 and to analyze the factors associated with this condition in adults and the elderly with cardiovascular disease in Brazil until the 30th Epidemiological Week of 2020. METHODS Cross-sectional study conducted with data from the Influenza Epidemiological Surveillance Information System (Sistema de Informação de Vigilância Epidemiológica da Gripe - SIVEP-Gripe), referring to the SARS notification forms of hospitalized individuals in Brazil, between the 1st and 30th Epidemiological Week of 2020. Adults and the aged (≥ 18 years old) with CVD. The dependent variable was SRAG confirmation by COVID-19 and factors related to sociodemographic characteristics, signs and symptoms, and clinical factors were analyzed. Poisson regression with robust variance was applied. The level of significance adopted was 5%. RESULTS Notifications from 116,343 individuals were analyzed. Of these, 61.9% were diagnosed with SARS by COVID-19. The prevalence of the outcome was 4% lower in women (95%CI: 0.94-0.99) and 18% lower in rural areas (95%CI: 0.77-0.87). There was a higher prevalence in the 50 to 59 age group (95%CI: 1.09-1.48) and in the northeast region (95%CI: 1.72-1.91). Fever, cough, admission to the ICU, use of ventilatory support, and nosocomial cases were also significantly associated with a higher probability of SRAS by COVID-19 in these individuals. CONCLUSION There is a high prevalence of SARS by COVID-19 in adults and aged people with CVD in Brazil. Factors associated with sociodemographic and clinical characteristics, signs, and symptoms were associated.
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Affiliation(s)
- Karina Mary de Paiva
- Universidade Federal de Santa CatarinaFlorianópolisSCBrasilUniversidade Federal de Santa Catarina (UFSC), Florianópolis, SC – Brasil
| | - Danúbia Hillesheim
- Universidade Federal de Santa CatarinaFlorianópolisSCBrasilUniversidade Federal de Santa Catarina (UFSC), Florianópolis, SC – Brasil
| | - Cassiano Ricardo Rech
- Universidade Federal de Santa CatarinaFlorianópolisSCBrasilUniversidade Federal de Santa Catarina (UFSC), Florianópolis, SC – Brasil
| | - Rodrigo Sudatti Delevatti
- Universidade Federal de Santa CatarinaFlorianópolisSCBrasilUniversidade Federal de Santa Catarina (UFSC), Florianópolis, SC – Brasil
| | - Rodrigo Vasconi Sáez Brown
- Universidade Federal de Santa CatarinaFlorianópolisSCBrasilUniversidade Federal de Santa Catarina (UFSC), Florianópolis, SC – Brasil
| | - Ana Inês Gonzáles
- Universidade Federal de Santa CatarinaFlorianópolisSCBrasilUniversidade Federal de Santa Catarina (UFSC), Florianópolis, SC – Brasil
- Centro Universitário Estácio de Santa CatarinaSão JoséSCBrasilCentro Universitário Estácio de Santa Catarina, São José, SC – Brasil
| | - Patricia Haas
- Universidade Federal de Santa CatarinaFlorianópolisSCBrasilUniversidade Federal de Santa Catarina (UFSC), Florianópolis, SC – Brasil
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Santos LG, Baggio JADO, Leal TC, Costa FA, Fernandes TRMDO, da Silva RV, Armstrong A, Carmo RF, de Souza CDF. Prevalence of Systemic Arterial Hypertension and Diabetes Mellitus in Individuals with COVID-19: A Retrospective Study of Deaths in Pernambuco, Brazil. Arq Bras Cardiol 2021; 117:416-422. [PMID: 34495244 PMCID: PMC8395789 DOI: 10.36660/abc.20200885] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 10/23/2020] [Accepted: 11/11/2020] [Indexed: 01/08/2023] Open
Abstract
Hipertensão arterial sistêmica (HAS) e diabetes mellitus (DM) são dois dos principais fatores de risco para a mortalidade por COVID-19. Descrever a prevalência e o perfil clínico-epidemiológico de óbito por COVID-19 ocorridos em Pernambuco, Brasil, entre 12 de março e 14 de maio de 2020 entre pacientes que possuíam hipertensão arterial sistêmica e/ou diabetes mellitus como doenças prévias. Estudo observacional transversal. Foram analisadas as seguintes variáveis: município de procedência, sexo, faixa etária, tempo entre o início dos sinais/sintomas e o óbito, sinais/sintomas, tipo de comorbidades e hábitos de vida. Variáveis categóricas foram descritas por meio de frequências e variáveis contínuas por meio de medidas de tendência central e de dispersão. Os testes de Mann-Whitney e Kruskal-Wallis foram utilizados. Dos 1.276 registros incluídos no estudo, 410 apresentavam HAS e/ou DM. A prevalência de HAS foi 26,5% (n=338) e de DM foi 19,7% (n=252). Dos registros, 158 (12,4%) eram de pacientes que possuíam somente HAS, 72 (5,6%) somente DM e 180 (14,1%) apresentavam HAS e DM. Dos indivíduos com HAS, 53,3% apresentavam DM e 71,4% dos diabéticos apresentam HAS. A mediana (em dias) do tempo entre o início dos sinais/sintomas e o desfecho óbito foi 8,0 (IIQ 9,0), sem diferença significativa entre os grupos de comorbidades (p=0,633), sexo (p=0,364) e faixa etária (p=0,111). Observou-se maior prevalência de DM e HAS na população masculina (DM — 61,3% eram homens e 38,9% mulheres; HAS — 53,2% eram homens e 46,8% mulheres). Os sinais/sintomas mais frequentes foram dispneia (74,1%; n=304), tosse (72,2%; n=296), febre (68,5%; n=281) e saturação de O2<95% (66,1%; n=271). Dos hipertensos, 73,3% (n=100) apresentavam outras comorbidades/fatores de risco associados, e 54,2% (n=39) dos diabéticos apresentavam outras comorbidades/fatores de risco associados. Destacaramse as cardiopatias (19,5%; n=80), obesidade (8,3%; n=34), doença respiratória prévia (7,3%; n=30) e nefropatia (7,8%; n=32). A prevalência de tabagismo foi 8,8% (n=36) e de etilismo alcançou 3,4% (n=14). O estudo mostrou que a prevalência de HAS foi superior à prevalência de DM nos indivíduos que foram a óbito por COVID-19. Em idosos, a prevalência foi superior à observada em indivíduos não idosos.
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Affiliation(s)
- Lucas Gomes Santos
- Universidade Federal de AlagoasCurso de MedicinaMaceióALBrasilUniversidade Federal de Alagoas - Curso de Medicina, Maceió, AL - Brasil.
| | | | - Thiago Cavalcanti Leal
- Universidade Federal de AlagoasCurso de MedicinaMaceióALBrasilUniversidade Federal de Alagoas - Curso de Medicina, Maceió, AL - Brasil.
| | - Francisco A. Costa
- Universidade Federal de AlagoasCurso de MedicinaMaceióALBrasilUniversidade Federal de Alagoas - Curso de Medicina, Maceió, AL - Brasil.
| | | | - Regicley Vieira da Silva
- Universidade Federal de AlagoasCurso de MedicinaMaceióALBrasilUniversidade Federal de Alagoas - Curso de Medicina, Maceió, AL - Brasil.
| | - Anderson Armstrong
- Universidade Federal do Vale do São FranciscoMedicinaPetrolinaPEBrasilUniversidade Federal do Vale do São Francisco – Medicina, Petrolina, PE – Brasil.
| | - Rodrigo Feliciano Carmo
- Universidade Federal do Vale do São FranciscoMedicinaPetrolinaPEBrasilUniversidade Federal do Vale do São Francisco – Medicina, Petrolina, PE – Brasil.
| | - Carlos Dornels Freire de Souza
- Universidade Federal de AlagoasCurso de MedicinaMaceióALBrasilUniversidade Federal de Alagoas - Curso de Medicina, Maceió, AL - Brasil.
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Santos BL, Oliveira AMP, Oliveira HA, Amorim RLOD. Primary central nervous system tumors in Sergipe, Brazil: descriptive epidemiology between 2010 and 2018. Arq Neuropsiquiatr 2021; 79:S0004-282X2021005014201. [PMID: 34231652 PMCID: PMC9394575 DOI: 10.1590/0004-282x-anp-2020-0151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 10/19/2020] [Accepted: 10/21/2020] [Indexed: 02/21/2024]
Abstract
BACKGROUND Central nervous system (CNS) tumors are a heterogeneous group with high morbidity and mortality. OBJECTIVES To describe the epidemiology of primary CNS tumors diagnosed in the state of Sergipe from 2010 to 2018. METHODS We evaluated histopathological and immunohistochemical reports on primary CNS tumors diagnosed in Sergipe, Brazil, between 2010 and 2018 and collected data regarding age, sex, location, World Health Organization (WHO) classification and histology. RESULTS Altogether, 861 primary CNS tumors were found. Tumors in brain locations occurred most frequently (50.8%; n=437). The neoplasms observed were most prevalent in the age range 45‒54 years (20.4%; n=176). Grade I tumors occurred most frequently, corresponding to 38.8% of the cases (n=38) in the age group of 0‒14 years, and 44.6% (n=340) in the population ≥15 years old. Between 0 and 14 years of age, other astrocytic tumors were the most prevalent (29.6%; n=29). In the age group between 15 and 34, gliomas were the most frequent (32.7%; n=54). Meningiomas predominated in the age group of 35 years and above, comprising 47.5% of cases (n=206) in the 35‒74 age group; and 61.2% (n=30) among patients over 75 years old. CONCLUSION The epidemiology of primary CNS tumors in Sergipe between 2010 and 2018 is consistent with data in other current studies on the subject. Studies on the epidemiological evolution of these entities in Sergipe are needed.
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Affiliation(s)
- Bárbara Loiola Santos
- Universidade Federal de Sergipe, Departamento de Medicina de Lagarto, Lagarto SE, Brazil
| | - Arthur Maynart Pereira Oliveira
- Universidade Federal de Sergipe, Departamento de Medicina, Aracaju SE, Brazil
- Fundação de Beneficência Hospital de Cirurgia, Serviço de Neurocirurgia, Aracaju SE, Brazil
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Moreira DG, Oliveira EMLD, Coelho FMDS, Ferraz HB, Francisco S, Borges V, Bichuetti DB. What can be expected to be seen in a Neurology ward? Eleven-year experience in a Brazilian university hospital. Arq Neuropsiquiatr 2021; 79:S0004-282X2021005011201. [PMID: 34190815 PMCID: PMC9394574 DOI: 10.1590/0004-282x-anp-2020-0310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 09/16/2020] [Accepted: 09/20/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Neurological disorders are significant causes of morbidity and mortality worldwide. However, data about general neurological inpatient admissions in Brazil is limited. Objective: To investigate the prevalence of neurological disorders according to disease group and lesion site among patients admitted to a general Neurology ward. METHODS This was an observational and descriptive study. The hospital discharge database for the Neurology ward was surveyed in accordance with the International Classification of Diseases, 10th edition (ICD-10), from September 2008 to October 2019. The final diagnosis was classified into neurological disorder groups and site. RESULTS Overall, 2,606 clinical neurological patient files were included, with mean length of hospitalization of 16.7 days and a total of 325 readmissions (12.5%). The overall mortality rate in the ward was 3.8% (100 patients). Among all the diagnoses, cerebrovascular disease was the most prevalent (45.8%), followed by inflammatory disorders (22.2%). The brain was the most common lesion site (66.0%), followed by peripheral nerves (10.0%) and meninges and cerebrospinal fluid (7.7%). CONCLUSIONS The disease pattern upon admission showed that a majority of the cases consisted of cerebrovascular disorders and that the brain was the most frequently affected structure, although we observed that a wide variety of cases were admitted, encompassing all neurological disorders.
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Affiliation(s)
- Daniel Gabay Moreira
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Disciplina de Neurologia, São Paulo SP, Brazil
| | | | | | - Henrique Ballalai Ferraz
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Disciplina de Neurologia, São Paulo SP, Brazil
| | - Silvio Francisco
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Disciplina de Neurologia, São Paulo SP, Brazil
| | - Vanderci Borges
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Disciplina de Neurologia, São Paulo SP, Brazil
| | - Denis Bernardi Bichuetti
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Disciplina de Neurologia, São Paulo SP, Brazil
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Franzoni L, Zubaran GPDR, da Motta SB. Walking Training Improve Ambulatorial Blood Pressure Variability in Claudicants. Arq Bras Cardiol 2021; 116:906-907. [PMID: 34008812 PMCID: PMC8121462 DOI: 10.36660/abc.20210140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Leandro Franzoni
- Universidade Federal do Rio Grande do SulPorto AlegreRSBrasilUniversidade Federal do Rio Grande do Sul - Programa de Pós-Graduação em Ciências da Saúde: Cardiologia e Ciências Cardiovasculares, Porto Alegre, RS - Brasil
| | - Gabriel Pereira de Reis Zubaran
- Hospital de Clínicas de Porto AlegrePorto AlegreRSBrasilHospital de Clínicas de Porto Alegre - Grupo de Pesquisa em Cardiologia do Exercício, Porto Alegre, RS - Brasil
| | - Stephanie Bastos da Motta
- Hospital de Clínicas de Porto AlegrePorto AlegreRSBrasilHospital de Clínicas de Porto Alegre - Grupo de Vascular e Exercício - VascuEx, Porto Alegre, RS - Brasil
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Nunes NSV, Carvalho JPM, Costa FS, Nacif MS, Dominato J, Mesquita CT, Mesquita ET. Syncope as a Phenotypic Expression of Hereditary Transthyretin Amyloidosis Val142Ile (Val122Ile). Arq Bras Cardiol 2020; 114:1-3. [PMID: 31751438 PMCID: PMC8149112 DOI: 10.36660/abc.20180130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 12/11/2018] [Accepted: 12/19/2018] [Indexed: 11/18/2022] Open
Affiliation(s)
- Nágela S. V. Nunes
- Complexo Hospitalar de NiteróiNiteróiRJBrasilComplexo Hospitalar de Niterói – Cardiologia, Niterói, RJ – Brasil
- Hospital Universitário Antônio PedroDepartamento de Cardiologia (Ebserh/UFF)NiteróiRJBrasilHospital Universitário Antônio Pedro, Departamento de Cardiologia (Ebserh/UFF), Niterói, RJ – Brasil
| | | | - Fernanda Salomão Costa
- Hospital Pró-CardíacoRio de JaneiroRJBrasilHospital Pró-Cardíaco - Medicina Nuclear, Rio de Janeiro, RJ – Brasil
| | - Marcelo Souto Nacif
- Complexo Hospitalar de NiteróiNiteróiRJBrasilComplexo Hospitalar de Niterói – Cardiologia, Niterói, RJ – Brasil
- Hospital Universitário Antonio PedroDepartamento de Radiologia (Ebserh/UFF)NiteroiRio de JaneiroBrasilHospital Universitário Antonio Pedro, Departamento de Radiologia (Ebserh/UFF), Niteroi, Rio de Janeiro – Brasil
| | - Joelma Dominato
- Complexo Hospitalar de NiteróiNiteróiRJBrasilComplexo Hospitalar de Niterói – Cardiologia, Niterói, RJ – Brasil
| | - Claudio Tinoco Mesquita
- Hospital Pró-CardíacoRio de JaneiroRJBrasilHospital Pró-Cardíaco - Medicina Nuclear, Rio de Janeiro, RJ – Brasil
- Hospital Universitário Antonio PedroDepartamento de Radiologia (Ebserh/UFF)NiteroiRio de JaneiroBrasilHospital Universitário Antonio Pedro, Departamento de Radiologia (Ebserh/UFF), Niteroi, Rio de Janeiro – Brasil
| | - Evandro Tinoco Mesquita
- Hospital Universitário Antônio PedroDepartamento de Cardiologia (Ebserh/UFF)NiteróiRJBrasilHospital Universitário Antônio Pedro, Departamento de Cardiologia (Ebserh/UFF), Niterói, RJ – Brasil
- Americas Medical CityCentro de Educação e Treinamento Edson BuenoRio de JaneiroRJBrasilAmericas Medical City - Centro de Educação e Treinamento Edson Bueno, Rio de Janeiro, RJ – Brasil
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Vasconcelos MJDOB, Rissin A, Figueiroa JN, Lira PICD, Batista Filho M. Factors associated with diarrhea in children under five years old in the state of Pernambuco, according to surveys conducted in 1997 and 2006. Rev Saude Publica 2018; 52:48. [PMID: 29723386 PMCID: PMC5947442 DOI: 10.11606/s1518-8787.2018052016094] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 08/28/2017] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Describe and compare variations of the factors associated with the prevalence of diarrhea in children under five years old in the state of Pernambuco. METHODS We used the databases of two population-based surveys from the years 1997 and 2006, with 2,078 and 1,650 children, respectively, evaluated in 18 municipalities of Pernambuco (Metropolitan Region of Recife, urban and rural interior). The variables, allocated at hierarchical levels, were analyzed using prevalence and Poisson regression ratios. RESULTS Only four variables were independently associated and were included in the final hierarchical model: geographical area, number of people per room, maternal age and the age of the child. In 1997: urban interior = 1.33 (95%CI 1.06-1.66), rural interior = 1.22 (95%CI 0.97-1.53) and in 2006: urban interior = 1.87 (95%CI 1.31-2.66), rural interior = 2.07 (95%CI 1.50-2.85); number of persons per room (1997): 1 to less than 2 = 1.29 (95%CI 0.98-1.68), two or more = 1.47 (95%CI 1.11-1.95) and in 2006: 1 to less than 2 = 0.86 (95%CI 0.68-1.09), two or more = 1.29 (95%CI 0.94-1.75); maternal age (1997): 10 to 19 years = 1.48 (95%CI 1.05-2.08), 20 to 24 years = 1.23 (95%CI 0.94-1.60), 25 to 34 years = 1.01 (95%CI 0.78-1.30) and in 2006: 10 to 19 years old = 1.70 (95%CI 1.08-2.66), 20 to 24 years old = 1.64 (95%CI 1.16-2.32), 25 to 34 years = 1.20 (95%CI 0.89-1.62); and age of the child (1997): 0-11 months = 1.57 (95%CI 1.27-1.94), 12-23 months = 1.73 (95%CI 1.41-2.12) and in 2006: 0-11 months = 1.04 (95%CI 0.76-1.41), 12-23 months = 1.77 (95%CI 1.41-2.23). CONCLUSIONS There was a great variability of the conditioners of diarrhea in children between the two periods analyzed. At the public policy level, despite changes in terms of people, time sequences, and geographic spaces, diarrhea remains on an important scale in the ranking of government power.
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Affiliation(s)
| | - Anete Rissin
- Instituto de Medicina Integral Prof. Fernando Figueira, Recife, PE, Brasil
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Ciaccia MCC, Pinto CN, Golfieri FDC, Machado TF, Lozano LL, Silva JMS, Rullo VEV. PREVALENCE OF GENU VALGUM IN PUBLIC ELEMENTARY SCHOOLS IN THE CITY OF SANTOS (SP), BRAZIL. Rev Paul Pediatr 2017; 35:443-447. [PMID: 28977127 PMCID: PMC5737256 DOI: 10.1590/1984-0462/;2017;35;4;00002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Accepted: 12/23/2016] [Indexed: 12/04/2022]
Abstract
OBJECTIVE To evaluate the prevalence of genu valgum and associated factors in elementary school students. METHODS Cross-sectional study, carried out in 2015, with 1,050 children and adolescents enrolled in an elementary school in Santos, Southeast Brazil. Misalignment of the knee was assessed by intermalleolar distance, considering ≥8 cm or <8 cm. Inter-examiners reliability was measured by Kappa coefficient, resulting in 0.94. Nutritional status was evaluated according to the World Health Organization 2006 references. Logistic regression model was applied to analyze variables associated with genu valgum. RESULTS Among schoolchildren, 7.1% had genu valgum. The frequency was higher among overweight or obese schoolchildren. On average, students with genu valgum are older than those without it. There was no association with gender. Upon logistic regression model, only nutritional status was significantly associated with this condition. The chance of occurrence of valgus knee in overweight and obese schoolchildren was, respectively, 6.0 and 75.7 times greater than among thin or eutrophic subjects. CONCLUSIONS The prevalence of genu valgum in elementary school children and adolescents was 7.1%, being higher among overweight/obese students and presenting no association with gender or age.
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Andall-Brereton G, Brown E, Slater S, Holder Y, Luciani S, Lewis M, Irons B. Prevalence of high-risk human papillomavirus among women in two English-speaking Caribbean countries. Rev Panam Salud Publica 2017. [PMID: 28614466 PMCID: PMC6660866 DOI: 10.26633/rpsp.2017.41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE To characterize high-risk human papillomavirus (HPV) infections in a sample of women in two small English-speaking Caribbean countries: Saint Kitts and Nevis and Saint Vincent and the Grenadines. METHODS Sexually active women ≥ 30 years old attending primary care health facilities participated in the study. Each participant had a gynecological examination, and two cervical specimens were collected: (1) a specimen for a Papanicolaou (Pap) test and (2) a sample of exfoliated cervical cells for HPV DNA testing, using the HPV High Risk Screen Real-TM (Sacace). High-risk HPV genotypes were assessed in 404 women in Saint Kitts and Nevis and 368 women in Saint Vincent and the Grenadines. RESULTS High-risk HPV was detected in 102 of 404 (25.2%) in Saint Kitts and Nevis and in 109 of 368 (29.6%) in Saint Vincent and the Grenadines. High-risk HPV genotypes 52, 35, 51, 45, and 31 were the most common high-risk types in Saint Kitts and Nevis. In Saint Vincent and the Grenadines, the most common high-risk HPV genotypes were 45, 35, 31, 18, and 51. Current age was found to be significantly associated with high-risk HPV infection in both countries. In addition, in Saint Vincent and the Grenadines, high parity (> 3 pregnancies) and having had an abnormal Pap smear were found to be independent risk factors for high-risk HPV. CONCLUSIONS These results contribute to the evidence on HPV prevalence for small island states of the Caribbean and support the accelerated introduction of the 9-valent HPV vaccine in the two countries and elsewhere in the English-speaking Caribbean. Use of the study's results to guide the development of policy regarding implementation of HPV testing as the primary screening modality for older women is recommended.
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Affiliation(s)
- Glennis Andall-Brereton
- Caribbean Public Health AgencyCaribbean Public Health AgencyPort-of-SpainTrinidad and TobagoCaribbean Public Health Agency, Port-of-Spain, Trinidad and Tobago.
| | - Eulynis Brown
- Ministry of HealthMinistry of HealthSaint Kitts and NevisMinistry of Health, Saint Kitts and Nevis, Basseterre, Saint Kitts and Nevis.
| | - Sherian Slater
- Ministry of Health, Wellness and the EnvironmentMinistry of Health, Wellness and the EnvironmentMinistry of Health, Wellness and the Environment, Saint Vincent and the Grenadines, Kingstown, Saint Vincent and the Grenadines.
| | - Yvette Holder
- Office of Eastern Caribbean CoordinationPan American Health Organization/World Health OrganizationBarbadosOffice of Eastern Caribbean Coordination, Pan American Health Organization/World Health Organization, Bridgetown, Barbados.,Send correspondence to Beryl Irons: ,
| | - Silvana Luciani
- Pan American Health OrganizationPan American Health OrganizationWashingtonUnited States of AmericaPan American Health Organization, Washington, D.C., United States of America.
| | - Merle Lewis
- Pan American Health OrganizationPan American Health OrganizationWashingtonUnited States of AmericaPan American Health Organization, Washington, D.C., United States of America.
| | - Beryl Irons
- Office of Eastern Caribbean CoordinationPan American Health Organization/World Health OrganizationBarbadosOffice of Eastern Caribbean Coordination, Pan American Health Organization/World Health Organization, Bridgetown, Barbados.
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de Carvalho RT, Canté JCL, Lima JHS, Tavares LAB, Takano MI, Tavares FG. Prevalence of knee arthroplasty in the state of São Paulo between 2003 and 2010. SAO PAULO MED J 2016; 134:417-422. [PMID: 27901242 PMCID: PMC10871848 DOI: 10.1590/1516-3180.2016.0111300616] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 06/30/2016] [Indexed: 01/22/2023] Open
Abstract
CONTEXT AND OBJECTIVE: The volume of knee arthroplasty procedures has increased over the last decade. The aim of this study was to estimate the frequency of these procedures performed within the public healthcare system of the state of São Paulo between 2003 and 2010. DESIGN AND SETTING: Cross-sectional study conducted in the state of São Paulo by researchers at Hospital do Servidor Público do Estado de São Paulo. METHODS: A sample of 10,952 patients (7,891 females and 3,061 males) who underwent primary total knee arthroplasty (TKA) and revision of total knee arthroplasty (RTKA) in the state of São Paulo between 2003 and 2010 was evaluated. The patients were cataloged using the public healthcare service's TABNET software. All of the patients presented primary osteoarthritis of the knee. The variables of gender, number of primary TKA procedures and number of RTKA procedures were evaluated. RESULTS: A total of 10,952 TKA procedures were performed (annual average of 1369), of which 9,271 (85%) were TKA and 1,681 (15%), RTKA. Of the TKA procedures, 72% were carried out on females (P < 0.0001), while 70% of the RTKA procedures were on females (P < 0.0001). The average ratio of TKA to RTKA was 5.5:1 (P < 0.0001); the ratios in 2003 and 2010 were 9.0:1 and 4.4:1 (P < 0.0001), respectively. CONCLUSION: The number and frequency of TKA and RTKA procedures increased in the state of São Paulo between 2003 and 2010. This increase was relatively greater in RTKA than in TKA and was predominantly in female patients.
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Affiliation(s)
- Rogério Teixeira de Carvalho
- MD. Attending Physician in the Knee Group, Orthopedics and Traumatology Service, Hospital do Servidor Público do Estado de São Paulo, São Paulo (SP), Brazil.
| | - Jonny Chaves Lima Canté
- MD. Fellow in the Knee Group, Orthopedics and Traumatology Service, Hospital do Servidor Público do Estado de São Paulo, São Paulo (SP), Brazil.
| | - Juliana Hoss Silva Lima
- MSc. Statistician, Orthopedics and Traumatology Service, Hospital do Servidor Público do Estado de São Paulo, São Paulo (SP), Brazil.
| | - Luiz Alberto Barbosa Tavares
- MD. Fellow in the Pediatric Orthopedics Group, Orthopedics and Traumatology Service, Hospital do Servidor Público do Estado de São Paulo, São Paulo (SP), Brazil.
| | - Marcelo Itiro Takano
- MD. Attending Physician in the Hip Group, Orthopedics and Traumatology Service, Hospital do Servidor Público do Estado de São Paulo, São Paulo (SP), Brazil.
| | - Fernando Gomes Tavares
- MD. Attending Physician in the Knee Group, Orthopedics and Traumatology Service, Hospital do Servidor Público do Estado de São Paulo, São Paulo (SP), Brazil.
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Depintor JDP, Bracher ESB, Cabral DMC, Eluf-Neto J. Prevalence of chronic spinal pain and identification of associated factors in a sample of the population of São Paulo, Brazil: cross-sectional study. SAO PAULO MED J 2016; 134:375-384. [PMID: 27901240 PMCID: PMC10871843 DOI: 10.1590/1516-3180.2016.0091310516] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 05/31/2016] [Indexed: 01/21/2023] Open
Abstract
CONTEXT AND OBJECTIVE: Chronic spinal pain, especially low-back pain and neck pain, is a leading cause of years of life with disability. The aim of the present study was to estimate the prevalence of chronic spinal pain among individuals aged 15 years or older and to identify the factors associated with it. DESIGN AND SETTING: Cross-sectional epidemiological study on a sample of the population of the city of São Paulo. METHOD: Participants were selected using random probabilistic sampling and data were collected via face-to-face interviews. The Hospital Anxiety and Depression Scale (HADS), EuroQol-5D, Alcohol Use Disorders Identification Test (AUDIT), Fagerström test for nicotine dependence and Brazilian economic classification criteria were used. RESULTS: A total of 826 participants were interviewed. The estimated prevalence of chronic spinal pain was 22% (95% confidence interval, CI: 19.3-25.0%). The factors independently associated with chronic spinal pain were: female sex, age 30 years or older, schooling level of four years or less, symptoms compatible with anxiety and high physical exertion during the main occupation. Quality of life and self-rated health scores were significantly worse among individuals with chronic spinal pain. CONCLUSION: The prevalence of chronic spinal pain in this segment of the population of São Paulo was 22.0%. The factors independently associated with chronic pain were: female sex, age 30 years or older, low education, symptoms compatible with anxiety and physical exertion during the main occupation.
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Affiliation(s)
| | | | | | - José Eluf-Neto
- MD, PhD. Professor, Department of Preventive Medicine, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.
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Moraes EVD, Campos RN, Avelino MM. Depressive Symptoms in Pregnancy: The Influence of Social, Psychological and Obstetric Aspects. Rev Bras Ginecol Obstet 2016; 38:293-300. [PMID: 27399924 PMCID: PMC10374235 DOI: 10.1055/s-0036-1585072] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Accepted: 05/19/2016] [Indexed: 10/21/2022] Open
Abstract
Purpose To assess the prevalence of depressive symptoms and their association with social, psychological, behavioral and obstetric characteristics in pregnant women. Methods This is a cross-sectional study. The sample consisted of 375 pregnant women who attended prenatal clinics in two public maternity hospitals located in the city of Goiania, Brazil. To testify the depressive symptoms, we used the Hospital Anxiety and Depression Scale (HADS). A descriptive statistical analysis was performed using programs such as CDC EPI-INFO™, version 7.1.5, and Statistical Package for Social Sciences (IBM SPSS), version 21.0. Results the patients had probable depressive symptoms (15.47%) and possible depressive symptoms (25.33%). The bivariate analysis showed a significant association among "depressive symptoms" and the following variables: "single or divorced" (prevalence ratio, PR = 2.08; 95% confidence interval, CI = 1.26 to 3.44); "physical activity during pregnancy" (PR = 3.96; 95%CI = 1.28 to 12.31); exposure to "psychological/emotional" violence (PR = 4.74; 95%CI = 2.94 to 7.64); "prior mental problem" (PR = 2.66; 95%CI =1.49 to 4.73) and "obstetric complications during pregnancy" (PR = 2.53; 95%CI = 1.55 to 4.13). The multivariate analysis confirmed the association of these depressive symptoms with the variables "suffered psychological/emotional violence" (odds ratio, OR = 5.821; 95%CI = 2.939 to 11.528); "physical activity during pregnancy" (OR = 3.885; 95%CI = 1.060 to 14.231); "obstetric complications during pregnancy" (OR = 2.442; 95%CI = 1.233 to 4.834) and "single or divorced" (OR = 2.943; 95%CI = 1.326 to 6.533). Conclusions the prevalence of depressive symptoms among pregnant women is of 15.47%, and emotional violence is the main factor associated with gestational depression.
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Affiliation(s)
| | - Rodolfo Nunes Campos
- Departament of Mental Health and Forensic Medicine, Faculdade de Medicina, Universidade Federal de Goiás (UFG), Goiânia, Goiás, Brazil
| | - Mariza Martins Avelino
- Departament of Pediatrics and Puericulture, Faculdade de Medicina, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
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Baldaçara L, Silva ÁF, Castro JGD, Santos GDCA. Common psychiatric symptoms among public school teachers in Palmas, Tocantins, Brazil. An observational cross-sectional study. SAO PAULO MED J 2015; 133:435-8. [PMID: 26648433 PMCID: PMC10871806 DOI: 10.1590/1516-3180.2014.8242810] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Revised: 10/17/2014] [Accepted: 10/28/2014] [Indexed: 11/21/2022] Open
Abstract
CONTEXT AND OBJECTIVE Teachers are at great risk of physical and mental stress due to material or psychological difficulties associated with their work. This study aimed to assess the prevalence of common psychiatric symptoms measured on the Self-Reporting Questionnaire (SRQ-20) scale that would suggest a diagnosis of psychiatric disorders among public school teachers in Palmas, Tocantins, Brazil, in 2012. DESIGN AND SETTING Observational cross-sectional study in Palmas, Tocantins, Brazil. METHOD We assessed 110 municipal teachers in the city of Palmas, Tocantins, Brazil. They were selected randomly from a list of employees of the Municipal Education Department of Palmas. All of them answered the SRQ-20 questionnaire after giving their consent. RESULTS Between the years 2008 and 2011, 24 cases of absence from work due to mental disorders were found. We excluded one case and 109 teachers answered the SRQ-20questionnaire. Out of the 109 teachers assessed, 54 had ≥ 7 points on the SRQ-20 scale. This finding suggests that 49.5% of the teachers had symptoms that were sufficient to consider a diagnosis of mental disorder, with the need for treatment. CONCLUSION Our study found that the prevalence of mental disorders among teachers is as high as seen in the literature. Our results suggest that recognition of mental disorders is low and that the current statistics fail to reach the occupational health sector.
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Affiliation(s)
- Leonardo Baldaçara
- PhD. Professor, Medicine Program and Master´s Health Science Program, Universidade Federal do Tocantins (UFT), Palmas, Tocantins, Brazil
| | - Álvaro Ferreira Silva
- MSc. Researcher, Master's Health Science Program, Universidade Federal do Tocantins (UFT), Palmas, Tocantins, Brazil
| | - José Gerley Díaz Castro
- PhD. Professor, Master's Health Science Program, Universidade Federal do Tocantins (UFT), Palmas, Tocantins, Brazil
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Passos VMDA, Caramelli P, Benseñor I, Giatti L, Barreto SM. Methods of cognitive function investigation in the Longitudinal Study on Adult Health (ELSA-Brasil). SAO PAULO MED J 2014; 132:170-7. [PMID: 24788031 PMCID: PMC10852095 DOI: 10.1590/1516-3180.2014.1323646] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Revised: 05/28/2013] [Accepted: 06/19/2013] [Indexed: 01/20/2023] Open
Abstract
CONTEXT AND OBJECTIVE Many uncertainties concerning risk factors and evolution of cognitive disorders remain. We describe the methods and preliminary results from the investigation of the cognitive function in the Longitudinal Study on Adult Health (ELSA-Brasil). DESIGN AND SETTING Multicenter cohort study on public employees at six public teaching and research institutions. METHODS The participants were interviewed and examined to obtain a broad range of social, clinical and environmental characteristics. The following standardized tools were used to assess memory, language and visuospatial and executive functions: words or figure memory test; semantic (animals) and phonemic (letter F) verbal fluency tests; and trail test B. RESULTS 15,101 out of 15,105 participants took the cognitive tests: 54% were women; the mean age was 51 years; and 52% had a university degree. 14,965 participants (99%) did the word test and 136 (1%) did the figure test due to low schooling level. The scores from the semantic verbal fluency tests (mean = 18.42 ± 5.29; median = 18 words) were greater than the scores from the phonemic verbal fluency tests (mean = 12.46 ± 4.5; median = 12 words). The median time taken to perform the trail test was 1.6 minutes. CONCLUSION The large cohort size, of young age, and the extensive amount of clinical and epidemiological data available will make it possible to investigate the prognostic value of biological, behavioral, environmental, occupational and psychosocial variables over the short and medium terms in relation to cognitive decline, among adults and elderly people.
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Affiliation(s)
- Valéria Maria de Azeredo Passos
- MD, PhD. Associate Professor, Department of Internal Medicine, School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Paulo Caramelli
- MD, PhD. Full Professor, Department of Internal Medicine, School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Isabella Benseñor
- MD, PhD. Associate Professor, Department of Internal Medicine, School of Medicine, Universidade de São Paulo (USP), São Paulo, Brazil
| | - Luana Giatti
- MD, PhD. Adjunct Professor, School of Nutrition, Universidade Federal de Ouro Preto (UFOP), Ouro Preto, Minas Gerais, Brazil
| | - Sandhi Maria Barreto
- MD, PhD. Full Professor, Department of Preventive and Social Medicine, School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
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Alves RA, Miszputen SJ, Figueiredo MS. Anemia in inflammatory bowel disease: prevalence, differential diagnosis and association with clinical and laboratory variables. SAO PAULO MED J 2014; 132:140-6. [PMID: 24760213 PMCID: PMC10852089 DOI: 10.1590/1516-3180.2014.1323568] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Revised: 06/14/2013] [Accepted: 07/16/2013] [Indexed: 12/21/2022] Open
Abstract
CONTEXT AND OBJECTIVES Anemia is the most frequent extraintestinal complication of inflammatory bowel disease. This study aimed to: 1) determine the prevalence of anemia among patients with inflammatory bowel disease; 2) investigate whether routine laboratory markers are useful for diagnosing anemia; and 3) evaluate whether any association exists between anemia and clinical/laboratory variables. DESIGN AND SETTING Cross-sectional at a federal university. METHODS 44 outpatients with Crohn's disease and 55 with ulcerative colitis were evaluated. Clinical variables (disease activity index, location of disease and pharmacological treatment) and laboratory variables (blood count, iron laboratory, vitamin B12 and folic acid) were investigated. RESULTS Anemia and/or iron laboratory disorders were present in 75% of the patients with Crohn's disease and in 78.2% with ulcerative colitis. Anemia was observed in 20.5% of the patients with Crohn's disease and in 23.6% with ulcerative colitis. Iron-deficiency anemia was highly prevalent in patients with Crohn's disease (69.6%) and ulcerative colitis (76.7%). Anemia of chronic disease in combination with iron deficiency anemia was present in 3% of the patients with Crohn's disease and in 7% of the patients with ulcerative colitis. There was no association between anemia and disease location. In ulcerative colitis, anemia was associated with the disease activity index. CONCLUSIONS Most patients present iron laboratory disorders, with or without anemia, mainly due to iron deficiency. The differential diagnosis between the two most prevalent types of anemia was made based on clinical data and routine laboratory tests. In ulcerative colitis, anemia was associated with the disease activity index.
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Affiliation(s)
- Rodrigo Andrade Alves
- Postgraduate Student, Division of Gastroenterology, Department of Medicine, Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil
| | - Sender Jankiel Miszputen
- PhD. Head of Intestine Sector, Division of Gastroenterology, Department of Medicine, Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil
| | - Maria Stella Figueiredo
- PhD. Professor, Discipline of Hematology, Department of Medicine, Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil
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Romero FR, Romero AW, de Almeida RMDSSA, de Oliveira FC, Tambara R. Prevalence and risk factors for scrotal lesions/anomalies in a cohort of Brazilian men ≥ 40 years of age. SAO PAULO MED J 2014; 132:73-9. [PMID: 24714986 PMCID: PMC10896572 DOI: 10.1590/1516-3180.2014.1322495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2012] [Revised: 05/20/2013] [Accepted: 05/28/2013] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To estimate the prevalence of and risk factors for cutaneous lesions of the scrotum and intrascrotal lesions/anomalies among men included in a prostatic cancer screening program in a Brazilian metropolitan city. DESIGN AND SETTING Cross-sectional study, private outpatient healthcare service. METHODS 1731 men aged 40 years or over, participating in a prostate cancer screening program conducted by the municipal public employees' healthcare system, underwent systematic urological assessment by a single examiner. RESULTS The prevalence of scrotal diseases in our sample was 44.7% (773/1731). Tinea cruris occurred in 203 (11.7%) of the participants, with higher risk among diabetics and lower prevalence among nonwhite individuals; scrotal tinea in eight (0.5%), with higher risk among hypertensive men; subcutaneous nodules in 12 (0.7%), especially in individuals with low schooling level; hydrocele in 283 (16.4%), with higher frequency among participants over the age of 60 years, diabetics or individuals with previous histories of nonspecific urethritis; spermatoceles in 174 (10.1%), with greater prevalence among individuals over the age of 60 years or diabetics, and lower frequency among individuals who underwent vasectomy; unilateral testicular hypotrophy/atrophy in 167 (9.7%) and bilateral hypotrophy/atrophy in 93 (5.4%), both occurring more frequently in individuals over the age of 60 years; absence of palpable testicles due to cryptorchidism in 7 (0.4%); and epididymitis/orchitis in 5 (0.3%), with higher prevalence among diabetics. No cases of cancer were identified in this sample. CONCLUSIONS Scrotal diseases were highly prevalent in this population of Brazilian men.
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Affiliation(s)
- Frederico Ramalho Romero
- MD, MSc, PhD, Department of Surgery, Discipline of Urology, Universidade Federal do Paraná (UFPR), Curitiba, Paraná, Brazil
| | | | | | - Fernando Cesar de Oliveira
- MD, MSc, Coordinator, Núcleo de Atenção à Saúde, Instituto Curitiba de Saúde (ICS), Curitiba, Paraná, Brazil
| | - Renato Tambara
- MD, MSc, PhD. Professor, Department of Surgery, Discipline of Urology, Universidade Federal do Paraná (UFPR), Curitiba, Paraná, Brazil
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Ciaccia MCC, Moreira RC, Ferraro AA, Lemos MF, Oba IT, Porta G. Epidemiological and serological aspects of hepatitis A among children and teenagers in the city of Santos: a cross-sectional study. SAO PAULO MED J 2012; 130:230-5. [PMID: 22965363 PMCID: PMC10619950 DOI: 10.1590/s1516-31802012000400005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2011] [Revised: 07/02/2011] [Accepted: 12/15/2011] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE Viral hepatitis A is still a concern at public health level in Brazil and around the world, due both to the number of affected subjects and the possibility of complications in the acute forms. The Brazilian Ministry of Health estimates that at least 70% of this country's population has already had contact with the hepatitis A virus (HAV). The aim here was to discover the prevalence of serological markers for the hepatitis A virus among children and teenagers at daycare facilities, kindergartens and elementary schools in the city of Santos. DESIGN AND SETTING Cross-sectional study in kindergartens and elementary schools within the municipal education network in several regions of the city of Santos. METHOD Students' family members were surveyed using a questionnaire and 4,680 finger-prick blood samples were taken and assayed by means of the ELISA technique. RESULTS The general prevalence of anti-HAV IgG was 9.72% and, of these cases, 74.6% were reactive to anti-HAV IgM. There was higher prevalence of anti-HAV IgG among older children, females, children who played in streams, those whose homes were not connected to the sewage system, those whose parents had low education levels, those with low household income and those who did not live along the seashore. The prevalence of anti-HAV IgM peaked in the early years and subsequently fell, and it was lower on the hills and in the Northwestern Zone. CONCLUSION The general prevalence of serological markers for hepatitis A was low in Santos.
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Affiliation(s)
- Maria Célia Cunha Ciaccia
- Department of Pediatrics, Instituto da Criança, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
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Noronha EP, Marinho HT, Thomaz EBAF, Silva CA, Veras GLR, Oliveira RAG. Immunophenotypic characterization of acute leukemia at a public oncology reference center in Maranhão, northeastern Brazil. SAO PAULO MED J 2011; 129:392-401. [PMID: 22249795 PMCID: PMC10868919 DOI: 10.1590/s1516-31802011000600005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2010] [Revised: 04/19/2011] [Accepted: 05/03/2011] [Indexed: 11/21/2022] Open
Abstract
CONTEXT AND OBJECTIVES The incidence of acute leukemia (AL) subtypes varies according to geographical distribution. The aim here was to determine the incidence of morphological and immunophenotypic AL subtypes in the state of Maranhão, Brazil, and to correlate the expression of aberrant phenotypes in children with acute lymphoblastic leukemia (ALL) with prognostic factors. DESIGN AND SETTING Single prospective cohort study at a public oncology reference center in Maranhão. METHODS Seventy AL cases were diagnosed between September 2008 and January 2010. For the diagnosis, complete blood cell counts, myelograms (at diagnosis and at the end of the induction phase), cytochemical analysis and immunophenotyping were performed. RESULTS Among adult patients (n = 22), the incidence of AL types was: ALL (22.7%) and acute myeloid leukemia (AML) (77.3%). The subtype AML M0 occurred most frequently (29.4%). In children (n = 48), the types were: AML (18.7%), most frequently subtype AML M4 (33.4%); biphenotypic acute leukemia (BAL) (4.2%); and ALL (77.1%), including the subtypes B-ALL (72.9%) and T-ALL (27.1%). Among the children with ALL, there were no statistically significant differences between patients with and without aberrant phenotypes, in relation to hematological parameters and treatment response. CONCLUSION This work demonstrates that the frequencies of AML M0 cases among adults and T-ALL cases among children in Maranhão were high. This suggests that there may be differences in AML subtype incidence, as seen with ALL subtypes, in different regions of Brazil. No association was found between the expression of aberrant phenotypes and prognostic factors, in children with ALL.
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Affiliation(s)
- Elda Pereira Noronha
- Clinical Research Center, University Hospital, Universidade Federal do Maranhão, São Luís, Maranhão, Brazil.
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Fagundes SD, Silva MT, Thees MFRS, Pereira MG. Prevalence of dementia among elderly Brazilians: a systematic review. SAO PAULO MED J 2011; 129:46-50. [PMID: 21437509 PMCID: PMC10865913 DOI: 10.1590/s1516-31802011000100009] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2010] [Revised: 03/10/2010] [Accepted: 11/03/2010] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE The rapid growth of the elderly population in Brazil has implied a significant rise in the number of individuals with dementia. The real prevalence of this disease needs to be ascertained in order to establish appropriate measures for improving the quality of life of those affected. The aim of this study was to estimate the prevalence of dementia among elderly Brazilians (≥ 60 years) through a systematic review of high-quality, population-based, double-blind studies published between 1990 and 2010. DESIGN AND SETTING Systematic review of prevalence studies. The manuscript was produced in the School of Medicine, Universidade de Brasília. METHODS Database searches for articles were conducted in Medline (Medical Literature Analysis and Retrieval System Online), Embase (Excerpta Medica database), Lilacs (Literatura Latino-Americana e do Caribe em Ciências da Saúde), SciELO (Scientific Electronic Library Online) and theses and dissertations, using specific keywords. Quality was assessed according to eight criteria for sampling and measurement of findings. RESULTS Out of 112 articles identified, eleven were included in the qualitative synthesis. In five higher-quality studies from São Paulo, the prevalence rates ranged from 5.1 to 19.0%. No meta-analysis was presented because of heterogeneity among the studies. Poor, illiterate, female and very elderly individuals were the groups most affected. CONCLUSION The findings from this review did not reflect the reality of the whole country. Although the results brought some information on the prevalence and distribution of dementia in Brazil, cross-sectional studies with consistent methodology are needed.
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Affiliation(s)
- Susana Dytz Fagundes
- MD, MSc. Gynecologist and Obstetrician, Universidade Católica de Brasília, Brasília, Federal District, Brazil.
| | - Marcus Tolentino Silva
- Pharmacist. Adviser, Department of Science and Technology, Secretariat of Science, Technology and Strategic Inputs, Ministry of Health, Brasília, Federal District, Brazil.
| | | | - Maurício Gomes Pereira
- MD, PhD. Full Professor, School of Medicine, Universidade de Brasília, Federal District, Brazil.
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Martins E, Freitas R, Curado MP, Freitas NMA, Silva CMB, Oliveira JC. Prevalence of breast cancer in the city of Goiânia, Goiás, Brazil, between 1988 and 2002. SAO PAULO MED J 2011; 129:309-14. [PMID: 22069129 PMCID: PMC10868936 DOI: 10.1590/s1516-31802011000500005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2010] [Revised: 04/25/2011] [Accepted: 05/02/2011] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE Studies have shown increased prevalence rates for breast cancer, relating to higher incidence, longer survival and breast cancer prevention programs among populations. The aim here was to analyze the annual prevalence of breast cancer in Goiânia over a 15-year period. DESIGN AND SETTING This was a cross-sectional study on women with breast cancer diagnosed in Goiânia, Goiás, Brazil, from 1988 to 2002. METHODS The breast cancer cases were identified in the database of the Population-Based Cancer Registry of Goiânia. The 15-year period was stratified into three five-year periods. The cases were followed up for five years, and the mortality database was used to exclude deaths. The population of the official census was used as the denominator for rate calculations. RESULTS The coefficient of breast cancer prevalence in Goiania was 22.87/100,000 in 1988 and 220.22/100,000 women in 2002. The analyses for periods showed that in the first period, the rate was 19.39/100,000 and that it was 44.79/100,000 in the last period. For the fifteen years analyzed, the prevalence rate for breast cancer was 127.24/100,000 women. The annual percentage change was 27.07 (P < 0.001; 95% confidence interval, CI: 20.79-33.67) from 1988 to 1992 and 9.39 (P < 0.001; 95% CI: 8.52-10.25) from 1992 to 2002. CONCLUSION There was an increase in the breast cancer prevalence rate in the city of Goiânia between 1988 and 2002, possibly relating to the improvement in the screening and treatment of breast cancer.
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Affiliation(s)
- Edesio Martins
- MHSc. Epidemiologist, Postgraduate Program on Health Sciences, School of Medicine, Universidade Federal de Goiás (UFG) and Population-Based Cancer Registry of Goiânia, Associação de Combate ao Câncer de Goiás (ACCG), Goiânia, Goiás, Brazil.
| | - Ruffo Freitas
- MD, PhD. Gynecologist and Mastologist, Gynecology and Breast Service of Hospital Araújo Jorge, Associação de Combate ao Câncer de Goiás (ACCG), Goiânia, Goiás, Brazil.
| | - Maria Paula Curado
- MD, PhD. Senior researcher at the International Prevention Research Institute, Lyon, France, and Population-Based Cancer Registry of Goiânia, Associação de Combate ao Câncer de Goiás (ACCG), Goiânia, Goiás, Brazil.
| | - Nilceana Maya Aires Freitas
- MD, PhD. Radiotherapist, Radiotherapy Service of Hospital Araújo Jorge, Associação de Combate ao Câncer de Goiás (ACCG), Goiânia, Goiás, Brazil.
| | - Carleane Maciel Bandeira Silva
- Technician at the Population-Based Cancer Registry of Goiânia, Associação de Combate ao Câncer de Goiás (ACCG), Goiânia, Goiás, Brazil.
| | - José Carlos Oliveira
- MD, PhD. Head of Head and Neck Surgery Service of Hospital Araújo Jorge and Population-Based Cancer Registry of Goiânia, Associação de Combate ao Câncer de Goiás (ACCG), Goiânia, Goiás, Brazil.
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Oliveira PM, Oliveira RPC, Travessa IÉM, Gomes MVDC, dos Santos MLDJ, Grassi MFR. Prevalence and risk factors for cervical intraepithelial neoplasia in HIV-infected women in Salvador, Bahia, Brazil. SAO PAULO MED J 2010; 128:197-201. [PMID: 21120429 PMCID: PMC10938988 DOI: 10.1590/s1516-31802010000400004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2009] [Revised: 06/11/2010] [Accepted: 06/11/2010] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE The human immunodeficiency virus (HIV) is frequently associated with high-grade intraepithelial neoplasia. Immunosuppression and high HIV viral load are the main risk factors for cervical intraepithelial neoplasia (CIN). The aim of this study was to determine the prevalence of CIN in HIV-infected women in Salvador, Bahia, Brazil, and to describe the risk factors in comparison with non-infected women. DESIGN AND SETTING Cross-sectional study at the AIDS Reference Center of Bahia and the Gynecological Outpatient Clinic of Fundação Bahiana para o Desenvolvimento da Ciência, in Salvador, Bahia, Brazil. METHODS Sixty-four HIV-infected women and 76 uninfected women from Salvador were enrolled between May 2006 and May 2007. Associations between CIN and presence of HIV infection, HIV viral load, proportion of T CD4+ lymphocytes and risk factors were evaluated. The independence of the risk factors was investigated using logistic regression. RESULTS CIN was more prevalent among HIV-infected women than in the control group (26.6% versus 6.6%; P = 0.01). The odds ratio for CIN among HIV-infected women was 3.7 (95% confidence interval, CI: 1.23-11; P = 0.01), after adjusting for the following variables: age at first sexual intercourse, number of partners, number of deliveries and previous history of sexually transmitted disease. CONCLUSION The prevalence of CIN among HIV-infected women was significantly higher than among women without HIV infection. HIV infection was the most important risk factor associated with the development of cervical lesions.
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Affiliation(s)
- Paula Matos Oliveira
- MD. Doctoral student in the Postgraduate Program on Medicine and Human Health, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Salvador, Bahia, Brazil.
| | - Rone Peterson Cerqueira Oliveira
- MD, MSc. Assistant professor, Gynecological Service, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Salvador, Bahia, Brazil.
| | | | | | - Maria Lícia de Jesus dos Santos
- MD. Gynecologist at the AIDS Reference Center of Bahia (Centro Especializado em Diagnóstico, Assistência e Pesquisa, CEDAP), Salvador, Bahia, Brazil.
| | - Maria Fernanda Rios Grassi
- MD, PhD. Head of the Advanced Public Health Laboratory, Centro de Pesquisa Gonçalo Muniz (CPqGM), Fundação Oswaldo Cruz (Fiocruz), Salvador, Bahia, Brazil.
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Abe IM, Goulart AC, Santos WR, Lotufo PA, Benseñor IM. Validation of a stroke symptom questionnaire for epidemiological surveys. SAO PAULO MED J 2010; 128:225-31. [PMID: 21120435 PMCID: PMC10938991 DOI: 10.1590/s1516-31802010000400010] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2010] [Revised: 06/11/2010] [Accepted: 06/18/2010] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE Stroke is a relevant issue within public health and requires epidemiological surveillance tools. The aim here was to validate a questionnaire for evaluating individuals with stroke symptoms in the Stroke Morbidity and Mortality Study (Estudo de Mortalidade e Morbidade do Acidente Vascular Cerebral, EMMA), São Paulo, Brazil. DESIGN AND SETTING This was a cross-sectional study performed among a sample of the inhabitants of Butantã, an area in the western zone of the city of São Paulo. METHODS For all households in the coverage area of a primary healthcare unit, household members over the age of 35 years answered a stroke symptom questionnaire addressing limb weakness, facial weakness, speech problems, sensory disorders and impaired vision. Thirty-six participants were randomly selected for a complete neurological examination (gold standard). RESULTS Considering all the questions in the questionnaire, the sensitivity was 72.2%, specificity was 94.4%, positive predictive value was 92.9% and negative predictive value was 77.3%. The positive likelihood ratio was 12.9, the negative likelihood ratio was 0.29 and the kappa coefficient was 0.67. Limb weakness was the most sensitive symptom, and speech problems were the most specific. CONCLUSIONS The stroke symptom questionnaire is a useful tool and can be applied by trained interviewers with the aim of identifying community-dwelling stroke patients, through the structure of the Family Health Program.
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Affiliation(s)
- Ivana Makita Abe
- PhD. Attending physician, Hospital Universitário (HU), Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil.
| | - Alessandra Carvalho Goulart
- PhD. Epidemiologist, Hospital Universitário (HU), Hospital das Clínicas (HC), Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil.
| | - Waldyr Rodrigues Santos
- MD. Neurologist, Hospital das Clínicas (HC), Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil.
| | - Paulo Andrade Lotufo
- PhD. Professor of Clinical Medicine and Epidemiology, Faculdade de Medicina da Universidade de São Paulo (FMUSP), and Superintendent of Hospital Universitário (HU), Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil.
| | - Isabela Martins Benseñor
- PhD. Attending physician, Hospital das Clínicas (HC), Faculdade de Medicina da Universidade de São Paulo (FMUSP), and Hospital Universitário (HU), Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil.
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