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Martins C, da Silva FN, Dias JDJ, Branco MDRFC, dos Santos AM, de Oliveira BLCA. Individual and contextual factors associated with the survival of patients with severe acute respiratory syndrome by COVID-19 in Brazil. Rev Bras Epidemiol 2024; 27:e240019. [PMID: 38655946 PMCID: PMC11027433 DOI: 10.1590/1980-549720240019] [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: 09/20/2023] [Revised: 01/22/2024] [Accepted: 01/30/2024] [Indexed: 04/26/2024] Open
Abstract
OBJECTIVE To analyze the influence of individual and contextual factors of the hospital and the municipality of care on the survival of patients with Severe Acute Respiratory Syndrome due to COVID-19. METHODS Hospital cohort study with data from 159,948 adults and elderly with Severe Acute Respiratory Syndrome due to COVID-19 hospitalized from January 1 to December 31, 2022 and reported in the Influenza Epidemiological Surveillance Information System. The contextual variables were related to the structure, professionals and equipment of the hospital establishments and socioeconomic and health indicators of the municipalities. The outcome was hospital survival up to 90 days. Survival tree and Kaplan-Meier curves were used for survival analysis. RESULTS Hospital lethality was 30.4%. Elderly patients who underwent invasive mechanical ventilation and were hospitalized in cities with low tax collection rates had lower survival rates compared to other groups identified in the survival tree (p<0.001). CONCLUSION The study indicated the interaction of contextual factors with the individual ones, and it shows that hospital and municipal characteristics increase the risk of death, highlighting the attention to the organization, operation, and performance of the hospital network.
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Affiliation(s)
- Carlos Martins
- Universidade Federal do Maranhão, Postgraduate Program in Collective
Health – São Luís (MA), Brazil
| | - Fábio Nogueira da Silva
- Universidade Federal do Maranhão, Postgraduate Program in Collective
Health – São Luís (MA), Brazil
| | - José de Jesus Dias
- Universidade Federal do Maranhão, Postgraduate Program in Collective
Health – São Luís (MA), Brazil
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do Vale MS, Marques PF, Cavalcante MCV, Brito MN, dos Santos AM, Salgado-Filho N, Duarte JLMB. Renal deficit and associated factors in children born with low birth weight. J Bras Nefrol 2024; 46:62-69. [PMID: 37015048 PMCID: PMC10962415 DOI: 10.1590/2175-8239-jbn-2022-0154en] [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: 10/05/2022] [Accepted: 01/13/2023] [Indexed: 04/06/2023] Open
Abstract
INTRODUCTION Kidney problems may be due to low birth weight alone or may occur in association with other conditions. The objective this study was to evaluate the association between maternal and birth characteristics, anthropometric measurements, and kidney function deficit in low birth weight infants. METHODS Cross-sectional study with children who were born weighing < 2500 grams and were under outpatient follow-up. Maternal factors investigated were prenatal care and presence of hypertension, diabetes, and infection during pregnancy. The children's variables were sex, gestational age, birth weight, Apgar score, use of nephrotoxic medications, age, body weight at the time of evaluation, height, and serum creatinine and cystatin C dosages. The glomerular filtration rate (GFR) was estimated with the combined Zapittelli equation. Multivariate logistic regression model was used for identification of associated factors, with renal function deficit (GFR < 60 mL/min/1.73 m2) as the dependent variable. RESULTS Of the 154 children evaluated, 34.42% had kidney function deficit. Most of them had a gestational age > 32 weeks (56.6%), a mean birth weight of 1439.7 grams, and mean estimated GFR of 46.9 ± 9.3 mL/min/1.73 m2. There was a significant association of GFR < 60 mL/min/1.73 m2 with children's current weight and use of nephrotoxic drugs. DISCUSSION Children born with low birth weight had a high prevalence of kidney function deficit and current normal weight was a protective factor while the use of nephrotoxic drugs during perinatal period increased the chance of kidney deficit. These findings reinforce the need to evaluate the kidney function in these children, especially those who use nephrotoxic drugs.
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Affiliation(s)
| | | | | | - Mateus Noleto Brito
- Universidade Federal do Maranhão, Departamento de Medicina I, São
Luís, MA, Brazil
| | | | | | - José Luiz M. B. Duarte
- Universidade do Estado do Rio de Janeiro, Departamento de Pediatria,
Rio de Janeiro, RJ, Brazil
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Martins C, Silveira VNDC, da Silva FN, Dias JDJ, Branco MDRFC, dos Santos AM, de Oliveira BLCA. Clinical-epidemiological characteristics and survival of cases of severe acute respiratory syndrome (SARS) due to COVID-19, according to the COVID-19 vaccination schedule in Brazil, 2021-2022: a prospective study. Epidemiol Serv Saude 2023; 32:e2023128. [PMID: 38126542 PMCID: PMC10727126 DOI: 10.1590/s2237-96222023000400003.en] [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: 03/07/2023] [Accepted: 10/16/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVE To analyze the clinical and sociodemographic characteristics and survival of individuals with severe acute respiratory syndrome due to COVID-19 according to the COVID-19 vaccination schedule, Brazil, 2021-2022. METHODS This was a cohort study based on data from the Influenza Epidemiological Surveillance Information System; the Kaplan-Meier and Survival Tree methods were used to analyze survival. RESULTS Among the 559,866 hospitalized cases, a higher proportion of vaccinated individuals was found among female (15.0%), elderly people aged ≥ 80 (34.5%), people from the Southeast region (15.7%), those who did not undergo respiratory support (21.2%) and those who did progress to death (15.2%); the survival curve showed that risk of death for unvaccinated individuals was higher in all age groups (p-value < 0.001); elderly people aged ≥ 80, who did not undergo mechanical ventilation and who had a booster dose had lower risk when compared to their peers who had two doses or were unvaccinated (hazard ratio = 0.64; 95%CI 0.62;0.67). CONCLUSION Lowest risk of death was found in vaccinated individuals, especially those who had two doses or a booster dose as well. MAIN RESULTS Prevalence was found to be high among unvaccinated individuals. Risk of death was lower among those vaccinated with a booster dose, compared to those not vaccinated, in all age groups analyzed. IMPLICATIONS FOR SERVICES The number of hospitalizations of unvaccinated individuals with severe acute respiratory syndrome was high, which increases the demand for health services to care for these individuals. PERSPECTIVES It is necessary to promote widespread vaccination of the entire population of Brazil, in addition to the regular provision of booster doses for the different population groups.
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Affiliation(s)
- Carlos Martins
- Universidade Federal do Maranhão, Programa de Pós-Graduação em Saúde Coletiva, São Luís, MA, Brazil
| | | | - Fábio Nogueira da Silva
- Universidade Federal do Maranhão, Programa de Pós-Graduação em Saúde Coletiva, São Luís, MA, Brazil
| | - José de Jesus Dias
- Universidade Federal do Maranhão, Programa de Pós-Graduação em Saúde Coletiva, São Luís, MA, Brazil
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Silveira VNDC, França AKTDC, Campelo CL, Machado PMA, dos Santos AM. Proposition of an Energy Intake Estimating Scale through Item Response Theory. Nutrients 2023; 15:4511. [PMID: 37960164 PMCID: PMC10650126 DOI: 10.3390/nu15214511] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/10/2023] [Accepted: 10/14/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Traditional methods for assessing individual energy consumption often involve lengthy and intricate procedures. This study aims to introduce an Energy Consumption Estimation Scale, utilizing Item Response Theory (IRT) for adolescents aged 18-19 years. METHODS This psychometric investigation applies IRT to 93 items extracted from a validated food frequency questionnaire. The study encompasses a representative sample of 2515 adolescents from the São Luís birth cohort in Brazil. The latent trait, energy intake, is derived using IRT and subsequently validated through hierarchical multiple linear regression modeling. Significance was established at p < 0.05. RESULTS A Samejima's model was successfully fitted (CFI and TLI > 0.9 and RMSEA < 0.08), effectively capturing variations across all energy consumption levels. Factors associated with the latent trait demonstrate consistent behavioral patterns. Adolescents with higher energy intake exhibited increased consumption of dairy products, artificially sweetened beverages, and seasonal fruits and vegetables. CONCLUSIONS The proposed Energy Consumption Estimation Scale demonstrates a reliable measurement of energy intake and serves as a practical and concise alternative for assessing energy consumption among adolescents. These findings suggest the potential for adapting similar models for different age groups and incorporating diverse food items based on the obtained results.
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Affiliation(s)
- Victor Nogueira da Cruz Silveira
- Postgraduate Programme in Collective Health, Federal University of Maranhão, São Luís 65020-070, Brazil; (A.K.T.d.C.F.); (A.M.d.S.)
| | | | - Cleber Lopes Campelo
- Higher School of Health Sciences—Bachelor of Nursing, State University of Amazonas, Nurse at Brazilian Hospital Services Company (EBSERH), Manaus 69850-000, Brazil;
| | | | - Alcione Miranda dos Santos
- Postgraduate Programme in Collective Health, Federal University of Maranhão, São Luís 65020-070, Brazil; (A.K.T.d.C.F.); (A.M.d.S.)
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Campelo CL, Batista RFL, Silveira VNDC, Figueiredo KNDRS, Machado PMA, Borgatto AF, dos Santos AM. Assessment of the Brazilian Version of the Epworth Sleepiness Scale Using Item Response Theory: A Psychometric Study. Clocks Sleep 2023; 5:581-589. [PMID: 37873839 PMCID: PMC10594512 DOI: 10.3390/clockssleep5040038] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 08/30/2023] [Accepted: 09/11/2023] [Indexed: 10/25/2023] Open
Abstract
There seems to be a consensus that adolescents worldwide are not getting enough sleep. This study aimed to evaluate the psychometric properties of the Epworth Sleepiness Scale (ESS) in adolescents using the item response theory. A psychometric study was conducted with 2206 adolescents aged 18 and 19 years in the city of São Luís, Maranhão, Brazil. The dimensionality of the ESS was assessed by principal component analysis. A Samejima's graded response model (SGRM) was fitted to it. The findings of this study showed a good internal consistency and the unidimensionality of the ESS. Considering the latent trait continuum, we obtained three levels, with anchor items. For the item 'Sitting still in a public place', the adolescents presented a small possibility of dozing in level 1, and a medium and great possibility in level 2. The item 'Sitting around talking to someone' presented small, medium, and great possibilities of dozing in level 3. The ESS with five items showed satisfactory psychometric properties. In addition, the results from the SGRM showed that adolescents with high levels of sleepiness are likely to nod off or sleep sitting up while talking to someone. This study allows us to understand excessive daytime sleepiness in adolescents.
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Affiliation(s)
- Cleber Lopes Campelo
- Department of Public Health, Postgraduate Program in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (R.F.L.B.); (V.N.d.C.S.); (K.N.d.R.S.F.); (A.M.d.S.)
- Higher School of Health Sciences, State University of Amazonas, Manaus 69065-001, AM, Brazil
| | - Rosângela Fernandes Lucena Batista
- Department of Public Health, Postgraduate Program in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (R.F.L.B.); (V.N.d.C.S.); (K.N.d.R.S.F.); (A.M.d.S.)
| | - Victor Nogueira da Cruz Silveira
- Department of Public Health, Postgraduate Program in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (R.F.L.B.); (V.N.d.C.S.); (K.N.d.R.S.F.); (A.M.d.S.)
| | - Kely Nayara dos Reis Silva Figueiredo
- Department of Public Health, Postgraduate Program in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (R.F.L.B.); (V.N.d.C.S.); (K.N.d.R.S.F.); (A.M.d.S.)
| | - Patrícia Maria Abreu Machado
- Department of Medicine I, Directorate of Technologies in Education, Federal University of Maranhão, São Luís 65020-240, MA, Brazil;
| | - Adriano Ferreti Borgatto
- Department of IT and Statistics, Postgraduate Program in Physical Education, Federal University of Santa Catarina, Florianópolis 88040-970, SC, Brazil;
| | - Alcione Miranda dos Santos
- Department of Public Health, Postgraduate Program in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (R.F.L.B.); (V.N.d.C.S.); (K.N.d.R.S.F.); (A.M.d.S.)
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Araújo MSM, Branco MDRFC, Costa SDSB, de Oliveira DC, Queiroz RCDS, de Oliveira BLCA, Pasklan ANP, dos Santos AM. [COVID-19 mortality in metropolitan areas vs. other regions of Brazil, 2020 to 2021Mortalidad por COVID-19 en las regiones metropolitanas y en el interior de Brasil, 2020-2021]. Rev Panam Salud Publica 2023; 47:e115. [PMID: 37489235 PMCID: PMC10361444 DOI: 10.26633/rpsp.2023.115] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 04/21/2023] [Indexed: 07/26/2023] Open
Abstract
Objective To compare hospital mortality rates (HMR) due to severe acute respiratory syndrome (SARS) associated with COVID-19 recorded in metropolitan areas and other regions (interior) of Brazil in 2020 and 2021. Method This ecological study used public data available on OpenDataSUS. The information was accessed in May 2022. The following variables were considered: age, sex, hospitalization, presence of a risk factor, ICU stay, use of ventilatory support, and final classification in the individual registration form of SARS cases due to COVID-19. Cases and deaths were stratified into five age groups (0-19 years, 20-39 years, 40-59 years, 60-79 years, and ≥80 years) and by place of residence (metropolitan area or interior). The HMR had as numerator the absolute number of deaths by SARS associated with covid-19; and, as a denominator, the absolute number of cases of SARS due to covid-19 according to the year of occurrence, area of residence, age bracket, sex, hospitalization, presence of a risk factor, ICU admission, and use of ventilatory support. Results There was a significant increase in HMR due to SARS associated with COVID-19 in 2021 in all age groups, except 0-19 years and ≥80 years, as well as among individuals admitted to an ICU and who used invasive ventilatory support, both in metropolitan areas as well as in the interior. Conclusions There was a worsening of the epidemiological scenario in 2021 with an increase in HMR. However, no differences were identified between the metropolitan regions and the interior of the country.
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Affiliation(s)
- Mayra Sharlenne Moraes Araújo
- Universidade Federal do Maranhão (UFMA)Programa de Pós-Graduação em Saúde ColetivaSão Luís (MA)BrasilUniversidade Federal do Maranhão (UFMA), Programa de Pós-Graduação em Saúde Coletiva, São Luís (MA), Brasil.
| | - Maria dos Remédios Freitas Carvalho Branco
- Universidade Federal do Maranhão (UFMA)Programa de Pós-Graduação em Saúde ColetivaSão Luís (MA)BrasilUniversidade Federal do Maranhão (UFMA), Programa de Pós-Graduação em Saúde Coletiva, São Luís (MA), Brasil.
| | - Silmery da Silva Brito Costa
- Universidade Federal do MaranhãoDepartamento de Saúde ColetivaSão Luís (MA)BrasilUniversidade Federal do Maranhão, Departamento de Saúde Coletiva, São Luís (MA), Brasil.
| | - Daniel Cavalcante de Oliveira
- Universidade Federal do ABC (UFABC)Departamento de Engenharia BiomédicaSanto André (SP)BrasilUniversidade Federal do ABC (UFABC), Departamento de Engenharia Biomédica, Santo André (SP), Brasil.
| | - Rejane Christine de Sousa Queiroz
- Universidade Federal do Maranhão (UFMA)Programa de Pós-Graduação em Saúde ColetivaSão Luís (MA)BrasilUniversidade Federal do Maranhão (UFMA), Programa de Pós-Graduação em Saúde Coletiva, São Luís (MA), Brasil.
| | - Bruno Luciano Carneiro Alves de Oliveira
- Universidade Federal do Maranhão (UFMA)Programa de Pós-Graduação em Saúde ColetivaSão Luís (MA)BrasilUniversidade Federal do Maranhão (UFMA), Programa de Pós-Graduação em Saúde Coletiva, São Luís (MA), Brasil.
| | - Amanda Namíbia Pereira Pasklan
- Universidade Federal do MaranhãoDepartamento de MedicinaSão Luís (MA)BrasilUniversidade Federal do Maranhão, Departamento de Medicina, São Luís (MA), Brasil.
| | - Alcione Miranda dos Santos
- Universidade Federal do Maranhão (UFMA)Programa de Pós-Graduação em Saúde ColetivaSão Luís (MA)BrasilUniversidade Federal do Maranhão (UFMA), Programa de Pós-Graduação em Saúde Coletiva, São Luís (MA), Brasil.
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de Oliveira BR, Magalhães EIDS, Bragança MLBM, Coelho CCNDS, Lima NP, Bettiol H, Barbieri MA, Cardoso VC, dos Santos AM, Horta BL, da Silva AAM. Performance of Body Fat Percentage, Fat Mass Index and Body Mass Index for Detecting Cardiometabolic Outcomes in Brazilian Adults. Nutrients 2023; 15:2974. [PMID: 37447300 PMCID: PMC10346298 DOI: 10.3390/nu15132974] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/21/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023] Open
Abstract
Obesity is a recognized risk factor for the development of cardiometabolic outcomes. Therefore, it is essential to evaluate anthropometric and body composition indicators used for its diagnosis. This study aimed to assess the diagnostic performance of body fat percentage (BF%), fat mass index (FMI) and body mass index (BMI) for detecting cardiometabolic outcomes in adults. A cross-sectional study was conducted involving adults at 30 years of age from Pelotas, RS (n = 3517) and at 37-39 years from Ribeirão Preto, SP (n = 1696). Receiver operating characteristic (ROC) curves were used to determine the cut-off points for predicting cardiometabolic risk factors, including altered blood pressure, blood glucose, triglycerides, total cholesterol, low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDDL-c), C-reactive protein and glycated hemoglobin. The cut-off points of BF% ranged from 25.2 to 27.8 in men and from 37.4 to 39.7 in women at 30 years, and from 26.1 to 27.8 in men and from 38.5 to 42.2 in women at 37-39 years. For FMI (kg/m2), the cut-off points ranged from 6.3 to 7.5 in men and from 9.5 to 10.8 in women at 30 years, and from 7.3 to 7.8 in men and from 10.2 to 12.2 in women at 37-39 years. The BMI cut-off points (kg/m2) ranged from 26.3 to 27.3 in men and from 25.4 to 27.2 in women at 30 years, and from 28.3 to 29.0 in men and from 27.2 to 29.6 in women at 37-39 years. The areas under the curve were similar for the three indicators, ranging from 0.523 to 0.746. BMI showed a performance similar to that of the body fat-based indicators in identifying cardiometabolic outcomes. The cut-off points of the three indicators showed acceptable discriminatory power in subjects with cardiometabolic risk factors.
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Affiliation(s)
- Bianca Rodrigues de Oliveira
- Postgraduate Programme in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (E.I.d.S.M.); (M.L.B.M.B.); (C.C.N.d.S.C.); (A.M.d.S.); (A.A.M.d.S.)
| | - Elma Izze da Silva Magalhães
- Postgraduate Programme in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (E.I.d.S.M.); (M.L.B.M.B.); (C.C.N.d.S.C.); (A.M.d.S.); (A.A.M.d.S.)
| | - Maylla Luanna Barbosa Martins Bragança
- Postgraduate Programme in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (E.I.d.S.M.); (M.L.B.M.B.); (C.C.N.d.S.C.); (A.M.d.S.); (A.A.M.d.S.)
| | - Carla Cristine Nascimento da Silva Coelho
- Postgraduate Programme in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (E.I.d.S.M.); (M.L.B.M.B.); (C.C.N.d.S.C.); (A.M.d.S.); (A.A.M.d.S.)
| | - Natália Peixoto Lima
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Pelotas 96020-220, RS, Brazil; (N.P.L.); (B.L.H.)
| | - Heloisa Bettiol
- Postgraduate Programme in Child and Adolescent Health, University of São Paulo, Ribeirão Preto 14048-900, SP, Brazil; (H.B.); (M.A.B.); (V.C.C.)
| | - Marco Antônio Barbieri
- Postgraduate Programme in Child and Adolescent Health, University of São Paulo, Ribeirão Preto 14048-900, SP, Brazil; (H.B.); (M.A.B.); (V.C.C.)
| | - Viviane Cunha Cardoso
- Postgraduate Programme in Child and Adolescent Health, University of São Paulo, Ribeirão Preto 14048-900, SP, Brazil; (H.B.); (M.A.B.); (V.C.C.)
| | - Alcione Miranda dos Santos
- Postgraduate Programme in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (E.I.d.S.M.); (M.L.B.M.B.); (C.C.N.d.S.C.); (A.M.d.S.); (A.A.M.d.S.)
| | - Bernardo Lessa Horta
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Pelotas 96020-220, RS, Brazil; (N.P.L.); (B.L.H.)
| | - Antônio Augusto Moura da Silva
- Postgraduate Programme in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (E.I.d.S.M.); (M.L.B.M.B.); (C.C.N.d.S.C.); (A.M.d.S.); (A.A.M.d.S.)
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Carvalho WRC, França AKTDC, dos Santos AM, Padilha LL, Bogea EG. Appropriate neck circumference and waist-to-height ratio cut-off points as predictors of obesity and cardiovascular risk in adolescents. Rev Saude Publica 2023; 57:24. [PMID: 37075407 PMCID: PMC10118407 DOI: 10.11606/s1518-8787.2023057004349] [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: 11/05/2021] [Accepted: 04/25/2022] [Indexed: 04/21/2023] Open
Abstract
OBJECTIVE To determine neck circumference (NC) and waist-to-height ratio (WHtR) cut-off points as predictors of obesity and cardiovascular risk in adolescents. METHODS Cross-sectional study developed with a subsample of 634 adolescents aged 18 and 19 years belonging to the third phase of the "RPS" cohort (Ribeirão Preto, Pelotas and São Luís) carried out in 2016. The area under the ROC curve (AUC) was identified to assess the predictive capacity of NC and WHtR in relation to the percentage of body fat (%BF), obtained by air displacement plethysmography (ADP), and the cardiovascular risk estimated by the Pathobiological Determinants of Atherosclerosis in Youth (PDAY). RESULTS The prevalence of obesity by %BF was 7.6% in males and 39.4% in females (p-value <0.001), and the high PDAY risk was 13.8% and 10.9%, respectively. For males, NC cut-off point was 44.0 cm and the AUCs were 0.70 (95%CI 0.58-0.83) to predict obesity and 0.71 (95%CI 0.62-0.80) to predict high cardiovascular risk; for females, NC cut-off point was 40 cm and the AUCs were 0.75 (95%CI 0.69-0.80) and 0.63 (95%CI 0.53-0.73), respectively. WHtR cut-off point was 0.50 for both sexes; for males, the AUCs to predict obesity and high risk according to PDAY were 0.90 (95%CI 0.80-0.99) and 0.73 (95%CI 0.63-0.82), respectively; for females, they were 0.87 (95%CI 0.83-0.90) and 0.55 (95%CI 0.45-0.65), respectively. CONCLUSION WHtR and NC are good discriminators to assess obesity and cardiovascular risk in adolescents, especially in males.
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Affiliation(s)
- Wyllyane Rayana Chaves Carvalho
- Universidade Federal do MaranhãoPrograma de Pós Graduação em Saúde ColetivaSão LuísMABrasilUniversidade Federal do Maranhão. Programa de Pós Graduação em Saúde Coletiva. São Luís, MA, Brasil
| | - Ana Karina Teixeira da Cunha França
- Universidade Federal do MaranhãoDepartamento de Saúde PúblicaSão LuísMABrasilUniversidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil
| | - Alcione Miranda dos Santos
- Universidade Federal do MaranhãoDepartamento de Saúde PúblicaSão LuísMABrasilUniversidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil
| | - Luana Lopes Padilha
- Universidade Federal do MaranhãoPrograma de Pós Graduação em Saúde ColetivaSão LuísMABrasilUniversidade Federal do Maranhão. Programa de Pós Graduação em Saúde Coletiva. São Luís, MA, Brasil
| | - Eduarda Gomes Bogea
- Universidade Federal do MaranhãoPrograma de Pós Graduação em Saúde ColetivaSão LuísMABrasilUniversidade Federal do Maranhão. Programa de Pós Graduação em Saúde Coletiva. São Luís, MA, Brasil
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Vale MSD, Marques PF, Cavalcante MCV, Brito MN, Santos AMD, Salgado-Filho N, Duarte JLMB. Déficit renal e fatores associados em crianças nascidas com baixo peso. J Bras Nefrol 2023. [DOI: 10.1590/2175-8239-jbn-2022-0154pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023] Open
Abstract
RESUMO Introdução: Problemas renais podem ser devido apenas ao baixo peso ao nascer ou podem ocorrer em associação com outras condições. O objetivo deste estudo foi avaliar a associação entre características maternas e de nascimento, medidas antropométricas e déficit da função renal em bebês de baixo peso ao nascer. Métodos: Estudo transversal com crianças que nasceram com peso < 2500 gramas e estavam sob acompanhamento ambulatorial. Os fatores maternos investigados foram cuidados pré-natal e presença de hipertensão, diabetes e infecção durante a gravidez. As variáveis das crianças foram sexo, idade gestacional, peso ao nascer, índice Apgar, uso de medicamentos nefrotóxicos, idade, peso corporal no momento da avaliação, altura e dosagens séricas de creatinina e cistatina C. A taxa de filtração glomerular (TFG) foi estimada com a equação combinada de Zapittelli. Utilizou-se um modelo de regressão logística multivariada para identificação de fatores associados, com déficit da função renal (TFG < 60 mL/min/1,73 m2) como variável dependente. Resultados: Das 154 crianças avaliadas, 34,42% apresentaram déficit da função renal. A maioria tinha idade gestacional > 32 semanas (56,6%), peso médio ao nascer de 1439,7 gramas, e TFG média estimada de 46,9 ± 9,3 mL/min/1,73 m2. Houve uma associação significativa da TFG < 60 mL/min/1,73 m2 com o peso atual das crianças e o uso de medicamentos nefrotóxicos. Discussão: Crianças nascidas com baixo peso apresentaram alta prevalência de déficit da função renal e o peso atual normal foi um fator de proteção, enquanto o uso de medicamentos nefrotóxicos durante o período perinatal aumentou a chance de déficit renal. Estes achados reforçam a necessidade de avaliar a função renal destas crianças, especialmente aquelas que usam medicamentos nefrotóxicos.
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Pereira AR, Branco MDRFC, Costa SDSB, Lopes DAM, Pinheiro VV, de Oliveira DC, Pasklan ANP, Gomes JA, dos Santos AM, Gama MEA. COVID-19 severe acute respiratory syndrome in Brazilian newborns in 2020-2021. Rev Bras Epidemiol 2023; 26:e230012. [PMID: 36820749 PMCID: PMC9949484 DOI: 10.1590/1980-549720230012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 11/23/2022] [Indexed: 02/22/2023] Open
Abstract
OBJECTIVE To describe the clinical characteristics of cases of COVID-19 severe acute respiratory syndrome (SARS) in Brazilian newborns (NBs) in 2020 and 2021, recorded in the Influenza Epidemiological Surveillance Information System (Sistema de Informação da Vigilância Epidemiológica da Gripe - SIVEP-Gripe). METHODS The variables analyzed were gender, race/skin color, hospitalization, intensive care unit (ICU) admission, use of ventilatory support, signs and symptoms (fever, cough, O2 saturation<95%, dyspnea, respiratory distress, diarrhea, and vomiting), progress (death or cure), risk factors/comorbidities. Categorical variables were expressed as absolute and relative frequencies. RESULTS We found 1,649 records of COVID-19 SARS in NBs, with a predominance of multiracial babies in both years. The most frequent symptoms in 2020 and 2021 were, respectively: respiratory distress (67.0 and 69.7%), fever (46.3 and 46.2%), and cough (37.0 and 46.3%). In 2020, 30.5% of patients received invasive ventilatory support; in 2021, this number was 41.6%. In addition, more than 55% of cases required ICU admission, and over 16% died. CONCLUSION We emphasize the high proportion of cases that required intensive care and progressed to death.
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Pereira AR, Branco MDRFC, Costa SDSB, Lopes DAM, Pinheiro VV, Oliveira DCD, Pasklan ANP, Gomes JA, Santos AMD, Gama MEA. Síndrome Respiratória Aguda Grave por COVID-19 em recém-nascidos no Brasil em 2020–2021. Rev bras epidemiol 2023. [DOI: 10.1590/1980-549720230012.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
RESUMO Objetivo: Descrever as características clínicas dos casos de Síndrome Respiratória Aguda Grave (SRAG) por COVID-19 em recém-nascidos (RNs) em 2020 e 2021, no Brasil, registrados no Sistema de Informação da Vigilância Epidemiológica da Gripe (SIVEP-Gripe). Métodos: As variáveis analisadas foram: sexo, raça/cor, hospitalização, internação em unidade de terapia intensiva (UTI), uso de suporte ventilatório, sinais e sintomas (febre, tosse, saturação de O2<95%, dispneia, desconforto respiratório, diarreia e vômitos), evolução (óbito ou cura), fatores de risco/comorbidades. As variáveis categóricas foram apresentadas em frequências absolutas e relativas. Resultados: Houve 1.649 registros de SRAG por COVID-19 em RNs, com predomínio de pardos nos dois anos. Os sintomas mais frequentes foram, respectivamente, em 2020 e 2021: desconforto respiratório (67,0 e 69,7%), febre (46,3 e 46,2%) e tosse (37,0 e 46,3%). Em 2020, 30,5% dos pacientes receberam suporte ventilatório invasivo, e 41,6% em 2021. Além disso, mais de 55% dos casos precisaram de internação em UTI, e acima de 16% morreram. Conclusão: Destaca-se a elevada proporção de casos que precisou de cuidados intensivos e que evoluíram para óbito.
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Martins Neto C, Campelo CL, Lima JFDB, Mendes KDSM, Mouzinho LSN, Santos AMD, Thomaz EBAF. Fatores associados à ocorrência de parto em posição vertical no Brasil. Rev bras epidemiol 2022. [DOI: 10.1590/1980-549720220041.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
RESUMO Objetivo: Identificar os fatores associados aos partos na posição vertical realizados em hospitais vinculados à Rede Cegonha no Brasil. Métodos: Estudo transversal com 3.073 parturientes que tiveram parto vaginal em 606 estabelecimentos de saúde no Brasil, localizados em regiões de saúde com plano de ação regional aprovado na Rede Cegonha. Foram avaliadas características socioeconômicas, demográficas e obstétricas das parturientes, aspectos organizacionais e de gestão das maternidades e processos de trabalho na atenção ao parto. Modelo de regressão logística multivariada com abordagem hierarquizada foi ajustado para identificar as variáveis associadas ao parto na posição vertical (desfecho), estimando-se odds ratio (OR) com nível de significância de 5%. Resultados: Do total de parturientes avaliadas, 6,7% das mulheres tiveram parto na posição vertical. Estiveram associados à maior chance de ocorrência do parto na posição vertical: ser preta (OR=2,07); ter 13 ou mais anos de estudo (OR=3,20); parir em hospital de alto risco (OR=1,58); parir em quartos PPP (que dispunham de assistência ao trabalho de parto, parto e puerpério no mesmo ambiente) em centros obstétricos (OR=2,07) ou em centros de parto normal intra-hospitalares (OR=1,62); ser assistida por enfermeiro obstetra (OR=1,64) ou por obstetriz (OR=7,62) quando comparado ao médico; receber massagem durante o trabalho de parto e parto (OR=1,91); utilizar banqueta (OR=4,35) e entre mulheres que não pediram/não receberem analgesia (OR=3,33). Conclusão: O parto na posição vertical é um evento relacionado a aspectos raciais e à escolaridade da parturiente, sendo estimulado em estabelecimentos de saúde onde estão implantadas boas práticas de assistência ao parto, com ambiência adequada e com equipes multiprofissionais contendo obstetriz e enfermeiro obstetra.
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Cardoso JP, Calazans MIP, Carneiro ALFC, Costa CM, Monteiro ELO, Aristizábal LYG, Oliveira JDS, dos Santos AM. Association between multimorbidity, intensive care unit admission, and death in patients with COVID-19 in Brazil: a cross-section study, 2020. SAO PAULO MED J 2022; 141:e2022226. [PMID: 36197353 PMCID: PMC10065096 DOI: 10.1590/1516-3180.2022.0226.r1.21072022] [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: 04/07/2022] [Accepted: 07/21/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Multimorbidity can influence intensive care unit (ICU) admissions and deaths due to coronavirus disease (COVID-19). OBJECTIVE To analyze the association between multimorbidity, ICU admissions, and deaths due to COVID-19 in Brazil. DESIGN AND SETTING This cross-sectional study was conducted using data from patients with severe acute respiratory syndrome (SARS) due to COVID-19 recorded in the Influenza Epidemiological Surveillance Information System (SIVEP-Gripe) in 2020. METHODS Descriptive and stratified analyses of multimorbidity were performed based on sociodemographic, ventilatory support, and diagnostic variables. Poisson regression was used to estimate the prevalence ratios. RESULTS We identified 671,593 cases of SARS caused by COVID-19, of which 62.4% had at least one morbidity. Multimorbidity was associated with male sex, age 60-70 and ≥ 80 years, brown and black skin color, elementary education and high school, ventilatory support, and altered radiologic exams. Moreover, all regions of the country and altered computed tomography due to COVID-19 or other diseases were associated with death; only the northeast region and higher education were associated with ICU admission. CONCLUSION Our results showed an association between multimorbidity, ICU admission, and death in COVID-19 patients in Brazil.
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Affiliation(s)
- Jefferson Paixão Cardoso
- PhD. Physiotherapist and Full Professor, Department of Health
II, Núcleo de Estudos em Saúde da População (NESP), Universidade Estadual do
Sudoeste da Bahia (UESB), Jequié (BA), Brazil
| | - Maria Inês Pardo Calazans
- MSc. Physiotherapist and Doctoral Student, Postgraduate Program
in Nursing and Health, Núcleo de Estudos em Saúde da População (NESP),
Universidade Estadual do Sudoeste da Bahia (UESB), Jequié (BA), Brazil
| | | | - Cayara Mattos Costa
- MSc. Dental Surgeon, Doctoral Student, Postgraduate Program in
Dentistry, Universidade Federal do Maranhão (UFMA), São Luís (MA), Brazil
| | - Edna Luisa Oliveira Monteiro
- MSc. Dental Surgeon, Postgraduate Program in Dentistry,
Universidade Federal do Maranhão (UFMA), São Luís (MA), Brazil
| | - Liliana Yanet Gómez Aristizábal
- PhD. Health Administrator, Postgraduate Program in Public
Health, Universidade Federal do Maranhão (UFMA), São Luís (MA), Brazil
| | - Juliana da Silva Oliveira
- PhD. Nurse and Full Professor, Department of Health II, Núcleo
de Estudos em Saúde da População (NESP), Universidade Estadual do Sudoeste da
Bahia, (UESB), Jequié (BA), Brazil
| | - Alcione Miranda dos Santos
- PhD. Statistician and Full Professor, Postgraduate Program in
Public Health, Universidade Federal do Maranhão (UFMA), São Luís (MA),
Brazil
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Takahasi EHM, Alves MTSSDBE, Ribeiro MRC, Santos AMD, Campos MAG, Simões VMF, Amaral GA, Sousa PDS, Miranda-Filho DDB, Silva AAMD. Decline in head circumference growth and associated factors in congenital Zika syndrome. CAD SAUDE PUBLICA 2022; 38:e00296021. [DOI: 10.1590/0102-311xen296021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 05/16/2022] [Indexed: 12/23/2022] Open
Abstract
Little is known about the evolution of head circumference (HC) in children with congenital Zika syndrome (CZS). This study aims to evaluate HC growth in children with CZS in the first three years of life and identify associated factors. HC data obtained at birth and in neuropediatric consultations from 74 children with CZS were collected from the Child’s Health Handbook, parents’ reports, and medical records. Predictors of HC z-score were investigated using different mixed-effects models; Akaike’s information criterion was used for model selection. The HC z-score decreased from -2.7 ± 1.6 at birth to -5.5 ± 2.2 at 3 months of age, remaining relatively stable thereafter. In the selected adjusted model, the presence of severe brain parenchymal atrophy and maternal symptoms of infection in the first trimester of pregnancy were associated with a more pronounced reduction in the HC z-score in the first three years of life. The decrease of HC z-score in CZS children over the first three months demonstrated a reduced potential for growth and development of the central nervous system of these children. The prognosis of head growth in the first 3 years of life is worse when maternal infection occurs in the first gestational trimester and in children who have severe brain parenchymal atrophy.
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Ribeiro MRC, Santos AMD, Gama MEA, Santos ALGDA, Lago DCF, Yokokura AVCP, Costa LC, Silva KM, Sá LP, Silva AAMD. Ocupação materna e duração do aleitamento materno exclusivo: resultados de uma coorte de nascimento em São Luís, Maranhão, Brasil. CAD SAUDE PUBLICA 2022; 38:e00180221. [DOI: 10.1590/0102-311xpt180221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 05/13/2022] [Indexed: 11/22/2022] Open
Abstract
Nas investigações dos determinantes da duração do aleitamento materno exclusivo (AME), a variável trabalho materno remunerado é quase sempre dicotomizada em não e sim. Este estudo analisa possíveis associações entre características da ocupação materna e menor duração do AME. Foi realizado um estudo de coorte em uma amostra sistemática de nascimentos do Município de São Luís (Maranhão, Brasil) em 2010. As exposições tipo de ocupação materna, números de dias trabalhados/semana e de horas trabalhadas/dia, trabalha em pé a maior parte do tempo e levanta objetos pesados nesse trabalho foram coletadas com 5.166 mães de nascidos vivos. A amostra final desse estudo teve 3.268 observações. Foi utilizada análise de sobrevida para testar associações entre as exposições e os desfechos AME até 4 meses (AME4) e AME até 6 meses (AME6). Não ter trabalho remunerado foi a categoria de referência. Regressões ajustadas de Cox mostraram que mães com ocupações manuais semiespecializadas (intervalo de 95% de confiança, IC95%: 1,02-1,58 para AME4 e IC95%: 1,11-1,56 para AME6) e mães que trabalhavam 8 ou mais horas diárias (IC95%: 1,01-1,36 para AME4 e IC95%: 1,11-1,41 para AME6) mais frequentemente interromperam AME. Mães com ocupações em funções de escritório (IC95%: 1,07-1,46), que trabalhavam 4-5 dias (IC95%: 1,01-1,36) ou 6-7 dias/semana (IC95%: 1,09-1,40) e por 5-7 horas (IC95%: 1,03-1,43) também praticaram menos AME6. Trabalhar (IC95%: 1,08-1,40) ou não (IC95%: 1,03-1,34) em pé a maior parte do tempo e levantar (IC95%: 1,07-1,56) ou não (IC95%: 1,06-1,33) objetos pesados no trabalho diminuíram a duração de AME6. Tipos de ocupação e de jornada de trabalho interferiram mais frequentemente na duração de AME6.
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Falcão Neto PADO, Branco MDRFC, Costa SDSB, Câmara APB, Marques TMNF, Araujo AS, Loureiro FHF, Dias Júnior JDJ, Silva MDSD, Queiroz RCDS, Ribeiro MRC, Kulkarni MA, Silva AAMD, Santos AMD. Análise espacial da taxa de detecção de casos suspeitos de síndrome congênita pelo vírus Zika, Maranhão, 2015 a 2018. Rev bras epidemiol 2022; 25:e220002. [DOI: 10.1590/1980-549720220002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 11/03/2021] [Indexed: 11/21/2022] Open
Abstract
RESUMO: Objetivo: Identificar padrões espaciais em casos de lactentes com alterações de crescimento e desenvolvimento relacionadas à infecção pelo vírus Zika e outras etiologias infecciosas (neste trabalho denominado de síndrome congênita pelo vírus Zika), notificados no Maranhão de 2015 a 2018 e sua relação com variáveis socioeconômicas e demográficas. Métodos: Estudo ecológico de casos suspeitos notificados de síndrome congênita pelo vírus Zika nos 217 municípios do Maranhão, Brasil. Calculou-se a autocorrelação espacial pelos índices de Moran local e global (I) univariado e bivariado da taxa de detecção de casos suspeitos de síndrome congênita pelo vírus Zika com índice de desenvolvimento humano municipal, densidade demográfica, índice de Gini e tempo de emancipação político-administrativa dos municípios. O índice de Moran local foi calculado para localizar clusters com autocorrelação espacial significativa. Resultados: Houve autocorrelação espacial na análise univariada da taxa municipal de detecção de casos suspeitos de síndrome congênita pelo vírus Zika (I=0,494; p=0,001) e, na análise bivariada, correlação positiva da taxa de detecção de casos suspeitos com índice de desenvolvimento humano municipal (I=0,252; p=0,001), densidade demográfica (I=0,338; p=0,001) e tempo de emancipação dos municípios (I=0,134; p=0,001). Não houve correlação significativa da taxa de detecção de casos suspeitos com o índice de Gini (I= -0,033; p=0,131). Cinco clusters de alta detecção de casos suspeitos foram encontrados em áreas distintas do estado. Conclusões: Os municípios com maior índice de desenvolvimento humano municipal, maior densidade demográfica e mais tempo de emancipação político-administrativa tiveram mais casos suspeitos notificados de síndrome congênita pelo vírus Zika.
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Melo DDA, Santos AMD, Furtado EVH, França AKT, Santos EMD, Arruda IKGD, Carvalho TRD, Pinho CPS, Diniz ADS, Lemos MDCCD. Visceral adiposity indicators and cardiovascular risk in hemodialytic patients. Archives of Endocrinology and Metabolism 2021; 65:811-820. [PMID: 34762791 PMCID: PMC10065383 DOI: 10.20945/2359-3997000000421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Cardiovascular diseases represent the main cause of death in chronic kidney disease (CKD). We aimed to evaluate the prevalence and association of the hypertriglyceridemia-waist phenotype (HWP) and visceral adiposity index (VAI) with cardiometabolic risk factors (CR) in patients with CKD on hemodialysis (HD). METHODS The study is based on a cross-sectional design with 265 HD patients in two cities in northeastern Brazil. The VAI was calculated considering the variables body mass index (BMI), waist circumference (WC), triglycerides (TG) and high density lipoprotein cholesterol (HDL-c). HWP was defined as the concomitant elevation of WC and TG. The Poisson Regression Model with robust variance estimation was adjusted considering a hierarchical approach for explanatory variables. Prevalence ratios (PR) were also estimated. The level of significance adopted was 5%. RESULTS In our study HWP and VAI prevalence's were 29.82% and 58.49%, respectively. In the final model, there was an association between VAI and female gender (PR = 1.46; p < 0.0001) and high body fat (% BF) (PR = 1.33; p < 0.0019). HWP was associated with females (PR = 1.80; p = 0.002), alcohol consumption (PR = 1.58; p = 0.033), obesity (PR = 1.89; p = 0.0001), high %BF (PR = 1.76; p = 0.012) and reduced HDL-c (PR = 1.48; p = 0.035). CONCLUSION The HWP stood out as the association with more CR factors, representing a promising method for tracking cardiometabolic risk in HD patients, mainly female.
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de Abreu SLL, de Abreu JDMF, Branco MDRFC, dos Santos AM. In- and Out-of-Hospital Deaths by Acute Myocardial Infarction in Brazilian State Capitals. Arq Bras Cardiol 2021; 117:319-326. [PMID: 34495227 PMCID: PMC8395787 DOI: 10.36660/abc.20200043] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 01/26/2020] [Revised: 06/21/2020] [Accepted: 08/12/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Acute myocardial infarction (AMI) is the main cause of death in Brazil and the world. Approximately half of these deaths occur outside the hospital. OBJECTIVES To analyze the distribution, temporal evolution, and sociodemographic characteristics (SDC) of in- and out-of-hospital deaths by AMI in Brazilian state capitals and their relationship with municipal development indicators (MDI). METHODS This is an ecological study of the number of deaths due to AMI reported annually by the 27 Brazilian state capitals from 2007 to 2016; these were divided into 2 groups: in-hospital (H) and out-of-hospital (OH). We evaluated the temporal evolution of mortality rates in each group and differences in SDC. Negative binomial regression models were used to compare the temporal evolution of the number of deaths in each group with the following variables: residing in the South/Southeast regions (S/SE), municipal human development index (MHDI), Gini coefficient, and expected years of schooling (EYS). We considered p-values<0.05 as statisticallysignificant. RESULTS The OH mortality rate increased with time for all state capitals. All studied SDC were different between groups (p<0.001). In the OH group, most deaths were of men and patients aged 80 years or older and not married. S/SE increased the incidence of OH deaths (incidence rate ratio [IRR]=2.84; 95% confidence interval [CI]=1.67-4.85), while higher EYS reduced it (IRR=0.86; 95% CI=0.77-0.97). In the H group, higher MHDI reduced the incidence of deaths (IRR=0.44; 95% CI=0.33-0.58), while higher EYS increased it (IRR=1.09; 95% CI=1.03-1.15). CONCLUSIONS In- and out-of-hospital deaths due to AMI in Brazilian state capitals were influenced by MDI, presented sociodemographic differences and a progressive increase in out-of-hospital occurrences.
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Affiliation(s)
- Sterffeson Lamare Lucena de Abreu
- Universidade Federal do MaranhãoHospital UniversitárioSão LuísMABrasilHospital Universitário da Universidade Federal do Maranhão, São Luís, MA - Brasil
- Universidade Federal do MaranhãoPós Graduação em Saúde ColetivaSão LuísMABrasilUniversidade Federal do Maranhão - Pós Graduação em Saúde Coletiva, São Luís, MA - Brasil
| | - Joana D’Arc Matos França de Abreu
- Universidade Federal do MaranhãoHospital UniversitárioSão LuísMABrasilHospital Universitário da Universidade Federal do Maranhão, São Luís, MA - Brasil
- Universidade Federal do MaranhãoPós Graduação em Saúde ColetivaSão LuísMABrasilUniversidade Federal do Maranhão - Pós Graduação em Saúde Coletiva, São Luís, MA - Brasil
| | - Maria dos Remédios Freitas Carvalho Branco
- Universidade Federal do MaranhãoPós Graduação em Saúde ColetivaSão LuísMABrasilUniversidade Federal do Maranhão - Pós Graduação em Saúde Coletiva, São Luís, MA - Brasil
| | - Alcione Miranda dos Santos
- Universidade Federal do MaranhãoPós Graduação em Saúde ColetivaSão LuísMABrasilUniversidade Federal do Maranhão - Pós Graduação em Saúde Coletiva, São Luís, MA - Brasil
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Machado PMA, Campelo CL, de Oliveira JVP, Batista RFL, Simões VMF, dos Santos AM. Analysis of the AUDIT factor structure in adolescents between 18 and 19 years. Rev Saude Publica 2021; 55:27. [PMID: 34037139 PMCID: PMC8139847 DOI: 10.11606/s1518-8787.2021055002777] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 09/22/2020] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To determine the factor structure of the instrument Alcohol Use Disorders Identification Test (AUDIT) in a representative sample of adolescents aged 18 to 19 years. METHODS Cross-sectional study performed with adolescents born in São Luís (MA). The internal consistency of the instrument was determined by the Cronbach's alpha coefficient, and the validity of the construct was assessed by Confirmatory Factor Analysis (CFA). The Kaiser-Meyer-Olkin (KMO) was estimated to analyze the adequacy of the sample. The fit quality of the factor model was analyzed according to the indexes of the Chi-square adjustment test, comparative fit index (CFI), Tucker-Lewis index (TLI) and root mean square error of approximation (RMSEA). RESULTS The sample of the study was composed of 1,002 adolescents aged from 18 to 19 years, being 56.8% girls, 68.5% with 18 years, 63.3% brown, 48.6% belonging to class C, 15.4% did not work or did not study, and 52.1% had divorced parents. The sample was suitable for confirmatory factor analysis (KMO = 0.79); Cronbach's alpha coefficient was 0.70, demonstrating satisfactory internal consistency with factor loads above 0.5, except for item 9, "was injured or someone else was injured due to drinking." Confirmatory factor analysis revealed the validity of the three-factor model for the studied sample based on the indices of psychometric adjustments. CONCLUSION The three-factor AUDIT factor structure was confirmed for the population of adolescents between 18 and 19 years old living in São Luís, ratifying the original conceptual domains proposed by the World Health Organization. AUDIT proved to be a reliable instrument to identify the consumption of alcohol.
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Affiliation(s)
- Patrícia Maria Abreu Machado
- Universidade Federal do MaranhãoPrograma de Pós-Graduação em Ciências da SaúdeSão LuísMABrasilUniversidade Federal do Maranhão. Programa de Pós-Graduação em Ciências da Saúde. São Luís, MA. Brasil
| | - Cleber Lopes Campelo
- Universidade Federal do MaranhãoPrograma de Pós-Graduação em Saúde ColetivaSão LuísMABrasilUniversidade Federal do Maranhão. Programa de Pós-Graduação em Saúde Coletiva. São Luís, MA, Brasil
| | - João Victor Pimentel de Oliveira
- Universidade Federal do MaranhãoFaculdade de MedicinaSão LuísMABrasilUniversidade Federal do Maranhão. Faculdade de Medicina. São Luís, MA, Brasil
| | - Rosângela Fernandes Lucena Batista
- Universidade Federal do MaranhãoDepartamento de Saúde PúblicaSão LuísMABrasilUniversidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil
| | - Vanda Maria Ferreira Simões
- Universidade Federal do MaranhãoDepartamento de Saúde PúblicaSão LuísMABrasilUniversidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil
| | - Alcione Miranda dos Santos
- Universidade Federal do MaranhãoDepartamento de Saúde PúblicaSão LuísMABrasilUniversidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil
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de Oliveira BLCA, Campos MAG, Queiroz RCDS, Alves MTSSDBE, de Souza BF, dos Santos AM, da Silva AAM. Prevalence and factors associated with covid-19 vaccine hesitancy in Maranhão, Brazil. Rev Saude Publica 2021; 55:12. [PMID: 33909868 PMCID: PMC8046425 DOI: 10.11606/s1518-8787.2021055003417] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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: 12/16/2020] [Accepted: 12/29/2020] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES To estimate the prevalence and factors associated with hesitancy in getting the vaccine against SARS-CoV-2 in Maranhão, Brazil. METHODS This is a cross-sectional population-based study conducted from October 19 to 30, 2020. The estimates were calculated based on clustering, stratification, and non-response. A three-stage sampling was adopted, considering stratum, census tracts, and domicile. After systematic analysis, thirty sectors were selected in each stratum, totaling 150 sectors. Each sector contained a fixed number of 34 households, thus totaling 5,100 households. One individual within each household (resident for at least six months and aged one year or more) was selected by a simple random sampling. We questioned participants about their vaccination intention. Univariate association between independent variables and the outcome were verified using descriptive analysis (weighted frequencies) and Pearson's chi-square test (p < 0.05). Robust multivariate analysis was performed using a three-level hierarchical model. RESULTS We found 17.5% (95%CI 16.1-19.1%) of the 4,630 individuals interviewed to report hesitancy to be vaccinated against covid-19. After final model adjustment, vaccination hesitancy was statistically higher among residents of the cities of Imperatriz (24.0%; RP = 1.48; IC95% 1.09-2.02) and municipalities of the Grande Ilha de São Luís (20.7%; RP = 1.34; 95%CI 1.02-1.76), female individuals (19.8%; RP = 1.44; 95%CI 1.20-1.75), older adults (22.8%; RP = 1.79; IC95% 1.30-2.46), evangelicals (24.1%; RP = 1.49; 95%CI 1.24-1.79), and those without reported symptoms (18.6%; RP = 1.24; 95%CI 1.02-1.51). We found no statistical differences for other socioeconomic and demographic characteristics, as well as variables related to the labor market, behaviors, and health conditions of the interviewees. CONCLUSION The prevalence of vaccine hesitancy in Maranhão and its association with individual, contextual, and clinical factors enable us to identify the groups and contexts of greatest resistance, requiring special attention from public strategies to ensure wide vaccination.
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Affiliation(s)
| | | | - Rejane Christine de Sousa Queiroz
- Universidade Federal do MaranhãoDepartamento de Saúde PúblicaSão LuísMABrasilUniversidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil
| | | | - Bruno Feres de Souza
- Universidade Federal do MaranhãoDepartamento de Engenharia da ComputaçãoSão LuísMABrasilUniversidade Federal do Maranhão. Departamento de Engenharia da Computação. São Luís, MA, Brasil
| | - Alcione Miranda dos Santos
- Universidade Federal do MaranhãoDepartamento de Saúde PúblicaSão LuísMABrasilUniversidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil
| | - Antônio Augusto Moura da Silva
- Universidade Federal do MaranhãoDepartamento de Saúde PúblicaSão LuísMABrasilUniversidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil
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Salgado Filho N, Lages JS, Brito DJDA, Santos EJF, dos Santos AM, de Souza FL, Mendes VGG, Silva GADS, Carneiro ECRDL, Muniz MPR, Silva GEB, Sesso RDCC. Variability in Hemoglobin Levels and the Factors Associated with Mortality in Hemodialysis Patients: A 78-Month Follow-Up Study. Int J Environ Res Public Health 2021; 18:ijerph18031078. [PMID: 33530448 PMCID: PMC7908351 DOI: 10.3390/ijerph18031078] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/13/2021] [Accepted: 01/16/2021] [Indexed: 12/02/2022]
Abstract
Some studies have described that when the hemoglobin levels of chronic kidney disease (CKD) patients change, especially in those taking erythropoiesis-stimulating agents (ESA), they are associated with unfavorable outcomes such as increased morbidity and mortality, mainly due to cardiovascular events. This prospective cohort study included patients with end-stage renal disease currently undergoing hemodialysis. The initial 6-month clinical evaluation provided data of the variability in hemoglobin, associated blood parameters, and the use of erythropoietin. Subsequently, the patients were followed up for 78 months to evaluate mortality-associated factors. In total, 133 patients completed the 6-month follow-up with a mean age of 47.1 (±13.2) years. The majority were women (51.9%). Six-month hemoglobin levels were as follows: always low (18.0%), intermediate/target (1.5%), always high (0.8%), low-amplitude fluctuation/Hb low (n = 37; 27.8%), low-amplitude fluctuation/Hb high (13.53%), and high-amplitude fluctuation (38.6%), among end-stage renal disease patients. At the end of 78 months, 50 (37.6%) patients died; 70% of deaths were attributed to cardiovascular etiologies. A high variability was observed in hemoglobin levels, which was not associated with mortality. Among all the variables evaluated, age, erythropoietin dose, and transferrin saturation were associated with a higher mortality. Thus, this study suggests that greater attention to erythropoietin doses and transferrin saturation levels may improve the survival of dialysis patients.
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Affiliation(s)
- Natalino Salgado Filho
- Renal Division, Federal University of Maranhão, São Luís 65020-070, Brazil; (J.S.L.); (D.J.d.A.B.); (E.J.F.S.); (A.M.d.S.); (F.L.d.S.); (V.G.G.M.); (G.A.d.S.S.); (E.C.R.d.L.C.); (M.P.R.M.); (G.E.B.S.)
- Correspondence: ; Tel.: +55-98-21091001
| | - Joyce Santos Lages
- Renal Division, Federal University of Maranhão, São Luís 65020-070, Brazil; (J.S.L.); (D.J.d.A.B.); (E.J.F.S.); (A.M.d.S.); (F.L.d.S.); (V.G.G.M.); (G.A.d.S.S.); (E.C.R.d.L.C.); (M.P.R.M.); (G.E.B.S.)
| | - Dyego José de Araújo Brito
- Renal Division, Federal University of Maranhão, São Luís 65020-070, Brazil; (J.S.L.); (D.J.d.A.B.); (E.J.F.S.); (A.M.d.S.); (F.L.d.S.); (V.G.G.M.); (G.A.d.S.S.); (E.C.R.d.L.C.); (M.P.R.M.); (G.E.B.S.)
| | - Elton John Freitas Santos
- Renal Division, Federal University of Maranhão, São Luís 65020-070, Brazil; (J.S.L.); (D.J.d.A.B.); (E.J.F.S.); (A.M.d.S.); (F.L.d.S.); (V.G.G.M.); (G.A.d.S.S.); (E.C.R.d.L.C.); (M.P.R.M.); (G.E.B.S.)
| | - Alcione Miranda dos Santos
- Renal Division, Federal University of Maranhão, São Luís 65020-070, Brazil; (J.S.L.); (D.J.d.A.B.); (E.J.F.S.); (A.M.d.S.); (F.L.d.S.); (V.G.G.M.); (G.A.d.S.S.); (E.C.R.d.L.C.); (M.P.R.M.); (G.E.B.S.)
| | - Francival Leite de Souza
- Renal Division, Federal University of Maranhão, São Luís 65020-070, Brazil; (J.S.L.); (D.J.d.A.B.); (E.J.F.S.); (A.M.d.S.); (F.L.d.S.); (V.G.G.M.); (G.A.d.S.S.); (E.C.R.d.L.C.); (M.P.R.M.); (G.E.B.S.)
| | - Vinícius Giuliano Gonçalves Mendes
- Renal Division, Federal University of Maranhão, São Luís 65020-070, Brazil; (J.S.L.); (D.J.d.A.B.); (E.J.F.S.); (A.M.d.S.); (F.L.d.S.); (V.G.G.M.); (G.A.d.S.S.); (E.C.R.d.L.C.); (M.P.R.M.); (G.E.B.S.)
| | - Giselle Andrade dos Santos Silva
- Renal Division, Federal University of Maranhão, São Luís 65020-070, Brazil; (J.S.L.); (D.J.d.A.B.); (E.J.F.S.); (A.M.d.S.); (F.L.d.S.); (V.G.G.M.); (G.A.d.S.S.); (E.C.R.d.L.C.); (M.P.R.M.); (G.E.B.S.)
| | - Erika Cristina Ribeiro de Lima Carneiro
- Renal Division, Federal University of Maranhão, São Luís 65020-070, Brazil; (J.S.L.); (D.J.d.A.B.); (E.J.F.S.); (A.M.d.S.); (F.L.d.S.); (V.G.G.M.); (G.A.d.S.S.); (E.C.R.d.L.C.); (M.P.R.M.); (G.E.B.S.)
| | - Monique Pereira Rêgo Muniz
- Renal Division, Federal University of Maranhão, São Luís 65020-070, Brazil; (J.S.L.); (D.J.d.A.B.); (E.J.F.S.); (A.M.d.S.); (F.L.d.S.); (V.G.G.M.); (G.A.d.S.S.); (E.C.R.d.L.C.); (M.P.R.M.); (G.E.B.S.)
| | - Gyl Eanes Barros Silva
- Renal Division, Federal University of Maranhão, São Luís 65020-070, Brazil; (J.S.L.); (D.J.d.A.B.); (E.J.F.S.); (A.M.d.S.); (F.L.d.S.); (V.G.G.M.); (G.A.d.S.S.); (E.C.R.d.L.C.); (M.P.R.M.); (G.E.B.S.)
- Pathology Division, University of São Paulo (USP), Ribeirão Preto 14049-900, Brazil
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da Silva AAM, Lima-Neto LG, de Azevedo CDMPES, da Costa LMM, Bragança MLBM, Barros AKD, Wittlin BB, de Souza BF, de Oliveira BLCA, de Carvalho CA, Thomaz EBAF, Simões-Neto EA, Leite JF, Cosme LMSS, Campos MAG, Queiroz RCDS, Costa SS, de Carvalho VA, Simões VMF, Alves MTSSDBE, dos Santos AM. Population-based seroprevalence of SARS-CoV-2 and the herd immunity threshold in Maranhão. Rev Saude Publica 2020; 54:131. [PMID: 33331525 PMCID: PMC7703539 DOI: 10.11606/s1518-8787.2020054003278] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [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: 10/23/2020] [Accepted: 10/27/2020] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE To estimate the seroprevalence of SARS-CoV-2 in the state of Maranhão, Brazil. METHODS A population-based household survey was performed, from July 27, 2020 to August 8, 2020. The estimates considered clustering, stratification and non-response. Qualitative detection of IgM and IgG antibodies was performed in a fully-automated Elecsys® Anti-SARS-CoV-2 electrochemiluminescence immunoassay on the Cobas® e601 analyzer (Roche Diagnostics). RESULTS In total, 3,156 individuals were interviewed. Seroprevalence of total antibodies against SARS-CoV-2 was 40.4% (95%CI 35.6-45.3). Population adherence to non-pharmaceutical interventions was higher at the beginning of the pandemic than in the last month. SARS-CoV-2 infection rates were significantly lower among mask wearers and among those who maintained social and physical distancing in the last month compared to their counterparts. Among the infected, 26.0% were asymptomatic. The infection fatality rate (IFR) was 0.14%, higher for men and older adults. The IFR based on excess deaths was 0.28%. The ratio of estimated infections to reported cases was 22.2. CONCLUSIONS To the best of our knowledge, the seroprevalence of SARS-CoV-2 estimated in this population-based survey is one of the highest reported. The local herd immunity threshold may have been reached or might be reached soon.
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Affiliation(s)
- Antônio Augusto Moura da Silva
- Universidade Federal do MaranhãoDepartamento de Saúde PúblicaSão LuísMABrasilUniversidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil
| | - Lídio Gonçalves Lima-Neto
- Laboratório Central do MaranhãoSão LuísMABrasilSecretaria de Saúde do Estado do Maranhão. Laboratório Central do Maranhão. São Luís, MA, Brasil
- Universidade CEUMASão LuísMABrasilUniversidade CEUMA. São Luís, MA, Brasil
| | - Conceição de Maria Pedrozo e Silva de Azevedo
- Universidade Federal do MaranhãoDepartamento de Medicina ISão LuísMABrasilUniversidade Federal do Maranhão. Departamento de Medicina I. São Luís, MA, Brasil
- Saúde do Estado do MaranhãoHospital Presidente VargasSão LuísMABrasilSecretaria de Saúde do Estado do Maranhão. Hospital Presidente Vargas. São Luís, MA, Brasil
| | - Léa Márcia Melo da Costa
- Saúde do Estado do MaranhãoSão LuísMABrasilSecretaria de Saúde do Estado do Maranhão. Assessoria. São Luís, MA, Brasil
| | - Maylla Luanna Barbosa Martins Bragança
- Universidade Federal do MaranhãoDepartamento de Ciências FisiológicasSão LuísMABrasilUniversidade Federal do Maranhão. Departamento de Ciências Fisiológicas. São Luís, MA, Brasil
| | - Allan Kardec Duailibe Barros
- Universidade Federal do MaranhãoDepartamento de Engenharia ElétricaSão LuísMABrasilUniversidade Federal do Maranhão. Departamento de Engenharia Elétrica. São Luís, MA, Brasil
| | - Bernardo Bastos Wittlin
- Saúde do Estado do MaranhãoHospital Presidente VargasSão LuísMABrasilSecretaria de Saúde do Estado do Maranhão. Hospital Presidente Vargas. São Luís, MA, Brasil
- Universidade Federal do MaranhãoHospital UniversitárioSão LuísMABrasilUniversidade Federal do Maranhão. Hospital Universitário. São Luís, MA, Brasil
| | - Bruno Feres de Souza
- Universidade Federal do MaranhãoDepartamento de Engenharia da ComputaçãoSão LuísMABrasilUniversidade Federal do Maranhão. Departamento de Engenharia da Computação. São Luís, MA, Brasil
| | | | - Carolina Abreu de Carvalho
- Universidade Federal do MaranhãoCurso de MedicinaPinheiroMABrasilUniversidade Federal do Maranhão. Curso de Medicina. Pinheiro, MA, Brasil
| | - Erika Barbara Abreu Fonseca Thomaz
- Universidade Federal do MaranhãoDepartamento de Saúde PúblicaSão LuísMABrasilUniversidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil
| | - Eudes Alves Simões-Neto
- Universidade Federal do MaranhãoHospital UniversitárioSão LuísMABrasilUniversidade Federal do Maranhão. Hospital Universitário. São Luís, MA, Brasil
- Secretaria Municipal de SaúdeSão LuísMABrasilSecretaria Municipal de Saúde. São Luís, MA, Brasil
| | - Jamesson Ferreira Leite
- Saúde do Estado do MaranhãoCentro de Informações Estratégicas de Vigilância em SaúdeSão LuísMABrasilSecretaria de Saúde do Estado do Maranhão. Centro de Informações Estratégicas de Vigilância em Saúde. São Luís, MA, Brasil
| | - Lécia Maria Sousa Santos Cosme
- Laboratório Central do MaranhãoSão LuísMABrasilSecretaria de Saúde do Estado do Maranhão. Laboratório Central do Maranhão. São Luís, MA, Brasil
| | - Marcos Adriano Garcia Campos
- Universidade Federal do MaranhãoPrograma de Pós-Graduação em Saúde ColetivaSão LuísMABrasilUniversidade Federal do Maranhão. Programa de Pós-Graduação em Saúde Coletiva. São Luís, MA, Brasil
| | - Rejane Christine de Sousa Queiroz
- Universidade Federal do MaranhãoDepartamento de Saúde PúblicaSão LuísMABrasilUniversidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil
| | - Sérgio Souza Costa
- Universidade Federal do MaranhãoDepartamento de Engenharia da ComputaçãoSão LuísMABrasilUniversidade Federal do Maranhão. Departamento de Engenharia da Computação. São Luís, MA, Brasil
| | - Vitória Abreu de Carvalho
- Universidade Federal do MaranhãoPrograma de Pós-Graduação em Saúde ColetivaSão LuísMABrasilUniversidade Federal do Maranhão. Programa de Pós-Graduação em Saúde Coletiva. São Luís, MA, Brasil
| | - Vanda Maria Ferreira Simões
- Universidade Federal do MaranhãoDepartamento de Saúde PúblicaSão LuísMABrasilUniversidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil
| | | | - Alcione Miranda dos Santos
- Universidade Federal do MaranhãoDepartamento de Saúde PúblicaSão LuísMABrasilUniversidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil
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Ferreira TF, Santos AMD, Oliveira BLCAD, Caldas ADJM. Tendência da tuberculose em indígenas no Brasil no período de 2011-2017. Ciênc saúde coletiva 2020; 25:3745-3752. [DOI: 10.1590/1413-812320202510.28482018] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Accepted: 02/11/2019] [Indexed: 11/21/2022] Open
Abstract
Resumo O objetivo deste artigo é analisar a tendência da tuberculose (TB) em indígenas no Brasil no período de 2011-2017. Trata-se de um estudo ecológico realizado com todos os casos novos de TB em indígenas notificados no Sistema de Informação de Agravos de Notificação, durante o período 2011 a 2017. Foram confeccionados mapas temáticos para acompanhamento da evolução espaço-temporal da TB na população indígena em cada ano. Para o estudo da tendência utilizou-se o modelo de regressão linear generalizada de Prais-Winsten. No período em estudo, foram notificados 6.520 casos de TB em indígenas. A incidência geral de TB em indígenas no Brasil foi de 109/100.000 habitantes. Na análise por regiões do país, as maiores incidências ocorreram nas regiões Centro-Oeste, Norte e Sudeste. Na análise por UF, as maiores incidências foram encontradas no Mato Grosso, São Paulo, Rondônia, Mato Grosso do Sul, Acre, Maranhão, Pará e Rio de Janeiro. A tendência da doença nos indígenas foi estável tanto no país quanto na maioria das suas regiões e UF. A TB afeta desproporcionalmente os indígenas brasileiros e o presente estudo ao identificar regiões e UF prioritárias pode contribuir para a elaboração e fortalecimento de ações de controle mais específicas.
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Lima RM, Leite EVNC, Furtado DF, Santos AMD. Prevalence and factors associated with the consumption of folic acid and iron in pregnant women in the BRISA cohort. Rev Bras Saude Mater Infant 2020. [DOI: 10.1590/1806-93042020000300008] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abstract Objectives: to describe the prevalence and factors associated with the consumption of folic acid and iron among puerperal women in the city of São Luís, Maranhão. Methods: a cross-sectional study with 4,036 puerperal women through a standardized questionnaire. The dependent variables (outcomes) were: the consumption of folic acid during pregnancy, iron and folic acid before pregnancy. The independent variables: age; schooling; skin color; marital status; income; planned pregnancy; place and number of prenatal consultations. Statistical analyzes were performed on STATA 14.0. For the first two outcomes, Poisson model with a robust variance was used. And for the last one, logistic regression. Results: the prevalence of consuming folic acid and iron during pregnancy were, respec-tively, 77.27% and 84.98%. However, only 0.37% reported the consume of folic acid and iron before pregnancy. In the adjusted analysis, the variables associated with the consumption of folic acid during pregnancy were: schooling and income; the consume of iron during preg-nancy, age only; and for those who consumed folic acid before pregnancy, no variable was statistically significant. Conclusions: high percentage of puerperal women who consumed folic acid and iron supplements during pregnancy, however, the recommended consumption of folic acid before pregnancy was low and maternal, social and economic factors influence the consumption of these supplements.
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Rodrigues LDS, Santos AMD, Lima MIS, Simões VMF, Pereira SR. Association between the FTO gene polymorphism and obesity in Brazilian adolescents from the Northeast region. Jornal de Pediatria (Versão em Português) 2020. [DOI: 10.1016/j.jpedp.2019.05.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Do Vale Nascimento AA, Chagas Ramos Magalhães F, Miranda dos Santos A, Regina de Castro Borba E. Avaliação físico-química do bicarbonato de sódio dispensado em farmácias. Sci Plena 2019. [DOI: 10.14808/sci.plena.2019.084601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
O controle de qualidade é um conjunto de atividades realizadas para assegurar que o produto não seja entregue ao consumidor, sem antes cumprir as especificações definidas. Este estudo avaliou a qualidade físico-química do bicarbonato de sódio, na forma farmacêutica de pó, dispensado em farmácias no município de São Luís- MA. As análises foram realizadas de acordo com os métodos descritos na Farmacopeia Brasileira 5ª edição. Foram utilizadas 10 amostras do mesmo lote de cada fabricante, sendo analisados 3 fabricantes diferentes, realizando-se ensaios de identificação, pureza, determinação de peso e doseamento. As amostras cumpriram as especificações farmacopeicas nos ensaios de identificação e pureza. Nos testes para determinação de peso, as amostras analisadas dos três fabricantes cumprem o teste com um valor encontrado na média dos resultados de 100% da massa em relação ao peso declarado, indicando homogeneidade no envase e o fornecimento do produto na quantidade informada. No ensaio de doseamento, os três fabricantes: A (99,73%), B (100,16%) e C (99,94%) apresentaram-se em conformidade com a especificação da Farmacopeia Brasileira 5ª edição. Os resultados encontrados demonstram pouca variação entre as unidades e a média, observado em análise estatística, sugerindo homogeneidade entre as amostras analisadas no estudo. Constatou-se que as amostras analisadas dos três fabricantes cumpriram os testes de qualidade físico-químicos aplicados no estudo, sugerindo estar em conformidade com os padrões de qualidade preconizados.
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Barbosa YC, Oliveira AGC, Rabêlo PPC, Silva FDS, Santos AMD. Fatores associados à não realização de mamografia: Pesquisa Nacional de Saúde, 2013. Rev bras epidemiol 2019; 22:e190069. [DOI: 10.1590/1980-549720190069] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 10/05/2018] [Indexed: 11/22/2022] Open
Abstract
RESUMO: Introdução: O acesso à mamografia, principal exame de detecção precoce do câncer de mama, não é igualitário entre as mulheres brasileiras. Objetivou-se analisar os fatores associados à não realização desse exame num período inferior a dois anos no Brasil e por macrorregião, considerando-se características sociodemográficas, condições de saúde, hábitos de vida e uso dos serviços de saúde. Método: Estudo transversal que utilizou dados da Pesquisa Nacional de Saúde (PNS). A amostra consiste de 10.571 mulheres (≥ 40 anos) residentes em todas as regiões brasileiras. Modelo de regressão de Poisson com abordagem hierarquizada foi utilizado para estimar razões de prevalência. Resultados: As características associadas à não realização de mamografia foram: idade ≥ 60 anos, baixa escolaridade, viver sem companheiro, avaliar negativamente o próprio estado de saúde, possuir alguma doença crônica, não praticar exercício físico, não realizar o exame clínico da mama até um ano, ou o exame de Papanicolaou até três anos, não ter consultado com médico no último ano, não possuir plano de saúde, sentir-se discriminada por profissional de saúde e ter cadastro em uma unidade de saúde da família. Variáveis sociodemográficas se sobressaíram no Norte e Nordeste; e nas outras regiões, condições de saúde e hábitos de vida. Conclusão: Variáveis relacionadas ao uso dos serviços de saúde tiveram destaque na não realização da mamografia. Ações que reduzam a desigualdade no acesso ao exame devem ser adotadas em cada macrorregião do Brasil.
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Brito DJDA, dos Santos EM, Dias RSC, Calado IL, Silva GEB, Lages JS, Monteiro Júnior FDC, dos Santos AM, Salgado Filho N. Association between renal damage markers and carotid atherosclerosis in Afro-descendants with hypertension belonging to a minority ethnic group from Brazil. Ren Fail 2018; 40:483-491. [PMID: 30278805 PMCID: PMC6171460 DOI: 10.1080/0886022x.2018.1496932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 11/15/2017] [Revised: 06/15/2018] [Accepted: 06/28/2018] [Indexed: 02/07/2023] Open
Abstract
Ethnicity appears to play an important role in the prevalence and severity of hypertension, renal disease, and atherosclerosis. A cross-sectional study was conducted, including 206 Afro-descendants with hypertension, living in the remaining quilombo communities. These subjects underwent a carotid intima-media thickness (CIMT) assessment. The presence of renal injury was assessed by: (1) The glomerular filtration rate (GFR) estimated by the formula CKD-EPI using creatinine and cystatin C and (2) Albuminuria (ACR ≥30 mg/g). The Poisson distribution model was set with robust variance to identify factors associated with carotid atherosclerosis. The statistical analysis was performed using the Stata 12.0 software, adopting a significance level of 5%. Most subjects were women (61.65%); the average age was 61.32 (±12.44) years. Subjects (12.62%) were identified with GFR <60 mL/min/1.73 m2 and 22.8% with albuminuria. Patients (59.22%) presented with a high CIMT. In the adjusted regression model, age ≥60 years (PR: 1.232 [CI 95%:1.091-1.390], p value = .001), ACR ≥30 mg/g (PR: 1.176 [CI 95%: 1.007-1.373], p = .040), and GFR/CKD-EPI using cystatin C (PR: 1.250 [CI 95%: 1.004-1.557], p = .045) were independently associated with carotid atherosclerosis. The occurrence of atherosclerotic lesions was high in the studied group. Age, albuminuria, and GFR (estimated by the formula CKD-EPI using cystatin C) influenced the prevalence of carotid atherosclerosis.
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Affiliation(s)
- Dyego José de Araújo Brito
- Postgraduate Program of Health Science, Federal University of Maranhão, São Luís, Brazil
- Nephrology Division, University Hospital of Federal University of Maranhão, São Luís, Brazil
| | - Elisangela Milhomem dos Santos
- Postgraduate Program of Health Science, Federal University of Maranhão, São Luís, Brazil
- Department of Nursing, Federal University of Maranhão, São Luís, Brazil
| | - Raimunda Sheyla Carneiro Dias
- Postgraduate Program of Health Science, Federal University of Maranhão, São Luís, Brazil
- Nephrology Division, University Hospital of Federal University of Maranhão, São Luís, Brazil
| | | | | | - Joyce Santos Lages
- Department of Public Health, Federal University of Maranhão, São Luís, Brazil
| | - Francisco das Chagas Monteiro Júnior
- Cardiology Division, University Hospital of Federal University of Maranhão, São Luís, Brazil
- Department of Medicine I, Federal University of Maranhão, São Luís, Brazil
| | - Alcione Miranda dos Santos
- Postgraduate Program of Health Science, Federal University of Maranhão, São Luís, Brazil
- Department of Public Health, Federal University of Maranhão, São Luís, Brazil
| | - Natalino Salgado Filho
- Postgraduate Program of Health Science, Federal University of Maranhão, São Luís, Brazil
- Nephrology Division, University Hospital of Federal University of Maranhão, São Luís, Brazil
- Department of Medicine I, Federal University of Maranhão, São Luís, Brazil
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dos Santos EM, Brito DJDA, Calado IL, França AKT, Lages JS, Monteiro Junior FDC, dos Santos AM, Salgado Filho N. Sodium excretion and associated factors in urine samples of African descendants in Alcântara, Brazil: a population based study. Ren Fail 2018; 40:22-29. [PMID: 29298567 PMCID: PMC6014324 DOI: 10.1080/0886022x.2017.1419967] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 07/17/2017] [Revised: 11/13/2017] [Accepted: 12/14/2017] [Indexed: 10/28/2022] Open
Abstract
In most countries, salt intake has been excessive and constitutes one of the main risk factors for disease development, especially hypertension. Factors such as age, gender, sedentary lifestyle, smoking, African descent, obesity, dietary habits and family history of hypertension may be associated with high blood pressure. Studies show a positive association between the excretion of sodium and increased blood pressure. We evaluated the urinary excretion of sodium and associated factors in isolated urine samples of African descendants from remaining Quilombos. We performed a cross-sectional, population-based study with 1162 African descendants living in remaining quilombos in Alcântara, Maranhão, Brazil. Demographic, nutritional, clinical and laboratory data were analyzed. Urinary sodium excretion was estimated using the Kawasaki equation. A multivariate linear regression model was used to identify the variables related to sodium excretion. The average age was 37.6 ± 11.8 years and 51.2% were women. The prevalence of hypertension was 21.3%. The average urinary excretion of sodium was high, especially among the hypertensive (217.9 ± 90.1 vs. 199.2 ± 83.0 mmol/d; p = .002). After an adjusted analysis, only the waist circumference (odds ratios (OR) = 1.16; confidence intervals(CI)95%: 1.03-1.30), triglyceride (OR = 1.13; CI95%: 1.05-1.22), systolic blood pressure (OR = 1.19; CI95%: 1.08-1.32) and Chronic Kidney Disease Epidemiology (CKD-EPI;OR = 1.24; CI95%: 1.15-1.35) remained related to urinary sodium excretion. African descendants had a high rate of sodium excretion, especially among those who had hypertension. Abdominal adiposity, triglyceride and systolic blood pressure levels and renal function by CKD-EPI equation were associated to urinary sodium excretion.
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Affiliation(s)
| | - Dyego José de Araújo Brito
- Department of Nephrology, University Hospital of Federal University of Maranhão, São Luis, Maranhão, Brazil
| | - Isabela Leal Calado
- Department of Health Sciences, Federal University of Maranhão, São Luis, Maranhão, Brazil
| | | | - Joyce Santos Lages
- Department of Public Health, Federal University of Maranhão, São Luis, Maranhão, Brazil
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Batalha MA, França AKTDC, Conceição SIOD, Santos AMD, Silva FDS, Padilha LL, Silva AAMD. Processed and ultra-processed food consumption among children aged 13 to 35 months and associated factors. CAD SAUDE PUBLICA 2017; 33:e00152016. [DOI: 10.1590/0102-311x00152016] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 02/01/2017] [Indexed: 11/21/2022] Open
Abstract
Abstract: The aim of this study was to evaluate the consumption of processed and ultra-processed foods among children aged 13-35 months and its associated factors. We studied 1,185 children within the BRISA cohort in São Luís, Maranhão State, Brazil. The food consumption was investigated using a 24-hour recall, and the percentages of daily caloric intake and nutrients were estimated by food groups according to “NOVA” classification. We chose to categorize children belonging to the upper tertile of the distribution as having a high consumption of processed and ultra-processed food products. The Poisson regression model with robust variance estimation using a hierarchical modeling approach was used to calculate the prevalence ratios (PRs) of variables associated with high consumption of processed and ultra-processed food products. The mean energy intake was 1,226Kcal/day. After adjustments, there was a higher proportion of high consumption of processed and ultra-processed food products among children whose mothers had < 12 years of education and among children who were older than 16 months. Mothers with low schooling and children older than 16 months should be the targets of interventions aimed at reducing consumption of these food products and preventing adverse health outcomes in later life.
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Dias JDJ, Branco MDRFC, Queiroz RCDS, dos Santos AM, Moreira EPB, da Silva MDS. Analysis of dengue cases according to clinical severity, São Luís, Maranhão, Brazil. Rev Inst Med Trop Sao Paulo 2017; 59:e71. [PMID: 29116291 PMCID: PMC5679683 DOI: 10.1590/s1678-9946201759071] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 04/12/2017] [Accepted: 08/29/2017] [Indexed: 11/22/2022] Open
Abstract
Severe dengue cases have increased in Brazil since 2001, with the first records in Maranhão dating back to 2002. The aim of this study was to determine the prevalence of severe dengue cases by age group and the possible risk factors. This was a study of secondary data on dengue in residents of São Luís, Maranhão, Brazil, using probable cases notified to the National Mandatory Reporting System (SINAN) from 2002 to 2011. The diagnosis and classification of dengue were based on the Brazilian Ministry of Health criteria: dengue fever (DF), dengue hemorrhagic fever (DHF) and dengue fever with complications (DWC). DHF and DWC were considered severe dengue, and DF was classified as non-severe dengue. A logistic regression analysis was performed with severe dengue as the outcome. During the study period, 1,229 cases of severe dengue were reported; of these, 812 in patients under the age of 15 (66%). Among the risk factors evaluated, age under 15 years old (OR = 3.10, 95% CI = 2.69-3.57, p-value = 0.001) was associated with severe dengue. The prevalence of severe dengue in children under the age of 15 was higher, and only this age group was associated with the occurrence of severe dengue.
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Affiliation(s)
- José de Jesus Dias
- Universidade Federal do Maranhão, Programa de Pós-Graduação em Saúde
Coletiva, São Luís, Maranhão, Brazil
| | - Maria dos Remédios Freitas Carvalho Branco
- Universidade Federal do Maranhão, Programa de Pós-Graduação em Saúde
Coletiva, São Luís, Maranhão, Brazil
- Universidade Federal do Maranhão, Programa de Pós-Graduação em Saúde e
Ambiente, São Luís, Maranhão, Brazil
| | | | - Alcione Miranda dos Santos
- Universidade Federal do Maranhão, Programa de Pós-Graduação em Saúde
Coletiva, São Luís, Maranhão, Brazil
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Silva FD, dos Santos AM, Corrêa RDGCF, Caldas ADJM. Temporal relationship between rainfall, temperature and occurrence of dengue cases in São Luís, Maranhão, Brazil. Cien Saude Colet 2017; 21:641-6. [PMID: 26910171 DOI: 10.1590/1413-81232015212.09592015] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2015] [Accepted: 06/26/2015] [Indexed: 11/22/2022] Open
Abstract
This study analyzed the relationship between rainfall, temperature and occurrence of dengue cases. Ecological study performed with autochthonous dengue cases reported during 2003 to 2010 in São Luís, Maranhão. Data of rainfall and temperature were collected monthly. The monthly incidence of dengue cases was calculated by year/100,000 inhabitants. In order to identify the influence of climate variables and dengue cases different distributed lag models using negative binomial distribution were considered. Model selection was based on the lowest AIC (Akaike Information Criterion). Thirteen thousand, four hundred forty-four cases of dengue between 2003 and 2010 were reported, with peaks in 2005, 2007 and 2010. The correlation between rainfall and the occurrence of dengue cases showed increase in the first months after the rainy months. Occurrence of dengue cases was observed during all the period of study. Only rainfall-lag per three months showed a positive association with the number of cases dengue. Thus, this municipality is considered as an endemic and epidemic site. In addition, the relation between rainfall and dengue cases was significant with a lag of three months. These results should be useful to the future development of politics healthy for dengue prevention and control.
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Barbosa JB, dos Santos AM, Barbosa MM, Barbosa MM, de Carvalho CA, Fonseca PCDA, Fonseca JM, Barbosa MDCL, Bogea EG, da Silva AAM. Metabolic syndrome, insulin resistance and other cardiovascular risk factors in university students. Cien Saude Colet 2017; 21:1123-36. [PMID: 27076011 DOI: 10.1590/1413-81232015214.10472015] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 08/15/2015] [Indexed: 12/22/2022] Open
Abstract
A cross-sectional population-based study using questionnaire and anthropometric data was conducted on 968 university students of São Luís, Brazil, from which 590 showed up for blood collection. In the statistical analysis the Student t-test, Mann-Whitney and chi-square tests were used. The prevalence of metabolic syndrome by the Joint Interim Statement (JIS) criteria was 20.5%, almost three times more prevalent in men (32.2%) than in women (13.5%) (P < 0.001). The prevalence of insulin resistance was 7.3% and the prevalence of low HDL-cholesterol was high (61.2%), both with no statistically significant differences by sex. Men showed a higher percentage of smoking, overweight, high blood pressure, high blood glucose and increased fasting hypertriglyceridemia. Women were more sedentary. University students of private institutions had higher prevalences of sedentary lifestyle, obesity, abdominal obesity, elevated triglycerides and metabolic syndrome than students from public institutions. High prevalences of metabolic syndrome, insulin resistance and other cardiovascular risk factors were found in this young population. This suggests that the burden of these diseases in the future will be increased.
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de Carvalho CA, Fonseca PCDA, Barbosa JB, Machado SP, dos Santos AM, da Silva AAM. The association between cardiovascular risk factors and anthropometric obesity indicators in university students in São Luís in the State of Maranhão, Brazil. Cien Saude Colet 2016; 20:479-90. [PMID: 25715142 DOI: 10.1590/1413-81232015202.02342014] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 06/19/2014] [Indexed: 01/22/2023] Open
Abstract
The article aims to evaluate the relation between cardiovascular risk factors (CVRF) and anthropometric indicators in a sample of university students from São Luís-MA, Brazil. It is a cross-sectional study conducted with 968 university students, with median age of 22. Glycemia, triglycerides, HDL-c, smoking, alcohol consumption, physical inactivity, metabolic syndrome (Joint Interim Statement criteria) and insulin resistance (IR), were associated and correlated with anthropometric indicators such as BMI, WC, WHR and WHtR. Associations were found between TGL, SH, SM and higher values of all anthropometric variables. The RI was associated with higher BMI values and WHtR in men and women. The low HDL-c was associated with higher values of all anthropometric variables in women. Consumption of alcohol was associated with higher values of BMI and WC in women and WHR in men and WHtR. Smoking was associated with higher values of WHtR in both sexes. Physical inactivity was associated with higher values of WHR in men only. The highest correlations were established for women between TGL and BMI CC, WHR and WHtR. The indicators most associated with CVRF were BMI, WC and WHtR in females and WHR and WHtR in men.
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Affiliation(s)
- Carolina Abreu de Carvalho
- Programa de Pós-Graduação em Ciência da Nutrição, Departamento de Nutrição e Saúde, Universidade Federal de Viçosa, Viçosa, MG, Brasil,
| | | | - José Bonifácio Barbosa
- Departamento de Saúde Pública, Centro de Ciências Biológicas e da Saúde, Universidade Federal do Maranhão
| | | | - Alcione Miranda dos Santos
- Departamento de Saúde Pública, Centro de Ciências Biológicas e da Saúde, Universidade Federal do Maranhão
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de O. Souza Filho JB, de Seixas JM, Galliez R, de Bragança Pereira B, de Q Mello FC, dos Santos AM, Kritski AL. A screening system for smear-negative pulmonary tuberculosis using artificial neural networks. Int J Infect Dis 2016; 49:33-9. [DOI: 10.1016/j.ijid.2016.05.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 04/15/2016] [Accepted: 05/18/2016] [Indexed: 12/27/2022] Open
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Furtado AS, Nunes FBBDF, Santos AMD, Caldas ADJM. Análise espaço-temporal da leishmaniose visceral no estado do Maranhão, Brasil. Ciênc saúde coletiva 2015; 20:3935-42. [DOI: 10.1590/1413-812320152012.01672015] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 04/09/2015] [Indexed: 11/22/2022] Open
Abstract
Resumo Este estudo analisou a distribuição espaço-temporal dos casos de leishmaniose visceral (LV) no estado do Maranhão, no período de 2000 a 2009. A partir do número de casos notificados, foram elaborados mapas temáticos para demonstrar a evolução da distribuição geográfica da doença no estado. Utilizou-se o método MCMC para estimação dos parâmetros do modelo bayesiano espaço-temporal para a identificação das áreas de risco. De 2000 a 2009, foram notificados 5.389 casos de leishmaniose visceral, distribuídos em todas as 18 Unidades Regionais de Saúde do estado, com as maiores incidências em: Caxias, Imperatriz, Presidente Dutra e Chapadinha. As Unidades Regionais de Saúde com maiores riscos relativos por biênio foram: Caxias e Barra do Corda (2000-2001), Imperatriz e Presidente Dutra (2002-2003), Imperatriz e Caxias (2004-2005), Presidente Dutra e Codó (2006-2007), e Imperatriz e Caxias (2008-2009). Houve uma considerável expansão geográfica da LV no Maranhão, sendo necessária a adoção de medidas mais eficazes de prevenção e controle da doença no estado.
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Chaves AS, Santos AMD, Alves MTSSDBE, Salgado Filho N. Associação entre declínio cognitivo e qualidade de vida de idosos hipertensos. Rev bras geriatr gerontol 2015. [DOI: 10.1590/1809-9823.2015.14043] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objetivo:Analisar a associação entre o declínio cognitivo e a qualidade de vida de idosos hipertensos.Métodos:Pesquisa de abordagem quantitativa com delineamento analítico transversal, com 125 idosos hipertensos, de ambos os sexos, atendidos no Programa HIPERDIA, de São Luís-MA. Para a avaliação do declínio cognitivo, aplicou-se o Miniexame do Estado Mental (MEEM) e para avaliar a qualidade de vida, o Medical Outcomes Study 36 - Short-Form Health Survey (SF-36). A normalidade dos dados foi testada por meio do teste de Shapiro-Wilk, utilizando-se ainda o teste de Mann Whitney (qualidade de vida). Para testar a associação entre declínio cognitivo e qualidade de vida, usou-se o coeficiente de Spearman.Resultados:A prevalência de declínio cognitivo foi de 20,80%, com predominância em idosos com baixa escolaridade (45,83%). Idosos hipertensos com declínio cognitivo apresentaram pior qualidade de vida, comparados aos idosos hipertensos sem declínio cognitivo. Houve associação positiva da função cognitiva com a qualidade de vida nos domínios: capacidade funcional (r=0,222; p=0,01), dor (r=0,1871; p=0,04) e aspectos emocionais (r=0,3136; p=0,0005).Conclusão:Os resultados encontrados neste estudo sugerem que o declínio cognitivo afeta diretamente a qualidade de vida do idoso hipertenso, na medida em que limita a capacidade de realização de atividades do cotidiano, principalmente se associado a quadros dolorosos e alterações emocionais.
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Affiliation(s)
- Anety Souza Chaves
- Universidade Federal do Maranhão, Brasil; Universidade Federal do Maranhão, Brasil
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Santos LJF, Garcia JBDS, Pacheco JS, Vieira EBDM, Santos AMD. Quality of life, pain, anxiety and depression in patients surgically treated with cancer of rectum. Arq Bras Cir Dig 2015; 27:96-100. [PMID: 25004285 PMCID: PMC4678670 DOI: 10.1590/s0102-67202014000200003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2013] [Accepted: 02/18/2014] [Indexed: 01/11/2023]
Abstract
Background The rectum cancer is associated with high rates of complications and morbidities
with great impact on the lives of affected individuals. Aim To evaluate quality of life, pain, anxiety and depression in patients treated for
medium and lower rectum cancer, submitted to surgical intervention. Methods A descriptive cross-sectional study. Eighty-eight records of patients with medium
and lower rectum cancer, submitted to surgical intervention were selected, and
enrolled. Forty-seven patients died within the study period, and the other 41 were
studied. Question forms EORTC QLQ-C30 and EORTC QLQ-CR38 were used to assess
quality of life. Pain evaluation was carried out using the Visual Analogical
Scale, depression and anxiety were assessed through Depression Inventories and
Beck's Anxiety, respectively. The correlation between pain intensity, depression
and anxiety was carried out, and between these and the EORTC QLQ-C30 General Scale
for Health Status and overall quality of life, as well as the EORTC QLQ-CR38
functional and symptom scales. Results Of the 41 patients of the study, 52% presented pain, depression in 47%, and
anxiety in 39%. There was a marking positive correlation between pain intensity
and depression. There was a moderate negative correlation between depression and
general health status, and overall quality of life as well as pain intensity with
the latter. There was a statistically significant negative correlation between
future depression perspective and sexual function, and also a strong positive
correlation between depression and sexual impairments. A positive correlation
between anxiety and gastro-intestinal problems, both statistically significant,
was observed. Conclusion Evaluation scales showed detriment on quality life evaluation, besides an elevated
incidence of pain, depression, and anxiety; a correlation among these, and factors
which influence on the quality of life of post-surgical medium and lower rectum
cancer patients was observed.
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Affiliation(s)
- Letácio José Freire Santos
- Hospital Aldenora Bello, Maranhão Institute of Oncology, Federal University of Maranhão, São Luis, MA, Brazil
| | | | - Jairo Sousa Pacheco
- Hospital Aldenora Bello, Maranhão Institute of Oncology, Federal University of Maranhão, São Luis, MA, Brazil
| | | | - Alcione Miranda dos Santos
- Hospital Aldenora Bello, Maranhão Institute of Oncology, Federal University of Maranhão, São Luis, MA, Brazil
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Nunes Neto TDA, Thomaz EBAF, Ferreira MC, Santos AMD, Queiroz RCDS. [Dental spacing problems and associated factors among Brazilian adolescents]. Cien Saude Colet 2014; 19:4555-68. [PMID: 25351321 DOI: 10.1590/1413-812320141911.15932013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2013] [Accepted: 08/27/2013] [Indexed: 11/22/2022] Open
Abstract
The scope of this study was to estimate the prevalence of dental spacing problems and associated factors among adolescents using data from the SB Brazil 2010 survey. The outcomes evaluated were dental spacing problems: space deficit (crowding and misalignment) and excess space (diastema and spacing) obtained using the DAI index. The association of independent variables with outcomes was assessed using a hierarchical model with four levels: contextual, socioeconomic and demographic characteristics, access to services and dental morbidity. Statistical analysis was performed using the chi-square test and univariate and multivariate Poisson distribution to estimate prevalence ratios (PR). The overall prevalence of space problems was 71.43%, with misalignment being the most common type (56.4%). The following aspects were significantly associated with excess space: age of 16, 18 and 19 years; being non-Caucasian (PR = 1.75), perception of speech problems (PR = 1.72) and periodontal pockets 4-5mm (RP = 1.56). For space deficit: family income up to 3 minimum wages, dental visit 1 year or more previously (PR = 1.19) and having one or more decayed teeth on average (PR = 1.32). There was a prevalence of spacing problems, especially with socioeconomic and demographic variables and morbidity as potential risk factors.
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Cavalcante MCV, Lamy ZC, Lamy Filho F, França AKTDC, dos Santos AM, Thomaz EBAF, da Silva AAM, Salgado Filho N. Factors associated with the quality of life of adults subjected to hemodialysis in a city in northeast Brazil. J Bras Nefrol 2014; 35:79-86. [PMID: 23812563 DOI: 10.5935/0101-2800.20130014] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Accepted: 02/25/2013] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION There is a known association between low scores for quality of life (QOL) and higher rates of hospitalization, mortality in hemodialysis vascular access catheter, older age, lack of regular occupation, presence of comorbidities and hypoalbuminemia. There is still no agreement about the influence of sex, educational level, socioeconomic status and treatment time on the worst levels of QOL. OBJECTIVE Identify socioeconomic, demographic, clinical, nutritional and laboratory factors associated with worse QOL in adults undergoing hemodialysis in Sao Luís, Maranhão, Brazil. METHODS A cross-sectional study which evaluated the QOL of patients with chronic renal disease, aged 20-59 years, undergoing hemodialysis. Two instruments were used: the Kidney Disease Quality of Life -Short Form 1.3 (KDQOL-SF™ 1.3) and a questionnaire on socioeconomic, demographic, clinical, nutritional and laboratory data. The reliability of KDQOL-SF™ 1.3 was assessed by Cronbach's alpha. For the multivariable analysis a Poisson regression model with robust adjustment of the standard error was used. RESULTS The reliability assessment of KDQOL-SF™ 1.3 showed a Cronbach's alpha test greater than 0.8 in all areas. The areas with the worst levels of QOL were "work situation", "burden of kidney disease", "patient satisfaction", "physical function" and "general health". Having less than 8 years of schooling, coming from the countryside and having cardiovascular disease were associated to the areas with the worst levels of QOL. CONCLUSIONS KDQOL-SF™ 1.3 is a reliable instrument to measure quality of life of hemodialysis patients. Demographic and clinical conditions can negatively influence QOL in chronic renal failure patients.
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Reis RS, Coimbra LC, Silva AAMD, Santos AMD, Alves MTSSDBE, Lamy ZC, Ribeiro SVO, Dias MSDA, Silva RAD. Acesso e utilização dos serviços na Estratégia Saúde da Família na perspectiva dos gestores, profissionais e usuários. Ciênc saúde coletiva 2013; 18:3321-31. [DOI: 10.1590/s1413-81232013001100022] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Accepted: 12/21/2012] [Indexed: 11/22/2022] Open
Abstract
Utilizaram-se questionários adaptados à realidade brasileira (PCATool) para avaliar acesso e utilização dos serviços, aplicados a 30 gestores, 80 profissionais e amostra aleatória de 882 usuários da Estratégia Saúde da Família (ESF) em São Luís. Diferenças entre as avaliações dos 3 tipos de entrevistados foram identificadas pelo teste de Kruskall-Wallis e pós-teste de Dunn. Usuários tiveram dificuldades no acesso e na utilização dos serviços, também considerados insatisfatórios pelos gestores e profissionais. O acesso foi a dimensão pior avaliada e o não funcionamento das unidades após as 18 horas e finais de semana foram suas principais dificuldades. A avaliação dos gestores e profissionais quase sempre divergiu com a dos usuários, sendo a avaliação dos gestores predominantemente mais favorável. Gratuidade, utilização de serviços preventivos e da ESF antes das consultas especializadas foram bem avaliadas. O funcionamento das unidades precisa se adequar às necessidades dos usuários, principalmente dos trabalhadores. Fortalecer a participação social na gestão local da ESF pode ajudar a identificar essas necessidades, dirimindo divergências entre os atores estudados.
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Moura GS, Santos AMD, Aquino DMCD, Silva AAMD, Caldas ADJM. Factors associated with asymptomatic infection in family members and neighbors of patients with visceral leishmaniasis. CAD SAUDE PUBLICA 2013; 28:2306-14. [PMID: 23288063 DOI: 10.1590/s0102-311x2012001400009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2011] [Accepted: 08/30/2012] [Indexed: 11/22/2022] Open
Abstract
This study analyzed factors associated with asymptomatic Leishmania chagasi infection in family members and neighbors of patients with visceral leishmaniasis (VL). A cross-sectional study was conducted with 361 individuals in the counties comprising Ilha de São Luís (São Luís Island) in Maranhão State, Brazil. The Montenegro skin test (MST) and serology by enzyme-linked immunosorbent assay (ELISA) were performed to detect infection. Odds ratios (OR) and prevalence ratios (PR) and their 95% confidence intervals (95%CI) were estimated by multilevel logistic regression and Poisson regression, respectively. The rates of positive reactions were 71.3% for MST and 9.7% for ELISA. The variable associated with infection according to MST was living in the same household as the index case (PR = 1.36; 95%CI: 1.03-1.78). According to ELISA, the statistically significant variables were: living in the county of Raposa (OR = 3.56; 95%CI: 1.24-10.19) and living in the same household as the index case (OR = 2.70; 95%CI: 1.19-6.08). Family members of individuals with LV are at increased risk of infection. Priority control measures should target these families.
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Affiliation(s)
- Germano Silva Moura
- Programa de Pós-graduaçãoem Saúde Coletiva, Universidade Federal doMaranhão, São Luís, Brasil.
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Goncalves Neto VS, Barros Filho AKD, Santos AMD, Prazeres MPCDS, Bezerril ACR, Fonseca AVDL, Rebelo JMM. An analysis of the spatiotemporal distribution of American cutaneous leishmaniasis in counties located along road and railway corridors in the State of Maranhao, Brazil. Rev Soc Bras Med Trop 2013; 46:322-8. [DOI: 10.1590/0037-8682-0056-2012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2012] [Accepted: 06/03/2013] [Indexed: 11/22/2022] Open
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Cabral NAL, Ribeiro VS, França AKTDC, Salgado JVL, Santos AMD, Salgado Filho N, Silva AAMD. Hypertriglyceridemic waist and cardiometabolic risk in hypertensive women. Rev Assoc Med Bras (1992) 2013; 58:568-73. [PMID: 23090228 DOI: 10.1590/s0104-42302012000500014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2012] [Accepted: 06/18/2012] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE To evaluate the association between hypertriglyceridemic waist (HW) and cardiometabolic risk factors in women with hypertension. METHODS A cross-sectional study was performed in 218 patients monitored by HiperDia (Enrollment and Monitoring Program for Hypertensive and Diabetic Individuals) in two health units in São Luis, MA, Brazil. The dependent variable was HW and the independent variables were sociodemographics, lifestyle, anthropometrics, and health problems. RESULTS HW was present in 33% of the sample and was predominant in women aged > 60 years (56.4%), non-whites (81.7%), those with eight or fewer years of schooling (57.3%), and those belonging to socioeconomic class C (49%). Excess weight (68.8%) and hypercholesterolemia (68.8%) were observed. HW was associated with: smoking (PR: 2.08; p = 0.017), overweight (PR: 2.46; p = 0.010), obesity (PR: 4.13; p < 0.001), hypercholesterolemia (PR: 1.87; p = 0.015), high levels of high-density lipoproteins (HDL) cholesterol (PR: 3.41; p < 0.001), and fasting glycemia > 100 mg/dL or being diabetic (PR: 1.86; p = 0.006). After adjustment, total cholesterol (PR = 1.78; p = 0.012), HDL-cholesterol (PR: 3.03; p < 0.001), body mass index (BMI) > 25 to < 30 kg/m² (PR = 2.60; p = 0.005), and BMI > 30 kg/m² (PR = 3.61; p < 0.001) remained associated. CONCLUSION A high prevalence of HW and its association with altered lipid profile and excess body weight was observed. HW showed to be an important diagnostic tool for the monitoring of hypertensive women with metabolic risk, which is low cost, easily accessible, and useful in clinical practice, especially in primary health care in the Brazilian Unified Health System (Sistema Único de Saúde - SUS).
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Abstract
OBJETIVO: Este trabalho teve como objetivo analisar o crescimento de crianças em regime de aleitamento materno exclusivo até o sexto mês, bem como comparar seu peso e comprimento com a referência do National Center for Health Statistics 1978 e com o padrão da World Health Organization 2006. MÉTODOS: Trata-se de estudo longitudinal realizado em um Banco de Leite Humano, na cidade de São Luís, Maranhão, entre outubro de 2007 e novembro de 2008. Foi feita amostragem não probabilística com 328 crianças nascidas a termo e submetidas a aleitamento materno exclusivo. Finalizaram o estudo 181 crianças. Avaliou-se o crescimento por meio de médias e desvio-padrão, comparando-se os resultados com aqueles dois parâmetros. RESULTADOS: Os meninos mostraram-se mais pesados que as meninas, do primeiro ao sexto mês (p<0,05). A maior velocidade no ganho ponderal ocorreu nos dois primeiros meses de vida, em ambos os sexos. Quanto ao peso, as meninas apresentaram peso médio superior ao padrão da World Health Organization 2006, ao nascer e do terceiro ao sexto mês (p<0,05), enquanto os meninos mostraram peso superior do quarto ao sexto mês (p<0.05). Já em relação à referência do National Center for Health Statistics 1978, ambos os sexos apresentaram peso superior desde o nascimento até o sexto mês (p<0,05), exceto os meninos ao nascer. Quanto ao tamanho, as meninas apresentaram comprimento médio semelhante ao padrão da World Health Organization 2006, porém menor do que a outra referência, ao nascer e no sexto mês (p<0,05). Já os meninos obtiveram comprimento médio inferior, tanto quando comparados ao padrão da World Health Organization 2006, do nascimento ao sexto mês (p<0,05), exceto o quinto; como quando comparados à referência da National Center for Health Statistics 1978, ao nascer e no primeiro, no quarto e no sexto meses de vida (p<0,05). CONCLUSÃO: O crescimento ponderal das crianças em aleitamento materno exclusivo assemelhou-se mais ao padrão World Health Organization 2006 que à referência National Center for Health Statistics 1978, ao passo que o crescimento linear mostrou-se compatível com os dois parâmetros.
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Lima WL, Lima EVNCL, Costa MDRDSR, Santos AMD, Silva AAMD, Costa ES. [Asthma and associated factors in students 13 and 14 years of age in São Luís, Maranhão State, Brazil]. CAD SAUDE PUBLICA 2012; 28:1046-56. [PMID: 22666809 DOI: 10.1590/s0102-311x2012000600004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2011] [Accepted: 03/19/2012] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to estimate the prevalence of asthma and associated factors among students 13 and 14 years of age in São Luís, Maranhão State, Brazil. A cross-sectional study was conducted using the questionnaire developed by ISAAC (International Study of Asthma and Allergies in Childhood) and an additional questionnaire from July 2008 to May 2009, including 3,069 adolescents. Asthma prevalence (wheezing in the previous 12 months) was 12.7%, lifetime prevalence was 32.4%, 3.9% reported difficulty speaking due to wheezing, and 9.8% reported wheezing after exercise. In the multivariate analysis, factors associated with increased asthma prevalence were family history of asthma, respiratory infection and wheezing in early life, eczema, allergic rhinitis, and passive smoking. Asthma prevalence was lower than for Brazil as a whole. Factors most strongly associated with asthma prevalence in these adolescents were family history of asthma (PR = 3.86), wheezing in early childhood (PR = 4.58), and allergic rhinitis (PR = 3.21).
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Silva FACCD, Nina VJDS, Santos AMD, Figueredo Neto JA, Silva AAMD, Sousa FLD, Figueredo ED, Salgado Filho N. Associações entre medidas ecocardiográficas e função renal em hipertensos na Atenção Básica. J Bras Nefrol 2012; 34:161-9. [DOI: 10.1590/s0101-28002012000200009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2011] [Accepted: 01/06/2012] [Indexed: 11/22/2022] Open
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Rafael RAA, Ribeiro VS, Cavalcante MCV, Santos AMD, Simões VMF. [Probabilistic record linkage: recovery of data on infant deaths and stillbirths in Maranhão State, Brazil]. CAD SAUDE PUBLICA 2012; 27:1371-9. [PMID: 21808821 DOI: 10.1590/s0102-311x2011000700012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2010] [Accepted: 05/18/2011] [Indexed: 11/22/2022] Open
Abstract
This study used probabilistic record linkage to estimate underreporting of stillbirths and infant deaths in Maranhão State, Northeast Brazil, in 2008. Records were linked between the Hospital Information System (SIH) (N = 374,418) and the Mortality Information System (SIM) (N = 26,597), using data extraction, identification, and processing software. Under-recording rates were 9.7% for stillbirths, 12% for neonatal deaths, and 5.3% for post-neonatal deaths. In the larger municipalities, the correction of the infant mortality rate was greater than 19%. The superiority of information on infant deaths in the SIH (as compared to the SIM) was 6.5% in municipalities with < 25 thousand inhabitants, 2% in municipalities with 25-80 thousand inhabitants, and 8.3% in those with > 80 thousand inhabitants. Inconsistencies involved non-completion of items/variables, discordant data on the same event, and in some cases even total absence of death records. The method proved useful for retrieving mortality data for the SIM from the SIH.
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Oliveira MIGD, Santos AMD, Filho NS. Survival analysis and associated factors to mortality of renal transplant recipients in a University Hospital in Maranhão. J Bras Nefrol 2012; 34:216-25. [DOI: 10.5935/0101-2800.20120002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2011] [Accepted: 05/11/2012] [Indexed: 11/20/2022] Open
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Jaldin MDGM, Pinheiro FS, Santos AMD, Muniz NC, Brito LMO. Crescimento do perímetro cefálico nos primeiros seis meses em crianças em aleitamento materno exclusivo. Rev paul pediatr 2011. [DOI: 10.1590/s0103-05822011000400007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: Analisar o perímetro cefálico de crianças amamentadas exclusivamente do nascimento ao sexto mês com relação à referência National Center for Health Statistics (NCHS/1977) e ao padrão internacional World Health Organization/2006 (WHO/2006). MÉTODOS: Estudo longitudinal realizado no Banco de Leite Humano do Hospital Universitário Materno-Infantil, São Luís (MA), entre outubro de 2007 e novembro de 2008. Amostra não probabilística de 328 crianças nascidas a termo, parto único, peso ao nascer > 2500g e < 4000g, em aleitamento exclusivo do nascimento ao sexto mês. Finalizaram o estudo 181 crianças (95 meninas e 86 meninos). Avaliou-se o perímetro cefálico por meio de média, desvio padrão e percentis 5, 50 e 95. Os resultados em percentis foram comparados aos da referência NCHS/1977 e do padrão WHO/2006. RESULTADOS: Nos primeiros seis meses, houve um aumento do perímetro cefálico, em média, de 1,5cm por mês nos meninos e de 1,4cm nas meninas. O crescimento do perímetro cefálico, em ambos os sexos, acompanhou o percentil 50 do padrão WHO/2006. Nos meninos, exceto ao nascer, o percentil 50 do perímetro cefálico foi equivalente ao da referência NCHS/1977; nas meninas, situou-se próximo desde o nascimento. CONCLUSÕES: As crianças em aleitamento materno exclusivo até o sexto mês de vida apresentaram crescimento satisfatório do perímetro cefálico, em conformidade com o percentil 50 do padrão WHO/2006 e da referência NCHS/1977.
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