Navegando por Palavras-chave "Epidemiologic studies"
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- ItemSomente MetadadadosConditional risk for posttraumatic stress disorder in an epidemiological study of a Brazilian urban population(Pergamon-Elsevier Science Ltd, 2016) Luz, Mariana Pires; Coutinho, Evandro S. F.; Berger, William; Mendlowicz, Mauro V.; Vilete, Liliane M. P.; Mello, Marcelo F. [UNIFESP]; Quintana, Maria Ines [UNIFESP]; Bressan, Rodrigo A. [UNIFESP]; Andreoli, Sergio B. [UNIFESP]; Mari, Jair J. [UNIFESP]; Figueira, IvanIntroduction: Conditional risk for PTSD is the risk of developing PTSD after exposure to traumatic events. This epidemiological study of the general urban population from the two largest cities in Brazil reports exposure to traumatic events conditional risk for PTSD and proportion/estimated number of PTSD cases secondary to each type of traumatic event. Method: Cross-sectional study of general population (15-75 y.o.) from Rio de Janeiro and Sao Paulo. PTSD was assessed through Composite International Diagnostic Interview 2.1. Results: Our main findings, from 3744 participants, were: 1) high prevalence of traumatic events (86%), urban violence being the most common 2) conditional risk for PTSD was 11.1% 3) women (15.9%) have overall conditional risk 3 times higher than men (5.1%) 4) war-related trauma (67.8%), childhood sexual abuse (49.1%) and adult sexual violence (44.1%) had the highest conditional risks 5) 35% of PTSD cases (estimated 435,970 individuals) were secondary to sudden/unexpected death of a close person, and 40% secondary to interpersonal violence. Conclusions: Brazilian urban population is highly exposed to urban violence, and overall conditional risk for PTSD was 11.1%. Violence prevention and enhancement of resilience should be part of public policies, and mental health sequelae of trauma should be better recognized and treated.
- ItemSomente MetadadadosConditional risk for posttraumatic stress disorder in an epidemiological study of a Brazilian urban population(Pergamon-Elsevier Science Ltd, 2016) Luz, Mariana Pires; Coutinho, Evandro S. F.; Berger, William; Mendlowicz, Mauro V.; Vilete, Liliane M. P.; Mello, Marcelo F. [UNIFESP]; Quintana, Maria Ines [UNIFESP]; Bressan, Rodrigo A. [UNIFESP]; Andreoli, Sergio B. [UNIFESP]; Mari, Jair J. [UNIFESP]; Figueira, IvanIntroduction: Conditional risk for PTSD is the risk of developing PTSD after exposure to traumatic events. This epidemiological study of the general urban population from the two largest cities in Brazil reports exposure to traumatic events
- ItemAcesso aberto (Open Access)Fatores associados ao óbito por tuberculose na zona leste da cidade de São Paulo, 2001(Sociedade Brasileira de Pneumologia e Tisiologia, 2007-06-01) Pelaquin, Monica Hid Haddad; Silva, Rebeca de Souza e [UNIFESP]; Ribeiro, Sandra Aparecida [UNIFESP]; Prefeitura do Município de São Paulo; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To identify factors associated with death from TB, evaluating TB cases reported for 2001 in the city of São Paulo (specifically in the neighborhoods of Cidade Tiradentes, Guaianazes, Itaquera and São Mateus) and comparing those evolving to death with those evolving to cure. METHODS: We investigated all deaths in which TB was given as the principal cause (n = 48), analyzing medical charts and conducting home visits to interview the caregiver(s). In parallel, we investigated 96 TB cases in which the patient had been discharged after a cure had been achieved. Patients with HIV were excluded from both groups. RESULTS: There were no differences between the two groups in terms of the clinical form of tuberculosis, laboratory test confirmation of the diagnosis and type of treatment. Death from TB was found to be associated, in a statistically significant manner, with being male, being over 50 years of age, having had less than 3 years of schooling, suffering from alcoholism and being unemployed. The logistic regression showed that the variables presenting the strongest associations with death from TB were suffering from alcoholism and being over 50, whereas being a new treatment and being employed were found to be protective. The combination of suffering from alcoholism, being unemployed and being over 50 increased the chance of evolving to death by 25 times (95%CI: 6.43-97.20). CONCLUSION: Ongoing education of health professionals, prompt epidemiological interventions and efficient patient referral systems could improve the indices related to this disease.
- ItemAcesso aberto (Open Access)Fatores de risco cardiovasculares em pacientes com acidente vascular cerebral isquêmico e idade maior ou igual a 80 anos(Universidade Federal de São Paulo (UNIFESP), 2011-04-27) Pieri, Alexandre [UNIFESP]; Gabbai, Alberto Alain [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Background and Purpose – Ischemic stroke is usually a catastrophic event, mostly in the elderly. Advanced age itself is a risk factor for stroke and cardiovascular involvement is the leading cause of ischemic stroke in this age population. Atrial fibrillation is also an important risk factor for ischemic stroke and therefore risk stratification schemes are important in these patients for indicating antithrombotic therapyand prevent stroke. Low socioeconomic status is also associated with a higher risk for ischemic stroke. Objectives - To evaluate the prevalence of cardiovascular risk factors in patients with age 80 or older in a hospital population with ischemic stroke and the relationship between socioeconomic status and ischemic stroke in different age groups, using a new socioeconomic stratification model. Methods – Retrospective analysis of consecutive patients diagnosed with ischemic stroke admitted to a tertiary health facility. For this population, we described the prevalence of cardiovascular risk factors and, for the patients who had the diagnosis of atrial fibrillation, we applied CHADS2 score and CHA2DS2-VASc score. For assessment of the relationship beteween socioeconomic status and ischemic stroke, we evaluated the incidence of ischemic stroke in two hospitals that serve different socioeconomic populations in Sao Paulo, with a new geographic socioeconomic segmentation tool. The patients were stratified by socioeconomic status and age (30 to 64 years, 65 to 79 years and 80 years or older). We also compared the number of ischemic stroke patients with patients from control groups from the same hospitals, to obtain the ischemic stroke rates in both hospitals. The odds ratio between ischemic stroke rates in the hospitals was calculated. Results .There was a female preponderance (p<0.01) in 215 patients admitted for ischemic stroke. Considering patients over eighty, 72% had hypertension and atrial fibrillation was more common among the oldest old (p<0.01). Among those patients who had ischemic stroke and atrial fibrillation, no patient had CHADS2 score of 0 and 25.5% had score of 1. All patients with CHADS2 score of 1 were not under anticoagulation, but in retrospect, had CHA2DS2-VASc score . 2, i.e., with indication for oral anticoagulation. Three hundred and seventy-seven patients with ischemic stroke and 2,297 patients of control group were analyzed in both hospitals. There was a greater proportion of older patients in the higher socioeconomic status population (χ2obs= 28.7, df= 2, p-value < 0.0001). In all ages, the odds of ischemic stroke was significantly higher in patients with lower socioeconomic status than in those with higher status, with χ2obs=21.3 (p-value< 0.0001) for age 30 to 64 years; χ2obs=39.8 (p-value< 0.0001) for age 65 to 79 years; and χ2obs=14.1 (p-value= 0.0002) for ≥ 80 years patients. The odds ratios between ischemic stroke odds in both hospitals were 2.4, 3.6 and 2.7 for groups of ages 30 to 64 years, 65 to 79 years and 80 years or older, respectively. Conclusions – Hypertension and atrial fibrillation are prevalent risk factors and should be treated aggressively in the elderly. Risk stratification using CHA2DS2-VASc score would have optimized indication for oral anticoagulation in our patients. Our study showed that, in São Paulo, lower socioeconomic status is associated with a higher odds of ischemic stroke, independent of age.
- ItemAcesso aberto (Open Access)Identificação de casos psiquiátricos em estudos epidemiológicos multifásicos: métodos, problemas e aplicabilidade(Faculdade de Saúde Pública da Universidade de São Paulo, 2000-10-01) Andreoli, Sergio Baxter [UNIFESP]; Almeida Filho, Naomar de; Coutinho, Evandro Sf; Mari, Jair de Jesus [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Federal da Bahia Instituto de Saúde Coletiva; Escola Nacional de Saúde Pública Departamento de EpidemiologiaOBJECTIVE: To discuss methodological aspects of the two stages in the identification of psychiatric cases in epidemiological studies. METHODS: Analyze the methodology used in the Multicentric Psychiatric Morbidity Study, which was conducted in three Brazilian cities (São Paulo, Brasília and Porto Alegre). In the first stage of that study, a random sample (6,740 individuals) of the population was drawn and all the participants were screened with the Questionnaire of Psychiatric Morbidity of the Adult (QMPA). In the second stage, a sample (775 individuals) of this population was drawn and these individuals were submitted to the Inventory of Symptoms of DSM-III, carried out by psychiatrists and trained psychologists. RESULTS: The study procedure for estimating the prevalence is described in details, showing that though the screening scales are a weak tool, they don't interfere with the methodology. CONCLUSION: The advantage of this methodology is to correct any distortions caused by the current tools used in the identification of psychiatric cases.
- ItemAcesso aberto (Open Access)Prevalência de maus-tratos na terceira idade: revisão sistemática(Faculdade de Saúde Pública da Universidade de São Paulo, 2007-04-01) Espíndola, Cybele Ribeiro [UNIFESP]; Blay, Sergio Luis [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To identify prevalence studies of abuse among elderly and assess their quality. METHODS: A systematic literature review was performed through PubMed, LILACS, Embase, ISI, and PsycInfo, for the period between 1988 and 2005. Population-based studies were included and studies without clear methodological definition and with clinical and service samples were excluded. RESULTS: There were found 440 articles, but only 11 of them were selected. Most were cross-sectional designs and only two were longitudinal studies. These studies were conducted in various countries worldwide, mostly in US and Europe. They varied widely in terms of abuse definition. Prevalence of physical abuse ranged from 1.2% (Holland) to 18% (Finland). CONCLUSIONS: There is a considerable prevalence variation between sites. The most influential variables on prevalence seem to be culture-related. As the number of elderly is increasing worldwide, there is a need for studies to better understand this phenomenon.
- ItemAcesso aberto (Open Access)Profile of trauma victims of motorcycle accidents treated at hospital São Paulo(Sociedade Brasileira de Ortopedia e Traumatologia, 2014-07-01) Miki, Natália; Martimbianco, Ana Luiza Cabrera; Hira, Lúcia Tomomi; Lahoz, Gisele Landim; Fernandes, Hélio Jorge Alvachian; Reis, Fernando Baldy dos [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE:To evaluate retrospectively, through analysis of medical records, the epidemiological aspects of patients traumatized by motorcycle accidents treated at the orthopedics ward, Hospital São Paulo, Brazil.METHODS:It is a retrospective observational study. The analysis of patients' medical records comprised the period from January 2008 to December 2009. The data checked were: age, gender, type of collision, type and location of fracture, treatment performed (conservative or surgical), type of surgery, cost of synthesis material and hospitalization, period of hospitalization and postoperative complications. After data collection, statistical analysis was performed.RESULTS:We analyzed 381 victims involved in motorcycle accidents. Patients were predominantly male (85%), with a mean age of 30.7 years old. Referring to distribution and site of lesions, 75.5% of individuals had lower limb fractures and in 95.4% of the cases, the treatment of choice was surgery. Twenty-nine patients were rehospitalized due to postoperative complications, such as exposure and failure of synthesis material, wound infection, necrosis, osteomyelitis, and pseudoarthrosis.CONCLUSION:It was possible to identify useful characteristics for planning preventative strategies to reduce the rate of motorcycle accidents and redirect public investment in health. Level of Evidence III, Retrospective Study.