Navegando por Palavras-chave "prevalence"

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    ADHD in a representative sample of the Brazilian population: estimated prevalence and comparative adequacy of criteria between adolescents and adults according to the item response theory
    (Wiley-Blackwell, 2010-09-01) Polanczyk, Guilherme; Laranjeira, Ronaldo [UNIFESP]; Zaleski, Marcos [UNIFESP]; Pinsky, Ilana [UNIFESP]; Caetano, Raul; Rohde, Luis Augusto; Univ Fed Rio Grande do Sul; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP); Universidade Federal de Santa Catarina (UFSC); Univ Texas Houston
    Background: Attention deficit hyperactivity disorder (ADHD) is a clinically significant disorder in adulthood, but current diagnostic criteria and instruments do not seem to adequately capture the complexity of the disorder in this developmental phase. Accordingly, there are limited data on the proportion of adults affected by the disorder, specially in developing countries.Method: We assessed a representative household sample of the Brazilian population for ADHD with the Adult ADHD Self-report Scale (ASRS) Screener, and evaluated the instrument according to the Rasch model of item response theory.Results: the sample was comprised by 3007 individuals, and the overal prevalence of positive screeners for ADHD was 5.8% [95% confidence interval (CI), 4.8-7.0]. Rasch analyses revealed the misfitt of the overall sample to expectations of the model. the evaluation of the sample stratified by age revealed that data for adolescents showed a signficant fittnes to the model expectations, while items completed by adults were not adequated.Conclusions: the lack of fitness to the model for adult respondents challenges the possibility of a linear transformation of the ordinal data into interval measures and the utilization of parametric analyses of data. This result suggests that diagnostic criteria and instruments for adult ADHD must take into account a developmental perspective. Moreover, it calls for further evaluation of currently employed research methods in light of modern theories of psychometrics. Copyright (C) 2010 John Wiley & Sons, Ltd.
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    Amphetamine-type stimulant use and conditional paths of consumption: data from the Second Brazilian National Alcohol and Drugs Survey
    (Assoc Brasileira Psiquiatria, 2017) Massaro, Luciana T. S. [UNIFESP]; Abdalla, Renata R. [UNIFESP]; Laranjeira, Ronaldo [UNIFESP]; Caetano, Raul; Pinsky, Ilana; Madruga, Clarice S. [UNIFESP]
    Objective: The aim of this study was to estimate nationally representative prevalence rates of amphetamine-type stimulant (ATS) use and to identify consumption-associated factors, proposing a conditional model of direct and indirect consumption paths. Method: Using data from the Second Brazilian National Alcohol and Drugs Survey, this cross-sectional study analyzed a subsample of 3,828 participants between 15 and 64 years old, gathering information on the use of psychoactive substances in a probabilistic sample of the Brazilian household population. Results: Rates of lifetime and last-year ATS use were, respectively, 4.1 and 1.6%. Economically privileged individuals and users of other substances were more at risk for using ATS. The results suggest that higher education decreases the chances of ATS consumption. The conditional model showed that higher income increased ATS use, higher education lowered the odds of such an increase, and cocaine use cancelled that associative effect. Conclusion: Brazil presents high rates of ATS use. Prevention and treatment strategies should focus on the protective effect of higher education levels and should target polydrug use. Knowledge of ATS-associated factors and user profiles is the starting point for developing effective treatments and tailored prevention strategies.
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    Amyotrophic lateral sclerosis in Brazil: 1998 national survey
    (Academia Brasileira de Neurologia - ABNEURO, 2000-09-01) Dietrich-neto, Flávia; Callegaro, Dagoberto; Dias-Tosta, Elza; Silva, Helga Cristina Almeida da [UNIFESP]; Ferraz, Maria Elizabeth [UNIFESP]; Lima, José Mauro Braz de; Oliveira, Acary Souza Bulle [UNIFESP]; Aventis Pharma; Universidade de São Paulo (USP); Hospital de Base do Distrito Federal Head of Neurology Unit; Universidade Federal de São Paulo (UNIFESP); Universidade Federal do Rio de Janeiro Neurological Institute
    OBJECTIVES: To assess the epidemiologic characteristics of amyotrophic lateral sclerosis (ALS) in Brazil in 1998. METHOD: Structured Clinical Report Forms (CRFs) sent to 2,505 Brazilian neurologists from January to September 1998 to be filled with demographic and clinical data regarding any ALS patient seen at any time during that year. RESULTS: Five hundred and forty CRFs were returned by 168 neurologists. Data on 443 patients meeting the criteria of probable or definite ALS according to El Escorial definition were analysed: 63 probable (14.2%) and 380 definite (85.8%). Two hundred and fifty-nine (58.5%) of the patients were male, mean age of onset was 52. Spinal onset occurred in 306 patients (69%); bulbar onset in 82 (18.5%), and both in 52 (11.7%). Twenty-six (5.9%) had a family history of ALS. Two hundred and fifty-nine (58.6%) were seen by private practitioners, and 178 (40.2%) at a hospital clinic. Age-ajusted incidence shows a peak incidence at the 65-74 years old range. CONCLUSIONS: The disease's characteristics are similar to those described in international studies, except for age of onset (Brazilian patients are younger). This difference is not confirmed when figures are age-adjusted.
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    Bone mineral density and osteoporosis among a predominantly Caucasian elderly population in the city of São Paulo, Brazil
    (Springer, 2005-11-01) Camargo, MBR; Cendoroglo, M. S.; Ramos, L.; Latorre, MDDD; Saraiva, G. L.; Lage, A.; Neto, N. C.; Araujo, LMQ; Vieira, JGH; Lazaretti-Castro, M.; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)
    This cross-sectional study covered 301 individuals over 70 years of age-207 women (W) and 94 men (M)-living in the city of São Paulo, Brazil. Our aims were to evaluate the prevalence of low bone mineral density (BMD) in this population and the possible factors that influence BMD. the subjects were submitted to a bone densitometry scan (DXA) to evaluate the BMD at lumbar spine (LS), femoral neck (FN), trochanter (T), total femur (TF) and total body composition. At the time, the participants filled in a questionnaire about lifestyle habits, diet and medical history, as well as having blood samples taken to check hormone and biochemical levels. Anthropometric parameters were measured. Osteopenia and osteoporosis were defined in accordance with the criteria suggested by the World Health Organization. in the different sites studied, the prevalence of osteopenia and osteoporosis varied, in men ranging 33.3-57.4% and 6.4-16.1%, respectively, and in women ranging 36.6-56.5% and 22.2-33.2%, respectively. Weight was the variable that most strongly correlated with BMD at the proximal femur in both sexes (men, r =0.44-0.52; women, r =0.48-0.52) and with BMD at LS in women ( r =0.44). Height was the parameter that best correlated with BMD at LS in men ( r =0.34). in men follicle-stimulating hormone, growth hormone and glycemia correlated with BMD at T and TF, while plasma albumin only correlated with BMD at T. in women glycemia correlated with BMD at LS, and follicle-stimulating hormone correlated with BMD at FN, T and TF. in conclusion, we found a high prevalence of osteopenia and osteoporosis in this population, with weight being the best predictor of BMD. the prevalence of osteoporosis and osteopenia at FN was as high in men as that observed in women.
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    Caracterização de indivíduos hospitalizados por síndrome coron'ria aguda e os fatores de risco para doença arterial coronária
    (Universidade Federal de São Paulo (UNIFESP), 2013-06-26) Brunori, Evelise Helena Fadini Reis [UNIFESP]; Barros, Alba Lucia Bottura Leite de Barros [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Knowledge of the distribution of risk factors (RF) for cardiovascular disease among individuals hospitalized for acute coronary syndrome (ACS) enables the strategic planning of educational interventions for primary and secondary prevention to patients and their families in order to minimize the impact of these factors. The general objective of the study was to characterize individuals hospitalized for ACS and the FR for coronary artery disease. The specific objectives were to identify the sociodemographic profile; Identify weight, height, body mass index, waist-hip ratio, blood glucose and lipid profile, identify the level of tobacco dependence; Identify the degree of alcohol consumption; Identify the level of activity / exercise; identify the association of the variables with the type of medical diagnosis (acute myocardial infarction with or without ST-segment elevation or unstable angina); to verify the association between the number of coronary lesions and the type of medical diagnosis; to verify the association between the types of treatment and type of medical diagnosis; to verify the association between education and income. A descriptive cross-sectional assessment of 150 hospitalized patients with the first event of ACS was performed. Sociodemographic and clinical data were collected by interview and chart review. The International Physical Activity Questionnaire, Fagerström nicotine dependence Test, Alcohol Disorder Identification Test. There was a predominance of male gender, white color, Catholics, with elementary education, marital status married, monthly income of 2- 3 minimum wages, overweight and obesity, increased waist-hip ratio in women, hypertension, dyslipidemia, diabetes and elevated fasting glucose. There was an association between education and income. Acute myocardial infarction (AMI) with ST-segment elevation (SSE) prevailed, and angioplasty as treatment. A higher proportion of male gender association with AMI with SSE was observed and female gender with unstable angina (UA), hypertension with AI, and LDL with AMI. Clinical treatment was associated with AI and angioplasty of the anterior descending and right coronary artery was associated with AMI with SSE. Most patients were active smokers, with very high dependence, and alcohol consumption at low risk. There was no association between physical activity, smoking and alcohol ingestion with different presentations of ACS. Given this characterization, health education measures should be implemented by nurses to patients and families in order to minimize the impact of these factors. These data, with data from a previous study, which characterized relatives of individuals with ACS substantiate the educational activities of the Health Education Outpatient Setting of Paulista School of Nursing.
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    Changes in the prevalence of asthma and allergic diseases among Brazilian schoolchildren (13-14 years old): Comparison between ISAAC phases one and three
    (Oxford Univ Press, 2007-02-01) Sole, D.; Melo, K. C.; Camelo-Nunes, I. C.; Freitas, L. S.; Britto, M.; Rosario, N. A.; Jones, M.; Fischer, G. B.; Naspitz, C. K.; Universidade Federal de São Paulo (UNIFESP); Universidade Federal da Bahia (UFBA); Inst Materno Infantil Pernambuco; Univ Fed Parana; Catholic Univ Rio Grande Sul; Fed Fac Fdn Med Sci Rio Grande Sul
    The present study is aimed to describe the changes in the prevalence of symptoms of asthma, rhinitis and eczema among Brazilian adolescents (AD, 13-14 years old) between Phases 1 and 3 of the International Study of Asthma and Allergies in Childhood (ISAAC). the prevalence of self-reported symptoms of asthma, rhinitis and eczema in AD from five Brazilian cities (Curitiba, Porto Alegre, Recife, Salvador and São Paulo), obtained during ISAAC Phase 1 (n = 15 419) and Phase 3 (n = 15 684), was compared to determine the trend of prevalence in a 7-year interval. There was a trend to reduction in the current prevalence of wheezing and increasing of nocturnal cough when averaging figures from the five cities. the prevalence of wheezing in the last 12 months was 27.7 vs. 19.9% (p < 0.01); asthma ever 14.9 vs. 14.7% (p > 0.05); severe episode of wheezing 5.2 vs. 5.2%; nocturnal cough 32.6 vs. 34.9% (p < 0.01); exercise wheezing 23.6 vs. 23.0% (p > 0.05) and awake with wheezing 11.8 vs. 11.2% (p > 0.05). Similar things were observed with the prevalence of current symptoms of rhinitis and eczema. in Brazil, there was a small but significant mean decrease in the prevalence of two asthma-related symptoms, wheezing and nocturnal cough, though this trend was not consistent in the surveyed cities. the prevalence of asthma symptoms in Brazil, despite its mean trend to a decrease, is still one of the highest in Latin America.
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    Chronic daily headache in Brazil: a nationwide population-based study
    (Sage Publications Ltd, 2008-12-01) Queiroz, L. P. [UNIFESP]; Peres, M. F. P. [UNIFESP]; Kowacs, F.; Piovesan, E. J.; Ciciarelli, M. C.; Souza, J. A.; Zukerman, E.; Universidade Federal de Santa Catarina (UFSC); Universidade Federal de São Paulo (UNIFESP); Hosp Israelita Albert Einstein; Fundacao Fac Fed Ciencias Med; Univ Fed Parana; Universidade de São Paulo (USP); Universidade Federal Fluminense (UFF)
    The objectives of this study were to estimate the 1-year prevalence of chronic daily headache (CDH) and the degree of the association of CDH with some sociodemographic characteristics of the adult population of Brazil. This was a cross-sectional, population-based study. We conducted telephone interviews with 3848 people, aged 18-79 years, randomly selected from the 27 States of Brazil. the degree of the association was calculated through prevalence ratios, adjusted with Poisson regression by gender, age and some sociodemographic factors. the estimated 1-year gender- and age-adjusted prevalence of CDH was 6.9%. CDH was 2.4 times more prevalent in women, 1.72 times more in unemployed, 1.63 times more in subjects with high household income and two times greater in those who did not exercise. the overall prevalence of CDH in Brazil is high. CDH is significantly more prevalent in women, the unemployed, subjects with higher income, and in those who do not exercise.
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    Chronic obstructive pulmonary disease and body mass index in five Latin America cities: the PLATINO study
    (W B Saunders Co Ltd, 2008-05-01) Oca, Maria Montes de; Talamo, Carlos; Pérez-Padilla, Rogelio; Jardim, José Roberto [UNIFESP]; Muino, Adriana; Lopez, Maria Victorina; Valdivia, Gonzalo; Pertuze, Julio; Moreno, Dolores; Halbert, Ronald J.; Menezes, Ana Maria Baptista; Platino Team; Cent Univ Venezuela; Inst Resp Dis; Universidade Federal de São Paulo (UNIFESP); Univ Republica; Pontificia Univ Catolica Chile; Univ Calif Los Angeles; Univ Fed Pelotas Duque Caxias
    Background: the body mass index (BMI) is a prognostic factor for chronic obstructive pulmonary disease (COPD). Despite its importance, little information is available regarding BMI alteration in COPD from a population-based study. We examined characteristics by BMI categories in the total and COPD populations in five Latin-American cities, and explored the factors influencing BMI in COPD.Methods: COPD was defined as a postbronchodilator forced expiratory volume in the first second/forced vital capacity (FEV(1)/FVC)< 0.70. BMI was categorized as underweight (< 20 kg/m(2)), normal weight (20 - 24.9 kg/m(2)), overweight (25.0 - 29.9 kg/m(2)), and obese (>= 30.0 kg/m(2)).Results: Interviews were completed in 5571 subjects from 6711 eligible individuals, and spirometry was performed in 5314 subjects. There were 759 subjects with COPD and 4555 without COPD. Compared with the non-COPD group, there was a higher proportion of COPD subjects in the underweight and normal weight categories, and a lower proportion in the obese category. Over one-half COPD subjects had BMI over 25 kg/m(2). No differences in BMI strata among countries were found in COPD subjects. Factors associated with lower BMI in mates with COPD were aging, current smoking, and global initiative for chronic obstructive lung disease (GOLD) stages III - IV, whereas wheeze and residing in Santiago and Montevideo were associated with higher BMI. in females with COPD, current smoking, lower education, and GOLD stages II - IV were associated with lower BMI, while dyspnea and wheeze were associated with higher BMI.Conclusions: BMI alterations are common in COPD with no significant differences among countries. Current smoking, age, GOLD stages, education level, residing in Santiago and Montevideo, dyspnea and wheeze were independently associated with BMI in COPD. (c) 2008 Elsevier B.V. All rights reserved.
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    Co-occurrence of chronic physical pain and psychiatric morbidity in a community sample of older people
    (Wiley-Blackwell, 2007-09-01) Blay, Sergio Luis; Andreoli, Sergio Baxter; Dewey, Michael E.; Gastal, Fabio Leite; Universidade Federal de São Paulo (UNIFESP); Kings Coll London
    Background Knowledge about co-occurrence of the most frequent chronic pain symptoms with psychiatric morbidity in older people is very limited. Objective To study the association of psychiatric morbidity and painful physical conditions in people aged 60 years and over. Method Population-based random sample of 7,040 household residents, aged 60 years and over, in Brazil. Results the overall prevalence of pain conditions is 76%. Age-sex specific prevalence of chronic pain conditions such as back pain,joint, abdominal, chest, headaches, reported by respondents ranged from 11.6% up to 5 1.1%. in logistic regression models, chest pain, head pain, back pain, joint pain and abdominal pain emerged as predictors of psychiatric morbidity. the odds of psychiatric morbidity are also affected by income, ethnicity, origin (urban/rural), and marital status. Conclusion the association of chronic painful conditions and psychiatric morbidity in late life is statistically strong in this surveyed population. Copyright (c) 2007 John Wiley & Sons, Ltd.
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    Community screening for rheumatic disorder: Cross cultural adaptation and screening characteristics of the COPCORD core questionnaire in Brazil, Chile, and Mexico
    (J Rheumatol Publ Co, 1997-01-01) Bennett, K.; Cardiel, M. H.; Ferraz, M. B.; Riedemann, P.; Goldsmith, C. H.; Tugwell, P.; INST NACL NUTR SALVADOR ZUBIRAN; Universidade Federal de São Paulo (UNIFESP); UNIV LA FRONTERA; UNIV OTTAWA; MCMASTER UNIV
    Objective. (1) To adapt the Community Oriented Programme for the Control of Rheumatic Disease (COPCORD) Core Questionnaire (CCQ) for use as a rheumatic disease screening instrument in Spanish and Portuguese communities in Brazil, Chile, and Mexico, including translation and back translation, and assessment of cross cultural equivalence and reliability. (2) To determine the screening characteristics of thr CCQ, specifically the sensitivity and specificity of Spanish and Portuguese versions for detecting cases of rheumatic disorder compared with a full clinical examination by a rheumatologist. (3) To determine the number of clinical examinations that could be avoided in population studies by applying the CCQ followed by a clinical examination in positive CCQ screenees.Methods. Translation and assessment of cross cultural equivalence were conducted by practising rheumatologists in Brazil, Chile, and Mexico using standardized methods. Back translation was done by an independent rheumatologist (Brazil), a radiologist (Chile), and a general physician (Mexico). Interviewer agreement was assessed in all sites in a convenience sample. Sensitivity and specificity were assessed by independently administering the CCQ and a full clinical examination to a sample of 200 persons aged 15 years or older, randomly selected from communities in Sao Paulo, Brazil (n = 200), Temuco, Chile (n = 200), and Mexico City, Mexico (n = 200).Results. (1) Cross cultural equivalence and back translation of the modified questionnaire were satisfactory. interviewer agreement was acceptable. (2) In groups From Brazil, Chile, and Mexico, respectively, the overall prevalence of rheumatic disease based on clinical examination was 33.3, 45.1, and 46.3%. The sensitivity and specificity of 2 definitions of a positive CCQ screening for thr presence of rheumatic disorder were: Definition 1 (no trauma, present pain, tenderness, swelling or stiffness in bones, joints or muscles): sensitivity, 91.8, 96.0, 84.0; specificity, 70.0, 35.5, 61.0; Definition 2 (Definition 1 plus pain intensity greater than or equal to 4 on 11 point category rating scale): sensitivity, 66.2, 86.3, 42.7; specificity, 82.3, 41.9, 80.0. (3) In groups from Brazil, Chile, and Mexico, respectively, positive screening by Definition 1 followed by a clinical examination avoids 499, 213, and 403 clinical examination per 1000 respondents screened and yields an overall prevalence of rheumatic disorder of 30, 43, and 40%. The addition of pain intensity (Definition 2) increased the total number of examinations avoided, but reduced the prevalence estimate compared to Definition 1 (22.0, 39.0, and 20.0%).Conclusion. The CCQ appears promising as a screening tool to detect rheumatic disorder in Spanish and Portuguese speaking communities in a developing country. The findings suggest that the CCQ followed by a full clinical examination in positive respondents can provide an acceptable estimate of prevalence of rheumatic disorder. The total number of clinical examinations that must be administered in population based prevalence surveys can be reduced by using the CCQ, while maintaining satisfactory accuracy. Our findings need to be confirmed in further applications of the CCQ.
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    A comparison of symptom prevalence in far advanced cancer, AIDS, heart disease, chronic obstructive pulmonary disease and renal disease
    (Elsevier B.V., 2006-01-01) Solano, Joao Paulo [UNIFESP]; Gomes, Barbara; Higginson, Irene J.; Universidade Federal de São Paulo (UNIFESP); Kings Coll London
    Little attention has been paid to the symptom management needs of Patients with life-threatening diseases other than cancer. in this study, we aimed to determine to what extent patients with progressive chronic diseases have similar symptom profiles. A systematic search of medical databases (MEDLINE, EMBASE, and PsycINFO) and textbooks identified 64 original studies reporting the prevalence of 11 common symptoms among end-stage patients with cancer, acquired immunodeficiency syndrome (AIDS), heart disease, chronic obstructive pulmonary disease, or renal disease. Analyzing the data in a comparative table (a grid), we found that the prevalence of the 11 symptoms was often widely but homogeneously spread across the five diseases. Three symptoms-pain, breathlessness, and fatigue- were found among more than 50% of patients, for all five diseases. There appears to be a common pathway toward death for malignant and nonmalignant diseases. the designs of symptom prevalence studies need to be improved because of methodological disparities in symptom assessment. and designs.
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    Correlates of lifetime alcohol misuse among older community residents in Brazil
    (Cambridge Univ Press, 2009-04-01) Blay, Sergio Luis [UNIFESP]; Fillenbaum, Gerda G.; Andreoli, Sergio Baxter [UNIFESP]; Gastal, Fabio Leite; Universidade Federal de São Paulo (UNIFESP); Duke Univ; Vet Adm Med Ctr; Universidade Federal de Minas Gerais (UFMG)
    Background: Little is known about the sociodemographic correlates and health effects associated with lifetime alcohol misuse in community dwelling elderly people in Brazil.Method: Data were obtained from a representative sample of 6961 residents aged 60+ in the state of Rio Grande do Sul, Brazil. the structured interview included a five-item lifetime alcohol use questionnaire addressing abuse and dependence, and questions regarding sociodemographic characteristics, lifestyle and social support, and health conditions.Results: in the interview, 10.6% respondents (25.3% men, 2.9% women) endorsed at least one lifetime alcohol misuse question. Controlled analyses comparing a gradient of alcohol misuse (none, one or more than one item endorsed), found that men, people aged 60-69 (compared to older persons) and tobacco users were more likely to endorse alcohol misuse items. Persons reporting lower income and who were of non-white race/ethnicity did not differ from their comparison groups with respect to endorsing one item, but they were more likely to endorse two or more items. Endorsing more than one item was associated with impaired activities of daily living, the presence of respiratory problems and psychiatric disorders, but was protective against vascular conditions.Conclusions: Major lifetime alcohol misuse (defined as endorsing more than one of five items reflecting alcohol abuse or dependence) is more common in certain sociodemographic groups (men, younger elderly) lower income, non-whites). With the exception of vascular conditions, it is associated with smoking, poorer functional status, respiratory problems, and psychiatric disorder. Endorsing only one item has a reduced association, significant only for male gender, smoking, and psychiatric disorder.
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    Could a rural lifestyle decrease the prevalence of erectile dysfunction?
    (Blackwell Publishing, 2007-01-01) Claro, Joaquim de Almeida [UNIFESP]; Kaufmann, Oskar Grau [UNIFESP]; Alarcon, Gustavo [UNIFESP]; Aguiar, Wilson [UNIFESP]; Nadozza, Archimedes; Ortiz, Valdemar [UNIFESP]; Srougi, Miguel [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE To determine the prevalence of erectile dysfunction (ED) in a specific population and explore potential correlates with lifestyle.SUBJECTS and METHODS This prospective observational study, covering a population of a very small rural town, included 2000 men aged >= 20 years from a total population of 121 831 (51% female and 49% male). the International Index of Erectile Function was completed by each of the 2000 men at their homes over a 1-year period.Another questionnaire assessing socioeconomic status and health-related determinants of ED were also completed.RESULTS All 2000 men completed the questionnaires; overall, only 34 reported ED (1.7%). the frequency of mild, mild to moderate, moderate and severe ED was 12%, 29%, 20% and 38%, respectively. Significantly more men aged > 51 years had ED than those aged < 41 years (0.05% and 0.45%, respectively; P < 0.001).There was no difference in ED with salary levels.CONCLUSION the prevalence of ED in this particular rural population of Brazil was very low, at only 1.7%. Although ED increases with age, this association was not apparent for all age groups. It seems that several others factors, e.g. lifestyle, culture and diet, could be important for the onset of ED.
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    Crack cocaine: An increase in use among patients attending clinics in São Paulo: 1990-1993
    (Marcel Dekker Inc, 1996-01-01) Dunn, J.; Laranjeira, R. R.; DaSilveira, D. X.; Formigoni, MLOS; Ferri, C. P.; Universidade Federal de São Paulo (UNIFESP)
    Unsubstantiated reports suggest that the availability and use of crack are increasing in São Paulo. To investigate this claim we used the databases from two outpatient clinics for drug users at a public hospital and examined the changes in the reported routes of administration of cocaine among 245 patients who had attended between 1990 and 1993. the proportion reporting crack use increased from 17% in 1990 to 64% in 1993 (p < .01). It does not seem that this increase was simply due to changes in demographic variables. Treatment policies need to be reviewed and HIV harm-reduction programs should focus more on the risks of sexual transmission.
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    Dementia and legal determination of capacity
    (Assoc Arquivos Neuro- Psiquiatria, 2017) Eboli Bello Delineau, Valeska Maria [UNIFESP]; Schultz, Rodrigo Rizek [UNIFESP]
    One of the consequences of dementia is the possibility of a guardianship proceeding that will deprive patients of legal capacity in taking decisions and managing their own assets. Objective: To assess the legal capacity and guardianship proceedings in patients diagnosed with dementia. Methods: Ninety-seven patients diagnosed with dementia and seen at a tertiary hospital were evaluated. Results: Of these 97 patients, 60 (62%) were female. The mean age of the patients was 77.9 years
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    Depression morbidity in later life: Prevalence and correlates in a developing country
    (Lippincott Williams & Wilkins, 2007-09-01) Blay, Sergio Luis; Andreoli, Sergio Baxter; Fillenbaum, Gerda G.; Gastal, Fabio Leite; Universidade Federal de São Paulo (UNIFESP); Duke Univ; VA Med Ctr
    Objective: To investigate the one-month prevalence of depression morbidity and its association with sociodemographic characteristics, health and functional status, and use of health services in community residents aged 60 years and over in Brazil. Methods: This study used a cross-sectional design of face-to-face interviews ( N = 7,040) in Rio Grande do Sul State, Brazil. Participants were household residents aged 60 years and older. Measurements included the Short Psychiatric Evaluation Schedule ( six-item version) and questionnaire that assessed sociodemographic characteristics, self-reported health status, systemic illnesses, activities of daily living ( ADL), use of medical services, and social support. Results: the overall prevalence of depression morbidity was 22% ( men: 18%, women: 25.2%). in controlled analyses, younger age, low income, rural origin, never or no longer married, poor self-rated health, presence of systemic illnesses, visual, hearing, or ADL impairments, hospitalization in the past 12 months, and lack of exercise or employment were significantly associated with depression morbidity, whereas living alone was nearly so associated. Gender, education, minority race, or outpatient visits in the previous six months were not associated with depression morbidity. Conclusion: the overall prevalence of depression morbidity was among the highest previously reported for older persons. in controlled analyses, prevalence declined as age increased, and rates were higher for those with lower income and poorer social, health, and functional status, but did not differ significantly by gender, education, or race/ethnicity. Increased attention should be paid to identifying depression morbidity in those with adverse circumstances and to identifying ameliorating interventions.
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    Diagnostic Labeling of COPD in five Latin American cities
    (Amer Coll Chest Physicians, 2007-01-01) Talamo, Carlos; Montes de Oca, Maria; Halbert, Ron; Perez-Padilla, Rogelio; Jardim, José Roberto B. [UNIFESP]; Muino, Adriana; Lopez, Maria Victorina; Valdivia, Gonzalo; Pertuze, Julio; Moreno, Dolores; Menezes, Ana Maria B.; PLATINO Team; Hosp Univ Caracas; Univ Calif Los Angeles; Inst Resp Dis; Universidade Federal de São Paulo (UNIFESP); Univ Republica; Pontificia Univ Catolica Chile; Fed Univ Pelotas
    Background: COPD is a major worldwide problem with a rising prevalence. Despite its importance, there is a lack of information regarding underdiagnosis and misdiagnosis of COPD in different countries. As part of the Proyecto Latinoamericano de Investigacion en Obstruccion Pulmonar study, we examined the relationship between prior diagnostic label and airway obstruction in the metropolitan areas of five Latin American cities (S (a) over tildeo Paulo, Santiago, Mexico City, Montevideo, and Caracas).Methods: A two-stage sampling strategy was used in each of the five areas to obtain probability samples of adults aged 40 years. Participants completed a questionnaire that included questions on prior diagnoses, and prebronchodilator and postbronchodilator spirometry. A study diagnosis of COPD was based on airway obstruction, defined as a postbronchodilator FEV1/FVC < 0.70.Results: Valid spirometry and prior diagnosis information was obtained for 5,303 participants; 758 subjects had a study diagnosis of COPD, of which 672 cases (88.7%) had not been previously diagnosed. the prevalence of undiagnosed COPD was 12.7%, ranging from 6.9% in Mexico City to 18.2% in Montevideo. Among 237 subjects with a prior COPD diagnosis, only 86 subjects (36.3%) had postbronchodilator FEV1/FVC < 0.7, while 151 subjects (63.7%) had normal spirometric values. in the same group of 237 subjects, only 34% reported ever undergoing spirometry prior to our study.Conclusions: Inaccurate diagnostic labeling of COPD represents an important health problem in Latin America. One possible explanation is the low rate of spirometry for COPD diagnosis.
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    Disturbances of glucose and lipid metabolism in first and second generation Japanese-Brazilians
    (Elsevier B.V., 1996-10-01) Ferreira, SRG; Iunes, M.; Franco, L. J.; Iochida, L. C.; Hirai, A.; Vivolo, M. A.; Universidade Federal de São Paulo (UNIFESP)
    Increased prevalence of self-reported NIDDM in Japanese-Brazilians was reported when compared to Japan. This study aimed at determining the prevalence of NIDDM and IGT in Japanese-Brazilians living in the city of Bauru, São Paulo. Brazil. the impact of western environment on the frequency of obesity, dyslipidemia and hypertension was investigated. All Issei (first generation; n=238) and a random sample of Nisei (second generation; n=292), aged 40-79 years, were selected for clinical examination and OGTT (WHO criteria), Age-adjusted prevalence of NIDDM did not differ between men and women for Issei (12.4 vs, 11.6%, respectively), but it became different for Nisei (21.7 vs. 11.4%, P <0.03) due to an increased rate among men. Increased IGT prevalence was also observed between Issei and Nisei men (8.5 vs 19.3%, P <0.03). Issei women had a higher IGT rate than Issei men (27.3 vs. 8.5%, P <0.0005). Body mass index (BMI) was higher in the second generation (24.1+/-3.6 vs. 23.3+/-3.1 kg/m(2), P <0.00005) and also the frequency of obesity, defined as BMI >25 kg/m(2). Comparison of waist/hip ratio by gender showed that only among women, Nisei had lower ratio than Issei (0.90 vs. 0.88, P <0.05). Nisei had a lower total and LDL-cholesterol than Issei but triglyceride and HDL-cholesterol did not differ. Nisei women (younger than the Issei) had lower triglyceride and total cholesterol. This pattern was not seen between the two generations of men. Considering the mean blood pressure values, Issei and Nisei groups with normal glucose tolerance were not hypertensive. Systolic blood pressure was lower in Nisei and the inverse was found concerning diastolic levels, NIDDM prevalence in Japanese-Brazilians is higher than in Japan and in the general Brazilian population. Besides environment, genetic factors may confer susceptibility to NIDDM when they are exposed to a western environment. Before developing glucose intolerance, disturbances of lipid profile and blood pressure could be detected. Nisei may be more affected due to a longer exposure to an unfavorable environment and these changes seem to occur earlier among men than women.
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    Ecological correlation among prevalence of asthma symptoms, rhinoconjunctivitis and atopic eczema with notifications of tuberculosis and measles in the Brazilian population
    (Blackwell Publishing, 2005-11-01) Sole, D.; Camelo-Nunes, I. C.; Wandalsen, G. F.; Sarinho, E.; Sarinho, S.; Britto, M. de; Rosario, N. A.; Souza, LSD; Stein, R.; Fischer, G. B.; Naspitz, C. K.; Universidade Federal de São Paulo (UNIFESP); Universidade Federal de Pernambuco (UFPE); Inst Materno Infantil Pernambuco; Univ Fed Parana; Universidade Federal da Bahia (UFBA); Catholic Univ Porto Alegre; Fed Fac Fdn Med Sci
    This study aims to assess the relationship among incidence of tuberculosis and measles, in the general population, within the year of birth and the prevalence of asthma, rhinoconjunctivitis and atopic eczema in teenagers from different Brazilian cities enrolled in the International Study of Asthma and Allergies in Childhood (ISAAC) phases I and III. Positive answers to the questions: 'Have you had wheezing or whistling in the chest in the past 12 months?', 'In the past 12 months, has this nose problem been accompanied by itchy-watery eyes?' and 'Has this itchy rash at any time affected any of the following places: the folds of the elbows, behind the knees, in front of the ankles, under the buttocks, or around the neck, ears or eyes?' identified the teenagers with asthma, rhinoconjunctivitis, and atopic eczema, respectively. the incidence of tuberculosis and measles, in the general population, observed in the year of birth of the enrolled teenagers (1981/82 and 1988/89) were obtained from governmental agencies: National Foundation of Health (FUNASA) and Brazilian Institute of Geography and Statistics (IBGE). They were compared with the prevalence of asthma, rhinoconjunctivitis and atopic eczema reported in both ISAAC phases I and III. Although we observed reduction of the incidence of tuberculosis and measles in the general population in all cities, the prevalence of asthma, rhinoconjunctivitis and atopic eczema remained stable in most of the centers. in Pernambuco and Parana, there has been a significant increase in the prevalence of rhinoconjunctivitis. These data do not corroborate the findings of an inverse relationship between the prevalence of atopic diseases and the decreasing incidence of tuberculosis and measles.
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    Epidemiologia do transtorno bipolar
    (Faculdade de Medicina da Universidade de São Paulo, 2005-01-01) Lima, Mauricio Silva de [UNIFESP]; Tassi, Juliana; Novo, Ingrid Parra [UNIFESP]; Mari, Jair de Jesus [UNIFESP]; Universidade Federal de Pelotas; Universidade Católica de Pelotas; Institute of Psychiatry Section of Epidemiology; Universidade Federal do Paraná; Universidade Federal de São Paulo (UNIFESP); Universidade Federal do Paraná Hospital de Clínicas; PUC-Paraná
    Information about the epidemiology of bipolar disorders is essential for providing a framework for the formulation of effective mental health policy. In the last two decades, population surveys of psychiatric morbidity in adults have been conducted and as a result details on the frequency, risk factor, social disabilities, and service use rates of mental disorders are now available. Epidemiological findings on bipolar disorders are discussed on the light of results from recent large population-based surveys namely the Epidemiological Catchment Area Study (ECA), the National Comorbidity Survey (NCS), the OPCS Survey of Psychiatric Morbidity in Great Britain, the Brazilian Multicentric Study of Psychiatric Morbidity, and the longitudinal studies conducted in Zurich by Angst. Prevalence rates for bipolar disorder were generally low, regardless setting, the type of instrument used for generating psychiatric diagnosis, and the time periods by which prevalence is defined. Since the introduction of the concept of bipolar spectrum, broadening the boundaries of the disease, the estimate rates have been found to be substantially higher. Such rates still need to be validated by populational-based studies. Bipolar disorder is as prevalent in women as in men, more common among singles and separated or divorced people. Those affected by the disease are more likely to use medical services and to be hospitalized. The cost-effectiveness of treatments must be balanced with the high individual and social impact associated to the bipolar illness.