Efetividade de uma intervenção digital na diminuição da prática de binge drinking entre frequentadores de baladas

OBJECTIVE: To evaluate the effectiveness of a web-based intervention in reducing binge drinking among nightclub patrons after six months. METHODS: We carried out a website survey with probabilistic sample in 31 nightclubs in the city of São Paulo, Brazil, which originated a randomized controlled trial with 1,057 participants. Those classified as problem drinkers (n = 465) using the Alcohol Use Disorders Identification Test were randomized into two study groups – intervention and control. The web-based intervention consisted of exposing the participants to a normative feedback screen about their alcohol consumption, characterizing the risks associated with amount consumed, money spent on drinks, drinking and driving, risk classification of Alcohol Use Disorders Identification Test, and tips to reduce damage. RESULTS: There was a significant reduction in the practice of binge drinking in the week estimated at 38% among participants in the intervention group after six months (p < 0.05). However, there was no significant reduction in the outcomes when we analyzed the intervention and control groups and at baseline and after sixth months, simultaneously. CONCLUSIONS: We cannot conclude that digital tools reduce the pattern of binge drinking among party goers in São Paulo. More studies are needed with this methodology because of its attractiveness to this type of group, given the privacy and speed that personalized information is transmitted.OBJETIVO: Avaliar, após seis meses, a efetividade de uma intervenção digital na diminuição da prática de binge drinking entre frequentadores de baladas. MÉTODOS: Foi realizado um inquérito de portal através de uma amostra probabilística em 31 baladas da cidade de São Paulo, a qual originou um ensaio controlado randomizado com 1.057 participantes. Aqueles classificados como uso problemático do álcool (n = 465) através do Alcohol Use Disorders Identification Test foram randomizados em dois grupos de estudo – intervenção e controle. A intervenção digital consistiu em expor os participantes a uma tela de feedback normativo sobre seu consumo de álcool, caracterizando os riscos associados à quantidade consumida, valores gastos com bebidas, beber e dirigir, classificação do risco do Alcohol Use Disorders Identification Test e dicas de redução de danos. RESULTADOS:Houve uma redução significativa da prática de binge drinking na semana estimada em 38% entre os participantes do grupo intervenção após seis meses (p < 0,05). Porém, não houve redução significativa nos desfechos quando se analisam os grupos intervenção e controle e os tempos início e seis meses após, simultaneamente. CONCLUSÕES: Não se pode concluir que as ferramentas digitais reduzem o padrão de binge drinking nos frequentadores de baladas paulistanas. São necessários mais estudos com esta metodologia devido ao caráter atrativo para esse grupo, tendo em vista a privacidade e a rapidez que as informações personalizadas são transmitidas

Sexual aggression in the São Paulo nightlife scenarios: a public health concern

Departamento de Medicina Preventiva. Escola Paulista de Medicina. Universidade Federal de São Paulo, R Botucatu,740 Vila Clementino, BR-04023062 Sao Paulo, SP, BrazilDepartamento de Medicina Preventiva. Escola Paulista de Medicina. Universidade Federal de São Paulo, R Botucatu,740 Vila Clementino, BR-04023062 Sao Paulo, SP, Brazil.Web of Scienc

Factors Associated with Pre-drinking Among Nightclub Patrons in the City of São Paulo

Aims: the aim of the study was to describe the phenomenon of pre-drinking (alcohol consumption before entering nightclubs or bars) and to identify factors associated with pre-drinking practices among patrons in the city of São Paulo, Brazil. Methods: Individual-level data were collected by a portal survey of 2422 patrons at the entrance and at the exit of 31 nightclubs. the nightclubs were selected by two-stage sampling using a probability proportional to the establishments' capacity in the first stage and a systematic sample of patrons in the second stage. Breath alcohol concentration (BrAC) was measured. Face-to-face interview identified pre-drinking characteristics and past-year risk behaviors. Analysis used sample weights to compensate for nightclubs or patrons that were possibly over- or under-represented. Results: of the study participants, 41.3% (95% confidence interval (CI) = 33.7-49.3) engaged in pre-drinking on the night of the interview. Being male (odds ratio (OR) = 1.98, 95% CI = 1.45-2.71), past-year binge drinking (OR = 2.28, 95% CI = 1.70-3.07), previous episodes of severe effects from drunkenness (OR = 1.77, 95% CI = 1.40-2.22) and sexual risk behavior (OR = 1.67, 95% CI = 1.20-2.33) were associated with recent pre-drinking. Pre-drinking predicted higher BrACs at the nightclub exit. Conclusion: Pre-drinking is prevalent among nightclub patrons and associated with risk behaviors, and is associated with alcohol intoxication at nightclub exits. Environmental prevention strategies must consider pre-drinking as a potential risk factor for alcohol intoxication in nightclubs.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Universidade Federal de São Paulo, Dept Prevent Med, Epidemiol Sect, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Informat Hlth, Sect Stat, São Paulo, BrazilUniversidade Federal de São Paulo, Sect Bioestat, Dept Prevent Med, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Prevent Med, Epidemiol Sect, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Informat Hlth, Sect Stat, São Paulo, BrazilUniversidade Federal de São Paulo, Sect Bioestat, Dept Prevent Med, São Paulo, BrazilFAPESP: 2011/51658-0FAPESP: 2012/03832-4Web of Scienc

Modulation of Toll Like Receptor-2 on sebaceous gland by the treatment of adult female acne

Adult female acne is a chronic inflammatory, immune-mediated disease that affects the pilosebaceous unit in women in their 20s to 40s, and is considered different from acne vulgaris. Propionibacterium acnes is recognized by TLR-2, resulting in activation of this receptor and an inflammatory response through the NF kappa B pathway. This therapeutic, interventional, open, randomized, evaluator-blinded and comparative trial included 38 adult women with moderate facial acne and 10 age-matched controls, all aged between 26 and 44 years. Two treatments were performed over six months: 15% azelaic acid gel (AA) bid (n = 18) and oral contraceptive (COC) drospirenone 3 mg/ethinylestradiol .02 mg (n = 20). Biopsies were taken at baseline (control, lesion, perilesional) and at the conclusion (lesion and perilesional) of the study to evaluate TLR-2 expression by immunohistochemistry. Lesion count and blind photographic evaluation were used for efficacy. The groups were homogeneous: 70% of lesions were located in the submandibular area, 95% of participants had inflammatory lesionsof these, 50% had persistent and 50% had late-onset acne. The mean ages were 33.7 +/- 5.5 and 33.1 +/- 5.3 years (COC and AA group, respectively). A moderate clinical improvement was observed in both groups. No difference in TLR-2 expression in the lesion or perilesional areas was observedhowever, reduced TLR-2 expression was seen in the control group. A significant reduction in expression was observed after both treatments, with no difference between the groups. This finding suggests an anti-inflammatory effect of COCs and AA in adult female acne, via modulation of the TLR-2 receptor.Dermatology - Sao Paulo Regional of BrazilianSociety of Dermatology - FUNADERSPUniv Fed Sao Paulo, Dept Prevent Med, Dept Dermatol, Sao Paulo, BrazilUniv Fed Sao Paulo, Dept Prevent Med, Sao Paulo, BrazilUniv Fed Sao Paulo, Dept Prevent Med, Dept Dermatol, Sao Paulo, BrazilUniv Fed Sao Paulo, Dept Prevent Med, Sao Paulo, BrazilWeb of Scienc

Initiation of resuscitation in the delivery room for extremely preterm infants: a profile of neonatal resuscitation instructors

OBJECTIVE: The goal of the present study was to examine the decisions of pediatricians who teach neonatal resuscitation in Brazil, particularly those who start resuscitation in the delivery room for newborns born at 23-26 gestational weeks. METHODS: The present study was a cross-sectional study that used electronic questionnaires (Dec/11-Sep/13) sent to instructors of the Neonatal Resuscitation Program of the Brazilian Society of Pediatrics. The primary outcome was the gestational age at which the respondent said that he/she would initiate positive pressure ventilation in the delivery room. Latent class analysis was used to identify the major profiles of these instructors, and logistic regression was used to identify variables associated with belonging to one of the derived classes. RESULTS: Of 685 instructors, 82% agreed to participate. Two latent classes were identified: ‘pro-resuscitation’ (instructors with a high probability of performing ventilation on infants born at 23-26 weeks) and ‘pro-limitation’ (instructors with a high probability of starting ventilation only for infants born at 25-26 weeks). In the multivariate model, compared with the ‘pro-limitation’ class, ‘pro-resuscitation’ pediatricians were more likely to be board-certified neonatologists and less likely to base their decision on the probability of the infant’s death or on moral/religious considerations. CONCLUSION: The pediatricians in the most aggressive group were more likely to be specialists in neonatology and to use less subjective criteria to make delivery room decisions

Factors associated with the need for ventilation at birth of neonates weighing ≥2,500 g

OBJECTIVES: Approximately 20-40% of annual global neonatal deaths occur among infants with birthweights ≥2,500 g, and most of these deaths are associated with intrapartum asphyxia in low- and middle-income countries. This study aims to evaluate the peripartum variables associated with the need for resuscitation at birth of neonates weighing ≥2,500 g. METHOD: This case-control retrospective study was performed on data from all public reference maternity units in the state of Ceará, Northeast Brazil, between March 2009 and March 2010. The subjects were singleton neonates without malformations weighing ≥2,500 g, who required positive-pressure ventilation in the delivery room. The controls had a 1-minute Apgar score of ≥8 and did not undergo resuscitation. Variables associated with positive-pressure ventilation in the delivery room were evaluated via conditional multivariate logistic regression. RESULTS: Of the 2,233 live births with birth weights ≥2,500 g, 1-minute Apgar scores ≤7, and no malformations, 402 patients met the inclusion criteria, and they were paired with 402 controls. Risk variables for positive-pressure ventilation at birth were a gestational ag

Transcutaneous Bilirubin in Exclusively Breastfed Healthy Term Newborns Up to 12 Days of Life

OBJECTIVE: To determine the curve of transcutaneous bilirubin in breastfed term neonates up to 12 days of life.METHODS: in a prospective cohort study, we performed a 12-day evaluation of 223 healthy, exclusively breastfed, appropriate-for-gestational-age neonates who roomed-in for at least 48 hours. Each newborn had forehead transcutaneous bilirubin and body weight measured at the end of 1, 2, 3, 4, 5, 6, 8, 10, and 12 days. Regression analysis was used with bilirubin as a third-degree polynomial function of time. the 25th, 50th, 75th, 90th, and 95th percentile curves were constructed by using the residual mean square for each day.RESULTS: Patients were 46% white, 34% mixed race, and 20% black, the mean birth weight was 3260 g (range: 2560-4090 g), the mean gestational age was 39.4 weeks (range: 37.0-41.9 weeks), 51% were male, 74% were born by vaginal delivery, and 66% had been breastfed since delivery. the mean highest weight loss was 4.7% (range: 1%-12%) at the second or third day, and in most infants the weight returned to the birth weight at the fifth day. With 2007 total bilirubin measurements, bilirubin concentrations reached the 50th percentile level (5.6 mg/dL) at the third and fourth days and returned to the 24-hour level (4.8 mg/dL) at the sixth day. the 95th percentile bilirubin level was 8.2 mg/dL at 24 hours of life, reached 12.2 mg/dL on the fourth day, and declined to 8.5 mg/dL on the 12th day.CONCLUSIONS: the transcutaneous bilirubin curve represents the natural history of bilirubinemia in exclusively breastfed healthy term newborns in the first 12 days of life. Pediatrics 2011; 128: e565-e571Universidade Federal de São Paulo, Dept Pediat, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Prevent Med, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Pediat, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Prevent Med, São Paulo, BrazilWeb of Scienc

Effects of curcumin in an orthotopic murine bladder tumor model

Cigarette smoking (CS) is the main risk factor for bladder cancer development. There are more than 100 carcinogens present in cigarette smoke. Among the potential mediators of CS-induced alterations is nuclear factor-kappa (NF-κB), which is responsible for the transcription of genes related to cell transformation, tumor promotion, angiogenesis, invasion and metastasis. Curcumin is a polyphenol compound derived from Curcuma longa that suppress cellular transformation, proliferation, invasion, angiogenesis, and metastasis by down regulating NF-κB and its regulated genes. The aim of our study was to assess the effects of curcumin in bladder urothelial carcinoma. We studied the effects of curcumin in vitro and in vivo using the orthotropic syngeneic bladder tumor animal model MB49. Curcumin promotes apoptosis of bladder tumor cells in vitro. In vivo tumors of animals treated with curcumin were significantly smaller as compared to controls. Using immunohistochemistry, we demonstrated a decrease in the expression of Cox-2 by 8% and Cyclin D1 by 13% in the animals treated with curcumin; both genes regulated by NF-κB and related to cell proliferation. In this study, we showed that curcumin acts in bladder urothelial cancer, possibly dowregulating NF-κB-related genes, and could be an option in the treatment of urothelial neoplasms. The results of our study suggest that further research is warranted to confirm our findings

Trends in alcohol and tobacco use among Brazilian students: 1989 to 2010

Objective: To analyze temporal trends of the prevalence of alcohol and tobacco use among Brazilian students. Methods: We analyzed data published between 1989 and 2010 from five epidemiological surveys on students from the 6th to the 12th grade of public schools from the ten largest state capitals of Brazil. The total sample consisted of 104,104 students and data were collected in classrooms. The same collection tool – a World Health Organization self-reporting questionnaire – and sampling and weighting procedures were used in the five surveys. The Chi-square test for trend was used to compare the prevalence from different years. Results: The prevalence of alcohol and tobacco use varied among the years and cities studied. Alcohol consumption decreased in the 10 state capitals (p < 0.001) throughout 21 years. Tobacco use also decreased significantly in eight cities (p < 0.001). The highest prevalence of alcohol use was found in the Southeast region in 1993 (72.8%, in Belo Horizonte) and the lowest one in Belem (30.6%) in 2010. The highest past-year prevalence of tobacco use was found in the South region in 1997 (28.0%, in Curitiba) and the lowest one in the Southeast in 2010 (7.8%, in Sao Paulo). Conclusions: The decreasing trend in the prevalence of tobacco and alcohol use among students detected all over the Country can be related to the successful and comprehensive Brazilian antitobacco and antialcohol policies. Despite these results, the past-year prevalence of alcohol consumption in the past year remained high in all Brazilian regions