Factors associated with the severity of menopausal symptoms in postmenopausal Brazilian women

AbstractPurposesTo identify the socio-demographic and anthropometric profile and correlate them with the severity of menopausal symptoms in postmenopausal women.MethodsCross-sectional study with 201 postmenopausal women attended in a Gynecology Outpatient Department in Rio de Janeiro city (RJ, Brazil). A questionnaire was applied for collection of demographic, socioeconomic, clinical and lifestyle variables. The Blatt–Kupperman Menopausal Index was used to evaluate the menopausal symptoms.ResultsWomen with moderate to severe symptoms (≥20) corresponded to 57.7% (116) of the sample. Obesity was not associated with the severity of menopausal symptoms (p<0.90). Severe to moderate symptoms were inversely associated with age (PR 0.96; CI 95% 0.94–0.99; p<0.01). Women within 6–10 years of menopause presented nearly 1.4 times higher prevalence of moderate to severe symptoms compared with those with more than 10 years of menopause. Unemployed women (PR 1.52; CI 95% 1.13–2.04; p<0.01) and housewives (PR 1.53; CI 95% 1.12–2.09; p<0.01) presented higher prevalence of menopausal symptoms compared with working women. Tobaccoism was associated with higher prevalence of moderate to severe symptoms (p<0.01).ConclusionsAge constituted a protection factor for moderate to severe symptoms, whereas having within 6–10 years of menopause, smoking and being unemployed or a housewife were factors related to higher prevalence of moderate to severe menopausal symptoms

[Catastrophic expenditure on congenital Zika syndrome: results of a cross-sectional study of caregivers of children in Rio de Janeiro, Brazil]

In 2015, there was an increase in cases of congenital malformations in newborns in Brazil, associated with maternal Zika virus infection, having serious social and economic repercussions for the families. The study aimed to estimate the prevalence of catastrophic expenditure by families of children with severe or mild/moderate congenital Zika syndrome (CZS) in comparison to families of children without a diagnosis of CZS in the state of Rio de Janeiro. Catastrophic expenditure occurs when spending exceeds a given proportion of the family income due to a disease. Family caregivers of children with severe CZS were younger and had less schooling and lower income. Prevalence of catastrophic expenditure was higher in families of children with CZS. Among caregivers of children with severe CZS, the prevalence of catastrophic expenditure was higher in those with severe or very severe depression, anxiety, and stress. Low social support among caregivers was also a determinant factor for increased prevalence of catastrophic expenditure. The burden on caregivers of children with severe CZS exacerbates a situation of vulnerability that requires the expansion of mechanisms for financial and social protection, through linkage of various policies capable of effectively reaching this group

GRAVIDADE DAS DOENÇAS RESPIRATÓRIAS DE CRIANÇAS E ADOLESCENTES ATRAVÉS DO VEF1: PERCENTUAL PREDITO VERSUS Z-ESCORE

Introdução: A espirometria é fundamental na avaliação de doenças pulmonares. A interpretação da gravidade do distúrbioventilatório obstrutivo (DVO) pelo percentual previsto do volume expiratório forçado no primeiro segundo (VEF ) proposta pela 1American Thoracic Society and European Respiratory Society (ATS/ERS) é controversa, por não considerar a idade. A análise doZ-Escore proposta por Quanjer pode corroborar com a resolução dessa limitação. Objetivo: Comparar a classificação da gravidadedo DVO proposta pela ATS/ERS e a estabelecida por Quanjer. Métodos: Estudo prospectivo e transversal, sendo realizados306 testes espirométricos em crianças e adolescentes (7 e 17 anos de idade) com doença respiratória entre 2017 e 2018.Pacientes com DVO foram classificados com padrão obstrutivo quando o VEF /capacidade vital (CV) encontrava-se abaixo do 5º 1percentil. Posteriormente, a gravidade do DVO foi estratificada em dois grupos: percentual predito do VEF e VEF em Z-Escore. 1 1Resultados: Dos 306 avaliados, 182 (59,5%) apresentaram DVO. Observou-se maior predomínio da população com diagnósticode asma (61%). Houve forte correlação (R=0,88) entre o Z-Escore e a porcentagem do valor predito do VEF . Contudo, quando 1estratificados os critérios de classificação da gravidade do DVO, foi observada fraca concordância (kappa = 0,285). Dos pacientescom DVO moderado (48,3%) pela porcentagem do valor predito do VEF foram classificados como graves pelo Z-Escore. 1Conclusão: Observou-se forte correlação linear entre o percentual predito do VEF e o Z-Escore. Entretanto, existem diferenças 1significativas entre as classificações. O percentual previsto do VEF tende a subestimar a gravidade do DVO em crianças e adoles- 1centes com doenças respiratórias.Palavras-chaves: Testes de Função Respiratória. Obstrução das vias respiratórias. Espirometria. Crianças. Adolescente

Há associação entre o valor do volume expiratório forçado no 1º segundo e o Teste de Controle da Asma e a classificação do grau de controle proposta pelo Global initiative for Asthmaem crianças e adolescentes asmáticos tratados com corticosteroide inalató

Objective: Evaluate the presence of association between the classification of the level of asthma control, using the method proposed by the Global Initiative for Asthma (GINA), the Asthma Control Test (ACT)/Childhood-ACT and the forced expiratory volume in the 1st second (FEV1), in asthmatic children and adolescents treated with inhaled corticosteroids, followed up at the National Institute of Women's, Children's and Adolescents' Health FernandesFigueira of the Oswaldo Cruz Foundation (IFF / FIOCRUZ). Method: A cross-sectional study was carried out with a review of the medical records of all children between 7 and 17 years of age followed up at the Asthma Outpatient Clinic and referred to the Respiratory Insertion Test (PFR) sector between March 2013 and September 2014. In the same day were applied the C-ACT/ACT questionnaires, an asthma control method proposed by the GINA and the FEV1 value in a spirometrictest. Results: From the total number of records evaluated (72), 16 children were excluded because they did not meet the required criteria for performing spirometry. The sample studied (56 children) was predominantly male (58.9%) and median age was 12 (7-17) years. It was observed an association between FEV1 and GINA values ??(p &lt;0.01). Conclusion: The results found in this study indicate that FEV1 measurement is a useful component among the instruments for assessing clinical control of asthma by GINA.Objetivo: Avaliar a presença de associação entre a classificação do grau de controle da asma, usando a proposta pelo Global initiative for Asthma(GINA), o AsthmaControl Test (ACT)/Childhood-ACT, e o volume expiratório forçado no 1º segundo (VEF1), em crianças e adolescentes asmáticos em tratamento com corticoide inalatório, atendidos no Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira da Fundação Oswaldo Cruz(IFF/FIOCRUZ). Método: Estudo transversal, com revisão de prontuários de todas as crianças entre 7 e 17 anos acompanhadas no Ambulatório de Asma e encaminhados ao setor de Prova de Função Respiratória (PFR) entre março de 2013 e setembro de 2014. Foram aplicados no mesmo dia, os questionários C-ACT/ACT, a classificação do grau de controle da asma proposta pelo GINA e o valor do VEF1 obtido em exame espirométrico. Resultados: Do total de prontuários avaliados (72), 16 crianças foram excluídas por não preencherem os critérios exigidos para realização da espirometria. A amostra estudada (56 crianças) apresentou predomínio do sexo masculino (58,9%) e mediana de idade igual a 12 (7-17) anos. Observou-se associação entre os valores de VEF1 e o GINA (p&lt;0,01). Conclusão: Os resultados encontrados nesse estudo indicam que a medida do VEF1é um componente útil dentre os instrumentos para avaliação do controle clínico da asma pelo GINA

Nutritional profile of newborns with microcephaly and factors associated with worse outcomes

OBJECTIVE: To describe the nutritional profile of newborns with microcephaly and factors associated with worse outcomes during the first 14 days of life. METHODS: This investigation is a longitudinal, descriptive study carried out in 21 full-term neonates exposed vertically to the Zika virus and hospitalized in a neonatal intensive care unit from February to September 2016. Patients receiving parenteral nutrition were excluded. Data analysis was performed using a generalized estimating equation model and Student’s t-test to evaluate the association between worsening weight-for-age z-scores and independent clinical, sociodemographic and nutritional variables during hospitalization, with po0.05 indicating significance. RESULTS: During hospitalization, there was a decrease in the mean values of the weight-for-age z-scores. The factors associated with worse nutritional outcomes were symptomatic exposure to the Zika virus, low maternal schooling, absence of maternal income and consumption of infant formula (po0.05). Calcification and severe microcephaly were also associated with poor nutritional outcomes. Energy and macronutrient consumption remained below the recommendations and had an upward trend during hospitalization. CONCLUSION: The presence of cerebral calcification, the severity of microcephaly and symptomatic maternal exposure to Zika virus affected the nutritional status of newborns. In terms of nutritional factors, human milk intake had a positive impact, reducing weight loss in the first days of life. Other known factors, such as income and maternal schooling, were still associated with a poor nutritional status

Depression, anxiety, stress, and social support: a cross-sectional study with caregivers of visually impaired children in Rio de Janeiro, Brazil - Views-QoL Study.

We aimed to identify the reports of symptoms of depression, anxiety, and stress among caregivers of children without visual impairment, with low vision, and with blindness and their relationship with the degree of social, emotional, material, and affective support. This cross-sectional and multicenter study was conducted in the municipality of Rio de Janeiro, Brazil, from 2019 to 2020. A questionnaire was applied to obtain caregivers' sociodemographic and economic data. The Medical Outcomes Study Social Support Scale (MOS-SSS) and The Depression, Anxiety, and Stress Scale (DASS-21) were used. Tests were used for multiple comparisons of these scales. The prevalence ratio of symptoms of depression, anxiety, and stress was estimated. Of all caregivers (N = 355), more than 90% were women-mothers. Caregivers of children with visual impairment show the highest proportion of no schooling, incomplete elementary education, or lower average monthly income. Most caregivers of children with blindness reported symptoms of depression, anxiety, and stress (66.7%, 73.3%, and 80%, respectively) as did those of children with low vision. The evaluation of the relationship between MOS-SSS and DASS-21 results shows greater support and lower scores of reports of depression, anxiety, and stress for caregivers of children without disabilities or with less visual impairment. For caregivers of blind children, the highest prevalence of such reports was independent of the received support. Results indicate the need for a care policy with mechanisms to protect the mental health of caregivers of visually impaired children

Impact of Bean Consumption on Nutritional Outcomes amongst Adolescents

Brazilian adolescents have undergone a noteworthy nutritional epidemiological transition. There is an increase in the prevalence of overweight and high consumption of ultra-processed foods in parallel with patterns of traditional meals that include beans. This study analyzed associations between bean consumption in the diet of adolescents and nutrition outcomes. Multiple regression analysis showed a significant reduction in body mass index (BMI), body fat percentage (%BF) and LDL-cholesterol (LDL-c) values among those with bean consumption equal to or greater than five times a week. Adolescents who had lunch outside the home and those who did not have the habit of having lunch showed a significantly higher BMI. There was an increase in the %BF among married adolescents and those who did not have lunch. There was a reduction of LDL-c among those with intermediate per capita income and those who consumed processed juice less than 5 times a week, and an increase among those who did not have breakfast. There were significant interactions between sexual maturation, energy consumption, physical activity and energy consumption. Thus, in the context of this study, the presence of beans in the diet, at frequencies equal to or greater than five times a week, can be considered a proxy for healthy eating

Spatiotemporal diffusion of influenza A (H1N1): Starting point and risk factors.

Influenza constitutes a major challenge to world health authorities due to high transmissibility and the capacity to generate large epidemics. This study aimed to characterize the diffusion process of influenza A (H1N1) by identifying the starting point of the epidemic as well as climatic and sociodemographic factors associated with the occurrence and intensity of transmission of the disease. The study was carried out in the Brazilian state of Paraná, where H1N1 caused the largest impact. The units of spatial and temporal analysis were the municipality of residence of the cases and the epidemiological weeks of the year 2009, respectively. Under the Bayesian paradigm, parametric inference was performed through a two-part spatiotemporal model and the integrated nested Laplace approximation (INLA) algorithm. We identified the most likely starting points through the effective distance measure based on mobility networks. The proposed estimation methodology allowed for rapid and efficient implementation of the spatiotemporal model, and provided evidence of different patterns for chance of occurrence and risk of influenza throughout the epidemiological weeks. The results indicate the capital city of Curitiba as the probable starting point, and showed that the interventions that focus on municipalities with greater migration and density of people, especially those with higher Human Development Indexes (HDIs) and the presence of municipal air and road transport, could play an important role in mitigation of effects of future influenza pandemics on public health. These results provide important information on the process of introduction and spread of influenza, and could contribute to the identification of priority areas for surveillance as well as establishment of strategic measures for disease prevention and control. The proposed model also allows identification of epidemiological weeks with high chance of influenza occurrence, which can be used as a reference criterion for creating an immunization campaign schedule

Spatiotemporal diffusion of influenza A (H1N1): Starting point and risk factors

Influenza constitutes a major challenge to world health authorities due to high transmissibility and the capacity to generate large epidemics. This study aimed to characterize the diffusion process of influenza A (H1N1) by identifying the starting point of the epidemic as well as climatic and sociodemographic factors associated with the occurrence and intensity of transmission of the disease. The study was carried out in the Brazilian state of Paraná, where H1N1 caused the largest impact. The units of spatial and temporal analysis were the municipality of residence of the cases and the epidemiological weeks of the year 2009, respectively. Under the Bayesian paradigm, parametric inference was performed through a two-part spatiotemporal model and the integrated nested Laplace approximation (INLA) algorithm. We identified the most likely starting points through the effective distance measure based on mobility networks. The proposed estimation methodology allowed for rapid and efficient implementation of the spatiotemporal model, and provided evidence of different patterns for chance of occurrence and risk of influenza throughout the epidemiological weeks. The results indicate the capital city of Curitiba as the probable starting point, and showed that the interventions that focus on municipalities with greater migration and density of people, especially those with higher Human Development Indexes (HDIs) and the presence of municipal air and road transport, could play an important role in mitigation of effects of future influenza pandemics on public health. These results provide important information on the process of introduction and spread of influenza, and could contribute to the identification of priority areas for surveillance as well as establishment of strategic measures for disease prevention and control. The proposed model also allows identification of epidemiological weeks with high chance of influenza occurrence, which can be used as a reference criterion for creating an immunization campaign schedule