Common Mental Disorders And The Use Of Psychoactive Drugs: The Impact Of Socioeconomic Conditions

Objective: To evaluate the infl uence of socioeconomic conditions on the association between common mental disorders and the use of health services and psychoactive drugs. Methods: This was a population-based cross-sectional study conducted in the city of Botucatu, Southeastern Brazil. The sample was probabilistic, stratifi ed and cluster-based. Interviews with 1,023 subjects aged 15 years or over were held in their homes between 2001 and 2002. Common mental disorders were evaluated using the Self-Reporting Questionnaire (SRQ-20). The use of services was investigated in relation to the fortnight preceding the interview and the use of psychotropic drugs, over the preceding three days. Logistic regression was used for multivariable analysis, and the design effect was taken into consideration. Results: Out of the whole sample, 13.4% (95% CI: 10.7;16.0) had sought health services over the fortnight preceding the interview. Seeking health services was associated with female gender (OR=2.0) and the presence of common mental disorders (OR=2.2). 13.3% of the sample (95% CI: 9.2;17.5) said they had used at least one psychotropic drug, especially antidepressives (5.0%) and benzodiazepines (3.1%). In the multivariable analysis, female gender and the presence of common mental disorders remained associated with the use of benzodiazepines. Per capita income presented a direct and independent association with the use of psychoactive drugs: the greater the income, the greater the use of these drugs was. Conclusions: Lower income was associated with the presence of common mental disorders, but not with the use of psychotropic drugs. The association of common mental disorders and the use of psychotropic drugs in relation to higher income strengthens the hypothesis that inequality of access to medical services exists among this population.424717723Ballester, D.A., Filipon, A.P., Braga, C., Andreoli, S.B., The general practitioner and mental health problems: Challenges and strategies for medical education (2005) Sao Paulo Med J, 123 (2), pp. 72-76. , doi:10.1590/ S1516-31802005000200008Beck, C.A., Williams, J.V., Wang, J.L., Kassam, A., El-Guebaly, N., Currie, S.R., Psychotropic medication use in Canada (2005) Can J Psychiatry, 50 (10), pp. 605-613Galduroz, J.C., Noto, A.R., Nappo, S.A., Carlini, E.L., First household survey on drug abuse in São Paulo, Brazil, 1999: Principal findings (2003) Sao Paulo Med J, 121 (6), pp. 231-237. , doi:10.1590/S1516-31802003000600003Harding, T.W., Arango, M.V., Baltazar, J., Climent, C.E., Ibrahim, H.H., Ladrido-Ignacio, L., Mental disorders in primary health care: A study of their frequency and diagnosis in four developing countries (1980) Psychol Med, 10 (2), pp. 231-241Hart, J.T., The inverse care law (1971) Lancet, 1 (7696), pp. 405-412Hennekens, C.H., Buring, J.E., (1987) Epidemiology in Medicine, , Boston: Little, Brown and Company;Hosmer, D.W., Lemeshow, S., (1989) Applied Logistic Regression, , New York: John Wiley & Sons;Iacoponi, E., Detecção de distúrbios emocionais pelo médico: Impacto do tipo de trabalho médico e do conceito sobre doenças mentais. (1997) Rev Cienc Med PUCCAMP, 6, pp. 41-45Lima, M.S., Hotopf, M., Mari, J.J., Béria, J.U., De Bastos, A.B., Mann, A., Psychiatric disorder and the use of Benzodiazepines: An example of the inverse care law from Brazil (1999) Soc Psychiatry Psychiatr Epidemiol, 34 (6), pp. 316-322Maragno, L., Goldbaum, M., Gianini, R.J., Novaes, H.M.D., Cesar, C.L., Prevalência de Transtorno mental comum em populacões atendidas pelo Programa Saúda da família (QUALIS) no município de Sao Paulo, Brasil. (2006) Cad Saude Publica, 22 (8), pp. 1639-1648. , doi: 10.1590/S0102-311X2006000800012Mari, J.J., Williams, P., A validity study of a Psychiatric Screening Questionnaire (SRQ-20) in Primary care in the city of São Paulo (1986) Br J Psychiatry, 148, pp. 23-26Mari, J.J., Almeida-Filho, N., Coutinho, E., Andreoli, S.B., Miranda, C.T., Streiner, D., The epidemiology of psychotropic use in the city of São Paulo (1993) Psychol Med, 23 (2), pp. 467-474Marín-Lŕon, L., Oliveira, H.B., Barros, M.B., Dalgalarrondo, P., Botega, N.J., Social inequality and common mental disorders (2007) Rev Bras Psiquiatr, 29 (3), pp. 250-253Mendoza-Sassi, R., Béria, J.U., Barros, A.J., Outpatient health service utilization and associated factors: A population-based study (2003) Rev Saude Publica, 37 (3), pp. 372-378Moncrieff, J., Psychiatric drug promotion and the politics of neo-liberalism (2006) Br J Psychiatry, 188, pp. 301-302Patel, V., Araya, R., Lima, M., Ludermir, A., Todd, C., Women, poverty and common mental disorders in four restructuring societies (1999) Soc Sci Med, 49 (11), pp. 1461-1471Rodrigues, M.A., Facchini, L.A., Lima, M.S., Modificações nos padrões de consumo de psicofármacos em localidade do Sul do Brasil. (2006) Rev Saude Publica, 40 (1), pp. 107-114. , doi:10.1590/ S0034-89102006000100017(2000) Collaborating Centre for Drug Statistics Methodoly Guidelines for ATC classification and DDD assignment, , World Health Organization, 3. ed. Oslo;Zandstra, S.M., Furer, J.W., van de Lisdonk, E.H., van't Hof, M., Bor, J.H.J., van Well, C., Different study criteria affect the prevalence of benzodiapine use (2002) Soc Psychiatry Psychiatr Epidemiol, 37 (3), pp. 139-14

Minimally invasive surgical management of primary venous ulcers vs. compression treatment: a randomized clinical trial

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Diet Quality Among Adolescents: A Population-based Study In Campinas, Brazil [qualidade Da Dieta De Adolescentes: Estudo De Base Populacional Em Campinas, Sp]

We assessed the overall diet quality and adequacy of diet consumption of each component of the diet of adolescents according to demographic, socioeconomic and body mass index (BMI) data. A cross-sectional population-based study analyzed a representative sample of 409 adolescents, aged 12-19 years, using the Healthy Eating Index (HEI). We estimated the prevalence of diets classified in the first quartile of the HEI and the average scores of each component of the HEI. Linear and Poisson multiple regressions were used in the analysis. The mean score of HEI was 59.7. We observed a lower prevalence of inadequate diets in the segment with heads of household presenting higher schooling. The lower socioeconomic status segments, measured by income and schooling, showed a lower consumption of vegetables, fruits, dairy products and a less diversified diet, and a higher intake of cereals and legumes. Overweight/obese adolescents consume more meat and eggs and less fruit compared to low weight/normal weight adolescents. Girls had a higher intake of total fat and lower sodium intake. The results identified diet components that deserve more attention in the strategies to promote healthy eating, and the more vulnerable segments among adolescents.153605616(2010) Child and adolescent health and development: Progress report 2009: Highlights, , World Health Organization, Geneva(2011) Ministério da Saúde, , Brasil, Secretaria de Vigilância em Saúde. Departamento de Análise de Situação de Saúde. Plano de ações estratégicas para o enfrentamento das doenças crônicas não transmissíveis (DCNT) no Brasil 2011-2022. BrasíliaLevy, R.B., Castro, I.R.R., Cardoso, L.O., Tavares, L.F., Sardinha, L.M.V., Gomes, F.S., Consumo e comportamento alimentar entre adolescentes brasileiros: Pesquisa Nacional de Saúde do Escolar (PeNSE), 2009 (2010) Rev Cien Saúde Colet, 15 (S2), pp. 3085-3097Toral, N., Slater, B., Cintra, I.P., Fisberg, M., Comportamento alimentar de adolescentes em relação ao consumo de frutas e verduras (2006) Rev Nutr, 19 (3), pp. 331-340(2011) Pesquisa de Orçamentos Familiares-2008-2009: Análise do consumo alimentar pessoal no Brasil, , Instituto Brasileiro de Geografia e Estatística, Rio de Janeiro(2010) Pesquisa de Orçamentos Familiares-2008-2009: Antropometria e estado nutricional de crianças, adolescentes e adultos no Brasil, , Instituto Brasileiro de Geografia e Estatística, Rio de JaneiroCervato, A.M., Vieira, V.L., Índices dietéticos na avaliação da qualidade global da dieta (2003) Rev Nutr, 16 (3), pp. 347-355Kennedy, E.T., Ohls, J., Carlson, S., Fleming, K., The Healthy Eating Index: Design and applications (1995) J Am Diet Assoc, 95, pp. 1103-1108Fisberg, R.M., Slater, B., Barros, R.R., Lima, F.D., Cesar, C.L.G., Carandina, L., Índice de Qualidade da Dieta: Avaliação da adaptação e aplicabilidade (2004) Rev Nutr, 17 (3), pp. 301-308Alves, M.C.G.P., Plano de amostragem (2008) As dimensões da saúde: Inquérito populacional em Campinas, pp. 46-55. , In: Barros MBA, Cesar CLG, Carandina L, Goldbaum M, org, São Paulo: Aderaldo & RothschildGodoy, F.C., Andrade, S.C., Morimoto, J.M., Carandina, L., Goldbaum, M., Barros, M.B.A., Índice de qualidade da dieta de adolescentes residentes no distrito do Butantã, município de São Paulo, Brasil (2006) Rev Nutr, 19 (6), pp. 663-671Thompson, F.E., Byers, T., Dietary assessment resource manual (1994) J Nutr, (124 S), pp. 2245-2317de Onis, M., Onyango, A.W., Borghi, E., Siyam, A., Nishida, C., Siekmann, J., Development of a WHO growth reference for school-aged children and adolescents (2007) Bull World Health Organ, 85, pp. 660-667Nielsen, S.J., Adair, L., An alternative to dietary data exclusions (2007) J Am Diet Assoc, 107, pp. 792-799de Andrade, S.C., Barros, M.B.A., Carandina, L., Goldbaum, M., Cesar, C.L.G., Fisberg, R.M., Dietary Quality Index and associated factors among adolescents of the State of Sao Paulo, Brazil (2010) J Peds, 156 (3), pp. 456-460Pinheiro, A.C., Atalah, E., Propuesta de una metodología de análisis de la calidad global de la alimentación (2005) Rev Méd Chile, 133 (2), pp. 175-182Fernández, I., Aguilar Vilas, M.V., Mateos Vega, C.J., Martínez Para, M.C., Calidad de la dieta de una población de jóvenes de Guadalajara (2009) Nutr Hosp, 24, pp. 200-206Goodwin, D.K., Knol, L.K., Eddy, J.M., Fitzhugh, E.C., Kendrick, O., Donohue, R.E., Sociodemographic correlates of overall quality of dietary intake of US adolescents (2006) Nutr Res, 26, pp. 105-110Garriguet, D., Diet quality in Canada (2009) Stat Canada, 20 (3), pp. 1-12Gomes, M.A., Pereira, M.L.D., Família em situação de vulnerabilidade social: Uma questão de políticas públicas (2005) Cien Saúde Colet, 10 (2), pp. 357-363Levy-Costa, R.B., Sichieri, R., Pontes, N.S., Monteiro, C.A., Disponibilidade domiciliar de alimentos no Brasil: Distribuição e evolução (2005) Rev Saúde Pública, 39 (4), pp. 530-540Fisberg, R.M., Morimoto, J.M., Bueno, M.B., Hábito alimentar: Qualidade da dieta (2008) As dimensões da saúde, pp. 59-66. , In: Barros MBA, Cesar CLG, Carandina L, Goldbaum M (org), Inquérito populacional em Campinas. São Paulo: Aderaldo & RothschildOrtiz-Hernández, L., Gómez-Tello, B.L., Food consumption in Mexican adolescents (2008) Rev Panam Salud Publica/Pan Am J Public Health, 24 (2), pp. 127-135Riediger, N.D., Shooshtari, S., Moghadasian, M.H., The influence of sociodemographic factors on patterns of fruit and vegetable consumption in Canadian adolescents (2007) J Am Diet Assoc, 107, pp. 1511-1518Panigassi, G., Segall-Corrêa, A.M., Marin-León, L., Pérez-Escamilla, R., Maranha, L.K., Sampaio, M.F.A., Insegurança alimentar intrafamiliar e perfil de consumo de alimentos (2008) Rev Nutr, 21 (S), pp. 135-144Lorson, B.A., Melgar-Quinonez, H.R., Taylor, C.A., Correlates of fruit and vegetable intakes in US children (2009) J Am Diet Assoc, 109, pp. 474-478Amin, T.T., Al-Sultan, A.I., Ali, A., Overweight and obesity and their relation to dietary habits and sócio-demographic characteristics among male primary school children in Al-Hassa, Kingdom of Saudi Arabia (2008) Eur J Nutr, 47 (6), pp. 310-318(2006) Ministério da Saúde, p. 210. , Brasil, Secretaria de Atenção à Saúde. Coordenação-Geral da Política de Alimentação e Nutrição. Guia alimentar para a população brasileira: promovendo a alimentação saudável. BrasíliaRolls, B.J., Ello-Martin, J.A., Tohill, B.C., What can intervention studies tell us about the relationship between fruit and vegetable consumption and weight management? (2004) Nutr Rev, 62 (1), pp. 1-17Villa, I., Yngve, A., Poortvliet, E., Grjibovski, A., Liiv, K., Sjöström, M., Dietary intake among under-, normal-and overweight 9-and 15-year-old Estonian and Swedish schoolchildren (2007) Public Health Nutr, 10 (3), pp. 311-322Winham, D., Webb, D., Barr, A., Beans and good health (2008) Nutr Today, 43 (5), pp. 201-209Feskanich, D., Rockett, H.R.H., Colditz, G.A., Modifying the Healthy Eating Index to assess diet quality in children and adolescents (2004) J Am Diet Assoc, 104 (9), pp. 1375-1383Brown, I.J., Tzoulaki, I., Candeias, V., Elliott, P., Salt intakes around the world: Implications for public health (2009) Int J Epidemiol, 38 (9), pp. 791-813Sarno, F., Claro, R.M., Levy, R.B., Bandoni, D.H., Ferreira, S.R.G., Monteiro, C.A., Estimativa de consumo de sódio pela população brasileira, 2002-2003 (2009) Rev Saúde Pública, 43 (2), pp. 219-225(2011) Consea acompanhará acordos para redução de sódio e gordura nos alimentos, , http://portal.saude.gov.br/portal/aplicacoes/noticias/default.cfm?pg=dspDetalheNoticia&id_area=124&CO_NOTICIA=12686, Ministério da Saúde, [Acessado em 4 de julho de], Disponível emSousa, M.H., Silva, N.N., Estimativas obtidas de um levantamento complexo (2003) Rev Saúde Pública, 37 (5), pp. 662-670Fisberg, R.M., Martini, L.A., Slater, B., Métodos de inquéritos alimentares (2005) Inquéritos alimentares: Métodos e bases científicos, pp. 1-31. , In: Fisberg RM, Slater B, Marchioni DML, Martini LA, São Paulo: Editora ManoleWillett, W.C., (1998) Nutritional epidemiology, , 2nd ed. New York: Oxford University PressJúnior, J.C.F., Validade das medidas autorreferidas de peso e estatura para o diagnóstico do estado nutricional de adolescentes (2007) Rev Bras Saúde Matern Infant, 7 (2), pp. 167-174Fonseca, H., Silva, A.M., Matos, M.G., Esteves, I., Costa, P., Guerra, A., Validity of BMI based on self-reported weight and height in adolescents (2010) Acta Paediatrica, 99 (1), pp. 83-88Waijers, P.M.C.M., Feskens, E.J.M., Ocké, M.C., A critical review of predefined diet quality scores (2007) Br J Nutr, 97 (2), pp. 219-23

Health Related Quality Of Life Among The Elderly: A Population-based Study Using Sf-36 Survey [qualidade De Vida Relacionada á Saúde Em Idosos, Avaliada Com O Uso Do Sf-36 Em Estudo De Base Populacional]

As life expectancy continues to rise, one of the greatest challenges of public health is to improve the quality of later years of life. The aim of this present study was to analyze the quality of life profile of the elderly across different demographic and socioeconomic factors. A cross-sectional study was carried out in two stages, involving 1,958 individuals aged 60 years or more. Health related quality of life (HRQOL) was assessed using the SF-36 questionnaire. The lowest scores were found among measures for vitality, mental health and general health and the highest among factors including social functioning and role limitations due to emotional and physical factors. HRQOL was found to be worse among women, in individuals at advanced ages, those who practiced evangelical religions and those with lower levels of income and schooling. The greatest differences in SF-36 scores between the categories were observed in functional capacity and physical factors. The results suggest that healthcare programs for the elderly should take into account the multi-dimensionality of health and social inequalities so that interventions can target the most affected elements of HRQOL as well as the most vulnerable subgroups of the population.251021592167Barros, M.B.A., César, C.L.G., Carandina, L., Torre, G.D., Desigualdades sociais na prevalência de doenças crônicas no Brasil, PNAD-2003 (2006) Ciênc Saúde Cole-tiva, 11, pp. 911-26Ramos, L.R., Fatores determinantes do envelheci-mento saudável em idosos residentes em centrourbano (2003) Cad Saúde Pública, 19, pp. 793-8. , Projeto Epidoso, São PauloBowling, A., Brazier, J., Quality of life in social science and medicine (1995) Soc Sci Med, 41, pp. 1337-8Position paper from the World Health Organization (1995) The World Health Organization Quality of Life As-sessment (whoqol), 41, pp. 1403-9Seidl, E.M.F., Zannon, C.M.L.C., Qualidade de vida e saúde: Aspectos conceituais e metodológicos (2004) Cad Saúde Pública, 20, pp. 580-8(2000) Measuring Health Days, , Centers for Disease Control and Prevention, Atlanta: Centers for Disease Control and PreventionIdler, E.L., Benyamini, Y., Self-rated health and mortality: A review of twenty-seven community studies (1997) J Health Soc Behav, 38, pp. 21-37Viacava, F., Informações em saúde: A importância dos inquéritos populacionais (2002) Ciênc Saúde Coletiva, 7, pp. 607-21Ware, J.E., Gandek, B., Overview of the SF-36 Health Survey and International Quality of Life Assessment (IQOLA) project (1998) J Clin Epidemiol, 51, pp. 903-12Tsay, S.Y., Chi, L.Y., Lee, C.H., Chou, P., Health-related quality of life as a predictor of mortality among community-dwelling older persons (2007) Eur J Epidemiol, 22, pp. 19-26Ciconelli, R.M., Ferraz, M.B., Santos, W., Meinão, I., Qua-Resma, M.R., Tradução para a língua portuguesa e validação do questionário genérico de avaliação de qualidade de vida SF-36 (Brasil SF-36) (1999) Rev Bras Reumatol, 39, pp. 143-50Perkins, A.J., Stump, T.E., Monahan, P.O., McHorney, C.A., Assessment of differential item functioning for demographic comparisons in the MOS SF-36 health survey (2006) Qual Life Res, 15, pp. 331-48Wyss, K., Wagner, A.K., Whiting, D., Mtasiwa, D.M., Tanner, M., Gandek, B., Validation of the Kiswalhili version of the SF-36 Health Survey in a representative sample of an urban population in Tanzania (1999) Qual Life Res, 8, pp. 111-20Li, L., Wang, H.M., Shen, Y., Chinese SF-36 Health Survey: Translation, cultural adaptation, validation and normalization (2003) J Epidemiol Community Health, 57, pp. 259-65Cesar, C.L.G., (2005) Metodologia, pp. 37-46. , Ce ́sar CLG, Carandina L, Alves MCGP, Barros MBA, Goldbaum M, organizadores. Saúde e condição de vida em São Paulo. Inquérito multicêntrico de saúde no Estado de São Paulo, 2005 ISA-SP, São Paulo: Faculdade de Saúde Pública, Universidade de São PauloAlves, M.C.G.P., (2005) Plano De Amostragem, pp. 47-62. , In: César CLG, Carandina L, Alves MCGP, Barros MBA, Goldbaum M, organizadores. Saúde e condição de vida em São Paulo. Inquérito multicêntrico de saúde no Estado de São Paulo 2005 ISA-SP, São Paulo: Faculdade de Saúde Pública, Universidade de São PauloHuang, I.-C., Wu, A.W., Frangakis, C., Do the SF-36 and WHOQOL-BREF measure the same constructs? Evidence from the Taiwan population (2006) Qual Life Res, 15, pp. 15-24Lam, C.L.K., Gandek, B., Ren, X.S., Chan, M.S., Tests of scaling assumptions and construct validity of the Chinese (HK) version of the SF-36 Health Survey (1998) J Clin Epidemiol, 51, pp. 1139-47Leplège, A., Escosse, E., Verdier, A., Pernerger, T.V., The French SF-36 Health Survey: Translation, cultural adaptation and preliminary psychometric evaluation (1998) J Clin Epidemiol, 51, pp. 1013-23Dachs, J.N.W., Santos, A.P.R., Auto-avaliação do estado de saúde no Brasil: Análise dos dados da PNAD/2003 (2006) Ciênc Saúde Coletiva, 11, pp. 887-94Szwarcwald, C.L., Souza-Júnior, P.R.B., Esteves, M.A.P., Damacena, G.N., Viacava, F., Socio-demographic determinants of self-rated health in Brazil (2005) Cad Saúde Pública, 21, pp. S54-64. , SupplBeltrão, K.I., Sugahara, S., Comparação de infor-mações sobre saúde das populações brasileira e norte-americana baseada em dados da PNAD/98e USA NHIS/96 (2002) Ciênc Saúde Coletiva, 7, pp. 841-67Barros, M.B.A., (2005) Auto-avaliação De Saúde, pp. 173-82. , In: César CLG, Carandina L, Alves MCGP, Barros MBA, Gold-baum M, organizadores. Saúde e condição de vida em São Paulo. Inquérito multicêntrico de saúde no Estado de São Paulo 2005 ISA-SP, São Paulo: Faculdade de Saúde Pública, Universidade de São PauloPinheiro, R.S., Viacava, F., Travassos, C., Brito, A.S., Gê-nero, morbidade, acesso e utilização de services de saúde no Brasil (2002) Ciênc Saúde Coletiva, 7, pp. 687-707Dachs, J.N.W., Determinantes das desigualdades na auto-avaliação do estado de saúde no Brasil: Análi-se dos dados da PNAD/1998 (2002) Ciênc Saúde Coletiva, 7, pp. 641-57Franks, P., Gold, M.R., Fiscella, K., Sociodemographics, self-rated health and mortality in US (2003) Soc Sci Med, 56, pp. 2505-14Amorim, V.M.S.L., Barros, M.B.A., Cã©sar, C.L.G., Carandi-Na, L., Goldbaum, M., Fatores associados à não rea-lização do exame de Papanicolaou: Um estudo debase populacional no Município de Campinas, São Paulo, Brasil (2006) Cad Saúde Pública, 22, pp. 2329-38Zaitune, M.P.A., Barros, M.B.A., Cã©sar, C.L.G., Carandi-Na, L., Goldbaum, M., Hipertensão arterial em ido-sos: Prevalência, fatores associados e práticas decontrole no Município de Campinas, São Paulo, Brasil (2006) Cad Saúde Pública, 22, pp. 285-94Moreira-Almeida, A., Neto, F.L., Koenig, H.G., Reli-giousness and mental health: A review (2006) Rev Bras Psiquiatr, 28, pp. 242-50Botega, N.J., Barros, M.B.A., Oliveira, H.B., Dalgalarron-Do, P., Marín-León, L., Suicidal behavior in the community: Prevalence and factors associated with suicidal ideation (2005) Rev Bras Psiquiatr, 27, pp. 45-53Barros, M.B.A., Botega, N.J., Dalgalarrondo, P., Marín-León, L., Oliveira, H.B., Prevalence of alcohol abuseand associated factors in a population-based study (2007) Rev Saúde Pública, 41, pp. 502-9Lima-Costa, M.F., Barreto, S., Giatti, L., Uchôa, E., De-sigualdade social e saúde entre idosos brasilei-ros: Um estudo baseado na Pesquisa Nacional por Amostras de Domicílios (2003) Cad Saúde Pública, 19, pp. 745-57Lima-Costa, M.F., Veras, R., Saúde pública e envelhe-cimento (2003) Cad Saúde Pública, 19, pp. 700-1(2005) Uma Política De Saúde, , Organização Mundial da Saúde. Envelhecimento ativo, Brasília: Organização Pan-Americana da Saúd

Prevalence of chronic obstructive pulmonary disease and risk factors in Sao Paulo, Brazil, 2008-2009

OBJECTIVE: To assess the prevalence of chronic obstructive pulmonary disease and related risk factors. METHODS:A population-based cross-sectional study with 1,441 individuals of both sexes aged 40 years or more was conducted in the city of Sao Paulo, Brazil, between 2008 and 2009. A two-stage (census tract, household) cluster random sampling stratified by sex and age was used and data was collected through home interviews. Multiple Poisson regression was used in the adjusted analysis. RESULTS: Of all respondents, 4.2% (95%CI: 3.1;5.4) reported chronic obstructive pulmonary disease. After adjustment the following factors were found independently associated with self-reported chronic obstructive pulmonary disease: number of cigarettes smoked in their lifetime (>1,500 vs. none) (PR=3.85; 95%CI: 1.87;7.94); easily fatigued (yes vs. no) (PR=2.61; 95%CI: 1.39;4.90); age (60;69 vs. 50;59) (PR 3.27; 95%CI: 1.01;11.24); age (70 and over vs. 50;59) (PR 4.29; 95%CI: 1.30;11.29); health conditions in the last 15 days (yes vs. no) (PR=1.31; 95%CI: 1.02;1.77); leisure-time physical activity (yes vs. no) (PR-0.57; 95%CI: 0.26;0.97). CONCLUSIONS: The prevalence of chronic obstructive pulmonary disease is high in the population studied and is associated with smoking and age over 60. Frequent health conditions and low leisure-time physical activity are a consequence of the disease.45588789

Spatial distribution of elderly individuals in a medium-sized city in Sao Paulo State, Brazil, according to key socio-demographic and morbidity characteristics

Geographic Information Systems serve as important public health tools for analyzing population disease distribution and thus for identifying individuals with chronic non-communicable diseases. The current study performed a spatial analysis of the distribution of the population 60 years and older in the city of Botucatu, Sao Paulo State, Brazil, studying the socio-demographic profile and the presence of diabetes mellitus and arterial hypertension. Data were analyzed from 468 elderly individuals from a population survey conducted in 2001-2002. Elders with the highest socioeconomic status live in the census tracts with the highest social strata, as proven statistically by spatial analysis techniques for income and schooling. No spatial distribution pattern was found for elderly individuals with hypertension and diabetes, who were located heterogeneously on the map. The study suggests the use of geoprocessing techniques for digital mapping of areas covered by primary health care units, aimed at better monitoring of the distribution of elderly individuals with chronic diseases and their care by health professionals.251778

Plasmapheresis in the treatment of myasthenia gravis: Retrospective study of 26 patients

We analyzed the experience of Unicamp Clinical Hospital with plasma exchange (PE) therapy in myasthenia gravis (MG). About 17.8% of a totality of MG patients had PE performed: 26 cases, 19 women and seven men. The mean age-onset of MG was 28 years, extremes 11 and 69. Minimum deficit observed in the group was graded IIb (O & G) or IIIa (MGFA scale). One patient had prethymectomy PE. In seven the procedures were performed due to myasthenic crisis and in 18 patients due to severe myasthenic symptoms or exacerbation of previous motor deficit. Two patients were also submitted to chronic PE considering refractoriness to other treatments. Twenty-six patients had 44 cycles of PE and 171 sessions. The mean number of sessions was 3.9 (SD +/- 1.4) each cycle; median 5, extremes 2 and 6. The mean time by session was 106,5 minutes (SD +/- 35.2); median 100.5 (extremes of 55 and 215). The mean volume of plasma exchanged in each session was 2396 ml (SD +/- 561); median 2225 (extremes 1512 and 4500). Side effects occurred: reversible hypotension (seven cases), mild tremor or paresthesias (seven cases). infection and mortality rates due to PE were zero. All patients had immediate benefit of each PE cycle and usually they also received prednisone or other immunosuppressors. Good acceptance of the procedure was observed in 80.7% of patients.622B39139

Psychobiological evidence of the stress resilience fostering properties of a cosmetic routine

Everyday life psychosocial stressors contribute to poor health and disease vulnerabilty. Means alternative to pharmacotherapy that are able to foster stress resilience are more and more under the magnifying glass of biomedical research. The aim of this study was to test stress resilience fostering properties of the self-administration of a cosmetic product enriched with essential oils. On day 0, fourty women, 25-50 years old, self-administered both the enriched cosmetic product (ECP) and a placebo one (PCP). Then, women were randomized for daily self-administration (from day 1 to 28) of either ECP

Phase II study of capecitabine-based concomitant chemoradiation followed by durvalumab as a neoadjuvant strategy in locally advanced rectal cancer: the PANDORA trial

Background: This study investigated the efficacy of chemoradiotherapy (CRT) followed by durvalumab as neoadjuvant therapy of locally advanced rectal cancer.Patients and methods: The PANDORA trial is a prospective, phase II, open-label, single-arm, multicenter study aimed at evaluating the efficacy and safety of preoperative treatment with durvalumab (1500 mg every 4 weeks for three administrations) following long-course radiotherapy (RT) plus concomitant capecitabine (5040 cGy RT in 25-28 fractions over 5 weeks and capecitabine administered at 825 mg/m2 twice daily). The primary endpoint was the pathological complete response (pCR) rate; secondary endpoints were the proportion of clinical complete remissions and safety. The sample size was estimated assuming a null pCR proportion of 0.15 and an alternative pCR proportion of 0.30 (a = 0.05, power = 0.80). The proposed treatment could be considered promising if >= 13 pCRs were observed in 55 patients (EudraCT: 2018-004758-39; NCT04083365).Results: Between November 2019 and August 2021, 60 patients were accrued, of which 55 were assessable for the study's objectives. Two patients experienced disease progression during treatment. Nineteen out of 55 eligible patients achieved a pCR (34.5%, 95% confidence interval 22.2% to 48.6%). Regarding toxicity related to durvalumab, grade 3 adverse events (AEs) occurred in four patients (7.3%) (diarrhea, skin toxicity, transaminase increase, lipase increase, and pancolitis). Grade 4 toxicity was not observed. In 20 patients (36.4%), grade 1-2 AEs related to durvalumab were observed. The most common were endocrine toxicity (hyper/hypothyroidism), dermatologic toxicity (skin rash), and gastrointestinal toxicity (transaminase increase, nausea, diarrhea, constipation).Conclusion: This study met its primary endpoint showing that CRT followed by durvalumab could increase pCR with a safe toxicity profile. This combination is a promising, feasible strategy worthy of further investigation