Association between C-reactive protein with all-cause mortality in ELSA-Brasil cohort

Background: High-sensitive C-reactive protein (hsCRP) has been proposed as a marker of incident cardiovascular disease and vascular mortality, and it may also be a marker of non-vascular mortality. However, most evidence comes from either North American or European cohorts. The present proposal aims to investigate the association of high-sensitive C-reactive protein with the risk of all-cause mortality in a multi-ethnic Brazilian population Methods: Cohort data from baseline (2008–2010) of 14 792 subjects participating in the Brazilian Longitudinal Study of Adult Health were used. HsCRP was assayed with Immunochemistry. The association of baseline covariates with all-cause mortality was calculated by Cox regression for univariate model and adjusted for different confounders after mean follow-up of 8.0 ± 1.1 years. The final model was adjusted for age, sex, self-rated race/ethnicity, schooling, health behaviours and prevalent chronic disease. Results: The risk of death increased steadily by quartiles of hsCRP from 1.45 (95% Confidence Interval: 1.05, 2.01) in Quartile 2 to 1.95 (1.42, 2.69) in Quartile 4 compared to Quartile 1. Furthermore, the persistence of a significant graded association after the exclusion of deaths in the first year of follow-up suggests that these results are unlikely to be due to reverse causality. Finally, the hazard ratios were unaffected by the exclusion of participants that had self-reported past medical history for diabetes, cancer and chronic obstructive pulmonary disease. Conclusions: Our study shows that hsCRP levels is associated with mortality in a highly admixed population, independently of a large set of lifestyle and clinical variables

Tabagismo entre trabalhadores de empresa bancária

OBJECTIVE: To describe the prevalence of cigarette smoking and its association with other risk factors for chronic diseases among active workers of communication and data processing centers of a Bank. METHODS: Cross-sectional study in a simple random sample of 647 active workers of the bank. The data were collected in the work environment, through self-administered questionnaires. RESULTS: The prevalence of cigarette smoking was 29.5% (95% Confidence Interval (CI): 27.5%-31.5%), 31.1% (95%CI: 26.2%-35.8%) among men and 27.8% (95%CI: 22.6%-32.9%) among women. On average, males started smoking at the age of 17.6 years and women at the age of 19.4. High prevalence of heavy smokers was observed among men and women (53% and 42%, respectively, smoked more than 20 cigarettes per day). Smokers were older, more likely to be divorced, separated and widowed, to have high blood pressure, to drink alcoholic beverages more often, and to exercise less often than to non-smokers. Those who gave up smoking were older, drank more alcoholic beverages, and were more often overweight. CONCLUSION: The considerable frequency of smoking and other risk factors for chronic diseases among those workers may be an indication of the need for new strategies for health interventions. Opportunities for preventive actions, which are more effective and less costly, may have been lost.OBJETIVO: Descrever a prevalência de tabagismo e sua associação com outros fatores de risco para doenças crônicas entre funcionários dos centros de processamentos de serviços e comunicações de uma empresa bancária. MÉTODO: Estudo seccional de amostra aleatória simples de 647 funcionários, através de questionário auto-respondido no ambiente de trabalho. RESULTADOS: A prevalência de tabagismo foi de 29,5% (Intervalo de Confiança (IC) 95%: 27,5% a 31,5%), sendo 31,1% (IC 95%: 26,2% a 35,8%) entre homens e 27,8% (IC 95%: 22,6% a 32,9%) entre mulheres. O início do hábito ocorreu, em média, aos 17,6 anos entre os homens e 19,4 anos entre as mulheres. Observou-se alta prevalência de grandes fumantes entre homens e mulheres (53% e 42% respectivamente fumavam mais de 20 cigarros por dia). A freqüência de tabagismo foi maior nos mais velhos, nos divorciados separados e viúvos, nos hipertensos, naqueles que consumiam mais bebidas alcoólicas, e nos que não praticavam exercícios físicos. Comparados aos não-fumantes, os ex-fumantes eram mais velhos, consumiam mais bebidas alcoólicas e apresentavam maior freqüência de sobrepeso. CONCLUSÃO: A freqüência de tabagismo e de outros fatores de risco para as doenças crônicas, nesta categoria de trabalhadores, aponta para a necessidade de repensar estratégias das ações de saúde atualmente desenvolvidas. Oportunidades de intervenções preventivas mais eficazes e de menor custo podem estar sendo perdidas

Tissue-specific conditional PKCε knockout mice: a model to precisely reveal PKCε functional role in initiation, promotion and progression of cancer

PKCε is a transforming oncogene and a predictive biomarker of various human cancers. However, a precise in vivo link of PKCε to cancer induction, progression and metastasis remain undefined. To achieve these goals, we generated tissue specific conditional PKCε knockout mice (PKCε-CKO) using cre-lox technology. Homozygous PKCεLoxP/LoxP mice have normal body weight and phenotype. To determine what effect loss of PKCε would have on the prostate, the PKCεLoxP/LoxP mice were bred to probasin cre (PB-Cre4+) mice which express cre specifically in the prostate epithelium of postnatal mice. Western blot and immunohistochemical analyses showed reduced levels of PKCε specifically in the prostate of PKCε-CKO mice. Histopathological analyses of prostate from both PKCεLoxP/LoxP and prostate PKCε-CKO mice showed normal pathology. To determine the functional impact of prostate specific deletion of PKCε on prostate tumor growth, we performed an orthotopic xenograft study. Transgenic adenocarcinoma of the mouse prostate (TRAMP) cells (TRAMPC1, 2×106) were implanted in the prostate of PKCε-CKO mice. Mice were sacrificed at 6th week post-implantation. Results demonstrated a significant (P\u3c0.05) decrease in the growth of TRAMPC1 cells-derived xenograft tumors in PKCε-CKO mice compared to wild type. To determine a link of PKCε to ultraviolet radiation (UVR) exposure-induced epidermal Stat3 phosphorylation, PKCεLoxP/LoxP mice were bred to tamoxifen-inducible K14 Cre mice. PKCε deletion in the epidermis resulted in inhibition of UVR-induced Stat3 phosphorylation. In summary, our novel PKCεLoxP/LoxP mice will be useful for defining the link of PKCε to various cancers in specific organ, tissue, or cells

Transcultural adaptation to the Brazilian Portuguese of the Postpartum Bonding Questionnaire for assessing the postpartum bond between mother and baby

The establishment of the bond between mother and baby in the postpartum period is important for ensuring the physical and psychological health of both. This short communication reports the first phase of the cross-cultural translation and adaptation to the Brazilian context of the Postpartum Bonding Questionnaire (PBQ). Four aspects of equivalence between the original scale and the Portuguese version were evaluated: the conceptual, semantic, operational and item equivalences. Literature review, the study of PBQ history, translation, expert evaluation, back-translation and pretests involving 30 mothers with children aging up to 7 months using a primary healthcare unit were conducted. Each step demonstrated the need for adjustments, which were made during the adaptation process. At the end of the study, a version of PBQ in Brazilian Portuguese equivalent to the original one was obtained, offering promise for national studies on the mother-baby bond, and its influence on health, and for use in health services

Adaptação transcultural de escalas de discriminação e vigilância no ELSA-Brasil

OBJECTIVE: To describe the process of cross-cultural adaptation for the use in Brazil of the Everyday Discrimination Scale (EDS) and the Heightened Vigilance Scale (HVS) applied in the Longitudinal Study of Adult Health (ELSA-Brasil). METHODS: Conceptual, item and semantic equivalence analyses were conducted by a group of four epidemiologists; evaluation of measurement equivalence (factorial analysis of configural, metric and scalar structures, according to sociodemographic characteristics) and reliability. A total of 11,987 participants responded to the discrimination scale, and a subsample of 260 people participated in the test-retest study. In the case of HVS, 8,916 people responded, while 149 individuals did so in the test-retest study. RESULTS: The scales presented conceptual, item and semantic equivalence pertinent in the Brazilian context, in addition to adequate correspondence of referential/denotative meaning of terms and also of the general/connotative of the items. The confirmatory factor analysis of EDS revealed a unidimensional structure, with residual correlations between two pairs of items, presenting configural and metric invariance among the four subgroups evaluated. Scalar invariance was identified according to sex and age group, but it was not observed for race/color and education. Heightened vigilance showed low loads and high residuals, with inadequate adjustment indicators. For the items of the discrimination scale the weighted kappa coefficient (Kp) ranged from 0.44 to 0.78, and the intraclass correlation coefficient (ICC) was 0.87. For HVS items, the Kp ranged from 0.47 to 0.59 and the ICC was 0.83. CONCLUSIONS: Although there are correlated items, it was concluded that the EDS is a promising scale to evaluate experiences of perceived discrimination in Brazilian daily life. However, the heightened vigilance scale did not present equivalence of measurement in the current format.OBJETIVO: Descrever o processo de adaptação transcultural para o uso no Brasil das escalas de discriminação no dia a dia (EDD) e vigilância intensificada (EVI), aplicadas no Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil). MÉTODOS: Foram realizadas análises das equivalências conceitual, de itens e semântica conduzidas por um grupo de quatro epidemiologistas; avaliação da equivalência de mensuração (análise fatorial das estruturas configural, métrica e escalares, segundo características sociodemográficas) e a confiabilidade. Responderam à escala de escala de discriminação 11.987 participantes e uma subamostra de 260 pessoas participaram do estudo teste-reteste. No caso da EVI, 8.916 pessoas responderam e 149 indivíduos no estudo teste-reteste. RESULTADOS: As escalas apresentaram equivalências conceitual, de itens e semântica pertinentes no contexto brasileiro, além de adequada correspondência de significado referencial/denotativa de termos e também da geral/conotativa dos itens. A análise fatorial confirmatória da EDD revelou estrutura unidimensional, com correlações residuais entre dois pares de itens, apresentando invariância configural e métrica entre os quatro subgrupos avaliados. Identificou-se invariância escalar segundo sexo e faixa etária, mas não foi observada para recortes de raça/cor e escolaridade. A vigilância intensificada apresentou cargas baixas e resíduos altos, com indicadores de ajuste inadequados. Para os itens da escala de discriminação o coeficiente de concordância kappa ponderado (Kp) variou de 0,44 a 0,78, e o Coeficiente de Correlação Intraclasse (CCI) foi 0,87. Para os itens da EVI, o Kp variou de 0,47 a 0,59 e o CCI foi 0,83. CONCLUSÕES: Embora haja itens correlacionados, concluiu-se que a EDD é uma escala promissora para avaliar experiências de discriminação percebidas no cotidiano brasileiro. Entretanto, a escala de vigilância intensificada não apresentou equivalência de mensuração no formato atual