Prevalence and correlates of inadequate glycaemic control: results from a nationwide survey in 6,671 adults with diabetes in Brazil

Diabetes is a significant public health burden on the basis of its increased incidence, morbidity, and mortality. This study aimed to estimate the prevalence of inadequate glycaemic control and its correlates in a large multicentre survey of Brazilian patients with diabetes. A cross-sectional study was conducted in a consecutive sample of patients aged 18 years or older with either type 1 or type 2 diabetes, attending health centres located in ten large cities in Brazil (response rate = 84%). Information about diabetes, current medications, complications, diet, and satisfaction with treatment were obtained by trained interviewers, using a standardized questionnaire. Glycated haemoglobin (HbA1c) was measured by high-performance liquid chromatography in a central laboratory. Patients with HbA1c ≥ 7 were considered to have inadequate glycaemic control. Overall 6,701 patients were surveyed, 979 (15%) with type 1 and 5,692 (85%) with type 2 diabetes. The prevalence of inadequate glycaemic control was 76%. Poor glycaemic control was more common in patients with type 1 diabetes (90%) than in those with type 2 (73%), P < 0.001. Characteristics significantly associated with improved glycaemic control included: fewer years of diabetes duration, multi professional care, participation in a diabetes health education program, and satisfaction with current diabetes treatment. Despite increased awareness of the benefits of tight glycaemic control, we found that few diabetic patients in Brazil met recommended glycaemic control targets. This may contribute to increased rates of diabetic complications, which may impact health care costs. Our data support the public health message of implementation of early, aggressive management of diabetes

Prevalência e grau de desconforto de bexiga hiperativa numa área urbana no nordeste brasileiro

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2012-08-02T21:38:04Z No. of bitstreams: 1 Raimundo Celestino Silva Neves. Prevalência e grau de desconforto de bexiga hiperativa numa área urbana no Nordeste brasileiro - CPqGM - Dissertação de Mestrado - 2008.pdf: 741822 bytes, checksum: 52611300a032353b413d569d677cd039 (MD5)Made available in DSpace on 2012-08-02T21:38:04Z (GMT). No. of bitstreams: 1 Raimundo Celestino Silva Neves. Prevalência e grau de desconforto de bexiga hiperativa numa área urbana no Nordeste brasileiro - CPqGM - Dissertação de Mestrado - 2008.pdf: 741822 bytes, checksum: 52611300a032353b413d569d677cd039 (MD5) Previous issue date: 2008Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilEstimar a prevalência da síndrome de bexiga hiperativa (BH) e de outros sintomas referentes ao trato urinário inferior em uma amostra com base populacional de um grande centro urbano do nordeste brasileiro. Adicionalmente, pretendeu-se avaliar o impacto desses sintomas na qualidade de vida dos participantes, investigar possíveis fatores associados à prevalência de BH e descrever a busca por tratamento para essa síndrome. Métodos: A prevalência de BH foi avaliada segundo sua definição mais recente, estabelecida em 2002 ,pela Sociedade Internacional de Continência (SIC) e o inquérito domiciliar utilizou o método de amostragem estratificado em três estágios, abrangendo 17 regiões administrativas da cidade de Salvador. Os resultados são apresentados de acordo o sexo e a faixa etária. Resultados: Três mil indivíduos com idade ≥ 30 anos foram incluídos no estudo, sendo 1.500 homens e 1.500 mulheres (taxa de resposta de 82,9%). A prevalência de BH foi de 5,1% em homens e 10% em mulheres. Nicturia (≥ 1 por noite) esteve presente em 64,4% dos homens e 71,2% das mulheres, enquanto que a prevalência de nictúria (≥2 por noite) foi de 33,3% e 36,5%, respectivamente. Já a freqüência urinária aumentada foi descrita por 15,4% dos homens e 23,7% das mulheres. A maioria das pessoas com urgência, 80% dos homens e 78% das mulheres, relatou algum grau de desconforto em possuir esse sintoma e indivíduos com BH tiveram alto grau de depressão e ansiedade (p<0,001). Conclusão: Esse é o maior estudo epidemiológico com base populacional no Brasil e que utiliza as novas definições referentes ao trato urinário inferior, recomendadas pela SIC em 2002. O incômodo provocado nos indivíduos, o impacto na qualidade de vida e a prevalência dos sintomas de BH destacam a gravidade dessa síndrome.To estimate the prevalence of overactive bladder syndrome (OAB) and the other lower urinary tract symptoms (LUTS) in a sample of the big urban center in the Brazilian Northeastern. Additionally, to evaluate the impact of these symptoms in quality of life of participants, to investigate possible factors associates to the prevalence of OAB and to describe help seeking behaviors for urinary problems. Methods: The prevalence of OAB was evaluated according to your more recent definition established in 2002 for the International Continence Society (ICS) and the domiciliary inquiry used a three-step sampling method, enclosing 17 administrative regions of the city of Salvador. The results are presented according to gender and age cohort. Results: A total of three thousand individuals aged ≥ 30 years were analyzed in the study, (1,500 men and 1,500 women) with response rate of 82.9%. The prevalence of BH was 5.1% in men and 10% in women. Nocturia (≥ 1 time/ night) was present in 64.4% of men and 71.2% of the women, while that the prevalence of nocturia (≥ 2 time/ night) was 33.3% and 36.5%, respectively. However the increased frequency was described for 15,4% of men and 23.7% of the women. The majority of the people with urgency, 80% of men and 78% of the women, report any bother with symptom and OAB subjects had high level of depression and anxiety. Conclusion: This is the largest epidemiologic study with population-based in Brazil and that it uses the new definitions of the ICS of 2002. The bother provoked in the individuals, the impact in the quality of life and the prevalence of the LUTS salient the gravity of this syndrome

Incidência e fatores de risco de bexiga hiperativa em adultos: resultados de um estudo prospectivo de base populacional

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2012-08-31T17:10:26Z No. of bitstreams: 1 Raimundo Celestino_Silva_Neves Incidência e fatores de risco de bexiga.pdf: 998634 bytes, checksum: 5eb364aec58c2f9083b13aac7f6e675c (MD5)Made available in DSpace on 2012-08-31T17:10:26Z (GMT). No. of bitstreams: 1 Raimundo Celestino_Silva_Neves Incidência e fatores de risco de bexiga.pdf: 998634 bytes, checksum: 5eb364aec58c2f9083b13aac7f6e675c (MD5) Previous issue date: 2010Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, Bahia, BrasilEstudar a história natural de bexiga hiperativa (BH) numa amostra da população adulta em Salvador, estimando a incidência e a remissão de BH. Adicionalmente, avaliar o grau de desconforto e a gravidade dos sintomas nos indivíduos com esta condição, investigar seus fatores de risco e descrever o comportamento de procura por tratamento nos pacientes sintomáticos. Trata-se de um estudo longitudinal que coletou informações numa amostra representativa da população urbana de homens e mulheres com idade de 30 anos ou mais, acompanhados de 2006 a 2008. BH foi avaliada segundo sua definição vigente, estabelecida em 2002, pela Sociedade Internacional de Continência. A coorte contou com a participação de 1350 mulheres e 1424 homens. A incidência de BH foi estimada em 1,7/1 00 pessoas-ano no sexo feminino e de 1,4/1 00 pessoas-ano no sexo masculino, aumentando com a idade em ambos os sexos (p=0,04). As estimativas de remissão nas mulheres variaram de 42% a 52%, e no sexo masculino de 49% a 75%. O número de partos naturais foi diretamente associado ao risco de apresentar BH em mulheres, RR=3,66 (Le.95%, 1,34 - 9,96). Os homens com sobrepeso tiveram risco significativamente menor de desenvolver BH, RR=0,29 (LC. 95%, 0,13 - 0,68). O percentual de casos prevalentes de BH com muito ou total incômodo pelos sintomas urinários foi de 58% em mulheres e 37% em homens. Apesar disso, apenas 46% e 32% de mulheres e homens respectivamente, buscaram ajuda médica para seus sintomas. BH é uma desordem comum na população adulta em Salvador. A incidência de BH foi semelhante em ambos os sexos e aumentou com a idade. Nossas estimativas foram inferiores à de outros estudos prévios realizados em populações com idade média mais alta, formadas por pacientes de cadastros/registros médicos ou de inquéritos postais com baixa taxa de participação e seguimento. Nossas projeções indicam que cerca de um milhão de casos novos de BH ocorrem a cada ano no Brasil. Portanto, podemos considerar que esta condição é um problema de saúde pública e que programas para diagnostico, tratamento e prevenção de BH devem ser desenvolvidos e implantados.To study the natural history of overactive bladder (OAB) in a sample of adult population in Salvador, estimating the incidence and remission rates of OAB. In addition, to assess the discomfort and severity of symptoms in subjects with this condition, to investigate its risk factors and to describe the help seeking behavior for urinary symptoms. Methods: This is a longitudinal study that has collected information on a representative sample of urban men and women aged 30 years old or more, followed from 2006 to 2008. OAB was assessed according to the International Continence Society current definition. Results: The initial cohort included 1,350 women and 1,424 men. The incidence ofOAB was 1.7 per 100 person­ years for females and 1.4 per 100 person-years in males, and increased with age in both genders (p=0.04). Estimates of remission rated in women varied from 42% to 52% and in males from 49% to 75%. Parity was direct1y associated with the risk for OAB in women, RR=3.66 (95% CI, 1.34 - 9.96), and overweight men had a significantly lower risk of developing OAB, RR = 0.29 (95% CI, 0.13 to 0.68). The percentage of prevalent cases of BH with very or total bother by the urinary symptoms was 58% in women and 37% in men. However, only 46% and 32% of women and men respectively, sought medical help for their symptoms. Conclusions: The incidence of OAB was similar in both genders and increased with age. Our rates were lower than estimates from previous studies conducted in populations with higher mean age, comprised by patients from general practitioner registers or postal surveys with low response and follow-up rates. Our projections indicate that about one million new OAB cases occur each year in Brazi1. Thus, this condition can be considered a public health problem, and programs for diagnosis, treatment and prevention of BH should be developed and implemented

A population-based survey of sexual activity, sexual problems and associated help-seeking behavior patterns in mature adults in the United States of America

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2014-12-04T19:36:07Z No. of bitstreams: 1 Laumann EO A population based....pdf: 117616 bytes, checksum: 683e746e5c671cefa9e419592e0d841d (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2014-12-04T19:36:16Z (GMT) No. of bitstreams: 1 Laumann EO A population based....pdf: 117616 bytes, checksum: 683e746e5c671cefa9e419592e0d841d (MD5)Made available in DSpace on 2014-12-05T12:47:33Z (GMT). No. of bitstreams: 1 Laumann EO A population based....pdf: 117616 bytes, checksum: 683e746e5c671cefa9e419592e0d841d (MD5) Previous issue date: 2009University of Chicago. Department of Sociology. Chicago, USA.Pfizer Inc., New York, NY, USA.Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil.Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil.GSSAB Investigators’ Group.To study sexual activity, the prevalence of sexual dysfunction and related help-seeking behaviors among mature adults in the United States of America, a telephone survey was conducted in 2001–2002. A total of 1491 individuals (742 men/749 women) aged 40–80 years completed the survey. Overall, 79.4% of men and 69.3% of women had engaged in sexual intercourse during the 12months preceding the interview. Early ejaculation (26.2%) and erectile difficulties (22.5%) were the most common male sexual problems. A lack of sexual interest (33.2%) and lubrication difficulties (21.5%) were the most common female sexual problems. Less than 25% of men and women with a sexual problem had sought help for their sexual problem(s) from a health professional. Many men and women in the United States report continued sexual interest and activity into middle age and beyond. Although a number of sexual problems are highly prevalent, few people seek medical help

Assessment of knowledge and attitudes of young uninsured women toward human papillomavirus vaccination and clinical trials

Submitted by Éder Freyre ([email protected]) on 2011-07-06T13:55:29Z No. of bitstreams: 1 MoreiraJr_Oliveira_Neves_etal.pdf: 129799 bytes, checksum: 4f0c432c78987a96d8a8f784e495ddba (MD5)Made available in DSpace on 2011-07-06T13:55:29Z (GMT). No. of bitstreams: 1 MoreiraJr_Oliveira_Neves_etal.pdf: 129799 bytes, checksum: 4f0c432c78987a96d8a8f784e495ddba (MD5) Previous issue date: 2006Associação Obras Sociais Irmã Dulce. Núcleo de Apoio à Pesquisa. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / Hospital São Rafael. Diretoria Científica. Salvador, BA, BrasilAssociação Obras Sociais Irmã Dulce. Núcleo de Apoio à Pesquisa. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilLaboratórios Merck, Sharp & Dohme. São Paulo, SP, BrasilLaboratórios Merck, Sharp & Dohme. São Paulo, SP, BrasilLaboratórios Merck, Sharp & Dohme. São Paulo, SP, BrasilStudy Objective: To assess knowledge and attitudes of young uninsured women toward human papillomavirus (HPV) vaccination and clinical trials. Design: Cross-sectional study. Setting: Clinic-based sample in Brazil. Participants: A consecutive sample of 204 women aged 16 to 23 years, attending a public outpatient gynecological clinic. Interventions: A questionnaire administered by in-person interview. Main Outcome Measures: Data on knowledge and attitudes towards HPV vaccination. Results: Overall, 72% of the respondents would enroll in a HPV vaccine trial, despite the fact that 69% of women were ignorant of what HPV may cause, and only 10% acknowledged that HPV might lead to cervical cancer. The need of a placebo arm (31%) and three vaccinations injections (26%) were the trial design characteristics most cited for deterring participation. Factors promoting participation were ‘‘careful/detailed consultations by the same physician’’ (92%), ‘‘access to more information on women’s health’’ (84%), and ‘‘office visits on time’’ (79%); whereas ‘‘clinic too far from home’’ (36%), ‘‘fear of adverse events’’ (29%), and ‘‘gynecologic examination discomfort’’ (25%) were the most commonly reported reasons for not enrolling in a trial. Being sexually active, more than three lifetime sexual partners and perception of high risk for cervical cancer were predictors of participation in a HPV vaccine trial. Conclusions: Knowledge of HPV infection and cervical cancer is low in this urban, young population. Thus, when planning HPV vaccine trials, it is important to consider implementing educational programs to provide knowledge of the benefits of a preventive vaccine and information on the etiology of and risk factors for cervical cancer

Factors associated with high levels of glycated haemoglobin in patients with type 1 diabetes: a multicentre study in Brazil

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2018-02-20T12:40:04Z No. of bitstreams: 1 Andrade CS Factors associated with high levels....pdf: 487243 bytes, checksum: b0c8f3bbdc89c4504b1fe22c53eaa4da (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2018-02-20T12:54:05Z (GMT) No. of bitstreams: 1 Andrade CS Factors associated with high levels....pdf: 487243 bytes, checksum: b0c8f3bbdc89c4504b1fe22c53eaa4da (MD5)Made available in DSpace on 2018-02-20T12:54:05Z (GMT). No. of bitstreams: 1 Andrade CS Factors associated with high levels....pdf: 487243 bytes, checksum: b0c8f3bbdc89c4504b1fe22c53eaa4da (MD5) Previous issue date: 2017The Brazilian Study of Diabetes Control was funded by Pfizer, Brazil. CSA received scholarship from the Coordination for the Improvement of Higher Education Personnel (CAPES), Brazilian Ministry of Education. GSR and EDM received scholarships from the National Council for Scientific and Technological Development (CNPq).Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Escola de Nutrição. Salvador, BA, BrasilFundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, BA, BrasilFundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / State University of Feira de Santana. Department of Exact Sciences. Feira de Santana, BA, BrazilFundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, BrasilFundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Charitable Works Foundation of Sister Dulce. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, BrasilLong-term complications of type 1 diabetes mellitus (DM1) can be prevented with adequate glycaemic control. However, high levels of glycated haemoglobin (HbA1c) occur in 60%-90% of the patients with DM1. Thus, we aimed to investigate the role of sociodemographic, behavioural and clinical factors on the HbA1c levels of patients with DM1 in Brazil. Design, setting and participants A cross-sectional study was conducted in ambulatory patients with DM1 aged ≥18 years from 10 Brazilian cities. Sociodemographic, behavioural and clinical data were obtained through interviews. Main outcome measures HbA1c level was measured by liquid chromatography. Hierarchical multiple variable linear regression models were used to identify factors correlated with high levels of HbA1c. Results Of 979 patients with DM1, 63.8% were women, and the mean age was 40 (SD 14.6) years. The mean HbA1c level was 9.4% (SD 2.2%), and 89.6% of the patients had HbA1c ≥7.0%. Factors independently correlated with increased HbA1c levels included: lower education, non-participation in diabetes classes/lecture during the year before, having a self-perception of poor adherence to diet and insulin, not having private medical care and not measuring the HbA1c levels in the prior year. Of note, poor adherence to diet and insulin were the independent factors most strongly associated with high levels of HbA1c (mean increment in HbA1c levels of 0.88% and 1.25%, respectively). Conclusion Poor glycaemic control, which is common among Brazilian patients with DM1, is associated with lower education, self-perception of insufficient adherence to diet and insulin and inadequate monitoring of HbA1c levels. Specific actions, particularly those targeting improving adherence to diet and insulin, may contribute to successful management of patients with DM1

A population-based survey of lower urinary tract symptoms (LUTS) and symptom-specific bother: results from the Brazilian LUTS epidemiology study (BLUES)

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2014-11-05T13:13:56Z No. of bitstreams: 1 Moreira Jr ED A population based....pdf: 295603 bytes, checksum: b9abea021ff1fd1d03eae00ddd47be37 (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2014-11-05T13:14:37Z (GMT) No. of bitstreams: 1 Moreira Jr ED A population based....pdf: 295603 bytes, checksum: b9abea021ff1fd1d03eae00ddd47be37 (MD5)Made available in DSpace on 2014-11-05T13:30:43Z (GMT). No. of bitstreams: 1 Moreira Jr ED A population based....pdf: 295603 bytes, checksum: b9abea021ff1fd1d03eae00ddd47be37 (MD5) Previous issue date: 2013Centro de Pesquisa Clínica. Associação Obras Sociais Irmã Dulce. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / McGill University. Division of Cancer Epidemiology. Montreal, QC, Canada.Centro de Pesquisa Clínica. Associação Obras Sociais Irmã Dulce. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil.Universidade Estadual de Londrina. Faculdade de Medicina. Departamento de Cirurgia. Londrina, PR, Brasil.Centro de Pesquisa Clínica. Associação Obras Sociais Irmã Dulce. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil.Instituto Brasileiro de Geografia e Estatística. Salvador, BA, Brasil.Instituto Brasileiro de Geografia e Estatística. Salvador, BA, Brasil.Pfizer Inc. New York, NY, USAPURPOSE: To examine the prevalence of lower urinary tract symptoms (LUTS) and the bother they impose in a population-based sample of adults in Brazil. METHODS: A cross-sectional population-based survey was conducted between September 2006 and January 2007 in the city of Salvador, Brazil. Cluster samples of representative households were randomly selected for interviews. A structured questionnaire was administered to men and women aged 30 years or older by trained interviewers. Participants were asked about the presence of individual LUTS using current International Continence Society (ICS) definitions and rated their symptom bother. Those with overactive bladder (OAB) also responded the OAB-Validated 8 and the Patient Perception of Bladder Condition questionnaires. RESULTS: Of 3,616 eligible subjects, 3,000 (83%) participated (1,500 men and 1,500 women). OAB was present in 5.1% of men and in 10% of the women, while the prevalence of any LUTS was 81.5 and 84.1%, respectively. The majority of subjects with OAB, 80% of men and 78% of women, reported some bother associated with their urgency symptoms. Overall, storage symptoms were more common than voiding or postmicturition symptoms. Women reported storage symptoms (76.4%) more frequently than men (67.7%), while the opposite was true for voiding (men 39.7%, women 33.7%) and postmicturition (men 30.9%, women 12.8%). CONCLUSIONS: This is the largest population-based survey of LUTS in Brazil, using the 2002 ICS definitions. LUTS prevalence was high and increased with age among both genders in Brazil, whereas the rates of OAB were somewhat lower than previously reported. The high prevalence of urinary symptoms and the bother commonly associated with them highlight their importance to overall well-being

Glycemic control and its correlates in patients with diabetes in Venezuela: Results from a nationwide survey

Aims: To determine the prevalence of inadequate glycemic control and its correlates in a large multicenter survey of Venezuelan patients with diabetes.Methods: A cross-sectional study in a sample of adult patients with diabetes, attending health centers in Venezuela. Information about diabetes, current medications, complications, and diet were obtained by trained interviewers, using a standardized questionnaire. HbA(1c) was measured by high-performance liquid chromatography in a central laboratory. Patients with HbA(1c) >= 7% were considered to have inadequate glycemic control.Results: Overall 4075 patients were surveyed, 349(8.6%) with type 1 diabetes (T1D) and 3726(91.4%) with type 2 diabetes(T2D). Subjects' mean age was 58 years, and 65% were female. the prevalence of inadequate glycemic control was 76%. Poor glycemic control was more common in T1D patients (87%) than in those with T2D(75%), p < 10(-4). Satisfaction with current diabetes treatment was associated with improved glycemic control among non-insulin-treated patients with T2D, but gender, multi-professional care, and participation in a diabetes education program were not.Conclusions: Despite clinical evidence supporting tight control of diabetes, few diabetic patients in Venezuela met recommended glycemic control targets. This may contribute to increased rates of diabetic complications. Our findings support the public health message of implementation of early, aggressive management of diabetes. (C) 2009 Elsevier Ireland Ltd. All rights reserved.Venezuelan Endocrinology Society and La Federacion Nacional de Asociaciones y Unidades de Diabetes (FENADIABETES)Pfizer Inc., VenezuelaBrazilian Minist Hlth, Oswaldo Cruz Fdn, Goncalo Moniz Res Ctr, BR-40296 Salvador, BA, BrazilCharitable Works Fdn Sister Dulce, Clin Res Ctr, BR-40415 Salvador, BA, BrazilUniversidade Federal de São Paulo, BR-04023 São Paulo, BrazilPfizer Inc, BR-04717 São Paulo, BrazilCent Univ Venezuela, Caracas 1041A, VenezuelaUniversidade Federal de São Paulo, BR-04023 São Paulo, BrazilWeb of Scienc