Estimativa do Risco Global Cardiovascular e fatores associados na população adulta. Senador Canedo, Goiás

Background: Among chronic noncommunicable diseases (NCDs), Cardiovascular Diseases (CVD) are the main causes of premature mortality globally. The comprehensive care model focused on these diseases, presents as one of its components, the global cardiovascular risk screening (CVR).Objectives: To estimate cvR stratified by sociodemographic variables, as well as factors associated with moderate/high risk, in the adult population living in the municipality of Senador Canedo, metropolitan region of the state of Goiás, Midwest region of Brazil.Methods: The study was conducted through a household survey, through the application of a questionnaire with questions related to lifestyle and data collection such as weight, height, waist circumference, blood pressure, glycated hemoglobin and cholesterol dosage of 526 participants. Bivariate and multivariate analyses were performed using the Poisson regression model to analyze the factors associated with CVR according to the model proposed by the Framingham study.Results: The prevalence of High CVR was 12.2% (95%CI:9.5 - 15.5) and moderate CVR was 13.3% (95%CI:10.5 -16.8). The factors associated with high/moderate CVR were individuals without incomplete education or elementary (RPaj: 6.2; 95% CI: 1.3 - 29.7), insufficiently active (RPaj: 3.1; 95% CI: 1.8-5.0), and self-assessment of regular health status (RPaj: 1.8; 95% CI: 1.1-3.2).Conclusion: The present study allowed verifying the magnitude of CVR and the factors associated with high risk, consisting of an important instrument to guide the actions to prevent cardiovascular outcomes in the population attached to the family health strategy in the municipality of Senador Canedo.Fundamentos: Dentre as Doenças Crônicas não Transmissíveis (DCNT), as Doenças Cardiovasculares (DCV) são as principais causas de mortalidade prematura globalmente. O modelo de atenção integral voltado para essas doenças, apresenta como um dos seus componentes, o rastreamento de risco global cardiovascular (RCV).Objetivos: Estimar o RCV estratificado por variáveis sociodemográficas, bem como fatores associados ao risco moderado/alto, na população adulta residente no município de Senador Canedo, região metropolitana da capital do estado de Goiás, Região Centro-Oeste do Brasil.Métodos: O estudo foi realizado por meio de um inquérito domiciliar, através da aplicação de questionário com perguntas relativas ao estilo de vida e coleta de dados como peso, altura, circunferência da cintura, pressão arterial, dosagem de hemoglobina glicada e de colesterol de 526 participantes. As análises bivariada e multivariada foram realizadas por meio do modelo de regressão de Poisson para analisar os fatores associados ao RCV segundo o modelo proposto pelo estudo de Framingham.Resultados: A prevalência do RCV Alto foi de 12,2% (IC95%:9,5 - 15,5) e do RCV Moderado foi 13,3% (IC95%:10,5 -16,8). Os fatores associados ao RCV Alto/moderado, foram: indivíduos sem instrução ou fundamental incompleto (RPaj: 6.2; IC 95%: 1.3 - 29.7), insuficientemente ativo (RPaj: 3.1; IC 95%: 1.8-5.0), e autoavaliação do estado de saúde regular (RPaj: 1.8; IC 95%: 1.1-3.2).Conclusão: O presente trabalho permitiu verificar a magnitude do RCV e os fatores associados ao alto risco, consistindo num importante instrumento para orientar as ações de prevenção de desfechos cardiovasculares na população adstrita a estratégia saúde da família no município de Senador Canedo

ANÁLISE DO PERFIL DA VIOLÊNCIA INFANTIL NO MUNICÍPIO DE GOIÂNIA-GOIÁS

Child violence is considered a serious public health problem, and with this several efforts are made to solve this situation. This study aimed to characterize the sociodemographic aspects related to child violence in the city of Goiânia-GO and to verify the spatial distribution and temporal tendency in relation to the differences in the number of notifications of child violence. This is a descriptive-analytical study, based on the notifications of violence available in the Notifiable Diseases Information System (SINAN NET), against children aged 0 to 11 years, 11 months and 29 days, which occurred in the municipality of Goiânia/Goiás, from 2010 to 2021. The results pointed to the higher prevalence of reports of violence by negligence. In relations with the violence studied, children aged 1 to 3 years, the most affected, female, the main place of occurrence is the victim's residence and the peripheral regions of the municipality of Goiânia-GO were more sensitive to child violence. In view of the findings, children are exposed to violence in various ways, and the period of growth and development is threatened by the event of violence.A violência infantil é considerada um grave problema de saúde pública, e com isso diversos esforços são realizados na tentativa de solucionar esta situação. O presente estudo objetivou caracterizar os aspectos sociodemográficos relacionados a violência infantil no município de Goiânia-GO e verificar a distribuição espacial e tendência temporal em relação às diferenças do número de notificações de violência infantil. Trata-se de um estudo descritivoanalítico, baseado nas notificações de violência disponíveis no Sistema de Informação de Agravos de Notificação (SINAN NET), contra crianças na faixa etária entre 0 e 11 anos, 11 meses e 29 dias, ocorridas no município de Goiânia/Goiás, no período de 2010 a 2021. Os resultados apontaram para a maior prevalência de notificações da violência por negligência. Em relações as violências estudadas, as crianças de a 1 a 3 anos as mais acometidas, do sexo feminino, o principal local de ocorrência é a residência da vítima e as regiões periféricas do município de Goiânia-GO foram mais sensíveis a violência infantil. Diante dos achados as crianças estão expostas a violências de diversas formas, tendo o período de crescimento e desenvolvimento ameaçados pelo evento de violência

Prevalência e fatores associados à hipertensão arterial em adultos residentes em Senador Canedo, Goiás: estudo de base populacional, 2016

Objective. To estimate the prevalence and factors associated with hypertension in adults from Senador Canedo, Goiás, Brazil, in the year 2016. Methods. Cross-sectional study, with three-stage cluster sampling. A questionnaire was applied and measurements of weight, height, waist circumference, blood pressure and total cholesterol levels were performed. Poisson regression was used to estimate prevalence ratios (PR) and 95% confidence intervals (95%CI). Results. Of the 709 participants, the prevalence of hypertension was 23.6% (95%CI – 19.3;28.6). The associated factors were: sedentarism (PR=1.7 – 95%CI% 1.1;2.5); increased waist circumference (PR=5.9 – 95%CI 3.6;9.6); hypercholesterolemia (PR=2.6 – 95%CI 1.3;5.2); and age ≥60 years (PR=2.9 – 95%CI 1.3;6.2). Conclusion. The prevalence of hypertension was lower than that described for Brazil in 2013. Physical inactivity, large weight circumference and age were factors associated with hypertension.Objetivo. Estimar a prevalência e fatores associados à hipertensão em adultos de Senador Canedo, Goiás, Brasil, no ano de 2016. Métodos. Inquérito transversal, de base populacional, com amostragem por conglomerados em três estágios. Foi aplicado questionário e realizadas aferições de peso, altura, circunferência da cintura, pressão arterial e dosagem do colesterol total. Empregou-se regressão de Poisson para estimar razões de prevalências (RP) e intervalos de confiança de 95% (IC95%). Resultados. Nos 709 participantes, a prevalência de hipertensão foi de 23,6% (IC95% 19,3;28,6). Os fatores associados foram: inativos no lazer (RP=1,7 – IC95% 1,1;2,5); circunferência de cintura aumentada (RP=5,9 – IC95% 3,6;9,6); hipercolesterolemia (RP=2,6 – IC95% 1,3;5,2); e idade ≥60 anos (RP=2,9 – IC95% 1,3;6,2). Conclusão. A prevalência de hipertensão foi inferior à descrita para o Brasil em 2013. Inatividade física, acúmulo de gordura abdominal e idade foram fatores associados à hipertensão.&nbsp

Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Risk Profile and 1-Year Outcome of Newly Diagnosed Atrial Fibrillation in Japan - Insights From GARFIELD-AF -

Background: Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective non-interventional study of stroke prevention in patients with newly diagnosed non-valvular AF (NAVF) that is being conducted in 35 countries

International trends in clinical characteristics and oral anticoagulation treatment for patients with atrial fibrillation: Results from the GARFIELD-AF, ORBIT-AF I, and ORBIT-AF II registries

Background Atrial fibrillation (AF) is the most common cardiac arrhythmia in the world. We aimed to provide comprehensive data on international patterns of AF stroke prevention treatment

International trends in clinical characteristics and oral anticoagulation treatment for patients with atrial fibrillation: Results from the GARFIELD-AF, ORBIT-AF I, and ORBIT-AF II registries

Background Atrial fibrillation (AF) is the most common cardiac arrhythmia in the world. We aimed to provide comprehensive data on international patterns of AF stroke prevention treatment

Risk factors for death, stroke, and bleeding in 28,628 patients from the GARFIELD-AF registry: Rationale for comprehensive management of atrial fibrillation

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