Página 41 dos resultados de 1440 itens digitais encontrados em 0.009 segundos

‣ Comorbidities, exposure to medications, and the risk of community-acquired clostridium difficile infection: a systematic review and meta-analysis

Furuya-Kanamori, Luis; Stone, Jennifer C.; Clark, Justin; McKenzie, Samantha J.; Yakob, Laith; Paterson, David L.; Riley, Thomas V.; Doi, Suhail A. R.; Clements, Archie C.
Fonte: Cambridge University Press Publicador: Cambridge University Press
Tipo: Artigo de Revista Científica
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BACKGROUND: Clostridium difficile infection (CDI) has been extensively described in healthcare settings; however, risk factors associated with community-acquired (CA) CDI remain uncertain. This study aimed to synthesize the current evidence for an association between commonly prescribed medications and comorbidities with CA-CDI. METHODS: A systematic search was conducted in 5 electronic databases for epidemiologic studies that examined the association between the presence of comorbidities and exposure to medications with the risk of CA-CDI. Pooled odds ratios were estimated using 3 meta-analytic methods. Subgroup analyses by location of studies and by life stages were conducted. RESULTS: Twelve publications (n=56,776 patients) met inclusion criteria. Antimicrobial (odds ratio, 6.18; 95% CI, 3.80-10.04) and corticosteroid (1.81; 1.15-2.84) exposure were associated with increased risk of CA-CDI. Among the comorbidities, inflammatory bowel disease (odds ratio, 3.72; 95% CI, 1.52-9.12), renal failure (2.64; 1.23-5.68), hematologic cancer (1.75; 1.02-5.68), and diabetes mellitus (1.15; 1.05-1.27) were associated with CA-CDI. By location, antimicrobial exposure was associated with a higher risk of CA-CDI in the United States, whereas proton-pump inhibitor exposure was associated with a higher risk in Europe. By life stages...

‣ Estimating the burden of occupational bladder cancer in Ontario using the CAREX Canada database

Angeles, Joy
Fonte: Quens University Publicador: Quens University
Tipo: Tese de Doutorado Formato: 704807 bytes; application/pdf
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Objective: This study attempts to estimate the proportion of incident cases of bladder cancer in Ontario, Canada that is due to exposure to occupational carcinogens. Methods: The population attributable risk approach is used to estimate the proportion of bladder cancer in Ontario that is due to occupation. Risk ratios were obtained from a review of epidemiologic literature using a priori inclusion and exclusion criteria. Summary risk estimates for each bladder carcinogen included were calculated using RevMan 4.2. The CAREX Canada database provided Ontario-specific estimates of the proportion of workers exposed to bladder carcinogens. Results: In Ontario, the proportion of bladder cancer due to occupational exposure is approximately 5.6% (95% CI 0.2% to 14%). Based on the incident number of bladder cancer cases in 2001 in Ontario, it is estimated that approximately 52 new cases of bladder cancer were due to occupational exposure to polycyclic aromatic hydrocarbons (PAHs), diesel exhaust, aromatic amines and 2-naphthylamine. An alternate interpretation is if these occupational exposures were eliminated, 52 cases of bladder cancer per year in Ontario alone could be avoided. Conclusion and Recommendations: The current study advances our knowledge of the extent to which specific occupational bladder carcinogens contribute to the overall bladder cancer burden in Ontario. The current study highlights the utility of the CAREX Canada database in advancing current knowledge on the burden of occupational cancer in Ontario. The methods used to estimate the proportion of bladder cancer attributable to occupational exposure in Ontario may be replicated to estimate the proportion of cancer in Ontario that is due to occupational exposure.; Thesis (Master...

‣ Air pollution and health: distribution and determinants of exposure in Montreal, Quebec with a focus on polycyclic aromatic hydrocarbon assessment

Miao, QUN
Fonte: Quens University Publicador: Quens University
Tipo: Tese de Doutorado
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Background: The International Agency for Research on Cancer has classified diesel exhaust as a carcinogen, and specific polycyclic aromatic hydrocarbons (PAHs) as probable carcinogens. Urban air pollution is one source of PAH exposure. These facts provided motivation to pursue three thesis objectives: 1) to critically review environmental inequity research in Canada and methods used in previous studies; 2) to determine associations between socio-demographic factors and residential traffic exposure; and, 3) to assess correlations between two PAH biomarkers and their relationship with a newer geographic information system (GIS) method (a proxy of PAH exposure measurement), and explore determinants of these two PAH biomarkers. Methods: The first objective was achieved through an extensive and critical literature review. The second and third objectives were achieved through conducting a cross-sectional study in Montreal where 107 female and 93 male volunteers completed a questionnaire and provided a urine sample for measurement of 1-hydroxypyrene (1-OHP) and 1-hydroxypyrene glucuronide (1-OHPG). GIS-based distance-weighted traffic density (DWTD) at participants’ residences and time- and distance-weighted traffic density (TDWTD) for all participants’ locations in the 48 hours before urine collection were calculated. Results: Participants with lower household income and unemployment/student status were more likely to be exposed to higher traffic density at their residence. DWTD was related to self-reported living within 100 meters of highway/major roads. Detection rates for the two biomarkers were over 95%...

‣ Chocolate and prevention of cardiovascular disease: a systematic review

Hutfless, Susan M; Ding, Xin; Girotra, Saket; Ding, Eric L.
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
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Background: Consumption of chocolate has been often hypothesized to reduce the risk of cardiovascular disease (CVD) due to chocolate's high levels of stearic acid and antioxidant flavonoids. However, debate still lingers regarding the true long term beneficial cardiovascular effects of chocolate overall. Methods: We reviewed English-language MEDLINE publications from 1966 through January 2005 for experimental, observational, and clinical studies of relations between cocoa, cacao, chocolate, stearic acid, flavonoids (including flavonols, flavanols, catechins, epicatechins, and procynadins) and the risk of cardiovascular disease (coronary heart disease (CHD), stroke). A total of 136 publications were selected based on relevance, and quality of design and methods. An updated meta-analysis of flavonoid intake and CHD mortality was also conducted. Results: The body of short-term randomized feeding trials suggests cocoa and chocolate may exert beneficial effects on cardiovascular risk via effects on lowering blood pressure, anti-inflammation, anti-platelet function, higher HDL, decreased LDL oxidation. Additionally, a large body of trials of stearic acid suggests it is indeed cholesterol-neutral. However, epidemiologic studies of serum and dietary stearic acid are inconclusive due to many methodologic limitations. Meanwhile...

‣ Residential magnetic fields and childhood leukemia: a meta-analysis.

Wartenberg, D
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /12/1998 Português
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OBJECTIVES: This article uses meta-analysis methodology to examine the statistical consistency and importance of random variation among results of epidemiologic studies of residential magnetic field exposure and childhood leukemia. METHODS: A variety of meta-analytic statistical methods were applied to all available studies combined and on sub-groups of studies chosen by exposure characteristics. Sample sizes and fail-safe n's were calculated to determine the robustness of results and the potential role of publication bias. RESULTS: Most studies show elevated but not statistically significant odds ratios. Results for exposures assessed by wire codes, distance, and/or historically reconstructed fields are relatively consistent, homogeneous, and positive, while those for direct magnetic field measurements are consistent, homogeneous, and marginally protective. Several unpublished studies, or a single unpublished study with several hundred subjects, would be needed to nullify the observed data. CONCLUSIONS: The observed results identify a consistent risk that cannot be explained by random variation. The data supporting magnetic fields as the principal risk factor are suggestive but inconsistent. Additional studies using innovative designs that focus on highly exposed children offer the most hope of untangling this issue.

‣ Exposure Assessment in the National Children’s Study: Introduction

Needham, Larry L.; Özkaynak, Halûk; Whyatt, Robin M.; Barr, Dana B.; Wang, Richard Y.; Naeher, Luke; Akland, Gerry; Bahadori, Tina; Bradman, Asa; Fortmann, Roy; Liu, L-J. Sally; Morandi, Maria; O’Rourke, Mary Kay; Thomas, Kent; Quackenboss, James; Rya
Fonte: National Institute of Environmental Health Sciences Publicador: National Institute of Environmental Health Sciences
Tipo: Artigo de Revista Científica
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The science of exposure assessment is relatively new and evolving rapidly with the advancement of sophisticated methods for specific measurements at the picogram per gram level or lower in a variety of environmental and biologic matrices. Without this measurement capability, environmental health studies rely on questionnaires or other indirect means as the primary method to assess individual exposures. Although we use indirect methods, they are seldom used as stand-alone tools. Analyses of environmental and biologic samples have allowed us to get more precise data on exposure pathways, from sources to concentrations, to routes, to exposure, to doses. They also often allow a better estimation of the absorbed dose and its relation to potential adverse health outcomes in individuals and in populations. Here, we make note of various environmental agents and how best to assess exposure to them in the National Children’s Study—a longitudinal epidemiologic study of children’s health. Criteria for the analytical method of choice are discussed with particular emphasis on the need for long-term quality control and quality assurance measures.

‣ Indicators of Family Care for Development for Use in Multicountry Surveys

Kariger, Patricia; Frongillo, Edward A.; Engle, Patrice; Britto, Pia M. Rebello; Sywulka, Sara M.; Menon, Purnima
Fonte: International Centre for Diarrhoeal Disease Research, Bangladesh Publicador: International Centre for Diarrhoeal Disease Research, Bangladesh
Tipo: Artigo de Revista Científica
Publicado em /12/2012 Português
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Indicators of family care for development are essential for ascertaining whether families are providing their children with an environment that leads to positive developmental outcomes. This project aimed to develop indicators from a set of items, measuring family care practices and resources important for caregiving, for use in epidemiologic surveys in developing countries. A mixed method (quantitative and qualitative) design was used for item selection and evaluation. Qualitative and quantitative analyses were conducted to examine the validity of candidate items in several country samples. Qualitative methods included the use of global expert panels to identify and evaluate the performance of each candidate item as well as in-country focus groups to test the content validity of the items. The quantitative methods included analyses of item-response distributions, using bivariate techniques. The selected items measured two family care practices (support for learning/stimulating environment and limit-setting techniques) and caregiving resources (adequacy of the alternate caregiver when the mother worked). Six play-activity items, indicative of support for learning/stimulating environment, were included in the core module of UNICEF's Multiple Cluster Indictor Survey 3. The other items were included in optional modules. This project provided...

‣ Immunoblot Method To Detect Streptococcus pneumoniae and Identify Multiple Serotypes from Nasopharyngeal Secretions

Bronsdon, Melinda A.; O'Brien, Katherine L.; Facklam, Richard R.; Whitney, Cynthia G.; Schwartz, Benjamin; Carlone, George M.
Fonte: American Society for Microbiology Publicador: American Society for Microbiology
Tipo: Artigo de Revista Científica
Publicado em /04/2004 Português
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Conventional culture techniques are limited in the ability to detect multiple Streptococcus pneumoniae serotypes in nasopharyngeal (NP) secretions. We developed an immunoblot (IB) method with monoclonal antibodies (MAbs) to detect S. pneumoniae and to identify serotypes. NP specimens stored in skim milk-tryptone-glucose-glycerol medium were assessed by the IB method and the reference culture method (RM). In the RM, four optochin-sensitive alpha-hemolytic colonies resembling pneumococci were typed by the Quellung reaction. In the IB method, a nitrocellulose membrane blot of surface growth was reacted with a pneumococcal surface adhesion (PsaA) MAb and visualized. Of 47 NP specimens, 32 (68%) were found to be positive and 13 (28%) were found to be negative for pneumococci by both methods; each method alone yielded one positive result. The sensitivity and specificity of the IB method for the detection of pneumococci were 97 and 93%, respectively. To identify serotypes, blots were tested with serotype-specific MAbs (4, 6A, 6B, 9V, 14, 18C, 19F, and 23F). To detect the remaining serotypes, positive serotype-specific replicate blots were compared visually to an original anti-PsaA-positive blot; four unidentified colonies were subcultured and serotyped by the Quellung reaction. Fifty-eight S. pneumoniae-positive NP specimens containing 69 pneumococcal strains (23 serotypes) were tested; 68 (98.6%) of the strains were detected by the IB method...

‣ Multiple-locus variable-number tandem repeat analysis of Salmonella Enteritidis isolates from human and non-human sources using a single multiplex PCR

Cho, Seongbeom; Boxrud, David J; Bartkus, Joanne M; Whittam, Thomas S; Saeed, Mahdi
Fonte: Blackwell Publishing Ltd Publicador: Blackwell Publishing Ltd
Tipo: Artigo de Revista Científica
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Simplified multiple-locus variable-number tandem repeat analysis (MLVA) was developed using one-shot multiplex PCR for seven variable-number tandem repeats (VNTR) markers with high diversity capacity. MLVA, phage typing, and PFGE methods were applied on 34 diverse Salmonella Enteritidis isolates from human and non-human sources. MLVA detected allelic variations that helped to classify the S. Enteritidis isolates into more evenly distributed subtypes than other methods. MLVA-based S. Enteritidis clonal groups were largely associated with sources of the isolates. Nei's diversity indices for polymorphism ranged from 0.25 to 0.70 for seven VNTR loci markers. Based on Simpson's and Shannon's diversity indices, MLVA had a higher discriminatory power than pulsed field gel electrophoresis (PFGE), phage typing, or multilocus enzyme electrophoresis. Therefore, MLVA may be used along with PFGE to enhance the effectiveness of the molecular epidemiologic investigation of S. Enteritidis infections.

‣ Confidence intervals for effect parameters common in cancer epidemiology.

Sato, T
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /07/1990 Português
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This paper reviews approximate confidence intervals for some effect parameters common in cancer epidemiology. These methods have computational feasibility and give nearly nominal coverage rates. In the analysis of crude data, the simplest type of epidemiologic analysis, parameters of interest are the odds ratio in case-control studies and the rate ratio and difference in cohort studies. These parameters can estimate the instantaneous-incidence-rate ratio and difference that are the most meaningful effect measures in cancer epidemiology. Approximate confidence intervals for these parameters including the classical Cornfield's method are mainly based on efficient scores. When some confounding factors exist, stratified analysis and summary measures for effect parameters are needed. Since the Mantel-Haenszel estimators have been widely used by epidemiologists as summary measures, confidence intervals based on the Mantel-Haenszel estimators are described. The paper also discusses recent developments in these methods.

‣ Improving knowledge of the prostate cancer screening dilemma among African American men: an academic-community partnership in Washington, DC.

Taylor, K. L.; Turner, R. O.; Davis, J. L.; Johnson, L.; Schwartz, M. D.; Kerner, J.; Leak, C.
Fonte: Association of Schools of Public Health Publicador: Association of Schools of Public Health
Tipo: Artigo de Revista Científica
Publicado em //2001 Português
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OBJECTIVE: Studies have shown that African American men are at greater risk than other men for prostate cancer in terms of both incidence and mortality. At the same time, the utility of screening asymptomatic men for prostate cancer remains controversial. The combination of high incidence and high mortality with the uncertain benefits of screening poses a difficult problem for African American men. This study was part of an ongoing project that sought to develop and evaluate health education materials designed to help African American men make an informed decision about prostate cancer screening. The project represented a collaboration between the Most Worshipful Prince Hall Grand Lodge of the District of Columbia and the Lombardi Cancer Center of Georgetown University. METHODS: The authors conducted eight focus groups with 44 members of the Prince Hall Masons. The focus groups covered men's understanding of prostate cancer screening and their preferences for methods of health education. RESULTS: Participants demonstrated a high level of awareness of the availability of prostate cancer screening, a low awareness of the screening controversy, and a desire for detailed epidemiologic information and information about the benefits and limitations of screening. The preferred forms of educational materials were video and print-based materials...

‣ Prevalence and associated factors of enuresis in turkish children

Ozden,Cuneyt; Ozdal,Ozdem L.; Altinova,Serkan; Oguzulgen,Ibrahim; Urgancioglu,Guvenc; Memis,Ali
Fonte: Sociedade Brasileira de Urologia Publicador: Sociedade Brasileira de Urologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/04/2007 Português
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OBJECTIVE: Enuresis, which is frequently diagnosed amongst schoolchildren, is an important psychosocial problem for both parents and children. In the present study we aimed to determine the prevalence and associated factors of enuresis in Turkish children and to identify common methods for its management. MATERIALS AND METHODS: A cross sectional epidemiological study was performed among primary school children living in Ankara, Turkey. A self-administered questionnaire was prepared for this study and distributed to the parents of 1,500 schoolchildren whom aged 6-12 years. RESULTS: Of the 1,500 questionnaires distributed, 1,339 (89%) were completed. The overall prevalence of nocturnal and diurnal enuresis were 17.5% (n = 234) and 1.9% (n = 25), respectively. Although male gender, low age, history of enuresis among parents, low educational level of the parents, deep sleep, increased number of siblings, increased number of people sleeping in the child's room, history of enuresis among siblings, poor school performance and history of recurrent urinary tract infections (UTI) were significantly associated with enuresis, but not with severe enuresis. The percentage of children with enuresis seen by physician for treatment was 17.2%. The most preferred treatment option for enuresis was medications (59.5%)...

‣ Mapping Community Determinants of Heat Vulnerability

Reid, Colleen E.; O’Neill, Marie S.; Gronlund, Carina J.; Brines, Shannon J.; Diez-Roux, Ana V.; Brown, Daniel G.; Schwartz, Joel David
Fonte: National Institute of Environmental Health Sciences Publicador: National Institute of Environmental Health Sciences
Tipo: Artigo de Revista Científica
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Background: The evidence that heat waves can result in both increased deaths and illness is substantial, and concern over this issue is rising because of climate change. Adverse health impacts from heat waves can be avoided, and epidemiologic studies have identified specific population and community characteristics that mark vulnerability to heat waves. Objectives: We situated vulnerability to heat in geographic space and identified potential areas for intervention and further research. Methods: We mapped and analyzed 10 vulnerability factors for heat-related morbidity/mortality in the United States: six demographic characteristics and two household air conditioning variables from the U.S. Census Bureau, vegetation cover from satellite images, and diabetes prevalence from a national survey. We performed a factor analysis of these 10 variables and assigned values of increasing vulnerability for the four resulting factors to each of 39,794 census tracts. We added the four factor scores to obtain a cumulative heat vulnerability index value. Results: Four factors explained > 75% of the total variance in the original 10 vulnerability variables: a) social/environmental vulnerability (combined education/poverty/race/green space), b) social isolation...

‣ Association between Residences in U.S. Northern Latitudes and Rheumatoid Arthritis: A Spatial Analysis of the Nurses’ Health Study

Vieira, Verónica M.; Webster, Thomas F.; Weinberg, Janice; Puett, Robin; Hart, Jaime Elizabeth; Laden, Francine; Costenbader, Karen Harte; Karlson, Elizabeth Wood
Fonte: National Institute of Environmental Health Sciences Publicador: National Institute of Environmental Health Sciences
Tipo: Artigo de Revista Científica
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Background: The etiology of rheumatoid arthritis (RA) remains largely unknown, although epidemiologic studies suggest genetic and environmental factors may play a role. Geographic variation in incident RA has been observed at the regional level. Objective: Spatial analyses are a useful tool for confirming existing exposure hypotheses or generating new ones. To further explore the association between location and RA risk, we analyzed individual-level data from U.S. women in the Nurses’ Health Study, a nationwide cohort study. Methods: Participants included 461 incident RA cases and 9,220 controls with geocoded addresses; participants were followed from 1988 to 2002. We examined spatial variation using addresses at baseline in 1988 and at the time of case diagnosis or the censoring of controls. Generalized additive models (GAMs) were used to predict a continuous risk surface by smoothing on longitude and latitude while adjusting for known risk factors. Permutation tests were conducted to evaluate the overall importance of location and to identify, within the entire study area, those locations of statistically significant risk. Results: A statistically significant area of increased RA risk was identified in the northeast United States (p-value = 0.034). Risk was generally higher at northern latitudes...

‣ Quantifying the transmission potential of pandemic influenza

Chowell, Gerardo; Nishiura, Hiroshi
Fonte: Universidade Cornell Publicador: Universidade Cornell
Tipo: Artigo de Revista Científica
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This article reviews quantitative methods to estimate the basic reproduction number of pandemic influenza, a key threshold quantity to help determine the intensity of interventions required to control the disease. Although it is difficult to assess the transmission potential of a probable future pandemic, historical epidemiologic data is readily available from previous pandemics, and as a reference quantity for future pandemic planning, mathematical and statistical analyses of historical data are crucial. In particular, because many historical records tend to document only the temporal distribution of cases or deaths (i.e. epidemic curve), our review focuses on methods to maximize the utility of time-evolution data and to clarify the detailed mechanisms of the spread of influenza. First, we highlight structured epidemic models and their parameter estimation method which can quantify the detailed disease dynamics including those we cannot observe directly. Duration-structured epidemic systems are subsequently presented, offering firm understanding of the definition of the basic and effective reproduction numbers. When the initial growth phase of an epidemic is investigated, the distribution of the generation time is key statistical information to appropriately estimate the transmission potential using the intrinsic growth rate. Applications of stochastic processes are also highlighted to estimate the transmission potential using the similar data. Critically important characteristics of influenza data are subsequently summarized...

‣ Application of molecular techniques to the diagnosis and epidemiology of Haemophilus parasuis

Olvera van der Stoep, Alexandre
Fonte: Bellaterra : Universitat Autònoma de Barcelona, Publicador: Bellaterra : Universitat Autònoma de Barcelona,
Tipo: Tesis i dissertacions electròniques; info:eu-repo/semantics/doctoralThesis Formato: application/pdf
Publicado em //2008 Português
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Consultable des del TDX; Títol obtingut de la portada digitalitzada; Haemophilus parasuis es l'agent etiológic de la malaltia de Glässer's, però aquesta bactèria pot causar altres manifestacions clíniques, a més a més de poder ser aïllat del tracte respiratori superior de porcs sans. Els aïllaments de H. parasuis poden presentar diferents fenotips (per exemple diferent perfil de proteïnes, morfologia de colònia o bé producció de càpsula) i diferent capacitat patogènica. Les diferencies entre soques també s'han demostrat a nivell genètic. S'han emprat varis mètodes de tipat per classificar soques de camp d' H. parasuis, però totes presentaven problemes de resolució o implementació. Per resoldre aquestes limitacions es van avaluar diferents tècniques basades en seqüenciació d'ADN. Conseqüentment l'objectiu d'aquest estudi fou millorar el tipat d' H. parasuis i examinar l'associació entre grups de soques i aparició de malaltia. En el primer capítol d'aquest treball s'estudià l'ús d'una seqüència parcial del gen «heat shock protein 60 KDa» (hsp60) com a marcador epidemiológic en un esquema de «single locus sequence typing» (SLST). Es compararen els resultats obtinguts emprant patrons de «enterobacterial repetitive intergenic consensus» (ERIC)-PCR...

‣ Prevalência de asma e sintomas asmáticos em escolares de 13 e 14 anos de idade; Prevalence of asthma and asthma symptoms among 13 and 14-year-old schoolchildren, Brazil

Maia, José Geraldo Soares; Marcopito, Luiz Francisco; Amaral, Adriano Neves; Tavares, Breno de Freitas; Santos, Fabiana Augusta Nogueira Lima e
Fonte: Universidade de São Paulo. Faculdade de Saúde Pública Publicador: Universidade de São Paulo. Faculdade de Saúde Pública
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; ; ; Formato: application/pdf
Publicado em 01/04/2004 Português
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OBJETIVO: Antes do uso do questionário padronizado ISAAC (International Study of Asthma and Allergies in Childhood) em inquéritos epidemiológicos, pouco se conhecia sobre a ocorrência comparativa de asma no mundo, dados os diferentes métodos empregados. No Brasil, outros estudos utilizaram o questionário ISAAC em regiões urbanas. Realizou-se estudo utilizando esse questionário nas zonas urbana e rural com o objetivo de estimar a prevalência de asma em escolares. MÉTODOS: Estudo transversal com o questionário escrito ISAAC, acrescido de perguntas sobre exposições de interesse, auto-aplicado em 3.770 escolares de 13 e 14 anos de idade do município de Montes Claros (MG) selecionados por sorteio. RESULTADOS: A prevalência de "sibilos no último ano" foi 15,8%, e de "asma ou bronquite alguma vez na vida" 23,8%, sem diferença significativa entre sexos. Houve diferença estatística (p; OBJECTIVE: Before the use of the ISAAC (International Study of Asthma and Allergies in Childhood) questionnaire in epidemiologic surveys, little could be told about the comparative occurrence of asthma in the world due to differences in employed methods. In Brazil, the ISAAC questionnaire has been used in some urban regions. In this study it was applied in both...

‣ Impacto econômico das mudanças epidemiológicas esperadas nas doenças associadas ao tabaco, México; Economic burden of expected epidemiological changes in diseases related to tobacco, Mexico

Arredondo, Armando; Carrillo, Carlos; Zuñiga, Alexis
Fonte: Universidade de São Paulo. Faculdade de Saúde Pública Publicador: Universidade de São Paulo. Faculdade de Saúde Pública
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; ; ; Formato: application/pdf
Publicado em 01/08/2007 Português
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OBJETIVO: Avaliar os custos da atenção médica a doenças associadas ao tabagismo e o impacto econômico das mudanças epidemiológicas. MÉTODOS: Análise de série temporal no México (1994-2005) de sete intervenções médicas em relação a: doença pulmonar obstrutiva crônica, câncer de pulmão com e sem intervenção cirúrgica, asma bronquial em fumantes e não-fumantes, tratamento com adesivos para deixar de fumar, tratamento com goma de mascar. As mudanças epidemiológicas esperadas e as necessidades financeiras para atender a demanda de serviços foram avaliadas pelos modelos probabilísticos de Box-Jenkins. Os custos foram determinados de acordo com método de instrumentação e a técnica de consenso. RESULTADOS: A comparação do impacto das mudanças epidemiológicas previstas para 2006 e 2008 mostrou incremento de 20% a 90%, dependendo do tipo de intervenção. O incremento nos custos da atenção médica foi de 25% a 93%. Há indícios que a demanda de serviços de saúde para as intervenções investigadas continuarão aumentando. CONCLUSÕES: Em termos econômicos, o aumento na quantidade de casos esperados refletem um fenômeno de competição interna em relação ao uso dos recursos adicionais entre atividades de promoção e prevenção da saúde relacionada ao tabagismo. Se não houver mudanças nos programas de prevenção...

‣ Economic burden of expected epidemiological changes in diseases related to tobacco, Mexico

Arredondo,Armando; Carrillo,Carlos; Zuñiga,Alexis
Fonte: Faculdade de Saúde Pública da Universidade de São Paulo Publicador: Faculdade de Saúde Pública da Universidade de São Paulo
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/08/2007 Português
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OBJECTIVE: To determine health care costs and economic burden of epidemiological changes in diseases related to tobacco consumption. METHODS: A time-series analysis in Mexico (1994-2005) was carried out on seven health interventions: chronic obstructive pulmonary diseases, lung cancer with and without surgical intervention, asthma in smokers and non-smokers, full treatment course with nicotine gum, and full treatment course with nicotine patch. According with Box-Jenkins methodology, probabilistic models were developed to forecast the expected changes in the epidemiologic profile and the expected changes in health care services required for selected interventions. Health care costs were estimated following the instrumentation methods and validated with consensus technique. RESULTS: A comparison of the economic impact in 2006 vs. 2008 showed 20-90% increase in expected cases depending on the disease (p<0.05), and 25-93% increase in financial requirements (p<0.01). The study data suggest that changes in the demand for health services for patients with respiratory diseases related to tobacco consumption will continue showing an increasing trend. CONCLUSIONS: In economic terms, the growing number of cases expected during the study period indicates a process of internal competition and adds an element of intrinsic competition in the management of preventive and curative interventions. The study results support the assumption that if preventive programs remain unchanged...

‣ Oral and maxillofacial surgery - Helmet and maxillofacial trauma: a 10-year retrospective study

Maliska, Maximiana Cristina de Souza x; Borba, Marcia; Asprino, Luciana; Moraes, Márcio de; Moreira, Roger Willian Fernandes
Fonte: UNICAMP/FOP Publicador: UNICAMP/FOP
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; Formato: application/pdf
Publicado em 30/10/2015 Português
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Aim: The aim of the present study was to retrospectively evaluate the epidemiologic characteristics of the prevalence, type and treatment modalities of maxillofacial trauma according to use of helmets by motorcyclists in traffic accidents. Methods: Data was collected from patients during a 10-year period (1999-2009). Data recorded included demographic, etiology, diagnosis, type of fracture, use of helmet, associated facial and general trauma, soft tissue lesions and treatment methods. Data analysis included a descriptive analysis, Chi-square test and Kruskal-Wallis test. Results: From 376 motorcycle crash victims, 260 had maxillofacial fractures with a male/female ratio of 4:1 and a mean age of 26.1. Considering the helmet as a security device, 89 patients were not wearing a helmet during the crash against 287 patients that were wearing it. One hundred and sixteen patients had soft tissue lesions, 80 of them wore a helmet at the moment of the crash and 36 did not (p<0.05). The most frequently fractured facial bone was the zygoma (24%) followed by the mandible. Conclusions: Motorcycle accidents represented almost one third of all maxillofacial injuries seen at this Oral and Maxillofacial Surgery Division, causing high morbidity. Educational campaigns...