BackgroundPopulation variation in the duration and amount of menstrual bleeding has received little attention in the literature. This study describes these characteristics and investigates the distribution of self-perceived amount of menstrual bleeding according to socio-demographic, behavioral, and reproductive characteristics.MethodsA community-based cross-sectional study was conducted among 18-45 years old women users of the 31 primary health care (PHC) facilities in Pelotas city (Brazil). Interviews with structured questionnaire were carried out in the waiting rooms during two work shifts. Heaviness of menstrual bleeding was determined through the answer to the question: "Usually how much blood do you lose in every period?" Crude and adjusted analyses through Poisson regression took into account the aggregation per PHC facility.ResultsA total of 865 women were enrolled. Prevalence of heavy menstrual flow was 35.3% (95% CI 32.1-38.6%). In adjusted analyses, heavy menstrual bleeding was higher among the older, less educated and obese women, with higher number of pregnancies and who reported longer menstrual periods, extra-menstrual bleeding and clots in the flow. Use of hormonal contraceptive methods was protective against heavy menses.ConclusionHeavy menstrual bleeding is highly prevalent at the community level, and is associated with socio-demographic and anthropometric women's characteristics, as well as with duration of menstruation, extra-bleeding and presence of clots.

To investigate the association between Helicobacter pylori and anemia, a community-based cross-sectional study was conducted among (-0.24-0.11; p = 0.4 BackgroundIdentification of the effect of Helicobacter pylori on the digestive system has given rise to studies of the risk factor of this infection for extra-gastric diseases. It has been proposed that H. pylori may be responsible for iron deficiency, among other risks. The factors that lend biological plausibility to this association include the deficiency in iron absorption by H. pylori-colonized gastric cells, competition for iron between gastric cells and H. pylori, and bleeding through peptic ulcers and other gastric lesions associated with H. pylori 1,2 .Anemia is a major public health problem in developing countries. The main causes of anemia include: dietary iron deficiency; infectious diseases such as malaria, hookworm infections and schistosomiasis; deficiencies of other key micronutrients including folate, vitamin B12 and vitamin A; and inherited conditions that affect red blood cells, such as thalassaemia. Nonetheless, about half of all cases of anemia can be attributed to iron deficiency 3 . Accordingly, if an association between H. pylori and anemia is demonstrated, eradication of this bacterium could become an important public health strategy for controlling anemia in developing countries.The present study was planned to investigate the association between H. pylori colonization and anemia among adult users of the primary health care network in the city of Pelotas, in Southern Brazil.ARTIGO ARTICLE

OBJECTIVE:To validate an epidemiological score for identifying dyspeptic patients at high risk of being H. pylori positive. METHODS:Cross-sectional study including 434 users of primary health care units in the city of Pelotas, Southern Brazil, aged 18-45 years, and with symptoms of non-investigated dyspepsia, between 2006 and 2007. Dyspepsia was diagnosed according to Roma-II. The gold standard for H. pylori infection was the 13 C-urea-breath-test. The association between presence of H. pylori and independent variables was assessed through Logistic Regression. The score was built based on adjusted odds ratios. Sensitivity, specifi city, and predictive values of different cutoffs were calculated. RESULTS:Prevalence of H. pylori dyspeptic subjects was 73.5% (95% CI: 69.3; 77.7). Prevalence was directly associated with age and number of siblings during childhood, and inversely associated with schooling; these variables were used in the construction of the score. The score ranged from 3 to 9 points. Scores 7, 8, and 9 had sensitivity of 36.6%, 22.3%, and 11.1%, and positive predictive values of 87.8%, 90.9%, and 92.1%, respectively. Without the score, 3 in every 4 dyspeptic patients would have received H. pylori erradication therapy. This proportion would have been lower with the score (one in three, six, and 11, for the cutoff points betwewen 7 and 9, respectively), albeit at the expense of a high rate of false-negatives. CONCLUSIONS:The score was not valid for selectively identifying dyspeptic individuals candidate to eradication therapy for H. pylori. Contrary to the recommendation in developed countries, the test-and-treat strategy seems inappropriate for use in developing settings due to the high prevalence of H. pylori infection.