Objective: To estimate the association between food intake and metabolic syndrome (MetS). Design: Cross-sectional design conducted from July 2006 to December 2007. Setting: Adolescents assisted by the Family Doctor Program (FDP) in Niterói, a metropolitan area in Rio de Janeiro State, Brazil. Subjects: Survey of 210 adolescents. Individuals with three or more of the following components of MetS were classified as having this syndrome: TAG $ 110 mg/dl; HDL cholesterol , 50 mg/dl for girls aged 12-19 years and boys aged 12-14 years or ,45 mg/dl for boys aged 15-19 years; waist circumference $75th percentile; serum glucose .100 mg/dl; and blood pressure $90th percentile. A semi-quantitative FFQ was used, and foods were grouped as: unprocessed or minimally processed foods (Group 1), processed culinary and food industry ingredients (Group 2) and ultra-processed foods (Group 3). The associations between food consumption and MetS were adjusted for sociodemographic, behavioural and family history covariates and were estimated using generalized estimation equations with the Poisson regression model. Results: MetS was diagnosed in 6?7 % of the adolescents; the most frequent diagnostic criteria included the reduction of HDL cholesterol (46?7 %), elevated serum glucose (17?1 %) and the elevation of waist circumference (16?7 %). Crude analysis showed higher average daily intakes of energy, carbohydrates and ultraprocessed foods among adolescents with MetS. After statistical adjustment, the intake of ultra-processed foods ($3rd quartile) remained associated with MetS (prevalence ratio 5 2?5; P 5 0?012). Conclusions: High consumption of ultra-processed foods was associated with the prevalence of MetS in this adolescents group.
(OR = 1.9; hemorrhage (OR = 2.2; hypertension (OR = 3.0; syphilis (OR = 3.3; lack of prenatal care (OR = 5.6;, cesarean section and hospital, were associated with near miss; while hemorrhage (OR = 4.6; 95%CI: 1,, lack of prenatal care (OR = 17.4;
O objetivo deste trabalho foi descrever o perfil epidemiológico e a tendência da mortalidade materna no Brasil, por meio de revisão de estudos sobre o tema. Foi realizada busca eletrônica de artigos científicos publicados entre 1980 e 2010, nas bases de dados LILACS e MEDLINE. Identificaram-se inicialmente 486 artigos. Após aplicação dos critérios de inclusão e exclusão restaram 50 artigos. A comparação dos dados mostrou queda da RMM de forma diferenciada nas regiões brasileiras. Os estudos sobre determinação do óbito materno apontaram desigualdades sociais relacionadas à cor da pele e escolaridade. O preenchimento incompleto da declaração de óbito e a subnotificação ainda persistem. Prevaleceram as causas obstétricas diretas, com predomínio das doenças hipertensivas. Quando analisada, a evitabilidade apontou falhas na assistência pré-natal e ao parto. Apesar de sua relevância, são poucos os artigos sobre mortalidade materna no Brasil. A RMM, embora em declínio, permanece em níveis elevados. Melhorias na qualidade da assistência pré-natal e ao parto são necessárias.
Como citarHeringer ALS, Kawa H, Fonseca SC, Brignol SMS, Zarpellon LA, Reis AC. Desigualdade na tendência da sífilis congênita no município de Niterói, Brasil 2007 a 2016. Rev Panam Salud Publica. 2020;44:e8. https://doi.
The systematic approach corroborated the results obtained by published studies: schoolchildren born with very low birth weights exhibited increased risk of learning difficulties when compared with those born at full term. There was a predominance of children with multiple academic subjects compromised and mathematics was the most affected. Risk was observed to follow an ascending gradient as birth weight reduced. There was an association between very low birth weight and cognitive compromise.
Leprosy remains a public health problem in developing countries. Among communicable diseases, it is one of the leading causes of permanent disability. Brazil had not reached the goal of reducing cases to less than 1 per 10,000 population. This study aimed to analyze the spatial distribution of leprosy cases in Brazil, using a literature review. The search strategy included the LILACS and MEDLINE databases with no language or period restriction. Ecological studies with spatial data analysis were considered as a criterion for the inclusion. We found 38 studies for review after the selection criteria. Among the epidemiological indicators of the disease, the most common was the new case detection rate. Several articles have explored the association between spatial distribution of leprosy and socioeconomic, demographic, and environmental factors. The most common unit of analysis was the municipality. The spatial distribution methods mostly used were: empirical Bayesian method, autocorrelation (Moran's I index) and Kernel estimates. The distribution of leprosy was very heterogeneous, independent of t h e unit of analysis. There was a decrease in the rate of detection and among under-15-year-olds, but some regions maintained high endemicity during the study period. The distribution and risk of illness were directly related to living conditions of the population. Improved access to health services was associated with increased detection rate in some regions. Spatial analysis seems to be a very useful tool to study leprosy and to guide interventions and surveillance.
Objective: To investigate severe maternal morbidity/near misses in a tertiary public maternity in the state of Rio de Janeiro, using different identification criteria. Methods: This is a cross-sectional study, performed in a regional reference hospital between June and October 2009, on severe maternal morbidity/near miss cases identified from the log books of the maternity hospital and review of medical records. This study focused on women who, during pregnancy, delivery, or the postpartum period, showed no clinical symptoms compatible with the defining criteria for severe maternal morbidity/near miss of Waterstone et al, Mantel et al. and the World Health Organization (WHO). Results: Among the 1,544 admissions during the period studied, 89 women with severe maternal morbidity were identified, considering all criteria. The occurrence of severe maternal morbidity/ near misses ranged from 81.4 to 9.4 per 1,000 live births (LB), depending on the criterion used. The mortality rate was 3.2%, reaching 23% in the WHO criteria. Only 40% of these women had more than six prenatal visits and 10% did not have any visit at all. The most common markers found were severe preeclampsia, followed by severe hemorrhage, ICU admissions, HELLP syndrome, and eclampsia. There were three maternal deaths with a MMR = 280/100.000 LB and one late death. The WHO criterion showed greater specificity, identifying more severe cases, while the Waterstone criterion was more sensitive. Conclusions: The study of severe maternal morbidity/near misses in a regional reference hospital can contribute to the knowledge of this event's magnitude, as well as to identify its most frequent characteristics and clinical conditions, being essential for dealing with maternal morbidity and mortality.
OBJECTIVE Evaluate the interaction between maternal age and education level in neonatal mortality, as well as investigate the temporal evolution of neonatal mortality in each stratum formed by the combination of these two risk factors.METHODS A nonconcurrent cohort study, resulting from a probabilistic relationship between the Mortality Information System and the Live Birth Information System. To investigate the risk of neonatal death we performed a logistic regression, with an odds ratio estimate for the combined variable of maternal education and age, as well as the evaluation of additive and multiplicative interaction. The neonatal mortality rate time series, according to maternal education and age, was estimated by the Joinpoint Regression program.RESULTS The neonatal mortality rate in the period was 8.09‰ and it was higher in newborns of mothers with low education levels: 12.7‰ (adolescent mothers) and 12.4‰ (mother 35 years old or older). Low level of education, without the age effect, increased the chance of neonatal death by 25% (OR = 1.25, 95%CI 1.14–1.36). The isolated effect of age on neonatal death was higher for adolescent mothers (OR = 1.39, 95%CI 1.33–1.46) than for mothers aged ≥ 35 years (OR = 1.16, 95%CI 1.09–1.23). In the time-trend analysis, no age group of women with low education levels presented a reduction in the neonatal mortality rate for the period, as opposed to women with intermediate or high levels of education, where the reduction was significant, around 4% annually.CONCLUSIONS Two more vulnerable groups – adolescents with low levels of education and older women with low levels of education – were identified in relation to the risk of neonatal death and inequality in reducing the mortality rate.
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