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Impacto das questões relacionadas com a idade e a nutrição na promoção da saúde e redução do risco das doenças mais comuns nos idosos; Impact of age-related nutrition issues promoting health and reducing the risk of the most common diseases among the elderly

Tavares, Nelson Rodrigues
Fonte: Repositório Científico Lusófona Publicador: Repositório Científico Lusófona
Tipo: Artigo de Revista Científica
POR
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Será revisto o Estado da Arte do Conhecimento sobre o impacto das questões relacionadas com a idade e a nutrição, que promovam a saúde e reduzem o risco das doenças mais comuns em idosos, particularmente as doenças cardiovasculares.; This paper reviews state of the art knowledge concerning the role of age related nutrition issues in promoting health and reducing the risk of the most common diseases of old age. Particular attention will be given to cardiovascular disease.

Mortalidade por doenças do aparelho circulatório no município de Ribeirão Preto - SP, de 1980 a 2004; Mortality rates due to diseases of the circulatory system (DCS) in Ribeirão Preto - SP, from 1980 to 2004; Mortalidad por enfermedades del aparato circulatorio en el municipio de Ribeirão Preto-SP, del 1980 a 2004

MORAES, Suzana Alves de; SUZUKI, Cláudio Shigueki; FREITAS, Isabel Cristina Martins de; COSTA JÚNIOR, Moacyr Lobo da
Fonte: Sociedade Brasileira de Cardiologia - SBC Publicador: Sociedade Brasileira de Cardiologia - SBC
Tipo: Artigo de Revista Científica
POR
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FUNDAMENTO: No âmbito da transição epidemiológica, estudos de tendência secular podem subsidiar a formulação de hipóteses para o gerenciamento em Saúde. OBJETIVO: Identificar o padrão de mortalidade por doenças do aparelho circulatório (DAC) no município de Ribeirão Preto, SP, no período de 1980 a 2004. MÉTODOS: Os óbitos por DAC foram obtidos do Sistema de Informações sobre Mortalidade (SIM). As estimativas populacionais para o município, segundo sexo, faixa etária e anos-calendário, foram obtidas do Instituto Brasileiro de Geografia e Estatística (IBGE). Os coeficientes específicos de mortalidade foram calculados, anualmente, segundo sexo e faixa etária classificada em intervalos de 10 anos, a partir dos 30 anos de idade. O estudo de tendência foi realizado por meio da construção de modelos de regressão polinomial para séries históricas, adotando-se nível de significância < 0,05. RESULTADOS: Os coeficientes específicos de mortalidade por DAC aumentaram com a idade, em ambos os sexos, sendo mais elevados no sexo masculino até a faixa etária de 40 a 49 anos, quando ocorreu aproximação em magnitude, sendo que, na faixa etária de 80 anos ou mais, esses indicadores, no sexo feminino e em alguns anos da série...

Efeito do exercício físico nos fatores de risco de doenças crônicas em mulheres obesas; Effect of physical exercise on risk factors for chronic diseases in obeses women

ROCCA, Silvia Vieira da Silva; TIRAPEGUI, Julio; MELO, Camila Maria de; RIBEIRO, Sandra Maria Lima
Fonte: Divisão de Biblioteca e Documentação do Conjunto das Químicas da Universidade de São Paulo Publicador: Divisão de Biblioteca e Documentação do Conjunto das Químicas da Universidade de São Paulo
Tipo: Artigo de Revista Científica
POR
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O presente estudo teve por objetivo avaliar os efeitos do exercício físico em um programa de emagrecimento. Durante 12 semanas, 22 mulheres obesas (IMC>30 kg/m²) foram submetidas a um programa de exercícios físicos. Ao início e ao final do programa foram avaliados: IMC, circunferências da cintura (CC) e do quadril (CQ), e a relação cintura/quadril (RCQ); composição corporal por DEXA; hemoglobina, eritrócitos, colesterol total, HDL, LDL, triacilgliceróis e glicose; potência aeróbia. Ao final do programa, os valores de potência aeróbia, hemácias e eritrócitos foram significativamente elevados, comprovando os efeitos do treinamento. Nos valores de antropometria e composição corporal, apenas os valores relacionados à gordura visceral (CC, CQ e RCQ) sofreram redução significativa. O exercício mostrou-se um importante coadjuvante nos processos de emagrecimento, não por promover redução da massa corporal total, mas em diminuir fatores de risco para o desenvolvimento de doenças crônicas.; This study aimed to evaluate the effects of physical exercise on body weight reduction. For 12 weeks, 22 obese women (BMI>30 kg/m²) were submitted to a physical exercise program. At the beginning and at the final of the program there were evaluated: BMI...

Tratamento cirúrgico das doenças da transição cervicotorácica; Surgical treatment of the cervicothoracic junction diseases; Tratamiento quirúrgico de las enfermedades de transición cervicotorácica

HERRERO, Carlos Fernando Pereira da Silva; PENNO, Ricardo Alberto Lupinacci; DEFINO, Helton LA
Fonte: Sociedade Brasileira de Coluna Publicador: Sociedade Brasileira de Coluna
Tipo: Artigo de Revista Científica
POR
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OBJETIVO: avaliar o resultado do tratamento cirúrgico de pacientes portadores de doenças na transição cervicotorácica da coluna vertebral. MÉTODOS: foram avaliados, retrospectivamente, 20 pacientes: nove (45%) apresentavam lesões traumáticas, sete (35%) lesões neoplásicas e quatro (20%) doenças degenerativas. No grupo de pacientes com lesões traumáticas, foi realizada fixação posterior em cinco deles (55,5%), fixação anterior em um (11,1%) e abordagem combinada (anterior e posterior) em três (33,3%). Dos sete pacientes com lesões tumorais, quatro (57,1%) foram submetidos ao tratamento cirúrgico pela abordagem combinada e três (42,8%) pela abordagem posterior isolada. No grupo de pacientes com doenças degenerativas da coluna vertebral, três (75%) foram tratados pela abordagem posterior e um (25%) de forma combinada. Todos os pacientes foram avaliados por meio de parâmetros clínicos (dor e déficit neurológico), radiológicos (manutenção da redução, soltura ou quebra dos implantes) e funcionais (SF-36, escala de dor e trabalho de Denis). RESULTADOS: os 20 pacientes foram seguidos por um período que variou de seis meses a 11 anos (média de 44,6 meses ± 29,02). Dos 13 pacientes que apresentavam déficit neurológico...

Smudge cells in peripheral blood smears did not differentiate chronic lymphocytic leukemia from other B-cell chronic lymphoprolipherative diseases; Sombras nucleares no esfregaço do sangue periférico não diferenciam a leucemia linfocítica crônica das outras doenças linfoproliferativas B crônicas

MATOS, Daniel M.; PERINI, Guilherme; KRUZICH, Carlos; REGO, Eduardo M.; FALCÃO, Roberto P.
Fonte: Associação Brasileira de Hematologia e Hemoterapia e daSociedade Brasileira de Transplante de Medula Óssea Publicador: Associação Brasileira de Hematologia e Hemoterapia e daSociedade Brasileira de Transplante de Medula Óssea
Tipo: Artigo de Revista Científica
ENG
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Smudge cells has been classically associated with chronic lymphocytic leukemia (CLL), but they are found in peripheral blood tests for other chronic B-cell lymphoproliferative diseases (CLD). We investigated whether the percentage of smudge cells in peripheral blood smears can be used in the clinical practice to differentiate CLL from other B-cell CLD. The peripheral blood smears of 63 patients with the diagnosis of CLL and 62 with other B-cell CLD were analyzed. Three hundred cells (both lymphoid cells and smudge cells) were counted for each peripheral blood smear. A comparison of the percentage of smudge cells between the two groups was performed and, subsequently, 5 cut-off values were fixed (10%, 20%, 30%, 40% and 50% of smudge cells) with the aim of defining cases as "positive" or "negative" for smudge cells and verifying whether there are any differences between CLL and the other B-cell CLD. The percentage of smudge cells in patients with CLL (median 26%, 4%-86%) was higher than in patients with B-cell CLD (median 14%, 1%-64%). However, none of the cut-off values tested presented suitable values of sensitivity, specificity and positive predictive value to separate the two groups. As it is necessary to have a single cut-off value with high sensitivity...

Effect of air pollution on diabetes and cardiovascular diseases in São Paulo, Brazil

PEREIRA FILHO, M.A.; PEREIRA, L.A.A.; ARBEX, F.F.; ARBEX, M.; CONCEIÇÃO, G.M.; SANTOS, U.P.; LOPES, A.C.; SALDIVA, P.H.N.; BRAGA, A.L.F.; CENDON, S.
Fonte: Associação Brasileira de Divulgação Científica Publicador: Associação Brasileira de Divulgação Científica
Tipo: Artigo de Revista Científica
ENG
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Type 2 diabetes increases the risk of cardiovascular mortality and these patients, even without previous myocardial infarction, run the risk of fatal coronary heart disease similar to non-diabetic patients surviving myocardial infarction. There is evidence showing that particulate matter air pollution is associated with increases in cardiopulmonary morbidity and mortality. The present study was carried out to evaluate the effect of diabetes mellitus on the association of air pollution with cardiovascular emergency room visits in a tertiary referral hospital in the city of São Paulo. Using a time-series approach, and adopting generalized linear Poisson regression models, we assessed the effect of daily variations in PM10, CO, NO2, SO2, and O3 on the daily number of emergency room visits for cardiovascular diseases in diabetic and non-diabetic patients from 2001 to 2003. A semi-parametric smoother (natural spline) was adopted to control long-term trends, linear term seasonal usage and weather variables. In this period, 45,000 cardiovascular emergency room visits were registered. The observed increase in interquartile range within the 2-day moving average of 8.0 µg/m³ SO2 was associated with 7.0% (95%CI: 4.0-11.0) and 20.0% (95%CI: 5.0-44.0) increases in cardiovascular disease emergency room visits by non-diabetic and diabetic groups...

Osteonecrose maxilar em pacientes portadores de doenças neoplásicas sob uso de bisfosfonatos; Jaw osteonecrosis in patients with neoplastic diseases taking bisphosphonates

SANTOS, Paulo S. S.; GAMBIRAZI, Liane M.; FELIX, Valtuir B.; MAGALHÃES, Marina Helena C. G.
Fonte: Associação Brasileira de Hematologia e Hemoterapia e daSociedade Brasileira de Transplante de Medula Óssea Publicador: Associação Brasileira de Hematologia e Hemoterapia e daSociedade Brasileira de Transplante de Medula Óssea
Tipo: Relatório
POR
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A osteonecrose induzida por bisfosfonatos é uma complicação que pode ocorrer em pacientes acometidos por doença osteolítica tais como mieloma múltiplo, portadores de metástases tumorais em tecido ósseo, osteoporose e que fizeram uso de droga do grupo dos bisfosfonatos. A despeito dos benefícios do uso destes fármacos, a osteonecrose maxilar é uma importante complicação. Seu mecanismo de ação reduz a reabsorção óssea, o estímulo à atividade osteoblástica, a inibição do recrutamento e promoção da apoptose de osteoclastos. Até o presente momento, não há na literatura um protocolo de tratamento para a osteonecrose por bisfosfonatos. No presente trabalho, os autores fazem uma revisão da literatura e descrevem dois casos clínicos em pacientes do sexo feminino, com diferentes doenças, mieloma múltiplo e metástases ósseas por carcinoma de mama, acometidas por osteonecrose em mandíbula induzida por bisfosfonatos.; The use of bisphosphonates among patients affected by osteolytic diseases, such as multiple myeloma, metastatic bone lesions and osteoporosis has been associated with the risk of osteonecrosis of the jaws. Bisphosphonates are found in areas of the bone that are undergoing inflammation or resorption. They are phagocytosed and internalized by osteoclasts. Once in the bone...

Aumento do índice de massa corporal após os 20 anos de idade e associação com indicadores de risco ou de proteção para doenças crônicas não transmissíveis; Body mass index increase after the age of 20 and associations with risk or protection factors for chronic non-communicable diseases

COELHO, Mara Sérgia Pacheco Honório; ASSIS, Maria Alice Altenburg de; MOURA, Erly Catarina
Fonte: Sociedade Brasileira de Endocrinologia e Metabologia Publicador: Sociedade Brasileira de Endocrinologia e Metabologia
Tipo: Artigo de Revista Científica
POR
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OBJETIVO: Investigar fatores sociodemográficos, de risco ou de proteção para doenças crônicas não transmissíveis (DCNT) que se associem ao aumento do índice de massa corporal (IMC) após os 20 anos de idade. MÉTODOS: Estudo transversal com 769 mulheres e 572 homens do Sistema Municipal de Monitoramento de Fatores de Risco para DCNT, 2005, Florianópolis, SC. O aumento do IMC foi definido em percentagem, pela diferença entre o IMC em 2005 e aos 20 anos. RESULTADOS: Desde os 20 anos, o aumento do IMC foi superior a 10% para a maioria dos indivíduos. Nas análises múltiplas, o aumento do IMC foi associado a aumento da idade, baixo nível educacional (mulheres), ser casado (homens), não trabalhar, baixo nível de percepção de saúde, pressão alta, colesterol/triglicerídeos elevados (homens), realização de dieta, sedentarismo e ex-tabagismo (mulheres). CONCLUSÕES: Estratégias de saúde para prevenir o ganho de peso em nível populacional devem considerar principalmente os fatores sociodemográficos.; OBJECTIVE: To examine sociodemographic risk or protection factors for chronic non-communicable diseases (CNCDs) that may be associated with increase in body mass index (BMI) after the age of 20. METHODS: Cross-sectional analysis based on data from 769 women and 572 men who participated in the 2005 Surveillance System for Risk factors for CNCDs...

Effect of physical exercise on risk factors for chronic diseases in obeses women

ROCCA, Silvia Vieira da Silva; TIRAPEGUI, Julio; MELO, Camila Maria de; RIBEIRO, Sandra Maria Lima
Fonte: UNIV SAO PAULO, CONJUNTO QUIMICAS Publicador: UNIV SAO PAULO, CONJUNTO QUIMICAS
Tipo: Artigo de Revista Científica
POR
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This study aimed to evaluate the effects of physical exercise on body weight reduction. For 12 weeks, 22 obese women (BMI>30 kg/m(2)) were submitted to a physical exercise program. At the beginning and at the final of the program there were evaluated: BMI, waist (WC) and hip circumferences (HC), and waist-hip ratio (WHR); body composition by DEXA; hemoglobin and erythroctye, total cholesterol, HDL and LDL, triacylglycerol and blood glucose; aerobic power. At the final of the program, aerobic power, hemoglobin and erythrocyte values were significantly increased, confirming the physical training effects. Related to anthropometric values, only the visceral fat (WC, HC and WHR) were reduced. The exercise shows to be an important supporting in the body weight loss program, not exactly promoting body weight loss, but lowering risk factors to develop chronic diseases.

Pathogenic role of anti-endothelial cell antibodies in autoimmune rheumatic diseases

DOMICIANO, D. S.; CARVALHO, J. F.; SHOENFELD, Y.
Fonte: SAGE PUBLICATIONS LTD Publicador: SAGE PUBLICATIONS LTD
Tipo: Artigo de Revista Científica
ENG
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Anti-endothelial cells antibodies have been detected in numerous autoimmune and inflammatory diseases, including systemic lupus erythematous, rheumatoid arthritis, vasculitis and sarcoidosis. Anti-endothelial cells antibodies bind to endothelial cell antigens and induce endothelial damage. Their effects on the endothelial cell have been considered responsible, at least in part, by the vascular injury which occurs in these pathological conditions. Lupus (2009) 18, 1233-1238.; Federico Foundation

The relevance of social network analysis on the epidemiology and prevention of sexually transmitted diseases

Périssé,André Reynaldo Santos; Nery,José Augusto da Costa
Fonte: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz Publicador: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2007 EN
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Historically, the epidemiology of sexually transmitted diseases (STD) has been based on individual attributes and behavior. However, STD constitute a good example of diseases that depend on personal contacts for dissemination. Social network analysis is a relatively new technique that studies the interactions among people. Since 1985 when it was first used for STD, some studies have been done using the technique, especially in the last 10 years. The two network-based designs, sociocentric or complete networks and egocentric or personal networks, are currently recognized as important tools for a better understanding of STD's dynamic. Here an overview is presented of social network analysis: the technique, its use, and its limitations. Ethical considerations regarding social network analyses are also briefly discussed.

Differential susceptibility according to gender in the association between air pollution and mortality from respiratory diseases

Oliveira,Marcio Sacramento de; Leon,Antônio Ponce de; Mattos,Inês Echenique; Koifman,Sérgio
Fonte: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz Publicador: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/09/2011 EN
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This study analyzed the association between air pollution and deaths from respiratory diseases, considering differential susceptibility according to gender. The authors used daily deaths from respiratory diseases (ICD-10, J00-J99), PM10, SO2, and O3 levels, and meteorological indicators in Volta Redonda, Rio de Janeiro State, Brazil, from January 2002 to December 2006. The association was estimated by Poisson regression using generalized additive models, where the increase in risk of deaths from PM10 to lag 1 was 10.01% (95%CI: 1.81-18.88%) in the total female population and 10.04% (95%CI: 0.90-20.02%) in elderly women. The increase in risk of deaths from PM10 to lag 9 was 8.25% in the total male population (95%CI: 0.86-16.18%) and 10.80% (95%CI: 2.18-20.15%) in elderly men. For exposure to SO2 and O3, the risk was significant in the total male population and the elderly, respectively. The results emphasize the need for further studies, focusing on modification of the effects of air pollution on health.

Can we prevent cardiovascular diseases in low- and middle-income countries?

Lenfant,Claude
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2001 EN
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Ischaemic heart disease, the largest cause of death worldwide, is rapidly becoming a major threat in low- and middle-income countries. Experience in a variety of populations has demonstrated that lowering certain risk factors, such as hypertension and hypercholesterolaemia, reduces illness and deaths from cardiovascular diseases. A dual approach is recommended: screening and intervening in cases of relatively high risk, while fostering population-wide preventive activities. This is both feasible and affordable. Now is the time to make such efforts.

Drugs and clinical trials in neurodegenerative diseases

Stanzione,Paolo; Tropepi,Domenicantonio
Fonte: Istituto Superiore di Sanità Publicador: Istituto Superiore di Sanità
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2011 EN
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Neurodegenerative diseases are disabling conditions continuously increasing due to aging of population. A disease modifying therapy that slows or stops disease progression is therefore a major unmet medical need. Unfortunately, research for effective treatments is hampered by lack of knowledge on the pathologic processes underpinning these diseases and of reliable biomarkers. Clinical trials are difficult, as they require large populations that need to be followed for very long periods to capture possible effects on disease progression. These difficulties produce frequent failures and waste of human and economic resources. Since research has to continue in this area, until comprehensive knowledge of basic pathologic processes is obtained, alternative study designs can be considered to identify disease modifiers and to reduce costs of clinical studies.

Air pollution and respiratory diseases in the Municipality of Vitória, Espírito Santo State, Brazil

Castro,Hermano Albuquerque de; Hacon,Sandra; Argento,Roberta; Junger,Washington Leite; Mello,Carla F. de; Castiglioni Júnior,Nilson; Costa,José Gustavo da
Fonte: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz Publicador: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2007 EN
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In Brazil, increasing air pollution in urban areas has led to a rise in respiratory diseases among children and the elderly and has also been the main cause of hospital admissions. This study aims to evaluate the air pollution levels in Vitória, capital of Espírito Santo State, Brazil, in comparison to Brazilian legislation and recent World Health Organization (WHO) guidelines, analyzing the spatial distribution of asthma cases treated at local outpatient services. A descriptive epidemiological study was performed with daily records on air pollution and outpatient treatment for respiratory diseases from 2001 to 2003, for children under 6 years of age. A geographic information system (GIS) was used to identify asthma distribution in the municipality. Air pollution levels were relatively low when compared to the Brazilian legislation and WHO guidelines. Only mean PM10 and NO2 exceeded the annual quality standard. The three highest asthma outpatient treatment rates were observed in the districts of São José, Jabou, and Morro do Quadro.

A cluster-randomized controlled trial of handrubs for prevention of infectious diseases among children in Colombia

Correa,Juan C.; Pinto,Diana; Salas,Lucas A.; Camacho,Juan C.; Rondón,Martín; Quintero,Juliana
Fonte: Organización Panamericana de la Salud Publicador: Organización Panamericana de la Salud
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2012 EN
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OBJECTIVE: To evaluate the effectiveness of alcohol-based handrubs (ABH) in reducing acute diarrheal diseases (ADD) and acute respiratory infections (ARI) among children 1-5 years of age in childcare centers with limited tap water. METHODS: This was the first cluster-randomized controlled trial in a developing country. The study took place at 42 childcare centers with sporadic and limited water availability in six towns in Colombia. Participants were randomly assigned to use ABH as a complement to handwashing (intervention arm: 21 centers/794 children); or to continue existing handwashing practices (control arm: 21 centers/933 children). ADD and ARI cases were identified through teacher-reported signs and symptoms of illness. Adverse events were monitored. Hazard ratios (HR) were obtained using Cox proportional hazards multivariate regression shared frailty models. RESULTS: Child-days of surveillance totaled 336 038. Loss to follow up was 14.5%. For both ADD and ARI, there were no differences in hazard ratios during the first trimester of the study. In the second and third trimesters, significant reductions in the risk of ADD were found in the intervention compared to control arm (HR = 0.55, P < 0.001 and HR = 0.44, P < 0.001, respectively). There were also significant risk reductions for ARI in the second trimester (HR = 0.80...

Methodology in the epidemiological research of respiratory diseases and environmental pollution

Barquera,Simón; Rico-Méndez,Favio G; Tovar,Víctor
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 01/02/2002 EN
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There are complex and diverse methodological problems involved in the clinical and epidemiological study of respiratory diseases and their etiological factors. The association of urban growth, industrialization and environmental deterioration with respiratory diseases makes it necessary to pay more attention to this research area with a multidisciplinary approach. Appropriate study designs and statistical techniques to analyze and improve our understanding of the pathological events and their causes must be implemented to reduce the growing morbidity and mortality through better preventive actions and health programs. The objective of the article is to review the most common methodological problems in this research area and to present the most available statistical tools used.

Should body mass index be adjusted for relative sitting height in cross-sectional studies of chronic diseases in Japanese-Brazilians?

Ribeiro,Adriana Bouças; Gimeno,Suely Godoy Agostinho; Andreoni,Solange; Ferreira,Sandra Roberta Gouveia
Fonte: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz Publicador: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/08/2006 EN
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The current article aimed to verify the degree of agreement in classification of nutritional status according to body mass index (BMI) and corrected body mass index (BMIc). Data were used from a cross-sectional study of Japanese-Brazilians. Statistical analysis provided prevalence rates for chronic diseases, kappa statistic, and Pearson's linear correlation coefficient. Some 5.9% of Japanese-Brazilians were discordant according to the BMI and BMIc classifications. The weighted kappa statistic (0.94; p = 0.000) indicated good agreement between the classifications. Similar prevalence rates for chronic diseases were obtained for individuals with excess weight classified by these two indices. Similar Pearson's linear correlation coefficients were obtained for these indices and waist circumference and body fat measurements. The results suggest that BMI correction for relative sitting height is probably unnecessary for these individuals.

Malnutrition as an underlying cause of childhood deaths associated with infectious diseases in developing countries

Rice,Amy L; Sacco,Lisa; Hyder,Adnan; Black,Robert E.
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2000 EN
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INTRODUCTION: Recent estimates suggest that malnutrition (measured as poor anthropometric status) is associated with about 50% of all deaths among children. Although the association between malnutrition and all-cause mortality is well documented, the malnutrition-related risk of death associated with specific diseases is less well described. We reviewed published literature to examine the evidence for a relation between malnutrition and child mortality from diarrhoea, acute respiratory illness, malaria and measles, conditions that account for over 50% of deaths in children worldwide. METHODS:MEDLINE was searched for suitable review articles and original reports of community-based and hospital-based studies. Findings from cohort studies and case-control studies were reviewed and summarized. RESULTS: The strongest and most consistent relation between malnutrition and an increased risk of death was observed for diarrhoea and acute respiratory infection. The evidence, although limited, also suggests a potentially increased risk for death from malaria. A less consistent association was observed between nutritional status and death from measles. Although some hospital-based studies and case-control studies reported an increased risk of mortality from measles...

Perspectives on stimulating industrial research and development for neglected infectious diseases

Webber,David; Kremer,Michael
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2001 EN
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This paper summarizes recent thinking on stimulating industrial research and development (R & D) for neglected infectious diseases and argues that it is critical to enlarge the value of the market for medicines and vaccines through, for example, global purchase funds. The most important economic barriers to R & D are that the commercial markets are small and that individual purchasing power is severely limited, even though the number of patients may be very large. Since R & D costs for all diseases are high, this means that returns will not cover investments. Various mechanisms have been proposed to address this economic imbalance (accepting that other barriers will also need to be considered). Economic devices which reduce the costs of R & D - push factors - are useful, but our review suggests that high costs do not explain the shortfall in R & D. Economic devices which address the lack of viable markets have been termed pull factors and are designed to create or secure a market, thereby improving the likelihood of a return on investments. One pull mechanism is the commitment in advance to purchase a product that meets specified criteria, if invented. The purchase-precommitment approach has a number of attractive features. For example...