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Family history of cancer: Pooled analysis in the International Head and Neck Cancer Epidemiology consortium

NEGRI, Eva; BOFFETTA, Paolo; BERTHILLER, Julien; CASTELLSAGUE, Xavier; CURADO, Maria Paula; MASO, Luigino Dal; DAUDT, Alexander W.; FABIANOVA, Eleonora; FERNANDEZ, Leticia; WUNSCH-FILHO, Victor; FRANCESCHI, Silvia; HAYES, Richard B.; HERRERO, Rolando; KOI
Fonte: WILEY-LISS Publicador: WILEY-LISS
Tipo: Artigo de Revista Científica
ENG
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Alcohol and tobacco consumption are well-recognized risk factors for head and neck cancer (HNC). Evidence suggests that genetic predisposition may also play a role. Only a few epidemiologic studies, however, have considered the relation between HNC risk and family history of HNC and other cancers. We pooled individual-level data across 12 case-control studies including 8,967 HNC cases and 13,627 controls. We obtained pooled odds ratios (OR) using fixed and random effect models and adjusting for potential confounding factors. All statistical tests were two-sided. A family history of HNC in first-degree relatives increased the risk of HNC (OR = 1.7, 95% confidence interval, CI, 1.2-2.3). The risk was higher when the affected relative was a sibling (OR = 2.2, 95% CI 1.6-3.1) rather than a parent (OR = 1.5, 95% CI 1.1-1.8) and for more distal HNC anatomic sites (hypopharynx and larynx). The risk was also higher, or limited to, in subjects exposed to tobacco. The OR rose to 7.2 (95% CI 5.5-9.5) among subjects with family history, who were alcohol and tobacco users. A weak but significant association (OR = 1.1, 95% CI 1.0-1.2) emerged for family history of other tobacco-related neoplasms, particularly with laryngeal cancer (OR = 1.3, 95% CI 1.1-1.5). No association was observed for family history of nontobacco-related neoplasms and the risk of HNC (OR = 1.0...

High prevalence of hepatitis C associated with familial history of hepatitis in a small town of south Brazil: efficiency of the rapid test for epidemiological survey

Ivantes,Cláudia Alexandra Pontes; Silva,Danilo; Messias-Reason,Iara
Fonte: Brazilian Society of Infectious Diseases Publicador: Brazilian Society of Infectious Diseases
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/10/2010 EN
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This report describes a cross-sectional survey on the prevalence of hepatitis C antibodies (anti-HCV) in Tamboara, a small community in the northwest area from Paraná State, south of Brazil with a high rate of accumulated detection for HCV. Eight hundred and sixteen residents (17.87% from all the population), independently of the age and time living in Tamboara were included in this study by an epidemiologic questionnaire and by testing for anti-HCV. The rapid immuno-chromatographic test was applied for detection of HCV antibodies. The anti-HCV prevalence by rapid test was 4.28%. The median age for positive and negative test was 60.49 ± 14.14 and 41.67 ± 20.25, respectively (p < 0.001). By multivariate analysis, only familial history of hepatitis (p = 0.001; OR = 6.41; CI 95% = 2.08-19.78) and age (p = 0.007; OR 1.06;95% CI = 1.02-1.10) showed statistical significance for positive anti-HCV. The rapid test sensitivity and specificity were 100% and 92.7% respectively, with an accuracy of 95.8% (95% CI = 91-100). These findings demonstrated a high prevalence of anti-HCV in Tamboara. The familial history of hepatitis was a significant risk factor to the infection and HCV rapid test showed to be accurate and feasible for epidemiological survey

Pathophysiology, Epidemiology, and Natural History of Benign Prostatic Hyperplasia

Lepor, Herbert
Fonte: MedReviews, LLC Publicador: MedReviews, LLC
Tipo: Artigo de Revista Científica
Publicado em //2004 EN
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The pathophysiology, epidemiology, and natural history of benign prostatic hyperplasia (BPH) are incompletely understood; however, the development of reliable instruments to measure symptom severity, prostatic enlargement, and bladder outlet obstruction has allowed major advances in their elucidation. The development of lower urinary tract symptoms (LUTS) in the aging male is influenced to some degree by the severity of bladder outlet obstruction and prostatic enlargement. Although the development of LUTS, bladder outlet obstruction, and BPH are age-dependent, they are not necessarily causally related; there are many other factors involved in the pathophysiology of LUTS. The clinically important parameters of disease progression in men with moderate to severe LUTS and low peak flow rates are symptom progression and the development of acute urinary retention (AUR). The risk of AUR is related to both baseline serum prostate-specific antigen level and prostate volume. In men with moderate prostate enlargement, the risk of AUR appears to be high enough to justify intervention with a 5α-reductase inhibitor in order to reduce this risk.

Research on smoking and lung cancer: a landmark in the history of chronic disease epidemiology.

White, C.
Fonte: Yale Journal of Biology and Medicine Publicador: Yale Journal of Biology and Medicine
Tipo: Artigo de Revista Científica
Publicado em //1990 EN
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This paper describes the history of the epidemiologic research on lung cancer prior to 1970 and its effect on chronic disease epidemiology. In the 1930s, epidemiology was largely concerned with acute infectious diseases. As the evidence grew that the incidence of lung cancer was increasing among men, however, epidemiologists undertook research into the etiology of the disease. In 1950, Doll and Hill, in England, and Wynder and Graham, in the United States, published substantial case-control studies that implicated the use of tobacco as a major risk factor for the disease. A controversy developed over the credibility of this finding and was increased in 1954 when a cohort study by Doll and Hill and another by Hammond and Horn each gave estimates that the risk of lung cancer was greatly increased among smokers relative to the risk among comparable non-smokers. An account is given of the disputes surrounding these and related studies. The controversy had a stimulating effect in fostering the developing discipline of chronic disease and epidemiology.

A brief perspective on the early history of American infectious disease epidemiology.

Kass, E. H.
Fonte: Yale Journal of Biology and Medicine Publicador: Yale Journal of Biology and Medicine
Tipo: Artigo de Revista Científica
Publicado em //1987 EN
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65.65%
The early history of epidemiology is closely linked to the history of infectious diseases and can be divided into three distinct periods. The earliest period, which can be traced to the writings of Hippocrates in the third and fourth centuries B.C., was that of clinical description of diseases with little investigation into their specific characteristics and etiologies. The second period, spanning the eighteenth and nineteenth centuries, may be distinguished by the rejection of early Hippocratic and Galenic doctrines and the more systematic description of morbid conditions. The third period, which was marked by the discovery of specific microbial causes of disease, spurred an extraordinary growth of knowledge and scientific exploration. This period will be the main focus of the paper, as it had the greatest influence on the development of American infectious disease epidemiology.

Improvements in Ability to Detect Undiagnosed Diabetes by Using Information on Family History Among Adults in the United States

Yang, Quanhe; Liu, Tiebin; Valdez, Rodolfo; Moonesinghe, Ramal; Khoury, Muin J.
Fonte: Oxford University Press Publicador: Oxford University Press
Tipo: Artigo de Revista Científica
EN
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Family history is an independent risk factor for diabetes, but it is not clear how much adding family history to other known risk factors would improve detection of undiagnosed diabetes in a population. Using the National Health and Nutrition Examination Survey for 1999−2004, the authors compared logistic regression models with established risk factors (model 1) with a model (model 2) that also included familial risk of diabetes (average, moderate, and high). Adjusted odds ratios for undiagnosed diabetes, using average familial risk as referent, were 1.7 (95% confidence interval (CI): 1.2, 2.5) and 3.8 (95% CI: 2.2, 6.3) for those with moderate and high familial risk, respectively. Model 2 was superior to model 1 in detecting undiagnosed diabetes, as reflected by several significant improvements, including weighted C statistics of 0.826 versus 0.842 (bootstrap P = 0.001) and integrated discrimination improvement of 0.012 (95% CI: 0.004, 0.030). With a risk threshold of 7.3% (sensitivity of 40% based on model 1), adding family history would identify an additional 620,000 (95% CI: 221,100, 1,020,000) cases without a significant change in false-positive fraction. Study findings suggest that adding family history of diabetes can provide significant improvements in detecting undiagnosed diabetes in the US population. Further research is needed to validate the authors’ findings.

A Brief Perspective on the Early History of American Infectious Disease Epidemiology

Kass, Edward Harold
Fonte: Yale Journal of Biology and Medicine Publicador: Yale Journal of Biology and Medicine
Tipo: Artigo de Revista Científica
EN_US
Relevância na Pesquisa
65.65%
The early history of epidemiology is closely linked to the history of infectious diseases and can be divided into three distinct periods. The earliest period, which can be traced to the writings of Hippocrates in the third and fourth centuries B.C., was that of clinical description of diseases with little investigation into their specific characteristics and etiologies. The second period, spanning the eighteenth and nineteenth centuries, may be distinguished by the rejection of early Hippocratic and Galenic doctrines and the more systematic description of morbid conditions. The third period, which was marked by the discovery of specific microbial causes of disease, spurred an extraordinary growth of knowledge and scientific exploration. This period will be the main focus of the paper, as it had the greatest influence on the development of American infectious disease epidemiology.

Association between Non-High-Density-Lipoprotein-Cholesterol Levels and the Prevalence of Asymptomatic Intracranial Arterial Stenosis

Wu, Jianwei; Zhang, Qian; Yang, Huajun; Gao, Xiang; Zhou, Yong; Wang, Anxin; Wang, Chunxue; Zhang, Shufeng; Wu, Shouling; Zhao, Xingquan
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
EN_US
Relevância na Pesquisa
55.54%
Objective: The aim of this study was to assess the association between non-high-density-lipoprotein-cholesterol (non-HDL-C) and the prevalence of asymptomatic intracranial arterial stenosis (ICAS). Methods and Results: The Asymptomatic Polyvascular Abnormalities Community (APAC) study is a prospective cohort study based on the Kailuan district (China) population. A total of 5351 eligible subjects, aged ≥40, and without history of stroke or myocardial infarction, were enrolled in this study. Transcranial Doppler Ultrasonography (TCD) was performed on all enrolled subjects for the evaluation of ICAS presence. Out of 5351 patients, 698 subjects showed evidence of ICAS (prevalence of 13.04%). Multivariate analysis showed that non-HDL-C is an independent indicator for the presence of ICAS (OR = 1.15, 95%CI: 1.08 – 1.23), but with a gender difference (P for interaction<0.01): in men, non-HDL-C is an independent indicator for ICAS (multivariate-adjusted OR = 1.28, 95%CI: 1.18–1.39), but not in women (multivariate-adjusted OR = 1.03, 95%CI: 0.93–1.14). Subjects were divided into five subgroups based non-HDL-C levels and these levels correlated linearly with the prevalence of ICAS (P for trend <0.01). Compared with the first quintile...

Clinical Characteristics of Children with Autism Spectrum Disorder and Co-Occurring Epilepsy

Viscidi, Emma W.; Triche, Elizabeth W.; Pescosolido, Matthew F.; McLean, Rebecca L.; Joseph, Robert M.; Spence, Sarah J.; Morrow, Eric M.
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
EN_US
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Objectives: To estimate the prevalence of epilepsy in children with Autism Spectrum Disorder (ASD) and to determine the demographic and clinical characteristics of children with ASD and epilepsy in a large patient population. Methods: Cross-sectional study using four samples of children with ASD for a total of 5,815 participants with ASD. The prevalence of epilepsy was estimated from a population-based sample. Children with and without epilepsy were compared on demographic and clinical characteristics. Multivariate logistic regression was used to examine the association between demographic and clinical characteristics and epilepsy. Results: The average prevalence of epilepsy in children with ASD 2–17 years was 12.5%; among children aged 13 years and older, 26% had epilepsy. Epilepsy was associated with older age, lower cognitive ability, poorer adaptive and language functioning, a history of developmental regression and more severe ASD symptoms. The association between epilepsy and the majority of these characteristics appears to be driven by the lower IQ of participants with epilepsy. In a multivariate regression model, only age and cognitive ability were independently associated with epilepsy. Children age 10 or older had 2.35 times the odds of being diagnosed with epilepsy (p<.001) and for a one standard deviation increase in IQ...

Self-Rated Health in the Last 12 Years of Life Compared to Matched Surviving Controls: The Health and Retirement Study

Stenholm, Sari; Pentti, Jaana; Kawachi, Ichiro; Westerlund, Hugo; Kivimäki, Mika; Vahtera, Jussi
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
EN_US
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Self-rated health (SRH) is a valid measure of health status and associated with mortality. Based on individual-level biannual repeat data on SRH we sought to characterize the natural history of poor SRH during the 12 years prior to death in men and women in different age groups. We conducted a retrospective analysis of the Health and Retirement Study participants who died between 1998 and 2010 and had at least two SRH measurements in the 12 years prior to death. We used a nested case-control design to compare SRH trajectories of deceased men and women aged 30–64, 65–79 and 80 years versus surviving participants. The cases comprised 3,350 deceased participants who were matched to surviving controls (n = 8,127). SRH was dichotomized into good vs. poor health. Men and women dying at age 65–79 and ≥80 years had 1.5 to 3 times higher prevalence of poor SRH already 11–12 years prior to death compared to surviving controls. The risk estimates remained statistically significant even after adjusting for life-style related risk factors and diagnosed diseases. Prevalence of poor SRH before death was lowest among those aged ≥80 years and highest in 30–64 year-olds. In conclusion, men and women who subsequently die perceive their health worse already 11–12 years prior to death compared to their surviving controls.

Self-reported history of chemotherapy and cognitive decline in adults aged 60 and older: The PATH Through Life Project.

Anstey, Kaarin J; Sargent-Cox, Kerry; Cherbuin, Nicolas; Sachdev, Perminder S
Fonte: Oxford University Press Publicador: Oxford University Press
Tipo: Artigo de Revista Científica Formato: 8 pages
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Background. There is a lack of data from cohort studies assessing cognitive function prior to and after chemotherapy. We evaluated the effect of self-reported cancer chemotherapy on cognitive function in a cohort assessed at baseline, 4 and 8 years. Methods. Participants were from the population-based PATH Through Life Study. Of the 2,551 participants aged 60–64 at baseline without cognitive impairment, 1,949 completed wave 3 and had data on cancer and chemotherapy and cognitive function. Linear mixed models were used to analyze the data. Results. At wave 3, participants reporting history of chemotherapy (n = 76) had lower scores on memory, processing speed, and executive function compared with those reporting cancer without chemotherapy (n = 289) and no cancer history (n = 1508). After adjustment for depression and disability, effects remained for processing speed and memory. Chemotherapy prior to the study commencement (n = 24), but not between waves 1 and 3 (n = 81), was associated with greater decline in delayed recall (β = −.21 [95% CI −0.38, −.03], p = .02) and digits backwards β = −.05 [95% CI −0.09, −.01], p = .02) over 8 years compared with those with no cancer history (n = 1562). Women reporting chemotherapy for breast cancer after wave 1 (n = 26) had slower choice reaction time (−0.81 (95% CI −1.28...

RECEIPT OF CARDIAC CARE FOLLOWING HOSPITALIZATION FOR AN ACUTE MYOCARDIAL INFARCTION FOR INDIVIDUALS WITH A HISTORY OF DEPRESSION OR SCHIZOPHRENIA

MORKEM, RACHAEL
Fonte: Quens University Publicador: Quens University
Tipo: Tese de Doutorado
EN; EN
Relevância na Pesquisa
55.58%
Background: The goal of this study was to improve upon methodological limitations of previous studies to determine the existence and source of differences in the cardiac care of individuals with a history of depression or schizophrenia. The selected outcomes were three cardiac procedures: catheterization, percutaneous transluminal coronary angiography (PTCA), and coronary artery bypass graft (CABG); and three cardiac pharmaceuticals: beta-blockers, angiotensin converting enzyme (ACE) inhibitors and statins. Methods: This population-based retrospective cohort study consisted of 309, 790 individuals diagnosed with an AMI and admitted to an acute care hospital in Ontario between April 1, 1995 and March 31, 2009. The time-to-intervention for the depression and schizophrenia was estimated and compared to those without a mental disorder using Cox Proportional Hazards regression. Subgroup analyses were performed to evaluate the interaction between well-established confounders and the receipt of a cardiac intervention. Results: Persons with a history of depression were found to be more likely to receive a catheterization (HR=1.42, 95% CI=1.34-1.50) or PTCA (HR=1.48, 95% CI=1.40-1.57) if they had no previous CVD history, but were less likely to receive a catheterization (HR=0.71...

Association between Melanocytic Nevi and Risk of Breast Diseases: The French E3N Prospective Cohort

Kvaskoff, Marina; Bijon, Anne; Mesrine, Sylvie; Vilier, Alice; Baglietto, Laura; Fournier, Agnès; Clavel-Chapelon, Françoise; Dossus, Laure; Boutron-Ruault, Marie-Christine
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
EN_US
Relevância na Pesquisa
55.57%
Background: While melanocytic nevi have been associated with genetic factors and childhood sun exposure, several observations also suggest a potential hormonal influence on nevi. To test the hypothesis that nevi are associated with breast tumor risk, we explored the relationships between number of nevi and benign and malignant breast disease risk. Methods and Findings: We prospectively analyzed data from E3N, a cohort of French women aged 40–65 y at inclusion in 1990. Number of nevi was collected at inclusion. Hazard ratios (HRs) for breast cancer and 95% confidence intervals (CIs) were calculated using Cox proportional hazards regression models. Associations of number of nevi with personal history of benign breast disease (BBD) and family history of breast cancer were estimated using logistic regression. Over the period 15 June 1990–15 June 2008, 5,956 incident breast cancer cases (including 5,245 invasive tumors) were ascertained among 89,902 women. In models adjusted for age, education, and known breast cancer risk factors, women with “very many” nevi had a significantly higher breast cancer risk (HR = 1.13, 95% CI = 1.01–1.27 versus “none”; ptrend = 0.04), although significance was lost after adjustment for personal history of BBD or family history of breast cancer. The 10-y absolute risk of invasive breast cancer increased from 3...

Dynamic Parameters of Balance Which Correlate to Elderly Persons with a History of Falls

Muir, Jesse W.; Kiel, Douglas P.; Hannan, Marian; Magaziner, Jay; Rubin, Clinton T.
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
EN_US
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Poor balance in older persons contributes to a rise in fall risk and serious injury, yet no consensus has developed on which measures of postural sway can identify those at greatest risk of falling. Postural sway was measured in 161 elderly individuals (81.8y±7.4), 24 of which had at least one self-reported fall in the prior six months, and compared to sway measured in 37 young adults (34.9y±7.1). Center of pressure (COP) was measured during 4 minutes of quiet stance with eyes opened. In the elderly with fall history, all measures but one were worse than those taken from young adults (e.g., maximal COP velocity was 2.7× greater in fallers than young adults; p<0.05), while three measures of balance were significantly worse in fallers as compared to older persons with no recent fall history (COP Displacement, Short Term Diffusion Coefficient, and Critical Displacement). Variance of elderly subjects' COP measures from the young adult cohort were weighted to establish a balance score (“B-score”) algorithm designed to distinguish subjects with a fall history from those more sure on their feet. Relative to a young adult B-score of zero, elderly “non-fallers” had a B-score of 0.334, compared to 0.645 for those with a fall history (p<0.001). A weighted amalgam of postural sway elements may identify individuals at greatest risk of falling...

Risk of a Second Primary Cancer after Non-melanoma Skin Cancer in White Men and Women: A Prospective Cohort Study

Song, Fengju; Qureshi, Abrar A.; Giovannucci, Edward L.; Fuchs, Charles Stewart; Chen, Wendy Yvonne; Stampfer, Meir Jonathan; Han, Jiali
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
EN_US
Relevância na Pesquisa
55.65%
Background: Previous studies suggest a positive association between history of non-melanoma skin cancer (NMSC) and risk of subsequent cancer at other sites. The purpose of this study is to prospectively examine the risk of primary cancer according to personal history of NMSC. Methods and Findings: In two large US cohorts, the Health Professionals Follow-up Study (HPFS) and the Nurses' Health Study (NHS), we prospectively investigated this association in self-identified white men and women. In the HPFS, we followed 46,237 men from June 1986 to June 2008 (833,496 person-years). In the NHS, we followed 107,339 women from June 1984 to June 2008 (2,116,178 person-years). We documented 29,447 incident cancer cases other than NMSC. Cox proportional hazard models were used to calculate relative risks (RRs) and 95% confidence intervals (CIs). A personal history of NMSC was significantly associated with a higher risk of other primary cancers excluding melanoma in men (RR = 1.11; 95% CI 1.05–1.18), and in women (RR = 1.20; 95% CI 1.15–1.25). Age-standardized absolute risk (AR) was 176 in men and 182 in women per 100,000 person-years. For individual cancer sites, after the Bonferroni correction for multiple comparisons (n = 28), in men, a personal history of NMSC was significantly associated with an increased risk of melanoma (RR = 1.99...

“Toward a Clearer Definition of Confounding” Revisited With Directed Acyclic Graphs

Howards, Penelope P.; Schisterman, Enrique F.; Poole, Charles; Kaufman, Jay S.; Weinberg, Clarice R.
Fonte: Oxford University Press Publicador: Oxford University Press
Tipo: Artigo de Revista Científica
EN
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In a 1993 paper (Am J Epidemiol. 1993;137(1):1–8), Weinberg considered whether a variable that is associated with the outcome and is affected by exposure but is not an intermediate variable between exposure and outcome should be considered a confounder in etiologic studies. As an example, she examined the common practice of adjusting for history of spontaneous abortion when estimating the effect of an exposure on the risk of spontaneous abortion. She showed algebraically that such an adjustment could substantially bias the results even though history of spontaneous abortion would meet some definitions of a confounder. Directed acyclic graphs (DAGs) were introduced into epidemiology several years later as a tool with which to identify confounders. The authors now revisit Weinberg's paper using DAGs to represent scenarios that arise from her original assumptions. DAG theory is consistent with Weinberg's finding that adjusting for history of spontaneous abortion introduces bias in her original scenario. In the authors' examples, treating history of spontaneous abortion as a confounder introduces bias if it is a descendant of the exposure and is associated with the outcome conditional on exposure or is a child of a collider on a relevant undirected path. Thoughtful DAG analyses require clear research questions but are easily modified for examining different causal assumptions that may affect confounder assessment.

Considerações acerca dos fundamentos teóricos da explicação em epidemiología; Considerations concerning the theoretical foundations of explanation in epidemiology

Silva, Luiz Jacintho da
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 01/08/1985 POR
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São analisadas as condições históricas do surgimento da epidemiologia como disciplina científica, em meados do século passado. É revista a evolução das bases teóricas do processo explicativo em epidemiologia até o momento atual. Especial atenção é dada ao papel da lógica positivista de Stuart Mill como base teórica da Epidemiologia até recentemente. São discutidas as alternativas teóricas correntes e proposta maior abertura da epidemiologia a diferentes correntes filosóficas como o caminho para o estabelecimento da epidemiologia como uma ciência madura.; The historical conditions surrounding the emergence, by the mid-19th century, of epidemiology as a scientific discipline, were analysed. Special consideration is given to the influence of the political milieu of Victorian England in the definition of the theoretical basis of epidemiology. The English Sanitary Movement is seen as a response of the emerging bourgeoise to problems created by industrialization and urbanization. As a consequence, epidemiology was strongly influenced by Stuart Mill's system of logic. During the latter part of the 19th century, bacteriology brought important transformations to epidemiology. However, its theoretical foundations suffered almost no change. Possibly the new challenges created by -the expanding colonial empires were the driving force in the evolution of epidemiology. As a science...

Causa versus predição: história de banhos em rios como fator de risco e preditor da infecção pelo Schistosoma mansoni; Cause versus prediction: the history of river-bathing as a risk factor and a predictor of infection by Schistosoma mansoni

Barreto, Mauricio L.
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 01/08/1987 POR
Relevância na Pesquisa
55.65%
Através da análise das relações existentes entre as medidas de risco e as medidas de eficiência de testes de diagnóstico ou triagem, são discutidos os problemas e limitações concernentes ao uso de fatores de risco na predição da distribuição de efeitos (infecção, doença, cura) em uma população. Para ilustrar o tema, foi utilizada a associação, em crianças, entre a questão "você já tomou banhos em rios?", muito utilizada em anamneses clínicas ensinadas em diversas escolas médicas do Brasil, e a infecção pelo Schistosoma mansoni. A história de banhos em rios, enquanto um importante fator de risco, mostrou-se mau preditor da ocorrência da infecção esquistossomótica. A análise demonstrou que este achado é, em grande parte, devido a baixa freqüência de história negativa de banhos em rios. Porém, a possibilidade da utilização de fatores de risco isoladamente ou agrupados, com o objetivo de predição de efeitos, é possível e desejável. Apesar de pouco explorado nos seus aspectos práticos ou conceituais, esta área de conhecimento representa um importante ponto de convergência entre a epidemiologia das causas e a epidemiologia das intervenções.; The analysis of the relationship between those parameters used to measure risk and those used to measure efficiency of diagnostic or screening tests is used...

Interpretação histórica e transformação científica: a tarefa hermenêutica de uma teoria crítica da epidemiologia; Historical interpretation and scientific transformation: the hermeneutical task of a critical theory of epidemiology

Ayres, José Ricardo de C. M.
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 01/08/1994 POR
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55.59%
São discutidas as contribuições trazidas pela abordagem histórica ao debate epistemológico da epidemiologia. Buscando-se na teoria do agir comunicativo, de Habermas, e na filosofia hermenêutica de Gadamer, enriquecimentos para uma compreensão práxica das ciências, procura-se explorar o sentido em que a perspectiva histórica redimensiona as questões epistemológicas básicas da epidemiologia. A argumentação aponta para a maior fecundidade desta aproximação, em contraste com as aproximações estritamente lógico-formais, na apreensão dos impasses teóricos com que se defronta a epidemiologia na busca de seus axiomas científicos. Destaca-se, em particular, o potencial emancipador do resgate da historicidade no âmbito da própria atividade epistemológica.; The objective of this work is to discuss the scope of historical issues in an epistemological approach to epidemiology. Considering the contributions to a practical comprehension of science made by Habermas's theory of communicative action and Gadamer's philosophical hermeneutics, this study attempts to explore the sense in which a historical point of view redirects the main epistemological questions of epidemiology. In contrast to strictly formal approaches, a historically enhanced epistemology seems to be a more prolific source of reasoning about the striving of epidemiology for scientific axioms. The relevance of historical theoretical improvements to epistemological methods themselves...

Historical development of epidemiology and of the concepto of risk; Desenvolvimento histórico da epidemiologia e do conceito de risco

Ayres, José Ricardo de Carvalho Mesquita
Fonte: Universidade de São Paulo. Faculdade de Medicina Publicador: Universidade de São Paulo. Faculdade de Medicina
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; Formato: application/pdf
Publicado em 06/09/2009 POR
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55.7%
A utilização do raciocínio probabilístico nas práticas de saúde foi originalmente introduzida pela epidemiologia e é hoje amplamente utilizado em todas as áreas da medicina. O objetivo deste trabalho foi revisitar o desenvolvimento histórico da epidemiologia e a formalização de seu elemento epistemológico nuclear, o conceito de risco, responsável pela emergência da probabilidade como parte do raciocínio causal nas ciências da saúde. O estudo situa-se na fronteira entre as disciplinas de medicina preventiva e social, história e filosofia das ciências, caracterizando-se como uma epistemologia histórico-crítica. O período de estudo abrangeu os anos de 1872 a 1965 e sua base documental foi constituída por trabalhos de periódicos científicos relacionados à construção do campo epidemiológico, em particular o American Journal of Hygiene, livros, anais de congressos, brochuras científicas etc. Foram identificadas e discutidas três etapas de desenvolvimento da epidemiologia: epidemiologia da constituição, epidemiologia da exposição e epidemiologia do risco, apontando-se aspectos epistemológicos e sócio-culturais relacionados a cada uma delas. Destacou-se a importância da reflexão crítica sobre a ciência epidemiológica...