DECPA - Departamento de Clínicas Pediátrica e do Adulto
URI permanente desta comunidadehttp://www.hml.repositorio.ufop.br/handle/123456789/8505
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Resultados da Pesquisa
Item A smoking prevention program delivered by medical students to secondary schools in Brazil called “Education Against Tobacco” : randomized controlled trial.(2019) Lisboa, Oscar Campos; Souza, Breno Bernardes; Xavier, Luiz Eduardo de Freitas; Almeida, Matheus Rocha; Corrêa, Paulo César Rodrigues Pinto; Brinker, Titus JosefBackground: Smoking is the largest preventable cause of mortality in Brazil. Education Against Tobacco (EAT) is a network of more than 3500 medical students and physicians across 14 countries who volunteer for school-based smoking prevention programs. EAT educates 50,000 adolescents per year in the classroom setting. A recent quasi-experimental study conducted in Germany showed that EAT had significant short-term smoking cessation effects among adolescents aged 11 to 15 years. Objective: The aim is to measure the long-term effectiveness of the most recent version of the EAT curriculum in Brazil. Methods: A randomized controlled trial was conducted among 2348 adolescents aged 12 to 21 years (grades 7-11) at public secondary schools in Brazil. The prospective experimental design included measurements at baseline and at 6 and 12 months postintervention. The study groups comprised randomized classes receiving the standardized EAT intervention (90 minutes of mentoring in a classroom setting) and control classes in the same schools (no intervention). Data were collected on smoking status, gender, social aspects, and predictors of smoking. The primary endpoint was the difference in the change in smoking prevalence between the intervention group and the control group at 12-month follow-up. Results: From baseline to 12 months, the smoking prevalence increased from 11.0% to 20.9% in the control group and from 14.1% to 15.6% in the intervention group. This difference was statistically significant (P<.01). The effects were smaller for females (control 12.4% to 18.8% vs intervention 13.1% to 14.6%) than for males (control 9.1% to 23.6% vs intervention 15.3% to 16.8%). Increased quitting rates and prevented onset were responsible for the intervention effects. The differences in change in smoking prevalence from baseline to 12 months between the intervention and control groups were increased in students with low school performance. Conclusions: To our knowledge, this is the first randomized trial on school-based tobacco prevention in Brazil that shows significant long-term favorable effects. The EAT program encourages quitting and prevents smoking onset, especially among males and students with low educational background.Item Adiposity indicators as a screening method for polysomnography in shift workers.(2019) Diniz, Amanda Popolino; Fajardo, Virgínia Capistrano; Freitas, Silvia Nascimento de; Oliveira, Fernando Luiz Pereira de; Nascimento Neto, Raimundo Marques do; Pimenta, Fausto Aloísio Pedrosa; Coelho, George Luiz Lins MachadoObjective: to verify the discriminatory power of adiposity indicators in the prediction of obstructive sleep apnoea (OSA) in shift workers. Methods: a crosssectional study carried out in an iron ore extraction company, in Minas Gerais, Brazil. Anthropometric data were collected and polysomnography (PSG) was performed in 118 male shift workers who owned at least one overall risk factor for cardiovascular disease. Results: the OSA prevalence in the sample was 84.7%. Among the adiposity indicators used to predict OSA (≥ 5 events/hour), body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), and total body fat (TBF) showed sensitivity values higher than 70%. Visceral fat (VF), neck circumference (NC), and neck-to-height ratio (NHtR) were the most effective in correctly identifying workers without OSA (specificity values higher than 70%). The areas under the receiver operating characteristic (ROC) curves for WC and NHtR were greater than 0.7, which indicated the test was effective in discriminating individuals with OSA. Conclusions: alterations in abdomen and neck adiposity indicators have a significant relationship with the presence of OSA and showed effectiveness as a screening method for PSG. WC and NHtR are considered good indicators for OSA prediction.Item Update on the approach to smoking in patients with respiratory diseases.(2019) Sales, Maria Penha Uchoa; Araújo, Alberto José de; Chatkin, José Miguel; Godoy, Irma de; Pereira, Luiz Fernando Ferreira; Castellano, Maria Vera Cruz de Oliveira; Minamoto, Suzana Erico Tanni; Almeida, Adriana Ávila de; Chatkin, Gustavo; Silva, Luiz Carlos Côrrea da Silva; Gonçalves, Cristina Maria Cantarino; Botelho, Clóvis; Santos, Ubiratan Paula; Viegas, Carlos Alberto de Assis; Sestelo, Maristela Rodrigues; Meireles, Ricardo Henrique Sampaio; Corrêa, Paulo César Rodrigues Pinto; Oliveira, Maria Eunice Moraes de; Reichert, Jonatas; Lima, Mariana Silva; Silva, Celso Antonio Rodrigues daSmoking is the leading cause of respiratory disease (RD). The harmful effects of smoking on the respiratory system begin in utero and influence immune responses throughout childhood and adult life. In comparison with “healthy” smokers, smokers with RD have peculiarities that can impede smoking cessation, such as a higher level of nicotine dependence; nicotine withdrawal; higher levels of exhaled carbon monoxide; low motivation and low self-efficacy; greater concern about weight gain; and a high prevalence of anxiety and depression. In addition, they require more intensive, prolonged treatment. It is always necessary to educate such individuals about the fact that quitting smoking is the only measure that will reduce the progression of RD and improve their quality of life, regardless of the duration and severity of the disease. Physicians should always offer smoking cessation treatment. Outpatient or inpatient smoking cessation treatment should be multidisciplinary, based on behavioral interventions and pharmacotherapy. It will thus be more effective and cost-effective, doubling the chances of success.Item EAT-Brazil award for tobacco control : a brief description of its first edition.(2019) Corrêa, Paulo César Rodrigues Pinto; Pereira, Rayanna Mara de Oliveira Santos; Temporão, José Gomes; Cavalcante, Tânia Maria; Lisboa, Oscar Campos; Azevedo, Lucas Guimarães de; Brinker, Titus Josef; Souza, Breno BernardesSmoking is a major global risk factor for preventable death and disability. EAT is an acronym for Education Against Tobacco, a multinational network of physicians and medical students that aims to improve tobacco control by means of school-based prevention targeted at adolescents through counseling, use of software and support materials. The first EAT-Brazil Award, launched in March 2018, was a competition designed to encourage the proposal of objective solutions for tobacco control in Brasil, and identify new talents in the area. Brazilian undergraduate students from any field of study could submit a one-page essay on the subject, competing for the amount of R$ 1000.00 (one thousand reais). There were a total of 39 applicants (20 women and 19 men) from 9 Brazilian states and 18 undergraduate programs, with a mean age of 22.5 years (SD = 3.7). Data from an online anonymous questionnaire answered after the submission of their essays revealed that most applicants were students of institutions from in the state of Minas Gerais (n = 26/39; 66.6%), studied medicine (n = 20/39, 51.3%), and had no prior knowledge of the EAT-Brazil Network (n = 27/39, 69.2%). The winner of the award was Lucas Guimarães de Azevedo, a fourth-year medical student at Federal University of Western Bahia. The next editions of the award should focus on increasing the number of applicants and diversifying their geographical distribution.Item Hipovitaminose D e índices glicêmicos em trabalhadores de turno alternante de empresa de mineração.(2019) Rocha, Débora de Oliveira Antunes; Barbosa, Polyana Almeida; Silveira, Gabriel Pessoa Herthel; Martins, Bianca Hellen Sousa; Fajardo, Virgínia Capistrano; Coelho, George Luiz Lins Machado; Nascimento Neto, Raimundo Marques do; Freitas, Silvia Nascimento de; Oliveira, Fernando Luiz Pereira de; Pimenta, Fausto Aloísio PedrosaObjetivo: Demonstrar a prevalência da hipovitaminose D em trabalhadores de turno de uma empresa de mineração e verificar se, nesta população, há correlação entre as variáveis glicêmicas (hemoglobina glicada e glicemia de jejum) e os níveis séricos de vitamina D. Métodos: Estudo transversal observacional realizado por 2 anos consecutivos com trabalhadores de turno. No primeiro ano, foram analisados os níveis séricos de vitamina D (25(OH)D) e glicemia de jejum, excluindo indivíduos que realizavam tratamento para controle glicêmico, suplementação de vitamina D e/ou participantes do sexo feminino, totalizando 548 trabalhadores. No ano seguinte, foram selecionados da amostra anterior apenas os indivíduos que apresentaram hipovitaminose D (25(OH) D<30ng/mL). Nestes, foram analisados os níveis de 25(OH)D, glicemia de jejum e hemoglobina glicada. Foram aplicados o teste de normalidade Kolmogorov-Smirnov e a correlação de Spearman. Resultados: A idade média dos participantes foi de 38,2 anos. No primeiro ano, 80,8% dos trabalhadores apresentaram hipovitaminose D e 10,8% apresentavam glicemia de jejum fora dos níveis de normalidade. Dentre a amostra do ano seguinte, 81,1% permaneceram com hipovitaminose D, 18,2% apresentaram glicemia de jejum fora dos níveis de normalidade e 15,8% apresentaramhemoglobina glicada alterada. Não foram encontradas correlações significativas entre a 25(OH)D e a glicemia de jejum e hemoglobina glicada. Conclusão: Foi observada alta prevalência de hipovitaminose nos trabalhadores de turno. Diferentemente de outros estudos, não foram encontradas correlações significativas entre as variáveis glicêmicas e a concentração sérica da vitamina D.Item Qualidade de vida e excesso de peso em trabalhadores em turnos alternantes.(2019) Pimenta, Fausto Aloísio Pedrosa; Alves, Rafaella Lemos; Oliveira, Fernando Luiz Pereira de; Nascimento Neto, Raimundo Marques do; Coelho, George Luiz Lins Machado; Freitas, Silvia Nascimento deObjetivo: identificar a percepção dos trabalhadores de turnos alternantes de uma mineradora da região dos Inconfidentes, Minas Gerais, sobre sua qualidade de vida (QV) e analisar sua associação com indicadores de excesso de adiposidade corporal. Métodos: estudo transversal com 437 trabalhadores em turnos alternantes com um ou mais fatores de risco cardiovascular. Dados sociodemográficos e clínicos foram analisados. A QV foi avaliada com o questionário SF-36 e a adiposidade corporal estimada a partir das medidas antropométricas e de composição corporal. Resultados: a pontuação para os domínios da QV variou de 67 a 100, no entanto, o aumento de gordura corporal apresentou correlação negativa com os domínios saúde geral, vitalidade e capacidade funcional. Foi observada, por análise de cluster, a formação de dois agrupamentos, um composto pelos domínios da QV e o outro constituído pelos indicadores de composição corporal. Não foi identificada associação entre os escores estimados de QV dos trabalhadores de turno e o tempo de trabalho. Conclusão: o declínio da QV apresentou associação com o excesso de adiposidade corporal. Recomenda-se a adoção de medidas visando reduzir o excesso de adiposidade corporal e melhorar a qualidade de vida dos trabalhadores em turno alternante da mineração.Item Comments : “The impact of intensive care admission criteria on elderly mortality”.(2019) Pimenta, Fausto Aloísio PedrosaItem Effects of vitamin D supplementation on cardiovascular risk factors in shift workers : study protocol for randomized, double-blind, placebo-controlled clinical trial.(2019) Fajardo, Virgínia Capistrano; Oliveira, Fernando Luiz Pereira de; Coelho, George Luiz Lins Machado; Pimenta, Fausto Aloísio Pedrosa; Freitas, Silvia Nascimento de; Ribeiro, Antônio Luiz Pinho; Soares, Maria Marta Sarquis; Lauria, Márcio Weissheimer; Farias, Rosielle da Costa; França, Ive Bahia; Nascimento Neto, Raimundo Marques doObjective: The present clinical study aims to describe protocol to evaluate the effects of vitamin D3 supplementation on the cardiovascular risk factors in a population of rotating shift workers. Design: A randomized, double-blind, placebo-controlled, parallel group clinical trial testing 2 oral dosages of cholecalciferol (14,000 IU and 28,000 IU per week) for 12 months. Setting: The primary outcome for evaluation is an 18% reduction in hypertriglyceridemia (≥150mg/dL) between pre and postintervention measurements. Baseline characteristics of the study population will be summarized separately within each randomized group, and will use tests for continuous and categorical variables. For all tests, a P<.05 will be considered significant. The analysis of primary and secondary outcomes will use an intention-to-treat population and a per-protocol population. The primary and secondary outcomes will be compared separately between each treatment group and placebo, using binary logistic regression or regressão de Poisson for proportions (for binary outcomes) and using linear regression for differences in means (for continuous endpoints), with 95% confidence intervals. Participants: Rotating shift workers, adults aged between 18 and 60 years, with hypovitaminosis D and alterations in at least 1 of the following parameters: fasting glucose, high-density lipoprotein cholesterol, triglycerides, low-density lipoprotein cholesterol, blood pressure, and waist circumference. Conclusion: This clinical trial aims to contribute to the gap in knowledge about the potential, dose, and time of vitamin D supplementation to generate beneficial effects on triglycerides in a population at increased risk for hypertriglyceridemia and vitamin D deficiency. Abbreviations: 25(OH)D = vitamin D, AUDIT = Alcohol Use Disorders Identification Test, BAI = body adiposity index, BMI = body mass index, C index = conicity index, CI = confidence interval, DMC = data monitoring committee, HDL = high-density lipoprotein, HOMA-IR = homeostatic model for insulin resistance, IPAQ = International Physical Activity Questionnaire, ITT = intention-to-treat, LDL = low-density lipoprotein, MMSE = Mini Mental State Examination, PP = per-protocol, PTH = parathyroid hormone, RR = relative risk, SF-36 = The Medical Outcomes Study 36-Item Short-Form Health Survey, TSC = Trial Steering Committee, WHOQOL = World Health Organization Quality Of Life Instrument, WHR = waist–hip ratio, WHtR = waist–height ratio.Item Facial-aging mobile apps for smoking prevention in secondary schools in Brazil : appearance-focused interventional study.(2018) Souza, Breno Bernardes; Pires, Francisco Patruz Ananias de Assis; Madeira, Gustavo Moreira; Rodrigues, Túlio Felício da Cunha; Gatzka, Martina; Heppt, Markus V.; Omlor, Albert J.; Enk, Alexander H.; Groneberg, David A.; Seeger, Werner; Kalle, Christof von; Berking, Carola; Corrêa, Paulo César Rodrigues Pinto; Suhre, Janina Leonie; Alfitian, Jonas; Assis, Aisllan Diego de; Brinker, Titus JosefBackground: Most smokers start smoking during their early adolescence, often with the idea that smoking is glamorous. Interventions that harness the broad availability of mobile phones as well as adolescents' interest in their appearance may be a novel way to improve school-based prevention. A recent study conducted in Germany showed promising results. However, the transfer to other cultural contexts, effects on different genders, and implementability remains unknown. Objective: In this observational study, we aimed to test the perception and implementability of facial-aging apps to prevent smoking in secondary schools in Brazil in accordance with the theory of planned behavior and with respect to different genders. Methods: We used a free facial-aging mobile phone app (“Smokerface”) in three Brazilian secondary schools via a novel method called mirroring. The students’ altered three-dimensional selfies on mobile phones or tablets and images were “mirrored” via a projector in front of their whole grade. Using an anonymous questionnaire, we then measured on a 5-point Likert scale the perceptions of the intervention among 306 Brazilian secondary school students of both genders in the seventh grade (average age 12.97 years). A second questionnaire captured perceptions of medical students who conducted the intervention and its conduction per protocol. Results: The majority of students perceived the intervention as fun (304/306, 99.3%), claimed the intervention motivated them not to smoke (289/306, 94.4%), and stated that they learned new benefits of not smoking (300/306, 98.0%). Only a minority of students disagreed or fully disagreed that they learned new benefits of nonsmoking (4/306, 1.3%) or that they themselves were motivated not to smoke (5/306, 1.6%). All of the protocol was delivered by volunteer medical students. Conclusions: Our data indicate the potential for facial-aging interventions to reduce smoking prevalence in Brazilian secondary schools in accordance with the theory of planned behavior. Volunteer medical students enjoyed the intervention and are capable of complete implementation per protocol.Item The influence of neighborhood social capital on leisure-time physical activity : a population-based study in Brazil.(2018) Rodrigues, Daiana Elias; César, Cibele Comini; Kawachi, Ichiro; Xavier, Cesar Coelho; Caiaffa, Waleska Teixeira; Proietti, Fernando AugustoEnvironmentally targeted approaches to promote physical activity are emerging in recent years as a complementary strategy to the traditional individual approaches. This study explored the relation between community social capital and leisure-time physical activity in an adult population-based sample in Brazil. We applied a generalized estimating equation approach to analyze a cross-sectional survey of 3667 adults living in 149 neighborhoods. Social capital was assessed by scales that measured collective efficacy and social cohesion in the neighborhood. We find that individuals living in areas with higher level of social cohesion were more likely to be physically active even after controlling for potentially confounding individual and area-level covariates (PR = 1.56; 95% CI = 1.13, 2.16). Collective efficacy was not significantly associated with leisure-time physical activity. Interventions to strengthen social cohesion in the community may be an avenue for promoting physical activity.