Aline Cristine Souza Lopes

Age patterns in undernutrition and helminth infection in a rural area of Brazil: associations with ascariasis and hookworm

Objective  To investigate the nutritional status of individuals from a rural area of Brazil, and associations with helminth infections in an age‐stratified sample.

Consumo de nutrientes em adultos e idosos em estudo de base populacional: Projeto Bambuí

A nutritional survey was performed in a random sample of 550 individuals (>= 18 years) in Bambui, Minas Gerais State, Brazil, using the Semi-Quantitative Food Frequency Questionnaire calibrated with 24-hour recall. Comparisons used means, proportions, and the nutrient adequacy ratio (NAR: 90.0-110.0%). Adequate intake was reported in only 2.4% of the individuals for carbohydrate, 17.6% for protein, 0.0 to 5.1% for vitamins, and 0.0 to 21.1% for minerals. NAR was influenced by gender and age: 90.2% and 91.8% of women presented low iron and B6 vitamin intake, respectively. Meanwhile, 87.7% of men reported excess iron, 80.3% phosphorous, and 11.9% cholesterol. Regarding aging, 64.3% of elderly (> 60 years old) reported low protein intake and 39.3% inadequate lipid fraction balance (P/S); 35.7% reported high unsaturated fatty acid intake. For adults (18-59 years), 67.8% reported excess protein and 53.4% deficient iron intake. In this population, high lipid consumption and low intake of fiber, vitamins, and minerals pose an important public health problem and may contribute to an increase in chronic non-communicable diseases.

Consumo alimentar da população adulta segundo perfil sócio-econômico e demográfico: Projeto Bambuí

A nutritional survey was performed in a random sample of 546 individuals (ages 18 and over) in a city named Bambuí (15,000 inhabitants) in Minas Gerais State, Brazil, using the Semi-Quantitative Food Frequency Questionnaire (SFFQ). Median calorie intakes for women and men were 2,807 and 3,775kcal, respectively. Men consumed four times more alcohol than women, and women consumed more carbohydrates, fiber, and polyunsaturated fatty acids (PUFA). The relative consumption of proteins (15%), carbohydrates (57%), and lipids (28%) were adequate in both genders. The average proportions, for all participants, of an inadequate share of lipids, saturated fatty acids (SFA), PUFA, and cholesterol in the total calorie intake were, respectively, 36%, 90%, and 50%, and were more pronounced in men than in women. The lipid, SFA, and PUFA intake for women and the lipid and SFA intake for men increased with income. The PUFA/SFA ratio and the PUFA and dietary fiber intake were below the recommended levels in both genders. Dietary habits presented a differential inadequacy, suggesting possible population risk clusters for cardiovascular diseases.Foi realizado inquerito nutricional em amostra probabilistica de 546 individuos (idade > 18 anos), residentes na cidade de Bambui (15 mil habitantes), Minas Gerais, Brasil, utilizando-se o Questionario Semiquantitativo de Frequencia Alimentar (QSFA). A mediana de ingestao calorica entre mulheres e homens foi de 2.807 e 3.775kcal, respectivamente. Homens ingeriram quatro vezes mais alcool que mulheres e estas, mais carboidratos, fibras e acidos graxos polinsaturados (AGP). A distribuicao de proteinas (15%), carboidratos (57%) e lipidios (28%) foi adequada. As proporcoes medias de inadequacao da participacao de lipidios, acidos graxos saturados (AGS), AGP e colesterol na energia total foram, respectivamente, 36%, 50% e 90%, sendo mais pronunciadas entre os homens. A ingestao de lipidios, AGS e AGP, entre mulheres, e de lipidios e AGS entre homens, aumentou de acordo com a renda. A ingestao de AGP e fibras e a relacao AGP/AGS estavam abaixo do recomendado nos dois generos. A dieta apresentou proporcoes de inadequacao diferenciais, sugerindo possiveis agregados de risco a saude da populacao para doencas cardiovasculares.

Adesão às precauções padrão pela equipe do atendimento pré-hospitalar móvel de Belo Horizonte, Minas Gerais, Brasil

This was a cross-sectional study of workers in the pre-hospital care team in Belo Horizonte, Minas Gerais State, Brazil, aimed at evaluating adherence to precautions. The study instrument included questions on knowledge, attitudes, and facilitating factors for adherence to standard precautions. Adherence was verified by percentage of adequacy: > 75% correct answers. Drivers showed the lowest degree of knowledge and physicians the highest. In self-reported answers, none of the workers demonstrated adequate use of face masks, goggles, or personal protective equipment (PPE), and drivers reported inadequate attitudes on all the items. In the univariate analysis, job position, gender, and specific rescue unit were associated with adoption of precautions. Meanwhile, in the multivariate analysis, only job position was related (drivers and nurse technicians/aides). The most frequently cited facilitating factors for improvement of adherence were: training focusing on infections, occupational risks, and use of PPE; periodic team meetings; and creation of a central unit for cleaning, disinfecting, and sterilizing equipment and materials. Workers in the pre-hospital care service demonstrated attitudes that were compatible with knowledge, but professional class affected knowledge on standard precautions and self-reported adequate attitudes.

Ingestão alimentar em estudos epidemiológicos

A epidemiologia da nutricao dispoe de uma gama de metodologias para avaliar o estado nutricional. Entretanto, os metodos dieteticos sao os unicos capazes de detectar a deficiencia nutricional em seu estagio inicial, sendo por isso bastante utilizados em estudos epidemiologicos de associacao entre exposicoes e eventos. Atualmente, o metodo dietetico mais indicado para estudos epidemiologicos, principalmente aqueles envolvendo doencas cronico-degenerativas, tem sido o questionario semiquantitativo de frequencia alimentar (QSFA). Este instrumento, nao diferente de outros, esta sujeito a variabilidade e a erros de medida. Entretanto, estes podem ser identificados e tratados utilizando-se metodos como comparacao de medias dieteticas, estudos de confiabilidade, de validacao relativa e de calibracao. Em estudo realizado em Bambui-MG, o consumo de nutrientes foi avaliado por tres diferentes metodos: QSFA e recordatorios 24 horas (R24) com e sem replicas de alimentos, tendo suas medias comparadas e calibradas. As medias encontradas pelo QSFA foram consistentemente maiores do que as dos R24. No entanto, quando essas foram ajustadas pelo consumo calorico total nao apresentaram diferencas importantes, exceto para fibras; zinco; vitaminas C; B6, e E; e colesterol. E as medias calibradas foram, em geral, menores do que as nao calibradas, sendo estatisticamente significantes para ingestao de lipideos; fibras; zinco; vitaminas C, E e A; acidos graxos saturados, monoinsaturados e poliinsaturados; e colesterol.

Estimation of the number of injecting drug users attending an outreach syringe-exchange program and infection with human immunodeficiency virus (HIV) and hepatitis C virus: the AjUDE-Brasil project.

This study estimated the number of street injecting drug user (IDU) clients of a syringe-exchange program (SEP) who were infected with human immunodeficiency virus (HIV) and hepatitis C virus (HCV). A two-sample capture-recapture method was carried out. The first capture listed all interviewed IDUs outreached for syringe exchange from April 1 to May 1, 1998; the second capture involved those outreached from May 2 to June 6, 1998. Blood spots were collected for HIV and HCV serologies. Analysis used captured probability model varying with time. We interviewed 55 IDUs in the first capture and 99 in the second; 17 participated in both samples. An estimate of 317 IDUs attending the SEP was obtained (95% confidence interval [CI] 235–467). Based on the overall seroprevalence rates for HIV (47.7%) and HCV (53.1%), it was estimated that 151 IDUs were HIV infected (95% CI 112–223) and 168 (95% CI 125–248) were HCV infected. Enumeration of IDUs associated with estimates of the total number of HIV and HCV seropositives provide a powerful tool for SEPs to help monitor the number of IDUs, to plan for provisions, and to organize the new demands on existing health facilities for HIV and HCV care.

Academia da Cidade: um serviço de promoção da saúde na rede assistencial do Sistema Único de Saúde

This is an analysis of the health and nutritional profile of users of the Unified Health System admitted to a City Academy in Belo Horizonte, Minas Gerais during a triennium. It is a cross-sectional study with users> 20 years and socio-demographic characteristics, health habits, food intake and anthropometrics were gathered. Kolmogorov-Smirnov tests, ANOVA, Kruskal-Wallis test, chi-square and Fisher exact test were applied. There was a high prevalence of hypertensive subjects (41.6%), overweight (70.6%) and metabolic risks associated with obesity (67.6%). About 40% of entrants had 1-3 chronic diseases and over 65% used medication daily. There was an imbalance in daily consumption of fruits and vegetables (75.3%), fatty meat (72.4%) and sweetened drinks (54.2%). They had low education and income, and inadequate eating habits and high prevalence of hypertension, overweight and metabolic risks associated with obesity, which suggests users seeking health care services for treatment of diseases. This illustrates the perceived quest for cure, further demonstrating the lack of healthcare initiatives in the population. This reveals the need to review the actions at different levels of health care, to promote greater comprehensiveness of care provided.

Knowledge and attitude regarding standard precautions in a Brazilian public emergency service: a cross-sectional study

Objetivou-se avaliar a adocao das medidas de precaucao padrao por meio de conhecimento e atitude dos profissionais de um servico publico de emergencia, assim como a incidencia de acidentes de trabalho envolvendo material biologico entre tais profissionais. A pesquisa foi realizada com 238 profissionais entre Junho e Novembro de 2006. Utilizou-se analise univariada e multivariada. A possibilidade de nao-adocao das medidas de precaucao foi 20.7 (95%CI: 5,68 - 75,14) vezes maior entre motoristas, quando comparados aos medicos. Nao houve associacao significante entre a adocao as medidas de precaucao padrao. A incidencia de acidentes de trabalho foi 20.6% (40.8% envolvendo material perfuro-cortante). O risco de medicos terem um acidente de trabalho foi 2.7(95%CI:1.05 - 7.09) vezes maior que os condutores. O fato de os membros da equipe apresentarem conhecimentos adequados sobre as medidas de precaucao padrao foi insuficiente para promover atitudes compativeis a fim de reduzir o risco de transmissao de agentes infecciosos e acidentes de trabalho.The purpose of this study was to assess the knowledge and attitude of health care professionals regarding their use of universal precaution measures at a public emergency service. The study also aimed to assess the rates of occupational accidents involving biological substances among those workers. This study was performed with 238 workers, from June to November 2006, using univariate and multivariate analysis. The chance of not adopting precaution measures was 20.7 (95% CI: 5.68 - 75.14) times greater among drivers compared to physicians. No significant association was found between adopting universal precaution measures. The occupational accident rate was 20.6% (40.8% involving sharp-edged objects). The risk of physicians having an occupational accident was 2.7(95% CI: 1.05 -7.09) times higher than that of drivers. The fact that a staff member had adequate knowledge about universal precaution measures was insufficient to foster compatible attitudes towards reducing the risk of transmitting infectious agents and causing occupational accidents.

Ultra-Processed Food Consumption and the Incidence of Hypertension in a Mediterranean Cohort: The Seguimiento Universidad de Navarra Project.

BACKGROUND Some available evidence suggests that high consumption of ultra‐processed foods (UPFs) is associated with a higher risk of obesity. Collectively, this association and the nutritional characteristics of UPFs suggest that UPFs might also be associated with hypertension. METHODS We prospectively evaluated the relationship between UPF consumption and the risk of hypertension in a prospective Spanish cohort, the Seguimiento Universidad de Navarra project. We included 14,790 Spanish adult university graduates who were initially free of hypertension at baseline who were followed for a mean of 9.1 years (SD, 3.9 years; total person‐years: 134,784). UPF (industrial formulations of chemical compounds which, beyond substances of common culinary use such as salt, sugar, oils, and fats, include substances also derived from foods but not used in culinary preparations) consumption was assessed using a validated semi‐quantitative 136‐item food‐frequency questionnaire. Cox proportional hazards models were used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for hypertension incidence. RESULTS During follow‐up, 1,702 incident cases of hypertension were identified. Participants in the highest tertile of UPF consumption had a higher risk of developing hypertension (adjusted HR, 1.21; 95% CI, 1.06, 1.37; P for trend = 0.004) than those in the lowest tertile after adjusting for potential confounders. CONCLUSIONS In this large prospective cohort of Spanish middle‐aged adult university graduates, a positive association between UPF consumption and hypertension risk was observed. Additional longitudinal studies are needed to confirm our results.

Acidentes ocupacionais por exposição a material biológico entre a equipe multiprofissional do atendimento pré-hospitalar

Estudo transversal, tipo survey, realizado com a equipe multiprofissional de Atendimento Pre-hospitalar (APh) de Belo Horizonte, entre junho e dezembro de 2006. Objetivou-se determinar a incidencia dos acidentes ocupacionais por exposicao a material biologico, condutas pos-acidente, e fatores demograficos determinantes. Utilizou-se questionario estruturado, analise descritiva, calculo de incidencias e regressao logistica. A incidencia de acidentes com material biologico foi de 20,6%: 40,8% por perfuro-cortantes e 49,0% por fluidos corporais; 35,3% entre medicos e 24,0% entre enfermeiros. Condutas pos-acidente: sem avaliacao medica, 63,3%; subnotificacao, 81,6%; nenhuma conduta, 55,0%; e, sem acompanhamento sorologico, 61,2%. Estiveram associados ao acidente: tempo na instituicao (Odds ratio-OR 2,84; Intervalo de confianca-IC 95% 1,22-6,62), lotacao na Unidade de Suporte Avancado (OR 4,18; IC 95% 1,64-10,64); interacao: tempo na instituicao e lotacao na Unidade de Suporte Basico (OR 0,27; IC 95% 0,07-1,00). Sugere-se a implantacao de protocolos pos-acidentes, visando a sua reducao; a subnotificacao e o aumento do acompanhamento pos-acidente.This transversal, survey-based research was carried out with a multiprofessional emergency care team in Belo Horizonte, between June and December 2006. The study aimed at estimating the incidence of occupational accidents by exposure to biological material, post-accidents conducts and demographic determinant factors. The study applied a structured questionnaire and descriptive analyses, as well as incidence calculations and logistic regression. The incidence of accidents with biological material reached 20.6%, being 40.8% by sharp materials and 49.0% by body fluids; 35.3% of the accidents took place among physicians and 24.0% among nurses. Post-accidents procedures: no medical assessment, 63.3%; under-notification, 81.6%; no conduct, 55.0%; and no serological follow-up, 61.2%. Factors associated with accidents: working time in the institution (Odds Ratio--OR, 2.84; Credible Interval--CI 95%-1.22-6.62); working in advanced support units (OR = 4.18; CI 95%--1.64-10.64); and interaction between working time in the institution and working in Basic Support Unit (OR 0.27; CI 95%--0.07-1.00). In order to reduce accidents, the implementation of post-accident protocols and follow-up, as well as under-notification norms, are suggested.