Fúlvio Borges Nedel

Anos de vida perdidos por mortalidade: um dos componentes da carga de doenças

INTRODUCTION The register of death by cause, sex and age groups of residents in 1994 in Rio Grande do Sul (RS) and Santa Catarina (SC), two Brazilian southern states, were studied to calculate the years of life lost (YLL), one of the two components that summarize disability adjusted life years (DALY), in RS, SC and Brazil. METHODS The methodology employed is the same used in the Global Burden of Disease study to quantify the mortality component (YLL) of DALY in the world. RESULTS The results show that the greatest proportion and rates caused by Group II (Noncommunicable diseases), linked with more advanced stages of the epidemiological transition, in RS, SC and Brazil. But in both states and especially in Brazil, Group I (Communicable, maternal, perinatal and nutritional conditions) causes an important proportion of YLL. The Group III (Injuries) was the second more important group in RS and SC and the third in Brazil. Road traffic accidents are particularly important in SC, where the intentional injury rate is half than the one in RS. The leading causes of YLL were road traffic accidents, ischemic heart disease and cerebrovascular disease in SC, and ischemic heart disease, cerebrovascular disease and road traffic accidents in RS. CONCLUSIONS Death certification in the southern region of Brazil has a complete coverage and miscoded death proportion is small, providing a reliable mortality information. DALY allow comparing fatal and nonfatal health outcomes to determine the importance of different diseases and to establish health priorities. DALY are also an useful tool to identify disadvantaged groups, target health interventions and provide information for social control of resource allocation.

The influence of active and passive smoking on the cardiorespiratory fitness of adults

BackgroundThe aim of this study was to analyze the influence of active and passive smoking on cardiorespiratory responses in asymptomatic adults during a sub-maximal-exertion incremental test.MethodsThe participants (n = 43) were divided into three different groups: active smokers (n = 14; aged 36.5 ± 8 years), passive smokers (n = 14; aged 34.6 ± 11.9 years) and non-smokers (n = 15; aged 30 ± 8.1 years). They all answered the Test for Nicotine Dependence and underwent anthropometric evaluation, spirometry and ergospirometry according to the Bruce Treadmill Protocol.ResultsVO2max differed statistically between active and non-smokers groups (p < 0.001) and between non-smokers and passive group (p=0.022). However, there was no difference between the passive and active smokers groups (p=0.053). Negative and significant correlations occurred between VO2max and age (r = - 0.401, p = 0.044), percentage of body fat (r = - 0.429, p = 0.011), and waist circumference (WC) (r = - 0.382, p = 0.025).ConclusionVO2max was significantly higher in non-smokers compared to active smokers and passive smokers. However, the VO2max of passive smokers did not differ from active smokers.

Food habits of hypertensive and diabetics cared for in a Primary Health Care service in the South of Brazil

OBJETIVO: Descrever habitos alimentares de hipertensos e diabeticos, classificar sua adequacao de acordo com Guia Alimentar para Populacao Brasileira do Ministerio da Saude e verificar a associacao entre a adequacao dos habitos alimentares e o problema de saude. METODOS: Estudo descritivo, a partir da linha de base de um estudo longitudinal iniciado em 2011, com amostra de adultos hipertensos e diabeticos usuarios de um servico de atencao primaria no sul do Brasil, entrevistados em seu domicilio. RESULTADOS: Foram analisadas 2.482 pessoas das quais 66,5% eram hipertensas, 6,5% eram diabeticas e 27,1% apresentavam hipertensao e diabetes. Dos entrevistados, 29,6% tinham habitos alimentares inadequados, 46,9% parcialmente adequados, e 23,4% estavam adequados. Foi identificado baixo consumo de fibras e alto consumo de refrigerante, acucar, sal e gordura saturada. A melhor adequacao alimentar estava associada a pior condicao de saude, sendo que a prevalencia de inadequacao alimentar foi 30,0% maior nos que eram somente hipertensos. CONCLUSAO: Os habitos alimentares dos diabeticos e hipertensos nao estavam adequados, considerando as diretrizes do Ministerio da Saude. A associacao da adequacao do habito alimentar com o problema de saude indicou uma melhora tardia do habito alimentar, o que aponta a necessidade premente de intervencoes preventivas e efetivas na promocao da alimentacao saudavel.

Artigo originalObesidade e hipertensão arterial em escolares de Santa Cruz do Sul – RS, BrasilObesity and arterial hypertension in schoolchildren from Santa Cruz do Sul – RS, Brazil

OBJECTIVE To verify the prevalence of obesity and hypertension in schoolchildren from Santa Cruz do Sul - RS, Brazil, in 2005 and 2008. METHOD The study was performed with two consecutive cross-sectional measurements, consisting of a stratified cluster sample, totaling 414 students, aged between 7 and 17 years, of which 215 (51.9%) were males and 199 (48.1%) were females. Obesity was assessed by body mass index (BMI) and percentage of body fat (%BF). Hypertension was measured by blood pressure values, both systolic (SBP) and diastolic (DBP). RESULTS BMI assessment showed 18.6% and 22.3% of excess weight in males and 22.6% and 14.6% in females (in 2005 and 2008, respectively). Regarding obesity, the prevalence was 4.7% in both years for males and a reduction from 12.6% to 9.0% was observed in females. When analyzing the difference between assessments, there was significance in the BMI classification (p = 0.022) and %BF (p = 0.017) only in females. Statistically significant changes in SBP were found only in males (p < 0.001). CONCLUSION The levels of excess weight, obesity, and %BF in females, as well as the increased levels of systolic blood pressure in males, demonstrate the need for early intervention through more effective public health campaigns.