José Maria Pacheco de Souza

Anthropometry of elderly residents in the city of São Paulo, Brazil

The article presents gender and age-specific selected anthropometric data for a representative sample of elderly Brazilians in the city of São Paulo. This was a cross-sectional, population-based household survey. A total of 1,894 older adults (men and women, > 60 years) were examined from January to March 2001. Data were presented as means and percentiles for body mass (BM); height or stature (ST); body mass index (BMI); waist (WC), hip (HC), arm (AC), and calf (CC) circumferences; triceps skinfold thickness (TST); and arm muscle circumference (AMC), and differences were described according to age (all variables) and gender (BMI). Except for HC (men), all anthropometric variables were lower in the oldest than in the youngest individuals (p < 0.01) in both genders. BMI was significantly higher (p < 0.01) in women than men (all age groups). The observations suggest that there is loss of muscle mass and redistribution and reduction of fat mass with age (both genders). The data can be used in clinical practice and epidemiological studies based on interpretation of anthropometric measurements in the elderly in São Paulo.

Cancer incidence rates among Japanese immigrants in the city of São Paulo, Brazil, 1969–78

Cancer incidence rates among first-generation Japanese immigrants in the city of São Paulo, Brazil, were estimated from the data of the São Paulo Cancer Registry during the years 1969 to 1978. From all registered cases, 2,179 cancer cases of Japan-born residents (1,288 males, 891 females) were selected and age-specific and summary age-adjusted incidence rates (AAIR) were calculated for the selected sites of cancer. The AAIR for all sites except non-melanoma skin cancer was 195.2 per 100,000 population (95 percent confidence interval: 176.4–214.1) in males and 147.3 (134.6–160.0) in females. Stomach cancer had the highest incidence rate of all cancers in both sexes (males, 69.3; females, 32.0). This was followed by cancer of the lung (22.5), esophagus (10.2), colon (8.3), and prostate (7.1) in males; and by breast (24.0), cervix (18.0), colon (8.4), and lung (7.2) in females. When these rates were compared with those among Japanese in Japan, cancer of the stomach and rectum revealed significantly lower rates, while non-melanoma skin cancer, and prostate and breast cancer showed higher rates. No significant increase of colorectal cancer was recognized among Japanese immigrants in São Paulo, contrary to the remarkably high rates of colorectal cancer being observed among Japanese immigrants in the U5.

IDDM and Milk Consumption: A case-control study in São Paulo, Brazil

OBJECTIVE To test the hypothesis that breast-feeding is a protective factor against IDDM and that early exposure to cows milk is a risk factor for the disease. RESEARCH DESIGN AND METHODS A case-control study was conducted in São Paulo, Brazil. A total of 346 diabetic children, aged < 18 years, were identified in two institutions in the city of São Paulo. Duration of exclusive breast-feeding and age of introduction to cows milk products in infant diet were compared with 346 sex-, age-, and neighborhood-matched control children. All comparisons between diabetic and control children were done using paired tests. RESULTS Statistically significant differences were found for the duration of exclusive breast-feeding (P = 0.007) and for the age of introduction to cows milk products (P = 0.047). Control children had a longer time of exclusive breast-feeding and had received cows milk later in their diet than the case children. CONCLUSIONS The results suggest that a shorter duration of exclusive breast-feeding is a risk factor for IDDM (odds ratio [OR] 2.13; 95% CI 1.8–3.55) and that the introduction to cows milk products before age 8 days is a risk factor for the disease (OR 2.29;95% CI 1.37–3.83).

Aleitamento materno, alimentação complementar, sobrepeso e obesidade em pré-escolares

OBJETIVO: Analizar la asociacion del sobrepeso y de la obesidad con el amamantamiento materno y la alimentacion complementaria en preescolares. METODOS: Estudio transversal envolviendo 566 ninos matriculados en escuelas privadas en el municipio de Sao Paulo (Sureste de Brasil), 2004-2005. La variable dependiente fue sobrepeso y obesidad. Para la clasificacion del estado nutricional de los ninos fueron utilizadas las curvas de percentiles del indice de masa corporal para edad, clasificando como sobrepeso valores ?P85 y <P95, y como obesidad valores ?P95. Las variables explicativas analizadas fueron: caracteristicas sociodemograficas del nino y su familia; peso al nacer; estado nutricional de los padres; amamantamiento materno; alimentacion complementaria y alimentacion actual. El analisis de asociacion de las variables explicativas con el hecho, fue realizado por medio de regresion logistica simple y regresion logistica multiple con modelo jerarquizado. RESULTADOS: La prevalencia de sobrepeso y obesidad de la poblacion estudiada fue de 34,4%. Fueron factores de proteccion contra sobrepeso y obesidad, el amamantamiento materno exclusivo por seis meses o mas (IC 95% [0,38;0,86]; OR=0,57; p=0,02) y el amamantamiento materno por mas de 24 meses (IC 95% [0,05;0,37]; OR=0,13; p=0,00). CONCLUSIONES: Los resultados sugieren que el amamantamiento materno puede proteger los ninos contra sobrepeso y la obesidad, agregando otra ventaja a la leche materna.

Riscos associados ao processo de desmame entre crianças nascidas em hospital universitário de São Paulo, entre 1998 e 1999: estudo de coorte prospectivo do primeiro ano de vida

O objetivo do estudo foi descrever a pratica do aleitamento materno de criancas nascidas em um hospital universitario em Sao Paulo, e identificar fatores associados com a duracao do aleitamento materno e aleitamento materno exclusivo. Criou-se uma coorte potencial de 506 recem-nascidos, destas, foi possivel utilizar informacoes de 450 que tinham dados sobre alimentacao, pelo menos, ate o segundo mes de vida. A mae anotava diariamente, em um questionario de frequencia alimentar, os alimentos consumidos pela crianca. Tecnicas de analise de sobrevida (Kaplan-Meier e Cox) foram utilizadas para as analises. A mediana do aleitamento materno foi 205 dias e do aleitamento materno exclusivo 23 dias. Os fatores de importância na duracao do aleitamento materno exclusivo foram idade da mae (rh mais jovem/mais velha = 1,22; IC95% = 1,006-1,486) e escolaridade da mae (rh fundamental/superior = 2,13; IC95% = 1,381-3,307 e rh medio/superior = 1,78; IC95% = 1,145-2,792), podendo estar relacionadas com o conhecimento dos beneficios do aleitamento materno exclusivo.

Comparação entre pesquisa larvária e armadilha de oviposição, para detecção de Aedes aegypti

This study compares two techniques for detecting the presence of Aedes aegypti: larval surveys and the oviposition trap. 5,026 households in two areas of the municipality of Salvador, Bahia, Brazil were investigated. Larval surveys and oviposition traps were used simultaneously in these households. Different positivity levels (larvae and/or eggs) were detected between and within the two areas. However, only the use of the oviposition trap detected a significant statistical difference between the areas (z = 9,520, p < 0.001). Comparison of the Breteau, Household and Oviposition Indices reveals greater power of detection of positivity in the oviposition trap. There were prevalence ratios of positivity for ovipositision trap of 3.4 and 2.1 (for areas 1 and 2 respectively) when compared with larval surveys. The oviposition trap proved to be an economical and operationally viable method, and the most effective in the surveillance of this species.This study compares two techniques for detecting the presence of Aedes aegypti: larval surveys and the oviposition trap. In two areas of the municipality of Salvador, Bahia, Brazil were investigated 5,026 households. Larval surveys and oviposition traps were used simultaneously in these households. Different positivity levels (larvae and/or eggs) were detected between and within the two areas. However, only the use of the oviposition trap detected a significant statistical difference between the areas (z = 9,520, p < 0.001). Comparison of the Breteau, Household and Oviposition Indices reveals greater power of detection of positivity in the oviposition trap. There were prevalence ratios of positivity for oviposition trap of 3.4 and 2.1 (for areas 1 and 2 respectively) when compared with larval surveys. The oviposition trap proved to be an economical and operationally viable method, and the most effective in the surveillance of this species.

Introdução de alimentos complementares e sua relação com variáveis demográficas e socioeconômicas, em crianças no primeiro ano de vida, nascidas em Hospital Universitário no município de São Paulo

INTRODUCAO: A alimentacao da crianca no 1o ano de vida e muito importante para seu crescimento e desenvolvimento. A alimentacao complementar e influenciada por complexos fatores sociais, economicos e culturais. OBJETIVO: Verificar a idade de introducao de alimentos complementares no primeiro ano de vida, e sua relacao com variaveis demograficas e socioeconomicas. METODOS: Estudou-se uma coorte de criancas nascidas em Hospital Universitario do Municipio de Sao Paulo. A verificacao da idade de introducao de alimentos foi feita a partir de fichas preenchidas pela mae, diariamente, onde constavam os alimentos oferecidos a crianca a cada dia, ate o final do seguimento. A introducao dos alimentos foi descrita utilizando-se a tecnica de analise de sobrevida de Kaplan & Meier, e a analise de associacao entre idade de introducao dos alimentos e as variaveis independentes foi feita pelo modelo de analise multivariavel de Cox. RESULTADOS: As idades medianas de introducao de agua ou cha, leite nao materno, frutas, verduras e legumes, cereais e tuberculos foram menores de 6 meses. Foram verificadas associacoes estatisticamente significativas entre escolaridade materna, renda familiar, trabalho materno e introducao de alguns alimentos. CONCLUSAO: Houve introducao precoce de agua ou cha e de leite nao materno. Alem da renda e do trabalho materno, a escolaridade materna parece ser a variavel que mais influencia a introducao de alimentos complementares.

Health-related quality of life and working conditions among nursing providers

OBJECTIVE To evaluate working conditions associated with health-related quality of life (HRQL) among nursing providers. METHODS Cross-sectional study conducted in a university hospital in the city of São Paulo, Southeastern Brazil, during 2004-2005. The study sample comprised 696 registered nurses, nurse technicians and nurse assistants, predominantly females (87.8%), who worked day and/or night shifts. Data on sociodemographic information, working and living conditions, lifestyles, and health symptoms were collected using self-administered questionnaires. The following questionnaires were also used: Job Stress Scale, Effort-Reward Imbalance (ERI) and Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Ordinal logistic regression analysis using proportional odds model was performed to evaluate each dimension of the SF-36. RESULTS Around 22% of the sample was found to be have high strain and 8% showed an effort-reward imbalance at work. The dimensions with the lowest mean scores in the SF-36 were vitality, bodily pain and mental health. High-strain job, effort-reward imbalance (ERI>1.01), and being a registered nurse were independently associated with low scores on the role emotional dimension. Those dimensions associated to mental health were the ones most affected by psychosocial factors at work. CONCLUSIONS Effort-reward imbalance was more associated with health than high-strain (high demand and low control). The study results suggest that the joint analysis of psychosocial factors at work such as effort-reward imbalance and demand-control can provide more insight to the discussion of professional roles, working conditions and HRQL of nursing providers.

Bronzeamento e risco de melanoma cutâneo: revisão da literatura

Epidemiological studies suggest a relationship between suntanning habits and high risk of melanoma. A literature review was carried out for the period between 1977 and 1998 using Medline and Embase (Excerpta Medica) databases. The analysis showed that intentional sun exposure is highly prevalent among youths, despite their awareness of the risks involved in excessive exposure to ultraviolet radiation and their knowledge on skin protection measures. Intentional exposure is a habit fostered by certain beliefs and attitudes towards suntanning and stimulated by peer pressure and aesthetic referents. The most common tanning practices involve a high risk of developing melanoma. It was concluded that the most effective means to prevent melanoma is mass media dissemination of the concept that having a tanned skin is not healthy -- since it implies the skin being damaged by solar ultraviolet radiation -- and education campaigns for effectively changing peoples behaviors and their motivations.

Decline in cardiovascular disease mortality in the city of S. Paulo, Brazil, 1970 to 1983.

Foi analisada a mortalidade por todas as causas e por grandes grupos de doencas cardiovasculares de residentes da cidade de Sao Paulo, SP, Brasil, nas idades de 40 a 69 anos, para os anos de 1970 a 1983, mediante os coeficientes especificos de mortalidade. No periodo observado houve um declinio (28% em media para as doencas isquemicas do coracao e 16% para as doencas cerebrovasculares), estatisticamente significativo. Os coeficientes de mortalidade de 40 a 69 anos, de ambos os sexos, foram ajustados por idade e comparados com os de 27 paises industrializados, observando-se alto risco de morrer de doencas cardiovasculares.