Laércio Lima Luz

Factors associated with functional incapacity in elders living in long stay institutions in Brazil: a cross-sectional study.

BackgroundThe increase of the elderly population and the high prevalence of chronic diseases have contributed to the increasing importance of functional ability as a global public health problem. This study aimed to assess functional capacity in institutionalized elders, as well as undertake an exploratory analysis of its associated factors.MethodsThis is a cross-sectional study with institutionalized Brazilian elders. Functional capacity was assessed using the Katz Index for Activities of Daily Living (ADL) and the Lawton Scale for Instrumental Activities of Daily Living (IADL). The characteristics of dependent individuals were described and logistic regression models were developed for both scales. Multiple models that included all selected variables were developed using a hierarchical approach. We considered the results from the Wald test (p < 0.05) as a rule for progressing to the next level.ResultsA population of 760 elders was considered. The prevalence of dependence was 50.3% for ADL and 81.2% for IADL. We observed associations between ADL dependence and the following factors: self-report of stroke, difficulty of walking 400 meters, lower total scores in questions related to the temporal orientation section of the cognition test, and self-reports of frequently feeling upset. IADL dependence was associated with educational level, self-report of cancer, difficulty of walking 400 meters, use of glasses, and self-reported memory problems.ConclusionsSociodemographic and health conditions were associated with functional incapacity in institutionalized elders. Based on these findings, we emphasize the importance of both prevention and treatment of chronic conditions as well as social support in the maintenance of individuals’ autonomy.

Tendência da mortalidade por diabetes melito em capitais brasileiras, 1980-2007

OBJECTIVE To analyze mortality patterns of patients with diabetes in Brazilian capitals from 1980 to 2007. MATERIALS AND METHODS Age-standardized quadrennial and annual mortality rates were calculated with the world population as reference. Linear regression models were estimated to analyze mortality trends in each capital. RESULTS In the first quadrennial period, the highest rate was 42.89/100,000 in Aracaju; and in the last quadrennial period, 54.38/100,000 in São Luis. Although mortality rates showed statistically significant incremental trends in most capitals, there were regional differences. Belo Horizonte was the only capital to show a declining trend. CONCLUSIONS Part of the observed increment could be attributed to improvements in access to diagnosis and death certification, but regional differences in the prevalence of diabetes risk and protective factors might also be implicated. The absence of a time series of incident cases makes it difficult to determine if these results reflect current trends in the incidence of diabetes in Brazil.

Exposure to pesticides and prostate cancer: systematic review of the literature

Abstract Introduction: Investigations about the association between prostate cancer and environmental and/or occupational pesticide exposure have evidenced a possible role of these chemical substances on tumor etiology, related to their action as endocrine disruptors. Objective: To assess the association between pesticide exposure and prostate cancer by conducting a systematic review of the scientific literature. Materials and methods: Articles published until August 18, 2015 were searched in the databases MEDLINE/Pubmed, Scielo, and Lilacs using the keywords “pesticides” and “prostate cancer”. Only the analytical observational studies whose methodological quality met the criteria established by the New Castle-Ottawa scale were included in this review. Results: The review included 49 studies published between 1993 and 2015. All studies were in English and analyzed exposure to pesticides and/or agricultural activities. Most studies (32 articles) found a positive association between prostate cancer and pesticides or agricultural occupations, with estimates ranging from 1.01 to 14.10. Conclusion: The evidence provided by the reviewed studies indicates a possible association between the development of prostate cancer and pesticide exposure and/or agricultural occupations.

First stage of the cross-cultural adaptation of the instrument The Vulnerable Elders Survey (VES-13) to Portuguese

The aim of this study was to describe the initial stages of the cross-cultural adaptation of the instrument The Vulnerable Elders Survey (VES-13) for use in the context of cancer care in Brazil. Two translations into Portuguese and two back-translations into English were carried out independently, and a formal assessment of the general and referential meanings was performed in order to obtain a synthesis version. Understanding of the synthesis version was evaluated in a pretest applied to 33 patients in an oncologic hospital of the Brazilian Unified National Health System (SUS). The version was easily applied in the intended context and was well-accepted by elders. The Portuguese version of the VES-13 proved to be well understood and adequate for testing its psychometric qualities. The latter step is currently in the final phase.

Tendência das taxas de mortalidade por linfoma não-Hodgkin na Região Sudeste do Brasil, 1980-2007

Mortality rates from non-Hodgkin lymphoma (NHL) have declined in many countries in recent decades. However, mortality estimates for Brazil indicate an increase in these rates. This study aimed to analyze NHL mortality trends for 1980-2007 in individuals 20 years and older in State capitals in Southeast Brazil. Population data were obtained from the Mortality Information System and the Health Statistics Division of the Unified National Health System (DATASUS). Age-related mortality trends were analyzed using polynomial regression models. In the 60 and older age group, a statistically significant upward linear trend was observed for Belo Horizonte and Sao Paulo in 1980-2007. When analyzed in two different periods, 1980-1995 and 1996-2007, statistically significant increases in NHL mortality rates were only observed in the former period. These results suggest that the increase in 1980-2007 may have resulted from the rising mortality rates from 1980 to 1995, since no statistically significant trends were observed in the latter period.