Luana Fiengo Tanaka

Alta prevalência de sedentarismo em adolescentes que vivem com HIV/Aids

Objective: To assess the prevalence of physical inactivity among adolescents with HIV/AIDS, as well as associated factors. Methods: Ninety-one adolescents (from 10 to 19 years old) with HIV/AIDS who are patients at a university follow-up service were interviewed. Anthropometric data (weight, height, and waist circumference) were measured twice; clinical information was obtained from medical records, and habitual physical activity was assessed by a questionnaire proposed by Florindo et al. The cutoff point for sedentariness was 300 minutes/week. Results: The prevalence of inadequate height for age, malnutrition, and overweight/obesity was 15.4%, 9.9% and 12.1%, respectively. The most common physical activities were soccer (44.4%), volleyball (14.4%) and cycling (7.8%). The median times spent with physical activity and walking/bicycling to school were 141 min and 39 min, respectively. Most adolescents (71.4%) were sedentary and this proportion was higher among girls (p=0.046). Conclusions: A high prevalence of physical inactivity among adolescents with HIV/AIDS was observed, similar to the general population. Promoting physical activity among adolescents, especially among girls with HIV/AIDS, as well as monitoring it should be part of the follow-up routine of these patients.

Poor diet quality among Brazilian adolescents with HIV/AIDS

OBJECTIVE This study aimed to assess diet quality among adolescents with HIV/AIDS. METHOD A cross-sectional study was conducted involving patients with HIV/AIDS treated in a referral hospital in Sao Paulo, Brazil. Eighty-eight adolescents (10-19 years of age) participated in the study. Information on disease history and use of medication were obtained from medical records. The participants responded to two 24-hour diet recalls. Diet quality was assessed by means of the Healthy Eating Index-2005 (HEI-2005) adapted to the Brazilian population. Pearsons correlation coefficients were calculated. Mean HEI-2005 scores were compared according to the independent variables using either the Students t-test or the Mann-Whitney test. RESULTS The mean HEI-2005 score was 51.90 (SE=0.90). The components with the lowest means were whole grains and sodium. Components with highest means were total grains and oils. No correlations were found between the independent variables and HEI score. Adolescents living in foster homes had higher means for total fruit and lower means for meat and beans in comparison to adolescents living with their families. Girls had higher means for milk and lower means for calories from solid fats, alcoholic beverages, and added sugars in comparison to boys. CONCLUSIONS Adolescents with HIV/AIDS exhibited a similar eating pattern to that of adolescents in the general population: high consumption of added sugar, saturated fat, and sodium, and insufficient ingestion of whole grains and fruits. Special attention should be paid to the diet of adolescents with HIV/AIDS, who are at greater risk of developing cardiovascular and other chronic diseases.

Prevalência de excesso de peso e seus fatores associados em adolescentes da rede de ensino público de Piracicaba, São Paulo

Objective: To estimate the prevalence of excess weight and the factors associated with its occurrence in adolescents enrolled at public schools in Piracicaba, SP, Brazil. Methods: This was a cross-sectional study of 269 adolescents of both sexes aged 10 to 14 years. Questionnaires were administered to collect data on dietary intake, sexual maturity, physical activity level and demographic characteristics. Univariate and multivariate logistic regression were used for statistical analysis. Results: The prevalence of excess weight was 35.7% for the boys and 26.2% for the girls. Factors significantly asso ciated with excess weight were only identified for the girls, among whom it was found that being in the 2nd tertile for carbohydrate intake (adjusted Odds Ratio [OR]: 0.28) and the accelerating/peak growth phase (adjusted OR: 0.37) were protective factors against excess weight . Conclusions: The findings of this study reveal a worrying prevalence of excess weight among the adolescents studied. The accelerating/peak growth phase and high carbohydrate intake were identified as protective factors against excess weight for the girls. It is, however, suggested that the second of these be treated with caution since this link has not been detected in other studies.

Risk for cancer among people living with AIDS, 1997-2012: the São Paulo AIDS-cancer linkage study.

Previous studies have reported an increased risk for certain types of cancer in the HIV-infected population. The aim of this study was to assess the risk for cancer in people with AIDS (PWA) in comparison with the general population in São Paulo (Brazil), between 1997 and 2012. A population-based registry linkage study was carried out to assess the risk for cancer, using a standardized incidence ratio (SIR) approach. A total of 480 102 person-years, of which 337 941 (70.4%) person-years were men, were included in the analysis. Around 2074 cancer cases were diagnosed among PWA, of which 51.0% were non-AIDS-defining cancers (NADC). The risk for AIDS-defining cancers and NADC in the male population with AIDS was significantly higher than that in the general population (SIR=27.74 and 1.87, respectively), as it was in the female population with AIDS compared with the general population (SIR=8.71 and 1.44, respectively). Most virus-related NADC occurred at elevated rates among PWA: anal cancer (SIR=33.02 in men and 11.21 in women), liver (SIR=4.35 in men and 4.84 in women), vulva and vagina (SIR=6.78 in women) and Hodgkin lymphoma (SIR=5.84 in men and 2.71 in women). Lung (SIR=2.24 in men and 2.60 in women) and central nervous system (SIR=1.92 in men and 3.48 in women) cancers also occurred at increased rates. Cancer burden among PWA in São Paulo was similar to that described in high-income countries such as the USA and Italy following the introduction of the highly active antiretroviral therapy. As coinfection with oncogenic viruses disproportionally affects this population, virus-related cancers accounted for a great share of excessive cases.

Melhora na qualidade e completitude da base de dados do Registro de Câncer de Base Populacional do município de São Paulo: uso das técnicas de linkage

Objective: The aim of this study was to improve the quality of information and data completeness through probabilistic and deterministic record linkage between Population-based Cancer Registry of São Paulo (PBCR-SP) for incident cancer cases, death database and drugs/medical procedures database. Methods: We used the database of the PBCRP-SP composed of 343,306 incident cancer cases in the municipality of São Paulo in the period between 1997 and 2005 with ages raging from under 1 to 106 years old, from both sexes. Three databases were used for linkage, namely Improvement Program for Mortality Information in São Paulo city (PRO-AIM), Authorization of Procedures of High Complexity/Cost of Outpatient Information System from the Unified Health System (APAC-SIA/SUS), and Foundation State System of Data Analysis (Foundation SEADE). Crude incidence (CIR) and mortality rates (CMR) were calculated and overall survival analysis was performed using the Kaplan-Meier method. Results: After record linkage, it was possible to observe gain of 4.3% for the CIR and 25.8% for CMR. The overall survival analysis showed that before record linkage there was an underestimation of the probability of being alive for all variables (p < 0.001). Conclusion: The linkage techniques contributed with the improvement of the quality of RCBP-SP information both on completeness of data, as in defining the vital status of the patient. In addition, the results found in this study reflect the ability of databases when worked jointly, providing subsidies for various types of studies and information for planning policies and strategic actions.

Determinação de um ponto de corte para a identificação de pares verdadeiros pelo método probabilístico de linkage de base de dados

O objetivo deste estudo foi propor pontos de corte nos escores calculados no processo de linkage probabilistico, para as diversas topografias de câncer. Neste estudo foi utilizada a base de dados do RCBP-SP, composta por 343.306 casos incidentes de câncer do municipio de Sao Paulo, registrados no periodo de 1997 a 2005, com idades que variaram de menos um a 106 anos, de ambos os sexos. Para o linkage probabilistico, realizado no programa Reclink III, foram utilizadas a base de dados do PRO-AIM e APAC-SIA/SUS. Foram calculados os valores da area sob a curva, sensibilidade e especificidade para determinar o ponto de corte do escore de maior precisao na identificacao dos pares verdadeiros. Na analise das topografias, verificou-se que o ponto de corte no escore 18 apresentou boa acuracia, com valores de sensibilidade que variaram de 73,7 a 96,7% e de especificidade de 98,5 a 99,4%. Conclui-se que, acima do escore 18 encontravam-se quase a totalidade dos pares verdadeiros, enquanto que abaixo deste, menos de 1% dos registros vinculados eram verdadeiros.

Disparidades na mortalidade de câncer colorretal nos estados brasileiros

OBJECTIVE To analyze the trend of colorectal cancer mortality adjusted for selected indicators, according to sex, by Brazilian federative units and regions, and countrywide from 1996 to 2012. METHODS This is a temporal time series on colorectal cancer mortality rates, using linear regression analysis, in which the independent variable was the centered year. Models were adjusted for selected indicators. RESULTS There was an increase in standardized colorectal cancer mortality rates for males in all states and for females in 21 states. In the model adjusted for mortality rate from ill-defined causes, for gross domestic product, and for Gini coefficient, the upward trend remained statistically significant (p < 0.05) countrywide only for men, with 0.17 deaths per 100 thousand inhabitants per year (py). In the States of Piauí (0.09 and 0.20 py), Ceará (0.17 and 0.19 py) and Rio Grande do Sul (0.61 and 0.42 py), there was an increase for both men and women, respectively; only among men in the States of Paraíba (0.16 py), Espírito Santo (0.28 py), São Paulo (0.24 py) and Goiás (0.31 py); and among women in Roraima (0.41 py), Amapá (0.97 P/Y), Maranhão (0.10 py), Sergipe (0.46 P/Y), Mato Grosso do Sul (0.47 py), and the Federal District (0.69 py). CONCLUSION The increase in colorectal cancer mortality remained significant when assessing Brazil as a whole only among men; in seven States among men, and in nine States among women, regardless of the studied indicators. These differences could be related to the possible increase in incidence and to late access to diagnosis and treatment.RESUMO: Objetivo: Analisar a tendencia da mortalidade por câncer colorretal, ajustado por indicadores selecionados, segundo sexo, para unidades federativas, regioes e Brasil, no periodo de 1996 a 2012. Metodos: Estudo ecologico de serie temporal das taxas de mortalidade por câncer colorretal, feita analise de regressao linear, sendo o ano centralizado a variavel independente. Os modelos foram ajustados por indicadores selecionados. Resultados: Houve aumento nas taxas de mortalidade padronizadas por câncer colorretal em todos os estados para o sexo masculino e em 21 estados para o sexo feminino. No modelo ajustado por taxa de mortalidade por causas mal definidas, produto interno bruto e coeficiente de Gini, a tendencia de aumento foi significativa (p < 0,05) no Brasil, somente para os homens, com 0,17 obitos por 100 mil habitantes ao ano (aa). Nos estados do Piaui (0,09 e 0,20 aa), Ceara (0,17 e 0,19 aa) e Rio Grande do Sul (0,61 e 0,42 aa) ocorreu aumento em homens e mulheres, respectivamente; somente em homens nos estados da Paraiba (0,16 aa), no Espirito Santo (0,28 aa), em Sao Paulo (0,24 aa) e Goias (0,31 aa); e em mulheres nos estados de Roraima (0,41 aa), do Amapa (0,97 aa), Maranhao (0,10 aa), Sergipe (0,46 aa), Mato Grosso do Sul (0,47 aa) e Distrito Federal (0,69 aa). Conclusao: O aumento da taxa de mortalidade por câncer colorretal manteve-se significativo no Brasil somente entre os homens; em sete estados, entre homens; e em nove estados, entre mulheres, independentemente dos indicadores estudados. Essas diferencas podem estar relacionadas ao possivel aumento da incidencia e ao acesso tardio ao diagnostico e tratamento.

Original ArticleHigh prevalence of physical inactivity among adolescents living with HIV/AIDSAlta prevalência de sedentarismo em adolescentes que vivem com HIV/Aids

Objective To assess the prevalence of physical inactivity among adolescents with HIV/AIDS, as well as associated factors.

Qualidade da dieta de escolares de 7 a 10 anos do município de São Paulo: associação com o número e os locais de refeições

OBJETIVO: Analisar a relacao entre a qualidade da dieta e o numero e os locais de refeicoes de escolares de 7 a 10 anos do municipio de Sao Paulo. METODOS: Trata-se de um estudo transversal, feito em 2013, com escolares de 7 a 10 anos de idade de duas escolas municipais de Sao Paulo. O consumo alimentar foi coletado a partir de tres recordatorios de 24 horas, tendo sido calculado o Indice de Qualidade da Dieta Revisado. As medias de cada componente do indice foram analisadas segundo habito de tomar cafe da manha, numero de refeicoes diarias, em casa, na escola e fora do lar. RESULTADOS: A maioria dos escolares ingeriu cafe da manha, realizou menos de cinco refeicoes, nenhuma refeicao na escola, tres ou mais refeicoes em casa e nenhum consumo de refeicoes fora do lar. O habito de tomar cafe da manha apresentou associacao com o maior consumo de vegetais e de leite e o maior numero de refeicoes diarias com o menor consumo de sodio. O maior consumo de refeicoes em casa esteve associado ao menor consumo de gordura saturada, calorias de gordura solida e acucar e a melhor qualidade da dieta. As refeicoes fora do lar apresentaram associacao com o maior consumo de cereais integrais e de calorias de gordura solida e acucar. CONCLUSAO: O maior consumo de alimentos saudaveis ocorre em casa, portanto acoes de educacao alimentar e nutricional devem incentivar o consumo de alimentos no lar e as escolhas alimentares saudaveis fora do lar.

Prevalencia de exceso de peso y sus factores asociados en adolescentes de la red de enseñanza pública de Piracicaba, São Paulo (Brasil)

Objective: To estimate the prevalence of excess weight and the factors associated with its occurrence in adolescents enrolled at public schools in Piracicaba, SP, Brazil. Methods: This was a cross-sectional study of 269 adolescents of both sexes aged 10 to 14 years. Questionnaires were administered to collect data on dietary intake, sexual maturity, physical activity level and demographic characteristics. Univariate and multivariate logistic regression were used for statistical analysis. Results: The prevalence of excess weight was 35.7% for the boys and 26.2% for the girls. Factors significantly asso ciated with excess weight were only identified for the girls, among whom it was found that being in the 2nd tertile for carbohydrate intake (adjusted Odds Ratio [OR]: 0.28) and the accelerating/peak growth phase (adjusted OR: 0.37) were protective factors against excess weight . Conclusions: The findings of this study reveal a worrying prevalence of excess weight among the adolescents studied. The accelerating/peak growth phase and high carbohydrate intake were identified as protective factors against excess weight for the girls. It is, however, suggested that the second of these be treated with caution since this link has not been detected in other studies.