Sandro Schreiber de Oliveira

Prevalência e fatores associados à doença do refluxo gastroesofágico

BACKGROUND O gastroesophageal reflux is a high prevalent disease with prevalence rates ranging from 21 to 56% in different countries. OBJECTIVE To study the epidemiology and the prevalence of gastroesophageal reflux disease among adult population (20 years and old) at the city of Pelotas, southern Brazil. METHODOLOGY A population-based cross-sectional study was conducted. Household interviews were done between October 1999 and January 2000. Association between gastroesophageal reflux disease and age, sex, skin color, years of formal education, income per capita, marital status, psychological variables (insomnia, stressful psychosocial events in the last year, psychological distress), body mass index, smoking and weekly consumption of alcoholic beverages was assessed through logistic regression. RESULTS Three thousands and nine-hundred thirty four (3,934) individuals were interviewed. A prevalence of 31,3% (CI 95% 29.9%-32.8%). After allowing for confounding gastroesophageal reflux disease was significantly associated with female sex, living without partner, low level of formal education, insomnia, psychological distress, reported stressful psychosocial events in the last year, obesity and overweight. CONCLUSION Gastroesophageal reflux disease is a high prevalent disease and its main associated factors are sex, anthropometric variables and psychological characteristics.

Associação entre abuso de álcool durante a gestação e o peso ao nascer

OBJECTIVE To assess the association between alcohol abuse during gestation and low birth weight. METHODS Cross-sectional, population-based nested study from a cohort of 957 pregnant women who received prenatal assistance through Sistema Único de Saúde (National Health System) in the city of Pelotas, Southern Brazil, and delivered their babies between September 2007 and September 2008. The mothers were interviewed at two distinct moments: prenatal and postpartum periods. In order to verify alcohol abuse, the CAGE (Cut down, Annoyed by criticism, Guilty and Eye-opener) scale was used. Bivariate analyses were carried out, as well as multiple logistic regression adjusted by the variables prematurity and alcohol abuse. The level of significance that was adopted was 95%. RESULTS Of the women who participated in the study, 2.1% abused alcohol during pregnancy and, among these, 26.3% had low birth weight children. There was an association between alcohol abuse and low birth weight (p<0.038). CONCLUSIONS The findings indicate that alcohol abuse during pregnancy is associated with low birth weight.OBJETIVO: Analisar a associacao entre abuso de alcool durante a gestacao e baixo peso ao nascer. METODOS: Estudo transversal de base populacional aninhado a uma coorte de 957 gestantes que realizaram acompanhamento pre-natal no Sistema Unico de Saude da cidade de Pelotas, RS, e deram a luz entre setembro de 2007 e setembro de 2008. As maes foram entrevistadas em dois momentos distintos: no periodo de pre-parto e apos o parto. Para verificar o abuso do alcool foi utilizada a escala Cut down, Annoyed by criticism, Guilty and Eye-opener. Foram realizadas analises bivariadas e regressao logistica multipla, ajustada pelas variaveis prematuridade e abuso de alcool. O nivel de significância adotado foi de 95%. RESULTADOS: Das mulheres que participaram do estudo, 2,1% abusaram de alcool na gestacao e, entre essas, 26,3% tiveram filhos com baixo peso. Houve associacao entre o abuso de alcool e baixo peso ao nascer (p < 0,038). CONCLUSOES: Os achados indicam que o abuso de alcool durante a gestacao esta associado ao baixo peso ao nascer.

Prevalência de dispepsia e fatores sociodemográficos

OBJETIVO: Medir a prevalencia e distribuicao de dispepsia e dispepsia frequente por subtipos na populacao com 20 anos ou mais segundo caracteristicas socioeconomicas e demograficas. METODOS: Estudo transversal, de base populacional, com 3.934 individuos moradores na cidade de Pelotas (RS), entrevistados em seus domicilios, de outubro de 1999 a janeiro de 2000. Dispepsia foi definida como dor ou desconforto no andar superior do abdome e/ou nauseas no ano anterior a entrevista (conforme criterios Roma I e II). Dispepsia frequente incluiu o registro de dispepsia mais de seis vezes e/ou nauseas, uma vez por mes ou mais. Esses desfechos foram analisados por idade, sexo, cor da pele, escolaridade, renda e estado civil. Os dados foram analisados por meio do teste qui-quadrado de Pearson de associacao para variaveis categoricas e teste de tendencia linear, quando aplicavel. RESULTADOS: A prevalencia de dispepsia foi de 44,4% e de dispepsia frequente, 27,4%. A prevalencia de dispepsia tipo refluxo, ulcera, dismotilidade e nao especificada foi, respectivamente, 19,4%, 6,3%, 13,9% e 16,6%; para dispepsia frequente foram 14,7%, 4,9%, 11,2% e 6,8%, respectivamente. As mulheres apresentaram cerca de 50% mais dispepsia frequente. Individuos mais jovens e de menor renda apresentaram maiores prevalencias de dispepsia e dispepsia frequente. Analise de acordo com criterios de Roma II mostrou prevalencias de 15,9% e 7,5% para dispepsia e dispepsia frequente, respectivamente. CONCLUSOES: A dispepsia constitui um problema prevalente na populacao estudada. A maioria dos individuos apresentaram mais de um subtipo de dispepsia.

Association between alcohol abuse during pregnancy and birth weight

OBJECTIVE To assess the association between alcohol abuse during gestation and low birth weight. METHODS Cross-sectional, population-based nested study from a cohort of 957 pregnant women who received prenatal assistance through Sistema Único de Saúde (National Health System) in the city of Pelotas, Southern Brazil, and delivered their babies between September 2007 and September 2008. The mothers were interviewed at two distinct moments: prenatal and postpartum periods. In order to verify alcohol abuse, the CAGE (Cut down, Annoyed by criticism, Guilty and Eye-opener) scale was used. Bivariate analyses were carried out, as well as multiple logistic regression adjusted by the variables prematurity and alcohol abuse. The level of significance that was adopted was 95%. RESULTS Of the women who participated in the study, 2.1% abused alcohol during pregnancy and, among these, 26.3% had low birth weight children. There was an association between alcohol abuse and low birth weight (p<0.038). CONCLUSIONS The findings indicate that alcohol abuse during pregnancy is associated with low birth weight.OBJETIVO: Analisar a associacao entre abuso de alcool durante a gestacao e baixo peso ao nascer. METODOS: Estudo transversal de base populacional aninhado a uma coorte de 957 gestantes que realizaram acompanhamento pre-natal no Sistema Unico de Saude da cidade de Pelotas, RS, e deram a luz entre setembro de 2007 e setembro de 2008. As maes foram entrevistadas em dois momentos distintos: no periodo de pre-parto e apos o parto. Para verificar o abuso do alcool foi utilizada a escala Cut down, Annoyed by criticism, Guilty and Eye-opener. Foram realizadas analises bivariadas e regressao logistica multipla, ajustada pelas variaveis prematuridade e abuso de alcool. O nivel de significância adotado foi de 95%. RESULTADOS: Das mulheres que participaram do estudo, 2,1% abusaram de alcool na gestacao e, entre essas, 26,3% tiveram filhos com baixo peso. Houve associacao entre o abuso de alcool e baixo peso ao nascer (p < 0,038). CONCLUSOES: Os achados indicam que o abuso de alcool durante a gestacao esta associado ao baixo peso ao nascer.

O impacto do baixo peso ao nascer relacionado à depressão gestacional para o financiamento federal da saúde pública: uma análise do Município de Pelotas, Rio Grande do Sul, Brasil

O baixo peso ao nascer esta relacionado com morbimortalidade e sequelas no desenvolvimento infantil, impactando nos custos dos sistemas de saude, por isso e importante avaliar fatores que o influenciam, estimando seu impacto no Sistema Unico de Saude (SUS). Este e um estudo prospectivo aninhado a uma coorte de gestantes que realizaram pre-natal e parto exclusivamente pelo SUS nos hospitais com UTI da cidade de Pelotas, Rio Grande do Sul, Brasil. Entre os resultados, concluiu-se que maes com episodios de depressao gestacional apresentam quase quatro vezes mais chances de ter um filho com baixo peso ao nascer (RP = 3,94; IC: 1,49-10,36). Valendo-se do calculo da fracao atribuivel na populacao, estima-se que, na populacao geral, 36,17% dos bebes com baixo peso ao nascer sao filhos de maes que tiveram episodio depressivo, estimando-se um custo que pode chegar a mais de R

Validity of an epidemiologic instrument for H. pylori screening among dyspeptic patients

76 milhoes no Brasil. Sugere-se que se ampliem as acoes preventivas e curativas para as gestantes na area da saude mental, possibilitando melhor desfecho de saude dos recem-nascidos, e que se utilizem adequadamente os recursos do SUS.

BRONQUIOLITE AGUDA COMO CONDIÇÃO SENSÍVEL A ATENÇÃO PRIMÁRIA, EM UMA CIDADE NO SUL DO BRASIL

OBJECTIVE To validate an epidemiological score for identifying dyspeptic patients at high risk of being H. pylori positive. METHODS Cross-sectional study including 434 users of primary health care units in the city of Pelotas, Southern Brazil, aged 18-45 years, and with symptoms of non-investigated dyspepsia, between 2006 and 2007. Dyspepsia was diagnosed according to Roma-II. The gold standard for H. pylori infection was the (13)C-urea-breath-test. The association between presence of H. pylori and independent variables was assessed through Logistic Regression. The score was built based on adjusted odds ratios. Sensitivity, specificity, and predictive values of different cutoffs were calculated. RESULTS Prevalence of H. pylori dyspeptic subjects was 74% (95% CI: 69;77.7). Prevalence was directly associated with age and number of siblings during childhood, and inversely associated with schooling; these variables were used in the construction of the score. The score ranged from 3 to 9 points. Scores 7, 8, and 9 had sensitivity of 36.6%, 22.3%, and 11.1%, and positive predictive values of 87.8%, 90.9%, and 92.1%, respectively. Without the score, 3 in every 4 dyspeptic patients would have received H. pylori erradication therapy. This proportion would have been lower with the score (one in three, six, and 11, for the cutoff points betwewen 7 and 9, respectively), albeit at the expense of a high rate of false-negatives. CONCLUSIONS The score was not valid for selectively identifying dyspeptic individuals candidate to eradication therapy for H. pylori. Contrary to the recommendation in developed countries, the test-and-treat strategy seems inappropriate for use in developing settings due to the high prevalence of H. pylori infection.

Asociación entre abuso de alcohol durante la gestación y el peso al nacer

The bronchiolitis , que often occurs in young infants , with predominance In the winter months . And Sensitive Primary Health Care (PHC ) by decree No. 221 of 17 April 2008 of the Ministry of Health , however occupies hum large contingent hospital . OS was observed hospitalization rates related to bronchiolitis in Age of Children 0-9 years , no period 2012/2013 , in Pelotas , assessing the Quality of Primary and ITS effects on Admission Process. -If Found que were 323 hospitalizations , being 174 in 2012 and 149 in 2013. More prevalent age group was in Children under 1 year ( 83.59 % ) , after 1-4 years ( 15.17% ) , and 5 -9 year (1.23 % ) . The Health and selflimited and and preventable BY simple hygiene measures it is possible to infer that the number of hospitalizations for bronchiolitis may be related to the lack of effective actions Prevention nos PHC services

Associação entre abuso de álcool durante a gestação e o peso ao nascer Association between alcohol abuse during pregnancy and birth weight

OBJECTIVE To assess the association between alcohol abuse during gestation and low birth weight. METHODS Cross-sectional, population-based nested study from a cohort of 957 pregnant women who received prenatal assistance through Sistema Único de Saúde (National Health System) in the city of Pelotas, Southern Brazil, and delivered their babies between September 2007 and September 2008. The mothers were interviewed at two distinct moments: prenatal and postpartum periods. In order to verify alcohol abuse, the CAGE (Cut down, Annoyed by criticism, Guilty and Eye-opener) scale was used. Bivariate analyses were carried out, as well as multiple logistic regression adjusted by the variables prematurity and alcohol abuse. The level of significance that was adopted was 95%. RESULTS Of the women who participated in the study, 2.1% abused alcohol during pregnancy and, among these, 26.3% had low birth weight children. There was an association between alcohol abuse and low birth weight (p<0.038). CONCLUSIONS The findings indicate that alcohol abuse during pregnancy is associated with low birth weight.OBJETIVO: Analisar a associacao entre abuso de alcool durante a gestacao e baixo peso ao nascer. METODOS: Estudo transversal de base populacional aninhado a uma coorte de 957 gestantes que realizaram acompanhamento pre-natal no Sistema Unico de Saude da cidade de Pelotas, RS, e deram a luz entre setembro de 2007 e setembro de 2008. As maes foram entrevistadas em dois momentos distintos: no periodo de pre-parto e apos o parto. Para verificar o abuso do alcool foi utilizada a escala Cut down, Annoyed by criticism, Guilty and Eye-opener. Foram realizadas analises bivariadas e regressao logistica multipla, ajustada pelas variaveis prematuridade e abuso de alcool. O nivel de significância adotado foi de 95%. RESULTADOS: Das mulheres que participaram do estudo, 2,1% abusaram de alcool na gestacao e, entre essas, 26,3% tiveram filhos com baixo peso. Houve associacao entre o abuso de alcool e baixo peso ao nascer (p < 0,038). CONCLUSOES: Os achados indicam que o abuso de alcool durante a gestacao esta associado ao baixo peso ao nascer.