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Brazilian Longitudinal Study Of Adult Health (Elsa-Brasil): Objectives And Design., Paulo A. Lotufo Feb 2012

Brazilian Longitudinal Study Of Adult Health (Elsa-Brasil): Objectives And Design., Paulo A. Lotufo

Paulo A Lotufo

The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) aims to contribute relevant information with respect to the development and progression of clinical and subclinical chronic diseases, particularly cardiovascular diseases and diabetes. In this report, the authors delineate the study's objectives, principal methodological features, and timeline. At baseline, ELSA-Brasil enrolled 15,105 civil servants from 5 universities and 1 research institute. The baseline examination (2008-2010) included detailed interviews, clinical and anthropometric examinations, an oral glucose tolerance test, overnight urine collection, a 12-lead resting electrocardiogram, measurement of carotid intima-media thickness, echocardiography, measurement of pulse wave velocity, hepatic ultrasonography, retinal fundus photography, and an …


A Reappraisal In São Paulo, Brazil (2008) Of "The Ecology Of Medical Care:" The "One Per Thousand's Rule"., Adriana Roncoletta, Gustavo D. Gusso, Isabela M. Bensenor, Paulo A. Lotufo Jan 2012

A Reappraisal In São Paulo, Brazil (2008) Of "The Ecology Of Medical Care:" The "One Per Thousand's Rule"., Adriana Roncoletta, Gustavo D. Gusso, Isabela M. Bensenor, Paulo A. Lotufo

Paulo A Lotufo

This paper reassessed in Brazil, the concept of "Medical ecology" i introduced in 1961 to describe the relationship and utilization of health care services by a given population. This was a cross-sectional telephone survey among a random sample of people enrolled in a private HMO. We interviewed a random sample of non-pregnant adults over age 18 using 10 questions about symptoms and health care use during the month prior to interview. The final sample consisted of 1,065 participants (mean age 68 years, 68% female). From this sample, 424 (39.8%) reported the presence of symptoms, 311 (29.2%) had a medical office …


Hypothyroidism In The Elderly, Paulo A. Lotufo Jan 2012

Hypothyroidism In The Elderly, Paulo A. Lotufo

Paulo A Lotufo

An overview adressing observational and randomized clinical trials about hypothyroidism in the elderly.


Chronic Non-Communicable Diseases In Brazil: Priorities For Disease Management And Research, Bruce B. Duncan, Dora Chor, Estela M. Aquino, Isabela M. Bensenor, J.Geraldo Mill, M.Ines Schmidt, Paulo A. Lotufo, Alvaro Vigo, Sandhi M. Barreto Jan 2012

Chronic Non-Communicable Diseases In Brazil: Priorities For Disease Management And Research, Bruce B. Duncan, Dora Chor, Estela M. Aquino, Isabela M. Bensenor, J.Geraldo Mill, M.Ines Schmidt, Paulo A. Lotufo, Alvaro Vigo, Sandhi M. Barreto

Paulo A Lotufo

Chronic Non-Communicable Diseases are the main source of disease burden in Brazil. In 2011, the Brazilian Ministry of Health launched the Strategic Plan of Action for Management of Chronic Non-Communicable Diseases focusing on population-based interventions to manage cardiovascular diseases, diabetes, cancer, and chronic respiratory diseases mainly through fi ghting tobacco use, unhealthy diets, physical inactivity and the harmful use of alcohol. Although a signifi cant number of scientifi c studies on chronic diseases and their risk factors have been undertaken in Brazil, few are of cohort design. In this context, the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), a cohort …


Elsa-Brasil: Historico [In Portuguese], Paulo A. Lotufo Nov 2011

Elsa-Brasil: Historico [In Portuguese], Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.


Vigilância Em Doença Cerebrovascular [Portuguese], Paulo A. Lotufo Nov 2011

Vigilância Em Doença Cerebrovascular [Portuguese], Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.


A Reappraisal Of Stroke Mortality Trends In Brazil (1979 To 2009), Paulo A. Lotufo Sep 2011

A Reappraisal Of Stroke Mortality Trends In Brazil (1979 To 2009), Paulo A. Lotufo

Paulo A Lotufo

Background: Brazil has the highest cerebrovascular death rate in the Western Hemisphere. We investigated temporal trends according to gender and stroke subtypes. Methods: We analysed mortality rates between 1979 and 2009 for different stroke subtypes. Data were stratified by sex and age (35–74 y). The annual percent change (APC) and significant changes in the trends were identified with joinpoint Poisson regression. The average annual percent change (AAPC) for 2005-09 was presented because that period had the best quality of information. Results: After excluding deaths due to stroke sequels, for men, the APCs (95% confidence intervals) were: 1979-84: 0.7 (-0.8 to …


Prevalence Of Thyroid Disorders Among Older People: Results From The São Paulo Ageing & Health Study, Paulo A. Lotufo Jan 2011

Prevalence Of Thyroid Disorders Among Older People: Results From The São Paulo Ageing & Health Study, Paulo A. Lotufo

Paulo A Lotufo

This study aimed to estimate prevalence of thyroid disorders in the São Paulo Ageing & Health Study, an epidemiological study addressing several health-adverse outcomes among elderly people living in a poor area of São Paulo, Brazil. All participants answered a questionnaire and had a blood sample collected to assess levels of tireotropic hormone and free-thyroxine. Among 1,373 people (60.8% women), prevalence rates (95% confidence interval) for thyroid dysfunction (%) were: overt hyperthyroidism, 0.7% (0.2-1.1) [women: 0.8% (0.2-1.5); men: 0.4% (0.01-0.9)]; overt hypothyroidism, 5.7% (4.5-6.9) [women: 5.9% (4.3-7.5); men: 5.4% (3.5-7.3)]; subclinical hyperthyroidism, 2.4% (1.6-3.2) [women: 2.8% (1.6-3.9); men: 1.9% (0.7-3.0)]; …


Pufa And Vitamin D And Type 2 Diabetes Inflammatory Markers, Paulo A. Lotufo Nov 2010

Pufa And Vitamin D And Type 2 Diabetes Inflammatory Markers, Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.


A Stepwise Approach To Stroke Surveillance In Brazil: The Emma (Estudo De Mortalidade E Morbidade Do Acidente Vascular Cerebral) Study, Paulo A. Lotufo Aug 2010

A Stepwise Approach To Stroke Surveillance In Brazil: The Emma (Estudo De Mortalidade E Morbidade Do Acidente Vascular Cerebral) Study, Paulo A. Lotufo

Paulo A Lotufo

Background: Stroke mortality rates in Brazil are the highest in the Americas. Deaths from cerebrovascular disease surpass coronary heart disease. Aim: To verify stroke mortality rates and morbidity in an area of Sa˜o Paulo, Brazil, using the World Health Organization Stepwise Approach to Stroke Surveillance. Methods: We used the World Health Organization Stepwise Approach to Stroke Surveillance structure of stroke surveillance. The hospital-based data comprised fatal and nonfatal stroke (Step 1). We gathered stroke-related mortality data in the community using World Health Organization questionnaires (Step 2). The questionnaire determining stroke prevalence was activated door to door in a family-healthprogramme neighbourhood …


Validation Of A Stroke Symptom Questionnaire For Epidemiological Surveys., Paulo A. Lotufo Jul 2010

Validation Of A Stroke Symptom Questionnaire For Epidemiological Surveys., Paulo A. Lotufo

Paulo A Lotufo

CONTEXT AND OBJECTIVE:Stroke is a relevant issue within public health and requires epidemiological surveillance tools. The aim here was to validate a questionnaire for evaluating individuals with stroke symptoms in the Stroke Morbidity and Mortality Study (Estudo de Mortalidade e Morbidade do Acidente Vascular Cerebral, EMMA), São Paulo, Brazil.DESIGN AND SETTING:This was a cross-sectional study performed among a sample of the inhabitants of Butantã, an area in the western zone of the city of São Paulo.METHODS:For all households in the coverage area of a primary healthcare unit, household members over the age of 35 years answered a stroke symptom questionnaire …


Socioeconomic Status And Coronary Heart Disease Mortality In The City Of Sao Paulo, Brazil (1996 To 2007), Paulo A. Lotufo Jun 2010

Socioeconomic Status And Coronary Heart Disease Mortality In The City Of Sao Paulo, Brazil (1996 To 2007), Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.


Non-Inferiority Trials [In Portuguese], Paulo A. Lotufo May 2010

Non-Inferiority Trials [In Portuguese], Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.


Cardiovascular And Cancer Mortality In Brazil, Paulo A. Lotufo May 2010

Cardiovascular And Cancer Mortality In Brazil, Paulo A. Lotufo

Paulo A Lotufo

Cancer are not surpassing Cardiovascular Diseases. Here you have an evaluation of mortality in Brazil. The debate was ignited by paper from IARC (International Agency for Research on Cancer) that forecasts cancer deaths surpassing heart diseases rates during de 2020’s. There is no dispute about the fact that - at least in the US and other countries - the decline of mortality deaths for heart diseases presenting a faster pace compared to cancer death rates. It is an epidemiological evidence that must be analyzed and some headline fueling hype as “heart diseases as an old agenda of public health and …


Gender Differences Of Case-Fatality Rate In A Brazilian Stroke Registry, Paulo A. Lotufo Feb 2010

Gender Differences Of Case-Fatality Rate In A Brazilian Stroke Registry, Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.


Characteristics Of Small Areas With A Higher Stroke Mortality, Paulo A. Lotufo Feb 2010

Characteristics Of Small Areas With A Higher Stroke Mortality, Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.


Higher Frequency Of Stroke Deaths On Monday And Saturday, Paulo A. Lotufo Feb 2010

Higher Frequency Of Stroke Deaths On Monday And Saturday, Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.


Social Inequalities And The Decline Of Stroke Mortality In The City Of Sao Paulo, Brazil, Paulo A. Lotufo Feb 2010

Social Inequalities And The Decline Of Stroke Mortality In The City Of Sao Paulo, Brazil, Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.


Stroke Prevalence In A Poor Neighbourhood Of Sao Paulo, Brazil: Applying A Stroke Symptom Questionnaire, Paulo A. Lotufo Jan 2010

Stroke Prevalence In A Poor Neighbourhood Of Sao Paulo, Brazil: Applying A Stroke Symptom Questionnaire, Paulo A. Lotufo

Paulo A Lotufo

Background Brazil has one of the highest stroke mortality rates in the world, these rates are most endemic in the poor. We verified the prevalence of stroke in a deprived neighbourhood in the city of Sa˜ o Paulo, Brazil and compared it with other surveys worldwide. Methods A questionnaire with six questions concerning limb and facial weakness, articulation, sensory disturbances, impaired vision, and past diagnosis of stroke was completed door-to-door in a well-defined area of 15 000 people. Questionnaires were considered positive when a participant answered two or more questions about stroke symptoms or the presence of stroke being confirmed …


Subclinical Hyperthyroidism And Dementia: The Sao Paulo Ageing & Health Study (Spah), Paulo A. Lotufo Jan 2010

Subclinical Hyperthyroidism And Dementia: The Sao Paulo Ageing & Health Study (Spah), Paulo A. Lotufo

Paulo A Lotufo

Background: Several epidemiologic studies have shown a possible association between thyroid function and cognitive decline. Our aim was to evaluate the association of subclinical hyperthyroidism and dementia in a population sample of older people. Methods: A cross-sectional study - São Paulo Ageing & Health Study (SPAH) - in a population sample of low-income elderly people ≥ 65 years-old to evaluate presence of subclinical thyroid disease as a risk factor for dementia. Thyroid function was assessed using thyrotropic hormone and free-thyroxine as well as routine use of thyroid hormones or antithyroid medications. Cases of dementia were assessed using a harmonized one-phase …


Stroke Mortality In Brazil: One Example Of Delayed Epidemiological Cardiovascular Transition, Paulo A. Lotufo Jan 2009

Stroke Mortality In Brazil: One Example Of Delayed Epidemiological Cardiovascular Transition, Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.


Nutritional Evaluation Of The Patients With Head And Neck Squamous Cell Carcinoma [Portuguese], Paulo A. Lotufo Jan 2009

Nutritional Evaluation Of The Patients With Head And Neck Squamous Cell Carcinoma [Portuguese], Paulo A. Lotufo

Paulo A Lotufo

Patients with head and neck squamous cell carcinoma (HNSCC) usually present nutritional disorders, secondary to the upper aerodigestive tract involvement or due to the treatment sequels. Objective: To assess the nutritional status of patients with HNSCC in different phases of the disease treatment. Methods: Cross-sectional study with 155 patients divided in 4 groups: 103 patients with HNSCC (29 before treatment, 47 post-treatment with no recurrence and 27 post treatment with recurrent disease) and 52 controls without HNSCC. Clinical and epidemiological data were collected and a nutrition assessment was performed from anthropometric parameters (weight, height and Body Mass Index – BMI), …


Patterns Of Viral Load In Chronic Hepatitis B Patients In Brazil And Their Association Withalt Levels And Hbeag Status, Paulo A. Lotufo Jan 2009

Patterns Of Viral Load In Chronic Hepatitis B Patients In Brazil And Their Association Withalt Levels And Hbeag Status, Paulo A. Lotufo

Paulo A Lotufo

Serum hepatitis B virus (HBV) DNA level is a predictor of the development of cirrhosis and hepatocellular carcinoma in chronic hepatitis B patients. Nevertheless, the distribution of viral load levels in chronic HBV patients in Brazil has yet to be described. This cross-sectional study included 564 participants selected in nine Brazilian cities located in four of the five regions of the country using the database of a medical diagnostics company. Admission criteria included hepatitis B surface antigen seropositivity, availability of HBV viral load samples and age >or=18 years. Males comprised 64.5% of the study population. Mean age was 43.7 years. …


Measurements Of Adiposity And High Blood Pressure Among Children And Adolescents Living In Belo Horizonte, Paulo A. Lotufo Dec 2008

Measurements Of Adiposity And High Blood Pressure Among Children And Adolescents Living In Belo Horizonte, Paulo A. Lotufo

Paulo A Lotufo

Abstract Objective: To verify an association, if it exists, between obesity and blood pressure raised beyond the 90th percentile in children and adolescents, and to determine the measure of adiposity that best correlates with blood pressure in these subjects. Design: Cross-sectional study. Setting: A school-based study in Belo Horizonte, Brazil. Participants: We selected randomly 1,403 students, aged from 6 to 18 years, from 545,046 students attending 521 public and private schools. Those selected completed the study. Main measures of outcome: We recorded the weight, height, skin fold in the triceps, subscapular, and suprailiac areas, waist and hip circumference, body-mass index, …


Estudo Longitudinal De Saúde Do Adulto -Elsa-Brasil [English], Paulo A. Lotufo Sep 2008

Estudo Longitudinal De Saúde Do Adulto -Elsa-Brasil [English], Paulo A. Lotufo

Paulo A Lotufo

Presentation update on September, 2011.


Framingham Score For Cardiovascular Diseases [Portuguese], Paulo A. Lotufo Jan 2008

Framingham Score For Cardiovascular Diseases [Portuguese], Paulo A. Lotufo

Paulo A Lotufo

Review about cardiovascular risk factors.


Race, Gender And Stroke Subtypes Mortality In Sao Paulo, Brazil., Paulo A. Lotufo Jan 2007

Race, Gender And Stroke Subtypes Mortality In Sao Paulo, Brazil., Paulo A. Lotufo

Paulo A Lotufo

Stroke mortality rates have a discrepant distribution according to socioeconomic variables as social exclusion in Brazil. Recently, data from race has been available from the official health statistics considering five categories: White, Mixed, Black, Asian and Native. We addressed in the city of São Paulo, Brazil, an analysis of cerebrovascular mortality according to race (excluding Asian and Native due to small number of events) and gender during 1999-2001 for people aged 30 to 79 years-old. For all cerebrovascular diseases, age-adjusted mortality rates (x 100,000) for men were higher for Black (150.2), intermediate for Mixed (124.2) and lower for White (104.5) …


Aterosclerose: Comparando Brasil E Estados Unidos, Paulo A. Lotufo Dec 2006

Aterosclerose: Comparando Brasil E Estados Unidos, Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.


Sunshine And Suicide At The Tropic Of Capricorn, São Paulo, Brazil, 1996–2004, Paulo A. Lotufo Dec 2006

Sunshine And Suicide At The Tropic Of Capricorn, São Paulo, Brazil, 1996–2004, Paulo A. Lotufo

Paulo A Lotufo

Several studies have confi rmed seasonal variation in suicide rates according to hours of sunshine. The suicide pattern was assessed in São Paulo, southeastern Brazil, at the tropic of Capricorn from 1996 to 2004. Poisson regression was employed to estimate parameters of seasonality, as well as to verify associations for each day between daylight duration and suicide. During the nine-year study period, there were 3,984 suicides (76.9% in men; median age=38.7 years old). Seasonal averages of suicides were similar, as were monthly averages. Poisson regression did not reveal any association between suicide rates and hours of sunshine (p=0.45) for both …


Air Pollutants And Respiratory Symptoms Among Adults, Paulo A. Lotufo Jan 2006

Air Pollutants And Respiratory Symptoms Among Adults, Paulo A. Lotufo

Paulo A Lotufo

Air pollutants are associated with adverse respiratory effects mainly in susceptible groups such as children, elderly people and people with pre-existent respiratory disease. This study was designed to assess the impact of the inorganic composition of particulate matter on 33 adult asthmatics respiratory functions in São Paulo city, Brazil. From May to July 2002, fine and coarse particulate matter fractions were collected and trace metals (Fe2+, Mn2+, Zn2+, Pb2+, Cu2+) and major ions (Na+, Mg2+, K+, Ca2+, NH4 +, Cl-, NO3-, SO42-) composition was determined in each aqueous-extract fraction by Atomic Absorption Spectrometry with Graphite Furnace (AAS-GF) and Ion Chromatography, …