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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 …


Bilateral Medial Medullary Infarction: A Systematic Review, Gustavo Saposnik Dec 2011

Bilateral Medial Medullary Infarction: A Systematic Review, Gustavo Saposnik

Gustavo Saposnik

No abstract provided.


Unmasking The Benefits Of B Vitamins In Stroke Prevention, Gustavo Saposnik Dec 2011

Unmasking The Benefits Of B Vitamins In Stroke Prevention, Gustavo Saposnik

Gustavo Saposnik

No abstract provided.


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 …


Virtual Reality In Stroke Rehabilitation: A Meta-Analysis And Practical Implications For Clinicians, Gustavo Saposnik Mar 2011

Virtual Reality In Stroke Rehabilitation: A Meta-Analysis And Practical Implications For Clinicians, Gustavo Saposnik

Gustavo Saposnik

No abstract provided.


Iscore: A Risk Score To Predict Stroke Mortality, Gustavo Saposnik Feb 2011

Iscore: A Risk Score To Predict Stroke Mortality, Gustavo Saposnik

Gustavo Saposnik

Stroke is a leading cause of death and adult disability. The ability to estimate prognosis in acute stroke patients directly affects treatment decisions for patients. It may also guide supportive care plans, facilitate patient and/or family counseling or discussions pertaining to end-of-life decisions. At the population level, prognostic estimations may assist policymakers in conducting fair comparisons when evaluating stroke fatality among different facilities for hospital outcomes and performance assessment. Clinicians usually rely on their own personal experience or average mortality reported in observational studies, which do not account for valuable information available at the time of the hospital presentation. Unfortunately, …


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)]; …


Organized Outpatient Stroke Care, Gustavo Saposnik Dec 2010

Organized Outpatient Stroke Care, Gustavo Saposnik

Gustavo Saposnik

Background and Purpose—Organized inpatient stroke care decreases mortality and morbidity irrespective of patient age, stroke severity, or stroke subtype. Limited information is available on whether organized outpatient care models such as stroke prevention clinics (SPC) improve outcomes after a transient ischemic attack or ischemic stroke. We compared 1-year mortality and stroke readmission in patients with transient ischemic attack or ischemic stroke referred versus not referred to an SPC. Methods—This was a retrospective cohort study including 16 468 consecutive patients with ischemic stroke or transient ischemic attack who were seen in the emergency department or admitted to a hospital between July …


Penumonia: Risk Factors And Outcomes After Stroke, Gustavo Saposnik Dec 2010

Penumonia: Risk Factors And Outcomes After Stroke, Gustavo Saposnik

Gustavo Saposnik

No abstract provided.


Vitamin B In Stroke Prevention: A Journey From Observational Studies To Rct's., Gustavo Saposnik Dec 2010

Vitamin B In Stroke Prevention: A Journey From Observational Studies To Rct's., Gustavo Saposnik

Gustavo Saposnik

No abstract provided.


Care And Outcomes In Patients With Ischemic Stroke With And Without Preexisting Dementia, Gustavo Saposnik Dec 2010

Care And Outcomes In Patients With Ischemic Stroke With And Without Preexisting Dementia, Gustavo Saposnik

Gustavo Saposnik

No abstract provided.


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 …


Association Between Weekend Hospital Presentation And Stroke Fatality, Gustavo Saposnik Dec 2009

Association Between Weekend Hospital Presentation And Stroke Fatality, Gustavo Saposnik

Gustavo Saposnik

No abstract provided.


Risk Of Premature Stroke In Recent Immigrants (Presario): Population-Based Matched Cohort Study., Gustavo Saposnik Dec 2009

Risk Of Premature Stroke In Recent Immigrants (Presario): Population-Based Matched Cohort Study., Gustavo Saposnik

Gustavo Saposnik

No abstract provided.


Myocardial Infarction Associated With Recency Of Immigration To Ontario., Gustavo Saposnik Dec 2009

Myocardial Infarction Associated With Recency Of Immigration To Ontario., Gustavo Saposnik

Gustavo Saposnik

No abstract provided.