Made available in DSpace on 2015-10-06T13:03:43Z (GMT). No. of bitstreams: 0 Previous issue date: 2015-05-04. Added 1 bitstream(s) on 2015-10-06T13:18:08Z : No. of bitstreams: 1 000847834.pdf: 2286659 bytes, checksum: edccbb02cf634ad2b495af3462eaae37 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Estudos observacionais têm revelado uma associação entre a presença de transtornos mentais e a falta de vivências de lazer. Esta pesquisa tem por objetivo estimar a prevalência de TMC e sua associação com lazer entre estudantes da área da saúde do campus de Botucatu, UNESP. Método: Trata-se de um estudo transversal, descritivo e analítico no qual foram analisados aspectos relacionados ao lazer e transtorno mental comum. A variável dependente foi à presença de Transtorno Mental Comum, investigado pelo Self Reporting Questionnaire. A principal variável exploratória foi o lazer, investigado por meio de um instrumento elaborado para avaliação de práticas do contexto do lazer na população universitária. As variáveis confundidoras foram as características sociodemográfico, rede de apoio, avaliada pela Escala de Apoio Social (EAS) e uso de álcool, avaliado pelo Alcohol Use Disorders Identification Test (Audit). A casuística foi composta por graduandos dos cursos de Enfermagem, Medicina, e Nutrição do campus de Botucatu, UNESP. Inicialmente foi feita análise descritiva, seguida de análise bivariada e, posteriormente, regressão logística. Foi adotado o nível de significância estatístico padrão de p < 0,05, para rejeição da hipótese de nulidade. Resultados: A prevalência global de TMC foi 40,9%, sendo 57,5% no curso de Enfermagem, 40,7% na Medicina e 26,6% na Nutrição. Após regressão logística, as variáveis que se mantiveram significativas como fatores de risco foram: curso de Enfermagem, seguido de Medicina; não ser solteiro; ter dificuldade em fazer amigos; sentir-se rejeitado; estar insatisfeito com a escolha do curso; desejo de abandonar o curso; insatisfação com a frequência do lazer; uso de álcool, tabaco e/ou substâncias psicoativas no lazer; menor escore de apoio interação; não praticar esportes e não tocar instrumento e/ou cantar. Conclusão: Observou-se que a prevalência de TMC foi... / Observational studies have shown an association between the presence of mental disorders and the lack of leisure time experiences. This study aims to evaluate the occurrence of CMD and its association with leisure time and activities among health students from the campus of Botucatu, UNESP. Method: This was a cross-sectional, descriptive and analytical study that analyzed aspects related to leisure time and common mental disorders. The dependent variable was the presence of Common Mental Disorder, investigated by the Self-Reporting Questionnaire. The main exploratory variable was leisure time, investigated by means of an specific tool for assessment practices Rest in the university population. The confounding variables were sociodemographic characteristics, support network, assessed by Social Support Scale (EAS) and alcohol use assessed by Alcohol Use Disorders Identification Test (Audit). The sample was composed of graduates from Nursing School, Medicine, and Nutrition in the campus of Botucatu, UNESP. Initially a descriptive analysis was performed, followed by bivariate analysis, and finally a logistic regression. The level of statistical significance pattern of p <0.05, to reject the null hypothesis, was adopted. Results: The overall prevalence of CMD was of 40.9% being 57.5% among students from Nursing School, 40.7% in Medicine and 26.6% in Nutrition. After logistic regression, the variables that remained significant risk factors were: Nursing School followed by Medicine; not being single; having difficulty making friends; feeling rejected; being dissatisfied with the choice of the course; desire to leave the course; dissatisfaction with the frequency of leisure time; use of alcohol, tobacco and / or psychoactive substances at leisure time; lowest score in support interaction; not playing sports and not playing instruments or singing. Conclusion: It was observed that the prevalence of CMD was similar to that found in the studied ... / FAPESP: 2014/15872

Made available in DSpace on 2016-01-13T13:26:54Z (GMT). No. of bitstreams: 0 Previous issue date: 2015-08-17. Added 1 bitstream(s) on 2016-01-13T13:32:14Z : No. of bitstreams: 1 000854658.pdf: 1674345 bytes, checksum: f11bd92734e04030411cea431e54abf6 (MD5) / Introdução: Estudos sugerem que a prevalência de Fobia Social (FS) ou Transtorno de Ansiedade Social (TAS) em estudantes universitários é alta, assim como a prevalência de insatisfação com a imagem corporal (IIC). As manifestações clínicas destes quadros podem causar muito sofrimento e interferir negativamente na vida dos estudantes, tanto em suas relações interpessoais quanto no seu desempenho acadêmico. Objetivos: Estimar a prevalência e avaliar a gravidade de manifestações de TAS e de IIC em estudantes de medicina de uma universidade pública do Estado de São Paulo, assim como os fatores associados a estes dois desfechos. Método: Estudo de corte transversal avaliou 479 estudantes do primeiro ao sexto ano do curso médico da Faculdade de Medicina de Botucatu - UNESP (taxa de resposta: 88,1%) por meio dos seguintes instrumentos de autopreenchimento: Questionário sobre características sociodemográficas e aspectos de vida acadêmica dos alunos, Inventário de Fobia Social - Social Phobia Inventory (SPIN), Questionário de Insatisfação com a Imagem Corporal - Body Shape Questionnaire (BSQ) e Inventário de Depressão de Beck - Beck Depression Inventory (BDI). Foi feita análise estatística descritiva, seguida de análise bivariada entre os desfechos de interesse (provável TAS e IIC) e variáveis explanatórias, pelo teste de qui-quadrado para variáveis categoriais e de Mann Whitney para variáveis quantitativas. O tamanho de efeito das associações foi descrito como razão de chances (odds ratios) com intervalos de confiança (IC) de 95% para variáveis categóricas e D de Cohen para variáveis quantitativas. Por fim, foram construídos três modelos de regressão logística (para provável TAS, IIC e os dois desfechos associados), incluindo as variáveis explanatórias que foram significativas (p < 0,05) na análise bivariada, para controle de confundidores e obtenção de odds ratios (OR) e IC... / Introduction: Previous studies described high prevalence rates of Social Anxiety Disorder (SAD) (or Social Phobia) and of body image dissatisfaction (BID) in college students. Manifestations of these clinical problems may cause much suffering and negatively interfere in the students' life, both in their interpersonal relationships and academic performance. Objectives: To estimate the prevalence and severity of SAD and BID manifestations in medical students of a public university in São Paulo state, Brazil, as well as to investigate the characteristics associated with these outcomes. Method: A cross-sectional study with 479 students from the first to the sixth year of the medical course at Botucatu Medical School - UNESP (response rate: 88.1%), using the following assessment instruments: a questionnaire to obtain data on demographics and social and academic life,, the Social Phobia Inventory (SPIN), the Body Shape Questionnaire (BSQ), and the Beck Depression Inventory (BDI). A descriptive analysis was conducted, followed by a bivariate analysis between the outcomes (probable SAD and BID) and all explanatory variables, using the chi - square test for categorical variables and the Mann-Whitney test for quantitative variables. The effect sizes of the associations were described as odds ratios (OR) with 95% confidence intervals (CI) for categorical variables, and Cohen's D for quantitative variables. Then, three logistic regression models (for probable SAD, BID and both outcomes combined) were built, including, in each of them, the explanatory variables that were significant (p<0.05) in the bivariate analysis to control for confounders and obtain adjusted ORs. Results: The median age of the students (58.7% female, 99.0% single) was 22.5 years (SD±2.6). The prevalence of probable SAD (SPIN ≥ 19) was 36.3% (95%CI 32.0-40.6), and some BID (BSQ > 81) was found in 34.7% (95%CI 30.4-38.9) of the students. Relevant depressive symptoms ...

Made available in DSpace on 2016-01-13T13:27:47Z (GMT). No. of bitstreams: 0 Previous issue date: 2015-08-28. Added 1 bitstream(s) on 2016-01-13T13:33:17Z : No. of bitstreams: 1 000855275.pdf: 4314599 bytes, checksum: 5de3d2e71c2959a77481625063d5cfbc (MD5) / Objectives: Translate and validate Juvenile Arthritis Multidimensional Assessment Report (JAMAR) into Brazilian Portuguese for Juvenile Idiopathic Arthritis (JIA). Methods: English JAMAR was translated according to international guidelines. The Brazilian-Portuguese version was applied in cross-sectional evaluation in JIA cases treated between May and December 2012. Clinical, demographic and joint assessments, physician global visual analog scale, Juvenile Arthritis Score Damage Index (JADI), with parents and children version in comparison to a healthy control group. The JAMAR components are: functional scales and quality of life scales. The scores were analyzed by intraclass correlation coefficient (ICC) for reliability between test-retest. The Median test was used to compare functional and quality of life scales, physician global assessment, pain and overall well-being for children and parents global assessment scales, Juvenile Arthritis Disease Activity Score (JADAS), clinical Juvenile Arthritis Disease Activity Score (cJADAS), Juvenile Arthritis Parent / Child Assessment Index (JAPAI / JACAI) scales. The Kappa test was used to measure the degree of agreement between parents, children and physician about disease activity perception. The Spearman correlation test was used to verify the association between JAPAI / JACAI and cJADAS scores. Results: The Brazilian-Portuguese version of JAMAR was obtained by 3 independent direct translations and 2 reverse translations and a final version by consensus expert committee. The pre-test was applied in ten JIA children of 9.8 to 18.6 years and their parents. Questionnaires from 72 parents and 69 children with JIA, and 72 parents and 62 children healthy were filled out. The JIA cases were classified as persistent oligoarticular (43.4%), enthesitis related arthritis (19.7%), extended oligoarticular (14.5%), polyarticular rheumatoid factor (RF) negative (10.5%), polyarticular RF positive ...

Made available in DSpace on 2016-01-13T13:28:15Z (GMT). No. of bitstreams: 0 Previous issue date: 2015-09-25. Added 1 bitstream(s) on 2016-01-13T13:33:49Z : No. of bitstreams: 1 000855384.pdf: 1994121 bytes, checksum: 0ac4562b0361b07db7ae9b057c58075e (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Made available in DSpace on 2014-06-11T19:32:51Z (GMT). No. of bitstreams: 0 Previous issue date: 2013-10-11Bitstream added on 2014-06-13T18:48:09Z : No. of bitstreams: 1 000735855.pdf: 2456045 bytes, checksum: d4163cc3219978e13e5e6d72726e31c5 (MD5) / O vírus respiratório sincicial bovino (BRSV), agente etiológico relacionado à doença respiratória bovina, causa grandes prejuízos econômicos principalmente na criação de bezerros. O BRSV já foi relatado no Brasil com prevalências sorológicas elevadas, no entanto, ainda não foram determinados os fatores de risco envolvidos na disseminação do vírus nos rebanhos brasileiros e poucas amostras do vírus foram caracterizadas. Assim, o presente estudo teve como objetivo caracterizar a epidemiologia da infecção pelo BRSV em rebanhos bovinos leiteiros do Estado de São Paulo (SP), por meio da análise sorológica e de fatores de risco, e também pelo vírus circulante nesses rebanhos. Foram colhidas 1.243 amostras de sangue e 352 amostras de secreções nasais de bovinos em 26 propriedades rurais, divididas nas regionais de Jaboticabal, São José do Rio Preto e Catanduva, localizadas na região norte do Estado SP. Durante a colheita das amostras, foi aplicado um questionário ao proprietário sobre informações relacionadas como prováveis fatores de risco para a infecção pelo BRSV em cada propriedade. Os soros foram analisados pela técnica de virusneutralização (VN) e as amostras de secreções nasais foram examinadas para detecção do gene das proteínas F e G do BRSV pela RT-nested PCR. Os resultados da VN mostraram elevada prevalência de BRSV nos rebanhos leiteiros, com total de 79,49% de reagentes. Os resultados separados por regionais revelaram prevalências de 76,19%, 83,68% e 69,14% de soropositivos, para Jaboticabal, São José do Rio Preto e Catanduva, respectivamente. Os rebanhos da regional de São José do Rio Preto apresentaram maiores prevalências de BRSV quando comparados aos rebanhos das outras duas regionais. A análise dos fatores de risco permitiu inferir que a idade dos animais e a ocorrência de infecção concomitante pelo herpesvírus bovino tipo 1 e vírus... / Bovine respiratory syncytial virus (BRSV), agent related to bovine respiratory disease, causes large economic losses mainly in calf rearing. BRSV has already been reported in Brazil with high serological prevalence, however, the risk factors related to its dissemination were not yet determined and a few number of virus strains was characterized in Brazilian herds. Thus, the study aimed to characterize the epidemiology of BRSV infection in dairy herds of São Paulo State, using serological and risk factors analysis, and also by virus circulating in these herds. For that, 1.243 blood samples and 352 nasal secretion samples were collected of animals from 26 farms divided into Jaboticabal, São José do Rio Preto and Catanduva regional, located in the northern region of São Paulo State. During the sample collection, a questionnaire was performed to the owner for each property regarding information about possible risk factors for BRSV. Sera were analyzed using virus neutralization test (VNT), and nasal secretions were examined to detect the F and G protein gene of BRSV by RT-nested PCR. VNT results showed high BRSV prevalence in dairy herds, reaching 79.49% of reagents. The separated results by regional revealed prevalence of 76.19%, 83.68% and 69.14% for Jaboticabal, São José do Rio Preto and Catanduva, respectively. The herds in the regional of São José do Rio Preto showed the highest prevalence of BRSV when compared to the other two regional herds. The analysis of risk factors allowed deducing that the age of the animals and the occurrence of concomitant infection by bovine herpesvirus type 1 and bovine viral diarrhea are associated with the high BRSV prevalence, while calving natural lactation was identified as a protective factor. The RT-nested PCR detected a positive sample for the F protein gene, and after its sequencing, the genetic relatedness of the sample to the other ...

Made available in DSpace on 2015-05-14T16:53:23Z (GMT). No. of bitstreams: 0 Previous issue date: 2014-12-16Bitstream added on 2015-05-14T16:58:54Z : No. of bitstreams: 1 000828431.pdf: 2597564 bytes, checksum: d2a5d2090c67ea6f9db3f644cfef982f (MD5) / Realizou-se levantamento sorológico dos seguintes vírus respiratórios Herpesvírus Bovino 1 (BoHV-1), Vírus da Diarreia Viral Bovina (BVDV), Vírus da Parainfluenza Bovina Tipo 3 (bPIV-3) e Vírus Respiratório Sincicial Bovino (BRSV) em bovinos da raça Holandesa variedade Preta e Branca (HPB), criados no estado do Paraná. Colheram-se 714 amostras de sangue da veia jugular de bovinos, não vacinados para os agentes estudados, com mais de seis meses de idade, de 26 propriedades leiteiras, distribuídas em 17 municípios do estado do Paraná. Paralelamente à colheita, aplicou-se um questionário para cada propriedade estudada, com a finalidade de avaliar os fatores de risco associados aos vírus examinados. As amostras sorológicas foram submetidas ao teste de diagnóstico de virusneutralização no Laboratório de Viroses de Bovinos do Instituto Biológico de São Paulo. Foram observadas prevalências de 22,3%; 35,8%; 80,4% e 93,5% de bovinos sororreagentes e 65,3%, 88,5%, 96,1% e 100% das propriedades reagentes para BoHV-1, BVDV, bPIV-3 e BRSV, respectivamente. A coinfecção que ocorreu com maior prevalência foi a bPIV-3 e BRSV (37,1%). Após análise de regressão logística, os fatores de risco associados ao BoHV-1 foram: bovinos com idade maior que 48 meses (OR=15,012; IC95% 7,500 – 30,051), área da propriedade 26 a 50 hectares (OR=11,328; IC95% 2,482 – 51,697), lotação maior de três bovinos por hectare (OR=1,026; IC95% 0,370 – 2,847), percentual de entrada maior que 10% de bovinos (OR=52,520; IC95% 13,269 – 207,876); para o BVDV foram: bovinos com idade maior que 48 meses (OR=4,407; IC95% 2,456 – 7,906), região Sudoeste (OR=52,388; IC95% 4,629 – 5892,873), sistema de produção semi-intensivo (OR=1,333; IC95% 0,261 – 6,815), propriedade com número de animais menor ou igual a 50 bovinos (OR=16,682; IC95% 3,218 – 86,481), percentual de entrada maior que 10% de bovinos (OR=17,56; IC95% 7,613 – 40,506) e ... / A serological survey of the following respiratory viruses: Bovine Herpesvirus 1 (BoHV-1), Bovine Viral Diarrhea Virus (BVDV), Bovine Parainfluenza Virus Type 3 (bPIV-3) and Bovine Respiratory Syncytial Virus (BRSV) in Holstein cattle black and White (HPB), raised in Paraná state was performed. 714 blood samples were collected from the jugular vein of cattle not vaccinated for the studied agents, over six months of age, from 26 dairy herds, distributed in 17 municipalities of Paraná state. Alongside the collection, a questionnaire was used for each property studied in order to assess the risk factors associated with the viruses examined. The serum samples were subjected to the diagnosis test of virus neutralization at the Laboratory of Viral Diseases of Cattle of the Biological Institute of São Paulo. Frequencies of 22.3%; 35.8%; 80.4% and 93.5% of seropositive cattle were observed and 65.3%, 88.5%, 96.1% and 100% of the seropositive properties BoHV-1, BVDV, bPIV-3 and BRSV, respectively. The co-infection that occurred most frequently was the bPIV-3 and BRSV (37.1%). After logistic regression analysis, risk factors associated with BoHV-1 were cattle with more than 48 months of age (OR = 15.012; 95% CI 7.500 to 30.051), property area 26-50 hectares (OR = 11.328; 95% CI 2.482 – 51.697), stocking higher than three animals per hectare (OR = 1.026; 95% CI 0.370 to 2.847), cattle entry percentage higher than 10% (OR = 52.520 entry; 95% CI 13.269 to 207.876); for BVDV were cattle older than 48 months (OR = 4.407; 95% CI 2.456 to 7.906), Southwest region (OR = 52.388; 95% CI 4.629 to 5892.873), semi-intensive production system (OR = 1.333; 95% CI 0.261 to 6.815),property with fewer animals than or equal to 50 (OR = 16.682; 95% CI 3.218 to 86.481), a percentage of cattle entry higher than 10% (OR = 17.56; 95% CI 7.613 – 40.506) and neighboring pasture sharing (OR = 9.148; 95% CI 3.751 to 22.310); for bPIV-3 cattle older than 48 months ...

Made available in DSpace on 2015-05-14T16:53:33Z (GMT). No. of bitstreams: 0 Previous issue date: 2014-02-06Bitstream added on 2015-05-14T16:58:40Z : No. of bitstreams: 1 000828889.pdf: 1474303 bytes, checksum: 5e90c0d81b102049672685d3cfea7b62 (MD5)

Made available in DSpace on 2015-06-17T19:33:57Z (GMT). No. of bitstreams: 0 Previous issue date: 2014-08-27. Added 1 bitstream(s) on 2015-06-18T12:47:47Z : No. of bitstreams: 1 000830951.pdf: 1671352 bytes, checksum: e150ad97472df641fe9aede1e51165a5 (MD5) / INTRODUÇÃO: O valor prognóstico da classificação molecular do carcinoma de mama recentemente proposta tem sido validado por numerosos estudos. Entretanto, a maioria destes trabalhos estudou o tipo histológico mais comum denominado carcinoma ductal invasivo usual (CDI), uma entidade reconhecidamente heterogênea. Poucos estudos concentraram-se especificamente em outros tipos histológicos como o carcinoma lobular invasivo (CLI) que é o tipo especial mais frequente. O CLI apresenta-se com características clínico-patológicas e história natural bastante distintas do CDI sendo claramente entidades biológicas diferentes. Além disso, é uma doença relativamente frequente com aumento de sua incidência no mundo. OBJETIVO: Estudar comparativamente os subtipos moleculares luminais A e B de dois grupos de pacientes com CLI e CDI da mama, bem como determinar o valor prognóstico independente da classificação molecular nestes tumores correlacionando os subtipos moleculares com a sobrevida específica por carcinoma de mama (BCSS) e a sobrevida global (OS). SUJEITOS E MÉTODOS: Estudo do tipo transversal analítico. Foram selecionados blocos de parafina de mulheres com diagnóstico histopatológico de CLI e CDI no Laboratório de Patologia do Hospital Amaral Carvalho (HAC), Jaú, São Paulo, Brasil. Os respectivos prontuários médicos e o Registro Hospital de Câncer (RHC) do HAC foram consultados para a pesquisa das informações clínicas e de seguimento destas mulheres (média de 121,77 e 131,27 meses para o CLI e CDI, respectivamente), totalizando 186 casos. Dos blocos doadores, foram extraídas duas amostras de 2 mm de diâmetro e depositadas nos blocos de parafina receptores usando Tissue Microarray Builder ab1802 (Abcam®, Cambridge, UK). Nestes cortes foi feita a pesquisa dos seguintes marcadores imunoistoquímicos: receptor de estrógeno α (RE), receptor de progesterona (RP), HER2 e Ki67. Os subtipos moleculares (luminal A, luminal ... / INTRODUCTION: The prognostic value of the molecular classification of breast cancer recently proposed has been validated by many studies. However, the great majority of these studies has focused on invasive ductal carcinoma no special type (IDC), a widely recognized heterogeneous entity. Few papers have studied other special types of breast cancer such as invasive lobular carcinoma (ILC) the most common special type. ILC shows clinico-pathological features and natural history quite distinctive from IDC being clearly separate biologic entities. Moreover, ILC is relatively frequent and has been increasing in incidence over the recent years. OBJECTIVE: to study comparatively the luminal molecular subtypes A e B of two groups of patients with ILC and IDC and to determine the prognostic independent value of the molecular classification in ILC patients by correlating the molecular subtypes with clinical outcomes such as breast cancer specific survival (BCSS) and overall survival (OS). MATERIALS AND METHODS: archival paraffin blocks from women diagnosed with ILC and IDC at the Pathology Laboratory of Hospital Amaral Carvalho, Jau, Sao Paulo, Brazil, were retrieved. Patient's charts and the Hospital Amaral Carvalho Cancer Registry were consulted for obtaining the staging and follow-up information (median 121.77 and 131.27 months for ILC and IDC, respectively) and 186 patients were selected. Two samples from each paraffin block were extracted to mount tissue microarray (TMA) blocks by using a Tissue Microarray Builder ab1802 (Abcam®, Cambridge, UK). The following immunohistochemical markers were performed in the TMA blocks: estrogen receptor α, progesterone receptor, HER2 and Ki67 protein. The intrinsic molecular subtypes (luminal A, luminal B, HER2 and triple negative) were determined based on the immunohistochemical profile of each tumor. Prognostic clinico-pathological features were analysed in absolute (n) and relative frequency (%). The ...

Made available in DSpace on 2015-06-17T19:34:17Z (GMT). No. of bitstreams: 0 Previous issue date: 2014-02-10. Added 1 bitstream(s) on 2015-06-18T12:49:09Z : No. of bitstreams: 1 000829953.pdf: 382824 bytes, checksum: dd8b4ad1283ed8e9ed431c802abc1f2e (MD5) / Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Fundamento: A AIDS representa importante problema de saúde pública da atualidade, assim como a doença aterosclerótica. Com a maior sobrevida entre os infectados pelo HIV, identificou-se aumento do número de eventos cardiovasculares nessa população. Os preditores e a fisiopatologia da associação HIV e aterosclerose não estão totalmente esclarecidos. Objetivos: Identificar a frequência da aterosclerose subclínica em pacientes HIV positivo, comparando-a com indivíduos controle; associar o diagnóstico de aterosclerose com carga viral, níveis de CD4 e tratamento antirretroviral; associar a presença de aterosclerose com fatores de risco cardiovasculares e escore de risco de Framingham, nos pacientes HIV positivo. Casuística e Métodos: estudo prospectivo, transversal, de casos e controles, que avaliou a presença de aterosclerose subclínica em 264 infectados pelo HIV e em 279 indivíduos do grupo controle. Foi avaliado o grau de espessamento médio-intimal de carótidas (EMIC), presença de placa em artérias carótidas, rigidez arterial através da velocidade de onda de pulso (VOP) e augmentation index (AIx), níveis séricos da PCR de alta sensibilidade, perfil lipídico, glicemia, albumina, hemograma, uréia, creatinina e o risco cardiovascular conforme critérios de Framingham. Resultados: Os pacientes foram, em média, seis anos mais velhos que os controles (43,2±10,5 vs. 37,9±11,5 anos; p<0,001), apresentaram menor frequência de sobrepeso / obesidade (51,1 vs. 63,1%; p=0,005) e maior frequência de tabagismo ativo (43,6 vs. 16,1%; p<0,001). Foram encontradas placas em 37% dos pacientes do grupo HIV e em 4% do grupo controle (p<0,001). Os pacientes com placas eram, em média, 11 anos mais velhos do que aqueles sem placas (51,4±9,21 vs. 40,2±9,40 anos; p<0,001) e apresentaram valores maiores de glicemia de jejum [90 (78; 100) vs. 83 (76,5; 90) mg/dL; p=0,012], colesterol total [200 (178; 244) vs. 181 (156; 208,5) mg/dL; ... / Background: AIDS as well as atherosclerosis are important public health problems. The longer survival among HIV-infected is associated to increased number of cardiovascular events in this population and this association is not fully understood. Objectives: To identify the frequency of subclinical atherosclerosis in HIV-infected patients, compared with control subjects; to analyze the association of atherosclerosis with viral load, CD4 counts and antiretroviral treatment, cardiovascular risk factors and with the Framingham risk score, in HIV-positive patients. Methods: a prospective, cross-sectional, case-control study assessed the presence of subclinical atherosclerosis in 264 HIV-infected patients and 279 control subjects. Clinical evaluation included carotid intima-media thickness (IMT) measurement, the presence of plaque in the carotid arteries, arterial stiffness by pulse wave velocity (PWV) and augmentation index (AIx), blood levels of hs-CRP, lipids, glucose, albumin, blood count, urea, creatinine and cardiovascular risk according to Framingham risk score criteria. Results: Patients were six years older than controls (43.2±10.5 vs. 37.9±11.5 years; p<0.001). Also presented lower prevalence of overweight / obesity (51.1 vs 63.1%; p=0.005) and higher frequency of active smoking (43.6 vs. 16.1%; p<0.001). Plaques were found in 37% of patients in the HIV group and 4% in the control group (p<0.001). Patients with carotid plaque were on average 11 years older than those without plaques (51.4±9.21 vs. 40.2±9.40 years; P<0.001) and had higher fasting glucose [90 (78, 100) vs. 83 (76.5, 90) mg/dl; p=0.012], total cholesterol [200 (178, 244) vs. 181 (156, 208.5) mg/dL; p<0.001], LDL-c [120.1 (96.2, 148.4) vs. 96.8 (80, 125) mg/dL; p<0.001] and triglycerides [188.5 (125.5, 288.5) vs. 150.5 (108, 226) mg/dL; p=0.010], mean systolic blood pressure 10 mmHg higher (132±21 vs. 121±16 mmHg; p<0.001) and mean diastolic blood pressure 6 mmHg ... / CNPq: PIBIC/16522 / FAPESP: 2010/11860-2

Made available in DSpace on 2015-06-17T19:34:22Z (GMT). No. of bitstreams: 0 Previous issue date: 2014-10-03. Added 1 bitstream(s) on 2015-06-18T12:48:58Z : No. of bitstreams: 1 000831358.pdf: 440427 bytes, checksum: 614119cd43a68e503ea6c263f3fbaf2c (MD5) / Objetivo: avaliar os fatores de risco para baixa densidade mineral óssea (DMO) em mulheres na pós-menopausa tratadas de câncer de mama comparadas a mulheres na pós-menopausa sem câncer de mama. Métodos: Realizou-se estudo transversal, com 112 mulheres tratadas de câncer de mama comparadas a 224 mulheres na pós-menopausa (controle), atendidas em Hospital Universitário. Foram incluídas no grupo de estudo mulheres com amenorréia ≥12 meses e idade ≥45 anos, tratadas de câncer de mama e livre de doença há pelo menos cinco anos. O grupo controle foi constituído de mulheres com amenorréia ≥12 meses e idade ≥45 anos sem câncer de mama, pareadas pela idade e tempo de menopausa, na proporção 1:2. Por meio de entrevista foram avaliados fatores de risco para baixa DMO (osteopenia e osteoporose). A DMO foi mensurada pela absorciometria de raios-X de dupla energia (DEXA) em coluna lombar (L1 a L4) e colo de fêmur. Regressão logística (odds ratio-OR) foi utilizada para identificar fatores associados à baixa DMO. Resultados: A média de idade das pacientes tratadas de câncer de mama foi de 61.3 ± 9.7 anos com tempo médio de seguimento de 10.2 ± 3.9 anos. Considerando ambos os sítios avaliados (coluna e colo de fêmur), 77.7% das mulheres tratadas de câncer de mama e 74.5% do grupo controle apresentavam baixa DMO (p=0.302). Na avaliação isolada da DMO em coluna lombar não houve diferença entre os grupos (p=0.332). Contudo, na DMO de colo de fêmur, as pacientes com câncer de mama apresentaram maior ocorrência de osteopenia (45.1%) e osteoporose (22.3%) quando comparadas ao controle (39.3% e 9.0%, respectivamente) (p=0.0005). Avaliando os fatores de risco para baixa DMO entre as mulheres com câncer de mama encontrou-se que quimioterapia prévia associou-se com aumento no risco (OR 6.90; IC 95% 5.57-9.77), enquanto que exercício físico regular (OR 0.24; IC 95% 0.06-0.98) e índice de massa corpórea (IMC) ≥ 30 kg/m2 ... / Objective: To evaluate the risk factors for low bone mineral density (BMD) in postmenopausal breast cancer survivors compared to postmenopausal women without breast cancer. Methods: In this cross-sectional study, 112 breast cancer survivors were compared to 224 postmenopausal women (control), seeking healthcare at a University Hospital. Eligibility criteria included women with amenorrhea ≥ 12 months and age ≥ 45 years, treated for breast cancer and metastasis-free for at least five years. The control group consisted of women with amenorrhea ≥ 12 months, age ≥ 45 years and without breast cancer, matched by age and menopause status (in a proportion of 1:2 as sample calculation). The risk factors for low BMD (osteopenia and osteoporosis) were assessed by interviews. BMD was measured by dual energy X-ray absorptiometry (DEXA) at the lumbar spine (L1-L4) and femoral neck. Logistic regression model (odds ratio, OR) was used to identify factors associated with low BMD. Results: The mean (SD) age of breast cancer survivors was 61.3 (9.7) years, with a mean (SD) follow-up of 10.2 (3.9) years. Considering both sites assessed (spine and femoral neck), 77.7% of breast cancer survivors and 74.5% in the control group had low BMD (p = 0.302). The BMD at the lumbar spine did not differ between groups (p = 0.332). However, breast cancer survivors had a higher incidence of osteopenia (45.1%) and osteoporosis (22.3%) in the BMD at the femoral neck when compared to control (39.3% and 9.0%, respectively) (p = 0.0005). Univariate analyses, adjusted for age and time since menopause, revealed that chemotherapy (OR 6.90; CI 95% 5.57-9.77) was associated with higher risk for low BMD. Contrarily, regular physical exercise (OR 0.24; 95%CI 0.06-0.98) and body mass index (BMI) ≥ 30 kg/m2 (OR 0.09; 95% CI 0.02-0.37) reduced risk among breast cancer survivors. Smoking, use of hormone therapy, tamoxifen or anastrozole, history of fracture, rheumatoid ...