Health-related quality of life (HRQL) has become an important outcome in asthma, since traditional outcomes, such as respiratory symptoms and pulmonary function, might not entirely express the patient’s perception of the limitations caused by the disease. The aim of this thesis was to study HRQL in asthma and to analyse if HRQL was related to asthma onset and prognosis. Other aims were to identify determinants of low HRQL in clinically-verified asthmatics, and to study whether low HRQL was a predictor of mortality. In 1990, a self-administered questionnaire was completed by 12,560 individuals from three age groups (16, 30-39, and 60-69 years) in two counties of Sweden. In a second phase, all subjects who reported a history of obstructive respiratory symptoms (n = 1,851) and 600 randomly-selected controls were invited to a clinical investigation including spirometry, allergy testing, and assessment of HRQL with the Gothenburg Quality of Life instrument. In 2003, the eligible subjects in the cohort (n=11,282) were sent a new questionnaire. Mortality data in the cohort was followed up during 1990–2008 using data from the National Board of Health and Welfare Mortality Database. The 616 subjects with clinically-verified asthma 1990 had significantly lower HRQL than subjects without asthma. In the 2003 follow-up, the 305 subjects with persistent asthma had a lower HRQL than the 155 subjects who showed improvement in asthma during the follow-up. Subjects who had developed asthma by the follow-up had a significantly lower HRQL at baseline than those who did not develop asthma. Significant determinants of quality of life in asthma were female sex, smoking habits, higher airway responsiveness to irritants, respiratory symptom severity, positive skin prick test, and absenteeism from work or school. Low HRQL was related to increased mortality, but this association was not found when analyzing the asthmatic group alone. In conclusion, measurements of HRQL are of value for evaluating both the impact and progression of asthma.

Objectives. To study whether birth weight (BW) was correlated to cardiovascular risk factors, coronary heart disease (CHD), cardiovascular disease (CVD), and prostate cancer (PCA) at adult ages, whether a possible relationship depended on mediating factors from birth time, hereditary circumstances, and adult life variables, and what importance possible associations might have for the rate of the complaint in the general population. Material and methods. Population-based cohorts of men born in 1913 and followed up until old age. Risk of outcome was estimated using Cox’s and Poisson regressions. The results were transformed to population attributable risk percentage (PAR%) of the complaint that could be attributed to low or high BW, given causality between exposure and outcome. Results. After adjustment for the influence of covariates, systolic blood pressure at age 50 decreased by 3.7 mmHg per 1000 g increase in BW, the prevalence of antihypertensive treatment decreased by 32%, diabetes by 53%, serum total cholesterol decreased by 0.20 mmol L-1, and being in top quintile of serum cholesterol decreased by 23%. The adjusted risks were somewhat more marked relative to the crude risks. CHD and CVD incidence and mortality were virtually unaffected by BW. In the general population, the risk percentage attributable to a BW ≤3000 g was 18% for diabetes, 2.5% for cholesterol, and ≤1% for antihypertensive treatment and CHD and CVD incidence and mortality. PCA incidence and mortality risk increased by 62% and 82%, respectively, among those whose BW was ≥4250 g compared with those whose BW was 3001-4249 g. The risk percentages attributable to a BW ≥4250 g in the general population for PCA incidence and mortality were 7.8% and 10.8%. Conclusions. Low BW seemed to affect cardiovascular risk factors but not incidence and mortality from CHD and CVD. A high proportion of diabetes on the community level could be attributed to low BW, while the proportional burden of other cardiovascular complaints that could be attributed to low BW was modest. PCA incidence and mortality seemed to be affected by high BW.

Introduction Neuropsychological development is a genetically guided process which is continuously modified by socio-environmental factors. This thesis aimed to study the main socio-environmental determinants of neuropsychological development in different time-periods, such in the first two years of life, during preschool, and during preadolescence. This thesis also aimed to summarize the work done in environmental epidemiology on neuropsychological development in a novel conceptual framework. Methods This thesis is based on the data of the INMA (Infancia y Medio Ambiente) Project. The main objective of this project is to evaluate the impact of environmental exposures in children’s health in 7 population-based birth cohorts in different regions of Spain. The neuropsychological development of approximate total of 2,650 children was assessed at different time-periods following the same protocols. Results (1) Maternal cognitive capacities were positively related with child cognitive development early in life in more disadvantaged occupational social classes. (2) The levels of child cortisol were not related to child neuropsychological development during the second year of life. (3) Higher levels of long-chain polyunsaturated fatty acids in colostrum due to prolonged periods of breastfeeding improved early neuropsychological development of children, in particular in those children exposed to maternal smoking during pregnancy. (4) Prenatal exposure to PCBs (specially for PCB congener 153) impacted negatively on psychomotor development during the second year in life and on general neuropsychological development at the age of 4 years. (5) Postnatal exposure to organochlorine compounds was associated with a delay in reaction time (speed processing) during the preadolescent period. (6) The conceptual framework proposed will improve the quality of research in this area. Conclusions Social and cultural determinants such as maternal intelligence, educational level or occupational social class, are configuring the proximal environment in which a child develops and determine their neuropsychological development. Current levels of some organochlorine compounds, particularly polychlorinated byphenils, measured in blood samples (from umbilical cord, mothers, or children) are impairing on neuropsychological development in the general population. / Introducció El desenvolupament neuropsicològic infantil és un procés guiat genèticament, el qual és contínuament influenciat per factors socials i ambientals. L’objectiu d’aquesta tesis fou l’estudi dels principals determinants socio-ambientals del desenvolupament neuropsicològic infantil en diferents períodes de temps. Aquesta tesis també té l’objectiu de resumir en un marc conceptual els diferents components del desenvolupament neuropsicològic pel seu ús en estudis d’epidemiologia ambiental. Mètodes Aquesta tesis està basada en dades del projecte INMA (Infancia y Medio Ambiente). El principal objectiu d’aquest projecte és avaluar l’impacte de les exposicions ambientals en la salud infantil en 7 cohorts de població establides en diferents regions d’Espanya. Dintre del marc d’aquest projecte, s’ha avaluat el desenvolupament neuropsicològic d’aproximadament 2.650 nens en diferents moments, seguint els mateixos protocols. Resultats (1) Les capacitats cognitives maternes estan positivament relacionades amb el desenvolupament cognitiu infantil en les primeres etapes, en les classes socials ocupacionals menys afavorides. (2) Els nivells de cortisol infantil no mostren associació amb el desenvolupament neuropsicològic durant el segon any de vida. (3) Nivells elevats d’àcids grassos poliinsaturats de cadena llarga en conjunció amb períodes prolongats de lactancia materna afavoreixen el desenvolupament neuropsicològic a les primeres etapes, especialment en aquells nens de mares fumadores durant l’embaràs. (4) L’exposició prenatal a PCBs (espcialment, al congener 153) impacta negativament en el desenvolupament psicomotor infantil durant el segon any de vida i en el desenvolupament neuropsicològic general als 4 anys d’edat. (5) L’exposició postnatal a compostos organocloroats està associada a una capacitat de reacció (velocitat de processament) més alentida en etapes preadolescents. (6) L’ús del marc conceptual propossat tesis afavorirà la qualitat de l’investigació en aquesta àrea. Conclussions Els determinants socials, com l’intel•ligència materna, el nivell educatiu o la classe social basada en l’ocupació, configuren l’entorn més proper del nen i determinen el seu desenvolupament neuropsicològic. Els nivells actuals de certs compostos organoclorats, especialment els bifenils policlorinats, mesurats en mostres de sang (de cordó umbilical, mares o nens) mostren efectes negatius sobre el desenvolupament neuropsicològic en la població general. / Introducción El desarrollo neuropsicológico infantil es un proceso guiado genéticamente, el cual está contínuamente influenciado por factores sociales y ambientales. El objetivo de esta tesis fue estudiar los principales determinantes socio-ambientales del desarrollo neuropsicológico infantil en diferentes periodos de tiempo. Esta tesis también tenía como objetivo resumir en un marco conceptual el trabajo hecho en epidemiología ambiental en el estudio del desarrollo neuropsicológico infantil. Métodos Esta tesis está basada en datos del proyecto INMA (Infancia y Medio Ambiente). El principal objetivo de esto proyecto es evaluar el impacto de las exposiciones ambientales en la salud infantil en 7 cohortes de población establecidas en diferentes regiones de España. El desarrollo neuropsicológico de aproximadamente 2.650 niños ha sido evaluado en diferentes momentos siguiendo los mismos protocolos. Resultados (1) Las capacidades cognitivas maternas están positivamente relacionadas con el desarrollo cognitivo infantil en edades tempranas en las clases sociales ocupacionales menos aventajadas. (2) Los niveles de cortisol en el niño no se asocian con el desarrollo neuropsicológico durante el segundo año de vida. (3) Niveles altos de ácidos grasos poliinsaturados de cadena larga debido a periodos largos de lactancia materna mejoraron el desarrollo neuropsicológico a edades tempranas, especialmente en esos niños cuyas madres fumaron durante el embarazo. (4) La exposición prenatal a PCBs (espcialmente para el congener 153) impacta negativamente en el desarrollo psicomotor durante el segundo año de vida y en desarrollo neuropsicológico general a la edad de 4 años. (5) La exposición postnatal a compuestos organoclorados está asociado con una peor capacidad de tiempo de reacción (velocidad de procesamiento) durante la preadolescencia. (6) El marco conceptual propuesto mejorará la calidad de la investigación en esta área. Conclusiones Los determinantes sociales tales como inteligencia maternal, nivel educativo o clase social basada en la ocupación, configuran el entorno más cercano en el cual el niño se desarrolla y determinan su desarrollo neuropsicológico. Los niveles actuales de ciertos compuestos organoclorados, especialmente los bifeniles policlorinados, medidos en sangre (de cordón umbilical, madre, o niño) tienen efectos negativos sobre el desarrollo neuropsicológico de la población general.

Thesis (Ph.D. in Analytic Health Sciences, Department of Preventive Medicine and Biometrics) -- University of Colorado Denver, 2007. / Typescript. Includes bibliographical references (leaves 75-77). Free to UCD affiliates. Online version available via ProQuest Digital Dissertations;

Thesis (Ph.D. in Clinical Science) -- University of Colorado Denver, 2007. / Typescript. Includes bibliographical references (leaves 86-91). Free to UCD affiliates. Online version available via ProQuest Digital Dissertations;

Recent research in economics and psychology has examined the childhood noncognitive skills which predict future economic success. However, there has been relatively little research on whether these skills predict future unemployment. This thesis uses data from four cohort studies (total N = 47,328) from Great Britain and the United States to examine how lifetime trajectories of unemployment are affected by childhood differences in self-control (chapter 3), conscientiousness (4), and mental health (5-6). These are some of the first studies to examine how pre-labor market measures of these psychological characteristics prospectively predict future unemployment. Chapters 3, 5 and 6 are the first studies to examine how early psychological characteristics interact with recessions to produce differential unemployment outcomes. After adjusting for cognitive ability and key sociodemographic indicators (e.g. gender, SES), all three of these psychological characteristics are found to predict future unemployment. The effects are statistically significant and economically meaningful, comparable in magnitude to the effects of intelligence. Chapter 3 shows that childhood with poor self-control were disproportionately more likely than their more self-controlled peers to become unemployed during the 1980s UK recession, and chapters 5 and 6 find a similar effect for children with high psychological distress compared to their less distressed peers during the 1980s UK recession and 2007 US recession. These studies demonstrate the value of using psychological research to examine economic outcomes. The chief policy implication is that interventions which improve childhood levels of self-control, conscientiousness and mental health may be an effective way to reduce future population unemployment levels. In the short term, remediation programs which take into account individual psychological differences may improve the efficacy of unemployment interventions, particularly during recessions when certain groups are more likely than others to become unemployed.

Objetivo: Avaliar a influência de mudanças no hábito de fumar sobre o ganho de peso gravídico materno. Métodos: Foram entrevistadas 5.564 gestantes com 20 anos ou mais, sem diabetes mellitus prévio em serviços de pré-natal geral de seis capitais brasileiras, entre 1991 e 1995, e acompanhamos, através de revisão de prontuários, as gestações até o parto, identificando 4.000 gestantes com peso pré-gravídico relatado, peso medido no terceiro trimestre, hábito de fumar e época de sua eventual modificação, quando disponíveis. Resultados: Entre as gestantes ex-fumantes (915, 23% do total), 240 (26%) pararam de fumar durante a gravidez. A mediana de cigarros/dia das que continuaram fumantes (717, 18%) foi reduzida de 10 para 5 após o início da gravidez. Após ajustar para idade, escolaridade, cor da pele, IMC pré-gravídico, paridade e centro clínico, as ex-fumantes ganharam 1.030 g (IC95% 590 a 1.460) a mais que as nunca fumantes, sendo maior a diferença (1.540, IC95% 780 a 2.300 g) nas que pararam após a concepção. O ganho do peso na gravidez se correlacionou, tanto em fumantes quanto em ex-fumantes, com o número de cigarros diminuídos na gravidez. Conclusão: Diminuir ou parar de fumar na gravidez, embora importante para uma gestação saudável, é fator de risco para ganho de peso materno. / Objective: Evaluate the association of changes in smoking habit with maternal weight gain. Methods: We interviewed 5564 pregnant women > 20 years, without prior diabetes mellitus, during a second trimester pre-natal visit in general prenatal care clinics in 6 Brazilian cities, from 1991 to 1995, and followed them, through chart review, to term. We now report associations in the 4000 women who had complete information concerning pre-pregnancy and 3rd trimester weight, smoking status and its eventual changes during pregnancy. Results: Of women who stopped smoking (915, 23% do total), 240 (26,2%) stopped during pregnancy. The median number of cigarettes smoked/day among those who continued (717, 18%) decreased from 10 to 5 with pregnancy. In linear regression models adjusting for age, educational level, ethnicity, pre-pregnancy body mass index, parity and clinical center, exsmokers gained 1030 (95%CI 590 – 1460) grams more than never smokers, this difference being greater – 1540 (95%CI 780 – 2300) grams – in those who quit while pregnant. The size of weight gain in both smokers and ex-smokers was proportional to the quantitative reduction in daily number of cigarettes smoked during pregnancy (p=0.007). Conclusion: Stopping to smoke or decreasing the quantity of cigarettes smoked in pregnancy, although important for maternal and child health, is a risk factor for maternal weight gain.

Objetivo: Avaliar a influência de mudanças no hábito de fumar sobre o ganho de peso gravídico materno. Métodos: Foram entrevistadas 5.564 gestantes com 20 anos ou mais, sem diabetes mellitus prévio em serviços de pré-natal geral de seis capitais brasileiras, entre 1991 e 1995, e acompanhamos, através de revisão de prontuários, as gestações até o parto, identificando 4.000 gestantes com peso pré-gravídico relatado, peso medido no terceiro trimestre, hábito de fumar e época de sua eventual modificação, quando disponíveis. Resultados: Entre as gestantes ex-fumantes (915, 23% do total), 240 (26%) pararam de fumar durante a gravidez. A mediana de cigarros/dia das que continuaram fumantes (717, 18%) foi reduzida de 10 para 5 após o início da gravidez. Após ajustar para idade, escolaridade, cor da pele, IMC pré-gravídico, paridade e centro clínico, as ex-fumantes ganharam 1.030 g (IC95% 590 a 1.460) a mais que as nunca fumantes, sendo maior a diferença (1.540, IC95% 780 a 2.300 g) nas que pararam após a concepção. O ganho do peso na gravidez se correlacionou, tanto em fumantes quanto em ex-fumantes, com o número de cigarros diminuídos na gravidez. Conclusão: Diminuir ou parar de fumar na gravidez, embora importante para uma gestação saudável, é fator de risco para ganho de peso materno. / Objective: Evaluate the association of changes in smoking habit with maternal weight gain. Methods: We interviewed 5564 pregnant women > 20 years, without prior diabetes mellitus, during a second trimester pre-natal visit in general prenatal care clinics in 6 Brazilian cities, from 1991 to 1995, and followed them, through chart review, to term. We now report associations in the 4000 women who had complete information concerning pre-pregnancy and 3rd trimester weight, smoking status and its eventual changes during pregnancy. Results: Of women who stopped smoking (915, 23% do total), 240 (26,2%) stopped during pregnancy. The median number of cigarettes smoked/day among those who continued (717, 18%) decreased from 10 to 5 with pregnancy. In linear regression models adjusting for age, educational level, ethnicity, pre-pregnancy body mass index, parity and clinical center, exsmokers gained 1030 (95%CI 590 – 1460) grams more than never smokers, this difference being greater – 1540 (95%CI 780 – 2300) grams – in those who quit while pregnant. The size of weight gain in both smokers and ex-smokers was proportional to the quantitative reduction in daily number of cigarettes smoked during pregnancy (p=0.007). Conclusion: Stopping to smoke or decreasing the quantity of cigarettes smoked in pregnancy, although important for maternal and child health, is a risk factor for maternal weight gain.

Introdução: Existe ampla variação no prognóstico de pacientes na fase subaguda após um episódio de síndrome coronariana aguda. O uso da troponina cardíaca de alta sensibilidade pode auxiliar na identificação de pacientes com maior risco de complicações em médio e longo prazo. Objetivos: Identificar, nos pacientes com SCA, a frequência de níveis persistentemente elevados de troponina; avaliar a relação entre a elevação persistente dos níveis de troponina e a incidência de desfechos adversos, como: morte por todas as causas, morte cardiovascular e morte por infarto agudo do miocárdio, pelo período de seguimento de até cinco anos após o evento índice; e avaliar se a incidência de desfechos adversos está relacionada a elevação dos níveis de troponina mesmo abaixo do valor de corte para o 99º percentil do método. Métodos: Foram avaliados todos os pacientes recrutados no estudo ERICO (Estratégia de Registro da Insuficiência Coronariana) com diagnóstico de angina instável (AI), infarto agudo do miocárdio (IAM) sem supradesnivelamento de segmento ST e IAM com supradesnivelamento de segmento ST. Níveis de troponina I de alta sensibilidade foram medidos em 525 pacientes no período de 25 a 90 dias após um episódio de síndrome coronariana aguda (SCA). Os participantes foram divididos em tercis de acordo com os níveis de troponina e seguidos entre fevereiro de 2009 e dezembro de 2015. Os desfechos analisados foram: mortalidade por todas as causas, mortalidade cardiovascular e incidência de infarto agudo do miocárdio. Resultados: Pacientes no tercil superior de troponina colhida entre 25 e 90 dias tiveram maior taxa de risco (TR) de mortalidade por todas as causas quando comparados com o tercil inferior, na análise não ajustada (TR: 5,17, intervalo de confiança de 95% [IC 95%]: 2,41-11,10) e ajustada por idade e sexo (TR: 4,93, IC95%: 2,29-10,64). Estes achados persistiram mesmo após o ajuste para fatores de risco cardiovascular conhecidos no modelo multivariado número 1 (TR: 5,24, IC95%: 2,08-13,20), e análise posterior com ajuste pela taxa de filtração glomerular abaixo de 60 ml/min/1.73m2 e fração de ejeção do ventrículo esquerdo abaixo de 0,40 (TR: 6,47, IC95% 1,77-23,66). A mortalidade cardiovascular foi significativamente maior no tercil superior após ajuste para idade e sexo (TR: 6,51, IC 95% 1,92-22,10) e no primeiro modelo de ajuste multivariado (TR: 7,47, IC 95%: 1,62-34,41); houve tendência não estatisticamente significativa de maior mortalidade cardiovascular no segundo modelo (TR: 4,52, IC 95%: 0,71-28,62). Não houve diferenças significativas entre os tercis em relação à incidência de infarto agudo do miocárdio. Conclusão: Nosso estudo demonstrou que níveis de troponina de alta sensibilidade medidos na fase subaguda após um episódio de SCA são preditores independentes de mortalidade por todas as causas / Introduction: Prognosis of patients in the stable phase after an acute coronary syndrome (ACS) event is widely variable. The use of high-sensitivity cardiac troponin I can aid in the identification of patients at higher risk for long-term adverse outcomes. Objectives: To identify, among ACS patients, the frequency of persistently elevated troponin levels 25 to 90 days after the event; to evaluate the relation between persistently elevated troponin levels and incidence of adverse outcomes, such as: allcause mortality, cardiovascular mortality, and myocardial infarction mortality; and to evaluate if the incidence of adverse outcomes is related to elevations in troponin levels even below the 99th percentile of the essay. Methods: All 525 patients recruited in the ERICO study (Acute Coronary Syndrome Registry Strategy) with a diagnosis of unstable angina (UA), non-ST elevation myocardial infarction (NSTEMI) or ST elevation myocardial infarction (STEMI) who had blood samples available 25 to 90 days after the ACS event had high sensitivity cardiac troponin I levels measured; these patients were then divided into tertiles and followed from February 2009 to December 2015. We evaluated all-cause mortality, cardiovascular mortality and myocardial infarction as endpoints during follow-up. Results: Patients in the highest tertile had a greater hazard ratio (HR) for all-cause mortality compared to the lowest tertile, on crude analysis (HR: 5.17, 95% Confidence Interval [95% CI]: 2.41-11.10) and after adjustment for age and sex (HR: 4.93, 95% CI: 2.29-10.64). These findings persisted even after adjustment for known cardiovascular risk factors on multivariate model 1 (HR: 5.24, 95% CI: 2.08-13.20), and further adjustment for estimated glomerular filtration rate < 60 ml/min/1.73m2 and left ventricular ejection fraction < 0.40 (HR: 6.47, 95% CI: 1.77-23.66). Cardiovascular mortality was significantly higher in the highest tertile after adjustment for age and sex (HR: 6.51, 95% CI: 1.92-22.10) and in the first model of multivariate adjustment (HR: 7.47, 95% CI: 1.62-34.41); there was a nonsignificant trend towards higher cardiovascular mortality in the second model of multivariate adjustment (HR: 4.52, 95% CI: 0.71-28.62). Conclusion: In conclusion, our study showed that elevated high sensitivity cardiac troponin I levels measured in the stabilized phase after an ACS event are independent predictors of long-term mortality

Introdução: A cateterização venosa central caracteriza-se pelo posicionamento de um dispositivo vascular cuja extremidade alcance o terço final da veia cava superior, independente do local de inserção. Grande parte dos pacientes com afecções cardiopulmonares são eletivos à sua implantação, por apresentarem rede venosa periférica fragilizada e necessidade de infusão prolongada de soluções. No entanto, tal procedimento possui caráter invasivo, associado a complicações. Objetivos: Analisar as complicações relacionadas ao uso de cateter venoso central semi-implantável não tunelizado. Material e método: Estudo de coorte prospectivo (6 meses) realizado em unidades de terapia intensiva e clínicas médico-cirúrgicas do Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, em pacientes adultos com afecções cardiopulmonares em uso de cateter central de inserção periférica (PICC) ou cateter de duplo lúmen (CDL), pela observação diária do cateter até sua retirada ou saída hospitalar, associada a consultas ao prontuário para obter informações sobre paciente e condições do cateter. Variáveis de estudo relacionadas a dados demográficos e de morbidade, de inserção de cateter, de uso e manutenção, de complicações relacionadas ao uso de cateter, de remoção de cateter. Análise de dados: Medidas de tendência central e de variabilidade, teste de qui-quadrado ou Mann-Whitney para dados qualitativos, teste t-students e ANOVA ou teste de Kruskall-Wallis para comparação de médias. Resultados: Houve predominância dos CDL, utilizados em 127 (67,2%) situações, e o PICC em 62 (32,8%). Dos cateteres, 55 (43,3%) CDL e 21 (37,0%) PICC apresentaram algum tipo de complicação. Houve diferença estatística (p=0,017) entre as complicações de acordo com os tipos de PICC, sendo maior nos de ponta aberta. Houve diferença entre as complicações de acordo com os sítios de inserção, porém sem diferença estatística (p=0,479). A obstrução ocorreu em apenas 3,9% (5) dos CDL, enquanto que nos PICCs esteve presente em 11,3% (7) dos casos. A flebite grau 1 esteve presente em 23 (18,1%) casos de CDL e 10 (16,1%) casos de PICC. O exsudato purulento no CDL foi verificado em 9 (7,0%) casos, enquanto que no PICC esteve presente em apenas 1 (1,6%) dispositivo. A exteriorização esteve presente apenas nos CDL, ocorrendo em 9 (7%) casos. A suspeita de trombose foi verificada em 3 (4,8%) casos de PICC, sendo confirmada em apenas 1 (1,6%) deles, assim como a ruptura, presente em apenas 1 (1,6%) PICC. O tempo de permanência do CDL foi de 8,8 (±6,8) dias em média (mediana de 8) com variação de 1 a 38 dias. No caso do PICC, teve média de 19,4 (±21) dias (mediana de 14) e variação de 1 a 141 dias. A suspeita de infecção foi maioria, sendo que no CDL esteve presente em 30 (23,6%) casos e no PICC em 9 (14,5%). Apenas em 1 (2,6%) CDL foi confirmada infecção de corrente sanguínea associada ao cateter, com ponta de cateter e hemocultura positivas para Chryseobacterium Indologenes. Conclusão: A suspeita de infecção foi a complicação com maior incidência, porém confirmada em apenas um caso. Não houve diferença estatística significava entre as densidades de incidência de complicação do CDL e do PICC.Os resultados encontrados indicam a necessidade de acompanhamento de maior número de dispositivos por mais tempo e que as principais estratégias para prevenção de complicações nesta população continua sendo o cuidado diário na manutenção dos mesmos. / Introduction: Central venous catheterization is characterized by positioning a vascular device whose end reaches the final third of the superior vena cava, regardless of the insertion site. Most patients with cardiopulmonary diseases are elective for its implementation, for presenting a fragile peripheral venous network and need for prolonged infusion solutions. However, this procedure presents invasive character associated with complications. Aim: Analyze the complications related to the use of non-tunneled semi-implantable central venous catheter. Methods: A prospective cohort study (6 months) conducted in intensive care units and medical-surgical clinics from the Heart Institute of the Medicine Course in University of São Paulo (USP), in adult patients with cardiopulmonary diseases in using peripherally inserted central catheter (PICC) or double lumen catheter (CDL), the daily observation of the catheter until its withdrawal or hospital discharge, associated with access to medical records for information on the patient and the catheter conditions. Study variables related to morbidity and demographics data, catheter insertion, use and maintenance, complications related to the use of catheter, catheter removal. Anlysis: Measures of central tendency and variability, chi-square test or Mann-Whitney test for qualitative data, students t-test and ANOVA or Kruskal-Wallis test to compare means. Results: There was a predominance of CDL, used in 127 (67.2%) cases, and the PICC in 62 (32.8%). As of the catheters, 55 (43.3%) CDL and 21 (37.0%) PICC had some type of complication. There was a statistical difference (p = 0.017) among the complications according to the types of PICC, being it higher in the open ended ones. There were differences between the complications according to the insertion sites, however, with no statistical difference (p = 0.479). Obstruction occurred in only 3.9% (5) of the CDL, while in PICCs it was present in 11.3% (7) of the cases. The phlebitis grade 1 was present in 23 (18.1%) cases of CDL and 10 (16.1%) cases of PICC. The purulent exudate in the CDL was observed in 9 (7.0%) cases while in PICC was present in only 1 (1.6%) device. The manifestation was present only in the CDL, occurring in 9 (7%) cases. The suspicion of thrombosis was seen in 3 (4.8%) PICC being confirmed in only 1 (1.6%) of them, as well as the rupture present in only 1 (1.6%) PICC. The CDL length of stay was 8.8 (± 6.8) days on average (median 8) ranging from 1 to 38 days. In the case of PICC, it averaged 19.4 (± 21) days (median 14) and ranged 1-141 days. The suspected infection was the majority, being present in CDL in 30 (23.6%) cases and in PICC in 9 (14.5%). In only 1 (2.6%) CDL a bloodstream infection associated with the catheter was confirmed, with tipped catheter and positive blood culture for Chryseobacterium indologenes. Conclusion: The suspected infection was the complication with highest incidence, but confirmed in only one of the cases. There was no statistical difference between the densities of incidence of complication of CDL and PICC. The results indicate the need for monitoring in longer and greater number of devices, and that the main strategies to prevent complications in this population remains the daily care in their maintenance