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"Fibrinogênio como marcador de trombose" / Fibrinogen in the prediction of thrombosisAlmeida, Maria Antônia Campos 25 May 2006 (has links)
INTRODUÇÃO: Um grande número de estudos epidemiológicos têm demonstrado que o fibrinogênio é fator de risco consistente e independente para doença cardiovascular. O fibrinogênio, além de ser um determinante de trombose arterial foi considerado fator de risco de trombose venosa. Foram avaliados os níveis plasmáticos do fibrinogênio em indivíduos que apresentaram algum tipo de trombose não influenciada por reação de fase aguda ou resposta inflamatória. MÉTODOS: Neste estudo de caso-controle realizado entre julho de 2003 a abril de 2005 foram incluídos 39 pacientes, entre 25 e 65 anos, com diagnóstico objetivamente confirmado de trombose, sem antecedentes de neoplasia e colagenose. O tempo mínimo entre a evento e a coleta da amostra de sangue foi de 6 meses. O grupo controle foi constituído de doadores e funcionários voluntários do Hemocentro Regional de Juiz de Fora. A concentração plasmática de fibrinogênio e a medida da Proteína C Reativa foram realizados nos dois grupos. RESULTADOS:Os níveis médios de fibrinogênio foram significativamente maiores nos pacientes ( 316)que no grupo controle (259), p=0,0002. a média de idade foi 48,3 para os pacientes e 45,5 para o controle. A aplicação do teste qui quadrado demonstrou que não houve diferenças significativas nos grupos de pacientes e controles (30,8% e 27%, respectivamente) em relação ao tabagismo(pvalor = 0,72). A frequência de hipertensão foi significativamente maior no grupo de pacientes (28,2%) que no controle (5,4%) (p-valor=0,008). O teste t para a diferença dos níveis médios de fibrinogênio entre os grupos de trombose venosa e arterial não apresentou resultado estatisticamente significante (p-valor = 0,69). CONCLUSÃO: Com base nos dados deste estudo, os níveis de fibrinogênio estão relacionados com trombose, independente se arterial ou venosa. / INTRODUCTION: A great number of prospective epidemiologic studies have reported that fibrinogen is consistently and independently risk factor for the cardiovascular disease. The fibrinogen, a determinant of arterial thrombosis, was also considered a risk factor for the venous thrombosis. It was valued the fibrinogen plasmatic level in patients that had showed some kind of thrombosis event without influence by acute phase reactions or ongoing inflamatory responses. METHODS: In this cases-control study, fulfilled between july 2003 and april 2005, was included 39 patients, among 25 e 65 ears, with confirmed diagnosis of thrombosis and none neoplasis and collagenosis antecedent. Six months was the minimum time between event and blood sample collect. The control group was composed by blood donor and voluntary employee of the Hemocentro Regional de Juiz de Fora. The fibrinogen plasmatic concentration and the C-reactive proteins measure was made in both groups. RESULTS: The medium levels of fibrinogen were significantly higher in patients (316) than the control group (259), p=0,0002. The age average was 48,3 for the patients and 45,5 for the control. The qui-quadrado" test application proved there wasnt any significatives differences in both groups, patients (30,8%) and control (27%), in the relation with smoking (p-value = 0,72). The frequency of arterial hypertension was significantly higher in patient group (28,2%) than the control group (5,4%) (p-value = 0,008). The t-test for the differences of the fibrinogen average levels between venous and arterial thrombosis didnt present any significant statistic result. CONCLUSION: Established in this research, the higher levels of fibrinogen are associated with thrombosis, independently if arterial or venous.
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Modelo matemático para o estudo da propagação de informações por campanhas educativas e rumores / Mathematical Model to study the spread of information from educative campaigns and rumorsPachi, Clarice Gameiro da Fonseca 08 February 2007 (has links)
Formulamos um modelo matemático determinístico baseado no princípio de ação de massas, em analogia aos trabalhos que estudam a dinâmica de doenças infecciosas em Epidemiologia. Analisamos a dinâmica do espalhamento de rumores levando em conta a simetria no número de contatos diretos entre suscetíveis e infectados pelo rumor e estudamos as implicações de uma campanha publicitária educativa na dinâmica do modelo. Posteriormente, propomos uma simplificação do modelo e desconsideramos o contato entre os indivíduos suscetíveis e infectados supostamente mais resistentes às novidades. Discutimos suas implicações no espalhamento do rumor e a conexão com os parâmetros que descrevem o comportamento social. / We have developed a deterministic mathematical model based on the mass-action principle, in analogy to the works that study the dynamics of infectious diseases in Epidemiology. We analyzed the dynamic of rumors spreading, taking into account the symmetry of contacts among susceptible and infectious individuals and studied the implications of an educative broadcasting advertising in the model. Afterwards, we proposed a simplification ot the model excluding the contact among susceptible and infected individuals supposedly more resistant to novelities. Their implications to the spread of rumor and its connection with parameters describing social behavior are discussed.
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Mortalidade relacionada à tuberculose no município de São Paulo - 2002 a 2004 / Mortality related to tuberculosis in the city of São Paulo - from 2002 to 2004.Pereira, Edméa Costa 28 June 2007 (has links)
Introdução A partir de 1999, os coeficientes anuais de mortalidade por tuberculose no Estado de São Paulo apresentam declínio, segundo dados do Centro de Vigilância Epidemiológica da Secretaria Estadual de Saúde (CVE). Para caracterizar os óbitos e entender a tendência, explora-se o fato de o óbito por tuberculose possuir características que possibilitam estudos com enfoque em causas múltiplas, podendo a doença ser causa básica ou causa associada da morte. Objetivo Traçar o perfil da mortalidade relacionada à tuberculose no Município de São Paulo, segundo causas múltiplas de morte e suas inter-relações com outras causas básicas e verificar se os casos de tuberculose estão notificados ao banco de dados do CVE. Metodologia Estudo descritivo utilizando dados secundários. Foram estudados todos os óbitos de pessoas residentes no Município de São Paulo, ocorridos entre 2002 e 2004, que tiveram, na declaração de óbito, tuberculose como causa básica ou causa associada, ou seqüela de tuberculose como causa básica (N=2.325). Causa básica e causas associadas de morte foram caracterizadas segundo as disposições da Organização Mundial de Saúde. Pesquisaram-se os registros do CVE para verificar se os casos de tuberculose estavam notificados. As fontes de dados foram o Programa de Aprimoramento das Informações de Mortalidade no Município de São Paulo (PRO-AIM) e o banco de dados do CVE. Os dados de população provieram da Fundação SEADE. Resultados A utilização de causas múltiplas de morte aumentou o número de óbitos em 82,6%. A tuberculose foi selecionada como causa básica de morte em 1.212 óbitos (54,8%), tendo sido mencionada como causa associada em 1.001 óbitos (45,2%). Destes, 676 (30,5%) foram devidos à aids e 325 (14,7%), a outras causas. A seqüela de tuberculose foi causa básica de morte em 112 óbitos. As formas clínicas mais freqüentes, quando a tuberculose foi causa básica, foram a pulmonar e a miliar. O sexo masculino foi o mais atingido (1.690 óbitos, ou 72,7%). Em 46,3% dos óbitos que tinham tuberculose como causa básica, a declaração de óbito foi fornecida pelo Serviço de Verificação de Óbitos ou pelo Instituto Médico Legal, indicando dificuldades para fazer o diagnóstico ou falha na assistência aos casos. Os óbitos não encontrados no banco de dados do CVE, portanto desconhecidos pelo Sistema de Vigilância, foram 1.200 (51,6%). Conclusões A análise segundo causas múltiplas de morte revelou óbitos em que a tuberculose estava presente mas não aparecia nas estatísticas de mortalidade por causa única. As notificações de casos de tuberculose ao CVE não foram satisfatórias, necessitando ter seus fluxos e procedimentos reavaliados. / Background According to data from CVE Centro de Vigilância Epidemiológica da Secretaria de Saúde do Estado de São Paulo (Epidemic Control Center / State Dept), yearly death rates caused by tuberculosis have declined in the state of São Paulo. In order to characterize deaths and understand the mentioned decrease, the issue death related to tuberculosis will be investigated whilst presenting certain characteristics that might enable studies to be taken over, by focusing on multiple causes. Moreover, the tuberculosis might be regarded as an underlying cause of death or as death-associated cause. Objective The outlining of tuberculosis mortality, as a result from multiple causes and its relations with other underlying causes, and to verify if patients were underreported to CVE. Methodology Secondary data descriptive study. Deaths occurring between 2002 and 2004 were considered for this study, from people living in São Paulo. The people died, as stated by their death certificate, from tuberculosis as an underlying or associated cause, or tuberculosis sequel as an underlying cause (N=2.325). Both underlying and associated causes of death were characterized according to the World Health Organization guidelines. The study searched tuberculosis cases on CVEs database. Data were supplied by Programa de Aprimoramento das Informações de Mortalidade no Município de São Paulo (PRO-AIM) and CVEs database. Results Studies focusing on multiple causes increase deaths (82,6%). Tuberculosis was selected as an underlying cause of death in 1.212 deaths (54,8%). In 1.001 deaths (45,2%) it was regarded as associated cause: in these deaths, the underlying cause was AIDS (676 deaths 30,5%) or other causes (325 deaths 14,7%). Tuberculosis sequel was underlying cause in 112 deaths. The most frequent clinical forms observed, having tuberculosis as an underlying cause, were the pulmonary and the miliary types. Male sex was inflicted the most (1.690 deaths 72,7%). Either Serviço de Verificação de Óbitos or Forensics issued death certificates where tuberculosis was selected as underlying cause of death in 46,3% of total deaths, denoting deficient diagnosis and poor assistance to cases. Death records 1.200 (51,6%) are not to be found in CVEs database, so tuberculosis cases are underreported. Conclusion Analyses that use multiple-cause data brings to view other deaths where tuberculosis was present, in spite of not being observed in statistics of mortality resulting from underlying causes. The flow of information to CVE must be inspected.
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Questionário de frequência alimentar quantitativo em pacientes com diabetes melito tipo 2 : desenvolvimento e validação de instrumentoSarmento, Roberta Aguiar January 2012 (has links)
Objective: To elaborate a quantitative food frequency questionnaire (FFQ) for patients with type 2 diabetes. Design: Dietary data using 3-day weighed diet records (WDR) from 188 outpatients with type 2 diabetes were used to construct the list of usually consumed foods. Foods were initially clustered into eight groups: “cereals, tubers, roots, and derivatives”; “vegetables”; “fruits”; “beans”; “meat and eggs”; “milk and dairy products”; “oils and fats”, and “sugars and sweets”. The frequency of food intake and the relative contribution of each food item to the total energy and nutrient intakes were calculated. A food was included if it contributed at least 80% to total energy or nutrient content in its respective food group. Portion sizes were determined according to the 25th, 50th, 75th, and 95th percentiles of intake for each food item. Setting: GNE - Group of Nutrition in Endocrinology - cohort - Southern Brazil. Subjects: Outpatients with type 2 diabetes. Results: A total of 62 food items were selected based on the 3-day WDR and another 27 foods or their preparation options and nine beverages were included after the expert examination, and accounted for 95% of total energy and nutrient intakes. Also, a portfolio with food photos of each included food item and its portion sizes was created to support the patients in identifying the consumed portion. Conclusions: We developed a practical quantitative FFQ and portfolio with photos of 98 food items covering the past 12 months of the most commonly consumed food items. This dietary method will be valuable to assess the usual diet pattern of patients with type 2 diabetes in Southern Brazil.
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Epidemiologia e controle da raiva bovina nos municípios da região de Rondonópolis - Estado de Mato Grosso, Centro-Oeste do Brasil / Epidemiology and control of bovine rabies in the region of Rondonópolis - state of Mato Grosso, Central-Western BrazilLopes, Isabela Ferreira 05 October 2009 (has links)
Realizou-se um estudo sobre a ocorrência da raiva bovina em 17 municípios que fazem parte da Unidade Regional de Supervisão de Rondonópolis do Instituto de Defesa Agropecuária do Estado de Mato Grosso - INDEA/MT. O objetivo do trabalho foi analisar a situação epidemiológica da doença com a finalidade de repensar as ações de atenção e vigilância epidemiológica. Foram analisados 70 Formulários de Investigação de Doenças (Inicial) (Form-in) da Coordenadoria de Controle das Doenças dos Animais do INDEA/MT, período correspondente de janeiro de 2003 a dezembro de 2007. Informações complementares foram obtidas junto ao Conselho Regional de Medicina Veterinária do Estado de Mato Grosso e banco de dados do IBGE. Verificou-se que a doença apresentou de forma endêmica entre os municípios, com pequena variação anual no número de casos. O maior porcentual dos casos ocorreu no mês de janeiro e julho, em animais com idade entre quatro a 12 meses e em propriedades com efetivo bovino superior a 500 cabeças no rebanho. Além disso, não existiu correlação entre densidade de bovinos com casos de raiva. A partir dos resultados, conclui-se a importância da manutenção das atividades de educação sanitária, o credenciamento ou incremento do diagnóstico laboratorial de raiva no estado, melhora das atividades de cadastramento e monitoramento dos abrigos e refúgios de morcegos hematófagos e o combate aos morcegos hematófagos, além da vacinação do gado bovino nas regiões endêmicas da raiva. / Study on the occurrence of bovine rabies was carried out in seventeen municipalities that are part of the Unidade Regional de Supervisão (Regional Unit of Supervision) of the Rondonópolis belonging to the Instituto de Defesa Agropecuária of the state of Mato Grosso. The objective of the study was to assess the epidemiological situation of the disease in order to rethink the actions of care and epidemiological surveillance. Seventy forms named as Formulários de Investigação de Doenças (Inicial) (Form-in), pertaining to the Coordenadoria de Controle das Doenças dos Animais of the INDEA/MT were analyzed, corresponding to the period of January 2003 to December 2007. Additional information was obtained from the Conselho Regional de Medicina Veterinária of the state of Mato Grosso and database of the IBGE. It was found that the disease had been endemic among the municipalities, with small annual variation in the number of cases. The higher percentages of cases occurred in January and July, in four to twelve year-old animals, in properties with the number of cattle greater than five hundred animals in the herd. Furthemore, there was no correlation between the cattle density and the occurrence of rabies. From these results, we conclude that it is important to keep maintaining the activities of health education, the accreditation or incrementation of laboratorial diagnosis of rabies in the state, amelioration of the activities of registration, monitoring of shelters and refuges of the vampire bats and bats control, besides the cattle vaccination in rabies endemic regions.
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COLONIZAÇÃO BACTERIANA NASAL EM RECÉM-NASCIDOS PREMATUROS E SUAS MÃES EM DUAS UNIDADES DE TERAPIA INTENSIVA NEONATAL / NASAL BACTERIAL COLONIZATION IN PRETERM NEWBORN AND THEIR MOTHERS IN TWO NEONATAL INTENSIVE CARE UNITSFreitas, Isolina Januária Sousa 07 December 2009 (has links)
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Previous issue date: 2009-12-07 / The bacterial colonization occurs soon after birth, depending on the environment where the
newborn is and can occur with bacteria as the normal microbiota or by bacteria resistant to
antibiotics. Once colonized, at any time, depending on factors such as low immunity,
inadequate protection of the skin, exposure to invasive procedures, length of stay in Intensive
Care Units - the newborn may be infected with the bacterium that colonizes them. Aiming to
know the nasal microbiota of newborns admitted to Neonatal Intensive Care Unit (ICU) and
their mothers, it was drew up this present cross-sectional and analytical study where 69 pairs
of newborns and their mothers were studied. Nasal swabs were collected from all newborns
admitted to the ICU of Parenting Marly Sarney and the University Hospital Materno-Infantil
in the period of April to September 2008, weighing between 1200 and 1800g. Were excluded
from this study newborns carrying ostomies, catheters, infection of the skin, twins, syndrome,
and mothers that were not found to collect the swab. The nasal microbiota of mothers showed
up predominantly sensitive to oxacillin, as represented by 48% of Staphylococcus aureus
(MSSA) and 29% of coagulase negative Staphylococcus (CONS), while the newborns were
colonized by Staphylococcus resistant to oxacillin, thus distributed: 44% of MRSA and 22%
of CONS. So this study shows that newborns hospitalized in intensive care units surveyed the
early home of resistant MRSA and Scone, this does not occur with their mothers. Meanwhile
the mothers have a rate of 19% of MRSA (13%) and Scone resistant (6%), may represent a
form of colonization of the newborn. It was also found strong statistical association, with
relative risk of 1.65 between the use of antibiotics by the mother and the newborn
colonization by Staphylococcus multiresistant. We conclude that the knowledge of the
colonizing nasal maternal flora and of the newborn may guide the health professionals about
the specific measures of prevention and epidemic surveillance. Additional studies such as
genotyping of the Staphylococcus enable the knowledge of the magnitude of the impact of
colonization of the mother and its transmission to the newborn to guide preventive measures
such as nasal decolonization of the mother before delivery. / A colonização bacteriana ocorre logo após o nascimento e, dependendo do ambiente onde se
encontra o recém-nascido, poderá ocorrer com bactérias consideradas da microbiota normal
ou por bactérias resistentes aos antibióticos. Uma vez colonizado, a qualquer momento, a
depender de fatores como baixa imunidade, proteção de pele inadequada, exposição a
procedimentos invasivos, tempo de permanência em Unidades de Terapia Intensiva, o recémnascido
poderá ser infectado com a bactéria que o coloniza. Objetivando conhecer a
microbiota nasal de recém-nascidos internados em Unidade de Terapia Intensiva Neonatal
(UTIN) e de suas mães, desenhou-se o presente estudo, transversal, analítico onde se estudou
69 duplas de recém-nascidos e suas mães. Foram colhidos swab nasal de todos os recémnascidos
internados na UTIN da Maternidade Marly Sarney e do Hospital Universitário
Materno-Infantil, no período de abril a setembro de 2008, com peso entre 1200 e 1800g.
Foram excluídos do estudo os recém-nascidos com ostomias, cateteres, infecção de pele,
sindrômicos, gemelares, pós-operatório e com drenagens, assim como aqueles cujas mães
apresentavam lesão de pele ou não estivessem presentes no momento da coleta dos swabs. A
microbiota nasal das mães mostrou-se predominantemente sensível à oxacilina, sendo
representada por 48% de Staphilococcus aureus (MSSA) e 29% de Staphilococcus coagulase
negativo (SCoN), enquanto que os recém-nascidos estavam colonizados por Staphilococcus
resistentes à oxacilina, assim distribuídos: 44% de MRSA e 22% de SCoN. Portanto, o
presente estudo demonstra que os recém-nascidos internados nas unidades de terapia intensiva
pesquisadas, albergam precocemente o MRSA e SCoN resistente, o mesmo não ocorrendo
com suas mães. Entretanto as mães apresentam um percentual de 19% entre MRSA (13%) e
SCoN resistentes (6%), podendo representar uma forma de colonização dos seus recémnascidos.
Também foi verificada associação estatística, com risco relativo de 1,65 entre o uso
de antibiótico pela mãe e a colonização do recém-nascido por Staphilococcus multirresistente.
Concluiu-se que o conhecimento da flora colonizadora nasal materna e dos recém-nascidos
poderá orientar aos profissionais de saúde quanto às medidas específicas de prevenção e
vigilância epidemiológica. Estudos complementares como a genotipagem dos Staphilococcus
possibilitarão o conhecimento da magnitude da influência da colonização da mãe e de sua
transmissão para o recém-nascido, o que orientará ações preventivas como a descolonização
nasal da mãe antes do parto.
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PERFIL COGNITIVO EM IDOSAS DE DOIS SERVIÇOS PÚBLICOS DE REFERÊNCIA EM SÃO LUÍS-MA / COGNITIVE PROFILE OF OLD WOMEN IN TWO PUBLIC SERVICES REFERENCE IN SAN LUÍS-MACorreia, Marcius Vinicius Goncalves 06 May 2007 (has links)
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Previous issue date: 2007-05-06 / As the population grows old, there is a proportional increase of cognitive disturbances. Due to
the great relevance, this study aims to establish a descriptive study about the cognition level
and correlated socio-demographic variables, in women ranging from sixty to eighty years old,
in two public health services in the city of São Luís-MA. For a period of four months, a
closed questionnaire which contained the socio-demographic variables and the Mental
Condition Mini Examination (MEEM), was applied. A number of eighty voluntaries were
evaluated in the Neurology clinics of the University Hospital President Dutra and State
Hospital Carlos Macieira. The results were: 31,2% were classified by MEEM with cognitive
disturbances; 71,4% in the 81-85 age bracket. In the population distribution according to
schooling time, 54,9% of those having seven years of school were classified as having
cognitive disturbances. As for the referred ethnicity and cognition level, 44.8% of mullatos
presented cognitive disturbances. As for income and cognition level, it was observed that
30,4% of the volunteers who presented an income level lower than one to two minimum
wage, were classified with cognitive disturbances. From the thirty-three volunteers that had
direct care, 57,6% (19) presented cognitive disturbances. As for the referred morbidities, it
was observed that 58,75% were referred to as having Systemic Arterial Hypertension;
regarding life styles, 12,5% were referred to as smokers. The study becomes relevant because
it provides epidemiologic substract for more complex methodological studies in order to
promote improvement in the elderly mental public health in the area. / À medida que a população envelhece existe um aumento proporcional dos transtornos
cognitivos. Diante desta relevância, busca-se um estudo descritivo do nível de cognição e
variáveis sócio-demográficas associadas, no sexo feminino, da sexta à oitava década, em dois
serviços públicos, na cidade de São Luís-MA. Foi aplicado, por quatro meses, um
questionário fechado com as variáveis sócio-demográficas e o Mini Exame do Estado Mental.
Oitenta voluntárias foram avaliadas nos ambulatórios de Neurologia dos Hospitais
Universitário Presidente Dutra e Estadual Carlos Macieira. Foram obtidos os seguintes
resultados: 31,2% classificadas com transtorno cognitivo ao MEEM; 71,4% na faixa etária de
81-85 anos. Na distribuição da população segundo tempo de estudo, 59,4% com até sete anos
de estudo classificadas com transtorno cognitivo. Quanto à etnia referida e nível de cognição,
44,8% pardas com transtorno cognitivo. Nível de renda e cognição, 30,4% com nível de renda
menor que um a dois salários mínimos com transtorno cognitivo. Das trinta e três voluntárias
que tinham cuidador direto, 57,6% (19) com transtorno cognitivo. Em relação às morbidades
referidas foi observado que, 58,75% referiram ter Hipertensão Arterial Sistêmica; quanto ao
hábito de vida, 12,5% referiram tabagismo. O estudo torna-se de relevância, pois proporciona
substrato epidemiológico para estudos metodológicos mais complexos, visando promover
melhoria na saúde pública mental do idoso na região.
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The Association of Calcium Intake and Other Risk Factors with Cardiovascular Disease among Obese Adults in USAChen, Yang, Strasser, Sheryl, Callahan, Katie, Blackley, David, Cao, Yan, Wang, Liang, Zheng, Shimin 10 March 2014 (has links)
In this study, we used a cross-sectional study design to examine the relationship between the calcium intake and risk factors for CVD among obese adults by using continuous waves of National Health and Nutrition Examination Survey (NHANES) data 1999-2010. The association between calcium intake and risk factors of CVD (hypertension, total cholesterol, HDL, glycohemoglobin), CRP, albuminuria) is assessed among obese adults in USA. The incidence of Cardiovascular Disease (CVD) is high among obese people. The potential effects of inadequate calcium intake on CVD are receiving increased epidemiologic attention. Understanding the association between risk factors for CVD and calcium intake among obese adults is important for the advancement of CVD, nutrition and obesity research. Data collected from the National Health and Nutrition Examination Survey from 1999-2010 were examined, utilizing a subset of 14,856 obese subjects. Analysis of Variance statistical tests were conducted to determine associations between calcium intake and CVD risk. Simple and multiple linear and logistic regression analyses were conducted to determine the predicted value of calcium intake with CVD. After adjusting for energy intake and other potential risk factors, systolic blood pressure, diastolic blood pressure, C-reactive protein, glycosylated hemoglobin and albuminuria were negatively associated with calcium intake at &alpha = 0.05 level in both linear and logistic regression analyses. In a comparison of calcium intake by quartiles, results reveal that total cholesterol had a weak negative association with calcium intake at &alpha = 0.1 level. The implications of these study results are important as the importance of adequate calcium intake and its potential to decrease CVD among obese adults has incredible preventive value for populations. Additional research that focuses on dietary intake, calcium thresholds and impacts on total cholesterol levels in the body is warranted.
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Sensitivity and uncertainty analyses of contaminant fate and transport in a field-scale subsurface systemWang, Jinjun 31 March 2008 (has links)
Health scientists often rely on simulation models to reconstruct groundwater contaminant exposure data for retrospective epidemiologic studies. Due to the nature of historical reconstruction process, there are inevitably uncertainties associated with the input data and, therefore, with the final results of the simulation models, potentially adversely impacting related epidemiologic investigations. This study examines the uncertainties associated with the historically reconstructed contaminant fate and transport simulations for an epidemiologic study conducted at U.S. Marine Corps Base Camp Lejeune, North Carolina. To achieve an efficient uncertainty analysis, sensitivity analysis was first conducted to identify the critical uncertain variables, which were then adopted in the uncertainty analysis using an improved Monte Carlo simulation (MCS) method. Particularly, uncertainties associated with the historical contaminant arrival time were evaluated. To quantify the uncertainties in an efficient manner, a procedure identified as Pumping Schedule Optimization System (PSOpS) was developed to obtain the extreme (i.e., earliest and latest) contaminant arrival times caused by pumping schedule variations. Two improved nonlinear programming methods Rank-and-Assign (RAA) and Improved Gradient (IG) are used in PSOpS to provide computational efficiency. Furthermore, a quantitative procedure named Pareto Dominance based Critical Realization Identification (PDCRI) was developed to screen out critical realizations for contaminant transport in subsurface system, so that the extreme contaminant arrival times under multi-parameter uncertainties could be evaluated efficiently.
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Questionário de frequência alimentar quantitativo em pacientes com diabetes melito tipo 2 : desenvolvimento e validação de instrumentoSarmento, Roberta Aguiar January 2012 (has links)
Objective: To elaborate a quantitative food frequency questionnaire (FFQ) for patients with type 2 diabetes. Design: Dietary data using 3-day weighed diet records (WDR) from 188 outpatients with type 2 diabetes were used to construct the list of usually consumed foods. Foods were initially clustered into eight groups: “cereals, tubers, roots, and derivatives”; “vegetables”; “fruits”; “beans”; “meat and eggs”; “milk and dairy products”; “oils and fats”, and “sugars and sweets”. The frequency of food intake and the relative contribution of each food item to the total energy and nutrient intakes were calculated. A food was included if it contributed at least 80% to total energy or nutrient content in its respective food group. Portion sizes were determined according to the 25th, 50th, 75th, and 95th percentiles of intake for each food item. Setting: GNE - Group of Nutrition in Endocrinology - cohort - Southern Brazil. Subjects: Outpatients with type 2 diabetes. Results: A total of 62 food items were selected based on the 3-day WDR and another 27 foods or their preparation options and nine beverages were included after the expert examination, and accounted for 95% of total energy and nutrient intakes. Also, a portfolio with food photos of each included food item and its portion sizes was created to support the patients in identifying the consumed portion. Conclusions: We developed a practical quantitative FFQ and portfolio with photos of 98 food items covering the past 12 months of the most commonly consumed food items. This dietary method will be valuable to assess the usual diet pattern of patients with type 2 diabetes in Southern Brazil.
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