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This study aims to assess the non-additivity effects of gender, race, and schooling on ideal cardiovascular health among participants of the Brazilian Longitudinal Study of Adult Health - ELSA-Brasil. This is a cross-sectional study using data from the baseline of ELSA-Brasil, conducted from 2008 to 2010. The American Heart Association defined a score of ideal cardiovascular health (ICH) as the sum of indicators for the presence of seven favorable health factors and behaviors: non-smoking, ideal body mass index, physical activity and healthy diet, adequate levels of total cholesterol, normal blood pressure, and absence of diabetes mellitus. Multiplicative and additive interactions between gender, race, and schooling were assessed using the Poisson regression model to discuss intersectionality. The mean cardiovascular health score was 2.49 (SD = 1.31). This study showed a positive interaction between gender and schooling (women with high school and higher education) in both additive and multiplicative scales for the score of ideal cardiovascular health. We observed a trend towards higher mean values of cardiovascular health for increased schooling, with a marked difference among women. The lowest cardiovascular health scores observed reinforce the importance of understanding the psychosocial experiences that influence health attitudes, access to health care, and healthy lifestyle choices, which affect ICH, to reduce inequities in health and propose more adequate public policies that assist and prevent cardiovascular diseases.

Previous analyses of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) identified four main dietary patterns (DP). The aim of this study was to explore the association between the previously defined DP and renal function (RF). A crosssectional study using the ELSA-Brasil baseline data was carried out. DP (‘‘traditional’’, ‘‘fruits and vegetables’’, ‘‘bakery’’, and ‘‘low sugar/low fat), metabolic syndrome (MS) using the Joint Interim Statement criteria, microalbuminuria (MA), and glomerular filtration rate (eGFR) through the CKD-EPI equation were evaluated. Abnormal RF was defined as eGFRo60 mL min–1 (1.73 m2 ) –1 and MAX3.0 mg/dL. Factors associated with RF were determined and mediation analysis was performed to investigate the association between DP, MS, and RF. A total of 15,105 participants were recruited, with a mean age of 52±9 years; 8,134 participants (54%) were females. The mediation analysis identified indirect associations between ‘‘bakery’’ and ‘‘fruits and vegetables’’, and both were associated with decreased eGFR and albuminuria in both genders, compared with ‘‘traditional’’ and ‘‘low sugar/low fat’’ patterns in the general population. There was a direct association of the ‘‘bakery’’ pattern with MA in men (OR: 1.17, 95%CI: 1.92–1.48). The ‘‘fruits and vegetables’’ pattern also showed a direct association with reduced eGFR in women (OR: 1.65, 95%CI: 1.28–2.12), although there was no significance after adjustment. The ‘‘fruits and vegetables’’ and ‘‘bakery’’ DPs were associated with renal dysfunction. The only independent, direct association was between ‘‘bakery’’ DP and MA in men, raising concerns about DP and renal damage in men.

Objective To evaluate the association between food consumption patterns and obesity in preschool children in Feira de Santana, Bahia, Brazil. Methods Cross-sectional, population-based nested within a live-birth cohort study of 813 children, which has started in 2004 in Feira de Santana, Bahia. The anthropometric status among children under four years of age was evaluated based on their body mass index; obesity/severe obesity was defined as a Z-score >+2. The Food Frequency Questionnaire was used to identify dietary patterns using principal components analysis. The association between obesity and food consumption patterns was assessed using Pearson’s Chi-squared test and logistic regression, adopting p+2). O Questionário de Frequência Alimentar foi o instrumento utilizado para identificar os padrões alimentares por meio da análise fatorial de componentes principais. A associação entre a obesidade e os padrões de consumo alimentar foi avaliada mediante teste Qui-quadrado de Pearson e da regressão logística, tomando-se como critério de associação, valor de p

Submitted by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2017-06-05T14:01:11Z No. of bitstreams: 1 Sheila Alvim. Eating patterns...2016.pdf: 269861 bytes, checksum: a7c8c4c0d22f5fca5615063d140ca7d6 (MD5) Made available in DSpace on 2017-06-05T14:01:11Z (GMT). No. of bitstreams: 1 Sheila Alvim. Eating patterns...2016.pdf: 269861 bytes, checksum: a7c8c4c0d22f5fca5615063d140ca7d6 (MD5) The food consumption of 15,071 public employees was analyzed in six Brazilian cities participating in the baseline for Brazilian Longitudinal Study of Adult Health (ELSA-Brasil, 2008-2010) with the aim of identifying eating patterns and their relationship to socio-demographic variables. Multiple correspondence and cluster analysis were applied. Four patterns were identified, with their respective frequencies: “traditional” (48%); “fruits and vegetables” (25%); “pastry shop” (24%); and “diet/light” (5%) The “traditional” and “pastry shop” patterns were more frequent among men, younger individuals, and those with less schooling. “Fruits and vegetables” and “diet/light” were more frequent in women, older individuals, and those with more schooling. Our findings show the inclusion of new items in the “traditional” pattern and the appearance of the “low sugar/low fat” pattern among the eating habits of Brazilian workers, and signal socio-demographic and regional differences. Rio de Janeiro

BACKGROUND AND OBJECTIVES: Dyslipidemia is a pivotal risk factor for coronary heart disease (CHD). The purpose of this study was to identify the profile of dyslipidemia in a Brazilian population, according to high low-density lipoprotein (LDL-C) levels. We used the classification of the 2004 update of National Cholesterol Education Program Adult Treatment Panel III (ATP-III). METHODS: Of the 15,105 men and women aged 35 to 74 years enrolled in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), we included 14,648 subjects (97%). They had data to categorize them according to the NCEP-ATP-III criteria. We compared 4 categories: ‘‘0–1’’ risk factors, ‘‘2 or more risk factors’’, ‘‘CHD or CHD risk equivalent’’, and ‘‘CHD at very high risk’’. The sociodemographic determinants used were sex, age, ethnicity, income, education, and health insurance. Poisson regression was used to estimate the prevalence ratios for cholesterol (LDL-C), frequency, awareness, treatment, and control of high LDL-C.

Background-—Although increasing effort has been devoted to the promotion of a healthy lifestyle such as leisure time physical activity for cardio-metabolic health, specific evidence supporting health policy remains sparse, particularly in those ethnically diverse populations where cardio-metabolic diseases are reaching epidemic proportion and yet are grossly understudied. Methods and Results-—We conducted a cross-sectional analysis of the baseline data from 10 585 participants aged 35 to 74 free of cardiovascular diseases in the Brazilian Longitudinal Study of Adult Health. Leisure time physical activity status was defined by the American Heart Association and the World Health Organization recommendations (≥150 min/week moderate activities or 75 min/week vigorous activities). In total, 1183 (21%) women and 1387 (29%) men were active. After accounting for covariates, the favorable effects of leisure time physical activity on cardio-metabolic parameters were evident. Specifically, the average blood pressure, heart rate, and Framingham Risk Score for cardiovascular diseases of the active were significantly lower within each sex. The ORs comparing the active versus the inactive women were 0.78 (95% CI: 0.66–0.92) for hypertension and 0.78 (95% CI: 0.65– 0.93) for cardiovascular diseases in 10 years. Among men, the ORs were 0.75 (95% CI: 0.65–0.87) for hypertension and 0.73 (95% CI: 0.61–0.87) for diabetes. The 10-year risk of cardiovascular diseases was significantly lower among the active men with a 33% reduction (OR=0.67, 95% CI: 0.57–0.78). Conclusions-—We observed beneficial effects of leisure time physical activity on cardio-metabolic health in this large Brazilian population that are consistent with studies in North America and Europe.

Submitted by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2016-05-18T17:35:17Z No. of bitstreams: 1 Art Per Estrang Sheila Alvim2. 2015.pdf: 374208 bytes, checksum: f7a98424ddaceb28836d67e2751926df (MD5) Made available in DSpace on 2016-05-18T17:35:18Z (GMT). No. of bitstreams: 1 Art Per Estrang Sheila Alvim2. 2015.pdf: 374208 bytes, checksum: f7a98424ddaceb28836d67e2751926df (MD5) Previous issue date: 2015-02 Background: Overweight and obesity are a public health problem with a multifactorial aetiology. The objective of this study was to evaluate risk factors for overweight and obesity in children at 6 years of age, including type of delivery and breastfeeding. Methods: This study relates to a cohort of 672 mother-baby pairs who have been followed from birth up to 6 years of age. The sample included mothers and infants seen at all ten maternity units in a large Brazilian city. Genetic, socioeconomic, demographic variables and postnatal characteristics were analyzed. The outcome analyzed was overweight and/or obesity defined as a body mass index greater than or equal to +1 z-score. The sample was stratified by breastfeeding duration, and a descriptive analysis was performed using a hierarchical logistic regression. P-values of

Objective: To assess glucose and triglyceride excursions 2 hours after the ingestion of a standardized meal and their associations with clinical characteristics and cardiovascular complications in individuals with diabetes. Research design and methods: Blood samples of 898 subjects with diabetes were collected at fasting and 2 hours after a meal containing 455 kcal, 14 g of saturated fat and 47 g of carbohydrates. Self-reported morbidity, socio-demographic characteristics and clinical measures were obtained by interview and exams performed at the baseline visit of the ELSA-Brasil cohort study. Results: Median (interquartile range, IQR) for fasting glucose was 150.5 (123–198) mg/dL and for fasting triglycerides 140 (103–199) mg/dL. The median excursion for glucose was 45 (15–76) mg/dL and for triglycerides 26 (11–45) mg/dL. In multiple linear regression, a greater glucose excursion was associated with higher glycated hemoglobin (10.7, 95% CI 9.1–12.3 mg/dL), duration of diabetes (4.5; 2.6–6.4 mg/dL, per 5 year increase), insulin use (44.4; 31.7–57.1 mg/dL), and age (6.1; 2.5–9.6 mg/dL, per 10 year increase); and with lower body mass index (−5.6; −8.4– -2.8 mg/dL, per 5 kg/m2 increase). In adjusted logistic regression models, a greater glucose excursion was marginally associated with the presence of cardiovascular comorbidities (coronary heart disease, myocardial infarction and angina) in those with obesity. Conclusions: A greater postprandial glycemic response to a small meal was positively associated with indicators of a decreased capacity for insulin secretion and negatively associated with obesity. No pattern of response was observed with a greater postprandial triglyceride excursion.

Submitted by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2016-05-16T20:19:14Z No. of bitstreams: 1 Art Per Estrang Sheila Alvim. 2015.pdf: 428309 bytes, checksum: a03823bade7ccce701647811ee84992a (MD5) Made available in DSpace on 2016-05-16T20:19:14Z (GMT). No. of bitstreams: 1 Art Per Estrang Sheila Alvim. 2015.pdf: 428309 bytes, checksum: a03823bade7ccce701647811ee84992a (MD5) Previous issue date: 2015 Background:Overweight and obesity are a public health problem with a multifactorial aetiology. The objective of this study was to evaluate risk factors for overweight and obesity in children at 6 years of age, including type of delivery and breastfeeding. Methods: This study relates to a cohort of 672 mother-baby pairs who have been followed from birth up to 6 years of age. The sample included mothers and infants seen at all ten maternity units in a large Brazilian city. Genetic,socioeconomic, demographic variables and postnatal characteristics were analyzed. The outcome analyzed was overweight and/or obesity defined as a body mass index greater than or equal to +1 z-score. The sample was stratified by breastfeeding duration, and a descriptive analysis was performed using a hierarchical logistic regression. P-values of

Submitted by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2015-06-15T14:49:15Z No. of bitstreams: 1 Sheila Alvim et al. 2014.pdf: 173410 bytes, checksum: 8201824424f077c2ed3e9629c200e743 (MD5) Made available in DSpace on 2015-06-15T14:49:15Z (GMT). No. of bitstreams: 1 Sheila Alvim et al. 2014.pdf: 173410 bytes, checksum: 8201824424f077c2ed3e9629c200e743 (MD5) Previous issue date: 2014-11 OBJECTIVE: To evaluate the association between weight gain in the first two years of life and the occurrence of wheezing, asthma, serum IgE, skin reactivity and pulmonary function. DESIGN: Cohort study. SETTING: The metropolitan region of Salvador, Bahia, Brazil. SUBJECTS: The association was studied between 1997 and 2005 in 669 children up to 11 years of age. Data were collected on asthma and risk factors, both current factors and those present in the first years of life. Weight gain was considered fast when the Z-score was >0·67. Poisson regression was used in the multivariate statistical analysis. RESULTS: Wheezing was reported in 25·6 % of the children. Weight gain was considered fast (Z-score >0·67) in 29·6 % of the children and slow (Z-score

Submitted by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2015-06-10T12:27:03Z No. of bitstreams: 1 Ichihara Maria. 2014.pdf: 943593 bytes, checksum: 50722386eaef7a002039efa2fa575c8f (MD5) Made available in DSpace on 2015-06-10T12:27:03Z (GMT). No. of bitstreams: 1 Ichihara Maria. 2014.pdf: 943593 bytes, checksum: 50722386eaef7a002039efa2fa575c8f (MD5) Previous issue date: 2014-05 Rotavirus is one of the leading cause of hospitalization and outpatients visits among children under five years. This study evaluated overall and genotype-specific vaccine effectiveness of oral monovalent rotavirus vaccine (G1P[8] strain) in preventing hospital admission of Brazilian children with rotavirus acute diarrhea. A hospital based case–control study was conducted in five Regions of Brazil using the National Rotavirus Acute Diarrhea Surveillance System from July 2008 to August 2011. A total of 215 cases (aged 4–24 months) admitted with confirmed rotavirus diarrhea were recruited and 1961 controls hospitalized without diarrhea were frequency matched by sex and age group to cases. Two-dose adjusted vaccine effectiveness (adjusted by year of birth and the frequency matching variables)was 76% (95%CI: 58–86) lasting for two years. Effectiveness controlled by the available potential confounders was 72% (95%CI: 44–85), suggesting no appreciable confounding by those factors for which adjustment was made. In a half of the cases the rotavirus genotype was G2P[4] and in 15% G1P[8]. Genotype-specific VE (two doses) was 89% (95%CI: 78–95), for G1P[8] and 76% (95%CI: 64–84) for G2P[4]. For all G1, it was 74% (95%CI: 35–90), for all G2, 76% (95%CI: 63–84), and for all non G1/G2 genotypes, 63% (95%CI:−27–99). Effectiveness for one dose was 62% (95%CI: 39–97). Effectiveness of two-dose monovalent rotavirus vaccine in preventing hospital admission with rotavirus diarrhea was high, lasted for two years and it was similar against both G1P[8] and G2P[4]. Based on the findings of the study we recommend the continued use of rotavirus in the Brazilian National Immunization Program and the monitoring of the early emergence of unusual and novel rotavirus genotypes. Kidlington

Submitted by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2014-01-14T18:05:33Z No. of bitstreams: 1 Sheila Matos. 2013.pdf: 577549 bytes, checksum: ae2b2f7952c9426b68ec0d100e815e33 (MD5) Made available in DSpace on 2014-01-14T18:05:33Z (GMT). No. of bitstreams: 1 Sheila Matos. 2013.pdf: 577549 bytes, checksum: ae2b2f7952c9426b68ec0d100e815e33 (MD5) Previous issue date: 2013-10 Objective: To evaluate the association between weight gain in the first two years of life and the occurrence of wheezing, asthma, serum IgE, skin reactivity and pulmonary function. Design: Cohort study. Setting: The metropolitan region of Salvador, Bahia, Brazil. Subjects: The association was studied between 1997 and 2005 in 669 children up to 11 years of age. Data were collected on asthma and risk factors, both current factors and those present in the first years of life. Weight gain was considered fast when the Z-score was .0?67. Poisson regression was used in the multivariate statistical analysis. Results: Wheezing was reported in 25?6% of the children. Weight gain was considered fast (Z-score .0?67) in 29?6% of the children and slow (Z-score,20?67) in 13?9%. Children in the slow weight gain group had 36% fewer symptoms of asthma (prevalence ratio50?65; 95% CI 0?42, 0?99). Conclusions: Slower weight gain in the early years of life may constitute a protective factor against symptoms of asthma. The relevance of this finding for public health is not yet certain, since it is known that children with slow and fast weight gain may be more likely to develop adverse health consequences related to both these situations. Wallingford

Submitted by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2015-05-12T20:43:09Z No. of bitstreams: 1 J Asthma 2013.docx: 14615 bytes, checksum: 7e5c43c7c5aa2edcf3b446ef903e1a82 (MD5) Made available in DSpace on 2015-05-12T20:43:09Z (GMT). No. of bitstreams: 1 J Asthma 2013.docx: 14615 bytes, checksum: 7e5c43c7c5aa2edcf3b446ef903e1a82 (MD5) Previous issue date: 2013-04 OBJECTIVE: To evaluate the relative importance of body mass index (BMI) and abdominal obesity in the prevalence of wheezing in Brazilian children. MATERIALS AND METHODS: This is a cross-sectional study of male and female students, 6-12 years old, from the public elementary schools of São Francisco do Conde, Bahia, Northeast Brazil. Reports of wheezing in the past 12 months were collected using a questionnaire from the International Study of Asthma and Allergies in Childhood Program (ISAAC) phase III, adapted to Portuguese. Anthropometric, demographic, and socioeconomic information was collected. Multivariate logistic regression analyses were used to assess the associations of interest. RESULTS: Of the children surveyed, 10.6% reported wheezing. Excess weight was observed in 16.2%, 10.5%, and 7.9% of the sample, measured by BMI, waist circumference (WC), and the waist-to-height ratio (WHtR), respectively. The percentage of patients with wheezing attributable to BMI ≥ 85th percentile (8.2%) slightly exceeded those identified with abdominal obesity, WC ≥ 80th percentile (7.3%) and WHtR > 0.5 (7.1%). CONCLUSION: The results suggest that an excess of fat deposits, either in the abdominal region or elsewhere in the body, increased the risk of wheezing. Since obesity is an important public health problem worldwide, control of this problem may partially reduce the occurrence of wheezing in youth. New York

Texto completo. Acesso restrito. p. 1064-1068 Submitted by Santiago Fabio (fabio.ssantiago@hotmail.com) on 2013-06-17T13:32:37Z No. of bitstreams: 1 22222222222.pdf: 154786 bytes, checksum: 0e61d96490c243a4bed35abd60aa18ea (MD5) Made available in DSpace on 2013-06-17T13:32:37Z (GMT). No. of bitstreams: 1 22222222222.pdf: 154786 bytes, checksum: 0e61d96490c243a4bed35abd60aa18ea (MD5) Previous issue date: 2013 Background It has been proposed that improved hygiene and reduced experience of infections in childhood influences the development of allergic diseases. The mechanisms by which the hygiene operates are not well established but are underpinned by two apparently incompatible immunologic paradigms, the balance of TH1 versus TH2 cytokines and IL-10–mediated regulation of TH2 cytokines. Objective This study defined immunologic phenotypes with the use of latent class analysis and investigated their associations with environmental factors, markers of allergy and asthma, in a Latin American population. Methods We studied 1127 children living in urban Brazil. Data on wheeze and environmental exposures were collected with standardized questionnaires. Atopy was measured by specific IgE in serum and skin prick test reactivity to aeroallergens. Cytokines were measured in culture after the stimulation of peripheral blood leukocytes with mitogen. Infections with pathogens were assessed by serology and stool examinations. Children were classified as having high or low burden of infection. Latent class analysis was used to identify immune phenotypes on the basis of cytokine production. Logistic regression was used to evaluate the adjusted effects of environment and burden of infection on the immunologic phenotypes and the effect of the phenotypes on atopy and asthma. Results Three phenotypes were identified, labeled underresponsive, intermediate, and responsive. Children of more educated mothers, living in improved environmental conditions, and with a low burden of infection were significantly more likely to have the responsive phenotype. The responsive phenotype was significantly associated with an increased prevalence of atopy but not asthma. Conclusion Our findings contribute to a better understanding of the immune mechanisms by which the hygiene hypothesis operates in urban Latin America. Salvador

Submitted by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2012-11-03T05:04:59Z No. of bitstreams: 1 Validacion Per Intern 2012.pdf: 113940 bytes, checksum: fe173c29882e6f785bb1f2267ada043e (MD5) Made available in DSpace on 2012-11-03T05:04:59Z (GMT). No. of bitstreams: 1 Validacion Per Intern 2012.pdf: 113940 bytes, checksum: fe173c29882e6f785bb1f2267ada043e (MD5) Previous issue date: 2012 Objective: To assess the validity of a food frequency questionnaire (FFQ) by applying it to children and adolescents living in Salvador, Bahia Methods: The validity of this FFQ with 98 food items was investigated among 108 children and adolescents who were selected from a sample of 1445 that had been planned for a study on the risk factors for asthma and other allergic diseases. The adults responsible for these children and adolescents gave responses for a 24-hour recall (R24h) and an FFQ. The average energy and nutrient values from the FFQ were compared with those from the R24h by means of the paired t test and Pearson correlation coefficients. The concordance was evaluated using the Bland-Altman method and kappa statistics. Results: The energy and nutrient intake estimated using the FFQ was significantly higher than what was obtained using the R24h. The correlation coefficients adjusted for energy were statistically significant for protein, fat, vitamin C and zinc. The weighted kappa values ranged from 0.06 for vitamin A (p = 0.24) to 0.34 for energy (p < 0.00). The results from the Bland-Altman plots for lipid, protein and zinc showed the most significant validity parameters, and zinc was found to show the best concordance. Conclusion: The results suggest that the FFQ showed satisfactory validity for use in studies involving children and adolescents. Madrid

p.2251-2262 Submitted by Rigaud Andréa (andrearigaud16@yahoo.com.br) on 2011-08-30T17:51:30Z No. of bitstreams: 1 repos2010.6.pdf: 243023 bytes, checksum: 98333b427337cc113309ce2af6cc4729 (MD5) Made available in DSpace on 2011-08-30T17:51:30Z (GMT). No. of bitstreams: 1 repos2010.6.pdf: 243023 bytes, checksum: 98333b427337cc113309ce2af6cc4729 (MD5) Previous issue date: 2010-12 Structural equation modeling (SEM) is an important statistical tool for evaluating complex relations in several research areas. In epidemiology, the use and discussion of SEM have been limited thus far. This article presents basic principles and concepts in SEM, including an application using epidemiological data analysis from a study on the determinants of cognitive development in young children, considering constructs related to organization of the child’s home environment, parenting style, and the child’s health status. The relations between the constructs and cognitive development were measured. The results showed a positive association between psychosocial stimulus at home and cognitive development in young children. The article presents the contributions by SEM to epidemiology, highlighting the need for an a priori theoretical model for improving the study of epidemiological questions from a new perspective. Rio de Janeiro

10 p. Submitted by Ana Valéria de Jesus Moura (anavaleria_131@hotmail.com) on 2011-12-11T17:24:14Z No. of bitstreams: 1 1465-9921-11-167.pdf: 308598 bytes, checksum: b19e8980ad52664002f3f839c7513596 (MD5) Made available in DSpace on 2011-12-11T17:24:14Z (GMT). No. of bitstreams: 1 1465-9921-11-167.pdf: 308598 bytes, checksum: b19e8980ad52664002f3f839c7513596 (MD5) Previous issue date: 2010 Background: The causation of asthma is poorly understood. Risk factors for atopic and non-atopic asthma may be different. This study aimed to analyze the associations between markers of poverty, dirt and infections and wheezing in atopic and non-atopic children. Methods: 1445 children were recruited from a population-based cohort in Salvador, Brazil. Wheezing was assessed using the ISAAC questionnaire and atopy defined as allergen-specific IgE ≥0.70 kU/L. Relevant social factors, environmental exposures and serological markers for childhood infections were investigated as risk factors using multivariate multinomial logistic regression. Results: Common risk factors for wheezing in atopic and non-atopic children, respectively, were parental asthma and respiratory infection in early childhood. No other factor was associated with wheezing in atopic children. Factors associated with wheezing in non-atopics were low maternal educational level (OR 1.49, 95% CI 0.98-2.38), low frequency of room cleaning (OR 2.49, 95% CI 1.27-4.90), presence of rodents in the house (OR 1.48, 95% CI 1.06-2.09), and day care attendance (OR 1.52, 95% CI 1.01-2.29). Conclusions: Non-atopic wheezing was associated with risk factors indicative of poverty, dirt and infections. Further research is required to more precisely define the mediating exposures and the mechanisms by which they may cause non-atopic wheeze.

The aim of this study was to estimate the association between Giardia duodenalis infection and anthropometric deficits, as measured by weight-for-age and height-for-age. This cross-sectional study included 629 children from 12 to 48 months of age, selected from 30 geographic areas in the city of Salvador, Bahia State, Brazil. Poisson regression and linear regression were used for the multivariate statistical analyses. G. duodenalis was diagnosed in 13.5% of the children. The children's breastfeeding duration and living conditions (garbage collection and paved streets or sidewalks) modified the effect of G. duodenalis infection on anthropometric status. Among infected children, there were statistically significant associations between weight deficit and shorter breastfeeding (PR = 2.22; 95%CI: 1.56-3.14) and inadequate paving of streets and sidewalks (PR = 2.00; 95%CI: 1.37-2.92), while height deficit was associated with deficient public garbage collection (PR = 2.21; 95%CI: 1.31-2.51). In the linear regression, the association with the anthropometric indicators remained positive and statistically significant. The child's unhealthy living environment aggravated the negative effect of G. duodenalis infection on anthropometric status, and breastfeeding was a protective factor in the outcome. Este estudo tem como objetivo estimar a associação entre a infecção por Giardia duodenalis e os déficits antropométricos segundo os indicadores peso por idade e altura/comprimento por idade. Trata-se de um estudo transversal envolvendo 629 crianças de 12 a 48 meses de idade, selecionadas em trinta áreas geográficas da cidade de Salvador, Bahia, Brasil. Adotou-se a regressão de Poisson e adicionalmente regressão linear nas análises estatísticas multivariadas. G. duodenalis foi diagnosticada em 13,5% das crianças. O tempo de amamentação e as condições de residência das crianças (coleta de lixo e pavimentação da rua/calçada) modificaram o efeito da infecção por G. duodenalis sobre o estado antropométrico. Entre os infectados, observaram-se associações estatisticamente significantes do déficit ponderal com o menor tempo de amamentação (RP = 2,22; IC95%: 1,56-3,14) e com as condições inadequadas de pavimentação da rua/calçada (RP = 2,00; IC95%: 1,37-2,92), e do déficit linear com a coleta pública de lixo (RP = 2,21; IC95%: 1,31-2,51). Na análise da regressão linear, a associação se manteve positiva e estatisticamente significante com a média dos indicadores antropométricos. O ambiente insalubre em que vive a criança acentuou o efeito negativo da infecção por G. duodenalis sobre o estado antropométrico, e a amamentação ao peito constituiu-se em fator de proteção para este desfecho.

p. 1527-1535, jul, 2008 Submitted by Rodrigo Meirelles (rodrigomei@ufba.br) on 2011-07-16T16:30:45Z No. of bitstreams: 1 nacionais 2008.3.pdf: 114373 bytes, checksum: 4b000c8a7e67aadad769d74640e5c687 (MD5) Made available in DSpace on 2011-07-16T16:30:45Z (GMT). No. of bitstreams: 1 nacionais 2008.3.pdf: 114373 bytes, checksum: 4b000c8a7e67aadad769d74640e5c687 (MD5) Previous issue date: 2008 The aim of this study was to estimate the association between Giardia duodenalis infection and anthropometric deficits, as measured by weight-for-age and height for-age. This crosssectional study included 629 children from 12 to 48 months of age, selected from 30 geographic areas in the city of Salvador, Bahia State, Brazil. Poisson regression and linear regression were used for the multivariate statistical analyses. G. duodenalis was diagnosed in 13.5% of the children. The children’s breastfeeding duration and living conditions(garbage collection and paved streets or sidewalks) modified the effect of G. duodenalis infection on anthropometric status. Among infected children, there were statistically significant associations between weight deficit and shorter breastfeeding (PR = 2.22; 95%CI: 1.56-3.14) and inadequate paving of streets and sidewalks (PR = 2.00; 95%CI: 1.37-2.92), while height deficit was associated with deficient public garbage collection (PR = 2.21; 95%CI: 1.31- 2.51). In the linear regression, the association with the anthropometric indicators remained positive and statistically significant. The child’s unhealthy living environment aggravated the negative effect of G. duodenalis infection on anthropometric status, and breastfeeding was a protective factor in the outcome. Rio de Janeiro

November 10, p. 1622- 1628. Submitted by Rodrigo Meirelles (rodrigomei@ufba.br) on 2011-07-09T16:25:27Z No. of bitstreams: 1 artigo internac.7.livre 2007.pdf: 155425 bytes, checksum: 52d9245ee890e55ffa16e771da15cb9b (MD5) Made available in DSpace on 2011-07-09T16:25:27Z (GMT). No. of bitstreams: 1 artigo internac.7.livre 2007.pdf: 155425 bytes, checksum: 52d9245ee890e55ffa16e771da15cb9b (MD5) Previous issue date: 2007 Background A city-wide sanitation intervention was started in Salvador, Brazil, in 1997 to improve sewerage coverage from 26% of households to 80%. Our aim was to investigate the epidemiological eff ect of this city-wide sanitation programme on diarrhoea morbidity in children less than 3 years of age. Methods The investigation was composed of two longitudinal studies done in 1997–98 before the intervention (the sanitation programme) and in 2003–04 after the intervention had been completed. Each study consisted of a cohort of children (841 in the preintervention study and 1007 in the postintervention study; age 0–36 months at baseline) who were followed up for a maximum of 8 months. Children were sampled from 24 sentinel areas that were randomly chosen to represent the range of environmental conditions in the study site. At the start of each study an individual or household questionnaire was applied by trained fi eldworkers; an environmental survey was done in each area before and after introduction of the sanitation programme to assess basic neighbourhood and household sanitation conditions. Daily diarrhoea data were obtained during home visits twice per week. The eff ect of the intervention was estimated by a hierarchical modelling approach fi tting a sequence of multivariate regression models. Findings Diarrhoea prevalence fell by 21% (95% CI 18–25%)—from 9·2 (9·0–9·5) days per child-year before the intervention to 7·3 (7·0–7·5) days per child-year afterwards. After adjustment for baseline sewerage coverage and potential confounding variables, we estimated an overall prevalence reduction of 22% (19–26%). Interpretation Our results show that urban sanitation is a highly eff ective health measure that can no longer be ignored, and they provide a timely support for the launch of 2008 as the International Year of Sanitation.

Submitted by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2018-07-04T12:56:10Z No. of bitstreams: 1 Tese RogerioTosta. 2017.pdf: 2417919 bytes, checksum: 62aea33f95dc5836b335164ef43dc711 (MD5) Approved for entry into archive by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2018-07-06T11:27:24Z (GMT) No. of bitstreams: 1 Tese RogerioTosta. 2017.pdf: 2417919 bytes, checksum: 62aea33f95dc5836b335164ef43dc711 (MD5) Made available in DSpace on 2018-07-06T11:27:24Z (GMT). No. of bitstreams: 1 Tese RogerioTosta. 2017.pdf: 2417919 bytes, checksum: 62aea33f95dc5836b335164ef43dc711 (MD5) A presente tese foi desenvolvida com o objetivo geral de analisar a relação entre IAC e risco coronariano no Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil). Os objetivos específicos indicam os três artigos que a compõem: a) Avaliar a performance do IAC como indicador de condições metabólicas e cardiovasculares adversas em adultos e identificar se a idade, sexo e etnia interferem nesta performance; b) propor pontos de corte do IAC mais apropriados para identificar risco coronariano na população adulta brasileira e investigar a associação entre IAC e risco coronariano, identificando potenciais modificadores de efeito e confundidores; e, c) avaliar o poder preditivo individual e combinado do IAC para identificar risco coronariano em adultos brasileiros. O primeiro artigo é uma revisão sistemática da literatura de treze estudos. Dois avaliaram a capacidade preditiva do IAC para rastrear hipertensão, quatro para Diabetes tipo 2 (DM2) e sete para Síndrome Metabólica (SMet). Apenas um estudo foi de desenho longitudinal. Os achados não são consistentes suficientes para afirmar que sexo, idade e etnia influenciam no desempenho do IAC para rastrear hipertensão, DM2 e SMet, porém, indicam a necessidade de se considerar estes fatores para rastreamentos mais precisos. O segundo artigo examinou participantes da linha de base do ELSA-Brasil (2008-2010), estratificados por sexo e faixa etária (35-59 anos e 60-74 anos). Os níveis mais elevados de IAC se associaram com maior risco de desenvolvimento de doença coronariana futura em todos os estratos. O IAC apresentou capacidade preditiva razoável para identificar RCA em participantes do ELSABrasil, sendo melhor nas mulheres (AUC acima de 60%, com exceção do grupo de homens com 60 ou mais anos). As limitações deste indicador são semelhantes à de outros indicadores antropométricos para rastreamento de riscos adversos à saúde. Os pontos de corte sugeridos foram: IAC= 27,0 para as duas faixas etárias nos homens e IAC= 34,0 e 36,0, respectivamente, para as idades entre 35-59 anos e 60-74 anos, nas mulheres. No terceiro artigo, o IAC apresentou capacidade preditiva razoável para identificar RCA, mas a Razão Cintura-Quadril (RCQ) foi o indicador que teve melhor desempenho individual. As combinações, de pelo menos, um indicador de obesidade geral com outro de obesidade central, foram mais fortemente associadas ao RCA, sendo, as AUC da união entre IAC+RCQ e IMC+RCQ, aquelas que apresentaram, respectivamente, melhor resultado para homens e mulheres. Todas as análises combinadas apresentaram valores de sensibilidade melhores do que as análises individuais. Este trabalho é o primeiro sobre o IAC e sua relação com risco coronariano realizado no Brasil com uma grande amostra de adultos. Espera-se que os dados apresentados sejam úteis para outras pesquisas de campo sobre o assunto ou mesmo na prática clínica. Ainda, com o seguimento da coorte ELSABrasil, ele pode ser o ponto de partida para novas análises longitudinais que poderão responder melhor as questões levantadas.