25 results on '"M, Bensenor"'
Search Results
2. Ideal vascular health and cognitive performance in the Brazilian Longitudinal Study of Adult Health
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Márcio Sommer Bittencourt, I. M. Bensenor, Alessandra C. Goulart, Claudia K. Suemoto, Itamar S. Santos, Andre R. Brunoni, Laiss Bertola, Paulo A. Lotufo, Maria Carmen Viana, Sandhi Maria Barreto, and Claudia Szlejf
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Adult ,Longitudinal study ,medicine.medical_specialty ,White People ,03 medical and health sciences ,Cognition ,0302 clinical medicine ,Risk Factors ,Epidemiology ,Humans ,Verbal fluency test ,Medicine ,Longitudinal Studies ,030212 general & internal medicine ,Effects of sleep deprivation on cognitive performance ,Aged ,business.industry ,Middle Aged ,Confidence interval ,Black or African American ,Cross-Sectional Studies ,Neurology ,Educational Status ,Female ,Neurology (clinical) ,Thyroid function ,business ,Body mass index ,030217 neurology & neurosurgery ,Demography - Abstract
BACKGROUND AND PURPOSE Most evidence for the association between ideal vascular health (IVH) and cognitive performance comes from high income countries. The aim was to investigate this association in the Brazilian Longitudinal Study of Adult Health. METHODS Cognition was assessed using the word list, verbal fluency and trail making tests. The IVH score included ideal metrics for body mass index, smoking, physical activity, diet, blood pressure, fasting glucose and total cholesterol. Poor, intermediate and optimal health were characterized in those presenting 0-2, 3-4, 5-7 ideal metrics, respectively. To determine the association between IVH score and cognitive performance, linear regression models adjusted for age, sex, education, race, alcohol use, depression and thyroid function were used. RESULTS In 12 271 participants, the mean age was 51.3 ± 8.9 years, 54% were women, 57% White and 53% had poor vascular health. Participants with intermediate (β = 0.064, 95% confidence interval 0.033; 0.096) and optimal health (β = 0.108, 95% confidence interval 0.052; 0.164) had better global cognitive Z-scores. In addition, interactions of IVH score with age, education and race were found, suggesting a better cognitive performance with higher IVH in older adults, Black/Brown participants and those with lower levels of education. CONCLUSION Ideal vascular health was associated with better cognitive performance. Older, Black/Brown and low-educated participants had better cognition in the presence of higher IVH scores.
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- 2020
3. ELSA-Brasil: a 4-year incidence of hearing loss in adults with and without hypertension
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Fernanda Yasmin Odila Maestri Miguel Padilha, Nágila Soares Xavier Oenning, Itamar de Souza Santos, Camila Maia Rabelo, Renata Rodrigues Moreira, Isabela M. Bensenor, Paulo A. Lotufo, and Alessandra Giannella Samelli
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Adult ,Epidemiologic Factors ,Incidence ,Hypertension ,otorhinolaryngologic diseases ,Public Health, Environmental and Occupational Health ,Humans ,Longitudinal Studies ,Middle Aged ,Hearing Loss ,Brazil ,Aged - Abstract
OBJECTIVE To compare the incidence of hearing loss among adults stratified by the occurrence of hypertension, and to investigate the association between hypertension and hearing loss. METHODS Longitudinal observational study, part of the Estudo Longitudinal da Saúde do Adulto (ELSA-Brasil, Longitudinal Study on Adult’s Health). Data from the first and second waves were analyzed, including information from audiological assessment and general health of the subjects. As outcome, we considered the presence of hearing loss (hearing thresholds above 25 dBHL at frequencies from 500 Hz to 8 kHz) and, as exposure variable, hypertension (report of medical diagnosis of hypertension; and/or use of drugs to treat hypertension; and/or pressure systolic blood pressure ≥ 140 mmHg; or diastolic blood pressure ≥ 90 mmHg). As covariables for adjustment were considered: sex, age, education, race / ethnicity, income, smoking, diabetes, and occupational exposure to noise. Poisson regression analysis was conducted, estimating the crude and adjusted relative risks, with 95% confidence intervals, in order to assess the factors associated with hearing loss. RESULTS In crude analyses, the incidence of hearing loss was higher for subjects with hypertension (9.7% versus 5.4%). The crude relative risks for hearing loss was almost double (1.93; 95%CI: 1.10–3.39) for subjects with hypertension in the right ear. In the adjusted analyses, the relative risks was not significant for the hypertension variable (1.42; 95%CI: 0.75–2.67). Being 60 years or older (RR: 5.41; 95%CI: 2.79–10.50) showed a statistically significant association with hearing loss, indicating that older adults have higher relative risks for hearing loss. CONCLUSION In the adjusted analyses controlled for multiple risk factors there was no association between hypertension and hearing loss. The dichotomous variable age (being 60 years or older), on the other hand, has shown a significant association with hearing loss.
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- 2022
4. Menopause
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Marília I H, Fonseca, Bianca de, Almeida-Pititto, Márcio S, Bittencourt, Isabela M, Bensenor, Paulo A, Lotufo, and Sandra R G, Ferreira
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Premenopause ,Risk Factors ,Humans ,Calcium ,Female ,Coronary Artery Disease ,Menopause ,Middle Aged - Published
- 2021
5. Self-reported versus actigraphy-assessed sleep duration in the ELSA-Brasil study: analysis of the short/long sleep duration reclassification
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Ronaldo B, Santos, Soraya, Giatti, Aline N, Aielo, Wagner A, Silva, Barbara K, Parise, Lorenna F, Cunha, Silvana P, Souza, Airlane P, Alencar, Paulo A, Lotufo, Isabela M, Bensenor, and Luciano F, Drager
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Adult ,Male ,Sleep Wake Disorders ,Polysomnography ,Humans ,Female ,Self Report ,Middle Aged ,Sleep ,Actigraphy - Abstract
This study was aimed to determine the magnitude and predictors of self-reported short/long sleep duration (SDUR) reclassifications using objective measurements.Adult participants from the ELSA-Brasil study performed self-reported SDUR, 7-day wrist actigraphy, and a portable sleep study. We explored two strategies of defining self-reported SDUR reclassification: (1) short and long SDUR defined by6 and ≥8h, respectively; (2) reclassification using a large spectrum of SDUR categories (5, 5-6, 7-8, 8-9, and9 h).Data from 2036 participants were used in the final analysis (43% males; age: 49±8 years). Self-reported SDUR were poorly correlated (r=0.263) and presented a low agreement with actigraphy-based total sleep time. 58% of participants who self-reported short SDUR were reclassified into the reference (6-7.99 h) or long SDUR groups using actigraphy data. 88% of participants that self-reported long SDUR were reclassified into the reference and short SDUR. The variables independently associated with higher likelihood of self-reported short SDUR reclassification included insomnia (3.5-fold), female (2.5-fold), higher sleep efficiency (1.35-fold), lowest OIn adults, we observed a significant rate of short/long SDUR reclassifications when comparing self-reported with objective data. These results underscore the need to reappraise subjective data use for future investigations addressing SDUR.
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- 2021
6. Reference values for the triglyceride to high-density lipoprotein ratio and its association with cardiometabolic diseases in a mixed adult population: The ELSA-Brasil study
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Maria Inês Schmidt, Sandhi Maria Barreto, Bruce Bartholow Duncan, Andrei C. Sposito, João Vitor Santos Calzavara, Rosane Harter Griep, Marcelo Perim Baldo, Paulo A. Lotufo, Maria del Carmen Bisi Molina, I. M. Bensenor, Deborah de Farias Lelis, José Geraldo Mill, and Raul D. Santos
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Adult ,Male ,Percentile ,Endocrinology, Diabetes and Metabolism ,Ethnic group ,chemistry.chemical_compound ,High-density lipoprotein ,Insulin resistance ,Reference Values ,Diabetes mellitus ,Internal Medicine ,medicine ,Humans ,Triglycerides ,Aged ,Metabolic Syndrome ,Nutrition and Dietetics ,Triglyceride ,business.industry ,Cardiometabolic Risk Factors ,Reproducibility of Results ,Middle Aged ,medicine.disease ,Obesity ,chemistry ,Female ,Metabolic syndrome ,Cardiology and Cardiovascular Medicine ,business ,Lipoproteins, HDL ,Biomarkers ,Brazil ,Demography - Abstract
BACKGROUND Among several lipid ratios available, the triglyceride/HDL-cholesterol (TG/HDL-C) may detect individuals at risk of cardiometabolic diseases. However, its reference values for different ethnicities are not well established. OBJECTIVE To define sex- and ethnicity-specific reference values for TG/HDL-C ratio in a large sample of healthy multiethnic adults and test its association with cardiometabolic conditions. METHODS An apparently healthy sample (n = 2,472), aged 35–74, free of major cardiovascular risk factors, was used to generate the reference values for the TG/HDL-C. Exclusion criteria were diabetes, elevated blood pressure, obesity, hypercholesterolemia, severe hypertriglyceridemia, and smoking history. Cut-offs based on the reference values were tested in the whole ELSA Brasil study (n = 13,245), stratified by sex and ethnicity, to identify cardiometabolic conditions. RESULTS TG/HDL-C ratio was higher in men than women, and did not change significantly with age, regardless of sex and ethnicity. Also, black individuals showed lower levels of TG/HDL-C as compared to other ethnic groups. ROC curve showed that the cut-off based on the 75th percentile displayed better sensitivities and specificities for men and women, regardless of ethnicity. Also, the sex- and ethnicity-specific cut-offs based on the 75th percentile were significantly associated with all tested cardiometabolic conditions (hypertension, diabetes, obesity, metabolic syndrome, and insulin resistance). Also, we observed that the use of a single sex-specific cut-off (men: 2.6; women: 1.7) could be used for the different ethnicities with good reliability. CONCLUSION The defined TG/HDL-C cut-offs (men: 2.6; women: 1.7) are reliable and showed good clinical applicability to detect cardiometabolic conditions in a multiethnic population.
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- 2021
7. Frequency and Reasons for Non-Administration and Suspension of Drugs During an Acute Coronary Syndrome Event. The ERICO Study
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Rafael C O, Santos, Isabela M, Bensenor, Alessandra C, Goulart, Paulo A, Lotufo, and Itamar S, Santos
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Male ,Aspirin ,Pharmaceutical Preparations ,Humans ,Angiotensin-Converting Enzyme Inhibitors ,Female ,Acute Coronary Syndrome ,Middle Aged ,Platelet Aggregation Inhibitors ,Clopidogrel - Abstract
Few studies have discussed the reasons for pharmacological undertreatment of Acute Coronary Syndrome (ACS).To determine the frequency and reasons for the non-administration and suspension of medications during in-hospital treatments of ACS in the Strategy of Registry of Acute Coronary Syndrome (ERICO) study.The present study analyzed the medical charts of the 563 participants in the ERICO study to evaluate the frequency and reasons for the non-administration and/or suspension of medications. Logistic regression models were built to analyze if sex, age ≥65 years of age, educational level, or ACS subtype were associated with (a) the non-administration of ≥1 medications; and (b) the non-administration or suspension of ≥1 medications. The significance level was set at 5%.This study's sample included 58.1% males, with a median of 62 years of age. In 183 (32.5%) participants, ≥1 medications were not administered, while in 288 (51.2%), ≥1 medications were not administered or were suspended. The most common reasons were the risk of bleeding (aspirin, clopidogrel, and heparin), heart failure (beta blockers), and hypotension (angiotensin-converting enzyme inhibitors and angiotensin receptor blockers). Individuals aged ≥65 (odds ratio [OR]:1.51; 95% confidence interval [95% CI]:1.05-2.19) and those with unstable angina (OR:1.72; 95% CI:1.07-2.75) showed a higher probability for the non-administration of ≥1 medication. Considering only patients with myocardial infarction, being ≥65 years of age was associated with both the non-administration and the non-administration or suspension of ≥1 medication.Non-administration or suspension of ≥1 medication proved to be common in this ERICO study. Individuals of ≥65 years of age or with unstable angina showed a higher probability of the non-administration of ≥1 medication and may be undertreated in this scenario. (Arq Bras Cardiol. 2020; 115(5):830-839).Poucos estudos discutiram causas para o subtratamento medicamentoso na SCA.Avaliar a não-administração e suspensão de medicamentos durante o tratamento intra-hospitalar da SCA na Estratégia de Registro de Síndrome Coronariana Aguda (estudo ERICO).Analisamos prontuários de 563 participantes ERICO para avaliar a frequência e motivos da não administração e/ou suspensão de medicamentos. Construímos modelos de regressão logística para avaliar se sexo, idade ≥65 anos, nível educacional ou subtipo de SCA estavam associados com (a) não administração de ≥1 medicamentos; e (b) não administração ou suspensão de ≥1 medicamentos. O nível de significância foi 5%.A amostra é composta por 58,1% de homens e com idade mediana de 62 anos. Em 183 (32,5%) participantes ≥1 medicamentos não foram administrados e 288 (51,2%) apresentaram ≥1 medicamentos não administrados ou suspensos. As causas mais frequentes foram risco de sangramento (aspirina, clopidogrel e heparina), insuficiência cardíaca (betabloqueadores) e hipotensão (inibidores da enzima conversora da angiotensina e bloqueadores dos receptores da angiotensina). Indivíduos com idade ≥65 anos (razão de chances [RC]:1,51; intervalo de confiança de 95% [IC95%]:1,05-2,19) e com angina instável (RC:1,72; IC95%:1,07-2,75) tiveram maior chance de não-administração. Considerando apenas pacientes com infarto do miocárdio, idade ≥65 anos foi associada tanto à não administração quanto à não administração ou suspensão.A não administração ou suspensão de ≥1 medicamento não foi rara no estudo ERICO. Indivíduos com idade ≥65 anos ou com angina instável tiveram maior chance de não administração e podem ser subtratados nesse cenário.
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- 2019
8. Leisure-time and commuting physical activity and high blood pressure: the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)
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C Treff, Paulo A. Lotufo, and I. M. Bensenor
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Adult ,Male ,medicine.medical_specialty ,Longitudinal study ,Blood Pressure ,Transportation ,030204 cardiovascular system & hematology ,03 medical and health sciences ,symbols.namesake ,Leisure Activities ,0302 clinical medicine ,Diabetes mellitus ,Epidemiology ,Prevalence ,Internal Medicine ,medicine ,Humans ,Longitudinal Studies ,030212 general & internal medicine ,Poisson regression ,Exercise ,Aged ,business.industry ,Incidence ,Incidence (epidemiology) ,Middle Aged ,medicine.disease ,Confidence interval ,Blood pressure ,Hypertension ,Physical therapy ,symbols ,Female ,Sedentary Behavior ,business ,Body mass index ,Brazil ,Demography - Abstract
This study investigates the association between leisure-time physical activity and commuting-related physical activity and high blood pressure among participants in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Physical activity was assessed through application of the International Physical Activity Questionnaire, particularly the domains addressing leisure and transportation. We used the World Health Organization’s definition (⩾150 min per week of moderate activities or 75 min per week of vigorous activities) to establish three categories: active, insufficiently active and inactive. Hypertension was defined as systolic/diastolic blood pressure of >140/90 mm Hg or use of antihypertensive medications. From a universe of 15 105 participants, we analysed 13 857 subjects without previous cardiovascular diseases. The association between physical activity and hypertension was obtained using Poisson regression with adjustment for age, race, education, income, body mass index, diabetes and sodium and alcohol intake. Men who were active during leisure time had a multivariate prevalence ratio (95% confidence interval) of 0.84 (0.77–0.92) for hypertension compared with inactive men. For women, the prevalence ratio of active vs inactive during leisure time was 0.86 (0.79–0.95). However, this protective effect of leisure-time physical activity was not observed among men and women with diabetes or obese women. The association found between commuting-related physical activity and hypertension was not detected among men, and the prevalence ratio for women who were active during commuting time compared with inactive women was 1.11 (1.01–1.21). In conclusion, leisure-time physical activity was protective against hypertension, and commuting-related physical activity was associated with high blood pressure among women.
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- 2016
9. Sex-specific associations of birth weight with measures of adiposity in mid-to-late adulthood: the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)
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Vivian Cristine Luft, Lawrence J. Appel, Maria Inês Schmidt, Noel T. Mueller, Bruce Bartholow Duncan, G Rockenbach, I. M. Bensenor, Sheila Maria Alvim Matos, Sandhi Maria Barreto, Maria de Jesus Mendes da Fonseca, Álvaro Vigo, and M C Stein
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Adult ,Male ,medicine.medical_specialty ,Longitudinal study ,Endocrinology, Diabetes and Metabolism ,Birth weight ,MEDLINE ,Medicine (miscellaneous) ,Article ,Body Mass Index ,03 medical and health sciences ,Sex Factors ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Prevalence ,Birth Weight ,Humans ,Medicine ,Nutritional Physiological Phenomena ,Longitudinal Studies ,030212 general & internal medicine ,Adult health ,Adiposity ,Aged ,Sex Characteristics ,030505 public health ,Nutrition and Dietetics ,Waist-Hip Ratio ,business.industry ,Middle Aged ,medicine.disease ,Obesity ,Endocrinology ,Obesity, Abdominal ,Female ,Waist Circumference ,medicine.symptom ,0305 other medical science ,business ,Body mass index ,Weight gain ,Brazil ,Demography ,Sex characteristics - Abstract
BACKGROUND/OBJECTIVES: To investigate sex-specific associations of birth weight with body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) in mid-to-late adulthood. SUBJECTS/METHODS: ELSA-Brasil is a multicenter cohort study of adults aged 35–74 years affiliated with universities or research institutions of six capital cities in Brazil. After exclusions, we investigated 11 636 participants. Socio-demographic factors and birth weight were obtained by interview. All anthropometry was directly measured at baseline. We categorized birth weight as low (⩽2.5 kg); normal (2.5–4 kg) and high (⩾4 kg). We performed analysis of covariance (ANCOVA) for continuous outcomes and ordinal logistic regression for categorical adiposity outcomes. We examined interaction on the multiplicative scale by sex and by race. RESULTS: High birth weight uniformly predicted greater overall and central obesity in men and women. However, low (vs normal) birth weight, in ANCOVA models adjusted for participant age, family income, race, education, maternal education, and maternal and paternal history of diabetes, was associated with lower BMI, WC and WHR means for men, but not for women (P(interaction) = 0.01
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- 2016
10. Gender, race and socioeconomic influence on diagnosis and treatment of thyroid disorders in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)
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I. M. Bensenor, Rodrigo Díaz Olmos, Paulo A. Lotufo, Estela M. L. Aquino, and R.C. de Figueiredo
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Male ,Pediatrics ,Longitudinal study ,Medicine (General) ,endocrine system diseases ,Physiology ,Cross-sectional study ,Levothyroxine ,Logistic regression ,Biochemistry ,Hyperthyroidism ,Medicine ,Longitudinal Studies ,General Pharmacology, Toxicology and Pharmaceutics ,Biology (General) ,lcsh:QH301-705.5 ,lcsh:R5-920 ,General Neuroscience ,Thyroid ,Thyroid dysfunction ,General Medicine ,Middle Aged ,medicine.anatomical_structure ,Socioeconomic status ,Female ,lcsh:Medicine (General) ,Brazil ,hormones, hormone substitutes, and hormone antagonists ,medicine.drug ,Cohort study ,Adult ,medicine.medical_specialty ,endocrine system ,Race ,QH301-705.5 ,Immunology ,Biophysics ,Ocean Engineering ,Family income ,R5-920 ,Hypothyroidism ,Humans ,Clinical Investigation ,Sex Distribution ,Psychiatry ,Aged ,business.industry ,Racial Groups ,Gender ,Cell Biology ,Thyroxine ,Cross-Sectional Studies ,Socioeconomic Factors ,lcsh:Biology (General) ,Treatment of thyroid disorders ,business - Abstract
Thyroid diseases are common, and use of levothyroxine is increasing worldwide. We investigated the influence of gender, race and socioeconomic status on the diagnosis and treatment of thyroid disorders using data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), a multicenter cohort study of civil servants (35-74 years of age) from six Brazilian cities. Diagnosis of thyroid dysfunction was by thyrotropin (TSH), and free thyroxine (FT4) if TSH was altered, and the use of specific medications. Multivariate logistic regression models were constructed using overt hyperthyroidism/hypothyroidism and levothyroxine use as dependent variables and sociodemographic characteristics as independent variables. The frequencies of overt hyper- and hypothyroidism were 0.7 and 7.4%, respectively. Using whites as the reference ethnicity, brown, and black race were protective for overt hypothyroidism (OR=0.76, 95%CI=0.64-0.89, and OR=0.53, 95%CI=0.43-0.67, respectively, and black race was associated with overt hyperthyroidism (OR=1.82, 95%CI=1.06-3.11). Frequency of hypothyroidism treatment was higher in women, browns, highly educated participants and those with high net family incomes. After multivariate adjustment, levothyroxine use was associated with female gender (OR=6.06, 95%CI=3.19-11.49) and high net family income (OR=3.23, 95%CI=1.02-10.23). Frequency of hyperthyroidism treatment was higher in older than in younger individuals. Sociodemographic factors strongly influenced the diagnosis and treatment of thyroid disorders, including the use of levothyroxine.
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- 2015
11. Evidence for increased motor cortical facilitation and decreased inhibition in atypical depression
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André F. Carvalho, Paulo A. Lotufo, R. Galhardoni, Zafiris J. Daskalakis, Marcel Simis, Rodrigo Machado-Vieira, Adriano H. Moffa, Beatriz P. Veronezi, I. M. Bensenor, and Andre R. Brunoni
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Adult ,Male ,medicine.medical_treatment ,Poison control ,Melancholic depression ,behavioral disciplines and activities ,gamma-Aminobutyric acid ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Receptors, GABA ,medicine ,Humans ,Atypical depression ,Depressive Disorder, Major ,GABAA receptor ,Motor Cortex ,Middle Aged ,medicine.disease ,Transcranial Magnetic Stimulation ,030227 psychiatry ,Transcranial magnetic stimulation ,Psychiatry and Mental health ,Receptors, Glutamate ,Major depressive disorder ,Silent period ,Female ,Psychology ,Neuroscience ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Major depressive disorder (MDD) is a clinically heterogeneous condition. However, the role of cortical glutamate and gamma-aminobutyric acid (GABA) receptor-mediated activity, implicated in MDD pathophysiology, has not been explored in different MDD subtypes. Our aim was to assess the atypical and melancholic depression subtypes regarding potential differences in GABA and glutamate receptor-mediated activity through established transcranial magnetic stimulation (TMS) neurophysiological measures from the motor cortex.We evaluated 81 subjects free of antidepressant medication, including 21 healthy controls and 20 patients with atypical, 20 with melancholic, and 20 with undifferentiated MDD. Single and paired-pulse TMS paradigms were used to evaluate intracortical facilitation (ICF), cortical silent period (CSP), and short intracortical inhibition (SICI), which index glutamate, GABAB receptor-, and GABAA receptor-mediated activity respectively.Patients with MDD demonstrated significantly decreased mean CSP values than healthy controls (Cohen's d = 0.22-0.3, P0.01 for all comparisons). Atypical depression presented a distinct cortical excitability pattern of decreased cortical inhibition and increased cortical facilitation, that is, an increased mean ICF and SICI ratios than other depression subtypes (d = 0.22-0.33, P0.01 for all comparisons).Different MDD subtypes may demonstrate different neurophysiology in relation to GABAA and glutamatergic activity. TMS as an investigational tool might be useful to distinguish between different MDD subtypes.
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- 2016
12. Age, Gender, and Race-Based Coronary Artery Calcium Score Percentiles in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)
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Alexandre C, Pereira, Luz M, Gomez, Marcio Sommer, Bittencourt, Henrique Lane, Staniak, Rodolfo, Sharovsky, Murilo, Foppa, Michael J, Blaha, Isabela M, Bensenor, and Paulo A, Lotufo
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Adult ,Male ,Time Factors ,Computed Tomography Angiography ,Racial Groups ,Clinical Investigations ,nutritional and metabolic diseases ,Coronary Artery Disease ,Middle Aged ,Coronary Angiography ,Prognosis ,Health Surveys ,Age Distribution ,Risk Factors ,Prevalence ,population characteristics ,Humans ,Female ,cardiovascular diseases ,Longitudinal Studies ,Prospective Studies ,Sex Distribution ,Vascular Calcification ,Brazil ,Aged - Abstract
BACKGROUND: Coronary artery calcium (CAC) has been demonstrated to independently predict the risk of cardiovascular events and all‐cause mortality, especially among White populations. Although the population distribution of CAC has been determined for several White populations, the distribution in ethnically admixed groups has not been well established. HYPOTHESIS: The CAC distribution, stratified for age, gender and race, is similar to the previously described distribution in the MESA study. METHODS: The Brazilian Longitudinal Study of Adult Health (ELSA‐Brasil) is a prospective cohort study designed to investigate subclinical cardiovascular disease in 6 different centers of Brazil. Similar to previous studies, individuals with self‐reported coronary or cerebrovascular disease and those treated for diabetes mellitus were excluded from analysis. RESULTS: Percentiles of CAC distribution were estimated with nonparametric techniques. The analysis included 3616 individuals (54% female; mean age, 50 years). As expected, CAC prevalence and burden were steadily higher with increasing age, as well as increased in men and in White individuals. Our results revealed that for a given CAC score, the ELSA‐derived CAC percentile would be lower in men compared with the Multi‐Ethnic Study of Atherosclerosis (MESA) and would be higher in women compared with MESA. CONCLUSIONS: In our sample of the Brazilian population, we observed significant differences in CAC by sex, age, and race. Adjusted for age and sex, low‐risk individuals from the Brazilian population present with significantly lower CAC prevalence and burden compared with other low‐risk individuals from other worldwide populations. Using US‐derived percentiles in Brazilian individuals may lead to overestimating relative CAC burden in men and underestimating relative CAC burden in women.
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- 2015
13. Postmenopausal hormone therapy in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil): who still uses it?
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Estela M L, Aquino, Maria-da-Conceição C, Almeida, Greice M S, Menezes, Roberta Carvalho, de Figueiredo, Isabela M, Bensenor, Sotero Serrate, Mengue, Maria de Jesus M, da Fonseca, and Ligia, Gabrielli
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Adult ,Postmenopause ,Risk ,Logistic Models ,Time Factors ,Estrogen Replacement Therapy ,Odds Ratio ,Humans ,Female ,Longitudinal Studies ,Middle Aged ,Brazil ,Aged - Abstract
We aim to investigate the patterns of hormone therapy (HT) use and associated factors in women participating in the Brazilian Longitudinal Study of Adult Health.This study included 3281 naturally menopausal women of 40 to 74 years of age at enrollment to the Brazilian Longitudinal Study of Adult Health study, who answered questions regarding their use and discontinuation of HT. Prevalence rates of current and previous HT use were calculated, and a multinomial logistic regression model was constructed to simultaneously analyze the associated factors.The prevalence of HT use increased from 1995 onwards, peaking at 55.7% in 1997. A sharp decline occurred in the decade beginning in 2000, reaching 11.1% at the study baseline interview (2008-2010). Current use was associated with being ≥60 years of age (Relative Risk Ratio (RRR): 1.81; 95%CI: 1.10-2.96), divorced (RRR: 1.72; 95%CI: 1.14-2.60), or married (RRR: 2.09; 95%CI: 1.41-3.10); having a university education (RRR: 1.66; 95%CI: 1.14-2.40) or postgraduate degree (RRR: 2.45; 95%CI: 1.80-3.35); and having private health insurance (RRR: 2.86; 95%CI: 2.00-4.09). Body mass index ≥30 kg/m(2) was inversely associated with HT use (RRR: 0.37; 95%CI: 0.26-0.53) as was the presence of at least one contraindication to HT use (RRR: 0.63; 95%CI: 0.44-0.89). Of the current users ≥60 years of age, 79.1% had been using HT for at least 5 years, and 73.6% had been menopausal for at least 10 years.Although the use of HT has declined in Brazil, the women who continue using it are largely exceeding evidence-based limits of age, time since menopause, and time of use. Copyright © 2016 John WileySons, Ltd.
- Published
- 2015
14. Artificially Sweetened Beverage Consumption Is Positively Associated with Newly Diagnosed Diabetes in Normal-Weight but Not in Overweight or Obese Brazilian Adults
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James, Yarmolinsky, Bruce B, Duncan, Lloyd E, Chambless, Isabela M, Bensenor, Sandhi M, Barreto, Alessandra C, Goulart, Itamar S, Santos, Maria de Fátima Sander, Diniz, and Maria Inês, Schmidt
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Adult ,Blood Glucose ,Glycated Hemoglobin ,Male ,Feeding Behavior ,Glucose Tolerance Test ,Middle Aged ,Overweight ,Weight Gain ,Body Mass Index ,Diet ,Beverages ,Cross-Sectional Studies ,Logistic Models ,Diabetes Mellitus, Type 2 ,Reference Values ,Sweetening Agents ,Humans ,Female ,Longitudinal Studies ,Obesity ,Insulin Resistance ,Brazil ,Aged - Abstract
Recent animal studies suggest that artificially sweetened beverage (ASB) consumption increases diabetes risk.We examined the relation of ASB intake with newly diagnosed diabetes and measures of glucose homeostasis in a large Brazilian cohort of adults.We used cross-sectional data from 12,884 participants from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). ASB use was assessed by questionnaire and newly diagnosed diabetes by a 2-h 75-g oral glucose tolerance test and/or glycated hemoglobin. Logistic and linear regression analyses were performed to examine the association of ASB consumption with diabetes and continuous measures of glucose homeostasis, respectively.Although ASB consumption was not associated with diabetes in logistic regression analyses after adjustment for body mass index (BMI; in kg/m(2)) overall, the association varied across BMI categories (P-interaction = 0.04). Among those with a BMI25, we found a 15% increase in the adjusted odds of diabetes for each increase in the frequency of ASB consumption per day (P = 0.001); compared with nonusers, ASB users presented monotonic increases in the adjusted ORs (95% CIs) of diabetes with increased frequency of consumption: 1.03 (0.60, 1.77), 1.43 (0.93, 2.20), 1.62 (1.08, 2.44), and 2.51 (1.40, 4.50) for infrequent, 1-2, 3-4, and4 times/d, respectively. In linear regression analyses, among normal-weight individuals, greater ASB consumption was also associated with increased fasting glucose concentrations (P = 0.01) and poorer β-cell function (P = 0.009). No such associations were seen for those with BMI ≥25. In fact, in overweight or obese participants, greater ASB consumption was significantly associated with improved indexes of insulin resistance and 2-h postload glucose.Normal-weight, but not excess-weight, individuals with greater ASB consumption presented diabetes more frequently and had higher fasting glucose and poorer β-cell function.
- Published
- 2015
15. Cognitive control therapy and transcranial direct current stimulation for depression: A randomized, double-blinded, controlled trial
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Andre R. Brunoni, I. M. Bensenor, Paulo S. Boggio, Marie-Anne Vanderhasselt, Paulo A. Lotufo, Leandro Valiengo, R. De Raedt, and Victoria Namur
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Male ,DISORDER ,genetic structures ,TERAPIA POR ESTIMULAÇÃO ELÉTRICA ,medicine.medical_treatment ,Social Sciences ,PREFRONTAL CORTEX ,law.invention ,Cognition ,Randomized controlled trial ,law ,Prospective Studies ,Cognitive decline ,Prefrontal cortex ,MOTOR CORTEX ,Transcranial direct-current stimulation ,WORKING-MEMORY IMPROVEMENT ,Control cognitive therapy ,Middle Aged ,Combined Modality Therapy ,Psychiatry and Mental health ,Clinical Psychology ,Major depressive disorder ,Female ,Transcranial direct current stimulation ,Randomized clinical trial ,Psychology ,Clinical psychology ,Adult ,medicine.medical_specialty ,Adolescent ,Electric Stimulation Therapy ,TDCS ,Young Adult ,Physical medicine and rehabilitation ,Double-Blind Method ,medicine ,Humans ,Geriatric depression ,Non-invasive brain stimulation ,METAANALYSIS ,Aged ,Depressive Disorder, Major ,Cognitive Behavioral Therapy ,Working memory ,MAJOR DEPRESSION ,PERFORMANCE ,medicine.disease ,SERIAL-ADDITION TASK ,BRAIN-STIMULATION ,Brain stimulation ,Neurocognitive - Abstract
Background Based on findings that major depressive disorder (MDD) is associated to decreased dorsolateral prefrontal cortical (DLPFC) activity; interventions that increase DLPFC activity might theoretically present antidepressant effects. Two of them are cognitive control therapy (CCT), a neurocognitive intervention that uses computer-based working memory exercises, and transcranial direct current stimulation (tDCS), which delivers weak, electric direct currents over the scalp. Methods We investigated whether tDCS enhanced the effects of CCT in a double-blind trial, in which participants were randomized to sham tDCS and CCT (n=17) vs. active tDCS and CCT (n=20). CCT and tDCS were applied for 10 consecutive workdays. Clinicaltrials.gov identifier: NCT01434836. Results Both CCT alone and combined with tDCS ameliorated depressive symptoms after the acute treatment period and at follow-up, with a response rate of approximately 25%. Older patients and those who presented better performance in the task throughout the trial (possibly indicating greater engagement and activation of the DLPFC) had greater depression improvement in the combined treatment group. Limitations Our exploratory findings should be further confirmed in prospective controlled trials. Discussion CCT and tDCS combined might be beneficial for older depressed patients, particularly for those who have cognitive resources to adequately learn and improve task performance over time. This combined therapy might be specifically relevant in this subgroup that is more prone to present cognitive decline and prefrontal cortical atrophy.
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- 2014
16. The influence of the day of the week of hospital admission on the prognosis of stroke patients
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Juliana B, Barros, Alessandra Carvalho, Goulart, Airlane P, Alencar, Paulo A, Lotufo, and Isabela M, Bensenor
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Adult ,Aged, 80 and over ,Male ,Time Factors ,Middle Aged ,Prognosis ,Hospitalization ,Stroke ,Survival Rate ,Educational Status ,Humans ,Female ,Hospital Mortality ,Intracranial Hemorrhages ,Aged - Abstract
This study aimed to evaluate the weekday and weekend distribution of stroke case hospital admissions and their respective prognosis based on a sample from the Estudo de Mortalidade e Morbidade do Acidente Vascular Cerebral (EMMA), a cohort of stroke patients admitted to a community hospital in the city of São Paulo, Brazil. We ascertained all consecutive cases of first-time strokes between April 2006 and December 2008 and performed a subsequent one-year follow-up. No association was found between frequency of hospital admissions due to ischemic and hemorrhagic strokes and the specific day of the week on which the admission occurred. However, ten-day and twelve-month case-fatality was higher in hemorrhagic stroke patients admitted at the weekend. We also found that intracerebral hemorrhage patients admitted on weekends had a worse survival rate (50%) compared with those admitted during weekdays (25.6%, P log-rank = 0.03). We found a multivariate hazard ratio of 2.49 (95%CI: 1.10-5.81, P trend = 0.03) for risk of death at the weekend compared to weekdays for intracerebral hemorrhage cases. No difference in survival was observed with respect to the overall sample of stroke or ischemic stroke patients.
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- 2012
17. A reappraisal in São Paulo, Brazil (2008) of 'The Ecology of Medical Care:' The 'One Per Thousand's Rule'
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Adriana, Roncoletta, Gustavo D, Gusso, Isabela M, Bensenor, and Paulo A, Lotufo
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Adult ,Male ,Primary Health Care ,Health Maintenance Organizations ,Health Services ,Middle Aged ,Hospitalization ,Interviews as Topic ,Cross-Sectional Studies ,Health Care Surveys ,Surveys and Questionnaires ,Humans ,Female ,Emergency Service, Hospital ,Delivery of Health Care ,Referral and Consultation ,Brazil ,Aged - Abstract
Medical ecology is a conceptual framework introduced in 1961 to describe the relationship and utilization of health care services by a given population. We applied this conception to individuals enrolled in a private health maintenance organization (HMO) in Sao Paulo, Brazil, with the aim of describing the utilization of primary health care, verifying the frequency of various symptoms, and identifying the roles of different health care sources.This was a cross-sectional telephone survey among a random sample of people enrolled in a private HMO. We interviewed a random sample of non-pregnant adults over age 18 using 10 questions about symptoms and health care use during the month prior to interview.The final sample consisted of 1,065 participants (mean age 68 years, 68% female). From this sample, 424 (39.8%) reported the presence of symptoms, 311 (29.2%) had a medical office consult, 104 (9.8%) went directly to an emergency medical department, 63 (5.9%) were hospitalized, 22 (2.1%) used complementary medicine resources, seven (0.7%) were referred to home care, and one (0.1%) was admitted to an academic hospital.The proportion of study participants referred to an academic care center was similar to that observed in previous "medical ecology" studies in different populations.
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- 2012
18. [Chronic non-communicable diseases in Brazil: priorities for disease management and research]
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Bruce Bartholow, Duncan, Dóra, Chor, Estela M L, Aquino, Isabela M, Bensenor, José Geraldo, Mill, Maria Inês, Schmidt, Paulo Andrade, Lotufo, Alvaro, Vigo, and Sandhi Maria, Barreto
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Adult ,Male ,Health Priorities ,Respiratory Tract Diseases ,Public Policy ,Middle Aged ,Cohort Studies ,Cardiovascular Diseases ,Risk Factors ,Neoplasms ,Chronic Disease ,Diabetes Mellitus ,Humans ,Female ,Obesity ,Public Health ,Brazil ,Aged - Abstract
Chronic Non-Communicable Diseases are the main source of disease burden in Brazil. In 2011, the Brazilian Ministry of Health launched the Strategic Plan of Action for Management of Chronic Non-Communicable Diseases focusing on population-based interventions to manage cardiovascular diseases, diabetes, cancer, and chronic respiratory diseases mainly through fighting tobacco use, unhealthy diets, physical inactivity and the harmful use of alcohol. Although a significant number of scientific studies on chronic diseases and their risk factors have been undertaken in Brazil, few are of cohort design. In this context, the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), a cohort study of 15,105 Brazilian public servants reflects the reality of high prevalences of diabetes, hypertension and the main chronic diseases risk factors. The diversity of information that the Study will produce can provide important input to better understand the causes of chronic diseases and to support public policies for fighting them.
- Published
- 2012
19. Validation of the short-version of Rose Angina Questionnaire in Brazil
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Maria-Socorro, Bastos, Paulo A, Lotufo, Aristarcho L, Whitaker, and Isabela M, Bensenor
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Adult ,Male ,Reproducibility of Results ,Middle Aged ,Angina Pectoris ,Predictive Value of Tests ,Surveys and Questionnaires ,Exercise Test ,Humans ,Female ,Translations ,Brazil ,Aged ,Language - Abstract
Stable angina pectoris is a serious condition with few epidemiological studies in Brazil.To validate the short-version of the Rose angina questionnaire in Brazilian Portuguese for its implementation in surveys and longitudinal studies.A total of 116 consecutive patients from an outpatient clinic without prior myocardial infarction and/or coronary revascularization were enrolled for application of three questions of the Rose angina questionnaire addressing chest pain after exertion. We used the treadmill test as the gold standard with the Ellestad protocol.The short-version of the Rose angina questionnaire of the 116 subjects submitted to the exercise treadmill test disclosed 89.7% of accuracy, 25% of sensitivity, 92.0% of specificity, 10.0% of positive predictive value, 97.2% of negative predictive value, and 3.1 of positive likelihood ratio and 0.82 of negative likelihood ratio.The Portuguese version with three items of the Rose angina questionnaire is suitable for epidemiological purposes.
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- 2012
20. Potent antiretroviral therapy for human immunodeficiency virus infection increases aortic stiffness
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Margareth, Eira, Isabela M, Bensenor, Egidio Lima, Dorea, Roberto Sá, Cunha, José Geraldo, Mill, and Paulo A, Lotufo
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Adult ,Male ,Chi-Square Distribution ,Age Factors ,HIV Infections ,Organ Size ,Middle Aged ,Pulse Wave Analysis ,Cross-Sectional Studies ,Sex Factors ,Vascular Stiffness ,Cardiovascular Diseases ,Risk Factors ,Antiretroviral Therapy, Highly Active ,Humans ,Female - Abstract
Highly active antiretroviral therapy for AIDS is known to increase cardiovascular risk, but the effects of potent antiretroviral agents according to gender are unknown.The present study evaluated the impact of HIV infection treatment on aortic stiffness according to gender.From university-affiliated hospitals, we recruited 28 AIDS patients undergoing highly active antiretroviral treatment (HAART), 28 treatment-naïve HIV-infected patients, 44 patients with type 2 diabetes, and 30 controls. Aortic stiffness was determined by measuring pulse wave velocity (PWV) using a validated and non-invasive automatic device.The crude mean PWV values and 95% confidence intervals (95% CI) for HAART, diabetics, and controls were 9.77 m/s (95% CI 9.17-10.36), , 9.00 m/s (95% CI 8.37-9.63), 9.90 m/s (95% CI 9.32-10.49), and 9.28 m/s (95% CI 8.61-9.95), respectively, for men (P-value for trend = 0.14), and 9.61 m/s (95% CI 8.56-10.66), 8.45 m/s (95% CI 7.51-9.39), 9.83 (95% CI 9.21-10.44), and 7.79 m/s (95% CI 6.99-8.58), respectively, for women (P-value for trend0.001). Post-hoc analysis revealed a significant difference between the mean PWV values in the HAART group and controls in women (P-value0.01). After adjusting for other potential covariates, including systolic blood pressure and diabetes, these results did not change. The findings indicate that the impact of HAART treatment on aortic stiffness was amplified in women with hypertension, dyslipidemia, and metabolic syndrome.Potent anti-retroviral agents used in the treatment of HIV infection increases aortic stiffness, mainly among women with higher cardiovascular risk.
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- 2011
21. Hypertension in the city of São Paulo: self-reported prevalence assessed by telephone surveys
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Décio, Mion, Angela M G, Pierin, Isabela M, Bensenor, Júlio César M, Marin, Karla Ryuko Abe, Costa, Luiz Fernando de Oliveira, Henrique, Natália de Pinho, Alencar, Rodrigo do Carmo, Couto, Tales Eduardo, Laurenti, and Thiago Arthur Oliveira, Machado
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Adult ,Interviews as Topic ,Male ,Diagnostic Self Evaluation ,Socioeconomic Factors ,Hypertension ,Prevalence ,Humans ,Female ,Self Report ,Middle Aged ,Brazil - Abstract
Little is known about the prevalence of hypertension in São Paulo, Brazil.To identify the prevalence of self-reported hypertension in the city of São Paulo.There were 613 telephone interviews using directories of household land-lines. The sample was calculated with an estimated prevalence of hypertension in 20.0%.The prevalence of self-reported hypertension was 23.0% and 9.0% of respondents reported that the value of their last pressure measurement was greater than 140/90 mmHg, but they were unaware that they were hypertensive, with a total prevalence 32.0%. Hypertensive patients reported that: 89.0% were under treatment and 35.2% were controlled; 27.0% miss medical appointments; 16.2% stop taking drugs; 14.8% have a history of stroke; 27.8% had heart disease and 38.7% had hypercholesterolemia; 71.2% received advice to reduce salt, 64.6% to perform physical activity, 60.0% to lose weight loss and 26.2% to control stress; and 78.9% measured pressure regularly. There was a statistically significant relation (p0.05) for: 1) missing medical appointments with longer treatment and irregular health monitoring; 2) stop taking the drugs with smoking, alcohol and failure to monitor health; 3) carry out treatment for hypertension with dyslipidemia, higher age and longer use of contraceptives for women; and 4) body mass index changed with diabetes, hypercholesterolemia, uncontrolled systolic blood pressure and use of more than one anti-hypertension drug.The prevalence of self-reported hypertension in the city of São Paulo resembles the prevalence found in other studies.
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- 2008
22. Higher burden of hemorrhagic stroke among women. An autopsy-based study in São Paulo, Brazil
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Vânia N, Aikawa, Alberto P, Bambirra, Luciana A, Seoane, Isabela M, Bensenor, and Paulo A, Lotufo
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Adult ,Male ,Stroke ,Death, Sudden ,Cause of Death ,Humans ,Female ,Autopsy ,Middle Aged ,Sex Distribution ,Intracranial Hemorrhages ,Brazil ,Aged - Abstract
The aim of this study was to verify the gender difference in sudden cardiovascular death, mainly comparing brain infarction and hemorrhagic stroke. We analyzed 970 autopsy cases from a total of 3,802 nonviolent deaths (448 considered as sudden deaths, 296 undetermined, and 226 non-sudden deaths) including patients aged 30-69 years. All cardiovascular diseases were responsible for 69% of sudden deaths, and all types of stroke for only 14%. The proportions of sudden death for all cardiovascular diseases, coronary heart disease and ischemic stroke deaths were similar for both sexes. However, sudden deaths due to all types of stroke (women 20.0%; men 11.1%; p = 0.012) and hemorrhagic stroke (women 15.6%; men 7.9%; p = 0.019) were significantly more frequent among women when compared to men, the main cause being subarachnoid hemorrhage (women 5.6%; men 1.0%; p = 0.011). Hemorrhagic stroke deaths were usually sudden deaths among women.
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- 2005
23. Blood pressure behaviour in chronic daily headache
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D Mion, Paulo A. Lotufo, Milton A. Martins, and I. M. Bensenor
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Adult ,Ambulatory blood pressure ,Adolescent ,Cross-sectional study ,Headache Disorders ,Diastole ,Monitoring, Ambulatory ,Blood Pressure ,Daily headache ,Medicine ,Humans ,Aged ,Analysis of Variance ,business.industry ,Significant difference ,Outcome measures ,General Medicine ,Middle Aged ,Blood pressure ,Chronic disease ,Cross-Sectional Studies ,Anesthesia ,Chronic Disease ,Hypertension ,Female ,Neurology (clinical) ,business - Abstract
The objective was to examine the association between high blood pressure (BP) and chronic daily headache using 24-h ambulatory blood pressure monitorization (24-h ABPM). This was a cross sectional study in an out-patient clinic. Women were selected among patients referred for first evaluation, 62 with chronic daily headache and 57 without chronic daily headache. The main outcome measures were mean office systolic and diastolic blood pressure (BP), mean systolic and diastolic daytime and night-time BP and BP load, and mean systolic and diastolic nocturnal fall. Office systolic BP was 138.2 mmHg for women with chronic daily headache and 141.7 mmHg for women without headache ( P = 0.36). Office diastolic BP was 88.9 mmHg for women with headache and 92.7 mmHg for women without headache ( P = 0.17). Mean daytime and mean night-time systolic BP was, respectively, 122.2 mmHg and 108.8 mmHg for women with headache and 122.9 mmHg and 109.5 for women without headache ( P = 0.82 and P = 0.80, respectively). Mean daytime and mean night-time diastolic BP was, respectively, 78.6 mmHg and 65.4 mmHg for women with headache and 79.9 mmHg and 67.1 mmHg for the women without headache ( P = 0.80 and P = 0.45, respectively). There was no difference between the two groups regarding systolic and diastolic BP load and nocturnal systolic and diastolic fall. No significant difference in BP values was observed in women with chronic daily headache compared with women without headache using 24-h ABPM.
- Published
- 2002
24. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019
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Sorin Hostiuc, Shaun Wen Huey Lee, Jorge R. Ledesma, Carsten Flohr, Masoumeh Sadeghi, João Mauricio Castaldelli-Maia, Behzad Karami Matin, Cyrus Alinia, Mehdi Bohluli, Félix Carvalho, Yun Jin Kim, Catalina Liliana Andrei, Seyyed Meysam Mousavi, Bernhard T. Baune, Ehsan Ahmadpour, Dinh-Toi Chu, Beatrix Haddock, Gianfranco Alicandro, Vasily Vlassov, Mohammad Taghi Khodayari, Gianna Gayle Herrera Amul, Arash Tehrani-Banihashemi, Govinda Prasad Dhungana, Fereshteh Ansari, Michael K. Hole, Azeem Majeed, Iman Halvaei, Saqib Ali, Arianna Maever L. Amit, Tomas Y. Yeheyis, John S. Ji, Martin McKee, Jamileh Shadid, Leonardo Roever, Peng Jia, Ettore Beghi, Pablo M. Lavados, Young Eun Kim, Vahid Alipour, Sowmya J. Rao, Ahmad Daryani, Cathleen Keller, Ibrahim Abdollahpour, Nicole K. DeCleene, Ebrahim Babaee, Saman Esmaeilnejad, Boris Bikbov, William M. Gardner, Lydia M. Haile, Luca Ronfani, Azalea M. Thomson, Irena Ilic, Ruth W. Kimokoti, Yingxi Zhao, Guoqing Hu, Mehran Shams-Beyranvand, Ilais Moreno Velásquez, Nathaniel J. Henry, Brijesh Sathian, Daniel Kim, Peter Memiah, Mohammad Hadi Abbasi, Andrea Farioli, Zahra Kamiab, Bolajoko O. Olusanya, Matthew C. Doxey, Tommi Vasankari, Hamideh Salimzadeh, Luisa Sorio Flor, Priya Rathi, Shanshan Li, Tanvir M. Huda, Dillon O Sylte, Rosario Cárdenas, Agegnehu Bante, Helen Ippolito, Alyssa Acebedo, Jeffrey D. Stanaway, Anwar Faraj, João Pedro Silva, Amin Mousavi Khaneghah, Pushpendra Kumar, Sangram Kishor Patel, Josephine W. Ngunjiri, Holly E. Erskine, Eugene Sobngwi, Filippo Ariani, Shane D. Morrison, Mohammad Aghaali, Meghan D. Mooney, Vera Marisa Costa, Palash Chandra Banik, Rupak Desai, Ken Takahashi, Maigeng Zhou, Morteza Oladnabi, Bogdan Oancea, Daniela Ribeiro, Mohammad Farahmand, Irmina Maria Michalek, Yetunde O. John-Akinola, Khem Narayan Pokhrel, Emilie R Maddison, Syed Mohamed Aljunid, Damian G. Hoy, Hosni Salem, V. Prakash, Shuhei Nomura, Inga Dora Sigfusdottir, Anders Larsson, Sharareh Eskandarieh, Abdollah Mohammadian-Hafshejani, Somayeh Bohlouli, Joana Morgado-da-Costa, Siamak Sabour, Theo Vos, Han Yong Wunrow, Khaled Khatab, Alireza Zangeneh, Ann Kristin Knudsen, Marissa B Reitsma, Hannah J. Henrikson, Randah R. Hamadeh, Tuomo J. Meretoja, Ireneous N. Soyiri, Giuseppe Grosso, Ziyad Al-Aly, Taraneh Yousefinezhadi, Joseph L Ward, Roba Khundkar, Ricardo Santiago Gomez, Reza Malekzadeh, John J. McGrath, Sandra B. Munro, Shahin Soltani, Amy E. Peden, Rufus Akinyemi, Marcel Ausloos, Naohiro Yonemoto, Bogdan Wojtyniak, Ahmad Ghashghaee, Guilherme Borges, Sadia Bibi, Farhad Islami, Hamed Mirzaei, Mohammad Ali Sahraian, M. Ashworth Dirac, Hosna Janjani, Kairat Davletov, Hermann Brenner, Yuichiro Yano, Elissa M. Abrams, Ana Vukovic, Bartosz Miazgowski, Jobert Richie Nansseu, Jennifer O Lam, Mona Pathak, Leeberk Raja Inbaraj, Thirunavukkarasu Sathish, Asadollah Gholamian, Carlos A Castañeda-Orjuela, Babak Eshrati, Edgar Denova-Gutiérrez, Atte Meretoja, Lorenzo Monasta, Ronan A. Lyons, Neda Kianipour, Desalegn Getnet Demsie, Yasir Waheed, Desta Debalkie Atnafu, Davide Sattin, Kevin S Ikuta, Ghobad Moradi, Srinivas Goli, Krittika Bhattacharyya, Mika Kivimäki, Christopher Troeger, Jordi Alonso, Alireza Ahmadi, Navid Manafi, Caroline Stein, Songhomitra Panda-Jonas, Jason Nguyen, Moses K. Muriithi, Aziz Rezapour, Ismael R. Campos-Nonato, Adrian Pana, H. Dean Hosgood, Noore Alam, James L. Fisher, Mariam Molokhia, Susan F. Rumisha, Ernoiz Antriyandarti, Ayman Grada, Emma Nichols, Babak Asghari, André Luiz Sena Guimarães, Ferrán Catalá-López, Aletta E. Schutte, Fiona B. Bennitt, Maciej Banach, Antonio Biondi, Donal Bisanzio, Josip Car, Ronny Westerman, Shafiu Mohammed, Biniyam Sahiledengle Geberemariyam, Kenji Shibuya, Meghdad Pirsaheb, Milena Santric-Milicevic, Karen M. Tabb, Paula Moraga, Soheil Hassanipour, Hasan Yusefzadeh, Avina Vongpradith, Dara K. Mohammad, Ralph Maddison, Babak Moazen, Getachew Mullu Kassa, Rahman Shiri, Fernando Neves Hugo, Hmwe H Kyu, Zachary V Dingels, Florian Fischer, Valentin Yurievich Skryabin, Rafael Tabarés-Seisdedos, Massimo Cirillo, Nikita Otstavnov, Robert C. Reiner, Van C. Lansingh, Rodrigo Sarmiento-Suarez, Ashkan Afshin, Benjamin A Stark, Mohsen Abbasi-Kangevari, Natalie C. Galles, Behnam Heidari, Eun-Kee Park, Mohammad Ali Jahani, Suzanne Polinder, Mahalaqua Nazli Khatib, Farhad Jadidi-Niaragh, Amir Radfar, Mowafa Househ, Derrick A Bennett, Gaorui Guo, Hesam Ghiasvand, Taweewat Wiangkham, Tamás Joó, Cristiana Abbafati, Kathryn Mei Ming Lau, Anita K. Nandi, Miklós Szócska, Manasi Kumar, Eduardo A. Undurraga, Oladimeji M. Adebayo, Simon Yadgir, Victor Aboyans, Justin J. Lang, Catherine O. Johnson, Soewarta Kosen, Carla Sofia e.Sá Farinha, Marcos Roberto Tovani-Palone, Kamarul Imran Musa, Farshad Pourmalek, Kiomars Sharafi, Heather Orpana, Samuel B. Albertson, Mahdi Afshari, Nicholas J K Breitborde, Nelson J. Alvis-Zakzuk, Adrian Oţoiu, Iván Landires, Robert G. Weintraub, Kidanemaryam Berhe, André Faro, Sophia Emmons-Bell, Lauren E. Schaeffer, Alexandre C. Pereira, Mehdi Naderi, Yordanos Gizachew Yeshitila, Mehdi Hosseinzadeh, Arash Etemadi, Oleguer Plana-Ripoll, Theodore Patrick Younker, Joemer C. Maravilla, Alireza Ansari-Moghaddam, Borhan Mansouri, Narayanaswamy Venketasubramanian, Seyed Mohammad Kazem Aghamir, Linda Morales, Amanda Deen, Noushin Mohammadifard, Obinna Onwujekwe, Ai Koyanagi, Michele Nguyen, Chieh Han, Kiana Ramezanzadeh, Mika Shigematsu, Mohammed Shannawaz, Khurshid Alam, Javad Nazari, Bryan L. Sykes, Rajat Das Gupta, Stephen S Lim, Lingkan Barua, Zubair Kabir, Michael Brauer, Afarin Rahimi-Movaghar, Deepa Jahagirdar, Kaja Abbas, Gholamreza Bazmandegan, Mark A. Stokes, Rajaa Al-Raddadi, Kanyin L. Ong, Kate Causey, Ahmed Omar Bali, Matilde Leonardi, Jeffrey V. Lazarus, Wondimeneh Shibabaw Shiferaw, André Karch, Blair R. Bumgarner, Nelson Alvis-Guzman, Jennifer H MacLachlan, Saeed Amini, Parvaiz A Koul, Blessing J. Akombi, Ro Ting Lin, Dabere Nigatu, Alaa Badawi, Flavia M. Cicuttini, Deanna Anderlini, Claudio Alberto Dávila-Cervantes, Rupert R A Bourne, Tanuj Kanchan, Catherine P. Benziger, Tahiya Alam, M. Mofizul Islam, Muktar Omer Omer, Leila Zaki, Mehdi Mirzaei-Alavijeh, Inbal Salz, Katharine J Looker, Shiwei Liu, Fatemeh Amiri, Christopher R. Cederroth, Mitra Abbasifard, Hamidreza Pazoki Toroudi, Gbenga A. Kayode, Antonio Luiz Pinho Ribeiro, Krishna Kumar Aryal, Mu'awiyyah Babale Sufiyan, Mohamed M. Gad, Assefa Desalew, Lidia Morawska, Davood Anvari, Mohammad Reza Salahshoor, Hadi Pourjafar, Abdu A. Adamu, Maryam Adabi, Zulfiqar A. Bhutta, Jessica A. Cruz, Foad Abd-Allah, Amir Hasanzadeh, Jordan Weiss, Maryam Ghadimi, Seyed-Mohammad Fereshtehnejad, Serge Resnikoff, Joanna L Whisnant, Kelly Compton, Priya Parmar, Sanjay Basu, Leila R Kalankesh, Nickolas Reinig, Ana Maria Mantilla Herrera, Fatemeh Rajati, Damian Santomauro, Mojisola Oluwasanu, Sheikh Mohammed Shariful Islam, David M. Pereira, Joht Singh Chandan, Deepak Kumar Pasupula, Aristidis Tsatsakis, Hoa Thi Do, Whitney L. Teagle, Hans W. Hoek, James Leigh, Morteza Arab-Zozani, Yasser Vasseghian, Stephanie R M Zimsen, Charlie Ashbaugh, Fariba Dorostkar, Abdelrahman Ibrahim Abushouk, Mikk Jürisson, Golnaz Heidari, Kala M. Mehta, Saeed Shahabi, Sarah Wulf Hanson, Nizal Sarrafzadegan, Dharmesh Kumar Lal, Hai Quang Pham, Aleksandr Y. Aravkin, Joshua A. Salomon, David C. Schwebel, Milena Ilic, Kareha M Agesa, Jost B. Jonas, Dian Kusuma, Benjamin B. Massenburg, Santosh Varughese, Yousef Mohammad, Beatriz Paulina Ayala Quintanilla, Mihaela Hostiuc, Richard G. Cowden, Morteza Shamsizadeh, Thomas Pilgrim, Alessandra C. Goulart, Leila Doshmangir, Gabriele Nagel, Saravanan Muthupandian, Zahra Sadat Dibaji Forooshani, Maryam Mirzaei, Zabihollah Yousefi, Shadrach Wilson, Iman El Sayed, Juanita A. Haagsma, Segun Emmanuel Ibitoye, Eirini Skiadaresi, Reza Shirkoohi, Tim Driscoll, Morteza Jafarinia, Maha El Tantawi, Telma Zahirian Moghadam, Katarzyna Kissimova-Skarbek, Abdilahi Yousuf Yousuf, Dickson A. Amugsi, Awoke Misganaw, Maseer Khan, Norito Kawakami, Jingkai Wei, Jai K Das, Vishnu Renjith, Tessa M. Pilz, Sameer Vali Gopalani, Roghiyeh Faridnia, Islam Y. Elgendy, Prateek Rastogi, Lauren B. Wilner, Josep Maria Haro, Zahiruddin Quazi Syed, Ben Lacey, Ketema Bizuwork Gebremedhin, Sam Rolfe, Iffat Elbarazi, Yannick Béjot, Raimundas Lunevicius, Sezer Kisa, Harish Chander Gugnani, Basema Saddik, Manu Raj Mathur, Mansour Ghafourifard, Riaz Uddin, Anna Poznańska, Faris Lami, Niguse Meles Alema, Michael T. Chung, Arya Aminorroaya, Arash Sarveazad, Erkin M. Mirrakhimov, Seyed Hossein Yahyazadeh Jabbari, João M. Furtado, Hamid Ahmadieh, Sara Conti, Yunquan Zhang, Manthan D Janodia, Aislyn U. Orji, S. Mohammad Sajadi, Jalal Arabloo, Gabrielle B. Britton, Colm McAlinden, Francisco Rogerlândio Martins-Melo, Simona Cătălina Ştefan, Ester Cerin, Nuno Taveira, Lars Jacob Stovner, Amir Taherkhani, Masoud Foroutan, Tomasz Miazgowski, Amir Manafi, Yeshambel T. Nigatu, Barthelemy Kuate Defo, Mithila Faruque, Alan D. Lopez, Man Mohan Mehndiratta, Graeme J. Hankey, Mojgan Gitimoghaddam, Chantal Huynh, G Anil Kumar, Martin Amogre Ayanore, Abbas Sheikhtaheri, Turki Alanzi, Simon Øverland, David Laith Rawaf, Brian J. Hall, Edward J Mills, Ali Kabir, Ravi Prakash Jha, Akbar Barzegar, Simin Mouodi, Alize J. Ferrari, Chirag P. Doshi, Saleh Salehi Zahabi, Mohsen Naghavi, Mohammad Hassan Emamian, Amir Jalali, Chukwudi A Nnaji, Kebadnew Mulatu Mihretie, Maarten J. Postma, David Edvardsson, Chhabi Lal Ranabhat, Catherine M. Antony, Hannah Han, Ken Lee Chin, Getinet Ayano, Kewal Krishan, Maryam Zamanian, Farshad Farzadfar, Ali A. Asadi-Pooya, Daniel Diaz, Oliver J. Brady, Mohsen Bayati, Christopher M Odell, Jalil Jaafari, Walter Mendoza, Susanna Dunachie, Raffaele Palladino, Raaj Kishore Biswas, Alessandra Lugo, Reshmi Bhageerathy, Paulo A. Lotufo, Maia Kereselidze, Salman Rawaf, Olayinka Stephen Ilesanmi, Mousa Yaminfirooz, Neeraj Bedi, Mahesh P A, Harvey Whiteford, Gina Agarwal, Pallab K. 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L., Department of Public Health, Clinicum, Department of Neurosciences, HUS Comprehensive Cancer Center, Environmental Sciences, Public Health, Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Microbes in Health and Disease (MHD), Sálfræðideild (HR), Department of Psychology (RU), Samfélagssvið (HR), School of Social Sciences (RU), Háskólinn í Reykjavík, Reykjavik University, GBD 2019 Diseases and Injuries Collaborator, Violante FS, Department of Earth Observation Science, Faculty of Geo-Information Science and Earth Observation, and UT-I-ITC-ACQUAL
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Male ,Life expectancy ,Disability-Adjusted Life Year ,Diseases ,Disease ,communicable disease ,systematic analysis ,Global Burden of Disease ,0302 clinical medicine ,80 and over ,Medicine ,10. No inequality ,Child ,11 Medical and Health Sciences ,injuries ,Aged, 80 and over ,education.field_of_study ,Sjúkdómar ,DEMENTIA ,FALLS ,General Medicine ,Forvarnir ,3. Good health ,Child, Preschool ,Human ,GBD ,Population health ,03 medical and health sciences ,SDG 3 - Good Health and Well-being ,Humans ,Global Burden of Disease Study ,education ,Aged ,Spatial Analysis ,Global burden ,Disability ,Prevention ,DISABILITY ,Infant ,Spatial Analysi ,Mortality rate ,Global Burden of Disease, Diseases, Injuries, Systematic analysis ,PREVENTION ,Years of potential life lost ,Risk factors ,Disease study ,ITC-ISI-JOURNAL-ARTICLE ,RISK-FACTORS ,Clinical Medicine ,RA ,Demography ,Fötlun ,Dánartíðni ,Áhættuþættir ,030204 cardiovascular system & hematology ,Risk Factors ,Cause of Death ,Global health ,030212 general & internal medicine ,1. No poverty ,Disability-Adjusted Life Years ,Public Health, Global Health, Social Medicine and Epidemiology ,Middle Aged ,3142 Public health care science, environmental and occupational health ,Adolescent ,Adult ,Age Distribution ,Female ,Infant, Newborn ,Young Adult ,Lýðheilsa ,CLINICAL-TRIALS ,Population ,Settore MED/01 - Statistica Medica ,diseases ,ITC-HYBRID ,Heilbrigðisvísindi ,General & Internal Medicine ,Mortality ,Preschool ,Disease burden ,business.industry ,Risk Factor ,Klinisk medicin ,Newborn ,purl.org/pe-repo/ocde/ford#3.02.00 [https] ,Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi ,Áverkar ,Systematic analysis ,NA ,business - Abstract
Publisher's version (útgefin grein), Background In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990-2010 time period, with the greatest annualised rate of decline occurring in the 0-9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10-24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10-24 years were also in the top ten in the 25-49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50-74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and development investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Copyright (C) 2020 The Author(s). Published by Elsevier Ltd., Research reported in this publication was supported by the Bill & Melinda Gates Foundation; the University of Melbourne; Queensland Department of Health, Australia; the National Health and Medical Research Council, Australia; Public Health England; the Norwegian Institute of Public Health; St Jude Children's Research Hospital; the Cardiovascular Medical Research and Education Fund; the National Institute on Ageing of the National Institutes of Health (award P30AG047845); and the National Institute of Mental Health of the National Institutes of Health (award R01MH110163). The content is solely the responsibility of the authors and does not necessarily represent the official views of the funders. The authors alone are responsible for the views expressed in this Article and they do not necessarily represent the views, decisions, or policies of the institutions with which they are affiliated, the National Health Service (NHS), the National Institute for Health Research (NIHR), the UK Department of Health and Social Care, or Public Health England; the United States Agency for International Development (USAID), the US Government, or MEASURE Evaluation; or the European Centre for Disease Prevention and Control (ECDC). This research used data from the Chile National Health Survey 2003, 2009-10, and 2016-17. The authors are grateful to the Ministry of Health, the survey copyright owner, for allowing them to have the database. All results of the study are those of the authors and in no way committed to the Ministry. The Costa Rican Longevity and Healthy Aging Study project is a longitudinal study by the University of Costa Rica's Centro Centroamericano de Poblacion and Instituto de Investigaciones en Salud, in collaboration with the University of California at Berkeley. The original pre-1945 cohort was funded by the Wellcome Trust (grant 072406), and the 1945-55 Retirement Cohort was funded by the US National Institute on Aging (grant R01AG031716). The principal investigators are Luis Rosero-Bixby and William H Dow and co-principal investigators are Xinia Fernandez and Gilbert Brenes. The accuracy of the authors' statistical analysis and the findings they report are not the responsibility of ECDC. ECDC is not responsible for conclusions or opinions drawn from the data provided. ECDC is not responsible for the correctness of the data and for data management, data merging and data collation after provision of the data. ECDC shall not be held liable for improper or incorrect use of the data. The Health Behaviour in School-Aged Children (HBSC) study is an international study carried out in collaboration with WHO/EURO. The international coordinator of the 1997-98, 2001-02, 2005-06, and 2009-10 surveys was Candace Currie and the databank manager for the 1997-98 survey was Bente Wold, whereas for the following surveys Oddrun Samdal was the databank manager. A list of principal investigators in each country can be found on the HBSC website. Data used in this paper come from the 2009-10 Ghana Socioeconomic Panel Study Survey, which is a nationally representative survey of more than 5000 households in Ghana. The survey is a joint effort undertaken by the Institute of Statistical, Social and Economic Research (ISSER) at the University of Ghana and the Economic Growth Centre (EGC) at Yale University. It was funded by EGC. ISSER and the EGC are not responsible for the estimations reported by the analysts. The Palestinian Central Bureau of Statistics granted the researchers access to relevant data in accordance with license number SLN2014-3-170, after subjecting data to processing aiming to preserve the confidentiality of individual data in accordance with the General Statistics Law, 2000. The researchers are solely responsible for the conclusions and inferences drawn upon available data. Data for this research was provided by MEASURE Evaluation, funded by USAID. The authors thank the Russia Longitudinal Monitoring Survey, conducted by the National Research University Higher School of Economics and ZAO Demoscope together with Carolina Population Center, University of North Carolina at Chapel Hill and the Institute of Sociology, Russia Academy of Sciences for making data available. This paper uses data from the Bhutan 2014 STEPS survey, implemented by the Ministry of Health with the support of WHO; the Kuwait 2006 and 2014 STEPS surveys, implemented by the Ministry of Health with the support of WHO; the Libya 2009 STEPS survey, implemented by the Secretariat of Health and Environment with the support of WHO; the Malawi 2009 STEPS survey, implemented by Ministry of Health with the support of WHO; and the Moldova 2013 STEPS survey, implemented by the Ministry of Health, the National Bureau of Statistics, and the National Center of Public Health with the support of WHO. This paper uses data from Survey of Health, Ageing and Retirement in Europe (SHARE) Waves 1 (DOI:10.6103/SHARE. w1.700), 2 (10.6103/SHARE.w2.700), 3 (10.6103/SHARE.w3.700), 4 (10.6103/SHARE.w4.700), 5 (10.6103/SHARE.w5.700), 6 (10.6103/SHARE.w6.700), and 7 (10.6103/SHARE.w7.700); see Borsch-Supan and colleagues (2013) for methodological details. The SHARE data collection has been funded by the European Commission through FP5 (QLK6-CT-2001-00360), FP6 (SHARE-I3: RII-CT-2006-062193, COMPARE: CIT5-CT-2005-028857, SHARELIFE: CIT4-CT-2006-028812), FP7 (SHARE-PREP: GA N degrees 211909, SHARE-LEAP: GA N degrees 227822, SHARE M4: GA N degrees 261982) and Horizon 2020 (SHARE-DEV3: GA N degrees 676536, SERISS: GA N degrees 654221) and by DG Employment, Social Affairs & Inclusion. Additional funding from the German Ministry of Education and Research, the Max Planck Society for the Advancement of Science, the US National Institute on Aging (U01_AG09740-13S2, P01_AG005842, P01_AG08291, P30_AG12815, R21_AG025169, Y1-AG-4553-01, IAG_BSR06-11, OGHA_04-064, HHSN271201300071C), and from various national funding sources is gratefully acknowledged. This study has been realised using the data collected by the Swiss Household Panel, which is based at the Swiss Centre of Expertise in the Social Sciences. The project is financed by the Swiss National Science Foundation. The United States Aging, Demographics, and Memory Study is a supplement to the Health and Retirement Study (HRS), which is sponsored by the National Institute of Aging (grant number NIA U01AG009740). It was conducted jointly by Duke University and the University of Michigan. The HRS is sponsored by the National Institute on Aging (grant number NIA U01AG009740) and is conducted by the University of Michigan. This paper uses data from Add Health, a program project designed by J Richard Udry, Peter S Bearman, and Kathleen Mullan Harris, and funded by a grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, with cooperative funding from 17 other agencies. Special acknowledgment is due to Ronald R Rindfuss and Barbara Entwisle for assistance in the original design. Information on how to obtain the Add Health data files is available on the Add Health website. No direct support was received from grant P01-HD31921 for this analysis. The data reported here have been supplied by the United States Renal Data System. The interpretation and reporting of these data are the responsibility of the authors and in no way should be seen as an official policy or interpretation of the US Government. Collection of data for the Mozambique National Survey on the Causes of Death 2007-08 was made possible by USAID under the terms of cooperative agreement GPO-A-00-08-000_D3-00. This manuscript is based on data collected and shared by the International Vaccine Institute (IVI) from an original study IVI conducted. L G Abreu acknowledges support from Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (Brazil; finance code 001) and Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq, a Brazilian funding agency). I N Ackerman was supported by a Victorian Health and Medical Research Fellowship awarded by the Victorian Government. O O Adetokunboh acknowledges the South African Department of Science and Innovation and the National Research Foundation. A Agrawal acknowledges the Wellcome Trust DBT India Alliance Senior Fellowship. S M Aljunid acknowledges the Department of Health Policy and Management, Faculty of Public Health, Kuwait University and International Centre for Casemix and Clinical Coding, Faculty of Medicine, National University of Malaysia for the approval and support to participate in this research project. M Ausloos, C Herteliu, and A Pana acknowledge partial support by a grant of the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084. A Badawi is supported by the Public Health Agency of Canada. D A Bennett was supported by the NIHR Oxford Biomedical Research Centre. R Bourne acknowledges the Brien Holden Vision Institute, University of Heidelberg, Sightsavers, Fred Hollows Foundation, and Thea Foundation. G B Britton and I Moreno Velasquez were supported by the Sistema Nacional de Investigacion, SNI-SENACYT, Panama. R Buchbinder was supported by an Australian National Health and Medical Research Council (NHMRC) Senior Principal Research Fellowship. J J Carrero was supported by the Swedish Research Council (2019-01059). F Carvalho acknowledges UID/MULTI/04378/2019 and UID/QUI/50006/2019 support with funding from FCT/MCTES through national funds. A R Chang was supported by National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases grant K23 DK106515. V M Costa acknowledges the grant SFRH/BHD/110001/2015, received by Portuguese national funds through Fundacao para a Ciencia e Tecnologia, IP, under the Norma Transitaria DL57/2016/CP1334/CT0006. A Douiri acknowledges support and funding from the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South London at King's College Hospital NHS Foundation Trust and the Royal College of Physicians, and support from the NIHR Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust and King's College London. B B Duncan acknowledges grants from the Foundation for the Support of Research of the State of Rio Grande do Sul (IATS and PrInt) and the Brazilian Ministry of Health. H E Erskine is the recipient of an Australian NHMRC Early Career Fellowship grant (APP1137969). A J Ferrari was supported by a NHMRC Early Career Fellowship grant (APP1121516). H E Erskine and A J Ferrari are employed by and A M Mantilla-Herrera and D F Santomauro affiliated with the Queensland Centre for Mental Health Research, which receives core funding from the Queensland Department of Health. M L Ferreira holds an NHMRC Research Fellowship. C Flohr was supported by the NIHR Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust. M Freitas acknowledges financial support from the EU (European Regional Development Fund [FEDER] funds through COMPETE POCI-01-0145-FEDER-029248) and National Funds (Fundacao para a Ciencia e Tecnologia) through project PTDC/NAN-MAT/29248/2017. A L S Guimaraes acknowledges support from CNPq. C Herteliu was partially supported by a grant co-funded by FEDER through Operational Competitiveness Program (project ID P_40_382). P Hoogar acknowledges Centre for Bio Cultural Studies, Directorate of Research, Manipal Academy of Higher Education and Centre for Holistic Development and Research, Kalaghatagi. F N Hugo acknowledges the Visiting Professorship, PRINT Program, CAPES Foundation, Brazil. B-F Hwang was supported by China Medical University (CMU107-Z-04), Taichung, Taiwan. S M S Islam was funded by a National Heart Foundation Senior Research Fellowship and supported by Deakin University. R Q Ivers was supported by a research fellowship from the National Health and Medical Research Council of Australia. M Jakovljevic acknowledges the Serbian part of this GBD-related contribution was co-funded through Grant OI175014 of the Ministry of Education Science and Technological Development of the Republic of Serbia. P Jeemon was supported by a Clinical and Public Health intermediate fellowship (grant number IA/CPHI/14/1/501497) from the Wellcome Trust-Department of Biotechnology, India Alliance (2015-20). O John is a recipient of UIPA scholarship from University of New South Wales, Sydney. S V Katikireddi acknowledges funding from a NRS Senior Clinical Fellowship (SCAF/15/02), the Medical Research Council (MC_UU_12017/13, MC_UU_12017/15), and the Scottish Government Chief Scientist Office (SPHSU13, SPHSU15). C Kieling is a CNPq researcher and a UK Academy of Medical Sciences Newton Advanced Fellow. Y J Kim was supported by Research Management Office, Xiamen University Malaysia (XMUMRF/2018-C2/ITCM/00010). K Krishan is supported by UGC Centre of Advanced Study awarded to the Department of Anthropology, Panjab University, Chandigarh, India. M Kumar was supported by K43 TW 010716 FIC/NIMH. B Lacey acknowledges support from the NIHR Oxford Biomedical Research Centre and the BHF Centre of Research Excellence, Oxford. J V Lazarus was supported by a Spanish Ministry of Science, Innovation and Universities Miguel Servet grant (Instituto de Salud Carlos III [ISCIII]/ESF, the EU [CP18/00074]). K J Looker thanks the NIHR Health Protection Research Unit in Evaluation of Interventions at the University of Bristol, in partnership with Public Health England, for research support. S Lorkowski was funded by the German Federal Ministry of Education and Research (nutriCARD, grant agreement number 01EA1808A). R A Lyons is supported by Health Data Research UK (HDR-9006), which is funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, NIHR (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation, and Wellcome Trust. J J McGrath is supported by the Danish National Research Foundation (Niels Bohr Professorship), and the Queensland Health Department (via West Moreton HHS). P T N Memiah acknowledges support from CODESRIA. U O Mueller gratefully acknowledges funding by the German National Cohort Study BMBF grant number 01ER1801D. S Nomura acknowledges the Ministry of Education, Culture, Sports, Science, and Technology of Japan (18K10082). A Ortiz was supported by ISCIII PI19/00815, DTS18/00032, ISCIII-RETIC REDinREN RD016/0009 Fondos FEDER, FRIAT, Comunidad de Madrid B2017/BMD-3686 CIFRA2-CM. These funding sources had no role in the writing of the manuscript or the decision to submit it for publication. S B Patten was supported by the Cuthbertson & Fischer Chair in Pediatric Mental Health at the University of Calgary. G C Patton was supported by an aNHMRC Senior Principal Research Fellowship. M R Phillips was supported in part by the National Natural Science Foundation of China (NSFC, number 81371502 and 81761128031). A Raggi, D Sattin, and S Schiavolin were supported by grants from the Italian Ministry of Health (Ricerca Corrente, Fondazione Istituto Neurologico C Besta, Linea 4-Outcome Research: dagli Indicatori alle Raccomandazioni Cliniche). P Rathi and B Unnikrishnan acknowledge Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal. A L P Ribeiro was supported by Brazilian National Research Council, CNPq, and the Minas Gerais State Research Agency, FAPEMIG. D C Ribeiro was supported by The Sir Charles Hercus Health Research Fellowship (#18/111) Health Research Council of New Zealand. D Ribeiro acknowledges financial support from the EU (FEDER funds through the Operational Competitiveness Program; POCI-01-0145-FEDER-029253). P S Sachdev acknowledges funding from the NHMRC of Australia Program Grant. A M Samy was supported by a fellowship from the Egyptian Fulbright Mission Program. M M Santric-Milicevic acknowledges the Ministry of Education, Science and Technological Development of the Republic of Serbia (contract number 175087). R Sarmiento-Suarez received institutional support from Applied and Environmental Sciences University (Bogota, Colombia) and ISCIII (Madrid, Spain). A E Schutte received support from the South African National Research Foundation SARChI Initiative (GUN 86895) and Medical Research Council. S T S Skou is currently funded by a grant from Region Zealand (Exercise First) and a grant from the European Research Council under the EU's Horizon 2020 research and innovation program (grant agreement number 801790). J B Soriano is funded by Centro de Investigacion en Red de Enfermedades Respiratorias, ISCIII. R Tabares-Seisdedos was supported in part by the national grant PI17/00719 from ISCIII-FEDER. N Taveira was partially supported by the European & Developing Countries Clinical Trials Partnership, the EU (LIFE project, reference RIA2016MC-1615). S Tyrovolas was supported by the Foundation for Education and European Culture, the Sara Borrell postdoctoral programme (reference number CD15/00019 from ISCIII-FEDER). S B Zaman received a scholarship from the Australian Government research training programme in support of his academic career., "Peer Reviewed"
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- 2020
25. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980–2016: a systematic analysis for the Global Burden of Disease Study 2016
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Sorin, Hotez, Peter J, Hoy, Damian G, Huynh, Chantal, Iburg, Kim Moesgaard, Ikeda, Chad, Ileanu, Bogdan Vasile, Irenso, Asnake Ararsa, Irvine, Caleb Mackay Salpeter, Islam, Sheikh Mohammed Shariful, Jacobsen, Kathryn H, Jahanmehr, Nader, Jakovljevic, Mihajlo B, Javanbakht, Mehdi, Jayaraman, Sudha P, Jeemon, Panniyammakal, Jha, Vivekanand, John, Denny, Johnson, Catherine O, Johnson, Sarah Charlotte, Jonas, Jost B, Jürisson, Mikk, Kabir, Zubair, Kadel, Rajendra, Kahsay, Amaha, Kamal, Ritul, Karch, André, Karimi, Seyed M, Karimkhani, Chante, Kasaeian, Amir, Kassaw, Nigussie Assefa, Kassebaum, Nicholas J, Katikireddi, Srinivasa Vittal, Kawakami, Norito, Keiyoro, Peter Njenga, Kemmer, Laura, Kesavachandran, Chandrasekharan Nair, Khader, Yousef Saleh, Khan, Ejaz Ahmad, Khang, Young-Ho, Khoja, Abdullah Tawfih Abdullah, Khosravi, Mohammad Hossein, Khosravi, Ardeshir, Khubchandani, Jagdish, Kiadaliri, Aliasghar Ahmad, Kieling, Christian, Kievlan, Daniel, Kim, Yun Jin, Kim, Daniel, Kimokoti, 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Nascimento, Bruno Ramo, Nasher, Jamal T, Natarajan, Gopalakrishnan, Negoi, Ionut, Ngunjiri, Josephine Wanjiku, Nguyen, Cuong Tat, Nguyen, Quyen Le, Nguyen, Trang Huyen, Nguyen, Grant, Nguyen, Minh, Nichols, Emma, Ningrum, Dina Nur Anggraini, Nong, Vuong Minh, Noubiap, Jean Jacques N, Ogbo, Felix Akpojene, Oh, In-Hwan, Okoro, Anselm, Olagunju, Andrew Toyin, Olsen, Helen E, Olusanya, Bolajoko Olubukunola, Olusanya, Jacob Olusegun, Ong, Kanyin, Opio, John Nelson, Oren, Eyal, Ortiz, Alberto, Osman, Majdi, Ota, Erika, PA, Mahesh, Pacella, Rosana E, Pakhale, Smita, Pana, Adrian, Panda, Basant Kumar, Panda-Jonas, Songhomitra, Papachristou, Christina, Park, Eun-Kee, Patten, Scott B, Patton, George C, Paudel, Deepak, Paulson, Katherine, Pereira, David M, Perez-Ruiz, Fernando, Perico, Norberto, Pervaiz, Aslam, Petzold, Max, Phillips, Michael Robert, Pigott, David M, Pinho, Christine, Plass, Dietrich, Pletcher, Martin A, Polinder, Suzanne, Postma, Maarten J, Pourmalek, Farshad, Purcell, Caroline, Qorbani, Mostafa, Quintanilla, Beatriz Paulina Ayala, Radfar, Amir, Rahimi-Movaghar, Vafa, Rahman, Mohammad Hifz Ur, Rahman, Mahfuzar, Rai, Rajesh Kumar, Ranabhat, Chhabi Lal, Rankin, Zane, Rao, Puja C, Rath, Goura Kishor, Rawaf, Salman, Ray, Sarah E, Rehm, Jürgen, Reiner, Robert C, Reitsma, Marissa B, Remuzzi, Giuseppe, Rezaei, Satar, Rezai, Mohammad Sadegh, Rokni, Mohammad Bagher, Ronfani, Luca, Roshandel, Gholamreza, Roth, Gregory A, Rothenbacher, Dietrich, Ruhago, George Mugambage, SA, Rizwan, Saadat, Soheil, Sachdev, Perminder S, Sadat, Nafi, Safdarian, Mahdi, Safi, Sare, Safiri, Saeid, Sagar, Rajesh, Sahathevan, Ramesh, Salama, Joseph, Salamati, Payman, Salomon, Joshua A, Samy, Abdallah M, Sanabria, Juan Ramon, Sanchez-Niño, Maria Dolore, Santomauro, Damian, Santos, Itamar S, Santric Milicevic, Milena M, Sartorius, Benn, Satpathy, Maheswar, Schmidt, Maria Inê, Schneider, Ione J C, Schulhofer-Wohl, Sam, Schutte, Aletta E, Schwebel, David C, Schwendicke, Falk, Sepanlou, Sadaf G, Servan-Mori, Edson E, Shackelford, Katya Anne, Shahraz, Saeid, Shaikh, Masood Ali, Shamsipour, Mansour, Shamsizadeh, Morteza, Sharma, Jayendra, Sharma, Rajesh, She, Jun, Sheikhbahaei, Sara, Shey, Muki, Shields, Chloe, Shigematsu, Mika, Shiri, Rahman, Shirude, Shreya, Shiue, Ivy, Shoman, Haitham, Shrime, Mark G, Sigfusdottir, Inga Dora, Silpakit, Nari, Silva, João Pedro, Singh, Jasvinder A, Singh, Abhishek, Skiadaresi, Eirini, Sligar, Amber, Smith, David L, Smith, Alison, Smith, Mari, Sobaih, Badr H A, Soneji, Samir, Sorensen, Reed J D, Soriano, Joan B, Sreeramareddy, Chandrashekhar T, Srinivasan, Vinay, Stanaway, Jeffrey D, Stathopoulou, Vasiliki, Steel, Nichola, Stein, Dan J, Steiner, Caitlyn, Steinke, Sabine, Stokes, Mark Andrew, Strong, Mark, Strub, Bryan, Subart, Michelle, Sufiyan, Muawiyyah Babale, Sunguya, Bruno F, Sur, Patrick J, Swaminathan, Soumya, Sykes, Bryan L, Tabarés-Seisdedos, Rafael, Tadakamadla, Santosh Kumar, Takahashi, Ken, Takala, Jukka S, Talongwa, Roberto Tchio, Tarawneh, Mohammed Rasoul, Tavakkoli, Mohammad, Taveira, Nuno, Tegegne, Teketo Kassaw, Tehrani-Banihashemi, Arash, Temsah, Mohamad-Hani, Terkawi, Abdullah Sulieman, Thakur, J.S., Thamsuwan, Ornwipa, Thankappan, Kavumpurathu Raman, Thomas, Katie E, Thompson, Alex H, Thomson, Alan J, Thrift, Amanda G, Tobe-Gai, Ruoyan, Topor-Madry, Roman, Torre, Anna, Tortajada, Miguel, Towbin, Jeffrey Allen, Tran, Bach Xuan, Troeger, Christopher, Truelsen, Thoma, Tsoi, Derrick, Tyrovolas, Stefano, Ukwaja, Kingsley N, Undurraga, Eduardo A, Updike, Rachel, Uthman, Olalekan A, Uzochukwu, Benjamin S Chudi, van Boven, Job F M, Vasankari, Tommi, Venketasubramanian, Narayanaswamy, Violante, Francesco S, Vlassov, Vasiliy Victorovich, Vollset, Stein Emil, Vos, Theo, Wakayo, Tolassa, Wallin, Mitchell T, Wang, Yuan-Pang, Weiderpass, Elisabete, Weintraub, Robert G, Weiss, Daniel J, Werdecker, Andrea, Westerman, Ronny, Whetter, Brian, Whiteford, Harvey A, Wijeratne, Tissa, Wiysonge, Charles Shey, Woldeyes, Belete Getahun, Wolfe, Charles D A, Woodbrook, Rachel, Workicho, Abdulhalik, Xavier, Deni, Xiao, Qingyang, Xu, Gelin, Yaghoubi, Mohsen, Yakob, Bereket, Yano, Yuichiro, Yaseri, Mehdi, Yimam, Hassen Hamid, Yonemoto, Naohiro, Yoon, Seok-Jun, Yotebieng, Marcel, Younis, Mustafa Z, Zaidi, Zoubida, Zaki, Maysaa El Sayed, Zegeye, Elias Asfaw, Zenebe, Zerihun Menlkalew, Zerfu, Taddese Alemu, Zhang, Anthony Lin, Zhang, Xueying, Zipkin, Ben, Zodpey, Sanjay, Giref, Ababi Zergaw, Rafay, Anwar, Tuzcu, Emin Murat, Ermakov, Sergey Petrovich, Shi, Peilin, Gupta, Parkash C, Erasmus MC other, Public Health, Neurosciences, Viðskiptadeild (HR), School of Business (RU), Háskólinn í Reykjavík, Reykjavik University, Mohsen, Naghavi, Amanuel, Alemu, Abajobir, Cristiana, Abbafati, Kaja, M, Abbas, Foad, Abd Allah, Semaw, Ferede, Abera, Victor, Aboyan, Olatunji, Adetokunboh, Johan, Ärnlöv, Ashkan, Afshin, Anurag, Agrawal, Aliasghar, Ahmad, Kiadaliri, Alireza, Ahmadi, Muktar, Beshir, Ahmed, Amani, Nidhal, Aichour, Ibtihel, Aichour, Miloud, Taki, Eddine, Aichour, Sneha, Aiyar, Ayman, Al Eyadhy, Fares, Alahdab, Ziyad, Al Aly, Khurshid, Alam, Noore, Alam, Tahiya, Alam, Kefyalew, Addi, Alene, Syed, Danish, Ali, Reza, Alizadeh Navaei, Juma, M, Alkaabi, Ala’A, Alkerwi, François, Alla, Peter, Allebeck, Christine, Allen, Rajaa, Al Raddadi, Ubai, Alsharif, Khalid, A, Altirkawi, Nelson, Alvis Guzman, Azmeraw, T, Amare, Erfan, Amini, Walid, Ammar, Yaw, Ampem, Amoako, Nahla, Anber, Hjalte, H, Andersen, Catalina, Liliana, Andrei, Sofia, Androudi, Hossein, Ansari, Carl, Abelardo, T, Antonio, Palwasha, Anwari, Megha, Arora, Al, Artaman, Krishna, Kumar, Aryal, Hamid, Asayesh, Solomon, W, Asgedom, Tesfay, Mehari, Atey, Leticia, Avila Burgo, Euripide, Frinel, G, Arthur, Avokpaho, Ashish, Awasthi, Beatriz, Paulina, Ayala, Quintanilla, Yannick, Béjot, Tesleem, Kayode, Babalola, Umar, Bacha, Kalpana, Balakrishnan, Aleksandra, Barac, Miguel, A, Barboza, Suzanne, L, Barker, Collo, Simon, Barquera, Lars, Barregard, Lope, H, Barrero, Bernhard, T, Baune, Neeraj, Bedi, Ettore, Beghi, Bayu, Begashaw, Bekele, Michelle, L, Bell, James, R, Bennett, Isabela, M, Bensenor, Adugnaw, Berhane, Eduardo, Bernabé, Balem, Demtsu, Betsu, Mircea, Beuran, Samir, Bhatt, Sibhatu, Biadgilign, Kelly, Bienhoff, Boris, Bikbov, Donal, Bisanzio, Rupert, R, A, Bourne, Nicholas, J, K, Breitborde, Lemma, Negesa, Bulto, Bulto, Blair, R, Bumgarner, Zahid, A, Butt, Rosario, Cárdena, Lucero, Cahuana Hurtado, Ewan, Cameron, Julio, Cesar, Campuzano, Josip, Car, Juan, Jesu, Carrero, Austin, Carter, Daniel, C, Casey, Carlo, A, Castañeda, Orjuela, Ferrán, Catalá López, Fiona, J, Charlson, Chioma, Ezinne, Chibueze, Odgerel, Chimed Ochir, Vesper, Hichilombwe, Chisumpa, Abdulaal, A, Chitheer, Devasahayam, Jesuda, Christopher, Liliana, G, Ciobanu, Aaron, J, and Cohen
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Dánarmein ,Male ,Heilsufar ,Dánartíðni ,Newborn infants ,Lífslíkur ,Life expectancy ,Communicable diseases ,Global Health ,Global Burden of Disease ,Disasters ,Pregnancy ,Cause of Death ,Psychology ,Child ,Konur ,Aged, 80 and over ,Ungbörn ,CLIMATE-CHANGE ,PLASMODIUM-FALCIPARUM ,Kransæðasjúkdómar ,Global burden of disease/statistics and numerical data ,Medicine (all) ,Men ,Þjóðir ,Öndunarfærasjúkdómar ,11 Medical And Health Sciences ,Middle Aged ,Nutrition Disorders ,PREVALENCE ,Coronary heart disease ,Smitsjúkdómar ,Death ,Suicide ,Cardiovascular diseases ,Sálfræði ,World health ,Child, Preschool ,Nýburar ,Female ,GBD, mortality ,Infants ,Life Sciences & Biomedicine ,Age distribution ,Global Health Metrics ,Adult ,Diarrhea ,AFRICA ,HUMAN HEALTH ,Adolescent ,GBD ,UNITED-STATES ,Socioeconomic factors ,Communicable Diseases ,Young Adult ,Age Distribution ,Heilbrigðisvísindi ,Medicine, General & Internal ,General & Internal Medicine ,Humans ,QUALITY ,Women ,Nutrition disorders ,INCOME COUNTRIES ,Mortality ,Noncommunicable Diseases ,Aged ,Science & Technology ,Infant, Newborn ,Infant ,Respiratory infections ,Næringarskortur ,ALCOHOL POLICY ,mortality ,Malaria ,Pregnancy Complications ,Socioeconomic Factors ,Áverkar ,Karlar ,Wounds and Injuries ,Félagshagfræði ,Accidental Falls ,Cause of death/trends ,RESISTANCE - Abstract
Correction: Group Author(s): GBD 2016 Causes Death LANCET Volume: 390 Issue: 10106 Pages: E38-E38 Published: OCT 28 2017 Group Author(s): GBD 2016 Dis Injury Incidence LANCET Volume: 390 Issue: 10106 Pages: E38-E38 Published: OCT 28 2017, Background Monitoring levels and trends in premature mortality is crucial to understanding how societies can address prominent sources of early death. The Global Burden of Disease 2016 Study (GBD 2016) provides a comprehensive assessment of cause-specific mortality for 264 causes in 195 locations from 1980 to 2016. This assessment includes evaluation of the expected epidemiological transition with changes in development and where local patterns deviate from these trends. Methods We estimated cause-specific deaths and years of life lost (YLLs) by age, sex, geography, and year. YLLs were calculated from the sum of each death multiplied by the standard life expectancy at each age. We used the GBD cause of death database composed of: vital registration (VR) data corrected for under-registration and garbage coding; national and subnational verbal autopsy (VA) studies corrected for garbage coding; and other sources including surveys and surveillance systems for specific causes such as maternal mortality. To facilitate assessment of quality, we reported on the fraction of deaths assigned to GBD Level 1 or Level 2 causes that cannot be underlying causes of death (major garbage codes) by location and year. Based on completeness, garbage coding, cause list detail, and time periods covered, we provided an overall data quality rating for each location with scores ranging from 0 stars (worst) to 5 stars (best). We used robust statistical methods including the Cause of Death Ensemble model (CODEm) to generate estimates for each location, year, age, and sex. We assessed observed and expected levels and trends of cause-specific deaths in relation to the Socio-demographic Index (SDI), a summary indicator derived from measures of average income per capita, educational attainment, and total fertility, with locations grouped into quintiles by SDI. Relative to GBD 2015, we expanded the GBD cause hierarchy by 18 causes of death for GBD 2016. Findings The quality of available data varied by location. Data quality in 25 countries rated in the highest category (5 stars), while 48, 30, 21, and 44 countries were rated at each of the succeeding data quality levels. Vital registration or verbal autopsy data were not available in 27 countries, resulting in the assignment of a zero value for data quality. Deaths from non-communicable diseases (NCDs) represented 72.3% (95% uncertainty interval [UI] 71.2-73.2) of deaths in 2016 with 19.3% (18.5-20.4) of deaths in that year occurring from communicable, maternal, neonatal, and nutritional (CMNN) diseases and a further 8.43% (8.00-8.67) from injuries. Although age-standardised rates of death from NCDs decreased globally between 2006 and 2016, total numbers of these deaths increased; both numbers and age-standardised rates of death from CMNN causes decreased in the decade 2006-16-age-standardised rates of deaths from injuries decreased but total numbers varied little. In 2016, the three leading global causes of death in children under-5 were lower respiratory infections, neonatal preterm birth complications, and neonatal encephalopathy due to birth asphyxia and trauma, combined resulting in 1.80 million deaths (95% UI 1.59 million to 1.89 million). Between 1990 and 2016, a profound shift toward deaths at older ages occurred with a 178% (95% UI 176-181) increase in deaths in ages 90-94 years and a 210% (208-212) increase in deaths older than age 95 years. The ten leading causes by rates of age-standardised YLL significantly decreased from 2006 to 2016 (median annualised rate of change was a decrease of 2.89%); the median annualised rate of change for all other causes was lower (a decrease of 1.59%) during the same interval. Globally, the five leading causes of total YLLs in 2016 were cardiovascular diseases; diarrhoea, lower respiratory infections, and other common infectious diseases; neoplasms; neonatal disorders; and HIV/AIDS and tuberculosis. At a finer level of disaggregation within cause groupings, the ten leading causes of total YLLs in 2016 were ischaemic heart disease, cerebrovascular disease, lower respiratory infections, diarrhoeal diseases, road injuries, malaria, neonatal preterm birth complications, HIV/AIDS, chronic obstructive pulmonary disease, and neonatal encephalopathy due to birth asphyxia and trauma. Ischaemic heart disease was the leading cause of total YLLs in 113 countries for men and 97 countries for women. Comparisons of observed levels of YLLs by countries, relative to the level of YLLs expected on the basis of SDI alone, highlighted distinct regional patterns including the greater than expected level of YLLs from malaria and from HIV/AIDS across sub-Saharan Africa; diabetes mellitus, especially in Oceania; interpersonal violence, notably within Latin America and the Caribbean; and cardiomyopathy and myocarditis, particularly in eastern and central Europe. The level of YLLs from ischaemic heart disease was less than expected in 117 of 195 locations. Other leading causes of YLLs for which YLLs were notably lower than expected included neonatal preterm birth complications in many locations in both south Asia and southeast Asia, and cerebrovascular disease in western Europe. Interpretation The past 37 years have featured declining rates of communicable, maternal, neonatal, and nutritional diseases across all quintiles of SDI, with faster than expected gains for many locations relative to their SDI. A global shift towards deaths at older ages suggests success in reducing many causes of early death. YLLs have increased globally for causes such as diabetes mellitus or some neoplasms, and in some locations for causes such as drug use disorders, and conflict and terrorism. Increasing levels of YLLs might reflect outcomes from conditions that required high levels of care but for which effective treatments remain elusive, potentially increasing costs to health systems., Bill & Melinda Gates Foundation.
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