The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil): Factors Related to Smoking Cessation.

BACKGROUND: Smoking cessation is not an easy accomplishment. However, the benefits are several for those who do it, such as cardiovascular risk reduction 1 year after quitting smoking. This study aimed to verify the factors related to smoking cessation in civil servants of The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). METHODS: This study had a longitudinal design using data from a prospective cohort of civil servants (ELSA-Brasil). Our variable of interest was smoking cessation. The relationship between socio-demographic characteristics, job stress, health-related variables, legislation, and smoking cessation was analyzed by Cox proportional hazard models. The analyses were stratified by gender. Second-hand smoke exposure, age, education, excessive alcohol consumption, common mental disorder, and smoking control law were the variables considered in the final model. RESULTS: Information of 2020 women and 2429 men was analyzed. Individuals without second-hand smoke exposure, with up to 49 years of age, with higher education, without excessive alcohol consumption, without common mental disorders, and who initiated smoking in 1989 or after the smoking control law had a higher risk of stopping smoking. The risks magnitudes were higher for women. CONCLUSIONS: Our study reinforces the necessity of alcohol consumption regulation, the relevance of Public Health Policies, and the need for more smoking cessation measures focused on men, on people with mental disorders, alcoholism, and older adults. Also, our results did not show significant risks regarding the psychosocial working environment.

Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) participant's profile regarding self-rated health: a multiple correspondence analysis.

BACKGROUND: Self-rated health (SRH) - one of the most common health indicators used to verify health conditions - can be influenced by several types of socioeconomic conditions, thereby reflecting health inequalities. This study aimed to evaluate the participant profiles regarding the association between self-rated health and social and occupational characteristics of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). METHODS: Cross-sectional design, including 11,305 individuals. Self-rated health was categorized as good, fair, and poor. The relationship between socio-demographic, psychosocial work environment, health-related variables, and self-rated health was analyzed by multiple correspondence analysis (stratified by age: up to 49 years old and 50 years old or more). RESULTS: For both age strata, group composition was influenced by socioeconomic conditions. Poor SRH was related to lower socioeconomic conditions, being women, black self-declared race/ethnicity, being non-married/non-united, low decision authority, low skill discretion, and obesity. CONCLUSION: To promote health, interventions should focus on reducing existing socioeconomic, race, and gender inequalities in Brazil.

Abnormal transcranial Döppler ultrasonography in children with sickle cell disease

BACKGROUND: Stroke is a potentially fatal complication of sickle cell disease in children between 2-16 years and transcranial Döppler has been recommended as a screening method in these cases. OBJECTIVE: The main goal of this study was to correlate transcranial Döppler results to complications related to stroke in sickle cell disease and baseline characteristics of the population. METHODS: This was an observational study of children and adolescents with ages between 2-16 years with sickle cell disease who were followed in three centers. RESULTS: From January 2008 to July 2009, 902 patients were enrolled in this study. The median age was 6.5 years (range: 1.8-15.8), 52.3% were male, 74.4% had hemoglobin SS; 221 (28.6%) had at least one complication associated with sickle cell disease. A total of 773 patients performed transcranial Döppler; in 91.2% this was a method of screening. Conditional or abnormal transcranial Döppler results were more common in patients with sickle cell disease complications versus those without complications (ODDS ratio = 3.18; 95% Confidence interval = 1.92-5.27). There was a significant difference in the frequency of conditional or abnormal transcranial Döppler results in patients with abnormal laboratory results compared to those without abnormalities (OR=4.03); 95% confidence interval = 2.30-7.06. CONCLUSIONS: Conditional or abnormal transcranial Döppler results were significantly more frequent in patients with complications of sickle cell disease confirming the increased risk of stroke in this subgroup of patients. This observation reinforces the recommendation of transcranial Döppler as a screening test for all patients with sickle cell disease with ages between 2 and 16 years.

Impacto das atividades profissionais na saúde física e mental dos policiais civis e militares do Rio de Janeiro (RJ, Brasil) / The impact of professional activities on the physical and mental health of the civil and military police of Rio de Janeiro (RJ, Brazil)

Neste artigo, analisamos o adoecimento físico e mental de policiais civis e militares do Estado do Rio de Janeiro, segundo condições de trabalho e atividades profissionais. Utilizamos a mesma metodologia para o estudo de duas categorias: abordagem quantitativa (amostragem aleatória simples por conglomerados, alcançando um total de 1.458 policiais civis e 1.108 policiais militares que responderam a questionários anônimos) e abordagem qualitativa (grupos focais com 143 profissionais e 18 entrevistas com gestores de ambas as polícias). Os dados aqui apresentados são todos originais. Constatamos sobrepeso e obesidade em especial na Polícia Militar; e precária frequência de atividade física e informação de elevados níveis de colesterol, especialmente na Polícia Civil. Dores no pescoço, nas costas ou na coluna, problemas de visão, dores de cabeça e enxaquecas foram os principais problemas encontrados. A presença de lesões físicas permanentes foi relatada por 16,2 por cento dos membros das duas corporações, sendo mais relevantes entre os militares, que também apresentam mais elevada frequência de sofrimento psíquico (SRQ-20). Enfatizamos a necessidade de mudanças nas dimensões individual e profissional e nos aspectos institucionais referentes às condições e à organização do trabalho e dos serviços de saúde.

In this article, we analyze the physical and mental stress and illness of military and civil police force officers in the State of Rio de Janeiro (Brazil) due to their working conditions and professional activities. The same methodology was used for the study of two categories, namely a quantitative approach (simple random sampling by conglomerates, involving a total of 1,458 civil police officers and 1,108 military police officers, who answered questionnaires anonymously) and a qualitative approach (focal groups involving 143 professionals and 18 interviews with managers of both police forces). The data presented here are all original. Disorders identified were: overweight and obesity in both forces but mainly in the Military Police; low frequency of physical exercise and high levels of cholesterol, especially in the Civil Police. The main health complaints are neck, back or spinal cord pain, eyesight complaints and headaches/ migraines. Sixteen point two per cent of officers of both forces reported physical lesions that were more prevalent in the Military Police, among whom psychic suffering was also more frequent (SRQ20). The need for changes in the individual and professional dimensions and in institutional aspects regarding the conditions and organization of work and of health services is emphasized.

Avaliação cardiológica de recém natos e lactentes com exposição vertical confirmada ao zika virus

A síndrome da Zika congênita por exposição vertical ao Zika vírus(ZIKV) inclui alterações neurológicas, oftalmológicas e ortopédicas. Avaliar a prevalência de cardiopatias congênitas nesses bebês contribui para melhor planejamento de exames necessários durante a gestação e/ou após o nascimento já que a maioria dos municípios brasileiros não tem profissional habilitado para realização desse exame. Determinar se a exposição vertical ao Zika vírus está relacionada à maior prevalência de cardiopatias congênitas. Estabelecer se há necessidade de realização de ecocardiograma fetal e/ou ao nascimento em todos os bebês com exposição vertical ao ZIKV. Estudo observacional prospectivo de alterações cardiológicas encontradas ao ecocardiograma de bebês com exposição vertical ao ZIKV confirmada por exame de reação em cadeia da polimerase (PCR) da mãe durante a gestação e/ou do recém nato, realizado de janeiro de 2016 a janeiro de 2017 no Instituto Fernandes Figueira,RJ.A análise dos dados foi descritiva através de frequências absolutas e relativas das variáveis qualitativas como sexo,resultado do PCR,presença ou não de microcefalia e sua correlação com alterações maiores ao ecocardiograma.Os intervalos de confiança de 95% e o valor de p do teste exato de Fischer foram descritos para as frequências relativas. Foram realizados ecocardiogramas de120 pacientes (idade mediana de 97 dias, igual proporção entre sexos e PCR positivo na mãe ou no bebê em 97 e em ambos em 23), e 13 (10.8%) apresentaram alterações maiores,mas nenhum apresentou cardiopatia grave que necessitasse de intervenção cirúrgica ou medicação nos primeiros meses de vida.A frequência de alterações maiores ao ecocardiograma foi mais de 10 pp maior entre os prematuros,nos com história materna de "rash" no segundo trimestre de gestação e com exames de imagem de sistema nervoso central alterados.Desses 13 pacientes,todos que haviam realizado PCR(9) tinham o resultado positivo. O estudo mostrou uma frequência de cardiopatias congênitas 10 vezes maior do que na população geral,mas nenhuma grave,sugerindo que não há necessidade de indicar ecocardiograma fetal/neonatal de rotina nos bebês expostos verticalmente ao ZIKV.Esses bebês podem seguir o mesmo protocolo de triagem de cardiopatias congênitas estabelecido para os recém natos em geral(exame clínico e teste de saturação de oxigênio na alta da maternidade).