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1.
Cad Saude Publica ; 35(11): e00236318, 2019.
Artigo em Português | MEDLINE | ID: mdl-31691788

RESUMO

Studies in developing countries report a steady increase in mental disorders, with major social and economic repercussions. The current study proposes to analyze the prevalence of common mental disorders (CMDs) and associated factors in urban residents of São Paulo, Brazil. Based on data collected in the Health Survey in São Paulo City (ISA-Capital) in 2015, the study identified the presence of CMDs using the Self-Reporting Questionnaire (SRQ-20). The association of CMDs with sociodemographic variables and health conditions was analyzed as relative frequency, corrected by the respective weights resulting from cluster sampling, estimating the prevalence and 95% confidence intervals (95%CI) and assessing the association's significance by the chi-square test, corrected by the F distribution. Prevalence of CMDs was 19.7% (95%CI: 18.2-21.4), higher in women (24.3%); persons 60 years or older (25.3%); followers of the African-Brazilian umbanda or candomblé religions (37.8%); widows/widowers (30.4%); individuals that had never attended school (31.4%); unemployed (28.3%); those with family income up to one minimum wage (28.8%); individuals that reported illness in the previous 15 days (36.9%); those with physical disabilities (21.6%); mental or intellectual disabilities (44.4%); emotional or mental problems (48.9%); headache (33.63%); and individuals with one or more chronic diseases (24.1%). The information in this study reaffirms the relevance of the prevalence of CMDs and their association with the most vulnerable social groups, corroborating the need to implement public measures in mental health.

2.
Cad. Saúde Pública (Online) ; 35(11): e00236318, 2019. tab
Artigo em Português | LILACS-Express | ID: biblio-1039401

RESUMO

Resumo: Estudos realizados nos países em desenvolvimento descrevem um aumento progressivo dos transtornos mentais, com grandes repercussões sociais e econômicas. O presente estudo se propõe a analisar a prevalência dos transtornos mentais comuns (TMC) e seus fatores associados nos moradores da área urbana da cidade de São Paulo, Brasil. A partir dos dados levantados pelo Inquérito de Saúde do Município de São Paulo (ISA-Capital) de 2015, foi identificada a presença de TMC com a utilização do Self-Reporting Questionnaire (SRQ-20). A associação de TMC com as variáveis sociodemográficas e de condições de saúde foi analisada pela frequência relativa, corrigida pelos respectivos pesos decorrentes de uma amostragem de conglomerados, estimando-se a prevalência e intervalos de 95% de confiança (IC95%) em cada situação e avaliando-se a significância da associação pelo qui-quadrado corrigido pela distribuição F. A prevalência de TMC encontrada foi de 19,7% (IC95%: 18,2-21,4), sendo maior nas seguintes categorias: mulheres (24,3%); pessoas com 60 anos ou mais (25,3%); praticantes da umbanda/candomblé (37,8%); viúvos (30,4%); quem nunca frequentou a escola (31,4%); inativos/desempregados (28,3%); e quem possuía renda familiar de até um salário mínimo (28,8%). Em relação às variáveis de condição de saúde, a prevalência de TMC foi maior nos indivíduos que referiram: morbidade nos últimos 15 dias (36,9%); deficiência física (21,6%); deficiência mental ou intelectual (44,4%); problema emocional ou mental (48,9%); cefaleia (33,63%); e nos portadores de uma ou mais doenças crônicas (24,1%). As informações desta pesquisa reafirmam a relevância da prevalência de TMC assim como sua associação com os grupos sociais mais vulneráveis, o que reforça a necessidade da implementação de medidas públicas de saúde mental.


Abstract: Studies in developing countries report a steady increase in mental disorders, with major social and economic repercussions. The current study proposes to analyze the prevalence of common mental disorders (CMDs) and associated factors in urban residents of São Paulo, Brazil. Based on data collected in the Health Survey in São Paulo City (ISA-Capital) in 2015, the study identified the presence of CMDs using the Self-Reporting Questionnaire (SRQ-20). The association of CMDs with sociodemographic variables and health conditions was analyzed as relative frequency, corrected by the respective weights resulting from cluster sampling, estimating the prevalence and 95% confidence intervals (95%CI) and assessing the association's significance by the chi-square test, corrected by the F distribution. Prevalence of CMDs was 19.7% (95%CI: 18.2-21.4), higher in women (24.3%); persons 60 years or older (25.3%); followers of the African-Brazilian umbanda or candomblé religions (37.8%); widows/widowers (30.4%); individuals that had never attended school (31.4%); unemployed (28.3%); those with family income up to one minimum wage (28.8%); individuals that reported illness in the previous 15 days (36.9%); those with physical disabilities (21.6%); mental or intellectual disabilities (44.4%); emotional or mental problems (48.9%); headache (33.63%); and individuals with one or more chronic diseases (24.1%). The information in this study reaffirms the relevance of the prevalence of CMDs and their association with the most vulnerable social groups, corroborating the need to implement public measures in mental health.


Resumen: Estudios realizados en los países en desarrollo describen un aumento progresivo de los trastornos mentales, con grandes repercusiones sociales y económicas. El presente estudio se propone analizar la prevalencia de los trastornos mentales comunes (TMC) y sus factores asociados en los habitantes del área urbana de la ciudad de São Paulo, Brasil. A partir de los datos recabados por la Encuesta de Salud en el Municipio de São Paulo (ISA-Capital) de 2015, se identificó la presencia de TMC con la utilización del Self-Reporting Questionnaire (SRQ-20). La asociación de TMC con las variables sociodemográficas y de condiciones de salud se analizó a través de la frecuencia relativa, corregida por los respectivos pesos derivados de una muestra de conglomerados, estimándose la prevalencia y intervalos de confianza (IC95%) y evaluándose la significancia de la asociación por el chi-cuadrado, corregido por la distribución F. La prevalencia de TMC encontrada fue de 19,7% (IC95%: 18,2-21,4), siendo mayor en mujeres (24,3%); personas con 60 años o más (25,3%); practicantes de umbanda/candomblé (37,8%); viudos (30,4%); que nunca asistieron a la escuela (31,4%); inactivos/desempleados (28,3%); quienes tenía una renta familiar de hasta un salario mínimo (28,8%); individuos que informaron morbilidad durante los últimos 15 días (36,9%); deficiencia física (21,6%); deficiencia mental o intelectual (44,4%); problema emocional o mental (48,9%); cefalea (33,63%); y en los portadores de una o más enfermedades crónicas (24,1%). La información de esta investigación reafirma la relevancia de la prevalencia de TMC, así como su asociación con los grupos sociales más vulnerables, lo que refuerza la necesidad de la implementación de medidas públicas de salud mental.

3.
Rev Bras Epidemiol ; 21: e180011, 2018 Aug 20.
Artigo em Português, Inglês | MEDLINE | ID: mdl-30133599

RESUMO

INTRODUCTION: The objective of this investigation was to check equity in coverage/complementation of health expenses by the Brazilian Unified Health System (SUS) for people with signs of common mental disorders, in 2008, in the city of São Paulo, Brazil. METHODS: Cross-sectional study with data from the 2008 São Paulo Health Survey. Individuals aged 16 or older and with signs of common mental disorders were selected and evaluated with the Self-Reporting Questionnaire (SRQ-20). The following aspects were analyzed: demand for SUS, coverage of health expenses by SUS, and health expenses in the previous month, withal according to sociodemographic and health conditions. RESULTS: The search for SUS services was lower among white people with higher per capita incomes, in a stable union, and with higher education degrees. Coverage by SUS was lower for people aged between 45 and 59 years and aged 60 years or older, with higher per capita incomes, with high or technical school, and college degrees. Subjects who spent more on family health were 60 years or older, white, with high per capita income, in a stable union, and with a college degree. CONCLUSIONS: Among people with signs of common mental disorders, SUS mainly services and covers the expenses of the poorer population with lower educational level; therefore coverage is unequal and favors who needs it the most. However, considering age, inequity became explicit, since SUS was shown to offer wider coverage of health expenses to the youngest population.


Assuntos
Gastos em Saúde , Transtornos Mentais/economia , Adolescente , Adulto , Brasil , Assistência à Saúde , Feminino , Disparidades em Assistência à Saúde/economia , Humanos , Masculino , Transtornos Mentais/terapia , Pessoa de Meia-Idade , Saúde da População Urbana , Adulto Jovem
4.
Epidemiol Serv Saude ; 27(2): e2017272, 2018.
Artigo em Inglês, Português | MEDLINE | ID: mdl-29742237

RESUMO

OBJECTIVE: to estimate the vaccination coverage against influenza and pneumonia and to analyze the utilization of Brazilian National Health System-SUS for vaccination in adults and elderly with self-reported diabetes in São Paulo, Brazil, in 2003, 2008 and 2015. METHODS: Cross-sectional studies with data from the ISA-Capital (population-based household surveys). RESULTS: 3,357, 3,271 and 4,043 were interviewed in 2003, 2008 and 2015; the prevalence of diabetes mellitus were 5.0% (2003), 6.4% (2008) and 7.7% (2015); fewer than half of people with diabetes, vaccinated against influenza (47.2%) and pneumonia (17.9%) in 2003, with a small increase in 2015 (59.2% and 26.1%, respectively); the majority of people who are vaccinated against influenza and pneumonia used SUS, 88.7% (2003) and 97.2% (2015) for influenza; 84.7% (2003) and 94.5% (2015) for pneumonia, without difference among age, sex, education level and ethnicity. CONCLUSION: despite the low vaccination coverage against influenza and pneumonia in the population with diabetes mellitus since 2003 the utilization of SUS to vaccination has been progressively expanding.


Assuntos
Diabetes Mellitus/epidemiologia , Vacinas contra Influenza/administração & dosagem , Vacinas Pneumocócicas/administração & dosagem , Cobertura Vacinal/tendências , Adulto , Idoso , Brasil , Estudos Transversais , Feminino , Humanos , Influenza Humana/prevenção & controle , Masculino , Pessoa de Meia-Idade , Programas Nacionais de Saúde , Pneumonia Pneumocócica/prevenção & controle , Prevalência , Autorrelato , Vacinação/tendências , Adulto Jovem
5.
Rev. bras. epidemiol ; 21: e180011, 2018. tab, graf
Artigo em Português | LILACS-Express | ID: biblio-958828

RESUMO

RESUMO: Introdução: O objetivo deste trabalho foi verificar a equidade na cobertura/complementação dos gastos com saúde pelo Sistema Único de Saúde (SUS) de pessoas com indicativos de transtornos mentais comuns (TMC), no ano de 2008, no município de São Paulo. Métodos: Foi realizado um estudo de corte transversal a partir dos dados do Inquérito de Saúde no Município de São Paulo de 2008 (ISA-Capital 2008). Os sujeitos incluídos na pesquisa tinham 16 anos de idade ou mais e indicativos de TMC, avaliados por meio do instrumento Self-Reporting Questionnaire (SRQ-20). Foram analisados: a procura pelo SUS, a cobertura dos gastos com saúde pelo SUS e os gastos com saúde no último mês, correlacionando-os com aspectos sociodemográficos e de condições de saúde. Resultados: A procura pelo SUS foi menor entre as pessoas de cor branca, renda per capita elevada, com união estável e Ensino Superior. A cobertura pelo SUS foi menor entre as faixas etárias de 45 a 59 anos e de 60 anos ou mais, com renda per capita elevada, Ensino Médio ou Técnico e Ensino Superior. As pessoas que gastaram mais com a saúde da família foram aquelas com idade igual ou superior a 60 anos, de cor branca, renda per capita mais elevada, com união estável e Ensino Superior. Conclusões: Foi observado que o SUS atende e cobre os gastos majoritariamente daqueles com renda per capita e escolaridade mais baixas, denotando uma cobertura desigual que favorece os mais necessitados. Porém, considerando o fator idade, ficou explícita uma situação de iniquidade, pois foi constatada maior cobertura dos gastos em saúde pelo SUS para a população mais jovem.


ABSTRACT: Introduction: The objective of this investigation was to check equity in coverage/complementation of health expenses by the Brazilian Unified Health System (SUS) for people with signs of common mental disorders, in 2008, in the city of São Paulo, Brazil. Methods: Cross-sectional study with data from the 2008 São Paulo Health Survey. Individuals aged 16 or older and with signs of common mental disorders were selected and evaluated with the Self-Reporting Questionnaire (SRQ-20). The following aspects were analyzed: demand for SUS, coverage of health expenses by SUS, and health expenses in the previous month, withal according to sociodemographic and health conditions. Results: The search for SUS services was lower among white people with higher per capita incomes, in a stable union, and with higher education degrees. Coverage by SUS was lower for people aged between 45 and 59 years and aged 60 years or older, with higher per capita incomes, with high or technical school, and college degrees. Subjects who spent more on family health were 60 years or older, white, with high per capita income, in a stable union, and with a college degree. Conclusions: Among people with signs of common mental disorders, SUS mainly services and covers the expenses of the poorer population with lower educational level; therefore coverage is unequal and favors who needs it the most. However, considering age, inequity became explicit, since SUS was shown to offer wider coverage of health expenses to the youngest population.

6.
Epidemiol. serv. saúde ; 27(2): e2017272, 2018. tab
Artigo em Português | LILACS | ID: biblio-953390

RESUMO

Objetivo: estimar a cobertura vacinal contra gripe e pneumonia e a utilização do SUS para vacinação em adultos e idosos com diabetes autorreferida em São Paulo, SP, Brasil, em 2003, 2008 e 2015. Métodos: painel de estudos transversais do ISA-Capital. Resultados: entrevistaram-se 3.357, 3.271 e 4.043 pessoas em 2003, 2008 e 2015; as prevalências de diabetes mellitus foram de 5,0% (2003), 6,4% (2008) e 7,7% (2015); menos da metade das pessoas com diabetes vacinou-se contra gripe (47,2%) e pneumonia (17,9%) em 2003, com pequeno aumento em 2015 (59,2% e 26,1%, respectivamente); a maioria da população que se vacinou contra gripe e pneumonia o fez pelo SUS, 88,7% (2003) e 97,2% (2015) para gripe e 84,7% (2003) e 94,5% (2015) para pneumonia, sem diferença entre idade, sexo, escolaridade e raça. Conclusão: embora as coberturas vacinais tenham sido baixas na população com diabetes, a utilização do SUS foi elevada entre os vacinados.


Objetivo: estimar la cobertura de vacunas contra gripe y neumonía y la utilización del Sistema Único de Salud-SUS para vacunación en adultos y ancianos con diabetes autorreferida en la ciudad de São Paulo, Brasil, en 2003, 2008 y 2015. Métodos: datos del ISA-Capital. Resultados: entrevistados 3.357, 3.271 y 4.043 personas en 2003, 2008 y 2015; las prevalencias de diabetes mellitus fueron de 5,0% (2003), 6,4% (2008) y 7,7% (2015); menos de la mitad de las personas con diabetes mellitus se vacunaron contra gripe (47,2%) y neumonía (17,9%) en 2003, con un pequeño aumento en 2015 (59,2% y 26,1%, respectivamente); la mayoría de la población que se vacunó contra gripe y neumonía lo hizo a través del SUS: 88,7% (2003) y el 97,2% (2015) para la gripe y 84,7% (2003) y 94,5% (2015) para neumonía, sin diferencia entre edad, sexo, escolaridad y raza. Conclusión: Aunque las coberturas fueron bajas en la población con diabetes, la utilización del SUS fue elevada entre los vacunados.


Objective: to estimate the vaccination coverage against influenza and pneumonia and to analyze the utilization of Brazilian National Health System-SUS for vaccination in adults and elderly with self-reported diabetes in São Paulo, Brazil, in 2003, 2008 and 2015. Methods: Cross-sectional studies with data from the ISA-Capital (population-based household surveys). Results: 3,357, 3,271 and 4,043 were interviewed in 2003, 2008 and 2015; the prevalence of diabetes mellitus were 5.0% (2003), 6.4% (2008) and 7.7% (2015); fewer than half of people with diabetes, vaccinated against influenza (47.2%) and pneumonia (17.9%) in 2003, with a small increase in 2015 (59.2% and 26.1%, respectively); the majority of people who are vaccinated against influenza and pneumonia used SUS, 88.7% (2003) and 97.2% (2015) for influenza; 84.7% (2003) and 94.5% (2015) for pneumonia, without difference among age, sex, education level and ethnicity. Conclusion: despite the low vaccination coverage against influenza and pneumonia in the population with diabetes mellitus since 2003 the utilization of SUS to vaccination has been progressively expanding.


Assuntos
Humanos , Masculino , Feminino , Adulto , Idoso , Idoso de 80 Anos ou mais , Pneumonia , Sistema Único de Saúde , Vacinação , Diabetes Mellitus/imunologia , Influenza Humana , Estudos Transversais
7.
Cad Saude Publica ; 33(4): e00078015, 2017 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-28538789

RESUMO

The study analyzed how socioeconomic factors are associated with seeking, access, use, and quality of health care services in São Paulo, Brazil. Data were obtained from two household health surveys in São Paulo. We used logistic regression to analyze associations between socioeconomic factors and seeking, access, use, and quality of health care services. Access to health care services was high among those who sought it (94.91% in 2003 and 94.98% in 2008). The proportion of access to and use of health care services did not change significantly from 2003 to 2008. Use of services in the public sector was more frequent in lower socioeconomic groups. There were some socioeconomic differences in seeking health care and resolution of health problems. The study showed almost universal access to health care services, but the results suggest problems in quality of services and differences in quality experienced by lower socioeconomic groups, who mostly use the Brazilian Unified National Health System (SUS).


Assuntos
Equidade em Saúde/estatística & dados numéricos , Acesso aos Serviços de Saúde/estatística & dados numéricos , Serviços de Saúde/estatística & dados numéricos , Adolescente , Adulto , Brasil , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Programas Nacionais de Saúde , Setor Público , Fatores Socioeconômicos , População Urbana , Adulto Jovem
8.
Cad. saúde pública ; 33(4): e00078015, 2017. tab
Artigo em Inglês | LILACS | ID: biblio-839701

RESUMO

Abstract: The study analyzed how socioeconomic factors are associated with seeking, access, use, and quality of health care services in São Paulo, Brazil. Data were obtained from two household health surveys in São Paulo. We used logistic regression to analyze associations between socioeconomic factors and seeking, access, use, and quality of health care services. Access to health care services was high among those who sought it (94.91% in 2003 and 94.98% in 2008). The proportion of access to and use of health care services did not change significantly from 2003 to 2008. Use of services in the public sector was more frequent in lower socioeconomic groups. There were some socioeconomic differences in seeking health care and resolution of health problems. The study showed almost universal access to health care services, but the results suggest problems in quality of services and differences in quality experienced by lower socioeconomic groups, who mostly use the Brazilian Unified National Health System (SUS).


Resumo: O estudo analisou os fatores socioeconômicos associados à procura, acesso, uso e qualidade dos serviços de assistência à saúde em São Paulo, Brasil. Os dados foram obtidos a partir de dois inquéritos domiciliares de saúde em São Paulo. A regressão logística foi utilizada para analisar as associações entre fatores socioeconômicos e a procura, acesso, uso e qualidade dos serviços de assistência à saúde. O acesso aos serviços de assistência à saúde era alto entre aqueles que procuravam (94,91% em 2003 e 94,98% em 2008). A proporção de acesso e uso dos serviços de assistência à saúde não mudou de maneira significativa entre 2003 e 2008. O use de serviços no setor público era mais frequente nos extratos socioeconômicos mais baixos. Houve algumas diferenças na procura de assistência e na resolução dos problemas de saúde. O estudo mostrou acesso quase universal aos serviços de assistência à saúde, mas os resultados sugerem problemas na qualidade dos serviços e diferenças na qualidade vivenciada pelos grupos socioeconômicos mais baixos, a maioria dos quais utilizavam o Sistema Único de Saúde (SUS).


Resumen: El estudio analizó los factores socioeconómicos asociados a la búsqueda, acceso, uso y calidad de los servicios de asistencia a la salud en São Paulo, Brasil. Los datos fueron obtenidos a partir de dos encuestas domiciliarias de salud en São Paulo. La regresión logística se utilizó para analizar las asociaciones entre factores socioeconómicos y la búsqueda, acceso, uso y calidad de los servicios de asistencia a la salud. El acceso a los servicios de asistencia a la salud era alto entre aquellos que lo buscaban (94,91% en 2003 y 94,98% en 2008). La proporción de acceso y uso de los servicios de asistencia a la salud no se vio modificado de manera significativa entre 2003 y 2008. El uso de servicios en el sector público era más frecuente en los estratos socioeconómicos más bajos. Hubo algunas diferencias en la búsqueda de asistencia y en la resolución de los problemas de salud. El estudio mostró un acceso casi universal a los servicios de asistencia a la salud, pero los resultados sugieren problemas en la calidad de los servicios y diferencias en la calidad experimentada por los grupos socioeconómicos más bajos, la mayoría de los cuales utilizaban el Sistema Único de Salud (SUS).


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Equidade em Saúde/estatística & dados numéricos , Acesso aos Serviços de Saúde/estatística & dados numéricos , Serviços de Saúde/estatística & dados numéricos , Brasil , Programas Nacionais de Saúde , Setor Público , Fatores Socioeconômicos , População Urbana
9.
BMC Health Serv Res ; 16(1): 683, 2016 12 07.
Artigo em Inglês | MEDLINE | ID: mdl-27927241

RESUMO

BACKGROUND: Access to, and use of, dental health services in Brazil have improved since 2003. The increase of private health care plans and the implementation of the "Smiling Brazil" Program, the largest public oral health care program in the world, could have influenced this increase in access. However, we do not yet know if inequalities in the use of dental health services persist after the improvement in access. The aims of this study are to analyze socioeconomic differences for dental health service use between 2003 and 2008 in São Paulo and to examine changes in these associations since the implementation of the Smiling Brazil program in 2003. METHOD: Data was obtained via two household health surveys (ISA-Capital 2003 and ISA-Capital 2008) which investigated living conditions, lifestyle, health status and use of health care services. Logistic regression was used to analyze associations between socioeconomic factors and dental services use. Additionally, trends from 2003 to 2008 regarding socioeconomic characteristics and dental health service use were explored. RESULTS: Overall, dental health service use increased between 2003 and 2008 and was at both time points more common among those who had higher income, better education, better housing conditions, private health care plans and were Caucasian. Inequalities in use of dental health care did not decrease over time. Among the reasons for not seeking dental care, not having teeth and financial difficulty were more common in lower socioeconomic groups, while thinking it was unnecessary was more common in higher socioeconomic groups. CONCLUSIONS: The Brazilian oral health policy is still in a period of expansion and seems to have contributed slightly to increased dental health service use, but has not influenced socioeconomic inequalities in the use of these services. Acquiring deeper knowledge about inequalities in dental health service use will contribute to better understanding of potential barriers to reducing them.


Assuntos
Serviços de Saúde Bucal/estatística & dados numéricos , Disparidades em Assistência à Saúde/estatística & dados numéricos , Adolescente , Adulto , Idoso , Brasil , Criança , Pré-Escolar , Assistência à Saúde/estatística & dados numéricos , Assistência Odontológica/estatística & dados numéricos , Inquéritos de Saúde Bucal , Características da Família , Feminino , Serviços de Saúde , Acesso aos Serviços de Saúde/estatística & dados numéricos , Nível de Saúde , Humanos , Renda/estatística & dados numéricos , Lactente , Masculino , Pessoa de Meia-Idade , Saúde Bucal/estatística & dados numéricos , Classe Social , Fatores Socioeconômicos , Adulto Jovem
10.
Epidemiol Serv Saude ; 25(2): 251-258, 2016.
Artigo em Inglês, Português | MEDLINE | ID: mdl-27869943

RESUMO

OBJECTIVE: to analyze the use and perception of generic drugs by people with diabetes and hypertension in São Paulo City, Brazil, considering the Brazilian Generic Drug Policy. METHODS: this was a cross-sectional study using data from a household health survey (ISA-Capital) in 2003; analysis was performed on knowledge regarding generic drugs and on the association between their use and sociodemographic and socio-economic characteristics. RESULTS: 603 people with hypertension and diabetes were included in the study, low use of generic drugs was found (33.3% and 26.3, respectively) and low cost was the major reported advantage of generic drugs (71.0% and 71.1%, respectively); there was no statistically significant difference between the use of generic medication and age, sex or schooling. CONCLUSION: low cost and there being no difference between generic drug use and education level strengthen the importance of generic drugs for promoting equity and universal access to medication.


Assuntos
Diabetes Mellitus/tratamento farmacológico , Medicamentos Genéricos/uso terapêutico , Hipertensão/tratamento farmacológico , Adulto , Fatores Etários , Idoso , Brasil , Estudos Transversais , Custos de Medicamentos , Medicamentos Genéricos/economia , Escolaridade , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Fatores Socioeconômicos , Adulto Jovem
11.
Epidemiol. serv. saúde ; 25(2): 251-258, abr.-jun. 2016. tab
Artigo em Português | LILACS | ID: lil-785218

RESUMO

OBJETIVO: analisar a utilização e a percepção sobre medicamentos genéricos pela população com diabetes e hipertensão na cidade de São Paulo, considerando-se a Política de Medicamentos Genéricos no Brasil. MÉTODOS: estudo transversal com dados do Inquérito de Saúde do Município de São Paulo (ISA-Capital), coletados em 2003; foi analisado o conhecimento sobre medicamentos genéricos e a associação entre utilização desses medicamentos e características sociodemográficas e socioeconômicas. RESULTADOS: foram incluídos 603 participantes; entre hipertensos e diabéticos, foi encontrada baixa utilização de medicamento genérico (33,3% e 26,3%, respectivamente) e a principal vantagem atribuída ao medicamento genérico foi o baixo custo (71,0% e 71,1%, respectivamente); não houve diferença estatisticamente significativa entre uso de medicamento genérico e idade, sexo ou escolaridade. CONCLUSÃO: o baixo custo e não haver diferença entre uso do genérico e escolaridade reforçam a importância do medicamento genérico para a promoção da equidade e do acesso universal a medicamentos.


OBJETIVO: analizar el uso de medicamentos genéricos en la población con diabetes e hipertensión en São Paulo, Brasil, considerando la política de medicamentos genéricos en Brasil. MÉTODOS: estudio transversal con datos de la Encuesta en Salud del municipio de São Paulo (ISA-Capital), colectados en 2003; se analizó el conocimiento sobre medicamentos genéricos y la asociación entre el uso de estos y las características sociodemográficas y socioeconómicas de la población. RESULTADOS: incluimos 603 participantes, entre hipertensos y diabéticos se encontró un uso escaso de genéricos (33,3% y 26,3%, respectivamente) y la principal ventaja atribuida al medicamento genérico fue el bajo costo (71,0% y 71,1%, respectivamente); no hubo diferencia entre el uso de medicación genérica y la edad, sexo o educación. CONCLUSIÓN: el bajo costo y ninguna diferencia entre el uso de genérico y educación refuerza la importancia de los genéricos para la promoción de la equidad y el acceso universal a los medicamentos.


OBJECTIVE: to analyze the use and perception of generic drugs by people with diabetes and hypertension in São Paulo City, Brazil, considering the Brazilian Generic Drug Policy. METHODS: this was a cross-sectional study using data from a household health survey (ISA-Capital) in 2003; analysis was performed on knowledge regarding generic drugs and on the association between their use and sociodemographic and socio-economic characteristics. RESULTS: 603 people with hypertension and diabetes were included in the study, low use of generic drugs was found (33.3% and 26.3, respectively) and low cost was the major reported advantage of generic drugs (71.0% and 71.1%, respectively); there was no statistically significant difference between the use of generic medication and age, sex or schooling. CONCLUSION: low cost and there being no difference between generic drug use and education level strengthen the importance of generic drugs for promoting equity and universal access to medication.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Medicamentos Genéricos/economia , Medicamentos Genéricos/uso terapêutico , Diabetes Mellitus/tratamento farmacológico , Hipertensão/tratamento farmacológico , Fatores Socioeconômicos , Brasil , Conhecimentos, Atitudes e Prática em Saúde , Estudos Transversais/métodos , Uso de Medicamentos/estatística & dados numéricos , Política de Medicamentos Genéricos
12.
Rev Bras Epidemiol ; 19(1): 26-37, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27167646

RESUMO

INTRODUCTION: Since 2003, the access to medication has been increasing in Brazil and particularly in São Paulo. The present study aimed to analyze the access to medication obtained in the public sector and the socioeconomic differences in this access in 2003 and 2008. Also, we explored the difference in access to medication from 2003 to 2008. METHOD: Data were obtained from two cross-sectional population-based household surveys from São Paulo, Brazil (ISA-Capital 2003 and ISA-Capital 2008). Concentration curve and concentration index were calculated to analyze the associations between socioeconomic factors and access to medication in the public sector. Additionally, the differences between 2003 and 2008 regarding socioeconomic characteristics and access to medication were studied. RESULTS: Access to medication was 89.55% in 2003 and 92.99% in 2008, and the proportion of access to medication did not change in the period. Access in the public sector increased from 26.40% in 2003 to 48.55% in 2008 and there was a decrease in the concentration index between 2003 and 2008 in access to medication in the public sector. CONCLUSIONS: The findings indicate an expansion of Brazilian Unified Health System (Sistema Único de Saúde ) users, with the inclusion of people of higher socioeconomic position in the public sector. As the SUS gives more support to people of lower socioeconomic position in terms of medication provision, the SUS tends to equity. Nevertheless, universal coverage for medication and equity in access to medication in the public sector are still challenges for the Brazilian public health system.


Assuntos
Acesso aos Serviços de Saúde/estatística & dados numéricos , Disparidades em Assistência à Saúde/estatística & dados numéricos , Assistência Farmacêutica/estatística & dados numéricos , Adolescente , Adulto , Brasil , Criança , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Saúde Pública , Setor Público , Fatores Socioeconômicos , População Urbana , Adulto Jovem
13.
Rev. bras. epidemiol ; 19(1): 26-37, Jan.-Mar. 2016. tab, graf
Artigo em Inglês | LILACS | ID: lil-781589

RESUMO

ABSTRACT: Introduction: Since 2003, the access to medication has been increasing in Brazil and particularly in São Paulo. The present study aimed to analyze the access to medication obtained in the public sector and the socioeconomic differences in this access in 2003 and 2008. Also, we explored the difference in access to medication from 2003 to 2008. Method: Data were obtained from two cross-sectional population-based household surveys from São Paulo, Brazil (ISA-Capital 2003 and ISA-Capital 2008). Concentration curve and concentration index were calculated to analyze the associations between socioeconomic factors and access to medication in the public sector. Additionally, the differences between 2003 and 2008 regarding socioeconomic characteristics and access to medication were studied. Results: Access to medication was 89.55% in 2003 and 92.99% in 2008, and the proportion of access to medication did not change in the period. Access in the public sector increased from 26.40% in 2003 to 48.55% in 2008 and there was a decrease in the concentration index between 2003 and 2008 in access to medication in the public sector. Conclusions: The findings indicate an expansion of Brazilian Unified Health System (Sistema Único de Saúde ) users, with the inclusion of people of higher socioeconomic position in the public sector. As the SUS gives more support to people of lower socioeconomic position in terms of medication provision, the SUS tends to equity. Nevertheless, universal coverage for medication and equity in access to medication in the public sector are still challenges for the Brazilian public health system.


RESUMO: Introdução: Desde 2003, o acesso da população a medicamentos tem aumentado no Brasil e particularmente em São Paulo. O estudo visou analisar o acesso a medicamentos obtidos do setor público e as desigualdades socioeconômicas nesse acesso em 2003 e em 2008. Método: Os dados são provenientes dos inquéritos domiciliares de saúde ISA-Capital, realizados na cidade de São Paulo em 2003 e em 2008. Foi feita Regressão Logística para analisar os fatores associados ao acesso a medicamentos. A análise das desigualdades no acesso a medicamentos foi feita a partir da Curva de Concentração e Índice de Concentração. Adicionalmente, as diferenças entre os anos de 2003 e 2008 com relação às características socioeconômicas e ao acesso a medicamentos foram estudadas. Resultados: O acesso a medicamentos foi 89,55% em 2003 e 92,99% em 2008. O acesso a medicamentos pelo setor público aumentou de 26,40% em 2003 para 48,55% em 2008 e foi maior na população com menor poder aquisitivo, porém houve mudança no índice de concentração entre 2003 e 2008. Conclusões: Os achados indicam a expansão da clientela do Sistema Único de Saúde na cobertura de medicamentos, com a entrada da população com maior poder aquisitivo no setor público. O acesso continua maior na população com menor poder aquisitivo, o que sugere que o SUS tenta a equidade na provisão de medicamentos. Entretanto, a cobertura universal para gastos com medicamentos essenciais e a equidade no acesso a medicamentos pelo setor público ainda são desafios para o SUS.


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Acesso aos Serviços de Saúde/estatística & dados numéricos , Disparidades em Assistência à Saúde/estatística & dados numéricos , Assistência Farmacêutica/estatística & dados numéricos , Brasil , Estudos Transversais , Inquéritos Epidemiológicos , Saúde Pública , Setor Público , Fatores Socioeconômicos , População Urbana
14.
Cien Saude Colet ; 20(2): 471-8, 2015 Feb.
Artigo em Inglês, Português | MEDLINE | ID: mdl-25715141

RESUMO

In Brazil hypertension and type 2 diabetes mellitus are responsible for 60% of cases of end-stage renal disease in renal replacement therapy. In the United States studies have identified family clustering of chronic kidney disease, predominantly in African-Americans. A single Brazilian study observed family clustering among patients with chronic kidney disease when compared with hospitalized patients with normal renal function. This article aims to assess whether there is family clustering of chronic kidney disease in relatives of individuals in renal replacement therapy caused by hypertension and/or diabetes mellitus. A case-control study with 336 patients in renal replacement therapy with diabetes mellitus or hypertension for at least 5 years (cases) and a control matched sample group of individuals with hypertension or diabetes mellitus and normal renal function (n = 389). Individuals in renal replacement therapy (cases) had a ratio of 2.35 (95% CI 1.42-3.89, p < 0.001) versus the control group in having relatives with chronic renal disease, irrespective of race or causative illness. There is family clustering of chronic kidney disease in the sample studied, and this predisposition is irrespective of race and underlying disease (hypertension or diabetes mellitus).


Assuntos
Diabetes Mellitus Tipo 2/complicações , Hipertensão/complicações , Insuficiência Renal Crônica/etiologia , Idoso , Idoso de 80 Anos ou mais , Brasil , Estudos de Casos e Controles , Análise por Conglomerados , Diabetes Mellitus Tipo 2/epidemiologia , Saúde da Família , Feminino , Humanos , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Insuficiência Renal Crônica/epidemiologia
15.
Cien Saude Colet ; 20(2): 557-64, 2015 Feb.
Artigo em Inglês, Português | MEDLINE | ID: mdl-25715149

RESUMO

This study analyzed the coverage by the public health service of expenses with medication and vaccines for the adult population of São Paulo with self-reported diabetes mellitus in 2003 and the implications for access to medicines and vaccination campaigns programs. Data were collected by the Multicenter Health Survey of São Paulo. The Unified Health System (SUS) was widely used by the population for vaccination against influenza and pneumonia and there was significant private sector participation for coverage of expenses with medication, with an estimated coverage of 38% by SUS. There were no significant differences in the prevalence of use of public services for vaccination among the categories of variables studied, suggesting a universal distribution of vaccination by the public health service. Unlike vaccinations, in 2003 the coverage of medication expenses by the public health service was recent in Brazil, which may explain the low level of coverage. An analysis of coverage of vaccination and medication expenses in diabetes mellitus population since 2003 may contribute to be the basis for policies to broaden access of the population to health services.


Assuntos
Diabetes Mellitus , Hipoglicemiantes , Programas de Imunização , United States Public Health Service , Vacinação , Adolescente , Adulto , Criança , Pré-Escolar , Estudos Transversais , Diabetes Mellitus/tratamento farmacológico , Feminino , Humanos , Hipoglicemiantes/uso terapêutico , Lactente , Masculino , Pessoa de Meia-Idade , Estados Unidos , Adulto Jovem
16.
Braz. j. infect. dis ; 19(1): 15-22, Jan-Feb/2015. tab
Artigo em Inglês | LILACS | ID: lil-741237

RESUMO

Introduction: in Brazil, chronic hepatitis C in patients coinfected with the human immunodeficiency virus (HIV) is treated with pegylated interferon (Peg-IFN) and ribavirin (RBV). However, few studies have evaluated the effectiveness of this treatment in this particular population. The identification of the factors that predict sustained virological response (SVR) under current clinical practice would enable clinicians to more accurately estimate the probability of achieving an SVR and therefore utilize the appropriate therapeutics, especially in the era of direct-acting antiviral (DAA) agents. Aims: the primary aim of our study was to determine the SVR rate under current clinical practice. The secondary aims were as follows: (1) to determine the factors before and during treatment that predict SVR; and (2) to identify the causes of treatment interruption. Methods: within a cohort of HIV/hepatitis C virus (HCV)-coinfected patients in Brazil, we performed a retrospective analysis of those individuals treated with Peg-IFN and RBV. Results: among the 382 analyzed patients, SVR was observed in 118 [30.9% (95% confidence interval (CI): 26.3-35.8)], which included 25.9% (75/289) of the patients with genotypes 1 and 4 and 48.2% (41/85) of those with genotypes 2 and 3. After multivariate analyses the independent positive predictors for SVR after treatment for chronic hepatitis C with PegIFN and RBV were: absence of an AIDS-defining illness (p = 0.001), HCV viral load lower than 600,000 IU/mL at the onset of treatment (p = 0.003), higher liver enzyme levels (p = 0.039) at baseline, infection with genotypes 2 or 3 (p = 0.003), and no transient treatment interruption (p = 0.001). The treatment was interrupted in 25.6% (98/382) of the patients because of adverse events (11.3%, 43/382), virologic failure (7.8%, 30/382), and dropout (6.5%, 43/382). The main adverse events were cytopenia and psychiatric disorders. Conclusions: ...


Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Antivirais/administração & dosagem , Hepatite C Crônica/tratamento farmacológico , Interferon-alfa/administração & dosagem , Polietilenoglicóis/administração & dosagem , Ribavirina/administração & dosagem , Antivirais/efeitos adversos , Estudos de Coortes , Quimioterapia Combinada , Genótipo , Hepacivirus/genética , Hepatite C Crônica/virologia , Interferon-alfa/efeitos adversos , Polietilenoglicóis/efeitos adversos , Estudos Retrospectivos , RNA Viral , Proteínas Recombinantes/administração & dosagem , Proteínas Recombinantes/efeitos adversos , Ribavirina/efeitos adversos , Resultado do Tratamento , Carga Viral
17.
Ciênc. saúde coletiva ; 20(2): 557-564, 02/2015. tab
Artigo em Português | LILACS | ID: lil-742224

RESUMO

O estudo analisou a cobertura do serviço público de saúde para gastos com medicamentos e vacinas para a população adulta do município de São Paulo que referiu ter diabetes mellitus em 2003 e as implicações dos programas de acesso a medicamentos e campanhas vacinais. Dados coletados pelo Inquérito Multicêntrico de Saúde de São Paulo. O SUS foi o mais utilizado pela população para a vacinação contra a gripe e pneumonia e na cobertura do gasto com medicamentos houve participação significativa do setor privado, sendo a cobertura SUS estimada em 38%. Não foram observadas diferenças significativas na prevalência de utilização do serviço público para vacinação entre as categorias das variáveis pesquisadas, o que sugere uma distribuição universal da vacinação pelo serviço público de saúde. Diferente da vacinação, a cobertura do gasto com medicamentos pelo serviço público de saúde em 2003 era recente, o que pode explicar a menor cobertura. A análise da cobertura dos gastos com medicamento e vacinas pelo serviço de saúde em 2003 pode contribuir para embasar políticas que visem ampliar o acesso da população ao serviço de saúde.


This study analyzed the coverage by the public health service of expenses with medication and vaccines for the adult population of São Paulo with self-reported diabetes mellitus in 2003 and the implications for access to medicines and vaccination campaigns programs. Data were collected by the Multicenter Health Survey of São Paulo. The Unified Health System (SUS) was widely used by the population for vaccination against influenza and pneumonia and there was significant private sector participation for coverage of expenses with medication, with an estimated coverage of 38% by SUS. There were no significant differences in the prevalence of use of public services for vaccination among the categories of variables studied, suggesting a universal distribution of vaccination by the public health service. Unlike vaccinations, in 2003 the coverage of medication expenses by the public health service was recent in Brazil, which may explain the low level of coverage. An analysis of coverage of vaccination and medication expenses in diabetes mellitus population since 2003 may contribute to be the basis for policies to broaden access of the population to health services.


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Diabetes Mellitus , Hipoglicemiantes , Programas de Imunização , United States Public Health Service , Vacinação , Estudos Transversais , Diabetes Mellitus/tratamento farmacológico , Hipoglicemiantes/uso terapêutico , Estados Unidos
18.
Ciênc. saúde coletiva ; 20(2): 471-478, 02/2015. tab
Artigo em Português | LILACS | ID: lil-742230

RESUMO

No Brasil, a hipertensão e o diabetes mellitus tipo 2 são responsáveis por 60% dos casos de doença renal crônica terminal em terapia renal substitutiva. Estudos americanos identificaram agregação familiar da doença renal crônica, predominante em afrodescendentes. Um único estudo brasileiro observou agregação familiar entre portadores de doença renal crônica quando comparados a indivíduos internados com função renal normal. O objetivo deste artigo é avaliar se existe agregação familiar da doença renal crônica em familiares de indivíduos em terapia renal substitutiva causada por hipertensão e/ou diabetes mellitus. Estudo caso-controle tendo como casos 336 pacientes em terapia renal substitutiva portadores de diabetes mellitus ou hipertensão há pelo menos 5 anos e controles amostra pareada de indivíduos com hipertensão ou diabetes mellitus e função renal normal (n = 389). Os indivíduos em terapia renal substitutiva (casos) apresentaram razão de chance de 2,35 (IC95% 1,42-3,89; p < 0,001) versus controles de terem familiares com doença renal crônica terminal, independente da raça ou doença de base. Existe agregação familiar da doença renal crônica na amostra estudada e esta predisposição independe da raça e da doença de base (hipertensão ou diabetes mellitus).


In Brazil hypertension and type 2 diabetes mellitus are responsible for 60% of cases of end-stage renal disease in renal replacement therapy. In the United States studies have identified family clustering of chronic kidney disease, predominantly in African-Americans. A single Brazilian study observed family clustering among patients with chronic kidney disease when compared with hospitalized patients with normal renal function. This article aims to assess whether there is family clustering of chronic kidney disease in relatives of individuals in renal replacement therapy caused by hypertension and/or diabetes mellitus. A case-control study with 336 patients in renal replacement therapy with diabetes mellitus or hypertension for at least 5 years (cases) and a control matched sample group of individuals with hypertension or diabetes mellitus and normal renal function (n = 389). Individuals in renal replacement therapy (cases) had a ratio of 2.35 (95% CI 1.42-3.89, p < 0.001) versus the control group in having relatives with chronic renal disease, irrespective of race or causative illness. There is family clustering of chronic kidney disease in the sample studied, and this predisposition is irrespective of race and underlying disease (hypertension or diabetes mellitus).


Assuntos
Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Cistectomia , Terapia Neoadjuvante/métodos , Neoplasias da Bexiga Urinária/tratamento farmacológico , Neoplasias da Bexiga Urinária/patologia , Quimioterapia Adjuvante , Cisplatino/administração & dosagem , Metotrexato/administração & dosagem , Análise de Sobrevida , Resultado do Tratamento , Neoplasias da Bexiga Urinária/cirurgia , Vimblastina/administração & dosagem
19.
Braz J Infect Dis ; 19(1): 15-22, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25181403

RESUMO

INTRODUCTION: in Brazil, chronic hepatitis C in patients coinfected with the human immunodeficiency virus (HIV) is treated with pegylated interferon (Peg-IFN) and ribavirin (RBV). However, few studies have evaluated the effectiveness of this treatment in this particular population. The identification of the factors that predict sustained virological response (SVR) under current clinical practice would enable clinicians to more accurately estimate the probability of achieving an SVR and therefore utilize the appropriate therapeutics, especially in the era of direct-acting antiviral (DAA) agents. AIMS: the primary aim of our study was to determine the SVR rate under current clinical practice. The secondary aims were as follows: (1) to determine the factors before and during treatment that predict SVR; and (2) to identify the causes of treatment interruption. METHODS: within a cohort of HIV/hepatitis C virus (HCV)-coinfected patients in Brazil, we performed a retrospective analysis of those individuals treated with Peg-IFN and RBV. RESULTS: among the 382 analyzed patients, SVR was observed in 118 [30.9% (95% confidence interval (CI): 26.3-35.8)], which included 25.9% (75/289) of the patients with genotypes 1 and 4 and 48.2% (41/85) of those with genotypes 2 and 3. After multivariate analyses the independent positive predictors for SVR after treatment for chronic hepatitis C with Peg-IFN and RBV were: absence of an AIDS-defining illness (p=0.001), HCV viral load lower than 600,000IU/mL at the onset of treatment (p=0.003), higher liver enzyme levels (p=0.039) at baseline, infection with genotypes 2 or 3 (p=0.003), and no transient treatment interruption (p=0.001). The treatment was interrupted in 25.6% (98/382) of the patients because of adverse events (11.3%, 43/382), virologic failure (7.8%, 30/382), and dropout (6.5%, 43/382). The main adverse events were cytopenia and psychiatric disorders. CONCLUSIONS: in our Brazilian case series, the SVR rate under current clinical practice conditions was similar to that reported in other studies. There was a correlation between an SVR and being infected by genotypes 2 and 3, low viral load, high ALT levels at the onset of treatment, and absence of an AIDS-defining illness. Cytopenia and psychiatric disorders were the major causes of treatment interruption. Efforts should be focused on optimizing management of side effects and counseling to improve adherence and to keep patients on treatment.


Assuntos
Antivirais/administração & dosagem , Hepatite C Crônica/tratamento farmacológico , Interferon-alfa/administração & dosagem , Polietilenoglicóis/administração & dosagem , Ribavirina/administração & dosagem , Adulto , Antivirais/efeitos adversos , Contagem de Linfócito CD4 , Estudos de Coortes , Quimioterapia Combinada , Feminino , Genótipo , Hepacivirus/genética , Hepatite C Crônica/virologia , Humanos , Interferon alfa-2 , Interferon-alfa/efeitos adversos , Masculino , Pessoa de Meia-Idade , Polietilenoglicóis/efeitos adversos , RNA Viral , Proteínas Recombinantes/administração & dosagem , Proteínas Recombinantes/efeitos adversos , Estudos Retrospectivos , Ribavirina/efeitos adversos , Resultado do Tratamento , Carga Viral
20.
Rev Bras Epidemiol ; 17(3): 577-81, 2014.
Artigo em Inglês, Português | MEDLINE | ID: mdl-25272253

RESUMO

OBJECTIVE: To Analyze the association between prevalence of fatigue referred by physical therapists and their occupational exposure to radiation emitted by therapeutic microwave diathermy equipment. METHODS: A Cross-sectional study conducted in 193 physical therapists from four cities of the west of Paraná State, Brazil. A specified structured web questionnaire was applied for collecting data about microwave diathermy exposition and potential confounders, plus the Multidimensional Assessment of Fatigue (MAF). Statistical analysis included logistic regression and Student's t-test. RESULTS: The prevalence of fatigue in the category exposed to microwave diathermy was higher (15.0%) than in non-exposed (2.9%). On multivariate logistic regression, a significant independent association between exposure to microwave diathermy and prevalence of fatigue was observed (odds ratio 4.93; 95% confidence interval 1.04 - 23.25; p = 0.04). The Student's t-test showed significant difference between the number of hours exposed to diathermy microwave, being 3,839.1 within physical therapists who referred fatigue and 497.6 within others (p = 0.004). CONCLUSION: The results demonstrate a significant and independent association between occupational exposure of physical therapists to radiation of microwave diathermy and prevalence of fatigue. Therefore, occupational safety guidelines aimed at these professionals as a prevention of possible adverse effects, as well as the replication of this study are suggested.


Assuntos
Diatermia/efeitos adversos , Fadiga/epidemiologia , Fadiga/etiologia , Micro-Ondas/efeitos adversos , Doenças Profissionais/epidemiologia , Doenças Profissionais/etiologia , Exposição Ocupacional/efeitos adversos , Fisioterapia , Adulto , Estudos Transversais , Diatermia/instrumentação , Feminino , Humanos , Masculino , Prevalência
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