RESUMEN

AIM: To estimate the association between consumption of sugar-sweetened soft drinks and unsweetened fruit juice with metabolic syndrome (MetS) and its components in participants of the Brazilian Longitudinal Adult Health Study (ELSA-Brasil) after 4 years of follow-up. METHODS: We used data from ELSA-Brasil cohort (N = 15,105). The sample consisted of 6,124 civil servants free of the MetS at baseline (35 to 74 years, both sexes). The consumption of sugar-sweetened soft drinks and unsweetened fruit juice was estimated by a food frequency questionnaire previously validated. The outcome was MetS and its components (Joint Interim Statement criteria). To test the association between beverage consumption at baseline (2008-2010) and MetS and its components at follow-up (2012-2014), we used Poisson regression models with robust variance adjusting for potential confounders. RESULTS: After 4-year follow-up, the higher consumption of sugar-sweetened soft drinks (≥ 1 serving/day = 250 mL/day) increased the relative risk of MetS (RR = 1.22; 95% CI 1.04-1.45), high fasting glucose (RR = 1.23; 95% CI 1.01-1.48), and high blood pressure (RR = 1.23; 95% CI 1.00-1.54). Moderate consumption of this beverage (0.4 to < 1 serving/day) increased the relative risk of high waist circumference (WC) (RR = 1.21; 95% CI 1.02-1.42). After adjustment for confounding variables, the consumption of unsweetened fruit juice was not associated with the MetS and its components. CONCLUSION: Higher sugar-sweetened soft drinks consumption was associated with a higher risk relative of MetS, high fasting glucose, and high blood pressure, while moderate consumption of this beverage increased the relative risk of high WC in Brazilian adults.

Asunto(s)

Hipertensión , Síndrome Metabólico , Bebidas Azucaradas , Adulto , Masculino , Femenino , Humanos , Síndrome Metabólico/epidemiología , Síndrome Metabólico/etiología , Azúcares , Bebidas Azucaradas/efectos adversos , Brasil/epidemiología , Glucosa

RESUMEN

OBJECTIVE: To investigate the mediation effect of socioeconomic position and racial discrimination in the association between race/color and incidence of hypertension in 4-years follow up. METHODS: We included 8,370 participants of the Longitudinal Study of Adult Health (ELSA-Brasil). A latent variable was constructed to represent socioeconomic position (SEP). The perception of discrimination was measured through an adaptation of the Lifetime Major Events Scale; and hypertension was defined using standard criteria. We investigated Body Mass Index (BMI) due to its role in proximal risk for hypertension. To investigate the mediating role of SEP and racial discrimination, we used structural equation modeling. RESULTS: SEP had a direct and negative effect on HT incidence (HT incidence increased in worse SEP categories), while the effect of BMI on HT was direct and positive. We did not find significant direct effects of race/color and racial discrimination on HT. As for indirect effects, we observed associations between race/color and HT only through SEP mediation. CONCLUSION: According to our results, race/color is indirectly related to HT incidence, mediated by SEP. Racial discrimination was not a mediator in the relationship between race/color and HT in the follow-up period.

Asunto(s)

Hipertensión , Racismo , Adulto , Humanos , Hipertensión/epidemiología , Incidencia , Estudios Longitudinales , Factores de Riesgo , Factores Socioeconómicos

RESUMEN

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 (ß = 0.064, 95% confidence interval 0.033; 0.096) and optimal health (ß = 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.

Asunto(s)

Negro o Afroamericano , Cognición , Adulto , Anciano , Estudios Transversales , Escolaridad , Femenino , Humanos , Estudios Longitudinales , Persona de Mediana Edad , Factores de Riesgo , Población Blanca

RESUMEN

Previous analyses of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) identified four main dietary patterns (DP). The aim of this study was to explore the association between the previously defined DP and renal function (RF). A cross-sectional study using the ELSA-Brasil baseline data was carried out. DP ("traditional", "fruits and vegetables", "bakery", and "low sugar/low fat), metabolic syndrome (MS) using the Joint Interim Statement criteria, microalbuminuria (MA), and glomerular filtration rate (eGFR) through the CKD-EPI equation were evaluated. Abnormal RF was defined as eGFR<60 mL·min-1·(1.73 m2)-1 and MA≥3.0 mg/dL. Factors associated with RF were determined and mediation analysis was performed to investigate the association between DP, MS, and RF. A total of 15,105 participants were recruited, with a mean age of 52±9 years; 8,134 participants (54%) were females. The mediation analysis identified indirect associations between "bakery" and "fruits and vegetables", and both were associated with decreased eGFR and albuminuria in both genders, compared with "traditional" and "low sugar/low fat" patterns in the general population. There was a direct association of the "bakery" pattern with MA in men (OR: 1.17, 95%CI: 1.92-1.48). The "fruits and vegetables" pattern also showed a direct association with reduced eGFR in women (OR: 1.65, 95%CI: 1.28-2.12), although there was no significance after adjustment. The "fruits and vegetables" and "bakery" DPs were associated with renal dysfunction. The only independent, direct association was between "bakery" DP and MA in men, raising concerns about DP and renal damage in men.

Asunto(s)

Dieta , Adulto , Brasil , Estudios Transversales , Femenino , Tasa de Filtración Glomerular , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Factores de Riesgo

RESUMEN

Recent evidence suggests that glaucoma and Alzheimer's disease are neurodegenerative diseases sharing common pathophysiological and etiological features, although findings are inconclusive. We sought to investigate whether self-reported glaucoma patients without dementia present poorer cognitive performance, an issue that has been less investigated. We employed cross-sectional data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) and included participants ≥50 years of age without a known diagnosis of dementia and a self-reported glaucoma diagnosis. We excluded those with previous stroke, other eye conditions, and using drugs that could impair cognition. We evaluated cognition using delayed word recall, phonemic verbal fluency, and trail making (version B) tests. We used multinomial linear regression models to investigate associations between self-reported glaucoma with cognition, adjusted by several sociodemographic and clinical variables. Out of 4,331 participants, 139 reported glaucoma. Fully-adjusted models showed that self-reported glaucoma patients presented poorer performance in the verbal fluency test (ß=-0.39, 95%CI=-0.64 to -0.14, P=0.002), but not in the other cognitive assessments. Thus, our results support the hypothesis that self-reported glaucoma is associated with poor cognitive performance; however, longitudinal data are necessary to corroborate our findings.

Asunto(s)

Cognición , Glaucoma , Anciano , Brasil , Estudios Transversales , Femenino , Humanos , Estudios Longitudinales , Persona de Mediana Edad , Pruebas Neuropsicológicas , Autoinforme

RESUMEN

AIMS: Depression is more prevalent in people with diabetes, and is associated with worse diabetes outcomes. Depression in diabetes is more treatment resistant, and as underlying mechanisms are unknown, development of more effective treatment strategies is complicated. A biopsychosocial model may improve our understanding of the pathophysiology, and therewith help improving treatment options. METHODS: Diabetes was diagnosed according to American Diabetes Association (ADA) criteria and a current depressive episode according to the International Classification of Diseases (ICD-10), based on the Clinical Interview Schedule Revised (CIS-R). From the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), we included 455 participants without diabetes with a current depressive episode and 10 900 without either diabetes or a current depressive episode. Furthermore, 2183 participants had diabetes alone and 106 had both diabetes and a current depressive episode. Variable selection was based on their relationship with depression and/or diabetes. Multinomial multivariate logistic regression was used to determine how the models differed between participants with and without diabetes. RESULTS: A current depressive episode in diabetes was related to being older and female, having poorer education, financial problems, experiencing discrimination at work, home and school, higher waist circumference, albumin to creatinine ratio and insulin resistance, and the presence of hypertension and cardiovascular disease. In non-diabetes, a current depressive disorder was related to being female, not being black, low income, psychological and social factors, non-current alcohol use, lower HDL cholesterol, higher insulin resistance and the presence of cardiovascular disease. CONCLUSIONS: A current depressive episode in the presence compared with the absence of diabetes was related more to biological than to psychosocial factors.

Asunto(s)

Trastorno Depresivo/psicología , Diabetes Mellitus/psicología , Adulto , Factores de Edad , Consumo de Bebidas Alcohólicas/epidemiología , Población Negra , Brasil/epidemiología , Enfermedades Cardiovasculares/epidemiología , Estudios de Casos y Controles , HDL-Colesterol/sangre , Creatinina/sangre , Escolaridad , Femenino , Estrés Financiero , Humanos , Renta , Resistencia a la Insulina , Modelos Logísticos , Masculino , Persona de Mediana Edad , Modelos Biopsicosociales , Análisis Multivariante , Albúmina Sérica , Factores Sexuales , Discriminación Social , Circunferencia de la Cintura

RESUMEN

We investigated whether high adherence to the Dietary Approaches to Stop Hypertension (DASH) diet was independently associated with lower risk of incident hypertension. Participants included 5632 adults, without hypertension at the baseline (2008-2010) of the Longitudinal Study of Adult Health, who took part in the second follow-up visit (2012-2014). Adherence to the DASH diet was estimated at baseline using a score based on eight food items (final scores from 8 to 40 points) and was categorised as high adherence (≥30 points, or ≥75 %) and low adherence (<75 %; reference). Hypertension was defined as systolic blood pressure (BP) ≥140 mmHg or diastolic BP ≥90 mmHg, or use of antihypertensive drugs. The association between adherence to the DASH diet and the risk of incident hypertension was estimated using Cox regression models adjusted by covariates. In total, 780 new cases of hypertension (13·8 %) were identified in about 3·8-year follow-up. Participants with high adherence to the DASH diet had 26 % lower risk of hypertension (hazard ratio (HR) 0·74; 95 % CI 0·57, 0·95) after adjustment for socio-demographic characteristics, health-related behaviours, diabetes and family history of hypertension. The HR reduced to 0·81 (95 % CI 0·63, 1·04) and was of borderline statistical significance after adjustment for BMI, suggesting that lower body weight explains about 10 % of the association between high adherence to the DASH diet and hypertension risk reduction. The results indicate that high adherence to the DASH diet lowered the risk of hypertension by one-fourth over a relatively short follow-up period.

Asunto(s)

Enfoques Dietéticos para Detener la Hipertensión , Hipertensión/prevención & control , Adulto , Animales , Peso Corporal , Brasil , Humanos , Estudios Longitudinales , Ratones , Cicatrización de Heridas/efectos de los fármacos

RESUMEN

Previous analyses of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) identified four main dietary patterns (DP). The aim of this study was to explore the association between the previously defined DP and renal function (RF). A cross-sectional study using the ELSA-Brasil baseline data was carried out. DP ("traditional", "fruits and vegetables", "bakery", and "low sugar/low fat), metabolic syndrome (MS) using the Joint Interim Statement criteria, microalbuminuria (MA), and glomerular filtration rate (eGFR) through the CKD-EPI equation were evaluated. Abnormal RF was defined as eGFR<60 mL·min-1·(1.73 m2)-1 and MA≥3.0 mg/dL. Factors associated with RF were determined and mediation analysis was performed to investigate the association between DP, MS, and RF. A total of 15,105 participants were recruited, with a mean age of 52±9 years; 8,134 participants (54%) were females. The mediation analysis identified indirect associations between "bakery" and "fruits and vegetables", and both were associated with decreased eGFR and albuminuria in both genders, compared with "traditional" and "low sugar/low fat" patterns in the general population. There was a direct association of the "bakery" pattern with MA in men (OR: 1.17, 95%CI: 1.92-1.48). The "fruits and vegetables" pattern also showed a direct association with reduced eGFR in women (OR: 1.65, 95%CI: 1.28-2.12), although there was no significance after adjustment. The "fruits and vegetables" and "bakery" DPs were associated with renal dysfunction. The only independent, direct association was between "bakery" DP and MA in men, raising concerns about DP and renal damage in men.

Asunto(s)

Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Dieta , Brasil , Estudios Transversales , Estudios Prospectivos , Factores de Riesgo , Estudios Longitudinales , Tasa de Filtración Glomerular

RESUMEN

Recent evidence suggests that glaucoma and Alzheimer's disease are neurodegenerative diseases sharing common pathophysiological and etiological features, although findings are inconclusive. We sought to investigate whether self-reported glaucoma patients without dementia present poorer cognitive performance, an issue that has been less investigated. We employed cross-sectional data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) and included participants ≥50 years of age without a known diagnosis of dementia and a self-reported glaucoma diagnosis. We excluded those with previous stroke, other eye conditions, and using drugs that could impair cognition. We evaluated cognition using delayed word recall, phonemic verbal fluency, and trail making (version B) tests. We used multinomial linear regression models to investigate associations between self-reported glaucoma with cognition, adjusted by several sociodemographic and clinical variables. Out of 4,331 participants, 139 reported glaucoma. Fully-adjusted models showed that self-reported glaucoma patients presented poorer performance in the verbal fluency test (β=-0.39, 95%CI=-0.64 to -0.14, P=0.002), but not in the other cognitive assessments. Thus, our results support the hypothesis that self-reported glaucoma is associated with poor cognitive performance; however, longitudinal data are necessary to corroborate our findings.

Asunto(s)

Humanos , Femenino , Persona de Mediana Edad , Anciano , Glaucoma , Cognición , Brasil , Estudios Transversales , Estudios Longitudinales , Autoinforme , Pruebas Neuropsicológicas

RESUMEN

OBJECTIVE: We investigated whether ideal cardiovascular health (ICH), a metric proposed by the American Heart Association, predicts depression development. METHODS: Cohort analysis from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Adults with no current depression and other common mental disorders, cardiovascular diseases, and antidepressant drug use at baseline had their ICH (composite score of smoking, dietary habits, body mass index, blood pressure, fasting glucose, cholesterol, and physical activity) assessed and classified into poor, intermediate, and optimal. Depression was assessed using the Clinical Interview Schedule-Revised (CIS-R). Poisson regression models, adjusted for sociodemographic factors and alcohol consumption, were employed. Stratified analyses were performed for age and sex. RESULTS: We included 9214 participants (mean age 52 ± 9 years, 48.6% women). Overall depression incidence at 3.8-year follow-up was 1.5%. Intermediate and poor ICH significantly increased the risk rate (RR) of developing depression (2.48 [95%CI 1.06-5.78] and 3 [1.28-7.03], respectively) at a 3.8-year follow-up. Higher ICH scores decreased the rate of depression development (RR = 0.84 [0.73-0.96] per metric). Stratified analyses were significant for women and adults < 55 years old. CONCLUSIONS: Poor cardiovascular health tripled depression risk at follow-up in otherwise healthy adults. Ameliorating cardiovascular health might decrease depression risk development.

Asunto(s)

Enfermedades Cardiovasculares/epidemiología , Trastorno Depresivo Mayor/epidemiología , Indicadores de Salud , Adulto , Anciano , Brasil/epidemiología , Femenino , Humanos , Incidencia , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Riesgo

RESUMEN

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 (Pinteraction=0.01, <0.0001 and <0.0001, respectively). In similarly adjusted ordinal logistic regression models, odds of obesity (odds ratio (OR)=0.65, 0.46-0.90) and of being in the high (vs low) tertile of WC (OR=0.66, 0.50-0.87) and of WHR (OR=0.79, 0.60-1.03) were lower for low (vs normal) birth weight men, but trended higher (BMI: OR=1.18, 0.92-1.51; WC: OR=1.21, 0.97-1.53; WHR: OR=1.44, 1.15-1.82) for low (vs normal) birth weight women. CONCLUSIONS: In this Brazilian sample of middle-aged and elderly adults who have lived through a rapid nutritional transition, low birth weight was associated with adult adiposity in a sex-specific manner. In men, low birth weight was associated with lower overall and central adult adiposity, while in women low birth weight was generally associated with greater central adiposity.

Asunto(s)

Adiposidad/fisiología , Peso al Nacer/fisiología , Obesidad Abdominal/epidemiología , Caracteres Sexuales , Adulto , Anciano , Índice de Masa Corporal , Brasil/epidemiología , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Fenómenos Fisiológicos de la Nutrición , Obesidad Abdominal/complicaciones , Prevalencia , Factores de Riesgo , Factores Sexuales , Circunferencia de la Cintura/fisiología , Relación Cintura-Cadera/estadística & datos numéricos

RESUMEN

The prevalence of obesity has increased to epidemic status worldwide. Thousands of morbidly obese individuals undergo bariatric surgery for sustained weight loss; however, mid- and long-term outcomes of this surgery are still uncertain. Our objective was to estimate the 10-year mortality rate, and determine risk factors associated with death in young morbidly obese adults who underwent bariatric surgery. All patients who underwent open Roux-in-Y gastric bypass surgery between 2001 and 2010, covered by an insurance company, were analyzed to determine possible associations between risk factors present at the time of surgery and deaths related and unrelated to the surgery. Among the 4344 patients included in the study, 79% were female with a median age of 34.9 years and median body mass index (BMI) of 42 kg/m2. The 30-day and 10-year mortality rates were 0.55 and 3.34%, respectively, and 53.7% of deaths were related to early or late complications following bariatric surgery. Among these, 42.7% of the deaths were due to sepsis and 24.3% to cardiovascular complications. Male gender, age ≥50 years, BMI ≥50 kg/m2, and hypertension significantly increased the hazard for all deaths (P<0.001). Age ≥50 years, BMI ≥50 kg/m2, and surgeon inexperience elevated the hazard of death from causes related to surgery. Male gender and age ≥50 years were the factors associated with increased mortality from death not related to surgery. The overall risk of death after bariatric surgery was quite low, and half of the deaths were related to the surgery. Older patients and superobese patients were at greater risk of surgery-related deaths, as were patients operated on by less experienced surgeons.

Asunto(s)

Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Derivación Gástrica/mortalidad , Obesidad Mórbida/cirugía , Complicaciones Posoperatorias/mortalidad , Factores de Edad , Índice de Masa Corporal , Brasil/epidemiología , Estudios de Seguimiento , Estimación de Kaplan-Meier , Mortalidad , Obesidad Mórbida/epidemiología , Competencia Profesional , Estudios Prospectivos , Factores de Riesgo , Factores Sexuales , Estadísticas no Paramétricas , Tasa de Supervivencia , Sepsis/mortalidad , Suicidio/estadística & datos numéricos , Resultado del Tratamiento , Tromboembolia/mortalidad

RESUMEN

The prevalence of obesity has increased to epidemic status worldwide. Thousands of morbidly obese individuals undergo bariatric surgery for sustained weight loss; however, mid- and long-term outcomes of this surgery are still uncertain. Our objective was to estimate the 10-year mortality rate, and determine risk factors associated with death in young morbidly obese adults who underwent bariatric surgery. All patients who underwent open Roux-in-Y gastric bypass surgery between 2001 and 2010, covered by an insurance company, were analyzed to determine possible associations between risk factors present at the time of surgery and deaths related and unrelated to the surgery. Among the 4344 patients included in the study, 79% were female with a median age of 34.9 years and median body mass index (BMI) of 42 kg/m(2). The 30-day and 10-year mortality rates were 0.55 and 3.34%, respectively, and 53.7% of deaths were related to early or late complications following bariatric surgery. Among these, 42.7% of the deaths were due to sepsis and 24.3% to cardiovascular complications. Male gender, age ≥50 years, BMI ≥50 kg/m(2), and hypertension significantly increased the hazard for all deaths (P<0.001). Age ≥50 years, BMI ≥50 kg/m(2), and surgeon inexperience elevated the hazard of death from causes related to surgery. Male gender and age ≥50 years were the factors associated with increased mortality from death not related to surgery. The overall risk of death after bariatric surgery was quite low, and half of the deaths were related to the surgery. Older patients and superobese patients were at greater risk of surgery-related deaths, as were patients operated on by less experienced surgeons.

Asunto(s)

Derivación Gástrica/mortalidad , Obesidad Mórbida/cirugía , Complicaciones Posoperatorias/mortalidad , Adulto , Factores de Edad , Índice de Masa Corporal , Brasil/epidemiología , Femenino , Estudios de Seguimiento , Humanos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Mortalidad , Obesidad Mórbida/epidemiología , Competencia Profesional , Estudios Prospectivos , Factores de Riesgo , Sepsis/mortalidad , Factores Sexuales , Estadísticas no Paramétricas , Suicidio/estadística & datos numéricos , Tasa de Supervivencia , Tromboembolia/mortalidad , Resultado del Tratamiento

RESUMEN

BACKGROUND: Migraine is an important source of social burden and work-related costs. Studies addressing the association of migraine with job stress are rare. OBJECTIVES: The aim of this paper was to study the association of job stress components and migraine using structured, validated questionnaires that were part of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). METHODS: The ELSA-Brasil is a multicentre cohort of 15,105 civil servants (12,096 current workers) in Brazil. Job strain was assessed using the 17-item Brazilian version of the Swedish Demand-Control-Support Questionnaire. Headache episodes in the preceding 12 months were assessed using a questionnaire based on the International Headache Society criteria. We analysed the association between job stress domains and migraine in men and women using adjusted logistic regression and interaction models. RESULTS: We included 3113 individuals without headache and 3259 migraineurs. Low job control [odds ratio (OR) 1.30; 95% confidence interval (95% CI) 1.10-1.53], high job demands (OR 1.37; 95% CI 1.18-1.59) and low social support (OR 1.49; 95% CI 1.29-1.71) were associated with migraine. Job control was more strongly associated with migraine in women (p for interaction = 0.02). High-strain (high demand and low control) jobs were associated with migraine in both men (OR 1.48; 95% CI 1.11-1.97) and women (OR 1.51; 95% CI 1.17-1.95). CONCLUSIONS: We observed a strong association between high-strain jobs and migraine. Job control was a stronger migraine-related factor for women. Low social support was associated with migraine in both sexes.

Asunto(s)

Empleo/estadística & datos numéricos , Trastornos Migrañosos/epidemiología , Enfermedades Profesionales/epidemiología , Poder Psicológico , Apoyo Social , Estrés Psicológico/epidemiología , Adulto , Anciano , Brasil/epidemiología , Comorbilidad , Empleo/psicología , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad

RESUMEN

Venous thrombosis, including deep vein thrombosis and pulmonary embolism, is a common disease that frequently recurs. Recurrence can be prevented by anticoagulants, but this comes at the risk of bleeding. Therefore, assessment of the risk of recurrence is important to balance the risks and benefits of anticoagulant treatment. This review briefly outlines what is currently known about the epidemiology of recurrent venous thrombosis, and focuses in more detail on potential new risk factors for venous recurrence. The general implications of these findings in patient management are discussed.

Asunto(s)

Femenino , Humanos , Anticoagulantes/uso terapéutico , Trombosis de la Vena/epidemiología , Medición de Riesgo , Factores de Riesgo , Recurrencia/prevención & control , Trombosis de la Vena/prevención & control

RESUMEN

Venous thrombosis, including deep vein thrombosis and pulmonary embolism, is a common disease that frequently recurs. Recurrence can be prevented by anticoagulants, but this comes at the risk of bleeding. Therefore, assessment of the risk of recurrence is important to balance the risks and benefits of anticoagulant treatment. This review briefly outlines what is currently known about the epidemiology of recurrent venous thrombosis, and focuses in more detail on potential new risk factors for venous recurrence. The general implications of these findings in patient management are discussed.

Asunto(s)

Anticoagulantes/uso terapéutico , Trombosis de la Vena/epidemiología , Femenino , Humanos , Masculino , Medición de Riesgo , Factores de Riesgo , Prevención Secundaria , Trombosis de la Vena/prevención & control

RESUMEN

Yeasts suplemented in the rumen have been produced benefic interations in the digestion and in the health of the ruminants. This study aimed to quantify, to isolate and, to identify aerobic fungi and yeasts naturally present in the rumen of goats and cattle raised on tropical pastures of the North of Minas Gerais State, Brazil. Samples of 15mL of ruminal juice from 18 hibrid goats and 31 crossbred Nellore steers were used. The physico-chemical characteristics of the samples were evaluated and mycological culture, quantification, and identification of the aerobic fungi were performed. The results indicated the absence of yeasts in the ruminal fluid of steers. However, theses microorganisms were cultured from ruminal juice for all evaluated goats, at an average concentration of 3.2 x 10VCFU/mL. The species Pichia membranifaciens was the most frequently identified yeast, suggesting its participation in the ruminal microbiot of theses small ruminants.

Asunto(s)

Animales , Levaduras/metabolismo , Rumiantes , Fermentación/fisiología , Rumen/anatomía & histología

RESUMEN

Yeasts suplemented in the rumen have been produced benefic interations in the digestion and in the health of the ruminants. This study aimed to quantify, to isolate and, to identify aerobic fungi and yeasts naturally present in the rumen of goats and cattle raised on tropical pastures of the North of Minas Gerais State, Brazil. Samples of 15mL of ruminal juice from 18 hibrid goats and 31 crossbred Nellore steers were used. The physico-chemical characteristics of the samples were evaluated and mycological culture, quantification, and identification of the aerobic fungi were performed. The results indicated the absence of yeasts in the ruminal fluid of steers. However, theses microorganisms were cultured from ruminal juice for all evaluated goats, at an average concentration of 3.2 x 10VCFU/mL. The species Pichia membranifaciens was the most frequently identified yeast, suggesting its participation in the ruminal microbiot of theses small ruminants.(AU)

Asunto(s)

Animales , Rumiantes/clasificación , Levaduras/metabolismo , Rumen/anatomía & histología , Fermentación/fisiología

RESUMEN

The presence of anaerobic fungi structures was evaluated in ruminal juice of beef goats and beef cattle raised in the North of Minas Gerais, Brazil. The strains were collected from 18 Anglo-Nubian crossbred male goats and 23 Nellore crossbred steers during the dry period of the year. Physical-chemical characteristics of the juice were evaluated and direct examination with KOH digestion was performed for anaerobic fungi detection. Structures of these fungi were detected in samples of 14 (77.8 percent) goats and 17 (73.9 percent) steers. The monocentric fungi frequency (56.5 percent) was significantly higher in cattle than polycentric fungi frequency (26.1 percent). This study is the first report of anaerobic ruminal fungi in these ruminants in Brazil and showed high prevalence of theses microorganisms in the ruminal ecosystem of both animals.

Asunto(s)

Animales , Bovinos , Hongos/aislamiento & purificación , Rumen/microbiología , Digestión Anaerobia , Bovinos , Cabras

RESUMEN

The presence of anaerobic fungi structures was evaluated in ruminal juice of beef goats and beef cattle raised in the North of Minas Gerais, Brazil. The strains were collected from 18 Anglo-Nubian crossbred male goats and 23 Nellore crossbred steers during the dry period of the year. Physical-chemical characteristics of the juice were evaluated and direct examination with KOH digestion was performed for anaerobic fungi detection. Structures of these fungi were detected in samples of 14 (77.8 percent) goats and 17 (73.9 percent) steers. The monocentric fungi frequency (56.5 percent) was significantly higher in cattle than polycentric fungi frequency (26.1 percent). This study is the first report of anaerobic ruminal fungi in these ruminants in Brazil and showed high prevalence of theses microorganisms in the ruminal ecosystem of both animals.(AU)

Asunto(s)

Animales , Bovinos , Rumen/microbiología , Hongos/aislamiento & purificación , Bovinos , Cabras , Digestión Anaerobia