RESUMEN
AIMS: To determine the prevalence of inadequate glycemic control and its correlates in a large multicenter survey of Venezuelan patients with diabetes. METHODS: A cross-sectional study in a sample of adult patients with diabetes, attending health centers in Venezuela. Information about diabetes, current medications, complications, and diet were obtained by trained interviewers, using a standardized questionnaire. HbA(1c) was measured by high-performance liquid chromatography in a central laboratory. Patients with HbA(1c) >or=7% were considered to have inadequate glycemic control. RESULTS: Overall 4075 patients were surveyed, 349(8.6%) with type 1 diabetes (T1D) and 3726(91.4%) with type 2 diabetes(T2D). Subjects' mean age was 58 years, and 65% were female. The prevalence of inadequate glycemic control was 76%. Poor glycemic control was more common in T1D patients (87%) than in those with T2D(75%), p<10(-4). Satisfaction with current diabetes treatment was associated with improved glycemic control among non-insulin-treated patients with T2D, but gender, multi-professional care, and participation in a diabetes education program were not. CONCLUSIONS: Despite clinical evidence supporting tight control of diabetes, few diabetic patients in Venezuela met recommended glycemic control targets. This may contribute to increased rates of diabetic complications. Our findings support the public health message of implementation of early, aggressive management of diabetes.
Asunto(s)
Diabetes Mellitus Tipo 1/epidemiología , Diabetes Mellitus Tipo 2/epidemiología , Hemoglobina Glucada/metabolismo , Adulto , Factores de Edad , Distribución de Chi-Cuadrado , Cromatografía Líquida de Alta Presión , Estudios Transversales , Diabetes Mellitus Tipo 1/tratamiento farmacológico , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Femenino , Encuestas Epidemiológicas , Humanos , Hipoglucemiantes/uso terapéutico , Insulina/uso terapéutico , Masculino , Persona de Mediana Edad , Educación del Paciente como Asunto , Satisfacción del Paciente , Prevalencia , Autocuidado , Factores Sexuales , Encuestas y Cuestionarios , VenezuelaRESUMEN
Diabetes is a significant public health burden on the basis of its increased incidence, morbidity, and mortality. This study aimed to estimate the prevalence of inadequate glycaemic control and its correlates in a large multicentre survey of Brazilian patients with diabetes. A cross-sectional study was conducted in a consecutive sample of patients aged 18 years or older with either type 1 or type 2 diabetes, attending health centres located in ten large cities in Brazil (response rate = 84%). Information about diabetes, current medications, complications, diet, and satisfaction with treatment were obtained by trained interviewers, using a standardized questionnaire. Glycated haemoglobin (HbA(1c)) was measured by high-performance liquid chromatography in a central laboratory. Patients with HbA(1c) > or = 7 were considered to have inadequate glycaemic control. Overall 6,701 patients were surveyed, 979 (15%) with type 1 and 5,692 (85%) with type 2 diabetes. The prevalence of inadequate glycaemic control was 76%. Poor glycaemic control was more common in patients with type 1 diabetes (90%) than in those with type 2 (73%), P < 0.001. Characteristics significantly associated with improved glycaemic control included: fewer years of diabetes duration, multi professional care, participation in a diabetes health education program, and satisfaction with current diabetes treatment. Despite increased awareness of the benefits of tight glycaemic control, we found that few diabetic patients in Brazil met recommended glycaemic control targets. This may contribute to increased rates of diabetic complications, which may impact health care costs. Our data support the public health message of implementation of early, aggressive management of diabetes.
Asunto(s)
Glucemia/metabolismo , Diabetes Mellitus Tipo 1/sangre , Diabetes Mellitus Tipo 2/sangre , Encuestas Epidemiológicas , Adolescente , Adulto , Anciano , Glucemia/análisis , Brasil/epidemiología , Estudios Transversales , Diabetes Mellitus Tipo 1/epidemiología , Diabetes Mellitus Tipo 1/rehabilitación , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/rehabilitación , Etnicidad , Femenino , Hemoglobina Glucada/análisis , Humanos , Hipoglucemiantes/uso terapéutico , Insulina/uso terapéutico , Masculino , Persona de Mediana Edad , Educación del Paciente como Asunto , Selección de Paciente , Grupos Raciales , Encuestas y Cuestionarios , Adulto JovenRESUMEN
CONTEXT: Sexual dysfunctions can have origins in physical, psychological and psychosocial factors. OBJECTIVE: To describe the frequency of erectile dysfunction (ED) and female inhibition of sexual desire (ISD) in a Brazilian sample, and to estimate the risks of these dysfunctions. TYPE OF STUDY: Non-random survey. SETTING: Ten Brazilian cities. METHODS: 2,835 subjects (53% women) aged over 18 years answered a questionnaire about their general health and sex life. The chi-squared test and multivariate logistic regression were used. Values of p < or = 0.05 were considered significant. RESULTS: The women's average age was 36.6 years (+/- 13.3) and the men's was 39.5 (+/- 13.3). 14.7% of men presented moderate/complete ED and 34.6% of women presented ISD. Depression was mentioned by 16.8% of men and 29.7% of women. The chances of having ED and ISD were higher for subjects who had had lower school attainment. Lack of a job and depression gave rise to 1.5 times (95% CI: 1.0 - 2.3) and 1.9 times (95% CI: 1.2 - 3.0) greater chances of ED respectively. Compared with men aged up to 25 years, those aged 41-60 had 1.9 times (95% CI: 1.0 - 3.4) and those aged 61 and over had 5.4 times (95% CI: 2.3 - 12.6) greater risk of ED. For women, lack of a job gave rise to 1.5 times (95% CI: 1.1 - 1.9) greater chance of ISD; depression was not associated with higher risk. Compared with women aged up to 25 years, those aged 41-60 and 61 or over had, respectively, 2.9 times (95% CI: 2.0 - 4.1) and 7.5 times (95% CI: 3.0 -18.6) greater risk of ISD. DISCUSSION: Increasing unemployment has affected the whole population, but especially those with lower levels of school attainment. Such levels are positively linked with presence of sexual dysfunctions. CONCLUSION: Lack of jobs, age and low school attainment are risks for the sexual dysfunctions studied. Depression increased the risk of ED but not female ISD.
Asunto(s)
Depresión/complicaciones , Disfunciones Sexuales Psicológicas/psicología , Desempleo/psicología , Adulto , Brasil/epidemiología , Depresión/psicología , Métodos Epidemiológicos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Distribución por Sexo , Disfunciones Sexuales Psicológicas/epidemiología , Factores Socioeconómicos , Encuestas y CuestionariosRESUMEN
CONTEXTO: As disfunções sexuais originam-se de fatores físicos, psicológicos e psicossociais. OBJETIVO: Apresentar freqüências de disfunção erétil e inibição do desejo sexual feminino em amostra brasileira e estimar riscos destas disfunções. TIPO DO ESTUDO: Transversal. LOCAL: 10 cidades brasileiras.MÉTODOS: 2.835 indivíduos (53% mulheres), maiores de 18 anos, responderam a um questionário sobre saúde geral e vida sexual. Foram utilizados testes de qui-quadrado e regressão logística multivariada. São significantes valores de p < 0.05. RESULTADOS: A idade média foi 36,6 anos (DP = 13,3) para mulheres e 39,5 anos (DP = 13,3) para homens. 14,7% dos homens apresentavam disfunção erétil moderada/completa (DE) e 34,6% das mulheres, inibição do desejo sexual (IDS). Depressão foi referida por 16,8% dos homens e 29,7% das mulheres. A chance para DE e IDS foi maior para indivíduos com menos anos de escolaridade. Falta de emprego e depressão aumentaram 1,5 vezes (95% CI; 1,0 - 2,3) e 1,9 vezes (95% CI; 1,2 - 3,0) as chances para DE, respectivamente. Comparados aos homens com até 25 anos de idade, aqueles com 41 a 60 anos tiveram risco 1,9 vezes maior para DE (95% CI; 1,0 - 3,4) e 5,4 vezes (95% CI; 2,3 - 12,6) para aqueles com 61 anos ou mais. Para mulheres, a falta de emprego aumentou 1,5 vezes a chance para IDS (95% CI; 1,1 - 1,9); a depressão não aumentou o risco. Comparadas às mulheres com até 25 anos, aquelas com 41 a 60 anos e com 61 anos ou mais têm risco 2,9 vezes maior para IDS (95% CI; 2,0 - 4,1) e 7,5 vezes maior (95% CI; 3,0 - 18,6), respectivamente. DISCUSSÃO: O desemprego, como tendência mundial crescente, tem afetado todos os níveis da população, especialmente os com baixo nível de escolaridade. Baixos níveis de escolaridade estão correlacionados positivamente à presença de disfunções sexuais. CONCLUSÕES: Ausência de emprego, idade e baixa escolaridade representam risco para as disfunções sexuais pesquisadas. Depressão aumentou o risco para disfunção erétil, mas não para inibição do desejo sexual feminino.
Asunto(s)
Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Depresión/complicaciones , Disfunciones Sexuales Psicológicas/psicología , Desempleo/psicología , Brasil/epidemiología , Depresión/psicología , Métodos Epidemiológicos , Encuestas y Cuestionarios , Distribución por Sexo , Disfunciones Sexuales Psicológicas/epidemiología , Factores SocioeconómicosRESUMEN
CONTEXT: Recent population-based surveys suggest that the prevalence of erectile dysfunction is between 30% and 56% among men over the age of 40. Most of these studies, however, are from the United States or Europe. We need estimates of erectile dysfunction from samples of Brazilian populations, as societies that differ ethnically, culturally, and economically may also differ with respect to potential risk factors for erectile dysfunction. OBJECTIVE: To determine the prevalence of erectile dysfunction and its potential correlates. SETTING: Santos, State of São Paulo. DESIGN: Cross-sectional study. PARTICIPANTS: A population-based sample of men aged 40-70 years. Out of 718 men invited, 342 (47.6%) returned a completed questionnaire. MAIN MEASUREMENTS: Data on demographic variables, medical history, lifestyle habits and degree of erectile dysfunction. RESULTS: The prevalence of any degree of erectile dysfunction was 45.9% (minimal, 33.9%; moderate, 8.5%; complete, 3.5%) and increased with age. In bivariate age-adjusted analyses comparing men with no erectile dysfunction or minimal erectile dysfunction with those with moderate or complete erectile dysfunction, histories of diabetes or hypertension, depressive symptoms, heavy smoking and obesity were significantly associated with increased prevalence of erectile dysfunction, whereas moderate alcohol consumption was inversely associated with erectile dysfunction. In the multivariate model, age was a strong predictor of erectile dysfunction, while history of diabetes or hypertension and heavy smoking remained significantly associated with increased prevalence of erectile dysfunction. CONCLUSION: We found higher prevalence of erectile dysfunction (45.9%) among men older than 40 years old in Brazil. The variables associated with erectile dysfunction may alert physicians to patients who are at risk of erectile dysfunction as well as offer clues to the etiology of erectile dysfunction. Physicians should routinely ask their patients about sexual health and erectile dysfunction.
Asunto(s)
Disfunción Eréctil/epidemiología , Adulto , Factores de Edad , Anciano , Brasil/epidemiología , Estudios Transversales , Humanos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Prevalencia , Factores de Riesgo , Índice de Severidad de la EnfermedadRESUMEN
CONTEXT: Recent population-based surveys suggest that the prevalence of erectile dysfunction is between 30 percent and 56 percent among men over the age of 40. Most of these studies, however, are from the United States or Europe. We need estimates of erectile dysfunction from samples of Brazilian populations, as societies that differ ethnically, culturally, and economically may also differ with respect to potential risk factors for erectile dysfunction. OBJECTIVE: To determine the prevalence of erectile dysfunction and its potential correlates. SETTING: Santos, State of Säo Paulo. DESIGN: Cross-sectional study. PARTICIPANTS: A population-based sample of men aged 40-70 years. Out of 718 men invited, 342 (47.6 percent) returned a completed questionnaire. MAIN MEASUREMENTS: Data on demographic variables, medical history, lifestyle habits and degree of erectile dysfunction. RESULTS: The prevalence of any degree of erectile dysfunction was 45.9 percent (minimal, 33.9 percent; moderate, 8.5 percent; complete, 3.5 percent) and increased with age. In bivariate age-adjusted analyses comparing men with no erectile dysfunction or minimal erectile dysfunction with those with moderate or complete erectile dysfunction, histories of diabetes or hypertension, depressive symptoms, heavy smoking and obesity were significantly associated with increased prevalence of erectile dysfunction, whereas moderate alcohol consumption was inversely associated with erectile dysfunction. In the multivariate model, age was a strong predictor of erectile dysfunction, while history of diabetes or hypertension and heavy smoking remained significantly associated with increased prevalence of erectile dysfunction. CONCLUSION: We found higher prevalence of erectile dysfunction (45.9 percent) among men older than 40 years old in Brazil. The variables associated with erectile dysfunction may alert physicians to patients who are at risk of erectile dysfunction as well as offer clues to the etiology of erectile dysfunction. Physicians should routinely ask their patients about sexual health and erectile dysfunction
Asunto(s)
Humanos , Masculino , Adulto , Persona de Mediana Edad , Disfunción Eréctil , Índice de Severidad de la Enfermedad , Brasil , Prevalencia , Estudios Transversales , Análisis Multivariante , Factores de Riesgo , Factores de EdadRESUMEN
Os autores apresentam um caso de adenocarcinoma in situ do colo uterino. Devido à raridade e à controvérsia a respeito do diagnóstico e terapêutica do adenocarcinoma in situ é de especial interesse o relato desse caso. Avaliaram, os autores, o quadro clínico, aspecto colpocitológico, anatomopatológico e tratamento realizado