Epidemiologia e Servicos de Saude最新文献

Objective: To identify the presence of therapeutic competitions according to the frailty component classification and to assess association between therapeutic competitions and frailty in people aged 60 or over in the city of São Paulo, Brazil.

Methods: This was a population-based cross-sectional study. Frailty was identified when three to five components defined by Fried were present, and pre-frailty was identified when one or two were present. Therapeutic competitions were characterized by use of medication for a specific chronic non-communicable disease that negatively affects another disease. We used multinomial logistic regression.

Results: Therapeutic competitions were identified for 13.2% of the 1,224 participants. Of this total, 18.7% were considered to be frail individuals. The most prevalent therapeutic competition involved diabetes and cardiovascular disease (4.2% of the total and 6.8% of frail people) with metformin or angiotensin-converting enzyme inhibitors. The presence of two therapeutic competitions in individuals with multimorbidity increased the likelihood of pre-frailty (odds ratio 2.51; 95% confidence interval 1.10; 5.76).

Conclusion: Therapeutic competitions are common in the elderly population and more frequent among frail elderly people, with increased likelihood of pre-frailty when two therapeutic competitions are present.

Objective: To investigate disparities in meat consumption in Brazil and analyze its relationship with the intake of fresh fruits and vegetables.

Methods: This is a cross-sectional study using secondary data from the 2019 National Health Survey. Red meat consumption (in days) was estimated according to socioeconomic and demographic data. Odds ratios (OR) were estimated using multinomial logistic regression, and the association between meat consumption and fruit and vegetable intake was assessed by means of Poisson regression.

Results: Of a total of 83,085 Brazilians participating in the study, 29.2% reported consuming meat 5-7 times per week. Sociodemographic and economic factors revealed a lower likelihood of consuming meat 5-7 days/week among women [OR 0.50, 95%CI 0.46; 0.53), older adults (OR 0.48, 95%CI 0.37; 0.63) and residents of the Northeast region of the country (OR 0.72, 95%CI 0.66; 0.79). After adjustments, red meat consumption was directly associated (p-value<0.001) with vegetable intake (0.04) and inversely associated with fruit intake (-0.04).

Conclusion: Meat consumption is unequal among Brazilians and may have an impact on the consumption of fresh foods, such as fruits.

Objective: To compare the 90-day survival of critically ill people with COVID-19 and acute kidney injury in intensive care units (ICU) of public and private hospitals.

Methods: This was a retrospective cohort study of critically ill people with COVID-19 and acute kidney injury undergoing hemodialysis in Joinville, Santa Catarina state.

Results: The 90-day survival rate in public ICU was 15.7% (95%CI 8.4; 25.1), while in private ICU it was 37.7% (95%CI 24.9; 50.5%). In the multivariate analysis adjusted for sociodemographic variables (Hazard ratio (HR) 2.01; 95%CI 1.31; 3.08) and comorbidities (HR 2.09; 95%CI 1.30; 3.37), admission to a public ICU was associated with a higher risk of death. After including severity of illness, admission to a public ICU was not associated with an increased risk of death compared to private ICU (HR 0.79; 95%CI 0.45; 1.42).

Conclusion: Measures implemented during the COVID-19 pandemic may have reduced inequalities between health systems for critically ill patients with acute kidney injury.