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O Risco de Doença Cardiovascular Segundo o Escore Não Laboratorial da OMS em uma População Brasileira Selecionada: Percentis da Distribuição e Concordância com o Escore Laboratorial Selecionada
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Cesena, Fernando Yue

; Generoso, Giuliano

; Santos, Itamar de S.

; Pereira, Alexandre C. Bittencourt, Marcio S. Santos, Raul D. Lotufo, Paulo A. Benseñor, Isabela M.

Arquivos Brasileiros de Cardiologia

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2024, Volume 121 N. 7 elocation e20240002

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

https://doi.org/10.36660/abc.20240002

Saúde Cardiovascular e Fibrilação ou Flutter Atrial: Um Estudo Transversal do ELSA-Brasil Atrial ELSABrasil ELSA Brasil
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Santos, Itamar S.

; Lotufo, Paulo A.

; Goulart, Alessandra C.

; Brant, Luisa C. C.

; Pinto Filho, Marcelo M Pereira, Alexandre C. Barreto, Sandhi M. Ribeiro, Antonio L. P. Thomas, G Neil Lip, Gregory Y. H. Bensenor, Isabela M. Arasalingam, Ajini Beane, Abi Bensenor, Isabela M Brocklehurst, Peter Cheng, Kar Keung El-Bouri, Wahbi Feng, Mei Goulart, Alessandra C Greenfield, Sheila Guo, Yutao Guruparan, Mahesan Gusso, Gustavo Gooden, Tiffany E Haniffa, Rashan Humphreys, Lindsey Jolly, Kate Jowett, Sue Kumarendran, Balachandran Lancashire, Emma Lane, Deirdre A Li, Xuewen Lip (Co-PI), Gregory Y.H. Li, Yan-guang Lobban, Trudie Lotufo, Paulo A Manseki-Holland, Semira Moore, David J Nirantharakumar, Krishnarajah Olmos, Rodrigo D Paschoal, Elisabete Pirasanth, Paskaran Powsiga, Uruthirakumar Romagnolli, Carla Santos, Itamar S Shantsila, Alena Sheron, Vethanayagam Antony Shribavan, Kanesamoorthy Szmigin, Isabelle Subaschandren, Kumaran Surenthirakumaran, Rajendra Tai, Meihui Neil Thomas (Co-PI), G Varella, Ana C Wang, Hao Wang, Jingya Zhang, Hui Zhong, Jiaoyue

Arquivos Brasileiros de Cardiologia

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nov 2022, Volume 119 N. 5 Pages 724 - 731

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

Abstract Background The association between ideal cardiovascular health (ICVH) status and atrial fibrillation or flutter (AFF) diagnosis has been less studied compared to other cardiovascular diseases. Objective To analyze the association between AFF diagnosis and ICVH metrics and scores in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Methods This study analyzed data from 13,141 participants with complete data. Electrocardiographic tracings were coded according to the Minnesota Coding System, in a centralized reading center. ICVH metrics (diet, physical activity, body mass index, smoking, blood pressure, fasting plasma glucose, and total cholesterol) and scores were calculated as proposed by the American Heart Association. Crude and adjusted binary logistic regression models were built to analyze the association of ICVH metrics and scores with AFF diagnosis. Significance level was set at 0.05. Results The sample had a median age of 55 years and 54.4% were women. In adjusted models, ICVH scores were not significantly associated with prevalent AFF diagnosis (odds ratio [OR]:0.96; 95% confidence interval [95% CI]:0.80-1.16; p=0.70). Ideal blood pressure (OR:0.33; 95% CI:0.15–0.74; p=0.007) and total cholesterol (OR:1.88; 95% CI:1.19–2.98; p=0.007) profiles were significantly associated with AFF diagnosis. Conclusions No significant associations were identified between global ICVH scores and AFF diagnosis after multivariable adjustment in our analyses, at least partially due to the antagonistic associations of AFF with blood pressure and total cholesterol ICVH metrics. Our results suggest that estimating the prevention of AFF burden using global ICVH scores may not be adequate, and ICVH metrics should be considered in separate. (ICVH (AFF diseases ELSABrasil. ELSABrasil ELSA Brasil . (ELSA-Brasil) 13141 13 141 13,14 System center diet, diet (diet activity index smoking glucose Association 005 0 05 0.05 5 544 54 4 54.4 women odds OR0.96 OR096 OR 0.96 96 [OR]:0.96 95 [95 CI0.801.16 CI080116 CI 0.80 1.16 80 1 16 CI]:0.80-1.16 p=0.70. p070 p p=0.70 70 p=0.70) OR0.33 OR033 0.33 33 (OR:0.33 CI0.15–0.74 CI015074 0.15–0.74 15 74 CI:0.15–0.74 p=0.007 p0007 007 OR1.88 OR188 1.88 88 (OR:1.88 CI1.19–2.98 CI119298 1.19–2.98 19 2 98 CI:1.19–2.98 analyses adequate separate (ELSA-Brasil 1314 14 13,1 00 0.0 54. OR0 OR0.9 OR09 096 0.9 9 [OR]:0.9 [9 CI0 801 CI0.801.1 CI08011 080 0.8 116 1.1 8 CI]:0.80-1.1 p07 p=0.7 7 OR0.3 OR03 033 0.3 3 (OR:0.3 CI0.15–0.7 CI01507 015074 0.15–0.7 CI:0.15–0.7 p=0.00 p000 OR1 OR1.8 OR18 188 1.8 (OR:1.8 CI1 CI1.19–2.9 CI11929 119298 1.19–2.9 CI:1.19–2.9 131 13, 0. OR0. 09 [OR]:0. [ CI0.801. CI0801 08 11 1. CI]:0.80-1. p0 p=0. 03 (OR:0. CI0.15–0. CI0150 01507 0.15–0. CI:0.15–0. p=0.0 p00 OR1. 18 (OR:1. CI1.19–2. CI1192 11929 1.19–2. CI:1.19–2. [OR]:0 CI0.801 CI080 CI]:0.80-1 p=0 (OR:0 CI0.15–0 CI015 0150 0.15–0 CI:0.15–0 (OR:1 CI1.19–2 CI119 1192 1.19–2 CI:1.19–2 [OR]: CI0.80 CI08 CI]:0.80- p= (OR: CI0.15– CI01 015 0.15– CI:0.15– CI1.19– CI11 119 1.19– CI:1.19– [OR] CI0.8 CI]:0.80 (OR CI0.15 01 0.15 CI:0.15 CI1.19 1.19 CI:1.19 [OR CI0. CI]:0.8 CI0.1 0.1 CI:0.1 CI1.1 CI:1.1 CI]:0. CI:0. CI1. CI:1. CI]:0 CI:0 CI:1 CI]: CI: CI]

Resumo Fundamento A associação entre o status de saúde cardiovascular ideal ( ideal cardiovascular health ( ICVH) e diagnóstico de fibrilação ou flutter atrial (FFA) foi menos estudado em comparação a outras doenças cardiovasculares. Objetivos Analisar a associação entre o diagnóstico de FFA e métricas e escores de ICVH no Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil). Métodos Este estudo analisou dados de 13141 participantes com dados completos. Os traçados eletrocardiográficos foram codificados de acordo com o Sistema de Minnesota, em um centro de leitura centralizado. As métricas do ICVH (dieta, atividade física, índice de massa corporal, tabagismo, glicemia de jeju, e colesterol total) e escores do ICVH foram calculados conforme proposto pela American Heart Association . Modelos de regressão logística bruta e ajustada foram construídos para analisar associações de métricas e escores do ICVH com diagnóstico de FFA. O nível de significância foi estabelecido em 0,05. Resultados A idade mediana da amostra foi de 55 anos, e 54,4% eram mulheres. Nos modelos ajustados, os escores de ICVH não apresentaram associação significativa com diagnóstico de FFA prevalente [odds ratio (OR):0,96; intervalo de confiança de 95% (IC95%):0,80-1,16; p=0,70). Perfis de pressão arterial ideal (OR:0,33; IC95%:0,1-0,74; p=0,007) e colesterol total ideal (OR:1,88; IC95%:1,19-2,98; p=0,007) foram significativamente associados com o diagnóstico de FFA. Conclusões Não foram identificadas associações significativas entre escores de ICVH global e diagnóstico de FFA após ajuste multivariado em nossas análises, devido, ao menos em parte, às associações antagônicas da FFA com métricas de pressão arterial e de colesterol total do ICVH. Nossos resultados sugerem que estimar a prevenção da FFA por meio de escore de ICVH global pode não ser adequado, e as métricas do ICVH devem ser consideradas separadamente. (FFA cardiovasculares ELSABrasil. ELSABrasil ELSA Brasil (ELSA-Brasil) 1314 completos Minnesota centralizado dieta, dieta (dieta física corporal tabagismo jeju 005 0 05 0,05 5 anos 544 54 4 54,4 mulheres ajustados odds OR0,96 OR096 OR 0,96 96 (OR):0,96 95 IC95%0,801,16 IC95080116 IC IC95% 0,80 1,16 IC95 80 1 16 (IC95%):0,80-1,16 p=0,70. p070 p p=0,70 70 p=0,70) OR0,33 OR033 0,33 33 (OR:0,33 IC95%0,10,74 IC9501074 0,1 0,74 74 IC95%:0,1-0,74 p=0,007 p0007 007 OR1,88 OR188 1,88 88 (OR:1,88 IC95%1,192,98 IC95119298 1,19 2,98 19 2 98 IC95%:1,19-2,98 análises devido parte adequado separadamente (ELSA-Brasil 131 00 0,0 54, OR0 OR0,9 OR09 096 0,9 9 (OR):0,9 801 IC95%0,801,1 IC9508011 080 0,8 116 1,1 IC9 8 (IC95%):0,80-1,1 p07 p=0,7 7 OR0,3 OR03 033 0,3 3 (OR:0,3 10 IC95%0,10,7 IC950107 01 0, 074 0,7 IC95%:0,1-0,7 p=0,00 p000 OR1 OR1,8 OR18 188 1,8 (OR:1,8 192 IC95%1,192,9 IC9511929 119 298 2,9 IC95%:1,19-2,9 13 OR0, 09 (OR):0, IC95%0,801, IC950801 08 11 1, (IC95%):0,80-1, p0 p=0, 03 (OR:0, IC95%0,10, IC95010 07 IC95%:0,1-0, p=0,0 p00 OR1, 18 (OR:1, IC95%1,192, IC951192 29 2, IC95%:1,19-2, (OR):0 IC95%0,801 IC95080 (IC95%):0,80-1 p=0 (OR:0 IC95%0,10 IC9501 IC95%:0,1-0 (OR:1 IC95%1,192 IC95119 IC95%:1,19-2 (OR): IC95%0,80 IC9508 (IC95%):0,80- p= (OR: IC95%0,1 IC950 IC95%:0,1- IC95%1,19 IC9511 IC95%:1,19- (OR) IC95%0,8 (IC95%):0,80 (OR IC95%0, IC95%:0,1 IC95%1,1 IC951 IC95%:1,19 (IC95%):0,8 IC95%0 IC95%:0, IC95%1, IC95%:1,1 (IC95%):0, IC95%:0 IC95%1 IC95%:1, (IC95%):0 IC95%: IC95%:1 (IC95%): (IC95%) (IC95% (IC95 (IC9 (IC

https://doi.org/10.36660/abc.20210970

Saúde Cardiovascular e Fibrilação ou Flutter Atrial: Um Estudo Transversal do ELSA-Brasil
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Santos, Itamar S.

; Lotufo, Paulo A.

; Goulart, Alessandra C.

; Brant, Luisa C. C.

Arquivos Brasileiros de Cardiologia

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2022, N. ahead

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.36660/abc.20210970

Chronic inflammatory diseases, subclinical atherosclerosis, and cardiovascular diseases: Design, objectives, and baseline characteristics of a prospective case-cohort study ‒ ELSA-Brasil
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Bensenor, Isabela M.

; Goulart, Alessandra C.

; Pereira, Alexandre C.

; Brunoni, André R.

; Alencar, Airlane

; Santos, Raul D.

; Bittencourt, Márcio S.

; Telles, Rosa W.

; Machado, Luciana Andrade Carneiro

; Barreto, Sandhi Maria

; de Almeida-Pititto, Bianca

; Janovsky, Carolina Porto Silva

; Sgarbi, José Augusto

; Tebar, William R.

; Meneghini, Vandrize

; Barbosa Junior, Fernando

; Ribeiro, Ana Cristina de Medeiros

; Pasoto, Sandra Gofinet

; Pereira, Rosa Maria R.

; Bonfá, Eloísa

; Sipahi, Aytan M.

; Santos, Itamar de S.

; Lotufo, Paulo A.

Clinics

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2022, Volume 77 elocation 100013

Abstract: En | Text: En | PDF: En

Abstract Objectives This analysis describes the protocol of a study with a case-cohort to design to prospectively evaluate the incidence of subclinical atherosclerosis and Cardiovascular Disease (CVD) in Chronic Inflammatory Disease (CID) participants compared to non-diseased ones. Methods A high-risk group for CID was defined based on data collected in all visits on self-reported medical diagnosis, use of medicines, and levels of high-sensitivity C-Reactive Protein >10 mg/L. The comparison group is the Aleatory Cohort Sample (ACS): a group with 10% of participants selected at baseline who represent the entire cohort. In both groups, specific biomarkers for DIC, markers of subclinical atherosclerosis, and CVD morbimortality will be tested using weighted Cox. Results The high-risk group (n = 2,949; aged 53.6 ± 9.2; 65.5% women) and the ACS (n=1543; 52.2±8.8; 54.1% women) were identified. Beyond being older and mostly women, participants in the high-risk group present low average income (29.1% vs. 24.8%, p < 0.0001), higher BMI (Kg/m2) (28.1 vs. 26.9, p < 0.0001), higher waist circumference (cm) (93.3 vs. 91, p < 0.0001), higher frequencies of hypertension (40.2% vs. 34.5%, p < 0.0001), diabetes (20.7% vs. 17%, p = 0.003) depression (5.8% vs. 3.9%, p = 0.007) and higher levels of GlycA a new inflammatory marker (p < 0.0001) compared to the ACS. Conclusions The high-risk group selected mostly women, older, lower-income/education, higher BMI, waist circumference, and of hypertension, diabetes, depression, and higher levels of GlycA when compared to the ACS. The strategy chosen to define the high-risk group seems adequate given that multiple sociodemographic and clinical characteristics are compatible with CID.

https://doi.org/10.1016/j.clinsp.2022.100013

Electrocardiogram in Chagas disease: can anything be learned from an old tool?
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Pereira, Alexandre C.

Revista da Sociedade Brasileira de Medicina Tropical

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oct 2018, Volume 51 N. 5 Pages 569 - 569

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/0037-8682-0379-2018 925 downloads

Clinical, Anthropometric and Biochemical Characteristics of Patients with or without Genetically Confirmed Familial Hypercholesterolemia
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Lorenzo, Andrea De Silva, Juliana Duarte Lopes da James, Cinthia E. Pereira, Alexandre C. Moreira, Annie Seixas Bello

Arquivos Brasileiros de Cardiologia

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feb 2018, Volume 110 N. 2 Pages 119 - 123

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Fundamentos: A hipercolesterolemia familiar (HF) é uma doença autossômica dominante, caracterizada por altos níveis plasmáticos do colesterol da lipoproteína de baixa densidade (LDL-C) e pelo alto risco de desenvolvimento prematuro de doenças cardiovasculares. Objetivo: Avaliar características clínicas e antropométricas de pacientes com fenótipo para hipercolesterolemia familiar (HF), com ou sem diagnóstico genético de HF. Métodos: Quarenta e cinco pacientes com LDL-C > 190 mg/dL foram genotipados para seis genes relacionados com a HF: LDLR, APOB, PCSK9, LDLRAP1, LIPA e APOE. Pacientes que apresentaram resultado positivo para qualquer uma das mutações foram diagnosticados com HF por confirmação genética. O fenótipo para HF foi classificado pelo critério da Dutch Lipid Clinic Network. Resultados: Comparando os pacientes com a HF geneticamente confirmada com aqueles sem a confirmação, os primeiros apresentaram maior pontuação do escore para HF, uma maior frequência de xantelasma e maiores níveis de LDL-C e apo B. Houve correlações significativas entre o LDL-C e a pontuação do escore para HF (R = 0,382, p = 0,037) e entre LDL-C e gordura corporal (R = 0,461, p = 0,01). Os pacientes com mutações, no entanto, não apresentaram qualquer correlação entre o LDL-C e outras variáveis, enquanto aqueles sem mutação apresentaram correlação entre o LDL-C e a pontuação do escore. Conclusão: O LDL-C correlacionou-se com a pontuação do escore e com a gordura corporal, tanto na população total de pacientes quanto nos pacientes sem a confirmação genética de HF. Naqueles com HF geneticamente confirmada, não houve correlação entre o LDL-C e outras variáveis clínicas ou bioquímicas dos pacientes.

Abstract Background: Familial hypercholesterolemia (FH) is a common autosomal dominant disorder, characterized by a high level of low-density lipoprotein cholesterol (LDL-C) and a high risk of premature cardiovascular disease. Objective: To evaluate clinical and anthropometric characteristics of patients with the familiar hypercholesterolemia (FH) phenotype, with or without genetic confirmation of FH. Methods: Forty-five patients with LDL-C > 190 mg/dl were genotyped for six FH-related genes: LDLR, APOB, PCSK9, LDLRAP1, LIPA and APOE. Patients who tested positive for any of these mutations were considered to have genetically confirmed FH. The FH phenotype was classified according to the Dutch Lipid Clinic Network criteria. Results: Comparing patients with genetically confirmed FH to those without it, the former had a higher clinical score for FH, more often had xanthelasma and had higher LDL-C and apo B levels. There were significant correlations between LDL-C and the clinical point score for FH (R = 0.382, p = 0.037) and between LDL-C and body fat (R = 0.461, p = 0.01). However, patients with mutations did not have any correlation between LDL-C and other variables, while for those without a mutation, there was a correlation between LDL-C and the clinical point score. Conclusions: LDL-C correlated with the clinical point score and with body fat, both in the overall patient population and in patients without the genetic confirmation of FH. In those with genetically confirmed FH, there were no correlations between LDL-C and other clinical or biochemical variables in patients.

https://doi.org/10.5935/abc.20180005 2664 downloads

Atualização da Diretriz Brasileira de Dislipidemias e Prevenção da Aterosclerose – 2017
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Faludi, André Arpad Izar, Maria Cristina de Oliveira Saraiva, José Francisco Kerr Chacra, Ana Paula Marte Bianco, Henrique Tria Afiune Neto, Abrahão Bertolami, Adriana Pereira, Alexandre C. Lottenberg, Ana Maria Sposito, Andrei C. Chagas, Antonio Carlos Palandri Casella Filho, Antonio Simão, Antônio Felipe Alencar Filho, Aristóteles Comte de Caramelli, Bruno Magalhães, Carlos Costa Negrão, Carlos Eduardo Ferreira, Carlos Eduardo dos Santos Scherr, Carlos Feio, Claudine Maria Alves Kovacs, Cristiane Araújo, Daniel Branco de Magnoni, Daniel Calderaro, Daniela Gualandro, Danielle Menosi Mello Junior, Edgard Pessoa de Alexandre, Elizabeth Regina Giunco Sato, Emília Inoue Moriguchi, Emilio Hideyuki Rached, Fabiana Hanna Santos, Fábio César dos Cesena, Fernando Henpin Yue Fonseca, Francisco Antonio Helfenstein Fonseca, Henrique Andrade Rodrigues da Xavier, Hermes Toros Mota, Isabela Cardoso Pimentel Giuliano, Isabela de Carlos Back Issa, Jaqueline Scholz Diament, Jayme Pesquero, João Bosco Santos, José Ernesto dos Faria Neto, José Rocha Melo Filho, José Xavier de Kato, Juliana Tieko Torres, Kerginaldo Paulo Bertolami, Marcelo Chiara Assad, Marcelo Heitor Vieira Miname, Márcio Hiroshi Scartezini, Marileia Forti, Neusa Assumpta Coelho, Otávio Rizzi Maranhão, Raul Cavalcante Santos Filho, Raul Dias dos Alves, Renato Jorge Cassani, Roberta Lara Betti, Roberto Tadeu Barcellos Carvalho, Tales de Martinez, Tânia Leme da Rocha Giraldez, Viviane Zorzanelli Rocha Salgado Filho, Wilson

Arquivos Brasileiros de Cardiologia

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aug 2017, Volume 109 N. 2 Pages 1 - 76

Abstract: Pt | Text: Pt | PDF: Pt

https://doi.org/10.5935/abc.20170121 199102 downloads

Growth hormone insensitivity with immune dysfunction caused by a STAT5B mutation in the south of Brazil: evidence for a founder effect
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Scalco, Renata C. Gonçalves, Fernanda T. Santos, Hadassa C. Cardena, Mari M. S. G. Tonelli, Carlos A. Funari, Mariana F. A. Aracava, Rosana M. Pereira, Alexandre C. Fridman, Cintia Jorge, Alexander A. L.

Genetics and Molecular Biology

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jun 2017, Volume 40 N. 2 Pages 436 - 441

Abstract: En | Text: En | PDF: En

ABSTRACT Homozygous STAT5B mutations causing growth hormone insensitivity with immune dysfunction were described in 10 patients since 2003, including two Brazilian brothers from the south of Brazil. Our objectives were to evaluate the prevalence of their STAT5B mutation in this region and to analyze the presence of a founder effect. We obtained DNA samples from 1,205 local inhabitants, 48 relatives of the homozygous patients and four individuals of another affected family. Genotyping for STAT5B c.424_427del mutation and for two polymorphic markers around it was done through fragment analysis technique. We also determined Y-chromosome and mtDNA haplotypes and genomic ancestry in heterozygous carriers. We identified seven families with STAT5B c.424_427del mutation, with 33 heterozygous individuals. The minor allelic frequency of this mutation was 0.29% in this population (confidence interval 95% 0.08-0.5%), which is significantly higher than the frequency of other pathogenic STAT5B allele variants observed in public databases (p < 0.001). All heterozygous carriers had the same haplotype present in the homozygous patients, found in only 9.4% of non-carriers (p < 0.001), supporting the existence of a founder effect. The Y-chromosome haplotype, mtDNA and genomic ancestry analysis indicated a European origin of this mutation. Our results provide compelling evidence for a founder effect of STAT5B c.424_427del mutation.

https://doi.org/10.1590/1678-4685-gmb-2016-0231 844 downloads

Differential reporting of discriminatory experiences in Brazil and the United States
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Burgard, Sarah Castiglione, Debora de Pina Lin, Katherine Y. Nobre, Aline A. Aquino, Estela M. L. Pereira, Alexandre C. Bensenor, Isabela J. Martins Barreto, Sandhi M. Chor, Dora

Cadernos de Saúde Pública

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2017, Volume 33 Suppl. 1 elocation e00110516

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

Resumo: Há poucos estudos comparativos entre países sobre a experiência com a discriminação percebida, e poucos examinaram a maneira pela qual as identidades interseccionais configuram a percepção do tratamento discriminatório nas diferentes sociedades. Com base em dados do ELSA-Brasil (um estudo de funcionários públicos brasileiros) e do Americans’ Changing Lives Study (em uma amostra nacional representativa de adultos americanos), os autores comparam os relatos de grupos diferentes em relação à discriminação sofrida ao longo da vida, de acordo com raça e gênero, em cada sociedade. O estudo também investiga se o grau de escolaridade explica as diferenças entre grupos, ou se as diferenças dentro do mesmo grupo variam de acordo com a escolaridade. Os resultados mostram uma percepção maior de discriminação entre indivíduos negros em ambos os países, principalmente homens negros, comparado com brancos, além de menos relatos de discriminação sofrida por mulheres brancas comparado com homens brancos. No Brasil, mulheres e homens pardos relataram maiores níveis de discriminação em comparação com homens brancos. Com exceção de homens brancos, para todos os grupos analisados por raça e gênero, os relatos de discriminação foram mais frequentes entre os mais escolarizados, embora o ajuste por diferenças de escolaridade dentro dos grupos não explicasse as diferenças entre grupos. No Brasil, encontramos as maiores disparidades raciais entre indivíduos com nível superior, enquanto nos Estados Unidos, os homens negros relatavam mais discriminação do que os homens brancos, independentemente de grau de escolaridade. Os resultados revelam semelhanças gerais entre os dois países, apesar de importantes diferenças históricas. A abordagem interseccional contribuiu para a identificação dessas semelhanças e de algumas diferenças nas experiências com a discriminação. Os achados do estudo têm implicações importantes para a vigilância social e sanitária, assim como, para intervenções voltadas ao enfrentamento das consequências danosas da discriminação.

Abstract: There has been little cross-national comparison of perceived discrimination, and few studies have considered how intersectional identities shape perception of discriminatory treatment in different societies. Using data from the ELSA-Brasil, a study of Brazilian civil servants, and the Americans’ Changing Lives Study, a nationally-representative sample of U.S. adults, we compare reports of lifetime discrimination among race-by-gender groups in each society. We also consider whether educational attainment explains any group differences, or if differences across groups vary by level of education. Results reveal higher lifetime discrimination experiences among Black respondents in both countries, especially Black men, than among Whites, and lower reports among White women than White men. Brown men and women also reported higher levels than White men in Brazil. For all race-by-gender groups in both countries, except Brazilian White men, reports of discrimination were higher among the more educated, though adjusting for educational differences across groups did not explain group differences. In Brazil, we found the greatest racial disparities among the college educated, while U.S. Black men were more likely to report discrimination than White men at all levels of education. Results reveal broad similarities across countries, despite important differences in their histories, and an intersectional approach contributed to identification of these similarities and some differences in discrimination experiences. These findings have implications for social and public health surveillance and intervention to address the harmful consequences of discrimination.

Resumen: Existen pocos estudios comparativos entre países sobre la experiencia con la discriminación percibida, y pocos examinaron la manera mediante la cual las identidades interseccionales configuran la percepción del tratamiento discriminatorio en las diferentes sociedades. En base a los datos del ELSA-Brasil (un estudio de funcionarios públicos brasileños) y del Americans’ Changing Lives Study (en una muestra nacional representativa de adultos americanos), los autores comparan los relatos de grupos diferentes, en relación a la discriminación sufrida a lo largo de la vida, de acuerdo con raza y género, en cada sociedad. El estudio también investiga si el grado de escolaridad explica las diferencias entre grupos, o si las diferencias dentro del mismo grupo varían de acuerdo con la escolaridad. Los resultados muestran una percepción mayor de discriminación entre individuos negros en ambos países, principalmente hombres negros, comparado con los blancos, además de menos relatos de discriminación sufrida por mujeres blancas, comparado con hombres blancos. En Brasil, mujeres y hombres mestizos relataron mayores niveles de discriminación, en comparación con los hombres blancos. Con excepción de hombres blancos, para todos los grupos analizados por raza y género, los relatos de discriminación fueron más frecuentes entre los más escolarizados, aunque el ajuste por diferencias de escolaridad dentro de los grupos no explicase las diferencias entre grupos. En Brasil, encontramos las mayores disparidades raciales entre individuos con nivel superior, mientras en los Estados Unidos, los hombres negros relataban más discriminación que los hombres blancos, independientemente del grado de escolaridad. Los resultados revelan semejanzas generales entre los dos países, a pesar de importantes diferencias históricas. El abordaje interseccional contribuyó a la identificación de esas semejanzas y de algunas diferencias en las experiencias con la discriminación. Los hallazgos del estudio tienen implicaciones importantes para la vigilancia social y sanitaria, así como, para intervenciones dirigidas a hacer frente a las consecuencias perniciosas de la discriminación.

https://doi.org/10.1590/0102-311x00110516 253 downloads

10.

Differential reporting of discriminatory experiences in Brazil and the United States
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Burgard, Sarah Castiglione, Debora de Pina Lin, Katherine Y. Nobre, Aline A. Aquino, Estela M. L. Pereira, Alexandre C. Bensenor, Isabela J. Martins Barreto, Sandhi M. Chor, Dora

Cadernos de Saúde Pública

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2017, Volume 33 Suppl. 1 elocation e00110516

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

https://doi.org/10.1590/0102-311x00110516 2890 downloads

11.

Delineamento e implementação do biobanco do ELSA-Brasil: estudo prospectivo na população brasileira
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Pereira, Alexandre C Bensenor, Isabela M Fedeli, Ligia M Castilhos, Cristina Vidigal, Pedro G Maniero, Viviane Leite, Claudia M Pimentel, Robercia A Duncan, Bruce B Mill, Jose Geraldo Lotufo, Paulo A

Revista de Saúde Pública

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jun 2013, Volume 47 Suppl. 2 Pages 72 - 78

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

O Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil) é uma coorte prospectiva multicêntrica de funcionários públicos delineada para avaliar os determinantes das doenças crônicas, principalmente a doença cardiovascular e o diabetes tipo 2. Neste artigo são descritos os principais pontos do delineamento e implementação do projeto do biobanco do ELSA-Brasil. São detalhados aspectos econômicos, políticos, logísticos e tecnológicos do estudo. O artigo também discute o protocolo final de estocagem de material biológico e as instalações implementadas para atingir esse objetivo. O processo de delineamento e implementação do biobanco do ELSA-Brasil durou três anos. Tanto os biobancos centrais quanto os locais foram constituídos de acordo com as melhores práticas de estocagem de material biológico, usando soluções tecnológicas diferentes para as diferentes necessidades previstas no estudo.

The Brazilian Longitudinal Study for Adult Health (ELSA-Brasil) is a multicenter prospective cohort of civil servants designed to assess the determinants of chronic diseases, especially cardiovascular diseases and type 2 diabetes. The present article describes the main design and implementation points of the ELSA-Brasil biobank project. Economic, political, logistical and technological aspects of this study are characterized. Additionally, it discusses the final biorepository protocol and the facilities implemented to achieve this objective. The design and implementation process of the ELSA-Brasil biobank took three years to be performed. Both the central and local biobanks were built according to the best biorepository techniques, using different technological solutions for the distinct needs expected in this study.

https://doi.org/10.1590/S0034-8910.2013047003822 4072 downloads

12.

Logística de coleta e transporte de material biológico e organização do laboratório central no ELSA-Brasil
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Fedeli, Ligia G Vidigal, Pedro G Leite, Claudia Mendes Castilhos, Cristina D Pimentel, Robércia Anjos Maniero, Viviane C Mill, Jose Geraldo Lotufo, Paulo A Pereira, Alexandre C Bensenor, Isabela M

Revista de Saúde Pública

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jun 2013, Volume 47 Suppl. 2 Pages 63 - 71

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

O Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil) é um estudo de coorte multicêntrico com o objetivo de identificar os fatores de risco associados ao diabetes tipo 2 e à doença cardiovascular na população brasileira. O artigo descreve as estratégias de coleta, processamento, transporte e de controle de qualidade dos exames de sangue e urina no ELSA. O estudo optou pela centralização dos exames em um único laboratório. O processamento das amostras foi realizado nos laboratórios locais, reduzindo o peso do material a ser transportado e diminuindo os custos do transporte para o laboratório central no Hospital da Universidade de São Paulo. O estudo incluiu exames para avaliação de diabetes, resistência à insulina, dislipidemias, alterações eletrolíticas, hormônios tireoidianos, ácido úrico, alterações de enzimas hepáticas, inflamação e hemograma completo. Além desses exames, foram estocados DNA de leucócitos, amostras de urina, plasma e soro. O laboratório central realizou aproximadamente 375.000 exames.

The ELSA (Estudo Longitudinal de Saúde do Adulto - Brazilian Longitudinal Study for Adult Health) is a multicenter cohort study which aims at the identification of risk factors associated with type 2 diabetes and cardiovascular diseases in the Brazilian population. The paper describes the strategies for the collection, processing, transportation, and quality control of blood and urine tests in the ELSA. The study decided to centralize the tests at one single laboratory. The processing of the samples was performed at the local laboratories, reducing the weight of the material to be transported, and diminishing the costs of transportation to the central laboratory at the Universidade de São Paulo Hospital. The study included tests for the evaluation of diabetes, insulin resistance, dyslipidemia, electrolyte abnormalities, thyroid hormones, uric acid, hepatic enzyme abnormalities, inflammation, and total blood cell count. In addition, leukocyte DNA, urine, plasma and serum samples were stored. The central laboratory performed approximately 375,000 tests.

https://doi.org/10.1590/S0034-8910.2013047003807 12984 downloads

13.

Delineamento e implementacao do biobanco do ELSA-Brasil: estudo prospectivo na populacao brasileira
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Pereira, Alexandre C Bensenor, Isabela M Fedeli, Ligia M Castilhos, Cristina Vidigal, Pedro G Maniero, Viviane Leite, Claudia M Pimentel, Robercia A Duncan, Bruce B Mill, Jose Geraldo Lotufo, Paulo A

Revista de Saúde Pública

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jun 2013, Volume 47 Suppl. 2 Pages 72 - 78

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.1590/S0034-8910.2013047003822

14.

Logistica de coleta e transporte de material biologico e organizacao do laboratorio central no ELSA-Brasil
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Fedeli, Ligia G Vidigal, Pedro G Leite, Claudia Mendes Castilhos, Cristina D Pimentel, Robercia Anjos Maniero, Viviane C Mill, Jose Geraldo Lotufo, Paulo A Pereira, Alexandre C Bensenor, Isabela M

Revista de Saúde Pública

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jun 2013, Volume 47 Suppl. 2 Pages 63 - 71

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.1590/S0034-8910.2013047003807

15.

Design and baseline characteristics of a coronary heart disease prospective cohort: two-year experience from the strategy of registry of acute coronary syndrome study (ERICO study)
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Goulart, Alessandra C. Santos, Itamar S. Sitnik, Debora Staniak, Henrique L. Fedeli, Ligia M. Pastore, Carlos Alberto Samesima, Nelson Bittencourt, Marcio S. Pereira, Alexandre C. Lotufo, Paulo A. Bensenor, Isabela M.

Clinics

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2013, Volume 68 N. 3 Pages 431 - 434

Abstract: En | Text: En | PDF: En

OBJECTIVES: To describe the ERICO study (Strategy of Registry of Acute Coronary Syndrome), a prospective cohort to investigate the epidemiology of acute coronary syndrome. METHODS: The ERICO study, which is being performed at a secondary general hospital in São Paulo, Brazil, is enrolling consecutive acute coronary syndrome patients who are 35 years old or older. The sociodemographic information, medical assessments, treatment data and blood samples are collected at admission. After 30 days, the medical history is updated, and additional blood and urinary samples are collected. In addition, a retinography, carotid intima-media thickness, heart rate variability and pulse-wave velocity are performed. Questionnaires about food frequency, physical activity, sleep apnea and depression are also applied. At six months and annually after an acute event, information is collected by telephone. RESULTS: From February 2009 to September 2011, 738 patients with a diagnosis of an acute coronary syndrome were enrolled. Of these, 208 (28.2%) had ST-elevation myocardial infarction (STEMI), 288 (39.0%) had non-ST-elevation myocardial infarction (NSTEMI) and 242 (32.8%) had unstable angina (UA). The mean age was 62.7 years, 58.5% were men and 77.4% had 8 years or less of education. The most common cardiovascular risk factors were hypertension (76%) and sedentarism (73.4%). Only 29.2% had a prior history of coronary heart disease. Compared with the ST-elevation myocardial infarction subgroup, the unstable angina and non-ST-elevation myocardial infarction patients had higher frequencies of hypertension, diabetes, prior coronary heart disease (p<0.001) and dyslipidemia (p = 0.03). Smoking was more frequent in the ST-elevation myocardial infarction patients (p = 0.006). CONCLUSIONS: Compared with other hospital registries, our findings revealed a higher burden of CV risk factors and less frequent prior CHD history.

https://doi.org/10.6061/clinics/2013(03)RC02 2618 downloads

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