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- Childhood cancer: incidence and spatial patterns in the city of Campinas, Brazil, 1996-2005Publication . Oliveira Friestino, Jane Kelly; Mendonça, Denisa; Oliveira, Pedro; Oliveira, Carla Maria; Moreira Filho, Djalma De CarvalhoThis article analyzes cancer incidence and spatial patterns in children and adolescents (0-19 years of age) residing in the city of Campinas in Southeastern Brazil who were diagnosed from 1996-2005. Cancers were classified according to the Third International Classification of Childhood Cancer (ICCC-3) Groups. The four most common groups were studied: leukemias, lymphomas, and central nervous system and soft tissue neoplasms. Age-standardized incidence rates were calculated using the world standard population. A spatial Bayesian hierarchical regression model (controlling for data heterogeneity and spatial autocorrelation) was fitted, assuming that the number of cancer cases follows a Poisson distribution. A total of 180 cases were diagnosed during the study period. Overall, the crude incidence rate was 54.2 per million and the age-standardized incidence rate was 56.5 per million. Although some regions present higher incidence rates, considering the spatial heterogeneity and the spatial autocorrelation, no statistically significant differences in the relative risks were observed.
- Marked socioeconomic inequalities in hip fracture incidence rates during the Bone and Joint Decade (2000-2010) in Portugal: age and sex temporal trends in a population based studyPublication . Oliveira, Carla Maria; Alves, Sandra Maria; Pina, Maria De FátimaBackground: Socioeconomic factors may influence changes in hip fracture (HF) incidence over time. We analysed HF temporal trends during the Bone and Joint Decade in Portugal (BJD-Portugal), 2000–2010, by regional socioeconomic status (SES), sex and age. Methods: We selected registers of patients aged 50+ years with HF (International Classification of Diseases, V.9—Clinical Modification, ICD9-CM) caused by traumas of low/moderate energy, from the National Hospital Discharge Database. Annual time series of age-specific incidence rates were calculated by sex and regional SES (deprived, medium, affluent). Generalised additive models were fitted to identify shape/turning points in temporal trends. Results: We selected 96 905 HF (77.3% in women). Women were older than men at admission (81.2±8.5 vs 78.2±10.1 years-old, p<0.001). For women 65–79 years, a continuously decreasing trend (1.7%/year) only in affluent and increasing trends (3.3–3.4%/year) after 2006/2007 in medium and deprived was observed. For men, trends were stable or increased in almost all age/SES groups (only two decreasing periods). For the oldest women, all SES present similar trends: turning points around 2003 (initiating decreasing periods: 1.8–2.9%/year) and around 2007 (initiating increasing periods: 3.7–3.3%/year). Conclusions: There were SES-sex-age inequalities in temporal trends during BJD-Portugal: marked SES inequalities among women aged 65–79 years (a persistent, decreasing trend only in the affluent) vanished among the oldest women; the same was not observed in men, for them, there were almost no declining periods; women aged ≥80 years, presented increasing trends around 2007, as in most deprived/age/sex groups. Despite some successful periods of decreasing trends, incidence rates did not improve overall in almost all age groups and both sexes.
- A incontinência urinária em mulheres praticantes de exercício recreativo: um estudo transversalPublication . Silva, Maria Francisca; Costa, Rui Prado; Oliveira, Carla Maria; Moreira, SusanaA incontinência urinária afeta até um terço das mulheres em Portugal. O exercício pode ser fator precipitante/de exacerbação, mas também protetor, se for adequado. O objetivo deste estudo é determinar a prevalência de incontinência urinária em mulheres praticantes de exercício recreativo, avaliar a relação com o tipo de exercício e outros fatores de risco coexistentes, e aferir se o tema é abordado nos ginásios. Material e Métodos: Estudo transversal através de questionários de auto-preenchimento em ginásios do Porto e Vila Nova de Gaia. Resultados: Duzentas e noventa mulheres completaram os questionários. Destas, 67,6% tinham menos de 40 anos, 25,2% referiam incontinência e 53,4% tinham pelo menos um fator de risco não relacionado com exercício. Verificou-se uma associação estatisticamente significativa (p < 0,05) entre incontinência, obesidade e obstipação. Exercícios de alto impacto eram incluídos nos treinos de 62,1% das mulheres continentes e 50,9% das incontinentes. O tema incontinência e fortalecimento muscular do pavimento pélvico foi abordado em apenas 5,5% na avaliação inicial, 9,7% em treinos coletivos e em 13,5% das 37 mulheres com treinos individuais. Discussão: A maior proporção de mulheres continentes, comparativamente às incontinentes, que praticavam exercício extenuante, sugere que este era um fator provocativo para algumas, não se verificando, contudo, uma associação estatisticamente significativa entre incontinência e tipo de exercício. Conclusão: A incontinência urinária afeta mulheres praticantes de exercício recreativo, independentemente da idade e características do exercício. É raramente abordada nos ginásios, sendo necessário sensibilizar os profissionais para potenciar os efeitos preventivos/ terapêuticos do exercício na função do pavimento pélvico e no controlo de fatores de risco modificáveis
- Regional drinking water composition effects on hip fracture risk: a spatial analysis of nationwide hospital admissions in Portugal, from 2000 to 2010Publication . Oliveira, Carla Maria; Teixeira, Hugo; Alves, Sandra Maria; Pina, Maria FátimaA variabilidade espacial existente na fratura do colo do fêmur (FCF) pode estar relacionada com a variabilidade geográfica da composição da água para consumo (CAC), devido à ação dos minerais na fragilidade óssea. O objetivo do artigo foi investigar o efeito da CAC no risco de FCF em Portugal (2000-2010). Do registo nacional de altas hospitalares, foram selecionadas todas as admissões em indivíduos ≥50, com diagnóstico de FCF causado por trauma de baixo/moderado impacto. Os componentes e características da água foram usados ao nível do município. Um modelo espacial aditivo generalizado, com a distribuição binomial negativa como função de ligação, foi usado para estimar a associação de FCF e as variações da CAC. Foram selecionadas 96.905 FCF (77,3% em mulheres).
- Osteoporotic hip fractures: Bisphosphonates sales and observed turning point in trend. A population-based retrospective studyPublication . Alves, Sandra Maria; Economou, Theodoros; Oliveira, Carla Maria; Ribeiro, Ana Isabel; Neves, Nuno; Goméz-Barrena, Enrique; Pina, Maria de FátimaThe aim is to examine the temporal trends of hip fracture incidence in Portugal by sex and age groups, and explore the relation with anti-osteoporotic medication. From the National Hospital Discharge Database, we selected from 1st January 2000 to 31st December 2008, 77,083 hospital admissions (77.4% women) caused by osteoporotic hip fractures (low energy, patients over 49 years-age), with diagnosis codes 820.x of ICD 9-CM. The 2001 Portuguese population was used as standard to calculate direct age-standardized incidence rates (ASIR) (100,000 inhabitants). Generalized additive and linear models were used to evaluate and quantify temporal trends of age specific rates (AR), by sex. We identified 2003 as a turning point in the trend of ASIR of hip fractures in women. After 2003, the ASIR in women decreased on average by 10.3 cases/100,000 inhabitants, 95% CI (− 15.7 to − 4.8), per 100,000 anti-osteoporotic medication packages sold. For women aged 65–69 and 75–79 we identified the same turning point. However, for women aged over 80, the year 2004 marked a change in the trend, from an increase to a decrease. Among the population aged 70–74 a linear decrease of incidence rate (95% CI) was observed in both sexes, higher for women: − 28.0% (− 36.2 to − 19.5) change vs − 18.8%, (− 32.6 to − 2.3). The abrupt turning point in the trend of ASIR of hip fractures in women is compatible with an intervention, such as a medication. The trends were different according to gender and age group, but compatible with the pattern of bisphosphonates sales.