MOISES GOLDBAUM
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Medicina Preventiva, Faculdade de Medicina - Docente
LIM/39 - Laboratório de Processamento de Dados Biomédicos, Hospital das Clínicas, Faculdade de Medicina
LIM/39 - Laboratório de Processamento de Dados Biomédicos, Hospital das Clínicas, Faculdade de Medicina
11 resultados
Resultados de Busca
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- Estilo de vida saudável em São Paulo, Brasil(2017) FERRARI, Tatiane Kosimenko; CESAR, Chester Luiz Galvao; ALVES, Maria Cecilia Goi Porto; BARROS, Marilisa Berti de Azevedo; GOLDBAUM, Moises; FISBERG, Regina MaraThe objective was to analyze adolescent, adult, and elderly lifestyles in the city of Sao Paulo, Brazil, according to demographic and socioeconomic variables. A cross-sectional, population-based study was performed with data from the Health Survey in Sao Paulo City (ISA-Capital 2008) database. Lifestyle was defined on the basis of physical activity, diet, smoking, and alcohol abuse and addiction, according to the respective guidelines. Prevalence of healthy lifestyle was 36.9% in the elderly, 15.4% in adults, and 9.8% in adolescents, and was higher in females in the elderly and adults. Among individuals with unhealthy lifestyle, 51.5% of the elderly, 32.2% of adults, and 57.9% of adolescents failed to reach the guidelines for adequate diet. Prevalence of healthy lifestyle was highest among the elderly, followed by adults and adolescents. Food consumption was the main factor associated with unhealthy lifestyle, demonstrating the importance of interventions to promote healthy lifestyle, especially adequate diet.
- Cobertura de serviços públicos de saúde para gastos com medicamentos e vacinas na população com diabetes mellitus(2015) MONTEIRO, Camila Nascimento; GIANINI, Reinaldo Jose; GOLDBAUM, Moises; CESAR, Chester Luiz Galvao; BARROS, Marilisa Berti AzevedoThis study analyzed the coverage by the public health service of expenses with medication and vaccines for the adult population of Sao Paulo with self-reported diabetes mellitus in 2003 and the implications for access to medicines and vaccination campaigns programs. Data were collected by the Multicenter Health Survey of Sao Paulo. The Unified Health System (SUS) was widely used by the population for vaccination against influenza and pneumonia and there was significant private sector participation for coverage of expenses with medication, with an estimated coverage of 38% by SUS. There were no significant differences in the prevalence of use of public services for vaccination among the categories of variables studied, suggesting a universal distribution of vaccination by the public health service. Unlike vaccinations, in 2003 the coverage of medication expenses by the public health service was recent in Brazil, which may explain the low level of coverage. An analysis of coverage of vaccination and medication expenses in diabetes mellitus population since 2003 may contribute to be the basis for policies to broaden access of the population to health services.
- Use of and access to health services in Brazil, 2013 National Health Survey(2017) STOPA, Sheila Rizzato; MALTA, Deborah Carvalho; MONTEIRO, Camila Nascimento; SZWARCWALD, Celia Landmann; GOLDBAUM, Moises; CESAR, Chester Luiz GalvaoOBJECTIVE: To analyze the use of health services in the Brazilian population by sociodemographic factors, according to data from the 2013 Brazilian National Health Survey. METHODS: The study analyzed data from 205,000 Brazilian citizens in all age groups who participated in the Brazilian National Health Survey, a cross-sectional study carried out in 2013. Prevalence and confidence intervals were estimated for indicators related to access to and use of health services according to age group, level of education of head of household, and Brazilian macroregions. RESULTS: Among individuals who sought health services in the two weeks prior to the survey, 95.3% (95% CI 94.9-95.8) received care in their first visit. Percentages were higher in the following groups: 60 years of age and over; head of household with complete tertiary education; living in the South and Southeast regions. In addition, 82.5% (95% CI 81.2-83.7) of individuals who received health care and prescriptions were able to obtain all the necessary medicines, 1/3 of them from SUS. Less than half the Brazilian population (44.4%; 95% CI 43.8-45.1) visited a dentist in the 12 months prior to the survey, with smaller percentages among the following groups: 60 years of age or older; head of household with no education or up to incomplete elementary; living in the North region of Brazil. CONCLUSIONS: People living in the South and Southeast regions still have greater access to health services, as do those whose head of household has a higher level of education. The (re) formulation of health policies to reduce disparities should consider differences encountered between regions and social levels.
- Social inequalities in access to cancer screening and early detection: A population-based study in the city of Sao Paulo, Brazil(2023) SANTOS, Edige Felipe de Sousa; MONTEIRO, Camila Nascimento; VALE, Diama Bhadra; LOUVISON, Marilia; GOLDBAUM, Moises; CESAR, Chester Luiz Galvao; BARROS, Marilisa Berti de AzevedoObjective: This study monitors trends in access to cancer screening, focusing on mammography, Papanicolaou (Pap smear), and Prostate-Specific Antigen (PSA), assessing the magnitude of inequality in the city of Sao Paulo from 2003 to 2015 according to education level. Method: This is a cross-sectional population-based study conducted with data from the 2003, 2008, and 2015 editions of the Health Survey of the City of Sao Paulo (ISA-Capital). Outcome variables were the proportion of mammography, Papanicolaou (Pap smear), and Prostate-Specific Antigen (PSA) tests according to the protocols. Inequality was measured by education level according to years of study. For static analysis, Poisson regression was used to estimate proportion ratios. Results: The proportion of Pap smears remained stationary at a high level (>89%) throughout the study period, while access to mammography and PSA tests significantly increased in the 2003-2015 period. The present results indicate inequalities in access to cancer screening due to education, and being more expressive for mammography and PSA tests. However, this inequality significantly decreased over the period analyzed comparing the most educated individuals with those with the lowest educational level. In addition, an increase in the proportion of tests performed in the Brazilian Unified Health System was identified, especially for mammography and PSA tests, in the period 2003-2015. Conclusions: The inequalities observed in the access to preventive exams were influenced by the level of education. The offer of exams was expanded, more significantly for mammography and PSA, especially among the less educated group.
- Validation of self-reported diabetes in a representative sample of Sao Paulo city(2017) FONTANELLI, Mariane de Mello; TEIXEIRA, Juliana Araujo; SALES, Cristiane Hermes; CASTRO, Michelle Alessandra de; CESAR, Chester Luiz Galvao; ALVES, Maria Cecilia Goi Porto; GOLDBAUM, Moises; MARCHIONI, Dirce Maria; FISBERG, Regina MaraOBJECTIVE: To validate the self-reported diabetes mellitus in adults and older adults living in the city of Sao Paulo, Brazil. METHODS: We have used data of 569 subjects (284 adults and 285 older adults), participants of the population-based cross-sectional study Inquerito de Saude do Municipio de Sao Paulo (Health Survey of Sao Paulo). Fasting glucose >= 7.0 mmol/L (126 mg/dL) and/or use of drugs (oral hypoglycemic and/or insulin) defined the diagnosis of diabetes mellitus. We have validated the self-reported diabetes mellitus by calculating the sensitivity, specificity, positive predictive values, and negative predictive values. We have used Poisson regression with robust variance to verify the factors associated with the sensitivity of the self-reported datum. For all analyses, we have considered the sample design of the study. RESULTS: The sensitivity of self-reported diabetes mellitus was 63.8% (95% CI 49.2-76.3), specificity was 99.7% (95% CI 99.1-99.9), positive predictive value was 95.5% (95% CI 84.4-98.8), and negative predictive value was 96.9% (95% CI 94.9-98.2). The correct reporting of diabetes mellitus was more prevalent among older adults (PR = 2.0; 95% CI 1.2-3.5) than among adults. CONCLUSIONS: The use of the datum of self-reported diabetes mellitus is valid, especially among older adults living in the city of Sao Paulo. The results highlight the need to track diabetes mellitus in asymptomatic subjects who have one or more risk factors for it, mainly in the adult population of this city.
- Associação entre deficiências físicas e hospitalizações na população da cidade de São Paulo, Brasil(2013) CASTRO, Shamyr Sulyvan; CARANDINA, Luana; BARROS, Marilisa Berti de Azevedo; GOLDBAUM, Moises; CESAR, Chester Luiz GalvaoThis study aimed to verify the association between physical disability and hospitalization in Sao Paulo, Brazil, based on a health survey conducted in 2008. The study used a probabilistic stratified sampling process (sex/age) with two-stage clustering (census tracts and households). Data were collected through structured interviews including thematic 21 sections, using mostly multiple-choice questions. The analysis used crude and adjusted prevalence ratios (PR) and 95% confidence intervals (95% CI) with Poisson regression. The survey module of Stata 9.2 was used, with significance set at 5%. A total of 2,690 persons were interviewed, with a mean age of 38.75 years (95% CI: 37.54-39.96). Hospitalization was associated with disability (hearing, PR = 1.59; physical, PR = 3.77; multiple PR = 3.26). People with disabilities (hearing, physical - paralysis/amputation, and multiple) reported more hospitalizations than those without disabilities.
- Psychotropic use patterns: Are there differences between men and women?(2018) FERNANDES, Camila Stefani Estancial; AZEVEDO, Renata Cruz Soares de; GOLDBAUM, Moises; BARROS, Marilisa Berti de AzevedoThis study analyzed differences between men and women regarding the use of psychotropic drugs and associated factors in a population of adults and seniors in the city of Campinas, Brazil. A population-based, cross-sectional study was conducted using data from the ISA-Camp 2014/2015 health survey in the city of Campinas. The sample was composed of 1999 individuals aged 20 years or older. For each sex, prevalence rates and prevalence ratios were estimated for the use of psychotropic drugs according to demographic characteristics, socioeconomic characteristics, health problems, degree of limitation and type of emotional/mental problem. The most used classes of medications were also determined. The prevalence of the use of psychotropic drugs was 11.7% (7.3% among men and 15.8% among women). The most common therapeutic classes were antidepressants (38.2%) and benzo-diazepines (24.0%). The frequency of antidepressant use was higher among women (44.3%) than men (25.5%). Regarding associated factors, reports of emotional/mental problems were associated with the greater use of this type of drug in both sexes. Among the men, white skin color, a lack of an occupational activity, a greater number of complaints of health problems and the occurrence of insomnia were associated with the use psychotropic drugs. Among the women, a significant increase in the use of these drugs was found with the increase in age and higher prevalence rates were found among those with a higher level of schooling, those with a greater number of diagnosed chronic diseases and those with a common mental disorder. The present results confirm the greater use of psychotropic agents, especially antidepressants, in the female sex and reveal that the pattern of associated factors differs between sexes. It is therefore necessary to understand the peculiarities of each sex that exert an influence on the perception of health problems and the desire to seek care, which, in turn, affect the use of psychotropic agents.
- Doenças respiratórias e fatores associados: estudo de base populacional em São Paulo, 2008-2009(2012) SOUSA, Clovis Arlindo de; CESAR, Chester Luiz Galvao; BARROS, Marilisa Berti de Azevedo; CARANDINA, Luana; GOLDBAUM, Moises; PEREIRA, Julio Cesar RodriguesOBJECTIVE: To assess the prevalence of acute bronchitis, rhinitis, and sinusitis among children and adolescents and identify associated factors. METHODS: This is a population-based, cross-sectional study. A household survey was conducted with 1,185 children and adolescents from the city of Sao Paulo (Southeastern Brazil), from 2008 to 2009. The participants were selected by means of probability sampling, stratified by sex and age, and by two-stage cluster sampling. For the adjusted analysis, multiple Poisson regression was used. RESULTS: Of the respondents, 7.3% reported acute bronchitis, 22.6% rhinitis and 15.3% sinusitis. After the adjusted analysis, the following characteristics were associated with self;reported acute bronchitis: age 0 to 4 years (PR=17.86; 95%Cl: 3.65;90.91), 5 to 9 years (PR=37.04; 95%CI: 8.13;166.67), 10 to 14 years (PR.=20,83; 95%Cl: 4.93;90.91), allergy (PR=3.12; 95%Cl: 1.70;5.73), black and mixed-ethnicity (black and white) skin color (PR=2.29; 95%Cl: 1.21;4.35), and living in a household with 1 to 3 rooms (PR=1.85; 95%Cl: 1.17;2.94). As to self-reported rhinitis, the following characteristics were associated: age 10 to 14 years (PR=2.77; 95%Cl: 1.60;4.78), 15 to 19 years (P.R=2.58; 95%Cl: 1.52;4.39), allergy (PR=4.32; 95%Cl: 2.79;6.70), asthma (PR=2.30; 95%CI: 1.30;4.10) and living in flats (PR=1.70; 95%Cl: 1.06;2.73). Concerning self-reported sinusitis, the following characteristics were associated: age 5 to 9 years (PR=2.44; 95%Cl: 1.09;5.43), 10 to 14 years (PR=2.99; 95%CI: 1.36;6.58), 15 to 19 years (PR=3.62; 95%Cl: 1.68;7.81), allergy (PR=2.23 (95%CI: 1.41;3.52) and obesity (PR=4.42; 95%Cl: 1.56;12.50). CONCLUSIONS: Respiratory diseases were more prevalent in population groups with defined characteristics, such as age group, self-reported diseases, type of household and obesity.
- Excess body weight in the city of SAo Paulo: panorama from 2003 to 2015, associated factors and projection for the next years(2018) PEREIRA, Jaqueline Lopes; VIEIRA, Diva Aliete dos Santos; ALVES, Maria Cecilia Goi Porto; CESAR, Chester Luis Galvao; GOLDBAUM, Moises; FISBERG, Regina MaraBackgroundExcess body weight (EBW: overweight and obesity) has high and rising prevalence in Brazil. Up-to-date information about the distribution and changes in the prevalence of EBW and their associated factors are essential to determine target groups and to identify priority actions. The aim of this study was to investigate the associated factors and to determine the prevalence of overweight and obesity in the adolescent and adult population of the city of SAo Paulo in the years of 2003, 2008, and 2015, as well as to estimate the prediction for the next years.MethodsIndividuals aged 12years and older from three editions of the Health Survey of SAo Paulo (ISA-Capital), a cross-sectional population-based survey, carried out in 2003 (n=2144), 2008 (n=2599), and 2015 (n=3939), had their socioeconomic, anthropometric, and lifestyle data collected at households. Individuals were classified according to their age and BMI as: without excess body weight, overweight, or obese. Differences were evaluated through Pearson's Chi-square test and comparison of 95% CI. Generalized ordered logit models were used to evaluate factors associated to overweight/obesity and logistic regression models were used to predict their prevalence for the next years.ResultsThe prevalence (95% CI) of obesity in total population doubled: from 10% (8.0, 12.5) in 2003 to 19.2% (17.8, 20.6) in 2015. The main increase occurred in female adolescents from 2.5% (1.2, 5.3) to 11.2% (8.4, 14.7) and adults, from 9.2% (6.4, 13.1) to 22.3% (20.0, 24.8). Those with higher chance of having EBW were adults, those with higher income, and former smokers. The prevalence of EBW increased 31% from 2003 to 2008, and 126% from 2003 to 2015, when half of the population had EBW. If this pattern does not change, 77% of the population is expected to have EBW by 2030.ConclusionsOur findings present up-to-date information about the distribution of EBW, which increased substantially over a short time and more prominently in specific groups. The factors associated with EBW may provide important information for decision makers and researchers to create or review the existing programs and interventions in order to decrease the trend for the next years.
- Vaccination coverage and use of the Brazilian Health System for vaccination against influenza and pneumonia in adults and elderly with self-reported diabetes, municipality of Sao Paulo, 2003, 2008 and 2015(2018) MONTEIRO, Camila Nascimento; GIANINI, Reinaldo Jose; STOPA, Sheila Rizzato; SEGRI, Neuber Jose; BARROS, Marilisa Berti de Azevedo; CESAR, Chester Luiz Galvao; GOLDBAUM, MoisesObjective: to estimate vaccination coverage against influenza and pneumonia and to analyze the use of the Brazilian National Health System (SUS) for vaccination in adults and elderly with self-reported diabetes in Sao Paulo, Brazil, in 2003, 2008 and 2015. Methods: Cross-sectional studies using ISA-Capital data (population-based household health surveys). Results: 3,357, 3,271 and 4,043 people were interviewed in 2003, 2008 and 2015 respectively; diabetes mellitus prevalence was 5.0% (2003), 6.4% (2008) and 7.7% (2015); less than half of people with diabetes vaccinated against influenza (47.2%) and pneumonia (17.9%) in 2003, with a small increase in 2015 (59.2% and 26.1%, respectively); the majority of people who are vaccinated against influenza and pneumonia used SUS, 88.7% (2003) and 97.2% (2015) for influenza; 84.7% (2003) and 94.5% (2015) for pneumonia, without difference among age, sex, education level and ethnicity. Conclusion: despite the low vaccination coverage against influenza and pneumonia in the population with diabetes mellitus since 2003 the use of SUS to get vaccinated against them has been progressively expanding.