PAULO ROSSI MENEZES
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 - Líder
LIM/39 - Laboratório de Processamento de Dados Biomédicos, Hospital das Clínicas, Faculdade de Medicina - Líder
17 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 17
- Prevalence of hepatitis B virus infection and carriage after nineteen years of vaccination program in the Western Brazilian Amazon(2012) BRAGA, Wornei Silva Miranda; CASTILHO, Marcia da Costa; BORGES, Fabiane Giovanella; MARTINHO, Ana Cristina de Souza; RODRIGUES, Ivo Seixas; AZEVEDO, Eliete Pereira de; SCAZUFCA, Marcia; MENEZES, Paulo RossiIntroduction: Reductions in the prevalence of hepatitis B virus (HBV) infection and carriage, decreases in liver cancer incidence, and changes in patterns of liver dysfunctions are described after hepatitis B vaccination. Methods: We conducted a population-based seroprevalence study aimed at estimating the HBV prevalence and risk of infection in the rural area of Labrea following nineteen years of HBV vaccination. Results: Half of the subjects showed total anti-HBc of 52.1% (95% CI 49.6-54.7). The HBsAg prevalence was 6.2% (95% CI 5.1-7.6). Multivariate analysis showed an inverse association between HBV infection and vaccination (OR 0.62; 95% CI 0.44-0.87). HBsAg remained independently associated with past hepatitis (OR 2.44; 95% CI 1.52-3.89) and inversely to vaccination (OR 0.43; 95% CI 0.27-0.69). The prevalence of HBeAg among HBsAg-positive individuals was 20.4% (95% CI 12.8-30.1), with the positive subjects having a median age of 11 years (1-46) p=0.0003. Conclusions: We demonstrate that HBV infection is still an important public health issue and that HBV vaccination could have had better impact on HBV epidemiology. If we extrapolate these findings to other rural areas in the Brazilian Amazon, we can predict that the sources of chronic infected patients remain a challenge. Future studies are needed regarding clinical aspects, molecular epidemiology, surveillance of acute cases, and risk groups.
- Atrial Fibrillation and Dementia: Results from the Sao Paulo Ageing & Health Study(2012) KAWABATA-YOSHIHARA, Liz Andrea; SCAZUFCA, Marcia; SANTOS, Itamar de Souza; WHITAKER, Aristarcho; KAWABATA, Vitor Sergio; BENSENOR, Isabela Martins; MENEZES, Paulo Rossi; LOTUFO, Paulo AndradeBackground: Atrial fibrillation (AF) is a controversial risk factor for dementia. Objective: The objective of this study was to assess the association between AF and dementia in the ""Sao Paulo Ageing & Health"" (SPAH) study participants. Methods: SPAH is a cross-sectional, population-based study of elderly people living in a deprived neighborhood in Sao Paulo, Brazil. Dementia diagnosis was performed according to the 10/66 study group protocol based on Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. Diagnosis of AF was made using a 12-lead electrocardiogram (ECG) recording, which was assessed by two cardiologists. Data on demographics and cardiovascular risk factors were also obtained. Results: Dementia was diagnosed in 66 (4.3%) and AF in 36 (2.4%) of 1,524 participants with a valid ECG. The crude odds ratio (OR) for dementia in participants with AF was 2.8 (95% confidence interval [CI]: 1.0-8.1; p=0.06) compared with individuals without AF. When analyzing data according to sex, a positive relationship was found in women (OR 4.2; 95% CI: 1.24-15.1; p=0.03). After age-adjustment, however, this association was no longer significant (OR 2.2; 95% CI: 0.6-8.9; p=0.26). Conclusion: There was no independent association between AF and dementia in this sample. The prevalence of AF may be low in this population owing to premature cardiovascular death. (Arq Bras Cardiol 2012;99(6):1108-1114)
conferenceObject Brain Structure and the Prediction of Outcome in First-Episode Schizophrenia-Spectrum Disorders and Affective Psychosis: A Population-Based Study(2012) ROSA, Pedro G.; SCHALFELBERGER, Maristela S.; DURAN, Fabio L. S.; SANTOS, Luciana C.; MENEZES, Paulo R.; SCAZUFCA, Marcia; MURRAY, Robin M.; BUSATTO, Geraldo F.Background: MRI studies of the prediction of outcome among subjects with first-episode psychosis (FEP) have brought misleading evidence to discussion. Cognitive impairment in subjects with psychosis is receiving particular attention, and may be the symptom dimension most associated with outcome in those patients. Methods: Structural MRI on a FEP (N=96) sample with subjects with schizophrenia-spectrum disorders (N=55) and affective psychoses (N=41). Outcome evaluation after a median period of one year consisted on PANSS, cognitive measures (verbal fluency and digit spans) and disability evaluation (WHO-DAS). Lateral ventricles, studied using a region of interest approach, and regional GM, analyzed using VBM with SPM, at the baseline entered statistics as predictive of outcome at the follow-up. Results: Frontal and temporal cortices GM volume were associated with outcome measures, in particular with the performance o cognitive tasks, in the overall FEP Group and in the subgroups (schizophrenia and affective psychoses). Particularly, the affective psychosis subgroup showed more robust associations of GM volumes with outcome measures than the schizophrenia-spectrum subgroup. Furthermore, temporal horns measures were negatively correlated with digit spans’ performances in the FEP group and in the subgroups. None of these findings could be attributed to confounding factors, such as outcome measures at baseline and antipsychotic intake. Conclusions: Brain structure at the moment of the first-episode of psychosis of patients with schizophrenia and subjects with affective psychoses was associated with outcome, particularly cognitive measures. The predominance of findings on frontal-temporal regions is compatible with the presence of a fronto-temporal disconnectivity underlying psychoses. Keyword(s): Schizophrenia, Bipolar Disorder, Neuroimaging, Outcome, Cognition- Antenatal depression strongly predicts postnatal depression in primary health care(2012) FAISAL-CURY, Alexandre; MENEZES, Paulo RossiObjective: To estimate the association between antenatal and postnatal depression and to examine the role of socioeconomic conditions in the risk of postnatal depression. Methods: A prospective cohort study, conducted between May 2005 and January 2006, with 831 pregnant women recruited from primary care clinics in the public sector in the city of Sao Paulo, Brazil. The presence of antenatal and postnatal depression was measured with the Self Report Questionnaire (SRQ-20). Sociodemographic and socioeconomic characteristics and obstetric information were obtained through a questionnaire. Crude and adjusted risk ratios (RR), with 95% CI, were calculated using a Poisson regression. Results: The prevalence of postnatal depressive symptoms was 31.2% (95% CI: 27.8-34.8%). Among the 219 mothers who had depressive symptoms, nearly 50% had already shown depressive symptoms during pregnancy. Women who had antenatal depression were 2.4 times more likely to present with postnatal depression than were women who did not have such symptoms during pregnancy. In the multivariate analysis, higher scores for assets (RR: 0.76, 95% CI 0.61-0.96), higher education (RR: 0.75 95% CI 0.59-0.96), daily contact with neighbors (RR: 0.68, 95% CI 0.51-0.90) and antenatal depression (RR: 2.44, 95% CI 1.93-3.08) remained independently associated with postnatal depression. Conclusions: Antenatal and postnatal depression are highly prevalent in the primary care setting.
- Voxelwise evaluation of white matter volumes in first-episode psychosis(2012) COLOMBO, Renata Rodrigues da Cunha; SCHAUFELBERGER, Maristela Spanghero; SANTOS, Luciana Cristina; DURAN, Fabio Luis de Souza; MENEZES, Paulo Rossi; SCAZUFCA, Marcia; BUSATTO, Geraldo Filho; ZANETTI, Marcus ViniciusThe occurrence of white matter (WM) abnormalities in psychotic disorders has been suggested by several studies investigating brain pathology and diffusion tensor measures, but evidence assessing regional WM morphometry is still scarce and conflicting. In the present study, 122 individuals with first-episode psychosis (FEP) (62 fulfilling criteria for schizophrenia/schizophreniform disorder, 26 psychotic bipolar I disorder, and 20 psychotic major depressive disorder) underwent magnetic resonance imaging, as well as 94 epidemiologically recruited controls. Images were processed with the Statistical Parametric Mapping (SPM2) package, and voxel-based morphometry was used to compare groups (t-test) and subgroups (ANOVA). Initially, no regional WM abnormalities were observed when both groups (overall FEP group versus controls) and subgroups (i.e., schizophrenia/schizophreniform, psychotic bipolar I disorder, psychotic depression, and controls) were compared. However, when the voxelwise analyses were repeated excluding subjects with comorbid substance abuse or dependence, the resulting statistical maps revealed a focal volumetric reduction in right frontal WM, corresponding to the right middle frontal gyral WM/third subcomponent of the superior longitudinal fasciculus, in subjects with schizophrenia/schizophreniform disorder (n = 40) relative to controls (n = 89). Our results suggest that schizophrenia/schizophreniform disorder is associated with right frontal WM volume decrease at an early course of the illness.
conferenceObject Structural Brain Changes in First-Episode Schizophrenia: A 4-5 Year Follow-Up Study Using MRI(2012) SCHALFELBERGER, Maristela S.; ROSA, Pedro G. P.; DURAN, Fabio L. S.; MENEZES, Paulo R.; SCAZUFCA, Marcia; MURRAY, Robin M.; BUSATTO, Geraldo F.Background: The presence of progressive structural brain changes over the first years of disease in first-episode schizophrenia (FES) patients is still controversial. The supposed progression of brain abnormalities in these patients may be associated with outcome and with antipsychotic exposure. Methods: Longitudinal population-based study performed in São Paulo - Brazil. Longitudinal analysis of GM matter volume using SPM was performed in 32 FES and 34 controls 4-5 years after baseline. Outcome measures were assessed by clinical course of symptoms (DSM-IV) and by global functioning (GAF scores). Results: FES did not differ from controls regarding GM changes over time, but those that remained psychotic and had lower global functioning over the follow-up period had GM concentration reduction in the left insula and in the left superior temporal gyrus in comparison to controls. Medication status had no effect on GM volumetric changes. Conclusions: Our findings suggest that a poor outcome, with chronic symptoms and a poor global functioning over 4-5 years after the first episode of psychosis is associated with brain abnormalities progression in brain regions which showed GM reduction at baseline (Schaufelberger et al, 2007). These results suggest that the progressive hypothesis in schizophrenia is probably not valid to all subjects that suffer from this illness.- Longitudinal follow-up of cavum septum pellucidum and adhesio interthalamica alterations in first-episode psychosis: a population-based MRI study(2012) TRZESNIAK, C.; SCHAUFELBERGER, M. S.; DURAN, F. L. S.; SANTOS, L. C.; ROSA, P. G. P.; MCGUIRE, P. K.; MURRAY, R. M.; SCAZUFCA, M.; MENEZES, P. R.; HALLAK, J. E. C.; CRIPPA, J. A. S.; BUSATTO, G. F.Background. Neurodevelopmental alterations have been described inconsistently in psychosis probably because of lack of standardization among studies. The aim of this study was to conduct the first longitudinal and population-based magnetic resonance imaging (MRI) evaluation of the presence and size of the cavum septum pellucidum (CSP) and adhesio interthalamica (AI) in a large sample of patients with first-episode psychosis (FEP). Method. FEP patients (n=122) were subdivided into schizophrenia (n=62), mood disorders (n=46) and other psychosis (n=14) groups and compared to 94 healthy next-door neighbour controls. After 13 months, 80 FEP patients and 52 controls underwent a second MRI examination. Results. We found significant reductions in the AI length in schizophrenia FEP in comparison with the mood disorders and control subgroups (longer length) at the baseline assessment, and no differences in any measure of the CSP. By contrast, there was a diagnosis x time interaction for the CSP length, with a more prominent increase for this measure in the psychosis group. There was an involution of the AI length over time for all groups but no diagnosis x time interaction. Conclusions. Our findings suggest that the CSP per se may not be linked to the neurobiology of emerging psychotic disorders, although it might be related to the progression of the disease. However, the fact that the AI length was shown to be shorter at the onset of the disorder supports the neurodevelopmental model of schizophrenia and indicates that an alteration in this grey matter junction may be a risk factor for developing psychosis.
- Anemia and dementia among the elderly: the Sao Paulo Ageing & Health Study(2012) SANTOS, Itamar S.; SCAZUFCA, Marcia; LOTUFO, Paulo A.; MENEZES, Paulo R.; BENSENOR, Isabela M.Background: Anemia and dementia are common diseases among the elderly, but conflicting data are available regarding an association between these two conditions. We analyzed data from the Sao Paulo Ageing & Health Study to address the relationship between anemia and dementia. Methods: This cross-sectional observational study included participants aged 65 years and older from a deprived area of the borough of Butantan, Sao Paulo, Brazil. Data about demographics, education, income, and cognitive and daily life function were collected, as well as blood samples. Anemia and dementia were defined according to WHO and DSM-IV criteria, respectively. Results: Of the 2267 subjects meeting the inclusion criteria, 2072 agreed to participate in the study; of whom 1948 had a valid total blood count and were included in the analysis. Anemia was diagnosed in 203 (10.2%) participants and dementia in 99 (5.1%). The frequency of anemia was higher in patients with dementia according to univariate analysis (odds ratio (OR) = 2.00, 95% confidence interval (CI) = 1.17-3.41, p = 0.01), but this association was not present after adjusting for age (OR = 1.33, 95% CI = 0.76-2.33, p = 0.32). Further multivariate adjustment did not change the results. Conclusion: Although anemia and dementia are frequent disorders in older people, we found their relationship to be mediated exclusively by aging in this low-income population from Sao Paulo.
- Longitudinal brain volumetric changes during one year in non-elderly healthy adults: a voxel-based morphometry study(2012) GUIMARAES, R. M.; SCHAUFELBERGER, M. S.; SANTOS, L. C.; DURAN, F. L. S.; MENEZES, P. R.; SCAZUFCA, M.; GOUVEA, M. T. V.; BUSATTO, G. F.Previous cross-sectional magnetic resonance imaging (MRI) studies of healthy aging in young adults have indicated the presence of significant inverse correlations between age and gray matter volumes, although not homogeneously across all brain regions. However, such cross-sectional studies have important limitations and there is a scarcity of detailed longitudinal MRI studies with repeated measures obtained in the same individuals in order to investigate regional gray matter changes during short periods of time in non-elderly healthy adults. In the present study, 52 healthy young adults aged 18 to 50 years (27 males and 25 females) were followed with repeated MRI acquisitions over approximately 15 months. Gray matter volumes were compared between the two times using voxel-based morphometry, with the prediction that volume changes would be detectable in the frontal lobe, temporal neocortex and hippocampus. Voxel-wise analyses showed significant (P < 0.05, family-wise error corrected) relative volume reductions of gray matter in two small foci located in the right orbitofrontal cortex and left hippocampus. Separate comparisons for males and females showed bilateral gray matter relative reductions in the orbitofrontal cortex over time only in males. We conclude that, in non-elderly healthy adults, subtle gray matter volume alterations are detectable after short periods of time. This underscores the dynamic nature of gray matter changes in the brain during adult life, with regional volume reductions being detectable in brain regions that are relevant to cognitive and emotional processes.
- Relationship Between Regional Brain Volumes and Cognitive Performance in the Healthy Aging: An MRI Study Using Voxel-Based Morphometry(2012) SQUARZONI, Paula; TAMASHIRO-DURAN, Jaqueline; DURAN, Fabio Luis Souza; SANTOS, Luciana Cristina; VALLADA, Homero Pinto; MENEZES, Paulo Rossi; SCAZUFCA, Marcia; BUSATTO FILHO, Geraldo; ALVES, Tania Correa Toledo de FerrazThe presence of cognitive impairment is a frequent complaint among elderly individuals in the general population. This study aimed to investigate the relationship between aging-related regional gray matter (rGM) volume changes and cognitive performance in healthy elderly adults. Morphometric magnetic resonance imaging (MRI) measures were acquired in a community-based sample of 170 cognitively-preserved subjects (66 to 75 years). This sample was drawn from the ""Sao Paulo Ageing and Health"" study, an epidemiological study aimed at investigating the prevalence and risk factors for Alzheimer's disease in a low income region of the city of Sao Paulo. All subjects underwent cognitive testing using a cross-culturally battery validated by the Research Group on Dementia 10/66 as well as the SKT (applied on the day of MRI scanning). Blood genotyping was performed to determine the frequency of the three apolipoprotein E allele variants (APOE epsilon 2/epsilon 3/epsilon 4) in the sample. Voxelwise linear correlation analyses between rGM volumes and cognitive test scores were performed using voxel-based morphometry, including chronological age as covariate. There were significant direct correlations between worse overall cognitive performance and rGM reductions in the right orbitofrontal cortex and parahippocampal gyrus, and also between verbal fluency scores and bilateral parahippocampal gyral volume (p < 0.05, familywise-error corrected for multiple comparisons using small volume correction). When analyses were repeated adding the presence of the APOE epsilon 4 allele as confounding covariate or excluding a minority of APOE epsilon 2 carriers, all findings retained significance. These results indicate that rGM volumes are relevant biomarkers of cognitive deficits in healthy aging individuals, most notably involving temporolimbic regions and the orbitofrontal cortex.