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
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conferenceObject PREVALENCE OF SARCOPENIA AND ASSOCIATED RISK FACTORS BY TWO DIAGNOSTIC CRITERIA IN COMMUNITY-DWELLING OLDER WOMEN: THE SAO PAULO AGEING & HEALTH STUDY (SPAH)(2016) DOMICIANO, D. S.; FIGUEIREDO, C. P.; LOPES, J. B.; CAPARBO, V. F.; TAKAYAMA, L.; MENEZES, P. R.; PEREIRA, R. M.- Work-Related Depression in Primary Care Teams in Brazil(2016) SILVA, Andrea Tenorio Correia da; LOPES, Claudia de Souza; SUSSER, Ezra; MENEZES, Paulo RossiObjectives. To identify work-related factors associated with depressive symptoms and probable major depression in primary care teams. Methods. Cross-sectional study among primary care teams (community health workers, nursing assistants, nurses, and physicians) in the city of Sao Paulo, Brazil (20112012; n = 2940), to assess depressive symptoms and probable major depression and their associations with job strain and other work-related conditions. Results. Community health workers presented higher prevalence of probable major depression (18%) than other primary care workers. Higher odds ratios for depressive symptoms or probable major depression were associated with longer duration of employment in primary care; having a passive, active, or high-strain job; lack of supervisor feedback regarding performance; and low social support from colleagues and supervisors. Conclusions. Observed levels of job-related depression can endanger the sustainability of primary care programs. Public Health implications. Strategies are needed to deliver care to primary care workers with depression, facilitating diagnosis and access to treatment, particularly in low-and middle-income countries. Preventive interventions can include training managers to provide feedback and creating strategies to increase job autonomy and social support at work.
conferenceObject Simultaneous Evaluation of Prepulse Inhibition with EMG and EEG using Advanced Artifact Removal Techniques(2016) FRAGA, Francisco J.; NOYA, Claudemiro V.; ZIMIANI, Maria I.; AVILA, Milton A.; SHUHAMA, Rosana; DEL-BEN, Cristina M.; MENEZES, Paulo R.; MARTIN, Rodrigo S.; SALUM, CristianePrepulse inhibition (PPI) consists of a reduction of the acoustic startle reflex (SR) magnitude (measured with EMG) when a startling stimulus is preceded by a non-startling one. This behavior has been extensively investigated in studies related to schizophrenia, since sensory-motor deficit plays a central role in its pathophysiology. However, the same auditory stimuli that trigger the SR also provoke intense auditory evoked responses (AEP), which can be measured with EEG. Comparing these two types of responses, acquired simultaneously, is a great opportunity to investigate the dependence and interdependence of their neural pathways. Nonetheless, so far very few studies have dared to perform such simultaneous recordings, because SR produces strong eye blinks and muscle contraction artifacts that contaminate EEG electrodes placed on the scalp. In this study we investigated the possibility of simultaneously obtaining both the acoustic SR (using EMG) and the AEP (using EEG) measures, through the use of advanced artifact removal techniques, to better characterize PPI in healthy humans.- ERICA: prevalence of common mental disorders in Brazilian adolescents(2016) LOPES, Claudia S.; ABREU, Gabriela de Azevedo; SANTOS, Debora Franca dos; MENEZES, Paulo Rossi; CARVALHO, Kenia Mara Baiocchi de; CUNHA, Cristiane de Freitas; VASCONCELLOS, Mauricio Teixeira Leite de; BLOCH, Katia Vergetti; SZKLO, MoysesOBJECTIVE: To describe the prevalence of common mental disorders in Brazilian adolescent students, according to geographical macro-regions, school type, sex, and age. METHODS: We evaluated 74,589 adolescents who participated in the Cardiovascular Risk Study in Adolescents (ERICA), a cross-sectional, national, school-based study conducted in 2013-2014 in cities with more than 100,000 inhabitants. A self-administered questionnaire and an electronic data collector were employed. The presence of common mental disorders was assessed using the General Health Questionnaire (GHQ-12). We estimated prevalence and 95% confidence intervals of common mental disorders by sex, age, and school type, in Brazil and in the macro-regions, considering the sample design. RESULTS: The prevalence of common mental disorders was of 30.0% (95% CI 29.2-30.8), being higher among girls (38.4%; 95% CI 37.1-39.7) when compared to boys (21.6%; 95% CI 20.5-22.8), and among adolescents who were from 15 to 17 years old (33.6%; 95% CI 32.2-35.0) compared to those aged between 12 and 14 years (26.7%; 95% CI 25.8-27.6). The prevalence of common mental disorders increased with age for both sexes, always higher in girls (ranging from 28.1% at 12 years to 44.1% at 17 years) than in boys (ranging from 18.5% at 12 years to 27.7% at 17 years). We did not observe any significant difference by macro-region or school type. Stratified analyses showed higher prevalence of common mental disorders among girls aged from 15 to 17 years of private schools in the North region (53.1; 95% CI 46.8-59.4). CONCLUSIONS: The high prevalence of common mental disorders among adolescents and the fact that the symptoms are often vague mean these disorders are not so easily identified by school administrators or even by health services. The results of this study can help the proposition of more specific prevention and control measures, focused on highest risk subgroups.
bookPart Princípios de Epidemiologia(2016) MATIJASEVICH, Alicia; MENEZES, Paulo Rossi- Building Research Capacity Across and Within Low- and Middle-Income Countries: The Collaborative Hubs for International Research on Mental Health(2016) PILOWSKY, Daniel J.; ROJAS, Graciela; PRICE, LeShawndra N.; APPIAH-POKU, John; RAZZAQUE, Bushra; SHARMA, Mona; SCHNEIDER, Marguerite; SEEDAT, Soraya; BONINI, Barbara B.; GUREJE, Oye; KOLA, Lola; LUND, Crick; SORSDAHL, Katherine; ARAYA, Ricardo; MENEZES, Paulo R.
conferenceObject VISCERAL FAT MEASURED BY DXA IS ASSOCIATED WITH INCREASED RISK OF NONSPINE FRACTURES IN NONOBESE ELDERLY WOMEN: A POPULATION-BASED PROSPECTIVE COHORT ANALYSIS FROM THE SAO PAULO AGEING & HEATHY (SPAH) STUDY(2016) MACHADO, L.; PEREIRA, R. M.; DOMICIANO, D.; FIGUEIREDO, C.; LOPES, J.; CAPARBO, V.; TAKAYAMA, L.; OLIVEIRA, R.; MENEZES, P.- Associations between OPG and RANKL polymorphisms, vertebral fractures, and abdominal aortic calcification in community-dwelling older subjects: the Sao Paulo Ageing & Health Study (SPAH)(2016) PEREIRA, R. M. R.; FIGUEIREDO, C. P.; CHA, C. C.; CAPARBO, V. F.; OLIVEIRA, R. M.; FRANCO, A. S.; MENEZES, P. R.; CASTRO, I. de; ONUCHIC, L. F.This is the first study analyzing concomitantly osteoprotegerin (OPG)/receptor activator of nuclear factor kappa B ligand (RANKL) polymorphisms and OPG/RANKL serum levels and their association with bone mineral density (BMD), vertebral fractures, and vascular aortic calcification in a cohort of 800 subjects in community-dwelling older individuals. Introduction Osteoprotegerin (OPG) and RANKL play an important role in osteoclast activation and differentiation as well as in vascular calcification. At present, there are no studies of OPG or RANKL gene polymorphisms in Brazilian older populations. The aim of this study was to evaluate OPG/RANKL polymorphism and their association with vertebral fractures (VFs) and aortic calcification. Methods Eight hundred subjects (497 women/303 men) were genotyped for the OPG 1181G>C (rs2073618), 163C>T (rs3102735), 245T>G (rs3134069), and 209G>A (rs3134070) and RANKL A>G (rs2277438) single-nucleotide polymorphisms (SNPs). VFs were evaluated by spine radiography (Genant's method). Aortic calcification was quantified using Kauppila's method. Results The isolated genotype analyses and single-allele frequency data showed association of OPG 163C, 245G, and 209A alleles with presence of VFs (P < 0.05). Multiple logistic regression of subjects with absence of VFs vs. those with VFs (grades II/III) revealed only OPG 209A homozygosity as a risk factor for higher-grade VFs (odds ratio (OR) = 4.17, 95 % CI 1.03-16.93, P = 0.046). Regarding aortic calcification, the isolated genotype analysis frequency data revealed a significant association of OPG 1181G, 163C, 245G, and 209A alleles with absent aortic calcification (P < 0.05). Multiple logistic regression data confirmed that the OPG 209A allele was protective for aortic calcification (OR = 0.63, 95 % CI 0.45-0.88, P = 0.007) and the OPG 1181C allele was a risk factor for aortic calcification (OR = 1.26, 95 % CI 1.00-1.58, P = 0.046). Conclusion This study showed that the OPG 209AA genotype was a risk factor for higher-grade VFs, the OPG 209A allele was protective for aortic calcification, and the OPG 1181C was a risk factor for aortic calcification, supporting the involvement of OPG polymorphisms in the analyzed phenotypes and the concept that the related pathogenesis is multifactorial.
- Inequities in access to depression treatment: results of the Brazilian National Health Survey - PNS(2016) LOPES, Claudia Souza; HELLWIG, Natalia; SILVA, Gulnar de Azevedo e; MENEZES, Paulo RossiBackground: Despite depression being one of the most prevalent mental disorders in the world, access to treatment is still insufficient, especially in low-and middle-income countries. The aim of this study is to investigate differences in access to treatment for depression according to socio-demographic characteristics, geographical area and multi-morbidity in a nationally representative sample of individuals with depression. Methods: This study analyses data from the National Health Survey (Pesquisa Nacional de Saude - PNS), a Brazilian household-based nationwide survey, which comprises 60,202 adults (aged 18 years or older). Depression was evaluated through the Patient Health Questionnaire-9 (PHQ-9). Prevalence Ratios and corresponding 95 % confidence intervals (95%CI) were calculated using Poisson regression. Results: The general prevalence of depression was 7.9 % (95 % CI 7.5 to 8.3). Among those with depression, 78.8 % did not receive any treatment, and 14.1 % received only pharmacotherapy. Multivariable analyses showed that being female, white, aged between 30 and 69 years, living in regions other than the North, having higher education and having multi-morbidities were independently associated with higher likelihood of access to any treatment. Conclusions: Most Brazilians with clinically relevant depressive symptoms are not receiving any treatment. Access to care is unequal, with the poor and those living in low resource areas having higher difficulties to access mental health care. Understanding these disparities is important for the provision of effective interventions aimed at reducing the prevalence of depression and inequities in access to mental health care.
- Patterns of health-related behaviours among adolescents: a cross-sectional study based on the National Survey of School Health Brazil 2012(2016) AZEREDO, Catarina Machado; LEVY, Renata Bertazzi; PERES, Maria Fernanda Tourinho; MENEZES, Paulo Rossi; ARAYA, RicardoObjectives: The aim of this study was to analyse the clustering of multiple health-related behaviours among adolescents and describe which socio-demographic characteristics are associated with these patterns. Design: Cross-sectional study. Setting: Brazilian schools assessed by the National Survey of School Health (PeNSE, 2012). Participants: 104 109 Brazilian ninth-grade students from public and private schools (response rate= 82.7%). Methods: Exploratory and confirmatory factor analyses were performed to identify behaviour clustering and linear regression models were used to identify socio-demographic characteristics associated with each one of these behaviour patterns. Results: We identified a good fit model with three behaviour patterns. The first was labelled 'problem-behaviour' and included aggressive behaviour, alcohol consumption, smoking, drug use and unsafe sex; the second was labelled 'health-compromising diet and sedentary behaviours' and included unhealthy food indicators and sedentary behaviour; and the third was labelled 'health-promoting diet and physical activity' and included healthy food indicators and physical activity. No differences in behaviour patterns were found between genders. The problem-behaviour pattern was associated with male gender, older age, more developed region (socially and economically) and public schools (compared with private). The 'health-compromising diet and sedentary behaviours' pattern was associated with female gender, older age, mothers with higher education level and more developed region. The 'health-promoting diet and physical activity' pattern was associated with male gender and mothers with higher education level. Conclusions: Three health-related behaviour patterns were found among Brazilian adolescents. Interventions to decrease those negative patterns should take into account how these behaviours cluster together and the individuals most at risk.