PAULO ROSSI MENEZES

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Departamento de Medicina Preventiva, Faculdade de Medicina - Docente
LIM/39 - Laboratório de Processamento de Dados Biomédicos, Hospital das Clínicas, Faculdade de Medicina - Líder

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  • article 18 Citação(ões) na Scopus
    Work-Related Depression in Primary Care Teams in Brazil
    (2016) SILVA, Andrea Tenorio Correia da; LOPES, Claudia de Souza; SUSSER, Ezra; MENEZES, Paulo Rossi
    Objectives. 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.
  • article 1 Citação(ões) na Scopus
    Plasma prevalence of anti-N-methyl-d-aspartate receptor IgG antibodies in early stages of psychosis
    (2021) LOUREIRO, Camila Marcelino; CORSI-ZUELLI, Fabiana; FACHIM, Helene Aparecida; SHUHAMA, Rosana; CHAGAS, Natalia Mota de Souza; MENEZES, Paulo Rossi; DEL-BEN, Cristina Marta; LOUZADA-JUNIOR, Paulo
    We investigated the feasibility of including plasma anti-NMDAR antibody screening in the assessment of first-episode psychosis patients in an early intervention programme in the Southern hemisphere. Anti-NMDAR IgG antibodies were assessed by ELISA in 166 patients (64.0% men), 166 matched population-based controls and 76 patients' siblings (30.3% men). Fisher's exact test and ANOVA were performed. Positive anti-NMDAR antibody patients were more often observed in bipolar disorder (10.0%) than schizophrenia (2.4%) or psychotic depression (3.1%), although no significant differences were observed. Our results are not conclusive regarding the inclusion of plasma anti-NMDAR IgG antibodies in differential diagnostic protocols for psychosis.
  • article 11 Citação(ões) na Scopus
    Development and validation of the WebAd-Q Questionnaire to monitor adherence to HIV therapy
    (2018) VALE, Felipe Campos; SANTA-HELENA, Ernani Tiaraju de; SANTOS, Maria Altenfelder; CARVALHO, Wania Maria do Espirito Santo; MENEZES, Paulo Rossi; BASSO, Caritas Relva; SILVA, Mariliza Henrique; ALVES, Ana Maroso; NEMES, Maria Ines Battistella
    OBJECTIVE To present the development and validation of the WebAd-Q Questionnaire, a self-report instrument to monitor adherence to antiretroviral therapy in HIV/AIDS centers in Brazil. METHODS The WebAd-Q is an electronic questionnaire that has three questions about the use of antiretrovirals in the last week. It was constructed from interviews and focus groups with 38 patients. Its validity was tested in a study with a sample of 90 adult patients on antiretroviral therapy for at least three months. We used electronic monitoring bottles, pill counting, and self-report interview to compare adherence. The WebAd-Q was answered on the sixtieth day, twice, with at least one hour of interval. The viral load of the patients was obtained from the service records. We have analyzed the agreement between the answers to the WebAd-Q, the associations, and the correlations with viral load and performance compared to other measures of adherence. RESULTS Among the invited patients, 74 (82.2%) answered the WebAd-Q. No difficulties were reported to answer the questionnaire. The average answer time was 5 min 47 sec. The set of three questions of the WebAd-Q obtained agreement of 89.8%, with Kappa of 0.77 (95%CI 0.61–0.94). The non-adherence answers of the WebAd-Q were associated with detectable viral load. We obtained moderate viral load correlations with the non-adherence scale according to the WebAd-Q. For the three questions of the WebAd-Q, patients with non-adherence answers were also reported as less adherent according to the other measures of adherence. CONCLUSIONS The WebAd-Q answered all the issues considered relevant in the validation of questionnaires, was well understood by patients, was associated with viral load, and obtained good agreement and good performance compared to the other measures. The feasibility analysis of its implementation still depends on a national study on its applicability.
  • article 38 Citação(ões) na Scopus
    Unplanned pregnancy and risk of maternal depression: secondary data analysis from a prospective pregnancy cohort
    (2017) FAISAL-CURY, Alexandre; MENEZES, Paulo Rossi; QUAYLE, Julieta; MATIJASEVICH, Alicia
    Purpose: to evaluate the relationship between unplanned pregnancy (UP), a common problem in high and low income countries and maternal depression (MD). Methods: Secondary analysis of data from a prospective cohort study with pregnant women recruited from 10 primary care clinics of the public sector in Sao Paulo, Brazil. Participants were questioned about pregnancy intention at 20-30 weeks of gestation. The Self Report Questionnaire score >7 was used to evaluated the presence of depression during pregnancy and 11 months after childbirth. Four groups of MD were defined: never; antenatal only; postnatal only; persistent (both antenatal/postnatal). Multinomial logistic regression was used to assess the relationship between UP and MD, controlling for confounding. Results: Data were analysed for 701 at the postpartum period. Five hundred and sixty-two (67.8%) women did not plan the pregnancy. Women with UP had 2.5 more risk of being depressed during both assessments (during pregnancy and postpartum) when compared to women with a planned pregnancy (RR: 2.5; 95% CI: 1.47: 4.30). In the adjusted models, women with UP were significantly more likely to have persistent depression (RR: 2.3; 95% CI: 1.2: 4.3). Conclusion: UP is an independent risk factor for persistent depression, but not for postpartum depression
  • article 64 Citação(ões) na Scopus
    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, Moyses
    OBJECTIVE: 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.
  • article 7 Citação(ões) na Scopus
    Ethnic differences in tobacco use during pregnancy: findings from a primary care sample in Sao Paulo, Brazil
    (2015) TABB, Karen Margaret; HUANG, Hsiang; MENEZES, Paulo Rossi; SILVA, Gulnar Azevedo e; CHAN, Ya-Fen; FAISAL-CURY, Alexandre
    Objectives. Tobacco use during pregnancy is a global health concern. To date the majority of research originates in developed countries, thus we have a need to better understand factors related to maternal health in developing countries. We examine the prevalence and correlates of smoking by ethnicity in a sample of pregnant primary care patients in Sao Paulo, Brazil. Design. Data were obtained from completed surveys during perinatal care visits in primary care clinics. We examine a sample of 811 pregnant women surveyed during 20-30 weeks of pregnancy. Multiple logistic regression was used to obtain odds ratios (OR) and 95% confidence intervals (95% CI). Results. We found significant ethnic differences in smoking during pregnancy. Compared to White women, Black women were more likely to use tobacco during pregnancy (OR: 1.95; 95% CI: 1.16-3.27). In the fully adjusted model, when accounting for common mental disorders, differences in smoking during pregnancy by ethnicity remained (OR: 1.96; 95% CI: 1.14-3.36). Conclusions. There are ethnic differences in tobacco use during pregnancy. Clinical implications including universal screening for tobacco use during pregnancy and culturally relevant approaches to smoking cessation are suggested.
  • article 17 Citação(ões) na Scopus
    The relationship between indicators of socioeconomic status and cesarean section in public hospitals
    (2017) FAISAL-CURY, Alexandre; MENEZES, Paulo Rossi; QUAYLE, Julieta; SANTIAGO, Kely; MATIJASEVICH, Alicia
    OBJECTIVE: To assess the relationship between indicators of socioeconomic status and cesarean section in public hospitals that adopt standardized protocols of obstetrical care. METHODS: This was a prospective cohort study conducted between May 2005 and January 2006 with 831 pregnant women recruited from 10 public primary care clinics in Sao Paulo, Brazil. Demographic and clinical characteristics were collected during pregnancy. The three main exposures were schooling, monthly family income per capita, and residential crowding. The main outcome was cesarean section at three public hospitals located in the area. Crude and adjusted risk ratios (RR), with 95% confidence intervals were calculated using Poisson regression with robust variance. We examined the effects of each exposure variable on cesarean section accounting for potential confounders by using four different models: crude, adjusted by mother's characteristics, by obstetrical complications, and by the other two indicators of socioeconomic status. RESULTS: Among the 757 deliveries performed in the public hospitals, 215 (28.4%) were by cesarean section. In the bivariate analysis, cesarean section was associated with higher family income per capita, higher education, lower residential crowding, pregnancy planning, white skin color, having a partner, and advanced maternal age. In the multivariate analysis, after adjustment for covariates, none of the socioeconomic status variables remained associated with cesarean section. CONCLUSIONS: In this group, the chance of women undergoing cesarean section was not associated with indicators of socioeconomic status only, but was defined in accordance with major obstetric and clinical conditions.
  • article 17 Citação(ões) na Scopus
    Loss of interest, depressed mood and impact on the quality of life: Cross-sectional survey
    (2011) GUAJARDO, Valeri D.; SOUZA, Bruno P. F.; HENRIQUES, Sergio G.; LUCIA, Mara C. S.; MENEZES, Paulo R.; MARTINS, Milton A.; TARDIVO, Leila S. L. P. C.; GATTAZ, Wagner F.; FRAGUAS, Renerio
    Background: Depressive symptoms and chronic disease have adverse effects on patients' health-related quality of life (H-RQOL). However, little is known about this effect on H-RQOL when only the two core depressive symptoms - loss of interest and depressed mood - are considered. The objective of this study is to investigate H-RQOL in the presence of loss of interest and depressed mood at a general medical outpatient unit. Methods: We evaluated 553 patients at their first attendance at a general medical outpatient unit of a teaching hospital. H-RQOL was assessed with the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36). Depressed mood and loss of interest were assessed by the Primary Care Evaluation of Mental Disorders (PRIME-MD)Patient Questionnaire. A physician performed the diagnosis of chronic diseases by clinical judgment and classified them in 13 possible pre-defined categories. We used multiple linear regression to investigate associations between each domain of H-RQOL and our two core depression symptoms. The presence of chronic diseases and demographic variables were included in the models as covariates. Results: Among the 553 patients, 70.5% were women with a mean age of 41.0 years (range 18-85, SD +/- 15.4). Loss of interest was reported by 54.6%, and depressed mood by 59.7% of the patients. At least one chronic disease was diagnosed in 59.5% of patients; cardiovascular disease was the most prevalent, affecting 20.6% of our patients. Loss of interest and depressed mood was significantly associated with decreased scores in all domains of H-RQOL after adjustment for possible confounders. The presence of any chronic disease was associated with a decrease in the domain of vitality. The analysis of each individual chronic disease category revealed that no category was associated with a decrease in more than one domain of H-RQOL. Conclusion: Loss of interest and depressed mood were associated with significant decreases in H-RQOL. We recommend these simple tests for screening in general practice.
  • article 29 Citação(ões) na Scopus
    Factors associated with risk of malnutrition in the elderly in south-eastern Brazil
    (2017) DAMIÃO, Renata; SANTOS, Álvaro da Silva; MATIJASEVICH, Alicia; MENEZES, Paulo Rossi
    ABSTRACT: Objective: The aim of this study was to evaluate the prevalence of malnutrition risk and its association with socioeconomic, behavioral, and health characteristics in the community-dwelling elderly. Methods: A cross-sectional study with individuals aged ≥ 60 years. Nutritional status was evaluated using the Mini Nutritional Assessment. Socioeconomic, behavioral, and health information was also collected from all participants. The association between each variable and the risk of malnutrition was calculated and adjusted using Poisson hierarchical regression. Results: The initial sample consisted of 3,101 elderly people, of whom 28.3% (95%CI 25.3 - 31.4%) were at risk of malnutrition. The multivariate analysis showed that the risk of malnutrition was significantly higher in women without formal education, who did not live with a partner, and identified as black-skinned. The risk of malnutrition was twice as high in individuals with no family income as compared to those who earned at least three minimum wages. Smokers were also more likely to be at risk of malnutrition than individuals who had never smoked. Participants suffering from kidney, respiratory or heart disease were at higher risk of malnutrition than those with no history of such illnesses. Conclusion: These findings could be used to help in the development of health policies and in the establishment of adequate programs aimed at reducing the risk of malnutrition in this population.
  • article 18 Citação(ões) na Scopus
    Intimate partner violence among undergraduate students of two universities of the state of Sao Paulo, Brazil
    (2013) FLAKE, Tania Aldrighi; BARROS, Claudia; SCHRAIBER, Lilia B.; MENEZES, Paulo Rossi
    INTRODUCTION: The prevalence of violence in intimate relationships, suffered or perpetrated, was estimated among undergraduate students, be it physical, psychological and sexual, describing the overlap between them. This is an original study and there is scarce literature on this matter in Brazil. Men and women were investigated and some issues on gender violence were discussed. METHODS: The study is part of the multicenter survey ""International Study of Violence in Dating - IDVS"" conducted in 2002 - 2003, using its standardized instrument. A total of 362 students, from two universities in the state of São Paulo, one public and one private, answered the self-reported questionnaire, being 37% male and 63% female, mean age of 20 years old. Suffered and perpetrated intimate partner violence during life was examined. RESULTS: Among all interviewees, 75.9% suffered and 76.4% perpetrated some kind of violence throughout life. Psychological violence was the most prevalent type, followed by sexual violence, both suffered and perpetrated. The great superposition between suffered and perpetrated violence (83.9%) reflects the reciprocity of aggression, with no observed difference between men and women. The results of this study are consistent with previous literature on dating violence, which shows high prevalence of suffered and perpetrated violence, besides reciprocity for both men and women. CONCLUSIONS: Intervention actions at this stage of intimate relationships may potentially impact on subsequent marital partnership situations.