MILTON ROBERTO FURST CRENITTE
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/66, Hospital das Clínicas, Faculdade de Medicina
LIM/66, Hospital das Clínicas, Faculdade de Medicina
13 resultados
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bookPart Delirium(2019) AVELINO-SILVA, Thiago Junqueira; CRENITTE, Milton Roberto Furst; CARVALHO, Flávia Barreto Garcez- Transforming the invisible into the visible: disparities in the access to health in LGBT plus older people(2023) CRENITTE, Milton Roberto Furst; MELO, Leonardo Rabelo de; JACOB-FILHO, Wilson; AVELINO-SILVA, Thiago JunqueiraObjectives: To compare variables of access to healthcare between the LGBT+ population aged 50 and over and those non-LGBT+.Methods: A cross-sectional study was carried out in Brazil through a confidential online questionnaire. The use of the health system was characterized by the number of preventive tests performed and measured by the PCATool-Brasil scale (a 10-point scale in which higher scores were associated with better assistance in healthcare). The association between being LGBT+ and access to health was analyzed in Poisson regression models.Results: 6693 participants (1332 LGBT+ and 5361 non-LGBT+) with a median age of 60 years were included. In the univariate analysis, it was observed not only lower scores on the PCATool scale (5.13 against 5.82, p < 0.001), but a greater proportion of individuals among those classified with the worst quintile of access to healthcare (< 4 points), 31% against 18% (p < 0.001). Being LGBT+ was an independent factor associated with worse access to health (PR = 2.5, 95% CI 2.04-3.06). The rate of screening cancer, for breast, colon, and cervical cancer was also found to be lower in the LGBT+ population. Conclusion: Healthcare access and health service experiences were worse in the LGBT+ group than in their non-LGBT peers. Inclusive and effective healthcare public policies are essential to promote healthy aging for all.
- Cancer Care Challenges for the LGBT Population in Brazil(2022) CRENITTE, M. R. F.; JUNIOR, A. L.; MELO, L. R. de; AVELINO-SILVA, T. J.Some improvements for the LGBT community have taken place in Brazil, such as the strengthening of progressive social movements and even the National Policy of Integral Healthcare for Lesbians, Gays, Bisexuals, Transsexuals, and Travestis (Travesti: Transfeminine person who identifies with a travesti gender identity, that has been marginalized throughout history. It is a predominantly Brazilian identity construction but is also found in other Latin American and European countries. As there is no consensus on the best translation of the term and its translation could sound pejorative, the authors of this chapter chose to keep its nomenclature in Portuguese. Travesti is not a pejorative term, and they want to be recognized as such by societys), in 2011. From there, it has been possible to consider public policies for caring for non-transmissible chronic diseases, such as cancer, and in barriers and inequalities in the access to the public healthcare system in the country. However, national healthcare has suffered ongoing budgetary cuts, stimulated by neoliberal policies, such as the constitutional amendment in 2016 that “froze” public investments for 20 years. Furthermore, our country has been the subject of worldwide scrutiny in view of escalating far-right conservative bids since the election of Jair Bolsonaro in 2018. The LGBT population already suffers with a lack of national data justifying the implementation of inclusive public policies, but in this context, it fears and dares to resist for the rights already fought for in the past. Thus, this chapter concerns the specificities of the Brazilian healthcare system and how the particulars that LGBT people face may interfere in the risk and follow-up of neoplasms. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.
bookPart Anticoagulação no idoso(2022) BISCAIA, Gabriela Tanajura; CARDOSO, Francisco Akira Malta; CRENITTE, Milton Roberto FurstbookPart Infecção urinária e bacteriúria assintomática(2020) MOREIRA, Felipe Vecchi; CRENITTE, Milton Roberto Furst- Safer sex in older age: putting combination HIV prevention strategies into practice(2021) CRENITTE, Milton R. F.; RICK, Fernanda; I, Vivian Avelino-Silva
conferenceObject Prognostic effect of enteral nutrition in hospitalized older adults with delirium(2018) CRENITTE, M. R.; APOLINARIO, D.; CAMPORA, F.; CURIATI, J. A.; JACOB-FILHO, W.; AVELINO-SILVA, T.- Use of noninvasive markers to predict advanced fibrosis/cirrhosis in severe obesity(2016) CLEVA, Roberto de; DUARTE, Livio Fiolo; CRENITTE, Milton Roberto Furst; OLIVEIRA, Claudia Pinto Marques de; PAJECKI, Denis; SANTO, Marco AurelioBackground: Nonalcoholic steatohepatitis is observed in 25%-55% of patients with severe obesity and in 2%-12% with bridging fibrosis or cirrhosis. There is currently no noninvasive test for the diagnosis of severe liver fibrosis before bariatric surgery. Objectives: To determine the best noninvasive test for predicting advanced liver disease in patients with severe obesity. Setting: University tertiary care hospital, Brazil. Methods: A cross-sectional retrospective study was conducted with 699 patients with severe obesity undergoing bariatric surgery: 568 without a biopsy (nonbiopsy cohort) and 131 patients who had undergone an intraoperative liver biopsy. The tissues were subjected to histologic diagnosis (Brunt criteria) and classified as advanced fibrosis (stages 3 and 4) or no significant fibrosis (absence of nonalcoholic steatohepatitis and stages 1 or 2). The following predictive indices of cirrhosis were calculated in all patients: aspartate aminotransferase/alanine aminotransferase ratio (AAR), age platelet (AP) index, aminotransferase-to-platelet ratio index (APRI), cirrhosis discriminant score (CDS), and hepatitis C antiviral long-term treatment against cirrhosis (HALT-C). The cutoff values, sensitivity, specificity, and areas under the receiver operating characteristic curves (AUROCs) were calculated for patients with biopsies. Results: The AUROC of the AAR, AP, APRI, CDS, and HALT-C model for predicting advanced fibrosis or cirrhosis were, respectively, .522, .88, .99, .905, and .921. The calculated cutoff values, sensitivity, and specificity, respectively, were as follows: AAR: .94, .7, .45; AP 5, .7, .93; APRI .44, 1.0, .97; CDS 6, .7, .97; and HALT-C: .76, 1.0, .77. Conclusion: APRI index was the best predictor of advanced liver disease in patients with severe obesity. (Surg Obes Relat Dis 2016;12:862-867.) (C) 2016 American Society for Metabolic and Bariatric Surgery. All rights reserved.
conferenceObject Association between frailty, gender and sexual orientation in older adults: a cross-sectional study.(2020) MELLO, L. R. de; CRENITTE, M. R. Furst; JACOB FILHO, W.; AVELINO-SILVA, T. J.- Predictors of Enteral Tube Feeding in Hospitalized Older Adults(2017) CRENITTE, Milton Roberto Furst; AVELINO-SILVA, Thiago Junqueira; APOLINARIO, Daniel; CURIATI, Jose Antonio Esper; CAMPORA, Flavia; JACOB-FILHO, WilsonBackground: Despite general recognition that enteral tube feeding (ETF) is frequently employed in long-term care facilities and patients with dementia, remarkably little research has determined which factors are associated with its use in acutely ill older adults. In this study, we aimed to investigate determinants of ETF introduction in hospitalized older adults. Methods: We examined a retrospective cohort of acutely ill patients, aged 60 years and older, admitted to a university hospital's geriatric ward from 2014-2015, in SAo Paulo, Brazil. The main outcome was the introduction of ETF during hospitalization. Predictors of interest included age, sex, referring unit, comorbidity burden, functional status, malnutrition, depression, dementia severity, and delirium. Multivariate analysis was performed using backward stepwise logistic regression. Results: A total of 214 cases were included. Mean age was 81 years, and 63% were women. Malnutrition was detected in 47% of the cases, dementia in 46%, and delirium in 36%. ETF was initiated in 44 (21%) admissions. Independent predictors of ETF were delirium (odds ratio [OR], 4.83; 95% CI, 2.12-11.01; P < .001) and total functional dependency (OR, 8.95; 95% CI, 2.87-27.88; P < .001). Malnutrition was not independently associated with ETF. Conclusion: One in five acutely ill older adults used ETF while hospitalized. Delirium and functional dependency were independent predictors of its introduction. Risks and benefits of enteral nutrition in this particular context need to be further explored.