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Search Results: 1 - 10 of 23 matches for " Lunet "
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Epidemiological studies are like cherries, one draws another
Lunet,Nuno;
Gaceta Sanitaria , 2009, DOI: 10.1590/S0213-91112009000500021
Abstract: the proverb "words are like cherries", meaning that when you start talking subjects pop up and you end up with long conversations, just like cherries coming out of the plate in chains when you pick one, may also be applied to epidemiological research. a sequence of epidemiological studies, each being drawn from the previous, is presented as an example of how each investigation may raise new questions to be addressed in following studies. this description stresses the need for appropriate planning and the usefulness of pilot testing to depict inadequacies that can hardly be anticipated without field work. i intend to illustrate how epidemiological research can provide a deep approach to research questions, as long as findings are properly interpreted and suboptimal methodological options are taken into account in future investigations.
Gastric cancer: frequency and trends
Lunet,Nuno;
Arquivos de Medicina , 2006,
Abstract: a continued international decline in gastric cancer mortality is one of the most remarkable events in cancer epidemiology. this "unplanned triumph", however, is characterized by geographical differences in cancer frequency and trends, both between and within countries. the declining incidence of gastric carcinoma could be explained primarily by the decrease in the relative number of intestinal type cases, and the cancers of the cardia show increasing or stable trends. the understanding of the site and histological type specific trends in each region, overcoming the methodological difficulties and the gaps in our knowledge of cancer aetiology, are essential to predict the future burden of gastric cancer.
Association between child-care and acute diarrhea: a study in Portuguese children
Barros,Henrique; Lunet,Nuno;
Revista de Saúde Pública , 2003, DOI: 10.1590/S0034-89102003000500009
Abstract: objective: to quantify the influence of the type of child-care on the occurrence of acute diarrhea with special emphasis on the effect of children grouping during care. methods: from october 1998 to january 1999 292 children, aged 24 to 36 months, recruited using a previously assembled cohort of newborns, were evaluated. information on the type of care and occurrence of diarrhea in the previous year was obtained from parents by telephone interview. the x2 and kruskal-wallis tests were used to compare proportions and quantitative variables, respectively. the risk of diarrhea was estimated through the calculation of incident odds ratios (or) and their respective 95% confidence intervals (95% ci), crude and adjusted by unconditional logistic regression. results: using as reference category children cared individually at home, the adjusted ors for diarrhea occurrence were 3.18, 95% ci [1.49, 6.77] for children cared in group at home, 2.28, 95% ci [0.92, 5.67] for children cared in group in day-care homes and 2.54, 95% ci [1.21, 5.33] for children cared in day-care centers. children that changed from any other type of child-care setting to child-care centers in the year preceding the study showed a risk even higher (or 7.65, 95% ci [3.25, 18.02]). conclusions: group care increases the risk of acute diarrhea whatsoever the specific setting.
Association between child-care and acute diarrhea: a study in Portuguese children
Barros Henrique,Lunet Nuno
Revista de Saúde Pública , 2003,
Abstract: OBJECTIVE: To quantify the influence of the type of child-care on the occurrence of acute diarrhea with special emphasis on the effect of children grouping during care. METHODS: From October 1998 to January 1999 292 children, aged 24 to 36 months, recruited using a previously assembled cohort of newborns, were evaluated. Information on the type of care and occurrence of diarrhea in the previous year was obtained from parents by telephone interview. The X2 and Kruskal-Wallis tests were used to compare proportions and quantitative variables, respectively. The risk of diarrhea was estimated through the calculation of incident odds ratios (OR) and their respective 95% confidence intervals (95% CI), crude and adjusted by unconditional logistic regression. RESULTS: Using as reference category children cared individually at home, the adjusted ORs for diarrhea occurrence were 3.18, 95% CI [1.49, 6.77] for children cared in group at home, 2.28, 95% CI [0.92, 5.67] for children cared in group in day-care homes and 2.54, 95% CI [1.21, 5.33] for children cared in day-care centers. Children that changed from any other type of child-care setting to child-care centers in the year preceding the study showed a risk even higher (OR 7.65, 95% CI [3.25, 18.02]). CONCLUSIONS: Group care increases the risk of acute diarrhea whatsoever the specific setting.
Effect of questionnaire structure on recall of drug utilization in a population of university students
Helena Gama, Sofia Correia, Nuno Lunet
BMC Medical Research Methodology , 2009, DOI: 10.1186/1471-2288-9-45
Abstract: Drug utilization was assessed by two alternative versions of a questionnaire (A – 4 pages, including specific questions for 12 indications/pharmacological groups and one question for "other medicines"; B – 1 page, including 1 open-ended question to cover overall drug consumption). Each of 32 classes in a private University in Maputo, Mozambique, was randomly assigned questionnaire A (233 participants) or B (276 participants). Logistic regression (allowing for clustering by classroom) was used to compare the two groups in terms of socio-demographic characteristics and medication used during the previous month.Overall, 67.4% of the subjects had used at least one drug during the previous month. The following prevalences were greater among participants completing questionnaire A: use of drugs from two or more pharmacological groups (60.5% vs. 34.4%, p < 0.001), use of two or more drugs (66.2% vs. 43.0%, p < 0.001), and use of antibiotics (14.6% vs. 6.9%, p = 0.001), antifungals (9.4% vs. 4.0%, p = 0.013), antiparasitics (5.6% vs. 1.8%, p = 0.031) and antacids (8.6% vs. 3.6%, p = 0.024). Information about duration of treatment and medical advice was more complete with version A.The indication/drug-specific questions (questionnaire A) revealed a significantly higher prevalence of use of medicines – antibiotics, antifungals, antiparasitics and antacids – without compromising the completeness of the information.Self-reported data are a common source of drug exposure information [1-4] and in many settings they provide the only method available for characterizing the use of medicines [5].Modes of data collection by questionnaire may differ in several ways, including the methods for contacting respondents and for questionnaire delivery, and the administration of questions (e.g. the appearance of the questionnaire, the language used and the cultural adaptation and wording). These differences may affect the reliability and validity of the method [6-8].Regarding drug utilization,
Investiga??o em cancro gástrico: artigos publicados em revistas nacionais e internacionais por autores portugueses
Lunet,Nuno; Carvalho,Rui; Barros,Henrique;
Arquivos de Medicina , 2005,
Abstract: background: gastric cancer remains one of the most frequent worldwide, though it may become a neglected disease concerning the research efforts due to its lower frequency in the developed countries. japan is responsible for most of the stomach cancer research all over the world, with an increasing trend in the study of genetic susceptibility and the use of molecular markers. portugal, like japan, presents one of the highest incidence and mortality rates in the developed world, and our aim was to characterize articles addressing gastric adenocarcinoma or the respective precancerous lesions published by portuguese researchers, according to the study subjects and authors? affiliation. methods: medline? and portuguese medical journals index databases were searched within the period 1992-2003 and the abstracts of the identified articles were reviewed. we obtained the number of citations for articles published in international journals through the web of science?. those not reporting original research and those based exclusively in the study of cell lines or animal experimentation, were excluded. results: we identified 88 articles in international journals (70% addressed cancer mechanisms/etiology/risk factors) and 53 in national journals (87% reported therapy/clinical and pathological descriptions). genetic/ molecular topics were the most studied in articles on cancer mechanisms/etiology/risk factors from international journals (n=55, 89%). most articles (81%) published in international journals come from groups from porto, and these were also the most cited (median number of citations until 2004 = 15). conclusion: the study scope is a major determinant for publication of stomach cancer research by portuguese authors in national or international journals. the high proportion of studies on genetics/molecular biology is in contrast with the scarce number of published works addressing the etiological role of environmental exposures.
Urinary Incontinence and Overactive Bladder: A Review
Correia,Soa; Dinis,Paulo; Lunet,Nuno;
Arquivos de Medicina , 2009,
Abstract: overactive bladder (oab) and urinary incontinence (ui) are common symptoms in the adult population. in 2002, the international continence society provided new de?nitions for lower urinary tract dysfunction but the prevalence, incidence and remission estimates of oab and ui (and its different types) vary considerably across studies. methodological aspects, such as the sample selection and the mode of data collection, should be taken into account when comparing results. while some risk factors are well established, others, mostly evaluated in cross-sectional studies, have not been consistently associated with the occurrence of the symptoms and some caution is necessary when attempting to de?ne causal relations. more longitudinal data are needed to con?rm ?ndings from previous studies. urinary tract dysfunctions are highly prevalent conditions among men and women and they present an important economic burden to society. despite an important negative impact in the quality of life, urinary symptoms are often under-diagnosed and under-treated.
Coffee and gastric cancer: systematic review and meta-analysis
Botelho, Francisco;Lunet, Nuno;Barros, Henrique;
Cadernos de Saúde Pública , 2006, DOI: 10.1590/S0102-311X2006000500002
Abstract: we systematically reviewed the literature on the association between coffee consumption and gastric cancer and performed a meta-analysis of the results. published cohort and case-control studies were identified in pubmed and reference lists. random effects meta-analysis was used to pool effects from 23 studies, and heterogeneity was explored by stratification and meta-regression. the odds ratio (or) for the overall association between coffee and gastric cancer (highest vs. lowest category of exposure) was 0.97 (95%ci: 0.86-1.09), similar for cohort (or = 1.02; 95%ci: 0.76-1.37) and case-control studies (population-based: or = 0.90; 95%ci: 0.70-1.15; hospital-based: or = 0.97; 95%ci: 0.83-1.13). the or was 1.26 (95%ci: 1.02-1.57) when considering five studies conducted in the usa, 0.97 (95%ci: 0.82-1.14) for the five japanese studies, 0.98 (95%ci: 0.81-1.17) for the six studies from europe, and 0.64 (95%ci: 0.47-0.86) for the two studies from south america. in this meta-analysis we found no adverse effect of coffee associated with gastric cancer. knowledge on the level of exposure to different coffee constituents may provide a deeper understanding of this reassuring result and the real role of coffee on cancer risk.
Evolu??o da mortalidade por cancro do pulm?o em Portugal (1955-2005)
Alves,Luís; Bastos,Joana; Lunet,Nuno;
Revista Portuguesa de Pneumologia , 2009,
Abstract: introduction: while the rate of smoking and lung cancer mortality has been decreasing in western europe, there was no decline in lung cancer mortality in portugal until 1998. aim: to describe lung cancer mortality trends in portugal. methods: lung cancer mortality rates (international disease classification 10: c33-34) in portugal 1955-2005 by gender and 5-year age groupings were provided by the world health organization and the national institute of statistics. standard mortality rates (direct method, world population) were calculated for the 35-74, 35-44, 45-54, 55-64 and 65-74 year-old age groups. joinpoint regression was used to calculate the annual percent change (apc) in mortality and to identify any inflection points. results: between 1955 and 2005 we observed a stabilisation in lung cancer mortality in men aged 35-74 years old, varying 3.77%/year (95% confidence interval [95%ci]: 3.53-4.01) in 1955-1986 and -0.15%/year (95%ci: -0.99-0.69) in 1996-2005. we observed negative apc point estimates (with none significantly below zero) in the most recent trends except for the 45-54 age group, where we only noted an apc deceleration since 1981. the mortality increased 1.60%/year (95%ci: 1.40-1.77) in women aged 35-74 years old 1955-2005. conclusion: in the last two decades we observed a lung cancer mortality stabilisation in males, whereas mortality in females increased continuously. these results place portugal at the end of the third stage of the smoking epidemic.
Coffee and gastric cancer: systematic review and meta-analysis
Botelho Francisco,Lunet Nuno,Barros Henrique
Cadernos de Saúde Pública , 2006,
Abstract: We systematically reviewed the literature on the association between coffee consumption and gastric cancer and performed a meta-analysis of the results. Published cohort and case-control studies were identified in PubMed and reference lists. Random effects meta-analysis was used to pool effects from 23 studies, and heterogeneity was explored by stratification and meta-regression. The odds ratio (OR) for the overall association between coffee and gastric cancer (highest vs. lowest category of exposure) was 0.97 (95%CI: 0.86-1.09), similar for cohort (OR = 1.02; 95%CI: 0.76-1.37) and case-control studies (population-based: OR = 0.90; 95%CI: 0.70-1.15; hospital-based: OR = 0.97; 95%CI: 0.83-1.13). The OR was 1.26 (95%CI: 1.02-1.57) when considering five studies conducted in the USA, 0.97 (95%CI: 0.82-1.14) for the five Japanese studies, 0.98 (95%CI: 0.81-1.17) for the six studies from Europe, and 0.64 (95%CI: 0.47-0.86) for the two studies from South America. In this meta-analysis we found no adverse effect of coffee associated with gastric cancer. Knowledge on the level of exposure to different coffee constituents may provide a deeper understanding of this reassuring result and the real role of coffee on cancer risk.
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