REGO, R.A. et al. Fatores de risco para doenças crônicas não-transmissíveis: inquérito domiciliar no Município de São Paulo, SP (Brasil). Metodologia e resultados preliminares. Rev. Saúde públ., S. Paulo, 24: 1990. RESUMO:As doenças crionicas não-transmissíveis são causa importante de morte no Brasil, principalmente nos grandes centros urbanos. Existem inúmeros fatores de risco relacionados a este tipo de doenças, cuja remoção, ou atenuação, pode contribuir para o declínio da mortalidade. Descreve-se a metodologia do primeiro estudo muiticêntrico abrangente realizado na América Latina sobre a questão dos fatores de risco de doenças crônicas não-transmissíveis. No Brasil o estudo foi realizado nos municípios de São Paulo, SP e Porto Alegre, RS. São apresentados resultados preliminares para o Município de São Paulo quanto à prevalência de hipertenção arterial (22,3%), tabagismo (37,9%), obesidade (18,0%), alcoolismo (7,7%) e sedentarismo (69,3%). Os resultados obtidos são comparados com dados existentes para o Brasil e outros países, e discute-se a relação entre a magnitude dos diversos fatores de risco e a mortalidade por doenças cardiovasculares em São Paulo e alguns países desenvolvidos. DESCRITORES: INTRODUÇÃOAs doenças crônicas não-transmissíveis constituem uma das principais causas de morte nos países desenvolvidos 38,40,62 Entre as doenças cardiovasculares, vem-se percebendo um declínio, nos últimos anos, na mortalidade relativa à doença isquémica do coração (DIG) 35,43,59,65,82 , e à doença cerebrovascular 41,42,58 , que entretanto não abala a posição deste grupo de doenças como um dos principais componentes da morbimortalidade. Apesar de ainda estar em discussão o que realmente levou a essa queda nas taxas, tem-se atribuído tal fato basicamente a : a) diminuição da exposição aos fatores de risco, como o consumo de cigarros e a ingestão de gorduras animais 5,16,35,44,78,79 ; e b) melhorias no diagnóstico, tratamento e cobertura dos serviços de saúde em relação à hipertensão e outras doenças cardiovasculares 4,39,41 .A expressão "fator de risco" refere-se a um conceito que vem ganhando importância crescente no campo das doenças crônicas não-transmissíveis 23,63,66 . Estas afecções caracterizam-se geralmente por uma etiologia multifatorial e pelo incipiente estado do conhecimento sobre os mecanismos etiológicos e fisiopatológicos que levam ao seu surgimento e desenvolvimento, o que dificulta uma intervenção sistemática e coerente a nível de saúde pública. Entretanto, estudos epidemiológicos têm mostrado consistentemente uma relação entre determinados fatores e determinadas doenças 18,26,45,74,75,77,81 . Além disto, tem-se verificado que a remoção ou reversão da exposição a estes fatores implica na redução da mortalidade e/ou da prevalência e/ou o surgimento mais tardio das patologias em estudo 5,40 . Desta maneira, a intervenção

Antiretroviral therapy contributes to decreasing morbidity and mortality, and ultimately to increasing survival. In Brazil, there are regional differences in HIV epidemiology regarding pregnant women and children with HIV/AIDS. This study evaluates survival time after AIDS diagnosis in 914 children infected by mother-to-child transmission, reported between 1983 and 1998 and followed until 2002, in Brazil's five regions. Time between birth and HIV diagnosis decreased over the years, mainly in the South and Southeast Regions. There was a significant improvement in survival; more than 75% of cases were still living four years after diagnosis in the 1997-1998 group. This Brazilian study demonstrates that even with regional inequalities in health care infrastructure it is possible for a developing country to establish an effective system of universal and free access to antiretroviral therapy that produces a significant increase in survival for children with AIDS.

Mortality rates by all cancers were heterogeneous in Brazil. The risk of death by cancer was higher in the Southern and Southeastern regions, but was decreasing in these regions, the more developed in the country. The other regions, less developed, had lower mortality rates by cancer, but the rates were on increase. From 1991 to 1995, it was observed the stability of mortality rates from tobacco related cancers, fact less perceived among females.

SummaryObjectives: To estimate hypertension prevalence and identify associated socioeconomic, demographic, and anthropometric variables.Methods: urban area of Formiga, Minas Gerais state, and registered with the Family Health Program (Programa Saúde da Família -PSF), which covers 94% of the population. Two hundred and eighty-five subjects (131 men and 154 women) were was used to collect socioeconomic and demographic data, as well as information on alcohol consumption, smoking, and physical activity level. Using appropriate techniques, trained interviewers with at least one year of experience in health care collected data and performed pertinent measurements (blood pressure, heart rate, plus waist and arm circumference). Conclusion: Hypertension prevalence was very high in the adult population registered with the PSF in Formiga, representing a major public health problem. Intervention programs that boost physical activity, promote compliance with drug treatment, and focus on hypertensive subjects unaware of their condition are needed. Results

CONTEXT: Around 90% of lung cancer worldwide is attributable to cigarette smoking, although less than 20% of cigarette smokers develop lung cancer. Other factors such as diet, chronic lung diseases, occupation and possibly environmental agents also contribute to this cancer. Genetic factors seem to play a role in lung cancer, but the precise characteristics influencing lung cancer susceptibility are not known, since genetic factors are easily obscured by the strong environmental determinants of lung cancer, particularly smoking. OBJECTIVE:To estimate the effect that cancer occurrence among first-degree relatives has on the risk of lung cancer. DESIGN:Hospital-based case-control study. SETTING:The metropolitan region of São Paulo, Brazil.PARTICIPANTS: 334 incident lung cancer cases and 578 controls matched by hospitals. MAIN MEASUREMENTS:By means of a structured questionnaire, cases and controls were interviewed about cancer occurrence in first-degree relatives, tobacco smoking, exposure to passive smoking, occupation, migration and socioeconomic status. Non-conditional logistic regression was used to calculate the risk of familial cancer aggregation, the effect of cancer in first-degree relatives and smoking in conjunction, and for controlling confounders. RESULTS:The adjusted odds ratio (OR) revealed a slight, but not statistically significant, excess risk of lung cancer for subjects with a history of lung cancer in relatives (OR 1.21; 95% confidence interval [CI] 0.50 -2.92). The same was found among those with a history of other tobacco-related cancers in relatives (OR 1.36; 95% CI 0.87 -2.14). A step gradient effect was observed regarding lung cancer risk, in accordance with increases in the number of pack-years of cigarette consumption. An interaction between familial cancer aggregation and tobacco smoking was detected. CONCLUSIONS:A mildly elevated risk of lung cancer among persons with a positive history of lung and other tobacco-related cancers was observed. The finding of an interaction between the variables of familial cancer aggregation and smoking suggests that familial cancer aggregation could be considered as a marker of susceptibility, increasing the risk of lung cancer among smokers. These results improve our knowledge of lung carcinogenesis and can guide future cancer genetic studies.