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Borracci R.A.,Austral University | Mulassi A.H.,Consejo de Epidemiologia y Prevencion Cardiovascular
Archivos argentinos de pediatria | Year: 2015

CONCLUSIONS: Adolescent tobacco use models adequately predicted the proportion of smokers among adults. Scenarios of restriction regarding the age of onset of tobacco use showed the expected reductions in the rates of tobacco use among adults. Although it was not evaluated in this study, restricting tobacco use among adolescents may help to protect their health and would probably have an impact on the reduction of tobacco-associated mortality among adults.INTRODUCTION: There is little information about the age of onset of smoking among adolescents and its continuation into adulthood. The objective of this study was to assess the influence of tobacco use during adolescence to predict the prevalence of adult smoking using simulation models.MATERIAL AND METHODS: Five models were examined based on initiation and tobacco use rates among 421 adolescents. After simulating different scenarios, expected adult tobacco use rates were obtained and compared to those observed in a validation sample made up of 1218 adults.RESULTS: Models adequately predicted adult smoking rates by comparing them to data obtained using the validation sample (Markov: 37.6% versus 34.5%, p=0.109; dynamic simulation: 32.0% versus 34.5%, p=0.197). The simulation demonstrated that smoking, at least, one cigarette per month during adolescence sufficed to predict adult tobacco use rates. Eliminating tobacco use during adolescence may reduce the rate of tobacco use among adults by 12.2-16.2%.


Mulassi A.H.,Consejo de Epidemiologia y Prevencion Cardiovascular | Borracci R.A.,Austral University | Calderon J.G.E.,Consejo de Epidemiologia y Prevencion Cardiovascular | Vinay P.,Consejo de Epidemiologia y Prevencion Cardiovascular | Mulassi M.,Consejo de Epidemiologia y Prevencion Cardiovascular
Archivos Argentinos de Pediatria | Year: 2012

Introduction. The objective was to study different social networks of adolescents regarding the use of tobacco, alcohol use or obesity, in order to know to what extent friends and schoolmates influenced them in keeping or quitting these habits. Materials and Methods. Two hundred and ninety six adolescents aged 14-18 years attending an urban school in the province of Buenos Aires were surveyed and clinically studied. Information was obtained on anthropometric parameters, tobacco and alcohol use and friendship relations were assessed so as to construct different social networks. Results: 18.8% of female adolescents and 16.5% of male adolescents were smokers; 23.3 and 39.4% drank alcohol and 15.3 and 19.0% were overweight. The networks showed that both smokers and alcohol users have close connections and a high level of centrality. The analysis showed that there is a strong affinity among people sharing the same habits. Conclusions. The study of adolescent social networks allowed to show the relation of affinity among people having the habit of smoking, alcohol use or presenting obesity. Both smokers and alcohol users are closely connected in the network, while obese adolescents seem to stay marginal. Knowledge on social networks and the possibility of working on their members could be used to disseminate healthy behaviors among adolescents.


PubMed | Austral University and Consejo de Epidemiologia y Prevencion Cardiovascular
Type: Journal Article | Journal: Archivos argentinos de pediatria | Year: 2015

There is little information about the age of onset of smoking among adolescents and its continuation into adulthood. The objective of this study was to assess the influence of tobacco use during adolescence to predict the prevalence of adult smoking using simulation models.Five models were examined based on initiation and tobacco use rates among 421 adolescents. After simulating different scenarios, expected adult tobacco use rates were obtained and compared to those observed in a validation sample made up of 1218 adults.Models adequately predicted adult smoking rates by comparing them to data obtained using the validation sample (Markov: 37.6% versus 34.5%, p=0.109; dynamic simulation: 32.0% versus 34.5%, p=0.197). The simulation demonstrated that smoking, at least, one cigarette per month during adolescence sufficed to predict adult tobacco use rates. Eliminating tobacco use during adolescence may reduce the rate of tobacco use among adults by 12.2-16.2%.Adolescent tobacco use models adequately predicted the proportion of smokers among adults. Scenarios of restriction regarding the age of onset of tobacco use showed the expected reductions in the rates of tobacco use among adults. Although it was not evaluated in this study, restricting tobacco use among adolescents may help to protect their health and would probably have an impact on the reduction of tobacco-associated mortality among adults.


Masson W.,Consejo de Epidemiologia y Prevencion Cardiovascular | Lobo M.,Consejo de Epidemiologia y Prevencion Cardiovascular | Huerin M.,Consejo de Epidemiologia y Prevencion Cardiovascular | Molinero G.,Consejo de Epidemiologia y Prevencion Cardiovascular | And 4 more authors.
Endocrinologia y Nutricion | Year: 2015

Background and objectives: Cardiovascular risk estimation in patients with overweight/obesity is not standardized. Our objectives were to stratify cardiovascular risk using different scores, to analyze use of statins, to report the prevalence of carotid atherosclerotic plaque (CAP), and to determine the optimal cut-off point (OCP) of scores that discriminate between subjects with or without CAP. Material and methods: Non-diabetic patients with overweight or obesity in primary prevention were enrolled. The Framingham score (FS), the European score (ES), and the score proposed by the new American guidelines (NS) were calculated, and statin indication was evaluated. Prevalence of CAP was determined by ultrasound examination. A ROC analysis was performed. Results: A total of 474 patients (67% with overweight and 33% obese) were enrolled into the study. The FS classified the largest number of subjects as low risk. PAC prevalence was higher in obese as compared to overweight subjects (44.8% vs. 36.1%, P=.04). According to the FS, ES, and NS respectively, 26.7%, 39.1%, and 39.1% of overweight subjects and 28.6%, 39.0%, and 39.0% of obese subjects had an absolute indication for statins. All three scores were shown to acceptably discriminate between subjects with and without CAP (area under the curve. >. 0.7). The OCPs evaluated did not agree with the risk category values. Conclusions: Risk stratification and use of statins varied in the overweight/obese population depending on the function used. Understanding of the relationship between scores and presence of CAP may optimize risk estimate. © 2014 SEEN.


PubMed | Consejo de Epidemiologia y Prevencion Cardiovascular
Type: Journal Article | Journal: Endocrinologia y nutricion : organo de la Sociedad Espanola de Endocrinologia y Nutricion | Year: 2015

Cardiovascular risk estimation in patients with overweight/obesity is not standardized. Our objectives were to stratify cardiovascular risk using different scores, to analyze use of statins, to report the prevalence of carotid atherosclerotic plaque (CAP), and to determine the optimal cut-off point (OCP) of scores that discriminate between subjects with or without CAP.Non-diabetic patients with overweight or obesity in primary prevention were enrolled. The Framingham score (FS), the European score (ES), and the score proposed by the new American guidelines (NS) were calculated, and statin indication was evaluated. Prevalence of CAP was determined by ultrasound examination. A ROC analysis was performed.A total of 474 patients (67% with overweight and 33% obese) were enrolled into the study. The FS classified the largest number of subjects as low risk. PAC prevalence was higher in obese as compared to overweight subjects (44.8% vs. 36.1%, P=.04). According to the FS, ES, and NS respectively, 26.7%, 39.1%, and 39.1% of overweight subjects and 28.6%, 39.0%, and 39.0% of obese subjects had an absolute indication for statins. All three scores were shown to acceptably discriminate between subjects with and without CAP (area under the curve>0.7). The OCPs evaluated did not agree with the risk category values.Risk stratification and use of statins varied in the overweight/obese population depending on the function used. Understanding of the relationship between scores and presence of CAP may optimize risk estimate.


PubMed | Consejo de Epidemiologia y Prevencion Cardiovascular
Type: Journal Article | Journal: Arquivos brasileiros de cardiologia | Year: 2015

Previous reports have inferred a linear relationship between LDL-C and changes in coronary plaque volume (CPV) measured by intravascular ultrasound. However, these publications included a small number of studies and did not explore other lipid markers.To assess the association between changes in lipid markers and regression of CPV using published data.We collected data from the control, placebo and intervention arms in studies that compared the effect of lipidlowering treatments on CPV, and from the placebo and control arms in studies that tested drugs that did not affect lipids. Baseline and final measurements of plaque volume, expressed in mm3, were extracted and the percentage changes after the interventions were calculated. Performing three linear regression analyses, we assessed the relationship between percentage and absolute changes in lipid markers and percentage variations in CPV.Twenty-seven studies were selected. Correlations between percentage changes in LDL-C, non-HDL-C, and apolipoprotein B (ApoB) and percentage changes in CPV were moderate (r = 0.48, r = 0.47, and r = 0.44, respectively). Correlations between absolute differences in LDL-C, nonHDL-C, and ApoB with percentage differences in CPV were stronger (r = 0.57, r = 0.52, and r = 0.79). The linear regression model showed a statistically significant association between a reduction in lipid markers and regression of plaque volume.A significant association between changes in different atherogenic particles and regression of CPV was observed. The absolute reduction in ApoB showed the strongest correlation with coronary plaque regression.

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