Estudo epidemiológico das parasitoses oculares na população de escolares da cidade de Natal-RN, Brasil

The objective of this study is to estimate the prevalence of Ocular Toxocariasis, Diffuse Unilateral Subacute Neuroretinitis (DUSN), Toxoplasma gondii infection and Ocular Toxoplasmosis in a student population in Natal-RN/Brazil and relate it to demographic, epidemiologic and socio-economic risk factors. The incidence of DUSN was observed in patients at the Federal University of Rio Grande do Norte Ophthalmology Service and the Prontoclinica de Olhos Ophthalmology clinic in Natal. In cases where a worm was found in the subretinal space, the result of treatment with photocoagulation using Green Laser (Eye Light ALCON) was evaluated in relation to final visual result. The sample was randomly selected among the schools of the four districts of Natal, according to the type of institution (public or private), its level (elementary or secondary), and study period (morning, afternoon or evening). The school population was studied from March to May, 2001. Initially, the students answered a questionnaire to evaluate demographic, epidemiologic and socio-economic risk factors. Afterwards, the following procedures were carried out: blood samples were taken for Toxoplasmosis (IgG, IgM) serology, hemogram, ophthalmological examination, consisting of clinical history, measurement of visual acuity, refraction under cycloplegia, biomicroscopy of the anterior segment and annexa, funduscopy and examination of extrinsic motility. The prevalence of Toxocariasis was 0.2% or 2 per one thousand students. The sample was insufficient to estimate the prevalence of DUSN. Seventy patients with DUSN diagnosis were examined from January, 2001 to January, 2003. A live worm was found in the subretinal space of all four patients in the acute phase, and these were treated with laser photocoagulation. After follow-up (average = 11.5 months), visual acuity improved in three eyes and remained unaltered in one eye. Worms were found in 22 of the 66 patients in the chronic phase, and these also were treated with laser photocoagulation. After a follow-up period of 13.1 months, on average, visual acuity improved in two of the patients, remained unchanged in 19 and worsened in one. The comparison of visual result before and after treatment was not statistically significant (p = 0.302). The diagnosis of DUSN in the acute phase, followed by prompt localization and destruction of the worm by photocoagulation, can improve the patient s vision. However, destruction of the worm by laser photocoagulation in eyes with DUSN in the chronic phase does not improve visual acuity. Seroprevalence for IgG was 46% (Confidence Interval CI 95%-42.9-49.2%) and for IgM it was 1.4% (CI 95% = 0.8-2.4%). The prevalence of ocular lesion was 1.15% (CI 95% = 0.6 - 2.0%). Socio-economic conditions were determinants in the prevalence of Systemic and Ocular Toxoplasmosis in the bivaried analysis and confirmed in the multivaried analysis (mother s scholarity illiterate/ OR = 2.9 and p < 0.001). The T. gondii infection prevalence, although high, was less than that found in studies performed in the South and Southeast of Brazil and that of Ocular Toxoplasmosis was completely discrepant, varying from 5 to 17 times less. Although important epidemiological variables such as owning a cat, drinking unfiltered water, and coming into contact with rivers or lakes showed an association in the preliminary analysis, they lost their influence when included in the logistic model. Future studies are scheduled to begin in March, 2004, in collaboration with other Brazilian and American universities in an attempt to discover the reason for these findings, as well as identifying the different strains of Toxoplasma gondii, and studying the sources of water utilized by the population of Natal Brazil

Cartografia da percepção de mês e profissionais sobre a atenção a saúde de crianças/adolescentes soropositivos no município de Natal

This study had as objective to identify to the perception of mothers and professionals of health on the attention to the health of HIV-Positive children/adolescents in the city of Natal-RN. It is a descriptive-exploratory study with quantitative and qualitative approach, carried through in the Giselda Trigueiro Hospital and in the State and Municipal Health Councils in Natal - RN, from march to december of 2005. The sample was composed by 56 participants, 33 mothers of children who use specialized assistance and 23 professionals. Data collection occurred with the application of a half-structuralized interview. Quantitative data were analyzed through descriptive statistics and qualitative data were submitted to content analysis. Prevailing categories in relation to the cartography of the attention to seropositive children and adolescents in Natal were: Organization and dynamics of the attention; Institutional management and human development; Control and prevention; other contexts of attention; relationship/communication team-patient and organization and functioning of the services. The profile epidemiologist of the children, adolescents and of the people/mothers, who take care of them with HIV/Aids, followed the evolution of the epidemic in the country and the world. It was verified that mothers need care and information; however they make a positive evaluation of the attendance they receive. It was also observed many gaps in the services of assistance, in which the researched group was attended, beyond imperfections in the communication between health professionals and users. The professionals recognize the advances that the politics represent for the assistance of people with Aids; however feel themselves limited by the precariousness of the system and the partner-economic conditions of the people. According to these data, it can be verified great challenges to go through in the context of integrality of the assistance to HIV positive children and adolescents in the city of Natal and in the improvement of the communication in the institution of reference

Estudo psicossocial das perdas dentárias na terceira idade

The present study seeks to understand tooth loss by investigating the social representations in the daily life of elderly individuals, thus characterizing itself as a comparative and analytic research. It is known that tooth loss is a common occurrence in elderly individuals, interfering at the psychosocial and biological levels, through its functional, esthetical and social implications. The area of oral health in Brazil is lacking studies on this topic, especially with respect to the psychosocial aspects of the elderly. The Theory of Social Representations and the Central Nucleus Theory were selected for theoretical-methodological support. The Free Association of Words Test was used, whose inducing stimulus were the words tooth loss , in which each subject was asked to associate 3 words, to respond to a questionnaire related to socio-economic conditions and containing an investigation of tooth loss, access to odontological services and the need for dental treatment, and to undergo a focus group interview. The study sample consisted of 120 individuals 60 years of age or over, resident in Natal, RN, Brazil and participants of the Live Together to Live Better group of the Basic Health Unit of Felipe Camarão Residential District and Unati (Open University of the Elderly); an interview was performed with 36 subjects. Data analysis was performed by Evoc 2000, SPSS/99, Graph Pad and Alceste softwares. The results demonstrate that the central nucleus of the social representations of tooth loss for the Live Together group emerged from the difficulty in eating categories, showing a relation between physiologic necessity, desire and pleasure from eating, not to mention the pain that resulted from justifying the tooth loss. Besides the central discourses, the following peripheral elements were gathered: difficulty in adapting to the prosthesis, treatment and difficulty in speaking. All of these categories, except the last, also comprised the class themes of the group interview. For the Unati group the central nucleus emerged from the socio-economic difficulties categories, demonstrating a narrow relation between poverty, access to health and education and esthetics, confirming in the discourse of common sense, the association between tooth loss and aging. At the margin of the central discourses was collected the peripheral element difficulty in adapting to the prosthesis, found both in the Live Together and Unati groups, which expresses the resistance of the subject to this new situation and the failure of the rehabilitation treatment in the sense of reviving the memory of their natural teeth. All of these categories also constitute the class themes of the of the group interview. Thus, through the study of the social representations, we can reveal a reality in the perspective of the social subjects, contemplating the multiple facets of the social-cultural reality experienced by these individuals

Aleitamento e infecções por parasitas intestinais em gestantes adolescentes e seus filhos

The exclusive breastfeeding in the first six months of life practice is essential for the health and development of children. Studies show there is in human milk protective antibodies against intestinal parasites and a relationship between the absence of breastfeeding or weaning and parasitic infections. This work was a prospective cohort study involving 34 pregnant adolescents attended school in Maternity Januario Cicco / RN and their children, to assess the influence of breastfeeding on intestinal parasites in them. Thus, the parasitic infection was investigated by examination of feces parasitological and environmental factors by use of questionnaires. The average age of the mothers studied was 16.2 years. Of these 76.4% were infected and the most prevalent species of parasites were Entamoeba histolytica/dispar (76.9%), Giardia lamblia (19.2%) and Ascaris lumbricoides (11.5%). The infected children had an average age of 5.1 months and the frequency of parasites was 61.7%. The infection was earlier detecctada with 45 days of life. The most common parasites were Giardia lamblia (40%), Entamoeba histolytica/dispar (35%), Ascaris lumbricoides (5%) and Ancylostoma (5%). The average length of exclusive breastfeeding was 2.2 months. There was an association between increased duration of exclusive breastfeeding and increased time to detection of parasites in the feces of children. There was no statistically significant correlation between the socio-economic conditions and cultural and breastfeeding. The data reinforce the importance of breastfeeding to protect the children in its first year of life

Habitus e territorialidade na composição da dinâmica imobiliária em Natal/RN

Many have sought to understand the spatial processes, which originate from land development and real estate dynamics, seeking also to build new categories of analysis to put some light on the less evident aspects of this process. The discussion about production of space has been adopted in this study, but has proved insufficient to explain this complex urban reality. Here, it is analysed the ways that, in Natal, the market fosters the material basis for capital accumulation. The research had as methodological basis, the analysis of discourse, having full interviews with institutional agents as background. It aimed at understanding the complex, material configuration in urban space. It thus investigates the theory of practices of existing (private and public) agents towards the real estate market, using several concepts, like production of space (Lefèbvre and Harvey); habitus (Bourdieu); spatial fix (Harvey); and territoriality (Haesbaert). Evidence shows that there has been a process of ‗naturalization of certain practices in the market that has had implications for the production of an urban space that is both segmented and segregated, giving rise also to complex material configurations, including different forms of heterotopies (Foucault). These spaces result from capital s own creative dynamics and of the reach for social realization for different groups of people making a living under different economic conditions of income.

Estudo de técnicas para o tratamento alternativo de efluentes oleosos oriundos da industrialização da castanha de caju

An evaluation project was conducted on the technique of treatment for effluent oil which is the deriving process to improve cashews. During the evaluation the following techniques were developed: advanced processes of humid oxidation, oxidative processes, processes of biological treatment and processes of adsorption. The assays had been carried through in kinetic models, with an evaluation of the quality of the process by means of determining the chemical demand of oxygen (defined as a technique of control by means of comparative study between the available techniques). The results demonstrated that the natural biodegradation of the effluent ones is limited, as result using the present natural flora in the effluent one revealed impracticable for an application in the industrial systems, independent of the evaluation environment (with or without the oxygen presence). The job of specific microorganisms for the oily composite degradation developed the viability technique of this route, the acceptable levels of inclusion in effluent system of treatment of the improvement of the cashew being highly good with reasonable levels of removal of CDO. However, the use combined with other techniques of daily pay-treatment for these effluent ones revealed to still be more efficient for the context of the treatment of effluent and discarding in receiving bodies in acceptable standards for resolution CONAMA 357/2005. While the significant generation of solid residues the process of adsorption with agroindustrial residues (in special the chitosan) is a technical viable alternative, however, when applied only for the treatment of the effluent ones for discarding in bodies of water, the economic viability is harmed and minimized ambient profits. Though, it was proven that if used for ends of I reuse, the viability is equalized and justifies the investments. There was a study of the photochemistry process which have are applicable to the treatment of the effluent ones, having resulted more satisfactory than those gotten for the UV-Peroxide techniques. There was different result on the one waited for the use of catalyses used in the process of Photo. The catalyses contained the mixing oxide base of Cerium and Manganese, incorporated of Potassium promoters this had presented the best results in the decomposition of the involved pollutants. Having itself an agreed form the gotten photochemistry daily paytreatment resulted, then after disinfection with chlorine the characteristics next the portability to the water were guarantee. The job of the humid oxidation presented significant results in the removal of pollutants; however, its high cost alone is made possible for job in projects of reuses, areas of low scarcity and of raised costs with the capitation/acquisition of the water, in special, for use for industrial and potable use. The route with better economic conditions and techniques for the job in the treatment of the effluent ones of the improvement of the cashew possesses the sequence to follow: conventional process of separation water-oil, photochemistry process and finally, the complementary biological treatment

As estruturas sociais e econômicas do Império Romano do Ocidente e o estabelecimento do reino dos visigodos nas Galliae Aquitania e Narbonensis

In the year 376 of the Common Era, a tribe of Germanic warriors known as Tervingi , of Gothic extraction, crossed the Hister (Danube) river due south, entering the Roman Empire. They fled the Huns, a nomadic group that came plundering their way from the East. It did not take long for a conflict between the Roman imperial authorities and the refugees to begin. Peace was reached in 382 and, henceforth, the Tervingi would be officially foederati (allies) of the Romans, gaining the right to remain an autonomous tribe inside the borders of the Empire. For the next thirteen years the Tervingi warriors fought beside the Roman imperial armies in every major conflict. Nevertheless, after the death of the emperor Theodosius I in 395, their relations deteriorated severely. In theory, the Tervingi remained Roman allies; in practice, they begun to extort monies and other assets from the emperors Honorius and Arcadius. The sack of Rome by the Tervingi king Alaric in 410 was both the culmination and the point of inflection of this state of affairs. During the 410s the Tervingi warriors would fought again beside the Roman Imperial armies and be rewarded with a piece of land in the southwestern portion of the Gallic diocese. Dubbed Visigoths , they would remain trusted Roman allies throughout the next decades, consolidating their own kingdom in the process. This dissertation deals not only with the institution of the Visigothic kingdom in the southwestern portion of the Galliae but also with the social and economic conditions that hindered the Roman ability to defend their territory by themselves, hence opening opportunities for foederati like the Tervingi to carve out a piece of it for themselves.

Avaliação longitudinal do impacto da saúde bucal na estratégia saúde da família em Natal

As a result of the financial incentive provided by the GM / MS 1.444, since 2000, Brazil has experienced a substantial increase in the number of oral health services at the Family Health Strategy. There is, however, evidence that these teams have produced qualitatively different experiences which do not translate necessarily into improved quality of life and health. Thus, evaluative research of great importance. This study aims to assess the impact of the Family Health Strategy in oral health in a longitudinal perspective natalense the years 2006 and 2009. This is an intervention study whose design is a community trial in parallel, nearly randomized. The sample consisted of census tracts covered by oral health teams in the Family Health and the Traditional Model (Basic Health Units and non-FHS Program of Community Health Agents and areas not covered.) The sample was determined by drawing ten census tracts to form the experimental group and ten other sectors for the control group by pairing intentional based on socio-economic and geographic. To check the net effect of the intervention was performed multivariate analysis by Poisson regression. As a result of cross-sectional analysis of year 2009, it was found that the effects of the ESF in Natal were satisfactory only for the variables of injuries and for other purposes without and with negative impact on stock coverage reclaimers. However, the longitudinal analysis revealed that the ESB / ESF improved their performance in dealing with grievances, access and coverage of the type of actions and this fact is independent of age, sex and social and economic conditions. In other employees' words are related to the presence of the Family Health Strategy in the region. However it does not say that both models under study (the Family Health Strategy Model and Traditional) are different in terms of performance and it is pertinent to reflect on the need for further development of evaluation studies that use other approaches able to clarify the dynamics of the process whose results can come to the knowledge of the actors responsible for leading the ESF and encourage them to incorporate the assessment in their routine

Os significados do tabagismo construídos na dinâmica social

The present study has the purpose of catching the significances of smoking in the social dinamics based on the Theory of Social Representations. It was developed among adults with ages from 20 to 59 years, low social and economic conditions, at Natal RN, Brazil. The Free-words Association Test was applied as the instrument of data collection and a semi-structured interview with the smokers and non-smokers, besides a structured interview with smokers, non-smokers and ex-smokers. All data was analyzed by the descriptive statistics using the Analysis of Content Technique of the thematic kind and by the softwares ALCESTE and EVOC 2000. Elaborations about smoking were marked by social, cultural and historical dimension, however they showed sensibility to changes and revealed positive and negative aspects of the habit. The analysis of the semi-structured interviews showed the following categories and under-categories respectively: Initiation of the habit (Friends and Family and Appreciation and Beauty); Psychosocial Implications of smoking (Personal relationship, Work and Financial); Behavior when facing smoking (Positive, Negative and Neutral); Smoking Effects (Smokers´ health and the other people health); Description about oral diseases ( Bad breath, Oral cancer and Dental problems); Smoking treatment (Physician and psychological, Supernatural and Difficulties). ALCESTE analysis presented 4 classes: Ambivalence between pleasure and get ill, Smoking as a trouble and danger to society, Social discrimination of smokers and Mouth as a place of reaffirmation of the discrimination. Those helped us to understand the psychosocial repercussion of the habit. On the social representation structure we identified as a probable central nucleus of the smoker group the categories Pleasure and Bad to the health and as peripheral elements Alcoholic Drink, Financial damage and Nervousness. For the non-smoker group the category Bad to the health comes first and Stop Smoking comes as a peripheral element. Finally, we hope that the knowledge of these representations can contribute to plan and/or to rethink over the professional practices and public policies related to smoking. Besides that, for an amplified comprehension of the study object the discussions over the identified representations should be deepen and amplified to other population and social groups

Relação das condições socioeconômicas com as condições de saúde bucal em capitais brasileiras

Despite the improvement of Brazilian s living conditions in recent decades, this improvement occurred in a polarized way between groups of better social position. Then, there is still a health inequity´s panorama in Brazil which encompasses the oral health state. This panorama instigated the attainment of this ecological study that aimed to evaluate the relationship of socioeconomic conditions, and public health policies with oral health status in Brazilian capitals. Thus, we performed factor analysis and linear regression using oral health indicators collected from SB Brasil 2010, of socioeconomic conditions from Brazilian Census 2010 and related to water´s supply fluoridation from SISAGUA. Factor analysis with indicators of living conditions revealed two common factors, economic deprivation and socio-sanitary condition. Economic deprivation showed statistically significant positive correlation with DMFT 12 years (p= 0,03) and mean missing teeth (p = 0,002) and negative correlation with caries-free population (p=0,012). Socio-sanitary negatively correlated with DMFT (p <0,0001) and a positive correlation with caries-free population (p = 0.002). Fluoridated water had a significant association with DMFT (p <0,0001), mean missing teeth (p <0,0001) and caries free population (p <0.0001). Multiple linear regression analysis for the DMFT of capital was estimated by socio-sanitary condition and fluoridation, adjusted by economic deprivation, whereas the model for the mean missing teeth was estimated only by fluoridation and economic deprivation, and finally the model the rate for the population free of caries in Brazilian capitals was estimated by economic and socio-sanitary status adjusted fluoridated water supply. Therefore, factors related to living conditions and public policies are intrinsically linked to tooth decay issues. Thus, actions, beyond dental care assistance, must be development to impact positively in social and economic conditions, especially, between the most vulnerable populations

Impactos sócio-econômicos e ambientais da introdução da Tilápia do Nilo, Oreochromis niloticus, em açudes públicos do semi-árido nordestino, Brasi

The stocking of exotic fish, especially the tilapia, has become a common practice in the public reservoirs of the Brazilian semi-arid region. The stocking of tilapias has had as its main aim the improvement of the fisheries in the reservoirs and consequently the improvement of the socio-economic conditions of the families that have fishing as the main source of income. However, the environmental risks associated with this practice are high and can lead to a loss in aquatic biodiversity and to changes in the quality of the water. The object of this work was to quantify the socio-economic and environmental effects of the introduction of the Nile tilapia in the public reservoirs of the semi-arid northeastern Brazil. The analysis of the fish yield of 100 public reservoirs from 1970 to 2000 demonstrated that the introduction of the Nile tilapia apparently contributed to an increase in the total fish yield from the late 1970 s until the mid-1980 s. Nevertheless, from that time onwards the fish yield in these reservoirs has fallen into decline to levels inferior to those observed prior to the introduction of the tilápia. The analysis of the fishing activity statistics of the Gargalheiras reservoir located in the city of Acari, Rio Grande do Norte, demonstrated that the introduction of the Nile tilapia in the reservoir has not significantly increased the fish yield, the gross overall income, the gross per capita income nor the number of fishermen actively fishing in the reservoir. On the other hand, the analysis of the fishing activity statistics of the Gargalheiras reservoir has revealed a significant reduction in the captures of other commercially important fish species after the introduction of the tilapia. This result suggests that the Nile tilapia could have negatively affected other species of fish in the reservoir, contributing to the decline in their stocks. In order to assess the perception of the fishermen concerning the effects of the Nile tilapia over other species of fish and the quality of the water, questionnaires containing open and multiple choice questions were applied with 30 fishermen from the colony of the Gargalheiras reservoir. The great majority of the local fishermen stated that the tilapia is currently the most important species of fish to those who depend on fishing as a source of income and that they have not caused damage to other species of fish nor to the quality of the water in the reservoir. However, the results of the present work indicate that the alleged socio-economic benefits, employed to justify the introduction of the Nile tilapia in the reservoirs, are overestimated while the environmental impacts of the introduction of this exotic species are underestimated

Prevalência e localização espacial dos casos de tracoma detectados em escolares de Botucatu, São Paulo - Brasil

OBJETIVO: Avaliar a prevalência de tracoma em escolares de Botucatu/SP-Brasil e a distribuição espacial dos casos. MÉTODOS: Foi realizado um estudo transversal, em crianças de 7-14 anos, que frequentavam as escolas do ensino fundamental de Botucatu/SP, em novembro/2005. O tamanho da amostra foi estimado em 2.092 crianças, considerando-se a prevalência histórica de 11,2%, aceitando-se erro de estimação de 10% e nível de confiança de 95%. A amostra foi probabilística, ponderada e acrescida de 20%, devido à possível ocorrência de perdas. Examinaram-se 2.692 crianças. O diagnóstico foi clínico, baseado na normatização da Organização Mundial da Saúde (OMS). Para avaliação dos dados espaciais, utilizou-se o programa CartaLinx (v1.2), sendo os setores de demanda escolar digitalizados de acordo com as divisões do planejamento da Secretaria de Educação. Os dados foram analisados estatisticamente, sendo a análise da estrutura espacial dos eventos calculadas usando o programa Geoda. RESULTADOS: A prevalência de tracoma nos escolares de Botucatu foi de 2,9%, tendo sido detectados casos de tracoma folicular. A análise exploratória espacial não permitiu rejeitar a hipótese nula de aleatoriedade (I= -0,45, p>0,05), não havendo setores de demanda significativos. A análise feita para os polígonos de Thiessen também mostrou que o padrão global foi aleatório (I= -0,07; p=0,49). Entretanto, os indicadores locais apontaram um agrupamento do tipo baixo-baixo para um polígono ao norte da área urbana. CONCLUSÃO: A prevalência de tracoma em escolares de Botucatu foi de 2,9%. A análise da distribuição espacial não revelou áreas de maior aglomeração de casos. Embora o padrão global da doença não reproduza as condições socioeconômicas da população, a prevalência mais baixa do tracoma foi encontrada em setores de menor vulnerabilidade social.

Fatores familiares associados à obesidade abdominal entre adolescentes

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Saúde bucal: uma revisão crítica sobre programações educativas para escolares

Em saúde bucal, a situação epidemiológica brasileira ainda é grave devido às condições sociais e econômicas da população, à pequena parcela de investimentos que a área recebe em relação ao total do SUS e à falta de informação sobre os cuidados básicos de saúde. Embora a odontologia se mostre muito desenvolvida em tecnologia, não responde em níveis significativos às demandas dos problemas de saúde bucal da população. Nesse contexto, a educação em saúde bucal tem sido cada vez mais requisitada, considerando o baixo custo e as possibilidades de impacto odontológico no âmbito público e coletivo. A importância de práticas preventivas e educativas em saúde bucal nos levou a realizar este estudo, apontando diferentes programas odontológicos, mediante estudo de revisão, para analisá-los em suas propostas, metodologias, possibilidades e limitações, visando refletir sobre o tema com foco nos aspectos educativos que ainda desafiam os programas de saúde bucal. Identificaram-se quatro tendências nos programas analisados. O estudo apontou para a necessidade de se repensar as práticas educativas.

Prevalência de fatores de risco para doenças cardiovasculares entre escolares em Londrina - PR: diferenças entre classes econômicas

OBJETIVO: Avaliar e comparar a prevalência de fatores de riscos cardiovasculares em adolescentes escolares de diferentes classes econômicas. MÉTODOS: Foram avaliados 1.021 adolescentes. Os indivíduos foram pesados e tiveram sua altura e circunferência abdominal medidos, além da sua pressão arterial aferida. A prática de atividade física e condição socioeconômica foram relatadas. Os resultados foram avaliados pela utilização da frequência das variáveis e pelo teste do qui-quadrado. RESULTADOS: Observou-se menor prevalência de sedentarismo (p < 0,001) e maiores prevalências de obesidade abdominal (p = 0,038) e de sobrepeso (p = 0,010) entre adolescentes da classe econômica alta. Não houve diferença de prevalência de pressão arterial elevada entre adolescentes da classe econômica baixa e alta. Quando os fatores de risco cardiovasculares foram agregados, a prevalência também foi maior na classe econômica alta para um ou dois fatores de risco. CONCLUSÃO: Com exceção do sedentarismo e da pressão arterial elevada, a prevalência de fatores de risco para doenças cardiovasculares foi maior na classe econômica alta.