Sao Paulo Medical Journal最新文献

{"title":"Intensity-modulated radiation therapy for early-stage breast cancer: a systematic review and meta-analysis.","authors":"Samir Abdallah Hanna, Bruna Salani Mota, Fabio Ynoe de Moraes, Gustavo Nader Marta, Heloísa de Andrade Carvalho, Rachel Riera","doi":"10.1590/1516-3180.2023.0324.R1.03072024","DOIUrl":"10.1590/1516-3180.2023.0324.R1.03072024","url":null,"abstract":"<p><strong>Background: </strong>Radiation therapy (RT) is a standard treatment for non-metastatic breast cancer and is associated with acute and late toxicities. Intensity-modulated RT (IMRT) may decrease toxicity and is convenient for patients.</p><p><strong>Objectives: </strong>To assess the efficacy and safety of IMRT in women with early stage breast cancer.</p><p><strong>Design and setting: </strong>Systematic review study; Multi-institutional centers.</p><p><strong>Methods: </strong>Seven databases were searched. Randomized controlled trials (RCT) comparing IMRT with any \"non-IMRT\" strategies were included. Primary outcomes were local control and acute toxicity. Cochrane Handbook was use to plan and conduct the review, and PRISMA 2020 was used to report results.</p><p><strong>Results: </strong>Five RCT involving 2,556 women (n = 1,283 IMRT; n = 1,274 control arm) were included. Baseline characteristics were similar between trials and arms. Local relapse-free survival rates were not different (hazard-ratio [HR] 0.62; 95%confidence interval [CI] -0.38 to 1.62; P > 0.05); however, IMRT reduced the overall acute toxicity (RR 0.69, 95%CI 0.58 to 0.82; P < 0.00001) and acute moist desquamation (risk-ratio [RR] 0.71, 95%CI 0.60 to 0.82; P < 0.00001). Lymphedema and pneumonitis rates, and survival outcomes were not affected by IMRT. The 2-year telangiectasia rate was decreased with IMRT (RR 0.66, 95%CI 0.47 to 0.93; P = 0.02); however, edema, pain, pigmentation, or fibrosis remained unaffected. IMRT did not improve cosmesis.</p><p><strong>Conclusions: </strong>IMRT improved acute toxicity and lowered telangiectasia rates, without affecting oncological and aesthetic outcomes.</p><p><strong>Systematic review registration: </strong>This review was registered at Cochrane Database of Systematic Reviews 2013, Issue 3. Art. No.: CD010420. https://doi.org/10.1002/14651858.CD010420.</p>","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":"143 1","pages":"e2023324"},"PeriodicalIF":1.3,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11655040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of depressive disorders among pregnant women in Brazil in 2019: A descriptive cross-sectional study.","authors":"Maira Gonçalves de Oliveira Lucas, Maria Isabel do Nascimento","doi":"10.1590/1516-3180.2023.0238.R1.03072024","DOIUrl":"10.1590/1516-3180.2023.0238.R1.03072024","url":null,"abstract":"<p><strong>Background: </strong>Prenatal depression threatens maternal and child well-being and interferes with issues prioritized by the 2030 agenda for the Sustainable Development Goals.</p><p><strong>Objectives: </strong>This study aimed to estimate the prevalence of depressive disorders during pregnancy using the Patient Health Questionnaire-9 (PHQ-9).</p><p><strong>Design and setting: </strong>A cross-sectional study using a sample of pregnant Brazilian women, representative of Brazil as a whole.</p><p><strong>Methods: </strong>Data were obtained from the National Health Survey 2019 (PNS-2019), as coordinated by the Instituto Brasileiro de Geografia e Estatística (IBGE). Women aged 18-49 years who were pregnant during PNS-2019 data collection were included. The prevalence of depressive disorders and 95% confidence intervals (95%CI) were calculated.</p><p><strong>Results: </strong>The prevalence of depression before the current pregnancy was 6.03% (95%CI: 3.80%; 8.25%). Using the PHQ-9, the prevalence of Major Depressive Disorder (MDD) in the current pregnancy was estimated to be 17.39% (95%CI: 12.70%-22.06%) among pregnant women who were targeted by the PNS-2019. Moreover, MDD was 15.26% (95%CI: 10.54%; 19.97%) among those who were free from depression history and in half of the pregnant woman population with depression history. Suicidal ideation has been reported in almost 23% of pregnant women with a history of depression. The two items from Patient Health Questionnaire-2 (PHQ-2) (anhedonia and depressed mood) with a cutoff of ≥ 3 presented similar results.</p><p><strong>Conclusions: </strong>Depression during pregnancy affects a non-negligible proportion of pregnant women, thus constituting an important public health problem. Therefore, it is crucial to discuss the implementation of regular screening for depression during prenatal care programs in Brazil.</p>","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":"143 1","pages":"e2023238"},"PeriodicalIF":1.3,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11655033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy and precision of non-invasive thermometers compared with the pulmonary artery temperature: a cross-sectional study.","authors":"Rafael Lima Rodrigues de Carvalho, Mariana Avendanha Victoriano, Camila Claúdia Campos, Paula Frizera Vassallo, Vandack Nobre, Flávia Falci Ercole","doi":"10.1590/1516-3180.2023.0409.R1.05062024","DOIUrl":"10.1590/1516-3180.2023.0409.R1.05062024","url":null,"abstract":"<p><strong>Background: </strong>Temperature fluctuations are critical indicators of a patient's condition in intensive care units (ICUs). While invasive methods offer a more reliable measurement of core temperature, they carry greater risks of complications, limiting their use in most situations. This underscores the need for research evaluating the reliability of non-invasive temperature monitoring methods.</p><p><strong>Objectives: </strong>This study aimed to assess the accuracy and precision of four non-invasive temperature measurement techniques compared to pulmonary artery temperature, considered the gold standard.</p><p><strong>Design and setting: </strong>We conducted a cross-sectional clinical study with repeated measures in the ICUs at Hospital das Clínicas da Universidade Federal de Minas Gerais and Hospital Felício Rocho, Belo Horizonte, Brazil.</p><p><strong>Methods: </strong>All patients admitted with a pulmonary artery catheter were included. We simultaneously recorded temperatures from the pulmonary artery, axillary area, oral cavity, temporal artery, and tympanic membrane. Bland-Altman plots were employed to assess the agreement between the different temperature measurements.</p><p><strong>Results: </strong>A total of 48 patients participated, with a mean age of 54 years. Females comprised 66.67% of the sample. Compared to pulmonary artery temperature, the accuracy and precision (mean and standard deviation) of the non-invasive methods were: axillary (-0.42°C, 0.59°C), oral (-0.30°C, 0.37°C), tympanic membrane (-0.21°C, 0.44°C), and temporal artery (-0.25°C, 0.61°C). Notably, in patients with abnormal body temperature (non-normothermic), only oral and tympanic membrane methods maintained their accuracy and precision.</p><p><strong>Conclusions: </strong>The non-invasive thermometers evaluated in this study demonstrated acceptable accuracy and precision (within the clinically relevant threshold of 0.5°C) compared to pulmonary artery temperature. Among the non-invasive methods, the tympanic membrane measurement proved to be the most reliable, followed by the oral method.</p>","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":"142 6","pages":"e2023409"},"PeriodicalIF":1.3,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11639236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alcohol consumption habits and their impact on academic performance: analysis of ethanol patterns among health students. A cross-sectional study.","authors":"Ana Paula Amaral de Brito, Aísa de Santana Lima, Átina Carneiro Rocha, Beatriz Muniz Gonçalves, Dalila Maria Costa Baraúna de Freitas, Gleice de Jesus Oliveira, Jamily Kaliny Azevedo Lima, Katia de Miranda Avena","doi":"10.1590/1516-3180.2023.0410.R1.05062024","DOIUrl":"10.1590/1516-3180.2023.0410.R1.05062024","url":null,"abstract":"<p><strong>Background: </strong>Studies have indicated a substantial increase in alcohol consumption among university students. Specifically, abusive consumption among health students can adversely affect their academic training and future professional practice.</p><p><strong>Objective: </strong>This study aimed to analyze alcohol consumption habits among healthcare students and investigate the associations between alcohol consumption patterns and sociodemographic and academic variables.</p><p><strong>Design and setting: </strong>We performed this cross-sectional study at a private university located in the city of Salvador, Bahia.</p><p><strong>Methods: </strong>We conducted this study with 770 students using a printed, self-administered, anonymous questionnaire containing sociodemographic and academic performance data, as well as the Alcohol Use Disorders Identification Test (AUDIT) and Rutgers Alcohol Problems Inventory (RAPI).</p><p><strong>Results: </strong>We observed that the prevalence of alcohol consumption (65.1%) and binge drinking (57.5%) among Brazilian healthcare students was high, with more frequent consumption among men (73.1%), in medicine (83.0%) and veterinary medicine (79.1%) programs and in semesters beyond the fourth (71.7%). We found associations between drinking habits and sex (P = 0.016), religion (P < 0.000), course (P < 0.000) and semester (P = 0.047). Binge drinking was associated with attending academic activities without getting any sleep (P < 0.000), missing classes due to hangovers (P < 0.000), encountering issues with the institution's administration (P = 0.028), and failing to complete activities due to alcohol consumption (P < 0.000).</p><p><strong>Conclusion: </strong>The prevalence of alcohol consumption and binge drinking among Brazilian healthcare students was high and associated with sex, religion, course, academic semester, risky behaviors, and negative academic impacts.</p>","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":"142 6","pages":"e2023410"},"PeriodicalIF":1.3,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11493372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions of childhood immunization in São Paulo: quantitative-qualitative cross-sectional study.","authors":"Lucas de Brito Costa, Carolina Nunes França, Luiz Henrique da Silva Nali, Patrícia Colombo-Souza, Neil Ferreira Novo, Yára Juliano","doi":"10.1590/1516-3180.2023.0447.R1.05062024","DOIUrl":"10.1590/1516-3180.2023.0447.R1.05062024","url":null,"abstract":"<p><strong>Background: </strong>Vaccination hesitation spans from historical diseases such as smallpox to the current challenges with the coronavirus disease (COVID-19). In Brazil, vaccination faces obstacles related to trust and convenience. Despite the National Immunization Program, fear of adverse effects as well as misinformation challenge confidence in vaccines, and anti-vaccine movements have gained momentum.</p><p><strong>Objectives: </strong>This study investigated childhood vaccine refusal, including COVID-19 vaccines, by comparing the reasons for and sociodemographic differences between vaccinated individuals and those who hesitated or refused immunization.</p><p><strong>Design and setting: </strong>A cross-sectional study was conducted in São Paulo, Brazil, using questionnaires administered during pediatric consultations between January and April 2023.</p><p><strong>Methods: </strong>This study investigated vaccine hesitancy and the attitudes of parents and caregivers of children (0-12 years) towards vaccines. The questionnaire was administered during routine pediatric consultations at three different locations, each with 50 participants for a total of 150 participants, to avoid selection bias.</p><p><strong>Results: </strong>Marked differences were evident among caregivers in terms of sex, race, income, education, and religion, which influenced their attitudes toward vaccination. There was an increase in the refusal of seasonal vaccinations and a significant distrust of the efficacy of the COVID-19 vaccine (52%), with concerns about its side effects. Although most patients did not stop vaccination, significant delays occurred, especially in the clinical setting (58%).</p><p><strong>Conclusions: </strong>This study emphasizes the importance of childhood health decisions, indicating the need to build trust in vaccines, tailor health policies, and investigate the causes of distrust to promote childhood immunizations.</p>","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":"142 6","pages":"e2023447"},"PeriodicalIF":1.3,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11493370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between angiogenic growth factors and atherosclerosis in renal transplantation recipients: a cross-sectional study.","authors":"Melahat Çoban, Beyza Algul Durak, Mine Sebnem Karakan","doi":"10.1590/1516-3180.2024.0120.05062024","DOIUrl":"10.1590/1516-3180.2024.0120.05062024","url":null,"abstract":"<p><strong>Background: </strong>Accelerated development of atherosclerosis has been observed in renal transplant recipients (RTRs). Angiopoietin-2 (Ang-2) and vascular endothelial growth factor (VEGF) are vascular enzymes that play important roles in vascular development and angiogenesis.</p><p><strong>Objective: </strong>This study aimed to investigate the relationship between Ang-2 and VEGF and atherosclerosis in RTRs.</p><p><strong>Design and setting: </strong>This study was conducted at Ankara City Hospital, Turkey.</p><p><strong>Methods: </strong>This cross-sectional study included 36 (37.5%) female and 60 (62.5%) male RTRs. All findings were compared with those of 70 healthy controls. Ultrasonographic measurements of the carotid artery intima-media thickness (CA-IMT) and renal resistive index (RRI) were used as indicators of atherosclerosis.</p><p><strong>Results: </strong>Log10 Ang-2, log10 VEGF, CA-IMT, and RRI levels were significantly higher in patients than in healthy controls. No significant differences were detected in CA-IMT and RRI between those with log10 Ang-2 ≥ 3.53 pg/mL and those with < 3.53 pg/mL. No significant differences were detected in CA-IMT and RRI between those with log10 VEGF ≥ 1.98 pg/mL and those with < 1.98 pg/mL. No correlation was detected between log10 Ang-2 and log10 VEGF, CA-IMT, or RRI.</p><p><strong>Conclusions: </strong>Increased serum angiogenic growth factor levels and increased atherosclerosis development were detected in RTRs compared to healthy individuals. No relationship was observed between angiogenic growth factors and atherosclerosis. This may be due to the decreased synthesis and effect of angiogenic growth factor receptors synthesized from atherosclerotic plaques due to atherosclerosis, which improves after renal transplantation.</p>","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":"142 6","pages":"e2024120"},"PeriodicalIF":1.3,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11493371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges and perspectives in preventing and treating obesity.","authors":"Denis Pajecki, Paulo Manuel Pêgo Fernandes","doi":"10.1590/1516-3180.2024.1426.13062024","DOIUrl":"10.1590/1516-3180.2024.1426.13062024","url":null,"abstract":"","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":"142 6","pages":"e20241426"},"PeriodicalIF":1.3,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11492533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence in scientific writing.","authors":"Isabele Alves Chirichela, Alessandro Wasum Mariani, Paulo Manuel Pêgo-Fernandes","doi":"10.1590/1516-3180.2024.1425.26062024","DOIUrl":"10.1590/1516-3180.2024.1425.26062024","url":null,"abstract":"","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":"142 5","pages":"e20241425"},"PeriodicalIF":1.3,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11370812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the improvement of living conditions on tuberculosis mortality in Brazil: an ecological study.","authors":"Marcio Natividade, Marcos Pereira, Christine Stauber, Samilly Miranda, Maria Glória Teixeira, Ramon Andrade de Souza, Marilia Santos Dos Anjos, Rafael Barros, Daniela Gonçalves Morato, Erika Aragão, Susan Martins Pereira, Maria da Conceição Nascimento Costa","doi":"10.1590/1516-3180.2023.0279.R1.13052024","DOIUrl":"10.1590/1516-3180.2023.0279.R1.13052024","url":null,"abstract":"<p><strong>Background: </strong>The risk of death due to tuberculosis (TB) in Brazil is high and strongly related to living conditions (LC). However, epidemiological studies investigating changes in LC and their impact on TB are lacking.</p><p><strong>Objectives: </strong>To evaluate the impact of LC on TB mortality in Brazil.</p><p><strong>Design and setting: </strong>This ecological study, using panel data on spatial and temporal aggregates, was conducted in 1,614 municipalities between 2002 and 2015.</p><p><strong>Methods: </strong>Data were collected from the Mortality Information System and the Brazilian Institute of Geography and Statistics. The proxy variable used for LC was the Urban Health Index (UHI). Negative binomial regression models were used to estimate the effect of the UHI on TB mortality rate. Attributable risk (AR) was used as an impact measure.</p><p><strong>Results: </strong>From 2002 to 2015, TB mortality rate decreased by 23.5%, and LC improved. The continuous model analysis resulted in an RR = 0.89 (95%CI = 0.82-0.96), so the AR was -12.3%. The categorized model showed an effect of 0.92 (95%CI = 0.83-0.95) in municipalities with intermediate LC and of 0.83 (95%CI = 0.82-0.91) in those with low LC, representing an AR for TB mortality of -8.7% and -20.5%, respectively.</p><p><strong>Conclusions: </strong>Improved LC impacted TB mortality, even when adjusted for other determinants. This impact was greater in the strata of low-LC municipalities.</p>","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":"142 6","pages":"e2023279"},"PeriodicalIF":1.3,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11364171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burden of metabolic syndrome on primary healthcare costs among older adults: A cross-sectional study.","authors":"Suelen Jane Ricardo, Monique Yndawe Castanho Araujo, Lionai Lima Dos Santos, Marcelo Romanzini, Rômulo Araújo Fernandes, Bruna C Turi-Lynch, Jamile Sanches Codogno","doi":"10.1590/1516-3180.2023.0215.R1.13052024","DOIUrl":"10.1590/1516-3180.2023.0215.R1.13052024","url":null,"abstract":"<p><strong>Background: </strong>The impact of metabolic syndrome (MetS) on healthcare costs remains unclear in the literature.</p><p><strong>Objectives: </strong>To determine the impact of MetS on primary healthcare costs of adults, as well as to identify the impact of physical activity and other covariates on this phenomenon.</p><p><strong>Design and setting: </strong>This cross-sectional study was conducted in the city of Presidente Prudente, State of São Paulo/Brazil, in 2016.</p><p><strong>Methods: </strong>The sample comprised 159 older adults (> 50 years) of both sexes (110 women) who were identified from their medical records in the Brazilian National Health Service. Healthcare costs (US$) were assessed through medical records and divided into medical consultations, medications, laboratory tests, and total costs. MetS was assessed using medical records.</p><p><strong>Results: </strong>The Brazilian National Health Service spent more on consultations (US$ 22.75 versus US$ 19.39; + 17.3%) and medication (US$ 19.65 versus US$ 8.32; + 136.1%) among adults with MetS than among those without MetS, but the costs for laboratory tests were similar (P = 0.343). Total costs were 53.9% higher in adults with MetS than in those without the diagnosis of the disease (P = 0.001). Regarding total costs, there was an increase of US$ 38.97 when five components of MetS were present (P = 0.015), representing an increase of approximately 700%, even after adjusting for sex, age, and physical activity.</p><p><strong>Conclusion: </strong>In conclusion, the presence of the MetS is responsible for increasing primary care costs among older adults, especially in those related to medicines.</p>","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":"142 6","pages":"e2023215"},"PeriodicalIF":1.3,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11318962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}