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BACKGROUND: There are no randomized studies comparing the maintenance of sinus rhythm after catheter ablation (CA) concerning treatment with antiarrhythmic drugs (AA) in elderly patients with paroxysmal atrial fibrillation (AF). OBJECTIVES: To compare the clinical results of pulmonary vein (PV) isolation with the second-generation PVAC Gold catheter against AA treatment in elderly people with recurrent symptomatic paroxysmal AF, refractory to at least one AA, and without structural heart disease. METHODS: Sixty patients with paroxysmal AF ≥ 65 years old were randomized to two forms of treatment: group 1: CA and group 2: AA drugs. The primary outcome was the AF recurrence-free rate after at least one year of follow-up. Secondary outcomes were: progression to persistent forms of AF, impact on quality of life (QOLF), and complications. The significance level adopted in the statistical analysis was 5% (p<0.05). RESULTS: The AF recurrence-free rate was 80% (10% with amiodarone) in the CA group, after 1.3 procedures per patient and 65% in the AA group (60% with amiodarone), (p = 0.119) in an average follow-up of 719 days (Q1: 566; Q3: 730). The persistent AF free rate was 83.4% in the AC group and 67.7% in the AA group (p = 0.073) Both strategies showed an improvement in the AFQoL score during follow-up (p < 0.001), with no difference between the groups. Although without clinical repercussions or impact on the intellectual assessment test, 25% of patients in the CA group showed signs of cerebral embolization on brain MRI. CONCLUSIONS: Both strategies for maintaining sinus rhythm promoted an improvement in the quality of life of elderly patients with symptomatic AF, with no statistical difference in the clinical outcomes. Additional studies using technologies with a better safety profile are needed to evaluate the benefits of CA in elderly patients with AF.

FUNDAMENTO: Não existem estudos randomizados comparando a manutenção do ritmo sinusal após ablação por cateter (AC) em relação ao tratamento com fármacos antiarrítmicos (AA) em pacientes idosos portadores fibrilação atrial (FA) paroxística. OBJETIVOS: Comparar os resultados clínicos do isolamento das veias pulmonares (VPs) com o cateter PVAC Gold de segunda geração com o uso de AA em idosos com FA paroxística sintomática, recorrente, apesar do uso de fármacos AA. MÉTODOS: Sessenta pacientes com FA paroxística ≥ 65 anos e sem cardiopatias estruturais foram randomizados para duas formas de tratamento: grupo 1: AC e grupo 2: AA. O desfecho primário foi a taxa livre de recorrência de FA após pelo menos um ano de seguimento. Os desfechos secundários foram: progressão para formas persistentes de FA, impacto na qualidade de vida (QVFA) e complicações. O nível de significância adotado na análise estatística foi de 5% (p<0,05). RESULTADOS: A taxa livre de recorrência de FA foi de 80% (10% com amiodarona) no grupo AC, após 1,3 procedimentos por paciente e de 65% no grupo AA (60% com amiodarona), (p = 0,119) num seguimento médio de 719 dias (Q1: 566; Q3: 730). A taxa livre de FA persistente foi de 83,4% no grupo AC e de 67,7% no grupo AA (p = 0,073). Ambas as estratégias apresentaram melhora no escore de QVFA durante o seguimento (p < 0,001), sem diferença entre os grupos. Embora sem repercussão clínica ou impacto no teste de avaliação intelectual, 25% dos pacientes do grupo PVAC apresentou sinais de embolização cerebral na RNM cerebral. CONCLUSÕES: Ambas as estratégias para manutenção do ritmo sinusal promoveram melhora na qualidade de vida de pacientes idosos com FA sintomática, sem diferença estatística nos desfechos clínicos preconizados. Estudos adicionais usando tecnologias com melhor perfil de segurança são necessários para avaliar os benefícios da AC em pacientes idosos com FA.

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Resumo Fundamento Não existem estudos randomizados comparando a manutenção do ritmo sinusal após ablação por cateter (AC) em relação ao tratamento com fármacos antiarrítmicos (AA) em pacientes idosos portadores fibrilação atrial (FA) paroxística. Objetivos Comparar os resultados clínicos do isolamento das veias pulmonares (VPs) com o cateter PVAC Gold de segunda geração com o uso de AA em idosos com FA paroxística sintomática, recorrente, apesar do uso de fármacos AA. Métodos Sessenta pacientes com FA paroxística ≥ 65 anos e sem cardiopatias estruturais foram randomizados para duas formas de tratamento: grupo 1: AC e grupo 2: AA. O desfecho primário foi a taxa livre de recorrência de FA após pelo menos um ano de seguimento. Os desfechos secundários foram: progressão para formas persistentes de FA, impacto na qualidade de vida (QVFA) e complicações. O nível de significância adotado na análise estatística foi de 5% (p<0,05). Resultados A taxa livre de recorrência de FA foi de 80% (10% com amiodarona) no grupo AC, após 1,3 procedimentos por paciente e de 65% no grupo AA (60% com amiodarona), (p = 0,119) num seguimento médio de 719 dias (Q1: 566; Q3: 730). A taxa livre de FA persistente foi de 83,4% no grupo AC e de 67,7% no grupo AA (p = 0,073). Ambas as estratégias apresentaram melhora no escore de QVFA durante o seguimento (p < 0,001), sem diferença entre os grupos. Embora sem repercussão clínica ou impacto no teste de avaliação intelectual, 25% dos pacientes do grupo PVAC apresentou sinais de embolização cerebral na RNM cerebral. Conclusões Ambas as estratégias para manutenção do ritmo sinusal promoveram melhora na qualidade de vida de pacientes idosos com FA sintomática, sem diferença estatística nos desfechos clínicos preconizados. Estudos adicionais usando tecnologias com melhor perfil de segurança são necessários para avaliar os benefícios da AC em pacientes idosos com FA.

Abstract Background There are no randomized studies comparing the maintenance of sinus rhythm after catheter ablation (CA) concerning treatment with antiarrhythmic drugs (AA) in elderly patients with paroxysmal atrial fibrillation (AF). Objectives To compare the clinical results of pulmonary vein (PV) isolation with the second-generation PVAC Gold catheter against AA treatment in elderly people with recurrent symptomatic paroxysmal AF, refractory to at least one AA, and without structural heart disease. Methods Sixty patients with paroxysmal AF ≥ 65 years old were randomized to two forms of treatment: group 1: CA and group 2: AA drugs. The primary outcome was the AF recurrence-free rate after at least one year of follow-up. Secondary outcomes were: progression to persistent forms of AF, impact on quality of life (QOLF), and complications. The significance level adopted in the statistical analysis was 5% (p<0.05). Results The AF recurrence-free rate was 80% (10% with amiodarone) in the CA group, after 1.3 procedures per patient and 65% in the AA group (60% with amiodarone), (p = 0.119) in an average follow-up of 719 days (Q1: 566; Q3: 730). The persistent AF free rate was 83.4% in the AC group and 67.7% in the AA group (p = 0.073) Both strategies showed an improvement in the AFQoL score during follow-up (p < 0.001), with no difference between the groups. Although without clinical repercussions or impact on the intellectual assessment test, 25% of patients in the CA group showed signs of cerebral embolization on brain MRI. Conclusions Both strategies for maintaining sinus rhythm promoted an improvement in the quality of life of elderly patients with symptomatic AF, with no statistical difference in the clinical outcomes. Additional studies using technologies with a better safety profile are needed to evaluate the benefits of CA in elderly patients with AF.

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BACKGROUND: Atrial fibrillation (AF) affects about 2% to 4% of the world population, and in patients hospitalized in intensive care units, this incidence can reach up to 23% in those with septic shock. The impact of AF in patients with sepsis is reflected in worse clinical outcomes, and the identification of the triggering factors can be a target for future prevention and treatment strategies. OBJECTIVES: To verify the relationship between the development of AF and mortality in patients over 80 years of age included in the sepsis protocol and to identify the risk factors that contribute to the development of AF in this population. METHODS: Retrospective observational study, with a review of electronic medical records and inclusion of 895 patients aged 80 years or older, included in the sepsis protocol of a high-complexity private hospital in São Paulo, SP, from January 2018 to December 2020. All tests were performed with a significance level of 5%. RESULTS: The incidence of AF in the sample was 13%. After multivariate analysis, using multiple logistic regression, it was possible to demonstrate an association of mortality, in the studied population, with the SOFA score (odds ratio [OR] 1.21 [1.09 - 1.35]), higher values of C-reactive protein (OR 1.04 [1.01 - 1.06]), need for vasoactive drugs (OR 2.4 [1.38 - 4.18]), use of mechanical ventilation (OR 3.49 [1.82 - 6.71]), and mainly AF (OR 3.7 [2.16 - 6.31]). CONCLUSION: In very elderly patients (80 years of age and older) with sepsis, the development of AF was shown to be an independent risk factor for in-hospital mortality.

FUNDAMENTO: A fibrilação atrial (FA) acomete cerca de 2% a 4% da população mundial. Nos pacientes internados em unidades de terapia intensiva, esta incidência pode chegar em até 23% naqueles com choque séptico. O impacto da FA nos pacientes sépticos se reflete em piores desfechos clínicos e o reconhecimento dos fatores desencadeantes pode ser alvo para estratégias de tratamento e prevenção futuras. OBJETIVOS: Verificar a relação entre desenvolvimento de FA e mortalidade nos pacientes acima de 80 anos incluídos no protocolo sepse e identificar fatores de risco que contribuam para o desenvolvimento de FA nesta população. MÉTODOS: Estudo observacional retrospectivo, com revisão de prontuários eletrônicos e inclusão de 895 pacientes com 80 anos ou mais, incluídos no protocolo sepse de um hospital privado de alta complexidade em São Paulo/SP, no período de janeiro de 2018 a dezembro de 2020. Todos os testes foram realizados com nível de significância de 5%. RESULTADOS: A incidência de FA na amostra foi de 13%. Após análise multivariada por regressão logística múltipla, foi possível demonstrar associação de mortalidade na população estudada, com o escore SOFA ( odds ratio [OR] 1,21 [1,09 ­ 1,35]), valores mais altos de proteína C-reativa (OR 1,04 [1,01 ­ 1,06]), necessidade de droga vasoativa (OR 2,4 [1,38 ­ 4,18]), uso de ventilação mecânica (OR 3,49 [1,82 ­ 6,71]) e principalmente FA (OR 3,7 [2,16 ­ 6,31). CONCLUSÕES: No paciente grande idoso (80 anos ou mais) com sepse, o desenvolvimento de FA se mostrou como fator de risco independente para mortalidade intra-hospitalar.

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Resumo Fundamento A fibrilação atrial (FA) acomete cerca de 2% a 4% da população mundial. Nos pacientes internados em unidades de terapia intensiva, esta incidência pode chegar em até 23% naqueles com choque séptico. O impacto da FA nos pacientes sépticos se reflete em piores desfechos clínicos e o reconhecimento dos fatores desencadeantes pode ser alvo para estratégias de tratamento e prevenção futuras. Objetivos Verificar a relação entre desenvolvimento de FA e mortalidade nos pacientes acima de 80 anos incluídos no protocolo sepse e identificar fatores de risco que contribuam para o desenvolvimento de FA nesta população. Métodos Estudo observacional retrospectivo, com revisão de prontuários eletrônicos e inclusão de 895 pacientes com 80 anos ou mais, incluídos no protocolo sepse de um hospital privado de alta complexidade em São Paulo/SP, no período de janeiro de 2018 a dezembro de 2020. Todos os testes foram realizados com nível de significância de 5%. Resultados A incidência de FA na amostra foi de 13%. Após análise multivariada por regressão logística múltipla, foi possível demonstrar associação de mortalidade na população estudada, com o escore SOFA ( odds ratio [OR] 1,21 [1,09 - 1,35]), valores mais altos de proteína C-reativa (OR 1,04 [1,01 - 1,06]), necessidade de droga vasoativa (OR 2,4 [1,38 - 4,18]), uso de ventilação mecânica (OR 3,49 [1,82 - 6,71]) e principalmente FA (OR 3,7 [2,16 - 6,31). Conclusões No paciente grande idoso (80 anos ou mais) com sepse, o desenvolvimento de FA se mostrou como fator de risco independente para mortalidade intra-hospitalar.

Abstract Background Atrial fibrillation (AF) affects about 2% to 4% of the world population, and in patients hospitalized in intensive care units, this incidence can reach up to 23% in those with septic shock. The impact of AF in patients with sepsis is reflected in worse clinical outcomes, and the identification of the triggering factors can be a target for future prevention and treatment strategies. Objectives To verify the relationship between the development of AF and mortality in patients over 80 years of age included in the sepsis protocol and to identify the risk factors that contribute to the development of AF in this population. Methods Retrospective observational study, with a review of electronic medical records and inclusion of 895 patients aged 80 years or older, included in the sepsis protocol of a high-complexity private hospital in São Paulo, SP, from January 2018 to December 2020. All tests were performed with a significance level of 5%. Results The incidence of AF in the sample was 13%. After multivariate analysis, using multiple logistic regression, it was possible to demonstrate an association of mortality, in the studied population, with the SOFA score (odds ratio [OR] 1.21 [1.09 - 1.35]), higher values of C-reactive protein (OR 1.04 [1.01 - 1.06]), need for vasoactive drugs (OR 2.4 [1.38 - 4.18]), use of mechanical ventilation (OR 3.49 [1.82 - 6.71]), and mainly AF (OR 3.7 [2.16 - 6.31]) Conclusion In very elderly patients (80 years of age and older) with sepsis, the development of AF was shown to be an independent risk factor for in-hospital mortality.

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BACKGROUND: There is a paucity of information about Brazilian COVID-19 in-hospital mortality probability of death combining risk factors. OBJECTIVE: We aimed to correlate COVID-19 Brazilian in-hospital patients' mortality to demographic aspects, biomarkers, tomographic, echocardiographic findings, and clinical events. METHODS: A prospective study, single tertiary center in Brazil, consecutive patients hospitalized with COVID-19. We analyzed the data from 111 patients from March to August 2020, performed a complete transthoracic echocardiogram, chest thoracic tomographic (CT) studies, collected biomarkers and correlated to in-hospital mortality. RESULTS: Mean age of the patients: 67 ± 17 years old, 65 (58.5%) men, 29 (26%) presented with systemic arterial hypertension, 18 (16%) with diabetes, 11 (9.9%) with chronic obstructive pulmonary disease. There was need for intubation and mechanical ventilation of 48 (43%) patients, death occurred in 21/111 (18.9%) patients. Multiple logistic regression models correlated variables with mortality: age (OR: 1.07; 95% CI 1.02-1.12; p: 0.012; age >74 YO AUC ROC curve: 0.725), intubation need (OR: 23.35; 95% CI 4.39-124.36; p < 0.001), D dimer (OR: 1.39; 95% CI 1.02-1.89; p: 0.036; value >1928.5 ug/L AUC ROC curve: 0.731), C-reactive protein (OR: 1.18; 95% CI 1.05-1.32; p < 0.005; value >29.35 mg/dl AUC ROC curve: 0.836). A risk score was created to predict intrahospital probability of death, by the equation: 3.6 (age >75 YO) + 66 (intubation need) + 28 (C-reactive protein >29) + 2.2 (D dimer >1900). CONCLUSIONS: A novel and original risk score were developed to predict the probability of death in Covid 19 in-hospital patients concerning combined risk factors.

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INTRODUCTION: Muscle fibers are lost and replaced by fat- and fibrous-tissue infiltration during aging. This process decreases muscle quality and influences tissue appearance on ultrasound images over time. Increased muscle "echogenicity" represents changes caused by fat- and fibrous-tissue infiltration and can be quantified with recently developed software. OBJECTIVE: To investigate skeletal muscle quality through echogenicity, estimates according to participant's body mass index (BMI) and age were taken. METHODS: This was a cross-sectional study performed at the Pennington Biomedical Research Center, Baton Rouge, Louisiana with 117 participants (57 men and 60 women), with mean age (±SD) 38.9 ± 17.0 years and BMI 28.6 ± 6.2 kg/m². All participants were examined by ultrasound (LOGIQ GE Healthcare), using a 5.0-MHz linear transducer. Participants had muscle thickness measured by ultrasound at 4 anatomic locations (biceps and triceps brachial, femoral quadriceps, and calf triceps). Echogenicity was analyzed with specific software (Pixel Health) that evaluated the image in gray scale. RESULTS: According to BMI, 41% of participants were obese. There was a positive correlation between age and thigh-muscle echogenicity (rp = 0.534, P < .0001) and a negative correlation between thigh-muscle echogenicity and thickness (rp = -0.395, P <.0001). There was high muscle echogenicity in participants with overweight and obesity aged 50 years or older (P < .05). CONCLUSION: Older age and higher BMI were associated with stronger echogenicity signals and smaller muscle thickness. People with overweight, obesity, and/or older than 50 years old have reduced muscle quality with smaller muscle thickness, as observed with ultrasound.

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OBJECTIVE: To identify the prevalence of chronic kidney disease (CKD) self-reported in Brazil and characterize the factors associated with it. METHODS: This study was a cross-sectional health survey with a household-based, the National Health Survey, performed in 2013. The outcome in the present study was the prevalence of CKD. The groups of explanatory variables were socio-demographic characteristics, lifestyles, chronic self-reported diseases, anthropometry, and health evaluation. The prevalence of CKD, e their 95% respective confidence interval were estimated, univariate analysis and the multiple logistic regression model were calculated, and remained the variables statistically significant (p < 0.05). RESULTS: It noticed that 1.42% (95%CI 1.33 - 1.52) of the 60,202 interviewees self-reported CKD. The OR increased progressively with age, being 2.68 among the elderly with 65 years or more (95%CI 1.75 - 4.09). Having health plans with OR = 1.51 (95%CI 1.28 - 1.78), as well as smoking, hypertension and high cholesterol and poor self-reported health with OR = 1.75 (95%CI 1.45 - 2.12), OR = 1.20 (95%CI 1.02 - 1.42), OR = 1.83 (95%CI 1.56 - 2.15), OR = 4.70 (95%CI 3.75 - 5.88), respectively, showed a higher chance of CKD. CONCLUSIONS: The associated variables were increasing age, health plan coverage, smoking, hypertension, hypercholesterolemia, and regular or poor health status. The knowledge of CKD prevalence in Brazil and risk and protection factors are essential for disease prevention and the establishment of supporting public health policies.

OBJETIVOS: Identificar a prevalência da doença renal crônica (DRC) autorreferida no Brasil e caracterizar os fatores associados a essa enfermidade. MÉTODOS: Trata-se de um inquérito epidemiológico de base domiciliar, a Pesquisa Nacional de Saúde (PNS) realizada em 2013. O desfecho analisado foi a prevalência de DRC. Os grupos de variáveis explicativas foram: características sociodemográficas, estilos de vida, doenças crônicas autorreferidas, antropometria e avaliação de saúde. Foram estimadas as prevalências de DRC e os respectivos intervalos de confiança de 95% e foram realizados a análise univariada e o modelo de regressão logística múltipla, permanecendo as variáveis estatisticamente significativas (p < 0,05). RESULTADOS: Observou-se que 1,42% (intervalo de confiança de 95% - IC95% 1,33 - 1,52) dos 60.202 entrevistados referiram ser portadores de DRC. O odds ratio (OR) aumentou com a idade, sendo 2,68 entre os idosos com 65 anos ou mais (IC95% 1,75 - 4,09). Apresentaram chance maior de DRC: possuir planos de saúde, com OR = 1,51 (IC95% 1,28 - 1,78), tabagismo, hipertensão, colesterol elevado e autoavaliação de saúde ruim, com OR = 1,75 (IC95% 1,45 - 2,12), OR = 1,20 (IC95% 1,02 - 1,42), OR = 1,83 (IC95% 1,56 - 2,15), OR = 4,70 (IC95% 3,75 - 5,88), respectivamente. CONCLUSÕES: A prevalência de DRC foi maior em idade mais avançada, baixa escolaridade, possuir plano de saúde, tabagismo, hipertensão, hipercolesterolemia e avaliação regular ou ruim do estado de saúde. O conhecimento da prevalência da DRC e dos fatores de risco e de proteção são essenciais para prevenção da doença e para subsidiar as políticas públicas de saúde.

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RESUMO: Objetivos: Identificar a prevalência da doença renal crônica (DRC) autorreferida no Brasil e caracterizar os fatores associados a essa enfermidade. Métodos: Trata-se de um inquérito epidemiológico de base domiciliar, a Pesquisa Nacional de Saúde (PNS) realizada em 2013. O desfecho analisado foi a prevalência de DRC. Os grupos de variáveis explicativas foram: características sociodemográficas, estilos de vida, doenças crônicas autorreferidas, antropometria e avaliação de saúde. Foram estimadas as prevalências de DRC e os respectivos intervalos de confiança de 95% e foram realizados a análise univariada e o modelo de regressão logística múltipla, permanecendo as variáveis estatisticamente significativas (p < 0,05). Resultados: Observou-se que 1,42% (intervalo de confiança de 95% - IC95% 1,33 - 1,52) dos 60.202 entrevistados referiram ser portadores de DRC. O odds ratio (OR) aumentou com a idade, sendo 2,68 entre os idosos com 65 anos ou mais (IC95% 1,75 - 4,09). Apresentaram chance maior de DRC: possuir planos de saúde, com OR = 1,51 (IC95% 1,28 - 1,78), tabagismo, hipertensão, colesterol elevado e autoavaliação de saúde ruim, com OR = 1,75 (IC95% 1,45 - 2,12), OR = 1,20 (IC95% 1,02 - 1,42), OR = 1,83 (IC95% 1,56 - 2,15), OR = 4,70 (IC95% 3,75 - 5,88), respectivamente. Conclusões: A prevalência de DRC foi maior em idade mais avançada, baixa escolaridade, possuir plano de saúde, tabagismo, hipertensão, hipercolesterolemia e avaliação regular ou ruim do estado de saúde. O conhecimento da prevalência da DRC e dos fatores de risco e de proteção são essenciais para prevenção da doença e para subsidiar as políticas públicas de saúde.

ABSTRACT: Objective: To identify the prevalence of chronic kidney disease (CKD) self-reported in Brazil and characterize the factors associated with it. Methods: This study was a cross-sectional health survey with a household-based, the National Health Survey, performed in 2013. The outcome in the present study was the prevalence of CKD. The groups of explanatory variables were socio-demographic characteristics, lifestyles, chronic self-reported diseases, anthropometry, and health evaluation. The prevalence of CKD, e their 95% respective confidence interval were estimated, univariate analysis and the multiple logistic regression model were calculated, and remained the variables statistically significant (p < 0.05). Results: It noticed that 1.42% (95%CI 1.33 - 1.52) of the 60,202 interviewees self-reported CKD. The OR increased progressively with age, being 2.68 among the elderly with 65 years or more (95%CI 1.75 - 4.09). Having health plans with OR = 1.51 (95%CI 1.28 - 1.78), as well as smoking, hypertension and high cholesterol and poor self-reported health with OR = 1.75 (95%CI 1.45 - 2.12), OR = 1.20 (95%CI 1.02 - 1.42), OR = 1.83 (95%CI 1.56 - 2.15), OR = 4.70 (95%CI 3.75 - 5.88), respectively, showed a higher chance of CKD. Conclusions: The associated variables were increasing age, health plan coverage, smoking, hypertension, hypercholesterolemia, and regular or poor health status. The knowledge of CKD prevalence in Brazil and risk and protection factors are essential for disease prevention and the establishment of supporting public health policies.

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OBJECTIVE: to identify the practice of bullying reported by Brazilian students, according to sex, age and geographical location. METHODS: this was a cross-sectional study based on two national samples from the National School Health Survey (PeNSE), 2015; a total of 102,301 students participated in the study forming a nationally representative sample; data were collected through a self-administered questionnaire. RESULTS: bullying prevalence was 19.8% (95%CI - 19.2;20.3), with higher prevalence in the Southeast region of the country (22.2% - 95%CI 21.1;23.4), and in the State of São Paulo (24.2% - 95%CI 22.3;26.2), however the city with the highest prevalence was Boa Vista (25.5% - 95%CI 22.9;28.1), capital of the State of Roraima; boys (24.2% - 95%CI 23.4;25.0) practiced more bullying than girls (15.6% - 95%CI 14.9;16.2), as did younger students aged 13 to 15 years (22.0% - 95%CI 20.4;23.6). CONCLUSION: higher rates of reported bullying practices were found among adolescents from the Southeast region, among male and younger students.

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The study analyzes factors associated with family aggression against adolescents. Data from the National School Health Survey for 2015 were analyzed, and the prevalence of physical aggression per family was calculated according to four blocks. The bivariate analysis was performed, calculating the unadjusted Odds Ratio (OR) within each block and the multivariate regression. Familial aggression was reported by 14.5%. The variables associated with the model were: female, black, yellow, brown, mothers with no higher educational level, adolescent workers (OR 2.10 CI 95% 1.78-2.47). In the family context, they remained associated with aggression, lack of parents "understanding" (OR 1.71 CI95% 1.63 -1.80) and their intrusion into adolescent's privacy (OR 1.80 CI95% 1.70 -1, 91). Report of missing school (OR1.43 CI95% 1.36-1.50). Among the behaviors: smoking (OR 1.23 CI95% 1.12-1.34), alcohol (OR 1.49 CI95% 1.41-1.57), drug experience (OR 1.24 CI95% 1, 15-1,33), early sexual intercourse (OR 1.40 CI95% 1.33 -1.48), reports of loneliness, insomnia and bullying (ORa 2.14 CI95% 2.00-2.30). It is concluded by the association between violence and gender, greater victimization of girls, living in unfavorable social and family contexts.

O estudo analisa fatores associados à agressão familiar contra adolescentes. Foram utilizados dados da Pesquisa Nacional de Saúde dos Escolares 2015 e calculada a prevalência de sofrer agressão física por familiar, segundo quatro blocos de investigação. Procedeu-se a análise bivariada, calculando-se os Odds Ratios (ORs) não ajustados e, por fim, foi realizada a regressão multivariada. A agressão familiar foi referida por 14,5%. Variáveis associadas no modelo mutivariado no bloco sociodemográfico foram: sexo feminino, raça cor preta, amarela, parda, mães sem nível superior de escolaridade, adolescente que trabalham (OR 2,10 IC95% 1,78-2,47). No contexto familiar: a falta de compreensão dos pais (OR 1,71 IC95% 1,63 -1,80) e a intromissão na privacidade dos adolescentes (OR 1,80 IC95% 1,70 -1,91). Relato de faltar às aulas (OR 1,43 IC95% 1,36-1,50). Dentre os comportamentos: tabagismo (OR 1,23 IC95% 1,12-1,34), álcool (OR 1,49 IC95% 1,41-1,57), experiência com drogas (OR 1,24 IC95% 1,15-1,33), relação sexual precoce (OR 1,40 IC95% 1,33 -1,48), relato de solidão, insônia e bullying (ORa 2,14 IC95% 2,00-2,30). Conclui-se pela associação entre violência e gênero, maior vitimização das meninas e adolescentes mais jovens, que vivem em contextos sociais e familiares desfavoráveis.

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