Assessment of oral health condition in recipients of allogeneic hematopoietic cell transplantation

ABSTRACT Objective: The objective of this study was to evaluate the oral health condition and dental treatments performed in patients in pre-allogeneic HCT. Method: The records of patients treated during 2018 at a Brazilian HCT service were reviewed. The following oral health data were obtained: 1. Decayed, missing and filled teeth / correlated index for primary dentition (DMFT/dmft); 2. Quality of oral hygiene and 3. Dental pathologies: 3.1 Periodontal infectious focus, 3.2 Endodontic infectious focus and 3.3 Carie incidence. All dental procedures performed were surveyed. Results: Thirty-three patients were included, with a mean age of 28.42 (±16.37), 20 male (60%) and 13 female. The average DMFT/dmft found in this study was 10.24 (± 8.37), similar to the index found in the population in southeastern Brazil. The younger study population presented a DMFT/dmft considered high, when compared to the general population. A total of 27.2% of the patients had active caries lesions, 33.3%, foci of periodontal infection, 15.1%, endodontic infectious focus and 40%, poor oral hygiene. Almost half of the patients (48.4%) had to undergo dental intervention, 24.2% needing periodontal scaling, 21.2%, fillings and 12.1%, tooth extractions. Conclusion: We conclude that the studied population had an important incidence of dental pathologies and infectious conditions that could complicate throughout HCT, especially in younger patients, therefore presenting a high demand for dental treatment in the pre-HCT. Studies that assess the impact of dental conditioning on the outcomes of HCT with an emphasis on dental infectious complications, days of hospitalization and survival are necessary."

Laryngeal Cancer Attributable Factors and the Influence on Survival Rates: A Single Brazilian Institution Experience

Abstract Introduction Epidemiological studies focused on prognostic factors associated with laryngeal cancer in the Brazilian population are poorly reported in the literature. Objective To evaluate the influence of certain risk factors on the survival rates of patients with squamous cell carcinoma (SCC) of the larynx. Methods This retrospective study was conducted on adult patients who were admitted to the outpatient clinic of the head and neck department in a tertiary care hospital. Evaluation of the influence of risk factors on the survival rates of patients registered in the hospital with laryngeal SCC was performed based on age, sex, initial stage, time of evolution, habits, educational levels and relapse and death. Overall survival (OS), disease-free survival (DFS) and clinical-demographic data were analyzed using the Kaplan-Meier method, Log-rank test and Cox regression. Results A total of 107 patients with a mean age of 59.8 years (range 19-81) were included in this study. Stages III and IV were associated with decreased DFS (p = 0.02) and OS (p = 0.02). Smoking patients had a greater period of disease evolution than non-smoking patients (p = 0.003). Alcohol consumption in smokers increased the risk of death by 2.8 (p = 0.002) compared with non-drinking smokers. Male patients presented lower DFS average when compared with female patients (p = 0.04). Conclusion Our study confirms that male gender, smoking habit combined with alcohol consumption, and advanced stages were strongly associated with poor prognosis.

Active transportation to school for children and adolescents from Brazil: a systematic review / Transporte ativo para escola de crianças e adolescentes do Brasil: uma revisão sistemática

Abstract The aim of this study was to describe the use of active transportation to school (ATS) for Brazilian children and adolescents through a systematic review. This review was carried out from February to March of 2018 by using databases from the area, governmental policies and research and by contacting researchers from this area. The databases used were: LILACS; BIREME; SCIELO; MEDLINE and SCOPUS. The search was performed in articles published from January 2007 to December 2017. The inclusion criteria were: original articles published in journals; articles that measured ATS; articles that evaluated Brazilian children and/or adolescents with ages ranging between 0 and 19 years of age, without specific clinical conditions, without diagnoses of diseases and non-athletes. Overall, 19 articles were selected for this study. Only 8 presented ATS values for gender, with boys and girls using ATS similarly, 4 for each gender. Regarding regions, 11 studies presented data from the Southern regions, 3 studies presented data from the Southeastern region, 3 from the Northeastern region and 2 studies presented data from Brazil as a whole. The Northern and Midwestern regions were not studied in any of the articles. Based on the results, the prevalence of ATS for children and adolescents varies according to the studies and regions in Brazil. Authorities should be encouraged to build monitoring systems for ATS to support planning and evaluation of public policies.

Resumo O objetivo desse estudo foi descrever o uso do transporte ativo para escola (TAE) em crianças e adolescentes brasileiros em uma revisão sistemática. A revisão foi realizada no período de vevereiro à março de 2018, utilizando bases de dados da área, e pesquisas políticas e governamentais através de pesquisadores da área. As bases de dados utilizadas foram: LILACS; BIREME; SCIELO; MEDLINE e SCOPUS. A busca foi realizada em artigos publicados no período de Janeiro de 2007 à Dezembro de 2017. Os critérios de inclusão foram: artigos originais publicados em periódicos; artigos que mediram TAE; artigos que avaliaram crianças e / ou adolescentes Brasileiros com idade entre 0 e 19 anos, sem condições clínicas específicas, sem diagnósticos de doenças e não atletas. No total, 19 artigos foram selecionados para este estudo. Apenas 8 apresentaram valores de TAE conforme o sexo, sendo que meninos e meninas usaram TAE de forma semelhante, sendo 4 para cada sexo. Em relação às regiões, 11 estudos apresentaram dados das regiões do Sul, 3 estudos apresentaram dados da região Sudeste, 3 da região Nordeste e 2 estudos apresentaram dados do Brasil como um todo. As regiões Norte e Centro-Oeste não foram analisadas em nenhum dos artigos. Com base nos resultados, a prevalência de TAE para crianças e adolescentes varia de acordo com os estudos e regiões no Brasil. As autoridades devem ser incentivadas a criar sistemas de monitoramento para o TAE para apoiar o planejamento e a avaliação de políticas públicas.

Mudanças no deslocamento para o trabalho e na atividade física da população de três municípios da região de São Paulo nos anos de 2000 e 2010 / Changes in commuting to work and physical activity in the population of three municipalities in the São Paulo region in 2000 and 2010

RESUMO: Objetivo: Verificar as mudanças no deslocamento para o trabalho e na atividade física (AF) na população de três municípios da região de São Paulo nos anos 2000 e 2010. Métodos: Estudo de coorte transversal com amostra representativa de 602 adultos (62,3% homens), realizado nos municípios de Santo André, São Bernardo do Campo e São Caetano do Sul nos anos 2000 (n = 304; 66,1% homens) e 2010 (n = 298; 58,4% homens). A AF foi analisada pelo Questionário Internacional de Atividade Física e os participantes foram classificados em ativos (≥ 150 min/sem) e insuficientemente ativos (< 150 min/sem). O deslocamento para o trabalho foi rotulado em transporte ativo (a pé e bicicleta), privado (moto, carro, vans e ônibus) e público (ônibus, vans, trem ou metrô). Resultados: As médias (min/sem) de AF de caminhada (229,4 versus 190,6), moderada (449,1 versus 347,4), vigorosa (354,4 versus 317,4) e total (552,3 versus 442,5) dos participantes foram maiores em 2010 do que em 2000. A prevalência de ativos aumentou de 62,2 para 78,2%, respectivamente. Foi encontrada relação negativa entre transporte ativo e público com nível socioeconômico; transporte ativo e grau de escolaridade; transporte público e faixa etária. Relação positiva foi verificada somente entre transporte privado e nível socioeconômico. A média da AF total (min/sem) foi maior (p = 0,024; 32,2%) em 2010 do que em 2000 para o transporte ativo. Conclusão: Os dados de vigilância em AF total nos três municípios de São Paulo indicam que a média do transporte ativo para o trabalho aumentou após dez anos, enquanto o transporte público diminuiu.

ABSTRACT: Objective: To evaluate the changes in commuting to work and physical activity (PA) in the population of three municipalities in the São Paulo region in 2000 and 2010. Methods: Cross-sectional study with a representative sample of 602 adults (62.3% men) carried out in the municipalities of Santo André, São Bernardo do Campo and São Caetano do Sul in 2000 (n = 304; 66.1% men) and 2010 (n = 298; 58.4% men). Physical activity was assessed by the International Physical Activity Questionnaire and participants were classified into active (≥ 150 min/week) and insufficiently active (< 150 min/week). The commuting to work was classified in active transport (walking and cycling), private (bike, car, vans and buses) and public (buses, vans, train or subway). Results: Average (min/week) PA walk (229.4 versus 190.6), moderate (449.1 versus 347.4), vigorous (354.4 versus 317.4) and total (552.3 versus 442.5) shows the participants were greater in 2010 than in 2000. The prevalence assets increased from 62.2 to 78.2%, respectively. A negative relationship was found between active transport and public with socioeconomic status; active transport and education level; public transport and age. Positive relationship was found only among private transport and socioeconomic status. The average of the total PA (min/week) was higher (p = 0.024; 32.2%) in 2010 than in 2000 for active transport. Conclusions: Surveillance data in full PA in the three municipalities of São Paulo indicate that the average active commuting to work increased after ten years, while public transport has decreased.

Estilo de vida saudável em São Paulo, Brasil / Healthy lifestyle in São Paulo, Brazil / Estilo de vida saludable en São Paulo, Brasil

Resumo: O objetivo foi analisar o estilo de vida das populações adolescente, adulta e idosa do Município de São Paulo, Brasil, de acordo com variáveis demográficas e socioeconômicas. Foi realizado estudo transversal, de base populacional, com dados do Inquérito de Saúde no Município de São Paulo (ISA-Capital 2008). O estilo de vida foi definido pela avaliação da atividade física, consumo alimentar, tabagismo, consumo abusivo e dependência de álcool, de acordo com as respectivas recomendações. A prevalência de estilo de vida saudável foi de 36,9% entre idosos, 15,4% entre adultos e 9,8% entre adolescentes, sendo maior no sexo feminino entre idosos e adultos. Dentre aqueles com estilo de vida não saudável, 51,5% dos idosos, 32,2% dos adultos e 57,9% dos adolescentes não atingiram a recomendação para uma dieta adequada. A prevalência de estilo de vida saudável foi maior entre idosos, seguida pelos adultos e adolescentes. O consumo alimentar foi o principal responsável pelo estilo de vida não saudável, evidenciando a importância de intervenções para a promoção do estilo de vida saudável e, principalmente, da dieta adequada.

Abstract: The objective was to analyze adolescent, adult, and elderly lifestyles in the city of São Paulo, Brazil, according to demographic and socioeconomic variables. A cross-sectional, population-based study was performed with data from the Health Survey in São Paulo City (ISA-Capital 2008) database. Lifestyle was defined on the basis of physical activity, diet, smoking, and alcohol abuse and addiction, according to the respective guidelines. Prevalence of healthy lifestyle was 36.9% in the elderly, 15.4% in adults, and 9.8% in adolescents, and was higher in females in the elderly and adults. Among individuals with unhealthy lifestyle, 51.5% of the elderly, 32.2% of adults, and 57.9% of adolescents failed to reach the guidelines for adequate diet. Prevalence of healthy lifestyle was highest among the elderly, followed by adults and adolescents. Food consumption was the main factor associated with unhealthy lifestyle, demonstrating the importance of interventions to promote healthy lifestyle, especially adequate diet.

Resumen: El objetivo fue analizar el estilo de vida de la población adolescente, adulta y anciana del municipio de Sao Paulo, Brasil, de acuerdo con variables demográficas y socioeconómicas. Se realizó un estudio transversal, de base poblacional, utilizando datos del Encuesta de Saúde en el Municipio de São Paulo (ISA-Capital 2008). El estilo de vida fue definido por la evaluación de la actividad física, consumo alimenticio, tabaquismo, consumo abusivo y alcoholismo, de acuerdo con sus respectivas recomendaciones. La prevalencia del estilo de vida saludable fue de un 36,9% entre ancianos, un 15,4% entre adultos y un 9,8% entre adolescentes, siendo mayor en el sexo femenino entre ancianos y adultos. Entre aquellos con un estilo de vida no saludable, un 51,5% de los ancianos, un 32,2% de los adultos y un 57,9% de los adolescentes no alcanzaron la recomendación para una dieta adecuada. La prevalencia de estilo de vida saludable fue mayor entre ancianos, seguidos por los adultos y adolescentes. El consumo alimentario fue el principal responsable del estilo de vida no saludable, evidenciando la importancia de intervenciones para la promoción del estilo de vida saludable y, principalmente, de una dieta adecuada.

Quantitative ultrasound at the hand phalanges in patients with bisphosphonate-related osteonecrosis of the jaws

Patients with bisphosphonate-related osteonecrosis of the jaws (BRONJ) who received intravenous or oral bisphosphonates (BP) were selected for determination of their bone microarchitecture as a risk predictor of BRONJ development. The diagnosis of BRONJ was made based on clinical and radiographic findings. The control group consisted of healthy patients. All patients underwent quantitative and qualitative ultrasound measurements of bone at the hand phalanges carried out using the DBM Sonic BP. Ultrasound bone profile index (UBPI), amplitude-dependent speed of sound (AD-SoS), bone biophysics profile (BBP), and bone transmission time (BTT) were measured. The BRONJ group consisted of 17 patients (62 ± 4.24; range: 45-82); 10 (58.8%) were male and seven (41.1%) were female, of whom 11 (64.7%) suffered from multiple myeloma, three (17.6%) from osteoporosis, one (5.8%) from prostate cancer, one (5.8%) from kidney cancer, and one (5.8%) from leukemia. Fourteen (82.3%) of them received intravenous BP whereas three (17.6%) received oral BP. Nine (9/17; 52.9%) patients developed bone exposure: two in the maxilla and seven in the mandible. Regarding quantitative parameters, Ad-SoS was low in the BRONJ group, but not significant. The UBPI score was significantly reduced in BRONJ patients with exposed bone when compared to controls (0.47 ± 0.12 vs. 0.70 ± 0.15; p = 0.004). The present study demonstrated that quantitative ultrasound was able to show bone microarchitecture alterations in BRONJ patients, and suggests that these analyses may be an important tool for early detection of bone degeneration associated with BRONJ.

Estilo de vida saudável em São Paulo / Healthy lifestyle in Sao Paulo

Estudos epidemiológicos têm comprovado a associação que as doenças cardiovasculares mantêm com um conjunto relativamente pequeno de fatores de risco modificáveis, como o tabagismo, o consumo de álcool, a dieta inadequada e a inatividade física. Objetivos: Analisar o estilo de vida saudável e não saudável da população adolescente, adulta e idosa do município de São Paulo, de acordo com as variáveis demográficas, socioeconômicas e com a quantidade e o tipo de domínios não cumpridos. Métodos: Trata-se de estudo transversal, de base populacional, realizado em 2008 e que utilizou dados do Inquérito de Saúde do Município de São Paulo (ISA-Capital 2008). As informações foram obtidas por meio de um questionário estruturado e entrevistas domiciliares realizadas por pessoas treinadas e supervisionadas durante toda a realização do inquérito. A população do estudo foi obtida por amostragem probabilística complexa, por conglomerados, em dois estágios: setores censitários e domicílios. Das 3271 pessoas entrevistadas, 1652 indivíduos adolescentes (1219; =15,3 anos), adultos (2059; =38,7 anos) e idosos (60 ou mais; =70,8 anos) de ambos os sexos possuíam dados de avaliação da atividade física, tabagismo, consumo alimentar, consumo abusivo e dependência de álcool. O estilo de vida foi determinado pela avaliação de cinco domínios: atividade física, consumo alimentar, tabagismo, consumo abusivo e dependência de álcool, de acordo com as respectivas recomendações. Os indivíduos foram...

Epidemiological studies have confirmed the association that cardiovascular disease maintain with a relatively small cluster of modifiable risk factors, like smoking, alcohol consumption, poor diet and physical inactivity. Objective: To analyze the healthy and unhealthy lifestyle of adolescents, adults and elderly population in São Paulo city, according to demographic and socioeconomic variables, and according to the number and type of no met domains. Methods: It is a cross-sectional study, population-based, conducted in 2008, which used data from the Health Survey of São Paulo (ISA Capital - 2008). The information was obtained through a structured questionnaire and household interviews conducted by trained and supervised people during the whole survey. The study population was obtained by complex probability sampling, by clusters, in two stages: census tracts and household. From 3271 surveyed people, 1652 adolescents (1219; =15.3 years), adults (2059; =38.7 years) and elderly (60 or more; =70.8 years) subjects of both sexes had data for assessment of physical activity, smoking, dietary intake, alcohol abuse and alcohol dependence. The lifestyle was determined by the valuation of five domains: physical activity, smoking, dietary intake, alcohol abuse and alcohol dependence, according to the respective recommendations. The subjects were classified as healthy or unhealthy lifestyle. Those classified as unhealthy lifestyle were also categorized according to the...

Modificações da adiposidade em escolares de acordo com o estado nutricional: análise de 20 anos / Modifications of adiposity in school-age children according to nutritional status: a 20-year analysis

OBJETIVO: Analisar as modificações da adiposidade de escolares durante 20 anos, de acordo com o estado nutricional. MÉTODOS: O estudo faz parte do Projeto Misto Longitudinal de Crescimento, Desenvolvimento e Aptidão Física de Ilhabela. Uma amostra de 1.095 escolares de ambos os sexos, de 7 a 10 anos, atendiam aos seguintes critérios de inclusão: (a) pelo menos uma avaliação completa em um dos períodos analisados; (b) estar no estágio pré-púbere de maturação sexual; (c) ser aparentemente saudável. Os períodos analisados foram 1990/1991 (inicial), 2000/2001 (10 anos) e 2010/2011 (20 anos). As variáveis analisadas foram: massa corporal, estatura e adiposidade, pela análise individual de cada dobra cutânea. Os indivíduos foram classificados em eutróficos, com excesso de peso e obesos mediante as curvas propostas pela Organização Mundial da Saúde de índice de massa corporal para idade e sexo. Foi utilizada a Anova one-way, seguida do post-hoc de Scheffé, com p < 0,01. RESULTADOS: Nos meninos, o maior aumento ocorreu no grupo com excesso de peso, seguido pelos grupos obesos e eutróficos. Já nas meninas, os maiores aumentos ocorreram nos grupos com excesso de peso e eutróficas, seguidos pelo grupo obesas. CONCLUSÃO: Houve modificações da adiposidade, mesmo com o controle do estado nutricional, durante o período de 20 anos analisado, mostrando que os indivíduos que têm semelhantes índices de massa corporal podem variar em proporção e distribuição de tecido adiposo subcutâneo. Para ambos os sexos, o aumento foi maior nos grupos classificados como excesso de peso e, principalmente, nas dobras cutâneas centrais.

OBJECTIVE: To analyze adiposity changes in school-age children over a 20 year-period, according to nutritional status. METHODS: The study is part of the Ilhabela Longitudinal Mixed Project on Growth, Development and Physical Fitness. A sample of 1,095 school students of both sexes, from 7 to 10 years, met the following inclusion criteria: (a) at least one complete assessment in one of the analyzed periods; (b) to be in prepubertal stage of sexual maturation; (c) to be apparently healthy. The periods analyzed were 1990/1991 (initial), 2000/2001 (10 years) and 2010/2011 (20 years). The variables analyzed were: body weight, height and adiposity through individual analysis of each skinfold. Children were classified as eutrophic, overweight and obese, according to the curves of body mass index for age and sex proposed by the World Health Organization. The statistical analysis used was one-way ANOVA, followed by Scheffé's post-hoc test, with p < 0.01. RESULTS: In boys, the largest increase occurred in the overweight group, followed by the obese and eutrophic groups. In girls, the largest increases occurred in the groups with overweight and eutrophic children, followed by the obese group. CONCLUSION: in adiposity, even when the nutritional status was controlled, showing that individuals who have similar body mass indexes may vary in proportion and distribution of subcutaneous adipose tissue. In both sexes, the increase was higher in the overweight group, and mainly in central skinfolds.