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ABSTRACT Objective: To determine the occurrence of hyposalivation in Brazilian adults and its association with individual determinants, such as the use of medications, systemic conditions, smoking, and alcohol consumption. Material and Methods: A cross-sectional study with 402 adults was developed. Information was collected on sociodemographic and general health characteristics, and sialometry was performed with stimulated salivary flow. It indicated low salivary flow when ≤ 0.7 mL/min. Bivariate and multivariate analyses were conducted using a decision tree (p<0.05). Results: The sample was comprised predominantly of women (68.2%) aged ≤ 29 years (25.4%). Most participants did not use medication (56.7%). Among systemic diseases, the most cited was hypertension (25.1%). More than a third of the participants presented hyposalivation (40.3%), being associated with the following variables: age between 50 to 59 years (p=0.011), female sex (p<0.001), menopause (p=0.001), use of alcohol (p=0.033), systemic disease (p=0.002) and medication use (p<0.001). In multivariate analysis, in addition to sex (p<0.001) and hypertension (p=0.005), an association was also found between hyposalivation and diabetes (p=0.014). Conclusion: Factors associated with hyposalivation in adults were sex and the presence of hypertension or diabetes.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Salivation , Xerostomia/prevention & control , Risk Factors , Chi-Square DistributionABSTRACT
Abstract Objective: To investigate the usefulness, reliability, quality, and content of Portuguese-language YouTube videos on COVID-19. Material and Methods: Three keywords selected on Google Trends were searched on YouTube, and the 60 first videos listed with each term were analyzed. Two calibrated researchers evaluated the reliability (DISCERN Modified Scale), the quality (Global Quality Score - GQS), and the usefulness of videos for the users (COVID-19 Specific Score - CSS). The number of views, likes, and engagement were also analyzed. The data were evaluated by the Mann-Whitney test and Spearman correlation (α=5%). Results: 59 videos were included. The average scores of quality, reliability, and usefulness were 3.0 (±1.1), 3.2 (± 0.8), and 1.5 (± 0.9), respectively. Two-thirds of the videos (64.4%) had low/moderate quality, and the majority (76.2%) were about signs and symptoms. The numbers of views (p=0.005), likes (p=0.006), and engagement (p=0.014) were significantly higher in moderate/good quality videos. The number of comments (p=0.007), duration of videos (p=0.004), and the DISCERN score (p<0.001) were significantly higher in videos made by health professionals. The general quality of the videos was positively correlated to the CSS scores, number of views, likes, and engagement (p<0.05). Conclusion: Most videos had moderate quality and reliability and low usefulness for the users.
Subject(s)
Health Communication , Data Accuracy , Internet-Based Intervention , COVID-19/prevention & control , Video Recording , Statistics, Nonparametric , Dentists , Social Networking , Observational StudyABSTRACT
Resumen: Los trastornos de la conducta alimentaria son de las enfermedades crónicas más frecuentes en adolescentes y mujeres jóvenes. En México se han encontrado porcentajes desde 5 hasta 18% de conductas alimentarias de riesgo en muestras de mujeres estudiantes universitarias (Unikel-Santoncini, et al., 2004). Por otro lado, la resiliencia se define como un constructo que incluye ciertos fenómenos que consisten en la adecuada adaptación del individuo ante situaciones traumáticas, privación extrema, amenazas graves o estrés elevado (González-Arratia, 2008, en Camacho-Valadez, 2016). Esta investigación examina la relación entre la resiliencia y las conductas alimentarias de riesgo por medio de la aplicación de los instrumentos EAT-26 y RESI-M a 201 mujeres mexicanas, con un promedio de edad de 22 años. Se realizó un análisis de correlación de Producto Momento de Pearson, el cual demostró que, aquellas mujeres con mayores niveles de resiliencia mostraban menos conductas alimentarias de riesgo. Se propone realizar el mismo estudio con poblaciones más jóvenes, así como con participantes de sexo masculino.
Abstract: Eating disorders are one of the most frequent chronic diseases in adolescents and young women. In Mexico, percentages from 5 to 18% of risk eating behaviors have been found in samples of female university students (Unikel-Santoncini, et al., 2004). On the other hand, resilience is defined as a construct that includes certain phenomena that consist of the individual's adequate adaptation to traumatic situations, extreme deprivation, serious threats, or high stress (González-Arratia, 2008, in Camacho Valadez, 2016). This research examines the relationship between resilience and risk eating behaviors through the application of the EAT-26 and RESI-M instruments to 201 Mexican women, with an average age of 22 years. A Pearson Product Moment correlation analysis was performed, which showed that those women with higher levels of resilience showed less risk eating behaviors. It's proposed to carry out the same study with younger populations, as well as with male participants.
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Introducción: Las enfermedades cardiovasculares constituyen la primera causa de muerte en el mundo, por lo que la identificación y modificación de los factores de riesgo asociados a ellas constituyen estrategias priorizadas por la Organización Mundial de la Salud. Contar con un modelo de predicción del riesgo cardiovascular enriquecido con la evaluación de la disfunción endotelial influiría positivamente en estas metas. Objetivos: Identificar la presencia de disfunción endotelial en pacientes con enfermedades cardiovasculares o sin estas y determinar la asociación entre ambas. Métodos: Se realizó un estudio observacional y descriptivo, de serie de casos, en el Centro de Cardiología y Cirugía Cardiovascular del Hospital Provincial Docente Clínico-Quirúrgico Saturnino Lora de Santiago de Cuba, desde enero del 2022 hasta igual mes del 2023, donde se analizaron como variables los factores de riesgo cardiovascular tradicionales y los biomarcadores de disfunción endotelial. Secundariamente, se llevó a cabo un estudio analítico de casos y controles en el cual se aplicó la regresión logística binaria multivariada. Resultados: Se confirmó la presencia de disfunción endotelial asociada a la aparición de las enfermedades cardiovasculares, lo que se evaluó a través del índice de vasodilatación, mediado por el flujo de la arteria braquial y las concentraciones plasmáticas de fibrinógeno. Conclusiones: Las características epidemiológicas y clínicas de los pacientes con enfermedades cardiovasculares o sin estas no difirieron de lo registrado en la literatura especializada acerca de la base de identificación de los factores de riesgo tradicionales.
Introduction: Cardiovascular diseases constitute the first death cause worldwide, reason why the identification and modification of associated risk factors constitute prioritized strategies by the World Health Organization. To have a prediction model of cardiovascular risk enriched with the evaluation of the endothelial dysfunction would influence positively in these goals. Objectives: To identify the presence of endothelial dysfunction in patients with or without cardiovascular diseases and to determine the association between them. Methods: An observational and descriptive cases series study was carried out in the Cardiology and Cardiovascular Surgery Center at Saturnino Lora Teaching Clinical Surgical Provincial Hospital in Santiago de Cuba, from January, 2022 to the same month, 2023, where the traditional cardiovascular risk factors and endothelial dysfunction biomarkers were analyzed as variables. Secondarily, an analytic case-control study was carried out in which multivariate binary logistic regression was applied. Results: The presence of endothelial dysfunction associated with the onset of cardiovascular diseases was confirmed, what was evaluated through the vasodilatation index, mediated by the brachial artery flow and the fibrinogen plasmatic concentrations. Conclusions: The clinical and epidemiological pattern of patients with or without cardiovascular diseases did not differ from that reported in the specialized literature on the base of the identification of traditional risk factors.
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Introducción: La pandemia por COVID-19 trajo consigo grandes cambios a nivel socioeconómico, producto de las medidas tomadas para mitigar su expansión, que implicó cierre de colegios y dificultad para el acceso a servicios de salud. Sin embargo, no se cuenta con mucha información respecto al impacto que estas medidas han tenido en la salud y el bienestar de niños y adolescentes, por lo cual se desarrolló una encuesta virtual para conocer la dimensión de los efectos de la pandemia en el bienestar integral de los menores y sus familias. Metodología: Estudio observacional de corte transversal que se realizó mediante la aplicación de una encuesta en formato electrónico a padres de familia de niños y adolescentes del Área Metropolitana de Bucaramanga. Resultados: Se obtuvieron 960 respuestas. El 25,63 % de los encuestados refieren cancelación de citas médicas. El 98 % de los estudiantes pudo continuar las actividades académicas durante el aislamiento. El factor económico fue la principal causa de preocupación en el periodo de la encuesta. Discusión: Durante el periodo de aislamiento, los problemas de salud mental, las dificultades para el acceso a herramientas para la educación virtual y las barreras para la atención, propias de la emergencia sanitaria, causaron efectos significativos en la calidad de vida de los menores. Conclusiones: Ante emergencias sanitarias, se deben mantener los servicios de atención en salud de la misma forma que se hacía previo a la ocurrencia del evento, como los programas de vacunación, crecimiento y desarrollo, promoción y prevención, además de la continuidad de la escolaridad.
Introduction: The COVID-19 pandemic has brought great changes along with, some of those were at the socioeconomic level, as a result of the actions taken to mitigate the virus expansion, which involved the closure of schools and restriction in accessing to some health services. However, there is not much information regarding the impact that these measures have had on the health and well-being of children and adolescents, for this reason, a virtual survey was developed to find out the dimension of the pandemic's effect on the comprehensive welfare of minors and families. Methodology: Cross-sectional observational study, which was carried out by applying a survey in electronic format to parents of children and adolescents in the Metropolitan Area of Bucaramanga. Results: A total of 960 responses were obtained. Of those surveyed, 25,63% refer cancellation of medical appointments. The 98% of students were able to continue academic activities during isolation. The economic factor was the main cause of concern in the survey period. Discussion: During the isolation period, mental health problems, difficulties in accessing tools for virtual education and barriers to care, typical of the health emergency, caused a significant effects on the quality of life of youngsters. Conclusions: In the event of health emergencies, health care services should be maintained in the same way as before the occurrence of the event, such as vaccination, growth and development, promotion and prevention programs, in addition to the continuity of schooling.
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ABSTRACT To investigate individual and contextual factors associated with seeking treatment for traumatic dental injuries. A cross-sectional study was conducted with 739 pairs of guardians and children. Guardians answered a questionnaire addressing sociodemographic characteristics, seeking treatment for a tooth injury in the child, and the Oral Health Literacy-Adult Questionnaire. Descriptive analysis and unadjusted and adjusted multilevel Poisson regression analysis (p<0.05). The prevalence of seeking treatment for traumatic dental injury was 44.7%. Sociodemographic variables associated were white skin of the child (PR = 1.30; 95% CI: 1.08-1.76), mother's age older than 35 years (PR = 1.70; 95% CI: 1.50-1.90), married parents (PR = 1.93; 95% CI: 1.70-2.23), guardians with more than eight years of schooling (PR = 2.00; 95% CI: 1.76-2.23), with adequate oral health literacy (PR = 3.33; 95% CI: 3.01-3.62) and the daily use of electronic devices by the child (PR = 1.26; 95% CI: 1.02-1.50). On the contextual level, attending a private school (PR = 1.77; 95% CI: 1.02-3.05) and the number of primary care units with oral health teams in the school district (PR = 1.78; 95% CI: 1.12-2.38) remained associated. Among the children who suffered TDI, adequate oral health literacy on the part of the parents stood out among the factors associated with seeking treatment.
Resumo Investigar fatores individuais e contextuais associados à busca de tratamento para lesões dentárias traumáticas. Foi realizado um estudo transversal com 739 pares de responsáveis e crianças. Os responsáveis responderam a um questionário abordando características sociodemográficas, busca por tratamento para traumatismo dentário na criança e o Questionário de alfabetização em saúde bucal para adulto. Análise descritiva e análise de regressão de Poisson multinível não ajustada e ajustada (p<0,05) foram realizadas. A prevalência de busca de tratamento para lesão dentária traumática foi de 44,7%. As variáveis sociodemográficas associadas foram a pele branca da criança (RP = 1,30; IC 95%: 1,08-1,76), idade da mãe maior que 35 anos (RP = 1,70; IC 95%: 1,50-1,90), os responsáveis casados (RP = 1,93; IC 95%: 1,70-2,23), com mais de oito anos de estudo (RP = 2,00; IC 95%: 1,76-2,23), com alfabetização adequada em saúde bucal (RP = 2,00; IC 95%: 1,76-2,23) e uso diário de dispositivos eletrônicos pela criança (RP = 1,26; IC 95%: 1,02-1,50). No nível contextual, frequentar uma escola particular (PR = 1,77; IC 95%: 1,02-3,05) e a quantidade de unidades básicas de saúde com equipes de saúde bucal no distrito sanitário da escola (PR = 1,78; IC 95%: 1,12-2,38) permaneceram associados. Entre as crianças que sofreram TDI, a alfabetização em saúde bucal adequada dos pais foi um fator que se destacou na busca por tratamento.
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Abstract The present study aimed to perform the cross-cultural adaptation of the Digital Health Literacy Instrument (DHLI) for native Brazilian Portuguese-speaking adolescents (DHLI-BrA). Cross-cultural adaptation consisted of the following steps: translation, assessment, and adjustments by the expert committee to ensure cultural equivalence; back-translation, and synthesis of back-translations. Cognitive testing was then performed in a pretest with adolescents using cognitive interviews with probing questions on the item's understanding interpretation and response options. Cronbach's alpha coefficient and McDonald's omega were used to estimate the instrument's reliability. Forty-two Brazilian adolescents participated in the study (mean age: 16.0 ± 2.0 years; range: 13 to 19 years). Items that were difficult to understand were adapted to the context of Brazilian adolescents. Cronbach's alpha coefficient and McDonald's omega for the 21 items of the DHLI-BrA were, respectively, 0.79 and 0.80. Cronbach's alpha coefficient for the subscales of the self-report instrument was 0.53-0.79 (range), demonstrating good reliability in the total instrument and moderate reliability in the subscales. This study provides the cross-cultural adapted version of the Digital Health Literacy Instrument (DHLI), which is an instrument for measuring digital Health literacy, for use in Brazilian adolescents (DHLI-BrA).
Resumo O estudo teve o objetivo de adaptar transculturalmente o Digital Health Literacy Instrument (DHLI) para adolescentes nativos do idioma português do Brasil (DHLI-BrA). O estudo de adaptação transcultural consistiu nas seguintes etapas: tradução, avaliação e adequação de equivalência cultural da tradução por comitê de especialistas; retrotradução e síntese das retrotraduções. Foi realizada a testagem cognitiva em pré-teste com adolescentes, utilizando-se entrevistas cognitivas com perguntas de sondagem sobre a compreensão e interpretação dos itens e opções de resposta. O alfa de Cronbach e ômega de McDonald's foram utilizados para estimar a confiabilidade do instrumento. Participaram do pré-teste 42 adolescentes brasileiros com média de idade de 16,0 ± 2,0 (variação de 13-19) anos. Os itens com dificuldade de compreensão foram adaptados ao contexto dos adolescentes brasileiros. O coeficiente alfa de Cronbach e o ômega de McDonald's, para os 21 itens do DHLI-BrA foi respectivamente, 0,79 e 0,80. O coeficiente alfa de Cronbach para as subescalas do instrumento de autorrelato foi de 0,53-0,79 (variação), demonstrando boa confiabilidade no instrumento total e confiabilidade moderada nas subescalas. Este estudo fornece a versão adaptada transculturalmente do Digital Health Literacy Instrument (DHLI), um instrumento de mensuração do letramento digital em saúde, para utilização em adolescentes brasileiros (DHLI-BrA).
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Objetivos: Describir la frecuencia de la respuesta clínica y patológica, entre los diferentes subtipos moleculares de cáncer de mama, en pacientes que previamente recibieron quimioterapia neoadyuvante. Materiales y métodos: Cohorte retrospectiva, descriptiva. Se incluyeron mujeres mayores de 18 años, con diagnóstico histológico de carcinoma invasivo de mama, en estadios IIA, IIB, IIIA, IIIB y IIIC, con clasificación por subtipos moleculares, que hubieran recibido quimioterapia neoadyuvante, atendidas en una clínica de alto nivel de complejidad localizada en Medellín (Colombia), entre el 1 de julio de 2017 y el 30 de julio de 2019. Las variables recolectadas fueron edad, estadio clínico, características histológicas, clasificación molecular y la respuesta clínica y patológica completa por subtipo molecular. Se realizó análisis descriptivo. Resultados: 255 pacientes cumplieron con los criterios de inclusión. La edad media fue de 55,2 años; los estadios clínicos con mayor prevalencia fueron IIIB (28,6 %) y IIB (26,3 %), respecto al grado histológico, los más frecuentes fueron grado 3 (48,2 %) y 2 (37,3 %). La frecuencia por subtipos moleculares fue: luminal A (10,2 %), luminal B HER2 negativo (39,6 %), triple negativo (23,1 %), luminal B HER2 positivo (13,7 %), y HER2 puro (13,3 %). La respuesta clínica completa posquimioterapia por subtipo molecular fue: luminal A (26,9 %), luminal B HER2 negativo (37,6 %), luminal B HER2 positivo (48,6 %), HER2 puro (41,2 %), triple negativo (45,8 %); se logró respuesta patológica completa por subtipo molecular, así: luminal A (19,2 %), luminal B HER2 negativo (32,7 %), luminal B HER2 positivo (54,3 %), HER2 puro (50 %), triple negativo (42,4 %). Conclusiones: En la práctica clínica, la clasificación por subtipos moleculares en cáncer de mama permite hacer una aproximación a la respuesta de la quimioterapia neoadyuvante. Se requieren estudios prospectivos en la región para determinar la capacidad predictiva de la respuesta patológica completa respecto a la sobrevida global y libre de enfermedad.
Objectives: To describe the frequency of clinical and pathological response in different molecular subtypes of breast cancer, in patients receiving prior neoadjuvant chemotherapy. Materials and methods: Descriptive retrospective cohort. The study population consisted of women 18 years of age and older with a histological diagnosis of invasive breast cancer stages IIA, IIB, IIIA, IIIB and IIIC, with a classification by molecular subtypes, who had received prior neoadjuvant chemotherapy, seen at a high complexity clinic in Medellin (Colombia), between July 1, 2017, and July 30, 2019. We measured age clinical stage, histological characteristics, molecular classification, and complete clinical and pathological responses by molecular subtype. A descriptive analysis was conducted. Results: Overall, 255 patients met the inclusion criteria. Mean age was 55.2 years; the clinical stages with the highest prevalence were IIIB (28.6 %) and IIB (26.3 %), and the most frequent by histologic grading were grades 3 (48.2 %) and 2 (37.3 %). Frequency by molecular types was as follows: luminal A (10.2 %), HER2-negative luminal B (39.6 %), triple-negative (23.1%), HER2-positive luminal B (13.7 %), and pure HER2 (13.3 %). Complete clinical response following chemotherapy, by molecular type, was as follows: luminal A (26.9 %), HER2-negative luminal B (37.6 %), HER2-positive luminal B (48.6 %), pure HER2 (41.2 %), triple-negative (45.8 %). Complete pathological response by molecular subtype was achieved in the luminal A (19.2 %), HER2-negative luminal B (32.7 %), HER2-positive luminal B (54.3 %), pure HER2 (50 %) and triple-negative (42.4 %) subtypes. Conclusions: In clinical practice, breast cancer classification by molecular subtypes is a means to approach the assess the to neoadjuvant chemotherapy. Se requieren estudios prospectivos en la región para determinar la capacidad predictiva de la respuesta patológica completa respecto a la sobrevida global y libre de enfermedad.
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Humans , Female , ColombiaABSTRACT
El estudio tuvo por Objetivo: Determinar el nivel de estrés académicos en alumnos de Enfermería de una universidad estatal de Ica 2022. Material y métodos: Investigación de enfoque cuantitativo, de nivel descriptivo, de corte transversal, con población de estudio de 432 alumnos de la Facultad de Enfermería y una muestra de 205, se utilizó la técnica de la encuesta, como instrumento un cuestionario validado por Condori Melisa Patricia, este test tiene como reseña al Inventario modificado por Arturo Barraza Masías de Estrés Académico. Para el análisis descriptivo se utilizó el estadístico de Z. Resultados: En los datos generales se identificó que el 88.3% fueron mujeres y el 11.7% varones, predominando la edad de 20 a 24 años con 79.5%. El estrés académico fue de nivel medio con un 53.2% y nivel alto con 21.0%. El 42.3% de los alumnos presentaron más de 3 situaciones estresantes, predominando la realización de exámenes, sobrecarga académica y número de tareas interpuestas, las principales manifestaciones físicas fueron la fatiga crónica, dolores de cabeza y somnolencia, en manifestaciones psicológicas predominó la inquietud, tristeza y depresión, problemas para concentrarse y sentimientos de miedo, las manifestaciones comportamentales más frecuentes fueron el desgano para realizar labores académicas, consumo disminuido o excesivo de alimentos, y aislamiento de los demás. Conclusiones: El estrés académico percibido por los alumnos de enfermería fue predominantemente de nivel medio. (AU)
The Objective of this study was: Determine the level of academic stress in Nursing students of a state university in Ica 2022. Material and methods: Research with a quantitative approach, descriptive level, cross-sectional, with a study population of 432 students of the Faculty of Nursing and a sample of 205, the survey technique was used, as an instrument a questionnaire validated by Condori Melisa Patricia, this test has as a review the Inventory modified by Arturo Barraza Masías of Academic Stress. For the descriptive analysis, the Z statistic was used. Results: In the general data, it was identified that 88.3% were women and 11.7% men, with a predominance of 20 to 24 years of age with 79.5%. Academic stress was of high-level medium with 53.2% and high level with 21.0%. The 42.3% of the students presented more than 3 stressful situations, predominantly taking exams, academic overload and number of tasks, the main physical reactions were chronic fatigue, headaches and drowsiness, in psychological reactions restlessness predominated, sadness and depression, problems concentrating and feelings of fear, the most frequent behavioral reactions were reluctance to carry out academic tasks, decreased or excessive consumption of food, and isolation from others. Conclusions: The academic stress perceived by the nursing students was predominantly medium level. (AU)
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Humans , Male , Female , Young Adult , Perception , Stress, Psychological , Students, Nursing , Cross-Sectional StudiesABSTRACT
Introducción: El tratamiento principal del cáncer esofágico es la esofagectomía. Objetivo: Determinar la morbilidad y mortalidad de los pacientes operados de cáncer esofágico. Métodos: Se realizó un estudio observacional, descriptivo y transversal en 87 pacientes operados de cáncer esofágico en el Servicio de Cirugía General del Hospital Provincial Docente Saturnino Lora de Santiago de Cuba durante el período comprendido de 2014 a 2018. Resultados: Dos pacientes en estadio II (100,0 por ciento) recibieron tratamiento quirúrgico curativo y 12 en estadio III (17,9 por ciento). Recibieron tratamiento quirúrgico paliativo 55 (82,1 por ciento) enfermos en estadio III y 18 (100,0 por ciento) en estadio IV. Predominó la técnica transhiatal de Denk-Sloan-Orringer aplicada en 10 (71,4 por ciento) pacientes. La gastrostomía predominó como proceder paliativo para alimentación en 53 (76,2 por ciento) pacientes. Se reportaron 45 complicaciones; el 53,3 por ciento de tipo médica, en las que prevalecieron las respiratorias: bronconeumonía (13,3 por ciento) y distrés respiratorio (11,1 por ciento). En cambio, el 46,7 por ciento de las complicaciones fueron de tipo quirúrgicas: infección del sitio operatorio (20,0 por ciento), seguida de la fuga anastomótica (15,6 por ciento). Fallecieron 16 (18,4 por ciento) pacientes del total de la serie. Las causas de muerte predominantes fueron el distrés respiratorio (31,3 por ciento) y la disfunción múltiple de órganos (25,0 por ciento). Conclusiones: La esofagectomía abierta o mínimamente invasiva se erige como el tratamiento quirúrgico de elección para el tratamiento del cáncer esofágico con intención curativa, proceder con elevada morbilidad y mortalidad a escala mundial. Los resultados de esta investigación coinciden con los reportados en la literatura médica nacional y extranjera(AU)
Introduction: The main treatment for esophageal cancer is esophagectomy. Objective: To determine the morbidity and mortality of patients operated on for esophageal cancer. Methods: An observational, descriptive and cross-sectional study was carried out with 87 patients operated on for esophageal cancer in the general surgery service of Hospital Provincial Docente Saturnino Lora, of Santiago de Cuba, during the period from 2014 to 2018. Results: Curative surgical treatment was received by 2 patients (100.0 percent) in stage II and 12 patients (17.9 percent) in stage III. Palliative surgical treatment was received by 55 ill patients (82.1 percent) in stage III and 18 ill patients (100.0 percent) in stage IV. There was a predominance of the Denk-Sloan-Orringer transhiatal technique, applied in 10 (71.4 percent) patients. Gastrostomy predominated in 53 (76.2 percent) patients as a palliative procedure for feeding. Forty-five complications were reported, 53.3 percent of which were medical, with respiratory complications prevailing: bronchopneumonia (13.3 percent) and respiratory distress (11.1 percent). On the other hand, 46.7 percent of the complications were surgical: surgical site infection (20.0 percent), followed by anastomotic leak (15.6 percent). Out of the total series, 16 (18.4 percent) patients died. The predominant causes of death were respiratory distress (31.3 percent) and multiple organ dysfunction (25.0 percent). Conclusions: Open or minimally invasive esophagectomy stands out as the surgical treatment of choice for esophageal cancer with curative purposes, being a procedure with high morbidity and mortality worldwide. The results of this research coincide with those reported in the national and foreign medical literature(AU)
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Humans , Esophageal Neoplasms/etiology , Epidemiology, Descriptive , Observational Studies as TopicABSTRACT
: Las prácticas adecuadas de lactancia materna (LM) y de alimentación complementaria (AC) contribuyen al crecimiento y desarrollo de los niños. Con el objetivo de determinar el nivel de conocimientos en LM y AC en madres usuarias de los Servicios de Salud Pública (SSP) de Guatemala, se realizó un estudio descriptivo y transversal, esperando que los resultados sean utilizados para diseñar intervenciones basadas en evidencia. Se diseñó un instrumento de recolección de datos, el cual se utilizó en una muestra de 1,956 madres entre 15 a 49 años. Se entrevistó a madres de niños menores de dos años usuarias de los SSP de los lugares de cobertura del Ejercicio Profesional Supervisado de la Universidad de San Carlos de Guatemala. Los datos se analizaron mediante estadística descriptiva, se calificó cada pregunta en cero (0) para respuesta incorrecta y uno (1) para respuesta correcta, estableciendo el nivel de conocimientos como alto (67 a 100% respuestas correctas), medio (34 a 66% respuestas correctas) o bajo (0 a 33% respuestas correctas), agrupando los resultados según variables sociodemográficas. El nivel de conocimiento sobre LM fue alto en 989 madres (51%), medio en 888 madres (45%) y bajo en 79 madres (4%) con un promedio de nota de 73.2(17.1)[58.2, 88.2] sobre 100 puntos. En cuanto al nivel de conocimiento sobre AC fue alto en 251 madres (13%), medio en 1,608 madres (82%) y bajo en 97 madres (5%) con un promedio de nota de 55.2(12.1)[44.5, 65.8]. Se concluyó que, a menor edad y escolaridad de la madre, mayor porcentaje de nivel bajo de conocimiento en LM y AC.
Appropriate breastfeeding (LM ,from its Spanish initials) and complementary feeding (AC, from its Spanish initials) practices contribute to the growth and development of children. The objective of this work was to determine the level of knowledge in LM and AC in mothers who use Public Health Services (SSP) in Guatemala. A descriptive and cross-sectional study was carried out, hoping that the results would be used to design an evidence-based impact. A data collection instrument was built, which was used in a sample of 1,956 mothers between 15 and 49 years of age. Mothers of children under two years of age who are users of the SSP covered by the Nutrition Supervised Professional Practice of the University of San Carlos of Guatemala were interviewed. The data was analyzed using descriptive statistics, each question was scored zero (0) for an incorrect answer and one (1) for a correct answer, establishing the level of knowledge as high (67 to 100% correct answers), medium (34 to 66% correct answers) or low (0 to 33% correct answers), grouping the results obtained according to sociodemographic variables. The level of knowledge about LM was high in 989 mothers (51%), medium in 888 mothers (45%), and low in 79 mothers (4%) with an average grade of 73.2(17.1)[58.2, 88.2] of a 100 points. Regarding the level of knowledge about AC, it was high in 251 mothers (13%), medium in 1,608 mothers (82%) and low in 97 mothers (5%) with an average grade of 55.2(12.1)[44.5, 65.8] . It was concluded that the lower the age and schooling of the mother, the higher the percentage of low level of knowledge in LM and AC.
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Introducción: La duodenopancreatectomía cefálica es una operación cada vez más frecuente en pacientes seleccionados. Objetivo: Identificar la morbilidad y la mortalidad concerniente a la duodenopancreatectomía cefálica convencional. Métodos: Se realizó un estudio observacional, descriptivo de una serie de 15 casos operados de duodenopancreatectomía cefálica. Se investigaron las variables: estadificación según clasificación tumor, linfonódulo, metástasis (TNM), diagnóstico anatomopatológico, complicaciones, tiempo quirúrgico y estado al egreso. Se utilizaron el número absoluto y el porcentaje como medidas de resumen para las variables estadificación y diagnóstico; la media, la mediana y el rango para el tiempo quirúrgico y el intervalo de confianza para el estado al egreso. Resultados: El diagnóstico anatomopatológico principal fue adenocarcinoma de páncreas con 9 pacientes (60,1 %) y de duodeno con 2 (13,3 %). El estadio posoperatorio IIA fue el que prevaleció con 5 (45,5 %). El retraso del vaciamiento gástrico fue la complicación quirúrgica que prevaleció, con 7 (46,7 %) enfermos, seguida de la fístula biliar con 3 (20,0 %). La fístula pancreática, la lesión de la vena mesentérica superior y la hemorragia posoperatoria se presentaron una sola vez (6,7 %), respectivamente. Estas 2 últimas, provocaron la muerte del enfermo en las primeras 48 horas del posoperatorio. Fallecieron 4 (26,7 %) pacientes de la serie. Conclusiones: Las complicaciones posquirúrgicas se observan principalmente a expensas del retardo del vaciamiento gástrico, la fístula biliar y pancreática. La mortalidad puede estar relacionada con la prolongación del tiempo quirúrgico igual o mayor de 5 horas, con el consiguiente aumento de las pérdidas hemáticas.
Introduction: Cephalic duodenopancreatectomy is an increasingly frequent operation in selected patients. Objective: To identify the morbidity and mortality related to conventional cephalic duodenopancreatectomy. Methods: An observational, descriptive study of a series of 15 cases operated on cephalic duodenopancreatectomy. The variables were investigated: staging according to the Tumor, Linphonod, Metastasis (TNM) classification, pathological diagnosis, complications, surgical time and discharge status. Absolute number and percentage were used as summary measures for the variables staging and diagnosis; mean, median and range for surgical time and confidence interval for discharge status. Results: The main pathological diagnosis was adenocarcinoma of the pancreas with 9 patients (60.1%) and of the duodenum with 2 (13.3%). Postoperative stage IIA was the one that prevailed with 5 (45.5%) patients. Delayed gastric emptying was the prevailing surgical complication, with 7 (46.7%) patients, followed by biliary fistula with 3 (20.0%). Pancreatic fistula, superior mesenteric vein injury, and postoperative hemorrhage occurred only once (6.7%), respectively. These last 2, caused the death of the patient in the first 48 hours of the postoperative period. Four (26.7%) patients in the series died. Conclusions: Postoperative complications are mainly observed at the expense of delayed gastric emptying and biliary and pancreatic fistula. Mortality may be related to the prolongation of surgical time equal to or greater than 5 hours with the consequent increase of blood loss.
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Abstract Coronary artery disease (CAD) and ischemic heart disease (IHD) are often indistinctly used terms. Both combined have generated, over the past years, concerns about sex disparities in their presentation. From an epidemiological perspective, females have several disadvantages regarding the prevention, diagnosis, and treatment of CAD. Most of the general cardiovascular risk factors affect women more frequently, or with a higher morbidity and mortality association. Besides, atypical manifestations of the disease and uncommon forms of CAD represent a diagnostic challenge for clinicians. Even if current treatments for CAD have no apparent sex bias, women representation in clinical trials and treatment patterns analyzed in clinical practice refuse this statement. Several disparities are caused by inevitable sex-particularities, but many of them are more social, cultural, and dogmatic beliefs that have to be addressed and overhaul.
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ABSTRACT Objective: To learn about the experience of families of children and adolescents in psychological distress facing hospitalization in a psychiatric inpatient unit of a general university hospital. Method: This is a qualitative phenomenological-social study, with data collection carried out from February to March 2022 through open interviews, analyzed using Alfred Schutz's framework with the construction of categories of meaning. Results: Based on the analysis of eight interviews, it was possible to understand changes in the families' way of life, impacts on their routine, work, and social relationships. Their expectations were about the recovery of mental health and autonomy. Conclusion: This study allowed us to understand the experience of families faced with the hospitalization of children and adolescents in psychological distress and understand their members' needs. The need for implementation of care spaces that incorporate the relationship between the multidisciplinary team and the family is highlighted.
RESUMEN Objetivo: Conocer la experiencia de familias de niños y adolescentes en sufrimiento psicológico ante la internación en una unidad de internación psiquiátrica de un hospital general universitario. Método: Estudio cualitativo fenomenológico-social, recolección de datos realizada de febrero a marzo de 2022 a través de entrevistas abiertas, analizadas utilizando el referencial de Alfred Schutz con la construcción de categorías de significado. Resultados: A partir del análisis de ocho entrevistas, fue posible comprender cambios en el modo de vida de las familias, impactos en su rutina, trabajo y relaciones sociales. Sus expectativas estaban puestas en la recuperación de la salud mental y la autonomía. Conclusión: Este estudio permitió comprender la experiencia de las familias ante la hospitalización de niños y adolescentes en sufrimiento psicológico y comprender las necesidades de sus miembros. Se destaca la necesidad de implementar espacios de atención que incorporen la relación entre el equipo multidisciplinario y la familia.
RESUMO Objetivo: Conhecer a experiência da família de crianças e adolescentes em sofrimento psíquico diante da hospitalização em uma unidade de internação psiquiátrica de um hospital geral universitário. Método: Estudo qualitativo fenomenológico-social, coleta de dados realizada nos meses de fevereiro a março de 2022 por meio de entrevistas abertas, analisadas sob referencial de Alfred Schutz com construção de categorias de significado. Resultados: Com base na análise de oito entrevistas, foi possível compreender mudanças no modo de vida das famílias, impactos na sua rotina, trabalho e relações sociais. Suas expectativas versaram sobre a recuperação da saúde mental e autonomia. Conclusão: Este estudo permitiu conhecer a experiência das famílias diante da hospitalização de crianças e adolescentes em sofrimento psíquico e compreender as necessidades de seus membros. Destaca-se a necessidade da implementação de espaços de cuidados que incorporem a relação entre a equipe multiprofissional e a família.
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Humans , Child , Adolescent , Child , Adolescent , Mental Disorders , Family , EmpathyABSTRACT
Abstract The aim of the present study was to investigate the impact of oral health literacy (OHL) on conceptions of care and behaviors related to COVID-19. The sample came from two preliminary cross-sectional studies that determined the level of OHL of parents/guardians of six-to-12-year-old children in two major Brazilian cities (Curitiba and Belo Horizonte). Functional OHL was measured using the Brazilian version of the Rapid Estimate of Adult Literacy in Dentistry (BREALD-30) and the Health Literacy Dental Scale (HeLD-14) for the evaluation of interactive OHL. Participants were recruited through e-mail, social media, and telephone contact. The questionnaire on conceptions of care and behaviors related to COVID-19 was created based on the guidelines of the World Health Organization. Two hundred nineteen individuals participated in the study. There was no significant difference in socioeconomic and demographic variables and in the medians of BREALD and HeLD-14 between the two cities (P>0.05). Higher levels of functional OHL were associated with an appropriate conception that individual care affects collective care (P=0.038), but with an inappropriate conception of seeking medical assistance in cases of mild symptoms (P=0.030). Higher levels of interactive OHL were related to social distancing behavior in the city of Curitiba (P=0.049) and in the overall sample (P=0.040). It is concluded that functional OHL was associated with two of the investigated conceptions about COVID-19, while interactive OHL was associated with social distancing behavior. These data may suggest that different dimensions of the OHL can have an impact on different aspects of coping with the pandemic.
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Abstract Resolution 658/2022 of the Brazilian Regulatory Agency requires the determination of the permitted daily exposure (PDE) of pharmaceutical agents. Ginkgo biloba L. is used therapeutically to treat memory deficits and other brain diseases. However, published results indicate that more studies are needed to confirm the safety of Ginkgo biloba. This study aimed to evaluate the dry extract of Ginkgo biloba L. leaves PDE as an ingredient in an oral pharmaceutical product in preclinical studies using mice. Acute oral toxicity and repeated dose experiments were performed based on OECD guidelines, as well as genotoxicity tests. The results indicate that Ginkgo biloba L. has low acute toxicity, no liver toxicity, and does not alter blood glucose levels. No changes in weight gain were observed, but food intake decreased in males during the first week of treatment at the highest dose. Hematological parameters were not altered in males, whereas females presented lower leukocyte and lymphocyte counts and higher neutrophil counts at the highest dose. The lipid profile was not altered in males, whereas total cholesterol was increased in females. The estimated PDE was 0.1 mg/day and, when related to the maximum residual concentration, indicates that the cleaning process used is safe and does not require reassessment.
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Abstract The study analyzed the clarity of publications on human papillomavirus (HPV) in the Instagram profiles of official Brazilian health agencies. An infodemiological study analyzed publications on HPV in the 81 Instagram profiles selected from the Health Ministry, States' Health Departments, and dental councils and associations. The following data were collected: classification of content, type of profiles, type of media, how the content was addressed, number of posts, frequency, likes, comments, viewings, and hashtags, and how the HPV vaccine was addressed. The clarity of the educational publications was assessed using the Brazilian version of the Clear Communication Index (BR-CDC-CCI). Data analysis was performed with Spearman's correlation and the Mann-Whitney test (p < 0.05). A total of 504 publications on HPV were found. The average number of likes was 528.3 (SD = 2388.2) and the average BR-CDC-CCI score was 67.1 (SD = 14.1). The quality and clarity of the information was considered adequate (BR-CDC-CCI score ≥ 90) in 6.9% of the publications. A weak positive correlation was found between the number of likes and both the BR-CDC-CCI score (r = 0.195) and number of posts (r = 0.124). Publications from the Health Ministry had a significantly higher BR-CDC-CCI score (72.9) compared to the other profiles analyzed (p = 0.01). Most publications concerned government actions, had low engagement, and written educational information was of low clarity and quality. However, the effort to reach the population was evident, with an increase in publications over the years.
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Abstract The aim of the present study was to investigate predictors of malocclusion in Brazilian schoolchildren eight to ten years of age based on a causal directed acyclic graph model. A cross-sectional study was conducted with 739 schoolchildren eight to ten years of age. Parents/guardians provided information on sleep disorders of the child (Sleep Disturbance Scale for Children) and family characteristics (Family Adaptability and Cohesion Evaluation Scale). The diagnosis of malocclusion was performed by four trained examiners using the Dental Aesthetic Index. Control variables were selected using a directed acyclic graph. Descriptive analysis was performed, followed by robust logistic regression analysis for complex samples (α = 5%). The following variables were associated with malocclusion in the final model: sleep disorders (OR = 2.61; 95%CI: 2.43-2.86), mouth breathing (OR = 1.04; 95%CI: 1.02-1.99), non-nutritive sucking habits (OR = 2.45; 95%CI: 2.37-4.85), and obesity (OR = 1.54; 95%CI: 1.02-2.33). Sociodemographic characteristics, family functioning, and premature tooth loss did not remain associated with malocclusion. Sleep disorders, mouth breathing, sucking habits, and obesity are predictors of malocclusion in schoolchildren eight to ten years of age.
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ABSTRACT Background Sleep bruxism (BS) is defined as involuntary jaw movements characterized by grinding and clenching teeth. Objective To verify the association between chronotype, sleep quality, and self-reporting of BS in dental students. Method A cross-sectional study was conducted with 214 undergraduate dental students at a public university in northeast Brazil. The participants answered the Munich Chronotype Questionnaire for the identification of chronotype and another questionnaire regarding daily aspects to collect information about sleep quality, self-reported sleep bruxism, the use of sleeping pills, snoring, concentration during daily activities and energy upon waking. Results The prevalence of self-reported sleep bruxism was 11.0%. In the final model, the eveningness chronotype (OR = 23.00; 95% CI: 2.36-223.84, p = 0.007), habitual snoring (OR = 3.12; 95% CI: 1.31-7.39, p = 0.01) and low energy upon waking in the morning (OR = 2.37; 95% CI: 1.96-5.58, p = 0.040) were associated with self-reported sleep bruxism. Conclusion The evening chronotype, presence of snoring, and low energy when waking up in the morning influenced self-reporting of sleep bruxism among undergraduate dental students.
RESUMO Introdução O bruxismo do sono (BS) é definido como movimentos involuntários da mandíbula caracterizados por ranger e apertar os dentes. Objetivo Verificar se o cronotipo e a qualidade do sono estão associados ao autorrelato de BS em graduandos de Odontologia. Método Um estudo transversal com 214 estudantes de uma universidade pública do Nordeste do Brasil. Os participantes responderam ao Morningness-Eveningness Questionnaire para identificar os cronotipos e outro questionário sobre aspectos diários em que foram coletadas informações sobre qualidade do sono, autorrelato de bruxismo do sono, uso de pílulas para dormir, ronco, concentração nas atividades diárias, energia ao acordar. Resultados A prevalência de autorrelato do bruxismo do sono foi de 11,0%. No modelo final, o cronotipo noturno (OR = 23,00; 95% IC: 2.36-223.84, p = 0,007), o hábito de roncar (OR = 3,12; 95% IC: 1.31-7.39, p = 0,01) e o baixo nível de energia ao acordar pela manhã (OR = 2,37; 95% IC: 1.96-5.58, p = 0,04) estiveram associados com o autorrelato de BS. Conclusão O cronotipo noturno, a presença do ronco e a baixa energia ao se levantar pela manhã influenciaram o autorrelato de bruxismo do sono entre os estudantes de graduação em Odontologia.
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Resumo Objetivo conhecer as percepções da equipe de enfermagem ante o cuidado de crianças e adolescentes com transtornos mentais internados. Método estudo qualitativo fenomenológico social cuja coleta de dados foi realizada com 12 membros das equipes de enfermagem por meio de entrevista fenomenológica. Resultados "Motivos porque" descritos em duas categorias: a percepção da equipe de enfermagem em face dos cuidados prestados e ações e cuidados da equipe de enfermagem da criança com transtornos mentais. "Motivos para" expressos na categoria: a recuperação da criança com transtorno mental e o seu retorno para casa. Conclusões e Implicações para a prática a possibilidade do estabelecimento da relação face a face entre equipe, família e criança como forma de apreender a situação biográfica e o acervo de conhecimento dos sujeitos envolvidos e, então, entender as suas reais necessidades e demandas promovem um cuidado integral. Através da fenomenologia social de Alfred Schutz, traz-se como implicação para a prática a possibilidade de compreender a percepção da equipe de enfermagem sobre a relevância da relação face a face no cuidado de crianças e adolescentes com transtornos mentais.
Resumen Objetivo conocer las percepciones del equipo de enfermería sobre los cuidados prestados a los niños y adolescentes hospitalizados con trastornos mentales. Método estudio cualitativo fenomenológico social cuya recogida de datos se realizó con 12 miembros de los equipos de enfermería mediante entrevista fenomenológica. Resultados "Motivos-por qué" se describen en dos categorías: la percepción del equipo de enfermería ante los cuidados prestados y las acciones y cuidados del equipo de enfermería del niño con trastornos mentales. "Motivos-para" expresadas en la categoría: la recuperación del niño con trastorno mental y su regreso a casa. Conclusiones e Implicaciones para la práctica La posibilidad de establecer una relación cara a cara entre el equipo, la familia y el niño como una forma de aprehender la situación biográfica y el cuerpo de conocimiento de los sujetos involucrados y luego comprender sus necesidades y demandas reales, promueve la atención integral. A través de la fenomenología social de Alfred Schutz, aporta como implicaciones para la práctica la posibilidad de entender la percepción del equipo de enfermería sobre la relevancia de la relación cara a cara en el cuidado de niños y adolescentes con trastornos mentales.
Abstract Objective to know the perceptions of the nursing team about the care of hospitalized children and adolescents with mental disorders. Method social phenomenological qualitative study whose data collection was carried out with 12 members of the nursing teams by means of phenomenological interviews. Results "Reasons why" described in two categories: the perception of the nursing team in view of the care provided and actions and care of the nursing team of the child with mental disorders. "Reasons for" expressed in the category: the recovery of the child with mental disorder and his return home. Conclusions and Implications for practice The possibility of establishing a face-to-face relationship between the team, the family, and the child to apprehend the biographical situation and the body of knowledge of the subjects involved, and then understand their real needs and demands promotes comprehensive care. Through Alfred Schutz's social phenomenology, it brings as implications for practice the possibility of understanding the perception of the nursing staff about the relevance of the face-to-face relationship in caring for children and adolescents with mental disorders.