COVID-19 post-vaccination in healthcare workers and vaccine effectiveness, Brazil, 2021

Abstract Objects: This study aimed to describe COVID-19 cases in healthcare workers at a large tertiary hospital, after a vaccination campaign, to understand the individual characteristics, timeliness, symptomatology, and severity of the conditions. Methods: The COVID-19 reporting files from the hospital's healthcare workers and their records in the vaccine registry were analyzed, regarding vaccination status, symptoms, sociodemographic characteristics, comorbidities, and outcomes. Vaccination descriptive analysis was carried out and the impact and effectiveness of vaccination in relation to symptomatic infection and hospitalization were estimated. Results: In a total of 696 PCR-confirmed COVID-19 patients, vaccination coverage for the 1st and 2nd dose was 92.8% and 85.5%. Patients with complete doses had a mean interval of 96.8 days between vaccination and the onset of symptoms. Of the 664 participants with available clinical data, 165 had at least 1 comorbidity. During the study, 12 patients were hospitalized, 58.3% with a complete vaccination schedule. Three of this group died. The effectiveness of vaccination for symptomatic cases and hospitalization was 22.1% and 69.0%, respectively. The impact of vaccination on symptomatic cases and hospitalization was 81.4% and 89.7%, respectively. Discussion: The majority of COVID-19 cases in the study were classified as mild. The impact of vaccination for confirmed cases was significant, both in reducing the incidence of symptomatic cases and hospitalizations. The presence of comorbidities in approximately » of the patients increased the risk of these individuals. The mean time interval between diagnosis and the 2nd dose of vaccine was longer in the hospitalized group, reinforcing the protective decline over longer periods.

Various Static And Dynamic Balance Measuring And Training Mechanical Tools In Patients With Clinical Conditions: A Literature Review

Background: Balance is defined as the ability to maintain a position within the limits of stability or base of support. It is indicated that postural control system plays an important role in maintenance of balance on the small support base. The complexity of balancing processes makes it challenging to assess balancing abilities in a concise, holistic approach. This study extends previous efforts by reviewing a large number of papers that use of various mechanical tools to assess postural balance and by providing a detailed overview of the common mechanical tools used to assess postural balance and gait. Methods: We searched the electronic database. The literature search produced a total of 302 items. After removal of duplicates, posters, other studies not mention mechanical tools to evaluate static and dynamic balance in clinical conditions, 28 papers met the inclusion criteria for this review. Results: This search selected 7 tools to assess trunk control in various clinical conditions: Inertial balance sensor, Computerised dynamic posturography, Biodex Balance System, Force plate., MatScan® pressure mat, Microsoft Kinect’s built-in RGB-D sensor and Clinical Test of sensory integration using Chinese lantern. Conclusion: Inertial as well as Microsoft Kinect’s built-in RGB-D sensors are cost effective, time effective, does not need a specific set up, analysis static balance as well as the gait parameters. This can therefore be chosen over other mechanical tools due to its better convenience and efficiency.

Estrategias de intervención psicológica de acuerdo a las condiciones clínicas y las variables biopsicosociales del adolescente en la consulta odontológica: Revisión de la literatura / Psychological Intervention Strategies According to the Clinical Conditions and the Biopsychosocial Variables of the Adolescent in the Dental Practice: Review of the Literature

RESUMEN Epidemiológicamente, los adolescentes conforman un subgrupo poblacional con indicadores bucodentales que ameritan atención en el ámbito de la salud pública. Asimismo, la mayoría de las facultades de odontología orientan la enseñanza odontológica dirigida al niño y al adulto, donde la atención enfocada al adolescente se suele diferir. Además, el desconocimiento en las alteraciones biopsicosociales y las particularidades clínicas inherentes a la adolescencia, hacen la atención de estos pacientes potencialmente compleja. Por lo tanto, el objetivo de este artículo es realizar una revisión de la literatura con el fin de ofrecerle al profesional las herramientas o recursos psicológicos (habilidades blandas) para el abordaje de la población adolescente que asiste a la consulta odontológica. Actualmente, la "Odontohebiatría" describe la atención integral e interdisciplinaria de la salud bucodental de los adolescentes, con énfasis en la prevención y la estética bucodental. De esta forma, la odontología moderna demanda una participación activa del profesional, el cual debe estar familiarizado con las afecciones clínicas y las variables psicológicas que puedan afectar al adolescente; asimismo, también se considera importante la instrucción y el adiestramiento en estrategias de intervención psicológica para ofrecer una atención adaptada a este grupo etario.

ABSTRACT Epidemiologically, the teenagers make up a population subgroup with oral indicators that need attention in the field of public health. In addition, the majority of the dental faculties orient the dental education directed to the child and the adult, where the attention focused to the teen is usually deferred. Moreover, the ignorance in the biopsychosocial alterations and the clinical peculiarities inherent to adolescence, make the attention of these potentially complex patients. Therefore, the objective of this article is to carry out a review of the literature in order to offer the professional the tools or psychological resources (soft skills) for the approach of the adolescent population that attends the dental consultation. Currently, the "Odontohebiatría" describes the comprehensive and interdisciplinary care of adolescent oral health, with an emphasis on oral prevention and esthetics. In this way, modern dentistry demands an active participation of the professional, who must be familiar with the clinical conditions and the psychological variables that may affect the teenager; also, it is considered important the instruction and training in strategies of psychological intervention to offer an attention adapted to this age group.

Trastornos de la alimentación y deglución en niños con parálisis cerebral: condiciones clínicas acompañantes / Feeding and swallowing disorders in children with cerebral palsy: co-occurring clinical conditions

Introduction: Cerebral Palsy (CP) is frequently accompanied by other cooccurring clinical conditions (CCC). Feeding and swallowing disorders (FSD) are a common problem among CP population and tend to be more complex when associated to certain CCC. Objective: To quantify the frequency of CCC in a group of children with CP and FSD, of both genders, GMFCS I to V, between the age of 3 to 6 years. Patients and Methods: 49 patients diagnosed with CP and FSD underwent 5 assessments: 1) physiatric evaluation; 2) Gross Motor Functional Classification System (GMFCS); 3) Eating and Drinking Ability Classification System (EDACS); 4) videofluoroscopic swallowing study; and 5) sensory processing test.Results: All 49 patients had at least one of the CCC usually present in CP, with an average of 3,8 (from 1 to 6). All GFMCS and EDACS levels were affected, including mild ones. Some of the CCC showed high frequencies: intellectual disability (ID) (83,7 percent), sensory processing disorder (SPD) (75,5 percent), sialorrhea (71,4 percent), malnutrition (67,4 percent), altered alertness (67,4 percent) and constipation (61,2 percent).There was a high frequency of association between CCC. In more than 50 percent of the cases, the association of ID with most of the other conditions was the commonest.Conclusions: Children diagnosed with CP and FSD present with multiple CCC able to worsen their prognosis. All GMFCS and EDACS levels are affected. ID is the most frequent CCC, being also the most associated with the others.

Introducción: La Parálisis Cerebral (PC) cursa junto a numerosas condiciones clínicas acompañantes (CCA), destacando los trastornos de la alimentación y deglución (TAD). En PC numerosas CCA pueden interactuar con los TAD y complicarlos. Objetivo: Cuantificar la frecuencia de determinadas CCA en niños con PC, GMFCS I a V, de 3 a 6 años, portadores de TAD. Pacientes y Métodos: 49 pacientes con PC y TAD fueron sometidos a 5 evaluaciones: 1) valoración fisiátrica; 2) Gross Motor Functional Classification System (GMFCS); 3) Eating and Drinking Ability Classification System (EDACS); 4) videofluoroscopía (VFC); y 5) pauta de integración sensorial. Resultados: Todos los pacientes con PC y TAD presentaron alguna de las CCA consideradas, con un promedio de 3,8 por niño (rango 1-6), afectando a todos los niveles GMFCS y EDACS, incluidos los leves. Algunas tuvieron elevada frecuencia: déficit cognitivo (DC) (83,7 por ciento), trastorno de la integración sensorial (TIS) (75,5 por ciento), sialorrea (71,4 por ciento), desnutrición (67,4 por ciento), alerta alterada (67,4 por ciento) y constipación (61,2 por ciento). Hubo una alta frecuencia de asociación de CCA, siendo más común la asociación de DC con varias de las otras condiciones, en más del 50 por ciento de los casos. Conclusiones: Los niños con PC y TAD cursan con CCA múltiples que complican su cuadro clínico. Todos los niveles GMFCS y EDACS se ven afectados. El DC es la condición más frecuente y muestra más asociación con las otras.

Gasto de bolsillo para salud en pacientes hipertensos / Pocket health expenditure in hypertension patients

Establecer la relación entre el gasto de bolsillo en salud de pacientes hipertensos del municipio de San José de Caldas de los regímenes contributivo y subsidiado del Sistema General de Seguridad Social (SGSSS) en salud. Métodos: Se realizó un estudio comparativo del gasto de bolsillo en salud de 278 pacientes hipertensos con y sin lesión en órgano blanco. A través de un modelo econométrico se estimó la propensión marginal al consumo en salud. Resultados: Una prueba chi cuadrado de 7,88 y un valor de p=0,029 hay dependencia entre la lesión en órgano blanco y la severidad de la hipertensión arterial. Se observan diferencias estadísticamente significativas para todos los gastos destinados a la atención en salud, excepto en medicamentos, servicios dentales y atención hospitalaria al comparar los pacientes según lesión en órgano blanco. La propensión marginal al consumo en salud muestra que por cada mil pesos de ingreso familiar los pacientes sin afectación de órgano blanco dedican 2 pesos a gastos en salud; en cambio, los pacientes con lesión en órgano blanco por cada mil pesos de ingreso familiar dedican 43 pesos al gasto en salud. Conclusiones: El gasto de bolsillo para el tratamiento de pacientes hipertensos se incrementa en pacientes que presentan lesión en órgano blanco. Si bien dicho gasto no alcanza a ser catastrófico, el seguimiento y la vigilancia da estos pacientes es una prioridad en el SGSS dado el impacto en la calidad de vida y costos de atención en salud.

Objective: To measure the pocket spending on health in hypertensive patients(278) of the municipality of San José department of Caldas, contributory andsubsidized regimes of the Social Security System in health (SHSS) accordingto clinical and socioeconomic conditions. Methods: Study to establish therelationship between the pocket health spending in hypertensive patients withand without target organ injury through econometric model that estimates themarginal propensity to consume health. Results: With a Chi2 of 7.88 and p =0.029 no dependence between target organ injury and severity of hypertension.Statistically significant differences for all expenditures on health care, exceptfor medication, dental and hospital care when comparing patients accordingto target organ damage are observed.The marginal propensity to consume health shows that for every thousanddollars of household income patients without involvement of target organ 2pesos devoted to health spending ; however , patients with target organ injuryper thousand pesos of 43 pesos household income devoted to health spending.Conclusions: The pocket expense for treatment of hypertensive patients isincreased in patients that present white organ injury. While this spending isnot enough to be catastrophic, monitoring and surveillance of these patients isgiven a high priority in the SHSS because of the impact on quality of life andhealth care costs.