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ABSTRACT: Objective: To examine the prevalence of psychiatric symptoms and associated factors in the adult population of Brumadinho (MG), after the dam collapse. Methods: We included 2,740 participants with information about symptoms of post-traumatic stress disorder (PTSD), depression, anxiety, thoughts of death/self-harm, and poor sleep quality collected in 2021. Prevalence values of all conditions were estimated to compare the prevalence of psychiatric symptoms with the participants' sociodemographic characteristics and place of residence. Pearson's c2 test was used, with Rao Scott's correction. Crude and adjusted logistic regressions estimated odds ratios and 95% confidence intervals to assess the association between psychiatric symptoms and participants' characteristics. Results: The most common condition was depressive symptoms (29.3%), followed by post-traumatic stress symptoms (22.9%) and anxious symptoms (18.9%). Regarding the association between participants' characteristics in the adjusted analysis, being a female and living in a mining area was positively associated with symptoms of PTSD, depression, anxiety, thoughts of death/self-harm, and poor sleep quality. A positive association was also found between high school education and post-traumatic stress symptoms. In contrast a negative association was found between being aged ≥60 years and symptoms of PTSD, depression, and anxiety. Conclusion: High prevalence values were found for all psychiatric symptoms after the dam failure in Brumadinho. Being a female, living in the mining area, being ≥60 years old, and having an educational level were all associated with the psychiatric symptoms investigated.
RESUMO: Objetivo: Examinar a prevalência dos sintomas psiquiátricos e seus fatores associados na população adulta de Brumadinho (MG), após o rompimento da barragem. Métodos: Foram incluídos 2.740 participantes com informações coletadas em 2021 sobre os sintomas de estresse pós-traumático (TEPT), depressão, ansiedade, ideias de morte/automutilação e pior qualidade do sono. Estimaram-se as prevalências de todas as condições. Para a comparação das prevalências dos sintomas psiquiátricos e as características sociodemográficas e local de moradia, empregou-se o teste χ2 de Pearson, com correção de Rao-Scott. Regressões logísticas brutas e ajustadas estimaram os odds ratios e intervalos de confiança de 95%, permitindo a avaliação da associação entre os sintomas psiquiátricos e as características dos participantes. Resultados: Os sintomas depressivos foram a condição mais prevalente (29,3%), seguidos pelos sintomas de TEPT (22,9%) e sintomas ansiosos (18,9%). Com relação à investigação da associação entre as características dos participantes na análise ajustada, observou-se que o sexo feminino e os moradores da área de mineração apresentaram relação positiva com os sintomas de TEPT, depressivos, ansiosos, ideia de morte e pior qualidade de sono. Também se encontraram associação positiva entre a escolaridade de nível médio e os sintomas de TEPT e associação negativa entre aqueles com ≥60 anos e os sintomas de TEPT, depressivos e ansiosos. Conclusão: Altas prevalências foram encontradas para todos os sintomas psiquiátricos após a ruptura da barragem em Brumadinho. Sexo feminino, local de moradia na área de mineração, ≥60 anos e escolaridade foram associados aos sintomas psiquiátricos investigados.
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ABSTRACT Objective: To describe the situation of food insecurity of families according to the socioeconomic characteristics and dimensions of the food system in Brumadinho, state of Minas Gerais, Brazil, after the dam rupture in Córrego do Feijão mine. Methods: This is a descriptive study focused on households carried out from the baseline of the Brumadinho Health Project. Food insecurity, the main outcome, was assessed by the short version of the Brazilian Food Insecurity Scale. Other investigated variables were: socioeconomic data; geographic stratum of the households; family's assets; income; expenses; cultivation of food and animal husbandry for consumption. Descriptive analyses were performed comparing the food insecurity of the household according to the other variables by the χ2 test to compare the proportions. Results: Of the investigated households (n=1,441), 35.1% were facing food insecurity. facing food insecurity had: lower prevalence of masonry households with coating (91.4%; 95%CI 87.7%−94.1% vs. 96.7%; 95%CI 94.9%−97.8%); highest proportion of rudimentary cesspit (16.9%; 95%CI 13.3%−21.2% vs. 9.4%; 95%CI 7.4−11.9); lower prevalence of own and paid-off homes (63.9%; 95%CI 56.8−70.5 vs. 77.3%; 95%CI 72.3−81.7); and income reduction after the dam rupture (33.0%; 95%CI 27.1−39.6 vs. 14.1%; 95%CI 11.2−17.6), when compared with those in a food security situation. Conclusion: The prevalence of food insecurity was high, with report of a reduction in household income after the dam rupture. Moreover, most of the households had worse structural quality and sewage outfall. These results evidence the vulnerability of families and possible violation of the human right to adequate food, denoting the urgency of continuous reparative actions.
RESUMO Objetivo: Descrever a situação de insegurança alimentar das famílias segundo as características socioeconômicas e dimensões do sistema alimentar em Brumadinho, Minas Gerais, Brasil, após desastre. Métodos: Estudo descritivo com foco no domicílio realizado pela linha de base do Projeto Saúde Brumadinho. A insegurança alimentar, desfecho principal, foi avaliada pela Escala Brasileira de Insegurança Alimentar curta. Outras variáveis investigadas foram: socioeconômicas; estrato geográfico do domicílio; ativos (bens); renda; despesas familiares; cultivo de alimentos e criação de animais para consumo. Foram realizadas análises descritivas comparando a insegurança alimentar do domicílio segundo as demais variáveis pelo teste χ2 para comparação das proporções. Resultados: Dos domicílios investigados (n=1.441), 35,1% estavam em situação de insegurança alimentar. As famílias em insegurança alimentar apresentavam: menores prevalências de domicílios de alvenaria com revestimento (91,4%; IC95% 87,7%−94,1% vs. 96,7%; IC95% 94,9%−97,8%); maior proporção de fossa rudimentar (16,9%; IC95% 13,3%−21,2% vs. 9,4%; IC95% 7,4−11,9); menor prevalência de domicílios próprios e quitados (63,9%; IC95% 56,8−70,5 vs. 77,3%; IC95% 72,3−81,7); e redução da renda após o rompimento da barragem (33,0%; IC95% 27,1−39,6 vs. 14,1%; IC95% 11,2−17,6), quando comparadas àquelas em segurança alimentar. Conclusão: A prevalência de insegurança alimentar foi elevada, com relato de redução da renda das famílias após o rompimento da barragem. Ademais, boa parte dos domicílios apresentava pior qualidade estrutural e escoamento de esgoto. Esses resultados evidenciam a vulnerabilidade das famílias e possível violação do direito humano à alimentação adequada, denotando a urgência de ações reparadoras contínuas.
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Objective:To investigate the related factors of vertebral body height reloss after pedicle screw fixation of thoracolumbar fracture and to determe the optimum prediction point.Methods:A retrospective case control study was made on 215 patients with thoracolumbar fracture admitted to Second Affiliated Hospital of Soochow University from January 2010 to December 2017. There were 155 males and 60 females，aged 21-80 years［（48.6±10.4）years］. According to Denis fracture classification，there were 73 patients with compression fractures（type A in 15 patients，type B in 51，type C in 7），135 burst fractures（type A in 28 patients，type B in 87，type C in 20）and flexion distraction fractures（type A in 4，type B in 2，type C in 1）. All patients were treated by pedicle screw fixation. Follow-up lasted for 12- 48 months［（23.8±8.2）months］. Vertebral body height loss occurred in 86 patients（loss group），but did not in 129 patients（non-loss group）. The two groups were compared concerning sex，age，osteoporosis self-assessment tool for Asians（OSTA），body mass index（BMI），fracture types，number of fractured vertebrae，preoperative sagittal Cobb angle，preoperative degree of vertebral compression，number of screws placed in injured vertebrae，extent of vertebral reset and other related factors. Univariate analysis was used to identify the correlation of those factors with vertebral body height reloss. Multivariate Logistic regression analysis was performed to identify the independent factors for the height reloss with the receiver operating characteristic curve（ROC）and area under the curve（AUC）calculated to evaluate the optimum point in prediction of vertebral height reloss.Results:The two groups showed no significant differences in sex，age，BMI，fracture types，number of injured vertebrae，preoperative sagittal Cobb angle and number of screws placed in injured vertebrae（ P>0.05），but the differences were statistically significant in OSTA，preoperative degree of vertebral compression and extent of vertebral reset（ P<0.05）. According to the univariate analysis，OSTA，preoperative degree of vertebral compression and extent of vertebral reset were significantly correlated with the occurrence of vertebral body height reloss（ P<0.05）. According to the multivariate Logistic regression，OSTA（ OR=1.109，95% CI 0.527-0.685， P<0.05）and preoperative degree of vertebral compression（ OR =0.038，95% CI 0.539-0.689， P<0.05）were significantly related to vertebral body height reloss. The AUC relating OSTA and preoperative degree of vertebral compression to vertebral body height reloss was 0.604 and 0.614，respectively. The optimum prediction point of OSTA and preoperative degree of vertebral compression for vertebral body height reloss was 1.9 and 31.3%，respectively. Conclusions:OSTA and the preoperative degree of vertebral compression are independent risk factors for vertebral body height reloss. OSTA≤1.9 or preoperative degree of vertebral compression ≥31.3% indicates a significantly higher risk of postoperative vertebral body height reloss.
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Objective To study the risk factors of MRI for the prediction of collapse in patients with avascular necrosis of the femoral head.Methods Twenty-two patients (39 hips) diagnosed avascular necrosis of femoral head by MR were enrolled in our study.The following MR appearances were evaluated:bone marrow edema,joint fluids,signal intensity and location of the lesion.The volume and surface area of the necrosis zone were calculated.The time of follow-up was 18-84 months (median,25 months).Logistic regression analysis was used to predict the risk factors by SPSS 13.0.The maximum value of Youden index was selected as the critical point to predict the collapse of femoral head and to define the sensitivity,specificity and accuracy.Results In the 39 hips with femoral head necrosis,21 hips had collapse.Bilateral collapse occurred in 5 cases.In 25 hips with the necrosis surface larger than 25％,collapse occurred in 21 (84％); In 8 hips with the volume of femoral head necrosis larger than 30％,collapse occurred in all cases; 1n 33 hips with the necrosis locating at the superolateral quadrant,collapse occurred in 21 (63.6％); In 22 hips with necrotic areas showing heterogeneous signal intensity,collapse occurred in 18(81.8％) ;In 25 hips with large amount of joint effusion,collapse occurred in 16 (64％) ;in 18 hips with bone marrow edema,collapse occurred in 13 (65％).Joint fluid,heterogeneous signal intensity and lesions in the superolateral quadrant,volume ratio,and area ratio were the high risk factors,while bone marrow edema was a relatively low risk factor.The area under ROC curves for area ratio of NASA was greater than that for volume ratio (0.987 vs 0.902).When the critical value for area ratio was 26.7％,the true positive rate was 95.2％,true negative rate was 94.4％,and Youden's index was 0.896.Conclusions The collapse of necrosis of femoral head may result from many factors.The femoral head was easy to collapse when it had large enough area of necrosis and mixed signal intensity,a large amount of joint effusion,bone marrow edema,and superolateral quadrant location.The critical value for area ratio to predict the collapse of femoral head was about 26.7％.The area ratio is more accurate than volume ratio in predicting the collapse of necrosis of femoral head.