Índice cpod e fatores associados dos moradores de um município de pequen o porte no nordeste brasileiro / DMF index and associated factors of residents in a small municipality in Northeast Brazil / Índice CPO y factores asociados de los residentes de un pequeño municipio en el noreste de Brasil

Introdução:A atenção à Saúde Bucal no Brasil foi qualificada a partir da Política Nacional de Saúde Bucal (PNSB), através do Sistema Único de Saúde (SUS), fomentando ações de promoção, prevenção e recuperação da saúde bucal da população. A avaliação da prevalência de cárie dentária em determinada comunidade, para Estudos Epidemiológicos em Saúde Bucal, pode ser realizada por meio do índice CPOD, que fornece a quantidade média de dentes cariados, perdidos e obturados. Objetivo:O presente trabalho objetivouaferir o índice CPOD dos moradores de uma área coberta pela Equipe de Saúde Bucal (ESB) de um município de pequeno porte, caracterizar seu perfil socioeconômico, verificar seu comportamento quanto ao uso de serviços odontológicos e identificar fatores associados ao índice. Metodologia:Foi realizado um estudo de prevalência do tipo exploratório e descritivo com abordagem quantitativaem residentes de um município de pequeno porte com cobertura pela Equipe de Saúde Bucal. Foi utilizado um questionário de caracterização individual abordando identificação socioeconômica e comportamento relacionado à saúde bucal.Resultados:Na análise do CPOD, a média de dentes perdidos (5,44) foi maior que a dos dentes obturados (4,31) e cariados (1,34). Odesfecho CPOD foi associado positivamente com a idade e a necessidade do uso de prótese dentária.Conclusões:Observou-se uma média mais alta de dentes perdidos, seguida por dentes obturados, e uma média menor de dentes cariados. Verificamos que o índice CPOD individual foi mais elevado em pessoas com mais de 34 anos e naqueles que necessitavam de próteses dentárias (AU).

Introduction:Oral Health care in Brazil was qualified basedon the National Oral Health Policy (PNSB), through the Unified Health System (SUS), promoting actions to promote, prevent and recover the oral healthof the population. Assessing the prevalence of tooth decay in a community, for Epidemiological Studies inOral Health, can be conductedusing the DMFT index, which provides the average number of Decayed, Missing and Filled Teeth. Objective:Thisstudy aimed to measure the DMFT index of residents of an area covered by anOral Health Team (ESB) of a small municipality, characterize their socioeconomic profile, verify their behavior regarding the use of dental services,and identify factors associated with this index. Methodology:An exploratory and descriptive prevalence study was conductedwith a quantitative approach in residents of a small municipality covered by the Oral Health Team. An individual characterization questionnaire addressing socioeconomic identification and behavior related to oral health was used. Results:The total samplewas of 283 individuals with an average of 34 years of age. In the DMFT analysis, the average number of missing teeth (5.44) was higher than that of filled (4.31) and decayed ones(1.34). The occurrence of a DMFTindexgreater than 11 was significantly higher in individuals over 34 years of age (p value 0.000) and in subjects who needed dental prosthesis (p value 0.001). Conclusions:A higher average of missing teeth was observed, followed by filled ones, and a lower average of decayed teeth. The DMFT outcome was positively associated with age and the need to use dental prostheses (AU).

Introducción:La atención a la salud bucal en Brasil ha sido calificada por la Política Nacionalde Saúde Bucal (PNSB), a través del Sistema Único de Saúde (SUS), promoviendo acciones de promoción, prevención y recuperación de la salud bucal de la población. Para estudios epidemiológicos de salud bucal, la prevalencia de caries dental en una determinada comunidad puede ser evaluada utilizando el índice DMFT, que proporciona el número medio de dientes cariados, perdidos y obturados. Objetivo:El objetivo de este estudio fue medir el índice DMFT de los residentes de un área cubierta por el Equipo de Salud Bucal (ESB) de un pequeño municipio, caracterizar su perfil socioeconómico, verificar su comportamiento en cuanto al uso de servicios odontológicos e identificar factores asociados al índice. Metodología:Se realizó un estudio exploratorio y descriptivo de prevalencia con abordaje cuantitativo en residentes de un pequeño municipio cubierto por un Equipo de Salud Bucal. Se utilizó un cuestionario de caracterización individual que abordaba la identificación socioeconómica y el comportamiento relacionado conla salud bucodental. Resultados:La muestra total fue de 283 individuos con una edad media de 34 años. En el análisis de la DMFT, la media de dientes ausentes (5,44) fue superior a la de dientes obturados (4,31) y cariados (1,34). La incidencia de un DMFTsuperior a 11 fue significativamente mayor en los individuos de más de 34 años (valor p 0,000) y en los que necesitaban un tratamiento dental. Conclusiones:Hubo un mayor número medio de dientes ausentes, seguido de dientes obturados, y un menor número medio de dientes cariados. El resultado del DMFT se asoció positivamente con la edad y la necesidad de prótesis dentales (AU).

Infección por Helicobacter pylori y factores asociados en adultos de la sierra norte del Perú / Helicobacter pylori infection and associated factors in adults from the northern highlands of Peru

INTRODUCCIÓN: Helicobacter pylori afecta a más de 50% de la población mundial, siendo más prevalente en poblaciones de nivel socioeconómico bajo; esta bacteria constituye la principal causa de cáncer gástrico a nivel global. OBJETIVO: Determinar la frecuencia y los factores asociados a la infección por H. pylori en personas adultas que viven en el centro histórico de la ciudad de Cajamarca, en el norte del Perú. MATERIAL Y MÉTODO: Estudio descriptivo que incluyó 124 personas encuestadas mediante un cuestionario y evaluadas mediante endoscopía y cultivo de biopsia gástrica. Una biopsia por persona fue sometida a prueba de ureasa y los cultivos se confirmaron por reacción de polimerasa en cadena (RPC). RESULTADOS: La frecuencia de infección fue de 60,5 % (IC 95% 51,3 - 69,2). El análisis univariado demostró asociación significativa entre la infección y la edad (p = 0,002), y entre la infección y el antecedente de patología gástrica (p = 0,015). El análisis multivariado reveló dos factores asociados: edad (OR = 0,94; IC95% 0,90-0,97) y antecedente de infección por H. pylori (OR = 0,23; IC95% 0,08 - 0,67). CONCLUSIONES: Existe alta frecuencia de infección por H. pylori en esta población; la edad y el antecedente de infección constituyen factores asociados que deben evaluarse con mayor profundidad.

BACKGROUND: Helicobacter pylori affects more than 50% of the world's population, being more prevalent in populations of low socioeconomic status. H. pylori is the main cause of gastric cancer globally. AIM: To establish the frequency and factors associated with H. pylori infection in adults living in the historic center of Cajamarca City, in northern Peru. METHODS: This was a descriptive study that included 124 individuals surveyed through a questionnaire and evaluated through endoscopy and gastric biopsy culture. One biopsy per person underwent the urease test, and the cultures were confirmed by PCR. RESULTS: The frequency of infection was 60.5% (95% CI 51.3 - 69.2). In the univariate analysis, there was a significant association between the infection and age (p = 0.002), and between the infection and a history of gastric pathology (p = 0.015). The multivariate analysis revealed two associated factors: age (OR = 0.94; 95% CI 0.90 - 0.97), and history of H. pylori infection (OR = 0.23; 95% CI 0.08 - 0.67). CONCLUSIONS: There is a high frequency of H. pylori infection in this population, and the age and history of H. pylori infection are factors that should be further evaluated.

Respuesta inmunitaria al SARS-CoV-2 previa a la vacunación en personal de salud de Alto Paraná, Paraguay, un estudio seroepidemiológico / Immune response to SARS-CoV-2 prior to vaccination among healthcare workers from Alto Paraná, Paraguay, a seroepidemiological study

INTRODUCCIÓN: La comprensión del comportamiento de la respuesta humoral en COVID-19 continúa siendo un desafío para la producción de vacunas que proporcionen inmunidad más duradera. OBJETIVO: Describir la respuesta humoral natural inducida por SARS- CoV-2 en personal de salud con base en el perfil epidemiológico y clínico. MATERIALES Y MÉTODOS: Estudio transversal en personal de salud de hospitales públicos de referencia del Departamento de Alto Paraná, Paraguay. Se incluyeron 962 participantes, mediante muestreo no probabilístico de tipo consecutivo, aplicación de cuestionario y toma de muestras sanguíneas. Se buscaron anticuerpos por ensayo inmunocromatográfico para detección de IgM e IgG contra SARS- CoV-2 y por el método ELISA de captura de IgG específicos contra la proteína spike (SARS-CoV-2) y se evaluaron factores asociados a la seropositividad. RESULTADOS: La seroprevalencia global fue 36,5% (IC 95%: 33,4 - 39,5); 59,3% (n: 571) de los encuestados refirió haber tenido síntomas compatibles al COVID-19 entre el inicio de la pandemia y la fecha de toma de muestra, de estos 44% (n: 251) resultó seropositivo; 10,4% (n: 100) manifestó no haber tenido síntomas en el periodo estudiado, pero tuvo un resultado positivo. Los factores asociados a la seropositividad fueron: presencia de síntomas (p 90 días). CONCLUSIONES: Las características clínicas fueron mayormente asociadas con la seropositividad y la seropreva- lencia en los sintomáticos varió de acuerdo con el tiempo transcurrido desde el inicio de los síntomas y la serología.

BACKGROUND: Understanding the behavior of humoral response in COVID-19 continues to be a challenge to produce vaccines that provide long-lasting immunity. AIM: To describe the natural humoral response induced by SARS-CoV-2 among healthcare workers based on epidemiological and clinical profiles. METHODS: Cross-sectional study in healthcare workers from public hospitals in the Department of Alto Paraná, Paraguay, 962 participants were recruited through consecutive sampling, using a questionnaire and blood sampling. Antibodies were determined by immunochromatography assay for detection of IgM and IgG and by SARS-CoV-2 IgG anti-spike capture ELISA method and factors associated with seropositivity were evaluated. RESULTS: The overall seropositivity was 36.5% (95% CI: 33.4 - 39.5); 59.3% (n: 571) of respondents reported symptoms compatible with COVID-19 since the start of the pandemic and the date of blood draw, 44% (n: 251) of them tested positive; 10.4% (n: 100) who reported no history of symptoms tested positive. The factors associated with seropositivity were the presence of symptoms (p 90 days). CONCLUSIONS: Clinical characteristics were mostly associated with seropositivity and sero prevalence in symptomatic participants varied according to the time elapsed from the onset of symptoms to serology.

Vancomicina contra metronidazol en infección por Clostridioides difficile leve-moderada de manejo ambulatorio / Vancomycin or metronidazole in the outpatient treatment of mild-moderate Clostridioides difficile infection

INTRODUCCIÓN: En la diarrea asociada a Clostridioides dfficile (DACD) leve-moderada se recomienda tratar con vancomicina por sobre metronidazol, a pesar de su difícil acceso y poca evidencia en el medio ambulatorio. OBJETIVO: Comparar la tasa de cura clínica y recurrencia entre vancomicina y metronidazol en adultos chilenos con primer episodio leve-moderado de DACD de manejo ambulatorio. MÉTODOS: Cohorte retrospectiva entre enero 2015 y diciembre 2020 en centros de una red de salud universitaria de pacientes de ≥ 18 años con DACD tratados ambulatoriamente. RESULTADOS: Se obtuvieron 161 pacientes, 59% mujeres, edad promedio de 53 años (entre 18 y 94 años). De ellos, 109 (67,7%) usaron metronidazol y 52 (32,3%) vancomicina. En el análisis multivariado ajustado por edad y comorbilidades se obtuvo un OR 3,00 (IC 95% 1,12-9,59) para cura clínica y 0,27 (IC 95% 0,06-0,88) para recurrencia a ocho semanas, ambos a favor de vancomicina, sin diferencias en recurrencia a 12 meses, necesidad de hospitalización o mortalidad. CONCLUSIÓN: La terapia con vancomicina comparada contra metronidazol en el tratamiento ambulatorio de la infección leve-moderada por C. dfficile se asocia a mayor cura clínica y menor tasa de recurrencia a corto plazo, sin diferencias en desenlaces a largo plazo.

BACKGROUND: Recommended treatment against mild cases of Clostridioides difficile associated diarrhea is vancomycin despite the difficulties of access compared to metronidazole. AIM: To compare the effectiveness of vancomycin and metronidazole in Chilean adults with first mild-moderate episode of Clostridiodes difficile infection (CDI). METHODS: Retrospective cohort of patients with CDI between January 2015 and December 2020 treated in centers of a university health network. The patients were adults treated for C. difficile infection on an outpatient basis. Recurrent and severe cases were excluded. Outcomes included clinical cure and recurrence rate. RESULTS: Data from 161 patients was recovered. Fifty-nine percent were women and average age was 53 (18-94). One hundred and nine patients were treated with metronidazole (67.7%) and 52 (32.3%) used vancomycin. Multivariate analysis adjusted by age and comorbidities showed an Odds Ratio of 3.00 (IC 95% 1.12-9.59) for clinical cure and 0.27 (IC 95% 0.06-0.88) for 8-week recurrence rate, both in favor of vancomycin, without differences in 12-month recurrence rate, hospitalization rate nor mortality. CONCLUSIONS: Vancomycin is associated with better short-term outcomes in the treatment of outpatient mild-moderate first episode C. difficile infection, without differences in long term recurrence or mortality when compared with metronidazole.

The association between vancomycin trough concentrations and nephrotoxicity in the paediatric intensive care unit / A associação entre concentrações no vale de vancomicina e nefrotoxicidade em uma unidade de terapia intensiva pediátrica

Objective: To analyze and describe the pharmacokinetic aspects of vancomycin usage in a cohort of critically ill children and to construct a pharmacokinetic model for this population. Method: We conducted an observational study in a pediatric intensive care unit from September 2017 to March 2019. Children receiving vancomycin with at least one serum measurement were included. Variables with a p-value lower than 0.2 in univariate analysis, and biologically plausible for inducing nephrotoxicity and not correlated with other predictors, were incorporated into logistic regression. Additionally, pharmacokinetic modeling was performed using the PMETRICS® package for patients with creatinine clearance (CLCR) > 30 mL/min. Result: The study included 70 children, with an average vancomycin dose of 60 mg/kg/day. Only eleven children achieved vancomycin levels within the target range (15-20 mg/L). No significant differences in doses/mg/kg/day were observed among children above, within, or below the vancomycin target range. In the multivariate model, children above the recommended serum range had an odds ratio of 4.6 [95% CI 1.4 ­ 17.2] for nephrotoxicity. A pharmacokinetic model was proposed using data from 15 children, estimating PK parameters for CLCR and V as 0.94 L/h and 5.71 L, respectively. Conclusion: Nephrotoxicity was associated with vancomycin plasma concentrations equal to or exceeding 15 mg/L. The developed model enhanced understanding of the drug's behavior within this population, potentially aiding clinical practice in dose calculations and estimation of the area under the curve ­ a recommended parameter for vancomycin monitoring.

Objetivo: Analisar e descrever os aspectos farmacocinéticos do uso de vancomicina em uma coorte de crianças sob cuidados intensivos e elaborar um modelo farmacocinético para essa população. Método: Estudo observacional em uma unidade de terapia intensiva pediátrica conduzido entre setembro de 2017 a março de 2019. Inclui-se crianças em uso de vancomicina com pelo menos uma mensuração sérica desse antimicrobiano. As variáveis com valor de p < 0,2 na análise univariada e com plausibilidade biológica para propiciar nefrotoxicidade, não correlacionadas com outras preditoras, foram incluídas na regressão logística. Adicionalmente, uma modelagem farmacocinética foi realizada usando o programa PMETRICS® para pacientes com clearance de creatinina (CLCR) > 30 mL/min. Resultado: Foram incluídas 70 crianças no estudo. A dose média de vancomicina foi de 60 mg/kg/dia. Apenas onze crianças apresentaram vancocinemia dentro da faixa alvo (15-20 mg/L). Não foram observadas diferenças significativas entre as doses administradas e a observação de vancocinemia acima, dentro ou abaixo da faixa preconizada. No modelo multivariado, crianças acima da faixa sérica preconizada apresentaram odd ratio de 4,6 [IC 95% 1,4 ­ 17,2] para nefrotoxicidade. Um modelo farmacocinético com os dados de 15 crianças foi proposto, no qual os parâmetros de PK estimados para CLCR e Volume de distribuição foram de 0,94 L/h e 5,71 L, respectivamente. Conclusão: A nefrotoxicidade mostrou-se associada às concentrações plasmáticas de vancomicina iguais ou maiores a 15 mg/L. O modelo desenvolvido permitiu entender o comportamento do fármaco nessa população e pode ser útil na prática clínica para o monitoramento do uso de vancomicina.

Avaliação do protocolo de biossegurança na pandemia em uma clínica odontológica de ensino na perspectiva do paciente / Evaluación del protocolo de bioseguridad en la pandemia en una clínica de enseñanza odontológica desde la perspectiva del paciente / Evaluation of the pandemic biosafety protocol in a dental clinic from the patient's perspective

This study aimed to assess whether patients feel safe or anxious when receiving dental care at a teaching clinic; the study was carried out from the perspective of patients, given the biosafety protocol during the 2019 Coronavirus (COVID-19) pandemic. Thiscross-sectional study was carried out with 217 patients assisted by students in the Dental Clinic of the Pontifícia Universidade Católica do Paraná. A semi-structured questionnaire was used to collect sociodemographic data, humanization and the safety protocols followed during care. Multivariate analysis was performed using Poisson regression (PR), and p values ≤0.05 were understood. Around 90% of patients reported that students were attentive, communicative, welcoming and confident during treatment about the risk of contracting COVID-19 during care. Patients who showed anxiety during treatment were 32.2%. Some patients were unable to keep their distance in the waiting room (PR 3.439) and did not feel safe during the appointment (PR 2.64) had a higher prevalence of anxiety during dental care. Anxiety about care was associated with the individual's color or ethnicity, ability to maintain social distancing in the waiting room, and feeling safe when receiving care (AU).

El objetivo de este estudio fue evaluar si los pacientes se sienten seguros o ansiosos al recibir atención odontológica en una clínica docente; el estudio se realizó desde la perspectiva de los pacientes, teniendo en cuenta el protocolo de bioseguridad durante la pandemia del Coronavirus 2019 (COVID-19). Se trata de un estudio transversal realizado con 217 pacientes atendidos por estudiantes de la Clínica Odontológica de la Pontificia Universidad Católica de Paraná. Se utilizó un cuestionario semiestructurado para recolectar datos sociodemográficos, humanización y protocolos de seguridad seguidos durante la atención. El análisis multivariado se realizó mediante regresión de Poisson (RP), con valores de p ≤0,05. Alrededor del 90% de los pacientes informaron que los estudiantes se mostraron atentos, comunicativos, acogedores y confiados durante el tratamiento sobre el riesgo de contraer COVID-19 durante el tratamiento. Los pacientes que demostraron ansiedad durante el tratamiento fueron el 32,2%. Algunos pacientes no pudieron mantener la distancia en la sala de espera (RP 3.439) y no se sintieron seguros durante la consulta (RP 2.64) y tuvieron mayor prevalencia de ansiedad durante la atención odontológica. La ansiedad con respecto a la atención se asoció con elcolor o el origen étnico del individuo, la capacidad de mantener el distanciamiento social en la sala de espera y sentirse seguro al recibir atención (AU).

O objetivo deste estudo foi avaliar se os pacientes se sentem seguros ou ansiosos ao receber atendimento odontológico em uma clínica-escola; o estudo foi realizado sob a perspectiva dos pacientes, tendo em vista o protocolo de biossegurança durante a pandemia do Coronavírus 2019 (COVID-19). Trata-se de um estudo transversal realizado com 217 pacientes atendidos por estudantes da Clínica Odontológica da Pontifícia Universidade Católica do Paraná. Foi utilizado questionário semiestruturado para coletar dados sociodemográficos, sobre humanização e protocolos de segurança seguidos durante o atendimento. A análise multivariada foi realizada por meio de regressão de Poisson (RP), sendo compreendidos valores de p ≤0,05. Cerca de 90% dos pacientes relataram que os estudantes se mostraram atentos, comunicativos, acolhedores e confiantes durante o tratamento sobre o risco de contrair a COVID-19 durante o atendimento. Os pacientes que demonstraram ansiedade durante o tratamento foram 32,2%. Alguns pacientes não conseguiram manter distância na sala de espera (RP 3,439) e não se sentiram seguros durante a consulta (RP 2,64) tiveram maior prevalência de ansiedade durante o atendimento odontológico. A ansiedade em relação ao atendimento esteve associada à cor ou etnia do indivíduo, capacidade de manter distanciamento social na sala de espera e sentir-se seguro ao receber atendimento (AU).

Identification of cancer inhibitors from Hystrix brachyura bezoar extracts using LC - MS multivariate data analysis and in silico evaluation on Bcl - 2, cyclin B/CDK1, VEGF and NM23 - H1 / Identificación de inhibidores de cáncer a partir de extractos de bezoar de Hystrix branchyura usando análisis multivariado LC - MS y evaluación in silico en Bcl - 2, cyclin B/CDK1, VEGF, y NM23 - H1

Hystrix brach yura bezoar is calcified undigested material found in the gastrointestinal tract known for various medicinal benefits including as an anticancer agent. However, the H. brachyura population has been declining due to its demand and is under Malaysian law pro tection. Therefore, present study aimed to identify bezoar anticancer active compounds through metabolomics and in - silico approaches. Five replicates of bezoar powder were subjected to extraction using different solvent ratios of methanol - water (100, 75, 5 0, 25, 0% v/v). Cytotoxicity and metabolite profiling using liquid chromatography - mass spectrometry were conducted. Putative compounds identified were subjected to in - silico analysis with targeted anticancer proteins namely, Bcl - 2, Cyclin B/CDK1 complex, V EGF and NM23 - H1. The correlation of LC - MS and cytotoxicity profile pinpointed two compounds, mangiferin and propafenone. In - silico study showed both compounds exerted good binding scores to all proteins with hydrophobic interaction dominating the ligand - pr otein complex binding, suggesting the ligands act as hydrophobes in the interactions.

El bezpar de Hystrix branchyura es material calcificado sin digerir encontr ados en el tracto gastrointestinal, conocido por sus variados beneficios médicos, incluyendo propiedades anticancerosas. De todas formas, la población de H. Branchyura ha ido declinando debido a su demanda y está bajo la protección de la ley de Malasia. Po r esto, este estudio busca identificar los componentes activos anticancerosos del bezoar mediante abordajes metabolómico e in silico. Cinco réplicas de polvo de bezoar fueron sometidos a extracción usando solventes con diferentes proporciones metanol - agua (100, 75, 50, 25, 0% v/v). Se hicieron perfiles de citotoxicidad y de metabolitos usando cromatografía líquida - espectrometría de masa ( LC - MS ). Se identificaron compuestos putativos yse sometieron a a nálisis in silico, buscando las proteínas anticancerosas B cl - 2, complejo Cyclin B/CDK1, VEGF, y NM23 - H1. La correlación LC - MS y el perfil de citotoxicidad identificaron dos compuestos: mangiferina y propafenona. El estudio in silico mostró que ambos compuestos tenían buenos índices de enlace con todas las proteín as con interacción hidrofóbica dominando el enlace complejo proteína - ligando, sugeriendo que los ligandos actúan como hidrófobos en las interacciones

Análise da relação entre medo da covid-19, ansiedade e depressão / Análisis de la relación entre el miedo a covid-19, la ansiedad y la depresión / Analysis of the Relationship Between Fear of covid-19, Anxiety and Depression

A pandemia da covid-19 causou múltiplas circunstâncias estressoras com potencial de ameaça à saúde mental. O medo está entre as respostas psicológicas mais fre-quentemente manifestadas durante uma crise em saúde e pode aumentar o risco de quadros psicopatológicos, como ansiedade e depressão. O presente estudo avaliou o efeito do medo da covid-19 sobre sintomas depressi-vos e ansiosos, considerando a influência de variáveis confundidoras ­ sexo, nível de escolaridade, cor da pele, raça ou etnia, idade e conhecer alguém que morreu por causa do novo coronavírus. Para tanto, foi realiza-da análise multivariada de covariância (mancova). A amostra foi composta de 4.641 adultos, de ambos os sexos, com idade média de 30,3 anos (DP = 10,57). Observou-se que o medo da covid-19 apresentou impac-to significativo nos sintomas de ansiedade e depressão, sendo identificado que esse efeito permanece mesmo quando controladas as variáveis sociodemográficas e de proximidade com o vírus. Análises com esse fim colaboram para a identificação dos fatores que levam a desfechos psicológicos negativos, o que representa pas-so importante para o desenvolvimento de intervenções específicas e com maiores possibilidades de sucesso

La pandemia de covid-19 causó múltiples circunstancias estresantes con potencial de amenaza para la salud mental. El miedo está entre las respuestas psicológicas más manifestadas de forma frecuente durante la crisis sanitaria y puede aumentar el riesgo de cuadros psicopatológicos, como ansiedad y depresión. El presente estudio evaluó el efecto del miedo al covid-19 sobre los síntomas depresivos y ansiosos, considerando la influencia de variables confusoras: sexo, nivel educativo, color de piel, raza o etnia, edad y conocer a alguien que murió a causa del nuevo coronavirus. Para ello, se realizó un análisis multivariado de covarianza (mancova). La muestra estuvo compuesta por 4.641 adultos, de ambos sexos, con una edad promedio de 30,3 años (DE = 10,57). Se observó que el miedo al covid-19 tuvo un impacto significativo en los síntomas de ansiedad y depresión, identificándose que este efecto permanece incluso cuando se controlan las variables sociodemográficas y de proximidad con el virus. El análisis con este objetivo colabora en la identificación de los factores que llevan a desenlaces psicológicos negativos, lo que representa un paso importante para el desarrollo de intervenciones específicas y con mayores posibilidades de éxito.

The covid-19 pandemic has caused multiple stressful circumstances with the potential to threaten mental health. Fear is among the most frequently manifested psychological responses during a health crisis and can increase the risk of psychopathological condi-tions such as anxiety and depression. This study evaluated the effect of fear of covid-19 on depressive and anxious symptoms, considering the influence of confounding variables­sex, education level, skin color, race or ethnicity, age, and knowing someone who died due to the novel coronavirus. To this end, a multivariate analysis of covariance (mancova) was conducted. The sample consisted of 4.641 adults of both sexes, with a mean age of 30,3 years (SD = 10,57). It was observed that fear of covid-19 had a sig-nificant impact on anxiety and depression symptoms, with this effect remaining even when controlling for sociodemographic variables and proximity to the virus. Analyses with this aim contribute to the identification of factors leading to negative psycho-logical outcomes, representing an important step towards the development of specific interventions with greater chances of success

Aspectos que influenciam a contagem bacteriana total e a contagem de células somáticas do leite de propriedades rurais do interior do estado de São Paulo, Brasil / Aspects that influence milk total bacterial count and somatic cell count from farms in interior of São Paulo State, Brazil / Aspectos que influyen el contaje bacteriano total y el contaje de células somáticas de la leche de propiedades rurales del interior del estado de São Paulo, Brasil

Este estudo objetivou avaliar aspectos que exercem influência sobre a contagem bacteriana total (CBT) e a contagem de células somáticas (CCS) do leite e avaliar a adequação das amostras do produto à Instrução Normativa nº 76, de 26 de novembro de 2018, do Ministério da Agricultura e Pecuária do Brasil (IN 76). A pesquisa foi realizada em propriedades rurais da microrregião de Birigui, São Paulo, Brasil, e se baseou em coleta de dados, por entrevista estruturada, e coletas de leite nas propriedades. Foi realizada amostragem por conveniência, sendo escolhidos 15 produtores de cada estrato (de acordo com a produção diária de leite: pequeno - até 100 L; médio - 101 a 300 L; grande - mais de 300 L), totalizando 45 produtores de leite. Participaram da pesquisa somente propriedades com base da alimentação volumosa em sistema de pastejo ou em semiconfinamento. Para avaliar a influência de diferentes fatores sobre a contagem bacteriana total (CBT) e a contagem de células somáticas (CCS), separadamente, realizou-se regressão multivariada. Ainda, foi determinado o coeficiente de correlação entre variáveis desta pesquisa. As variáveis resposta foram transformadas em logaritmo para normalização dos dados. Foi feita comparação entre os resultados da pesquisa e os parâmetros da IN 76 para verificar o cumprimento das normas pelos produtores. Foram encontrados valores médios de 6.986.977,818.961.790,7 UFC/mL para CBT e de 608.911,1 ± 414.802,9 CS/mL para CCS. A utilização de tanque de resfriamento individual mostrou-se favorável à baixa CBT, em comparação com não uso de tanque ou uso de tanque comunitário, conforme o esperado, pois quanto mais tempo leva para resfriar o leite, maior é a proliferação de bactérias no produto. Foi verificado que o leite de produtores que realizam o California Mastitis Test (CMT) com maior frequência apresentou CCS mais elevada, o que não era esperado. As análises físico-químicas médias foram densidade 1,031 g/mL a 15°C, índice crioscópico -0,538 °H, teor de proteína 3,58%, teor de gordura 4,06%, extrato seco total 12,75%, extrato seco desengordurado 8,69%, acidez titulável 16,2 °D e estabilidade ao álcool (Alizarol 72%) 100%. Em 13,3% (6/45) das amostras foi detectada presença de antibióticos. Considerando a IN 76, o leite de somente 8,9% (4/45) dos produtores apresentou-se adequado simultaneamente para todos os parâmetros analisados (CBT, CCS, densidade, índice crioscópico, proteína, gordura, extrato seco total, extrato seco desengordurado, acidez titulável, estabilidade ao alizarol e pesquisa de antibióticos). A utilização de tanque de resfriamento individual e a realização de CMT favoreceram menor CBT e maior CCS, respectivamente.

This study aimed to evaluate aspects that exerts influence on the total bacterial count (TBC) and somatic cell count (SCC) of milk and evaluate the conformity of the samples to the Normative Instruction no. 76, from November 26, 2018, of the Brazilian Agriculture and Livestock Ministry (NI 76). The research was done in farms around Birigui micro-region, São Paulo State, Brazil, and was based on data collection obtained by structured interviews and milk collection in the farms. Convenience sampling was carried out from 15 producers of each stratum (according to daily milk production: small - up to 100 L; medium - 101 to 300 L; large - more than 300 L), totalizing 45 milk producers. Only farms with grazing or semi-feedlot system for roughage feeding base were included. To evaluate the influence of different factors on Total Bacterial Count (TBC) and Somatic Cell Count (SCC), separately, a multivariate regression was done. Moreover, the correlation coefficient among variables was determined. The response variables were transformed into logarithms for the normalization of the data. A comparison between results and NI 76 parameters was done to verify the standard compliance by producers. Mean TBC was 6.986.977,8 ± 18.961.790,7 CFU/mL and mean SCC was 608.911,1414.802,9 cells/mL. The use of individual cooler tank was favorable to lower TBC, compared with the non-use of the tank or with the use of the communitarian tank, as expected, since the longer it takes to cool the milk, the higher the proliferation of bacteria in the product. It was verified that milk from farmers that more frequently perform California Mastitis Test (CMT) showed higher SCC, which was not expected. The average physicochemical analyzes were density 1.031 g/mL at 15°C, cryoscopic index -0.538 °H, protein content 3.58%, fat content 4.06%, total dry extract 12.75%, dry extract defatted 8.69%, titratable acidity 16.2 °D and alcohol stability (Alizarol 72%) 100%. The presence of antibiotics was detected in 13.3% (6/45) of the samples. Considering NI 76, milk from only 8.9% (4/45) farmers were proper simultaneously for all the parameters analyzed (TBC, SCC, density, cryoscopic index, protein, fat, total dry extract, defatted dry extract, titratable acidity, alizarol stability and antibiotics). The use of individual cooling tank and the CMT performance support lower TBC and higher SCC respectively.

Este estudio tuvo como objetivo evaluar los aspectos que influyen en el contaje bacteriano total (CBT) y el contaje de células somáticas (CCS) de la leche y evaluar la adecuación de las muestras del producto a la Instrucción Normativa nº 76, de 26 de noviembre de 2018, del Ministerio de Agricultura y Ganadería en Brasil (IN 76). La investigación se llevó a cabo en propiedades rurales en la microrregión de Birigui, São Paulo, Brasil, y se basó en la recolección de datos, a través de entrevistas estructuradas, y colectas de leche en las propiedades. Se realizó un muestreo por conveniencia, escogiendo 15 productores de cada estrato (de acuerdo con la producción diaria de leche: pequeño - hasta 100 L; medio - 101 hasta 300 L; grande ­ más de 300 L), totalizando 45 productores de leche. Participaron de la investigación únicamente propiedades basadas en alimentación voluminosa en sistema de pastoreo o, a lo sumo, en semiconfinamiento. Para evaluar la influencia de diferentes factores sobre el contaje bacteriano total (CBT) y el contaje de células somáticas (CCS), por separado, se realizó una regresión multivariada. Asimismo, se determinó el coeficiente de correlación entre las variables de esta investigación. Las variables de respuesta se transformaron en logaritmos para la normalización de datos. Se realizó una comparación entre los resultados de la investigación y los parámetros de la IN 76 para verificar el cumplimiento de las normas por parte de los productores. Se encontraron valores medios de 6.986.977,818.961.790,7 UFC/mL para CBT y de 608.911,1 +414.802,9 CS/mL para CCS. El uso de un tanque de enfriamiento individual se ha mostrado favorable a la baja CBT, en comparación con no usar un tanque o usar un tanque comunitario, conforme lo esperado, ya que cuanto más se tarda en enfriar la leche, mayor es la proliferación de bacterias en el producto. Se verificó que la leche de los productores que realizan el California Mastitis Test (CMT) con mayor frecuencia presentó CCS más alto, lo cual no se esperaba. Los análisis fisicoquímicos promedio fueron densidad 1,031 g/mL a 15°C, índice crioscópico -0,538 °H, contenido de proteína 3,58%, contenido de grasa 4,06%, extracto seco total 12,75%, extracto seco desgrasado 8,69%, acidez titulable 16,2°D y estabilidad del alcohol (Alizarol 72%) 100%. En el 13,3% (6/45) de las muestras se detectó la presencia de antibióticos. Considerando la IN 76, la leche de solo el 8,9% (4/45) de los productores se presentó adecuado simultáneamente para todos los parámetros analizados (CBT, CCS, densidad, índice crioscópico, proteína, grasa, extracto seco total, extracto seco desgrasado, acidez titulable, estabilidad al alizarol e investigación de antibióticos). El uso de un tanque de enfriamiento individual y la realización de CMT favorecieron un CBT más bajo y un CCS más alto respectivamente.

Ansiedad, autoeficacia y percepción de riesgo en estudiantes de Odontología durante la pandemia del COVID-19 / Anxiety, Self-Efficacy, and Risk Perception in Dental Students During the COVID-19 Pandemic

Introducción: Las medidas de contención por el COVID-19 afectan el estilo de vida y las relaciones sociales y es razonable esperar efectos psicológicos por la idea de infectarse. En la práctica odontológica las reacciones psicológicas han sido diversas. Objetivo: Identificar la ansiedad y la percepción de riesgo por la pandemia del COVID-19, así como la autoeficacia de los estudiantes de la carrera de Odontología para tomar medidas preventivas. Métodos: Estudio transversal en alumnos de la Facultad de Odontología de una universidad pública al noreste de México en mayo del 2020 (n = 412). Se colectaron datos en línea sobre ansiedad, percepción de riesgo y autoeficacia en escala de Likert y el perfil sociodemográfico. Se utilizó la estadística descriptiva y el análisis multivariado de regresión logística binaria. Resultados: La media de edad fue 21,8 ± 2,8 años; el 72,1 por ciento era del sexo femenino. Veintidós de cada 100 estudiantes de Odontología reportaron haberse sentido con ansiedad por la pandemia del COVID-19 durante al menos ocho días de las últimas dos semanas; la percepción de riesgo (OR = 2,46, IC95 por ciento 1,75 - 3,48) y el ser mujer (OR = 2,23, IC95 por ciento 1,33 - 3,76) incrementaron las probabilidades de ansiedad. Mientras que la autoeficacia (OR = 0,71, IC95 por ciento 0,51 - 0,99) y el antecedente de capacitación en COVID-19 (RM = 0,63, IC95 por ciento 0,4 - 0,99) las disminuyeron. Conclusiones: La alta percepción de riesgo y ser del sexo femenino se asocia con un aumento significativo de la ansiedad ante el COVID-19(AU)

Introduction: Containment measures by COVID-19 affect lifestyle and social relationships and it is reasonable to expect psychological effects from the thought of becoming infected. In dental practice, psychological reactions have been diverse. Objective: To identify anxiety and risk perception due to the COVID-19 pandemic, as well as the self-efficacy of dental students to take preventive measures. Methods: Cross-sectional study in students of the School of Dentistry of a public university in northeastern Mexico in May 2020 (n = 412). Online data were collected on anxiety, risk perception and self-efficacy on Likert scale and sociodemographic profile. Descriptive statistics and binary logistic regression multivariate analysis were used. Results: Mean age was 21.8 ± 2.8 years; 72.1 percent were female. Twenty-two out of 100 dental students reported feeling anxious about the COVID-19 pandemic for at least eight days in the last two weeks; risk perception (OR = 2.46, 95 percentCI 1.75 - 3.48) and being female (OR = 2.23, 95 percentCI 1.33-3.76) increased the odds of anxiety. While self-efficacy (OR = 0.71, CI95 percent 0.51 - 0.99) and history of COVID-19 training (OR = 0.63, CI95 percent 0.4-0.99) decreased them. Conclusions: High risk perception and being of the female sex are associated with a significant increase in COVID-19 anxiety(AU)

Multivariate guard-bands and total risk assessment on multiparameter evaluations with correlated and uncorrelated measured values

Abstract The quality, efficacy, and safety of medicines are usually verified by analytical results. Measurement uncertainty is a critical aspect for the reliability of these analytical results. The pharmacopeial compendia usually adopt a simple acceptance rule that does not consider information from measurement uncertainty. In this work, we compared decision-making using simple acceptance and decision rules with the use of guard-band for multiparameter evaluation of ofloxacin ophthalmic solution and acyclovir topical cream. Ciprofloxacin ophthalmic solution and acyclovir topical cream samples were subject to pharmacopeial tests and assays. Multivariate guard-band widths were calculated by multiplying the standard uncertainty (u) by an appropriate multivariate coverage factor (k'). The multivariate coverage factor (k') was obtained by the Monte Carlo method. According to the simple acceptance rule, all the results obtained for ciprofloxacin ophthalmic solution and acyclovir topical cream are within the specification limits. However, the risk of false conformity decisions increases for ciprofloxacin tests. Decisions made using the simple acceptance rule and decision rules with the use of guard-band may differ. The simple acceptance rule may increase the risk of false conformity decisions when the measured value is close to the regulatory specification limits and/or when the measurement uncertainty value is inappropriately high. Nevertheless, the guard-band decision rule will always reduce the risk of false conformity decisions. Therefore, using information on measurement uncertainty in conformity assessment is highly recommended to ensure the proper efficacy, safety, and quality of medicines.

A Community Survey on Association of Sociodemographic Characteristics with Risk Perception and Awareness about Oral Cancer in Lagos, Nigeria

ABSTRACT Objective: To assess the level of oral cancer awareness and risk factors perception and the relationship between this awareness and the sociodemographic and behavioral characteristics. Material and Methods: This descriptive study was conducted among rural and urban residents in Lagos State, Nigeria. A multi-stage random sampling method was utilized. The sociodemographic and behavioral characteristics of respondents, as well as their knowledge about oral cancer risk factors, were assessed with a validated questionnaire. The bivariate association was done using an independent t-test and one-way ANOVA. Multivariate regression was used to determine the association between predictor variables and oral cancer knowledge scores. The statistical significance level is set at p<0.05. Results: 590 participants between 18 and 82 years (mean age 34.5 ±13.7) completed the survey. The prevalence of cigarette smoking was 25.7%, of which 16 (1.5%) were heavy smokers (20+ cigarettes per day). The prevalence of alcohol consumption was 66.1%, with 57 (9.7%) being heavy drinkers, consuming drinks for 5-7 days of the week. A high proportion of the respondents (>60%) exhibited gaps in their knowledge of oral cancer. Uneducated participants had lower oral cancer knowledge than those with >12 years of formal education (aOR = 5.347; 95% CI: 4.987-6.240). Participants who were smokers had lower oral cancer knowledge compared with non-smokers (aOR = 3.341; 95% CI: 2.147-4.783); Participants who consumed alcohol had more deficient oral cancer knowledge compared with non-drinkers (aOR = 1.699; 95% CI: 1.087-2.655); While heavy smokers aOR = 4.023; 95% CI: 3.615-4.825) and heavy drinkers aOR = 4.331; 95% CI: 3.158-5.939) had lower oral cancer knowledge compared with those who did not abuse both substances. Conclusion: A high proportion of the respondents exhibited gaps in their knowledge of oral cancer in their responses. Delayed diagnosis of oral cancer can be reduced by increasing the awareness and knowledge of the populace about risk factors and also in the recognition of its signs and symptoms.

Impact of Molar Incisor Hypomineralization on Oral Health-Related Quality of Life in Brazilian Schoolchildren Aged 8 to 10 Years

ABSTRACT Objective: To assess the impact of Molar Incisor Hypomineralization (MIH) and confounding factors on oral health-related quality of life (OHRQoL) according to the perception of 8 to 10-year-old children and their parents/caregivers. Material and Methods: A cross-sectional study including 403 students aged 8-10 years was carried out, in which OHRQoL was measured using the Child Perceptions Questionnaire administered to both children and parents/caregivers. The diagnosis of MIH was performed according to the previously proposed index. Dental caries experience, malocclusion, and sociodemographic factors were evaluated as confounders. Cluster analysis and Poisson regression with robust variance (p<0.05) were performed. Results: The prevalence of MIH was 13.4%. Parents/caregivers of children with MIH in incisors showed a higher impact prevalence in the emotional well-being domain (PR=1.92; 95%CI=1.16-3.19). Children with hypoplasia had a higher prevalence of negative impact on OHRQoL in the oral symptoms domain (PR=1.51; 95%CI=1.03-2.23). According to the perception of parents/caregivers, dental caries experience had a negative impact on the quality of life of students in the emotional well-being domain (PR=4.19; 95%CI=1.06-16.49) and in the total questionnaire score (PR=3.21; 95%CI=1.06-9.71). Conclusion: According to the perception of parents/caregivers, children with MIH in incisors showed a greater impact on OHRQoL. Additionally, the presence of hypoplasia affected the self-perception of OHRQoL in children, and caries experience influenced the OHRQoL of children, as perceived by parents/caregivers.

Manifestaciones clínicas y factores asociados a mortalidad por COVID-19 en receptores de trasplante renal en un centro colombiano / Clinical manifestations and factors associated with mortality from COVID-19 in kidney transplant recipients in a Colombian center

Objetivo: Los pacientes receptores de trasplante renal (TxR) tienen alta carga de comorbilidades y un riesgo aumentado de muerte por COVID-19. Nuestro objetivo es describir las manifestaciones y los desenlaces clínicos en un grupo de receptores de TxR con enfermedad por coronavirus 2019 (COVID-19) y definir factores asociados a mortalidad. Métodos: Estudio de corte transversal que incluyó la revisión retrospectiva de registros clínicos de pacientes receptores de TxR y diagnóstico de COVID-19 entre marzo de 2020 y febrero de 2022 en un centro de alta complejidad en Bogotá (Colombia). Se ejecutó un análisis bivariante y multivariante para establecer asociaciones entre las variables de interés y el desenlace en mortalidad. Resultados: Se incluyeron un total de 94 casos. El 71,28% tenía un TxR, principalmente de donante cadavérico. Las manifestaciones clínicas incluyeron la tos en el 79,7%, fiebre en el 50% y disnea en el 42,55% de los casos. La tasa de mortalidad global fue del 18,09%. En el 54,9% se realizó un ajuste inmunosupresor, con interrupción completa del esquema hasta en el 74% de estos casos. Conclusiones: La tasa de mortalidad evidenciada en receptores de TxR con COVID-19 es mayor que la descrita en la población general. La severidad de la COVID-19 en este grupo poblacional implica de forma frecuente la necesidad de ajustes a la terapia inmunosupresora. Los factores asociados a mortalidad fueron la disnea, la necesidad de intubación orotraqueal y de estancia en unidad de cuidados intensivos

Objective: Kidney transplant (KTx) recipients have a high burden of comorbidities and are at increased risk of death from coronavirus disease 2019 (COVID-19). Our objective is to describe the clinical manifestations and outcomes in a group of KTx recipients with COVID-19 and to define factors associated with mortality. Methods: Cross-sectional study that included the retrospective review of clinical records of KTx recipients diagnosed with COVID-19 between March 2020 and February 2022 in a transplant center in Bogotá (Colombia). A bivariate and multivariate analysis was performed to establish associations between the variables of interest and the primary outcome (mortality). Results: Ninety-four cases were included. 71.28% had a KTx, mainly from a cadaveric donor. Clinical manifestations included cough in 79.7%, fever in 50%, and dyspnea in 42.55% of cases. The overall mortality rate was 18.09%. In 54.9% an immunosuppressive adjustment was made, with complete interruption of the scheme in up to 74% of these cases. Conclusions: The mortality rate evidenced in KTx recipients with COVID-19 is higher than in general population. The severity of the COVID-19 in this group frequently requires adjustments to immunosuppressive therapy. The factors associated with mortality were dyspnea, the need for orotracheal intubation and intensive care unit sta

Salivary Changes, Systemic Conditions, and Medication Use in Independently-Living Aged: A Cross-Sectional Study

ABSTRACT Objective: To determine the unstimulated salivary flow, pH, and buffering capacity and their associations with systemic conditions and medication use in independently living aged. Material and Methods: This cross-sectional study included 72 participants with a minimum of 60 years recruited in Belo Horizonte, Brazil. A questionnaire was used to collect age, sex, presence of systemic diseases, and medications in continuous use. Salivary data collection was performed to determine unstimulated salivary flow, pH, and buffering capacity. Descriptive, bivariate, and multivariate analyses were performed (p<0.05). Results: Most of the sample had at least one systemic disease (81.9%) and used at least one medication (79.2%). Female participants (p=0.01), those with five or more systemic diseases (p<0.01), and hypertension (p=0.04) had reduced salivary flow. Participants with systemic diseases (p=0.02), taking any medication (p=0.04), in a polypharmacy regimen, and presenting hypertension (p=0.02) had more acidic salivary pH. Participants with diabetes had average salivary buffering capacity (p=0.02). In the adjusted multiple regression models, no explanatory variable was significantly associated with the salivary outcomes. Conclusion: Systemic alterations and medication use appear to be related to salivary changes in older adults. Integrative assessment of older adults is fundamental to identifying and controlling the factors that may modify their salivary characteristics.

Maternal Education Level as a Risk Factor for Early Childhood Caries / Maternal Education Level as a Risk Factor for Early Childhood Caries

ABSTRACT Objective: To determine the prevalence and risk factors associated with dental caries in Brazilian preschool children aged 2 to 5 years. Material and Methods: The following independent variables were evaluated: dental caries, dental trauma, and malocclusions. Data were analyzed using the Mann-Whitney test and Poisson regression (p<0.05). Results: The prevalence of dental caries in preschoolers was 55.1%. Child age, family income, maternal education, and tooth color alteration from trauma were significantly associated with dental caries (p<0.05). The final adjusted multivariate model showed a significant association between maternal education and dental caries; children of mothers with low education were 1.89 times more likely to have caries (PR: 1.89; 95%CI: 1.40-2.55) (p<0.01). Children with tooth color change from trauma were more likely to have dental caries (PR: 1.69; 95%CI: 1.22-2.34 (p=0.001). Conclusion: Child age, family income, maternal education, tooth discoloration and discoloration color are risk factors for the development of caries disease in children. Also, children of mothers with low educational levels have a higher chance of developing dental caries.

Maternal-fetal attachment and interrelated factors in pregnant women assisted in Primary Health Care / Apego materno-fetal y factores interrelacionados en gestantes atendidas en la Atención Primaria de Salud / Apego materno-fetal e fatores inter-relacionados em gestantes assistidas na Atenção Primária à Saúde

Objective: to analyze maternal-fetal attachment and interrelated factors in pregnant women assisted in Primary Health Care. Method: a cross-sectional, population-based, analytical epidemiological survey. A sample of 937 participants attended by Family Health Strategy teams was investigated. Maternal-fetal attachment (outcome), sociodemographic and clinical variables, social support, family functionality, depressive symptoms and perceived stress were assessed. Multivariate analysis was adopted using structural equation modeling. Results: maternal-fetal attachment had an average of 92.6 (SD=±15.3). The adjusted structural model showed that the following factors had a direct effect on the outcome: gestational weeks (β=0.29; p<0.001), household crowding (β=-0.07; p=0.027), depressive symptoms (β=-0.11; p=0.003), social support (β=0.08; p<0.001) and family functionality (β=0.19; p<0.001). Indirect effects of social support (β=-0.29; p<0.001) and family functionality (β=-0.20; p<0.001) were identified, mediated by depressive symptoms. Conclusion: a set of interrelationships was identified between maternal-fetal attachment, gestational weeks, household crowding, depressive symptoms, social support and family functionality. It is suggested that the Family Health Strategy offer prenatal care anchored in integrality and humanization, which promotes biopsychosocial well-being during pregnancy and healthy maternal-fetal attachment.

Objetivo: analizar el apego materno-fetal y los factores interrelacionados en gestantes atendidas en la Atención Primaria de Salud. Método: encuesta epidemiológica seccional, de base poblacional y analítica. Se investigó una muestra de 937 participantes atendidas por equipos de la Estrategia de Salud de la Familia. Se evaluaron apego materno-fetal (resultado), variables sociodemográficas y clínicas, apoyo social, funcionalidad familiar, síntomas depresivos y estrés percibido. Se adoptó un análisis multivariado mediante la modelización con ecuaciones estructurales. Resultados: el apego materno-fetal presentó una media de 92,6 (DE=±15,3). El modelo estructural ajustado evidenció que los siguientes factores ejercieron un efecto directo sobre el resultado: semanas gestacionales (β=0,29; p<0,001), aglomeración del domicilio (β=-0,07; p=0,027), síntomas depresivos (β=-0,11; p=0,003), apoyo social (β=0,08; p<0,001) y funcionalidad familiar (β=0,19; p<0,001). Se identificaron efectos indirectos del apoyo social (β=-0,29; p<0,001) y de la funcionalidad familiar (β=-0,20; p<0,001), mediados por los síntomas depresivos. Conclusión: se identificó un conjunto de interrelaciones entre apego materno-fetal, semanas gestacionales, aglomeración domiciliaria, síntomas depresivos, apoyo social y funcionalidad familiar. Se sugiere que la Estrategia de Salud de la Familia ofrezca una atención prenatal anclada en la integralidad y humanización, que propicie el bienestar biopsicosocial en el embarazo y un apego materno-fetal saludable.

Objetivo: analisar o apego materno-fetal e os fatores inter-relacionados em gestantes assistidas na Atenção Primária à Saúde. Método: inquérito epidemiológico seccional, de base populacional e analítico. Foi investigada a amostra de 937 participantes, assistidas por equipes da Estratégia Saúde da Família. Avaliaram-se apego materno-fetal (desfecho), variáveis sociodemográficas e clínicas, apoio social, funcionalidade familiar, sintomas depressivos e estresse percebido. Foi adotada análise multivariada por meio da modelagem com equações estruturais. Resultados: o apego materno-fetal apresentou média de 92,6 (DP=±15,3). O modelo estrutural ajustado evidenciou que os seguintes fatores exerceram efeito direto sobre o desfecho: semanas gestacionais (β=0,29; p<0,001), aglomeração do domicílio (β=-0,07; p=0,027), sintomas depressivos (β=-0,11; p=0,003), apoio social (β=0,08; p<0,001) e funcionalidade familiar (β=0,19; p<0,001). Foram identificados efeitos indiretos do apoio social (β=-0,29; p<0,001) e da funcionalidade familiar (β=-0,20; p<0,001), mediados pelos sintomas depressivos. Conclusão: identificou-se um conjunto de inter-relações entre apego materno-fetal, semanas gestacionais, aglomeração domiciliar, sintomas depressivos, apoio social e funcionalidade familiar. Sugere-se que a Estratégia Saúde da Família oferte uma atenção pré-natal ancorada na integralidade e humanização, que propicie o bem-estar biopsicossocial na gravidez e o apego materno-fetal saudável.

Adherencia terapéutica y factores relacionados a un grupo de pacientes sometidos a intervenciones de un proceso de rehabilitación / Therapeutic adherence and related factors in a group of patients undergoing interventions in a rehabilitation process

Introducción. La adherencia es parte importante de los programas de rehabilitación y constituye una medida indirecta del éxito de los mismos. Conocer la adherencia terapéutica y los factores relacionados a esta ofrece información valiosa para el diseño y la implementación de intervenciones que mejoren la adherencia misma y los resultados de los procesos de rehabilitación. Objetivo. Describir la adherencia terapéutica y los factores relacionados a esta en los pacientes admitidos al Proceso Interdisciplinario de Rehabilitación de la Clínica Universidad de La Sabana de Chía (Colombia). Métodos. Estudio observacional descriptivo. Los datos se recolectaron de forma consecutiva y por conveniencia de la población que asistió al Proceso Interdisciplinario de Rehabilitación entre enero de 2021 y marzo de 2023. Resultados. El estudio incluyó 352 participantes con una edad mediana de 24,5 años, quienes tuvieron una alta adherencia terapéutica (93,75%). El análisis multivariado mostró que para el grupo de adultos la variable relacionada con la adherencia fue la procedencia urbana (OR: 15,411, IC95%: 1,632-145,482; p=0,017) y para el de menores de edad mostró que la alternancia de múltiples cuidadores (OR: 0,035, IC95%: 0,003-0,415; p=0,008) o un cuidador definido que no participa en el tratamiento (OR: 0,008, IC95%: 0,0002-0,278; p=0,007) tenían asociación con la no adherencia. Conclusión. El estudio mostró alta adherencia, lo cual puede estar relacionado con las intervenciones realizadas a los cuidadores de manera temprana en el programa, así como con el grado de compromiso encontrado.

Objective. To describe therapeutic adherence and related factors in patients admitted to the Interdisciplinary Reha-bilitation Process of the Clínica Universidad de La Sabana in Chía (Colombia). Methods. Descriptive observational study. The data were collected consecutively and by convenience from the population who attended the Interdisciplinary Rehabilitation Process between January 2021 and March 2023. Results. The study included 352 participants with a median age of 24.5 years, who had high therapeutic adherence (93.75%). The multivariate analysis showed that for the group of adults, the variable related to adherence was urban origin (OR: 15.411, 95% CI: 1.632-145.482; p=0.017) and for the group of minors it showed that the alternation of multiple caregivers (OR: 0.035, 95% CI: 0.003-0.415; p=0.008) or a defined caregiver who does not participate in the treatment (OR: 0.008, 95% CI: 0.0002-0.278; p=0.007) were associated with non-adherence.Conclusion. The study showed high adherence, which may be related to the interventions carried out to the caregivers early in the program, as well as to the degree of commitment found.

Sex Determination in the Contemporary Chilean Population by Mandible Analysis in Panoramic Radiographies / Estimación Sexual de la Población Chilena Contemporánea Mediante Análisis de la Mandíbula en Radiografías Panorámicas

SUMMARY: Sex identification of a deceased human individual by means of the mandible is very important for forensic dentistry. The aim of the present study was to determine the sex of Chilean individuals by mandible analysis in panoramic radiographies. Linear and angular parameters of the mandible were analyzed from panoramic radiographies (PR). The study included PR of adult Chilean individuals, of both sexes, with optimum solution and contrast, and which allowed the angles and rami of the mandible to be viewed. Sex was determined by univariate and bivariate discriminant function analysis. The sample consisted of 594 PR of individuals aged between 18 and 84 years. The best sex predictor using univariate discriminant function analysis was the mandibular ramus height (MRH) (74.1 %), followed by the distance from the mental foramen - mandibular base (DMF-MB) (69.1 %) and the bicondylar breadth (BC) (66.7 %). The parameters that presented the lowest sex prediction were the angle of the mandible (AM) with 55.0 % and the distance between mental foramina (DMF) with 53.7 %. The best sex prediction was obtained by the step model of discriminant function analysis (80.2 %), including only three parameters: MRH, BC and DMF-MB. The parameters height of the mandibular ramus, bicondylar breadth and distance from the mental foramen - base of the mandible are good predictors of sex in Chilean individuals when used in conjunction; they are therefore indicated for sex determination in the contemporary Chilean population.

La identificación humana de un individuo fallecido a través de la mandíbula es muy relevante para la odontología forense. El objetivo de este estudio fue estimar el sexo de individuos Chilenos a través del análisis de la mandíbula, utilizando radiografías panorámicas. Fueron analizados parámetros lineales y angulares de la mandíbula, a través de radiografías panorámicas (RP). Se incluyeron RP de individuos chilenos adultos, ambos sexos, con solución y contraste óptimos, y que permitían la visualización de los ángulos y ramas de la mandíbula. Se realizó análisis por función discriminante univariada y bivariada para estimación del sexo. Fueron incluidas 594 RP de individuos entre 18 y 84 años. Para el análisis de función discriminante univariado, la altura de la rama mandibular (ARM) fue el parámetro más predictivo (74,1 %), seguido de la distancia foramen mentoniano - base de la mandíbula (DFM-BM) (69,1 %) y el ancho bicondilar (ABCo) (66,7 %). Los parámetros que presentaron menor predicción sexual fueron el ángulo de la mandíbula (AM) con un 55,0 % y la distancia inter-forámenes mentonianos (DIFM), con el 53.7 %. El análisis por pasos fue el modelo de análisis de función discriminante que presentó la mayor predicción sexual (79,5 %), en el cual fueron incluidos sólo tres parámetros: ARM, ABCo y DFM-BM. Los parámetros altura de la rama de la mandíbula, ancho bicondilar y distancia desde el foramen mentoniano hasta la base de la mandíbula son buenos predictores del sexo en individuos Chilenos cuando utilizados en conjunto y están indicados para estimar el sexo en la población chilena contemporánea.

Comprehensive Analysis of CLCA1 Expression, Immune Infiltration and Immune Checkpoints in Colon Adenocarcinoma / Análisis Completo de la Expresión de CLCA1, Infiltración Inmune y Puntos de Control Inmunológico en Colonadenocarcinoma

SUMMARY: Colon adenocarcinoma (COAD) is a prevalent disease worldwide, known for its high mortality and morbidity rates. Despite this, the extent of investigation concerning the correlation between COAD's CLCA1 expression and immune cell infiltration remains insufficient. This study seeks to examine the expression and prognosis of CLCA1 in COAD, along with its relationship to the tumor immune microenvironment. These findings will offer valuable insights for clinical practitioners and contribute to the existing knowledge in the field. In order to evaluate the prognostic significance of CLCA1 in individuals diagnosed with colorectal cancers, we conducted a comprehensive analysis using univariate and multivariate Cox regression models along with receiver operating characteristic curve (ROC) analysis. This study was performed on the patient data of COAD obtained from The Cancer Genome Atlas (TCGA) database. Nomograms were developed to anticipate CLCA1 prognostic influence. Furthermore, the CLCA1 association with tumor immune infiltration, immune checkpoints, immune checkpoint blockade (ICB) response, interaction network, and functional analysis of CLCA1-related genes was analyzed. We found that Colon adenocarcinoma tissues significantly had decreased CLCA1 expression compared to healthy tissues. Furthermore, the study revealed that the group with high expression of CLCA1 demonstrated a significantly higher overall survival rate (OS) as compared to the group with low expression. Multivariate and Univariate Cox regression analysis revealed the potential of CLCA1 as a standalone risk factor for COAD. These results were confirmed using nomograms and ROC curves. In addition, protein-protein interaction (PPI) network analysis and functional gene enrichment showed that CLCA1 may be associated with functional activities such as pancreatic secretion, estrogen signaling and cAMP signaling, as well as with specific immune cell infiltration. Therefor, as a new independent predictor and potential biomarker of COAD, CLCA1 plays a crucial role in the advancement of colon cancer.

El adenocarcinoma de colon (COAD) es una enfermedad prevalente a nivel mundial, conocida por sus altas tasas de mortalidad y morbilidad. Sin embargo, el alcance de la investigación sobre la correlación entre la expresión de CLCA1 de COAD y la infiltración de células inmunes sigue siendo insuficiente. Este estudio busca examinar la expresión y el pronóstico de CLCA1 en COAD, junto con su relación con el microambiente inmunológico del tumor. Estos hallazgos ofrecerán conocimientos valiosos para los profesionales clínicos y contribuirán al conocimiento existente en el campo. Para evaluar la importancia de pronóstico de CLCA1 en personas diagnosticadas con cáncer colorrectal, realizamos un análisis exhaustivo utilizando modelos de regresión de Cox univariados y multivariados junto con un análisis de la curva característica operativa del receptor (ROC). Este estudio se realizó con los datos de pacientes de COAD obtenidos de la base de datos The Cancer Genome Atlas (TCGA). Se desarrollaron nomogramas para anticipar la influencia pronóstica de CLCA1. Además, se analizó la asociación de CLCA1 con la infiltración inmunitaria tumoral, los puntos de control inmunitarios, la respuesta de bloqueo de los puntos de control inmunitarios (ICB), la red de interacción y el análisis funcional de genes relacionados con CLCA1. Descubrimos que los tejidos de adenocarcinoma de colon tenían una expresión significativamente menor de CLCA1 en comparación con los tejidos sanos. Además, el estudio reveló que el grupo con alta expresión de CLCA1 demostró una tasa de supervivencia general (SG) significativamente mayor en comparación con el grupo con baja expresión. El análisis de regresión de Cox multivariado y univariado reveló el potencial de CLCA1 como factor de riesgo independiente de COAD. Estos resultados se confirmaron mediante nomogramas y curvas ROC. Además, el análisis de la red de interacción proteína- proteína (PPI) y el enriquecimiento de genes funcionales mostraron que CLCA1 puede estar asociado con actividades funcionales como la secreción pancreática, la señalización de estrógenos y la señalización de AMPc, así como con la infiltración de células inmunes específicas. Por lo tanto, como nuevo predictor independiente y biomarcador potencial de COAD, CLCA1 desempeña un papel crucial en el avance del cáncer de colon.