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Acta bioeth ; 26(1): 91-100, mayo 2020. tab
Article in English | LILACS (Americas) | ID: biblio-1114602


PURPOSE: To estimate the influence of clinical and demographical information in the understanding of cataract surgery informed consent, identifying less understandable areas. To assess informed consent document concept. METHODS: Multiple-choice questionnaire was designed to collect information and to evaluate the understanding of cataract surgery and informed consent. An ordinary regression model was adjusted to express the effect of clinical and demographic variables to the questionnaire score. RESULTS: The study comprised 180 patients. Sex (female, p=0.404), non-ophthalmologist source of information (p=0.397), previous surgical history (p=0.571), not having a companion (p=0.396) nor the days since the signing of informed consent form (p=0.535) had no influence in the understanding of cataract surgery informed consent. Age (r=-0.083, p<0.001) and educational level (secondary studies r=1.845, p<0.001; tertiary studies r=4.289, p<0.001) showed statistical significance with greater strength of association educational level (OR secondary studies = 6.33, OR tertiary studies = 72.86) than age had (OR = 0.92). CONCLUSION: Patient's knowledge about cataract informed consent is influenced by age and educational level. The purpose and the risks, consequences of not performing surgery and postoperative indications are the least understood topics. Informed consent is seen as a forced legal obligation.

OBJETIVOS: estimar la influencia de la información clínica y demográfica en la comprensión del consentimiento informado de la cirugía de cataratas, identificando áreas menos comprensibles. Evaluar el concepto de "documento de consentimiento informad". MÉTODOS: el cuestionario de opción múltiple se diseñó para reunir información y evaluar la comprensión de la cirugía de cataratas y el consentimiento informado. Se ajustó un modelo de regresión ordinario para expresar el efecto de las variables clínicas y demográficas en la puntuación del cuestionario. RESULTADOS: El estudio abarcó 180 pacientes. Sexo (femenino, p = 0.404); fuente de información no oftalmológica (p = 0.397); historial quirúrgico previo (p = 0.571); no tener acompañante (p = 0.396), y los días desde la firma del formulario de consentimiento informado (p = 0,535), que no tuvo influencia en la comprensión del consentimiento informado en la cirugía de cataratas. La edad (r = -0.083, p <0.001) y el nivel educativo (estudios secundarios r = 1.845, p <0.001; estudios terciarios r = 4.289, p <0.001) mostraron significación estadística con una mayor fuerza del nivel educativo de asociación (OR estudios secundarios = 6.33, OR estudios terciarios = 72.86) que la edad (OR = 0.92). CONCLUSIÓN: El conocimiento del paciente sobre el consentimiento informado en cirugía de cataratas está influenciado por la edad y el nivel educativo. Los temas menos entendidos son el propósito y los riesgos, las consecuencias de no realizar la cirugía y las indicaciones postoperatorias. El consentimiento informado se considera una obligación legal forzada.

OBJETIVO: Estimar a influência de informações clínicas e demográficas na compreensão do consentimento informado para cirurgia de catarata, identificando áreas menos compreensíveis. Avaliar o conceito do documento de consentimento informado. MÉTODOS: Um questionário de múltipla escolha foi desenvolvido para coletar informações e avaliar a compreensão sobre cirurgia de catarata e de consentimento informado. Um modelo de regressão ordinária foi ajustado para expressar o efeito das variáveis clínicas e demográficas no escore do questionário. RESULTADOS: O estudo envolveu 180 pacientes. Sexo (feminino, p=0,404), fonte de informações não oftalmológica (p=0,397), história cirúrgica prévia (p=0,571), não ter um/a companheiro/a (p=0,396) nem os dias desde a assinatura do formulário de consentimento informado (p=0,535) tiveram influência na compreensão do consentimento informado para cirurgia de catarata. Idade (r=-0,083, p<0,001) e nível educacional (estudos secundários r=1,845, p<0,001; estudos terciários r=4,289, p<0,001) mostraram significância estatística, com maior força de associação para o nível educacional (OR estudos secundários = 6,33, OR estudos terciários = 72,86) que para a idade (OR = 0,92). CONCLUSÃO: O conhecimento do paciente sobre o consentimento informado para cirurgia de catarata é influenciado pela idade e nível educacional. O objetivo e os riscos, consequências, de não fazer a cirurgia e as indicações pós-operatórias são os tópicos menos compreensíveis. O consentimento informado é visto como uma obrigação legal compulsória.

Humans , Male , Female , Aged , Cataract Extraction/psychology , Health Knowledge, Attitudes, Practice , Cataract Extraction/ethics , Cross-Sectional Studies , Surveys and Questionnaires , Regression Analysis , Age Factors , Paternalism , Personal Autonomy , Educational Status , Informed Consent/psychology , Informed Consent/ethics , Jurisprudence
Int. j. morphol ; 37(4): 1286-1293, Dec. 2019. tab, graf
Article in English | LILACS (Americas) | ID: biblio-1040126


Profile and standards for the diagnostics of percent of body fat and muscles were defined on a sample of 1924 women from the Republic of Serbia, aged 18.0 to 69.9, where the body structure of subjects was measured by applying multichannel segmental bioimpedance. Total sample was divided into six age groups, for the purpose of the definition of standard with regards to age. When it comes to body fat percentage results have shown that the average value of the total sample was 28.51±9.26 %, and between the range of 23.81 and 39.94 % for age groups 18.0-19.9 yr and 60.0-69.9 yr, respectively. Regression analysis results have shown that the constant of body fat percentage increase by trend of 3.417 % per decade, and that 25.1 % of mutual variance trend was explained by the model, with prediction error of 4.55 %. With regards to the percentage of skeletal muscles in the body, the results have shown that the average value of the total sample was 39.30±5.25 %, and within the range of 42.25 to 32.58 % for age groups 18.0-19.9 yr and 60.0-69.9 yr, respectively. Regression analysis results have shown that the constant of the skeletal muscles decrease by tend of -2.016 % per decade and that the model explained 23.8 % of mutual variance trend with prediction error of 8.08 %.

El perfil y estándares para el diagnóstico del porcentaje de grasa corporal y masa muscular fueron definidos en una muestra de 1924 mujeres de la República de Serbia, con edades comprendidas entre 18,0 y 69,9 años, donde la composición corporal de los sujetos fue medida por bioimpedancia segmentaria multicanal. La muestra fue dividida en seis grupos, con el propósito de definir los estándares respecto a la edad. Respecto al porcentaje de grasa corporal los resultados han mostrado que el valor promedio de la muestra fue de 28,51±9,26 %, y entre los rangos de 23,81 y 39,94 para los grupos de edad de 18,0-19,9 años y 60,069,9 años, respectivamente. Los resultados del análisis de regresión mostraron que la constante del porcentaje de grasa corporal aumentó 3,417 % por década, y que un 25,1 % de la varianza fue explicada por el modelo, con un error de predicción de 4,55 %. Con respecto al porcentaje de masa muscular, los resultados han mostrado que el valor promedio de la muestra fue de 39,30±5,25 %, y entre los rangos de 42,24 y 32,58 para los grupos de edad de 18,0-19,9 años y 60,0-69,9 años, respectivamente. Los resultados del análisis de regresión han mostrado que la constante de masa muscular decreció -2,016 % por década y que el modelo explicó 23,8 % de la varianza con un error de predicción de 8,08 %.

Humans , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Body Composition , Adipose Tissue/anatomy & histology , Muscle, Skeletal/anatomy & histology , Reference Values , Cross-Sectional Studies , Surveys and Questionnaires , Regression Analysis , Analysis of Variance , Electric Impedance , Age Distribution , Serbia
Rev. Bras. Saúde Mater. Infant. (Online) ; 19(4): 797-805, Sept.-Dec. 2019. tab
Article in English | LILACS (Americas) | ID: biblio-1057123


Abstract Objectives: to investigate factors associated with the route of birth delivery in a hospital extending public and private healthcare services, in the Northeast region in the State of Rio Grande do Sul. Methods: a cross-sectional study with 676 postpartum women, conducted from January to May 2017. The data were collected from the hospital records and women were interviewed shortly after childbirth in the maternity. Data analysis was performed by associating the Pearson's chi-square and the Poisson regression tests with robust variance. Results: the prevalence of cesarean sections was 58.7%, that is, 41.7% in public health-care and 83.9% in private healthcare. The main reason for having a cesarean section was having had a previous one (PR=5.69; CI95%=3.64 - 8.90; p<0.001), followed by having source of childbirth financing (PR=1.54; CI95%=1.27 - 1.87; p<0.001), having source of prenatal care financing (PR=1.48; CI95%=1.22 - 1.79; p<0.001), the childbirth and prenatal care professional (PR=1.46; CI95%=1.28 - 1.66; p<0.001) and the prenatal care professional (PR=1.43; CI95%=1.07 - 1.90; p=0.016). Conclusions: the high cesarean section rates identified in this study were mainly associated with previous cesarean section. The findings suggest a change in the current childbirth care model in the city, characterized as highly medicalized, focused on the physician and on hospital care.

Resumo Objetivos: investigar os fatores associados à via de nascimento em um hospital de atendimento misto, público e privado, da região nordeste do Rio Grande do Sul. Métodos: estudo transversal com 676 puérperas realizado entre janeiro e maio de 2017. Os dados foram obtidos de registros hospitalares e entrevistas com as mulheres logo após o parto na maternidade. A análise dos dados foi realizada por intermédio do teste de associação do Qui-quadrado de Pearson e Regressão de Poisson com variância robusta. Resultados: a prevalência de cesariana foi de 58,7%, sendo 41,7% no setor público e 83,9%, no privado. Cesárea prévia foi o principal fator associado à realização de cesariana (RP=5,69; IC95%=3,64-8,90; p<0,001), seguido por fonte de financiamento do parto (RP=1,54; IC95%=1,27-1,87; p<0,001), fonte de financiamento do pré-natal (RP=1,48; IC95%=1,22-1,79; p<0,001), profissional do pré-natal e parto (RP=1,46; IC95%=1,28 - 1,66; p<0,001) e profissional do pré-natal (RP=1,43; IC95%=1,07-1,90; p=0,016). Conclusões: as elevadas taxas de cesariana identificadas neste estudo foram associadas principalmente à realização de cesárea prévia. Os achados indicam a necessidade de mudança no modelo de assistência ao parto no município, o qual é altamente medicalizado, centrado no profissional médico e na atenção hospitalar.

Humans , Female , Pregnancy , Cesarean Section/statistics & numerical data , Maternal-Child Health Services , Healthcare Financing , Midwifery/statistics & numerical data , Brazil , Chi-Square Distribution , Hospital Records , Cross-Sectional Studies , Regression Analysis , Hospitals, Private , Hospitals, Maternity , Hospitals, Public
Arch. Clin. Psychiatry (Impr.) ; 46(5): 125-131, Sept.-Oct. 2019. tab, graf
Article in English | LILACS (Americas) | ID: biblio-1054907


Abstract Background Optical coherence tomography (OCT) has been recently used to investigate neuropsychiatric disorders. Objective The aim of this study was to compare the retinal nerve fiber layer thickness (RNFLT) and the ganglion cell layer (GCL) volume in patients with type 1 bipolar disorder (BPD1, diagnosed according to DSM 5) to the values in healthy controls. Methods Eighty consecutive outpatients with a diagnosis of euthymic BPD1 and 80 healthy controls were enrolled in the study. Following assessment with the Sociodemographic Data Form, Structured Clinical Interview for DSM-IV (SCID-I), Hamilton Depression Scale and Young Mania Evaluation Scale, both groups underwent Optical coherence tomography (OCT). Results The mean RNFL thickness and mean GCL volume were significantly lower in the BPD1 group than in the controls (p < 0.05). The GCL global value had a significant and independent effect in distinguishing the BPD1 patients from the controls. A cut-off value of 101 mm3 for global GCL volume was proposed to distinguish BPD1 patients from controls with a sensitivity of 87.5%. Discussion Lower values of GCL volume and RNFLT in patients suffering from BPD1 suggest that neurodegeneration may occur during the course of BPD and that this degeneration can be characterized in particular by a thinning of the GCL volume.

Humans , Male , Female , Adult , Middle Aged , Retinal Ganglion Cells/pathology , Bipolar Disorder/diagnostic imaging , Tomography, Optical Coherence , Nerve Fibers/pathology , Psychiatric Status Rating Scales , Bipolar Disorder/drug therapy , Surveys and Questionnaires , Regression Analysis , Valproic Acid/therapeutic use , Valproic Acid/pharmacology , Lithium Compounds/therapeutic use , Lithium Compounds/pharmacology , Antimanic Agents/therapeutic use , Antimanic Agents/pharmacology , Neurodegenerative Diseases/prevention & control , Neurodegenerative Diseases/diagnostic imaging , Interview, Psychological
Gac. méd. espirit ; 21(2): 146-160, mayo.-ago. 2019.
Article in Spanish | LILACS (Americas) | ID: biblio-1090436


RESUMEN Fundamento: Los estudios de causalidad deben aportar resultados certeros, lo cual depende de la adecuación de los mismos, de ahí la necesidad de conocer los métodos que aseguren la validez de estas investigaciones. Objetivo: Sistematizar los métodos actuales para el estudio de causalidad en Medicina que incluye el diseño, los requerimientos que aseguran su validez y los métodos para el cumplimiento de estos requerimientos. Desarrollo: Se realizó una revisión bibliográfica en bases de datos biomédicas, se seleccionó la literatura de mayor actualidad, integralidad y cientificidad con la cual se organizó una síntesis crítica, a la que se le agregó la experiencia de las autoras. Se presentan técnicas para la detección y tratamiento de la confusión y la interacción y para garantizar la comparabilidad entre grupos. Entre las técnicas se destacan la aleatorización mendeliana, el puntaje de susceptibilidad, los G-métodos, los modelos estructurales marginales y anidados, la lógica difusa y el análisis estadístico implicativo. Conclusiones: A pesar del avance en los métodos estadísticos es el investigador el encargado de garantizar la no confusión residual y discernir entre lo estadísticamente significativo y lo clínicamente aceptable.

ABSTRACT Background: Causality studies must provide accurate results, which depends on their adequacy, therefore the need of knowing the methods that ensure the validity of these investigations. Objective: To systematize the current methods for the study of causality in Medicine that includes the design, the requirements that ensure its validity and the methods for complying with these requirements. Development: It was carried out a bibliographic review in biomedical databases and selected the most current, comprehensive, scientific literature, with this, a critical synthesis was organized, with the experience of the authors. Techniques for the detection and treatment of confusion and interaction were presented, also to ensure comparability between groups. Among the techniques, Mendelian randomization, susceptibility score, G-methods, marginal and nested structural models, fuzzy logic and implicative statistical analysis stand out. Conclusions: Despite the progress in statistical methods, the researcher is responsible for guaranteeing residual non-confusion and distinguishing between statistically significant and clinically acceptable.

Reproducibility of Results , Data Interpretation, Statistical , Biomedical Research/statistics & numerical data , Case-Control Studies , Regression Analysis , Models, Structural
Arch. Clin. Psychiatry (Impr.) ; 46(3): 61-65, May.-June 2019. tab
Article in English | LILACS (Americas) | ID: biblio-1011153


Objective The purpose of this study is to determine the relation between smart phone addiction and personality beliefs of university students. Methods A total of 1007 students, 637 females (63.3%) and 370 males (36.7%) participated in the study. "Smart phone addiction scale short form" was used to measure smart phone addiction and "personality beliefs scale" was used to identify personality beliefs. Results According to the performed multiple regression analysis, it was found out that dependent, antisocial, narcissist, histrionic, borderline, paranoid personality, schizoid personality, obsessive compulsive personality, passive-aggressive personality and avoidant personality beliefs predicted smart phone addiction at significant level (R = 0.38, R2 = 0.15, p < 0.001). The mentioned variables explain 15% of the variance. An examination of the t-test shows that dependent personality (t = 5.585, p < 0.001), passive-aggressive personality (t = -4.485, p < .001) and paranoid personality (t = 2.901, p < .01) belief among the mentioned variables are a significant predictor of smart phone addiction. Discussion The obtained results show that dependent, passive-aggressive and paranoid personality beliefs are a significant predictor of smart phone addiction. Research findings are discussed in the light of relevant literature.

Humans , Male , Female , Personality Disorders/psychology , Behavior, Addictive/psychology , Smartphone , Students/psychology , Universities , Surveys and Questionnaires , Regression Analysis , Compulsive Behavior/psychology , Cyprus
Pesqui. bras. odontopediatria clín. integr ; 19(1): 4550, 01 Fevereiro 2019. ilus, tab, graf
Article in English | LILACS (Americas), BBO | ID: biblio-997907


Objective: To evaluate the facial morphology of Caucasian obese adults in relation to normal weight peers, and to study the association between three-dimensional soft-tissue facial measurements and cardiometabolic risk factors. Material and Methods: Nineteen Caucasian obese subjects aged 25 to 73 years underwent anthropometric measurements, blood samples and a stereophotogrammetric facial scan. Soft-tissue facial linear distances, angles, and volumes were obtained and compared to those collected on normal weight subjects by computing z-scores. Spearman correlation was used to assess the associations between facial measurements and metabolic parameters. Logistic regression analysis adjusted for sex and age was used to assess the risk of metabolic syndrome associated to the facial measurements. Results: Overall, when compared to normal weight persons, obese adults had a wider face in the horizontal dimension, with a middle face (maxilla) that was larger both in absolute value and relatively to the lower face (mandible), and a larger right side gonial angle (Wilcoxon test, p < 0.01). Only the mean (left and right) gonial angle was positively associated to serum triglycerides level, while the other facial measurements were associated with none of the cardiometabolic parameters. Moreover, none of the facial measurements was associated with the risk of metabolic syndrome. Conclusion: Despite larger facial dimensions and altered mandible/maxilla volume ratio, three-dimensional soft-tissue facial morphometry in Caucasian obese adults is not related to cardiometabolic risk factors. The actual association between morphological facial characteristics and clinical information on the health conditions of patients is still to be investigated.

Humans , Adult , Middle Aged , Aged , Risk Factors , Adult , Imaging, Three-Dimensional/methods , Metabolic Syndrome , Face/anatomy & histology , Obesity/etiology , Photogrammetry/methods , Cardiovascular Diseases/diagnosis , Regression Analysis , Statistics, Nonparametric , Italy
Pesqui. bras. odontopediatria clín. integr ; 19(1): 3807, 01 Fevereiro 2019. ilus, tab
Article in English | LILACS (Americas) | ID: biblio-997960


Objective: To perform the transcultural adaptation to Brazil and validation of the Halitosis Associated Life-quality Test (HALT) for use in adolescents. Material and Methods: Students aged 12 to 15 years, of both sexes, with healthy permanent dentition, attending public schools in Piracicaba, Brazil, were selected for this study. The HALT was translated, backtranslated, reviewed by an expert committee and submitted to a pre-test. In the first phase (n = 13), 15% of the sample did not understand items 2, 12 and 15; therefore, these items were reformulated and resubmitted to 13 adolescents. The version with a sociocultural adaptation was self-applied by 56 adolescents (64% females, 13.4 ± 1.0 years), of whom 25 participated in the test-retest. The presence of visible biofilm, gingival bleeding, calculus and tongue coating, was evaluated. Selfperception of halitosis after exhalation/breathing was assessed by a single question. Results: The HALT score ranged from 0 to 62 points (mean = 10.1±13.4) and the floor effect was 5.4%. Internal consistency was excellent (Cronbach's alpha = 0.92) and reproducibility was moderate (Intraclass Correlation Coefficient = 0.59). Individuals with "excessive" tongue coating had a higher HALT score than those with mild and/or moderate coating (p<0.001). Multiple linear regression analysis indicated that only the male sex was related to a higher HALT score (p<0.05). Conclusion: The Brazilian Portuguese version of the HALT was easily understood by adolescents. Those with greater tongue coating accumulation reported more frequently the presence of halitosis, which was only associated to male sex.

Humans , Male , Female , Adolescent , Quality of Life , Brazil , Cross-Cultural Comparison , Adolescent , Halitosis/etiology , Psychometrics/methods , Self-Assessment , Translating , Clinical Diagnosis , Cross-Sectional Studies/methods , Surveys and Questionnaires , Regression Analysis , Validation Studies as Topic
Pesqui. bras. odontopediatria clín. integr ; 19(1): 4455, 01 Fevereiro 2019. tab
Article in English | LILACS (Americas), BBO | ID: biblio-997970


Objective: To evaluate the relationship of impacted mandibular third molars (M3M) status with caries on distal surface (CODS) of mandibular second molars (M2M). Material and Methods: A retrospective study on digital panoramic radiographs. Information on age, gender, eruption status of impacted mandibular third molars and mandibular second molars caries on distal surface were recorded. Winters' classification and Pell and Gregory classification were used to classify impacted mandibular third molars. The Chi-square test and Poisson regression were used. A p-value of <0.05 was considered statistically significant. Results: A total of 1497 radiographs were evaluated out of which 2704 sites were recorded. A total of 33.2% M3M were impacted and 1053 (38.9%) M2M had caries on distal surface. Among the total M3M teeth, 39.1% of erupted and 38.6% of impacted teeth had CODS of M2M. However, there was no significant difference in the distribution of CODS of M2M in erupted and impacted mandibular third molars teeth (p=0.796). As per Winters classification, mesio-angular and horizontal impaction types were significantly associated with CODS (p<0.001). Conclusion: All impacted mandibular third molars may not be associated with caries on distal surface of mandibular second molars. But, the angulation like mesioangular and horizontal, class I and II may predispose to caries on distal surface of mandibular second molars.

Humans , Male , Female , Tooth, Impacted , Radiography, Panoramic/instrumentation , Dental Caries , Molar , Molar, Third , Chi-Square Distribution , Regression Analysis , Retrospective Studies
Pesqui. bras. odontopediatria clín. integr ; 19(1): 4432, 01 Fevereiro 2019. tab
Article in English | LILACS (Americas), BBO | ID: biblio-998243


Objective: To describe the Early Childhood Caries (ECC) in Indonesian preschool children based on biopsychosocial risk factors. Material and Methods: This research is an analytic observational with a cross sectional design toward 506 preschool children aged 2-6 years at East Luwu Regency, Indonesia. The biopsychosocial data studied were gender, ethnicity, personal hygiene, child psychology, age, nutritional status, and dental and oral health behavior. These data were obtained through a questionnaire and clinical examination (nutritional status). Multiple linear regression analysis was performed. The statistical tests were performed at the significance level of 0.05. Results: Characteristics of respondents based on parents' origin, found that the majority of respondents were parents from Bugis tribes (68.4%) with ECC frequency of 72.2%. Regarding the visit to the dentist, 12.6% were afraid of the dentist, with ECC frequency of 71.9%. Most children had normal nutritional status (67%) with ECC frequency of 69.3%. Biopsychosocial factors, which significantly affect the Early Childhood Caries, were parents' tribe (p=0.022) and age (p=0.011). There was an association between ECC with brushing teeth before going to bed (p=0.049), use of mouthwash (p=0.002) and consumption of snacks (p<0.001). Conclusion: Biopsychosocial factor indicators are affect the Early Childhood Caries towards Indonesian preschool children.

Humans , Male , Female , Child, Preschool , Child , Child, Preschool , Risk Factors , Dental Caries/prevention & control , Social Determinants of Health , Indonesia , Cross-Sectional Studies/methods , Surveys and Questionnaires , Regression Analysis
Acta cir. bras ; 34(3): e201900310, 2019. tab, graf
Article in English | LILACS (Americas) | ID: biblio-989069


Abstract Purpose: To evaluate serum levels of high-sensitivity C-reactive protein (hs-CRP) in chronic gastritis patients to predict Helicobacter pylori (HP) infection, inflammatory activity, and precancerous lesions. Methods: A total of 811 patients with upper gastrointestinal symptoms and histopathological diagnosis of chronic gastritis were enrolled in the study. On endoscopy, five gastric biopsies were taken according to Modified Sydney protocol, which were stained with hematoxylin & eosin and Giemsa Results: HP infection was found in 28.6% of patients, being significantly more common in specimens with acute and chronic inflammatory activity. Mucosal atrophy, intestinal metaplasia, and dysplasia were found in 20.2%, 18.8% and 2.7% of biopsy specimens. Mean hs-CRP was 1.9±1.6 mg/dl for males and 2.2±1.9 mg/dl for females. hs-CRP average were significantly higher in patients with severe acute inflammation (p:0.049), in patients with severe chronic inflammation (p:0.015) and in those with HP (p: 0.001) . The severity of HP infection increased significantly with the increased degree of acute inflammation, chronic inflammation and hs-CRP level (p=0.001 for both). Conclusion: Serum hs-CRP level increases in patients with chronic gastritis, it could be an indicator of severity of acute or chronic mucosal inflammation, and presence of HP infection. Therefore, hs-CRP may aid the diagnosis of chronic gastritis, but it is not associated with pre-cancerous lesions.

Humans , Male , Female , Adolescent , Adult , Middle Aged , Young Adult , C-Reactive Protein/analysis , Helicobacter pylori , Helicobacter Infections/pathology , Helicobacter Infections/blood , Gastroscopy/methods , Gastritis/pathology , Gastritis/blood , Reference Values , Biopsy , Blood Cell Count , Severity of Illness Index , Acute Disease , Chronic Disease , Regression Analysis , Retrospective Studies , Analysis of Variance , Gastric Mucosa/pathology , Metaplasia/pathology
Rev. ABENO ; 19(1): 58-65, 2019. tab
Article in English | LILACS (Americas), BBO | ID: biblio-1022362


The study aimed to verify the adherence of undergraduate Dentistry students to the hepatitis B and tetanus vaccination campaign in a private Dental school. The hypothesis tested was that the vaccination campaign would be an effective program in prevention of HBV and tetanus infection. The vaccination's card copies and the Anti-HBs exam were analyzed as main outcome. Data were submitted to bivariate and multivariate Poisson regression analyses (0.05). Age, admission year, studying shift, doses of hepatitis B and tetanus vaccinations were independent variables. Out of the 485 students, 318 delivered the vaccination's card, and 295 presented the Anti-HBs exam. The median age of the students was 21 years (76.1% female and 23.9% male). In the univariate and multivariate Poisson regression model, failure to receive the tetanus vaccination was considered as a risk factor. Undergraduate students enrolled in the initial years were more likely to have not received the vaccination than the senior years (p ≤0.001). Out of the total number of students (318) who submitted the documentation for hepatitis B, 86.1% completed the vaccination protocol (3 doses), while 13.9% the incomplete protocol (1 or 2 doses). Older students were more likely to have refrained from taking the vaccinations compared to younger (p ≤ 0.001). In relation to the Anti-HBs, 73.9% had positive protective titer. Vaccination campaigns for undergraduate students may be effective if adherence of the individuals to the schedule can be ensured. Strategies for greater adherence of students, should be thought and planned by Dental Schools (AU).

O estudo objetivou verificar a adesão dos estudantes de graduação em Odontologia à campanha de vacinação contra hepatite B e tétano em uma escola particular de Odontologia. A hipótese testada foi que a campanha de vacinação seria um programa efetivo na prevenção da infecção pelo HBV e tétano. O cartão de vacinação e o exame anti-HBs foram analisados como desfecho principal. Os dados foram submetidos à regressão de Poisson bivariada e multivariada (0, 5). Idade, ano de admissão, turno de estudos, número de doses de vacinas para hepatite B e vacinação para tétano foram variáveis independentes. Dos 485 estudantes, 318 entregaram a cópia do cartão de vacinação e 295 apresentaram o exame anti-HBs. A mediana de idade dos estudantes foi de 21 anos (76,1% do sexo feminino, 23,9% do sexo masculino). Nos modelos de regressão de Poisson univariada e multivariada, a não vacinação contra o tétano foi considerada fator de risco. Os alunos de graduação matriculados nos anos iniciais foram mais propensos a não receberem a vacinação do que aqueles dos anos finais (p≤0,001). Do total de alunos (318) que entregaram a documentação para hepatite B, 86,1% completaram o protocolo de vacinação (3 doses), enquanto 13,9% o protocolo incompleto (1 ou 2 doses). Os estudantes mais velhos foram mais propensos a não terem tomado as vacinas em comparação com mais jovens (p≤0,001). Em relação ao anti-HBs, 73,9% apresentaram título de proteção positivo. As campanhas de vacinação para estudantes de graduação podem ser efetivas se a adesão dos indivíduos ao calendário vacinal puder ser assegurada. Estratégias para maior adesão dos estudantes, como essa campanha, devem ser pensadas e planejadas pelos cursos de Odontologia (AU).

Humans , Male , Female , Adolescent , Adult , Students, Dental , Tetanus/prevention & control , Immunization Programs , Hepatitis B/prevention & control , Brazil , Multivariate Analysis , Regression Analysis , Statistics, Nonparametric
Chinese Medical Journal ; (24): 294-301, 2019.
Article in English | WPRIM (Western Pacific) | ID: wprim-774851


BACKGROUND@#Non-Hodgkin T/NK cell lymphoma is a rare and widely variable type of lymphoma with the most dismal prognosis. This study aimed to investigate varied impact of the clinical indicators to the overall survival (OS).@*METHODS@#We conducted a retrospective study to identify the non-invasive clinical features of T cell lymphoma that can predict prognosis with an innovative analysis method using quantile regression. A total of 183 patients who visited a top-tier hospital in Beijing, China, were enrolled from January 2006 to December 2015. Demographic information and main clinical indicators were collected including age, erythrocyte sedimentation rate (ESR), survival status, and international prognostic index (IPI) score.@*RESULTS@#The median age of the patients at diagnosis was 45 years. Approximately 80% of patients were at an advanced stage, and the median survival time after diagnosis was 5.1 months. Multivariable analysis of the prognostic factors for inferior OS associated with advanced clinical staging [HR=3.16, 95%CI (1.39-7.2)], lower platelet count [HR = 2.57, 95%CI (1.57-4.19), P < 0.001] and higher IPI score [HR = 1.29, 95%CI (1.01-1.66), P = 0.043]. Meanwhile, T cell lymphoblastic lymphoma [HR = 0.40, 95%CI (0.20-0.80), P = 0.010], higher white blood cell counts [HR = 0.57, 95%CI (0.34-0.96), P = 0.033], higher serum albumin level [HR = 0.6, 95%CI (0.37-0.97), P = 0.039], and higher ESR [HR = 0.53, 95%CI (0.33-0.87), P = 0.011] were protective factors for OS when stratified by hemophagocytic lymphohistiocytosis (HLH). Multivariable quantile regression between the OS rate and each predictor at quartiles 0.25, 0.5, 0.75, and 0.95 showed that the coefficients of serum β2-microglobulin level and serum ESR were statistically significant in the middle of the coefficient curve (quartile 0.25-0.75). The coefficient of IPI was negatively associated with OS. The coefficients of hematopoietic stem cell transplantation (HSCT) and no clinical symptoms were higher at the middle of the quartile level curve but were not statistically significant.@*CONCLUSIONS@#The IPI score is a comparatively robust indicator of prognosis at 3 quartiles, and serum ESR is stable at the middle 2 quartiles section when adjusted for HLH. Quantile regression can be used to observe detailed impacts of the predictors on OS.

Adolescent , Adult , Aged , Aged, 80 and over , Child , Disease-Free Survival , Female , Hematopoietic Stem Cell Transplantation , Humans , Lymphoma, Large B-Cell, Diffuse , Mortality , Pathology , Lymphoma, Non-Hodgkin , Mortality , Pathology , Lymphoma, T-Cell , Mortality , Pathology , Male , Middle Aged , Prognosis , Regression Analysis , Retrospective Studies , Survival Rate , Young Adult
Chinese Medical Journal ; (24): 1053-1062, 2019.
Article in English | WPRIM (Western Pacific) | ID: wprim-772219


BACKGROUND@#High on-treatment platelet reactivity (HTPR) has been suggested as a risk factor for patients with ischemic vascular disease. We explored a predictive model of platelet reactivity to clopidogrel and the relationship with clinical outcomes.@*METHODS@#A total of 441 patients were included. Platelet reactivity was measured by light transmittance aggregometry after receiving dual antiplatelet therapy. HTPR was defined by the consensus cutoff of maximal platelet aggregation >46% by light transmittance aggregometry. CYP2C19 loss-of-function polymorphisms were identified by DNA microarray analysis. The data were compared by binary logistic regression to find the risk factors. The primary endpoint was major adverse clinical events (MACEs), and patients were followed for a median time of 29 months. Survival curves were constructed with Kaplan-Meier estimates and compared by log-rank tests between the patients with HTPR and non-HTPR.@*RESULTS@#The rate of HTPR was 17.2%. Logistic regression identified the following predictors of HTPR: age, therapy regimen, body mass index, diabetes history, CYP2C192, or CYP2C193 variant. The area under the curve of receiver operating characteristic for the HTPR predictive model was 0.793 (95% confidence interval: 0.738-0.848). Kaplan-Meier analysis showed that patients with HTPR had a higher incidence of MACE than those with non-HTPR (21.1% vs. 9.9%; χ = 7.572, P = 0.010).@*CONCLUSIONS@#Our results suggest that advanced age, higher body mass index, treatment with regular dual antiplatelet therapy, diabetes, and CYP2C192 or CYP2C193 carriers are significantly associated with HTPR to clopidogrel. The predictive model of HTPR has useful discrimination and good calibration and may predict long-term MACE.

Aged , Blood Platelets , Clopidogrel , Pharmacology , Coronary Artery Disease , Metabolism , Cytochrome P-450 CYP2C19 , Metabolism , Female , Genotype , Glycated Hemoglobin A , Metabolism , Humans , Kaplan-Meier Estimate , Logistic Models , Male , Middle Aged , Multivariate Analysis , Myocardial Ischemia , Metabolism , Regression Analysis
Article in Chinese | WPRIM (Western Pacific) | ID: wprim-772093


OBJECTIVE@#To analyze the correlation of lipoprotein(a) [Lp(a)] with the clinical stability and severity of coronary artery stenosis in patients with coronary artery disease (CAD).@*METHODS@#A total of 531 patients undergoing coronary angiography in Nanfang Hospital between January, 2013 and December, 2016 were enrolled in this study. At the cutoff Lp(a) concentration of 300 mg/L, the patients were divided into high Lp(a) group (=191) and low Lp(a) group (=340). In each group, the patients with an established diagnosis of CAD based on coronary angiography findings were further divided into stable angina pectoris (SAP) group and acute coronary syndrome (ACS) group. The correlation between the severity of coronary artery stenosis and Lp(a) was evaluated.@*RESULTS@#The patients in high and low Lp(a) groups showed no significant differences in age, gender, body mass index, smoking status, hypertension, or diabetes (>0.05). Multivariate logistic regression analysis revealed that age, gender, and serum levels of low-density lipoprotein cholesterol (LDL-C) and Lp(a) were independent risk factors for CAD in these patients. A high Lp(a) level was associated with an increased risk of CAD (OR=2.443, 95%CI: 1.205-4.951, =0.013). The patients with a high Lp(a) level were at a significantly higher risk of CAD than those with a low Lp(a) level irrespective of a low or high level of LDL-C (=0.006 and 0.020). In the patients with CAD, the ACS group had a significantly higher Lp(a) level than the SAP group ( < 0.001); the proportion of the patients with high Gensini scores was significantly greater in high Lp(a) group than in low Lp(a) group (17.3% vs 5.6%, =0.026), and a linear relationship was found between Lp(a) level and Gensini score (R=0.130, =0.006).@*CONCLUSIONS@#Serum level of Lp(a) is an independent risk factor for CAD, and an increased Lp(a) is the residual risk for CAD. In patients with CAD, a high Lp(a) level is associated with the clinical instability and severity of coronary artery stenosis.

Acute Coronary Syndrome , Blood , Angina Pectoris , Blood , Cholesterol, LDL , Blood , Coronary Angiography , Coronary Artery Disease , Blood , Classification , Coronary Stenosis , Blood , Pathology , Humans , Lipoprotein(a) , Blood , Regression Analysis , Risk Factors , Severity of Illness Index
Article in English | WPRIM (Western Pacific) | ID: wprim-777639


OBJECTIVES@#Public service motivation refers to the idea of commitment to the public service, pursuit of the public interest, and the desire to perform work that is worthwhile to society. This study investigates how challenge stress and hindrance stress influence job performance among healthcare workers in Chinese public hospitals. It has also examined the mediating effect of public service motivation.@*METHODS@#Data of 1594 healthcare workers were obtained from typical public hospitals in eastern, central, and western China. To test our hypotheses, we used descriptive statistical analysis, correlation analysis, structural equation modeling, and subgroup analysis to investigate the sample.@*RESULTS@#Challenge stress and hindrance stress were strongly correlated among healthcare workers in Chinese public hospitals (β = 0.59; p < 0.001). Challenge stress was significantly positively associated with public service motivation (β = 0.14; p < 0.001) and job performance (β = 0.13; p < 0.001). Hindrance stress was significantly negatively associated with public service motivation (β = - 0.27; p < 0.001) and job performance (β = - 0.08; p < 0.05). Public service motivation was directly positively associated with job performance (β = 0.58; p < 0.001), and it indirectly mediated the association between job stress and job performance.@*CONCLUSIONS@#This study provides important empirical evidence on the effects of job stress and public service motivation on job performance among healthcare workers in Chinese public hospitals. Job performance may be raised by limiting hindrance stress, which provides moderate challenge stress and increases public service motivation.

Adult , China , Cross-Sectional Studies , Female , Health Personnel , Psychology , Hospitals, Public , Humans , Male , Middle Aged , Motivation , Occupational Stress , Psychology , Public Sector , Regression Analysis , Self Report , Work Performance , Workplace , Psychology , Young Adult
Article in English | WPRIM (Western Pacific) | ID: wprim-777558


INTRODUCTION@#Erectile dysfunction (ED) is a serious global burden that affects men as well as their partners. This study aimed to determine the prevalence and predictors of ED among male outpatient clinic attendees in Johor, Malaysia.@*METHODS@#We conducted a cross-sectional study of Malaysian men aged ≥ 18 years attending two major outpatient clinics in Johor Bahru and Segamat in Johor, Malaysia, between 1 January 2016 and 31 March 2016. Subjects were chosen via simple random sampling and 400 patients were recruited. The study instrument was a survey form that consisted of three sections: sociodemographic and comorbid profile, validated English and Malay versions of the 15-item International Index of Erectile Function, and the 21-item Depression Anxiety Stress Scale.@*RESULTS@#The overall prevalence of self-reported ED was 81.5%. The prevalence of ED according to severity was as follows: mild (17.0%), mild to moderate (23.8%), moderate (11.3%) and severe (29.5%). Multivariate analysis showed that ED was associated with increasing age (odds ratio [OR] 4.023, 95% confidence interval [CI] 1.633-9.913), Indian as compared to Malay ethnicity (OR 3.252, 95% CI 1.280-8.262), secondary as compared to tertiary education (OR 2.171, 95% CI 1.203-3.919), single as compared to married status (OR 6.119, 95% CI 2.542-14.734) and stress (OR 4.259, 95% CI 1.793-10.114).@*CONCLUSION@#ED has significant prevalence and severity among adult male outpatient clinic attendees in Johor. Increasing age, Indian ethnicity, lower educational level, singlehood and stress were significant predictors of ED.

Adolescent , Adult , Aged , Comorbidity , Cross-Sectional Studies , Depression , Educational Status , Erectile Dysfunction , Diagnosis , Epidemiology , Humans , Malaysia , Epidemiology , Male , Middle Aged , Prevalence , Regression Analysis , Risk Factors , Severity of Illness Index , Social Class , Young Adult
Singapore medical journal ; : 136-139, 2019.
Article in English | WPRIM (Western Pacific) | ID: wprim-777552


INTRODUCTION@#Paediatric epidurals can present technical challenges due to wide variations in age and weight among children, ranging from neonates to teenagers. This study evaluated the skin-to-epidural distance in the thoracic and lumbar regions to determine the relationship between age, weight and ethnicity and depth to the epidural space in our Singapore paediatric population.@*METHODS@#Data from the Acute Pain Service was prospectively collected over 16 years. Details included patient demographics, level of epidural performed and distance from skin to epidural space. Multivariable regression analysis was performed to determine the association of weight, age, ethnicity and gender with the depths to the thoracic and lumbar epidural spaces. A simple linear regression was calculated to predict the depth to both thoracic and lumbar epidural spaces based on body weight. Equations were formulated to describe the relationship between weight and depth of epidural space.@*RESULTS@#A total of 616 midline epidurals were studied. Regression analysis was performed for 225 thoracic epidurals and 363 lumbar epidurals. Our study revealed a clear correlation between skin-to-lumbar epidural distance and weight in children. The best correlation was demonstrated between skin-to-lumbar epidural distance and body weight (R = 0.729). This relationship was described by the formula: depth (mm) = (0.63 × weight [kg]) + 9.2.@*CONCLUSION@#Skin-to-lumbar epidural distance correlated with weight in children. Our results highlighted the clinical significance of differences between Southeast Asian paediatric populations when compared to other populations.

Adolescent , Anesthesia, Epidural , Methods , Body Weight , Child , Child, Preschool , Epidural Space , Female , Humans , Infant , Infant, Newborn , Lumbar Vertebrae , Male , Multivariate Analysis , Pain Management , Methods , Pediatrics , Methods , Regression Analysis , Singapore , Skin , Thoracic Vertebrae
Article in English | WPRIM (Western Pacific) | ID: wprim-764234


Legionella species are abundant in the built environment and are increasingly recognized as a cause of Legionnaires' disease (LD). As the number of cases of Legionnaires' disease acquired by local communities in the Seoul metropolitan area in Korea has been increased, there was concern that changes in environmental factors could affect disease outbreaks. We described the association between climatic variables and occurrence of legionellosis in Korea and Legionella detection rate in Seoul area. A total of 418 cases of legionellosis were reported between 2014 and 2017. There was a seasonal peak in summer. LD continuously occurred from early spring to winter every year and rapidly increased in summer. In the regression analysis, the primary variables of interest- PM2.5 (µg/m³), NO₂ (ppb), and a number of the date of issue O₃ warning were not significant except for average temperature (R²=0.8075). The Legionella detection rate in Seoul, Korea showed a trend similar to precipitation (P=0.708, ANOVA). A relatively high proportion of Legionella detection rate was shown, especially cooling tower (17.7%) and public bath (19.3%). This finding is in line with current understanding of the ecological profile of this pathogen and supports the assertion that legionellosis occurs through contamination of water sources.

Baths , Disease Outbreaks , Epidemiology , Korea , Legionella , Legionellosis , Legionnaires' Disease , Regression Analysis , Seasons , Seoul , Water
Arq. Inst. Biol ; 86: e0672018, 2019. tab, graf
Article in English | LILACS (Americas), VETINDEX | ID: biblio-1045990


Control of phytonematodes is very hard and requires a combination of techniques to succeed. Alternative control through plant extracts may result in the discovery of nematicide substances. Research aimed at evaluating the effect of 33 plants submitted to aqueous extraction against Panagrellus redivivus in vitro. Concentrations were prepared at 1.25, 2.5, 5, 10, and 20%. Monitoring happened at 0, 6, 12, 24 and 30 hours after preparation. Counting considered dead nematodes subtracted from alive ones. Juveniles were also counted, and extract efficiency was expressed in percentage of control or stimuli. Data were submitted to variance analysis. Significant results got with the Scott-Knott test (5%), and multiple linear regression analysis. Extracts were observed acting as controllers, but also as stimulators to nematode reproduction. The best controlling performance was set by Carica papaya (-66% at 20%; -33.7% at 10%), Euphorbia milii (-37% at 20%), Psychotria carthagenensis (-25.5% at 2.5%), Clusia variegate (-22% at 20%), and Zamioculcas zamiifolia (-21.5% at 20%). Stimulator extracts were Mentha villosa at 10% (+148%) and 2.5% (+131.5%), followed by Aloe vera (+123% at 5%), Schinus molle (+112.5% at 10%), Schefflera arboricola (+93.5% at 5%), C. variegate (+89% at 5%), and S. molle (+88% at 5%). Some extracts kept population stable throughout the experiment, presenting lower control indexes. Besides an additive effect, there was an individual influence of concentration or time on control.(AU)

O controle de fitonematoides é muito difícil e requer uma combinação de técnicas para ter sucesso. O controle alternativo via extrato vegetal pode resultar na descoberta de substâncias nematicidas. Esta pesquisa objetivou avaliar o efeito de 33 plantas submetidas à extração aquosa contra Panagrellus redivivus in vitro. As concentrações foram preparadas a 1,25; 2,5; 5; 10; e 20%. O monitoramento ocorreu em 0, 6, 12, 24 e 30 horas após a preparação. Para a contagem, foram considerados nematoides mortos subtraídos dos vivos. Nematoides jovens também foram contados, e a eficiência dos extratos foi expressa em porcentagem de controle ou de estímulo. Os dados foram submetidos à análise de variância. Resultados significativos foram analisados pelos testes de Scott-Knott (5%) e análise de regressão múltipla. Foram observados extratos agindo como controladores, bem como estimuladores da reprodução de nematoides. A melhor performance de controle foi obtida por Carica papaya (-66% a 20%; -33,7% a 10%), Euphorbia milii (-37% a 20%), Psychotria carthagenensis (-25,5% a 2,5%), Clusia variegate (-22 a 20%) e Zamioculcas zamiifolia (-21,5% a 20%). Os extratos estimuladores foram Mentha villosa a 10% (+148%) e 2,5% (+131,5%), seguido por Aloe vera (+123% a 5%), Schinus molle (+112.5% a 10%), Schefflera arboricola (+93.5% a 5%), C. variegate (+89% a 5%) e S. molle (+88% a 5%). Alguns extratos mantiveram a população estável durante todo o experimento, apresentando menores índices de controle. Além do efeito aditivo houve uma influência individual da concentração e do tempo no controle.(AU)

Nematoda , Antinematodal Agents , Regression Analysis