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2.
Acta bioquím. clín. latinoam ; 54(3): 257-266, set. 2020. graf, tab
Article in Spanish | LILACS | ID: biblio-1130600

ABSTRACT

EL HOMA-IR (homeostasis model assessment-insulin-resistance) es un estimador de insulinorresistencia (IR) pero depende de la determinación de insulina. Los índices triglicéridos-glucosa (T-G)-circunferencia de la cintura (CC) (T-G-CC) o triglicéridos-glucosa-índice de masa corporal (TG- IMC) podrían ser sustitutos. Los objetivos de este trabajo consistieron en investigar en personas con riesgo de desarrollar diabetes tipo 2 (DT2): a) los índices T-G, T-G-CC y T-G-IMC como estimadores de HOMA-IR>2,1; b) determinar su poder discriminante. Se realizó un estudio prospectivo en el que se estudiaron 223 individuos ≥45 años con riesgo de desarrollar diabetes tipo 2 (DT2). La relación T-G se calculó como ln [triglicéridos (mg/dL) x glucemia (mg/dL)/2]. La relación T-G-CC y T-G-IMC fue el producto de T-G por CC o IMC. Se utilizó análisis de regresión logística y se calcularon las áreas bajo las curvas ROC (receiver operating characteristic curves) (ABC) para comparar las asociaciones de T-G, T-G-CC y T-G-IMC con HOMA-IR>2,1. Mediante análisis discriminante se evaluó la clasificación de los sujetos entre HOMA-IR>2,1 y HOMA-IR≤2,1. ABC, sensibilidad, especificidad, poder predictivo positivo y negativo para T-G-CC y T-G-IMC fueron mayores que para T-G, con los siguientes valores de corte: T-G=8,75, T-G-CC=821 y T-G-IMC=255. Los odds ratios (OR) para HOMA-IR>2,1, ajustados para confusores, fueron: T-G>8,75, OR: 4,85 (IC 95% 2,73-8,62); T-G-CC>821, OR: 10,41 (IC 95% 5,55-19,53); T-GIMC> 255, OR: 10,41 (IC 95% 5,55-19,53). Con el análisis discriminante T-G>8,75 clasificó correctamente 69,2% individuos con HOMA-IR≤2,1 y 68,3% con HOMA-IR>2,1; T-G-CC y T-G-IMC clasificaron 74,4% y 78,2% respectivamente (p<0,001 en todos los casos). Se concluyó que T-GCC> 821 y T-G-IMC>255 fueron mejores estimadores de HOMA-IR>2,1 que T-G>8,75. Estas son determinaciones simples y accesibles y podrían ser útiles en la práctica clínica y en estudios epidemiológicos.


HOMA-IR ((homeostasis model assessment-insulin-resistance) is a surrogate estimator of insulin resistance (IR) but it depends on insulin determination. Triglyceride-glucose-waist circumference (T-G-WC) or triglyceride-glucose-body mass index (BMI) (T-G-BMI) could be substitutes. The objectives of this work were: to investigate in people at risk of developing type 2 diabetes (T2D): a) T-G, T-G-CC and T-G-BMI as estimators of HOMA-IR>2.1 and b) to determine their discriminating power. A prospective study was conducted studying 223 individuals ≥45 years of age at risk of developing type 2 diabetes (T2D). The T-G ratio was calculated as ln [triglycerides (mg/dL) x glycemia (mg/dL)/2]. The T-G-CC and T-G-BMI ratio was the product of T-G by CC or BMI. Logistic regression analysis was used and the areas under the receiver operating characteristic curves (ROC) curves were calculated to compare the associations of T-G, T-G-CC and T-G-BMI with HOMA-IR>2.1. Using a discriminant analysis, the classification of the subjects between HOMA-IR>2.1 or HOMA-IR≤2.1 was evaluated. AUC, sensitivity, specificity, positive and negative predictive powers for T-G-CC and T-G-BMI were higher than for T-G, with the following cut-off values: TG=8.75, T-G-CC=821 and T-G-BMI=255. Odds ratios (OR) for HOMA-IR>2.1, adjusted for confounders, were: T-G>8.75, OR 4.85 (95% CI 2.73-8.62); T-G-CC>821, OR 10.41 (95% CI 5.55-19.53); T-G-BMI>255, OR 10.41 (95% CI 5.55-19.53). With the discriminant analysis T-G>8.75, 69.2% correctly classified with HOMA-IR≤2.1 and 68.3% with HOMA-IR>2.1; T-G-CC and T-G-BMI correctly classified 74.4% and 78.2% respectively (p <0.001 in all cases). It is concluded that T-G-CC>821 and T-G-BMI>255 were better estimators of HOMA-IR>2.1 than T-G>8.75. T-G-WC and T-G-BMI are simple and reliable determinations and could be useful in clinical practice and epidemiological studies.


O HOMA-IR (homeostasis model assessment-insulin-resistance) e um estimador de resistencia a insulina (RI), mas depende da determinacao da insulina. Triglicerideos-glicose (T-G), circunferencia da cintura (CC) (T-G-CC) ou triglicerideos-glicose-indice de massa corporal (T-G-IMC) poderiam ser substitutos. Os objetivos desse trabalho foram investigar em pessoas com risco de desenvolver diabetes tipo 2 (DT2): a) os indices T-G, T-G-CC e T-G-IMC como estimadores de HOMA-IR> 2,1; b) determinar seu poder discriminante. Um estudo prospectivo foi realizado em 223 pessoas ≥45 anos com risco de desenvolver diabetes tipo 2 (DT2). A razao T-G foi calculada como ln [triglicerideos (mg/dL) x glicemia (mg/dL)/2]. A razao T-G-CC e T-G-IMC foi o produto de T-G por CC ou IMC. A analise de regressao logistica foi utilizada e as areas sob as curvas ROC (receiver operating features) ABC foram calculadas para comparar as associacoes de T-G, T-G-CC e T-G-IMC com HOMA-IR>2.1. Por meio de analise discriminante, avaliou-se a classificacao dos sujeitos entre HOMA-IR>2,1 e HOMA-IR≤2,1. ABC, sensibilidade, especificidade, poder preditivo positivo e negativo para TG-CC e TG-IMC foram maiores que para TG, com os seguintes valores de corte: TG=8,75, TG-CC=821 e TG-IMC=255. Odds Ratios (OR) para HOMA-IR>2,1, ajustados para fatores de confusao, foram: TG>8,75, OR 4,85 (IC95% 2,73-8,62); T-G-CC>821, OR 10,41 (IC 95% 5,55-19,53); T-G-IMC>255, OR 10,41 (IC 95% 5,55-19,53). Com a analise discriminante T-G>8,75, 69,2% foram classificados corretamente com HOMA-IR≤2,1 e 68,3% com HOMA-IR>2,1; T-G-CC e T-G-IMC classificaram 74,4% e 78,2%, respectivamente (p<0,001 em todos os casos). Conclui-se que T-G-CC>821 e TG- IMC>255 foram melhores estimadores de HOMA-IR>2,1 que T-G>8,75. Elas sao determinacoes simples e acessiveis e poderiam ser uteis na pratica clinica e em estudos epidemiologicos.


Subject(s)
Humans , Triglycerides , Power, Psychological , Epidemiologic Studies , Logistic Models , Odds Ratio , Confounding Factors, Epidemiologic , ROC Curve , Sensitivity and Specificity , Classification , Area Under Curve , Courtship , Diabetes Mellitus, Type 2 , Diabetes Mellitus, Type 2/complications , Glucose , Goals , Insulin , Persons , Organization and Administration , Association , Blood Glucose , Insulin Resistance , Body Mass Index , Discriminant Analysis , Risk , Regression Analysis , Waist Circumference
3.
Arq. bras. med. vet. zootec. (Online) ; 72(3): 961-969, May-June, 2020. tab, graf
Article in English | LILACS, VETINDEX | ID: biblio-1129665

ABSTRACT

A total of 6593 weight records collected from 796 male and female Anglo-Nubian goats aged up to 130 days, offspring from 29 sires and 225 dams, were used to compare models and estimate genetic parameters throughout the growth curve by applying random regression models. Direct and maternal additive genetic effects and direct and maternal permanent environmental effects were included as random in the models. The contemporary groups were included as fixed effects and goat age at kidding was included as a covariable (linear and quadratic). The choice of the best model was based on the AIC, BIC and AICc criteria. Variance estimates of the four random effects increased as the animals aged. Direct heritability (h2) rose from 0.13 to 0.40 with age, whereas maternal heritability showed a low value. Genetic correlations of weight between closer ages were high. The most suitable random regression model to compare the fitting of random effects was that which employed the Legendre polynomials of quadratic order with homogeneous variance (3333-1).(AU)


Utilizaram-se 6593 pesos de 796 caprinos da raça Anglonubiana, coletados em machos e fêmeas com idade até 130 dias, descendentes de 29 reprodutores e 225 matrizes, com o objetivo de se compararem modelos e de se estimarem parâmetros genéticos ao longo da curva de crescimento com aplicação de modelos de regressão aleatória. Nos modelos, incluíram-se os efeitos genéticos aditivos diretos e maternos e os de ambiente permanente diretos e maternos como aleatórios; os grupos de contemporâneos foram incluídos como efeitos fixos, e a idade da cabra ao parto como covariável (linear e quadrática). A escolha do melhor modelo foi realizada pela avaliação dos critérios AIC, BIC e AICc. As estimativas de variâncias dos quatro efeitos aleatórios cresceram de acordo com o aumento da idade. A herdabilidade direta (h2) aumentou de 0,13 a 0,40 com a idade, e a materna apresentou baixo valor. As correlações genéticas do peso entre idades mais próximas foram altas. O modelo de regressão aleatório mais adequado ao se comparar o ajuste dos efeitos aleatórios foi o que empregou polinômios de Legendre de ordem quadrática com variância homogênea (3333-1).(AU)


Subject(s)
Animals , Ruminants/growth & development , Regression Analysis , Genetic Profile , Heredity , Correlation of Data
4.
Acta bioeth ; 26(1): 91-100, mayo 2020. tab
Article in English | LILACS | ID: biblio-1114602

ABSTRACT

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.


Subject(s)
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
5.
J. oral res. (Impresa) ; 9(2): 93-97, abr. 30, 2020. ilus, tab
Article in English | LILACS | ID: biblio-1151849

ABSTRACT

Objective: To determine regression models to predict the mesiodistal widths of the maxillary anterior teeth from interalar width of the nose in subjects with facial harmony. Materials and Methods: A cross-sectional study was carried out in a sample of 75 subjects with facial harmony and ages ranging from 18 to 30 years (21.28±3.75 years). The mesiodistal width of the central (CI), lateral (LI) incisors, and canines (C), as well as the interalar width (IW) of each subject were measured using a digital vernier caliper. Simple linear regression analyses were used to predict the width of the maxillary anterior teeth from the nasal interalar width, from which formulas for predicting the dimensions of each anterior tooth were obtained. Results: A statistically significant relationship was found between the nasal interalar width and the mesiodistal widths of the upper central incisor (p=0.019, R2=5.23%), upper lateral incisor (p=0.019, R2=2.31%), and upper canine (p=0.016, R2=12.04%) that allowed to develop simple linear prediction models for each tooth represented by the following formulas: CI=7.04+0.04(IW); LI=6.01+0.03 (IW); C=6.19+0.05 (IW). Conclusion: The nasal interalar width is a good predictor of the mesiodistal widths of the maxillary anterior teeth.


Objectivo: Determinar modelos de regresión para predecir los anchos mesiodistales de los dientes anterosuperiores a partir del ancho interalar de la nariz en individuos con armonía facial. Materiales and Métodos: Se realizó un estudio transversal con una muestra de 75 sujetos con armonía facial entre 18 a 30 años (21.28 ± 3.75 años), se midió el ancho mesiodistal de incisivos centrales (IC), laterales (IL) y caninos (C) así como el ancho interalar (AI) de cada sujeto empleando un calibrador vernier digital. Para la predicción del ancho de los dientes anterosuperiores a partir del ancho interalar nasal se emplearon análisis de regresión lineal simple, a partir de los cuales se obtuvieron fórmulas de predicción de las dimensiones de cada pieza dentaria anterior. Resultados: Se encontró relación estadísticamente significativa entre el ancho interalar nasal y los anchos mesiodistales del incisivo central superior (p=0.019, R2 5.23%), incisivo lateral superior (=0.019, R2=2.31%) y canino superior (p=0.016, R2=12.04%) que permitieron generar modelos de predicción lineal simple para cada pieza dentaria representados mediante las siguientes fórmulas: IC=7.04+0.04(AI); IL=6.01+0.03(AI); C=6.19+0.05(AI). Conclusión:El ancho interalar nasal es un buen predictor de los anchos mesiodistales de los dientes anterosuperiores.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Young Adult , Nose/anatomy & histology , Cuspid/anatomy & histology , Incisor/anatomy & histology , Maxilla/anatomy & histology , Peru , Linear Models , Cross-Sectional Studies , Regression Analysis
6.
Arq. bras. oftalmol ; 83(2): 87-91, Mar.-Apr. 2020. tab
Article in English | LILACS | ID: biblio-1088975

ABSTRACT

ABSTRACT Purpose: The present study's aim was to compare the biomechanical properties of corneal tissue in patients who underwent deep anterior lamellar keratoplasty (DALK) surgery, with successful big bubble formation and manual lamellar dissection, during failed big bubble formation. Methods: This retrospective comparative study included 60 eyes from 60 keratoconus patients who previously underwent DALK surgery. These patients were categorized as big bubble (+) or big bubble (−) based on the success or failure of big bubble formation during the surgery. The big bubble (+) group included 42 eyes, while the big bubble (−) group had 18 eyes. Moreover, the patients were regrouped as 0.25 mm and 0.50 mm to evaluate the effects of the disparity between donor and trephine punches on the biomechanical properties of the cornea. These biomechanical properties, characterized by corneal hysteresis and the corneal resistance factor, were measured using the Ocular Response Analyzer 12 months after the surgery. Results: There was no statistically significant difference between the big bubble (+) and big bubble (−) groups in the biomechanical properties of the cornea (corneal hysteresis: 10.06, 10.25; p=0.716/corneal resistance factor: 10.15, 10.07; p=0.805, respectively). In addition, pachymetry results were not statistically different between the two groups. Multivariate regression analysis revealed that corneal hysteresis and corneal resistance factor were positively associated with central corneal thickness (p<0.001/r2=0.506; p<0.001/r2=0.561, respectively). However, the study did not demonstrate a relationship between any of the punch sizes and corneal hysteresis or between the punch sizes (p=0.673) and the corneal resistance factor (p=0.643). Conclusions: The corneal hysteresis and corneal resistance factor values were similar in big bubble and manual lamellar dissection after DALK. Thus, manual lamellar dissection was not a disadvantage considering the cornea's biomechanical properties.


RESUMO Objetivo: O objetivo do estudo foi comparar pa râmetros biomecânicos corneanos de pacientes com cirurgia de ceratoplastia lamelar anterior profunda com formação bem-sucedida de bolha e dissecção lamelar manual, frente à falha de formação da grande bolha. Métodos: Este estudo comparativo retrospectivo incluiu 60 olhos de 60 pacientes com ceratocone submetidos à cirurgia de ceratoplastia lamelar anterior profunda. Os pacientes foram agrupados como grande bolha (+) e grande bolha (-) de acordo com o sucesso da formação da grande bolha durante a cirurgia. O grupo grande bolha (+) incluiu 42 olhos, enquanto o grupo grande bolha (-) tinha 18 olhos. Além disso, para a avaliação dos efeitos da disparidade entre alterações individuais nas propriedades biomecânicas da córnea, reagrupamos os pacientes em 0,25 mm e 0,50 mm. Parâmetros biomecânicos da córnea, caracterizados por histerese corneana e fator de resistência corneana foram medidos com o ORA 12 meses após a cirurgia. Resultados: Não houve diferença estatisticamente significativa entre os grupos grande bolha (+) e grande bolha (-) em relação aos parâmetros biomecânicos da córnea (histerese corneana: 10,06, 10,25, p=0,716/fator de resistência da córnea: 10,15, 10,07, p=0,805, respectivamente). Além disso, os resultados de paquimetria não diferiram estatisticamente entre os dois grupos. A análise de regressão multivariada demonstrou que a histerese da córnea e o fator de resistência corneana estavam associados positivamente com a espessura corneana central (p<0,001/r2=0,506, p<0,001/r2=0,561 respectivamente). No entanto, o estudo não revelou associação entre qualquer um dos tamanhos de punção e histerese corneana, bem como entre os tamanhos de punção e o fator de resistência corneano (p=0,673, p=0,643). Conclusões: A histerese da córnea e os valores do fator de resistência da córnea foram comparáveis com formação de grande bolha e dissecção manual lamelar na ceratoplastia lamelar anterior profunda. Assim, a dissecção manual lamelar não foi uma desvantagem, considerando os fatores biomecânicos da córnea.


Subject(s)
Humans , Male , Female , Adult , Young Adult , Corneal Transplantation/methods , Cornea/surgery , Keratoconus/surgery , Reference Values , Biomechanical Phenomena , Multivariate Analysis , Regression Analysis , Retrospective Studies , Treatment Outcome , Cornea/physiopathology , Dissection/methods , Keratoconus/physiopathology
7.
Arq. neuropsiquiatr ; 78(2): 70-75, Feb. 2020. tab
Article in English | LILACS | ID: biblio-1088995

ABSTRACT

ABSTRACT Although fatigue is an expressive symptom of Parkinson's disease (PD), few studies have investigated the association between fatigue, mobility and walking capacity of these patients. Objective: To investigate whether fatigue is an independent factor associated with mobility and the walking capacity in patients with PD. Methods: Forty-eight patients with PD (22 with fatigue) were tested for mobility and their walking capacity: Timed Up and Go (TUG), 10-Meter Walk Test (10MWT) at usual and fastest speed, and 6-Minute Walk Test (6MWT). Fatigue was measured with Parkinson's Fatigue Scale (PFS-16). Linear regression analysis was used to investigate if fatigue is an independent factor contributing to variance in mobility and walking capacity. Results: There was a positive correlation between PFS-16 and TUG (rs=0.385; p=0.007). There was a negative correlation between PFS-16 and 10MWT at comfortable (r=-0.385; p=0.007) and fast speeds (r=-0.396; p=0.005), and 6MWT (r=-0.472; p=0.001). Linear regression analysis revealed that fatigue did not explain the variance of TUG and 10MWT. PFS-16, age and section III of UPDRS explained 49.6% (adjusted R2; p<0.001) variance in the 6MWT, and fatigue was the most significant predictor (F=-32.1; p=0.022). Conclusions: Fatigue is an independent factor contributing to the distance covered during 6MWT in patients with PD. Our results highlight the importance of recognition and management of this symptom.


RESUMO Embora a fadiga seja um sintoma importante na doença de Parkinson (DP), poucos estudos investigaram a associação entre fadiga, mobilidade e capacidade de marcha nesses pacientes. Objetivo: Investigar se a fadiga é um fator independente associado à mobilidade e à capacidade de marcha em pacientes com DP. Métodos: Quarenta e oito pacientes com DP (22 com fadiga) foram avaliados com testes de mobilidade e capacidade de marcha: Timed Up and Go (TUG), Teste de Caminhada de 10 metros (T10m) na velocidade usual e máxima, Teste de Caminhada de Seis Minutos (TC6m). A fadiga foi medida pela Escala de Fadiga no Parkinson (PFS-16). A análise de regressão linear foi utilizada para investigar se a fadiga é um fator independente que contribui para a variação na mobilidade e capacidade de marcha. Resultados: Houve correlação positiva entre PFS-16 e TUG (rs=0,385; p=0,007). Houve correlação negativa entre PFS-16 e T10m na velocidade usual (r=-0,385; p=0,007) e máxima (r=-0,396; p=0,005) e TC6m (r=-0,472; p=0,001). Análise de regressão linear revelou que a fadiga não explicava a variância do TUG e T10m. A PFS-16, a idade e a seção III da UPDRS explicaram 49,6% (R2 ajustado, p<0,001) da variância no TC6m e a fadiga foi o preditor mais significativo (F=-32,1; p=0,022). Conclusões: A fadiga é um fator independente que contribui para a distância percorrida durante o TC6m em pacientes com DP. Nossos resultados destacam a importância do reconhecimento e manejo desse sintoma.


Subject(s)
Humans , Parkinson Disease , Walking , Fatigue , Regression Analysis , Walk Test
8.
Article in English | LILACS-Express | LILACS, BBO | ID: biblio-1101289

ABSTRACT

Abstract Objective: To identify the clinical and radiographic conditions associated with failure of pulp therapy in primary teeth through a survival analysis. Material and Methods: A total of 1000 records of children assisted at the pediatric dentistry clinic of the Federal University of Parana, Brazil, from the years 2000 to 2010, were analyzed. The mean evaluation time was 10.61 months (minimum/maximum: 1/28) from the report of pulp therapy. The different types of treatments analyzed included indirect pulp treatment (IPT), direct pulp treatment (DPT), pulpotomy and pulpectomy. The Kaplan-Meyer method and log-rank test were used for the survival analysis. Exodontia was considered as the outcome variable and censors included: traumatic tooth loss, presence of the tooth in the oral cavity and physiologic tooth exfoliation. Results: A total of 122 records reporting pulp therapy in the primary teeth were selected. From this, 16 teeth (13.12%) were extracted. Survival analysis showed that pulpectomy presented lower survival rates when compared to conservative therapies (p=0.0297). Teeth with furcal lesions and pathological root resorption before pulp therapy had lower survival rates when compared to those that did not present these conditions (P=0.006). Presence of fistula and abscess after pulp therapy were also associated with lower survival rates (P=0.0062 and 0.0143, respectively). Conclusion: Signals of pulp necrosis were associated to lower survival rates in primary teeth submitted to pulp therapy.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Pulpectomy , Pulpotomy , Tooth, Deciduous , Survival Analysis , Dental Pulp Necrosis , Dental Pulp , Brazil , Multivariate Analysis , Survival Rate , Regression Analysis
9.
J. appl. oral sci ; 28: e20190198, 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1056596

ABSTRACT

Abstract Pathological parameters have been indicated as tumor prognostic factors in oral carcinoma. Objective: The objective of this study was to investigate the impact of pathological parameters on prognosis of patients affected only by tongue and/or floor of the mouth squamous cell carcinoma (SCC). Methodology: In total, 380 patients treated in the Brazilian National Cancer Institute (INCA) from 1999 to 2006 were included. These patients underwent radical resection followed by neck dissection. The clinical and pathological characteristics were recorded. The Kaplan-Meier method and Cox proportional hazards model were used in survival analysis. Overall survival (OS), cancer-specific survival (CSS) and disease-free interval (DFI) were estimated. Cox residuals were evaluated using the R software version 3.5.2. Worst OS, CSS and DFI were observed in patients with tumors in advanced pathological stages (p<0.001), with the presence of perineural invasion (p<0.001) and vascular invasion (p=0.005). Results: Advanced pathological stage and the presence of a poorly differentiated tumor were independent prognostic factors for OS and CSS. However, advanced pathological stage and perineural invasion were independent predictors of a shorter OS, DFI and CSS. Conclusion: Pathological stage and perineural invasion were the most significant pathological variables in survival analysis in tongue and/or floor of the mouth SCC.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Mouth Neoplasms/pathology , Tongue Neoplasms/pathology , Carcinoma, Squamous Cell/pathology , Mouth Floor/pathology , Neck Dissection/methods , Time Factors , Mouth Neoplasms/surgery , Mouth Neoplasms/mortality , Tongue Neoplasms/surgery , Tongue Neoplasms/mortality , Carcinoma, Squamous Cell/surgery , Carcinoma, Squamous Cell/mortality , Regression Analysis , Disease-Free Survival , Kaplan-Meier Estimate , Neoplasm Grading/methods , Neoplasm Staging
10.
Article in English | LILACS-Express | LILACS | ID: biblio-1091647

ABSTRACT

Abstract Objective: To approbate the complex approach for assessment of second molar mesialization outcomes with the use of orthodontic mini-implants. Material and Methods: The sample consisted of 62 patients, divided into study (n=32) and control group (n=30). Mesialization procedure in the study group was conducted with the use of braces system and orthodontic mini-implants as additional anchorage devices, while in control group mesialization was provided only with the use of the brace system. Dynamic registration of bone level changes and the entire range of tooth movement were carried out on digital orthopantomograms obtained with the use of Planmeca ProMax 2D. Results: Findings of orthopantomographic (OPG) analysis have shown that cases of second molar mesialization with the use of mini-implants as temporary anchorage characterized with more stable conditions of bone levels around displaced teeth compare to cases, where mesialization was provided only with the use of braces systems without any additional anchorage. The terms of treatment in the study group with the use of dental mini-implants as the anchorage was reduced by 8.8 ± 0.12 months compared to the control group (p<0.05). Conclusion: The use of orthodontic mini-implants as anchorage constructions during the mesialization of the mandibular second molars contributes to the reduction of treatment duration and support the more prognostic movement of teeth, that does not provoke significant pathological changes in the levels of the surrounded alveolar ridge and minimize the risk of associated periodontal complication occurrence.


Subject(s)
Humans , Male , Female , Adolescent , Tooth Movement Techniques/methods , Radiography, Dental, Digital/instrumentation , Molar , Orthodontics, Corrective , Ukraine , Regression Analysis
11.
Article in English | LILACS-Express | LILACS, BBO | ID: biblio-1101298

ABSTRACT

Abstract Objective: To determine the prevalence and factors associated with malocclusion in the primary dentition of preschool children in a city of Brazilian Northeast. Material and Methods: A cross-sectional study was conducted with 566 five-years-old preschool children who were enrolled in public and private preschools in the city of Teresina, Piauí, Brazil. Data were collected using a sociodemographic questionnaire administrated to parents/caregivers and clinical oral examination of the children was performed. Foster and Hamilton Index for primary teeth was used for the diagnosis of malocclusions. Descriptive analysis was carried out and Poisson regression was used to assesses the association with independent variables. Results: The prevalence of malocclusion was 51.2%. The most frequent types were Class II canines (17% and 16.8%), increased overjet (15.2%) and reduced overbite (14%). Anterior crossbite was present in 3.5% of the preschool children evaluated. There was an association between malocclusion and low family income (PR = 1.22; 95% CI = 1.01-1.47). Conclusion: The prevalence of malocclusion in the primary dentition was high and associated with a low family income.


Subject(s)
Humans , Male , Female , Child, Preschool , Orthodontics , Socioeconomic Factors , Tooth, Deciduous , Child, Preschool , Malocclusion/prevention & control , Brazil , Cross-Sectional Studies , Cross-Sectional Studies/methods , Surveys and Questionnaires , Regression Analysis
12.
Rev. panam. salud pública ; 44: e17, 2020. tab
Article in Spanish | LILACS | ID: biblio-1101763

ABSTRACT

RESUMEN Objetivo. Determinar las asociaciones existentes entre las características sociodemográficas y la prevalencia del consumo actual de tabaco en Costa Rica, según los resultados de la Encuesta Global de Tabaquismo en Adultos (GATS). Métodos. Estudio epidemiológico, observacional de tipo transversal con representación nacional (n = 8607), que utilizó las variables sociodemográficas incluidas en la GATS realizada durante 2015. Se diseñó un modelo de regresión logística para predecir la influencia de esas variables en el consumo actual de tabaco. La variable dependiente es el consumo actual de tabaco considerando los determinantes sociales disponibles en la encuesta: género, nivel educativo, zona de residencia, edad y la composición del hogar. Resultados. El modelo de regresión logística demuestra que ser mujer (OR = 0,29; P < 0,01), tener 65 años y más (OR = 0,61; P = 0,02), vivir en zona rural (OR = 0,63; P < 0,01) y vivir con otras personas (OR = 0,68; P < 0,01), en particular con niños de 15 años o menos (OR = 0,55; P < 0,01), son factores protectores del consumo de tabaco. El consumo de tabaco disminuye de forma significativa con el aumento de la riqueza medida por los artefactos en la casa en las mujeres, pero no en los hombres. Completar la educación secundaria es un factor protector en las personas de 15-34 años (OR = 0,47; P < 0,01), aunque no en las personas de 35 años y más. Conclusiones. Existe una asociación entre las variables sociodemográficas disponibles en la encuesta GATS Costa Rica realizada en el 2015 y el consumo actual de tabaco. Intervenciones a nivel familiar y comunal podrían contribuir a que los consumidores abandonen el tabaquismo.(AU)


ABSTRACT Objective. To determine the associations between sociodemographic characteristics and the current prevalence of tobacco use in Costa Rica, based on the results of the Global Adult Tobacco Survey (GATS). Methods. Cross-sectional observational epidemiological study, country-wide (n = 8607), that used the sociodemographic variables included in GATS 2015. A logistic regression model was designed to predict the impact of those variables on current tobacco use. The dependent variable is current tobacco use, considering the social determinants available in the survey: sex, educational level, area of residence, age, and household composition. Results. The logistic regression model shows that being female (OR = 0.29; P < 0.01), being 65 years old and over (OR = 0.61; P = 0.02), living in a rural area (OR = 0.63; P < 0.01), and living with other people (OR = 0.68; P < 0.01), in particular with children 15 years old or under (OR = 0.55; P < 0.01), are protective factors against tobacco use. Tobacco use declines significantly with increased wealth, as measured by household items, in women but not in men. Completing secondary education is a protective factor in people 15-34 years old (OR = 0.47; P < 0.01) but not in people 35 and over . Conclusions. There is an association between the sociodemographic variables found in the GATS Costa Rica survey carried out in 2015 and current tobacco use. Interventions at the family and community levels could help consumers give up smoking.(AU)


RESUMO Objetivo. Determinar as associações existentes entre as características sociodemográficas e a prevalência do consumo presente de tabaco na Costa Rica, segundo os resultados da Pesquisa Global sobre Tabagismo em Adultos (Global Adult Tobacco Survey - GATS). Métodos. Trata-se de um estudo epidemiológico observacional transversal com representatividade nacional (n = 8.607) com o uso das variáveis sociodemográficas estudadas na GATS realizada em 2015. Usou-se um modelo de regressão logística para predizer a influência das variáveis estudadas no consumo presente de tabaco. A variável dependente foi o consumo presente de tabaco levando em consideração os determinantes sociais disponíveis na pesquisa: gênero, nível de escolaridade, área de residência, idade e composição do domicílio. Resultados. Observou-se, no modelo de regressão logística, que ser do sexo feminino (OR 0,29; P < 0,01), ter 65 anos ou mais (OR 0,61; P = 0,02), residir na zona rural (OR 0,63; P < 0,01) e viver em um domicílio com outras pessoas (OR 0,68; P < 0,01), sobretudo com crianças menores de 15 anos (OR 0,55; P < 0,01), são fatores de proteção contra o consumo de tabaco. O consumo de tabaco diminui de forma significativa com o aumento da renda (medida de acordo com o número de serviços e utilidades domésticas) apenas entre as mulheres. Ter o ensino médio completo é um fator de proteção na faixa etária entre 15 e 34 anos (OR 0,47; P < 0,01), mas não entre as pessoas acima de 35 anos. Conclusões. Existe uma associação entre as variáveis sociodemográficas estudadas na GATS de 2015 e o consumo presente de tabaco na Costa Rica. Intervenções realizadas ao nível da família e da comunidade poderiam contribuir para a cessação do tabagismo.(AU)


Subject(s)
Humans , Demographic Indicators , Tobacco Use/epidemiology , Sociological Factors , Epidemiologic Studies , Cross-Sectional Studies/instrumentation , Regression Analysis , Costa Rica/epidemiology
13.
Ciênc. Saúde Colet ; 24(12): 4633-4642, dez. 2019. tab, graf
Article in Portuguese | LILACS | ID: biblio-1055756

ABSTRACT

Resumo O objetivo do estudo é analisar a associação entre as desigualdades sociais e o risco gestacional em regiões administrativas do estado do Espírito Santo. Estudo transversal, com base em duas regiões administrativas do estado do Espírito Santo. A amostra foi composta por 1.777 mulheres que realizaram o pré-natal nos municípios da Região Metropolitana da Grande Vitória (RMGV-ES) e Microrregião de São Mateus internadas nos estabelecimentos da rede pública de saúde, por ocasião do parto, entre 2010 e 2012/2013. Realizou-se Regressão Logística Multivariada para testar a associação entre variáveis sociais e risco gestacional. As variáveis que apresentaram nível de significância menor que 20% no teste Qui-quadrado foram utilizadas para o modelo final, permanecendo aquelas com significância menor que 5%. Encontrou-se associação entre alto risco gestacional e o local de moradia da mulher na RMGV-ES (OR = 1,74; IC 95% 1,32-2,28), a chefia da mulher na família (OR = 3,03; IC 95% 1,64-5,61), a escolaridade da chefia familiar menor que cinco anos (OR = 1,58; IC 95% 1,14-2,20) e o recebimento do benefício social "Bolsa Família" (OR = 1,46; IC 95% 1,04-2,03). Apesar de algumas variáveis sociais comporem a classificação do risco gestacional, outros fatores sociais revelaram-se como produtores do risco gestacional.


Abstract This study aims to analyze the association between social inequalities and gestational risk in administrative regions of the state of Espírito Santo. This is a cross-sectional study based on two administrative regions of the state of Espírito Santo. The sample consisted of 1,777 women who underwent prenatal care in the municipalities of the Greater Vitória Metropolitan Region (RMGV-ES) and São Mateus Microregion (MRSM) and were admitted to the public health facilities at the time of delivery between 2010 and 2012/2013. The multivariate logistic regression was performed to test the association between social and gestational risk variables. Variables with a significance level < 0.20 in the Chi-square test were adopted for the final model, and only those variables with a p-value < 0.05 remained. An association was found between high gestational risk and women's dwelling place in the RMGV-ES (OR = 1.74; CI95% 1.32-2.28), women as head of households (OR = 3.03; CI95% 1.64-5.61), head of household with less than five years of schooling (OR = 1.58; CI95% 1.14-2.20) and receipt of social benefit "Bolsa Família" (Family Grant) (OR = 1.46; CI95% 1.04-2.03). While some social variables underpin the classification of gestational risk, other social factors have been shown to produce this risk.


Subject(s)
Humans , Female , Pregnancy , Adolescent , Adult , Young Adult , Socioeconomic Factors , Residence Characteristics , Pregnancy, High-Risk , Prenatal Care/statistics & numerical data , Social Welfare , Brazil , Chi-Square Distribution , Family Characteristics , Cross-Sectional Studies , Regression Analysis , Risk Factors , Educational Status
14.
Ciênc. Saúde Colet ; 24(12): 4395-4404, dez. 2019. tab, graf
Article in Portuguese | LILACS | ID: biblio-1055753

ABSTRACT

Resumo O objetivo do estudo foi analisar como as crises econômicas afetam a saúde infantil a nível global e entre subgrupos de países com diferentes níveis de renda. Foram utilizados dados do Banco Mundial e da OMS para 127 países entre os anos de 1995 e 2014. Foi utilizado um modelo de efeitos fixos, avaliando o efeito da mudança em indicadores macroeconômicos (PIB per capita, taxa de desemprego e de inflação, e taxa de desconforto) na taxa de mortalidade neonatal, infantil, e de menores de cinco anos. Adicionalmente, avaliou-se a modificação do efeito da associação de acordo com a renda dos países e também a influência do gasto público em saúde nessa relação. As evidências mostraram que piores indicadores econômicos (menor PIB per capita e maiores inflação, taxa de desemprego e taxa de desconforto) estão associados com maiores taxas de mortalidade infantil. Nas subamostras por estrato de renda, observa-se a mesma relação, porém com efeitos de maior magnitude entre os países de renda baixa e média. Verificou-se ainda que um maior percentual nos gastos públicos em saúde ameniza os efeitos dos indicadores econômicos nas taxas de mortalidade infantil. Desta forma, é necessário aumentar a atenção aos efeitos nocivos das crises macroeconômicas para garantir melhorias na saúde infantil.


Abstract The aim of the study was to analyze how economic crises affect child health globally and between subgroups of countries with different levels of income. Data from the World Bank and the World Health Organization were used for 127 countries between 1995 and 2014. A fixed effects model was used, evaluating the effect of the change on macroeconomic indicators (GDP per capita, unemployment and inflation rates and misery index) in neonatal, infant and under-five mortality rates. Moreover, we evaluated whether there was a change in the association effect according to the income of the countries and also analyzed the role of public health expenditure in this association. Evidence has shown that worse economic indicators (lower GDP per capita, higher inflation, unemployment rates and misery index) are associated with higher child mortality rates. In the subsamples by income strata, the same association is observed, but with effects of greater magnitude for low- and middle-income countries. We also verified that a higher percentage in public health expenditures alleviates the effects of economic indicators on child mortality rates. Thus, more attention needs to be paid to the harmful effects of the macroeconomic crises to ensure improvements in child health.


Subject(s)
Humans , Pregnancy , Infant, Newborn , Infant , Infant Mortality , Public Health/economics , Global Health/economics , Economic Recession , Poverty/economics , Unemployment/statistics & numerical data , Developed Countries/economics , Global Health/statistics & numerical data , Regression Analysis , Health Expenditures , Developing Countries/economics , Gross Domestic Product , Inflation, Economic
15.
Rev. Bras. Saúde Mater. Infant. (Online) ; 19(4): 797-805, Sept.-Dec. 2019. tab
Article in English | LILACS | ID: biblio-1057123

ABSTRACT

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.


Subject(s)
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
16.
Int. j. morphol ; 37(4): 1286-1293, Dec. 2019. tab, graf
Article in English | LILACS | ID: biblio-1040126

ABSTRACT

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 %.


Subject(s)
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
17.
Ciênc. Saúde Colet ; 24(12): 4385-4394, dez. 2019. tab, graf
Article in English | LILACS | ID: biblio-1055762

ABSTRACT

Abstract Economic crisis is often managed with austerity policies. These measures seem to burden the population disproportionately, with the poorer being more affected. This paper aims to investigate health outcomes performance after the recent Brazilian crisis and gauge whether that pattern also emerged. Public domain data from 2010 to 2017 was used, and it was found that suicide and homicide rates increased after 2014, while mortality by road traffic injuries decreased at the same time. Furthermore, these trends were exacerbated in the North and Northeast regions and in the municipalities with the poorest quintiles of Human Development Index (HDI). The austerity policies followed by the Brazilian economic crisis may have influenced the mortality trends due to external causes, with a possible stronger impact in the North and Northeast regions and among less developed municipalities.


Resumo Crises econômicas são comumente administradas com políticas de austeridade. Estas medidas atingem a população de modo desproporcional, sendo os mais pobres os mais afetados. Este artigo pretende investigar a performance dos desfechos de saúde após a crise econômica recente e avaliar se o padrão de desproporcionalidade também ocorreu no Brasil. Dados públicos de 2010 a 2017 foram utilizados e encontramos que suicídios e taxas de homicídios aumentaram depois de 2014, enquanto mortalidade por acidentes de trânsito diminuíram. Além disto, estas tendências foram exacerbadas no Norte e no Nordeste e em municípios no quintil mais pobre em termos de Índice de Desenvolvimento Humano (IDH). As políticas de austeridade que se seguiram à crise econômica brasileira podem ter influenciado a tendência de mortalidade por causas externas, com um possível maior impacto no Norte e no Nordeste e em municípios menos desenvolvidos.


Subject(s)
Humans , Suicide/statistics & numerical data , Accidents, Traffic/mortality , Resource Allocation/economics , Economic Recession , Homicide/statistics & numerical data , Suicide/trends , Time Factors , Violence , Brazil/epidemiology , Accidents, Traffic/trends , Poverty Areas , Regression Analysis , Mortality/trends , Cause of Death , Homicide/trends
18.
Rev. chil. pediatr ; 90(6): 624-631, dic. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1058193

ABSTRACT

INTRODUCCIÓN: El objetivo de este trabajo es describir factores de riesgo de reconsulta en pacientes con diagnóstico de gastroenteritis aguda, identificables en su primera visita a Urgencias. PACIENTES Y MÉTODO: Estudio casos-control, incluye pacientes entre 0-16 años que consultan en Urgencias de un hospital terciario durante 4 años. Se define caso el episodio de Urgencias con diagnóstico de gastroenteritis que reconsulta durante las 72 h posteriores. Se seleccionó un control por cada caso, siendo este el primer paciente que consultó tras cada caso con el mismo diagnóstico y que no reconsultó posteriormente. Se estudiaron variables epidemiológicas, clínicas e intervenciones diagnóstico-terapéuticas llevadas a cabo durante la primera visita, realizándose análisis uni y multivariable del riesgo de reconsulta utilizando modelos de regresión logística. RESULTADOS: Los diagnósticos de gastroenteritis supusieron el 5,3% de todas las visitas a urgencias. 745 pacientes (6,2%) reconsultaron en las siguientes 72 h. En el análisis multivariado se encontró asociación entre la reconsulta con cada año de aumento de edad (OR 0,94; IC 95%: 0,91-0,97), ausencia de vacunación de rotavirus (OR 1,47; IC 95%: 1,11-1,95), no valoración previa en atención primaria (OR 1,55; IC 95%: 1,09-2,19), mayor número de deposiciones en las últimas 24 h (OR 1,06; IC 95% 1,02-1,10) y recogida de coprocultivo en Urgencias (OR 1,54; IC 95%: 1,05-2,24). CONCLUSIONES: Los pacientes de menor edad con elevada frecuencia de deposiciones son especialmente susceptibles de volver a consultar en los servicios de Urgencias. La vacunación frente a rotavirus podría disminuir las reconsultas. Ninguna de las actuaciones diagnóstico-terapéuticas realizadas parece disminuir el número de revisitas a Urgencias.


INTRODUCTION: The objective of this work is to describe risk factors for reconsultation in patients with an acute gastroenteritis diagnosis, identifiable in their first visit to the Emergency Department. PATIENTS AND METHOD: Case-control study, including patients aged between 0-16 years who consulted in the Emer gency Department (ED) of a tertiary hospital for 4 years. The case is defined as the episode with a gastroenteritis diagnosis that reconsulted within 72 hours. A control was selected for each case, which was the first patient to consult after each case with the same diagnosis and not reconsulted later. Epidemiological and clinical variables, and diagnostic-therapeutic interventions carried out during the first visit were studied. Univariate and multivariate analyses of the reconsultation risk were per formed using logistic regression models. RESULTS: Gastroenteritis diagnoses accounted for 5.3% of all ED visits. 745 patients (6.2%) reconsulted within 72 hours. Multivariate analysis found association between reconsultation with each year of increasing age (OR 0.94, 95% CI 0.91-0.97), absence of rotavirus vaccination (OR 1.47, 95% CI: 1.11-1.95), no prior assessment in primary care (OR 1.55, 95% CI 1.09-2.19), increased stool output in the last 24 hours (OR 1.06, 95% CI 1.02-1.10), and stool collection in the ED (OR 1.54, 95% CI 1.05-2.24). CONCLUSIONS: Younger patients with an increased stool output are especially susceptible to return to the ED for consultation. Rotavirus vaccination could reduce reconsultation. None of the diagnostic-therapeutic actions carried out seems to reduce the number of visits to the ED.


Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Emergency Service, Hospital/statistics & numerical data , Gastroenteritis/epidemiology , Health Services Needs and Demand/statistics & numerical data , Case-Control Studies , Acute Disease , Regression Analysis , Risk Factors , Retreatment/statistics & numerical data , Gastroenteritis/diagnosis , Gastroenteritis/therapy
19.
Rev. salud pública ; 21(5): e380949, sep.-oct. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1127217

ABSTRACT

RESUMEN Objetivos Determinar las tendencias de la incidencia del contagio por VIH en Chile, según edad y género, para el período 2010-2017. Métodos Análisis desde la base de datos de casos confirmados de diagnóstico de VIH positivos. Las tasas de incidencia de VIH se confeccionaron a partir de los casos confirmados por VIH ajustados por año, edad y sexo, con denominadores poblacionales del INE. Se realizó un análisis de tendencia general y específica mediante ecuaciones de regresión. Resultados Existe tendencia al aumento en tasas de incidencia del VIH en el periodo de estudio. El 36,48% de los casos reportados corresponde al sexo masculino entre 20 y 29 años, grupo con más alta incidencia en el período. Las ecuaciones de regresión estimadas efectivamente aumentan más sostenidamente en población masculina y joven. Conclusiones Existen factores informativos y educacionales deficitarios en la prevención del VIH en la población chilena. A pesar de la fuerte progresión de los casos nuevos, aún resta consolidar la brecha diagnóstica de personas que viven con VIH que desconocen su estado de salud. Se identificaron brechas entre recomendaciones, políticas públicas y resultados chilenos obtenidos.(AU)


ABSTRACT Objetive To determine the trends in the incidence of contagion by the HIV in Chile, according to age and gender, for the period 2010-2017. Methods Analysis from the database of confirmed HIV positive diagnosis cases. HIV incidence rates were made from HIV-confirmed cases adjusted for year, age, and sex, with population denominators from the INE. A general and specific trend analysis was performed using regression equations. Results There is a trend to increase in HIV incidence rates in the study period. 36.48% of the reported cases correspond to the male sex between 20-29 years, group with the highest incidence in the period. The estimated regression equations effectively increase more steadily in the male and young population. Conclusions There are deficit informative and educational factors in HIV prevention in the Chilean population. Despite the strong progression of new cases, the diagnostic gap of people living with HIV who are unaware of their health remains to be consolidated. Gaps were identified between recommendations, public policies and the Chilean results obtained.(AU)


Subject(s)
Humans , HIV Infections/epidemiology , HIV , Chile/epidemiology , Incidence , Regression Analysis
20.
Arq. bras. cardiol ; 113(4): 699-709, Oct. 2019. tab, graf
Article in English | LILACS | ID: biblio-1038567

ABSTRACT

Abstract Background: Smoking and an inadequate diet are behavioral risk factors that contribute to the majority of deaths and disabilities caused by noncommunicable diseases. Objectives: To estimate the prevalence of the co-occurrence of smoking and inadequate diet and identify associated factors in adults. Methods: A cross-sectional population-based study was conducted with a sample of 28,950 Brazilian adults (18 to 59 years old). Data were obtained from Sistema de Vigilância por Inquérito Telefônico (Vigitel [Brazilian Health Surveillance Telephone Survey]) in 2014. Independent associations were investigated using Poisson hierarchical regression analysis with 5% significance level. Results: The prevalence of the co-occurrence of smoking and unhealthy eating was 8.6% (95% CI: 7.9-9.3) and was higher among individuals residing in the southern region of the country than in those living in the central western region (PR = 1.50; 95% CI: 1.18-1.89), those with no private health insurance (PR = 1.14; 95% CI: 1.03-1.25), those who drank alcohol abusively (binge drinkers) (PR = 3.22; 95% CI: 2.70-3.85) and those who self-rated their health as fair (PR = 1.65; 95% CI: 1.36-1.99) or poor/very poor (PR = 1.70; 95% CI: 1.18-2.44). The prevalence of both factors was lower among individuals residing in the northeastern region of the country, women, individuals with brown skin color, those with a spouse, the more educated ones and those with overweight or obesity. Conclusion: The more vulnerable segments to the co-occurrence of the risk factors studied were men residing in the southern region of the country, individuals with a lower socioeconomic status and those who reported binge drinking. Interventions addressing multiple behavioral risk factors adapted to specific contexts could have a greater impact on the Brazilian population.


Resumo Fundamentos: O tabagismo e a alimentação inadequada integram os fatores comportamentais de risco responsáveis pela maioria das mortes e das incapacidades causadas por doenças crônicas não transmissíveis. Objetivos: Estimar a prevalência e identificar os fatores associados à coocorrência de tabagismo e alimentação inadequada em adultos. Métodos: Estudo transversal de base populacional com 28.950 adultos (18-59 anos), cujas informações foram obtidas pelo Sistema de Vigilância por Inquérito Telefônico (Vigitel), em 2014. As associações independentes foram verificadas por meio de regressão hierárquica de Poisson, com nível de significância de 5%. Resultados: A prevalência de coocorrência de tabagismo e alimentação não saudável foi de 8,6% (IC95%: 7,9-9,3), mostrando-se mais elevada entre os que residiam na região Sul (RP = 1,50; IC95%: 1,18-1,89) comparados aos do Centro-Oeste, nos que não possuíam plano privado de saúde (RP = 1,14; IC95%: 1,03-1,25), nos que ingeriam bebidas alcoólicas de forma abusiva (RP = 3,22; IC95%: 2,70-3,85) e nos que autoavaliaram a saúde como regular (RP = 1,65; IC95%: 1,36-1,99) ou ruim/muito ruim (RP = 1,70; IC95%: 1,18-2,44). Apresentaram menor prevalência de ambos os fatores os que viviam na região Nordeste, as mulheres, os de cor da pele parda, aqueles que tinham cônjuge, os mais escolarizados e os que estavam com sobrepeso ou obesidade. Conclusão: Os segmentos mais vulneráveis à coocorrência dos fatores de risco estudados foram os homens, os residentes na região Sul do país, aqueles com menor nível socioeconômico, os que referiram consumo abusivo de álcool, entre outros. Intervenções sobre múltiplos comportamentos de risco, adaptadas às realidades diversas, podem ter maior impacto na população brasileira.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Young Adult , Smoking/epidemiology , Diet/statistics & numerical data , Health Risk Behaviors , Socioeconomic Factors , Time Factors , Brazil/epidemiology , Diet Surveys , Prevalence , Cross-Sectional Studies , Regression Analysis , Risk Factors , Diabetes Mellitus/epidemiology , Dyslipidemias/epidemiology , Hypertension/epidemiology
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