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1.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 42(1): 40-45, Jan.-Feb. 2020. tab
Article in English | LILACS (Americas) | ID: biblio-1055358

ABSTRACT

Objective: To describe and analyze data on self-injurious behavior (SIB) and related mortality in children under 10 years old in Brazil. Methods: A descriptive study was performed using secondary public health care data extracted from the Hospital Information System (Sistema de Informações Hospitalares, SIH) and Mortality Information System (Sistema de Informações sobre Mortalidade, SIM) in Brazil. The databases are available for online access at http://datasus.saude.gov.br/. Results: In Brazil, according to SIH data, 11,312 hospitalizations of patients under 10 years of age were recorded from 1998 to 2018 as resulting from SIB (ICD-10 X60-X84 codes). Of these, 65 resulted in death. According to the SIM, from 1996 to 2016, 91 deaths related to SIB were recorded, 81 (89%) in children aged 5 to 9 years, nine (9.9%) in children aged 1 to 4 years, and one (1.1%) in a child below 1 year of age. Conclusion: These results highlight the relevance of creating measures to better understand SIB and related mortality in this age group. They also reveal the vulnerability of children in Brazil and warrant further studies to address these issues.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Self-Injurious Behavior/mortality , Child Mortality/trends , Brazil , Retrospective Studies , Risk Factors , Hospital Mortality/trends , Sex Distribution , Age Distribution , Hospitalization/statistics & numerical data
2.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 42(1): 63-67, Jan.-Feb. 2020. tab
Article in English | LILACS (Americas) | ID: biblio-1055364

ABSTRACT

Objective: To determine whether people with a Sardinian genetic background who live in the megacities of South America have a higher frequency of hypomania than residents of Sardinia. Methods: A community survey of Sardinian immigrants was carried out in four Brazilian metropoles (n=218) and Buenos Aires (n=306). The results were compared with those of a study involving a similar methodology (Mood Disorder Questionnaire [MDQ] as a screening tool) conducted in seven Italian regions, including a sub-sample from Sardinia. Results: There was a higher prevalence of lifetime hypomania among Sardinians living in the Brazilian metropoles than among those living in Sardinia. This result was also consistent with Sardinian immigrants in Buenos Aires. After stratification by sex and age, the lifetime prevalence of MDQ scores ≥ 8 among Sardinians in South-American megacities and Sardinia was 8.6% vs. 2.9%, respectively (p < 0.0001). Conclusions: The higher frequency of hypomania in migrant populations appears to favor an evolutionary view in which mood disorders may be a maladaptive aspect of a genetic background with adaptive characteristics.


Subject(s)
Humans , Male , Female , Adult , Transients and Migrants/psychology , Bipolar Disorder/epidemiology , Argentina/epidemiology , Brazil/epidemiology , Cross-Cultural Comparison , Prevalence , Surveys and Questionnaires , Risk Factors , Cities/epidemiology , Sex Distribution , Age Distribution , Italy/ethnology
3.
Annals of Dermatology ; : 109-114, 2020.
Article in English | WPRIM (Western Pacific) | ID: wprim-811088

ABSTRACT

BACKGROUND: Tinea capitis is a cutaneous infection of dermatophytes and predominant in children. Although tinea capitis in Korea is controlled by oral antifungal medications and concerted public health initiatives, it's still a health issue.OBJECTIVE: To investigate changes in the epidemiological and mycological characteristics of adult patients with tinea capitis in southeastern Korea.METHODS: Using medical records from Kyungpook National University Hospital and Catholic Skin Clinic from 1989 to 2018, we retrospectively investigated the epidemiological and mycological characteristics of 266 adult patients (aged over 20) with tinea capitis.RESULTS: Among total 266 patients, 239 were KOH-positive. The annual incidence of tinea capitis ranged from 3 to 18 between 1989 and 2018. Of the total, 54 (20.30%) were male and 212 (79.70%) were female. Eighty patients (30.08%) were in their seventies, the most commonly affected age group. Of the remaining, 58 (21.80%) were in their sixties, and 41 (15.41%) in eighties. Among all, 77 (28.95%) visited the hospital in summer, 72 (27.07%) in spring, 64 (24.06%) in winter, and 53 (19.92%) in fall. Dermatophytes were cultured from 171 patients. Microsporum canis was the most common dermatophyte (42.48%), while Trichophyton rubrum was the second (15.79%). Of the 266 patients, 186 (69.92%) lived in urban areas and 80 (30.08%) in rural areas.CONCLUSION: The epidemiological and mycological characteristics of adult patients with tinea capitis were different from those of children in terms of annual incidence, sex distribution, and isolated dermatophytes. These results provide useful information for the treatment and prevention of tinea capitis.


Subject(s)
Adult , Arthrodermataceae , Child , Epidemiology , Female , Humans , Incidence , Korea , Male , Medical Records , Microsporum , Public Health , Retrospective Studies , Sex Distribution , Skin , Tinea Capitis , Tinea , Trichophyton
4.
Braz. dent. sci ; 23(1): 1-8, 2020. tab
Article in English | LILACS (Americas), BBO | ID: biblio-1049727

ABSTRACT

Objective: Periodontal diseases are very common dental disease. Many risk factors may play significant role in the periodontal disease initiation and progression. This study was performed to evaluate the effects of khat chewing, smoking, age and gender on periodontal status among Yemeni adults. Material and Methods: This cross-sectional study was performed on 1231 patients attending the outpatient dental polyclinics of University of Science and Technology during the academic years 2017/2018. All completed sheets were collected throughout the year by the supervisors. Data cleaning, descriptive statistics, and inferential statistics were then performed. Results: Khat chewers were more frequent than non-chewers counterparts (60.7% vs. 39.3%). The prevalence of smoking was 25.5% (297 patients). Study results indicated that periodontitis is more associated with female gender and participants aged more than 35 years old. Results also showed that female and age older participants aged more than 35 years were significantly associated with gingival recession. Mean number of the teeth with gingival recession in male patients were higher than in females. Male gender and patients aged more than 35 years old were significantly associated with furcation involvement. Conclusion: The present study has shown females gender and age older than 35 seem to be risk factors of periodontal diseases. Males has more teeth affected by gingival recession and more furcation involvement (AU)


Objetivo: As doenças periodontais são patologias dentárias com alta prevalência. Diversos fatores de risco podem desempenhar papel significativo no início e progressão das doenças periodontais. Este estudo foi realizado para avaliar os efeitos da mastigação de khat, tabagismo, idade e gênero na condição periodontal de adultos iemenitas. Material e Métodos: Este estudo transversal foi realizado em 1231 pacientes atendidos nas policlínicas odontológicas ambulatoriais da Universidade de Ciência e Tecnologia durante os anos acadêmicos de 2017/2018 através de um questionário para coleta de dados préestabelecido. Todas os questionários preenchidos foram coletados ao longo do ano pelos supervisores. A apuração dos dados, estatística descritiva e estatística inferencial foram realizadas. Resultados: os mastigadores de Khat foram mais frequentes do que as não-mastigadores (60,7% vs. 39,3%). A prevalência de tabagismo foi de 25,5% (297 pacientes). Os resultados do estudo indicaram que a periodontite está mais associada ao gênero feminino e aos participantes com mais de 35 anos de idade. Os resultados também mostraram que participantes do gênero feminino e acima de 35 anos foram significativamente associadas à recessão gengival. O número médio de dentes com recessão gengival em pacientes do gênero masculino foi maior que no feminino. O gênero masculino e os pacientes com mais de 35 anos de idade foram significativamente associados ao envolvimento da furca. Conclusão: O presente estudo mostrou que o gênero feminino e a idade acima de 35 anos parecem ser fatores de risco para doenças periodontais. Pacientes do gênero masculino têm mais dentes afetados pela recessão gengival e mais envolvimento de furca.(AU)


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Periodontal Diseases/epidemiology , Tobacco Use Disorder/epidemiology , Catha , Mastication , Periodontal Diseases/etiology , Periodontitis/etiology , Periodontitis/epidemiology , Tobacco Use Disorder/complications , Yemen/epidemiology , Cross-Sectional Studies , Risk Factors , Sex Distribution , Furcation Defects/etiology , Furcation Defects/epidemiology , Age Distribution , Catha/adverse effects , Gingival Recession/etiology , Gingival Recession/epidemiology
5.
Braz. dent. sci ; 23(1): 1-8, 2020. tab, ilus
Article in English | LILACS (Americas), BBO | ID: biblio-1049723

ABSTRACT

Objective: Facial appearance has become an important factor of social interaction. The perception of patients regarding the changes promoted by treatment has become a focus of study today. Thus, the proposal of the present study was to evaluate the esthetic perception of lay people regarding esthetic periodontal changes. Method: The total sample comprised 180 individuals divided into three different age groups (15-19, 35-44, and 65-74 years). Nine images with digital alterations in the gingival contour were used. One of the images served as an esthetic standard for the research (ideal image). The images were presented to the evaluators using slide show software (Microsoft PowerPoint 2013, Microsoft, California). Was used the Wilcoxon, Kruskal-Wallis and Mann-Whitney test. The level of significance was 5% (α = 0.05). Results: Statistical differences were found between the esthetic perception of different age groups. The sample was composed only of lay people of three different age groups, and it was evident that the younger age group has a more accurate perception regarding changes in the gingival contour. Conclusion: The changes in the gingival contour perceived as less attractive were the changes between the central incisors. The younger age group had a more accurate esthetic perception in this study. (AU)


Introdução: A aparência facial tornou-se um fator importante de interação social. A percepção dos pacientes quanto as alterações promovidas pelo tratamento tem se tornado foco de estudo na atualidade. Dessa forma a proposta do presente estudo foi avaliar a percepção estética de leigos em relação às alterações estéticas periodontais. Metodologia: A amostra total foi composta por 180 indivíduos divididos em três faixas etárias diferentes (15-19, 35-44, 65-74). Foram utilizadas 09 imagens com alterações digitais no contorno gengival, sendo que uma delas serviu como padrão estético para a pesquisa (imagem ideal). As imagens foram apresentadas aos avaliadores usando o software de apresentação de slides (Microsoft PowerPoint 2013, Microsoft, Califórnia). Foi utilizado o teste de Wilcoxon, Kruskal-Wallis e MannWhitney. O nível de significância foi de 5% (α = 0,05). Resultados: Foram encontradas diferenças estatísticas entre a percepção estética dos grupos de diferentes faixas etárias. Na amostra composta apenas por pessoas leigas de 3 diferentes faixas etárias, ficou evidente que a faixa etária mais jovem tem uma percepção mais apurada em relação às alterações no contorno gengival. Conclusão: As alterações no contorno gengival percebidas como menos atraentes foram as alterações entre os incisivos centrais. A faixa etária mais jovem teve uma percepção estética mais precisa neste estudo.(AU)


Subject(s)
Humans , Male , Female , Adolescent , Adult , Aged , Young Adult , Perception , Esthetics, Dental , Physical Appearance, Body , Gingiva , Cross-Sectional Studies , Sex Distribution , Age Distribution
6.
Int. j. morphol ; 37(4): 1382-1386, Dec. 2019. tab
Article in English | LILACS (Americas) | ID: biblio-1040141

ABSTRACT

Agenesis of permanent teeth is the most frequent dental anomaly. The most affected tooth is the third molar (M3), and its congenital absence poses interesting questions from a clinical and evolutionary perspective. M3 agenesis can occur isolated or as part of syndromes. Researchers have reported prevalences that vary largely among populations, between 5 % and 56 %, with a mean prevalence of 22.6 %. Previous Chilean studies, mainly in Northern populations, have determined a prevalence between 19.8 % and 26.7 %. The aim of this work was to assess the prevalence of M3 agenesis and to characterize its presentation in a sample from Santiago, the largest to date in a M3 agenesis prevalence study in Chile. In this study, 535 panoramic radiographies and clinical histories of patients from the Dental Clinic of the Universidad de Chile were used to determine prevalence and distribution according to sex, affected tooth, and location (left or right; maxilla or mandible). The Chi-square test was used to assess statistical significance in distribution. The calculated M3 agenesis prevalence was of 12.89 %. No statistically significant differences were found between sexes, sides or location within the jaws. The agenesis of one third molar was more common, then two, three and finally of all the third molars. The prevalence of M3 agenesis in the sample is 12.89 %, with a random manner of presentation. We propose that as it currently stands, M3 agenesis should be considered an anatomical variation rather than a developmental anomaly.


La agenesia de dientes definitivos es la anomalía dental más común. El diente más afectado es el tercer molar (M3), y su ausencia congénita plantea preguntas interesantes desde una perspectiva clínica y evolutiva. La agenesia de M3 puede ocurrir de manera aislada o asociada a síndromes. Estudios a nivel mundial reportan una prevalencia variable entre poblaciones: 5 % a 56 %, con una prevalencia media del 22,6 %. Estudios chilenos anteriores, principalmente en poblaciones del norte, han determinado una prevalencia entre 19,8 % y 26,7 %. El objetivo de este trabajo fue determinar la prevalencia de agenesia de M3 y caracterizar su presentación en una muestra de Santiago, la más grande hasta la fecha en un estudio de prevalencia de agenesia de M3 en Chile. Se utilizaron 535 radiografías panorámicas y antecedentes de pacientes atendidos en la Clínica Odontológica de la Universidad de Chile para evaluar la prevalencia y modo de presentación de la agenesia de M3. Se analizó su distribución según ubicación, sexo y simetría, mediante test estadístico Chi-cuadrado. Se calculó una prevalencia de agenesia de M3 de 12,89 %, sin un patrón claro ni estadísticamente significativo en su distribución. Fue más común la agenesia de un tercer molar, luego de dos, tres y finalmente de todos los terceros molares. La prevalencia de agenesia en una muestra de la Región Metropolitana es de 12,89 % y su distribución es aleatoria según la ubicación, sexo y simetría. Se propone que esta condición actualmente debiera considerarse como una variación anatómica más que a una anomalía del desarrollo.


Subject(s)
Humans , Male , Female , Anodontia/epidemiology , Molar, Third/abnormalities , Radiography, Panoramic , Chi-Square Distribution , Chile/epidemiology , Prevalence , Sex Distribution , Anatomic Variation , Anodontia/diagnostic imaging , Molar, Third/anatomy & histology , Molar, Third/diagnostic imaging
7.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 41(6): 511-517, Nov.-Dec. 2019. tab
Article in English | LILACS (Americas) | ID: biblio-1055340

ABSTRACT

Objective: To estimate the association of parental drunkenness and parenting style with alcohol consumption among adolescents and the contributions of parental drunkenness and parenting style to the prevalence of binge drinking among adolescents. Method: Cross-sectional survey of a representative sample of secondary students aged 13 to 18 from 27 Brazilian state capitals (n=17,028). Private and public schools were included. A self-report questionnaire collected data on adolescents' alcohol drinking behavior, parenting styles, and parenting and peer models of drunkenness. Results: Non-authoritative parenting style and parental drunkenness are associated with binge drinking among adolescents. Authoritarian, indulgent, and negligent parenting styles were associated with 1.50-, 2.51-, and 2.82-fold increases in prevalence of adolescent binge drinking, and parental drunkenness, with a 1.99-fold increase. The non-authoritative parenting style made a larger contribution than parental drunkenness to adolescent binge drinking. Conclusions: Non-authoritative parenting style and parental drunkenness seem to play an important role in adolescents' binge drinking behavior. At the population level, parenting style appears associated with a greater contribution to this behavior among adolescents. Prevention strategies targeting parental drunkenness may be bolstered if a broader approach including parenting styles is in place.


Subject(s)
Humans , Male , Female , Adolescent , Parent-Child Relations , Parenting , Alcoholic Intoxication/epidemiology , Binge Drinking/epidemiology , Underage Drinking/statistics & numerical data , Risk-Taking , Authoritarianism , Brazil/epidemiology , Prevalence , Cross-Sectional Studies , Surveys and Questionnaires , Risk Factors , Adolescent Behavior , Sex Distribution
8.
Rev. argent. coloproctología ; 30(4): 80-87, dic. 2019. graf, tab, ilus
Article in Spanish | LILACS (Americas) | ID: biblio-1096677

ABSTRACT

Introducción: Las infecciones transmisibles sexualmente (ITS) con afectación anorrectal constituyen un desafío pues las manifestaciones producidas por Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) y Treponema pallidum (TP) son similares. Objetivo: Evaluar si las manifestaciones anorrectales debidas a CT, NG y TP asociadas al examen proctológico permiten diagnóstico certero, sin estudios complementarios. Pacientes y método: Estudio retrospectivo. Revisión de registros de pacientes atendidos en consultorio coloproctológico. Periodo: 01/08/2015-01/07/2016. Se incluyeron pacientes con diagnóstico de ITS anorrectal, excepto aquellos con HPV únicamente. A todos se les pesquisaron ITS mediante hisopado anal para CT por inmunofluorescencia y para estudio directo y cultivo de NG, VDRL para TP y además HIV. Variables: sexo, edad, HIV, sexo anal, uso de preservativo, motivo de consulta y resultado de estudios efectuados. Resultados: Treinta y cuatro pacientes (32 hombres). Edad mediana 31,5 años (rango: 19-65). Veinticinco pacientes HIV + (73,5%). Veintinueve pacientes (28 hombres) mantenían sexo anal. 91% no usaba preservativo adecuadamente. 65% tuvo una única infección (ITS pura). Se diagnosticaron 14 sífilis (8 puras), 14 clamidiasis (7 puras) y 11 gonococcias (7 puras). Co-infección entre ellas: 9% y con HPV: 26%. La úlcera fue la manifestación en 7/8 casos de sífilis puras (todas dolorosas, excepto una). El resto presentó síntomas variados (condilomas virales atípicos, secreción purulenta y proctorragia). Más del 50% de las gonococias puras (4/7) se manifestó con úlcera, sin embargo, el dolor estuvo presente siempre (8/8) y en tres se asoció secreción purulenta. En cambio, la mitad de los pacientes con clamidiasis puras, se manifestó con proctorragia causada por un tumor rectal/sigmoideo inflamatorio, clínicamente indistinguible de neoplasia maligna. Todos las sífilis y gonococias tuvieron correlato con las pruebas diagnósticas, no así las clamidiasis cuyo diagnóstico no pudo confirmarse en tres casos (37,5%), que respondieron al tratamiento empírico. Conclusión: NG y TP anorrectal provocaron mayormente síntomas similares a los de etiología no venérea y se requirió del laboratorio para el diagnóstico etiológico. La presencia de tumor con biopsia negativa para neoplasia maligna en pacientes de riesgo para ITS obliga a descartar clamidiasis. (AU)


Introduction: Sexually transmitted infections (STIs) are a challenge in medical consultation. The clinical manifestations of infection by Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Treponema pallidum ( TP) share symptoms at anorectal level. This implies the need for a high index of suspicion for diagnosis, which is based on history, physical examination and laboratory tests that not always are accurate or available . Purpose: Assess whether clinical signs of anorectal infections by CT, NG and TP associated with proctologic exams, lead to an accurate etiologic diagnosis without the help of specific laboratory studies. Patients and methods: Observational, retrospective study, based on a review of records of patients treated at the outpatient clinic of the Hospital Fernandez (City of Buenos Aires) department of coloproctology, in the period between August 2015 and July 2016. Patients who underwent STI diagnosis were all considered, but to those whose only diagnosis was infection by human papilloma virus (HPV) were excluded from the analysis. All patients were tested after the three etiologies of STI (anal swab for CT study by immunofluorescence, swabbing for direct study, and cultivation of NG and TP VDRL) and HIV. Variables analyzed: sex, age, presence of HIV infection, practice of receptive anal sex, proper use of condoms, signs and symptoms that prompted the consultation, and results of diagnostic tests. Results: 34 patients (32 men) were included. Median age 31.5 years (range: 19-65, interquartile range: 26-37). Twenty-five patients (73.5%) were HIV+. Twenty-nine patients (28 men) remained receptive anal sex. 91% did not use condoms properly. 65% of infections were pure, without other STI asociada-. 14 cases of syphilis (8 pure), 14 Chlamydia (7 pure) and 11 gonococcias (7puras), including co-infection in 9% of cases, no evidence of a more frequent another co-infection diagnosed. Co-infection with HPV was detected in 9 (26%) cases. The ulcer was the sign in 7/8 cases of pure syphilis (all painful, except one). The rest is expressed by a variety of symptoms (atypical viral warts, purulent and bloody diarrhea). Similarly, just over 50% (4/7) of pure gonococcias demonstrated ulcer, but the pain was always present (8/8 of pure gonococcias) and three associated with purulent discharge. Instead of the ten patients with pure chlamydia, 50% manifested with bloody diarrhea caused by a rectal tumor / inflammatory sigmoid, clinically indistinguishable from malignancy. All cases of syphilis and gonococcal were correlated with diagnostic tests; not those whose diagnosis of chlamydial infection (confirmed in eight and was negative in three, 37.5%) who responded to empiric treatment indicated by the clinical suspicion. Conclusion: While this is a small series, it shows that the NG and TP in the anorectal location mostly caused symptoms similar to those of non-venereal ethology most of the times, and laboratory assistance for etiologic diagnosis was required. The presence of tumor with negative biopsy for malignancy in patients at risk for STIs, leads chlamydia to be ruled out. (AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Young Adult , Proctitis/etiology , Proctitis/microbiology , Sexually Transmitted Diseases, Bacterial/complications , Sexually Transmitted Diseases, Bacterial/diagnosis , Chlamydia Infections/diagnosis , Gonorrhea/diagnosis , Syphilis/diagnosis , Pain , Proctitis/epidemiology , Rectum/microbiology , Sexually Transmitted Diseases, Bacterial/epidemiology , Comorbidity , HIV Infections , Retrospective Studies , Sex Distribution , Clinical Laboratory Techniques
9.
An. bras. dermatol ; 94(6): 664-670, Nov.-Dec. 2019. tab, graf
Article in English | LILACS (Americas) | ID: biblio-1054902

ABSTRACT

Abstract Background: Reports regarding the causative drugs of drug-induced cutaneous adverse reactions in China are indistinct, such that different regions have reported the spectrum of drugs differs substantially in different clinical conditions. Objective: To explore the causative drugs that led to cutaneous reactions. Methods: Adverse drug reaction reports from central China were collected and divided into cutaneous adverse reactions and severe cutaneous adverse reactions groups. Cases were reviewed retrospectively for causative drugs. Results: The male:female ratio was equal in both cutaneous adverse reactions and severe cutaneous adverse reactions. In cutaneous adverse reactions (n = 482), the highest incidence happened between 51 and 60 years of age and the top three causative drugs were antibiotics (48%), Chinese medicine (16%), and allopurinol (9%). In severe cutaneous adverse reactions (n = 126), the highest incidence happened between 41 and 50 years of age and the top three causative drugs were sedative-hypnotics and antiepileptics (39%), antibiotics (22%), and allopurinol (15%). Carbamazepine was the most frequently used single-drug (16/18) in sedative-hypnotics and antiepileptics. β-lactams were the most frequently used antibiotics that induced both cutaneous adverse reactions and severe cutaneous adverse reactions. Study limitations: The small sample size, retrospective design, collection of cutaneous adverse reactions and severe cutaneous adverse reactions at different time frames and locations, and exclusion of patients taking more than five medications are limitations of the study. Conclusions: Gender does not affect cutaneous adverse reactions and severe cutaneous adverse reactions. The top three drugs to induce cutaneous adverse reactions are antibiotics, Chinese medicine, and allopurinol, while those that triggered severe cutaneous adverse reactions are sedative-hypnotics and antiepileptics, antibiotics, and allopurinol. Carbamazepine is the most frequent single drug that induces severe cutaneous adverse reactions. β-lactams are the most frequently used antibiotics that induce both cutaneous adverse reactions and severe cutaneous adverse reactions.


Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Drug Eruptions/etiology , Drug Eruptions/epidemiology , China/epidemiology , Incidence , Retrospective Studies , Age Factors , Sex Distribution , Age Distribution , Hypnotics and Sedatives/adverse effects , Anti-Bacterial Agents/adverse effects , Anticonvulsants/adverse effects
10.
An. bras. dermatol ; 94(5): 567-573, Sept.-Oct. 2019. tab
Article in English | LILACS (Americas) | ID: biblio-1054861

ABSTRACT

Abstract Background One of the main prevention methods against skin cancer is the use of sunscreen; however, incidence of this disease has not declined despite prevention campaigns. Objective Investigate the prevalence of non-use of sunscreen and its associated factors. Method A population-based cross-sectional study with individuals aged 18 years or over living in the urban area. Conducted between April and July of 2016. Participants were interviewed about socioeconomic, demographic, and behavioral questions. Non-use of sunscreen was considered as the outcome. For multivariate analysis, Poisson regression with robust adjustment for variance was used. Results Among the 1300 participants, prevalence of non-use of sunscreen was 38.2% (95% CI: 34.6-41.8). The variables independently associated with the outcome were male sex, older age, brown or black skin color, lower income, fewer years of education, no physical activity in leisure time, no medical consultations in the last year, and self-perception of health as regular or poor. Study limitations The prevalence may be underestimated by reports of more use of sunscreen than actually used, which could increase the figure in the outcome. Conclusion It was estimated that about four out of ten adults and elderly do not use sunscreen in this sample. Prevention strategies are needed to advance health policy and ensure that sun protection options are easily accessible.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Young Adult , Sunscreening Agents/therapeutic use , Ultraviolet Rays/adverse effects , Radiation Exposure/prevention & control , Skin Neoplasms/prevention & control , Brazil , Cross-Sectional Studies , Surveys and Questionnaires , Risk Factors , Sex Distribution , Age Distribution , Diagnostic Self Evaluation , Health Risk Behaviors
11.
An. bras. dermatol ; 94(5): 527-531, Sept.-Oct. 2019. tab
Article in English | LILACS (Americas) | ID: biblio-1054860

ABSTRACT

Abstract Background Malassezia, a skin saprophyte, is frequently isolated from patients with seborrheic dermatitis, which is one of the most common dermatoses in HIV-infected patients. Its role in pathophysiology has not been defined. Objective To determine whether patients living with HIV and seborrheic dermatitis have more Malassezia than those without seborrheic dermatitis. Method This is an descriptive, observational, prospective cross-sectional study to which all adult patients living with HIV that attend the infectious disease outpatient clinic at the Dr. Manuel Gea González General Hospital were invited. Patients presenting with scale and erythema were included in Group 1, while patients without erythema were included in Group 2. Samples were taken from all patients for smear and culture. Results Thirty patients were included in each group. All patients with seborrheic dermatitis had a positive smear, with varying amounts of yeasts. In the control group, 36.7% of patients had a negative smear. The results are statistically significant, as well as the number of colonies in the cultures.Study limitations The study used a small sample size and the subspecies were not identified. Conclusions Patients with clinical manifestations of seborrheic dermatitis have larger amounts of Malassezia. Further studies need to be performed to analyze if the greater amount is related to imbalances in the microbiota of the skin.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , HIV Infections/microbiology , Dermatitis, Seborrheic/microbiology , Malassezia/isolation & purification , Skin/microbiology , Colony Count, Microbial , Cross-Sectional Studies , Prospective Studies , Sex Distribution , CD4 Lymphocyte Count
12.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 41(5): 389-395, Sept.-Oct. 2019. tab, graf
Article in English | LILACS (Americas) | ID: biblio-1039101

ABSTRACT

Objective: To examine suicide rates among adolescents from six large cities in Brazil and to analyze the relationship between adolescent suicide rates and socioeconomic indicators between 2006 and 2015. Methods: Generalized estimating equation models were used to assess the impact of socioeconomic factors - including social inequality and unemployment rates - on adolescent suicide rates. Results: The rate of adolescent suicide increased by 24% over the course of the study period. Social inequality (assessed using the Gini index), was positively associated with overall adolescent suicide rates (β = 10.68; 95%CI = 2.32-19.05; p ≤ 0.012). After disaggregating the findings by age (10-14 and 15-19 years), social inequality was associated with suicide rate only for adolescents aged 15-19 years (β = 9.63; 95%CI = 2.31-16.96; p ≤ 0.005). Disaggregating these findings by sex, the association with economic variables became significant only among females. Males had a higher overall suicide rate than females, and the highest rate was observed in male adolescents aged 15-19 years. Higher levels of unemployment were associated with higher suicide rates. Conclusion: Our findings suggest that socioeconomic indicators, particularly unemployment and social inequality, are relevant social determinants of suicide in adolescence.


Subject(s)
Humans , Male , Female , Child , Adolescent , Young Adult , Suicide/trends , Suicide/statistics & numerical data , Socioeconomic Factors , Time Factors , Unemployment/statistics & numerical data , Brazil/epidemiology , Sex Factors , Retrospective Studies , Risk Factors , Sex Distribution , Statistics, Nonparametric
13.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 41(5): 380-388, Sept.-Oct. 2019. tab
Article in English | LILACS (Americas) | ID: biblio-1039103

ABSTRACT

Objectives: To analyze time trends of suicide rates in Brazil overall and in Brazilian states and compare the estimated suicide rates projected for 2020 with the World Health Organization (WHO) Mental Health Action Plan target. Methods: This was an ecological time-series study from 1997 to 2015, stratified by Brazilian states, specific age groups, and sex. Data were obtained from the Mortality Information System (Sistema de Informações sobre Mortalidade [SIM]) of the Brazilian Ministry of Health. Polynomial regression models were used to analyze the trends in suicide rates and to project suicide rates for 2020. Results: Considering 224 units of analysis, 21 (9.4%) showed a decreasing trend, 108 (48.2%) were stable, and 95 (42.4%) showed an increasing trend. Thus, 67% of units of analysis will not meet the WHO target in 2020. Mean suicide rates were higher in males than in females. People aged 60 years and older presented the highest suicide rates, while 84.7% of total deaths by suicide occurred among 15-to-59-year-olds. Conclusion: Overall, 90.6% of units of analysis had a stable or increasing trend in suicide rates from 1997 to 2015. If these trends remain, most of Brazil will fail to achieve the WHO-recommended reduction in suicide rates by 2020.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Young Adult , Suicide/trends , Suicide/statistics & numerical data , Time Factors , World Health Organization , Brazil/epidemiology , Sex Factors , Sex Distribution , Age Distribution , Spatial Analysis , Geography , Middle Aged
14.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 41(5): 396-402, Sept.-Oct. 2019. tab
Article in English | LILACS (Americas) | ID: biblio-1039105

ABSTRACT

Objective: To assess the prevalence of depression and sociodemographic, behavioral, and health-related risk factors therefor in a southern Brazilian city. Methods: Population-based, cross-sectional study of adults from Rio Grande, state of Rio Grande do Sul, Brazil. Individuals (n=1,295) were selected using a multistage sampling procedure. The Patient Health Questionnaire-9 (PHQ-9) was used to screen for major depressive episodes (MDEs). We used a conceptual causal framework to organize and assess risk factors for MDE and calculated prevalence ratios (PR) using regression models. Results: The prevalence of MDE was 8.4% (95%CI 6.0-10.7) for men and 13.4% (95%CI 11.0-15.8) for women. For men, physical inactivity (PR 2.34, 95%CI 1.09-5.00) and perceived stress (PR 20.35, 95%CI 5.92-69.96) were associated with MDE. In women, MDE prevalence was higher among those in the first tertile of economic index (PR 2.61, 95%CI 1.53-4.45), with 0-8 years of schooling (PR 2.25, 95%CI 1.24-4.11), alcohol users (PR 1.91, 95%CI 1.21-3.02), those physically inactive (PR 2.49, 95%CI 1.22-5.09), with the highest perceived stress (PR 9.17, 95%CI 3.47-24.23), with another mental disorder (PR 1.85, 95%CI 1.32-2.59), and with more noncommunicable diseases (PR 1.85, 95%CI 1.06-3.22). Conclusion: Women had a higher prevalence of depression, and socioeconomic disadvantages were important for the occurrence of MDE; however, for men, only physical inactivity and stress were important predictors, suggesting possible different causal pathways for each sex.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Young Adult , Depressive Disorder, Major/etiology , Depressive Disorder, Major/epidemiology , Socioeconomic Factors , Brazil/epidemiology , Poisson Distribution , Prevalence , Cross-Sectional Studies , Surveys and Questionnaires , Risk Factors , Sex Distribution , Age Distribution , Middle Aged
15.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 41(5): 433-436, Sept.-Oct. 2019. tab
Article in English | LILACS (Americas) | ID: biblio-1039109

ABSTRACT

Objective: To evaluate the association between social and health contextual variables, and between major depressive episodes (MDE) and suicidal thoughts in Brazilian adults. Methods: This population-based cross-sectional study used data from the 2013 National Health Survey (Pesquisa Nacional de Saúde). The Patient Health Questionnaire was used to evaluate the presence of MDE and suicidal thoughts. We used number of Family Health Strategy teams (FHS) per 20,000 state population, number of Psychosocial Care Centers (Centros de Atenção Psicossocial [CAPS]) per 1,000 state population, gross domestic product (GDP), and Gini index for each Brazilian state as contextual variables. Multilevel logistic regression models were used to calculate OR and the intraclass correlation coefficient (ICC). Results: Prevalence of MDE and suicidal thoughts was 4.1% (95%CI 3.8-4.4) and 3.8% (95%CI 3.5-4.1), respectively. Multilevel regression models showed an ICC of 1.1% for MDE (95%CI 0.5-2.3) and 1.3% for suicidal thoughts (95%CI 0.6-2.6). Neither GDP, Gini, FHS, or CAPS showed evidence of association with the outcomes. Conclusions: In general, contextual variables, within each Brazilian state, do not seem to affect the prevalence of MDE and suicidal thoughts.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Aged , Young Adult , Depressive Disorder, Major/etiology , Depressive Disorder, Major/epidemiology , Suicidal Ideation , Socioeconomic Factors , Brazil/epidemiology , Logistic Models , Prevalence , Cross-Sectional Studies , Surveys and Questionnaires , Risk Factors , Health Surveys , Sex Distribution , Age Distribution , Multilevel Analysis , Middle Aged
16.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 41(5): 437-440, Sept.-Oct. 2019. tab
Article in English | LILACS (Americas) | ID: biblio-1039112

ABSTRACT

Objective: To investigate the prevalence rates of suicidal ideation (SI) and suicide attempts (SA) and their association with substance use in a nationally representative sample of Brazilians. Methods: The Second Brazilian National Alcohol and Drug Survey (II BNADS) is a household cross-sectional survey that investigated the consumption of psychotropic drugs and associated risk factors. This national probability sample survey used a multistage cluster design to select 4,607 participants aged 14 or older and had a total response rate of 77%. Illegal drug use, SI and SA were obtained by confidential self-report assessment. Results: SI and SA were reported by 9.9 and 5.4% of the sample, respectively. This prevalence was 20.8 and 12.4% among individuals with alcohol use disorders (AUD), 31.5 and 16.5% among cannabis users and 40.0 and 20.8% among cocaine users. After adjusting for demographic characteristics, tobacco use, family history of suicide and depression, both SI and SA were positively associated with AUD, cannabis and cocaine use. Conclusion: AUD, cannabis and cocaine use were significantly associated with SI and SA, even after the adjustments. Public health initiatives targeting suicide prevention should consider including assessment and management of substance misuse, and therapeutic approaches to substance misuse should include assessment of suicidality.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Young Adult , Suicide, Attempted/statistics & numerical data , Substance-Related Disorders/psychology , Substance-Related Disorders/epidemiology , Drug Users/psychology , Suicidal Ideation , Psychiatric Status Rating Scales , Socioeconomic Factors , Brazil/epidemiology , Poisson Distribution , Prevalence , Cross-Sectional Studies , Risk Factors , Sex Distribution , Age Distribution , Middle Aged
17.
J. pediatr. (Rio J.) ; 95(5): 600-606, Sept.-Oct. 2019. tab
Article in English | LILACS (Americas) | ID: biblio-1040363

ABSTRACT

Abstract Objective: The aim of this study was to identify the causes of congenital microcephaly in Rio Grande do Sul, a state in southern Brazil, where no ZIKV outbreak was detected, from December 2015 to December 2016, which was the period when ZIKV infection was at its peak in northeast Brazil. Methods: This was a cross-sectional study where all notifications of congenital microcephaly in the state of Rio Grande do Sul were included for analysis. Evaluation of cases followed the guidelines of the Brazilian Ministry of Health. Dysmorphological and neurological evaluations were performed by a specialized team, and genetic tests and neuroimaging were performed when clinically indicated. STORCH infections were diagnosed using standard tests. ZIKV infection was diagnosed through maternal serum RT-PCR and/or neuroimaging associated with clinical/epidemiological criteria. Results: From 153 744 registered live births in the study period, 148 cases were notified, but 90 (60.8%) of those were later excluded as "non-confirmed" microcephaly. In the 58 confirmed cases of microcephaly (prevalence = 3.8/10 000 live births), congenital infections (syphilis, toxoplasmosis, cytomegalovirus, and ZIKV) constituted the predominant etiology (50.0%), followed by isolated CNS (15.5%), and genetic syndromes (10.3%). Congenital ZIKV syndrome (CZS) with typical phenotype was diagnosed in three cases (5.2% of all confirmed microcephaly cases or 10.4% of all congenital infections). Conclusion: In Rio Grande do Sul, where no outbreak of ZIKV infection was recorded, congenital infections were the leading cause of congenital microcephaly, and the attributable risk for CZS in the etiology of microcephaly was 5.2%.


Resumo: Objetivo: Identificar as causas da microcefalia congênita no Rio Grande do Sul, Região Sul do Brasil, onde não foi detectado surto de ZIKV, de dezembro de 2015 a dezembro de 2016. Esse foi o período em que a infecção por ZIKV estava em seu auge no Nordeste do Brasil. Métodos: Este é um estudo transversal no qual todas as notificações de microcefalia congênita no estado do Rio Grande do Sul foram incluídas para análise. A avaliação dos casos seguiu as orientações do Ministério da Saúde. A avaliação dismorfológica e neurológica foi feita por uma equipe especializada e os testes genéticos e as neuroimagens foram feitos quando indicado clinicamente. As infecções STORCH (Sífilis, Toxoplasmose, Rubéola, Citomegalovírus e Herpes simples) foram diagnosticadas utilizando testes padrão. A infecção por ZIKV foi diagnosticada por meio da transcriptase reversa seguida de reação em cadeia da polimerase (RT-PCR) no soro materno e/ou neuroimagem associada a critérios clínicos/epidemiológicos. Resultados: De 153.744 nascidos vivos registrados no período do estudo, 148 bebês foram casos notificados, porém 90 (60,8%) casos foram excluídos posteriormente como microcefalia "não confirmada". Nos 58 casos confirmados de microcefalia (prevalência = 3,8/10.000 nascidos vivos), as infecções congênitas (sífilis, toxoplasmose, citomegalovírus e ZIKV) constituíram a etiologia predominante (50,0%), seguidas de doenças ligadas ao SNC isolado (15,5%) e síndromes genéticas (10,3%). A síndrome congênita do ZIKV (SCZ) com fenótipo típico foi diagnosticada em três casos (5,2% de todos os casos confirmados de microcefalia ou 10,4% de todas as infecções congênitas). Conclusão: No Rio Grande do Sul, Brasil, onde não foi registrado surto de infecção por ZIKV, a principal causa de microcefalia congênita foram infecções congênitas e o risco atribuível para SCZ na etiologia de microcefalia foi de 5,2%.


Subject(s)
Humans , Male , Female , Pregnancy , Infant, Newborn , Pregnancy Complications, Infectious/epidemiology , Zika Virus Infection/complications , Zika Virus Infection/epidemiology , Microcephaly/epidemiology , Microcephaly/virology , Pregnancy Complications, Infectious/virology , Brazil/epidemiology , Prevalence , Disease Outbreaks , Cross-Sectional Studies , Risk Factors , Gestational Age , Sex Distribution
18.
An. bras. dermatol ; 94(4): 405-410, July-Aug. 2019. tab, graf
Article in English | LILACS (Americas) | ID: biblio-1038299

ABSTRACT

Abstract: Background: A high prevalence of leprosy among children under 15 years of age indicates the need to implement actions to prevent new cases of the disease. Serological tests have been developed with the aim of helping to control the disease by indicating, through seropositivity, the presence of infection. Objective: To analyze the prevalence and factors associated with seropositivity rate for anti-NDO-LID antibodies in children under 15 years of age, contacts of leprosy patients. Method: We performed a cross-sectional study with 210 children under 15 years old of age. Of them, 50 were household contacts and 160 were neighborhood contacts living in the municipality of Cuiabá, state of Mato Grosso, in 2016. The data were obtained from interviews and the NDO-LID rapid test during home visits from February to July 2016. For the analysis, we used Poisson regression and prevalence ratio. Results: Seropositivity in contacts was 6.2%. Variables associated with seropositive tests included sex (PR = 1.05; 95% CI: 1.01 - 1.08), race/skin color (PR = 0.95; 95% CI: 0.90 - 0.99), residence area (PR = 1.05; 95% CI: 1.01 - 1.09), and number of people per household (PR = 1.06; 95% CI: 1.02 - 1.08). Study Limitations: The small sample size, besides leading to wide confidence intervals, may have been a limitation for the identification of associated factors. Conclusions: The prevalence of seropositivity was high. Variables associated with NDO-LID seropositivity included female sex, not to be brown skinned, live in urban areas, and live with five or more people.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Antibodies, Anti-Idiotypic/immunology , Leprosy/immunology , Leprosy/epidemiology , Antibodies, Bacterial/immunology , Socioeconomic Factors , Brazil/epidemiology , Serologic Tests/methods , Residence Characteristics , Family Characteristics , Antibodies, Anti-Idiotypic/blood , Cross-Sectional Studies , Age Factors , Sex Distribution , Age Distribution , Infant , Antibodies, Bacterial/blood
19.
An. bras. dermatol ; 94(4): 442-445, July-Aug. 2019. tab, graf
Article in English | LILACS (Americas) | ID: biblio-1038313

ABSTRACT

Abstract: Background: Basal cell carcinoma is the most common type of skin cancer. Although the literature provides a great deal of information on the recurrences of basal cell carcinoma, studies about these indices addressing only the cases in which flaps and/or grafts have been performed for surgical reconstruction of the excision of this tumor are still lacking. Objectives: To evaluate rates of recurrence of basal cell carcinoma submitted to conventional surgery with pre-established margins and reconstruction by flaps or grafts. Methods: A retrospective and observational study was performed through the analysis of 109 patients, who met inclusion criteria with 116 basal cell carcinomas submitted to conventional surgery and pre-established safety margins, requiring reconstruction through a graft or cutaneous flap. This work was performed the small surgeries sector of Dermatology of the Specialty Outpatient Clinic of the University Hospital of the State University of Londrina, between January 1, 2011 and December 31, 2015. The following data were collected and inserted in an Excel worksheet: name, registration number of the hospital patient, sex, age, tumor location, histopathological type of BCC, procedure performed (type of flap and/or graft), follow-up time, recurrence. Results: Of the 116 procedures, there were recurrences in 3 cases (2.6%) that were located in the nasal region and related to sclerodermiform or micronodular histological types. Study limitations: Retrospective nature of the study. Conclusion: The present study of the dermatology department of this university hospital showed a low rate of recurrence of basal cell carcinoma in cases where flaps and/or grafts were used in the surgical reconstruction.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Skin Neoplasms/etiology , Surgical Flaps/adverse effects , Carcinoma, Basal Cell/etiology , Skin Transplantation/adverse effects , Neoplasm Recurrence, Local/etiology , Skin Neoplasms/surgery , Skin Neoplasms/epidemiology , Carcinoma, Basal Cell/surgery , Carcinoma, Basal Cell/epidemiology , Retrospective Studies , Follow-Up Studies , Sex Distribution , Margins of Excision , Neoplasm Recurrence, Local/epidemiology
20.
An. bras. dermatol ; 94(4): 422-428, July-Aug. 2019. tab
Article in English | LILACS (Americas) | ID: biblio-1038314

ABSTRACT

Abstract: Background: Body dysmorphic disorder is a relatively common psychiatric disorder in the context of dermatology and cosmetic and plastic surgery but is underdiagnosed and underreported in Africa. Objective: To evaluate the prevalence of body dysmorphic disorder and symptoms of anxiety/depression and determine their sociodemographic and clinical correlates. Methods: A systematic random sampling design was made to recruit 114 patients with skin diseases. Sociodemographic and clinical data were obtained. The Body Dysmorphic Disorder Modification of the Yale-Brown Obsessive-Compulsive Scale, Hospital Anxiety and Depression Scale was administered, and data were analyzed using SPSS 20. Results: Mean age of participants was 37.70±17.47 years, and 67/114 (58.8%) were females. Prevalence of body dysmorphic disorder was 41/114 (36.0%), and prevalence of anxiety/depression symptoms was 35/114 (30.7%). Prevalence of body dysmorphic disorder in patients with anxiety/depression symptoms was 15/41 (36.6%), and patients with facial disorders expressed the highest burden of anxiety/depression symptoms, in 15/35 (42.9%). Factors associated with significantly higher mean body dysmorphic disorder include age<50years (p=0.039), and anxiety/depression (p<0.001), education below high school was associated with higher mean anxiety/depression score (P= 0.031). In a binary logistic regression model, presence of anxiety/depression symptoms was predictive of body dysmorphic disorder (OR=10.0, CI: 4.1-28.2, p<0.001). Study limitations: the study is uncontrolled, conducted in a single source of care, thus limiting generalization to nonrelated settings. Conclusion: Prevalence of body dysmorphic disorder is high among dermatology patients and most prevalent in facial disorders. Facial diseases are associated with the highest burden of anxiety/depression symptoms. This is a clarion call for dermatologists to routinely assess for body dysmorphic disorder and appropriately refer affected patients to mental health care.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Young Adult , Anxiety/epidemiology , Skin Diseases/psychology , Skin Diseases/epidemiology , Depression/epidemiology , Body Dysmorphic Disorders/psychology , Body Dysmorphic Disorders/epidemiology , Psychiatric Status Rating Scales , Socioeconomic Factors , Test Anxiety Scale , Time Factors , Logistic Models , Prevalence , Cross-Sectional Studies , Sex Distribution , Age Distribution , Statistics, Nonparametric , Nigeria/epidemiology
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