Uncovering the impact of COVID-19 on the place of death of cancer patients in South America / Descobrindo o impacto da COVID-19 no local de morte de pacientes com câncer na América do Sul / Descubriendo el impacto de la COVID-19 en el local del fallecimiento de pacientes con cáncer en América del Sur

Abstract: The COVID-19 pandemic has significantly impacted healthcare systems worldwide, especially on the management of chronic diseases such as cancer. This study explores the effects of COVID-19 on cancer mortality trends in Brazil, Chile, and Peru. The monthly age-standardized mortality rates in different places of death (hospital/clinic or home) were estimated using vital statistics and death certificate databases. An interrupted time series analysis was performed for each country, using the date of lockdown implementation as the intervention point. Overall cancer mortality rates reduced after the implementation of pandemic restrictions, with a significant decrease in Brazil. In total, 75.3%, 55.4%, and 45.7% of deaths in Brazil, Peru, and Chile, respectively, occurred in hospitals. After lockdowns were implemented, at-home deaths increased in all countries, and in-hospital deaths correspondingly decreased only in Chile. Our results suggest that COVID-19 has significantly affected rates of cancer mortality and place of death in Latin America.

Resumo: A pandemia de COVID-19 impactou significativamente os sistemas de saúde ao redor do mundo, especialmente no manejo de doenças crônicas, como o câncer. Este estudo explora os efeitos da COVID-19 nas tendências de mortalidade por câncer no Brasil, Chile e Peru. As taxas de mortalidade mensais padronizadas por idade em diferentes locais de morte (hospital/clínica ou domicílio) foram estimadas usando estatísticas vitais e bancos de dados de atestados de óbito. Uma análise de série temporal interrompida foi realizada para cada país, tendo como ponto de intervenção a data de implementação do lockdown. As taxas gerais de mortalidade por câncer reduziram após a implementação das restrições, com uma queda significativa no Brasil. No total, 75,3%, 55,4% e 45,7% dos óbitos no Brasil, Peru e Chile, respectivamente, ocorreram em hospitais. Depois da implementação dos lockdowns, as mortes em domicílio aumentaram em todos os países, e as mortes hospitalares diminuíram de forma correspondente apenas no Chile. Nossos resultados sugerem que a COVID-19 afetou significativamente as taxas de mortalidade por câncer e o local de morte na América Latina.

Resumen: La pandemia de COVID-19 impactó significativamente los sistemas de salud de todo el mundo, sobre todo en el manejo de enfermedades crónicas, como el cáncer. Este estudio explora los efectos de la COVID-19 en las tendencias de mortalidad por cáncer en Brasil, Chile y Perú. Las tasas de mortalidad mensuales estandarizadas por edad en diferentes locales de fallecimiento (hospital/clínica o domicilio) se estimaron utilizando estadísticas vitales y base de datos de certificados de defunción. Se realizó un análisis de serie temporal interrumpida para cada país, teniendo como punto de intervención la fecha de implementación del lockdown. Las tasas generales de mortalidad por cáncer redujeron tras la implementación de las restricciones, con una disminución significativa en Brasil. En total, el 75,3% de los óbitos ocurrieron en hospitales en Brasil, el 55,4% en Perú y el 45,7% en Chile. Tras la implementación del lockdown, las muertes domiciliarias aumentaron en todos los países, y las muertes hospitalarias solo redujeron de forma correspondiente en Chile. Nuestros resultados sugieren que la COVID-19 afectó significativamente las tasas de mortalidad por cáncer y el local del fallecimiento en América Latina.

Oral health-related quality of life of young people with mucopolysaccharidosis: a paired cross-sectional study

Abstract The purpose of the present study was to compare the perceptions of the parents/ caregivers of young people with and without Mucopolysaccharidosis (MPS) with regards to their oral health-related quality of life (OHRQoL). A cross-sectional study was conducted with 29 individuals with MPS and 29 normotypic individuals aged three to 21 years and their parents/caregivers. All parents/caregivers of young people with MPS in follow-up at two reference hospitals in the city of Belo Horizonte, southeastern Brazil, were invited to participate in the study. Individuals without MPS were recruited from the pediatric clinics of both hospitals. Parents/caregivers answered a structured questionnaire addressing the sociodemographic characteristics, behavioral habits and medical and dental history of the children as well as the Brazilian short-form version of the Parental-Caregiver (P-CPQ). The individuals with and without MPS were examined for malocclusion, dental caries and oral hygiene by an examiner who had undergone training and calibration exercises. Mean age of the subjects was 12.1 years (± 4.2). Comparing total P-CPQ scores and scores on the oral symptoms, functional limitations and wellbeing domains, the parents/caregivers individuos with MPS reported a statistically significant greater negative impact on OS domain than their counterparts. Regarding the clinical variables, malocclusion was also associated a greater negative impact on OHRQoL of young people with MPS when compared to those of young people without MPS. Our findings show the great negative impact caused by the malocclusion of young people with MPS.

"Tihik quando bebe Kaxmuk não tem pai, nem mãe, nem irmão": Percepções sociais das consequências do uso da cachaça no povo indígena Maxakali/MG/Brasil / "When a Tihik drinks kaxmuk he neither has a father, nor a mother, or a brother": perceptions of Maxakali on the effects of sugarcane liquor consumption

Resumo Este artigo explora um dos aspectos mais interessantes e menos estudados no Brasil: as consequências das experiências complexas e contraditórias da substituição total de bebidas tradicionais indígenas pela cachaça, introduzida pelo contato interétnico. Contribui com a carência de ampliação de estudos na temática, analisando as consequências negativas do uso de álcool Maxakali. Enquanto estudos antropológicos enfatizam funções do beber tradicional e contemporâneo como "lubrificantes" sociais, as percepções sociais Maxakali ressaltam consequências negativas do uso da cachaça vendida ou trocada no contato interétnico. Interpretou-se no cotidiano, símbolos e significados dessas consequências, narradas por 21 lideranças em grupos focais. Com a substituição da Kaxmuk pelos Maxakali, ocorreram adaptações surgidas pelo contato interétnico, com relações negativas para quem bebe, suas família, aldeia e comunidade. No mundo-da-vida, as consequências negativas apresentaram-se em forma de acidentes, desarmonias conjugais, negligências, além de comportamentos violentos, doenças e mortes. Este estudo reforça a importância de produção de conhecimentos aprofundados e abrangentes visando a identificação de grupos vulneráveis em busca de soluções participantes.

Abstract This study explores one of the most interesting and least studied issues in Brazil: the consequences of complex and contradictory experiences by replacing the traditional drinks by cachaça, introduced through interethnic contact. Given the rarity of the study of Maxakali alcohol consumption in research, this study aims to understand, from the native's point of view, the negative aftereffect of alcohol consumption. Although anthropological studies emphasize functions of traditional and contemporary drinking as social "lubricants", social perceptions of the Maxakali highlight the problems of cachaça bought through interethnic contact. Symbols and meanings of these consequences were interpreted through their daily life histories, recorded by 21 leaders in focus group. Through the interethnic contact, some adaptations have occurred in the Maxakali alcohol use, with negative consequences for those who drink, their families, their villages and their community. In the world-of-life, these changes these changes can be seen through accidents, insults, marital disharmony, neglects, violent behavior, illness and death. This study's findings highlight the importance of producing comprehensive and in-depth knowledge in search of to identify vulnerable groups and to develop participatory solutions.

Prevençäo da cárie de cemento radicular / Root caries prevention

Levantamentos epidemiológicos têm demonstrado que a prevalência de cárie radicular está diretamente relacionada com a idade dos pacientes, assim como a presença de doença periodontal. A melhoria significante nos padröes de higiene oral, a limpeza profissional regularmente aplicada e o uso diário de dentifrícios fluoretados constituem as medidas mais importantes para a prevençäo da doença