Factors Associated with Hyposalivation in Brazilian Adults

ABSTRACT Objective: To determine the occurrence of hyposalivation in Brazilian adults and its association with individual determinants, such as the use of medications, systemic conditions, smoking, and alcohol consumption. Material and Methods: A cross-sectional study with 402 adults was developed. Information was collected on sociodemographic and general health characteristics, and sialometry was performed with stimulated salivary flow. It indicated low salivary flow when ≤ 0.7 mL/min. Bivariate and multivariate analyses were conducted using a decision tree (p<0.05). Results: The sample was comprised predominantly of women (68.2%) aged ≤ 29 years (25.4%). Most participants did not use medication (56.7%). Among systemic diseases, the most cited was hypertension (25.1%). More than a third of the participants presented hyposalivation (40.3%), being associated with the following variables: age between 50 to 59 years (p=0.011), female sex (p<0.001), menopause (p=0.001), use of alcohol (p=0.033), systemic disease (p=0.002) and medication use (p<0.001). In multivariate analysis, in addition to sex (p<0.001) and hypertension (p=0.005), an association was also found between hyposalivation and diabetes (p=0.014). Conclusion: Factors associated with hyposalivation in adults were sex and the presence of hypertension or diabetes.

Fatores associados ao estado nutricional de crianças menores de 5 anos na região Nordeste do Brasil / Factors associated with the nutritional status of children under 5 years of age in the Northeast region of Brazil

Resumo Introdução: A dupla carga de má nutrição apresenta na atualidade novos e complexos desafios para a saúde pública, afetando de modo crescente populações vulneráveis, com consequências sociais negativas. Objetivo: Avaliar inter-relações de fatores biológicos e sociais com indicadores antropométricos do estado nutricional de crianças menores de cinco anos de idade. Método: Estudo transversal realizado em dois municípios do Estado da Paraíba, com crianças atendidas na Estratégia Saúde da Família. Analisaram-se fatores representativos das causas imediatas, intermediárias e básicas do estado nutricional das crianças, por meio de análise de correlação canônica. Resultados: Das 413 crianças que participaram do estudo, 9,4% foram diagnosticadas com déficit de estatura e 16,5% com sobrepeso/obesidade. O crescimento linear da criança associou-se ao peso ao nascer, à idade gestacional, à estatura materna e ao nível socioeconômico da família. O sobrepeso/obesidade revelou-se relacionado à idade da criança, ao índice de massa corporal materno, ao benefício do Bolsa Família e ao suporte social. Conclusões: A associação de características da criança ao nascimento, do estado nutricional materno e do entorno social com as proporções importantes de déficit de estatura e sobrepeso/obesidade observadas fundamentam a melhoria do estado nutricional da criança com foco na prevenção desde os estágios iniciais da vida.

Abstract Background: The double burden of malnutrition currently presents new and complex public health challenges, increasingly affecting vulnerable populations, with negative social consequences. Objective: To evaluate the interrelationships of biological and social factors with anthropometric indicators of the nutritional status of children under 5 years of age. Method: It is a cross-sectional study carried out in two municipalities in the state of Paraíba, with children assisted by the Family Health Strategy. Factors representative of the immediate, intermediate and basic causes of children's nutritional status were analyzed, through canonical correlation analysis. Results: Of the 413 children who participated in the study, 9.4% were diagnosed stunting and 16.5% were overweight/obese. The linear growth of child was associated with birth weight, gestational age, maternal height, and socioeconomic level of the family. Overweight/obesity was related to the child's age, maternal body mass index, the benefit of the Bolsa Família and social support. Conclusions: The association of child characteristics at birth, maternal nutritional status, and social environment with the important proportions of stunting and overweight/obesity observed support the improvement of the child's nutritional status with a focus on prevention from the early stages of life.

Avaliação do crescimento fetal de crianças por meio da razão peso/perímetro cefálico / Weight/head circumference ratio at birth for assessing fetal growth

Resumo O objetivo deste artigo é utilizar a razão peso/perímetro cefálico ao nascimento para avaliar o crescimento fetal. Estudo transversal aninhado a uma coorte de nascimentos do estado da Paraíba, Nordeste do Brasil, com 726 crianças nascidas a termo e com peso maior ou igual a 2.500 gramas. As medidas antropométricas da criança, características sociodemográficas, cuidados na gestação e tipo de parto foram coletados nas primeiras 24 horas pós-parto. As crianças foram classificadas em proporcionais (peso/perímetro cefálico ≥ 0,87) e desproporcionais (peso/perímetro cefálico < 0,87). Recém-nascidos de menor idade gestacional, com peso ao nascer inferior, do sexo feminino, de famílias não beneficiárias do Programa Bolsa Família, de mães não suplementadas com ácido fólico durante a gravidez e nascidos por cesariana apresentaram menores médias da razão peso/perímetro cefálico. As médias de peso, comprimento e perímetro cefálico foram menores entre as crianças classificadas com desproporção peso/perímetro cefálico, ajustadas pelo sexo da criança. A razão peso/perímetro cefálico é um indicador útil na avaliação do crescimento fetal.

Abstract The scope of this article was to use the weight/head circumference ratio at birth to assess fetal growth. A cross-sectional study was conducted in a birth cohort in the State of Paraíba, Northeast of Brazil, with 726 children born at term and weighing 2,500 grams or more. The anthropometric measurements, sociodemographic characteristics, gestational care and type of delivery were collected in the first 24 hours after birth of infants were assessed. Infants were classified as proportionate (weight/head circumference ratio ≥0.87) versus disproportionate (<0.87). Lower mean weight/head circumference ratio was identified in newborns of lower gestational age, with lower birth weight, female, from families not benefiting from the Bolsa Família Program, of mothers who did not take folic acid during pregnancy and were born by cesarean section. Mean weight, length, and head circumference were lower among infants with disproportionate weight/head circumference ratio, independently of sex. Weight/head circumference ratio is an important indicator of fetal growth.

Use of platelet-rich fibrin for bone repair: a systematic review and meta-analysis of preclinical studies

Abstract This systematic review evaluated the potential utility of platelet-rich fibrin (PRF) in bone repair in animals. The question is: can the use of PRF in bone defects in healthy rats induce bone repair compared to clot? This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (Prisma). The protocol was registered with Prospero (CRD [42020162319]). The literature search involved nine databases, including grey literature. All studies evaluated the bone defects created in rats filled with PRF and clots (control). Biomaterial evaluation was also performed in this study. The risk of bias was assessed using the Systematic Review Center for Laboratory Animal Experimentation (Syrcle) tool for animal studies. A meta-analysis of quantitative data was performed to estimate the effect of PRF on bone repair in rats. Heterogeneity among the studies was assessed using the I2 statistic. The literature search retrieved 685 studies, 10 of which fulfilled the eligibility criteria, and 4 were included in the quantitative assessment. Analysis of the risk of bias revealed that most studies had a high risk of bias in performance and detection. Meta-analysis yielded divergent results and the absence of a statistically significant effect: PRF with control (standardized mean difference 2.54, 95% confidence interval -0.80-5.89; p = 0.14). In general, study heterogeneity was high (I2 ≥ 75.0%). The quality of the studies that influenced the conclusion of the review was based on the PICO, the sources and form of the search, the study selection criteria, the form of evaluation of publication bias, the evaluation of the quality of the studies, and data extraction by two researchers. PRF did not provide significant benefits for bone repair, resulting in unpredictable effects.

Fatores associados ao estado nutricional de crianças menores de cinco anos da Paraíba, Brasil / Factors associated with nutritional status of children under five years old from Paraíba, Brazil

Resumo Objetivou-se analisar se o estado nutricional de crianças menores de cinco anos de idade está relacionado às condições biológicas de suas mães, ao acesso a serviços de saúde, ao benefício de programas sociais e às condições socioeconômicas. Trata-se de um estudo transversal realizado no contexto da Estratégia Saúde da Família, em sete municípios do interior do estado da Paraíba. A metodologia incluiu o diagnóstico do déficit de estatura e do excesso de peso (sobrepeso e obesidade) das crianças, cujos determinantes foram analisados por meio de árvore de decisão. Como resultado, foram avaliadas 469 crianças, das quais 7,9% apresentaram déficit de estatura e 12,8% excesso de peso. Encontrou-se associação desses desfechos com o estado nutricional materno. A baixa estatura também teve como exposições relevantes a idade da criança inferior a dois anos (p = 0,018) e a insegurança alimentar e nutricional moderada/grave (p = 0,008). Para o excesso de peso, não ser beneficiário do Programa Bolsa Família (p = 0,049) e a pior situação socioeconômica (p = 0,006) também representaram fatores associados ao desfecho. Como conclusão do presente estudo, podemos afirmar que existe uma associação entre o estado nutricional materno e o da criança.

Abstract This paper aimed to analyze whether the nutritional status of children under 5 years of age is related to the biological conditions of their mothers, access to health services, the benefit of social programs, and socioeconomic conditions. This is a cross-sectional study carried out in the context of the Family Health Strategy in seven municipalities in inland Paraíba State. The methodology included the diagnosis of stunting and excess weight (overweight and obesity) in children, which determinants were analyzed through the Decision Tree. As a result, 469 children were evaluated, of which 7.9% had stunting and 12.8% had excess weight. An association of these outcomes was found with maternal nutritional status. Also, the relevant exposures of stunting were the age of the child of less than 2 years (p = 0.018) and the moderate/severe food and nutritional insecurity (p = 0.008). For excess weight, not being a beneficiary of the Programa Bolsa Família (p = 0.049) and the worst socioeconomic situation (p = 0.006) were also factors associated with the outcome. As a conclusion of the present study, we can affirm that there is an association between the maternal and child nutritional status.

Quality of life of Family Health Strategy professionals: a systematic review

ABSTRACT BACKGROUND: Individuals' quality of working life and motivation are directly related to their satisfaction and wellbeing. Although studies on the quality of life of family health workers have been conducted, there are none correlating these professionals' wellbeing with this work model. OBJECTIVE: To review the scientific literature in order to identify the levels of quality of life, in their dimensions, of Family Health Strategy workers. DESIGN AND SETTING: Systematic review of observational studies developed through a partnership between two postgraduate schools (Piracicaba and Uberlândia). METHODS: The review followed the PRISMA recommendations and was registered in the PROSPERO database. Ten databases were used, including the "grey literature". Two evaluators selected the eligible studies, collected the data and assessed the risk of biases, independently. The JBI tool was used to assess the risk of bias. A complementary statistical analysis was conducted on the means and standard deviations of the results from the WHOQOL-100 and WHOQOL-bref questionnaires. RESULTS: The initial search presented 1,744 results, from which eight were included in the qualitative analysis. The studies were published between 2007 and 2018. The total sample included 1,358 answered questionnaires. All the studies presented low risk of bias. The complementary analysis showed that the environmental factor (mean score 56.12 ± 2.33) had the most influence on the quality of life of community health workers, while physical health (mean score 14.29 ± 0.21) had the most influence on graduate professionals. CONCLUSION: Professionals working within the Family Health Strategy had dimensions of quality of life that varied according to their professional category.

Insegurança alimentar e nutricional de famílias usuárias da Estratégia Saúde da Família no interior da Paraíba / Food and nutritional insecurity of families using the Family Health Strategy in the inner Paraíba State

Resumo Introdução A segurança alimentar e a melhoria da nutrição constituem um aspecto importante no desenvolvimento sustentável. Objetivo Identificar fatores domiciliares que possam influenciar na segurança alimentar e nutricional de famílias com crianças menores de 5 anos em áreas de abrangência da Estratégia Saúde da Família (ESF). Método Trata-se de um estudo transversal que envolveu 469 famílias de sete municípios do interior da Paraíba. Para a avaliação da segurança alimentar e nutricional das famílias foi utilizada a Escala Brasileira de Insegurança Alimentar (EBIA). Foram analisadas informações relacionadas aos determinantes domiciliares de insegurança alimentar moderada/grave. Resultados A Insegurança Alimentar e Nutricional (IAN) atingiu 74,2% das famílias, sendo 17,5% de insegurança alimentar moderada/grave. A variável que mais interferiu na insegurança alimentar moderada/grave foi maior vulnerabilidade socioeconômica. A não suplementação com ferro/ácido fólico durante a gravidez e recebimento do benefício do Programa Bolsa Família também representaram exposições associadas ao desfecho. Conclusão Os resultados mostram prevalências elevadas de IAN, cujos graus mais graves sugerem a importância de melhorias na condição socioeconômica da família e o reforço das ações no contexto do Programa Bolsa Família e dos cuidados nutricionais durante a gravidez.

Abstract Background Food security and improved nutrition are an important aspect of sustainable development. Objective To identify household factors that may influence the food and nutritional security of families with children under five years of age in areas covered by the Family Health Strategy. Method A cross-sectional study involving 469 families from seven municipalities in the interior of Paraíba. The food and nutritional security of the families-was evaluated using the Brazilian Scale of Food Insecurity. We analyzed information related to household determinants of moderate/severe food insecurity. Results Food and nutritional insecurity reached 74.2% of families, of which 17.5% were moderate/severe food insecurity. Higher socioeconomic vulnerability was the most interfered variable in moderate/severe food insecurity. Failure to supplement with iron/folic acid during pregnancy and to be beneficiaries of the Programa Bolsa Família also represented exposures associated with the outcome. Conclusion The results show high prevalence of food and nutritional insecurity, the most serious of which suggests the importance of improvements in the socioeconomic status of the family and the reinforcement of actions in the context of the Programa Bolsa Família and nutritional care during pregnancy.

Rank, rankl, and opg in dentigerous cyst, odontogenic keratocyst, and ameloblastoma: a meta-analysis

Abstract The aim of this study was to assess and compare RANK, RANKL, and OPG immunoexpression in dentigerous cyst, odontogenic keratocyst, and ameloblastoma. The protocol was registered in PROSPERO (CRD42018105543). Seven databases (Embase, Lilacs, LIVIVO, PubMed, Scopus, SciELO, and Web of Science) were the primary search sources and two databases (Open Grey and Open Thesis) partially captured the "grey literature". Only cross sectional studies were included. The JBI Checklist assessed the risk of bias. A meta-analysis with random effects model estimated the values from the OPG and RANKL ratio reported by the individual studies and respective 95% confidence intervals. The heterogeneity among studies was assessed with I2 statistics. Only nine studies met the inclusion criteria and were considered in the analyses. The studies were published from 2008 to 2018. Two studies presented low risk of bias, while seven studies presented moderate risk. The meta-analysis showed the highest OPG>RANKL ratio for dentigerous cyst (ES=43.3%; 95% CI=14.3-74.8) and odontogenic keratocyst (ES=36.8%; 95% CI=18.8-56.7). In contrast, the highest OPG<RANKL ratio was found for ameloblastoma (ES=73.4%; 95% CI=55.4-88.4) and it was higher in the stromal region compared to the odontogenic epithelial region. The results may explain the aggressive potential of ameloblastoma from the higher OPG<RANKL ratio in this tumor, while it was lower for dentigerous cyst and odontogenic keratocyst.

Resumo O objetivo deste estudo foi avaliar e comparar a imunoexpressão de RANK, RANKL e OPG em cisto dentígero, ceratocisto odontogênico e ameloblastoma. O protocolo foi registrado no PROSPERO (CRD [Oculto]). Sete bancos de dados (Embase, Lilacs, LIVIVO, PubMed, Scopus, SciELO e Web of Science) foram as principais fontes de pesquisa e duas bases de dados (Open Grey e Open Thesis) capturaram parcialmente a "literatura cinza". Apenas estudos transversais foram incluídos. A ferramenta JBI avaliou o risco de viés. Uma metanálise com modelo de efeitos aleatórios estimou os valores da razão OPG e RANKL relatados pelos estudos individuais e seus respectivos intervalos de confiança de 95%. A heterogeneidade entre os estudos foi avaliada por meio do teste I2. Apenas nove estudos preencheram os critérios de inclusão e foram considerados nas análises. Os estudos foram publicados entre 2008 e 2018. Dois estudos apresentaram baixo risco de viés, enquanto sete estudos apresentaram risco moderado. A meta-análise mostrou a maior razão OPG> RANKL para cisto dentígero (ES=43,3%; IC95%=14,3-74,8) e ceratocisto odontogênico (ES=36,8%; IC95%=18,8-56,7). Por outro lado, a maior razão OPG <RANKL foi encontrada para ameloblastoma (ES=73,4%; IC95%=55,4-88,4) e foi maior na região estromal em comparação com a região epitelial odontogênica. Os resultados podem explicar o potencial agressivo do ameloblastoma devido a uma maior proporção OPG <RANKL nesse tumor, enquanto tal proporção foi menor no cisto dentígero e no ceratocisto odontogênico.

Accuracy of the dental pulp sensibility test using cold spray for the diagnosis of pulp diseases: an observational clinical study

The dental pulp sensibility test is one of the main auxiliary resources for the diagnosis of pulp pathologies, and its accuracy is still debatable. This cross-sectional observational study evaluated the accuracy of the pulp sensibility test (PST) using cold spray (1,1,1,2-tetrafluoroethane) for the diagnosis of pulp diseases and determined the effect of individual and clinical variables on the reliability of this test. The paper was designed following the STROBE statement. Sixty patients with indications for primary endodontic treatment were selected and examined from August 2017 to July 2018. Data collection was performed through interviews, clinical/radiographic examinations and the PST. The results of the cold test, along with data on sex, age, the tooth type regarding the root number, and the presence of restorations and caries, as well as the recent consumption of analgesics, were recorded. The presence of bleeding within the pulp chamber was used as the gold standard to compare with the clinical diagnosis and to identify the true-positive, false-positive, true-negative, and false-negative responses. The accuracy of PST achieved in subgroups of individual and clinical variables was compared using the chi-square test with a significance level of 5% (p < 0.05). The PST with the use of cold spray showed a sensitivity of 0.88, a specificity of 1.00, a positive predictive value of 1.00, a negative predictive value of 0.86, and an accuracy of 0.93. The accuracy of the cold spray was not affected by individual or clinical variables. The PST with the use of cold spray is an accurate and reliable method for determining the diagnosis of pulp diseases, especially in cases of pulp vitality or irreversible pulpitis.

Impact of dental treatment on the oral health-related quality of life of Brazilian schoolchildren

Abstract: This before-after experimental study evaluated the impact of dental treatment on the oral health-related quality of life (OHRQoL) in children aged 6-8 years from Paranoá, DF, considering the presence or absence of cavitated dentin carious lesions pre- and post-treatment. The responsiveness and sensitivity of the questionnaires were also investigated. Caries was detected by using the Caries Assessment Spectrum and Treatment (CAST) instrument, while the impact of oral health on the children's health-related quality of life was assessed using the Brazilian version of the Child Perceptions Questionnaire (CPQ8-10), which was completed by the children and the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS), which was completed by their parents. Sociodemographic characteristics were also assessed. After the examinations, the children were categorized into two groups according to the presence (treatment/n = 34) or absence (control/n = 34) of cavitated dentin carious lesions. Restorative/curative care was provided to the treatment group, while the control group received preventive measures. OHRQoL was assessed at baseline and at four weeks post-treatment. No significant sociodemographic differences were observed between the groups. In the treatment group, the children and their families reported a greater impact of oral health on their OHRQoL in both questionnaires (p < 0.05). However, there was a significant reduction in the impact of oral health, with differences between the pre-treatment and post-treatment phases (p = 0.001). Good sensitivity and responsiveness were observed for both questionnaires. Dental treatment was found to reduce the negative impact of dental caries on OHRQoL in 6-8-year-old children, which was detected by both questionnaires (B-ECOHIS and CPQ8-10).

Facial injuries and the gender issue: expressions of violence in a metropolitan region of Northeastern Brazil

Abstract The aims of this investigation were to describe the profile of men and women victims of violence and identify factors associated with the severity of facial trauma. A retrospective study was carried out from 762 records of victims attended at the Institute of Legal Medicine and Dentistry located in a metropolitan region of Northeastern Brazil. The dependent variable was type of facial trauma suffered by victims. Independent variables were the sociodemographic characteristics of victims, characteristics of aggressors and circumstances of violence. Descriptive, bivariate (c2 test) and multivariate statistics were made through logistic regression. Level of significance was set at p < 0.05. The mean age of victims was 29.78 years (SD=13.33). Based on the final regression model, male subjects [odds ratio (OR)=2.22, 95% CI=1.08-4.57, p=0.030], assaulted by other male subjects (OR=4.88; 95% CI=1.12-21.26; p=0.035) through instrument (OR=6.67; 95% CI=2.85-15.60; p<0,001) or mixed aggressions (OR=4.34; 95% CI=1.44-13.02; p=0.009) were more likely to exhibit facial bone fractures or dentoalveolar fractures. The findings highlight that men and women present important victimization differentials in relation to interpersonal violence and facial trauma. Victim's gender, aggressor's gender and mechanism of aggression may exert influence on facial trauma patterns.

Resumo Os objetivos desta investigação foram descrever o perfil de homens e mulheres vítimas de violência e identificar fatores associados à gravidade do trauma facial. Foi realizado um estudo retrospectivo de 762 prontuários de vítimas atendidas no Instituto de Medicina Legal e Odontologia de uma região metropolitana do Nordeste do Brasil. A variável dependente foi o tipo de trauma facial sofrido pelas vítimas. Variáveis ​​independentes foram as características sociodemográficas das vítimas, características dos agressores e circunstâncias de violência. Estatísticas descritivas, bivariadas (teste c2) e multivariadas foram feitas por meio de regressão logística. O nível de significância foi fixado em p<0,05. A idade média das vítimas foi de 29,78 anos (DP =13,33). Com base no modelo de regressão final, os indivíduos do sexo masculino [odds ratio (OR)=2,22, IC 95%=1,08-4,57, p=0,030], agredidos por outros sujeitos do sexo masculino (OR=4,88; IC 95%=1,12-21,26; p=0,035) por meio de instrumentos (OR=6,67; IC 95%=2,85-15,60; p<0,001) ou agressões mistas (OR=4,34; IC 95%=1,44-13,02; p=0,009) foram mais propensos a apresentar fraturas de ossos faciais ou fraturas dentoalveolares. Os achados apontam que homens e mulheres apresentam importantes diferenciais de vitimização em relação à violência interpessoal e trauma facial. O gênero da vítima, o gênero do agressor e o mecanismo de agressão podem exercer influência sobre os padrões de trauma facial.

Uso dos serviços de saúde segundo determinantes sociais, comportamentos em saúde e qualidade de vida entre diabéticos / Use of the health services according to social determinants, health behaviors and quality of life among diabetics

Resumo Este estudo investigou a utilização dos serviços de saúde segundo determinantes sociais, comportamentos em saúde e qualidade de vida entre diabéticos. A amostra foi composta por 416 diabéticos cadastrados na Estratégia Saúde da Família de um município do Nordeste do Brasil. A análise dos dados incluiu estatísticas descritivas, bivariadas e multivariada por meio da modelagem de Árvore de Decisão usando o algoritmo Chi-squared Automatic Interaction Detector (CHAID). Evidenciou-se expressiva utilização dos serviços públicos de saúde (80,7%). A utilização do serviço público de saúde com regularidade envolveu indivíduos com escolaridade baixa ou média (p < 0,001), empregados ou aposentados e/ou pensionistas (p = 0,019), com alto impacto do diabetes na qualidade de vida (p = 0,032), e que realizavam a quantidade recomendada de exames de glicemia em jejum ao ano (p < 0,001). A utilização dos serviços de saúde pôde ser explicada por diferenças relacionadas aos determinantes sociais, aos comportamentos em saúde e ao impacto do diabetes na qualidade de vida dos usuários.

Abstract The aim of this study was to investigate the use of health services according to social determinants, health behaviors and quality of life among diabetics (n = 416) attended by the Family Health Strategy in a northeastern city in Brazil. Data analysis included descriptive, bivariate and multivariate statistics. Decision Tree modeling was applied using the Chi-squared Automatic Interaction Detector (CHAID) algorithm. Results showed that public health services were used by 80.7% of the sample. The regular use of public health services involved individuals with low or medium schooling (p < 0.001), employed or retired and/or pensioners (p = 0.019), with a high impact of diabetes on quality of life (p = 0.032), and who performed the number of fasting blood glucose tests per year recommended by the Ministry of Health (p < 0.001). The use of health services could be explained by differences related to social determinants, health behaviors and the impact of diabetes on quality of life.

Fatores associados à cura e ao abandono do tratamento da tuberculose na população privada de liberdade / Factors associated with recovery and the abandonment of tuberculosis treatment in the incarcerated population

RESUMO: Objetivo: Este estudo objetivou investigar os fatores associados aos desfechos de cura e abandono na população privada de liberdade com tuberculose. Métodos: Estudo quantitativo, observacional e analítico. Realizado com dados oriundos do Sistema de Informação de Agravos de Notificação (Sinan), de tuberculose da população privada de liberdade nos anos de 2007 a 2016 no estado da Paraíba. Foram incluídas as notificações de indivíduos maiores de 18 anos notificados como "casos novos" e como encerramento por "cura" ou "abandono". Excluíram-se aqueles que até dezembro de 2016 não tinham a situação de encerramento. Realizaram-se estatísticas bivariada e multivariada, por meio de regressão de Poisson. Resultados: Com 614 notificações, a maioria foi do sexo masculino (93,8%). Na análise bivariada, houve associação estaticamente relevante dos desfechos com síndrome da imunodeficiência adquirida (p = 0,044), sorologia para vírus da imunodeficiência humana (p = 0,048) e não realização de baciloscopia de acompanhamento (p = 0,001). Na análise multivariada ajustada, a síndrome da imunodeficiência adquirida (risco relativo - RR = 1,998; intervalo de confiança de 95% - IC95% 1,078 - 3,704; p = 0,028) e a não realização de baciloscopia de acompanhamento (RR = 5,211; IC95% 2,158 - 12,583; p < 0,001*) permaneceram significativamente associadas ao desfecho de abandono. Conclusão: Os desfechos de cura e abandono estão associados principalmente com a realização ou não da baciloscopia de acompanhamento e com a síndrome da imunodeficiência adquirida.

ABSTRACT: Objective: This study aimed to investigate the factors associated with the outcomes of recovery and abandonment in the incarcerated population with tuberculosis. Methods: A quantitative and observational analytical study was performed with data from the Notification Disease Information System (Sinan), tuberculosis data from the incarcerated population in the state of Paraiba from 2007 to 2016; Notifications of individuals over the age of 18, reported as "new cases" and the outcome, "recovery" or "abandonment" status were included. Those people who until December 2016 had no outcome information were excluded. Analyses were performed using bivariate and multivariate statistics from the Poisson regression. Results: Of the 614 notifications, most were male (93.8%). In the bivariate analysis, there was a statistically relevant association of outcomes with Acquired Immunodeficiency Syndrome (p = 0.044), Human Immunodeficiency Virus (HIV) serology (p = 0.048) and lack of completion of follow-up bacilloscopy (p = 0.001). In the adjusted multivariate analysis, Acquired Immunodeficiency Syndrome (RR = 1.998; 95%CI 1.078 - 3.704; p = 0.028) and lack of completion of follow-up bacilloscopy (RR = 5.251; 95%CI 2.158 - 12.583; p <0.001*) remained significantly associated with the dropout outcome. Conclusion: Recovery and abandonment outcomes were mainly associated with whether the follow-up bacilloscopy was performed or not and Acquired Immunodeficiency Syndrome.

Factors associated with feeding practices among Brazilian children aged 12 to 23 months old / Fatores associados à prática alimentar de crianças brasileiras de 12 a 23 meses de vida

Abstract Objectives: a quantitative analytical cross-sectional study aimed to identify demographic characteristics to access health services and housing conditions in relation to inadequate feeding practices among Brazilian children from 12 to 23 months of age. Methods: the analysis of the feeding practices (consumption of recommended food groups) of 2541 Brazilian children (aged 12-23 months old) was performed using data from the Pesquisa Nacional de Saúde 2013 (National Health Survey). Descriptive and multivariate statistics used the Decision Tree Analysis based on CHAID (Chi-squared Automatic Interaction Detector) algorithm, as well as hierarchically adjusted Poisson regression analyses were performed. The variables were entered in a hierarchical model at distal (demographic), intermediate (access to health) and proximal (housing conditions) levels. Results: the results showed a high prevalence of sugar consumption (85.5%; CI95%=83.7-87.2) and highlighted inadequate feeding practices among non-white children (p=0.001), resident in the North (p<0.001) and Northeast (p=0.010) of Brazil and in towns in the countryside (p<0.001) presented feeding practices that were not recommended for consumption in the food groups. Conclusions: non-white children, who lived in the North and Northeast regions of Brazil and in the countryside, which are known to be more socioeconomically vulnerable, were more likely to experience inadequate feeding practices.

Resumo Objetivos: estudo transversal analítico, de natureza quantitativa buscou identificar características demográficas, de acesso aos serviços de saúde e de condições de moradia relacionadas à prática alimentar de crianças brasileiras de 12 a 23 meses de vida. Métodos: a partir dos dados da Pesquisa Nacional de Saúde 2013, as práticas alimentares de 2541 crianças brasileiras de 12 a 23 meses, foram analisadas quanto à recomendação de consumo dos grupos alimentares. A análise das características associadas às práticas alimentares foi realizada pela árvore de decisão usando o algoritmo CHAID (Chi-squared Automatic Interaction Detector) e análise de regressão de Poisson ajustada hierarquicamente. As variáveis foram inseridas em modelo hierárquico em níveis distal (demográficas), intermediário (acesso à saúde) e proximal (condições de moradia). Resultados: verificou-se uma alta prevalência no consumo de açúcar (85,5%; IC95%=83,7-87,2) e que crianças que não eram da cor branca (p=0,001), e residiam nas regiões Norte (p<0,001) e Nordeste (p=0,010) do país e em cidades do interior (p<0,001) apresentaram práticas alimentares que não atingem a recomendação de consumo dos distintos grupos alimentares. Conclusão: crianças que não eram da cor branca, residentes no Norte/Nordeste e no interior, áreas de maior vulnerabilidade do país, foram mais propensas à práticas alimentares inadequadas. Medidas para melhorar tais práticas devem abordar as desigualdades socioeconómicas e intervenções de promoção à saúde.

Insegurança alimentar e nutricional de famílias usuárias da Estratégia Saúde da Família em dois municípios paraibanos, Brasil / Food and nutritional insecurity of families using the Family Health Strategy in two municipalities in Paraíba, Brazil

Resumo O objetivo deste artigo é avaliar fatores associados à insegurança alimentar e nutricional de famílias com crianças menores de 5 anos de idade residentes em áreas de abrangência da Estratégia Saúde da Família. Estudo transversal que envolveu 406 famílias de dois municípios da Região Metropolitana de João Pessoa, Paraíba. Para a avaliação da segurança alimentar e nutricional das famílias foi utilizada a Escala Brasileira de Insegurança Alimentar. Os determinantes da insegurança alimentar moderada/grave foram analisados por meio de Árvore de Decisão. A insegurança alimentar e nutricional atingiu 71,4% das famílias. A insegurança alimentar moderada/grave (32%) associou-se, primeiramente, ao benefício do Programa Bolsa Família, além de à família constituída por crianças menores de 2 anos, ao menor nível socioeconômico e à disfunção familiar. Os resultados mostram prevalências elevadas de insegurança alimentar e nutricional, cujos graus mais graves sugerem a importância de intervenções direcionadas a melhorias do Programa Bolsa Família, nas condições dos domicílios com crianças menores de 2 anos, na situação socioeconômica das famílias e na funcionalidade familiar.

Abstract The objective of this article is to evaluate factors associated with food and nutritional insecurity in families with children under 5 years of age living in areas covered by the Family Health Strategy. Cross-sectional study involving 406 families from two municipalities in the Metropolitan Region of João Pessoa, Paraíba. The Brazilian Food Insecurity Scale was used to assess the families' food and nutritional security. The determinants of moderate/severe food insecurity were analyzed using the Decision Tree. Food and nutritional insecurity reached 71.4% of families. Moderate/severe food insecurity (32%) was primarily associated with the benefit of the Family Allowance (Bolsa Família) Program, and also with family composition consisting of children under 2 years of age, lower socioeconomic status, and family dysfunction. The results showed high prevalence of food and nutritional insecurity whose more serious levels suggest the importance of interventions aimed at improving the Family Allowance Program for the conditions of households with children under 2 years of age, socioeconomic situation of families, and functionality of families.

Atitudes e práticas de profissionais atuantes na Estratégia Saúde da Família quanto à abordagem aos usuários de drogas no município de Campina Grande, Paraíba, Brasil / Attitudes and practices of professionals who working in the Family Health Strategy regarding the approach to drug users in the municipality of Campina Grande. Paraíba. Brazil

Resumo O objetivo deste estudo foi avaliar as atitudes e as práticas dos profissionais da Estratégia Saúde da Família (ESF) quanto à abordagem aos usuários drogas no município de Campina Grande, Paraíba. Tratou-se de um estudo transversal e exploratório realizado com 126 médicos, enfermeiros e dentistas da Atenção Primária à Saúde (APS). As variáveis investigadas foram relacionadas a dados sociodemográficos, atuação profissional, atitudes e práticas sobre a abordagem aos usuários de drogas de acordo com o Plano Integrado de Enfrentamento ao Crack e outras Drogas. Foi realizada estatística descritiva e multivariada por meio da Análise de Correspondência Múltipla (ACM). A maioria dos profissionais era do sexo feminino (88,9%) e relatou questionar apenas às vezes quanto ao uso de drogas durante a anamnese (53,2%). Baseando-se na ACM, as variáveis com maior poder discriminatório para a dimensão 1 foram: tempo de formado (0,776), tempo de trabalho na APS (0,688), faixa etária (0,656); enquanto que para a dimensão 2 foram: categoria profissional (0,383) e se conhece os usuários de drogas em sua área de abrangência (0,166). Existem diferenças importantes nas atitudes e nas práticas acerca da abordagem dos usuários de drogas entre os profissionais.

Abstract The aim of this study was to evaluate the attitudes and practices of professionals of the Family Health Strategy regarding the approach to drug users in the municipality of Campina Grande. Paraíba. The cross-sectional and exploratory study carried out with 126 doctors. nurses and dentists of Primary Health Care (PHC). Variables investigated were related to sociodemographic data. professional profile. attitudes and practices about the approach to drug users according to the Integrated Plan to Confront Crack and Other Drugs. Descriptive and multivariate statistics were performed through Multiple Correspondence Analysis (MCA). Most professionals were female (88.9%) and reported questioning only sometimes about the use of drugs during the anamnesis (53.2%). Based on MCA results. variables with the greatest discriminatory power for dimension 1 were: training time (0.776). working time in the PHC (0.688). age group (0.656); while for dimension 2 were: professional category (0.383) and knowledge of drug users in their coverage area (0.166). There are important differences in attitudes and practices about the approach of drug users among professionals.

Profile of the demand assisted by a team of oral and maxillofacial surgeons in the city of Cuiabá, Brazi l: a time-series study / Perfil da demanda atendida por uma equipe de cirurgiões bucomaxilofacial em Cuiabá, Brasil: um estudo de série temporal

The present study aimed to characterize the procedures performed by the oral and maxillofacial surgery team at a Brazilian reference hospital in a Brazilian city, as well as to describe the time trend of the number of services related to different types of surgery. It is a time-series study that assessed the data from the medical records of patients assisted at a reference hospital in a city in the state of Mato Grosso (Brazil), from 2011 to 2017. The data were assessed using descriptive statistical analysis, correspondence analysis (CA), and time trend analysis. A total of 1488 medical records were evaluated, the majority of which corresponded to male patients (59%), extractions were the most performed procedures (46.2%), local anesthesia was the most applied technique (50.3%), and the procedures were mostly performed in an outpatient environment (53.2%). There was a decreasing global time trend (R2 = 0.248; p < 0.001). Male patients are the most assisted in hospital care and are particularly related to more invasive procedures; there is also a decreasing curve of assistance over the years in the oral and maxillofacial surgery and traumatology service of the hospital studied.

O presente estudo teve como objetivo caracterizar os procedimentos realizados pela equipe de cirurgia bucomaxilofacial em um hospital brasileiro de referência de uma cidade brasileira, bem como descrever a tendência temporal da quantidade de atendimentos relacionados a diferentes tipos de cirurgia. Trata-se de um estudo de série temporal que avaliou os dados dos prontuários de pacientes atendidos em um hospital de referência em uma cidade do estado do Mato Grosso (Brasil) entre os anos de 2011 e 2017. Os dados foram avaliados por meio de uma análise estatística descritiva, teste de Análise de correspondência (AC) e análise de tendência temporal. No total, 1488 registros foram avaliados, dos quais a maioria correspondia a pacientes do sexo masculino (59%), exodontias foram os procedimentos mais realizados (46,2%), a técnica anestésica mais empregada foi a local (50,3%) e os procedimentos foram realizados em sua maioria em âmbito ambulatorial (53,2%). A tendência temporal global foi decrescente do tempo global (R2 = 0,248; p <0,001). Os pacientes do sexo masculino são os mais assistidos no atendimento hospitalar e estão particularmente relacionados a procedimentos mais invasivos; há também uma curva decrescente de assistência ao longo dos anos no serviço de cirurgia oral e bucomaxilofacial do hospital estudado.

Maxillofacial trauma, etiology and profile of patients: an exploratory study / Traumas maxilofaciais, etiologia e perfil dos pacientes: um estudo exploratório

ABSTRACT Objective: To describe the profile of patients with facial trauma admitted in a hospital located in a metropolitan area of Northeast Brazil. Methods: A cross-sectional and exploratory study was performed. A total of 244 cases were in agreement with the eligibility criteria. The variables include the sociodemographic characteristics of patients, etiology, type of trauma, treatment modalities, length of stay in a hospital and quarter of care. Descriptive statistics and Cluster Analysis were performed. Results: The average age of patients was 31.16 years (SD = 15.17 years) and average hospitalization was 6.32 days (SD = 7.75 days). It was verified the automatic formation of four clusters with different profiles of patients. The variables which most contributed to the external differentiation between clusters were: length of stay in a hospital (p <0.001), etiology (p <0.001), type of facial trauma (p <0.001), presence of associated trauma (p <0.001), treatment modalities (p <0.001) and quarter of care (p <0.001). Conclusion: The most of patients were men, victims of traffic accidents, which suffered fracture of zygomatic complex and underwent surgery. Level of Evidence III, Retrospective Study.

RESUMO Objetivo: Traçar o perfil dos pacientes internados com trauma de face em um hospital localizado em região metropolitana do Nordeste do Brasil. Métodos: Tratou-se de estudo transversal e exploratório. Um total de 244 casos atendeu aos critérios de elegibilidade, sendo incluídos na amostra. As variáveis estudadas incluíram características sociodemográficas das vítimas, etiologia, tipos de traumas, modalidades de tratamento, tempo de internação e trimestre de atendimento. Foi feita estatística descritiva e análise de cluster. Resultados: A média de idade dos pacientes foi 31,16 anos (DP = 15,17 anos) e o tempo médio de internação foi de 6,32 dias (DP = 7,75 dias). Verificou-se a formação automática de quatro clusters com perfis distintos de pacientes. As variáveis que mais contribuíram para a diferenciação externa entre os clusters foram: tempo de internação (p < 0,001), etiologia (p < 0,001), tipo do trauma facial (p < 0,001), presença de trauma associado (p < 0,001), tipo de tratamento (p < 0,001) e trimestre de atendimento (p < 0,001). Conclusão: A maioria dos pacientes eram homens, vítimas de acidentes de trânsito, que apresentaram fratura do complexo zigomático, submetidos a tratamento cirúrgico. Nível de Evidência III, Estudo Retrospectivo.

Violência contra mulheres em diferentes estágios do ciclo de vida no Brasil: um estudo exploratório / Violence against women in different stages of the life cycle in Brazil: an exploratory study

RESUMO: Objetivo: Descrever o perfil da violência contra mulheres em diferentes ciclos de vida, de acordo com as características sociodemográficas das vítimas e dos agressores. Métodos: Estudo transversal e exploratório realizado com base em 1.388 registros de ocorrências, durante período de quatro anos, em uma região metropolitana do Nordeste do Brasil. A variável dependente foi o tipo de agressão sofrido pelas vítimas. As variáveis independentes foram as características sociodemográficas das vítimas e dos agressores. A análise estatística incluiu o teste χ2 (p < 0,05) e a análise de árvore de decisão, por meio do algoritmo Chi-squared Automatic Interaction Detector (CHAID). Resultados: Os casos de agressão física (n = 644) foram os mais comuns, seguidos de ameaça (n = 415) e agressão verbal (n = 285). Os perfis da violência puderam ser explicados pela relação entre vítimas e agressores (p < 0,001) e faixa etária das vítimas (p = 0,026 em Nó 1; p = 0,019 em Nó 3). Conclusão: Foi observado que mulheres em diferentes fases da vida apresentam mais exposição a diferentes tipos de violência.

ABSTRACT: Objective: The aim of this study was to describe the profile of violence against women in different life cycles, according to the sociodemographic characteristics of the victims and offenders. Methods: A cross-sectional and exploratory study was performed based on 1,388 police reports during a four-year period, in a metropolitan area of Northeast Brazil. The dependent variable was the type of aggression suffered by the victims. The independent variables were sociodemographic characteristics of the victims and offenders. Statistical analysis included the χ2 test (p < 0.05) and the decision tree analysis, through the Chi-squared Automatic Interaction Detector (CHAID) algorithm. Results: Cases of physical abuse (n = 644) were the most common, followed by threat (n = 415) and verbal aggression (n = 285). The violence profiles could be explained by the relationship between victims and offenders (p < 0.001) and age of the victims (p = 0.026 in Node 1; p = 0.019 in Node 3). Conclusion: It was observed that women in different stages of life are more exposed to different types of violence.

Ground transportation accidents involving two categories of motorcyclists who transport passengers / Acidente de transporte terrestre envolvendo duas modalidades de motociclistas que fazem transporte de passageiros

ABSTRACT Objective: The aim of the present cross-sectional study was to analyze the occurrence of ground transportation accidents involving two categories of motorcyclists who transport passengers in a city located in northeastern Brazil: those who work for city hall and those who work for a private transportation firm. Methods: Interviews were held with the aid of a questionnaire administered to a probabilistic sample of 210 individuals (125 from city hall and 85 from the private firm). Results: A high number of motorcyclists in both categories combined (78.6%) suffered traffic accidents in the 12 months prior to the inquiry. Collisions with automobiles constituted the most frequent type of accident (43.6%). Accidents were more associated with motorcyclists working for city hall (p < 0.05), due mainly to the fact that these individuals had been employed for a longer period of time (p < 0.001). The occurrence of bodily injuries was high in both categories (63.6%). Facial injuries were the least frequent in both categories due mainly to the use of protection equipment (98.2%). Conclusion: The occurrence of traffic accidents was high in the two motorcycle passenger transportation categories analyzed, demonstrating that motorcycles are used to transport passengers in a risky manner.

RESUMO Objetivo: Analisar a ocorrência de acidente de transporte terrestre entre duas modalidades de motociclistas que realizam o transporte de passageiros em um município do Nordeste Brasileiro. Métodos: Nesta cidade existem dois grupos de motociclistas regulamentados, um destes trabalhava para prefeitura e outro para uma empresa privada. Foi realizada uma entrevista por meio de um questionário para uma amostra probabilística de 210 sujeitos (n = 125 da prefeitura, n = 85 empresa). Resultados: Um elevado número de motociclistas entre as duas modalidades (78,6%) sofreram acidente de trânsito nos últimos 12 meses à realização do inquérito, sendo a colisão coo o automóvel o tipo mais frequente (43,6%). Entretanto, a modalidade de motociclistas da prefeitura estiveram mais associados com a presença de acidentes (p < 0,05), principalmente pelo fato de estarem trabalhando a mais tempo (p < 0,001). A ocorrência de injúrias corporais foi alta (63,6%) em ambas as modalidades. Injúrias faciais foram menos frequentes para as duas modalidades analisadas, principalmente devido ao uso do equipamento de proteção (98,2%). Conclusão: O alto número de motociclistas acidentados entre as duas modalidades de transporte de passageiros, mostra a falta de segurança deste tipo de transporte. Considerando que estes motociclistas realizam o transporte público de passageiros é necessário melhorias na regulamentação e na prevenção de acidentes.