Representação social da Covid-19 para a população de uma cidade de pequeno porte / Social representation of Covid-19 for the population of a small-sized city / Representación social del Covid-19 para la población de un pequeño pueblo

Objetivo: analisar a representação social da Covid-19 para a população geral de uma cidade de pequeno porte do Estado do Rio de Janeiro. Método: estudo qualitativo, apoiado na abordagem estrutural das representações sociais. Participaram 100 usuários de serviços de saúde. Os dados foram coletados por questionário sociodemográfico de evocações livres de palavras e roteiro de entrevista semiestruturada. Os dados foram analisados com o auxílio dos softwares Excel, EVOC 2005 e análise de conteúdo temático-categorial para contextualização das evocações respectivamente. Resultados: os termos do possível núcleo central foram: morte, sofrimento, cuidados, ansiedade-angústia e vacina. Na primeira periferia: medo e prevenção. À segunda periferia: informação-desinformação; desgoverno; ter-fé e proteção. A zona de contrate: doença; isolamento-social; dificuldades; catástrofe-mundial; desemprego e pandemia. Considerações finais: marcaram essa representação os impactos psicossociais negativos resultantes da desestruturação da vida e das mortes ocasionadas pela nova doença, no entanto o grupo aderiu as medidas de cuidados de proteção.

Objective: to analyze the social representation of Covid-19 among the general population of a small-sized city in the State of Rio de Janeiro. Method: Qualitative study, based on the structural approach of social representations. One hundred healthcare service users participated. Data were collected through a sociodemographic questionnaire, free word evocation, and a semi-structured interview guide. The data were analyzed using Excel software, EVOC 2005, and thematic-categorical content analysis for contextualization of the evocations, respectively. Results: the terms of the possible central core were: death, suffering, care, anxiety-distress, and vaccine. In the first periphery: fear and prevention. In the second periphery: information-misinformation; mismanagement; having faith and protection. The contrast zone: disease; social isolation; difficulties; global catastrophe; unemployment; and pandemic. Final considerations: this representation was marked by the negative psychosocial impacts resulting from the disruption of life and the deaths caused by the new disease; however, the group adhered to protective care measures.

Objetivo: analizar la representación social del Covid-19 para la población general de una pequeña ciudad del Estado de Río de Janeiro. Método: estudio cualitativo, basado en el enfoque estructural de las representaciones sociales. Participaron 100 usuarios de servicios de salud. Los datos se recolectaron mediante un cuestionario sociodemográfico con evocación libre de palabras y una guía de entrevista semiestructurada. Los datos fueron analizados utilizando lo software Excel y EVOC 2005 y análisis de contenido temático-categórico para contextualizar las evocaciones respectivamente. Resultados: los términos del posible núcleo central eran: muerte, sufrimiento, cuidados, ansiedad-angustia y vacuna. En la primera periferia: miedo y prevención. En la segunda periferia: información-desinformación; desgobierno; tener fe y protección. La zona de contraste: enfermedad; aislamiento-social; dificultades; catástrofe-mundial; desempleo y pandemia. Consideraciones finales: esta representación se caracterizó por los impactos psicosociales negativos derivados de la desestructuración de la vida y de las muertes causada por la nueva enfermedad, sin embargo, el grupo adhirió a las medidas de protección.

Inflammatory profile of patients with different weight diagnoses and similar periodontal condition: A systematic review.

Background: This study aimed to systematically review the literature regarding the inflammatory profiles, measured by cytokines and chemokines, of individuals with different diagnoses of weight, but with the similar periodontal condition. Materials and Methods: Searches were performed in five databases (Scopus, EMBASE, PubMed, Web of Science, and Cochrane-Central). Studies that compared the inflammatory profile of normal-weight individuals to those with obesity and evaluated the same cytokine, collection method, and periodontal diagnosis (periodontal health, gingivitis, or periodontitis) were included. Cross-sectional studies underwent evaluation by independent researchers using the Joanna Briggs Institute Critical Appraisal Checklist. The GRADE (Grades of Recommendation, Assessment, Development and Evaluation) system assessed evidence certainty. Results: Twelve studies were included. The diagnosis of obesity was done on the basis of body mass index, waist circumference, and waist-hip ratio. Pro-inflammatory cytokines (interleukin-6 [IL-6], tumor necrosis factor-α [TNF]-α, IL-1ß, IL-31, and IL-34) were analyzed in serum, saliva, gingival crevicular fluid (GCF), and plasma. Periodontal diagnoses varied across studies. TNF-α expression was significantly higher in individuals with obesity and periodontal health or periodontitis. Serum IL-1ß levels showed mixed results, but salivary IL-1ß levels were elevated in obese individuals. IL-6 levels were higher in obese individuals, regardless of periodontal status. IL-34 and IL-10 showed no significant differences across groups. Monocyte chemoattractant protein-4 (MCP-4) levels were higher in obese individuals with periodontitis or periodontal health. IL-31 and IL-34 in GCF showed no significant differences between obese and nonobese individuals, without periodontitis. Conclusions: Heterogeneous results were noted for IL-6, IL-1ß, IL-31, IL-34, TNF-α, and MCP-4, hindering conclusions on weight's impact on inflammatory profiles in periodontal patients.

Taxogenomic analyses of Starmerella gilliamiae f.a, sp. nov. and Starmerella monicapupoae f.a., sp. nov., two novel species isolated from plant substrates and insects.

Four yeast isolates collected from flowers from different ecosystems in Brazil, one from fruit of Nothofagus alpina in Argentina, three from flowers of Neltuma chilensis in Chile and one obtained from the proventriculus of a female bumblebee in Canada were demonstred, by analysis of the sequences of the internal transcribed spacer (ITS) region and D1/D2 domains of the large subunit rRNA gene, to represent two novel species of the genus Starmerella. These species are described here as Starmerella gilliamiae f.a, sp. nov. (CBS 16166T; Mycobank MB 851206) and Starmerella monicapupoae f.a., sp. nov. (PYCC 8997T; Mycobank MB 851207). The results of a phylogenomic analysis using 1037 single-copy orthogroups indicated that S. gilliamiae is a member of a subclade that contains Starmerella opuntiae, Starmerella aceti and Starmerella apicola. The results also indicated that S. monicapupoae is phylogenetically related to Starmerella riodocensis. The two isolates of S. monicapupoae were obtained from flowers in Brazil and were probably vectored by insects that visit these substrates. Starmerella gilliamiae has a wide geographical distribution having been isolated in flowers from Brazil and Chile, fruit from Argentina and a bumblebee from Canada.

The role of glycated hemoglobin in the diagnosis of prediabetes and diabetes mellitus in young women with polycystic ovary syndrome.

OBJECTIVE: To compare glycated hemoglobin (HbA1c) and the oral glucose tolerance test (OGTT) for the diagnosis of prediabetes and diabetes in young women with polycystic ovary syndrome (PCOS). PATIENTS AND DESIGN: This cross-sectional study included 154 women aged 20-40 years with a diagnosis of PCOS, who were screened for prediabetes and diabetes by the OGTT and HbA1c. Women with diabetes, hyperprolactinemia, thyroid or adrenal diseases, and anemia and users of hormonal contraception or corticosteroids were excluded. MEASUREMENTS: Clinical, biochemical and ultrasound data were collected from the electronic medical records. The women were classified as having normal glucose metabolism, prediabetes, or diabetes based on the diagnostic tests. Sensitivity and specificity were calculated and the Kappa method was used to assess agreement between the two methods. RESULTS: According to the OGTT and HbA1c values, 79.2% and 76% of the women were within the normal range, respectively, 16.8% and 19.5% had prediabetes, and 4% and 4.5% had diabetes (p > .05). The Kappa coefficient of 0.41 (95% confidence interval: 0.24-0.58) indicated medium agreement between methods. Considering the OGTT as the gold standard, the specificity of HbA1c was 89.5% and sensitivity was 85.7% in the diagnosis of prediabetes and 100% and 66.7%, respectively, in the diagnosis of diabetes. CONCLUSION: The HbA1c, when compared to the OGTT, showed high sensitivity and specificity in the diagnosis of prediabetes in young women with PCOS.

Association between sequelae of COVID-19 with periodontal disease and obesity: A cross-sectional study.

BACKGROUND: To assess the sequelae of coronavirus disease 2019 (COVID-19) and associated factors, such as obesity and periodontitis in adults. METHODS: The study included 128 individuals aged ≥35 years with a history of a diagnosis of COVID-19 through real-time polymerase chain reaction (RT-PCR), from Pelotas, Brazil. Self-report sequelae from COVID-19 were defined as the primary outcome. A questionnaire containing sociodemographic, medical, behavioral and self-report of sequelae of COVID-19 was applied. A complete periodontal clinical examination was performed. Weight and height were assessed. Uni-, bi- and multivariate analyses were performed using Poisson regression with robust variance. Additional analyses were performed considering obesity as a subgroup. RESULTS: When considering the whole sample, no statistically significant associations between sequelae of COVID-19 with periodontitis (prevalence ratio [PR]:1.14;95% confidence interval [95%CI]: 0.80-1.61) and obesity (0.93 [0.68-1.26]) were identified. In the subgroup analysis, considering only individuals with obesity, those diagnosed with generalized periodontitis had 86% higher probability to have sequelae of COVID-19 when compared to individuals with periodontal health or localized periodontitis. However, when only those without obesity were considered, no significant association with periodontal status was detected (0.82 [0.55-1.23). No significant association with periodontal status were observed when the severity of sequelae (no sequelae, 1 sequela, and >1 sequela) were considered (p > 0.05). CONCLUSIONS: Individuals diagnosed with obesity and periodontitis have a higher PR of reporting sequelae from COVID-19 compared to individuals with only obesity.

In vitro activity of the novel Fe-cyclam complex against clinical multidrug-resistant bacterial isolates from Brazil.

Aim: To evaluate the effect of a new Fe-cyclam complex on pathogenic bacterial species, including multidrug-resistant clinical specimens. Materials & methods: The complex [Fe(cyclam)ox]PF6 (D2) was tested in cytotoxicity and MIC tests. Clinical and reference strains of Gram-negative and Gram-positive bacteria were used. Considering Staphylococcus aureus strains, the profile of antimicrobial susceptibility and time-kill kinetics for D2 was performed. An in silico analysis for D2 was also performed. Results: D2 showed broad bacterial activity, mainly against specimens of Cutibacterium acnes, S. aureus, Pseudomonas aeruginosa and Acinetobacter baumannii. Low cytotoxicity in human cells was demonstrated. Conclusion: The tested compound proved to be a promising agent against resistant bacterial infections.

Association between sickle cell disease and periodontal disease: A systematic review.

Previous studies have evaluated the association between sickle cell disease (SCD) and periodontal disease; however, their effect on the periodontal parameters remains unclear. This systematic review aimed to investigate whether individuals with sickle cell disease (SCD) increase the risks of periodontal disease more than those without. For the selection of eligible studies, an electronic search was conducted in the MEDLINE/PubMed, Web of Science, Cochrane Library, and Scopus databases. The meta-analysis was based on the inversion of variance using the mean difference (MD) of the continuous outcomes. The quality assessment of included studies was performed using the JBI Critical Appraisal Tools. In total, 13 studies and 2381 participants were included in the qualitative analysis, while 9 studies were considered for the meta-analysis. The meta-analysis indicated that patients with SCD present similar Plaque Index, Clinical Attachment Level, Bleeding on Probing, and Probing Depth when compared to healthy patients (p > .05). However, the Gingival Index was higher for patients with SCD (p = .0002; MD: 0.20). Compared to healthy patients, patients with SCD did not have an increase in periodontal parameters, except for the gingival index. However, further well-designed studies are recommended to reassess the association between SCD and periodontal diseases.

Assessment of fetal heart aortic and pulmonary valve annulus area by three-dimensional ultrasonography: reference curves and applicability in congenital heart diseases.

OBJECTIVES: To determine reference curves for fetal aortic and pulmonary valve annulus area by three-dimensional ultrasonography using the spatio-temporal image correlation (STIC) in the rendering mode, and to ascertain its applicability in congenital heart disease (CHD). METHODS: We performed a retrospective cross-sectional study of 328 normal fetuses and 42 fetuses with CHD between 20 and 33 weeks 6 days of gestation. The outflow plane view of the great vessels was used to measure the areas of the valvar annuli, and the measurements were performed in systole. A linear regression model adjusted according to the determination coefficient (R2) was utilized to construct the reference intervals. The concordance correlation coefficient (CCC) was used to calculate the reproducibility of the mitral and tricuspid valve areas. RESULTS: The mean ± standard deviation (SD) of the aortic and pulmonary valve annulus areas ranged from 6.6 ± 1.2 to 32.9 ± 1.1 mm2 and 10.7 ± 1.3 to 40.3 ± 1.2 mm2, respectively. We observed a linear relationship and strong positive correlation between the area of the aortic and pulmonary valve annuli with r=0.97 and 0.96, respectively. Good intra (CCC=0.99) and interobserver agreement (CCC=0.98) was observed for the measurement of the aortic valve annulus area. A good intra (CCC=0.99) and interobserver (CCC=0.97) agreement was also observed for the measurement of the pulmonary valve annulus area. The mean ± SD of the difference of the areas of the aortic and pulmonary valve annuli between the normal fetuses and those with CHD were -1.801 ± 1.429 mm2 (p=0.208) and -1.033 ± 1.467 mm2 (p<0.0001), respectively. CONCLUSIONS: The reference curves for the areas of the aortic and pulmonary valve annuli of fetal hearts were determined, and showed good inter and intraobserver reproducibility. The constructed reference curves showed applicability in different types of CHD.

Factors associated with poor academic performance among undergraduate dental students: A cross-sectional study.

OBJECTIVE: To evaluate the factors associated with poor academic performance among undergraduate dental students enrolled at a public university in Brazil. METHODS: A semi-structured questionnaire addressing the exploratory variables of interest (sociodemographic and economic characteristics, use of medications and drugs, dentistry as the first choice of undergraduate course, and the Pittsburgh Sleep Quality Index) was hosted on Google Forms and shared with all dental students at the Federal University of Pelotas. Academic performance was evaluated based on institutional records, access to which the participants had previously authorized; students with good (average ≥7.0 points) or poor academic performance (average <7.0 points) were considered. Adjusted logistic regressions were performed to verify the association between academic performance and the exploratory variables (p < 0.05). RESULTS: In total, 244 students were included, of whom 18.8% had poor academic performance. Increased age (OR: 1.34; 95%CI: 1.18-1.52), non-white skin color (OR: 1.34; 95%CI: 1.18-1.52), the use of medications for anxiety and depression (OR: 1.34; 95%CI: 1.18-1.52), and poor sleep quality (OR: 1.34; 95%CI: 1.18-1.52) were factors associated with poor academic performance. CONCLUSION: A low prevalence of poor academic performance was observed. Non-white skin color, increased age, use of anxiolytics or antidepressants, and poor or disturbed sleep may reduce dental students' academic performance.

Fetal heart foramen ovale area by three-dimensional ultrasound using stic in the rendering mode: reference range and applicability in congenital heart diseases.

To determine reference values for the foramen ovale (FO) area of fetal hearts by three-dimensional (3D) ultrasound using spatio-temporal image correlation (STIC) method in the rendering mode, as well as applicability in fetuses with congenital heart disease (CHD). A retrospective and prospective study was performed of 242 normal fetuses and 36 fetuses with CHD between 20 and 33 + 6 weeks of gestation. The FO area was determined in the four-chamber view with manual delineation. To determine the reference curve of the FO area as a function of gestational age (GA), a linear regression model was utilized with an adjusted coefficient of determination (R2). For intra- and interobserver reproducibility calculations, the concordance correlation coefficient (CCC) was used. The mean ± standard deviation (SD) of the FO measurement area was 21.2 ± 1.8 and 48.1 ± 1.9 mm2 at 20 and 33 weeks' gestation, respectively. A linear correlation was observed between the FO area and GA (1.924*GA - 17.95; R2 = 0.91). Good intra- (CCC = 0.97) and interobserver (CCC = 0.94) agreement was observed for the FO area measurement. The mean difference in FO area between normal and CHD fetuses was - 14.4 mm2 (p < 0.001). Reference values for the FO area of fetal hearts were determined by 3D ultrasound using STIC in the rendering mode. This method showed good intra- and interobserver reproducibility and could be used to assess different CHD types.

Entrevista com Sonia Guajajara: o movimento indígena frente à pandemia da COVID-19 / Interview with Sonia Guajajara: the Indigenous movement in the face of the COVID-19 pandemic

Resumo Nesta entrevista, Sonia Guajajara, coordenadora executiva da Articulação dos Povos Indígenas do Brasil (APIB), aborda as análises e estratégias desenvolvidas pelo movimento indígena para o enfrentamento da pandemia da COVID-19. Entre os pontos destacados, estão as estratégias de comunicação, vigilância e monitoramento da COVID-19, o apoio aos territórios indígenas, as iniciativas no Legislativo e no Judiciário, a incidência internacional e a articulação com a academia. Torna-se evidente o importante protagonismo do movimento indígena nas ações de contenção da emergência sanitária e na defesa dos direitos dos povos indígenas, em uma conjuntura de embate com o governo federal e de retrocessos nas políticas públicas.

Abstract In this interview, Sonia Guajajara, the executive coordinator of the Brazil's Indigenous Peoples Articulation (APIB), addresses the analyzis and strategies developed by the Indigenous movement to face the COVID-19 pandemic. Among other topics, she highlights some of the movement's strategies concerning communication, surveillance, and the monitoring of COVID-19, as well as its actions to support Indigenous territories, the initiatives carried out in the Legislative and Judiciary realms, the movement's international incidence, and its articulation with academia. Sonia shows the important role played by the Indigenous movement to control the health emergency and to defend the rights of the Indigenous peoples, in the framework of intense conflicts with the federal government and setbacks in public policies.

Interview with Sonia Guajajara: the Indigenous movement in the face of the COVID-19 pandemic. / Entrevista com Sonia Guajajara: o movimento indígena frente à pandemia da COVID-19.

In this interview, Sonia Guajajara, the executive coordinator of the Brazil's Indigenous Peoples Articulation (APIB), addresses the analyzis and strategies developed by the Indigenous movement to face the COVID-19 pandemic. Among other topics, she highlights some of the movement's strategies concerning communication, surveillance, and the monitoring of COVID-19, as well as its actions to support Indigenous territories, the initiatives carried out in the Legislative and Judiciary realms, the movement's international incidence, and its articulation with academia. Sonia shows the important role played by the Indigenous movement to control the health emergency and to defend the rights of the Indigenous peoples, in the framework of intense conflicts with the federal government and setbacks in public policies.

Nesta entrevista, Sonia Guajajara, coordenadora executiva da Articulação dos Povos Indígenas do Brasil (APIB), aborda as análises e estratégias desenvolvidas pelo movimento indígena para o enfrentamento da pandemia da COVID-19. Entre os pontos destacados, estão as estratégias de comunicação, vigilância e monitoramento da COVID-19, o apoio aos territórios indígenas, as iniciativas no Legislativo e no Judiciário, a incidência internacional e a articulação com a academia. Torna-se evidente o importante protagonismo do movimento indígena nas ações de contenção da emergência sanitária e na defesa dos direitos dos povos indígenas, em uma conjuntura de embate com o governo federal e de retrocessos nas políticas públicas.

REPERCUSSIONS OF BARIATRIC SURGERY ON METABOLIC PARAMETERS: EXPERIENCE OF 15-YEAR FOLLOW-UP IN A HOSPITAL IN MACEIÓ, BRAZIL. / REPERCUSSÕES DA CIRURGIA BARIÁTRICA SOBRE PARÂMETROS METABÓLICOS. EXPERIÊNCIA DE 15 ANOS EM HOSPITAL DE MACEIÓ - BRASIL.

OBJECTIVE: Obesity is a disease characterized by an excessive accumulation of body fat, which is harmful to health, and it has grown significantly in the past years in the majority of countries. The surgery should be recommended to those patients with obesity who did not succeed in conservative clinical therapy after a rigorous analysis by a multidisciplinary team. The aim of this study was to compare metabolic results, weight loss, and parameters associated with obesity in the preoperative and postoperative periods of patients treated with bariatric surgery. METHODS: This was a retrospective, descriptive, cross-sectional, and quantitative study through consultation medical records. Data were collected from May to September 2020 from individuals treated with bariatric surgery in a period of 15 years (from 2003 to 2018). A comparative and descriptive statistical analysis of anthropometric, metabolic, biochemical, and associated morbidities was performed. RESULTS: The majority of patients were female (68.50%). In both sexes, the highest prevalence was found in the age group of 30-39 years and more than half had grade III obesity. The surgical technique used was gastroplasty with Roux-en-Y gastric bypass. After 4 months, there was a significant reduction in the lipid profile, anthropometric parameters, and liver enzymes in both sexes, which remained decreasing till the end of the first year, with marked improvement in the metabolic syndrome (MS). CONCLUSIONS: The positive impact resulted from gastroplasty in terms of weight loss, reduction of body mass index, and lipid profile is quite relevant after 4 months and it is maintained until 1 year after the procedure, showing benefits in reducing the risk factors of the MS.

OBJETIVO: A obesidade é caracterizada pelo acúmulo excessivo de gordura corporal prejudicial à saúde e nos últimos anos tem crescido significativamente na maioria dos países. A cirurgia bariátrica deverá ser recomendada para pacientes obesos que não obtiveram êxito no tratamento clínico e após análise da equipe multiprofissional. comparar os resultados metabólicos, perda ponderal e parâmetros associados à obesidade no pré e pós-operatório dos pacientes submetidos à cirurgia bariátrica. MÉTODOS: estudo retrospectivo, descritivo, transversal, de abordagem quantitativa através da consulta a prontuários. Os dados foram coletados no período de maio a setembro de 2020, de indivíduos submetidos à cirurgia bariátrica no período de 15 anos (2003 a 2018). Foi realizada análise estatística comparativa e descritiva das variáveis antropométricas, metabólicas, bioquímicas e morbidades associadas. RESULTADOS: a maioria era do sexo feminino (68,50%). Em ambos os sexos a maior prevalência se encontravam na faixa etária de 30 a 39 anos e mais da metade tinha obesidade grau III. A técnica cirúrgica utilizada foi o gastroplastia em Y de Roux. Após 4 meses houve uma redução significativa do perfil lipídico, dos parâmetros antropométricos e enzimas hepáticas em ambos os sexos, os quais permaneceram em declínio no final do primeiro ano, com melhora acentuada da síndrome metabólica. CONCLUSÕES: O impacto positivo determinado pela gastroplastia na perda de peso, na redução do IMC e perfil lipídico é bastante relevante já após quatro meses, e se mantém após um ano da realização do procedimento, demonstrando benefícios na redução dos fatores de risco da síndrome metabólica.

Vozes indígenas na saúde: trajetórias, memórias e protagonismos / Indigenous voices in health: trajectories, memories and protagonisms

Analisa histórias sobre a saúde indígena por meio de narrativas dos próprios indígenas que apresentam a temática da saúde a partir de seis olhares, memórias e experiências. Traz relatos de conquistas, retrocessos e desafios nas lutas dos movimento e na implementação da saúd einídgena, considerando as realidades específicas e diferenciadas vividas por esses povos.

Phaffia brasiliana sp. nov., a yeast species isolated from soil in a Cerrado-Atlantic Rain Forest ecotone site in Brazil.

During studies of yeasts associated with soil in a Cerrado-Atlantic Rain Forest ecotone site in Brazil, three orange-pigmented yeast strains were isolated from samples collected in Minas Gerais state, Brazil. Molecular analyses combining the 26S rRNA gene (D1/D2 domains) and the internal transcribed spacer (ITS) sequences as well as whole-genome sequence data showed that these strains could not be ascribed to any known species in the basidiomycetous genus Phaffia, and thus they are considered to represent a novel species for which the name Phaffia brasiliana sp. nov. is proposed. The holotype is CBS 16121T and the MycoBank number is MB 839315. The occurrence of P. brasiliana in a tropical region is unique for the genus, since all other species occur in temperate regions. Two factors appear to contribute to the distribution of the novel taxon: first, the region where it was found has relatively moderate temperature ranges and, second, an adaptation to grow or withstand temperatures higher than those of the other species in the genus seems to be in place.

Three-dimensional ultrasound evaluation of the pelvic floor in postmenopausal women using hormone therapy.

OBJECTIVE: To evaluate the three-dimensional (3D) ultrasound characteristics of the pelvic floor muscles (PFM) in two groups of postmenopausal women: users and nonusers of menopausal hormone therapy (MHT). STUDY DESIGN: Observational, cross-sectional cohort study. MAIN OUTCOME MEASURES: In this study 226 sexually active heterosexual women, aged 45-60 years with amenorrhea >12 months and without clinical pelvic floor disorders or urinary incontinence were included. Women using MHT ≥ 6 months were classified as systemic users. PFM strength was assessed by digital vaginal palpation and scored on the Modified Oxford Scale. Biometry of the PFM was performed by 3D transperineal ultrasound for evaluation of total urogenital hiatus area, transverse and anteroposterior diameters, and levator ani muscle thickness. RESULTS: The participants were divided into users (n = 78) and nonusers (n = 148) of MHT. There were no differences in clinical or anthropometric parameters between groups. The mean age was 55 years and the time since menopause was six years in both groups. The mean duration of MHT use was 43.4 ± 33.3 months. Users of MHT had greater levator ani muscle thickness (p = 0.001) and higher PFM strength (p = 0.029) than nonusers. Risk analysis adjusted for age, time since menopause, BMI, parity, and type of delivery showed an association of MHT use with greater levator ani muscle thickness (OR = 2.69; 95% CI 1.42-5.11, p = 0.029), and higher PFM strength (OR = 1.78; 95% CI1.01-3.29, p = 0.046). There was a weak positive correlation between levator ani muscle thickness and duration of MHT use (r = 0.25, p = 0.0002) and PFM strength (r = 0.12, p = 0.043). CONCLUSIONS: Postmenopausal women using MHT had a greater levator ani muscle thickness associated with higher PFM strength than nonusers.

Políticas antes da política de saúde indígena

Apresenta os contextos e atores no cenário da (in)visibilidade da saúde indígena, as trajetórias e articulações na formulação do subsistema.

Análise morfológica comparativa do côndilo mandibular e outras estruturas da mandíbula e base do crânio em maloclusões classe I, II e III esqueléticas / Comparative morphological analysis of the mandibular condyle and other structures of mandible and cranial base in class I, II and III skeletal malocclusions

O objetivo deste estudo foi comparar o volume condilar em indivíduos com diferentes maloclusões esqueléticas. Também foram realizadas análises das semelhanças morfológicas entre o côndilo mandibular e outras estruturas da mandíbula e base do crânio, por meio de medidas lineares e volumétricas. Essas análises foram realizadas usando Tomografia Computadorizada de Feixe Cônico (TCFC), modelos tridimensionais de côndilos mandibulares e sínfise mandibular de 58 indivíduos foram construídos, e os volumes e áreas foram mensurados. A amostra foi dividida nos seguintes grupos: Classe I (0 ≤ ANB ≥ 4,5°) (n=18), Classe II (ANB > 4,5°) (n=21) e Classe III (ANB < 0°) (n=19). Dezesseis pontos de referência do tecido duro na mandíbula e base do crânio foram identificados por um operador treinado e calibrado. Foram obtidas as distâncias 3D entre os pontos e as projeções nos três planos do espaco (x, y e z). A comparação do volume condilar entre os lados direito e esquerdo foi realizada pelo teste de Wilcoxon (Classe I) e Test t pareado (Classe II e III) e a comparação inter-grupos foi realizada com o teste ANOVA/Tukey (a=0,05). Análises de correlação de Pearson e regressão linear foram realizadas para avaliar a relação entre o volume dos côndilos e a sínfise mandibular, e o volume dos côndilos e as medidas lineares realizadas na mandíbula e base do crânio. Não foi observada diferença estatisticamente significativa entre os volumes condilares dos lados direito e esquerdo em diferentes maloclusões esqueléticas (Classe I: p=0,728; Classe II: p=0,741 e Classe III: p=0,155). Indivíduos de classe III apresentaram maior volume condilar (Classe III: 1990,85 ± 559,42) em comparação aos indivíduos de classe I e II (Classe I: 1835,22 ± 552,15; Classe II: 1725,47 ± 394,64), embora a diferença não tenha sido estatisticamente significativa (p=0,214). Houve uma correlação significativa, mas moderada, entre os volumes condilares e as medidas lineares da sínfise mandibular (p <0,01). Conclui-se que os volumes condilares não variam significativamente em diferentes padrões esqueléticos sagitais e, entre os lados direito e esquerdo. A relação entre o volume condilar e a sínfise mandibular foi moderada e equações de regressão foram desenvolvidas para estimar o volume condilar. (AU)

The aim of this study was to compare the condylar volume in individuals with different skeletal classes. Analyzes of the morphological similarities between the mandibular condyle and other structures of the mandible and cranial base were also performed, using linear and volumetric measurements. These analyzes were performed using Cone Beam Computed Tomography (CBCT), three-dimensional models of mandibular condyles and mandibular symphysis of 58 individuals were constructed, and volumes and areas were measured. The sample was divided into the following groups: Class I (0 ≤ ANB ≥ 4.5 °) (n = 18), Class II (ANB> 4.5°) (n = 21) and Class III (ANB <0 °) (n = 19). Sixteen hard tissue reference points in the mandible and cranial base were identified by a trained and calibrated operator. 3D distances were obtained between the points and the projections in the three planes of the space (x, y and z). The comparison of the condylar volume between the right and left sides was performed by the Wilcoxon test (Class I) and the paired t-test (Class II and III) and the inter-group comparison was performed with the ANOVA / Tukey test (a = 0, 05). Pearson's correlation analyzes and linear regression were performed to assess the relationship between condylar volume and mandibular symphysis, and condylar volume and linear measurements. There was no statistically significant difference between condylar volumes on the right and left sides in different skeletal malocclusions (Class I: p = 0.728; Class II: p = 0.741 and Class III: p = 0.155). Class III individuals had a higher condylar volume (Class III: 1990.85 ± 559.42) compared to Class I and II individuals (Class I: 1835.22 ± 552.15; Class II: 1725.47 ± 394, 64), although the difference was not statistically significant (p = 0.214). There was a significant, but moderate, correlation between condylar volumes and linear measurements of the mandibular symphysis (p <0.01). It is concluded that the condylar volumes do not vary significantly in different sagittal skeletal patterns and, between the right and left sides. The relationship between the condylar volume and the mandibular symphysis was moderate and regression equations were developed to estimate the condylar volume. (AU)

Repercussões da cirurgia bariátrica sobre parâmetros metabólicos. experiência de 15 anos em hospital de maceió - brasil / Repercussions of bariatric surgery on metabolic parameters: experience of 15-year follow-up in a hospital in maceió, brazil

RESUMO - RACIONAL: A obesidade é caracterizada pelo acúmulo excessivo de gordura corporal prejudicial à saúde e nos últimos anos tem crescido significativamente na maioria dos países. A cirurgia bariátrica deverá ser recomendada para pacientes obesos que não obtiveram êxito no tratamento clínico e após análise da equipe multiprofissional. Objetivo: comparar os resultados metabólicos, perda ponderal e parâmetros associados à obesidade no pré e pós-operatório dos pacientes submetidos à cirurgia bariátrica. Métodos: estudo retrospectivo, descritivo, transversal, de abordagem quantitativa através da consulta a prontuários. Os dados foram coletados no período de maio a setembro de 2020, de indivíduos submetidos à cirurgia bariátrica no período de 15 anos (2003 a 2018). Foi realizada análise estatística comparativa e descritiva das variáveis antropométricas, metabólicas, bioquímicas e morbidades associadas. Resultados: a maioria era do sexo feminino (68,50%). Em ambos os sexos a maior prevalência se encontravam na faixa etária de 30 a 39 anos e mais da metade tinha obesidade grau III. A técnica cirúrgica utilizada foi o gastroplastia em Y de Roux. Após 4 meses houve uma redução significativa do perfil lipídico, dos parâmetros antropométricos e enzimas hepáticas em ambos os sexos, os quais permaneceram em declínio no final do primeiro ano, com melhora acentuada da síndrome metabólica. Conclusões: O impacto positivo determinado pela gastroplastia na perda de peso, na redução do IMC e perfil lipídico é bastante relevante já após quatro meses, e se mantém após um ano da realização do procedimento, demonstrando benefícios na redução dos fatores de risco da síndrome metabólica.

ABSTRACT - BACKGROUND: Obesity is a disease characterized by an excessive accumulation of body fat, which is harmful to health, and it has grown significantly in the past years in the majority of countries. The surgery should be recommended to those patients with obesity who did not succeed in conservative clinical therapy after a rigorous analysis by a multidisciplinary team. Objective: The aim of this study was to compare metabolic results, weight loss, and parameters associated with obesity in the preoperative and postoperative periods of patients treated with bariatric surgery. Methods: This was a retrospective, descriptive, cross-sectional, and quantitative study through consultation medical records. Data were collected from May to September 2020 from individuals treated with bariatric surgery in a period of 15 years (from 2003 to 2018). A comparative and descriptive statistical analysis of anthropometric, metabolic, biochemical, and associated morbidities was performed. Results: The majority of patients were female (68.50%). In both sexes, the highest prevalence was found in the age group of 30-39 years and more than half had grade III obesity. The surgical technique used was gastroplasty with Roux-en-Y gastric bypass. After 4 months, there was a significant reduction in the lipid profile, anthropometric parameters, and liver enzymes in both sexes, which remained decreasing till the end of the first year, with marked improvement in the metabolic syndrome (MS). Conclusions: The positive impact resulted from gastroplasty in terms of weight loss, reduction of body mass index, and lipid profile is quite relevant after 4 months and it is maintained until 1 year after the procedure, showing benefits in reducing the risk factors of the MS.