Retinoblastoma in Ceara: An epidemiological study in a Brazilian pediatric oncology referral center

ABSTRACT Purpose: Although Brazil has a high prevalence of retinoblastoma, there is a lack of epidemiological data on the disease. Thus, in this study, we aimed to evaluate the epidemiological profile of patients diagnosed with retinoblastoma in the ophthalmology department of a pediatric tertiary referral hospital in Ceara, Brazil. Methods: A descriptive and cross-sectional study was conducted by retrospectively analyzing the clinical and socioeconomic data from the medical records of pediatric patients followed-up at the hospital between 2007 and 2021. Retinoblastoma was diagnosed on the basis of a fundoscopic or histopathologic examination. Results: The data of 105 patients were included in the study, and the mean patient age at the time of diagnosis was 1.7 years. Most of the patients were women (50.5%) and hailed from rural areas (57.4%), which was associated with a higher tumor stage. Of the 150 patients, 57.1% initially presented with leukocoria. Ocular hyperemia was associated with more advanced stages of retinoblastoma (p=0.004). Bilateral involvement was observed in 25.7% of the patients and at a significantly younger age (p=0.009). The presence of retinal detachment, vascularized lesions, and vitreous seeds significantly increased the likelihood of requiring enucleation. Discussion: This study presents an epidemiological description of retinoblastoma in Brazil, which highlights the significance of early detection. Delayed diagnosis is associated with a poorer visual prognosis and higher mortality rate, particularly in patients with unilateral disease. Risk factors for a more severe disease were retinal detachment, vascularized lesions, and vitreous seeds. The correlation between histopathological features and clinical outcomes was limited. Conclusion: Further studies are required to assess the influence of ocular hyperemia, fundoscopic assessment, and histopathologic findings on the prognosis of retinoblastoma. Moreover, it is critical to devise interventions to reduce the time-to-diagnosis in rural areas.

Brazilian children's quality of life during the COVID-19 pandemic: analysis of contextual factors and dimensions / Qualidade de vida de crianças brasileiras durante a pandemia de COVID-19: análise de fatores e dimensões contextuais

ABSTRACT Objective: The aim of this study was to investigate the contextual factors associated with the quality of life (QOL) of Brazilian children aged 0-12 years during the strict period of social isolation. Methods: This observational cross-sectional study was conducted between July and September 2020 using an online questionnaire on QOL-related family factors and the Pediatric Quality of Life Inventory (PedsQL™). Results were analyzed by multinomial logistic regression analysis. Results: The sample had 849 children, mostly from the South Region of Brazil (75%), white (83%), with typical development (79%), sedentary (68%), using screen (85%) for >3 h/day (44%). Their mothers were their main caregivers (90%). The following variables were significantly associated with high scores of QOL: typical health status (OR 2.38; 95%CI 1.60-3.55; screen time ≤2 h/day (OR 1.62; 95%CI 1.17-2.24); social distancing considered as "easy" (OR 1.67; 95%CI 1.20-2.32), and stimulation of the child by the family (OR 1.93; 95%CI 1.08-3.45). Conclusions: This study indicates that the family context can influence children's QOL, especially during the COVID-19 pandemic and home environment reorganization.

RESUMO Objetivo: Investigar os fatores contextuais associados à qualidade de vida (QV) de crianças brasileiras de zero a 12 anos, em momento de ápice de distanciamento social. Métodos: Estudo observacional, transversal, online, de julho a setembro de 2020, com questionário sobre fatores do contexto familiar associados à QV e Inventário Pediátrico sobre QV — PedsQL™. A análise dos dados foi feita por de regressão logística multinomial. Resultados: A amostra foi de 849 crianças, na maioria da Região Sul (75%), brancas (83%), com desenvolvimento típico (79%), sedentárias (68%), com uso de telas (85%) em tempo >3h/dia (44%). As mães eram as cuidadoras principais (90%). Foram significativamente associadas a escores mais elevados de QV: a condição de saúde típica (odds ratio — OR 2,38; intervalo de confiança de 95% — IC95% 1,60-3,55), o tempo de tela ≤2h/dia (OR 1,62; IC95% 1,17-2,24), o distanciamento social considerado "fácil" (OR 1,67; IC95% 1,20-2,32) e a família afirmar estimular a criança (OR 1,93; IC95% 1,08-3,45). Conclusões: Este estudo mostra que o contexto familiar pode influenciar a QV de crianças, especialmente no período de pandemia e de reorganização do ambiente domiciliar.

Estudiar y trabajar como factores de riesgo en estudiantes de enfermería, Universidad Nacional Formosa, 2022 / Study and work as risk factors in nursing students, National University of Formosa,2022

Objetivo: Correlacionar la variable principal sostén del hogar con las variables género, edad, horas de trabajo, horas de sueño y factores de riesgo cardiovascular (índice de masa corporal, hipertensión arterial, dislipemia y diabetes mellitus), en estudiantes de 3º, 4 y 5º año de la Licenciatura en Enfermería, Universidad Nacional de Formosa. Metodología: estudio descriptivo, correlacional, transversal realizado en 214 estudiantes, durante el año 2022, utilizándose un cuestionario on-line autoadministrado, estructurado y medición de peso y talla. Resultados: el 76% fueron mujeres; 64%, principal fueron principal sostén del hogar, 57% refirió dormir menos de 6 horas al día, 15 % trabaja más de 41 horas semanales; 67% tuvo respuestas no saludables a la variable estrés, para la variable actividad física este valor ascendió a 71% y el 53,8% presentó exceso de peso. Se encontró asociación significativa entre ser el principal sostén del hogar con exceso de peso, trabajar 41 horas o más semanalmente, dormir menos de 6 horas al día y con la presencia de 3 o más factores de riesgo cardiovascular. Conclusiones: Las condiciones de vida que afrontan los estudiantes que de manera simultánea estudian, trabajan y son principal sostén del hogar pueden generar estrés, el cual es un factor de riesgo para las enfermedades cardiovasculares[AU]

Objetive: to correlate the main variable of primary income earner or primary breadwinner with gender, age, working hours, sleep hours, and cardiovascular disease risk factors (body mass index, hypertension, dyslipidemia, and diabetes mellitus) in 3rd, 4th, and 5th-year nursing students at the Nursing Program at the National University of Formosa. Methodology: The study was a descriptive, correlational, cross-sectional, conducted with 214 students during 2022 using a self-administered structured online questionnaire and measurement of weight and height. Results: 76% were women, 64% were the main breadwinner, 57% reported sleeping less than 6 hours a day, 15% working more than 41 hours per week; 67% had unhealthy responses to the stress variable, this value rose to 71% for the physical activity variable, and 53.8% were overweight. A significant association was found between the main variable of primary breadwinner and being overweight, working 41 or more hours weekly, and the presence of 3 or more cardiovascular risk factors. Conclusions: The living conditions faced by students who simultaneously study and work, and being the main breadwinner in the household can generate stress, which is a risk factor for cardiovascular diseases[AU]

Objetivo:: correlacionar a variável principal de sustento econômico do lar com as variáveis gênero, idade, horas de trabalho, horas de sono e fatores de risco cardiovascular (índice de massa corporal,hipertensão arterial, dislipidemia e diabetes mellitus) em estudantes do 3º, 4º e 5º ano do curso de graduação em Enfermagem, Universidade Nacional de Formosa. Metodologia: O estudo foi descritivo, correlacional e transversal, realizado em 214 estudantes durante o ano de 2022. Foi utilizado um questionário online autoadministrado e estruturado, e a medição de peso e altura dos estudantes foi realizada. Resultados: 76% dos estudantes eram mulheres; 64% eram o principal sustento econômico do lar; 57% relataram dormir menos de 6 horas por dia, 15% responderam que trabalham mais de 41 horas por semana; em relação aos fatores de risco cardiovascular, 67% tiveram respostas não saudáveis para a variável estresse, para a variável atividade física esse valor aumentou para 71% e 53,8% apresentaram excesso de peso. Foi encontrada uma associação significativa entre a variável principal de sustento econômico do lar com as variáveis excesso de peso, trabalhar 41 horas ou mais por semana, dormir menos de 6 horas al día e a presença de 3 ou mais fatores de risco cardiovascular. Conclusões: As condições de vida enfrentadas pelos estudantes que simultaneamente estudam, trabalham e são o principal sustento do lar podem gerar estresse, que é um fator de risco para doenças cardiovasculares[AU]

A qualidade do sono está associada a determinantes sociodemográficos e clínicos em usuários acompanhados na Atenção Primária à Saúde durante a pandemia de COVID-19 / Sleep quality is associated with sociodemographic and clinical determinants in users attended in Primary Health Care during the COVID-19 pandemic / La calidad del sueño se asocia con determinantes sociodemográficos y clínicos en usuarios monitoreados en Atención Primaria de Salud durante la pandemia de COVID-19

Introdução: O avanço da pandemia de COVID-19 acarretou alterações no sono da população. Os distúrbios do sono têm relação com as principais alterações de saúde mental e também possuem relação com os fatores psicossociais. Objetivo: Estimar a prevalência e fatores associados às alterações na qualidade do sono em usuários acompanhados na Atenção Primária à Saúde durante a pandemia de COVID-19. Métodos: Estudo do tipo transversal, com adultos (idade >18 anos) de ambos os gêneros, acompanhados por uma unidade de saúde. Foram levantadas as informações do prontuário eletrônico da unidade e, durante a visita domiciliar (entre agosto e setembro de 2021), os dados socioeconômicos, fatores de risco, sinais vitais, variáveis antropométricas, hábitos de vida, medicações em uso, uso dos serviços de saúde, internação e consultas no último ano. A qualidade de vida foi avaliada pelo questionário SF-36 e foi usado o Índice de Qualidade do sono Pittsburgh (PSQI). Resultados: A amostra foi formada predominantemente por mulheres (82,9%) com 60,5±11,7 anos de idade, da cor branca (70,7%), com companheiro (61%) e pertencentes à classe C (65,8%). 53,7% da amostra apresentou até duas comorbidades, 87,8% apresentavam sobrepeso/obesidade e 80% faziam uso de anti-hipertensivo. A prevalência de qualidade do sono ruim foi de 87,8% (IC95% 73,1­95,0). Os achados apontam para uma relação entre má qualidade do sono com consumo de álcool, presença de ≥3 comorbidades, níveis de PAS, uso de ansiolíticos, nível de escolaridade e uso de serviços de saúde durante a pandemia. Conclusões: A alta prevalência de qualidade do sono ruim na amostra estudada sugere que determinantes sociodemográficos, presença de comorbidades e hábitos de vida devem ser considerados para minimizar os efeitos das alterações do sono na pandemia.

Introduction: The advancement of the COVID-19 pandemic has resulted in changes in the sleep patterns of the population. Sleep disorders are related to major mental health changes and are also associated with psychosocial factors. Objective: To estimate the prevalence and factors associated with sleep quality changes among users attended in Primary Health Care during the COVID-19 pandemic. Methods: This was a cross-sectional study involving adults (age >18 years) of both genders who were being followed at a healthcare unit. Information was gathered from the unit's electronic medical records, and during home visits (between August and September 2021), socioeconomic data, risk factors, vital signs, anthropometric variables, lifestyle habits, current medications, healthcare service utilization, hospitalization, and consultations in the past year were collected. Quality of life was assessed using the SF-36 questionnaire, and the Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality. Results: The sample consisted predominantly of women (82.9%) with an average age of 60.5±11.7 years, of white ethnicity (70.7%), with a partner (61%), and belonging to class C (65.8%). 53.7% of the sample had up to two comorbidities, 87.8% were overweight/obese, and 80% were using antihypertensive medication. The prevalence of poor sleep quality was 87.8% (95%CI 73.1­95.0). The findings indicate a relationship between poor sleep quality and alcohol consumption, the presence of ≥3 comorbidities, systolic blood pressure levels, use of anxiolytics, education level, and the use of healthcare services during the pandemic. Conclusions: The high prevalence of poor sleep quality in the study sample suggests that sociodemographic determinants, presence of comorbidities, and lifestyle habits should be considered to minimize the effects of sleep disturbances during the pandemic.

Introducción: El avance de la pandemia de COVID-19 ha ocasionado cambios en el sueño de la población. Los trastornos del sueño están relacionados con los principales cambios en la salud mental y también se asocian con factores psicosociales. Objetivo: Estimar la prevalencia y los factores asociados con alteraciones en la calidad del sueño en usuarios atendidos en la Atención Primaria de Salud durante la pandemia de COVID-19. Métodos: Estudio transversal con adultos (edad >18 años) de ambos géneros que son atendidos en una unidad de salud. Se recopilaron datos del historial clínico electrónico de la unidad y durante la visita domiciliaria (entre agosto y septiembre de 2021) se obtuvieron datos socioeconómicos, factores de riesgo, signos vitales, variables antropométricas, hábitos de vida, medicamentos utilizados, uso de servicios de salud, hospitalización y consultas en el último año. La calidad de vida se evaluó mediante el cuestionario SF-36 y se utilizó el Índice de Calidad del Sueño de Pittsburgh (PSQI). Resultados: La muestra estuvo compuesta predominantemente por mujeres (82,9%) con una edad de 60,5±11,7 años, de raza blanca (70,7%), con pareja (61%) y pertenecientes a la clase C (65,8%). El 53,7% de la muestra presentó hasta dos comorbilidades, el 87,8% tenían sobrepeso/obesidad y el 80% utilizaba medicación antihipertensiva. La prevalencia de mala calidad del sueño fue del 87,8% (IC95% 73,1­95,0). Los hallazgos señalan una relación entre la mala calidad del sueño y el consumo de alcohol, la presencia de ≥3 comorbilidades, los niveles de presión arterial sistólica (PAS), el uso de ansiolíticos, el nivel de escolaridad y el uso de servicios de salud durante la pandemia. Conclusiones: La alta prevalencia de mala calidad del sueño en la muestra estudiada sugiere que se deben considerar los determinantes sociodemográficos, la presencia de comorbilidades y los hábitos de vida para minimizar los efectos de los trastornos del sueño en la pandemia.

Perfil lipídico e fatores de risco para doenças cardiovasculares em idosos acompanhados na atenção primária à saúde / Lipid profile and risk factors for cardiovascular diseases in older people seen in primary health care / Perfil lipídico y factores de riesgo de enfermedades cardiovasculares en ancianos seguidos en la atención primaria de salud / Lipid profile and risk factors for cardiovascular diseases in older people seen in primary health care

Introdução: As dislipidemias estão entre os fatores de riscos mais importantes para o desenvolvimento de doenças cardiovasculares (DCV), além de estarem relacionadas a outras patologias que predispõem às DCV. Em função da elevada prevalência e da incidência de complicações associadas à cronicidade da doença, as dislipidemias representam elevados custos ao setor da saúde e da previdência social. Diante disso, ressalta-se a importância do Sistema Único de Saúde, representado pela Atenção Primária à Saúde (APS), em prover práticas de prevenção, diagnóstico e acompanhamento dos pacientes dislipidêmicos, a fim de desonerar o sistema financeiro e promover o envelhecimento saudável. Objetivo: Descrever a prevalência de perfil lipídico alterado entre os idosos. Além disso, pretendeu-se caracterizar a amostra quanto aos aspectos sociodemográficos, de saúde e de comportamento, bem como analisar os fatores associados à distribuição do perfil lipídico alterado e às características da amostra. Métodos: Estudo transversal com dados secundários, obtidos de agosto de 2021 a julho de 2022, tendo como população pacientes idosos em acompanhamento na APS do município de Marau (RS). Todos os dados foram coletados dos prontuários eletrônicos da rede de APS e, após dupla digitação e validação dos dados, a amostra foi caracterizada por meio de estatística descritiva. Foi calculada a prevalência de perfil lipídico alterado com intervalo de confiança de 95% (IC95%) e foi verificada sua distribuição conforme as variáveis de exposição, empregando-se o teste do χ2 e admitindo-se erro tipo I de 5%. Resultados: A prevalência de dislipidemia proporcional entre os sexos foi maior no feminino (33%). A cor de pele predominante foi a branca (76,7%). Cerca de 20% dos pacientes apresentavam colesterol total, colesterol HDL-c e triglicerídeos alterados, enquanto cerca de 15% apresentavam o colesterol HDL-c anormal. Constatou-se que os pacientes dislipidêmicos apresentam mais diabetes e hipertensão em relação aos não dislipidêmicos, ocorrendo a sinergia de fatores de risco para as DCV. Conclusões: A caracterização exercida neste estudo serve de base científica para a compreensão da realidade local e, também, para o direcionamento de políticas públicas na atenção primária que atuem de forma efetiva na prevenção e no controle das dislipidemias e demais fatores de risco cardiovascular.

Introduction: Dyslipidemias are among the most important risk factors for the development of cardiovascular diseases (CVD), in addition to being related to other pathologies that predispose to CVD. Because of the high prevalence and incidence of complications associated with the chronicity of the disease, dyslipidemias represent high costs for the health and social security sector. This highlights the importance of the Unified Health System, represented by primary health care (PHC), in providing prevention, diagnosis and follow-up practices for dyslipidemic patients to relieve the financial system and promote healthy aging. Objective: The study aimed to describe the prevalence of altered lipid profile among older people. In addition, we sought to characterize the sample in terms of sociodemographic, health and behavioral aspects, as well as to analyze the factors associated with the distribution of the altered lipid profile and the characteristics of the sample. Methods: We conducted a cross-sectional study with secondary data, from August 2021 to July 2022, with older patients being followed up at the PHC in the city of Marau (RS) as the study population. All data were collected from the electronic medical records of the PHC network, and after double-typing and validation, the sample was characterized using descriptive statistics. The prevalence of altered lipid profile was determined with a 95% confidence interval (95%CI), and its distribution was verified according to the exposure variables, using the chi-square test and a type I error of 5%. Results: The prevalence of proportional dyslipidemia between sexes was higher in females (33%). The predominant skin color was white (76.7%). About 20% of the patients had altered total cholesterol, HDL-C and triglycerides, while about 15% had abnormal HDL-C. It was found that more dyslipidemic patients had diabetes and hypertension than non-dyslipidemic patients, with a synergy of risk factors for CVD. Conclusions: The characterization carried out in this study serves as a scientific basis for understanding the local reality and also for directing public policies in PHC that act effectively in the prevention and control of dyslipidemia and other cardiovascular risk factors.

Introducción: las dislipidemias se encuentran entre los factores de riesgo más importantes para el desarrollo de enfermedades cardiovasculares (ECV), además de estar relacionadas con otras patologías que predisponen a ECV. Debido a la alta prevalencia e incidencia de complicaciones asociadas a la cronicidad de la enfermedad, las dislipidemias representan altos costos para los sectores de salud y seguridad social. Frente a eso, se destaca la importancia del Sistema Único de Salud, representado por la Atención Primaria de Salud (APS), en la provisión de prácticas de prevención, diagnóstico y seguimiento de pacientes dislipidémicos, con el fin de descongestionar el sistema financiero y promover el envejecimiento saludable. Objetivo: El estudio tiene como objetivo describir la prevalencia del perfil lipídico alterado entre los ancianos. Además, se pretende caracterizar la muestra en cuanto a aspectos sociodemográficos, de salud y conductuales, así como analizar los factores asociados a la distribución del perfil lipídico alterado y las características de la muestra. Métodos: estudio transversal con datos secundarios, de agosto de 2021 a julio de 2022, con pacientes ancianos en seguimiento en la APS del municipio de Marau (RS) como población. Todos los datos fueron recolectados de la historia clínica electrónica de la red de la APS y, luego de doble digitación y validación, la muestra fue caracterizada mediante estadística descriptiva. Se calculó la prevalencia de perfil lipídico alterado con un intervalo de confianza del 95% (IC95%) y se verificó su distribución según las variables de exposición, utilizando la prueba de chi-cuadrado y admitiendo un error tipo I del 5%. Resultados: la prevalencia de dislipidemia proporcional entre sexos fue mayor en el sexo femenino (33%). El color de piel predominante fue el blanco (76,7%). Alrededor del 20% de los pacientes tenían colesterol total, colesterol HDL-C y triglicéridos alterados, mientras que alrededor del 15% tenían colesterol HDL-C anormal. Se encontró que los pacientes dislipidémicos tienen más diabetes e hipertensión que los pacientes no dislipidémicos, con una sinergia de factores de riesgo para ECV. Conclusiones: la caracterización realizada en este estudio sirve de base científica para comprender la realidad local y también para orientar políticas públicas en atención primaria que actúen de manera efectiva en la prevención y control de la dislipidemia y otros factores de riesgo cardiovascular.

Factores de riesgo asociados a progresión de Enfermedad Renal Crónica en Hospital de Pamplona, Norte de Santander / Risk factors associated with CKD progression in Pamplona Hospital, Norte de Santander, Colombia

Resumen Introducción: la enfermedad renal crónica (ERC) provoca cambios irreversibles en la función del riñón o en su estructura alrededor de 3 meses . Se considera en salud pública como un grave problema, dado a su comportamiento y potencial letalidad. Objetivo: determinar los factores de riesgo asociados a la progresión de la enfermedad renal crónica en pacientes atendidos en el Hospital San Juan de Dios del municipio de Pamplona, Norte de Santander durante el período 2019 - 2021. Metodología: estudio de corte transversal, analítico, retrospectivo. Se estudiaron y analizaron características sociodemográficas y clínicas mediante métodos de estadística descriptiva e inferencial, se construyó un modelo multivariado de regresión logística con nivel de significancia de 0,05. Resultados: la prevalencia de la ERC estadio 3A fue del 74,9%. Del total de pacientes incluidos en la investigación, 186 (53,7%) tuvieron reporte de progresión. El modelo multivariado indicó que ser mujer está asociado a la progresión de la enfermedad renal cuando se ajusta por TFG (OR 1,07 (IC 1,03-1,12; p = <0,001)), la edad (OR 1,07 (IC 1,03-1,11; p = <0,001)), creatinina (OR 25,2 (IC 5,10-125,1); p = <0,001)) y albuminuria (OR 1,00 (IC 0,99 - 1,01); p= <0,001)). Conclusión: se hace necesario en un futuro estudio involucrar variables de adherencia al tratamiento, así como el tiempo de evolución de la patología y algunos elementos como hábitos, estilos de vida y calidad del control.

Abstract Introduction : Chronic kidney disease (CKD) is considered in public health as a serious problem, given its behavior and lethal potential, this is defined as irreversible changes in kidney function or its structure that last at least 3 months. Objective : To determine the risk factors associated with the progression of CKD in patients treated at the Hospital San Juan de Dios in the municipality of Pamplona Norte de Santander for the period 2019 - 2021. Methodology : Cross-sectional, analytical, retrospective study. Sociodemographic and clinical characteristics were studied and analyzed using descriptive and inferential statistical methods, a multivariate logistic regression model was constructed with a significance level of 0.05. Results : The prevalence of stage 3a chronic kidney disease (CKD) was 74.9%. Out of the total patients included in the research, 186 (53.7%) showed evidence of progression. The multivariate model indicated that being female is associated with the progression of renal disease when adjusted for glomerular filtration rate (GFR) (OR 1.07 (IC 1.03-1.12; p < 0.001)), age (OR 1.07 (IC 1.03-1.11; p < 0.001)), creatinine (OR 25.2 (IC 5.1-125.1); p < 0.001)), and albuminuria (OR 1.00 (IC 0.99-1.01); p < 0.001)). Conclusions: It is necessary in a future study to involve variables of adherence to treatment and treatment, as well as the time of evolution of the pathology and some elements such as habit, lifestyles and quality of control.

Prevalence and associated factors of chronic kidney disease among Truká Indigenous adults in Cabrobó, Brazil: a population-based study.

Background: The prevalence of chronic kidney disease (CKD) is increasing worldwide, especially in developing countries, due to factors such as lifestyle changes and the rise of non-communicable diseases. Populations living in socioeconomically disadvantaged areas are subject to a higher burden of CKD. However, the burden of CKD on Brazilian Indigenous people, especially those undergoing an advanced urbanisation process, has not yet been described. Methods: This cross-sectional study included 1715 Truká Indigenous adults from Cabrobó, Brazil. CKD was defined according to the Kidney Disease Improving Global Outcomes guidelines classification as a urinary albumin/creatinine ratio ≥30 mg/g and/or an estimated glomerular filtration rate <60 mL/min/1.73 m2. Univariate and multiple logistic regression models were used to evaluate factors associated with CKD. Odds ratio (OR) with a 95% confidence interval (CI) was used to measure association. Findings: Out of the 1654 participants analysed (61 excluded due to missing data), the prevalence of CKD was 10% (95% CI, 8.6%-11.5%), with a higher prevalence in women compared to men (12.4% versus 6.9%, p < 0.001). The mean age was 40.5 years, with 55.6% being women. In univariate analysis, female sex (OR, 1.9; 95% CI, 1.3-2.7), age ≥60 years (OR, 4.6; 95% CI, 3.2-6.6), cardiovascular disease (OR, 2.1; 95% CI, 1.1-4.1), and dyslipidemia (OR, 1.6; 95% CI, 1.1-2.4) were identified as associated factors with CKD. Multiple logistic regression analysis identified age ≥60 years, female sex, and dyslipidemia as independently associated factors with CKD. Interpretation: The prevalence of CKD among Truká Indigenous adults analysed is high and affects a higher proportion of women. Our study found no association between hypertension, diabetes, obesity, and CKD risk, despite their high prevalence. These findings assist in developing early CKD detection strategies in Brazilian Indigenous communities, supporting disease treatment and prevention. Funding: National Council for Scientific and Technological Development (CNPq)-Ministry of Science, Technology, and Innovation of Brazil, and the Maria Emília Foundation.

Patient positioning in minimally invasive gynecologic surgery: strategies to prevent injuries and improve outcomes.

Effective patient positioning is a critical factor influencing surgical outcomes, mainly in minimally invasive gynecologic surgery (MIGS) where precise positioning facilitates optimal access to the surgical field. This paper provides a comprehensive exploration of the significance of strategic patient placement in MIGS, emphasizing its role in preventing intraoperative injuries and enhancing overall surgical success. The manuscript addresses potential complications arising from suboptimal positioning and highlights the essential key points for appropriate patient positioning during MIGS, encompassing what the surgical team should or shouldn't do. In this perspective, the risk factors associated with nerve injuries, sliding, compartment syndrome, and pressure ulcers are outlined to guide clinical practice. Overall, this paper underscores the critical role of precise patient positioning in achieving successful MIGS procedures and highlights key principles for the gynecological team to ensure optimal patient outcomes.

Tubal ectopic pregnancy: comparative management between pre and Covid-19 pandemic periods.

Objective: To evaluate whether there were differences in the presentation of patients with tubal ectopic pregnancy (EP) during the first year of the COVID-19 pandemic. Methods: We performed a retrospective cohort study of all cases of tubal EP between March 2019 and March 2020 (pre-pandemic) and between March 2020 and March 2021 (pandemic). We compared between these two groups the risk factors, clinical characteristics, laboratory data, sonographic aspects, treatment applied and complications. Results: We had 150 EP diagnoses during the two years studied, of which 135 were tubal EP. Of these, 65 were included in the pre-pandemic and 70 in the pandemic period. The prevalence of lower abdominal pain was significantly higher in the pandemic compared to the pre-pandemic period (91.4% vs. 78.1%, p=0.031). There was no significant difference in shock index, initial beta-hCG level, hemoglobin level at diagnosis, days of menstrual delay, aspect of the adnexal mass, amount of free fluid on ultrasound, and intact or ruptured presentation between the groups. Expectant management was significantly higher during the pandemic period (40.0% vs. 18.5%, p=0.008), surgical management was lower during the pandemic period (47.1% vs. 67.7%, p=0.023), and number of days hospitalized was lower in the pandemic period (1.3 vs. 2.0 days, p=0.003). Conclusion: We did not observe a significant difference in patient history, laboratory and ultrasound characteristics. Abdominal pain was more common during the pandemic period. Regarding treatment, we observed a significant increase in expectant and a decrease in surgical cases during the pandemic period.

Mobile health apps for cardiovascular risk assessment: a systematic review.

Introduction: mHealth apps (MHA) are emerging as promising tools for cardiovascular risk assessment, but few meet the standards required for clinical use. We aim to evaluate the quality and functionality of mHealth apps for cardiovascular risk assessment by healthcare professionals. Methods: We conducted a systematic review of MHA for cardiovascular risk assessment in the Apple Store, Play Store, and Microsoft Store until August 2023. Our eligibility criteria were based on the 2021 European Society Cardiology Guidelines on Cardiovascular Disease Prevention in Clinical Practice, the Framingham Risk Score, and the Atherosclerotic Cardiovascular Disease score. Our protocol was drafted using the Preferred Reporting items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. To assess quality, we used the validated Mobile Apps Rating Scale (MARS) score, which includes 19 items across four objective scales (engagement, functionality, aesthetics, and information quality) and one additional subjective scale. For functionality evaluation, we used the IMS Institute for Healthcare Informatics functionality scale. We performed data synthesis by generating descriptive statistics. Results: A total of 18 MHA were included in the review. The most common scores used were the Framingham score, ASCVD score, and Score 2. Only six apps achieved an overall score of 4 or greater in the MARS evaluation. The MHA with the highest MARS score was ESC CVD Risk Calculation (5 points), followed by ASCVD Risk Estimator Plus (4.9 points). In the IMS scale, four MHA had a high functionality score: ASCVD Risk Estimator Plus (5 points), ESC CVD Risk Calculation (5 points), MDCalc Medical Calculator (4 points), and Calculate by QsMD (4 points). Discussion: A gap exists in the availability of high-quality MHA designed for healthcare professionals to facilitate shared decision-making in cardiovascular risk assessment. Systematic Review Registration: The International Prospective Register of Systematic Reviews, identifier CRD42023453807.

Risk factors and outcomes of ventilator-associated pneumonia in patients with traumatic brain injury: A systematic review and meta-analysis.

BACKGROUND: Ventilator-associated pneumonia (VAP) is a common complication in traumatic brain injury (TBI) patients, which increases morbidity and negatively affects outcomes. Risk factors and outcomes in these patients remain controversial. The aim of the present study is to explore the risk factors and clinical outcomes of patients with VAP and TBI. METHODS: Two researchers conducted independent systematic literature searches of Pubmed, Cochrane Database, Scopus, Medline Ovid, Science Direct databases, published from inception to January 2024. The Newcastle-Ottawa scale was used to assess study quality. A meta-analysis was performed using a random-effects model when heterogeneity I2 > 50 % and a fixed-effects model when I2 < 50 %; in addition, a subgroup analysis was performed to explore VAP risk factors, and publication bias was assessed with the funnel plot and Begg's and Egger's tests. All results were considered statistically significant when p < 0.05. The certainty of the evidence was evaluated using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) methodology. RESULTS: Twelve studies were included in the meta-analysis with a total of 2883 patients. Male gender [OR 1.58 (95 % CI 1.23, 2.02) p < 0.05 I2 0 %] and abbreviated injury scale (head: H-AIS) [≥ 3 OR 2.79 (95 % CI 1.58, 4.93) p < 0.05 I2 0 %] increased the risk of VAP. After subgroup analysis, blood transfusion on admission [OR 1.97 (95 % CI 1.16-3.35) p ≤0.05 I2 5 %] and barbiturate infusion [OR 3.55 (95 % CI 2.01-6.30) p ≤0.05 I2 0 %] became risk factors. Prophylactic antibiotic use [OR 0.67 (95 % CI 0.51-0.88) p ≤0.05 I2 0 %] and younger age MD -3.29 (95 % CI -5.18, -1.40) p ≤0.05 I2 41 %] emerged as significant protective factors. In VAP patients ICU stay [MD 7.02 (95 % CI 6.05-7.99) p ≤0.05 I2 37 %], duration of mechanical ventilation [MD 5.79 (95 % CI 4.40, 7.18) p ≤0.05 I2 79 %] and hospital stay [MD 11.88 (95 % CI 8.71-15.05) p ≤0.05 I2 0 %] were significantly increased. The certainty of the evidence was moderate-high for the outcomes studied. CONCLUSIONS: Male gender, H-AIS ≥ 3, blood transfusion on admission, and barbiturate infusion were risk factors for VAP. In patients with VAP, ICU stay, duration of mechanical ventilation, hospital stay were significantly increased.

Acute kidney injury and mortality in patients with critical COVID-19 in Mexico: case-control study.

OBJECTIVE: We aimed to test the association between acute kidney injury (AKI) and mortality in critically ill patients with Coronavirus disease 2019 (COVID-19). METHOD: We conducted a single-center case-control study at the intensive care unit (ICU) of a second-level hospital in Mexico. We included 100 patients with critical COVID-19 from January to December 2021, and collected demographic characteristics, comorbidities, APACHE II, SOFA, NEWS2, and CO-RADS scores at admission, incidence of intrahospital complications, length of hospital and ICU stay, and duration of mechanical ventilation, among others. RESULTS: The median survival of deceased patients was 20 days. After multivariable logistic regression, the following variables were significantly associated to mortality: AKI (adjusted odds ratio [AOR] 6.64, 95% confidence intervals [CI] = 2.1-20.6, p = 0.001), age > 55 years (AOR 5.3, 95% CI = 1.5-18.1, p = 0.007), and arrhythmias (AOR 5.15, 95% CI = 1.3-19.2, p = 0.015). Median survival was shorter in patients with AKI (15 vs. 22 days, p = 0.043), as well as in patients with overweight/obesity (15 vs. 25 days, p = 0.026). CONCLUSION: Our findings show that the development of AKI was the main risk factor associated with mortality in critical COVID-19 patients, while other factors such as older age and cardiac arrhythmias were also associated with this outcome. The management of patients with COVID-19 should include renal function screening and staging on admission to the Emergency Department.

OBJETIVO: Probar la asociación entre lesión renal aguda y mortalidad en pacientes con COVID-19 grave. MÉTODO: Realizamos un estudio de casos y controles unicéntrico en la unidad de cuidados intensivos (UCI) de un hospital de segundo nivel en México. Incluimos 100 pacientes con COVID-19 grave de enero a diciembre 2021, recolectando características demográficas, comorbilidad, APACHE II, SOFA, NEWS2 y CO-RADS al ingreso, incidencia de complicaciones intrahospitalarias, duración de la estancia hospitalaria y en la UCI, duración de ventilación mecánica, etc. RESULTADOS: La mediana de supervivencia de los pacientes que fallecieron fue de 20 días. Al realizar el análisis de regresión logística multivariable, las siguientes variables se asociaron significativamente con la mortalidad: lesión renal aguda (odds ratio ajustada [ORa]: 6.64; intervalo de confianza del 95% [IC95%]: 2.1-20.6; p = 0.001), edad > 55 años (ORa: 5.3; IC95%: 1.5-18.1; p = 0.007) y arritmias (ORa: 5.15; IC95%: 1.3-19.2; p = 0.015). La supervivencia fue menor en pacientes con lesión renal aguda (15 vs. 22 días; p = 0,043), así como en pacientes con sobrepeso u obesidad (15 vs. 25 días; p = 0.026). CONCLUSIONES: Nuestros resultados muestran que el desarrollo de lesión renal aguda es el principal factor de riesgo asociado a mortalidad en pacientes con COVID-19 grave, mientras que otros factores, como la edad > 55 años y la presencia de arritmias cardiacas, también se asocian a mortalidad por COVID-19. El manejo de pacientes con COVID-19 debe incluir el tamizaje y la estadificación de la función renal al ingreso a urgencias.

Biofilm formation and increased mortality among cancer patients with candidemia in a Peruvian reference center.

BACKGROUND: Candidemia is an invasive mycosis with an increasing global incidence and high mortality rates in cancer patients. The production of biofilms by some strains of Candida constitutes a mechanism that limits the action of antifungal agents; however, there is limited and conflicting evidence about its role in the risk of death. This study aimed to determine whether biofilm formation is associated with mortality in cancer patients with candidemia. METHODS: This retrospective cohort study included patients treated at Peru's oncologic reference center between June 2015 and October 2017. Data were collected by monitoring patients for 30 days from the diagnosis of candidemia until the date of death or hospital discharge. Statistical analyses evaluated the association between biofilm production determined by XTT reduction and mortality, adjusting for demographic, clinical, and microbiological factors assessed by the hospital routinary activities. Survival analysis and bivariate and multivariate Cox regression were used, estimating the hazard ratio (HR) as a measure of association with a significance level of p < 0.05. RESULTS: A total of 140 patients with candidemia were included in the study. The high mortality observed on the first day of post-diagnosis follow-up (81.0%) among 21 patients who were not treated with either antifungal or antimicrobial drugs led to stratification of the analyses according to whether they received treatment. In untreated patients, there was a mortality gradient in patients infected with non-biofilm-forming strains vs. low/medium and high-level biofilm-forming strains (25.0%, 66.7% and 82.3%, respectively, p = 0.049). In treated patients, a high level of biofilm formation was associated with increased mortality (HR, 3.92; 95% p = 0.022), and this association persisted after adjusting for age, comorbidities, and hospital emergency admission (HR, 6.59; CI: 1.87-23.24, p = 0.003). CONCLUSIONS: The association between candidemia with in vitro biofilm formation and an increased risk of death consistently observed both in patients with and without treatment, provides another level of evidence for a possible causal association. The presence of comorbidities and the origin of the hospital emergency, which reflect the fragile clinical condition of the patients, and increasing age above 15 years were associated with a higher risk of death.

Cardiovascular Health Among Young Men and Women in Puerto Rico as Assessed by the Life's Essential 8 Metrics.

BACKGROUND: Cardiovascular health (CVH) in young adulthood is associated with CVD in later life, yet CVH in young adults in the United States falls below ideal levels, with noticeable sex differences. Research on CVH in young adults in Puerto Rico is scarce. This study examined CVH and sex differences in CVH in a large cohort of young adults in Puerto Rico. METHODS AND RESULTS: Data from 2162 Puerto Rican young adults aged 18 to 29 residing in PR were obtained from the PR-OUTLOOK (Puerto Rico Young Adults' Stress, Contextual, Behavioral, and Cardiometabolic Risk) study (2020-2023). Participants were recruited through various media and community outreach. CVH scores, graded on a 0 (worst) to 100 (best) scale, were derived from survey responses, physical exams, and laboratory assays. Linear regression with the margins postestimation command was used to determine adjusted means (95% CIs) for CVH scores by sex, controlling for age, marital status, education, childhood material deprivation, subjective social status, health insurance, and depressive symptoms. CVH was less than ideal (score<80) in 72.6% of the cohort (70.5% of women, 75.9% of men, P<0.05). Men had a significantly lower adjusted mean overall CVH score than women (70.7 versus 73.0) and lower adjusted mean scores for nicotine exposure (78.3 versus 86.7), non-high-density lipoprotein cholesterol (80.6 versus 86.4), and blood pressure (79.5 versus 92.2). Women had a significantly lower adjusted mean physical activity score compared with men (50.4 versus 59.5). CONCLUSIONS: Less-than-ideal CVH is notable among young adults, with men having worse CVH than women. These identified sex differences warrant further investigation and the design of interventions to enhance and preserve CVH.

Predictors of ischemic stroke in Chagas disease: Insights into mechanisms beyond cardiomyopathy severity.

BACKGROUND: Chagas disease is a risk factor for ischemic stroke, which causes high mortality rates and significant disability. This study aims to determine the incidence and risk factors for ischemic strokes in a large cohort of Chagas cardiomyopathy patients, with a particular focus on the mechanisms involved in the pathophysiology of stroke in this condition. METHODS: The study enrolled 517 patients with Chagas cardiomyopathy who were referred to our institution from March 2000 to December 2021. All patients underwent systematic cardiological and neurological assessments. The primary outcome was the occurrence of ischemic stroke during the follow-up period, classified based on the SSS-TOAST and CCS criteria. Natural cubic splines functions were applied to examine the potential nonlinear association between continuous variables and stroke risk. RESULTS: The mean age of the cohort was 52 ± 13 years, and 299 (58 %) were men. During a mean follow-up period of 4.8 years (interquartile range-IQR 1.1 to 7.1 years), a total of 72 patients (14.8 %) had an ischemic stroke, being fatal in 10. The overall incidence rate of ischemic stroke was 3.0/100 patient-years (95 % confidence interval 2.4 to 3.8). The stroke subtypes were cardioembolic (n = 41), undetermined (n = 11), and other subtypes (n = 20). The predictors of stroke were age, left atrial volume, left ventricular ejection fraction (LVEF), LV thrombus and prior stroke with thrombus. There was a nonlinear relationship between stroke risk, LVEF, and left atrial volume. A bimodal distribution of stroke occurrences was observed according to the severity of LV dysfunction, with a threshold for LVEF of 45 %. The final model for stroke risk prediction showed good discrimination, with a C statistic of 0.775. CONCLUSIONS: In a contemporary cohort of Chagas disease patients with a broad spectrum of disease severity, stroke incidence remains high despite anticoagulation. Stroke risk shows a nonlinear association with ventricular dysfunction and left atrial size, highlighting a distinct bimodal pattern of stroke occurrence in Chagas disease.

Blood mercury concentrations in preschool children and potential risk factors in São Paulo, Brazil.

Environmental exposure of preschool children to mercury can elevate blood mercury levels (BML) and negatively affect their health. This study aimed to determine BML in preschool children from Brazil's largest city and explore potential associated risk factors. Blood samples were collected in 2013 from 2436 children (age 1-5 years) attending 50 daycare centers (DCC) located in São Paulo, Brazil. Parents or guardians answered questionnaires collecting information on sociodemographics and potential risk factors. BML was determined by Cold Vapor Atomic Absorption Spectrophotometry (CV-AAS) and categorized using a cutoff point of 2.77 µg L⁻1, corresponding to the 75th percentile. Multiple logistic regression was performed (p < 0.05). Data were georeferenced and associations with air pollution, wind frequency and direction were evaluated. The results showed a geometric mean for BML of 1.65 µg L⁻1 (95% CI: 1.60-1.70), arithmetic mean of 2.15 µg L⁻1 (95% CI: 2.09-2.22), 75th percentile of 2.77 µg L⁻1 (95% CI: 2.67-2.91) and 95th percentile of 5.51 µg L⁻1 (95% CI: 5.18-5.92). DCCs located in the Northwest and East zones (p < 0.001) and fish consumption in the past two days (p = 0.04) were associated with high BML. The elevated BML observed in children living in the eastern zone might be attributed to the southeasterly winds passing through a petrochemical complex located nearby. The 95th percentile of BML in this study exceeded the U.S. 95th percentile by five times. BML in São Paulo preschool children was associated with individual and environmental risk factors. This finding highlights the need to identify and control hot spots in São Paulo, Brazil, especially in peripheral and surrounding areas, where individuals are more vulnerable. Further research is needed in Latin America to identify additional sources of urban environmental mercury exposure and guide interventions for protecting the environment and safeguarding children's health.

Host drivers of canine dirofilariosis in an arid environment of western Argentina.

Canine dirofilariosis is a mosquito-borne zoonotic disease largely caused by Dirofilaria immitis. Mainly present in temperate, semitropical, and tropical areas, its worldwide emergence and spread are causing concern. In Argentina, most cases have been reported in humid regions of the center and northeast of the country. The occurrence of canine dirofilariosis in an arid environment of western Argentina was investigated by blood smears, microhematocrit tube test, and Knott's technique. Association and odds ratio were determined in relation to dog characteristics. Thirty-three dogs (51.6%) had microfilariae, morphologically identified as D. immitis. Knott's test was more sensitive in detecting the positive animals. The odds of harboring microfilariae were 12, 29, and 66 if the dog was male, adult (three to 6 years old), or older (> 7 years old), respectively. The prevalence of canine dirofilariosis herein reported outstands among the highest in Argentina and extends to the west its geographic distribution in the country. Far from being an exception, this epidemiological situation might reflect similar circumstances in several arid locations in the west and center of Argentina. Being this a disease of recent appearance in the region, both veterinarians and physicians should be aware of its potential to cause disease in animals and humans.

Prevalence of erosive tooth wear in risk group patients: systematic review.

OBJECTIVE: This systematic review investigates the prevalence of erosive tooth wear (ETW) in individuals classified as risk groups (gastroesophageal reflux disease, eating disorders, special diets, acidic beverage, drugs and alcohol, legal drugs and medications, and occupational or sports). MATERIALS AND METHODS: The research was conducted in nine databases (PubMed/MEDLINE, Embase, Cochrane Library, LILACS/BVS, SciELO, Scopus, Science Direct, Open Grey, and Web of Science) up to April 2024 (PROSPERO CRD42021270150), along with a manual search of grey literature. Observational studies involving children and adults from these previously mentioned risk groups, which provided data on ETW prevalence, were included without date or language restrictions. The methodological quality of studies was evaluated using the Joanna Briggs Institute's Prevalence Data Critical Appraisal Tool. General and subgroup data were meta-analyzed using a random-effects model. RESULTS: Overall, 4403 studies were retrieved, out of which 148 met the inclusion criteria. Each risk group showed higher prevalences of ETW in these patients in general and subgroup analysis; although subgroup analysis was not possible for all risk groups due to the heterogeneity of the indices found. CONCLUSIONS: The Legal drugs and Medications risk group showed lower overall prevalence values (30%), while the Drugs and Alcohol risk group obtained higher values (67%). Prevalence rates for other groups were: Gastroesophageal reflux disease (54.1%), Eating Disorders (65%), Special Diets (65.9%), Acidic Beverages (40%), Occupational and Sports (51%). CLINICAL RELEVANCE: This systematic review highlights that risk groups are indeed at significant risk for the development of ETW and greater preventive care and dental monitoring are needed.

[Factors associated with the intention to donate blood in patients of a hospital in Peru]. / Factores asociados a la intención de donación de sangre en pacientes de un hospital de Perú.

OBJECTIVE: Research on factors that modify the intention to donate blood voluntarily in the general population in Peru is scarce, and most of it are focused on health science personnel. The aim of the present study was to estimate the factors associated with the intention to donate blood in patients attending an outpatient clinic in a hospital in northern Peru. METHODS: A prospective unpaired study of cases (n=185) and controls (n=185) was designed. A case was defined as a patient who responded "if I would voluntarily donate blood in the future" to the initial filter question. The response variable was intention to donate blood and the exposure variables were sex, age, marital status, educational level, employment status, monthly income, religion, donation practices, and knowledge about donation. In addition, the motivations for blood donation were explored. To identify the associated factors, crude odds ratios (ORc) were calculated by means of generalized linear models, using the Poisson family, log link function and robust models; then the variables that showed a significant statistical association were adjusted by multivariate analysis, adjusting for sociodemographic variables, and the adjusted odds ratios (ORa) were obtained. RESULTS: In the multivariate analysis, male sex (ORa=1.37), having a high monthly income (ORa=1.26), professing the catholic religion (ORa=5.27), having a higher score in the knowledge questionnaire (ORa=1.04), having previously donated (ORa=1.64) and having a family member who had previously donated (ORa=1.72) increased the probability of intention to donate blood. On the other hand, older age (ORa=0.97) decreased said probability. CONCLUSIONS: Several factors associated with the intention to donate blood are identified, most of which were similar to previous studies. It is highlighted that a high level of knowledge, as well as previous donation experiences, increase the intention to donate blood.

OBJECTIVE: Las investigaciones sobre factores que modifiquen la intención de donar sangre voluntariamente en población general en Perú son escasas, y la mayoría se centran en el personal de Ciencias de la Salud. El objetivo del presente estudio fue estimar los factores asociados a la intención de donación de sangre en pacientes que acudían a consulta externa de un hospital del norte peruano. METHODS: Se diseñó un estudio de casos (n=185) y controles (n= 185) prospectivo no pareado. Se definió como caso al paciente que respondía "si donaría voluntariamente sangre en el futuro" a la pregunta filtro inicial. La variable respuesta fue la intención de donación de sangre y las de exposición fueron sexo, edad, estado civil, grado de instrucción, situación laboral, ingresos mensuales, religión, prácticas sobre la donación y conocimientos sobre la donación. Adicionalmente se exploraron las motivaciones para la donación de sangre. Para identificar los factores asociados se calcularon odds ratio crudos (ORc) mediante modelos lineales generalizados, haciendo uso de la familia Poisson, función de enlace log y modelos robustos; luego, las variables que mostraron asociación estadística significativa se ajustaron mediante análisis multivariado, ajustándolas por las variables sociodemográficas, y se obtuvieron los odds ratio ajustados (ORa). RESULTS: En el análisis multivariado aumentaron la probabilidad de intención de donación de sangre ser de sexo masculino (ORa=1,37), tener ingresos mensuales altos (ORa=1,26), profesar la religión católica (ORa=5,27), tener una mayor puntuación en el cuestionario de conocimientos (ORa=1,04), haber donado previamente (ORa=1,64) y que un familiar hubiera donado previamente (ORa=1,72). Por otro lado, la edad más avanzada (ORa=0,97) disminuyó dicha probabilidad. CONCLUSIONS: Se identifican diversos factores asociados a la intención de donación de sangre. Se resalta que el nivel de conocimientos elevado, así como experiencias previas en donación, aumentan la intención de donar sangre.

Leptospirosis seroprevalence and associated risk factors in dairy goats in the Brazilian semi-arid region.

Leptospira spp. infection is a worldwide zoonosis that causes economic losses to goat rearing, mainly due to reproductive disorders. Hence, the objective of this research was to determine the seroprevalence and associated risk factors of leptospirosis in a goat milk-producing region in the states of Paraiba and Pernambuco, Northeast Brazil. The microscopic agglutination test was used as serological method and risk factor analysis was carried out using univariable and multivariable analyses. Out of the 937 animals sampled, 102 (10.9 %; 95 % CI = 8.9-12.9 %) were seropositive for Leptospira spp. and the most frequent serogroups were Ballum (41.2 %; 95 % CI = 31.6-50.7 %), Icterohaemorrhagiae (25.5 %, 95 % CI = 17-33.9 %) and Semaranga (23.5 %, 95 % CI = 15.3-31.8 %), with antibody titres ranging from 1:50 to 1:200. Thirty-four of 51 herds (66.7 %; 95 % CI = 53.7-79.6 %) had at least one seropositive animal. The risk factor identified in the multivariable two-level random effect binary logistic regression was the animal being an adult (odds ratio = 4.2; 95 % CI = 1.93-9.13; P < 0.001). Our results provide important information on the epidemiology and risk factors associated with goat leptospirosis seroprevalence in one of the main Brazilian goat milk-producing regions. Furthermore, the need for adopting sanitary control measures, especially those involving sanitary management practices, is highlighted.