Short-term heart rate variability at rest in individuals with temporomandibular disorder: a comparative analysis.

OBJECTIVE: Compare heart rate variability (HRV) indices in participants with and without myogenic temporomandibular disorder (TMD). Secondarily, we correlated HRV indices with pain and quality of life variables. METHODS: This is a comparative observational cross-sectional study. Individuals of both genders with and without a history of TMD were included. Short-term heart rate variability was assessed using a Polar V800. Central sensitization was assessed using the Central Sensitization Inventory. Pain through the numeric pain scale and the impact of oral health on quality of life using the OHIP-14 questionnaire. RESULTS: A total of 80 participants were enrolled in the study: most individuals included in both groups were young adults, women and slightly overweight. We observed a decrease in HRV in the TMD group (p < 0.01) when compared to the control group. In addition, we observed a greater impact of oral health on quality of life, central sensitization in addition to high resting pain scores (p < 0.01). We observed significant correlation between the LF index of HRV and the FAI score (r = 0.311; p = 0.05). The NPS, CSI and OHIP-14 scores did not correlate with any of the HRV indices (p > 0.05). CONCLUSION: The short-term HRV in individuals with TMD is significantly lower when compared to a control group. Furthermore, there seems to be a relationship between the severity of the dysfunction and the HRV variables. CLINICAL RELEVANCE: Using portable and low-cost devices, the HRV can be easily collected and analyzed, without the need for an arsenal of equipment such as the conventional electrocardiogram. This measure can contribute to the therapy adopted and identify individuals prone to unfavorable outcomes involving ANS modulation.

Delirium in the intensive care unit: identifying difficulties in applying the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU).

BACKGROUND: Delirium is an underdiagnosed condition and this may be related, among other causes, to the incorrect use of assessment tools due to lack of knowledge about cognitive assessment and lack of training of the care team. The aim of this study was to investigate the difficulties encountered by the nursing team in the application of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) in patients on mechanical ventilation. METHODS: This is descriptive study with a qualitative approach in a private tertiary hospital located in northeast Brazil. Data collection took place from July 2018 to January 2019. We included 32 nurses and used face-to-face semi-structured interviews. The recorded data were analysed using content analysis. This study followed the recommendations of the Standards for Reporting Qualitative Research (SRQR). RESULTS: We identified three major categories: lack of knowledge of professionals, subdivided into deficit in academic formation, difficulty in the differential diagnosis of delirium and delusion, and lack of knowledge about the steps of the CAM-ICU; difficulty in patient cooperation; and lack of adequate training to apply the CAM-ICU. CONCLUSION: Nurses have a deficit in academic formation on delirium and need adequate training for the correct and frequent use of the CAM-ICU.

Intra- and Interrater Reliability of Short-Term Measurement of Heart Rate Variability on Rest in Individuals Post-COVID-19.

Individuals affected by COVID-19 have an alteration in autonomic balance, associated with impaired cardiac parasympathetic modulation and, consequently, a decrease in heart rate variability (HRV). This study examines the inter- and intrarater reliability of HRV) parameters derived from short-term recordings in individuals post-COVID. Sixty-nine participants of both genders post-COVID were included. The RR interval, the time elapsed between two successive R-waves of the QRS signal on the electrocardiogram (RRi), were recorded during a 10 min period in a supine position using a portable heart rate monitor (Polar® V800 model). The data were transferred into Kubios® HRV standard analysis software and analyzed within the stable sessions containing 256 sequential RRi. The intraclass correlation coefficient (ICC) ranged from 0.920 to 1.000 according to the intrarater analysis by Researcher 01 and 0.959 to 0.999 according to the intrarater by Researcher 02. The interrater ICC ranged from 0.912 to 0.998. The coefficient of variation was up to 9.23 for Researcher 01 intrarater analysis, 6.96 for Researcher 02 intrarater analysis and 8.83 for interrater analysis. The measurement of HRV in post-COVID-19 individuals is reliable and presents a small amount of error inherent to the method, supporting its use in the clinical environment and in scientific research.

Translation, cross-cultural adaptation, and validation of the heart disease fact questionnaire among the Brazilian population.

OBJECTIVE: This study aimed to translate, cross-culturally adapt, and validate the Heart Disease Fact Questionnaire into Brazilian Portuguese. METHODS: The Brazilian version of the Heart Disease Fact Questionnaire was developed through the processes of translation, back-translation, review committee, and pre-test. Test-retest reliability was measured using the intraclass correlation coefficient and the kappa coefficient. Internal consistency was measured using Cronbach's alpha. For construct validity, the total Heart Disease Fact Questionnaire score was correlated with the Diabetes Knowledge Scale and the Diabetes Attitudes Questionnaire. Ceiling and floor effects were also evaluated in this study. RESULTS: For construct validity and floor and ceiling effect measurements, a total of 100 participants were selected. Reliability was measured using a sub-sample of 30 participants from the total sample. We identified adequate values of reliability (kappa between 0.22 and 1.00 and ICC=0.75) and internal consistency (Cronbach's alpha=0.79). We observed adequate correlations of the Heart Disease Fact Questionnaire score with Diabetes Knowledge Scale (r=0.348) and Diabetes Attitudes Questionnaire (r=0.136). No ceiling or floor effects found. CONCLUSION: Brazilian Portuguese version of the Heart Disease Fact Questionnaire has adequate psychometric properties according to the best scientific recommendations.

Translation, cross-cultural adaptation, and validation of the heart disease fact questionnaire among the Brazilian population

SUMMARY OBJECTIVE: This study aimed to translate, cross-culturally adapt, and validate the Heart Disease Fact Questionnaire into Brazilian Portuguese. METHODS: The Brazilian version of the Heart Disease Fact Questionnaire was developed through the processes of translation, back-translation, review committee, and pre-test. Test-retest reliability was measured using the intraclass correlation coefficient and the kappa coefficient. Internal consistency was measured using Cronbach's alpha. For construct validity, the total Heart Disease Fact Questionnaire score was correlated with the Diabetes Knowledge Scale and the Diabetes Attitudes Questionnaire. Ceiling and floor effects were also evaluated in this study. RESULTS: For construct validity and floor and ceiling effect measurements, a total of 100 participants were selected. Reliability was measured using a sub-sample of 30 participants from the total sample. We identified adequate values of reliability (kappa between 0.22 and 1.00 and ICC=0.75) and internal consistency (Cronbach's alpha=0.79). We observed adequate correlations of the Heart Disease Fact Questionnaire score with Diabetes Knowledge Scale (r=0.348) and Diabetes Attitudes Questionnaire (r=0.136). No ceiling or floor effects found. CONCLUSION: Brazilian Portuguese version of the Heart Disease Fact Questionnaire has adequate psychometric properties according to the best scientific recommendations.

Condições socioeconômicas estão associadas ao overbite e overjet? Uma avaliação utilizando fotografias digitais / Are socioeconomic factors associated with overbite and overjet? An evaluation using digital photographs

OBJETIVO: estimar a associação entre fatores socioeconômicos e más oclusões do tipo overbite e overjet em escolares em fase de dentição permanente jovem. MÉTODO: trata-se de um estudo transversal realizado em 251 escolares de sete a 15 anos, de ambos os sexos, regularmente matriculadas no ensino fundamental de escolas públicas e privadas do município de São Luís, Maranhão, Brasil. Todos os sujeitos da amostra realizaram fotografias extrabucais padronizadas de face (frontal em repouso, frontal sorrindo e perfil) e intrabucais (frontal, lateral direita e lateral esquerda em oclusão, oclusal superior e oclusal inferior), para o diagnóstico das alterações. As fotografias foram avaliadas por três examinadores em regime cego e as discordâncias foram discutidas até a obtenção de consenso. Overbite e overjet foram diagnosticados segundo critérios de Angle. RESULTADOS: constatou-se que 35,4% das crianças apresentaram overbite e 18,3%, overjet. Houve associação estatisticamente significante entre a renda familiar com overbite (p=0.003) e com overjet (p=0.029), observando-se que a maioria das crianças que não possuíam overbite (69,4%) era de famílias com baixa renda (até 2 salários mínimos). De modo semelhante, a maioria dos portadores de overjet era de famílias com renda mais elevada, ao passo que a maioria daqueles sem overjet tinha renda familiar baixa. Para as demais variáveis não houve diferenças estatisticamente significante na distribuição de frequência de overjet e overbite. CONCLUSÃO: a prevalência de overbite e overjet nos escolares estudados é alta, especialmente entre aqueles com maior renda familiar.

PURPOSE: to estimate the association between socioeconomic factors and occlusal changes like overbite and overjet in students aged 7 to 15 years. METHOD: this is a cross-sectional study in 251 students of both gender regularly enrolled in the school of public and private schools in São Luís, Maranhão, Brazil. All subjects carried out the sample photos extra-oral standardized face (front resting, smiling front and profile) and intraoral (front, right side and left side in occlusion, occlusal upper and lower occlusal) for the diagnosis of changes. The photographs were evaluated by three observers under blind and disagreements were discussed to achieve consensus. Overbite and overjet were diagnosed according to criteria of Angle. RESULTS: it was found that 35.4% of the children were 18.3% and overbite, overjet. There was a statistically significant association between family income and overbite (p = 0.003) and overjet (p = 0.029), noting that most children who had no overbite (69.4%) were low-income families (up to 2 minimum wage). Similarly, most people with overjet were families with higher incomes, while the majority of those without overjet had low family income. For other variables there was no statistically significant difference in frequency distribution of overjet and overbite. CONCLUSION: the prevalence of overbite and overjet among the studied population is high, especially among those with higher family income.