Brain metastasis risk prediction model in females with hormone receptor-positive breast cancer.

BACKGROUND: Breast cancer is a leading cause of cancer-related deaths in females, and the hormone receptor-positive subtype is the most frequent. Breast cancer is a common source of brain metastases; therefore, we aimed to generate a brain metastases prediction model in females with hormone receptor-positive breast cancer. METHODS: The primary cohort included 3,682 females with hormone receptor-positive breast cancer treated at a single center from May 2009 to May 2020. Patients were randomly divided into a training dataset (n = 2,455) and a validation dataset (n = 1,227). In the training dataset, simple logistic regression analyses were used to measure associations between variables and the diagnosis of brain metastases and to build multivariable models. The model with better calibration and discrimination capacity was tested in the validation dataset to measure its predictive performance. RESULTS: The variables incorporated in the model included age, tumor size, axillary lymph node status, clinical stage at diagnosis, HER2 expression, Ki-67 proliferation index, and the modified Scarff-Bloom-Richardson grade. The area under the curve was 0.81 (95 % CI 0.75-0.86), p < 0.001 in the validation dataset. The study presents a guide for the clinical use of the model. CONCLUSION: A brain metastases prediction model in females with hormone receptor-positive breast cancer helps assess the individual risk of brain metastases.

Prediction of Multimorbidity in Brazil: Latest Fifth of a Century Population Study.

BACKGROUND: Multimorbidity is characterized by the co-occurrence of 2 or more chronic diseases and has been a focus of the health care sector and health policy makers due to its severe adverse effects. OBJECTIVE: This paper aims to use the latest 2 decades of national health data in Brazil to analyze the effects of demographic factors and predict the impact of various risk factors on multimorbidity. METHODS: Data analysis methods include descriptive analysis, logistic regression, and nomogram prediction. The study makes use of a set of national cross-sectional data with a sample size of 877,032. The study used data from 1998, 2003, and 2008 from the Brazilian National Household Sample Survey, and from 2013 and 2019 from the Brazilian National Health Survey. We developed a logistic regression model to assess the influence of risk factors on multimorbidity and predict the influence of the key risk factors in the future, based on the prevalence of multimorbidity in Brazil. RESULTS: Overall, females were 1.7 times more likely to experience multimorbidity than males (odds ratio [OR] 1.72, 95% CI 1.69-1.74). The prevalence of multimorbidity among unemployed individuals was 1.5 times that of employed individuals (OR 1.51, 95% CI 1.49-1.53). Multimorbidity prevalence increased significantly with age. People over 60 years of age were about 20 times more likely to have multiple chronic diseases than those between 18 and 29 years of age (OR 19.6, 95% CI 19.15-20.07). The prevalence of multimorbidity in illiterate individuals was 1.2 times that in literate ones (OR 1.26, 95% CI 1.24-1.28). The subjective well-being of seniors without multimorbidity was 15 times that among people with multimorbidity (OR 15.29, 95% CI 14.97-15.63). Adults with multimorbidity were more than 1.5 times more likely to be hospitalized than those without (OR 1.53, 95% CI 1.50-1.56) and 1.9 times more likely need medical care (OR 1.94, 95% CI 1.91-1.97). These patterns were similar in all 5 cohort studies and remained stable for over 21 years. A nomogram model was used to predict multimorbidity prevalence under the influence of various risk factors. The prediction results were consistent with the effects of logistic regression; older age and poorer participant well-being had the strongest correlation with multimorbidity. CONCLUSIONS: Our study shows that multimorbidity prevalence varied little in the past 2 decades but varies widely across social groups. Identifying populations with higher rates of multimorbidity prevalence may improve policy making around multimorbidity prevention and management. The Brazilian government can create public health policies targeting these groups, and provide more medical treatment and health services to support and protect the multimorbidity population.

125I brachytherapy: a useful treatment to control painful osteoblastic bone metastases.

BACKGROUNDS: 125I brachytherapy is effective in relieving cancer pain due to osteolytic bone metastases. However, fewer studies focused on painful osteoblastic bone metastases (OBMs), we conducted a retrospective study to evaluate the efficacy of 125I brachytherapy for the treatment of painful OBMs. METHODS: From April 2017 to April 2019, clinical data of a total of 65 patients with OBMs who underwent CT/cone beam CT -guided 125I brachytherapy were collected and analyzed. The primary study endpoints were technical success, relief of pain (RoP), and quality of life (QoL). The secondary study endpoints were treatment-related complications, local tumor control (LCR), and overall survival (OS). The logistic regression analysis was performed to predict RoP. RESULTS: Technical success rate was 100%. Visual analog scale scores and daily morphine consumption continuously decreased significantly at 2 weeks, 6 weeks, and 10 weeks (all P < 0.05). The RoP at 6 weeks was 84.62%. QoL presented improvement at 6 and 10 weeks. Only minor complications occurred in 12 patients (18.46%). LCR was 93.85% at 10 weeks. The OS was 29.80 months. Two factors were significantly associated with the RoP: max diameter (MD, < 3 cm vs. ≥ 3 cm, P = 0.019) and serum levels of bone alkaline phosphatase (B-ALP, ≥ 100 U/L vs. < 100 U/L, P = 0.016). CONCLUSIONS: 125I brachytherapy is an effective treatment in relieving painful OBMs and improving patients' QoL.

Factors Associated with Common Mental Disorders in Truck Drivers / Fatores Associados aos Transtornos Mentais Comuns em Caminhoneiros

Abstract This study aimed to identify the risk factors of Common Mental Disorders (CMD) using a sample of 565 Brazilian truck drivers. For data capture were applied the Self-Reporting Questionnaire (SRQ-20), Scale subscale of Psychosocial risks and questionnaire with socio-demographic, working and occupational stressors. The results obtained by multivariate binary logistic regression analysis, have explained the 39.9% of variation on CMD. The occupational stressor working hours is the predictor variable with highest impact, may implying in an increase of 5.41 times more chance of the trucker to present CMD. The results indicate actions by management level as work organization and public authorities with regard to the external work conditions.

Resumo Este estudo objetivou identificar os fatores de risco dos Transtornos Mentais Comuns (TMC) em uma amostra de 565 caminhoneiros brasileiros. Para a coleta de dados, foram utilizados o Self-Reporting Questionnaire (SRQ-20), Subescalas da Escala de Riscos Psicossociais e questionários sociodemográfico, laboral e de estressores ocupacionais. Os resultados obtidos por meio da análise de Regressão Logística Binária Multivariada explicaram 39,9% das variações dos TMC. A variável preditora de maior impacto foi o estressor ocupacional jornada de trabalho que implicou em um aumento de 5,41 vezes mais chance do caminhoneiro apresentar TMC. Os resultados sugerem ações por parte dos gestores quanto à organização do trabalho e por parte do poder público no que diz respeito às condições externas de trabalho.

Determining Factors Affecting Consumers Decision to Purchase Organic Chicken Meat

In the present study, the effect of consumers perception levels (product, price, and benefit perception), consciousness levels (health, environment, and animal welfare), and sociodemographic characteristics on the purchase decision of organic chicken meat were examined.Logistic regression analysis was used to determine the relationship between the purchase decision of organic chicken meat and the perception level, consciousness level, sociodemographic characteristics. As a result of the analyses made, it has been determined that organic chicken meat naturalness perception, value-quality perception, health control awareness, awareness of animal life quality, and income level havestatistically significant effects on the probability of purchasing organic chicken meat.In conclusion, to raise consumer awareness the issues that need to be emphasized are that organic meat is natural, reliable, healthy and suitable for animal welfare.(AU)

Determining Factors Affecting Consumers Decision to Purchase Organic Chicken Meat

In the present study, the effect of consumers perception levels (product, price, and benefit perception), consciousness levels (health, environment, and animal welfare), and sociodemographic characteristics on the purchase decision of organic chicken meat were examined.Logistic regression analysis was used to determine the relationship between the purchase decision of organic chicken meat and the perception level, consciousness level, sociodemographic characteristics. As a result of the analyses made, it has been determined that organic chicken meat naturalness perception, value-quality perception, health control awareness, awareness of animal life quality, and income level havestatistically significant effects on the probability of purchasing organic chicken meat.In conclusion, to raise consumer awareness the issues that need to be emphasized are that organic meat is natural, reliable, healthy and suitable for animal welfare.

Os fatores clássicos e a falha dos implantes dentários: qual o significado estatístico para a prática clínica? / On classic factors and dental implant failures: what is the statistical significance for the daily practice?

Objetivo: identificar quais dos fatores clássicos (material, desenho, superfície do implante, hospedeiro, técnica cirúrgica, protocolo de carga) possuem significado estatístico no prognóstico dos implantes. Material e métodos: uma busca eletrônica foi realizada no sistema PubMed/Medline até junho de 2015 com palavras-chave representativas dos estimadores, combinadas por operadores booleanos. Foram incluídos estudos clínicos contendo amostras com pelo menos 50 pacientes e 100 implantes, mínimo de um ano de acompanhamento, apresentando os estimadores obtidos através de modelo de Cox (Hazard ratio) ou regressão logística (Odds ratio, Risk ratio). O desfecho primário foi a falha do implante. Resultados: das 871 referências iniciais, foram selecionadas 20 após leitura integral, com mais de dez mil pacientes e mais de 30 mil implantes. Nos artigos com modelo de Cox, foram identificados o tabagismo (valores entre 1,04 e 3,9), o diâmetro (valores HR entre 1,72 e 6,35) e o comprimento (valores HR entre 0,8 e 2,7) do implante, as técnicas cirúrgicas específicas para melhorar o leito receptor (HR entre 2 e 5), os protocolos de carga (HR entre 0,1 e 9,7), o operador (HR=4,2; um estudo) e a maxila (HR=10; um estudo). Nos artigos com regressão logística, foram identificados os maiores valores de risco para implantes de largo diâmetro (OR=4,25; um estudo), implantes colocados na região posterior da maxila (OR=6,83; um estudo) e ausência de gengiva queratinizada (OR=4,7; um estudo). Conclusão: os fatores têm frequência variada, dependem da homogeneidade das amostras e nem sempre demonstram significado estatístico. Possíveis explicações podem ser atribuídas para as falhas. Mesmo assim, a documentação clínica detalhada continua fundamental para anteciparmos problemas em áreas estratégicas.

Objective: to identify which of the classic factors (implant material, design, surface; host, surgical technique, loading protocol) can have a statistical significance on dental implant prognosis. Material and methods: an electronic search at the PubMed/Medline was made until June 2015 with representative keywords combined by Boolean operators. Clinical studies with at least 50 patients and 100 implants, 1 year of follow-up, having statistical estimators such as Cox model (Hazard ratio) or logistic regression (Odds ratio, Risk ratio) analyses were included. The primary outcome was implant failure. Results: of the 871 retrieved records, 20 references were finally selected, summing up more than 10 thousand patients and 30 thousand dental implants. For articles using the Cox´s model, tobacco (HR values between 1.04 to 3.9), diameter (HR between 1.72 to 6.35), and implant length (HR between 0.8 to 2.7); specific surgical techniques to improve the recipient bed (HR between 2 and 5), loading protocols (HR from 0.1 to 9.7), the operator (HR=4.2, one study), and the maxillary arch (HR=10, 1 study) were identified. For articles containing logistic regression, the highest chance values were identified for large diameter implants (OR=4.25, one study), implants at the posterior maxillary region (OR=6.83, one study), and the lack of keratinized gingiva (OR=4.7, one study). Conclusion: these factors have a varied frequency, depend on sample´s homogeneity, and not always provide statistical meaning. Possible explanations can be attributed to failures. Even thus, a detailed clinical documentation remains mandatory to anticipate problems in strategic areas.

Prevalence and risk factors associated with pediculosis capitis in an impoverished urban community in lima, peru.

BACKGROUND: Pediculosis capitis is a ubiquitous parasitic skin disease associated with intense pruritus of the scalp. In developing countries it frequently affects children and adults, but epidemiological data at the community level are rare. OBJECTIVES: To assess prevalence and risk factors associated with pediculosis capitis in a resource-poor community in Lima, Peru. MATERIALS AND METHODS: In total, 736 persons living in 199 households in a circumscribed neighbourhood were examined for head lice and nits by visual inspection. At the same time, socio-demographic data were collected using a structured questionnaire. Variables associated with pediculosis were identified by performing a bivariate analysis, followed by a multivariate logistic regression analysis. RESULTS: Prevalence of pediculosis capitis was 9.1% (95% confidence interval (CI): 7.0-11.2 %) in the general population and 19.9% (CI: 15.4-24.4%) in children ≤15 years of age. Multivariate analysis showed that pediculosis capitis was significantly associated with age ≤ 15 years (OR: 16.85; CI:7.42-38.24), female sex (OR: 2.84; CI: 1.58-5.12), household size of >4 persons (OR: 1.98; CI: 1.11-3.55), low quality of house construction material (OR:2.22; CI: 1.20-4.12), and presence of animals in the household (OR: 1.94; CI: 1.11-3.39). CONCLUSION: Pediculosis capitis was a very common disease in the studied community in Lima, Peru. Our logistic regression analysis affirms that young age is the most important risk factor for pediculosis capitis. Moreover, female sex, large household size, living in wooden houses and the presence of animals were identified as being significantly associated with head lice infestation.

Prevalence and risk factors for Toxoplasma gondii infection in certified and non-certified pig breeding farms in the Toledo microregion, PR, Brazil / Prevalência e fatores de risco para a infecção pelo Toxoplasma gondii em granjas de reprodutores suídeos certificados ou não da microregião de Toledo, PR, Brasil

Toxoplasma gondii infection has been diagnosed in pigs all over the world. Economical losses are generally related to reproductive disorders. Toxoplasma infection is also a matter of public health because tissue cysts of the parasite may remain in pork and pork products, and become sources of human infection. The objective of this study was to evaluate the frequency and risk factors associated with Toxoplasma infection in certified and non-certified pig breeding farms in the Toledo microregion, in the State of Paraná, Brazil which includes the cities of Toledo, Nova Santa Rosa, Sao José das Palmeiras and Sao Pedro do Iguaçu. Relative frequency of infection was 13.4 percent, independently of the type of farm. Logistic regression analysis showed that the following factors were associated with infection: absence of workers exclusive for each area of the farm, access of other animals to feeders and drinkers, lack of lids in drinkers, lack of rodent control measures, mean piglet number and weight at weaning per female.

A infecção pelo Toxoplasma gondii tem sido diagnosticada em suínos em todo o mundo. Perdas econômicas geralmente estão relacionadas a distúrbios reprodutivos. A infecção pelo Toxoplasma tem também importância em saúde pública, já que cistos teciduais do parasito podem persistir na carne e subprodutos oriundos de suínos, que servirão de fontes de infecção para o ser humano. O objetivo deste trabalho foi verificar a frequência e os fatores de risco associados à infecção pelo Toxoplasma em granjas de reprodutores suídeos certificados ou não da microrregião de Toledo, no Paraná, que inclui os municípios de Toledo, Nova Santa Rosa, São José das Palmeiras e São Pedro do Iguaçú. A frequência relativa de infecção foi 13,4 por cento, sem diferença com o tipo de granja. A análise de regressão logística demonstrou os seguintes fatores associados à infecção: não utilização de funcionários separados por área da granja, o acesso de animais ao cocho de ração e ao reservatório de água, a não utilização de tampa neste reservatório, a não prevenção de roedores, o número e peso médio de leitões ao desmame por porca.

Dyslipidaemia and undernutrition in children from impoverished areas of Maceió, state of Alagoas, Brazil.

Chronic undernutrition causes reduced growth and endocrine adaptations in order to maintain basic life processes. In the present study, the biochemical profiles of chronically undernourished children were determined in order to test the hypothesis that chronic undernutrition also causes changes in lipid profile in pre-school children. The study population comprised 80 children aged between 12 and 71 months, including 60 with moderate undernutrition [height-for-age Z (HAZ) scores ≤ -2 and > -3] and 20 with severe undernutrition (HAZ scores ≤ -3). Socioeconomic, demographic and environmental data were obtained by application of a questionnaire, and anthropometric measurements and information relating to sex, age and feeding habits were collected by a trained nutritionist. Blood samples were analysed for haemoglobin, vitamin A, insulin-like growth factor 1 (IGF-1) and serum lipids, while cortisol was assayed in the saliva. Faecal samples were submitted to parasitological investigation. Analysis of variance and χ² methods were employed in order to select the variables that participated in the multivariate logistic regression analysis. The study population was socioeconomically homogeneous, while the lack of a treated water supply was clearly associated with the degree of malnutrition. Most children were parasitised and anaemia was significantly more prevalent among the severely undernourished. Levels of IGF-1 decreased significantly with increasing severity of undernutrition. Lipid analysis revealed that almost all of the children had dyslipidemia, while low levels of high-density lipoprotein were associated with the degree of undernutrition. It is concluded that chronic malnutrition causes endocrine changes that give rise to alterations in the metabolic profile of pre-school children.

Prevalence and risk factors for Toxoplasma gondii infection in certified and non-certified pig breeding farms in the Toledo microregion, PR, Brazil

Toxoplasma gondii infection has been diagnosed in pigs all over the world. Economical losses are generally related to reproductive disorders. Toxoplasma infection is also a matter of public health because tissue cysts of the parasite may remain in pork and pork products, and become sources of human infection. The objective of this study was to evaluate the frequency and risk factors associated with Toxoplasma infection in certified and non-certified pig breeding farms in the Toledo microregion, in the State of Paraná, Brazil which includes the cities of Toledo, Nova Santa Rosa, Sao José das Palmeiras and Sao Pedro do Iguaçu. Relative frequency of infection was 13.4%, independently of the type of farm. Logistic regression analysis showed that the following factors were associated with infection: absence of workers exclusive for each area of the farm, access of other animals to feeders and drinkers, lack of lids in drinkers, lack of rodent control measures, mean piglet number and weight at weaning per female.

A infecção pelo Toxoplasma gondii tem sido diagnosticada em suínos em todo o mundo. Perdas econômicas geralmente estão relacionadas a distúrbios reprodutivos. A infecção pelo Toxoplasma tem também importância em saúde pública, já que cistos teciduais do parasito podem persistir na carne e subprodutos oriundos de suínos, que servirão de fontes de infecção para o ser humano. O objetivo deste trabalho foi verificar a frequência e os fatores de risco associados à infecção pelo Toxoplasma em granjas de reprodutores suídeos certificados ou não da microrregião de Toledo, no Paraná, que inclui os municípios de Toledo, Nova Santa Rosa, São José das Palmeiras e São Pedro do Iguaçú. A frequência relativa de infecção foi 13,4%, sem diferença com o tipo de granja. A análise de regressão logística demonstrou os seguintes fatores associados à infecção: não utilização de funcionários separados por área da granja, o acesso de animais ao cocho de ração e ao reservatório de água, a não utilização de tampa neste reservatório, a não prevenção de roedores, o número e peso médio de leitões ao desmame por porca.