Exon-junction complex association with stalled ribosomes and slow translation-independent disassembly.

Exon junction complexes are deposited at exon-exon junctions during splicing. They are primarily known to activate non-sense mediated degradation of transcripts harbouring premature stop codons before the last intron. According to a popular model, exon-junction complexes accompany mRNAs to the cytoplasm where the first translating ribosome pushes them out. However, they are also removed by uncharacterized, translation-independent mechanisms. Little is known about kinetic and transcript specificity of these processes. Here we tag core subunits of exon-junction complexes with complementary split nanoluciferase fragments to obtain sensitive and quantitative assays for complex formation. Unexpectedly, exon-junction complexes form large stable mRNPs containing stalled ribosomes. Complex assembly and disassembly rates are determined after an arrest in transcription and/or translation. 85% of newly deposited exon-junction complexes are disassembled by a translation-dependent mechanism. However as this process is much faster than the translation-independent one, only 30% of the exon-junction complexes present in cells at steady state require translation for disassembly. Deep RNA sequencing shows a bias of exon-junction complex bound transcripts towards microtubule and centrosome coding ones and demonstrate that the lifetimes of exon-junction complexes are transcript-specific. This study provides a dynamic vision of exon-junction complexes and uncovers their unexpected stable association with ribosomes.

Poor access to health services for depression treatment in Brazil.

OBJECTIVE: To analyze the factors associated with poor access to health services for the depression treatment in Brazil. METHODS: This study used data from the Brazilian National Survey of Health, conducted in the years 2019 and 2020. The sample consisted of 8,332 individuals with a self-reported diagnosis of depression, and poor access to healthcare was identified from the question "what is the main reason for you to not visit the physician/health service regularly for your depression?" From which poor access was identified by the affirmative answer reporting distance of health services or difficulties with transportation; waiting time at the health service; financial difficulties; opening hours of the health service; Not being able to schedule a consultation via health insurance; does not know who to look for or where to go, among others. Sociodemographic aspects and health conditions were analyzed. Bivariate and multivariate analysis was performed using Poisson Regression. RESULTS: The prevalence of poor access to health services for depression treatment was 14.9% (95%CI: 13.6-16.2), relating to individuals aged 15-29 years (PR = 1.52) and 30-59 years old (PR = 1.22), without education (PR = 1.43), who rate their health as regular/poor/very poor (PR = 1.26), who have some limitation in their usual activities (PR = 2.71), who had the last consultation within 6 months of less than 2 years (PR = 2.63) and for more than 2 years (PR = 2.25) and who do not undergo psychotherapy (PR = 4.28). CONCLUSION: Poor access to health services for depression treatment was associated with individual factors and health conditions.

Dietary Intake of Micronutrients and Disease Severity in Patients with Amyotrophic Lateral Sclerosis.

Vitamins and essential metals have been studied as potential risk and prognostic factors in amyotrophic lateral sclerosis (ALS). This study aimed to evaluate the prevalence of inadequate micronutrient intake in ALS patients, comparing subgroups according to the disease severity. Data were obtained from the medical records of 69 individuals. Assessment of disease severity was determined by the revised ALS Functional Scale (ALSFRS-R), using the median as the cutoff. The prevalence of inadequate micronutrient intake was estimated using the Estimated Average Requirements (EAR) cut-point method. The prevalence of inadequate vitamin D, E, riboflavin, pyridoxine, folate, cobalamin, calcium, zinc, and magnesium intake was considered severe. Patients with lower ALSFRS-R scores had lower intakes of vitamin E (p < 0.001), niacin (p = 0.033), pantothenic acid (p = 0.037), pyridoxin (p = 0.008), folate (p = 0.009) and selenium (p = 0.001). Therefore, ALS patients should be monitored regarding dietary intake of micronutrients essential in neurological processes.

Pneumonia in Children under 5 Years: Temporal Trends and Spatial Patterns of Hospitalizations in Brazil.

This study aimed to identify temporal and spatial patterns in the distribution of hospitalization rates for pneumonia in children under 5 years in Brazil. An ecological study was developed using data from the Unified Health System of hospitalizations for pneumonia in children under 5 years in Brazil from 2000 to 2019. Hospitalization rates per 1,000 children were calculated and Joinpoint Regression analyzed the temporal trends. Different spatial analysis techniques were performed. Annual rates of 25 hospitalizations per 1,000 children were observed in 2000 and of 13.83 per 1,000 children in 2019, with a significant downward trend for the country (annual percentage change = -3.4%; 95% confidence interval: -3.8 to -3.0) and for the regions. There was weak spatial autocorrelation; however, there were regions with high rates of hospitalization in the south region and clusters of low rates in the northeast and southeast. Clusters of areas with high hospitalization rates were observed in areas of favorable socioeconomic conditions and provision of health services in the interior of southern Brazil. There is a decreasing trend in hospitalizations for pneumonia in general; however, there are clusters of high rates in the south of Brazil.

Exclusion of m6A from splice-site proximal regions by the exon junction complex dictates m6A topologies and mRNA stability.

N6-methyladenosine (m6A), a widespread destabilizing mark on mRNA, is non-uniformly distributed across the transcriptome, yet the basis for its selective deposition is unknown. Here, we propose that m6A deposition is not selective. Instead, it is exclusion based: m6A consensus motifs are methylated by default, unless they are within a window of ∼100 nt from a splice junction. A simple model which we extensively validate, relying exclusively on presence of m6A motifs and exon-intron architecture, allows in silico recapitulation of experimentally measured m6A profiles. We provide evidence that exclusion from splice junctions is mediated by the exon junction complex (EJC), potentially via physical occlusion, and that previously observed associations between exon-intron architecture and mRNA decay are mechanistically mediated via m6A. Our findings establish a mechanism coupling nuclear mRNA splicing and packaging with the covalent installation of m6A, in turn controlling cytoplasmic decay.

Wind instrumentalists' work-related vocal tract discomfort.

BACKGROUND: Wind instrumentalist use the vocal tract intensively in their professional activities, which can lead to the development work-related voice disorders. OBJECTIVE: To analyze the perception of vocal tract discomfort (VTD) by wind instrumentalists from Natal, Brazil. METHOD: Cross-sectional study with 117 professional musicians and music students from six official bands/orchestras in the city of Natal. Both the Vocal Tract Discomfort Scale and a sample characterization questionnaire were applied. The Chi-square test, Fisher's exact test, and Mann-Whitney U test were applied in the statistical analysis of the variables. RESULTS: The most frequent and intense symptoms of VTD were sensitive throat and sore throat. There was a significant difference between the values of frequency and intensity of all symptoms both before and after playing the instrument. Dryness was the most intense symptom felt after playing the instrument. Musicians who report muscle pain and gastroesophageal reflux showed more VTD symptoms. CONCLUSION: Symptoms of VTD are experienced by wind instrumentalists and can be work-related since there was a difference in their perception after playing their instruments. There was also a relationship with gastroesophageal reflux and muscle pain, indicating that, in addition to collective issues, the individual musicians' health should be taken into account.

Poor access to health services for depression treatment in Brazil

ABSTRACT OBJECTIVE To analyze the factors associated with poor access to health services for the depression treatment in Brazil. METHODS This study used data from the Brazilian National Survey of Health, conducted in the years 2019 and 2020. The sample consisted of 8,332 individuals with a self-reported diagnosis of depression, and poor access to healthcare was identified from the question "what is the main reason for you to not visit the physician/health service regularly for your depression?" From which poor access was identified by the affirmative answer reporting distance of health services or difficulties with transportation; waiting time at the health service; financial difficulties; opening hours of the health service; Not being able to schedule a consultation via health insurance; does not know who to look for or where to go, among others. Sociodemographic aspects and health conditions were analyzed. Bivariate and multivariate analysis was performed using Poisson Regression. RESULTS The prevalence of poor access to health services for depression treatment was 14.9% (95%CI: 13.6-16.2), relating to individuals aged 15-29 years (PR = 1.52) and 30-59 years old (PR = 1.22), without education (PR = 1.43), who rate their health as regular/poor/very poor (PR = 1.26), who have some limitation in their usual activities (PR = 2.71), who had the last consultation within 6 months of less than 2 years (PR = 2.63) and for more than 2 years (PR = 2.25) and who do not undergo psychotherapy (PR = 4.28). CONCLUSION Poor access to health services for depression treatment was associated with individual factors and health conditions.

Mental health services accessibility for women and men: A protocol for a systematic review and meta-analysis.

INTRODUCTION: Mental and behavioral disorders constitute a serious public health problem and require adequate access among women and men for promotion, prevention and treatment of mental illness. METHODS AND ANALYSIS: For the writing of this protocol we will use the guidelines of the PRISMA-P Checklist (Main Items for Reporting Systematic Reviews and Meta-analyzes). This protocol was registered under the number: CRD42021243263. To this end, research will be conducted in the PubMed, Web of Science, Scopus, CINAHL and ScienceDirect databases in search of cross-sectional studies that assess the prevalence of access to mental health services among women and men. All cross-sectional studies that examined the prevalence of mental health services accessibility among women and men will be included. The search will be conducted by two independent researchers who will identify the articles; they will exclude duplicate studies. Through a blinded assessment, they will select articles using the Rayyan QCRI application. The methodological quality of the included studies will be assessed by the Joanna Briggs Institute Checklist for Analytical Cross-Sectional Studies. Meta-analyses will be performed according to the conditions of the included data. ETHICS AND DISCLOSURE: For the development of this study, there is no need for ethical review, as this is a systematic review that will use secondary studies. The conclusions of this study will be disseminated through peer-reviewed publications, conference presentations and condensed abstracts to key stakeholders and partners in the field. The database search is scheduled to start on May 10th, 2021. The entire review process is expected to be completed by August 30th, 2021.

Gender and race inequalities in adolescent and young adult homicide mortality rates: a multilevel ecological analysis of Brazilian municipalities.

OBJECTIVE: The aim of this study was to analyze the relationship between adolescent and young adult homicide mortality rates in Brazilian municipalities according to gender, race, and contextual characteristics at the municipal and federation unit levels. METHODS: This is an ecological study that used secondary data available from the death records of the Mortality Information System and socioeconomic data from the Brazilian Census. The dependent variables were homicide mortality rates among people aged 15-29 years by sex and race from 2015 to 2017. The contextual variables were related to education, income, schooling, and vulnerability. Multilevel linear regression was applied in an ecological model to verify the first- and second-level variables' effect. Each variable's effect was estimated using ß and its respective confidence intervals (95%CI) and statistical significance. RESULTS: There was a direct and significant relationship between the adolescent and young adult mortality rates and the homicide mortality rates among adults, regardless of sex and race/skin color. However, this relationship was more pronounced among black adolescents and young adults. At the federative unit level, the human development index was significantly related to the mortality rates of black men, white men, and white women. CONCLUSION: There is racial inequality in adolescent and young adult mortality from violence in Brazil; the rates are related to municipal characteristics, such as violence in the adult population and inequalities in education and social protection.

Prevalence and factors associated with suicidal ideation among farmers.

This study aimed to analyze the prevalence and factors associated with suicidal ideation among farmers. Cross-sectional study carried out between 2019 and 2020 with 450 farmers in Rio Grande do Norte. The prevalence of suicidal ideation was evaluated using the Beck Suicidal Ideation Inventory, and sociodemographic, health, income, work and alcohol abuse variables were analyzed. The Chi-square test was used to compare the proportions of the outcome between the categories of each variable. Poisson regression with robust variance was used to analyze associated factors and estimate prevalence ratios [PR]. The prevalence of suicidal ideation was 12.4% [95%CI 9.69-15.84] and, in the bivariate analysis, it was associated with sociodemographic, health, income and work variables. In the final multivariate model, the variables that remained significant and were associated with a higher prevalence of SI were: female gender [PR = 3.28], diagnosis of mental disorder in the family [PR = 2.37], presence of common mental disorder [PR = 2.50], alcohol abuse [PR = 2.22] and employment relationship-salaried or temporary [R = 1.91]. Thus, suicidal ideation among farmers is mainly associated with health aspects, especially mental health, work and the female sex, and signals the need to strengthen public policies for suicide prevention with the targeting of effective strategies for the farmers.

Factors associated with common mental disorders among farmers in a medium-sized municipality in Northeastern Brazil.

OBJECTIVE: To identify the prevalence and factors associated with common mental disorders among farmers living in a medium-sized municipality in Northeastern Brazil between 2019 and 2020. METHODS: Trained interviewers applied the standardized questionnaire in 450 participants. Sociodemographic, health, income and working characteristics were assessed. The screening of common mental disorders was performed using the Self-Reporting Questionaire, with the cutoff point ≥ 7 for women and ≥ 5 for men. Poisson regression with robust estimation was applied to verify the prevalence ratios in the bivariate and multivariate analysis. RESULTS: The prevalence of common mental disorders among farmers was 55.1% (95%CI: 50.4-59.6). The variables that remained significant and associated with common mental disorders were: men (PR = 1.7), > 60 years old (PR = 0.5), poor or very poor self-assessment of health (PR = 1.4), previous mental health treatment (PR = 1.2), alcohol abuse (PR = 1.2) and loss of production (PR = 1.3). CONCLUSION: These results indicate that common mental disorders are associated with individual factors and with the farmers' context of life and work, which shows the importance of social, economic and health services support to this group of workers.

Motivação para o trabalho voluntário: proposição de um modelo compreensivo / Motivación para el trabajo voluntario: propuesta de un modelo integral / Motivation for Volunteer Work: Proposition of a Comprehensive Model

No Brasil, estudos sobre a motivação para o trabalho voluntário e suas nuances permanecem escassos, enquanto no exterior identificase uma dificuldade para o consenso teórico. Adicionalmente, os estudos existentes, com frequência, não ponderam sobre os diferentes tipos de trabalho voluntário, as diferenças sociodemográficas e a importância das variáveis culturais de cada país. Logo, este estudo analisou as motivações para o voluntariado de 150 trabalhadores brasileiros, de diferentes organizações e com variadas características demográficas, objetivando propor um modelo compreensivo que refletisse tanto as peculiaridades da realidade nacional, quanto as recomendações da literatura internacional. Os dados foram analisados qualitativamente, através do softwareiramuteq, que apresentou 5 possíveis classes lexicais ou tipos de motivação para o trabalho voluntário: religiosa, fraternal, altruísta, transformadora e pessoal. Dessa forma, esperase gerar subsídios para o aumento da compreensão sobre o trabalho voluntário no Brasil, contribuindo para o aprimoramento de políticas de atração, manutenção e avaliação de sua qualidade.

En Brasil los estudios sobre la motivación para el trabajo voluntario y sus matices siguen siendo escasos, mientras que en el extranjero se identifica una dificultad para el consenso teórico. Además, los estudios existentes a menudo no consideran los diferentes tipos de trabajo voluntario, las diferencias sociodemográficas y la importancia de las variables culturales en cada país. De ese modo, este estudio analizó las motivaciones para el voluntariado de 150 trabajadores brasileños, de diferentes organizaciones y con características demográficas variadas, con el objetivo de proponer un modelo integrado que reflejara tanto las peculiaridades de la realidad nacional como las recomendaciones de la literatura internacional. Los datos se analizaron cualitativamente a través del software iramuteq, que pre-sentó cinco posibles clases léxicas o tipos de motivación para el trabajo voluntario: religioso, fraterno, altruista, transformador y personal. Por lo tanto, se espera ayudar a aumentar la comprensión del trabajo voluntario en Brasil, contribuyendo a la mejora de las políticas para atraer y mantener personas, y evaluar la calidad de los programas .

In Brazil, studies on the motivation for voluntary work and its nuances remain scarce. Abroad, there are difficulties for a theoretical consensus. In addition, existing studies often do not consider the different types of volunteer work, the sociodemographic differences, and the importance of cultural variables in each coun-try. Therefore, this study analyzed the motivations for volunteering of 150 Brazilian workers from different organizations and diverse demographic characteris-tics, aiming to propose a comprehensive model that reflected both the national reality's peculiarities and the recommendations from the international literature. The data were analyzed qualitatively using the iramuteqsoftware, which presented five possible lexical classes or types of motivation for voluntary work: religious, fraternal, altruistic, transformative, and personal. Thus, it is expected to help increase the understanding of volun-teer work in Brazil, contributing to the improvement of policies aimed at attracting and maintaining volunteers, and evaluate the quality of the programs.

Factors associated with sleep problems and sleeping pill use in Brazilians.

OBJECTIVE: To estimate the prevalence of sleep problems and sleeping pill use and associated factors in the Brazilian population. METHODS: This study was conducted with data from the 2019 Brazilian National Health Survey. Our sample consisted of 94,114 participants and the outcomes analyzed were sleep problems and sleeping pill use. Sociodemographic, lifestyle, and health characteristics were explored in a descriptive and multivariate analysis with Poisson regression, robust variance, and 5% significance. RESULTS: We found a 35.1% (95%CI: 34.5-35.7) and 8.5% (95%CI: 8.2-8.9) prevalence of sleep problems and sleeping pill use, respectively. Sleep problems were associated with women (PR = 1.41; 95%CI: 1.36-1.46), individuals who self-assess their health as regular/poor/very poor (PR = 1.56; 95%CI: 1.51-1.62), those with chronic diseases (PR = 1.70; 95%CI: 1.64-1.78), those who use alcohol excessively (PR = 1.14; 95%CI: 1.09-1.20), and smokers (PR = 1.16; 95%CI: 1.10-1.22). Sleeping pill use was associated with women (PR = 1.57; 95%CI: 1.43-1.73), divorcees (PR = 1.46; 95%CI: 1.30-1.65), urban denizens (PR = 1.32; 95%CI: 1.21-1.45) those who self-assess their health as regular/poor/very poor (PR = 1.79; 95%CI: 1.64-1.95), those with chronic diseases (PR = 4.07; 95%CI: 3.48-4.77), and smokers (PR = 1.49; IC95%: 1.33-1.67). CONCLUSION: This study found that the prevalence of sleep problems and sleeping pill use in Brazilians indicates the need for attention and sleep care for this population, especially in women and those with lifestyle and health conditions associated with the analyzed outcomes.

Prevalence of Access to Prenatal Care in the First Trimester of Pregnancy Among Black Women Compared to Other Races/Ethnicities: A Systematic Review and Meta-Analysis.

Objective: To analyze the prevalence of access to prenatal care in the first trimester of pregnancy among black women compared to other races/ethnicities through a systematic review and meta-analysis. Methods: Searches were carried out at PUBMED, LILACS, Web of Science, Scopus, CINAHL, and in the grey literature. The quality of the studies and the risk of bias were analyzed using the Joanna Briggs Critical Appraisal Checklist for Analytical Cross-Sectional Studies instrument. The extracted data were tabulatesd and analyzed qualitatively and quantitatively through meta-analysis. Results: Black women had the lowest prevalence of access to prenatal services in the first trimester, with prevalence ranging from 8.1% to 74.81%, while among white women it varied from 44.9 to 94.0%; 60.7% of black women started prenatal care in the first trimester, while 72.9% of white women did so. Conclusion: Black women compared to other racial groups had lower prevalence of access to prenatal care, with less chance of access in the first trimester, and it can be inferred that the issue of race/skin color is an important determinant in obtaining obstetric care. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020159968_, PROSPERO CRD42020159968.

Prevalence of primary dysmenorrhea and associated factors in adult women.

OBJECTIVE: This study aimed to assess the prevalence and factors associated with primary dysmenorrhea in a sample of adult women. METHODS: A cross-sectional study was carried out with women aged between 19 and 49 years from a city of northeastern Brazil. Sociodemographic, gynecological, and obstetric variables were assessed by questionnaires and interviews. Dysmenorrhea was measured by self-report, and the Numerical Pain Rating Scale measured the intensity of pain. Statistical analyses included χ2 test, ANOVA, and logistic regression. RESULTS: The average age was 33.2±9.1 years and the prevalence of primary dysmenorrhea was 56% for the whole sample. The average duration of symptoms was 2.7±1.8 days and the mean intensity was 6.1±2.6. The previous cesarean section was associated with a higher rate of primary dysmenorrhea (PR=2.33; 95%CI 1.11-4.90) when considering the whole sample. Women who aged 25-39 years and are insufficiently active had higher rates of primary dysmenorrhea (PR=5.24; 95%CI 1.08-27.31). CONCLUSION: Primary dysmenorrhea has a high prevalence in young adults, adults, and middle-aged women. Cesarean section and being physically inactive was associated with increased rates of dysmenorrhea among adult women.

Cigarros eletrônicos e suas consequências histopatológicas relacionadas à doenças pulmonares / E-cigarettes and histopathological consequences related to lung diseases

O cigarro eletrônico surgiu como uma tentativa para minimizar a dependência ao uso de tabaco, entretanto, engloba controvérsias e dúvidas acerca das reais implicações para o organismo humano. Diante disso, o presente estudo tem como objetivo realizar uma revisão da literatura a fim de relacionar o uso de cigarro eletrônico com suas consequências para os humanos. Os estudos analisados relatam experimentos in vitro e in vivo em camundongos, demonstrando menor concentração de poluentes e nocividades no cigarro eletrônico comparado ao convencional, porém, seu potencial efeito maléfico está relacionado à composição do e-líquido, à maneira do uso e à variedade de aromas presentes nos produtos. Além disso, foram verificadas lesões celulares, hiperreatividade das vias aéreas, liberação de citocinas ­ IL-8, IL-10 e TNF, redução da ação antimicrobiana de queratinócitos e potencial apoptose nas células alveolares. Foi observado também um aumento em até cinco vezes da concentração de carboxihemoglobina em comparação ao cigarro comum e um aumento na auto renovação de células de adenocarcinoma pulmonar de células não pequenas, devido à expressão de SOX2. Observa-se também que em casos de DPOC, o cigarro eletrônico não apresenta agravamentos na fisiologia respiratória, contrapondo outras ocorrências como asma, pneumonia, câncer de pulmão e doenças infecciosas que podem ser ocasionadas ou exacerbadas pelo seu uso. Contudo, pelo curto prazo de observação de seus efeitos, não é possível determinar com precisão a segurança dos cigarros eletrônicos, dessa forma, faz-se necessário que mais pesquisas longitudinais sejam desenvolvidas, auxiliando, assim, na construção de evidências sobre a segurança dos cigarros eletrônicos e na regulamentação futura do produto.

Electronic cigarettes emerged as an attempt to minimize tobacco dependence. However, its use is surrounded by controversies and doubts about the real implications for the human organism. Therefore, this study aims at performing a review of the most recent literature to corelate the use of e-cigarettes with their consequences for the human body. The analyzed studies relate in vitro and in vivo experiments on mice, demonstrating lower concentration of pollutants and harmfulness in the electronic cigarette than in conventional cigarettes. However, its potential harmful effect is related to the composition of the e-liquid, in its use and in the variety of aromas in the products. In addition, cellular lesions, airway hyperreactivity, release of IL-8, IL-10 and TNF cytokines could be observed, as well as reduced keratinocyte antimicrobial action and potential apoptosis in alveolar cells. An increase of up to five-fold the concentration of carboxyhemoglobin in comparison to ordinary cigarettes and an increase in self-renewal of non-small pulmonary adenocarcinoma cells due to the expression of SOX2 have also been related. It could also be observed that in COPD cases, e-cigarettes do not present worsening in respiratory physiology, which contrasts with other occurrences such as asthma, pneumonia, lung cancer, and infectious diseases that can be caused or exacerbated by its use. However, due to the short term of observation of the effects, the safety of e-cigarettes could not be accurately determined, thus, the need for further longitudinal research is necessary, which could be used to help build evidence about the safety of e-cigarettes and also to create future regulation of the product.

Pancreatic cáncer incidence and mortality trends: a population-based study / incidencia de cáncer pancreático y tendencias de mortalidad: un estudio basado en la población

ABSTRACT Objectives To analyze trends in pancreatic cancer incidence and mortality in Latin American countries. Methods An ecological study with incidence data from the International Agency for Research on Cancer and mortality data from the World Health Organization. The trend of incidence by Joinpoint regression, the variation of the annual average and the 95% confidence interval were analyzed. Results There were increasing trends in incidence in Brazil, in males, aged 40-59 years, and reduction in Costa Rica. In females, there was stability in all age groups. The mortality rates increased in the elderly in Brazil (AAPC: 1.09%; 95% CI: 0.76; 1.42), Peru (AAPC: 1.76%; 95% CI: 0.36; 3.17) and El Salvador (AAPC: 2.88%; 95% CI: 0.38; 5.43), while in Mexico, there was a reduction. In females, this rate increased in Brazil (AAPC: 1.38%; 95% CI: 1.07; 1.69), Peru (AAPC: 2.25%; 95% CI: 0.68; 3.85), Chile (AAPC: 3.62%; 95% CI: 1.96; 5.31), Nicaragua (AAPC: 2.51%; 95% CI: 0.36; 4.71) and Paraguay (AAPC: 1.17%; 95% CI: 0.37; 1.98) and a downward trend was observed in Colombia and Ecuador. Conclusions Pancreatic cancer had a higher incidence in the elderly population of both sexes and an increase of the mortality trend in females was noted.

RESUMEN Objetivo Analizar las tendencias en la incidencia y mortalidad por cáncer de páncreas en los países latinoamericanos. Método Se realizó un estudio ecológico con datos de incidencia de la Agencia Internacional de Investigación sobre Cáncer y datos de mortalidad de la Organización Mundial de la Salud. Se analizó la tendencia de incidencia por regresión de Joinpoint, la variación del promedio anual y el intervalo de confianza del 95%. Resultados Hubo tendencias crecientes en la incidencia en Brasil en varones entre 40 y 59 años, y una reducción en Costa Rica. En las mujeres, hubo estabilidad en todos los grupos de edad. Las tasas de mortalidad aumentaron en los ancianos en Brasil (AAPC: 1,09%; IC 95%: 0,76; 1.42), Perú (AAPC: 1,76%; IC 95%: 0,36; 3,17) y El Salvador (AAPC: 2,88%; 95% IC 0,38; 5,43), mientras que en México hubo una reducción. En las mujeres, esta tasa aumentó en Brasil (AAPC: 1,38%; IC 95%: 1,07; 1.69), Perú (AAPC: 2,25%; IC 95%: 0,68; 3.85), Chile (AAPC: 3,62%; IC 95%: 1,96; 5,31), Nicaragua (AAPC: 2,51%; IC 95%: 0,36; 4,71) y Paraguay (AAPC: 1,17%; IC 95%: 0,37; 1,98) y se observó una tendencia a la baja en Colombia y Ecuador. Conclusiones El cáncer de páncreas tuvo una mayor incidencia en la población anciana de ambos sexos; cabe también señalar que debido a este aumentó su mortalidad en las mujeres.

Prevalence of primary dysmenorrhea and associated factors in adult women

SUMMARY OBJECTIVE: This study aimed to assess the prevalence and factors associated with primary dysmenorrhea in a sample of adult women. METHODS: A cross-sectional study was carried out with women aged between 19 and 49 years from a city of northeastern Brazil. Sociodemographic, gynecological, and obstetric variables were assessed by questionnaires and interviews. Dysmenorrhea was measured by self-report, and the Numerical Pain Rating Scale measured the intensity of pain. Statistical analyses included χ2 test, ANOVA, and logistic regression. RESULTS: The average age was 33.2±9.1 years and the prevalence of primary dysmenorrhea was 56% for the whole sample. The average duration of symptoms was 2.7±1.8 days and the mean intensity was 6.1±2.6. The previous cesarean section was associated with a higher rate of primary dysmenorrhea (PR=2.33; 95%CI 1.11-4.90) when considering the whole sample. Women who aged 25-39 years and are insufficiently active had higher rates of primary dysmenorrhea (PR=5.24; 95%CI 1.08-27.31). CONCLUSION: Primary dysmenorrhea has a high prevalence in young adults, adults, and middle-aged women. Cesarean section and being physically inactive was associated with increased rates of dysmenorrhea among adult women.

Frequency of Vitamin a Deficiency in Children Hospitalized for Pneumonia: An Integrative Review.

Objective: To identify the frequency of vitamin A deficiency in children aged 6 months to 5 years hospitalized for pneumonia. Methods: An integrative literature review was carried out, where searches were made by two independent researchers, with no language limits or publication time in the databases PubMed, LILACS, Web of Science, Scopus and CINAHL, and in the gray literature-OpenGrey, Proquest and Google Scholar. In the eligibility phase, the screened studies were read in full and those that did not answer the research question were excluded. Methodological quality was assessed using the Downs & Black (1998) checklist. Results: 1642 articles were identified, after all stages of screening and selection, 10 studies were included, of which 5 were longitudinal, 4 were intervention and 1 transversal. All studies identified subclinical vitamin A deficiency in children hospitalized with pneumonia; the highest frequency of subclinical vitamin A deficiency was 93.2%. All studies evaluated showed frequencies of subclinical vitamin A deficiency >20%. Conclusion: There is a high frequency of subclinical vitamin A deficiency in children with pneumonia; these data need to be further explored in terms of their associations. For this reason, new studies that evaluate this topic are of fundamental importance.

Factors associated with sleep problems and sleeping pill use in Brazilians / Fatores associados aos problemas de sono e ao uso de medicação para dormir em brasileiros

ABSTRACT OBJECTIVE To estimate the prevalence of sleep problems and sleeping pill use and associated factors in the Brazilian population. METHODS This study was conducted with data from the 2019 Brazilian National Health Survey. Our sample consisted of 94,114 participants and the outcomes analyzed were sleep problems and sleeping pill use. Sociodemographic, lifestyle, and health characteristics were explored in a descriptive and multivariate analysis with Poisson regression, robust variance, and 5% significance. RESULTS We found a 35.1% (95%CI: 34.5-35.7) and 8.5% (95%CI: 8.2-8.9) prevalence of sleep problems and sleeping pill use, respectively. Sleep problems were associated with women (PR = 1.41; 95%CI: 1.36-1.46), individuals who self-assess their health as regular/poor/very poor (PR = 1.56; 95%CI: 1.51-1.62), those with chronic diseases (PR = 1.70; 95%CI: 1.64-1.78), those who use alcohol excessively (PR = 1.14; 95%CI: 1.09-1.20), and smokers (PR = 1.16; 95%CI: 1.10-1.22). Sleeping pill use was associated with women (PR = 1.57; 95%CI: 1.43-1.73), divorcees (PR = 1.46; 95%CI: 1.30-1.65), urban denizens (PR = 1.32; 95%CI: 1.21-1.45) those who self-assess their health as regular/poor/very poor (PR = 1.79; 95%CI: 1.64-1.95), those with chronic diseases (PR = 4.07; 95%CI: 3.48-4.77), and smokers (PR = 1.49; IC95%: 1.33-1.67). CONCLUSION This study found that the prevalence of sleep problems and sleeping pill use in Brazilians indicates the need for attention and sleep care for this population, especially in women and those with lifestyle and health conditions associated with the analyzed outcomes.

RESUMO OBJETIVO Estimar a prevalência e fatores associados a problemas de sono e uso de medicamentos para dormir na população brasileira. MÉTODOS Estudo executado com os dados da Pesquisa Nacional de Saúde realizada no Brasil, nos anos de 2019 e 2020. A amostra foi composta por 94.114 participantes e os desfechos analisados foram problemas de sono e uso de medicamentos para dormir. Aspectos sociodemográficos, de estilo de vida e condições de saúde foram explorados em uma análise descritiva e multivariada, utilizando a regressão de Poisson com variância robusta, considerando nível de significância de 5%. RESULTADOS As prevalências de problemas de sono e uso de medicamentos indutores do sono foram de 35,1% (IC95% 34,5-35,7) e 8,5% (IC95% 8,2-8,9), respectivamente. Os problemas de sono foram associados ao sexo feminino (RP = 1,41; IC95% 1,36-1,46), aos indivíduos que autoavaliam a saúde como regular/ruim/muito ruim (RP = 1,56; IC95% 1,51-1,62), aos que possuem alguma doença crônica (RP = 1,70; IC95% 1,64-1,78), aos que fazem uso excessivo de álcool (RP = 1,14; IC95% 1,09-1,20) e aos fumantes (RP = 1,16; IC95% 1,10-1,22). O uso de medicamentos para dormir foi associado ao sexo feminino (RP = 1,57; IC95% 1,43-1,73), a indivíduos divorciados (RP = 1,46; IC95% 1,30-1,65), aos que vivem no meio urbano (RP = 1,32; IC95% 1,21-1,45), que autoavaliam sua saúde como regular/ruim/muito ruim (RP = 1,79; IC95% 1,64-1,95), com diagnóstico de doença crônica (RP = 4,07; IC95% 3,48-4,77) e aos fumantes (RP = 1,49; IC95% 1,33-1,67). CONCLUSÃO As prevalências de problemas de sono e uso de medicamentos para dormir na população brasileira observadas neste estudo indicam a necessidade de atenção e cuidado com o sono dessa população, principalmente nas mulheres e aqueles que apresentam estilo de vida e condições de saúde que se associaram aos desfechos.