Cluster-Based Multinomial Logistic Regression Model for Health-Related Quality of Life Among People Living with HIV in Brazil.

Improvement in treatment options has increased the survival of people living with HIV (PLHIV). Thus, we evaluated the factors associated with better health-related quality of life (HRQoL) among PLHIV in Brazil. This was a cross-sectional study carried out among 349 PLHIV. Data were collected using an interview-based questionnaire, and HRQoL was assessed by the Brazilian version of the WHOQOL HIV BREF instrument. We used non-hierarchical cluster analysis (K-means) to compile the WHOQOL HIV BREF's overall and domain scores into a unique more multidimensional measure for HRQoL consisting of three clusters: poor, fair and good; associations with clusters of better HRQoL were assessed using multinomial logistic regression models. The mean and median overall HRQoL scores were 15.13 (SD = 3.39) and 16, respectively. The reliability and validity of the Brazilian version of the WHOQOL HIV BREF instrument was confirmed among PLHIV in a non-metropolitan, medium-sized municipality of Brazil, which reaffirmed the cross-cultural validity of this instrument. The factors male sex; heterosexual and asexual orientations; higher individual income; undetectable viral load; absence of any comorbidity and presence of an infectious or a chronic comorbidity, with mental illness as the reference; and never having consumed illegal substances were independently associated with good HRQoL. Thus, the compilation of the WHOQOL HIV BREF's overall and domain scores into a unique multidimensional measure for HRQoL, which this study proposed for the first time, may facilitate more robust interpretations and models of predictors. These differentials could simplify HRQoL as an indicator of health and wellbeing to be routinely used as a key outcome in the clinical management of patients and in the global monitoring of health system responses to HIV.

RESUMEN: La mejora en las opciones de tratamiento ha aumentado la supervivencia de las personas que viven con el VIH (PVVIH). Por lo tanto, evaluamos los factores asociados con una mejor calidad de vida relacionada con la salud (CVRS) entre las PVVIH en Brasil. Se trata de un estudio transversal realizado con 349 PVVIH. Los datos se recopilaron mediante un cuestionario basado en entrevistas y la CVRS se evaluó mediante la versión brasileña del instrumento WHOQOL VIH BREF. Usamos un análisis de conglomerados no jerárquico (K-medias) para compilar las puntuaciones generales y de dominios del WHOQOL HIV BREF en una medida única más multidimensional para la CVRS que consta de tres conglomerados: deficiente, regular y bueno; y las asociaciones con grupos de mejor CVRS se evaluaron mediante modelos de regresión logística multinomial. Las puntuaciones de la CVRS global media y mediana fueron 15,13 (DE = 3,39) y 16. La confiabilidad y validez del WHOQOL VIH BREF versión brasileña fue confirmada entre personas que viven con el VIH en un municipio no metropolitano de mediana población de Brasil, lo que reafirma la validez transcultural de este instrumento. Los factores sexo masculino; orientaciones heterosexuales y asexuales; mayores ingresos individuales; carga viral indetectable; ausencia de comorbilidad y presencia de comorbilidad infecciosa o crónica, teniendo como referencia la enfermedad mental; y nunca haber consumido sustancias ilegales se asociaron de forma independiente con una buena CVRS. Por lo tanto, la compilación de las puntuaciones generales y de dominio del WHOQOL HIV BREF en una medida multidimensional única para la CVRS, que este estudio propuso por primera vez, puede facilitar interpretaciones y modelos de predictores más robustos. Estos diferenciales podrían simplificar la HRQoL como un indicador de salud y bienestar para ser utilizado de forma rutinaria como un resultado clave en el manejo clínico de los pacientes y en el monitoreo global de las respuestas del sistema de salud al VIH.

Oral manifestations of syphilis: Knowledge and skills of senior dental students and newly graduated dentists.

OBJECTIVES: To evaluate the knowledge of senior dental students and newly graduated dentists about the prevention, diagnosis and treatment of oral manifestations of syphilis. MATERIALS AND METHODS: A 32-question questionnaire was designed with three domains: (I) demographic, academic and professional data of the participants, (II) attitudes, practices and self-perception regarding training about syphilis and (III) knowledge about syphilis. All knowledge responses were classified as correct or incorrect. Scores ranging from 1 to 14 were calculated, and grades were assigned to each participant according to their level of knowledge. RESULTS: The sample comprised 408 dental students and 339 newly graduated dentists. The mean score was 7.70 ± 3.35 for undergraduates and 9.09 ± 3265 for dentists. The highest frequency of correct answers (>70%) was attributed to questions about the aetiology, transmission and treatment of syphilis. The questions with the lowest frequency of correct answers (<50%) were about the identification of oral manifestations and stages of syphilis. CONCLUSIONS: The knowledge of dental practitioners and academics about the oral manifestations of syphilis was unsatisfactory. The lack of understanding of these aspects can delay the diagnosis and treatment of patients with this disease, which is concerning given the steady increase in cases in recent years.

Factors associated with recent and regular non-use of dental services by students from a university in southeastern Brazil: a cross-sectional study.

BACKGROUND: Lack of use of dental services can be a risk factor for oral health. In addition to recent visits to dental services, it is important to assess the regularity of use of these services, as well as the motivations for visiting the dentist. There is a gap in literature studies on the patterns of use of oral health services by the young university students. The goal of this study was to assess the factors associated with recent and regular non-use of dental services by young university students, using the Andersen model as a reference. METHODS: This was a cross-sectional study with 477 university students between 18 and 24 years old, carried out as a web survey, through which predisposing, enabling and need variables were collected, according to the model proposed by Andersen, to test the factors associated with recent and regular non-use of dental services. Bivariate analyses and robust Poisson regression were performed, with estimation of crude and adjusted prevalence ratios, using confidence intervals of 95%. The variables with p < 0.05 remained in the final model. RESULTS: The prevalence of recent non-use was of 19.5% (95% CI 16.0-23.3%), and of regular non-use, of 53.5% (95% CI 48.9-58.0%). After the adjusted analysis, the following were found to be associated with the outcome of recent non-use: type of service used (PR = 0.91; 95% CI 0.85-0.98) and perceived need for dental treatment (PR = 0.98; 95% CI 0.97-0.99); and the following variables were associated with regular non-use: father's level of education (PR = 0.86; 95% CI 0.78-0.96), area of study (PR = 1.08; 95% CI 1.02-1.15), reason for last dental appointment (PR = 0.81; 95% CI 0.75-0.88), use of dental services throughout childhood (PR = 0.92; 95% CI 0.86-0.97), self-perceived oral health (PR = 0.86; 95% CI 0.76-0.88), and toothaches over the last 2 years (PR = 0.93; 95% CI 0.87-0.99). CONCLUSION: The motivation for young university students to use dental services are curative treatment needs, not prevention. The results point to the need to implement health prevention and promotion policies in higher education institutions and to expand access to dental services for this young population.

Brazilian adolescents' perception of the orthodontic appliance: A qualitative study.

INTRODUCTION: Orthodontic treatment has a significant impact on the quality of life and self-esteem of adolescents, with emotional and behavioral implications. The objective of this research was to understand Brazilian adolescents' perception of the orthodontic treatment. METHODS: A qualitative research study was carried out through content analysis of data collected from 142 adolescents using the word-association technique (WAT), followed by 8 focus groups with 71 of these students. RESULTS: The most recurrent words on the WAT demonstrated a positive esthetic impact of the orthodontic appliance, both for the adolescents' self-assessment and in the assessment of friends. Several themes were identified in the qualitative analysis, with the esthetic benefit of orthodontic treatment and the esthetic impact of the appliance being the most relevant positive points. The most-cited negative aspect in the study was the pain associated with the treatment, followed by the discomfort and trauma caused by the fixed appliance. CONCLUSIONS: Orthodontic treatment has a positive esthetic impact for Brazilian adolescents, with improvement of their self-image. Fixed orthodontic appliances have an immediate positive impact on appearance and are an important factor in behavioral relationships among Brazilian adolescents, particularly owing to their association with social status. The understanding of the sociobehavioral aspects involved in orthodontic treatment is of fundamental importance for the clinical relationship between patient and professional.

Functional status of patients with metastatic spinal cord compression.

PURPOSE: This prospective study was conducted to evaluate the functional status and clinical features of inpatients with metastatic spinal cord compression and to explore possible associated factors and the correlation with neurological deficits. METHODS: Cases were identified through an active search in the hospital units of the National Cancer Institute. For 47 patients, clinical and demographic characteristics were collected; functional status was measured by the Functional Independence Measure; modified Tokuhashi score was used to predict survival time; neurological deficits were measured using the American Spinal Injury Association Impairment Scale; and general condition was evaluated using the Karnofsky Performance Status Scale. The correlation between the level of neurological deficits and functional status was calculated using the Spearman correlation test. The difference in the functional independence score according to neurological status was assessed with the Kruskall-Wallis test. RESULTS: The degree of functional status was associated with Karnofsky Performance Status, level of neurological deficits, ability to walk, survival time, and skin color (p < 0.05). There was difference in the functional status (p = 0.004) and in the motor domain (p = 0.001) according to the level of neurological deficits. The correlation of the Functional Independence Measure with level of neurological deficits and with Karnofsky Performance Status was moderate (r = 0.46, p < 0.02). CONCLUSION: The Functional Independence Measure was adequate for evaluating the functional status of patients with metastatic spinal cord compression. Palliative rehabilitation should be integrated early and strategies should be linked to the prognosis of survival.

Sexual function of women surviving cervical cancer.

OBJECTIVE: The objective of this study was to evaluate the sexual function of survivors of cervical cancer (CC) in comparison to the control group of women without a history of cancer. METHODS: This was an observational, analytical, case-control study. In the cancer group, women subjected to CC treatment of at least 3 months in the past were included (n = 37). For each survivor, one random selection from a base population control group was made (n = 37) of a woman without a history of cancer and with similar socioeconomic and demographic characteristics. The sexual function was evaluated through the female sex function index (FSFI) instrument. Data collection occurred through the application of questions in a face-to-face interview. RESULTS: In the cancer group, 64.9 % related vaginal stenosis or shortening; 59.5 % were not sexually active and of those which had sexual relations, 80 % showed dysfunction. The total FSFI score varied between 9.60 and 35.10 in the cancer group and 23.90 and 36.00 in the control group. The means of the cancer group were statistically inferior (P < 0.05) to the control group in all the FSFI domains and in the total score. The mean total score was 21.72 in the cancer group, classified as sexual dysfunction when considering a score of 26 as the cutoff point. CONCLUSION: CC treatment was found to have a negative impact on the sexual function of women. Further, sexual function should be monitored routinely by interdisciplinary teams to provide comprehensive care with the objective of an improved quality of life post-cancer.

The quality of life of Brazilian adolescents with asthma: associated clinical and sociodemographic factors.

OBJECTIVE: Asthma is the most common chronic disease among adolescents. This study assessed the quality of life (QOL) related to health in adolescents with asthma and its determining factors (demographic, socioeconomic, and clinical). We also separately evaluated each of the parameters that comprised the asthma control classification. METHODS: This was an observational, cross-sectional study of 114 adolescents who had doctor-diagnosed asthma. QOL was assessed using a version of the Pediatric Asthma Quality of Life Questionnaire (PAQLQ) that was adapted and validated for Brazil, and higher scores indicated a better QOL. The level of asthma control was assessed using the rating system proposed by the Global Initiative for Asthma, and sociodemographic factors were evaluated. RESULTS: When the averages of the PAQLQ domains and overall scores were compared to the potentially explanatory variables, significantly lower average PAQLQ scores were obtained for individuals with an inadequate level of asthma control (p < 0.001). Of the control components, daytime symptoms, nighttime symptoms, and limited physical activity were related to QOL. However, the use of the ß2 agonist and the peak flow functional parameter were not related to QOL. CONCLUSIONS: The level of asthma control was related to QOL, but this association manifested mainly in the subjective control domains, such as nighttime and daytime symptoms and physical activity limitations. The objective domain for control classification, represented by pulmonary function, was not an independent predictor or determinant of the QOL of adolescent asthma patients.

Spatial analysis of care for patients undergoing dialysis therapy in the state of Minas Gerais, Brazil, between 2015 and 2019.

OBJECTIVE: To analyze the spatial flow of care for patients undergoing dialysis therapy in the health regions of the State of Minas Gerais. METHODS: Ecological study whose population was patients undergoing dialysis therapy in public, philanthropic institutions or whose treatment was paid for by the Unified Health System in private clinics in partnership, in the State of Minas Gerais. Patients were grouped by health region of residence. The proportions of patients who underwent dialysis were calculated, as well as enrollment on the kidney transplant list in their own region of residence or outside it. Person correlations of these proportions with socioeconomic and care indicators of the health regions were estimated. Spatial exploratory techniques estimated general (Moran's I) and local (LISA) spatial correlation coefficients. RESULTS: Regions with higher GDP had a higher number of nephrologists and a higher proportion of registrations in the region of residence. A cluster of regions with low GDP was identified further to the northeast of the State (also with lower nephrologist ratio values), a cluster with a high proportion of those registered on the transplant list in the center of the State, and a cluster with a low proportion of dialysis in the same region of residence further southeast. CONCLUSION: Regional disparities were evident in relation to the proportion of patients registered on the waiting list for kidney transplantation, the proportion of patients undergoing dialysis in the same region of residence and the proportion of patients registered on the waiting list for kidney transplantation in the same region of residence. residence.

The impact of socioenvironmental characteristics on domains of oral health-related quality of life in Brazilian schoolchildren.

BACKGROUND: Recent researches have pointed out the need to consider the functional and psychosocial dimensions of oral health, such as Oral Health-related Quality of Life (OHRQoL). The aim of this study was to investigate the influence of oral health status, socioeconomic factors and home environment of children on the four health domains of Child Perceptions Questionnaire (CPQ11-14). METHODS: A cross-sectional study was conducted in Brazil with a sample of 286 schoolchildren aged 12 years and their parents. The schoolchildren were clinically examined, and participants were asked to complete the CPQ11-14, as well as a questionnaire about home environment. In addition, a questionnaire was sent to each child's parents asking them about family socioeconomic status. The chi-square test and Poisson's regression analysis were performed. RESULTS: After adjusting for potential confounders, variables sex, monthly family income, mothers' education showed a statistically significant association with all health domains of the CPQ11-14. The family structure and presence of bleeding impacted on emotional (p = 0.0135), and social (p = 0.0010) well-being health domain scores. Orthodontic treatment need showed a strong negative effect on functional limitations domain score (p = 0.0021). CONCLUSIONS: Clinical and socio-environmental factors had different impacts on domains of oral health-related quality of life, demonstrating the need to consider these conditions in planning strategies for the oral health of schoolchildren.

Randomized clinical trial with fractional CO2 laser and Clobetasol in the treatment of Vulvar Lichen Sclerosus: a clinic study of feasibility.

OBJECTIVES: The main objective of the study was to describe and compare the feasibility of using fractional CO2 laser to the usual treatment with Clobetasol. Randomized clinical trials brought together 20 women from a Brazilian university hospital, 9 of them were submitted to Clobetasol treatment and 11 to laser therapy. Sociodemographic data were obtained and quality of life parameters, vulvar anatomy, self-perception and histopathological analysis of vulvar biopsies were evaluated. Evaluations were made before the beginning of the treatment, during its implementation, right after its completion (3 months), and 12 months after. The SPSS 14.0 software was used, obtaining descriptive measurements. The level of significance adopted was 5%. RESULTS: The clinical/anatomical characteristics of the vulva did not differ between the treatment groups, as much before as after its performance. There was no statistically significant difference between the treatments performed regarding the impact on the life quality of the patients. A higher satisfaction degree with the treatment was obtained with the patients in the Laser group in the third month of evaluation. Laser therapy also revealed higher occurrence of telangiectasia after treatment completion. Fractional CO2 laser has proven to be well accepted and is a promising therapeutic option. Registration number and name of trial registry The institutional review board status was approved by the Research Ethics Committee of HU/ UFJF under advisory number 2881073 and registered in the Brazilian Clinical Trials, with consent under registration RBR-4p9s5y. Access link: https://ensaiosclinicos.gov.br/rg/RBR-4p9s5y.

Epidemiological characteristics and adherence of a cohort of elderly people with HIV/AIDS in the Public Health System.

OBJECTIVE: To characterize the epidemiological profile of patients aged 50 years or older diagnosed as HIV/AIDS, in a Specialized Service of the Public Health System. METHODS: A retrospective cohort study using secondary data from medical records in the period 2014 to 2018. Sociodemographic and clinical characteristics, and features related to treatment adherence were organized in a database. Quantitative variables were expressed as mean (or median) ± standard deviation (or interquartile range), and categorical variables expressed as number and percentage of patients. The Kaplan-Meier method was applied to assess the probability of overall specific survival. RESULTS: Of the 241 initially eligible patients, 149 patients were evaluated, registering 19 deaths in the studied period. There was a predominance of males aged 50-59 years, with severe immunodeficiency upon admission (29.7%), and with a CD4+ T lymphocyte count below 200 cells in 62 (46.3%) of patients. Elderly people aged 61 or over were more adherent. There was an increase in the CD4+ T lymphocyte count by an average of 139.63 in the first 6 months, and 50.51 from the first 6 months to 12 months of follow-up, with an average increase in the first 12 months of 157.63 cells. Specific overall survival in the period was 85%. CONCLUSION: Patients older than 50 years had an immune response and no viral load detection in the 12-month period, deserving further studies to improve survival.

Prevalence and factors associated with anxiety and depressive symptoms in women deprived of liberty in Juiz de Fora-MG, Brazil. / Prevalência e fatores associados a sintomas ansiosos e depressivos em mulheres privadas de liberdade em Juiz de Fora-MG, Brasil.

Psychological distress and developing mental disorders in prisons are globally recognized public health issues. This study aimed to identify the prevalence of these symptoms and associated factors in 99 women over 18 years of age in the provisional, closed, and semi-open regimes in Juiz de Fora-MG, Brazil. This cross-sectional census study collected data face-to-face through a semi-structured and multidimensional questionnaire. We assessed outcomes using the Patient Health Questionnaire-4 (PHQ-4). We built a theoretical determination model with three hierarchical blocks for the association analysis. We estimated crude prevalence ratios using the chi-square test and adjusted for each other within each block (p≤0.20). We adopted p≤0.05 for the final Poisson regression model with robust variance. The prevalence of anxiety and depressive symptoms was 75.8% (95%CI 66.1%-83.8%) and 65.7% (95%CI 55.4%-74.9%), respectively. In the final model, anxiety symptoms were associated with depressive symptoms. On the other hand, depressive symptoms were associated with the 20-29 years age group and anxiety symptoms. We identified a prevalence of the outcomes in more than half of the participants, emphasizing the inter-association between them.

Sofrimento psíquico e desenvolvimento de transtornos mentais nas prisões são questões de saúde pública reconhecidas mundialmente. Objetivou-se identificar a prevalência destes sintomas e os fatores associados em 99 mulheres com mais de 18 anos de idade, nos regimes provisório, fechado e semiaberto de Juiz de Fora-MG. Trata-se de um estudo transversal, do tipo censo, com dados coletados face a face através de questionário semiestruturado e multidimensional. Os desfechos foram avaliados pelo Patient Health Questionannaire-4 (PHQ-4). Para a análise de associação foi construído um modelo teórico de determinação com três blocos hierarquizados. Foram estimadas razões de prevalência brutas por meio do teste Qui-quadrado e ajustadas entre si dentro de cada bloco (p≤0,20). Para o modelo final de regressão de Poisson com variância robusta foi adotado p≤0,05. A prevalência de sintomas ansiosos e depressivos foi, respectivamente, de 75,8% (IC95% 66,1%-83,8%) e 65,7% (IC95% 55,4%-74,9%). No modelo final, sintomas ansiosos associaram-se à presença de sintomas depressivos. Já sintomas depressivos associaram-se à faixa etária de 20 a 29 anos e à presença de sintomas ansiosos. Verificou-se prevalência dos desfechos em mais da metade das participantes, com destaque para interassociação entre eles.

Cytology-based Screening for Anal Intraepithelial Neoplasia in Immunocompetent Brazilian Women with a History of High-Grade Cervical Intraepithelial Neoplasia or Cancer.

OBJECTIVE: To determine the prevalence and possible variables associated with anal intraepithelial neoplasia and anal cancer in immunocompetent women with high-grade cervical intraepithelial neoplasia. METHODS: A cross-sectional study involving immunocompetent women with a histological diagnosis of high-grade cervical intraepithelial neoplasia and cervical cancer, conducted between January 2016 and September 2020. All women underwent anal cytology and answered a questionnaire on characterization and potential risk factors. Women with altered cytology were submitted to anoscopy and biopsy. RESULTS: A total of 69 women were included in the study. Of these, 7 (10.1%) had abnormal anal cytology results: (high-grade lesion, atypical squamous cells of undetermined significance, and atypical squamous cells, cannot exclude high-grade lesions: 28,5% each; low grade lesion: 14,3%). Of the anoscopies, 3 (42.8%) showed alterations. Of the 2 (28,5% of all abnormal cytology results) biopsies performed, only 1 showed low-grade anal intraepithelial neoplasia. The average number of pregnancies, vaginal deliveries, and abortions was associated with abnormal anal cytology. However, the highest mean regarding the cesarean sections was associated with normal cytology. CONCLUSION: The prevalence of anal intraepithelial neoplasia was compatible with data from recent studies, especially those conducted in Brazil. Opportunistic screening for anal intraepithelial neoplasia in this high-risk population should be considered. Anal cytology is suitable for this purpose, due to its low cost and feasibility in public health services.

OBJETIVO: Determinar a prevalência e as possíveis variáveis associadas à neoplasia intraepitelial anal e ao câncer anal em mulheres imunocompetentes com neoplasia intraepitelial cervical de alto grau. MéTODOS: Estudo transversal em mulheres imunocompetentes com diagnóstico histológico de neoplasia intraepitelial cervical de alto grau e câncer cervical, feito entre janeiro de 2016 e setembro de 2020. Todas as mulheres foram submetidas a citologia anal e responderam a um questionário de caracterização e potenciais fatores de risco. Mulheres com citologia alterada foram submetidas a anuscopia e biópsia. RESULTADOS: No total, 69 mulheres foram incluídas no estudo. Destas, 7 (10,1%) tiveram resultados anormais de citologia anal (lesão de alto grau, células escamosas atípicas de significado indeterminado, e células escamosas atípicas, não se pode excluir lesões de alto grau: 28,5% cada; lesão de baixo grau: 14,3%). Das anuscopias, 3 (42,8%) demonstraram alterações. Das 2 biópsias realizadas, apenas 1 apresentou neoplasia intraepitelial anal de baixo grau. O número médio de gestações, partos vaginais e abortos estava associado à citologia anal anormal. No entanto, a maior média de partos cesáreos estava associada à citologia normal. CONCLUSãO: A prevalência de neoplasia intraepitelial anal foi compatível com dados de estudos recentes, principalmente daqueles feitos no Brasil. O rastreamento oportunista para neoplasia intraepitelial anal nesta população de alto risco deve ser considerado. A citologia anal é adequada para esse fim, devido ao seu baixo custo e viabilidade nos serviços públicos de saúde.

Knowledge about oral cancer among dental students and Primary Health Care dentists: A Brazilian study.

PURPOSE/OBJECTIVES: The present study aims to evaluate the knowledge of dental students and dentists who work in Primary Health Care (PHC). These are professionals who work in the public basic health units regarding oral cancer prevention, diagnosis, and treatment. METHODS: A cross-sectional and observational Brazilian study was conducted. A survey with 27 questions was carried out regarding the (i) demographic, academic, and professional data of the participants, (ii) attitudes, practices, and self-perception about their training, and (iii) knowledge about oral cancer. With the exception of one question regarding the clinical characteristics of oral cancer, all knowledge answers were graded as correct or incorrect. Grades were assigned to each participant according to their level of knowledge, and scores for each participant were calculated ranging from 1 to 10. Mann-Whitney and Kruskal-Wallis tests were used to examine the difference in the knowledge score of oral cancer according to explanatory variables. The level of significance adopted was 5%. RESULTS: The sample comprised 541 dental students and 82 PHC dentists. Most participants did not consider it appropriate or had not received training for palpation of lymph nodes or for identifying lymphadenopathies associated with oral cancer. Less than 20% of the participants had some kind of practice before and felt safe performing biopsy surgery. The average student score was 7.01 ± 2.15, and the average dentist score was 7.81 ± 1.467. CONCLUSION: Although the scores were satisfactory, most of the participants did not show adequate knowledge about biopsy and palpation of cervical lymph nodes.

Heart rate variability in men with lower urinary tract symptoms: a case-control study.

PURPOSE: Measurement of heart rate variability (HRV) allows evaluation of autonomic nervous system activity. Decreased HRV is associated with autonomic disbalance, poor health and higher mortality. Our objective is to evaluate the HRV in men with lower urinary tract symptoms (LUTS) through a case-control study. METHODS: LUTS were considered as the outcome and HRV variables were considered as exposure. The protocol included anamnesis, LUTS assessment, anthropometry, blood pressure and HRV measurement by analyzing the variation in the time interval between consecutive heartbeats or RR intervals. The mathematical study of HRV indicators allowed the assessment of the cardiac autonomic modulation of the volunteers. RESULTS: Eighty nine patients were included in the study, with 34 allocated to the case group (with LUTS) and 55 to the control group (without LUTS). The patients were similar in terms of age and systolic and diastolic blood pressure. Among the HRV variables, the mean VLF index for the very low frequency of the spectrum associated with the frequency domain was significantly higher in volunteers without LUTS. Control group patients presented a mean of 113.18 ± 166.74 ms2, while patients with LUTS presented a mean of 69.21 ± 61.98 ms2 (p = 0.032). CONCLUSIONS: Men 50-59 years of age without chronic diseases and with LUTS have an unfavorable cardiac autonomic profile indicated by significantly lower levels of the VLF component of HRV compared to men without LUTS.

COVID-19's intra-urban inequalities and social vulnerability in a medium-sized city.

BACKGROUND: Social conditions are related to the impact of epidemics on human populations. This study aimed to investigate the spatial distribution of cases, hospitalizations, and deaths from COVID-19 and its association with social vulnerability. METHODS: An ecological study was conducted in 81 urban regions (UR) of Juiz de Fora from March to November 2020. Exposure was measured using the Health Vulnerability Index (HVI), a synthetic indicator that combines socioeconomic and environmental variables from the Demographic Census 2010. Regression models were estimated for counting data with overdispersion (negative binomial generalized linear model) using Bayesian methods, with observed frequencies as the outcome, expected frequencies as the offset variable, and HVI as the explanatory variable. Unstructured random-effects (to capture the effect of unmeasured factors) and spatially structured effects (to capture the spatial correlation between observations) were included in the models. The models were estimated for the entire period and quarter. RESULTS: There were 30,071 suspected cases, 8,063 confirmed cases, 1,186 hospitalizations, and 376 COVID-19 deaths. In the second quarter of the epidemic, compared to the low vulnerability URs, the high vulnerability URs had a lower risk of confirmed cases (RR=0.61; CI95% 0.49-0.76) and a higher risk of hospitalizations (RR=1.65; CI95% 1.23-2.22) and deaths (RR=1.73; CI95% 1.08-2.75). CONCLUSIONS: The lower risk of confirmed cases in the most vulnerable UR probably reflected lower access to confirmatory tests, while the higher risk of hospitalizations and deaths must have been related to the greater severity of the epidemic in the city's poorest regions.

Analgesia and Side Effects of Codeine Phosphate Associated with Paracetamol Versus Oxycodone After the Extraction of Mandibular Third Molars: A Randomized Double-Blind Clinical Trial Using the Split-Mouth Model.

Purpose: To assess the analgesia and side effects of 10 mg oxycodone as compared to 30 mg of codeine phosphate associated with 500 mg of paracetamol after bilateral lower third molar extraction. Methods: This is a prospective, randomized, double-blind study applied to a sample of 16 patients. They were evaluated for seven days postoperatively, and the mean score of the visual analogue scale (VAS) of pain between test and control medications was assessed by the Wilcoxon distribution. The side effects of these medications were assessed by the Q Cochran test. A p value of < .05 was considered statistically significant. Results: The mean score of the VAS of pain was higher in the oxycodone side, where few patients reported the use of rescue analgesic. There was no report of rescue medication in codeine phosphate associated with paracetamol side. The most common side effects reported in both groups, predominantly in patients using the oxycodone, were drowsiness, dizziness, and headache. Conclusion: The use of codeine phosphate associated with paracetamol after the extraction of impacted mandibular third molars is a better choice than oxycodone for controlling postoperative pain. Trial Registration Number and Date of Registration: RBR-8ntwmyq 07/07/2021.

Text messaging interventions to support smoking cessation among hospitalized patients in Brazil: a randomized comparative effectiveness clinical trial.

OBJECTIVE: A clinical trial carried out in patients hospitalized for clinical and surgical conditions. This study evaluated the effectiveness of text messaging interventions (TM) versus telephone counseling (TC) to promote smoking cessation among hospitalized smokers in a middle-income country. Seven-day abstinence was measured during follow-up phone calls one month after discharge. The comparative cost of the two interventions considered the cost of calls, time spent on phone calls and sending SMS and cost of the professional involved in the approaches. RESULTS: Past 7-day tobacco abstinence was not statistically different between groups (30.5% in TM group and 26% in TC, p = 0.318). Costs were significantly lower in the TM group (U$9.28 × U$19.45- p < 0,001). Continuous abstinence was reported by 26% of TM participants and 24.5% of TC participants (p = 0.730). In the 3-month follow-up, 7-day abstinence was 23% in the TMI and 27% in the TC (p = 0.356) group. Continuous abstinence was reported by 20% of TM participants and 24% of TC participants (p = 0.334). TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT03237949 Registred on: 30th May 2017.

Self-Perceived Impact of Oral Health on the Quality of Life of Women Deprived of Their Liberty.

BACKGROUND: Prison units are marked by structural deficiencies, especially in relation to the female gender. OBJECTIVES: To measure the self-perceived impact of oral health on the quality of life of Brazilian women in detention. Methodology. A survey was carried out conducted in the penitentiary at Juiz de Fora (Minas Gerais, Brazil) using an instrument with semistructured questions and validated scales, including the Oral Health Impact Profile-14. 99 women were interviewed. The analysis was based on a theoretical model of determination, with hierarchical blocks of variables. Bivariate analysis was done using the Mann-Whitney, test and multivariate analysis was used using linear regression. The significance level was set at 5%. RESULTS: 33% experienced tooth loss after incarceration, (3.70 ± 3.26 lost teeth). 65.6% rated the dental service as fair/poor. The highest prevalence of oral health impact was for the domains of psychological discomfort (50.5%) and physical pain (40.4%). There is a negative impact on psychological discomfort: the number of dental consultations in the past year and self-perceived general health. There is an impact on physical pain: self-declared color and anxiety. Self-perceived general health had an impact on the domains of psychological disability and social disadvantage. Depression had an impact on the total score. CONCLUSION: This study revealed a self-perceived impact of oral health on the quality of life of women inmates. We need to ensure high-quality access to dental treatment in prisons.

Epidemiologic profile and quality of life of patients treated for oral cancer in Juiz de Fora, Minas Gerais, Brazil.

OBJECTIVES: To assess the quality of life of patients treated for oral cancer, analyzing their physical, social/family, functional and emotional well-being; to identify socioeconomic and clinical functional variables that may potentially influence their quality of life; to describe the patients' epidemiologic profile (sex and age) and tumor features (histopathology, anatomical location and stage); to identify the frequency of risk factors associated with the malignancy. STUDY DESIGN: Observational cross-sectional study-case series study undertaken in 2 cancer treatment institutions in Juiz de Fora, Minas Gerais, Brazil, between 2000 and 2007. RESULTS: Of the 88 registered oral cancer patients, 16 were selected for the study sample. The majority of the study sample (87%) included males, with a mean age of 57.06 years; 43.8% were retired; 50% had not completed elementary education. Most (56.3%) had a monthly income of less than the minimum wage. Most (83.7%) smoked before cancer diagnosis and 43.8% from this sample continued to smoke after treatment. In addition, those who drank alcohol before treatment continued drinking (31.3%). The tongue was the predominant anatomic site (37.5%). The patients' quality of life score was fair; the best result was for emotional well-being. CONCLUSIONS: Despite the limitations imposed by low survival, it was possible to evaluate the quality of life of these patients. Patients having a family income higher than the minimum monthly wage scored significantly better in final indexes FACT-G and FACT-HN than those with a lower income.