Immunotherapeutic Properties of Dexmedetomidine on Pain Management and Cardiovascular Function in Videolaparoscopic Cholecystectomies: A Randomized, Two-Arm, Double-Blinded, Placebo-Controlled Trial.

BACKGROUND: Laparoscopy represented one of the most innovative surgical techniques approached in the surgery field. Dexmedetomidine association with general anesthesia promotes the response control to trauma by altering the neuroinflammatory reflex, provides better clinical outcomes in the postoperative period and reduces the excessive use of drugs with risk for addiction. This trial aims to evaluate the potential drug treatment of dexmedetomidine on organic function, with the targets in neuroinflammation, perioperative pain control and blood pressure measurements in a medium-sized surgical model. METHODS: Fifty-two patients were randomized in two groups: Sevoflurane and Dexmedetomidine - A (dexmedetomidine infusion [1 µg/kg loading, .2-.5 µg/kg/h thereafter]) vs Sevoflurane and Saline .9% - B. Three blood samples were collected at three times: before surgery, 4 to 6 hours after surgery and 24 hours postoperatively. The primary outcome was inflammatory and endocrine mediators dosage analisys. Finally, we evaluated pain and opioid use as secondary outcomes, also the hemodynamic values. RESULTS: In Dexmedetomidine group A, a reduction of Interleukin 6 was found during 4-6 hours after surgery. A reduction of IL-10 was noted in the measurement of its values 24 hours after the procedure, with statistical significance. Also, systolic and diastolic blood pressure, as well heart rate were attenuated, and there was a lower incidence of pain and opioid consumption in the first postoperative hour (P < .0001) in the anesthetic recovery room. CONCLUSIONS: Dexmedetomidine provided anti-inflammatory activity, sympatholytic effect and analgesia with cardiovascular safety. It reinforces the therapeutic nature of highly selective α2-adrenergic agonists when combined within anesthetic interventions.

Azathioprine is more effective than mesalazine at preventing recurrent bowel obstruction in patients with ileocecal Crohn's disease.

BACKGROUND: Patients with subocclusive Crohn's disease (CD) who received azathioprine (AZA) therapy had lower re-hospitalization rates due to all causes and for surgical management of CD compared to those treated with mesalazine during a 3-year period. We investigated whether AZA also was effective for prevention of recurrent bowel obstruction. MATERIAL/METHODS: Rates of recurrent bowel occlusion were compared between patients treated with AZA and those treated with mesalazine. We assessed the time interval-off intestinal obstruction as well as the occlusion-free survival for both groups. RESULTS: There was a significantly lower cumulative rate of patients with recurrent subocclusion in the AZA group (56%) compared with the mesalazine group (79%; OR 3.34, 95% CI 1.67-8.6; P=0.003), with the number needed to treat in order to prevent 1 subocclusion episode of 3.7 favoring AZA. The occlusion-free time interval was longer in the AZA group compared with the mesalazine group (28.8 vs. 18.3 months; P=0.000). The occlusion-free survival at 12, 24, and 36 months was significantly higher in the AZA group (91%, 81%, and 72%, respectively) than in the mesalazine group (64.7%, 35.3%, and 23.5%, respectively; P<0.05 for all comparisons). CONCLUSIONS: In an exploratory analysis of patients with subocclusive ileocecal CD, maintenance therapy with AZA is more effective than mesalazine for eliminating or postponing recurrent intestinal obstruction during 3 years of therapy.

Immunomodulatory effect of bovine lactoferrin during SARS-CoV-2 infection.

Introduction: Lactoferrin (Lf) is an important immunomodulator in infections caused by different agents. During SARS-CoV-2 infection, Lf can hinder or prevent virus access to the intracellular environment. Severe cases of COVID-19 are related to increased production of cytokines, accompanied by a weak type 1 interferon response. Methods: We investigated the influence of bovine Lf (bLf) in the immune response during SARS-CoV-2 infection in vitro and in vivo assays. Results: Our results show a strong binding between bLf and TLR4/NF-κB in silico, as well as an increase in mRNA expression of these genes in peripheral blood mononuclear cells (PBMCs) treated with bLf. Furthermore, the treatment increased TLR4/TLR9 mRNA expression in infected K18-hACE2 mouse blood, indicating an activation of innate response. Our results show that, when bLf was added, a reduction in the NK cell population was found, presenting a similar effect on PD-1 in TCD4+ and TCD8+ cells. In the culture supernatant of PBMCs from healthy participants, bLf decreased IL-6 levels and increased CCL5 in COVID-19 participants. In addition, K18-hACE2 mice infected and treated with bLf presented an increase of serum pro-inflammatory markers (GM-CSF/IL-1ß/IL-2) and upregulated mRNA expression of IL1B and IL6 in the lung tissue. Furthermore, bLf treatment was able to restore FTH1 levels in brain tissue. Discussion: The data indicate that bLf can be part of a therapeutic strategy to promote the immunomodulation effect, leading to homeostasis during COVID-19.

Anteroposterior condylar position: a comparative study between subjects with normal occlusion and patients with Class I, Class II Division 1, and Class III malocclusions.

BACKGROUND: The present study aimed to determine and compare the anteroposterior position of the condyle in the mandibular fossa between groups of asymptomatic subjects with normal occlusion and asymptomatic subjects with Class I, Class II Division 1, and Class III malocclusions. MATERIAL AND METHODS: Thirty persons with normal occlusion, 30 with Class I malocclusion, 30 with Class II Division 1, and 30 with Class III had computed tomography scans of their temporomandibular joints. The anterior joint space/posterior joint space (AJS/PJS) ratio was determined for the right and left joints. The paired t test was used to analyze the AJS/PJS ratio between both sides for each group. The ANOVA test was applied to verify the differences between the groups for the measurements of the right and left sides. In case the ANOVA test confirmed significance, the Dunnett's t test was performed to compare the groups of malocclusion with that of normal occlusion. RESULTS: The paired t test between the AJS/PJS relationships in the right and left sides showed the following p values: Class I (0.168), Class II Division 1 (0.662), Class III (0.991), and normal occlusion (0.390). The ANOVA test showed a p value of 0.445 for the comparisons of the right side and 0.040 for the left side. The Dunnett's t test demonstrated a statistically significant difference between the Class II group and the normal occlusion group (p value of 0.026) in the joints of the left side. CONCLUSIONS: Bilateral symmetry and lack of condyle centralization were common characteristics among all groups. The greatest condylar decentralization was observed in the Class II group, whereas the least condylar decentralization was found in the normal occlusion group.

Effect of azathioprine or mesalazine therapy on incidence of re-hospitalization in sub-occlusive ileocecal Crohn's disease patients.

BACKGROUND: Although the cost of Crohn's disease (CD) treatment differs considerably, hospitalization and surgery costs account for most of the total treatment cost. Decreasing hospitalization and surgery rates are pivotal issues in reducing health-care costs. MATERIAL/METHODS We evaluated the effect of azathioprine (AZA) compared with mesalazine on incidence of re-hospitalizations due to all causes and for CD-related surgeries. In this controlled, randomized study, 72 subjects with sub-occlusive ileocecal CD were randomized for AZA (2-3 mg/kg per day) or mesalazine (3.2 g per day) therapy during a 3-year period. The primary end point was the re-hospitalization proportion due to all causes, as well as for surgical procedures during this period evaluated between the groups. RESULTS: On an intention-to-treat basis, the proportion of patients re-hospitalized within 36 months due to all causes was lower in patients treated with AZA compared to those on mesalazine (0.39 vs. 0.83, respectively; p=0.035). The AZA group had also significantly lower proportions of re-hospitalization for surgical intervention (0.25 vs. 0.56, respectively; p=0.011). The number of admissions (0.70 vs. 1.41, p=0.001) and the length of re-hospitalization (3.8 vs. 7.7 days; p=0.002) were both lower in AZA patients. CONCLUSIONS: Patients with sub-occlusive ileocecal CD treated with AZA had lower re-hospitalization rates due to all causes and for surgical management of CD compared to those treated with mesalazine during a 3-year period. The long-term use of AZA in ileocecal CD patients recovering from a sub-occlusion episode can save healthcare costs.

Standardisation of Western blotting to detect HTLV-1 antibodies synthesised in the central nervous system of HAM/TSP patients.

Intrathecal synthesis of human T-lymphotropic virus type 1 (HTLV-1) antibodies (Abs) represents conclusive evidence of a specific immune response in the central nervous system of HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP) patients. Western blotting (WB) for HTLV Abs in serum is a confirmatory test for HTLV-1 infection. The aim of this study was to standardise the Western blot to demonstrate the intrathecal pattern of Abs against HTLV-1 proteins in HAM/TSP patients. Paired cerebrospinal fluid (CSF) and serum samples were selected from 20 patients with definite HAM/TSP, 19 HTLV-1 seronegative patients and two HTLV-1 patients without definite HAM/TSP. The presence of reactive bands of greater intensity in the CSF compared to serum (or bands in only the CSF) indicated the intrathecal synthesis of anti-HTLV-1 Abs. All definite HAM/TSP patients presented with an intrathecal synthesis of anti-HTLV-1 Abs; these Abs were not detected in the control patients. The most frequent intrathecal targets of anti-HTLV-1 Abs were GD21, rgp46-I and p24 and, to a lesser extent, p19, p26, p28, p32, p36, p53 gp21 and gp46. The intrathecal immune response against env (GD21 and rgp46-I) and gag (p24) proteins represents the most important humoral pattern in HAM/TSP. This response may be used as a diagnostic marker, considering the frequent association of intrathecal anti-HTLV-1 Ab synthesis with HAM/TSP and the pathogenesis of this neurological disease.

Double screening for syphilis and HIV in pregnant women in a priority municipality for the elimination of vertical transmission in Brazil: incidence, risk factors and spatial analysis.

BACKGROUND: The Brazilian Ministry of Health (MoH) recommends double screening (DS) for syphilis and HIV during the first and third trimesters of antenatal care (ANC) to mitigate vertical transmission. We surveyed DS outcomes and their associated factors in a priority Brazilian municipality with >100 000 inhabitants who face challenges for both health problems. METHODS: A total of 399 women were followed up throughout pregnancy using medical records. Spatial and multinomial logistic analyses were performed. RESULTS: There was an incidence rate of 24.8%, 59.4% and 15.8% for 'full DS', 'partial DS' and 'without DS', respectively. Younger women and those with a history of both prematurity and multiparity were less likely to be in the 'full DS' category. There was an overlap of high-density clusters of 'full DS' and 'ANC in better quality basic health units', adherent to both the Family Health Strategy and the National Program for Access and Quality Improvement in Primary Care. CONCLUSIONS: The poor DS outcomes presented in 75% of the cases were mostly linked to delays in starting ANC appointments or their discontinuity. Thus, the MoH recommendations, accompanied by ongoing training, technical assistance and the periodic evaluation of their implementation, need to effectively reach providers and promote counseling and awareness about the importance of DS for pregnant women.

Factors associated with women diagnosed with syphilis who received prenatal care in a primary healthcare unit.

OBJECTIVE: To estimate the prevalence of syphilis and its associated factors in women who were treated at public maternity hospitals and received prenatal care in a primary healthcare unit. METHODS: This cross-sectional study included 399 postpartum women. Interviews were conducted, and additional data were extracted from the pregnant woman's booklet, medical records, and printed tests. The dependent variable was a gestational syphilis diagnosis. The independent variables were grouped into socioeconomic and demographic, behavioral, reproductive, and prenatal blocks. The prevalence, prevalence ratios, and 95% confidence intervals (95%CI) were calculated. The χ 2 test was also performed (p≤0.05). Multivariate analysis was performed using Poisson regression models. RESULTS: The prevalence of gestational syphilis was 9.61% (95%CI: 7.14-12.83). We identified the following determining factors (adjusted prevalence ratios): history of sexually transmitted infections (2.3), first sexual intercourse by the age of 15 (2.42), partner having a history of syphilis (5.98), partner using crack/cocaine (6.42) and marijuana and others (3.02), not having a partner (3.07), low income (2.85), history of stillbirth (5.21), beginning prenatal care in the third trimester (3.15), and prenatal care received in a primary healthcare unit (without a Family Health Strategy team) (0.35). CONCLUSION: Individual and prenatal factors were associated with gestational syphilis. To control congenital syphilis, targeted interventions are needed to control syphilis in the adult population including expansion of access to quality prenatal care with identification of risks for syphilis and connection between prevention and treatment actions, implementation of strategies focused on early sexual education, effective establish prenatal care involving both partners, and effective implementation of the National Men's Health Policy (PNAISH - Política Nacional de Atenção Integral à Saúde dos Homens ).

Polymerase chain reaction for the evaluation of Schistosoma mansoni infection in two low endemicity areas of Minas Gerais, Brazil.

This study aimed to evaluate the occurrence of schistosomiasis in areas with low endemicity using polymerase chain reaction (PCR) as a diagnostic method. We analysed faecal samples from 219 individuals residing in Piau and Coronel Pacheco, state of Minas Gerais, Brazil, using a single faecal sample from each individual and two slides of the Kato-Katz technique as a gold standard. Fifteen out of the 219 samples were positive with both methods of diagnosis. One sample was diagnosed as positive by the Kato-Katz technique only and 61 were diagnosed only by PCR. The positivity rates were 7.3% with the Kato-Katz method and 34.7% with PCR. When both techniques were assumed to have 100% specificity and positive individuals were identified by both methods, the sensitivity of the Kato-Katz method was 20.8% and the PCR sensitivity was 98.7%. The Kappa index between the two techniques was 0.234, suggesting weak agreement. The assessment of a single faecal sample by PCR detected more cases of infection than the analysis of one sample with two slides using the Kato-Katz technique, suggesting that PCR can be a useful diagnostic tool, particularly in areas with low endemicity.

[Religious-spiritual coping and the consumption of alcoholic beverages in male patients with liver disease]. / Coping religioso-espiritual e consumo de alcoólicos em hepatopatas do sexo masculino.

This cross-sectional study was performed with the objective to evaluate the use of Religious Spiritual Coping (RSC) and verify its relationship with the pattern of alcoholic beverage consumption in patients attending a liver disease outpatient clinic between April and December of 2009, using the CAGE, AUDIT and RSC Scale. Associations were observed between negative religious-spiritual coping (NRSC) and the consumption of alcoholic beverages over the last year and with the resulting combination. Subjects identified as negative CAGE with low-risk consumption over the last year had a frequency above the expected in the category below the median. Those identified as positive CAGE with moderate-risk consumption were relatively more frequent in the category above the median (p=0.017). Results reinforce the relevance of the NRSC in the evaluation of health-related events.

[The socioeconomic and demographic characterization of children and adolescents who study and work outside their home]. / Caracterización socioeconómica y demográfica de niños y adolescentes que estudian y trabajan simultáneamente fuera de casa.

The objective of this study was to identify the socioeconomic and demographic characteristics of children and adolescents who study and work outside their home. This non-experimental, correlational, cross-sectional study was performed using questionnaires applied to primary education students, enrolled in public schools in Ribeirão Preto (Brazil). Two schools were selected through a draw. Data analysis was performed using Statistical Package for Social Sciences, version 14.0. Of the 133 students who answered the questionnaire, 36 (27.7%) reported working outside their home, 20.6% were between 11 and 13 years of age, and 66.7% were male (p=0.000) and had started working early to help with the family income (p=0.003). The salary they received helped comprise the family income, and it was found that as the family income increased, the need for the youngsters to work was reduced. It was found that many factors contribute to these subjects' early start at work, including family size, structure and poverty.

Factors associated with premature birth: a case-control study.

OBJECTIVE: To analyze the socioeconomic, demographic, environmental, reproductive, behavioral, and health-care factors associated with preterm birth. METHODS: Case-control study, with case group composed of preterm infants and the control group by full term live births. Each case was paired with two controls according to sex and date of birth. Interviews were carried out with the mothers, as well as analysis of medical records. A logistic regression model was used for data analysis following the hierarchical order of entry of the blocks. RESULTS: 221 live births were allocated in the case group and 442 in the control group. After analysis adjusted for other factors under study, the highest chances of prematurity were associated with being the first child (OR 1.96; 95%CI 1.34-2.86; p=0.001); mothers with the highest income (OR 2.08; 95%CI 1.41-3.08; p<0.001), mothers with previous preterm births (OR 3.98; 95%CI 2.04-7.79; p<0.001), mothers that suffered violence during pregnancy (OR 2.50; 95%CI 1.31-4.78; p=0.005) and underwent cesarean section (OR 2.35; 95%CI 1.63-3.38; p<0.001). Live births to mothers who had more than six prenatal consultations had a lower risk of prematurity (OR 0.39; 95%CI 0.26-0.58; p<0.001). CONCLUSIONS: The factors associated with a higher chance of prematurity were: higher family income, previous preterm child, primiparity, violence against pregnant women and cesarean section. Having attended more than six prenatal visits was associated with a lower chance of premature birth. Violence against pregnant women showed a strong and consistent association, remaining in all final models, and should serve as an alert for the population and professionals.

Higher Muscle Damage Triggered by Shorter Inter-Set Rest Periods in Volume-Equated Resistance Exercise.

Objectives: The aim of the manuscript was to analyze the effects of two rest periods between volume-equated resistance exercise (RE) on inflammatory responses (cytokines and leukocyte) and muscle damage. Methods: Ten trained men (26.40 ± 4.73 years, 80.71 ± 8.95 kg, and 176.03 ± 6.11 cm) voluntarily participated in training sessions consisting of five sets of 10 reps performed at 10-RM on (1) the barbell bench press followed by (2) leg press, with either 1- or 3-min rest between sets and exercises. Circulating concentrations of different biomarkers was measured before (Pre), and after 3 h (excepted for cytokines), 6, 12, and 24 h from exercise. The rate of perceived exertion (RPE) was recorded after each set on both planned visits. Results: We found greater increases triggered by the 1-min rest period in Creatine Kinase (CK), occurring from 12 to 24 h post-exercise compared to the 3-min rest condition. A significant increase in the 1-min rest condition was also observed in the total number of leukocytes, neutrophils, and monocytes. The 1-min rest period also triggered increases compared to baseline in pro-inflammatory cytokines [Interleukin 1 beta (IL-1ß), p = 0.004; tumor necrosis factor α (TNF-α), p = 0.01; and granulocyte-macrophage colony-stimulating factor (GM-CSF), p = 0.01], which were more evident after 6 and 12 h post-exercise. Similarly, increases in anti-inflammatory cytokines [Interleukin 5 (IL-5), p = 0.01; Interleukin 6 (IL-6), p = 0.01; and Interleukin 10 (IL-10), p = 0.01] at all time-points were observed. Conclusion: Our results indicate that a 1-min rest condition in volume-equated RE promoted greater overall muscle tissue damage with a longer duration of the inflammatory processes compared to a 3-min rest.

Prevalence and risk factors for giardiasis and soil-transmitted helminthiasis in three municipalities of Southeastern Minas Gerais State, Brazil: risk factors for giardiasis and soil-transmitted helminthiasis.

Giardiasis and soil-transmitted helminthiasis (STH) are parasitic diseases that are among the major health concerns observed in economically disadvantaged populations of developing countries, and have clear social and environmental bases. In Brazil, there is a lack of epidemiologic data concerning these infections in the study area, whose inhabitants have plenty of access to health care services, including good dwelling and adequate sanitary conditions. In this survey we investigated the risk factors for giardiasis and STH in three municipalities with good sanitation, situated in Minas Gerais state, Brazil. A cross-sectional survey was conducted in the municipalities of Piau, Coronel Pacheco and Goianá, in both urban and rural areas. The fieldwork consisted of a questionnaire and the examination of 2,367 stool samples using the Hoffmann, Pons and Janer method. Of all individuals from the population sample, 6.1% were found infected with the parasitic diseases included in this work. Hookworm infection was the most prevalent disease, followed by giardiasis, trichuriasis and ascariasis. Infection was more prevalent in males (8.1%, p < 0.001; odds ratio [OR] = 1.975) and in individuals living in rural areas (8.6%, p = 0.003; OR = 1.693). Multivariate analysis showed that variables such as inadequate sewage discharge (p < 0.001), drinking of unsafe water (p < 0.001), lack of sanitary infrastructure (p = 0.015), and host sex (p < 0.001) were the risk factors more strongly associated with infection status (95% confidence interval [CI]). In this study we demonstrate that giardiasis and STH still persist, infecting people who have good housing conditions and free access to public health care and education.

Factors associated with low birthweight: a case-control study in a city of Minas Gerais.

OBJECTIVE To analyze the many factors regarding socioeconomic and healthcare-related variables linked to maternal diseases and the possible impact of the environmental disaster of Mariana, given the prenatal exposure to different water sources for human consumption that were associated with low birthweight in full-term live births in the Municipal Hospital of Governador Valadares, Minas Gerais. METHODS Case-control study, carried out with live births at the Municipal Hospital of Governador Valadares, from May 2017 to July 2018. The case group consisted of full-term live births and low birthweight, and the control group consisted of full-term live births with adequate weight, matched by gender and date of birth. For each case, two controls were selected. Data collection was performed through interviews with the puerperal women, and complementary information was obtained by analyzing the prenatal card and medical records. For data analysis, logistic regression was performed. RESULTS The study included 65 live births from the case group and 130 from the control group. After the analysis was adjusted for other factors under study, we found that the higher risks of low birthweight are associated with the first childbirth (OR = 2.033; 95%CI = 1.047-3.948; p = 0.036), smoking during pregnancy (OR = 2.850; 95%CI = 1.013-8.021; p = 0.047) and consumption of water supplied by the municipalities affected by the tailings from the Fundão dam failure (RC = 2.444; 95%CI = 1.203-4.965; p = 0.013). CONCLUSIONS The variables "water consumed during pregnancy," "previous pregnancies" and "maternal smoking" were associated with low birthweight in the population studied. The importance of epidemiological studies that assess water quality and its adverse health effects is reinforced, as well as greater prenatal control of first-time pregnant women and greater support of policies against smoking, especially during pregnancy.

Violence against pregnant women and associated factors in the city of Governador Valadares.

OBJECTIVE: To characterize violence against women during pregnancy and to verify its association with socioeconomic, demographic, obstetric, behavioral factors, health care and diseases during pregnancy. METHODS: Cross-sectional study carried out with puerperal women whose birth took place at the Municipal Hospital of Governador Valadares, in Minas Gerais, from May 2017 to July 2018. Data collection was performed through interviews, and complementary information was obtained by analyzing the prenatal file and medical records. For data analysis, logistic regression was used. RESULTS: The total of 771 puerperal women participated in the study. Of these, 62 (8.0%) reported having suffered physical, psychological or sexual violence during pregnancy. The pregnant women most likely to have suffered violence were alcohol dependent (OR = 4.97; 95%CI 2.30-10.75; p < 0.001), those who did not perform prenatal care (OR = 3.88; 95%CI 1.00-15.09; p = 0.050), those who used health services in an emergency during pregnancy (OR = 2.47; 95%CI 1.42-4.30; p = 0.001) and who had gestational diabetes (OR = 2.59; 95%CI 1.06-6.32; p = 0.037) and sexually transmitted diseases (OR = 3.85; 95%CI 1.41-10.50; p = 0.009). CONCLUSION: Violence against pregnant women is associated with behavioral factors and related to health care and diseases during pregnancy. It is essential to recognize factors associated by health professionals through actions to track situations of violence against women since the beginning of prenatal care, in order to enable early intervention.

Qualitative and quantitative molecular analysis of bacteria in root canals of primary teeth with pulp necrosis.

Information about bacterial diversity, such as the number of each species in the root canals of primary teeth, contributes to improving our effective management of infections of endodontic origin in primary teeth. This study made a qualitative and quantitative assessment of the bacteria in the root canals of primary teeth with necrotic pulp, using the fluorescence in situ hybridization (FISH) technique. Thirty-one primary teeth with pulp necrosis from 31 children were evaluated using the FISH technique, to detect the presence and density of Aggregatibacter actinomycetemcomitans, Campylobacter rectus, Enterococcus faecalis, Fusobacterium nucleatum, Porphyromonas gingivalis, Prevotella intermedia, Prevotella nigrescens, Streptococcus, Streptococcus mutans, Streptococcus sobrinus, Tannerella forsythia and Treponema denticola. Descriptive measures explained the data related to density, and Student's t-test assessed the differences among the densities of each bacterium, according to signs and symptoms. The bacterial density was paired and correlated. All bacteria tested were detected and identified in all the samples. The average number of bacterial individuals from each species ranged from 1.9 x 108 cells/mL (S. mutans) to 3.1 x 108 cells/mL (F. nucleatum) (p > 0.05). The sum of the mean counts of each bacterium represented almost 80% of the entire microbial community. Patients with pain had significantly more T. denticola, and those with edema showed a greater density of Streptococcus and P. nigrescens (p < 0.05). This study revealed that all 12 bacteria evaluated were found in all primary teeth with pulp necrosis. There was no predominance among the species studied; all species had a similar number of individuals.

Reproductive factors associated with overweight in adult women attended by the Family Health Strategy. / Fatores reprodutivos associados ao excesso de peso em mulheres adultas atendidas pela Estratégia Saúde da Família.

Overweight stands out as a growing health problem in the population, resulting in individual and societal burdens. This study aimed to identify the association between reproductive factors and overweight in women of reproductive age attended by a Primary Health Care Unit (UAPS).This is a cross-sectional study with home capitation and data collection in two PHC Units, in the city of Juiz de Fora (MG), Brazil, in women aged 20 to 59 years, whose outcome was the overweight measured by the Body Mass Index. The prevalence of overweight was 61.0% among the 2,018 women included in the analysis. In the multivariate analysis, overweight was associated with the variables age at menarche before 12 years of age, having children, age greater than or equal to 30years, and hypertension. The prevalence of overweight in women who had menarche before 12 years of age was 12.4% higher than those who had menarche aged 12 years or more, and the prevalence of overweight in women who had children was 58.2% higher than those who never had any. There was a high prevalence of overweight in the adult female population, emphasizing the influence of reproductive factors.

O excesso de peso se destaca como um problema de saúde crescente na população, resultando em ônus para o indivíduo e para a sociedade. O objetivo deste artigo é identificar a associação entre os fatores reprodutivos e o excesso de peso em mulheres de 20 a 59 anos de áreas cobertas pela Unidade de Atenção Primária à Saúde. Trata-se de um estudo transversal com captação domiciliar e coleta de dados em duas Unidades de Atenção Primária à Saúde, no município de Juiz de Fora, em mulheres de 20 a 59 anos, cujo desfecho foi o Excesso de Peso medido por meio do Índice de Massa Corporal. Entre as 2018 mulheres incluídas na análise, a prevalência de Excesso de Peso foi de 61,0%. Na análise multivariada, o Excesso de Peso apresentou associação com as variáveis idade da menarca antes dos 12 anos, ter filhos, idade maior ou igual a 30 anos e relato de hipertensão arterial. A prevalência de excesso de peso em mulheres que tiveram menarca antes dos 12 anos foi 12,4% maior do que naquelas que a tiveram com 12 anos ou mais; enquanto que a prevalência de Excesso de Peso em mulheres que tiveram filhos foi 58,2% maior do que entre as que nunca tiveram. Foi observada elevada prevalência de Excesso de Peso na população feminina adulta, com ênfase na influência dos fatores reprodutivos.

[Political, institutional, and organizational evaluation of primary health care with an emphasis on comprehensiveness]. / Avaliação da atenção básica pela ótica político-institucional e da organização da atenção com ênfase na integralidade.

This article presents part of the data from an evaluation of primary care, implemented as part of research funded by the Brazilian Ministry of Health in 2005. Thirty-one municipalities from the States of Minas Gerais and Espírito Santo comprised the study sample. Data collected with qualitative methods (interviews and documents) were summarized, with the production of a set of categorical variables. The article presents the distribution of values for the variables by municipality. The variables were submitted to correspondence analysis, which showed their internal validity. The article also provides observations on relevant aspects of the field. In conclusion, the evaluation demonstrates advances in the Family Health Strategy in Brazil, with important contributions to the Project for Expansion and Consolidation of the Family Health Strategy, despite persistent obstacles, particularly related to human resources in the family health strategies and local use of the data produced.

Factors associated with women diagnosed with syphilis who received prenatal care in a primary healthcare unit

ABSTRACT Objective To estimate the prevalence of syphilis and its associated factors in women who were treated at public maternity hospitals and received prenatal care in a primary healthcare unit. Methods This cross-sectional study included 399 postpartum women. Interviews were conducted, and additional data were extracted from the pregnant woman's booklet, medical records, and printed tests. The dependent variable was a gestational syphilis diagnosis. The independent variables were grouped into socioeconomic and demographic, behavioral, reproductive, and prenatal blocks. The prevalence, prevalence ratios, and 95% confidence intervals (95%CI) were calculated. The χ 2 test was also performed (p≤0.05). Multivariate analysis was performed using Poisson regression models. Results The prevalence of gestational syphilis was 9.61% (95%CI: 7.14-12.83). We identified the following determining factors (adjusted prevalence ratios): history of sexually transmitted infections (2.3), first sexual intercourse by the age of 15 (2.42), partner having a history of syphilis (5.98), partner using crack/cocaine (6.42) and marijuana and others (3.02), not having a partner (3.07), low income (2.85), history of stillbirth (5.21), beginning prenatal care in the third trimester (3.15), and prenatal care received in a primary healthcare unit (without a Family Health Strategy team) (0.35). Conclusion Individual and prenatal factors were associated with gestational syphilis. To control congenital syphilis, targeted interventions are needed to control syphilis in the adult population including expansion of access to quality prenatal care with identification of risks for syphilis and connection between prevention and treatment actions, implementation of strategies focused on early sexual education, effective establish prenatal care involving both partners, and effective implementation of the National Men's Health Policy (PNAISH - Política Nacional de Atenção Integral à Saúde dos Homens ).