Patient needs four years after first psychiatric hospitalization in a Brazilian cohort

Knowledge about the needs of psychiatric patients is essential for mental health care planning. However, research on met and unmet needs is still scarce, particularly in low- and middle-income countries. This study aimed to describe the patients' needs (met and unmet) at least four years after their first psychiatric hospitalization and to verify the role of demographic and clinical features as possible predictors of these needs. Patients who had their first psychiatric admission between January 1, 2006 and December 31, 2007 at an inpatient unit in the city of Ribeirão Preto, Brazil, were eligible to participate in the study. Patients were contacted and face-to-face interviews were conducted by psychologists using the Camberwell Assessment of Need. Data were analyzed using zero-inflated negative binomial regression model. Of 933 eligible patients, 333 were interviewed. The highest level of needs was related to welfare benefits (32.4%, unmet=25.5%), followed by household skills (30.3%, unmet=3.0%), psychotic symptoms (29.4%, unmet=9.0%), psychological distress (27.6%, unmet=8.4%), physical health (24.3%, unmet=5.4%), daytime activities (19.5%, unmet=16.5%), and money (16.8%, unmet=9.0%). Fewer years of schooling, living with relatives, and unemployment at the moment of the first admission were significantly associated with a higher number of both met and unmet needs in the follow-up. Unmet needs were also more often reported by patients living alone. In conclusion, socioeconomic indicators were the best predictors of needs. The unmet needs related to welfare benefits point to the need for specific social and health policies.

Utilização experimental de hidroxiapatita sintética em alvéolos dentários de gatos domésticos (Felis catus): estudo clínico, radiográfico e histomorfométrico / Experimental application of hydroxyapatite in feline (Felis catus) dental sockets: clinic, radiographic, histologic and histomorphometric studies

A fim de avaliar a resposta biológica da hidroxiapatita sintética (HAP-91) nos alvéolos de felinos domésticos, este biomaterial foi implantado após extração do terceiro pré-molar inferior direito em 12 gatos e mantida por meio de uma membrana de celulose bacteriana. No lado esquerdo, os alvéolos foram apenas recobertos com a membrana de celulose bacteriana, formando o grupo-controle. Observou-se, durante a avaliação clínica, que todos os animais voltaram a comer normalmente ração úmida, sem apresentarem sinais de dor ou desconforto após a recuperação anestésica. A cicatrização da ferida cirúrgica ocorreu de forma satisfatória, sendo que a membrana de celulose bacteriana evitou a saída precoce da hidroxiapatita. Radiograficamente, aos 50 dias, todos os animais apresentaram radiopacidade óssea homogênea em ambos os lados. À análise histomorfométrica, observou-se adiantamento do processo de reparo do osso alveolar nos oito primeiros dias do grupo-tratado quando comparado ao grupo-controle, bem como atraso aos 30 dias, porém, aos 50 dias, ambos os grupos apresentavam porcentagem de tecido ósseo semelhante e morfologicamente normal. Os resultados sugerem que a hidroxiapatita é biocompatível, integra-se ao tecido ósseo alveolar e pode ser utilizada em felinos.

The biocompatibility of a material depends on its characteristics, as well as the species and the environment recipient. In order to evaluate the biological response of the synthetic hydroxyapatite (HAP-91) in feline dental alveoli, it was implanted in the right inferior third premolar after extraction in 12 cats and maintained through a bacterial cellulose membrane. On the left side the alveoli was covered with a bacterial cellulose membrane (control group). During clinical evaluations it was observed that the animals started to eat after the anesthetic recovery time, without clinical signs of pain. There was a satisfactory cicatrization of the surgical wound and the bacterial cellulose membrane aided in repairing the gum, avoiding the loss of the hydroxyapatite. Radiographs taken 50 days post surgery presented homogeneous bone radiopacity on both sides. The histological and histomorfometrical analysis showed a positive progress of the alveolar repair in the first 8 days in the treated group when compared to the control group and a delay at 30 days, however at 50 days both presented a similar and morphologically normal percentage of bone tissue. These findings suggest that HAP-91 is biocompatible and integrates into the feline alveolar bone.