A longitudinal assessment of heat exposure and biomarkers of kidney function on heat shock protein 70 and antibodies among agricultural workers.

Background: Exposure to extreme heat impacts millions of people worldwide and outdoor workers are among the populations most affected by high temperatures. Heat stress induces several biological responses in humans, including the production of heat shock proteins (HSP) and antibodies against HSP (anti-HSP) which may play a central role in the body's cellular response to a hot environment. Objective: This longitudinal study investigated the impact of high temperatures and humidity on the presence of HSP70 and anti-HSP70 and examined relationships with markers of kidney function in an at-risk workforce under conditions of extreme heat and exertion in Guatemala. Methods: We collected ambient temperature and relative humidity data as well as biomarkers and clinical data from 40 sugarcane workers at the start and the end of a 6-month harvest. We used generalized mixed-effects models to estimate temperature effects on HSP70 and anti-HSP70 levels. In addition, we examined trends between HSP70 and anti-HSP70 levels and markers of kidney function across the harvest. Results: At the end of the harvest, temperatures were higher, and workers had, on average, higher levels of HSP70 and anti-HSP70 compared to the beginning of the season. We observed significant increasing trends with temperature indices and HSP70 levels. Maximum temperature was associated with HSP70 increments after controlling for age, systolic and diastolic blood pressure (ß: 0.21, 95% Confidence Interval: 0.09, 0.33). Kidney function decline across the harvest was associated with both higher levels of anti-HSP70 levels at the end of the harvest as well as greater increases in anti-HSP70 levels across the harvest. Conclusions: These results suggest that workplace heat exposure may increase the production of HSP70 and anti-HSP70 levels and that there may be a relationship between increasing anti-HSP70 antibodies and the development of renal injury. HSP70 holds promise as a biomarker of heat stress in exposed populations.

The Role of Socioeconomic and Health Services Organizational Factors on Infection Control Structure Score, Brazil.

This study aimed to analyze possible associations between the Infection Control Structure Score (ICSS), health services, and social characteristics of the municipalities in Brazil. Secondary data from the third cycle 2017-2018 of the Brazilian National Program for Improving Primary Care Access and Quality (PMAQ) was analyzed. Six independent variables - FIRJAN Index of Municipal Development, number of inhabitants, number of family health teams receiving a financial incentive from the federal government, healthcare expenditure per capita, and number of Oral Health Teams modalities 1 and 2 - were included to assess their influence on ICSS, measured for each Brazilian town. Data analysis used the Classification and Regression Tree model performed with IBM SPSS 25. A total of 4,900 municipalities were included, and the mean ICSS was 0.905 (±0.092). A positive relationship was observed between healthcare expenditure per capita, municipal development, and the outcome. Conversely, towns with a higher number of family health teams receiving a financial incentive from the federal government showed lower mean ICSS. The findings suggest that inequalities in the infection control structures exist within the country, and they were related to the health services and social characteristics of the municipalities.

The Role of Socioeconomic and Health Services Organizational Factors on Infection Control Structure Score, Brazil / O Papel dos Fatores Socioeconômicos e de Organização dos Serviços de Saúde sobre o Escore da Estrutura de Controle de Infecção, Brasil

Abstract This study aimed to analyze possible associations between the Infection Control Structure Score (ICSS), health services, and social characteristics of the municipalities in Brazil. Secondary data from the third cycle 2017-2018 of the Brazilian National Program for Improving Primary Care Access and Quality (PMAQ) was analyzed. Six independent variables - FIRJAN Index of Municipal Development, number of inhabitants, number of family health teams receiving a financial incentive from the federal government, healthcare expenditure per capita, and number of Oral Health Teams modalities 1 and 2 - were included to assess their influence on ICSS, measured for each Brazilian town. Data analysis used the Classification and Regression Tree model performed with IBM SPSS 25. A total of 4,900 municipalities were included, and the mean ICSS was 0.905 (±0.092). A positive relationship was observed between healthcare expenditure per capita, municipal development, and the outcome. Conversely, towns with a higher number of family health teams receiving a financial incentive from the federal government showed lower mean ICSS. The findings suggest that inequalities in the infection control structures exist within the country, and they were related to the health services and social characteristics of the municipalities.

Resumo Este estudo objetivou analisar as possíveis associações entre o Escore da Estrutura de Controle de Infecção (EECI), os serviços de saúde e características sociais dos municípios brasileiros. Foram analisados dados secundários do terceiro ciclo 2017-2018 do Programa Nacional de Melhoria do Acesso e Qualidade da Atenção Básica (PMAQ). Seis variáveis independentes - Índice FIRJAN de Desenvolvimento Municipal, número de habitantes, número de Equipes de Saúde da Família que recebiam incentivo financeiro do governo federal, gasto com saúde per capita e número de Equipes de Saúde Bucal modalidades 1 e 2 - foram incluídas para avaliar a influência sobre o EECI, medido para cada município brasileiro. Para a análise dos dados, foi utilizado o modelo de Árvore de Classificação e Regressão no IBM SPSS 25. Foram incluídos 4.900 municípios, e o EECI médio foi de 0,905 (±0,092). Observou-se uma associação positiva entre o gasto com saúde per capita, o desenvolvimento municipal e o desfecho. Por outro lado, municípios com maior número de Equipes de Saúde da Família com incentivo financeiro do governo federal apresentaram menor média do EECI. Os achados sugerem que existem desigualdades nas estruturas de controle de infecções no país, relacionadas aos serviços de saúde e às características sociais dos municípios.

Dental Pain Medication Prescriptions in Minas Gerais, Brazil (2011-2021): A Time-Series Analysis.

To describe trends of dentist-prescribed non-steroidal anti-inflammatory drugs (NSAIDs) and analgesics, from January 2011 to December 2021, as well as to examine the relationship between these trends and characteristics of public oral health services in Minas Gerais, Brazil. In this time-series analysis, all drugs were classified according to the Anatomical Therapeutic Chemical classification system. Drugs categorized as NSAIDs (M01A), and other analgesics and antipyretics (N02B) were included for analysis. The outcome was the number of Defined Daily Doses (DDDs)/1000 inhabitants/year for NSAIDs and analgesics in each town. Covariates referred to characteristics of public oral health services, such as coverage, estimates of dental procedures, and frequency of toothache. Linear time-series regression models were used to determine the influence of covariates on the outcome. Overall, there were 58,482 prescriptions of NSAIDs recorded in thirty-eight towns, while 47,499 prescriptions of analgesics in forty-three towns. For each year, there was a 0.38 (p < 0.001), and 0.28 (p < 0.001) increase in the average log of DDD/1000 inhabitants/year for NSAIDs and analgesics, respectively. A positive association was detected between toothache (p < 0.001) and the prescription of NSAIDs. Over the eleven years, there was a general rising trend in the prescriptions. Toothache was the only characteristic of public oral health services associated with the prescription rates of NSAIDs, implying that as the frequency of toothaches increase, so do the prescriptions of NSAIDs in the studied towns.

Describing the Oral Health of Warfarin Users. A Short Report

Aim: To describe the burden of oral diseases and of self-reported periodontal disease of patients under Oral Anticoagulation Therapy (OAT) with warfarin. Methods: A cross-sectional study was conducted. Validated questionnaires assessed self-reported periodontal disease and demographic variables. After calibration (Kappa > 0.80), an examiner evaluated dental caries and the need for dental prostheses. Statistical analysis involved proportions and measures of central tendency. Results: The sample consisted of 158 individuals, with a mean age of 58.8 years (SD = 12.1), of which 62.7% of the participants were women. The average DMFT (Decayed, Missing, and Filled Teeth) index was 22.9 (SD = 7.6), with the missing component being the highest (Mean = 16.23). The use of maxillary prosthesis (53.2%) was higher than mandibular (32.3%). The need for mandibular prosthesis reached 66.5%. The percentage of participants that referred gum disease, tooth migration, and tooth mobility was 29.6%, 37.4%, and 30.4%, respectively. Conclusions: The burden of oral diseases among individuals undergoing OAT is worrisome.

Objetivo: Describir la carga de enfermedades bucales y la enfermedad periodontal autorreportada de pacientes en tratamiento con anticoagulación oral con warfarina. Métodos: Se realizó un estudio transversal. Los cuestionarios validados evaluaron la enfermedad periodontal autoinformada y las variables demográficas. Después de la calibración (Kappa> 0.80), un examinador evaluó la caries dental y la necesidad de prótesis dentales. El análisis estadístico involucró proporciones y medidas de tendencia central. Resultados: La muestra estuvo formada por 158 individuos, con una edad media de 58.8 años (DE = 12.1), de los cuales el 62.7% de los participantes eran mujeres. El índice CPOD promedio fue de 22.9 (DE = 7.6), siendo el componente perdido el que más contribuyó al índice (Media = 16.23). El uso de prótesis maxilar (53.2%) fue mayor que el de prótesis mandibular (32.3%). La necesidad de prótesis mandibular alcanzó el 66.5%. El porcentaje de participantes que informaron enfermedad de las encías, migración de los dientes y movilidad de los dientes fue del 29.6%, 37.4% y 30.4%, respectivamente. Conclusiones: Las enfermedades bucales y la necesidad de rehabilitación oral entre los individuos sometidos a anticoagulación oral con warfarina fue motivo de preocupación.

High prevalence of potential psychotropic drugs interactions among Brazilian dental patients.

OBJECTIVE: To determine the prevalence of potential drug-drug interactions involving psychotropics prescribed by dentists, and dispensed by the public healthcare system, as well as to describe the severity and level of evidence of those interactions in the state of Minas Gerais, Brazil. MATERIALS AND METHODS: We conducted data analysis from pharmaceutical claims in which dental patients received systemic psychotropics in 2017. Data from the Pharmaceutical Management System provided the drug dispensing history of the patients, allowing the identification of those on concomitant medication use. The outcome was the occurrence of potential drug-drug interactions, which were detected according to IBM Micromedex®. Independent variables were the patient's sex, age, and the number of drugs used. Descriptive statistics was performed using SPSS v. 26. RESULTS: Overall, 1480 individuals were prescribed psychotropic drugs. The prevalence of potential drug-drug interactions was 24.8% (n = 366). The total of 648 interactions was observed and, most of which were of major severity (n = 438, 67.6%). Most interactions occurred in female individuals (n = 235; 64.2%), with 46.0 (±17.3) years-old, concurrently taking 3.7 (±1.9) drugs. CONCLUSION: A substantial proportion of dental patients presented potential drug-drug interactions, mostly of major severity, which might be life-threatening.

Point-of-Care Testing in Chronic Kidney Disease of Non-Traditional Origin: Considerations for Clinical, Epidemiological, and Health Surveillance Research and Practice.

Purpose: As the prevalence of chronic kidney disease of non-traditional origin (CKDnt) rises in low-resource settings, there is a need for reliable point-of-care creatinine testing. The purpose of this analysis was to assess the accuracy of two commonly used point-of-care creatinine devices, the i-STAT handheld (Abbott, Princeton, NJ, USA) and the StatSensor Creatinine (Nova Biomedical, Waltham, MA, USA) in comparison to venipuncture serum creatinine measures. The affordability, sensitivity, specificity, ease of use, and other considerations for each device are also presented. Methods: Three paired data sets were compared. We collected 213 paired i-STAT and venipuncture samples from a community study in Nicaragua in 2015-2016. We also collected 267 paired StatSensor Creatinine and venipuncture samples, including 158 from a community setting in Nicaragua in 2014-2015 and 109 from a Guatemala sugarcane worker cohort in 2017-2018. Pearson correlation coefficients, Bland-Altman plots, and no intercept linear regression models were used to assess agreement between point-of-care devices and blood samples. Results: The i-STAT performed the most accurately, overestimating creatinine by 0.07 mg/dL (95% CI: 0.02, 0.12) with no evidence of proportional bias. The StatSensor Creatinine performed well at low levels of creatinine (Mean (SD): 0.87 (0.19)). Due to proportional bias, the StatSensor Creatinine performed worse in the Nicaragua community setting where creatinine values ranged from 0.31 to 7.04 mg/dL. Discussion: Both devices provide acceptable sensitivity and specificity. Although adequate for routine surveillance, StatSensor Creatinine is less accurate as the values of measured creatinine increase, a consideration when using the point-of-care device for screening individuals at risk for CKDnt. Research, clinical, and screening objectives, cost, ease of use, and background prevalence of disease must all be carefully considered when selecting a point-of-care creatinine device. Conclusion: POC testing can be more accessible in resource-limited settings. The selection of the appropriate device will depend on the use-case.

Arabica-coffee and teobroma-cocoa agro-industrial waste biosorbents, for Pb(II) removal in aqueous solutions.

Agro-industrial waste biosorbents of arabica-coffee (WCA) and theobroma-cocoa (WCT) have been characterized and tested to remove Pb(II) from aqueous media. The maximum adsorption capacity of WCA and WCT (qmax = 158.7 and 123.5 mg·g-1, respectively) is comparable or even higher than for several other similar agro-industrial waste biosorbents reported in the literature. Structural and morphological characterization were performed by infrared spectrometry with Fourier transform (FT-IR), scanning electron microscopy/energy-dispersive X-ray spectroscopy (SEM/EDS), and charge measurements at the zero point charge (pHPZC). Both biosorbents, WCA and WCT, show cracked surfaces with heterogeneous plates which ones include functional adsorption groups such as OH, C = O and C-O-C. Optimal Pb(II) adsorption occurs for a pH between 4 and 5 at [WCA] and [WCT] dose concentrations of 2 g·L-1. We found that the adsorption process follows pseudo-second order kinetics with a rapid growth rate (almost six times larger for WCA than for WCT), basically controlled by the chemisorption process. The regeneration of both biosorbents was carried out in an eluent of 0.1M HNO3 and they can be efficiently reused up to 5 times.

A machine learning approach to analyse ozone concentration in metropolitan area of Lima, Peru.

The main objective of this study is to model the concentration of ozone in the winter season on air quality through machine learning algorithms, detecting its impact on population health. The study area involves four monitoring stations: Ate, San Borja, Santa Anita and Campo de Marte, all located in Metropolitan Lima during the years 2017, 2018 and 2019. Exploratory, correlational and predictive approaches are presented. The exploratory results showed that ATE is the station with the highest prevalence of ozone pollution. Likewise, in an hourly scale analysis, the pollution peaks were reported at 00:00 and 14:00. Finally, the machine learning models that showed the best predictive capacity for adjusting the ozone concentration were the linear regression and support vector machine.

Effect of Layer Thickness and Heat Treatment on Microstructure and Mechanical Properties of Alloy 625 Manufactured by Electron Beam Powder Bed Fusion.

This research program investigated the effects of layer thickness (50 µm and 100 µm) on the microstructure and mechanical properties of electron beam powder bed fusion (EBPBF) additive manufacturing of Inconel 625 alloy. The as-built 50 µm and 100 µm layer thickness components were also heat treated at temperatures above 1100 °C which produced a recrystallized grain structure containing annealing twins in the 50 µm layer thickness components, and a duplex grain structure consisting of islands of very small equiaxed grains dispersed in a recrystallized, large-grain structure containing annealing twins. The heat-treated components of the microstructures and mechanical properties were compared with the as-built components in both the build direction (vertical) and perpendicular (horizontal) to the build direction. Vickers microindentation hardness (HV) values for the vertical and horizontal geometries averaged 227 and 220 for the as-built 50 µm and 100 µm layer components, respectively, and 185 and 282 for the corresponding heat-treated components. The yield stress values were 387 MPa and 365 MPa for the as-built horizontal and vertical 50 µm layer geometries, and 330 MPa and 340 MPa for the as-built 100 µm layer components. For the heat-treated 50 µm components, the yield stress values were 340 and 321 MPa for the horizontal and vertical geometries, and 581 and 489 MPa for the 100 µm layer components, respectively. The elongation for the 100 µm layer as-built horizontal components was 28% in contrast with 65% for the corresponding 100 µm heat-treated layer components, an increase of 132% for the duplex grain structure.

Statistical modeling approach for PM10 prediction before and during confinement by COVID-19 in South Lima, Perú.

A total of 188,859 meteorological-PM[Formula: see text] data validated before (2019) and during the COVID-19 pandemic (2020) were used. In order to predict PM[Formula: see text] in two districts of South Lima in Peru, hourly, daily, monthly and seasonal variations of the data were analyzed. Principal Component Analysis (PCA) and linear/nonlinear modeling were applied. The results showed the highest annual average PM[Formula: see text] for San Juan de Miraflores (SJM) (PM[Formula: see text]-SJM: 78.7 [Formula: see text]g/m[Formula: see text]) and the lowest in Santiago de Surco (SS) (PM[Formula: see text]-SS: 40.2 [Formula: see text]g/m[Formula: see text]). The PCA showed the influence of relative humidity (RH)-atmospheric pressure (AP)-temperature (T)/dew point (DP)-wind speed (WS)-wind direction (WD) combinations. Cool months with higher humidity and atmospheric instability decreased PM[Formula: see text] values in SJM and warm months increased it, favored by thermal inversion (TI). Dust resuspension, vehicular transport and stationary sources contributed more PM[Formula: see text] at peak times in the morning and evening. The Multiple linear regression (MLR) showed the best correlation (r = 0.6166), followed by the three-dimensional model LogAP-LogWD-LogPM[Formula: see text] (r = 0.5753); the RMSE-MLR (12.92) exceeded that found in the 3D models (RMSE [Formula: see text]) and the NSE-MLR criterion (0.3804) was acceptable. PM[Formula: see text] prediction was modeled using the algorithmic approach in any scenario to optimize urban management decisions in times of pandemic.

A rigorous in silico genomic interrogation at 1p13.3 reveals 16 autosomal dominant candidate genes in syndromic neurodevelopmental disorders.

Genome-wide chromosomal microarray is extensively used to detect copy number variations (CNVs), which can diagnose microdeletion and microduplication syndromes. These small unbalanced chromosomal structural rearrangements ranging from 1 kb to 10 Mb comprise up to 15% of human mutations leading to monogenic or contiguous genomic disorders. Albeit rare, CNVs at 1p13.3 cause a variety of neurodevelopmental disorders (NDDs) including development delay (DD), intellectual disability (ID), autism, epilepsy, and craniofacial anomalies (CFA). Most of the 1p13.3 CNV cases reported in the pre-microarray era encompassed a large number of genes and lacked the demarcating genomic coordinates, hampering the discovery of positional candidate genes within the boundaries. In this study, we present four subjects with 1p13.3 microdeletions displaying DD, ID, autism, epilepsy, and CFA. In silico comparative genomic mapping with three previously reported subjects with CNVs and 22 unreported DECIPHER CNV cases has resulted in the identification of four different sub-genomic loci harboring five positional candidate genes for DD, ID, and CFA at 1p13.3. Most of these genes have pathogenic variants reported, and their interacting genes are involved in NDDs. RT-qPCR in various human tissues revealed a high expression pattern in the brain and fetal brain, supporting their functional roles in NDDs. Interrogation of variant databases and interacting protein partners led to the identification of another set of 11 potential candidate genes, which might have been dysregulated by the position effect of these CNVs at 1p13.3. Our studies define 1p13.3 as a genomic region harboring 16 NDD candidate genes and underscore the critical roles of small CNVs in in silico comparative genomic mapping for disease gene discovery. Our candidate genes will help accelerate the isolation of pathogenic heterozygous variants from exome/genome sequencing (ES/GS) databases.

Risco nutricional e fatores associados em pacientes hospitalizados pelo sistema único de saúde: comparação entre os sexos / Nutricional risk and associated factors in hospitalized patients: comparison between genders

Introdução: a desnutrição representa um problema clínico-nutricional frequente em pacientes hospitalizados, sendo que a detecção precoce do risco nutricional torna-se fundamental, pois possibilita à equipe multidisciplinar o início imediato de uma conduta dietética adequada, minimizando o sinergismo entre a desnutrição e os demais fatores clínicos. Objetivo: determinar o risco nutricional, associando com o estado nutricional, estilo de vida e variáveis clínicas de hospitalização de pacientes internados pelo SUS, comparando tais condições entre os sexos. Metodologia: trata-se de estudo transversal. Para avaliação do risco nutricional dos pacientes hospitalizados foi utilizado o protocolo de triagem nutricional Nutricional Risk Screening (NRS) 2002, além disso foram coletados dados antropométricos, clínicos, sociodemográficos e dietéticos para comparação com o risco nutricional. Resultados: a amostra foi composta por 100 pacientes, sendo 50% adultos e 50% idosos, com média de idade de 56,11±19 anos, sendo a maioria do sexo masculino (51%). O risco nutricional esteve presente em 34% dos pacientes avaliados, sendo 58,8% no sexo feminino e 41,2% no sexo masculino. Não houve diferença das demais variáveis quando comparadas entre os sexos (p>0,05). A maior prevalência de risco observada foi em idosos (27%). Conclusão: o risco nutricional obteve maior prevalência nos pacientes idosos, porém não houve diferença entre os sexos. Sabe-se que a presença de comorbidades e uma inadequada aceitação da dieta por parte dos mesmos pode levar a uma piora significativa do estado nutricional.

Malnutrition is a frequent clinical and nutritional problem in hospitalized patients, and early detection of nutritional risk is essential, as it allows the multidisciplinary team to immediately start an adequate dietary approach, minimizing the synergism between malnutrition and other clinical factors. Objective: to determine the nutritional risk, associating it with the nutritional status, lifestyle and clinical variables of hospitalization of patients hospitalized by the SUS, comparing such conditions between the sexes. Methodology: this are a cross-sectional study. To assess the nutritional risk of hospitalized patients, the Nutritional Risk Screening (NRS) 2002 protocol was used. In addition, anthropometric, clinical, sociodemographic and dietary data were collected for comparison with nutritional risk. Results: the sample consisted of 100 patients, 50% adults and 50% elderly, with a mean age of 56.11±19 years, the majority being male (51%). Nutritional risk was present in 34% of the patients evaluated, being 58.8% female and 41.2% male. There was no difference in the other variables when compared between the sexes (p>0.05). The highest prevalence of risk observed was in the elderly (27%). Conclusion: nutritional risk was more prevalent in elderly patients, but there was no difference between the sexes. It is known that the presence of comorbidities and an inadequate acceptance of the diet by them can lead to a significant worsening of the nutritional status.

Association of sociodemographic factors with the prescription pattern of opioids for dental patients: a systematic review.

Aim To evaluate the association of patients' sociodemographic factors (sex, age, ethnicity, income, educational level, living environment and health insurance) with the prescription pattern of opioids provided by oral health practitioners.Methods Observational studies that evaluated the association of patients' sociodemographic factors and the likelihood of receiving an opioid prescription provided by an oral health practitioner were eligible. Electronic searches were conducted in Medline (PubMed), Embase, Scopus, Web of Science, LILACS, SciELO, Google Scholar, and OpenGrey up to March 2021. Two authors independently screened the studies, performed data extraction, and assessed the risk-of-bias using the critical appraisal tools developed by the Joanna Briggs Institute (JBI). Certainty of the evidence was assessed with the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE).Results Eight studies were included in this systematic review. Publication year ranged from 2011 to 2021. Narrative synthesis showed with very low certainty of evidence that younger individuals were more likely to receive a prescription of opioids than older individuals. Regarding the other sociodemographic factors and the prescriptions of opioids in dentistry, the evidence is controversial. Risk of bias was low for most items assessed in the included studies.Conclusion The available evidence suggests that there is an association between patients' sociodemographic factors and the prescription patterns of opioids provided by oral health practitioners.

Factors associated with the use of a public information system of dentist-prescribed antibiotics in Minas Gerais, Brazil / Fatores associados ao uso de um sistema de informação público de antibióticos prescritos por cirurgiões-dentistas em Minas Gerais, Brasil

Abstract This article aims to investigate the association between socioeconomic factors, health care organizations, and the use of a management and monitoring system for the dispensing of antibiotics prescribed by dentists in public health services in Minas Gerais, Brazil. This is an ecological-epidemiological study that analyzed secondary data from the Integrated Pharmaceutical Care Management System (SIGAF) of the Department of Health of the state of MG, Brazil, in 2017. Thirteen independent variables were analyzed to assess their influence on municipal adherence to SIGAF system considering dental prescriptions of antibiotics. Descriptive statistical analyses were performed, and the Classification and Regression Tree technique was used to identify the municipal variables associated with the outcome. A total of 57,279 antibiotic courses prescribed by dentists and recorded in SIGAF were examined. Socioeconomic factors were not associated with the use of SIGAF to record these prescriptions. Oral healthcare coverage was positively associated with the use of SIGAF for the dispensing of antibiotics prescribed by dentists. Dental Specialties Center were negatively associated with the outcome. Municipalities with high oral healthcare coverage and those without a Dental Specialties Center were more likely to use SIGAF.

Resumo O objetivo deste artigo é avaliar a associação entre fatores socioeconômicos, organização dos serviços de saúde e a utilização de um sistema de gestão e monitoramento da dispensação de antibióticos prescritos por cirurgiões-dentistas em Minas Gerais, Brasil. Estudo epidemiológico ecológico que analisou dados secundários do Sistema Integrado de Gestão da Assistência Farmacêutica (SIGAF) da Secretaria de Estado de Saúde de MG, Brasil, em 2017. Treze variáveis independentes foram analisadas para testar a influência destas com a adesão dos municípios ao SIGAF das prescrições odontológicas de antibióticos. Foram realizadas análises estatísticas descritivas, e a técnica de Árvore de Classificação e Regressão foi utilizada. Foram examinadas 57.279 prescrições de antibióticos prescritos por dentistas e registradas no SIGAF. Fatores socioeconômicos não foram associados ao uso do SIGAF para registro dessas prescrições. A cobertura de saúde bucal esteve positivamente associada à utilização do SIGAF para as dispensações de antibióticos prescritos por cirurgiões-dentistas. A presença de Centro De Especialidade Odontológica, esteve negativamente associado ao desfecho. Municípios com maior cobertura de saúde bucal e sem Centro de Especialidade Odontológica foram mais propensos a utilizar o SIGAF.

Factors associated with the use of a public information system of dentist-prescribed antibiotics in Minas Gerais, Brazil.

This article aims to investigate the association between socioeconomic factors, health care organizations, and the use of a management and monitoring system for the dispensing of antibiotics prescribed by dentists in public health services in Minas Gerais, Brazil. This is an ecological-epidemiological study that analyzed secondary data from the Integrated Pharmaceutical Care Management System (SIGAF) of the Department of Health of the state of MG, Brazil, in 2017. Thirteen independent variables were analyzed to assess their influence on municipal adherence to SIGAF system considering dental prescriptions of antibiotics. Descriptive statistical analyses were performed, and the Classification and Regression Tree technique was used to identify the municipal variables associated with the outcome. A total of 57,279 antibiotic courses prescribed by dentists and recorded in SIGAF were examined. Socioeconomic factors were not associated with the use of SIGAF to record these prescriptions. Oral healthcare coverage was positively associated with the use of SIGAF for the dispensing of antibiotics prescribed by dentists. Dental Specialties Center were negatively associated with the outcome. Municipalities with high oral healthcare coverage and those without a Dental Specialties Center were more likely to use SIGAF.

Cyberchondria and Associated Factors Among Brazilian and Portuguese Dentists.

Cyberchondria is a psychopathological behavior that affects people who compulsively consult the internet, by searching the symptoms of different pathologies from which they believe they are suffering, and when influenced by what they read, are sure they have some of these diseases. The aim of this study was to assess the cyberchondria level and associated factors among Brazilian and Portuguese dentists. A total 597 Brazilian and Portuguese dentists participated in this cross-sectional study. They were contacted via WhatsApp and asked to complete an online questionnaire on the Google Forms platform, from January 17 to 31, 2021, during the COVID-19 pandemic. Sociodemographic information was collected and cyberchondria was measured using the Portuguese language version of the Cyberchondria Severity Scale. Binary logistic regression models were used to estimate the unadjusted and adjusted Odds Ratio (OR) and corresponding 95% confidence interval (CI) for theassociationofcyberchondria and covariates. Each covariate was individually included in the regression model, and the unadjusted OR (95% CI) was estimated. Most participants were Brazilian (62.8%), women (75.5%), married (60.5%) and with children (55.6%). Average age was 42.1 years (+ 12.5). In the final model, it was found that with each increase of one year in age, the chance of a high level of cyberchondria decreased (OR=0.97; 95% CI 0.95-0.98). Brazilian dentists were 1.85 times more likely (95% CI 1.25-2.75) to have a high level of cyberchondria than Portuguese dentists. Women were 1.62 times more likely (95% CI 1.07-2.44) to have a high level of cyberchondria than men. It was concluded that young age, Brazilian nationality, and female gender favored the high level of cyberchondria among the participants in this sample during COVID-19 pandemic.

A cibercondria é um comportamento psicopatológico que atinge as pessoas que consultam compulsivamente a internet, pesquisando os sintomas das diferentes patologias de que acreditam estar sofrendo e, quando influenciadas pelo que leem, têm a certeza de possuir alguma dessas doenças. O objetivo deste estudo foi avaliar o nível de cibercondria e fatores associados entre dentistas brasileiros e portugueses. Participaram deste estudo transversal 597 dentistas brasileiros e portugueses. Eles foram contatados via WhatsApp e solicitados a preencher um questionário online na plataforma do Google Forms, no período de 17 a 31 de janeiro de 2021, durante a pandemia de COVID-19. Informações sociodemográficas foram coletadas e a cibercondria foi mensurada através da versão em língua portuguesa da Cyberchondria Severity Scale. Modelos de regressão logística binária foram usados para estimar a Odds Ratio (OR) não ajustada e ajustada e o intervalo de confiança(IC)de 95%correspondente para a associação de cibercondria e covariáveis. Cada covariável foi incluída individualmente no modelo de regressão, e o OR não ajustado (IC 95%) foi estimado. A maioria dos participantes eram brasileiros (62,8%), mulheres (75,5%), casados (60,5%) e com filhos (55,6%). A média de idade foi de 42,1 anos (+ 12,5). No modelo final, verificou-se que a cada aumento de um ano de vida, a chance de um nível elevado de cibercondria diminuía (OR = 0,97; IC95% 0,95-0,98). Os dentistas brasileiros tiveram 1,85 vezes mais probabilidade (IC95% 1,25-2,75) de apresentar alto índice de cibercondria quando comparados aos portugueses. As mulheres tinham 1,62 vezes mais probabilidade (IC 95% 1,07-2,44) de ter um alto nível de cibercondria em comparação com os homens. Concluiu-se que a idade mais jovem, a nacionalidade brasileira e o sexo feminino favoreceram o alto índice de cibercondria entre os participantes desta amostra durante a pandemia COVID-19.

Factors associated with dentists' search for oral health information during the COVID-19 pandemic.

The aim of this cross-sectional study was to evaluate the factors associated with the search by Brazilian and Portuguese dentists for oral health information on social networks during the COVID-19 pandemic. A total of 597 Brazilian and Portuguese dentists answered an online questionnaire between January 17 and 31, 2021. Respondents were asked about sociodemographic data, weight and height, hours of sleep per night, screen time for work and leisure, and where they sought information about general and/or oral health for themselves and for their loved ones and information about COVID-19. Descriptive statistics and binary regression were used for the statistical analysis. Most participants were Brazilian (62.8%) and 451 (75.5%) were female. Mean age was 42.1 years (± 12.5 years). For every lost hour of sleep, the chances of participants frequently or always searching for information about self-perceived oral health problems on lay websites increased by 1.33 times. For every additional hour spent on social networks or on the Internet, the likelihood of participants frequently searching for self-perceived oral health problems on lay websites increased by 17% (OR = 1.17; 95% CI: 1.06-1.30). Individuals who searched the Internet for information about COVID-19 symptoms before consulting their doctors were 3.85 times more likely (95% CI: 2.22-6.67) to frequently or always search for information about self-perceived oral health problems on lay websites. Dentists used lay websites to search for general and oral health knowledge during the COVID-19 pandemic, and shorter sleep duration favored screen use.

Cyberchondria and Associated Factors Among Brazilian and Portuguese Dentists / Cibercondria e fatores associados entre dentistas brasileiros e portugueses

ABSTRACT Cyberchondria is a psychopathological behavior that affects people who compulsively consult the internet, by searching the symptoms of different pathologies from which they believe they are suffering, and when influenced by what they read, are sure they have some of these diseases. The aim of this study was to assess the cyberchondria level and associated factors among Brazilian and Portuguese dentists. A total 597 Brazilian and Portuguese dentists participated in this cross-sectional study. They were contacted via WhatsApp and asked to complete an online questionnaire on the Google Forms platform, from January 17 to 31, 2021, during the COVID-19 pandemic. Sociodemographic information was collected and cyberchondria was measured using the Portuguese language version of the Cyberchondria Severity Scale. Binary logistic regression models were used to estimate the unadjusted and adjusted Odds Ratio (OR) and corresponding 95% confidence interval (CI) for the association of cyberchondria and covariates. Each covariate was individually included in the regression model, and the unadjusted OR (95% CI) was estimated. Most participants were Brazilian (62.8%), women (75.5%), married (60.5%) and with children (55.6%). Average age was 42.1 years (+ 12.5). In the final model, it was found that with each increase of one year in age, the chance of a high level of cyberchondria decreased (OR=0.97; 95% CI 0.95-0.98). Brazilian dentists were 1.85 times more likely (95% CI 1.25-2.75) to have a high level of cyberchondria than Portuguese dentists. Women were 1.62 times more likely (95% CI 1.07-2.44) to have a high level of cyberchondria than men. It was concluded that young age, Brazilian nationality, and female gender favored the high level of cyberchondria among the participants in this sample during COVID-19 pandemic.

RESUMO A cibercondria é um comportamento psicopatológico que atinge as pessoas que consultam compulsivamente a internet, pesquisando os sintomas das diferentes patologias de que acreditam estar sofrendo e, quando influenciadas pelo que leem, têm a certeza de possuir alguma dessas doenças. O objetivo deste estudo foi avaliar o nível de cibercondria e fatores associados entre dentistas brasileiros e portugueses. Participaram deste estudo transversal 597 dentistas brasileiros e portugueses. Eles foram contatados via WhatsApp e solicitados a preencher um questionário online na plataforma do Google Forms, no período de 17 a 31 de janeiro de 2021, durante a pandemia de COVID-19. Informações sociodemográficas foram coletadas e a cibercondria foi mensurada através da versão em língua portuguesa da Cyberchondria Severity Scale. Modelos de regressão logística binária foram usados para estimar a Odds Ratio (OR) não ajustada e ajustada e o intervalo de confiança (IC) de 95% correspondente para a associação de cibercondria e covariáveis. Cada covariável foi incluída individualmente no modelo de regressão, e o OR não ajustado (IC 95%) foi estimado. A maioria dos participantes eram brasileiros (62,8%), mulheres (75,5%), casados (60,5%) e com filhos (55,6%). A média de idade foi de 42,1 anos (+ 12,5). No modelo final, verificou-se que a cada aumento de um ano de vida, a chance de um nível elevado de cibercondria diminuía (OR = 0,97; IC95% 0,95-0,98). Os dentistas brasileiros tiveram 1,85 vezes mais probabilidade (IC95% 1,25-2,75) de apresentar alto índice de cibercondria quando comparados aos portugueses. As mulheres tinham 1,62 vezes mais probabilidade (IC 95% 1,07-2,44) de ter um alto nível de cibercondria em comparação com os homens. Concluiu-se que a idade mais jovem, a nacionalidade brasileira e o sexo feminino favoreceram o alto índice de cibercondria entre os participantes desta amostra durante a pandemia COVID-19.

What we know about antibiotics prescribed by dentists in a Brazilian southeastern state.

The objective of this study was to analyze possible associations between antibiotic dental prescriptions in the public health service, health service characteristics, and social characteristics of the municipalities. Using the register of dispensing in the public health service of a state in the Southeast region of Brazil, in 2017 we analyzed patterns of antibiotic prescriptions by dentists. Data were obtained from the Integrated Pharmaceutical Services Management System (SIGAF, in Portuguese). The outcome variable was the number of Daily Defined Doses (DDD) per 1,000 residents/year in each municipality. CART (Classification and Regression Tree) technique was used to determine the influence of the following variables: populational social characteristics (Human Development Index, Gini Index, the proportion of rural population and proportion of families benefiting from the Bolsa Família Program) and oral health services characteristics (access to individual dental care, number of dentists and oral health teams per 1,000 residents, and percentage of preventive and restorative individual dental procedures. Data analysis was performed using IBM SPSS Statistics 21.0. Antibiotics were the medications most prescribed by dentists in the public health service, with penicillin being the most frequently prescribed class. The average DDD/1,000 residents/year for the 421 municipalities surveyed was 96.54 (range 0.008 and 619.660). Select factors were associated with antibiotic prescriptions including access to individual dental care (Adjusted p-value ≤0.001), a number of oral health teams/1,000 inhabitants (Adjusted p-value=0.001), and Gini Index (Adjusted p-value = 0.046). Access to oral health services and inequality were associated with the use of antibiotics.