Outcomes and Costs in Patients with Immune Thrombotic Thrombocytopenic Purpura Receiving Front-Line Versus Delayed Caplacizumab: A US Hospital Database Study.

European real-world data indicate that front-line treatment with caplacizumab is associated with improved clinical outcomes compared with delayed caplacizumab treatment. The objective of the study was to describe the characteristics, treatment patterns, and outcomes in hospitalized patients with an immune-mediated thrombotic thrombocytopenic purpura (iTTP) episode treated with front-line versus delayed caplacizumab in the US. This retrospective cohort analysis of a US hospital database included adult patients (≥18 years) with an acute iTTP episode (a diagnosis of thrombotic microangiopathy and ≥1 therapeutic plasma exchange [TPE] procedure) from January 21, 2019, to February 28, 2021. Unadjusted baseline characteristics, treatment patterns, healthcare resource utilization, and costs were compared between patients who received front-line versus delayed (<2 vs ≥2 days after TPE initiation) caplacizumab treatment. Out of 39 patients, 16 (41.0%) received front-line and 23 (59.0%) received delayed treatment with caplacizumab. Baseline characteristics and symptoms were similar between the two groups. Patients who received front-line caplacizumab treatment had significantly fewer TPE administrations (median: 5.0 vs 12.0); and a significantly shorter hospital stay (median: 9.0 days vs 16.0 days) than patients receiving delayed caplacizumab therapy. Both of these were significantly lower in comparison of means (t-test P < .01). Median inpatient costs (inclusive of caplacizumab costs) were 54% higher in the delayed treated patients than in the front-line treated patients (median: $112 711 vs $73 318). TPE-specific cost was lower in the front-line treated cohort (median: $6 989 vs $10 917). In conclusion, front-line treatment with caplacizumab had shorter hospitalizations, lower healthcare resource utilization, and lower costs than delayed caplacizumab treatment after TPE therapy.

Conocimiento y Autoeficacia en Personas con Diabetes Mellitus tipo 2 / Conhecimento e Autoeficácia em Indivíduos com Diabetes Mellitus tipo 2 / Knowledge and Self-efficacy in Individuals with Type 2 Diabetes Mellitus

Objetivo: Analizar el conocimiento y la autoeficacia de personas con diabetes mellitus tipo 2. Metodología: Estudio transversal y cuantitativo, realizado en un hospital público de la ciudad de Recife - PE, con 86 personas con diabetes. Se analizaron variables sociodemográficas, clínicas y de laboratorio, además del conocimiento y autoeficacia en diabetes mediante la Diabetes Knowledge Scale y la Diabetes Management Self-efficacy Scale, respectivamente. Para el análisis se utilizó estadística descriptiva y prueba t de Student para muestras independientes para verificar homogeneidad y comparación de medias. Resultados: La mayoría de los pacientes eran del sexo femenino, menores de 60 años, con baja escolaridad, bajos ingresos y control inadecuado de la diabetes. Predominó el conocimiento insuficiente y la baja autoeficacia. El conocimiento suficiente interfirió positivamente en la autoeficacia en la práctica de ejercicio físico y el conocimiento insuficiente interfirió en la autoeficacia para la corrección de la glucemia. Los individuos eran autoeficaces independientemente de la edad. Conclusión: Fue posible identificar el perfil de conocimientos y autoeficacia de los participantes, apoyando la planificación de intervenciones de enfermería en el cuidado de personas con Diabetes Mellitus con el objetivo de promover el autocuidado. (AU)

Objetivo: Analisar o conhecimento e a autoeficácia de indivíduos com diabetes mellitus tipo 2. Metodologia: Estudo transversal e quantitativo, realizado em um hospital público da cidade do Recife – PE, com 86 indivíduos com diabetes. Foram analisadas variáveis sociodemográficas, clínicas e laboratoriais, além do conhecimento e a autoeficácia em diabetes pelo Diabetes Knowledge Scale e a Diabetes Management Self-efficacy Scale, respectivamente. Para a análise, utilizou-se estatística descritiva e teste T Student para amostras independentes na verificação da homogeneidade e comparação de média. Resultados: A maioria dos pacientes era do sexo feminino, com idade inferior a 60 anos, baixa escolaridade, baixa renda e com controle inadequado do diabetes. Prevaleceu o conhecimento insuficiente e a baixa autoeficácia. O conhecimento suficiente interferiu positivamente na autoeficácia quanto à prática de exercício físico e o conhecimento insuficiente interferiu na autoficácia para a correção da glicose sanguínea. Indivíduos foram autoeficazes independente da idade. Conclusão: Os indivíduos com diabetes têm conhecimento insuficiente e baixa autoeficácia, sendo necessário que os enfermeiros considerem tais aspectos no planejamento das intervenções de enfermagem voltadas a este público com vistas à promoção do autocuidado. (AU)

Objective: To analyze the knowledge and self-efficacy of individuals with type 2 diabetes mellitus. Methodology: A cross-sectional and quantitative study was conducted in a public hospital in Recife, PE, with 86 individuals with diabetes. Sociodemographic, clinical, and laboratory variables were analyzed, in addition to knowledge and self-efficacy in diabetes, using the Diabetes Knowledge Scale and the Diabetes Management Self-Efficacy Scale, respectively. Descriptive statistics and Student's t-test for independent samples were used to verify homogeneity and compare means. Results: Most patients were female, under 60, with low education, low income, and inadequate diabetes control. Insufficient knowledge and low self-efficacy prevailed. Sufficient knowledge positively interfered with self-efficacy regarding physical exercise, and insufficient knowledge interfered with self-efficacy for blood glucose control. Individuals were self-efficacious regardless of age. Conclusion: Individuals with diabetes have insufficient knowledge and low self-efficacy, and nurses need to consider these aspects when planning nursing interventions aimed at these persons to promote self-care. (AU)

Occurrence and Treatment of Antibiotic-Resistant Bacteria Present in Surface Water.

According to the World Health Organization, antibiotic resistance is one of the main threats to global health. The excessive use of several antibiotics has led to the widespread distribution of antibiotic-resistant bacteria and antibiotic resistance genes in various environment matrices, including surface water. In this study, total coliforms, Escherichia coli and enterococci, as well as total coliforms and Escherichia coli resistant to ciprofloxacin, levofloxacin, ampicillin, streptomycin, and imipenem, were monitored in several surface water sampling events. A hybrid reactor was used to test the efficiency of membrane filtration, direct photolysis (using UV-C light emitting diodes that emit light at 265 nm and UV-C low pressure mercury lamps that emit light at 254 nm), and the combination of both processes to ensure the retention and inactivation of total coliforms and Escherichia coli as well as antibiotic-resistant bacteria (total coliforms and Escherichia coli) present in river water at occurrence levels. The membranes used (unmodified silicon carbide membranes and the same membrane modified with a photocatalytic layer) effectively retained the target bacteria. Direct photolysis using low-pressure mercury lamps and light-emitting diode panels (emitting at 265 nm) achieved extremely high levels of inactivation of the target bacteria. The combined treatment (unmodified and modified photocatalytic surfaces in combination with UV-C and UV-A light sources) successfully retained the bacteria and treated the feed after 1 h of treatment. The hybrid treatment proposed is a promising approach to use as point-of-use treatment by isolated populations or when conventional systems and electricity fail due to natural disasters or war. Furthermore, the effective treatment obtained when the combined system was used with UV-A light sources indicates that the process may be a promising approach to guarantee water disinfection using natural sunlight.

Sentidos de (des)regulação do mercado de trabalho no setor da saúde em Portugal / Directions of health labor market (de)regulation in Portugal

Resumo Reconhece-se a escassez de investigação sobre o mercado de trabalho do setor da saúde. Com a ampliação dos fenómenos de precarização objetiva e subjetiva, decorrente da agenda neoliberal de mercadorização do valor do trabalho e das reformas gestionárias da saúde, a "atipicidade" dos vínculos laborais e a "insegurança" de vida dos profissionais de saúde têm introduzido lógicas de segmentação e polarização do mercado de trabalho. Este deixa de ser palco apenas de mercados protegidos, passando a incluir mercados desregulados e "híbridos". Neste artigo pretende-se explorar os sentidos, com implicações desiguais, da (des)regulação do mercado de trabalho no setor da saúde em Portugal. Parte-se de fontes secundárias e de investigação qualitativa suportada em 32 entrevistas semiestruturadas feitas com profissionais de saúde, que atestam o fenômeno da crescente individualização e subcontratação laboral. Propõe-se um modelo conceitual que capte os sentidos de (des)regulação, num continuum de regulação social e mobilidade profissional, traduzindo mercados protegidos (profissionais e internos) e mercados híbridos (terciarizados e secundários) a serem testados por confronto empírico e investigação futura.

Abstract The need for further research on the labor market in the health sector is acknowledged. With the expansion of the phenomena of objective and subjective precariousness, resulting from the neoliberal agenda of commodification of the value of work and the managerial reforms in health, the "atypicality" of labor ties and the "insecurity" of health professionals' lives have introduced segmentation and polarization logics into the labor market. The latter is no longer the stage for protected markets, but includes deregulated and "hybrid" markets. This article aims to explore the directions, with unequal implications, of the (de)regulation of the labor market in the health sector in Portugal. We begin from secondary and qualitative research supported by 32 semi-structured interviews with health professionals, which attest to the phenomenon of increasing individualization and labor subcontracting. A conceptual model is proposed that captures the meanings of (de)regulation, in a continuum of social regulation and professional mobility, translating protected markets (professional and internal) and hybrid markets (outsourced and secondary) to be tested by empirical confrontation and future research.

Fatores associados à capacidade para o trabalho de enfermeiros idosos / Factors associated with the capacity for the work of elderly nurses / Factores asociados a la capacidad para el trabajo de enfermeras mayores

Objetivo: Avaliar os fatores associados a capacidade para o trabalho de enfermeiros idosos. Métodos: Estudo seccional, realizado com 233 profissionais de enfermagem idosos atuantes em hospitais públicos na cidade do Recife, Pernambuco, Brasil. Os dados foram coletados por meio do Índice de Capacidade para o Trabalho e questionário estruturado, sendo analisados posteriormente por estatística descritiva e inferencial. Resultados: A capacidade para o trabalho foi considerada boa 119(51%) e esteve associada a raça negra/parda (p-valor = 0,030) e ao fato de não possuir um segundo emprego (p-valor = 0,010). Conclusão: A raça e a quantidade de empregos acumulados são fatores que interferem na capacidade para o trabalho de profissionais de enfermagem idosos, permitindo subsidiar estratégias visando promover a saúde e o bem-estar no trabalho. (AU)

Objective: To evaluate the factors associated with the work capacity of elderly nurses. Methods: Sectional study conducted with 233 elderly nursing professionals working in public hospitals in the city of Recife, Pernambuco, Brazil. Data were collected through the Work Ability Index and a structured questionnaire, which were subsequently analyzed using descriptive and inferential statistics. Results: The ability to work was considered good 119 (51%) and was associated with the black / brown race (p-value = 0.030) and the fact of not having a second job (p-value = 0.010). Conclusion: The race and the amount of accumulated jobs are factors that interfere in the work capacity of elderly nursing professionals, allowing to subsidize strategies to promote health and well-being at work. (AU)

Objetivo: Evaluar factores asociados a la capacidad laboral de enfermeras ancianas. Métodos: Estudio transversal realizado con 233 ancianos profesionales de enfermería que laboran en hospitales públicos de la ciudad de Recife, Pernambuco, Brasil. Los datos fueron recolectados mediante el Work Ability Index y un cuestionario estructurado, y posteriormente analizados mediante estadística descriptiva e inferencial. Resultados: la capacidad para el trabajo se consideró buena 119 (51%) y se asoció con la raza negra / morena (valor de p = 0,030) y no tener un segundo trabajo (valor de p = 0,010). Conclusión: La raza y la cantidad de puestos de trabajo acumulados son factores que interfieren en la capacidad laboral de los profesionales de enfermería de edad avanzada, permitiendo estrategias de subsidio para promover la salud y el bienestar en el trabajo. (AU)

Factors associated with absenteeism in elderly nursing workers.

OBJECTIVE: To analyze the factors associated with absenteeism in elderly nursing workers. METHODS: Cross-sectional study with 233 elderly nursing workers carried out in six hospitals in Recife, Pernambuco, Brazil. The data were analyzed using univariate analysis and multivariate regression. RESULTS: Of the 233 elderly nursing professionals interviewed, self-reported absenteeism was present in 34.3% (80) participants. 20.1% (47) of them reported having missed a few days and 14.2% (33) having done so in many days. After adjusted analysis, only work hours and satisfaction with health influenced absenteeism. CONCLUSION: Absenteeism is a complex phenomenon which, among elderly nursing professionals, had a low prevalence and was associated with a workload of more than 40 hours a week and dissatisfaction with health. Therefore, further research is needed in the field to provide quality of life and better working conditions for nursing professionals and regulate their workload.

Late peripheral facial paralysis after COVID-19: a rapid systematic review and two case reports.

Peripheral facial paralysis (PFP) has been shown to be a neurological manifestation of COVID-19. The current study presents two cases of PFP after COVID-19, along with a rapid review of known cases in the literature. Both case reports were conducted following CARE guidelines. We also performed a systematic review of PFP cases temporally related to COVID-19 using PubMed, Embase, and Cochrane Library databases on August 30, 2021, using a rapid review methodology. The two patients experienced PFP 102 and 110 days after COVID-19 symptom onset. SARS-CoV-2 RNA was detected in nasal samples through reverse-transcription real-time polymerase chain reaction (RT-qPCR) testing. Anosmia was the only other neurological manifestation. PFP was treated with steroids in both cases, with complete subsequent recovery. In the rapid review, we identified 764 articles and included 43 studies. From those, 128 patients with PFP were analyzed, of whom 42.1% (54/128) were male, 39.06% (50/128) female, and in 23 cases the gender was not reported. The age range was 18 to 59 (54.68%). The median time between COVID-19 and PFP was three days (ranging from the first symptom of COVID-19 to 40 days after the acute phase of infection). Late PFP associated with COVID-19 presents mild symptoms and improves with time, with no identified predictors. Late PFP should be added to the spectrum of neurological manifestations associated with the long-term effects of SARS-CoV-2 infection as a post COVID-19 condition.

A Study on Biofouling and Cleaning of Anion Exchange Membranes for Reverse Electrodialysis.

This study covers the modification, (bio)fouling characterization, use, and cleaning of commercial heterogeneous anion exchange membranes (AEMs) to evaluate their feasibility for reverse electrodialysis (RED) applications. A surface modification with poly (acrylic) acid resulted in an improved monovalent perm-selectivity (decreased sulfate membrane transport rate). Moreover, we evaluated the (bio)fouling potential of the membrane using sodium dodecyl sulfate (SDS), sodium dodecyl benzenesulfonate (SDBS), and Aeromonas hydrophila as model organic foulants and a biofoulant, respectively. A detailed characterization of the AEMs (water contact angle, ion exchange capacity (IEC), scanning electron microscopy (SEM), cyclic voltammetry (CV), and Fourier Transform Infrared (FTIR) spectra) was carried out, verifying that the presence of such foulants reduces IEC and the maximum current obtained by CV. However, only SDS and SDBS affected the contact angle values. Cleaning of the biofouled membranes using a sodium hypochlorite aqueous solution allows for (partially) recovering their initial properties. Furthermore, this work includes a fouling characterization using real surface and sea water matrixes, confirming the presence of several types of fouling microorganisms in natural streams. A lower adhesion of microorganisms (measured in terms of total bacteria counts) was observed for the modified membranes compared to the unmodified ones. Finally, we propose a cleaning strategy to mitigate biofouling in AEMs that could be easily applied in RED systems for an enhanced long-term process performance.

Malignancy risk of thyroid nodules: quality assessment of the thyroid ultrasound report.

BACKGROUND: Thyroid nodules are a challenge in clinical practice and thyroid ultrasonography is essential for assessing the risk of malignancy. The use of ultrasound-based malignancy risk classification systems has been recommended by several scientific societies but radiologist's adherence to these guidelines may vary. The authors aimed to analyze the quality of the information provided by the thyroid ultrasound report, to assess the malignancy risk of thyroid nodules, in Portugal. METHODS: Multicenter and retrospective study, conducted in three of the five Portuguese NUTS2 corresponding to about 88.3% of the mainland population. We included 344 consecutive unselected participants aged ≥ 18 years who underwent thyroid ultrasonography in 2019. The description of six features of the dominant thyroid nodule was analyzed: maximum size, shape, margins, composition, echogenicity and echogenic foci. A utility score, including these six features, was used as an indicator of the report's quality. A score of 4 was considered as a minimum value. RESULTS: Maximum diameter was reported for all nodules. Shape, margins, composition, echogenicity and echogenic foci were reported in 8.1%, 25.0%, 76.5%, 53.2% and 20.9%, respectively. Only 21.8% of the nodules had a score ≥ 4. At least one of four suspicious features, including marked hypoechogenicity, microcalcifications, irregular margins and non-oval shape, was identified in 8.7% of the nodules. Cervical lymph nodes' status was reported in 93% of the exams. The risk category was only reported in 7.8% of the participants. CONCLUSION: The adherence of Portuguese radiologists to a standardized reporting model and to an ultrasound-based malignancy risk stratification system is still low and has implications for the correct characterization of the malignancy risk of nodules and the decision to perform fine-needle aspiration biopsy.

Factors associated with absenteeism in elderly nursing workers / Factores asociados al absentismo en trabajadores de enfermería de edad avanzada / Fatores associados ao absenteísmo em trabalhadores idosos de enfermagem

ABSTRACT Objective: To analyze the factors associated with absenteeism in elderly nursing workers. Methods: Cross-sectional study with 233 elderly nursing workers carried out in six hospitals in Recife, Pernambuco, Brazil. The data were analyzed using univariate analysis and multivariate regression. Results: Of the 233 elderly nursing professionals interviewed, self-reported absenteeism was present in 34.3% (80) participants. 20.1% (47) of them reported having missed a few days and 14.2% (33) having done so in many days. After adjusted analysis, only work hours and satisfaction with health influenced absenteeism. Conclusion: Absenteeism is a complex phenomenon which, among elderly nursing professionals, had a low prevalence and was associated with a workload of more than 40 hours a week and dissatisfaction with health. Therefore, further research is needed in the field to provide quality of life and better working conditions for nursing professionals and regulate their workload.

RESUMEN Objetivo: Analizar los factores asociados al absentismo en trabajadores de enfermería ancianos. Métodos: Estudio transversal con 233 trabajadores de enfermería de edad avanzada realizado en seis hospitales de Recife, Pernambuco, Brasil. Los datos se analizaron mediante análisis univariado y regresión multivariada. Resultados: De los 233 profesionales de enfermería ancianos entrevistados, el ausentismo autonotificado estuvo presente en el 34,3% (80) de los participantes. De estos, el 20,1% (47) informó haber perdido algunos días y el 14,2% (33) muchos días. En el análisis ajustado, solo las horas trabajadas y la satisfacción con la salud influyeron en el absentismo. Conclusión: El absentismo es un fenómeno complejo y entre los profesionales de enfermería ancianos tuvo baja prevalencia y se asoció con una carga de trabajo de más de 40 horas a la semana y la insatisfacción con la salud. Por lo tanto, más investigaciones sobre el tema son necesarias para traer calidad de vida y mejores condiciones laborales a los profesionales de enfermería y regular su carga de trabajo.

RESUMO Objetivo: Analisar os fatores associados ao absenteísmo em trabalhadores idosos de enfermagem. Métodos: Estudo transversal com 233 trabalhadores idosos de enfermagem realizado em seis hospitais do Recife, Pernambuco - BR. A análise de dados foi univariada e regressão multivariada. Resultados: Dos 233 profissionais de enfermagem idosos entrevistados, o absenteísmo autorreferido esteve presente em 34,3% (80) dos participantes. From them, 20.1% (47) reported having missed few days, while 14.2% (33) stated to have missed many days. Na análise ajustada, apenas as horas trabalhadas e a satisfação com a saúde influenciaram o absenteísmo. Conclusão: O absenteísmo é um fenômeno complexo e entre os profissionais de enfermagem idosos apresentou baixa prevalência e esteve associado a carga horária de trabalho acima de 40 horas semanais e a insatisfação com a saúde. Portanto, se faz necessário novas pesquisas na área para fornecer qualidade de vida e melhores condições de trabalho aos profissionais de enfermagem e regulamentação de sua carga horária.

Qualidade de vida segundo comorbidades mais prevalentes em idosos com o vírus da imunodeficiência adquirida / Quality of life according to the most prevalent comorbidities in the elderly with the acquired immunodeficiency virus / Calidad de vida según las comorbilidades más prevalentes en el anciano con el virus de la inmunodeficiencia adquirida

Objetivo: avaliar a qualidade de vida segundo as comorbidades mais prevalentes em idosos com HIV. Método: estudo transversal realizado com 241 idosos de ambos os sexos usuários dos serviços de referência para acompanhamento do paciente com HIV. Os dados foram obtidos por meio da entrevista face a face com o preenchimento de um questionário sociodemográfico e clínico além do HIV/AIDS Target-Quality of life. Resultados: as três comorbidades mais prevalentes foram hipertensão, diabetes e osteoporose e dentre todas as comorbidades encontradas, apenas a hipertensão e o diabetes não apresentaram diferença estatisticamente significante com nenhuma das dimensões do HIV/AIDS Target-Quality of life. Conclusão: osteoporose e osteoartrose são as comorbidades que tem impacto em mais dimensões da qualidade de vida

Objective: to assess quality of life according to the most prevalent comorbidities in elderly people with HIV. Method: cross-sectional study carried out with 241 elderly people of both sexes, users of reference services for monitoring HIV patients. The data were obtained through a face-to-face interview by completing a sociodemographic and clinical questionnaire in addition to the HIV / AIDS Target-Quality of life. Results: the three most prevalent comorbidities were hypertension, diabetes and osteoporosis and among all the comorbidities found, only hypertension and diabetes did not show a statistically significant difference with any of the dimensions of HIV / AIDS Target-Quality of life. Conclusion: osteoporosis and osteoarthritis are comorbidities that have an impact on more dimensions of quality of life

Objetivo: evaluar la calidad de vida según las comorbilidades más prevalentes en ancianos con VIH. Método: estudio transversal realizado con 241 ancianos de ambos sexos, usuarios de servicios de referencia para el seguimiento de pacientes con VIH. Los datos se obtuvieron a través de una entrevista presencial mediante la cumplimentación de un cuestionario sociodemográfico y clínico además de la HIV/AIDS Target-Quality of life. Resultados: las tres comorbilidades más prevalentes fueron hipertensión, diabetes y osteoporosis y entre todas las comorbilidades encontradas, solo la hipertensión y la diabetes no mostraron diferencia estadísticamente significativa con ninguna de las dimensiones de HIV/AIDS Target-Quality of life. Conclusión: la osteoporosis y la osteoartritis son comorbilidades que repercuten en más dimensiones de la calidad de vida

Late peripheral facial paralysis after COVID-19: a rapid systematic review and two case reports

Peripheral facial paralysis (PFP) has been shown to be a neurological manifestation of COVID-19. The current study presents two cases of PFP after COVID-19, along with a rapid review of known cases in the literature. Both case reports were conducted following CARE guidelines. We also performed a systematic review of PFP cases temporally related to COVID-19 using PubMed, Embase, and Cochrane Library databases on August 30, 2021, using a rapid review methodology. The two patients experienced PFP 102 and 110 days after COVID-19 symptom onset. SARS-CoV-2 RNA was detected in nasal samples through reverse-transcription real-time polymerase chain reaction (RT-qPCR) testing. Anosmia was the only other neurological manifestation. PFP was treated with steroids in both cases, with complete subsequent recovery. In the rapid review, we identified 764 articles and included 43 studies. From those, 128 patients with PFP were analyzed, of whom 42.1% (54/128) were male, 39.06% (50/128) female, and in 23 cases the gender was not reported. The age range was 18 to 59 (54.68%). The median time between COVID-19 and PFP was three days (ranging from the first symptom of COVID-19 to 40 days after the acute phase of infection). Late PFP associated with COVID-19 presents mild symptoms and improves with time, with no identified predictors. Late PFP should be added to the spectrum of neurological manifestations associated with the long-term effects of SARS-CoV-2 infection as a post COVID-19 condition.

Association of clinical, social and environmental variables with dental caries prevalence in adolescents from a Brazilian municipality supplied with fluoridated water / Associação de variáveis clínicas, sociais e ambientais sobre a cárie dentária em adolescentes de um município brasileiro com água fluoretada

Abstract Background Although a trend towards dental caries reduction has been observed, further investigations on its pattern and development are still needed. Objective To investigate the influence of clinical, social and environmental variables on dental caries prevalence in adolescents from a Brazilian municipality supplied with fluoridated water in 2018. Method This study was conducted with a non-probabilistic sample of 277 adolescents aged 12 years of public schools in Nova Friburgo, state of Rio de Janeiro, Brazil. Clinical examinations were carried out by calibrated examiners to assess caries, periodontal disease, and fluorosis according to criteria of the World Health Organization (WHO). Semi-structured questionnaires were applied to record socio-environmental information. Results Individuals living in regions supplied with fluoridated water below the minimum required levels (OR=3.60, p=0.0006), with low income (OR=1.90, p=0.0444), presence of gingivitis (OR=3.36; p=0.0016), and whose reason for visiting the dentist was dental treatment (OR=2.41; p=0.0203) were more likely to have dental caries. A significant reduction (p<0.0001) in dental caries indexes was observed between 2012 and 2018. Conclusion Fluoridation of public water supply at unsuitable levels, as well as other social and clinical variables can influence the caries pattern in adolescents.

Resumo Introdução A tendência de redução da cárie dentária tem sido constatada, apesar de maiores investigações sobre seu padrão e desenvolvimento serem ainda necessárias. Objetivo investigar a influência de variáveis clínicas, sociais e ambientais sobre a cárie em adolescentes de um município brasileiro com água fluoretada, no ano de 2018. Método Empregou-se uma amostra não probabilística de 277 adolescentes de 12 anos, de escolas públicas de Nova Friburgo, Rio de Janeiro, Brasil. Exames clínicos foram realizados por examinadores calibrados, para avaliação de cárie, doença periodontal e fluorose, sob critérios da Organização Mundial da Saúde (OMS). Questionários semiestruturados foram aplicados para coletar informações socioambientais. Resultados Indivíduos residentes em regiões com flúor na água em subdoses (OR=3,60, p=0,0006), e aqueles com baixa renda (OR =1,90, p=0,0444), com presença de gengivite (OR = 3,36; p = 0,0016) e cuja razão para a visita ao dentista foi para tratamento dentário (OR=2,41; 0,0203), apresentaram mais chances de terem cárie. Uma redução significativa (p<0,0001) nos índices de cárie foi observada entre 2012 (primeiro levantamento epidemiológico) e 2018. Conclusão A fluoretação das águas de abastecimento público, quando em níveis não adequados, assim como outras variáveis sociais e clínicas, podem influenciar o padrão de cárie nos adolescentes.

Evidence of altitudinal gradient modifying genomic and chemical diversity in populations of Lychnophora pinaster Mart.

Lychnophora pinaster Mart. (Asteraceae) is endemic to the Brazilian Cerrado. It is distributed along the altitudinal gradient of the mountainous ranges of the state of Minas Gerais. This study aimed to evaluate the influence of altitude on the genetic diversity of L. pinaster populations and the effects of altitude and climatic factors on essential oil chemical composition. Essential oils from L. pinaster populations from the north (North 01, North 02, and North 03, 700-859 m) and the Metropolitan region of Belo Horizonte (MhBH 01 and MrBH 02, 1366-1498 m) were analyzed. SNP markers from L. pinaster in these regions and Campos das Vertentes (CV 01, CV 02, and CV 03, 1055-1292 m) were also analyzed. The main compounds in essential oils were 14-hydroxy-α-humulene (North 01 and North 03), cedr-8(15)-en-9-α-ol (North 02), 14-acetoxy-α-humulene (MrBH 01), and 4-oxo-15-nor-eudesman-11-ene (MrBH 02). Hierarchical cluster and heatmap analyses showed that the North and MrBH populations included five different groups, indicating the chemical composition of essential oils is distinct in each population. Furthermore, principal component analysis showed that higher altitudes (1366 m and 1498 m) in the MrBH influence the chemical composition of essential oils, and climatic factors determine the chemical composition in North region. The genetic diversity showed that most alleles are in Hardy-Weinberg equilibrium and imply high genetic variation and genetic polymorphisms between populations. Furthermore, the results of Mantel tests (R = 0.3861517; p = 0.04709529; R = 0.9423121; p = 0.02739726) also showed that higher altitude (>1360 m) shapes the genetic diversity at the MrBH. The genetic structure showed that higher altitudes (>1360 m) contribute to the structure of the MrBH populations, but not to North and CV populations. Therefore, the altitudinal ranges of Minas Gerais mountainous ranges determine the higher genetic and chemical diversity of L. pinaster populations.

Correlation between quality of life, depression, satisfaction and functionality of older people with HIV.

OBJECTIVE: To analyze the correlation between the quality of life, depression, life satisfaction, and functional capacity in elderly people living with the Human Immunodeficiency Virus (HIV). METHODS: A cross-sectional study developed in reference hospitals for treatment and follow-up of people with HIV. 241 elderly people participated by applying a questionnaire containing sociodemographic variables, the HIV/AIDS target quality of Life, the Barthel Index, the Life Satisfaction Scale, and the abbreviated version with 15 items of the Yesavage Geriatric Depression Scale. RESULTS: The analyses showed an inverse correlation between the dimensions of the HAT-Qol with depression, a positive correlation in the domain satisfaction with life, and statistically significant, but weak, with functionality. CONCLUSION: Depression impairs quality of life in all dimensions, while life satisfaction influences this aspect more positively than functional capacity. DESCRIPTORS: Quality of Life; Depression; Personal Satisfaction; Aged; HIV.