Prevalencia de urticaria crónica: un estudio en población pediátrica de un hospital general / Prevalence of chronic urticaria: A study in the pediatric population of a general hospital

Introducción. La urticaria crónica es una afección inflamatoria de la piel caracterizada por presencia de habones evanescentes y/o angioedema, que ocurren durante un período ≥ 6 semanas. Objetivo. Determinar la prevalencia de esta enfermedad y describir características clínicas en niños y adolescentes menores de 19 años de un hospital general. Población y métodos. Estudio corte transversal, realizado entre el 2015 y el 2020, en una población de niños y adolescentes de un sistema de salud privado. Resultados. Se revisaron 1567 historias clínicas de pacientes con urticaria atendidos durante el período de estudio. Se identificaron 36 pacientes con urticaria crónica; se estableció una prevalencia del 0,16 % (IC95% 0,11-0,22). Conclusión. La prevalencia de urticaria crónica en niños y adolescentes fue del 0,16 %. Se observó mayor frecuencia en el sexo femenino y adolescentes.

Introduction. Chronic urticaria is an inflammatory skin condition characterized by the presence of evanescent wheals or angioedema that last for ≥ 6 weeks. Objective. To determine the prevalence of urticaria and describe its clinical characteristics in children and adolescents under 19 years of age in a general hospital. Population and methods. This was a cross-sectional study carried out between 2015 and 2020 in a population of children and adolescents seen at a private healthcare facility. Results. A total of 1567 medical records of patients with urticaria seen during the study period were reviewed. Thirty-six patients with chronic urticaria were identified; the prevalence was 0.16% (95% CI: 0.11­0.22). Conclusion. The prevalence of chronic urticaria in children and adolescents was 0.16%. A higher frequency was observed among girls and adolescents.

Prevalencia de hipertirotropinemia neonatal comoindicador de deficiencia de yodo en la provincia de La Pampa: un análisis epidemiológico / Prevalence of high neonatal thyroid stimulating hormone levels as an indicator of iodine deficiency in the province of La Pampa: An epidemiological analysis

Introducción. El yodo desempeña un rol fundamental en el metabolismo, el crecimiento y el desarrollo humano. Durante el embarazo y la infancia, la demanda de este micronutriente aumenta considerablemente. La tirotropinemia neonatal (TSHn) aumentada, definida como TSHn ≥5 mUI/l, es un marcador que señala la deficiencia de yodo en una población cuando su prevalencia supera el 3 %. Objetivo. Determinar la prevalencia de TSHn ≥ 5 en La Pampa durante el período 2021-2022, analizar su correlación con diferentes variables y compararla con datos de una cohorte histórica. Población y métodos. Estudio transversal, de diseño descriptivo-analítico, sobre una población de neonatos nacidos en las cinco zonas sanitarias de la provincia de La Pampa durante los años 2021 y 2022. Resultados. De los 5778 neonatos evaluados, el 9,6 % presentó niveles de TSHn ≥5 mUI/l. El 70,4 % de estas mediciones fueron realizadas después del tercer día de vida. No se observaron diferencias significativas en la frecuencia de niveles elevados de TSHn según el año de nacimiento, peso al nacer o días hasta la extracción. Se registró una mayor prevalencia en el sexo masculino (10,6 % versus 8,5 %; p = 0,007) y entre los neonatos nacidos a término (9,8 % versus 6,6 %; p = 0,02). La prevalencia de hipertirotropinemia fue superior a la observada en una cohorte de 2001-2002. Conclusiones. La prevalencia de hipertirotropinemia neonatal en La Pampa durante los años 2021 y 2022 fue del 9,6 %, lo que indica un estado de deficiencia leve de yodo en la provincia, superior al reportado hace dos décadas.

Introduction. Iodine plays a key role in human metabolism, growth, and development. During pregnancy and childhood, the demand for this micronutrient increases notably. Increased neonatal thyroid stimulating hormone (nTSH) levels, defined as nTSH ≥ 5 mIUL, are a marker of iodine deficiency in a population if its prevalence is higher than 3%.Objective. To establish the prevalence of nTSH ≥ 5 in La Pampa in the 2021­2022 period, analyze its correlation with different variables, and compare it with data from a historical cohort.Population and methods. Cross-sectional, descriptive-analytical study in a population of newborn infants born in the 5 health regions of the province of La Pampa in 2021 and 2022. Results. Of  the  5778  assessed  newborn  infants,  9.6%  had  nTSH  levels  ≥  5  mIU/L. It was reported that 70.4% of these measurements were done after the third day of life. No significant differences were observed in the frequency of high nTSH levels by year of birth, birth weight, or days until samplecollection.A higher prevalence was observed among male infants (10.6% versus 8.5%; p = 0.007) and term infants (9.8% versus 6.6%; p = 0.02). The prevalence of high TSH levels was superior to that observed in the 2001­2002 cohort. Conclusions. The  prevalence of high nTSH levels in La Pampa during 2021 and 2022 was 9.6%, suggesting the presence of mild iodine deficiency in the population of this province, higher that what  had been reported 2 decades ago.

Prevalence of depressive symptoms among young adults in Brazil: Results of the 2013 and 2019 editions of the National Health Survey.

OBJECTIVE: To estimate the prevalence of depressive symptoms in the population aged 18 to 24, according to socioeconomic and demographic aspects in Brazil, comparing its evolution between 2013 and 2019. METHODS: Cross-sectional study carried out with secondary data obtained from National Health Survey 2013 and 2019. It were included 7,823 young adulthood (aged 18 to 24) from 2013 and 8,047 from 2019. The instrument used to assess depression was the Patient Health Questionnaire-9 (PHQ-9). All estimates included population weights and complex sampling. RESULTS: The prevalence of depression almost doubled: 10.9% (95%CI 9.6-12.2) in 2019, compared to 5.6% (95%CI 4.8-6.4) in 2013, an absolute difference of 5.3% (4.5-6.0) greater. Women were the most affected in both surveys, with an increase between 2013 (8.3%; 95%CI 6.9-9.6) and 2019 (15.6%; 95%CI 13.5-17.6) higher than that of men (2013: 2.9%; 95%CI 2.0-3.8 and 2019: 6.2%; 95%CI 4.7-7.7). In both sexes, the pattern of increase was greater for the groups aged 18 to 20, not participating in religious activities, who were at the lowest levels of education and income, who lived with two or three or more people, who lived in the Northeast, Southeast, capitals and metropolitan areas of the country. CONCLUSION: There was a significant increase in the prevalence of depressive symptoms over the six years between the two surveys. However, this increase did not occur homogeneously among the characteristics analyzed, indicating population groups and locations in Brazil where the presence of these symptoms increased most in the period.

Prevalence, reasons and factors associated with intentional nonadherence to prescribed medications: a population-based study.

OBJECTIVE: To evaluate the frequency, reasons and factors associated with intentional nonadherence to drug therapy. METHODS: A population-based cross-sectional study was conducted with data from the National Survey on Access, Use and Promotion of Rational Use of Medicines (PNAUM). The questionnaire consisted of sociodemographic questions, presence of chronic diseases, medication use, self-rated health, and medication use behaviors. Data analysis included Poisson regression models adjusted for variance. RESULTS: A total of 31,573 individuals were included, most of whom were women (53.8%), with low level of education (57.7%), and self-rated good health (56.5%). Of those interviewed, 8.8% reported increasing the medication dose and 21.2% reported reducing it. The most common reason for dose reduction was the adverse effects of the medication. There were no differences in the reasons for increasing doses. Increasing or reducing doses were most commonly reported by younger people, with lower per capita income and worse self-rated health. CONCLUSION: A considerable portion of the respondents did not intentionally adhere to drug therapy. Understanding nonadherence and identifying those who practice it is crucial for creating effective strategies that promote adherence to treatment and prioritize patients' needs and perspectives.

Analysis of reported cases of repeated violence in Espírito Santo.

OBJECTIVES: Identify the frequency of recurrent violence in cases reported in Espírito Santo and the associated factors. METHODS: Cross-sectional study. Which included data on violence in Espírito Santo from 2011 to 2018, from the Notifiable Diseases Information System, and, Statistical analyzes were performed using the chi-square test and Poisson regression. RESULTS: 54.2% (N:14.966) of reported cases of violence are repeated, and higher prevalences were associated with female sex (PR:1.54), child (PR: 1.29) or elderly victims (PR: 1.25), the presence of disabilities/disorders (PR:1.42) and occurrence in urban/peri-urban areas (PR: 1.10). Furthermore, there is a greater frequency of injuries caused by a single aggressor (PR: 1.20), man (PR: 1.28), aged 25 or over (PR: 1.09), known to the victim (PR: 2.81) and at home (PR: 1.69). CONCLUSION: The reported cases of violence showed a high frequency of recurrence, and were associated with the studied characteristics of the victim, the aggressor and the event.

Prevalence of temporomandibular joint dysfunction in patients with ankylosing spondylitis and comparison of the findings with healthy controls.

OBJECTIVE: This study aimed to assess the prevalence of temporomandibular dysfunction in ankylosing spondylitis patients and healthy controls, examining the relationship between temporomandibular dysfunction and disease activity in ankylosing spondylitis patients, as well as associations with psychosocial factors. METHODS: The study included 113 ankylosing spondylitis patients and 110 healthy individuals aged 18-75. Temporomandibular dysfunction presence was evaluated using Diagnostic Criteria for Temporomandibular Disorders Axis I. Disease activity was assessed with the Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Metrology Index, and Bath Ankylosing Spondylitis Functional Index. RESULTS: Among healthy individuals, 60.9% did not receive a temporomandibular dysfunction diagnosis, while 39.1% received at least one diagnosis. In contrast, 69.9% of the 113 ankylosing spondylitis patients received at least one temporomandibular dysfunction diagnosis, and only 30.1% were not included in any diagnosis group (p<0.001). Joint (p=0.001) and pain disorders (p=0.008) were significantly more common in the ankylosing spondylitis group than in the healthy controls. Significant associations emerged between Bath Ankylosing Spondylitis Disease Activity Index (p<0.001) and Bath Ankylosing Spondylitis Functional Index (p=0.005) scores and pain disorders. CONCLUSION: Temporomandibular dysfunction is more prevalent in ankylosing spondylitis patients than in healthy individuals, linked to increased joint issues and pain associated with disease activity. CLINICALTRIALS.GOV ID: NCT05839925.

Prevalence of pulp canal obliteration after traumatic dental injuries: a systematic review and meta-analysis.

This systematic review aimed to answer the following question: What is the estimated prevalence of pulp canal obliteration in subtypes of traumatic dental injury (TDI) in deciduous and permanent teeth? The searches were conducted in PubMed, Embase, Scopus, Web of Science, LILACS, Grey Literature, and Google Scholar, and complemented by a manual search, until April 16th, 2023. Observational studies were selected based on population, exposure, and outcome (PEO) (P, deciduous or permanent teeth; E, TDI; O, pulp canal obliteration). Two reviewers (kappa 0.90) applied the eligibility criteria, extracted qualitative data, and assessed the methodological quality using the Newcastle-Ottawa tool. A meta-analysis was performed using MedCalc 17.2. Thirty-four articles were selected after screening. The methodological quality was moderate to high. The estimated prevalence of pulp canal obliteration was 27.6% (95%CI: 18.7-37.7) and 21.9% (95%CI:16.0-28.4), for permanent and deciduous teeth, respectively. Considering the TDI subtypes, the prevalence of pulp canal obliteration was higher in root fractures of the permanent teeth (78.6 %, 95%CI: 62.8-90.9) and lateral luxation injuries in deciduous teeth (29.4%, 95%CI:19.1-41.0). Our review of 34 articles of moderate and high methodological quality found that the prevalence of pulpal canal obliteration ranges from 21.9% to 27.6%. Pulp canal obliteration was most frequently detected following lateral luxation injuries of the deciduous teeth and root fractures of the permanent teeth (PROSPERO CRD42020179438).

A cascade of care for diabetes in people living with HIV in a tertiary care center in Mexico City.

BACKGROUND: Diabetes affects 4.5% of people living with HIV in Mexico. This study aims to describe the diabetes cascade of care (DMC) in people with HIV in a tertiary center in Mexico City. METHODS: We conducted a single-center review of people with HIV aged over 18, using medical records of active people enrolled at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ) HIV Clinic (HIVC). Our analysis focused on their last visit to describe the DMC, aiming to identify gaps in control goals. We included people who had a consultation within the 12 months preceding May 2020. RESULTS: Out of the 2072 active people, medical records were available for 2050 (98.9%). Among these, 326 people (15.9%) had fasting glucose (FG) abnormalities, of which 133 (40.7%) had diabetes. The prevalence of diabetes among people with HIV was of 6.4% (133/2050). Regarding the DMC, the following proportions of people achieved control goals: 133/133 (100%) received medical care in the last 12 months, 123/123 (100%) had blood pressure (BP) <140/90 mmHg, 73/132 (55.3%) had LDL cholesterol (c-LDL) <100 mg/dl, 63/132 (47.7%) had FG <130 mg/dl, 50/116 (43.1%) had glycosylated hemoglobin (HbA1c) <7%. ABC goals (HbA1c <7%, c-LDL <100 mg/dl, BP <140/90 mmHg) were met in 28/109 (25.6%) people. 126/133 (94%) people with HIV achieved HIV-viral load <50 copies/mL. CONCLUSIONS: Despite the high rate of viral suppression among people with HIV and diabetes, significant challenges remain in achieving comprehensive diabetes control. These findings highlight the need for targeted interventions to improve metabolic outcomes and the overall management of diabetes in people with HIV.

Ticks (Acari: Ixodidae) and tick-borne agents associated with domestic dogs in an environmental protection area in Brazil, with molecular evidence of Rhipicephalus linnaei (Audouin, 1826).

Wild animals and domestic dogs living in human dwellings near forested areas can share ectoparasites, including ticks. In this study, we surveyed ticks associated with dogs which tutors living in the Palmares Environmental Protection Area (EPA Palmares). Dogs were classified into three categories, domiciled, semi-domiciled and wandering dogs according to dog care/ type of dwelling. Ticks were collected monthly from January to December, 2020. Overall, 60 (33.9%) out of 177 examined dogs were infested by ticks. Six species of ticks were identified: Rhipicephalus linnaei, Amblyomma aureolatum, Amblyomma sculptum, Amblyomma ovale, Amblyomma dubitatum and Rhipicephalus microplus. The overall prevalence and presence in semi-domicilied+wandering dogs was higher for A. aureolatum than for R. linnaei by the Chi-square statistic tests. A random sample of 50 ticks, collected from 22 different dogs, were processed through molecular analyses. Ticks were submitted to DNA extraction and also by PCR, using specific primers in order to pathogens monitoring. Four males of A. aureolatum yielded DNA sequences (350 bp) that were 100% identical to the type strain of Rickettsia bellii in GenBank (CP000087).

Unveiling the hidden threat: investigating gastrointestinal parasites and their costly impact on slaughtered livestock.

This study investigated the prevalence of gastrointestinal (GI) parasites in ruminants slaughtered at the abattoir in district Narowal, Punjab, Pakistan. The overall prevalence of parasitic infection was determined to be 72.92% based on faecal examination. Among the ruminant species, goats exhibited a significantly higher (P < 0.05) prevalence of parasitic infection (78.63%) compared to cattle, buffalo, and sheep. Additionally, female ruminants showed a significantly higher (P<0.05) prevalence of infection (85.62%) compared to males (65.13%). The intestines (both small and large) of small and large ruminants were found to be significantly more affected, with a prevalence of 39.58% of parasitic infection compared to other examined organs. A total of ten parasitic genera were identified in ruminants, including hydatid cysts. Ruminants with a high burden of parasites (45.74%) significantly outnumbered those with light (23.40%) and moderate (30.85%) burdens. Economically, the estimated annual losses in Pakistan due to organ condemnation with GI parasites were substantial, amounting to Pak. Rs. 405.09/- million (USD = 1,428,760). These findings underscore the significance of GI parasite infections as a major animal health concern and a cause of significant economic losses in the research area.

Refractive error and ocular alignment in school-aged children from low-income areas of São Paulo, Brazil.

BACKGROUND: Uncorrected refractive errors and amblyopia are reported as the two main causes of childhood visual impairment and blindness worldwide. Our purpose was to evaluate refractive status, ocular alignment and effective refractive error coverage (eREC) of school-aged children from low-income areas of Sao Paulo city, Brazil. METHODS: Data from the "Ver na Escola" Project were used for the current study. Children enrolled in the selected schools had an ophthalmic exam including eye alignment assessed by cover test, automatized and subjective dynamic and static refraction. The associations of demographic variables with occurrence and magnitude of refractive errors and eREC were investigated by multiple logistic regressions and multilevel mixed effect models. RESULTS: A total of 17,973 children (51.12% females) with mean ± sd age 8.24 ± 3.54 years old examined from July 2018 to July 2019, were included in the study. Most of the participants (73%) showed orthoposition of the visual axis for both distance and near. Heterophoria was found in about 25% of participants (N = 4,498), with 71.7% of them (N= 3,222) classified as exophoria. Less than 2% (N = 232) showed strabismus, most of them (N = 160) esotropia. Overall, 1,370 (7.70%) of participants had myopia and 577 (3.24%) had hyperopia. Age was found to be significantly associated with increasing static subjective refraction spherical equivalent (Coefficient: -0.18; 95% Confidence Interval (CI): -0.21 to -0.16; p < 0.001). Female sex (Odds Ratio (OR) = 1.13; 95%CI: 1.01-1.27; p = 0.027) and older age (OR = 1.17; 95%CI: 1.16-1.19; p < 0,001) were significantly associated with myopia diagnosis. Older age decreased the odds of hyperopia (OR = 0.95; 95%CI: 0.93-0.98; p < 0.001). The overall effective refractive coverage was 51.76% and was significantly associated with age group, ranging from 32.25% in children aged 3 to 7 years to 61.35% in children aged 8 to 12 years. CONCLUSIONS: Most children have shown eye alignment for both distance and near assessments and no refractive error. Myopia was observed in 7.70% of the population and it was associated with older age and female sex. Hyperopia was observed in 3.24% and was associated with younger age. The overall eREC was 51.76%, significantly associated with age.

Prevalence and management of ectopic and molar pregnancies in 17 countries in Africa and Latin America and the Caribbean: a secondary analysis of the WHO multi-country cross-sectional survey on abortion.

INTRODUCTION: There are limited global data on ectopic pregnancy (EP) and molar pregnancy (MP), making it important to understand their epidemiology and management across different regions. Our study aimed to describe their prevalence for both conditions, severity of their complications and management among women in selected health facilities across 17 countries in Africa and Latin America and the Caribbean (LAC). METHODS: This is a secondary analysis of the WHO multi-country survey on abortion. Data were collected from 280 healthcare facilities across 11 countries in Africa and 6 in LAC. Sociodemographic information, signs and symptoms, management and clinical outcomes were extracted from medical records. Facility-level data on post-abortion care (PAC) capabilities were also collected, and facilities were classified accordingly. χ2 or Fisher's exact tests were used to compare categorical data. RESULTS: The total number of women with EP and MP across both regions was 9.9% (2 415/24 424) where EP accounted for 7.8% (1 904/24 424) and MP for 2.1% (511/24 424). EP presented a higher severity of complications than MP. At admission, 49.8% of EP had signs of peritoneal irritation. The most common surgical management for EP was laparotomy (87.2%) and for MP, uterine evacuation (89.8%). Facilities with higher scores in infrastructure and capability to provide PAC more frequently provided minimal invasive management using methotrexate/other medical treatment (34.9%) and laparoscopy (5.1%). CONCLUSION: In Africa and LAC, EP and MP cause significant maternal morbidity and mortality. The disparity in the provision of good quality care highlights the need to strengthen the implementation of evidence-based recommendations in the clinical and surgical management of EP and MP.

Molecular detection of Ehrlichia spp., Anaplasma spp., and Bartonella spp. in dogs treated at a veterinary teaching clinic in Peru.

In recent years, vector-borne diseases have become widespread throughout the world and affect the health of humans and domestic animals. These diseases spread to areas where their primary vectors, fleas and ticks, thrive, particularly in tropical and subtropical climate regions, providing ideal conditions for their proliferation. The growing closeness between people and their pets increases the likelihood of bites from these ectoparasites, which represents a latent zoonotic risk. Therefore, the objective of the study was to determine the presence of Anaplasma spp., Ehrlichia spp., and Bartonella spp. in dogs treated at the Small Animal Clinic of the Faculty of Veterinary Medicine of the Universidad Nacional Mayor de San Marcos, located in Lima, Peru. Blood samples from 214 dogs were molecularly analyzed for hemopathogen detection. The results revealed prevalences of 2.6 % (6/214) for Anaplasma platys, 5.14 % (11/214) for Ehrlichia canis, and 0.46 % (1/214) for Bartonella rochalimae. No statistically significant relationship was found between the animal infection and the age, sex, breed, presence of fleas (Ctenocephalides felis) and ticks (Rhipicephalus sanguineus), and locality. This study reported molecularly for the first time the presence of A. platys, E. canis, and B. rochalimae in dogs from Lima city, and demonstrates the occurrence of zoonotic pathogens in pets treated at the veterinary clinic.

Rheumatoid arthritis in Latin America: pharmacotherapy and clinical challenges.

INTRODUCTION: Rheumatoid arthritis (RA) poses significant healthcare challenges in Latin America (LA) due to its high prevalence and unique healthcare dynamics. Despite global advancements, LA faces specific hurdles in effectively managing RA. AREAS COVERED: This review examines RA epidemiology, treatment strategies, and clinical challenges in LA. RA prevalence varies, with higher rates among indigenous populations. While conventional disease-modifying antirheumatic drugs (csDMARDs) are recommended as first-line therapy, access remains inconsistent. Biologics and targeted synthetic DMARDs are available, but biosimilars have limited accessibility, with drug prices varying significantly. Key barriers include supply interruptions, diagnosis delays, and high non-adherence rates driven by socioeconomic factors. A severe shortage of rheumatologists, particularly in rural areas, affects patient care. Cardiovascular events, comorbidities, and endemic infections further complicate RA management. EXPERT OPINION: Although RA care in LA has improved through better use of csDMARDs and advanced treatments, major challenges persist, such as a shortage of specialists, limited medical education, and fragmented healthcare systems. Expanding training programs, enhancing telemedicine, and ensuring drug supply continuity are essential. Strengthening clinical research, improving access to affordable treatments, and developing comprehensive, region-specific strategies are crucial to closing the gap between LA and more developed regions in RA care..

Prevalence of syphilis and associated factors among pregnant women in Brazil: systematic review and meta-analysis.

Objective: This systematic review accompanied by a meta-analysis aimed to estimate the prevalence of syphilis in pregnant women in Brazil and describe its associated factors. Methods: Following the establishment the search strategies and the registration of the review protocol in PROSPERO, we conducted a search for relevant articles in the Pubmed, LILACS, Science Direct, SciELO and Web of Science databases. Our inclusion criteria were cross-sectional studies published between 2005 and 2023, with no language restrictions. The combined prevalence of syphilis infection was estimated using the random effects model in the R Software with a 95% confidence interval (95% CI) and p < 0.01 as statistically significant. Results: A total of 24 articles were recruited, which together investigated 221,884 women. The combined prevalence of syphilis in pregnant women in Brazil was 1.79% (95% CI: 1.24-2.57%), and the main factors associated with its occurrence were black and brown skin color, low education and factors related to the partner. Conclusion: There was a high prevalence of syphilis in pregnancy in Brazil, mainly associated with socioeconomic factors.

Prevalence of erosive tooth wear in risk group patients: systematic review.

OBJECTIVE: This systematic review investigates the prevalence of erosive tooth wear (ETW) in individuals classified as risk groups (gastroesophageal reflux disease, eating disorders, special diets, acidic beverage, drugs and alcohol, legal drugs and medications, and occupational or sports). MATERIALS AND METHODS: The research was conducted in nine databases (PubMed/MEDLINE, Embase, Cochrane Library, LILACS/BVS, SciELO, Scopus, Science Direct, Open Grey, and Web of Science) up to April 2024 (PROSPERO CRD42021270150), along with a manual search of grey literature. Observational studies involving children and adults from these previously mentioned risk groups, which provided data on ETW prevalence, were included without date or language restrictions. The methodological quality of studies was evaluated using the Joanna Briggs Institute's Prevalence Data Critical Appraisal Tool. General and subgroup data were meta-analyzed using a random-effects model. RESULTS: Overall, 4403 studies were retrieved, out of which 148 met the inclusion criteria. Each risk group showed higher prevalences of ETW in these patients in general and subgroup analysis; although subgroup analysis was not possible for all risk groups due to the heterogeneity of the indices found. CONCLUSIONS: The Legal drugs and Medications risk group showed lower overall prevalence values (30%), while the Drugs and Alcohol risk group obtained higher values (67%). Prevalence rates for other groups were: Gastroesophageal reflux disease (54.1%), Eating Disorders (65%), Special Diets (65.9%), Acidic Beverages (40%), Occupational and Sports (51%). CLINICAL RELEVANCE: This systematic review highlights that risk groups are indeed at significant risk for the development of ETW and greater preventive care and dental monitoring are needed.

[Prevalence and underdiagnosis of burn out syndrome in critical services in the context of the COVID-19 pandemic] / Prevalencia y subdiagnóstico del síndrome de burn out en servicios criticos en el contexto de la pandemia COVID-19.

Introduction: The importance of knowing the impact of work on people's health has increased after the COVID-19 pandemic. Burn Out (BO) syndrome arises from the tension emerging from the conflictive interaction between the worker and his or her employment. The objective was to describe the prevalence and frequency of diagnosis of BO in the health human resources of critical services of the Bahía Blanca Municipal Hospital in the context of the COVID-19 pandemic.Methods: Descriptive, cross-sectional study. The study population was the medical and nursing staff of the Intensive Care (IT), Emergency Medicine (SMU) and Clinic services who worked with COVID-19 during 2021. The Maslach Burnout Inventory (MBI) questionnaire was used and complementary closed questions to identify, among these cases, those that were diagnosed and treated by the institution.Results: Of the 219 workers, 55.3% (121/219) were nurses. In the SMU, 25% (24/96) of respondents had BO, followed by 20.4% (11/54) in Clinic and 8.7% (6/69) in IT (p value=0.004). Only 5.5% (12/219) of the total were diagnosed with BO by the institution and of this group, two people (0.9%) had previously consulted for characteristic symptoms.Discussion: A high prevalence of BO and a marked underdiagnosis were evident at the institutional level during the pandemic. Although the IT Service had the highest demand for attention, it was the one that presented the lowest BO values in relation to other services.

Introducción: La importancia del conocimiento del impacto del trabajo en la salud de las personas se ha acrecentado tras la pandemia por COVID-19. El síndrome de Burn Out (BO) nace de la tensión emergente de la interacción conflictiva entre el trabajador y su empleo. El objetivo fue describir la prevalencia y frecuencia de diagnóstico del BO en el recurso humano en salud de servicios críticos del Hospital Municipal de Bahía Blanca en el contexto de la pandemia COVID-19. Métodos: Estudio descriptivo, de corte transversal. La población de estudio fue el personal médico y de enfermería de los servicios de Terapia intensiva (TI), Médico de Urgencias (SMU) y Clínica que trabajaron con COVID-19 durante el 2021. Se empleó el cuestionario Maslach Burnout Inventory (MBI) y preguntas cerradas complementarias para identificar, entre estos casos, aquellos que fueron diagnosticados y tratados por la institución. Resultados: De los 219 trabajadores, el 55,3% (121/219) fueron enfermeros. En el SMU el 25% (24/96) de encuestados tenía BO, seguido por un 20,4% (11/54) en Clínica y un 8.7% (6/69) en TI (valor p=0.004). Sólo el 5,5% (12/219) del total fue diagnosticado con BO por la institución y de este grupo, dos personas (0,9%) habían consultado previamente por síntomas característicos. Discusión: Se evidenció una elevada prevalencia de BO y un marcado sub-diagnóstico a nivel institucional durante la pandemia. A pesar de que el Servicio de TI tuvo la mayor demanda de atención, fue el que presentó los valores más bajos de BO en relación a otros servicios.

Clinical and laboratorial profile of patients with ATTR cardiomyopathy: comparison between wild type and pVal142Ile forms in the Brazilian population

BACKGROUND: In Brazil, besides the wild type (wt) form, transthyretin amyloid cardiomyopathy (ATTR-CM) is predominantly caused by hereditary form with Val142Ile mutation. Considering that both forms occur in elderly people, the clinical presentation may be similar. We sought to compare the clinical presentation of patients with wt and Val142Ile mutation in a Brazilian cohort of ATTR-CM patients. METHODS: Among the 642 patients enrolled in REACT/SP, 283 presented ATTR-CM, being 85 wt and 90 Val142Ile patients. We compared the main clinical characteristics between groups. RESULTS: The wt in comparison to Val142Ile patients, respectively, presented: older age (78.4+/-8.5 vs 74.2+/-8.1 y.o., p = 0.0009); similar proportion of males (82% vs 81%, p=0.85); lower proportion of blacks (11% vs 39%, p=0.0001); similar prevalence of heart failure (HF) symptoms (85% vs 79%, p=0.33); higher prevalence of syncope (13% vs 2%, p=0.008) and Pacemakers (PM) implantation (8% vs 1%, p=0.027); similar prevalence of neuropathy manifestations (38% vs 51%, p=0.17); lower creatinine (1.5+/-0.8 vs 2.1+/-2.1 mg/dL, p=0.02) and NT-ProBNP levels (2860.0+/-2843.3 vs. 5488.3+/-5455.6 pg/ml, p=0.0001); reduced interventricular septal thickness (15.6+/-3.3 vs 17.0+/-3.3 mm, p= 0.006), posterior left ventricular (LV) posterior wall thickness (14.2+/-2.4 vs 16.2+/-4.4 mm, p=0.0003), higher LV ejection fraction (52.0 +/-10.1 vs 48.2+/-13.6%, p=0.038), higher global LV longitudinal strain (8.6+/-8.7 vs 3.4+/-9.8, p=0.0003), smaller LV diastolic diameter (45.9 +/-6.1 vs 43.0+/-7.3 mm, p=0.005) at 2D-Echocardiogram. CONCLUSIONS: In the Brazilian population wt and Val142Ile patients had similar clinical presentation regarding HF and neuropathy symptoms, but higher prevalence of syncope and PM in wt patients. Conversely, Val142Ile patients presented more severe amyloid cardiac infiltration.

Level of support/commitment and behavior during mealtime and dental care negatively impact the dental caries prevalence in autistic individuals: cross-sectional study.

OBJECTIVE: To verify whether factors associated with Autism Spectrum Disorder (ASD) would have impact on the dental-caries prevalence. MATERIALS AND METHODS: All ASD-individuals receiving care in a specialized center with minimum of 4y old were recruited. Demographic, socioeconomic and behavioral characteristics, level of support/commitment (Childhood Autism Rating Scale), mealtime behavior (Brief Autism Mealtime Behavior Inventory) and medication use were answered by ASD-individual's parents. Behavior during dental care was evaluated from Frankl scale. Dental-caries prevalence was the primary outcome. Three examiners calibrated/trained collected the data. Chi-square test was used to compare the variables impact on the dental-caries prevalence. RESULTS: 61 ASD-individuals were potentially eligible, and the all parents/guardians consent to participate. Dental-caries prevalence was 42.9%, which was statistically associated with lower toothbrushing frequency, higher level of support/commitment, and worse behavior at meals and during in dental care. Dental-caries prevalence was approximately higher twice in ASD-individuals: (i) uncooperative with dental care when compared those cooperative (62% versus 32%, respectively); (ii) with severe level of support when compared to those with mild/moderate level (58% versus 28%, respectively); and (iii) with worse mealtime behavior when compared to those with better behavior (59% versus 28%, respectively). A medium statistical correlation was observed between support level and mealtime behavior (rS=0.39). The BAMBI component statistically associated with dental-caries prevalence was the food refusal (capture problem when a child rejects a presented food, crying, spitting out food). CONCLUSION: higher required level of support, worse mealtime behavior and uncooperative profile in dental care negatively affect the dental-caries prevalence. CLINICAL RELEVANCE: our findings provide evidence of the need of specialized, preventive and individualized dental care among ASD-individuals.

Frequency of polymorphisms in the IKZF1 and CDKN2A/2B genes and descriptive analysis in pediatric patients with acute lymphoblastic leukemia: a multicenter hospital-based prevalence study in Rio De Janeiro.

BACKGROUND: Acute lymphoblastic leukemia (ALL) is the most common childhood cancer, and B-cell ALL (B-ALL) is the most common subtype. The understanding of ALL has advanced significantly in recent years due to genomic sequencing, which has made it possible to identify genetic variants and detect the association between "single nucleotide polymorphisms" (SNP) and certain diseases. METHODS: We evaluated 126 patients diagnosed with B-ALL in hospitals in Rio de Janeiro. We described the frequency of polymorphisms in the IKZF1, CDKN2A/2B genes, the contribution of these genetic variants in pediatric ALL, and compared them with the general population of Rio de Janeiro. RESULTS: We demonstrated that the SNPs rs3731217, rs4132601, and rs11978267 were more frequent in patients with B-ALL. CONCLUSIONS: These findings contribute to a more complete understanding of B-ALL. They can guide future studies, bringing new perspectives on personalized therapies with reduced side effects and optimization efficacy of B-ALL treatment in children.