Association between burnout syndrome and obesity: A cross-sectional population-based study.

BACKGROUND: Burnout Syndrome (BS) is a response of organism against long-lasting exposure to occupational stressors. Those affected usually have comorbidities, as well as cardiovascular and metabolic problems. OBJECTIVE: Estimating the association between BS and obesity in primary health care nurses of in the state of Bahia, Brazil. METHODS: Population-analytical, cross-confirmatory, integrated and multicenter study, conducted with a random sample of primary health care nursing professionals in 43 municipalities from 07 mesoregions of Bahia, Brazil. This study was funded by the Brazilian Board for Scientific and Technological Development. The independent variable (BS) was evaluated by using the Maslach Burnout Inventory (MBI) scale, and the dependent one (obesity) was based on the Body Mass Index (BMI)≥30. Effect modification and confounding factors were verified by crude, stratified, and multivariate analysis. RESULTS: The prevalence of BS and obesity was 17.7% and 12.7%, respectively. BS was statistically associated with obesity, even after adjustment (RPa: 1.85; CI 95% 1.11-3.06) per gender, age, physical activity, healthy eating, satisfaction with occupation, another job, night shift, primary health care (PHC) time, and working conditions. Effect-modifying variables were not identified. CONCLUSIONS: The specialized literature points out a path to the association identified here. New studies on the subject are relevant and should have more robust methodologies so that the path of causality is better clarified. In addition, occupational health programs become an alternative to control stress and, therefore, its complications, such as burnout and other health aggravations.

Prevalence and Factors Associated with Metabolic Syndrome in Patients at a Psychosocial Care Center: A Cross-Sectional Study.

BACKGROUND: Metabolic syndrome (MS) is associated with greater risk of morbimortality and it has high prevalence in people with mental illness. OBJECTIVE: Estimate the prevalence of Metabolic Syndrome (MS) and its associated factors in the patients of a Psychosocial Care Center (CAPS in Brazilian Portuguese) in the city of Salvador, state of Bahia, Brazil. METHOD: Cross-sectional study set at CAPS in the city of Salvador-Bahia between August 2019 and February 2020. MS was evaluated according to the National Cholesterol Education Program's Adult Treatment Panel III. In addition to descriptive statistics, gross and adjusted prevalence ratios were described. RESULTS: MS was found in 100 (35.2%) individuals, 116 (40.9%) were obese and 165 (58.1%) had increased waist circumference. Polypharmacy was identified in 63 (22.3%) patients and 243 (85.9%) used antipsychotics. Under gross evaluation, women (PR = 1.88; 95%CI: 1.35-2.63) and those who used antidepressants (PR = 1.41; 95%CI: 1.05-1.88) showed an association with MS. After logistic regression, depression (PR = 1.86; 95%CI: 1.38-2.51), acanthosis (PR = 1.50; 95%CI: 1.18-1.90), use of antipsychotics (PR = 1.88; 95%CI: 1.13-2.75), and hypertriglyceridemic waist (PR = 3.33; 95%CI: 2.48-4.46) were associated with MS. CONCLUSION: The prevalence of MS signals multimorbidity among individuals with mental disorders and suggests a need for clinical screening.

Interaction between Work and Metabolic Syndrome: A Population-Based Cross-Sectional Study.

Metabolic syndrome (MS) is a clinical condition and a relevant risk factor in the development of cardiovascular diseases; it occurs as a result of lifestyle factors, e.g., work. The aim of this research was to estimate the interaction between work and MS among primary health care (PHC) nursing professionals in the state of Bahia, Brazil. A sectional multicentered study carried out in 43 municipalities in Bahia, whose study population consisted of nursing professionals. The exposure variables were occupation, professional exhaustion, and working time, and the outcome variable was MS. Interaction measures based on the additivity criteria were verified by calculating the excess risks due to the interactions and according to the proportion of cases attributed to the interactions and the synergy index. The global MS prevalence is 24.4%. There was a greater magnitude in the exposure group regarding the three investigated factors (average level occupation, professional exhaustion, and working time in PHC for more than 5 years), reaching an occurrence of 44.9% when compared to the prevalence of 13.1% in the non-exposure group (academic education, without professional burnout, and working time in PHC for up to 5 years). The study's findings showed a synergistic interaction of work aspects for MS occurrence among PHC nursing professionals.

Anxiety and dyslipidemia among primary health care professionals: A Cross-sectional study.

BACKGROUND: Cross-sectional studies point out important evidence between anxiety and dyslipdemic disorders in health workers. OBJECTIVE: Our main objective was to estimate the association between anxiety and dyslipidemia in Primary Health Care (PHC) nursing professionals in Feira de Santana, Bahia, Brazil. METHODS: A confirmatory cross-sectional study involving 376 PHC nursing professionals. Data collection occurred through the application of a questionnaire containing sociodemographic, labor and lifestyle issues, and the Beck Inventory for anxiety; to evaluate the lipid profile, the HDL-c, LDL-c, and triglycerides markers were evaluated. Descriptive, bivariate analysis and Logistic Regression were performed. RESULTS: The estimated prevalence of moderate/severe anxiety corresponded to 26.1% and dyslipidemia was 54.8%, with a statistically significant association between both of variables stratified by physical activity (PR = 2.69; 95% CI = 1.87-3.85) and (PR = 1.87; 95% CI = 1.53-2.28). CONCLUSIONS: There is a positive association between anxiety and dyslipidemia in Primary Health Care nursing professionals.

Effectiveness of auriculotherapy on stress reduction in health workers: a controlled randomized clinical trial.

OBJECTIVE: to assess the effectiveness of auriculotherapy in reducing occupational stress among Family Health Strategy workers during the COVID-19 pandemic. METHOD: a controlled randomized clinical trial divided into two groups, namely: auriculotherapy for stress group and placebo group. The Shapiro-Wilk test was used to assess data normality. The ANOVA test for repeated measures and the Tukey post-hoc test were applied to the group with normal samples. In turn, the Friedman and Durbin-Conover tests were employed in the group with non-normal distribution. Cohen's d index was calculated for the therapy effect size. A 95% significance level and p<0.05 were considered. RESULTS: the auriculotherapy group presented 16.3% and 23.7% reductions in occupational stress after the third and sixth auriculotherapy sessions, with Cohen's d indices of 1.12 (large effect) and 1.82 (very large effect), respectively. CONCLUSION: auriculotherapy proved to be effective in reducing occupational stress among Family Health Strategy workers during the COVID-19 pandemic. It is suggested that new studies are developed both during and after the pandemic in order to improve health workers' Quality of Life. ReBEC registration: RBR - 38hjyt3.

Mothers' high glycemic levels and the association between periodontitis and low birth weight.

BACKGROUND: Maternal hyperglycemia, periodontitis, and adverse gestational outcomes are important health problems. The present study investigated the hypothesis that periodontitis and the glycemic level of mothers may have opposing influences on birth weight (BW). This study evaluated the effect of high glycemic levels, albeit within the normal range, on the association between periodontitis and low birth weight (LBW). METHODS: A total of 732 women took part in this case-control study; 172 were mothers of children with LBW <2,500 g, and 560 were mothers of children with BW ≥2,500 g. The BW of newborns was obtained from medical records, and information on socioeconomic-demographic, lifestyle behavior were obtained through interviews. Glycated hemoglobin (HbA1c) levels were evaluated, and full-mouth periodontal examination was carried out within 7 days postpartum. Hierarchical and logistic regression analysis evaluated the effect of glycemic levels on the association between periodontitis and LBW by subgroups, estimating odds ratios (OR) with 95% confidence intervals (95% CI). RESULTS: In the group with HbA1c levels <5.6%, a statistically significant relationship existed between periodontitis and LBW. Using the Centre for Disease Control/American Academy of Periodontics criteria, the ORadjusted was 1.55; 95% CI: 1.04 to 2.31; using the Gomes-Filho et al. criteria the ORadjusted was 1.91; 95% CI, 1.06 to 3.45. In the group with higher HbA1c levels but still within the normal range (≥5.6% and <6.5%), the findings showed no association between periodontitis and LBW. CONCLUSION: Higher maternal glycemic levels within the normal range, inferior to those indicative of gestational diabetes, diabetes mellitus, or hyperglycemia, and periodontitis have opposing effects on BW, altering the association magnitude.

Effect of immunonutrition on serum levels of C-reactive protein and lymphocytes in patients with COVID-19: a randomized, controlled, double-blind clinical trial.

INTRODUCTION: Introduction: patients with COVID-19 undergo changes in leukocyte count, respiratory disorders, and an increase in inflammatory substances. To improve the inflammatory condition, some nutrients can be used, including arginine, omega-3 fatty acids and nucleotides. This study aims to evaluate how oral immunonutrient supplements affects serum C-reactive protein (CRP) levels and lymphocyte count in patients with COVID-19. Methods: in this double-blind clinical trial, we randomized 43 adult patients with COVID-19 to receive a standard high-protein normocaloric supplement (control) or an immunonutrient-enriched supplement (experiment) for 7 days. The primary outcome was to evaluate changes in total lymphocyte count and serum level of CRP. The assessment of risk and nutritional status of these patients was also performed. Results: forty-three patients with mean age of 41.5 (± 1.8) years were followed up, 39.5 % of them women. The mean body mass index was 27.6 (± 0.8) kg/m² and 58.1 % had low nutritional risk. In the experiment group, there was a CRP reduction of 23.6 (± 7.5) mg/L, while in the control branch the decrease was 14.8 (± 12.1) mg/L (p = 0.002). There was an increase in lymphocytes in the experiment group (+367.5 ± 401.8 cells/mm³) and a reduction in the control group (-282.8 ± 327.8 cells/mm³), although there was no statistical significance (p = 0.369). Relative risk (RR) of treatment in reducing CRP by 30 % or more was 4.45 (p < 0.001; 95 % CI, 1.79-11.07). RR in increasing lymphocyte count by 30 % or more was 1.28 (p = 0.327; 95 % CI, 0.67-2.45). Conclusion: we conclude that immunonutrient supplements seem to reduce CRP levels more than standard high-protein normocaloric supplements.

INTRODUCCIÓN: Introducción: los pacientes con COVID-19 sufren cambios en el recuento de leucocitos, trastornos respiratorios y aumento de sustancias inflamatorias. Para mejorar la condición inflamatoria se pueden usar algunos nutrientes, como la arginina, los ácidos grasos omega-3 y los nucleótidos. Este estudio tiene como objetivo evaluar cómo los suplementos de inmunonutrientes orales afectan a los niveles séricos de proteína C-reactiva (PCR) y al recuento de linfocitos en pacientes con COVID-19. Métodos: en este ensayo clínico doble ciego, aleatorizamos a 43 pacientes adultos con COVID-19 para recibir un suplemento normocalórico estándar alto en proteínas (control) o un suplemento enriquecido con inmunonutrientes (experimento) durante 7 días. El resultado primario fue evaluar los cambios en el recuento total de linfocitos y el nivel sérico de PCR. También se realizó la evaluación del riesgo y el estado nutricional de estos pacientes. Resultados: cuarenta y tres pacientes con edad media de 41,5 (± 1,8) años fueron seguidos, el 39,5 % de ellos mujeres. El índice de masa corporal medio fue de 27,6 (± 0,8) kg/m² y el 58,1 % tenían bajo riesgo nutricional. En el grupo experimental hubo una reducción de la PCR de 23,6 (± 7,5) mg/L, mientras que en la rama de control la disminución fue de 14,8 (± 12,1) mg/L (p = 0,002). Hubo un aumento de linfocitos en el grupo experimental (+367,5 ± 401,8 células/mm³) y una reducción en el grupo de control (-282,8 ± 327,8 células/mm³), aunque no hubo significación estadística (p = 0,369). El riesgo relativo (RR) del tratamiento para reducir la PCR en un 30 % o más fue de 4,45 (p < 0,001; IC 95 %: 1,79-11,07). El RR en el aumento del recuento de linfocitos en un 30 % o más fue de 1,28 (p = 0,327; IC 95 %: 0,67-2,45). Conclusión: se concluye que los suplementos de inmunonutrientes parecen reducir los niveles de PCR más que los suplementos normocalóricos estándar altos en proteína.

Effectiveness of auriculotherapy on stress reduction in health workers: a controlled randomized clinical trial / Efetividade da auriculoterapia na redução de estresse em trabalhadores de saúde: ensaio clínico controlado randomizado / Efectividad de la auriculoterapia para la reducción del estrés de trabajadores de la salud: ensayo clínico controlado aleatorizado

Abstract Objective: to assess the effectiveness of auriculotherapy in reducing occupational stress among Family Health Strategy workers during the COVID-19 pandemic. Method: a controlled randomized clinical trial divided into two groups, namely: auriculotherapy for stress group and placebo group. The Shapiro-Wilk test was used to assess data normality. The ANOVA test for repeated measures and the Tukey post-hoc test were applied to the group with normal samples. In turn, the Friedman and Durbin-Conover tests were employed in the group with non-normal distribution. Cohen's d index was calculated for the therapy effect size. A 95% significance level and p<0.05 were considered. Results: the auriculotherapy group presented 16.3% and 23.7% reductions in occupational stress after the third and sixth auriculotherapy sessions, with Cohen's d indices of 1.12 (large effect) and 1.82 (very large effect), respectively. Conclusion: auriculotherapy proved to be effective in reducing occupational stress among Family Health Strategy workers during the COVID-19 pandemic. It is suggested that new studies are developed both during and after the pandemic in order to improve health workers' Quality of Life. ReBEC registration: RBR - 38hjyt3.

Resumo Objetivo: avaliar a efetividade da auriculoterapia na redução do estresse ocupacional em trabalhadores de saúde da Estratégia de Saúde da Família durante a pandemia da COVID-19. Método: ensaio clínico controlado randomizado em dois grupos: grupo auriculoterapia para o estresse e grupo placebo. Foi utilizado o teste de Shapiro-Wilk para avaliar a normalidade dos dados. O teste ANOVA de medidas repetidas e o teste post-hoc Tukey foram aplicados para o grupo com amostras normais. Já o teste de Friedman e de Durbin-Conover foram utilizados no grupo com distribuição não normal. Para o tamanho do efeito da terapia, foi calculado o índice d de Cohen. Considerou-se o nível de significância de 95% e valor p<0,05. Resultados: o grupo auriculoterapia apresentou redução do estresse ocupacional de 16,3 e 23,7% após a terceira e sexta sessões de auriculoterapia, com índices d de Cohen de 1,12 (grande efeito) e 1,82 (efeito muito grande), respectivamente. Conclusão: a auriculoterapia mostrou-se efetiva na redução do estresse ocupacional em trabalhadores de saúde da Estratégia Saúde da Família durante a pandemia da COVID-19. Sugere-se que novos estudos sejam desenvolvidos durante e após a pandemia de maneira a melhorar a qualidade de vida dos trabalhadores de saúde. Registro ReBEC: RBR - 38hjyt3.

Resumen Objetivo: evaluar la efectividad de la auriculoterapia para la reducción del estrés laboral en trabajadores de salud de la Estrategia Salud de la Familia durante la pandemia de COVID-19. Método: ensayo clínico controlado aleatorizado en dos grupos: grupo auriculoterapia para el estrés y grupo placebo. Se utilizó la prueba de Shapiro-Wilk para evaluar la normalidad de los datos. Al grupo con muestras normales se les aplicó la prueba ANOVA de medidas repetidas y la prueba post-hoc de Tukey. Se utilizaron las pruebas de Friedman y Durbin-Conover en el grupo con distribución no normal. Para el tamaño del efecto de la terapia se calculó el índice d de Cohen. Se consideró un nivel de significación del 95% y un valor de p <0,05. Resultados: el grupo auriculoterapia mostró una reducción del estrés laboral de 16,3 y 23,7% después de la tercera y sexta sesión de auriculoterapia, con índices d de Cohen de 1,12 (efecto grande) y 1,82 (efecto muy grande), respectivamente. Conclusión: la auriculoterapia demostró ser eficaz para la reducción del estrés laboral en trabajadores de la salud de la Estrategia Salud de la Familia durante la pandemia de COVID-19. Se sugiere desarrollar nuevos estudios durante y después de la pandemia con el fin de mejorar la calidad de vida de los trabajadores de la salud. Registro ReBEC: RBR - 38hjyt3.

The Prevalence of Abdominal Adiposity among Primary Health Care Physicians in Bahia, Brazil: An Epidemiological Study.

BACKGROUND: Labor activities are demanding for workers and can induce occupational stress. Primary health care (PHC) workers have faced problems that can lead to the development of stress and abdominal obesity. The aim of this study was to estimate the prevalence of abdominal adiposity among primary health care physicians in the metropolitan mesoregion of Salvador, Bahia. METHODS: This is a cross-sectional study conducted with physicians from the family health units (FHUs) of the metropolitan mesoregion of Salvador, Bahia, Brazil. The number of FHUs corresponded to 41 teams (52 physicians). Anamnesis was performed and a questionnaire was applied. The clinical examination consisted of measuring waist circumference (WC), blood pressure levels (BP), and body mass index (BMI), as well as examining for acanthosis nigricans. Blood samples were collected for biochemical dosages. The data obtained were analyzed by SPSS version 22.0. RESULTS: The sample included 41 physicians (response rate: 78.8%), of which 18 were women (44.0%). The percentage of overweight participants represented by BMI was 31.7%. The hypertriglyceridemia prevalence was 29.2%. HDL-c was low in 48.7% of the participants. The waist circumference measurement revealed a prevalence of abdominal adiposity of 38.8% (women) and 34.8% (men). CONCLUSIONS: Medical professionals in PHC are more susceptible to having higher abdominal adiposity, especially female physicians.

Burnout syndrome and metabolic syndrome: a cross-sectional population-based study.

In the population of Primary Health Care Nursing (PHC) professionals, the association between Burnout Syndrome (BS) and Metabolic Syndrome (MS) has not been investigated. The objective was to evaluate the association between BS and MS among PHC Nursing Professionals. A cross-sectional, multicenter, population-based study was conducted in the state of Bahia, Brazil, with 1,125 professionals. The prevalence of BS and MS corresponded to 18.3% and 24.4%, respectively. The prevalence in women of BS was 16.4% and of MS 23.7%, in men 31.6% for BS and 29.4% for MS. Men with BS are 3.23 times more likely to develop MS, and women 1.48 times more. BS was associated between men and women and exhibited a good discriminatory predictive power.

An accuracy study of the clinical diagnosis of periodontitis in pregnant women.

BACKGROUND: There exists a diverse range of criteria used in epidemiological studies for the diagnosis of periodontitis. The results from these studies should be evaluated with consideration to the diagnostic criteria used, and this may account for differences between studies especially in some population groups such as pregnant females. The objective is to evaluate the diagnostic criteria used in a variety of epidemiologic studies of periodontitis in pregnant females. METHODS: An accuracy study with cross-sectional design was performed out from a database of 671 pregnant females, using six different sets of criteria for the diagnosis of periodontitis. Women were classified for periodontitis, as follows: Center for Disease Control and Prevention/American Academy of Periodontology (CDC/AAP, 2012 criterion), the gold standard, Gomes-Filho et al.(2018) criterion, Albandar et al.(2007) criterion, Bassani et al.(2007) criterion, López et al.(2002) criterion, and Nesse et al.(2008) criterion. For comparison amongst the gold standard and the other criteria, sensitivity, specificity, predictive values, and likelihood ratio were determined. RESULTS: The frequency of periodontitis ranged from 25.0% to 90.2%. The Bassani et al. (2007) criterion was found to be more sensitive among the studies, and thus more suitable for diagnostic screening studies. Gomes-Filho et al.(2018), Albandar et al. (2007), López et al. (2002), and Nesse et al. (2008) criteria were considered more specific, which makes them more useful for studies of periodontitis with the aim of using diagnosis for confirmation of disease. CONCLUSIONS: A variation in the occurrence of periodontitis was observed. The criterion must be chosen according to the research aims and population characteristics.

Prevalence and Factors Associated with Burnout Syndrome among Primary Health Care Nursing Professionals: A Cross-Sectional Study.

The objective of the study was to evaluate the prevalence and factors associated with Burnout Syndrome (BS) in Primary Health Care (PHC) nursing professionals from the state of Bahia, Brazil. A multicentre, cross-sectional population-based study was conducted in a cluster sample among 1125 PHC Nursing professionals during the years 2017 and 2018. We used a questionnaire that included sociodemographic, labor and lifestyle variables and the Maslach Burnout Inventory scale to identify BS. The associations were evaluated using a robust Poisson regression with the hierarchical selection of the independent variables. The prevalence of BS was 18.3% and the associated factors were ethnicity (prevalence ratio (PR) = 0.62, confidence interval (CI) 95% = 0.47-0.83), residence (PR = 2.35, CI 95% = 1.79-3.09), economic situation (PR = 1.40, CI 95% = 1.06-1.86), satisfaction with current occupation (PR = 1.75, CI 95% = 1.31-2.33), (PR = 1.60, CI 95% = 1.23-2.08), rest (PR = 1.83, 95% CI = 1.41-2.37), technical resources and equipment (PR = 1.37, CI 95% = 1.06-1.77), night shift (PR = 1.49, CI 95% = 1.14-1.96), physical activity practice (PR = 1.72; CI 95% = 1.28-2.31), smoking (PR = 1.82, CI 95% = 1.35-2.45), and satisfaction with physical form (PR = 1.34, CI 95% = 1.01-179). Strategies are needed to prevent BS, with an emphasis on implementing worker health programs in the context of PHC.

Evidências científicas sobre a associação entre burnout e síndrome metabólica: revisão integrativa / Evidencias científicas sobre la asociación entre el burnout y el síndrome metabólico: revisión integradora / Scientific evidence on the association between burnout and metabolic syndrome: integrative review

Resumo Objetivo Avaliar as evidências científicas disponíveis na literatura sobre a associação entre Síndrome de Burnout e Síndrome Metabólica. Métodos Revisão integrativa da literatura, com buscas nas bases de dados do Cumulative Index to Nursing and Allied Health Literature, National Library of Medicine National Institutes of Health, Web of Science, Scopus, Cochrane Library, Latin American and Caribbean Center on Health Sciences Information, Scientific Eletronic Library Online e Springer Link. Os artigos selecionados foram analisados de acordo com a Agency for Healthcare Research and Quality. Resultados A maioria (80%) dos 5 artigos que atenderam aos critérios de seleção estava na língua inglesa e indexada nas bases de dados Web of Science e Scopus. Dentre os trabalhos, 80% tinham médicos como autores principais. O continente asiático (Israel, Japão e China) concentrou a maior parte de produção. Não ocorreu predominância de desenho de estudo. A área financeira correspondeu a 60% do público pesquisado. Conclusão As evidências disponíveis na literatura são incipientes, apenas 20% dos artigos elegíveis apresentou associação entre as síndromes estudadas e os demais, indicam associação entre Burnout e componentes da SM separadamente.

Resumen Objetivo evaluar las evidencias científicas disponibles en la literatura sobre la asociación entre el síndrome de burnout y el síndrome metabólico. Métodos revisión integradora de la literatura, con búsquedas en las bases de datos del Cumulative Index to Nursing and Allied Health Literature, National Library of Medicine National Institutes of Health, Web of Science, Scopus, Cochrane Library, Latin American and Caribbean Center on Health Sciences Information, Scientific Eletronic Library Online y Springer Link. Los artículos seleccionados fueron analizados de acuerdo con la Agency for Healthcare Research and Quality. Resultados la mayoría (80%) de los cinco artículos que cumplieron los criterios de selección estaba en inglés e indexada en las bases de datos Web of Science y Scopus. Entre los trabajos, 80% tenía médicos como autores principales. El continente asiático (Israel, Japón y China) concentró la mayor parte de la producción. No ocurrió predominio de diseño de estudio. El área financiera correspondió al 60% del público investigado. Conclusión las evidencias disponibles en la literatura son incipientes, solo el 20% de los artículos elegibles presentó asociación entre los síndromes estudiados y los demás indican asociación entre burnout y componentes del SM separadamente.

Abstract Objective To evaluate the scientific evidence available in the literature on the association between Burnout Syndrome and Metabolic Syndrome. Methods Integrative literature review, searching the databases of the Cumulative Index to Nursing and Allied Health Literature, National Library of Medicine, National Institutes of Health, Web of Science, Scopus, Cochrane Library, Latin American and Caribbean Center on Health Sciences Information, Scientific Eletronic Library Online and Springer Link. The selected articles were analyzed according to the Agency for Healthcare Research and Quality. Results Most (80%) of the 5 studies that met the selection criteria were in English language and indexed in the Web of Science and Scopus databases. Among the studies, 80% had physicians as the main authors. The Asian continent (Israel, Japan and China) concentrated the majority of production. There was no predominance of study design. The financial area corresponded to 60% of the study participants. Conclusion The available evidence in the literature is incipient, only 20% of the eligible articles showed association between the syndromes studied and the others, indicate association between Burnout and MS components separately.

Metabolic Syndrome Among Primary Health Care Nursing Professionals: A Cross-Sectional Population-Based Study.

This research aims at evaluating prevalence and factors associated with metabolic syndrome (MS) in primary health care (PHC) nursing professionals. A multicenter, population-based and cross-sectional study was conducted in a team-tested sample of 1125 PHC nurses in the state of Bahia, Brazil. Sociodemographic, labor, lifestyle and human biology variables were investigated by mean of anamnesis. MS was evaluated according to the criteria of the first Brazilian Guideline for Metabolic Syndrome, which fully adopts the criteria of the National Cholesterol Education Program's Adult Treatment Panel III. MS-associated factors were tested by using robust Poisson Regression. The prevalence of MS found was 24.4%; low High Density Lipoprotein (HDL) cholesterol was the most prevalent component of the syndrome. In the multivariate analysis, physical inactivity (PR = 1.25, 95% CI = 1.02-1.53), alcohol use (PR = 1.84, 95% CI = 1.22-2.77), acanthosis nigricans (PR = 3.23, 95% CI = 2.65-3.92), burnout syndrome (PR = 1.45, 95% CI = 1.17-1.81), (PR = 1.37, 95% CI = 1.12-1.69), working as a nursing technician (PR = 1.43, 95% CI = 1.14-1.80), were associated to MS. It was found that the prevalence of MS was high, which evidences the need for interventions in the PHC environment, improvement of working conditions, monitoring of worker safety and health, diet programs and physical activity.

Association between periodontitis and severe asthma in adults: A case-control study.

OBJECTIVE: To evaluate the association between periodontitis and severe asthma, with participants in treatment for severe asthma, controlled by therapy. METHODS: A case-control investigation was performed to compare 130 adults with severe asthma with 130 without asthma. Individuals with periodontitis were those with ≥4 teeth with ≥1 site with probing depth ≥4 mm, clinical attachment level ≥3 mm, and bleeding upon probing at the same site. Severe asthma diagnosis was based on Global Initiative for Asthma criteria. RESULTS: Association between exposure to periodontitis and severe asthma was found: ORcrude  = 2.98 (95% CI: 1.74-5.11). When confounders were considered, the association between exposure to periodontitis and severe asthma was maintained: ORadjusted  = 3.01-3.25. Individuals with periodontitis had about a threefold increased risk of severe asthma than those without periodontitis. Frequency of periodontitis in participants with severe asthma was greater than that of those without asthma (46.6% vs 22.3%, p ≤ .05). CONCLUSIONS: Association between periodontitis and severe asthma was observed. Further investigation is required to determine the direction of this relationship. It may be causal, but it may also be a consequence of the immunopathological process that characterizes asthma, or else, consequence of the medication used for treatment.

Fatores intervenientes na proteção radiológica ocupacional no controle de qualidade em câmaras gama / Intervening Factors in Occupational Radiological Protection in Quality Control in the Gamma Cameras

Introdução: a proteção radiológica é campo do conhecimento que permeia os ambientes radiológicos. Sua aplicação envolve benefícios aos serviços, profissionais e usuários. Objetivo: identificar fatores intervenientes, bem como, dispositivos de proteção radiológica disponíveis em um serviço de medicina nuclear (MN), envolvidos nos testes de Controle de Qualidade em Câmaras Gama (CQCG). Metodologia: realizou-se um estudo observacional, do tipo exploratório e descritivo, em um serviço de MN conveniado com o Instituto Federal da Bahia (IFBA), com ênfase na proteção radiológica em testes de CQCG. A coleta de dados foi realizada em janeiro de 2016. Foram acompanhados testes diários de inspeção visual da integridade física, radiação de fundo da sala de exames, uniformidade intrínseca e centralização da largura da janela energética para cada radionuclídeo. Para os testes semanais, acompanharam-se os de resolução espacial e linearidade. Os dados foram analisados à luz da legislação/normativas vigentes para serviços de MN no Brasil. Resultados: referente à proteção radiológica em testes de CQCG, o serviço dispunha de três aventais plumbíferos e três protetores de tireóide com equivalência de 0,5mm de chumbo, além de pinças utilizadas para manipulação de fontes radioativas. Foi observada a presença de óculos de proteção, entretanto, os mesmos não eram plumbíferos. Os profissionais eram monitorados por dosímetros termoluminescentes de uso individual. Conclusão: de maneira geral, eram observados os fatores de proteção radiológica: tempo, distância e blindagem. O CQCG requer planejamento prévio com protocolo devidamente seguido que poderá minimizar a exposição ocupacional.

Introduction: radiation protection is a field of knowledge that permeates radiological environments. Its application involves benefits to services, professionals and patients. Objective: To identify intervening factors, as well as the radiological protection devices available in a nuclear medicine service (MN) involved in the Quality Control tests in Gamma Camera (CQCG). Methodology: an observational, exploratory and descriptive study was carried out at the MN service in partnership with Instituto Federal da Bahia (IFBA), with emphasis on radiological protection in CQCG tests. Data collection was performed in January 2016. Daily tests were conducted to visually inspect the physical integrity of the system, to test the background radiation of the examination room, and intrinsic uniformity and centralization of the energetic window width for each radionuclide were monitored. For the weekly tests, those of spatial resolution and linearity were monitored. The data was analyzed in accordance with the legislation/regulations for MN services in Brazil. Results: with regard to the radiological protection during CQCG tests, the service had three lead aprons and three thyroid protectors with a 0.5mm equivalence of lead, in addition, tweezers used to manipulate radioactive sources. The presence of protective goggles was observed, however, they did not contain lead. The professionals were monitored by thermoluminescent dosimeters for individual use. Conclusion: in general, the principles of radiation protection of time, distance and shielding were adopted. CQCG requires prior planning with a properly followed protocol that can minimize occupational exposure.

Effect of maternal periodontitis and low birth weight--a case control study.

INTRODUCTION: Since the 1990s, evidence has been raised that there is an association between maternal periodontal disease and undesirable gestational events, for example low birth weight; this issue is controversial. OBJECTIVE: To evaluate whether there is an association between maternal periodontitis and low birth weight (LBW). METHODS: A case-control study was carried out on 951 mothers that had been cared for by the Brazilian Unified Health System in Petrolina-PE and Juazeiro-BA, Brazil. The case group (n = 269) consisted of mothers of newborns with birth weight <2500 g and a control group (n = 682) of mothers of newborns with birth weight ≥2500 g. An interview was realized, using a questionnaire as well as a full mouth examination to diagnose the periodontal condition. Women who had at least four teeth with probing depth ≥4 mm and clinical attachment loss ≥3 mm, with bleeding on probing at the same site, were diagnosed with periodontitis. The birth weight was obtained through the hospital book record. The main association was evaluated using the multivariate regression model, considering confounders. RESULTS: The frequency of periodontitis was 16.4% (case group) and 17.4% (control group). Periodontitis did not show an association with LBW (ORcrude = 0.92; 95% CI = 0.63-1.35), even after adjustment for the following confounders: maternal age, pre-gestational body mass index, number of pre-natal consultations, number of pregnancies, maternal schooling level, smoking habit during pregnancy and hypertension (ORadjusted = 1.00; 95% CI = 0.61-1.68). CONCLUSION: The findings of this study showed no association between maternal periodontal disease and low birth weight, even after appropriate adjustments for confounding factors.

Women with low bone mineral density and dental panoramic radiography.

OBJECTIVE: The aim of this study was to investigate whether some mandibular measurements on panoramic radiographs are associated with low bone mineral density in postmenopausal women. METHODS: A sample of 122 panoramic dental radiographs and bone density tests from women 50 years or older were examined. Bone mineral density was measured in the lumbar spine and proximal femur regions through dual-energy x-ray absorptiometry. The mandibular cortical bone thickness below the mental foramen, mandibular alveolar bone resorption, and panoramic mandibular index were measured. RESULTS: The mandibular cortical thickness and mandibular alveolar bone resorption showed the highest specificity (lumbar spine: 89.8% vs 73.5%, proximal femur: 83.6% vs 71.2%, respectively). The panoramic mandibular index demonstrated the highest sensitivity (lumbar spine: 43.8%; proximal femur: 40.8%). The association between the mandibular cortical thickness and bone mineral density was statistically significant even after adjustment for hormonal treatment, smoking, age at menopause, and body mass index (P = 0.04). CONCLUSIONS: It is suggested that panoramic radiography may be useful for confirming individuals who present with low bone mineral density.

Fatores associados à pneumonia nosocomial em indivíduos hospitalizados / Factors associated with nosocomial pneumonia in hospitalized individuals

OBJETIVO: Identificar os fatores associados à pneumonia nosocomial em hospital público de Feira de Santana, Bahia. MÉTODOS: Este estudo caso-controle foi realizado em 211 indivíduos adultos (46 casos e 165 controles), com idade média de 41 anos, atendidos na Clínica Médica, Clínica Cirúrgica ou na Unidade de Terapia Intensiva Adulta do Hospital Geral Clériston Andrade, em Feira de Santana. Os casos foram constituídos por indivíduos que desenvolveram infecção do trato respiratório (pneumonia nosocomial) após admissão hospitalar. Os controles foram formados por não portadores de pneumonia nosocomial. Informações socioeconómicas, história médica, estilo de vida e hábitos de higiene bucal foram obtidos por meio de entrevistas. Os prontuários foram checados para registro da condição de saúde do indivíduo e diagnóstico de pneumonia. Exame clínico bucal foi realizado por cirurgião-dentista treinado. Na análise bivariada, foi estimado o odds ratio (OR) como medida de associação e seus respectivos intervalos de confiança de 95 por cento (IC 95 por cento) com uso do método de Mantel-Haenzel. RESULTADOS: A frequência de pneumonia nosocomial na amostra foi de 21,8 por cento. A ocorrência de hipertensão e o tempo de internamento foram maiores nos casos do que nos controles (p < 0,05). A falta de uso de fio dental e de enxaguatório bucal foram maiores no grupo controle (p = 0,01). CONCLUSÃO: Os achados apontam a hipertensão, tempo de internamento > 5 dias e ausência do fio dental e enxaguatório bucal como fatores possivelmente associados à pneumonia nosocomial, apontando-os como alvos efetivos de prevenção.

OBJECTIVE: To identify factors associated with nosocomial pneumonia in individuals admitted to apublic hospital in Feira de Santana, Bahia. METHODS: This case control study was carried out in 211 adult individuals (46 cases and 165 controls), of a mean age of 41 years, treated at clinical wards, surgical wards or the adult intensive care unit of Cleriston Andrade General Hospital in Feira de Santana. The cases comprised individuals who developed respiratory tract infections (nosocomial pneumonia) after hospital admission. The controls consisted of patients without nosocomial pneumonia. Information on socioeconomic status, medical history, lifestyle and oral hygiene habits was obtained through interviews. The medical records were checked to verify subjects' health status and the diagnosis opneumonia. A clinical oral examination was performed by a trained dental surgeon. Odds ratio (OR) was estimated in the bivariate analysis as an association measurement, along with the respective 95 percent confidence interval through the Mantel-Haenszel method. RESULTS: The frequency of nosocomial pneumonia in the sample was 21.8 percent. The occurrence of hypertension was higher and hospital stay duration was longer in the cases than in controls (p ≤ 0.05). Lack of dental floss and mouthwash use were higher in the controls (p = 0.01). CONCLUSION: The findings indicate that arterial hypertension, length of hospital stay of five days and lack of dental floss and mouthwash use are factors likely associated with nosocomial pneumonia, suggesting that these factors should be targeted for effective prevention.

Factors associated with nosocomial pneumonia in hospitalized individuals.

OBJECTIVE: To identify factors associated with nosocomial pneumonia in individuals admitted to a public hospital in Feira de Santana, Bahia. METHODS: This case control study was carried out in 211 adult individuals (46 cases and 165 controls), of a mean age of 41 years, treated at clinical wards, surgical wards or the adult intensive care unit of Cleriston Andrade General Hospital in Feira de Santana. The cases comprised individuals who developed respiratory tract infections (nosocomial pneumonia) after hospital admission. The controls consisted of patients without nosocomial pneumonia. Information on socioeconomic status, medical history, lifestyle and oral hygiene habits was obtained through interviews. The medical records were checked to verify subjects' health status and the diagnosis of pneumonia. A clinical oral examination was performed by a trained dental surgeon. Odds ratio (OR) was estimated in the bivariate analysis as an association measurement, along with the respective 95% confidence interval through the Mantel-Haenszel method. RESULTS: The frequency of nosocomial pneumonia in the sample was 21.8%. The occurrence of hypertension was higher and hospital stay duration was longer in the cases than in controls (p ≤ 0.05). Lack of dental floss and mouthwash use were higher in the controls (p = 0.01). CONCLUSION: The findings indicate that arterial hypertension, length of hospital stay of five days and lack of dental floss and mouthwash use are factors likely associated with nosocomial pneumonia, suggesting that these factors should be targeted for effective prevention.