Validation of a New and Straightforward Algorithm to Evaluate Signal Quality during ECG Monitoring with Wearable Devices Used in a Clinical Setting.

BACKGROUND: Wearable devices represent a new approach for monitoring key clinical parameters, such as ECG signals, for research and health purposes. These devices could outcompete medical devices in terms of affordability and use in out-clinic settings, allowing remote monitoring. The major limitation, especially when compared to implantable devices, is the presence of artifacts. Several authors reported a relevant percentage of recording time with poor/unusable traces for ECG, potentially hampering the use of these devices for this purpose. For this reason, it is of the utmost importance to develop a simple and inexpensive system enabling the user of the wearable devices to have immediate feedback on the quality of the acquired signal, allowing for real-time correction. METHODS: A simple algorithm that can work in real time to verify the quality of the ECG signal (acceptable and unacceptable) was validated. Based on simple statistical parameters, the algorithm was blindly tested by comparison with ECG tracings previously classified by two expert cardiologists. RESULTS: The classifications of 7200 10s-signal samples acquired on 20 patients with a commercial wearable ECG monitor were compared. The algorithm has an overall efficiency of approximately 95%, with a sensitivity of 94.7% and a specificity of 95.3%. CONCLUSIONS: The results demonstrate that even a simple algorithm can be used to classify signal coarseness, and this could allow real-time intervention by the subject or the technician.

Molar-Incisor Hypomineralization: Prevalence Comparative Study in 6 Years of Interval.

The aim of this study was to evaluate the prevalence evolution rate of MIH (molar-incisor hypomineralization) after a 6-year period in Araraquara/SP, Brazil. This population-based study evaluated MIH in 545 schoolchildren (6-12 years of age) and other associated alterations, dental caries and dental fluorosis (DF). A semistructured questionnaire was sent to the schoolchildren's parents/guardians with the purpose of identifying the socioeconomic profile. Associations between MIH and the clinical characteristics were analyzed by the Poisson analysis of regression with robust variance, estimating the RPc (crude prevalence ratio) with CI 95%. The level of significance of 5% was adopted. The MIH prevalence in Araraquara/SP in 2016 was 14.3% (n = 78), and at this time, an increase of 2% was observed, in comparison with the data of the first prevalence study conducted in 2010 (12.3%). The mild degree compromise was the most prevalent diagnosis in the affected teeth (82.0%). Among children with MIH, the mean number of affected teeth was 2.78. Of the total number of children with MIH, 32.0% presented alterations in both first permanent molars and permanent incisors. There is no significant association between MIH and dental caries experience on permanent dentition (PRc = 1.141; CI 95% 0.709-1.835) or on primary dentition (PR c = 1.132; CI 95% 0.749-1.709). Children with MIH presented significantly less prevalence of dental fluorosis (PR c = 0.505; CI 95% 0.268-0.950). There is no association between MIH and monthly Brazilian minimal wage income (PR c = 1.130; CI 95% 0.655-1.949). It was concluded that the number of MIH cases had increased, revealing a greater need for defining the etiological factors and establishing a correct diagnosis to make it possible to institute early intervention.

Educational program in oral health for caregivers on the oral hygiene of dependent elders / Programa educacional em saúde bucal para cuidadores sobre a higiene oral de idosos dependentes

Objective: Due increased number of elders living in long-term care institutions, actions designs to improve their oral health are essential. Thus, the aim of this study was to evaluate the impact of an educational program for the caregivers through the assessment of the oral hygiene of institutionalized elders. Material and method: The education program consisted in lectures to caregivers about oral health that were performed once a month. The subjects were 40 functionally dependent institutionalized elders and 14 caregivers. Hygiene habits, plaque index, and tongue coating/discoloration of the elders were measured before the educational program (baseline- T0) and after 6 (T1), 12 (T2), 18 (T3) and 24 months (T4). Caregivers answered questions about their knowledge, doubts and implementation of dental care (T0 to T4). Result: After analyzing the data (Friedman, Chi-square and Spearman α = 0.05), a gradual improvement in the oral hygiene of the subjects was observed, with an increased frequency of brushing (p=0.0005), a change in the brush type (p=0.0065) and a reduction in the plaque index (p<0.05) and tongue coating (p<0.05). Caregivers showed a marked improvement in their dental care knowledge. Conclusion: It was concluded that the educational program for caregivers had a positive impact in the oral health of institutionalized elderly observed by the increased in the effectiveness of oral hygiene parameters such as plaque index and tongue coating, contributing to the knowledge gain in hygiene by caregivers.

Objetivo: Devido ao aumento do número de idosos que vivem em instituições de longa permanência são essenciais projetos de ações para melhorar a saúde bucal. Assim, o objetivo deste estudo foi avaliar o impacto de um programa educacional para os cuidadores de idosos institucionalizados por meio da avaliação da higiene bucal. Material e método: O programa de educação consistiu em palestras para cuidadores sobre saúde bucal que foram realizadas uma vez por mês. Foram avaliados 40 idosos institucionalizados dependentes funcionalmente e 14 cuidadores. Os hábitos de higiene, o índice de placa e o revestimento/descoloração da língua dos idosos foram avaliados antes do programa educacional (T0) e após 6 (T1), 12 (T2), 18 (T3) e 24 meses (T4). Os cuidadores responderam perguntas sobre seus conhecimentos, suas dúvidas e sobre a implementação de cuidados bucais (T0 a T4). Resultado: Após análise dos dados (Friedman, Qui-quadrado e Spearman, α = 0,05), observou-se melhora gradual na higiene oral dos idosos, com maior freqüência de escovação (p = 0,0005), alteração do tipo de escova (p = 0,0065) e redução do índice de placa (p <0,05) e revestimento da língua (p <0,05). Os cuidadores mostraram uma melhoria acentuada no seu conhecimento sobre saúde bucal. Conclusão: Concluiu-se que o programa educacional para cuidadores teve um impacto positivo na saúde bucal dos idosos institucionalizados observado pelo aumento na eficácia dos parâmetros de higiene bucal, como índice de placa e revestimento da língua, contribuindo para o ganho de conhecimento em higiene pelos cuidadores.