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1.
Zhonghua Yi Xue Za Zhi ; 100(1): 32-36, 2020 Jan 07.
Artigo em Chinês | MEDLINE | ID: mdl-31914555

RESUMO

Objective: To investigate the correlation between social support, resilience, self-esteem and post-traumatic stress disorder (PTSD) in intensive care unit (ICU) nurses. Methods: A total of 717 ICU nurses from 24 provinces conducted these questionnaires (Chinese version of Impact of Event Scale-Revised(IES-R), Social Support Rate Score(SSRS), Cannor-Davidson Resilience(CD-RISC) and Self-Esteem Scale(SES)). There were 101 males and 616 females, with an average age of (30±5) years. With the aim to investigate PTSD impact factors, the ICU nurses were divided into the PTSD positive group (IES-R>35) and PTSD negative group (IES-R<35). The correlation between IES-R and other scales were analyzed with linear regression analysis. Results: In this investigation, 414 nurses were screened with PTSD and 303 nurses without. IES-R score was negatively correlated with SSRS, CD-RISC and SES (r=-0.275, -0.202, -0.709, all P<0.05). Multivariate regression analysis showed that ICU clinical experience was an independent risk factor for PTSD, and SES Score, SSRS Score and physical health status were protective factors. SES partially mediated the association of SSRS with IES-R, and the mediating effect were 51.5%. The area under characteristic curve (ROC) showed that SSRS score, CD-RISC score, SES score and PTSD risk score Logit (P) for prediction of PTSD was 0.629, 0.604, 0.831 and 0.848, respectively. Conclusions: Social support, physical health and self-esteem are protective factors of PTSD, while ICU clinical experience is a risk factor. SES partially mediated the association of SSRS with IES-R.


Assuntos
Transtornos de Estresse Pós-Traumáticos , Adulto , Feminino , Humanos , Unidades de Terapia Intensiva , Masculino , Análise de Regressão , Apoio Social , Inquéritos e Questionários
2.
Chemosphere ; 239: 124667, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31499299

RESUMO

Exposure to air pollution can have both short-term and long-term effects on health. However, the relationships between specific pollutants and their effects can be obscured by characteristics of both the pollution and the exposed population. One way of elucidating the relationships is to link exposures and internal changes at the level of the individual. To this end, we combined personal exposure monitoring (59 individuals, Oxford Street II crossover study) with mass-spectrometry-based analyses of putative serum albumin adducts (fixed-step selected reaction monitoring). We attempted to infer adducts' identities using data from another, higher-resolution mass spectrometry method, and were able to detect a semi-synthetic standard with both methods. A generalised least squares regression method was used to test for associations between amounts of adducts and pollution measures (ambient concentrations of nitrogen dioxide and particulate matter), and between amounts of adducts and short-term health outcomes (measures of lung health and arterial stiffness). Amounts of some putative adducts (e.g., one with a positive mass shift of ∼143 Da) were associated with exposure to pollution (11 associations), and amounts of other adducts were associated with health outcomes (eight associations). Adducts did not appear to provide a link between exposures and short-term health outcomes.


Assuntos
Poluentes Atmosféricos/análise , Poluição do Ar/análise , Exposição Ambiental/efeitos adversos , Monitoramento Ambiental/métodos , Albumina Sérica/química , Estudos Cross-Over , Feminino , Humanos , Masculino , Dióxido de Nitrogênio/análise , Material Particulado/análise , Análise de Regressão
3.
J Sci Food Agric ; 100(1): 371-375, 2020 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-31577843

RESUMO

BACKGROUND: The identification of tea varieties is essential to obtain high-quality tea that can command a high price. To identify tea varieties quickly and non-destructively, and to fight against counterfeit and inferior products in the tea market, a new method of visible / near-infrared spectrum processing based on competitive adaptive reweighting algorithms-stepwise regression analysis (CARS-SWR) variable optimization is proposed in this paper. RESULTS: The spectral data of five different tea varieties were obtained by visible / near-infrared spectrometry. The spectral data were preprocessed by the multivariate scattering correction (MSC) algorithm. First, 20 wavelength variables were selected by CARS, and then six optimal wavelength variables were selected using the SWR method, based on the CARS optimal variables. The generalized regression neural network (GRNN) classification model and probabilistic neural network (PNN) classification model were established, based on spectral information from the full wavelength, the CARS preferred wavelength variable, the SWR preferred wavelength variable, and the CARS-SWR preferred wavelength variable. CONCLUSION: It was found that the CARS-SWR-PNN model had the best classification effect by comparing different modeling results. The classification accuracy of its training set and test set reached 100%. This shows that the CARS-SWR preferred variable method combined with the visible / near-infrared spectrum is feasible for the rapid and non-destructive identification of tea varieties. © 2019 Society of Chemical Industry.


Assuntos
Camellia sinensis/química , Espectroscopia de Luz Próxima ao Infravermelho/métodos , Algoritmos , Camellia sinensis/classificação , Folhas de Planta/química , Folhas de Planta/classificação , Análise de Regressão , Chá/química
4.
Huan Jing Ke Xue ; 40(6): 2565-2571, 2019 Jun 08.
Artigo em Chinês | MEDLINE | ID: mdl-31854647

RESUMO

Based on the annual average concentration values, the health effects and health benefits as well as 95% confidence intervals of PM10 and PM2.5 pollution control from 2014 to 2016 in Zhengzhou were evaluated by applying the Poisson regression relative risk model. Results showed that the health benefits of PM10 pollution control were 18.18 billion RMB (15.04, 21.12), 24.25 billion RMB (20.25, 27.94), and 20.62 billion RMB (17.33, 23.92), which accounted for 2.7%, 3.3%, and 2.5% of the GDP of Zhengzhou, respectively, in 2014-2016. The health benefits of PM2.5 pollution control were 17.88 billion RMB (14.37, 21.16), 21.65 billion RMB (17.46, 25.53), and 17.25 billion RMB (13.78, 20.55), which accounted for 2.6%, 3.0%, and 2.1% of the GDP of Zhengzhou, respectively, in 2014-2016. After the PM10 and PM2.5 pollution was controlled, the number of urban beneficiaries was higher than that of rural areas, and acute bronchitis beneficiaries were higher than the beneficiaries of other health end-points. For chronic bronchitis, adults benefited more than children, while the opposite occurred for asthma. In this study, chronic bronchitis had the highest health benefit, followed by asthma, and outpatient and inpatient setting had the lower health benefits.


Assuntos
Poluentes Atmosféricos/efeitos adversos , Poluição do Ar/prevenção & controle , Material Particulado/efeitos adversos , Adulto , Asma/prevenção & controle , Bronquite Crônica/prevenção & controle , Criança , China , Humanos , Análise de Regressão
5.
Medicine (Baltimore) ; 98(51): e18364, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31860995

RESUMO

Gallbladder cancer (GBC) is a rare biliary malignancy. The relationship between red blood cell distribution width (RDW) and cancer prognosis has been confirmed by many studies, however, the relationship between RDW and gallbladder cancer is rarely reported. Therefore, we aimed to assess the correlation between RDW and the advancements of GBC in this study.A retrospective study was performed on 108 GBC patients and 119 age and gender-matched individuals who were admitted to the First Affiliated Hospital of Guangxi Medical University from January 2012 to December 2018.The GBC patients had significantly higher RDW(%) levels compared to the healthy controls group (15.7 ±â€Š2.4 vs 13.5 ±â€Š0.6; P = .000). In addition, GBC patients with stage III+IV had higher levels of RDW(%) than stage I+II (16.1 ±â€Š2.5 vs 14.9 ±â€Š2.0, P = .011). Correlation analysis showed that RDW had positive correlations with TNM stage (correlation coefficient = 0.302, P = .002). The cut-off value of RDW was observed to be 14.5% in patients with GBC (area under the curve = 0.757, 95% confidence interval = 0.677-0.838, P = .000). Univariate logistic regression and multivariate logistic regression analysis showed that RDW was an independent risk factor for GBC lymph node metastasis.Our results suggest that elevated levels of RDW are independently associated with GBC patients and may serve as potential markers for the advancements of GBC.


Assuntos
Índices de Eritrócitos , Neoplasias da Vesícula Biliar/patologia , Biomarcadores/sangue , Estudos de Casos e Controles , Feminino , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Análise de Regressão , Estudos Retrospectivos , Fatores de Risco , Sensibilidade e Especificidade
6.
Medicine (Baltimore) ; 98(51): e18033, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31860953

RESUMO

OBJECTIVES: Although there is evidence that aspirin might be able to prevent pancreatic cancer, the findings have been inconsistent. In this paper, we conducted a meta-analysis of observational studies to examine the relationship between aspirin use and the risk of pancreatic cancer. METHODS: We identified potential studies by searching the MEDLINE, EMBASE, and Wangfang (Chinese database) database (from 1967 to March 2017) and by reviewing the bibliography of relevant publications. Random effects model was used to calculate odds ratio (OR) and 95% confidence interval. The Cochran Q statistic (significance level at P < .1) was used to assess heterogeneity in this study. The author adopted weighted regression method of Egger to assessed publication bias. RESULTS: A total of 12 studies involving 4748 pancreatic cancer cases, were included in the meta-analysis. The study reflected that there was no signification association between aspirin use and mortality risk of pancreatic cancer. Aspirin use might reduce the incidence of pancreatic cancer. Specifically, there was a high signification association between frequent aspirin use and reduced pancreatic cancer incidence, without heterogeneity. In addition, there was a high signification association between duration of aspirin use more than 5 years and reduced pancreatic cancer incidence, without obvious heterogeneity among the original studies. CONCLUSIONS: In summary, this meta-analysis suggested that the aspirin use might be negatively related to the incidence risk of pancreatic cancer. Specifically, the frequency and duration of aspirin use might play an important role in decreasing the incidence of pancreatic cancer.


Assuntos
Anti-Inflamatórios não Esteroides/uso terapêutico , Aspirina/uso terapêutico , Neoplasias Pancreáticas/epidemiologia , Neoplasias Pancreáticas/prevenção & controle , Idoso , China , Relação Dose-Resposta a Droga , Esquema de Medicação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Observacionais como Assunto , Neoplasias Pancreáticas/fisiopatologia , Prevalência , Prognóstico , Análise de Regressão , Medição de Risco
7.
Anticancer Res ; 39(11): 6359-6363, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31704868

RESUMO

BACKGROUND/AIM: To analyze whether demographic and facility type characteristics cause inequality in the type of biopsy performed in patients with cutaneous melanoma. PATIENTS AND METHODS: The skin cancer National Cancer Database was assessed. Men and women of all ages with cutaneous melanoma in situ and malignant melanoma at any stage of the disease were included. Patients were selected who underwent one of the following biopsy types: excisional, punch, shave, or incisional. Bivariate and multivariate analyses were performed. RESULTS: We found that the likelihood of undergoing an excisional biopsy decreased in patients who were: Hispanic [odds ratio (OR)=0.63, confidence interval (CI)=0.55-0.71], non-White (OR=0.66, CI=0.58-0.76), older than 80 years (OR=0.77, CI=0.72-0.87), or in Comprehensive Community Cancer Programs (OR=0.33, CI=0.31-0.36), Community Cancer Programs (OR=0.52, CI=0.50-0.54) and Integrated Network Cancer Programs (OR=0.58, CI=0.55-0.61). CONCLUSION: Our study results demonstrate disparities in biopsy type in the treatment of melanoma.


Assuntos
Biópsia/métodos , Disparidades em Assistência à Saúde , Melanoma/patologia , Neoplasias Cutâneas/patologia , Padrão de Cuidado , Fatores Etários , Biópsia/normas , Grupos de Populações Continentais , Grupos Étnicos , Feminino , Disparidades em Assistência à Saúde/etnologia , Hispano-Americanos , Humanos , Cobertura do Seguro/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Análise de Regressão , Características de Residência , Fatores Sexuais , Fatores Socioeconômicos
8.
J Contemp Dent Pract ; 20(7): 818-821, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31742565

RESUMO

AIM: The aim of this study was to determine the predictors of proximal decay in the permanent first molar. MATERIALS AND METHODS: A cross-sectional study was conducted at the Department of Oral Medicine, Dow Dental College, Dow University of Health Sciences. A total of 171 patients presenting with 227 first molars were included. Calibrated examiners performed a detailed history and examination using a specialized form. The form recorded caries predictors and assigned a caries risk category based on the presence of these predictors. The statistical analysis was performed using the SPSS for windows version 17. A descriptive analysis was used to calculate the mean and proportions. Backward regression was carried out to evaluate the predictor for caries on mesial and distal surfaces at p ≤ 0.05. RESULTS: The included 171 patients presented with a total of 227 decayed first molars and 412 decayed proximal surfaces. The mesial surface was found to be more affected by decay (0.92 ± 0.85). The caries risk profile explains 60%, and caries on the adjacent surface explains 90% of caries occurrence on the mesial surface. In the case of distal surfaces, the predictor which can cause caries significantly was caries risk only. The caries risk profile explains the 3% of caries occurrence on distal surfaces. CONCLUSION: Our study identified caries on the adjacent tooth surface and the caries risk profile as significant predictors of future caries risk for the mesial surface of permanent molars. CLINICAL SIGNIFICANCE: Predictors for mesial and distal surfaces of the permanent first molar may differ. Overall caries risk and status of adjacent teeth must be taken into account to predict future caries occurrence.


Assuntos
Cárie Dentária , Dente Molar , Estudos Transversais , Índice CPO , Suscetibilidade à Cárie Dentária , Humanos , Análise de Regressão
9.
Medicine (Baltimore) ; 98(44): e17725, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689813

RESUMO

Bladder cancer (BC) is a common malignancy associated with high morbidity and mortality, however, accurate and convenient risk assessment tools applicable to BC patients are currently lacking. Previous studies using nomograms to evaluate bladder cancer (BC) survival have been based on small samples. Using a large dataset, this study aimed to construct more precise clinical nomograms to effectively predict bladder cancer survival.Data on patients with pathologically-confirmed bladder cancer were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Additional BC patient data for an external validation cohort were extracted from the Cancer Genome Atlas (TCGA) database. Clinical parameters that constituted potential risk factors were reviewed and analyzed using univariate and multivariate Cox proportional hazards regression. A nomogram was constructed with parameters that significantly correlated with the overall survival (OS). Prognostic performance of a nomogram was assessed using the concordance index (c-index), area under the receiver operating characteristic curve (AUC), and a calibration curve. The model was then tested with data from an internal and external validation cohort. Patients' survival was analyzed and compared with the Kaplan-Meier (KM) method.Multivariate Cox regression showed that age, sex, race, stage_T1, stage_T2a, stage_T2b, stage_T3a, stage_Ta, stage_Tis, stage_N, stage_M were independent predictors of BC survival. A nomogram was constructed based on these factors. The c-index of the nomogram was 0.7916 (95% confidence interval CI, 0.79-0.80). The calibration curve showed excellent agreement between the predicted and observed values. The c-index for the internal validation cohort was 0.7917 (95% CI 0.79-0.80), which was higher than for the training cohort, suggesting robustness of the model. For the training cohort, the AUC for the 3- and the 5-year survival was 0.82 and 0.813, respectively. The c-index for the TNM-based model was superior to that for the AJCC-TNM classification.The models presented in this study might be suitable for clinical use, supporting clinicians in their individualized assessment of expected survival in BC patients. They might also be used as a layered tool for clinical research.


Assuntos
Nomogramas , Neoplasias da Bexiga Urinária/mortalidade , Idoso , Idoso de 80 Anos ou mais , Área Sob a Curva , Bases de Dados Factuais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Modelos de Riscos Proporcionais , Curva ROC , Análise de Regressão , Reprodutibilidade dos Testes , Medição de Risco , Fatores de Risco , Programa de SEER , Taxa de Sobrevida , Neoplasias da Bexiga Urinária/patologia
10.
Medicine (Baltimore) ; 98(44): e17740, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689822

RESUMO

To identify independent factors associated with prolonged hospital length of stay (LOS) in elderly patients undergoing first-time elective open posterior lumbar fusion surgery.We retrospectively analyzed the data of 303 elderly patients (age range: 60-86 years) who underwent first-time elective open lumbar posterior fusion surgery at our center from December 2012 to December 2017. Preoperative and perioperative variables were extracted and analyzed for all patients, and multivariate stepwise regression analysis was used to determine the variables affecting the LOS and important predictors of LOS prolongation (P < .001).The mean age of the patients was 67.0 ±â€Š5.5 years, and the mean LOS was 18.5 ±â€Š11.8 days, ranging from 7 to 103 days. Of the total, 166 patients (54.8%) were men and 83 patients (27.4%) had extended LOS. Multiple linear regression analysis determined that age (P < .001), preoperative waiting time ≥7 days (P < .001), pulmonary comorbidities (P = .010), and diabetes (P = .010) were preoperative factors associated with LOS prolongation. Major complications (P = .002), infectious complications (P = .001), multiple surgeries (P < .001), and surgical bleeding (P = .018) were perioperative factors associated with LOS prolongation. Age (P < .001), preoperative waiting time ≥7 days (P < .001), infectious complications (P < .001), and multiple surgeries (P < .001) were important predictors of LOS prolongation.Extended LOS after first-time elective open posterior lumbar fusion surgery in elderly patients is associated with factors including age, preoperative waiting time, infectious complications, and multiple surgeries. Surgeons should recognize and note these relevant factors while taking appropriate precautions to optimize the modifiable factors, thereby reducing the LOS as well as hospitalization costs.


Assuntos
Procedimentos Cirúrgicos Eletivos/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos , Fusão Vertebral/estatística & dados numéricos , Fatores de Tempo , Tempo para o Tratamento/estatística & dados numéricos , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Procedimentos Cirúrgicos Eletivos/efeitos adversos , Procedimentos Cirúrgicos Eletivos/métodos , Feminino , Humanos , Vértebras Lombares/cirurgia , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Complicações Pós-Operatórias/etiologia , Período Pré-Operatório , Análise de Regressão , Estudos Retrospectivos , Fatores de Risco , Fusão Vertebral/efeitos adversos , Fusão Vertebral/métodos , Listas de Espera
11.
Medicine (Baltimore) ; 98(44): e17781, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689846

RESUMO

BACKGROUND: Opinion regarding whether Helicobacter pylori infection can promote the occurrence and development of nonalcoholic fatty liver (NAFLD) is divided. Therefore, we aimed to assess the exact relationship between H pylori infection and NAFLD by integrating all available data. METHODS: The articles about H pylori infection and NAFLD were collected by searching the databases of PubMed, Embase, Web of Science, Scopus, China National Knowledge Infrastructure, and WanFang. The random-effects model was used for data analysis, followed by subgroup analysis and meta-regression to explore sources of heterogeneity. RESULTS: Twenty-one articles were included in the study. Pooled analysis showed that H pylori infection indeed promoted NAFLD. Subgroup analysis and regression analysis showed that case-control ratio may be one of the sources of heterogeneity. CONCLUSIONS: H pylori infection is indeed one of the factors that promotes the progression of NAFLD for the Asian population. This provides new approaches for clinical prevention and treatment for NAFLD.


Assuntos
Infecções por Helicobacter/complicações , Infecções por Helicobacter/microbiologia , Helicobacter pylori , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Hepatopatia Gordurosa não Alcoólica/microbiologia , Adulto , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Análise de Regressão , Fatores de Risco
12.
Braz Oral Res ; 33: e094, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31618294

RESUMO

This study aimed to analyze the association of sociodemographic, child health, healthcare service, and access indicators with developmental defects of enamel (DDE) acquired outside the uterus, based on gestational factors. A cohort of births was carried out, and 982 children aged 12 to 30 months were examined. A total of 1,500 women were followed up as of the 5th month of gestation, and the child's gestational age was evaluated at follow-up. The clinical examination was performed as recommended by the World Health Organization, and defects were classified using the modified DDE index. Six models were considered: presence of DDE (Model 1) or opacities (Model 4), number of teeth with DDE (Model 2) or opacities (Model 5), and incidence rate of DDE (Model 3) or opacities (Model 6). Associations were estimated by relative risk (RR) in Poisson regression models. In the adjusted analysis, the mother's lowest education level was associated with the highest occurrence of DDE in Models 1 (RR = 26.43; p = 0.002), 2 (RR = 9.70; p = 0.009), and 3 (RR = 5.63; p = 0.047). Breastfeeding for over 12 months (RR = 0.45; p = 0.030) and recent use of anti-infection drugs (RR = 0.20; p = 0.039) had a protective effect on DDE (Model 1). The factors associated with the highest incidence of opacities were not having health insurance (RR = 2.00; p = 0.043) (Model 5), and belonging to a family of poor social class (RR = 4.67; p = 0.007) (Model 6). Children in a situation of socioeconomic vulnerability have a higher risk of presenting extrauterine DDE. Breastfeeding was a protection factor for DDE development.


Assuntos
Hipoplasia do Esmalte Dentário/epidemiologia , Hipoplasia do Esmalte Dentário/etiologia , Esmalte Dentário/anormalidades , Brasil/epidemiologia , Aleitamento Materno , Pré-Escolar , Hipoplasia do Esmalte Dentário/prevenção & controle , Feminino , Idade Gestacional , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Incidência , Lactente , Masculino , Modelos Teóricos , Estudos Prospectivos , Análise de Regressão , Medição de Risco , Fatores de Risco , Fatores Socioeconômicos , Populações Vulneráveis
13.
Bull Cancer ; 106(11): 959-968, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31623835

RESUMO

INTRODUCTION: Totally implanted venous access (TIVA) improves the safety and welfare of patients treated with cancer chemotherapy (CCT). We aimed to evaluate patients' perception of TIVA placement, TIVA use, and information on TIVA, and to assess the association between patients' perception and their attitude regarding a potential TIVA re-implantation. METHODS: We conducted a single center cross-sectional survey in a university hospital in Northern France. Patients included were consecutive urologic or digestive cancer inpatients admitted for a CCT cycle via TIVA between April 9th and May 9th 2014. We analyzed patients' satisfaction, experience, and attitude, especially when requiring potential TIVA re-implantation under local anesthesia (LA), using a standardized questionnaire and medical records. We analyzed risk factors for refusing potential TIVA re-implantation under LA using multivariate logistic regression. RESULTS: Eighty-one patients were interviewed (no refusals), including 57 with a TIVA device placed under LA in our university hospital. Among them, 52/57 (91%) reported satisfactory TIVA placement, but respectively 21/57 (37%) and 18/57 (32%) complained of painful or uncomfortable TIVA placement; 51/57 (89%) were satisfied with care provided during CCT cycles. Risk factors for refusing potential re-implantation under LA were: TIVA placement considered painful (P=0.012) or uncomfortable (P=0.038) and dissatisfaction with care provided during CCT cycles (P=0.028). DISCUSSION: We show that despite good overall satisfaction regarding TIVA, some aspects were less positive and warrant improvement actions. It suggests that these actions could not only improve patients' experience of TIVA use but could also facilitate continuation of treatment in the long term.


Assuntos
Atitude , Neoplasias do Sistema Digestório/psicologia , Satisfação do Paciente , Neoplasias Urológicas/psicologia , Dispositivos de Acesso Vascular , Adulto , Idoso , Idoso de 80 Anos ou mais , Anestesia Local , Estudos Transversais , Neoplasias do Sistema Digestório/tratamento farmacológico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor Processual/etiologia , Análise de Regressão , Retratamento/psicologia , Fatores de Risco , Inquéritos e Questionários , Recusa do Paciente ao Tratamento/psicologia , Recusa do Paciente ao Tratamento/estatística & dados numéricos , Neoplasias Urológicas/tratamento farmacológico , Dispositivos de Acesso Vascular/efeitos adversos
14.
Beijing Da Xue Xue Bao Yi Xue Ban ; 51(5): 919-924, 2019 Oct 18.
Artigo em Chinês | MEDLINE | ID: mdl-31624399

RESUMO

OBJECTIVE: To evaluate the efficacy of occlusal improvement in the labial fixed orthodontic treatment in aggressive periodontitis patients and to explore the relationship between occlusal improvement and inflammation control. METHODS: Twenty-two aggressive periodontitis patients who underwent combined periodontal-orthodontic treatment were included in this study. The patient's photos were matched to the dental models and digital three dimentional models were acquired using 3Shape R700 laser scanner. The occlusal force distribution maps were generated in the OrthoAnalyzer software. The newly established occlusal force distribution score (OFDS) and proximal contact score (PCS) were used to evaluate the occlusal distribution changes before and after labial fixed orthodontic treatment for assessing the effectiveness of orthodontic treatment. The multi-level linear regression analysis was used to explore the relationship between the probing depth changes and OFDS or PCS changes to screen out the favorable orthodontic strategy for inflammation control, which would provide clinical strategy for combined periodontal-orthodontic treatment in aggressive periodontitis patients. RESULTS: At the patient level, OFDS was improved significantly after orthodontic treatment compared with the score before orthodontic treatment (84.5±20.9 vs.105.3±22.6, P <0.001) and PCS was improved significantly after orthodontic treatment compared with the score before orthodontic treatment (68.9±9.1 vs. 83.7±6.3, P <0.001).At the tooth level, the OFDS was significantly increased in the maxillary anterior teeth (P <0.001) while the PCS of the anterior teeth in both maxillary and mandible arches were significantly increased significantly (P <0.01). No significant changes were found in other tooth positions. The multilevel linear regression model showed that no significant correlation was found between age and gender and probing depth decrease (P >0.05). The baseline probing depth,OFDS improvements and PCS improvements (P <0.001) were positively correlated with probing depth decrease. CONCLUSION: This study showed that the distribution of occlusal force was more reasonable and the proximal contacts were more ideal in aggressive periodontitis patients. Orthodontic treatment was effective in improving occlusal force distribution by the above two ways. Especially, the OFDS and PCS improvements were both positively correlated with probing depth decrease, indicating that in the combined periodontal-orthodontic treatment for aggressive periodontitis patients, occlusal force distribution and proximal contact should be improved in order to facilitate periodontal improvement.


Assuntos
Periodontite Agressiva , Força de Mordida , Assistência Odontológica , Humanos , Análise de Regressão
15.
Br J Radiol ; 92(1104): 20190466, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31600090

RESUMO

OBJECTIVE: One approach to reduce treatment-related morbidity for human papilloma virus (HPV)-associated tonsil cancer is omitting radiotherapy to the contralateral neck. Pathologic risk factors for early contralateral neck disease, however, are poorly understood. We report on the risk contralateral neck failures from the time of pre-operative diagnostic imaging to time of planning for adjuvant radiation in a single institution series of HPV-associated tonsillar cancer patients undergoing surgery followed by radiotherapy (RT). METHODS: Retrospective analysis of 123 patients with T1-T3 HPV-positive tonsillar squamous cell carcinoma treated between 2010 and 2016 with transoral robotic surgery and selective ipsilateral neck dissection followed by adjuvant RT. Contralateral neck recurrence was classified as the detection of a pathologic node in the contralateral neck prior to initiation of adjuvant RT. RESULTS: Seven patients (5.7%) developed contralateral neck disease/failure between the time of pre-operative diagnostic neck imaging and time of planning of adjuvant radiation. Increased ratio of positive/resected nodes [odds ratio (OR) 1.073, p = 0.005] was significantly associated with increased risk of contralateral neck recurrence, with a trend found for close/positive margins (OR 5.355, p = 0.06), tumor size (OR 2.046, p = 0.09), and total number of nodes positive (OR 1.179, p = 0.062). CONCLUSIONS: Patients who develop very early contralateral neck disease, between completion of ipsilateral neck dissection and the initiation of radiotherapy, have a higher ratio of positive nodes to total nodes resected in the ipsilateral neck. These findings suggest that proper selection of patients for omission of treatment of the contralateral, node-negative neck should be made with this in mind, with future studies needed to document the impact on toxicity and disease outcomes from such an approach. ADVANCES IN KNOWLEDGE: Pathologic risk factors in the dissected, ipsilateral neck in patients with tonsil cancer may inform the risk of contralateral neck failure. Patient selection for future, prospective efforts to examine sparing of the contralateral neck need to be based with these risk factors in mind.


Assuntos
Carcinoma de Células Escamosas/radioterapia , Carcinoma de Células Escamosas/cirurgia , Segunda Neoplasia Primária/etiologia , Infecções por Papillomavirus/complicações , Neoplasias Tonsilares/radioterapia , Neoplasias Tonsilares/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/virologia , Feminino , Humanos , Excisão de Linfonodo , Metástase Linfática , Masculino , Margens de Excisão , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Razão de Chances , Papillomaviridae , Período Pós-Operatório , Radioterapia Adjuvante/métodos , Radioterapia de Intensidade Modulada , Análise de Regressão , Estudos Retrospectivos , Risco , Neoplasias Tonsilares/patologia , Neoplasias Tonsilares/virologia , Carga Tumoral
16.
Rev Bras Epidemiol ; 22Suppl 02(Suppl 02): E190015.SUPL.2, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31596386

RESUMO

INTRODUCTION: Despite the improvement in oral health conditions observed in the Brazilian population, there are still high social inequalities that must be monitored. OBJECTIVE: To evaluate income inequality in oral hygiene practices, oral health status and the use of dental services in the adult and senior Brazilian population. METHODS: Data from the National Health Survey conducted in 2013 (Pesquisa Nacional de Saúde - PNS 2013) were used for the population aged 18 years old or older. RESULTS: Inequalities were found among the income strata in most of the oral health indicators evaluated. The greatest inequalities were observed in the use of dental floss, in hygiene practices (PR = 2.85 in adults and PR = 2.45 in seniors), and in total tooth loss (PR = 6.74 in adults and PR = 2.24 in seniors) and difficulty in chewing (PR = 4.49 in adults and PR = 2.67 in seniors) among oral condition indicators. The magnitude of inequalities was high in both groups in most oral condition indicators. Income was a factor that persisted in limiting access to dental services, and even the lower income segments had high percentages that paid for dental consultations. CONCLUSION: Based on data from the first PNS, the findings of this study enabled the identification of oral health and dental care aspects more compromised by income differentials, thus, contributing to the planning of dental care in Brazil and to stimulate the monitoring of these disparities with data from future surveys.


Assuntos
Serviços de Saúde Bucal/estatística & dados numéricos , Inquéritos de Saúde Bucal/métodos , Acesso aos Serviços de Saúde/estatística & dados numéricos , Renda/estatística & dados numéricos , Saúde Bucal/estatística & dados numéricos , Classe Social , Adolescente , Adulto , Brasil/epidemiologia , Inquéritos de Saúde Bucal/estatística & dados numéricos , Feminino , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Higiene Bucal , Prevalência , Análise de Regressão , Fatores Socioeconômicos , Adulto Jovem
17.
Pan Afr Med J ; 33: 136, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31565115

RESUMO

Introduction: Shisha consumption is a growing public health issue all over the globe and public health awareness about its deleterious health consequences is still not sufficiently raised. Methods: In this location-based study of nightclubs in Ibadan, Nigeria, 633 patrons of selected nightclubs were interviewed in order to obtain information on prevalence, correlates and predictors of shisha smoking. Results: The overall prevalence of shisha smoking was 7.1%. The age of initiation into shisha smoking was lower among women, p = 0.03, but men were significantly more likely to be more frequent users, daily or weekly users, p < 0.001 and also to be current cigarette smokers, p = 0.03. There was no significant gender variability in the stage of readiness to quit. Regression analysis showed that after adjusting for age, the predictors of shisha smoking were: cigarette smoking, OR = 4.83, 95% CI (1.49-15.70) and more than 12 years of education, OR = 7.55, 95% CI (1.88 - 30.37), while being a rural dweller was a protective factor, OR = 0.05, 95% CI (0.01-0.20). Conclusion: Shisha smoking has emerged as a prevalent public health issue in Nigeria. There is a need for an immediate response from policy providers towards shisha smoking intervention in Nigeria.


Assuntos
Fumar Cigarros/epidemiologia , Abandono do Hábito de Fumar/psicologia , Cachimbos de Água/estatística & dados numéricos , Fumar/epidemiologia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Prevalência , Fatores de Proteção , Análise de Regressão , Fatores de Risco , Fatores Sexuais
18.
Pan Afr Med J ; 33: 158, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31565120

RESUMO

Introduction: While HIV care among tuberculosis (TB) patients is successfully implemented and monitored, it is not routinely reported among "presumptive TB patients without TB". The present study describes the ascertainment of HIV status and receipt of antiretroviral therapy (ART) and the associated factors among presumptive TB patients (with and without TB) in 35 public health facilities of Masvingo district of Zimbabwe from January to June 2017. Methods: This was an analysis of secondary programme data. We performed log binomial regression to calculate adjusted relative risks (aRR) and 95% confidence intervals (CI). Results: Of 1369 presumptive TB patients, 1181 (86%) were ascertained for HIV status (98% among those subsequently diagnosed with TB, 83% among non-TB). Of them, 748 (63%) were HIV positive, more among TB patients (69%) than those without TB (61%). Among HIV-positive patients, 475 (64%) received ART, significantly higher among TB patients (78%) compared to those without TB (57%). Patients without TB were significantly more likely to have non-ascertained for HIV status (aRR=2.4, 95% CI=1.4-5.0) and not receiving ART (aRR=1.8, 95% CI=1.6-2.0), compared to those with TB. Conclusion: We found high rates of HIV status ascertainment among presumptive TB patients. But, ART uptake was poor among "presumptive TB patients without TB", despite implementation of "test and treat" strategy in Zimbabwe. The programme should step up the monitoring of HIV status and ART receipt among presumptive TB patients, by introducing an indicator in the quarterly reports of the national TB programme.


Assuntos
Fármacos Anti-HIV/administração & dosagem , Infecções por HIV/diagnóstico , Programas de Rastreamento/métodos , Tuberculose/epidemiologia , Adolescente , Adulto , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde , Análise de Regressão , Tuberculose/diagnóstico , Adulto Jovem , Zimbábue
19.
Plant Dis ; 103(12): 3093-3100, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31613191

RESUMO

In Nebraska, rotation of soybean (Glycine max) fields to corn (Zea mays) is a major practice to manage the soybean cyst nematode (SCN; Heterodera glycines). However, factors associated with SCN population density decline during corn rotation are not clearly defined. This study addresses that question using a modeling approach. Seventy-nine fields were sampled in 2009, 2010, and 2011 to determine SCN population densities (eggs/100 cm3 of soil) before and after rotation. After rigorous field screening and model testing and validation, the regression model Log(Pf)^=-2.3360+0.8368LogPi+0.4333pH was developed, where Log Pf is the natural log of SCN eggs at the end of the rotation year, Pi is the population density before rotation, and pH is the soil pH. Model goodness-of-fit was assessed through residual analysis, information criteria, and other remedial measures. Model overdispersion was 1.04. Validation in a 50 and a 75% random sample from the original data set showed little change in model regression coefficients, standard errors, and associated significance, confirming model fit and performance. The model indicates that for one-unit increase in soil pH, SCN Pf is expected to increase by 53.7% at constant Pi, and correspondingly, a 10% change in Pi will result in about 8.3% change in Pf at constant soil pH. The model suggested that SCN population levels before corn rotation and soil pH are major determinants of observed SCN population density reduction after annual corn rotation in Nebraska. This model has potential for use in SCN risk analysis and in predicting SCN population decline after corn rotation in the state.


Assuntos
Agricultura , Nematoides , Solo , Zea mays , Agricultura/métodos , Animais , Nebraska , Nematoides/fisiologia , Doenças das Plantas/parasitologia , Doenças das Plantas/prevenção & controle , Densidade Demográfica , Análise de Regressão , Rotação , Solo/parasitologia , Zea mays/crescimento & desenvolvimento , Zea mays/parasitologia
20.
Rev Saude Publica ; 53: 83, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31576943

RESUMO

OBJECTIVE: Assess the magnitude and trend of hospitalization rates due to traumatic injuries in intensive care units (ICU) in Brazil from 1998 to 2015. METHODS: This is an ecological time-series study that analyzed data from the Hospital Information System. A trend analysis of hospitalization rates was performed according to diagnosis, sex and age using generalized linear regression models and Prais-Winsten estimation. RESULTS: Rates were higher among male patients, but increased hospitalization due to trauma among female patients influenced the ratio between both sexes. Falls and transport accidents were the most frequent causes of trauma. The average annual growth was 3.6% in ICU trauma hospitalization rates in Brazil, the highest growth was reported in the North region (8%; 95%CI 6.4-9.6), among women (5.4%; 95%CI 4.5-6.3), and among people aged 60 years and older (5.5%; 95%CI, 4.7-6.3). The most frequent causes of trauma are falls (4.5%; 95%CI 3.5-5.5) and care complications (5.4%; 95%CI 4.5-6.3). On the other hand, the annual hospital mortality rate due to trauma in ICU is 1.7% lower, on average (95%CI 2.1-1.3). CONCLUSION: An increase in ICU hospitalization rate due to trauma in Brazil may be the result of some factors, such as an increasing number of accidents and cases of violence, the implementation of pre-hospital care, and improved access to care, with more beds in ICU. In addition, population aging is another factor, as a greater increase in hospitalization was observed among people aged 60 years and older.


Assuntos
Hospitalização/estatística & dados numéricos , Hospitalização/tendências , Unidades de Terapia Intensiva/estatística & dados numéricos , Unidades de Terapia Intensiva/tendências , Ferimentos e Lesões/epidemiologia , Acidentes por Quedas/estatística & dados numéricos , Acidentes de Trânsito/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Brasil/epidemiologia , Feminino , Mortalidade Hospitalar/tendências , Humanos , Masculino , Pessoa de Meia-Idade , Análise de Regressão , Distribuição por Sexo , Fatores de Tempo , Adulto Jovem
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