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1.
Medicine (Baltimore) ; 99(1): e18470, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31895779

RESUMO

The appropriate approach to dental patients, developed during the course of dentists' training, is a prerequisite for the holistic treatment of patients. Empathy is an important component of such an approach. This study aimed to determine the levels of empathy among students of dentistry at different stages in their training.The Jefferson Scale of Empathy - Health Profession Students Version was used to conduct the research, and 100 dental students (66 female and 34 male) ranging from first to fifth year participated in the survey. The scale contained 20 questions, with a possible score interval between 20 and 140. A higher score indicates increased ability to express empathy.The level of empathy among dentistry students increased from the first and second to fourth years, where it reached its maximum. During the fifth year, a decrease in levels of empathy was observed.The increase in empathy during the dental course may be correlated with the growth of clinical practice during the subsequent years of study. A slight decrease in empathy in the fifth-year students may be due to the curricular focus on performing procedures, with students having to meet a set target in order to finish the course.


Assuntos
Atitude do Pessoal de Saúde , Empatia , Estudantes de Odontologia/psicologia , Adulto , Educação em Odontologia , Feminino , Humanos , Masculino , Assistência Centrada no Paciente/métodos , Polônia , Distribuição por Sexo , Inquéritos e Questionários
2.
Braz Oral Res ; 33: e118, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31859707

RESUMO

The objective of this study was to investigate the experience of caries related to social capital and associated factors in adults in large-scale population-based study. A Cross-sectional study was performed in 163 municipalities in the State of São Paulo, Brazil (SBSP-2015). 17,560 people were evaluated, of which 6051 were adults aged 35-44 years. Hierarchical logistic regression analysis was proposed. Outcome variables (decayed teeth, missing teeth and DMFT) and independent variables were included in the model, considering the distal (income and schooling); intermediate (social capital) and proximal levels (sex and ethnicity). Results showed that income up to 1,500 reais - US$ 367.6 in 11/11/2019 - (OR = 1.91;1.75-2.08), schooling up to 8 years (OR = 1.32;1.12-1.56) and non-white ethnicity (OR = 1.54;1.35-1.76) were more likely to have decayed teeth. Income up to 1500 reais (OR = 1.29;1.15-1.44), schooling up to 8 years (OR = 2.13;1.90-2.38), low social capital (OR = 1.84;1.65-2.04), medium social capital (OR = 1.15;1.01-1.30) and females were more likely to have lost teeth (OR = 1.13;1.03-1.23). Schooling up to 8 years (OR = 1.51;1.35-1.69), low social capital (OR = 1.25; 1.14-1.37) and female (OR = 1.40,1.19-1.53) were associated with DMFT. It was concluded that sociodemographic factors and low social capital were associated with the experience of caries, which should be taken into account in the formulation of public policies.


Assuntos
Cárie Dentária/epidemiologia , Capital Social , Adulto , Brasil/epidemiologia , Estudos Transversais , Índice CPO , Feminino , Humanos , Modelos Logísticos , Masculino , Prevalência , Distribuição por Sexo , Fatores Socioeconômicos , Inquéritos e Questionários
3.
N Engl J Med ; 381(25): 2440-2450, 2019 12 19.
Artigo em Inglês | MEDLINE | ID: mdl-31851800

RESUMO

BACKGROUND: Although the national obesity epidemic has been well documented, less is known about obesity at the U.S. state level. Current estimates are based on body measures reported by persons themselves that underestimate the prevalence of obesity, especially severe obesity. METHODS: We developed methods to correct for self-reporting bias and to estimate state-specific and demographic subgroup-specific trends and projections of the prevalence of categories of body-mass index (BMI). BMI data reported by 6,264,226 adults (18 years of age or older) who participated in the Behavioral Risk Factor Surveillance System Survey (1993-1994 and 1999-2016) were obtained and corrected for quantile-specific self-reporting bias with the use of measured data from 57,131 adults who participated in the National Health and Nutrition Examination Survey. We fitted multinomial regressions for each state and subgroup to estimate the prevalence of four BMI categories from 1990 through 2030: underweight or normal weight (BMI [the weight in kilograms divided by the square of the height in meters], <25), overweight (25 to <30), moderate obesity (30 to <35), and severe obesity (≥35). We evaluated the accuracy of our approach using data from 1990 through 2010 to predict 2016 outcomes. RESULTS: The findings from our approach suggest with high predictive accuracy that by 2030 nearly 1 in 2 adults will have obesity (48.9%; 95% confidence interval [CI], 47.7 to 50.1), and the prevalence will be higher than 50% in 29 states and not below 35% in any state. Nearly 1 in 4 adults is projected to have severe obesity by 2030 (24.2%; 95% CI, 22.9 to 25.5), and the prevalence will be higher than 25% in 25 states. We predict that, nationally, severe obesity is likely to become the most common BMI category among women (27.6%; 95% CI, 26.1 to 29.2), non-Hispanic black adults (31.7%; 95% CI, 29.9 to 33.4), and low-income adults (31.7%; 95% CI, 30.2 to 33.2). CONCLUSIONS: Our analysis indicates that the prevalence of adult obesity and severe obesity will continue to increase nationwide, with large disparities across states and demographic subgroups. (Funded by the JPB Foundation.).


Assuntos
Obesidade Mórbida/epidemiologia , Obesidade/epidemiologia , Adulto , Índice de Massa Corporal , Feminino , Previsões , Humanos , Renda , Masculino , Obesidade/etnologia , Obesidade Mórbida/etnologia , Prevalência , Autorrelato , Distribuição por Sexo , Estados Unidos/epidemiologia
4.
Orv Hetil ; 160(52): 2047-2053, 2019 Dec.
Artigo em Húngaro | MEDLINE | ID: mdl-31868011

RESUMO

Introduction: The harmful effects represent an important public health problem in tha world. Aim: Our aim is to report and compare the results of screenings performed in Hungary's Comprehensive Health Screening Program 2010-2020-2030 (MÁESZ) with international data. Method: During the 9-year continuous screening, we analyzed the data of 71 922 women and 60 934 men in the 18-80-year-old population and examined the occurrence of regular daily smokers. Data were collected with the help of special screening data sheets. Results: 24.4% of males and 24.2% of females smoked regularly during the 9-year screening period. Between 2012 and 2015, smoking prevalence showed a temporary significant decline, then, from 2016, it started to increase again. The downturn coincided with the opening of national tobacco stores. In men, the proportion of smokers was significantly higher in young adults (18-25 years) than in women. Later in life, the difference leveled off and even between 46-55 years, the prevalence of smoking was greater in women. There is a difference in smoking patterns between the two genders, which is probably related to marriage and motherhood in women. After 56 years, the proportion of smokers in both genders decreased rapidly. The prevalence of smoking in Hungary in all age groups significantly exceeds the European and world average. Transient increases in middle-aged women have also been reported in European surveys. Conclusion: Compared to 2010, the proportion of smokers has decreased in Hungary, but a new surge observed after 2015 is not a positive phenomenon. We find the high proportion of smoking women worrying. Orv Hetil. 2019; 160(52): 2047-2053.


Assuntos
Fumar/epidemiologia , Tabagismo/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Hungria/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Distribuição por Sexo , Fatores Sexuais , Fumar/tendências , Abandono do Hábito de Fumar , Tabaco sem Fumaça , Adulto Jovem
5.
Medicine (Baltimore) ; 98(51): e18354, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31860991

RESUMO

Many cancer patients develop diabetes, which may result in reduction of chemotherapy effectiveness and increased infection risk and cardiovascular mortality. Diabetes may also increase the risks of chemotherapy-related toxicity and post-operative mortality, or represent an obstacle to optimal cancer treatment. However, the clinical predictors of diabetes in cancer patients remain largely unknown. Therefore, the aim of our study was to evaluate the risk factors for developing diabetes and construct a nomogram to predict diabetes in cancer patients.We investigated patients from a national sample cohort obtained from the Korea National Health Insurance Service (KNHIS), which included 2% of the Korean population. Patients who had undergone routine medical evaluation by the KNHIS between 2004 and 2008 and been hospitalized due to cancer (ICD-10 codes C00-97) during the past 3 years were included. After excluding patients with type 2 diabetes and missing data, 10,899 patients were enrolled and followed-up until 2013. A total of 7630 (70%) patients were assigned as the training cohort and used to construct the nomogram which was based on a multivariable logistic regression model. The remaining patients (n = 3269) were used as the validation cohort.The incidence rate of diabetes was 12.1 per 1000 person-years over a mean follow-up of 6.6 ±â€Š1.8 years. Significant risk factors for developing diabetes were age, sex, obesity, fasting plasma glucose, hypertension, and hypercholesterolmia. A nomogram was constructed using these variables and internally validated. The area under the curve was 0.70 (95% confidence interval, .666-.730, P < .0001) and the calibration plot showed agreement between the actual and nomogram-predicted diabetes probabilities.The nomogram developed in this study is easy to use and convenient for identifying cancer patients at high-risk for type 2 diabetes, enabling early type 2 diabetes screening and management.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Neoplasias/epidemiologia , Medição de Risco , Fatores Etários , Idoso , Glicemia/análise , Estudos de Coortes , Feminino , Seguimentos , Humanos , Hipercolesterolemia/epidemiologia , Hipertensão/epidemiologia , Incidência , Masculino , Nomogramas , Obesidade/epidemiologia , República da Coreia/epidemiologia , Fatores de Risco , Distribuição por Sexo , Fatores Sexuais
6.
MMWR Morb Mortal Wkly Rep ; 68(46): 1050-1056, 2019 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-31751321

RESUMO

Traumatic brain injury (TBI) affects the lives of millions of Americans each year (1). To describe the trends in TBI-related deaths among different racial/ethnic groups and by sex, CDC analyzed death data from the National Vital Statistics System (NVSS) over an 18-year period (2000-2017). Injuries were also categorized by intent, and unintentional injuries were further categorized by mechanism of injury. In 2017, TBI contributed to 61,131 deaths in the United States, representing 2.2% of approximately 2.8 million deaths that year. From 2015 to 2017, 44% of TBI-related deaths were categorized as intentional injuries (i.e., homicides or suicides). The leading category of TBI-related death varied over time and by race/ethnicity. For example, during the last 10 years of the study period, suicide surpassed unintentional motor vehicle crashes as the leading category of TBI-related death. This shift was in part driven by a 32% increase in TBI-related suicide deaths among non-Hispanic whites. Firearm injury was the underlying mechanism of injury in nearly all (97%) TBI-related suicides among all groups. An analysis of TBI-related death rates by sex and race/ethnicity found that TBI-related deaths were significantly higher among males and persons who were American Indians/Alaska Natives (AI/ANs) than among all other groups across all years. Other leading categories of TBI-related deaths included unintentional motor vehicle crashes, unintentional falls, and homicide. Understanding the leading contributors to TBI-related death and identifying groups at increased risk is important in preventing this injury. Broader implementation of evidence-based TBI prevention efforts for the leading categories of injury, such as those aimed at stemming the significant increase in TBI-related deaths from suicide, are warranted.


Assuntos
Lesões Encefálicas Traumáticas/mortalidade , Acidentes de Trânsito/estatística & dados numéricos , Lesões Encefálicas Traumáticas/etnologia , Lesões Encefálicas Traumáticas/etiologia , Grupos de Populações Continentais/estatística & dados numéricos , Grupos Étnicos/estatística & dados numéricos , Feminino , Armas de Fogo/estatística & dados numéricos , Humanos , Intenção , Masculino , Fatores de Risco , Distribuição por Sexo , Suicídio/etnologia , Suicídio/estatística & dados numéricos , Estados Unidos/epidemiologia
7.
Orv Hetil ; 160(47): 1864-1871, 2019 Nov.
Artigo em Húngaro | MEDLINE | ID: mdl-31736345

RESUMO

Introduction: The analysis of the mortality data of patients is important. Aim: Examination of data from patients treated in the Addictological Out-patient Clinic in Józsefváros and deceased between 2001 and 2018. Method: Patients' data originated from medical records. The national and Budapest data were from the publications of the Hungarian Central Statistical Office. Results: The age of patients was 52.85 ± 11.81 years for women and 51.99 ± 12.47 years for men. Two-thirds, regardless of gender, were alcoholic. There were many violent deaths. A new phenomenon was the high number of drug- and murder-associated deaths. The former group was dominated by men. The latter group showed female dominance. The completed suicide rate was 14.6%. Suicide attempts occurred in 22.4% of patients. The majority of patients were skilled workers. Conclusion: Data support the view that addict patients die earlier. Leading deaths, unlike previous investigations, were violent deaths. The rate of suicide was higher than the national rate, but it was the same as previously reported, indicating a high risk of this population. Gender differences were observed with regard to violent death, requiring further elucidation. Orv Hetil. 2019; 160(47): 1864-1871.


Assuntos
Alcoolismo/mortalidade , Pacientes Ambulatoriais/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/mortalidade , Suicídio/estatística & dados numéricos , Adulto , Idoso , Alcoolismo/etnologia , Instituições de Assistência Ambulatorial , Feminino , Homicídio , Humanos , Hungria/epidemiologia , Masculino , Pessoa de Meia-Idade , Distribuição por Sexo , Tentativa de Suicídio , Violência/estatística & dados numéricos
8.
Pan Afr Med J ; 33: 252, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692814

RESUMO

Introduction: HIV and syphilis are major public health problems in Morocco. The region of Souss-Massa, south-west of the country, hold more than 24% of HIV seropositive cases registered in Morocco during 2009. The aim of this study is to evaluate the seroprevalence of syphilis among HIV seropositive patients in the region of Souss-Massa, south-west of Morocco. Methods: To evaluate the seroprevalence of syphilis and neurosyphilis among HIV seropositive patients, we retrospectively investigated the medical records of HIV-infected patients attending the regional hospital located in the city of Agadir, during the period comprised between 2011 and 2016. Results: The population studied involved 1381 males (49.18%) and 1427 females (50.82%) HIV seropositive patients. Among them, 481 patients were seropositive for syphilis and three cases were diagnosed with neurosyphilis. The sex ratio distribution was 243 male (52.71%) and 218 female (47.29%). The prevalence of syphilis among the studied population was estimated to 16.42% with a slight dominance in male (17.63%) compared to female (15.28%). By contrast, neurosyphilis was only detected in male patients, with a prevalence estimated to 0.11%. Conclusion: Even if the prevalence of HIV and syphilis is stable in the region of Souss-Massa, the prevalence of syphilis among HIV seropositive patients remained high and correlated positively with that of HIV infection. We did not find a significant difference between the genders, in relation to the prevalence of HIV and syphilis. We concluded that it was essential to continue monitoring the population, in order to improve the prevention and the access to the medical care in the south-west of Morocco.


Assuntos
Infecções por HIV/epidemiologia , Neurossífilis/epidemiologia , Sífilis/epidemiologia , Feminino , Humanos , Masculino , Marrocos/epidemiologia , Prevalência , Estudos Retrospectivos , Estudos Soroepidemiológicos , Distribuição por Sexo
9.
Anticancer Res ; 39(11): 6333-6337, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31704864

RESUMO

BACKGROUND/AIM: To characterize the demographics, tumor staging and treatment of African American (AA) patients diagnosed with melanoma in the United States. PATIENTS AND METHODS: The National Cancer Database was used to extrapolate data from patients with melanoma between January 1, 2004, and December 31, 2015. The patients were then further divided based on ethnicity (AAs vs. Caucasians) to compare patient efficacy of treatment. RESULTS: The mean time for AA patients to receive treatment was 20.37 days compared with 11.25 days for Caucasians (p<0.001), while time to surgery was 38.86 days compared to 31.12 days for Caucasians (p<0.001). Moreover, AA race was a predictor of American Joint Committee on Cancer stage greater than II, tumor diagnosed at autopsy, presence of ulceration, and distribution in the extremities. CONCLUSION: AA patients with melanoma are more likely to have worse tumor staging, treatment delay, treatment at an Integrated Cancer Program, and diagnosis at autopsy.


Assuntos
Afro-Americanos , Grupo com Ancestrais do Continente Europeu , Melanoma/etnologia , Melanoma/terapia , Neoplasias Cutâneas/etnologia , Neoplasias Cutâneas/terapia , Tempo para o Tratamento/estatística & dados numéricos , Distribuição por Idade , Autopsia , Bases de Dados Factuais , Diagnóstico Tardio , Feminino , Humanos , Masculino , Melanoma/patologia , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Distribuição por Sexo , Neoplasias Cutâneas/patologia , Estados Unidos
10.
Orv Hetil ; 160(45): 1791-1797, 2019 Nov.
Artigo em Húngaro | MEDLINE | ID: mdl-31680539

RESUMO

Introduction: There are conflicting data on the prevalence and prognosis of AMI patients with non-obstructive coronary artery disease (MINOCA). Aim: We studied the prevalence and prognosis of MINOCA patients. Method: In the Hungarian Myocardial Infarction Registry (HUMIR) 45,223 patients (pts) with acute myocardial infarction (AMI) were found who were treated between Jan 1, 2014, and June 30, 2018, and coronary arteriography was performed. ST-elevation myocardial infarction was diagnosed in 22,469 pts (49.7%). Patients without obstructive coronary artery disease who had no previous myocardial infarction, heart failure, PCI and CABG procedure were selected to the MINOCA group (n = 2003). Patients with obstructive coronary artery disease belonged to the MICAD group (n = 43,220). We investigated clinical characteristics of the patients, overall survival and reinfarction. Survival curves were estimated with the Kaplan-Meier method and were modeled with the Cox proportional hazards model. Results: The proportion of MINOCA pts among all myocardial infarction was by 4.4% higher in the STEMI pts compared to the NSTEMI group (2.0% vs. 6.8%). The MINOCA pts were younger (age 64.0 ± 14.4 vs. 65.5 ± 12.2 years), and the proportion of women was higher (55.7% vs. 36.5%). Hypertension, diabetes mellitus and peripheral artery disease were more common in the MICAD group (79.1% vs. 73.7%, 33.0% vs. 21.2%, and 12% vs. 8%). The mortality was higher among the MICAD pts. In the MINOCA group, the mortality of men did not differ between STEMI and NSTEMI, as opposed to women: women with STEMI had higher mortality than women with NSTEMI. The risk of reinfarction was higher in the MICAD group, especially in NSTEMI, the risk in the MINOCA group was lower, and there was no substantial difference between types. Conclusion: In this real word, retrospective, observational study, we found a significant difference in the prevalence of MINOCA pts according to different types of myocardial infarction. In the MINOCA group, the mortality of women with STEMI was substantially higher. Orv Hetil. 2019; 160(45): 1791-1797.


Assuntos
Vasos Coronários/fisiopatologia , Infarto do Miocárdio/cirurgia , Intervenção Coronária Percutânea , Idoso , Angiografia Coronária , Vasos Coronários/diagnóstico por imagem , Feminino , Humanos , Hungria/epidemiologia , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/epidemiologia , Prevalência , Prognóstico , Sistema de Registros , Estudos Retrospectivos , Fatores de Risco , Distribuição por Sexo
11.
Undersea Hyperb Med ; 46(5): 581-601, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31683356

RESUMO

Introduction: We aimed to document identified cases of immersion pulmonary edema (IPE) in divers from Oceania (the Indo-Pacific region) from January 2002 to May 2018, inclusive. Method: Cases were identified using various sources, including searches of the Divers Alert Network Asia-Pacific (DAN AP) Fatality Database, published case reports, and interviews with survivors who had reported their incident to DAN AP. Where available, investigations, pathology and autopsy results were obtained. Only incidents diagnosed as IPE by diving physicians or pathologists with experience in the investigation of diving accidents were included. Individual case histories and outcomes, together with brief individual summaries of the associations and possible contributing factors were recorded. Results: Thirty-one IPE incidents in divers from Oceania were documented. There were two surface snorkelers, 22 scuba air divers and seven nitrox divers which included three closed-circuit rebreathers (CCR). The mean (SD) age was 53 (12) years, 58% of victims were females, and the average dive profile was to a maximum depth of 19 meters of seawater for 25 minutes. Six victims (19%) had previous episodes of IPE. There were nine recorded fatalities. Cardiac anomalies dominated the associated or possible contributing factors. These included valvular disease in 29%, transient cardiomyopathies in 26% and dysrhythmias in 16%. Conclusions: Previously reported associations of IPE such as exertion, stress, cold exposure, negative inspiratory pressure, hypertension, overhydration, ascent or surfacing, tight wetsuit, aspiration and certain medications were identified. Cardiac conditions were frequent and included chronic disorders (valvular pathology, coronary artery disease) and transient disorders (dysrhythmias, transient myocardial dysfunction, takotsubo or stress cardiomyopathy). It is likely that the chronic cardiac disorders may have contributed to the IPE, whereas the transient cases could be either sequelae, contributors or coincidental to the IPE.


Assuntos
Mergulho/efeitos adversos , Edema Pulmonar/etiologia , Adulto , Idoso , Autopsia , Doença das Coronárias/patologia , Suscetibilidade a Doenças/etiologia , Suscetibilidade a Doenças/patologia , Evolução Fatal , Feminino , Cardiopatias/complicações , Humanos , Imersão/efeitos adversos , Masculino , Pessoa de Meia-Idade , Oceania/epidemiologia , Esforço Físico , Edema Pulmonar/diagnóstico , Edema Pulmonar/epidemiologia , Edema Pulmonar/patologia , Fatores de Risco , Água do Mar , Distribuição por Sexo , Natação , Cardiomiopatia de Takotsubo/complicações , Adulto Jovem
12.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(11): 1158-1161, 2019 Nov 06.
Artigo em Chinês | MEDLINE | ID: mdl-31683405

RESUMO

The incidence and mortality rate of leukemia in the cancer registration areas of Zhejiang Province from 2010 to 2014 were analyzed to depict their epidemiological characteristics. From 2010 to 2014, 3789 new cases were diagnosed as leukemia in Zhejiang cancer registration areas, with a crude incidence rate of 6.47 per 100 000. The age-standardized incidence rate of males (standardized by China census data 2000) was 1.35 times that of females. The age-standardized incidence rate of urban areas was similar to that in rural areas (1.04∶1). From 2010 to 2014, 2 568 cases died due to leukemia, with a crude mortality rate of 4.38 per 100 000. The age-standardized mortality rate of males was 1.44 times that of females. The age-standardized mortality rate of urban areas was 0.99 times that of rural areas. The age-standardized incidence and mortality rate did not show any significant change from 2010 to 2014. The annual percent change of these two metrics was -2.36% (t=-0.62, P=0.579) and -3.46% (t=-2.41, P=0.095).


Assuntos
Leucemia/mortalidade , Vigilância da População/métodos , Sistema de Registros , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Distribuição por Idade , China/epidemiologia , Feminino , Humanos , Incidência , Masculino , Neoplasias , Distribuição por Sexo
13.
Am J Forensic Med Pathol ; 40(4): 312-317, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31688052

RESUMO

BACKGROUND: Schizophrenia is a detrimental psychiatric disorder, with an increased mortality from natural and nonnatural causes. METHODS: This study was a retrospective review of autopsy cases of all the individuals with history of schizophrenia investigated by the Office of the Chief Medical Examiner, State of Maryland, for a 5-year period from 2008 to 2012. RESULT: A total of 391 schizophrenia patients were autopsied at the Office of the Chief Medical Examiner because they died suddenly and unexpectedly. Their age ranged from 15 to 100 years with the mean age of 49.5 years. Of the 391 deaths, 191 (48.8%) were white, 185 (47.3%) were African American, and 15 (3.9%) were either Hispanic or Asian. The male and female ratio was 1.5:1. The majority of deaths (64.2%) were caused by natural diseases, 12.0% deaths were accidents, 11.5% deaths were suicides, and 9.7% deaths were homicides. The manner of death remained undetermined in 38 cases (9.7%). Of the 251 natural deaths, 198 cases (78.9%) were owing to cardiovascular diseases. Cause of death was listed as cardiac arrhythmia in 11 cases. This diagnosis of cardiac arrhythmia was made by exclusion based on death scene investigation, review of medical history, complete autopsy, and toxicological tests. Drug intoxication was the second most common cause of death. CONCLUSIONS: The study shows high fatality caused by cardiovascular diseases and drug intoxication among schizophrenia patients, which calls attention of the medical community to closely monitor the high risk factors of sudden death among schizophrenia patients.


Assuntos
Morte Súbita/epidemiologia , Esquizofrenia/epidemiologia , Acidentes/mortalidade , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/mortalidade , Grupos de Populações Continentais/estatística & dados numéricos , Médicos Legistas , Feminino , Homicídio/estatística & dados numéricos , Humanos , Masculino , Maryland/epidemiologia , Pessoa de Meia-Idade , Envenenamento/mortalidade , Estudos Retrospectivos , Distribuição por Sexo , Suicídio/estatística & dados numéricos , Adulto Jovem
14.
Niger Postgrad Med J ; 26(4): 211-215, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31621660

RESUMO

Introduction: Recent evidence suggests that rates of drug use and abuse in Nigeria exceed the global average. There is a strong treatment demand for psychoactive drug use disorders in Nigeria; however, it is not known whether available treatment facilities are attending to the array of treatment needs. This audit compares the pattern of presentations at a tertiary facility with a community-based survey. Methods: A review of cases (n = 212) seen at a regional drug treatment facility over a 4-year period, using local data retrieved from the Nigerian Epidemiological Network of Drug Use (NENDU) and comparison with data from the recently published national drug use survey. Results: Nine out of ten clients seen were male (93.4%). About half (49.5%) of the clients used psychoactive substances for the first time between ages 10 and 19 years. Cannabis was the primary drug of use overall and also among males, while females were more likely to present with opiate abuse. Over half had a co-occurring physical or mental disorder, and a minority had received testing for hepatitis C in the past 12 months. Conclusion: Although patterns of drug abuse presentations were consistent with findings from a national community-based survey, there was an under-representation of females in treatment. Implications for policy development and practice are discussed.


Assuntos
/efeitos adversos , Transtornos Mentais/epidemiologia , Pacientes/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/terapia , Adolescente , Adulto , Distribuição por Idade , Alcoolismo/epidemiologia , Alcoolismo/reabilitação , Criança , Comorbidade/tendências , Estudos Transversais , Feminino , Hospitais Psiquiátricos , Humanos , Tempo de Internação/estatística & dados numéricos , Tempo de Internação/tendências , Masculino , Abuso de Maconha/epidemiologia , Transtornos Mentais/reabilitação , Pessoa de Meia-Idade , Nigéria/epidemiologia , Pacientes/psicologia , Fatores de Risco , Distribuição por Sexo , Fatores Socioeconômicos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Inquéritos e Questionários , Adulto Jovem
15.
West Afr J Med ; 36(3): 222-231, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31622484

RESUMO

BACKGROUND: Knowledge of HIV/AIDS and use of HIV Testing Services in Nigeria is still far from optimal. Good HIV/AIDS-related knowledge and attitudes are important in prevention. The aim of this study was to assess and compare HIV/AIDS knowledge, attitudes and the uptake of HIV Testing Services between male and female senior secondary school students in Lagos, Nigeria. METHODS: Using multistage sampling, 543 (50.3% male, 49.7 % female) participants were selected in a comparative cross-sectional study carried out in six senior secondary schools in Alimosho LGA, Lagos. Data was collected using a pre-tested, self-administered questionnaire and analyzed using SPSS- 20, p<0.05 was considered significant. RESULTS: Participants' level of knowledge of HIV/AIDS was good (86.4% male, 86.3% female), the difference was not statistically significant. The main source of HIV/AIDS information was their teachers (male - 53.6%, female - 49.3%). Attitudes were positive (99.3% males, 98.1% females). However, the uptake of HIV testing was low (27.8% male, 24.1% female). Only 41.8% of males and 34.1% of females knew where HIV Testing Services were offered. The uptake of HIV testing showed a significant association, for the males, with family structure (p=0.034), confiding in their fathers (p=0.039) and religion (p=0.044), and for the females, mothers' level of education (p=0.036), number of siblings (p=0.044) and alcohol use (p=0.006). CONCLUSION: In both groups, knowledge and attitude were optimal, however. the uptake of HIV testing was low due to poor access. Teaching about HIV/AIDS in schools should be sustained, but to improve the use of HIV Testing Services, stronger families are encouraged, though providing more HIV testing centers, especially Youth Friendly Centers should be considered.


Assuntos
Infecções por HIV/diagnóstico , Infecções por HIV/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Estudantes/psicologia , Adolescente , Estudos Transversais , Feminino , Infecções por HIV/epidemiologia , Humanos , Masculino , Programas de Rastreamento , Nigéria/epidemiologia , Distribuição por Sexo , Estudantes/estatística & dados numéricos , Inquéritos e Questionários
16.
J Appl Oral Sci ; 27: e20180678, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31596369

RESUMO

OBJECTIVES: Bulk-fill restorative materials such as bulk-fill composite resins and high viscous glass ionomer cements have become very popular materials in operative dentistry because their application is easy and time-saving. The aim of this clinical study was to evaluate the clinical performance of a highly viscous reinforced glass ionomer material, a bulk-fill composite resin and a micro hybrid composite resin in Class II restorations. METHODOLOGY: In total, 109 Class II restorations were performed in 54 patients using three different restorative materials: Charisma Smart Composite (CSC); Filtek Bulk Fill Posterior Restorative (FBF); Equia Forte Fil (EF). Single Bond Universal adhesive (3M ESPE, Germany) was used with composite resin restorations. The restorations were evaluated using modified USPHS criteria in terms of retention, color match, marginal discoloration, anatomic form, contact point, marginal adaptation, secondary caries, postoperative sensitivity and surface texture. The data were analyzed using Chi-Square, Fischer's and McNemar's tests. RESULTS: At the end of one year, 103 restorations were followed up. No changes were observed during the first 6 months. At the end of one year, there were small changes in composite restorations (FBF and CSC) but no statistically significant difference was observed between the clinical performances of these materials for all criteria (p>0.05). However, there was a statistically significant difference between EF, FBF and CSC groups in all parameters except marginal discoloration, secondary caries and postoperative sensitivity in one-year evaluation (p<0.05). CONCLUSION: Bulk-fill composite resins and conventional composite resins showed more successful clinical performance than highly viscous reinforced glass ionomers in Class II cavities.


Assuntos
Resinas Compostas/uso terapêutico , Restauração Dentária Permanente/métodos , Cimentos de Ionômeros de Vidro/uso terapêutico , Adulto , Bis-Fenol A-Glicidil Metacrilato/uso terapêutico , Cárie Dentária/terapia , Adaptação Marginal Dentária , Feminino , Humanos , Masculino , Estudos Prospectivos , Reprodutibilidade dos Testes , Distribuição por Sexo , Resultado do Tratamento , Adulto Jovem
17.
Rev Bras Epidemiol ; 22Suppl 02(Suppl 02): E190005.SUPL.2, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31596376

RESUMO

OBJECTIVE: To analyze the prevalence of altered total cholesterol and fractions levels in the Brazilian population, according to biochemical data from the National Health Survey. METHODS: A descriptive study, using data from the National Health Survey, collected between 2014 and 2015. Total cholesterol and fractions were analyzed and population prevalences of altered values according to socio-demographic variables were calculated. The cutoff points considered were: total cholesterol ≥ 200mg/dl; low-density lipoprotein LDL ≥ 130mg/dL and high-density lipoprotein HDL < 40mg/dL. RESULTS: The prevalence of total cholesterol ≥200mg/dL in the population was 32.7%, and higher in women (35.1%). The prevalence of altered HDL was 31.8%, 22.0% in females and 42.8% in males. LDL ≥ 130mg/dL was found in 18.6% and was higher in women (19.9%). The population aged 45 years old and older and those with low levels of education presented a higher prevalence of altered cholesterol. CONCLUSION: Altered values of total cholesterol and fractions were frequent in the Brazilian population, especially among women, the elderly and people with low levels of education. These results may guide control and preventative actions such as healthy eating, physical activity and treatment, all of which aim to prevent coronary diseases.


Assuntos
HDL-Colesterol/sangue , LDL-Colesterol/sangue , Colesterol/sangue , Inquéritos Epidemiológicos/métodos , Hipercolesterolemia/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Fatores Etários , Brasil/epidemiologia , Estudos Epidemiológicos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Valores de Referência , Distribuição por Sexo , Fatores Sexuais , Fatores Socioeconômicos , Adulto Jovem
18.
Rev Bras Epidemiol ; 22Suppl 02(Suppl 02): E190006.SUPL.2, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31596377

RESUMO

OBJECTIVE: To analyze the prevalence of diabetes mellitus (DM) according to different diagnostic criteria, in the Brazilian adult population, according to laboratory results from the Brazilian National Health Survey. METHODS: Analysis of laboratory data from the National Health Survey, collected between 2014 and 2015. The prevalence of diabetes was calculated according to different diagnostic criteria. The prevalence of diabetes was calculated according to the criterion of glycosylated hemoglobin ≥ 6.5% or using medication, using Poisson regression and calculating crude and adjusted PR and 95%CI. RESULTS: The prevalence of diabetes according to different criteria varies from 6.6 to 9.4%. Intermediate or pre-diabetes hyperglycemia ranged from 6.8 to 16.9%. Considering laboratory criteria or medication use, the prevalence of DM was 8.4 (95%CI 7.65-9.11). The adjusted PR for gender, age, educational level and region was lower for males (PR 0.75; 95%CI 0.63 - 0.89), increased with age: 30 to 34 years (PR 2.32; 95% CI 1.33 - 4.07), 40 to 59 years PR 8.1; 95%CI 4.86 - 13.46), 60 years old or older (PR 12.6; 95%CI 7.1 - 21.0), and higher educational levels was protective (PR 0.8; 95%CI 0.6 - 0.9). Therewas a higher PR in the Central West Region (PR 1.3; 95%CI 1.04 - 1.7), in overweight people (PR 1.8; 95%CI 1.4 - 2.1), and in obese people (PR 3.3; 95%CI 2.6 - 4.1). CONCLUSION: The prevalence of diabetes was higher in females, people over 30 years of age, in populations with low educational levels, and people who were overweight and obese. The study advances in determining the diabetes situation in the country through laboratory criteria.


Assuntos
Diabetes Mellitus/epidemiologia , Hemoglobina A Glicada/análise , Inquéritos Epidemiológicos/métodos , Adolescente , Adulto , Distribuição por Idade , Brasil/epidemiologia , Estudos Transversais , Feminino , Inquéritos Epidemiológicos/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Sobrepeso/epidemiologia , Prevalência , Fatores de Risco , Distribuição por Sexo , Fatores Socioeconômicos , Adulto Jovem
19.
Rev Bras Epidemiol ; 22Suppl 02(Suppl 02): E190007.SUPL.2, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31596378

RESUMO

OBJECTIVE: To describe the prevalence of hemoglobinopathies in the Brazilian adult population, according to laboratory tests from the National Health Survey. METHODS: A descriptive study was carried out with National Health Survey laboratory data collected between 2014 and 2015. The hemoglobinopathies test was performed using the High Performance Liquid Chromatography method. The results of the individual tests were interpreted as providing normal, homozygous or heterozygous results for S, C and D hemoglobin, in addition to other possible hemoglobinopathies. Prevalence of hemoglobinopathies according to gender, skin color, region, age and schooling was estimated. RESULTS: Hemoglobinopathies were present in 3.7% of the population. The main ones were the sickle cell trait (2.49%), thalassemia minor (0.30%) and suspected thalassemia major (0.80%). In relation to the sickle cell trait and suspected thalassemia major, there was a statistically significant difference for the skin color variable (p<0.05). The prevalences found for sickle cell trait according to skin color was: 4.1% among dark-skinned blacks, 3.6% among light-skinned blacks, 1.2% among whites, and 1.7% among others. CONCLUSION: The most prevalent hemoglobinopathies were the sickle cell trait and minor thalassemia, and were predominate among light- and dark-skinned black people. The study helps in identifying hemoglobinopathies and in genetic counseling in pre-conception.


Assuntos
Inquéritos Epidemiológicos/métodos , Traço Falciforme/epidemiologia , Talassemia beta/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Brasil/epidemiologia , Cromatografia Líquida de Alta Pressão , Estudos Transversais , Feminino , Inquéritos Epidemiológicos/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Distribuição por Sexo , Fatores Socioeconômicos , Adulto Jovem
20.
Rev Bras Epidemiol ; 22Suppl 02(Suppl 02): E190008.SUPL.2, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31596379

RESUMO

OBJECTIVE: To verify the prevalence of anemia in Brazilian adults and elderly. METHODS: This is a cross-sectional study consisted of 8,060 subjects aged over 18 years old in all Brazilian states. We used data from laboratory tests of the Brazilian National Health Survey (Pesquisa Nacional de Saúde - PNS). The following indicators obtained by erythrogram were used: hemoglobin, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and red cell distribution width (RDW). Reference values of the World Health Organization (WHO) were used to determine anemia, which considers hemoglobin levels below 13.0 g/dL for men and less than 12.0 g/dL for women. Sociodemographic information was obtained by interview. RESULTS: The prevalence of anemia among Brazilian adults and elderly was 9.9%. Higher prevalence of anemia and more severe cases were found among women, elderly, people with low schooling, black skin color and residents of the North and Northeast regions. Normocytic normochromic anemia was the most common type of anemia (56.0%). CONCLUSION: The anemia prevalence found in the study was in agreement with the literature. It must be stressed that higher anemia prevalence was found in disadvantaged and older population. Considering the increase of the population over 60 years of age, interventions to prevent and treat anemia among adults and elderly is imperative in the health service network.


Assuntos
Anemia/epidemiologia , Inquéritos Epidemiológicos/métodos , Adolescente , Adulto , Distribuição por Idade , Fatores Etários , Idoso , Brasil/epidemiologia , Estudos Transversais , Índices de Eritrócitos , Feminino , Inquéritos Epidemiológicos/estatística & dados numéricos , Hemoglobinas/análise , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Valores de Referência , Índice de Gravidade de Doença , Distribuição por Sexo , Fatores Sexuais , Fatores Socioeconômicos , Adulto Jovem
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