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1.
Einstein (Sao Paulo) ; 18: eGS4442, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31576910

RESUMO

OBJECTIVE: To analyze the legal demands of tiotropium bromide to treat chronic obstructive pulmonary disease. METHODS: We included secondary data from the pharmaceutical care management systems made available by the Paraná State Drug Center. RESULTS: Public interest civil action and ordinary procedures, among others, were the most common used by the patients to obtain the medicine. Two Health Centers in Paraná (Londrina and Umuarama) concentrated more than 50% of the actions. The most common specialty of physicians who prescribed (33.8%) was pulmonology. There is a small financial impact of tiotropium bromide on general costs with medicines of the Paraná State Drug Center. However, a significant individual financial impact was observed because one unit of the medicine represents 38% of the Brazilian minimum wage. CONCLUSION: Our study highlights the need of incorporating this medicine in the class of long-acting anticholinergic bronchodilator in the Brazilian public health system.


Assuntos
Broncodilatadores/economia , Medicamentos Essenciais/provisão & distribução , Necessidades e Demandas de Serviços de Saúde/legislação & jurisprudência , Função Jurisdicional , Doença Pulmonar Obstrutiva Crônica/economia , Brometo de Tiotrópio/economia , Brasil , Medicamentos Essenciais/economia , Acesso aos Serviços de Saúde/economia , Acesso aos Serviços de Saúde/legislação & jurisprudência , Acesso aos Serviços de Saúde/tendências , Necessidades e Demandas de Serviços de Saúde/economia , Necessidades e Demandas de Serviços de Saúde/tendências , Humanos , Programas Nacionais de Saúde , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Estudos Retrospectivos , Estatísticas não Paramétricas , Fatores de Tempo
2.
Undersea Hyperb Med ; 46(5): 619-623, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31683359

RESUMO

Objective: Scuba diving and freediving are popular activities around the world, and their growth has increased the frequency of related pathology. A good ability to equalize is of paramount importance for diving. This is especially true for freediving, during which dive time is limited to just one breath. Even though equalization disorders are quite common in divers, a scoring system does not exist to date. In this paper we propose a new scoring system for equalization problems of freedivers: the EP score, shorthand for "equalization problems." Methods: We administered the EP score assessment to 40 Italian freediving spearfishermen who were divided in two groups: Group A comprised 20 freedivers complaining of equalization problems and multiple barotraumas but totally asymptomatic in their everyday lives. These individuals had already received medical treatment and nasal surgery without improvement and then had undergone Eustachian tube balloon dilation. Group B comprised 20 healthy freedivers without any history of equalization disorders. We performed a statistical analysis to evaluate the reliability of this scoring system and to evaluate its usefulness in diagnosis and follow-up. Results: Our data show substantial statistical differences between healthy freedivers and freedivers complaining of equalization disorders (Z-Score = -5.396 at p ⟨ 0.05); data do not show any statistical difference between healthy freedivers and patients successfully treated by Eustachian tube balloon dilation (U-value = 152.5 and Z-Score= -1.271 at p ⟨ 0.05). Conclusion: The EP score assessment seems to be a reliable tool to quantify equalization disorders during freediving and to evaluate how the difficulty varies over time and after treatment. Since equalization disorders could be present in different populations, the EP score assessment could be applicable to a wider group.


Assuntos
Suspensão da Respiração , Mergulho/fisiologia , Otopatias/diagnóstico , Orelha Média/fisiologia , Tuba Auditiva , Adulto , Pressão Atmosférica , Barotrauma/etiologia , Barotrauma/prevenção & controle , Dilatação , Otopatias/etiologia , Otopatias/terapia , Tuba Auditiva/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Estatísticas não Paramétricas , Inquéritos e Questionários , Adulto Jovem
3.
Anticancer Res ; 39(11): 6209-6216, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31704849

RESUMO

BACKGROUND: The appropriate extent of lymphadenectomy on gastric cancer patients with positive peritoneal cytology (CY1) is uncertain. This study retrospectively compared overall survival (OS) after standard and limited lymphadenectomy. PATIENTS AND METHODS: The medical records from four institutions from 2004 to 2018 were reviewed and data for 91 patients with CY1, but no other distant metastases, who underwent gastrectomy were analyzed. D2 or greater lymphadenectomy and less than D2 lymphadenectomy were performed in 51 and 40 patients, respectively. RESULTS: Full cohort analyses showed that patients who underwent D2 or greater lymphadenectomy had better prognostic nutritional indices and more such patients received postoperative chemotherapy. The OS in the group treated with D2 or greater lymphadenectomy was also significantly better (p=0.045). Twenty-seven pairs of patients were generated via propensity score matching, and analysis of their OS showed no significant difference between the groups according to lymphadenectomy (p=0.61). CONCLUSION: The extent of lymphadenectomy may not affect the prognoses for patients with CY1 gastric cancer.


Assuntos
Excisão de Linfonodo/métodos , Neoplasias Gástricas/patologia , Neoplasias Gástricas/cirurgia , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Causas de Morte , Feminino , Gastrectomia/métodos , Gastrectomia/mortalidade , Humanos , Excisão de Linfonodo/mortalidade , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Peritônio/patologia , Prognóstico , Pontuação de Propensão , Estudos Retrospectivos , Estatísticas não Paramétricas , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/mortalidade , Taxa de Sobrevida , Fatores de Tempo
4.
Anticancer Res ; 39(11): 6339-6346, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31704865

RESUMO

BACKGROUND/AIM: To evaluate the chronological changes in health-related quality of life and treatment satisfaction after robot-assisted radical prostatectomy (RARP). PATIENTS AND METHODS: A total of 196 patients were included, and treatment satisfaction was evaluated using the Expanded Prostate Cancer Index Composite (EPIC) score before and at 1, 3, 6, and 12 months after RARP. RESULTS: At 12 months after RARP, 64.8% of patients were satisfied. On the contrary, 4.6% of patients were dissatisfied at 12 months after RARP. In a multivariate analysis, only urinary bother of EPIC was significantly associated with satisfaction at 12 months after RARP (p=0.025, odds ratio=1.029). CONCLUSION: Treatment satisfaction with RARP was generally acceptable from 1 to 12 months after surgery and did not change over time. Urinary bother was associated with satisfaction at 12 months after RARP. Compared with the objective 24-hour pad test, questionnaires answered subjectively were more associated with satisfaction.


Assuntos
Satisfação do Paciente/estatística & dados numéricos , Prostatectomia/psicologia , Qualidade de Vida , Procedimentos Cirúrgicos Robóticos/psicologia , Idoso , Disfunção Erétil/etiologia , Disfunção Erétil/psicologia , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/psicologia , Antígeno Prostático Específico/sangue , Prostatectomia/efeitos adversos , Prostatectomia/métodos , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Terapia de Salvação/métodos , Estatísticas não Paramétricas , Fatores de Tempo , Resultado do Tratamento , Incontinência Urinária/etiologia , Incontinência Urinária/psicologia
5.
Int Braz J Urol ; 45(5): 965-973, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31626519

RESUMO

OBJECTIVE: We aimed to evaluate the results of laparoscopic pyeloplasty with concomitant pyelolithotomy and compare results with a cohort of patients undergoing laparoscopic pyeloplasty without pyelolithotomy. MATERIALS AND METHODS: We retrospectively reviewed records of 43 patients undergoing transperitoneal laparoscopic Anderson-Hynes dismembered pyeloplasty between December 2012 and July 2018 at our department. Eighteen patients (42%) underwent laparoscopic pyeloplasty with concomitant pyelolithotomy. The results of patients with renal stones were compared with 25 matched patients undergoing laparoscopic pyeloplasty without concomitant renal stones. Demographic data, operative and stone parameters were compared between the groups. RESULTS: The groups were similar regarding to demographic characteristics. All operations were completed laparoscopically with no conversions to open surgery. In 3 cases without renal stones and 15 cases with renal stones, transposition of the ureter due to crossing vessels was performed. The mean stone size was 13±5.24 mm, and the median number of stones was 1 (1-18). The success of laparoscopic pyeloplasty with and without pyelolithotomy was 93.3% and 92.9%, respectively, as confirmed by negative diuretic renogram at postoperative 3rd months. Overall stone-free rate after laparoscopic pyelolithotomy was 93.3%. Mean operative time was 222.6765.71 minutes vs. 219.11±75.63 minutes for the pyeloplasty with concomitant pyelolithotomy vs. pyeloplasty, respectively (p=0.88). CONCLUSIONS: Laparoscopic pyeloplasty with concomitant pyelolithotomy is a safe and effective intervention with associated good cosmetic results and high stone-free rates without significant increase in operative time or complications.


Assuntos
Pelve Renal/cirurgia , Laparoscopia/métodos , Nefrolitíase/cirurgia , Nefrotomia/métodos , Obstrução Ureteral/cirurgia , Adolescente , Adulto , Criança , Feminino , Humanos , Hidronefrose/cirurgia , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Nefrolitíase/patologia , Duração da Cirurgia , Reprodutibilidade dos Testes , Estudos Retrospectivos , Estatísticas não Paramétricas , Resultado do Tratamento , Procedimentos Cirúrgicos Urológicos/métodos , Adulto Jovem
6.
Rev Lat Am Enfermagem ; 27: e3180, 2019.
Artigo em Português, Inglês, Espanhol | MEDLINE | ID: mdl-31596415

RESUMO

OBJECTIVE: to evaluate the effectiveness of menthol chewing gum, in the relief of the intensity and discomfort of the surgical patient's thirst in the preoperative period. METHOD: a randomized controlled trial, with 102 patients in the preoperative period, randomized in a control group, with usual care, and an experimental group, which received menthol gum, which was the study treatment variable. The primary clinical outcome was the variation in thirst intensity, evaluated by the Numeral Verbal Scale, and the secondary, the variation of the discomfort of thirst, evaluated by the Perioperative Thirst Discomfort Scale. Mann-Whitney test was used to compare measures between groups. The significance level adopted was of 0.05. RESULTS: menthol chewing gum significantly reduced the intensity (p <0.001), with Cohen's medium-effect d, and thirst discomfort (p <0.001), with a large-effect Cohen's d. CONCLUSION: menthol chewing gum was effective in reducing the intensity and discomfort of preoperative thirst. The strategy proved to be an innovative, feasible and safe option in the use for the surgical patient, in the management of the preoperative thirst, in elective surgeries. NCT: 03200197.


Assuntos
Goma de Mascar , Mentol/farmacologia , Sede/efeitos dos fármacos , Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cuidados Pré-Operatórios , Período Pré-Operatório , Estatísticas não Paramétricas , Adulto Jovem
7.
An Bras Dermatol ; 94(4): 411-415, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31644612

RESUMO

BACKGROUND: Serum amyloid A is an acute-phase protein. There is no available data regarding serum amyloid A levels in patients with acute (AU) and chronic urticaria (CU). OBJECTIVE: To investigate the association between serum amyloid A and urticaria. METHODS: This was a case-control study of 81 patients who visited our Hospital between June and December 2016 with a diagnosis of urticaria. Eighty healthy controls (HC) who visited for routine health examination and physical checkups were recruited. Serum amyloid A and C-reactive protein levels were measured by automated methods. RESULTS: Serum amyloid A and C-reactive protein levels were significantly higher in AU (Serum amyloid A: 207.1 (6.7-439.0) mg/L; C-reactive protein: 16.0 (0.2-90.0) mg/L) and CU (Serum amyloid A: 6.5 (2.5-35.8) mg/L; C-reactive protein: 1.0 (0.1-16.0) mg/L) compared with HC (Serum amyloid A: 5.04 (2.0-9.1) mg/L; C-reactive protein: 1.2 (0.1-5.6) mg/L), and in AU compared with CU (all P<0.05). There were no differences between the CU and HC group. In CU, Serum amyloid A levels in those with moderate/severe urticaria (median, 16.4 (9.7-35.8) mg/L) were higher than in those with mild urticaria (median, 5.7 (2.5-9.5) mg/L) and HC (all P<0.05). Serum amyloid A and C-reactive protein levels exceeded the normal lab range in 90.7% and 72.1% patients with AU compared with 28.9% and 13.2% patients with CU, respectively. Significant positive correlations were found between serum amyloid A and C-reactive protein (r = 0.562, P < 0.001). STUDY LIMITATIONS: There was no comparison between active disease and remission. CONCLUSION: There was an association between serum amyloid A levels and urticaria. Higher serum amyloid A levels were associated with AU and more severe CU. Serum amyloid A may help to identify CU patients earlier.


Assuntos
Proteína Amiloide A Sérica/análise , Urticária/sangue , Adolescente , Adulto , Idoso , Biomarcadores/sangue , Proteína C-Reativa/análise , Estudos de Casos e Controles , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Valores de Referência , Índice de Gravidade de Doença , Estatísticas não Paramétricas , Adulto Jovem
8.
An Bras Dermatol ; 94(4): 422-428, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31644614

RESUMO

BACKGROUND: Body dysmorphic disorder is a relatively common psychiatric disorder in the context of dermatology and cosmetic and plastic surgery but is underdiagnosed and underreported in Africa. OBJECTIVE: To evaluate the prevalence of body dysmorphic disorder and symptoms of anxiety/depression and determine their sociodemographic and clinical correlates. METHODS: A systematic random sampling design was made to recruit 114 patients with skin diseases. Sociodemographic and clinical data were obtained. The Body Dysmorphic Disorder Modification of the Yale-Brown Obsessive-Compulsive Scale, Hospital Anxiety and Depression Scale was administered, and data were analyzed using SPSS 20. RESULTS: Mean age of participants was 37.70±17.47 years, and 67/114 (58.8%) were females. Prevalence of body dysmorphic disorder was 41/114 (36.0%), and prevalence of anxiety/depression symptoms was 35/114 (30.7%). Prevalence of body dysmorphic disorder in patients with anxiety/depression symptoms was 15/41 (36.6%), and patients with facial disorders expressed the highest burden of anxiety/depression symptoms, in 15/35 (42.9%). Factors associated with significantly higher mean body dysmorphic disorder include age<50years (p=0.039), and anxiety/depression (p<0.001), education below high school was associated with higher mean anxiety/depression score (P= 0.031). In a binary logistic regression model, presence of anxiety/depression symptoms was predictive of body dysmorphic disorder (OR=10.0, CI: 4.1-28.2, p<0.001). STUDY LIMITATIONS: the study is uncontrolled, conducted in a single source of care, thus limiting generalization to nonrelated settings. CONCLUSION: Prevalence of body dysmorphic disorder is high among dermatology patients and most prevalent in facial disorders. Facial diseases are associated with the highest burden of anxiety/depression symptoms. This is a clarion call for dermatologists to routinely assess for body dysmorphic disorder and appropriately refer affected patients to mental health care.


Assuntos
Ansiedade/epidemiologia , Transtornos Dismórficos Corporais/epidemiologia , Transtornos Dismórficos Corporais/psicologia , Depressão/epidemiologia , Dermatopatias/epidemiologia , Dermatopatias/psicologia , Adolescente , Adulto , Distribuição por Idade , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Prevalência , Escalas de Graduação Psiquiátrica , Distribuição por Sexo , Fatores Socioeconômicos , Estatísticas não Paramétricas , Escala de Ansiedade Frente a Teste , Fatores de Tempo , Adulto Jovem
9.
An Bras Dermatol ; 94(4): 434-441, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31644616

RESUMO

BACKGROUND: In-vitro studies showed that Leucine-rich glioma inactivated 3 (LGI3) is a keratinocyte-derived cytokine that stimulates melanin synthesis and is increased after ultra violet B (UVB) irradiation. So, we postulated that LGI3 may be involved in vitiligo aetiopathogenesis and may participate in narrow band ultra violet B (NB-UVB) induced pigmentation in vitiligo. OBJECTIVES: To assess this hypothesis, lesional LGI3 immunohistochemical expression of vitiligo patients before and after NB-UVB phototherapy was studied, and its correlation with repigmentation was evaluated. METHODS: Forty vitiligo patients and 20 age, sex, and skin phenotype-matched controls were enrolled. Patients were treated with NB-UVB thrice weekly for 12 weeks. VASI score was evaluated before and after NB-UVB sessions. For vitiligo patients, baseline LGI3 immunohistochemical staining was estimated, and compared to that of controls and to its post-treatment data in those patients. Results: Baseline LGI3 immunohistochemical studied parameters (expression, intensity, percentage and H score) were significantly lower in vitiligo cases than controls (p=0.003, 0.013, 0.001 and 0.001 respectively). After 12 weeks of NB-UVB phototherapy, these LGI3 immunohistochemical parameters were up-regulated and became comparable to that of controls (p >0.05 for all). There was a significant positive correlation between the improvement of both VASI score and LGI3 H score mean values (r=-0.349 , p=0.027). STUDY LIMITATIONS: Small number of investigated subjects. CONCLUSIONS: Decreased LGI3 protein may play an active role in vitiligo pathogenesis and its up-regulation after NB-UVB phototherapy, may actively participate in NB-UVB photo-induced melanogenesis.


Assuntos
Citocinas/análise , Proteínas/análise , Terapia Ultravioleta/métodos , Vitiligo/patologia , Vitiligo/radioterapia , Adolescente , Adulto , Estudos de Casos e Controles , Criança , Feminino , Humanos , Imuno-Histoquímica , Queratinócitos/efeitos da radiação , Masculino , Melanócitos/efeitos da radiação , Pessoa de Meia-Idade , Valores de Referência , Índice de Gravidade de Doença , Estatísticas não Paramétricas , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
10.
Fisioterapia (Madr., Ed. impr.) ; 41(5): 250-257, sept.-oct. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-183934

RESUMO

Introducción: La empatía es un concepto importante en la interacción entre el profesional fisioterapeuta y el paciente, y contribuye a una mejor atención del mismo. La formación empática en estudiantes de fisioterapia debe ser asumida por las universidades desde el primer año de estudio por el carácter complejo de este atributo; sin embargo, cualquier intervención debe estar precedida por un diagnóstico empático exhaustivo. Objetivo: Determinar los niveles de empatía y de sus componentes en estudiantes de fisioterapia según los factores curso y género. Material y métodos: Estudio exploratorio y de corte transversal. Se estudió una muestra de 191 estudiantes. Los datos de empatía fueron recogidos mediante la aplicación de la escala de empatía de Jefferson. Fueron estimadas la mediana, los cuartiles 1 y 3, la diferencia intercuartílica y el intervalo de confianza de la mediana. Se estudiaron las posibles diferencias en la empatía y sus componentes mediante pruebas no paramétricas (mediana de Mood). Resultados: Hubo diferencias en la empatía y en el componente cuidado con compasión en el factor curso. Se manifiesta la declinación empática en el componente cuidado con compasión. La empatía y sus componentes no se diferenciaron en el género. Conclusiones: La diferencia encontrada en la empatía y en el componente cuidado con compasión, la ausencia de diferencias de empatía entre los géneros y la manifestación de declinación empática solo en el componente cuidado con compasión constituyen características específicas en los estudiantes examinados y representan un diagnóstico empático concreto y se constituye en la base para elaborar una estrategia de intervención que debe ser coherente con estos resultados


Introduction: Empathy is an important concept in the interaction between the physiotherapist and the patient, and contributes to a better care of the patient. Empathy training in physiotherapy students must be taught by the universities from the first year of study because of the complex character of this attribute. However, any intervention must be preceded by a comprehensive empathy diagnosis. Objective: To determine the levels of empathy and its components in physiotherapy students according to course and gender factors. Material and methods: Exploratory and cross-sectional study conducted on a sample of 191 students. The empathy data was collected by applying the Jefferson Empathy Scale. The median, 1st and 3rd quartile, interquartile difference and confidence interval of the median were estimated. The possible differences in Empathy and its components were analysed using of non-parametric tests (Mood's median). Results: There were differences in empathy and in the compassionate care component in the course factor. The empathy decline in the compassionate component was observed. Empathy and its components did not differ by gender. Conclusions: The differences found in empathy and in the compassionate care component, the absence of empathy differences in empathy between the genders, and observation of a decline in empathy only in the compassionate care component, were specific characteristics in the students examined. These represent a specific empathy diagnosis, and are the basis for developing an intervention strategy consistent with these results


Assuntos
Humanos , Masculino , Feminino , Fisioterapia , Empatia , Estudantes de Ciências da Saúde/psicologia , Estudantes de Ciências da Saúde/estatística & dados numéricos , Estudos Transversais , Estatísticas não Paramétricas , Comportamento Exploratório , Intervalos de Confiança
11.
Rev. Ciênc. Plur ; 5(2): 49-67, ago. 2019. ilus, tab
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1021754

RESUMO

Introdução:A Hipertensão Arterial Sistêmica tem apresentado alta mortalidade em todo o mundo, associada a fatores de risco cardiovascular como o excesso de peso e a obesidade abdominal.Objetivo:Avaliar os índices antropométricos e pressão arterial em adolescentes e adultos jovens do município de Santa Cruz-RN.Método:Trata-se de um estudo quantitativo, do tipo transversal, realizado com 86 indivíduos com idade média de 19,0 ± 0,97 anos. Foram avaliados o Índice deMassa Corporal (IMC), Relação Cintura Estatura (RCE), Relação Cintura Quadril (RCQ), Índice de Conicidade (IC) e Pressão Arterial (PA). Os dados foram analisados no programa SPSS versão 23.0, apresentados em percentual, média e desvio padrão. O teste T deStudentfoi aplicado para avaliar a diferença entre as médias, a correlação entre medidas antropométricas e a pressão arterial pela correlação de Pearson.Resultados:A prevalência maior foi do sexo feminino, 81,4%. A obesidade esteve mais presente nos meninos adolescentes do que nas meninas, 33,3 e 13,9% respectivamente, bem como nos adultos jovens 28,6% em homens e 11,8% em mulheres. A RCE se mostrou mais elevada nas meninas e mulheres adultas (0,46 ± 0,07, 0,50 ± 0,08). Em contrapartida, a RCQ e IC se mostraram maiores nos meninos(0,79 ± 0,06; 1,12 ± 0,74) e nos homens adultos(0,82 ± 0,09; 1,15 ± 0,12) respectivamente. Em ambos os grupos houve correlação positiva moderada entre o IMC e a RCE com a PA (p<0,05).Conclusão:Os índices antropométricosapresentaram correlação positiva com a elevação da pressão arterial, destacando-se o IMC e a RCE nos adolescentes e adultos jovens (AU).


Introduction:Systemic arterial hypertension has presented high mortality worldwide, associated with cardiovascular risk factors such as overweight and abdominal obesity.Objective:To evaluate the anthropometric indexes and blood pressure in adolescents and young adults in the municipality of Santa Cruz-RN.Methods:This is a cross-sectional quantitative study of 86 individuals with a mean age of 19.0 ± 0.97 years. Body mass index (BMI), Waist Stature Ratio (WSR), Waist Hip Ratio (WHR), Conicity Index (CI) and Blood Pressure (BP) were evaluated. Data were analyzed using SPSS version 23.0, presented in percentage, mean and standard deviation. The T test was applied to evaluate the difference between the means, the correlation between anthropometric measures and blood pressure by the Pearson correlation.Results:The highest prevalence was female, 81.4%. Obesity was more present in adolescent boys than in girls, 33.3 and 13.9% respectively, as well as in young adults, 28.6% in men and 11.8% in women. The WSR was higher in girls and adult women (0.46 ± 0.07, 0.50 ± 0.08). On the other hand, WHR and CI were higher in boys(0.79 ± 0.06, 1.12 ± 0.74)and in adult males (0.82 ± 0.09, 1.15 ± 0.12) respectively. In both groups there was a moderate positive correlation between BMI and WSR with BP (p <0.05).Conclusion:The anthropometric indices showed a positive correlation with the elevation of blood pressure, especially BMI, WSR in adolescents and young adults (AU).


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Brasil , Antropometria/métodos , Adolescente , Pressão Arterial , Hipertensão , Estudos Transversais/métodos , Estatísticas não Paramétricas , Adulto Jovem
12.
Rev. Ciênc. Plur ; 5(2): 94-110, ago. 2019. tab
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1021764

RESUMO

Introdução:Diabetes Mellitus tipo 2 é uma doença crônica, silenciosa, caracterizada por hiperglicemia causada pela produção insuficiente, ou resistência a ação da insulina. No Brasil, em 2017, diagnosticou 12,5 milhões de pessoas com diabetes mellitus, com uma prevalência de 8 a 9%, ocupando o quinto lugar no mundo. Dianteda transição nutricional, várias pesquisas tem demonstrado prevalência desta patologia em crianças, adolescentes e jovens. Objetivo:Identificar o risco de desenvolver Diabetes mellitus tipo 2 nos estudantes do curso de Biomedicina, da Faculdade Unigran Capital, Campo Grande, MS. Método:Trata-se de um Estudo Epidemiológico Descritivo Quantitativo Transversal, com uma amostra de 132 estudantes, através da aplicação de um questionário, determinação de glicemia capilar, coleta do peso, altura, cintura abdominal, e aferição da pressão arterial. Resultados:Foi identificado fatores de riscos importantes nos estudantes de biomedicina: obesidade, sedentarismo, hipertensão, consumo de dieta não saudável e a predisposição genética. Os homens apresentaram mais fatores dos que as mulheres, as faixas etárias mais jovens de 18-20 anos encontravam-se mais sedentários e mais obesos, e, as faixas etárias mais velhas apresentaram hipertensão e consumo de dieta não saudável. Conclusões:Há necessidade de promover medidas de prevenção: consumo de dieta saudável e prática de atividade física entre os estudantes, para evitar o desenvolvimento desta patologia (AU).


Introduction:Type 2 Diabetes Mellitus is a chronic silent disease characterized by hyperglycemia caused by insufficient production, or resistance to the action of insulin. In Brazil, in 2017, diagnosed 12.5 million people with Diabetes Mellitus, with prevalence of 8 to9%, ranking fifth in the world. Faced with the nutritional transition, several studies have demonstrated the prevalence of this pathology in children, adolescents and young people. Objective:To identify the risk of developing Type 2 Diabetes Mellitus instudents of Biomedicine, Faculty of Unigran Capital, Campo Grande, MS.Methods:This is an Epidemiological Descriptive Cross-Sectional Study, with a sample of 132 students, through the application of a questionnaire, determination of capillary glycemia, weight, height, abdominal waist, and blood pressure measurement. Results:: Important risk factors were identified in biomedicine students: obesity, sedentary lifestyle, hypertension, consumption of unhealthy diet and genetic predisposition. Males presentedmore factors than females, the younger age groups of 18-20 years were more sedentary and more obese, and the older age groups presented hypertension and unhealthy diet consumption.Conclusions:There is a need to promote prevention measures: consumption of healthy diet and practice of physical activity among students, to avoid the development of this pathology (AU).


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Estudantes de Ciências da Saúde , Fatores de Risco , Diabetes Mellitus Tipo 2/prevenção & controle , Comportamento Sedentário , Brasil , Epidemiologia Descritiva , Inquéritos e Questionários , Estatísticas não Paramétricas
13.
Braz Oral Res ; 33(suppl 1): e065, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31576949

RESUMO

Additive manufacturing (AM) is an emerging process for biomaterials and medical devices. Direct Laser Metal Sintering (DLMS) is an AM technique used to fabricate Ti-6Al-4V implant materials with enhanced surface-related properties compared with wrought samples; thus, this technique could influence microbial adsorption and colonization. Therefore, this in vitro study was conducted to evaluate the impact of different implant production processes on microbial adhesion of periodontal pathogens. Titanium discs produced using two different processes-conventional and AM-were divided into three groups: conventional titanium discs with machined surface (G1), AM titanium discs with chemical treatment (G2) and AM titanium discs without chemical treatment (G3). Subgingival biofilm composed of 32 species was formed on the titanium discs, and positioned vertically in 96-well plates, for 7 days. The proportions of microbial complexes and the microbial profiles were analyzed using a DNA-DNA hybridization technique, and data were evaluated using Kruskal-Wallis and Dunnett tests (p < 0.05). Lower proportions of the red complex species were observed in the biofilm formed in G2 compared with that in G1 (p < 0.05). Moreover, the proportions of the microbial complexes were similar between G2 and G3 (p > 0.05). Compared with G1, G2 showed reduced levels of Porphyromonas gingvalis , Actinomyces gerencseriae, and Streptococcus intermedius , and increased levels of Parvimonas micra , Actinomyces odontolyticus, and Eikenella corrodens (p < 0.05). The microbial profile of G3 did not differ from G1 and G2 (p > 0.05). The results of this in vitro study showed that titanium discs produced via AM could alter the microbial profile of the biofilm formed around them. Further clinical studies should be conducted to confirm these findings.


Assuntos
Biofilmes/crescimento & desenvolvimento , Titânio/química , Titânio/farmacologia , Análise de Variância , Bactérias/efeitos dos fármacos , Biofilmes/efeitos dos fármacos , Sondas de DNA , Microscopia de Força Atômica , Microscopia Eletrônica de Varredura , Espectroscopia Fotoeletrônica , Valores de Referência , Reprodutibilidade dos Testes , Estatísticas não Paramétricas , Propriedades de Superfície , Fatores de Tempo
14.
Braz Oral Res ; 33(suppl 1): e072, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31576956

RESUMO

Different surgical treatment strategies for peri-implantitis with the use of graft material and membranes have been suggested without any longitudinal remarkable success rate. The present preliminary study was aimed to analyze a new clinical approach based on the disinfection of the implant connection, the disinfection of the implant surface and GBR approach in the treatment of circumferential and semi-circumferential bony defect resulting from peri-implantitis. Six consecutive patients were selected for the present study. After removal of factors that could potentially influence peri-implant pathology, the prosthetic rehabilitation was always removed and a full thickness flap was elevated to allow access to the peri-implant defect and the exposed implant surface. Once the defect was degranulated and the implant surface cleaned, a mixture (50:50) of autogenous bone and allograft was used. Guided bone regeneration technique using membranes was adopted and the flaps were closed for a submerged healing. Six months thereafter, a new re-opening procedure was performed and cleaned superstructures and crowns were repositioned. Patients were followed for one year thereafter and recalled for a customized oral hygiene every three months. Radiological and periodontal analysis was performed before surgery and every six months. The studied procedure was associated with a pronounced increase in REC and CAL with stable peri-implant conditions at 6 and 12 months. PI, BOP and PD values were significantly reduced both at 6 and 12 months. At 12 months, a mean PD gain of 4.5 mm and a bone loss reduction of 5.1 mm was obtained. Within the limitation of the present preliminary study, the proposed technique might represent a promising result for treatment of circumferential and semi-circumferential bone defects around implants affected by peri-implantitis.


Assuntos
Implantes Dentários , Desinfecção/métodos , Peri-Implantite/cirurgia , Regeneração Óssea , Prótese Ancorada no Osso , Seguimentos , Humanos , Peri-Implantite/diagnóstico por imagem , Estudos Prospectivos , Radiografia Dentária , Reprodutibilidade dos Testes , Estatísticas não Paramétricas , Propriedades de Superfície , Fatores de Tempo , Resultado do Tratamento
15.
Braz Oral Res ; 33(suppl 1): e080, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31576959

RESUMO

The aim of this study was to evaluate the effects of adjunct systemic antibiotic treatment with metronidazole (MTZ) and amoxicillin (AMX) in patients receiving non-surgical subgingival debridement (NSD) for peri-implantitis. Forty subjects presenting with at least one implant with severe peri-implantitis were randomized into an experimental group [treated with NSD plus MTZ (400 mg) and AMX (500 mg) three times a day for 14 days] and a control group treated with NSD plus placebo. Clinical parameters and submucosal biofilm profiles were evaluated up to 1 year post-treatment. Overall, both treatments improved clinical parameters over time. At 1 year, mean probing depth (PD), mean clinical attachment (CA) level and proportions of red complex pathogens did not differ significantly between the two groups. In addition, mean PD and CA changes to 1-year posttreatment did not differ significantly between the two groups between baseline and 1-year post-treatment. These results suggest that the addition of MTZ and AMX to the treatment protocol of patients undergoing NSD for with severe peri-implantitis does not improve the clinical and microbiological outcomes of NSD. The fact that half of the implants in both groups did not achieve clinical success (PD < 5 mm, no BoP, no bone loss) suggest that neither of the tested protocols were effective for treating severe peri-implantitis.


Assuntos
Amoxicilina/uso terapêutico , Antibacterianos/uso terapêutico , Metronidazol/uso terapêutico , Peri-Implantite/tratamento farmacológico , Idoso , Combinação de Medicamentos , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Peri-Implantite/microbiologia , Índice Periodontal , Valores de Referência , Reprodutibilidade dos Testes , Estatísticas não Paramétricas , Fatores de Tempo , Resultado do Tratamento
16.
Bone Joint J ; 101-B(10): 1307-1312, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31564143

RESUMO

AIMS: In order to determine whether and for whom serial radiological evaluation is necessary in one-part proximal humerus fractures, we set out to describe the clinical history and predictors of secondary displacement in patients sustaining these injuries. PATIENTS AND METHODS: Between January 2014 and April 2016, all patients with an isolated, nonoperatively treated one-part proximal humerus fracture were prospectively followed up. Clinical and radiological evaluation took place at less than two, six, 12, and 52 weeks. Fracture configuration, bone quality, and comminution were determined on the initial radiographs. Fracture healing, secondary displacement, and treatment changes were recorded during follow-up. RESULTS: In 100 patients (59 female, 41 male; mean age 57 years), 91 of the fractures (91%) remained stable. In five of nine patients (55%) with secondary displacement, surgery was recommended. Comminution, present in 23 patients (23%), was identified as a predictor of secondary displacement (p < 0.001). Patients' age, sex, fracture configuration, and bone quality were not associated with secondary displacement (p ≥ 0.438). Nonoperative treatment resulted in a mean absolute Constant score (CS) of 80 (49 to 98), relative CS of 101% (63% to 138%), median subjective shoulder value of 95% (interquartile range (IQR) 90% to 100%), and median EuroQol five-dimensional questionnaire score of 0.89 (IQR 0.80 to 1.00) with bone union in all cases at one-year follow-up. CONCLUSION: Radiological re-evaluation was only necessary in patients presenting with comminution and may be redundant for 77% of patients with one-part proximal humerus fractures. Nonoperative treatment of one-part proximal humerus fractures remains the mainstay of treatment with a low rate of secondary surgery, a high union rate, and good clinical results. Cite this article: Bone Joint J 2019;101-B:1307-1312.


Assuntos
Tratamento Conservador/métodos , Consolidação da Fratura/fisiologia , Radiografia/estatística & dados numéricos , Sistema de Registros , Fraturas do Ombro/diagnóstico por imagem , Procedimentos Desnecessários/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Seguimentos , Fixação de Fratura/métodos , Humanos , Escala de Gravidade do Ferimento , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Radiografia/métodos , Fraturas do Ombro/terapia , Estatísticas não Paramétricas , Fatores de Tempo
17.
Bone Joint J ; 101-B(10): 1192-1198, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31564144

RESUMO

AIMS: Radiostereometric analysis (RSA) studies of vitamin E-doped, highly crosslinked polyethylene (VEPE) liners show low head penetration rates in cementless acetabular components. There is, however, currently no data on cemented VEPE acetabular components in total hip arthroplasty (THA). The aim of this study was to evaluate the safety of a new cemented VEPE component, compared with a conventional polyethylene (PE) component regarding migration, head penetration, and clinical results. PATIENTS AND METHODS: We enrolled 42 patients (21 male, 21 female) with osteoarthritis and a mean age of 67 years (sd 5), in a double-blinded, noninferiority, randomized controlled trial. The subjects were randomized in a 1:1 ratio to receive a reverse hybrid THA with a cemented component of either argon-gas gamma-sterilized PE component (controls) or VEPE, with identical geometry. The primary endpoint was proximal implant migration of the component at two years postoperatively measured with RSA. Secondary endpoints included total migration of the component, penetration of the femoral head into the component, and patient-reported outcome measurements. RESULTS: In total, 19 control implants and 18 implants in the VEPE group were analyzed for the primary endpoint. We found a continuous proximal migration of the component in the VEPE group that was significantly higher with a difference at two years of a mean 0.21 mm (95% confidence interval (CI) 0.05 to 0.37; p = 0.013). The total migration was also significantly higher in the VEPE group, but femoral head penetration was lower. We found no difference in clinical outcomes between the groups. CONCLUSION: At two years, this cemented VEPE component, although having a low head penetration and excellent clinical results, failed to meet noninferiority compared with the conventional implant by a proximal migration above the proposed safety threshold of RSA. The early proximal migration pattern of the VEPE component is a reason for continued monitoring, although a specific threshold for proximal migration and risk for later failure cannot be defined and needs further study. Cite this article: Bone Joint J 2019;101-B:1192-1198.


Assuntos
Artroplastia de Quadril/efeitos adversos , Migração de Corpo Estranho/diagnóstico por imagem , Osteoartrite do Quadril/cirurgia , Polietilenos/química , Desenho de Prótese , Falha de Prótese/tendências , Fatores Etários , Idoso , Artroplastia de Quadril/métodos , Método Duplo-Cego , Feminino , Migração de Corpo Estranho/epidemiologia , Prótese de Quadril , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Osteoartrite do Quadril/diagnóstico por imagem , Prognóstico , Análise Radioestereométrica , Medição de Risco , Índice de Gravidade de Doença , Fatores Sexuais , Estatísticas não Paramétricas , Suécia , Vitamina E/farmacologia
18.
Bone Joint J ; 101-B(10): 1238-1247, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31564153

RESUMO

AIMS: Options for the treatment of intra-articular ligament injuries are limited, and insufficient ligament reconstruction can cause painful joint instability, loss of function, and progressive development of degenerative arthritis. This study aimed to assess the capability of a biologically enhanced matrix material for ligament reconstruction to withstand tensile forces within the joint and enhance ligament regeneration needed to regain joint function. MATERIALS AND METHODS: A total of 18 New Zealand rabbits underwent bilateral anterior cruciate ligament reconstruction by autograft, FiberTape, or FiberTape-augmented autograft. Primary outcomes were biomechanical assessment (n = 17), microCT (µCT) assessment (n = 12), histological evaluation (n = 12), and quantitative polymerase chain reaction (qPCR) analysis (n = 6). RESULTS: At eight weeks, FiberTape alone or FiberTape-augmented autograft demonstrated increased biomechanical stability compared with autograft regarding ultimate load to failure (p = 0.035), elongation (p = 0.006), and energy absorption (p = 0.022). FiberTape-grafted samples also demonstrated increased bone mineral density in the bone tunnel (p = 0.039). Histological evaluation showed integration of all grafts in the bone tunnels by new bone formation, and limited signs of inflammation overall. A lack of prolonged inflammation in all samples was confirmed by quantification of inflammation biomarkers. However, no regeneration of ligament-like tissue was observed along the suture tape materials. Except for one autograft failure, no adverse events were detected. CONCLUSION: Our results indicate that FiberTape increases the biomechanical performance of intra-articular ligament reconstructions in a verified rabbit model at eight weeks. Within this period, FiberTape did not adversely affect bone tunnel healing or invoke a prolonged elevation in inflammation. Cite this article: Bone Joint J 2019;101-B:1238-1247.


Assuntos
Lesões do Ligamento Cruzado Anterior/cirurgia , Reconstrução do Ligamento Cruzado Anterior/métodos , Polietilenos/química , Tendões/transplante , Resistência à Tração/fisiologia , Análise de Variância , Animais , Fenômenos Biomecânicos , Modelos Animais de Doenças , Feminino , Humanos , Peso Molecular , Coelhos , Sensibilidade e Especificidade , Estatísticas não Paramétricas , Técnicas de Sutura , Suturas , Transplante Autólogo
19.
Am Surg ; 85(10): 1134-1138, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31657309

RESUMO

Traumatic esophageal injury is a highly lethal but rare injury with minimal data in the trauma population. We sought to provide a descriptive analysis of esophageal trauma (ET) to identify the incidence, associated injuries, interventions, and outcomes. We hypothesized that blunt trauma is associated with higher risk of death than penetrating trauma. The Trauma Quality Improvement Program (2010-2016) was queried for patients with ET. Patients with blunt and penetrating trauma were compared using chi-square and Mann-Whitney U tests. A multivariable logistic regression model was used to determine risk of mortality. Of 1,403,466 adult patients, 651 (<0.01%) presented with ET. The most common associated thoracic injuries were rib fractures (38.7%) and pneumothorax (26.7%). More patients with a penetrating mechanism underwent open repair of the esophagus than those with blunt mechanism (46.2% vs 11.7%, P < 0.001). After controlling for covariates, there was no difference in risk of mortality between blunt and penetrating trauma (P = 0.65). The mortality rate for patients with esophageal injury surviving greater than 24 hours was 7.5 per cent. In this large national database analysis, ET was rare and most commonly associated with rib fractures and pneumothorax. Contrary to our hypothesis, the risk of mortality was equivalent between blunt and penetrating ET.


Assuntos
Esôfago/lesões , Ferimentos não Penetrantes/mortalidade , Ferimentos Penetrantes/mortalidade , Adulto , Distribuição de Qui-Quadrado , Esôfago/cirurgia , Feminino , Mortalidade Hospitalar , Humanos , Incidência , Tempo de Internação , Modelos Logísticos , Masculino , Morbidade , Pneumonia/epidemiologia , Pneumonia/etiologia , Pneumotórax/complicações , Pneumotórax/epidemiologia , Melhoria de Qualidade , Estudos Retrospectivos , Fraturas das Costelas/complicações , Fraturas das Costelas/epidemiologia , Fatores de Risco , Estatísticas não Paramétricas , Stents/estatística & dados numéricos , Taxa de Sobrevida , Ferimentos não Penetrantes/complicações , Ferimentos não Penetrantes/epidemiologia , Ferimentos não Penetrantes/cirurgia , Ferimentos Penetrantes/complicações , Ferimentos Penetrantes/epidemiologia , Ferimentos Penetrantes/cirurgia
20.
Am Surg ; 85(10): 1139-1141, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31657310

RESUMO

Decisions regarding whether to close the skin in trauma patients with hollow viscus injuries (HVIs) are based on surgeon discretion and the perceived risk for an SSI. We hypothesized that leaving the skin open would result in fewer wound complications in patients with HVIs. We performed a retrospective analysis of all adult patients who underwent operative repair of an HVI. The main outcome measure was superficial or deep SSIs. Of 141 patients, 38 (27%) had HVIs. Twenty-six patients developed SSIs, of which 13 (50%) were superficial or deep SSIs. On adjusted analysis, only female gender (P = 0.03) and base deficit were associated (P = 0.001) with wound infections Open wound management was not associated with a decreased incidence of SSIs (P = 0.19) in patients with HVIs. Further research is required to determine optimal strategies for reducing wound complications in patients sustaining HVIs.


Assuntos
Traumatismos Abdominais/cirurgia , Técnicas de Fechamento de Ferimentos Abdominais/efeitos adversos , Procedimentos Cirúrgicos Dermatológicos/efeitos adversos , Infecção da Ferida Cirúrgica/epidemiologia , Ferida Cirúrgica/cirurgia , Técnicas de Fechamento de Ferimentos Abdominais/estatística & dados numéricos , Adulto , Antibioticoprofilaxia/estatística & dados numéricos , Procedimentos Cirúrgicos Dermatológicos/métodos , Duodeno/lesões , Feminino , Humanos , Intestino Delgado/lesões , Jejuno/lesões , Masculino , Estudos Retrospectivos , Pele , Estatísticas não Paramétricas , Estômago/lesões , Infecção da Ferida Cirúrgica/classificação , Infecção da Ferida Cirúrgica/etiologia , Infecção da Ferida Cirúrgica/prevenção & controle
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