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OBJECTIVE: To evaluate the ability of the variables Muscle Mass percentage (%MM), Body Fat percentage (%BF), Phase Angle (PhA), and Standardized Phase Angle (SPhA) to predict overall survival rates in individuals with surgically treated HNC. METHODS: A prospective cohort study of surgically treated HNC patients was carried out between 2017 and 2022 at a cancer referral center in Feira de Santana, Bahia. All subjects were seen by an experienced dietitian the week before surgery. During this visit, patients had their sociodemographic and clinical data collected, as well as anthropometric measurements (weight and height) and BIA variables. In this study, postoperative overall 5-year survival was defined as the time in months between the date of surgery and the date of death, regardless of the cause of death. Patients were followed up after surgery until death. RESULTS: Seventy-eight older adult patients were consecutively included. Patients had a median age of 65.5-years, were mostly men (83.3%), and most had low education levels (62.3%) and low household income, ranging from zero (19.2%) to the minimum wage (60.2%). They were mostly alcohol drinkers (91%) and tobacco smokers (87.2%). Glottic cancer was diagnosed in 48.7% of patients, with 44.8% of cases with stage-IV disease. Forty (51.2%) deaths were recorded in the follow-up period, with a median survival time of 39 months. Variables %MM, %BF, and SPhA were not significantly different between groups (alive vs. dead patients). PhA was considered an independent predictor of overall survival, with an accuracy of 69% (95% CI 0.57â0.80). When comparing survival curves, patients with a preoperative PhA < 6.8° were more than twice as likely to die during follow-up (HRâ¯=â¯2.38; pâ¯=⯠0.02; 95% CI 1.14â4.97). CONCLUSION: Out of the assessed BIA variables, preoperative PhA was considered a good predictor of overall survival after HNC surgery.
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Chikungunya, arbovirose que provoca febre e artralgia debilitante, demonstra potencial crônico e incapacitante por longos períodos, não havendo vacinas ou terapias específicas. Recentemente, a doença evoluiu da condição negligenciada para uma ameaça à saúde pública, impactando milhões de pessoas em regiões tropicais e subtropicais. Este estudo analisa a produção do conhecimento sobre a Chikungunya, na perspectiva da Vigilância em Saúde. Trata-se de metodologia exploratória-descritiva, com análise bibliométrica. Realizou-se a coleta nas bases Scopus e Web of Science para artigos de 2008 a 2022. A análise revelou uma série temporal de produção destacando a contribuição de Estados Unidos, Brasil e França. Identificaram-se como áreas mais produtivas: doenças transmissíveis, medicina tropical e parasitologia, fundamentais à Vigilância em Saúde e ao planejamento de políticas públicas. Quanto aos pesquisadores, Weaver, Scott C., Failloux, Anna-Bella e De Lamballerie, Xavier foram relevantes no cenário global, indicando a importância da colaboração e da abordagem interdisciplinar.
Chikungunya, an arbovirus that causes fever and debilitating arthralgia, has potential to be chronic and incapacitating for long periods, and there are no vaccines or therapies available for it. Recently, the disease has evolved from a neglected condition to public health threat, impacting millions in tropical and subtropical regions. This study analyzed the knowledge production about chikungunya, from the perspective of Health Surveillance, using an exploratory-descriptive methodology and bibliometric analysis. Articles from 2008 to 2022 were collected from Scopus and Web of Science databases. The analysis showed a production time series, highlighting the contribution of United States, Brazil, and France. The most productive areas were identified as: communicable diseases, tropical medicine and parasitology, which are fundamental to Health Surveillance and public policy planning. Regarding researchers, Weaver, Scott C., Failloux, Anna-Bella, and De Lamballerie, Xavier were relevant in the global scenario, indicating the importance of collaboration and of the interdisciplinary approach.
El chikungunya, arbovirus que causa fiebre y artralgia debilitante, tiene potencial de ser crónico e incapacitante por largos periodos, todavía no hay vacunas ni terapias. Recientemente, la enfermedad ha pasado de afección desatendida a amenaza para la salud pública, afectando a millones en regiones tropicales y subtropicales. Este estudio analiza la producción de conocimientos sobre chikungunya, desde la perspectiva de la Vigilancia Sanitaria. Se utilizó una metodología exploratoria-descriptiva con análisis bibliométrico. Se recompilaron artículos de Scopus y Web of Science, 2008-2022. El análisis reveló una serie temporal de producción, destacando la contribución de EEUU, Brasil y Francia. Se identificaron como áreas más productivas: enfermedades transmisibles, medicina tropical y parasitología, fundamentales para la Vigilancia Sanitaria y la planificación de políticas públicas. En cuanto a los investigadores, Weaver, Scott C., Failloux, Anna-Bella y De Lamballeire, Xavier fueron relevantes en el escenario global, indicando la importancia de la colaboración y del enfoque interdisciplinario.
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Epidemiología , Bibliometría , Virus Chikungunya , Actividades Científicas y Tecnológicas , Comunicación en Salud , Política de Salud , Infecciones por Arbovirus , Vigilancia Sanitaria , Salud Pública , Enfermedades Transmisibles , Vigilancia en Salud PúblicaRESUMEN
BACKGOUND: Potentially inappropriate prescribing (PIP) has been evaluated in several countries, and several strategies have been devised for deprescribing drugs in older adults. The aim of this study was to evaluate the efficacy of a mobile application in reducing PIP for older adults in primary care facilities in Brazil. METHODS: This randomised, triple-blind, parallel-group trial was conducted in 22 public primary care facilities in Brazil. During the intervention phase, the general practitioners (GPs) were randomly allocated to the intervention (MPI Brasil app provides information about PIP, therapeutic alternatives and deprescribing) or control (MedSUS app provides general information about medications) group. All GPs were trained on the Clinical Decision-Making Process and how to access an Evidence-Based Health website. The GPs received an Android tablet with an installed mobile application depending on their allocated group, which they used when caring for older patients over at least 3 months. At the end of this period, a sample of older patients aged ≥ 60 years who had been awaiting medical consultation by the participating GPs were interviewed and their prescriptions analysed. The primary outcome was the frequency of PIP in and between the groups. RESULTS: Among 53 GPs who were administered the baseline survey, 14 were included in the clinical trial. At baseline, 146 prescriptions were analysed: the PIP overall was 37.7% (55/146), in the intervention group was 40.6% (28/69), and in the control group was 35.1% (27/77). After the intervention, 284 prescriptions were analysed: the PIP overall was 31.7% (90/284), in the intervention group was 32.2% (46/143), and in the control group was 31.2% (44/141) (RR: 1.16; 95% CI, 0.76-1.76). In the within-group analysis, the PIP reduced from before to after the intervention in both groups-more significantly in the intervention than in the control group (p < 0.001). In the stratified analysis of PIP frequency by GPs, there was a relative risk reduction in 86% (6/7) of GPs in the intervention group compared to 71% (5/7) in the control group. CONCLUSION: We found that the MPI Brasil app effectively reduced PIP, suggesting that it may be useful to incorporate this tool into clinical practice. TRIAL REGISTRATION: The study was registered at ClinicalTrials.gov (NCT02918643). First registration on 22/09/2016.
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Prescripción Inadecuada , Aplicaciones Móviles , Humanos , Anciano , Brasil/epidemiología , Prescripción Inadecuada/prevención & control , Toma de Decisiones Clínicas , Atención Primaria de SaludRESUMEN
BACKGROUND: Ameloblastoma and ameloblastic carcinoma are epithelial odontogenic tumors that can be morphologically similar. In the present study, we evaluated the DNA content and Ki-67 index in the two tumors. METHODS: The paraffin blocks of the tumors were selected to obtain sections for the immunohistochemical reactions and preparation of the cell suspension for acquisition in a flow cytometer. The Random Forest package of the R software was used to verify the contribution of each variable to classify lesions into ameloblastoma or ameloblastic carcinoma. RESULTS: Thirty-two ameloblastoma and five ameloblastic carcinoma were included in the study. In our sample, we did not find statistically significant differences in Ki-67 labeling rates. A higher fraction of cells in 2c (G1) was correlated with the diagnosis of ameloblastoma, whereas higher rates of 5c-exceeding rate (5cER) were correlated with ameloblastic carcinoma. The Random Forest model highlighted histopathological findings and parameters of DNA ploidy study as important features for distinguishing ameloblastoma from ameloblastic carcinoma. CONCLUSION: Our findings suggest that the parameters of the DNA ploidy study can be ancillary tools in the classification of ameloblastoma and ameloblastic carcinoma.
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Ameloblastoma , Carcinoma , Tumores Odontogénicos , Humanos , Ameloblastoma/diagnóstico , Ameloblastoma/genética , Ameloblastoma/patología , Antígeno Ki-67/genética , Tumores Odontogénicos/genética , Carcinoma/patología , Ploidias , ADNRESUMEN
The aim of the present study was to summarize the effectiveness of amino acid supplementation on muscle strength, muscle volume, and functional capacity in patients undergoing total knee arthroplasty. For this, in November 2022, a search was carried out in the PubMed, Cochrane Library, and EMBASE databases, identifying a total of 2182 documents, of which only 4 were included in the present review. The included studies had 148 participants (47 men and 101 women), with a minimum age of 53 and a maximum of 92 years, and supplementation times of 13 to 30 days (1 to 3 times a day). For the results, in relation to muscle performance, when comparing the control and experimental groups, greater muscle atrophy was observed in the pre- and post-moments of the control group, in relation to the experimental group. In addition, studies suggest a good tendency for muscle mass gain, and improvement in the functional capacities of patients who used supplementation. Therefore, the use of amino acids after TKA surgery reduces muscle atrophy, which preserves muscle mass and leads to better performance in tests of strength and functional capacity, when compared to the use of a placebo.
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Aminoácidos , Artroplastia de Reemplazo de Rodilla , Suplementos Dietéticos , Fuerza Muscular , Músculo Esquelético , Ensayos Clínicos Controlados Aleatorios como Asunto , Anciano , Humanos , Masculino , Aminoácidos/administración & dosificación , Artroplastia de Reemplazo de Rodilla/efectos adversos , Artroplastia de Reemplazo de Rodilla/métodos , Músculo Esquelético/fisiopatología , Atrofia Muscular/prevención & control , Atrofia Muscular/etiologíaRESUMEN
Habitat loss and fragmentation are drivers of biodiversity loss, such as Euglossini bees in continental regions. Knowledge about these effects on this group of pollinators in coastal regions is still incipient and needs to be further investigated. This study aimed to evaluate the effects of landscape structure on the abundance, richness, diversity and species composition of Euglossini bees on the coast of the Brazilian Amazon. We mapped the surrounding landscape around 48 sampling points in the east of the island of Marajó, Pará, Brazil where we collected bees using chemical baits. We used Generalized Linear Models (GLMs) to evaluate the effects of landscape structure (composition and configuration) on the abundance, richness, diversity and composition of Euglossini bees. We collected a total of 1017 males belonging to four genera and 22 species. Forest cover (%) and landscape heterogeneity were the best predictors of the bee community. Increased forest cover positively affected the abundance, richness and diversity of bees at a local scale. On the other hand, abundance, richness and diversity decreased with increasing landscape heterogeneity, also at a local scale. The hypothesis that the amount of habitat favors Euglossini communities was corroborated by our results. Based on our conclusions, landscapes with greater forest cover can effectively contribute to the conservation of these bees and their pollination services along the Amazon coast.
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Ecosistema , Bosques , Masculino , Abejas , Animales , Biodiversidad , Brasil , PolinizaciónRESUMEN
The posture undergoes changes during aging and may serve as a marker for the evaluation of the thoracic spine. This study aimed to correlate the variables for the evaluation of thoracic spine mobility and propose predictive equation models from the measurements of the thoracic Schober test and the digital inclinometer in older adults. The mobility of thoracic flexion and extension by levels (T1, T8 and T12) of 41 older adult subjects (66 ± 7 years) was quantified with a digital inclinometer (degrees) and Schober's test (cm). There was a moderate positive correlation between the digital inclinometer and the Schober test at T1 (r = .69), T12 (r = .60), and total flexion levels T1 to T12 (r = .74). Simple linear regression equations showed that thoracic Schober predicts thoracic mobility measures for these same levels. Moderate to strong correlations were observed between the inclinometer and the Schober Test measurements. The development of predictive equation models based on the thoracic Schober test could potentially enhance the ability to predict spinal mobility in physically independent older adults.
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Postura , Humanos , Anciano , Rango del Movimiento ArticularRESUMEN
OBJECTIVES: To evaluate the use of point-of-care testing to detect new cases of diabetes mellitus at a Brazilian public community pharmacy. METHODS: This cross-sectional study included individuals without a previous diagnosis of diabetes mellitus who met the criteria for screening according to the Brazilian Diabetes Society, which were identified during their presence at a Brazilian public community pharmacy. The measurements of HbA1c were performed using a Cobas b101 device (Roche Diagnostics) and were categorized according to the following classification established by the Brazilian Society of Diabetes: HbA1c <5.7%, normal; HbA1c between 5.7% and 6.4%, pre-diabetes; and HbA1c >6.4%, new diagnosis of T2DM. KEY FINDINGS: One hundred and eight users met the inclusion criteria. The patients' mean age was 54.4 (± 15.4) years old, ranging from 22 to 80 years old. Eighty (74.1%) participants presented with glycated haemoglobin levels over the standard threshold, of which 58 (72.5%) were in the pre-diabetes range (glycated haemoglobin levels between 5.7% and 6.4%), and 22 (27.5%) had glycated haemoglobin levels >6.4%, which corresponds to a new diagnosis of type 2 diabetes mellitus. CONCLUSIONS: The use of point-of-care glycated haemoglobin testing allowed community pharmacists at a Brazilian public community pharmacy to identify health system users with glycated haemoglobin alterations that corresponded to the pre-diabetes state or a new diagnosis of type 2 diabetes mellitus. This presented a good opportunity to refer these users to diabetes diagnosis and treatment services.
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Diabetes Mellitus Tipo 2 , Farmacias , Estado Prediabético , Humanos , Persona de Mediana Edad , Adulto Joven , Adulto , Anciano , Anciano de 80 o más Años , Hemoglobina Glucada , Diabetes Mellitus Tipo 2/diagnóstico , Estado Prediabético/diagnóstico , Sistemas de Atención de Punto , Estudios Transversales , Pruebas en el Punto de Atención , Preparaciones FarmacéuticasRESUMEN
As alterações orais potencialmente malignas e o câncer oral, quando diagnosticados precocemente, possuem um bom prognóstico. No entanto, a imprecisão nos atendimentos odontológicos dificulta a detecção precoce, fazendo com que o câncer bucal permaneça como um problema de saúde pública atualmente. Objetivo: Avaliar o conhecimento de graduandos em odontologia sobre lesões orais de câncer e alterações orais potencialmente malignas. Método: Os dados foram coletados por meio de um questionário virtual, enviado para graduandos de odontologia de algumas universidades/faculdades localizadas no Estado da Bahia, entre os meses de junho e outubro de 2022. Posteriormente, os dados foram analisados estatisticamente e quatro conceitos foram estabelecidos: A (ótimo nível de informação); B (bom nível de informação); C (nível insatisfatório de informação); e D (péssimo nível de informação). Resultados: A amostra foi composta por 161 estudantes, a maioria entre 20 e 29 anos e do sexo feminino (78,3%). Não houve uma diferença estatística significativa entre os estudantes com até um ano de aprovação em componentes curriculares de estomatologia, patologia ou correlatos, com discentes com mais de um ano de aprovação (p = 0,126). A leucoplasia foi a alteração mais relacionada ao câncer (77%) para os entrevistados, e apenas 23% dos graduandos obtiveram o conceito A; no entanto, 96,9% dos entrevistados possuem interesse em assistir ao curso de educação contínua sobre o assunto. Conclusão: A maioria dos acadêmicos avaliados apresentou um bom nível de informação, entretanto, observou-se que os fatores de risco e a localização das lesões malignas geraram grandes dúvidas nos participantes deste estudo.
Potentially malignant oral disorders and oral cancer in early stages, when diagnosed early, have good prognosis. However, oral cancer is a public health problem today due to imprecision of dental care which makes early detection difficult. Objective: To evaluate the knowledge of dental students about oral cancer lesions and potentially malignant oral disorders. Method: Data were collected through a virtual questionnaire sent to undergraduate dentistry students from some universities/colleges located in the state of Bahia, between June and October 2022. Subsequently, the data were statically analyzed and four concepts were established: A (excellent level of information); B (good level of information); C (unsatisfactory level of information) and D (very poor level of information). Results: The sample consisted of 161 female students (78.3%) mostly between 20 and 29 years old. There was no statistically significant difference between students with up to one year of approval in stomatology, pathology or related disciplines, an students with more than one year of approval (p = 0.126). Leukoplakia was the disorder most related to cancer (77%) and only 23% of undergraduates obtained grade A, however, 96.9% of the respondents are interested in attending a continuing education course on the subject. Conclusion: The majority of the students evaluated had good level of information, nevertheless, the study participants had great doubts about the risk factors and the location of malignant lesions.
Los trastornos orales potencialmente malignos y el cáncer oral en estadios tempranos, cuando se diagnostican a tiempo, tienen un buen pronóstico. Sin embargo, la imprecisión en los tratamientos dentales dificulta la detección previa, por lo que el cáncer bucal sigue siendo un problema de salud pública en la actualidad. Objetivo: Evaluar el conocimiento de los estudiantes de odontología sobre las lesiones orales cancerosas y los trastornos orales potencialmente malignos. Método: Los datos fueron recolectados a través de un cuestionario virtual, enviado a estudiantes de grado en odontología de algunas universidades/facultades ubicadas en el estado de Bahía, entre junio y octubre de 2022. Posteriormente, los datos fueron analizados estadisticamente y se establecieron cuatro conceptos: A (nivel excelente de información); B (buen nivel de información); C (nivel de información insatisfactorio) y D (nivel de información muy bajo). Resultados: La muestra estuvo conformada por 161 estudiantes, la mayoría entre 20 y 29 años y de sexo femenino (78,3%). No hubo diferencia estadísticamente significativa entre estudiantes con hasta un año de aprobación en estomatología, patología o disciplinas afines, con estudiantes con más de un año de aprobación (p=0,126). La leucoplasia fue el trastorno que más se relacionó con el cáncer (77%) y solo el 23% de los estudiantes de pregrado obtuvo la calificación A, sin embargo, el 96,9% de los encuestados está interesado en asistir a un curso de educación continua sobre el tema. Conclusión: La mayoría de los estudiantes evaluados presentaron un buen nivel de información, sin embargo, se observó que los factores de riesgo y la localización de las lesiones malignas generaron grandes dudas entre los participantes de este estudio
Asunto(s)
Neoplasias de la Boca , Estudio de Evaluación , Detección Precoz del CáncerRESUMEN
Resumo Este estudo tem como objetivo analisar os atributos da Atenção Primária à Saúde (APS) abrangente a partir da atuação das equipes de Saúde da Família com foco nas doenças crônicas não transmissíveis. Pesquisa qualitativa realizada entre agosto de 2018 a julho de 2019, na APS de Vitória da Conquista, Bahia, com 40 profissionais de saúde, por meio de grupos focais e entrevistas. A partir da análise temática, os temas centrais corresponderam aos sete atributos da APS abrangente. Como resultados, as potencialidades do trabalho das equipes relacionaram-se com a priorização do acesso, ao amplo leque de serviços oferecidos e o reconhecimento da realidade comunitária/familiar. Destacaram-se obstáculos relacionados a oferta, acessibilidade e cobertura dos serviços, fragmentação na coordenação assistencial e informacional, dificuldades de desenvolvimento de práticas inclusivas com a família e etnicamente situadas, bem como na continuidade da assistência, notadamente para o contexto rural. Espera-se que os resultados apresentados possam confirmar a necessidade de investimentos e a instituição de processos sistemáticos de avaliação do trabalho das equipes de saúde da família, a fim de acompanhar a trajetória de consolidação da APS no contexto do Sistema Único de Saúde brasileiro.
Abstract This study aims to analyze the attributes of comprehensive Primary Health Care (PHC) based on the work of the family health teams focused on non-communicable chronic diseases. Qualitative research conducted from August 2018 to July 2019, in primary health care in Vitória da Conquista, Bahia, Brazil, with 40 health professionals, through interviews and focus groups. From the thematic analysis, the central themes were defined, corresponding to the seven attributes of comprehensive PHC. As a result, the potentials work of the family health teams was related to prioritizing access, the wide range of services offered and the recognition of the community and family reality. The study highlighted obstacles related to service provision, accessibility, coverage, care fragmentation and in information coordination, challenges in developing practices with the family, in practices ethnically situated, and continuity of care, notably for the rural context. It is expected that the results presented may confirm the need for investments and the institution of systematic evaluation processes regarding the work of family health teams, in order to follow the trajectory of PHC consolidation in the context of the Brazilian Unified Health System.Resumo: Este estudo tem como objetivo analisar os atributos da Atenção Primária à Saúde (APS) abrangente a partir da atuação das equipes de Saúde da Família com foco nas doenças crônicas não transmissíveis. Pesquisa qualitativa realizada entre agosto de 2018 a julho de 2019, na APS de Vitória da Conquista, Bahia, com 40 profissionais de saúde, por meio de grupos focais e entrevistas. A partir da análise temática, os temas centrais corresponderam aos sete atributos da APS abrangente. Como resultados, as potencialidades do trabalho das equipes relacionaram-se com a priorização do acesso, ao amplo leque de serviços oferecidos e o reconhecimento da realidade comunitária/familiar. Destacaram-se obstáculos relacionados a oferta, acessibilidade e cobertura dos serviços, fragmentação na coordenação assistencial e informacional, dificuldades de desenvolvimento de práticas inclusivas com a família e etnicamente situadas, bem como na continuidade da assistência, notadamente para o contexto rural. Espera-se que os resultados apresentados possam confirmar a necessidade de investimentos e a instituição de processos sistemáticos de avaliação do trabalho das equipes de saúde da família, a fim de acompanhar a trajetória de consolidação da APS no contexto do Sistema Único de Saúde brasileiro.
RESUMEN
Introduction: Self-medication consists of selecting and using medication without a poprescription or guidance from a healthcare professional. This practice has been widely reported worldwide, which has contributed to a series of adverse health outcomes, such as delayed diagnosis, worsening of clinical conditions, drug interactions, intoxication, and adverse reactions, which tend to compromise patient safety. Objective:To analyze the prevalence of self-medication associated with toothache, the main factors associated with self-medication in dental patients, as well as outline the profile of medications used by these individuals, the preferred route of administration, and the main sources of medication.Methodology:Asystematic review was developed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Relevant articles published in the last ten years, without limitations of language were searched using the following descriptors/MeSHterms and keywords: "self-medication" and (toothache or "dental pain") not Child. Results:The initial search returned 61 manuscripts. Fourteen papers, all cross-sectional studies, were eligible for inclusion in the systematic review.Conclusions:The prevalence of self-medication for toothache ranged from 6.5% to 100.0%. Cultural and economic factors, barriers to access, the high cost of dental treatments, lack of time and money, and the perception that dental problems are not a serious problem are among the main factors associated with the practice. Regarding the drugs used, the most used classes were paracetamol, especially anti-inflammatory drugs, particularly ibuprofen, and analgesics administered orally (AU).
Introdução:A automedicação consiste na escolha e uso de medicamentos sem prescrição ou orientação de um profissional de saúde. Essa prática tem sido amplamente divulgada em todo o mundo, o que tem contribuído para uma série de desfechos adversos à saúde, como atraso no diagnóstico, piora do quadro clínico, interações medicamentosas, intoxicações e reações adversas, que tendem a comprometer a segurança do paciente. Objetivo:Analisar a prevalência da automedicação associada à dor de dente, os principais fatores associados à automedicação em pacientes odontológicos, bem como traçar o perfil dos medicamentos utilizados por esses indivíduos, a via preferencial de administração e as principais fontes de medicação. Metodologia:Uma revisão sistemática foi desenvolvida de acordo com os itens de relatório preferidos para revisões sistemáticas e meta-análises (PRISMA). Foram pesquisados artigos relevantes publicados nos últimos dez anos, sem limitação de linguagem, utilizando os seguintes descritores/MeSHterms e palavras-chave: "self-medication" e (toothache or "dental pain") não Child. Resultados:A busca inicial encontrou61manuscritos. Quatorze artigos, de delineamento transversal,foram considerados elegíveis e incluídos para a revisão.Conclusões:A prevalência de automedicação para dor de dente variou de 6,5% a 100,0%. Fatores culturais e econômicos, barreiras de acesso, alto custo dos tratamentos odontológicos, falta de tempo e dinheiro e a percepção de que os problemas odontológicos não são um problema grave estão entre os principais fatores associados à prática. Em relação aos medicamentos utilizados, as classes mais utilizadas foram o paracetamol, principalmente os anti-inflamatórios, principalmente o ibuprofeno, e os analgésicos por via oral (AU).
Introducción: La automedicación consiste en seleccionar y utilizar medicamentos sin receta ni orientación de un profesional sanitario. Esta práctica ha sido ampliamente reportada a nivel mundial, lo que ha contribuido a una serie de resultados adversos para la salud, como retraso en el diagnóstico, empeoramiento de las condiciones clínicas, interacciones medicamentosas, intoxicaciones y reacciones adversas, que tienden a comprometer la seguridad del paciente.Objetivo: Analizar la prevalencia de automedicación asociada al dolor de muelas, los principales factores asociados a la automedicación en pacientes odontológicos, así como delinear el perfil de medicamentos utilizados por estos individuos, la vía de administración preferida y las principales fuentes de medicación. Metodología: Se desarrolló una revisión sistemática de acuerdo con los Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Se buscaron artículos relevantes publicados en los últimos diez años, sin limitaciones de idioma, utilizando los siguientes descriptores/MeSHterms y palabras clave: "self-medication" y (toothache or "dental pain") not Child. Resultados: La búsqueda inicial arrojó 61 manuscritos. Catorce artículos, todos estudios transversales, fueron elegibles para su inclusión en la revisión sistemática.Conclusiones: La prevalencia de automedicación para el dolor de muelas osciló entre 6,5% y 100,0%. Los factoresculturales y económicos, las barreras de acceso, el alto costo de los tratamientos dentales, la falta de tiempo y dinero, y la percepción de que los problemas dentales no son un problema grave se encuentran entre los principales factores asociados con la práctica. En cuanto a los fármacos utilizados, las clases más utilizadas fueron el paracetamol, especialmente los antiinflamatorios, especialmente el ibuprofeno, y los analgésicos por vía oral (AU).
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Automedicación , Odontalgia , Odontología en Salud Pública , Utilización de MedicamentosRESUMEN
INTRODUCTION: In general, two characteristics are ever present in NMR-based metabolomics studies: (1) they are assays aiming to classify the samples in different groups, and (2) the number of samples is smaller than the feature (chemical shift) number. It is also common to observe imbalanced datasets due to the sampling method and/or inclusion criteria. These situations can cause overfitting. However, appropriate feature selection and classification methods can be useful to solve this issue. OBJECTIVES: Investigate the performance of metabolomics models built from the association between feature selectors, the absence of feature selection, and classification algorithms, as well as use the best performance model as an NMR-based metabolomic method for prostate cancer diagnosis. METHODS: We evaluated the performance of NMR-based metabolomics models for prostate cancer diagnosis using seven feature selectors and five classification formalisms. We also obtained metabolomics models without feature selection. In this study, thirty-eight volunteers with a positive diagnosis of prostate cancer and twenty-three healthy volunteers were enrolled. RESULTS: Thirty-eight models obtained were evaluated using AUROC, accuracy, sensitivity, specificity, and kappa's index values. The best result was obtained when Genetic Algorithm was used with Linear Discriminant Analysis with 0.92 sensitivity, 0.83 specificity, and 0.88 accuracy. CONCLUSION: The results show that the pick of a proper feature selection method and classification model, and a resampling method can avoid overfitting in a small metabolomic dataset. Furthermore, this approach would decrease the number of biopsies and optimize patient follow-up. 1H NMR-based metabolomics promises to be a non-invasive tool in prostate cancer diagnosis.
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Quimiometría , Neoplasias de la Próstata , Masculino , Humanos , Metabolómica , Neoplasias de la Próstata/diagnóstico , Imagen por Resonancia Magnética , AlgoritmosRESUMEN
Identifying human leukocyte antigen (HLA) haplotype-homozygous donors for the generation of induced pluripotent stem (iPS) cell lines permits the construction of biobanks immunologically compatible with significant numbers of individuals for use in therapy. However, two questions must be addressed to create such a bank: how many cell lines are necessary to match most of the recipient population and how many people should be tested to find these donors? In Japan and the UK, 50 and 100 distinct HLA-A, -B, and -DRB1 triple-homozygous haplotypes would cover 90% of those populations, respectively. Using data from the Brazilian National Registry of Bone Marrow Donors (REDOME), encompassing 4,017,239 individuals, we identified 1,906 distinct triple-homozygous HLA haplotypes. In Brazil, 559 triple-homozygous cell lines cover 95% of the population, and 3.8 million people would have to be screened. Finally, we show the contribution of the 30 most frequent triple-homozygous HLA haplotypes in Brazil to populations of different countries.
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Células Madre Pluripotentes Inducidas , Humanos , Brasil , Células Madre Pluripotentes Inducidas/metabolismo , Antígenos HLA/metabolismo , Antígenos HLA-A/genética , Antígenos HLA-A/metabolismo , Donantes de Tejidos , Antígenos de Histocompatibilidad Clase I/metabolismo , Haplotipos/genética , Antígenos de Histocompatibilidad Clase II/metabolismo , Alelos , Frecuencia de los GenesRESUMEN
BACKGROUND: Odontogenic tumors (OT) are composed of heterogeneous lesions, which can be benign or malignant, with different behavior and histology. Within this classification, ameloblastoma and ameloblastic carcinoma (AC) represent a diagnostic challenge in daily histopathological practice due to their similar characteristics and the limitations that incisional biopsies represent. From these premises, we wanted to test the usefulness of models based on artificial intelligence (AI) in the field of oral and maxillofacial pathology for differential diagnosis. The main advantages of integrating Machine Learning (ML) with microscopic and radiographic imaging is the ability to significantly reduce intra-and inter observer variability and improve diagnostic objectivity and reproducibility. METHODS: Thirty Digitized slides were collected from different diagnostic centers of oral pathology in Brazil. After performing manual annotation in the region of interest, the images were segmented and fragmented into small patches. In the supervised learning methodology for image classification, three models (ResNet50, DenseNet, and VGG16) were focus of investigation to provide the probability of an image being classified as class0 (i.e., ameloblastoma) or class1 (i.e., Ameloblastic carcinoma). RESULTS: The training and validation metrics did not show convergence, characterizing overfitting. However, the test results were satisfactory, with an average for ResNet50 of 0.75, 0.71, 0.84, 0.65, and 0.77 for accuracy, precision, sensitivity, specificity, and F1-score, respectively. CONCLUSIONS: The models demonstrated a strong potential of learning, but lack of generalization ability. The models learn fast, reaching a training accuracy of 98%. The evaluation process showed instability in validation; however, acceptable performance in the testing process, which may be due to the small data set. This first investigation opens an opportunity for expanding collaboration to incorporate more complementary data; as well as, developing and evaluating new alternative models.
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Ameloblastoma , Carcinoma , Aprendizaje Profundo , Tumores Odontogénicos , Humanos , Ameloblastoma/diagnóstico por imagen , Ameloblastoma/patología , Inteligencia Artificial , Reproducibilidad de los Resultados , Tumores Odontogénicos/diagnóstico por imagen , Tumores Odontogénicos/patologíaRESUMEN
Olixon Cameron, 1887 is a genus of solitary wasps belonging to Rhopalosomatidae with 28 species worldwide, all of which are distinct being brachypterous and having the inner eye margins straight. In this paper, we describe Olixon pantanensis Bulbol, Bartholomay & Somavilla sp. nov., based on a male from the Brazilian Pantanal biome and provide new distribution records for O. testaceum Cameron, 1887 in the country. We also provide the first descriptions and illustrations of the male genitalia for both species.
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Trigona Jurine, 1807 (Hymenoptera: Apidae: Meliponini) is a Neotropical genus of stingless bees that is most diverse in the Amazon biome. The subgenus T. (Nostotrigona) was recently described and contains the taxa of the T. recursa species-group. In the present study, three new species of this subgenus are described: T. daianeae sp. nov., T. juvenili sp. nov., and T. mandaloriana sp. nov., including new records of T. permodica Almeida, 1992 for Brazil. A distribution map for T. (Nostotrigona) species are also provided.
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Heterópteros , Himenópteros , Abejas , Animales , Brasil , EcosistemaRESUMEN
The Analytic Hierarchy Process (AHP) is a multi-criteria decision support method and is widely applied in many areas. The original AHP method proposed by Thomas L. Saaty in the 1970s requires (n²-n)/2 comparisons. The number of required comparisons can make using this method challenging for maintaining consistent judgments in problems involving many criteria and/or alternatives. Furthermore, the available software is platform-dependent and generally does not support group decision-making. In this paper, we present software for AHP that demands n-1 comparisons. Additionally, the software supports group decision-making using individual aggregation of priorities with arithmetic and geometric means. The system is available at http://ahpweb.net/ and is accessible from any internet-connected device. It currently has more than 100 users and dozens of decision problems in various areas.â¢The original AHP formulation requires (n²-n)/2 comparisons per cluster which makes it difficult to make consistent judgments.â¢AHP avaliable software does not enable group decision making.â¢The proposed system AHP-WEB fills these gaps. The method demands n-1 comparisons per cluster without any inconsistency and allows group decision making on a web system.
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Avaliar as condições de saúde bucal e sua relação com os aspectos socioculturais e de acesso a serviços odontológicos em quilombolas do Município de Cachoeira (BA). Realizou-se um estudo transversal, examinando 128 indiíduos. A análise estatística foi conduzida através da distribuição das frequências das variáveis demográficas e socioeconômicas. O cálculo de associação entre as variáveis e os desfechos foi obtido pelas Razões de Prevalências e respectivos intervalos de confiança. Constatou-se que há significância estatística (IC 95%) entre a doença periodontal e dieta cariogênica, plantas medicinais e bochecho com chá ou enxaguante bucal, assim como existiu associação entre a cárie dentária e a dificuldade de acesso a serviços odontológicos, odontalgia e o edentulismo. A maior prevalência dos agravos bucais investigados foi em indivíduos adultos e predominantemente em mulheres, sendo que a maior parte dos indivíduos possuía apenas o ensino fundamental e renda inferior a um salário-mínimo.
To evaluate oral health conditions and their relationship with sociocultural aspects and access to dental services in quilombolas in the municipality of Cachoeira, Bahia. A cross-sectional study was carried out, examining 128 individuals. Statistical analysis was conducted through the frequency distribution of demographic and socioeconomic variables. The calculation of the association between variables and outcomes was obtained using Prevalence Ratios and respective confidence intervals. It was found that there is statistical significance (CI 95%) between periodontal disease and cariogenic diet, medicinal plants and mouthwash with tea or mouthwash, as well as an association between dental caries and difficulty in accessing dental services, toothache and edentulism. The highest prevalence of oral diseases investigated was in adult individuals and predominantly in women, and most individuals had only elementary education and income below the minimum wage.
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PURPOSE: Incorporating technology such as home blood pressure monitoring (HBPM) into the clinical routine generates opportunities to improve BP monitoring and control in primary health care. It is also important to prevent overtreatment. However, the combination of HBPM with collaborative drug therapy management (CDTM) has not yet been studied. This study aimed to assess the efficacy of combining HBPM with CDTM to optimize hypertension treatment for older patients. METHODS: This open-label, parallel-group, randomized clinical trial was conducted between June 2021 and August 2022 in a Brazilian community pharmacy and included older patients (aged ≥60 years) with hypertension. Those who were classified as poorly adherent or nonadherent to the prescribed drug treatment or who were unable to perform HBPM were excluded. In the control group, participants received a BP monitor and instructions on how to perform HBPM. A general practitioner, who was provided a report with the obtained BP values, determined any changes to the treatment protocol. In the intervention group, a pharmacist enrolled participants in a drug therapy management protocol and provided the general practitioner with suggestions to optimize the antihypertensive drug therapy, in addition to the report with the BP values. The following outcomes were considered: the proportion of participants receiving deprescriptions of antihypertensive drugs, other treatment adjustments, and the difference in mean BP between the groups 45 days after performing HBPM. The study used a t test combined with Levene's test to calculate mean intergroup differences in BP, the paired t test to calculate mean intragroup differences in BP, and Pearson's χ2 test to determine intergroup differences in changes in drug therapy. FINDINGS: In each group, 161 participants completed the trial. Antihypertensive agents were deprescribed for 31 (19.3%) participants in the intervention group versus 11 (6.8%) in the control group (P = 0.01). In addition, 14 (8.7%) participants were prescribed antihypertensive drugs in the intervention group versus 11 (6.8%) in the control group (P = 0.52). The mean office systolic BP and HBPM values were lower in the intervention group (P = 0.22 and P = 0.29, respectively). IMPLICATIONS: Combining HBPM with a CDTM protocol effectively optimized antihypertensive treatment for older patients in a primary health care setting. CLINICALTRIALS: gov identifier: NCT04861727.