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1.
Heliyon ; 10(14): e34833, 2024 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-39148974

RESUMO

Objective: To investigate if individual and contextual socioeconomic factors are associated with contraceptive use in Brazilian women from 18 to 49 years old, stratified by parity. Methods: Cross-sectional, population-based study that analyzed data from 16,879 women from 18 to 49 years old, respondents of the 2013 National Health Survey. Individual factors such as reproductive history, access to health services, and sociodemographic characteristics were considered; and as contextual factors, Human Development Index (HDI), Sociodemographic Index (SDI) Primary Health Care Coverage (PHC coverage) and Average Monthly Income were included. Multilevel logistic regression models were estimated, stratified by parity, with women being level 1 and States and Federal District of level 2 units. Results: Nulliparous women had lower prevalence of contraceptive use (77.9 %) when compared with primiparous and multiparous (88.7 %), as well as greater variability in the chance of using contraception (ICC = 2.1 vs. ICC = 1.1, respectively). Women who lived in States with higher levels of HDI, average monthly income and SDI were more likely to use contraception. The greater PHC coverage was positively associated with the use of contraceptives for primiparous/multiparous women and negatively for the nulliparous. Furthermore, higher education increased the chances of using contraception, both for nulliparous and primiparous/multiparous women. Conclusions: The high contraceptive coverage in Brazil hides important inequities in access, highlighting contextual characteristics associated with the use of contraceptives, in addition to individual factors. The lower prevalence and chance of using contraceptives for nulliparous women with greater social vulnerability reveal inequity and priority in public policies. Implications for practice: The need to improve access to contraception is highlighted, considering both the individual and contextual vulnerabilities of women, which implies ensuring timely and qualified access to contraceptive methods, especially for young and nulliparous women who are more socially vulnerable.

2.
Rev Bras Enferm ; 77(3): e20230099, 2024.
Artigo em Inglês, Português | MEDLINE | ID: mdl-39082532

RESUMO

OBJECTIVES: to evaluate the trends in cesarean sections from 2014 to 2020 across both public and private sectors, utilizing the Robson Classification. METHODS: this time series study analyzed the proportion of women who underwent cesarean sections between 2014 and 2020, considering both the Robson classification and the type of healthcare service. Trend analysis was conducted using the Prais-Winsten regression. RESULTS: higher proportions of cesarean sections were observed in all Robson groups within the private sector compared to the public sector. This was despite a decreasing trend in the private sector and an increasing trend in the public sector. Notably, elevated proportions of cesarean sections were recorded in groups that are typically favorable to normal childbirth (Robson 1, 4, and 5). CONCLUSIONS: although there was a decreasing trend in cesarean sections within the private sector, an increasing trend was observed in the public sector. Additionally, there was a high proportion of cesarean sections among women with conditions favorable to normal childbirth. It is crucial to continuously monitor these indicators to evaluate and implement interventions aimed at reducing unnecessary cesarean sections.


Assuntos
Cesárea , Setor Privado , Setor Público , Cesárea/estatística & dados numéricos , Cesárea/tendências , Cesárea/classificação , Brasil , Humanos , Feminino , Gravidez , Setor Público/estatística & dados numéricos , Setor Público/tendências , Setor Privado/estatística & dados numéricos , Setor Privado/tendências , Adulto
3.
Pharmaceuticals (Basel) ; 17(7)2024 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-39065700

RESUMO

The development and course of inflammatory bowel disease (IBD) are significantly influenced by inflammation and oxidative stress. Antioxidant therapy is a promising therapeutic option to enhance the clinical results of these individuals in this particular scenario. The purpose of this study is to assess the impact of curcumin, with or without piperine, on cytokines, fecal calprotectin (CalF), and oxidative stress enzymatic and non-enzymatic indicators in patients with IBD. METHODS: Patients with Crohn's disease (CD) or ulcerative colitis (UC) who were at least 18 years old and had intact liver and kidney function participated in this randomized, double-blind trial (trial registration: ensaiosclinicos.gov.br as RBR-89q4ydz). For 12 weeks, participants were randomly assigned to one of three groups: placebo, curcumin (1000 mg/day), or curcumin plus piperine (1000 mg + 10 mg/day). In order to examine oxidative stress indicators, CalF, and pro-inflammatory cytokines, blood and fecal samples were obtained, both prior to and following the intervention time. RESULTS: After adjusting for age, sex, and type of IBD, the curcumin plus piperine group had substantially higher serum levels of superoxide dismutase (SOD) than the placebo group (4346.9 ± 879.0 vs. 3614.5 ± 731.5; p = 0.041). There were no discernible variations between the groups in CalF, inflammatory markers, or other indicators of oxidative stress. CONCLUSIONS: In patients with inflammatory bowel disease (IBD), our study indicates that a 12-week curcumin plus piperine treatment effectively increases enzymatic antioxidant defense, especially SOD. These results demonstrate the potential therapeutic benefits of managing redox imbalance in individuals with IBD.

4.
Front Immunol ; 15: 1385850, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38726014

RESUMO

Introduction: Chagas disease is a neglected parasitic disease caused by Trypanosoma cruzi. While most patients are asymptomatic, around 30% develop Chronic Chagasic Cardiomyopathy (CCC). Methods: Here, we employed high-dimensional flow cytometry to analyze CD4+ T and B cell compartments in patients during the chronic phase of Chagas disease, presenting the asymptomatic and mild or moderate/severe cardiac clinical forms. Results: Effector CD27-CD4+ T cells were expanded in both CCC groups, and only mild CCC patients showed higher frequencies of effector memory and T follicular helper (Tfh) cells than healthy donors (CTL) and asymptomatic patients. Unsupervised analysis confirmed these findings and further revealed the expansion of a specific subpopulation composed of Tfh, transitional, and central memory CD4+ T cells bearing a phenotype associated with strong activation, differentiation, and exhaustion in patients with mild but not moderate/severe CCC. In contrast, patients with mild and moderate/severe CCC had lower frequencies of CD4+ T cells expressing lower levels of activation markers, suggesting resting status, than CTL. Regarding the B cell compartment, no alterations were found in naïve CD21-, memory cells expressing IgM or IgD, marginal zone, and plasma cells in patients with Chagas disease. However, expansion of class-switched activated and atypical memory B cells was observed in all clinical forms, and more substantially in mild CCC patients. Discussion: Taken together, our results showed that T. cruzi infection triggers changes in CD4+ T and B cell compartments that are more pronounced in the mild CCC clinical form, suggesting an orchestrated cellular communication during Chagas disease. Conclusion: Overall, these findings reinforce the heterogeneity and complexity of the immune response in patients with chronic Chagas disease and may provide new insights into disease pathology and potential markers to guide clinical decisions.


Assuntos
Linfócitos T CD4-Positivos , Cardiomiopatia Chagásica , Humanos , Cardiomiopatia Chagásica/imunologia , Masculino , Pessoa de Meia-Idade , Feminino , Linfócitos T CD4-Positivos/imunologia , Adulto , Linfócitos B/imunologia , Trypanosoma cruzi/imunologia , Doença Crônica , Idoso , Ativação Linfocitária/imunologia
5.
Fitoterapia ; 175: 105939, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38570096

RESUMO

Sesquiterpenes are a class of metabolites derived from plant species with immunomodulatory activity. In this study, we evaluated the effects of treatment with costic acid on inflammation, angiogenesis, and fibrosis induced by subcutaneous sponge implants in mice. One sponge disc per animal was aseptically implanted in the dorsal region of the mice and treated daily with costic acid (at concentrations of 0.1, 1, and 10 µg diluted in 10 µL of 0.5% DMSO) or 0.5% DMSO (control group). After 9 days of treatment, the animals were euthanized, and the implants collected for further analysis. Treatment with costic acid resulted in the reduction of the inflammatory parameters evaluated compared to the control group, with a decrease in the levels of inflammatory cytokines and chemokines (TNF, CXCL-1, and CCL2) and in the activity of MPO and NAG enzymes. Costic acid administration altered the process of mast cell degranulation. We also observed a reduction in angiogenic parameters, such as a decrease in the number of blood vessels, the hemoglobin content, and the levels of VEGF and FGF cytokines. Finally, when assessing implant-induced fibrogenesis, we observed a reduction in the levels of the pro-fibrogenic cytokine TGF-ß1, and lower collagen deposition. The results of this study demonstrate, for the first time, the anti-inflammatory, anti-angiogenic, and anti-fibrotic effects of costic acid in an in vivo model of chronic inflammation and reinforce the therapeutic potential of costic acid.


Assuntos
Colágeno , Citocinas , Inflamação , Sesquiterpenos , Animais , Camundongos , Sesquiterpenos/farmacologia , Sesquiterpenos/isolamento & purificação , Colágeno/metabolismo , Inflamação/tratamento farmacológico , Citocinas/metabolismo , Masculino , Fibrose , Poríferos , Anti-Inflamatórios/farmacologia , Anti-Inflamatórios/isolamento & purificação , Neovascularização Patológica/tratamento farmacológico , Angiogênese
6.
PLoS One ; 19(2): e0297944, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38359009

RESUMO

OBJECTIVES: The aim of this study was to assess the prevalence of Temporomandibular Disorders (TMD) in subjects with skeletal class II dentofacial deformity referred for orthognathic surgery, as well as to elucidate its association with sociodemographic and psychosocial features. METHODS: This was a cross-sectional study using the Research Diagnostic Criteria for Temporomandibular Disorders. The sample comprised class II skeletal patients referred to an Oral and Maxillofacial Surgery center in the Brazilian Northeast. RESULTS: Seventy-three subjects were enrolled and completed the data collection, which consisted of a physical examination according to Axis I of the Research Diagnostic Criteria for Temporomandibular Disorders and facial analysis. Women represented 82.2% of the sample. Among the assessed subjects, 68.5% were already undergoing orthodontic treatment, and the mean overjet of patients was 6.97 mm. The prevalence of TMD in this sample was 46.6%, with muscular disorders being the most common. Patients with an anteroposterior discrepancy greater than 7 mm showed a higher occurrence of TMD (p = 0.017). CONCLUSION: This study demonstrated a high prevalence of TMD in skeletal class II patients referred for orthognathic surgery, especially in those with a pronounced overjet, being Group I (muscular disorders) and Group III (degenerative disorders) the most prevalent.


Assuntos
Cirurgia Ortognática , Transtornos da Articulação Temporomandibular , Humanos , Feminino , Estudos Transversais , Transtornos da Articulação Temporomandibular/epidemiologia , Transtornos da Articulação Temporomandibular/diagnóstico , Brasil/epidemiologia , Articulação Temporomandibular
7.
J. Health Biol. Sci. (Online) ; 12(1): 1-15, jan.-dez. 2024. ilus, tab
Artigo em Inglês | LILACS | ID: biblio-1566673

RESUMO

Objective: we evaluated the seroprevalence and levels of anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies among medical students and the possible associated factors. Methods: a survey was conducted using the data collected in November 2020 and February 2022 in Fortaleza, Northeast Brazil. A questionnaire was administered, and blood and nasopharyngeal swab samples were collected. The Abbott test was used for the assessment of humoral response to the SARS-CoV-2 spike (S) and nucleocapsid (N) proteins. The total antibodies were detected using a SARS-CoV-2 antibody test (Wodfo). Swab samples were subjected to qualitative detection of viral RNA. Chi-square test and multinomial logistic regression analysis were performed using SPSS and GraphPad Prism. Results: the seroprevalence rate in 2020 was 6.22% (40/643), and no difference in prevalence was observed between the semesters (p=0.520). The seroconversion rate was 51.1%. The seropositivity rates were 48.9% for N antibodies and 100% for S antibodies. The antibody response to N protein was higher in 2022 (p<0.001). Loss of smell was the most prevalent positive symptom (p=0.032). The adherence rate to protection measures was >75%. Most students reported a decrease in family income (63.7%), an increase in anxiety (82.6%), and a negative impact on their mental health (85.7%) regardless of the seroconversion status. The worst indicators of mental health quality were observed in students who attended classes up to the eighth semester (p<0.001). Conclusion: students showed lower immune response than the general population, with excellent adherence to the preventive and control measures. Medical schools played an important role in the formation but not transmission.


Objetivo: avaliamos a soroprevalência e os níveis de anticorpos anti-síndrome respiratória aguda grave coronavírus 2 (SARS-CoV-2) entre estudantes de medicina e os possíveis fatores associados. Métodos: foi realizada uma pesquisa com dados coletados em novembro de 2020 e fevereiro de 2022 em Fortaleza, Nordeste do Brasil. Um questionário foi aplicado e amostras de sangue e swab nasofaríngeo foram coletadas. O teste de Abbott foi utilizado para avaliação da resposta humoral às proteínas spike (S) e nucleocapsídeo (N) do SARS-CoV-2. Os anticorpos totais foram detectados usando um teste de anticorpos SARS-CoV-2 (Wodfo). Amostras de swab foram submetidas à detecção qualitativa de RNA viral. O teste qui-quadrado e a análise de regressão logística multinomial foram realizados utilizando SPSS e GraphPad Prism. Resultados: a taxa de soroprevalência em 2020 foi de 6,22% (40/643), e não foi observada diferença de prevalência entre os semestres (p=0,520). A taxa de soroconversão foi de 51,1%. As taxas de soropositividade foram de 48,9% para anticorpos N e 100% para anticorpos S. A resposta de anticorpos à proteína N foi maior em 2022 (p<0,001). A perda do olfato foi o sintoma positivo mais prevalente (p=0,032). A taxa de adesão às medidas de proteção foi >75%. A maioria dos estudantes relatou diminuição da renda familiar (63,7%), aumento da ansiedade (82,6%) e impacto negativo na saúde mental (85,7%), independentemente do estado de soroconversão. Os piores indicadores de qualidade em saúde mental foram observados nos alunos que frequentavam aulas até o oitavo semestre (p<0,001). Conclusão: os estudantes apresentaram resposta imunológica menor que a da população em geral, com excelente adesão às medidas preventivas e de controle. As escolas médicas desempenharam um papel importante na formação, mas não na transmissão.


Assuntos
Humanos , COVID-19 , Estudantes de Medicina , RNA Viral
8.
Rev. bras. enferm ; Rev. bras. enferm;77(3): e20230099, 2024. tab, graf
Artigo em Inglês | LILACS-Express | LILACS, BDENF - Enfermagem | ID: biblio-1569668

RESUMO

ABSTRACT Objectives: to evaluate the trends in cesarean sections from 2014 to 2020 across both public and private sectors, utilizing the Robson Classification. Methods: this time series study analyzed the proportion of women who underwent cesarean sections between 2014 and 2020, considering both the Robson classification and the type of healthcare service. Trend analysis was conducted using the Prais-Winsten regression. Results: higher proportions of cesarean sections were observed in all Robson groups within the private sector compared to the public sector. This was despite a decreasing trend in the private sector and an increasing trend in the public sector. Notably, elevated proportions of cesarean sections were recorded in groups that are typically favorable to normal childbirth (Robson 1, 4, and 5). Conclusions: although there was a decreasing trend in cesarean sections within the private sector, an increasing trend was observed in the public sector. Additionally, there was a high proportion of cesarean sections among women with conditions favorable to normal childbirth. It is crucial to continuously monitor these indicators to evaluate and implement interventions aimed at reducing unnecessary cesarean sections.


RESUMEN Objetivos: evaluar la tendencia de las cesáreas, en el período de 2014 a 2020, en los sectores público y privado según la Clasificación de Robson. Métodos: estudio de serie temporal de la proporción de mujeres que tuvieron cesáreas entre 2014 y 2020, considerando la clasificación de Robson y el tipo de servicio. Para el análisis de tendencia, se utilizó la regresión de Prais-Winsten. Resultados: se observaron mayores proporciones de cesáreas en todos los grupos de Robson en el sector privado en comparación con el público, incluso con una tendencia a la reducción en el privado y un aumento en el público. También se registraron proporciones elevadas de cesáreas en grupos favorables al parto normal (Robson 1, 4 y 5). Conclusiones: a pesar de la tendencia a la reducción de las cesáreas en el sector privado, hubo una tendencia creciente en el público y una elevada proporción de cesáreas en mujeres con condiciones favorables al parto normal. Se destaca la necesidad de monitorear estos indicadores para evaluar y proponer intervenciones para la reducción de cesáreas innecesarias.


RESUMO Objetivos: avaliar a tendência de cesáreas, no período de 2014 a 2020, nos setores público e privado segundo a Classificação de Robson. Métodos: estudo de série temporal da proporção de mulheres que tiveram cesáreas entre 2014 e 2020, considerando a classificação de Robson e o tipo de serviço. Para análise de tendência, utilizou-se a regressão de Prais-Winsten. Resultados: observaram-se maiores proporções de cesáreas em todos os grupos de Robson no setor privado em relação ao público, mesmo com tendência de redução no privado e aumento no público. Também foram registradas elevadas proporções de cesáreas em grupos favoráveis ao parto normal (Robson 1, 4 e 5). Conclusões: apesar da tendência de redução das cesáreas no setor privado, houve tendência crescente no público e elevada proporção de cesáreas em mulheres com condições favoráveis ao parto normal. Ressalta-se a necessidade de monitorar esses indicadores para avaliar e propor intervenções para a redução de cesáreas desnecessárias.

9.
Braz. j. oral sci ; 23: e240398, 2024. tab
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1553456

RESUMO

Aim: This study aimed to assess the polymerization effectiveness of bulk-fill composite resins in longitudinal microhardness. Methods: Blocks of bulk-fill composite resin with thicknesses of 6 mm were analyzed with Vickers microhardness. The resin blocks were divided into two groups (n=6): resin AURA and OPUS. The microhardness test was performed before (base and top) and after (longitudinal microhardness) sectioning the blocks at distances of 2 mm, 4 mm, and 6 mm from the top of the block. The mean microhardness values were tabulated and subjected to ANOVA followed by Tukey's test (p<0.05). Results: The OPUS bulk-fill resin samples presented microhardness means of 55.9 kgf/mm2, 53.7 kgf/mm2, and 49.3 kgf/mm2, the AURA bulk-fill resin samples presented microhardness means of 57,02 kgf/mm2, 55,86 kgf/mm2 e 51,77 kgf/mm2 for the distances of 2 mm, 4 mm, and 6 mm, respectively. Tukey's statistical test showed a significant difference in microhardness values at different distances of 2 mm, 4 mm, and 6 mm (p<0.001) for each resin. Although there was a statistically significant difference within and between the groups assessed, all samples showed polymerization effectiveness when comparing the top and base of the block. Conclusion: Polymerization was effective in different thicknesses (2 mm, 4 mm, and 6 mm) in both resins studied. The microhardness ratio was adequate when comparing the base and top


Assuntos
Eficácia , Resinas Compostas , Polimerização , Dureza
10.
PLoS One ; 18(12): e0295534, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38096159

RESUMO

The study aims to understand the dispersal patterns of non-indigenous Tubastraea spp. (Sun Coral) larvae in the Brazil Current (BC), specifically in the Cape Frio recurrent cyclonic eddy (CFE) scenario. For this, the Regional Ocean Model System was used to simulate the hydrodynamic fields in a high-resolution nested grid, where a model of lagrangian floats, in a good approximation of the larvae properties and considering massive planulation events, was coupled with surface larval release from the Campos Basin area. The simulation was representative of mesoscale features compared to similar studies, ARGO vertical profiles and a py-eddy-track algorithm was used to obtain eddy variables, such as radius, rotational and translational velocities. These parameters are fundamental to access when an eddy tends to trap or not the water, heat and plankton in its interior. CFE turned out to be highly nonlinear, with a strong tendency to trap larvae in its core, acting as a dispersal constrictor when compared with the organisms in the axis of the higher speed of BC. A strong negative correlation (-0.75) was found between the days that larvae were inside the eddy and their distance from the origin. None of the 48,000 larvae released during simulated experiment a 16-day spawning event reached the coast. There are two different patterns for the dispersal, one along the shelf break and another, with higher larval density, off from the 1000 m isobath. The CFE's presence allows larvae to remain in the same region for longer periods, although in offshore areas. Therefore, as there is considerable availability of fixed substrates on oil rig structures, larvae could settle on them resulting in a possible inter-platforms connectivity between populations of Tubastraea spp. Also, regions in the CFE that present downward vertical velocities (downwelling), may move young larvae to depths of about 60 m suggesting that subsurface colonizations are possible due to specific dynamics of propagating cyclonic eddies. So, identifying the main factors that affect the dispersion of propagules is essential to subsidize management policies for controlling bioinvasion associated with exploitation of hydrocarbon resources in offshore areas.


Assuntos
Antozoários , Fenômenos Fisiológicos , Animais , Larva , Brasil , Simulação por Computador
11.
Cien Saude Colet ; 28(11): 3367-3381, 2023 Nov.
Artigo em Português, Inglês | MEDLINE | ID: mdl-37971017

RESUMO

This article aims to evaluate the performance of preconception health indicators according to sociodemographic characteristics among Brazilian women of reproductive age. We conducted a descriptive epidemiological study using data from 21,645 and 25,228 women, respectively, who responded the 2013 and 2019 national health surveys, and data for the period 2010 to 2020 derived from the national health system's Department of Informatics (DATASUS). We calculated the prevalence of indicators according to sociodemographic characteristics and statistical significance of differences was measured using Pearson's chi-squared test. Syphilis and HIV incidence rates were also calculated. There was an increase in the prevalence of access to health service indicators (medical and dental consultations and recent Pap smear). However, there was an increase in the prevalence of hypertension, alcohol use, and obesity. The prevalence of use of contraceptive methods and fertility treatment remained stable. Syphilis incidence increased sevenfold between 2010 and 2020. Black/brown women with a low level of education, higher parity, and living in the North or Northeast performed worse for preconception health indicators. Despite the increase in access to health services, performance on preconception health indicators declined and health inequities continued.


O objetivo deste artigo é avaliar o desempenho de indicadores de saúde pré-concepcional das mulheres brasileiras em idade reprodutiva segundo as características sociodemográficas. Estudo epidemiológico e descritivo com dados de 21.645 e 25.228 mulheres que responderam à Pesquisa Nacional de Saúde de 2013 e 2019 e provenientes do DATASUS de 2010 a 2020. Estimou-se a prevalência de indicadores, segundo características sociodemográficas, e as diferenças estatísticas por meio do teste qui-quadrado de Pearson. Calculou-se a taxa de incidência dos indicadores de sífilis e HIV. Houve aumento da prevalência de indicadores que se referem ao acesso aos serviços de saúde (consultas médica, odontológica e realização de Papanicolau recente). Contudo, houve aumento da hipertensão, do consumo de álcool e da obesidade. Observou-se manutenção da prevalência do uso de contraceptivo e tratamento de fertilidade. Além disso, a taxa de incidência da sífilis aumentou sete vezes entre 2010-2020. Os resultados foram ainda piores entre mulheres de baixa escolaridade, pretas/pardas, com maior paridade e do Norte/Nordeste. Apesar do aumento no acesso aos serviços de saúde, houve piora do desempenho de indicadores de saúde pré-concepcional, e manutenção das iniquidades em saúde.


Assuntos
Cuidado Pré-Concepcional , Sífilis , Gravidez , Humanos , Feminino , Prevalência , Brasil/epidemiologia , Anticoncepção
12.
Ciênc. Saúde Colet. (Impr.) ; Ciênc. Saúde Colet. (Impr.);28(11): 3367-3381, nov. 2023. tab, graf
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1520650

RESUMO

Resumo O objetivo deste artigo é avaliar o desempenho de indicadores de saúde pré-concepcional das mulheres brasileiras em idade reprodutiva segundo as características sociodemográficas. Estudo epidemiológico e descritivo com dados de 21.645 e 25.228 mulheres que responderam à Pesquisa Nacional de Saúde de 2013 e 2019 e provenientes do DATASUS de 2010 a 2020. Estimou-se a prevalência de indicadores, segundo características sociodemográficas, e as diferenças estatísticas por meio do teste qui-quadrado de Pearson. Calculou-se a taxa de incidência dos indicadores de sífilis e HIV. Houve aumento da prevalência de indicadores que se referem ao acesso aos serviços de saúde (consultas médica, odontológica e realização de Papanicolau recente). Contudo, houve aumento da hipertensão, do consumo de álcool e da obesidade. Observou-se manutenção da prevalência do uso de contraceptivo e tratamento de fertilidade. Além disso, a taxa de incidência da sífilis aumentou sete vezes entre 2010-2020. Os resultados foram ainda piores entre mulheres de baixa escolaridade, pretas/pardas, com maior paridade e do Norte/Nordeste. Apesar do aumento no acesso aos serviços de saúde, houve piora do desempenho de indicadores de saúde pré-concepcional, e manutenção das iniquidades em saúde.


Abstract This article aims to evaluate the performance of preconception health indicators according to sociodemographic characteristics among Brazilian women of reproductive age. We conducted a descriptive epidemiological study using data from 21,645 and 25,228 women, respectively, who responded the 2013 and 2019 national health surveys, and data for the period 2010 to 2020 derived from the national health system's Department of Informatics (DATASUS). We calculated the prevalence of indicators according to sociodemographic characteristics and statistical significance of differences was measured using Pearson's chi-squared test. Syphilis and HIV incidence rates were also calculated. There was an increase in the prevalence of access to health service indicators (medical and dental consultations and recent Pap smear). However, there was an increase in the prevalence of hypertension, alcohol use, and obesity. The prevalence of use of contraceptive methods and fertility treatment remained stable. Syphilis incidence increased sevenfold between 2010 and 2020. Black/brown women with a low level of education, higher parity, and living in the North or Northeast performed worse for preconception health indicators. Despite the increase in access to health services, performance on preconception health indicators declined and health inequities continued.

13.
Cad Saude Publica ; 39(8): e00229322, 2023.
Artigo em Português | MEDLINE | ID: mdl-37820236

RESUMO

This study aims to describe the contraceptive mix and analyze the factors associated with the type of contraceptive used by Brazilian women of reproductive age. This is a cross-sectional, population-based study with data from 19,962 women aged 15 to 49 years. The outcomes were use and type of contraceptive, classified as: short-acting reversible contraceptives (SARC), long-acting (LARC), and permanent. The explanatory variables were characteristics of reproductive history, sociodemographic history, and access to health services. Multinomial logistic regression was used for odds ratio (OR) estimates, with SARC being the reference category. The analyses were performed in the Survey module of the Stata software, which considered the effect of the complex sampling plan of the 2019 Brazilian National Health Survey. The prevalence of contraceptive use was 83.7%. Of the total number of users, 72% used SARC, 23.2% permanent methods, and 4.8% LARC. Women with higher education, health insurance, who had deliveries, and who participated in reproductive planning groups had a higher chance of using LARC when compared with the use of SARC, while registration at the basic health unit was associated with a lower chance of use. Still, the higher the age and parity, in addition to living with the partner, the greater the chance of using permanent methods in relation to the use of SARC. Despite the high coverage of contraception, the contraceptive mix remains obsolete, with a predominance of the use of SARC. In addition, important inequalities in access were observed, with LARC being accessible only to women with better socioeconomic conditions, while permanent methods were associated with a profile of greater social vulnerability.


O objetivo deste estudo é descrever o mix contraceptivo e analisar os fatores associados ao tipo de contraceptivo usado pelas mulheres brasileiras em idade reprodutiva. Trata-se de estudo transversal, de base populacional, com dados de 19.962 mulheres de 15 a 49 anos. Os desfechos foram uso e tipo de contraceptivo, classificados em: contraceptivos reversíveis de curta duração (SARC), longa duração (LARC) e permanentes. As variáveis explicativas foram: características da história reprodutiva, sociodemográficas e de acesso aos serviços de saúde. Utilizou-se a regressão logística multinomial para estimativas da odds ratio (OR), tendo os SARC como categoria de referência. As análises foram realizadas no módulo survey do software Stata, que considerou o efeito do plano amostral complexo da Pesquisa Nacional de Saúde de 2019. A prevalência do uso de contraceptivos foi de 83,7%. Do total de usuárias, 72% usavam SARC, 23,2% métodos permanentes e 4,8%, LARC. Mulheres com maior escolaridade, plano de saúde, que tiveram partos e participaram de grupos de planejamento reprodutivo tiveram maior chance de usar LARC na comparação com o uso de SARC, enquanto o cadastro na unidade básica de saúde se associou a menor chance de uso. Ainda, quanto maior a idade e paridade, além de viver com o companheiro, maior a chance de usar métodos permanentes em relação ao uso de SARC. Apesar da elevada cobertura de contracepção, o mix contraceptivo permanece obsoleto, com predomínio do uso de SARC. Além disso, observou-se importante desigualdade de acesso, sendo os LARC acessíveis apenas por mulheres com melhores condições socioeconômicas, enquanto os métodos permanentes foram associados a um perfil de maior vulnerabilidade social.


El objetivo fue describir la combinación anticonceptiva y analizar los factores asociados al tipo de anticonceptivo usado por las mujeres brasileñas en edad reproductiva. Estudio transversal, de base poblacional, con datos de 19.962 mujeres de 15 a 49 años. Los resultados fueron el uso y el tipo de anticonceptivo, clasificados en: anticonceptivos reversibles de corta duración (SARC), de larga duración (LARC) y permanentes. Las variables explicativas fueron características de la historia reproductiva, sociodemográficas y de acceso a los servicios de salud. Se utilizó la regresión logística multinomial para las estimaciones de la odds ratio (OR), siendo los SARC la categoría de referencia. Los análisis fueron realizados en el módulo survey, del software Stata, que consideró el efecto del sistema de muestreo complejo de la Encuesta Nacional de Salud de 2019. La prevalencia del uso de anticonceptivos fue del 83,7%. Del total de usuarias, 72% usaban SARC, el 23,2% métodos permanentes y el 4,8% LARC. Las mujeres con mayor educación, plan de salud, que tuvieron partos y participaron de grupos de planificación reproductiva tuvieron mayor posibilidad de usar LARC cuando comparados al uso de SARC, mientras que el registro en la unidad básica de salud se asoció con una menor posibilidad de uso. Además, cuanto mayor sea la edad y la paridad, además de vivir con el compañero, mayor será la posibilidad de utilizar métodos permanentes en relación con el uso de SARC. A pesar de la alta cobertura de anticoncepción, la combinación anticonceptiva sigue siendo obsoleta, con un uso predominante de SARC. Además, se observaron importantes desigualdades en el acceso, siendo los LARC accesibles solo para mujeres con mejores condiciones socioeconómicas, mientras que los métodos permanentes se asociaron con un perfil de mayor vulnerabilidad social.


Assuntos
Anticoncepção , Anticoncepcionais , Gravidez , Feminino , Humanos , Estudos Transversais , Brasil , Anticoncepção/métodos , Inquéritos e Questionários , Comportamento Contraceptivo
14.
Mol Immunol ; 163: 13-19, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37717421

RESUMO

Understanding COVID-19 exposure differences among Healthcare Workers (HCWs) across various healthcare units is crucial for their protection and effective management of future outbreaks. However, comparative data on COVID-19 among HCWs in different healthcare units are scarce in Brazil. This study evaluated the relationship between SARS-CoV-2 infection and workplaces in HCWs from three distinct healthcare settings in Brazil. It also examined COVID-19 symptom dynamics reported by them. The cohort comprised 464 HCWs vaccinated with two doses of CoronaVac and a BNT162b2 booster from different institutions: Primary Health Care Units (PHCUs), Emergency Care Units (ECUs), and Hospitals. Participants answered a questionnaire and underwent blood collection at various time points after vaccinations. RT-PCR data and post-vaccination antibody responses were utilized as indicators of SARS-CoV-2 infection. We found that most infected HCWs worked in ECUs, where positive RT-PCR percentages were higher compared to PHCUs and Hospitals. ECUs also showed the highest seropositivity and antibody levels, especially after the first CoronaVac dose. The second dose of CoronaVac diminished the differences in the antibody levels among HCWs from ECUS, PHCUs, and Hospitals, indicating the benefit of the second dose to equalize the antibody levels between previously exposed and unexposed persons. Moreover, COVID-19 symptoms appeared to evolve over time.


Assuntos
COVID-19 , Saúde Pública , Humanos , Brasil/epidemiologia , Vacina BNT162 , SARS-CoV-2 , Pessoal de Saúde , Anticorpos Antivirais
15.
J Med Virol ; 95(8): e29055, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37641396

RESUMO

We investigated the impact of the fourth dose with ChAdOx1 nCoV-19 (AstraZeneca) in the humoral immune response to SARS-CoV-2 during a 9-month follow-up period in which Omicron was the predominant variant in Brazil. IgG for the SARS-CoV-2 spike protein (S) and nucleocapsid (N) proteins were analyzed in samples collected before and after the fourth dose. All participants were tested monthly for SARS-CoV-2 infection by RT-qPCR. The antibody response induced by the fourth dose of the coronavirus disease 2019 vaccine was evaluated and compared with the response induced by the second and third doses. The additional antibody response to the viral S protein after the fourth dose was smaller than those after the third vaccine dose. In contrast, an increase in the N IgG levels could be observed after the fourth dose compared to other vaccine doses. In the comparison of the antibody response before and after the fourth dose, an increase in both S-and-N IgG was noted, mainly in the positive qPCR group. We did not observe a significant decline in IgG levels after the fourth dose, as observed after the second and third doses, therefore, a sustained humoral response to both S and N proteins seems to be achieved.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Humanos , Formação de Anticorpos , ChAdOx1 nCoV-19 , Brasil/epidemiologia , COVID-19/prevenção & controle , SARS-CoV-2 , Imunoglobulina G
16.
Molecules ; 28(13)2023 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-37446907

RESUMO

The present study aims to explore the anti-inflammatory potential activity of the hexane extract from branches (HEB) of Endlicheria paniculata (Lauraceae) and its main compound, methyldehydrodieugenol B, in the inflammatory response induced by a murine implant sponge model. HPLC-ESI/MS analysis of HEB led to the identification of six chemically related neolignans, with methyldehydrodieugenol B as the main compound. An in silico analysis of the pharmacokinetic parameters of the identified compounds suggested moderate solubility but good absorption and biodistribution in vivo. Thus, the treatment of mice with HEB using in vivo assays indicated that HEB promoted pro-inflammatory, antiangiogenic, and antifibrogenic effects, whereas treatment with methyldehydrodieugenol B caused anti-inflammatory, antifibrogenic, and antiangiogenic effects. The obtained results shown the therapeutic potential of HEB and methyldehydrodieugenol B in the treatment of pathologies associated with inflammation and angiogenesis, including chronic wounds.


Assuntos
Hexanos , Lauraceae , Camundongos , Animais , Distribuição Tecidual , Extratos Vegetais/farmacologia , Inflamação/tratamento farmacológico , Anti-Inflamatórios/farmacologia , Lauraceae/química , Fatores de Transcrição Hélice-Alça-Hélice Básicos
17.
Food Chem ; 429: 136718, 2023 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-37487392

RESUMO

The use of a sprout suppressor is crucial for the use of potatoes beyond their natural dormancy period. The main sprout inhibitor used on a commercial scale, chlorpropham (CIPC), is becoming increasingly limited owing to its toxicity. Therefore, we evaluated the effectiveness of 1,4-dimethylnaphthalene (1,4-DMN) compared to CIPC in controlling sprouting and maintaining the quality of potato, Solanum tuberosum 'Asterix', during cold storage. Treatment with 1,4-DMN reduced fresh weight loss and controlled the number and length of sprouts comparable to CIPC. Compared to the control, both sprouting inhibitors led to higher starch and lower reducing sugar contents, and the tubers retained the recommended quality for industrial processing. After frying, less browning was observed in French fries obtained from 1,4-DMN- or CIPC-treated tubers. We ascertain that 1,4-DMN besides being an efficient sprouting inhibitor and alternative to CIPC, it contributes to maintaining the quality of French fries after cold storage.


Assuntos
Clorprofam , Solanum tuberosum , Clorprofam/metabolismo , Clorprofam/farmacologia , Solanum tuberosum/metabolismo , Naftalenos , Metabolismo dos Carboidratos , Tubérculos/metabolismo
18.
Inflammopharmacology ; 31(3): 1539-1549, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37022573

RESUMO

Several species of the genus Ocotea are used in traditional medicine due to their anti-inflammatory and analgesic properties. In this work we sought to investigate the effects of biseugenol, the main component of the hexane extract from the leaves of Ocotea cymbarum (Lauraceae), during a chronic inflammatory process induced by polyester-polyurethane sponge in mice. In addition to the inflammatory component, sponge discs also allowed us to evaluate parameters associated with the formation of new blood vessels and the deposition and organization of the extracellular matrix, processes that are related to the chronification of the inflammatory response. Daily treatment with biseugenol (0.1, 1 or 10 µg in 10 µl of 0.5% DMSO) inhibited the synthesis of inflammatory cytokines (TNF-α, CXCL-1 and CCL2) and the neutrophil and macrophage infiltrate into to the implants, indirectly evaluated by the activity of myeloperoxidase and N-acetyl-ß-D-glycosaminidase enzymes, respectively. In implants treated with biseugenol, we observed a reduction in angiogenesis, assessed through histological quantification of mean number of blood vessels, the levels of the pro-angiogenic cytokines FGF and VEGF and the activity of metalloproteinases. Except for VEGF levels, all mentioned parameters showed significant reductions after treatment with biseugenol. Finally, the administration of the compound also reduced TGF-ß1 levels, collagen synthesis and deposition, in addition to modifying the organization of the newly formed matrix, presenting a potential anti-fibrotic effect. Therefore, our results demonstrate the potential therapeutic use of biseugenol for the treatment of a series of pathological conditions, where parameters associated with inflammation, angiogenesis and fibrogenesis are deregulated.


Assuntos
Lauraceae , Ocotea , Animais , Camundongos , Fator A de Crescimento do Endotélio Vascular , Neovascularização Patológica/tratamento farmacológico , Inflamação/tratamento farmacológico , Colágeno , Citocinas
19.
Artigo em Inglês | MEDLINE | ID: mdl-37068544

RESUMO

Serotonin (5-HT) receptors have been implicated in social behavior in vertebrates. Zebrafish (Danio rerio) have been increasingly being used behavioral neuroscience to study the neurobiological correlates of behavior, including sociality. Nonetheless, the role of 5-HT2C receptors in different social functions were not yet studied in this species. Zebrafish were treated with the agonist MK-212 (2 mg/kg) or the antagonist RS-102221 (2 mg/kg) and tested in the social interaction and social novelty tests, conditional approach test, or mirror-induced aggressive displays. MK-212 increased preference for an unknown conspecific in the social investigation test, but also increased preference for the known conspecific in the social novelty test; RS-102221, on the other hand, decreased preference in the social investigation test but increased preference for the novel conspecific in the social novelty test. MK-212 also decreased predator inspection in the conditional approach test. While RS-102221 decreased time in the display zone in the mirror-induced aggressive display test, it increased display duration. Overall, these results demonstrate the complex role of 5-HT2C receptors in different social contexts in zebrafish, revealing a participation in social plasticity in vertebrates.


Assuntos
Receptor 5-HT2C de Serotonina , Peixe-Zebra , Animais , Peixe-Zebra/fisiologia , Serotonina , Comportamento Social , Comportamento Animal/fisiologia
20.
Mol Immunol ; 156: 148-155, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-36921489

RESUMO

Vaccines induce specific long-term immunological memory against pathogens, preventing the worsening of diseases. The COVID-19 health emergency has caused more than 6 million deaths and started a race for vaccine development. Antibody response to COVID-19 vaccines has been investigated primarily in healthcare workers. The heterogeneity of immune responses and the behavior of this response in particular groups were still very little explored. In this review, we discuss whether antibody responses after vaccination are influenced by age, gender, previous SARS-CoV-2 infection, or pre-existing diseases.


Assuntos
COVID-19 , Humanos , COVID-19/prevenção & controle , Formação de Anticorpos , Vacinas contra COVID-19 , Cobertura de Condição Pré-Existente , SARS-CoV-2 , Vacinação , Anticorpos Antivirais
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