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OBJECTIVE: The study objectives were to estimate the standardized incidence and evaluate factors associated with moderate/severe pediatric traumatic brain injury (p-TBI) in children aged 5-15 years in Western, Mexico. METHODS: The study was cross-sectional in design. We estimated the standardized incidence of moderate/severe p-TBI using the direct methods of the World Health Organization (WHO) standard populations. We utilized the Glasgow Coma Scale (GCS) to identify moderate/severe p-TBI patients (GCS ≤ 13). Logistic regression analysis was applied to evaluate variables associated with moderate/severe p-TBI. RESULTS: The standardized incidence of patients diagnosed with moderate/severe p-TBI was 31.0/100,000 person-years (95 % CI 28.7-33.4). According to age, the moderate/severe TBI group was included. A total of 254 (38.5 %) patients were aged 5-9 years, 343 (52.0 %) were aged 10-14 years, and 62 (9.5 %) were aged 15 years. Factors associated with moderate/severe TBI in the crude analysis were male sex (OR 5.50, 95 % CI 4.16-7.39, p < 0.001), primary school (OR 2.15, 95 % CI 1.62-2.84, p < 0.001), and falls (OR 1.34, 95 % CI 1.02-1.77, p = 0.035). Factors associated with moderate/severe p-TBI in the adjusted analysis were male sex (OR 6.12, 95 % CI 4.53-8.29, p < 0.001), primary school (OR 3.25, 95 % CI 2.31-4.55, p < 0.001), and falls (OR 1.78, 95 % CI 1.28-2.47, p < 0.001). CONCLUSION: The incidence of moderate/severe p-TBI in children aged 5-15 years in western Mexico in this study was higher than that in other studies. One of the biggest factors associated with moderate/severe p-TBI was male sex, specifically those with lower education levels and those who were prone to falls.
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Lesões Encefálicas Traumáticas , Humanos , Criança , Masculino , Feminino , México/epidemiologia , Adolescente , Lesões Encefálicas Traumáticas/epidemiologia , Pré-Escolar , Incidência , Estudos Transversais , Escala de Coma de Glasgow , Fatores de Risco , Fatores SexuaisRESUMO
The objective was to evaluate the sociodemographic factors associated with the level of knowledge of early puerperal women about oral health prevention in infants. This cross-sectional and analytical study evaluated 303 early puerperal women from a hospital in the Peruvian capital. A validated 18-question questionnaire was used to measure the level of knowledge. A logistic regression model was used to evaluate the influence of age, marital status, educational level, number of children, monthly income, and having a dentist as a family member. A significance of p < 0.05 was considered. A total of 46.86%, 30.36%, and 22.77% of the puerperal had poor, fair, and good knowledge, respectively. The risk of having poor knowledge was two times higher (OR = 2.43; CI: 1.26-4.70) in early postpartum women aged 18 to 25 years than in those older than 35 years. Early postpartum women with no education, primary and secondary education were 11 times (OR = 11.76; CI: 2.41-57.43), 6 times (OR = 6.61; CI: 1.72-25.45), and 5 times (OR = 5.50; CI: 1.52-19.89), respectively, more likely to have significantly poor knowledge compared to those with university education. In conclusion, only a small minority of early postpartum women had a good knowledge of oral health prevention in infants aged 0 to 2 years. Younger and less educated puerperal were at greater risk of having little knowledge on this topic. Finally, not having basic education was the main risk factor identified.
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Saúde Bucal , Fatores Sociodemográficos , Criança , Humanos , Feminino , Lactente , Recém-Nascido , Pré-Escolar , Estudos Transversais , Período Pós-Parto , EscolaridadeRESUMO
Abstract Aim: To investigate whether foraminal widening performed at primary treatment has an effect on the amount of apically extruded obturator material during retreatment and to evaluate the sensitivity of cone beam computed tomography (CBCT) in detecting extruded obturator material. Methods: Forty palatal roots of maxillary molars were selected based on micro-CT and divided into two groups (n=20): with foraminal widening (WE) and without foraminal widening (NE). To standardize the apical foramen, all specimens were instrumented to the foramen using the Protaper Next system, up to instrument X3. The WE group was instrumented to the foramen up to instrument X5, and the NE group was instrumented 1 mm lower. The canals were obturated 1 mm below the apical foramen with gutta-percha and AH Plus and stored for 7 days at 37 °C and 95% humidity. Roots were fixed in microtubes filled with 1.5% agar gel. The obturation material was removed with Reciproc R50. Scans of the teeth and agar were performed using micro-CT and CBCT. Comparison between groups and between methods was performed using Mann-Withney test (p ≤0.05). Results: No statistical difference was found when comparing the extruded material between groups using micro-CT (p = 0.589) or CBCT (p = 0.953). CBCT measured a greater volume of extruded material than micro- CT (p = 0.0004). Conclusion: Foraminal widening had no effect on the extrusion of filling material during retreatment. The CBCT favored the evaluation of apically extruded filling material.
Resumo Objetivo: Investigar se o alargamento do foramen realizado durante o tratamento primário tem um efeito na quantidade de material obturador apicalmente extruído durante oretratamento e verificar a sensibilidade da tomografia computorizada de feixe cônico (TCFC) na detecção de material obturador extruído. Métodos: Quarenta raízes palatinas de molares superiores foram selecionadas de acordo com a microtomografia computorizada, e foram divididas em dois grupos (n=20): com alargamento do foraminal (CA) e sem alargamento do foraminal (SA). Para padronizar o forame apical, todas as amostras foram instrumentadas com o sistema ProTaper Next até ao instrumento X3 até o forame. O grupo CA foi instrumentado até ao instrumento X5 até o forame, e o grupo SA foi instrumentado 1 mm aquém. Os canais foram obturados 1 mm abaixo do forame apical com gutta-percha e AH Plus e armazenados durante 7 dias a 37 °C e 95% de umidade. As raízes foram fixadas em microtubos preenchidos com gel de ágar a 1,5%. O material obturador foi removido com Reciproc R50. Os escaneamentos dos dentes e do ágar foram realizados com micro-CT e CBCT. A comparação entre grupos e entre métodos foi realizada utilizando o teste Mann-Withney (p ≤0.05). Resultados: Não foi encontrada diferença estatística ao comparar o material extruído entre grupos utilizando o Micro-CT (p = 0,589) ou TCFC (p = 0,953). Foi medido um volume maior de material extruído com a TCFC do que com a Micro- CT (p = 0,0004). Conclusão: O alargamento foraminal não teve qualquer efeito na extrusão do material obturador durante o retratamento. A TCFC favoreceu a avaliação do material de obturador apicalmente extruído.
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Objetivo: Determinar las principales causas de muerte y los factores asociados en los pacientes infectados con el VIH ingresados en el hospital del Instituto de Medicina Tropical "Pedro Kourí" durante los años 2017-2018. Métodos: Se realizó un estudio retrospectivo de casos y controles para determinar las causas de la muerte y algunos factores asociados a ella, en el hospital del Instituto de Medicina Tropical "Pedro Kourí", en el período 2017-2018. Para determinar estos factores se utilizó un análisis multivariado basado en un modelo de regresión logística binaria. Resultados: Las causas de muerte más frecuentes fueron las asociadas al SIDA, fundamentalmente las infecciones oportunistas del sistema respiratorio (41,4%), seguidas por las neoplasias no asociadas al SIDA (25,1%). Los factores que mayor influencia tuvieron sobre la mortalidad fueron la presencia de enfermedad oportunista (OR 14,07 p<0,001) y de neoplasias no asociadas al SIDA (OR 6,76 p=0,005), la alteración de las funciones renal (3,54 p=0,019) y hepática (OR 2,90 p=0,054) y tener mayor carga viral (OR 1,50 p=0,001) y menos tiempo de diagnóstico al momento del ingreso (OR 0,793 p<0,001). El modelo matemático resultante del análisis permitió identificar los principales factores asociados a la mortalidad y explicar su relación con la misma. Conclusiones: Las enfermedades asociadas al SIDA, principalmente las infecciones oportunistas del sistema respiratorio, seguidas por las neoplasias no asociadas al SIDA fueron las causas predominantes de muerte en los pacientes infectados con el VIH que fallecieron en el Instituto de Medicina Tropical "Pedro Kourí" durante el período de estudio. La presencia de neoplasias no asociadas al SIDA, de enfermedades oportunistas, de alteraciones de las funciones renal y hepática, el aumento de la carga viral y el tener menos años de diagnóstico al momento del ingreso, fueron los factores que más contribuyeron a la mortalidad en los pacientes ingresados e infectados con el VIH. El modelo matemático resultante se ajustó bien a los datos y explicó de manera consistente los factores asociados a la mortalidad.
Aim: To determine the main causes of death and associated factors in HIV-infected patients admitted to the Tropical Medicine Institute "Pedro Kourí" hospital during the years 2017-2018. Methods: A retrospective case-control study was carried out to determine the causes of death and some factors associated with it, in the Tropical Medicine Institute "Pedro Kourí" hospital, in the period 2017-2018. To determine these factors, a multivariate analysis based on a binary logistic regression model was used. Results: The most frequent causes of death were those associated with AIDS, mainly opportunistic infections of the respiratory system (41.4%), followed by neoplasms not associated with AIDS (25.1%). The factors that had the greatest influence on mortality were the presence of opportunistic disease (OR 14.07 p <0.001) and neoplasms not associated with AIDS (OR 6.76 p = 0.005), alteration of renal functions (3, 54 p = 0.019) and liver (OR 2.90 p = 0.054) and have a higher viral load (OR 1.50 p = 0.001) and less time to diagnosis at admission (OR 0.793 p <0.001). The mathematical model resulting from the analysis made it possible to identify the main factors associated with mortality and explain their relationship with it. Conclusions: AIDS-associated diseases, mainly opportunistic infections of the respiratory system, followed by non-AIDS-associated neoplasms were the predominant causes of death in HIV-infected patients who died in the Tropical Medicine Institute "Pedro Kourí" during the study period. The presence of neoplasms not associated with AIDS, opportunistic diseases, alterations in kidney and liver functions, increased viral load and having fewer years of diagnosis at the time of admission, were the factors that most contributed to mortality in patients admitted and infected with HIV. The resulting mathematical model fitted the data well and consistently explained the factors associated with mortality.
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Introducción: Las malformaciones congénitas del riñón y del tracto urinario representan entre 20 y 30 por ciento de todas las malformaciones reconocidas en humanos. Objetivo: Identificar los antecedentes patológicos familiares y las enfermedades durante el embarazo asociados a la aparición de defectos congénitos renales. Métodos: Estudio descriptivo prospectivo transversal realizado en 672 niños nacidos entre julio de 2014 y junio de 2015 en Santa Clara, con ultrasonido prenatal normal. A todos los niños durante la consulta médica se les hizo examen físico detallado y previo consentimiento informado del familiar acompañante, se aplicó a estos una encuesta y se registraron variables epidemiológicas, antecedentes familiares de enfermedades renales, morbilidad de la madre durante el embarazo y se realizó un ultrasonido renal para identificar las alteraciones sonográficas sugerentes de algún tipo de anomalías del desarrollo renal. Resultados: En 40 (5,95 por ciento) pacientes se detectó alteración sonográfica. El 27,50 por ciento eran hijos de madres que presentaron alguna enfermedad durante el embarazo. La glucemia elevada afectó 10 por ciento de las madres de los niños con anomalías del desarrollo renal, seguida del bajo peso materno (7,5 por ciento). El hecho de presentar antecedente patológico familiar de enfermedad renal aportó un riesgo de 1,88 y en las de tipo obstructivo el riesgo fue de 5,08. Conclusiones: Las alteraciones sonográficas sugestivas de malformación congénita renal son más frecuentes en los lactantes cuyas madres presentaron concentraciones elevadas de glucosa y bajo peso durante el embarazo. Los niños con antecedentes familiares de malformación renal tienen mayor riesgo de presentar una anomalía del desarrollo renal(AU)
Introduction: Kidney and urinary tract´s malformations represent among 20 and 30 percent of all malformations known in humans. Objective: To identify during pregnancy family pathological history and diseases associated to the onset of renal congenital malformations. Methods: Prospective, descriptive, cross-sectional study carried out to 672 children with normal prenatal ultrasound whom were born from July, 2014 to June 2015 in Santa Clara province. All children during the medical consultation had a detailed physical examination and previous informed concent; it was applied also a survey and the epidemiologic variables, family history of renal diseases, morbility of the mother during pregnancy were recorded, and it was made a renal ultrasound to identify sonographic alterations suggesting any kind of anomaly in the renal development. Results: In 40 patients (5,95 percent), it was detected any sonographic alteration. 27,50 percent were children of mothers that presented any disease during pregnancy. High glycemia affected the 10 percent of mothers of children with anomalies in the renal development, followed by low maternal weight (7,5 percent). The fact of presenting a family pathological history of renal disease implied a risk of 1,88 percent and the risk was of 5,08 percent in the obstructive kind of diseases. Conlusions: Sonographic alterations suggesting renal congenital malformations are more frequent in newborns whose mothers had high concentrations of glycemia and low weight during pregnancy. Children with family history of renal malformations have higher risk of presenting an anomaly of the renal development(AU)
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Humanos , Masculino , Feminino , Lactente , Anormalidades Congênitas/diagnóstico , Insuficiência Renal Crônica/etiologia , Rim/anormalidades , Sistema Urinário/anormalidades , Epidemiologia Descritiva , Estudos Transversais , Estudos ProspectivosRESUMO
Objectives: Suicide is one of the leading causes of death in adolescence, and the second most common cause of death among young people. The objective of this study was to identify trends in suicidal ideation by sex and ascertain factors associated with this outcome. Methods: Secular trend study with statewide coverage conducted at 5-year intervals, with 4,207 adolescents (2006), 6,264 adolescents (2011) and 6,026 adolescents (2016). Logistic regression was used to evaluate the secular trend of suicidal ideation. Multilevel logistic regressions evaluated the factors associated with suicidal ideation in the survey conducted in 2016. Results: There was a positive trend in suicidal ideation prevalence in 2016 compared to the prevalence in 2006 and 2011, in both boys and girls. Low social support, poor sleep quality, and low parental supervision were associated with suicidal ideation in boys and girls. Exposure to violence and bullying was associated with suicidal ideation only in girls. TV time and computer and videogame time were not associated with suicidal ideation in boys or girls. Conclusion: There is an alarming trend of increased suicidal ideation in adolescents. Several dimensions were associated with suicidal ideation in adolescents, especially social support, sleep quality, and parental supervision.
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Humanos , Masculino , Feminino , Adulto , Suicídio , Ideação Suicida , Tentativa de Suicídio , Prevalência , Inquéritos e Questionários , Fatores de RiscoRESUMO
BACKGROUND: Currently, bariatric surgery is the most effective treatment for severe obesity and its metabolic complications; however, 15-35% of the patients that undergo bariatric surgery do not reach their goal for weight loss. The aim of this study was to determine the proportion of patients that didn't reach the goal of an excess weight loss of 50% or more during the first 12 months and determine the factors associated to this failure. METHODS: We obtained the demographic, anthropometric and biochemical information from 130 patients with severe obesity who underwent bariatric surgery in our institution between 2012 and 2017. We used self-reports of physical activity, caloric intake and diet composition. An unsuccessful weight loss was considered when the patient lost < 50% or more of the excess weight 12 months after surgery. We compared the characteristics between the successful and unsuccessful groups in order to find the factors associated with success. RESULTS: We included 130 patients (mean age 48 ± 9 years, 81.5% were women). One year after surgery, 26 (20%) had loss < 50% EBW. Unsuccessful surgery was associated with an older age, previous history of hypertension, abdominal surgery or depression/anxiety, also the number of comorbidities and unemployment affected the results. These patients loss enough weight to improve some of their comorbidities, but they are more prone to regain weight 2 years after surgery. CONCLUSIONS: A fifth of the patients undergoing bariatric surgery may not lose enough weight to be considered successful by current standards. Some patients may benefit from the surgery in the short term, but they are more likely to regain weight after 2 years. The factors influencing this result are still controversial but may be population-specific. Early detection of the patients that are more likely to fail is imperative to establish additional therapeutic strategies, without denying them the opportunity of surgery or waiting for weight re-gain to occur.
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Cirurgia Bariátrica/métodos , Índice de Massa Corporal , Obesidade/cirurgia , Aumento de Peso , Redução de Peso , Dieta , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/patologia , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Objetivo: Determinar los factores asociados y el grado de adherencia al TARGA en los pacientes con VIH/SIDA en el hospital Central PNP "Luis N. Sáenz" en los meses de octubre a diciembre del 2015. Métodos: Estudio observacional, transversal, analítico y descriptivo donde se evaluó a 123 pacientes con un cuestionario CEAT-VIH. Se realizó la recolección de datos en el programa Microsoft Excel y el análisis estadístico mediante el programa SPSS v.22. Resultados: Donde encontramos que la edad promedio de los todos los pacientes evaluados es 40.11 años. El tiempo de infección de los pacientes evaluados fue un promedio un año y 7 meses. El tiempo de tratamiento con el TARGA consto de un promedio de 20 meses. El 52 % (64 pacientes) de la población estudiada fue algún familiar del titular, ya sea esposa (o), hijo (a) o padres. El género que prevalece en la muestra es masculino con el 63.4 % (78 pacientes). Y la carga viral, el 77.2 % es indetectable (< 400 copias/ml). El grado encontrado fue una adecuada adherencia al TARGA, con una puntuación de 82.51 y al relacionar el grado de adherencia con las características socio-demográficas no son significativas. Pero si se encontró relación el grado de adherencia con la carga viral. Conclusión: La población estudiada tiene una adecuada adherencia al tratamiento antirretroviral y los 5 factores que mide el cuestionario: cumplimento del tratamiento, antecedentes de la falta de adherencia, interacción médico-paciente, creencias del paciente y estrategia para la toma de medicamentos, tienen muy buena influencia en la adherencia al TARGA.
Objective: To determine the associated factors and the degree of adherence to HAART in patients with HIV / AIDS at the PNP Central hospital "Luis N. Saenz" from October to December 2015. Methods: Observational, cross- sectional, analytical and descriptive study where 123 patients with a CEAT-HIV questionnaire were evaluated. Data collection was performed in the Microsoft Excel program and statistical analysis using the SPSS v.22 program. Results: Where we found that the average age of all patients evaluated was 40.11 years. The infection time of the evaluated patients was an average of one year and 7 months. Treatment time with HAART averaged 20 months. Fifty-two percent (64 patients) of the study population were any family members of the holder, either wife (s), child (ren) or parents. The gender that prevails in the sample is male with 63.4% (78 patients). And viral load, 77.2% is undetectable (<400 copies / ml). The grade found was adequate adherence to HAART, with a score of 82.51. And relating the degree of adherence to socio-demographic characteristics are not significant. But if the degree of adherence to viral load was found to be related. Conclusion: In the study population has adequate adherence to antiretroviral treatment and the 5 factors measured by the questionnaire: adherence to treatment, history of lack of adherence, physician-patient interaction, patient's beliefs and strategy for taking medications, have a very good influence on adherence to HAART.
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Resumen: Introducción: La epilepsia es la enfermedad neurológica crónica más común en el mundo. En México es considerada dentro de las principales enfermedades vinculadas a la mortalidad por enfermedades no infecciosas de la población infantil. El objetivo del estudio fue identificar los factores asociados a epilepsia en niños derechohabientes del Instituto Mexicano del Seguro Social (IMSS), en Acapulco, México. Métodos: Estudio de casos y controles realizado entre abril de 2010 y abril de 2011. Fueron seleccionados 118 casos de la consulta externa de neurología pediátrica, con criterios diagnósticos de epilepsia de acuerdo a la Liga Internacional Contra la Epilepsia, con máximo dos años de evolución. Los controles fueron seleccionados de las Unidades de Medicina Familiar de donde procedieron los casos. En una encuesta a las madres, se obtuvo información sobre antecedentes heredofamiliares, prenatales, perinatales y posnatales. El análisis bivariado y multivariado se realizó mediante el procedimiento de Mantel-Haenszel. Resultados: Tres factores estuvieron asociados con la epilepsia: el antecedente familiar de epilepsia en familiares de primer grado (Razón de Momios ajustada (RMa) 2.44, IC95% 1.18 - 5.03), la asfixia al nacimiento (RMa 2.20, IC95% 1.16-34.18) y la infección de la vía urinaria en la etapa prenatal (RMa, 1.80 IC95% 1.0 - 3.24). Conclusiones: La asfixia al nacimiento y el reporte de infecciones de vías urinarias durante la gestación fueron factores asociados a epilepsia independientemente del antecedente de epilepsia en familiares de primer grado.
Abstract: Background: Epilepsy is the most common chronic neurological disease in the world. In Mexico, epilepsy is among the diseases more related to mortality due to non-infectious diseases in children. The objective of the study was to identify the factors associated with epilepsy in children entitled to the Mexican Social Security Institute (IMSS), in Acapulco, Mexico. Methods: We carried out a case-control study from April 2010 to April 2011. We selected 118 cases from the database of outpatient pediatric neurology with epilepsy diagnostic with two year of evolution according to the International League Against Epilepsy criteria. We selected 118 controls from the same Medical Units where cases were detected. Data collected throughout an interview with the mothers included information on history of epilepsy among relatives, prenatal, perinatal and postnatal history. Bivariate and multivariate analysis was performed using Mantel-Haenszel process. Results: Multivariate analysis identified three factors associated with epilepsy: family history of epilepsy in first-degree relatives (adjusted Odds ratio (ORa) 2.44, 95%CI 1.18 -5.03), birth asphyxia (ORa 2.20, 95%CI 1.16-34.18), and urinary tract infection in the prenatal stage (ORa, 1.80, 95%CI 1.0 - 3.24). Conclusions: Preventing birth asphyxia and urinary tract infections during pregnancy reduces the risk of epilepsy regardless of the history of epilepsy in first-degree relatives.
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Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Recém-Nascido , Masculino , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Asfixia Neonatal/complicações , Infecções Urinárias/complicações , Epilepsia/epidemiologia , Complicações Infecciosas na Gravidez/prevenção & controle , Asfixia Neonatal/prevenção & controle , Asfixia Neonatal/epidemiologia , Infecções Urinárias/prevenção & controle , Infecções Urinárias/epidemiologia , Estudos de Casos e Controles , Saúde da Família , Análise Multivariada , Fatores de Risco , Epilepsia/etiologia , México/epidemiologiaRESUMO
Victimization of Mexican youth (aged 12-17) has received little attention compared to that of adults. Using the 2014 Social Survey on Social Cohesion for the Prevention of Violence and Delinquency, we examine prevalence and types of victimization; describe the characteristics of incidents in terms of relationship with perpetrator(s) and places where took place; and study significant correlates of forms of victimization and poly-victimization. During 2014 alone, more than 2.8 million minors were victims of bullying, cyberbullying, theft, sexual abuse, physical assault, threats, robbery, or extortion. About 10% of these were poly-victims-experienced at least four different types of victimization by at least four types of perpetrators. Youth tended to be victimized by people in their inner circle. The factors associated with victimization tended to vary by victimization type, but proximity to crime and peer delinquency increased the risk of experiencing all types of victimization. Implications for future research and practice are discussed.
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Maus-Tratos Infantis/estatística & dados numéricos , Vítimas de Crime/estatística & dados numéricos , Adolescente , Bullying/estatística & dados numéricos , Criança , Maus-Tratos Infantis/psicologia , Crime/psicologia , Crime/estatística & dados numéricos , Vítimas de Crime/psicologia , Exposição à Violência/psicologia , Exposição à Violência/estatística & dados numéricos , Feminino , Humanos , Relações Interpessoais , Masculino , México/epidemiologia , Grupo Associado , Prevalência , Fatores de Risco , Inquéritos e Questionários , Violência/psicologia , Violência/estatística & dados numéricosRESUMO
Background: Understanding problems of access to oral health services requires knowledge of factors that determine access. This study aimed to evaluate factors that determine access to oral health services among children aged <12 years in Peru between 2014 and 2015. Methods: We performed a secondary data analysis of 71,614 Peruvian children aged <12 years and their caregivers. Data were obtained from the Survey on Demography and Family Health 2014-2015 (Encuesta Demográfica y de Salud Familiar - ENDES). Children's access to oral health services within the previous 6 months was used as the dependent variable (i.e. Yes/No), and the Andersen and col model was used to select independent variables. Predisposing (e.g., language spoken by tutor or guardian, wealth level, caregivers' educational level, area of residence, natural region of residence, age, and sex) and enabling factors (e.g. type of health insurance) were considered. Descriptive statistics were calculated, and multivariate analysis was performed using generalized linear models (Poisson family). Results: Of all the children, 51% were males, 56% were aged <5 years, and 62.6% lived in urban areas. The most common type of health insurance was Integral Health Insurance (57.8%), and most respondents were in the first quintile of wealth (31.6%). Regarding caregivers, the most common educational level was high school (43.02%) and the most frequently spoken language was Spanish (88.4%). Univariate analysis revealed that all variables, except sex and primary educational level, were statistically significant. After adjustment, sex, area of residence, and language were insignificant, whereas the remaining variables were statistically significant. Conclusions: Wealth index, caregivers' education level, natural region of residence, age, and type of health insurance are factors that determine access to oral health services among children aged <12 years in Peru. These factors should be considered when devising strategies to mitigate against inequities in access to oral health services.
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BACKGROUND: Epilepsy is the most common chronic neurological disease in the world. In Mexico, epilepsy is among the diseases more related to mortality due to non-infectious diseases in children. The objective of the study was to identify the factors associated with epilepsy in children entitled to the Mexican Social Security Institute (IMSS), in Acapulco, Mexico. METHODS: We carried out a case-control study from April 2010 to April 2011. We selected 118 cases from the database of outpatient pediatric neurology with epilepsy diagnostic with two year of evolution according to the International League Against Epilepsy criteria. We selected 118 controls from the same Medical Units where cases were detected. Data collected throughout an interview with the mothers included information on history of epilepsy among relatives, prenatal, perinatal and postnatal history. Bivariate and multivariate analysis was performed using Mantel-Haenszel process. RESULTS: Multivariate analysis identified three factors associated with epilepsy: family history of epilepsy in first-degree relatives (adjusted Odds ratio (ORa) 2.44, 95%CI 1.18 -5.03), birth asphyxia (ORa 2.20, 95%CI 1.16-34.18), and urinary tract infection in the prenatal stage (ORa, 1.80, 95%CI 1.0 - 3.24). CONCLUSIONS: Preventing birth asphyxia and urinary tract infections during pregnancy reduces the risk of epilepsy regardless of the history of epilepsy in first-degree relatives.
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Asfixia Neonatal/complicações , Epilepsia/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Infecções Urinárias/complicações , Adolescente , Asfixia Neonatal/epidemiologia , Asfixia Neonatal/prevenção & controle , Estudos de Casos e Controles , Criança , Pré-Escolar , Epilepsia/etiologia , Saúde da Família , Feminino , Humanos , Recém-Nascido , Masculino , México/epidemiologia , Análise Multivariada , Gravidez , Complicações Infecciosas na Gravidez/prevenção & controle , Fatores de Risco , Infecções Urinárias/epidemiologia , Infecções Urinárias/prevenção & controleRESUMO
Introdução: A hipertensão arterial é de causa multifatorial, envolvendo hábitos de vida e estilos de vida inadequados como o consumo excessivo de bebida alcoólica que propiciam a elevação dos níveis pressóricos. Além disso, os sintomas relacionados ao transtorno mental comum também podem se associar ao estado de saúde, provocando mais danos ao sujeito com hipertensão arterial. Diante disso, o presente estudo teve como objetivo principal identificar associação entre a ocorrência de hipertensão arterial com o consumo de bebidas alcoólicas e a presença de transtorno mental comum em indígenas das aldeias Muras, residentes em região rural e urbana. Casuística e Métodos: Estudo transversal, de base populacional, com 455 indígenas Mura residentes no município de Autazes, Amazonas, Brasil. Foi aplicada a entrevista semi-estruturada com questões referentes aos dados socioeconômicos e educacionais, hábitos de vida, história clínica, histórico familiar, além dos questionários Alcohol Use Disorders Identification Test (AUDIT) e Self-Reporting Questonnaire (SRQ-20), para avaliar o consumo de álcool e presença de transtorno mental, respectivamente. A pressão arterial foi medida com aparelho automático de braço validado. Foram realizadas três medidas e usada a média das duas últimas medidas. Realizaram-se ainda, medida do peso, altura, circunferência do pescoço, circunferência da cintura, avaliação de bioimpedância; glicemia, triglicérides e colesterol com medida capilar. Na análise bivariada, foi testada a associação entre hipertensos, separadamente, com os dois desfechos: consumo de bebidas alcoólicas e a presença de transtorno mental comum explorando especialmente, os aspectos relacionados à hipertensão arterial. Foi ajustada a regressão de Poisson com variância robusta, para ambos os desfechos, com modelagem em stepwise backward automatizado, tendo como critério de entrada, p<0,20 e de significância no modelo final, p0,05. Utilizou-se como estimativa, as razões de prevalência e respectivos intervalos de confiança de 95%. Resultados: A maioria dos participantes era do sexo feminino (57,8%), com 42,10 (16,74) anos, vivendo com companheiro (74,7%) e cerca de quatro filhos por família, baixo nível de escolaridade Analfabeto/Fundamental incompleto (41,1%) e renda até dois salários mínimos (85,0%). A prevalência de hipertensão arterial foi de 26,6%, tabagismo (20,4%) e ser sedentário/irregularmente ativo (52,8%). O consumo de bebida alcoólica foi de 40,2%, sendo 13,4% classificados como alto risco para dependência alcoólica, e maior na área rural em comparação à urbana (57,3% vs 22,2%) p<0,001. Destacam-se os seguintes aspectos do uso abusivo de álcool: sentimento de culpa/remorso (45,9%); amnésia repentina por não lembrar o ocorrido na noite em que bebeu (31,7%); além de machucar-se ou sentir-se prejudicado por causa da bebida (29,6%); preocupação por parte de parentes, amigos ou profissionais de saúde, que aconselharam o entrevistado a interromper o consumo (51,5%). Não houve associação entre a presença e consumo de bebida alcoólica (23% e 26%). Os indígenas com diagnóstico de hipertensão referida, faziam menos uso de bebida alcoólica (14,2%vs 85,8%, p=0,009), porém nas ocasiões em que bebiam, ingeriam maior quantidade, comparado com os que não referiram hipertensão [55,3(72,2) vs 33,3(62,2) gramas de Etanol p=0,008]. A prevalência de transtorno mental comum foi de 45,7%, com destaque para os seguintes itens: referência de dores de cabeça frequentes (69,5%), sentir-se nervoso, tenso ou preocupado (66,2%), ter se sentido triste ultimamente (56,0%), dormir mal (55,2%) e ter sensações desagradáveis no estômago (42,9%). Além disso, destaca-se que 7,3% referiram ideia de acabar com a própria vida e 4,2% sentiram-se incapazes de desempenhar papel útil. Após análise ajustada a razão de prevalência após análise ajustada (Razão de prevalência, IC-95%), verificou-se associação positiva entre ingestão de bebida alcoólica e sexo masculino (2,72, IC-2,12-3,48), tabagismo (1,29, IC-1,06-1,56) e morar na zona rural (2,09, IC-1,61-2,72). Porém, a ação foi protetora para idade (0,98, IC-0,98-0,99), consumo de alimentos in natura (0,97, IC-0,95-0,99), e ausência de dislipidemias (0,75, IC-0,62-0,9). Entre os que apresentaram transtorno mental comum, a hipertensão arterial identificada esteve presente em 30,3% e o consumo de álcool uma vez ao mês em 22,1%. Após a análise ajustada (Razão de prevalência, IC-95%) verificou-se associação positiva entre o transtorno mental comum e a zona de moradia urbana (1.25, IC-1,02-1,54), não sabia que tinham antecedentes para diabetes (1.56, IC-1,24-1,96) e a ingestão de bebida alcoólica (1.01, IC-1,00-1,02). Porém, foi ação protetora não ter antecedentes pessoais de cardiopatia (0.59, IC-0,48-0,73). Conclusão: Observou-se que a presença de hipertensão arterial, consumo de bebida alcoólica e de transtorno mental comum foram elevados nos indígenas da etnia Mura. Esses achados podem ser decorrentes da aproximação e convivência entre indígenas e não indígenas favorecendo mudanças culturais, especialmente de hábitos e estilos de vida, com aumento do risco de doenças crônicas não transmissíveis.
Background: The arterial hypertension has a multifactorial disorder, including unappropriated habits and lifestyle as the excessive consumption of alcoholic beverages that may increase the blood pressure. Additionally, the symptoms related to the common mental disorder may be also associated with the health status, producing even more damages to the hypertensive subjects. Thus, this study aimed to identify the association of arterial hypertension occurrence with alcoholic beverages consumption and presence of common mental disorder in Indigenous from Mura villages, who live in rural and urban zones. Casuistic and Methods: Its a cross-sectional investigation, with demographic base, conducted with 455 Mura Indigenous from Autazes, Amazon, Brazil. Through a semi-structured interview, we gathered data about sociodemographic and educational profile, lifestyle, clinical records, family antecedents. In this occasion, the Alcohol Use Disorders Identification Test (AUDIT) and the Self-Reporting Questionnaire (SRQ-20) were applied to assess respectively the alcohol consumption and the presence of common mental disorder. The blood pressure was measured with an arm automatic device, validated for this goal, being three measures taken and, from the two last of them, a mean was obtained. Furthermore, we gathered weight, height, neck circumference, waist circumference, bioimpedance, glycemia, triglycerides and cholesterol, capillary measure for the last ones. In the bivariate analysis, we analyzed the association between hypertensive persons and the both outcomes- the alcohol consumption and the presence of common mental disorder, emphasizing the issues hypertension-related issues. The Poison regression, with robust variance, was adjusted for both outcomes, with a modelling in automatized stepwise backward, being p<0,20 the entrance criteria and p<0,05 the significance level for the final model. As estimative, we used the odds ratios and their respective confidence intervals of 95%. Results: Most were females (57,8%), with mean age of 42,2(16,74) years, living with a partner (74,7%), with about four children per family, poor educational level- Illiterate/Incomplete Basic (41,1%) and income of up two minimum wages (85,0%). 26,6% of the sample had hypertension, 20,4% were smokers and 52,8% were sedentary/irregularly active. Alcohol consumption was of 40,2%, with 13,4% showed high risk for alcohol addiction, and the consumption was higher in rural area in comparison with the urban one (57,3% vs 22,2%) p<0,001. We emphasize the following aspects of alcohol abuse: feeling of guilty and remorse (45,9%); abrupt amnesia for not remembering what happened in the night that they had drunk (31,7%); feeling hurt or impaired due to the drink consumption (29,6%); concerns from relatives, friends or healthcare professionals who advised the interviewed to interrupt the consumption (51,5%). There was not association between presence and alcoholic beverages consumption (23% and 26%). Indigenous diagnosed with referred arterial hypertension drank less alcoholic beverages (14,2%vs 85,8% p=0,009), but, when they drank, they had a larger amount than those with referred hypertension [55,3(72,2) vs 33,3(62,2) grams of Ethanol p=0,008]. The common mental disorder was identified in 45,7% of the individuals, being highlighted the following items: reporting of frequent headaches (69,5%), feeling nervous, anxious or worried (66,2%), feeling sad in the last days (56,0%), sleeping badly (55,2%) and having upset stomach (42,9%). Additionally, 7.3% reported the idea of committing suicide, and 4,2% felt themselves unable to play a useful role. We verified positive association between alcoholic beverage consumption and male gender (2.72, CI-2,12-3,48); smoking (1.29, CI-1.06-1.56); and living in rural area (2.09, CI-1.61-2.72). However, the action was protective for the age (0.98, CI-0,98-0,99), intake of natural foods (0.97, CI-0,95-0,99), and absence of dyslipidemias (0.75, CI-0,62-0,9). Among those diagnosed with common mental disorder, the arterial hypertension was found in 30,3% and the alcohol consumption once a month in 22,1%. We observed a positive association of common mental disorder and: living in the urban area (1.25, CI-1,02-1,54); unknowing the antecedents for diabetes (1.56, CI-1,24-1,96); and the alcohol consumption (1.01,CI-1,00-1,02). However, the absence of personal background of heart diseases was not protective (0.59, CI-0,48-0,73). Conclusion: We observed that the presence of arterial hypertension, alcoholic beverages consumption and common mental disorder were high in the Mura ethnicity. This finding may be explained for the approach and interaction among Indigenous and non-Indigenous, which favors cultural changes, especially in habits and lifestyle, increasing the risk of non-transferable chronic diseases.
Assuntos
Alcoolismo , Saúde de Populações Indígenas , Hipertensão , Doenças Cardiovasculares , Fatores de Risco , Enfermagem , Transtornos MentaisRESUMO
BACKGROUND: Active commuting to school (ACS) can contribute to daily physical activity (PA) levels in children and adolescents. The aim of the study was to analyze the characteristics of active commuting to and from school by bicycle and to identify the factors associated with the use of bicycles for active commuting to school based in a sample of schoolchildren in Bogotá, Colombia. METHODS: A cross-sectional study was conducted in 8,057 children and adolescents. A self-reported questionnaire was used to measure frequency and mode of commuting to school and the time it took them to get there. Weight, height, and waist circumference measurements were obtained using standardized methods, and mothers and fathers self-reported their highest level of educational attainment and household level. Multivariate analyses using unordered multinomial logistic regression models were conducted in the main analysis. RESULTS: 21.9 % of the sample reported commuting by bicycle and 7.9 % reported commuting for more than 120 min. The multivariate logistic regression showed that boys, aged 9-12 years, and those whose parents had achieved higher levels of education (university/postgraduate) were the factors most strongly associated with a use bicycles as a means of active commuting to and from school. CONCLUSION: The findings of this study suggest that it's necessary to promote ACS from childhood and to emphasize its use during the transition to adolescence and during adolescence itself in order to increase its continued use by students.
Assuntos
Ciclismo/fisiologia , Saúde da Criança , Aptidão Física/fisiologia , Inquéritos e Questionários , Meios de Transporte/métodos , Adolescente , Criança , Colômbia , Estudos Transversais , Exercício Físico/fisiologia , Feminino , Humanos , Modelos Logísticos , Masculino , Análise Multivariada , Instituições Acadêmicas , AutorrelatoRESUMO
The main objective of the study was identify the prevalence and factors associated with leisure time physical activity (LTPA) in adult participants of the Longitudinal Study of Adult Health (ELSA-Brasil). The LTPA was measured using the International Physical Activity Questionnaire (IPAQ), long version. A hierarchical ecological model was built with the possible factors associated with LTPA distributed across blocks. We estimated crude and adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) using logistic regression. In men, being more educated, having a high family income, living in environments with conditions and opportunities for PA, being retired and being overweight were positively associated, while current smoking, obesity and abdominal obesity were associated negatively with the LTPA. Among women, being over 60years old, being more educated, having a high family income, living in an environment with conditions and opportunities for PA practice and being retired were positively associated, while being overweight, obese and having abdominal obesity were associated negatively with the LTPA. The proposed ecological model explains the LTPA through the social, physical and personal environment and highlights gender differences in physical activity.
Assuntos
Exercício Físico/fisiologia , Atividades de Lazer , Estilo de Vida , Adulto , Fatores Etários , Brasil , Meio Ambiente , Feminino , Inquéritos Epidemiológicos , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores SexuaisRESUMO
O tabagismo é considerado um problema de saúde pública, e, durante a gestação, traz problemas ainda maiores, como complicações obstétricas e efeitos nocivos para o recém-nascido. O objetivo foi avaliar o hábito tabágico e fatores associados ao tabagismo na gestação. Trata-se de estudo transversal, que incluiu 241 puérperas, no Serviço de Ginecologia e Obstetrícia da Maternidade do Hospital Regional de São José Dr. Homero Miranda Gomes, em São José, Santa Catarina. Os dados foram coletados por questionários autoaplicados, além de buscas nos prontuários das puérperas e recém-nascidos. Os dados foram analisados pelo SPSS 16.0, utilizou-se o teste qui-quadrado (χ2 ) ou prova exata de Fisher, foi calculado OddsRatio (OR), o nível de significância foi valor de p < 0,05. O tabagismo foi mais frequente em gestantes usuárias de álcool (100%), com poucas consultas de pré-natal (31,9%) e multíparas (37,7%). O fumo ocasionou no recém-nascido: prematuridade (p=0,003), baixo peso ao nascer (p=0,035) e baixo perímetro cefálico (p<0,001). A prevalência do tabagismo materno ativo foi 24,5% e passivo, 42,3%. Conclui-se que não há nenhuma novidade em afirmar que o cigarro pode estimular o desenvolvimento de diversas doenças; ainda assim, muitas pessoas insistem em manter o vício. O que agrava a situação, no caso das gestantes, é que elas não estão prejudicando apenas o próprio organismo, mas também o de uma criança
Smoking is considered a public health problem, and during pregnancy it brings even greater problems and obstetric complications like harm to the new born effects. The goal was to evaluate the smoking habit and its associated factors during pregnancy. This is a cross-sectional study with a sample of 241 post partum women at the Department of Obstetrics and Gynecology, Maternity Hospital Regional de São José Dr. Homero Miranda Gomes - in São José, Santa Catarina. Data were collected by selfadministered questionnaire sand in the records of the mothers and newborns. Data were analyzed by SPSS 16.0, it was used the chi-square test (χ2) or Fisher exact test, it was calculated Odds Ratio (OR) with level of significance at p < 0.05. Smoking was more frequent in women alcohol users (100%), with few prenatal visits (31.9%) and multiparous (37.7%). Maternal smoking caused in newborns, prematurity (p=0.003), low birth weight (p=0.035) and low head circumference (p<0.001). The prevalence of active maternal smoking was 24.5 % and passive, 42.3%. It was concluded that there is nothing new in stating that cigarettes can stimulate the development of many diseases; yet many people insist on maintaining the addiction. What aggravates the situation in pregnant women, is that they are not only harming themselves, but also their children.
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PURPOSE: To investigate the prevalence of scleral hyaline plaque among older adults in the city of Niterói in southeastern Brazil. A second goal was to assess the correlation between scleral hyaline plaque and several age-related diseases, including eye diseases and systemic diseases. METHODS: The study sample comprised 667 participants who were followed for 15 months. The study had a prospective, longitudinal, observational design that established inclusion and exclusion criteria. The following variables were selected for correlation with scleral hyaline plaque: sex, age, age range, iris color, ethnicity, presence of cataract, moderate to high myopia, age-related macular degeneration (AMD), diabetes mellitus, systemic arterial hypertension, degenerative arthritis, and osteoporosis. These correlations were assessed by means of the χ (2) test and Student's t-test. Multivariate analysis was performed to exclude factors that were potentially associated with aging exclusively but that did not have a direct relationship with hyaline plaque. Binary logistic regression was used to calculate odds ratios, significance, and confidence intervals. RESULTS: Scleral hyaline plaques were found in 177 patients (17.54%). There was a statistically significant association between the presence of hyaline plaques and sex (female), age range (≥70 years old), ethnicity (Caucasian), cataract, moderate to high myopia, systemic arterial hypertension, degenerative arthritis, and osteoporosis (P<0.05). On multivariate binary logistic regression analysis, only female sex, age range (≥70 years), moderate to high myopia, and degenerative arthritis exhibited significant correlation. CONCLUSION: The prevalence of scleral hyaline plaque in the present study was higher than in previous reports in the medical literature. Several age-related diseases exhibited a correlation with scleral hyaline plaque. The most significant factors associated with scleral hyaline plaque were advanced age, female sex, moderate to high myopia, and degenerative arthritis.
RESUMO
OBJECTIVES: To analyse the clinical and epidemiological profiles of dengue haemorrhagic fever (DHF), dengue shock syndrome (DSS) and complicated dengue cases and deaths from 2008 to 2010 that occurred in the state of Minas Gerais, south-eastern Brazil, and to identify factors associated with death from dengue. METHODS: Historical cohort study using data from the Brazilian Information System for Notifiable Diseases. A descriptive analysis of the DHF, DSS and complicated dengue cases and deaths was performed; the incidence, mortality and case-fatality rates were estimated. Logistic regression analysis was used to identify factors associated with death from dengue. Comorbidities were not included in the analysis because the information system does not contain such data. RESULTS: During the study period, 2214 DHF, DSS and complicated dengue cases were reported, including 156 deaths. The annual case-fatality rates for DHF/DSS and complicated dengue cases in the period of 2008-2010 were 7.3%, 4.8% and 7.9%, respectively. The factors associated with death from dengue included residence in a municipality with a population of fewer than 100,000 inhabitants [odds ratio (OR) 2.46; 95% confidence interval (CI) 1.71-3.55], age over 65 years (OR 3.05; 95% CI 1.99-4.68) and plasma leakage (OR 1.69; 95% CI 1.16-2.46). CONCLUSIONS: The results support the importance of plasma leakage as a warning sign associated with death from dengue as well as the signs and symptoms that allow the diagnosis of DHF. Moreover, our findings suggest that increased attention is necessary for individuals over 65 years of age and in municipalities with populations under 100,000 inhabitants to ensure a better quality of care during the management of severe patients of dengue in these locations. Differences in the interpretation of the DHF definition have hindered the comparison of data from different countries; it can improve from the WHO 2009 dengue classification.