RESUMO
Boletim epidemiológico que apresenta informações sobre os casos de HIV no estado de Goiás e tem como objetivo descrever o perfil epidemiológico, tendências da infecção na população adulta entre os anos 2020 a 2024 e fornecer subsídios para a tomada de decisão, medidas de vigilância, prevenção e controle da infecção pelo HIV em sua quinta década de epidemia. Trata-se de um estudo descritivo, a partir dos dados obtidos do Sistema de Informação de Agravos de Notificação (SINAN) e Sistema de Informação de Mortalidade (SIM). Foram tabulados os dados: diagnosticados e notificados por HIV/Aids por município de residência
Epidemiological bulletin that presents information on HIV cases in the state of Goiás and aims to describe the epidemiological profile, infection trends in the adult population between the years 2020 and 2024 and provide support for decision-making, surveillance, prevention and control of HIV infection in its fifth decade of epidemic. This is a descriptive study, based on data obtained from the Notifiable Diseases Information System (SINAN) and the Mortality Information System (SIM). The data were tabulated: diagnosed and reported by HIV/AIDS by municipality of residence
Assuntos
Humanos , Síndrome da Imunodeficiência Adquirida/epidemiologia , Síndrome da Imunodeficiência Adquirida/mortalidadeRESUMO
Este trabalho teve como o objetivo comparar dois Projetos Políticos Pedagógicos, descrever e analisar o desenvolvimento da visão humanística no curso de graduação em Odontologia da Universidade Federal Fluminense, a partir da ótica dos acadêmicos do referido curso. Realizou-se uma pesquisa descritivo-exploratória com enfoque quanti-qualitativo. A coleta de dados deu-se em 03 etapas, as duas primeiras por meio de categorização dos fatores selecionados pelos alunos e a terceira pelo método denominado grupo focal. As estratégias de análises utilizadas foram a categorização, operações estatísticas simples, análise temática e análise crítica com a literatura revisada. Entre os resultados da pesquisa têm-se: não existe diferença entre a visão humanística dos alunos no período inicial quando comparada com as dos alunos no final do período do ciclo profissional no Projeto Pedagógico Antigo, no Projeto Pedagógico Novo, em curso, os alunos demonstram em sua maioria estar voltados para uma visão mais humanística. Conclui-se que a humanização, do processo ensino-aprendizagem no contexto acadêmico pesquisado, apresenta ainda deficiências, constituindo-se, portanto, em um caminho a perseguir, onde o comprometimento de todos os envolvidos neste processo de transformação e formação tem um papel fundamental.
The aim of this paper was to compare two Pedagogical Political Projects, to describe and analyze the development of humanistic vision in the undergraduate course in Dentistry of the Federal University of Fluminense, from the perspective of the academics of this course. A descriptive-exploratory research with quantitative-qualitative approach was carried out. The data collection took place in 03 stages; the first two by categorizing the factors selected by the students and the third by the method called the focal group. The analysis strategies used were categorization, simple statistical operations, thematic analysis and critical analysis with the reviewed literature. The results of the research are: there is no difference between the humanistic view of the students in the initial period when compared to the students at the end of the professional cycle in the Pedagogical Project. In the New Pedagogical Project, in progress, students demonstrate, in majority, aimed at a more humanistic view. It is concluded that the humanization of the teaching-learning process in the researched academic context still presents deficiencies, constituting, therefore, a path to be pursued, where the commitment of all those involved in this process of transformation and formation plays a fundamental role.
Assuntos
Humanos , Masculino , Feminino , Estudantes de Odontologia , Ensino , Educação em Odontologia , Humanização da Assistência , AprendizagemRESUMO
O objetivo do presente estudo foi avaliar em tomografias computadorizadas as dimensões dos tecidos periodontais supracrestais (TPSC). Cem pacientes, 600 dentes anteriores da maxila (200 incisivos centrais, 200 incisivos laterais e 200 caninos), foram avaliados. A distância média da margem gengival até a crista óssea alveolar (COA) foi de 3.25mm (95% IC: 3.20-3.30), enquanto que da junção cemento-esmalte até a COA foi de 1.77mm (95% IC: 1.72-182mm). As medidas foram significativamente diferentes entre os grupos de dentes (ANOVA, p < 0.001). A tomografia, pode representar uma importante ferramenta para a avaliação das dimensões dos TPSC.
The aim of this study was to evaluate the dimensions of the supracrestal periodontal tissues (SPT) on tomographic scans. One hundred patients, 600 maxillary anterior teeth (200 central incisors, 200 lateral incisors and 200 canines), were evaluated. The average distance from the gingival margin to the alveolar bone crest (ABC) was 3.25mm (95% CI: 3.20-3.30), while the distance from the cemento-enamel junction to ABC was 1.77mm (95% CI: 1.72-182mm). The measurements were significantly different between the tooth groups (ANOVA, p < 0.001). When properly indicated, tomography can be an important tool for assessing the dimensions of TPSCs on a case-by-case basis.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Tecidos , Periodonto , Tomografia Computadorizada de Feixe Cônico , MaxilaRESUMO
Este estudo teve como objetivo avaliar o dimorfismo sexual em uma coleção de mandíbulas portuguesas através de uma metodologia métrica digital, utilizando análise estatística descritiva, inferencial e multivariada para identificar quais parâmetros são mais dimórficos e quais são os melhores preditores de sexo. Trinta e três mandíbulas (14 mulheres e 19 homens) e pertences pessoais foram fotograficamente registrados com código e sexo. Os dados foram coletados por tomografia e as medidas foram feitas pelo software Simplant Pro. Foram registrados a largura máxima e mínima do ramo mandibular, altura condilar, altura do processo coronoide, altura da sínfise mandibular, ângulo mandibular, distâncias bimentual, biantegonial, bigonial e bicondilar e comprimento máximo mandibular. A análise estatística foi realizada utilizando IBM® SPSS. Os resultados mostraram diferenças estatisticamente significativas para os seguintes parâmetros: altura do processo coronoide, altura do côndilo, comprimento máximo da mandíbula e largura mínima do ramo mandibular. Na análise estatística multivariada foi possível identificar a altura do processo coronoide como melhor preditor de sexo com precisão em 72,2% dos casos. Isto permite uma diferenciação mais fácil entre mandíbulas femininas e masculinas com uma precisão de 64,3% e 78,9%, respectivamente. Foi possível concluir que a altura do processo coronoide é o parâmetro mais dimórfico e o melhor preditor de sexo na amostra.
This study aimed to assess sex dimorphism in a collection of Portuguese mandibles through a digital metric methodology by using descriptive, inferential, and multivariate statistical analysis to identify which parameters are the most dimorphic and which are the best sex predictors. Thirty-three mandibles (14 females and 19 males) and personal belongings were photographically registered with code and sex. Data was collected using tomography, and measurements were made using the Simplant Pro software. The maximum and minimum width of the mandibular ramus, condylar height, coronoid process height, mandibular symphysis height, mandibular angle, bi-mental, bi-antegonial, bi-gonial and bi-condylar distances, and maximal mandibular length were registered. Statistical analysis was performed using IBM® SPSS. The results showed statistically significant differences for the following parameters: coronoid process height, condyle height, the maximum length of the mandible, and the minimum width of the mandibular ramus. In the multivariate statistical analysis, it was possible to identify the coronoid process height as the best sex predictor accurately in 72.2% of cases. This allows for easier differentiation between female and male mandibles with an accuracy of 64.3% and 78.9%, respectively. It was possible to conclude that the coronoid process height is the most dimorphic parameter and the best sex predictor in the sample.
Assuntos
Humanos , Masculino , Feminino , Caracteres Sexuais , Diagnóstico , Tomografia Computadorizada de Feixe Cônico , MandíbulaRESUMO
Os defeitos de esmalte são alterações qualitativas ou quantitativas na estrutura dentária, que originam-se de fatores sistêmicos, locais ou genéticos. A hipoplasia de Turner é um defeito na espessura do esmalte localizado cuja etiologia decorre de um traumatismo ou infecção periapical presente no dente decíduo predecessor, afetando o desenvolvimento do dente permanente. O objetivo do presente estudo foi apresentar um caso clínico de paciente infantil com dente hipoplásico de Turner em pré-molar, que tornou-se não vital sem que houvesse lesão de cárie ou trauma adicional. Em razão das características clínicas e radiográficas do dente afetado, bem como do risco de cárie e do comportamento cooperador da paciente, optou-se pela reabilitação do elemento afetado por meio de tratamento endodôntico e de restauração semidireta em resina composta. Torna-se de fundamental importância o conhecimento da etiologia e a realização de um exame clínico e radiográfico minucioso visando ao diagnóstico precoce e à elaboração de um plano de tratamento adequado para todos os defeitos de desenvolvimento do esmalte, incluindo-se a hipoplasia de Turner, cujo tratamento dependerá da severidade da alteração, do comportamento do paciente e do risco de cárie. Sugere-se a realização de estudos que associem a microestrutura do esmalte hipoplásico com a ausência de vitalidade pulpar.
Enamel defects are qualitative or quantitative changes in the tooth structure originating from systemic, local, or genetic factors. Turner's hypoplasia is a defect in the thickness of the localized enamel whose etiology arises from trauma or periapical infection in the predecessor deciduous tooth, affecting the permanent tooth's development. The objective of the present study was to present a clinical case of a child patient with a hypoplastic Turner premolar tooth, which became non-vital without the occurrence of caries, or additional trauma. Due to the affected tooth's clinical and radiographic characteristics, the risk of cavities, and the patient's cooperative behavior, it was decided to rehabilitate the affected element through endodontic treatment and semidirect restoration in composite resin. It is of fundamental importance to know the etiology and carry out a thorough clinical and radiographic examination aiming at early diagnosis and the development of an adequate treatment plan for all enamel developmental defects, including Turner's hypoplasia, whose treatment will depend on the severity of the change, the patient's behavior and the risk of caries. Studies are suggested to be carried out that associate the microstructure of hypoplastic enamel with the absence of pulp vitality.
Assuntos
Humanos , Feminino , Criança , Planejamento de Assistência ao Paciente , Reabilitação , Dente Pré-Molar , Assistência Odontológica , Hipoplasia do Esmalte DentárioRESUMO
Introducción: Las enfermedades cerebrovasculares son consideradas un problema de salud pública que afectan muchas capacidades en el individuo, entre ellas la comunicación; de esta manera el cuidador cumple un papel fundamental en su recuperación. Objetivo: Describir el rol comunicativo del cuidador en la atención a pacientes con secuelas de accidente cerebrovascular en la ciudad de Sincelejo, Colombia. Materiales y métodos: Paradigma positivista, enfoque cuantitativo y estudio descriptivo de corte transversal realizado con 40 cuidadores, seleccionados según muestreo por criterios y reclutamiento en cadena. Se utilizó una encuesta sociodemográfica, una sobre favorecimiento y bienestar comunicativo y Escala Likert, se realizó análisis de fiabilidad y consistencia interna del instrumento. Resultados: Predominaron cuidadores de sexo femenino, sobresale el cuidador informal, con estudios de secundaria y estrato socioeconómico bajo. Se encontró una actitud favorable en la competencia del ser y saber hacer, prima el buen trato, justicia y respeto. La competencia del saber evidenció actitud desfavorable, caracterizada por un conocimiento limitado frente a la patología, insuficientes destrezas, técnicas y habilidades para cumplir sus funciones y estrategias empleadas. Conclusión: Es necesario cualificar al cuidador en la atención del paciente con accidente cerebrovascular, mediante programas de que dinamicen la competencia del ser, saber y saber hacer
Introduction: Cerebrovascular diseases are a public health problem affecting the different capabilities of patients, including communication. Thus, caregivers play a fundamental role in their recovery. Objective: To describe the communicative role of caregivers in the support of patients with stroke sequelae in the city of Sincelejo, Colombia. Materials and methods: A positivist paradigm, quantitative approach, and descriptive cross-sectional study was carried out with 40 caregivers, who were selected according to criteria sampling and chain recruitment. A sociodemographic survey about favorability and communicative well-being as well as the Likert Scale were applied. A reliability and internal consistency analysis was conducted. Results: The majority of caregivers were women. Informal caregivers, with high school education, and belonging to low socioeconomic status were also predominant. A positive attitude regarding competences such as being and knowing what to do; appropriate treatment of patients, with justice and respect, were observed as common features. The knowledge competence was considered unfavorable, which was characterized by limited understanding regarding pathology, strategies used, and insufficient skills, techniques, and abilities to fulfill their functions. Conclusions: Caregivers of stroke patients should be qualified through programs that improve the being, knowing, and knowing how to do competencies.
Introdução: As doenças cerebrovasculares são consideradas um problema de saúde pública que afeta diversas capacidades do indivíduo, incluindo a comunicação; desta forma, o cuidador desempenha um papel fundamental na sua recuperação. Objetivo: Descrever o papel comunicativo do cuidador no cuidado de pacientes com sequelas de acidente vascular cerebral na cidade de Sincelejo, Colômbia. Materiais e métodos: Paradigma positivista, abordagem quantitativa e estudo transversal descritivo realizado com 40 cuidadores, selecionados segundo critérios de amostragem e recrutamento em cadeia. Foi utilizado um inquérito sociodemográfico, um de favorabilidade e bem-estar comunicativo e uma Escala Likert, foi realizada uma análise da fiabilidade e consistência interna do instrumento. Resultados: Predominaram cuidadores do sexo feminino, destacando-se os cuidadores informais, com escolaridade média e baixo nível socioeconômico. Encontrou-se na competição uma atitude favorável por ser e saber fazer, prevalecendo o bom tratamento, a justiça e o respeito. A competência conhecimento apresentou atitude desfavorável, caracterizada por conhecimento limitado sobre a patologia, habilidades, técnicas e habilidades insuficientes para cumprir suas funções e estratégias utilizadas. Conclusões: É necessário qualificar o cuidador no cuidado ao paciente com AVC, por meio de programas que potencializem a competência de ser, saber e saber fazer.
Assuntos
Humanos , Masculino , FemininoRESUMO
Introducción: La calidad de vida relacionada con la salud (CVRS) y los estados de ánimo son indicadores cruciales del bienestar en adolescentes, pero su relación con estudiantes de Antioquia, Colombia, no ha sido ampliamente estudiada. Objetivo: Determinar la CVRS y los estados de ánimo en escolares de Antioquia-Colombia. Materiales y métodos: Estudio transversal con 1957 escolares de 9 a 20 años. Se aplicaron mediciones de CVRS, ansiedad, depresión, hostilidad y alegría, actividad física, comportamiento sedentario, apoyo social de padres y nivel socioeconómico. Resultados: La calidad de vida alta (CVA) es más elevada en hombres, personas con alegría, estudiantes con apoyo de padres, activos físicamente y personas de nivel socioeconómico alto y medio. AL aumentar un año de edad, disminuye en un 15 % la CVA, y al aumentar la depresión, la ansiedad y el comportamiento sedentario disminuye la CVA. Además, los niveles de depresión y ansiedad son mayores en mujeres, estudiantes mayores, sin apoyo de los padres y personas sedentarias. Conclusiones: La CVRS se asocia con estados de ánimo, actividad física, comportamiento sedentario y apoyo de los padres; mientras que los estados de ánimo se asocian con el sexo, el apoyo de los padres, la CVS y el sedentarismo.
Introduction: Even though health-related quality of life (HRQL) and mood states are key indicators of the well-being of adolescents, their relationship has not been analyzed in students from Antioquia, Colombia. Objective: To determine HRQL and mood states in schoolchildren from Antioquia. Materials and methods: A cross-sectional study was conducted on 1,957 schoolchildren and adolescents aged between 9 and 20 years. Measurements of HRQL, anxiety, depression, hostility and happiness, physical activity, sedentary behavior, parental social support, and socioeconomic status were applied. Results: A high quality of life (HQL) was observed more frequently in male participants, students with parental support, physically active, and those belonging to medium and high socioeconomic status. HQL decreased 15% as their age increased by one year. Also, HQL was reduced when depression, anxiety, and sedentary behavior increased. Furthermore, depression and anxiety levels were higher in women, older students, as well as in those without parental control and with sedentary behavior. Conclusions: HRQL is associated with mood states, physical activity, sedentary behavior, and parental support. In contrast, mood states are related to gender, parental support, HQL, and sedentary lifestyle.
Introdução: A qualidade de vida relacionada à saúde (CVRS) e os estados de humor são indicadores cruciais de bem-estar em adolescentes, mas sua relação com estudantes de Antioquia, Colômbia, não foi amplamente estudada. Objetivo: Determinar a CVRS e os estados de humor em escolares de Antioquia-Colômbia. Materiais e métodos: Estudo transversal com 1.957 escolares de 9 a 20 anos. Foram aplicadas medidas de QVRS, ansiedade, depressão, hostilidade e felicidade, atividade física, comportamento sedentário, apoio social dos pais e nível socioeconômico. Resultados: A alta qualidade de vida (CVA) é maior em homens, pessoas com alegria, estudantes com apoio parental, fisicamente ativos e pessoas de nível socioeconômico alto e médio. À medida que a idade aumenta em um ano, diminui em 15% o CVA, e ao aumentar a depressão, a ansiedade e o comportamento sedentário aumentam, o CVA diminui. Além disso, os níveis de depressão e ansiedade são mais elevados nas mulheres, nos estudantes mais velhos, sem apoio dos pais e nas pessoas sedentárias. Conclusões: A QVRS está associada a estados de humor, atividade física, comportamento sedentário e apoio parental; enquanto os estados de humor estão associados ao sexo, apoio parental, CVS e estilo de vida sedentário.
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Humanos , Masculino , Feminino , Criança , Adolescente , Adulto Jovem , Saúde , Emoções , Felicidade , HostilidadeRESUMO
Purpose: To quantify outer retina structural changes and define novel biomarkers of inherited retinal degeneration associated with biallelic mutations in RPE65 (RPE65-IRD) in patients before and after subretinal gene augmentation therapy with voretigene neparvovec (Luxturna). Methods: Application of advanced deep learning for automated retinal layer segmentation, specifically tailored for RPE65-IRD. Quantification of five novel biomarkers for the ellipsoid zone (EZ): thickness, granularity, reflectivity, and intensity. Estimation of theâ EZarea in single and volume scans was performed with optimized segmentation boundaries. The control group was age similar and without significant refractive error. Spherical equivalent refraction and ocular length were evaluated in all patients. Results: We observed significant differences in the structural analysis of EZ biomarkers in 22 patients with RPE65-IRD compared with 94 healthy controls. Relative EZ intensities were already reduced in pediatric eyes. Reductions of EZ local granularity and EZ thickness were only significant in adult eyes. Distances of the outer plexiform layer, external limiting membrane, and Bruch's membrane to EZ were reduced at all ages. EZ diameter and area were better preserved in pediatric eyes undergoing therapy with voretigene neparvovec and in patients with a milder phenotype. Conclusions: Automated quantitative analysis of biomarkers within EZ visualizes distinct structural differences in the outer retina of patients including treatment-related effects. The automated approach using deep learning strategies allows big data analysis for distinct forms of inherited retinal degeneration. Limitations include a small dataset and potential effects on OCT scans from myopia at least -5 diopters, the latter considered nonsignificant for outer retinal layers.
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Aprendizado Profundo , Terapia Genética , Mutação , Tomografia de Coerência Óptica , cis-trans-Isomerases , Humanos , cis-trans-Isomerases/genética , Tomografia de Coerência Óptica/métodos , Masculino , Feminino , Terapia Genética/métodos , Adulto , Criança , Adolescente , Adulto Jovem , Pessoa de Meia-Idade , Degeneração Retiniana/genética , Degeneração Retiniana/terapia , Pré-Escolar , Acuidade Visual/fisiologia , Retina/diagnóstico por imagem , Retina/patologiaRESUMO
Boletim com o objetivo de apresentar o estudo dos casos de acidentes com exposição a material biológico notificados no Sistema de Informação de Agravo de Notificação de notificação (SINAN), no Estado de Goiás e oferecer subsídios para o desenvolvimento de estratégias preventivas que reduzam a exposição aos fatores de riscos envolvidos e aç~çoes de promoção em Saúde do Trabalhador
Bulletin with the objective of presenting the study of cases of accidents with exposure to biological material reported in the Notification Disease Information System (SINAN), in the State of Goiás and offering subsidies for the development of preventive strategies that reduce exposure to risk factors involved and occupational health promotion actions
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Humanos , Masculino , Feminino , Derramamento de Material Biológico/estatística & dados numéricos , Notificação de Acidentes de Trabalho , Acidentes de Trabalho/estatística & dados numéricosRESUMO
PURPOSE: The presence of chaperones during intimate physical examinations is a matter of ongoing debate. While most guidelines recommend the use of chaperones in all cases, there are no clinical trials specifically investigating intimate exams performed on women by male physicians. We aimed to evaluate female patients' perceptions regarding the presence or absence of chaperones during proctological examinations conducted by male physicians. METHODS: In this randomised clinical trial, patients were assigned, unaware that they were participating in a study, to either Group 1 (without a chaperone during their proctological exam) or Group 2 (with a chaperone). After the appointment, they completed a questionnaire regarding the examination they had just undergone. The study was conducted at two hospitals in Southern Brazil. RESULTS: Ninety-five patients were included in each group. The mean (SD) comfort score was 8.3 (2.9) with a chaperone and 8.8 (2.5) without a chaperone (P = 0.25). When asked if they would want the exam performed the same way in the future, 72.6% in Group 1 answered 'yes', compared to 58.9% in Group 2 (P = 0.046). In Group 2, 48.4% of patients did not feel more protected by the chaperone, while none of the patients in Group 1 felt less protected without one. CONCLUSIONS: Forgoing chaperones during proctological examinations of women, when the physician is male, is well accepted by most patients. Preferences regarding chaperones are complex, demanding a selective approach. The use of chaperones should remain a recommendation, not a requirement, to accommodate individual needs while maintaining the doctor-patient relationship. TRIAL REGISTRATION: ClinicalTrials.gov number, NCT03615586.
Assuntos
Acompanhantes Formais em Exames Físicos , Preferência do Paciente , Humanos , Feminino , Masculino , Adulto , Pessoa de Meia-Idade , Inquéritos e Questionários , Médicos/psicologia , Exame Físico , Relações Médico-PacienteRESUMO
The Sustainable Development Goals (SDGs) aim to eradicate poverty and promote sustainable development; however, socioeconomic disparities persist globally, particularly in Colombia. With a Gini index of 0.556 in 2022, Colombia ranks among the most unequal countries in Latin America, with its southwest region of Nariño facing severe socioeconomic challenges. Concurrently, Nariño registers the highest levels of coca cultivation in Colombia, accounting for 65% of national cocaine production, reflecting the region's precarious conditions. This study investigates the extent to which the spatial distribution of socioeconomic factors explains coca cultivation patterns in Nariño. Grounded in conflict economics, social capital, and social marginalization theories, the research constructs composite indices representing education, health, public services, economic conditions, and vulnerability. Using spatial analysis, it identifies areas with heightened poverty and vulnerability and examines their relationship with illicit crops. The findings highlight spatial non-stationarity in the factors influencing coca cultivation, offering region-specific insights and policy recommendations to combat illicit crops and foster sustainable development. These results provide a foundation for targeted interventions and contribute to broader strategies addressing inequality and illegal economies in Colombia.
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Fatores Socioeconômicos , Análise Espacial , Colômbia , Humanos , Produtos Agrícolas/crescimento & desenvolvimento , Produtos Agrícolas/economia , Coca/crescimento & desenvolvimento , Pobreza , Desenvolvimento Sustentável , Agricultura/economiaRESUMO
INTRODUCTION: Sarcopenia and Osteoporosis are two prevalent conditions in the older population and are defined by low strength, muscle quality/volume and low Bone Mineral Density, respectively. When there is a concomitant presence of both, there is a novel musculoskeletal condition called Osteosarcopenia. These conditions adversely affect quality of life and elevate the risk of fractures, disability, and mortality among older individuals. Dysbiosis of the gut microbiota is the impairment of the mutualistic relationship between microorganisms, metabolic products and the host's immune system. Gut microbiota dysbiosis could be intricately linked to sarcopenia and osteoporosis, shedding light on the complex microbiota-gut-bone-muscle axis. Furthermore, the intestinal microbiota experiences a notable decline in beneficial microorganisms as part of the aging process. The relationship between dysbiosis of the intestinal microbiota in older people and sarcopenia, osteoporosis or osteosarcopenia is still unclear. This review protocol aims to systematically review the literature and compile evidence on the influence of gut microbiota dysbiosis on musculoskeletal function in older people with sarcopenia, osteoporosis or osteosarcopenia. METHODS/ANALYSIS: This systematic review will analyze observational studies that have investigated the relationship between the effects of gut microbiota dysbiosis and sarcopenia, osteoporosis and osteosarcopenia in older people aged 65 and over. Studies will be retrieved from PubMed/MEDLINE, EMBASE, Scopus, Web of Science and the Cochrane Library. Outcome measures will include body composition for diagnosing osteoporosis and screening for sarcopenia/osteosarcopenia by any criteria. Data synthesis will involve quantitative analysis using summary measures. If sufficient studies, homogeneity and heterogeneity analysis will be performed to conduct Meta-analysis and pooled OR, RR and HR measures will be provided.
Assuntos
Disbiose , Microbioma Gastrointestinal , Osteoporose , Sarcopenia , Revisões Sistemáticas como Assunto , Humanos , Sarcopenia/microbiologia , Osteoporose/microbiologia , Disbiose/complicações , Disbiose/microbiologia , IdosoRESUMO
INTRODUCTION: Very low-calorie diets with hospitalization have demonstrated promise as a viable therapeutic option for severe obesity and its associated comorbidities. However, large studies providing a comprehensive longitudinal observation of patients undergoing this therapy are lacking. We evaluated the effectiveness of treating severe obesity in hospitalized patients, using very low-calorie diets and clinical support to develop lifestyle changes. METHODS: This study was a retrospective cohort comparing exposure variables in a secondary data analysis with a pre-post treatment design. Data were obtained from medical records of patients with severe obesity (grade II or III) treated in a Brazilian obesity specialist hospital from 2016 to 2022. The patients underwent a very low-calorie diet (500-800 kCal/day) and immersive changes in lifestyle habits, monitored by a multidisciplinary team. At 3 months, 777 patients presented complete data and 402 presented complete data at 6 months. The study compared changes in bioimpedance and laboratory tests, between men and women and age groups. RESULTS: Three months of hospitalization yielded significant reductions in weight, body mass index (BMI), body fat, skeletal muscle mass, glucose, inflammatory, and lipid parameters. These reductions were more pronounced after 6 months, nearly doubling those observed at 3 months. In women, BMI and fat mass reduced by 10.4% and 15.2% at 3 months and 20.4% and 31.3% at 6 months, respectively. In men, BMI and fat mass decreased by 12.9% and 25.3 at 3 months and 23.6% and 45.3% at 6 months, respectively. Elderly individuals (aged ≥ 60 years) had smaller reductions in BMI and fat mass than non-elderly individuals (aged < 60 years) but still presented significant improvements. CONCLUSION: This study suggests the viability of treating severe obesity by hospitalization with low-calorie diets and immersive lifestyle changes. This treatment modality significantly improves anthropometric measurements, glucose, lipids, and inflammatory markers, thereby reducing cardiovascular risk.
Assuntos
Índice de Massa Corporal , Pacientes Internados , Obesidade Mórbida , Humanos , Feminino , Masculino , Estudos Retrospectivos , Pessoa de Meia-Idade , Brasil/epidemiologia , Adulto , Obesidade Mórbida/terapia , Obesidade Mórbida/dietoterapia , Hospitalização , Restrição Calórica/métodos , Idoso , Análise de Dados , Estilo de Vida , Análise de Dados SecundáriosRESUMO
Nasopharyngeal transmission of Streptococcus pneumoniae is a prerequisite for the development of pneumococcal diseases. Previous studies have reported a relationship between respiratory viruses and S. pneumoniae infections. However, there are few studies on this issue among healthy children. This study aimed to examine the relationships between these agents in healthy children from Southern Brazil. This cohort study included 229 nasopharyngeal samples collected from children aged 18-59 months at baseline. S. pneumoniae was detected using bacterial culture, whereas respiratory viruses were identified using quantitative polymerase chain reaction. A questionnaire was used at the time of sample collection and medical records were reviewed 14 days after participant inclusion. The prevalence of pneumococcal carriage was 63.7% (146/229), while respiratory viruses were detected in 49.3% (113/229) of the children. Respiratory viruses were more frequently found among pneumococcal carriers than among non-carriers (54.4% vs. 39.7%, p = 0.033). Additionally, rhinovirus (hRV) was more frequent among the pneumococcal carriers (39% vs. 21.7%, p = 0.012), and the presence of human bocavirus (hBOV) alone was associated with the absence of pneumococcal carriage (2.7% vs. 10.8%, p = 0.016). No differences were found in the frequency of pneumococcal carriage, respiratory virus detection, or the co-occurrence of clinical symptoms and diagnosis in the participants 14 days after specimen collection. Our findings revealed a positive relationship between pneumococcal carriage and respiratory virus detection, particularly for hRV. However, we did not observe a relationship between nasopharyngeal respiratory viruses and pneumococci detection during medical appointments, respiratory symptoms, or diseases. This study was one of the first investigations in Latin America to explore the relationship between respiratory viruses and pneumococcal carriage in a healthy children.
Assuntos
Portador Sadio , Coinfecção , Nasofaringe , Infecções Pneumocócicas , Streptococcus pneumoniae , Humanos , Streptococcus pneumoniae/isolamento & purificação , Brasil/epidemiologia , Nasofaringe/microbiologia , Nasofaringe/virologia , Feminino , Masculino , Lactente , Pré-Escolar , Coinfecção/microbiologia , Coinfecção/epidemiologia , Coinfecção/virologia , Infecções Pneumocócicas/epidemiologia , Infecções Pneumocócicas/microbiologia , Portador Sadio/microbiologia , Portador Sadio/epidemiologia , Infecções Respiratórias/microbiologia , Infecções Respiratórias/virologia , Infecções Respiratórias/epidemiologia , Prevalência , Estudos de CoortesRESUMO
During the transition from the Pleistocene to the Holocene and in the early Holocene period, hunter-gatherer communities across tropical South America deployed a range of technological strategies to adapt to diverse environmental conditions. This period witnessed a rich tapestry of technological practices, from enduring, widely disseminated tools to local and sporadically utilized technologies, shaping a multifaceted landscape of technological traditions. Lithic technology during this period was mainly marked by localized sourcing of raw materials, the use of multifunctional tools, a variety of projectile point designs, and the frequently utilization of unifacial shaping technology. In tropical Central Brazil, the Itaparica technocomplex, with unique unifacial lithic tools like limaces, is a pivotal innovation from the Late Pleistocene through the Holocene. However, the factors influencing their morphological and structural variability remain largely unexplored, obscuring our understanding of their ergonomics and their role as mediators between humans and tropical environments. This study hypothesizes that the variability observed within and among unifacial tools from the GO-Ni sites in Central Brazil is a result of a combination of factors, including raw material availability and functional and ergonomic requirements. To test this hypothesis, a study of 67 unifacial tools from this region was conducted, employing techno-structural analysis and 3D geometric morphometrics. This approach was designed to precisely quantify tool geometry and uncover their functional potentials. The analysis revealed significant variability within the techno-structural groups, often intersecting with typological classifications. These results indicate that despite their production attributes, unifacially shaped artifacts demonstrate considerable morpho-structural diversity. The study delineated nine distinct techno-structural groups, each suggesting potentially different functional organizations and deviating from conventional typologies. These results indicate that unifacially shaped artifacts, while embodying a novel technological paradigm of production, exhibit a broader spectrum of variation mainly due to different tool functions. The combined approach adopted in this research highlights on the cultural significance of unifacial tools within Paleoamerican technological systems. It suggests probable unique tool concepts specific to the study area, challenges existing classifications, and enriches our comprehension of early lithic technology in South America.
Assuntos
Arqueologia , Brasil , Humanos , Arqueologia/métodos , Tecnologia/história , Imageamento Tridimensional/métodosRESUMO
Polymorphisms in the MBL2 gene exon 1 can decrease serum levels of mannose-binding lectin (MBL), increasing the risk of infection in immunocompromised individuals. This study evaluated the association between the polymorphism in exon 1 of the MBL2 gene, genotypes, serum MBL levels, and infection in 122 patients with acute lymphoid leukemia (ALL). The MBL*A allele exhibited the highest frequency (0.37) within the study population. The MBL*D (0.32) was the predominant variant. The combined frequency of O polymorphic alleles (either B or D) was 0.63. The frequencies of the A/A, A/O and O/O genotypes were 0.13, 0.49 and 0.38, respectively. All patients exhibited consistently low levels of serum MBL, irrespective of their exon 1 genotype. Parasitic infections (n = 103), bacterial (n = 69) and viral (n = 48). A/O genotype (0.49) had higher infection rates, A/A (0.13) had lower rates, and O/O showed increased viral susceptibility (OR: 0.37; 95% CI 0.13-1.06; p = 0.05). Our findings demonstrated that the study population were MBL-deficient, regardless of their MLB2 genotype. Individuals with the A/O genotype had more infections, while those with the O/O genotype appeared more susceptible to viral infections. These findings highlight the impact of MBL levels and genetic variants on infection susceptibility in ALL patients.
Assuntos
Éxons , Predisposição Genética para Doença , Lectina de Ligação a Manose , Leucemia-Linfoma Linfoblástico de Células Precursoras , Humanos , Lectina de Ligação a Manose/genética , Lectina de Ligação a Manose/sangue , Masculino , Feminino , Éxons/genética , Adulto , Leucemia-Linfoma Linfoblástico de Células Precursoras/genética , Leucemia-Linfoma Linfoblástico de Células Precursoras/sangue , Pessoa de Meia-Idade , Adolescente , Genótipo , Adulto Jovem , Idoso , Alelos , Polimorfismo de Nucleotídeo Único , Criança , Frequência do Gene , Polimorfismo GenéticoRESUMO
Cardiorespiratory fitness is the most important variable related to health and a strong predictor of mortality. However, it is rarely used in clinics due to costs, specialized equipment, space needs, and the requirements of expert staff such as an exercise physiologist, physician, or other health professional. This work aims to validate and test the reliability of a submaximal step test to estimate VO2max of 8-to 16-year-old pediatric populations as a simple and low-cost tool for clinical practice. A cross-sectional study included 242 children and adolescents (42.1% girls) aged 8-16. Cardiorespiratory fitness was determined by a maximal incremental test on a treadmill until exhaustion. The step test entailed maintaining a steady pace of 22 steps per minute for 3 min (60 bpm), with the heart rate being recorded at the end of the test. Nutritional status was computed through BMI z-score. A multiple linear regression model validated the step test and developed a new equation to predict VO2max, including the third-minute heart rate, weight, and height. The reliability among predicted and measured VO2max was assessed by Bland-Altman analysis. The mean age was 12.5 ± 2.6; 51.6% were overweight or obese. The cardiorespiratory fitness measured as VO2max was 35.01 ± 0.58 ml·min-1·kg-1. A robust correlation was observed between the predicted VO2max from the step test and the measured VO2max (r = 0.86, p < 0.001). Bland-Altman analysis indicated statistical concordance between predicted and measured VO2max. Our findings indicate that the step test protocol is valid and reliable for estimating VO2max in children and adolescents. Furthermore, the predictive equation is suitable for application among children aged 8-16.
Assuntos
Aptidão Cardiorrespiratória , Teste de Esforço , Consumo de Oxigênio , Humanos , Criança , Feminino , Masculino , Consumo de Oxigênio/fisiologia , Adolescente , Teste de Esforço/métodos , Aptidão Cardiorrespiratória/fisiologia , Estudos Transversais , Reprodutibilidade dos Testes , Frequência Cardíaca/fisiologiaRESUMO
Foreign body (FB) ingestion and aspiration are frequent causes of pediatric emergency room visits, with significant morbidity and mortality risks. This cross-sectional study analyzed 1,052 pediatric patients admitted for suspected FB events at a single institution between 2008 and 2015, including 886 cases of suspected ingestion and 166 cases of suspected aspiration. Cluster analysis identified three distinct clusters for both groups, with respiratory symptoms being predominant in clusters with worse outcomes. The respiratory clusters were associated with increased complication rates (13.0% for aspiration, 3.6% for ingestion) and all mortalities (three in aspiration and two in ingestion). In ingestion cases, Respiratory Cluster patients showed increased complications, prolonged hospital stays (mean 55.1 h), and accounted for all mortalities, a relationship not previously reported. Caregiver-reported certainty of event occurrence showed moderate sensitivity (72.5%) and low specificity (45.4%) for aspiration, and higher sensitivity (86.8%) with lower specificity (19.8%) for ingestion. Decision Curve Analysis revealed a net benefit in utilizing caregiver certainty for clinical decision-making. Confirmatory radiographic findings were commonly observed in ingestion cases (84.2%) than in aspiration cases (37.7%), likely due to the higher incidence of metal ingestions compared to mostly organic aspirations. Endoscopic management had high success rates (97.6%), and low mortality, highlighting its central role in FB treatment. These findings underscore the importance of assessing respiratory symptom severity within the broad clinical spectrum of FBs to identify patients at risk of worse clinical outcomes, which helps prioritize resources when necessary. Caregiver-reported information has been shown to be valuable in guiding diagnostic decisions.
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Cuidadores , Corpos Estranhos , Humanos , Feminino , Masculino , Pré-Escolar , Criança , Estudos Transversais , Análise por Conglomerados , Lactente , AdolescenteRESUMO
Unhealthy lifestyles risk factors, such as smoking, alcohol consumption, physical inactivity, poor diet, and obesity, have been associated with a higher risk of all-cause and cause-specific mortality. However, composite score of these unhealthy behaviours has not been considered, particularly in Latin American populations. Herein, we examined the association of lifestyle risk factors score with all-cause and cause-specific mortality in Mexican adults. A total of 159,517 adults from the Mexico City Prospective Study (MCPS) were included. Data on sociodemographic, lifestyle risk factors and medical histories was collected through a self-reported baseline questionnaire in a census-style door-to-door interviews. Lifestyle risk factors assessment was based on five modifiable lifestyle risk factors and their respective cut-off points according to current health recommendations, including obesity, physical inactivity, tobacco, alcohol consumption and fruits and vegetables intake. Multivariable Cox regression models were used to estimate the associations of lifestyle risk factor score (ranging from 0 to 5) with all-cause and cause-specific mortality (cardiovascular disease, renal or hepatobiliary diseases, diabetes, respiratory diseases, cancer and all-cause mortality). We excluded the first 2, 5, 10, and 15 years of follow-up to account for reverse causation bias. We found a high prevalence (77%) of Mexican adults, with two or more lifestyle risk factors. Hazard ratio for respiratory diseases and renal or hepatobiliary diseases were 1.86 (95%CI: 1.45-2.39) and 2.00 (95%CI: 1.60-2.52) comparing participants with 4-5 lifestyle risk factors vs. those with none. For all-cause mortality, participants with 4-5 lifestyle risk factors had a 49% (HR: 1.49; 95%CI: 1.03-2.16) higher risk as compared to participants with none. The magnitude of the associations increased as the exclusion of follow-up time increased after 2, 5, 10 and 15 years. There was a positive association between the number of lifestyle risk factors and all-cause and cause-specific mortality, showing the highest rate of respiratory, renal or hepatobiliary and all-cause mortality among participants with 4-5 lifestyle risk factors. After accounting for reverse causation, associations were stronger.
Assuntos
Estilo de Vida , Humanos , México/epidemiologia , Masculino , Feminino , Fatores de Risco , Estudos Prospectivos , Pessoa de Meia-Idade , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/efeitos adversos , Idoso , Fumar , Obesidade/mortalidade , Obesidade/epidemiologia , Mortalidade , Causas de MorteRESUMO
Throughout history, food has played a fundamental role in the development of societies. An understanding of the diets of different cultures and their impact on health can provide valuable insights into their lifestyle. The identification of the animal remains found within two vessels is reported and, in addition, an assessment of whether the diet and soil composition of the period may be associated with toxic elements was carried out. The animal bones retrieved from the settlement, which dated from 25 to 203 cal AD, were identified as belonging to Zenaida cf. auriculata, commonly known as eared dove. Ancient starch was discovered in the sediments inside the vessels. These sediments, along with the pre-Hispanic soil collected in the study zone, showed moderate pollution, suggesting potential environmental contamination. For the first time, evidence that eared doves were part of the diet of the ancient inhabitants of Quito is presented, as shown by the occurrence of their bones within food processing utensils. Furthermore, the study highlights the possibility of environmental contamination due to volcanic eruptions that occurred during the Regional Development period from 500 BC to AD 500. These results can contribute to a better understanding of the living conditions of the early inhabitants of Quito and similar regions.