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[SciELO Preprints] - Brazilian Guidelines for In-office and Out-of-office Blood Pressure Measurement – 2023
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Feitosa, Audes Diógenes de Magalhães Barroso, Weimar Kunz Sebba Mion Júnior, Décio Nobre, Fernando Mota-Gomes, Marco Antonio Jardim, Paulo Cesar Brandão Veiga Amodeo, Celso Camargo, Adriana Alessi, Alexandre Sousa, Ana Luiza Lima Brandão, Andréa Araujo Pio-Abreu, Andrea Sposito, Andrei Carvalho Pierin, Angela Maria Geraldo Paiva, Annelise Machado Gomes de Spinelli, Antonio Carlos de Souza Machado, Carlos Alberto Poli-de-Figueiredo, Carlos Eduardo Rodrigues, Cibele Isaac Saad Forjaz, Cláudia Lúcia de Moraes Sampaio, Diogo Pereira Santos Barbosa, Eduardo Costa Duarte Freitas, Elizabete Viana de Cestário , Elizabeth do Espírito Santo Muxfeldt, Elizabeth Silaid Lima Júnior, Emilton Campana, Erika Maria Gonçalves Feitosa, Fabiana Gomes Aragão Magalhães Consolim-Colombo, Fernanda Marciano Almeida, Fernando Antônio de Silva, Giovanio Vieira da Moreno Júnior, Heitor Finimundi, Helius Carlos Guimarães, Isabel Cristina Britto Gemelli, João Roberto Barreto Filho, José Augusto Soares Vilela-Martin, José Fernando Ribeiro, José Marcio Yugar-Toledo, Juan Carlos Magalhães, Lucélia Batista Neves Cunha Drager, Luciano Ferreira Bortolotto, Luiz Aparecido Alves, Marco Antonio de Melo Malachias, Marcus Vinícius Bolívar Neves, Mario Fritsch Toros Santos, Mayara Cedrim Dinamarco, Nelson Moreira Filho, Osni Passarelli Júnior, Oswaldo Valverde de Oliveira Vitorino, Priscila Valverde de Oliveira Miranda, Roberto Dischinger Bezerra, Rodrigo Pedrosa, Rodrigo Pinto Paula, Rogério Baumgratz de Okawa, Rogério Toshiro Passos Póvoa, Rui Manuel dos Santos Fuchs, Sandra C. Inuzuka, Sayuri Ferreira-Filho, Sebastião R. Paffer Fillho, Silvio Hock de Jardim, Thiago de Souza Veiga Guimarães Neto, Vanildo da Silva Koch, Vera Hermina Gusmão, Waléria Dantas Pereira Oigman, Wille Nadruz, Wilson

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Publication date: 2023-09-23

Abstract: En Es Pt

Hypertension is one of the primary modifiable risk factors for morbidity and mortality worldwide, being a major risk factor for coronary artery disease, stroke, and kidney failure. Furthermore, it is highly prevalent, affecting more than one-third of the global population. Blood pressure measurement is a MANDATORY procedure in any medical care setting and is carried out by various healthcare professionals. However, it is still commonly performed without the necessary technical care. Since the diagnosis relies on blood pressure measurement, it is clear how important it is to handle the techniques, methods, and equipment used in its execution with care. It should be emphasized that once the diagnosis is made, all short-term, medium-term, and long-term investigations and treatments are based on the results of blood pressure measurement. Therefore, improper techniques and/or equipment can lead to incorrect diagnoses, either underestimating or overestimating values, resulting in inappropriate actions and significant health and economic losses for individuals and nations. Once the correct diagnosis is made, as knowledge of the importance of proper treatment advances, with the adoption of more detailed normal values and careful treatment objectives towards achieving stricter blood pressure goals, the importance of precision in blood pressure measurement is also reinforced. Blood pressure measurement (described below) is usually performed using the traditional method, the so-called casual or office measurement. Over time, alternatives have been added to it, through the use of semi-automatic or automatic devices by the patients themselves, in waiting rooms or outside the office, in their own homes, or in public spaces. A step further was taken with the use of semi-automatic devices equipped with memory that allow sequential measurements outside the office (ABPM; or HBPM) and other automatic devices that allow programmed measurements over longer periods (HBPM). Some aspects of blood pressure measurement can interfere with obtaining reliable results and, consequently, cause harm in decision-making. These include the importance of using average values, the variation in blood pressure during the day, and short-term variability. These aspects have encouraged the performance of a greater number of measurements in various situations, and different guidelines have advocated the use of equipment that promotes these actions. Devices that perform HBPM or ABPM, which, in addition to allowing greater precision, when used together, detect white coat hypertension (WCH), masked hypertension (MH), sleep blood pressure alterations, and resistant hypertension (RHT) (defined in Chapter 2 of this guideline), are gaining more and more importance. Taking these details into account, we must emphasize that information related to diagnosis, classification, and goal setting is still based on office blood pressure measurement, and for this reason, all attention must be given to the proper execution of this procedure.

La hipertensión arterial (HTA) es uno de los principales factores de riesgo modificables para la morbilidad y mortalidad en todo el mundo, siendo uno de los mayores factores de riesgo para la enfermedad de las arterias coronarias, el accidente cerebrovascular (ACV) y la insuficiencia renal. Además, es altamente prevalente y afecta a más de un tercio de la población mundial. La medición de la presión arterial (PA) es un procedimiento OBLIGATORIO en cualquier atención médica o realizado por diferentes profesionales de la salud. Sin embargo, todavía se realiza comúnmente sin los cuidados técnicos necesarios. Dado que el diagnóstico se basa en la medición de la PA, es claro el cuidado que debe haber con las técnicas, los métodos y los equipos utilizados en su realización. Debemos enfatizar que una vez realizado el diagnóstico, todas las investigaciones y tratamientos a corto, mediano y largo plazo se basan en los resultados de la medición de la PA. Por lo tanto, las técnicas y/o equipos inadecuados pueden llevar a diagnósticos incorrectos, subestimando o sobreestimando valores y resultando en conductas inadecuadas y pérdidas significativas para la salud y la economía de las personas y las naciones. Una vez realizado el diagnóstico correcto, a medida que avanza el conocimiento sobre la importancia del tratamiento adecuado, con la adopción de valores de normalidad más detallados y objetivos de tratamiento más cuidadosos hacia metas de PA más estrictas, también se refuerza la importancia de la precisión en la medición de la PA. La medición de la PA (descrita a continuación) generalmente se realiza mediante el método tradicional, la llamada medición casual o de consultorio. Con el tiempo, se han agregado alternativas a través del uso de dispositivos semiautomáticos o automáticos por parte del propio paciente, en salas de espera o fuera del consultorio, en su propia residencia o en espacios públicos. Se dio un paso más con el uso de dispositivos semiautomáticos equipados con memoria que permiten mediciones secuenciales fuera del consultorio (AMPA; o MRPA) y otros automáticos que permiten mediciones programadas durante períodos más largos (MAPA). Algunos aspectos en la medición de la PA pueden interferir en la obtención de resultados confiables y, en consecuencia, causar daños en las decisiones a tomar. Estos incluyen la importancia de usar valores promedio, la variación de la PA durante el día y la variabilidad a corto plazo. Estos aspectos han alentado la realización de un mayor número de mediciones en diversas situaciones, y diferentes pautas han abogado por el uso de equipos que promuevan estas acciones. Los dispositivos que realizan MRPA o MAPA, que además de permitir una mayor precisión, cuando se usan juntos, detectan la hipertensión de bata blanca (HBB), la hipertensión enmascarada (HM), las alteraciones de la PA durante el sueño y la hipertensión resistente (HR) (definida en el Capítulo 2 de esta guía), están ganando cada vez más importancia. Teniendo en cuenta estos detalles, debemos enfatizar que la información relacionada con el diagnóstico, la clasificación y el establecimiento de objetivos todavía se basa en la medición de la presión arterial en el consultorio, y por esta razón, se debe prestar toda la atención a la ejecución adecuada de este procedimiento.

A hipertensão arterial (HA) é um dos principais fatores de risco modificáveis para morbidade e mortalidade em todo o mundo, sendo um dos maiores fatores de risco para doença arterial coronária, acidente vascular cerebral (AVC) e insuficiência renal. Além disso, é altamente prevalente e atinge mais de um terço da população mundial. A medida da PA é procedimento OBRIGATÓRIO em qualquer atendimento médico ou realizado por diferentes profissionais de saúde. Contudo, ainda é comumente realizada sem os cuidados técnicos necessários. Como o diagnóstico se baseia na medida da PA, fica claro o cuidado que deve haver com as técnicas, os métodos e os equipamentos utilizados na sua realização. Deve-se reforçar que, feito o diagnóstico, toda a investigação e os tratamentos de curto, médio e longo prazos são feitos com base nos resultados da medida da PA. Assim, técnicas e/ou equipamentos inadequados podem levar a diagnósticos incorretos, tanto subestimando quanto superestimando valores e levando a condutas inadequadas e grandes prejuízos à saúde e à economia das pessoas e das nações. Uma vez feito o diagnóstico correto, na medida em que avança o conhecimento da importância do tratamento adequado, com a adoção de valores de normalidade mais detalhados e com objetivos de tratamento mais cuidadosos no sentido do alcance de metas de PA mais rigorosas, fica também reforçada a importância da precisão na medida da PA. A medida da PA (descrita a seguir) é habitualmente feita pelo método tradicional, a assim chamada medida casual ou de consultório. Ao longo do tempo, foram agregadas alternativas a ela, mediante o uso de equipamentos semiautomáticos ou automáticos pelo próprio paciente, nas salas de espera ou fora do consultório, em sua própria residência ou em espaços públicos. Um passo adiante foi dado com o uso de equipamentos semiautomáticos providos de memória que permitem medidas sequenciais fora do consultório (AMPA; ou MRPA) e outros automáticos que permitem medidas programadas por períodos mais prolongados (MAPA). Alguns aspectos na medida da PA podem interferir na obtenção de resultados fidedignos e, consequentemente, causar prejuízo nas condutas a serem tomadas. Entre eles, estão: a importância de serem utilizados valores médios, a variação da PA durante o dia e a variabilidade a curto prazo. Esses aspectos têm estimulado a realização de maior número de medidas em diversas situações, e as diferentes diretrizes têm preconizado o uso de equipamentos que favoreçam essas ações. Ganham cada vez mais espaço os equipamentos que realizam MRPA ou MAPA, que, além de permitirem maior precisão, se empregados em conjunto, detectam a HA do avental branco (HAB), HA mascarada (HM), alterações da PA no sono e HA resistente (HAR) (definidos no Capítulo 2 desta diretriz). Resguardados esses detalhes, devemos ressaltar que as informações relacionadas a diagnóstico, classificação e estabelecimento de metas ainda são baseadas na medida da PA de consultório e, por esse motivo, toda a atenção deve ser dada à realização desse procedimento.

https://doi.org/10.1590/SciELOPreprints.7057

Situational diagnosis of policies in Latin American and Caribbean countries for the use of fluoride and reduction of sugar consumption
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PAIVA, Saul Martins

; PRADO, Ivana Meyer

; PERAZZO, Matheus França

; GUARNIZO-HERREÑO, Carol C.

; ACEVEDO, Ana Maria

; CASTILLO, Jorge Luis

; ABREU-PLACERES, Ninoska

; GIACAMAN, Rodrigo Andrés

; RICOMINI-FILHO, Antônio Pedro

; MARTIGNON, Stefania

; MALHEIROS, Zilson

; STEWART, Bernal

; BÖNECKER, Marcelo

Brazilian Oral Research

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2023, Volume 37 Suppl. 1 elocation e121

Abstract: En | Text: En | PDF: En

Abstract Policy evaluation and guidance on fluoride use and sugar consumption in Latin American and Caribbean countries (LACC) may provide a scientific evidence basis for policymakers, dental professionals, civil society organizations and individuals committed to improving public oral health. A cross-sectional study was conducted to evaluate the extent of implementation of policies/guidelines on fluoride use, and sugar consumption in LACC. The study had two stages. First a questionnaire covering four major areas was developed: fluoridation of public water supplies; salt fluoridation; fluoride dentifrices, and sugar consumption. Then, the questionnaire was applied to collect data among representative participants in public oral health from LACC. Ninety-six participants from 18 LACC answered the questionnaire. One-hundred seventy documents were attached, and 285 links of websites were provided by the respondents. Implementation of policies and guidelines on water and table salt fluoridation and processed and ultra-processed food consumption were found in most countries, with some issues in the consensus and coverage. Thus, differences were identified in the extent of implementation of public oral health strategies on sugar consumption and fluoridation among the countries. There is no consensus on the policies in LACC to reduce sugar consumption and for the use of fluoride. A few policies and guidelines were applied in isolated countries, with a variety of strategies and standards. For future actions, it will be important to encourage the development of strategies and public policies within countries, and to evaluate the effectiveness of existing policies in reducing dental caries and in improving oral health in LACC.

https://doi.org/10.1590/1807-3107bor-2023.vol37.0121

Demografía y COVID-19: Diferenciales sociales y epidemiológicos
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Aja Díaz, Antonio

; Molina Cintra, Matilde de la Caridad

; Trinquete Díaz, Dixie Edith

; Barros Díaz, Otilia Zenaida

; Rodríguez García, Arianna

; Orbea López, Marbelis

; Mora Pérez, Arelis Rosalen

; Araujo González, Rafael

; Farnós Morejón, Alfonso

; Martin Fernández, Consuelo M.

; Dujarric Bermúdez, Gabriela

; Rodríguez Javiqué, Daylin Cecilia

; Terrero Trinquete, Amanda

; Díaz Fernández, Marta

; Benítez Jiménez, Iliana

; Bourzac Macia, Lisset

; Oliveros Domínguez, Eloy Rafael

; Alfonso de Armas, Marisol

; Quintana Llanio, Livia

; Rodríguez Gómez, Grisell

; Castellanos Cabrera, Roxanne

; Bárcenas Alfonso, Jany

; López Bauta, Adis Aymee

; Oroza Fraíz, Teresa

; Cancio-Bello Ayes, Claudia

; Pérez León, Marta Valeria

; Vera Vergara, Vivian

; Llantá Abreu, María del C.

; Lozano Pérez, Teresa Isabel

; Zas Ros, Bárbara

; Gener Serralta, Sandra

; Rivera Fernández, Rosa M.

; Martínez Debs, Leyti

; Quintosa Puebla, Yissel

; Pérez Rodríguez, Nancy

; Oviedo Álvarez, Vivian

; Fernández Lorenzo, Juan Manuel

; Remond Noa, Ricardo

; Torres Reyes, Antonio

; Veranes Miranda, Alejandro

; de la Garma García, Lic. Diana

Anales de la Academia de Ciencias de Cuba

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dec 2022, Volume 12 N. 3 elocation e1115

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

ABSTRACT Introduction. The behavior of COVID-19 is influenced by diverse social differentials that transcend demographic variables and include morbidity, the conditions of their homes, family dynamics, job performance, gender roles and stereotypes, care tasks, habits, and behaviors of life and consumption, among others. Methods. Statistical and demographic analysis and tools of metric studies of the information were used. Results and Discussion. The research showed the importance of incorporating into the analysis of the behavior of COVID-19 in Cuba the influence of social and epidemiological differentials determined by skin color, marital status, employment status, income levels, types of families, mobility, hygienic environmental conditions, access to health services, among others, which can place populations in greater or lesser conditions of vulnerability. Conclusions: The composition and dynamics of the population together with other social differentials are determinants of the behavior and expression of the pandemic. The crossing of epidemiological factors with the analysis of containment measures and the composition and structure of the affected population allows for the design of health policies that are more adjusted to the needs of the pandemic. Distance psychological counseling makes it possible to identify and deal with situations related to confinement and changes in life routines that affect the mental health of different groups of people.

RESUMEN Introducción. El comportamiento de la COVID-19 está influenciado por diferenciales sociales que trascienden las variables demográficas e incluyen la morbilidad, las condiciones de sus viviendas, las dinámicas familiares, el desempeño laboral, los roles y estereotipos de género, las tareas de cuidado, los hábitos y comportamientos de vida y consumo, entre otros. Métodos. Se empleó el análisis estadístico y demográfico y herramientas de los estudios métricos. Resultados y Discusión. La investigación mostró la importancia de incorporar a los análisis del comportamiento de la COVID-19 en Cuba la influencia de diferenciales sociales y epidemiológicos determinados por el color de la piel, el estado conyugal, la situación laboral, los niveles de ingreso, los tipos de familias, la movilidad, las condiciones higiénico ambientales, el acceso a los servicios de salud, entre otros, que pueden ubicar a las poblaciones en mayores o menores condiciones de vulnerabilidad. Conclusiones, la composición y la dinámica de la población junto a otros diferenciales sociales son determinantes del comportamiento de la pandemia. El cruzamiento de los factores epidemiológicos con el análisis de las medidas de contención y la composición y estructura de población afectada permite diseñar políticas sanitarias más ajustadas a las necesidades de la pandemia. La orientación psicológica a distancia permite identificar y atender situaciones vinculadas al confinamiento y los cambios en las rutinas de vida que afectan la salud mental de diferentes grupos de personas.

Cambios en las características clínicas y desenlaces de pacientes hospitalizados por COVID-19 durante dos años de pandemia: experiencia en un hospital venezolano
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Arvelo, María C.

; Montes de Oca, María

; Sánchez-Traslaviña, Laura

; Pujol, Flor H.

; Jaspe, Rossana C.

; Silva, Isabel C.

; Stulin, Irene

; Blanco, Gabriela

; Quevedo, Jennireth

; Valera, Nathalia

; Papa, Irene

; Bacci, Santiago

; de Abreu, Fátima

; Villarroel, Héctor

; Catari, Juan C.

; Lopez, José L.

; Moran, Brigitte

; Cárdenas, Claudio

; Santucci, Saverio

; Viloria, José L.

; García, Eleonora

; Gómez, Jerry

; Martinelli, Antonio

; Guzmán, Manuel

Revista Peruana de Medicina Experimental y Salud Pública

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sep 2022, Volume 39 N. 3 Pages 292 - 301

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

RESUMEN Objetivos. Determinar los cambios en las características clínicas y desenlaces intrahospitalarios de los pacientes hospitalizados por COVID-19 en un hospital privado de Caracas durante dos años de pandemia. Materiales y métodos. Estudio retrospectivo, observacional, de pacientes hospitalizados por COVID-19. Se investigó la correspondencia entre las olas de ingresos hospitalarios con las variantes circulantes del SARS-CoV-2 en la población general del Distrito Capital y estado Miranda. Resultados. Se incluyeron 1025 pacientes (569 hombres y 456 mujeres), con edad promedio de 62,9 DE: 16,2 años. Cuatro olas de ingresos hospitalarios fueron identificadas: primera (marzo-noviembre 2020) 150/1025 (14,6%) casos; segunda (diciembre-2020 a mayo-2021) 415/1025 (40,5%) casos; tercera (junio-diciembre 2021) 344/1025 (33,6%) casos; cuarta (enero-febrero 2022) 116/1025 (11,3%) casos. La edad promedio fue mayor en la cuarta ola (primera 64,0±15,7, segunda 61,4±15,8, tercera 62,1±16,5, y cuarta ola 68,5±16,4), mientras que la proporción de pacientes masculinos (primera 66,7%, segunda 58,8%, tercera 50,3%, y cuarta 44,8%), los pacientes con enfermedad grave-crítica (primera 65,3%, segunda 57%, tercera 51,7% y cuarta 44,8%), la estadía intrahospitalaria (primera 9,1±6,0, segunda 9,0±7,3, tercera 8,8±7,7, y cuarta 6,9±5,0 días), los ingresos a la UCI (primera 23,3%, segunda 15,7%, tercera 14,0%, y cuarta 11,2%; p=0,027) y la mortalidad (primera 21.8%, segunda 10,7%, tercera 9,1%, y cuarta 7,1%; p<0,001) disminuyeron progresivamente con el tiempo. Conclusiones. Los resultados muestran menor frecuencia de casos severos y mejoría de los desenlaces intrahospitalarios en dos años de pandemia. Es probable que los cambios en las variantes circulantes, las mejoras del manejo de la enfermedad y la vacunación hayan influido sobre estos resultados.

ABSTRACT Objectives. To determine changes in the clinical characteristics and in-hospital outcomes of patients hospitalized for COVID-19 in a private hospital in Caracas during two years of the pandemic. Materials and Methods. Retrospective, observational study of patients hospitalized for COVID-19. We evaluated the correspondence between waves of hospital admissions and circulating variants of SARS-CoV-2 in the general population of the Capital District and Miranda state. Results. A total of 1025 patients (569 men and 456 women) were included, with a mean age of 62.9 SD: 16.2 years. Four waves of hospital admissions were identified: first (March-November 2020) 150/1025 (14.6%) cases; second (December 2020 to May 2021) 415/1025 (40.5%) cases; third (June-December 2021) 344/1025 (33.6%) cases; fourth (January-February 2022) 116/1025 (11.3%) cases. The mean age was higher in the fourth wave (first: 64.0±15.7, second: 61.4±15.8, third: 62.1±16.5, and fourth wave: 68.5±16.4), while the proportion of male patients (first: 66.7%, second: 58.8%, third: 50.3%, and fourth wave: 44.8%), patients with severe-critical illness (first: 65.3%, second: 57%, third: 51.7%, and fourth wave: 44.8%), in-hospital stay (first: 9.1±6.0, second: 9.0±7.3, third: 8.8±7.7, and fourth wave: 6.9±5.0 days), ICU admissions (first: 23.3%, second: 15.7%, third: 14.0%, and fourth wave: 11.2%; p=0.027) and mortality (first: 21. 8%, second: 10.7%, third: 9.1%, and fourth wave: 7.1%; p<0.001) progressively decreased over time. Conclusions. The results show lower frequency of severe cases and improvement of in-hospital outcomes in two years of the pandemic. Changes in circulating variants, improvements in disease management and vaccination are likely to have influenced these results.

https://doi.org/10.17843/rpmesp.2022.393.11195

Cambios en las características clínicas y desenlaces de pacientes hospitalizados por COVID-19 durante dos años de pandemia: experiencia en un hospital venezolano
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Arvelo, María C.

; Montes de Oca, María

; Sánchez-Traslaviña, Laura

; Pujol, Flor H.

; Jaspe, Rossana C.

; Silva, Isabel C.

; Stulin, Irene

; Blanco, Gabriela

; Quevedo, Jennireth

; Valera, Nathalia

; Papa, Irene

; Bacci, Santiago

; de Abreu, Fátima

; Villarroel, Héctor

; Catari, Juan C.

; Lopez, José L.

; Moran, Brigitte

; Cárdenas, Claudio

; Santucci, Saverio

; Viloria, José L.

; García, Eleonora

; Gómez, Jerry

; Martinelli, Antonio

; Guzmán, Manuel

Revista Peruana de Medicina Experimental y Salud Publica

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jul 2022, Volume 39 N. 3 Pages 292 - 301

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

https://doi.org/10.17843/rpmesp.2022.393.11195

Effective recommendations towards healthy routines to preserve mental health during the COVID-19 pandemic
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Pilz, Luísa K.

; Couto Pereira, Natividade S.

; Francisco, Ana Paula

; Carissimi, Alicia

; Constantino, Débora B.

; Caus, Letícia B.

; Abreu, Ana Carolina O.

; Amando, Guilherme R.

; Bonatto, Fernanda S.

; Carvalho, Paula V.V.

; Cipolla-Neto, José

; Harb, Ana

; Lazzarotto, Gabriela

; Marafiga, Joseane Righes

; Minuzzi, Luciano

; Montagner, Francisco

; Nishino, Fernanda A.

; Oliveira, Melissa A.B.

; dos Santos, Bruno G.T.

; Steibel, Eduardo G.

; Tavares, Patrice S.

; Tonon, André C.

; Xavier, Nicóli B.

; Zanona, Querusche Klippel

; Amaral, Fernanda G.

; Calcagnotto, Maria Elisa

; Frey, Benicio N.

; Hidalgo, Maria Paz

; Idiart, Marco

; Russomano, Thais

Brazilian Journal of Psychiatry

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apr 2022, Volume 44 N. 2 Pages 136 - 146

Abstract: En | Text: En | PDF: En

Objective: To assess the adherence to a set of evidence-based recommendations to support mental health during the coronavirus disease 2019 (COVID-19) pandemic and its association with depressive and anxiety symptoms. Methods: A team of health workers and researchers prepared the recommendations, formatted into three volumes (1: COVID-19 prevention; 2: Healthy habits; 3: Biological clock and sleep). Participants were randomized to receive only Volume 1 (control), Volumes 1 and 2, Volumes 1 and 3, or all volumes. We used a convenience sample of Portuguese-speaking participants over age 18 years. An online survey consisting of sociodemographic and behavioral questionnaires and mental health instruments (Patient Health Questionnaire-9 [PHQ-9] and Generalized Anxiety Disorder-7 [GAD-7]) was administered. At 14 and 28 days later, participants were invited to complete follow-up surveys, which also included questions regarding adherence to the recommendations. A total of 409 participants completed the study – mostly young adult women holding university degrees. Results: The set of recommendations contained in Volumes 2 and 3 was effective in protecting mental health, as suggested by significant associations of adherence with PHQ-9 and GAD-7 scores (reflecting anxiety and depression symptoms, respectively). Conclusion: The recommendations developed in this study could be useful to prevent negative mental health effects in the context of the pandemic and beyond.

https://doi.org/10.1590/1516-4446-2021-2109

Pros y contras de las innovaciones en educación médica
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Lifshitz-Guinzberg, Alberto

; Abreu-Hernández, Luis F.

; Sepúlveda-Vildósola, Ana C.

; Urrutia-Aguilar, María Esther

; Córdova-Villalobos, José Á.

; López-Bárcena, Joaquín

; Sánchez-Mendiola, Melchor

Gaceta médica de México

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jun 2021, Volume 157 N. 3 Pages 338 - 348

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract Medical education has implemented various innovative strategies with the purpose to attain better learning achievements. An evaluation is made of the experiences in the competencies approach, new learning technologies, curricular alternatives, professional evaluation and distance education technologies in order to locate them in the areas they belong.

Resumen La educación médica ha puesto en práctica diversas estrategias innovadoras con el propósito de alcanzar mejores logros de aprendizaje. Se hace una evaluación de las experiencias relacionadas con el enfoque por competencias, las nuevas tecnologías educativas, las alternativas curriculares, la profesionalización de la evaluación y las técnicas educativas a distancia, para ubicarlas en el lugar que les corresponde.

https://doi.org/10.24875/gmm.20000688 277 downloads

Excess weight and obesity prevalence in the RPS Brazilian Birth Cohort Consortium (Ribeirão Preto, Pelotas and São Luís)
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Carvalho, Carolina Abreu de

; Magalhães, Elma Izze da Silva

; Bettiol, Heloisa

; Barbieri, Marco Antonio

; Cardoso, Viviane Cunha

; Matijasevich, Alicia

; Menezes, Ana Maria Baptista

; Horta, Bernardo Lessa

; Wehrmeister, Fernando C.

; Gonçalves, Helen

; Santos, Iná S.

; Lima, Natália Peixoto

; França, Ana Karina Teixeira da Cunha

; Silva, Antônio Augusto Moura da

Cadernos de Saúde Pública

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2021, Volume 37 N. 4 elocation e00237020

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

O estudo teve como objetivo estimar as prevalências de excesso de peso e de obesidade, de acordo com sexo e renda, no Consórcio RPS (Ribeirão Preto, Pelotas e São Luís) de coorte de nascimentos brasileiros. Os participantes nas coortes de Ribeirão Preto (1978/1979 e 1994), Pelotas (1982, 1993 e 2004) e São Luís (1997/1998) foram incluídos em diferentes seguimentos a partir dos sete anos de idade. O excesso de peso (sobrepeso e obesidade) e a obesidade foram avaliados pelo índice de massa corporal. As maiores prevalências foram observadas em Ribeirão Preto (excesso de peso: 27,7% aos 9-11 e 47,1% aos 22-23 anos; obesidade: 8,6% aos 9-11 e 19,8% aos 22-23 anos) e as menores taxas em São Luís (excesso de peso: 5,4% aos 7-9 e 17,2% aos 18-19 anos; obesidade: 1,8% aos 7-9 e 3,6% aos 18-19 anos). Quanto mais jovem a coorte, maior a prevalência de excesso de peso e de obesidade, na comparação entre grupos etários semelhantes. O aumento na prevalência de obesidade foi maior que na prevalência de excesso de peso. As mulheres tiveram menor prevalência de excesso de peso nas coortes mais velhas e maior prevalência de obesidade nas coortes mais jovens. Maiores prevalências de excesso de peso e de obesidade foram observadas nas crianças e adolescentes com renda familiar mais alta e em adultos de renda mais baixa. As diferenças nas prevalências de excesso de peso e de obesidade evidenciaram que os indivíduos das coortes mais jovens estão mais expostos a essa morbidade, assim como, aqueles nascidos na cidade mais desenvolvida, os adultos de baixa renda e crianças e adolescentes pertencentes a família do tercil de maior renda. Portanto, os resultados indicam a necessidade de priorizar medidas dirigidas aos indivíduos mais jovens.

Our objective was to estimate the prevalence of excess weight and obesity, according to sex and income in the RPS Brazilian Birth Cohort Consortium (Ribeirão Preto, Pelotas, and São Luís). Participants in the Ribeirão Preto (1978/1979 and 1994), Pelotas (1982, 1993 and 2004) and São Luís (1997/1998) birth cohorts were included in different follow-ups from 7 years old onwards. Excess weight (overweight and obesity) were assessed by body mass index. The highest prevalences were observed in Ribeirão Preto (excess weight: 27.7% at 9-11 and 47.1% at 22-23 years; obesity: 8.6% at 9-11 and 19.8% at 22-23 years) while the smallest was in São Luís (excess weight: 5.4 to 7-9 and 17.2% at 18-19 years; obesity: 1.8% at 7-9 and 3.6% at 18-19 years). The younger the cohort, the greater the prevalence of excess weight and obesity when comparing similar age groups. Increases in obesity prevalence were greater than in excess weight prevalence. Women had lower excess weight prevalence in older cohorts and higher obesity prevalence in younger cohorts. Higher excess weight and obesity prevalence were observed in higher income children and adolescents, and in poorer adults. Differences in the prevalence of excess weight and obesity evidenced that individuals from younger cohorts are more exposed to this morbidity, as well as those who were born in the most developed city, low-income adults as well as children and adolescents belonging to families of the highest income tertile. Therefore, the results of this study indicate the need to prioritize actions aimed at younger individuals.

El objetivo de este estudio fue estimar la prevalencia de sobrepeso y obesidad, según sexo e ingresos en el Consorcio RPS (Ribeirão Preto, Pelotas and São Luís) cohortes brasileñas de nascimientos. Los participantes en las cohortes de nacimiento de Ribeirão Preto (1978/1979 y 1994), Pelotas (1982, 1993 y 2004) y São Luís (1997/1998) fueron incluidos en diferentes seguimientos desde los 7 años de edad. El exceso de peso (sobrepeso y obesidad) fueron evaluados por el índice de masa corporal. Las prevalencias más altas se observaron en Ribeirão Preto (exceso de peso: 27,7% a los 9-11 y 47,1% a los 22-23 años; obesidad: 8,6% a los 9-11 y 19,8% a los 22-23 años) y los más pequeños en São Luís (exceso de peso: 5,4 a los 7-9 y 17,2% a los 18-19 años; obesidad: 1,8% a los 7-9 y 3,6% a los 18-19 años). Cuanto más joven fuera la cohorte, mayor era la prevalencia de exceso de peso y obesidad, cuando se comparan con grupos de edad similares. El incremento en la prevalencia de obesidad fue mayor que en la prevalencia de exceso de peso. Las mujeres tenían una prevalencia de exceso de peso más baja en las cohortes más viejas y una mayor prevalencia de obesidad en las cohortes más jóvenes. Se observaron prevalencias más altas de exceso de peso y obesidad en los niños y adolescentes con mayores ingresos, y en los adultos más pobres. Las diferencias en las prevalencias de exceso de peso y obesidad evidenciaron que las personas de las cohortes más jóvenes estaban más expuestas a esta morbilidad, al igual que aquellas que habían nacido en las ciudades más desarrolladas, adultos con bajos ingresos, además de niños y adolescentes pertenecientes a las familias del tercil de ingresos más altos. Por eso, los resultados de este estudio indican la necesidad de priorizar acciones dirigidas a las personas más jóvenes.

https://doi.org/10.1590/0102-311x00237020

Excess weight and obesity prevalence in the RPS Brazilian Birth Cohort Consortium (Ribeirão Preto, Pelotas and São Luís)
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Carvalho, Carolina Abreu de

; Magalhães, Elma Izze da Silva

; Bettiol, Heloisa

; Barbieri, Marco Antonio

; Cardoso, Viviane Cunha

; Matijasevich, Alicia

; Menezes, Ana Maria Baptista

; Horta, Bernardo Lessa

; Wehrmeister, Fernando C.

; Gonçalves, Helen

; Santos, Iná S.

; Lima, Natália Peixoto

; França, Ana Karina Teixeira da Cunha

; Silva, Antônio Augusto Moura da

Cadernos de Saúde Pública

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2021, Volume 37 N. 4 elocation e00237020

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

https://doi.org/10.1590/0102-311x00237020 257 downloads

10.

A Real Time PCR strategy for the detection and quantification of Candida albicans in human blood
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Busser, Felipe Delatorre

; Coelho, Vivian Caso

; Fonseca, Claudia de Abreu

; Del Negro, Gilda Maria Barbaro

; Shikanai-Yasuda, Maria Aparecida

; Lopes, Marta Heloisa

; Magri, Marcello Mihailenko Chaves

; Freitas, Vera Lucia Teixeira de

Revista do Instituto de Medicina Tropical de São Paulo

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2020, Volume 62 elocation e9

Abstract: En | Text: En | PDF: En

ABSTRACT Candidemia is a significant cause of bloodstream infections (BSI) in nosocomial settings. The identification of species can potentially improve the quality of care and decrease human mortality. Quantitative PCR (qPCR) was evaluated for Candida albicans detection using culture suspensions containing C. albicans , spiked human blood, the cloned qPCR target fragment (ITS2 region) and the results of these assays were compared. The assays showed a good detection limit: C. albicans DNA extracted from yeast (sensitivity 0.2 CFU/µL), spiked human blood (sensitivity 10 CFU/mL), and cloned fragment of ITS2 region (sensitivity 20 target copies/μL). The efficiency of ITS2 fragment-qPCR ranged from 89.67 to 97.07, and the linearity (R2) of the standard curve ranged from 0.992 to 0.999. The results showed that this ITS2-qPCR has a great potential as a molecular prototype model for the development of a test to be applied in clinical practice, greatly reducing the time of candidemia diagnosis, which is extremely important in this clinical setting.

https://doi.org/10.1590/s1678-9946202062009 1050 downloads

11.

Proton Pump Inhibitors Use for Stress Ulcer Prophylaxis in Non-Critically Ill Patients
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Sousa, Ana C. Isabel Chora

; Jacinto, Margarida Maria Maia Leonardo Pimenta

; Pires, Vitória Isabel Duarte

; Abreu, Tiago Tribolet de

Medicina Interna

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mar 2019, Volume 26 N. 1 Pages 28 - 32

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Introdução: A utilização de inibidores da bomba de protões (IBPs) tem um papel bem estabelecido na profilaxia da hemorragia gastrointestinal no doente crítico; contudo, a sua utilização em doentes não-críticos é controversa. Os autores propuseram-se a avaliar a prescrição de IBPs em doentes num Serviço de Medicina Interna, incluindo a sua indicação e os custos associados. Material e Métodos: : Estudo prospectivo, observacional, transversal. Foram incluídos todos os doentes admitidos no nosso Serviço de Medicina Interna durante 31 dias. Na admissão foi preenchido pelo médico assistente uma escala de risco para hemorragia gastrointestinal. A pontuação igual ou superior 10 pontos afirmava a indicação para profilaxia com IBPs. Os custos associados ao uso de IBPs foram avaliados no período do estudo. Resultados: Foram admitidos 115 doentes, dos quais 99 doentes foram incluídos no estudo (54,5% mulheres, idade média 76,2 anos). Factores de risco: 28,3% lesão renal aguda, 10,1% patologia hepática, 20,2% sépsis, 40,4% anticoagulação profiláctica e 30,3% coagulopatia. De acordo com a escala de risco, 67,7% encontrava-se nos grupos baixo risco e 32,4% nos grupos alto risco. Verificámos que 59,6% dos doentes realizaram terapêutica com IBPs; destes, 45,8% de acordo com a escala de risco utilizada não apresentavam indicação para tal. O gasto em IBPs durante o estudo foi de 101,9€, portanto o valor estimado de gastos inapropriados foi de 46,6€ durante o estudo. Conclusão: A utilização de IBPs foi elevada no nosso departamento de medicina interna (59,6%). Destes doentes a utilização de IBPs foi inapropriada em 45,8%, o que representa um problema actual com risco iatrogénico e impacto económico.

Introduction: The use of proton pump inhibitors (PPIs) has a well-established role in the prophylaxis of gastrointestinal bleeding in critically care patients; however, its use in non-intensive care patients is controversial. The authors proposed to evaluate the prescription of PPIs as gastrointestinal bleeding prophylaxis during hospitalization of non-critically ill patients, including the indication and costs. Material and Methods: A prospective, observational, cross-sectional study. All patients admitted to our medical department during a 31 day period were included. At the time of admission, a gastrointestinal bleeding risk score was completed by the attending physician. A score equal or greater than 10 points identified appropriateness of PPIs for prophylactic therapy. Costs with PPI use were collected on the study period. Results: During the study period, 115 patients were admitted, of which 99 were included in the study (54.5% women, mean age 76.2 years). Of the gastrointestinal bleeding risk factors assessed: 28.3% acute kidney injury, 10.1% liver disease, 20.2% sepsis, 40.4% prophylactic anticoagulation, and 30.3% coagulopathy. According to the score used, 67.7% of the patients were in low or low-medium risk and 32.4% in high-medium or high risk. During hospitalization, 59.6% of the patients received PPIs, 45.8% of which inappropriately according to the risk score. The total cost of PPIs use was 101.9€, with an inappropriate spending of 46.6€ during a 31 day period in our Internal Medicine department alone. Conclusion: PPIs use was prevalent in non-critically ill patients (59.6%), of which 45.8% were inappropriate, representing a problem associated with iatrogenic risk and economic impact.

https://doi.org/10.24950/rspmi/original/115/1/2019 457 downloads

12.

Prospective cohort analyzing risk factors for chronic kidney disease progression in children,
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Belangero, Vera M.S.

; Prates, Liliane C.

; Watanabe, Andreia

; Schvartsman, Benita S.G.

; Nussenzveig, Paula

; Cruz, Natalia A.

; Abreu, Ana L.S.

; Paz, Isabel P.

; Facincani, Inalda

; Morgantetti, Fernanda E.C.

; Silva, Andreia O.

; Andrade, Olberes V.B.

; Camargo, Maria F.C.

; Nogueira, Paulo C. Koch

Jornal de Pediatria

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oct 2018, Volume 94 N. 5 Pages 525 - 531

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Objetivo: Identificar os fatores de risco para progressão da DRC em crianças do Brasil e avaliar as interações entre os fatores. Métodos: Coorte prospectiva multicêntrica em São Paulo, envolvendo 209 crianças com DRC em estágios 3-4. O desfecho do estudo incluiu: a) óbito, b) início da terapia de substituição renal, c) redução de > 50% na taxa estimada de filtração glomerular (eGFR) durante o acompanhamento. Foram testados 13 fatores de risco com o modelo de regressão univariada seguido do modelo de regressão multivariado de Cox. Os termos de interação entre as variáveis mostraram associação significativa e foram introduzidos ao modelo. Resultados: Após média de acompanhamento de 2,5 anos (IIQ = 1,4 a 3,0), 44 casos (21%) apresentaram desfecho: 22 iniciaram diálise, 12 apresentaram redução de > 50% na eGFR, sete foram submetidos a transplante e três morreram. Estágio avançado de DRC no acometimento (RR = 2,16, IC = 1,14-4,09), proteinúria nefrótica (RR = 2,89, IC = 1,49-5,62), idade (RR - 1,10, IC = 1,01-1,17), escore Z da pressão arterial sistólica (RR = 1,36, IC = 1,08-1,70) e anemia (RR = 2,60, IC - 1,41-4,77) foram associados ao resultado. Foi detectada interação entre anemia e proteinúria nefrótica na primeira visita (V1) (RR = 0,25, IC = 0,06-1,00). Conclusões: Como a primeira coorte de DRC no hemisfério sul, este estudo é concordante com os principais fatores relatados em países desenvolvidos com relação à progressão da DRC, afirmando o possível papel dos tratamentos para mostrar a evolução da DRC. A interação detectada sugere que a anemia pode ser mais nociva na progressão da DRC em pacientes sem proteinúria e deve ser ainda mais estudada.

Abstract Objective: To identify risk factors for chronic kidney disease progression in Brazilian children and to evaluate the interactions between factors. Methods: This was a multicenter prospective cohort in São Paulo, involving 209 children with CKD stages 3-4. The study outcome included: (a) death, (b) start of kidney replacement therapy, (c) eGFR decrease >50% during the followup. Thirteen risk factors were tested using univariate regression models, followed by multivariable Cox regression models. The terms of interaction between the variables showing significant association with the outcome were then introduced to the model. Results: After a median follow-up of 2.5 years (IQR = 1.4-3.0), the outcome occurred in 44 cases (21%): 22 started dialysis, 12 had >50% eGFR decrease, seven underwent transplantation, and three died. Advanced CKD stage at onset (HR = 2.16, CI = 1.14-4.09), nephrotic proteinuria (HR = 2.89, CI = 1.49-5.62), age (HR = 1.10, CI = 1.01-1.17), systolic blood pressure Z score (HR = 1.36, CI = 1.08-1.70), and anemia (HR = 2.60, CI = 1.41-4.77) were associated with the outcome. An interaction between anemia and nephrotic proteinuria at V1 (HR = 0.25, CI = 0.06-1.00) was detected. Conclusions: As the first CKD cohort in the southern hemisphere, this study supports the main factors reported in developed countries with regards to CKD progression, affirming the potential role of treatments to slow CKD evolution. The detected interaction suggests that anemia may be more deleterious for CKD progression in patients without proteinuria and should be further studied.

https://doi.org/10.1016/j.jped.2017.07.015 1352 downloads

13.

Immunophenotyping lymphocyte and acute phase proteins in canine X-linked muscular dystrophy
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ABREU, DILAYLA K. DE

; MONTEIRO, JANAINA M.

; SOUZA, CAROLINA C.

; KARAM, RAFAEL G.

; FERNANDES, RENATA A.

; LESSA, THAIS B.

; FAGLIARI, JOSÉ J.

; MIGLINO, MARIA ANGELICA

; AMBROSIO, CARLOS EDUARDO

Anais da Academia Brasileira de Ciências

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sep 2018, Volume 90 N. 3 Pages 2977 - 2990

Abstract: En | Text: En | PDF: En

Abstract Duchenne Muscular Dystrophy (DMD) is the most common X-linked muscular disease affecting humans. The Golden Retriever Muscular Dystrophy model (GRMD) is considerthe most suitable for several studies. This assay aims to quantify lymphocyte subpopulations CD4, CD5, and CD8, and standardize, the serum electrophoretic profile, to understand their contribution to the pathologic process in normal Golden Retriever dogs (GR group) and dystrophic´s (GRMD group), through the umbilical cord blood, in dogs aged from 2 to 3 months (GR II and GRMD II), and in dogs over 1 year of age (GR III and GRMD III). No significant differences were observed between the CD8+ lymphocyte subpopulations of the groups studied. The CD4+ and CD5+ lymphocyte subpopulations were significantly higher in the GRMD III group compared to the GR III group. Twenty-two different proteins in the gel were identified. The serum concentrations of the proteins belonging to the GR I and GRMD I groups were significantly lower than those of the other groups. We show that expression of acute phase proteins are worst during the aging of the dogs. We hope to expand knowledge to better understand the GRMD model and the translational data.

https://doi.org/10.1590/0001-3765201820170838 1137 downloads

14.

Prevalência e susceptibilidade antimicrobiana de sorotipos de Salmonella spp. isolados de frangos vivos e carcaças no estado do Rio de Janeiro
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Baptista, Daniela Q.

; Santos, André F.M.

; Aquino, Maria Helena C.

; Abreu, Dayse L.C.

; Rodrigues, Dália P.

; Nascimento, Elmiro R.

; Pereira, Virginia L.A.

Pesquisa Veterinária Brasileira

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jul 2018, Volume 38 N. 7 Pages 1278 - 1285

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO: A presença de Salmonella spp. em produtos de origem avícola e seus subprodutos se mostra um grande desafio para a produção comercial. Dados de prevalência, dos sorotipos circulantes e do perfil de susceptibilidade antimicrobiana de cepas de Salmonella spp. no Estado do Rio de Janeiro são escassos. Portanto, objetivou-se detectar a presença Salmonella spp. em frangos vivos e carcaças em matadouros do Estados do Rio de Janeiro, identificar os sorotipos e avaliar a susceptibilidade antimicrobiana dessas cepas para fluoroquinolonas e betalactâmicos. Foram coletadas 60 amostras cloacais de frangos vivos e 60 amostras de carcaça de seis matadouros sob Inspeção Estadual (SIE). Os isolados foram sorotipificados e testados frente a oito antimicrobianos: enrofloxacina, ciprofloxacina, norfloxacina, cefalotina, ceftiofur, cefotaxima, amoxicilina/ácido clavulânico e ampicilina pelo método de difusão em disco. Os resultados mostraram uma prevalência de Salmonella spp. de 1,66% (1/60) em amostras de suabe de cloaca e de 26,66% (16/60) em carcaças. Em amostras de suabe de cloaca, somente o sorotipo Senftenberg (1,66%) foi isolado. No total, foram isolados sete sorotipos diferentes nas carcaças: Senftenberg (15%) o mais frequente, seguido por Mbandaka (8,3%), Schwarzengrund (3,3%), Cerro (3,3%), Ohio (3,3%), Minnesota (1,66%) e Tennessee (1,66%). Em relação à susceptibilidade antimicrobiana, 29 (87,87%) isolados foram sensíveis a todos os antimicrobianos testados e 4 (12,12%) isolados foram resistentes a pelo menos três antimicrobianos betalactâmicos ou mais. Não foi observada resistência às fluoroquinolonas. Os resultados encontrados demonstram uma prevalência de Salmonella spp. acima da esperada em matadouros do Estado do Rio de Janeiro, além da presença de vários sorotipos de Salmonella spp. A resistência encontrada para betalactâmicos alerta para a disseminação dessas cepas pela cadeia alimentar.

ABSTRACT: The presence of Salmonella spp. in poultry products and their by-products is a major challenge for commercial production. Data about the prevalence, the circulating serotypes and the antimicrobial susceptibility profile of Salmonella spp. strains in the State of Rio de Janeiro are scarce. Therefore, the aim of this study was to detect the presence of Salmonella spp. in live chickens and carcasses in slaughterhouses of the State of Rio de Janeiro, to identify the serotypes and to evaluate the antimicrobial susceptibility of these strains for fluoroquinolones and beta-lactams. Sixty cloacal swabs samples from broiler chickens and sixty samples of carcasses from six slaughterhouses under State Inspection were collected. The isolates were serotyped and resistance was tested to eight antimicrobials: enrofloxacin, ciprofloxacin, norfloxacin, cephalothin, ceftiofur, cefotaxime, amoxicillin/clavulanic acid and ampicillin by disc diffusion method. The results showed a prevalence of Salmonella spp. of 1.66% (1/60) in cloacal swabs samples and 26.66% (16/60) in carcasses. In cloacal swabs sample only Senftenberg (1.66%) serotype was isolated. In total, seven different serotypes were obtained from carcasses: Senftenberg (15%), followed by Mbandaka (8.3%), Schwarzengrund (3.3%), Cerro (3.3%), Ohio (3.3%), Minnesota (1.66%) and Tennessee (1.66%). Regarding antimicrobial susceptibility, 29 (87.87%) isolates were sensitive to all antimicrobials tested and 4 (12.12%) isolates were resistant to three or more beta-lactams antimicrobials. No susceptibility to fluoroquinolones was observed. These results showed a prevalence of Salmonella spp. higher than expected in slaughterhouses in the State of Rio de Janeiro, besides the presence of several serotypes of Salmonella spp. The resistance found for beta-lactams alerts to the spread of these strains through the food chain.

https://doi.org/10.1590/1678-5150-pvb-5289 2222 downloads

15.

Measurement of oral health quality of life among patients who underwent haematopoietic stem-cell transplantation
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PEREIRA, Nayara Fernanda

; SILVA, Paula Verona Ragusa da

; FUKUOKA, Cíntia Yuki

; MICHEL-CROSATO, Edgard

; GONÇALVES, Alyne Simões

; ALVES, Fábio Abreu

; VIEIRA, Garles Miller Matias

; BIAZEVIC, Maria Gabriela Haye

Brazilian Oral Research

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- Sobre o periódico
- SciELO Analytics

2018, Volume 32 elocation e78

Abstract: En | Text: En | PDF: En

Abstract Oral mucositis is a painful condition that occurs in patients who have undergone haematopoietic stem-cell transplantation (HSCT) and has a huge impact on their quality of life. The objective of this study was to examine the extent to which interleukin-6 (IL-6) and tumour necrosis factor alpha (TNF-α) are associated with oral health quality of life among patients who underwent HSCT. A. C. Camargo Cancer Center patients were evaluated over 20 months at 4 different time-points: a) at patient admission (M1); b) on the day of infusion of HSC (M2); c) 12 and 20 days after the first day of the conditioning regimen for autologous and allogeneic transplantation, respectively (M3); and d) 30 days after the first day of the conditioning regimen (M4). Mucositis clinical evaluations were performed using World Health Organization (WHO) criteria. Oral health quality of life was measured using the Oral Health Impact Profile short form (OHIP-14), Oral Mucositis Quality of Life (OMQoL) and Patient-Reported Oral Mucositis Symptom (PROMS) scales. Correlations between clinical data and quality of life scores were examined. STATA 11.0 was used to perform the statistical analyses (5% level of significance). Eighty-two patients participated in the study; 62.2% were male, 28.05% had multiple myeloma, and the mean age was 48.49 years (SD 13.76). Higher scores (worse quality of life) were observed as mucositis scores increased, but the results were not significant. The OMQoL had a high correlation with OHIP-14 (0.8377), but the correlation between the PROMS scale and the OHIP-14 was lower (0.6643). Higher concentrations of IL-6 and TNF-α were associated with worse quality of life, according to all indices (p < 0.05). Oral mucositis was associated with quality of life scores (p < 0.01).

https://doi.org/10.1590/1807-3107bor-2018.vol32.0078 1892 downloads

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