Analisar os fatores associados ao uso dos Equipamentos de Proteção Individual entre médicos brasileiros durante a pandemia da COVID-19.
Estudo transversal analítico realizado no período de outubro a ...dezembro de 2020 com médicos de todas as regiões do Brasil. A coleta de dados foi realizada por meio de mídias sociais como Facebook, Twitter, Instagram, Whatsapp e e-mail, com envio de um link para o acesso ao formulário da pesquisa. Os dados foram coletados por meio da plataforma surveymonkey e analisados no software R, versão 4.0.4. O teste qui-quadrado e teste exato de Fisher foram utilizados para testar a hipótese da associação entre o desfecho e as variáveis independentes. Regressão logística foi aplicada considerando todas as variáveis do estudo.
1298 médicos de todas as regiões do Brasil participaram do estudo. Quanto aos fatores associados a usar EPI recomendados durante assistência a pacientes com COVID-19, observou-se: ser do sexo feminino (OR = 1,570; IC: 1,242-1,986; p = 0,000); atuava em UTI (OR = 2,785; IC: 2,067-3,751; p = 0,000) e recebeu capacitação no contexto da COVID-19 (OR = 1,620; IC: 1,254-2,092; p = 0,000) tiveram mais chance de usar os EPI necessários para assistência a pacientes com COVID-19. Quanto aos procedimentos que geram aerossóis no contexto da COVID-19, verificou-se os seguintes fatores associados: atuava na UTI (OR = 2,631; IC: 1,993-3,474; p = 0,000); prestou assistência em hospital de campanha (OR = 1,349; IC: 1,046-1,740; p = 0,021) e a instituição de trabalho forneceu EPI de boa qualidade (OR = 1,931; IC: 1,200-3,107; p = 0,007) tiveram mais chance de usar corretamente o EPI durante procedimentos que geram aerossóis no contexto da COVID-19.
Foram identificados fatores associados ao uso de EPI necessário em pacientes com COVID-19 e fatores associados ao uso de EPI para procedimentos que geram aerossóis. Intervenções educativas para profissionais e gestores devem ser implementadas a fim de orientá-los a se protegerem e aos demais.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
The study showed the effectiveness of photodynamic therapy based on methylene blue to treat severe distal and lateral subungual toenail onychomycosis. 22 patients were divided into two groups: group ...A consisting of 11 patients with severe toenail onychomycosis and group B consisting of 11 patients with mild-to-moderate toenail onychomycosis. All patients had onychomycosis caused by Trichophyton rubrum. The patients were treated with sessions of 2% methylene blue aqueous solution irradiated with light emission diode device with 630 nm and 36 J/cm2 biweekly for six months. The clinical response was significantly better in patients with mild-to-moderate (100%) onychomycosis compared with patients with severe onychomycosis (63.6%).
Introduction: The objective was to analyze the factors associated with use of Personal Protective Equipment (PPE) among Brazilian physicians during the COVID-19 pandemic.
Methodology: An analytical ...cross-sectional study was conducted from October to December 2020 with 1298 Brazilian physicians. The respondent driven sampling technique was used by sharing the survey through social media.
Results: Factors associated with the use of PPE while caring for COVID-19 patients were: being female (AOR = 1.57; 95% CI: 1.24-1.98; p ≤ 0.001); working in Intensive Care Unit (ICU) (AOR = 2.78; 95% CI: 2.06-3.75; p ≤ 0.001); training (AOR = 1.62; 95% CI: 1.25-2.09; p ≤ 0.001); access to sufficient PPE (AOR = 2.22; 95% CI: 1.27-3.90; p = 0.0050), and PPE of good quality (AOR = 1.84; 95% CI: 1.16-2.92; p = 0.009). The following factors were associated with the use of recommended PPE during procedures that generate aerosols in the context of COVID-19: working in the ICU (ORA=2.73; 95% CI: 2.06-3.62; p < 0.01); working in a field hospital (AOR = 1.37; 95% CI: 1.06-1.79; p = 0.018;) training (AOR = 1.72 95% CI: 1.32-2.24; p < 0.01); access to sufficient PPE (AOR = 1.63; 95% CI: 0.91-2.92; p < 0.01), PPE of good quality (AOR = 2.07; 95% CI: 1.28-3.35; p = 0.003).
Conclusions: The factors associated with the use of necessary PPE with COVID-19 patients and for procedures that generate aerosols were identified. Educational interventions for professionals and managers must be implemented to direct them towards protecting themselves and others.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
to identify the dietary patterns of adolescents attending public municipal schools in Northern Minas Gerais, Brazil, and to test the association between these patterns and socioeconomic variables and ...nutritional status of the adolescents.
this was an analytical, cross-sectional study with randomized sample of 474 adolescents of both genders, between 11 and 17 years of age, attending municipal public schools in the urban area of Montes Claros, MG, Brazil. The parents provided demographic and economic data. The nutritional status (body mass index - BMI) of the adolescents was determined at school, and their dietary habits were assessed though the administration of the Food Frequency Questionnaire for Adolescents (FFQA). Based on 26 categories extracted from FFQA, dietary patterns were determined using principal component analysis (PCA) and associated to anthropometric and socioeconomic factors using multiple regression analysis.
the three dietary patterns identified, “junk food,” “healthy,” and “traditional”, explained 23.26%, 6.90%, and 5.24% of data variability, respectively. Adolescents with per capita family income exceeding half a minimum wage were more likely to consume the “junk food” pattern (OR=1.66; 95% CI=1.07-2.56), and overweight adolescents had lower chances of eating the “healthy” food pattern (OR=0.56, 95% CI=0.35-0.91).
deviations from the “healthy” patterns were not associated to low income, but rather to bad eating habits in the studied population. Overweight adolescents did not adhere to the “healthy” dietary pattern, emphasizing the need for nutritional education among them.
identificar os padrões de consumo alimentar de adolescentes de escolas públicas do norte de Minas Gerais e testar a associação desses padrões com variáveis socioeconômicas e estado nutricional.
estudo analítico e transversal com amostra aleatória de 474 adolescentes de ambos os sexos, 11 a 17 anos de idade, matriculados do 6° ao 9° ano de escolas públicas municipais da zona urbana de Montes Claros, MG. Os pais forneceram informações demográficas e econômicas. Nas escolas, avaliou-se o estado nutricional dos adolescentes (índice de massa corporal - IMC) e investigou-se seus hábitos alimentares aplicando-se um Questionário de Frequência Alimentar para Adolescentes (QFAA). Com base em 26 categorias de alimentos extraídas do QFAA, aplicou-se uma análise fatorial de componentes principais (ACP) para identificar os padrões alimentares, que foram associados a fatores antropométricos e socioeconômicos por análise de regressão múltipla.
os três padrões alimentares identificados, “junk food”, “saudável” e “tradicional”, explicaram 23,26%, 6,90% e 5,24% da variabilidade dos dados, respectivamente. Adolescentes com renda familiar per capita superior a 1/2 salário mínimo apresentaram maior chance de aderir ao padrão “junk food” (OR=1,66; IC 95%=1,07-2,56), enquanto aqueles com excesso de peso possuíram menor chance de aderir ao padrão “saudável” (OR=0,56; IC 95%=0,35-0,91).
desvios do padrão alimentar “saudável” não estão relacionados à baixa renda, mas sim aos maus hábitos alimentares da população estudada. Adolescentes com sobrepeso não aderiram ao padrão “saudável”, reforçando a necessidade da implementação de educação nutricional junto aos mesmos.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
The profile of a sample population of elderly receiving treatment under the Family Health Strategy in the municipality of Teófilo Otoni, State of Minas Gerais, Brazil, is described, and the factors ...associated with diseases prevalence examined. Using simple random sampling, 385 elderly were interviewed using Form A and Elderly Form from the Primary Health Care Information System. The majority of the sample (83.1%) self-reported at least one disease, 69.9% had hypertension, and 17.7% had diabetes. Poisson regression analysis showed that the main factors associated with hypertension and other diseases were being non-white, having a low level of education, medication use, dental prosthesis use, and lack of a private health plan. The prevalence of diabetes was greater among women and individuals who depended on other people to live. It can be concluded that this sample population of elderly has a generally low socioeconomic status and are more susceptible to developing diseases, particularly hypertension. Diabetes should be controlled although had relatively low prevalence. It is suggested investments in structuring the health system network to provide adequate care for the elderly and in training health professionals to play an effective role in improving the quality of life of the elderly in Brazil.
Chagas disease currently affects 5.7 million people in Latin America and is emerging in non-endemic countries. There is no consensus concerning the efficacy of trypanocidal therapy for patients with ...the chronic form of the disease. We evaluated cardiac function and sociodemographic, clinical, and serologic characteristics of a group of asymptomatic Trypanosoma cruzi-seropositive former blood donors, and compared the effects of benznidazole treatment applied for different lengths of time.
Blood donors who screened positive for T. cruzi between 1998 and 2002 were recruited 10 years later for follow-up (n = 244); 46 individuals had received treatment. Three subjects had terminated treatment prematurely. The remaining 43 individuals were divided into two groups: individuals who had received benznidazole therapy for 50-60 days (n = 28; BT ≤60 group) or more than 60 days (n = 15; BT >60). Serologic assays, biochemical tests, electrocardiographic, echocardiographic, and clinical examinations were performed on all participants. Parasite loads were determined by qualitative and quantitative polymerase chain reaction.
Parasitemia was significantly reduced in the BT ≤60 and BT >60 groups compared with the untreated group. There were no differences in epidemiologic profiles or clinical, biochemical, electrocardiographic, or echocardiographic data between any of the groups.
Despite elimination or significant reduction in parasitemia in patients with chronic Chagas disease who received benznidazole, there was no clinical difference between those who were treated for >60 days and those treated for a shorter duration. Furthermore, the adverse effects of benznidazole appear to be less severe than previous reports would suggest.
Objective
The aim of this study was to evaluate the expression of RAS components and SIRTs enzymes in the adipose tissue of mice fed diets with different macronutrient composition.
Design and Methods
...The body weight, food intake, and energy intake (kcal) were evaluated. Blood parameters (insulin sensitivity, glucose tolerance, total cholesterol, HDL‐C triglyceride, and glucose levels) were also assessed. Real‐time PCR was performed in epididymal adipose tissue samples to analyze the expression of renin, angiotensinogen (AGT), angiotensin‐converting enzyme 1 and 2 (ACE and ACE2), and SIRTs 1‐7. Male FVB/N mice were divided into 5 groups (N = 10 each) that were fed with experimental diets for 60 days. Test diets were divided into standard (ST), AIN‐93M, high glucose (HG), high protein (HP) and high lipid (HL).
Results
The main results showed that HL diet treatment induced reduction in HDL‐C and triglyceride plasma levels; increased ACE (Ang II marker) expression and decreased ACE2 (Ang‐1‐7 catalyzer) expression in adipose tissue; and also increased SIRT4 expression.
Conclusion
Diets with high lipid content induced a degenerative state associated with deregulation of adipose tissue enzymes expression.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
This study shows the effectiveness of photodynamic therapy based on methylene blue dye for the treatment of endonyx toenail onychomycosis. Four patients with endonyx onychomycosis caused by ...Trichophyton rubrum were treated with 2% methylene blue aqueous solution irradiated with light emission diode at 630 nm and an energy density of 36 J/cm2 for 6 months at 2-week intervals. The preliminary study showed the effectiveness of this therapy in the treatment of endonyx onychomycosis, and also indicated that the disease can be caused by T. rubrum.
This study investigated the immunodetection of CD57+ inflammatory cells in patients with head and neck squamous cell carcinoma (HNSCC) and its association with clinicopathological parameters and ...overall survival. Data collected from the morphological analysis and immunohistochemical reaction testing of archived HNSCC specimens (n=70) were statistically analyzed by bivariate and multivariate statistical testing at a significance level of P<0.05. The results indicate that CD57+ inflammatory cells predominate within the peritumoral stroma of HNSCC lesions and the existence of two significant relationships: between high CD57+ cell density and the development of a tumor of a large size odds ratio (OR)=5.610, 95% confidence interval (CI)=1.516-20.763) and between high CD57+ cell density and the development of locoregional metastatic disease (OR=3.401, 95% CI=1.162-9.951). A significant difference in the rate of survival was detected only in HNSCC patients that presented large size tumors (OR=4.747, 95% CI=1.281-17.594). Together, these results suggest that although high CD57+ inflammatory cell density is associated with HNSCC lesions of greater clinical severity, the variable of cell density is not an independent predictor of HNSCC patient survival. Our findings also suggest that the relatively aggressive infiltration of CD57+ inflammatory cells in the peritumoral stroma of head and neck carcinomas may contribute to an ineffective locoregional antitumoral response.
The aim of this study is to unravel the vital role of Primary Health Care (PHC) in addressing the Covid-19 pandemic. This is an Integrative Literature Review that selected 13 scientific articles ...published from January 2020 to June 2023, in the Virtual Health Library (VHL) and Scientific Electronic Library Online (SciELO) databases, through the descriptors "Covid-19", "Primary Health Care" and "Brazil". From the analysis of the articles, the following categorization was carried out: Primary Health Care and Covid-19 in Brazil; Restructuring of Popular Health Education in Health and its focus on PHC; Reorganization of service flows in the health care network; Successful strategies for coping with Covid-19 in PHC at municipal, state and national level; Mental health and the Covid-19 pandemic - Coping in PHC; Integrated health surveillance and APS actions in the Covid-19 pandemic. It is concluded that there is a need for greater investments and public policies that strengthen PHC, enabling it to play a central role in responding to future health crises, as well as strengthening health systems as a whole, aiming at a more resilient approach and effective way to face present and future challenges.
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