Análise espacial da taxa de detecção de casos suspeitos de síndrome congênita pelo vírus Zika, Maranhão, 2015 a 2018

RESUMO: Objetivo: Identificar padrões espaciais em casos de lactentes com alterações de crescimento e desenvolvimento relacionadas à infecção pelo vírus Zika e outras etiologias infecciosas (neste trabalho denominado de síndrome congênita pelo vírus Zika), notificados no Maranhão de 2015 a 2018 e sua relação com variáveis socioeconômicas e demográficas. Métodos: Estudo ecológico de casos suspeitos notificados de síndrome congênita pelo vírus Zika nos 217 municípios do Maranhão, Brasil. Calculou-se a autocorrelação espacial pelos índices de Moran local e global (I) univariado e bivariado da taxa de detecção de casos suspeitos de síndrome congênita pelo vírus Zika com índice de desenvolvimento humano municipal, densidade demográfica, índice de Gini e tempo de emancipação político-administrativa dos municípios. O índice de Moran local foi calculado para localizar clusters com autocorrelação espacial significativa. Resultados: Houve autocorrelação espacial na análise univariada da taxa municipal de detecção de casos suspeitos de síndrome congênita pelo vírus Zika (I=0,494; p=0,001) e, na análise bivariada, correlação positiva da taxa de detecção de casos suspeitos com índice de desenvolvimento humano municipal (I=0,252; p=0,001), densidade demográfica (I=0,338; p=0,001) e tempo de emancipação dos municípios (I=0,134; p=0,001). Não houve correlação significativa da taxa de detecção de casos suspeitos com o índice de Gini (I= -0,033; p=0,131). Cinco clusters de alta detecção de casos suspeitos foram encontrados em áreas distintas do estado. Conclusões: Os municípios com maior índice de desenvolvimento humano municipal, maior densidade demográfica e mais tempo de emancipação político-administrativa tiveram mais casos suspeitos notificados de síndrome congênita pelo vírus Zika.

Physical activity in pregnancy and adverse birth outcomes

This study focused on the association between physical activity in the second trimester of pregnancy and adverse perinatal outcomes: low birth weight (LBW), preterm birth (PTB), and intrauterine growth restriction (IUGR). The study used a sample from the BRISA cohort, São Luís, Maranhão State, Brazil, which included women with singleton pregnancy, gestational age from 22 to 25 weeks confirmed by obstetric ultrasound performed at < 20 weeks, and re-interviewed in the first 24 hours postpartum (n = 1,380). Level of physical activity was measured by the International Physical Activity Questionnaire (IPAQ), short version, categorized as high, moderate, and low. A directed acyclic graph (DAG) was used to identify minimum adjustment to control confounding. High physical activity was not associated with LBW (RR = 0.94; 95%CI: 0.54-1.63), PTB (RR = 0.86; 95%CI: 0.48-1.54), or IUGR (RR = 0.80; 95%CI: 0.55-1.15). The results support the hypothesis that physical activity during pregnancy does not result in adverse perinatal outcomes.

Changes in perinatal health in two birth cohorts (1997/1998 and 2010) in São Luís, Maranhão State, Brazil

The objective of this study was to analyze changes in perinatal health in two birth cohorts started in 1997/1998 and 2010, respectively, in São Luís, Maranhão State, Brazil. A total of 2,493 live born infants were included in 1997/1998 and 5,166 in 2010. Low birth weight (LBW) rate did not change (8.5% in 1997/1998 and 8.6% in 2010). Preterm birth (PTB) rate also remained stable (13.2% in 1997/1998 and 13% in 2010). Teenage deliveries and births to single mothers decreased. Maternal schooling and prenatal care coverage increased. Intrauterine growth restriction (IUGR) decreased from 13.3% to 10.6% (p < 0.001). The perinatal mortality rate decreased from 36.6 to 20.7 per 1,000 (p < 0.001) and the infant mortality rate (IMR) dropped from 28.5 to 12.8 per 1,000 (p < 0.001). The cesarean rate increased from 34.1% to 47.5% (p < 0.001). In conclusion, despite favorable changes in socio-demographic, behavioral, and health service factors and decreasing rates of IUGR and perinatal and infant mortality, LBW and PTB remained stable, while the cesarean rate increased.

Análise Clínica e Epidemiológica de 348 Casos de Adenocarcinoma Prostático Atendidos em um Centro Oncológico de Referência no Maranhão, Brasil

Introdução: O câncer de próstata e a principal neoplasia maligna no sexo masculino, depois do câncer de pele não melanoma. Informações clinicas e epidemiológicas sobre essa patologia no Maranhão são escassas. Objetivos: Analisar informações clinicas e epidemiológicas de pacientes diagnosticados com câncer de próstata em um centro oncológico de referência no Maranhão, no período de janeiro de 2008 a dezembro de 2009. Método: Trata-se de um estudo retrospectivo e descritivo onde foram pesquisados 348 prontuários de pacientes com diagnostico de câncer de próstata no Instituto Maranhense de Oncologia Aldenora Bello. As variáveis pesquisadas foram: faixa etária; procedência; ocupação; antígeno prostático especifico inicial; escore de Gleason da biopsia; escore de Gleason da peça cirúrgica (em pacientes cujas terapêuticas incluíram prostatectomia radical ou ressecção transuretral de próstata); e tratamento instituído. Resultados: A faixa etária mais acometida foi de 71 a 80 anos (39,7%). A maior parte dos pacientes era procedente de São Luís - MA (64,1%) e não possuía ocupação (55,2%). A maioria dos pacientes (32,8%) apresentou antígeno prostático especifico inicial entre 4,1 e 10 ng/ml. O Gleason da biopsia revelou, em 48,5% dos casos, tumores moderados a fracamente diferenciados. A terapêutica predominante foi composta de tratamento clinico e/ou orquiectomia subcapsular bilateral. Conclusão: O presente estudo demonstrou uma associação significativa do antígeno prostático especifico com a faixa etária e o Gleason, revelando maior tendência de aumento dos seus níveis quanto maior a idade e maior a graduação histológica dos tumores. Do total dos pacientes, 36,5% obtiveram escores de Gleason da biopsia e peca cirúrgica equivalentes.

Comparison between two methods to evaluate temperature changes produced by composite light curing units and polymerization techniques

AIM

This study evaluated the temperature change into the pulp chamber during the light curing of composite resin by direct (bovine tooth) and indirect (matrix) methods.

METHODS

Direct method: fifty standardized cavities (2x2x2 mm) were prepared in bovine incisors, which were randomly assigned to evaluation of the temperature changes in the pulp chamber. Indirect method: temperature changes were evaluated through a dentine slice of 1.0 mm thickness in a elastomer cubic mold (2x2x2 mm). Filtek Z250 composite resin (3M/ESPE) was photo-activated using three light curing units: quartz-tungsten-halogen (QTH) by continuous, soft-start or intermittent light modulations; light emitting diode (LED); and plasma arc-curing (PAC). Ten groups (N.=10) were established according to technique evaluation and photo-activation methods. All experiments were carried out in a controlled environment (37 °C and 50 ± 10% relative humidity). The temperature changes were recorded using a digital thermometer attached to a type-K thermocouple in contact with the dentin slice (indirect method) or in contact with the axial wall (dentin) of pulp chamber (direct method). The results were submitted to ANOVA and Tukey's test (α=0.05).

RESULTS

Temperature changes were statistically higher for the matrix indirect method (2.56 ºC) than bovine teeth direct method (1.17ºC). The change temperature was statistically higher for the PAC (1.77 ºC) when compared to other photo-activation modes in bovine teeth direct method.

CONCLUSION

The two methods of temperature evaluation were different, however indirect method detected the higher temperature increase. Higher energy density arising from the light curing units and polymerization techniques promoted higher temperature increase.

[Association between osteoporosis and periodontal disease]

PURPOSE

to verify the association of osteoporosis with periodontal disease.

METHODS

the study has included 39 postmenopausal women divided in three groups according to bone mass categories, through evaluation of mineral bone density (MBD), measured by X-ray double emission absorbimetry in the lumbar area (L1-L4): ): normal bone; osteopenia and osteoporosis. In all the participants the Clinical Insertion Level (CIL) index has been determined at the research onset and after one year, by the same examiner. The periodontal situation data have been submitted to statistical analysis with the paired t-Student test.

RESULTS

the periodontal exam has shown that postmenopausal women in the osteopenia presented lower CIL at the initial periodontal clinical exam (2.1+/-1.1 mm), while the ones in the normal bone showed less teeth support tissue loss after one year (3.1+/-1.6 mm). The statistical analysis has shown that there was no significant difference for the periodontal situation in the normal bone, but there was significant statistical difference for the osteopenia and osteoporosis patients, when CIL values from both evaluation periods were compared.

CONCLUSIONS

it is concluded that postmenopausal osteoporosis may be a possible risk factor for periodontal disease.