Tag: statistics

Laryngoscope. 2021 Aug 11. doi: 10.1002/lary.29815. Online ahead of print.

ABSTRACT

OBJECTIVES/HYPOTHESIS: For patients with submandibular sialolithiasis, there are many gland-preserving treatment options including sialendoscopy. Sialendoscopy, however, requires expensive instrumentation with limited availability, which may not be required for routine cases. The objective of this study is to compare the outcomes of patients with submandibular sialolithiasis undergoing sialendoscopy versus those undergoing transoral incisional sialithotomy.

STUDY DESIGN: Longitudinal, prospective study of patient undergoing gland-preserving therapy for submandibular sialolithiasis.

METHODS: The study was a prospective, nonrandomized trial of 30 patients with submandibular sialolithiasis who received gland-preserving treatment by either sialendoscopy-assisted techniques (Scope group; 14 patients) or transoral sialithotomy with or without dochoplasty (No Scope group; 16 patients). Factors analyzed between the two groups included age, race, gender, size of stone, location of stone, gland(s) involved, surgical method, and modified salivary Oral Health Impact Profile (sOHIP) scores before and after therapy.

RESULTS: There were no significant differences between the Scope and No Scope groups regarding age, race, or gender. There was a significant difference in stone size between the groups, with the No Scope group having larger stones on average. Both treatments led to statistically significant symptomatic improvement in sOHIP scores. There was no statistically significant difference in salivary quality of life improvement between the Scope and No Scope groups (P = .33).

CONCLUSIONS: Sialendoscopy is an important diagnostic and therapeutic tool in the management of salivary disorders, but is not associated with improved outcomes in gland-preserving treatments for routine submandibular sialolithiasis. Transoral stone removal alone may have equivalent symptomatic outcomes in the management of select sialoliths.

LEVEL OF EVIDENCE: III Laryngoscope, 2021.

PMID:34378799 | DOI:10.1002/lary.29815

Cien Saude Colet. 2021 Aug;26(8):3301-3310. doi: 10.1590/1413-81232021268.08882020. Epub 2020 Jun 3.

ABSTRACT

The aim of this study was to analyze health service accessibility and the care pathways of children admitted to hospital for ambulatory care sensitive conditions (ACSCs). A cross-sectional study was conducted of a random sample of children hospitalized over a period of one year in a town in the north of Minas Gerais, Brazil. The Primary Care Assessment Tool Child Edition, adapted and validated for use in Brazil (PCAT-CE), was used to assess accessibility and interviews were conducted with the children’s carers to determine the pathway taken to hospitalization. Of the 376 pediatric hospitalizations assessed, 109 (28.9%) were classified as ACSC admissions. Health service accessibility and utilization scores were low for both the ACSC and non-ACSC groups. No statistically significant differences (p<0.05) were found between the two groups. The care pathways reveal that most families visited hospitals as the first service and that visits to other health services were frequent. Well over half (63.3%) of the families of children admitted for ACSCs did not seek primary health services at any time. Accessibility was poor among the study group, regardless of the reason that led to hospitalization. The care pathways reveal an irregular pattern of service utilization for children admitted for ACSCs, suggesting a fragile health care network.

PMID:34378717 | DOI:10.1590/1413-81232021268.08882020

Rev Bras Epidemiol. 2021 Aug 9;24:e210026. doi: 10.1590/1980-549720200026. eCollection 2021.

ABSTRACT

OBJECTIVES: To characterize the study population, estimating the in-hospital lethality rate by state and analysing associated factors with COVID-19-related deaths.

METHODS: A retrospective cohort study was carried out of hospitalised children and adolescents diagnosed with COVID-19, confirmed by RT-PCR, whose outcome was death by COVID-19 or recovery, from 2020 March 1 to August 1. The data source was the Influenza Epidemiological Surveillance Information System (SIVEP-Gripe in Brazilian acronym), where patients with Severe Acute Respiratory Syndrome (SARS) are notified. Children were defined as those between the ages of 0 and 11, and adolescents those between 12 and 18. A bi and multivariate analysis were performed using Poisson Regression with robust variance, with adjusted Relative Risk as the final association measure.

RESULTS: A total of 4,930 cases were analysed; 2,553 (51.8%) were males, 2,335 (47.4%) were brown-skinned. The Federative Unit of Roraima presented the highest in-hospital case-fatality rate, with 68.8% (11/16). Multivariate analysis showed that belonging to the age group adolescent (RR = 1.59; 95%CI 1.12 – 2.25; p = 0.009), SARS-critical patient (RR = 4.56; 95%CI 2, 77 – 7.51; p < 0.001) and presenting immunological disorders (RR = 2.24; 95%CI 1.58 – 3.17; p < 0.001) as comorbidities were statistically associated factors with death by COVID-19.

CONCLUSION: It was observed that adolescents, SARS-critical patients, and presence of immunological disorders were important factors associated with death. Active surveillance and differentiated care are recommended for patients with chronic diseases and special immunological conditions.

PMID:34378752 | DOI:10.1590/1980-549720200026

Endokrynol Pol. 2021 Aug 11. doi: 10.5603/EP.a2021.0070. Online ahead of print.

ABSTRACT

BACKGROUND: Gynecomastia (GM) is benign unilateral or bilateral proliferation of the glandular tissue of breast in males. Its development during adolescence is usually considered a physiologic phenomenon and is expected to resolve within months. Sometimes however it is due to pathologic conditions or diseases and it is not uncommon these not to be recognized on time. The present study aims to investigate the causes of prepubertal and pathologic pubertal GM, its association with obesity, age of appearance and whether GM has a psychological impact on boys and adolescents admitted at endocrine department.

MATERIAL AND METHODS: A total of 157 boys and adolescents with GM were included in a cross-sectional retrospective study in a single tertiary center for endocrine diseases. Patients were evaluated by anthropometric measurements, serum hormonal levels and a questionnaire.

RESULTS: For the period 2009-2018 a total of 157 boys and adolescents were diagnosed with GM (76.43 % obese, 3.18%- overweight). Twelve (7.64 %, mean age of GM development -7.53 years) were prepubertal, 5.09%- with primary or secondary testicular damage, 5.73% with hypogonadotropic hypogonadism, 11.48% -with elevated prolactin level and 110 boys (70.06%) with physiologic pubertal GM. A statistically significant difference was found between the age of development of physiologic GM -11.85 years (9.35-16.92) and those due to hypergonadotropic 13.57 years (10-16.25) (p=0.006) and hypogonadotropic 12.77 (10.50-14.0) (p=0.028) hypogonadism. Onset of pubertal GM in normal weight boys was 13.13 years, and in obese/overweight -11.69 years (p <0.001). Eighty four patients (53.5%) confessed a psychological burden of GM, 12.1 % consulted because of its development, in 8.2 % led to cessation of sports and 2.5 % changed their clothes.

CONCLUSIONS: Prepubertal and pubertal GM has a high association with obesity. Excess adipose tissue has an impact on the age of development in both groups. Nearly a quarter of pubertal cases are due to pathologic conditions and those are often diagnosed more than 18 months after the appearance of breast. So although greater number of pubertal GM is physiologic it may be reasonable adolescents to be evaluated within the first 6 months of breast development so not to delay the diagnosis of pathologic ones. Additionally we have found that GM has a complex influence on psychologic state of boys and adolescents.

PMID:34378787 | DOI:10.5603/EP.a2021.0070

Cien Saude Colet. 2021 Aug;26(8):3255-3264. doi: 10.1590/1413-81232021268.06092021. Epub 2021 Apr 28.

ABSTRACT

This study sought to analyze the evidence of the validity of a Brazilian version of the Fear of COVID-19 Scale (FCV-19S), based on indicators relating to: (1) the internal structure; (2) the internal consistency; (3) the relation with external variables; and (4) the content. The instrument was culturally adapted, focusing on semantic and specifically Brazilian linguistic aspects. The Brazilian version of the FCV-19S was then applied, in a virtual environment, to 211 participants (72.98% female) with an average age of 37.07 years (SD=13.03), together with the Self-Perception Questionnaire on Mental Health in Pandemics and the Sociodemographic and Functional Questionnaire. The confirmatory factor analysis revealed one-dimensionality. The internal consistency indices obtained (Cronbach’s alpha =0.921; McDonald’s omega =0.926) can be considered high. The correlation between fear and obsessive thinking of the disease, generalized anxiety, generalized stress, phobic-avoidant behavior and bereavement due to the pandemic was found to be statistically significant. Evidence of the validity related to content, derived from a qualitative approach, were satisfactory. The conclusion drawn is that the Brazilian version of the FCV-19S proved to be adequate regarding the evidence of the expected validity.

PMID:34378713 | DOI:10.1590/1413-81232021268.06092021

Braz J Biol. 2021 Aug 9;83:e246781. doi: 10.1590/1519-6984.246781. eCollection 2021.

ABSTRACT

The agouti (Dasyprocta leporina) is a rodent that is found in the Neo-tropical region. This animal is hunted for its meat but has recently been reared in captivity as a source of meat protein in rural communities. A 20-month experiment was carried out to evaluate the effect of an anthelmintic on the reproductive performance of the agouti (Dasyprocta leporina) reared in captivity. This experiment was conducted in the humid tropics of Trinidad and Tobago. Sixteen animals (15 females, 1 male) placed in each of the two treatment groups in a completely randomized study design. In treatment 1 (T1) animals were given subcutaneous injections of Endovet Ces® (Ivermectin/Praziquantel) at 0.2 mg/kg every three months. Treatment 2 (T2) was the negative control group where animals were not exposed to an anthelmintic. Reproductive data were collected at parturition which included birth weight, litter weight, litter size and gender of offspring. The results showed that there was no statistical difference (p > 0.05) between the treatment groups with respect to birth weight, litter weight, litter size and gender. However, agoutis that were dewormed had a higher birth weight (220.24 g vs 209.1 g) and litter weight (369.8 g vs 343 g). The same values were obtained for the litter size (1.7 vs 1.7) and animals that were dewormed had a higher female offspring to male offspring (2.41:1 vs 1.11:1). This experiment demonstrated that the use of an anthelmintic strategically in the management of captive reared agoutis had no statistical effect (p > 0.05) on the reproductive parameters. Therefore, these animals can be kept in captive conditions without being dewormed and produce efficiently with proper feeding and housing management.

PMID:34378685 | DOI:10.1590/1519-6984.246781

Cien Saude Colet. 2021 Aug;26(8):3135-3145. doi: 10.1590/1413-81232021268.04672020. Epub 2020 Jun 3.

ABSTRACT

The study analyzed and compared the types of food sold in the surroundings of 30 private and 26 public elementary schools in the city of Niterói, Rio de Janeiro. Data were collected by audit using a checklist instrument to characterize establishments (formal or informal) and identify the types of food and beverages sold, which were classified by processing level (fresh, processed, and ultraprocessed). Mann-Whitney statistical tests were used to verify the difference in the type of trade outlets d the categories of food sold between schools. The Kruskal-Wallis test was used to verify the difference in the amount of food traded between the categories. The amount of ultraprocessed food in the surroundings of public and private schools was statistically higher (p=0.0001) than the other categories. Some culinary preparations had a high rate of energy contribution from ultraprocessed foods (above 15%). There was no statistically significant difference (p = 0.478) in the categories of food sold between public and private schools. The sale of ultraprocessed products predominates around public and private schools, favoring the exposure of children to an environment that encourages the consumption of these products.

PMID:34378704 | DOI:10.1590/1413-81232021268.04672020

Cien Saude Colet. 2021 Aug;26(8):3175-3185. doi: 10.1590/1413-81232021268.09182020. Epub 2020 Jun 3.

ABSTRACT

We present results of initial steps of the psychometric evaluation of a proposed modified version of the Brazilian Household Food Insecurity Measurement Scale aimed at assessing adults’ recall of food insecurity at age 12. Data were obtained through self-administered questionnaires from civil servants at university campuses in Rio de Janeiro, who participated in the first and fourth waves of the longitudinal Pró-Saúde Study. We evaluated test-retest reliability (n=58), internal consistency, factor structure, convergent, discriminant validity (n=3,253). Test-retest reliability kappa coefficients were above 0.65; Cronbach’s α coefficient was 0.84. Factor loadings were above 0.800. The composite reliability was above 0.90. The square root values of the Average Variance Extracted were positive and statistically significant. Household food insecurity during childhood was strongly associated with larger family size and several sociodemographic conditions at age 12: female head of household, residence in rural area or small town, worse standard of living, and insufficient food due to lack of money. This initial evaluation suggests good performance. Further investigation should include additional psychometric properties and other population contexts.

PMID:34378707 | DOI:10.1590/1413-81232021268.09182020

Arq Bras Cardiol. 2021 Aug 6:S0066-782X2021005012202. doi: 10.36660/abc.20200600. Online ahead of print.

ABSTRACT

BACKGROUND: Left ventricular hypertrophy (LVH) is an important cardiovascular risk factor, regardless of arterial hypertension. Despite the evolution of imaging tests, the electrocardiogram (ECG) is still the most used in the initial evaluation, however, with low sensitivity.

OBJECTIVE: To evaluate the performance of the main electrocardiographic criteria for LVH in elderly and very elderly hypertensive individuals.

METHODS: In a cohort of hypertensive patients, ECGs and doppler echocardiographies (ECHO) were performed and separated into three age groups: <60 years, Group I; 60-79 years Group II; and ≥80 years, Group III. The most used electrocardiographic criteria were applied for the diagnosis of LVH: Perugia; Pegaro-Lo Presti; Gubner-Ungerleider; Narita; (Rm+Sm) x duration; Cornell voltage; Cornell voltage duration; Sokolow-Lyon voltage; R of aVL ≥11 mm; RaVL duration. In evaluating the performance of these criteria, in addition to sensitivity (Sen) and specificity (Esp), the “Diagnostic Odds Ratios” (DOR) were analyzed. We considered p-value <0.05 for the analyses, with two-tailed tests.

RESULTS: In 2,458 patients, LVH was present by ECHO in 781 (31.7%). In Groups I and II, the best performances were for the criteria of Narita, Perugia, (Rm+Sm) x duration, with no statistical differences between them. In Group III (very elderly) the Perugia criteria and (Rm+Sm) x duration had the best performances: Perugia [44,7/89.3; (Sen/Esp)] and (Rm+Sm) duration [39.4%/91.3%; (Sen/Esp), p<0.05)], with the best PAIN results:6.8. This suggests that in this very elderly population, these criteria have greater discriminatory power to separate patients with LVH.

CONCLUSION: In very elderly hypertensive patients, the Perugia electrocardiographic criteria and (Rm+Sm) x duration showed the best diagnostic performance for LVH.

PMID:34378674 | DOI:10.36660/abc.20200600

Braz J Med Biol Res. 2021 Aug 6;54(10):e11035. doi: 10.1590/1414-431X2021e11035. eCollection 2021.

ABSTRACT

In this eight-year retrospective study, we evaluated the associations between climatic variations and the biological rhythms in plasma lipids and lipoproteins in a large population of Campinas, São Paulo state, Brazil, as well as temporal changes of outcomes of cardiovascular hospitalizations. Climatic variables were obtained at the Center for Meteorological and Climatic Research Applied to Agriculture (University of Campinas – Unicamp, Brazil). The plasma lipid databases surveyed were from 27,543 individuals who had their lipid profiles assessed at the state university referral hospital in Campinas (Unicamp). The frequency of hospitalizations was obtained from the Brazilian Public Health database (DATASUS). Temporal statistical analyses were performed using the methods Cosinor or Friedman (ARIMA) and the temporal series were compared by cross-correlation functions. In normolipidemic cases (n=11,892), significantly different rhythmicity was observed in low-density lipoprotein (LDL)- and high-density lipoprotein (HDL)-cholesterol (C) both higher in winter and lower in summer. Dyslipidemia (n=15,651) increased the number and amplitude of lipid rhythms: LDL-C and HDL-C were higher in winter and lower in summer, and the opposite occurred with triglycerides. The number of hospitalizations showed maximum and minimum frequencies in winter and in summer, respectively. A coincident rhythmicity was observed of lower temperature and humidity rates with higher plasma LDL-C, and their temporal series were inversely cross-correlated. This study shows for the first time that variations of temperature, humidity, and daylight length were strongly associated with LDL-C and HDL-C seasonality, but moderately to lowly associated with rhythmicity of atherosclerotic outcomes. It also indicates unfavorable cardiovascular-related changes during wintertime.

PMID:34378675 | DOI:10.1590/1414-431X2021e11035