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The evaluation of water sorption and solubility is pivotal for the development of new resin-based restorative materials with the potential for clinical application. The purpose of the present study was to evaluate the influence of the specimen dimension, water immersion protocol, and surface roughness on the water sorption and solubility of three resin-based restorative materials. Disk-shaped specimens of 15 mm × 1 mm, 10 mm × 1 mm, and 6 mm × 1 mm were produced with a composite resin (Z100), a resin cement (RelyX ARC), and an adhesive system (Single Bond 2-SB2). The specimens were immersed in distilled water according to four protocols: ISO (all the specimens for each group were vertically immersed in 50 mL); IV-10 (the specimens were individually and vertically immersed in 10 mL); IH-10 (the specimens were individually and horizontally immersed in 10 mL); and IH-2 (the specimens were individually and horizontally immersed in 2 mL). The surface roughness (Sa and Sp) was evaluated using an atomic force microscope, and the degree of conversion was determined using FT-IR spectrometry. The specimen dimension and water immersion protocol had no effect on water sorption and solubility. For the three resin-based restorative materials, Sp was higher than Sa. The degree of conversion was not influenced by the specimen dimension. The variations in the specimen dimension and water immersion protocol compared to those determined by ISO 4049 did not prevent the comparison between the values of water sorption and solubility obtained for a given resin-based restorative material.
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Health care workers (HCWs) are at an increased risk of being exposed to COVID-19. This study aimed to characterize flu-like syndrome cases (FS) in HCWs notified in Brazil and compare them with FS cases in the general community (GC). In the Brazilian protocol, FS corresponds to a suspected case of COVID-19. The manuscript analyzed cases of FS in five Brazilian states, estimating the incidence rates of cases of FS and clinical and epidemiological characteristics. Registered cases (March to June 2020) totaled about 1,100,000 cases of FS. HCWs represented 17% of the registers, whose incidence was 20.41/100 vs. 2.15/100 in the GC. FS cases in HCWs concentrated the highest percentages in the age group of 30 to 49 years (65.15%) and among the nursing staff (46.86%). This study was the first interstate evaluation in Brazil to estimate suspected cases of FS by COVID-19 in HCWs. In order to control the spread of viral respiratory infections in HCWs, including COVID-19, it is necessary to review the management of health information to identify who they are, how many they are, and to what situations these workers are most frequently exposed, as well as in what professions they have. This information can guide specific, practical, and far-reaching actions.
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COVID-19 , Adulto , Brasil/epidemiologia , Pessoal de Saúde , Humanos , Incidência , Pessoa de Meia-Idade , SARS-CoV-2RESUMO
Resumo Objetivo: realizar comparação interpaíses e entre estados brasileiros quanto ao conteúdo dos protocolos de proteção para profissionais de saúde que atuam na assistência aos doentes da COVID-19 e desenvolver análise crítica ao modelo de prevenção que adota indicação e uso de equipamentos de proteção individual (EPI) como resposta única a um problema de caráter multidimensional. Métodos: estudo exploratório com base em revisões disponíveis na biblioteca Cochrane, articuladas com a análise dos protocolos nacionais de Argentina, Brasil, China e Estados Unidos da América e as normas previstas nos estados do Amazonas, Bahia, Minas Gerais e São Paulo, todos selecionados por critérios de conveniência. Resultados: observou-se dissensos quanto aos tipos de proteção recomendados. Somente na China eram indicados respiradores de alta eficiência de filtragem, além de modelos para o rosto inteiro nos casos de procedimentos invasivos. O reuso de equipamentos não é indicado, mas estava autorizado no protocolo brasileiro. Quanto aos dispositivos de vestuário, também não há convergência. Conclusão: os resultados reforçam a necessidade de revisão dos protocolos de proteção dos profissionais da saúde que atuam no enfrentamento da Covid-19. Ações em busca de debate institucional, interpaíses e interestaduais sobre modelos de prevenção são essenciais para alcançar consistência nas recomendações.
Abstract Objective: to make a comparison between countries and between Brazilian states regarding the contents of protection protocols for COVID-19 healthcare workers and to undertake a critical analysis of the prevention model that adopts the recommendation and use of personal protective equipment (PPE) as the only response to a multidimensional problem. Methods: exploratory study based on revisions available at the Cochrane Library, articulated with the analysis of the national protocols of Argentina, Brazil, China, and the United States of America and those of the states of Amazonas, Bahia, Minas Gerais, and São Paulo, all selected by convenience criteria. Results: there were differences between the recommended types of protection. Only China recommended high filtration efficiency respirators as well equipment covering the whole face for invasive procedures. Reusing the equipment is not recommended, but it was authorized in the Brazilian protocol. There was also no convergency about clothing devices. Conclusion: the results reinforce the need for revision of the protocols for the protection of health workers dealing with the COVID-19. Actions to promote institutional, inter-country and interstate debate on prevention models are essential for achieving consistency in the recommendations.
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The aim of this study was to fabricate and characterize dental composites containing hydroxyapatite nanoparticles (HApNPs). Four dental composites were produced from the same organic matrix (70 wt% Bis-GMA and 30 wt% TEGDMA), with partial replacement of BaBSi particles (65 wt%) by HApNPs in the following concentrations (wt%): E0 (0) - control, E10 (10), E20 (20) and E30 (30). Ca2+ and PO43- release was evaluated in solutions with different pHs (4, 5.5, and 7) using atomic emission spectroscopy with microwave-induced nitrogen plasma while the enamel remineralization potential was evaluated in caries-like enamel lesions induced by S. mutans biofilm using micro-CT. The following properties were characterized: degree of conversion (DC%), microhardness (KHN), flexural strength (FS), elastic modulus (EM) and translucency (TP). The higher the HApNPs content, the higher the Ca2+ and PO43- release. The ions release was influenced by pH (4 > 5.5 > 7) (p < 0.05). All composites loaded with HApNPs were able to remineralize the enamel (E30 = E20 > E10) (p < 0.05). Contrarily, E0 was not able of recovering the enamel mineral loss. E0 and E10 presented highest DC%, while E20 and E30 showed similar and lowest DC%. KHN and FS were decreased with the addition of HApNPs, while EM was not influenced by the incorporation of HApNPs. E10 presented statistically similar TP to E0, while this property decreased for E20 and E30 (p < 0.05). Incorporation of HApNPs into dental composites promoted enamel remineralization, mainly at potentially cariogenic pH (= 4), while maintained their overall performance in terms of physicomechanical properties.
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Durapatita , Nanopartículas , Bis-Fenol A-Glicidil Metacrilato , Resinas Compostas , Teste de Materiais , Ácidos PolimetacrílicosRESUMO
OBJETIVO: Avaliar o conhecimento científico produzido em relação aos fatores associados à prática de atividade física de idosos diabéticos assistidos na atenção primária à saúde no Brasil. MÉTODOS: Trata-se de uma revisão integrativa, e a busca por estudos ocorreu de forma on-line, sendo incluídos artigos originais da língua portuguesa, inglesa ou espanhola, publicados de outubro de 2008 a setembro de 2018, nas bases de dados Medical Literature and Retrieval System Online (MEDLINE), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e Scopus. Os descritores utilizados foram: idosos, diabetes mellitus, exercícios e atenção primária à saúde. A qualidade metodológica dos artigos foi avaliada por meio de dois instrumentos: Critical Appraisal Skills Programme e Hierarchy of Evidence for Intervention Studies. Após análise, quatro artigos foram incluídos. RESULTADOS: Não foram encontrados artigos com amostras constituídas apenas de idosos, e somente um deles fazia uma análise diferenciada para essa faixa etária, chamando atenção para a necessidade de estudos abordando idosos diabéticos, por causa das especificidades desses indivíduos. Nenhum dos artigos fez uso de instrumentos para avaliação da atividade física. CONCLUSÃO: A prática da atividade física esteve associada à melhora da qualidade de vida, do autocuidado e da adesão ao tratamento do diabetes mellitus, evidenciando a importância do aconselhamento dessa prática por meio dos profissionais de saúde. Fatores como frequência e tipo da prática de atividade física não foram verificados nos estudos, o que destaca a necessidade do uso de instrumentos para a sua avaliação.
OBJECTIVE: To evaluate the scientific knowledge produced in relation to the factors associated to the practice of physical activity of older diabetic primary care patients in Brazil. METHODS: It involved an on-line research including original articles published between October 2008 and September 2018 in Portuguese, English, and Spanish, from the databases: Medline, Lilacsand Scopus. The keywords used were elderly, diabetes mellitus, exercise, and primary health care. The methodological quality of the articles was evaluated by means of two instruments: Critical Appraisal Skills Programme and Hierarchy of Evidence for Intervention Studies. After analysis, four articles were included. RESULTS: No articles were found with samples consisting only of older people, and only one of them made an exclusive analysis for this age group. There is a need for studies addressing the older diabetic individuals, due to the specificities of this population. None of the articles made use of instruments for physical activity evaluation. CONCLUSION: The practice of physical activity was associated to an improvement in quality of life, self-care, and adherence to treatment for diabetes mellitus, highlighting the importance of professional counseling. Factors such as frequency and type of physical activity were not verified in the studies, which highlights the need for the use of instruments for this evaluation.
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Humanos , Atenção Primária à Saúde , Exercício Físico/fisiologia , Diabetes Mellitus/prevenção & controle , Diabetes Mellitus/epidemiologia , Qualidade de Vida , Autocuidado/tendências , Saúde do Idoso , Fatores Etários , Longevidade/fisiologiaRESUMO
OBJECTIVE: The aims of this study were to determine the course of plasma levels of inflammatory mediators (interleukin 6 [IL-6], tumor necrosis factor α [TNF-α], soluble TNF receptor 1 [sTNF-R1]) and the severity of low-back pain (LBP) over 6 to 12 months after an acute episode of LBP in elderly women and to establish an association between inflammatory mediators and LBP recovery. DESIGN: This was a longitudinal study of a subsample (155 elderly women with acute LBP, aged ≥65 years) of the international Back Complaints in the Elders cohort study. Plasma levels of IL-6, TNF-α, and sTNF-R1 were measured using enzyme-linked immunosorbent assays and pain severity using the numerical pain scale. RESULTS: There was a decrease in the severity of LBP (P = 0.033) and in the levels of IL-6 and TNF-α (P < 0.001) and an increase in sTNF-R1 (P < 0.001) in the first year after an acute episode of LBP. The probability of occurrence of pain relief at the 12-month follow-up was 2.22 times higher in elderly women who had low levels of IL-6 (<1.58 pg/mL) at baseline. CONCLUSIONS: Our findings showed a relationship between inflammation and LBP by establishing that low IL-6 plasma levels preceded outcome (LBP recovery), supporting the concept that proinflammatory cytokines promote pain.
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Mediadores da Inflamação/sangue , Interleucina-6/sangue , Dor Lombar/sangue , Receptores Tipo I de Fatores de Necrose Tumoral/sangue , Fator de Necrose Tumoral alfa/sangue , Doença Aguda , Idoso , Idoso de 80 Anos ou mais , Brasil , Ensaio de Imunoadsorção Enzimática , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Medição da Dor/métodos , Índice de Gravidade de Doença , Fatores de TempoRESUMO
OBJECTIVE: To investigate the prevalence of voice complaints among bus transport workers in a metropolitan area in Brazil and examine whether sociodemographic and occupational factors were associated with this outcome. This study is part of a larger study that investigated the working conditions and health of drivers and conductors of urban transportation. METHODS: The sample size (1,607 participants) was calculated by means of quotas and was stratified according to occupation (drivers and conductors) in the bus companies of Belo Horizonte, Betim and Contagem. Face-to-face interviews were facilitated by means of a digital questionnaire, applied by the interviewer using a netbook. The outcome variable was constructed from combining the responses to the following two questions: (1) Over the last two weeks, have you felt tired when speaking? (no/sometimes/every day). (2) Over the last two weeks, have you noticed any worsening of your voice quality? (no/sometimes/every day). Sociodemographic, lifestyle, occupational characteristic and health situation data were gathered. RESULTS: The prevalence found was 29% overall: 24% for drivers and 34% for conductors. Attention was drawn to positive associations with the function of conductor and with reports of exposure to vibration and thermal discomfort. Among the individual factors, only female gender reached statistical significance. CONCLUSION: Risk factors exist that justify interventions to promote voice health within the urban transport sector under study. It would be appropriate to investigate whether vibration of the whole body would influence the functioning and morphology of the larynx.
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Doenças Profissionais/epidemiologia , Meios de Transporte , Distúrbios da Voz/epidemiologia , Absenteísmo , Adulto , Idoso , Brasil , Estudos Transversais , Escolaridade , Feminino , Nível de Saúde , Temperatura Alta , Humanos , Entrevista Psicológica , Masculino , Pessoa de Meia-Idade , Veículos Automotores , Prevalência , Fatores Socioeconômicos , Inquéritos e Questionários , População Urbana , Vibração , Violência , Adulto JovemRESUMO
OBJETIVO: Analisar se o modelo explicativo para a avaliação da saúde do idoso com base no auto-relato é comparável com o modelo de relato do informante secundário e se a auto-avaliação de saúde do informante secundário influencia a avaliação da saúde do idoso. MÉTODOS: Estudo transversal com 230 pares idoso-informante secundário realizado em Belo Horizonte, MG, em 2007. Foram investigadas variáveis sociodemográficas e de saúde dos idosos por meio de entrevista estruturada. Utilizou-se regressão logística múltipla para analisar associação com auto-avaliação da saúde do idoso como ruim e com as informações prestadas pelo informante secundário. RESULTADOS: No modelo com base no auto-relato, a variável mais fortemente associada à avaliação da saúde do idoso como ruim foi a presença de restrições ou incapacidade para realizar atividades relacionadas à vida diária e/ou à mobilidade. No modelo baseado no informante secundário, a variável explicativa mais relevante foi o número de doenças crônicas apresentadas pelo idoso. Além disso, a chance de o informante secundário avaliar a saúde do idoso como ruim foi três vezes maior quando ele auto-avaliou sua saúde da mesma forma. CONCLUSÕES: Os resultados mostram diferenças importantes entre o modelo da avaliação da saúde do idoso com base nas respostas do próprio indivíduo e nas do informante secundário. O idoso tende a valorizar suas restrições ou incapacidade de realizar atividades da vida diária/mobilidade, enquanto o informante secundário tende a valorizar o diagnóstico de doenças crônicas. O informante secundário com pior auto-avaliação da saúde apresenta chance quase três vezes maior de relatar a saúde do idoso da mesma forma. Assim, informações auto-relatadas refletem melhor a condição de saúde do indivíduo do que se relatadas por informantes secundários.
OBJETIVO: Analizar si el modelo explicativo para la evaluación de la salud del anciano con basa en el auto-relato es comparable con el modelo de relato del informante secundario y si la autoevaluación de salud del informante secundario influencia la evaluación de la salud del anciano. MÉTODOS: Estudio transversal con 230 pares anciano-informante secundario realizado en Belo Horizonte, Sureste de Brasil, en 2007. Fueron investigadas variables sociodemográficas y de salud de los ancianos por medio de entrevista estructurada. Se utilizó regresión logística múltiple para analizar asociación con autoevaluación mala de la salud del anciano y con las informaciones prestadas por el informante secundario. RESULTADOS: En el modelo basado en el auto-relato, la variable más fuertemente asociada a la evaluación mala de la salud del anciano fue la presencia de restricciones o incapacidad para realizar actividades relacionadas con la vida diaria y/o a la movilidad. En el modelo basado en el informante secundario, la variable explicativa más relevante fue el número de enfermedades crónicas presentadas por el anciano. Asimismo, la probabilidad del informante secundario evaluar la salud del anciano como mala fue tres veces mayor cuando el mismo autoevaluó su salud como mala. CONCLUSIONES: Los resultados muestran diferencias importantes entre el modelo de la evaluación de la salud del anciano basado en las respuestas del propio individuo e en las del informante secundario. El anciano tiende a valorizar sus restricciones o incapacidad de realizar actividades de la vida diaria/movilidad, mientras que el informante secundario tiende a valorizar el diagnóstico de enfermedades crónicas. El informante secundario con peor autoevaluación de la salud presenta una probabilidad casi tres veces mayor de relatar la salud del anciano de la misma forma. Así, informaciones auto-relatadas reflejan mejor la condición de salud del individuo que aquellas relatadas por informantes secundarios.
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Humanos , Idoso , Autoavaliação (Psicologia) , Conhecimentos, Atitudes e Prática em Saúde , Saúde do Idoso , Variações Dependentes do Observador , Estudos TransversaisRESUMO
OBJECTIVE: To analyze whether the explanatory model for health assessments among elderly people based on self-reporting is comparable with the model based on secondary informant reporting, and whether the secondary informant's self-assessed health influences the health assessment among these elderly people. METHODS: This was a cross-sectional study on 230 pairs consisting of one elderly individual and one secondary informant, conducted in Belo Horizonte, Southeastern Brazil, in 2007. The sociodemographic and health variables of the elderly people were investigated by means of a structured interview. Multiple logistic regression was used to analyze associations with self-assessed poor health among the elderly individuals and with the information provided by the secondary informants. RESULTS: In the model based on self-reporting, the variable most strongly associated with poor health assessment among these elderly individuals was the presence of limitations or disabilities relating to performing activities of daily living and/or mobility. In the model based on the secondary informant, the most important explanatory variable was the number of chronic diseases presented by the elderly individual. Furthermore, the chance that the secondary informant would assess the elderly individual's health as poor was three times greater when this informant assessed his own health as poor. CONCLUSIONS: The results showed significant differences between the health assessment model for elderly people based on the individual's own responses and the model based on a secondary informant's responses. The elderly individuals tended to place value on their limitations or disabilities relating to performing activities of daily living and mobility, while secondary informants tended to place value on the diagnoses of chronic diseases. Secondary informants with poor self-assessed health presented almost three times greater chance of reporting elderly individuals' health as the same as their own. Thus, self-reported information better reflects individuals' health conditions than do reports from secondary informants.