Prevalence of undiagnosed hypertensive young people of dental policlinics of University of Amazonas State

Objetivo: avaliar a prevalência de jovens hipertensos não diagnosticados que procuraram atendimento na policlínica odontológica da Universidade do Estado do Amazonas (UEA) quanto a sexo, raça, idade e índices antropométricos.Metodologia: foi entregue um questionário de perguntas fechadas e realizadas duas aferições de pressão arterial com intervalo de 10 minutos entre elas para diagnóstico da hipertensão em 124 sujeitos. Em seguida, os pacientes foram pesados e medidos para obtenção do índice de massa corporal (IMC) e foi obtida a medida da circunferência abdominal (CA). Os dados foram analisados pelos testes Exato de Fisher e t de Student, com nível de significância de 5%. Resultados:a prevalência de jovens hipertensos não diagnosticados foi de 4,8% (n=6) e a média de idade encontrada foi de 19,3 ± 1,9 anos. O sexo feminino apresentou 8,0% (n=4) e o masculino 2,5% (n=2) de hipertensos. Houve predominância da raça parda (n=4; 5,0%). A prevalência de sobrepeso/obeso foi superior nos jovens hipertensos em comparação aos valores de IMC normal (p foi observada associação entre hipertensão e CA, em ambos os sexos (p0,05). Conclusão: a prevalência de hipertensos jovens foi baixa, sendo que a maioria destes era de mulheres de raça parda, sendo associada a indivíduos em sobrepeso ou obesos.   Aim: to evaluate the prevalence of non-diagnosed hypertensive young-adults searching for dental treatment at dentistry policlinics of Amazonas State University in function of gender, race, age and anthropometric indexes.   Metodology: a survey with non-open questions was applied along with two measurements of arterial pressure toke 10 minutes apart between them in 124 subjects. The patients were weighed and their height was measured to obtain the body-mass index (BMI). The abdominal circumference (AC) was also obtained. Data were analyzed by Fisher’s exact and Student t tests (alpha=5%). Results: the prevalence of hypertensive young-adults, aging 19.3 ± 1.9 years, was 4.8% (n=6), being 8% (n=4) females and 2.5 % (n=2) males. The predominant race was brown (5%, n=4). Overweighed/obese hypertensive subjects were prevalent when compared to normal BMI subjects (p0.05).Conclusion: the prevalence of hypertensive young-adults was low, being the majority of them brown females, being associated with overweigh or obesity.

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)