Contextual and individual assessment of dental pain period prevalence in adolescents: a multilevel approach

<p>Abstract</p> <p>Background</p> <p>Despite evidence that health and disease occur in social contexts, the vast majority of studies addressing dental pain exclusively assessed information gathered at individual level.</p> <p>Objectives</p> <p>To assess the association between dental pain and contextual and individual characteristics in Brazilian adolescents. In addition, we aimed to test whether contextual Human Development Index is independently associated with dental pain after adjusting for individual level variables of socio-demographics and dental characteristics.</p> <p>Methods</p> <p>The study used data from an oral health survey carried out in São Paulo, Brazil, which included dental pain, dental exams, individual socioeconomic and demographic conditions, and Human Development Index at area level of 4,249 12-year-old and 1,566 15-year-old schoolchildren. The Poisson multilevel analysis was performed.</p> <p>Results</p> <p>Dental pain was found among 25.6% (95%CI = 24.5-26.7) of the adolescents and was 33% less prevalent among those living in more developed areas of the city than among those living in less developed areas. Girls, blacks, those whose parents earn low income and have low schooling, those studying at public schools, and those with dental treatment needs presented higher dental-pain prevalence than their counterparts. Area HDI remained associated with dental pain after adjusting for individual level variables of socio demographic and dental characteristics.</p> <p>Conclusions</p> <p>Girls, students whose parents have low schooling, those with low <it>per capita </it>income, those classified as having black skin color and those with dental treatment needs had higher dental pain prevalence than their counterparts. Students from areas with low Human Development Index had higher prevalence of dental pain than those from the more developed areas regardless of individual characteristics.</p

Desigualdades contextuais e individuais da prevalencia de dor dentaria em adultos e idosos no Brasil

Abstract published in English and Portuguese English title: Contextual and individual inequalities in dental pain prevalence among Brazilian adults and eldersThis study aimed to assess the prevalence of dental pain among adults and older people living in Brazil’s State capitals. Information was gathered from the Telephone Survey Surveillance System for Risk and Protective Factors for Chronic Diseases (VIGITEL) in 2009 (n = 54,367). Dental pain was the outcome. Geographic region, age, gender, race, schooling, private health coverage, smoking, and soft drink consumption were the explanatory variables. Multilevel Poisson regression models were performed. Prevalence of dental pain was 15.2%; Macapá and São Luís had prevalence rates greater than 20%; all capitals in the South and Southeast, plus Cuiabá, Campo Grande, Maceió, Recife, and Natal had prevalence rates less than 15%. Factors associated with increased prevalence of dental pain were the North and Northeast regions, female gender, black/brown skin color, lack of private health insurance, smoking, and soft drink consumption. Dental pain is a public health problem that should be monitored by health surveillance systems. = O objetivo deste estudo foi conhecer a prevalência de dor dentária e fatores associados em adultos e idosos residentes nas capitais brasileiras usando os dados do Sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (VIGITEL), de 2009 (n = 54.367). Dor dentária foi a variável dependente. Macrorregião, idade, sexo, raça, escolaridade, posse de plano de saúde, tabagismo e consumo de refrigerantes foram as variáveis exploratórias. Foram realizadas regressões de Poisson multinível. A prevalência de dor dentária foi de 15,2%; Macapá e São Luís apresentaram prevalências maiores que 20% enquanto em todas as capitais do Sul e Sudeste, em Cuiabá, Campo Grande, Maceió, Recife e Natal foram encontradas prevalências menores que 15%. Residentes no Norte e Nordeste, mulheres, pretos e pardos, aqueles que não possuem plano de saúde, tabagistas e consumidores de refrigerantes apresentaram as maiores prevalências de dor dentária. A dor dentária é um problema de saúde pública que deve ser monitorado pelos sistemas de vigilância em saúde.Marco A. Peres, Betine Pinto Moehlecke Iser, Karen Glazer Peres, Deborah Carvalho Malta, José Leopoldo Ferreira Antune

Respiratory muscle strength no influence the need for noninvasive ventilation after heart surgery

The aim of this study was to investigate the relation between preoperative respiratory muscle strength and indication and performance of noninvasive ventilation in the planned heart surgery. We conducted a retrospective study using data collected from clinical records and analyzed 109 medical records and noninvasive ventilation accompanying paper. We analyzed the values of respiratory muscle strength, peak flow and respirometry, as well as the postoperative respiratory complications, correlating them with indication and performance of the noninvasive ventilation. The t test was performed for continuous variables; the chi-square was used to investigate the influence of preoperative respiratory muscle strength values in the indication of noninvasive ventilation. Noninvasive ventilation was used in 32 (29%) subjects and the prime motive indication was hipercapy (44%). The successful use of noninvasive ventilation was observed in 94%. The decrease in preoperative strength, despite having a lower performance, showed no significant difference in relation to its use and outcome (p=0.73). The preoperative respiratory muscle strength was not able to provide for the use of noninvasive ventilation or its performance