Angle’s classification among Brazilian racial biotypes: a university based observational study

Background: The purpose of this study is to determine demographic profile and the pattern of malocclusion from the initial clinical records of patients who sought the dental clinics for orthodontic treatment and to determine difference in Angle’s classification among racial biotypes.Materials and Methods: Between the years 2011 and 2014, 1576 clinical records were selected and reviewed by one examiner to identify epidemiological characteristics. Angle’s classification, age, dentition, and others were scored, and after tabulation, data were grouped to find percentiles.Results: Class I was found at 57.9%; Class II, 31.4%, and Class III, 10.8%; there was no significant difference in gender distribution (49.6% of men and 50.4% of women); the orthodontic treatment plan indicated was comprehensive (77.4%) and the sample was composed, mainly, by white and mulatto biotypes (40.8% and 41.1%, respectively) and by youth aged 5–10 y.o. (32.1%) and aged 11–15 y.o. (29.4%). Conclusion: There was a high incidence of Class I and indication for comprehensive treatment. There were differences in the incidence of malocclusion for the Afro-Brazilian ethnic group

Sickle-cell Anemia And Latent Diastolic Dysfunction: Echocardiographic Alterations

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)1044E30E33Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Arterial hypertension diagnostic and drug therapy failure among Brazilian elderly: FIBRA study

O objetivo deste estudo foi investigar prevalências de falhas no diagnóstico, no uso de anti-hipertensivos e na eficácia do tratamento medicamentoso da hipertensão, e a associação destes parâmetros com variáveis sociodemográficas, de saúde e acesso ao serviço de saúde em idosos não institucionalizados. O estudo foi descritivo, transversal, com 3478 idosos, analisados separadamente em regiões Norte/Nordeste e Sul/Sudeste. Utilizou-se a regressão múltipla de Poisson para estimar razões de prevalência brutas e ajustadas pelo tipo de serviço de saúde utilizado. Do total, 29,6% dos idosos apresentaram falhas no diagnóstico, 4,6% no uso de anti-hipertensivos e 65,3% na eficácia medicamentosa. A falha no diagnóstico associou-se ao sexo masculino, menos morbidades, ter um companheiro, raça/cor branca, ter acesso ao convênio ou serviço privado de saúde, possuir renda pessoal inferior/média e ainda trabalhar. A falha no uso de anti-hipertensivos esteve associada à renda pessoal inferior/média e trabalhar. As falhas no manejo da hipertensão são prevalentes em idosos não institucionalizados. Há necessidade de ações que minimizem os impactos negativos destas insuficiências em saúde, em um país com diferenças sociais, econômicas e étnicas.241037333742This study aimed to investigate the prevalence of failure in hypertension diagnosis, antihypertensive drug use and drug therapy efficacy and the association of these parameters with sociodemographic, health-related and access to health services variables in community-dwelling elderly. This is a descriptive cross-sectional study with 3,478 elderly from different Brazilian regions. We used Pearson's chi-square test to verify associations between outcomes and independent variables, and Poisson multiple regression to estimate crude and adjusted prevalence ratios. Of the total, 29.6% of the elderly evidenced failure in the diagnosis, 4.6% in the use of antihypertensives and 65.3% in drug efficacy. Diagnostic failure was associated with males, presence of morbidity, having a partner, white skin color/ethnicity, having access to the health covenant or private health service, with low/medium personal income and working. Antihypertensive use failure was associated with low/medium personal income and work. Hypertension management failures are prevalent in community-dwelling elderly. There is a need for actions that minimize the negative impact of these health shortcomings, in a country burdened by social, economic and ethnic differences

Thalassemia major phenotypes secondary to the association of beta 5 ' UTR +20(C -> T) allele with beta 39(C -> T)

89327327

Survival of elderly outpatients: effects of frailty, multimorbidity and disability

O objetivo deste estudo foi analisar o impacto da fragilidade, da multimorbidade e da incapacidade funcional na sobrevida de idosos assistidos em ambulatório de geriatria e identificar os fatores clínicos de risco associados ao óbito. Estudo longitudinal, com 133 idosos avaliados inicialmente em relação à fragilidade, multimorbidade (presença simultânea de 3 doenças crônicas ou mais) e perda funcional nas Atividades de Vida Diária. Utilizou-se o método Kaplan Meier, para a análise de sobrevida, e a regressão de Cox, para a associação dos fatores clínicos com o óbito. Após seguimento de seis anos, 21,2% dos participantes faleceram, sendo a sobrevida menor entre os idosos frágeis (p < 0,05). As variáveis fragilidade (HR = 2,26; IC95%: 1,03-4,93) e Insuficiência Renal Crônica (HR = 3,00; IC95%: 1,20-7,47) foram fatores de maiores riscos para óbito na análise multivariada. A fragilidade impactou negativamente na sobrevida desses pacientes, porém não foi observada associação estatisticamente significativa em relação à multimorbidade e perda funcional. O rastreio de vulnerabilidades no serviço ambulatorial de geriatria é relevante, em virtude do número expressivo de idosos portadores de síndromes geriátricas que utilizam este tipo de atendimento e do direcionamento dos cuidados desses indivíduos.241137146This study aims to analyze the impact of frailty, multimorbidity and disability on the survival of elderly people attended in a geriatric outpatient facility, and identify the clinical risk factors associated with death. It is a longitudinal study, with 133 elderly people initially evaluated in relation to frailty, multimorbidity (simultaneous presence of three or more chronic diseases) and disability in Daily Life Activities. The Kaplan Meier method was used to analyze survival time, and the Cox regression was used for association of the clinical factors with death. In follow-up over six years, 21.2% of the participants died, survival being lowest among those who were fragile (p < 0.05). The variables frailty (HR = 2.26; CI95%: 1.03-4.93) and Chronic Renal Insufficiency (HR = 3.00; CI95%: 1.20-7.47) were the factors of highest risk for death in the multivariate analysis. Frailty had a negative effect on the survival of these patients, but no statistically significant association was found in relation to multimorbidity or disability. Tracking of vulnerabilities in the outpatient geriatric service is important, due to the significant number of elderly people with geriatric syndromes that use this type of service, and the taking of decisions on directions for care of these individuals

A Novel Beta-globin Variant: Hb Poços De Caldas [beta 61(e5)lys-->gln].

26385-

The Role of Heart Rate Variability (HRV) in Different Hypertensive Syndromes

Cardiac innervation by the parasympathetic nervous system (PNS) and the sympathetic nervous system (SNS) modulates the heart rate (HR) (chronotropic activity) and the contraction of the cardiac muscle (inotropic activity). The peripheral vasculature is controlled only by the SNS, which is responsible for peripheral vascular resistance. This also mediates the baroreceptor reflex (BR), which in turn mediates blood pressure (BP). Hypertension (HTN) and the autonomic nervous system (ANS) are closely related, such that derangements can lead to vasomotor impairments and several comorbidities, including obesity, hypertension, resistant hypertension, and chronic kidney disease. Autonomic dysfunction is also associated with functional and structural changes in target organs (heart, brain, kidneys, and blood vessels), increasing cardiovascular risk. Heart rate variability (HRV) is a method of assessing cardiac autonomic modulation. This tool has been used for clinical evaluation and to address the effect of therapeutic interventions. The present review aims (a) to approach the heart rate (HR) as a CV risk factor in hypertensive patients; (b) to analyze the heart rate variability (HRV) as a “tool” to estimate the individual risk stratum for Pre-HTN (P-HTN), Controlled-HTN (C-HTN), Resistant and Refractory HTN (R-HTN and Rf-HTN, respectively), and hypertensive patients with chronic renal disease (HTN+CKD)