Dependence in instrumental activities of daily living and its implications for older adults’ oral health

We aimed to assess the association between dependence in instrumental activities of daily living (IADL) and oral health in older adults. We conducted a cross-sectional study of 280 people aged �60 years served at public primary health care centers in Northeastern Brazil. Sociodemographic, oral discomfort and general health data were collected. The Lawton and Brody scale were used to assess IADL. This research adheres to the STROBE checklist. Most participants were married (n = 139; 49.6%), women (n = 182; 65.0%) and retired (n = 212; 75.7%). A total of 37 (13.2%) older adults had some degree of dependence in IADL. Dependence in IADL was associated with: retirement (p<0.040), poor general health (p = 0.002), speech problems (p = 0.014), use of medications (p = 0.021), difficulty chewing and swallowing food (p = 0.011), voice changes (p = 0.044), edentulism (p = 0.011), use of toothbrush (p<0.001), use of toothpaste (p<0.001), and visit to the dentist in the previous year (p = 0.020). Functional disability was associated with older age, cardiovascular diseases, speech problems, chewing and swallowing difficulties, use of medication and brushing deficiency. The functional dependence in IADL can be considered an indicator of oral health status in older adults.info:eu-repo/semantics/publishedVersio

Brazilian adolescents’ oral health trends since 1986: an epidemiological observational study

Oral health is part of general health, and in adolescence, it represents a good individual health indicator. Three country-based oral health epidemiological studies have been developed in Brazil (1986, 2003 and 2010). The objective of this study was to analyze oral disease trends among Brazilian adolescents and to compare these trends to the World Health Organization's goals with a focus on public health policies implemented between 1986 and 2010. This is an epidemiological observational study performed with secondary data from Brazilian Oral Health surveys (1986, 2003 and 2010). The DMFT (number of decayed, missing and filled teeth) index was used for the 12-year-old and 15- to 19-year-old groups, and periodontal disease (CPI) and the percentage of individuals who needed and/or had prostheses were evaluated in the 15- to 19-year-old group. Between 1986 and 2010, DMFT decreased from 6.65 to 2.07 (68.9 % reduction) in the 12-year-old group and from 12.68 to 4.25 (66.5 % reduction) in the 15- to 19-year-old group. In all groups, the missing component had the strongest decrease. Adolescents had a reduction of 20.3 % in access to dental care. In 2003, in the 15- to 19-year-old group, 89.5 % of teenagers had at least one decayed tooth, while in 2010, the value was 76.1 %. In 2010, the percentage of adolescents without gingival problems varied among different regions of Brazil, with 30.8 % in the North and 56.8 % in the Southeast. Regarding DMFT, the difference between the North and Southeast Regions was 84 %. Improvement trends regarding adolescent oral health were observed, which seem to be supported by health education and promotion activities along with the reorganization of the Brazilian health system.855

Prolonged mechanical ventilation patient outcome after discharge from an intensive care unit

Background: Mechanical ventilation (MV) is one of the pillars of therapy in the Intensive Care Unit (ICU) as many patients require ventilatory support. This study aimed to analyze the outcome of Prolonged Mechanical Ventilation (PMV) patients after discharge from an Intensive Care Unit (ICU). Methods: This is a retrospective cross-sectional study of 142 medical charts of patients admitted to an ICU and a Special Care Unit (SCU) in Brazil from 2012 to 2014. Results: Participants’ mean age was 66.5 and the majority were men (58.5%). Outcome in the ICU was correlated with laparotomies before (p=0.043) and after (p=0.049) admission, sepsis (p=0.013), dialysis-requiring acute kidney injury (AKI) (p<0.001), and hemodynamic instability (p=0.003). Dialysis requiring AKI (p=0.012), non-dialysis-requiring AKI (p=0.023) and atelectasis (p=0.045) during ICU stay were correlated with death in SCU patients. Only hemodynamic instability (p=0.002) and diarrhea (p=0.045) were correlated with outcome in the SCU. Additionally, 91 (64.1%) PMV patients in the ICU were discharged to the SCU, 50 (35.2%) died, and one (0.7%) was transferred to another hospital. Furthermore, 15 (16.5%) SCU patients were discharged to the Home Care Program and one (1.1%) was transferred to another hospital. Conclusions: PMV patients exhibited longer hospital stay and higher mortality. Dialysis-requiring AKI and hemodynamic instability were associated with increased risk of death. Only a few PMV patients were successfully discharged or referred to Home Care.info:eu-repo/semantics/publishedVersio