Search

This study compared the incidence of hip fractures before and during the COVID-19 pandemic in Brazil, aged ≥ 60 years excluding all fractures related to any trauma. There was a significant reduction in the number of hip fractures and the length of hospital stay during the period of social isolation., Purpose: To compare the incidence of hip fractures before and during the COVID-19 pandemic in Brazil and in the main regions of the country in patients covered by the Brazilian public health care system (SUS). As far as we are aware, no studies have evaluated the impact of COVID-19 pandemic on hip fractures in Brazil., Methods: Descriptive, cross-sectional study in individuals aged ≥ 60 years who presented with a hip fracture before and during the COVID-19 pandemic and received treatment covered by the SUS. The data were collected from the DATASUS electronic database. We calculated the incidence, mortality, lethality, duration of hospitalization, and average reimbursement associated with the treatment of the fractures., Results: There was a significant reduction in the incidence of hip fractures among individuals aged ≥ 60 years in Brazil during the period of social isolation due to COVID-19. The observed incidence was 15.58/10,000 inhabitants between March and December 2020 and 16.07/10,000 inhabitants in the same period of 2019 (p < 0.005; main decline observed in the age groups > 70 years). The average length of hospital stay reduced from 8.35 days in 2019 to 7.33 days in 2020, following a similar pattern of reduction across all regions. The Southeast was the only region with a significant reduction in mortality during the pandemic (relative risk 0.90, 95% confidence interval 0.84-0.97, p < 0.005)., Conclusion: During the COVID-19 pandemic in Brazil, the incidence rate of hip fractures and the associated duration of hospital stay decreased among patients aged ≥ 60 years., (© 2022. International Osteoporosis Foundation and National Osteoporosis Foundation.)

Background: Immunopreventable diseases are a public health reality in Brazil and worldwide, a reality that is not exclusive to children, but affects the adult population., Objectives: Discriminating the total costs of hospitalizations from immunopreventable diseases in the population aged 20 to 59 years., Methods: A population, observational, descriptive, retrospective study was conducted with secondary information from DATASUS to discriminate the hospitalizations associated with immunopreventable diseases in Brazil and their care costs, within the Scope of the SUS, between 2008 and 2018, in the economically active population (20 to 59 years)., Results: It was analyzed 127,746 hospitalizations for immunopreventable diseases, (27.92% of all hospitalizations) were observed in the adult population, totaled R$115,682,097.54 (29.72% of the total costs). Of this population studied, 51.48% were registered as male; 66.74% were associated with influenza disease; 16.05% to chickenpox/herpes zoster infection and 7.55% to acute hepatitis B infections. The trend analysis of the time series of hospitalizations in this population showed a stationary trend., Conclusions: The 127,746 hospitalizations could be avoided with immunization, and 127,746 workers who could be working and not hospitalized. There were also R$115,682,097.54 that could be invested in other public health needs, which became necessary for the treatment of preventable diseases., (© 2021. The Author(s).)

Objective: The aim of this cross-sectional study was to estimate the prevalence of XLH in Paraná, a state in southern Brazil, and report the clinical features and complications of the disease., Methods: We invited all endocrinologists (n = 205), nephrologists (n = 221), orthopedic surgeons (n = 1020), and pediatricians (n = 1000) in Paraná to fill out an electronic survey with information on patients with X-linked hypophosphatemia (XLH), and searched the records of the state's health department for all calcitriol prescriptions in 2018., Results: In all, 244 (10%) specialists responded to the email, of whom 18 (7.4%) reported to be taking care of patients with XLH and answered the online survey. A total of 57 patients with XLH were identified (prevalence 5 per million inhabitants). The median age at diagnosis was 22 years, and 42.2% were children and adolescents. Fifteen patients had genetic testing showing a PHEX mutation. Overall, 91.2% had bone deformities, 30.8% had a history of fragility fractures, and 22.4% had renal complications., Conclusion: This study demonstrated a prevalence of XLH of 5 cases per million inhabitants in the state of Paraná, a rate lower than the one reported in other countries. Manifestations of renal calcification and bone fragility were frequent among the patients. This is the first epidemiological study evaluating the prevalence and clinical presentation of XLH in Latin America.

Introduction: The occurrence of the immunopreventable diseases in a population global reality., Objective: To discriminate the direct costs of the hospitalizations from the immunopreventable diseases in the Unified Health System (SUS), in Brazil and their areas, between 2008 and 2018., Methods: A population, observational, descriptive and retrospective study, with data from the information supplied by the DATASUS website, these data were collected during the 2019., Results: It was identified 457,479 hospitalizations in the period; with a total of 2,450,870 days of hospital stay, with total costs of R$389,243,264.85. Only the disease mumps presented a growing tendency in whole areas; the chickenpox was decreasing; the illness whooping cough, yellow fever and tetanus were stationary in this period., Conclusions: The costs related to immunopreventable diseases were relevant in all the Brazil areas, with tendencies different between the geographic areas and between the several illnesses analysed., (© 2021. The Author(s).)

After hospital discharge, workers are expected to return to work (RTW). However, the ability to return and any possible limitations after returning are unclear. Will they be able to RTW? Do they face limitations? This is a prospective cohort study with descriptive analysis aimed to investigate the RTW during 1 year following hospital discharge and to identify any limitations faced by the workers. Data collection occurred between February 2017 and July 2018 in an Internal Medicine Unit at a General Hospital. Convenience sampling was used, and participation was voluntary. Participants comprised 170 adults. Participants' RTW and limitations were followed for 1 year after discharge. During hospitalisation, 95.9% of participants planned to RTW. However, only 30% and 34.1% had returned after 1 month and 1 year respectively. Initially, 57.6% did not believe that they would present any limitation after discharge. However, 85.3% experienced restrictions after 1 month, and after 1 year this percentage rose to 88.2%. A correlation was found between young adults and RTW. The presence of limitations increased non-RTW risk. Therefore, it is recommended that the worker role should not be merely replaced by that of a patient, but it deserves attention of the latter in order to RTW activities. The work-return process must focus on understanding, treating and monitoring workers' limitations over time., (© 2020 John Wiley & Sons Ltd.)

Objective: The aim of this study was to evaluate the search for health information on the Internet and to determine the frequency and main means of spreading fake health news., Methods: A descriptive cross-sectional study was conducted through the virtual distribution of questionnaires on social media platforms in 2019 by using the snowball technique. The questionnaire collected information regarding sociodemographics, means used to clarify doubts about health, implementation of information obtained through the Internet, receipt of fake news, and means of transmission of fake news. Quantitative variables are described as means and standard deviations, and categorical variables are described as frequencies and percentages. The chi-square and Fisher's exact tests were used., Results: Out of 1,195 respondents, 53% had followed Internet guidance without consulting a health professional, especially young people and individuals with low education levels (p<0.05). The resources most used to answer questions about health were a physician (78%) and Google (51%), and searches using the latter were more predominant among younger age groups (p<0.05). A large part of the sample (89.4%) had received fake news, and the main means of receipt were Facebook and WhatsApp., Conclusions: The Internet was the second most commonly used means to search for health information. A significant portion of the population adopts actions based on this information. The frequency of broadcasting fake news through this digital medium is high.

Bisphenol A (BPA) is a substance extensively used in daily life, mainly in plastic materials. This study assessed the exposure of university students to endocrine disruptor BPA, their knowledge about this substance and the damage it causes to human health. This is a cross-sectional descriptive study carried out with 500 students from a University in Curitiba. The sample was selected proportionally to the three major areas of knowledge, and the courses interviewed were drawn at random. Students were asked to fill out an objective questionnaire consisting of three parts: socioeconomic, assessment of exposure and knowledge tests. Of the respondents, 91.3% consume food stored in plastic packaging, 90.06% use drinks in this type of container and 84.8% consume canned food/drinks. However, only 19.8% have heard of BPA and 97.2% do not know about the relationship between exposure to BPA and endocrine changes. A high rate of exposure to BPA and a low level of knowledge on the subject was detected. This disproportion highlights the need for more in-depth research on the topic among the Brazilian population, in addition to broadening dissemination of information measures on the issue.

Purpose: To evaluate the association of dental caries with behavioural, socioeconomic and cultural factors; and Streptococcus mutans (SM) levels in the saliva and oral hygiene index of children aged 4 and 6 years old placed in an oral health programme., Materials and Methods: This study was an analytic cross-sectional oral health survey conducted over a 9-month period. A total of 466 children aged 4 and 6 years old were included for evaluation of SM levels in saliva, simplified oral hygiene index and dental caries activity., Results: High SM levels were associated with dmft index, toothbrushing without parental assistance, deficient oral hygiene and ingestion of sweet foods. Deficient oral hygiene was found in children aged 4 years old and with three or more siblings. Dental caries was associated with low family income, deficient oral hygiene, sucrose ingestion by children younger than three years old, bottle-feeding habit and low parental compliance., Conclusions: High SM levels in saliva, deficient oral hygiene and high frequency of sucrose ingestion had association with dental caries in children. Cultural, socioeconomic and behaviour factors indirectly influenced the onset of dental caries.

Introduction: Background and aims: home enteral nutrition (HEN) is an established treatment for clinically stable patients. The objective of this study was to determine the frequency and the situation of patients in HEN, in the capital city in the south of Brazil. Methods: in this retrospective study, we recorded all new cases of HEN in adults in Curitiba, Brazil, from January 2006 to December 2015. Data were collected by a dietitian from medical records of patients attending public health settings. The following data were analyzed: clinical diagnosis, diet prescribed during hospitalization and at discharge, and feeding access types. Kaplan-Meier and Cox regression analyses were used to calculate survival. Results: a total of 1,231 patients were included. There was a 425% increase in the frequency of HEN over the years studied. The mean age was 66.7 years, and 54.4% were men. Neurological diseases were the most prevalent (46.4%), followed by cancer (33.6%). Eight hundred and one patients (65.1%) died during this period. Mean HEN duration was 180 days (95% CI 163.6-193.4), with a significant difference between neurological diseases (median: 180 days) and cancer (median: 210 days) (p < 0.05). Neurological disease was an independent risk factor for mortality in patients on HEN (HR: 1.17; CI: 1.08-1.27). Conclusions: the study shows an increase in HEN. Neurological diseases prevailed and presented a risk of mortality, and more than half of the patients with NED died in this period.