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Background/Objectives: Prematurity rates remain high and represent a challenge for the public health systems of any country, with a high impact on neonatal mortality. This study aimed to evaluate the frequency and environmental and maternal–fetal risk factors for premature birth in a cohort of parturient women, with their newborns monitored in a neonatal intensive care unit at a private reference hospital. Methods: A cohort was carried out between 2013 and 2018 among parturient women living in a capital city in the Northeast of Brazil whose newborns were admitted to the neonatal intensive care unit. This study was approved by the Research Ethics Committee of the University of Fortaleza. The information collected comprised data from both medical records and hydrosanitary data from maternal homes. Results: The prevalence of prematurity among live births (n = 9778) between 2013 and 2018 at this hospital was 23%. The frequency of prematurity among those eligible (n = 480) was 76.9%, and the frequency of eligible premature babies (n = 369) in relation to the total number of births in this period was 3.8%. In the multivariate analysis, the significant risk factors for prematurity were primigravida (RR = 1.104, 95%CI: 1.004–1.213) and hypertensive syndromes during pregnancy (RR = 1.262, 95%CI: 1.161–1.371), and the significant protective factor was the highest number of prenatal consultations (RR = 0.924, 95%CI: 0.901–0.947). Conclusions: This study contributes to providing greater visibility to prenatal care and the understanding of complications during pregnancy and childbirth care. These results indicate the need to implement public policies that promote improvements in the population's living conditions and care for pregnant women to reduce premature births and, consequently, neonatal and infant mortality. [ABSTRACT FROM AUTHOR]

The goal of this comprehensive review was to verify if the prevalence of Helicobacter pylori (Hp) bacteria in patients with dyspepsia is higher in the oral cavity of periodontal or non-periodontal patients. The bibliographic search was conducted on scientific studies published in PubMed, Cochrane Library, SciELO, and BVS. The focus question was: "In patients with dyspepsia and periodontitis, is the prevalence of Hp bacteria in the oral cavity higher than in patients with only dyspepsia or without any disease?" The inclusion criteria were human studies in English, Portuguese, or Spanish languages, published between 2000 and 2022, that included patients over the age of 18 and aimed to evaluate the presence of Hp bacteria in the oral cavity and in the protective mucosal layer of the gastric lining of patients with the diseases (periodontitis and dyspepsia) or without disease; clinical trials, randomized controlled clinical trials, comparative studies, case-control studies, cross-sectional studies, and cohort studies. The methodological quality evaluation of the included articles was performed using the Joanna Briggs Institute tools. The final scores could be of "Low" quality (at least two "no" [red] or ≥ five "unclear" found), "Moderate" quality (one "no" [red] was found or up to four "unclear" criteria were met), or "High" quality (all green [yes] or at maximum two "unclear"). Of 155 potentially eligible articles, 10 were included in this comprehensive review after the application of the eligibility criteria. The selected studies were scrutinized regarding the relationship between Hp colonization in the oral cavity and stomach, its impact on severity and complications of gastric infection, as well as the effect of the presence of oral and gastric Hp on dental and systemic parameters. Hp can colonize periodontal pockets regardless of its presence in the stomach. There was a higher prevalence of oral biofilm in dyspeptic patients with periodontal disease, and worse control of bleeding and low oral hygiene was observed in periodontal compared to non-periodontal patients. For que quality assessment, the scientific studies included presented low to moderate methodological quality. Conclusions: It is possible to conclude that Hp is a bacterium that can colonize dental plaque independently of the stomach and vice versa; however, when both diseases are found, its presence may be more significant. Supra and subgingival dental plaque may be a reservoir of Hp, suggesting that patients with gastric infections are more likely to have Hp in the oral cavity. The results must be carefully analyzed due to the limitations present in this review. [ABSTRACT FROM AUTHOR]

This study aims to assess the self-perception of the QoL (WHOQOL-bref) in the Canal of Anil zone and its neighbor zone of the center of the District of Anil in Rio de Janeiro and to identify which factors are associated with the population self-perception of the need to "improve" their quality of life (QoL). A cross-sectional observational analytical study was carried out after approval by the competent ethics committee (CEP/CONEP) approval. A non-probabilistic sampling of residents of the Canal of Anil (n = 494) and the central district of Anil (n = 250) was used. A questionnaire was administered in person to collect data on self-reported sociodemographic characteristics, general health, sanitation, lifestyle in the residential area, and the WHOQOL-Bref. Although with a worse self-perceived water/sanitation participants in the Anil Canal community report fewer allergies, less medication, fewer skin diseases, less Zika virus, and less Chikungunya, among others. The self-perception of the need to improve the QoL in the Anil Canal community and the zone at the central District of Anil has proved to be influenced by several social and economic factors as well as residential practices and conditions. The multivariate analysis allowed us to identify both modifiable and non-modifiable risk factors for the need to improve physical QoL: taking medication, respiratory problems, skin disease diagnosed by a doctor, having a water tank at home or having filtered water at home, unpleasant odor of the water of the Anil Canal and the level of education, and age. Regarding the need to improve the environmental QoL, both areas are largely modifiable (e.g., having had ascariasis/roundworm; having a water tank in the house; not drinking bottled water; not having pavements in the street). Sociodemographic and environmental factors, in addition to health conditions, play a pivotal role in influencing individuals' perceptions of the necessity for enhanced physical and environmental well-being. [ABSTRACT FROM AUTHOR]

Despite advances in neonatology, neonatal mortality from preventable causes remains high in the North and Northeast regions of Brazil. This study aimed to analyze the determinants associated with neonatal and postneonatal mortality in newborns admitted to a neonatal intensive care unit. A cohort study was carried out in a capital in the Brazilian Northeast from 2013 to 2018. The outcome studied was death. Poisson regression was performed in the multivariate analysis of variables. Four hundred and eighty newborns were eligible, and 8.1% (39 newborns) died. Among them, 34 died in the neonatal period. The determinants that remained significantly associated with neonatal and postneonatal mortality in the final adjustment model (p < 0.05) were history of abortion, perinatal asphyxia, early neonatal sepsis and umbilical venous catheterization. All causes of this outcome were preventable. The neonatal mortality rate, although it did not include twins, neonates with malformations incompatible with life and other conditions, was 3.47 deaths per thousand live births (95% CI:1.10−8.03‰), well below the national average. In this study, pregnant women from different social classes had in common a private plan for direct access to health services, which provided them with excellent care throughout pregnancy and postnatal care. These results indicate that reducing neonatal mortality is possible through public policies with strategies that promote improvements in access to health services. [ABSTRACT FROM AUTHOR]

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Objectives: Adherence to the daily use of dental floss in childhood is recommended by various international health institutions/organizations. This systematic review (PROSPERO number CRD42020205232) aims to evaluate the prevalence of dental floss use in deciduous dentition. Materials and methods: A systematic review was conducted in six databases (B‐on, Cochrane Library, PubMed, Scielo, Science Direct and Web of Science) up to December 2020. The CoCoPop mnemonic allowed for obtaining 2333 articles and resulted in the inclusion of 7 observational studies that evaluated the prevalence of dental floss use (primary outcome) in children up to 6 years old. The Joanna Briggs Institute critical appraisal checklist was used to evaluate the risk of bias, showing that most articles presented good quality. Meta‐analyses were performed using the proportion of dental floss use (yes or once/day) and the random effects model. Results: The meta‐analysis showed a prevalence of dental floss use of only 12.60% (95% CI: 7.69%–18.52%) based on studies with high heterogeneity of results (I2 = 94.75%; 95% CI: 91.44%–96.78%). Six of the seven studies showed that more than 70% of children never used dental floss. Conclusions: A low prevalence of dental floss use was observed in children up to 6 years old. Given the diversity of evaluating the use of dental floss, different options should be the target of standardization in future studies. [ABSTRACT FROM AUTHOR]

Purpose: To assess the self-reported Oral Health Related Quality of Life (OHRQoL) among institutionalised patients in an alcoholic detoxification programme in northern Portugal.Materials and Methods: This analytical cross-sectional study using the Oral Health Impact Profile-49 (OHIP-49) was carried out in 300 individuals institutionalised for alcohol detoxification in withdrawal units. The seven OHIP-49 domain scores and three summary indicators were examined: 'Prevalence' (percentage of people reporting one or more of 49 items at least 'fairly often'), 'Extent' (number of impacts [items] reported at least 'fairly often') and 'Severity' (mean sum of the participants' OHIP score).Results: The sample comprised 83.3% males with a mean age of 44 ± 8.6 years and an abusive alcoholic consumption history of 21.2 ± 11.5 years. The results show a 'prevalence' of 62.4% (95% CI: 56.7%-67.7%), the mean 'extent' was 3.8 (95% CI: 3.2-4.5) impacts and the mean 'severity' level was 54.8 (95% CI: 49.9-59.7). 'Prevalence' was significantly and positively associated with patients with gastroesophageal reflux disease (GERD), those with a higher estimated daily alcohol intake, who previously used hashish and who brushed their teeth after drinking alcohol. 'Extent' was higher among females, those with higher levels of education, patients with GERD, smokers, and those with a higher estimated daily alcohol consumption; it was negatively associated with not brushing teeth. 'Severity' was significantly and positively associated with female gender and smoking, and negatively associated with not brushing teeth.Conclusion: This population of alcohol-dependent patients undergoing an addiction rehabilitation programme presented a high prevalence of negative oral health impacts, but not a high extent or severity. [ABSTRACT FROM AUTHOR]

Unilateral vocal folds paralysis is a disorder that affects a patient's quality-of-life by disturbing their phonation, breathing, and swallowing activities. This systematic review aimed to estimate the efficacy of voice treatment on the vocal fold motility in adult patients with unilateral vocal folds paralysis. PubMed, CINAHL, CENTRAL, and Web of Science were searched for retrospective and prospective cohort, case-control, and cross-sectional with comparative studies with adults that were published between 1 January 2008 to 31 December 2018. After applying the inclusion and exclusion criteria a total of 10 studies containing morpho-functional evaluation results were included in the analysis. Pooled data analysis of the motility of the vocal folds before and after voice therapy allowed inferring about the efficacy of voice therapy intervention in patients with unilateral vocal folds paralysis. A random-effect model was used to estimate the effect size. Publication bias was considered. The pooled data analysis of the visual-perceptual measures revealed that vocal fold motility improved in 72% (95% CI: 64.0–80.0) of all patients after the therapeutic interventions. The inconsistency index (I2 = 18.35%) of the studies included in this meta-analysis revealed an extremely low heterogeneity. Funnel plot and Cochran's Q test showed no publication bias. The systematic review was limited to only English language articles. This meta-analysis supports the evidence that voice therapy intervention can have a positive effect on the vocal fold motility, that is, they can improve the glottal gap closure, irrespective of the exercises and techniques used. [ABSTRACT FROM AUTHOR]

Background: The anatomical and morphological alterations associated with cleft lip and palate (CLP) favour the buildup of dental plaque. Aim: To assess the efficacy of a new add‐on to regular toothbrush—the Cleft Toothbrush, in removing the dental plaque of CLP patients, compared to a regular toothbrush. Design: Forty‐five children with CLP were randomly organized into two groups: A (n = 26, 2‐6 years old) and B (n = 19, 7‐12 years old). They were evaluated at days 0, 15, 30, and 60. After brushing their teeth with a regular toothbrush or with the Cleft Toothbrush, the dental plaque was recorded using an adapted Plaque Index (aPI). Data analyses were performed in IBM SPSS(c), and all statistic inference comparisons were made using non‐parametric tests. Results: In the first 15 days, children used a new regular toothbrush and aPI‐C (teeth adjacent to the cleft) was recorded. The Cleft Toothbrush, used by all children from day 15 to day 30, showed high efficacy in removing dental plaque in the cleft area, evidenced by significantly lower aPI‐C values, compared to those observed with the regular toothbrush (P < 0.001). When given free option of brushing technique, from day 30 to day 60, most of the children (38 out of 45) chose the Cleft Toothbrush. Conclusions: The Cleft Toothbrush showed high efficacy in removing dental plaque in the cleft area, and presented high level of acceptance by parents and children, compared to a regular toothbrush. This is expected to improve the health status of the local adjacent tissues, a requirement for their rehabilitation. [ABSTRACT FROM AUTHOR]