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Purpose: To evaluate the electromyographic (EMG) activity of masseter muscles (MMs) after the provision of new complete dentures (CDs) and to assess the possible correlations between clinical behavior and the EMG findings., Materials and Methods: The sample included 78 edentulous participants (56 women, 22 men; mean age: 65.59 ± 10.47 years). Prior to provision of the new CDs, surface EMG activity of the masseter muscles was recorded during rest, maximum voluntary contraction, and mastication (MAST) using a wax artifact (WA). The tests were repeated using the new CDs, followed by the WA, at 7 days, 14 days, 21 days, and 10 months. At each assessment after placement of the CDs, the participants were questioned regarding five parameters (comfort, esthetics, retention, mastication, and speech)., Results: There was an initial decline in the EMG activity of the masseter muscles after the provision of new CDs during MAST, followed by a gradual increase in this activity over time (P > .05). There was a significant improvement in MAST reported by participants at 10 months (3.59 ± 1.141) compared to 7 days (2.50 ± 1.058) (P = .011). There was no significant correlation between the EMG findings and the clinical parameters (P > .05)., Conclusion: Although there was no significant difference in EMG activity of the MMs over time, an improvement in MAST reported by the participants was observed.

Background: The assessment of adherence to warfarin therapy is useful in clinical practice due to its wide variability in dose-response and risks of complications. The aim of this study was to investigate validated instruments used to assess adherence to warfarin therapy., Methods: Information was collected from the MEDLINE (PubMed), LILACS, EMBASE, and Cochrane Library databases. Search strategies were applied for each database, with no time limit or language restriction. Inclusion criteria consisted of study participants of ≥ 18 years of age, from both sexes, on chronic anticoagulation with warfarin for any indication and the use of validated instruments to assess adherence to warfarin therapy. Exclusion criteria consisted of duplicate articles, narrative or systematic reviews, and meta-analyses, as well as case reports/series and experimental studies involving animals. Two independent reviewers performed the following steps: evaluation of titles/abstracts, selection of studies after full reading, data extraction, and evaluation of potential bias. Discrepancies were resolved by a third reviewer., Results: Overall, 19 articles were selected for this systematic review, including 17 cross-sectional studies, one cohort study, and one quasi-experimental study, published from 2009 to 2019. The validated instruments identified in this review were Morisky Medication Adherence Scale (MMAS), the eight-item Morisky Medication Adherence Scale (MMAS-8), Measurement of Treatment Adherence (MTA), and Brief Medication Questionnaire (BMQ). Only MMAS-8 was tested for reliability, using the internal consistency assessment, with Cronbach's α range 0.56-0.71., Conclusions: This review highlighted a gap in knowledge regarding the scarcity of validated instruments to assess adherence to warfarin therapy. Limitations were found in instruments that comprised the assessment of the isolated use of medication and the lack of analysis of other relevant therapeutic aspects. Future studies are needed to develop and validate more comprehensive instruments in an attempt to assess adherence to warfarin therapy., Prospero: Registration number CRD42019128324., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Oral anticoagulant therapy (OAT) has increased substantially due to the aging population and prevalence rise of atrial fibrillation (AF). Medication adherence is important to achieve effectiveness and safety of OAT. The study aim was to investigate the relationship between health literary (HL) and the adherence to OAT in patients with atrial fibrillation (AF). This is a cross-sectional study conducted in a public cardiology clinic in Brazil, 2019. Sociodemographic and clinical data were collected by the review of medical records and interviews with patients. The relation between health literacy (HL) and adherence to OAT was investigated by a multiple logistic regression model. Overall, 100 AF patients were included in this study, with average age of 68.8 ± 13.8 years and predominance of women (54 %). Inadequate HL was found in 79 % of the patients and non-adherence was identified in 66 % of the participants. Sex was the only variable with a statistically significant association with non-adherence to OAT. Men presented a 2.54-fold greater chance of non-adherence to OAT, when compared to the women (Odds ratio (OR) = 2.54; 95 % confidence interval (CI): 1.03-6.62; p = 0.047). No statistically significant relationship was found between inadequate HL and non-adherence to OAT (OR 1.48; 95 % CI, 0.47-4.61; p = 0.49). High rates of inadequate HL and non-adherence to OAT were identified in this study; however, this relationship did not prove to be statistically significant. Further studies are needed to investigate factors associated with non-adherence to OAT in large samples of vulnerable populations and strategies for its improvement in public health., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objective: This review will aim to assess the influence of sex-based differences on oral anticoagulation control in patients taking coumarin derivatives., Introduction: Coumarin derivatives, such as warfarin, have a narrow therapeutic index, requiring frequent monitoring to achieve adequate anticoagulation control, which can be assessed by the time in therapeutic range. Differences in the quality of oral anticoagulation control between men and women have been reported, although the current evidence is controversial. A systematic review on this topic would provide results that could be incorporated into clinical practice to enhance oral anticoagulation control and treatment outcomes., Inclusion Criteria: Observational and experimental studies were assessed for eligibility, with participants aged ≥18 years of either sex taking oral anticoagulation or other coumarin derivatives for ≥3 months, for any indication of chronic use, who had oral anticoagulation control evaluated by time in therapeutic range., Methods: Electronic databases to be searched include MEDLINE, BVS, CINAHL, Embase, Cochrane CENTRAL, and Web of Science. Two reviewers will independently perform title/abstract selection and screening, and then full text retrieval and screening of articles that meet the inclusion criteria. The evaluation of methodological quality and data extraction will also be performed by two independent reviewers. Data will be synthesized in tables and then the compiled results will be meta-analyzed. In the presence of subgroup differences, meta-regression methods will be used to investigate the effects of categorical or continuous covariates. If statistical pooling is not possible, a narrative synthesis will be presented., Systematic Review Registration Number: PROSPERO (CRD42019128329)., Competing Interests: The authors declare no conflict of interest., (Copyright © 2021 JBI.)

Metsulfuron-methyl is one of the most used sulfonylurea herbicides, being applied alone in pre-emergence and with a mineral oil (as adjuvant) in post-emergence. In risk assessment of pesticides, ecotoxicity tests have been applied to assess the effects of products and mixtures under laboratory conditions, but they are limited in their ecological relevance when compared to field assessments. Considering the differences between laboratory and field exposure, and the lack of data on the effects of metsulfuron-methyl in natural soils, this study consisted in a set of tests to assess the ecotoxicity of this herbicide applied alone, combined with an adjuvant (mineral oil) and the adjuvant applied alone, both under laboratory and field exposure, with artificial and natural soil respectively. Reproduction tests with four non-target soil invertebrates species were performed in laboratory, while two experiments were performed in field evaluating avoidance behaviour, feeding activity, mesofauna abundance and pesticide residual. Laboratory results showed that metsulfuron-methyl alone is not a threat to soil fauna on the recommended doses. However, the presence of mineral oil as adjuvant showed ecotoxicity to Eisenia andrei, Enchytraeus crypticus and Proisotoma minuta on laboratory tests. Field evaluations indicated that metsulfuron-methyl and the adjuvant do not impaired the feeding activity of the soil fauna. The low abundance of native communities could be related to soil management. Results showed that laboratory and field evaluations are necessary to better understanding of the effects of pesticides to soil fauna and adjuvant addition should be considered on pesticides risk assessment., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Objective: to analyze the self-care competence in the administration of insulin performed by older people aged 70 or over., Method: cross-sectional study carried out with 148 older people aged 70 or over, who performed self-administration of insulin. Data collection was carried out using a structured questionnaire and an adapted guide for the application of the Scale to Identify Self-Care Competence of Patients with Diabetes, at the participants' home. Data analysis included descriptive and inferential statistical tests, with forward logistic regression., Results: the prevalence of self-care competence in the administration of insulin was 35.1%. Handwashing error was the most frequent in self-administration of insulin. Self-care competence was negatively associated with retirees and positively associated with senior patients who performed capillary blood glucose monitoring and skin pinching during insulin application., Conclusion: there was low self-care competence and it was associated with both the sociodemographic and the clinical characteristics with regard to self-application of insulin by the older people.

This article seeks to investigate environmental aspects that may be associated with falls among elderly residents in the state of Rio Grande do Sul. It is a population-based, descriptive, cross-sectional study, with primary data collection taken from an epidemiological study entitled A Profile of the Elderly in the state of Rio Grande do Sul. The study was conducted between the years of 2010 and 2011 with 6751 elderly individuals in 59 cities in the state of Rio Grande do Sul. The association between falling and the independent variables was verified by univariate and multivariate analysis, to estimate chances of falling, adjusted for sex and age. The frequency of falls was 10.7%. Factors detected to be effective against falling: being male, having higher education, perception of insecurity, placing of seats in public places and participation in social and civic activities. The following were considered risk factors: old age, use of walking aids and participation in community activities. The results remained significant after adjustment for demographic factors. Falling is commonly associated with physical and behavioral aspects, though social and environmental factors also prove significant in this respect.

Prevalence of intestinal parasites was investigated in 1381 low-income children under five years of age from March 1990 to October 1991 in the city of Rio de Janeiro, Brazil. Stool tests were run using the Blagg et al. method. Observed prevalence of infection was 54.5%. The most frequent parasites were Giardia lamblia and Ascaris lumbricoides (25.0% of the children). A significant statistical difference (p<0.05) was demonstrated between age and infection according to the species of parasite studied. Infection rates demonstrated the need for control of parasites in these child.