ABSTRACT Objective Hypoparathyroidism is a rare condition, whose most common etiology is complications of neck surgery. The aim of the study was to identify the clinical and biochemical profile of the patients with diagnosis of hypoparathyroidism, including the frequency of symptoms, clinical signs, long-term complications and disease control. Additionally, the study sought to know what the medication profile was, and the doses required by the patients. Subjects and method A retrospective cohort study was conducted wherein all patients with ICD-10 codes associated with hypoparathyroidism between 2011 and 2018 at the Hospital Universitario San Vicente Fundación were included. We investigated the etiology of the disease; biochemical profile including lowest serum calcium, highest serum phosphorus, 25OHD levels, calciuria and calcium/phosphorus product; medication doses, disease control, and presence of complications, especially renal and neurologic complications were also evaluated. Results The cohort included 108 patients (99 women/9 men) with a mean age of 51.6 ± 15.6 years. The main etiology was postoperative (93.5%), the dose of elemental calcium received was relatively low (mean 1,164 mg/day), and in only 9.2% of cases more than 2,500 mg/day of elemental calcium was necessary. We were able to evaluate the follow-up in 89 patients, and found that only 57.3% met the criteria for controlled disease. Conclusion The clinical profile of patients with hypoparathyroidism in our cohort is similar to that described in other international studies, with predominantly postoperative etiology. With standard therapy, only adequate control is achieved in a little more than half of patients. Arch Endocrinol Metab. 2020;64(3):282-9

Resumo O objetivo deste estudo foi avaliar a associação entre cárie dentária não tratada (CDNT) e insegurança alimentar (IA) em escolares de diferentes estratos de renda. Foi realizado um estudo de base populacional com uma amostra de 584 escolares de 12 anos de idade. Exames clínicos bucais foram realizados e IA foi determinada por meio de uma escala validada. Outras variáveis foram analisadas por serem de interesse para a estratificação dos resultados (renda domiciliar per capita) ou como variáveis de confusão. A prevalência de CDNT e IA foi de 45% e 39%, respectivamente. Os modelos multivariados demonstraram que a CDNT foi significativamente mais prevalente entre as crianças com IA alimentar e renda per capita de até US$ 70,71 do que entre aqueles no mesmo estrato de renda que estavam livres de IA [RP = 1,52 (IC 95% = 1,01 -2,29)]. A IA foi associada com uma maior frequência de CDNT em escolares de baixa renda, porém não teve impacto significativo sobre esta variável entre crianças de diferentes estratos de renda. Diante disso, garantir o acesso a uma alimentação de qualidade pode representar uma boa estratégia para minimizar as iniquidades em saúde bucal e reduzir a experiência de cárie dentária em escolares de baixa renda.

Abstract The aim of the present study was to assess the association between untreated dental caries (UDC) and household food insecurity (HFI) among schoolchildren in different income strata. A population-based study was carried out with a sample of 584 12-y-old schoolchildren. Oral examinations were performed and HFI was determined using a validated scale. Other independent variables were analyzed for being of interest to the stratification of the results (per capita household income) or for acting as potential confounding variables. The prevalence of UDC and HFI was 45% and 39%, respectively. The multivariate models demonstrated that the UDC was significantly more prevalent among children in food-insecure households with per capita income of up to US$ 70.71 than among those in the same income stratum that were free of HFI [PR = 1.52 (95%CI = 1.01-2.29)]. HFI was associated with a greater frequency of UDC among low-income schoolchildren, but had no significant impact on this variable among children from other income strata. Thus, ensuring access to quality food may be a good strategy for minimizing inequities in oral health and reducing dental caries experience among schoolchildren from low-income families.

Resumo O objetivo deste estudo foi avaliar a associação entre cárie dentária não tratada (CDNT) e insegurança alimentar (IA) em escolares de diferentes estratos de renda. Foi realizado um estudo de base populacional com uma amostra de 584 escolares de 12 anos de idade. Exames clínicos bucais foram realizados e IA foi determinada por meio de uma escala validada. Outras variáveis foram analisadas por serem de interesse para a estratificação dos resultados (renda domiciliar per capita) ou como variáveis de confusão. A prevalência de CDNT e IA foi de 45% e 39%, respectivamente. Os modelos multivariados demonstraram que a CDNT foi significativamente mais prevalente entre as crianças com IA alimentar e renda per capita de até US$ 70,71 do que entre aqueles no mesmo estrato de renda que estavam livres de IA [RP = 1,52 (IC 95% = 1,01 -2,29)]. A IA foi associada com uma maior frequência de CDNT em escolares de baixa renda, porém não teve impacto significativo sobre esta variável entre crianças de diferentes estratos de renda. Diante disso, garantir o acesso a uma alimentação de qualidade pode representar uma boa estratégia para minimizar as iniquidades em saúde bucal e reduzir a experiência de cárie dentária em escolares de baixa renda.

Abstract The aim of the present study was to assess the association between untreated dental caries (UDC) and household food insecurity (HFI) among schoolchildren in different income strata. A population-based study was carried out with a sample of 584 12-y-old schoolchildren. Oral examinations were performed and HFI was determined using a validated scale. Other independent variables were analyzed for being of interest to the stratification of the results (per capita household income) or for acting as potential confounding variables. The prevalence of UDC and HFI was 45% and 39%, respectively. The multivariate models demonstrated that the UDC was significantly more prevalent among children in food-insecure households with per capita income of up to US$ 70.71 than among those in the same income stratum that were free of HFI [PR = 1.52 (95%CI = 1.01-2.29)]. HFI was associated with a greater frequency of UDC among low-income schoolchildren, but had no significant impact on this variable among children from other income strata. Thus, ensuring access to quality food may be a good strategy for minimizing inequities in oral health and reducing dental caries experience among schoolchildren from low-income families.

ABSTRACT Objective To evaluate the influence of disease control, expressed by the mean values of glycated hemoglobin (HbA1c), in the oral health of children and adolescents with diabetes mellitus type 1 (T1DM). Subjects and methods A cross sectional study involving 87 children and adolescents (59 girls), 10 ± 2.6 years old. The participants were divided into three groups: HbA1c ≤ 8%, 8% < HbA1c ≤ 10% and HbA1c > 10%. The duration of the disease, age and average HbA1c were obtained from their medical records. Oral health was evaluated according to the following indexes: Simplified Oral Hygiene Index (OHI-S); Community Periodontal Index (CPI); Decayed, Missing or Filled Teeth Index (DMFT/dmft) for permanent and deciduous teeth; and the stimulated salivary flow rate (SSFR). Results The median SSFR was 1.1 mL/min in the group with HbA1c ≤ 8%, 0.7 mL/min in the intermediary group and 0.6 mL/min in the HbA1c > 10% group. A significant decrease in salivary flow was observed with an increase in HbA1c (p = 0.007). The DMFT/dmft and CPI indexes were higher in individuals with higher HbA1c values. More caries-free individuals were found in the group with HbA1c ≤ 8% compared to those with HbA1c > 10%. The group with HbA1c > 10% exhibited more caries and bleeding gums than the other groups. HbA1c values in girls were higher than in boys. Conclusion Children and adolescents with unsatisfactory glycemic control, represented by higher HbA1c concentrations, exhibited a higher frequency of caries and gingivitis, and a reduction in salivary flow. Arch Endocrinol Metab. 2015;59(6):535-40

Background: in recent years, researching about new oral antineoplastics has progressed while its impact on dietary intake and nutritional status (NS) hasn�ft developed enough yet. Objectives: dietary intake and NS assessment in patients who start treatment with tyrosine kinase inhibitors (TKI) and evaluate its impact on them. Methods: an observational, prospective-six-months study, in which were included patients starting treatment with TKI. The intake was evaluated by a 24 h dietary record and a food frequency questionnaire. The NS was evaluated by anthropometric measurements and the patient-generated Global Subjective Assessment (PG-GSA); the results were compared with the Spanish references (SENC-semFYC, 2007 and O. Moreiras, 2013). Friedman test, χ2, Wilcoxon, Kruskal-Wallis and Mann-Whitney were used in the statistical analysis. Significance p<0.05. Results: 22 patients (54.5% male) were included. At baseline, NS was adequate in 73.9% of patients according PG-GSA. Weight loss was no significant, although a high percentage of the energy and protein requirements hadn�Lt been reached. The caloric intake was positively related with the number of meals. Dietary habits did not change during treatment. Conclusion: dietary intake did not reach nutritional requirements at baseline. The TKI don�Lt seem to affect the patient�Ls intake and nutritional status. The research about these parameters before starting treatment could prevent future complications and it would guide the dietary advice.

Introduccion: la investigacion sobre nuevos antineoplasicos orales sigue avanzando en los ultimos anos mientras que su repercusion sobre la ingesta dietetica y el estado nutricional (EN) no progresa de la misma forma. Objetivos: evaluar la ingesta dietetica y EN de pacientes que inician tratamiento con inhibidores tirosina quinasa (ITK) y valorar el impacto que tienen sobre ellos. Metodos: estudio observacional y prospectivo de seis meses en el que se incluyeron pacientes que iniciaban tratamiento con ITK. La ingesta se evaluo con: recuerdo 24 h y cuestionario de frecuencia de consumo. El EN se valoro con: medidas antropometricas y cuestionario de valoracion subjetiva global generada por el paciente (VSGGP); los resultados se compararon con las referencias SENC-semFYC, 2007 y Moreiras O., 2013. Para el analisis estadistico se utilizaron: Test de Friedman, χ2, Wilcoxon, Kruskall-Wallis y Mann-Whitney. Significacion p<0,05. Resultados: se incluyeron 22 pacientes (54,5% hombres). Al inicio del tratamiento, el 73,9% tenia un EN adecuado segun VSG-GP. No se produjeron perdidas de peso significativas, pese a que un porcentaje elevado no cubrio los requerimientos energeticos y proteicos. El numero de comidas se relaciono positivamente con la ingesta calorica. La ingesta y los patrones de frecuencia de consumo por grupos de alimentos tampoco variaron durante el tratamiento. Conclusion: la ingesta dietetica al inicio del tratamiento no alcanza los requerimientos nutricionales. Los ITK no parecen afectar la ingesta ni el estado nutricional de los pacientes. El estudio de estos parametros antes de comenzar el tratamiento evitaria futuras complicaciones y guiaria el consejo dietetico.

Background and Objective: The consumption of oral antineoplastics -and more particularly of tyrosinekinase inhibitors (TKI)- has increased in recent years. These therapies show a better tolerance but still, the nutritional alterations related to their daily and chronic clinical use are under investigation. This study assesses the effects of TKI on the intake, nutritional status and micronutrients as well as the patients quality of life. Methods: A prospective longitudinal study was conducted including adult patients having started some TKI treatment from July 2012 to June 2013, and a 6 month follow-up period was established. Demographic pharmacotherapeutic, nutritional and biochemical variables were collected and also a EORTC-QLQ30 questionnaire at baseline, first, third and sixth month of treatment. Results: 31 patients were included in the study. The percentage of weight loss at treatment baseline was statistically matched to the results on the patient-generated Global Subjective Assessment. Appetite decreased after one month of treatment, and so did the calorie consumption; 62.1% of the patients lost weight, 55.5% on the third month and 70.6% on the sixth month. 6-17% of the patients suffered from malnutrition to some degree during the follow-up period and a decrease of calcium, phosphate and magnesium plasma levels was detected. The emotional scale was the one with a lowest score in EORTC QLQ-30, and fatigue and lack of appetite were the most common symptoms at treatment baseline, progressively increasing those of nausea, vomits and diarrhea. Discussion: Patients treated with TKI did not show a relevant malnutrition. Considering the results, it is important to take into account weight loss at treatment baseline; it is also important to control calcium and phosphate levels during treatment, to advise and counsel the patient on the GI effects (nausea, vomits and diarrhea) and emotionally reinforce the patient.

Introducción y objetivo: El consumo de antineoplásicos orales y concretamente de inhibidores tirosin kinasa (ITK) se ha incrementado en los últimos años. Son terapias mejor toleradas y, sin embargo, las alteraciones nutricionales relativas a su uso clínico diario y crónico están aún en estudio. El presente estudio valora la repercusión de los ITK sobre la ingesta, estado nutricional y micronutrientes y valora la calidad de vida de estos pacientes. Métodos: Se realizó un estudio prospectivo y longitudinal en el que se incluyeron aquellos pacientes adultos que iniciaron tratamiento con algún ITK de julio 2012 a junio 2013 con un periodo de seguimiento de 6 meses. Se recogieron variables demográficas, farmacoterapéuticas, nutricionales, bioquímicas y el cuestionario EORTC-QLQ30 al inicio, primer, tercer y sexto mes de tratamiento. Resultados: Se incluyeron 31 pacientes. El porcentaje de pérdida de peso al inicio del tratamiento se relacionó estadísticamente con la clasificación de la Valoración Subjetiva Global-generada por el paciente. Tras un mes de tratamiento descendió el apetito, las calorías consumidas y un 62,1% de los pacientes perdió peso, 55,5% al tercer mes y 70,6% al sexto mes. Entre un 6-17% de los pacientes sufría algún grado de desnutrición durante el seguimiento y se detectó una disminución de los niveles plasmáticos de calcio, fosfato y magnesio. En el EORTC QLQ-30, la escala emocional fue la peor puntuada y los síntomas más comunes al inicio de tratamiento fueron la fatiga y pérdida de apetito, aumentando progresivamente las náuseas, vómitos y la diarrea. Discusión: Los pacientes tratados con ITK no presentaron una desnutrición importante. A la vista de los resultados es importante valorar la pérdida de peso al inicio de tratamiento, monitorizar los niveles de calcio y el fosfato durante el tratamiento, aconsejar y prevenir al paciente sobre los efectos gastrointestinales (náuseas, vómitos y diarrea) y reforzar emocionalmente al paciente.

Introdução: A duração média do aleitamento materno ainda é insuficiente e apresenta grandes variações em razão do local e das características da população estudada.Objetivo: Analisar os fatores associados ao desmame em crianças sul brasileiras de comunidades de baixa renda.Material e método: Estudo transversal realizado através de entrevista envolvendo 124 mães de crianças com até 12 meses de idade, atendidas pela Pastoral da Criança, em Almirante Tamandaré, Paraná, Brasil. O risco ao desmame foi considerado como variável resposta e os dados do questionário, variáveis preditoras. Os dados foram analisados através do método de Kaplan-Meier, modelo de regressão de Cox e correlação de Spearman (α = 0,05).Resultado: A tábua de vida atuarial revelou uma probabilidade condicional de desmame maior aos 12 meses de idade, seguido do primeiro e quarto meses. A análise multivariada mostrou que o contato com a mamadeira antes do sexto mês de vida [HR=17,16 (2,34-125,86)] e o contato com a chupeta antes do sexto mês de vida [HR=3,48 (1,90-6,38)] foram variáveis de risco associadas ao desmame. Entre as crianças desmamadas, por ocasião da entrevista, a duração da amamentação apresentou correlação positiva com a idade do primeiro contato com açúcar (r s=+0,419; p=0,001) e negativa com a duração do uso de chupeta (r s=-0,300; p=0,017).Conclusão:O uso da mamadeira e da chupeta estiveram relacionados a uma menor duração do aleitamento materno nestas comunidades.

Introduction: The average duration of breastfeeding is still insufficient and differ widely taking in account the location and specific characteristic of local people involved in these studies.Aim: This research aimed at studying factors associated to weaning among South Brazilian children living in a low-income household.Material and method: Cross-sectional study was carried out enrolling 124 mothers of 1 to 12-month-old children, who were interviewed at "Pastoral da Criança" (non-governmental organization) in Almirante Tamandaré, Paraná, Brazil. The risk of weaning considered was the dependent variable and the information collected from the questionnaires, independent variables. The method used to collect information in this study was Kaplan-Meier method and Cox regression model and Spearman's rank correlation (α = 0.05).Result: Actuarial life table presented a higher weaning conditional probability at 12 months of age, followed by first and fourth months of age. Multivariate analysis pointed out that contact with bottle feeding before the sixth month of age [HR=17.16 (2.34-125.86)] and contact with pacifier before the sixth months of age [HR=3.48 (1.90-6.38)] are risk factors associated with weaning. Among children who were not breastfed at the moment of the interview, breastfeeding duration presented a positive correlation with the ages when the children had their first contact with sugar (r s=+0.419, p=0.001) and negative correlation with the use of pacifier (r s=-0.300, p=0.017).Conclusion: Results from this study showed that the use of the feeding bottle and pacifier were related to a shorter breastfeeding time span at these communities.

The aim of this in vitro study was to evaluate the erosive capacity of fermented milk beverages, as well as some of their properties that affect the demineralization of dental enamel (pH, buffering capacity, fluoride, calcium and phosphorus contents). Three different batches of 6 commercial brands of fermented milk beverages were analyzed. pH evaluation was accomplished using a potentiometer. The buffering capacity was measured by adding 1 mol L-1 NaOH. Fluoride concentration was assessed by an ion specific electrode after hexamethyldisiloxane-facilitated diffusion, and calcium and phosphorus concentrations were assessed by a colorimetric test using a spectrophotometer. Sixty specimens of bovine enamel were randomly assigned to 6 groups (n = 10). They were exposed to 4 cycles of demineralization in the fermented milk and remineralization in artificial saliva. Enamel mineral loss was determined by surface microhardness (%SMHC) and profilometric tests. The samples' pH ranged from 3.51 to 3.87; the buffering capacity ranged from 470.8 to 804.2 µl of 1 mol L-1 NaOH; the fluoride concentration ranged from 0.027 to 0.958 µgF/g; the calcium concentration ranged from 0.4788 to 0.8175 mgCa/g; and the phosphorus concentration ranged from 0.2662 to 0.5043 mgP/g. The %SMHC ranged from -41.0 to -29.4. The enamel wear ranged from 0.15 µm to 0.18 µm. In this in vitro study, the fermented milk beverages did not promote erosion of the dental enamel, but rather only a superficial mineral loss.

Com o objetivo de estudar a prevalência de anemia (hemoglobina < 12g/dl) e os fatores associados, foi realizado um estudo transversal de base populacional com uma amostra representativa de 312 mulheres de 20 a 60 anos residentes em São Leopoldo, Rio Grande do Sul, Brasil. As análises bivariadas incluíram testes de qui-quadrado, cálculo das razões de prevalências (RP) e intervalos de confiança de 95% (IC 95%). A análise multivariada foi realizada utilizando regressão de Poisson com variância robusta. Entre o total das mulheres 19,2% (IC95%: 14,8-23,6) estavam anêmicas. A maior prevalência ocorreu nas mulheres negras (54%). Após controle para fatores de confusão, as mulheres negras apresentaram um risco de anemia cerca de três vezes maior comparadas com as brancas (RP = 3,17; IC95%: 1,85-5,41; p < 0,001). Para as mulheres de 50 anos ou mais de idade foi observado um efeito protetor em comparação com as mulheres jovens (RP = 0,44; IC95%: 0,19-1,07; p = 0,07). Os resultados do presente estudo indicam a necessidade de focalização das políticas públicas de combate à anemia, especialmente em mulheres negras.

A cross-sectional population-based study was conducted to investigate the prevalence of anemia and associated factors in adult women. A representative sample was selected with 312 women aged 20 to 60 in São Leopoldo, Rio Grande do Sul State, Brazil. The bivariate analyses included the chi-squared test, prevalence ratios, and 95% confidence intervals. Poisson regression was used to adjust effects in the multivariate analyses. Anemia prevalence was 19.2% (95%CI: 14.8-23.6) for all women in the sample. The highest prevalence was in black women (54%). After controlling for confounding factors, the risk of anemia in black women was three times that of whites (PR = 3.17; 95%CI: 1.85-5.41; p < 0.001). A protective effect against anemia (PR = 0.44; 95%CI: 0.19-1.07; p = 0.07) was found in women over 50 as compared to younger women (20-29 years). These findings suggest the need for public health policies for anemia prevention in black women.

Com o objetivo de estudar a prevalência de anemia (hemoglobina < 12g/dl) e os fatores associados, foi realizado um estudo transversal de base populacional com uma amostra representativa de 312 mulheres de 20 a 60 anos residentes em São Leopoldo, Rio Grande do Sul, Brasil. As análises bivariadas incluíram testes de qui-quadrado, cálculo das razões de prevalências (RP) e intervalos de confiança de 95% (IC 95%). A análise multivariada foi realizada utilizando regressão de Poisson com variância robusta. Entre o total das mulheres 19,2% (IC95%: 14,8-23,6) estavam anêmicas. A maior prevalência ocorreu nas mulheres negras (54%). Após controle para fatores de confusão, as mulheres negras apresentaram um risco de anemia cerca de três vezes maior comparadas com as brancas (RP = 3,17; IC95%: 1,85-5,41; p < 0,001). Para as mulheres de 50 anos ou mais de idade foi observado um efeito protetor em comparação com as mulheres jovens (RP = 0,44; IC95%: 0,19-1,07; p = 0,07). Os resultados do presente estudo indicam a necessidade de focalização das políticas públicas de combate à anemia, especialmente em mulheres negras.

A cross-sectional population-based study was conducted to investigate the prevalence of anemia and associated factors in adult women. A representative sample was selected with 312 women aged 20 to 60 in São Leopoldo, Rio Grande do Sul State, Brazil. The bivariate analyses included the chi-squared test, prevalence ratios, and 95% confidence intervals. Poisson regression was used to adjust effects in the multivariate analyses. Anemia prevalence was 19.2% (95%CI: 14.8-23.6) for all women in the sample. The highest prevalence was in black women (54%). After controlling for confounding factors, the risk of anemia in black women was three times that of whites (PR = 3.17; 95%CI: 1.85-5.41; p < 0.001). A protective effect against anemia (PR = 0.44; 95%CI: 0.19-1.07; p = 0.07) was found in women over 50 as compared to younger women (20-29 years). These findings suggest the need for public health policies for anemia prevention in black women.