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Papers by Katrini Martinelli

Revista Brasileira de Pesquisa em Saúde/Brazilian Journal of Health Research

Introdução: Os casos de intoxicações medicamentosas têm aumentado em todo o país e se revelado um... more Introdução: Os casos de intoxicações medicamentosas têm aumentado em todo o país e se revelado um grande desafio para a saúde pública, além de gerar preocupações para as autoridades e profissionais de saúde. Objetivos: Caracterizar as intoxicações medicamentosas por circunstância no Espírito Santo, segundo região de saúde, sexo e faixa etária no período de 2011 a 2015. Métodos: Trata-se de um estudo ecológico envolvendo notificações dos casos de intoxicação por medicamentos, no Espírito Santo, no período de 2011 a 2015, tendo como fonte o SINAN. Realizou-se a estatística descritiva dos dados. Resultados: A taxa de incidência no ES para o período foi de 27,7/100.000 habitantes. Em relação às regiões de saúde, a maior taxa foi observada na região Central (50,6/ 100.000 hab.) e a menor na região Metropolitana (19,9/100.000 hab.). As principais circunstâncias de intoxicação envolvem suicídio e acidente. O sexo feminino com faixa etária de 10-39 anos obteve as maiores taxas nas circunstâ...

Revista da Escola de Enfermagem da USP

Objective: To identify the associated factors of neonatal near miss among newborns of Brazilian a... more Objective: To identify the associated factors of neonatal near miss among newborns of Brazilian adolescents and to compare their occurrence in young women aged 12 to 16 years and 17 to 19 years. Method: Cross-sectional, hospital-based study, using data from the study Nascer no Brasil (“Birth in Brazil”) on puerperal adolescents and their newborns in all regions of Brazil. Multiple and univariate logistic regression were employed to identify the associated factors of neonatal near miss. Results: The following factors were found to be associated to neonatal near miss among newborns of adolescent mothers: public source of payment (OR = 4.57, 95% CI = 2.02–10.32), having to seek help in different maternity hospitals (OR = 1.52; 95% CI = 1.05–2.20), and maternal near miss (OR = 5.92; 95% CI = 1.94–18.05), in addition to a record of low weight in a previous pregnancy (OR = 3.12; 95% CI = 1.61–6.04) and twin pregnancy (OR = 7.49; 95% CI = 3.28–16.82). Conclusion: Neonatal near miss affecte...

A 3ª edição do Congresso Internacional de Estudantes e Profissionais da Saúde – DELTA SAÚDE, real... more A 3ª edição do Congresso Internacional de Estudantes e Profissionais da Saúde – DELTA SAÚDE, realizou-se de forma presencial no período de 04 a 06 de novembro de 2022, no Centro de Convenções do Hotel SESC Praia, Luis Correia, Piauí. O Delta Saúde 2022 trouxe como tema geral: “O pós-pandemia e os principais desafios da saúde global”; e as discussões foram norteadas pelos eixos centrais, a saber: a) Pandemia de COVID-19, b) Vigilância em Saúde, c) Saúde Pública e a Atenção Primária, d) Saúde Mental, e) Doenças Crônicas e Doenças Transmissíveis, f) Educação, Formação e Trabalho na Saúde, g) Inovação em Saúde, h) Eixos Transversais. O evento foi criado em 2017 e nesta edição alcançamos pelo menos 10 estados brasileiros em participação direta, palestrantes, convidados, além dos conferencistas internacionais on-line. Esta diversidade aliada a qualidade dos trabalhos apresentados, contribuiu de forma decisiva para o alcance dos objetivos do congresso que primam pela qualificação do ensino...

Ciência & Saúde Coletiva

The present study aims to analyze the socioeconomic and demographic factors associated with the r... more The present study aims to analyze the socioeconomic and demographic factors associated with the recurrence of teenage pregnancy, as well as to verify the association with unfavorable maternal and neonatal outcomes. It is a cross-sectional study, based on data from “Nascer no Brasil”, comprised of adolescent mothers and their newborns. Univariate and multiple logistic regression were used to indicate the factors associated with this recurrence. Recurrence of teenage pregnancy was associated with a maternal age of 17-19 years (OR=3.35; 95%CI=2.45-4.59); an inadequate education for their age (OR=4.34; 95%CI=3.50-5.39), with no intention of becoming pregnant; residency in the state capital; and the fact that the partner is the head of the family. However, as independent primiparous teenagers, there is a greater chance of hypertension and restricted intrauterine growth. It can therefore be concluded that there is a high percentage of teenage pregnancies in Brazil. Teenagers with a partne...

Ciência & Saúde Coletiva

Resumo O objetivo é analisar os fatores socioeconômicos e demográficos associados à reincidência ... more Resumo O objetivo é analisar os fatores socioeconômicos e demográficos associados à reincidência de gravidez na adolescência, assim como verificar a associação com desfechos maternos e neonatais desfavoráveis. É um estudo transversal, a partir dos dados do “Nascer no Brasil”, composto por puérperas adolescentes e seus recém-nascidos. Utilizou-se regressão logística univariada e múltipla para indicar os fatores associados à essa reincidência. A reincidência da gravidez na adolescência esteve associada à idade materna de 17-19 anos (OR=3,35; IC95%=2,45-4,59), à escolaridade inadequada para a idade (OR=4,34; IC95%=3,50-5,39), à intenção de engravidar, à residência na capital do estado e ao fato do companheiro ser chefe da família. No entanto, as adolescentes primíparas apresentaram maior chance de doença hipertensiva e crescimento intrauterino restrito. Conclui-se que há um elevado percentual de reincidência de gravidez na adolescência no Brasil. Adolescentes com companheiro, pouca esc...

Viruses

Several hepatitis B virus (HBV)-related factors, including the viral load, genotype, and genomic ... more Several hepatitis B virus (HBV)-related factors, including the viral load, genotype, and genomic mutations, have been linked to the development of liver diseases. Therefore, in this study we aimed to investigate the influence of HBV genetic variability during acute and chronic infection phases. A real-time nested PCR was used to detect HBV DNA in all samples (acute, n = 22; chronic, n = 49). All samples were sequenced for phylogenetic and mutation analyses. Genotype A, sub-genotype A1, was the most common genotype in the study population. A total of 190 mutations were found in the pre-S/S gene area and the acute profile revealed a greater number of nucleotide mutations (p < 0.05). However, both profiles contained nucleotide mutations linked to immune escape and an increased risk of hepatocellular carcinomas (acute, A7T; chronic, A7Q). Furthermore, 17 amino acid substitutions were identified in the viral polymerase region, including the drug resistance mutations lamivudine and ent...

Revista de Saúde Pública, 2022

OBJECTIVE Describe and estimate the rate of recurrent preterm birth in Brazil according to the ty... more OBJECTIVE Describe and estimate the rate of recurrent preterm birth in Brazil according to the type of delivery, weighted by associated factors. METHODS We obtained data from the national hospital-based study “Birth in Brazil”, conducted in 2011 and 2012, from interviews with 23,894 women. Initially, we used the chi-square test to verify the differences between newborns according to previous prematurity and type of recurrent prematurity. Sequentially, we applied the propensity score method to balance the groups according to the following covariates: maternal age, socio-economic status, smoking during pregnancy, parity, previous cesarean section, previous stillbirth or neonatal death, chronic hypertension and chronic diabetes. Finally, we performed multiple logistic regression to estimate the recorrence. RESULTS We analyzed 6,701 newborns. The rate of recurrence was 42.0%, considering all women with previous prematurity. Among the recurrent premature births, 62.2% were spontaneous an...

Revista Brasileira de Saúde Materno Infantil, 2021

Objectives: describing maternal characteristics, risk behavior, obstetric data, prenatal care and... more Objectives: describing maternal characteristics, risk behavior, obstetric data, prenatal care and childbirth in adolescent mothers in Brazil (age groups: 12-16 years and 17-19 years). Methods: hospital-based cross-sectional study substantiated by Nascer no Brasil”, (Born in Brazil) data. The study encompassed puerperal adolescent mothers from all regions in the country, and their newborns. Chi-square test was used to compare adolescents in the 12-16 years old age group and those in the 17-19 years old age group. Results: pregnant women in the 12-16 years old age group mostly lived in the Northeast of Brazil (p=0.014); most of them did not have a partner (p<0.001), unplanned pregnancy (p<0.001), they had inadequate schooling for their age (p=0.033), had less than six prenatal consultations (p=0.021), were subjected to episiotomy (p=0.042) and accounted for the largest number of premature babies (p=0.014). Conclusions: puerperal women in the 12-16 years old age group presented v...

Revista de Saúde Pública, 2021

OBJECTIVE to evaluate whether advanced maternal age (AMA) is associated with prelabor cesarean se... more OBJECTIVE to evaluate whether advanced maternal age (AMA) is associated with prelabor cesarean section and to identify the factors associated with prelabor cesarean section in AMA women, according to the mode of type of labor financing (private or public). METHODS Based on the Birth in Brazil survey, the research was conducted on representative sample of mothers for the country (Brazil), regions, type of hospital and location (capital or not), in 2011/2012. This study included 15,071 women from two age groups: 20–29 years and ≥ 35 years. The information was collected from interviews with puerperal woman, prenatal cards, and medical records of mothers and newborns. Multiple logistic regression modelling was used to verify the association between prelabor cesarean section and maternal, prenatal and childbirth characteristics, according to the mode of financing. RESULTS Our results showed a higher use of prelabor cesarean section for AMA (≥ 35 years) women in the public service (OR = 1...

This study aimed to evaluate the relationship between sociodemographic factors and the impact on ... more This study aimed to evaluate the relationship between sociodemographic factors and the impact on Oral Health-Related Quality of Life (OHR-QoL) in Brazilian pregnant women users of the Unified Health System. This is a cross-sectional epidemiological study developed with pregnant women living in two regions with different sociodemographic characteristics. In total, 1,777 puerperae were interviewed. A structured and previously tested questionnaire collected sociodemographic variables, and the Oral Health Index Profile (OHIP-14) assessed the impact on the OHR-QoL. The statistical analysis was performed using the Chi-square test and multiple logistic regression, both with a significance of 5%. The "psychological discomfort" realm was the only one with a difference between the puerperae of the RMGV and the MRSM (p=0.042). The following variables were associated with the impact on the OHR-QoL: residing in the RMGV (OR=1.69; 95%CI: 1.16-2.47); having a low level of schooling (OR=1...

Additional file 1. Data file of clinical and epidemiological information of patients with occult ... more Additional file 1. Data file of clinical and epidemiological information of patients with occult hepatitis B and HCV enrolled in this study. SAH (Subarachnoid hemorrhage); HCC (Hepatocellular carcinoma); IFN-Peg (Pegylated interferon); HBV (Hepatitis B virus); HCV (Hepatitis C virus); HAV (Hepatitis A virus); HIV (human immunodeficiency virus); IgG (Immunoglobulin G); HBsAg (Hepatitis B virus surface antigen); HBc (Antigen "c" or core of the hepatitis B virus); AST (alanine aminotransferase); ALT (alkaline phosphatase); GGT (gamma-glutamyl transferase); TGO (oxalacetic glutamic transaminase); TGP (glutamic-pyruvic transaminase); ALB (albumin); AFP (alpha-fetoprotein); LDL (Low Density Lipoproteins); HDL (High Density Lipoproteins); HGB (Hemoglobin); A.T (After treatment)

Microbiology and Immunology, 2021

Hepatitis B virus (HBV) is one of the leading causes of acute and chronic hepatitis and represent... more Hepatitis B virus (HBV) is one of the leading causes of acute and chronic hepatitis and represents a serious public health threat. Cytokines are important chemical mediators that regulate the differentiation, proliferation, and function of immune cells, with accumulating evidence indicating that the inadequate immune responses are responsible for the elimination or persistence of HBV. This study aimed to determine the cytokine profiles (IFN‐γ, TNF‐α, IL‐2, IL‐4, IL‐6, IL‐10, and IL‐17A) during HBV infection and investigate their association with genotypes. A total of 66 plasma samples, 19 from patients with acute and 47 with chronic hepatitis B infection, were subjected to biochemical tests, nested‐PCR, and real‐time PCR, with cytokines evaluated using a commercial BD Cytometric Bead Array Human Th1/Th2/Th17 Cytokine Kit. Healthy controls (10 individuals) were selected from blood donors with no history of liver diseases. No correlation was found between genotypes, viral load, and cytokines analyzed. All cytokines showed higher levels of production among infected individuals when compared with the control group. A positive correlation classified as moderate to strong was found between cytokines IFN‐γ, TNF, IL‐10, IL‐6, IL‐4, and IL‐2 through the Spearman correlation coefficient. TNF (P = 0.009), IL‐10 (P < 0.001), and IL‐6 (P < 0.001) levels were higher in acute individuals compared with chronic and control groups. Theses cytokines could be involved in the elimination of virus and protection against chronicity.

Viral Immunology, 2020

Several hepatitis B virus (HBV) factors, including viral load, genotype, genome mutations, and cy... more Several hepatitis B virus (HBV) factors, including viral load, genotype, genome mutations, and cytokine production, have been reported to be associated with different risks of progression of liver disease. The aim of this study was to verify if there is an association among the levels of cytokines (interleukin [IL]-35, IL-6, IL-17A, interferon [IFN]-c) in the plasma, viral load, and the different genotypes of HBV in patients with acute or chronic hepatitis B. Methods: 49 serum samples, 20 from acute and 29 from chronic cases, were submitted to a real-time and nested-polymerase chain reaction to quantify, detect, and genotype HBV DNA. The cytokines IL-35, IL-6, IL-17A, and IFN-c were detected by an enzyme-linked immunosorbent assay (ELISA). The median viral load was 3.15 log 10 IU DNA/mL and 2.90 log 10 IU DNA/mL for acute and chronic patients, respectively. Genotype A, D, E, and F were identified in chronic carriers of HBV infection, while only genotype A and F were identified in individuals with acute infection. IFN-c (p = 0.024) and IL-17A (p = 0.046) levels were significantly increased in chronic patients and IL-6 and IL-35 were higher in patients with acute infection, however, without statistical difference. IL-17A and IFN-c can be modulating proinflammatory effects and inducing hepatocellular damage, in chronic patients, and IL-6 and IL-35 may be involved in viral elimination and protection against chronicity during the acute phase of infection. These results can contribute to understanding of the complex regulatory mechanisms of the host antiviral response related to cytokine production during acute and chronic HBV infection.

Ambiente e Agua - An Interdisciplinary Journal of Applied Science, 2021

This study investigated the demographic, socioeconomic, and municipal health indicators related t... more This study investigated the demographic, socioeconomic, and municipal health indicators related to the quality of water fluoridation. An ecological study was carried out in Espirito Santo state (ES), based on data from the Drinking Water Quality Surveillance Information, from 2014 to 2017. The non-parametric Mann-Whitney and Spearman tests were applied to compare municipal indicators with the availability of information and the quality of fluoridation, respectively. Fluoridation quality was calculated to define the percentage of fluoride concentration values in each municipality within the range of the optimal level corresponding to the maximum benefit for preventing dental caries and minimum risk for the occurrence of dental fluorosis. The proportion of 80% or more samples were defined as a compliance criterion. In 2014, 62.8% of the municipalities had information available, and 16.7% performed analyses of fluoride concentration. The percentage of available data increased about 30%...

Dental Press Endodontics, 2021

Introdução: Pacientes com Síndrome de Sjögren Primária (SSP) apresentam maior incidência de cárie... more Introdução: Pacientes com Síndrome de Sjögren Primária (SSP) apresentam maior incidência de cárie dentária. Como consequência da cárie, podem ocorrer lesões periapicais radiolúcidas (LPR). Objetivo: Determinar a prevalência de LPR nos pacientes com SSP e caracterizar radiologicamente os dentes associados às LPR. Métodos: Estudo transversal envolvendo pacientes com SSP, recrutados em uma Clínica de Reumatologia (HUCAM-ES), que foram submetidos, inicialmente, a um questionário socioeconômico e avaliação clínica do fluxo salivar. Posteriormente, radiografias foram obtidas por um sistema digital intrabucal, com posicionador para a técnica periapical do paralelismo. Realizou-se a estatística descritiva por meio da média e desvio-padrão para as variáveis quantitativas, e frequências absoluta e relativa para as variáveis qualitativas. Realizou-se o teste qui-quadrado com IC95% e o teste t de Student para comparação dos pacientes com e sem lesão periapical. Resultados: No total, 24 paciente...

Revista Brasileira de Pesquisa em Saúde/Brazilian Journal of Health Research, 2021

Em janeiro de 2020 o mundo tomou conhecimento da existência de uma nova cepa de coronavírus, o Sa... more Em janeiro de 2020 o mundo tomou conhecimento da existência de uma nova cepa de coronavírus, o Sars-CoV-2 (Síndrome Respiratória Aguda Grave-coronavírus 2), que causa a doença denominada de COVID-19. Em 11 de março de 2020, a Organização Mundial da Saúde (OMS) elevou a COVID-19 à pandemia devido à disseminação geográfica alcançada. Em 21 de março de 2021 o número de casos de COVID-19 confirmados no mundo ultrapassava os 120 milhões e no Brasil, os 11 milhões. Já morreram mais de 2,7 milhões de pessoas no mundo e 290 mil pessoas no Brasil devido à infecção por Sars-CoV-2 1,2. A COVID-19 pode causar complicações graves, principalmente em pessoas idosas e com comorbidades, mas todos podem ser afetados, incluindo mulheres grávidas e recém-nascidos. Não houve a indicação formal, por parte das autoridades sanitárias do Brasil, de inclusão das gestantes no grupo de risco, podendo garantir um afastamento protegido do trabalho. Esta iniciativa foi tomada individualmente apenas por algumas organizações.

Oral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology, 2020

Objective: Define prevalence of radiolucent periapical lesions (RLP) in patients with primary Sjo... more Objective: Define prevalence of radiolucent periapical lesions (RLP) in patients with primary Sjogren syndrome (SSP) and characterize the teeth associated with RLP. Methods: The radiographs were analyzed using Image J software by a radiologist. A socioeconomic questionnaire was applied. The salivary flow was evaluated through the collection of nonstimulated saliva. Mean and standard deviation (SD) for the quantitative variables and absolute and relative frequency of the qualitative variables was calculated. The χ2 test (95% CI) compared the difference between proportions of the qualitative variables, and the Student t test compared means of quantitative variables between patients with and without periapical lesions. Results: All 24 patients were female, aged between 20 and 71 years, with xerostomia, and 80% had hyposalivation. At least 1 RLP was found in 70.8% of patients. The mean number of teeth per patient was 23.3 ± 3.1 with a prevalence of RLP in the teeth of 7.86% of patients....

This thesis is structured in the form of scientific papers. The first paper investigates the exis... more This thesis is structured in the form of scientific papers. The first paper investigates the existence and magnitude of the association between Advanced Maternal Age (AMA) and the occurrence of placenta praevia (PP) and placental abruption (PA) among nulliparous and multiparous women through a systematic review and meta-analysis. The second paper verifies if the AMA increases the chance of negative perinatal outcomes, in addition to identifying which factors are associated with neonatal near miss, according to parity. And the third, sought association between AMA and relabor cesarean section, in addition to identifying which factors are associated with this outcome in women with AMA, also according to parity. Both were done with "Birth in Brazil" data. In the meta-analysis, searched for articles published between January 1st, 2005 and December 31th, 2015, an any language, in the databases PubMed, Scopus, Web of Science and LILACS, which grouped women into two age categorie...

O objetivo deste estudo é analisar a tendência de prematuridade no Brasil, entre 2012 e 2019, seg... more O objetivo deste estudo é analisar a tendência de prematuridade no Brasil, entre 2012 e 2019, segundo características sociodemográficas, do pré-natal e parto. Trata-se de um estudo ecológico de série temporal, em que foram calculadas as proporções de prematuridade segundo as regiões do Brasil, idade materna, escolaridade materna, raça/cor, número de consultas pré-natal e tipo de parto, a partir dos dados do Sistema de Informações sobre Nascidos Vivos (Sinasc). Sequencialmente, foram aplicados modelos de regressão polinomial para análise de tendência temporal. De 2012 a 2019, a proporção de prematuridade no Brasil apresentou tendência decrescente, variando de 10,87% a 9,95%, com a menor proporção em 2015, que foi de 9,77%. As mulheres na faixa etária de 45 anos ou mais e com 4 a 6 consultas de pré-natal apresentaram as maiores proporções de prematuridade para o período (14,88% a 17,92%) e com tendência crescente. Já as mulheres analfabetas e indígenas mostraram tendência decrescente ...

Revista Brasileira de Pesquisa em Saúde/Brazilian Journal of Health Research

Introdução: Os casos de intoxicações medicamentosas têm aumentado em todo o país e se revelado um... more Introdução: Os casos de intoxicações medicamentosas têm aumentado em todo o país e se revelado um grande desafio para a saúde pública, além de gerar preocupações para as autoridades e profissionais de saúde. Objetivos: Caracterizar as intoxicações medicamentosas por circunstância no Espírito Santo, segundo região de saúde, sexo e faixa etária no período de 2011 a 2015. Métodos: Trata-se de um estudo ecológico envolvendo notificações dos casos de intoxicação por medicamentos, no Espírito Santo, no período de 2011 a 2015, tendo como fonte o SINAN. Realizou-se a estatística descritiva dos dados. Resultados: A taxa de incidência no ES para o período foi de 27,7/100.000 habitantes. Em relação às regiões de saúde, a maior taxa foi observada na região Central (50,6/ 100.000 hab.) e a menor na região Metropolitana (19,9/100.000 hab.). As principais circunstâncias de intoxicação envolvem suicídio e acidente. O sexo feminino com faixa etária de 10-39 anos obteve as maiores taxas nas circunstâ...

Revista da Escola de Enfermagem da USP

Objective: To identify the associated factors of neonatal near miss among newborns of Brazilian a... more Objective: To identify the associated factors of neonatal near miss among newborns of Brazilian adolescents and to compare their occurrence in young women aged 12 to 16 years and 17 to 19 years. Method: Cross-sectional, hospital-based study, using data from the study Nascer no Brasil (“Birth in Brazil”) on puerperal adolescents and their newborns in all regions of Brazil. Multiple and univariate logistic regression were employed to identify the associated factors of neonatal near miss. Results: The following factors were found to be associated to neonatal near miss among newborns of adolescent mothers: public source of payment (OR = 4.57, 95% CI = 2.02–10.32), having to seek help in different maternity hospitals (OR = 1.52; 95% CI = 1.05–2.20), and maternal near miss (OR = 5.92; 95% CI = 1.94–18.05), in addition to a record of low weight in a previous pregnancy (OR = 3.12; 95% CI = 1.61–6.04) and twin pregnancy (OR = 7.49; 95% CI = 3.28–16.82). Conclusion: Neonatal near miss affecte...

A 3ª edição do Congresso Internacional de Estudantes e Profissionais da Saúde – DELTA SAÚDE, real... more A 3ª edição do Congresso Internacional de Estudantes e Profissionais da Saúde – DELTA SAÚDE, realizou-se de forma presencial no período de 04 a 06 de novembro de 2022, no Centro de Convenções do Hotel SESC Praia, Luis Correia, Piauí. O Delta Saúde 2022 trouxe como tema geral: “O pós-pandemia e os principais desafios da saúde global”; e as discussões foram norteadas pelos eixos centrais, a saber: a) Pandemia de COVID-19, b) Vigilância em Saúde, c) Saúde Pública e a Atenção Primária, d) Saúde Mental, e) Doenças Crônicas e Doenças Transmissíveis, f) Educação, Formação e Trabalho na Saúde, g) Inovação em Saúde, h) Eixos Transversais. O evento foi criado em 2017 e nesta edição alcançamos pelo menos 10 estados brasileiros em participação direta, palestrantes, convidados, além dos conferencistas internacionais on-line. Esta diversidade aliada a qualidade dos trabalhos apresentados, contribuiu de forma decisiva para o alcance dos objetivos do congresso que primam pela qualificação do ensino...

Ciência & Saúde Coletiva

The present study aims to analyze the socioeconomic and demographic factors associated with the r... more The present study aims to analyze the socioeconomic and demographic factors associated with the recurrence of teenage pregnancy, as well as to verify the association with unfavorable maternal and neonatal outcomes. It is a cross-sectional study, based on data from “Nascer no Brasil”, comprised of adolescent mothers and their newborns. Univariate and multiple logistic regression were used to indicate the factors associated with this recurrence. Recurrence of teenage pregnancy was associated with a maternal age of 17-19 years (OR=3.35; 95%CI=2.45-4.59); an inadequate education for their age (OR=4.34; 95%CI=3.50-5.39), with no intention of becoming pregnant; residency in the state capital; and the fact that the partner is the head of the family. However, as independent primiparous teenagers, there is a greater chance of hypertension and restricted intrauterine growth. It can therefore be concluded that there is a high percentage of teenage pregnancies in Brazil. Teenagers with a partne...

Ciência & Saúde Coletiva

Resumo O objetivo é analisar os fatores socioeconômicos e demográficos associados à reincidência ... more Resumo O objetivo é analisar os fatores socioeconômicos e demográficos associados à reincidência de gravidez na adolescência, assim como verificar a associação com desfechos maternos e neonatais desfavoráveis. É um estudo transversal, a partir dos dados do “Nascer no Brasil”, composto por puérperas adolescentes e seus recém-nascidos. Utilizou-se regressão logística univariada e múltipla para indicar os fatores associados à essa reincidência. A reincidência da gravidez na adolescência esteve associada à idade materna de 17-19 anos (OR=3,35; IC95%=2,45-4,59), à escolaridade inadequada para a idade (OR=4,34; IC95%=3,50-5,39), à intenção de engravidar, à residência na capital do estado e ao fato do companheiro ser chefe da família. No entanto, as adolescentes primíparas apresentaram maior chance de doença hipertensiva e crescimento intrauterino restrito. Conclui-se que há um elevado percentual de reincidência de gravidez na adolescência no Brasil. Adolescentes com companheiro, pouca esc...

Viruses

Several hepatitis B virus (HBV)-related factors, including the viral load, genotype, and genomic ... more Several hepatitis B virus (HBV)-related factors, including the viral load, genotype, and genomic mutations, have been linked to the development of liver diseases. Therefore, in this study we aimed to investigate the influence of HBV genetic variability during acute and chronic infection phases. A real-time nested PCR was used to detect HBV DNA in all samples (acute, n = 22; chronic, n = 49). All samples were sequenced for phylogenetic and mutation analyses. Genotype A, sub-genotype A1, was the most common genotype in the study population. A total of 190 mutations were found in the pre-S/S gene area and the acute profile revealed a greater number of nucleotide mutations (p < 0.05). However, both profiles contained nucleotide mutations linked to immune escape and an increased risk of hepatocellular carcinomas (acute, A7T; chronic, A7Q). Furthermore, 17 amino acid substitutions were identified in the viral polymerase region, including the drug resistance mutations lamivudine and ent...

Revista de Saúde Pública, 2022

OBJECTIVE Describe and estimate the rate of recurrent preterm birth in Brazil according to the ty... more OBJECTIVE Describe and estimate the rate of recurrent preterm birth in Brazil according to the type of delivery, weighted by associated factors. METHODS We obtained data from the national hospital-based study “Birth in Brazil”, conducted in 2011 and 2012, from interviews with 23,894 women. Initially, we used the chi-square test to verify the differences between newborns according to previous prematurity and type of recurrent prematurity. Sequentially, we applied the propensity score method to balance the groups according to the following covariates: maternal age, socio-economic status, smoking during pregnancy, parity, previous cesarean section, previous stillbirth or neonatal death, chronic hypertension and chronic diabetes. Finally, we performed multiple logistic regression to estimate the recorrence. RESULTS We analyzed 6,701 newborns. The rate of recurrence was 42.0%, considering all women with previous prematurity. Among the recurrent premature births, 62.2% were spontaneous an...

Revista Brasileira de Saúde Materno Infantil, 2021

Objectives: describing maternal characteristics, risk behavior, obstetric data, prenatal care and... more Objectives: describing maternal characteristics, risk behavior, obstetric data, prenatal care and childbirth in adolescent mothers in Brazil (age groups: 12-16 years and 17-19 years). Methods: hospital-based cross-sectional study substantiated by Nascer no Brasil”, (Born in Brazil) data. The study encompassed puerperal adolescent mothers from all regions in the country, and their newborns. Chi-square test was used to compare adolescents in the 12-16 years old age group and those in the 17-19 years old age group. Results: pregnant women in the 12-16 years old age group mostly lived in the Northeast of Brazil (p=0.014); most of them did not have a partner (p<0.001), unplanned pregnancy (p<0.001), they had inadequate schooling for their age (p=0.033), had less than six prenatal consultations (p=0.021), were subjected to episiotomy (p=0.042) and accounted for the largest number of premature babies (p=0.014). Conclusions: puerperal women in the 12-16 years old age group presented v...

Revista de Saúde Pública, 2021

OBJECTIVE to evaluate whether advanced maternal age (AMA) is associated with prelabor cesarean se... more OBJECTIVE to evaluate whether advanced maternal age (AMA) is associated with prelabor cesarean section and to identify the factors associated with prelabor cesarean section in AMA women, according to the mode of type of labor financing (private or public). METHODS Based on the Birth in Brazil survey, the research was conducted on representative sample of mothers for the country (Brazil), regions, type of hospital and location (capital or not), in 2011/2012. This study included 15,071 women from two age groups: 20–29 years and ≥ 35 years. The information was collected from interviews with puerperal woman, prenatal cards, and medical records of mothers and newborns. Multiple logistic regression modelling was used to verify the association between prelabor cesarean section and maternal, prenatal and childbirth characteristics, according to the mode of financing. RESULTS Our results showed a higher use of prelabor cesarean section for AMA (≥ 35 years) women in the public service (OR = 1...

This study aimed to evaluate the relationship between sociodemographic factors and the impact on ... more This study aimed to evaluate the relationship between sociodemographic factors and the impact on Oral Health-Related Quality of Life (OHR-QoL) in Brazilian pregnant women users of the Unified Health System. This is a cross-sectional epidemiological study developed with pregnant women living in two regions with different sociodemographic characteristics. In total, 1,777 puerperae were interviewed. A structured and previously tested questionnaire collected sociodemographic variables, and the Oral Health Index Profile (OHIP-14) assessed the impact on the OHR-QoL. The statistical analysis was performed using the Chi-square test and multiple logistic regression, both with a significance of 5%. The "psychological discomfort" realm was the only one with a difference between the puerperae of the RMGV and the MRSM (p=0.042). The following variables were associated with the impact on the OHR-QoL: residing in the RMGV (OR=1.69; 95%CI: 1.16-2.47); having a low level of schooling (OR=1...

Additional file 1. Data file of clinical and epidemiological information of patients with occult ... more Additional file 1. Data file of clinical and epidemiological information of patients with occult hepatitis B and HCV enrolled in this study. SAH (Subarachnoid hemorrhage); HCC (Hepatocellular carcinoma); IFN-Peg (Pegylated interferon); HBV (Hepatitis B virus); HCV (Hepatitis C virus); HAV (Hepatitis A virus); HIV (human immunodeficiency virus); IgG (Immunoglobulin G); HBsAg (Hepatitis B virus surface antigen); HBc (Antigen "c" or core of the hepatitis B virus); AST (alanine aminotransferase); ALT (alkaline phosphatase); GGT (gamma-glutamyl transferase); TGO (oxalacetic glutamic transaminase); TGP (glutamic-pyruvic transaminase); ALB (albumin); AFP (alpha-fetoprotein); LDL (Low Density Lipoproteins); HDL (High Density Lipoproteins); HGB (Hemoglobin); A.T (After treatment)

Microbiology and Immunology, 2021

Hepatitis B virus (HBV) is one of the leading causes of acute and chronic hepatitis and represent... more Hepatitis B virus (HBV) is one of the leading causes of acute and chronic hepatitis and represents a serious public health threat. Cytokines are important chemical mediators that regulate the differentiation, proliferation, and function of immune cells, with accumulating evidence indicating that the inadequate immune responses are responsible for the elimination or persistence of HBV. This study aimed to determine the cytokine profiles (IFN‐γ, TNF‐α, IL‐2, IL‐4, IL‐6, IL‐10, and IL‐17A) during HBV infection and investigate their association with genotypes. A total of 66 plasma samples, 19 from patients with acute and 47 with chronic hepatitis B infection, were subjected to biochemical tests, nested‐PCR, and real‐time PCR, with cytokines evaluated using a commercial BD Cytometric Bead Array Human Th1/Th2/Th17 Cytokine Kit. Healthy controls (10 individuals) were selected from blood donors with no history of liver diseases. No correlation was found between genotypes, viral load, and cytokines analyzed. All cytokines showed higher levels of production among infected individuals when compared with the control group. A positive correlation classified as moderate to strong was found between cytokines IFN‐γ, TNF, IL‐10, IL‐6, IL‐4, and IL‐2 through the Spearman correlation coefficient. TNF (P = 0.009), IL‐10 (P < 0.001), and IL‐6 (P < 0.001) levels were higher in acute individuals compared with chronic and control groups. Theses cytokines could be involved in the elimination of virus and protection against chronicity.

Viral Immunology, 2020

Several hepatitis B virus (HBV) factors, including viral load, genotype, genome mutations, and cy... more Several hepatitis B virus (HBV) factors, including viral load, genotype, genome mutations, and cytokine production, have been reported to be associated with different risks of progression of liver disease. The aim of this study was to verify if there is an association among the levels of cytokines (interleukin [IL]-35, IL-6, IL-17A, interferon [IFN]-c) in the plasma, viral load, and the different genotypes of HBV in patients with acute or chronic hepatitis B. Methods: 49 serum samples, 20 from acute and 29 from chronic cases, were submitted to a real-time and nested-polymerase chain reaction to quantify, detect, and genotype HBV DNA. The cytokines IL-35, IL-6, IL-17A, and IFN-c were detected by an enzyme-linked immunosorbent assay (ELISA). The median viral load was 3.15 log 10 IU DNA/mL and 2.90 log 10 IU DNA/mL for acute and chronic patients, respectively. Genotype A, D, E, and F were identified in chronic carriers of HBV infection, while only genotype A and F were identified in individuals with acute infection. IFN-c (p = 0.024) and IL-17A (p = 0.046) levels were significantly increased in chronic patients and IL-6 and IL-35 were higher in patients with acute infection, however, without statistical difference. IL-17A and IFN-c can be modulating proinflammatory effects and inducing hepatocellular damage, in chronic patients, and IL-6 and IL-35 may be involved in viral elimination and protection against chronicity during the acute phase of infection. These results can contribute to understanding of the complex regulatory mechanisms of the host antiviral response related to cytokine production during acute and chronic HBV infection.

Ambiente e Agua - An Interdisciplinary Journal of Applied Science, 2021

This study investigated the demographic, socioeconomic, and municipal health indicators related t... more This study investigated the demographic, socioeconomic, and municipal health indicators related to the quality of water fluoridation. An ecological study was carried out in Espirito Santo state (ES), based on data from the Drinking Water Quality Surveillance Information, from 2014 to 2017. The non-parametric Mann-Whitney and Spearman tests were applied to compare municipal indicators with the availability of information and the quality of fluoridation, respectively. Fluoridation quality was calculated to define the percentage of fluoride concentration values in each municipality within the range of the optimal level corresponding to the maximum benefit for preventing dental caries and minimum risk for the occurrence of dental fluorosis. The proportion of 80% or more samples were defined as a compliance criterion. In 2014, 62.8% of the municipalities had information available, and 16.7% performed analyses of fluoride concentration. The percentage of available data increased about 30%...

Dental Press Endodontics, 2021

Introdução: Pacientes com Síndrome de Sjögren Primária (SSP) apresentam maior incidência de cárie... more Introdução: Pacientes com Síndrome de Sjögren Primária (SSP) apresentam maior incidência de cárie dentária. Como consequência da cárie, podem ocorrer lesões periapicais radiolúcidas (LPR). Objetivo: Determinar a prevalência de LPR nos pacientes com SSP e caracterizar radiologicamente os dentes associados às LPR. Métodos: Estudo transversal envolvendo pacientes com SSP, recrutados em uma Clínica de Reumatologia (HUCAM-ES), que foram submetidos, inicialmente, a um questionário socioeconômico e avaliação clínica do fluxo salivar. Posteriormente, radiografias foram obtidas por um sistema digital intrabucal, com posicionador para a técnica periapical do paralelismo. Realizou-se a estatística descritiva por meio da média e desvio-padrão para as variáveis quantitativas, e frequências absoluta e relativa para as variáveis qualitativas. Realizou-se o teste qui-quadrado com IC95% e o teste t de Student para comparação dos pacientes com e sem lesão periapical. Resultados: No total, 24 paciente...

Revista Brasileira de Pesquisa em Saúde/Brazilian Journal of Health Research, 2021

Em janeiro de 2020 o mundo tomou conhecimento da existência de uma nova cepa de coronavírus, o Sa... more Em janeiro de 2020 o mundo tomou conhecimento da existência de uma nova cepa de coronavírus, o Sars-CoV-2 (Síndrome Respiratória Aguda Grave-coronavírus 2), que causa a doença denominada de COVID-19. Em 11 de março de 2020, a Organização Mundial da Saúde (OMS) elevou a COVID-19 à pandemia devido à disseminação geográfica alcançada. Em 21 de março de 2021 o número de casos de COVID-19 confirmados no mundo ultrapassava os 120 milhões e no Brasil, os 11 milhões. Já morreram mais de 2,7 milhões de pessoas no mundo e 290 mil pessoas no Brasil devido à infecção por Sars-CoV-2 1,2. A COVID-19 pode causar complicações graves, principalmente em pessoas idosas e com comorbidades, mas todos podem ser afetados, incluindo mulheres grávidas e recém-nascidos. Não houve a indicação formal, por parte das autoridades sanitárias do Brasil, de inclusão das gestantes no grupo de risco, podendo garantir um afastamento protegido do trabalho. Esta iniciativa foi tomada individualmente apenas por algumas organizações.

Oral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology, 2020

Objective: Define prevalence of radiolucent periapical lesions (RLP) in patients with primary Sjo... more Objective: Define prevalence of radiolucent periapical lesions (RLP) in patients with primary Sjogren syndrome (SSP) and characterize the teeth associated with RLP. Methods: The radiographs were analyzed using Image J software by a radiologist. A socioeconomic questionnaire was applied. The salivary flow was evaluated through the collection of nonstimulated saliva. Mean and standard deviation (SD) for the quantitative variables and absolute and relative frequency of the qualitative variables was calculated. The χ2 test (95% CI) compared the difference between proportions of the qualitative variables, and the Student t test compared means of quantitative variables between patients with and without periapical lesions. Results: All 24 patients were female, aged between 20 and 71 years, with xerostomia, and 80% had hyposalivation. At least 1 RLP was found in 70.8% of patients. The mean number of teeth per patient was 23.3 ± 3.1 with a prevalence of RLP in the teeth of 7.86% of patients....

This thesis is structured in the form of scientific papers. The first paper investigates the exis... more This thesis is structured in the form of scientific papers. The first paper investigates the existence and magnitude of the association between Advanced Maternal Age (AMA) and the occurrence of placenta praevia (PP) and placental abruption (PA) among nulliparous and multiparous women through a systematic review and meta-analysis. The second paper verifies if the AMA increases the chance of negative perinatal outcomes, in addition to identifying which factors are associated with neonatal near miss, according to parity. And the third, sought association between AMA and relabor cesarean section, in addition to identifying which factors are associated with this outcome in women with AMA, also according to parity. Both were done with "Birth in Brazil" data. In the meta-analysis, searched for articles published between January 1st, 2005 and December 31th, 2015, an any language, in the databases PubMed, Scopus, Web of Science and LILACS, which grouped women into two age categorie...

O objetivo deste estudo é analisar a tendência de prematuridade no Brasil, entre 2012 e 2019, seg... more O objetivo deste estudo é analisar a tendência de prematuridade no Brasil, entre 2012 e 2019, segundo características sociodemográficas, do pré-natal e parto. Trata-se de um estudo ecológico de série temporal, em que foram calculadas as proporções de prematuridade segundo as regiões do Brasil, idade materna, escolaridade materna, raça/cor, número de consultas pré-natal e tipo de parto, a partir dos dados do Sistema de Informações sobre Nascidos Vivos (Sinasc). Sequencialmente, foram aplicados modelos de regressão polinomial para análise de tendência temporal. De 2012 a 2019, a proporção de prematuridade no Brasil apresentou tendência decrescente, variando de 10,87% a 9,95%, com a menor proporção em 2015, que foi de 9,77%. As mulheres na faixa etária de 45 anos ou mais e com 4 a 6 consultas de pré-natal apresentaram as maiores proporções de prematuridade para o período (14,88% a 17,92%) e com tendência crescente. Já as mulheres analfabetas e indígenas mostraram tendência decrescente ...