cometadata/datacite-titles-descriptions-related-identifiers huggingface dataset:
DOI: 10.6084/m9.figshare.14306337
title: Diagnostic discrepancies between emergency department admissions and hospital discharges among older adults: secondary analysis on a population-based survey

description: ABSTRACT BACKGROUND: Older adults frequently experience nonspecific clinical features. However, there is limited evidence on how often admission diagnoses for hospitalized older patients are incorrect, potentially leading to treatment delays. OBJECTIVES: To determine the consistency between hospital admission and discharge diagnoses, and identify factors associated with diagnostic discrepancies in older adults. DESIGN AND SETTING: Population-based cohort study in the United States. We included adults aged ≥ 18 years who were admitted from emergency departments (EDs) to hospitals, identified using the 2005-2010 National Hospital Ambulatory Medical Survey, a nationally representative survey. METHODS: Three admission diagnoses and the principal discharge diagnosis were captured and classified as discrepant if they involved considerably different conditions within the same organ system, or different organ systems altogether. RESULTS: Each year, 12 million adults were hospitalized following ED visits in the United States; 45% were aged ≥ 65 years. These patients' mean age was 79 years and 58% were women. Diagnostic discrepancies between admission and discharge were more common among adults ≥ 65 years (12.5 versus 8.3%; P &lt; 0.001). Certain admission diagnoses had particularly high rates of diagnostic discrepancies: 26-27% of patients presenting with mental disorders or with endocrine and metabolic diseases had substantial diagnostic discrepancies between admission and discharge. Substantial diagnostic discrepancy was independently associated with longer hospitalization and higher in-hospital mortality. CONCLUSION: One out of eight older adults hospitalized from EDs was discharged with a principal diagnosis differing considerably from the admission diagnosis. Given that missed or delayed diagnoses are a critical safety problem, clinicians should be vigilant and frequently cogitate alternative diagnostic possibilities.
DOI: 10.6084/m9.figshare.14307890
title: Untitled Item

description: atac data
DOI: 10.6084/m9.figshare.14307890.v2
title: Untitled Item

description: atac data
DOI: 10.6084/m9.figshare.14306336
title: Characterization of prenatal healthcare for implementation of congenital toxoplasmosis surveillance program: cross-sectional study

description: ABSTRACT BACKGROUND: Prenatal toxoplasmosis remains a neglected disease worldwide and few government programs focusing on its prevention are available. Success in these programs has been extensively reported in the literature, yet the strategies used for their implementation, as a model for such actions in different communities, have not been described. OBJECTIVE: To describe the aspects of prenatal care strategies in 13 municipalities within the regional healthcare unit of Araçatuba, in the northwestern region of the state of São Paulo in 2017, focusing on congenital toxoplasmosis. DESIGN AND SETTING: Descriptive study on prenatal healthcare within the Brazilian National Health System, in 13 participating municipalities. METHODS: Data on serological tests, referral clinics, notifications, healthcare strategies, health education and drugs for infected children were requested through a questionnaire that was sent via e-mail to people responsible for healthcare services in these municipalities. RESULTS: Major differences relating to diagnoses, reference outpatient clinics, notifications, health education and healthcare and drugs for infected children were reported among the prenatal strategies of these 13 municipal healthcare services. CONCLUSION: The lack of standardized prenatal strategy in the study area may compromise the prevention of infection. However, our identification of each aspect of prenatal care corroborates the need to implement a healthcare surveillance program relating to congenital toxoplasmosis.
DOI: 10.6084/m9.figshare.14307890.v1
title: Untitled Item

description: atac data
DOI: 10.6084/m9.figshare.14306334
title: Satisfaction with body weight among adolescents with excess weight: findings from a cross-sectional population-based study

description: ABSTRACT BACKGROUND: Individuals who are overweight or obese often underestimate their size, and they are less likely to consider their weight status to be a health problem and consequently to make lifestyle changes. OBJECTIVES: To estimate the proportion of satisfaction with weight among adolescents classified as overweight/obese, according to sociodemographic factors, morbidities and health-related behaviors. DESIGN AND SETTING: Cross-sectional population-based study conducted among adolescents aged 10 to 19 years in the city of Campinas (SP), Brazil. METHODS: The sample (n = 217) included participants with self-reported weight and height who were classified as overweight or obese, based on body mass index (BMI) according to age-specific cutoff points recommended by the World Health Organization. Participants whose answer to the question: “Would you like to gain or lose weight?” was “no” (i.e. no change) were deemed to be satisfied with their body weight. Odds ratios and 95% confidence intervals (95% CI) were calculated using logistic regression. RESULTS: The proportions of the respondents who were satisfied with their weight were 75.8% (95% CI: 65.3-83.9) among the overweight adolescents and 24.2% (95% CI: 16.1-34.7) among the obese adolescents (P &lt; 0.01). Satisfaction was lower among individuals aged 15 to 19 years (versus 10 to 14 years), those born outside of Campinas (versus in Campinas), those with ≥ 8 household appliances (versus &lt; 8), and those reporting ≥ two health complaints (versus none). CONCLUSIONS: More than half of the overweight adolescents and almost a quarter of the obese adolescents were satisfied with their weight. These results support the need for strategies for healthy weight management among Brazilian adolescents.
DOI: 10.6084/m9.figshare.14306330
title: Reasons for non-vaccination against influenza among older adults with hypertension in Brazil: a cross-sectional study

description: ABSTRACT The aim of this study was to estimate the prevalence of non-vaccination against influenza among Brazilian older adults with systemic arterial hypertension and determine the main reasons for non-adherence. A cross-sectional study was conducted using data from older adults (≥ 60 years of age) with hypertension who participated in the 2013 National Health Survey and reported not having been vaccinated against flu over the previous 12 months (n = 1,295). The analyses were performed using the Stata 14.0 software. The data were weighted because of the sampling design. An estimated 3,026,080 older adults with hypertension had not received a flu vaccine over the 12 months prior to the survey (22.6%). No significant associations were found with sex, age group or schooling. The prevalence of unvaccinated older adults was lower in the southern and southeastern regions of Brazil than in the northern and northeastern regions, even after adjusting for age. The prevalence was higher among individuals without private health insurance. The main reasons for non-vaccination were fear of a reaction, rarely having the flu and not believing in the protection of the vaccine. The present findings underscore the need for healthcare professionals to explain to the population the benefits of the vaccine for preventing severe influenza (protective effect and possible reactions) and for secondary prevention of cardiovascular events. Increasing the prevalence of vaccination in older adults with hypertension and other cardiovascular diseases is of fundamental importance within the realm of public health as a strategy for reducing occurrences of complications and deaths associated with influenza.
DOI: 10.6084/m9.figshare.14306329
title: Evaluation of knowledge and attitudes among intensive care physicians during the COVID-19 pandemic: a cross-sectional survey

description: ABSTRACT BACKGROUND: The novel coronavirus (COVID-19) emerged in Wuhan, China, in December 2019. OBJECTIVES: To evaluate the knowledge of intensive care physicians in Turkey about COVID-19 and their attitudes towards the strategies and application methods to be used for COVID-19 cases that need to be followed up in an intensive care unit, and to raise awareness about this issue. DESIGN AND SETTING: The population for this descriptive study comprised clinicians working in a variety of healthcare organizations in Turkey who provide monitoring and treatment within the intensive care process for COVID-19 patients. METHODS: Data were collected online using a survey form on the SurveyMonkey website between April 20 and April 25, 2020. RESULTS: The mean age of the 248 intensive care clinicians participating in the study was 37.2 ± 13.7 years and 49.19% were female. High rates of classical laryngoscope use were observed, especially among clinicians employed in state hospitals. Among all the participants, 54.8% stated that they were undecided about corticosteroid treatment for patients who had been intubated due to COVID-19. CONCLUSIONS: Many medications and methods are used for COVID-19 treatment. All national science committees are attempting to create standard treatment protocols. For intensive care treatment of COVID-19 patients, many factors require management, and clinicians’ experience is guiding future processes. We believe that this study will create awareness about this topic and contribute to the creation of standard treatment algorithms and the provision of better and safer healthcare services for this patient group.
DOI: 10.6084/m9.figshare.14306325
title: Does Enoxaparin treatment have any effects on the placenta in women with unexplained histories of habitual abortion? A case control study

description: ABSTRACT BACKGROUND: It is very common to offer low molecular weight heparin (LMWH) medications to women with unexplained habitual abortion, to increase the livebirth rate. Although no benefit from LMWH has been clearly demonstrated, examination of the effects of enoxaparin on placental structure is lacking. OBJECTIVE: To assess placental structural changes in pregnancies treated with enoxaparin, compared with controls. DESIGN AND SETTING: Case-control study in an obstetrics and gynecology unit of a tertiary-level university hospital in Turkey. METHODS: Forty patients who had had term pregnancies and live births but also histories of habitual abortion were recruited for this study. Placentas were sampled using a systematic random sampling method. Tissue samples were obtained, embedded and sectioned for routine histological analyses. Hematoxylin and eosin staining was used. Surface area and length estimates from placental components were evaluated by using Image J. Cell proliferation and apoptosis were also assessed via immunohistochemistry. RESULTS: There were no significant differences between the groups regarding maternal age, abortion rate, birth weight or gestational age. Comparison of the enoxaparin and control groups showed that there were no significant differences in terms of surface area and ratios of placental components. We found that Bcl-2 was generally expressed at high levels in the enoxaparin group, while there was no difference in terms of Ki-67 between the groups. CONCLUSIONS: This study demonstrates that enoxaparin did not show any significant effect on the placental structure of cases that had histories of habitual abortion.
DOI: 10.6084/m9.figshare.14306322
title: Suicide mortality in the city of São Paulo: epidemiological characteristics and their social factors in a temporal trend between 2000 and 2017. Retrospective study

description: ABSTRACT BACKGROUND: Suicide is one of the leading causes of death worldwide, accounting for one million deaths annually. Greater understanding of the causal risk factors is needed, especially in large urban centers. OBJECTIVE: To ascertain the epidemiological profile and temporal trend of suicides over two decades and correlate prevalence with social indicators. DESIGN AND SETTING: Descriptive population-based longitudinal retrospective study conducted in the city of São Paulo, Brazil. METHODS: A temporal trend series for suicide mortality in this city was constructed based on data from the Ministry of Health’s mortality notification system, covering 2000-2017. It was analyzed using classic demographic variables relating to social factors. RESULTS: Suicide rates were high throughout this period, increasing from 4.6/100,000 inhabitants in the 2000s to 4.9/100,000 in 2017 (mean: 4.7/100,000). The increase in mortality was mainly due to increased male suicide, which went from 6.0/100,000 to the current 8.0/100,000. Other higher coefficients corresponded to social risk factors, such as being a young adult (25-44 years old), being more educated (eight years of schooling) and having white ethnicity (67.2%). Suicide was also twice as likely to occur at home (47.8%). CONCLUSION: High suicide rates were seen over the period 2000-2017, especially among young adults and males. High schooling levels and white ethnicity were risk factors. The home environment is the crucial arena for preventive action. One special aspect of primary prevention is the internet and especially social media, which provides a multitude of information for suicide prevention.
DOI: 10.6084/m9.figshare.14306319
title: COVID-19: laboratory diagnosis for clinicians. An updating article

description: ABSTRACT COVID-19 (coronavirus disease 2019) is an infectious disease caused by the new coronavirus associated with severe acute respiratory syndrome 2 (SARS-CoV-2). Coronaviridae comprises a large family, of which at least seven members are known to cause respiratory diseases in humans. Coronaviruses have the ability to infect virtually all major groups of animals and, eventually, can infect humans. SARS-CoV-2 is the third coronavirus to cross the species barrier and infect humans. This virus was identified in an outbreak of pneumonia cases in Wuhan city, Hubei province, China, in December 2019. Its entire genome is inscribed on a single strand of ribonucleic acid. Some proteins present on the surface of the virus act as facilitators for its entry into host cells, while others, apparently, are related to its pathogenesis. Coronaviruses are responsible for respiratory infections in humans and some animals. The infection is often mild to moderate in intensity, but some coronaviruses may cause serious illnesses, such as severe acute respiratory syndrome (SARS), which occurred in 2002, and the Middle East respiratory syndrome (MERS). Coronaviruses can activate an excessive and unregulated immune response, which may promote SARS development. Although the lungs are one of the target organs, the hypoxia mechanism is systemic and other organs begin to suffer both through lack of oxygen and through deregulation of inflammation control mechanisms.
DOI: 10.6084/m9.figshare.14306318
title: Detecting the extent of control over selection bias relating to oral health and otorhinolaryngology: cross-sectional study

description: ABSTRACT BACKGROUND: The authors of randomized controlled trials will usually claim that they have met the randomization process criterion. However, sequence generation schemes differ and some schemes that are claimed to be randomized are not genuinely randomized. Even less well understood, and often more difficult to ascertain, is whether the allocation was really concealed. OBJECTIVE: To detect the extent of control over selection bias, in a comparison between two Cochrane groups: oral health and otorhinolaryngology; and to describe the methods used to control for this bias. DESIGN AND SETTING: Cross-sectional study conducted in a public university in São Paulo, Brazil. METHODS: The risk of selection bias in 1,714 records indexed in Medline database up to 2018 was assessed, independent of language and access. Two dimensions implicated in the allocation were considered: generation of the allocation sequence; and allocation concealment. RESULTS: We included 420 randomized controlled trials and all of them were evaluated to detect selection bias. In the sample studied, only 28 properly controlled the selection bias. Lack of control over selection bias was present in 80% of the studies evaluated in both groups. CONCLUSION: The two groups were similar regarding control over selection bias. They are also similar to the methods used. The dimension of allocation concealment appears to be a limiting factor with regard to production of randomized controlled trials with low risk of selection bias. The quality of reporting in studies on oral health and otorhinolaryngology is suboptimal and needs to be improved, in line with other fields of healthcare.
DOI: 10.6084/m9.figshare.14306315
title: Theory-based training to promote breast cancer screening among women with breast cancer worries: randomized controlled trial

description: ABSTRACT BACKGROUND: Breast cancer worries are important determinants in relation to behavior favoring breast cancer screening. OBJECTIVE: To determine the effect of theory-based training to promote breast cancer screening among women with high and low levels of breast cancer worries. DESIGN AND SETTING: Randomized controlled trial, conducted in two family health centers. METHODS: In total, 285 women were recruited. Women with low levels of breast cancer worries were included in the first intervention group (112 women) and the first control group (112 women), while women with high levels of breast cancer worries were included in the second intervention group (37 women) and the second control group (43 women). Theory-based training to promote breast cancer screening was given to intervention groups. The women’s willingness to undergo breast cancer screening and breast cancer worry scores were evaluated at 1, 3 and 6 months. RESULTS: The women in the low cancer-worry intervention group performed breast self-examination more in months 1 and 6 following the training, and the women in the high cancer-worry control group performed breast self-examination more in month 3 (P &lt; 0.05). No difference between the women who had low or high levels of breast cancer worries were observed in relation to breast self-examination, clinical breast examination or mammography (P &gt; 0.05). CONCLUSION: The level of worry did not affect the success of theory-based training, and the training was partially effective with regard to willingness to undergo breast cancer screening.
DOI: 10.6084/m9.figshare.14306312
title: Comparison of scores for the classification of cardiometabolic risk in adult patients enrolled in a Venezuelan program for chronic non-communicable diseases: a cross-sectional study

description: ABSTRACT BACKGROUND: Several continuous measurements of cardiometabolic risk (CMR) have emerged as indexes or scores. To our knowledge, there are no published data on its application and validation in Latin America. OBJECTIVE: To evaluate four continuous measurements of metabolic status and CMR. We established its predictive capacity for four conditions associated with CMR. DESIGN AND SETTING: Cross-sectional study conducted at a healthcare center in the state of Carabobo, Venezuela. METHODS: The sample comprised 176 Venezuelan adults enrolled in a chronic disease care program. Four CMR scores were calculated: metabolic syndrome (MetS) Z-score; cardiometabolic index (ICMet); simple method for quantifying MetS (siMS) score; and siMS risk score. CMR biomarkers, proinflammatory status and glomerular function were assessed. MetS was established in accordance with a harmonized definition. RESULTS: Patients with MetS showed higher levels of all scores. All scores increased as the number of MetS components rose. The scores showed significant correlations with most CMR biomarkers, inflammation and glomerular function after adjusting for age and sex. In the entire sample, MetS Z-score, siMS score and siMS risk score showed the ability to detect MetS, reduced glycemic control, proinflammatory status and decreased estimated glomerular filtration rate. ICMet only discriminated MetS and proinflammatory state. There were some differences in the predictive capacity of the scores according to sex. CONCLUSIONS: The findings support the use of the scores assessed here. Follow-up studies should evaluate the predictive capacity of scores for cardiovascular events and diabetes in the Venezuelan population.
DOI: 10.6084/m9.figshare.14306310
title: Muscle depletion in cirrhotic patients assessed using computed tomography: a cross-sectional study

description: ABSTRACT BACKGROUND: Sarcopenia is a common complication in patients with cirrhosis and may lead to increased morbidity and mortality. OBJECTIVE: To investigate the prevalence of sarcopenia and its association with disease severity scores, among patients with cirrhosis. DESIGN AND SETTING: Observational and retrospective cohort study carried out in a tertiary-care hospital in southern Brazil. METHODS: This study was conducted among patients with chronic liver disease who were followed up at the gastroenterology and hepatology outpatient clinic of a tertiary-care hospital in southern Brazil and who underwent computed tomography scans of the abdomen through any indication. RESULTS: We included 83 patients in the study. In the population evaluated, there was a predominance of males (57.80%) and the mean age was 56 years. Hepatitis B or C virus was present in the genesis of the disease in 34.9% of the cases, followed by an etiology of alcohol abuse (30.1%). Sarcopenia was diagnosed in 41 (49.4%) of the patients when the cutoff point for cirrhotic patients was used. There was no significant correlation between the Child-Pugh and MELD severity scores and the occurrence of sarcopenia. CONCLUSION: Sarcopenia presents high prevalence among patients with chronic liver disease, without any association with predictors of severity.
DOI: 10.6084/m9.figshare.14306309
title: Association of serum levels of secreted frizzled-related protein 5 and Wnt member 5a with glomerular filtration rate in patients with type 2 diabetes mellitus and chronic renal disease: a cross-sectional study

description: ABSTRACT BACKGROUND: Diabetic nephropathy is a common complication of chronic kidney disease (CKD). Inflammation in the kidneys is crucial for promoting development and progression of this complication. Wnt member 5a (Wnt5a) and secreted frizzled-related protein 5 (Sfrp5) are proinflammatory proteins associated with insulin resistance and chronic low-grade adipose tissue inflammation. OBJECTIVE: To determine the correlation between serum Sfrp5 and Wnt5a concentrations and glomerular filtration rate in patients with type 2 diabetes mellitus and CKD. DESIGN AND SETTING: Cross-sectional, comparative and observational study in the Department of Endocrinology, Civil Hospital, Culiacán, Sinaloa, Mexico. METHODS: Eighty individuals with chronic kidney disease were recruited. Their serum Sfrp5 and Wnt5a concentrations were quantified using the enzyme-linked immunosorbent assay (ELISA) test. The statistical analysis consisted of the Mann-Whitney U test for independent samples and Spearman correlation, with statistical significance of P &lt; 0.05. RESULTS: Serum Sfrp5 concentration continually increased through the stages of CKD progression, whereas serum Wnt5a concentration presented its highest levels in stage 3 CKD. Negative correlations between estimated glomerular filtration rate (eGFR) and serum concentrations of Sfrp5 (r = -0434, P = 0.001) and Wnt5a (r = -0481, P = 0.001) were found. CONCLUSIONS: There were negative correlations between serum Sfrp5 and Wnt5a concentrations and eGFR at each stage of CKD, with higher levels in female patients. This phenomenon suggests that Sfrp5 and Wnt5a might be involved in development and evolution towards end-stage renal disease.