Brazilian Population Research Articles

Task force of the Brazilian Society of Otology — evaluation and management of peripheral facial palsy

ObjectiveTo review key evidence-based recommendations for the diagnosis and treatment of peripheral facial palsy in children and adults. MethodsTask force members were educated on knowledge synthesis methods, including electronic database search, review and selection of relevant citations, and critical appraisal of selected studies. Articles written in English or Portuguese on peripheral facial palsy were eligible for inclusion. The American College of Physicians’ guideline grading system and the American Thyroid Association’s guideline criteria were used for critical appraisal of evidence and recommendations for therapeutic interventions. ResultsThe topics were divided into 2 main parts: (1) Evaluation and diagnosis of facial palsy: electrophysiologic tests, idiopathic facial palsy, Ramsay Hunt syndrome, traumatic peripheral facial palsy, recurrent peripheral facial palsy, facial nerve tumors, and peripheral facial palsy in children; and (2) Rehabilitation procedures: surgical decompression of the facial nerve, facial nerve grafting, surgical treatment of long-term peripheral facial palsy, and non-surgical rehabilitation of the facial nerve. ConclusionsPeripheral facial palsy is a condition of diverse etiology. Treatment should be individualized according to the cause of facial nerve dysfunction, but the literature presents better evidence-based recommendations for systemic corticosteroid therapy.

Pediatric anesthesiology in Brazil, Chile, and Mexico.

Latin America comprises an extensive and diverse territory composed of 33 countries in the Caribbean, Central, and South America where Romance languages-languages derived from Latin are predominantly spoken. Economic disparities exist, with inequitable access to pediatric surgical care. The Latin American Surgical Outcomes Study in Pediatrics (LASOS-Peds), a multi-national collaboration, will determine safety of pediatric anesthesia and perioperative care. Below, we provide a descriptive initiative to share how pediatric anesthesia in Brazil, Chile, and Mexico operate. Theses descriptions do not represent all of Latin America. Brazil an upper middle-income country, population 203 million, has a public system insufficiently resourced and a private system, resulting in inequitable safety and accessibility. Surgical complications constitute the third leading cause of mortality. Anesthesiology residency is 3 years, with required rotations in pediatric anesthesia; five hospitals offer pediatric anesthesia fellowships. Anesthesiology is a physician-only practice. A Pediatric Anesthesia Committee within the Brazilian Society of Anesthesiology offers education through seasonal courses and workshops including pediatric advanced life support. Chile is a high-income country, population 19.5 million, the majority cared for in the public system, the remainder in university, private, or military systems. Government efforts have gradually corrected the long-standing anesthesiology shortage: twenty 3-year residency programs prepare graduates for routine pediatric cases. The Chilean Society of Anesthesiology runs a 1-month program for general anesthesiologists to enhance pediatric anesthesia skills. Pediatric anesthesia fellowship training occurs in Europe, USA, and Australia, or in two 2-year Chilean university programs. Public health policies have increased the medical and surgical pediatric specialists and general anesthesiologists, but not pediatric anesthesiologists, which creates safety concerns for neonates, infants, and medically complex. Chile needs more pediatric anesthesia fellowship programs. Mexico, an upper middle-income country, with a population of about 126 million, has a five-sector healthcare system: public, social security for union workers, state for public employees, armed forces for the military, and a private "self-pay." There are inequities in safety and accessibility for children. Pediatric Anesthesiology fellowship is 2 years, after 3 years residency. A shortage of pediatric anesthesiologists limits accessibility and safety for surgical care, driven by added training at low salary and hospital under appreciation. The Mexican Society of Pediatric Anesthesiology conducts refresher courses, workshops, and case conferences. Insufficient resources and culture limits research.

A nationwide study on immunosenescence biomarkers profile in older adults: ELSI-Brazil

Immunosenescence is a phenomenon caused by changes in the immune system, and part of these changes involves an increase in circulating immunological biomarkers, a process known as “Inflammaging.” Inflammaging can be associated with many diseases related to older people. As the older population continues to grow, understanding changes in the immune system becomes essential. While prior studies assessing these alterations have been conducted in countries with Caucasian populations, this investigation marks a pioneering effort. The object of the study is to describe for the first time that the distribution of cytokines, chemokines, and growth factors serum levels, assessed by Luminex platform, has been examined in a Brazilian population-based study of older adult females and males by age. Blood samples from 2111 participants (≥50 years old) were analyzed at the baseline (2015/2016) of the ELSI-Brazil study. The exploratory variables considered in the study were age, sex, educational level, residence area, geographic region, alcohol and smoking consumption, physical activity, and self-reported medical diagnoses of hypertension, diabetes, asthma, arthritis, and cancer. The association between serum biomarker levels and age was assessed by a quantile regression model adjusted in the total population and stratified by sex. The significance level considered in the analysis was 0.05. The mean age of the participants was 62.9 years, with a slight majority of female (52.7 %). Differences were found between the sexes in the median circulating levels of the CCL11, CXCL10, and FGF biomarkers. Eight biomarkers showed significant associations with age, including the pro-inflammatory CXCL10, TNF-α, IL-6, IL-17, and IL-2; and type 2/regulatory CCL11 and IL-4, showing positive associations, and anti-inflammatory IL-1Ra showing a negative association. The results suggest similar associations between the sexes, revealing an inflammatory profile characterized by types 1 and 2. Remarkably, these findings reinforce the concept of the Inflammaging process in Brazilian population. These findings add novel insights to about the immunosenescence aspects in middle-income countries and help define biomarkers capable of monitoring inflammation in older adults.

Beyond ultra-processed foods: the new direction of the basic food basket in Brazil

Decree 11.936/2024 initiates a significant transformation in the Brazilian basic food basket, focusing on encouraging healthier and more sustainable eating habits. By prioritizing whole foods and restricting ultra-processed foods, it aligns with nutritional policy guidelines and tax reform, demonstrating a commitment to public health and food sustainability. The document reconciles with the recommendations set forth by the Dietary Guidelines for the Brazilian Population, which emphasizes seasonality, family farming, local and regional traditions, biodiversity, and environmental respect essential elements for food and nutritional security that offer direct benefits to public health. Through this approach, it seeks to guide the population towards balanced eating practices, ensuring access to nutritionally adequate and sustainable food, especially for the most vulnerable segments of society.

Comparative analysis of the national curriculum guidelines for the dentistry courses in 2002 and 2021

Introduction: faced with the challenge of training dental surgeons who are fit for the job market, especially the Unified Health System, the National Curriculum Guidelines were established in 2002 with the aim of organizing the curricula of undergraduate dentistry courses, which were updated in 2021.
 Objective: a comparative analysis of the 2002 and 2021 National Curriculum Guidelines for dentistry courses, verifying their proposals’ theoretical and practical similarities and differences.
 Methods: this is a qualitative, descriptive, and exploratory study, using documentary analysis of these guidelines.
 Results: from the documentary analysis, six analytical categories were identified: Profile of the graduate; General and specific competencies; Contents for the training of the dental surgeon; Supervised curricular internship and course completion work; Pedagogical project and curricular organization; and Assessment. The 2021 National Curriculum Guidelines is more detailed and complete than the 2002 and strengthens mechanisms for improving and adapting dentistry courses in Brazil.
 Conclusion: progress has been made with the inclusion of aspects such as permanent training for teachers, humanization in relationships, interprofessional and entrepreneurship, with the aim of providing training that meets the health needs of the Brazilian population.

Trends in the Brazilians' engagement with insects on the internet

Abstract It is estimated that the tropical and south temperate regions harbour approximately 85% of the total entomofauna, and Brazil, which is the largest country in the Neotropical region, shows the greatest insect diversity in the world. However, to the best of our knowledge, the Brazilian population's interest in insects is yet to be investigated. We use Google Trends platform for prospecting temporal variation in the public engagement with nature. From searches in this database, from 2012 to 2020, using common names of 21 insect groups, we evaluated: (I) Brazilians' internet interest on insects over time, (II) the highest search themes for each insect group and (III) which pairs of insects are positively or negatively correlated regarding the public interest through years. Our findings demonstrate that Brazilians' internet interest regarding the studied insect groups is constant over time, which may be linked with the low attention these organisms generally receive, and that Brazilians are prone to perceive them as harmful, as we can observe in many of the top queries related to studied groups. We observed a considerable synchronous growth in interest regarding pairs of insects considered as domestic pests, medically important and charismatic, and the searches on these groups referred mainly to their biological, ecological and cultural aspects. Our results indicate that investment in environmental education in Brazil can motivate public engagement with insects. Also, our data can be crucial for directing conservation policies for insects in the tropical region.

Short Sleep Duration and Skipping Main Meals among University Students

Abstract Introduction Admission to university influences lifestyle behaviors and is marked by a daily routine of accumulation of activities that can interfere with sleep duration, affecting food choices and meal consumption habits throughout the day. Objective To analyze the association between short sleep duration and skipping main meals among university students. Materials and Methods We conducted a cross-sectional study with 1,608 university students aged between 16 and 25 years, who were enrolled in full-time undergraduate courses at a public university in the Midwestern region of Brazil. Information on skipping breakfast, lunch, and dinner was collected through the question “On average, how often do you eat the following meals?”. Given the lack of a uniform criterion to define “skipping a meal”, in the present study, any answer that did not correspond to the daily consumption of the meal was classified as meal skipping, based on the recommendation of the Dietary Guidelines for the Brazilian Population. Short sleep duration was determined according to sleep time during the night (≤ 6 hours for those aged ≥18 years and ≤ 7 hours for those under 18 years of age). Associations were estimated using adjusted Poisson regression models. Results The prevalences of skipping breakfast, lunch, and dinner were of 51.0%, 13.9%, and 35.6% respectively. Short sleep duration was observed in 27.2% of the study population. After adjusting for confounding variables, short sleep duration was positively associated with skipping breakfast (adjusted prevalence ratio [PRadj] = 1.20; 95% confidence interval [95%CI] = 1.08–1.34) and skipping lunch (PRadj = 1.64; 95%CI = 1.27–2.12). Conclusion University students presented a high prevalence of skipping main meals. Short sleep duration was directly associated with skipping two major meals of the day: breakfast and lunch.

Phylogeography of a Widely Distributed Atlantic Species: The Case of the Ghost Crab Ocypode quadrata (Fabricius, 1787) (Decapoda: Brachyura: Ocypodidae)

Ocypode Weber, 1795 (Brachyura: Ocypodidae) is popularly known as ghost crab, and encompasses 21 valid species, including Ocypode quadrata (Fabricius, 1787). This species has wide distribution along the Atlantic coast of America, from the USA (Massachusetts) to Brazil (Rio Grande do Sul), Central America, and Antilles. Such distribution, along with some biological characteristics of its life cycle and the presence of geographic barriers, could lead to genetic structuring. Herein, we evaluate the hypothesis of the presence of geographic barriers using COI and 16S partial gene fragments. The Maximum Likelihood tree suggests the monophyly of O. quadrata, while the values of intraspecific genetic distance along with the star-shaped haplotype network suggested a lack of genetic structure in Brazilian, Panama, and French Guiana populations, probably caused by larval dispersion. USA and Mexico populations may be a new lineage, but we cannot say it with few sequences and with no morphological characters.

Age estimation by volumetric analysis of teeth using cone beam computed tomography.

To evaluate the feasibility of using the pulp volume (Pv) to total volume (Tv) ratio (Pv:Tv), obtained from cone beam computed tomography (CBCT) scans of single-rooted teeth, for age estimation in a Brazilian population sample. After obtaining approval from the ethics committee, the study commenced by applying inclusion criteria to screen CBCT scans, resulting in a probability-based sample of participants aged 18years and older (ranging from 18 to 82years, with a mean age of 46.44years). A total of 517 single-rooted teeth, including maxillary central incisors (CI), mandibular canines (C), and mandibular first premolars (FP), were chosen based on excellent agreement values (> 0.9). Pv and Tv measurements were conducted using semi-automatic segmentation with ITK-SNAP 3.8 software. Statistical analysis was performed using Jamovi software, with a significance level set at 5% (α = 0.05). A strong negative correlation (r > -0.7) was observed between chronological age and the Pv:Tv ratio across all examined teeth. However, when conducting regression analysis with Pv:Tv data and chronological age as the independent variable, only the mandibular FP teeth exhibited a normal distribution. The resulting linear model demonstrated moderate predictive value (approximately 64%) in explaining the variance in chronological age, but caution should be exercised when interpreting these findings. The method of measuring individual tooth volume using CBCT to estimate chronological age via Pv:Tv has been demonstrated as effective and reproducible within the Brazilian population sample.

Diagnosis of hyperprolactinemia in women: A Position Statement from the Brazilian Federation of Gynecology and Obstetrics Associations (Febrasgo) and the Brazilian Society of Endocrinology and Metabolism (SBEM).

Hyperprolactinemia is a frequent cause of menstrual irregularity, galactorrhea, hypogonadism, and infertility. The most common etiologies of hyperprolactinemia can be classified as physiological, pharmacological, and pathological. Among pathological conditions, it is essential to distinguish prolactinomas from other tumors and pituitary lesions presenting with hyperprolactinemia due to pituitary stalk disconnection. Proper investigation considering clinical data, laboratory tests, and, if necessary, imaging evaluation, is important to identify the correctcause of hyperprolactinemia and manage the patient properly. This position statement by the Brazilian Federation of Gynecology and Obstetrics Associations (Febrasgo) and Brazilian Societyof Endocrinology and Metabolism (SBEM) addresses the recommendations for measurement of serum prolactin levels and the investigations of symptomatic and asymptomatic hyperprolactinemia and medication-induced hyperprolactinemia in women.

Treatment of hyperprolactinemia in women: A Position Statement from the Brazilian Federation of Gynecology and Obstetrics Associations (Febrasgo) and the Brazilian Society of Endocrinology and Metabolism (SBEM).

Dopamine agonists are the first line of treatment for patients with symptomatic hyperprolactinemia due to prolactinomas and in those with idiopathic hyperprolactinemia. Treatment with these agents is effective in 80%-90% of the cases. Infertility treatment of patients with hyperprolactinemia is also carried out with dopamine agonists, aiming for the normalization of prolactin levels. The risk of symptomatic growth of prolactinomas during pregnancy is dependent on the tumor's size, duration of previous treatments, and prolactin levels. Notably, the corresponding risk is relatively low in cases of microprolactinomas (<5%). Remission of hyperprolactinemia occurs in about 30% of the patients after drug treatment and may also occur after pregnancy and menopause. The use of some drugs, such as antidepressants and antipsychotics, is a frequent cause of hyperprolactinemia, and managing this occurrence involves unique considerations. This position statement by the Brazilian Federation of Gynecology and Obstetrics Associations (Febrasgo) and Brazilian Society of Endocrinology and Metabolism (SBEM) addresses the recommendations for measurement of serum prolactin levels and the investigations of symptomatic and asymptomatic hyperprolactinemia and drug-induced hyperprolactinemia in women.

Ecosystem services provided by green areas and their implications for human health in Brazil

Green areas provide numerous ecosystem services (ES) that are essential for human well-being, such as climate regulation, air quality regulation, disease regulation, and recreational opportunities. In this study, we assessed the ecosystem services provided by green areas and their implications for human health in Brazil. Considering emerging problems in Brazil, such as population growth, the health crisis, and the increase in deforestation, ES mapping is essential to understand barriers and diagnose strategies for promoting the health and well-being of the Brazilian population. Using remote sensing data and geographic information systems, we evaluated the Green Areas Ecosystem Services (GAES), composed of i) the provision of green areas; ii) regulation of air quality; iii) climate regulation; iv) diseases regulation (cardiorespiratory); and v) cultural services, including recreation, sports, and ecotourism. Our findings suggest that green areas in Brazil provide a considerable amount of ecosystem services that are relevant to human health. Over 70 % of Brazil exhibited GAES values exceeding 0.5 (relative scale ranging from 0 to 1). This indicates that a significant portion of the Brazilian population has access to green spaces that provide important services, such as air and water purification, climate regulation, and disease regulation. The mean GAES value for the entire country was 0.78, with notable regional variations. The highest GAES was found in regions dominated by the Amazon Forest (GAES = 0.81), while the smallest offers of GAES are in the northeast (GAES = 0.40) and south (GAES = 0.41) regions of the country The type of vegetation was an important factor in the regulation of climate and air quality. However, factors such as population density and urbanization interfere with the regulation of diseases. Considering the 10 states with the highest and lowest per capita income and population density, the state of Rio Grande do Sul, located in the South region, had the highest mean GAES value; while the state of Acre, in the North region, had the lowest. Our findings suggest that interventions to improve green area provision and quality may be most effective in the northeast and South regions of Brazil. This is indicative of the observed lower GAES provision in these regions, primarily attributed to elevated urbanization levels leading to the conversion of green areas into urban zones. Overall, our study highlights the importance of green areas for human well-being and provides valuable information for policymakers to prioritize interventions to improve GAES provision across Brazil.

Division of Responsibility in Child Feeding and Eating Competence: A Cross-Sectional Study in a Sample of Caregivers of Brazilian Children with Celiac Disease.

The objective of this cross-sectional study was to assess eating competence (EC) and the adherence to the division of responsibility in child feeding (sDOR) of Brazilian caregivers of children with celiac disease (CD). It also examined the association between EC and sDOR, children's adherence to a gluten-free diet, and sociodemographic data. This study administered a survey set that included sociodemographic data, health-related data, eating habits, and the instruments ecSI2.0TMBR and sDOR.2-6yTM BR, validated for a Brazilian population. The sample comprised 50 caregivers of children with CD (between 24 and 72 months of age). The participants following a gluten-free diet (GFD) presented higher scores for all EC domains and the total EC. The total EC scores were higher for the participants over 40 y/o, frequently having meals as a family, with their children consuming more than three servings of fruit and at least one serving of vegetables daily and complying with a GFD. Different from the EC, the sDOR.2-6yTM scores did not differ between the participants complying with a GFD. The sDOR.2-6yTM mealtime structure domain scores were significantly associated with the EC eating attitude, food acceptance, contextual skills, and total. These findings support the need for greater attention to exploring the division of responsibility in feeding and EC in pediatric celiac disease, potentially enhancing intervention strategies for patients and their families.

[Estimation of prevalence of chronic Chagas disease in Brazilian municipalitiesEstimación de la prevalencia de la enfermedad de Chagas crónica en los municipios brasileños].

The objective of this study is to estimate the prevalence of chronic Chagas disease (CCD) in Brazil: in the general population, in women, and in women of childbearing age. A meta-analysis of the literature was conducted to extract data on the prevalence of CCD in municipalities in Brazil in the 2010-2022 period: in the general population, in women, and in women of childbearing age. Municipal-level CCD indicators available in health information systems were selected. Statistical modeling of the data extracted from the meta-analysis (based on data obtained from information systems) was applied to linear, generalized linear, and additive models. The five most appropriate models were selected from a total of 549 models tested to obtain a consensus model (adjusted R2 = 54%). The most important predictor was self-reported CCD in the primary health care information system. Zero prevalence was estimated in 1 792 (32%) of Brazil's 5 570 municipalities; in the remaining 3 778 municipalities, average prevalence of the disease was estimated at 3.25% (± 2.9%). The number of carriers of CCD was estimated for the Brazilian population (~3.7 million), for women (~2.1 million) and for women of childbearing age (~590 000). The disease reproduction rate was calculated at 1.0336. All estimates refer to the 2015-2016 period. The estimated prevalence of CCD, especially among women of childbearing age, highlights the challenge of vertical transmission in Brazilian municipalities. Mathematical projections suggest that these estimates should be included in the national program for the elimination of vertical transmission of Chagas disease.

The importance of small producers and their difficulty in accessing rural credit

The activities carried out by Brazilian family farmers form the foundation for the regional, economic, and social development of the country. Not only do these endeavors generate employment, but they also contribute to an enhancement of food security for the Brazilian population. Therefore, the overall objective of this study is to substantiate the real importance of the small producer and to investigate the primary causes that hinder their access to credit lines, thereby impeding the progression of regional agriculture. The significance of the small producer arises from their role in supplying a larger portion of the national territory with food. Additionally, they produce food free from harmful chemical processes that pose risks to public health, while also significantly reducing environmental degradation compared to the methods employed in large-scale agricultural productions. Regarding the methodological procedures, the research is explanatory, aiming to elucidate the causes that make credit access challenging. Both primary and secondary sources were used. The research can also be considered quantitative, as it involved the analysis of a phenomenon through statistical and theoretical data. In terms of results, a greater difficulty in accessing rural credit lines by small producers was observed. According to the analyses, the lower the income, the more challenging it is for farmers to secure credit. Based on the findings, adjustments and necessary changes in relation to rural credit have been identified.

Professor Carla Bottoli, an enthusiastic scientific researcher, kindly spoke to BrJAC

Carla Beatriz Grespan Bottoli holds a degree in Industrial Chemistry from the Federal University of Santa Maria (1996), as well as a Ph.D. in Chemistry (2002), and a postdoctoral degree in Chemistry (2002-2004), both from the State University of Campinas (Unicamp). In 2005, she undertook an internship at the Institute of Nuclear Sciences of the National Autonomous University of Mexico (UNAM) to study radiolysis in vitamins using gamma radiation from a source of Cobalt 60. In 2017, she presented her habilitation thesis (associate professor's thesis) at Unicamp. Currently, she is Associate Professor and Postgraduate Advisor at the Institute of Chemistry at Unicamp (IQ-Unicamp), where she works in the area of analytical chemistry, with emphasis on separation methods, mainly liquid chromatography. Prof. Bottoli coordinates the NovaCrom – Liquid Chromatography Laboratory (https://novacromlab.wixsite.com/novacrom), which is a research group that has been working on the development of new monolithic stationary phases for capillary liquid chromatography. Research is also focused on the development of analytical methods that employ liquid chromatography coupled with mass spectrometry to study the translocation of pesticides in plants such as coconut, palm, and soybean. Between 2019 and 2021, Prof. Bottoli was an associate coordinator of the Research Commission of the IQ-Unicamp and is currently a member of the Research Integrity Commission at Unicamp. She is a member of the Brazilian Chemical Society and a researcher at the National Institute of Science and Technology in Bioanalytics (INCTBio). Carla Bottoli is the mother of Murilo, 13 and Mateus, 10.

Head rotation and the perception of eyelid height and contour

PurposeEffective visual perceptual processing is one of the many components of surgical competence. Human face identification is most efficient when viewed upright. However, it is not yet clear how this...

Globalização, empresa e responsabilidade socioambiental

The research addresses the globalization’s issue and socio-environmental responsibility of Brazilian companies concerning to adoption of ethical standards and business commitment based on the criteria of Environmental, Social and Corporate Governance, concepts that support the new process of internationalization of business law, globally. This is a systematic interpretation of the corporate production of wealth with emphasis of globalization for a better understanding of the role of the modern company which, in addition to being a supplier of goods and services, must be allied to socio-environmental interests with the creation of new markets, generating jobs and attracting new consumers. As a basis, scientific and bibliographical productions by Brazilian and international authors were researched. It is clear to conclude that there is a need for public policies to promote environmental education and social accountability of all Brazilian business people and thus guarantee the preservation and protection of the sustainable environment through the search for social and ethical values in defense of the global ecosystem.

Education and structural racism: teachers’ views on racial discrimination experienced in the workplace

The research in question was developed together with the Center for Research and Extension in Human Rights (NUPEDH) and the Research Group Law, Gender and Plural Identities (DGIPLUS), both linked to the Postgraduate Program in Law and Social Justice at the Faculty of Law (FADIR) from the Federal University of Rio Grande (FURG/Brazil). We sought to investigate, analyze, and understand how structural racism – a phenomenon understood as systematic racial discrimination present in sociopolitical structures – is experienced by teachers who self-identify as black and who work in the public and private primary and secondary education network in the city of Canguçu located in the state of Rio Grande do Sul (RS), Brazil. Aiming to achieve the proposed objective, the deductive research method was adopted, comprising bibliographical research (scientific articles, theses, and books) and critical-reflective analysis of the collected material. As the aim was also to understand the reality of black teachers, empirical research was carried out through semi-structured interviews with all 41 black teachers out of a total of 775 teachers who work in the educational system in the city of Canguçu. Among the obtained results, the fact that the majority, that is, 99% of the teachers interviewed, stated that they had experienced situations of prejudice in work relationships and when teaching in the classroom stands out. Both the number of black teachers in the city of Canguçu and the testimonies of the interviewees corroborate the existence of structural racism in the educational sphere, since, as the authors who underlie the research emphasize, racial discrimination is one of the elements that make up the sociopolitical organization and economic aspects of Brazilian society.

Aortic\\Height Index as a Predictor of Symptomatic Status in Patients With AAA in a Southern Brazilian Population

Aortic\\Height Index as a Predictor of Symptomatic Status in Patients With AAA in a Southern Brazilian Population