Efficacy of entecavir and tenofovir in chronic hepatitis B under treatment in the public health system in southern Brazil

There are about 350 million hepatitis B virus (HBV) carriers worldwide and chronic HBV is considered a major public health problem. The objective of the present study was to assess the effectiveness of the nucleos(t)ide analogues tenofovir (TDF) and entecavir (ETV) in the treatment of chronic HBV. A cross-sectional study was carried out from March-December 2013, including all patients with chronic HBV, over 18 years of age, undergoing therapy through the public health system in southern Brazil. Only the data relating to the first treatments performed with TDF or ETV were considered. Retreatment, co-infection, transplanted or immunosuppressed patients were excluded. Six hundred and forty patients were evaluated, of which 336 (52.5%) received TDF and 165 (25.8%) ETV. The other 139 (21.7%) used various combinations of nucleos(t)ide analogues and were excluded. The negativation of viral load was observed in 87.3% and 78.8% and the negativation of hepatitis B e antigen was achieved in 79% and 72% of those treated with ETV or TDF, respectively. Negativation of hepatitis B surface antigen was not observed. There was no occurrence of adverse effects. This is a real-life study demonstrating that long-term treatment with ETV and TDF is both safe and effective.

Factors influencing dental appearance satisfaction in adolescents: a cross-sectional study conducted in Southern Brazil

The perception of dental aesthetic appearance may affect social interaction and psychological status, influencing dental needs and the search for treatments. Aim: To investigate the satisfaction with dental appearance and influencing factors among adolescents. Methods: The study was carried out among adolescents aged 14 to 19 years attending a private high school in Brazil. Data on demographic information, the perception of dental appearance, previous aesthetic treatments and wish to perform dental treatments were collected in the school. Data were analyzed using Pearson’s chi-square test or Linear Trend. Multivariate analysis was performed using the Poisson regression. Results: A total of 531 adolescents (Response rate = 98.3%) answered the questionnaire. The prevalence of dissatisfaction with dental appearance was 17.4%. Almost 65% had history of previous orthodontic treatment and 16% performed dental bleaching. Approximately 45% of children wished to undergo orthodontics and 54.8% to bleach their teeth. Dissatisfaction with dental appearance was associated with individuals unsatisfied with dental color (95% IC[1.73;4.32]), those perceiving poor dental alignment (PR3.16 95% IC[2.11;4.72]) and those wishing orthodontic treatment (PR2.9; 95% IC[1.79; 4.70]). Conclusions: The prevalence of dissatisfaction was considerable and was associated with aesthetic concerns such as tooth color, dental alignment and with the wish for orthodontics. In this young population, a large part of adolescents had already performed orthodontic and bleaching treatments and wished to perform those treatments again. Satisfaction with dental appearance could affect the adolescents’ behavior regarding search for dental treatment, thus causing possible overtreatment.