30 research outputs found
Treatment of condylar fractures: : a retrospective cohort study
Objective: Evaluate routine alterations in patients submitted to treatment of unilateral fractures of the mandibular condyle. Patients and methods: The sample consisted of 30 patients of both sexes submitted to surgical and nonsurgical treatment. All patients answered an evaluation questionnaire on perception of the Oral Impact on Daily Performances (OIDP) and underwent physical and imaging examination. The following aspects were evaluated in temporo mandibular join (TMJ) physical examination: maximum mouth opening, left/right lateral movements and protrusive movements. Vertical height measurements of right and left mandibular branches were evaluated by means of orthopantomography. Lateromedial and anteroposterior displacements were measured using Hirtz?s axial radiography. Evaluation of diameter of the mandibular fossa and height of the glenoid fossa were measured by hypocycloidal tomography. Results: A minority (13.3%) answered the questions on OIDP positively, with a similar rate for both treatments. With regard to the vertical height variable, average vertical height was similar for both treatments. However, comparing fractured and nonfractured sides, the difference observed was statistically significant for both treatments. On the basis of the statistical results of this study, for both treatments there were no significant alterations in the maximum mouth opening variable, with an average of 43.35 mm for open treatment and 44 mm for closed treatment. Conclusion: In the present study there were no significant differences between open and closed treatment of unilateral fractures of the mandibular condyle
Risk factors for temporomandibular disorder: binary logistic regression analysis
Objectives: To analyze the influence of socioeconomic and demographic factors (gender, economic class, age and
marital status) on the occurrence of temporomandibular disorder.
Study Design: One hundred individuals from urban areas in the city of Recife (Brazil) registered at Family Health
Units was examined using Axis I of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/
TMD) which addresses myofascial pain and joint problems (disc displacement, arthralgia, osteoarthritis and oeste
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oarthrosis). The Brazilian Economic Classification Criteria (CCEB) was used for the collection of socioeconomic
and demographic data. Then, it was categorized as Class A (high social class), Classes B/C (middle class) and
Classes D/E (very poor social class). The results were analyzed using Pearson's chi-square test for proportions,
Fisher's exact test, nonparametric Mann-Whitney test and Binary logistic regression analysis.
Results: None of the participants belonged to Class A, 72% belonged to Classes B/C and 28% belonged to Classes
D/E. The multivariate analysis revealed that participants from Classes D/E had a 4.35-fold greater chance of ex
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hibiting myofascial pain and 11.3-fold greater chance of exhibiting joint problems.
Conclusions: Poverty is a important condition to exhibit myofascial pain and joint problems
Oral Health Care of Children and Adolescents with Different Impairments of Cerebral Palsy: Barriers and Challenges
Objective: To evaluate the barriers to access and oral health care faced by children and adolescents with Cerebral Palsy (CP) according to their motor impairment through the perception of caregivers. Material and Methods: A case series study was carried out at three health institutions in Pernambuco, Brazil. The study sample consisted of 94 caregivers of 5-to-18-year-old patients with CP, according to GMFCS (The Gross Motor Function Classification System). Data were collected using a semi-structured form to evaluate the barriers to access and analyzed statistically by the chi-square and Fisher exact tests, adopting a 5% level of significance. In addition, binary logistic regression was performed to determine the weight of the variables in explaining the outcome variable. Results: There were major difficulties involving transportation (p=0.04) and structural accessibility to dental services (p<0.01) among children and adolescents with severe CP. In addition, the more severe the CP, the greater the difficulty of accessibility (OR=4.09,) and the lower the income (OR=8.80), the greater the motor impairment. Conclusion: Despite the availability of access to dental services, low-income families have more severe CP patients, contributing to the daily difficulties already faced by them in oral health care
Survival and prognostic factors in patients with oral squamous cell carcinoma
This study aimed to evaluate sociodemographic and clinical factors influencing overall survival (OS) in patients with oral squamous cell carcinoma (OSCC). Medical charts of 547 patients with OSCC from a public hospital in northeastern Brazil seen between 1999 and 2013 were evaluated. Survival analysis was performed using the Kaplan-Meier method. The influence of age, sex, ethnicity, clinical stage, anatomical location, type of treatment, and comorbidities on the patients? prognosis was evaluated. Cox proportional hazards regression model was used to identify independent prognostic factors. The 5-year OS was 39%. Multivariate analysis showed that age < 40 years (HR = 2.20; 95%CI: 1.02-4.72) and a single treatment modality (HR = 1.91; 95%CI: 1.37-2.67) were associated with a poor prognosis, while early clinical stage resulted in better outcomes (HR = 0.38; 95%CI: 0.25-0.58). OSCC patients in advanced clinical stages, diagnosed at a younger age, and submitted to a single therapeutic modality have a poorer prognosis
Ressecção de carcinoma basocelular do tipo metatĂpico com reconstrução a base de autoenxertia / Resection of metatypical type basocellular carcinoma with self-grafting reconstruction
O carcinoma basocelular constitui a maior parte do chamado cĂąncer de pele nĂŁo melanoma e pode ser classificado em vĂĄrias formas que demonstram comportamentos clĂnicos diferentes. TĂȘm patogĂȘnese multifatorial, com a influĂȘncia da radiação ultravioleta. Os pacientes geralmente sĂŁo de meia-idade ou idosos e Ă© mais comum em caucasianos. A incidĂȘncia Ă© aproximadamente 30% maior em homens que em mulheres e cerca de 80% estĂŁo localizados na cabeça ou no pescoço. O carcinoma metatĂpico Ă© um tipo incomum de carcinoma basocelular que exibe um comportamento clĂnico agressivo. Ele mostra uma frente invasiva exibindo uma mistura de carcinoma basocelular e carcinoma espinocelular com um carcinoma basocelular superficial ou nodular claro sobrejacente. O tratamento pode ser cirĂșrgico ou nĂŁo-cirĂșrgico. O presente artigo tem o objetivo de relatar um caso clĂnico de uma paciente do sexo feminino, 77 anos de idade, que apresentava um carcinoma metatĂpico na regiĂŁo parassinfisĂĄria. A paciente foi submetida Ă ressecção do tecido lesionado seguida de reconstrução atravĂ©s de um autoenxerto com tecido retirado da regiĂŁo peitoral. Observa-se que devido ao alto grau de malignidade e recidiva da patologia foi realizada uma minuciosa anamnese e conduta clĂnica minimizando os riscos que envolvem a patologia e devolvendo estĂ©tica e função a paciente.Â
ViolĂȘncia contra a mulher, coesĂŁo familiar e drogas
OBJETIVO: Avaliar a associação entre coesĂŁo, adaptabilidade e risco mental familiar com violĂȘncia fĂsica contra a mulher e uso de drogas. MĂTODOS: Estudo tipo caso-controle pareado realizado entre 2004 e 2005 na cidade de JoĂŁo Pessoa, ParaĂba. A amostra foi constituĂda por 260 mulheres, divididas em 130 agredidas e 130 nĂŁo agredidas. O grupo caso foi constituĂdo de mulheres que prestaram queixa por agressĂŁo fĂsica domĂ©stica na Delegacia Especializada da Mulher. O grupo controle foi pareado com mulheres vizinhas de bairro das vĂtimas queixosas na Delegacia. A coesĂŁo, a adaptabilidade e o risco mental foram avaliados pela escala Family Adaptability and Cohesion Evaluation Scales. Na anĂĄlise estatĂstica, foram utilizados os testes qui-quadrado e Exato de Fisher, com nĂvel de significĂąncia de 5%. RESULTADOS: Os dois grupos se comportaram de forma diferente em relação ao risco mental e coesĂŁo, mas semelhantes quanto Ă adaptabilidade familiar (p=0,0917). As mulheres agredidas apresentaram risco mental alto (43,1%) e mĂ©dio (39,2%), diferentemente das nĂŁo agredidas (p=0,0016), que apresentaram mĂ©dio risco (55,4%). Houve diferença significativa entre os dois grupos para o uso de drogas, com consumo maior nas famĂlias das mulheres agredidas (90,8%) do que das nĂŁo agredidas (56,9%). A droga mais utilizada foi o ĂĄlcool, sendo o mais alto fator de risco para a agressĂŁo, quando consumido diariamente (OR=37,33) ou associado a outra droga (OR=29,56). CONCLUSĂES: O desequilĂbrio pela falta de uniĂŁo entre a famĂlia e o uso de drogas altera decisivamente no funcionamento familiar, podendo gerar conflitos e agressĂ”es domĂ©sticas
DimensĂ”es da violĂȘncia sexual contra crianças e adolescentes do sexo masculino: Um estudo exploratĂłrio sob a Ăłtica do gĂȘnero
Objective: To characterize victims, aggressors and sexual violence against adolescents of both genders, occurred in Brazil. Method: The population was composed for 14.361 victims of complaints of violence in the Management of Child and Adolescent Policy. The variables analyzed were related to adolescent, to sexual violence and to offender. To identify victims and offenders characteristics according to the types of sexual violence, t-Student test with analysis of variance and Qui-square test were used at a significance equal to 5,0%. Results: Sexual violence corresponded to 2.136 (14.9%) of total denouncements. Amongst sexual violence, sexual abuse was more frequent (98%) than commercial sexual exploration (2%). Considered the age groups, boys were more victimized in early adolescence and girls in late adolescence (p=0,031). Most offenders were male (92.8%), aged between 20 and 39 years old (66.7%), and were acquaintance of the adolescent (83.5%). Concerning to victimsâ age, it showed significant association with offenderâs gender and age, who belonged to the victims family circle and had ignored labor situation. The violent attempted against oneâs modesty was associated with male victims, aging from 10 to 14 years old (p<0.001). Conclusions: The high occurrence of sexual crimes against male adolescents confirms the need for public policies and (re) analysis of legal aspects to face the problem.Objetivos: Caracterizar as vĂtimas, os agressores, as violĂȘncias e os crimes sexuais contra adolescentes do sexo masculino ocorridos no Brasil. MĂ©todos: O universo de estudo foi composto por 14.361 menores que tiveram registro de ter sido vĂtima de delito registrado na GerĂȘncia de PolĂcia da Criança e do Adolescente (GPCA). As variĂĄveis de estudo foram agrupadas segundo trĂȘs critĂ©rios: relativas ao adolescente, ao agressor e Ă violĂȘncia sexual. Para anĂĄlise dos dados empregouse o teste de Qui-quadrado ou teste exato de Fisher. Todos os testes foram analisados em nĂvel de significĂąncia de 0,05. Resultados: No perĂodo foram registrados 14.361 violĂȘncias das quais 2.136 (14,9%) foram classificadas como violĂȘncia sexual. Dentre as violĂȘncias sexuais, 2.094 (98%) constituĂram abusos sexuais e 2% pertencia Ă categoria exploração sexual comercial. Consideradas as faixas etĂĄrias, os meninos foram mais vitimados na adolescĂȘncia inicial e as meninas, na adolescĂȘncia tardia, diferença esta significativa (p=0,031). Os agressores mais freqĂŒentemente eram do sexo masculino (92,8%), com idade entre 20 e 39 anos (66,7%) e do circulo de relaçÔes do adolescente (83,5%). O atentado violento ao pudor foi mais freqĂŒente entre vĂtimas adolescentes do sexo masculino, na faixa etĂĄria de 10 a 14 anos e essas diferenças foram significativas (p<0,001). ConclusĂ”es: A alta ocorrĂȘncia de crimes sexuais contra adolescentes masculinos confirma a necessidade de polĂticas pĂșblicas e (re)anĂĄlise dos dispositivos legais para o correto enfrentamento do problema