Estudo de prevalência de sintomas de distúrbios da articulação temporomandibular em estudantes de medicina da Universidade da Beira Interior

INTRODUÇÃO E OBJECTIVOS: Os Distúrbios Temporomandibulares (DTM) englobam todos os distúrbios funcionais do complexo crânio-cervico mandibular (CCCM) e têm elevada prevalência na população geral. A etiologia dos DTM é complexa e multifactorial, destacando-se as alterações na morfologia das superfícies articulares, os traumatismos, as alterações da oclusão, os factores psicossociais e emocionais e os factores sistémicos. As estruturas mais afectadas são os músculos, as articulações temporomandibulares (ATMs) e os dentes. Como sintomas mais comuns, assinalam-se o desgaste dentário, a mobilidade dos dentes, a dor nos músculos da mastigação, a dor na ATM, a limitação no movimento da mandíbula, os sons na ATM, a otalgia e a cefaleia. O objectivo principal deste trabalho é a determinação da prevalência de sintomas de DTM nos estudantes de Medicina da Universidade da Beira Interior (UBI). Pretende-se, ainda, verificar a existência de uma relação entre os DTM e o seu grau com as características sócio-demográficas da amostra. MÉTODOS: Este estudo populacional transversal consistiu na aplicação online de um questionário anónimo, que esteve disponível entre 15 de Setembro e 15 de Dezembro de 2009, constituído por duas secções: I. Dados sócio-demográficos; II. Questionário Fonseca et al. (1994)6. Os resultados foram analisados nos programas Microsoft Excel 2007® e SPSS® versao 17.0, ambos para Windows e consideraram-se os resultados significativos para p <0,05. RESULTADOS: No total, 324 estudantes (53,1% da população) responderam ao questionário, sendo 240 do género feminino. As idades distribuíram-se entre os 18 e os 51 anos. A prevalência de sintomas de DTM foi de 58,3%, sendo que o grau mais prevalente foi o ligeiro (41,7%). No género feminino encontrou-se maior prevalência de DTM (60,8%) do que no género masculino (51,2%), não se tendo obtido significância estatística. No estudo da relação entre as variáveis sócio-demográficas e DTM, verificou-se uma associação estatisticamente significativa entre a presença de DTM e o ciclo de curso frequentado, com maior predomínio nos anos clínicos da formação. Os sintomas mais frequentes foram as cefaleias frequentes, as cervicalgias, os ruídos nas ATMs associados ao movimento, o bruxismo e o cerrar dos dentes e a percepção de ansiedade. DISCUSSÃO E CONCLUSÃO: Nos estudantes de Medicina da UBI, existem DTM com maior prevalência no género feminino e essencialmente nos anos clínicos de formação. Neste sentido, propõe-se a realização de investigações que procurem compreender em que medida as actividades constituintes desses anos se relacionam com a prevalência de sintomas de DTM. Além disso, pretende-se alertar para a importância do diagnóstico precoce destes distúrbios.INTRODUCTION AND OBJECTIVES: The Temporomandibular Disorders (TMD) include all functional disturbances of masticatory system and have high prevalence in the general population. The etiology of TMD is complex and multifactorial; the most common causes are: changes in the morphology of articular surfaces, injuries, changes in occlusion and dental malocclusion, psychosocial and emotional factors and systemic factors. The main affected structures are the muscles, the temporomandibular joints (TMJ) and the teeth. Some of the more commom symptoms are: tooth wear, tooth mobility, masticatory muscle pain, Temporomandibular joint pain, jaw movement limitation, TMJ sounds during movement, ear pain and headache. The purpose of this study is to investigate the prevalence of TMD symptoms in students of Master in Medicine of the University of Beira Interior (UBI). Furthermore we aim to verify the existence of a relationship between the DTM and its severity, with socio-demographic characteristics of the sample. METHODS: This cross-sectional population study consisted of an online application questionnaire, available between 15th September and 15th December 2009, with two sections: I. Socio-demographic data; II. Questionnaire Fonseca et al. (1994)6 . The results were analyzed on Microsoft Excel 2007 ® and SPSS ® version 17.0, both for Windows and significant results for p <0,05 were considered. RESULTS: A total of 324 students (53,1% of the population) answered the questionnaire, of which 240 were female, aged 18 to 51 years. The prevalence of TMD symptoms in students was 58,3%; the light TMD was the most prevalent with 41,7%. In females, a higher prevalence of TMD (60,8%), was revealed, compared to males (51,2%); such relation had no statistical significance. When the relation between socio-demographic data and TMD was examined, it was found a statistically significant association between the presence of TMD and the cycle of the attended course, with a higher prevalence in the clinical years. The most common symptoms reported were frequent headaches, neck pain, TMJ sounds associated with movement, bruxism and clench and perception of anxiety. DISCUSSION AND CONCLUSION: In medical students of the UBI, there are TMD with higher prevalence in females and mostly in the clinical years of the course. In this sense, it is proposed to conduct investigations that seek to understand the extent in which the activities of those years relate to the prevalence of TMD symptoms, in this population in particular. Moreover, it is intended to alert to the importance of early diagnosis of this disorders

Effects of light-curing time on the cytotoxicity of a restorative composite resin on odontoblast-like cells

This in vitro study evaluated the cytotoxicity of an experimental restorative composite resin subjected to different light-curing regimens. METHODS: Forty round-shaped specimens were prepared and randomly assigned to four experimental groups (n=10), as follows: in Group 1, no light-curing; in Groups 2, 3 and 4, the composite resin specimens were light-cured for 20, 40 or 60 s, respectively. In Group 5, filter paper discs soaked in 5 µL PBS were used as negative controls. The resin specimens and paper discs were placed in wells of 24-well plates in which the odontoblast-like cells MDPC-23 (30,000 cells/cm²) were plated and incubated in a humidified incubator with 5% CO2 and 95% air at 37ºC for 72 h. The cytotoxicity was evaluated by the cell metabolism (MTT assay) and cell morphology (SEM). The data were analyzed statistically by Kruskal-Wallis and Mann-Whitney tests (p<0.05). RESULTS: In G1, cell metabolism decreased by 86.2%, indicating a severe cytotoxicity of the non-light-cured composite resin. On the other hand, cell metabolism decreased by only 13.3% and 13.5% in G2 and G3, respectively. No cytotoxic effects were observed in G4 and G5. In G1, only a few round-shaped cells with short processes on their cytoplasmic membrane were observed. In the other experimental groups as well as in control group, a number of spindle-shaped cells with long cytoplasmic processes were found. CONCLUSION: Regardless of the photoactivation time used in the present investigation, the experimental composite resin presented mild to no toxic effects to the odontoblast-like MDPC-23 cells. However, intense cytotoxic effects occurred when no light-curing was performed.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq

Toxicity of chlorhexidine on odontoblast-like cells

Chlorhexidine gluconate (CHX) is recommended for a number of clinical procedures and it has been pointed out as a potential cavity cleanser to be applied before adhesive restoration of dental cavities. OBJECTIVE: As CHX may diffuse through the dentinal tubules to reach a monolayer of odontoblasts that underlies the dentin substrate, this study evaluated the cytotoxic effects of different concentrations of CHX on cultured odontoblast-like cells (MDPC-23). MATERIAL AND METHODS: Cells were cultured and exposed to CHX solutions at concentrations of 0.06%, 0.12%, 0.2%, 1% and 2%. Pure culture medium (&#945;-MEM) and 3% hydrogen peroxide were used as negative and positive control, respectively. After exposing the cultured cells to the controls and CHX solutions for 60 s, 2 h or 60 s with a 24-h recovery period, cell metabolism (MTT assay) and total protein concentration were evaluated. Cell morphology was assessed under scanning electron microscopy. CHX had a dose-dependent toxic effect on the MDPC-23 cells. RESULTS: Statistically significant difference was observed when the cells were exposed to CHX in all periods (

Nutrition education in portuguese medical students: impact on the attitudes and knowledge

Nutrition has been underrepresented in the curriculum of many medical schools and therefore physicians do not feel adequately prepared to provide dietary counselling. The aim of the present study is to determine the impact of a Nutrition and Metabolism curricular unit on nutrition attitudes, knowledge and confidence on future clinical practice of medical students.info:eu-repo/semantics/publishedVersio

CARACTERIZAÇÃO DOS PRODUTOS GERADORES DE RESÍDUOS QUÍMICOS PERIGOSOS: ESTUDO EM UM HOSPITAL PÚBLICO UNIVERSITÁRIO

This descriptive study aimed to identify, in the areas of Pharmacy and the stockroom of a Public University Hospital, the groups of products characterized as creating Dangerous Chemical Waste, according to the legal classification. A form for identifying these products was used for data collection, which took place in 2008. Analysis of the data revealed the existence of 138 items classified in 12 Groups of products which, once used or out of date, create waste with dangerous characteristics, according to the Brazilian National Health Surveillance Agency. These products’ active ingredients present risks to health, such as toxicity to various organs or systems in the human body, as well as the potential for inflammability, corrosiveness and reactivity of some substances. These characteristics are highly relevant, as the chemical wastes can, at some point, impact negatively on the worker’s health, on public health, or on the environment.Estudo descritivo com o objetivo de identificar nas áreas de farmácia e almoxarifado de um Hospital Universitário os grupos de produtos caracterizados como geradores de Resíduos Químicos Perigosos segundo a classificação dos dispositivos legais. Para coleta de dados, realizada em 2008, foi utilizado um formulário para identificação destes produtos. A análise dos dados revelou a existência de 138 itens classificados em 12 Grupos de produtos que, uma vez utilizados ou vencidos, geram resíduos com características de periculosidade de acordo com a Agência Nacional de Vigilância Sanitária brasileira. O princípio ativo desses produtos apresentam riscos à saúde, como toxicidade aos diversos órgãos e sistemas do corpo humano, assim como potencial de inflamabilidade, corrosividade e reatividade de algumas substâncias. Essas características são de grande relevância, uma vez que os resíduos químicos poderão, em algum momento, causar impacto negativo para a saúde do trabalhador, saúde pública e meio ambiente. Estudio descriptivo cuyo objetivo fue identificar en las áreas de farmacia y depósito de un Hospital Universitario los grupos de productos caracterizados como generadores de Residuos Químicos Peligrosos de acuerdo a la clasificación de los dispositivos legales. Para recoger los datos, lo que se dio en 2008, fue utilizado un formulario que identificaba eses productos. El análisis de los datos reveló la existencia de 138 ítenes clasificados en 12 Grupos de productos que, una vez utilizados o vencidos, generan residuos con características de peligrosidad de acuerdo con la Agencia Nacional de Vigilancia Sanitaria brasileña. El principio activo de eses productos presenta riesgos a la salud, como si es tóxico a los diversos órganos y sistemas del cuerpo humano, así como potencial de inflamabilidad, corrosividad y reactividad de algunas substancias. Esas características son de grande relevancia, una vez que los residuos químicos podrán, en algun momento, causar impacto negativo a la salud del trabajador, salud pública y medio ambiente

Psychology, the United Health System (SUS) and the Ambulatory Care Information System (SIA): innovations, propositions and misdirections

Desde as primeiras incursões de psicólogos no sistema público de saúde discute-se a adeqüabilidade de seus padrões de atuação que, atualmente, redundam numa atenção curativa, individual e ineficiente. Contudo, ressalta-se a interferência das deliberações, orientações e exigências do Sistema Único de Saúde na figura do Sistema de Informações Ambulatoriais (SIA/SUS) que fornece uma lista de procedimentos a serem desenvolvidos pelos psicólogos. Este estudo analisou estatísticas dos procedimentos realizados pela Psicologia em Natal/RN, disponíveis no SIA/SUS, com o objetivo de dimensionar como sua estrutura influencia a manutenção dos modelos de atuação. Os dados revelam uma permanência de ações compartimentalizadas, cuja maior proporção abrange os quadros mórbidos. A dificuldade para o desenvolvimento de ações diferentes ou obriga os profissionais a registrarem-nas de forma distorcida, ou os resigna aos atendimentos previstos. Na Psicologia, o sistema de informações restringe atividades que poderiam configurar um modelo de atuação condizente com os ideais da reforma sanitária.Palavras-chave: Psicologia; Saúde Pública; Sistema de Informações Ambulatoriais.  The adequability of Psychology patterns of intervention have been discussed since the first incursions of psychologists on the Public Health System, that have a redundant health care, individual and inefficient. However, the interference on deliberations, orientations and exigencies of the Brazilian United Health System’s Ambulatory Care Information System (SIA/SUS), that provides psychologists with a set of procedures has been overlooked. This study analised the reports of psychological procedures in Natal/RN, available at SIA/SUS, aiming to verify how its structure influences the maintenance of models of professional practice. Data suggest a permanence of compartmentalized actions, specially in morbid occurrences. Constraints to the development of innovative actions has led psychology professionals either to record them in a disguised format or to persist in using traditional procedures. It is our conclusion that, in what concerns Psychology, the information system constrains the development of a model of professional practice more in agreement with the sanitation reform ideals.   Keywords: Psychology; Public Health; Ambulatory Care Information System

Indicações terapêuticas na paralisia de Erb-Duchenne neonatal: uma revisão bibliográfica / Therapeutic indications in neonatal Erb-Duchenne's palsy: a literature review

INTRODUÇÃO: A paralisia de Erb-Duchenne é a mais frequente paralisia neonatal do plexo braquial, correspondendo a mais de 60% dos casos. Para o tratamento têm-se os procedimentos cirúrgicos convencionais e os complementares. Diante do prejuízo de qualidade de vida, da constância dos casos e da ausência de um protocolo que guie as escolhas terapêuticas da patologia, este estudo visa orientar a utilização de cada método de tratamento. METODOLOGIA: O estudo consistiu em uma revisão sistemática com busca nas bases de dados BVS e PubMed utilizando os descritores "Erb-Duchenne", "neonatal", "treatment" e "plexus brachial". RESULTADOS: As opções de tratamento são definidas pela avaliação clínica e pelo tipo de lesão. É consenso que a abordagem conservadora seja iniciada precocemente. DISCUSSÃO: Os estudos apresentam divergências no que se refere às alternativas terapêuticas. Muitos evidenciam a relevância do acompanhamento multidisciplinar e a inclusão de técnicas complementares como a injeção de toxina botulínica. Sobre o tratamento cirúrgico destaca-se as cirurgias primárias, comumente indicadas para crianças que não apresentam nenhum tipo de recuperação espontânea dentro de um espectro entre três a nove meses; e as cirurgias secundárias. CONCLUSÃO: Ressalta-se a necessidade de mais estudos nesta área, a fim de se direcionar a seleção terapêutica de forma mais assertiva, no fito de se priorizar a reabilitação e recuperação dos bebês e crianças

Toxicity of chlorhexidine on odontoblast-like cells

Chlorhexidine gluconate (CHX) is recommended for a number of clinical procedures and it has been pointed out as a potential cavity cleanser to be applied before adhesive restoration of dental cavities. OBJECTIVE: As CHX may diffuse through the dentinal tubules to reach a monolayer of odontoblasts that underlies the dentin substrate, this study evaluated the cytotoxic effects of different concentrations of CHX on cultured odontoblast-like cells (MDPC-23). MATERIAL AND METHODS: Cells were cultured and exposed to CHX solutions at concentrations of 0.06%, 0.12%, 0.2%, 1% and 2%. Pure culture medium (&#945;-MEM) and 3% hydrogen peroxide were used as negative and positive control, respectively. After exposing the cultured cells to the controls and CHX solutions for 60 s, 2 h or 60 s with a 24-h recovery period, cell metabolism (MTT assay) and total protein concentration were evaluated. Cell morphology was assessed under scanning electron microscopy. CHX had a dose-dependent toxic effect on the MDPC-23 cells. RESULTS: Statistically significant difference was observed when the cells were exposed to CHX in all periods (p<0.05). Significant difference was also determined for all CHX concentrations (p<0.05). The 60-s exposure time was the least cytotoxic (p<0.05), while exposure to CHX for 60 s with a 24-h recovery period was the most toxic to the cells (p<0.05). CONCLUSION: Regardless of the exposure time, all CHX concentrations had a high direct cytotoxic effect to cultured MDPC-23 cells

Intervention strategies for the health of university hospital nursing staff in Brazil

OBJECTIVE: The aim of this study was to propose intervention strategies for the health of hospital-based nursing staff. METHOD: It was a field study, with a quantitative and qualitative approach, developed from data collected through the Monitoring System of Nursing Workers' Health in seven public and university hospitals of Brazil. Intervention strategies proposed considered regional specificities and the demands presented by professionals in each setting. RESULTS: The interventions were developed for: each workload to which nursing staff was exposed; processes of strain generated; and intervention strategies at the settings, according to the needs of the national scenario. CONCLUSION: Monitoring the health of nursing staff is a beginning point for building strategies directed at the health profile of each reality