La diabetes mellitus, el abuso de drogas durante el embarazo y el riesgo de malformaciones craneofaciales y anomalías relacionadas

Objetivos: esta investigación estableció la prevalencia de diabetes mellitus (DM) y el abuso de drogas en madres de niños con malformaciones creaneofaciales (MCF). Métodos: 325 mujeres que tuvieron hijos (0-3 años) con malformaciones fueron entrevistadas. Se obtuvieron datos referentes a: tipo de diabetes; uso de drogas lícitas o ilícitas durante el embarazo; circunferencia de la cintura; y, glucemia en ayunas en la primera consulta prenatal. Resultados: el veintisiete por ciento de las mujeres tenían DM. Entre estas, el 89% tuvieron DM gestacional, el 5,5% DM tipo 1 y el 5,5% DM tipo 2. La prevalencia de DM en madres de hijos con MCF fue de 27%. Esto es significativamente más alto que el promedio de la población brasileña afectada por esa enfermedad, que es de 7,6% (pObjective: to assessed the prevalence of diabetes mellitus (DM) and drug abuse in mothers of children with orofacial clefts (OFC). Methods: 325 women who had children (0-3y) with clefts were interviewed. Data regarding type of diabetes, use of legal/illegal drugs during pregnancy, waist girth and fasting blood sugar at the first prenatal consult were collected. Results: twenty seven percent of the women had DM, out of these, 89% had gestational DM, 5,5% type 1 DM and 5,5% type 2 DM. The prevalence of DM in mothers of children with OFC was 27%, it is significantly higher than the average Brazilian population which is 7.6% (pObjetivos: avaliar a prevalência de diabetes mellitus (DM) e o uso de drogas em mães de crianças com fissuras orofaciais (FOF). Método: 325 mulheres que tiveram filhos (0-3 anos) com fissuras foram entrevistadas. Os dados referentes tipo de diabetes, uso de drogas lícitas / ilícitas durante a gravidez, circunferência abdominal e glicemia em jejum na primeira consulta pré-natal foram coletados. Resultados: vinte e sete por cento das mulheres tinham DM. Destes, 89% tinham DM gestacional, 5,5% DM tipo 1 e 5,5% DM tipo 2. A prevalência de DM em mães de crianças com FOF foi de 27%, significativamente mais elevado que a média da população brasileira que é de 7,6% (

Diabetes mellitus and drug abuse during pregnancy and the risk for orofacial clefts and related abnormalities

Abstract Objective: to assessed the prevalence of diabetes mellitus (DM) and drug abuse in mothers of children with orofacial clefts (OFC). Methods: 325 women who had children (0-3y) with clefts were interviewed. Data regarding type of diabetes, use of legal/illegal drugs during pregnancy, waist girth and fasting blood sugar at the first prenatal consult were collected. Results: twenty seven percent of the women had DM, out of these, 89% had gestational DM, 5,5% type 1 DM and 5,5% type 2 DM. The prevalence of DM in mothers of children with OFC was 27%, it is significantly higher than the average Brazilian population which is 7.6% (p<0.01) (OR=4.5, 95%CI=3.5-5.8). Regarding drug abuse during pregnancy, 32% of the mothers used drugs and a significant positive correlation was observed between drug abuse and the occurrence of clefts and other craniofacial anomalies (p=0.028) (OR=2.87; 95%CI=1.1-7.4). Conclusions: DM and drug abuse during pregnancy increases the risk for OFC and related anomalies and early diagnosis of DM and prevention of drug abuse, especially in pregnant women, should be emphasized

Sistema kanban e o uso racional de recusos em unidades de internação de um hospital público/ Kanban system and the rational use of refuses in hospital public hospital units

Introdução: Metodologia Kanban é um processo implantado em serviços de saúde cuja finalidade é de manter qualidade na assistência, monitorizando o processo de internação de clínica médica. Objetivo: Avaliar a metodologia Kanban instituída em um hospital de atendimento SUS, relacionado ao tempo de internação, utilização de recursos da instituição, atendimento multidisciplinar e resolutividade. Método: Estudo retrospectivo, observacional, aprovado pelo Comitê de Ética (nº 3.222.731), com análise de prontuários de pacientes, de ambos os sexos, acima de 18 anos, internados na especialidade Clínica Médica, de um Hospital Público de Bauru. Coletou-se dados referentes ao tempo de internação (dias), utilização de recursos da instituição (exames complementares), atendimento multidisciplinar e resolutividade, em dois momentos (M): M1=antes e M2= após a implantação do Kanban. Foi realizado estatística descritiva, com distribuições de frequências absoluta e relativa. Resultados: Foram analisados 2118 prontuários dos pacientes, sendo incluídos no estudo 684 da clínica médica. O CID principal predominante foi o de neoplasias, seguidos por doenças do aparelho circulatório. Houve redução no tempo de realização e dos laudos de exames complementares e, melhora no atendimento da equipe multidisciplinar. Conclusão: A implantação do Sistema Kanban em um Hospital Público, pode gerar beneficios aos usuários, assim como ao “Estado”, com uso racional dos recursos, como controle sobre a necessidade de realização de exames complementares e a agilidade dos mesmos. No tempo de internação considerou-se as formas de tratamento e encaminhamento do individuo, com enfoque multidisciplinar.  A resolutividade foi comprovada por melhor atenção ao individuo, que no momento da alta passou a ser avaliado e encaminhado para o tratamento ambulatorial ou contrareferenciado para o municipio

A new technique for tongue brushing and halitosis reduction: the X technique

The tongue is one of the primary sources of halitosis. The manual or mechanical removal of biofilm is known to decrease oral malodor. Objective: To evaluate a new tongue hygiene technique hereby referred to as “the X technique” and its effects on both halitosis and the number of microorganisms based on microbiological parameters and diagnostic features of the breath. Material and Methods: The study included thirty patients divided into a control group (patients without systematized guidelines of lingual hygiene, but who performed the mechanical cleaning of tongue dorsum, each in its own way), the 3R group (instructed to perform the movements of the X technique for 3 repetitions at each brushing), and the 6R group (instructed to perform 6 repetitions of the technique at each brushing). After two weeks, a new data collection was performed. Results: Patients in the 6R group presented the lowest score on the organoleptic assessment scale at the second consultation, followed by the 3R group and the controls. Regarding the self-perception of breath by the method of Visual Analog Scale (VAS), the control group did not perceive improvements in oral malodor; the results of the 3R group and the 6R group were similar. Conclusion: These results indicate that the X technique improves both measurements and perceptions of halitosis. Microbiological analyses revealed greatest reduction in the 6R group. The findings show that the X technique reduces both organoleptic scores and the number of bacterial colonies, and improves users’ perceptions of their breath

Analysis of predictors of root resorption in the orthodontic treatment (Part II)

This study aims to analyze the predictors of root resorption in orthodontic treatment. From 407 records, 377 pretreatment and posttreatment periapical radiographs of permanent maxillary central incisors of 199 patients treated with fixed appliances were divided according to the apical morphologies: pipetteshaped, dilacerated, pointed, rounded and rectangular; crown/root ratio; and presence or absence of partial hypodontia. Changes in root length between the onset and completion of orthodontic treatment were measured in digitized images and statistically compared using T student, one-way ANOVA and Tukey tests. The apical morphology influenced the occurrence of root resorption; teeth with rounded and rectangular apical morphologies were more resistant to root resorption (.001 and .0007, respectively). Short teeth and the presence of partial hypodontia or multiple partial hypodontia did not present greater tendency to root resorption (.1008 and .1544, respectively). The results indicated that abnormal apical morphology is a predictor of external apical root resorption after corrective orthodontic therapy. However, short teeth and partial hypodontia did not increase the prevalence of apical resorption. The susceptibility or individual predisposition to tooth resorptions during orthodontic treatment may be related to the apical morphology

Distribuição dos mastócitos nas fases intra-óssea e submucosa na erupção dentária humana

A erupção dos dentes decíduos e permanentes é um processo fisiológico que acompanha o desenvolvimento do ser humano por aproximadamente duas décadas. Vários mecanismos biológicos controlam a odontogênese, erupção e esfoliação fisiológica dos decíduos até o estabelecimento dos dentes permanentes na arcada. A fim de elucidar aspectos anatômicos e fisiológicos relacionados à erupção dentária, sua sintomatologia e outros sinais clínicos, decidiu-se investigar a presença de mastócito nos tecidos pericoronários na fase intra-óssea (Grupo 1) e submucosa (Grupo 2), comparando-os entre si e com a mucosa bucal (Grupo3). Em cada grupo, 14 espécimes foram analisados microscopicamente em cortes corados com hematoxilina e eosina e imunocitoquimicamente marcados com ckit e triptase. A partir dos resultados obtidos concluiu-se que a quantidade/densidade dos mastócitos é diferente nos tecidos foliculares de acordo com a fase de erupção (P<0,05). Na fase intra-óssea da erupção, os tecidos conjuntivos foliculares não revelam pela imunocitoquimicamente uma marcante presença de mastócitos. Na fase submucosa, o número de mastócitos está significantemente elevado quando comparado com a fase intra-óssea da erupção dentária (P<0,05). Nos tecidos conjuntivos foliculares, na fase submucosa de erupção, os mastócitos aumentam sua concentração quando comparados à quantidade/densidade detectada na submucosa da mucosa bucal normal não relacionada aos dentes (P<0,05).The eruption of deciduous and permanent teeth is a physiologic process that takes place during approximately two decades of human development. Several biological mechanisms control odontogenesis, eruption and physiological exfoliation of deciduous leading to the establishment of permanent teeth in the jaw. With the aim to investigate anatomical and physiological aspects related to eruption of tooth, symptoms and other clinical sign, it has been decided to investigate the presence of mastocytes in the pericoronary tissue in the intra-osteo (group 1) and submucous (group 2), inter comparing them and with the oral mucous (Group 3). In each group, 14 samples were microscopically analysed in slides stained with hematoxilin and eosin immunocytochemistry marked with ckit and triptase. Results showed that the quantity/density of mastocytes is different in the follicular tissues according to the eruption stage (P<0.05). Intra osteo stage of eruption, follicular conjuctive tissues have not shown immunecytochemistry marker for mastocyte. Follicular conjunctive tissues, in the follicular conjuctive tissues, in submucous eruption stage, mastocytes concentration was increased when compared to quantity, density in the submucous from normal oral mucous non related to teeth (P<0.05)

Premaxilla: up to which age it remains separated from the maxilla by a suture, how often it occurs in children and adults, and possible clinical and therapeutic implications: Study of 1,138 human skulls

ABSTRACT Objective: To evaluate topographic and temporal aspects of premaxillary bone and premaxillary-maxillary suture, since they are fundamental anatomical elements little explored clinically. Methods: 1,138 human dry skulls were evaluated, of which 116 (10.19%) of the specimens were children, and 1,022 (89.81%) were adults. The skulls were photographed and the percentage of premaxillary-maxillary suture opening was determined. Subsequently the data were tabulated and submitted to statistical analysis, adopting a level of significance of 5%. Results: The progression of premaxillary suture closure from birth to 12 years of age was 3.72% per year. In 100% of the skulls up to 12 years, the premaxillary-maxillary suture open in the palatal region was observed, while 6.16% of adults presented different degrees of opening. Conclusions: The premaxilla exists in an independent way within the maxillary complex and the presence of the premaxilla-maxillary suture justifies the success of anteroposterior expansions to stimulate the growth of the middle third of the face, solving anatomical and functional problems

Explanation for the signs and symptoms of tooth eruption: mast cells

Abstract This study contributes to the understanding of the mechanisms associated with signs and symptoms of tooth eruption, by investigating the presence of mast cells in pericoronal tissues during the intraosseous (Group 1) and submucosal (Group 2) phases of eruption. We compared findings for these two groups with each other and with those for the oral mucosa (Group 3). In each group, 14 specimens were analyzed microscopically after hematoxylin and eosin staining and immunohistochemical analysis of c-Kit and tryptase expression. Results revealed that the number and density of mast cells is different in follicular tissues according to the eruption phase, which may mean that: 1) masticatory trauma of the oral mucosa and dental follicles in the submucosa may explain why reduced enamel epithelium exposes enamel to the cells of the connective tissue; 2) exposure of antigenic enamel proteins might correspond to the release of sequestered antigens, which may lead to the interaction of IgE and a greater number of mast cells in the region; and 3) the consequent degranulation and the local release of mediators, such as histamine, leukotrienes, prostaglandins, proteases, cytokines and growth factors, contribute to the understanding of signs and symptoms associated with tooth eruption