Brazilian adolescents’ oral health trends since 1986: an epidemiological observational study

Oral health is part of general health, and in adolescence, it represents a good individual health indicator. Three country-based oral health epidemiological studies have been developed in Brazil (1986, 2003 and 2010). The objective of this study was to analyze oral disease trends among Brazilian adolescents and to compare these trends to the World Health Organization's goals with a focus on public health policies implemented between 1986 and 2010. This is an epidemiological observational study performed with secondary data from Brazilian Oral Health surveys (1986, 2003 and 2010). The DMFT (number of decayed, missing and filled teeth) index was used for the 12-year-old and 15- to 19-year-old groups, and periodontal disease (CPI) and the percentage of individuals who needed and/or had prostheses were evaluated in the 15- to 19-year-old group. Between 1986 and 2010, DMFT decreased from 6.65 to 2.07 (68.9 % reduction) in the 12-year-old group and from 12.68 to 4.25 (66.5 % reduction) in the 15- to 19-year-old group. In all groups, the missing component had the strongest decrease. Adolescents had a reduction of 20.3 % in access to dental care. In 2003, in the 15- to 19-year-old group, 89.5 % of teenagers had at least one decayed tooth, while in 2010, the value was 76.1 %. In 2010, the percentage of adolescents without gingival problems varied among different regions of Brazil, with 30.8 % in the North and 56.8 % in the Southeast. Regarding DMFT, the difference between the North and Southeast Regions was 84 %. Improvement trends regarding adolescent oral health were observed, which seem to be supported by health education and promotion activities along with the reorganization of the Brazilian health system.855

Prolonged mechanical ventilation patient outcome after discharge from an intensive care unit

Background: Mechanical ventilation (MV) is one of the pillars of therapy in the Intensive Care Unit (ICU) as many patients require ventilatory support. This study aimed to analyze the outcome of Prolonged Mechanical Ventilation (PMV) patients after discharge from an Intensive Care Unit (ICU). Methods: This is a retrospective cross-sectional study of 142 medical charts of patients admitted to an ICU and a Special Care Unit (SCU) in Brazil from 2012 to 2014. Results: Participants’ mean age was 66.5 and the majority were men (58.5%). Outcome in the ICU was correlated with laparotomies before (p=0.043) and after (p=0.049) admission, sepsis (p=0.013), dialysis-requiring acute kidney injury (AKI) (p<0.001), and hemodynamic instability (p=0.003). Dialysis requiring AKI (p=0.012), non-dialysis-requiring AKI (p=0.023) and atelectasis (p=0.045) during ICU stay were correlated with death in SCU patients. Only hemodynamic instability (p=0.002) and diarrhea (p=0.045) were correlated with outcome in the SCU. Additionally, 91 (64.1%) PMV patients in the ICU were discharged to the SCU, 50 (35.2%) died, and one (0.7%) was transferred to another hospital. Furthermore, 15 (16.5%) SCU patients were discharged to the Home Care Program and one (1.1%) was transferred to another hospital. Conclusions: PMV patients exhibited longer hospital stay and higher mortality. Dialysis-requiring AKI and hemodynamic instability were associated with increased risk of death. Only a few PMV patients were successfully discharged or referred to Home Care.info:eu-repo/semantics/publishedVersio

Transtorno do déficit de atenção com hiperatividade e desempenho acadêmico:: revisão sistemática

Attention deficit hyperactivity disorder (ADHD) is usually diagnosed in school-age children. Thus, we have aimed to describe, through the literature, interventions for children with ADHD focusing on academic performance. This is a systematic review conducted in the databases BVS, SciELO, PubMed, LILACS, Periódicos CAPES, and IndexPsi, within the period from August 2018 to August 2019. This starting question has been adopted: do children with ADHD using pharmacological treatment show improvement in school performance when compared to another type of intervention? The eligibility criteria for the articles have been: publication between 2009 and 2019; at least one of the descriptors adopted in this study included in the title and abstract; and analysis of school performance. Eight studies have been selected; 1,132 children participated in them, from countries such as the United States of America (USA), China, and Norway. The most frequent intervention to treat ADHD for school/academic performance outcomes was pharmacotherapeutic, through the use of Methylphenidate. It was found that there are no studies focusing on multimodal treatment, thus, it is recommended to carry out research that addresses its effectiveness.El trastorno por déficit de atención con hiperactividad (TDAH) generalmente se diagnostica en niños de edad escolar. Así, se ha buscado describir, a través de la literatura, intervenciones para niños con TDAH centradas en el logro académico. Se trata de una revisión sistemática realizada en las bases BVS, SciELO, PubMed, LILACS, Periódicos CAPES e IndexPsi, en el período de agosto de 2018 a agosto de 2019. Se ha adoptado esta pregunta de partida: ¿niños con TDAH en tratamiento farmacológico muestran mejoría en rendimiento escolar en comparación con otro tipo de intervención? Los criterios de elegibilidad de los artículos han sido: publicación entre 2009 y 2019; al menos uno de los descriptores adoptados en este estudio incluido en el título y resumen; y análisis del rendimiento escolar. Se han seleccionado 8 estudios; en ellos participaron 1.132 niños, de países como Estados Unidos de América (EE. UU.), China y Noruega. La intervención más frecuente para tratar el TDAH para los resultados de rendimiento escolar/académico fue el farmacoterapéutico, mediante el uso de Metilfenidato. Se constató que no existen estudios enfocados en el tratamiento multimodal, por lo que se recomienda realizar investigaciones que aborden su efectividad.Le trouble du déficit de l’attention avec hyperactivité (TDAH) est généralement diagnostiqué chez les enfants d’âge scolaire. Ainsi, nous avons cherché à décrire, à travers la littérature, des interventions réalisées pour les enfants atteints de TDAH axées sur la réussite scolaire. Il s’agit d’une revue systématique effectuée dans les bases BVS, SciELO, PubMed, LILACS, Periódicos CAPES et IndexPsi, au cours de la période d’août 2018 à août 2019. Cette question de départ a été adoptée : enfants atteints de TDAH utilisant un traitement pharmacologique montrent-ils une amélioration de leurs réussite scolaire par rapport à un autre type d’intervention ? Les critères d’éligibilité des articles étaient : publication entre 2009 et 2019; au moins un des descripteurs adoptés dans cette étude inclus dans le titre et le résumé; et analyse de la réussite scolaire. Huit études ont été sélectionnées; 1 132 enfants y ont participé, de pays comme les États-Unis d’Amérique (USA), la Chine et la Norvège. L’intervention la plus fréquemment utilisée dans le traitement du TDAH pour les résultats de réussite scolaire/académique était pharmacothérapeutique, par l’utilisation du Méthylphénidate. Il a été constaté qu’il n’y a pas d’études axées sur le traitement multimodal, il est donc recommandé de mener des recherches sur son efficacité.O transtorno do déficit de atenção com hiperatividade (TDAH) é geralmente diagnosticado em crianças em idade escolar. Assim, buscou-se descrever, por meio da literatura, intervenções realizadas em crianças com TDAH focando no desempenho acadêmico. Trata-se de uma revisão sistemática realizada nas bases BVS, SciELO, PubMed, LILACS, Periódicos CAPES e IndexPsi, no período de agosto de 2018 a agosto de 2019. Adotou-se a seguinte pergunta de partida: crianças com TDAH em uso de tratamento farmacológico apresentam melhora do desempenho escolar quando comparadas a outro tipo de intervenção? Os critérios de elegibilidade dos artigos foram: publicação entre 2009 e 2019; ao menos um dos descritores adotados neste estudo incluído no título e resumo; e análise do desempenho escolar. Foram selecionados 8 estudos; deles participaram 1.132 crianças, de países como Estados Unidos da América (EUA), China e Noruega. A intervenção usada em maior frequência no tratamento do TDAH para os desfechos de desempenho escolar/acadêmico foi o farmacoterapêutico, mediante o uso do Metilfenidato. Constatou-se a inexistência de estudos com foco no tratamento multimodal, assim, recomenda-se a realização de pesquisas que abordem sua eficácia

Saúde bucal de idosos: rastreio de lesões dos tecidos moles na prevenção do câncer bucal

Objective: To detect oral soft tissue injuries in older people. Method: A quantitative analytical cross-sectional study conducted in Fortaleza, Ceará. Individual interviews addressed age, gender, marital status, income, and education. The community oral health indicator was used to detect oral soft tissue injuries and their location. Results: Most of the 821 participants aged 60-100 years were women (580; 70.6%), attended school for up to 5 years (401; 48.8%), were illiterate (201; 24.5%), were retired (608; 74.1%), and received up to 2 wages (701; 85.4%). A total of 604 participants (73.6%) wore dentures. Injuries included red patches (152; 55.9%), blisters (58; 21.3%), lesions and/ or wounds (39; 14.3%), and white patches (30; 11%). Locations of injuries were the roof of the mouth (167; 61.4%), gums (62; 22.8%), cheeks (39; 14.3%), tongue (15; 5.5%), lips (15; 5.5%), and the floor of the mouth (12; 4.4%). Injuries were associated with age (p&lt;0.001), retirement (p=0.005), education (p=0.010), dentures (p&lt;0.001) and red patches (p&lt;0.001). Conclusion: Tracking soft tissue injuries and referring older adults with suspected malignant lesions to the health team should be included as oral cancer identification and prevention measures. Furthermore, health care providers should raise older adults’ awareness of the importance of regular preventive examinations

Idosos com depressão: uma análise dos fatores de institucionalização e apoio familiar

Objetivo: Identificar a prevalência de depressão de idosos residentes em instituições de longa permanência (ILPI) e sua relação com os motivos de institucionalização. Métodos: Estudo quantitativo e transversal realizado em Fortaleza, Ceará, que utilizou um instrumento de coleta de dados elaborado para realizar avaliação clínica concernente à depressão maior, utilizando os critérios diagnósticos do Diagnostical and statistical manual of mental disorders (DSM-IV-TR). Serviu também para registrar os dados secundários obtidos dos prontuários dos pacientes idosos no intuito de complementar as informações relativas ao contexto da institucionalização. Resultados: Do total de idosos pesquisados, 82 (34,6%) apresentaram diagnóstico de Depressão Maior segundo os critérios do DSM-IV-TR. No diagnóstico de depressão por ILPI, verifica-se significância estatística entre as duas ILPI (p=0,042). Na associação verificada entre depressão e tempo de institucionalização (p=0,001), é importante destacar o maior percentual entre os idosos com até três anos de institucionalização (37,8% dos casos de depressão), levando se a considerar que o pouco tempo de afastamento familiar e o processo de adaptação ao novo tipo de moradia possam constituir fatores de risco para a doença. Conclusão: Os achados acima descritos aludem à ideia de que o tempo de institucionalização, a carência das relações interpessoais, a solidão e o fato de o idoso receber visitas de familiares neste período constituem fatores de risco para a depressão

Leprosy: The Present Of A Disease From The Past

Introduction: Leprosy is one of the oldest and most stigmatizing diseases to affect mankind and is still considered a public health problem in many developing countries.&nbsp; Objective: To analyze how the social representations of leprosy patients are structured.&nbsp; Method: The purpose of this study was to analyze how the social consequences of leprosy affect people carrying the disease. A multi-method approach was used, based on the Theory of Social Representations. A total of 100 subjects participated in this study (50 males and 50 females). Data were analyzed using the following software: SPSS (to assess social, economic, and clinical aspects, EVOC, SIMI, and AVRIL (to integrate the structure of social consequences).&nbsp; Results: The central core for women was “family”. In the similitude test, this word was associated with “exclusion”. For men, the central core was composed of “family”, “work”, and “treatment”.&nbsp; Conclusions: The healthcare model must strive to take into account the day-to-day concerns of leprosy patients, with a view towards greater consideration of gender differences and the development of a more humanized care system based on full assistance in order to control this disease

Factors associated with self-rated health in older adults receiving oral prosthetic rehabilitation

Objectives: To assess factors associated with self-perception of health in older adults submitted to oral prosthetic rehabilitation in order to contribute to a more contextualized planning of public policies, actions and health services aimed at healthy aging. Design: Analytical cross-sectional study. Setting: Dental specialty centers. Participants: 244 people aged 60 years and older enrolled for oral prosthetic rehabilitation. Intervention: Interviews, oral examination and anthropometric measurements. Measurements: A questionnaire assessed demographic and economic data, general health and oral health and self-perception of oral health-related quality of life was measured by the Geriatric Oral Health Assessment Index (GOHAI). Performance in instrumental activities of daily living was assessed by the Lawton and Brody scale, mood was assessed by the Geriatric Depression Scale and nutritional status was assessed by the Mini Nutritional Assessment. Results: The multivariate analysis showed that factors such as hospitalization in the previous year, diabetes and risk of malnutrition determined the negative self-perception of general health and current health status compared with 12 months ago. Needing assistance to perform AIDL significantly influenced self-perception of general health while income and vision problems interfered with older adults’ perception of their current health status compared with 12 months ago. Conclusion: Older adults who needed oral prosthetic rehabilitation exhibited a predominantly negative self-perception of oral health.info:eu-repo/semantics/publishedVersio

Prevalence and health promotion actions related to hyposalivation and mouth discomfort in a nursing homesfor elders

Objectiveto verify the prevalence of hyposalivation inan institutionalized elder population and its relationship with oral discomfort. A cross-sectional study was conducted with older people living in a Nursing Homein Fortaleza-Brazil. Data collection occurred through the application of sociodemographic questionnaire; sialometry examination, test for evaluating the salivary flow speed; and by a subjective quantification of dry mouth intensity (Visual Analog Scale). Results: sixty-five older people aged between 61 and 91 years (mean74.5±8.0) were evaluated, 30(46.2%) were women and 35(53.8%) men. The majority had low monthly income (55;84.6%) and low schooling (44;67.7%). The mean salivary flow was 0.4 ±0.2, withvery low flow (0.1-0.3 ml/min) being more prevalent; females presented lower salivary flow (p=0.033) than males; there was an association between salivary flow and dry mouth sensation (p<0.001) and halitosis (p<0.001). The correlation between sialometry and VAS showed that the lower the salivary flow, the greater the perception of dry mouth sensation. Health promotion actions and treatment (proper hydration; tooth brushing; saliva stimulants) can be performed in order to minimize dry mouth/ hyposalivation impact on elders’ quality of life. Conclusion: Low salivary flow was prevalent in the study subjects. It interferes in oral discomfort and causes dry mouth sensation.info:eu-repo/semantics/publishedVersio

Self-reported oral health of a quilombola population in the semi-arid region of Piauí

The needy epidemiology of oral health in quilombola populations has been demonstrated by different researches, with the intention that studies be carried in order to identify and determine situations that are liable to be resolved through the help of social and health policies. Objective. To know the perception of oral health regarding oral discomfort and to compare it with general health in a quilombola population in the semi-arid region of Piauí. Methodology. Cross-sectional, descriptive and analytical study. From the adult and elderly population, a sample was calculated considering a margin of error of 5% and 90% of reliability, obtaining a total of 120 people as a minimum sample. Results. Inhabitants of the Canabrava, Tronco and Custaneiras quilombola communities participated - whose age ranged from 21 to 81 years old, SD±16.0. There is a predominance of: married (67.5%), female (60.8%) small farmers (90%), non-retired (71.7%), income of up to 01 (one) minimum wage (58.3%), and incomplete primary school (42.5%). Oral discomfort had a higher percentage due to the variable -Feels dry mouth (30.8%). There was a significant association (p= 0.031) between the perception of general health (excellent, reasonable and poor) and having oral health problems. Conclusion. The association between the perception of general health and having oral health problems reinforces the fact that the poor condition of oral healthinfo:eu-repo/semantics/publishedVersio