Oral health status of children and adolescents victims of abuse: a literature review

Violence against minors can manifest in many forms and is considered a public health problem due to the physical and emotional consequences it produces. The dentist has a fundamental role in detecting victims of violence, as the face is often the most affected region. Objective: To review the national and international literature concerning injuries and most common oral conditions of children and adolescents victims of abuse. Literature review: The descriptors used were “child abuse”, “child violence”, “physical violence”, “psychological violence”, “dental caries”, and “oral health” for international databases and the corresponding terms in Portuguese for Brazilian databases, with no restriction of year of publication and language. Through the articles included in this review, it appears that children with maltreatment history presents not only high prevalence of head injuries and dental traumas, but may also have poor oral hygiene and low search for dental services and consequently higher rates of untreated caries compared with children who lived in contexts without violence. Conclusion: Although the literature suggested that children and adolescents who have suffered abuse may have worse oral health status than those who were not victims of violence, more studies are needed to understand whether there are actually significant differences in the prevalence trauma, soft tissue injuries, tooth decay, and periodontal disease among types of child abuse

An observational study of dental abnormalities in the primary teeth

Introduction: Pregnancy and early childhood are the most critical phases with regard to biological, cognitive, emotional, and social development. Adverse events in these periods of life may be related to alterations in dental development, including alterations in size, shape and mineralization. Objective: To evaluate the frequency of dental abnormalities and the factors associated with the developmental defects of the enamel in primary teeth. Material and methods: Information about family income, maternal education level, pretermbirth, and hospitalization history up to 11 months of age were collected from the dental records of 544 children. Clinical examination of the children was performed to investigate abnormalities of tooth number, form, size, and developmental defects of the enamel (DDE). Data were analyzed using χ2 test and Poisson regression. Results: In all, 544 children were evaluated. Sixty children (11.0%) presented some alterations in the primary teeth; and 7.5% showed DDE. Children born preterm were 3.17 times more likely to develop DDE in primary teeth (prevalence ratio – PR = 3.17, 95% confidence interval– 95%CI 1.26–7.98, p = 0.014). Among the alterations of number, 1.7% was hypodontia, and among the abnormalities of shape, 1.7% was fused teeth. Conclusion: The prevalence of dental anomalies in this sample was, in general, expressive. Children born preterm were more vulnerable to present developmental defects of the enamel.Introduction: Pregnancy and early childhood are the most critical phases with regard to biological, cognitive, emotional, and social development. Adverse events in these periods of life may be related to alterations in dental development, including alterations in size, shape and mineralization. Objective: To evaluate the frequency of dental abnormalities and the factors associated with the developmental defects of the enamel in primary teeth. Material and methods: Information about family income, maternal education level, pretermbirth, and hospitalization history up to 11 months of age were collected from the dental records of 544 children. Clinical examination of the children was performed to investigate abnormalities of tooth number, form, size, and developmental defects of the enamel (DDE). Data were analyzed using χ2 test and Poisson regression. Results: In all, 544 children were evaluated. Sixty children (11.0%) presented some alterations in the primary teeth; and 7.5% showed DDE. Children born preterm were 3.17 times more likely to develop DDE in primary teeth (prevalence ratio – PR = 3.17, 95% confidence interval– 95%CI 1.26–7.98, p = 0.014). Among the alterations of number, 1.7% was hypodontia, and among the abnormalities of shape, 1.7% was fused teeth. Conclusion: The prevalence of dental anomalies in this sample was, in general, expressive. Children born preterm were more vulnerable to present developmental defects of the enamel

Translation and Cultural Adaptation of the Modified Child Dental Anxiety Scale - Faces (MCDASf) into Brazilian Portuguese

Objective: To translate and culturally adapt the Modified Child Dental Anxiety Scale - Faces (MCDASf) into Brazilian Portuguese. Material and Methods: The MCDASf consists of eight questions about anxiety toward dental procedures that are answered on a five-point Likert scale ranging from “not worried” (1 point) to “very worried” (5 points). The answers correspond to a scale of face drawings ranging from extremely negative to extremely positive. The process consisted of initial translation, back-translation, expert committee review, and pretesting. Results: The first revised version was applied to 32 children aged 5 to 12 years, 16 from the city of Governador Valadares, Brazil (southeastern region) and 16 from the city of Pelotas, Brazil (southern region). In the first pretest, Item 5 was misunderstood by 6.25% of children in the southern region; Item 6 by 6.25% in both regions; Items 7 and 8 by 87.5% and 100% of those from the southeastern region, respectively, and by 12.5% and 25% of those from the southern region, respectively. Items 7 and 8 were modified by the expert committee, and the second revised version was applied to 32 children, 16 from each region. The only misunderstood items were 4 and 5, both by a 7-year-old boy in Governador Valadares. Conclusion: The Brazilian Portuguese version of the MCDASf was well understood by the sample of children.&nbsp

Comparative Study of the Vertebral Heart Scale (VHS) and the Cardiothoracic Ratio (CTR) in Healthy Poodle Breed dogs

Background: Veterinary cardiology has been widely divulged, especially because of the search for diagnostic methods that allow early identification of heart disease in companion animals. Several techniques are available, such as digital radiography (DR), computerized tomography (CT) and magnetic resonance (MR) that are being applied to patients with various diseases. VHS has been widely used in clinical practice in veterinary medicine as a way to diagnose heart size increases in lateral thoracic radiography in small animals. Cardiothoracic ratio (CTR) is a predictive factor for cardiac insufficiency in humans. In veterinary medicine, this index is still little used. The objective of the present study was to compare the vertebral heart scale (VHS) and cardiothoracic ratio (CTR) to assess changes in the size of the cardiac silhouette dogs in thoracic radiographs.Materials, Methods & Results: The VHS and CTR of forty healthy poodle breed dogs (20 males and 20 females) from University Veterinary Hospital at the Federal University of Piauí were assessed. The animals were placed in supine and lateral decubitus, to obtain radiographic images in dorsoventral (DV) and right and left laterolateral projections of the thoracic region. The images acquired on the photosensitive radiographic chassis were analyzed by digital radiographic image system installed in the Image Diagnosis Service of the University Veterinary Hospital -HVU/UFPI. VHS (Vertebral Heart Scale) measurements were taken using the sum of the heart length and heart width at its greatest diameter, comparing with the vertebral bodies from the fourth thoracic vertebra (T4). The CTR was assessed by comparing the greatest width of the heart silhouette and the distance between the thoracic walls at height T8. The heart width was measured from the two greatest distances (ML and MR), from the vertical line that divides the limit between the right and left sides of the heart, at the point of its greatest diameter. Similarly, the thoracic width was measured at the point of greatest thoracic diameter (MTD). The mean of the VHS and CTR in the males was 9.83 ± 0.85v and 0.48 ± 0.05, respectively. The females showed values of 9.65 ± 0.65v and 0.50 ± 0.03, respectively (P > 0.05). The mean of the VHS and CTR, considering males and females, was 9.72 ± 0.73v and 0.48 ± 0.04, respectively. VHS and weight correlated positively (r = 0.96), as the CTR and weight (r = 0.94). VHS and age showed high correlation (r = 0.96) as CTR and age (r = 0.93). VHS and CTR showed high correlation (r = 0.96).Discussion: Although congenital malformations and genetic diseases can occur, the acquired heart diseases correspond to most of the complications found in dogs. VHS increases considerably 6 to 12 months before the development of congestive heart failure (CHF). The poodles studied, considering the universe of males and females (P < 0.05), presented mean VHS values of 9.72 ± 0.73v. Similarly, there was no significant difference between genders for VHS measured in right and left decubitus in normal dogs. The cardiothoracic ratio measured for the poodles studied showed mean values of 0.48 ± 0.05. In humans, values below 0.5 are considered normal, while values above this may indicate the presence of cardiomegaly. The CTR is intimately related to the volume of the left ventricle and CTR values above 0.5 in humans are pathological. Our results demonstrated that VHS and CTR showed strong correlation in their measurements, suggesting that CTR, constantly used in humans, could be considered as a tool to assess the size of the heart silhouette in dogs of the poodle breed

Trilhas de aprendizagem para capacitação dos profissionais em uma instituição de saúde / Learning tracks for qualification of professionals in a health institution

A aprendizagem deve ser compreendida como um processo contínuo, ocorrendo a partir da interação do indivíduo com estímulos do meio em que vive. A partir desse conceito, o objetivo da educação corporativa é preparar profissionais para o desempenho esperado pela empresa. A Sociedade Beneficente Israelita Brasileira Albert Einstein (SBIBAE) implementou as trilhas de aprendizagem como estratégia para capacitação dos profissionais. Este modelo de treinamento das equipes  tem um caráter estratégico e visa alcançar 3 objetivos: desenvolver competências, fortalecer a cultura organizacional, alinhar comportamentos e atitudes, sendo um desafio passar de um modelo educacional tradicional, baseado no levantamento das necessidades de treinamento e das solicitações de treinamentos, para um modelo proativo, no qual considera as competências organizacionais e profissionais e que, diferente do modelo anterior, responde ao negócio, pois se baseia também no planejamento estratégico da instituição. Este artigo tem como objetivo apresentar o modelo de Trilhas de Aprendizagem da Sociedade Beneficente Israelita Brasileira Albert Einstein (SBIBAE). Resultados:   Houve  melhora significativa nos indicadores assistenciais, sugerindo que a implementação das trilhas de aprendizagem pode ter influenciado nestes resultados

REABILITAÇÃO ESTÉTICA ATRAVÉS DE RESTAURAÇÃO DIRETA EM PACIENTE BRUXÔMANO: RELATO DE CASO

O bruxismo consiste num hábito parafuncional, apertamento excêntrico, que gera atrito entre os dentes antagonistas, podendo provocar alteração da dimensão vertical da oclusão (DVO) e desordens temporomandibulares (DTMs)

AVALIAÇÃO DO RISCO E PREVENÇÃO DE ÚLCERA POR PRESSÃO EM PACIENTES COM LESÃO MEDULAR / RISK ASSESSMENT AND PREVENTION OF PRESSURE ULCER IN PATIENTS WITH SPINAL CORD INJURY

Introdução: A Úlcera por Pressão (UP) é uma ferida crônica que se caracteriza como umas das complicações mais comuns na pessoa com Lesão Traumática da Medula Espinhal (LTME). Objetivo: Determinar o risco de pacientes internados com LTME desenvolver UP e descrever as medidas de prevenção. Métodos: Trata-se de uma pesquisa epidemiológica, do tipo exploratório–descritivo, realizada em um hospital universitário. A Escala de Braden foi aplicada na admissão do paciente, avaliando a percepção sensorial, umidade, atividade, mobilidade, nutrição, fricção e cisalhamento, totalizando um escore de 23 pontos. Foram realizadas avaliações duas vezes por semana durante o período de internação. Resultados: Foram avaliados 61 pacientes com LTME, observando-se escores baixos na avaliação de risco da Escala de Braden. O escore médio de 11,1 indicou risco elevado para desenvolvimento de UP. As medidas de prevenção adotadas foram a mudança de decúbito, uso de colchão especial, hidratação da pele, coxim cilíndrico, uso da placa de hidrocoloide e coxim de luva. Conclusão: Considerando os fatores de risco, os pacientes apresentaram baixos escores nas subescalas da Escala de Braden, exceto percepção sensorial, indicando que o paciente com LTME possui risco elevado para desenvolvimento de UP. Conclui-se que o paciente com LTME traz consigo uma série de aspectos que necessitam de atenção e cuidado permanente. Podem desenvolver UP em qualquer fase, necessitando de medidas de prevenção o mais precoce possível.Palavras-chave: Úlcera por pressão. Traumatismo da medula espinhal. Fatores de risco. Prevenção. Enfermagem.AbstractIntroduction: Pressure Ulcer (PU) is a chronic wound that is characterized as one of the most common complications in people with traumatic spinal cord injury (TSCI). Objective: To determine the pressure ulcer risk of hospitalized patients with TSCI and describe the preventive interventions against PU adopted for these patients. Methods: Exploratory, descriptive and epidemiological study conducted in a university hospital during six months. We used the Braden scale for selecting the patients. It was evaluated the sensory perception, moisture activity, mobility, nutrition, friction and shear, with a total score of 23 points. We did the evaluations twice a week during the period of patients' hospitalization. Results: 61 patients with TSCI participated of this study. Most of the patients had low scores on all items of the Braden Scale. The mean score of 11.1 shows that these patients have a high risk for PU development. Position change, special mattress, skin hydration, cylindrical cushion, hydrocolloid plate and water cushion were the preventive interventions adopted. Conclusion: Regarding the risk factors, the patients had low scores on all subscales of the Braden Scale, with the exception of sensory perception. This indicates that the patient with TSCI has high risk for PU development. We conclude that patients with TSCI have several aspects that need constant attention and care. PU can be developed at any time, requiring preventive interventions as early as possible.Keywords: Pressure ulcer. Traumatic spinal cord injury. Risk factors. Prevention. Nursing

WHIPPLE’s DISEASE: A CASE REPORT

Male, 46 years old, with arthralgia, abdominal pain, weight loss, diarrhea and inappetence. An upper digestive endoscopy was performed, which showed the duodenal bulb with diffuse whitish stippling. The anatomopathological examination of the duodenum showed positive periodic acid-Schiff, confirming the diagnosis of Whipple's disease. In view of the findings, treatment with sulfamethoxazole and trimethoprim was initiated, with significant improvement in symptoms. Whipple's disease is a rare pathology, as a consequence it presents a difficult diagnosis and the ideal treatment of the pathology is still not completely elucidated. Thus, clinical studies with greater scientific impact are needed to aid in the diagnosis and define the preferential approach to the condition.Masculino, 46 anos, com artralgia, dor abdominal, perda de peso, diarreia e inapetência. Realizada endoscopia digestiva alta que evidenciou bulbo duodenal apresentando pontilhado esbranquiçado difuso. Ao anatomopatológico de duodeno evidenciado periodic acid-Schiff positivos, firmando-se o diagnóstico de Doença de Whipple. Diante dos achados, iniciou-se o tratamento com sulfametoxazol+trimetropina, com melhora significativa dos sintomas. A Doença de Whipple é uma patologia rara, como consequência apresenta um difícil diagnóstico e o tratamento ideal da patologia ainda não é completamente elucidado. Assim, são necessários estudos clínicos com maior impacto científico para auxiliar no diagnóstico e definir a conduta preferencial diante do quadro.&nbsp

A diabetes como fator agravante da infecção por COVID-19

O Coronavírus-2 (SARS-CoV-2) é uma síndrome respiratória grave, que apareceu no final de 2019 em uma província na China e espalhou-se por todo o mundo. Essa doença agressiva, frequentemente, teve seus sintomas agravados por condições associadas, como a diabetes. Essa condição metabólica de origem múltipla é considerada uma das comorbidades mais comuns em pessoas com COVID-19. A maioria das evidências disponíveis também revela que a doença tem uma ligação intrínseca com o aumento da gravidade e mortalidade, especialmente em relação a pacientes com níveis glicêmicos descompensados. Este presente estudo tem como objetivo analisar a associação da Diabetes como agravante dos quadros de COVID-19. A pesquisa envolveu a análise de artigos relevantes publicados entre 2020 e 2023, selecionados em bases renomadas como SCIELO, MEDLINE/PubMed e RBAC, analisando descritores específicos correlacionados à Diabetes e ao COVID-19, principalmente tomando como base as duas patologias simultâneas.&nbsp; Os resultados indicam que o indivíduo com diabetes tem uma grande prevalência de óbito e um aumento de chances de caso severo quando infectado pelo SARS-CoV-2. Isso porque, enquanto uma doença crônica, a diabetes altera as funções metabólicas e, com isso, as respostas imunológicas. Ademais, a diabetes aumenta o risco de fibrose pulmonar, distúrbios pulmonares obstrutivos e redução da função respiratória, que podem também diminuir a oxigenação dos órgãos. Diante dessa próxima interação entre as enfermidades, torna-se necessário o desenvolvimento de mais pesquisas no ramo científico acerca da temática para proporcionar um maior conhecimento na área da saúde, consequentemente provocando um aumento da prevenção, além de um manejo mais específico e um maior zelo por pacientes acometidos, com o intuito de evitar complicações maiores provocadas por essas alterações, melhorando o prognóstico e avançando nesse âmbito