Mortality Rate In Children Caused By Traffic Accidents According To Geographical Regions - Brazil, 1997 - 2005.

Fatal injuries in children caused by motor vehicle accidents represent a common situation in many countries worldwide. The present study addresses the mortality rate in children as vehicle passengers in Brazil, from 1997 to 2005. To evaluate mortality rates, the number of deaths was collected from the National Mortality Information System (SIM) and the population size was obtained using the Brazilian Bureau Census (IBGE) data available at DATASUS. Mortality rates were estimated in three-year periods and analyzed according to age groups (younger than 1 year old, 1-4 years old, 5-9 years old) and geographical regions using a 95% confidence interval. Overall results showed mortality rates of 5.68, 7.32 and 6.78 (per 1,000,000) for the 1997-1999, 2000-2002 and 2003-2005 periods, respectively for the whole country. Children younger than 1 year old had a mortality rate of 10.18 (per 1,000,000), which was higher than for the other age groups. For the period analyzed, the highest rates were observed for the Mid-West and South regions of Brazil, with rates of 13.88 and 11.47 (per 1,000,000), respectively. These results show the risk of fatal injury in children caused by motor vehicle accidents and may contribute to the establishment of educational campaigns aiming injury prevention in children as vehicle passengers.15308-1

Comparison between inverted and unprocessed digitized radiographic imaging in periodontal bone loss measurements

The advances in digital imaging technology in dentistry have provided an alternative to film-based radiography and have given new options to detect periodontal bone loss. The purpose of this study was to compare inverted and unprocessed digitized radiographic imaging in periodontal bone loss measurements. Thirty-five film-based periapical radiographs of patients suffering from moderate to advanced untreated periodontal bone loss associated to lower premolar and molars was selected from the department files, with 40 bone loss areas. The film-based radiographs were digitized with a flatbed scanner with a transparency and radiograph adapter used for transilluminating the radiograph imaging. Digitization was performed at 600 dpi and in gray scale. The images were digitized using Image Tool software by applying image inversion, that is, transformation of radiopaque structures into radiolucent structures and vice-versa. The digital data were saved as JPEG files. The images were displayed on a 15-inch and 24-bit video monitor under reduced room lighting. One calibrated examiner performed all radiographic measurements, three times, from the cementoenamel junction to the most apical extension of the bone loss, in both types of image (inverted and unprocessed). Brightness and contrast were adjusted according to the examiner's individual demand. Intraclass correlation coefficient was used to compare the measurements from both types of images. The means of radiographic measurements, in mm, for inverted and unprocessed digitized imaging were 6.4485 and 6.3790, respectively. The intraclass correlation coefficient was significant (0.99) The inverted and unprocessed digitized radiographic images were reliable and there was no difference in the diagnostic accuracy between these images regarding periodontal bone loss measurements

Effect of drying on the reproducibility of DIAGNOdent to detect caries-like lesions

The aim of this study was to verify the drying effect on the reproducibility of DIAGNOdent (Dd) devices to detect caries-like lesions. Three areas were created in each of the 34 bovine incisors: sound (S), demineralized (DE) and remineralized (RE). One examiner measured each area with two Dd devices (denominated X and Y), twice under humid, and twice under dry condition. Intra-rater agreement according each device and inter-device agreement were estimated by kappa statistics (k). Intra-rater agreement for device Y was substantial under humid (k DE=0.68 and k RE+S=0.68) and dry condition (k DE=0.64 and k RE+S=0.67). For device X, it was substantial under humid condition (k DE=0.57 and k RE+S=0.49), and it was almost perfect after air drying (k DE=1.0 and kRE+S=1.0). Inter-device agreement was slight (k =0.17) under humid condition, and it was substantial under dry condition (k =0.62). As reproducibility increased under dry condition, drying is advised to detect caries-like lesions on free smooth surfaces when different devices are used.Este estudo verificou o efeito da secagem sobre o resultado de reprodutibilidade de aparelhos laser DIAGNOdent (Dd) no diagnóstico de cárie artificial. Três áreas foram produzidas em cada um dos 34 incisivos bovinos: hígida (S), desmineralizada (DE) e remineralizada (RE). Um examinador mediu cada área com dois aparelhos Dd (denominados X e Y), sendo duas vezes sob a condição úmida e duas vezes sob a condição seca. A concordância intra-examinador segundo cada aparelho, e a concordância entre aparelhos foram estimadas por meio da estatística kappa (k). A reprodutibilidade intra para o aparelho Y foi substancial sob a condição úmida (kDE=0,68 e k RE+S=0,68) e seca (k DE=0,64 e k RE+S=0,67). Para o aparelho X, a concordância foi substancial sob a condição úmida (kDE=0,57 e k RE+S=0,49) e foi quase perfeita após a secagem (kDE=1,0 e k RE+S+1,0). A concordância entre aparelhos foi fraca (k=0,17) na condição úmida, porém foi substancial na condição seca (k=0,62). Como a reprodutibilidade foi melhor sob a condição seca, a secagem da superfície dentária é aconselhada para se detectar lesões de cárie incipientes em superfícies lisas livres, quando mais de um aparelho é utilizado no diagnóstico

Reprodutibilidade diagnóstica do alongamento do processo estilóide

The aim of this study was to estimate the reproducibility related to the presence and to the measurements of elongated styloid process (ESP), based on panoramic radiographs and the prevalence of ESP. Experimental design: one hundred sixty six panoramic radiographs were used, from edentulous patients from the Radiology Clinic files, at Araraquara Dental School, Unesp, during a four-year period. One hundred and twenty one were female and 45 were male. Two calibrated observers evaluated the radiographs. A caliper was used to measure, in mm, the ESP from the base of the temporal bone to the tip of the structure. The ESP was considered present when the measurements were 30mm or more. Kappa statistics (k ) and intra-class correlation coefficient (r ), were applied to estimate the reproducibility. The results showed that related to the presence of ESP, the interobserver agreement was k =0.85. Related to the measurements of ESP, the interobserver agreement was r =0.52. The prevalence of ESP was estimated in 12.6%. ESP distribution in females was similar to that for males. In conclusion, we found a greater level of agreement when observers evaluated the presence of ESP than when they did the measurement of ESP. The prevalence of ESP was 12.6%.O objetivo deste trabalho foi avaliar a reprodutibilidade relacionada à presença e às medidas do alongamento e a prevalência do processo estilóide (APE), utilizando radiografias panorâmicas. Foram utilizadas cento e sessenta e seis radiografias, do arquivo da Clínica de Radiologia, da Faculdade de Odontologia de Araraquara, Unesp, de pacientes desdentados, atendidos num período de quatro anos. Cento e vinte um pacientes eram do gênero feminino e quarenta e cinco do masculino. Dois examinadores calibrados avaliaram as radiografias. Foi utilizado um paquímetro para medir, em mm, o APE da base do osso temporal à extremidade da estrutura. O APE foi considerado presente quando as medidas ultrapassaram 30 mm. A reprodutibilidade foi avaliada utilizando a estatística Kappa (ê) e o coeficiente de correlação intra-classe (ñ). Os resultados mostraram que a concordância interexaminador foi ê=0,85, relativa à presença do APE e ñ=0,52 relativa às medidas do APE. A prevalência do APE foi 12,6%. A distribuição do APE no gênero feminino foi semelhante ao masculino. Concluindo, o nível de concordância entre os dois examinadores quanto à presença do APE foi maior do que quando eles mediram o APE. A prevalência do APE foi 12,6%

Eficácia de três condições de interpretação radiográfica em odontometria

OBJECTIVE: To compare the efficacy of three conditions of image interpretation for radiographic root measurements and calculating the intra-observer reproducibility of the measurements. MATERIAL AND METHODS: Thirty intra-operative periapical radiographs of maxillary central and lateral incisors were measured, in mm, from the tip of the file to the radiographic apex, using a caliper. Three separate measurements were made of the 30 radiographs. The three measurements for each tooth were averaged and the mean used for further calculations. After a 12-day period, the measurements were repeated. The three experimental viewing conditions used: 1) standard viewbox without masking of background light around the radiograph and without magnification (Visual); 2) standard viewbox with use of a magnifying lens of 2.5x and with background light masked (Magnification); and 3) viewer device that restricts room lighting and enlarges the image by a magnifying lens of 1.75x (Viewer). The mean and standard deviation of the measurements were calculated and used for descriptive analysis. Two-way analysis of variance (ANOVA) was used to evaluate intra-observer and inter-method agreement of the measurements. The measurement error was estimated by Dalhberg's formula. RESULTS: The ANOVA showed no significant differences between measurement sessions, viewing methods, or interaction between observation session and method (p>;0.05). The intra-observer measurement error was 0.02 mm for Visual and the Magnification methods and 0.01 mm for the Viewer. CONCLUSION: There does not seem to be any advantage in using viewbox masking or magnification for measuring the distance between the end of the endodontic file and the root apex in maxillary incisors.OBJETIVO: Comparar a eficácia de três condições de interpretação radiográfica em odontometria e avaliar a concordância intra-observador. MATERIAL E MÉTODO: Trinta radiografias periapicais de incisivos central e lateral superiores, de arquivos foram medidas, em mm, da extremidade da lima ao ápice radiográfico, com a utilização de um paquímetro digital. Foram feitas três medidas em cada radiografia e em seguida foi calculada a média. Após um período de 12 dias, as medidas foram repetidas. As três condições experimentais de interpretação radiográfica foram: negatoscópio sem máscara e sem magnificação (Visual); 2) negatoscópio com lente de aumento de 2,5 X e com máscara (Magnificação) e 3) bloqueador de luz e lente de aumento de 1,75 X (Bloqueador). As médias e os desvios-padrão das medidas foram calculados e realizada uma análise descritiva. Foi utilizada a análise de variância a dois critérios (ANOVA) para avaliar a concordância intra-observador e intramétodo. O erro das medidas foi calculado pela fórmula de Dalhberg. RESULTADOS: O teste ANOVA não mostrou diferenças significantes entre as duas sessões de observação, métodos de interpretação ou interação entre as sessões de interpretação e método (p>;0,05). A medida intra-observador foi 0,02 mm para os métodos Visual e Magnificação e 0,01 mm para o Bloqueador. CONCLUSÃO: Parece não haver qualquer vantagem realizar medidas da distância entre o ápice radicular e o extremo da lima endodôntica em dentes incisivos superiores utilizando máscara ou magnificação da imagem

Reprodutibilidade de um teste microbiológico para estreptococos do grupo mutans

The development of simple predictive microbiological tests allows targeting those children at highest risk for caries, even if they do not exhibit the disease activity. The aim of this study was to evaluate the reproducibility of CARITEST SM®, a dip slide test for mutans streptococci. Fourteen subjects participated in this study. Saliva was stimulated by having the subject chew an inert gum and then collected until there was enough to perform two CARITEST SM® tests - from different batches (set of kits 1 and set of kits 2) - applied twice for the same subject. Two calibrated examiners read each dip slide test once, by independent and blind means. The results were classified according to two criteria: scores from 1 to 6, recommended by the manufacturer’s instructions, and scores according to high and low microbiological count. Kappa statistics was applied according to Light. The reproducibility results according to the 6 scores exhibited distinct values for the set of kits 1 and for the set of kits 2, kappa = 0.57 and kappa = 0.21, respectively. The results according to high and low microbiological count were kappa = 1.00 for the set of kits 1 and kappa = 0.55 for the set of kits 2. This study showed a variability in the results of both kits from different batches. Furthermore, there was greater interexaminer agreement when the results were classified according to high and low microbiological count.Com o desenvolvimento de testes microbiológicos salivares simplificados tornou-se mais prático o diagnóstico de pacientes com baixa atividade, porém com alto risco de cárie. O propósito desta pesquisa foi avaliar a reprodutibilidade do CARITEST-SM®, um teste específico para estreptococos do grupo mutans. Catorze voluntários participaram do estudo. A produção de saliva foi estimulada com uma goma de mascar inerte e coletada até a obtenção do volume suficiente para a execução de dois testes - pertencentes a dois conjuntos de lotes diferentes de "kits" CARITEST-SM® (1 e 2) - aplicados para um mesmo indivíduo. Dois examinadores calibrados realizaram a leitura de forma independente e cega, classificando os resultados de duas maneiras: escores de 1 a 6, conforme recomenda o fabricante, e conforme a classificação quanto à contagem microbiológica, baixa e alta. Foi aplicada a estatística Kappa, segundo Light. Os resultados de concordância, conforme 6 escores, mostraram valores distintos para o conjunto dos "kits" 1 e para o conjunto dos "kits" 2, valendo, respectivamente, kapa = 0,57 e kapa = 0,21. Em relação à classificação conforme a contagem microbiológica, alta e baixa, os resultados foram kapa = 1,00, para o conjunto dos "kits" 1, ekapa = 0,55, para o conjunto dos "kits" 2. Assim, estes índices de concordância mostraram que a diferença no lote exerceu uma variabilidade no resultado. Além disso, houve maior concordância interexaminador quando se utilizou a classificação conforme a contagem microbiológica alta e baixa

Atitudes em relação à bioestatística de discentes e docentes da Faculdade de Ciências Farmacêuticas de Araraquara-UNESP

O objetivo deste estudo foi verificar a atitude de discentes e docentes da Faculdade de Ciências Farmacêuticas de Araraquara (UNESP) em relação à Bioestatística. Como instrumento de medida, utilizou-se a Escala de Atitudes em Relação à Estatística (EAE). A reprodutibilidade da Escala foi estimada pela estatística Kappa (k) com ponderação linear e sua consistência interna pelo Coeficiente alfa-Cronbach (α). Os indivíduos foram agrupados segundo sua atitude em relação à Estatística em positiva e negativa; posteriormente, estudou-se sua associação com as variáveis de interesse pelo teste de qui-quadrado (χ2) ao nível de significância de 5%. A amostra foi composta por 272 alunos de graduação, 83 de pós-graduação e 24 docentes, sendo predominantemente feminina (78,2%). Entre os estudantes, 67,5% participaram do programa de iniciação científica. A reprodutibilidade e a consistência interna da Escala foram adequadas (κ=0,7093; α=0,9334). A maior parte da amostra (74,4%) apresentou atitude positiva frente à Estatística. Houve associação entre a atitude e a atividade funcional (p=0,0204), série cursada (p=0,0316) e desempenho (p=0,0002). Assim, conclui-se que a maioria dos participantes apresentou atitude positiva em relação à Bioestatística, sendo que os estudantes de graduação e aqueles que relataram bom desempenho em Bioestatística apresentaram proporção significativamente maior de atitude positiva em relação aos demais

Effect of Four Bleaching Regimens on Color Changes and Microhardness of Dental Nanofilled Composite

Objective. The purpose of this study was to compare the color changes and microhardness of a nanocomposite after four bleaching regimens. Materials. Twenty-five specimens (n = 25) were made with a nanocomposite resin (Filtek Supreme XT). The specimens were divided into five groups equally (n = 5): bleaching groups and control group, as follows: G1: artificial saliva at 37°C; (control) G2: hydrogen peroxide (HP) at 7%; G3: hydrogen peroxide (HP) at 35%; G4: carbamide peroxide (CP) at 10%; G5: carbamide peroxide (CP) 35%. Color measurements were made with spectrophotometer using CIELAB color scale. The Vickers hardness (VHN) measurements were performed at the top surface. The data were analyzed with two-way Analysis of Variance. Results. ΔE and VHN mean values into the groups were not statistically different, however, the VHN mean values before and after storage and bleaching showed statistically significant differences. Conclusion. Nanocomposite samples showed no significant alteration (color and microhardness) after bleaching. Thus, no replacement of restorations is required after bleaching

Fissuras lábio-palatais: estudo caso-controle

This study relates to a case-control analysis for the purpose of verifying the association between oral clefts and possible risk factors. The analysed variables were: place of mother's residence (urban/ rural), pollution, parental diseases, mother's diseases during the first four months of pregnancy, intake of drugs related to this period, heredity, smoking habits, alcohol consumption and X-ray examinations during pregnancy or X-ray examinations prior to preganacy. There were 450 cases of clefts of whom 354 had a cleft lip with or without cleft palate and 96 had a cleft palate. The relative risk (RR) for each variable by was estimated points and at a 95% of confidence interval and multivariate analysis was applied. As regards cleft lip with or without cleft palate, the risk factors are heredity (RR = 4.96), epilepsy in the mother (RR = 2.39) and the intake of drugs such as anti-inflammatory substance in the first four months of pregnancy (RR = 2.59). Related to cleft palate, the risk factors are heredity (RR = 2.82) and pollution (RR = 2.58).Realizou-se um estudo caso-controle com o propósito de se detectar possíveis fatores de risco para o aparecimento de fissuras orais. Foram objeto de análise: local de moradia da mãe nos quatro primeiros meses de gestação, poluição, aplicação de pesticida/herbicida na lavoura, doenças dos pais, doenças da mãe nos quatro primeiros meses de gestação, ingestão medicamentosa nesse período, hereditariedade, tabagismo, consumo de bebida alcoólica e exposição a raio-X. Foram aplicados formulários às mães referentes aos 450 casos, sendo 354 portadores de fissuras labiais ou lábio-palatais e 96 de fissuras palatinas, e às mães referentes aos 450 controles. Empregou-se análise multivariada e as variáveis hereditariedade (RR=4,96), epilepsia na mãe (RR=2,39) e ingestão de anti-inflamatório (RR=2,59) foram consideradas fatores de risco para fissuras labiais ou lábio-palatais. As variáveis hereditariedade (RR=2,82) e poluição (RR=2,58) foram consideradas fatores de risco para fissuras palatinas

Dengue Incidence and Climatic Factors

Introduction: This study was carried out to analyze the temporal evolution of the incidence of dengue in Araraquara-SP, Brazil, from 2012 to 2016, correlating the incidence with temperature and pluviometry. Methods: It was a cross-sectional design. The monthly number of cases from 2012 to 2016 was collected in the datafile of the Special Health Service of Araraquara-SESA of USP. Climatic variables related to temperature and rainfall were obtained from the websites of Agritempo and Department of Water and Electric Power, respectively. Statistical planning included incidence rates, and the tendency from 2012 to 2016, and it was studied the correlation between the number of dengue cases and each one of the climatic variables, considering the time-lag concept. Results: The incidence rates were 52.68, 376.52, 737.39, 3,660 and 809.48 per 100,000 inhabitants. Significant correlations were observed between the number of dengue cases and climatic variables after 2-4 months for high temperature and after 1-4 months for rainfall. Conclusions: The city faced an epidemic of dengue in 2015. It was identified the time lag in which hot weather and rain favored the occurrence of new cases: 2 to 4 months later for high temperature, and 1 to 4 months later for rainfall