Informação e conhecimento (ou líquido e sólido): dois estados da mesma matéria?

Conhecer demanda tempo, leitura, imersão no objeto que se deseja aprender. Conhecer é um processo que depende do manuseio das páginas de muitos livros (aqueles completos, na própria acepção da palavra), das incursões em ambientes onde possamos senti-lo e respirá-lo, nos templos de sua ovação, as bibliotecas. É desbravar, cavar trincheiras, explorar o “desconhecido”. É muito mais que um abrir e fechar de olhos (e já “saber” de tudo). Conhecer é o que impulsiona a vida de um verdadeiro cientista

Federalism and decentralization: Impact on International and Brazilian Health Policies

This article discusses the implications of decentralization in the light of international and Brazilian federalism, and its effects on public health policy. In a comparative analysis among countries, the authors find there is no single model; rather, each country has a unique structure of institutions and norms that have important implications for the operation of its health system. Brazil shares some similarities with other countries that have adopted a decentralized system and is assuming features ever closer to U.S. federalism, with a complex web of relationships. The degree of inequality among Brazilian municipalities and states, along with the budgetary imbalances caused by the minimal levels of resource utilization, undermines Brazil's constitutional principles and, consequently, its federalism. To ensure the constitutional mandate in Brazil, it is essential, as in other countries, to create a stable source of funds and increase the volume and efficiency of spending. Also important are investing in the training of managers, improving information systems, strengthening the principles of autonomy and interdependence, and defining patterns of cooperation within the federation

Titanium tetrafluoride and dental caries: a systematic review

The aim of this systematic review was to evaluate the effectiveness of titanium tetrafluoride as a preventive or cariostatic agent against caries. The databases used to find the articles analyzed were MEDLINE LILACS, and BBO. In MEDLINE and LILACS the search strategy utilized was "titanium" [Words] and "tetrafluoride" [Words] and Spanish or English or Portuguese [Language], whereas In BBO "titânio" [Words] and "tetrafluoreto" [Words] and Espanhol or Inglês or Português [Language]. Out of a total of 42 studies found, which assessed possible preventive/cariostatic effects of titanium tetrafluoride against caries in vivo, only 2 were selected. In both studies, titanium tetrafluoride was shown to be effective against caries. However, given that the quality and consequently the validity of these two clinical studies are questionable, their results do not allow to conclude that titanium tetrafluoride is effective against caries clinically

Tetrafluoreto de titânio e cárie dentária: uma revisão sistemática

Esta revisão sistemática foi desenvolvida com o objetivo de avaliar a eficácia do tetrafluoreto de titânio como agente preventivo contra a cárie e/ou cariostático. Foram revisados, através da BIREME, artigos publicados nas revistas indexadas nas bases de dados MEDLINE, LILACS e BBO, utilizando as estratégias de busca titanium [Palavras] and tetrafluoride [Palavras] and Spanish or English or Portuguese [Idioma] na MEDLINE e no LILACS, já na BBO foram utilizados titânio [Palavras] and tetrafluoreto [Palavras] and Espanhol or Inglês or Português [Idioma]. De um total de 42 trabalhos diferentes encontrados, que avaliaram os efeitos preventivo/cariostático do tetrafluoreto de titânio contra a cárie in vivo, apenas 2 foram selecionados. Em ambos os estudos, o tetrafluoreto de titânio se mostrou efetivo contra a cárie. No entanto, considerando que a qualidade e, conseqüentemente, as validades desses poucos trabalhos clínicos existentes estão abertas para alguns questionamentos, conclui-se que os resultados apresentados não nos permitem dizer se o tetrafluoreto de titânio apresenta benefícios nos cuidados relacionados à cárie.The aim of this systematic review was to evaluate the effectiveness of titanium tetrafluoride as a preventive or cariostatic agent against caries. The databases used to find the articles analyzed were MEDLINE LILACS, and BBO. In MEDLINE and LILACS the search strategy utilized was "titanium" [Words] and "tetrafluoride" [Words] and Spanish or English or Portuguese [Language], whereas In BBO "titânio" [Words] and "tetrafluoreto" [Words] and Espanhol or Inglês or Português [Language]. Out of a total of 42 studies found, which assessed possible preventive/cariostatic effects of titanium tetrafluoride against caries in vivo, only 2 were selected. In both studies, titanium tetrafluoride was shown to be effective against caries. However, given that the quality and consequently the validity of these two clinical studies are questionable, their results do not allow to conclude that titanium tetrafluoride is effective against caries clinically

Eficacia del uso tópico de fluoruros y del cepillado en el control de caries producidas “in vivo”: revisión sistemática

El objetivo de esta revisión fue evaluar la eficacia del cepillado y del ion flúor en forma de dentífricos y enjuagues bucales en la inactivación de las lesiones blancas de esmalte inducidas “in vivo”. Para la identificación de los estudios considerados en éste trabajo, fueron revisados artículos en revistas indexadas en el Medline, Lilacs y BBO en el período comprendido entre los años 1966-2006, sin restricción de idiomas. Los criterios de selección utilizados para la inclusión fueron estudios clínicos, donde fueron desarrolladas lesiones blancas de esmalte, utilizando bandas ortodóncicas especialmente diseñados con la finalidad de crear un “sitio cariogénico” sobre las superficies vestibulares del esmalte sano “in vivo”. Esos estudios fueron clasificados como estudios de casos, serie de casos o ensayos clínicos controlados y randomizados. Los artículos fueron localizados a partir de la estrategia de busca desarrollada para el MEDLINE, revisada adecuadamente para cada base de datos. Los resultados evaluados fueron: La presencia o ausencia de lesiones blancas de esmalte después del período de 28 días con el “sitio cariogénico”, diferencia en el tamaño y severidad de las lesiones blancas entre los dientes de control y los sometidos a los diversos tipos de tratamiento, evaluación cuantitativa y cualitativa de la perdida mineral del esmalte utilizando técnicas directas o indirectas. Cuatro estudios fueron seleccionados, sin embargo no llenaron todos los criterios de calidad metodológica. El cepillado con dentífricos no fluorados redujo la severidad y profundidad de las lesiones blancas del esmalte. El uso de flúor tópico con bajo pH (0,6%-pH 1,9) y el enjuague diario con solución de NaF al 0,2% retardaron el desarrollo de la progresión de las lesiones blancas de esmalte significativamente (p<0,05) en poblaciones con agua potable fluorada o no. Diferentes fórmulas de flúor tópico parecen disminuir la desmineralización del esmalte, sin embargo ninguna parece ser superior a la otra. A partir del análisis de los estudios seleccionados se concluye que no existe evidencia de la eficacia de uno cualquiera de los métodos evaluados en la inactivación de las lesiones blancas de esmalte producidas “in vivo”

Susceptibilities of enterococcus faecalis biofilms to some antimicrobial medications

Enterococcus faecalis has bEnterococcus faecalis has been suggested to be an important etiological agent in endodontic failures. The purpose of this study was to evaluate the effectiveness of chlorhexidine- or antibiotics-based medications in eliminating E. faecalis biofilms. One-day and three-day biofilms of E. faecalis were induced on cellulose nitrate membrane filters. Each biofilm-containing membrane was thoroughly covered with 1 ml of the test medications and incubated for 1 day at 37°C. Treated biofilms were then aseptically transferred to vials containing a neutralizing agent in saline solution and vortexed. Suspensions were 10-fold diluted, seeded onto Mitis salivarius agar plates, and the colony-forming units counted after 48 h of incubation. There were significant differences between the formulations tested. The association of clindamycin with metronidazole significantly reduced the number of cells in 1-day biofilms. However of all medications tested, only 2% chlorhexidine-containing medications were able to thoroughly eliminate most of both 1-day and 3-day E. faecalis biofilms

Oral health care activities performed by caregivers for institutionalized elderly in Barcelona-Spain

Objectives: To describe the frequency of brushing teeth and cleaning of dentures, performed by caregivers, for institutionalized elderly people. Methods: A cross-sectional study in a sample of 196 caregivers of 31 health centers in Barcelona. The dependent variables were frequency of dental brushing and frequency of cleaning of dentures of the elderly by caregivers. The independent variables were characteristics of caregivers and institutions. We performed bivariate and multivariate descriptive analyses. Robust Poisson regression models were fitted to determine factors associated with the dependent variables and to assess the strength of the association. Results: 83% of caregivers were women, 79% worked on more than one shift, 42% worked only out of necessity, 92% were trained to care for elderly persons, 67% were trained in oral hygiene care for the elderly, and 73% recognized the existence of institutional protocols on oral health among residents. The variables explaining the lower frequency of brushing teeth by caregivers for the elderly, adjusted for the workload, were: no training in the care of elderly persons (PRa 1.7 CI95%: 1.6-1.8), not fully agreeing with the importance of oral health care of the elderly (PRa 2.5 CI95%: 1.5-4.1) and not knowing of the existence of oral health protocols (PRa 1.8 CI95%: 1.2-2.6). The variables that explain the lower frequency of cleaning dentures, adjusted for the workload, were lack of training in elderly care (PRa 1.7 CI95%: 1.3-1.9) and not knowing of the existence of protocols (PRa 3.7 CI95%: 1.6-8.7). Conclusion: The majority of caregivers perform activities of oral health care for the elderly at least once per day. The frequency of this care depends mainly on whether caregivers are trained to perform these activities, the importance given to oral health, the workload of caregivers and the existence of institutional protocols on oral health of institutionalized elderly persons

Prevalence and factors associated with orolabial lesions in beach workers

OBJECTIVE: To assess the prevalence and factors associated with orolabial lesions caused by sun exposure in beach workers. METHODS: Cross-sectional study with 362 beach workers from five urban beaches in the city of Natal, northeastern Brazil, from August to December 2010. All subjects completed a validated questionnaire to collect personal, occupational, and health-related information and underwent an orolabial clinical examination by trained examiners. Potential associations between sociodemographic, occupational, and health-related variables and the presence of orolabial lesions were assessed using the chi-square test at a 5% significance level. The multivariate analysis was performed using Poisson regression. RESULTS: Of the 362 workers examined, 27.1% had orolabial lesions. Of these, 76.8% were males, 61.6% dark or black skinned, 94.5% informal workers, and 85.4% reported sun exposure. Most (81.1%) reported using sun protection methods including sunscreen (38.7%), lip balm (15.3%), and cap/hat (72.4%). Twenty-eight percent reported smoking and 48% regular drinking. Sun protection with cap/hat was associated with orolabial lesions caused by sun exposure. CONCLUSIONS: There was found a high prevalence of orolabial lesions in workers exposed to sunlight that was associated with the use of a cap/hat as a sun protection method

Prediction equations for fat and fat-free body mass in adolescents, based on body circumferences

Fat mass (FM) and fat-free body mass (FFB) are important parameters for assessing nutritional status, since they are associated with higher prevalence of excess body fat and malnutrition worldwide. To develop prediction equations for fat and fat-free body mass in adolescents using body circumferences. This cross-sectional study included 218 adolescents (10-16 years) with normal weight as defined by body mass index. FM(Pred) and FFB(Pred) were estimated using stepwise multiple linear regression, considering age and body circumferences. Response variables, FM(BIA) and FFB(BIA) were estimated using bioelectric impedance analysis (BIA). The accuracy of the prediction equations was evaluated using the coefficient of determination (R(2)) and Akaike's Information Criterion (AIC). The best prediction equations for males were FM(Pred) = -7.114 - 0.592(age) - 0.958(wrist)+0.191(hip)+0.295(abdomen); R(2) = 0.552; AIC = 416.04 and FFB(Pred) = - 52.180+1.913(age)+1.954(wrist)+1.635(forearm); R(2) = 0.869; AIC = 578.24. For females, the best equations were FM(Pred) = -17.580 - 0.678(wrist)+0.221(abdomen)+0.241(hip)+0.202(proximal thigh) - 0.228(calf); R(2) = 0.838; AIC = 415.36 and FFB(Pred) = -31.066+0.90(age)+1.090(wrist) - 0.139(abdomen)+0.326(hip)+0.632(calf); R(2) = 0.878; AIC = 512.48. The equations developed to estimate fat body mass in females and fat-free body mass in both genders had high adjusted coefficients of determination and are therefore preferable to those derived using BIA

Incontinência urinária em idosos institucionalizados no Brasil: uma revisão integrativa

Este estudo teve como objetivo abordar os principais aspectos relacionados à incontinência urinária (IU) em idosos institucionalizados no Brasil, por meio de revisão integrativa de literatura. Em agosto de 2013, foram pesquisadas as bases de dados PubMed, Scopus, LILACS, SciELO, PAHO, MedCarib, CAPES e Google Acadêmico, utilizando combinações dos termos "incontinência urinária", "idosos", "institucionalizados" e "Brasil". Após aplicação dos critérios de elegibilidade, selecionaram-se 11 trabalhos: nove artigos científicos e duas dissertações de mestrado. A maior parte dos estudos foi do tipo seccional, realizado na Região Sul ou Sudeste, e com amostra menor que 100 indivíduos. A frequência da IU variou entre 22 e 100%, ultrapassando 50% na maior parte das pesquisas, com acometimento maior no sexo feminino. A forma clínica mais comum foi a IU de esforço, seguida pela IU de urgência, e o volume das perdas urinárias referido pelos residentes variou entre pequena e grande quantidade, sem predominância de nenhuma das categorias. O impacto da condição na qualidade de vida do indivíduo é diverso, entre leve e elevado, mas parece ser menor que em idosos não institucionalizados. Com base neste trabalho, conclui-se que a IU é um problema de saúde frequente no âmbito asilar, que pode afetar a qualidade de vida do residente e se associar ao declínio da mobilidade e à função cognitiva. As pesquisas no Brasil, contudo, são escassas e com amostra reduzida e, portanto, são necessários estudos com maior rigor metodológico que facilitem o planejamento de medidas adequadas de prevenção e tratamento, que visem reduzir os gastos sanitários, a sobrecarga dos cuidadores e profissionais de saúde e que permitam diminuir o impacto desta condição na saúde dos idosos institucionalizados