Vaccination against HPV in Brazil: What is New in the Year 2017?

We would like to discuss briefly new information regarding the article “Evolução do sistema público de saúde no Brasil frente ao estágio atual da prevenção do câncer de colo uterino em mulheres jovens e adolescentes

Fonoaudiologia e fissuras labiopalatinas

Li com muito interesse o artigo intitulado “Fonoaudiología en los cuidados paliativos” (1). Em acréscimo, gostaria oportunamente de destacar o foco de atuação da fonoaudiologia no tratamento reabilitador das fissuras labiopalatinas, nas situações em que há comprometimento do palato. Por sua vez, tem-se que as ocorrências mais comuns neste âmbito surgem a partir de variações da extensão do tamanho das fissuras, bem como do reposicionamento incorreto das fibras musculares do palato, o que por vezes impossibilita a separação adequada da cavidade oral da nasal e, por conseguinte acarreta em prejuízos para a ressonância e articulação dos sons da fala. Assim, nestes casos a atuação da fonoaudiologia pauta-se principalmente acerca da ocorrência de alterações do mecanismo velofaríngeo, mediante as quais desenvolve-se a chamada disfunção velofaríngea, diferenciada em duas modalidades: insuficiência ou incompetência velofaríngea (Figura 1)

The importance of oral microbiota control and utilization of biomaterial in secondary alveolar bone graft surgeries in patients with cleft lip and palate

A cavidade bucal é uma das portas de entrada ao nosso organismo. Pertencendo ao sistema digestório, também funciona como uma via de acesso às vias respiratórias. A fissura labiopalatina é uma anomalia que pode promover perda de continuidade nos tecidos labiais, alveolares e palatinos da maxila, necessitando de procedimentos cirúrgicos para reabilitação estética e funcional do paciente. Diante disso, o objetivo do presente estudo foi realizar um trabalho de atualização enfatizando a influência da microbiota bucal e o uso de rhBMP-2 em pacientes submetidos a cirurgia de enxerto alveolar secundário, visto que a cirurgia apresenta um período pós-operatório crítico e de grande importância para o sucesso do tratamento, o qual requer muitos cuidados tanto no que diz respeito à alimentação quanto à higienização bucal, esta com o propósito de diminuir os riscos de infecção no respectivo período. O cuidado com a higiene bucal destes pacientes é um fator importante no processo saúde/doença a partir de uma concepção holística, em prevenir não somente as alterações na cavidade bucal como evitar que esses micro-organismos residentes se tornem agentes complicadores do estado geral do paciente.The oral cavity is one of the entrance ways to the body, belonging to the digestive system, and also allows access to the respiratory pathways. Cleft lip and palate is an anomaly that may cause continuity of lip, alveolar and palatal tissues of the maxilla, requiring surgical procedures for the esthetic and functional rehabilitation of the patient. This study conducted a literature review emphasizing the influence of the oral microbiota and utilization of rhBMP-2 in patients submitted to secondary alveolar graft surgery. This surgery presents a critical postoperative recovery that is fundamental for the treatment success and requires much care both concerning feeding and oral hygiene, to reduce the risk of infection in this period. The care with oral hygiene of these patients is an important factor in the health/disease process based on a holistic approach, to prevent not only changes in the oral cavity and avoid that these microorganisms may complicate the overall status of the patient

Association of nutritional status and anemia with multimicronutrient supplementation in young children in Peru

Introduction: Although several social interventions have been developed by the Peruvian State, anemia is present in one out of every two children in Peru. Thus, it is important to evaluate whether such interventions are achieving their objectives. Objective: This study aimed to determine the association of nutritional status and anemia with multi-micronutrient supplementation in children younger than three years in Huancayo, Peru. Materials and Methods: This retrospective, longitudinal, analytical, and observational study included secondary data of children younger than 3 years from the Sicaya District, in the Huancayo province. Data were collected from health center medical records. Nutritional and anemia status, and socio-demographic characteristics of children receiving multi-micronutrient supplementation were recorded. Statistical analyses were based on generalized linear models. Results: Data of 76 children with available medical records were analyzed, and their pre- and post-intervention median ages were 6 and 11 months (range: 7–35 months), respectively. Significant positive linear correlations were observed between the number of multi-micronutrient doses and weight, height, and hemoglobin concentration. In bivariate and multivariate analyses, no significant associations were observed between anthropometric measurements and anemia (after multi-micronutrient intervention) (p>0.05), nor between the number of received doses of multi-micronutrients, sex, and age. Conclusion: Multi-micronutrient supplementation may be correlated with both physiological and anthropometric variables, but not with indicators of child development. These associations require further evaluations to determine whether social programs promoting multi-micronutrient supplementation improve the development of children with anemia

Preoperative dental treatment for children with cleft lip and palate

Introduction: Children with cleft lip and palate present diverse risk factors to dental caries and some differentiated needs concerning the dental treatment. This paper will describe the stages of definitive dental treatment before cheiloplasty, aiming at oral health adequacy for a child with cleft lip and palate. Material and methods: The paper will present a literature review with emphasis on the dental particularities and risk factors, including a case report to illustrate the preoperative dental treatment required before primary repair surgeries. Results and discussion: The male boy of African descent first attended HRAC-USP at the age of eight years, without previous treatment, presenting complete right cleft lip and palate. The intraoral clinical examination revealed presence of seveal carious lesions and need of extractions. The dental treatment planning comprised several sessions and was initiated by pediatric dental management, followed by anmalgam and glass ionomer restorations and tooth extractions, beginning by regions with smaller lesions and where local anesthetics causes less discomfort. The anterior teeth close to the cleft area were extracted under general anesthesia immediately before cheiloplasty. Conclusion: The definitive preoperative dental treatment with complete removal of carious tissue is fundamental for patients with cleft lip and palate, because dental caries is an infectious disease and, if present, it may contaminate the primary surgery and even compromise its outcomes.CAPE

The burden of mental disorders, substance use disorders and self-harm among young people in Europe, 1990-2019 : Findings from the Global Burden of Disease Study 2019

Background Mental health is a public health issue for European young people, with great heterogeneity in resource allocation. Representative population-based studies are needed. The Global Burden of Disease (GBD) Study 2019 provides internationally comparable information on trends in the health status of populations and changes in the leading causes of disease burden over time. Methods Prevalence, incidence, Years Lived with Disability (YLDs) and Years of Life Lost (YLLs) from mental disorders (MDs), substance use disorders (SUDs) and self-harm were estimated for young people aged 10-24 years in 31 European countries. Rates per 100,000 population, percentage changes in 1990-2019, 95% Uncertainty Intervals (UIs), and correlations with Sociodemographic Index (SDI), were estimated. Findings In 2019, rates per 100,000 population were 16,983 (95% UI 12,823 - 21,630) for MDs, 3,891 (3,020 4,905) for SUDs, and 89.1 (63.8 - 123.1) for self-harm. In terms of disability, anxiety contributed to 647.3 (432 -912.3) YLDs, while in terms of premature death, self-harm contributed to 319.6 (248.9-412.8) YLLs, per 100,000 population. Over the 30 years studied, YLDs increased in eating disorders (14.9%;9.4-20.1) and drug use disorders (16.9%;8.9-26.3), and decreased in idiopathic developmental intellectual disability (-29.1%;23.8-38.5). YLLs decreased in self-harm (-27.9%;38.3-18.7). Variations were found by sex, age-group and country. The burden of SUDs and self-harm was higher in countries with lower SDI, MDs were associated with SUDs. Interpretation Mental health conditions represent an important burden among young people living in Europe. National policies should strengthen mental health, with a specific focus on young people. Funding The Bill and Melinda Gates Foundation Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)Peer reviewe