Análise da eficiência do sistema de referência e contra-referência na odontologia pública municipal sul catarinense

Monografia apresentada ao Programa de Residência Multiprofissional em Atenção Básica / Saúde da Família, da Universidade do Extremo Sul Catarinense – UNESC, para obtenção do título de Especialista na Modalidade de Residência Multiprofissional em Atenção Básica / Saúde da Família.O presente estudo, apresenta como meta, analisar o funcionamento do sistema de referência e contra-referência na Odontologia Pública Municipal, de Criciúma – SC. A escolha do tema surgiu por meio da preocupação sobre a eficiência dessa estratégia na odontologia de Criciúma-SC e a justificativa do tema se dá pela necessidade de se analisar o funcionamento desse sistema. Foram comparados os encaminhamentos realizados por cirurgião dentista que possui pós-graduação, em residência multiprofissional, em atenção básica/Saúde da Família, e aquele que é encaminhado pelo cirurgião dentista que não possui pós-graduação na área, de modo a verificar se há distinção na forma de encaminhamento. A abordagem realizada para a pesquisa é de característica predominantemente quantitativa, por meio de um questionário estruturado, elaborado para investigar junto aos usuários, como é realizada a estratégia de referência e contra-referência de encaminhamentos para a especialidade de endodontia. Esta pesquisa foi do tipo descritivo, transversal e aconteceu nos seguintes locais: Centro de Especialidades Odontológicas (CEO) e nas Estratégias Saúde da Família (ESF) do Paraíso, Ana Maria, Mineira Velha e São Simão. A amostra foi universal (n=40), composta pelo número total de usuários encaminhados a especialidade de endodontia, pelas ESF, como também aqueles que tiveram suas contra-referências realizadas no período de abril de 2011 a julho de 2012. Os que aceitaram participar da pesquisa assinaram o Termo de Consentimento Livre e Esclarecido, conforme resolução 196/1996 do Conselho Nacional de Saúde. Os dados obtidos com as entrevistas foram devidamente tabulados, analisados e avaliados pelo programa de estatística SPSS versão 18.0, Windows, utilizando a estatística descritiva para obtenção das porcentagens, média, mínimo, máximo e desvio padrão (DP). Após os resultados foram confirmados conforme a necessidade através do teste Exato de Fisher ou Teste Qui-Quadrado de Pearson para frequência das variáveis categórigas dicotômicas. Para comparar as variáveis quantitativas foi utilizado o teste U, de Mann-Whitney para duas Amostras Independentes para a Comparação entre os grupos. Foi considerada como estatisticamente significativa as questões que obtiveram p<0,05 (*) e p<0,01 (#). Depois de realizados os testes estatísticos, os dados foram transferidos ao software Microsoft Excel versão 2007 para construção de gráficos. Concluiu-se que o grau de eficiência dos encaminhamentos dos usuários da atenção primária para a secundária foi muito satisfatório, onde os usuários foram bem esclarecidos e não tiveram dúvidas em relação ao atendimento no CEO de Criciúma-SC

The Influence of the First Thousand Days of Life on Establishing Determinant Behaviors for Dental Caries in Childhood

Objective: To study the influence of the first thousand days of life on establishing determinant behaviors for dental caries in childhood. Material and Methods: Longitudinal retrospective study involving 664 children born in 2009 living in a southern Brazilian municipality was carried out. Data was collected through interviews with mothers and through child’s health card. Dependent variables were 1) tooth brushing onset after two years of age; 2) absent tooth brushing or once a day; 3) tooth brushing without adult supervision; 4) not having gone to the dentist until the age of 6; and 5) seek for dental services due to toothache at 6 years of age, over the last 30 days. Bivariate and multivariate analyses were performed using Poisson Regression to estimate relative risks (RR) and respective confidence intervals at the 95% accuracy level. Results: Mothers with lower schooling at child’s birth presented a higher risk of “child’s tooth brushing onset only after two years of age”, “brushing the teeth once a day only or not brushing” and with “child not having gone to the dentist until the age of 6”. Mothers who did not have a job when the child was born were associated with “not having gone to the dentist until the age 6”. Children with gastroesophageal reflux who underwent hospitalization for more than 2 days under age 2 were associated with “seeking dental services because of pain at 6 years of age over the last 30 days”. Conclusion: Higher risks of some determinant behaviors related to dental caries were associated with variables of the period of the first thousand days of life

First Thousand Days of Child Life and the Development of Risk Factors for Malocclusions

Objective: To identify the association between individual and socioeconomic factors during the first thousand days of the child\u27s life and the occurrence of risk behaviors for the development of malocclusions. Material and Methods: Cross-sectional study. A sample of 655 6-year-old schoolchildren and families was included. Interviews with mothers were performed at home. The dependent variables were risk behaviors to the development of malocclusions. Independent variables were socioeconomic conditions, aspects of gestation, birth and health of the child up to two years of age. Bivariate and multivariate analyzes were performed through Poisson regression. Results: Maternal education of less than eight years was independently associated with the interruption of exclusive breastfeeding until the fourth month (PR=1.58 CI 95%; 1.07; 2.37). Occupation of the mother with income [PR=1.26; 1.02; 1.56)], occupation of the father without income [PR=1.46 (1.01; 2.14)] were associated fwith interruption of breastfeeding until the sixth month. Pregnancy in adolescence [PR=0.83 (0.70; 0.98)] and nursery attendance [PR=1.15 (1.02; 1.28)] were associated with bottle use. Nursery attendance [PR=1.27 (1.01; 1.59)], hospitalization in the first 29 days of life [PR=1.34 (1.01; 1.80)], occurrence of reflux [PR=1.30 (1.01; 1.70)] were associated with pacifier using. Conclusion: Variables related to the period of the first thousand days of life are associated with higher risk behaviors for the occurrence of malocclusions

Prevalence and Associated Factors of Dental Trauma in Six-Year-Old School-Children

Objective: To estimate the prevalence and associated factors of dental trauma in 6-year-old school children in the city of Palhoça, Brazil. Material and Methods: Cross-sectional study nested in a cohort study. It involved a representative sample of school children born in 2009, residing in the municipality and regularly enrolled in public and private schools (n = 1,102). Clinical data were obtained through oral exams. To evaluate the incisal overjet, the distance in millimeters was measured horizontally from the labial surface of the lower central incisor to the labial surface of the upper incisor. Bivariate analyses were performed using the Chi-square test, with a p-value &lt;0.05 considered statistically significant. Multivariate analyses using Poisson Regression were performed to identify independent associations between the prevalence and the independent variables studied. Results: Prevalence of dental trauma was 4.2% (95% CI 3.0-5.4). Dental trauma was statistically associated with studying in a private school (PR = 1.03; 95% CI 1.01-1.06) (p=0.016) and with inadequate lip coverage (PR = 1.08; 95% CI 1.01-1.14) (p=0.016). Conclusion: The prevalence of 4.2% of dental trauma in six-year-old children, associated with inadequate and greater lip coverage in children from private schools should be taken into account, since most teeth at this stage are newly erupted

Prevalence and Associated Factors of Dental Trauma in Six-Year-Old School-Children

Objective: To estimate the prevalence and associated factors of dental trauma in 6-year-old school children in the city of Palhoça, Brazil. Material and Methods: Cross-sectional study nested in a cohort study. It involved a representative sample of school children born in 2009, residing in the municipality and regularly enrolled in public and private schools (n = 1,102). Clinical data were obtained through oral exams. To evaluate the incisal overjet, the distance in millimeters was measured horizontally from the labial surface of the lower central incisor to the labial surface of the upper incisor. Bivariate analyses were performed using the Chi-square test, with a p-value &lt;0.05 considered statistically significant. Multivariate analyses using Poisson Regression were performed to identify independent associations between the prevalence and the independent variables studied. Results: Prevalence of dental trauma was 4.2% (95% CI 3.0-5.4). Dental trauma was statistically associated with studying in a private school (PR = 1.03; 95% CI 1.01-1.06) (p=0.016) and with inadequate lip coverage (PR = 1.08; 95% CI 1.01-1.14) (p=0.016). Conclusion: The prevalence of 4.2% of dental trauma in six-year-old children, associated with inadequate and greater lip coverage in children from private schools should be taken into account, since most teeth at this stage are newly erupted

First Thousand Days of Child Life and the Development of Risk Factors for Malocclusions

Objective: To identify the association between individual and socioeconomic factors during the first thousand days of the child's life and the occurrence of risk behaviors for the development of malocclusions. Material and Methods: Cross-sectional study. A sample of 655 6-year-old schoolchildren and families was included. Interviews with mothers were performed at home. The dependent variables were risk behaviors to the development of malocclusions. Independent variables were socioeconomic conditions, aspects of gestation, birth and health of the child up to two years of age. Bivariate and multivariate analyzes were performed through Poisson regression. Results: Maternal education of less than eight years was independently associated with the interruption of exclusive breastfeeding until the fourth month (PR=1.58 CI 95%; 1.07; 2.37). Occupation of the mother with income [PR=1.26; 1.02; 1.56)], occupation of the father without income [PR=1.46 (1.01; 2.14)] were associated fwith interruption of breastfeeding until the sixth month. Pregnancy in adolescence [PR=0.83 (0.70; 0.98)] and nursery attendance [PR=1.15 (1.02; 1.28)] were associated with bottle use. Nursery attendance [PR=1.27 (1.01; 1.59)], hospitalization in the first 29 days of life [PR=1.34 (1.01; 1.80)], occurrence of reflux [PR=1.30 (1.01; 1.70)] were associated with pacifier using. Conclusion: Variables related to the period of the first thousand days of life are associated with higher risk behaviors for the occurrence of malocclusions

Protective effect of Melissa officinalis aqueous extract against Mn-induced oxidative stress in chronically exposed mice

AbstractManganese (Mn) is an essential element for biological systems; however occupational exposure to high levels of this metal may lead to neurodegenerative disorders, resembling Parkinson's disease (PD). While its mechanisms of neurotoxicity have yet to be fully understood, oxidative stress plays a critical role. Thus, the main goal of this study was to investigate the efficacy of aqueous extract of Melissa officinalis in attenuating Mn-induced brain oxidative stress in mice. Sixteen male mice were randomly divided into two groups and treated for 3 months: the first group consumed tap water (control group) and the second group was treated with Mn (50mg/kg/day for habituation during the first 15 days followed by 100mg/kg/day for additional 75 days) in the drinking water. After 3 months both groups were sub divided (n=4 per group) and treated for additional 3 months with Mn and/or M. officinalis in the drinking water. The first group (control) was treated with water and served as control; the second group (M. officinalis) was treated with M. officinalis (100mg/kg/day); the third group was treated with Mn (100mg/kg/day); the fourth group (Mn+M. officinalis) was treated with both Mn and M. officinalis (100mg/kg/day each). Mn-treated mice showed a significant increase in thiobarbituric acid reactive species (TBARS) levels (a marker of oxidative stress) in both the hippocampus and striatum. These changes were accompanied by a decrease in total thiol content in the hippocampus and a significant increase in antioxidant enzyme activity (superoxide dismutase and catalase) in the hippocampus, striatum, cortex and cerebellum. Co-treatment with M. officinalis aqueous extract in Mn-treated mice significantly inhibited the antioxidant enzyme activities and attenuated the oxidative damage (TBARS and decreased total thiol levels). These results establish that M. officinalis aqueous extract possesses potent antioxidative properties, validating its efficacy in attenuating Mn-induced oxidative stress in the mouse brain

SUPERJOY : A CRIAÇÃO DE UM GAME PARA ALFABETIZAÇÃO NA PÓS-PANDEMIA

This work presents the process of building the Educational Game Super Joy, aimed at helping public school students who have difficulties to become literate, as a result of the social isolation that occurred during the Covid-19 pandemic. This production is an integral part of the ongoing research “Alfabeclicando: Reforço Escolar de Alfabetização with Use of Educational Games”, which is being developed by the Instituto Superior de Educação do Rio de Janeiro (ISERJ), linked to the Fundação de Apoio à Escola Técnica do Estado of Rio de Janeiro (FAETEC) and the Municipal Department of Education of Rio de Janeiro (SME/RJ), represented by its unit Ginásio Experimental Tecnológico (GET) Elza Soares, with support from the Carlos Chagas Filho Foundation for Research Support of the State of Rio de Janeiro (FAPERJ). As partial results, we observed that the proposal to build games with and for children has proved to be an effective pedagogical strategy in the elaboration of a school reinforcement that does not reproduce traditional activities, but seeks to offer them innovative and meaningful learning. As partial results we have: the elaboration of the two fundamental guidelines for the creation of Educational Games of Literacy in Research, which are: 1. There must be a balance between the pedagogical aspects and the technical aspects in the produced games and 2. The Games production process Educational must contain spaces of authorship for children to participate in its elaboration.Este trabalho apresenta o processo de construção do Game Educativo Super Joy, destinado a ajudar alunos do ensino público que apresentam dificuldades para se alfabetizarem, em consequência do isolamento social ocorrido durante a pandemia de Covid-19. Esta produção é parte integrante da Pesquisa em andamento “Alfabeclicando: Reforço Escolar de Alfabetização com Uso de Games Educativos”, que está sendo desenvolvida pelo Instituto Superior de Educação do Rio de Janeiro (ISERJ), vinculado à Fundação de Apoio à Escola Técnica do Estado do Rio de Janeiro (FAETEC) e a Secretaria Municipal de Educação do Rio de Janeiro (SME/RJ), representada pela sua unidade Ginásio Experimental Tecnológico (GET)  Elza Soares, com apoio da Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ). Como resultados parciais, observamos que a proposta de construção de games com e para crianças tem se mostrado como uma estratégia pedagógica eficaz na elaboração de um reforço escolar que não reproduza atividades tradicionais, mas que busque oferecer a elas aprendizagens inovadoras e significativas. Como resultados parciais temos: a elaboração das duas diretrizes fundamentais para a criação de Games Educativos de Alfabetização na Pesquisa, que são: 1. Deve haver equilíbrio entre os aspectos pedagógicos e os aspectos técnicos nos games produzidos e 2. O processo de produção dos Games Educativos deve conter espaços de autoria para as crianças participarem de sua elaboração

Cirurgia endoscópica intrarrenal combinada (ECIRS) em posição galdakao-valdívia modificada: um relato de caso / Endoscopic combined intrarenal surgery (ECIRS) in galdakao modified supine valdivia position: a case report

Introdução: A nefrolitíase é uma patologia de alta prevalência. Possui importante morbidade por complicações agudas, relacionadas a obstrução de vias urinárias e quadros de insuficiência renal, bem como quadros infecciosos que podem evoluir à sepsis. Classicamente seu tratamento é cirúrgico e tem-se a nefrolitotomia percutânea (NPC) como padrão ouro para cálculos renais maiores que 2 cm.  Relato de caso: Paciente masculino, 48 anos, com repetidos quadros de infecção urinária. A investigação foi realizada com exames laboratoriais e de imagem. Possui sobrepeso, hipertensão leve, sem outras comorbidades. Apresentando cálculo coraliforme, complexo à esquerda, foi submetido a abordagem endoscópica combinada, ureteroscópica e percutânea em posição supina modificada, com completa extirpação de cálculos, com alta no segundo dia de pós-operatório, retornando em 45 dias para retirada de duplo jota, com boa evolução