Satisfação dos usuários e qualidade dos tratamentos protéticos realizados nos centros de especialidades odontológicas da grande Natal RN

Aim: To evaluate user satisfaction and quality of prosthetic treatments performed in specialized dental clinics (CEOs) of Natal Metropolitan Region - RN. Methods: Cross-sectional study with subjects who underwent prosthetic CEOs in the cities of Natal, Macaíba, Parnamirim and Sao Goncalo do Amarante in the period 2007 to 2009. Data collection was performed by questionnaire, clinical examination of the oral cavity and examination of fabricated denture. This analysis involved the following aspects: retention, stability, aesthetics and prosthesis fixation. The variables are presented by means of absolute numbers and proportions. The determination of the association between the independent and dependent variables was conducted by the association of Chi-square test and Fisher exact test. Results: A total of 149 users, totaling 233 conventional dentures (148 upper and 85 lower). Most patients (56.4%) were rehabilitated with conventional complete dentures. The technical quality of the denture was regarded as satisfactory in the majority (52.7%), whereas the inferior dentures were rated as unsatisfactory in 90.5% of cases. Satisfaction with the prosthesis was 69.1% (N = 103). The average time to begin treatment was 3 months to receive while the prosthesis was 4 months old. The presence of injury from the upper prosthesis occurred in 21.5% of cases (N = 32), candidiasis being the most frequent (N = 18). The technical quality of the upper prosthesis (p=0,041), as well as retention (p=0,002) and stability (p<0,001) were significantly associated with user satisfaction. Conclusions: The specialized Dental clinics has been fulfilling its role of providing treatment of intermediate complexity for low-income population with the majority of satisfield patients, even when their dentures have problems of technical quality

Avaliação dos níveis de proteína C-reativa ultra-sensível em pacientes com periodontite crônica severa generalizada e sem periodontite

INTRODUCTION: The high sensitivity C-reactive protein (hsCRP) constitutes an inflammatory mediator used as predictor of cardiovascular risk that comes being researched as indicative relation factor between cardiovascular and periodontal diseases. PROPOSITION: To compare serumals levels of C-reactive protein between patients with and without generalized severe chronic periodontitis. METHODOLOGY: A seccional study was realized using a sample with 62 patients, being 31 participants carriers of periodontal diseases (Group I) and 31 without periodontal diseases (Group II), grouped to the pairs by age and sex. As inclusion criterio were selected patients with diagnosis of generalized severe chronic periodontitis, being preculeds, individuals which presented systemic disease, recent infection history, historical of CVA or stroke, smokers, pregnants and lactants. The research consisted of two stages, a clinc and other biochemist. The clinical stage is constituted of periodontal examination and the biochemist stage, of the peripheral blood collection for determination hsCRP levels and a hemogram to inquire any panel which could suggest infectious and/or inflammatory process. RESULTS: Periodontal disease group presented a average of 0,36mg/dL, while the group without disease presented 0,17 mg/dL, do not existing significant difference statistically between the averages (p = 0,061). The cardiovascular risk for the group I was classified high for 27,6% of participants and low for 72,4% of them. In the group II, 6,45% presented high risk e 93,5% low risk, being this significant relation statistically gotten for Fisher s Test (p = 0,042) presenting OR = 5,33; IC = 95% (1,02 27,4). The independets variables reseacred do not presented significant association statistically with the levels of hsCRP. CONCLUSION: The study indicated that despite of carriers patients of periodontal diseases do not present differents serumals levels of hsCRP from the other group, the periodontal disease was considered as risk factor for hsCRP plasmatic levels elevation

Análise quantitativa das células CD4 e sua importância no diagnóstico de lesões orais em pacientes HIV positivos

The oral manifestations due to HIV infection are, a lot of times, the first clinical signs of the disease. These injuries may also function as beepers and sentries of the curse and progression of the HIV infection and AIDS. The objective of this work was to evaluate the prevalence of the oral injuries in HIV positive patients, relating them with the CD4+ cells counting and the viral load in patients from the Hospital of Infected contagious Gizelda Trigueiro in Natal-RN. One hundred and one patients were evaluated, where after the clinical exam of the oral cavity, these ones were conducted to the peripheral blood collection for the counting of CD4+ lymphocytes. We observed a prevalence of 25,6%, that is, 31 cases. The Oral Candidiasis was the most commum injure, followed by Oral Hairy Leukoplakia, linear gingival erytema, lips herpes, gingivitis and periodontitis - HIV. The average counting of cells CD4+ of the injury carrying patients was of 250 cells/mm3. We did not observe relation between the presence of injuries and the viral load of the individuals

Avaliação de alterações orais em pacientes submetidos a transplante de medula óssea

Bone marrow transplantation (BMT) is currently the best therapeutic option for patients with hematologic diseases, solid tumors or autoimmune disorders. It is characterized by intravenous infusion of hematopoietic stem cells in order to restore marrow function. However, this procedure requires concomitant immunosuppression treatment, which favors the development of certain complications, often manifested in the oral cavity. This study aimed to evaluate the incidence of oral changes in patients undergoing BMT and to correlate these results with clinical aspects related to the patients and the transplants performed. This is a prevalence study, with cross-sectional design, carried out in a BMT service at the Institute of Onco-Hematology of Natal (ION) and Natal Hospital Center. Data collection was based on questionnaires, clinical examination of the oral cavity and consultation in the medical records. The sample consisted of 51 patients undergoing BMT. After the analysis, was found a general status with good health conditions and presence of oral changes in about half of patients who composed the sample. The manifestations observed were, in decreasing order of frequency: mucositis; gingival alteration and thrombocytopenic purpura; mucosal pigmentation; lichenoid reaction and candidiasis. The oral changes were observed more frequently in cases of allogeneic TMO, in different periods post-transplant, without significant differences related to the source of cells. It was found statistically significant association between the presence of graft-versus-host disease (GVHD) and oral changes (p < 0,001). Therefore, it is concluded that there is a relatively high incidence of changes in oral cavity of patients receiving bone marrow transplantation, a fact which confirms the need to consider this site for examination, diagnosis, treatment and prognosis of possible complications of BMT

Avaliação clínica da saúde bucal de crianças com neoplasias malignas atendidas no Hospital Infantil Varela Santiago em Natal-RN

The childhood cancer is characterized by a predominance of hematogenic and lymphatic system neoplasm, although a fTequency of the central nervous system tumors and sarcomas are widely common. Particularities of many childhood cancers and the adverses effect of the antineoplastic agents can change radically the oral environrnent and predisposes to the risk of oral complications. This study assessment clinically the oral health of 40 children on treatment for different types of malignant neoplasm with age range of O to 1S years old (Group I) and compared to 38 nonnal children in the same age range (Group lI). The results shown that nonnal patients had a gingival bleeding index (GBI) and caries experience minar than patients of Group lI, the visivel plaque index (VPI) was lightly higher in patients of Group 1. There was not difference statistically significant in the variables. Sixteen patients of Group I developed together 61 oral complications with predominance of mucositis, followed by spontaneous oral bleeding, candidiasis and xerostomy, that complication were most commons in patients with systemic neoplasm. Its was concluded that patients submitted to antineoplastic therapy with poor oral health had a higher risk to develop oral complications

Influência do tratamento periodontal sobre os níveis da proteína c-reativa ultrassensível em pacientes com insuficiência renal crônica em fase de prétransplante

The present study evaluated the influence of non-surgical periodontal treatment on the levels of C- reactive protein (hsCRP) in patients with chronic renal failure (CRF) in pretransplant. We conducted a controlled and randomized trial to evaluate the periodontal condition and plasma concentrations of hsCRP, albumin and transferrin in 56 dialysis patients divided into two groups: experimental and control. The study was conducted at the dental clinic of Family and Community Health s Unit (USFC), located in Onofre Lopes University Hospital (HUOL), Federal University of Rio Grande do Norte (UFRN), from December 2010 to November 2011. Severe periodontitis was the type of periodontal disease more common, affecting 78.6% of patients. Periodontal conditions, evaluated through the means of probing depth, clinical attachment level, bleeding index and plaque index, proved to be uniform for both groups at the initial examination. There were no differences in levels of inflammatory markers between the two groups. The analysis of the concentrations of hsCRP allowed classifying study participants as at high risk of developing cardiovascular disease. After completion of periodontal treatment in the experimental group, there was a statistically significant reduction of the mean of all periodontal parameters assessed; however this improvement of periodontal health was not accompanied by changes in the levels of hsCRP, albumin and transferrin in the evaluation time. Given this, the periodontal treatment did not promote the reduction of systemic inflammatory burden and risk of cardiovascular complications in patients with CRF

Perfil imuno-histoquímico do infiltrado inflamatório no front de invasão em carcicomas epidermóides de língua e lábio inferior

The progression of the oral squamous cells carcinomas (OSCCs) seems to suffer influence from related factors to the host, as local and systemic immunologic response, which are essential to the antineoplasic defenses. The purpose of this study was evaluate the local immunity in 30 tongue and 20 lower lip SCC by immunohistochemistry method, utilizing antibodies anti-CD3, CD4, -CD8, -CD25 e -ζ(zeta), which immunoexpressions were compared considering the anatomical localization, the intensity of the inflammatory infiltrate into the front of invasion and metastases. The CD4/CD8+ ratio was calculated for each case and associate with the mentioned variable, being the intensity of the inflammatory infiltrated also compared with the anatomical localization and metastase and for this the cases had been grouped in two categories: (n = 10) absent/scarce inflammatory infiltrate; and (n = 40) moderate/intense infiltrate. Fisher´s exact test was performed (α= 0.05) and it was not observed any significant correlation between these groups with anatomical sites and metastases. With regard to the immunoexpression, the CD3+, CD4+, CD8+ and CD25+ cells count was higher in the lower lip SCCs while the anti-ζimmunomarcation was more evident in the non metastatic cases. Through the statistical analyses, it was verified that the CD3 exhibited positive-significant correlation with the inflammatory infiltrate (p = 0.023). Furthermore, antibodies against CD8 and CD25 cells were also significantly correlated with the inflammatory infiltrate (p = 0.002 and 0.030, respectively) and with the anatomical site (p = 0.004 and p = 0.004) mainly in the lower lip SCCs. CD4/CD8 ratio did not show significant association with metastase nor with anatomical localization. We conclude that the inflammatory infiltrated of the Bryne s (1998) system did not constitute an indicator of aggressiveness in the tongue and lower lip SCCs analyzed and that clinical behavior of the SCCs studied was related in part to the immunohistochemical profile of infiltrated the inflammatory present in tumoral invasion front

Estudo dos efeitos comportamentais do neuropeptídeos em camundongos submetidos a modelos animais de Parkinson

Neuropeptide S (NPS) is the endogenous ligand of a G-protein coupled receptor. Preclinical studies have shown that NPSR receptor activation can promote arousal, anxiolytic-like behavioral, decrease in food intake, besides hyperlocomotion, which is a robust but not well understood phenomenon. Previous findings suggest that dopamine transmission plays a crucial role in NPS hyperactivity. Considering the close relationship between dopamine and Parkinson Disease (PD), and also that NPSR receptors are expressed on dopaminergic nuclei in the brain, the current study attempted to investigate the effects of NPS in motor deficits induced by intracerebroventricular (icv) administration of 6-OHDA and systemic administration of haloperidol. Motor deficits induced by 6-OHDA and haloperidol were evaluated on Swiss mice in the rota-rod and catalepsy test. Time on the rotating rod and time spent immobile in the elevated bar were measured respectively in each test. L-Dopa, a classic antiparkinsonian drug, and NPS were administrated in mice submitted to one of the animal models of PD related above. 6-OHDA injection evoked severe motor impairments in rota-rod test, while the cataleptic behavior of 6-OHDA injected mice was largely variable. The administration of L-Dopa (25 mg/kg) and NPS (0,1 and 1 nmol) reversed motor impairments induced by 6-OHDA in the rota-rod. Haloperidolinduced motor deficits on rota-rod and catalepsy tests which were reversed by L-Dopa (100 e 400 mg/kg), but not by NPS (0,1 and 1 nmol) administration. The association of L-Dopa 10 mg/kg and NPS 1 nmol was also unable to counteract haloperidol-induced motor deficits. To summarize, 6-OHDA-, but not haloperidol-, induced motor deficits were reversed by the central administration of NPS. These data suggest that NPS possibly facilitates dopamine release in basal ganglia, what would explain the overcome of motor performance promoted by NPS administration in animals pretreated with 6-OHDA, but not haloperidol. Finally, the presented findings point, for the first time, to the potential of NPSR agonist as an innovative treatment for PD.

Tontura em idosos institucionalizados da cidade do NATAL/RN: Um estudo caso-controle em vestibulopatas e não-vestibulopatas

the institutionalized elderly presents for being more fragile a lot of body balance s changes, which can induce falls and health frailty. One of the consequences of it is the appearance of dizziness, vestibular or not. This study aims to identify the risk factors related to dizziness in institutionalized elderly, with and without vestibular disorders, in the city of Natal-RN. Method: a case-control study realized in 12 regulated by Health Surveillance Long Term Care Institutions for the elderly in Natal-RN. Elected seniors with good cognitive level and able to walk, totaling 115 individuals, and of these, 102 were selected according to the presence of dizziness in the last year (n = 51) and their controls (n = 51), paired by sex and age. The 51 elderly patients with dizziness were divided into 3 groups case: case one, for elderly with dizziness and without vestibulopathy (n=38); case two, for elderly with dizziness and vestibulopathy (n=13) and case three, for all the seniors with dizziness, or added to the case 1 case 2 (n=51). The 51 seniors who served as controls were also divided into three groups, according to the number of individuals of each case: control 1, n = 38, control 2, n = 13 control and 3 (sum of 1 control with control 2), n = 51. As possible risk factors were analyzed variables related to characteristics of the institution, to the habits of life of older people and those concerned with the health of the elderly. For statistical analysis, we used the chi-square or Fisher exact test for a significance level of 5% and calculating the association magnitude between variables by measuring the Odds Ratio. Results: as risk factors for dizziness without vestibular disorders were found the presence of hypertension and cardiovascular disease, as well as the presence of three or more disorders for elderly and use of gastric protector drugs. For the elderly group from case two were found no associated risk factor. For elderly patients with dizziness in the case group three, we observed the same risk factors found for the elderly in the case group one, plus the presence of osteoarthritis pathology, which was also significant for this group. Conclusion: dizziness in institutionalized elderly is associated with systemic common diseases in this age group and the vestibulopathy presents itself as pathology on an isolated way, not being possible, with our data, associate it with non-risk factors

Análise da degradação ambiental das áreas de preservação permanente localizadas no estuário do rio Ceará-mirim/RN

The purpose of this paper is to identify and analyze the main environmental impacts taking place in the permanent preservation areas located in the Ceará-Mirim River estuary/RN and its surrounding areas. For that, the study was divided in two chapters, structured in the shape of a scientific paper. The first is a theoretical proposition on the occupation of the APPs in light of the discussion of the geographic space and the sustainability of the development, where a bibliographical review was made emphasizing the production of the geographic space, the sustainability of the development and the permanent preservation areas. In the second chapter, from a systemic approach, geoprocessing techniques and the adaptation of the Pressure-State- Response Indicators System were used, the latter being developed by the Organization for Economic Co-operation and Development OECD. Therefore, from the methodological approaches used, it's been observed that the use of permanent preservation areas for purposes other than those determined in the legislation and, mainly guided by capitalist interests, leads to the environmental degradation of these areas, fact which has been confirmed in the empiric study conducted in the second chapter, where it was possible to identify a series of environmental impacts such as: deforestation of mangrove and riparian vegetation for carciniculture implantation, the devastation of dune areas caused by the urban expansion in the coastal stretch and siltation of fluvial channel

Estudo epidemiológico da Toxoplasmose em gestantes atendidas na Maternidade Escola Januário Cicco, Natal, Rio Grande do Norte

Congenital Toxoplasmosis results in severe systemic disease. If mother is infected for the first time during gestation, she can infect the fetus causing substantial damage. However, relatively little is known about the seroprevalence and epidemiological and economic factors of Toxoplasmosis infection in pregnancy in the most state in northeastern Brazil and knowledge about this can be essential in determining effective and acceptable prevention strategies. Our aim was to determine the prevalence of Toxoplasmosis in pregnant woman consulted by reference Maternity Escola Januário Cicco in Natal, a city in Northeastern Brazil, which belongs to the public health system, correlating to the risk factors involved in the infection and to accomplish active Search in the Hospital of Pediatrics Profº Heriberto Bezerra of the damages caused by the Toxoplasmic infection in children up to 12 years of age. The study was conducted from March to December 2007 and sera obtained from 190 pregnant women were tested for IgM and IgG antibodies avidity to Toxoplasma by Microparticle enzyme immunoassay (Abbott AxSYM system - Abbott Laboratories, Chicago, IL, USA). Data were examined with univariate analysis. Chi-squared (x2) and Odds ratio was calculated (IC 95% p 0,05). Of these women, 126 (66,3%) had only IgG antibodies high-avidity against T. gondii; 01 (0,52%) had a IgM and IgG high-avidity antibodies against T. gondii and 63 (33,1%) have neither IgM nor IgG against T. gondii. Our studies shown that the direct contact with cats or dogs was highly associated with the Toxoplasma gondii infection (OR, 2.72, p<0.001, 95% CI 1.46 5.02). The years school (p<0,001), socioeconomic status and knowledge about the disease (both p value 0.05) also were associated with Toxoplasmosis. The pattern of risk factors for infection presents regional variations, however our data corroborate others studies in Brazil. In children up to 12 years, one case of Congenital Toxoplasmosis was just registered in seven years (2000 - 2006). There were several suggestive cases, with signs and characteristic symptoms, but that the infection was not confirmed due to lack in the researches through laboratorial and images exams that addressed that it zoonosis

Proposta de critérios adicionais para definição de Área Prioritária para Conservação no Semiárido brasileiro

Environmental changes and their consequences on the global level have challenged the different fields of study to integrate towards effective solutions to minimize and /or equate the negative impacts of these changes in different types of environments. In this context, the Environmental Perception has been a widely used and relevant in studies that consider the relationship between the environment and human actions, by allowing analysis of perceptions, attitudes and values, key influencers of topophilia that resonates in conservation tool. Allied to Environmental Perception, Integrated Analysis of the Landscape is relevant because it allows to analyze in a systematic way the geographical space where all its elements are interrelated in a way that supports needed to understand the complex physical and human environment of a given environment. In this perspective, we have studied the João do Vale Serrano Complex, located in semiarid of Rio Grande do Norte state, which features a set of landscapes with different faces, which are being replaced by various economic activities and disordered population growth, with consequent exploitation the potential of natural resources. This thesis main goal was to combine the Environmental Perception of rural communities to the of Serrano Complex Landscape Analysis as additional criteria for the definition of Priority Areas for Conservation. The perception data were collected through direct observation, questioning, interviews and application forms to 240 people (100 % of occupied households in the mountain community) during the months of february and august 2011, with theoretical and methodological basis Environmental Perception. Integrated Landscape Analysis was performed by GTP (Geosystem - Territory - Landscape) method, using the Geographic Information System (GIS), using the technique of GIS for mapping the landscape. The results showed that respondents have a sense of topophilia by where they live, hold a vast knowledge of the natural resources in this Serrano Complex, and responded positively regarding the choice of an exclusive area for conservation. The Integrated Analysis of Landscape possible to identify the different forms of existing uses and occupations in Serrano Complex, have caused significant changes in space, especially on the plateau where vegetation was virtually replaced by human dwellings and cashew plantations. Through the maps of slope and environmental vulnerability was identified that areas with high slopes (gullies) are limiting factor for occupation by communities and therefore relevant and amenable to conservation, including by being Permanent Preservation Areas. These results, together, made possible to define a map of Priority Areas for Conservation in Serrano Complex, with three priority categories: low, medium and high. Therefore, the use of these additional criteria are relevant for the definition /designation of Priority Areas for Conservation

Modelagem de vulnerabilidade de sistemas ambientais no municípo de Guadalupe/PI

In the Guadalupe city, with the arrival of the Boa Esperança Hydroelectric, the landscape of the municipal district lived important transformations. Those transformations continue growing today, now together with new vectors of territorial ordering, especially the agricultural industry. In front of the context of stability-instability of the environmental systems, it original of its natural vulnerability to the instability and of the transformations in the territorial dynamics of Guadalupe, the present research it analyzed and it mapped that municipal territory with relationship to the degrees of vulnerability of the environmental systems. Therefore, working a leaning methodology in a systemic perspective of the landscape and in the geoprocessing technique, the dissertation showed with thematic mapping, the most vulnerable and less vulnerable parts of the municipal district of Guadalupe, looking for a strategic vision of the problem.

Dinâmica costeira entre as praias de Areia Preta e do Forte, Natal/RN

The coastal zone has been studied worldwide with a focus on the coastal erosion. In the present days, much of the world's coastlines are being affected by erosion, which causes great damage to the economy. This work had as study case the beaches of Areia Preta, Artistas, Meio and Forte located in Natal in Rio Grande do Norte. It shows as result the monitoring of the beach strip that makes possible to obtain quantitative and qualitative data, allows the study of the coastal dynamics of the beaches and the Recovery Project of the Areia Preta beach interference on adjacent beaches. This research was guided by the integrated analysis method on the systemic perspective. The pratical procedures adopted were: bibliographic research; fieldwork during eleven months (environmental characterization, collection of hydrodynamic data, topographic leveling, collection of sediments) and; sedimentological analysis of samples collected. By monitoring of the points A, B, C, D and E we were able to find the occurrence of the coastal erosion on their biggest part except by the C and D profiles. It was noted the need for the government to complete the hydraulic fill, as it made only 60% of the landfill planed. It was found that the spikes built on the beach of Areia Preta are preventing the natural transport of sediments that the longshore performs towards South-North. This interference is causing the lack of sediment on the beaches of Forte and Meio and their coastal erosion in consequence