Impacto da cárie precoce severa na infância na qualidade de vida relacionada à saúde bucal de pré-escolares sob privação social

Early childhood caries, especially in its severe form, which is characterized by an acute and aggressive nature, can have negative impacts on thequality of life of a child, due to effects such as difficulty in chewing, decreased appetite, weight loss, insomnia, changes in behavior and a decreased performance in school, among others. Moreover, the quality of life of the child`s family can also be affected, as the pain and discomfort caused by this type of caries result in loss of working days of parents, spending on dental treatments, changes in sleep patterns and stress. The aim of this study was to evaluate the impact of severe early childhood caries in the Oral Health-Related Quality of Life (OHRQoL) of public daycares`s preschool children through the Escala de Impacto da Saúde Bucal na Primeira Infância, a Brazilian version of the Early Childhood Oral Health Impact Scale (ECOHIS). A single calibrated examiner (kappa=1.0) evaluated, through the dmfs index, the oral health of 116 children aged between 3 and 5, which were included in one of three study groups: "caries-free", "not-severe early childhood caries" and "severe early childhood caries". The parents responded to ECOHIS, to assess their perception regarding the OHRQoL of their children, and a questionnaire on socioeconomic conditions. The OHRQoL was measured through the total scores and domains of ECOHIS. Descriptive analysis, Mann-Whitney test, Kruskal-Wallis test, chi-square test and Poisson multiple regression with robust variance were used. Among the children observed, 38.8% were caries-free, 27.6% showed not-severe early childhood caries and 33.6% showed severe early childhood caries. Regarding the total score of ECOHIS, severe early childhood caries had a greater negative impact on OHRQoL, compared to caries-free and not-severe early childhood caries groups (p <0.001). Regarding the child subscale, there was significant difference between the "severe early childhood caries" group and the other groups in all domains, except for theone of self-image / social interaction. In the family subscale domains, there was statistical significance between the severe early childhood caries and the caries-free groups in all domains (p <0.001), whereas between the "severe early childhood caries and not-severe early childhood caries groups there was a statistically significant difference only in the domain of parental anguish (p <0.001). Multivariate analysis showed that early childhood caries and the parent`s age were significantly associated to OHRQoL (p <0.05), independently of the other variables in the model. The presence of severe early childhood caries resulted in greater negative impact on OHRQoL (AdjPR= 6.016; 95%CI = 3.12 11.56; p<0.001), while older parents reported better OHRQoL (AdjPR = 0.603; 95%CI = 0.428 - 0.850; p = 0.004). The presence of severe early childhood caries had a negative impact on OHRQoL of preschool children and their families.

Eosinófilos sanguíneos e fecais em crianças infectadas por helmintos e protozoários

Conselho Nacional de Desenvolvimento Científico e Tecnológico

Aleitamento materno e alimentação complementar em crianças menores de um ano: chamada neonatal, RN, 2010

Avaliar os dados de aleitamento materno e alimentação complementar de crianças menores de um ano, do Rio Grande do Norte (RN), de acordo com o que é preconizado pelas políticas e ações de alimentação e nutrição. Métodos: Foi analisado o banco de dados da Chamada Neonatal do RN, pesquisa realizada pelo Ministério da Saúde em 2010. A amostra analisada foi de 837 pares mãe/filho que responderam ao questionário da pesquisa nos municípios investigados. Foram analisadas a prevalência de dados de aleitamento materno exclusivo (AME), na primeira hora de vida, parcial (AMP) e total (AMT), assim como dos alimentos ingeridos, pelas crianças, nas ultimas 24 horas anterior a entrevista. As frequências e médias foram feitas pelo comando Complex samples, no SPSS® 20.0, com IC95%. Foram estimadas as medianas de tempo de AME e AMT, assim como a mediana de tempo de introdução dos grupos de alimentos consumidos, em relação a idade da criança pelo método de probitos. Foi feita associação das probabilidades de tempo de AME e AMT com as variáveis sociodemográficas e de pré-natal (p<0.05). Resultados: Foram encontradas médias de idades de 5,28 ± 3,4 meses e 25,9 ± 6,4 anos, para crianças e mães, respectivamente. A prática de aleitamento na primeira hora de vida foi considerada boa (66,6%) e o percentual de AME (20%) razoável,segundo a Organização Mundial da Saúde, 2008. Mais da metade das crianças (55,1%) estavam em AMP. No total 60% estavam sendo amamentadas (AMT) ao final do primeiro ano de vida. O AME teve mediana de 63 dias e AMT de 358 dias. Estes dados não se diferenciaram muito entre a capital e os municípios do interior. A maioria das mães entrevistadas (73,8%) referiu ter tido orientação sobre aleitamento no pré- natal, tendo associação (p=0,03) com a probabilidade de tempo de AME, porém com pouca explicabilidade (R2= 0,011). Água ou chá, alimentos lácteos, frutas, legumes e verduras foram introduzidos precocemente com medianas menores que 180 dias. O aleitamento tende a diminuir e os alimentos tendem a aumentar o consumo de acordo com a idade da criança, com aumento exponencial do grupo calorias vazias . Conclusões: Conclui-se que mesmo com maioria das crianças amamentadas até um ano de vida, poucas estavam em AME e introduziram alimentos precocemente, não tendo resultado satisfatório frente ao preconizado pelas políticas públicas de alimentação e nutrição

Concepções e práticas dos profissionais que atuam na educação infantil diante da violência doméstica contra crianças de zero a cinco anos

El estudio presenta el problema de la violencia doméstica contra los niños de hasta cinco años en el contexto de los centros municipales de Educación Infantil (CMEI) en la ciudad de Natal-RN. Constituye un análisis bajo el enfoque teórico y metodológico de carácter cualitativo, en vista de la totalidad, con la asunción de la violencia doméstica contra los niños en su guía sociales, legales, históricos y culturales con el tema. Tiene como objetivo investigar si los profesionales que trabajan en Educación Infantil son capaces de identificar las posibles situaciones de violencia doméstica contra los niños que están bajo su responsabilidad, e incluso si, en los casos de los casos sospechosos o reales de la identidad de saber que las referencias deben ser adoptadas. La ruta entre el conocimiento y el método establecido implica el análisis conceptual de la infancia, la educación infantil y violencia doméstica contra los niños, además de la realización de grupos focales con los participantes de la encuesta con sus registros en un diario de campo. Perciben a sí mismos para el estudio de las contradicciones en la lucha contra la violencia doméstica contra los niños. Incluso con los conocimientos teóricos sobre el tema, los profesionales no pueden dar referencias adecuadas para proteger a los niños y detener la violencia. Nos encontramos con que las condiciones objetivas del trabajo de los profesionales que trabajan en CMEI, asociados con poco conocimiento sobre el tema, no contribuyen a las referencias. Llegamos a la conclusión de que es necesario la participación de la Secretaría Municipal de Educación, sin olvidar que todas las acciones tienen limitaciones como la violencia doméstica contra los niños también se relaciona con problemas estructurales de la sociabilidad capitalista.

A Violência sexual contra crianças e adolescentes na Cidade do Natal: direitos garantidos ou negados?

This study presents the issue of sexual violence against children and adolescents in the city of Natal RN from a critical approach over the work carried out at the Delegacia Especializada em Defesa da Criança e Adolescente DCA, with the perspective towards guaranteeing their rights. It is constituted of an analysis under a theoretical-methodological focus, both quantitative and qualitative, taking as a premise the sexual violence against children and adolescents in its social, legal, historical, cultural and economical dimensions that are behind this issue. The established course between knowledge and methodology involved: a conceptual analysis of the sexual violence, a research in the official records of the Public Power, the application of questionnaires with the coordinators of social projects and programmes, the accomplishment of interviews with key institutional actors and mothers of victimized children and adolescents, besides the analysis of quantitative indicators from the data made available by the DCA. The research took place within the Delegacia Especializada em Defesa da Criança e Adolescente, and also took for reference the information from institutions that develop actions directed towards children and adolescents victims of sexual abuse. Through this study, the strategies and the contradictions existing in the struggle against sexual violence towards children and adolescents implemented by the Public Power were learnt, the need for a greater articulation was identified to guarantee their rights and it also allowed for the tracing of a panorama of the sexual violence against children and adolescents in the period from 2001 to 2004 in the city of Natal-RN

Ativação das células hepáticas estreladas e fibrose hepática em crianças portadoras de hepatite autoimune tipo 1: estudo imuno-histoquímico de biópsias hepáticas pareadas antes do tratamento e após a remissão clínica

The activation of hepatic stellate cells (HSC) is considered the most important event in hepatic fibrogenesis. The precise mechanism of this process is unknown in autoimmune hepatitis (AIH), and more evidence is needed on the evolution of fibrosis. The aim of this study was to assess these aspects in children with type 1 AIH. We analyzed 16 liver biopsy samples from eight patients, paired before treatment and after clinical remission, performed an immunohistochemical study with anti-actin smooth muscle antibody and graded fibrosisand inflammation on a scale of 0:4 (Batts and Ludwig scoring system). We observedthere was no significant reduction in fibrosis scores after 24± 18 months (2.5 ± 0.93 vs. 2.0± 0.53, P = 0.2012). There was an important decrease in inflammation: portal (2.6 ±0.74 vs. 1.3± 0.89, P = 0.0277), periportal/periseptal (3.0 ±0.76 vs. 1.4 ± 1.06, P = 0.0277), and lobular (2.8 ± 1.04 vs. 0.9± 0.99, P =0.0179). Anti-actin smooth muscle antibodies were expressed in the HSC of the initial biopsies (3491.93 ±2051.48 lm2), showing a significant reduction after remission (377.91 ±439.47 lm2) (P = 0.0117). HSC activation was demonstrated in the AIH of children. The reduction of this activation after clinical remission, which may precede a decrease in fibrosis, opens important perspectives in the follow-up of AIH.