Epidemiologia e saúde bucal coletiva: um caminhar compartilhado.

The public health dentistry is a way to bring oral health to Brazilian National Health System (SUS) and vice-versa. Thus, the epidemiology, in this context, it is one of the most important allies. In this article we intend to discuss the "shared walkway" between epidemiology and public health dentistry, through two views: first, we analyzed the efforts to establish methodological models for oral health sectional studies and the possibilities to construct a national data base. Second, we discussed how this knowledge has been transformed in a qualified scientific production presented in meetings and papers, which reflects, at the same time, about the contribution of this process in the consolidation of public health dentistry field. We concluded that this "shared walkway" was (and still is), influenced by political aspects, which, in different moments, leads to an improvement of public health dentistry. The oral health epidemiology has been established as a knowledge area, with regard to the scientific production in Brazil. At the same time, provide a tool that contributes to make oral health care models more appropriate to National Health System principles and, in other hand, make better the discussions about the social determinants of oral diseases.

Epidemiologia e saúde bucal coletiva: um caminhar compartilhado.

The public health dentistry is a way to bring oral health to Brazilian National Health System (SUS) and vice-versa. Thus, the epidemiology, in this context, it is one of the most important allies. In this article we intend to discuss the "shared walkway" between epidemiology and public health dentistry, through two views: first, we analyzed the efforts to establish methodological models for oral health sectional studies and the possibilities to construct a national data base. Second, we discussed how this knowledge has been transformed in a qualified scientific production presented in meetings and papers, which reflects, at the same time, about the contribution of this process in the consolidation of public health dentistry field. We concluded that this "shared walkway" was (and still is), influenced by political aspects, which, in different moments, leads to an improvement of public health dentistry. The oral health epidemiology has been established as a knowledge area, with regard to the scientific production in Brazil. At the same time, provide a tool that contributes to make oral health care models more appropriate to National Health System principles and, in other hand, make better the discussions about the social determinants of oral diseases.

Avaliação da capacidade de caminhar do portador de obesidade mórbida utilizando teste de caminhada de 6 minutos

Introduction: The ability to walk is impaired in obese by anthropometric factors (BMI and height), musculoskeletal pain and level of inactivity. Little is known about the influence of body adiposity and the acute response of the cardiovascular system during whole the 6-minute walk test (6mWT). Objective: To evaluate the effect of anthropometric measures (BMI and WHR waist-to-hip ratio), the effort heart and inactivity in ability to walk the morbidly obese. Materials and Methods: a total 36 morbidly obese (36.23 + 11.82 years old, BMI 49.16 kg/m2) were recruited from outpatient department of treatment of obesity and bariatric surgery in University Hospital Onofre Lopes and anthropometric measurements of obesity (BMI and WHR), pulmonary function, pattern habitual physical activity (Baecke Questionnaire) and walking capacity (6mWT). The patient was checking to measure: heart rate (HR), breathing frequency (BF), peripheral oxygen saturation, level of perceived exertion, systemic arterial pressure and duplo-produto (DP), moreover the average speed development and total distance walking. The data were analysed between gender and pattern of body adiposity, measuring the behavior minute by minute of walking. The Pearson and Spearmam correlation coefficients were calculated, and stepwise multiple Regression examined the predictors of walking capacity. All analyses were performed en software Statistic 6.0. Results: 20 obese patients had abdominal adiposity (WHR = 1.01), waist circumference was 135.8 cm in women (25) and 139.8 cm in men (10). Walked to the end of 6mWT 412.43 m, with no differences between gender and adiposity. The total distance walked by obesity alone was explained by BMI (45%), HR in the sixth minute (43%), the Baecke (24%) and fatigue (-23%). 88.6% of obese (31) performed the test above 60% of maximal HR, while the peak HR achieved at 5-minute of 6mWT. Systemic arterial pressure and DP rised after walking, but with no differences between gender and adiposity. Conclusion: The walk of obese didn´t suffers influence of gender or the pattern of body adiposity. The final distance walked is attributed to excess body weight, stress heart, the feeling of effort required by physical activity and level of sedentary to obese. With a minute of walking, the obeses achieved a range of intensity cardiovascular trainning

Avaliação das variáveis cardiovasculares, capacidade de caminhar e nível de atividade física de obesos mórbidos antes e depois da cirurgia bariátrica

Morbidly obese patients present an increase in heart rate, blood pressure and perceived exertion besides lower walking ability compared to normal weight people. However, little is known about how these variables are presented after bariatric surgery. Moreover, despite the distance walked during the six-minute walk (6MWT) improve after surgery is not well established if the level of physical activity influences this improvement. Objective: To evaluate cardiovascular performance, perceived effort, ability of walking and physical activity level of patients with morbid obesity before and after bariatric surgery. Methods: The cardiovascular performance, perception of effort, the ability to walk and level of physical activity were assessed in 22 patients before (BMI = 50.4 kg/m2) and after (BMI = 34.8 kg/m2) bariatric surgery through the 6MWT. The heart rate, blood pressure and perceived exertion were assessed at rest, at the end of the 6MWT and in the second minute post-test (HR recovery). The ability to walk was measured by total distance walked at the end of the test while the level of physical activity was estimated by applying the Baecke questionnaire, analyzing domains occupation, leisure and locomotion and leisure and physical activity. Results: The HR at rest and recovery decreased significantly (91.2 ± 15.8 bpm vs. 71.9 ± 9.8 bpm, 99.5 ± 15.3 bpm vs 82.5 ± 11.1 bpm, respectively), as well as all the arterial pressure and perceived exertion after surgery. The distance achieved by the patients increased by 58.4 m (p = 0.001) postoperatively. Time postoperatively had correlation with the percentage of excess weight lost (r = 0.48, p = 0.02), BMI (r =- 0.68, p = 0.001) and the Baecke (r = 0.52, p = 0.01) which did not happen with the distance walked (r = 0.37, p = 0.09). Despite weight loss, patients showed no difference in the level of physical activity in any of the areas before and after surgery. Conclusion: The cardiovascular performance, the perception of effort and ability to walk seem to improve after bariatric surgery. However, despite improvement in the ability to walk by the distance achieved in the 6MWT after weight loss, this is not reflected in an increase in physical activity level of obese patients after surgery