A influência do tempo de diálise e do paratormônio sobre as condições clínico-radiográficas bucais de indivíduos com insuficiência renal crônica em diálise

Universidade Estadual do Rio Grande do Norte

Construção e validação de instrumento simplificado para diagnóstico de disfunção temporomandibular em pacientes adultos

As disfunções temporomandibulares (DTM) representam a maior causa de dor não dentária da região orofacial. Dada sua alta prevalência na população em geral e a existência de inúmeros instrumentos diagnósticos não padronizados, buscou-se elaborar e validar um questionário simples, de acessibilidade ampla e aplicação prática, com vistas a contribuir para o diagnóstico e o estudo epidemiológico das mesmas. A estratégia utilizada na montagem do instrumento foi estabelecida com base na avaliação criteriosa de questionários já existentes na literatura, validação de expertos na área de DTM, validação fatorial, de face (na primeira fase do estudo) e, frente ao padrão ouro (RDC/TMD), na segunda fase do estudo. Na primeira fase, participaram 160 indivíduos. A consistência interna resultou num Coeficiente Alfa de Cronbach de 0,752 para o questionário com sete itens; enquanto que para o questionário com cinco itens, este resultado foi de 0,694, não sendo o mesmo, considerado baixo por avaliar apenas cinco questões e ainda, em razão do tema central da pesquisa ser bastante subjetivo. A análise fatorial confirmatória apontou para uma variância total dos fatores extraídos do questionário com sete itens, de 58,2 % e do questionário com cinco itens de 70,04%. Portanto, o questionário com cinco questões, apresentou resultados estatísticos superiores ao de sete questões. Na validação frente ao padrão ouro (RDC/TMD), foram avaliados 99 indivíduos tendo sido testados os dois questionários, com sete e com cinco questões. Na estrutura com sete questões, ao se categorizar as mesmas por totais de pontos obtidos, em quatro condições, obteve-se o melhor resultado quando se considerou com DTM a faixa entre 10 e 21 pontos, sendo 85,1% positivos também no RDC/TMD, com acurácia de 90,1% e Kappa 0,817. Nesta condição, a sensibilidade encontrada foi de 95% (IC 95%, 91 a 99), especificidade de 87% (IC 95%, 81 a 93), VPP 85%, VPN 96%, LR+ 7,3 e LR- 17,4. Quando os dados foram avaliados para o questionário com cinco questões (QST/DTM), pode-se observar que o melhor ponto de corte foi quando se considerou como portadores de DTM, os indivíduos na faixa entre 7 e 15 pontos, com acurácia de 85,8% e Kappa 0,817. Nesta condição, a sensibilidade foi 88% (IC 95%, 81,6 a 94,4), especificidade 84% (IC 95%, 76,8 a 91,2), VPP 80%, VPN 90,5%, LR+ 5,5 e LR- 7,0. A simplicidade do presente questionário (QST/DTM) com apenas cinco questões, possibilita seu uso como elemento de triagem inicial na área da dor orofacial em disfunção temporomandibular, com boa compreensibilidade, confiabilidade, reprodutibilidade e possibilidade de aplicação em pesquisas epidemiológicas. Concluiu-se que o questionário aqui validado, permite sua aplicação de forma simples tanto por profissionais e pesquisadores da Odontologia como de outras áreas da saúde

Perfil periodontal de pacientes portadores de alterações endócrino-metabólicas

Objective- Convinced that periodontium, many times, can show alterations in human health, the aim of these studies was to investigate the periodontal situation in patients with endocrine-metabolic disorders such as, Berardinelli-Seip Syndrome, hyperthyroidism, hypothyroidism and acromegaly. Methods- Eight patients with Berardinelli-Seip Syndrome, 16 acromegalics, 30 hypothyroids, 30 hyperthyroids, and a control group with 35 patients were evaluated. Clinical attachment loss, probing depth, gingival bleeding index, gingival overgrowth and Index of Decayed, Missing and Filled Teeth were measured in each patient. All ethical aspects were rigidly observed, being the study conducted after its approval by the University of Fortaleza Research Ethics Committee. Results- The presence of periodontitis was marked in hyperthyroids and in patients with Berardinelli-Seip Syndrome. Hypothyroids showed not much presence of periodontitis, while all acromegalics presented absence of periodontitis. Conclusions- The protective effect of periodontitis in acromegalic patients is a new finding, whose mechanisms are not yet clear, but may be related to the anabolic effects of growth hormone. The presence of periodontitis in Berardinelli-Seip Syndrome may occur due the early onset of diabetes. In hyperthyroids, the high prevalence of periodontitis could be linked to thyroid hormones effects on bone, explaining also the minor prevalence in hypothyroids

Medidas de parâmetros morfológicos e funcionais do Coração em brasileiros: um subestudo do primeiro registro multicêntricos latino-americano em ressonância magnética cardiáca

There is no data about cardiac measurements em Brazilians obtained by CMR. This a muldisciplinary study with the objective of obtaining measurements of the left ventricle (LV) and right ventricle (RV) diastolic diameter (Dd), systolic diameter (Ds), diastolic volume (Dv), systolic volume (Sv), ejection fraction (EF) and myocardial mass in Brazilians. One hundred and seven (54 men and 53 women, mean age of 43.4 ± 13.1 years) asymptomatic individuals without heart disease were submitted to cardiac magnetic resonance (cMR) studies using steady state free precession technique. The means and standard deviations of the parameters of the LV and RV were respectively: LVDD = 4,8 ± 0,5 cm; LVSD = 3,0±0,6 cm; LVDV = 128,4±29,6 ml; LVSV = 45,2±16,6 ml; LVEF = 65,5±6,3%; LV mass = 95,2±30,8.1 g; RVDD = 3,9±1,3 cm; RVSD = 2,5±0,5 cm; RVDV = 126,5±30,7 ml; RVSV = 53.6±18,4 ml; RVEF = 58.3±8,0.0% and RV mass = 26,1±6,1 g. The masses and volumes were significantly higher in men, except for the LVSV. The RV EF was significantly higher in women. There was inverse correlation between RV systolic volume and with age, being more significant in men. This study describes for the first time benchmarks for cardiac measurements obtained by CMR among asymptomatic Brazilians individuals without heart disease and demonstrated differences according to sex and age

Registro da informação sobre nascidos vivos no nordeste: uma avaliação da evolução do SINASC entre 2000 e 2010

Os nascimentos ocorridos em uma população consistem em informação de grande valia para diversos estudos e planejamento de políticas públicas. O Sistema de informações sobre Nascidos Vivos (SINASC) representa uma promissora fonte de informação sobre o tema, uma vez que coleta continuamente e no âmbito municipal, dados sobre nascimentos. Tendo em vista a necessidade de avaliação contínua do SINASC e o panorama do declínio da fecundidade no Nordeste, objetivou-se avaliar a qualidade das informações provenientes do SINASC para o Nordeste, estados e microrregiões, nos anos 2000 e 2010, utilizando o Censo Demográfico como informação de referência, avaliando a cobertura do SINASC e identificando níveis e padrões de fecundidade. Pretendeu-se ainda verificar a relação entre os níveis de fecundidade, o grau de cobertura do SINASC e as condições socioeconômicas das microrregiões sintetizadas pelo Índice Social de Desenvolvimento Municipal (ISDM), utilizando-se a análise de cluster, associada à análise de variância (ANOVA) e o teste de Tukey. Por último, analisou-se a incompletude no preenchimento dos campos da Declaração de Nascido Vivo (DNV). De acordo com os resultados, observou-se que houve ampliação da qualidade das informações do SINASC no período estudado, resultando em uma maior aproximação das TFTs oriundas das duas fontes de dados consideradas no estudo. Maranhão e Paraíba foram os estados com maiores ganhos em cobertura das TFTs no período, e os estados do Rio Grande do Norte e Sergipe revelaram um grau de cobertura ligeiramente inferior em 2010 frente aos resultados de 2000, bem como ainda persistem várias microrregiões com TFTs oriundas do SINASC bem abaixo daquelas estimadas pelo Censo. Na verificação da associação entre o ISDM, TFTs e cobertura, a análise de cluster resultou em três agrupamentos, GrISDM A com melhores coberturas, ISDM e mais baixas TFT; GrISDM B , intermediário e GrISDM C com piores coberturas, ISDM e TFT mais altas. Notou-se a evolução das condições socioeconômicas no Nordeste, tendo o GrISDM A passado de 8% do total de microrregiões em 2000 para 37% em 2010. Reiterou-se ainda que quanto melhores as condições socioeconômicas de uma população, menores são as TFTs e melhores as coberturas do SINASC. A análise de variância apontou interações significativas entre o ano estudado versus ISDM (p-valor < 0,016) e o ano versus fonte de informação (p-valor < 0,020), e o teste Tukey apontou que não houve similaridade entre as médias das TFT das fontes Censo versus SINASC no período, fato que aponta para a captação ainda deficiente do SINASC nas microrregiões. O resultado da análise de variância da cobertura do SINASC em relação ao Censo apresentou uma interação significativa entre as variáveis UF versus Ano (p-valor < 0,0001), causada pelos estados que apresentaram queda de cobertura entre 2000 e 2010. Quanto à incompletude dos itens da DNV, evidenciou-se uma melhor coleta no período, embora alguns itens ainda careçam de atenção, como o apgar no 1º e 5º minuto e ocupação da mãe, sendo esta a que apresenta maiores percentuais de informações ignoradas. Destaca-se a possibilidade de preenchimento inconsistente nas variáveis referentes ao histórico de gestações anteriores, com o uso da informação zero inserida no lugar da informação ignorado . Concluiu-se que o SINASC é uma importante base de dados sobre nascimentos e que dispõe de dados confiáveis para o acompanhamento dos nascimentos e de seu panorama epidemiológico no Nordeste brasileiro, embora para alguns estados, assim como para algumas microrregiões, ainda faz-se necessária a ampliação da cobertura do Sistema. As informações constantes na DNV podem servir como embasamento para diversos estudos sobre as condições epidemiológicas dos nascituros e das suas mães, e dos indicadores baseados as informações dos nascimentos

Registro da atuação do movimento dos atingidos por barragens nos reassentamentos de Acauã: a alfabetização de jovens e adultos

This work contains the problematic of sub-education among the population that was excluded from school attendance in the regular time, contributing to knowledge production about educational practices developed in EJA (the Young and Adult Education). It focuses on the Pedagogical proposal and on the experience in young and adult literacy in the context of the mobilization of people affected by dam building. It depicts the international, national and regional mobilization against huge dams building and the emergence of the Movement of Dam Affected People (MAB), highlighting their general project and registering their teaching performance, particularly in young and adult literacy. In methodological and theoretical approaches, two interconnected categories are considered: the historical entirety, essentially theoretical, and the young and adult education practice. Based on the entirety, it outlines a contextualized explanation about the stakeholder s situation and, respecting the second category, which is part of the first one, places literacy as one of the basic aspects of an omnilateral man upbringing. The study broaches a wide context of dams in the world, placing the socio-environmental effects resulting from dams building in Brazil, in Northeast region and in Paraíba, and emphasizing the consequences of Acauã Dam building in the Paraíba cities of Aroeiras, Itatuba and Natuba. It presents the particular context of the population affected by Acauã, summarizing a panoramic view about the involved Paraíba cities and learning the conditions of residents relocation. It appraises the educational project and the National-MAB literacy proposal, operationalized by Paraíba-MAB in resettlements sited on Acauã s surroundings. It ensures that, besides public policies including financing, the feasibility of literacy problem solution can be completed with Pedagogical actions attached to the target people peculiarities and immediate necessities, respecting actions connected through one comprehensive and contextualized educational project. It evaluates the young and adult literacy project developed in the restricted Paraíba-MAB area, as an example of a Pedagogical action minimally contextualized. Eventually, it recommends researchers and teachers in general, that are committed to this work perspective, to pay attention to the way they articulate discussions and participation, so as to contemplate these communities expectations and necessities in Pedagogical projects and spaces based on discussion, dialogue and collective reflection

Registro de enfermagem no prontuário em um hospital universitário: uma busca pela humanização do cuidado

T he aim of this study is to analyze the view of nurses about nursing records in the patient chart, in perspective of the record of humanized care. This is a case study, with qualitative approach. For its achievement, was sought and granted authorization from the direction of the Hospital Universitário Onofre Lopes (HUOL) and the Ethics Committee in Research of HUOL as Statement No. 422/10. During data collection, interviews were conducted with 20 nurses of the institution. The data analysis was based on the theoretical framework of Minayo to thematic content analysis, grounded in authors who work with themes, nursing records and quality care. With the empirical material, we constructed a framework of analysis, which was identified four categories thus nominated, "Reading and learning from those who register," "nursing records and quality of care," "the essence of nursing records" and "intention and action on the record of the subjective aspects of the patient." The results show that the records are insufficient, even in the case of the procedures performed with the patients often do not inform about the aspects that deal with the subjectivity that surround it, and admit that the records do not represent a parameter for evaluating the quality of care at least at that institution. In summary, the respondents recognize the importance of valuing subjectivity of the patient in their treatment, yet admit to neglect this aspect as significant for comprehensive health care, humane and quality

Análise de Handover inter e intra-célula em um sistema de telefonia celular através de método de medição simplificado

This dissertation has the purpose to present a portable device named PlugData MG100G, equipped with a cellular module, to analyze the radiofrequency coverage in a GSM network situated in João Pessoa city, state of Paraíba, at four distinct regions. The equipment, originally, was developed to be used in fixed environments, so it was adapted so that it could be used in conditions of mobility. From the Mobile Measurement Reports (MMRs) RF coverage and the handover process are analyzed. The MMRs enable the identification of the serving cell and the list of the closest neighboring cells monitored by the mobile. This work analyses only data referent to the serving cell and the two closest neighboring cells. Inter-cell and intra-cell handovers are identified. The frequency planning and quality of service offered by the network related to the regions are discussed as well

Efeitos da eletroestimulação percutânea na incontinência urinária e qualidade de vida pós-prostatectomia: registro de seis casos

Introduction: Radical prostatectomy surgery is the best treatment currently adopted by detecting prostate cancer. The urinary incontinence is one more common and difficult to treat postoperative complications, which causes a negative impact on quality of life of the individual prostatectomy . The surface electrical nerve stimulation involves the transmission of electrical impulses from an external stimulator for peripheral nerve through surface electrodes attached to skin. It is an easy and efficient technique, widely used for pain relief, rehabilitation and muscle strengthening. Objective: To analyze the effect of T10-L2 percutaneous electrical stimulation, in individuals with urinary incontinence who underwent radical prostatectomy by the laparoscopic technique. Methods: Six patients had previously undergone radical prostatectomy were submitted to 20 sections of surface electrical stimulation with frequency of 4 Hz, pulse width of 1ms during 20 minutes. All subjects fillid a quality of life - International Consultation on Incontinence Questionnaire- Short FormI - ICIQ-SF questionnaire evaluating. Results: Results showed reduction in the use of the number of pads, number of leaks before and after treatment, and reduced voiding frequency and consequent improvement in quality of life. No side effects were reported. Conclusion: Percutanous electrical stimulation in T10-L2 may be an effective technique to treat urinary incontinence (UI) after radical prostatectomy video laparoscopy

Controle profissional de biofilme dentário como estratégia para manutenção da saúde periodontal de pacientes com aparelho ortodôntico fixo: análise comparativa entre diferentes períodos

The presence of fixed orthodontics appliances interfere on sanitation, allowing periodontal diseases to appear, despite the fact patients keep on visiting the dentist every month. This research aims to determine a protocol for the mechanical control of the dental biofilm performed by the professional. A protocol that was able to maintain the periodontal health of the patients under orthodontic treatment with fixed appliances, and in order to do so, it used a non-controlled, randomized and blind clinical essay. The sample involved 40 adolescents who were under the installation of fixed orthodontics appliances and it was divided in three groups, as follows: monthly controlled group (group 1) composed of 11 patients, the quarterly controlled group (group 2) with 16 patients and the semestrial controlled group (group 3) with 13 patients. For data collection, an interview and clinical exams with probing depth measurement, quantity of keratinized mucosa, Gingival Index and the Plaque Index were used. On the initial exam all patients received brushing guidelines as well as the professional control of dental biofilm, with periodontal scaler, Robinson s brush and prophylactic paste. However, Group 1 returned every month for control procedures; Group 2 every three months and Group 3 after six months. The intervention had a six-month duration (for all the three groups), when all the exams were repeated by another examiner who did not know which group each patient was inserted in. Finally, the research concluded that despite the fact there is no statistically significant difference among the three groups, clinically the patients from the monthly group presented a better response to professional control, with less accumulation of dental biofilm and less rate of gingival inflammation. Thus, the mechanical control of the dental biofilm performed by the professional could not avoid gingival increase, characterized by the raise of probing depth measurement, neither the quantity of keratinized mucosa

Adesão de células mesenquimais da medula óssea de camundongos e do ligamento periodontal de ratos a diferentes superfícies de titânio: estudo comparativo in vitro

The present experiment used cell culture to analyze the adhesion capacity of mouse mesenchymal bone marrow cells and rat periodontal ligament to different titanium surfaces. Grade II ASTM F86 titanium discs 15mm in diameter and 1.5mm thick were used and received 2 distinct surface treatments (polished and cathodic cage plasma nitriding). The cells were isolated from the mouse bone marrow and rat periodontal ligament and cultured in α-MEM basic culture medium containing antibiotics and supplemented with 10% FBS and 5% CO2, for 72 hours at 37ºC in a humidified atmosphere. Subculture cells were cultured in a 24-well plate with a density of 1 x 104 cells per well. The titanium discs were distributed in accordance with the groups, including positive controls without titanium discs. After a 24-hour culture, the cells were counted in a Neubauer chamber. The results show that both the mouse mesenchymal bone marrow cells and rat periodontal ligament cells had better adhesion to the control surface. The number of bone marrow cells adhered to the polished Ti surface was not statistically significant when compared to the same type of cell adhered to the Ti surface treated by cathodic cage plasma nitriding. However a significant difference was found between the control and polished Ti groups. In relation to periodontal ligament cell adhesion, a significant difference was only found between the control and plasma-treated Ti surfaces. When comparing equal surfaces with different cells, no statistically significant difference was observed. We can therefore conclude that titanium is a good material for mesenchymal cell adhesion and that different material surface treatments can influence this process

Doença periodontal e angina pectoris estável: um estudo caso-controle

The search which it aim was to analyze the Periodontal Disease as a risk factor for the development of the Stable Angina Pectoris. For that, 120 patients (52 blokes and 68 wenches ), ages ranging from 40 to 65 years old, and attended to the Hemodinamic´s Sector of the Natal Hospital Center, showing the historic of Angina Pectoris to accomplishment of cinecoronariografhy. Before the accomplishment of this exam, the patients were submitted to interview, to investigate the possible risk factors for the Cardiovascular diseases , and it was followed of clinical periodontal examination to evaluate the presence of Periodontal Disease. After the cinecoronariography, the patients who presented diagnosis of important arterial obstruction (above 70%) were enrolled to the case grup. However the individuals with arteries free of obstruction, or obstrution below 30%, were considered without historic of Cardiovascular disease and therefore enrolled for the control grup. The groups were paired by the variables age and gender. From the analysis of the results, a did not observed statisticment the significant association between the presence of the Periodontal Disease, probing depth, periodontal attachment level, severity and extension index of the Periodontal Disease, besides the visible plaque index (VPI) an gingival bleeding index (GBI) regarding to the existence of Stable Angina Pectoris. Nevertheless , it was identified statisticment the significant association between the sistemic arterial hypertension , seric level of total cholesterol, LDL, HDL and triglycerides, showing all of them, classic risk factors appointed by the literature. Therefore, it was conclued that Periodontal Disease did not represent association with the StableAngina Pectoris at least among the studied population

A influência da criopreservação nas células mesenquimais indiferenciadas do ligamento periodontal de humanos análise comparativa in vitro

Cryopreservation is a process where cells or biological tissues are preserved by freezing at very low temperatures and aims to cease reversibly, in a controlled manner, all the biological functions of living tissues, i.e., maintain cell preservation so that it can recover with high degree of viability and functional integrity. This study aimed to evaluate the influence of cryopreservation on the mesenchymal stem cells originating from the periodontal ligament of human third molars by in vitro experiments. Six healthy teeth were removed and the periodontal cells grown in culture medium containing α-MEM supplemented with antibiotics and 15% FBS in a humidified atmosphere with 5% CO2 at 37° C. Cells isolated from each sample were divided into two groups: Group I - immediate cell culture (not fresh cryopreserved cells) and Group II - cell cryopreservation, during a period of 30 days. Analyses of rates of cell adhesion and proliferation in different groups were performed by counting the cells adhered to the wells, in intervals of 24, 48 and 72 hours after the start of cultivation. The number of cells in each well was obtained by counting viable cells with the use of hemocytometer and the method of exclusion of cells stained by trypan blue. The difference between groups for each of the times was analyzed by Wilcoxon test. Regarding the temporal evolution for each group, analysis was done by Friedman's test to verify the existence of differences between times and, when it existed, the Wilcoxon penalty was applied. The results showed no statistically significant difference between the two groups analyzed in this study. Therefore, we conclude that the cryopreservation process, after a period of 30 days, did not influence the cell type studied, and there was no difference in growth capacity in vitro between the groups

Avaliação in vitro da adesão e proliferação de células mesenquimais do ligamento periodontal humano em diferentes superfícies de titânio

In the last years, many scientific researches in implantology have been focused on alternatives that would provide higher speed and quality in the process of osseointegration. Different treatment methods can be used to modify the topographic and chemical properties of titanium surface in order to optimize the tissue-implant reactions by a positive tissue response. This study aimed to evaluate the adhesion and proliferation of mesenchymal cells from human periodontal ligament on two different titanium surfaces, using cell culture techniques. Grade II titanium discs received different surface treatments, forming two distinct groups: polished and cathodic cage plasma nitriding. Human periodontal ligament mesenchymal cells were cultured on titanium discs in 24-well cell culture plates, at a density of 2 x 104 cells per well, including wells with no discs as positive control. Data obtained by counting the cells that adhered to the titanium surfaces (polished group and cathodic cage group) and to the plastic surface (control group), in the 24, 48 and 72-hour periods after plating, were used to analyze cell adhesion and proliferation and to obtain the cell growing curve in the different groups. The data were submitted to nonparametric analysis and the differences between groups were compared by Kruskal-Wallis and Friedman statistical tests. No statistically significant differences were found in the cells counts between the groups (p>0.05). It was concluded that both treatments produced surfaces compatible with the adhesion and proliferation of human periodontal ligament mesenchymal cells

Relação entre a doença periodontal e doença cardiovascular: há uma preocupação por parte dos que fazem clínica médica e odontológica na cidade de Natal?

The relationship between periodontal and cardiovascular diseases is a reality in the current days. The knowledge about the role of periodontal disease as a risk factor to cardiovascular disease from dentistry and physicians is very important to try to eliminate this risk factor. The aim of this work was to investigate, using a questionary, if physicians and dentistry are aware about this relationship and if they think that it is important. These forms were distributed in 4 groups: cardiologists (n=90), physicians from other specialist (POS) (n=110), periodontists (n=35) and dentistry from other specialist (DOE) (n=85). We had a loss off 32,4% of the total sample due to a lack of response of some professionals. Our results showed that all cardiologists, all dentists and 68,2% of POE said that they had gotten information about the relationship between periodontal and cardiovascular disease, and just 6 POS don t believe that this relationship can occur. When questioned if, even when a periodontal disease is diagnosed, there is a habit to treat or orient the patient for treatment, 29,5% of cardiologists answered no, 25,5% of POE also answered that they did not orient and only 1 DOE answered that he did not treat nor orient. All periodontists said that treat their patients when periodontal disease was identify. The physicians seem not to find important the relationship that exist between periodontal and cardiovascular diseases and the dentistry have shown a good knowledge about this subject. Maybe, if physicians and dentistry work together, the incidence of cardiovascular disease decreases