Perfil clínico-epidemiológico de saúde bucal em pacientes de hanseníase

O objetivo deste estudo foi avaliar o perfil clínico-epidemiológico de saúde bucal em pacientes portadores de hanseníase em PQT através da avaliação clínica da mucosa bucal, dos indicadores epidemiológicos IPV (Índice de Placa Visível), ISG (ìndice de Sangramento Gengival), ICPOD (Índice de Dentes Cariados, Perdidos e Obturados) e mensuração do fluxo salivar pelo ISS (Índice de Secreção Salivar), além da capacidade tampão pelo pH salivar. A amostra foi de 80 pacientes na faixa etária de 8 a 73 anos submetidos ao exame clínico bucal e coleta estimulada de saliva, divididos em Grupo de Estudo (GE), constituído de 40 pacientes portadores de hanseníase em PQT, atendidos no CRTDS Dr. Marcello Candia Marituba-Pa; e Grupo Controle (GC), de pacientes não portadores de hanseníase. Os resultados apontaram, 62,5% de alterações inespecíficas da mucosa bucal, dentre as mais frequentes pigmentação racial na gengiva, linha alba mordiscada na mucosa jugal, inflamação gengival, varicosidade no ventre lingual e trauma por uso de prótese no GE, não havendo diferença estatística significante (p=0,14) com o GC. A média do IPV no GE foi de 50,4% das superfícies dentárias com acúmulo de placa bacteriana, não havendo também diferença estatisticamente significante (p=0,40) com o GC. O IPV foi maior nos indivíduos sem acesso ao serviço odontológico e à medida que aumentou o grau de incapacidade dos pacientes menor foi o acesso ao serviço. A média do ISG foi de 29,7% das superfícies dentárias com sangramento gengival, não havendo diferença estatística significante (p=0,35) com o GC. O ICPOD médio foi de 11,6 variando de 4,0 a 24, o que aumentou com o avanço da idade. O maior acúmulo de placa, o sangramento gengival e o consumo de alimentos carigênicos fora do horário da refeição também contribuiram para o aumento do ICPOD. Outro fator relacionado ao aumento de ICPOD foi o não acesso ao serviço odontológico por 70% dos pacientes hansenianos, havendo diferença estatisticamente significante (p=0,0005) com o GC e a falta de orientação de higiene bucal em 60%, havendo diferença estatisticamente significante (p=0,01) com o GC. O ISS médio foi de 0,9ml/min e não apresentou associação com as doses do PQT e nem com o uso de prednisona. Dos pacientes do GE, 25% apresentaram hipossalivação, mas não houve aumento de ICPOD e nenhum dos grupos revelou alteração de pH salivar, variando de 5,85 a 7,34, com capacidade tampão dentro do padrão de normalidade. Concui-se que perfil clínico-epidemiológico dos pacientes portadores de hanseníase assemelha-se a do grupo controle, não tendo sido diagnosticado nenhuma alteração da mucosa bucal específica para hanseníase, o que não anula, entretanto a póssibilidade da cavidade bucal ser fonte de infecção para hanseníase necessitando de confirmação histopatológica e/ou PCR para detecção de M. leprae viável. Além disso, os dados mostraram que a maioria dos pacientes hansenianos avaliados não tem acesso ao serviço odontológico, nem orientação de higiene bucal, resultante da falta de políticas públicas de saúde bucal para hansenianos.

Web Service para geração de VRS no contexto de posicionamento GPS

Internet is fully inserted in contemporary society, specially in relation to entertainment services and trading. Its reach has transposed the traditional desktop computer models coming to mobile devices like cell phones and GPS receivers. Likewise, the scientific community takes its benefits, both for publication of studies and for communication between clusters processing information, such as at LHC, located in Switzerland. Concerning geodetic positioning, researches in the area present the concept of Virtual Reference Stations - VRS, in which is necessary a communication way between the real reference stations and a central system as well as between central system and a service requester. In this work, we analyze the current solutions for generation of VRS with regard to data delivery for the service requester and present a solution based on Web Services as an alternative to the model being developed by Spatial Geodesy Study Group – GEGE/FCT/UNESP. Comparing solutions, it was verified the potential of Web Services to aid in researches of geodetic positioning using VRS. Using such technology, it is obtained interoperability, providing greater flexibility to develop client applications, both development carried out by researchers of the university or by any person or enterprise wishing to use the service

Service Utilization Patterns of Homeless Youth

Few studies exist on the types of characteristics associated with service utilization (e.g., shelters, food programs) among homeless youth in the U.S. Services are important, however, because without food and shelter, numerous homeless youth resort to trading sex in order to meet their daily survival needs. Access to physical and mental health services gives homeless youth more of an opportunity to integrate into mainstream society than they would otherwise have. To address this gap in our understanding, my study examines what traits (e.g. age, race, abuse history) correlate with the use of shelters, food programs, street outreach, counseling, STD/STI testing, and HIV testing among homeless youth. The Theory of Reasoned Action is used as an ideological framework in conjunction with theoretical constructs of risk, need, and prior service exposure. Data were obtained from the Social Network and Homeless Youth Project (SNHYP), a sample of 249 Midwestern homeless youth ages 14 to 21, which used trained interviewers to conduct structured interviews with youth. Respondents were interviewed in both shelters and on the street over a period of approximately one year. My findings revealed that homeless youth’s service usage varied across gender, sexual orientation, age, having recently held a job, and having ever been physically or sexually abused, in addition to other characteristics. Conversely, service use was not associated with social network size or subjective norms (i.e. attitudes of peers, such as acceptance of condom use) of youths’ social networks. By examining these areas, my study builds on previous research on homeless youth and lays the framework for future research on service utilization by homeless youth.

NATIONWIDE ESTIMATES OF BLACKBIRDS AND STARLINGS

An estimated 538 million blackbirds and Starlings are found in the United States, based on the national cooperative blackbird/Starling winter roost survey conducted by the U.S. Fish and Wildlife Service during the 1974-75 winter period of December 20-February 15. Ap- proximately 74% or 398 million of these blackbirds and Starlings occurred in the Eastern States, including the tier from Minnesota to Louisiana; 26% or 139 million birds were in the West. The national roosting population in 1974-75 was composed of 11 species (Table 1) in the following approximate proportions: 38% Red-winged Blackbirds; 22% Common Grackles; 20% Starlings; 18% Brown-headed Cowbirds; 2% Brewer’s Blackbirds; and less than 1% six species combined (Rusty Blackbirds, Boat-tailed Grackles, Great-tailed Grackles, Tri-colored Black- birds, Yellow-headed Blackbirds, and Bronzed Cowbirds). (Some 2 million robins also were reported in the 1974-75 survey, though not solicited and therefore not tabulated, from 20 of the blackbird roosts in the Southeast.) The 1974-75 species proportions are similar to those found in the last nationwide winter survey (1969-70). In the 1963-64 national winter survey, Redwings made up 33% and Common Grackles 31% of the total population.

STATE REGISTRATION AND LICENSING REGULATIONS: A NEW PROGRAM (OHIO)

We enacted a bill in Ohio this year, Senate Bill 445, that has to do with the application of pesticides. It is a very wide bill as you would normally look at it with most of the meat going to come from the regulations that are presently being written into it. In other words, the framework was developed and accepted by the two houses in our state legislature and empowered the Director of Agriculture to establish the regulations or the so-called teeth to this bill. The governor signed the bill in June and it became effective in September. The committees as of this time are meeting to develop philosophies and regulations that will be promulgated and brought into hearings and sifted through, and eventually, with a target date of December of this year, (1970), brought to the Director of Agriculture's office for acceptance. There is a committee established for rodent and bird control which is very well represented by our industry here in Ohio. John Beck (Rose Exterminator Company) is the chairman of the committee, William B. Jackson (Bowling Green State University) and Robert Yaeger (Cincinnati) are also on the committee. The important feature of this new law, in terms of pest control operators, is the examinations that will be required. We operators and our service people will both be tested and licensed, if sufficient proficiency is demonstrated on the tests. For your information they use a little different terminology in the bill than we in the industry normally use. We think of an applicator in the industry as service people. In the bill an applicator is defined as an operator. Therefore in reading the law the word operator means the man who does the job, the service man. Just the reverse is true in the industry. We think of the operator as the man who owns or manages the company while these people are referred to in the bill as applicators. The Bill calls for the development of schools for the training of our people throughout the state. Those of us who are in bird control should begin to prepare ourselves to meet this request, to be available for the schooling, have our people available for the schooling, and give this program all the co-operation that we can.

BLACKBIRD DAMAGE AND CONTROL--AN INFORMAL SEMINAR

The object is to hash over a few problems as we see them on this red-winged blackbird situation. I'm Mel Dyer, University of Guelph, Guelph, Ontario. Around the table are Tom Stockdale, Extension Wildlife Specialist, Ohio Cooperative Extension Service, Columbus; Maurice Giltz, Ohio Agriculture Research and Development Center, Wooster, Ohio; Joe Halusky, U.S. Fish and Wildlife Service, Columbus, Ohio; Daniel Stiles, U.S. Fish and Wildlife Service, Washington, D.C.; Paul Rodeheffer, U.S. Fish and Wildlife Service, Columbus, Ohio; Brian Hall, Blackbird Research Project, University of Guelph, Guelph, Ontario; George Cornwell, Virginia Polytechnic Insti¬tute, Blacksburg, Va.; Dick Warren, Peavey Grain Company, Minneapolis, Minn.; Bob Fringer, N.J. Department of Agriculture, Trenton, N.J.; Charles Stone, U.S. Fish and Wildlife Service, Columbus, Ohio; Larry Holcomb, Ohio Agricultural Research and Development Center, Wooster, Ohio; Doug Slack, Ohio Agricultural Research and Development Center, Wooster, Ohio; Charles Wagg, N.J. Department of Agriculture, Trenton, N.J.; Dick Smith, U.S. Fish and Wildlife Service, Columbus, Ohio; and Jim Caslick, U.S. Fish and Wildlife Service, Gainesville, Fla. As I see the situation, as a director of a red-winged blackbird research project, we have a problem which has been defined in human terms concerning a natural animal population.

Qualifying instrument for evaluation of food and nutritional care in hospital

Establishing criteria for hospital nutrition care ensures that quality care is delivered to patients. The responsibility of the Hospital Food and Nutrition Service (HFNS) is not always well defined, despite efforts to establish guidelines for patient clinical nutrition practice. This study describes the elaboration of an Instrument for Evaluation of Food and Nutritional Care (IEFNC) aimed at directing the actions of the Hospital Food and Nutrition Service. This instrument was qualified by means of a comparative analysis of the categories related to hospital food and nutritional care, published in the literature. Elaboration of the IEFNC comprised the following stages: (a) a survey of databases and documents for selection of the categories to be used in nutrition care evaluation, (b) a study of the institutional procedures for nutrition practice at two Brazilian hospitals, in order to provide a description of the sequence of actions that should be taken by the HFNS as well as other services participating in nutrition care, (c) design of the IEFNC based on the categories published in the literature, adapted to the sequence of actions observed in the routines of the hospitals under study, (d) application of the questionnaire at two different hospitals that was mentioned in the item (b), in order to assess the time spent on its application, the difficulties in phrasing the questions, and the coverage of the instrument, and (e) finalization of the instrument. The IEFNC consists of 50 open and closed questions on two areas of food and nutritional care in hospital: inpatient nutritional care and food service quality. It deals with the characterization and structure of hospitals and their HFNS, the actions concerning the patients' nutritional evaluation and monitoring, the meal production system, and the hospital diets. "This questionnaire is a tool that can be seen as a portrait of the structure and characteristics of the HFNS and its performance in clinical and meal management dietitian activities." (Nutr Hosp. 2012;27:1170-1177) DOI:10.3305/nh.2012.27.4.5868

Forum: social network for the surveillance and prevention of workplace accidents

In 2008, academic researchers and public service officials created a university extension studies platform based on online and on-site meetings denominated "Work-Related Accidents Forum: Analysis, Prevention, and Other Relevant Aspects. Its aim was to help public agents and social partners to propagate a systemic approach that would be helpful in the surveillance and prevention of work-related accidents. This article describes and analyses such a platform. Online access is free and structured to: support dissemination of updated concepts; support on-site meetings and capacity to build educational activities; and keep a permanent space for debate among the registered participants. The desired result is the propagation of a social-technical-systemic view of work-related accidents that replaces the current traditional view that emphasizes human error and results in blaming the victims. The Forum uses an educational approach known as permanent health education, which is based on the experience and needs of workers and encourages debate among participants. The forum adopts a problematizing pedagogy that starts from the requirements and experiences of the social actors and stimulates support and discussions among them in line with an ongoing health educational approach. The current challenge is to turn the platform into a social networking website in order to broaden its links with society.

Gauging food and nutritional care quality in hospitals

Background: Food and nutritional care quality must be assessed and scored, so as to improve health institution efficacy. This study aimed to detect and compare actions related to food and nutritional care quality in public and private hospitals. Methods: Investigation of the Hospital Food and Nutrition Service (HFNS) of 37 hospitals by means of structured interviews assessing two quality control corpora, namely nutritional care quality (NCQ) and hospital food service quality (FSQ). HFNS was also evaluated with respect to human resources per hospital bed and per produced meal. Results: Comparison between public and private institutions revealed that there was a statistically significant difference between the number of hospital beds per HFNS staff member (p = 0.02) and per dietitian (p < 0.01). The mean compliance with NCQ criteria in public and private institutions was 51.8% and 41.6%, respectively. The percentage of public and private health institutions in conformity with FSQ criteria was 42.4% and 49.1%, respectively. Most of the actions comprising each corpus, NCQ and FSQ, varied considerably between the two types of institution. NCQ was positively influenced by hospital type (general) and presence of a clinical dietitian. FSQ was affected by institution size: large and medium-sized hospitals were significantly better than small ones. Conclusions: Food and nutritional care in hospital is still incipient, and actions concerning both nutritional care and food service take place on an irregular basis. It is clear that the design of food and nutritional care in hospital indicators is mandatory, and that guidelines for the development of actions as well as qualification and assessment of nutritional care are urgent.

Depression in children and adolescents: family narratives in Brazilian primary attention

Background: The incidence of depression in children and adolescents still increasing and this disorder is now a major public health challenge worldwide. The Psychiatric Reform suggested an end to the fragmented and inefficient service by proposing integrated and quality care. In this context, family narratives are a way to recognize vulnerabilities and provide psychopathology prevention in primary care. Methods: Two medical databases (LILACS and SciELO) were surveyed and 14 texts published between 2004 and 2011 were selected and reviewed. Results and discussion: Children and adolescents are nowadays exposed to several stressing factors, in addition to natural vulnerabilities of this age group. Prevention is associated with a qualified hearing of family narratives in primary care and healthcare professionals should be able to perceive said and unsaid elements across the speech. Conclusion: In spite of the advances about children and adolescents mental health, some procedures must be adapted to achieve an efficient mental health policy though analyzing family discourse.

Bioremediation of PAHs - Limitations and soultions

Introduction 1.1 Occurrence of polycyclic aromatic hydrocarbons (PAH) in the environment Worldwide industrial and agricultural developments have released a large number of natural and synthetic hazardous compounds into the environment due to careless waste disposal, illegal waste dumping and accidental spills. As a result, there are numerous sites in the world that require cleanup of soils and groundwater. Polycyclic aromatic hydrocarbons (PAHs) are one of the major groups of these contaminants (Da Silva et al., 2003). PAHs constitute a diverse class of organic compounds consisting of two or more aromatic rings with various structural configurations (Prabhu and Phale, 2003). Being a derivative of benzene, PAHs are thermodynamically stable. In addition, these chemicals tend to adhere to particle surfaces, such as soils, because of their low water solubility and strong hydrophobicity, and this results in greater persistence under natural conditions. This persistence coupled with their potential carcinogenicity makes PAHs problematic environmental contaminants (Cerniglia, 1992; Sutherland, 1992). PAHs are widely found in high concentrations at many industrial sites, particularly those associated with petroleum, gas production and wood preserving industries (Wilson and Jones, 1993). 1.2 Remediation technologies Conventional techniques used for the remediation of soil polluted with organic contaminants include excavation of the contaminated soil and disposal to a landfill or capping - containment - of the contaminated areas of a site. These methods have some drawbacks. The first method simply moves the contamination elsewhere and may create significant risks in the excavation, handling and transport of hazardous material. Additionally, it is very difficult and increasingly expensive to find new landfill sites for the final disposal of the material. The cap and containment method is only an interim solution since the contamination remains on site, requiring monitoring and maintenance of the isolation barriers long into the future, with all the associated costs and potential liability. A better approach than these traditional methods is to completely destroy the pollutants, if possible, or transform them into harmless substances. Some technologies that have been used are high-temperature incineration and various types of chemical decomposition (for example, base-catalyzed dechlorination, UV oxidation). However, these methods have significant disadvantages, principally their technological complexity, high cost , and the lack of public acceptance. Bioremediation, on the contrast, is a promising option for the complete removal and destruction of contaminants. 1.3 Bioremediation of PAH contaminated soil & groundwater Bioremediation is the use of living organisms, primarily microorganisms, to degrade or detoxify hazardous wastes into harmless substances such as carbon dioxide, water and cell biomass Most PAHs are biodegradable unter natural conditions (Da Silva et al., 2003; Meysami and Baheri, 2003) and bioremediation for cleanup of PAH wastes has been extensively studied at both laboratory and commercial levels- It has been implemented at a number of contaminated sites, including the cleanup of the Exxon Valdez oil spill in Prince William Sound, Alaska in 1989, the Mega Borg spill off the Texas coast in 1990 and the Burgan Oil Field, Kuwait in 1994 (Purwaningsih, 2002). Different strategies for PAH bioremediation, such as in situ , ex situ or on site bioremediation were developed in recent years. In situ bioremediation is a technique that is applied to soil and groundwater at the site without removing the contaminated soil or groundwater, based on the provision of optimum conditions for microbiological contaminant breakdown.. Ex situ bioremediation of PAHs, on the other hand, is a technique applied to soil and groundwater which has been removed from the site via excavation (soil) or pumping (water). Hazardous contaminants are converted in controlled bioreactors into harmless compounds in an efficient manner. 1.4 Bioavailability of PAH in the subsurface Frequently, PAH contamination in the environment is occurs as contaminants that are sorbed onto soilparticles rather than in phase (NAPL, non aqueous phase liquids). It is known that the biodegradation rate of most PAHs sorbed onto soil is far lower than rates measured in solution cultures of microorganisms with pure solid pollutants (Alexander and Scow, 1989; Hamaker, 1972). It is generally believed that only that fraction of PAHs dissolved in the solution can be metabolized by microorganisms in soil. The amount of contaminant that can be readily taken up and degraded by microorganisms is defined as bioavailability (Bosma et al., 1997; Maier, 2000). Two phenomena have been suggested to cause the low bioavailability of PAHs in soil (Danielsson, 2000). The first one is strong adsorption of the contaminants to the soil constituents which then leads to very slow release rates of contaminants to the aqueous phase. Sorption is often well correlated with soil organic matter content (Means, 1980) and significantly reduces biodegradation (Manilal and Alexander, 1991). The second phenomenon is slow mass transfer of pollutants, such as pore diffusion in the soil aggregates or diffusion in the organic matter in the soil. The complex set of these physical, chemical and biological processes is schematically illustrated in Figure 1. As shown in Figure 1, biodegradation processes are taking place in the soil solution while diffusion processes occur in the narrow pores in and between soil aggregates (Danielsson, 2000). Seemingly contradictory studies can be found in the literature that indicate the rate and final extent of metabolism may be either lower or higher for sorbed PAHs by soil than those for pure PAHs (Van Loosdrecht et al., 1990). These contrasting results demonstrate that the bioavailability of organic contaminants sorbed onto soil is far from being well understood. Besides bioavailability, there are several other factors influencing the rate and extent of biodegradation of PAHs in soil including microbial population characteristics, physical and chemical properties of PAHs and environmental factors (temperature, moisture, pH, degree of contamination). Figure 1: Schematic diagram showing possible rate-limiting processes during bioremediation of hydrophobic organic contaminants in a contaminated soil-water system (not to scale) (Danielsson, 2000). 1.5 Increasing the bioavailability of PAH in soil Attempts to improve the biodegradation of PAHs in soil by increasing their bioavailability include the use of surfactants , solvents or solubility enhancers.. However, introduction of synthetic surfactant may result in the addition of one more pollutant. (Wang and Brusseau, 1993).A study conducted by Mulder et al. showed that the introduction of hydropropyl-ß-cyclodextrin (HPCD), a well-known PAH solubility enhancer, significantly increased the solubilization of PAHs although it did not improve the biodegradation rate of PAHs (Mulder et al., 1998), indicating that further research is required in order to develop a feasible and efficient remediation method. Enhancing the extent of PAHs mass transfer from the soil phase to the liquid might prove an efficient and environmentally low-risk alternative way of addressing the problem of slow PAH biodegradation in soil.

Spondylodiscitis in the elderly patient: clinical mid-term results and quality of life

Focusing on spondylodiscitis in elderly patients current literature does not contain much information.

Chondrocyte function after osteochondral transfer: comparison of concave and plane punches

An incongruity between instrument and articular surfaces in osteochondral transfer (OCT) results in unevenly distributed impact forces exerted on the cartilage which may cause a loss of functional chondrocytes. We tested whether a plane instead of a concave design of the punch of an osteotome can reduce these cartilage damages.

Mandibular implant overdentures followed for over 10 years: patient compliance and prosthetic maintenance

PURPOSE: The mandibular implant overdenture is a popular treatment modality and is well documented in the literature. Follow-up studies with a long observation period are difficult to perform due to the increasing age of patients. The present data summarize a long-term clinical observation of patients with implant overdentures. MATERIALS AND METHODS: Between 1984 and 1997, edentulous patients were consecutively admitted for treatment with an implant overdenture. The dentures were connected to the implants by means of bars or ball anchors. Regular maintenance was provided with at least one or two scheduled visits per year. Recall attendance and reasons for dropout were analyzed based on the specific history of the patient. Denture maintenance service, relining, repair, and fabrication of new dentures were identified, and complications with the retention devices specified separately. RESULTS: In the time period from 1984 to 2008, 147 patients with a total of 314 implants had completed a follow-up period of >10 years. One hundred one patients were still available in 2008, while 46 patients were not reexamined for various reasons. Compliance was high, with a regular recall attendance of >90%. More than 80% of dentures remained in continuous service. Although major prosthetic maintenance was rather low in relation to the long observation period, visits to a dental hygienist and dentist resulted in an annual visit rate of 1.5 and 2.4, respectively. If new dentures became necessary, these were made in student courses, which increased the treatment time and number of appointments needed. Complications with the retention devices consisted mostly of the mounting of new female retainers, the repair of bars, and the changing of ball anchors. The average number of events and the rate of prosthetic service with ball anchors were significantly higher than those with bars. Twenty-two patients changed from ball anchors to bars; 9 patients switched from a clip bar to a rigid U-shaped bar. CONCLUSIONS: This long-term follow-up study demonstrates that implant overdentures are a favorable solution for edentulous patients with regular maintenance. In spite of specific circumstances in an aging population, it is possible to provide long-term care, resulting in a good prognosis and low risk for this treatment modality. For various reasons the dropout rate can be considerable in elderly patients and prosthetic service must be provided regularly.

7-year follow-up after open reduction and internal screw fixation in Bennett fractures

Bennett fractures are unstable, and, with inadequate treatment, lead to osteoarthritis, weakness and loss of function of the first carpometacarpal joint. This study focuses on long-term functional and radiological outcomes after open reduction and internal fixation.