Factores sociodemográficos na saúde oral : influências nos comportamentos de rotinas de saúde oral, frequências de idas a consultas, auto avaliação do estado de saúde oral e presença de dor em jovens de 12 anos

RESUMO - Introdução: A saúde oral é uma componente essencial na saúde geral e no bem-estar dos indivíduos. Sabe-se que os problemas de saúde oral afectam predominantemente os elementos de níveis socioeconómicos mais baixos, evidenciando a influência dos determinantes sociais da saúde na saúde oral das populações. Os objectivos deste estudo são caracterizar os comportamentos de rotinas diárias de higiene oral, frequências de idas a consultas de saúde oral, auto-avaliação do estado de saúde oral e percepção de dor na cavidade oral em crianças de 12 anos em Portugal e analisar a associação entre estes e os factores sociodemográficos. Métodos: Foi realizado um estudo observacional, transversal e analítico, abrangendo 1309 jovens e baseado em informação recolhida no III Estudo Nacional de Prevalência de Doenças Orais (ENPDO). Para além das estatísticas descritivas usuais, as estatísticas inferenciais basearam-se predominantemente em modelos de regressão logística binária. Resultados: Dos participantes, 70.6% (n=924) escova “duas ou mais vezes por dia” com associação com todas as variáveis sociodemográficas. Na análise multivariada, o género masculino (OR=2.088; IC95%: 1.574-2.770, em relação ao género feminino), a área de residência predominantemente rural ou mediamente urbana (OR= 1.800; IC95%: 2.587; OR=1.516; IC95%: 1.093-2.103, em relação a zonas predominantemente urbanas), a escolaridade da mãe ser o ensino básico (OR= 2.112; IC95%: 1.408-3.168, em relação ao ensino superior) e a actividade laboral do pai ser desempregado (OR= 1.938; IC95%: 1.280-2.934, em relação a ser trabalhador) foram as variáveis com mais impacto para a adopção de comportamentos de escovagem potencialmente inadequados (p<0.05). A maioria dos inquiridos (94.2%; n=1247) já tinham ido a uma consulta de saúde oral e 74.5% (n=860) nos últimos 12 meses, 95.5% (n=1250) encontram-se satisfeitos com a saúde oral e 44.5% (n=578) afirma ter tido algum tipo de dor na cavidade oral nos últimos 12 meses. Conclusão: Os resultados obtidos estão de acordo com a literatura em termos de factores de associação. Desta forma, a saúde oral nos jovens de 12 anos em Portugal, nos diversos contextos aqui analisados, pode ser considerada como satisfatória. A única excepção relevante é a componente da dor, com valores alarmantes embora de natureza mais subjectiva. A influência dos factores sociodemográficos sugere que futuras abordagens para a promoção da saúde oral tenham em conta os determinantes de saúde no delineamento de estratégias quer a nível individual quer a nível comunitário.

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Primary ciliary dyskinesia (PCD) is an autosomal recessive disease with an incidence estimated between 1:2,000 and 1:40,000. Ciliated epithelia line the airways, nasal and sinus cavities, Eustachian tube and fallopian tubes. Congenital abnormalities of ciliary structure and function impair mucociliary clearance. As a consequence, patients present with chronic sinopulmonary infections, recurrent glue ear and female subfertility. Similarities in the ultrastructure of respiratory cilia, nodal cilia and sperm result in patients with PCD also presenting with male infertility, abnormalities of left-right asymmetry (most commonly situs inversus totalis) and congenital heart disease. Early diagnosis is essential to ensure specialist management of the respiratory and otological complications of PCD. Diagnostic tests focus on analysis of ciliary function and electron microscopy structure. Analysis is technically difficult and labour intensive. It requires expertise for interpretation, restricting diagnosis to specialist centres. Management is currently based on the consensus of experts, and there is a pressing need for randomised clinical trials to inform treatment.

A t(7;12) balanced translocation with breakpoints overlapping those of the Williams-Beuren and 12q14 microdeletion syndromes.

The molecular characterization of balanced chromosomal rearrangements have always been of advantage in identifying disease-causing genes. Here, we describe the breakpoint mapping of a de novo balanced translocation t(7;12)(q11.22;q14.2) in a patient presenting with a failure to thrive associated with moderate mental retardation, facial anomalies, and chronic constipation. The localization of the breakpoints and the co-occurrence of Williams-Beuren syndrome and 12q14 microdeletion syndrome phenotypes suggested that the expression of some of the dosage-sensitive genes of these two segmental aneuploidies were modified in cells of the proposita. However, we were unable to identify chromosomes 7 and/or 12-mapping genes that showed disturbed expression in the lymphoblastoids of the proposita. This case showed that position-effect might operate in some tissues, but not in others. It also illustrates the overlap of phenotypes presented by patients with the recently described 12q14 structural rearrangements.

Polysomy 8 defines a clinico-cytogenetic entity representing a subset of myeloid hematologic malignancies associated with a poor prognosis: report on a cohort of 12 patients and review of 105 published cases.

Tetrasomy, pentasomy, and hexasomy 8 (polysomy 8) are relatively rare compared to trisomy 8. Here we report on a series of 12 patients with acute myeloid leukemia (AML), myelodysplastic syndrome (MDS), or myeloproliferative disorder (MPD) associated with polysomy 8 as detected by conventional cytogenetics and fluorescence in situ hybridization (FISH). In an attempt to better characterize the clinical and hematological profile of this cytogenetic entity, our data were combined with those of 105 published patients. Tetrasomy 8 was the most common presentation of polysomy 8. In 60.7% of patients, polysomy 8 occurred as part of complex changes (16.2% with 11q23 rearrangements). No cryptic MLL rearrangements were found in cases in which polysomy 8 was the only karyotypic change. Our study demonstrates the existence of a polysomy 8 syndrome, which represents a subtype of AML, MDS, and MPD characterized by a high incidence of secondary diseases, myelomonocytic or monocytic involvement in AML and poor overall survival (6 months). Age significantly reduced median survival, but associated cytogenetic abnormalities did not modify it. Cytogenetic results further demonstrate an in vitro preferential growth of the cells with a high level of aneuploidy suggesting a selective advantage for polysomy 8 cells.

Contextual determinants of alcohol consumption changes and preventive alcohol policies: a 12-country European study in progress.

Beginning with France in the 1950s, alcohol consumption has decreased in Southern European countries with few or no preventive alcohol policy measures being implemented, while alcohol consumption has been increasing in Northern European countries where historically more restrictive alcohol control policies were in place, even though more recently they were loosened. At the same time, Central and Eastern Europe have shown an intermediate behavior. We propose that country-specific changes in alcohol consumption between 1960 and 2008 are explained by a combination of a number of factors: (1) preventive alcohol policies and (2) social, cultural, economic, and demographic determinants. This article describes the methodology of a research study designed to understand the complex interactions that have occurred throughout Europe over the past five decades. These include changes in alcohol consumption, drinking patterns and alcohol-related harm, and the actual determinants of such changes.

Comprehensive clinical and molecular analysis of 12 families with type 1 recessive cutis laxa.

Autosomal recessive cutis laxa type I (ARCL type I) is characterized by generalized cutis laxa with pulmonary emphysema and/or vascular complications. Rarely, mutations can be identified in FBLN4 or FBLN5. Recently, LTBP4 mutations have been implicated in a similar phenotype. Studying FBLN4, FBLN5, and LTBP4 in 12 families with ARCL type I, we found bi-allelic FBLN5 mutations in two probands, whereas nine probands harbored biallelic mutations in LTBP4. FBLN5 and LTBP4 mutations cause a very similar phenotype associated with severe pulmonary emphysema, in the absence of vascular tortuosity or aneurysms. Gastrointestinal and genitourinary tract involvement seems to be more severe in patients with LTBP4 mutations. Functional studies showed that most premature termination mutations in LTBP4 result in severely reduced mRNA and protein levels. This correlated with increased transforming growth factor-beta (TGFβ) activity. However, one mutation, c.4127dupC, escaped nonsense-mediated decay. The corresponding mutant protein (p.Arg1377Alafs(*) 27) showed reduced colocalization with fibronectin, leading to an abnormal morphology of microfibrils in fibroblast cultures, while retaining normal TGFβ activity. We conclude that LTBP4 mutations cause disease through both loss of function and gain of function mechanisms.

Situación de stocks de peces demersales en la primavera de 1989: Crucero BIC Humboldt 8911-12 (24 de noviembre - 08 de diciembre 1989)

Describe las acciones que realizó el crucero de evaluación de peces demersales, a bordo del BIC Humboldt entre noviembre y diciembre de 1989, cuya información ha permitido determinar la situación actual del subsistema demersal en lo referente a las condiciones oceanográficas, estructura especiológica, distribuón, concentración, biomasa y estructura poblacional de las diferentes especies, poniéndose especial énfasis en las de mayor abundancia económica, entre las que destaca la merluza.

Evaluación de los recursos pelágicos: anchoveta, sardina, jurel y caballa en primavera 1989 : Crucero de evaluacion acustica BIC/SNP-1 8911-12 (Chicama - Punta Doña Maria)

Describe los principales resultados obtenidos en el Crucero evaluación de recursos pelágicos, efectuado a bordo del BIC/SNP-1 del 14 de noviembre de 1989, entre Chicama y Punta Doña María, constituyendo la segunda prospección planificada dentro del marco del proyecto Evaluación de los recursos: anchoveta, sardina, jurel y caballa, auspiciado por el Instituto del mar del Perú y la Comunidad económica europea.

Comentario general sobre prospección de recursos pelágicos costeros y demersales costeros. E/E Huamanga 9611-12

Describe la actividad pesquera artesanal en el Perú, desarrollada hasta las 20 millas aproximadamente. En esta zona se captura una variedad de recursos hidrobiológicos que en su mayoría son destinados al consumo humano directo, considerando que el nivel de las capturas de la pesca artesanal representan el 43% de los detinados al consumo humano y de éstos el 100% son derivados al consumo fresco.

Distribución, concentración y características biológicas de los recursos pelágicos costeros y demersales costeros. Prospección E/E Huamanga 9611-12

Se presentan los resultados de la prospección de recursos pelágicos costeros y demersales costeros 9611-12, a bordo de la EE Huamanga entre Callao y Puerto Pizarro. La metodología empleada consistió en un rastreo hidroacústico complementado con lances de comprobación, así como una prospección costera con arrastre de fondo en zonas donde la eco abundancia del rastreo acústico detectó concentraciones. Los recursos pelágicos costeros se determinaron de Huacho a Puerto Pizarro entre 0 a 20 mn de la costa. Los recursos demersales costeros se encontraron distribuidos en toda el área evaluada, fuertemente concentrados entre Punta Falsa y Puerto Pizarro. Cabrillas, mojarrillas y rayas, tuvieron mayores índices de abundancia en la subárea A (03° a 04° S); cachema, suco y lenguado destacaron en la subárea B (4° a 5°S). Por su alta frecuencia en las capturas, se han determinado las condiciones sexuales de los recursos cabrilla, cachema, lorna, suco y vocador, presentando un comportamiento normal para la época.

Geometría de la red de arrastre de fondo utilizada en la prospección de recursos pelágico costeros y demersales costeros E/E Huamanga 9611-12

Describe las actividades de rastreo del E/E Huamanga, que efectuó del 01 al 18 de diciembre de 1996, entre Puerto Pizarro y Callao. Se demuestra la longitud del cable principal de arrastre y la profundidad que se determinó en una proporción de 3:1. Así mismo, la correspondencia entre los parámetros de abertura vertical y horizontal de la boca de red en función a la velocidad de arrastre, la misma que fue inversa y directamente proporcional teniendo un alto grado de correlación.

Estructura especiológica de los subsistemas dermesal costero y pelagial costero. Prospección E/E Huamanga 9611-12

Se analiza la composición especiológica y distribución de las capturas obtenidas en la Prospección Pesquera Costera efectuada entre Punta Malpelo (03°30,32 'S; 80°33,36 'W), sur de Puerto Pizarro, y bahía Grande (11°12,46 'S; 77°43,20 'W), al norte de Huacho. Se capturaron 115 especies: 86 peces, 17 crustáceos, 6 moluscos, 3 equinodermos, un cnidario, un sálpido y un poliqueto. Los recursos demersales, con lances de arrastre de fondo, efectuados entre las Puntas Malpelo y Malabrigo (07°43,05 'S, 79°38,75 'W), tuvieron la mayor diversidad (113 especies) y la mayor captura (11 639,4 kg de pesca) destacando por sus volúmenes, tres especies que representaron el 74% de la pesca de arrastre: la merluza (Merluccius gayi peruanus con 6.508,1 kg) seguida del falso volador (Prionotus stephanophrys con 1.603,85 kg) y la anchoveta blanca (Anchoa nasus con 499,85 kg). Los recursos pelágicos se capturaron en menor volumen (581,2 kg), y dos especies constituyeron el 95,3% del total: la anchoveta (Engraulis ringens con 251,95 kg) y el bagre con faja (Galeichthys peruvianus con 301,7 kg).

Aspectos oceanográficos durante la prospección de recursos pelágico costeros y demersales costeros E/E Huamanga 9611-12

Ligera proyección de Aguas Ecuatoriales Superficiales originaron anomalías de 0,6 °C a 2,7 °C al norte de los 6°S, mientras que anomalías negativas asociadas al afloramiento costero se ubicaron al sur de esta latitud, con valores entre -04° C a -2,6° C. La extensión sur de la Corriente de Cromwell se vio moderadamente fortalecida frente a Paita (100 m de profundidad), disminuyendo su espesor en Punta Falsa. La merluza se presentó entre Puerto Pizarro a Punta Falsa, en temperaturas de 14,2 °C a 17,2 °C, salinidades de 34,89‰ a 35,13‰ y oxígeno entre 0,29 a 3,0 mL/L.