Avaliação de fatores de risco para infecção pelo vírus da hepatite C em candidatos à doação de sangue como potencial instrumento de redução de risco transfusional

As hepatites virais constituem um dos mais importantes assuntos de saúde pública, podendo ser causadas por diferentes agentes etiológicos. Dentre estes, encontra-se o Vírus da hepatite C (HCV), que segundo a Organização Mundial da Saúde (OMS) afeta mundialmente cerca de 123 milhões de pessoas, com uma prevalência de 2%. A principal forma de transmissão do HCV é a exposição ao sangue contaminado. O HCV pertence à família Flaviviridae, gênero Hepacivirus, possui 6 genótipos e múltiplos subtipos. No Brasil, o genótipo 1 é observado em 70% dos pacientes infectados, seguido pelo genótipo 3 (25%) e o genótipo 2 (5%). Alguns fatores de risco são fortemente associados à transmissão do HCV, dentre eles: o uso de seringa de vidro esterilizada em domicílio; o compartilhamento de utensílios de higiene pessoal como a lâmina de barbear, escova de dente, alicates de manicure e cortadores de unhas e também a transfusão de sangue antes de 1993. O presente estudo teve como objetivo executar um inquérito epidemiológico sobre fatores de risco relacionados à infecção pelo HCV e, determinar a soroprevalência de anti-HCV em candidatos a doação de sangue, no Estado do Pará. Foram analisados os seguintes fatores de risco: o uso de agulhas e seringas esterilizadas em domicílio; o uso de material próprio de manicure e pedicure; o uso de lâminas descartáveis em ambiente público; o uso compartilhado de lâminas em ambiente domiciliar; a realização de tratamento dentário invasivo e; o recebimento de transfusão antes de 1993. Foram alocados ao acaso, 11.916 candidatos ao processo de doação sanguínea da Fundação HEMOPA, no período de fevereiro de 2008 a março de 2009, posteriormente divididos em dois grupos: (1) aqueles com sorologia positiva para anti-HCV e; (2) aqueles com sorologia negativa para anti-HCV. O primeiro grupo foi constituído de 53 candidatos com sorologia positiva (0,4%) e o segundo grupo de 11.863 candidatos com sorologia negativa (99,6%). A análise dos dados mostrou que a mediana de idade entre os indivíduos anti-HCV positivos foi de 35 anos. Observou-se que dentre os indivíduos com sorologia positiva, 36 eram do sexo masculino (68%) e 17 do sexo feminino (32%). Já entre os candidatos com sorologia negativa, 9.250 pertenciam ao sexo masculino (78%) e 2.613 ao sexo feminino (22%). A análise dos fatores de risco estudados demonstrou que o uso de seringa de vidro em domicílio, a utilização de material não-próprio de manicure e pedicure e o recebimento de transfusão antes de 1993, foram fatores significativos para a transmissão do HCV na população de candidatos à doação de sangue, no Estado do Pará. Estes achados poderão propiciar estratégias de redução da hepatite C transfusional.

Correlação entre autoimunidade tireoidiana e o vírus da hepatite C

As hepatites virais constituem um dos mais importantes assuntos de saúde pública, podendo ser causadas por diferentes agentes etiológicos. Dentre estes, encontra-se o vírus da hepatite C (VHC), que segundo a Organização Mundial da Saúde (OMS) afeta mundialmente cerca de 123 milhões de pessoas, com uma prevalência de 3%. A principal forma de transmissão do VHC é a exposição ao sangue contaminado. O VHC pertence à família Flaviviridae, gênero Hepacivirus, possui 6 genótipos e múltiplos subtipos. No Brasil, o genótipo 1 é observado em 70% dos pacientes infectados, seguido pelo genótipo 3 (25%) e o genótipo 2 (5%). Alguns fatores de risco são fortemente associados à transmissão do VHC, dentre eles: o uso de seringa de vidro esterilizada em domicílio; o compartilhamento de utensílios de higiene pessoal como a lâmina de barbear, escova de dente, alicates de manicure e cortadores de unhas e também a transfusão de sangue antes de 1993. A proposta do presente estudo foi investigar a frequência de auto-anticorpos em indivíduos brasileiros portadores de hepatite C crônica. Foram incluídos 14 indivíduos com diagnóstico clínico e laboratorial de VHC crônica e 45 indivíduos foram incluídos como controle. Foi realizada a pesquisa de auto-anticorpos tireoidianos por Imunoensaio Quimioluminescente de Micropartículas (CMIA). Em relação ao anti-TPO, os portadores do vírus da hepatite C foram negativos em 92,86% e no grupo controle foram encontrados 15,56% positivos e 84,44% negativos. Para antireoglobulina 92,86% dos portadores de HVC foram positivos e 88,37% no grupo controle. Neste estudo não foi encontrada diferença na frequência de desordens tireoidianas quando comparados os pacientes com Hepatite C sem tratamento específico com aqueles sem Hepatite C, justificado provavelmente, pela alta prevalência de DAT na população do grupo controle. Os resultados indicam a necessidade de uma amostragem maior de indivíduos para que comprovação do papel do vírus C isoladamente como desencadeador de DAT.

Influência do tipo de tratamento odontológico em parâmetros fisiológicos e comportamentais de crianças

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Perception and Attitude About Systemic Health and Periodontal Disease Among Dentistry Undergraduates

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

A visão do usuário sobre o serviço público odontológico e a autopercepção em saúde bucal

Pós-graduação em Odontologia Preventiva e Social - FOA

Saúde e qualidade de vida de adolescentes de um assentamento rural no Pontal do Paranapanema-SP

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Resistência de união e microinfiltração em restaurações de resina

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Schwartz-Jampel Syndrome: a paediatric dentistry approach

Schwartz-Jampel syndrome (SJS) is a rare recessive disorder characterized mainly by myotonia. As the clinical signs and symptoms are manifested in the oromaxillofacial region, paediatric dentists may be first choice of parents that seek information and assistance to their children. A female patient diagnosed with SJS was brought to our clinic for dental treatment with main complain of difficulty on oral hygiene and mastication due to tooth crowding. The treatment included preventive measures, extraction of a supernumerary tooth and the maxillary primary second molars. Furthermore, the patient was referred to orthodontic treatment for correction of tooth crowding. When dealing with children with confirmed diagnosis of SSJ, paediatric dentists should be understand the need of planning the dental treatment considering the characteristics and possible complications associated with the syndrome in order to reduce the risks to patients, especially when surgical procedures are necessary.

Redução do medo durante o tratamento odontológico utilizando pontas ultrassônicas

Over the last few years, new technologies have been developed to making cavity preparations, among which the diamond burs CVDentus® (CVDentus, São José dos Campos, Brazil) are outstanding. These points are produced by chemical deposition from the vapor phase, forming a single diamond stone, with greater durability than the conventional diamond burs. Coupled to the ultrasound appliance, they have several clinical applications in Dentistry with advantages over conventional rotary instruments, such as lower pressure, noise, vibration and heat, as well as reducing the need to use local anesthesia, contributing to minimize patient’s fear and anxiety. The aim of this study was to present the complete restorative dental treatment performed with this system in a child patient with a prior history of non-cooperative behavior. The use of this new technology offered the patient greater comfort, making it possible recondition the patient’s attitude to dental treatment, in addition to favoring conservative cavity preparations to be made.

Prevalência de alterações sistêmicas em pacientes atendidos na disciplina de cirurgia e traumatologia bucomaxilofacial do curso de Odontologia da UNIARA

Introduction: pre-operative assessment is of fundamental importance for the prevention of transoperative and of postoperative complications. Objective: to identify the prevalence of diseases and systemic conditions in patients undergoing surgical treatment in the discipline of surgery and Traumatology of University Center of Araraquara, in the period of 2004 to 2009. Material and method: for the development of this study, a survey in medical records of patients was performed and the factors considered included: age, sex, presence of vices, and systemic conditions that affect the world’s population. The data obtained were analyzed quantitatively and recorded in a table. Result:  Considering all patient records analyzed (693), 340 affirmative responses were detected (49,06%) to one or more diseases. Cardiovascular diseases were the most prevalent (22,34%). Considering the prevalence of diseases related to age, the age of less than 20 years represented 16,32%; of 20-29 years, 43,06%; 30-39 years, 45,16%; 40-44 years, 48,64%; 45-49 years, 56,25%; 50-54 years, 58,33%; 55-59 years, 57,74%; 60-64 years, 70,37%; 65-69 years, 66,66%; and 70 years or more, 68,75%. Conclusion: diseases and systemic alterations with higher prevalence were cardiovascular diseases, anemia, sinusitis and diabetes. The frequency of affirmative answers to systemic conditions was age-dependent and there was a predominance of females. The tobacco addiction was the most frequent. Thus, it was found that the preoperative assessment of the health of patients who will undergo surgical dental treatment is of fundamental importance.

Displasia ectodérmica hipohidrótica: un síndrome de interés para la odontología

Hypohidrotic ectodermal dysplasia (HED) is a rare disease of genetic etiology. The most frequent form is of recessive linked to X-chromosome inheritance with affected male and female carriers. It can occur through autosomal mutations, of the gene EDA1 gene being responsible for the majority of the cases. It is characterized by the triad: hypohidrosis, oligodontia and hypotrichosis. We present two cases of patients with HED in which we observed characteristic signs of this syndrome: delicate skin, sparce hair, eyebrows and eyelashes, periorbital wrinkles, perioral and periorbital hyperpigmentation, prominent lips, in addition the patient in case 2 also present the depressed nasal bridge. We also found decreased salivary and lacrimal secretion and maxillary hypoplasia in both cases. At the oral examination in case 1 the upper right and left deciduous canines and lower right deciduous canine were present, and in case 2 the upper and lower (right and left) deciduous canines and two upper (one right and other left) permanent incisors were present with altered morphology, all of these dental elements were healthy. The early dental treatment of patients with HED, especially in the presence of oligodontia, as observed in our cases, is important not only to provide a better quality of life for these patients in the short term, but also an attempt to minimize the changes in facial growth to which these patients are subject.

Retardo na procura do tratamento odontológico e percepção da saúde bucal em mulheres grávidas

The objective was to assess in women with children under 5 years old what happened to your pregnancy in relation to dental care, coupled with a probable correlation between the level of their knowledge on dental health and possible reasons which lead or have led to a late seeking such treatment. The interviews were conducted in an environment of health center in the city center and the Odontoly Faculty in Araraquara. Among the interviews mothers, 57% refused the dental treatment during pregnancy. It appears on mothers that are afraid to perform a dental treatment during pregnancy. The misinformation on this issue often associated with this belief in the medical field that dental care during the first three months of pregnancy is harmful to the baby. Such information passed on to mothers leads to a hesitancy with dental treatment during this period. The educational level of mothers did not interfere in this pursuit, and 24.5% of them avoid treatment during pregnancy. The difference, however, is between those mothers of high educational level, performing oral prevention before pregnancy.

Impacto dos problemas de saúde bucal na qualidade de vida de gestantes

Objectives: 1) to evaluate the impact of oral health problems on the quality of life of pregnant women by the simplified Oral Health Impact Profile (OHIP-14) questionnaire as well by the presence of dental caries, periodontal disease and denture use/need; 2) to correlate the sociodemographic variables and the oral health conditions revealed in the clinical examinations with the OHIP-14. Method: In addition to the application of the OHIP-14 questionnaire, clinical examination of the oral conditions (CPI - community periodontal index, DMFT and prosthetic evaluation) was performed on 51 pregnant women, who sought dental treatment between April 2008 and August 2010 at the Preventive Dentistry Clinic. Descriptive analyses were made for sample characterization, bivariate analysis (chi-square or Fisher’s exact tests) and multiple logistic regressions at a 5% significance level to assess the correlation between the impact of oral health on the quality of life of pregnant women and the socio-demographic and clinical variables. Results: The OHIP-14 data showed a lesser impact of oral health on the women’s quality of life. The mean DMFT was 12.8; 70.6% of the pregnant women presented dental calculus and 58.8% needed prostheses. The association between OHIP-14 data and last dental visit and DMFT remained in the final regression model (p<0.05). Conclusion: Caries experience of the pregnant women was considered high. Most of them needed prostheses and presented dental calculus. The OHIP-14 presented a low impact on this population and was significantly influenced by the last dental visit and the DMFT index.

Estudo qualitativo sobre as justificativas de adolescentes para a não adesão ao tratamento odontológico

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Prosthetic rehabilitation of a patient with gastroesophageal reflux disease: 4-year followup

The gastroesophageal reflux disease (GERD) is one of the main causes of dental erosion. The aim of this case presented is to describe the prosthetic rehabilitation of a patient with GERD after 4 years of followup. A 33-year-old male patient complained about tooth sensitivity. The lingual surface of the maxillary anterior teeth and the cusps of the upper and lower posterior teeth presented wear. It was suspected that the feeling of heartburn reported by the patient associated with the intake of sports supplements (isotonics) was causing gastroesophageal changes. The patient was referred to a gastroenterologist and was diagnosed with GERD. Dental treatment was performed with metal-free crowns and porcelain veneers after medical treatment of the disease. With the change in eating habits, the treatment of GERD and lithium disilicate ceramics provided excellent cosmetic results after 4 years and the patient reported satisfaction with the treatment.