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The use of games may constitute an innovative strategy for training. OBJECTIVE: Develop an educational quiz type game, construct 60 assessment items and validate this content. METHODOLOGY: Elaboration of the didactic-pedagogical project, development of the game, creation of the assessment items and validation of the content. RESULTS: the technical evaluation obtained a Content Validity Index (CVI) over 80%. CONCLUSIONS: The game can be used as a tool for making information available, thus contributing to the democratization of knowledge.
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Juegos de Video , Odontología , Juegos RecreacionalesRESUMEN
OBJECTIVE: The aim of this study was to compare the influence of a serious game dedicated to primary health care with traditional learning methods on knowledge of undergraduate medical students. METHODS: A randomized controlled trial was conducted with undergraduate medical students. The students (nâ¯=â¯27) attended to an expositive leveling lesson regard the theme "Screening on Primary Health Care", and answered to a baseline knowledge test, comprised by objective questions. Students were randomly allocated to the control and game groups, in which received a text-based material regarding "Screening on Primary Health Care" or were exposed to a serious game. An immediate knowledge test and a retention knowledge test, presenting the same questions of baseline test, were responded by students at the finish of exposure and four weeks later. The students also performed a survey evaluating the user experience on the serious game. Knowledge test scores were analysed by repeated measures ANOVA and paired sample t-test. User experience and expectation surveys were descriptively analyzed. RESULTS: For the control group, the mean scores and standard deviation were 7.85⯱â¯0.99, 9.00⯱â¯1.87 and 7.69⯱â¯1.44 for baseline, immediate and retention knowledge tests, respectively; the score at immediate test was higher than for baseline and retention tests. The game group presented 7.07⯱â¯1.98, 8.00⯱â¯1.84 and 7.15⯱â¯1.41 for baseline, immediate and retention knowledge tests, respectively. The comparison between groups did not show differences at any moment (pâ¯<â¯0.05). The majority of the participants consider that the serious game has understandable instructions, presented the contents clearly, and it favors the engagement on study. CONCLUSION: The serious game was effective to improve the students' knowledge on primary health care contents. Learning based on a serious game is as effective as learning based on printed text.
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Educación de Pregrado en Medicina/métodos , Educación de Pregrado en Medicina/normas , Atención Primaria de Salud/normas , Estudiantes de Medicina/estadística & datos numéricos , Juegos de Video/estadística & datos numéricos , Adulto , Femenino , Humanos , Aprendizaje , Masculino , Encuestas y Cuestionarios , Adulto JovenRESUMEN
Introdução: O uso de tecnologia educacional sobre biossegurança pode constituir uma estratégia inovadora e interativa que proporciona conhecimentos a respeito de assuntos específicos e processos de trabalho. Objetivo: Desenvolver um jogo educacional do tipo quiz sobre biossegurança em odontologia; construir e validar de forma pedagógica e técnica os 60 itens avaliativos a serem incorporados ao sistema. Método: O estudo foi organizado em diversas etapas: elaboração do projeto didático-pedagógico, desenvolvimento do game, elaboração dos 60 itens avaliativos e validação do conteúdo por dois profissionais da área pedagógica e cinco com expertise na área de biossegurança. Resultados: Os resultados da avaliação pedagógica possibilitaram que as questões do game fossem ajustadas conforme critérios pedagógicos. Os resultados da avaliação técnica foram obtidos utilizando o Índice de Validação de Conteúdo (IVC), sendo superiores a 80% para os critérios de clareza textual, relevância prática, adequação ao público e tempo de resposta das questões. Conclusões: De acesso aberto e gratuito, o jogo educacional poderá ser utilizado como uma ferramenta do conhecimento em biossegurança, em resposta à demanda contínua de alunos e profissionais em busca da democratização da informação.
Introduction: The use of educational technologies on biosafety can be an innovative and interactive strategy to provide knowledge concerning specific issues and work processes. Objective: To develop an educational quiz game on biosafety in Dentistry; to construct and validate, in a pedagogical and technical way, the 60 evaluation items to be incorporated into the system. Method: The study was organized in several stages: elaboration of the didactic-pedagogical project; development of the game; elaboration of 60 evaluative items; and validation of content by two professionals in the field of pedagogy and five experts in the field of biosafety. Results: The pedagogical evaluation results allowed us to adjust the game questions according to pedagogical criteria. The technical evaluation results were obtained by using the Content Validation Index (CVI), which exceeded 80% in the textual clarity criteria, practical relevance, adequacy to the public and response time of the questions. Conclusions: An open and free access instrument, the educational game can be used as a knowledge tool in biosafety, responding to the continuous demand of students and professionals in search of democratization of information.
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Na Odontologia, diversos recursos vêm sendo adotados como estratégias de auxílio ao processo de ensino-aprendizagem na perspectiva de integrar a teoria com a prática. Este estudo objetivou levantar os principais recursos educacionais digitais na área de Radiologia Odontológica e discorrer sobre as características de aprendizagem destes recursos, de acordo com o modelo de Kirkpatrick. Realizouse revisão integrativa de trabalhos publicados no período de 2007 a 2017, nas bases de dados PubMed, Biblioteca Virtual em Saúde e Biblioteca Digital Brasileira de Teses e Dissertações, considerando os descritores: "computer-assisted instruction"; "dental education"; "educational technology"; "radiology". A amostra final foi composta por 13 artigos que atenderam aos critérios de inclusão e exclusão, em que foram identificados os seguintes recursos educacionais digitais: 3 módulos interativos baseado na Web; 3 objetos de aprendizagem digital; 2 cursos em plataforma virtual; 2 ferramentas digitais interativas; 1 software de visualização 3D; 1 simulador em radiologia oral e 1 sistema tecnológico de resposta ao aluno. A partir modelo de aprendizagem adotado, foram identificados os seguintes níveis nos trabalhos: satisfação dos participantes e/ou ganho de conhecimento dos participantes antes ou depois de uma intervenção ou ambos. A presente revisão de literatura identificou 7 tipos de recursos educacionais digitais utilizados em radiologia oral, que apresentaram atitudes positivas dos alunos em relação ao e-learning em todos os estudos, além de ganho significativo do conhecimento na maioria dos estudos (AU).
In dentistry, several resources have been adopted as strategies to aid the teaching-learning process in order to integrate theory and practice. This study aims to raise the main digital educational resources in the area of Dental Radiology and discuss the learning characteristics of these resources, according to the Kirkpatrick model. An integrative review of papers published between 2007 and 2017 was carried out in the databases PubMed, Virtual Health Library and Brazilian Digital Library of Theses and Dissertations, considering the descriptors: "computer-assisted instruction"; dental education"; "educational technology"; "radiology". The final sample consisted of 13 articles that met the inclusion and exclusion criteria, in which the following digital educational resources were identified: 03 interactive module based on the Web; 03 digital learning objects; 02 virtual platform courses; 02 interactive digital tools; 01 3D visualization software; 01 simulator in oral radiology and 01 technological system of response to the student. From the adopted learning model, the following levels were identified in the study: participants' satisfaction and / or gain of knowledge of the participants before or after an intervention or both. The present literature review identified 7 types of digital educational resources used in oral radiology, which presented positive attitudes of students in relation to e-learning in all studies, in addition to a significant gain in knowledge in most of the studies (AU).
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Radiología/educación , Instrucción por Computador/métodos , Tecnología Odontológica/métodos , Tecnología Educacional/métodos , BrasilRESUMEN
O uso das Tecnologias de Informação e Comunicação (TIC) para a troca de dados e informações em Odontologia, provendo serviços de saúde em situações em que seja necessário transpor barreiras geográficas, temporais, sociais e culturais é chamado de Teleodontologia. O objetivo dessa revisão integrativa foi analisar o panorama situacional global da Teleodontologia. Foram selecionados artigos científicos publicados nos últimos 10 anos, na íntegra, tanto em português quanto em inglês. A busca dos periódicos foi realizada nas bases de dados Scientific Eletronic Library Online, Literatura Latinoamericana e do Caribe em Ciências da Saúde e PubMed, por meio da combinação dos seguintes descritores "Telemedicine", "Dentistry", "Distance, Education", nas línguas portuguesa e inglesa. Foram encontrados 340 artigos, sendo 14 incluídos para avaliação final, sendo o PubMed a base de dados que mais prevaleceu (71,4%). A maioria dos estudos (85,7%) foi incluída no nível IV de evidência. Foram identificados estudos informando sobre o uso dessa tecnologia para minimizar as barreiras geográficas e fornecer uma assistência adequada às populações mais vulneráveis e outros sobre relatos de profissionais, estudantes de Odontologia e pacientes quanto ao uso da Teleodontologia. Concluiu-se que a Teleodontologia é uma realidade global, mas ainda necessita de disseminação de suas experiências na comunidade científica, para sua consolidação como uma ferramenta educativa e de assistência à saúde (AU).
The use of Information and Communication Technologies (ICT) for the exchange of data and information in Dentistry, providing health services in situations where it is necessary to overcome geographical, temporal, social and cultural barriers is called Teleodontology. The objective of this integrative review was to analyze the overall situational panorama of Teleodontology. Scientific articles published in the last 10 years have been selected, in full, in portuguese and in english. The search for the journals was carried out in the Scientific Eletronic Library Online databases, LILACS and PubMed, by means of combining the following descriptors: "Telemedicine", "Dentistry", "Education, Distance", in portuguese and english. A total of 340 articles were found, of which 14 were included for final evaluation, with PubMed the most prevalent database (71.4%). Most studies (85.7%) were included in level 4 evidence. Were identified studies reporting the use of this technology to minimize geographical barriers and to provide adequate assistance to the most vulnerable populations and others on reports from professionals, dentists and patients regarding the use of Teleodontology. It was concluded that Teleodontology is a global reality, but still needs to disseminate its experiences to the scientific community, for its consolidation as an educational and health care tool (AU).
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Telemedicina/métodos , Educación a Distancia/métodos , Educación en Odontología/métodos , Tecnología de la Información , Brasil , Tecnología Educacional/métodos , Informática Odontológica , Servicios de SaludRESUMEN
Resumo Esta revisão integrativa da literatura tem por objetivo identificar as principais lesões bucais que afetam pacientes pediátricos com HIV, bem como descrever o efeito da terapia antirretroviral altamente ativa (HAART) sobre essas lesões, comparando-a com a terapia antirretroviral (ART). Foi feita uma busca nas bases de dados PubMed e Scielo, seguindo critérios de inclusão e exclusão pré-determinados. Foram selecionados dezenove artigos científicos e extraídas as informações principais sobre prevalência e a frequência das manifestações bucais em pacientes pediátricos HIV positivos e o efeito da terapêutica aplicada. As lesões mais frequentes foram candidíase oral, gengivite, aumento das parótidas e eritema gengival linear. O uso da HAART mostrou diminuir a prevalência das manifestações bucais nos pacientes pediátricos com HIV e ser mais eficaz que a ART. Os achados deste estudo sugerem que a manifestação bucal mais frequente em pacientes pediátricos com HIV é a candidíase oral, seguida de alterações como gengivite e aumento das glândulas parótidas. O uso de HAART parece reduzir a prevalência dessas lesões orais, apresentando resultados mais eficazes que os da ART.
Abstract This integrative literature review aims to identify the main oral lesions affecting pediatric patients with HIV, and describe the effect of highly active antiretroviral therapy (HAART) on these injuries, comparing it to antiretroviral therapy (ART). A search was conducted in PubMed and Scielo databases, following predetermined inclusion and exclusion criteria. 19 papers were selected and the main information on the prevalence and frequency of oral manifestations in HIV-positive pediatric patients and effect of therapy applied were extracted. The most frequent injuries were oral candidiasis, gingivitis, parotid gland enlargement and linear gingival erythema. The use of HAART shown to reduce the prevalence of oral manifestations in pediatric patients with HIV and be more effective than ART. The findings of this study suggest that the most frequent oral manifestation in HIV-infected children is oral candidiasis, followed by changes such as gingivitis and enlargement parotid glands. The use of HAART appears to reduce the prevalence of these oral lesions, showing more effective results than ART.
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Humanos , Niño , Infecciones por VIH/complicaciones , Fármacos Anti-VIH/administración & dosificación , Enfermedades de la Boca/etiología , Glándula Parótida/patología , Candidiasis Bucal/etiología , Candidiasis Bucal/prevención & control , Candidiasis Bucal/epidemiología , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/epidemiología , Prevalencia , Infecciones Oportunistas Relacionadas con el SIDA/prevención & control , Infecciones Oportunistas Relacionadas con el SIDA/epidemiología , Terapia Antirretroviral Altamente Activa/métodos , Gingivitis/etiología , Gingivitis/prevención & control , Gingivitis/epidemiología , Enfermedades de la Boca/prevención & controlRESUMEN
This integrative literature review aims to identify the main oral lesions affecting pediatric patients with HIV, and describe the effect of highly active antiretroviral therapy (HAART) on these injuries, comparing it to antiretroviral therapy (ART). A search was conducted in PubMed and Scielo databases, following predetermined inclusion and exclusion criteria. 19 papers were selected and the main information on the prevalence and frequency of oral manifestations in HIV-positive pediatric patients and effect of therapy applied were extracted. The most frequent injuries were oral candidiasis, gingivitis, parotid gland enlargement and linear gingival erythema. The use of HAART shown to reduce the prevalence of oral manifestations in pediatric patients with HIV and be more effective than ART. The findings of this study suggest that the most frequent oral manifestation in HIV-infected children is oral candidiasis, followed by changes such as gingivitis and enlargement parotid glands. The use of HAART appears to reduce the prevalence of these oral lesions, showing more effective results than ART.
Esta revisão integrativa da literatura tem por objetivo identificar as principais lesões bucais que afetam pacientes pediátricos com HIV, bem como descrever o efeito da terapia antirretroviral altamente ativa (HAART) sobre essas lesões, comparando-a com a terapia antirretroviral (ART). Foi feita uma busca nas bases de dados PubMed e Scielo, seguindo critérios de inclusão e exclusão pré-determinados. Foram selecionados dezenove artigos científicos e extraídas as informações principais sobre prevalência e a frequência das manifestações bucais em pacientes pediátricos HIV positivos e o efeito da terapêutica aplicada. As lesões mais frequentes foram candidíase oral, gengivite, aumento das parótidas e eritema gengival linear. O uso da HAART mostrou diminuir a prevalência das manifestações bucais nos pacientes pediátricos com HIV e ser mais eficaz que a ART. Os achados deste estudo sugerem que a manifestação bucal mais frequente em pacientes pediátricos com HIV é a candidíase oral, seguida de alterações como gengivite e aumento das glândulas parótidas. O uso de HAART parece reduzir a prevalência dessas lesões orais, apresentando resultados mais eficazes que os da ART.
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Fármacos Anti-VIH/administración & dosificación , Infecciones por VIH/complicaciones , Enfermedades de la Boca/etiología , Infecciones Oportunistas Relacionadas con el SIDA/epidemiología , Infecciones Oportunistas Relacionadas con el SIDA/prevención & control , Terapia Antirretroviral Altamente Activa/métodos , Candidiasis Bucal/epidemiología , Candidiasis Bucal/etiología , Candidiasis Bucal/prevención & control , Niño , Gingivitis/epidemiología , Gingivitis/etiología , Gingivitis/prevención & control , Infecciones por VIH/tratamiento farmacológico , Humanos , Enfermedades de la Boca/epidemiología , Enfermedades de la Boca/prevención & control , Glándula Parótida/patología , PrevalenciaRESUMEN
O presente trabalho relata a experiência de tutoria em educação a distância no Curso de Especialização em Saúde da Família da Universidade Aberta do SUS (UNASUS), na Universidade Federal do Maranhão (UFMA). O objetivo é destacar os aspectos relacionados à interação entre aluno e tutor, com ênfase na sua necessidade e positivas repercussões no seu desenvolvimento. Os processos comunicativos e interativos aconteceram em um Ambiente Virtual de Aprendizagem, com reconhecida importância do acompanhamento e orientação adequada do tutor como papel fundamental na satisfação e no aprendizado do aluno. Para isso, a experiência na tutoria foi pautada na busca da menor distância entre tutor e aluno, como meio facilitador desta relação, considerada o caminho para os melhores resultados no processo ensino-aprendizagem. Os principais pontos abordados foram as possíveis causas de distanciamento entre aluno e tutor e as condutas que podem ser adotadas para uma interação humanizada entre os atores envolvidos. Diante disso, o presente trabalho sugere que a qualidade da referida interação deve ser considerada como uma das principais metas do curso tendo em vista sua influência positiva exercida em todos os aspectos responsáveis pelo aprendizado do aluno.
This paper reports the experience tutoring in distance education in the Specialization Course in Family Health at the Open University of SUS (UNASUS), the Federal University of Maranhão (UFMA). The aim is to highlight the aspects related to the interaction between student and tutor, with emphasis on their need and positive impact on their development. Communicative and interactive processes happened in a Virtual Learning Environment, with recognized importance of monitoring and proper guidance of the tutor as a key role in meeting and student learning. For this, experience in mentoring was based on finding shortest distance between tutor and student, as a facilitator in this respect, considered the way to the best results in the teaching-learning process. The main points discussed were the possible causes of distance between student and tutor and behavior that can be adopted for a humane interaction between the actors involved. Therefore, this study suggests that the quality of student-tutor interaction should be considered as one of the main goals of the course given its positive influence in all aspects responsible for student learning.
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Humanos , Educación a Distancia/métodos , Ciencias de la Salud/educación , Relaciones Interpersonales , Mentores , Estudiantes , Brasil , Programas Nacionales de SaludRESUMEN
BACKGROUND: This paper presents the results of a study of the Monsys monitoring system, an educational support tool designed to prevent and control the dropout rate in a distance learning course in family health. Developed by UNA-SUS/UFMA, Monsys was created to enable data mining in the virtual learning environment known as Moodle. METHODS: This is an exploratory study using documentary and bibliographic research and analysis of the Monsys database. Two classes (2010 and 2011) were selected as research subjects, one with Monsys intervention and the other without. The samples were matched (using a ration of 1:1) by gender, age, marital status, graduation year, previous graduation status, location and profession. Statistical analysis was performed using the chi-square test and a multivariate logistic regression model with a 5 % significance level. RESULTS: The findings show that the dropout rate in the class in which Monsys was not employed (2010) was 43.2 %. However, the dropout rate in the class of 2011, in which the tool was employed as a pedagogical team aid, was 30.6 %. After statistical adjustment, the Monsys monitoring system remained in correlation with the course completion variable (adjusted OR = 1.74, IC95% = 1.17-2.59; p = 0.005), suggesting that the use of the Monsys tool, isolated to the adjusted variables, can enhance the likelihood that students will complete the course. Using the chi-square test, a profile analysis of students revealed a higher completion rate among women (67.7 %) than men (52.2 %). Analysis of age demonstrated that students between 40 and 49 years dropped out the least (32.1 %) and, with regard to professional training, nurses have the lowest dropout rates (36.3 %). CONCLUSIONS: The use of Monsys significantly reduced the dropout, with results showing greater association between the variables denoting presence of the monitoring system and female gender.
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Educación a Distancia/métodos , Evaluación Educacional/métodos , Salud de la Familia/educación , Abandono Escolar/estadística & datos numéricos , Estudiantes de Medicina/estadística & datos numéricos , Adulto , Educación a Distancia/normas , Femenino , Humanos , Masculino , Factores de Riesgo , Facultades de Medicina , Abandono Escolar/psicologíaRESUMEN
CONTEXT: Atherosclerosis affects large and medium caliber arteries by forming calcific atheromas, precursors of cerebral vascular disease. Diabetes mellitus, obesity, and hypertension are considered as risk factors of atherosclerosis. Panoramic radiographs can display images suggestive of carotid artery calcifications (CACs). AIMS: To investigate the prevalence of images suggestive of CAC in panoramic radiographs of the jaws (PRJs) and confirm them by Doppler ultrasonography. To evaluate their anatomic locations and relationships between systemic conditions (diabetes, hypertension, and obesity) and the presence of unilateral or bilateral CAC detected on PRJ or by Doppler ultrasonography. MATERIALS AND METHODS: Of the 723 routinely performed PRJ in patients over 40 years at the Radiology Center in São Luís, Maranhão, Brazil, 21 PRJ containing images suggestive of CAC were selected in this cross-sectional study. The findings from the PRJ were confirmed by Doppler sonography. RESULTS: Images suggestive of CAC was detected in 21 (2.9%) of the PRJ evaluated, consisting of 11 (52.4%) hypertensive, 7 (33.3%) diabetics, and 9 (42.9%) obese. There was a higher prevalence of hypertensive patients in the unilateral CAC group (100%) and bilateral CAC (60%) compared to patients without CAC (25%). CONCLUSIONS: CACs can be detected in PRJs, and are more frequent in common carotid arteries. No significant associations were detected between the presence of unilateral or bilateral CAC in PRJ and hypertension, diabetes, or obesity.
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Calcinosis/diagnóstico por imagen , Arterias Carótidas/diagnóstico por imagen , Radiografía Panorámica , Ultrasonografía Doppler en Color , Calcinosis/patología , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , PrevalenciaRESUMEN
Telemental Health Care has reported very good results and is included within mental health priorities by the World Health Organization. Objective To provide an overview of the current situation of the integration of Brazilian telemedicine activities into primary health care. Methods Critical review based on MEDLINE database, using the keywords telemedicine, primary health care mental health and telemental health, on websites of the Brazilian Ministry of Health and Brazilian Telehealth Network Program, and on personal communication. Results The Brazilian Telehealth Network Program is well positioned and connects primary health care with academic centers. Regulations standards allow a broader scope of activities for psychologists, however, are more restrictive for physicians. In Brazil most of telemental health activities are focused on education and second opinion consulting. A huge challenge must be overcome considering the regional differences and the telehealth implementation experience. Research initiatives have been initiated both in the implementation and evaluation of the mental health assistance into primary health care. Discussion Brazilian Telemental Health initiatives into Primary Care are aligned with other examples around the world, have a great potential for improving mental health care service delivery, and access to proper mental health care, especially if articulated in a national program and coordinated research...
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Humanos , Atención a la Salud , Salud Mental , Telemedicina , Servicios de Salud MentalRESUMEN
INTRODUCTION: The objective of this study was to investigate the association between chronic apical periodontitis (CAP) and low-birth-weight preterm births (LBWPB). METHODS: Sixty-three women in postpartum period were included in this case-control study. The case group consisted of mothers of LBWPB infants (n = 33), and the control group was represented by mothers of newborns at term (n = 30). The CAP diagnosis was performed by using periapical radiographs through the periapical index in postpartum period. The χ(2) test, Fisher exact test, and linear and logistic regression were used for statistical analysis. RESULTS: It was observed that CAP was present in 54.5% of mothers in the case group and 20.0% in the control group (P = .004); postpartum women with CAP had about 3.5 times greater odds of LBWPB newborns than women without CAP (adjusted odds ratio, 3.52; 95% confidence interval, 1.01-12.32). Postpartum women who reported 6 or more prenatal consultations reduced odds of LBWPB newborns in 80% (adjusted odds ratio, 0.20; 95% CI, 0.06-0.69). It can be estimated that the increase of 1 unit of periapical index had a significant association with the reduction of 1½ gestational weeks in the crude analysis (ß = -1.5, P = .010) and the reduction of 211 g in birth weight after the adjusted analysis (ß = -211, P = .058). CONCLUSIONS: Prematurity and low birth weight were associated with radiographically detected CAP. Women with CAP in postpartum period had greater odds of LBWPB.
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Periodontitis Crónica/epidemiología , Recién Nacido de Bajo Peso/fisiología , Recien Nacido Prematuro/fisiología , Periodontitis Periapical/epidemiología , Adolescente , Adulto , Femenino , Edad Gestacional , Humanos , Recién Nacido , Modelos Lineales , Adulto JovenRESUMEN
INTRODUCTION: Studies have shown that periodontal disease is independently associated with coronary artery disease. However, this same association has not been demonstrated with chronic apical periodontitis. The goal of this study was to establish the relationship between chronic apical periodontitis and coronary artery disease. METHODS: This cross-sectional study included 103 patients who underwent coronary angiography at the University Hospital Presidente Dutra, Federal University of Maranhão, São Luís-Maranhão, Brazil. The patients answered a structured questionnaire and underwent physical and laboratory examinations. For each patient, a full-mouth set of periapical radiographs was taken. To compare numerical data, Student's t test for independent samples or the Mann-Whitney U test (nonparametric) was used. The homogeneity of variance was assessed by using Levene's test. For comparison of categorical data, the chi-square test or Fisher's exact test was used. The logistic regression analysis was performed to identify the independent predictors of coronary artery disease. The criterion for statistical significance was set at 5%. Statistical analysis was conducted by using SAS version 6.11 software. RESULTS: The study comprised 103 patients (52 men, 51 women; mean age, 61.9 years); 31.1% were literate, and 55.3% were married. In the study sample, the prevalence of chronic apical periodontitis was 41.7% and of coronary artery disease, it was 65%. The patients with chronic apical periodontitis had a 2.79 times higher risk of developing coronary artery disease. CONCLUSIONS: In these study patients, chronic apical periodontitis was independently associated with coronary artery disease.
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Enfermedad de la Arteria Coronaria/complicaciones , Periodontitis Periapical/complicaciones , Factores de Edad , Anciano , Glucemia/análisis , Presión Sanguínea/fisiología , Índice de Masa Corporal , Colesterol/sangre , HDL-Colesterol/sangre , LDL-Colesterol/sangre , VLDL-Colesterol/sangre , Enfermedad Crónica , Angiografía Coronaria/métodos , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Estudios Transversales , Complicaciones de la Diabetes , Escolaridad , Femenino , Humanos , Hipertensión/complicaciones , Masculino , Estado Civil , Persona de Mediana Edad , Periodontitis Periapical/diagnóstico por imagen , Radiografía de Mordida Lateral/métodos , Factores de Riesgo , Triglicéridos/sangreRESUMEN
A Universidade Aberta do Sistema Único de Saúde (Unasus) foi instituída para suprir as necessidades de capacitação e educação permanente dos trabalhadores do SUS, facilitando o acesso à formação continuada por meio da educação a distância. Este trabalho relata a experiência de alunos dos cursos de especialização em Saúde da Família e Saúde Materno-Infantil da Unasus, da Universidade Federal do Maranhão, a partir da produção de seus estudos científicos e da contribuição da educação a distância para a transformação das condições de saúde das comunidades em que atuam. Os principais temas estudados abordaram a saúde materno-infantil e constituíram-se em planos de ação, visando ao enfrentamento dos problemas identificados e à defesa da vida saudável como um direito de cidadania e bem público. A educação a distância possibilitou a esses profissionais o acesso à capacitação permanente e a ferramentas que sugerem meios de modificar a formação e execução de políticas na área da saúde.
The Open University of Brazilian National Health System (UNASUS) was established to meet the training and education needs of the Unified Health System workers, facilitating access to continuing instruction through distance learning. This paper aims to report the experience of the students from UNASUS specialization courses in Family Health and Mother-Child Health, offered by the Federal University of Maranhão, based on the production of their scientific studies and the contribution of distance learning to the transformation of the health conditions in the communities they serve. The main issues studied were mother and child health care and consisted of action plans, aiming to tackle the identified problems and to ensure healthy living as a citizen's right public asset. Distance learning allowed to these professionals to access continuous training and also, provided tools that suggest ways of modifying the formation and implementation of health policies.
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Objetivo: Identificar a autopercepção de impactos das condições bucais na qualidade de vida de mulheres, após a menopausa, usuárias e não usuárias de terapia hormonal. Método: Foram entrevistadas 200 mulheres que se encontram no climatério, fase pós-menopausa, das quais 50 são usuárias de terapia de reposição hormonal e as outras 150 não usuárias. Os dados pretendidos foram obtidos através da aplicação do questionário Oral Health Impact Profile simplificado (OHIP-14), que visa quantificar níveis de impacto sobre o bem-estar. Resultados: Do total de participantes, 23% (46) são solteiras, 60,5% (121) são casadas, 8,5% (17) são divorciadas e 8% (16) são viúvas. A idade das mulheres entrevistadas foi, em média, de 55,32 anos entre as usuárias da terapia e 56,64 anos entre as não usuárias. Com relação à ocupação, entre as usuárias de terapia hormonal, 78% (39) possuem uma atividade remunerada e 22% (11) não possuem. Já no que concerne às não usuárias da terapia, 84% (126) são remuneradas e 16% (24) não são. A distribuição dos resultados de todas as questões OHIP-14 mostrou não haver diferenças entre o grupo das usuárias e o das não usuárias de TRH. Observou-se que 133 (66,5%), dentre as 200 participantes, relataram ausência total de impactos da condição de saúde bucal na qualidade de vida das mesmas, sendo que 96 delas não faziam uso de terapia de reposição hormonal enquanto 37 faziam uso desta terapia. Conclusão: Em relação à saúde bucal das mulheres na pós-menopausa, tanto usuárias como não usuárias da terapia de reposição hormonal demonstraram não possuir percepção de impactos das condições bucais na qualidade de vida...
Objective: To identify the impact of self-perceived oral conditions on the quality of life of postmenopausal women under hormone therapy or not.Method: Two hundred postmenopausal women using (n=50) or not (n=150) hormone replacement therapy (HRT) were interviewed. The desired data were obtained from the simplified Oral Health Impact Profile (OHIP-14) questionnaire, which quantifies the impact levels on well being.Results: In the studied sample, 23% (n=46) were single, 60.5% (n=121) were married, 8.5% (n=17) divorced and 8% (n=16) widows. The mean age of the interviewed women was 55.32 years among HRT users and 56.64 among non-HRT users. As regards occupation, 78% (n=39) of HRT users had remunerated occupations and 22% (n=11) did not. Among the non-HRT users, 84% (n=126) had remunerated occupations and 16% (n=24) did not. Distribution of all the results for the OHIP-14 questions did not show significant difference between HRT users and non-HRT users. Among the 200 subjects, 133 (66.5%) reported no impact of oral health conditions on their quality of life; 37 of them were HRT users and 96 of them were non-HRT usersConclusion: Among the postmenopausal women under use or not HRT, evaluated in this study, there seemed to be no impact of self-perceived oral conditions on quality of life...
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Humanos , Femenino , Adulto , Persona de Mediana Edad , Climaterio , Posmenopausia , Calidad de Vida/psicología , Salud Bucal , Terapia de Reemplazo de Hormonas , Autoimagen , Encuestas y CuestionariosRESUMEN
OBJETIVO: Verificar a relação entre periodontite e osteoporose em um estudo caso-controle sobre a condição periodontal das mulheres na pós-menopausa. MÉTODOS: A amostra foi composta por 99 mulheres na pós-menopausa, divididas em três grupos: osso normal (Gn), osteopenia (Gpenia) e osteoporose (Gporose), com 45, 31 e 23 casos, respectivamente. A categorização da massa óssea foi aferida pela absorciometria de dupla emissão com raios X na área lombar (L2 - L4), e pela avaliação da densidade mineral óssea. Os índices de nível de inserção clínica (NIC), sangramento gengival (IG), de placa (IP) e profundidade de sondagem (PS) foram obtidos de todas as participantes, por apenas um examinador. Foi utilizado o programa BioEstat 2.0 para análise dos dados com os testes paramétricos análise de variância (ANOVA) e teste de Bonferroni, empregando-se o nível de significância de 5%. RESULTADOS: O grupo de mulheres com osteoporose apresentou o maior percentual de presença da doença periodontal, com maior média do NIC (2,6±0,4 mm), assim como PS (2,8±0,6 mm), IG (72,8±25,9 mm) e IP (72,9±24,2 mm). Após a realização do tratamento estatístico, observou-se que houve diferença significativa para a situação periodontal, principalmente entre os grupos Gn e Gporose (p=0,01) e entre os grupos Gpenia e Gporose (p=0,03). CONCLUSÃO: A osteoporose pode ter uma influência na condição periodontal, por haver relação entre periodontite e osteoporose em mulheres na pós-menopausa.
PURPOSE: To investigate the relationship between periodontitis and osteoporosis, using a case-control study about periodontal status of postmenopausal women. METHODS: A total of 99 postmenopausal women were divided into three groups: normal bone (Gn, n=45), osteopenia (Gpenia, n=31) and osteoporosis (Gporosis, n=23). The categorization of bone mass was measured by dual energy absorptiometry with X-rays in the lumbar spine (L2 - L4), by assessing bone mineral density. Clinical attachment level (CAL), gingival bleeding index (GI), plaque index (PI), and probing depth (PD) were determined in all participants by a single examiner. The data were submitted to BioEstat 2.0 software through parametric analysis of variance (ANOVA) and the Bonferroni test, with the level of significance set at 5%. RESULTS: Women with osteoporosis presented the highest percentage of periodontal disease, with higher average CAL (2.6±0.4 mm) and PD (2.8±0.6 mm), GI (72.8±25.9 mm) and PI (72.9±24.2 mm). Statistical analysis revealed a significant difference in periodontal situation between Gn and Gporosis (p=0,01) and between Gpenia and Gporosis (p=0,03). CONCLUSION: Osteoporosis may have an influence on periodontal condition, based on the relation between periodontitis and osteoporosis in postmenopausal women.
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Femenino , Humanos , Persona de Mediana Edad , Osteoporosis/complicaciones , Posmenopausia , Enfermedades Periodontales/complicaciones , Estudios de Casos y Controles , Enfermedades Periodontales/epidemiologíaRESUMEN
Atherosclerosis is a chronic inflammatory disease that can cause death and physical and/ormental disabilities. It represents a serious public health problem owing to the high healthcare costsinvolved in rehabilitating patients. Among the different methods available for diagnosingatherosclerotic disease, color Doppler examination may be considered the gold standard. Onthe other hand, panoramic radiography of the jaws (PRJ) is a diagnostic resource commonlyused by dentists, and the obtained images allow examining other structures apart from the maxillaand the mandible. Aim: To evaluate the sensitivity and accuracy of panoramic radiography inidentifying calcified carotid atheroma, and compare the results to those obtained with color Dopplerexamination. Methods: Forty-two cervical regions were evaluated in panoramic radiographsand color Doppler scans. The kappa test (p < 0.05) was used to assess agreement between theexaminations. Data were tested for sensitivity, specificity and negative predictive value, as well aspositive and negative likelihood ratios. Results: The kappa value was 0.11. The sensitivity andspecificity of PRJ were 73.9 and 36.8%, respectively, and the positive and negative likelihoodratios were 1.2 and 0.7, respectively. Conclusions: Although a low correlation between PRJand color Doppler examination was observed, as shown by the kappa test, the sensitivity of PRJin identifying calcified carotid atheroma was considered acceptable.
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Enfermedades de las Arterias Carótidas , Radiografía Panorámica , Accidente CerebrovascularRESUMEN
PURPOSE: To investigate the relationship between periodontitis and osteoporosis, using a case-control study about periodontal status of postmenopausal women. METHODS: A total of 99 postmenopausal women were divided into three groups: normal bone (Gn, n=45), osteopenia (Gpenia, n=31) and osteoporosis (Gporosis, n=23). The categorization of bone mass was measured by dual energy absorptiometry with X-rays in the lumbar spine (L2 - L4), by assessing bone mineral density. Clinical attachment level (CAL), gingival bleeding index (GI), plaque index (PI), and probing depth (PD) were determined in all participants by a single examiner. The data were submitted to BioEstat 2.0 software through parametric analysis of variance (ANOVA) and the Bonferroni test, with the level of significance set at 5%. RESULTS: Women with osteoporosis presented the highest percentage of periodontal disease, with higher average CAL (2.6±0.4 mm) and PD (2.8±0.6 mm), GI (72.8±25.9 mm) and PI (72.9±24.2 mm). Statistical analysis revealed a significant difference in periodontal situation between Gn and Gporosis (p=0,01) and between Gpenia and Gporosis (p=0,03). CONCLUSION: Osteoporosis may have an influence on periodontal condition, based on the relation between periodontitis and osteoporosis in postmenopausal women.
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Osteoporosis/complicaciones , Enfermedades Periodontales/complicaciones , Posmenopausia , Estudios de Casos y Controles , Femenino , Humanos , Persona de Mediana Edad , Enfermedades Periodontales/epidemiologíaRESUMEN
Introdução: As restaurações proximais ainda representam um desafio na prática da Odontologia Restauradora. Margens com excesso de material são frequentemente observadas, favorecendo o acúmulo de placa na região e interferindo na manutenção de uma gengiva saudável. Objetivo: O objetivo deste trabalho foi verificar as alterações gengivais em áreas de restaurações classe II com excesso de material restaurador bem como detectar a prevalência de restaurações classe II com excessos de material restaurador em duas Clínicas do Curso de Odontologia da Universidade Federal do Maranhão. Materiais e Métodos: Foram selecionados 20 pacientes por meio de exame clínico e radiográfico, nos quais foram analisados excessos de material restaurador, profundidade clínica de sondagem e sangramento gengival nas áreas adjacentes às restaurações proximais. Resultados: Foram encontradas 55 superfícies proximais restauradas com amálgama ou resina composta, as quais demonstraram um número relativamente alto de superfícies com excessos (50,9%), aumento da profundidade clínica de sondagem e presença de sangramento gengival nas áreas adjacentes a essas restaurações. Conclusões: Os autores concluíram que os excessos de material restaurador representam danos aos tecidos gengivais, estando diretamente relacionados ao aumento da profundidade de sondagem e sangramento gengival.
Introduction: The proximal restorations still represent a challenge in the practice of restorative dentistry. Overhanging restorations are frequently observed, favoring the accumulation of plaque in the region and may interfere in the maintenance of healthy gums. Objective:The aim of this study was to detect the prevalence of overhanging class II restorations and the relationship with gingival alterations in two Dental Clinics at the School of Dentistry of Federal University of Maranhão. Materials and Methods: Twenty patients were assessed by clinical and radiographic examination in order to observe overhanging restorations, probing pocket depth and gingival bleeding in the areas adjacent to the proximal restorations. Results: There were found 55 proximal surfaces restored with amalgam or composite resin which showed a relatively high number of overhanging surfaces (50,9%), increased probing pocket depth and presence of gingival bleeding in the adjacent areas to the restorations. Conclusions: Authors had concluded that overhanging restorative material represents damage to gingival tissues, being directly related to increased periodontal pocket depth and gingival bleeding.
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Introdução: A aterosclerose é uma doença inflamatória crônica que pode ser causa de morte e incapacitação física/mental, representando um sério problema de saúde pública devido aos altos custos desprendidos com a reabilitação dos pacientes. Dentre os diferentes métodos para diagnosticar doenças ateroscleróticas, a angiografia é considerada o "padrão-ouro". No entanto, outros métodos de diagnóstico de imagem têm sido citados na literatura. Desde 1981, a presença de determinadas imagens radiopacas em radiografias panorâmicas tem sido descrita como sinal da presença de placas de ateroma carotídeas calcificadas. Apesar do benefício social que a radiografia panorâmica traria como novo método de diagnóstico para esse tipo de doença aterosclerótica, diminuindo assim o risco de acidente vascular cerebral, ainda existem controvérsias na literatura sobre seu uso como método confiável para esse fim. Objetivo: Nessa revisão vamos expor algumas das obras mais relevantes publicadas sobre esse assunto desde o primeiro estudo, em 1981, analisando a possibilidade do uso da radiografia panorâmica como exame de triagem para pacientes suscetíveis a acidente vascular cerebral. Métodos: No período de setembro de 2010 a março de 2011 foram utilizados os bancos de dados eletrônico do Medline e Lilacs para a seleção dos estudos. Foram incluídos aqueles que relacionavam o exame radiográfico panorâmico e a doença aterosclerótica. Conclusão: Existem divergências na literatura estudada, no que se refere à confiabilidade da radiografia panorâmica como método de diagnóstico de pacientes com risco de Acidente Vascular Cerebral. Novos estudos devem ser realizados a fim de determinar a sensibilidade e especificidade, bem como os valores preditivos, positivo e negativo, desse exame na identificação de placa de ateroma carotídea calcificada. Além disso, a generalização do conhecimento sobre o referido tema, bem como a capacitação de cirurgiões dentistas gerais na identificação do problema deve ser instituída.
Introduction: Atherosclerosis is a chronic inflammatory disease that can cause death and physical/mental disability, representing a serious public health problem due to cost related to the rehabilitation of the patients. Among the different methods to diagnose atherosclerotic disease, angiography is considered the "gold standard". However, other methods of diagnostic imaging have been cited in the literature. Since 1981, the presence of certain radiopaque images in panoramic radiographs has been described as a sign of the presence of calcified carotid atheromatous plaques. Despite the social benefit that panoramic radiography would provide as a new diagnostic method for this type of atherosclerotic disease, thereby reducing the risk of stroke, there is still controversy in literature about its use as a reliable method for this purpose. Objective: This review will expose some of the most relevant works published on this subject since the first study in 1981 examining the possibility of the use of panoramic radiography as a screening test for patients susceptible to stroke. Methods: From September 2010 to March 2011 was used the electronic databases Medline and Lilacs for the selection of studies. Was included those that related the panoramic radiographs and atherosclerotic disease. Conclusion: There are differences in the literature studied in relation to the reliability of panoramic radiography as a method to diagnose patients at risk for stroke. Further studies should be conducted to determine the sensitivity and specificity as well as predictive values, positive and negative, in this radiography for the identification of calcified carotid atheroma. Moreover, the generalization of knowledge on that topic as well as training of general dentists in identifying the problem should be instituted.