RESUMO

This study aimed to identify the provision of actions and procedures by family health teams (FHSt), based on Rio de Janeiro Municipality's (MRJ) Health Services Portfolio (HSP) and the main factors associated with this provision, in the different population strata. Data from the National Program for Improving Access and Quality of Primary Healthcare were used and implemented at the national level into 17,202 FHSts from June to September 2012. Outcome variables were "FHSt belonging to MRJ" and "FHSt providing all nine CS-MRJ procedures". Uni-, bi- and multivariate analysis were performed. A better performance of the MRJ in relation to other major urban centers (EP6#) (p<5%) was noted in 10 of the 14 health actions analyzed. The electronic medical record showed a level of deployment in MRJ's FHSts of 96%, contrasting with 34% in the EP6# and 14% in Brazil. Both the MRJ and EP6# evidenced low supply of mental health services (about 56%). While the supply of low-complexity procedures was a major problem in large cities, the supply of health actions in the different health care lines was a larger problem in small municipalities. Overall, the MRJ showed better performance when compared to the average of large municipalities. The health service portfolio appeared to be an important management tool.

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RESUMO

Resumo Objetivou-se identificar a oferta de ações e procedimentos pelas equipes de saúde da família (eSF), tendo por base a Carteira de Serviços (CS) do Município do Rio de Janeiro (MRJ) e os principais fatores associados a esta oferta, nos diferentes estratos populacionais. Foram utilizados dados do Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica, aplicado a 17.202 eSF, de junho a setembro de 2012 no Brasil. Foram variáveis desfecho: eSF pertencer ao MRJ; eSF ofertar todos os nove procedimentos da CS-MRJ. Foram conduzidas análises uni, bi e multivariada. Evidenciou-se melhor desempenho do MRJ em relação aos demais grandes centros urbanos (EP6#) (p < 5%) em 10 das 14 ações de saúde analisadas. O prontuário eletrônico apresentou 96% de implantação nas eSF do MRJ, contrastando com 34% nas dos EP6# e 14% no Brasil. Tanto no MRJ quanto no EP6# encontrou-se baixa oferta de serviços de saúde mental (cerca de 56%). Enquanto a oferta de procedimentos de baixa complexidade foi um problema maior nos grandes centros, a oferta de ações em saúde nas diferentes linhas de cuidado foi um problema maior nos municípios pequenos. No geral, o MRJ mostrou melhor desempenho quando comparado à média de municípios de grande porte. A carteira de serviço pareceu ser um importante instrumento gerencial.

Abstract This study aimed to identify the provision of actions and procedures by family health teams (FHSt), based on Rio de Janeiro Municipality's (MRJ) Health Services Portfolio (HSP) and the main factors associated with this provision, in the different population strata. Data from the National Program for Improving Access and Quality of Primary Healthcare were used and implemented at the national level into 17,202 FHSts from June to September 2012. Outcome variables were "FHSt belonging to MRJ" and "FHSt providing all nine CS-MRJ procedures". Uni-, bi- and multivariate analysis were performed. A better performance of the MRJ in relation to other major urban centers (EP6#) (p<5%) was noted in 10 of the 14 health actions analyzed. The electronic medical record showed a level of deployment in MRJ's FHSts of 96%, contrasting with 34% in the EP6# and 14% in Brazil. Both the MRJ and EP6# evidenced low supply of mental health services (about 56%). While the supply of low-complexity procedures was a major problem in large cities, the supply of health actions in the different health care lines was a larger problem in small municipalities. Overall, the MRJ showed better performance when compared to the average of large municipalities. The health service portfolio appeared to be an important management tool.

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RESUMO

O objetivo deste trabalho foi avaliar o efeito antimicrobiano da solução manipulada de gluconato de clorexidina a 0,12% associada a acetato de zinco e Periogard®, por meio de concentrações inibitórias mínimas (CIMs). As soluções foram analisadas através de teste de diluição em caldo Mueller-Hinton para Pseudomonas aeruginosa, Staphylococcus aureus, Enterococcus faecalis e Escherichia coli. As amostras foram incubadas durante 24 horas a 37ºC. O crescimento bacteriano foi avaliado pela turvação do meio de cultura. As soluções manipuladas de clorexidina associada a acetato de zinco e Periogard® apresentaram CIMs semelhantes, respectivamente, para Enterococcus faecalis (1,875µg/ml para ambos) e Staphylococcus aureus (< 0,625µg/ml para ambos). Resultados parecidos também foram encontrados para cepas de Escherichia coli (1,875µg/ml versus 1,25µg/ml) e Pseudomonas aeruginosa (5,0µg/ml versus 3,75µg/ml). Os resultados obtidos indicam que a combinação de acetato de zinco com clorexidina não altera a sua propriedade antimicrobiana frente aos microrganismos testados.

The purpose of this study was to evaluate the antimicrobial effects of manipulated solution of 0,12% chlorhexidine gluconate in association with zinc acetate and Periogard®, through minimum inhibitory concentrations (MICs). The solutions was analyzed through of Mueller-Hinton broth dilution test to Pseudomonas aeruginosa, Staphylococcuus aureus, Enterococcus faecalis e Escherichia coli. The samples were incubated at 37°C for 24 hours. Microbial growth was evaluated by turbidimetric in culture media. The manipulated solution of chlorhexidine in association with zinc acetate and Periogard® showed similar MIC, for Enterococcus faecalis (1,875µg/ml for both) and Staphylococcuus aureus (< 0,625µg/ml for both). Similar results was found for strains Escherichia coli (1 ,875µg/ml versus 1,25µg/ml) and Pseudomonas aeruginosa (5,Oµg/ml versus 3,75µg/ml). The obtained results indicated that the association of zinc acetate with chlorhexidine doesn't change the antimicrobial effects of chlorhexidine against the tested microorganisms.

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O objetivo deste trabalho foi avaliar o poder de redução de placa bacteriana de um enxaguatório à base de peróxido de hidrogênio 1,5% (Peroxyl®) em indivíduos sem medidas de higiene bucal. Quinze indivíduos periodontalmente saudáveis foram usados no experimento. Os participantes foram divididos aleatoriamente em 3 grupos e requisitados a abolir toda e qualquer medida de higiene bucal, por um período de 3 dias. Durante este período de ausência de higiene bucal, cada grupo usou 3 vezes ao dia, respectivamente, um dos seguintes enxaguatórios bucais: (i) Peroxyl®, (ii) clorexidina 0,12% (Periogard®) e (iii) solução placebo. Após o término do período experimental, os participantes retornaram às suas medidas comuns de higiene bucal por 10 dias. Este esquema experimental foi repetido por mais 2 vezes até que os 3 grupos utilizaram as 3 soluções diferentes. Logo após o término dos respectivos períodos experimentais (3 dias), a quantidade de placa formada nas superfícies dentárias dos participantes foi avaliada clinicamente, utilizando-se o índice de placa de Quigley e Hein modificado por Turesky (IQH). Os resultados do IQH para todas as faces dos dentes nos grupos que usaram Periogard®, Peroxyl® e placebo foram, respectivamente 0,63; 1,24 e 1,78. Estas diferenças neste índice foram estatisticamente significantes (p<0,05). Estes resultados indicam que o uso do enxaguatório Peroxyl® pode diminuir a formação de placa na ausência de medidas mecânicas de higiene bucal.

The aim of the present study was to evaluate the potential of the mouthrinse Peroxyl® to inhibit plaque formation in individuals without oral hygiene measurements. Fifteen periodontally healthy individuals were selected for the study. The participants were divided randomly into three groups and asked to suppress any oral hygiene measures for three days, during wich period each group rinsed three times a day with: (i) Peroxyl®, (ii) Chlorhexidine 0.12% and (iii) placebo. Following, the subjects returned to their oral hygiene routine for ten days. This experimental scheme was repeated twice until the three groups used the three different solutions. After the respective 3-day experimental periods, plaque formation was assessed clinically by means of the Quigley & Hein plaque index (IQH) modified by Turesky. Results regarding IQH and all dental surfaces for the groups that used chlorhexidine, Peroxyl® and placebo were, respectively: 0,63, 1,24, 1.78. Differences were rendered statistically significant (p<0.05). The results indicated that Peroxyl® can prevent plaque formation in the absence of mechanical measures of oral hygiene.

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