Satisfação dos usuários com a qualidade da Atenção Primária à Saúde no estado da Paraíba: estudo transversal / User's satisfaction with the quality of Primary Health Care in the state of Paraíba: cross-sectional study

Resumo Objetivo Visa analisar a satisfação dos usuários em relação aos atributos essenciais da Atenção Primária à Saúde, no Estado da Paraíba, a partir de dados secundários do PMAQ- AB. Método Estudo transversal realizado entre 2020 e 2021, com dados de 5.347 usuários vinculados a 1.363 equipes de saúde na APS do Estado. Foram selecionadas questões do material utilizado na Avaliação Externa no 3º ciclo do PMAQ-AB referentes ao perfil demográfico, condição socioeconômica e instrumento elaborado pelos pesquisadores com 42 variáveis. As respostas dos usuários foram categorizadas por equipe de saúde: "Muito Bom" (valor 4), "Bom" (valor 3), "Regular" (valor 2), "Ruim" (valor 1) e "Muito Ruim" (valor 0). Os dados foram tabulados por meio de frequência, porcentagens simples e analisados sob forma de tabelas no Excel 2010. Resultado A classificação "Muito Bom" foi de 10.751 (52,5%) em Acesso de Primeiro Contato, 9757 (55,1%) em Longitudinalidade, 1.315 (48,2%) em Coordenação da Atenção; com menor, proporção 4.146 (25,3%) em Integralidade no Estado da Paraíba. Conclusão O estudo demonstrou classificação geral positiva com a satisfação dos usuários e a presença dos atributos, nas Macrorregiões e Estado. Todavia, verificou-se baixo desempenho no atributo Integralidade e piores avaliações atribuídas à Macrorregião I.

Abstract Objective To analyze user satisfaction in relation to the essential attributes of Primary Health Care, in the State of Paraíba, based on secondary data from the PMAQ-AB. Method Cross-sectional study carried out between 2020 and 2021, with data from 5,347 users linked to 1,363 health teams in the State's PHC. Questions were selected from the material used in the External Assessment in the 3rd cycle of the PMAQ-AB referring to the demographic profile, socioeconomic status and instrument prepared by the researchers with 42 variables. User responses were categorized by health team: "Very Good" (value 4), "Good" (value 3), "Regular" (value 2), "Bad" (value 1) and "Very Bad" (value 0). Data were tabulated using frequency, simple percentages and analyzed in the form of tables in Excel 2010. Result The "Very Good" classification was 10,751 (52.5%) in First Contact Access, 9757 (55.1%) in Longitudinality, 1,315 (48.2%) in Care Coordination; with a smaller proportion of 4,146 (25.3%) in Integrality in the State of Paraíba. Conclusion The study showed a positive general classification with user satisfaction and the presence of attributes, in the Macro-regions and State. However, there was low performance in the Comprehensiveness attribute and worse evaluations attributed to Macroregion I.

Assessment of Primary Health Care Attributes in Campina Grande, Paraíba, Brazil / Evaluación de los atributos de la Atención Primaria de Salud en Campina Grande, Paraíba, Brasil / Avaliação dos atributos da atenção primária à saúde em Campina Grande, Paraíba, Brasil

ABSTRACT Objective: to assess the presence and extent of Primary Health Care attributes in Campina Grande, Paraíba. Method: this is a cross-sectional study with 202 professionals from the Basic Health Units. The Primary Care Assessment Tool, Brazil, was used, which includes eight attributes of primary care whose scores were converted into a scale from 0 to 10, with those considered satisfactory > 6.60. Result: the general score mean was 7.6, but First contact access obtained a score of 3.7. Dental surgeons attributed the worst scores for all attributes (p <0.05). Permanent education activity was associated with a high general score (p <0.01). Conclusion: with the exception of First contact access, the other attributes are present, but initiatives by teams and managers are necessary for its expansion, with permanent education being the main strategy in this process.

RESUMEN Objetivo: evaluar la presencia y extensión de los atributos de la Atención Primaria de Salud em Campina Grande, Paraíba. Método: se trata de em rocess transversal em 202 profesionales de las Unidades Básicas de Salud. Se rocess la herramienta de evaluación de atención primaria, Brasil, que incluye ocho atributos de atención primaria cuyas puntuaciones se convirtieron em em escala de 0 a 10, considerándose aquellos> 6.60 son satisfactorios. Resultado: el promedio de la puntuación general fue de 7,6, pero la accesibilidad al primer contacto obtuvo em puntuación de 3,7. Los cirujanos dentales atribuyeron las peores puntuaciones para todos los atributos (p <0.05). El desempeño de la actividad de educación permanente se asoció em em puntaje general alto (p <0.01). Conclusión: em la excepción de Accesibilidad para el primer contacto, los otros atributos están presentes, pero las iniciativas de los equipos y gerentes son rocessoa para su expansión, siendo la educación permanente la rocessoa principal em este rocesso.

RESUMO Objetivo: avaliar a presença e extensão dos atributos da Atenção Primária à Saúde de Campina Grande, Paraíba. Método: trata-se de um estudo transversal, com 202 profissionais das Unidades Básicas de Saúde. Foi utilizado o instrumento Primary Care Assessment Tool, Brasil, que contempla oito atributos da atenção primária cujos escores foram convertidos em escala de 0 a 10, sendo considerados satisfatórios aqueles ≥6,60. Resultado: a média do Escore Geral foi de 7,6, mas a Acessibilidade de primeiro contato obteve escore de 3,7. Os cirurgiões dentistas atribuíram piores escores para todos os atributos (p<0,05). A realização de atividade de educação permanente esteve associada ao Escore Geral alto (p<0,01). Conclusão: com exceção da Acessibilidade de primeiro contato, os demais atributos estão presentes, mas iniciativas das equipes e gestores são necessárias para sua ampliação, sendo a educação permanente a principal estratégia nesse processo.

Offer and Use of Oral Health in Primary Care Before and After the Beginning of the COVID-19 Pandemic in Brazil

Abstract Objective: To compare the offer and use of oral health services in primary care, before and after the beginning of the COVID-19 pandemic in Brazil. Material and Methods: An observational study with a cross-sectional ecological design, using data from the Health Information System for Primary Care. Data regarding the number of Oral Health Teams (OHT), Oral Health Coverage in Primary Care (OHC), number of First Programmatic Dental Consultations (FPDC), and number of visits due to dental abscess and toothache were collected. Data regarding the 26 Brazilian states and Federal District were collected, as consolidated of the first quarter (January to April) of 2019 and of 2020. The median of the difference (MD) and the percentage of variation (%V) were obtained for each variable and were compared by Wilcoxon test (α<0.05). Results: An increase in the number of OHT was observed in 25 states (MD=45; %V=6.13; p<0.001), whilst the OHC increased in 17 states (MD=1.01; %V=1.62; p=0.035) between the 2019 and 2020. We also verified a significant reduction in the number of FPDC (MD=- 42.806; %V=-38.70; p<0.001), as well as in the number of visits due to dental abscess (MD=-1.032; %V=-29.04; p=0.002) and due to toothache (MD=-14.445; %V=-32.68; p<0.001). Conclusion: Although an expansion of OHT and OHC between 2019 and 2020 was verified, the offer and use of oral health services in primary care has decreased due to the COVID-19 pandemic.

In Vitro Evaluation of Fluoride in Saliva After Topical Application of Professional Use Products

Objective: To evaluate in vitro the presence of fluoride in saliva after applying professional use products on the surface of dental enamel. Material and Methods: Experimental groups were composed by: Cariostatic 12% (CA), Fluoridated Varnish 5% (FV), Fluorine Acidulate Gel 1.23% (AG) and Fluorine Neutral Gel 2% (NG). Fluoridated dentifrice (FD) and Artificial Saliva (AS) were used as controls. Products (10 µL) were applied to the surface of bovine enamel blocks (4×4×1 mm, n = 18) and immersed in 10 mL of artificial saliva at room temperature. Aliquots of artificial saliva (750 µL) of each sample were collected 1, 2, 4, 8, 24 and 48 hours after application of the products. Analyses were performed in triplicate, using a fluoride ion-specific electrode coupled to a potentiometer. The equipment was calibrated using a standard curve for fluoride analysis from 0.125 to 64 µgF-/mL. Results: Greater fluoride concentration (µgF-/mL) was observed after 1h application, as follows: 197.40 (NG), 172.21 (AG), 20.25 (CA), 14.49 (FV) e 11.81 (FD). Fluoride concentration increased overtime for all groups. After 48h, the following fluoride concentrations were assessed: 428.12 (AG), 267.25 (NG), 65.36 (FV), and 62.52 (CA). Conclusion: Greater fluoride release was observed for AG and NG groups, mostly after 1h application.

Factors Associated with the Caregivers' Perception of the Oral Health of Individuals with Cerebral Palsy

Abstract Objective: To evaluate factors associated with the caregivers' perception of the oral health of children and adolescents with cerebral palsy. Material and Methods: A cross-sectional study was carried out with 80 children and adolescents with cerebral palsy aged 2-18 years, registered at a reference institution and their respective caregivers. Caregivers provided socioeconomic, systemic and health perception and access to dental services data. A calibrated researcher (Kappa=0.75-0.98) performed oral examinations using DMF-T, dmf-t, dental trauma, gingival bleeding index, community periodontal index, malocclusion index and the dental aesthetic index. The Poisson Regression was used (α=0.05) Results: According to the caregivers' perception, the oral health reports of children and adolescents with cerebral palsy considered good and poor was 73.8% and 26.3%, respectively. The poor oral health perception is associated with the presence of dental caries in anterior teeth (PR 1.34, 95% CI=1.11-1.63) and bleeding during tooth brushing (PR 1.20, 95% CI=1.04-1.40) Conclusion: Children and adolescents with cerebral palsy who presented lesions of caries in the anterior teeth and gingival bleeding during tooth brushing, more frequently, had poor oral health by their caregivers.

The fluoride concentration of the public water supply in the urban zone and indigenous villages of Baía da Traição, Paraíba, Brazil

Introduction: It is known that the municipality of Baía da Traição, Brazil, has a system for fluoridation of the water supply. Objective: To evaluate the fluoride concentration (F-) of the public water supply in the city of Baía da Traição-PB. Methods: Public water samples were collected in 13 sites, being one in the urban zone (downtown) and 12 in the rural zone (indigenous villages). In each site, three distinct collection points were selected for convenience between November 2015 and January 2016. The analysis was performed in duplicate using a fluoride ion- specific electrode coupled to a potentiometer, previously calibrated. The samples (750 µL) were added to 750 µL of TISAB II solution, considered on a calibration curve with concentrations of 0.2 to 1 mg/L. Results: In November, December and January, respectively, concentrations of F- in the downtown area were 0.32, 0.11 and 0.09 mg/L, while the average concentrations in the indigenous villages were 0.08 (± 0.02), 0.08 (± 0.03) and 0.07 (± 0.02) mg/L. All samples had concentrations below the recommended levels (<0.60 mg/L) by the Ministry of Health for the anticaries benefit. Conclusion: The public water supply of Baía da Traição presented concentrations of F- insufficient to prevent dental caries at the population level.

Introdução: É sabido que o município de Baía da Traição possuía sistema de fluoretação de águas de abastecimento. Objetivo: Avaliar a concentração de fluoreto (F-) na água de abastecimento público do município de Baía da Traição-PB. Métodos: Amostras de água de abastecimento público foram coletadas em 13 locais, sendo um na zona urbana (Centro) e 12 distribuídas na zona rural (aldeias indígenas). Para cada local, três pontos de coleta distintos foram selecionados por conveniência entre novembro de 2015 e janeiro de 2016. A análise foi realizada em duplicata, utilizando-se um eletrodo íon-específico para fluoreto acoplado a um potenciômetro, previamente calibrados. As amostras (750 µL) foram adicionadas a 750 µL de solução TISAB II, consideradas a uma curva de calibração com concentrações de 0,2 a 1 mg/L. Resultados: Em novembro, dezembro e janeiro, respectivamente, as concentrações de F- no Centro foram 0,32, 0,11 e 0,09 mg/L, e a média das aldeias indígenas, 0,08 (±0,02), 0,08 (±0,03) e 0,07 (±0,02) mg/L. Todas as amostras apresentaram concentrações abaixo do recomendado (<0,60 mg/L) pelo Ministério da Saúde para o benefício anticárie. Conclusão: Portanto, as águas de abastecimento público de Baía da Traição apresentaram concentrações de F- insuficientes para prevenir a cárie dentária em nível populacional.

Satisfaction, Resolution and Social Participation of users of Centers for Dental Specialties in Brazil: A PMAQ-CEO Analysis

Objective: To describe satisfaction, resolution and social participation of users regarding the service offered in Brazilian Centers for Dental Specialties (CEOs). Material and Methods: An analysis was made of the first phase of PMAQ-CEO, developed during 2014, in which 8,897 users were interviewed. Module III of the instrument external evaluation was used, considering the socio-demographic characterization of the assisted population, and an analysis of satisfaction, resolution and social control of Brazilian CEOs. The bivariate and multivariate Poisson regression analysis with robust variance was used (α<0.05). Results: The profile of interviewed users is female, from the Northeastern region, brown color, living in the urban zone, incomplete elementary school, income of up to two minimum wages and resident of area covered by the family health strategy. The overall CEO rating is "good" (46.1%) or "very good" (49.2%). The score (0 to 10) given to reception staff and dentists was, respectively, 9.31±1.32 and 9.52±1.02. Among subjects who completed treatment (33.3%), the resolution was 95.3%. Although 89.1% stated they never needed to file a complaint, 68.4% did not know the Unified Health System ombudsman. The positive evaluation of CEO was associated with the good evaluation of professionals involved (p<0.05) and the absence of treatment interruption due to lack of material (p=0.037). Conclusion: The satisfaction of users with the services of Centers for Dental Specialties is high and treatments offered are resolutive. Social control tools need to be better known by users.

Theoretical and Methodological Aspects of the External Evaluation of the Improvement, Access and Quality of Centers for Dental Specialties Program

Objective: To introduce the main theoretical and methodological aspects of the external evaluation of the 1st cycle National Program for Quality Evaluation (AEPMAQ/ CEO). Material and Methods: This is an evaluative and quantitative research carried out in all Centers for Dental Specialties - CEO of Brazil, and macro-geographical regions were taken into account for analysis. The general AE-PMAQ/CEO coordination was from the Collaborative Centre for Oral Health Surveillance of the Ministry of Health - Federal University of Pernambuco and Department for Primary Health Care of the Ministry of Health. A collaborative network was established to offer a scientific and technical support for the Project among different higher education institutions around the country, state oral health coordination and quality researchers of AE-PMAQ/CEO. Data collection was carried out through interviews with managers, dentists and users. In addition, researchers used an observation template to check for infrastructure and a questionnaire to register previously discussed quality standards. Conclusion: The external evaluation of the 1st cycle National Program for Quality Evaluation offered data to demonstrate and give recognition to CEO services and municipalities' managers to assure quality for specialized dental care.

The Regulation of Services in Secondary Oral Health Care in Brazil

Objective: To analyze the regulation of access to Centers for Dental Specialties (CEO) in the 1st cycle of Program for Improving Access and Quality of Centers for Dental Specialties (PMAQ-CEO), specifically the waiting time for the first consultation in association with socioeconomic and demographic factors of users and the characteristics of services. Material and Methods: The quantitative database of the 1st cycle PMAQCEO external evaluation was used, with question directed to the CEO user (Module III - 3.1 and 3.2), which sought to identify user characteristics and access to CEO. To obtain data, a field phase was carried out between months of February to June 2014 in 930 CEOs in all Brazilian states. Results: Users who obtained the first appointment within thirty days of waiting were those who had family incomes above 10 minimum wages; which showed higher schooling; appointment scheduling by telephone made directly to the CEO; and that the consultation was accomplished by "squeeze in" option. Conclusion: It was observed that aspects related to schooling, family income and primary health care coverage influence the waiting time to obtain the first consultation in CEO. There were several ways of referencing of users, and those who performed better were those who shared accountability for the appointments between service and user.

Desafios da Regulação Assistencial na Organização do Sistema Único de Saúde / Challenges for Managed Care Regulations in the Organization of the Brazilian Healthcare System

Introdução: a regulação assistencial é um local de observação e ordenamento da rede de serviços e de gerenciamento do fluxo do usuário. Os constantes incrementos de novos procedimentos especializados devido às evoluções em ciência e tecnologias, e ao mercado de serviços em saúde requerem um planejamento dinâmico e uma gestão focada em melhorias de eficiência e eficácia. A identificação de problemas comuns às regulações pode colaborar para a prática dos gestores desta atividade. Objetivo: descrever os principais desafios enfrentados pela regulação assistencial. Materiais e Métodos: trata-se de um estudo de revisão integrativa da literatura com consulta a base SciELO scielo. Utilizou-se os assuntos "regulação de redes e sistemas de saúde", "regulação de serviços de saúde" e "regulação em saúde" sem definição de filtros, e com a opção AND entre as palavras dos assuntos. Após leitura dos títulos fez-se um segundo filtro com leitura de resumos. Resultados: foram categorizados os seguintes desafios: 1. limitada oferta de consultas e exames na rede assistencial. 2. precariedade da referência e contrarreferência. 3. dificuldades na organização das atividades de regulação. 4. baixa utilização / inexistência de protocolos para encaminhamentos. 5. precariedade de sistemas de informação e comunicação. 6. significativa influência política na gestão das unidades de saúde. 7. desorganização da rede de serviços. Conclusão: os desafios elencados sintetizam uma agenda estratégica de gestão, podendo auxiliar os gestores na tomada de decisão, no monitoramento e avaliação. (AU)

Introduction: Managed care regulation is a strategy for observation and ordering of the service network and user flow management. The steady increase in new specialized procedures due to developments in science and technology and the health services market, require dynamic planning and management focused on efficiency and effectiveness improvements. The identification of problems common to regulations can contribute to the practice of managers involved with this activity. Objective: to describe the main challenges faced by health care regulation. Material and Methods: This was an integrative review of the literature based on searches in SciELO databases. The topics "regulation of health systems and networks", "regulation of health services" and "regulation of health" without definition of filters, and with the option "AND" between the words of the subjects, were used. After reading the titles, a second screening was performed by reading the abstracts. Results: The following challenges were categorized: 1. limited offer of appointments and examinations in the care network. 2. Precariousness of reference and counter-reference. 3. difficulties in the organization of regulatory activities. 4. low usage / lack of protocols for referrals. 5. precariousness of information and communication systems. 6. significant political influence in the management of facilities. 7. disorganization of the service network. Conclusion: The challenges listed synthesize a strategic management agenda, which can assist managers in decision-making, monitoring and evaluation. (AU)

Bullying: prevalência e fatores associados à vitimização e à agressão no cotidiano escolar / Bullying: prevalence and factors associated with vitimization and aggression in the school quotidian

RESUMO Objetivo: analisar a prevalência de vitimização e agressão por bullying e tipologias associadas aos fatores sociodemográficos e comportamentos de risco em estudantes. Método: estudo transversal, desenvolvido em escolas municipais de ensino fundamental em Campina Grande, Paraíba, Brasil, sendo a amostra representada por 678 adolescentes matriculados do 6º ao 9º ano escolar. Os dados foram atualizados com o programa escolar estatístico Statistical Package for the Social Sciences, sendo utilizado nível de significância de 5% e intervalo de confiança de 95% para realização do teste qui-quadrado de Person. Resultados: a prevalência de vitimização de bullying alcançou 29,5%, com predomínio do bullying psicológico, 23,3% e envolvimento majoritário do sexo masculino. Quanto à prática de bullying, 8,4% dos estudantes afirmaram praticarem bullying contra os pares. Conclusão: pode-se observar associação entre agressores de bullying com comportamento de risco na escola.

ABSTRACT Objective: to analyze the prevalence of bullying victimization and aggression and the typologies associated with the sociodemographic factors and risk behaviors in students. Method: cross-sectional study, developed in municipal schools of elementary education in Campina Grande, Paraíba, Brazil, with the sample being comprised of 678 adolescents enrolled in the 6th to 9th school years. The data were processed using the statistical school program Statistical Package for the Social Sciences, considering a significance level of 5% and a confidence interval of 95% for carrying out the Person's chi-squared test. Results: the prevalence of bullying victimization reached 29.5%, with a predominance of psychological bullying, 23.3%, with the majority involved being male. Regarding the practice of bullying, 8.4% of the students said they practiced bullying against their peers. Conclusion: an association between bullying aggressors and risk behavior in school was observed.

Fracture Resistance of Endodontically Treated Teeth Restored with Different Types of Intracanal Posts

Objective: To evaluate the fracture resistance of endodontically treated teeth restored with different types of intracanal posts. Material and Methods: Sixty human upper central incisors (n = 60) were divided according to the performance of different protocols for restoration with intracanal posts. Groups without endodontic treatment (NT) and with endodontic treatment (TR) without placement of intracanal posts, served as controls. The experimental groups received endodontic treatment and were restored with: fiberglass post with composite resin filling core (PFV-NP); carbon fiber post with composite resin filling core (PFC-NP); nickel-chromium metal cast and core posts (NiCr); or copper-aluminum metal cast and core posts (CuAl). The specimens were then tested to determine the maximum fracture resistance and the failure types of fracture (infra-crestal and supra-crestal). Data were analyzed by one-way ANOVA and Tukey test (α<0.05). Results: Increased fracture resistance was observed for NT group (p<0.05). Within endodontically treated teeth groups, NiCr showed higher resistance to fracture, differing statistically from groups FV+NP and FC+NP (p<0.05). Higher frequency of infra-crestal fractures was observed in NT and TR groups. Conclusion: The installation of nickel-chromium intracanal cast and core posts contributed to higher fracture resistance and lower risk of fractures difficult to repair.

Antibacterial Activity of Melaleuca alternifolia (tea tree essential oil) on Bacteria of the Dental Biofilm

Objective: To evaluate the antibacterial activity of tea tree EO on Streptococcus mutans (ATCC 25175), S. salivarius (ATCC 7073) and Lactobacillus rhaminosus (ATCC 9595). Material and Methods: The antibacterial activity of M. alternifolia EO was evaluated by the broth dilution method, by which minimum inhibitory and bactericidal concentrations (MIC and MBC) were determined. Serial dilutions range from 70243.90 µg/mL to 26.14 µg/mL. The MIC evaluation was performed in 96-well microplates, in which 100 µL of Brain Heart Infusion (BHI), 100 µL of the EO dilution and 5 µL of the inoculum (final concentration = 5x105 CFU/mL) were inserted. After 24 h of incubation, MIC was determined as the lowest concentration capable of inhibiting microbial growth, identified by the resazurin reaction (100 µg/mL). CBM was identified by the absence of subculture growths (50 µL) of dilutions equal to or greater than MIC. Tests were performed in triplicate and at three different times (n = 9). Pharmacological controls (0.05% and 0.12% Chlorhexidine), growth and sterility were used to validate the results. Results: The MIC of M. alternifolia compared to S. mutans, S. salivarius and L. rhaminosus was 1940.16 µg/mL, 3977.34 µg/mL and 3977.34 µg/mL, respectively. The MBC values were 70243.90 µg/mL, 3977.34 µg/mL and 34265.31 µg/mL, respectively. Conclusion: The essential oil of M. alternifolia presented antibacterial activity against the microorganisms evaluated when in high concentration.

Efeito sobre a morfologia do esmalte dental e análise físico-química de medicamentos utilizados por pacientes pediátricos com paralisia cerebral / Effect on dental enamel morphology and physical-chemical analysis of medicines used by pediatric patients with cerebral palsy

Introdução: Muitos medicamentos pediátricos líquidos são considerados fatores de risco para a estrutura dentária. Esse potencial pode aumentar quando ingeridos de forma crônica, como é o caso do tratamento de algumas condições, tal como a paralisia cerebral. Objetivo: Avaliar o efeito sobre a morfologia do esmalte dental e as propriedades físico-químicas de medicamentos de uso contínuo indicados a pacientes infantis com Paralisia Cerebral. Material e método: A amostra foi constituída por quatro medicamentos: Fenobarbital (M1), Carbamazepina (M2), Oxcarbazepina (M3) e Domperidona (M4), todos em suspensão oral. Analisaram-se o pH, o teor de Sólidos Solúveis Totais (SST) e a viscosidade dos medicamentos. Todos os testes foram realizados em duplicata. Para análise em microscopia eletrônica de varredura (MEV), 15 blocos de esmalte bovino foram distribuídos aleatoriamente e imersos em oxcarbamazepina (n=5), carbamazepina (n=5) e saliva artificial (n=5). Os ciclos de imersão foram feitos por seis dias, durante cinco minutos, duas vezes ao dia, com intervalos de 12 horas, quando ficavam mantidos em saliva artificial. O grupo controle permaneceu em saliva artificial. Os dados foram analisados descritivamente. Resultado: Em relação ao pH endógeno, os valores variaram de 2,82 (M3) a 9,60(M1). Para o SST, as médias de maior e menor valor foram, respectivamente, de 20,5% (M3) e 46% (M1). A viscosidade variou de 6,89 mm2/s (M1) a 58 mm2/s (M3). Em MEV, observaram-se alterações sugestivas de perda de estrutura no esmalte dental em oxcarbamazepina e carbamazepina, proveniente da ação dos medicamentos analisados. Conclusão: Concluiu-se que os medicamentos líquidos pediátricos analisados, indicados a pacientes com paralisia cerebral, apresentam potencial cariogênico e erosivo, destacando-se a Oxcarbazepina.

Introduction: Many liquid pediatric medicines are considered risk factors for tooth structure. This potential may increase when taken chronically as is the case of some conditions such as cerebral palsy. Objective: To evaluate the effect on the morphology of dental enamel and the physicochemical properties of continuous use of drugs given to pediatric patients with cerebral palsy. Material and method: The sample consisted of three drugs for epilepsy: Phenobarbital (D1), Carbamazepine (D2), Oxcarbazepine (D3); and one drug for gastroesophageal reflux: Domperidone (D4). All in oral suspension. The pH, content of total soluble solids (TSS), and viscosity of the drugs were analyzed. The tests were made two measurements. For SEM analysis, 15 bovine enamel blocks were randomly distributed and immersed in oxcarbazepine (n=5); carbamazepine (n=5); and artificial saliva (n=5). The immersion cycles were made for 6 days, during 5 minutes, 2 times a day with intervals of 12 hours, when they were kept in artificial saliva. The control group remained in artificial saliva. Data were descriptively analyzed. Result: Regarding endogenous pH, values ranged from 2.82 (D3) to 9.60 (D1). For TSS, the highest and lowest mean values were, respectively, 20.5% (D3) and 46% (D1). Viscosity ranged from 6.89 mm2/s (D1) to 58 mm2/s (D3). In SEM, observed alterations suggestive of loss of structure in the enamel in oxcarbazepine and carbamazepine from the action of the drugs analyzed. Conclusion: It was concluded that the pediatric liquid drugs analyzed, indicated to patients with cerebral palsy, have the potential cariogenic and erosive, especially the Oxcarbazepine.

Participação do Projeto de Extensão SaBuComu na Formação de Graduandos da Área da Saúde / Participation of the SaBuComu Extension Project on the Formation of Undergraduate Health Students

Construir um perfil quantitativo da participação dosextensionistas e avaliar o impacto do SaBuComu na formaçãoem saúde com ênfase nas percepções sobre humanização,cidadania, habilidades de organização e protagonismoestudantil. Metodologia: Utilizou-se uma abordagem indutiva,com procedimento histórico e técnica documental por meiode diários de campo e de questionário com perguntas abertas.Resultados: Observou-se nos diários de campo (n=45) que asfrequências dos registros e o número de atividades registradasvariaram, respectivamente, de 25-108 e de 21-99 porextensionista, predominando os relatos de reuniões (22,0). Asatividades registradas com maior frequência foram: campanhasde vacinação contra hepatite B (13,0%), desenhos e pinturas(9,0%) e corte e colagem (7,7%). Os tipos de participaçãomais observados foram: interação com crianças (19,3%),explicação sobre o tema abordado na atividade (16,8%) edivulgação da campanha de vacinação contra hepatite B(10,7%). Os problemas abordados mais frequentemente foram:problemas de saúde (9,5%), descontrole das crianças (9,1%) ebriga entre crianças (7,0%). Entre os 273 problemas registrados,48,7% não apresentou registro de solução. A partir dosquestionários (n=6), verificou-se que o projeto contribui paraampliar o conceito de saúde, formar profissionais maishumanizados, incentivar a participação em pesquisascientíficas e desenvolver a autonomia estudantil. Conclusão:Houve variação no número de registros por extensionista, assimcomo uma diversidade dos tipos de atividades e de participaçãonas mesmas, além da pluralidade dos problemas encontrados.O projeto contribui na formação em saúde, modificando apercepção de conceitos e realidades por meio de vivências.Há o incentivo à pesquisa científica, entretanto algunsextensionistas relataram dificuldades em desenvolver aautonomia no projeto...

To outline a quantitative profile of the studentsparticipating of SaBuComu extension project and evaluate itsimpact on health training focused on humanization, citizenshipvalues, organizational skills and student leadership. Materialand Methods: This study used an inductive approach, withhistorical procedure and documentary technique by means offield diaries and questionnaires with open questions. Results:According to the field diaries (n=45), the frequencies of recordsand the number of registered activities of each student rangedbetween 25-108 and 21-99, respectively. There was apredominance of reports about the meetings (22). The mostfrequently reported activities were: vaccination campaignsagainst hepatitis B (13.0%), drawings and paintings (9.0%),and collages (7.7%). The most frequent types of participationincluded interaction with children (19.3%), explanation on thetopics addressed in the activities (16.8%) and advertising ofthe hepatitis B vaccination campaign (10.7%). The problemsaddressed more often were: health issues (9.5%), uncontrolledchildren (9.1%) and fight among children (7.0%). Among the273 registered issues, 48.7% remained unsolved. Based onthe questionnaires (n = 6), it was found that the projectcontributes to extend the concept of health, form more humaneprofessionals, encourage participation in scientific research,and develop student autonomy. Conclusion: There was avariation in the number of records by each student, as well asa diversity of types of activities and participation beyond theplurality of the problems found. The project contributes tohealth education, changing the perception of concepts andrealities through experiences. It is reported to encourage theinvolvement of students in scientific research, although someof them reported difficulties in developing autonomy in theproject...

Antifungal activity of components used for decontamination of dental prostheses on the growth of Candida albicans / Atividade antifúngica de produtos utilizados na descontaminação de próteses dentárias sobre o crescimento de Candida albicans

Introduction: The effectiveness of antimicrobial solutions employed in dental prosthesis decontamination is still uncertain. Aim: To evaluate the antifungal activity of cleaners used in the decontamination of dental prostheses on the growth of Candida albicans. Material and method: The evaluated products were: Corega Tabs(r) (S1), Sodium Hypochlorite 1% (S2), Sodium Bicarbonate 1% (S3), Hydrogen Peroxide 1% (S4), Chlorhexidine Digluconate 0.12% - Periogard (r) (S5), Mouthrinse based on essential oils - Listerine(r) (S6), essential oil from Rosmarinus officinalis (rosemary) at concentrations of 1% (S7) and 2% (S8). The antifungal activity of the products was evaluated by agar diffusion technique and the determination of microbial death curve of samples of C. albicans (ATCC 90028) in concentration 1.5 × 106 CFU/mL. The tests were performed in triplicate and statistical analysis was made by ANOVA Two-Way and Tukey tests, with the confidence level of 95%. Result: The average of the zones of inhibition growth, in millimeters, obtained for the products were: 0.0 (S1), 44.7 (S2), 0.0 (S3), 21.6 (S4), 10.0 (S5), 6.1 (S6), 0.0 (S7) and 2.4 (S8). Considering the determination of microbial death curve, all products showed a statistical difference (p<0.01) from control (0.85% sodium chloride) and S3 groups. Fungal growth less than 2×104 CFU/mL and an accentuation of the microbial death curve were observed after 30 minutes, with exception for S3 and control groups. Conclusion: The studied compounds, with the exception of Sodium Bicarbonate, have antifungal effect against C. albicans, which contribute for dental prostheses hygiene. .

Introdução: A efetividade de soluções antimicrobianas empregadas na descontaminação de próteses ainda é incerta. Objetivo: Avaliar a atividade antifúngica de soluções empregadas na descontaminação de próteses sobre o crescimento de Candida albicans. Material e método: Foram avaliados os produtos: Corega Tabs Branqueador(r) (S1), Hipoclorito de Sódio 1% (S2), Bicarbonato de Sódio 1% (S3), Peróxido de Hidrogênio 1% (S4), Digluconato de Clorexidina 0,12% - Periogard(r) (S5), Enxaguatório bucal a base de óleos essenciais - Listerine(r) (S6), e óleo essencial de Rosmarinus officinalis (alecrim) nas concentrações 1% (S7) e 2% (S8). A atividade antifúngica foi avaliada por meio da técnica de difusão em ágar e da determinação da curva de morte microbiana de amostras de C. albicans (ATCC 90028) na concentração 1,5×106 UFC/mL. Os testes foram realizados em triplicata e a análise estatística se deu pelos testes ANOVA Two-Way e Tukey, sendo adotado nível de confiança de 95%. Resultado: A média dos halos de inibição do crescimento, em milímetros, obtidos para os produtos foram: 0,0 (S1); 44,7 (S2); 0,0 (S3); 21,6 (S4); 10,0 (S5); 6,1 (S6); 0,0 (S7) e 2,4 (S8). Para curva de morte microbiana, todos os produtos apresentaram diferença estatisticamente significante (p<0,05) do grupo controle (cloreto de sódio 0,85%) e do grupo S3. Verificou-se crescimento fúngico inferior a 2×104 UFC/mL e acentuação na curva de morte microbiana após 30 minutos de ação, a exceção do grupo S3. Conclusão: As substâncias analisadas, a exceção do Bicarbonato de Sódio, possuem ação antifúngica frente C. albicans, podendo contribuir para higienização de próteses. .

Qualificação de processos de gestão e atenção no município de Caaporã, PB: relatos de tutoria de educação permanente em saúde / Qualification of management and attention processes in the city of Caaporã, state of Paraíba, Brazil: mentoring reports on permanent education in health

Objetivou-se relatar a formação em Educação Permanente em Saúde (EPS) de Equipes de Saúde da Família (ESF) do município de Caaporã - PB. Os problemas identificados dizem respeito a dificuldades de acesso dos usuários, fragilidade do vínculo com a comunidade e ausência de ações educativas e preventivas. As intervenções propostas envolvem a reorientação das estratégias de acesso, integração entre a ESF e comunidade e a redistribuição das tarefas entre os membros da ESF. Os resultados revelam a eliminação da fila de espera para o atendimento, o fortalecimento do vínculo com a comunidade e a introdução de ações preventivas na ESF. A EPS em Caaporã contribuiu para modificar as práticas de gestão e atenção em saúde.

The aim of this paper was to report the training on Permanent Education in Health (PEH) of Family's Health Teams (FHT) from the Muncipality of Caaporã, State of Paraíba. The problems identified involved the difficulties to access health services, fragility of the link with the community, and lack of educational and preventive actions. The proposed interventions encompass redirection of access strategies, integration between ESF and the community, and redistribution of tasks among FHT members. Results show the elimination of queue for care service, strengthening of the link with the community, and introduction of preventive measures in the FHT. The PEH in Caaporã contributed to modify the management and health care practices.

Uso de Fitoterápicos Associadosa Próteses Dentárias / Use of Herbal Medicines Associated with Dental Prosthesis

Objetivo: Realizar uma revisão das pesquisas que utilizaramsubstâncias fitoterápicas contra microorganismos dacavidade oral e da superfície de próteses dentárias e verificarse a eficácia destes fitoterápicos tem sido investigada.Material e Métodos: Foi realizada uma revisão de literaturaatravés de uma busca bibliográfica nas seguintes bases dedados: BBO, BIREME, LILACS, Portal de Periódicos CAPES,PUBMED, SCIELO e Google Acadêmico. Resultados: Osfitoterápicos quando associados às próteses dentárias, emsua maioria, foram estudados quanto a sua ação antifúngica,in vitro, sobre cepas de C. albicans no tratamento deestomatite protética. Conclusão: Os fitoterápicos utilizadoscom maior frequência nestes estudos foram a Uncariatomentosa L., o Ricinus communis e a própolis, sendo quea última dentre estes, quando em forma de gel, apresentouresultados discordantes, enquanto que a Ricinus communis,na sua apresentação em dentifrício, não apresentou efeitoantimicrobiano frente a E. coli, C. albicans e C. glabrata.Portanto, a eficácia dos diversos fitoterápicos deve sermelhor estudada para obtenção dos resultados esperadosquando associados às próteses dentárias...

Objective: Conduct a review of research that used herbalsubstances against microorganisms of the oral cavity andthe surface of dental prostheses and verify if theeffectiveness of these herbal medicines have been studied.Material and Methods: The survey was conducted in thedatabases: BBO, BIREME, LILACS, Portal of periodicalsCAPES, PUBMED, SCIELO and Academic Google. Results:Herbal when associated with dentures, mostly, they werestudied for their antifungal activity in vitro of C. albicansstrains in the treatment of denture stomatitis. Conclusion:Herbal frequently used in these studies were Uncariatomentosa L., Ricinus communis and propolis, with the lastof these, when in gel form, showed conflicting results, whileRicinus communis, in its dentifrice presentation didn’tshowed antimicrobial effect against E. coli, C. albicans andC. glabrata. Therefore, the effectiveness of several herbalmedicines should be better studied to obtain the expectedresults when associated with dentures...

Estudo comparativo da infiltração marginal em Copings de Níquel-Cromo fixados com diferentes cimentos resinosos / Marginal microleakage in nickel-chromium copings fixed with different resin cements - A comparative study

Objetivo: Avaliar, com o corante azul-de-metileno, a microinfiltração marginal na interface de dentes preparados para coroas totais metalocerâmica e copings, fixados com diferentes cimentos resinosos. Método: Quarenta dentes foram preparados e moldados paraconfeccionar copings em níquel-cromo. A amostra foi dividida em 4 grupos, conforme o agente de cimentação: Grupo I: copings cimentados com Scothbond e RelyX ARC; Grupo II: copings fixados com Single Bond e RelyX ARC; Grupo III: colados com RelyX U100; Grupo IV: fixados com Pavavia F. Os dentes foram armazenados por 6 meses em água destilada a 37OC, submetidos à ciclagem térmica e recolocados na água por mais 6 meses. Exceto nas margens, foram impermeabilizados externamente e imersos em soluçÆo de azul-de-metileno a 1%, por 72 horas. Os copings foram seccionados com discos de carborundum e avaliados com e sem cimento resinoso na superfície do preparo, sendoaplicado para cada face um escore de infiltraçÆo, variando de 0 a 4.Resultados: Na análise com cimento, o grau 0 ocorreu em 65% dasobservaçães do grupo I; 52% no Grupo IV; 42,5% no II e 5% no Grupo III. Na avaliaçÆo sem cimento, ocorreu 95% de graus 0 nas observaçães do Grupo IV; 90% para o I, 57% no Grupo II e 50% no III. Por meio do teste de Kruskal Wallis foi constatada diferença estatisticamente significante entre os grupos (p<0,05), sendo os Grupos I e IV superiores aos demais. ConclusÆo: Antes e após a remoçÆo do cimento, o Panavia F e o Scothbond Multiuso + RelyX ARC apresentaram maior resistência a penetraçÆo do corante...

Objective: To evaluate marginal microleakage at the interface of teethprepared for full metal-ceramic crowns and copings fixed with differentresin cements, using methylene blue staining. Method: Forty teeth were prepared and impressions were obtained to fabricate Ni-Cr copings. The sample was assigned to four groups,according to the luting agent: Group I: coping cemented with Scotchbond and RelyX ARC; Group II: copings fixed with Single Bond and RelyX ARC; Group III: copings fixed with RelyX U100; Group IV: copings fixed with Pavavia F. The teeth were stored in distilled water at37 ºC for six months, subjected to a thermocycling regimen and storedagain in water for another six months. The tooth surfaces were rendered waterproof except for the margins and were immersed in a 1% methylene blue solution for 72 h. The copings were sectioned with carborundum disks and evaluated with or without resin cement on the prepared dental surface. Each face was scored 0 to 4 for leakage.Results: Analysis of the samples with cement revealed that score 0 wasattributed to 65% of the samples of Group I; 52% of Group IV; 42.5% ofGroup II and 5% of Group III. In the analysis of samples without cement,score 0 was attributed to 95% of the samples of Group IV; 90% of Group I; 57% of Group II and 50% of Group III. Statistically significant difference among the groups was found by the Kruskal-Wallis test (p<0.05). Groups I and IV were superior to the others. Conclusion: Before and after removal of the cement, Panavia F and Scotchbond + RelyX ARC presented greater resistance to dyepenetration...

Caracterização da oferta do serviço de radiologia odontológica no Estado da Paraíba: evidenciando desigualdades e sub-registros / Characterization of dental radiographic service in the state of Paraíba: highlighting inequalities and sub-records

Caracterizar o serviço de radiologia odontológica no estado da Paraíba. Os dados coletados, do Departamento de Informática do Sistema Único de Saúde, foram: população total, população cadastrada na Atenção Básica (AB), número e distribuição de aparelhos de Raios-X Odontológico (ARXO), e produção de radiografias odontológicas. As cidades que possuíam aparelho foram agrupadas e comparadas segundo as mesorregiões paraibanas. Calculou-se para cada cidade: a razão entre população total e quantitativo de aparelhos; a razão entre população cadastrada na AB e quantitativo de aparelhos públicos; produção semestral e média mensal de produção de radiografias. Das 223 cidades da Paraíba, 21,1% possuem ARXO, sendo 356 aparelhos em uso, 77,2% privados e 66,9% concentrados na Zona da Mata. A média de pessoas para cada ARXO do Estado é 16.609, enquanto a média de usuários cadastrados na AB para cada ARXO público é 20.922. A produção semestral e média mensal de radiografias ambulatoriais são, respectivamente, 1.272 e 212. Verificou-se que 36,2% das cidades não registraram produção de radiografias durante o último semestre de 2008. O serviço ofertado concentra-se em poucas cidades, sendo, majoritariamente, de caráter privado, com alta taxa de pessoas por aparelhos e distribuição desigual. Há, provavelmente, sub-registro da produção.

To characterize the dental radiology service in Paraíba State. From Department of Informatics of the Unified Health System, data collected were: total population, population covered by Primary Care (PC), number and distribution of dental X-ray equipment (DXRE), and dental radiographs production. The cities which had the equipment were grouped and compared according to Paraíba's regions. We calculated for each city: ratio between total population and amount of equipment; ratio between population covered by PC and quantity of public equipment; biannual and the monthly averages of radiographs production. Of the 223 cities, 21.1% are equipped with DXRE, which 356 are in use, 77.2% are private, and 66.9% concentrate in Zona da Mata region. The average of person per each DXRE is 16,609, while the average of people enrolled in PC for each public DXRE is 20,922. The biannual and the monthly production of radiographs are, respectively, 1,272 and 212. We found that 36.2% of the cities reported no X-rays production during the last half of 2008. The service is concentrated in a few cities, being mostly private, with a high rate of people per equipment and inequitable distribution. Probably, there is a production underreporting.