Consulta à beira do leito e os diagnósticos de enfermagem em pessoas com diabetes mellitus / Bedside nursing consultation and nursing diagnoses in people with diabetes mellitus / Consulta de enfermería a la beira del lecho y los diagnósticos de enfermería en la en personas con diabetes mellitus

Objetivo: Identificar o perfil sociodemográfico, clínico e os diagnósticos de enfermagem pessoas com diabetes mellitus estabelecidos em consultas de enfermagem à beira do leito. Método: Estudo observacional descritivo, realizado em 2017 com 37 participantes, amostra não probabilística, em unidade de clínica médica ou cirúrgica de um hospital escola do sul do Brasil. Variáveis do estudo: dados sociodemográficos, clínicos e diagnósticos de enfermagem da North American Nursing Diagnosis Association, submetidos à estatística descritiva simples. Resultados: 89,21% dos participantes diabéticos tipo 2; tempo médio de diagnóstico de 9,6 anos; 70,2% hipertensos; 56,7% tabagistas; 16,2% insulinodependentes; 32,4% faziam uso de açúcar refinado; 59,45% associavam dois ou mais carboidratos na mesma refeição. Os diagnósticos mais frequentes: Risco de glicemia instável (97,37%), Risco de infecção (97,37%), Conhecimento deficiente (81,58%), Estilo de vida sedentário (60,53%), Controle ineficaz da saúde (60,53%). Conclusão: A identificação do perfil e dos diagnósticos de enfermagem possibilita melhor planejamento de enfermagem

Objective: To identify the sociodemographic, clinical profile and nursing diagnoses established through bedside nursing consultation in people with diabetes mellitus. Method: Descriptive observational study, conducted in 2017 with 37 participants (non-probabilistic sample), in a medical or surgical clinic unit of a school hospital in southern Brazil. Study variables: sociodemographic, clinical and nursing diagnoses according to the North American Nursing Diagnosis Association, submitted to simple descriptive statistics. Results: 89.21% type 2 diabetic; mean time of diagnosis of 9.6 years; 70.2% hypertensive; 56.7% smokers; 16.2% insulin-dependent; 32.4% used refined sugar; 59.45% associated two or more carbohydrates in the same meal. The most frequent diagnoses: Risk for unstable blood glucose level(97.37%), Risk for infection (97.37%), Deficient knowledge (81.58%), Sedentary lifestyle (60.53%), Ineffective health management (60.53%). Conclusion: The identification of profile and nursind diagnoses enables better nursing planning

Objetivo: Identificar el perfil sociodemográfico, clínico y diagnósticos de enfermería establecidos en la consulta de enfermería a la beira del lechoen personas con diabetes mellitus. Método: Estudio observacional descriptivo, realizado en 2017 con 37 participantes (muestra no probabilística), en unidad de clínica médica o quirúrgica de un hospital escuela del sur de Brasil. Variables del estudio: datos sociodemográficos, clínicos y diagnósticos de enfermería según la North American Nursing Diagnosis Association, sometidas a la estadística descriptiva simple. Resultados:89,21% diabéticos tipo 2; tiempo promedio de diagnóstico de 9,6 años; 70,2% hipertensos; 56,7% fumadores; 16,2% insulinodependientes; 32,4% hacía uso de azúcar refinado; 59,45% asociaba dos o más carbohidratos en la misma comida. Diagnósticos más frecuentes: Riesgo de glucemia inestable (97,37%), Riesgo de infección (97,37%), Conocimiento deficiente (81,58%), Estilo de vida sedentario (60,53%), Control ineficaz de la salud (60,53%). Conclusión: La identificación del perfil y de los diagnósticos de enfermería posibilita mejor planificación de enfermería

Excise taxes on sugar-sweetened beverages in Latin America and the Caribbean / Impuestos selectivos al consumo de bebidas azucaradas en América Latina y el Caribe / Imposto especial de consumo sobre bebidas açucaradas na América Latina e no Caribe

ABSTRACT Objective. To characterize the design of excise taxes on sugar-sweetened beverages (SSBs) in Latin America and the Caribbean and assess opportunities to increase their impact on SSB consumption and health. Methods. A comprehensive search and review of the legislation in effect as of March 2019, collected through existing Pan American Health Organization and World Health Organization monitoring tools, secondary sources, and surveying ministries of finance. The analysis focused on the type of products taxed, and the structure and base of these excise taxes. Results. Out of the 33 countries analyzed, 21 apply excise taxes on SSBs. Seven countries also apply excise taxes on bottled water and at least four include sugar-sweetened milk drinks. Ten of these excise taxes are ad valorem with some tax bases set early in the value chain, seven are amount-specific, and four have either a combined or mixed structure. Three countries apply excise taxes based on sugar concentration. Conclusions. While the number of countries applying excise taxes on SSBs is promising, there is great heterogeneity in design in terms of structure, tax base, and products taxed. Existing excise taxes could be further leveraged to improve their impact on SSB consumption and health by including all categories of SSBs, excluding bottled water, and relying more on amount-specific taxes regularly adjusted for inflation and possibly based on sugar concentration. All countries would benefit from additional guidance. Future research should aim to address this gap.

RESUMEN Objetivo. Caracterizar el diseño de los impuestos selectivos al consumo de bebidas azucaradas en América Latina y el Caribe, y evaluar las oportunidades de aumentar su impacto en el consumo y la salud. Métodos. Se llevó a cabo una búsqueda y una evaluación exhaustivas de legislaciones vigentes a marzo del 2019, recopilada mediante las herramientas de seguimiento ya existentes de la Organización Panamericana de la Salud y de la Organización Mundial de la Salud, fuentes secundarias, así como mediante una encuesta a ministerios de finanzas. El análisis se centró en el tipo de productos gravados y la estructura y la base de estos impuestos selectivos. Resultados. De los 33 países evaluados, en 21 se aplican impuestos selectivos al consumo de bebidas azucaradas. En siete países también se aplican impuestos selectivos al consumo de agua embotellada y en al menos cuatro, se incluyen las bebidas lácteas azucaradas. Diez de estos impuestos selectivos al consumo son de tipo ad valorem con algunas bases imponibles fijadas al principio de la cadena de valor, siete son de tipo específico y cuatro son de estructura combinada o mixta. En tres países se aplican impuestos selectivos al consumo en función de la concentración de azúcares del producto. Conclusiones. Si bien el número de países en que se aplican impuestos selectivos al consumo de bebidas azucaradas es prometedor, existe una gran heterogeneidad en su diseño en cuanto a la estructura, la base imponible y los productos gravados. Se podrían aprovechar aún más los impuestos selectivos existentes a fin de que tengan un mayor impacto sobre la salud y el consumo si se incluyen todas las categorías de bebidas azucaradas, excluyendo el agua embotellada, y recurriendo más a impuestos de tipo específico ajustados frecuentemente según la inflación y basados posiblemente en la concentración de azúcares del producto. Todos los países se beneficiarían si hubiera mayor orientación. Las próximas investigaciones deberían abordar esta brecha.

RESUMO Objetivo. Caracterizar o modelo dos impostos especiais de consumo sobre bebidas açucaradas na América Latina e no Caribe e avaliar oportunidades para aumentar o impacto desses impostos no consumo de bebidas açucaradas e na saúde. Métodos. Realizou-se uma pesquisa ampla e a análise de legislações vigentes em março de 2019, com informações obtidas por meio de instrumentos de monitoramento da Organização Pan-Americana da Saúde (OPAS) e da Organização Mundial da Saúde (OMS) já existentes, fontes secundárias e levantamento junto aos ministérios da Fazenda. A análise centrou-se no tipo de produtos tributados e na estrutura e base desses impostos especiais de consumo. Resultados. Dos 33 países analisados, 21 aplicam impostos especiais de consumo sobre bebidas açucaradas. Em sete países os impostos especiais de consumo incidem também sobre água engarrafada e, em pelo menos quatro, incluem bebidas lácteas açucaradas. Dez desses tributos especiais são ad valorem com algumas bases tributárias estabelecidas no início da cadeia de valor, sete são de tipo específico e quatro têm uma estrutura combinada ou mista. Em três países os impostos especiais são estabelecidos com base na concentração de açúcares do produto. Conclusões. Apesar do número promissor de países com impostos especiais de consumo sobre bebidas açucaradas, verifica-se grande heterogeneidade nos modelos de tributação em termos de estrutura, base tributária e produtos tributados. Os impostos especiais de consumo vigentes poderiam ser mais bem aproveitados para aumentar o impacto no consumo de bebidas açucaradas e na saúde: incluir todas as categorias de bebidas açucaradas, excluir água engarrafada e recorrer mais a impostos de tipo específico com a correção periódica pela inflação e, possivelmente, com base na concentração de açúcares do produto. Todos os países se beneficiariam em receber mais orientação. Pesquisas futuras devem ter como objetivo abordar essa lacuna.

High consumption of sucrose induces DNA damage in male Wistar rats

ABSTRACT The purpose of this study was to determine the effects of the high consumption of sucrose on the levels of DNA damage in blood, hippocampus and bone marrow of rats. Male Wistar rats were treated for 4 months with sucrose (10% for 60 initial days and 34% for the following 60 days) in drinking water, and then, glycemia and glycated hemoglobin (A1C) were measured. Levels of DNA damage in blood and hippocampus were evaluated by the comet assay. The micronucleus test was used to evaluate chromosomal damages in the bone marrow. The sucrose treatment significantly increased (p<0.01) the serum glucose levels (~20%) and A1C (~60%). The level of primary DNA damage was significantly increased (p<0.05) in hippocampal cells (~60%) but not in peripheral blood leukocytes (p>0.05). Additionally, it was observed a significative increase (p<0.05) in the markers of chromosomal breaks/losses in bone marrow, as indicated by the micronucleus test. This is the first study that evaluated DNA damage induced by high sucrose concentration in the hippocampus and bone marrow of rats. Sucrose-induced DNA damage was observed in both tissues. However, the mechanism of sucrose toxicity on DNA remains unknown.

Risk factors for dental caries in children with developmental disabilities

Abstract The aim of the present study was to investigate risk factors for dental caries in children with developmental disabilities who were treated at a clinical reference service for patients with special needs in Belo Horizonte, MG, Brazil. This is a retrospective cohort study that evaluated 401 dental charts of individuals without dental caries or restorations in their first dental appointment. The dependent variable was the time of occurrence of new dental caries or restorations and was measured in months. Gender, age, International Code of Diseases (ICD), mother´s education, sugar consumption, use of fluoride toothpaste, oral hygiene, mouth breathing, reports of xerostomia, gingival status, use of psychotropic or asthma drugs, and history of asthma were covariates. The Cox proportional hazards regression model was used to estimate the raw and adjusted hazard ratios and their respective 95% confidence intervals. The average time that individuals remained free of dental caries/restoration was equal to 107.46 months (95%CI 95.41 to 119.51), with a median of caries-free children up to 94 months. For each point increase in the scale of sucrose consumption, the increase in caries risk was 1.07 (95%CI 1.01 to 1.15). Sucrose consumption was the only risk factor for dental caries found in this group of individuals with developmental disabilities.

Avaliação de diários alimentares de crianças atendidas na clínica infantil de uma universidade privada de São Paulo / Daily food records evaluation of children treated in children's dental clinic of a private universidade de São Paulo

Como o início da ingestão da sacarose tem sido cada vez mais precoce, a avaliação da dieta infantil tem sido fundamental para enquadrar o paciente em um programa preventivo odontológico de qualidade e eficiência, para promoção de saúde bucal. Para a pesquisa, foram utilizados 60 diários alimentares, obtidos de prontuários de crianças atendidas na Clínica Odontológica Infantil de uma universidade privada de São Paulo, após aprovação do Comitê de Ética em Pesquisa (CAAE 49117815.0.000.5512). O objetivo foi estabelecer o risco cariogênico da dieta. Esses diários foram analisados em relação à frequência de ingestão de sacarose e à pegajosidade dos alimentos ingeridos, para determinação do risco cariogênico da dieta. A pegajosidade dos alimentos ingeridos nas refeições principais e nas entre refeições apresentou uma diferença estatisticamente significante (p=0,0003). O número de entre refeições, apresentou um valor maior que o preconizado para um risco cariogênico baixo da dieta, que seria dois, porém não mostrou resultado estatisticamente significante. Os resultados permitiram concluir que o risco cariogênico da dieta foi alto e que para a elaboração de um protocolo preventivo é necessária a avaliação dos alimentos que apresentam consistência pegajosa, que implicam em um maior risco cariogênico da dieta, assim como a frequência de ingestão de alimentos, principalmente os que contem sacarose. Palavras-chave: cárie dental; dieta cariogênica; fatores de risco(AU)

Since the ingestion of sucrose has been increasingly premature, the assessment of a child's diet has been essential to integrate the patient in a quality and efficiency preventive dental program in order to promote the oral health. For the research, it was used 60 daily food records from the children treated at Children's Dental Clinic of the Universidade Paulista (FOUNIP) - Campus Indianópolis, São Paulo, after sanction by the Research Ethics Committee (CAAE 49117815.0.000.5512). The diaries were analyzed by the frequency of ingestion of sucrose and the stickiness of the food ingested, to determine the cariogenic risk's in a diet. The stickiness of the food eaten at main meals and between the meals showed a statistically significant difference (p = 0.0003). The number between meals, presented an higher recommended value for a low risk cariogenic diet, although it would be two, however it presented no significant results. Moreover, the results presented that for the preparation of a preventive protocol is necessary to estimate foods that have sticky consistency, which results in an higher cariogenic risk in a diet, furthermore as the frequency of ingested food, especially those that contain sucrose.(AU)

Caries risk assessment in schoolchildren - a form based on Cariogram® software

Identifying caries risk factors is an important measure which contributes to best understanding of the cariogenic profile of the patient. The Cariogram® software provides this analysis, and protocols simplifying the method were suggested. Objectives: The aim of this study was to determine whether a newly developed Caries Risk Assessment (CRA) form based on the Cariogram® software could classify schoolchildren according to their caries risk and to evaluate relationships between caries risk and the variables in the form. Material and Methods: 150 schoolchildren aged 5 to 7 years old were included in this survey. Caries prevalence was obtained according to International Caries Detection and Assessment System (ICDAS) II. Information for filling in the form based on Cariogram® was collected clinically and from questionnaires sent to parents. Linear regression and a forward stepwise multiple regression model were applied to correlate the variables included in the form with the caries risk. Results: Caries prevalence, in primary dentition, including enamel and dentine carious lesions was 98.6%, and 77.3% when only dentine lesions were considered. Eighty-six percent of the children were classified as at moderate caries risk. The forward stepwise multiple regression model result was significant (R2=0.904; p<0.00001), showing that the most significant factors influencing caries risk were caries experience, oral hygiene, frequency of food consumption, sugar consumption and fluoride sources. Conclusion: The use of the form based on the Cariogram® software enabled classification of the schoolchildren at low, moderate and high caries risk. Caries experience, oral hygiene, frequency of food consumption, sugar consumption and fluoride sources are the variables that were shown to be highly correlated with caries risk. .

The effect of fluoride toothpaste on root dentine demineralization progression: a pilot study

The anticaries effect of fluoride (F) toothpaste containing 1100 µg F/g in reducing enamel demineralization is well established, but its effect on dentine has not been extensively studied. Furthermore, it has been shown that toothpaste containing a high F concentration is necessary to remineralize root dentine lesions, suggesting that a 1100 µg F/g concentration might not be high enough to reduce root dentine demineralization, particularly when dentine is subjected to a high cariogenic challenge. Thus, the aim of this pilot study was to evaluate in situ the effect of F toothpaste, at a concentration of 1100 µg F/g, on dentine demineralization. In a crossover and double-blind study, conducted in two phases of 14 days, six volunteers wore a palatal appliance containing four slabs of bovine root dentine whose surface hardness (SH) was previously determined and to which a 10% sucrose solution was applied extra-orally 8×/day. Volunteers used a non-F toothpaste (negative control) or F toothpaste (1100 µg F/g, NaF/SiO2) three times a day. On the 10th and 14th days of each phase, two slabs were collected and SH was determined again. Dentine demineralization was assessed as percentage of SH loss (%SHL). The effect of toothpaste was significant, showing lower %SHL for the F toothpaste group (42.0 ± 9.7) compared to the non-F group (62.0 ± 6.4; p < 0.0001), but the effect of time was not significant (p > 0.05). This pilot study suggests that F toothpaste at 1100 µg F/g is able to decrease dentine caries even under a high cariogenic challenge of biofilm accumulation and sugar exposure.

Effect of (+)-catechin hydrate on oxidative stress induced by high sucrose and high fat diet in male Wistar rats.

Increased lipid peroxidation and reduced glutathione levels in liver of rats fed high sucrose high fat (HSHF) diet were normalized by concomitant administration of (+)-catechin hydrate. Plasma non-enzymatic antioxidants viz. α-tocopherol, ascorbic acid and total thiols decrease were also significantly less in rats administered with (+)-catechin hydrate concomitantly with HSHF diet. Thus the present results indicate that (+)-catechin hydrate has antioxidant activity and is effective in reducing oxidative stress. The study is of clinical importance as oxidative stress is known to be the cause of many clinical manifestations viz. cancer, Parkinson’s disease, atherosclerosis, heart failure, myocardial infarction and many other diseases.

High-sucrose effect on bone structure, hardness and biomechanics in an obesity model using Wistar male rats

Introduction: Excessive consumption of sugar-sweetened beverage is positively related to overweight. Despite the epidemic of childhood obesity, body mass can have a positive or negative effect on bone health. Material and methods: Wistar rats 8 weeks olds were randomly assigned to consume water (Control group, n = 10), sucrose 30% (HS group, n = 10) and water + sucrose 30% (WHS group, n = 14) for 8 weeks. All animals received standard laboratory chow ad libitum. Femur measurements included microhardness, bone mineral density (BMD) by DXA, mechanical compression test and microcomputed tomography (microCT) analysis. Results: We observed significant difference in final body weight in HS and WHS groups, significant increase in triacylglycerol/fructosamine in HS and WHS groups, significantly high BMD in WHS group, increased periosteal/endosteal cortical microhardness in WHS group. Compared with control, microCT parameters evidenced lower amount of connected trabecular bone, decreased bone volume, lower trabecular number with high trabecular separation in distal epiphysis in WHS animals. Conclusion: High-sucrose consumption causes obesity induced by a liquid diet with negative effects on cancellous bone.

Dime qué comes y te diré cómo está tu salud bucal / Tell me what do you eat and I will tell you how is your oral health

Para un estado óptimo de salud se requiere de un buen equilibrio de la condición oral. Una dieta balanceada comprende alimentos saludables y diversos, lo cual es clave para mantener un buen estado de salud bucodental, debería tomarse en consideración ellimitar el exceso de carbohidratos en las comidas. La dieta afecta la salud oral de muchas maneras como la generación de caries dental, defectos en el desarrollo del esmalte, erosión dental y enfermedad periodontal y esta situación podría afectar la salud general dando como resultado la aparición de enfermedades cardiovasculares o infecciosas, entre otras.

For an optimal health a good oral equilibrium is required. A balanced diet comprising of diverse and healthy foods is key to promoting good oral health, limitation of high carbohydrates intake should be taken into consideration. Diet affects oral health in many ways such as diet include dental caries, developmental defects of enamel, dental erosion and periodontal disease and this situation could affect general health in many ways like cardiovascular and infectious diseases.

Influence of diltiazem in combination with a sucrose-rich diet on gingival alterations in rats

The aim of this study was to evaluate the influence of diltiazem in combination with a sucrose-rich diet on gingival alterations in rats. One hundred and twenty male Holtzman rats were randomly assigned to 10 groups (n = 12), being 2 control groups treated with saline and 8 test groups treated with diltiazem in daily doses of 5, 25, 50 and 100 mg/kg during 40 or 60 days. Afterwards, the mandibles were removed for macroscopic, histologic and histometric analyses of the buccal gingiva of the mandibular right first molar. No macroscopic characteristic of gingival overgrowth was observed in any of the groups. The microscopic analysis showed characteristics of normality with inflammatory cells only adjacent to the crevicular epithelium in all groups for both periods. The histometric analysis showed significant differences only for the epithelial tissue area in the 40-day period (Kruskal-Wallis; P = 0.032). Comparing the periods, significant differences regarding the connective and epithelial tissue areas were observed only in the group treated with a 25 mg/kg dose (Mann-Whitney; P = 0.004 and P = 0.007, respectively). Oral administration of diltiazem in combination with a sucrose-rich diet did not induce gingival alterations in rats.

Patrones de consumo de bebidas y estado dentario en adolescentes / Beverages consumption patterns and dental status in adolescents

Introducción: los hogares han incorporado masivamente el consoumo de bebidas ácidas. El propósito del presente estudio fue determinar en estudiantes de escuelas secundarias el patrón de consumo de bebidas de uso frecuente y el estado dentario. Materiales y métodos: sobre un total de 126 alumnos de una escuela pública secundaria, 62 hombres y 64 mujeres, con una edad promedio de 17,21 (+-DS 1.16) se realizó una encuesta de carácter anónimo, referida a salud general, medidas preventivas educativas y consumo de bebidas. Sobre udna muestra de 31 alumnos seleccionados aleatoriamente, se realizó examen dentario y se confeccionó CPOD, CPOS, pérdida de tejido dentario, según Smith y Knight (1984) y pH salival. Se realizó distribución de la frecuencia de las variables; media y ES de los indicadores dentarios y salivales, y correlación de las variables. Resultados: la distribución de frecuencia mostró: recibe medicamentos 11 por ciento, presenta alergia 19 por ciento, tiene asma 11 por ciento, regurgitación 4 por ciento y gusto ácido 5 por ciento, trabaja 28 por ciento. El 18 por ciento recibe aplicación tópica de fluoruros, 75 por ciento usa pastas fluoradas y el 8 por ciento realiza enjuagatorios fluorados. El 40 por ciento se cepilla 3 veces por día, con cepillo de dureza mediana el 40 por ciento. El 87 por ciento desconoce la técnica. El 9 por ciento usa elementos interdentarios. El 32 por ciento manifiesta sensibilidad dentaria. Las bebidas preferidas son las gaseosas regulares en un 84 por ciento; durante los días de semana 46 por ciento consume agua, el 30 por ciento gaseosas regulares y jugos en polvo diluidos más de 3 veces el 20 por ciento y bebidas alcohólicas los fines de semana, 18 por ciento vinos y 31 por ciento otras. El 100 por ciento presentó pérdida dentaria. Conclusión: la escasa aplicación de medidas preventivas, los patrones de consumo de bebidas y el incremento de las erosiones hace necesario implementar acciones educativas en las escuelas.

Consumo de refrigerantes, suco e leite, e índice de massa corporal em escolares de Niterói / Soft drinks, juice and milk intekes, and body mass index among students in Niterói

Mudanças nos padrões dietéticos caracterizados pelo maior consumo decarboidratos simples presentes em bebidas ricas em açúcar têm sido associadas à obesidadeentre adolescentes. O objetivo do estudo foi avaliar a associação entre, consumo de refrigerantes e outras bebidas, e o índice de massa corporal (IMC) em adolescentes. Métodos:Foram analisados os dados da linha de base de um ensaio clínico randomizado por conglomerados visando à redução do consumo de refrigerantes em 1423 alunos da 4ª série de 22 escolas públicas estudais e municipais de Niterói- RJ. O consumo de refrigerantes,sucos,guaraná natural, leite e iogurte foi avaliado através do recordatório alimentar de 24h e questionário de freqüência de consumo de bebidas. Dados antropométricos de peso e estatura foram coletados para cálculo do IMC. As análises estatísticas foram desenvolvidas no software Statistical Analyses System- SAS versão 9.1. Utilizou-se o teste t de Student paraavaliar as diferenças nas médias de peso, estatura, IMC e idade entre os sexos e ANOVA para detectar diferenças nas médias de IMC segundo tipos e freqüências de consumo de bebidas. Oteste qui-quadrado foi utilizado para testar as diferenças nas prevalências de sobrepeso, obesidade e tipos de bebidas consumidas entre os sexos, além de examinar a significânciaestatística da associação entre consumo de bebidas e faixa etária. O coeficiente de correlação de Pearson foi usado para avaliar as correlações entre as bebidas consumidas. A análise de regressão linear foi utilizada para avaliar a associação entre a freqüência de consumos das bebidas e IMC, estratificando-se por sexo e ajustando-se por idade e efeito do conglomerado...

Estratégias para prevenção da obesidade em crianças e adolescentes / Strategies for obesity prevention in children and adolescents

Poucos estudos obtiveram resultados favoráveis na prevenção da obesidade. Teoricamente, crianças e adolescentes, se comparados aos adultos, poderiam mais facilmente prevenir o ganho excessivo de peso, pois estão crescendo e têm maior possibilidade de gastar energia em atividades de lazer. Entretanto, não se consegue superar os muitos fatores que concorrem para a crescente epidemia de obesidade e as intervenções na sua maioria abordam uma fração muito pequena dos fatores que geram a obesidade. Aspectos importantes, como o papel da indústria de alimentos, das cadeias de fast food, das propagandas, de um estilo de vida que mantêm as crianças cada vez mais sedentárias e submetidas a um hiperconsumo calórico, não têm espaço nos desenhos de estudos tradicionais. Das intervenções publicadas, as que integram a família no tratamento têm obtido melhores resultados. Estudos com elementos isolados da dieta como cálcio, proteína, fibras e índice glicêmico não têm mostrado eficácia, e embora não conclusivos, os resultados referentes à redução de bebidas com alto teor de açúcar e redução do sedentarismo são promissores.

Few studies on treatment or prevention of obesity have shown significant results. Theoretically, in children and adolescents as compared to adults, prevention of excessive weight gain should be easy due to the energy expended during growth, associated with more time spent in leisure-time activities. However, numerous factors that stimulate overeating and sedentary behaviors are difficult to overcome. Additionally, most intervention studies have focused on a minor portion of the many factors associated with obesity. Important aspects of the obesity epidemic such as the role of the food industry, fast food chains, advertising, and a lifestyle that limits children to sedentary activities and overeating cannot be explored by a traditional clinical trial design. At any rate, among the published interventions, those including the family in weight-reduction strategies have shown the best results, as compared to children-centered approaches. Meanwhile, studies on specific nutrient or dietary composition (such as calcium, protein, or glycemic index) related to prevention or treatment of obesity have failed to yield good results. Reducing the intake of high-sugar carbonated drinks and juices has shown promising but still inconclusive results.

Caries dental e higiene bucal en adolescentes / Dental caries and oral hygiene in adolescents

Objetivo: Determinar la prevalencia de caries dental e higiene bucal en estudiantes de bachillerato. Material y métodos: Transversal, en muestra de conveniencia (128), que cumplieron los criterios de selección y previo consentimiento informado de sus padres. Se aplicó una encuesta ad hoc para el estudio que mide variables sociodemográficas y estomatológicas, mediante revisión bucal se aplicaron el índice de caries dental (CPOD) y el índice de higiene bucal (IHB). Se realizó análisis estadístico univariado y bivariado. Resultados: De los entrevistados, sólo 113 completaron los cuestionarios, media de edad de 17.06 ±2.18. El 23 por ciento consume golosinas casi siempre, no hubo diferencia significativa en el consumo de ellas por sexo (p > 0.05). Prevalencia de caries del 97 por ciento, la media del índice CPOD fue de 26.84 ± 15, media de dientes cariados de 6.8 ±4.19. La media del índice de higiene bucal total fue de 0.88 ± 0.60, siendo menor en los hombres. Todos cepillan los dientes diariamente pero sólo 40.7 por ciento lo hace tres veces al día, en 28 por ciento la técnica de cepillado es mala. Conclusiones: La prevalencia de caries es alta, pero la media del IHB es parecida a la reportada por otros autores, los hábitos de salud oral de los adolescentes deben modificarse.

Sobrepeso e prevalência de cárie utilizando-se leite formulado: estudos em ratos / Overweight and caries prevalence using formulated milk: rats study

Verificar a influência de uma dieta com leite formulado, leite formulado acrescido de 20% de sacarose e dieta controle, na prevalência de cárie nos molares de 36 ratos (Rattus norvegicus albinus wistar). Os animais, de ambos os sexos, com 23 dias de vida, foram divididos em três grupos, que ingeriram, durante 60 dias, as seguintes dietas: grupo A, leite formulado; grupo B, leite formulado acrescido de 20% de sacarose e o grupo C, ração padrão de biotério. Após o período experimental os animais foram sacrificados e, em seguida, seccionados os molares das mandíbulas e das maxilas; as peças foram coradas e realizado a leitura através do microscópio esterioscópico, das lesões de cárie que cada dieta produziu. A prevalência de cárie em molares de ratos foi estimada em: 68,8% no grupo de dieta com leite formulado sem açúcar; 90,0% no grupo de dieta com leite formulado acrescido de 205 de sacarose e 80,3% no grupo alimentado com a labina. A prevalência de cárie, com dieta de leite formulado acrescido de 20% de sacarose, foi significativamente maior do que a prevalência quando utilizada uma dieta com leite formulado sem açúcar (p<0,001) e quando utilizada a ração padrão (labina) (p=0.001). Assim as dietas utilizadas foram consideradas cariogênicas

The prevalence and pattern of nursing caries in preschool children of Tehran.

This cross sectional study was carried out to determine the prevalence and pattern of nursing caries and its relevant factors in preschool children of Tehrari. 620 children aged 2-6 yrs were selected randomly from 22 kindergartens in Tehran. They were examined for dental caries. The criteria used for nursing caries was presence of caries on buccal or palatal surfaces of at least two maxillary incisors with absence of caries in mandibular incisors. A questionaire was used for evaluation of related factors.