Peri-implantitis: Knowledge and attitudes of implantology clinicians regarding the disease management: Peri-implantitis knowledge.

OBJECTIVES: Since peri-implantitis is an increasing and prevalent concern in clinical practice and there is no consensus regarding the best therapeutic protocol, this study evaluated the knowledge and behaviours of dentists working in Implantology regarding implant-related infections modulating factors and therapeutic protocols used in the management of peri-implantitis. METHODS: Cross-sectional study was conducted with 86 Brazilian Implantology clinicians. Data were collected using a structured and online questionnaire evaluating socioeconomic characteristics, education, work/clinical practice, knowledge and attitudes regarding the risk factors and management of peri-implantitis. The reliability of the questionnaire was evaluated by test-retest technique. The questionnaire was developed based on the last consensus on peri-implant diseases (2018) and the current evidence related to implant-related infections. Descriptive, bivariate and logistic regression analyses were conducted adopting a significance level of 5%. RESULTS: In this study, 89.5% of included dentists reported that already treated patients with peri-implantitis. Approximately 80% of dentists use antibiotics and mouth rinses during the treatment, and surgical procedures seem the main choice to treat peri-implantitis (91.8%) by dentists. As a preventive approach, 94.2% of dentists reported that routinely assessed biofilm accumulation in the follow-up visits after implant placement. Logistic regression showed that the self-reported ability to treat peri-implantitis was statistically (p < 0.05) higher among dentists who reported abilities to diagnose the disease and use laser for peri-implantitis treatment. CONCLUSION: Dentists working in Implantology have a good level of knowledge and behaviors in the management of peri-implantitis. However, the lack of consensus regarding the best treatment protocols may reflect dentist's behaviours because different treatment protocols have been used by evaluated clinicians.

Unraveling the signs and symptoms of oral conditions that affect daily life activities and oral health-related quality of life.

OBJECTIVES: Since oral conditions negatively affect oral health-related quality of life (OHRQoL), this study evaluated which oral clinical condition, signs, and symptoms are associated with the impact on OHRQoL, its domains, and specific daily life activities among adults. MATERIALS AND METHODS: Data from a probabilistic sample of adults (35-44 years old) was used. The Oral Impacts on Daily Performance (OIDP) was used to evaluate OHRQoL, its domains (physical, psychological, and social), and nine daily life activities. Signs and symptoms of oral diseases (dental caries, periodontal disease, need for dental prothesis, and tooth loss) and oral self-perception were considered. Descriptive, bivariate, and multi-level analyses were conducted. RESULTS: A total of 5,834 adults were included, of which 52.9% had some negative impact of oral conditions on OHRQoL. Difficulty in eating was the most affected daily life activity. For multiple models, dental caries lesions (cavities), filled teeth with caries, gingival bleeding, periodontal pocket, dental pain, need for upper or lower dental prosthesis, and oral health self-perception were associated (p < 0.05) with overall OHRQoL or at least one of its domains. The impact on daily life activities of each individual was associated with at least one oral condition. Dental caries lesions (cavity) and dental pain were associated (p < 0.05) with the impact on most daily life activities evaluated. CONCLUSIONS: Different signs and symptoms of prevalent oral diseases are associated with the impact on specific daily life activities among adults, which may compromise the OHRQoL. CLINICAL RELEVANCE: Knowledge of how signs, symptoms, and oral conditions affect OHRQoL and daily life activities can provide essential information for clinicians to establish proper disease management and preventive strategies focusing on improving patients' lives.

Modes of disciplinary interaction as a line of escape in Family Health practice: a cartographic analysis / Modos de interação disciplinar como linha de escape no trabalho em Saúde da Família: uma análise cartográfica

Abstract The present study aims to discuss the knowledge and practices of Primary Health Care professionals about the modes of disciplinary interaction. It is a descriptive study, with qualitative approach following the methodological proposal of cartography, in which we ran four focus groups with the participation of 33 professionals, among them doctors, nurses and dental surgeons who are part of Family Health teams (FHt). With a cartographic mapping, it was possible to see that the work context of the FHt can be represented by the plan of form, which is affected by the plan of forces, generating interrelationships. From this, the modes of disciplinary interaction emerge as a line of escape, producing new assemblages characterized by the perspectives and proposals listed by the professionals. Through this mapping, the importance of the modes of disciplinary interaction in the FHt practice was evident, mainly as a response to the micropolitics of living labor in health with a focus on lightweight technologies.

Resumo O presente estudo objetiva discutir o conhecimento e as práticas dos profissionais da Atenção Primária à Saúde sobre os modos de interação disciplinar. Trata-se de um estudo descritivo, de abordagem qualitativa, com a proposta metodológica da Cartografia, em que foram realizados quatro grupos focais com a participação de 33 profissionais, dentre eles médicos, enfermeiros e cirurgiões-dentistas, de equipes de Saúde da Família (eSF). A partir de um mapeamento cartográfico, foi possível perceber que o contexto do trabalho das eSF pode ser representado pelo plano de forma, que é afetado pelo plano de forças, gerando inter-relações. A partir destas, emergem os modos de interação disciplinar como linha de escape, produzindo novos agenciamentos, caracterizados pelas perspectivas e proposições elencadas pelos profissionais. Por meio desse mapeamento, ficou evidente a importância dos modos de interação disciplinar na prática das eSF como resposta, principalmente, à micropolítica do trabalho vivo em saúde, com centralidade nas tecnologias leves.

Association between Hand Digit Ratio (2D : 4D) and Acute Lymphoblastic Leukemia.

OBJECTIVE: Digit ratio (2D : 4D) has been suggested as a biomarker for prenatal hormone activity and has been linked to several types of cancer. This study investigated the possible correlation between 2D : 4D ratios and acute lymphoblastic leukemia. METHODS: A case-control study was performed with Brazilian subjects. Direct measurements of the lengths of index and ring fingers of both hands of patients with acute lymphoblastic leukemia (n = 43) and controls matched by age and gender (n = 86) were obtained by using a digital vernier caliper. Mean ratios between the second and fourth digits were compared. Data were analyzed by Student's t-test with a significance level of 5%. RESULTS: No significant difference was found between the mean digit ratios of the right and left hands between the groups for any analysis (p > 0.05), neither for the whole sample nor for the distribution by gender. CONCLUSIONS: We observed that patients with acute lymphoblastic leukemia do not have a different digit pattern when compared with unaffected individuals, which may suggest that exposure to prenatal sex hormone is similar between groups.

Association Between Hand Digit Ratio (2D:4D) and Nonsyndromic Orofacial Clefts.

OBJECTIVES: Digit ratio (2D:4D) has been considered to be a marker in studies evaluating an individual's susceptibility to diseases, especially those diseases that show sex differences in their occurrence. We aimed to assess whether 2D:4D ratios are associated with nonsyndromic cleft lip and/or palate (NSCL/P) and verify the existence of a specific pattern of 2D:4D ratio in individuals affected by orofacial clefts. DESIGN: This was a case-control study. METHODS: Digital measurements of index and ring finger lengths of both hands of patients with NSCL/P (n = 54) and age- and gender-matched controls (n = 54) were obtained using a digital vernier caliper. Mean ratios between the second and fourth digits were compared. Data were analyzed by Student's t test and Mann-Whitney test with a significance level of 5%. RESULTS: No significant difference was found between the mean digit ratios of the right and left hands between the groups for any analysis (P > .05), neither for the whole sample nor for the distributions by type of cleft and by gender. CONCLUSIONS: Although the development of the fingers and the occurrence of NSCL/P can be regulated by the actions of similar genes, our results are not consistent with an association between 2D:4D ratio and this craniofacial deformity. This suggests that intrauterine exposure to fetal androgens, assessed using this marker, is similar between patients with NSCL/P and healthy individuals. We highlight the need for further studies in populations with different ancestries.

Orofacial manifestations in patients with sickle cell anemia.

OBJECTIVE: To compare the prevalence of orofacial manifestations between patients with and without sickle cell anemia and to investigate the distribution of such events in patients with sickle cell anemia by sex and age. METHOD AND MATERIAL: A cross-sectional study was conducted in which 330 subjects divided into two groups (a group of individuals with sickle cell anemia and a healthy control group) were examined. RESULTS: It was observed that patients with sickle cell anemia had a significantly higher prevalence of previous mental nerve neuropathy (P = .000) and delayed tooth eruption (P = .006) than patients without the disease. Regarding the distribution of orofacial manifestations in patients with sickle cell anemia by sex and age, the only statistical associations were between the prevalence of previous mental nerve neuropathy and sex (P = .023) and previous mandibular pain and age (P = .019). CONCLUSIONS: This study found that sickle cell anemia is associated with the prevalence of previous mental nerve neuropathy and delayed tooth eruption. Moreover, previous mental nerve neuropathy is more frequent among females with sickle cell anemia, and previous mandibular pain is more frequent among individuals older than 21 years of age with sickle cell anemia. Further studies using a methodology similar to the one in this study are necessary considering the scarcity of studies using this approach.

Facial features of patients with sickle cell anemia.

OBJECTIVE: To characterize the craniofacial features of patients with sickle cell anemia (SCA). MATERIALS AND METHODS: Fifty patients with SCA in the north of Minas Gerais, Brazil, were evaluated using standardized photographs (front and profile) for a subjective facial analysis and digital radiographs for a computerized cephalometric analysis. To obtain linear and angular measurements, cephalometric points were marked on the digital images by a single examiner, using the program Radiocef 6.0, and facial analyses were performed by four different orthodontists. RESULTS: Of the population studied, 28 patients were female with a mean age of 27.7 years. Most of the patients (64%) had their faces classified as esthetically acceptable, although results showed a predominance of convex profiles (72%). The mean of the SNA angle was 84.56°, diagnosing proper positioning of the maxilla from the base of the skull. The prevalence of pattern II was 32%, and 31% showed maxillary protrusion; the effective length of the maxilla was reduced in 64%. Retrusion of the mandible was observed in 30%, and 76% had reduced mandibular length. Four measurements (mandibular length, maxillary length, anterior face height, and maxillomandibular difference) showed statistically significant differences between genders, where these measurements were higher for males than for females. CONCLUSION: Most patients did not show compensatory maxillary expansion, which was determined by the prevalence of decreased maxillary length (64%) and by the absence of maxillary protrusion in 69% of the SCA patients evaluated.

Saúde do trabalhador: uma experiência de educação em saúde vivenciada pelo PET-Saúde Independência III - Montes Claros/M / Occupational health: a health education experience undergone by "Independência III PET-Saúde" - Montes Claros, MG

Atualmente, o Ministério da Saúde desenvolve políticas públicas e incentiva ações em saúde voltadas para grupos vulneráveis, dentre estes o gênero masculino e os trabalhadores. Tais grupos procuram pouco as unidades de atenção primária à saúde ficando mais predispostos a agravos de doenças possivelmente evitáveis. Nesse sentido, uma importante ferramenta utilizada na estratégia saúde da família é a educação em saúde, uma vez que a compreensão dos condicionantes do processo saúde-doença oferece subsídios para a adoção de hábitos saudáveis. O presente trabalho tem por objetivo descrever, através de um relato de experiência, uma atividade de educação em saúde, relacionada às Doenças Sexualmente Transmissíveis, voltada para um grupo de homens trabalhadores de uma empresa de construção civil. A ação foi realizada por acadêmicos e preceptores do PET-Saúde da Estratégia Saúde da Família Independência III do município de Montes Claros/MG. A atividade de educação em saúde foi avaliada satisfatoriamente tanto pelos trabalhadores, que destacaram positivamente o fato de a ação ter sido desenvolvida em ambiente de trabalho, como pelos acadêmicos, que tiveram a oportunidade de vivenciar o trabalho em equipe e intersetorial. Pode-se concluir que a atenção à saúde do trabalhador é uma importante estratégia para atingir a população masculina em idade produtiva, prevenindo doenças e melhorando a qualidade de vida. Além disso, iniciativas como o PET-Saúde estão em consonância com a integralidade da assistência proposta pelo SUS, através de ações multidisciplinares que buscam a efetividade da atenção primária (AU).

The Ministry of Health is currently developing public policies and encouraging health-related measures targeting vulnerable groups that include males and workers. These groups rarely seek primary healthcare units, and this makes them more prone to an exacerbation of a potentially preventable disease. With this in mind, an important tool used in the Family Health Strategy is health education, since the understanding of the determinants of the health-disease process helps adopting healthy habits. This paper aims to describe a health education activity related to sexually transmitted diseases, through an experience report. It is focused on a group of male workers of a construction company. The action was taken by students and instructors of the "PET-Saúde of Independência III" Family Health Strategy Program. The activity of health education was evaluated satisfactorily both by workers, who highlighted the fact that action was taken in the workplace, and by students, who had the opportunity to experience the teamwork and inter-area work. It can be concluded that heightening awareness to occupational health is an important strategy for reaching the male population of working age, thus preventing disease and improving quality of life. In addition, initiatives like "PET-Saúde" are consistent with the integral care offered by SUS, through multidisciplinary actions seeking primary care effectiveness (AU).

Educação em saúde ­ estratégia de cuidado integral e multiprofissional para gestantes / Health education ­ strategy of integral and multiprofessional care for pregnant women

O Programa de Educação pelo Trabalho para a Saúde (PET-Saúde) objetiva iniciar os estudantes das graduações em saúde no trabalho da Estratégia Saúde da Família, oportunizando a vivência das ações desenvolvidas na atenção básica à saúde. Dentre estas atividades, destaca-se a educação em saúde que integra o saber científico com o popular. Um dos grupos prioritários que deve ser alvo da atividade de educação em saúde na Estratégia Saúde da Família é o grupo de gestantes, por se tratar de um período em que a mulher está mais susceptível a receber informações e modificar o comportamento. O objetivo deste trabalho é expor uma experiência de cuidado integral e multiprofissional, utilizando-se a educação em saúde como ferramenta para a adoção de novos hábitos em saúde por parte de um grupo de gestantes assistidas por uma equipe da Estratégia Saúde da Família. O projeto foi realizado no mês de janeiro de 2011 na Equipe de Saúde da Família Independência III, localizado no município de Montes Claros/MG, tendo como agentes facilitadores os acadêmicos da área da saúde da Universidade Estadual de Montes Claros, participantes do PET-Saúde, bem como os profissionais de saúde, que integram a equipe, sendo também preceptores do programa. O curso foi estruturado em sete oficinas, abordando temas chaves para as gestantes. Esse projeto foi de grande importância tanto para as gestantes, que avaliaram de forma positiva a atividade, quanto para os acadêmicos, que puderam adquirir conhecimentos de forma crítica e multidisciplinar (AU).

The Education Program through Health Work ("PET-Saúde") aims at initiating undergraduate students of health into Family Health Strategy work, allowing them to experience the actions conducted in primary care. Among these activities, there is health education that combines scientific with popular knowledge. One of the priority groups that should be targeted for health education activities in the Family Health Strategy is that of pregnant women, considering that this is a period in which a woman is more likely to receive information and to modify her behavior. The objective of this study was to present an experience of integral and multiprofessional care, using health education as a tool for adopting new health habits by a group of pregnant women assisted by a team from the Family Health Strategy. The project was conducted in January 2011 by the Independence III Family Health Team, located in Montes Claros, MG. The team included students from the health field at the State University of Montes Claros as facilitators, participants in the "PET-Saúde" Program, and health professionals, who were also instructors of the program. The course was structured around seven workshops, and addressed key issues for pregnant women. This project was of great importance not only for the pregnant women, who evaluated the activity positively, but also for the students, who were able to acquire critical and multidisciplinary knowledge (AU).

Perfil dos pesquisadores bolsistas de produtividade científica em medicina no CNPq, Brasil / Profile of medical researchers with scientific productivity grants from the Brazilian National Research Council (CNPq)

O objetivo deste estudo foi avaliar o perfil dos bolsistas de produtividade científica da área de medicina no Conselho Nacional de Desenvolvimento Científico e Tecnológico. Foram analisados os currículos Lattes de todos os pesquisadores da área de medicina no triênio 2005-2007. As variáveis estudadas foram: gênero, categoria do bolsista, instituição de origem, tempo de conclusão do doutorado, artigos nacionais e estrangeiros com o respectivo Qualis, publicação de livros e capítulos, orientações de iniciação científica, mestrado e doutorado, e os periódicos utilizados para publicação. Entre os pesquisadores, houve prevalência do gênero masculino em relação ao feminino (1,94:1), com a maioria dos bolsistas na categoria 2 (51,4 por cento), distribuídos por 13 estados da federação, com predomínio de São Paulo e Rio de Janeiro. Do total, 97,1 por cento dos bolsistas estão vinculados a universidades e 49,4 por cento deles concluíram o doutorado entre 6 e 15 anos. Na produção científica, verifica-se prevalência de artigos internacionais Qualis A e C e nacional B. Quanto à orientação, há prevalência na formação de mestres, seguida de iniciação científica e doutores. Os periódicos que concentraram a maior parte das publicações foram Brazilian Journal of Medical and Biological Research e Transplantation Proceedings. Estudos com metodologias similares poderão ser importantes para melhor aferição da produção científica brasileira em outras áreas do conhecimento, visto que existem poucos estudos nacionais sobre o perfil da produção científica gerada pelos bolsistas de produtividade científica do CNPq.

Scientific output by Brazilian researchers has increased. The aim of this study was to evaluate the profile of medical research projects funded with scientific productivity grants from the Brazilian National Research Council (CNPq). The authors analyzed the Lattes curricula of all Brazilian medical researchers from 2005 to 2007. The independent variables were gender, type of grant, origin of the resident institution, year of the PhD, number of national and international published articles with respective Qualis classification, number of books and book chapters, number of Master's and PhD theses and scientific initiation monographs supervised, and the journals used for publication. The male/female ratio was 1.94:1. Most of the grantees were in the second class (51.4 percent), spread across 13 States of Brazil but with the largest contingent in Sao Paulo and Rio de Janeiro. 97.1 percent of the researchers were in universities, and 49.4 percent of them had completed their PhDs program in the previous 6 to 15 years. Articles were mainly published in Qualis A and C international journals and Qualis B Brazilian journals. The most common form of supervision was for Master's theses, followed by scientific initiation monographs and PhD dissertations. The two journals that published the most articles were the Brazilian Journal of Medical and Biological Research and Transplantation Proceedings. Studies in other areas with similar methodologies could provide better knowledge of Brazil's scientific output and help define strategies to meet research needs, since there are few Brazilian studies on the scientific output generated by CNPq grants.