Periodontal condition, changes in salivary biochemical parameters, and oral health-related quality of life in patients with anorexia and bulimia nervosa.

BACKGROUND: Anorexia and bulimia nervosa can have significant effects on oral health. Assessment of enzyme concentrations in saliva can be useful for obtaining information on molecular biomarkers for the prevention, monitoring, and diagnosis of oral diseases. This study investigated the periodontal condition, changes in salivary biochemical parameters, and oral health-related quality of life (OHRQoL) in patients with anorexia and bulimia nervosa. METHODS: The study comprised 60 women patients who attended a Brazilian medical school. Participants were divided into two groups: patients with anorexia and bulimia nervosa (ABN; n = 30) and control patients (CN; n = 30). Oral clinical examinations were carried out to evaluate the periodontal condition by Community Periodontal Index, and interviews using the Oral Health Impact Profile (OHIP-14) were conducted to assess OHRQoL. Saliva samples were collected for the evaluation of salivary concentrations of total protein, alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), and thiobarbituric acid reactive substance (TBARS), and salivary flow rate. RESULTS: Periodontal condition in the ABN group was significantly worse than that in the CN group. The ABN group showed significantly higher salivary concentrations of total protein, AST, ALT, and LDH than the CN group. There was no significant difference in the salivary concentrations of TBARS among the groups. The OHIP-14 score was higher in the ABN group than in the CN group. CONCLUSION: Anorexia and bulimia nervosa are associated with poor periodontal condition, elevated salivary concentrations of total protein, AST, ALT, and LDH, decreased salivary flow rate and a significant adverse impact on OHRQoL.

Alteraciones auditivas, percepción y conocimientos de estudiantes sobre ruido en una clínica de enseñanza odontológica / Auditory alterations and student knowledge and perception on noise at a dental teaching clinic

RESUMEN Objetivo Identificar alteraciones auditivas en estudiantes de odontología y evaluar el nivel de conocimiento con relación a la pérdida auditiva inducida por ruido. Metodología Estudio transversal, se realizaron encuestas a estudiantes del tercer año curso diurno y cuarto año del curso nocturno de estomatología. Las variables estudiadas: trastornos auditivos y conocimiento sobre PAIR (pérdida auditiva inducida por ruido). Resultados Muestran la presencia de trastornos auditivos en 14,8% de los estudiantes, de los que 7,4% recibieron tratamiento. El 28,4% había realizado exámenes audio métricos. De los estudiantes, 24,6% tenían familiares con problemas de audición; 11,1% enfermedades preexistentes;49,3% necesitan repetición durante una conver-sación;34,4% estaba irritado en el ambiente de clases prácticas y consideraban las piezas de mano de alta rotación el instrumento más ruidoso; el 75,3% refirió usar audífonos y un 72,1% por más de 5 años. En relación a los resultados sobre conocimientos 93,8% afirmaron que el dentista es un profesional con riesgo de pérdida auditiva por ruido, pero el 83,9% no había recibido orientación sobre el PAIR. Respecto al protector auricular 77,7% lo conocía, pero sólo 3,7% lo había usado. Conclusión Los estudiantes de estomatología presentaron alteraciones auditivas inducidas por el ruido, y consideraban el local de las clases prácticas un ambiente ruidoso; es necesario un mayor conocimiento en los alumnos de las consecuencias negativas del ruido en la salud y la utilización de medidas de prevención para evitar la pérdida de la audición a largo plazo.(AU)

ABSTRACT Objective To identify auditory alterations in dentistry students and evaluate the level of knowledge in relation to noise-induced hearing loss. Materials and Methods Cross-sectional study. Surveys applied to third-year students of the day school, and fourth-year students of the night stomatology school. The variables studied were auditory disorders and knowledge about NIHL (noise-induced hearing loss). Results Hearing disorders were found in 14.8% of the students, of whom 7.4% were receiving treatment. Audiometric examinations were performed in 28.4% of the students. It was also found that 24.6% of the students had relatives with hearing problems; 11.1% had pre-existing conditions; 49.3% needed repetition during a conversation; 34.4% felt irritated during practical classes and considered high rotation hand pieces to be the noisiest instrument; and 75.3% reported using hearing aids (72.1% for more than 5 years). With regard to knowledge, 93.8% said that dentists are professionals at risk of hearing loss due to noise, but 83.9% had not received guidance on NIHL. Regarding the hearing protector, 77.7% knew about it, but only 3.7% had used it. Conclusion Stomatology students have noise-induced hearing loss, and also considered that the places where practical classes are given are a noisy environment. More knowledge is needed in students about the negative consequences of noise in health and the use of preventive measures to avoid hearing loss in the long term.(AU)

[Auditory alterations and student knowledge and perception on noise at a dental teaching clinic]. / Alteraciones auditivas, percepción y conocimientos de estudiantes sobre ruido en una clínica de enseñanza odontológica.

OBJECTIVE: To identify auditory alterations in dentistry students and evaluate the level of knowledge in relation to noise-induced hearing loss. MATERIALS AND METHODS: Cross-sectional study. Surveys applied to third-year students of the day school, and fourth-year students of the night stomatology school. The variables studied were auditory disorders and knowledge about NIHL (noise-induced hearing loss). RESULTS: Hearing disorders were found in 14.8% of the students, of whom 7.4% were receiving treatment. Audiometric examinations were performed in 28.4% of the students. It was also found that 24.6% of the students had relatives with hearing problems; 11.1% had pre-existing conditions; 49.3% needed repetition during a conversation; 34.4% felt irritated during practical classes and considered high rotation hand pieces to be the noisiest instrument; and 75.3% reported using hearing aids (72.1% for more than 5 years). With regard to knowledge, 93.8% said that dentists are professionals at risk of hearing loss due to noise, but 83.9% had not received guidance on NIHL. Regarding the hearing protector, 77.7% knew about it, but only 3.7% had used it. CONCLUSION: Stomatology students have noise-induced hearing loss, and also considered that the places where practical classes are given are a noisy environment. More knowledge is needed in students about the negative consequences of noise in health and the use of preventive measures to avoid hearing loss in the long term.

OBJETIVO: Identificar alteraciones auditivas en estudiantes de odontología y evaluar el nivel de conocimiento con relación a la pérdida auditiva inducida por ruido. METODOLOGÍA: Estudio transversal, se realizaron encuestas a estudiantes del tercer año curso diurno y cuarto año del curso nocturno de estomatología. Las variables estudiadas: trastornos auditivos y conocimiento sobre PAIR (pérdida auditiva inducida por ruido). RESULTADOS: Muestran la presencia de trastornos auditivos en 14,8% de los estudiantes, de los que 7,4% recibieron tratamiento. El 28,4% había realizado exámenes audio métricos. De los estudiantes, 24,6% tenían familiares con problemas de audición; 11,1% enfermedades preexistentes;49,3% necesitan repetición durante una conver-sación;34,4% estaba irritado en el ambiente de clases prácticas y consideraban las piezas de mano de alta rotación el instrumento más ruidoso; el 75,3% refirió usar audífonos y un 72,1% por más de 5 años. En relación a los resultados sobre conocimientos 93,8% afirmaron que el dentista es un profesional con riesgo de pérdida auditiva por ruido, pero el 83,9% no había recibido orientación sobre el PAIR. Respecto al protector auricular 77,7% lo conocía, pero sólo 3,7% lo había usado. CONCLUSIÓN: Los estudiantes de estomatología presentaron alteraciones auditivas inducidas por el ruido, y consideraban el local de las clases prácticas un ambiente ruidoso; es necesario un mayor conocimiento en los alumnos de las consecuencias negativas del ruido en la salud y la utilización de medidas de prevención para evitar la pérdida de la audición a largo plazo.

Maternal periodontal disease in rats decreases insulin sensitivity and insulin signaling in adult offspring.

BACKGROUND: Periodontal disease during pregnancy has been recognized as one of the causes of preterm and low-birth-weight (PLBW) babies. Several studies have demonstrated that PLBW babies are prone to developing insulin resistance as adults. Although there is controversy over the association between periodontal disease and PLBW, the phenomenon known as programming can translate any stimulus or aggression experienced during intrauterine growth into physiologic and metabolic alterations in adulthood. The purpose of the present study is to investigate whether the offspring of rats with periodontal disease develop insulin resistance in adulthood. METHODS: Ten female Wistar rats were divided into periodontal disease (PED) and control (CN) groups. All rats were mated at 7 days after induction of periodontal disease. Male offspring were divided into two groups: 1) periodontal disease offspring (PEDO; n = 24); and 2) control offspring (CNO; n = 24). Offspring body weight was measured from birth until 75 days. When the offspring reached 75 days old, the following parameters were measured: 1) plasma concentrations of glucose, insulin, fructosamine, lipase, amylase, and tumor necrosis factor-α (TNF-α); 2) insulin sensitivity (IS); and 3) insulin signal transduction (IST) in insulin-sensitive tissues. RESULTS: Low birth weight was not detected in the PEDO group. However, plasma concentrations of glucose, insulin, fructosamine, lipase, amylase, and TNF-α were increased and IS and IST were reduced (P <0.05) in the PEDO group compared with the CNO group. CONCLUSION: Maternal periodontal disease may induce insulin resistance and reduce IST in adult offspring, but such alterations are not attributable to low birth weight.

Percepção de adolescentes em relação a doenças sexualmente transmissíveis e métodos contraceptivos / Teenagers? percept ion about sexually transmitted diseases and contraception

Introdução: as doenças sexualmente transmissíveis (DST) podem representar um sério impacto na saúde dos adolescentes, dadas as suas consequências. Objetivo: identificar a percepção e o conhecimento de adolescentes sobre DST, suas formas de transmissão e métodos contraceptivos. Métodos: foi realizado estudo transversal tipo inquérito com 136 adolescentes estudantes de uma instituição pública de formação profissional em um município paulista de médio porte. Utilizou-se um questionário validado, autoaplicável, com perguntas sobre o tema e dados sociodemográficos. Os mesmos foram digitados e analisados pelo programa Epi Info, 3.5.1. Resultados: 97,1% afirmaram conhecer a camisinha masculina; 89,0%, a pílula; 87,5%, a camisinha feminina,; 74,3%, a pílula do dia seguinte; 47,8%, a tabelinha; 41,9%, a injeção hormonal; 33,1%, o DIU; 31,6%, o coito interrompido e 1,5% outros. Segundo eles, a informação foi fornecida principalmente na escola (46,1%), por amigos ou parceiro (20,3%), médico (10,9%) e televisão(10,2%). No que se refere às DST, 98,5% afirmaram que doenças podem ser transmitidas durante a relação sexual. A aids (91,2%) e o herpes (72,8%) foram as mais citadas. 31,6% dos adolescentes afirmaram que correm risco de contrair alguma DST, sendo 88,4% destes por não utilizar a camisinha, 30,2% porque o parceiro se relaciona com outras pessoas, 18% por possuírem vários parceiros e 9,3% por outros motivos. Conclusão: os adolescentes mesmo conhecendo diversos métodos contraceptivos e doenças sexualmente transmissíveis, ainda não se previnem. É necessário que a escola reforce o uso dos métodos, já que a mesma é importante fonte de informações educativas em saúde.

Introduction: sexually transmitted diseases (DST) can represent an important impact on teenager?s health due its consequences. Objective: to identify the perception and knowledge of teenagers about DST, its transmission forms and contraception. Methods: it was made a cross-sectional study type investigation, with 136 teenager students from a Technical Education Public Institution in a middle-sized city. It was used a tested instrument, self answered, with opened and closed questions about theme and sociodemographic data. The same data were stored and analyzed by Program Epi Info version 3.5.1. Results: 97,1% affirmed to know male condoms, 89,0% oral contraceptives, 87,5% female condoms, 74,3% postcoital contraceptives, 47,8% natural family planning methods, 41,9% hormonal injection, 33,1% intrauterine devices, 31,6% coitus interruptus and 1,5% other contraceptive methods. According with them, the information was gave principally on high school (46,1%), by friends or partners (20,3%), doctor (10,9%), television (10,2%). In relation to DST, 98,5% affirmed that diseases can be transmitted during coitus. The aids (91,2%) and herpes (72,8%) were the most cited diseases. Just 31,6% of teenagers affirmed that run the risk to acquire some DST, and 88,4% of them, due no use of condoms, 30,2% due their partner make relation with other people, 18% due have many sexual partners and 9,3% due other causes. Conclusion: even teenagers knowing many contraceptive methods and sexually transmitted diseases, the teenagers have not prevented theirselves yet. It?s necessary that the high school reinforce the use of contraceptive methods, because the school is an important source of educative information on health area.

[Adolescents' perception of oral health]. / La salud bucal en la percepción del adolescente.

OBJECTIVE: An individual does not always experience the best health and vitality indexes during her/his adolescence. This study evaluated young people's awareness of their oral health and the factors involved in dental maintenance and promotion MATERIAL AND METHOD: Adolescents (n=493) from the Mirim Foundation in the town of Araçatuba in the state of São Paulo, Brazil, were asked to fill in a semi-structured questionnaire. RESULTS: 68.4% of the youngsters interviewed regarded oral health as referring to hygiene and 16.2% to physical appearance; 53.6% of the group perceived their oral health to be good and 24% optimum. 90.1% indicated oral hygiene when asked how oral health could be ensured; however, only 4.8% mentioned brushing their tongues. Physical appearance (62.9%) was one of the main reasons stated as being important for teeth. A statistically significant relationship was observed between perception of regular dental and mouth health and having visited the dentist at least six months beforehand (x2 =30.75; p<0.05). CONCLUSION: Even though the youngsters had a general idea regarding their oral health, its maintenance and promotion, better information should be made available regarding such topics and be approached through health education so that these adolescents can have good oral health for the rest of their lives, as well as becoming knowledge multiplying agents for those who do not have access to the same information.

La salud bucal en la percepción del adolescente / Adolescents' perception of oral health

Objetivo En la fase de la adolescencia, el individuo no siempre experimenta los mejores índices de salud y vitalidad. El objetivo de éste es evaluar la percepción del adolescente sobre las condiciones de su salud bucal, así como sobre los factores para su manutención y promoción. Material y Método Fue aplicado un cuestionario semi estructurado a los adolescentes (n=493) de la Fundación Mirim del Municipio de Araçatuba-SP, Brasil. Resultados Entre los entrevistados, el 68,4 por ciento conceptuó salud bucal como higiene y el 16,2 por ciento como apariencia. Ya la percepción de los mismos cuanto a su Salud bucal fue un 53,6 por ciento buena y un 24 por ciento óptima. Con referencia a los medios para tener salud bucal, el 90,1 por ciento relató la higiene bucal, pero apenas el 4,8 por ciento de los adolescentes mencionó el cepillado de la lengua. La estética (62,9 por ciento) fue uno de los principales motivos citados, cuanto a la importancia de los dientes. Fue observada una relación estadística significante entre la percepción de la Salud bucal regular y la visita al dentista hace menos de 6 meses (X 2 =30,75, p < 0,05). Conclusión Pese a que los adolescentes presentan una idea sobre Salud bucal, y sobre su manutención y promoción, estos temas deben ser más trabajados, principalmente por medio de Educación en Salud, para que esos adolescentes obtengan una buena Salud bucal y que ésta se mantenga por el resto de sus vidas. Además, ellos se vuelven multiplicadores de conocimientos para aquéllos que no tienen acceso a las mismas informaciones.

Objective An individual does not always experience the best health and vitality indexes during her/his adolescence. This study evaluated young people's awareness of their oral health and the factors involved in dental maintenance and promotion Material and Method Adolescents (n=493) from the Mirim Foundation in the town of Araçatuba in the state of São Paulo, Brazil, were asked to fill in a semi-structured questionnaire. Results 68.4 percent of the youngsters interviewed regarded oral health as referring to hygiene and 16.2 percent to physical appearance; 53.6 percent of the group perceived their oral health to be good and 24 percent optimum. 90.1 percent indicated oral hygiene when asked how oral health could be ensured; however, only 4.8 percent mentioned brushing their tongues. Physical appearance (62.9 percent) was one of the main reasons stated as being important for teeth. A statistically significant relationship was observed between perception of regular dental and mouth health and having visited the dentist at least six months beforehand (x 2 =30.75; p<0.05). Conclusion Even though the youngsters had a general idea regarding their oral health, its maintenance and promotion, better information should be made available regarding such topics and be approached through health education so that these adolescents can have good oral health for the rest of their lives, as well as becoming knowledge multiplying agents for those who do not have access to the same information.

Percepção de pacientes HIV-positivo de um centro de referência em relação a tratamentos de saúde / Percption of HIV-positive patients from a referral center for health care

Introdução: os profissionais de saúde, em muitos casos, apresentam práticas defensivas e excludentes, características do preconceito e da discriminação, no atendimento a pacientes HIV-positivo. Objetivo: verificar a percepção de pacientes soropositivos de um centro de referência para DST/HIV/aids em relação a tratamentos de saúde. Métodos: realizaram-se entrevistas com perguntas relacionadas às atitudes discriminatórias sofridas, acesso e assistência à saúde. Resultados: participaram da pesquisa 130 indivíduos, dos quais 30 (23,1%) relataram eventos de discriminação sofrida fora do centro de referência, predominantemente do cirurgião-dentista e 112 (86,2%) acreditavam ter o mesmo acesso e assistência à saúde que outros cidadãos. Sessenta e dois (47,7%)tratavam-se com o dentista do centro de referência, sendo que destes, 56 (90,3%) achavam bom serem atendidos em uma unidade odontológica somente para HIV-positivo e seis (9,7%) mostraram-se indiferentes, acreditavam estar mais expostos, ou ser preconceito haver um dentista para atender indivíduos soropositivos. Conclusão: conclui-se que muitos pacientes já foram discriminados fora do centro de referência. Porém, a maioria apresenta um sentimento positivo ao tratamento recebido num local específico para pacientes HIV-positivo, devido ao acolhimento compreendido pela humanização e acesso aos serviços de saúde.

Introduction: health professionals, in many cases, have defensive and exclusionary practices, patterns of prejudice and discrimination in response to HIVpositive patients. Objective: to verify the perception of patients seropositives from a reference center for STD/HIV/aids in relation to health care. Methods: there were interviews with questions related to discriminatory attitudes suffered, access and health care. Results: 130 individuals participated in the survey, from which 30 (23.1%) reported events of discrimination suffered outside the center of reference, predominantly from surgeon-dentists and 112 (86.2%) believed to have the same access and health care as other citizens. 62 (47.7%) treated with the dental center of reference, of which 56 (90.3%) felt goodbeing treated in a dental unit only for HIV positive and six (9.7%) were indifferent, believed to be more exposed, or have a bias to attend dental seropositive individuals. Conclusion: it is concluded that many patients have already been discriminated against outside the reference center. However, most of them have a positive feeling towards the treatment received at a specific place for treating HIV-positive patients, due to the feeling of being welcome at that place due to the humanization and access to health care.

HIV attitudes and practices among professors in a Brazilian dental school.

Although there is considerable published research on Acquired Immunodeficiency Syndrome (AIDS), individual biases persist because of lack of information regarding HIV virus transmission. As a result, both infected patients and health care professionals suffer. The objective of this study was to determine if there is prejudice among university professors at the School of Dentistry at Aracatuba's Sao Paulo State University (FOA-UNESP) concerning HIV-positive patients or HIV-positive health care professionals. Out of the seventy-seven professors who responded to the questionnaire, 62.3 percent (forty-eight) stated that they advise their students not to refuse to treat a patient with HIV. Although 96.2 percent (fifty-two) of the fifty-four professors who treat patients have reported that they treat patients who are HIV-positive, only 65.3 percent of them were aware of infection control precautions, and only 32.7 percent reported that they would treat an HIV-positive patient like any other patient. There is also prejudice regarding HIV-positive professionals because only 48.1 percent (thirty-seven) of the professors responded that they would be willing to be treated by an infected professional. It can be concluded that there is prejudice among some of the FOA-UNESP university professors regarding individuals who are HIV-positive.