Qualificação profissional em saúde da família na região Nordeste: o modelo RENASF / Professional qualification in family health in the northeast: the RENASF model

No Brasil, o acesso a Rede de Atenção à Saúde tem como porta de entrada a atenção básica, que se caracteriza por ações de saúde, direcionadas a promoção e a proteção da saúde, a prevenção de agravos, o diagnóstico, o tratamento, a reabilitação e a manutenção da saúde,desenvolvidas no âmbito individual e coletivo. Na atenção básica as ações de saúde são desenvolvidas por práticas de cuidado e gestão, realizadas pelo trabalho em equipe, de forma democrática e participativa(¹).Esse modelo redireciona práticas de saúde centradas na doença para um novo paradigma voltado ao acolhimento, à vinculação e à corresponsabilização do usuário pela atenção às suas necessidades de saúde. Para tanto, requer dos profissionais de saúde e da gestão, principalmente no nível local, um saber e um fazer que garantam novas práticas de cuidado, gestão e participação popular.

In Brazil, access to health care Network as agateway to primary health care, which is characterised by health actions, directed to promotion and protection of health, the prevention of diseases, the diagnosis, treatment, rehabilitation and maintenance of health, carried out within the individual and collective scope. In basic care actions are developed by health care practices and management, carried out by team work, in a democratic and participatory manner(¹).This template redirects health practices focusedon disease to a new paradigm back to reception, the binding and the bailout provisions of the userby attention to their health needs. To do so,requires health professionals and management,especially at the local level, a knowledge and doingto ensure that new practices of care, management and popular participation.

The relation between gender in the access to dental services and goods / Relação entre o gênero no acesso ao serviço odontológico e aos artigos de higiene bucal / La relación del género en el acceso al servicio odontológico y los artículos de higiene bucal

Objective: Identify the influence of gender in the access to dental services and goods such as consultation, toothbrush, toothpaste and dental prostheses use. Methods: Cross-sectional, quantitative and population coverage study, with the population of Guaiuba municipality. Data were collected by Community Health Agents from 2007 to 2008. We used the Community Oral Health Indicator to verify the access to oral health services, oral hygiene, dental visit, use and need of dental prosthesis. Data were analyzed using SPSS 15.0 software, using the chi-square test and significance level of 5%. Results: 2581 people participated, with a mean age of 24.42 years (SD± 19, 365), predominance of females (n=1628; 63.1%). Among the interviewees, 2,341 (90.7%) had access to a toothbrush, 2272 (88.0%) to toothpaste, and 1175 (45.5%) to a dental appointment. The need for dental prosthesis was higher in women, 581 (35.7%) versus 221 (23.2%) men and their access [354 (60.9%)] versus [96 (43.4%)] with p<0.05. Conclusion: The access to health services and dental treatment presents gender as an influence factor. Women have most of the needs and benefits.

Objetivo: Identificar a influência do gênero no acesso ao serviço odontológico e aos artigos de higiene bucal. Métodos: Estudo transversal do tipo quantitativo, tendo como universo a população do Município de Guaiuba-Ceará e coleta de dados realizada por Agentes Comunitários de Saúde treinados, entre 2007 a 2008. Utilizaram-se variáveis do Indicador Comunitário em Saúde Bucal para averiguar acesso aos serviços de saúde, itens de higiene bucal, consulta odontológica, assim como uso e necessidade de prótese dentária. Os dados foram analisados com teste Qui-quadrado de Pearson com nível de significância de 5%. Resultados: Participaram 2.581 indivíduos, com idade média de 24,4 anos (DP ± 19,7). Predominou sexo feminino (63,1%; n=1628). Dos entrevistados, 2.341 (90,7%) tiveram acesso à escova dental, 2.272 (88,0%) ao dentifrício, 1.175 (45,5%) à consulta odontológica. A necessidade de prótese dentária foi maior nas mulheres com 581 (35,7%) versus 221 (23,2%) homens e seu acesso [354(60,9%)] versus [96 (43,4%)] com p<0,05. Conclusão: O acesso a artigos de higiene bucal e serviços de saúde e a oferta para tratamento odontológico, apresenta o sexo como fator influenciador. As mulheres possuem a maioria das necessidades e dos benefícios.

Objetivo: Identificar la influencia del género en el acceso al servicio odontológico y los artículos de higiene bucal. Métodos: Estudio transversal de abordaje cuantitativo con la población Del Município de Guaiuba-Ceará y recogida de datos realizada por Agentes Comunitarios de Salud entrenados, entre 2007 y 2008. Se utilizaron variables del Indicador Comunitario en Salud Bucal para verificar el acceso a los servicios de salud, ítems de higiene bucal, consulta odontológica bien como el uso y necesidad de prótesis dental. Los datos fueron analizados con la prueba de Chi-cuadrado de Pearson con nivel de significación del 5%. Resultados: Participaron 2.581 individuos con edad media de 24,4 años (SD ± 19,7). Hubo predominio del sexo femenino (63,1%; n=1628). De los entrevistados 2.341 (90,7%) tuvieron acceso al cepillo de dientes, 2.272 (88,0%) al dentífrico, 1.175 (45,5%) a la consulta odontológica. La necesidad de prótesis dental fue mayor en las mujeres con 581 (35,7%) versus 221 (23,2%) hombres y su acceso [354(60,9%)] versus [96 (43,4%)] con p<0,05. Conclusión: El acceso a artículos de higiene bucal y servicios de salud y la oferta de tratamiento odontológico presenta el sexo como factor influyente. Las mujeres poseen la mayoría de las necesidades y beneficios.

Child, neglect and oral health.

BACKGROUND: Despite advancements in oral health policies, dental caries still a problem. The lack of parents/caregiver's care regarding child's oral health, which characterizes neglect, may lead to a high prevalence of caries. Therefore, the objective of this study was to analyze the relation between dental caries and neglect in five year-old children. METHODS: Quantitative study performed in two different moments. First, the children underwent oral examinations and physical inspection. Then, a semi-structured interview was performed with parents of children with high and low caries rate. RESULTS: In all, 149 physical inspections and oral exams were performed. The number of decayed, missing and filled teeth - dmf-t was 2.75 (SD 2.83); 16 children had extremely high values (dmf-t ≥ 7), 85 intermediate values (1 ≤ dmf-t ≥ 6) and 48 extremely low (dmf-t = 0). Nearly all caregivers were female (96.7%; n = 29), mostly mothers (93.3%; n = 28). Associations were found between caries experience and reason of the last consultation (p = 0.011), decayed teeth and child's oral health perception (p = 0.001). There was a trend towards a significant association between general health and decayed teeth (p = 0.079), general hygiene and caries experience (p = 0.083), and caries experience and number of times the child brushes the teeth (p = 0.086). CONCLUSION: There's a relation between caries experience and children's oral health perception by caregivers, as well as between caries experience and children's access to dental care. There is a trend towards association between caries experience and risk factors suggestive of neglect.

Application of the community oral health indicator by non-dental personnel and its contribution to oral healthcare.

OBJECTIVE: To validate the Community Oral Health Indicator-COHI by non-dental personnel. METHODS: Risk assessment is an essential component in the decision-making process. Therefore, the COHI, an instrument to evaluate population oral health situation in a simple manner, was created. Community Health Agents (CHA) were trained to use the COHI (variables as number of teeth, presence of cavities, residual dental roots, oral lesions, etc.), while dentists for the COHI and DMFT. 60 individuals were examined, by CHA and DS, with these indicators in order to validate the use of COHI by non-dental personnel. RESULTS: Dental and soft tissues problems were well spread among those individuals. People with and without soft tissue damage, as well as with and without use and/or need for prostheses were found in the sample, proving it to be a heterogeneous population for the evaluated factors and representing the real population. The results of examinations performed by dentists using the COHI and DMF-T/dmf-t presented strong agreement when comparing the two instruments. When COHI and DMFT were compared, the results showed a concordance of 0.86 for the number of present teeth, and 0.85 for the number of residual roots. Likewise, when analyzing the data comparing the use of the COHI by DS and CHA a high agreement level, specificity and sensitivity was found. CONCLUSION: The COHI has shown to be useful for detecting problems in oral health. Therefore, COHI may be used, after training, by non-dental personnel, contributing to the planning and organization of the community dental assistance.

Saúde bucal do adolescente: necessidades odontológicas levantadas pelos agentes comunitários de saúde / Adolescent oral health: odontological needs raised by community health agents

Objetivo: Apresentar dados epidemiológicos relativos à saúde bucal de adolescentes, obtidos com a utilização do Indicador Comunitário em Saúde Bucal (ICSB) e levantados pelos Agentes Comunitários de Saúde (ACS) em um município do Estado do Ceará, Brasil. Métodos: Estudo transversal, realizado em Guaiúba-CE, Brasil, entre julho/2007 e fevereiro/2008. Agentes comunitários de saúde (ACS) utilizaram ICSB para coletar dados. O ICSB averigua capacidade mastigatória (número de dentes); necessidade de tratamento curativo (dentes com cárie e raiz residual); presença de agravos aos tecidos moles; e uso e necessidade de prótese dentária. Este possibilita a priorização do atendimento de pacientes com maiores necessidades, através de uma lista de sinais relacionados a problemas bucais. Foram examinados 743 adolescentes. Resultados: Os adolescentes tinham em média 26,14 ±3,61 dentes; 129 (17,4%) sem cárie, 301 (40,5%) possuíam uma ou duas, 223 (30,0%) três ou mais; 110 (14,8%) tinham raiz residual, 121 (25,7%) cálculo, 74 (10,0%) gengiva inflamada, 15 (2,0%) agravos aos tecidos da boca; 49 (6,6%) necessitavam prótese; 694 (93,4%) usavam escova dental; e 281 (51,3%) visitaram o dentista no último ano. Detectou-se associação entre visita ao dentista no último ano e gênero feminino (p=0, 0001), e entre idade menor de 12 anos e três ou mais cáries (p=0,023). Conclusão: Os dados levantados demonstram baixos indicadores de saúde bucal nos adolescentes. Identificou-se agravamento do nível de saúde bucal dos menores de 12 anos em relação aos mais velhos, o que demanda política pública voltada para esta realidade. Os dados sugerem que ICSB pode ser utilizado em levantamentos feitos em bases populacionais.

Objective: To present epidemiological data on adolescents oral health, collected by Community Health Agents (CHA) using Community Oral Health Indicator (COHI) in a city of Ceará State, Brazil. Methods: Cross-sectional study conducted in Guaiúba-CE from July, 2007 to February, 2008. Community health agents collected data using the COHI. The COHI evaluates the masticatory capacity (number of teeth); the need of restorative care (dental cavities and residual roots); presence of soft tissue injury; use and need of dental prosthesis. It allows giving priority care to the patients with greater needs by means of a list of signs related to oral health problems. A total of 743 adolescents were examined. Results: adolescents had 26.14 ± 3.61 teeth on average; 129 (17.4%) did not present cavities, 301 (40.5%) had one or two, 223 (30.0%), had three or more; 110 (14.8%) presented residual root, 121 (25.7%) tartar, 74 (10.0%) sore gums, 15 (2.0%) oral tissues injuries; 49 (6.6%) required prosthesis; 694 (93.4%) used toothbrush; and 281 (51.3%) had visited the dentist last year. It was detected an association between visit to the dentist in the last year and gender (p = 0, 0001), and between age below 12 and having three or more cavities (p = 0.023).Conclusion: Collected data demonstrated low oral health indicators among teenagers. It was noted that those aged under 12 present oral health indicators worse than the older ones, which demands public policies concerning such reality. Data suggests that COHI is suitable for epidemiological surveys.

Use and satisfaction with electronic health record by primary care physicians in a health district in Brazil.

It is believed that Electronic Health Records (EHR) improve not only quality of care but also patient safety and health care savings. This seems to be true for developed countries but not necessarily in emerging economies. This paper examined the primary care physicians' satisfaction with a specific EHR in a health district of a major city in Brazil and describes how they are using it as well as its specific functions. A cross-sectional questionnaire survey with all physicians from all Community Health Centers of the 6th health district of the City of Fortaleza that were using HER was conducted. From the 111 subjects (100%), a total of 99 physicians answered the survey (89% response rate). For overall satisfaction with the EHR, 2 (2%) were satisfied, 50 (50.5%) were satisfied in part and 47 (47.5%) were not satisfied. For the functionalities, a proportion of correct answers (PCA) and an index of functionality usage (IFU) were developed. PCA and IFU were significantly correlated (p < 0.001). Inverse and weak correlations were found between PCA and age (p < 0.001), years since medical school and years of work (p < 0.01). For usage (IFU), there was inverse correlation with "years working in Family Health Strategy" (p < 0.05). High IFU was associated with physicians who stated to use easily Internet and Email; who saw less patients per half-day; who were women (p < 0.05), younger (p < 0.05), in training (p < 0.05) and not satisfied with the EHR (p < 0.05).The use of EHR was associated with being young, female, still in training and seeing less than 16 patients per half-day. Structural issues (e.g. network and system support) seemed to be major barriers in this setting. Lack of classical functionalities such as problem list and clinical reminders could have contributed to exacerbate misperceptions about what EHRs can do in improving work processes and patient care.

Relação entre fluorose dental e a concentração de flúor no dente ? um estudo em área endêmica / The relat ionship between denta l fluorosis and toot h fluoride concentrat ion ? A studyn in an endemic area

Objective: To determine the relationship between dental fluorosis (DF) severity and fluoride [F] concentration in tooth and water in DF endemic areas. Methods: Life-long residents from two DF endemic communities were studied. Forty-five extracted teeth were collected and analyzed for DF severity and tooth [F]. Thylstrup-Ferjeskov Index (TFI) was used to measure DF severity and instrumental neutron activation analysis (INAA) for tooth [F] concentration. Water from regional wells was also collected (n=9) and analyzed for F content using specific ion F electrode. Results: Water [F] varied between 0.2ppm and 4.7ppm. TFI scores ranged from 0 to 6; [F] from 120ppm to 2,140ppm in enamel and 304ppm to 4,800ppm in dentin. No correlation was found between DF severity and [F] in enamel (rs=0.22,p=0.15) and dentin (rs=-0.19,p=0.20), nor between water [F] and [F] in enamel (rs=-0.09,p=0.65) and dentin (rs=-0.11,p=0.56). Weak correlation between DF severity and water [F] (rs=0.38,p=0.04) was found. Linear regression analysis showed that TFI couldn?t be predicted from a linear combination of the independent variables (age, enamel and dentin [F]). When enamel, dentin and water [F] were used as independent variables in the linear regression (predict DF severity), only water [F] showed influence in DF severity (p=0.013;t=2.67). Conclusion: Even in areas of endemic DF, tooth [F] didn?t correlate with DF severity and the relationship between water [F] and DF severity was very weak. Therefore, tooth [F] may not be a good predictor/indicator of DF severity.

Objetivo: Determinar a relação entre severidade de fluorose dental (FD), e concentração de flúor [F] no dente e água em áreas endêmicas de FD. Métodos: Residentes de duas comunidades endêmicas de FD foram estudados. 45 dentes foram coletados e analisados para severidade de FD e concentração de flúor. O índice de Thylstrup-Ferjeskov (TFI) foi utilizado para medir a severidade de FD e análise por ativação com nêutrons (AAN) para concentração de [F] dental. Águas de poços da região foram coletadas (n=9) e analisadas para [F], utilizando eletrodo específico de flúor. Resultados: Concentração de [F] da água variou entre 0,2 e 4,7ppm. Os escores do TFI variaram entre 0 e 6; [F] no esmalte entre 120 e 2140ppm e na dentina entre 304 e 4800ppm. Não se observou correlação entre severidade de DF e [F] no esmalte (rs=0,22,p=0,15) e dentina (rs=-0,11,p=0,56). Encontrou-se correlação fraca entre FD e [F] na água (rs=0,38,p=0,04). Análise de regressão linear demonstrou que TFI não podia ser predito por uma combinação linear das variáveis (idade, e concentração de flúor no esmalte e dentina). Quando a concentração de flúor no esmalte, dentina e água foram analisadas de forma independente na regressão linear, apenas flúor na águademonstrou influência na severidade de FD (p=0,013;t=2,67). Conclusão: Mesmo em áreas endêmicas de FD, concentração de flúor dental não se correlaciona com severidade de FD, e a relação entre este e a concentração de flúor nas águas foi fraca. Assim, concentração de flúor dental pode não ser um bom preditor/indicador de severidade de FD.

Impacto da atenção odontológica na saúde bucal de crianças / The impact of dental care in oral health of children

Objetivo: Avaliar a prevalência de cárie dentária em crianças institucionalizadas (abrigo) ou não (situação familiar estável), com e sem acesso à atenção odontológica, verificando o impacto desta em ambos os grupos. Métodos: O estudo teve 133 participantes de ambos os sexos, mesmo nível socioeconômico e idade de 3 a 6 anos, distribuídas em quatro diferentes grupos. Dois grupos eram compostos de crianças institucionalizadas, um deles dispondo de tratamento odontológico regular e o outro não; os outros dois grupos eram formados por crianças de creches-escola, um apresentando tratamento odontológico e o outro não. A coleta de dados constituiu-se de anamnese e exame clínico realizados por uma única pesquisadora devidamente calibrada. O índice de dentes decíduos cariados, extraídos e obturados (ceo-d) foi utilizado para a determinação da prevalência de cárie. Resultados: A análise dos dados demonstrou diferença estatística significante entre os grupos quanto ao ceo-d que, embora elevado para todos, foi significantemente menor para aqueles que dispunham de assistência odontológica (p<0,001). A comparação entre abrigos e escolas também forneceu valores estatisticamente diferentes de ceo-d (p<0,001), assim como a comparação das escolas e abrigos entre si (p=0,012). Adicionalmente, observou-se que as necessidades de tratamento na dentição decídua foram superiores às necessidades atendidas e, assim, deve-se destacar o enfoque preventivo, seja nas escolas, seja nos abrigos para a redução efetiva dos índices de cárie dentária nesta população. Conclusão: O fator institucionalização não indicou maior probabilidade de cárie nas crianças estudadas. Entretanto, a ausência do cirurgião-dentista tornou significantemente maior a probabilidade de ocorrência da doença cárie.

Objective: To evaluate the prevalence of dental decay in institutionalized children (shelter) or not (stable family situation), with and without access to dental care, verifying the impact of this in both groups. Methods: The study had 133 participants of both sexes, with the same socioeconomic level and aged 3 to 6 years old, divided into four different groups. Two groups consisted of institutionalized children, one of whom had regular dental treatment and the other not; the other two groups consisted of children from nursery school, one group presenting dental treatment and the other not. Data collection consisted of medical history and clinical examination performed by one researcher properly calibrated. The index of decayed, missing and filled deciduous teeth (dmf-t) was used to determine the prevalence of caries. Results: Data analysis showed statistically significant difference between groups in the dmf-t that, although high for everyone, was significantly lower for those who had dental care (p <0.001). The comparison between shelters and schools also provided statistically different values of dmf-t (p <0.001), as well as the comparison of schools and shelters among themselves (p = 0.012). In addition, we observed that treatment needs in primary dentition were higher than treatment received and, thus, the preventive approach should be highlighted, both in schools and in shelters for the effective reduction of dental caries rates in this population. Conclusion: Institutionalization as factor did not indicate a higher probability of dental decay in children. However, the absence of the dentist turned significantly higher the probability of dental caries? occurrence.

[Self-perception of oral health condition of the institutionalized and non institutionalized elders]. / Autopercepção da condição de saúde bucal em idosos institucionalizados e não institucionalizados.

This study evaluated the self-perception of oral health condition of institutionalized and non institutionalized elder population using a oral examination and a questionnaire divided in three parts: demographic data, general health and the GOHAI index. A total of 96 individuals above 60 years old living in Fortaleza, Brazil, were interviewed. They were divided in two groups, G1--institutionalized (n=48) and G2--non-institutionalized (n=48). The mean age of the study population was 69.8 years (SD 7.5) and 70.8% of the interviewed were woman. 62% had some type of medical treatment in the last year, and despite the fact that the majority (84.4%) of the elders thought that their general health was good or regular, the average number of teeth presented was 3.9 in both groups. Among them, 47.9% were using superior prosthesis and 26% inferior prosthesis. The GOHAI average was 17.53 qualifying as negative the self-perception of oral health. There was no difference between the two groups regarding physical and psychological aspects.

Influência da informação oral e escrita sobre antirretrovirais no conhecimento de usuários com hiv/aids / The influence of oral and written information on antiretroviral drugs in the knowledge of users with HIV/AIDS

Avaliar a influência da transmissão oral e escrita de informação sobre medicamentos antirretrovirais na geração de conhecimentos nos seus usuários e na retenção dessa informação pelos mesmos. Método: Na primeira fase, 18 indivíduos portadores de HIV/AIDS atendidos em um hospital de referência analisaram três folhetos informativos sobre medicamentos e escolheram o melhor. Na segunda fase, foram formados três grupos de 47 pessoas entre portadores de HIV/AIDS que recebem medicamentos antirretrovirais no mesmo hospital. O primeiro grupo, considerado o grupo controle (grupo C), recebeu seu medicamento na farmácia de forma usual, sem qualquer informação adicional; o segundo grupo (grupo F) recebeu o folheto com informações sobre o medicamento em uso, que deveria ser lido naquele momento; o terceiro grupo (grupo O) recebeu, de forma oral, as mesmas informações detalhadas no folheto. Todos responderam um questionário que avaliava seus conhecimentos sobre o medicamento. Resultados: As respostas do grupo O tiveram maior índice de concordância com a informação que lhes foi repassada quanto à ação do medicamento no organismo (78,7%), a duração do tratamento (83%), ao procedimento ao perder uma dose (91,5%) e quanto ao armazenamento (95,7%). Conclusão: A transmissão de informação, seja de forma oral ou escrita, gera conhecimento e as instruções e informações quando transmitidas oralmente, de modo detalhado e numa linguagem adequada, são mais facilmente compreendidas e assimiladas. Constata-se também que, no grupo estudado, a informação oral resultou mais efetiva de imediato do que a escrita.

To assess the influence of oral and written transmission of information on antiretroviral drugs in knowledge generation in their users and in the retention of information by them. Method: In the first phase, 18 individuals with HIV/AIDS treated at a referral hospital analyzed three brochures containing information on antiretroviral drugs and chose the best. In the second phase, three groups of 47 individuals with HIV/AIDS who received antiretroviral drugs in the same hospital were formed. The first group, considered the control group (group C) received their medication at the pharmacy as usual, without any additional information; the second group (group F) received a brochure with information about the drug in use, which should be read at that moment; and the third group (group O) received orally, the same information detailed in the brochure. All answered a questionnaire that assessed their knowledge on the referred drug. Results: The responses of group ?O? had a higher level of agreement with the information they received regarding action of the drug in the body (78.7%), duration of treatment (83%), procedure when missing a dose (91.5%) and storage (95.7%). Conclusion: The transmission of information, whether oral or written, generates knowledge and the instructions and information when orally transmitted, in a detailed manner and in appropriate language, are more easily understood and assimilated. It appears also that, in the studied group, oral information resulted more immediately effective than written one.

Autopercepção da condição de saúde bucal em idosos institucionalizados e não institucionalizados / Self-perception of oral health condition of the institutionalized and non institutionalized elders

Este estudo avaliou a autopercepção das condições de saúde bucal em idosos institucionalizados ou não, por intermédio da aplicação de um exame bucal e um questionário composto por três partes: dados demográficos, saúde geral e o índice GOHAI. A amostra foi de 96 indivíduos com 60 anos ou mais, residentes em Fortaleza, CE, Brasil, dividida em G1 - idosos institucionalizados (n=48) e G2 - idosos não institucionalizados (n=48). Apesar de 84,4 por cento dos idosos acreditarem que sua saúde está excelente ou razoável, a média de dentes presentes foi de 3,9 nos dois grupos, constatando-se uma população predominantemente de edêntulos. Dentre eles, 47,9 por cento usavam prótese total superior e 26 por cento inferior. A média do GOHAI foi de 17,53, qualificando como negativa a saúde bucal, e não houve diferença entre os dois grupos em relação aos aspectos físicos e psicológicos.

This study evaluated the self-perception of oral health condition of institutionalized and non institutionalized elder population using a oral examination and a questionnaire divided in three parts: demographic data, general health and the GOHAI index. A total of 96 individuals above 60 years old living in Fortaleza, Brazil, were interviewed. They were divided in two groups, G1 - institutionalized (n=48) and G2 - non-institutionalized (n=48). The mean age of the study population was 69,8 years (SD 7,5) and 70,8 percent of the interviewed were woman. 62 percent had some type of medical treatment in the last year, and despite the fact that the majority (84.4 percent) of the elders thought that their general health was good or regular, the average number of teeth presented was 3.9 in both groups. Among them, 47.9 percent were using superior prosthesis and 26 percent inferior prosthesis. The GOHAI average was 17.53 qualifying as negative the self-perception of oral health. There was no difference between the two groups regarding physical and psychological aspects.

Evaluation of HIV/AIDS patients' knowledge on antiretroviral drugs

Lack of information on antiretroviral drugs or the misunderstanding of available information can facilitate incorrect use of such drugs. This can result in non-adherence to the prescribed regimen, leading to a great possibility of a therapeutic failure. The aim of this study was to know which information HIV/AIDS patients, who receive their medicines at the pharmacy of a reference hospital in the northeast Brazil, have on the drugs they use, the source of this information and whether there is a need for additional information. A total of 195 HIV/AIDS patients, who were using either zidovudina + lamivudina 300+150mg (AZT+3TC), efavirenz 600mg (EFZ) or lopinavir/ritonavir 133.33/33mg (LPV/r), were interviewed. The mean age was 41 years (SD = 9.55) and 70.8 percent were males. Of the total, 55.4 percent didn't know the effect of the drug in the organism; 35.9 percent were unaware of the necessity of taking antiretroviral drugs for the rest of their lives; only 14.4 percent knew how to proceed when a dosage was missed; 22.1 percent said they could die and the same number of individuals believed in aggravation of the disease in case of treatment interruption. The majority, 68.2 percent, considered it very necessary to receive drug information. The results show that there is an apparent lack of general information among users of antiretroviral drugs, and at the same time a need for it. It is necessary that all professionals involved in the health care of the patients agree that an efficient supply of information on prescribed drugs is an ethical component of the treatment that favors and fosters its adherence.

Absence of periodontitis in acromegalic patients.

Acromegaly is a metabolic disorder caused by increased growth hormone (GH) secretion. Common oral features are prognatism, increased interdental spaces, macroglosia, and dental mobility. However, not much is known about the periodontal status of acromegalics. The periodontal status of 16 acromegalic subjects was investigated and compared with 20 controls (similar socioeconomic profile and age). Periodontal probing, followed by the assessment of gingival overgrowth, tooth loss and mobility, and malocclusion was performed. Acromegalic patients' did not present periodontitis and all of them had complete absence of periodontal pockets, while 50% of the control group presented periodontitis. All acromegalic patients presented dental mobility degree 1, mainly in the anterior inferior teeth. Malocclusion (100%) and diastemas (93.75%) were also present in these patients. It was concluded that acromegalic patients may be less prone to periodontal diseases than control subjects.

Evaluation of HIV/AIDS patients' knowledge on antiretroviral drugs.

Lack of information on antiretroviral drugs or the misunderstanding of available information can facilitate incorrect use of such drugs. This can result in non-adherence to the prescribed regimen, leading to a great possibility of a therapeutic failure. The aim of this study was to know which information HIV/AIDS patients, who receive their medicines at the pharmacy of a reference hospital in the northeast Brazil, have on the drugs they use, the source of this information and whether there is a need for additional information. A total of 195 HIV/AIDS patients, who were using either zidovudina + lamivudina 300+150 mg (AZT+3TC), efavirenz 600 mg (EFZ) or lopinavir/ritonavir 133.33/33 mg (LPV/r), were interviewed. The mean age was 41 years (SD = 9.55) and 70.8% were males. Of the total, 55.4% didn't know the effect of the drug in the organism; 35.9% were unaware of the necessity of taking antiretroviral drugs for the rest of their lives; only 14.4% knew how to proceed when a dosage was missed; 22.1% said they could die and the same number of individuals believed in aggravation of the disease in case of treatment interruption. The majority, 68.2%, considered it very necessary to receive drug information. The results show that there is an apparent lack of general information among users of antiretroviral drugs, and at the same time a need for it. It is necessary that all professionals involved in the health care of the patients agree that an efficient supply of information on prescribed drugs is an ethical component of the treatment that favors and fosters its adherence.

Prevalência de sintomas de estresse nos estudantes de medicina / Prevalence of stress symptoms among medical students

Objetivo: Identificar o perfil sociodemográfico dos acadêmicos de Medicina e avaliar a prevalência de sintomas de estresse nesses estudantes. Métodos: A população estudada respondeu ao Inventário de Sintomas de Stress para Adultos de Lipp (ISSL), para identificação de sintomas de estresse e a um questionário sociodemográfico. Resultados: Duzentos estudantes de Medicina, matriculados nos Ciclos Básico ou Clínico da Universidade Federaldo Ceará (UFC), foram estudados. Houve predominância do sexo masculino (54,5%), solteiros (100%), naturais de Fortaleza (87%), com idade média de 21 (± 2,3) anos. As alunas apresentaram níveis de sintomas de estresse maiores do que os estudantes homens, representando 30,1% e 19,6%, respectivamente (p ≤ 0,001). A prevalência de sintomas de estressefoi de 49,7%, sendo o quarto semestre o período com níveis mais altos desses sintomas (p = 0,002). Conclusões: Conclui-se que estudantes de Medicina da Universidade Federal do Ceará (UFC) têm níveis de estresse similares àqueles relatados para amostras internacionais.

Objective: To study the social-demographic profile of Medical students and assess the prevalence of stress symptoms in these students. Methods: The Inventory of Symptoms of Stress forAdults of Lipp (ISSL) was used to evaluate the symptoms of stress and a questionnaire was applied to identify the participants' social-demographic characteristics. Results: Two hundred Medical students registered at the Federal University of Ceará (UFC), taking Basic and Clinical courses, wereinterviewed. Participants were predominantly male (54.5%), single (100%), born in Fortaleza (87%), mean age 21 years (SD = 2.3). Female students showed higher levels of stress' symptoms than male students, 30.1% and 19.6% respectively, (p ≤ 0.001). The prevalence of symptoms of stresswas 49.7% and students attending the fourth semester showed the highest levels of symptoms (p = 0.002). Conclusions: The conclusion is that Medical students at UFC have levels of stress similar to those reported in international studies.

Cementoblastoma related to a primary tooth: a case report.

Cementoblastomas are benign lesions of the odontogenic ectomesenchyme that rarely occur related to the primary dentition, especially on the left side of the mandible. This study describes a case of a true cementoblastoma related to the left second primary mandibular molar in a 7-year-old child (the largest one seen in the left side of the mandible). Additionally, the radiographic and histologic findings of the lesion are described in details.