The accuracy of the modified Evan's blue dye test in detecting aspiration in tracheostomised patients.

OBJECTIVES: To evaluate the sensitivity and specificity of the modified Evans blue dye test compared to the fibre-optic endoscopic evaluation of swallowing to detect aspiration in tracheostomised patients. METHODS: This observational accuracy study included 17 patients hospitalised for respiratory complications, subjected to prolonged intubation, and for this reason, tracheostomised. RESULTS: Mean patient age was 60.2 ± 21.0 years. Aspiration was identified in 10 patients when assessed by fibre-optic endoscopic evaluation of swallowing; of these, 1 had aspiration when evaluated by modified Evans blue dye test. The dye test had a sensitivity of 10.0 per cent and specificity of 100.0 per cent for detecting aspiration. Fibre-optic endoscopic evaluation of swallowing revealed no statistically significant associations between aspiration presence and: speech and language therapy duration, intubation time, or tracheostomy plus mechanical ventilation duration. CONCLUSION: The modified Evans blue dye test is simple and inexpensive, and does not require prior knowledge in endoscopy; it may be used as an initial screening test in all tracheostomised patients for evaluating aspiration. However, fibre-optic endoscopic evaluation of swallowing should be used for a more comprehensive diagnosis of tracheostomy patients, especially for those at high risk for aspiration.

Factors associated with Brazilian adolescents' satisfaction with oral health.

OBJECTIVE: To identify the sociodemographic, clinical and self-reported indicators of oral health associated with Brazilian adolescents' satisfaction with oral health. METHODS: Secondary data were used following the examination of 4,231 adolescents, aged 15 to 19 years, participating in a national oral health survey (SBBrasil 2010). The independent variables were grouped into demographics, predisposition/facilitation, oral health conditions and perceived dental treatment need. Satisfaction with oral health was considered the dependent variable. Ordinal logistic (multiple) regression models tested the variables in sequence (hierarchical), as per the conceptual model, assuming p≤0.05 as the criterion for remaining in the model (Wald test). Adjustment of the model was evaluated with the Akaike information criterion (AIC) and -2 Log L. RESULTS: Participants with perceived treatment need (OR=2.36, 95% CI = 2.14-2.61), toothache (OR=1.18, 1.10-1.28), presence of oral impacts on daily performance (OIDP) (OR= 1.55, 1.44-1.68), severe and very severe dental aesthetic index (DAI) (OR=1.17, 1.08-1.27), were female (OR=1.16, 1.10-1.23), were of black/brown ethnicity (OR=1.10, 1.04-1.17), and had caries in anterior (OR=1.20, 1.08-1.32) and posterior teeth (OR=1.22, 1.13-1.32) presented lower satisfaction with oral health. CONCLUSION: Satisfaction with oral health in Brazilian adolescents is linked to a multidimensional structure of factors that include demographic aspects, such as gender and ethnic group, self-perception aspects, such as perceived treatment need and oral health impact on daily activities, and clinical aspects, such as the presence of toothache, severe malocclusion and caries in anterior and posterior teeth.

Evaluation of an educational activity in the oral health of students.

OBJECTIVE: To investigate the influence of educational activity in the school environment based on prescriptive and subjective oral health indicators. METHODS: Cross-sectional, comparative study involving students between 9 and 12 years of age, from schools that have educational activities and those that do not, designated schools A and B. The oral health indicators used were the Simplified Oral Hygiene Index (OHI-S) and the Community Periodontal Index (CPITN). Knowledge and attitudes with regard to oral health were evaluated using a structured questionnaire. RESULTS: A total of 289 schoolchildren took part, 50.5% from school A and 49.5% from school B, in the town of Montes Claros, in the Brazilian state of Minas Gerais. In school A, the schoolchildren's OHI-S was satisfactory for 9.6%, normal for 78.8% and deficient for 11.6%, while in school B, the respective percentages were 3.5%, 17.5% and 79% (chi-squared, P < 0.001). The students in school A showed better CPITN results, namely lack of bleeding for 61.6%, the presence of bleeding for 29.5% and presence of tartar for 8.9%, while in school B, the respective results were 25.2%, 45.5% and 29.4% (chi-squared, P < 0.001). Students in school A achieved more correct answers in questions that evaluated knowledge of oral health. The account of daily use of dental floss in school A was 21.7% and in B, 3.6% (chi-squared, P < 0.001). CONCLUSION: It is believed that educational activity in the school environment had a positive effect on oral health conditions, the consolidation of knowledge and incorporation of oral hygiene habits.

Prevalência e tipo de lesöes ungueais em escolares de Ribeiräo Preto, SP, Brasil / Prevalence and type of ungueal lesions in schoolchildren of Ribeiräo Preto, SP, Brazil

Em sete escolas, selecionadas ao acaso, os autores examinaram 5.150 escolares, entre 7 e 15 anos de idade. A prevalência de lesöes ungueais nas mäos foi maior (56,7//) que a dos pés (29,5//). Ela foi significantemente maior no sexo masculino, com tendência a aumentar com a idade, até 14 anos no sexo masculino e até 11 anos no feminino. O tipo e a freqüência de lesöes ungeais säo indicadas em tabelas. As mais comuns nas mäos foram leuconíquia (42,13//), onicofagia (13,57//) e depressöes cupuliformes (1,16//); nos pés, onicoatrofia no 5§ artelho (9,26//), sulcos transversais (9,14//), leuconíquia (2//) e hematoma subungueal (1,53//). As alteraçöes foram habitualmente discretas. O status sócio-econômico näo pareceu influenciar significantemente a prevalência de lesöes ungueais nas diferentes escolas

Censo Epidemiológico de lesôes e afeccôes cutâneas em escolares de Ribeirâo Prêto, S. P., Brasil / Epidemiologieal census of cutaneous lesions in schoolchildren of R. Preto, S.P., Brazil

Um total de 5150 escolares de 6 a 16 anos foram examinados em uma cidade subtropical. Excluídas cicatrizes e lesôes traumáticas a prevalência de dermatoses foi de 72%. As mais comun (>2%) foram nevos pigmentados (72%),cicatrizes e lesôes residuais (36%), efélides (19,6%), pediculose (19,6%), dermatite seborréica (19,5%), dermatoviroses (18,6%), acne (15,7%), lesôes traumáticas (9,5%), pitiríase capitis (5%), piodermites (4,3%), dermatite eozematosa (2,6%), estrófulo + picada de inseto (3,1%), ceratose palmar el ou plantar (2,1%) e disidrose (2%). Muitos doentes apresentaron dois ou mais tipos de lesoes ou affeccôes cutâneas. A prevalencia de vibix, estomatite angular, dermatoses actínicas, ictiose, pele xerótica, intertrigo, milia, livedo reticular, hipertricosee escabiose foi menor porén relativamente elevada (de 1,61 a 0,66%). A prevalencia foi discretamente maior em escolares de sexo masculino que no feminino e as diferencas estatisticamente significantes (p<0,001). A diferenca de prevalência entre os grupos etarios nâo foi significante para masculinos e femininos. As meninas aprentaron taxa mais elevada de pediculose, enquanto em meninos prevaleceram pitiríase alba (dartro volante), pitiríase versicolor e piodermites. As condicôes sócioeconômicas parecen ter tido influencia nas taxas de prevalênia de pediculose, pitiríase alba e "tinea pedis", mas nâo nas de dermatoviroses, pitiríase versicolor e piodermite. Os resultados e comentários sâo válidos para uma àrea subtropical semelhante à de Ribeirâo Prêto, com as mesmas características ecológicas, socio-econômicas e de populacâo. Quando se planeja um programa de saúde pública em escolas é importante realizar antes um censo epidemiológico ou estudo piloto, a fim de obter as relevantes informacôes bàsicas.

Censo Epidemiológico de les¶es e afecc¶es cutÔneas em escolares de RibeirÔo PrÛto, S. P., Brasil / Epidemiologieal census of cutaneous lesions in schoolchildren of R. Preto, S.P., Brazil

Um total de 5150 escolares de 6 a 16 anos foram examinados em uma cidade subtropical. Excluídas cicatrizes e les¶es traumáticas a prevalÛncia de dermatoses foi de 72%. As mais comun (>2%) foram nevos pigmentados (72%),cicatrizes e les¶es residuais (36%), efélides (19,6%), pediculose (19,6%), dermatite seborréica (19,5%), dermatoviroses (18,6%), acne (15,7%), les¶es traumáticas (9,5%), pitiríase capitis (5%), piodermites (4,3%), dermatite eozematosa (2,6%), estrófulo + picada de inseto (3,1%), ceratose palmar el ou plantar (2,1%) e disidrose (2%). Muitos doentes apresentaron dois ou mais tipos de lesoes ou affecc¶es cutÔneas. A prevalencia de vibix, estomatite angular, dermatoses actínicas, ictiose, pele xerótica, intertrigo, milia, livedo reticular, hipertricosee escabiose foi menor porén relativamente elevada (de 1,61 a 0,66%). A prevalencia foi discretamente maior em escolares de sexo masculino que no feminino e as diferencas estatisticamente significantes (p<0,001). A diferenca de prevalÛncia entre os grupos etarios nÔo foi significante para masculinos e femininos. As meninas aprentaron taxa mais elevada de pediculose, enquanto em meninos prevaleceram pitiríase alba (dartro volante), pitiríase versicolor e piodermites. As condic¶es sócioecon¶micas parecen ter tido influencia nas taxas de prevalÛnia de pediculose, pitiríase alba e "tinea pedis", mas nÔo nas de dermatoviroses, pitiríase versicolor e piodermite. Os resultados e comentários sÔo válidos para uma Orea subtropical semelhante O de RibeirÔo PrÛto, com as mesmas características ecológicas, socio-econ¶micas e de populacÔo. Quando se planeja um programa de saúde pública em escolas é importante realizar antes um censo epidemiológico ou estudo piloto, a fim de obter as relevantes informac¶es bOsicas. (AU)

Epidemiological survey of skin diseases in schoolchildren living in the Purus Valley (Acre State, Amazonia, Brazil).

A total of 9,955 schoolchildren aged 6-16 years have been examined in a tropical region. The prevalence of dermatosis varied from 21 to 87% in the municipalities surveyed. The most common dermatoses were pediculosis (prevalence 50%), nevi (16.8%), pityriasis versicolor (13.2%), pyoderma (12.2%), pityriasis alba (9.9%), dermatophytosis (6.2%), viral dermatosis (6.2%), scabies (3.0%) and acne vulgaris (2.7%). The prevalence of angular stomatitis, miliaria rubra, candidiasis, piedra nigra, keratosis pilaris, ephelides and geographic tongue is lower but still relatively high. Females had higher rates of pediculosis capitis and males higher prevalence of pityriasis alba. The prevalence of pityriasis versicolor, pigmented nevus and scabies was similar in males and females. Folliculitis, macular pigmented nevi and especially pityriasis versicolor tended to increase with age. Leprosy is hyperendemic in the surveyed area and its rate in the schoolchildren examined was 0.08%. Population movement (urbanization), socioeconomic situation, living conditions, promiscuity, and lack of hygiene may be the cause of such high prevalence and of association of two or more skin conditions. Climatic conditions might have enhanced the prevalence of certain dermatoses (pityriasis versicolor, dermatophytosis, piedra nigra, candidiasis, miliaria rubra).