Physical Violence Against Children and Adolescents in Porto: A 5-Year Study.

The aim of the present study was to analyze the prevalence of physical violence against children and adolescents (PVCA) in a 5-year period in the city of Porto, Portugal. All forensic reports between 2009 and 2013 in the clinical services of the North Branch of the National Institute of Legal Medicine and forensic sciences were analyzed. Victims were classified according to sex, age, relationship with perpetrator, traumatic consequences of the event, and year of occurrence. Statistical analysis was performed using SPSS (Version 22.0). Continuous variables were described when appropriated frequencies were displayed. The association between variables was evaluated using chi-square, Fisher's exact test, or Kruskal-Wallis test, when appropriate and a logistic regression was performed. The margin of error for the statistical tests was 5.0%. A total of 2,148 occurrences were evaluated. Most subjects were male, and mean victim age was 13 years. The single most frequent perpetrator was an unknown individual, but most offenders were known to the victim. The majority site of injury was the face. The larger number of complaints of aggression maintained a similar frequency over the 5 years analyzed. A physical examination to confirm the reasons between the complaint and the type of aggression was performed and shown a high relationship. Adolescents were more susceptible to violence than younger children were. The most affected region was the face.

Environmental conditions associated with shark attacks against humans: a case report about territoriality.

This article describes the autopsy findings of a victim of a shark attack that took place off the coast of Pernambuco, Brazil. The victim was rescued and immediately taken to a nearby hospital but did not survive, even though the lapse of time between the attack and verification of death did not exceed 15 minutes. The presence of a single, large, contused and incised, semiarched wound with a serrated aspect was decisive in elucidating the event. Thus, this study discusses aspects related to the aggressor species, to the autopsy, to the type of wound, and to the causes that have led to a significant increase in this type of event in the area. It was concluded that the lesion was produced while the victim was still alive and that it was the cause of death.

Work-related musculoskeletal disorders among Brazilian dental students.

The aim of this analytical cross-sectional study was to evaluate the presence of work-related musculoskeletal disorders (WMSD) among dental students in two Brazilian dental schools. The sample included 227 randomized subjects from fifth to ninth semesters who were developing clinical activities. Each student signed an informed consent form. A self-reporting questionnaire was used to obtain data on the practice of physical exercise, the presence of pain during or soon after treating patients, and the adoption of preventive measures related to clinical activities. Results were analyzed using the Statistical Package for Social Sciences 13.0. The chi(2) test was used to identify associations between variables. The presence of pain during or after clinical work was reported by 173 participants (76.2 percent). Statistically significant differences were found between gender and the occurrence of pain. Pain was present during clinical activities (p=0.006) and imposed limitations on the work routine (p=0.011). Among those who practiced physical exercise, eighty-eight (74.6 percent) reported pain. The high percentage of pain reported by dental students suggests the value of reviewing work conditions in dental practices in order to minimize the exposure of all workers to WMSD.

Dental trauma: an evidence-based approach to care.

BACKGROUND: One of the key aspects of improving the dental care we offer to our patients is in basing our practice on the best available evidence. AIM: The main purpose of this paper is to present some basic ways of searching reliable papers on Internet and to introduce some techniques to facilitate the development of strategic search skill to improve the quality of dental care, using dental trauma as an example. MATERIALS AND METHODS: After formulation of a clinical question on a dental trauma issue, a comparison was made between: data collected in PubMed using a given term; data collected in PubMed using the Medical Subject Headings vocabulary (Mesh) and data collected using the principles of evidence-based research, all by an independent researcher. A number of papers searched about a clinical question on dental trauma and a brief commentary about each Internet research database is presented. The authors reported that the best sites available to perform the sample search were those produced by academic centers, professional organizations and government-sponsored. To get evidence-based clinical papers we did internet search on PubMed, Cochrane, Center of Evidence-Based Dentistry and Knowledge Finder using the clinical question "Emergency Treatment for Avulsed Tooth". RESULTS: All searched databases were efficient for scientific journals, but when we used the PI strategy, the search seemed to be more relevant and specific. The Cochrane, Center of Evidence-Based Dentistry and Knowledge Finder presented more reliable papers to answer our clinical question about dental trauma treatment. CONCLUSION: It is imperative that dentists understand the advantages of searching the Internet and learning to use it effectively to guide practice and assist their patients in their pursuit for better oral health.

Relationship between oral health, nutrient intake and nutritional status in a sample of Brazilian elderly people.

OBJECTIVE: To evaluate the relationship between the oral health condition, the nutrient intake and the body mass index (BMI) in elderly people. BACKGROUND: Impaired dentition has been associated with an inadequate consumption of key nutrients and with changes in nutritional status in elderly people. MATERIALS AND METHODS: The sample comprised 887 elderly people, aged 60 and over, of whom 816 underwent a clinical oral examination and were allocated into groups according to the numbers of teeth and number of posterior occluding pairs of natural teeth. Nutritional status was determined using the BMI. Dietary intake was assessed by a 24-h diet recall interview and the data from these records were converted to nutritional intake using DietPro software. Differences between means were evaluated using ANOVA, together with the Tukey test or Dunnet test, according to the normality of the data. Associations between categorical variables were tested using chi-square analysis. RESULTS: Ages ranged from 60 to 96 years (mean, 71.46 years), with 47% of the respondents in the 60-to 69-year-old group. A high DMFT index (mean, 27.81) was observed with the missing component accounting for 88.8% of the index. Significant differences were observed between the mean intake of nutrients and the number of posterior occluding pairs of natural teeth (p < 0.05). No significant differences were found between the number of teeth and BMI. CONCLUSION: Nutrient intake is associated with the oral health status as defined by clinical measures.

[Prevalence of malocclusion and its association with functional alterations of the stomatognathic system in schoolchildren]. / Prevalência de maloclusão e sua associação com alterações funcionais do sistema estomatognático entre escolares.

The aim of this research was to estimate the prevalence of malocclusion among 12-year-old schoolchildren in Camaragibe, Pernambuco State, Brazil. Malocclusions were stratified by the degree of severity, and their association with alterations of the following functions was also analyzed: speech articulation, respiration, and deglutition. Occlusion was assessed by means of the Treatment Priority Index (TPI) and the functions referred to by means of the criteria used in routine clinical speech therapy by a single calibrated examiner (kappa values ranging from 0.64 to 1.00). Schoolchildren were selected randomly from 11 public schools. Of the 173 selected children, 82.1% presented malocclusion (95%CI: 76.4-87.8), with 38.2% classified as minor manifestations of malocclusion; 20.8% definite malocclusions; 13.3% severe malocclusions; and 9.8% very severe malocclusions. The conclusion was that there is a high repressed demand for orthodontic treatment, and that the greater the severity of the malocclusion, the stronger the possibility of association with functional alterations, which must be taken into consideration when planning appropriate public services for these conditions.

A systematic review of the diagnostic classifications of traumatic dental injuries.

A systematic review of the literature was undertaken to evaluate the criteria used for the diagnostic classification of traumatic dental injuries from an epidemiological standpoint. The methodology used was that suggested by the Cochrane Collaboration and the National Health Service. A total of 12 electronic bibliographical databases (BBO, BioMed Central, Blackwell Synergy, Cochrane, DARE, EMBASE, HighWire, LILACS, MEDLINE, PubMed Central, SciELO, SciSearch) and the World Wide Web were searched. There was no attempt to specify the strategy in relation to date, study design, or language. The last search was performed in May 2003. Two reviewers screened each record independently for eligibility by examining titles, abstracts, keywords and using a standardized reference form. Disagreements were resolved through consensus. The final study collection consisted of 164 articles, from 1936 to 2003, and the population sample ranged from 38 to 210,500 patients. 54 distinct classification systems were identified. According to the literature, the most frequently used classification system was that of Andreasen (32%); as regards the type of injury, the uncomplicated crown fracture was the most mentioned lesion (88.5%). Evidence supports the fact that there is no suitable system for establishing the diagnosis of the studied injuries that could be applied to epidemiological surveys.