Andréa Silvia Walter de Aguiar

Antimicrobial activity of the synthetic peptide Lys-a1 against oral streptococci

The peptide LYS-[TRP(6)]-Hy-A1 (Lys-a1) is a synthetic derivative of the peptide Hy-A1, initially isolated from the frog species Hypsiboas albopunctatus. According to previous research, it is a molecule with broad antimicrobial activity. The objective of this study was to evaluate the antimicrobial activity of the synthetic peptide Lys-a1 (KIFGAIWPLALGALKNLIK-NH2) on the planktonic and biofilm growth of oral bacteria. The methods used to evaluate antimicrobial activity include the following: determination of the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) in microtiter plates for growth in suspension and quantification of biomass by crystal violet staining and counting of colony forming units for biofilm growth. The microorganisms Streptococcus oralis, Streptococcus sanguinis, Streptococcus parasanguinis, Streptococcus salivarius, Streptococcus mutans and Streptococcus sobrinus were grown in Brain Heart Infusion broth at 37°C under atmospheric pressure with 10% CO2. The peptide was solubilized in 0.1% acetic acid (v/v) at various concentrations (500-1.9 μg mL(-1)). Chlorhexidine gluconate 0.12% was used as the positive control, and BHI culture medium was used as the negative control. The tested peptide demonstrated a remarkable antimicrobial effect, inhibiting the planktonic and biofilm growth of all strains tested, even at low concentrations. Thus, the peptide Lys-a1 is an important source for potential antimicrobial agents, especially for the control and prevention of microbial biofilms, which is one of the most important factors in cariogenic processes.

Integralidade: desafio pedagógico do PET-Saúde /UFC

Practical activities in primary care have been identified as a fulfilling experience, to the extent that they convene professors, students, health professionals, administrators, and the community, who are challenged to add values, knowledge, and experience based on the interdisciplinary and comprehensive nature of the teaching activities. Progress in this area has been identified in the Educational Program for Health Work at UFC, as an efficient methodological proposal for comprehensive, interdisciplinary learning in undergraduate health courses. The current study reports on the pedagogical strategies that fostered an understanding of primary care as a whole through the development of a methodological approach for grasping the total living experience, as a movement in the construction of formative processes.

Prevalence of oral and maxillofacial trauma in elders admitted to a reference hospital in northeastern Brazil

Objective To know the prevalence and etiology of oral and maxillofacial trauma in elders. Methods Analytical quantitative cross-sectional study conducted at a public trauma hospital located in Fortaleza-Ceará, Brazil. The study population comprised patients with trauma who were hospitalized from April to August 2014. Of these patients, patients with oral and maxillofacial trauma were chosen to be included in the research. A questionnaire was administered in order to obtain information on socio-demographics, systemic comorbidities, use of medication, deleterious habits (smoking and alcohol consumption), etiology of oral and maxillofacial trauma and type of pre-hospital care. Results Of the 280 elderly hospitalized with trauma, 47 had oral and maxillofacial trauma, with a prevalence of 16.8%. In this group, the age ranged from 60 to 88 years, with a mean age of 72.4 years (SD± 8.38). The elderly were mostly women (55.3%), self-declared pardos (53.2%), who presented with cardiovascular disorders (48.9%), and who received formal pre-hospital care (70.2%). Elderly who were in the 60–69 years age group, spent 6–9 years at school and drank alcohol were 2.64, 3.75, and 1.97, respectively, more likely to suffer oral and maxillofacial trauma. The main causes of trauma were physical aggression, traffic accidents, falls and domestic accidents. All of the physical aggressions resulted in oral and maxillofacial traumas, and the elderly who suffered traffic accidents were four times more likely to have oral and maxillofacial trauma. Conclusion The prevalence of 16.8% and the lack of research on oral and maxillofacial traumas in the elderly is worrisome and should be included in the oral health indicators for the elderly population to support the importance of oral health.

Rapid Prototyping as an Auxiliary in Mandibular Reconstructions

The reconstruction of mandible is a challenge with regard to aesthetic and reconstructive demands. The etiology of mandibular fractures is variable, trauma, pathology, bone infections. There are many materials that provide an excellent form of rehabilitation for these defects, where the autogenous graft presents important characteristics that favor a greater success rate. Furthermore, the rapid prototyping method is quite interesting, because it brings a series of advantages to the surgeon, like reducing the operative time, among others. The purpose of the present article is to describe a clinical case of a patient with mandible bone defect caused by gunshot perforation, treated through iliac crest bone graft with planning through rapid prototyping. The mandibular reconstruction can present a real challenge for the surgeon. Biomodels should be required in complex cases because they help to decrease surgical time and to increase the predictability of the procedure.

USO DO CARIOGRAM® NA AVALIAÇÃO DO RISCO DE CÁRIE EM CRIANÇAS EM UM MUNICÍPIO BRASILEIRO: ESTUDO PILOTO

Objective: To analyze the risk of dental caries in 12-year-old children through the use of Cariogram®. Methods: Descriptive study conducted with 31 children, aged 12 years, in apublic elementary school in a city of the Brazilian Northeast, in 2009. Data was collected regarding caries experience and related systemic disease; presence of sugar in the diet and intake frequency; Streptococcus mutans biofilm growth and bacterial counts; use of fluoride products, salivary flow and buffering capacity. All this data was inserted into Cariogram®, in order to obtain a profile of individual caries risk and the ability to prevent new cariouslesions. Results: It was found that 78% (n=24) of the children had individual risk of dental caries in the intermediate and high levels; 45% (n=14) of the participants had less than a 50% chance of avoiding new cavities. Furthermore, 6.45% (n=2) of the children had less than 75% possibility of avoiding new carious lesions, i.e., they featured high risk of caries development, and 12.90% (n=4) had a possibility of more than 75%, being characterized as low risk of developing such injuries. There were positive associations (p<0.05) between the presence of sugar in the diet and salivary flow, in which subjects with cariogenic diet had decreased salivary flow. Conclusion: A caries risk pattern was found in the intermediate and high levels, with susceptibility above 10% and possibility of avoiding new caries lesions under 50%. 10.5020/18061230.2014.p62

Atributos essenciais e qualificadores da atenção primária a saúde - doi:10.5020/18061230.2012.s1

Historically, the primary health care (PHC) has been associated with the first level of care from a health system and characterized by the kind of professional that in it operates, where is expected a predominance of specialists in this area. However, the major limitation for this type of characterization is that the profile of professionals engaged in this service may vary from country to country. Several theoretical and conceptual landmarks proposed approaches and indicators to assess and characterize the APS. In 1978, the American Institute of Medicine suggested an approach in which listed its attributes such as accessibility, integrality, coordination, continuity and responsibility. This was an important landmark in an attempt to outline a normative approach to measure it. However, most indicators and specific definition was not suggested. The selected indicators required a high level of performance, were difficult to be achieved, and focused on the capacity of services and not in its concrete realization(1).A 1996 report, from the same institution, defined PHC as the provision of integrated services and accessible by clinicians who are responsible for attending a large majority of personal care needs, developing a continued partnership with patients and working within family and community. This definition does not include the first contact and focuses on individual attention.The Canadian Medical Association, in 1996, considered the APS as a front door of the health system and community interventions included in the definition of the functions of APS. In the same year was published a Charter for General Practice / Family Medicine in Europe (Letter to General Practice / Family Medicinein Europe), which describes 12 characteristics: general, accessible, integrated,continuous, as a team, holistic, personalized, targeted for the family and the community, coordinated, confidential and protectress(2).Donabedian(3) systematized a group of important variables that can assess the quality of a system or health service and rated according to their characteristics in structure, process and outcome. The evaluation of the process includes the quality of services provided by health professionals individually or in groups and refer to professional qualifications, organization and coordination of the work process of teams. The evaluation of the structure includes environmental conditions and equipment in which the services are provided and the results are evaluated starting from the verification of changes in health status of a population that can be attributed to the care process. Among the theoretical and conceptual landmarks of the PHC highlights the publication “Primary Care: Balancing Health Needs, Services, and Technology”, by Professor Barbara Starfield, in 1998, translated into Portuguese and published in Brazil in 2002. The book provides evidence on the role of PHC in health systems, evidence of its impact on population health, and compares the cost-effectiveness between countries with different forms and different degrees of implementation of this strategy, and propose a structure for measure it and set its attributes(1). The views of PHC, centered in the individual and in the population, provided the normative basis for evaluating it in a health system and contributed to the construction of the evaluation framework proposed by Starfield(1).The author also proposed a framework for evaluating the PHC which considered the concepts of the essential attributes and derivative measures of structure (capacity) and process (performance).The essential and exclusive attributes of the PHC include: access / care on first contact, longitudinality, integrality and coordination of care. A high level of reach of essential attributes of the PHC results in three additional aspects, denominated derivatives, which qualify the actions and services at this level of care(1,4).The aspects qualifiers are: centered on the family, cultural competence and community orientation. In most countries, nor centered on the family nor the community orientation are systems focus. The community orientation is an ideal rather than a reality(1,4).The National Primary Care Policy points out, in its guidelines, the universal and continuing access to health care quality and resolute, featuring primary care as the entry door and preferred care network. This care network should embrace users and promote linking and co-responsibility for the attention to their health needs(5). In the current issue of Brazilian Journal of Health Promotion, the reader can look into the User of the Family Health Strategy: knowledge and satisfaction with embracement, which contains important information that demonstrate mechanisms to ensure accessibility and embracement, from the comprehension of the user. Among the strategies for the development of integrality and coordinated care, now are exalted communities of practice, in which groups are formed around the practice of profession, linked from the need to share experiences so that knowledge can be collective(6). Articles “Community of practice as way of collective learning” and “Development of practices and knowledge in the Family Health Strategy: theoretical study” emphasize the learning derived from the exchange of experiences, sharing of meanings, observations, reflections on PHC.

SELF‐PERCEPTION OF ORAL HEALTH IN OLDER ADULTS: AN IMPORTANT INPUT INTO PUBLIC POLICY‐MAKING

Conflict of Interest: There were no relevant financial interests in this manuscript. The Intramural Research Program of the National Institutes of Health, National Institute on Aging supported this research. Author Contributions: Alyssa Gamaldo analyzed data and wrote the letter. Luigi Ferrucci contributed vital new reagents and assisted in writing the letter. Joseph Rifkind contributed new reagents and assisted in writing the letter. Alan Zonderman assisted in data analyses and writing the letter. Sponsor’s Role: The sponsors did not participate in the design or data analysis of any aspect of the study or in manuscript preparation.