Andreia Cristina Leal Figueiredo

Child sexual abuse in southern Brazil and associated factors: a population-based study

BackgroundThe prevalence of child sexual abuse (CSA) in the population has been poorly described in developing countries. Population data on child sexual abuse in Brazil is very limited. This paper aims to estimate lifetime prevalence of child sexual abuse and associated factors in a representative sample of the population aged 14 and over in a city of southern Brazil.MethodsA two-stage sampling strategy was used and individuals were invited to respond to a confidential questionnaire in their households. CSA was defined as non-consensual oral-genital, genital-genital, genital-rectal, hand-genital, hand-rectal, or hand-breast contact/intercourse between ages 0 and 18. Associations between socio-demographic variables and CSA, before and after age 12, were estimated through multinomial regression.ResultsComplete data were available for 1936 respondents from 1040 households. Prevalence of CSA among girls (5.6% 95%CI [4.8;7.5]) was higher than among boys (1.6% 95%CI [0.9;2.6]). Boys experienced CSA at younger ages than girls and 60% of all reported CSA happened before age 12. Physical abuse was frequently associated with CSA at younger (OR 5.6 95%CI [2.5;12.3]) and older (OR 9.4 95%CI [4.5;18.7]) ages. CSA after age 12 was associated with an increased number of sexual partners in the last 2 months.ConclusionResults suggest that CSA takes place at young ages and is associated with physical violence, making it more likely to have serious health and developmental consequences. Except for gender, no other socio-demographic characteristic identified high-risk sub-populations.

Access by hearing-disabled individuals to health services in a southern Brazilian city

This cross-sectional study aimed to compare access to health services and preventive measures by persons with hearing disability and those with normal hearing in Canoas, Rio Grande do Sul State, Brazil. The sample included 1,842 individuals 15 years or older (52.9% of whom were females). The most frequent income bracket was twice the minimum wage or more, or approximately U

Distribuição da gordura corporal e câncer de mama: um estudo de caso-controle no Sul do Brasil

360/month (42.7%). Individuals with hearing disability were more likely to have visited a physician in the previous two months (PR = 1.3, 95%CI: 1.10-1.51) and to have been hospitalized in the previous 12 months (PR = 2.1, 95%CI: 1.42-3.14). Regarding mental health, individuals with hearing disability showed 1.5 times greater probability of health care due to mental disorders and 4.2 times greater probability of psychiatric hospitalization as compared to those with normal hearing. Consistent with other studies, women with hearing disability performed less breast self-examination and had fewer Pap smears. The data indicate the need to invest in specific campaigns for this group of individuals with special needs.

Avaliação do usuário sobre o atendimento oftalmológico oferecido pelo SUS em um centro urbano no sul do Brasil

O presente estudo tem como objetivo verificar a associacao entre a distribuicao da gordura corporal e o câncer de mama em mulheres do Rio Grande do Sul. Para este estudo, utilizou-se um delineamento de caso-controle, no qual foram avaliadas cem mulheres com diagnostico histopatologico de câncer de mama em comparacao com o grupo controle ambulatorial (400 mulheres) durante os meses de janeiro a outubro de 2005. As variaveis antropometricas coletadas foram: massa corporal (kg), estatura, circunferencia da cintura (CC) e perimetro do quadril. Nao foi encontrada associacao entre o indice de massa corporal (IMC) e a razao cintura/quadril (RCQ) com ocorrencia de câncer de mama. Ja para CC, observou-se que mulheres com essa medida elevada (> 88 cm) apresentam 2,08 vezes mais chance de desenvolver a doenca do que aquelas com as medidas normais ou moderadas ( 88 cm) e um preditor de câncer de mama especialmente em mulheres pre-menopausa.

Immunohistochemical assessment of CD1a-positive Langerhans cells and their relationship with E-cadherin in minor salivary gland tumors.

The users evaluation is an important component of the quality of the health services. The goal of the present study was to evaluate the users satisfaction with the ophthalmologic service provided by an accredited service of the Brazilian Unified Health System (SUS) in an urban center of the South of Brazil. It is a transversal study in which a questionnaire was applied about the users socioeconomic and demographic profile, questions related to the quality of the service and suggestions and/or complaints regarding to the attendance and the service. The sample was calculated in the program EPINFO version 6.0, it had as its base 1200 monthly services, in a total of 355 users. The results showed that 77.1% of the users were satisfied with the medical service. However, 75.4% pointed deficiencies related to the time they had to wait in the place, to the duration of the consultation and at the interpersonal relationship with doctor and other attendants. It was verified that 36.3% considered the ophthalmologic service offered by SUS as terrible and regular. This way, it is fundamental to rethink the professional practices and to intervene on the form of organization of this service, seeking its improvement and the users satisfaction.

CD1a-positive Langerhans cells and their relationship with E-cadherin in ameloblastomas and keratocystic odontogenic tumors

OBJECTIVE The aim of this study was to investigate the presence of CD1a-positive Langerhans cells and their relationship with E-cadherin in minor salivary gland tumors. METHODS Twenty-seven minor salivary gland tumors were investigated using immunohistochemistry for CD1a and E-cadherin. RESULTS A significant difference regarding the mean density of CD1a-positive Langerhans cells was observed between pleomorphic adenomas and malignant tumors studied (P = 0.001). No CD1a-positive cells were detected in most cases (n = 5) of cystic adenoid carcinomas. CD1a-positive cells were detected in one mucoepidermoid carcinoma case, and six low-grade polymorphous adenocarcinomas cases. Comparison of the mean density of CD1a-positive cells between the three malignant tumors showed no significant difference (P = 0.127). No significant difference was observed in the presence of E-cadherin between tumors (P = 0.73), but it was detected in 24 cases. CONCLUSIONS The lack of CD1a-positive in malignant salivary gland tumors facilitates the neoplastic development and suggests that these cells might be useful as auxiliary diagnostic and prognostic tool in minor salivary gland tumors. Furthermore, it is suggested that E-cadherin mediates cell adhesion in these tumors although we did not demonstrate significance.

Características do acesso e utilização de serviços odontológicos em municípios de médio porte

BACKGROUND Ameloblastomas and keratocystic odontogenic tumors (KOTs) are lesions that are characterized by locally invasive growth and cause extensive bone destruction. In addition, it is known that E-cadherin influences the adhesion of Langerhans cells (LCs) to keratinocytes. OBJECTIVE AND METHODS The aim of this study was to investigate, using immunohistochemistry, the distribution of CD1a-positive cells in ameloblastomas and KOTs and their relationship with E-cadherin, in comparison to calcifying cystic odontogenic tumor (CCOT). RESULTS The CD1a-positive LCs were observed in 11 ameloblastomas and KOTs. All of the cases of CCOT showed CD1a-positive LCs and a significant difference was found when this tumor was compared with ameloblastomas (P < 0.05, Mann-Whitney test). A statistically significant difference was also noted when comparing CD1a-positive LCs between CCOTs and KOTs (P < 0.05, Mann-Whitney test). Lower expression of E-cadherin in ameloblastomas (AMs) in relation to KOTs and CCOTs (P < 0.05, Fisher test) was observed. There was no correlation between E-cadherin and CD1a-positive LCs between all odontogenic tumors that were studied (P > 0.05, Spearman test). CONCLUSION A quantitative difference of CD1a-positive cells between AMs and KOTs in comparison to CCOTs was observed. This permits to speculate that a depletion of CD1a-positive LCs might influence the local invasiveness of ameloblastomas and KOTs. Furthermore, it is suggested that E-cadherin mediates cell adhesion in these tumors.

Destructive periodontal disease in adult Indians from Northeast Brazil: cross‐sectional study of prevalence and risk indicators

Este estudo de corte transversal descreve as principais caracteristicas de acesso e utilizacao de servicos odontologicos basicos e especializados em dois municipios de medio porte da Bahia com 100% de cobertura da Estrategia de Saude da Familia. Realizou-se um inquerito com 2.539 individuos de idade acima de 15 anos em 952 domicilios. As principais variaveis analisadas foram a necessidade de saude bucal percebida, a procura pelo servico, a barreira de acesso organizacional e o tipo de servico e o procedimento utilizado. A utilizacao de servicos publicos odontologicos especializados foi de 11,7% e basicos de 26%. No municipio com maior utilizacao de servicos publicos odontologicos, foi menor o uso de servicos privados. A principal barreira de acesso situou-se na AP (Atencao Primaria), entre 5,0% e 15,2%. Observou-se pouca interface da atencao secundaria com a AP ja que apenas 16,6% dos usuarios retornaram a esse nivel de atencao. Pode-se concluir que a principal barreira de acesso, em municipios com realidades organizacionais e geograficas especificas parece se situar na AP. Acoes preventivas individuais foram pouco relatadas. Recomenda-se a reducao de barreiras de acesso na AP, bem como a instituicao de um protocolo que estimule a longitudinalidade do cuidado nesse nivel.

Risk indicators for tooth loss in Kiriri Adult Indians: a cross‐sectional study

AIM The aim of this cross-sectional study was to evaluate the prevalence of destructive periodontal disease and its risk indicators in adult Kiriri Indians from Northeast Brazil. MATERIALS AND METHODS Full-mouth periodontal examinations were performed on a sample of 215 Indians (≥19 years). Bivariate analyses and logistic models were applied to assess associations between periodontitis and its putative risk factors. RESULTS Prevalence of clinical attachment loss of ≥3, ≥5 and ≥7 mm was 97.8%, 63.8% and 30.8% respectively. Percentage of teeth per individual showing clinical attachment loss of ≥3, ≥5 and ≥7 mm was 49.8%, 18.4% and 8.0% respectively. After adjustment for covariates, individuals aged ≥35 years (OR = 5.83, 95% CI: 3.09-11.00; p < 0.001), men (OR = 2.18, 95% CI: 1.15-4.11; p = 0.02) and diabetics (OR = 3.92, 95% CI 1.03-14.99; p = 0.05) had a higher risk for destructive periodontitis, classified according to the CDC/AAP case definition. CONCLUSION Though periodontitis was highly prevalent in Kiriri Indians, only few teeth showed advanced disease, and periodontitis was associated with higher age, male sex and diabetes. A public health action that includes programs of prevention and treatment targeting high-risk groups is vital to improve the periodontal status of this population.

Oral mucosal lesions in Indians from Northeast Brazil: cross-sectional study of prevalence and risk indicators.

BACKGROUND The aim of this cross-sectional study was to evaluate the risk indicators of tooth loss in adult Kiriri Indians from Brazil. METHODS A representative sample of 225 Indians (≥ 19 years of age) was assessed. Interviews using a structured written questionnaire were performed to collect data on demographics and socio-economic status, and health-related data. Probing depth, the distance between the cement-enamel junction and the free gingival margin, and decayed, missing or filled teeth were evaluated. Bivariate and logistic models were used to assess associations between tooth loss and age, sex, income, education, diabetic status, smoking habits, dental caries, severe periodontitis, plaque index and previous dental visit. RESULTS Eighty per cent of subjects had lost one tooth or more, and 20% had lost eight teeth or more. Mean (± standard deviation) tooth loss was 5.09 (± 5.83) teeth. After adjustment for covariates, loss of one tooth or more was associated with older age [≥ 35 years; odds ratio (OR) = 4.06, 95% confidence interval (95% CI): 1.38-11.94, P = 0.01], severe periodontitis (OR = 3.35, 95% CI: 0.99-11.24, P = 0.05), higher dental caries (OR = 3.24, 95% CI: 1.35-7.78, P = 0.01) and previous dental visit (OR = 23.32, 95% CI: 5.75-94.63, P < 0.001). CONCLUSION Tooth loss is highly prevalent in Kiriri Indians. Older age, severe periodontitis, higher caries index and previous dental visit were associated with tooth loss. Prevention and treatment programmes, targeting high-risk groups, are required to promote the oral health of the population.