Isabel Cristina Gonçalves Leite

Prevalência de quedas e fatores associados em idosos

OBJECTIVE To estimate the prevalence of falls in elderly individuals and to analyze associated factors. METHODS Cross-sectional study with 420 elderly subjects (aged 60 years or older) living in the city of Juiz de Fora (Southeastern Brazil) in 2010. A household survey was conducted and the occurrence of falls in the 12 previous months was described. For the analysis of factors associated with the outcome, a theoretical determination model with three hierarchical blocks was built. The variables were adjusted among each other within each block; those with level of significance < 0.20 were included in the Poisson regression model and adjusted to the immediately higher level, with 5% significance level. RESULTS The prevalence of falls among the elderly was 32.1% (95%CI: 27.7; 36.9). Among those who experienced falls, 53% had a single fall and 19% had fractures as a consequence. Most of the falls (59%) occurred at the elderly persons home. The occurrence of falls was associated with old age, female sex, need of help for locomotion and self-reported diagnosis of osteoporosis. CONCLUSIONS Falls are frequent among the elderly. Knowledge of the factors associated with the occurrence of this event can aid the development of prevention strategies and adequate health services.OBJETIVO: Estimar la prevalencia de caidas en ancianos y analizar factores asociados. METODOS: Estudio transversal con 420 ancianos (60 anos o mas) residentes en Juiz de Fora, Sureste de Brasil, en 2010. Se realizo pesquisa domiciliaria y se describio la ocurrencia de caida en los ultimos 12 meses. Para analisis de los factores asociados al resultado, se construyo un modelo teorico de determinacion con tres bloques jerarquizados. Las variables fueron ajustadas entre si dentro de cada bloque; las que presentaron nivel de significancia < 0,20 fueron incluidas en el modelo de regresion de Poisson y ajustadas al nivel superior al de cada una, con el nivel de 5% de significancia. RESULTADOS: La prevalencia de caidas entre los ancianos fue de 32,1% (IC95% 27,7;36,9). Entre aquellos que sufrieron caida, 53% tuvieron una unica caida y 19% tuvieron fractura como consecuencia. La mayor parte de las caidas (59%) ocurrio en el domicilio del anciano. La ocurrencia de caidas se asocio con edad avanzada, sexo femenino, necesidad de auxilio para locomocion y diagnostico auto-referido de osteoporosis. CONCLUSIONES: Las caidas son frecuentes entre ancianos. El conocimiento de los factores asociados a la ocurrencia de este evento puede auxiliar en la elaboracion de estrategias de prevencion y servicios de salud adecuados.

Aspectos etiológicos da mordida aberta anterior e suas implicações nas funções orofaciais

BACKGROUND: open bite is a complex anomaly that has a difficult treatment. Frequently, unsatisfactory results and relapse of orthodontic treatment are observed. AIM: to associate orofacial malfunction and deleterious oral habits to anterior open bite. To congregate evidences for the better understanding of the etiology and of the development of anterior open bite and its potential association to myofunctional disorders. METHOD: an exploratory study, to obtain relative risk measurements associating clinical characteristics, sucking habits and myofunctional alterations in 130 scholars. This study was developed in two stages: the first was based on a questionnaire about the childs oral habits which was answered by the parents, and the second involved odontologic and speech-language evaluations. RESULTS: in this sample, the most prevalent occlusion disorder was anterior open bite, which was associated to vertical facial growth (relative risk (RR) 3.12; confidence internal (CI) 1.20 - 9.90) and to Angles Class II malocclusion (p-value = 0.01). An association was also observed for anterior open bite and lingual interference (RR 2.44; CI 1.13-5.27). The same was not observed for speech disorders (RR 0.80; CI 0.20-2.30). CONCLUSION: a correlation exists between the etiology of anterior open bite, deleterious oral habits, and a few orofacial malfunctions. An association between the history of deleterious habits and the occurrence of lingual interposition during swallowing, as well as with speech disorders was identified. These findings emphasize the necessary interaction between orthodontists and speech-language pathologist during the treatment of patients. The rehabilitation role of speech-language therapy stands out, through the oral myofunctional therapy, emphasizing the positioning of the tongue during swallowing, speech and when in habitual position.

Dental caries in the primary dentition in public nursery school children in Juiz de Fora, Minas Gerais, Brazil

The aim of this study was to assess the prevalence of dental caries in the primary dentition and associated variables in low socioeconomic preschool children enrolled in public nursery schools in Juiz de Fora, Minas Gerais, Brazil. Four public institutions were selected by geographic criteria (two in the central region and two in the peripheral region). The study population comprised 338 children (181 boys; 157 girls) aged 2-6 years old. Dental caries was recorded using the decayed, missing, and filled teeth (dmf-t) index. Among the examined children, 50.6% were caries-free. The mean dmf-t index was 2.03. It was higher in the peripheral nursery schools (p<0.01). A trend towards a difference between sexes (p = 0.06) was observed. Logistic regression analysis selected a previous childs visit to dentist (p<0.001), geographic location of the public nursery school (p<0.01), and age (p<0.01) as predictive variables for the dmf-t index. The study showed the need for an oral health program for this population, including both curative and preventive measures in order to achieve the WHO/FDI goals for the year 2000, namely 50% of children free of caries at age 5-6 years.

The impact of socioenvironmental characteristics on domains of oral health-related quality of life in Brazilian schoolchildren

BackgroundRecent researches have pointed out the need to consider the functional and psychosocial dimensions of oral health, such as Oral Health-related Quality of Life (OHRQoL). The aim of this study was to investigate the influence of oral health status, socioeconomic factors and home environment of children on the four health domains of Child Perceptions Questionnaire (CPQ11-14).MethodsA cross-sectional study was conducted in Brazil with a sample of 286 schoolchildren aged 12 years and their parents. The schoolchildren were clinically examined, and participants were asked to complete the CPQ11-14, as well as a questionnaire about home environment. In addition, a questionnaire was sent to each child’s parents asking them about family socioeconomic status. The chi-square test and Poisson’s regression analysis were performed.ResultsAfter adjusting for potential confounders, variables sex, monthly family income, mothers’ education showed a statistically significant association with all health domains of the CPQ11-14. The family structure and presence of bleeding impacted on emotional (p = 0.0135), and social (p = 0.0010) well-being health domain scores. Orthodontic treatment need showed a strong negative effect on functional limitations domain score (p = 0.0021).ConclusionsClinical and socio-environmental factors had different impacts on domains of oral health-related quality of life, demonstrating the need to consider these conditions in planning strategies for the oral health of schoolchildren.

Prevalence of falls and associated factors in elderly individuals

OBJECTIVE To estimate the prevalence of falls in elderly individuals and to analyze associated factors. METHODS Cross-sectional study with 420 elderly subjects (aged 60 years or older) living in the city of Juiz de Fora (Southeastern Brazil) in 2010. A household survey was conducted and the occurrence of falls in the 12 previous months was described. For the analysis of factors associated with the outcome, a theoretical determination model with three hierarchical blocks was built. The variables were adjusted among each other within each block; those with level of significance < 0.20 were included in the Poisson regression model and adjusted to the immediately higher level, with 5% significance level. RESULTS The prevalence of falls among the elderly was 32.1% (95%CI: 27.7; 36.9). Among those who experienced falls, 53% had a single fall and 19% had fractures as a consequence. Most of the falls (59%) occurred at the elderly persons home. The occurrence of falls was associated with old age, female sex, need of help for locomotion and self-reported diagnosis of osteoporosis. CONCLUSIONS Falls are frequent among the elderly. Knowledge of the factors associated with the occurrence of this event can aid the development of prevention strategies and adequate health services.OBJETIVO: Estimar la prevalencia de caidas en ancianos y analizar factores asociados. METODOS: Estudio transversal con 420 ancianos (60 anos o mas) residentes en Juiz de Fora, Sureste de Brasil, en 2010. Se realizo pesquisa domiciliaria y se describio la ocurrencia de caida en los ultimos 12 meses. Para analisis de los factores asociados al resultado, se construyo un modelo teorico de determinacion con tres bloques jerarquizados. Las variables fueron ajustadas entre si dentro de cada bloque; las que presentaron nivel de significancia < 0,20 fueron incluidas en el modelo de regresion de Poisson y ajustadas al nivel superior al de cada una, con el nivel de 5% de significancia. RESULTADOS: La prevalencia de caidas entre los ancianos fue de 32,1% (IC95% 27,7;36,9). Entre aquellos que sufrieron caida, 53% tuvieron una unica caida y 19% tuvieron fractura como consecuencia. La mayor parte de las caidas (59%) ocurrio en el domicilio del anciano. La ocurrencia de caidas se asocio con edad avanzada, sexo femenino, necesidad de auxilio para locomocion y diagnostico auto-referido de osteoporosis. CONCLUSIONES: Las caidas son frecuentes entre ancianos. El conocimiento de los factores asociados a la ocurrencia de este evento puede auxiliar en la elaboracion de estrategias de prevencion y servicios de salud adecuados.

A inclusão da equipe de saúde bucal na Estratégia Saúde da Família: entraves, avanços e desafios

O objetivo deste artigo e discutir a inclusao da saude bucal na Estrategia Saude da Familia, em cidades de uma microrregiao do sudeste do Brasil, sob a perspectiva dos recursos humanos. Foram aplicados questionarios aos integrantes do servico de saude bucal: dentistas, auxiliares e gestores. O instrumento considerou tres dimensoes: como e porque se adotou o novo modelo, como o servico esta se reorganizando e que avancos foram percebidos pelos profissionais. O motivo mais mencionado pelos gestores, para inclusao da Saude Bucal foi a possibilidade de mudanca do modelo tecno-assistencial. Dentistas e auxiliares quando questionados sobre sua motivacao, tambem consideraram prioritariamente a possibilidade de mudanca na pratica. Observou-se ainda que existem nos criticos na contratacao e capacitacao de recursos humanos para atuar na equipe de saude bucal e na integracao entre os profissionais de saude. Mas o acesso esta melhor, seja pela organizacao efetuada, seja pela expansao de equipes. Os municipios da microrregiao ainda enfrentam percalcos para que o funcionamento do servico de saude bucal, apos a Saude da Familia, apresente avancos reais nas praticas de atencao. Porem, os avancos existem e estes devem ser reforcados, para consolidacao do sistema de saude e melhoria na qualidade de vida da populacao.

Qualidade das prescrições em município de Minas Gerais: uma abordagem farmacoepidemiológica

OBJECTIVE: To evaluate the quality of medical prescriptions dispensed in pharmacies. METHODS: This cross-sectional study was conducted to assess if precriptions met all the necessary requirements. A total of 800 prescriptions was collected in four different pharmacies in the city of Muriae, MG. Prescriptions were assessed according to the requirements of the WHO indicators, including presence and legibility of essential information. RESULTS: Each prescription contains an average of 2.2 medications, and 22.1% of drugs were antibiotics. Drugs were prescribed by generic name in 33% of all prescriptions and 46.5% were part of RENAME. As for readability, 32% of prescriptions had poor legibility, 36% were illegible, and 32% readable. Essential information was lacking in several respects: the pharmaceutical form (64%), concentration (47%), dose (22%), interval between doses (63%), duration of treatment (30%) and route of administration (84 %) were absent in prescriptions. CONCLUSION: The prescriptions assessed in this study did not provide all the information necessary for correct and safe use of medication and drugs , They were largely legible, showed a high percentage of trade names with limited presence in the RENAME and many were for antibiotics.

Cárie dental e consumo de açúcar em crianças assistidas por creche pública

This study determined the sugar consumption and its relationship to caries development in a group of 51 public nursery school children (mean age = 48 months). The dmf-t score (number of decayed, missing and filled primary teeth) was recorded for each child. A four-day diary was obtained using the local observation method and the average sugar consumption was calculated. The mean dmf-t score was 2.75. From the 51 children examined, 15 were caries free (29.4%) and 36 (70.6%) had caries development. The average sugar consumption was 130g/day. An increase in the sugar consumption has been associated with a significant increase in the dmf-t score.

Oportunidades do ambiente domiciliar para o desenvolvimento motor

OBJETIVO: Avaliar as oportunidades presentes no ambiente domiciliar para o desenvolvimento motor de lactentes. METODOS: Estudo epidemiologico de base populacional, transversal, realizado com 239 lactentes com idade entre tres e 18 meses, residentes no municipio de Juiz de Fora, MG, em 2010. Os participantes foram selecionados por amostragem aleatoria estratificada, conglomerada, em multiplos estagios. Para avaliar a qualidade e quantidade de estimulo motor no ambiente domiciliar foi utilizado o instrumento Affordance in the Home Environment for Motor Development - Infant Scale. Procedeu-se a analise bivariada com aplicacao do teste qui-quadrado, seguida de regressao logistica multinomial para verificar a associacao entre as oportunidades presentes no domicilio e fatores biologicos, comportamentais, demograficos e socioeconomicos. RESULTADOS: As oportunidades de estimulacao ambiental foram relativamente baixas. Na analise bivariada, para a faixa etaria de tres a nove meses, foi encontrada associacao com os fatores: ordem de nascimento (p = 0,06), classificacao socioeconomica (p = 0,08), renda mensal (p = 0,06) e renda per capita (p = 0,03). No modelo de regressao, prevaleceu a classificacao socioeconomica (RC = 7,46; p = 0,03). Para a faixa etaria de dez a 18 meses, os fatores associados, na analise bivariada, foram: estado civil materno (p < 0,01), convivio da crianca com o pai (p = 0,08), chefe da familia (p = 0,04), numero de pessoas no domicilio (p = 0,05), escolaridade materna (p < 0,01) e paterna (p < 0,01), classificacao socioeconomica (p < 0,01) e renda per capita (p = 0,03). No modelo de regressao, o estado civil materno (RC = 4,83; p = 0,02), escolaridade materna (RC = 0,29; p = 0,03) e paterna (RC = 0,33; p = 0,04) permaneceram associados as oportunidades de estimulacao ambiental. CONCLUSOES: A uniao estavel dos pais, maior escolaridade materna e paterna e maior nivel economico foram os fatores associados as melhores oportunidades de estimulacao motora no lar.

Evaluation of temporomandibular joint disc displacement as a risk factor for osteoarthrosis

Temporomandibular joint (TMJ) disc displacement is a clinical sign often found in patients with temporomandibular disorders (TMDs) and associated with TMJ osteoarthrosis. Osteoarthrosis is a degenerative joint disease that may be associated with pain and functional disability. The aim of this study was to evaluate the odds ratio (OR) of joints with disc displacement presenting osteoarthrosis via magnetic resonance imaging (MRI) analysis. In total, 224 TMJ images from patients with signs and symptoms of a TMD were evaluated. The OR, a measure of association, was used to calculate the likelihood of TMJ disc displacement (with or without reduction) with osteoarthrosis. Joints with anterior disc displacement with reduction (ADDwR) and anterior disc displacement without reduction (ADDwoR) were 2.73- and 8.25-times, respectively, more likely to have osteoarthrosis. A nine-times greater likelihood of osteophyte occurrence was observed in cases of ADDwoR, whereas a lower OR for their occurrence (OR 2.96) was observed in cases of ADDwR. The significant OR of joints with disc displacement presenting osteoarthrosis, particularly in cases of ADDwoR, emphasizes the importance of accurate assessment of changes in disc position, which may be associated with other painful and functional disorders of the TMJ.