Maria do Socorro Costa Feitosa Alves

A dor e a perda dentária: representações sociais do cuidado à saúde bucal

The objective of this study was identify the social representations of the oral care on daily activities to understand how the common sense works with the oral health, we realized the research with Brazilian northeast people. Thirty residents of Cidade da Esperanca District, Natal, RN, Brazil were analyzed. The data was obtained from a semi-structured interview. The interviews were analyzed by Technique of Content Analysis (Bardin1) as well as by Alceste 4.5 software. The categories were Toothache and Tooth Loss. The Toothache shows how the public health service is restrict. The Tooth Loss shows how the dentistry practice resolved the toothache, and how the prosthetics is limited by the social condition. The Social Representations of the oral care on daily activities show the negative consequences of the dentistry practice and the necessity of the new paradigm to the organization of the public health service taking into consideration the common sense about the oral care on daily activities.

Effect of telmisartan on levels of IL-1, TNF-α, down-regulated COX-2, MMP-2, MMP-9 and RANKL/RANK in an experimental periodontitis model.

Aim The aim of this study was to evaluate the effect of telmisartan (TELM) on inflammation, oxidation and the expression of matrix metalloproteinases (MMPs) and the expression RANKL/RANK/OPG in the periodontal tissue of a rat model for ligature-induced periodontitis. Materials and methods Male Wistar albino rats were randomly divided into five groups of 10 rats each: (i) non-ligated, given water; (ii) ligated, given water; (iii) ligated, given 1 mg/kg TELM; (iv) ligated, given 5 mg/kg TELM; and (v) ligated, given 10 mg/kg TELM. All groups were treated with saline or TELM for 10 days. Periodontal tissue was analysed by histopathology; by the immunohistochemical examination of COX-2, MMP-2, MMP-9 and the RANKL/RANK/OPG pathway; and by ELISA analysis of the levels of IL-1β, IL-10, TNF-α, myeloperoxidase (MPO), malonaldehyde (MDA) and glutathione (GSH). Results Treatment with 10 mg/kg TELM resulted in reduced concentrations of MPO, MDA (p < 0.05) and the pro-inflammatory cytokine IL-1β (p < 0.05); reduced expression of MMP-2, MMP-9, RANK, RANKL and COX-2; and an increase in OPG. The levels of TNF-α were significantly reduced in all TELM-treated groups. Conclusions These findings confirm the involvement of TELM in reducing the inflammatory response, oxidative stress and bone loss in ligature-induced periodontitis in rats.

Carvedilol decrease IL-1β and TNF-α, inhibits MMP-2, MMP-9, COX-2, and RANKL expression, and up-regulates OPG in a rat model of periodontitis.

Periodontal diseases are initiated primarily by Gram-negative, tooth-associated microbial biofilms that elicit a host response that causes osseous and soft tissue destruction. Carvedilol is a β-blocker used as a multifunctional neurohormonal antagonist that has been shown to act not only as an anti-oxidant but also as an anti-inflammatory drug. This study evaluated whether Carvedilol exerted a protective role against ligature-induced periodontitis in a rat model and defined how Carvedilol affected metalloproteinases and RANKL/RANK/OPG expression in the context of bone remodeling. Rats were randomly divided into 5 groups (n = 10/group): (1) non-ligated (NL), (2) ligature-only (LO), and (3) ligature plus Carvedilol (1, 5 or 10 mg/kg daily for 10 days). Periodontal tissue was analyzed for histopathlogy and using immunohistochemical analysis characterized the expression profiles of MMP-2, MMP-9, COX-2, and RANKL/RANK/OPG and determined the presence of IL-1β, IL-10 and TNF-α, myeloperoxidase (MPO), malonaldehyde (MDA) and, glutathione (GSH). MPO activity in the group with periodontal disease was significantly increased compared to the control group (p<0.05). Rats treated with 10 mg/kg Carvedilol presented with significantly reduced MPO and MDA concentrations (p<0.05) in addition to presenting with reduced levels of the pro-inflammatory cytokines IL-1 β and TNF-α (p<0.05). IL-10 levels in Carvedilol-treated rats remained unaltered. Immunohistochemical analysis demonstrated reduced expression of MMP-2, MMP-9, RANK, RANKL, COX-2, and OPG in rats treated with 10 mg/kg Carvedilol. This study demonstrated that Carvedilol affected bone formation/destruction and anti-inflammatory activity in a rat model of periodontitis.

Os fatores associados à tuberculose pulmonar e a baciloscopia: uma contribuição ao diagnóstico nos serviços de saúde pública

OBJETIVO: Verificar os principais fatores associados a tuberculose pulmonar e os resultados da baciloscopia. DESENHO DO ESTUDO: Trata-se de um estudo seccional de base secundaria. METODOLOGIA: A coleta de dados foi realizada com 189 prontuarios de pacientes com idade acima de 25 anos atendidos no Hospital Giselda Trigueiro em Natal/RN, Brasil, no periodo de 2000 a 2002. Os fatores associados identificados e os resultado da baciloscopia foram apresentados atraves da distribuicao percentual. RESULTADOS: A media de idade dos pacientes variou entre 43,5 + 18,5 anos, sendo 73% do sexo masculino. Os principais fatores associados foram etilismo e tabagismo (20,6%), tabagismo (19,8%), etilismo (16,7%), contagio direto (10,3%), diabetes mellitus (8,7%), pneumonia nao tratada (6,3%), abandono de esquema (6,3%) e outros fatores (11,1%). A baciloscopia foi realizada em 84,1% dos pacientes. Em 44,7% deles, o diagnostico foi negativo, enquanto que em 55,3% foi positivo. CONCLUSAO: Os fatores associados contribuem para o diagnostico da tuberculose pulmonar na medida em que a baciloscopia apresenta uma baixa sensibilidade.

Atorvastatin Decreases Bone Loss, Inflammation and Oxidative Stress in Experimental Periodontitis

The aim of this study is to determine the effects of Atorvastatin treatment, an inhibitor of 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, in periodontal disease. Male Wistar albino rats were randomly divided into five groups of ten rats each: (1) non-ligated treatment (NL), (2) ligature only (L), (3) ligature plus 1 mg/kg Atorvastatin daily for 10 days, (4) ligature plus 5 mg/kg Atorvastatin daily for 10 days, and (5) ligature plus 10 mg/kg Atorvastatin daily for 10 days. Following the treatment course, the periodontal tissue of the animals was analyzed by Measurement of alveolar bone loss, Histopathology and immunohistochemistry to determine of the expression of COX-2, MMP-2, MMP9, and RANKL/RANK/OPG. ELISA assay was used to quantitate the levels of IL-1β, IL-10, TNF-α, myeloperoxidase, malondialdehyde, and glutathione. The periodontal group treated with 10 mg/kg of Atorvastatin (3.9±0.9 mm; p<0.05) showed reverse the alveolar bone loss caused Experimental Periodontal Disease compared to (L) (7.02±0.17 mm). The periodontal group treated with 10 mg/kg of Atorvastatin showed a significant reduction in MPO and MDA (p<0.05) compared to ligature only group (L). Similarly in this group, the levels of the proinflammatory cytokines IL-1β and TNF-α were significantly decreased (p<0.05). Furthermore, MMP-2, MMP-9, RANKL/RANK, and COX-2 were all downregulated by Atorvastatin treatment, while OPG expression was increased. The findings support a role of Atorvastatin for reducing the bone loss, inflammatory response, oxidative stress, and expression of extracellular matrix proteins, while reducing RANK/RANKL and increase OPG in periodontal disease.

Experiência extramural em hospital público e a promoção da saúde bucal coletiva

OBJETIVO: Descrever a atividade docente assistencial, cujo objetivo e proporcionar experiencia de promocao da saude bucal coletiva a estudantes concluintes do curso de odontologia. METODOS: Tal experiencia fundamenta-se na avaliacao do desempenho do aluno, como educador em saude bucal, a medida que ele tem, entre outras tarefas, a de motivar pacientes internados e seus acompanhantes, na geracao de habitos saudaveis, visando a assistencia integral e mais humanizada do paciente hospitalizado. RESULTADOS: Os resultados mostraram que as metas desejadas foram atingidas, visto que a higiene bucal dos pacientes ja se tornou uma tarefa incorporada a rotina hospitalar, considerando-se os indices de biofilme dentario: inicial, 1,72; e final, 1,17, respectivamente. Essa diferenca, de acordo com a estatistica U-Mann-Whitney, mostrou-se significativa, pois o valor de p<0,0001 traduz o alto nivel de motivacao, alcancado pelo binomio mae-crianca, no que se refere a higiene oral. CONCLUSOES: Conclui-se que as experiencias de ensino-aprendizagem, oriundas das atividades interdisciplinares e multiprofissionais, tem permitido melhor entendimento do processo saude-doenca, por parte do aluno de odontologia. Servem ainda como oportunidade para o seu aprendizado sobre o planejamento e execucao de atividades educativo-preventivas, que complementam sua vivencia tecnico-profissional e despertam a sensibilidade social, tao necessaria a sua formacao academica.

Sintomatologia de depressão autorreferida por idosos que vivem em comunidade

The scope of this quantitative exploratory study was to evaluate the symptomatology of self-referred depression by the elderly, taking socio-demographic variables into consideration. The data collected by means of semi-structured interviews and the Abbreviated Geriatric Depression Scale involving 240 elderly residents in Joao Pessoa in the state of Paraiba between October and December 2010 were analyzed by Excel and SPSS software. It was found that 75.8 % had no degree of symptomatology of depression, and 24.2 % manifested mild or severe depression. According to these variables, in the elderly patients with depression it was found that: in relation to age, the elderly with mild and severe depression appear more frequently between 71 to 76 years - 31%; in relation to gender, females stand out with 86%; on marital state, married couples with 41.3 %, and widowers with 34.5 %; considering family income, from 1 up to 3 minimum wages, 50 %, revealed mild incidence; with respect to schooling, elderly people who have no depression, 84.6 %, can read and write. Therefore, it can be said that the symptomatology of depression in the elderly is related to socio-economic and cultural conditions, emphasizing the need for public health policies that ensure comprehensive care and quality considering these variables.

Código dos direitos e deveres da pessoa hospitalizada no SUS: o cotidiano hospitalar na roda de conversa

Os direitos dos pacientes consistem em dispositivo para mudar a atencao e a gestao no Sistema Unico de Saude - SUS. O objetivo deste trabalho e apresentar as rodas de conversa sobre os direitos e deveres dos usuarios do SUS no âmbito das unidades hospitalares. Trata-se de um estudo descritivo e exploratorio, realizado em dois hospitais de Fortaleza, Ceara. Foram promovidas, em cada servico, tres rodas de conversa com 40 trabalhadores de varias profissoes e setores. Utilizou-se para o debate o texto do Codigo de Direitos e Deveres do Paciente no SUS/CE. Os discursos foram analisados segundo a Analise de Conteudo, consoante Lawrence Bardin. Percebeu-se que normas consolidadas dificultam a efetivacao dos direitos, e a roda de conversa ampliou a visao critica, promovendo discernimento. Esta se revelou importante instrumento de educacao para a cidadania e humanizacao do processo de cuidado.

Representações sociais de trabalhadores da atenção básica de saúde sobre envelhecimento

Este estudo teve o objetivo de conhecer as representacoes sociais sobre envelhecimento construidas por trabalhadores de saude da Atencao Basica. Trata-se de um estudo exploratorio, com a participacao de 204 trabalhadores da Atencao Basica em Saude, do municipio de Joao Pessoa, Paraiba. Para coleta de dados, foi utilizada uma entrevista semiestruturada. Os dados obtidos das 204 entrevistas foram analisados com o auxilio do programa informatico Alceste, versao 2010. Os resultados apontaram cinco classes ou categorias: visao sobre envelhecimento; dimensoes psicossociais; tempo de duvidas; envelhecimento como processo; envelhecimento versus doenca, com conteudos tanto positivos: alegria, atencao, filhos, aposentadoria, cuidador, direitos, maturidade e sabedoria, quanto negativos: deficiencias, decadencia, esquecimento, fragilidade, limitacao, rugas, dependencia e doenca. Observou-se que os sentidos associados ao envelhecimento mostra a necessidade de um cuidar integral e humanizado a pessoa idosa.The objective of this study was to get to know the social representations on aging developed by primary care health workers. This is an exploratory study involving 204 primary health care workers, in the city of João Pessoa, in the state of Paraíba. For data collection we used a semi-structured interview. The data obtained from 204 interviews was analyzed with the help of the Alceste software version 2010. The results indicated five classes or categories: vision of aging,psychosocial dimensions, a time of doubts, aging as a process, and aging versus disease, with positive content: joy, care, children, retirement, caregiver rights, maturity and wisdom, as well as negative factors: impairments, decadence, neglect, fragility, limitation, wrinkles, dependency and disease. It was observed that these meanings associated with aging express the need for total and humanized elderly care.

Percepção dos estudantes sobre o idoso e seus direitos: o caso da saúde

Trata-se de um estudo retrospectivo que tem os objetivos de verificar a percepcao dos estudantes universitarios sobre o idoso e seus direitos, e averiguar o conhecimento acerca dos direitos do idoso. Participaram deste estudo 63 estudantes de diferentes curso (ambos os sexos), no âmbito academico. Utilizou-se para coleta de informacoes uma entrevista semi-estruturada centrada em questoes pertinentes aos direitos do idoso e ser idoso. Os dados foram analisados com a tecnica de analise de conteudo tematica. Os resultados sao apresentados em categorias e sao interpretados amparados na Constituicao Federal, Codigo Civil Brasileiro e Politica Nacional do Idoso, em particular, os direitos a saude. Os resultados apontaram percepcoes negativas dos estudantes acerca do idoso e pouco conhecimento sobre os direitos do idoso, em particular os mais amplos, como: receber medicacao especial, ser atendido nos hospitais prioritariamente, nao sofrer constrangimentos nos servicos publicos de saude, direito integral a saude, entre outros.