Sérgio d’Ávila

Facial trauma as physical violence markers against elderly Brazilians: A comparative analysis between genders

The aim of this study was to characterize the profile of elderly Brazilians with injuries resulting from physical violence and identify victimization differences. A descriptive and exploratory study was conducted involving the analysis of medico-legal and social records of 259 elderly victims of physical violence treated at an Institute of Forensic Medicine and Dentistry over four years (from January 2008 to December 2011). The forensic service database was evaluated by researchers properly trained and calibrated to perform this function between January and March 2013. Socio-demographic variables of victims, aggression characteristics, aggressors profile and types of lesions were evaluated. Descriptive and multivariate statistics using Multiple Correspondence Analysis (MCA) were performed. The prevalence of facial trauma was 42.9%. Based on the MCA results, two groups with different victimization profiles were identified: married men aged 70-79 years, victims of community violence at night, suffering facial injuries; and single, widowed or separated women aged 60-69 years, victims of domestic violence during the day, suffering trauma in other areas of the body. The results suggest that there is a high prevalence of facial injuries among elderly Brazilians victims of physical violence and there are important differences related to victimization characteristics according to gender.

Quality of life related to oral health of patients undergoing hemodialysis and associated factors: QUALITY OF LIFE, ORAL HEALTH AND HEMODIALYSIS

PURPOSE To evaluate quality of life related to oral health (QoLROH) of Brazilians undergoing hemodialysis and to identify associated factors. MATERIAL AND METHODS A cross-sectional study was conducted with 226 patients undergoing hemodialysis at two reference medical centers. Participants answered a sociodemographic questionnaire and the Brazilian version of the Oral Health Impact Profile (OHIP-14). Descriptive and multivariate statistics using Decision Tree Analysis by the Chi-square Automatic Interaction Detector (CHAID) algorithm, as well as Ordinal Logistic Regression analyses were performed. RESULTS The Decision Tree revealed that the impact on QoLROH could be explained by age (p = 0.002), tooth pain in the last 6 months (p = 0.026), and region of residence (p = 0.025). CONCLUSIONS The results suggest that being older, living in rural areas, and reporting tooth pain in the last 6 months may influence the QoLROH of patients undergoing hemodialysis.

Violência interpessoal, circunstâncias das agressões e padrões dos traumas maxilofaciais na região metropolitana de Campina Grande, Paraíba, Brasil (2008-2011)

RESUMO O objetivo deste estudo foi determinar as circunstâncias das agressoes e os padroes dos traumas maxilofaciais entre vitimas de violencia interpessoal. Tratou-se de um estudo transversal e exploratorio feito a partir da analise de 7.132 registros medico-legais e sociais de vitimas de violencia interpessoal atendidas em um Centro de Medicina Legal e Odontologia Forense. Foi feita estatistica descritiva e multivariada, usando Analise de Correspondencia Multipla. Tres grupos com perfis distintos de vitimizacao foram identificados. O primeiro grupo foi formado majoritariamente por homens, de diferentes faixas etarias, vitimas de violencia comunitaria, resultando em fratura de ossos faciais ou fratura dentoalveolar. O segundo grupo foi composto essencialmente por adolescentes (10-19 anos), de ambos os sexos, vitimas de violencia interpessoal e que nao apresentaram um padrao especifico de trauma. O terceiro grupo reuniu mulheres, adultas (≥ 20 anos), vitimas de violencia domestica, resultando em lesao de tecidos moles da face ou em outras regioes do corpo. Os resultados sugerem que as caracteristicas sociodemograficas e circunstanciais sao fatores importantes na vitimizacao por traumatismo maxilofacial e violencia interpessoal.The aim of this study was to determine the circumstances of aggressions and patterns of maxillofacial injuries among victims of interpersonal violence. This was a cross-sectional and exploratory study conducted from the analysis of 7,132 medical-legal and social records of interpersonal violence victims seen in a Forensic Medicine and Dentistry Center. Descriptive and multivariate statistics were performed using Multiple Correspondence Analysis. Three groups with different victimization profiles were identified. The first group was mainly composed of men of different age groups, victims of community violence that resulted in facial bones or dentoalveolar fracture. The second group was mainly composed of adolescents (10-19 years) of both sexes, victims of interpersonal violence and without specific pattern of injuries. The third group was composed of adult women (≥ 20 years) victims of domestic violence that resulted in injuries of soft tissues of face or other body regions. The results suggest that sociodemographic and circumstantial characteristics are important factors in victimization by maxillofacial injuries and interpersonal violence.

Tomada de decisão de estudantes frente a um case scenario de Endodontia

This cross-sectional study evaluates the decision-making process of students in the 4th and 5th years of the Dentistry course of a public university in the Northeast region, facing a case scenario of Endodontics. The sample consisted of 80 students, who, in view of the described scenario and radiographic image presented, answered a questionnaire about the probable reason for rarefaction, clinical conduct and decision making. For data analysis, absolute distributions, uni, and bivariate percentages were obtained. The majority of respondents were female (55.0%). Analyzing the probable cause of periapical rarefaction, 43.8% of respondents believe that it is due to the apical limit of obturation. Anamnesis, clinical examination, and radiography were mentioned by 95% of the students as the means indicated for the treatment decision-making in the case presented. The majority (60%) decided for endodontic retreatment using intracanal medication. It is concluded that the students consider the undesirable apical limit of obturation as a reason for apical rarefaction; that anamnesis, clinical examination, radiographic examination are indicated for decision making and have chosen endodontic retreatment. The students of the 5th year, with more clinical experience than those of the 4th, presented a more conservative therapeutic decision.

Head and Face Injuries in Automobile Accidents and Associated Factors in a city in Northeastern Brazil

Objective: To evaluate the occurrence of head and face injuries and associated factors among victims of automobile accidents in a trauma center. Material and Methods: A cross-sectional study was developed through the analysis of 9,734 medical records of children and adults hospitalized due to external causes in the Regional Hospital of Emergency and Trauma at Campina Grande, Brazil. Data were analyzed with the SPSS software version 15, also using the Pearson’s chi-square test. The significance level adopted was 5 %. Results: Cases of automobile accidents accounted for 25.9% (n = 463) of hospitalizations due to external causes, and 83.8 % of victims were male and 16.2 % were female, representing a sex ratio of 5.1:1. As for age group, most had between 20 and 29 years (38.1%) and with respect to the day of the week, 40.8 % of incidents occurred over the weekend. The occurrence of injury was greater on the face (17.4%) than on the head (7.8%) and most victims had a single injury (58.5%). The existence of bone fractures was observed in 76.9 % of victims and 14.7 % had functional impairment. There was association between variables age (p < 0.001), sex (p < 0.001), day of the week (p < 0.001), presence of bone fractures (p < 0.001) and functional impairment (p = 0.002) with the occurrence of automobile accidents. Conclusion: The most automobile accidents occur on weekends and affect young male individuals, with frequent presence of fractures among victims. The occurrence of injury was greater on the face than on the head. Factors such as age, sex, presence of bone fractures and functional impairment was associated with automobile accidents.

Multiple correspondence analysis as a strategy to explore the association between categories of qualitative variables related to oral–maxillofacial trauma and violent crimes at the community level

The main objective of this study was to show the applicability of multiple correspondence analysis (MCA) in the detection and representation of underlying structures in large datasets used to investigate oral-maxillofacial lesions. A cross-sectional study was conducted involving the analysis of the medical-forensic and social records of 992 people who experienced oral-maxillofacial trauma resulting from non-fatal violent crimes that occurred in the community. Based on the MCA results, two distinct victim profiles were identified. The first profile was characterized by adult men, victims of instruments of violence (such as firearms, knives, or mixed aggression), resulting in severe trauma, mainly affecting the upper or middle third of the face. The second profile was characterized by adolescent and young adult women, victims of aggression using physical force, resulting in soft tissue traumas, mainly affecting the lower third of the face or more than one region at the same time. MCA has been demonstrated to be a powerful tool for exploring complex data related to oral-maxillofacial trauma, showing whether there is a relationship and how variables are related. This multivariate method can also be very valuable in the study of several outcomes in oral and maxillofacial surgery and supporting specialties.

MAXILLOFACIAL TRAUMA, ETIOLOGY AND PROFILE OF PATIENTS: AN EXPLORATORY STUDY

ABSTRACT Objective: To describe the profile of patients with facial trauma admitted in a hospital located in a metropolitan area of Northeast Brazil. Methods: A cross-sectional and exploratory study was performed. A total of 244 cases were in agreement with the eligibility criteria. The variables include the sociodemographic characteristics of patients, etiology, type of trauma, treatment modalities, length of stay in a hospital and quarter of care. Descriptive statistics and Cluster Analysis were performed. Results: The average age of patients was 31.16 years (SD = 15.17 years) and average hospitalization was 6.32 days (SD = 7.75 days). It was verified the automatic formation of four clusters with different profiles of patients. The variables which most contributed to the external differentiation between clusters were: length of stay in a hospital (p <0.001), etiology (p <0.001), type of facial trauma (p <0.001), presence of associated trauma (p <0.001), treatment modalities (p <0.001) and quarter of care (p <0.001). Conclusion: The most of patients were men, victims of traffic accidents, which suffered fracture of zygomatic complex and underwent surgery. Level of Evidence III, Retrospective Study.

Violência contra mulheres em diferentes estágios do ciclo de vida no Brasil: um estudo exploratório

Objective: The aim of this study was to describe the profile of violence against women in different life cycles, according to the sociodemographic characteristics of the victims and offenders. Methods: A cross-sectional and exploratory study was performed based on 1,388 police reports during a four-year period, in a metropolitan area of Northeast Brazil. The dependent variable was the type of aggression suffered by the victims. The independent variables were sociodemographic characteristics of the victims and offenders. Statistical analysis included the χ2 test (p < 0.05) and the decision tree analysis, through the Chi-squared Automatic Interaction Detector (CHAID) algorithm. Results: Cases of physical abuse (n = 644) were the most common, followed by threat (n = 415) and verbal aggression (n = 285). The violence profiles could be explained by the relationship between victims and offenders (p < 0.001) and age of the victims (p = 0.026 in Node 1; p = 0.019 in Node 3). Conclusion: It was observed that women in different stages of life are more exposed to different types of violence.

Formação e perspectiva do mercado de trabalho sob o olhar de alunos de odontologia

Objective: To identify the socioeconomic profile of undergraduate dental students of a public Dental School at the State of Paraiba, Brazil and their expecta...

ATENÇÃO À SAÚDE BUCAL NAS COMUNIDADES INDÍGENAS: EVOLUÇÃO E DESAFIOS – UMA REVISÃO DE LITERATURA

Objective: The aim of this literature review is to investigate aspects on oral health care in indigenous communities, highlighting the progress and challenges. Material and Methods The literature search was conducted in the databases: PubMed, SciELO, BBO and LILACS. Results: The Subsystem for Indigenous Healthcare has evolved since its inception. The creation of a new department within the Ministry of Health, the Special Secretariat for Indigenous Healthcare, responsible solely for health care of indigenous people, aimed to meet the expectations of these communities, professionals and managers regarding comprehensive and differentiated health care. One of the first initiatives of the Department was establishing the Indigenous Smiling Brazil program, which has the purpose of providing access to dental care in the local settlements by improving the structure and quality of oral health services, and by ensuring comprehensive dental care for these people. The challenges of providing dental care in indigenous areas are diverse, due to difficult geographical, linguistic and cultural aspects. Conclusion: It is important for health professionals to acquire cultural competence, and to transcend the boundaries of an assistance model focused on the individual, emphasizing prevention under a collective view, respecting and valuing social and cultural aspects of indigenous peoples. DESCRIPTORS: Oral Health. Health Public Policy. Indigenous Health. Indians. South American.