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Urban health is strongly linked to mental illness, being overweight, smoking behaviors, diabetes mellitus, hypertension, and coronary disease; most of these are chronic diseases/conditions. Healthy...

The global health scenario shows an epidemic of non-communicable diseases that lead to long-term chronic conditions, some of which are incurable. Many infectious diseases, owing to their development and length, also generate chronic conditions. Similarly, non-morbid states, such as pregnancy, and some life cycles such as adolescence and ageing, follow the same logic. Among all these chronic conditions there is a significant interrelationship with oral health, both in parallel events and common risk factors. This article presents cross-sectional qualitative research into World Health Organisation recommended health policies to address chronic conditions. Several documents published by the organisation were analysed to verify the presence of references to oral health in relation to chronic conditions, particularly cardiovascular diseases and diabetes as these most frequently have oral manifestations. The analysis showed no significant references to oral health or its indicators within the published texts. The study recognises the value of the work developed by the World Health Organisation, as well as its worldwide leadership role in the development of health policies for chronic conditions. This article proposes a coalition of dentistry organisations that could, in a more forceful and collective way, advocate for a greater presence of oral health in drafting policies addressing chronic conditions.

The purpose of this study was to analyze social determinants of health through the relationship between Sustainable Development and child health outcomes. The population studied lives in 37 municipalities of the Curitiba mesoregion, in the State of Parana, Brazil. It is a cross-cutting ecological study. In the 1st phase of the study, 16 contextual indicators were obtained from the 2010 demographic census performed by the Brazilian Institute of Geography and Statistics. Principal Components Factor Analysis was undertaken to demonstrate possible correlations between social determinants of health, resulting in Sustainable Development indices for the places where the children live. In the 2nd phase the mortality rate in children aged under 5 was obtained from the Ministry of Health database. Pearson's correlation demonstrated statistically significant, moderate and negative association between the mortality rate in children aged under 5 (2001-2010) and the Sustainable Development Index (r = -0.62, p

Objective: To evaluate the impact of xerostomia on the quality of life (QOL) of people living with HIV/AIDS (PLWHA) from Brazil. Study Design: A cross-sectional study was performed on 195 PLWHA. Xerostomia was detected by asking a question about the sensation of having “dry mouth,” and Oral Health Impact Profile 14 (OHIP-14) was used to measure the impact of xerostomia on QOL. Time of diagnosis of HIV/AIDS was assessed. Results: A total of 78 (40.0%) subjects presented with xerostomia. Xerostomia was associated with female gender, low amount of saliva perceived (p ≤ .01), difficulty in swallowing food (p ≤ .05), and showed to have a negative impact on QOL as measured by OHIP-14 (p ≤ .01). Conclusion: Xerostomia was frequent and showed to have a negative impact on the QOL of PLWHA.

OBJETIVO: Identificar iniquidades raciais em saude bucal entre grupos de pessoas adultas autodeclaradas como brancas, pretas ou pardas no Brasil. METODOS: Foram utilizados dados secundarios obtidos da base de dados da pesquisa nacional sobre a condicao de saude bucal da populacao brasileira (SB Brasil 2002-2003). Inicialmente, foi realizado um estudo transversal para comparar as variaveis de desfecho carie, perda dental, dor de origem dentaria e necessidade de protese por grupo de raca/cor para uma amostra de 12 811 adultos de ambos os sexos, na faixa etaria de 35 a 44 anos. Na segunda etapa, realizou-se um estudo ecologico com dados agregados por estado brasileiro para contextualizar as iniquidades raciais para uma populacao de 6 918 negros, agregando pretos e pardos, analisando a correlacao entre os desfechos em saude bucal estudados na primeira fase e os indicadores de desenvolvimento humano e concentracao de renda. RESULTADOS: Diferencas significativas foram observadas entre os grupos de raca/cor para todos os desfechos de saude bucal analisados (P < 0,01). Foram encontradas correlacoes entre desfechos em saude bucal e indicadores ligados ao perfil de desenvolvimento humano, renda media familiar e desigualdade de renda por estado brasileiro para o grupo de negros. CONCLUSOES: Os resultados evidenciaram iniquidades raciais em saude bucal no Brasil em todos os indicadores analisados (carie, perda dentaria, dor e necessidade de protese), com maior vulnerabilidade da populacao negra (pretos e pardos) em relacao aos brancos. Fatores contextuais relacionados ao perfil de desenvolvimento humano, a distribuicao de renda e ao acesso a politicas de cuidado em saude parecem ter papel essencial na caracterizacao da vulnerabilidade de grupos populacionais a agravos em saude bucal.

Avaliou-se a percepção das equipes de saúde bucal sobre o tratamento restaurador atraumático (ART) como estratégia da atenção básica em saúde bucal na Secretaria Municipal da Saúde de Curitiba (PR). Foram pesquisadas as Unidades de Saúde (US) que trabalham com a Estratégia da Saúde da Família (USESF) e as que não trabalham (USB). A amostra foi de 191 profissionais proporcionalmente (IC=95%, e=6%). Utilizou-se questionário para a coleta de dados. As informações foram analisadas por meio do programa SPSS 13.0. A taxa de resposta foi 82%. O teste qui-quadrado não revelou diferença estatisticamente significativa entre as USESF (83,1%) e USB (74,3%) quanto ao conhecimento da técnica (p>0,05). Diferença foi encontrada quanto à capacitação em ART entre as diferentes US (p0.05). A difference was found as to training in ART among the different HU (p

OBJECTIVES: Fanconi anemia (FA) is a genetic disease characterized by a chromosomal instability that develops a progressive pancitopenia, leukemia, and/or solid tumors. Nevertheless, it is unknown if this illness induces changes on the salivary gland parenchyma and function. The aim of this study was to assess the stimulated salivary flow rate (SSFR) and calcium, urea, total protein, and amylase levels in saliva of FA patients. METHODS: Stimulated whole saliva was collected from 34 randomly selected FA patients and 34 age-matched and sex-matched controls. Both samples were analyzed for salivary flow rate, calcium, urea, total proteins, and amylase. The SSFR was analyzed by gravimetric method and calcium, urea, total protein, and amylase concentrations were realized by chemistry tests. RESULTS: Mean values of SSFR for experimental and control groups were, respectively, 0.5 mL/min and 0.8 mL/min (P

Objective: To evaluate the parent's esthetic acceptance of the use of the cariostatic agent diamine silver fluoride in children aged 0 to 3 years treated at ...

The aim of this study was to identify and analyze inequities in the access to specialized services in the municipalities of the metropolitan area of Curitiba, Paraná, Brazil. This is an ecological study. In its preparatory stage, this study focused on the socioeconomic, epidemiologic, healthcare network and sectoral financing network profiles of the 26 municipalities comprising this area. Factor analysis was employed to obtain the six principal components, and a synthetic index was calculated from them, allowing municipalities to be ranked according to living conditions and health situation. Primary data was collected from 24 municipalities, regarding their capacity, directed and repressed demand of specialized healthcare services. The context analysis revealed accentuated intermunicipal inequities. The synthetic index allowed municipalities to be classified in four relatively homogeneous groups regarding living and health conditions. Municipalities located in Vale do Ribeira obtained the worse outcomes for the Living Conditions and Health Situation Synthetic Index, as well as the higher repressed demand for specialized healthcare services. The geographical distance from the capital showed to contribute to worse living and health conditions and greater difficulties in access to healthcare services. O objetivo deste estudo foi identificar e analisar iniquidades intermunicipais no acesso à atenção especializada nos municípios da região metropolitana de Curitiba, Paraná. Trata-se de estudo ecológico. Na etapa preparatória deste estudo, trabalhou-se com os perfis socioeconômico, epidemiológico, da rede de cuidados à saúde e de financiamento setorial, dos 26 municípios que compõem essa região. Foi realizada análise fatorial, pela qual foram obtidos seis componentes principais, e a partir desses foi calculado um índice sintético, que permitiu ordenar os municípios segundo condição de vida e situação de saúde. Dados primários foram coletados de 24 municípios, referentes à capacidade instalada, demanda encaminhada e demanda reprimida de serviços de atenção especializada. A análise de contexto revelou acentuadas iniquidades intermunicipais e o índice sintético permitiu classificar os municípios em quatro grupos relativamente homogêneos quanto às condições de vida e situação de saúde. Os municípios localizados no Vale do Ribeira obtiveram os piores resultados para o Índice Sintético de Condições de Vida e Situação de Saúde, assim como apresentaram maior demanda reprimida para os serviços da atenção especializada. A distância geográfica do município polo demonstrou contribuir para piores condições de vida e saúde e maiores dificuldades no acesso aos serviços de saúde.

Dislocation of the temporomandibular joint (TMJ) is a troublesome condition that occurs in a chronic or acute form. It is a distressing and highly embarrassing situation that may occur as a result of daily activities such as yawning, laughing, or during events that require keeping the mouth open for a long time. This review aims to present and discuss different conservative and surgical techniques to treat patients with a dislocated mandible, and to present two cases of surgical treatment.A search of the literature was completed (Medline, PubMed) using the keywords TMJ dislocation, TMJ luxation, mandibular dislocation and surgical and non-surgical methods of treatment for this condition.Eminectomy (Myrhaug's surgery) has been used with satisfactory results. Most of reports present large series of patients with more than one year of follow-up and no recurrence of complications. Is less invasive and take a short operation time; need no bone transplantation or placing any kind of foreign body into the joint.Eminectomy results in long-term resolution of recurrent TMJ dislocations, when compared with others surgical techniques.

The complexities of Eagle’s syndrome are examined according to anatomical, historical, clinical, and treatment aspects. There appears to be little correlation between the extent, form, and size of the anomalies of the styloid process and the stylohyoid ligament and the predictability of patients with related symptoms. Surgical treatment and the advantages and disadvantages of each surgical approach (intra- and extraoral) are discussed. The probable causes of enlargement of the styloid process and ossification of the stylohyoid ligament are addressed. Two cases of Eagle´s syndrome are presented: one unilateral and the other bilateral. An intraoral modified surgical technique is presented.

A provisão adequada de serviços de atenção primária à saúde e o acesso aos serviços especializados, também usualmente referidos como de média/alta complexidade, apresentam-se como uma dificuldade em vários municípios brasileiros, tendo em vista as questões gerenciais envolvidas que incluem a força de trabalho, os custos e a densidade tecnológica exigida. Este estudo objetivou compreender a prática discursiva de gestores em relação à articulação entre os níveis de atenção primária e de média/alta complexidade dos serviços públicos de saúde na Região Metropolitana de Curitiba (RMC). Realizouse um estudo exploratório de abordagem qualitativa com 17 gestores de saúde da RMC. Os dados discursivos foram coletados por meio de entrevista semiestruturada, sendo processados pelo método de análise de discurso. A interpretação do material permitiu a classificação dos dados discursivos, que foram agrupados em categorias: atenção primária municipal, acesso na média complexidade, atendimento hospitalar, saúde bucal e articulação política. A análise demonstrou que os municípios se encontram em diferentes estágios de implantação e organização da atenção primária. A dificuldade no acesso aos serviços de média/alta complexidade promove interrupção na continuidade das linhas de cuidado, as quais visam à integralidade da atenção em saúde e implicam a adequada coordenação da atenção primária articulada à atenção especializada de segundo e/ou terceiro níveis de densidade tecnológica. The appropriate provision of primary healthcare services and access to specialized services, also commonly referred as medium/high complexity, presents as a difficulty in several municipalities, considering the managerial issues involved including the workforce, cost and technological density required. This study aimed to understand the discursive practice of managers regarding the articulation between primary and middle/ high complexity levels of public health services in the Metropolitan Region of Curitiba (RMC). An exploratory study was conducted with seventeen health administrators in the CMA. The data were obtained in semi-structured interviews, being processed by speech analysis method. The material interpretation allowed the discourse data classification, which were grouped into categories: access of municipal primary care, medium complexity access, hospital care, oral health and political articulation. The analysis has shown that the municipalities are in different stages regarding primary health care. The difficulty in accessing medium/high complexity services promotes disruption in care lines continuity, which aim at comprehensive care in health and imply the proper coordination of primary care articulated to specialized care of second and/or third level of technology density. La prestación adecuada de los servicios de atención primaria a la salud y acceso a los servicios especializados, también conocidos comúnmente como la media/alta complejidad, se presenta como una dificultad en varias ciudades brasileñas, em vista de los cuestiones de gestión, incluyendo fuerza de trabajo, los costos y la densidad tecnológica necesario. Este estudio tuvo como objetivo comprender la práctica discursiva del directivos en relación a los servicios de salud en la Región Metropolitana de Curitiba (RMC). Se realizó un estudio exploratorio de abordaje cualitativo, con diecisiete gerentes de salud de RMC. Los datos fueron obtenidos mediante entrevista semi-estructurada y se procesaron mediante el método de análisis del discurso. La interpretación del material permitió la clasificación de los datos del discurso, que se agruparon en categorías: atención primaria municipal, acceso a la atención especializada, hospitalizaciones, salud bucal y articulación política. El análisis muestra que los municipios están en diferentes etapas de la atención primaria. La dificultad en acceso a los servicios de media/alta complejidad favorece la interrupción en la continuidad de las líneas de atención que tienen como objetivo la atención atención integral en salud e implican en la adecuada coordinación de la atención primaria articulada a la atención especializada de segundo y/o tercer nivel de densidade de tecnología.

Depression is the most common form of affective disorders and may range from discrete to severe. Various studies have worked with the hypothesis that depression arises from the deficiency of monoamines (noradrenaline, serotonin and dopamine), the most adequate treatment being to raise the supply of these neurotransmitters in the central nervous system (CNS). Statistical data have shown that depression has increased as a result of the longer life expectancy and is common among the elderly population (Glassman et al., 1984).

Context: The orthodontists usually have to manage patient’s expectations and treatment plans at the same time. Consequently, the civil responsibility and the bioethics involved on orthodontic routine are matters of relevance. Therefore, the importance of adequate conducts is addressed in this research. Aim: The present aim is to analyze the tendency of the courts judging the orthodontists’ responsibility and to observe the bioethical aspects on the current jurisprudence. Materials and Methods: The sample consisted of 108 lawsuits related to the orthodontist’s civil responsibility, dated from 2003 to 2009. The qualitative data were obtained by the Bardin’s method for detailed reading. The quantitative collection was performed by observing statistical distribution of the following variables: (1) reason of the complaint against the orthodontist, (2) type of obligation designated to the professional, (3) presence of expert’s examination, and (4) jury decision. The correlations between the jury decision and the other variables were verified by applying the Chi-square test. Results: The main reason of the complaints against the orthodontist was the personal dissatisfaction (32%). Subjective and objective obligations had pair incidence (26% and 27%, respectively). The experts’ examination was present in 63, 89%, of the cases, and the jury decision acquitted 57, 78%, of the orthodontists. The passages involving bioethical principles supported properly the qualitative approach. Conclusion: The orthodontists show deviations from the correct daily attitudes. In order to avoid further conflicts, more attention must be given to the principles of bioethics. ispartof: European Journal of General Dentistry vol:1 issue:1 pages:20-23 status: published

This study deals with public health management in small Brazilian municipalities with low HDI-M through analysis of financial resources. Findings indicated some innovations, but not enough, with managers needing specific administration learning, although they state their desire to improve services. Unstructured reports do not contribute to health planning, showing no relationship between the scope of health actions and financial resources. Management needs to evolve to intersectoral decisions, with social participation in planning. This would make it possible to solve more health problems and provide a universal and equitable service to the population in the process of National Health System decentralisation.