Behavioral and neurochemical effects of alpha lipoic acid associated with omega-3 in tardive dyskinesia induced by chronic haloperidol in rats.

Tardive dyskinesia (TD) is characterized by involuntary movements of the lower portion of the face being related to typical antipsychotic therapy. TD is associated with the oxidative imbalance in the basal ganglia. Lipoic acid (LA) and omega-3 (ω-3) are antioxidants acting as enzyme cofactors, regenerating antioxidant enzymes. This study aimed to investigate behavioral and neurochemical effects of supplementation with LA (100 mg/kg) and ω-3 (1 g/kg) in the treatment of TD induced by chronic use of haloperidol (HAL) (1 mg/kg) in rats. Wistar male rats were used, weighing between 180-200 g. The animals were treated chronically (31 days) with LA alone or associated with HAL or ω-3. Motor behavior was assessed by open-field test, the catalepsy test, and evaluation of orofacial dyskinesia. Oxidative stress was accessed by determination of lipid peroxidation and concentration of nitrite. LA and ω-3 alone or associated caused an improvement in motor performance by increasing locomotor activity in the open-field test and decreased the permanence time on the bar in the catalepsy test and decreased the orofacial dyskinesia. LA and ω-3 showed antioxidant effects, decreasing lipid peroxidation and nitrite levels. Thus, the use of LA associated with ω-3 reduced the extrapyramidal effects produced by chronic use of HAL.

Plasticity of mesenchymal stem cells from mouse bone marrow in the presence of conditioned medium of the facial nerve and fibroblast growth factor-2.

A number of evidences show the influence of the growth of injured nerve fibers in peripheral nervous system as well as potential implant stem cells (SCs). The SCs implementation in the clinical field is promising and the understanding of proliferation and differentiation is essential. This study aimed to evaluate the plasticity of mesenchymal SCs from bone marrow of mice in the presence of culture medium conditioned with facial nerve explants and fibroblast growth factor-2 (FGF-2). The growth and morphology were assessed for over 72 hours. Quantitative phenotypic analysis was taken from the immunocytochemistry for glial fibrillary acidic protein (GFAP), protein OX-42 (OX-42), protein associated with microtubule MAP-2 (MAP-2), protein ß-tubulin III (ß-tubulin III), neuronal nuclear protein (NeuN), and neurofilament 200 (NF-200). Cells cultured with conditioned medium alone or combined with FGF-2 showed morphological features apparently similar at certain times to neurons and glia and a significant proliferative activity in groups 2 and 4. Cells cultivated only with conditioned medium acquired a glial phenotype. Cells cultured with FGF-2 and conditioned medium expressed GFAP, OX-42, MAP-2, ß-tubulin III, NeuN, and NF-200. This study improves our understanding of the plasticity of mesenchymal cells and allows the search for better techniques with SCs.

Morphofunctional regeneration by mesenchymal stem cell and IGF-1 inoculation in a model of facial nerve crush injury in rats.

OBJECTIVE: To analyze the morphofunctional regeneration process of facial nerve injury in the presence of insulin-like growth factor-1 and mesenchymal stem cells. METHODS: Fourteen Wistar rats suffered unilateral facial nerve crushing and were randomly divided into two groups. All received insulin-like growth factor-1 inoculation, but only half of the animals received an additional inoculation of mesenchymal stem cells. The animals were followed for 90 days and facial nerve regeneration was analyzed via spontaneous facial motor function tests and immunohistochemistry in the nerve motor nucleus. RESULTS: The group that received the growth factor and stem cells showed a statistically superior mean in vibrissae movements (p < 0.01), touch reflex (p = 0.05) and eye closure (p < 0.01), in addition to better immunohistochemistry reactivity. There was a statistically significant difference in the mean number of cells in the facial nerve nucleus between the experimental groups (p = 0.025), with the group that received the growth factor and stem cells showing the highest mean. CONCLUSION: The association between growth factor and stem cells potentiates the morphofunctional regeneration of the facial nerve, occurring faster and more effectively. LEVEL OF EVIDENCE: 4, degree of recommendation C.

[Dental condiction of patients with temporomandibular dysfunction]. / Condição dentária de pacientes com disfunção temporomandibular.

OBJECTIVE: To evaluate the dental condition and the vertical dimension in patients with TMD, and the age and origin of the DTM. METHODS: Was performed a descriptive study, observational, cross-sectional, with a sample of thirty patients with TMD, diagnosed by Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). This sample was determined based on estimates the service thus a sample of convenience. The association between gender, age, vertical dimension and dental condition with TMD were verified using the chi-square statistical test with 95% confidence intervals. RESULTS: It found that 26 patients were female and 4 males. Fifteen subjects presented aged below 36.5 years. How much the origin of the DTM, 19 subjects had articular disorder, and 11 muscle disorder. Has been determined that there was no statistically significant association between the independent variables with the DTM. CONCLUSION: The etiological factors analyzed in isolation do not seem to influence in a unique way in the development of TMD, but may act together with other factors, because the cause is multifactorial.

Prenatal Care and Hypertensive Gestational Syndromes: A Systematic Review.

OBJECTIVE: Evaluate the influence of prenatal care on the occurrence of gestational hypertension. METHODS: The Web of Science, Scopus, Pubmed, Cochrane and ClinicalTrials electronic databases were searched for articles published between January 1st, 2012 and December 31st, 2016. No language restrictions were imposed. The following keywords were used: prenatal care, medical assistance, prenatal education, pregnancy-induced hypertension. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) checklist was employed. Two hundred and forty articles were identified during the initial search, but only seven met the inclusion criteria. This systematic review is registered with the international prospective register of systematic reviews (PROSPERO; #CRD42017064103). RESULTS: The seven studies had a low risk of bias, with methodological quality scores ranging from six to eight points. Five studies found a positive relationship between prenatal care and pregnancy-induced hypertension, whereas two studies found no significant association between the two variables. The divergence among the studies may have been due to the type of healthcare service at which the study was conducted and the sample size. CONCLUSION: Although the studies analyzed differed with regard to methodological aspects, the findings demonstrate the importance of prenatal care during the gestational period as a prevention and health promotion measure.

OBJETIVO: Avaliar a influência da assistência pré-natal no acometimento de síndromes hipertensivas gestacionais. MéTODOS: A revisão buscou artigos publicados nas plataformas eletrônicas de pesquisa Web of Science, Scopus, Pubmed, Cochrane e Clinical Trials, sem restrições de linguagem e com os artigos publicados entre 01/01/2012 e 31/12/2016. Os descritores utilizados foram: assistência pré-natal, assistência médica, educação pré-natal, hipertensão induzida pela gravidez, gestação. Foi utilizado o checklist preferred reporting items for systematic reviews and meta-analyses PRISMA. A busca na literatura, de acordo com a estratégia adotada, identificou 240 artigos. Contudo, somente 7 artigos foram selecionados de acordo com os critérios de inclusão. A revisão sistemática foi incluída no registro prospectivo internacional de revisões sistemáticas (PROSPERO, na sigla em inglês; #CRD42017064103). RESULTADOS: Cinco estudos encontraram relação positiva entre a assistência pré-Natal e síndromes hipertensivas gestacionais. Dois estudos não encontraram uma associação estatística significativa entre estas duas variáveis. Os sete estudos apresentam um baixo risco de viés, com as pontuações na análise de qualidade variando entre seis e oito. As possíveis diferenças entre os achados podem ser devidas ao momento do diagnóstico das síndromes hipertensiva gestacionais, tipo de serviço onde foi realizada a pesquisa e o tamanho amostral. CONCLUSãO: Embora os estudos apresentem diferentes aspectos metodológicos, observou-se a importância da implementação da Assistência Pré-Natal durante o período gestacional, o que atuará como medida de promoção e prevenção em saúde.

Morphofunctional regeneration by mesenchymal stem cell and IGF-1 inoculation in a model of facial nerve crush injury in rats

Abstract Objective: To analyze the morphofunctional regeneration process of facial nerve injury in the presence of insulin-like growth factor-1 and mesenchymal stem cells. Methods: Fourteen Wistar rats suffered unilateral facial nerve crushing and were randomly divided into two groups. All received insulin-like growth factor-1 inoculation, but only half of the animals received an additional inoculation of mesenchymal stem cells. The animals were followed for 90 days and facial nerve regeneration was analyzed via spontaneous facial motor function tests and immunohistochemistry in the nerve motor nucleus. Results: The group that received the growth factor and stem cells showed a statistically superior mean in vibrissae movements (p<0.01), touch reflex (p = 0.05) and eye closure (p<0.01), in addition to better immunohistochemistry reactivity. There was a statistically significant difference in the mean number of cells in the facial nerve nucleus between the experimental groups (p = 0.025), with the group that received the growth factor and stem cells showing the highest mean. Conclusion: The association between growth factor and stem cells potentiates the morphofunctional regeneration of the facial nerve, occurring faster and more effectively. Level of Evidence: 4, degree of recommendation C.

Prevalence of Sexual Dysfunction among Expectant Women.

Purpose To identify pregnancy as a causative factor of sexual dysfunction among expectant women. Methods A prospective study with 225 expectant mothers seen in the prenatal clinic of a federal university. Sexual function was evaluated by means of the Female Sexual Function Index (FSFI), and all domains were analyzed (desire, arousal, lubrication, orgasm, satisfaction, and pain). Initially, a univariate analysis of the sample was done. The averages for each domain according to the risk of sexual dysfunction (FSFI ≤ 26.5) were compared using the Student's t-test for independent samples. The strength of the correlation between sexual dysfunction and all sociodemographic, clinical and behavioral variables was measured by the Chi-Square (χ2) test. Then, odds ratios (ORs) and their confidence intervals were assigned to perform a bivariate analysis. Any p values less than 0.05 were considered significant. Results Approximately two-thirds of the women (66.7%) showed signs of risk of sexual dysfunction (FSFI ≤ 26.5). Within these cases, all sexual dysfunction domains (desire, arousal, lubrication, orgasm, satisfaction, and pain) were found to be statistically significant (p < 0.001). The domains most affected were desire (2.67), satisfaction (2.71) and arousal (2.78). Conclusions Pregnancy appears to be an important causative factor of sexual dysfunction among pregnant women.

Experiências brasileiras no acompanhamento de crescimento e desenvolvimento infantil no contexto da Atenção Básica / Brazilian experiences in monitoring growth and child development in the context of primary care

Objetivo: Identificar as experiências brasileiras no acompanhamento de crescimento e desenvolvimento infantil no contexto da Atenção Básica. Método: Trata-se de um estudo do tipo Revisão Integrativa de Literatura. As bases de dados utilizadas nesse estudo foram: Scientific Eletronic Library Online, Literatura Latino-Americana e do Caribe em Ciências da Saúde e SCOPUS. Resultados: Durante a busca inicial foram encontrados setenta e oito artigos, onze artigos repetiam-se dentro das bases e por esse motivo, a amostra final foi composta por oito artigos. O acompanhamento do crescimento e desenvolvimento infantil é realizado por meio de consultas na ESF e, em sua maioria, com ações de aferição de medidas antropométricas, verificação do esquema vacinal e orientação nutricional. Conclusão: Foi possível identificar experiências de consultas que ainda estão voltadas para o modelo biomédico, pautado na queixa conduta. É preciso que os profissionais atuantes na Atenção Básica recebam capacitação de qualidade, para que suas ações sejam efetivas na prevenção e promoção de saúde infantil. (AU)

Objective: To identify the Brazilian experiences in monitoring growth and child development in the context of Primary Care. Methods: This is an Integrative Literature Review study. The databases used in this study were: Scientific Electronic Library Online, Latin American and Caribbean Health Sciences Literature and SCOPUS. Seventy-eight articles were found during the initial search, eleven articles were repeated within the bases and for this reason. The final sample of eight articles. Results: The monitoring of child growth and development is carried out through consultations in the FHS and, mostly, with actions of measurement of anthropometric measures, verification of the vaccination scheme and nutritional guidance. It was possible to identify consultation experiences that are still focused on the biomedical model, based on the conduct complaint. Conclusion: It is necessary that professionals working in Primary Care receive quality training, so that their actions are effective in the prevention and promotion of child health. (AU)

Objetivo: Identificar las experiencias brasileñas en el monitoreo del crecimiento y desarrollo infantil en el contexto de la Atención Primaria. Métodos: Este es un estudio de Revisión Integral de Literatura. Como base de datos utilizada en este estudio: Biblioteca científica electrónica en línea, Literatura latinoamericana y caribeña en ciencias de la salud y SCOPUS. Durante una búsqueda inicial, se encontraron setenta y ocho artículos, algunos artículos repetidos dentro de las bases y por esa razón. La muestra final fue de ocho artículos. Resultados: En caso de extracción de resultados, verifique si el monitoreo del crecimiento y desarrollo infantil se realiza a través de consultas en la FHS y, en la mayoría de los casos, con medidas para medir medidas antropométricas, verifique el calendario de vacunación y la guía nutricional. Conclusión: Fue posible identificar experiencias de consulta que todavía se centran en el modelo biomédico, basado en la queja de conducta. Es necesario que los profesionales que trabajan en Atención Primaria reciban capacitación de calidad, para que sus acciones sean efectivas en la prevención y promoción de la salud infantil. (AU)

Índice de sucesso de exodontias realizadas com extrator minimamente traumático / Exodonticssuccess index performed with a minimally traumatic extractor / Índice de éxito de exodonciarealizado com unextractor traumático mínimo

Introdução:Técnicas para extração dentária vêm sendo aperfeiçoadas objetivando um procedimento que diminua o esforço profissional, o tempo cirúrgicoeamenize as dores e os processos inflamatórios. Neste sentido os extratores minimamente traumáticos,com a exodontia vertical, propõem-se a preservar o osso alveolar e proporcionar uma recuperação mais rápida e confortável para o paciente. Objetivo:Avaliar a efetividade do kit para extração minimamente traumática da Maximus® (Contagem, Minas Gerais, Brasil) na exodontia de raízes residuais de incisivos, caninos e pré-molares unirradiculares. Metodologia:Trata-se de um ensaio clínico, prospectivo e analítico. Os pacientes foram operados utilizando o dispositivo, sendo avaliados os dados demográficos, tempo cirúrgico, dor e conforto após a cirurgia, bem como o grau de satisfação profissional com o uso do dispositivo. Para verificar diferenças significativas foi utilizado o teste de Mann-Whitney e a busca de associações foi realizada com o Exato de Fisher. Para todos os testes foi estabelecida uma significância com p<0,05.Resultados:Quarenta elementos foram removidos, o tempo cirúrgico foi em média 16,28 minutos, níveis de dor e conforto imediatamente após a cirurgia se mantiveram baixos (p<0,0001), e o grau de satisfação profissional se manteve alto (p<0,0001). A taxa de sucesso do dispositivo foi de 93,3% para os elementosincisivos e 20% para os elementos caninos e pré-molares (p<0,0001).Conclusões:A eficácia do extrator é determinada pelo tamanho da superfície radicular cobertas com fibras periodontais e a localização do dente. No entanto pode ser bem indicada no planejamento de reabilitações implantosuportadas em região anterior de maxila e mandíbula (AU).

Introduction:Techniques for tooth extraction have been improvedaiming at a procedure that reduces professional effort, surgical time, pain and inflammatory processes. In this sense, minimally traumatic extractors with vertical extraction, propose to preserve the alveolar bone and provide a faster and more comfortablerecovery for the patient. Objective:To evaluate the effectiveness of the Maximus® Minimally Traumatic Extraction Kit (Contagem, Minas Gerais, Brasil) in the extraction of uniradicular residual roots from incisors, canines and premolars.Methodology:Thisis a clinical, prospective and analytical trial. Patients were operated on using the device, and demographic data, surgical time, pain and comfort after surgery were evaluated, as well as the degree of professional satisfaction with the use of the device.To verify significant differences, the Mann-Whitney test was used and the search for associations was performed with Fisher's exact test. For all tests, significance was set at p<0.05.Results:Forty elements were removed, surgical time averaged 16.28 minutes, levels of pain and comfort immediately after surgery remained low (p<0.0001), and the degree of job satisfaction remained high (p<0.0001). The success rate of the device was 93.3% for the incisor elements and 20% for the canine and premolar elements (p<0.0001).Conclusions:The effectiveness of the extractor is determined by the size of the root surface covered with periodontal fibers and the location of the tooth. However, can be well indicated in planning implanted rehabilitation in the anterior region of the maxilla and mandible (AU).

Introducción: Se han mejorado las técnicas de extracciónde dientescon el objetivo de un procedimiento que reduzca el esfuerzo profesional, el tiempo quirúrgico, el dolor y los procesos inflamatorios. En este sentido, los extractores mínimamente traumáticos con extracción vertical tienen como objetivo preservar el hueso alveolar y proporcionar una recuperación más rápida y cómoda para el paciente. Objetivo: Evaluar la efectividad del Kit de Extracción Mínimamente Traumática Maximus® (Contagem, Minas Gerais, Brasil) en la extracción de raíces residuales de incisivos, caninos y premolares uniradiculares. Metodología: Es un ensayo clínico, prospectivo y analítico. Los pacientes fueron intervenidos con el dispositivo y se evaluaron datos demográficos, tiempo quirúrgico, dolor y comodidad después de la cirugía, así como el grado de satisfacción laboral con el uso del dispositivo. Para verificar diferencias significativas se utilizó la prueba de Mann-Whitney y la búsqueda de asociaciones se realizó mediante la prueba exacta de Fisher. Para todas las pruebas, la significancia se estableció en p <0,05. Resultados:Se retiraron cuarenta ítems, el tiempo quirúrgico promedió 16,28 minutos, los niveles de dolor y comodidad inmediatamente después de la cirugía permanecieron bajos (p<0,0001) y el grado de satisfacción laboral se mantuvo alto (p<0,0001). La tasa de éxito del dispositivo fue del 93,3% para los elementos incisivos y del 20% para los elementos caninos y premolares (p<0,0001).Conclusiones: La efectividad del extractor está determinada por el tamaño de la superficie radicular cubierta por fibras periodontales y la ubicación del diente. Sin embargo, puede resultar muy adecuado para planificar la rehabilitación con implantes en la región anterior del maxilar y la mandíbula (AU).

Effect of FGF-2 and sciatic nerve grafting on ChAT expression in dorsal root ganglia neurons of spinal cord transected rats.

Neurotrophic factors and peripheral nerves are known to be good substrates for bridging CNS trauma. The involvement of fibroblast growth factor-2 (FGF-2) activation in the dorsal root ganglion (DRG) was examined following spinal cord injury in the rat. We evaluated whether FGF-2 increases the ability of a sciatic nerve graft to enhance neuronal plasticity, in a gap promoted by complete transection of the spinal cord. The rats were subjected to a 4mm-long gap at low thoracic level and were repaired with saline (Saline or control group, n=10), or fragment of the sciatic nerve (Nerve group, n=10), or fragment of the sciatic nerve to which FGF-2 (Nerve+FGF-2 group, n=10) had been added immediately after lesion. The effects of the FGF-2 and fragment of the sciatic nerve grafts on neuronal plasticity were investigated using choline acetyl transferase (ChAT)-immunoreactivity of neurons in the dorsal root ganglion after 8 weeks. Preservation of the area and diameter of neuronal cell bodies in dorsal root ganglion (DRG) was seen in animals treated with the sciatic nerve, an effect enhanced by the addition of FGF-2. Thus, the addition of exogenous FGF-2 to a sciatic nerve fragment grafted in a gap of the rat spinal cord submitted to complete transection was able to improve neuroprotection in the DRG. The results emphasized that the manipulation of the microenvironment in the wound might amplify the regenerative capacity of peripheral neurons.

Associação de hábitos parafuncionais e DTM em pacientes classe II / Association of parafunctional habits and TMD class II patients

Introdução: A Disfunção Temporomandibular (DTM) é a dor orofacial crônica mais comum, encontrada por dentistas e outros profissionais de saúde. Sua etiologia tem caráter multifatorial, e pode envolver, desde fatores hereditários, hábitos parafuncionais, maloclusões, até ansiedade e estresse. Objetivo: Este estudo investigou a frequência da DTM e a sua relação entre hábitos parafuncionais em uma população de pacientes classe II esquelética. Método: Uma amostra composta por pacientes classe II esquelética foi selecionada de forma não probabilística. Setenta e três indivíduos concordaram em participar da pesquisa, se submetendo ao exame físico que consistia na aplicação do Eixo I do (RDC/TMD). Resultados: Quarenta e seis por cento dos pacientes examinados apresentaram diagnóstico positivo. A média de idade dos pacientes foi de 27 anos+ 8,73 anos, 82% do gênero feminino e 80% brancos. Trinta e quatro pacientes referiram alguma atividade parafuncional. Desses a onicofagia representou o grupo com maior frequência, seguido pelo bruxismo, interposição de objetos entre os dentes e por último o apertamento. As variáveis não apresentaram associação estatisticamente significante com o desfecho primário estudado. Conclusão: Na amostra estudada não se observou associação entre a ocorrência de DTM e hábitos parafuncionais em pacientes classe II esquelética... (AU)

Introduction: Temporomandibular disorder (TMD) is the most common chronic orofacial pain, found by dentists and other health professionals. Its etiology has a multifactorial character, and may involve, from hereditary factors, parafunctional habits, malocclusions, to anxiety and stress. Objective: This study investigated the TMD frequency and its relationship among parafunctional habits in a population of skeletal class II patients. Method: A sample composed by a class II patients was selected in a non probabilistic manner. Seventy-three members agreed to participate in the research, submitting themselves to a physical examination that consists in the application of Axis I (RDC/TMD). Results: Forty-six percent of patients diagnosed with a positive diagnosis. The average age of the patients was 27 years ± 8.73 years, 82% female and 80% white. Thirty-four patients reported some parafunctional activity. Of these, biting nail represented the group most frequently, followed by bruxism, interposition of objects between the teeth and lastly clenching. As variables did not present a statistically significant association with the primary outcome studied. Conclusion: In the sample studied, it is observed that there is no association between TMD occurrence and parafunctional habits in skeletal class II patients... (AU)

Prevalência do consumo de substâncias psicoativas entre estudantes de medicina no interior do Nordeste brasileiro / Prevalence of consumption of psychoactive substances among medicine students in the interior of Northeastern Brazil

Resumo: Introdução: No contexto da formação em Medicina, muitos estudantes buscam alívio e equilíbrio emocional por meio do uso de substâncias psicoativas. Objetivo: Este estudo teve como objetivo avaliar o consumo de substâncias psicoativas entre os acadêmicos de Medicina da Faculdade de Ciências da Saúde da Universidade do Estado do Rio Grande do Norte (UERN) com o intuito de contribuir para a formulação de atividades de prevenção. Método: A pesquisa possui corte transversal e abordagem quantitativa e descritiva. Aplicaram-se questionários padronizados entre outubro e dezembro de 2020 para discentes do primeiro ano e do internato. Analisaram-se variáveis de natureza categórica por meio de frequências e percentuais, e a relação entre essas variáveis foi realizada pelo teste qui-quadrado ou exato de Fisher. As associações e comparações, em relação aos períodos, foram consideradas significativas no caso de p-valor < 0,05. Resultado: A prevalência do uso de substâncias psicoativas na vida foi de 81,7% (n = 107). O consumo de tabaco e Cannabis foi significativamente maior em mulheres em relação aos homens: p = 0,019 e p = 0,05, respectivamente. Além disso, 48,4% dos discentes que têm insônia, 85,7% dos que relataram possuir dependência e 39% dos que acreditam que cursar Medicina é fator precipitante de consumo fazem uso de ansiolíticos, sedativos e hipnóticos: p = 0,025, p = 0,004 e p = 0,01, respectivamente. Conclusão: Observaram-se um elevado uso de substâncias psicoativas entre os estudantes de Medicina da UERN e a manutenção do perfil de uso ao longo dos períodos do curso com a presença de achados atípicos que divergiram de outros trabalhos, evidenciando a heterogeneidade das populações estudantis médicas, o que aponta para a necessidade de mais estudos para ampliação e análise dos resultados encontrados.

Abstract: Introduction: In the context of medical training, many students seek relief and emotional balance through the use of psychoactive substances. Objective: This study aimed to evaluate the consumption of psychoactive substances among medical students at the Faculty of Health Sciences, State University of Rio Grande do Norte, with the aim of contributing to the formulation of prevention activities. Method: This cross-sectional study adopted a quantitative and descriptive approach. Standardized questionnaires were applied between October and December 2020 for first-year and internship students. Categorical variables were analyzed using frequencies and percentages and the relationship between these variables was performed using the chi-square test or Fisher's exact test. Associations and comparisons, in relation to the study periods, were considered significant in the case of p-value < 0.05. Results: The lifetime prevalence of psychoactive substance use was 81.7% (n = 107). Tobacco and cannabis consumption was significantly higher in women compared to men, p = 0.019 and p = 0.05, respectively. Furthermore, 48.4% of the students who suffer from insomnia, 85.7% of those who reported being substance-dependant, and 39% of those who believe that studying medicine is a precursor for consumption, make use of anxiolytics, sedatives, and hypnotics, p = 0.025, p = 0.004 and p = 0.01, respectively. Conclusion: A high use of psychoactive substances was found among medical students at the State University of Rio Grande do Norte and the use profile maintained throughout the course included atypical findings that diverged from other studies, demonstrating the heterogeneity of medical student populations, which points to the need for more studies to expand and analyze the results found.

Simulação clínica no desempenho cognitivo, satisfação e autoconfiança na aprendizagem: estudo quase-experimental / Simulacro clínico en el rendimiento cognitivo, satisfacción y autoconfianza en el aprendizaje: estudio cuasi experimental / Clinical simulation in cognitive performance, satisfaction and self-confidence in learning: a quasi-experimental study

Resumo Objetivo: Analisar o conhecimento cognitivo, a satisfação e a autoconfiança de estudantes de enfermagem a partir do uso da simulação no ensino de consulta de enfermagem em vacinação no contexto da enfermagem comunitária. Métodos: Estudo de intervenção, quantitativo, compreendido em duas fases. Foi utilizado o delineamento quase-experimental de grupo controle não equivalente do tipo pré-teste e pós-teste. Foram respeitados todos os aspectos éticos. A amostra final foi composta por 94 estudantes de enfermagem portugueses. Os estudantes foram alocados em dois grupos: controle e experimental. O grupo controle teve acesso a uma aula de habilidade tradicional. O grupo experimental participou de uma sessão de simulação com dois casos. Além da caracterização sociodemográfica, os estudantes responderam a um pré-teste e pós-teste para aferir o desempenho cognitivo. Além disso, foi aplicada uma escala de satisfação e autoconfiança na aprendizagem. Adotou-se um nível de significância de 5%. Resultados: Dos 94 estudantes, (95,7%) são do sexo feminino, com faixa etária entre 18 e 20 anos (91,5%), solteiros (98,9%), sem vínculo laboral (94,7%). A partir da simulação clínica os estudantes aprendem mais quando comparado aos estudantes que participaram da estratégia tradicional (p valor = 0,000). Além disso, a simulação clínica promove satisfação entre os estudantes. Conclusão: Por ser uma estratégia de ensino e aprendizagem que permite um melhor desempenho cognitivo, por gerar satisfação nos estudantes, a simulação clínica pode ser apontada como uma estratégia potencial para o ensino em enfermagem comunitária.

Resumen Objetivo: Analizar el conocimiento cognitivo, la satisfacción y la autoconfianza de estudiantes de enfermería a partir del uso de simulacro en la enseñanza de consulta de enfermería en vacunación, en el contexto de enfermería comunitaria. Métodos: Estudio experimental, cuantitativo, realizado en dos fases. Se utilizó el diseño cuasi experimental de grupo de control no equivalente tipo pretest y postest. Se respetaron todos los aspectos éticos. La muestra final estuvo compuesta por 94 estudiantes de enfermería portugueses. Los estudiantes fueron separados en dos grupos: control y experimental. El grupo de control tuvo acceso a una clase de habilidad tradicional. El grupo experimental participó en una sesión de simulacro con dos casos. Además de la caracterización sociodemográfica, los estudiantes respondieron un pretest y postest para determinar el rendimiento cognitivo. También se aplicó una escala de satisfacción y autoconfianza en el aprendizaje. Se adoptó un nivel de significación de 5 %. Resultados: De los 94 estudiantes, el 95,7 % era de sexo femenino, del grupo de edad entre 18 y 20 años (91,5 %), solteros (98,9 %), sin vínculo laboral (94,7 %). A partir del simulacro clínico, los estudiantes aprendieron más en comparación con los estudiantes que participaron de la estrategia tradicional (p valor = 0,000). Además, el simulacro clínico promueve la satisfacción de los estudiantes. Conclusión: Por ser una estrategia de enseñanza y aprendizaje que permite un mejor rendimiento cognitivo, por generar satisfacción en los estudiantes, el simulacro clínico puede indicarse como una estrategia potencial para la enseñanza de enfermería comunitaria.

Abstract Objective: To analyze the cognitive knowledge, satisfaction and self-confidence of nursing students based on simulation use in teaching nursing consultation in community nursing vaccination. Methods: An intervention and quantitative study comprised in two phases. A quasi-experimental design of a control group not equivalent to the pre- and post-test type was used. All ethical aspects have been respected. The final sample consisted of 94 Portuguese nursing students. They were allocated into two groups: control and experimental. The control group had access to a traditional skill class. The experimental group participated in a simulation session with two cases. In addition to the sociodemographic characterization, the students answered a pre- and post-test to measure cognitive performance. Moreover, satisfaction and self-confidence in learning scale was applied. A significance level of 5% was adopted. Results: Of the 94 students, 95.7% were female, 91.5% were aged between 18 and 20 years, 98.9% were single and 94.7% were unemployed. From the clinical simulation, students learn more when compared to students who participated in the traditional strategy (p value = 0.000). Furthermore, clinical simulation promotes satisfaction among students. Conclusion: Since it is a teaching and learning strategy that allows a better cognitive performance, and because it generates satisfaction among students, clinical simulation can be pointed out as a potential strategy for teaching in community nursing. Universal Trial Number: U1111-1227-2241

Prevalência e fatores associados ao deficit cognitivo em idosos na comunidade / Prevalence and associated factors to the cognitive deficit in community-dwelling elderly

Resumo Objetivo Estimar a prevalência do deficit cognitivo e verificar associações com variáveis sociodemográficas e de saúde em idosos de Unidades Básicas de Saúde (UBSs) de uma cidade no interior do nordeste brasileiro. Método Estudo transversal de prevalência e associação a respeito da população idosa. Os instrumentos utilizados para coleta dos dados foram Miniexame do Estado Mental (função cognitiva), Escala de Depressão Geriátrica Abreviada (sintomas depressivos), Escala de Lawton (capacidade funcional), Miniavaliação Nutricional (estado nutricional) e teste Timed Get Up and Go (risco de quedas). A associação bivariada entre o deficit cognitivo e as variáveis independentes foi avaliada pelo teste qui-quadrado. A análise multivariada foi feita usando um modelo de regressão logística com as razões de prevalência (RP) e intervalo de confiança de 95% (IC95%). Resultados Foram avaliados 818 idosos. A prevalência de deficit cognitivo foi de 65,9% (IC95%=62,50 - 69,10). Ao compor o modelo de análise multivariada, verificou-se maior ocorrência de deficit cognitivo em indivíduos mais velhos (RP=1,48; IC95%=1,07-2,05), funcionalmente dependentes (RP=3,27; IC95%=2,01-5,10), analfabetos (RP=1,66; IC95%=1,15-2,40) e com risco de desnutrição ou desnutridos (RP=2,09; IC95%=1,47-2,96). Conclusão O presente trabalho evidenciou alta prevalência de deficit cognitivo e que foi associada à idade, escolaridade, capacidade funcional e estado nutricional. É possível questionar se isso se deve à grande quantidade de pessoas com comprometimento cognitivo leve sem demência com remissão posterior dos sintomas, ou pela ocorrência de demência de início precoce.

Abstract Objective To estimate the prevalence of cognitive deficit and verify associations with sociodemographic and individual health variables in senior patients from units in the primary health system. Method Prevalence and association study about the elderly population. The instruments used were the Mini-Mental State Examination (cognitive function), Shorten Geriatric Depression Scale (depression symptoms), Lawton Scale (functional capacity), Mini-Nutritional Assessment (nutritional state), and Timed Up and Go Test (fall risk). The association between cognitive deficit and independent variables was verified by the Chi-square test. Multivariate analysis was performed using a logistic regression model with the prevalence ratio (PR) and 95% confidence interval (95%CI). Results The data were collected from 818 old-aged patients. The cognitive deficit had a prevalence of 65.9% (95%CI= 62.50-69.10). In the multivariate analysis model, it was verified a larger occurrence of cognitive deficit individuals, with risks of malnutrition (PR=2.09; CI95%=1.47-2.96), illiteracy (PR=1.66; 95%CI=1.15-2.40), dependents (PR=3.27; 95%CI=2.01-5.10), and with more than 70 years old (PR=1.48; 95%CI=1.07-2.05). Conclusion The present study showed a high prevalence of cognitive deficit and was associated with age, education, functional capacity, and nutritional status. It is possible to question if it is caused by the big amount of people with mild cognitive impairment without dementia with posterior remission of the symptoms, or by the occurrence of early start dementia.

Occupation and factors associated with exposure to the sun among beach workers.

Subjects were selected from five urban beaches to characterize the type of work conducted on urban beaches in the city of Natal, state of Rio Grande do Norte, Brazil, and determine potential associated factors among workers exposed to the sun. Data collection was based on a validated questionnaire. Results were obtained for 362 workers. Individuals were predominantly male (72.6%) who worked under direct exposure to the sun (87.8%). Almost 95% had no more than 6 years of schooling and 87.91% earned an average monthly income of $318.75 dollars or more. Photoprotection was reported by 80.1%, among which sunscreen and caps/hats were predominant. Around 25% smoked and more than half did not consume alcohol. Male gender, no more than 6 years of schooling, daily exposure for up to 6 hours and use of photoprotection were the factors associated with the outdoor work category.

Adoption of photoprotection measures on lip and perioral regions among beach workers in North Brazil.

BACKGROUND: Workers from various occupational groups stand out as being more susceptible to photodamage. Behaviors that can reduce the risk of onset of these disorders include the limitation or reduction of sun exposure, use of photoprotective clothing, and correct use of sunscreen. The present study aimed to verify the use of photoprotection measures by beach workers on the lips and perioral regions, as well as investigate possible associations with sociodemographic, occupational, and health variables. MATERIALS AND METHODS: For this purpose, calibrated researchers applied validated questionnaires. The participants were 362 beach workers with a minimum age of 18 years. Data were analyzed using chi-square tests and robust Poisson regression. RESULTS: In regard to photoprotection measures, most of the population studied reported using some form of protection (80.1%). Among these, the most common were the use of a cap/hat (66.2%) and sunscreen (41.6%). Applying lipstick (3.6%) and using some other measure (4.2%) were the least reported. When compiling a multivariate analysis model, type of work (P = 0.001) was the only variable that explained the adoption of photoprotection measures, regardless of daily and accumulated exposure and the presence of habits. CONCLUSIONS: In general, most workers reported using some form of photoprotection in the oral and perioral regions, and those exposed to direct solar radiation effectively confirmed this.

Condição dentária de pacientes com disfunção temporomandibular / Dental condiction of patients with temporomandibular dysfunction / Condición dental de pacientes con disfunción temporomandibular

RESUMO Objetivo Avaliar a condição dentária e a dimensão vertical em pacientes portadores de DTM, bem como a idade e origem da DTM. Metodologia Realizou-se um estudo descritivo, observacional de corte transversal, com uma amostra de trinta pacientes com DTM, diagnosticado pelo Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Esta amostra foi determinada através de estimativas de atendimento, desta forma, uma amostra de conveniência. A associação entre o gênero, idade, dimensão vertical e condição dentária com DTM foram verificadas através do teste estatístico qui-quadrado, com intervalos de confiança de 95%. Resultados Constatou-se que 26 pacientes eram do sexo feminino e 4 do sexo masculino. Quinze sujeitos apresentaram idade inferior a 36,5 anos. Quanto a origem da DTM, 19 sujeitos tinham desordem articular, e 11 muscular. Determinou-se que não houve associação estatisticamente significante entre as variáveis independentes com a DTM. Conclusão Os fatores etiológicos analisados isoladamente parecem não influenciam de forma única no desenvolvimento da DTM, mas poderão atuar em conjunto com outros fatores, já que a sua causa é multifatorial.(AU)

ABSTRACT Objective To evaluate the dental condition and the vertical dimension in patients with TMD, and the age and origin of the DTM. Methods Was performed a descriptive study, observational, cross-sectional, with a sample of thirty patients with TMD, diagnosed by Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). This sample was determined based on estimates the service thus a sample of convenience. The association between gender, age, vertical dimension and dental condition with TMD were verified using the chi-square statistical test with 95% confidence intervals. Results It found that 26 patients were female and 4 males. Fifteen subjects presented aged below 36.5 years. How much the origin of the DTM, 19 subjects had articular disorder, and 11 muscle disorder. Has been determined that there was no statistically significant association between the independent variables with the DTM. Conclusion The etiological factors analyzed in isolation do not seem to influence in a unique way in the development of TMD, but may act together with other factors, because the cause is multifactorial.(AU)

RESUMEN Objetivo Evaluar la condición dental y la dimensión vertical en pacientes portadores de DTM, así como la edad y origen de la DTM. Metodología Se realizó un estudio descriptivo, observacional de corte transversal, con una muestra de treinta pacientes con DTM, diagnosticado por el Research Diagnostic Criteria para desórdenes temporomandibulares (RDC / TMD). Esta muestra se determinó a través de estimaciones de atención, a través de una muestra de conveniencia. La asociación entre el género, la edad, la dimensión vertical y la condición dental con DTM se verificó mediante la prueba estadística chi-cuadrado, con intervalos de confianza del 95%. Resultados Se constató que 26 pacientes eran del sexo femenino y 4 del sexo masculino. 15 sujetos presentaron una edad inferior a 36,5 años. En cuanto al origen de la DTM, 19 sujetos tenían desorden articular, y 11, muscular. Se determinó que no hubo asociación estadísticamente significativa entre las variables independientes con la DTM. Conclusión Los factores etiológicos analizados aisladamente parecen no influenciar de forma única en el desarrollo de la DTM, pero podrán actuar en conjunto con otros factores, ya que su causa es multifactorial.(AU)

Lisura superficial do amálgama frente a técnicas de polimento / Amalgam surface smoothness as regards techniques of polishing

Introdução: uma superfície polida aumenta a resistência, a compressão, a corrosão e as fraturas marginais do amálgama. Objetivo: o presente estudo avalia a eficácia de quatro técnicas de polimento em restaurações de amálgama quanto à capacidade de promover lisura superficial nas mesmas, e se entre elas, existe, alguma mais eficaz em comparação às demais. Método: neste experimento, realizaram- -se polimentos em 60 corpos de prova de amalgama divididos em 4 grupos, de acordo com a técnica de polimento: taça de borracha +pedra pomes; pontas de silicone abrasiva; pontas de silicone abrasiva + pedra pomes; taça de borracha, pedra pomes + pontas de silicone abrasiva. Mensurou-se a rugosidade superficial em micrômetros, computando os dados em Microsoft Excel e submetendo-os ao teste de Kruskal-Wallis. Resultados e Conclusão: após a avaliação dos resultados, constatou-se que houve diferença estatisticamente significante entre uma das técnicas em relação às dos demais grupos: o tratamento feito com o grupo pontas de silicone abrasivas apresentou a melhor lisura de superfície.

Introduction: a polished surface increases the compression resistance, corrosion and marginal fractures of amalgam. Objective: the present study evaluates the effectiveness of four techniques for polishing in amalgam restorations, as well as its ability to promote surface smoothness in it, and if among them is there any more effective when compared to another. Methods: in the experimental phase, was carried out polishes in 60 specimens of amalgam, divided into four groups by the technique of polishing: rubber cup and pumice stone; abrasive silicone tips; abrasive silicone tips and pumice stone; rubber cup, pumice stone and abrasive silicone. Surface roughness was measured in micrometres, computing the data in Microsoft Excel and subjecting it to the Kruskal-Wallis test. Results and conclusion: the evaluation of the results showed that there was a difference statistically significant between one of the techniques regarding the other ones: the treatment done by the group of abrasive silicone tips presented the best smoothness of the surface.

Serotonergic fibers distribution in the midline and intralaminar thalamic nuclei in the rock cavy (Kerodon rupestris).

The thalamic midline/intralaminar complex is part of the higher-order thalamus, which receives little sensory input, and instead forms extensive cortico-thalamo-cortical pathways. The midline thalamic nuclei connect with the medial prefrontal cortex and the medial temporal lobe. On the other hand, the intralaminar nuclei connect with the fronto-parietal cortex. Taking into account this connectivity pattern, it is not surprising that the midline/intralaminar complex has been implicated in a broad variety of cognitive functions, including memory process, attention and orientation, and also reward-based behavior. Serotonin (5-HT) is a neurotransmitter that exerts different post-synaptic roles. Serotonergic neurons are almost entirely restricted to the raphe nuclei and the 5-HT fibers are distributed widely throughout the brain, including the midline/intralaminar complex. The present study comprises a detailed description of the morphologic features and semiquantitative analysis of 5-HT fibers distribution in the midline/intralaminar complex in the rock cavy, a typical rodent of the Northeast region of Brazil, which has been used by our group as an anatomical model to expand the comprehension about phylogeny on the nervous system. The 5-HT fibers in the midline/intralaminar nuclei of the rock cavy were classified into three distinct categories: (1) beaded fibers, which are relatively fine and endowed with large varicosities; (2) fine fibers, with thin axons and small varicosities uniformly distributed in whole axon; and (3) stem axons, showing thick non-varicose axons. Moreover, the density of 5-HT fibers is variable among the analyzed nuclei. On the basis of this diversity of the morphological fibers and the differential profile of optical density among the midline/intralaminar nuclei of the rock cavy, we conclude that the serotonergic system uses a diverse morphologic apparatus to exert a large functional repertory in the midline/intralaminar thalamic nuclei.

Perfil Epidemiológico das Malformações Congênitas em Recém-Nascidos no Estado do Rio Grande do Norte no Período de 2004 a 2011 / The Epidemiological Profile of Congenital Malformations in Newborns from Rio Grande do Norte State from 2004 to 2011

Objetivo: Traçar um perfil epidemiológico das malformações congênitas (MCs) em recém-nascidos (RNs) no Estado do Rio Grande do Norte no período de 2004 a 2011. Metodologia: Estudo descritivo-quantitativo com base em dados secundários do Sistema de Informações sobre Nascidos Vivos (SINASC), no qual foram avaliados dados referentes a ocorrência de malformações congênitas em RNs do Rio Grande do Norte no período de 2004 a 2011. Foi realizada uma análise descritiva de todos os dados relativos às variáveis sociodemográficas, maternas e assistenciais e em seguida foi construído o mapa temáticos. Resultados e conclusões: As MCs foram observadas em 2.305 (0,58%) RNs, e predominaram entre as mães que eram solteiras (61,41%), com idade entre 20-24 anos (27,24%), com grau de escolaridade de 8-11 anos de estudo (40,24%), que tinham realizado mais do que 7 consultas de pré-natal (42,75%) e que tiveram seus filhos com 37-41 semanas (74,1%). O sistema osteomuscular foi o mais acometido (24,97%), seguido pelas deformidades congênitas dos pés (20%) e outras malformações do sistema nervoso (13,16%). O estudo permite conhecer as características epidemiológicas de malformação congênita em recém-nascidos, sendo útil o planejamento de ações para com esse grupo. Diante disso, faz-se necessário a adoção de medidas de prevenção, assistência e políticas públicas voltadas para este aspecto da saúde materno-infantil. Além de melhoria na qualidade dos serviços de diagnóstico. (AU)

Objective: To describe the epidemiological profile of congenital malformations (CM) in newborns (NB) from Rio Grande do Norte state from 2004 to 2011. Methods: This was a descriptive and quantitative study using secondary data from the Information System on Live Births (Sistema de Informações sobre Nascidos Vivos, SINASC). The data addressed occurrences of congenital malformations in newborns from Rio Grande do Norte state from 2004 to 2011. A descriptive analysis of sociodemographic, maternal and health care variables was carried out and the thematic map was constructed. Results and Conclusions: CMs were observed in 2,305 (0.58%) NBs, and prevailed among single mothers (61.41%), aged from 20 to 24 years old (27.24%), having 8-11 years of schooling (40.24%), who had had more than 7 prenatal consultations (42.75%) and had given birth after 37-41 weeks of pregnancy (74.1%). The musculoskeletal system was the most affected component (24.97%), followed by congenital deformities of feet (20%) and other malformations of the nervous system (13.16%). This study describes the epidemiological characteristics of congenital malformations in newborns and may be useful for action planning. It is necessary to adopt prevention and healthcare measures along with public policies focused on this aspect of mother-child health, besides improving the quality of diagnostic services. (AU)