Diagnóstico e notificação de casos de violência contra crianças e adolescentes: conhecimento de estudantes de Odontologia / Diagnosis and reporting of cases of violence against children and adolescents: knowledge of dental students

O objetivo desse estudo foi avaliar o conhecimento de estudantes de Odontologia acerca do diagnóstico e da notificação em casos de violência contra crianças e adolescentes (VCA). Trata-se de um estudo transversal, descritivo e exploratório realizado com os estudantes (n=100) que cursavam oitavoe décimo períodos no semestre 2018.1, dos turnos diurno e noturno do curso de Odontologia do Nordeste brasileiro.Os dados foram coletados por meiodequestionárioautoaplicável, composto por 22 perguntas. Os dados foram tabulados e analisadossegundo estatística descritiva e teste de associação entre as variáveis, considerando p-valor <0,05 como significância estatística. A importância do tema foi reconhecida pela quase totalidade dos estudantes(99,0%), no entanto,menos da metade (45,0%) considerou que as informações recebidas na graduação foram suficientes. Destaca-se, porém, que os estudantes demonstraram conhecimento razoável do assunto,com percentual de acertos de 75,27%. Não houve diferença significativa entre o número de acertos dos alunos do oitavo e décimo períodos. Embora 85,0% dos estudantes afirmaram que a conduta correta em caso suspeito de VCA seja fazer denúncia ao Conselho Tutelar da localidade, menos da metade afirmou conhecer a ficha de notificação específica e apenas 10,0% conheciam que a pena para os profissionais que não notificarem é multa de 3 a 20 salários de referência. Conclui-se que os estudantes apresentaram conhecimento satisfatório no que diz respeito ao diagnóstico de VCA e domínio sobre os meios de denúncia para notificação específica (AU).

The aim of this study was to evaluate the knowledge of dental students about the diagnosis and notification in cases of violence against children and adolescents (VCA). This is a cross-sectional, descriptive and exploratory study conducted with dental students (n = 100) attending the eighth and tenth periods, between March and June 2018, at an undergraduate dental program in a northeastern Brazilian city. Data were collected through a self-administered questionnaire consisting of 22 questions. Data were tabulated and analyzed according to descriptive statistics and association test between variables, considering a p-value <0.05 as statistically significant. The importance of the topic was recognized by almost all students (99.0%); however, less than half (45.0%) considered that the information received during the undergraduate course was sufficient. It is noteworthy that the students demonstrated reasonable knowledge of the subject, with a percentage of correct answers of 75.27%. There was no significant difference regarding the number of correct answers between the eighth-and tenth-period students. Although 85.0% of students said that the correct conduct in case of suspected VCA is to report them to the local Guardianship Council, less than half said they knew the specific notification form and only 10.0% knew that the penalty for professionalswho do not notify these cases is a fine ranging from 3 to 20 minimum wages. It was concluded that the students demonstrated satisfactory knowledge regarding the diagnosis of VCA and knew about the means of reporting these cases (AU).

An analysis of prehospital care for victims of accidents and violence in Recife, Brazil.

OBJECTIVES: This study was aimed at carrying out a situational diagnosis of the prehospital healthcare network for victims of accidents and violence in Recife, Brazil. METHODS: National policy for reducing accident- and violence-related morbidity and mortality was used as reference. Questionnaires were applied and half-structured interviews conducted with managers and healthworkers from thirteen prehospital fixed units and one mobile unit. RESULTS: Children, adolescents and females predominantly sought attention; there were few preventative actions, little social coverage and deficient referral, counterreferral and communication with other sectors. A lack of equipment and basic materials, insufficient multidisciplinary teams and the need for ongoing training were also observed. Notifying and recording accidents and violence also lacked precision; ensuring that these were done properly would allow track to be kept of them as well as developing a proper assessment and action plan. However, important state, city and academic initiatives towards preventing and reducing morbidity and mortality caused by accidents and violence in particular municipalities were identified. CONCLUSIONS: Taking national policy for reducing accident- and violence-related morbidity and mortality as a point of reference, then it can be seen that some advances have been made in the city of Recife; however, many shortcomings can still be seen in terms of introducing such policy.

An analysis of prehospital care for victims of accidents and violence in Recife, Brazil / Análisis de la atención prehospitalaria proporcionada a las víctimas de accidentes y violencia en Recife, Brasil

Objectives This study was aimed at carrying out a situational diagnosis of the prehospital healthcare network for victims of accidents and violence in Recife, Brazil. Methods National policy for reducing accident- and violence-related morbidity and mortality was used as reference. Questionnaires were applied and half-structured interviews conducted with managers and healthworkers from thirteen prehospital fixed units and one mobile unit. Results Children, adolescents and females predominantly sought attention; there were few preventative actions, little social coverage and deficient referral, counterreferral and communication with other sectors. A lack of equipment and basic materials, insufficient multidisciplinary teams and the need for ongoing training were also observed. Notifying and recording accidents and violence also lacked precision; ensuring that these were done properly would allow track to be kept of them as well as developing a proper assessment and action plan. However, important state, city and academic initiatives towards preventing and reducing morbidity and mortality caused by accidents and violence in particular municipalities were identified. Conclusions Taking national policy for reducing accident- and violence-related morbidity and mortality as a point of reference, then it can be seen that some advances have been made in the city of Recife; however, many shortcomings can still be seen in terms of introducing such policy.

Objetivo El objetivo de este estudio fue realizar un diagnóstico situacional de la atención prehospitalaria proporcionada por el sistema de salud de la ciudad de Recife a las víctimas de accidentes y violencia, utilizandose como referencia la Política Nacional de Reducción de la Mortalidad y la Morbilidad por Accidentes y Violencia. Métodos Se aplicaron cuestionarios y se llevaron a cabo entrevistas semiestructuradas con los directores y profesionales de trece unidades hospitalarias fijas y móviles de un hospital. Resultados Hubo predominio de la atención a niños, niñas y adolescentes y a las mujeres; se observó escasas acciones de prevención, insuficiente cobertura de atención al público, deficientes sistemas de referencia y contrarreferencia; ausencia de articulación extra-sectorial; falta de equipo básico y suministros; disponibilidad de equipo multiprofesional, pero, con poca calificación; registro y comunicación pobres sobre la violencia y los accidentes para su control, vigilancia y planificación de las acciones. Sin embargo, fueron identificadas importantes iniciativas provinciales, municipales y académicas dirigidas a la prevención y la reducción de la morbilidad por accidentes y violencia en la ciudad. Conclusiones Tomando como un punto de referencia la Política Nacional de Reducción de la Mortalidad y la Morbilidad por Accidentes y Violencia, algunos avances y muchos defectos pueden ser vistos en términos de la introducción de esta política en la ciudad de Recife.

Risco e atividade de cárie em crianças com e sem infecção pelo HIV / Caries risk and activity in HIV infected children and their controls

Objetivo: Determinar os fatores de risco e a prevalência de cárie em um grupo de crianças infectadas pelo HIV (GI), e em crianças sem evidência clínica de imunossupressão (GII). Métodos: Foram avaliados 133 pacientes de um Ambulatório de AIDS Pediátrica do Rio de Janeiro e 85 pacientes da Clínica de Odontopediatria da mesma instituição. Os responsáveis foram entrevistados, respondendo a questões sobre higiene bucal, dieta e medicação. As crianças foram examinadas, para determinação do índice de cárie (ceo/CPOD). O teste de Mann-Withney verificou a associação entre as variáveis, com significância de 5%. Resultados: Os dois grupos (GI: 6,8 e GII: 8,1 anos de idade) não apresentaram diferença significante no ceo/CPOD (ceo: 6,4 e 8,0; CPOD: 1,0 e 1,4 para GI e GII respectivamente). O GII apresentou mais elementos restaurados (p<0,05), assim como maior frequência de escovação (p<0,05). Nos dois grupos verificou-se que a maioria das crianças realizava escovação sem a supervisão de um adulto. Observou-se associação significante entre o ceo e o hábito de ingestão de sacarose entre as refeições no GII, embora no GI o hábito de ingestão de sacarose entre as refeições tenha sido maior (p<0,05). Foi constatado que 78,9% das crianças do GI faziam uso da terapia antirretroviral combinada, e que a forma de administração da medicação apresentou alto potencial cariogênico (45,1%). Conclusão: Os dois grupos apresentaram exposição a fatores de risco e alta prevalência de cárie. O hábito de ingestão de sacarose entre as refeições, em crianças sem evidência clínica de imunossupressão, demonstrou-se importante, associado à alta prevalência de cárie na dentição decídua.

Objective: To determine the risk factors and prevalence of caries in HIV infected children (GI) and in children with no evidence of immunosupression (GII). Methods: One hundred and thirty-three patients of a Pediatric AIDS Ambulatorial Service in Rio de Janeiro and 85 patients of a Pediatric Dentistry Service were examined. The patient´s guardians were interviewed, and provided information about children´s oral higyene, use of medication and dietary habits. The children were examined to determine DMFT and dmft indexes. The Mann-Whitney test was performed ata level of significance of 5%. Results: The two groups (mean age: G1=6.8 years, GII=8.1 years) showed no significant difference in dmft/DMFT indexes (dmft: 6.4 and 8.0; DMFT: 1.0 and 1.4 for GI and GII), but GII showed a higher number of restored teeth (p<0.05). GII showed also a higher frequency of toothbrushing (p<0.05), and in both groups, most of the children brushed their teeth withouth any adult supervision. Sucrose ingestion between meals was higher for GI (p<0.05). In GI 78.9% had been using combined antiretroviral therapy and the cariogenic potential of thetherapy administration classified as high was the most frequently observed (45.1%). Significant association was observed only between dmft and sucrose ingestion in GII. Conclusion: GI and GII were exposed to risk factors for a high caries prevalence. The habit of sucrose ingestion between meals was considered an important factor associated with the high prevalence of caries in deciduous dentition in children with no clinical signs of immunosupression.

Cessation of dental development in a child with idiopathic hypoparathyroidism: a 5-year follow-up.

Idiopathic hypoparathyroidism is a rare endocrinopathy whose origin is unknown, and which is characterized by a deficiency of parathyroid hormone causing low serum calcium and high serum phosphorus concentrations. Disorders of ectodermal tissues are common in this pathology, and enamel hypoplasia is the most frequently found dental pathology. This article describes the case of a 9-year-old child with hypoparathyroidism that had gone undiagnosed for 6 years. The permanent dentition showed enamel hypoplasia, delayed eruption, and cessation of root formation (i.e., shortened roots), resulting from nontreated hypocalcemia during the developmental phase of the dentition.

Premature loss of primary teeth associated with congenital syphilis: a case report.

Congenital syphilis is an infectious disease transmitted by an infected mother to her fetus. Several reports in the literature have focused on oral manifestations of congenital syphilis, mainly about Hutchinson's teeth and dysplastic molars, which are more common. However, this paper describes an unusual feature of congenital syphilis in a four-year-old child. A case of premature loss of primary teeth associated with congenital syphilis is reported.