Brazilian Dysphonia Screening Tool (Br-DST): An Instrument Based on Voice Self-Assessment Items.

OBJECTIVE: To propose a short instrument for the screening of dysphonia in the Brazilian population through the investigation of traditional voice self-assessment instrument items. METHODS: We analyzed the medical records of 139 individuals with an average age of 37.4 years and a minimum and maximum age of 18 and 77 years, respectively. The participants were classified as dysphonic (D) or non-dysphonic (ND) according to an analysis of the combination of vocal complaints and laryngological reports. Responses to the items of the following self-assessment instruments were collected: the Questionário de Qualidade de Vida em Voz - QVV (Voice-Related Quality of Life - V-RQOL), the Índice de Desvantagem Vocal - IDV (Voice Handicap Index - VHI) and the Escala de Sintomas Vocais - ESV (Voice Symptom Scale - VoiSS). These items were analyzed regarding their predictive capacities for dysphonia through logistic regression models. RESULTS: The model containing items of the QVV was not observed to be valid. The model for the IDV produced a set of three items (10, 13, and 14), and the ESV model showed two items (4 and 20) to be significant. A Global model combining the previous models shows that items I feel as though I have to strain to produce voice from the IDV and "Is your voice hoarse?" from the ESV are the most significant in the classification of the presence of dysphonia. This decision-making model was considered the most efficient to identify the dysphonia, with the highest level of accuracy compared to the other models investigated (83.4%). CONCLUSION: Dysphonia screening can be performed using a simple, rapid protocol with a high-efficiency index that includes two items taken from traditional voice self-assessment instruments.

Oral Mucositis in Pediatric Oncology Patients: A Nested Case-Control to a Prospective Cohort.

This study aimed to evaluate the factors associated with the occurrence of severe oral mucositis (SOM) in pediatric oncology patients during the chemotherapeutic treatment. This is a nested case-control to a prospective cohort that monitored 105 patients for 10 consecutive weeks after the beginning of the chemotherapy treatment. Logistic regression was used to identify the factors associated with SOM, by group of malignancy (hematologic or solid tumors) (Sig.=5%). To patients with hematologic tumors were found factors associated with SOM in two weeks of treatment: in the 6th week (increase in frequency of chemotherapy doses (OR=3.02)) and in the 7th week (female sex (OR=21.28); and increase in frequency of chemotherapy doses (OR=2.51)); and to patients with solid tumors were found factors associated with SOM in five weeks of treatment: in the 1st week (female sex (OR=14.43); age increase (OR=1.24)); in the 2nd week (Miscellany (OR=6.39)); in the 5th week (Antimetabolites (OR=17.44); Miscellany (OR=45.42); and platelets reduction (OR=1.12)); in the 6th week (creatinine increase (OR=1.63)); and in the 7th week (creatinine increase (OR=2.39)). For patients with hematologic tumors, to be female, and the increase in the frequency of chemotherapy doses increased the risk for SOM and for patients with solid tumors, to be female, the increase in age and in level blood concentration of creatinine, the reduction in number of platelets and the use of chemotherapy with miscellany and antimetabolites agents were associated with an increase in risk for occurrence of SOM.

Oral Mucositis in Pediatric Oncology Patients: A Nested Case-Control to a Prospective Cohort

Abstract This study aimed to evaluate the factors associated with the occurrence of severe oral mucositis (SOM) in pediatric oncology patients during the chemotherapeutic treatment. This is a nested case-control to a prospective cohort that monitored 105 patients for 10 consecutive weeks after the beginning of the chemotherapy treatment. Logistic regression was used to identify the factors associated with SOM, by group of malignancy (hematologic or solid tumors) (Sig.=5%). To patients with hematologic tumors were found factors associated with SOM in two weeks of treatment: in the 6th week (increase in frequency of chemotherapy doses (OR=3.02)) and in the 7th week (female sex (OR=21.28); and increase in frequency of chemotherapy doses (OR=2.51)); and to patients with solid tumors were found factors associated with SOM in five weeks of treatment: in the 1st week (female sex (OR=14.43); age increase (OR=1.24)); in the 2nd week (Miscellany (OR=6.39)); in the 5th week (Antimetabolites (OR=17.44); Miscellany (OR=45.42); and platelets reduction (OR=1.12)); in the 6th week (creatinine increase (OR=1.63)); and in the 7th week (creatinine increase (OR=2.39)). For patients with hematologic tumors, to be female, and the increase in the frequency of chemotherapy doses increased the risk for SOM and for patients with solid tumors, to be female, the increase in age and in level blood concentration of creatinine, the reduction in number of platelets and the use of chemotherapy with miscellany and antimetabolites agents were associated with an increase in risk for occurrence of SOM.

Resumo Este estudo objetivou avaliar os fatores associados com a ocorrência de mucosite oral grave (SOM) em pacientes pediátricos oncológicos durante o tratamento quimioterápico. Trata-se de um estudo de caso-controle aninhado a uma coorte prospectiva que monitorou 105 pacientes por 10 semanas consecutivas após o início do tratamento quimioterápico. Regressão logística foi utilizada para identificar os fatores associados com a MOG, por grupo de malignidade (tumores hematológicos ou sólidos) (Sig.=5%). Para pacientes com tumores hematológicos foram encontrados fatores associados com a MOG em duas semanas de tratamento: na 6ª semana (aumento na frequência de doses de quimioterapia (OR=3,02)) e na 7ª semana (sexo feminino (OR=21,28); e aumento na frequência de doses de quimioterapia (OR=2,51)); e para pacientes com tumores sólidos foram encontrados fatores associados com MOG em cinco semanas de tratamento: na 1ª semana (sexo feminino (OR=14,43), aumento na idade (OR=1,24)); na 2ª semana (Miscelânea (OR=6,39)); na 5ª semana (Antimetabólitos (OR=17,44); Miscelânea (OR=45,42); e redução de plaquetas (OR=1,12)); na 6ª semana (aumento na creatinina (OR=1,63)); e na 7ª semana (aumento na creatinina (OR=2,39)). Para pacientes com tumores hematológicos, ser do sexo feminino e o aumento na frequência de doses de quimioterapia aumentou o risco para MOG; e, para pacientes com tumors sólidos, ser do sexo feminino, o aumento na idade e nos níveis de concentração sanguínea de creatinina, a redução no número de plaquetas e o uso de quimioterapia com agentes das classes Miscelânea e Antimetabólitos estiveram associados com o aumento no risco para a ocorrência de MOG.

Oral health actions in the primary health care network of northeastern brazil in relation to oral cancer / Ações de saúde frente ao câncer bucal na atenção básica do nordeste brasileiro

ABSTRACT Objective: To describe oral health actions against oral cancer promoted by Primary Health Care Teams in northeastern Brazil. Methods: This is a descriptive and inferential study based on data related to detection, referral, registration, follow-up and documents related to these actions in the External Evaluation of the 1st and 2nd Program for Improving Access and Quality of Primary Care Cycles. Results: Overall, 5,599 and 7,700 teams were evaluated, respectively, in the first and second cycles, with the highest and lowest concentrations in the states of Bahia / Maranhão and Bahia / Sergipe. In all, 58.9% / 79.7% Health Teams conducted campaigns to detect oral lesions and referred suspected cases of oral cancer, and 43.9% / 23% of them recorded and followed suspicious / confirmed cases and only 20.7% / 16.2% had documents proving these records in the respective cycles. There was statistical significance in the comparisons of actions and the evaluation cycles (p ? 0.01). Conclusion: Health teams in northeastern Brazil need to improve actions related to detection, referral, registration, follow-up and verification of oral health documents related to oral cancer.

RESUMO Objetivo: Descrever as ações em saúde bucal frente ao câncer de boca promovidas pelas Equipes de Saúde da Atenção Básica do nordeste brasileiro. Métodos: Estudo descritivo e inferencial a partir de dados referentes à detecção, encaminhamento, registro, acompanhamento e documentos comprovatórios relacionados a estas ações relativos ao 1º e 2º Ciclo de Avaliação Externa do Programa de Melhoria do Acesso e da Qualidade da Atenção Básica. Os dados foram analisados pelos testes Qui-Quadrado e McNemar (?=0,05). Resultados: Foram avaliadas 5.559 e 7.700 equipes, respectivamente, nos 1º e 2º ciclos, sendo, a maior e menor concentração na Bahia/Maranhão e Bahia/Sergipe. 58,9%/79,7% das Equipes realizam campanhas para detecção de lesões bucais e encaminham os casos suspeitos de câncer de boca. Além disso, 43,9%/23% delas registram e acompanham os casos suspeitos/confirmados e apenas 20,7%/16,2% possuem documentos que comprovem esses registros, nos respectivos ciclos. Houve significância estatística nas comparações das ações e os ciclos de avaliação (p ? 0,01). Conclusão: As Equipes de Saúde na região nordeste necessitam melhorar as ações referentes à detecção, encaminhamento, registro, acompanhamento e documentos comprovatórios em saúde bucal frente ao câncer de boca.

Factors Contributing to the Duration of Chemotherapy-Induced Severe Oral Mucositis in Oncopediatric Patients.

This study analyzes the factors contributing to the duration of severe oral mucositis in oncopediatric patients. A longitudinal study was conducted in the pediatric department of a cancer referral hospital between 2013 and 2017. Seventy-three patients diagnosed with cancer undergoing chemotherapy protocols were analyzed. Oral evaluations were performed using the Modified Oral Assessment Guide criteria, and the data were collected from the patients' records. The Kaplan-Meier method was used to estimate survival curves. Most patients were males (52.1%), of mixed race ("pardo") (49.3%), with a mean age of 7.56 years (±5.34). There was a predominance of patients diagnosed with solid tumors (52.1%), with no metastasis (86.3%), using natural product chemotherapeutics (56.2%), who had not undergone a bone marrow transplant (97.3%); amputation was observed in 35.6% of patients, while death rates were as high as 8.2%. The survival analysis estimated a mean time of 30.6 days until complete remission of severe oral mucositis. The regression analysis showed that patients over 10 years old had a median mucositis duration 1.4 times greater than those at the age of 10 years or younger. Patients without metastasis had a median mucositis duration 1.7 times greater than those with metastasis (p-value ≤ 0.10). Increasing age and the absence of metastasis were conditions that prolonged the duration of severe oral mucositis.

Evolução dos Índices CEO-D/CPO-D e de Cuidados Odontológicos em Crianças e Adolescentes com Base no SB Brasil 2003 e SB Brasil 2010 / Evolution of DMF-T/DMF-T and Dental Care Index in Children and Adolescents Based on SB Brasil 2003 and SB Brasil 2010

Objetivo: Analisar a evolução dos índices ceo-d/CPO-D e do Índice de Cuidados Odontológicos, em crianças e adolescentes, tendo como referência os resultados dos levantamentos epidemiológicos nacionais. Material e Métodos: Estudo ecológico, exploratório onde foi realizada análise da série histórica dos índices em crianças de 5 e 12 anos e de 15 a 19 anos, a partir dos resultados do SB Brasil 2003 e SB Brasil 2010. Os dados foram analisados descritivamente, considerando a variação, em percentagem, de indivíduos livres de cárie (ceo-d=0 e CPO-D =0), médias de ceo-d e CPO-D e do Índice de Cuidados Odontológicos. Resultados: Houve uma evolução de +6,0% do índice ceod=0 em crianças de 5 anos, de +12,4% em indivíduos de 12 anos e de +12,8% na faixa etária de 15 a 19 anos. Em relação ao índice ceo-d, aos 5 anos a evolução foi de -13,2%, aos 12 anos de -25,5% e na faixa etária de 15 a 19 anos, -31,11%. A evolução do Índice de Cuidados Odontológicos no Brasil, em crianças de 5 anos, foi de +0,7%, aos 12, foi de +2,6% e na faixa dos 15 aos 19 anos, +10,4%. No Nordeste e Sudeste houve aumento no número de crianças livres de cárie aos 5 anos. Aos 12 e dos 15 a 19 observou-se um aumento, em todas as regiões brasileiras, de indivíduos livres de cárie. Conclusão: Observou-se aumento no número de indivíduos livres de cárie em crianças e adolescentes, constatando-se declínio nos valores dos índices ceo-d/CPO-D e maior cuidado odontológico. (AU)

Objective: To analyze the evolution of dmf-t / DMF-T and Dental Care Index among children aged 5 to 12 years and 15 to 19 years, with reference to the results of national epidemiological surveys. Material and Methods: An ecological, exploratory study was performed to analyze the historical evolution of dmf-t / DMF-T and dental care index in children 5 to 12 years and aged 15 to 19 years, based on the results of the Brazilian national epidemiological surveys "SB Brazil 2003" and "SB Brazil 2010". The data were analyzed descriptively, considering the variation in percentage of caries-free individuals (dmf-t and DMF-T = 0), mean dmf-t and DMF-T and Dental Care Index. Results: There was an increase of +6.0% in dmf-t = 0 in 5-year-old children; +12.4% in 12-year-old children; and 12.8% in the age group 15 to 19 years. In relation to dmf-t, the trend was -13.2% for 5-year-olds, -25.5% for 12-year-olds, and -31.11% for the age group 15 to 19 years. The evolution of the Dental Care Index in Brazil was +0.7% among 5-year-old children, +2.6% among 12-year-olds, and +10.4% for those in the age group 15 to 19 years. In northeastern and southeastern Brazil, there was an increase in the number of 5-year-old children with caries-free status. As for 12 and 15 to 19 years of age, there was an increase in the number of caries-free individuals in all Brazilian regions. Conclusion: There was an increase in the number of caries-free children and adolescents, with a decline in the dmf-t/ DMF-T indices and an improvement in dental care. (AU)

Fatores de risco associados à intervenção com injeção intravítrea de anti-VEGF em pacientes com edema macular diabético / Risk factors related to the intervention with intravitreal anti-VEGF injection in patients with diabetic macular edema

Resumo Objetivo: Propor um modelo de regressão logística para auxiliar na decisão de realização da injeção intravítrea (IIV) de anti-VEGF, a partir da quantificação e hierarquização dos fatores de risco que compõem o perfil dos indivíduos diabéticos. Métodos: Trata-se de estudo transversal, observacional e inferencial, realizado em três instituições da Paraíba, de julho de 2015 a setembro de 2016. O modelo de regressão logística foi utilizado para obtenção do modelo preditivo e os dados foram analisados no software R®. Resultados: Foram avaliados 80 pacientes com diabetes tipo 1 ou 2, maiores de 18 anos, dos quais 57,5% não tiveram indicação de IIV e 42,5% receberam indicação deste tratamento. No grupo com edema macular diabético (EMD), a média de idade foi de 60,65 anos, sendo 52,94% do sexo feminino. Ainda nesse grupo, a maioria apresentou retinopatia diabética não-proliferativa severa ou retinopatia proliferativa (79,41%). Foram identificados como fatores de risco para EMD: o indivíduo ser aposentado (OR=5,22; p-valor 0,05), ter histórico pessoal de retinopatia diabética (OR=20,27; p-valor 0,006) e de tratamento prévio com anti-VEGF (OR=23,23; p-valor 0,002). Conclusão: Os resultados da pesquisa evidenciaram que um indivíduo diabético com baixa visual e apresentando esses três fatores deve ser encaminhado o quanto antes ao especialista, pois possui, com 91,17% de acerto, risco de apresentar EMD com necessidade de IIV de anti-VEGF. Essa ferramenta pode servir como coadjuvante na tomada de decisão, sobretudo do não-retinólogo, a fim de encaminhar para diagnóstico e tratamento precoces os indivíduos com EMD, o que pode ser decisivo na prevenção da perda visual irreversível nesses pacientes.

Abstract Purpose: To propose a predictive model to aid in the decision to perform the intravitreal anti-VEGF injection, based on the risk factors quantification and hierarchy presented by diabetic patients. Methods: It is a cross-sectional, observational and inferential study carried out in three institutions in Paraíba from July 2015 to September 2016. The logistic regression model was used to obtain the predictive model and data were analyzed in R(r) software. Results: Eighty patients with type 1 or 2 diabetes, over 18 years of age, were included, 57.5% of whom had no indication of IIV and 42.5% received an indication of this treatment. In the group with diabetic macular edema (DME), the mean age was 60.65 years, of which 52.94% were female. In this group, the majority presented severe non-proliferative diabetic retinopathy or proliferative retinopathy (79.41%). The main risk factors for DME were: be retired (OR = 5.22, p-value0.05), had a personal history of diabetic retinopathy (OR = 20.27, p-value 0.006), and previous treatment with anti-VEGF (OR = 23.23, p-value 0.002). Conclusion: The results of the research showed that a diabetic patient with low visual acuity and presenting these three factors should be referred as soon as possible to the specialist, since he presents a risk of presenting DME with need for anti-VEGF IIV, with 91.17% of accuracy. This tool can serve as an adjunct to decision making, especially the nonretinologist, in order to refer individuals with EMD to early diagnosis and treatment, which may be crucial in preventing irreversible visual loss in these patients.

Factors Associated with Toothache in Patients Affected by Hereditary Coagulopathies

Objective: To determine a probabilistic model that represents the likelihood of the event Dental Pain to occur in Brazilians patients affected by hereditary coagulopathies. Material and Methods: In this cross-sectional study, information on use and access to dental services, oral morbidity, self-perceived oral health and behavioral health habits were obtained through semi-structured questionnaire and analyzed by means of logistic regression. Results: High prevalence of dental caries was observed for children aged 1-5 years (50%) and for adolescents aged 13-19 years (66%). Cumulative pattern of dental caries in the age groups of 20-35 years and 36-59 years was observed. Most patients did not report pain in the last six months prior to the survey (24.5%). It was observed that searching for dental care for the last time in case of localized pain (OR=26.7), for feeling uncomfortable when brushing teeth (OR=7.3) and difficulty searching for health professionals, not only the dentist (OR 3.7) was considered risk factors for the determination of Dental Pain diagnosis. However, if the patient has mild hemophilia A (OR=0.21), this likelihood decreases, being thus a protective factor. Conclusion: Patients affected by hereditary coagulopathies have high prevalence of caries, indicating the cumulative nature of this disease, which suggests the symptomatic effect of Dental Pain.

Condições sensíveis à atenção primária: panorama brasileiro em 2013 / Sensitive primary conditions: brazilian panorama in 2013 / Condiciones sensibles a la atención primaria: panorama brasileño en 2013

Objetivo: descrever e analisar os dados de registros por Internações por Condições Sensíveis à Atenção Primária nas regiões brasileiras no ano de 2013. Método: estudo exploratório do tipo epidemiológico, descritivo, ecológico, de natureza quantitativa, utilizando dados secundários do Sistema de Informações sobre Internações Hospitalares (SIH-SUS) de 299 cidades brasileiras com população de mais de 100.000 habitantes. Resultados: registrou-se a ocorrência de 1.146.735 internações, com destaque para Pneumonias (23,30%), Insuficiência Cardíaca (9,43%) e Doenças Cerebrovasculares (9,17%). As médias por regiões apresentaram-se semelhantes, variando de 90,84/10,000 hab. a 127,71/10.000 hab., com maior representação na região Norte, seguida das regiões Sul, Centro-Oeste, Nordeste e a menor na região Sudeste. Conclusões: apesar da heterogeneidade demográfica e socioeconômica das regiões brasileiras, com relação à ocorrência de internações por condições sensíveis à atenção primária, esses valores são aproximativos, diferindo apenas os grupos que prevalecem em cada território.(AU)

Objective: to describe and analyze the data records for Hospitalization due to Sensitive Conditions to Primary Care in Brazilian regions in 2013. Method: an exploratory study of an epidemiological, descriptive, ecological, quantitative nature, using secondary data from the Hospitalization Information System (HIS-UHS) of 299 Brazilian cities with population of over 100,000 inhabitants. Results: the occurrence of 1,146,735 admissions, especially pneumonia (23.30%), heart failure (9.43%) and cerebrovascular diseases (9.17%) was recorded. The average regions were similar ranging from 90.84 / 10,000 inhab. to 127.71 / 10,000 inhab., with greater representation in the North, then South, Midwest, Northeast and lowest in the Southeast. Conclusions: Despite the demographic and socioeconomic heterogeneity of Brazilian regions, with the occurrence of hospitalizations due to sensitive conditions to primary care, these values are approximate, differing only in groups that prevail in each territory.(AU)

Objetivo: describir y analizar los datos de registros por Internaciones por Condiciones Sensibles a la Atención Primaria en las regiones brasileñas en el ano de 2013. Método: estudio exploratorio del tipo epidemiológico, descriptivo, ecológico, de naturaliza cuantitativa utilizando datos secundarios del Sistema de Informaciones sobre Internaciones Hospitales (SIH-SUS) de 299 ciudades brasileñas con población con más de 100.000 habitantes. Resultados: Se ha registrado la ocurrencia de 1.146.735 internaciones, con destaque para neumonías (23,30%), Insuficiencia cardíaca (9,43%) y Enfermedades cerebrovasculares (9,17%). Las medias por regiones se han presentado semejantes variando de 90,84/10,00 habitantes a 127,71/10.000 habitantes, con mayor representación en la región Norte, seguida del Sur, Centro-Oeste, Nordeste y la más chica en la región Sudeste. Conclusiones: a pesar de la heterogeneidad demográfica y socioeconómica de las regiones brasileñas, con relación a la ocurrencia de internaciones por condiciones sensibles a la atención primaria, estos valores son aproximativos, diferendo solo a los grupos que prevalecen en cada territorio.(AU)

Perfil das Internações por Condições Sensíveis à Atenção Primária subsidiando ações de saúde nas regiões brasileiras / Profile of Hospitalization for Primary Care Sensitive Conditions subsidizing health activities in Brazilian regions

O estudo objetiva analisar dados de Internações por Condições Sensíveis à Atenção Primária nas regiões brasileiras em 2014 por meio de estudo ecológico quantitativo, utilizando dados secundários do Sistema de Informações Hospitalares nas cidades com mais de 100 mil habitantes. Registraram-se 1.116.917 internações com taxas por 10 mil habitantes variando entre 89,81 (Sudeste) e 121,99 (Sul), com destaque para pneumonias, doenças cerebrovasculares e insuficiência cardíaca. Apesar dos valores aproximados entre as regiões, Norte e Sul apresentaram grupos com valores expressivos, representando critério direcionador de programas e ações diferenciadas para cada região do País.

The study aims to analyze the data of Hospitalization for Primary Care Sensitive Conditions in the Brazilian regions in 2014 through quantitative ecological study, using secondary data from the Hospital Information System in cities with over 100,000 inhabitants. There is a register of 1.116.917 admissions with rates per 10.000 inhabitants ranging from 89.81 (Southeast) and 121.99 (South), especially pneumonia, cerebrovascular disease, and heart failure. Despite approximate values between regions, North and South groups presented significant values, representing guiding criteria of differentiated programs and actions for each region.

Factors associated with lip and oral cavity cancer / Fatores associados ao câncer de lábio e cavidade oral

This study aimed to identify factors associated with the occurrence of primary cancer of the lip and oral cavity regions compared to other types of head and neck cancers according to demographic, socioeconomic data and lifestyle, in Brazil, from 2000 to 2011.

Objetivou-se identificar fatores associados à ocorrência de câncer primário nas regiões de lábio e cavidade oral frente aos demais tipos de cânceres de cabeça e pescoço segundo dados demográficos, socioeconômicos e de estilo de vida, no Brasil, no período de 2000 a 2011.

Factors associated with lip and oral cavity cancer.

PURPOSE: This study aimed to identify factors associated with the occurrence of primary cancer of the lip and oral cavity regions compared to other types of head and neck cancers according to demographic, socioeconomic data and lifestyle, in Brazil, from 2000 to 2011. METHODS: A study was conducted using Hospital Cancer Records (Instituto Nacional do Câncer), from 2000 to 2011, totaling 23,153 cases. Data were analyzed by binary logistic regression (response category: primary cancers located in the lip and oral cavity; comparison category; other types of primary cancer in the head and neck, which does not affect the lip and oral cavity) at a significance level α = 5%. RESULTS: The study showed factors associated with higher incidence of cancer in the lip and oral cavity: being of advanced age (OR = 1.16), not having a family history of cancer (OR = 2.38), alcohol consumption (OR = 1.17); former tobacco use (OR = 1.51) or current tobacco use (OR = 1.65); having a previous diagnosis of cancer without treatment (OR =1.66). Being female (OR = 0.92), having completed basic (OR = 0.71) and higher (OR = 0.46) education and having previous diagnosis of cancer with treatment (OR = 0.74) constituted factors associated with lower prevalence of cancer of the lip and oral cavity. CONCLUSION: Age, absence of family history of cancer, smoking habits and alcohol consumption, and previous diagnosis of cancer without treatment were associated with a higher incidence of cancer of the lip and oral cavity.

Internações por condições sensíveis à atenção primária: revisão integrativa / Hospitalizations caused by primary care-sensitive conditions: an integrative review

Objetivo: analisar a produção científica sobre as Internações por Condições Sensíveis à Atenção Primária. Método: revisão integrativa para responder à questão << As internações por condições sensíveis à atenção primária podem ser consideradas um bom indicador de saúde para avaliar a efetividade da atenção primária à saúde? >> realizada nas bases de dados LILACS e PubMed além de bibliotecas eletrônicas Cochrane Library e SciELO, de julho e agosto de 2014, pela combinação de descritores empregando o booleano AND: Hospitalização AND Atenção Primária à Saúde AND Indicador de saúde". Resultados: identificaram-se 55 artigos, 14 integraram o estudo: sete da PubMed, quatro da LILACS e três da SciELO. Conclusão: o indicador possui potencial para avaliar a efetividade dos serviços de Atenção Primária e amparar a tomada de decisão em saúde; contudo, possui suas limitações nas fontes de alimentação dos bancos de dados que estão sujeitas a falhas e subnotificações.(AU)

Access to and Satisfaction with Oral Health Care from the Perspective of Pediatric Cancer Patients and Their Caregivers

To investigate the access to dental care and the oral health care provided to cancer patients aged zero to 19 years old; to detect possible difficulties hindering the delivery of oral health care; and to identify the main oral complications associated with anticancer treatment.Material and Methods:Interviews were conducted with 84 children and adolescents (or their caregivers) who were treated at Napoleão Laureano Hospital, João Pessoa County, Paraíba, Brazil; the interviews were recorded in audio files. The data were analyzed based on systematic reading of the interviews according to the content analysis technique.Results:Six categories were established: Access to health care services, which was reported as posing difficulties by only 16.6% of the sample; Access to the hospital, considering that 40.4% of the participants reported traveling to the hospital in cars provided by the city government; Dental care, which was procured at basic health units (BHUs) by 52.3% of the participants; Conceptions on oral health care, in which 64.2% of the participants mentioned cariogenic diets and/or poor oral hygiene; Quality of life perception, whereby 70.2% of the interviewees reported to be satisfied or very satisfied and 63.0% rated their quality of life good or very good; and Health problems derived from treatment, with nausea being the most mentioned (27.2%).Conclusion:The patients did not meet difficulties in the procurement of dental care, which was most often sought at BHUs; they were satisfied or very satisfied with their health and rated their quality of life as good or very good...

Condições Sensíveis à Atenção Primária: uma revisão descritiva dos resultados da produção acadêmica brasileira / Primary Care-Sensitive Conditions: a descriptive review of results of the Brazilian academic production

O estudo propõe-se descrever e analisar os resultados da produção acadêmica brasileira sobre Internações por Condições Sensíveis à Atenção Primária. Revisão descritiva e analítica realizada em artigos científicos de Portais de Periódicos. Vinte e um artigos integraram o estudo, os quais foram subdivididos segundo a abrangência territorial, sendo 9,6% nacional, 4,8% do Nordeste, 9,6% do Centro-Oeste, 33,3% do Sul e 42,7% do Sudeste. As Internações por Causas Sensíveis à Atenção Primária, apesar de se apresentarem altas em alguns estados e/ou cidades isoladas, sofrem uma tendência para estabilização e redução nas diferentes regiões brasileiras.

The study proposes to describe and examine the results of the Brazilian academic production about Hospitalizations for Primary Care-Sensitive Conditions. Descriptive and analytical review conducted in scientific articles Periodicals portals. Twenty-one articles have integrated the study, which were divided according to territorial coverage, with 9.6% National, 4.8% in the Northeast, 9.6% in the Midwest, 33.3% in the South and 42.7 % in the Southeast. The Sensitive Cause to Primary Care Hospitalizations, despite presenting increase in some states and/or isolated cities show a tendency for stabilization and reduction in different regions.

Construção de um Vê de Gowin para análises de produções acadêmicas de Enfermagem / Construcción de una "V" de Gowin para análisis de producciones académicas de enfermería / Constructing a Gowin's V diagram to analyze academic work in nursing

O artigo apresenta uma ferramenta da Aprendizagem Significativa denominada V de Gowin e a possibilidade de seu uso em um processo de desempacotamento de produções acadêmicas de Enfermagem. Objetiva construir uma proposta de alteração da ferramenta com a utilização dos elementos que compõem a trajetória processual da Teoria da Intervenção Práxica da Enfermagem em Saúde Coletiva (TIPESC) e analisar uma dissertação produzida nesta área de conhecimento. Trata-se de um estudo descritivo e exploratório que apresenta o V de Gowin, propondo alterações no seu domínio metodológico. Constatou-se a possibilidade de utilização para análises de produções acadêmicas de enfermagem deste instrumento heurístico que já se mostrou útil para apoiar processos de ensino e aprendizagem e analisar produções acadêmicas na área, pela capacidade de captar e interpretar qualquer fenômeno articulado aos processos de produção e reprodução social.

El artículo presenta una herramienta de Aprendizaje Significativo denominada V de Gowin y su posible utilización en un proceso de desempaquetado de producciones académicas de Enfermería. Objetiva construir una propuesta de alteración de la herramienta con la utilización de los elementos que componen la trayectoria del proceso de la Teoría de la Intervención Práxica de Enfermería en Salud Colectiva (TIPESC) y analizar una disertación generada en tal área cognoscitiva. Estudio descriptivo-exploratorio, que presenta la V de Gowin, proponiendo alteraciones de su dominio metodológico. Se constató la posibilidad de utilización para el análisis de producciones académicas de enfermería de este instrumento heurístico, que ya fue útil como apoyo de procesos de enseñanza-aprendizaje y para analizar producciones académicas en el área, en razón de que permite captar e interpretar cualquier fenómeno articulado al os procesos de producción y reproducción social.

The paper presents a meaningful learning tool known as Gowin's V and highlights the possibility of using it in the process of unpacking academic work in nursing. Our study aims to propose an amendment to this tool using the elements that comprise the procedural trajectory of the Theory of Nursing Praxis Intervention in Collective Health (TIPESC) and to analyze a dissertation produced in this field. This descriptive and exploratory study presents Gowin's V and proposes changes to its methodology. It thus shows the possibility of using this heuristic instrument to analyze academic work in nursing. Gowin's V has already proven to be useful in supporting teaching and learning processes and analyzing academic work in the area through its ability to capture and interpret any phenomenon articulated in the processes of social production and reproduction.

Tooth loss and associated factors in patients with coagulopathies in the State of Paraiba, Brazil

BACKGROUND The most common and best known hereditary coagulopathies are hemophilia A and B followed by von Willebrand Disease. OBJECTIVE This study aimed to estimate the prevalence of tooth loss and investigate its association with demographic and socioeconomic data, as well as to discuss self-reported oral morbidity and use of health services by patients with coagulopathies treated in blood centers in Paraíba, Brazil. METHODS This was a quantitative cross-sectional epidemiological survey. Data was collected in the period from October 2011 to July 2012 by clinical examination and by assessing interviews using a semi-structured questionnaire. The findings were analyzed by descriptive and inferential statistics with the level of significance (α) being set at 10%. RESULTS One hundred and six, predominantly male (88.8%), patients with coagulopathies were evaluated. The ages ranged from one to 59 years. Most patients were of mixed race (61.3%), most reported family incomes between R$ 501.00 and R$ 1500.00 (49.1%), and most had not completed elementary school (37.1%). Hemophilia A was found in 76.4% of the cases. The prevalence of dental caries among individuals was 50.0% predominantly in the 13- to 19-year-old age range (66.7%). As regards to tooth loss, teeth were missing in 35.1% of the study participants. CONCLUSION Tooth loss is high in this population. Males with severe hemophilia A, those who use fluoride and have a good or very good perception about their last dental appointment have a reduced chance of losing their teeth.

O processo do ensino de tomada de decisão em enfermagem: avaliação perceptiva de docentes de uma instituição de ensino superior pública / The teaching of decision making in nursing: perceptive evaluation of professors working in a public higher education institution

Objetivo: avaliar o processo de ensino de tomada de decisão veiculado nas disciplinas das Ciências da Enfermagem sob a ótica docente. Material e Métodos: estudo exploratório, descritivo e inferencial com abordagem quantitativa realizado em uma Instituição de Ensino Superior pública que possui o curso de graduação em enfermagem na cidade de João Pessoa, Paraíba, onde foram aplicados questionários semi estruturados a uma amostra de 36 docentes. Com apoio estatístico do Software R, para a análise dos dados foi utilizado Testes de Hipóteses para Proporções e Teste de Independência. Resultados: os docentes referem: a não formação específica para exercer suas atividades na instituição; a não interferência da coordenação nos planos de curso; o ensino da tomada de decisão na disciplina ministrada e que o discente deve aprender um modelo de tomada de decisão. Conclusão: o processo de ensino de tomada de decisão veiculado nas disciplinas das Ciências da Enfermagem apresentou aspectos positivos, porém com ressalvas em relação à não formação didático-pedagógica aos docentes.

Objective: To evaluate the teaching process of decision making in the disciplines of nursing sciences from the professors’ perspective. Material and Methods: This was an exploratory, descriptive and inferential study with quantitative approach performed in a Public Higher Education Institution that has an undergraduate program in nursing inthe city of João Pessoa, Paraíba. A semi-structured questionnaire was applied to a sample of 36 professors. Data analysis was carried out on Software R by means of hypothesis tests for proportions and independence tests. Results: The professors reported: non-specific training to perform their activities in the institution; non-interference of coordination staff in course plans; teaching of decision makingin the discipline; and that the students should learn a model of decision making. Conclusion: The teaching of decision-making in the disciplines of nursing sciences was found to have positive aspects, with exception to the lack of didactic-pedagogical training for professors.

[Alternative experiences rescuing knowledge for working processes in health]. / Experiências alternativas resgatando saberes para os processos de trabalho em saúde.

This descriptive study was performed using a qualitative approach, with the objective to understand the working process of nurses and physicians of the Family Health Strategy (FHS) in João Pessoa-PB, and identify the alternative strategies and procedures they developed. The material was analyzed according to the discourse analysis technique. It was shown that the elements of the working process were disconnected, allied with a possibility of change by overcoming the invisibility of the subjects and their knowledge in healthcare services. In conclusion, the identified alternative strategies and procedures are in the embryonic stage in terms of the transformation of working processes and overcoming of hegemonic healthcare models, therefore demanding a continuous problematization of concepts and practices.

Experiências alternativas resgatando saberes para os processos de trabalho em saúde / Alternative experiences rescuing knowledge for working processes in health / Experiencias alternativas rescatando saberes para los procesos de trabajo en salud

O presente trabalho trata-se de um estudo descritivo de abordagem qualitativa, que objetivou compreender o processo de trabalho de enfermeiros e médicos da Estratégia Saúde da Família (ESF), do município de João Pessoa-PB, e identificar as estratégias e táticas alternativas desenvolvidas. O material foi analisado por meio da técnica de análise de discurso. Evidenciou-se a desarticulação entre os elementos do processo de trabalho aliada à possibilidade de transformação pela superação da invisibilidade dos sujeitos e seus saberes nos serviços de saúde. Conclui-se que as estratégias e táticas alternativas visualizadas constituem embrião para transformação dos processos de trabalho e superação dos modelos de atenção à saúde hegemônicos, demandando problematização contínua de concepções e práticas.

This descriptive study was performed using a qualitative approach, with the objective to understand the working process of nurses and physicians of the Family Health Strategy (FHS) in João Pessoa-PB, and identify the alternative strategies and procedures they developed. The material was analyzed according to the discourse analysis technique. It was shown that the elements of the working process were disconnected, allied with a possibility of change by overcoming the invisibility of the subjects and their knowledge in healthcare services. In conclusion, the identified alternative strategies and procedures are in the embryonic stage in terms of the transformation of working processes and overcoming of hegemonic healthcare models, therefore demanding a continuous problematization of concepts and practices.

Estudio descriptivo, de abordaje cualitativo, que objetivó comprender el proceso de trabajo de enfermeros y médicos de la Estrategia Salud de la Familia (ESF) del municipio de João Pessoa-PB e identificar las estrategias y tácticas alternativas desarrolladas. El material fue analizado mediante la técnica de análisis de discurso. Se evidenció la desarticulación entre los elementos del proceso de trabajo, sumada a la posibilidad de transformación por la superación de la no percepción de los sujetos y sus saberes en los servicios de salud. Se concluyó en que las estrategias y tácticas alternativas visualizadas se constituyen en un embrión para la transformación de los procesos de trabajo y superación de los modelos de atención de salud hegemónicos, demandando problematización continua de concepciones y prácticas.