Câncer de boca no Estado do Rio de Janeiro: cuidado e rede de atenção a partir do Centro de Especialidades Odontológicas (CEO) / Oral cancer in the state of Rio de Janeiro: care and care network from the Dental Specialties Center (DSC)

O câncer (CA) de boca representa um problema de saúde pública a nível mundial, com altas taxas de morbimortalidade. A desvalorização das lesões iniciais pelo profissional, somada à incapacidade técnica de reconhecimento dessas lesões, a demora do atendimento, erros no diagnóstico inicial, assim como a ausência de campanhas sobre a doença e seus fatores de risco, são fatores que diminuem as chances de diagnóstico do CA de boca em seus estágios iniciais. Para realização do diagnóstico precoce das lesões potencialmente malignas ou suspeitas de malignidade, é fundamental contar com uma rede de atenção à saúde estruturada e organizada, com profissionais capacitados para identificar as lesões em estágio inicial e realizar a biópsia para fins diagnósticos e posterior análise em laboratório que possua profissional especializado em anatomia patológica. O presente estudo teve como objetivo discutir o papel e desempenho dos Centros de Especialidades Odontológicas (CEOs) em relação ao procedimento de coleta de biópsia de tecidos moles da boca no Estado do Rio de Janeiro, com finalidade diagnóstica, considerando seu papel na oferta deste procedimento. Trata-se de uma pesquisa descritiva e exploratória acerca do papel e desempenho dos CEOs com foco na oferta do exame de diagnóstico do CA de boca por estes centros, no período de 2017 a 2019. Os resultados apontam que os CEOs possuem um papel central para o diagnóstico do câncer de boca, mas aquém do que potencialmente poderia ofertar já que não houve produção de biópsias em 47 (57%) dos 82 CEOs existentes, no período analisado. Um dos limites do trabalho foi a incapacidade de avaliação dos sistemas de apoio, assim como a contribuição dos serviços de saúde das universidades para as análises desses exames devido a insuficiência de dados públicos sobre os exames anatomopatológicos específicos para o câncer de boca. Tais resultados buscam fornecer subsídios para que os gestores de saúde possam otimizar o fluxo dos usuários através da organização e do fácil acesso à rede, identificando e solucionando dificuldades enfrentadas por estes centros para a realização destes procedimentos, reduzindo atrasos na investigação diagnóstica e no tratamento desta patologia. (AU)

Mouth cancer (CA) represents a public health problem worldwide, with high morbidity and mortality rates. The devaluation of initial injuries by the professional, combined with the technical inability to recognize these injuries, as well as the delay in public assistance, errors in the initial diagnosis, as well as the lack of campaigns about the disease and its risk factors, are factors that reduce the chances diagnosis of oral CA in its initial stages. To carry out early diagnosis of potentially malignant and suspected malignant lesions, it is essential to have a structured and organized health care network, with professionals trained to identify lesions at an early stage and perform biopsy for diagnostic purposes and subsequent analysis in the laboratory. that has a professional specialized in pathological anatomy. In this sense, the present study aimed to discuss the role and performance of Dental Specialty Centers (CEOs) in relation to the procedure for collecting soft tissue biopsies from the mouth in the State of Rio de Janeiro, with diagnostic purposes, considering their role in offering this procedure. The study is a descriptive and exploratory research on the role and performance of CEOs with a focus on offering diagnostic examinations for oral CA by these centers, from 2017 to 2019. The results indicate that CEOs have a central role in the diagnosis of oral cancer, but below what they could potentially offer as there was no production of biopsies in 47 CEOs (57%) of the 82 existing CEOs in the period analyzed. One of the limits of the work was the inability to evaluate support systems, as well as the contribution of university health services to the analysis of these exams due to insufficient public data on specific anatomopathological exams for oral cancer. Such results seek to provide support so that health managers can optimize the flow of users through the organization and easy access to the network, identifying and resolving difficulties faced by these centers in carrying out these procedures, reducing delays in diagnostic investigation and treatment of this condition. (AU)

Patients and physician's self-assessment regarding clinical stability in severe mental disorders: a cross-sectional study / Autoavaliação de pacientes e médicos em relação à estabilidade clínica em transtornos mentais graves: um estudo transversal

OBJECTIVE: This study explores the relationship between patients' self-assessment and physicians' evaluation regarding clinical stability. METHODS: This cross-sectional study was carried out at the general outpatient clinic of the Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro (IPUB-UFRJ) in a large sample (1,447) of outpatients, of which 67.9% were patients with severe mental disorders (SMD). We collected information using a structured questionnaire developed for this purpose, filled in by the patient's physician. Clinical stability was assessed by means of five psychiatric instability criteria and by the physician's global clinical impression over the six previous months. The patients' self-assessment was based on a question about how they evaluated their health status: stable/better, worse, does not know. For the analyses, patients' self-evaluation was considered as our standard. RESULTS: The sample was composed of 824 (57%) women with an average age of 49 years. The most prevalent diagnoses within the SMD category corresponded to 937 patients, of whom 846 (90.3%) assessed themselves as stable/better. The physicians' evaluations agreed more with patients with bipolar disorders and less with schizophrenics regarding stability. As for patients with depressive disorder, physicians agreed more with them regarding instability. CONCLUSION: The data analysis confirms our hypothesis that the self- -assessment made by patients with SMD was accurate regarding their health condition, and that the self- -assessment made by patients who considered themselves stable agree with the physicians' evaluation.

OBJETIVO: Este estudo explora a relação entre a autoavaliação dos pacientes e a avaliação dos médicos quanto à estabilidade clínica. MÉTODOS: Trata-se de um estudo transversal realizado no ambulatório do Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro (IPUB-UFRJ) em uma ampla amostra de pacientes (1.447), dos quais 67,9% eram portadores de transtornos mentais graves (TMG). Coletamos informações por meio de um questionário estruturado desenvolvido para esse fim, preenchido pelo médico assistente. A estabilidade clínica foi avaliada por meio de cinco critérios de instabilidade psiquiátrica e pela impressão clínica global do médico, nos seis meses anteriores. A autoavaliação dos pacientes baseou-se em uma pergunta sobre como eles avaliavam seu estado de saúde: estável/melhor, pior, não sabe. Para as análises, a autoavaliação dos pacientes foi considerada como nosso padrão. RESULTADOS: A amostra foi composta por 824 (57%) mulheres, com idade média de 49 anos. Os diagnósticos mais prevalentes na categoria TMG corresponderam a 937 pacientes, dos quais 846 (90,3%) se avaliaram como estáveis/melhores. As avaliações dos médicos concordaram mais com pacientes portadores de transtorno bipolar e menos com esquizofrênicos em relação à estabilidade. Quanto aos pacientes com transtorno depressivo, os médicos concordaram mais com eles em relação à instabilidade. CONCLUSÃO: A análise dos dados confirma nossa hipótese de que a autoavaliação feita por pacientes com TMG foi precisa quanto à sua condição de saúde e que a autoavaliação feita por pacientes que se consideravam estáveis concorda com a avaliação dos médicos.

Factors related to lower limb performance in children and adolescents aged 7 to 17 years: A systematic review with meta-analysis.

BACKGROUND: The literature identifies several factors that are associated with lower limb performance (LLP). However, there is little consensus on which factors have the major associations with LLP. OBJECTIVE: Examine, analyze and summarize the scientific evidence on the factors associated with the performance of LLP in children and adolescents of both sexes aged between 7 and 17 years. DESIGN: This systematic review was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement and was registered in PROSPERO. DATA SOURCES: A systematic literature search of five electronic databases (i.e., SPORTDiscus, PubMed, CINAHL, Google Scholar, and SCOPUS) with date restrictions was conducted (2010 to 2021). ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Eligibility criteria included (i) a study published between 2010 and 2021; (ii) a research study with observational design; (iii) a study analyzing LLP; and (iv) a sample composed of young people between 7 and 17 years old (regardless of sex). ANALYSES: Literature analysis was carried out in English and Portuguese between 2018 and 2021, "blindly" by two researchers. For data sorting, Rayyan® was used. Data extraction and evidence analysis were performed "blindly", using the Loney scale. The minimum items for observational studies were analyzed by the STROBE checklist. Meta-analyses were conducted based on age group (Childhood [7 to 11 Yrs] and Adolescence [12 to 17 Yrs]) and puberty stages (i.e., Prepupertal and Pubertal). The heterogeneity between the samples of the studies was assessed using the "Cochran's Q" and "I^2" statistics. Meta-regression analyses were performed to check the factors related to heterogeneity of the studies and to check the associations between chronological age and LLP. RESULTS: The literature search resulted in 1,109,650 observational studies of which 39 were included in this review. Through Meta-analysis and Meta-regressions, it was possible to indicate that advancing chronological age related to increased LLP (p<0.01), and that in relation to puberty stages pubertal subjects had higher LLP than their pre-pubertal peers (p<0.01). DISCUSSION: The main findings of the present systematic review suggest that as chronological age advances (childhood to adolescence), neuromuscular systems mature and this may be due to advancing puberty, which is also associated with an increase in LLP. CONCLUSION: The factors associated with lower limbs performance are still inconsistent in the literature. However, advancing chronological age and stage of puberty are both associated with increased lower limbs performance. TRIAL REGISTRATION: ID-PROSPERO-CRD42020137925.

Relationship of Biological Maturation with Muscle Power in Young Female Athletes.

There is still no consensus on how biological maturation (BM) affects the muscle power of upper and lower limbs in young people. The objective was to verify associations between BM and muscle power, as well as to compare the muscle power of upper (ULP) and lower limbs (LLP) among young athletes in different stages of BM. The sample consisted of 79 female athletes (10.9 ± 1.11 years old). Regarding BM, the sample was divided into three groups: delayed BM, synchronized BM, and accelerated BM. BM was identified by subtracting chronological age from bone age (BA). BA was measured by a mathematical model based on anthropometry. The muscular power of the upper limbs was analyzed by the medicine ball launch test, and that of the lower limbs was analyzed by the countermovement jump on a force platform. BM and BA correlated with ULP (BA: r =0.74; BM: r =0.65) and LLP (BA: r = 0.50; BM: r =0.41). In the comparisons of the tests of ULP and LLP, the groups with synchronized and accelerated BM were superior to the group with delayed BM. The advance of BM is associated with the ULP and LLP, as well as the advance of the BM affects muscle power in young female athletes. This occurs due to the increase in body mass resulting from the advancement of BM, which may favor the predominance of lean body mass, assisting in the production of muscle strength.

Occurrence of IGG antibodies anti-TOXOPLASMA GONDII and NEOSPORA CANINUM in cattle raised in family agricultural properties in Realeza, Parana, Brazil

This cross-sectional study evaluates the presence of antibodies against Neospora caninum and Toxoplasma gondii in cattle raised in Realeza, PR. There was a seroprevalence of N. caninum and T. gondii of 87.5% and 67.9%, respectively in the properties assessed. The frequencies of T. gondii and N. caninum in the animals were 41.1% and 55.1%, respectively. The studied coccidia are widely distributed in dairy cows reared on family farms in the municipality of Realeza, PR. Sanitary control for reproductive diseases must be adopted to prevent miscarriages and the economic damage caused by the disease. Future studies should be performed to investigate how widespread these pathogens are in cattle herds in southwestern Parana.

Can the Neuromuscular Performance of Young Athletes Be Influenced by Hormone Levels and Different Stages of Puberty?

BACKGROUND: Endocrine mechanisms can be a determining factor in the neuromuscular performance of young athletes. OBJECTIVE: The objective of the present study was to relate maturational and hormonal markers to neuromuscular performance, as well as to verify whether young athletes with different testosterone levels show differences in muscle strength. METHODS: The sample consisted of 37 young male Brazilian athletes (11.3 ± 0.94 years) who were members of a sports initiation project. Hormonal markers were analyzed biochemically by blood samples, and maturation markers by mathematical models based on anthropometry. Body composition was verified by tetrapolar bioimpedance. The performance of upper and lower limb strength and body speed were analyzed. RESULTS: Hormonal and maturational markers were related to neuromuscular performance (p < 0.05). Young people with higher testosterone levels showed higher muscle strength (p < 0.05). Artificial neural networks showed that testosterone predicted the performance of upper limbs by 49%, and maturation by 60%. Maturation foreshadowed the performance of lower limbs by 30.3%. CONCLUSION: Biological maturation and hormonal levels can be related to neuromuscular performance, and young people with higher testosterone levels show superior muscle strength in relation to the others.

Biological Maturation and Hormonal Markers, Relationship to Neuromotor Performance in Female Children.

Background: Mechanisms that influence muscle strength can interfere with neuromotor performance and overall health, thus hormone markers and maturation can interact in this process. Objective: The present study aimed to verify the relationship of hormonal markers and biological maturation on neuromotor abilities in young people. Methods: This is a cross-sectional study with 44 female participants (11.5 ± 1.5 years). Hormones were analyzed biochemically. Skeletal and somatic maturation were analyzed using anthropometry. The muscular power of the upper and lower limbs, body speed with change of direction, and speed of the upper limbs were verified. Results: Bone age was correlated with hormonal markers (estradiol: r = 0.58; p = 0.0007), (testosterone: r = 0.51; p = 0.005). Peak growth velocity correlated with estradiol (r = 0.51; p = 0.004). The power of the lower limbs (estradiol: r = 0.52; p = 0.006; testosterone: r = 0.42; p = 0.03) and of the upper limbs (estradiol: r = 0.51; p = 0.007; testosterone: r = 0.42; p = 0.02) had a positive correlation with hormone levels and had similar results with maturation. The analysis by artificial neural networks indicated that the maturation can predict the neuromotor performance between 57.4% and 76%, while the hormonal markers showed a potential of more than 95% for the foreshadowing of the neuromotor performance of the upper limbs. Conclusion: It was possible to conclude that the hormones had a relationship with maturational development and bone age in female subjects.

Level of physical activity and motor coordination of schoolchildren in different maturational stages / Nível de atividade física e coordenação motora de escolares em diferentes estágios maturacionais

INTRODUCTION: Studies and debates in the field of motor development reveal that sport and physical activity develop and improve motor skills. These studies seek to understand the changes that occur with movement, which becomes more complex as it develops through physical activity. OBJECTIVE: To compare the level of physical activity and motor coordination of students in different maturational stages and to relate the level of physical activity with the motor coordination of young people. METHODS: Descriptive research with cross section. The study included 46 male individuals, aged between 10 and 14 years. The Baecke Habitual Physical Activity questionnaire was applied; the maturity stage was verified through the Pubertal Maturation Prediction Equation; body composition was assessed using the Guedes protocol for children and adolescents; Finally, the coordinating performance was rated using the Korperkoordinationstest fur Kinder (KTK) test battery. RESULTS: There were significant differences for the variables Age and Height between all stages: P3, P4 and P5 of maturation. The differences found in body mass occurred only between stages P3 and P5; P4 and P5. It was also observed that no significant differences were found for motor coordination between the maturation stages. The same occurred when the physical activity indices were compared CONCLUSION: There is no difference in the level of physical activity between stages 3, 4 and 5 of sexual maturation, nor does the maturational stage seem to influence the level of motor coordination of young schoolchildren.

INTRODUÇÃO: Estudos e debates na área do desenvolvimento motor revelam que o esporte e a atividade física desenvolvem e melhoram as habilidades motoras. Esses estudos buscam compreender as mudanças que ocorrem com o movimento, o qual se torna mais complexo à medida que se desenvolve através da atividade física. OBJETIVO: Comparar o nível de atividade física e coordenação motora de escolares em diferentes estágios maturacionais e relacionar o nível de atividade física com a coordenação motora de jovens MÉTODO: Pesquisa descritiva com corte transversal. Participaram do estudo 46 indivíduos do sexo masculino, com idades entre 10 e 14 anos. Foi aplicado o questionário de Atividade Física Habitual de Baecke; o estágio de maturidade foi verificado através da Equação de Predição da Maturação Puberal; a composição corporal foi avaliada através do protocolo de Guedes para crianças e adolescentes; por fim, o desempenho coordenativo foi classificado por meio da bateria de testes Korperkoordinationstest fur Kinder (KTK). RESULTADOS: Houve diferenças significativas para as variáveis Idade e Estatura entre todos os estágios: P3, P4 e P5 de maturação. As diferenças encontradas na massa corporal ocorreram apenas entre os estágios P3 e P5; P4 e P5. Observou-se também que não foram encontradas diferenças significativas para a coordenação motora entre os estágios de maturação. O mesmo ocorreu quando os índices de atividade física foram comparados. CONCLUSÃO: Não existe diferença no nível de atividade física entre os estágios 3, 4 e 5 da maturação sexual, assim como o estágio maturacional não parece influenciar o nível de coordenação motora de jovens escolares

Clinical stability, diagnosis and catchment area: the patients of a university-based psychiatric outpatient clinic / Estabilidade clínica, diagnóstico e território: os pacientes de um ambulatório psiquiátrico universitário

ABSTRACT Objective This study aimed to characterize the patients assisted at the general outpatient clinic of the Psychiatry Institute of Universidade Federal do Rio de Janeiro (IPUB-UFRJ) and to assess these patients' clinical stability. Methods This cross-sectional study collected information using a structured questionnaire filled in by the patient's physician. The questionnaire, specifically developed for this purpose, included sociodemographic data; the dwelling area; psychiatric diagnosis according to ICD-10; clinical stability assessment by means of five psychiatric instability criteria and the physician's global clinical impression over the six previous months. Clinical stability was defined as a negative answer to all five pre-defined instability criteria. Results Overall, 1,447 questionnaires were filled in. The sample was composed of 824 (57%) women; with an average age of 49 years; 1,104 (76.3%) patients lived in the city of Rio de Janeiro and 343 (23.7%) lived outside the city; 983 (67.9%) patients had a severe mental disorder (SMD) diagnosis and 946 (65.3%) patients were considered stable. Statistically, the clinical stability by dwelling area did not differ. The most frequent clinical instability criterion was "exacerbation or emergence of acute manifestations of the disease". Conclusion The major part of the patients displayed a SMD and was considered clinically stable.

RESUMO Objetivo Este trabalho buscou caracterizar os pacientes atendidos no ambulatório geral do Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro (IPUB-UFRJ) e avaliar sua estabilidade clínica. Métodos Este estudo descritivo, transversal, coletou informações utilizando um questionário estruturado preenchido pelo médico assistente. O questionário, especificamente desenvolvido para esse propósito, continha dados sociodemográficos, área de moradia, diagnóstico psiquiátrico de acordo com a CID-10, avaliação da estabilidade clínica por meio de cinco critérios de instabilidade psiquiátrica e a impressão clínica global do médico, nos últimos seis meses. A estabilidade clínica foi definida como uma resposta negativa a todos os cinco critérios de instabilidade predefinidos. Resultados No total, 1.447 questionários foram preenchidos. A amostra foi composta por 824 (57%) mulheres, com média de idade de 49 anos; 1.104 (76,3%) pacientes residentes na cidade do Rio de Janeiro e 343 (23,7%) residentes fora da cidade; 983 (67,9%) pacientes com diagnóstico de transtorno mental grave (TMG) e 946 (65,3%) pacientes foram considerados estáveis. Estatisticamente, a estabilidade clínica por área de moradia não apresentou diferenças. O critério de instabilidade mais frequente foi "recrudescimento ou o surgimento de manifestações agudas da doença". Conclusão A maioria dos pacientes apresentava um TMG e foi considerada clinicamente estável.

Prediction of pubertal maturation from anthropometric variables: proposal for a non-invasive method.

BACKGROUND: Identifying new perspectives for the development of methods to analyze biological maturation is a very important step for the selection of sports talent. The current study proposed a non-invasive method for evaluating the pubertal status of young males based on anthropometric variables. METHODS: Two hundred six male participants between 8 and 18 years old were evaluated, selected randomly from a school in Natal, Brazil. Seven anthropometric variables were evaluated, as recommended by ISAK, in addition to the pubertal stages being measured through analysis of genital development. The statistics were represented through means and standard deviations of the groups. An Analysis of Variance and multivariate method of discriminative analysis were performed to compare groups and create the predictive equation. RESULTS: The significant differences in the anthropometric variables between the pubertal stages were able to predict the stage of maturity of the participants with an accuracy of 75%. Through a validation sample (N.=52), the level of agreement between the proposed equation and the objective method was excellent, presenting an index of 0.840. CONCLUSIONS: The predicted equation proposed in this study demonstrated a high level of validity, presenting it as a new alternative for the evaluation of pubertal maturity of male youths.

Estágios maturacionais: comparação de indicadores de crescimento e capacidade física em adolescentes / Maturational stages: comparison of growth and physical capacity indicators in adolescents

INTRODUCTION: The identification of physical capacity is an important marker related to healthy behavior during childhood and adolescence, in which some factors appear to contribute to motor performance such as maturation and hormonal levels. OBJECTIVE: To compare growth indicators, physical capacity and hormonal markers according to gender and maturational stage in adolescents. METHODS: Eighty-nine adolescents of both genders aged 10-13 years participated in the study. Sexual maturation was evaluated using the Tanner's self-evaluation method. Physical capacity (explosive strength of upper and lower limbs, upper limb velocity and agility) and hormonal markers (testosterone and estradiol) were evaluated through the chemiluminescence method. RESULTS: In the comparison by gender, girls had higher weight (p = 0.023), height (p = 0.018) and fat percentage values (p = 0.001), while boys presented better motor performance for the explosive strength of upper limbs (p = 0.005) and lower limbs (p = 0.011), agility (0.018) and upper limb velocity (p = 0.014). Regarding maturational stage, boys did not present differences in any variable analyzed; (Stage V versus I), height (stage III, IV and V versus I) and upper limb explosive strength (stage III and IV versus I). CONCLUSION: Growth, weight and height, as well as explosive strength of upper limbs were higher in girls at more advanced maturational stages and appear to be gender dependent.

INTRODUÇÃO: A identificação da capacidade física se apresenta como importante marcador relacionado ao comportamento saudável durante a infância e adolescência, no qual alguns fatores aparentam contribuir para o desempenho motor como a maturação e níveis hormonais. OBJETIVO: Comparar indicadores de crescimento, capacidades físicas e marcadores hormonais de acordo com o sexo e estágio maturacional em adolescentes. MÉTODO: Participaram do estudo 89 adolescentes de ambos os sexos de 10 a 13 anos. Foram avaliados a maturação sexual, obtida através do método de autoavaliação de Tanner, capacidades físicas (força explosiva de membros superiores e inferiores, velocidade de membros superiores e agilidade) e marcadores hormonais (testosterona e estradiol) através do método de quimiluminescência. RESULTADOS: Na comparação pelo sexo, as meninas obtiveram maiores valores para o peso (p=0,023), estatura (p=0,018) e percentual de gordura (p=0,001), enquanto que os meninos apresentaram melhor rendimento motor para a força explosiva de membros superiores (p=0,005) e inferiores (p=0,011), agilidade (0,018) e velocidade de membros superiores (p=0,014). Em relação ao estágio maturacional os meninos não apresentaram diferenças em nenhuma variável analisada; enquanto as meninas em estágio maturacional mais avançado apresentaram maiores valores para o peso (estágio V versus I), estatura (estágio III, IV e V versus I) e força explosiva de membros superiores (estágio III e IV versus I). CONCLUSÃO: Os indicadores de crescimento, peso e estatura, bem como a força explosiva de membros superiores foram mais elevados nas meninas em estágios maturacionais mais avançados e parecem ser dependentes do sexo.

Skeletal age and explosive strength in young volleyball players / Idade óssea e força explosiva de jovens praticantes de voleibol

Abstract Identifying different anthropometric, physiological and motor aspects is essential to obtain success in sports practice. However, these components may be developed in same age subjects differently, in part due biological development. The aim of the study was compare and correlate the explosive strength to biological maturation by sex, obtained by estimation of skeletal age based on anthropometric variables. The sample consisted of 239 subjects of both sexes, aged 10 to 13 years. Maturation was assessed by skeletal age predictive equation and upper and lower limbs explosive strength using medicine ball throw test and vertical jump, respectively. Skeletal age was assessed by skeletal age using a predictive anthropometrical based equation. Upper and lower limbs explosive strength were evaluated by medicine ball throwing test and vertical jump test, respectively. Post hoc analysis showed delayed biological development subjects had worst medicine ball throwing test performance than accelerated boys (p=0.001; d=0.96) and girls (p< 0.01; d= 2.01); regarding to vertical jump test, worst performance was also detected to maturational delayed boys when compared to accelerated ones (p=0.24; d=1.1) and girls (p=0.007; d=0.75). Regression analysis showed skeletal age explained variance of 36% and 19.2% for boys and 45.2% and 16.1% for girls upper and lower limbs explosive strength. Skeletal age is positively related to upper and lower limbs explosive strength and show higher performance for accelerated biological development young players when compared to delayed ones, independently from sex.

Resumo Para se alcançar o sucesso no esporte, a identificação de diferentes aspectos antropométricos, motores e fisiológicos são imprescindíveis. Porém, esses componentes podem se desenvolver diferentemente em indivíduos na mesma faixa etária, em parte pelo desenvolvimento biológico. O objetivo do estudo foi comparar e relacionar a força explosiva com a maturação biológica de acordo com o sexo. A amostra foi composta por 239 sujeitos, com idades entre 10 a 13 anos. A idade óssea foi estimada por uma equação preditora baseada em variáveis antropométricas. A força explosiva de membros superiores e inferiores foram avaliadas através do teste de arremesso de medicine ball e de salto vertical, respectivamente. A análise de post hoc mostrou que os sujeitos com desenvolvimento biológico atrasado obtiveram o pior desempenho no teste de arremesso de medicine ball quando comparados com o grupo acelerado dos meninos (p=0.001; d=0.96) e meninas (p< 0.01; d= 2.01); em relação ao teste de salto vertical, desempenho inferior também foi observado para o estágio atrasado quando comparado com o grupo acelerado dos meninos (p=0.24; d=1.1) e meninas (p= 0.007; d=0.75). Análise de regressão demonstrou que 36% e 19,2% da variância no desempenho da força explosiva de membros superiores e inferiores foi compartilhada pela idade óssea dos meninos, e 45,2% e 16,1%, respectivamente, nas meninas. Conclui-se que a força explosiva de membros superiores e inferiores se relaciona de forma positiva com a idade óssea, sendo o desempenho destes componentes superiores em jovens com desenvolvimento biológico acelerado, quando comparados com o desenvolvimento atrasado, independente do sexo.

Relação da idade óssea e marcadores hormonais com a capacidade física de adolescentes / Relationship between skeletal age, hormonal markers and physical capacity in adolescents

INTRODUCTION: Physical capabilities are an important parameter of the functional development of adolescents, not only by chronological age but also by their maturational state, as individuals with the same chronological age can have different performance to their less mature counterparts. OBJECTIVE: To compare and relate the physical capabilities and hormonal markers according to sex and maturity of adolescents. METHODS: The sample consisted of adolescents of both sexes, aged 10 to 14 years. We evaluated the maturity achieved by a predictive equation of skeletal age, physical capabilities (explosive power of upper and lower limbs, velocity of upper limbs and agility) and hormonal markers (testosterone and oestradiol) via chemiluminescence. RESULTS: Females showed more advanced maturational status, higher weight, body height and oestradiol levels; males performed better in the explosive force of upper and lower limbs, upper limb speed, agility and testosterone levels. In the normal maturational state males showed greater skeletal age, body weight, body height, explosive strength of upper and lower limbs, and testosterone levels; the females in the normal maturational state had higher skeletal age, body weight, body height, explosive upper limb strength and oestradiol levels. In the male correlation analysis, skeletal age was related to the explosive strength of upper and lower limbs and testosterone; while skeletal age in females was related to explosive upper limb strength and oestradiol. CONCLUSION: It is concluded that maturation, testosterone and oestradiol levels play an important role in the physical aspects and performance of motor skills of adolescents, especially in upper limb force which was more related to the maturation obtained by skeletal age of males and females.

INTRODUÇÃO: A capacidade física é um importante parâmetro do desenvolvimento funcional a ser investigado em crianças e adolescentes, não apenas pela idade cronológica e sim pelo seu estado maturacional, já que sujeitos com mesma idade cronológica podem apresentar desempenho diferente ao seu par menos maturado. OBJETIVO: Comparar e relacionar as capacidades físicas e marcadores hormonais de acordo com o sexo e maturação de crianças e adolescentes. MÉTODO: A amostra foi composta por 89 crianças e adolescentes de ambos os sexos de 10 a 13 anos. Foram avaliados a maturação obtida através de uma equação preditora da idade óssea, capacidades físicas (força explosiva de membros superiores e inferiores, velocidade de membros superiores e agilidade) e marcadores hormonais (testosterona e estradiol) através do método de quimioluminescência RESULTADOS: Na comparação entre os sexos as meninas obtiveram estado maturacional mais avançado, maior peso, estatura corporal e níveis de estradiol; já os meninos apresentaram melhor desempenho na força explosiva de membros superior e inferior, velocidade de membro superior, agilidade e níveis de testosterona. Relativo à maturação, os meninos em estado maturacional normal apresentaram maior idade óssea, peso e estatura corporal, força explosiva de membros superior e inferior, e níveis de testosterona; já as meninas no estado maturacional normal obtiveram maior idade óssea, peso, estatura corporal, força explosiva de membro superior e níveis de estradiol. Na análise de correlação dos meninos a idade óssea se relacionou com a força explosiva de membros superior e inferior e testosterona; já a idade óssea das meninas se relacionou com a força explosiva de membro superior e estradiol. CONCLUSÃO: Desta forma, se conclui que maturação e os níveis de testosterona e estradiol exercem um importante papel nos aspectos físicos e no desempenho das habilidades motoras das crianças e dos adolescentes, principalmente na força de membro superior a qual se mostrou mais relacionada com a maturação obtida pela idade óssea de meninos e meninas.

The nutritional state of children and adolescents with cerebral palsy is associated with oral motor dysfunction and social conditions: a cross sectional study.

BACKGROUND: Cerebral palsy (CP) is the main cause of severe physical impairment during childhood and has commonly shown oral motor association. It has been considered as the main cause of the high prevalence of problems in children's nutrition. Respiration, chewing, swallowing, speaking and facial expressionare part of the orofacial motor functions and when affected they can interfere in children's well-being. The aim of this study was to correlate two methods of orofacial motor evaluation, analyze the influence of orofacial motor functional impairment on the nutritional status of children and adolescents with CP, and the association between socioeconomic factors. METHODS: Seventy children and adolescents with CP were selected, age range 6-16 years and following the exclusion criteria previously determined; 129 normoreactive children (control group), sex and age-matched to patients with CP. For the orofacial motor analysis two evaluation instruments were applied, the "Oral Motor Assessment Scale" (OMAS) and "Nordic Orofacial Test-Screening" (NOT-S). The anthropometric evaluation was based on the World Health Organization (WHO) and followed the criteria recommended by the Brazilian Ministry of Health. RESULTS: There was statistically significant correlation between the oral motor methods of evaluation (r = -0.439, p < 0.0001). Concerning the nutritional status evaluation, being overweight was associated with dystonic and mixed CP forms variables (p = 0.034), mother with no partnership (p = 0.045) and mild oral motor impairment (p = 0.028). CONCLUSION: It could be concluded that, the weight's gain by children and adolescents might be favored by a better functional oral motor performance and social factors.

Relação da idade óssea com antropometria e aptidão física em jovens praticantes de voleibol / Relationship of age with bone and fitness anthropometry practitioners in youth volleyball / Relación de edad ósea con antropometría y condición física en jugadores jóvenes de vóleibol

Resumo O estudo teve como objetivo correlacionar a idade óssea, os componentes antropométricos e a aptidão física em 149 crianças de 8 a 14 anos. Foram aferidos estatura, massa corporal, perímetros de braço e de perna, perímetros de braço e de perna corrigidos, diâmetros bicristailíaco e biacromial, dobras cutâneas tricipital e perna, teste motores de agilidade, velocidade de membros superiores e força explosiva de membros inferiores e superiores e o exame de raios X de mão e punho para verificar maturação. Nos resultados, encontramos correlação positiva entre a idade óssea e as demais variáveis, com exceção das dobras cutâneas tricipital, de perna e teste de agilidade. Dessa forma, verificamos a influência da maturação sobre componentes antropométricos e motores. Assim, possibilitamos uma melhor forma de controle dos processos de detecção, seleção e orientação esportiva.

Abstract The study aimed to correlate bone age, anthropometric measurements and physical fitness in 149 young volleyball players between ages 8 and 14. Height, weight, arm and leg circumferences, adjusted arm and leg circumferences, bi-iliac and biacromial breadths, tricipital and leg skin fold thicknesses, physical fitness tests, coordination and explosive strength of the upper and lower limbs were measured, in addition to x-rays of hand and wrist to check for maturation. Results showed positive correlation between bone age and all other variables, except tricipital skinfold, leg skinfold and agility. We concluded that maturation has influence on anthropometric and motor components, leading to a better control in the process of selecting and promoting young athletes.

Resumen El estudio tuvo como objetivo observar la correlación entre edad ósea, variables antropométricas y condición física en 149 niños de 8 a 14 años. Se midieron la estatura, la masa corporal, la circunferencia del brazo y de la pierna, la circunferencia corregida del brazo y de la pierna, el diámetro bi-cresta ilíaca y biacromial, y el pliegue cutáneo del tríceps. Se hicieron pruebas motoras de agilidad de las piernas, de velocidad de los miembros superiores y de fuerza explosiva de los miembros superiores e inferiores, y se hicieron radiografías de la mano y el puño para verificar la maduración. En los resultados se encontró una correlación positiva entre la edad ósea y otras variables, con la excepción del pliegue cutáneo del tríceps y la prueba de agilidad de las piernas. Por tanto, se observa la influencia de la maduración de las variables antropométricas y motoras, lo que permite una mejor manera de controlar los procesos de detección, selección y orientación deportiva.

Adversidade na infância prediz sintomas depressivos e tentativas de suicídio em mulheres adultas portuguesas / Adversity in childhood predicts depressive symptoms and suicide attempts in adult portuguese women

Este estudo examinou a prevalência de 10 categorias de experiências adversas na infância autorrelatadas em mulheres adultas portuguesas, e avaliou se essas experiências eram preditoras do índice de sintomatologia depressiva e de tentativas de suicídio. Um total de 225 mulheres completou o Adverse Childhood Experiences Study Questionnairee a subescala de depressão do Inventário de Sintomas Psicopatológicos. Quase 96,0% das mulheres relatou ter sido exposta a pelo menos uma experiência adversa na infância e adolescência. Os resultados da regressão linear indicam que a adversidade total explica 6,6% da variância dos sintomas de depressão, enquanto a regressão logística mostra que o incremento de um ponto na adversidade total aumenta o risco de tentativas de suicídio em 1,818 vezes. Os resultados deste estudo mostram que a exposição a experiências adversas na infância é frequente e o seu grau é preditor de sintomatologia depressiva e tentativas de suicídio.

This study examined the prevalence of 10 categories of self-reported childhood adverse experiences in adult Portuguese women and assessed whether these factors were predictive of depressive symptoms and suicide attempts. A total of 225 women completed the Adverse Childhood Experiences Study Questionnaire and evaluated the depression subscale of the Brief Symptoms Inventory. Almost 96.0% of the participant women reported being exposed to at least one adverse experience in childhood and adolescence. Linear regression indicated that the total adversity explains 6.6% of the variance in symptoms of depression, whereas logistic regression indicated that the increase in adversity by one point increased the risk of suicide attempts 1,818 times. The results obtained show that exposure to adverse childhood experiences is frequent and that the degree of exposure is a predictor of depressive symptoms and suicide attempts.

Adversidade na infância prediz sintomas depressivos e tentativas de suicídio em mulheres adultas portuguesas / Adversity in childhood predicts depressive symptoms and suicide attempts in adult Portuguese women

Este estudo examinou a prevalência de 10 categorias de experiências adversas na infância autorrelatadas em mulheres adultas portuguesas, e avaliou se essas experiências eram preditoras do índice de sintomatologia depressiva e de tentativas de suicídio. Um total de 225 mulheres completou o Adverse Childhood Experiences Study Questionnairee a subescala de depressão do Inventário de Sintomas Psicopatológicos. Quase 96,0% das mulheres relatou ter sido exposta a pelo menos uma experiência adversa na infância e adolescência. Os resultados da regressão linear indicam que a adversidade total explica 6,6% da variância dos sintomas de depressão, enquanto a regressão logística mostra que o incremento de um ponto na adversidade total aumenta o risco de tentativas de suicídio em 1,818 vezes. Os resultados deste estudo mostram que a exposição a experiências adversas na infância é frequente e o seu grau é preditor de sintomatologia depressiva e tentativas de suicídio.(AU)

This study examined the prevalence of 10 categories of self-reported childhood adverse experiences in adult Portuguese women and assessed whether these factors were predictive of depressive symptoms and suicide attempts. A total of 225 women completed the Adverse Childhood Experiences Study Questionnaire and evaluated the depression subscale of the Brief Symptoms Inventory. Almost 96.0% of the participant women reported being exposed to at least one adverse experience in childhood and adolescence. Linear regression indicated that the total adversity explains 6.6% of the variance in symptoms of depression, whereas logistic regression indicated that the increase in adversity by one point increased the risk of suicide attempts 1,818 times. The results obtained show that exposure to adverse childhood experiences is frequent and that the degree of exposure is a predictor of depressive symptoms and suicide attempts.(AU)

Influência do comprometimento funcional orofacial no estado nutricional de crianças e adolescentes com paralisia cerebral / Influence of orofacial functional impairment on the nutritional status of children and adolescents with cerebral palsy

A Paralisia Cerebral (PC) é considerada a principal causa de deficiência física grave na infância, sendo comum o comprometimento motor associado. Esse, por sua vez, é apontado como a maior causa da alta prevalência de problemas na alimentação dessas crianças. Faz parte da função motora orofacial a respiração, a mastigação, a deglutição, a fala, a expressão facial e a aparência, e dessa forma, a disfunção pode comprometer o bem-estar da criança e de seu cuidador, uma vez que, quando presente, interfere na dinâmica interna e na rotina da família. O presente trabalho objetivou correlacionar 2 métodos de avaliação motora orofacial, avaliar a influência do comprometimento funcional orofacial no estado nutricional de crianças e adolescentes com PC e sua associação com condições socioecônomicas. Foram selecionadas 70 crianças e adolescentes com diagnóstico de PC, com idade de 6 a 16 anos (grupo estudo), e 129 crianças normorreativas, pareadas por gênero e idade aos PCs (grupo controle). Para a avaliação motora orofacial foram aplicados os instrumentos Oral Motor Assessment Scale (OMAS) e Nordic Orofacial Test-Screening (NOT-S). A avaliação antropométrica foi baseada nas curvas da Organização Mundial da Saúde (OMS), segundo os critérios do Ministério da Saúde do Brasil. Houve correlação estatisticamente significante entre os métodos de avaliação oromotora (r= -0,439, p<0,0001). Quanto à avaliação nutricional, observamos maior prevalência de estar acima do peso para as variáveis tipo de PC- distônico e misto (p=0,034), mães sem companheiro (p=0,045) e para menor comprometimento oromotor (p=0,028). Concluimos que, o ganho de peso em crianças e adolescentes é favorecido por um melhor desempenho funcional oromotor e fatores sociais.

Cerebral palsy (CP) is the main cause of severe physical impairment during childhood, which has commonly shown motor association. This has been pointed out as the main cause of high prevalence of problems in childrens nutrition. It is part of orofacial motor function: respiration, chewing, swallowing, speaking, facial expression and appearance, and therefore, the impairment can affect childrens well-being. The aim of this study was to correlate 2 methods of oral facial motor evaluation, evaluate the influence of oral facial functional impairment on the nutritional status of children and adolescents with CP, and the association between socioeconomic factors. 70 children and adolescents were selected with definitive CP diagnosis, age range 6-16 yrs and exclusion criteria previously determined, 129 normoreactive children, sex and age-matched to CPs (control group). For the oral facial motor evaluation two evaluation instruments were applied Oral Motor Assessment Scale (OMAS) and Nordic Orofacial Test-Screening (NOT-S). The anthropometric evaluation was based on the World Health Organization (WHO), according to the criteria recommended by the Brazilian Ministry of Health. There was statistically significant correlation between the oral motor methods of evaluation (r=-0.439, p<0.0001). With regards to the nutritional status evaluation, the studied population showed greater prevalence for overweight referring to the variables CP forms, dystonic and mixed (p=0.034), mother with no partnership (p=0.045) and a smaller oral motor impairment (p=0.028). It was concluded that, the weight´s gain by children and adolescents is favoured by a better functional oral motor performance and social factors.

Oficinas terapêuticas em saúde mental: um olhar na perspectiva dos usuários do caps / The quality of therapeutic wokrshops on mental health

Estudo descritivo, de natureza qualitativa, acerca da narrativa dos usuários do Centro de Atenção Psicossocial II sobre as características de qualidade das oficinas terapêuticas em saúde mental. Utilizamos como guia os Indicadores de Qualidade de Projeto (IQPs), conjunto de técnicas elaboradas e testadas na área educacional, que possuem a finalidade de avaliar projetos educacionais. Este nos propiciou atender aos nossos objetivos que foram: descrever as características de qualidade das oficinas terapêuticas, a partir da narrativa dos usuários, utilizando como guia os IQPs; discutir os IQPs como guia para a construção de critérios de qualidade nas oficinas terapêuticas em saúde mental; analisar as oficinas terapêuticas, enquanto dispositivo assistencial, a partir do olhar dos usuários. O estudo fundamentou-se em conceitos da Reabilitação Psicossocial e de estudiosos do Campo da Saúde Mental...

Recomendacão do uso de dentifrício, escova e fio dental pelo cirurgião-dentista / Recommending the use of toothpaste, toothbrush and floss at dentist

Atualmente há uma variedade de instrumentos que auxiliam o controle de biofilme dentário eprevenção das doenças bucais no ãmbito domiciliar. O objetivo desse estudo foi avaliar os hábitos e as práticas de higiene bucal dos Cirurgiões-Dentistas, seus conhecimentos científicos a respeito destes produtos destinados à higiene oral bem como a prescrição dos mesmos. A amostra foi constituída por 92 Cirurgiões-Dentistas presentes no Congresso Odontorio, na Associação Brasileira de Odontologia, seção Rio de Janeiro, em agosto de 2010, que responderam a um questionário com perguntas fechadas e abertas. Os resultados mostraram que, 64,1% observam a composição química do dentifrício, mas apenas 3,5% afirmam ser pelo valor da concentração de flúor, 61,9% verificam a data de validade dos dentifrícios apesar de não terem respondido o motivo, e 57,6% nunca prescreveram um dentifrício como coadjuvante a um tratamento odontológico. Apenas 2,9% baseiam-se em evidências científicas para se ter um dentifrício como opção. Quanto à preferência por alguma marca de escova dental, 54,3% afirmam não a ter. 51,1% não utilizam enxaguatório bucal na própria higiene oral, mas 79,3% o indicam aos seus pacientes. 95,7% consideram necessária a utilização do fio dental e 52,1% dos cirurgiões-den¬tistas recomendam uma marca específica. Existe uma desinformação por parte dos cirurgiões-dentistas, em relação à utilização e prescrição de instrumentos de higiene bucal, sendo necessária uma educação continuada, para que as indicações sejam baseadas em evidências científicas.

Currently there are a variety of tools to aid in plaque control and prevention of oral diseasesin the home. The aim of this study was to evaluate the habits and hygiene practices of dentists, their scientific knowledge about these products for oral hygiene and the prescription of them. The sample consisted of 92 Dental Surgeons Odontorio present in Congress, Brazilian Association of Dentistry, Section Rio de Janeiro in August 2010, who answered a questionnaire with closed and open questions. The results showed that 64.1% see the chemistry of toothpaste, but only 3.5% claim to be the amount of fluoride concentration, 61.9% check the expiration date of dentifrices although they did not answer why, and 57.6% had never prescribed a dentifrice as a adjuvant in dental treatment. Only 2.9% are based on scientific evidence to have an option like toothpas¬te. The preference for some brand of toothbrush, 54.3% claim not to have. 51.1% do not use mouthwash in their own oral hygiene, but the 79.3% indicated their patients. 95.7% considered necessary the use of dental floss and 52.1% of dentists recommend a specific brando There is a disinformation by the dentists in relation to the use and prescription of oral hygiene instruments, and need continuing education so that the particulars are based on scientific evídence.