Correlations between childhood maltreatment, anxiety and depressive symptoms, and risk behaviors in adolescent schoolchildren.

OBJECTIVE: Childhood maltreatment is extremely harmful to health, especially in relation to development of the psychiatric disorders throughout life. The objective of this study was to describe the prevalence and types of maltreatment in a sample of adolescent schoolchildren and to investigate associations between maltreatment types and anxiety and depressive symptoms, sociodemographic variables, and risk behaviors. The study also identified which variables were the greatest predictors of anxiety and depressive symptoms. METHODS: We conducted a cross-sectional study with a sample of 654 school students aged 11 to 17 years. We collected sociodemographic data and administered the Revised Child Anxiety and Depression Scale (RCADS-47) to measure anxiety and depressive symptoms as well as the Childhood Trauma Questionnaire (CTQ) to evaluate maltreatment and adverse experiences such as abuse and negligence during childhood and adolescence. Statistical analyses were conducted to estimate correlations between sociodemographic data, anxiety, depression, and types of maltreatment. A regression analysis was also conducted to identify maltreatment types that predict psychological symptoms. RESULTS: Emotional abuse and emotional neglect were the most prevalent types of maltreatment. Statistically, emotional abuse was the maltreatment type most strongly correlated with depression and anxiety and tended to co-occur with other types of maltreatment. Additionally, emotional and sexual abuse were the greatest predictors of anxiety and depression in adolescents. CONCLUSION: The above results reinforce the findings of previous studies in terms of understanding the effects of maltreatment. They identify emotional abuse as the main predictor of depressive and anxiety symptoms.

Correlations between childhood maltreatment, anxiety and depressive symptoms, and risk behaviors in adolescent schoolchildren

Abstract Objective Childhood maltreatment is extremely harmful to health, especially in relation to development of the psychiatric disorders throughout life. The objective of this study was to describe the prevalence and types of maltreatment in a sample of adolescent schoolchildren and to investigate associations between maltreatment types and anxiety and depressive symptoms, sociodemographic variables, and risk behaviors. The study also identified which variables were the greatest predictors of anxiety and depressive symptoms. Methods We conducted a cross-sectional study with a sample of 654 school students aged 11 to 17 years. We collected sociodemographic data and administered the Revised Child Anxiety and Depression Scale (RCADS-47) to measure anxiety and depressive symptoms as well as the Childhood Trauma Questionnaire (CTQ) to evaluate maltreatment and adverse experiences such as abuse and negligence during childhood and adolescence. Statistical analyses were conducted to estimate correlations between sociodemographic data, anxiety, depression, and types of maltreatment. A regression analysis was also conducted to identify maltreatment types that predict psychological symptoms. Results Emotional abuse and emotional neglect were the most prevalent types of maltreatment. Statistically, emotional abuse was the maltreatment type most strongly correlated with depression and anxiety and tended to co-occur with other types of maltreatment. Additionally, emotional and sexual abuse were the greatest predictors of anxiety and depression in adolescents. Conclusion The above results reinforce the findings of previous studies in terms of understanding the effects of maltreatment. They identify emotional abuse as the main predictor of depressive and anxiety symptoms.

Burden in caregivers of children with congenital Zika syndrome in Pernambuco, Brazil: analysis and application of the Zarit burden interview scale.

With the increase in cases of microcephaly caused by the Zika virus, the demand for special care and a better quality of life for the child and caregiver increased proportionally. Objective: This study aimed to analyze the burden on caregivers of children with congenital Zika syndrome associated with viral infections in the state of Pernambuco, Brazil using the Zarit Burden interview scale. Method: A quantitative study was conducted at the Oswaldo Cruz University Hospital, Recife City, State of Pernambuco, Brazil. By convenience sampling, 56 mothers, two grandmothers, and two caregivers were enrolled, all are female. Data were collected from July 2019 to January 2020. In the analysis, the percentage frequencies were calculated. The normality was identified using the Kolmogorov-Smirnov test, and participant profiles were compared using Student's t-test and analysis of variance. In descriptive statistics, quantitative variables are described by the median and interquartile range and categorical variables by proportions using the Chi-square test. Results: In the comparative analysis, all factors evaluated were significant, except for the "gestational period in which the disease occurred" (p < 0.111). The significance of differences in all activities was evaluated. In the mean comparison test, only the factor "has a job" was significant (p < 0.043). When comparing the average of caregivers' responses to the categories of the Zarit burden interview scale, the highest level of burden was regarding the feeling that the child is dependent on the caregiver (3.62 points). Caregiver burden was classified as absence, light, moderate, and high. Conclusion: The consequences of contracting the Zika virus in the first trimester of pregnancy, lack of paid work, financial scarcity, full-time dedication to the child, and lack of time for themselves increase the burden on caregivers. Thus, caregivers have mild burden.

Tradução e adaptação transcultural do instrumento de avaliação do profissionalismo P-MEX para uso em médicos residentes / Translation and transcultural adaptation of the Professional Mini-Evaluation Exercise (P-MEX) for use on medical residents

Resumo: Introdução: Profissionalismo médico refere-se a vários atributos, valores, comportamentos, responsabilidades e compromissos dos médicos com os pacientes e com a sociedade. O profissionalismo é traduzido, hoje, como uma nova competência agregada ao conjunto de habilidades médicas, devendo ser demonstrada, ensinada e avaliada durante a formação desses profissionais. O Professionalism Mini-Evaluation Exercise (P-MEX) é um instrumento de avaliação do profissionalismo médico criado no Canadá, em 2006, e já validado para uso em alguns países, mostrando evidências de validade, confiabilidade e reprodutibilidade dos resultados nesses lugares. Objetivo: O objetivo deste estudo foi desenvolver uma versão do instrumento em língua portuguesa e adaptada transculturalmente para uso no Brasil. Método: A tradução e a adaptação transcultural foram realizadas seguindo as diretrizes da International Test Commission (ITC) - segunda versão 2017. Adotaram-se as seguintes etapas: tradução para o português por dois médicos brasileiros fluentes na língua inglesa, revisão da tradução por um comitê revisor, retrotradução por dois professores de inglês procedentes de países de língua inglesa, revisão da retrotradução por um comitê revisor, aprovação da retrotradução pelo autor original do questionário e, por último, aplicação da versão consenso final do instrumento ao público-alvo da pesquisa para avaliar a clareza, compreensão e aceitabilidade. Resultados: A versão final em português foi considerada adequada e utilizada como definitiva, constituindo a versão final em português do P-MEX. Todo o processo realizado seguindo guias internacionais classicamente utilizados, inclusive a aprovação final do autor do instrumento original, reitera que a nova versão adaptada do questionário tem validade de conteúdo correspondente ao original. Conclusão: Diante da lacuna de instrumentos para medir o profissionalismo médico no Brasil, realizaram-se a tradução e a adaptação transcultural do P-MEX para uso no país, podendo ser utilizado para estimular uma prática profissional mais adequada para os pacientes e a sociedade.

Abstract: Introduction: Medical Professionalism refers to several attributes, values, behaviors, responsibilities and commitments of physicians in relation to their patients and society. Professionalism translates today as a new competence composed of the medical skill set that should be demonstrated, taught and evaluated during the training of these professionals. The Professionalism Mini-Evaluation Exercise (P-MEX) is a medical professionalism evaluation tool created in Canada in 2006 and validated for use in Japan, Finland and Iran, having demonstrated its validity, reliability and reproducibility in these countries. Objective: The objective of this study is to develop a version of this instrument in Portuguese and adapt it transculturally to be used in Brazil. Method: The translation and transcultural adaptation was made according to the International Test Commission (ITC) - 2nd edition 2017 guidelines. The following steps were taken: translation into Portuguese by two fluent English-speaking Brazilian physicians, review of the translation by a Review Committee, backtranslation by two English teachers from English speaking countries, review of the backtranslation by a Review Committee, approval of the backtranslation by the original author of the questionnaire and, finally, application of the agreeded final form of the instrument to the target population to evaluate its clarity, understandability and acceptability. Results: The final Portuguese form was considered suitable, constituting the final Portuguese version of the Professionalism Mini-Evaluation Exercise (P-MEX). The entire process was conducted in accordance with classically used international guidelines, including the final approval of the author of the original form, reasserting that the validity of the new adapted version of the form matches that of the original. Conclusion: In view of the lack of instruments to measure medical professionalism in Brazil, translation and cross-cultural adaptation of the P-MEX for use in the country was carried out, to be used to stimulate a more appropriate professional practice for patients and society.

Life satisfaction mediates the association between childhood maltreatment and depressive symptoms: a study in a sample of Brazilian adolescents.

OBJECTIVE: To evaluate the interrelationships between childhood maltreatment, life satisfaction (LS), and depressive symptoms, and to investigate LS as a mediating factor in the association between childhood maltreatment and depressive symptoms. METHODS: The sample consisted of 342 adolescents, aged 11 to 17 years (mean = 13.3, SD = 1.52 years), recruited from a public school in Salvador, Brazil. Participants filled out instruments for the collection of sociodemographic data and evaluation of childhood maltreatment, LS, and depressive symptoms. Structural equation modeling (SEM) was used to evaluate the mediating effect of LS. RESULTS: We detected significant negative correlations between childhood maltreatment and LS and between LS and depressive symptoms. We observed a significant positive correlation between childhood maltreatment and depressive symptoms. LS partially mediated the association between childhood maltreatment and depressive symptoms, mitigating the impact of maltreatment. CONCLUSION: LS played an important mediating role in the association between childhood maltreatment and depressive symptoms. Longitudinal studies are recommended to fully elucidate these associations, reinforcing the need for attention and care of this vulnerable population.

Violência no contexto escolar e ideação suicida na adolescência / Violencia en el contexto escolar e ideación suicida en la adolescencia / Violence in the school context and suicidal ideation in adolescence

Objetivo: analisar a violência escolar sofrida e praticada e a sua associação com a ideação suicida, entre adolescentes com 12 a 18 anos. Método: pesquisa realizada com 643 adolescentes, matriculados em escolas estaduais da cidade do Recife, Pernambuco, Brasil. Foram aplicados dois questionários: "Global School-based Student Health Survey" e "Violência na Escola". Para análise estatística utilizou-se o teste Qui-quadrado, grau de associação foi analisado por meio da razão de prevalências. Resultados: as prevalências de violência escolar e de ideação suicida foram de 62,2% e 17,4%, respectivamente. Cerca de 28% dos adolescentes relataram já terem se sentido muito triste, 14% deles declararam sentir solidão frequentemente. Houve associação significativa da ideação suicida com a violência sofrida na faixa etária de 15-18 anos. Conclusão: os resultados apontam para a necessidade de ações de saúde, que visem fortalecer os fatores de proteção e prevenção das situações de risco para a violência e ideação suicida.

Objective: to analyze the school violence suffered and practiced and its association with suicidal ideation among adolescents aged 12 to 18 years. Method: study conducted with 643 adolescents registered in state schools in the city of Recife, Pernambuco, Brazil. Two questionnaires were applied: "Global School-based Student Health Survey" and "Violence at School". For statistical analysis, the Chi-square test was used, degree of association was analyzed using the prevalence ratio. Results: the prevalence of school violence and suicidal ideation was 62.2% and 17.4%, respectively. About 28% of the adolescents reported having felt very sad, 14% of them reported feeling loneliness frequently. There was a significant association between suicidal ideation and violence in the age group of 15-18 years. Conclusion: the results point to the need for health actions aimed at strengthening the protective and prevention factors of risk situations for violence and suicidal ideation.

Objetivo: analizar la violencia escolar sufrida y practicada y su asociación con la ideación suicida entre adolescentes de 12 a 18 años. Método: estudio realizado con 643 adolescentes matriculados en escuelas estatales en la ciudad de Recife, Pernambuco, Brasil. Se aplicaron dos cuestionarios: "Global School-based Student Health Survey" y "Violencia en la Escuela". Para el análisis estadístico, se utilizó la prueba Chi-cuadrada, se analizó el grado de asociación utilizando la relación de prevalencia. Resultados: la prevalencia de la violencia escolar y la ideación suicida fue del 62,2% y del 17,4%, respectivamente. Alrededor del 28% de los adolescentes informaron que se habían sentido muy triste, el 14% de ellos reportaron sentir la soledad con frecuencia. Hubo una asociación significativa entre la ideación suicida y la violencia en el grupo de edad de 15-18 años. Conclusión: los resultados apuntan a la necesidad de acciones sanitarias encaminadas a fortalecer los factores de protección y prevención de las situaciones de riesgo para la violencia y la ideación suicida.

Qualidade de vida e uso abusivo de álcool: relação em moradores da comunidade quilombola Lagoa dos Índios* / Quality of life and alcohol abuse: relationship in residents of the Lagoa dos Índios quilombo / Calidad de vida y el uso abusivo del alcohol: relación en residentes de la comunidad quilombo Lagoa dos Índios

OBJETIVO: avaliar a qualidade de vida e o consumo abusivos de álcool em moradores da comunidade quilombola Lagoa dos Índios em Macapá- Amapá. MÉTODO: instrumentos utilizados World Health Organization Quality of Life Instrument abreviado (WHOQOL-BREF). RESULTADOS: prevalência do sexo masculino, escolaridade baixa e consumo de álcool na adolescência. Para a QV, os domínios evidenciados foram relações sociais (75,64%) e psicológico (65,11%); o domínio menos evidenciado foi meio ambiente (49,77%). CONCLUSÃO: a qualidade de vida propõe repensar essa condição, considerando o meio ambiente mais favorável e a importância de intervenções efetivas para as variáveis sociodemográficas multidimensionais.

OBJECTIVE: to evaluate the Quality of life (QoL) and abusive alcohol consumption by residents of the Lagoa dos Índios quilombola community in the city of Macapá, state of Amapá. METHOD: the instrument used was the short version of the World Health Organization Quality of Life Instrument (WHOQOL-BREF). RESULTS: there was prevalence of males, low educational levels and alcohol consumption in adolescence. As for QoL, the domains that stood out were the social relationships (75.64%) and psychological (65.11%); the domain with lowest scores was the environmental (49.77%). CONCLUSION: the QoL proposes to rethink this condition considering a more favorable environment and the importance of effective interventions for multidimensional sociodemographic variables.

OBJETIVO: evaluar la calidad de vida y el consumo abusivo de alcohol en los habitantes de la comunidad quilombola Lagoa dos Indios en Macapá- Amapá. MÉTODO: Instrumentos utilizados World Health Organization Quality of Life Instrument abreviado (WHOQOL-BREF). RESULTADOS: Prevalencia del género masculino; bajo nivel de educación y consumo de alcohol en la adolescencia. Para la CV, las áreas destacadas fueron las relaciones sociales (75,64%); psicológica (65,11%), el área menos destacada fue el entorno (49,77%). CONCLUSIÓN: la calidade de vida propone reconsiderar esta condición, teniendo en cuenta un entorno más favorable y la importancia de las intervenciones efectivas en las variables socio-demográficas multidimensionales

The incidence of sexual violence among children and adolescents in Recife, State of Pernambuco, Brazil, in 2012 and 2013. / Incidência de violência sexual em crianças e adolescentes em Recife/Pernambuco no biênio 2012- 2013.

The scope of this study was to establish the incidence of sexual violence against children and adolescents in Recife, State of Pernambuco (Brazil) between 2012 and 2013. Data was collected from the records of rape examination reports carried out at the Recife Institute of Forensic Medicine. Of the 867 cases recorded, 328 of the victims were children and adolescents. An incidence of 3.67 cases per 10,000 inhabitants in the 0 to 18 age range was identified. The majority of the victims were female (92.1%) between 10 and 14 years of age (59.2%). In two thirds of the cases, rape was the most frequent type of sexual abuse and the majority of perpetrators were known to the victim (57.8%). An association between the type of sexual violence and the age and sex of the victim and perpetrator (p < 0.001) was determined. The most common type of sexual violence was rape among adolescents and sexual abuse not involving rape among children. The cases of sexual violence against children and adolescents shown in this study increase the visibility of this serious health problem and the need for preventive public policies.

Este estudo objetivou identificar a incidência da violência sexual em crianças e adolescentes em Recife/Pernambuco, no período 2012-2013. Os dados foram obtidos a partir dos registros de exames sexológicos, realizados no instituto de Medicina Legal do Recife. Identificaram-se 867 registros no período e foi de 328 o total de crianças e adolescentes vitimadas, com incidência de 3,67/10.000 habitantes, na faixa etária de 0 a 18 anos. A maioria das vítimas era do sexo feminino (92,1%), e estava na faixa etária de 10 a 14 anos (59,2%). A violência sexual do tipo conjunção carnal predominou em 2/3 dos casos, sendo uma pessoa conhecida da vítima o agressor mais frequente (57,8%). Foram significantes (p < 0,001) as associações entre o tipo de violência e as variáveis idade e sexo da vítima, e agressor. Os resultados do presente estudo evidenciaram que ainda há notificação deste tipo de violência, que ainda são indicativos de violência sexual tipo conjunção carnal, e que vitimou com maior frequência os adolescentes, além de atos libidinosos diversos com crianças. A elevada frequência de violência sexual contra crianças e adolescentes evidenciada neste estudo amplia a visibilidade desse grave problema de saúde e é indicativa da necessidade de políticas públicas preventivas.

Incidência de violência sexual em crianças e adolescentes em Recife/Pernambuco no biênio 2012- 2013 / The incidence of sexual violence among children and adolescents in Recife, State of Pernambuco, Brazil, in 2012 and 2013

Resumo Este estudo objetivou identificar a incidência da violência sexual em crianças e adolescentes em Recife/Pernambuco, no período 2012-2013. Os dados foram obtidos a partir dos registros de exames sexológicos, realizados no ĩnstituto de Medicina Legal do Recife. Identificaram-se 867 registros no período e foi de 328 o total de crianças e adolescentes vitimadas, com incidência de 3,67/10.000 habitantes, na faixa etária de 0 a 18 anos. A maioria das vítimas era do sexo feminino (92,1%), e estava na faixa etária de 10 a 14 anos (59,2%). A violência sexual do tipo conjunção carnal predominou em 2/3 dos casos, sendo uma pessoa conhecida da vítima o agressor mais frequente (57,8%). Foram significantes (p < 0,001) as associações entre o tipo de violência e as variáveis idade e sexo da vítima, e agressor. Os resultados do presente estudo evidenciaram que ainda há notificação deste tipo de violência, que ainda são indicativos de violência sexual tipo conjunção carnal, e que vitimou com maior frequência os adolescentes, além de atos libidinosos diversos com crianças. A elevada frequência de violência sexual contra crianças e adolescentes evidenciada neste estudo amplia a visibilidade desse grave problema de saúde e é indicativa da necessidade de políticas públicas preventivas.

Abstract The scope of this study was to establish the incidence of sexual violence against children and adolescents in Recife, State of Pernambuco (Brazil) between 2012 and 2013. Data was collected from the records of rape examination reports carried out at the Recife Institute of Forensic Medicine. Of the 867 cases recorded, 328 of the victims were children and adolescents. An incidence of 3.67 cases per 10,000 inhabitants in the 0 to 18 age range was identified. The majority of the victims were female (92.1%) between 10 and 14 years of age (59.2%). In two thirds of the cases, rape was the most frequent type of sexual abuse and the majority of perpetrators were known to the victim (57.8%). An association between the type of sexual violence and the age and sex of the victim and perpetrator (p < 0.001) was determined. The most common type of sexual violence was rape among adolescents and sexual abuse not involving rape among children. The cases of sexual violence against children and adolescents shown in this study increase the visibility of this serious health problem and the need for preventive public policies.

A Novel Aldosterone Antagonist Limits Renal Injury in 5/6 Nephrectomy.

Aldosterone antagonists slow the progression of chronic kidney disease (CKD), but their use is limited by hyperkalemia, especially when associated with RAS inhibitors. We examined the renoprotective effects of Ly, a novel non-steroidal mineralocorticoid receptor (MR) blocker, through two experimental protocols: In Protocol 1, male Munich-Wistar rats underwent 5/6 renal ablation (Nx), being divided into: Nx+V, receiving vehicle, Nx+Eple, given eplerenone, 150 mg/kg/day, and Nx+Ly, given Ly, 20 mg/kg/day. A group of untreated sham-operated rats was also studied. Ly markedly raised plasma renin activity (PRA) and aldosterone, and exerted more effective anti-albuminuric and renoprotective action than eplerenone. In Protocol 2, Nx rats remained untreated until Day 60, when they were divided into: Nx+V receiving vehicle; Nx+L treated with losartan, 50 mg/kg/day; Nx+L+Eple, given losartan and eplerenone, and Nx+L+Ly, given losartan and Ly. Treatments lasted for 90 days. As an add-on to losartan, Ly normalized blood pressure and albuminuria, and prevented CKD progression more effectively than eplerenone. This effect was associated with strong stimulation of PRA and aldosterone. Despite exhibiting higher affinity for the MR than either eplerenone or spironolactone, Ly caused no hyperkalemia. Ly may become a novel asset in the effort to detain the progression of CKD.

A mediação no processo de construção e representação de conhecimentos em deficientes visuais / Mediation in the construction and representation of knowledge in the visually impaired

O objetivo desse ensaio é apresentar as inquietações sobre como são construídos e representados os conhecimentos pelos deficientes visuais. A percepção de quem escreve é de um vidente, e por isso ainda maior a busca por algumas respostas e/ou novas perguntas. A investigação tem como objetivo refletir sobre a utilização da mediação, em especial o método do quarto excluído, no processo de construção de conceitos, em todos os seus níveis, desde o mais simples até o mais abstrato, em pessoas que apresentem problemas visuais (cegueira total ou visão subnormal), assim como iniciar uma discussão sobre o significado de representação mental e percepção visual, tanto para os videntes quanto para os deficientes visuais. Busca-se, com a continuidade do trabalho, ampliar a pesquisa para um grupo maior de deficientes visuais, proporcionando um diálogo mais constante que permita a observação do cotidiano dessas pessoas, as dificuldades enfrentadas, as habilidades desenvolvidas e a percepção de mundo.

A mediação no processo de construção e representação de conhecimentos em deficientes visuais / Mediation in the construction and representation of knowledge in the visually impaired

O objetivo desse ensaio é apresentar as inquietações sobre como são construídos e representados os conhecimentos pelos deficientes visuais. A percepção de quem escreve é de um vidente, e por isso ainda maior a busca por algumas respostas e/ou novas perguntas. A investigação tem como objetivo refletir sobre a utilização da mediação, em especial o método do quarto excluído, no processo de construção de conceitos, em todos os seus níveis, desde o mais simples até o mais abstrato, em pessoas que apresentem problemas visuais (cegueira total ou visão subnormal), assim como iniciar uma discussão sobre o significado de representação mental e percepção visual, tanto para os videntes quanto para os deficientes visuais. Busca-se, com a continuidade do trabalho, ampliar a pesquisa para um grupo maior de deficientes visuais, proporcionando um diálogo mais constante que permita a observação do cotidiano dessas pessoas, as dificuldades enfrentadas, as habilidades desenvolvidas e a percepção de mundo

Early brief treatment with losartan plus mycophenolate mofetil provides lasting renoprotection in a renal ablation model.

BACKGROUND: Inflammatory events antecede established renal injury in rats with 5/6 renal ablation (Nx), as indicated by the beneficial effects of early, uninterrupted treatment with mycophenolate mofetil (MMF). Angiotensin II also exerts a major pathogenic role at this initial phase. We investigated whether losartan (L) or L+MMF treatment, started early, and L+MMF treatment, started late, would exert lasting renoprotection in Nx even after being discontinued. METHODS: Adult male Munich-Wistar rats underwent Nx and were divided into three groups: Nx (untreated), Nx(L) (given L), and Nx(LMMF) (given L and MMF). Protocol 1: treatments began on day 1, and ceased on day 30, after Nx. Protocol 2: L+MMF treatment began on day 30 and ceased on day 60. RESULTS: Protocol 1: on day 30, hypertension, albuminuria and renal injury were strongly attenuated in Groups Nx(L) and Nx(LMMF). On day 120, these abnormalities were still attenuated in group Nx(LMMF). Protocol 2: on day 120, all parameters were similar between this late Nx(LMMF) group and untreated Nx. CONCLUSION: In Nx, temporary suppression of early, transitory hemodynamic/inflammatory phenomena affords relatively durable renoprotection even after treatment discontinuation. This effect is not obtained with similar temporary treatment initiated later in the course of renal disease.

Proposta de um protocolo para o atendimento odontológico do paciente idoso na atenção básica / Proposal of a protocol for the elderly patient dental attendance in basic health attention

Com o considerável aumento da população idosa, cresce a demanda por profissionais capacitados a lidar com essa faixa etária. Devido as suas modificações morfo-funcionais, essa população necessita de uma abordagem e de cuidados diferenciais. A saúde bucal merece atenção especial, pois este grupo populacional é detentor de altos níveis de edentulismo, doenças periodontais, ósseas e musculares, além do uso de próteses inadequadas. Um dos motivos se deve à incípiência de programas de saúde bucal voltados para os idosos. O objetivo deste estudo é desenvolver um protocolo de atendimento odontológico para o paciente idoso no programa de saúde da família, propondo uma reorientação da prática dos procedimentos odontológicos, evidenciando a importância do atendimento multidisciplinar, para a prevenção, controle e tratamento das suas afecções. As fontes foram obtidas nas bases de dados do BIREME, LILACS, BBO e SCIELO, sendo todos os artigos publicados em periódicos nacionais no período de 2000 a 2008, além do Caderno de Atenção Básica (nº 17) de 2006 do Ministério da Saúde.

With the considerable increasein the eldery population, growing demand for trained professionals to deal with this age group. Because their morphofunctional changes, this population needs a differencial approach and care. The oral health deserves special attention, because this population group is holding high levels of edentulism, periodontal disease, bone and muscle, in addition to the inappropriate use of prostheses. One reason is due to the scarcity of programs for oral health facing the elderly. The purpose of this study is to develop a protocol for dental care for the elderly patients in the program of family health, an reorientation of the proposed practice of dental procedures, emphasizing the importance of multidisciplinary care for the prevention, control and treatment of their diseases. The sources were obtained in the databases from BIREME, LILACS, BBO and SCIELO, and all articles published in national journals in the period 200 to 2008 in addition to Notebook basic care (No. 17) 2006 Ministry of Health.

Revisão de literatura sobre a saúde bucal do idoso / Literature review on aged’s buccal health

Objetivos: realizar revisão da produção de conhecimentos nacional sobre saúde bucal do idoso, identificar a estruturametodológica dos estudos e determinar o número de publicações sobre a saúde bucal do idoso no Brasil. Metodologia:estudo de revisão de literatura com busca em bases de dados eletrônicos da BIREME, LILACS e SCIELO, cujos descritoresutilizados foram saúde bucal e idoso. Os artigos selecionados foram caracterizados segundo tema do artigo, ano depublicação, revista, metodologia do artigo, onde foram identificados tipo de estudo, população/amostra, local de estudoe instrumento. Resultados: dos 19 artigos analisados, oito referiam-se à epidemiologia da saúde bucal, dois a perfil desaúde, quatro à autopercepção da saúde bucal, três a autopercepção e uso de serviços odontológicos pelos idosos e umreferente à validação de modelo teórico. Considerações finais: conclui-se que há necessidade de uma maior qualificaçãodos profissionais de odontologia e adequação dos serviços odontológicos às demandas dos idosos para uma efetivaimplementação de políticas públicas de atenção a terceira idade.

[Health risk behavior among young offenders]. / Comportamentos de risco para a saúde entre adolescentes em conflito com a lei.

The objective of this study was to investigate health risk behavior among teenage offenders committed to a social-educational institution in a city in Greater Metropolitan Recife, Pernambuco State, Brazil. The sample included 241 males 12-18 years of age. Data were collected with a brief self-completed questionnaire used by the Centers for Disease Control and Prevention, translated and adapted for young Brazilians. 79.7% of subjects reported having carried a gun and 52.7% had been in fights involving physical aggression in the previous 12 months. Most of the young offenders smoked cigarettes (87.6%) and consumed alcohol (64.7%). The majority reported having sniffed inhalants (68.9%), and 81.3% had smoked marijuana. The vast majority (95.4%) reported being sexually initiated, most having had sex with more than one partner. Young offenders showed high rates of various health risk behaviors.

Comportamentos de risco para a saúde entre adolescentes em conflito com a lei / Health risk behavior among young offenders

O objetivo deste estudo foi investigar as condutas de saúde entre adolescentes em conflito com a lei, internos em instituição de atendimento sócio-educativo em município da região metropolitana do Recife, Pernambuco, Brasil. A amostra foi composta por 241 jovens do sexo masculino, de 12 a 18 anos de idade. Para a coleta de dados, utilizou-se uma versão reduzida do questionário de autopreenchimento utilizado pelo Centers for Disease Control and Prevention dos Estados Unidos, traduzido e adaptado para jovens brasileiros. Entre os jovens pesquisados, 79,7 por cento afirmaram ter portado arma, assim como 52,7 por cento estiveram envolvidos em briga com agressão física nos últimos 12 meses. Verificou-se que a maioria dos jovens pesquisados era usuário de tabaco (87,6 por cento) e álcool (64,7 por cento). Grande parte dos jovens afirmou já ter experimentado algum produto inalante na vida (68,9 por cento) e ter feito uso de maconha (81,3 por cento). A maioria dos jovens (95,4 por cento) já tinha tido relação sexual, em geral com mais de um parceiro. Os jovens em situação de conflito com a lei apresentaram vários comportamentos de risco à saúde em percentuais elevados.

The objective of this study was to investigate health risk behavior among teenage offenders committed to a social-educational institution in a city in Greater Metropolitan Recife, Pernambuco State, Brazil. The sample included 241 males 12-18 years of age. Data were collected with a brief self-completed questionnaire used by the Centers for Disease Control and Prevention, translated and adapted for young Brazilians. 79.7 percent of subjects reported having carried a gun and 52.7 percent had been in fights involving physical aggression in the previous 12 months. Most of the young offenders smoked cigarettes (87.6 percent) and consumed alcohol (64.7 percent). The majority reported having sniffed inhalants (68.9 percent), and 81.3 percent had smoked marijuana. The vast majority (95.4 percent) reported being sexually initiated, most having had sex with more than one partner. Young offenders showed high rates of various health risk behaviors.

Short-term nitric oxide inhibition induces progressive nephropathy after regression of initial renal injury.

Chronic nitric oxide (NO) inhibition and salt overload (HS) promote severe hypertension and renal injury, which regress quickly, although not completely, on treatment withdrawal. We investigated whether renal function and structure remain stable 6 mo after cessation of these treatments. Adult male Munich-Wistar rats were distributed among three groups: HS, receiving 3.1% Na diet; HS+N, receiving HS and the NO inhibitor N(omega)-nitro-l-arginine methyl ester (l-NAME; 30 mg.kg(-1).day(-1) orally); and HS+N+L, receiving HS+N and the ANG II blocker losartan (L; 50 mg.kg(-1).day(-1) orally). In studies performed after 20 days of treatment (protocol 1), HS+N rats exhibited severe glomerular and systemic hypertension, massive albuminuria, glomerular and interstitial injury, and infiltration by macrophages and cells expressing ANG II. These abnormalities were largely prevented in the HS+N+L group. A second cohort (protocol 2) received HS+N for 20 days, followed by a conventional (0.5% Na) diet and no l-NAME treatment during the subsequent 30 days. At this time, systemic and glomerular pressure, along with parameters of renal injury and inflammation, were still higher than in HS or HS+N+L rats, although differences were much smaller than in protocol 1. Six months after 20-day l-NAME/salt overload treatment was ceased (protocol 3), severe albuminuria, hypertension, and renal injury developed in HS+N rats. Again, losartan prevented most of these changes. We conclude 1) short-term HS+N treatment triggers the autonomous development of progressive glomerulosclerosis; 2) this process may involve activation of the AT(1) receptor; and 3) temporary HS+N treatment may represent a new model of slowly progressive chronic nephropathy.