Odontologia UFES em 10 anos perfil profissional e sociodemográfico dos egressos / Odontología UFES en 10 años: perfil profesional y sociodemográfico de los egresados / Dentistry UFES in 10 years: professional and sociodemographic profile of graduates

Desde a sua regulamentação profissional, a Odontologia passou por muitas mudanças até sua consolidação. O aumento indiscriminado e sem planejamento da oferta de cursos de Odontologia resultou em um crescimento exagerado do número de profissionais no mercado de trabalho, culminando no atual momento de saturação e de acelerada reorganização do curso. Tais mudanças não se limitaram ao desenvolvimento tecnológico e científico. Observou-se, também, alteração no perfil do estudante e do profissional de odontologia no decorrer deste percurso, portanto essa pesquisa tem o objetivo de conhecer o perfil da força de trabalho dos profissionais graduados e verificar a inserção regional do Curso de Odontologia da Universidade Federal do Espírito Santo (UFES). Este estudo quantitativo de natureza descritiva e exploratória analisou o perfil profissional e sociodemográfico de 533 egressos do Curso de Odontologia da UFES entre 2008 e 2018, a partir do banco de dados do Conselho Regional de Odontologia do Espírito Santo e do DATASUS. Como resultados observou-se uma maioria feminina (70%), comidade entre 25-40 anos, ativos na Odontologia (85,1%), atuando no estado no setor privado. A maioria é formada por clínicos gerais (65,2%), mas existe uma tendência à especialidade que, quando presente, concentra-se na Ortodontia, Endodontia, Prótese e Implantodontia. Os resultados confirmaram a importante inserção regional do Curso de Odontologia da UFES no desenvolvimento local. Entretanto, apesar das Diretrizes Curriculares Nacionais direcionarem para um perfil generalista, voltado para a coletividade, constata-se maior tendência ao mercado privado, possivelmente pelos honorários mais atrativos (AU).

Desde su regulación profesional, la Odontología ha sufrido muchos cambios hasta su consolidación. El aumento indiscriminado y no planificado de la oferta de carreras de Odontología resultó en un crecimiento exagerado del número de profesionales en el mercado de trabajo, culminando en el momento actual de saturación y reorganización acelerada de la carrera. Tales cambios no se limitaron al desarrollo tecnológico y científico. También se observó un cambio en el perfil del estudiante y del profesional de odontología durante este curso, por lo que esta investigación tiene como objetivo conocer el perfil de la fuerza de trabajo de los profesionales graduados y verificar la inserción regional del Curso de Odontología en la Universidad Federal de Espírito Santo (UFES). Este estudio cuantitativo, descriptivo y exploratorio analizó el perfil profesional y sociodemográfico de 533 egresados de la Carrera de Odontología de la UFES entre 2008 y 2018, a partir de la base de datos del Consejo Regional de Odontología de Espírito Santo y DATASUS. Como resultado, hubo una mayoría femenina (70%), con edad entre 25-40 años, activa en Odontología (85,1%), trabajando en el estado en el sector privado. La mayoría está formada por médicos generales (65,2%), pero existe una tendencia a la especialización que, cuando está presente, se centra en Ortodoncia, Endodoncia, Prótesis e Implantología. Los resultados confirmaron la importante inserción regional de la Carrera de Odontología de la UFES en el desarrollo local. Sin embargo, a pesar de que los Lineamientos Curriculares Nacionales apuntan hacia un perfil generalista, dirigido a la comunidad, existe una mayor tendencia hacia el mercado privado, posiblemente por las tarifas más atractivas (AU).

Since its professional regulation, Dentistry has undergone many changes until its consolidation. The indiscriminate and unplanned increase in the offer of Dentistry courses led to a marked growth in the number of professionals in the job market, culminating in the current moment of saturation and accelerated reorganization of the course. Such changes were not limited to technological and scientific development; changes were also observed in the profile of students and dental professionals during this course. Thus, this study investigated the profile of the workforce of graduated professionals and verified the regional insertion of the Dentistry Course at the Federal University of Espírito Santo (UFES). This quantitative, descriptive and exploratory study analyzed the professional and sociodemographic profile of 533 graduates of the Dentistry Course at UFES between 2008 and 2018, based on the database of the Regional Dental Council of Espírito Santo and DATASUS. As a result, there was majority of females (70%), aged between 25-40 years, active in Dentistry (85.1%), working in the state in the private sector. The majority is formed by general practitioners (65.2%), but there is a tendency to specialize which, when present, focuses on Orthodontics, Endodontics, Prosthodontics and Implantology. The results confirmed the important regional insertion of the UFESDentistry Course in local development. However, despite the National Curriculum Guidelines directing towards a generalist profile, aimed at the community, there is a greater tendency towards the private market, possibly due to the more attractive incomes (AU).

Brazilian Nutritional Consensus in Hematopoietic Stem Cell Transplantation: children and adolescents.

The Brazilian Nutritional Consensus in Hematopoietic Stem Cell Transplantation: Children and Adolescents was developed by dietitians, physicians, and pediatric hematologists from 10 Brazilian reference centers in hematopoietic stem cell transplantation. The aim was to emphasize the importance of nutritional status and body composition during treatment, as well as the main characteristics related to patient´s nutritional assessment. This consensus is intended to improve and standardize nutrition therapy during hematopoietic stem cell transplantation. The consensus was approved by the Brazilian Society of Bone Marrow Transplantation.

Explotación Sexual de Niños y Adolescentes: reflexión acerca el papel de la escuela / Exploração sexual de crianças e adolescentes: reflexão sobre o papel da escola / Sexual exploitation of children and adolescents: a reflection of the role played by schools

Este artigo analisa o papel da escola no enfrentamento da Exploração Sexual de Crianças e Adolescentes, com base em um estudo realizado em unidades de ensino da rede pública estadual de Porto Velho-RO, município que nos últimos anos convive com as consequências sociais da construção de usinas hidrelétricas no Rio Madeira. A investigação foi desenvolvida por meio de entrevistas semiestruturadas, da qual participaram 20 agentes escolares, vinculados a quatro instituições de ensino. A análise das informações foi realizada à luz de referenciais críticos sobre direitos humanos, educação e psicologia, por meio da construção de categorias e subcategorias. Os resultados revelam que a maioria dos agentes escolares desconhece a problemática e que nenhuma das escolas pesquisadas desenvolve ações de enfrentamento. A educação sexual não é trabalhada como um tema transversal e a sexualidade é reduzida ao enfoque do risco e vitimização, não entendida sob a perspectiva dos direitos humanos.

En este artículo se analiza el papel de la escuela en el enfrentamiento de la Explotación Sexual de Niños y Adolescentes, con base en un estudio realizado en unidades de enseñanza de la red pública estatal de Porto Velho-RO, municipio que en los últimos años convive con las consecuencias sociales de la construcción de usinas hidroeléctricas en el río Madeira. Se desarrolló la investigación por intermedio de entrevistas semiestructuradas, de la cual participaron 20 agentes escolares, ligados a cuatro instituciones de enseñanza. El análisis de las informaciones se realizó a la luz de referenciales críticos sobre derechos humanos, educación y psicología, por intermedio de la construcción de categorías y subcategorías. Los resultados mostraron que la mayor parte de los agentes escolares desconoce la problemática y que ninguna de las escuelas investigadas desarrolla acciones de enfrentamiento. La educación sexual no es trabajada como un tema transversal y la sexualidad es reducida al enfoque del riesgo y victimización, no entendida bajo la perspectiva de los derechos humanos.

This article analyzes the school's role on tackling the sexual exploitation of children and adolescents, based on a study carried out in state schools of Porto Velho - RO , a municipality that in recent years has been suffering from the social consequences of the construction of two hydroelectric power plants on the Madeira River. The research was carried out by means of semi-structured interviews, with the participation of 20 school agents linked to four educational institutions. The analysis of information was carried out in the light of critical references on human rights, education, and psychology, and through the definition of categories and subcategories. The results show that most of the school agents are unaware of the problem and that none of the surveyed schools are actively taking action. Sex education is not seen as a cross-sectional issue and discussions on sexuality are reduced to a focus on risk and victimization, not being understood from a human rights perspective.

Brazilian Nutritional Consensus in Hematopoietic Stem Cell Transplantation: children and adolescents / Consenso Brasileiro de Nutrição em Transplante de Células-Tronco Hematopoiéticas: crianças e adolescentes

ABSTRACT The Brazilian Nutritional Consensus in Hematopoietic Stem Cell Transplantation: Children and Adolescents was developed by dietitians, physicians, and pediatric hematologists from 10 Brazilian reference centers in hematopoietic stem cell transplantation. The aim was to emphasize the importance of nutritional status and body composition during treatment, as well as the main characteristics related to patient´s nutritional assessment. This consensus is intended to improve and standardize nutrition therapy during hematopoietic stem cell transplantation. The consensus was approved by the Brazilian Society of Bone Marrow Transplantation.

RESUMO O Consenso Brasileiro de Nutrição em Transplante de Células-Tronco Hematopoiéticas: crianças e adolescentes foi elaborado com a participação de nutricionistas, médicos nutrólogos e médicos hematologistas pediátricos de 10 centros brasileiros que são referência em transplante de células-tronco hematopoiéticas. O objetivo foi salientar a importância do estado nutricional e da composição corporal durante o tratamento, bem como as principais características relacionadas à avaliação nutricional do paciente. As intenções, ao se estabelecer o consenso, foram aprimorar e padronizar a terapia nutricional durante o transplante de células-tronco hematopoiéticas. O consenso foi aprovado pela Sociedade Brasileira de Transplante de Médula Óssea.

Oral nutritional support to adult patients with acute intestinal Graft Versus Host Disease (GVHD): A proposal for dietary intervention as a model to clinical trials.

BACKGROUND: Acute Graft Versus Host Disease (GVHD) affects about 20%-80% of the patients after the hematopoietic stem cell transplant (HSCT) and it is amongst the main causes of morbidity and mortality both in children and adults. The intestine is one of the most affected organs by GVHD causing important alterations in the nutritional status and quality of life, considering that the dysfunctional intestine could decrease food intake as well as an inappropriate dietary plan could worsen the clinical condition. In addition to GVHD, chemotherapy conditioning regimen suppresses the immune system, promotes mucositis and increases the risk of infectious complications. Taking the above into consideration, when per oral diet is possible; the food choices should be carefully planned and monitored to promote nutritional support and avoid worsening the intestinal function and clinical condition. OBJECTIVE: This work was aimed to present a practice guideline proposal, to be validated, based on literature review, regarding to oral dietary recommendations for acute intestinal GVHD after HTSC. METHODS: Two research phases were defined: Phase one: evidence-based literature review; Phase 2: Practice Guideline Proposal. 1: Evidence based literature review SEARCH METHODS: A literature review (1997-2019) was performed including PubMed, in English, and Lilacs, in Portuguese electronic database to address the subject of dietary intervention for intestinal GVHD related to the HSCT, with children and adults, whose receiving oral or tube feeding nutrition therapy. SELECTION CRITERIA: The study selection was based on the PRISMA method. Controlled clinical trials were searched. Randomization was not possible considering the rare condition. DATA COLLECTION AND ANALYSIS: Two independent authors assessed the abstracts of the selected studies to determine the articles feasible to compose the review as the base to elaborate the practice guideline proposal protocol, object of the present study. To determine the level of evidence of the selected article, GRADE criteria were used. MAIN RESULTS: One controlled clinical trial study was included. The study was developed in Japan with a total of 35 patients. The dietary plan was characterized by gradual increasing food consistency/density. They found better nutritional parameters in the treated group, however, following GRADE criteria, we rated the quality of evidence as very low. AUTHORS' CONCLUSIONS: We could not demonstrate confidence in the effect estimate based on the selected study. However, considering the lack of literature information and the relevance of the topic, we decided to proceed and propose a practice guideline for an oral diet protocol for acute intestinal GVHD as a reference to be a starting point to validate protocols in future clinical trials. 2: Practice Guideline Proposal The criteria to elaborate the protocol were based on the RIGHT Statement. In addition to the literate information about diet and intestinal health, recommendations already adopted in the Service of Bone Marrow Transplant in the Complex Hospital of Clinics of Curitiba, in the state of Paraná, Brazil, were also considered.

Phase angle as a screening tool for mortality risk among hematopoietic stem cell transplanted adult patients.

BACKGROUND: Mortality among adult patients undergoing hematopoietic stem cell transplantation (HSCT) is high, especially within the first 100 days after the event. Therefore, identifying prognostic factors would be useful as screening tools to protect patients at risk throughout early intervention. In our previous work, the standardized phase angle (SPA) was explored as a useful indicator of survival and nutritional status among children and adolescent within the first 180 days after HSCT. The aim of this study was to evaluate the SPA and the arm muscle area (AMA) as prognostic indicators of mortality and nutritional status among adults in the same population. METHODS: This study was conducted with 29 adult patients undergoing allogeneic HSCT and 28 controls. Anthropometric assessment as well as body composition and laboratory data were analyzed. The phase angle was standardized according to reference values for healthy population. The correlation of SPA and AMA with other variables was verified and sensibility and specificity were tested by constructing ROC curves considering mortality and nutritional status as outcomes. Kaplan-Meier analysis was applied to calculate survival considering the cut-off points found in ROC curves. Chi-squared test and Kappa coefficient were used for evaluate the agreement among methods of nutritional assessment. RESULTS: SPA presented a predictive value for mortality and nutritional status considering the cut-off point at -0.19. In fact, the mortality incidence was higher among patients with values below the cut-off point for SPA as compared to the ones with SPA above this value up to 90 days after the HSCT. Regarding to AMA, mortality was higher using the values bellow P15 (percentile 15) as reference. The average SPA decreased after the beginning of conditioning and after the HSCT, while the decrease of AMA was observed only 90 days after the transplant. CONCLUSIONS: In this study SPA was confirmed as a prognostic tool for adult HSCT patients. In addition, it seems that SPA is more sensitive to detect structural body changes among the transplanted patients as compared to AMA. More studies are needed to confirm it as a tool to screen patients at risk of mortality for early intervention.

Segurança e Benefício do Uso de Probióticos em Pacientes Submetidos ao TCTH: Revisão Integrativa / Safety and Benefit of Using Probiotics in Patients Undergoing HSCT: Integrative Review / Seguridad y Beneficio del Uso de Probióticos en Pacientes Sometidos al TCTH: Revisión Integradora

Introdução: O transplante de células-tronco hematopoiéticas (TCTH) é um dos potenciais tratamentos curativos utilizados para pacientes com doenças hematológicas e outras doenças imunes. Durante o transplante, o paciente é submetido ao condicionamento e a outros tratamentos, como radioterapia e quimioterapia, o que pode causar a perda da diversidade da microbiota intestinal. A manipulação da microbiota intestinal com probióticos vem sendo apontada como uma estratégia de prevenção de complicações nos pacientes submetidos ao TCTH. Objetivo: Identificar se há evidências científicas relacionadas à segurança e aos benefícios da utilização de probióticos em pacientes submetidos ao TCTH. Método: Revisão integrativa com base em estudos que abordassem o uso de probióticos para o caso específico de pacientes submetidos ao TCTH publicados entre 2000 a 2018. Resultados: Foram selecionados cinco estudos que atenderam aos critérios de inclusão e exclusão, com um total de 52 pacientes. A utilização de probióticos na prevenção e/ou tratamento da diarreia tem mostrado resultados positivos em pacientes com diarreia induzida por antibióticos ou por infecções bacterianas, porém os estudos ainda não destacam benefícios no uso de probióticos no caso específico de pacientes submetidos ao TCTH. Poucos estudos mostram o uso de probióticos para auxílio na melhora dos sintomas associados a infecções ou bacteremias em pacientes imunossuprimidos. Conclusão: O uso de probióticos na população submetida ao TCTH e em imunossuprimidos ainda é controverso, sendo necessários mais estudos que demonstrem os benefícios no uso dessa estratégia para esse público.

Introduction: Hematopoietic stem cell transplantation (HSCT) is one of the potential curative treatments used for patients with hematological and other immune diseases. During transplantation, the patient undergoes conditioning and other treatments, such as radiotherapy and chemotherapy, which may cause loss of the intestinal microbiota diversity. The manipulation of the intestinal microbiota with probiotics has been pointed out as a strategy to prevent complications in patients undergoing HSCT. Objective: To identify if there is scientific evidence related to the safety and benefits of the use of probiotics in patients submitted to HSCT. Method: Integrative review based on studies addressing the use of probiotics for the specific case of patients undergoing HSCT published between 2000 and 2018. Results: Five studies that met the inclusion and exclusion criteria were eligible, with a total of 52 patients. The use of probiotics in the prevention and/or treatment of diarrhea has shown positive results in patients with antibiotic-induced diarrhea or bacterial infections, but the studies do not yet emphasize the benefits of using probiotics in the specific case of patients submitted to HSCT. Few studies show the use of probiotics to help the improvement of the symptoms associated to infections or bacteremia in immunosuppressed patients. Conclusion: The use of probiotics in the population submitted to HSCT and immunosuppressed is still controversial, and further studies are necessary to demonstrate the benefits of using probiotics for this public.

Introducción: El trasplante de células madre de las hematopoyéticas (TCTH) es uno de los posibles tratamientos curativos utilizados para pacientes con enfermedades hematológicas y otras enfermedades inmunes. Durante el transplante, el paciente es sometido al condicionamiento ya otros tratamientos, como radioterapia y quimioterapia, lo que puede causar la pérdida de la diversidad de la microbiota intestinal. La manipulación de la microbiota intestinal con probióticos viene siendo apuntada como una estrategia de prevención de complicaciones en los pacientes sometidos al TCTH. Objetivo: Identificar si hay evidencias científicas relacionadas con la seguridad y beneficios de la utilización de probióticos en pacientes sometidos al TCTH. Método: Revisión integradora basada em estúdios que abordan el uso de probióticos para el caso específico de pacientes sometidos a TCMH publicados entre 2000 y 2018. Resultados: Fueron elegibles 4 estudios que atendieron a los criterios de inclusión y exclusión, con un total de 52 pacientes. La utilización de probióticos en la prevención y/o tratamiento de la diarrea ha mostrado resultados positivos en pacientes con diarrea inducida por antibióticos o por infecciones bacterianas, pero los estudios aún no aportan beneficios en el uso de probióticos en pacientes sometidos al TCTH. Pocos estudios muestran infecciones o bacterias en pacientes inmunosuprimidos que utilizaron probióticos para ayudar en la mejora de los síntomas asociados al tratamiento. Conclusión: El uso de probióticos en la población sometida al TCTH e inmunosuprimidos aún es controvertido, siendo necesarios más estudios que comprueben los beneficios en el uso de probióticos para este público.

Short-term follow-up of the nutritional status of children with Fanconi anemia undergoing hematopoietic stem cell transplant.

OBJECTIVE: The objective of this study was to evaluate the nutritional status of children diagnosed with Fanconi anemia (FA) during hematopoietic stem cell transplant (HSCT), comparing it with healthy children and children with other hematologic diseases. METHODS: Observational retrospective study was conducted with patients submitted to HSCT in a period of 5 years. We assessed anthropometric and biochemical data, food intake, and gastrointestinal complications in 49 FA patients. We compared the anthropometric information with those of transplanted patients with other diagnoses (n = 54) in three periods (pre-transplant, 15 and 30 days after the HSCT), and with a group of healthy children (n = 24). RESULTS: Throughout the post-HSCT period, there was a significant decline in the nutritional status of FA patients: 83.3% presented weight loss equal to or greater than 5%. A progressive decrease in food intake after the transplantation was observed, with weekly deficits reaching 7841.3 kcal and 347.6 g of protein (both p < 0.05). When comparing FA with other diagnoses patients, the former displayed a poorer nutritional status prior to HSCT (p < 0.01 for BMI/age z-score), and that difference was maintained during the transplant (p < 0.01 for the same parameter), with similar weight loss values for both groups (8.99 vs 7.91%, respectively; p > 0.05). When compared to the control group of healthy children, FA patients prior HSCT showed substantially lower z-scores for Ht./age (p < 0.01) and BMI/age (p < 0.05). CONCLUSION: Although FA patients demonstrated poorer nutritional status as compared to other diagnosis and healthy children, the decline of anthropometric measures along the treatment is similar to other transplanted patients, imposing a greater risk to FA patients.

Body composition of Fanconi anemia patients after hematopoietic stem cell transplantation

[]

Body composition of Fanconi anemia patients after hematopoietic stem cell transplantation.

INTRODUCTION: Fanconi anemia is a rare genetic disease linked to bone marrow failure; a possible treatment is hematopoietic stem cell transplantation. Changes in the nutritional status of Fanconi anemia patients are not very well known. This study aimed to characterize body composition of adult, children and adolescent patients with Fanconi anemia who were submitted to hematopoietic stem cell transplantation or not. METHODS: This cross-sectional study enrolled 63 patients (29 adults and 34 children and adolescents). Body composition was assessed based on diverse methods, including triceps skin fold, arm circumference, arm muscle area and bioelectrical impedance analysis, as there is no established consensus for this population. Body mass index was also considered as reference according to age. RESULTS: Almost half (48.3%) of the transplanted adult patients were underweight considering body mass index whereas eutrophic status was observed in 66.7% of the children and adolescents submitted to hematopoietic stem cell transplantation and in 80% of those who were not. At least 50% of all groups displayed muscle mass depletion. Half of the transplanted children and adolescents presented short/very short stature for age. CONCLUSION: All patients presented low muscle stores, underweight was common in adults, and short stature was common in children and adolescents. More studies are needed to detect whether muscle mass loss measured at the early stages of treatment results in higher risk of mortality, considering the importance of muscle mass as an essential body component to prevent mortality related to infectious and non-infectious diseases and the malnutrition inherent to Fanconi anemia.

Profile of physiotherapy intervention for Down syndrome children / Perfil do atendimento fisioterapêutico às crianças com Síndrome de Down

Abstract Introduction: Down Syndrome (DS) is a genetic disorder that causes global delay in development, including motor function, language and cognitive. Physiotherapy is offered from birth in order to stimulate the acquisition of motor skills. Early intervention presents most benefits, as neural plasticity is at its peak in the first months of life. Objective: This study aimed to investigate the profile of physiotherapy intervention for children with DS during their first three years in specialized institutions. Methods: Data for this qualitative study were collected through semi-structured interviews, with 11 physiotherapists who worked in São Paulo coastal and metropolitan areas. Results: Results indicate that, although most professionals use the internet as a means to being up-to-date, and doing specialized courses, not always in pediatric neurology, they felt safe to work in the area shortly after graduation, using the principles of Bobath Concept, characterized by 30-minute therapies, with a frequency of once to twice per week to guide treatment. Conclusion: Data should serve as a basis for parents' reflections, who must seek to know the experience of therapists who attend to their children, as well as institutions to encourage professionals to update their knowledge and search for appropriate expertise, in order to optimize therapy.

Resumo Introdução: A Síndrome de Down (SD) é um distúrbio genético que acarreta atraso global no desenvolvimento, incluindo funções motoras, linguagem e cognitivo. O tratamento fisioterapêutico é indicado desde o nascimento, visando estimular a aquisição de habilidades motoras. Quanto mais precoce for o tratamento, mais beneficiada poderá ser a criança, pois a plasticidade neural tem sua maior intensidade nos primeiros meses de vida. Objetivo: Este estudo teve como objetivo investigar o perfil do atendimento fisioterapêutico às crianças com SD, nos primeiros três anos de idade, em instituições especializadas. Métodos: Tratou-se de um estudo qualitativo, sendo a coleta de dados realizada a partir de entrevistas semi-estruturadas, com 11 fisioterapeutas que atuavam em cidades do litoral paulista e da região metropolitana de São Paulo. Resultados: Os resultados indicam que, apesar da maioria dos profissionais utilizarem a internet como meio para atualização e terem cursos de especialização nem sempre na área de neuropediatria, sentiam-se seguros para trabalhar na área logo após a graduação, utilizando os princípios do Conceito Bobath para nortear o tratamento, caracterizado por terapias de 30 minutos com frequência de uma a duas vezes por semana. Conclusão: Esses dados devem servir como base para a reflexão dos pais, que devem buscar conhecer quais são as experiências dos fisioterapeutas que atenderão seus filhos, e das instituições especializadas, que devem incentivar os profissionais na busca de uma especialização adequada, visando melhor qualidade e aproveitamento terapêutico.

Prevalência da mordida aberta anterior em crianças de 3 a 5 anos / Anterior open bite in 3-5 years-old children

Objetivo: Verificar a prevalência de mordida aberta anterior e possíveis associações com variáveis sociodemográficas, hábitos de sucção não nutritivos e mamadeira em crianças de 3 a 5 anos. Métodos: Estudo transversal utilizou uma amostra aleatória obtida de uma população de 388 crianças matriculadas em escolas públicas da zona rural e urbana de um município da Região Sudeste. Para o cálculo amostral utilizou-se como parâmetros uma prevalência de 20%, nível de confiança de 95% e margem de erro de 5%. Foi calculada uma amostra mínima de 150 crianças e adotado um critério de substituição para garantir o poder amostral, envolvendo o sorteio de uma nova criança sorteada da mesma escola. A coleta de dados foi realizada em duas etapas. A primeira constituiu-se de um questionário dirigido aos responsáveis para obter dados sobre escolaridade materna, idade, gênero e a presença de hábitos deletérios ­ uso de mamadeira e sucção digital e chupeta; a segunda etapa, de um exame clínico conduzido por três examinadores previamente treinados, para detectar a presença de mordida aberta anterior. O exame foi realizado com a criança sentada de frente para o examinador, utilizando espátulas de madeira com 2 mm de espessura e sob luz natural. Para a confirmação da presença de mordida aberta anterior, o examinado deveria estar em oclusão cêntrica e não ocorrer a apreensão da espátula. O Teste Qui-quadrado foi utilizado para verificar a possível associação entre as variáveis. O projeto de pesquisa foi aprovado pelo CEP da UFES. Resultados: Foi encontrada uma prevalência de 16% de mordida aberta anterior, associada ao gênero masculino (p=0,008), sucção digital (p=0,011), ao uso de mamadeiras (p=0,026) e chupetas (p<0,001). Conclusão: A prevalência de mordida aberta em crianças pré- escolares foi considerada importante e significativamente associada com hábitos de sucção.(AU)

Aim: This study aimed to assess the prevalence of anterior open bite and possible associations with sociodemographic variables as regards non-nutritive sucking habits and the use of baby bottles in 3-5-year-old children. Methods: Cross sectional study with longitudinal design used a random sample selected from a population of 388 children, enrolled in public schools, in rural and urban areas of a southeastern Brazilian city. This sample was calculated based on the following parameters: prevalence of 20%, a confidence interval of 95%, and a 5% error, which resulted in a final sample of 150 children. A substitution criteria was adopted considering a new child that was randomly selected from the same school. Data collection was performed in two stages. The first consisted of a questionnaire directed towards the parents to obtain information about mother's education, age, gender, sucking habits, and bottlefeeding; the second stage was a clinical examination, carried out by three previously trained examiners to detect the presence of anterior open bite. The exams were performed with children seated in front of the examiner using a 2 mm wooden spatula and under natural light. To confirm the presence of anterior open bite, the examined child should present centric occlusion and not bit the spatula. The chi-square test was used to verify the possible association among the variables. The research project was approved by the Ethics Committee of UFES. Results: A prevalence of 16 % of anterior open bite was found, and it was associated with male gender (p=0.008), finger sucking (p=0.011), use of bottles (p=0.026) and pacifiers (p<0.001). Conclusion: Prevalence of anterior open bite in preschool children was considered important and significantly associated with sucking habits.(AU)

Twin-twin transfusion syndrome: neurodevelopment of infants treated with laser surgery.

OBJECTIVE: To assess the neurodevelopmental functions of survivors of twin-twin transfusion syndrome (TTTS) treated by fetoscopic laser coagulation (FLC), during the first year of life, comparing them to a control group; and to verify the influence of specific variables on neurodevelopment. METHOD: This was a prospective, longitudinal study. The sample comprised 33 monochorionic diamniotic twins who underwent FLC for treatment of TTTS and 22 full-term infants of single-fetus pregnancies. Bayley Scales of Infant and Toddler Development Screening Test were used for evaluation. Prenatal, perinatal and postnatal information were obtained. RESULTS: There was an increased frequency of infants in the TTTS group with inadequate performance compared to the control group. The identified variables (fetal donor, low economic income and cardiorespiratory disease) negatively impacted expressive communication and fine motor skills. CONCLUSION: Although through follow-up is recommended in all TTTS survivors, particular attention is required for the high-risk group as defined in this study.

Twin-twin transfusion syndrome: neurodevelopment of infants treated with laser surgery / Síndrome de transfusão feto-fetal: neurodesenvolvimento de lactentes tratados com cirurgia a laser

ABSTRACT Objective To assess the neurodevelopmental functions of survivors of twin-twin transfusion syndrome (TTTS) treated by fetoscopic laser coagulation (FLC), during the first year of life, comparing them to a control group; and to verify the influence of specific variables on neurodevelopment. Method This was a prospective, longitudinal study. The sample comprised 33 monochorionic diamniotic twins who underwent FLC for treatment of TTTS and 22 full-term infants of single-fetus pregnancies. Bayley Scales of Infant and Toddler Development Screening Test were used for evaluation. Prenatal, perinatal and postnatal information were obtained. Results There was an increased frequency of infants in the TTTS group with inadequate performance compared to the control group. The identified variables (fetal donor, low economic income and cardiorespiratory disease) negatively impacted expressive communication and fine motor skills. Conclusion Although through follow-up is recommended in all TTTS survivors, particular attention is required for the high-risk group as defined in this study.

RESUMO Objetivo Avaliar o desenvolvimento neurológico de sobreviventes da sindrome de transfusão feto-fetal (STFF) submetidos à coagulação a laser por fetoscopia (CLF), durante o primeiro ano de vida, comparando estes ao grupo controle; e verificar a influência de variáveis específicas no desenvolvimento. Método Tratou-se de estudo prospectivo, longitudinal. A amostra foi composta por 33 gêmeos diamnióticos monocoriônicos submetidos à CLF para tratamento da STFF e 22 lactentes a termo de gestação única. Bayley Scales of Infant and Toddler Development Screening Test foram utilizadas para avaliação. Informações pré-natal, perinatal e pós-natal foram coletadas. Resultados Houve maior número de lactentes com desempenho inadequado no grupo STFF do que no controle. As variáveis identificadas (feto doador, baixa renda econômica e doença cárdio-respiratória) influenciaram negativamente a comunicação expressiva e as habilidades motoras finas. Conclusão Embora o acompanhamento seja recomendado para todos lactentes com STFF, especial atenção deve ser dada àqueles que apresentam fatores de risco.

Early Weaning as a Risk Factor for Deleterious Oral Habits in 3-5 Year- Old Children

Objective: To verify the association between early weaning, sociodemographic variables and deleterious oral habits in 3-5 year-old Brazilian children. Material and Methods: Retrospective observational study with longitudinal design used a random sample of 150 children representing a population of 388 children enrolled in public schools of Domingos Martins, Brazil. Data collection was performed using a questionnaire aimed at parents / guardians. The dependent variable considered for analysis was the presence of habits - pacifier and finger sucking - and as explanatory variables: gender, age, early weaning and socioeconomic status. Early weaning was considered when exclusive breastfeeding was suspended before six months of age. Chisquare test was used to verify association among variables. Significance level adopted was 5%. To check the strength of association, Odds Ratio and 95% confidence intervals were used. Results: Significant association was found between variables age of 4 and 5 years (p = 0.030, OR = 2.193, CI = 1.029; 4.673) and early weaning (p = 0.001, OR = 5.045, CI = 2.087; 12.199) with pacifier sucking habit. Conclusion: Association between age, early weaning and pacifier sucking habits was observed. Early weaning can be considered a risk factor for pacifier sucking habit.

Pre-transplant arm muscle area: a simple measure to identify patients at risk.

PURPOSE: This study aims to explore parameters of nutritional assessment and food intake as predictors of clinical outcomes after hematopoietic stem cell transplant (HSCT). METHODS: The study was conducted retrospectively with 56 adult patients undergoing allogeneic HSCT. Energy and protein daily intake were used to calculate the energy and protein cumulative deficit. The nutritional assessment tools were weight, body mass index (BMI), triceps skinfold (TSF), and arm muscle area (AMA) before HSCT and after HSCT. RESULTS: Food intake decreased immediately after the transplant and the energy and protein cumulative deficit increased during hospitalization (p < 0.01). Almost 70 % of patients had severe weight loss (greater than 5 %), and the average percentage of weight loss was 8.5 ± 3.9 %. BMI and weight loss percentage were not correlated with the presence of acute graft versus host disease (GVHD) and mortality within 180 days in this population. On the other hand, correlation was found between the initial (pre-HSCT) AMA equal to or below the 15th percentile, with the presence of acute GVHD (p = 0.024), and mortality within 180 days after HSCT (p = 0.010). CONCLUSIONS: The AMA measured pre-HSCT showed to be a potential predictor of acute GVHD and mortality up to 180 days after transplant in adult patients.

Twin-twin transfusion syndrome: neurodevelopmental screening test.

OBJECTIVE: To assess the neurodevelopmental functions (cognition, language and motor function) of survivors of twin-twin transfusion syndrome (TTTS). METHOD: Observational cross-sectional study of a total of 67 monochorionic diamniotic twins who underwent fetoscopic laser coagulation (FLC) for treatment of TTTS. The study was conducted at the Center for Investigation in Pediatrics (CIPED), Universidade Estadual de Campinas. Ages ranged from one month and four days to two years four months. Bayley Scales of Infant and Toddler Development Screening Test-III, were used for evaluation. RESULTS: Most children reached the competent category and were classified as having appropriate performance. The preterm children scored worse than term infants for gross motor subtest (p = 0.036). CONCLUSION: The majority of children reached the expected development according to their age. Despite the good neurodevelopment, children classified at risk should be monitored for development throughout childhood.

Twin-twin transfusion syndrome: neurodevelopmental screening test / Síndrome de transfusão feto-fetal: teste de triagem do desenvolvimento neurológico

Objective To assess the neurodevelopmental functions (cognition, language and motor function) of survivors of twin-twin transfusion syndrome (TTTS). Method Observational cross-sectional study of a total of 67 monochorionic diamniotic twins who underwent fetoscopic laser coagulation (FLC) for treatment of TTTS. The study was conducted at the Center for Investigation in Pediatrics (CIPED), Universidade Estadual de Campinas. Ages ranged from one month and four days to two years four months. Bayley Scales of Infant and Toddler Development Screening Test-III, were used for evaluation. Results Most children reached the competent category and were classified as having appropriate performance. The preterm children scored worse than term infants for gross motor subtest (p = 0.036). Conclusion The majority of children reached the expected development according to their age. Despite the good neurodevelopment, children classified at risk should be monitored for development throughout childhood. .

Objetivo Avaliar as funções do desenvolvimento neurológico (cognição, linguagem e motricidade) de sobreviventes da síndrome de transfusão feto-fetal (STFF). Método Estudo transversal observacional, total de 67 gêmeos diamnióticos monocoriônicos submetidos à coagulação a laser por fetoscopia para o tratamento da STFF. O estudo foi realizado no Centro de Investigação em Pediatria (CIPED), Universidade Estadual de Campinas. A idade variou entre um mês e quatro dias a dois anos e quatro meses. Foram utilizadas as Bayley Scales of Infant and Toddler Development Screening Test-III para avaliação. Resultados A maioria das crianças atingiu a categoria competente e foi classificada como tendo desempenho adequado. As crianças prematuras obtiveram desempenho inferior quando comparadas às nascidas a termo no subteste motor global (p = 0,036). Conclusão A maioria das crianças alcançou o desenvolvimento esperado de acordo para idade. Apesar do bom desenvolvimento neurológico, crianças classificadas na categoria de risco devem ser monitoradas para o desenvolvimento, durante a infância. .