Análise de lacunas e perspectivas sobre programas de doação de corpos: relato de experiência no Brasil / Gap analysis and perspectives on body donation programs: experience report in Brazil

Resumo: Introdução: As recomendações internacionais reforçam o estímulo à prática da doação voluntária para a disponibilidade de corpos destinados à formação de profissionais de saúde, substituindo o sistema de corpos não reclamados nas instituições de ensino superior (IES). Relato de experiência: Este trabalho reuniu informações sobre programas de doação de corpos (PDC) brasileiros, analisou lacunas e fatores impeditivos à doação do corpo, e propôs estratégias para ampliar as informações sobre o cadastro de participantes em PDC e a efetivação da doação. Discussão: No Brasil existem 39 PDC em funcionamento - seis no Nordeste, quatro no Centro-Oeste, um no Norte, 11 no Sul e 17 no Sudeste - e duas comissões de distribuição de corpos para ensino. O cadastro como participante no PDC pode agilizar as providências documentais, mas não garante a doação na ocasião da morte. No geral, as IES recebem o corpo doado e a documentação necessária. Quando o óbito acontece no município da IES, é possível ter o translado do corpo providenciado por parcerias com funerárias e prefeitura. Conclusão: Embora a legislação tenha regulamentado desde 2002 a doação do próprio corpo em vida, é necessária a implementação de campanhas de esclarecimento à população geral sobre essa possibilidade, além de mecanismos que possam promover a celeridade nos prazos de para obtenção das documentações com a finalidade de doação de corpo para fins científicos, a isenção das taxas cartoriais e a viabilização do translado do corpo doado por carro de funerária das prefeituras, sem custo. O apoio da IES por meio do cadastro do PDC como atividade de extensão universitária colabora para assegurar aspectos éticos relacionados à participação dos doadores no programa em vida, no que se refere ao tratamento com respeito e dignidade dos doadores e de suas famílias.

Abstract: Introduction: International recommendations reinforce the practice of voluntary donation for providing bodies for the training of health professionals, replacing the system of unclaimed bodies in medical courses (MC). Experience report: This work gathered information on Brazilian body donation programs (BDP), analyzed gaps and difficulties to the effectiveness of body donation, and proposed strategies to expand the information offered on the registration of participants in BDP and the effectiveness of the donation. Discussion: In Brazil, there are 39 BDP - six in the Northeast, four in the Midwest, one in the North, 11 in the South, and 17 in the Southeast - and two committees for body donation. Documents may be easily available through registration during life as a participant in the BDP, but it does not guarantee donation. In general, Brazilian's institutions receive the donated body along with the documentation. When the death occurs in the same city of the institution, it is possible to have the transfer of the body provided by partnerships with funeral services and the city hall. There is no fee to be paid or received either for registration during life or for donation after death. Conclusion: Although the legislation has regulated the donation of body in life since 2002, it is necessary to implement campaigns to inform about the donation, in addition to mechanisms that can promote speed in the deadlines for obtaining documentation for the purpose of donating body for scientific purposes, the exemption of notary fees and the possibility of transporting the body donated with no fees by funeral home of municipal governments. The MC support through the registration of the PDC as an extension activity collaborates to ensure ethical aspects related to the participation of donors in the living program, with regard to the treatment with respect and dignity of donors and their families.

Salivary alpha-amylase and hormones levels of young adults with different body composition.

The aim of this study was to assess the differences in salivary biomarker levels of young adults classified according to body fat accumulation. One hundred and thirty-four volunteers were evaluated (mean age 21 ± 2 years). Body composition was calculated through skinfold thickness: supra-iliac, biceps, and triceps, sub-scapular. Body fat percentage (BF%) was used to classify subjects according to fat tissue accumulation: normal-weight (n = 37, 19 females, 18 males), overweight (n = 42, 30 females, 12 males), and obese (n = 55, 42 females, 13 males). Saliva samples were collected 30 min after awakening to determine salivary levels of 17-beta-estradiol. For salivary cortisol and alpha-amylase activity (sAA) three samples were obtained, just after awakening, 30 min after awakening and at bedtime. Oral contraceptive intake was considered for the female group. The results showed that overweight and obese females using oral contraceptive presented lower levels of 17-ß-estradiol than normal-weight females. In overweight and obese males, sAA levels were higher 30 min post-awakening when compared with the normal-weight group. The comparison of sAA levels within time showed no difference for males; obese females showed significant higher values at bedtime than 30 min post-awakening. The salivary cortisol concentration showed higher values at morning decreasing significantly at bedtime for all groups. Concluding, differences in 17-ß-estradiol and sAA levels were found in females and males, respectively, according to body fat accumulation, showing the usefulness of salivary biomarkers in the study of systemic conditions. PRACTICAL APPLICATIONS: Saliva is an advantageous biological fluid in innovative methods for diagnosis. Besides being a noninvasive method, salivary steroid measurements have the potential to provide a convenient assessment of serum free steroid concentrations.

Masticatory muscle activity evaluation by electromyography in subjects with zygomatic implants

BACKGROUND: Zygomatic implants are an alternative treatment in the rehabilitation of atrophic maxilla to promote stability in the stomatognathic system. The aim of this study was to compare the electromyographic (EMG) activity of masseter and temporalis muscles in controls and in individuals with complete implant-supported dentures anchored in the zygomatic bone. MATERIAL AND METHODS: Fifty-four volunteers of both genders (mean age 52.5 years) were selected and distributed into two groups: Individuals with zygomatic implant (ZIG; n=27) and fully dentate patients (CG; n=27). MyoSystem-BR1 was used to assess masseter and temporalis muscles EMG activity in different mandibular movements: protrusion, clenching, maximal voluntary contraction (MVC) with Parafilm M(R), right and left laterality and chewing (peanuts and raisins). Data was processed, normalized (MVC) and analyzed using the SPSS 21.0. Student t-test (P ≤ 0.05) was used for group comparison. RESULTS: The results were statistically significant (P ≤ 0.05) for protrusion, clenching, right and left laterality and raisin chewing. For the mandibular posture conditions, the ZIG obtained higher EMG activity patterns when compared to CG. For the masticatory performance during chewing of peanuts and raisins, the ZIG showed higher EMG mean values when compared to CG. CONCLUSIONS: The zygomatic implant promoted an active response of the muscle fibers (hyperactivity) during both mandibular posture and chewing conditions, probably due to the absence of periodontal receptors, which play a significant role for preparing a bolus for swallowing

Characteristics of salivary secretion in normal-weight, overweight and obese children: a preliminary study: salivary composition and excessive fat tissue.

UNLABELLED: Information on salivary characteristics of young subjects with different body composition is scarce. Thus, the aim of this pilot study was to assess salivary characteristics of normal-weight, overweight and obese children. This is a basic research design in which 68 children (5-12 years) were recruited and anthropometric measurements consisted of body mass index (BMI = Kg/m(2)), body perimeters (waist/arm circumferences) and subcutaneous fat tissue (triceps/subscapular thicknesses). Stimulated (SS) and unstimulated morning saliva (US) were collected to determine flow rate, pH and triglycerides, urea, alpha-amylase, total protein, phosphate and calcium concentrations. Data were analyzed using normality tests, t test/Wilcoxon, one-way ANOVA/Kruskal-Wallis and Pearson's/Spearman's correlation tests, where appropriate. RESULTS: Age, household income, parents' education, saliva flow and pH did not differ among groups. Waist circumference and subscapular skinfold differed significantly between normal-weight and obese groups; only waist circumference showed significant correlation with BMI in all groups. pH increased significantly from US to SS in all groups; but flow rate increased from US to SS only in normal-weight and overweight groups. Total protein, amylase, urea, phosphate, triglyceride and calcium concentrations did not differ among groups. However, urea, phosphate and calcium concentrations differed significantly between US and SS in the normal-weight and overweight groups, with the lowest values for SS. In the overweight group, total protein also differed between saliva samples and obese group showed no difference in biochemical parameters between US and SS. Finally, some salivary characteristics may vary among normal-weight, overweight and obese children; thus, future studies in a larger sample are needed to fully understand salivary secretion and composition of these subjects.

Comparação da largura dos dentes anteriores artificiais e naturais / Comparison of the width of artificial and natural anterior teeth

OBJETIVO: Verificar se a largura combinada dos seis dentes anteriores superiores artificiais fabricados e comercializados pela Dental Vipi Ltda. (Pirassununga, Brasil) é similar à mesma dimensão dos dentes naturais de brasileiros jovens e dentados. MÉTODOS: Participaram do estudo 49 estudantes jovens e dentados, sendo 20 do sexo masculino e 29 do feminino. Foram confeccionados modelos de gesso pedra para medir a largura dos seis dentes anteriores superiores por meio de uma régua milimetrada flexível. Os valores obtidos foram comparados aos valores fornecidos para os dentes artificiais, na carta molde, pelo fabricante. RESULTADOS: Foi encontrada uma média de 53,544 milímetros (desvio-padrão de 3,525) para a distância entre as faces distais dos caninos superiores, em curva. Os modelos de dentes artificiais atendem apenas a faixa de 40 a 50 milímetros de largura. CONCLUSÃO: Os dentes artificiais das marcas analisadas são substancialmente menores do que os dentes naturais da amostra em estudo.

OBJECTIVE: This study verified whether the combined width of the six artificial anterior maxillary teeth manufactured and marketed by VIPI (Dental Vipi Ltda., Pirassununga, Brazil), was similar to that of the respective natural teeth of young, dentate Brazilians. METHODS: Forty-nine dentate, healthy students (20 males and 29 females) participated in this study. Dental stone casts were made for measuring the combined width of the six anterior maxillary teeth with a flexible millimeter ruler. The combined width of the natural teeth was compared with that of the artificial teeth reported by the manufacturer in the selection chart. RESULTS: The mean anterior outside distance between the distal surfaces of the maxillary canines was 53.544 mm (standard deviation 3.525). The combined width of the artificial anterior teeth lies within the 40-50 millimeter range. CONCLUSION: The artificial teeth of the studied brand were substantially smaller than the natural teeth of the study sample.

Interalar distance to estimate the combined width of the six maxillary anterior teeth in oral rehabilitation treatment.

STATEMENT OF THE PROBLEM: The face's architecture of dentate subjects has been studied to find a reliable guide for the selection of artificial anterior teeth. However, there is no consensus of data regarding a reference to estimate the width of artificial teeth. PURPOSE: The purpose of this study was to analyze whether there is a consistent relationship between the interalar distance (IAD) and the combined mesiodistal width of the six maxillary anterior teeth. METHODS: Standardized digital photographs of 81 dentate Brazilian subjects were included in the sample. They were 37 men and 44 women (age 17 to 33). Through image processing software, the IAD and the distance between the tips of the maxillary canines were measured when viewed from the frontal aspect. Accurate casts were made to quantify the distance between the distal surfaces of the maxillary canines on a curve, by use of a flexible millimeter ruler. Nonparametric statistics were performed to analyze the results (p < 0.05). RESULTS: The IAD when compared with the width of the six maxillary anterior teeth, on a straight line and on a curve, presented a ratio of 0.914 and of 1.305, respectively. The Wilcoxon test showed no significant difference between the calculated width values and the mesiodistal width measured on a curve and on a straight line (p = 0.986). CONCLUSION: The IAD, when increased by 31% of its value, can suggest the circumferential distance of the six maxillary anterior teeth. CLINICAL SIGNIFICANCE: The width of the nose, when measured in digital photographs, can be utilized as a reliable guide for the selection of the maxillary anterior teeth width. It can improve the esthetic result of the oral rehabilitation treatment for the edentulous patient by offering a natural dentofacial relation.

Imagem digital da face para estimar a dimensão vertical de oclusão por meio de uma fórmula matemática / Facial digital images to identify vertical dimension of occlusion through a mathematical formula

Para reabilitar funções do sistema estognático, tais como deglutição, fonação, mastigação e aparência facial, é essencial manter a correta relação entre a maxila e a mandíbula. Ao se restabelecer a dimensão vertical alterada de uma paciente em tratamento reabilitador, é necessário recorrer a métodos que dependem de fatores subjetiovs. Não existe um consenso na literatura quanto ao procedimento adequado para identificar a dimensão vertical e, dessa forma, uma associação de métodos é frequentemente utilizada para garantir maior segurança nos resultados. Este estudo buscou aferir a dimensão vertical de oclusão (DVO) e a dimensão vertical de repouso (DVR), comparando-se à distância entre o canto externo dos olhos e a comissura labial, a fim de determinar uma correlação entre as estruturas observadas. participaram da amostra cinquenta alunos do curso de graduação em odontologia da Universidade Federal de Uberlândia (UFU), todos dentados e apresentando entre 19 a 29 anos de idade. As distâncias da base do nariz ao mento e do ângulo lateral dos olhos à comissura labial foram mensuradas em fotos digitais e analisadas no programa de leitura de imagens HL Image 97++ (Western Vision Software, LC). os resultados foram submetidos ao tete de correlação de Pearson, que revelou correlação significativa positiva entre o DVO e a DVR. A análise da regessão linear permitiu desenvolver uma fórmula específica que possibilita calcular a DVO a partir da DVR, efetiva em 87 por cento dos casos.