Acidentes ocupacionais com material biológico em Odontologia: uma responsabilidade no ensino / Occupational accidents with biological material in Dentistry: a teaching responsibility

Durante a graduação em Odontologia o aluno enfrenta situações que podem causar danos à própria saúde, visto que estão expostos a diversos riscos ocupacionais com material biológico. Com o intuito de contribuir com dados que auxiliem na formação acadêmica, propõe-se verificar a ocorrência, as características dos acidentes com material biológico, o conhecimento e a aplicação de ações preventivas e condutas pós-exposição. Trata-se de uma pesquisa observacional, transversal e descritiva utilizando um questionário de autopreenchimento aplicado a 195 estudantes do curso de Odontologia que tenham contato com procedimentos clínicos. Dos entrevistados, 23,6% sofreram acidentes ocupacionais, com predomínio do sexo feminino (78,3%), frequentemente acometendo as mãos (66,7%), e a maioria causados por sonda exploradora (30,1%). Observou-se que 34,9% sofreram acidentes percutâneos, somente 18,7% procurou auxílio médico e 6,3% relataram não usar equipamentos de proteção individual (EPI) no momento do acidente. Lavar o local afetado com água e sabão (54,7%) foi a principal conduta pós-exposição. A ocorrência de acidentes frente ao contato com material contaminado desperta atenção devido ao uso incompleto ou não uso de EPI, além da pouca procura por atendimento médico após os acidentes. Os acadêmicos relataram ter conhecimento da legislação relacionada à saúde do trabalhador e de como proceder em caso de acidentes ocupacionais. É necessário o desenvolvimento de estratégias de ensino que incluam uma supervisão mais eficaz, medidas que motivem a atenção para redução dos acidentes ocupacionais e o aumento da notificação de casos, de maneira contínua (AU).

In Dental School, undergraduate students face situations that can cause health problems due to exposure to various occupational risks with biological material. In order to make contributions using data in academic training, the aim of this study is to verify the occurrence, characteristics of accidents with biological material, the knowledge and application of preventive actions, and post-exposure behavior. This observational, cross-sectional, and descriptive study was conducted using a self-administered questionnaire by 195 dental students who have started clinical procedures. Of the interviewees, 23.6% had occupational accidents with a higher frequency of females (78.3%), commonly in the hands (66.7%) and most of them caused by an explorer probe (30.1%). It was observed that 34.9% had percutaneous accidents, but only 18.7% sought medical assistance and 6.3% reported not using Personal Protective Equipment (PPE) at the time of the exposure. Washing the affected area with soap and water (54.7%) was the most common behavior performed postexposure. The occurrence of accidents with contaminated materials is alarming due to the incomplete use or non-use of PPE, in addition to the low demand for medical care after the injury. The students reported that they were aware of work health and safety legislation and how to proceed in case of occupational accidents. There is a need for the development of teaching strategies in a continuous way that include more effective supervision that motivates the students to reduce occupational accidents while increasing the number of students reporting incidents of biological exposure (AU).

Influence of ovariectomy in the right ventricular contractility in heart failure rats.

BACKGROUND: Clinical studies in postmenopausal women suggest that female hormones play an important role in maintaining healthy cardiovascular conditions. The objective of this study was to evaluate the influence of ovarian hormones in the right ventricle contractility in heart failure (HF) rats following myocardial infarction (MI). METHODS: Female Wistar rats were divided into four groups: healthy ovariectomized (OVX), ovariectomized with HF (OVX-HF), HF, and sham operated (SHAM). Ovariectomy was performed in 10-week-old rats, and MI was induced 1 week later. Eight weeks after MI, right ventricular (RV) performance was analyzed using RV strip preparations. RESULTS: Ovariectomy did not change the infarct size (HF: 42 +/- 3.5 vs. OVX-HF: 39 +/- 1.5%). In the presence of isoproterenol (ISO) and calcium, the isometric force was reduced in both HF groups. Ovariectomy did not modify the positive inotropic parameter in the control and in HF rats. Time to peak tension (TPT) was prolonged in both ovariectomized groups compared to SHAM (ISO 10(-7) M OVX: 125 +/- 12( *); SHAM: 81 +/- 4; HF: 87 +/- 4; OVX-HF: 102 +/- 6( *) msec, ( *)p <0.01 vs. SHAM), and relaxation time (RT) was prolonged in OVX (270 +/- 16( *) msec) and OVX-HF (241 +/- 10( *) msec) vs. SHAM (197 +/- 6 msec; ( *)p <0.01 vs. SHAM). CONCLUSIONS: We conclude that the absence of female ovarian hormones during nine weeks does not influence the right ventricle positive inotropic response, but it prolongs the time of contraction and relaxation in normal and in HF rats following MI.

Myocardial infarction increases reactivity to phenylephrine in isolated aortic rings of ovariectomized rats.

Clinical studies demonstrated that the incidence of cardiovascular disease is low in premenopausal women, rises in postmenopausal women, and is reduced to premenopausal levels in postmenopausal women who receive estrogen therapy. The interaction between gender and myocardial infarction indicates that the survival advantage of women is modified by the occurrence of myocardial infarction. Therefore, the effect of myocardial infarction on mortality is greater in women than men. The aim of our study was to investigate the influence of the ovariectomy on the reactivity to phenylephrine in aortic rings of female rats post-myocardial infarction. Animals were divided in four groups: Control (Cont), Ovariectomized (Ovx), Infarcted (Inf) and Ovariectomized and Infarcted (Ovx-Inf). Aortic rings were studied 60 days after ovariectomy and infarction surgery. The infarct area was similar among groups. The maximal response to phenylephrine was increased in the Ovx-Inf group compared to all the other groups (Cont = 2.411+/-0.131 (N = 11); Ovx = 2.863+/-0.121(N = 15); Inf = 2.794+/-0.102 (N = 13); Ovx-Inf = 3.40+/-0.201* (N = 12) g; *P < 0.05). In the absence of endothelium and L-NAME perfusion, the maximal response to phenylephrine was similarly increased in all groups. Relaxation to acetylcholine was also similar. The indirect evaluation of NO bioavailability analyzed by the area under the curve demonstrated a reduction on NO on the Ovx-Inf group that could contributes to increased response to phenylephrine. In conclusion our results showed that ovariectomy associated to a myocardial infarction leads to an increment of aorta reactivity to phenylephrine associated to a reduction of basal NO bioavailability in spite of a normal endothelium-dependent relaxation induced by acetylcholine.