Caracterização do câncer infantojuvenil no Brasil a partir dos Registros Hospitalares de Câncer (RHC), 2000-2016 / Characterization of childhood cancer in Brazil from the hospital-based cancer registries, 2000-2016 / Caracterización del cáncer infantil en Brasil a partir de los Registros de Cáncer del Hospital (RCH), 2000-2016

Objetivo: caracterizar o câncer infantojuvenil no Brasil, a partir da investigação nacional e regional dos registros hospitalares de câncer, no período de 2000 a 2016. Método: estudo observacional, retrospectivo e de base secundária, com amostra de 71.925 registros contendo informações de crianças e adolescentes (0 a 19 anos). Resultados: o câncer infantojuvenil foi mais frequente no sexo masculino com 39.049 (54,3%) casos, existindo 22.391 (31,1%) registros de crianças de 0 e 4 anos de idade e 19.892 (40,4%) com cor de pele parda. As leucemias, doenças mieloproliferativas e doenças mielodisplásicas acometeram 20.744 (28,8%) indivíduos. Os tumores sólidos foram diagnosticados em 42.087 (58,5%) crianças e adolescentes, sendo 23.941 (48,7%) submetidas a quimioterapia no início do tratamento e 56.518 (78,6%) que iniciaram o tratamento até 60 dias após comprovação diagnóstica. Conclusão: foi possível conhecer o perfil demográfico, clínico e assistencial das crianças e adolescentes com câncer no Brasil, e por regiões

Objective: to characterize childhood cancer in Brazil, based on the national and regional investigation of hospital-based cancer registries, from 2000 to 2016. Method: observational, retrospective and secondary-based study, with a sample of 71,925 records containing information of children and adolescents (0 to 19 years old). Results: infant-juvenile cancer was more frequent in males with 39,049 (54.3%) cases, with 22,391 (31.1%) records of children aged 0 and 4 years and 19,892 (40.4%) with color of brown skin. Leukemias, myeloproliferative diseases and myelodysplastic diseases affected 20,744 (28.8%) individuals. Solid tumors were diagnosed in 42,087 (58.5%) children and adolescents,23,941 (48.7%) of which underwent chemotherapy at the beginning of treatment and 56,518 (78.6%) who started treatment within 60 days of the diagnosis. Conclusion: it was possible to know the demographic, clinical and care profile of children and adolescents with cancer in Brazil, and by region

Objetivo: caracterizar el cáncer infantil en Brasil, con base en la investigación nacional y regional de registros hospitalarios de cáncer, de 2000 a 2016. Método: estudio observacional, retrospectivo y secundario, con una muestra de 71,925 registros que contienen información de niños. y adolescentes (0 a 19 años). Resultados: el cáncer infantil-juvenil fue más frecuente en el sexo masculino con 39.049 (54,3%) casos, con 22.391 (31,1%) registros de niños de 0 y 4 años y 19.892 (40,4%) con color de piel morena. Las leucemias, enfermedades mieloproliferativas y enfermedades mielodisplásicas afectaron a 20.744 (28,8%) individuos. Se diagnosticaron tumores sólidos en 42.087 (58,5%) niños y adolescentes, 23.941 (48,7%) de los cuales se sometieron a quimioterapia al inicio del tratamiento y 56.518 (78,6%) que iniciaron el tratamiento dentro de los 60 días del diagnóstico. Conclusión: fue posible conocer el perfil demográfico, clínico y de atención de niños y adolescentes con cáncer en Brasil y por región

Geographic Distribution of Childhood Cancer in Brazil and the Time between the Diagnosis and the Start of Treatment: An Analysis of Hospital-Based Cancer Registries, 2010-2016

Abstract Objective: To analyze the distribution of childhood cancer in Brazil and the time between the diagnosis and the start of treatment, according to hospital-based cancer registries (2010-2016). Material and Methods: This was an observational descriptive study using secondary data (36,187 records) from hospital databases of the National Cancer Institute (INCA) and the Onco-center Foundation of São Paulo (FOSP). Epidemiological data were obtained, and compliance with Federal Law 12,732/12 was verified, which establishes a maximum period of 60 days to start cancer therapy after the diagnosis. Absolute and percent frequencies, central tendency and dispersion measures, and the coefficient of prevalence of childhood cancer were calculated. Results: The mean age of the pediatric patients was 9.3 years (± 6.2); 54.1% (n=19,586) of them were males; 32.0% (n=11,440) were aged 0 to 4 years; and 43.4% (n=11,338) had a self-reported mixed-race skin color. The Southeast region of Brazil accounted for 40.2% (n=14,564) of the cases, of which 63.0% (n=9,178) corresponded to solid neoplasms, as opposed to the North region, where hematological neoplasms prevailed (53.9%, n=1,535). Most registered patients aged 0 to 19 years were treated in 60 days or less (77%, n=27,929). However, for 24.0% (n = 2,207) of adolescents (15 to 19 years) this time was more than 60 days after the diagnosis. Conclusion: The characteristics related to childhood cancer varied across the Brazilian geographic regions, and most patients were properly treated within the time enforced by law.

Factors Associated with Toothache in Patients Affected by Hereditary Coagulopathies

Objective: To determine a probabilistic model that represents the likelihood of the event Dental Pain to occur in Brazilians patients affected by hereditary coagulopathies. Material and Methods: In this cross-sectional study, information on use and access to dental services, oral morbidity, self-perceived oral health and behavioral health habits were obtained through semi-structured questionnaire and analyzed by means of logistic regression. Results: High prevalence of dental caries was observed for children aged 1-5 years (50%) and for adolescents aged 13-19 years (66%). Cumulative pattern of dental caries in the age groups of 20-35 years and 36-59 years was observed. Most patients did not report pain in the last six months prior to the survey (24.5%). It was observed that searching for dental care for the last time in case of localized pain (OR=26.7), for feeling uncomfortable when brushing teeth (OR=7.3) and difficulty searching for health professionals, not only the dentist (OR 3.7) was considered risk factors for the determination of Dental Pain diagnosis. However, if the patient has mild hemophilia A (OR=0.21), this likelihood decreases, being thus a protective factor. Conclusion: Patients affected by hereditary coagulopathies have high prevalence of caries, indicating the cumulative nature of this disease, which suggests the symptomatic effect of Dental Pain.

Tooth loss and associated factors in patients with coagulopathies in the State of Paraíba, Brazil.

BACKGROUND: The most common and best known hereditary coagulopathies are hemophilia A and B followed by von Willebrand Disease. OBJECTIVE: This study aimed to estimate the prevalence of tooth loss and investigate its association with demographic and socioeconomic data, as well as to discuss self-reported oral morbidity and use of health services by patients with coagulopathies treated in blood centers in Paraíba, Brazil. METHODS: This was a quantitative cross-sectional epidemiological survey. Data was collected in the period from October 2011 to July 2012 by clinical examination and by assessing interviews using a semi-structured questionnaire. The findings were analyzed by descriptive and inferential statistics with the level of significance (α) being set at 10%. RESULTS: One hundred and six, predominantly male (88.8%), patients with coagulopathies were evaluated. The ages ranged from one to 59 years. Most patients were of mixed race (61.3%), most reported family incomes between R$ 501.00 and R$ 1500.00 (49.1%), and most had not completed elementary school (37.1%). Hemophilia A was found in 76.4% of the cases. The prevalence of dental caries among individuals was 50.0% predominantly in the 13- to 19-year-old age range (66.7%). As regards to tooth loss, teeth were missing in 35.1% of the study participants. CONCLUSION: Tooth loss is high in this population. Males with severe hemophilia A, those who use fluoride and have a good or very good perception about their last dental appointment have a reduced chance of losing their teeth.

Tooth loss and associated factors in patients with coagulopathies in the State of Paraiba, Brazil

BACKGROUND The most common and best known hereditary coagulopathies are hemophilia A and B followed by von Willebrand Disease. OBJECTIVE This study aimed to estimate the prevalence of tooth loss and investigate its association with demographic and socioeconomic data, as well as to discuss self-reported oral morbidity and use of health services by patients with coagulopathies treated in blood centers in Paraíba, Brazil. METHODS This was a quantitative cross-sectional epidemiological survey. Data was collected in the period from October 2011 to July 2012 by clinical examination and by assessing interviews using a semi-structured questionnaire. The findings were analyzed by descriptive and inferential statistics with the level of significance (α) being set at 10%. RESULTS One hundred and six, predominantly male (88.8%), patients with coagulopathies were evaluated. The ages ranged from one to 59 years. Most patients were of mixed race (61.3%), most reported family incomes between R$ 501.00 and R$ 1500.00 (49.1%), and most had not completed elementary school (37.1%). Hemophilia A was found in 76.4% of the cases. The prevalence of dental caries among individuals was 50.0% predominantly in the 13- to 19-year-old age range (66.7%). As regards to tooth loss, teeth were missing in 35.1% of the study participants. CONCLUSION Tooth loss is high in this population. Males with severe hemophilia A, those who use fluoride and have a good or very good perception about their last dental appointment have a reduced chance of losing their teeth.

Ortodontia como tratamento da disfunção temporomandibular: determinação do nível de evidência científica da literatura / Orthodontics as a treatment of temporomandibular disorders: determination of the scientific evidence level

Objetivo: Identificar, a partir de uma revisão crítica da literatura, a evidência científica disponível sobre a Ortodontia como tratamento para Disfunção Temporomandibular (DTM).Material e Métodos: Utilizou-se uma abordagem indutiva, com procedimento estatístico-comparativo e técnica de documentação direta. Realizou-se a pesquisa bibliográficado descritor “temporomandibular disorder and orthodontics treatment” nas bases de dados PubMed, CAPES, BBO, SCIELOe Cochrane. Os dados coletados e analisados descritivamente foram: Grau de Evidência Científica (GEC) e tipo de estudo. Resultados: Do total de 1035 artigos científicos encontrados e publicados nos anos de 2000 a 2010 foram selecionados 38 estudos. A média geral do GEC dos artigos foi de 5,5. Quanto ao nível de evidência científica, 28,94%(n=11) dos estudos são de nível 5 – estudos observacionais,23,68% (n=9) nível 8 – ensaio clínico randomizado e 47,38%estudos estão distribuídos entre os níveis 1, 4, 10, 9, 6 e 2.Conclusão: O grau de evidência científica na relação de tratamento entre Ortodontia e DTM é baixo.

Objective: To identify the scientific evidence available on orthodontics as a treatment for Temporomandibular Disorders(TMD), by means of a critical literature review. Material and Methods: It was used an inductive approach, statistical comparative procedure and direct documentation technique. Literature searches were conducted using the key-word"temporomandibular disorder and orthodontics treatment” inthe databases: PubMed, CAPES, BBO, Scielo and Cochrane.The data collected and analyzed descriptively were: Scientific Evidence Level (SEL) and study type. Results: From a total of1,035 scientific papers found and published between 2000and 2010, 38 studies were selected. SEL general average ofthe papers was 5.5 As regards the scientific evidence level,28.94% (n=11) of the studies were classified as level 5 –observational studies; 23.68% (n=9) were level 8 – randomized clinical trial; and 47.38% were included among the levels 1, 4,10, 9, 6 and 2. Conclusion: The scientific evidence level foundfor the relationship between orthodontics and TMD treatment was low.

Avaliação microestrutural do esmalte bovino exposto a bebidas lácteas fermentadas e propriedades físico químicas / Microstructural evaluation of bovine enamel exposed to fermented dairy beverages and analysis of their physical-chemical properties

Objetivo: Analisar o padrão de desmineralização do esmalte bovino submetido à ação de bebidas lácteas fermentadas frente a variações de tempo e avaliar as propriedades físico-químicas destes componentes da dieta líquida. Método: Analisaram-se seis marcas de bebidas lácteas, utilizando-se refrigerante a base de cola e água destilada como controle positivo (CP) e negativo (CN), respectivamente. Avaliou-se o pH por meio de pHmêtro digital enquanto a concentração de sólidos solúveis totais (°Brix) foi mensurada por um refratômetro específico de campo. Por meio de um viscosímetro capilar aferiu-se a viscosidade cinemática. Analisou-se a ação das bebidas sobre o esmalte em Microscopia Eletrônica de Varredura (MEV) após exposição às soluções nos intervalos de tempo: 5, 15 e 30 minutos, sendo as alterações microestruturais classificadas em escores, de acordo com o grau de desmineralização promovido na estrutura dentária. Resultados: Os valores de pH variaram de 2,59 (CP) a 6,24 (CN), estando as demais bebidas lácteas fermentadas abaixo do pH 3,92. Os valores de °Brix oscilaram de 0° a 19° Brix e a viscosidade variou de 2,41 mm²/s a 7,26 mm²/s. Alterações sugestivas de erosão foram evidentes nos espécimes submetidos ao CP e ao produto de menor pH. A maioria das bebidas registrou dissoluções iniciais a partir de 15 minutos, correspondendo a alterações Grau 1 (leve alteração microestrutural). Conclusão: As bebidas lácteas revelaram-se potencialmente erosivas e cariogênicas, apresentando valores de pH críticos para dissolução do esmalte, bem como presença de sólidos solúveis totais e expressiva variação de viscosidade. A análise morfológica pela MEV da superfície dentária revelou alterações microestruturais de leve a acentuada, de acordo com o tempo de exposição às bebidas.

Objective: The aim of this study was to analyze the pattern of demineralization of bovine enamel subjected to the action of fermented dairy beverages after different times and to evaluate their physical-chemical properties. Method: Six brands of dairy beverages were analyzed, having cola-type soft drink and distilled water as positive (PC) and negative (NC) controls, respectively. The pH was evaluated using a digital pH-meter and the soluble solids content (°Brix) was measured using a specific refractometer. A capillary viscometer measured the kinematic viscosity. The action of the beverages on enamel was analyzed by scanning electron microscopy (SEM) after exposure to solutions at the following time intervals: 5, 15 and 30 minutes. The microstructural alterations were scored according to the degree of demineralization observed on tooth structure. Results: The pH values ranged from 2.59 (PC) to 6.24 (NC), while the pH of the fermented dairy beverages was below 3.92. The soluble solids content values ranged from 0° to 19° Brix and viscosity ranged from 2.41 to 7.26 mm²/s. Changes suggestive of erosion were evident in the specimens submitted to the PC and to the beverage with the lowest pH. Most beverages promoted initial enamel dissolution after 15 minutes, corresponding to grade 1 alterations (mild microstructural alteration). Conclusion: The fermented dairy beverages were found to be potentially erosive and cariogenic, presenting pH values compatible with the critical value for enamel dissolution as well as total soluble solids and significant viscosity variation. Morphological analysis of tooth surface by SEM revealed microstructural changes from mild to severe, according to the exposure time to the beverages.

Propriedades físico-químicas de bebidas à base de soja: um estudo in vitro / Physical and chemical properties of soy-based beverages: an in vitro study

Objetivo: Avaliar o pH, a concentração de Sólidos Solúveis Totais - SST (°Brix), a titrabilidade ácida, e o teor de cálcio e fosfato de três bebidas à base de soja, sabor maçã (AdeS®, Sollys®, AdeS Zero®), água mineral sem gás Água Schin® (controle negativo - CN) e de Coca-Cola® (controle positivo - CP),comercializadas na cidade de João Pessoa - Brasil. Materiais e Métodos: A avaliação do pH foi realizada mediante o uso de pHmetro digital e a do °Brix foi determinada por um refratômetro específico de campo. Para avaliação da titrabilidade ácida foi medida o momento de viragem do indicador fenolftaleína. O teor de cálcio foi mensurado a partir do uso de solução padrão de Ácido Etilenodiamino Tetra-Acético - EDTA (0,01 M) e sua reação com o cálcio na presença do indicador em meio alcalino. A quantificação de fosfato foi feita por meio de espectofotômetro. Para obtenção dos valores de pH, °Brix e titrabilidade ácida foram feitas três aferições, para o cálcio foram feitas duas (a média aritmética foi considerada como resultado final para estas aferições) e para o fosfato, uma aferição. Os resultados foram analisados descritivamente, Resultados: Os valores de pH variaram de 4,01 (Sollys®) a 4,25 (AdeS Zero®). Para os SST a variação obtida foi de 4,17°Brix (AdeS Zero®) a 8,00°Brix (AdeS®). A titrabilidade ácida variou de 5,87mg/100ml (AdeS®) a 7,7mg/100ml (Sollys®). Para a quantidade de cálcio e fosfato a variação foi de 25,55mg/100ml (AdeS®) a 98,15mg/100ml (Sollys®) e24mg/100ml (AdeS®) a 49,5mg/100ml (Sollys®), respectivamente. Conclusões: As bebidas analisadas neste estudo revelaram-se potencialmente erosivas e cariogênicas.

Motivações, práticas e percepções de cirurgiões-dentistas sobre o trabalho na Atenção Básica de João Pessoa - PB / Motivation, practices and perception of surgeons-dentists about the work on Primary Care on João Pessoa - PB

Objetivo: conhecer, pelo relato dos cirurgiões-dentistas (CDs) que trabalham na atenção básica (AB) de João Pessoa-PB, as motivações para o trabalho na AB, o perfil necessário para o CD que trabalha na AB e a percepção sobre as políticas do Sistema Único de Saúde (SUS) para a saúde bucal na AB. Métodos: Foram entrevistados 22 CDs da AB de João Pessoa, selecionados por sorteio. As entrevistas, gravadas em áudio, foram transcritas e analisadas qualitativamente segundo a metodologia do discurso do sujeito coletivo. Resultados: Discursos obtidos: motivação para trabalho na AB ? ?A minha motivação foi trabalhar com saúde pública e promover uma odontologia preventiva, tendo a certeza de uma remuneração fixa?. Perfil do dentista na AB ? ?O den-tista da AB deve ser um bom clínico geral, entender o funcionamento da atenção primária, ser humanizado e atender o usuário de forma integral. Deve saber tra-balhar em equipe e fazer ações preventivas?. Opinião sobre políticas do SUS para AB ? ?Na teoria, acho que são bastante eficientes, mas ainda estão excessivamente ligadas a números e indicadores. A aplicabilidade des-sas políticas, muitas vezes, fica comprometida pelo des-conhecimento dos profissionais e pela falta de recursos humanos e financeiros?. Conclusões: Como motivação para o trabalho na AB, os entrevistados destacaram a estabilidade financeira e a afinidade com o trabalho em saúde pública. Quanto ao perfil do CD na AB, valori-zaram as características que atendam aos princípios do SUS. Sobre as políticas do SUS para AB, consideram a limitação nos aspectos burocráticos, de recursos huma-nos e financeiros.