The influence of hormone replacement therapy on the salivary flow of post-menopausal women.

The aim of this study is to investigate the influence of hormone therapy on salivary flow in menopausal women. It is a case-control study involving 86 post-menopausal women. The case group consisted of 47 women undergoing estroprogestative or estrogen hormone replacement therapy (HRT), and the control group consisted of 39 women who did not receive any HRT. All patients were submitted to a standard questionnaire, followed by total stimulated sialometry and determination of body mass index (BMI). The salivary flow was classified as follows: normal (1.0-3.0 mL/min), low (0.7-1.0 mL/min), and hyposalivation (<0.7 mL/min). The results were analyzed statistically by the chi-square test, logistic regression model, and linear regression (p < 0.05). The HRT group presented an association of protection, even after adjusting the analysis, for low salivary flow (Adjusted OR = 0.22; 95% CI = 0.05-0.88; p = 0.034), and hyposalivation (Adjusted OR = 0.30; 95% CI = 0.10-0.92; p = 0.036). The results suggest that estroprogestative therapy (ß = + 0.53; p = 0.022) has greater influence on the increase of salivary flow than estrogen therapy (ß = +0.35; p = 0.137). The study concludes stating salivary flow was influenced by HRT on the post-menopausal women studied.

Prevalence of carotid artery calcifications detected on panoramic radiographs and confirmed by Doppler ultrasonography: Their relationship with systemic conditions.

CONTEXT: Atherosclerosis affects large and medium caliber arteries by forming calcific atheromas, precursors of cerebral vascular disease. Diabetes mellitus, obesity, and hypertension are considered as risk factors of atherosclerosis. Panoramic radiographs can display images suggestive of carotid artery calcifications (CACs). AIMS: To investigate the prevalence of images suggestive of CAC in panoramic radiographs of the jaws (PRJs) and confirm them by Doppler ultrasonography. To evaluate their anatomic locations and relationships between systemic conditions (diabetes, hypertension, and obesity) and the presence of unilateral or bilateral CAC detected on PRJ or by Doppler ultrasonography. MATERIALS AND METHODS: Of the 723 routinely performed PRJ in patients over 40 years at the Radiology Center in São Luís, Maranhão, Brazil, 21 PRJ containing images suggestive of CAC were selected in this cross-sectional study. The findings from the PRJ were confirmed by Doppler sonography. RESULTS: Images suggestive of CAC was detected in 21 (2.9%) of the PRJ evaluated, consisting of 11 (52.4%) hypertensive, 7 (33.3%) diabetics, and 9 (42.9%) obese. There was a higher prevalence of hypertensive patients in the unilateral CAC group (100%) and bilateral CAC (60%) compared to patients without CAC (25%). CONCLUSIONS: CACs can be detected in PRJs, and are more frequent in common carotid arteries. No significant associations were detected between the presence of unilateral or bilateral CAC in PRJ and hypertension, diabetes, or obesity.

Educação a distância e formação continuada: em busca de progressos para a saúde / Distance learning and continuing education: searching for progress in health

A Universidade Aberta do Sistema Único de Saúde (Unasus) foi instituída para suprir as necessidades de capacitação e educação permanente dos trabalhadores do SUS, facilitando o acesso à formação continuada por meio da educação a distância. Este trabalho relata a experiência de alunos dos cursos de especialização em Saúde da Família e Saúde Materno-Infantil da Unasus, da Universidade Federal do Maranhão, a partir da produção de seus estudos científicos e da contribuição da educação a distância para a transformação das condições de saúde das comunidades em que atuam. Os principais temas estudados abordaram a saúde materno-infantil e constituíram-se em planos de ação, visando ao enfrentamento dos problemas identificados e à defesa da vida saudável como um direito de cidadania e bem público. A educação a distância possibilitou a esses profissionais o acesso à capacitação permanente e a ferramentas que sugerem meios de modificar a formação e execução de políticas na área da saúde.

The Open University of Brazilian National Health System (UNASUS) was established to meet the training and education needs of the Unified Health System workers, facilitating access to continuing instruction through distance learning. This paper aims to report the experience of the students from UNASUS specialization courses in Family Health and Mother-Child Health, offered by the Federal University of Maranhão, based on the production of their scientific studies and the contribution of distance learning to the transformation of the health conditions in the communities they serve. The main issues studied were mother and child health care and consisted of action plans, aiming to tackle the identified problems and to ensure healthy living as a citizen's right public asset. Distance learning allowed to these professionals to access continuous training and also, provided tools that suggest ways of modifying the formation and implementation of health policies.