Resumo As vulnerabilidades intrínsecas à migração despertam o olhar bioético no que concerne às iniquidades em saúde, que muitas vezes comprometem o acesso a serviços sanitários. Com isso, esta pesquisa avalia o acesso à saúde de migrantes haitianos, buscando reconhecer situações que geram maior vulnerabilidade, com vistas ao aperfeiçoamento de políticas públicas. O estudo utilizou abordagem qualitativa, coletando dados por meio de grupo focal formado por haitianos de ambos os sexos. Conclui-se que é preciso sensibilizar profissionais de saúde em relação a diferenças culturais, combater a xenofobia e o racismo e conscientizar quanto à vulnerabilidade de migrantes e refugiados. A partir disso, será possível repensar políticas e ações em saúde de modo a alcançar a universalidade, a integralidade e a equidade fomentadas pelo Sistema Único de Saúde.

Abstract The vulnerabilities of migrants arouse the bioethical view of health inequities that often affect the access to health. This research evaluates the access to healthcare of Haitian migrants, recognizing the situations that generate greater vulnerability, aiming at the improvement of public health policies. The study used a qualitative approach by conducting a focus group with adult Haitians of both sexes. We verified the need for raising health professionals’ awareness of cultural differences, migrants and refugees’ vulnerability and the fight against xenophobia and racism. Only after this it will be possible to rethink health policies and actions to achieve the universality, integrality and equity promoted by the Brazilian Unified Health System.

Resumen Las vulnerabilidades intrínsecas a la migración despiertan la mirada bioética referente a las inequidades en salud, que a menudo comprometen la accesibilidad a los servicios sanitarios. Esta investigación evalúa el acceso a la salud de migrantes haitianos, buscando reconocer cuáles son las situaciones con más vulnerabilidad para el grupo, con miras a mejorar las políticas de salud pública. Se utilizó un enfoque cualitativo mediante la recolección de datos de un grupo focal con haitianos adultos de ambos sexos. Es necesario sensibilizar a los profesionales de la salud en cuanto a las diferencias culturales, al combate a la xenofobia y el racismo, y a la vulnerabilidad de los migrantes y refugiados. Esto posibilita repensar las políticas y acciones en salud para cumplir con el papel de universalidad, integralidad y equidad fomentado por el Sistema Único de Salud brasileño.

Abstract Introduction: Panoramic radiography and cone beam computed tomography (CBCT) are very important in the diagnosis of oral diseases, however patients are exposed to the risk of ionizing radiation. This paper describes our study aimed at comparing absorbed doses in the salivary glands and thyroid due to panoramic radiography and CBCT and estimating radiation induced cancer risk associated with those methods. Methods Absorbed doses of two CBCT equipment (i-CAT® Next Generation and SCANORA® 3D) and a digital panoramic device (ORTHOPANTOMOGRAPH® OP200D) were measured using thermoluminescent dosimeters loaded in an anthropomorphic phantom on sublingual, submandibular, parotid and thyroid glands. Results Absorbed doses in the i-CAT® device ranged between 0.02 (+/-0.01) and 2.23 mGy (+/-0.03), in the SCANORA™ device ranged from 0.01 (+/-0.01) to 2.96 mGy (+/-0.29) and in the ORTHOPANTOMOGRAPH® OP200D ranged between 0.04 mGy and 0.78 mGy. The radiation induced cancer risk was highlighted in the salivary glands, which received higher doses. The protocols that offer the highest risk of cancer are the high resolution protocols of CBCT equipment. Conclusion CBCT exposes patients to higher levels of radiation than panoramic radiography, so the risks and benefits of each method should be considered. The doses in CBCT were dependent on equipment and exposure parameters, therefore adequate selection minimizes the radiation dose.

Abstract Introduction: The dental radiology represents about 20% of human exposure to radiation in radio diagnostic. Although the doses practiced in intraoral dentistry are considered low, they should not be ignored due to the volume of the performed procedures. This study presents the radiation protection conditions for intraoral radiology in Curitiba - PR. Methods Data was collected through a quantitative field research of a descriptive nature during the period between September of 2013 and December of 2014. The survey sample consisted of 97 dentists and 130 intraoral equipments. The data related to the equipments was collected using structured questions and quality control evaluations. The evaluations of the entrance skin dose, the size of the radiation field and the total filtration were performed with dosimetry kits provided and evaluated by IRD/CNEN. The exposure time and voltage were measured using noninvasive detectors. The occupational dose was verified by thermoluminescent dosimeters. The existence of personal protection equipment, the type of image processing and knowledge of dentists about radiation protection were verified through the application of a questionnaire. Results Among the survey's results, it is important to emphasize that 90% of the evaluated equipments do not meet all the requirements of the Brazilian radiation protection standards. Conclusion The lack of knowledge about radiation protection, the poor operating conditions of the equipments, and the image processing through visual method are mainly responsible for the unnecessary exposure of patients to ionizing radiation.

Introduction Intraoral film processing can be performed manually using chambers manufactured from opaque material to prevent light from entering and consequently blurring images. The aim of this study was to evaluate whether portable darkrooms used in offices, clinics and educational institutions prevent the entry of light during the processing of intraoral films. Methods To this end, tests were carried out and images were analyzed by measuring the optical base-plus-fog densities (ODs) upon imaging. Results Review of the OD measurements revealed that in 70.7% of the evaluated manual portable revelation cameras, the base-plus-veil density of intraoral films was not in accord with that of the protocol reference. Discussion The results of this work can be used to identify chambers that are commonly exposed to light from fluorescent lamps and solar lighting.

O objetivo desta pesquisa foi comparar dois sistemas digitais de armazenamento de fósforo e filme convencional, assim como verificar a concordância interexaminadores em diagnóstico radiográfico de cáries oclusais e proximais. Dois sistemas radiográficos digitais e filme convencional foram usados para avaliar 144 superfícies dentais com e sem cavitação; as radiografias foram analisadas e classificadas em uma escala de 4 pontos. Participaram como examinadores 13 alunos de graduação e um radiologista odontológico. Para validar esta pesquisa foram realizadas análises em microscopia ótica. Os resultados mostraram não haver diferença significante entre os sistemas radiográficos, entretanto, todos tiveram diferenças significantes quando comparados a microscopia óptica, com exceção do sistema Digora® nas superfícies proximais quando o radiologista foi o examinador. Na avaliação interexaminadores, foi obtido concordância moderada, e entre os alunos e o radiologista obteve-se nível sofrível a moderado. Com relação a validade (sensibilidade, especificidade, preditivos positivos e preditivos negativos), os valores foram semelhantes entre os alunos e o radiologista, com exceção dos valores de sensibilidade nas superfícies oclusais. Os estudantes obtiveram um maior numero de resultados falso-positivos e o radiologista odontológico obteve um maior numero de resultados falso-negativos.

The purpose of this research was to compare two digital storage phosphor systems and conventional film, as well as verify the interexaminer agreement in radiographic diagnosis on occlusal and proximal cavities. Two digital systems and conventional radiographic film were used to evaluate 144 tooth surfaces with and without cavities; the radiographs were analyzed and scored in a scale of 4 points. Thirteen undergraduates and an oral radiologist participated as examiners. A light microscopy analysis was accomplished in order to validate the research. The results showed that there was no significant difference between the radiographic systems, however all of them had significant differences when compared to light microscopy, except for the Digora system on the proximal surface when the radiologist was the examiner. In the interexaminer evaluation, a moderate agreement level was obtained, and a fair to moderate level was obtained between the students and the oral radiologist. Regarding the validation (sensitivity, specificity, positive predict and negative predict) the values were similar between students and the oral radiologist, except for the sensitivity value on the occlusal surface. The students had the highest number of false-positive results and the oral radiologist the highest number of false-negative results.