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ABSTRACT Objective. To provide a comprehensive overview of geographical patterns (2001–2010) and time trends (1993–2012) of cancer incidence in children aged 0–19 years in Latin America and the Caribbean (LAC) and interpret the findings in the context of global patterns. Methods. Geographical variations in 2001–2010 and incidence trends over 1993–2012 in the population of LAC younger than 20 years were described using the database of the third volume of the International Incidence of Childhood Cancer study containing comparable data. Age-specific incidence per million person-years (ASR) was calculated for population subgroups and age-standardized (WSR) using the world standard population. Results. Overall, 36 744 unique cases were included in this study. In 2001–2010 the overall WSR in age 0–14 years was 132.6. The most frequent were leukemia (WSR 48.7), central nervous system neoplasms (WSR 23.0), and lymphoma (WSR 16.6). The overall ASR in age group 15–19 years was 152.3 with lymphoma ranking first (ASR 30.2). Incidence was higher in males than in females, and higher in South America than in Central America and the Caribbean. Compared with global data LAC incidence was lower overall, except for leukemia and lymphoma at age 0–14 years and the other and unspecified tumors at any age. Overall incidence at age 0–19 years increased by 1.0% per year (95% CI [0.6, 1.3]) over 1993–2012. The included registries covered 16% of population aged 0–14 years and 10% of population aged 15–19 years. Conclusions. The observed patterns provide a baseline to assess the status and evolution of childhood cancer occurrence in the region. Extended and sustained support of cancer registration is required to improve representativeness and timeliness of data for childhood cancer control in LAC.

RESUMO Objetivo. Apresentar uma visão abrangente dos padrões geográficos (2001 a 2010) e das tendências temporais (1993 a 2012) da incidência de câncer em crianças e jovens de 0 a 19 anos na América Latina e no Caribe (ALC) e interpretar os resultados no contexto de padrões mundiais. Métodos. Foram descritas variações geográficas de 2001 a 2010 e tendências de incidência de 1993 a 2012 na população com menos de 20 anos da ALC usando informações comparáveis da base de dados do terceiro volume do estudo International Incidence of Childhood Cancer. Foram calculadas taxas de incidência específica por idade por milhão de pessoas-ano (ASR, na sigla em inglês) para subgrupos populacionais e taxas padronizadas por idade usando a população padrão mundial (WSR, na sigla em inglês). Resultados. No total, foram incluídos 36 744 casos únicos. No período de 2001 a 2010, a WSR para todos os tumores combinados na faixa etária de 0 a 14 anos foi de 132,6. Os diagnósticos mais frequentes foram leucemia (WSR de 48,7), neoplasias do sistema nervoso central (WSR de 23,0) e linfoma (WSR de 16,6). A ASR para todos os tumores combinados na faixa etária de 15 a 19 anos foi de 152,3, e a maior taxa foi a de linfoma (ASR de 30,2). A incidência foi maior no sexo masculino do que no sexo feminino e maior na América do Sul do que na América Central e no Caribe. De modo geral, em comparação com as estimativas mundiais, a incidência na ALC foi menor, exceto para leucemia e linfoma entre 0 e 14 anos e para outros tumores e tumores não especificados em qualquer idade. A taxa de incidência na faixa etária de 0 a 19 anos aumentou em 1,0% ao ano (IC de 95% [0,6, 1,3]) entre 1993 e 2012. Os registros incluídos cobriam 16% da população de 0 a 14 anos e 10% da população de 15 a 19 anos. Conclusões. Os padrões observados servem de referência para avaliar o status e a evolução da ocorrência de câncer infantil na região. É necessário garantir um apoio ampliado e consistente aos registros de câncer para aprimorar a representatividade e a disponibilidade das informações em tempo adequado para o controle do câncer infantil na ALC.

https://doi.org/10.26633/rpsp.2024.11

PREVENÇÃO DE INFEÇÕES POR NEISSERIA MENINGITIDIS NO LOCAL DE TRABALHO: UM PROTOCOLO DE EXPOSIÇÃO OCUPACIONAL
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Ribeiro, C

; Aguiar, A

; Miranda, G

; Silva, P

; Silva, C

; Soares, J

; Cruz, L

Revista Portuguesa de Saúde Ocupacional online

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dec 2023, Volume 16 elocation esub0412

Abstract: Pt | Text: Pt | PDF: Pt

https://doi.org/10.31252/rpso.07.10.2023

Trayectorias del dolor en sujetos con afección post-covid-19: estudio prospectivo y transversal con evaluación presencial
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Kubota, Gabriel T

; Soares, Felipe HC

; da Fonseca, Alessandra S

; dos Santos-Rosa, Talita

; da Silva, Valquiria A

; Gouveia, Gisele R

; Faria, Viviane G

; da Cunha, Pedro HM

; Brunoni, André R

; Teixeira, Manoel J

; de Andrade, Daniel C

Revista de la Sociedad Española del Dolor

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apr 2023, Volume 30 N. 2 Pages 131 - 145

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

ABSTRACT Background: New-onset chronic pain has been acknowledged as part of the post-COVID-19 condition. However, available fine-grained data about its clinical phenotype, trajectories and main associated characteristics remain scarce. We described the distinct temporal evolutions of post-COVID-19 pain and their epidemiological and phenotypical features. Methods: A prospective cross-sectional study enrolled post-COVID-19 condition patients (i.e. who had persisting COVID-19-related symptoms over 30 days since their first positive laboratory test), whose COVID-19 diagnosis had been supported by RT-PCR of oral/nasopharyngeal swab or serology. They underwent in-person evaluations with a structured interview, pain and quality-of-life-related questionnaires and thorough physical examination. Chronic pain (CP) and probable neuropathic pain (NP) were defined according to IASP criteria. Results: The present study included 226 individuals, 177 (78.3 %) of whom presented over 3 months since their first COVID-19 symptom. New-onset pain occurred in 170 (75.2 %) participants and was chronic in 116 (68.2 %). A chronic course was associated with COVID-19-related hospitalization, new-onset fatigue, lower cognitive performance, motor and thermal sensory deficits, mood and sleep impairments and overall lower quality-of-life levels. Probable NP occurred in only 7.6 % new-onset pain patients, and was associated with pain chronification, new-onset fatigue, motor and thermal sensory deficits, mechanical allodynia and lower rates of SARS-CoV-2 vaccination. Previous CP was reported by 86 (38.1 %) individuals and had aggravated after the infection in 66 (76.7 %) of them, which was associated with orthostatic hypotension. Conclusions: Post-COVID pain phenomena follow different paths, which are associated with specific clinical and epidemiological features, and possibly distinct underlying mechanisms, prognostic and therapeutic implications. Significance: COVID-19-related pain usually follows a chronic course and is non-neuropathic. Its possible courses and phenotypes are associated with distinct clinical and epidemiological features. This suggests differing underlying mechnisms, which may have significant prognostic and therapeutic implications.

RESUMEN Antecedentes: El dolor crónico de nueva aparición se considera que forma parte de la condición o afección post-COVID-19. Sin embargo, los datos detallados existentes sobre el fenotipo clínico, las trayectorias y las principales características asociadas siguen siendo escasos. Describimos las distintas evoluciones temporales del dolor post-COVID-19 y sus rasgos epidemiológicos y fenotípicos. Métodos: Estudio prospectivo y transversal de pacientes con afección post-COVID-19 (es decir, con síntomas persistentes relacionados con la COVID-19 durante 30 días desde la primera prueba positiva de laboratorio) cuyo diagnóstico de COVID-19 estuviera basado en la RT-PCR de un frotis oral/nasofaríngeo o una serología. Se sometieron a evaluaciones presenciales mediante una entrevista estructurada, cuestionarios de dolor y calidad de vida y una exploración física exhaustiva. El dolor crónico (DC) y el dolor neuropático (DN) probablemente se definieron conforme a los criterios IASP. Resultados: El presente estudio incluyó 226 individuos, 177 (78,3 %) de los cuales se presentaron pasados más de 3 meses desde el primer síntoma de COVID-19. Tenían dolor de nueva aparición 170 (75,2 %) de los participantes y dolor crónico 116 (68,2 %). El curso crónico se asociaba a hospitalización por COVID-19, fatiga de nueva aparición, menor rendimiento cognitivo, déficits motores y sensitivos térmicos, alteraciones del ánimo y el sueño, y niveles generalmente inferiores de calidad de vida. El DN probable afectaba a solo el 7,6 % de los pacientes con dolor de nueva aparición y se asociaba a cronificación del dolor, fatiga de nueva aparición, déficits motores y de sensación térmica, alodinia mecánica y tasas menores de vacunación frente al SARS-CoV-2. Referían DC previo 86 (38,1 %) individuos, y este había empeorado tras la infección en 66 (76,7 %) de ellos, lo que se asociaba a hipotensión ortostática. Conclusiones: Los fenómenos dolorosos post-COVID siguen diferentes trayectorias que se asocian a rasgos clínicos y epidemiológicos específicos, y posiblemente a distintos mecanismos de base y diferentes implicaciones pronósticas y terapéuticas. Significado: El dolor relacionado con la COVID-19 sigue normalmente un curso crónico y no es neuropático. Los posibles cursos y fenotipos se asocian a rasgos clínicos y epidemiológicos distintos. Esto sugiere que los mecanismos de base difieren, lo que podría tener implicaciones pronósticas y terapéuticas importantes.

https://doi.org/10.1002/ejp.2094

Transcatheter vascular plugs for the treatment of massive haemoptysis from Rasmussen aneurysms
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Shaw, J A

; John, T J

; Koegelenberg, C F N

; da Silva, M

; Allwood, B W

; Weich, H

SAMJ: South African Medical Journal

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feb 2023, Volume 113 N. 2 Pages 65 - 68

Abstract: En | Text: En | PDF: En

Rasmussen aneurysms are abnormalities of the pulmonary arterial system caused by tuberculosis (TB). They are associated with a high mortality rate when they cause life-threatening haemoptysis. High TB-prevalence regions have a large burden of TB-related haemoptysis but often limited resources. This series of 25 patients who presented with life-threatening haemoptysis from current and/or previous TB were found to have abnormal pulmonary arteries on computed tomography pulmonary angiogram (CTPA), which were judged to be likely contributors to their bleeding, either in isolation or with concomitant abnormal bronchial or systemic vasculature. These patients underwent transcatheter placement of Amplatzer vascular plugs in the feeder pulmonary artery. Bronchial and systemic lesions were addressed separately as needed. Immediate technical success was achieved in all patients, but four of them experienced intraoperative haemoptysis related to dislodgement of the occluding platelet plug by the high-pressure automatic injector and wire. At 48 hours after the procedure, 18 (72%) remained haemoptysis-free. Six of these experienced recurrence within 1 year of their procedure. Pulmonary artery placement of an Amplatzer vascular plug is a feasible option for treating bleeding Rasmussen aneurysms, but should be part of a combined approach to addressing suspected culprit vascular lesions in all intrathoracic vascular systems.

https://doi.org/10.7196/SAMJ.2022.v113i2.16758

HPV 18 variants in women with cervical cancer in Northeast Brazil
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Santos, Gerusinete Rodrigues Bastos dos

; Cunha, Ana Paula Almeida

; Batista, Zulmira da Silva

; Silva, Marcos Antonio Custódio Neto da

; Figueiredo, Fábio Vidal de

; Santos, Flávia Rodrigues Bastos dos

; Fraga, Elmary da Costa

; Barros, Maria Claudene

; Vidal, Flávia Castello Branco

; Nascimento, Maria do Desterro Soares Brandão

Brazilian Journal of Infectious Diseases

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2023, Volume 27 N. 1 elocation 102734

Abstract: En | Text: En | PDF: En

Abstract Background Human Papillomavirus (HPV) is the main etiological factor for the development of cervical cancer. HPV 18 is the second most frequent type, accounting for up to 65% of all cases. HPV intratypic variation may influence the potential for progression to invasive cancer. The aim of this study was to evaluate the prevalence of human papillomavirus 18 intratypic variants in cervical cancer samples from women in the state of Maranhão, Brazil. Methods The study included 118 women over 18 years of age with a diagnosis of cervical cancer. Tumor fragments were collected and subjected to DNA extraction and Polymerase Chain Reaction (PCR) for HPV detection using the PGMY09/11 and GP+5/6 primers. Positive samples were submitted to automated sequencing for viral genotyping. To determine the HPV 18 lineages, positive samples were submitted to PCR, using specific primers to amplify the LCR and E6 regions of HPV 18 virus. Results HPV was present in 88 women (73.3%). Of those, 48 (54%) were HPV 16, the most prevalent, followed by 12 (13.6%) HPV 18. Histologically, squamous cell carcinoma was predominant (79.1%). Among the HPV 18 variants identified, 10 (80%) belonged to lineage A, and sublineages A1, A2, A3, and A4. Two (29%) HPV 18 B variant was also detected, with the sublineages B1 and B2. In this study, the C variant was not found. There was no statistically significant association between the HPV 18 lineages found and sociodemographic and lifestyle variables (p > 0.05). Conclusions A higher frequency of HPV 16 and 18 were found in women with cervical cancer in the state of Maranhão, Brazil, with a high prevalence of the lineage A among women with HPV 18.

https://doi.org/10.1016/j.bjid.2022.102734

Toxic effects of Arianor Ebony hair dye on human cells
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Tafurt-Cardona, Y.

; Suares-Rocha, P.

; Silva, B.O.

; Moraes, K.C.M.

; Marin-Morales, M.A.

Brazilian Journal of Medical and Biological Research

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2023, Volume 56 elocation e12777

Abstract: En | Text: En | PDF: En

To evaluate the risks of hair dye exposure, we investigated cellular and molecular effects of Arianor Ebony dye, which is a mixture of azo and anthraquinone dyes, used in the composition of the black color. Cytotoxicity, genotoxicity, and gene expression of relevant molecules of apoptotic and oxidative stress mechanisms were investigated in HepG2 cells exposed to Arianor Ebony. Results showed that the dye did not induce cytotoxicity to exposed cells at a concentration up to 50 µg/mL compared to the negative control. However, genotoxic assays indicated that the dye was able to damage the genetic material at a concentration of 25 µg/mL, with induction factor values of exposed cells two- to five-fold higher than those recorded for the negative control. Moreover, the lowest observed effect concentration was 12.5 µg/mL. For gene expression, relevant changes were observed in cytochrome c and caspase 9, which decreased in cells incubated with the dye in a dose-dependent manner when compared with the negative control. In parallel, the expression of genes for antioxidant enzymes was increased in exposed cells, suggesting the presence of metabolic routes that protect cells against the toxic effect of the dye, avoiding exacerbated cellular death. Results suggested that the dye disrupted cellular homeostasis through mitochondrial dysfunction, which may be hazardous to human health. Thus, further investigations are necessary to deeply understand the mechanisms of action of the dye, considering its toxic potential found in our ex vivo assays.

https://doi.org/10.1590/1414-431x2023e12777

Survival analysis over a 20-year period of a Brazilian cohort of blood donors coinfected HIV-HCV
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Menezes Filho, Hélio Ranes de

; Grandi, Giuliano

; Cardoso, Ludimila Paula Vaz

; Silva, Juan Felipe Galvão da

; Machado, Soraia Mafra

; Almeida-Neto, Cesar de

; Sabino, Ester Cerdeira

; Mendes-Corrêa, Maria Cássia

Brazilian Journal of Infectious Diseases

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2023, Volume 27 N. 5 elocation 102810

Abstract: En | Text: En | PDF: En

ABSTRACT Among individuals coinfected with HCV and HIV, studies of mortality from non-hepatic causes have shown inconsistent results. The aim of this study was to investigate the contribution of HCV and HIV co-infection to mortality from hepatic and non-hepatic causes in Brazil. This retrospective cohort study included blood donors from Fundação Pró-Sangue de São Paulo (FPS) who were followed from 1994 to 2016 to compare mortality and its causes between HIV-HCV coinfected individuals versus those seronegative for all tested infections. Records from the FPS database and the Mortality Information System were linked through a probabilistic record Relationship (RL). The Hazard Ratio (HR) was estimated using Cox multiple regression models. HCV-HIV coinfected individuals compared to seronegative individuals had a higher risk of death from all causes (HR = 14.54), non-liver neoplasms (HR = 2.55), infections (HR = 10.37) and liver disease (HR = 7.0). In addition, HCV mono-infected individuals compared to seronegative individuals had a higher risk of death from all causes (HR = 2.23), liver cancer (HR = 32.21), liver disease (HR = 14.92), infection (HR = 3.22), and trauma (HR = 1.68). Individuals coinfected with HCV and HIV have increased overall mortality and death due to infections, liver diseases and non-liver neoplasms as compared to those uninfected with HCV and HIV.

https://doi.org/10.1016/j.bjid.2023.102810

Leishmanicidal and Antimicrobial Activities of 4-Quinolone Alkaloids from Stems of the Medicinal Plant Waltheria indica (Malvaceae) and Their Chemotaxonomic Significance
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Silva, Raquel M.

; Domingos, Levy T. S.

; Castro, Gabriellen M. M. de

; Laport, Marinella S.

; Ferreira-Pereira, Antônio

; Lima, Murilo M. C.

; Cotinguiba, Fernando

Journal of the Brazilian Chemical Society

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nov 2022, Volume 33 N. 11 Pages 1291 - 1298

Abstract: En | Text: En | PDF: En

A chemical investigation of the stem of Waltheria indica (Malvaceae) yielded twelve 4-quinolone alkaloids, which were primarily waltheriones. These were waltherione A (1), waltherione B (2), waltherione C (3), waltherione G (4), waltherione H (5), waltherione J (6), waltherione L (7), waltherione P (8), chamaedrone (9), 8-deoxy-antidesmone (10), antidesmone (11), and the previously unreported alkaloid N-methoxy-waltherione A (12). These alkaloids belong to an unusual class of 4-quinolones and therefore, have chemosystematic significance for distinguishing the Waltheria and Melochia genera from the rest of the Malvaceae family. The ability of the alkaloid isolates to reverse the phenotypic expression of fluconazole-resistance was tested by using a mutant strain of Saccharomyces cerevisiae that expressed a Candida albicans transporter. Of the isolates tested, waltherione G afforded a positive result. Leishmanicidal activity and bactericidal tests were also performed using the isolated alkaloids, which showed promising results.

https://doi.org/10.21577/0103-5053.20220060

Effects of a 10-week dry-land strength and conditioning program in physical capacities and start of previously federated and regular swimming practitioners
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Silva, C

; Jesus, J

; Vilarigues, I

; Aranha, I

; Candeias, I

; Santos, F

; Figueiredo, T

; Espada, M

Cuadernos de Psicología del Deporte

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apr 2022, Volume 22 N. 1 Pages 230 - 244

Abstract: Pt Es En | Text: Pt Es En | PDF: Pt | PDF: Es | PDF: En

RESUMO O objetivo deste estudo foi avaliar o efeito de um programa de força e condicionamento (F&C) em seco de 10 semanas nas capacidades físicas e salto em praticantes regulares de natação previamente federados. 16 nadadores (9 masculinos, 17.00±2.16 anos de idade, 179.14±5.76 cm de altura e 69.79±3.11 kg de peso; 7 femininos, 15.86±2.34 anos de idade, 163.86±4.98 cm de altura e 60.19±3.60 kg de peso) foram equitativamente, mas de forma aleatória divididos em dois grupos (controlo e experimental, respetivamente, GC e GE). No pré-teste, nadadores realizaram três saltos em dois modelos, grab start e track start, sendo registado o melhor. Foram determinados parâmetros do salto na natação e o tempo aos 15 m. Flexibilidade, salto em contramovimento e lançamento de bola medicinal de 3 kg foram também avaliados. No pós-teste, 10 semanas após programa de F&C em seco com 2 sessões semanais de 60 min realizado por GE, testes foram repetidos. As melhorias de flexibilidade, força e potência muscular foram significativas no GE, contrariamente ao GC. As variáveis da fase inicial do salto associadas ao voo melhoraram mais no GE comparativamente ao GC, com especificidades observadas no grab start e track start, mas não uma consequência linear com o desempenho aos 15 m em ambos os grupos. Um programa de F&C em seco de 10 semanas pode promover benefícios nas capacidades físicas de praticantes regulares de natação, facto que pode melhorar a fase inicial do salto na natação, anterior ao momento subaquático, que deve merecer atenção pelos treinadores nas sessões diárias visando uma melhoria de desempenho aos 15 m.

RESUMEN El propósito de esto estudio fue evaluar el efecto de un programa de fuerza y acondicionamiento (F&A) en seco de 10 semanas sobre las habilidades físicas y el salto en practicantes habituales de natación previamente federados. 16 nadadores (9 masculino, 17.00±2.16 años de edad, 179.14±5.76 cm de altura y 69.79±3.11 kg de peso and 7 mujer, 15.86±2.34 años de edad, 163.86±4.98 cm de altura y 60.19±3.60 kg de peso) fueron equitativamente, pero al azar divididos en dos grupos (control y experimental, respectivamente, GC e GE). En el pre-test realizaron tres saltos en dos modelos, grab start e track start, siendo el mejor registrado. Se han determinado parámetros cinemáticos del salto en natación y el tiempo a los 15 m. También se evaluaron la flexibilidad, el salto con contramovimiento y el lanzamiento de una pelota medicinal de 3 kg. En el post-test, 10 semanas después de un programa de F&A en seco con 2 sesiones semanales de 60 min interpretado por GE, las pruebas se repitieron. Las mejoras de flexibilidad, fuerza y potencia muscular fueron significativas en el GE, en contraste con el GC. Las variables de la fase de vuelo en el salto mejoraron más en el GE en comparación con el CG, con especificidades observadas en el grab start e track start, pero no una consecuencia lineal con el rendimiento a 15 m en ambos grupos. Un programa de F&A seco de 10 semanas puede promover beneficios en las habilidades físicas de nadadores habituales, hecho que puede mejorar la fase inicial del salto en la natación, previa al momento subacuático, que debe merecer la atención de los entrenadores en las sesiones diarias con el objetivo de a una mejora del rendimiento a 15 m.

ABSTRACT The aim of this study was to evaluate the effects of a 10-week strength and conditioning (S&C) program in physical capacities and start in previously federated and regular swimming practitioners. 16 swimmers (9 male, 17.00±2.16 years of age, 179.14±5.76 cm of height and 69.79±3.11 kg of weight; 7 female, 15.86±2.34 years of age, 163.86±4.98 cm of height and 60.19±3.60 kg of weigh) were equality, but randomly separated in two groups (control group and experimental group, CG and EG, respectively). In the pre-test, swimmers performed three starts in two different models, grab start and track start, the best start was registered. Kinematic parameters of the swimming start and time at 15 m were determined. Flexibility, countermovement jump and 3 kg medicine ball throw were also assessed. In post-test, 10-weeks after a regular 2-sessions week specific dry-land S&C program of 60 min was performed by the EG, all tests were repeated. Flexibility, strength and muscular power gains were significant in EG, contrarily to CG. Swimming start flight phase variables improved more in EG compared to CG, with specificities observed in grab and track start but not a linear consequence with performance in 15-m mark in both groups. A 10-week dry-land S&C program can provide benefits in physical capacities in regular swimming practitioners, fact that may improve the initial phase of the swimming start, prior to the underwater moment, which should deserve attention by the coaches in daily training aiming performance enhancement at 15 m.

https://doi.org/10.6018/cpd.468821

10.

PROJETO DE INTERVENÇÃO BURN-DOWN: O IMPACTO DO BURNOUT NOS CUIDADOS DE SAÚDE PRIMÁRIOS E O BENEFÍCIO DA PREVENÇÃO QUINQUENÁRIA NUMA UNIDADE DE SAÚDE FAMILIAR
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Abreu, I

; Baía, C

; Silva, J

; Borges, R

; Pinto, S

Revista Portuguesa de Saúde Ocupacional online

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dec 2021, Volume 12 Pages 164 - 177

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Introdução O Burnout constitui uma síndrome psicológica complexa, secundária a uma resposta crónica excessiva ao stress laboral, caracterizando-se por exaustão emocional, despersonalização e diminuição da realização profissional. Os profissionais de saúde integram um grupo suscetível a esse fenómeno. Recentemente, as exigências impostas pela pandemia COVID-19 aumentaram eventualmente a prevalência e/ou gravidade desta questão, particularmente nos Cuidados de Saúde Primários. Assim, intervenções para o minimizar são urgentes. Objetivo Reduzir o Burnout e promover mecanismos de coping adequados, capacitando os Profissionais de Saúde para a adoção de um estilo de vida saudável. Metodologia Trata-se de uma Intervenção dirigida aos Profissionais de Saúde de uma Unidade de Saúde Familiar (USF). Previamente colheram-se dados sociodemográficos e aplicaram-se dois questionários de autopreenchimento: o Copenhagen Psychosocial Questionnaire II (COPSOQ II) para aferição dos níveis de Burnout e o “Questionário de Modos de Lidar com os Acontecimentos”, para avaliação das estratégias de coping utilizadas. A intervenção consistiu na realização de sessões teórico-práticas online e sessões presenciais de prática de yoga. As sessões versaram os temas “Burnout e mecanismos de coping”, “Trabalho e convívio em equipa”, “Mindfullness” e “Exercício Físico” na prevenção do Burnout. O COPSOQ II foi reaplicado para avaliar os efeitos da intervenção. A análise estatística incluiu a utilização do coeficiente Alfa de Cronbach, cálculo de média± desvio-padrão para cada item avaliado e o teste t-Student para comparação, assumindo-se diferenças estatisticamente significativas para valores de p≤0,050. Resultados A amostra ficou constituída por 22 elementos. Os resultados do COPSOQ II pré-intervenção revelaram que a maioria se encontrava em situação de risco para a saúde nas subdimensões afetas às “Exigências Laborais”, “Organização do Trabalho e Conteúdos” e à “Personalidade” e em situação intermédia de risco nas “Relações sociais e de Liderança”. As estratégias de coping mais utilizadas foram a “Resolução Planeada de Problemas”, a “Aceitação da Responsabilidade” e o “Autocontrolo”. Após a intervenção, obteve-se uma melhoria estatisticamente significativa nas subdimensões “Atenção”, “Compromisso Face ao Local do Trabalho”, “Saúde Geral” e “Problemas em Dormir”. Discussão e Conclusão Obteve-se uma melhoria significativa da saúde física e mental dos Profissionais de Saúde, com redução dos níveis de Burnout. A implementação de intervenções de prevenção quinquenária e a identificação de áreas onde atuar pode melhorar a saúde e as suas estratégias de coping.

ABSTRACT Introduction Burnout is a complex psychological syndrome, secondary to a chronic and excessive response to work stress. It is characterized by emotional exhaustion, depersonalization and decreased professional fulfilment. Health professionals are a susceptible group to this phenomenon. Recently, challenges imposed by the COVID-19 pandemic have eventually increased the prevalence and/or severity of this issue, particularly in Primary Health Care. Thus, interventions aimed at minimizing its effects are urgent. Objective To reduce Burnout and promote appropriate coping strategies, empowering Health Professionals to adopt a healthy lifestyle. Methodology This intervention is aimed at Health Professionals from a Family Health Unit. Previously, sociodemographic data were collected and applied two self-completed questionnaires: the Copenhagen Psychosocial Questionnaire II (COPSOQ II) to assess Burnout levels and the The Ways of Coping Questionnaire, to assess coping strategies used and areas of action. The intervention consisted of online theoretical-practical sessions and face-to-face yoga practice sessions. The sessions dealt with the topics "Burn-out and coping mechanisms", "Working and socializing in a team", “Mindfulness” and "Physical exercise" in Burnout prevention. The COPSOQ II was reapplied to assess the effects of the intervention. Statistical analysis included the use of Cronbach's alpha coefficient, calculation of mean± standard deviation for each item assessed and the t-Student test for comparison, assuming statistically significant differences if p ≤ 0,050. Results The sample was formed by 22 elements. The pre-intervention COPSOQ II results revealed that the majority was at risk for health in the subdimensions related to "Work Demands", "Work Organization and Content" and "Personality" and in an intermediate risk situation in "Social and Leadership Relationships". The most used coping strategies were "Planned Problem Solving", "Acceptance of Responsibility" and "Self-control". After the intervention, a statistically significant improvement was obtained in the subdimensions "Attention", "Commitment to the Workplace", "General Health" and "Sleeping Problems". Discussion and Conclusion It was obtained a significant improvement on the physical and mental health of Health Professionals, with a reduction of Burnout levels. The implementation of quinquenary prevention interventions and the identification of areas where to act can improve their health and coping strategies.

https://doi.org/10.31252/rpso.06.11.2021 31 downloads

11.

SÍNDROME DE BURNOUT EM PROFISSIONAIS DE SAÚDE ANGOLANOS DURANTE A PANDEMIA DA COVID-19
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Oliveira, P

; Martín-Garcia, D

; Lueto, O

; Gómez-Martinez, F

; Lucama, C

; Bernardo, J

; Silva, P

; Mirandela, M

; Gamboa, I

; Amaro, T

Revista Portuguesa de Saúde Ocupacional online

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dec 2021, Volume 12 Pages 30 - 41

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Introdução Segundo a Organização Mundial da Saúde, a síndrome de Burnout ocorre devido ao stresse crónico no local de trabalho e inclui sintomas físicos e psíquicos. A atual pandemia da COVID-19 gerou uma sobrecarga de trabalho aos profissionais de saúde em todo o mundo, por vezes excedendo as suas capacidades podendo conduzir ao suicídio. Angola é um país em desenvolvimento e o seu sistema de saúde ainda é frágil- por esta razão a pandemia poderá ter um sério impacto. Em Março de 2020 registaram-se os primeiros casos da COVID-19 que aumentaram progressivamente. Objetivo Determinar a prevalência da Síndrome de Burnout nos Profissionais de Saúde que assistem os casos suspeitos e confirmados de COVID-19 em Angola, de Maio a Setembro de 2020. Metodologia Realizou-se um estudo observacional, descritivo e transversal a 250 profissionais (196 de Luanda e 54 de Benguela) que trabalham em instituições de saúde que atendem pacientes com COVID-19. Aplicou-se o Inventário de Burnout de Maslach, que inclui três subescalas: esgotamento ou cansaço emocional, despersonalização e realização pessoal. Níveis elevados nas duas primeiras e baixos na terceira são indicativos de Burnout. Obteve-se também a informação sociodemográfica dos profissionais. Resultados Verificou-se que 60% dos participantes eram do sexo feminino, com a idade média 35 anos e com predomínio de enfermeiros (50%). Os profissionais de Luanda atenderam em média 61 pacientes por semana enquanto os de Benguela atenderam 12. A pontuação média das três subescalas do comportamento é elevada em ambos sexos e províncias, com valores superiores de cansaço emocional em mulheres e maior realização pessoal entre os profissionais de Luanda. Diagnosticou-se Síndrome de Burnout em 9,3% dos profissionais de Luanda e 4,6% de Benguela, sem diferenças significativas entre mulheres e homens (6,2 versus 4,5). Conclusões Apesar da baixa frequência de síndrome de Burnout e pelo facto de existirem elevados níveis de cansaço emocional e despersonalização no início da pandemia, é de supor que possa existir um aumento do número de casos perante uma demanda de trabalho superior, causada pela mesma. Este achado deve ser tomado em conta pelos gestores do sistema de saúde para salvaguardar o bem- estar dos seus profissionais e dos pacientes nomeadamente promovendo turnos de trabalho com períodos mais reduzidos; integração de mais profissionais em equipas de serviço desfalcadas; incentivo às pausas ao longo do dia; alimentação adequada conforme o horário do dia e rica em nutrientes; criação de programas de apoio social; incentivo à prática de exercícios fisicos e de relaxamento, pagamento mensal dos subsídios de risco epidemiológico da COVID-19; Equipamento de Protecção Individual (EPI); maior disponibilidade de medicamentos e materiais de monitorização clínica dos doentes graves; presença de médico especialista em cuidados intensivos em cada turno de trabalho; bem como apoio e acompanhamento psicológico.

ABSTRACT Introduction According to the World Health Organization, "Burnout syndrome occurs due to chronic stress in the workplace” and includes physical and psychological symptoms. The current COVID-19 pandemic has created an overload of work for health professionals worldwide, sometimes exceeding their capacities and even leading to suicide. Angola is a developing country and its health system is still fragile, for this reason the pandemic could have a serious impact. In March the first cases of COVID-19 were registered and their incidence progressively increased. Objective To determine the prevalence of Burnout Syndrome in Health Professionals who assisted suspected and confirmed cases with COVID-19 in Angola, between May and September 2020. Methodology An observational, descriptive and transversal study was carried out with 250 professionals (196 from Luanda and 54 from Benguela) who work in health institutions that care suspected and confirmed cases with COVID-19. The Maslach Burnout Inventory (MBI-HSS) was applied, which includes three subscales: emotional exhaustion or fatigue, depersonalization and personal fulfillment. High levels of the first two and low levels of the third are indicative of the situation. The professionals' sociodemographic information was also obtained. Results It was found that 60% of participants were female, mean age 35 years, with a predominance of nurses (50%). Professionals from Luanda assisted an average of 61 patients per week while those from Benguela assisted 12. The average score on the three behavior subscales was high in both genders and provinces, with significantly higher values of emotional fatigue in women and greater personal fulfillment among professionals in Luanda. Burnout Syndrome was diagnosed in 9.3% of professionals in Luanda and 4.6% in Benguela, with no statistical differences found between women and men (6.2 vs 4.5) Conclusions Despite the low frequency of Burnout syndrome and the fact that there are high levels of exhaustion and depersonalization at the beginning of the pandemic, it leads to believe that there will be an increase in the number of cases of Burnout due to a greater demand for work, triggered by the worsening of the pandemic. This finding should be taken into account by health system managers to safeguard the well-being of their professionals and patients, namely Work shifts with shorter periods; Integration of more professionals in understaffed service teams; encouraging breaks throughout the day; Adequate food/nutrients according to the time of day; creation of social support programs; encouragement to practice physical exercises and relaxation; monthly payment of COVID-19 epidemiological risk subsidies; Personal Protective Equipment; greater availability of drugs and materials for clinical monitoring of critically ill patients; presence of a physician specialized in intensive care in each work shift; as psychological support.

https://doi.org/10.31252/rpso/11.09.2021 31 downloads

12.

Effect of Titanium Hardness on the Integrity and Stress Concentration of External Hexagon Dental Implants
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Silva, Alecsandro de Moura

; Matos, Jefferson David Melo de

; Tribst, João Paulo Mendes

; da Rocha Scalzer Lopes, Guilherme

; da Silva Machado Martinelli, Carolina

; de Souto Borges, Alexandre Luiz

; Tomomitsu Kimpara, Estevão

; Nogueira-Junior, Lafayette

; Marques de-Melo, Renata

; Bottino, Marco Antonio

International journal of odontostomatology

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dec 2021, Volume 15 N. 4 Pages 1053 - 1059

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

ABSTRACT: The aim of this study was to evaluate the influence of overtorque on integrity, strength and stress on external hexagonal implants (EH), with two different grades (N=10): conventional (C), grade 4; and modified (M), grade 4 with thermal treatment. The dimensions of EH were 3.75 x 13 mm; the specimens were fixed and submitted to SEM analysis and image acquisition. The abutment was then retained with 70 N/cm, re-analyzed by SEM, and a second image was obtained. The images were analyzed by Image J software (1.44o- NIH, USA) for dimensional variations measurement on surface of the hexagonal area. The finite element method was applied with a similar compliance to calculate the resultant stress (MPa) during the torque. Results were statistically analyzed with t-student test (5 %). The dimensional accuracy of M (0.22 mm2) was statistically significant (p<0.05). Minimum principal stress and von-Mises stress of C (-19.95 MPa, -19.94 MPa), were lower than M values (-55.83 MPa, -55.96 MPa), respectively. However, the M group showed lower deformation than C group. Therefore, more rigid titanium alloy is a promising alternative to avoid plastic deformation of prosthetic connec tions even concentrating higher stress magnitude on its structure.

RESUMEN: El objetivo de este estudio fue evaluar la influencia del sobrepar en la integridad, la fuerza y la tensión en los implantes hexagonales externos (EH), con dos grados diferentes (N = 10): convencional (C), grado 4; y modificado (M), grado 4 con tratamiento térmico. Las dimensiones de EH eran 3,75 de diámetro x 13 mm de longitud; las muestras se fijaron y se sometieron a análisis SEM y adquisición de imágenes. A continuación, el pilar se retuvo con 70 N / cm, se volvió a analizar por SEM y se obtuvo una segunda imagen. Las imágenes se analizaron con el software Image J (1.44o-NIH, EE. UU.) Para medir las variaciones dimensionales en la superficie superior del área hexagonal, que fue causada por un par excesivo. El método de los elementos finitos se aplicó con un cumplimiento similar para calcular la tensión resultante (MPa) durante el par. Los resultados se analizaron estadísticamente con la prueba t-student (5 %). La precisión dimensional de M (0,22 mm2) fue estadísticamente significativa (p <0,05). La tensión principal mínima y la tensión de von-Mises de C (-19,95 MPa, -19,94 MPa), fueron inferiores a los valores de M (-55,83 MPa, -55,96 MPa), respectivamente. Sin embargo, el hexágono del grupo M mostró menor deformación que el grupo C. Por lo tanto, la aleación de titanio más rígida es una alternativa prometedora para evitar la deformación plástica de las conexiones protésicas incluso concentrando una mayor magnitud de tensión en su estructura.

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13.

HEALTH-RELATED QUALITY OF LIFE IN ADOLESCENTS AND YOUNG ADULTS WITH INFLAMMATORY BOWEL DISEASE IS ASSOCIATED WITH REDUCTION IN SCHOOL AND WORK PRODUCTIVITY RATHER THAN PHYSICAL IMPAIRMENT: A MULTIDISCIPLINARY STUDY
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OBA, Jane

; SOBRADO, Carlos W

; DAMIÃO, Aderson O M C

; AZEVEDO, Matheus

; CARLOS, Alexandre

; QUEIROZ, Natália

; LEN, Claudio A

; TOMA, Ricardo K

; DEBONI, Mariana

; OZAKI, Marcos J

; CARRILHO, Flair José

; NAHAS, Sergio

; SILVA, Clovis A

Arquivos de Gastroenterologia

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oct 2021, Volume 58 N. 4 Pages 541 - 547

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO CONTEXTO: As doenças inflamatórias intestinais (DII), que englobam a doença de Crohn e a colite ulcerativa, são doenças inflamatórias crônicas do trato gastrointestinal que frequentemente se manifestam em adolescentes e adultos jovens (AAJ). As DII são caracterizadas por episódios de doença ativa intercalados com períodos de remissão, e sua atividade se correlaciona inversamente com a qualidade de vida relacionada à saúde (QVRS). OBJETIVO: Este estudo teve como objetivo determinar se AAJ em remissão ou com baixa atividade de DII exibiria QVRS semelhante à de indivíduos saudáveis pareados por idade, e se fatores demográficos da doença poderiam afetar a QVRS usando um instrumento de medidas de desfecho relatadas pelo paciente. MÉTODOS: Este estudo envolveu apenas AAJ com DII, com baixa atividade. Esta pesquisa incluiu cinco clínicas multidisciplinares de dois Hospitais Universitários: Divisões de Gastroenterologia Pediátrica, Gastroenterologia, Coloproctologia, Reumatologia Pediátrica e Adolescentes, São Paulo, Brasil. Um total de 59 AAJ com DII (13-25 anos de idade) e 60 AAJ controle saudáveis (13-25 anos de idade) responderam os questionários Pediatric Quality of Life Inventory 4.0 e 36-Item Short-Form Health Survey e as escalas visuais de dor. Dados demográficos, manifestações extra intestinais, tratamentos e desfechos da doença de Crohn e a colite ulcerativa foram avaliados. RESULTADOS: AAJ com DII e os controles saudáveis foram grupos semelhantes com relação à média de idade (18,63 [13,14-25,80] vs 20,5 [13,68-25,84] anos, P=0,598), quanto à proporção de pacientes do sexo feminino (42% vs 38%, P=0,654), e quanto à porcentagem da classe socioeconômica brasileira média elevada/ média (94% vs 97%, P=0,596). Os escores escola/trabalho foram significativamente mais baixos nos AAJ com DII do que nos controles saudáveis (70 [10-100] vs 75 [5-100], P=0,037). O escore ‘percepção geral de saúde’ foi significativamente mais baixo nos AAJ com DII do que no agrupamento controle saudável (50 [10-80] vs 0 [25-90], P=0,0002). As escalas de avaliação visual de dor foram semelhantes entre os dois grupos (2 [0-10] vs 3 [0-9], P=0,214). Nenhuma associação entre QVRS e parâmetros clínicos e demográficos foi identificada entre os pacientes com DII. CONCLUSÃO: AAJ com baixa atividade das DII relataram baixa QVRS nos domínios da escola/trabalho e percepção geral da saúde, o que destaca um critério de incapacidade nesta vulnerável população.

ABSTRACT BACKGROUND: Inflammatory bowel diseases (IBD), comprising Crohn’s disease and ulcerative colitis, are chronic inflammatory diseases of the gastrointestinal tract that often have their onset among adolescents and young adults (AYA). IBD are characterized by episodes of active disease interspersed with periods of remission, and its activity is inversely correlated with health-related quality of life (HRQL). OBJECTIVE: This study aimed to determine whether AYA in remission or with low IBD activity would exhibit HRQL similar to that of age-matched healthy individuals, and whether demographic and disease factors could affect HRQL using a ‘patient-reported outcome’ instrument. METHODS: This study enrolled only AYA with IBD, with low activity. This research included five multidisciplinary clinics of two academic hospitals: Paediatric Gastroenterology, Gastroenterology, Coloproctology, Paediatric Rheumatology and Adolescent divisions, São Paulo, Brazil. A total of 59 AYA with IBD (age, 13-25 years) and 60 healthy AYA (age, 13-25 years) completed the Pediatric Quality of Life Inventory 4.0 and 36-Item Short-Form Health Survey questionnaires and the visual analogue scale (VAS) for pain. Demographic data, extra-intestinal manifestations, treatment, and outcomes regarding CD and UC were evaluated. RESULTS: AYA with IBD and healthy controls were similar with respect to median ages (18.63 [13.14-25.80] years vs 20.5 [13.68-25.84] years, P=0.598), proportion of female sex (42% vs 38%, P=0.654), and percentage of upper middle/middle Brazilian socioeconomic classes (94% vs 97%, P=0.596). The school/work score was significantly lower in AYA with IBD than in healthy controls (70 [10-100] vs 75 [5-100], P=0.037). The ‘general health-perception’ score was significantly lower in AYA with IBD than in healthy controls (50 [10-80] vs 0 [25-90], P=0.0002). The median VAS, FACES pain rating scale, and total VAS scores were similar between the two groups (2 [0-10] vs 3 [0-9], P=0.214). No association between HRQL and clinical and demographic parameters was identified among IBD patients. CONCLUSION: AYA with low IBD activity reported poor HRQL in school/work and general health perception domains, which highlights a disability criterion in this vulnerable population.

https://doi.org/10.1590/s0004-2803.202100000-96 1 downloads

14.

INCIDÊNCIA DE ACIDENTES DE TRABALHO COM RISCO BIOLÓGICO E DESCRIÇÃO DE PADRÕES - ANÁLISE RETROSPETIVA ENTRE 2015 E 2019
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Afonso, A

; Belo, C

; Santos, J

; Silva, J

; Silva, R

; Pacheco, V

; Rodrigues, T

; Pinheiro, V

; Antunes, I

Revista Portuguesa de Saúde Ocupacional online

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jun 2021, Volume 11 Pages 38 - 46

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Introdução: Os acidentes de trabalho (AT) podem ter grande impacto no indivíduo, na sociedade e na economia. Os que têm risco biológico são particularmente frequentes em profissionais de saúde. A sua ocorrência não é homogénea e a análise dos padrões de ocorrência pode permitir uma melhor compreensão do problema. Objetivos: Caracterizar os padrões de incidência de AT com risco biológico, relacionando o dia da semana e hora de ocorrência, número de horas trabalhadas e a evolução ao longo dos anos. Metodologia: Análise retrospetiva dos AT com risco biológico num Centro Hospitalar da Região Centro de Portugal. Foram consultados os processos dos AT ocorridos entre 2015 e 2019, de acordo com: género, idade, categoria profissional, dia da semana, hora da ocorrência e número de horas trabalhadas até ao momento do acidente. Resultados: Entre 2015 e 2019 ocorreram 2213 AT, onde, 888 (40%) envolveram risco biológico. Destes, a idade média dos sinistrados foi de 38,81 +/- 10,44 anos, sendo que 80% (n=712) foram do sexo feminino. A categoria profissional mais acometida foi a dos enfermeiros com 48,4% (n=430) seguida dos médicos com 30,2% (n=268). O dia com maior número de eventos foi a segunda-feira (n=170), seguindo-se a quinta-feira (n=158). A mediana de horas trabalhadas até o acidente ocorrer foi quatro horas. Verificou-se ainda que o período da manhã foi o onde houve maior incidência de sinistros. Conclusão: A maioria dos AT com risco biológico ocorreu no período da manhã entre as dez e as doze horas da manhã, coincidindo com o horário em que há maior volume de trabalho e maior afluência de pessoas à instituição. Constatamos também uma diminuição de sinistros ao longo dos anos, que relacionamos com o papel do Serviço de Saúde Ocupacional na análise dos AT, formação e informação dos profissionais de saúde na definição e implementação de medidas corretivas.

ABSTRACT Introduction: Work accidents may have a great impact on the individual, society and economy. Work accidents with biological risk are especially frequent in healthcare professionals. Its occurrence is not homogeneous. The analysis of the patterns of its occurrence can aid to a better understanding of the issue. Objective: Characterize patterns of incidence of work accidents with biological risk, concerning weekday and hour of occurrence, number of hours worked and the evolution over the years. Methodology: A retrospective analysis of work accidents with biological risk was carried out in a Hospital Center in the Central Region of Portugal. Work accidents occurred between 2015 and 2019 were considered and analyzed according to gender, age, professional category, day of the week, hour of the day and number of hours worked until the occurrence. Results: Between 2015 and 2019 there were 2213 work accidents. Forty percent (888) involved biological risk. Of those, the average age of the victims was 38.81+/-10.44 years. Eighty percent 80% (n=712) were females. The most frequent professional category was nursing with 48.4% (n=430) followed by medical staff with 30.2% (n= 268). Work accidents occurred mostly on Monday (n=170), followed by Thursday (n=158). The median hours worked until the accident occurred was four hours. It was also found that the morning period had the highest incidence. Conclusion: Work accidents occurred mostly in the morning, between ten am and twelve pm. This could be explained by the greater volume of work and greater influx of people to the institution at this period. Moreover, we observed a decrease of work accidents over the years that might be explained by the role of the Occupational Health Department in analyzing accidents, training and informing health professionals in the definition and implementation of corrective measures.

https://doi.org/10.31252/rpso.13.03.2021 47 downloads

15.

Abordaje clínico mínimamente invasivo de fluorosis dental en estadios de TF1 a TF5. Revisión sistemática
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Covaleda Rodriguez, J

; Torres Peñuela, A

; Sánchez Esparza, M

; Pineda, R

; Silva Borrero, V

; Parra Galvis, D

; Rodríguez Lara, C

; Aguilera-Rojas, S

; Revelo Mejía, I

Avances en Odontoestomatología

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jun 2021, Volume 37 N. 2 Pages 87 - 93

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

RESUMEN Introducción: El manejo clínico de las lesiones dentales ocasionadas por fluorosis dental se realiza mediante diversas técnicas que resultan ser muy agresivas y con pobres resultados estéticos, por estas razones se plantea como objetivo determinar el tratamiento mínimamente invasivo y estético para fluorosis dental en los estadios de 1 a 5 según el índice de Thylstrup and Fejerskov, descritos en la literatura. Metodología: Revisión sistemática de 2.299 artículos, procedentes de cuatro bases de datos: PubMed, Embase, Science Direct y EBSCO; la búsqueda se realizó con ocho términos MeSH y tres conectores booleanos para una selección final de 22 artículos en inglés, español y portugués, publicados entre enero de 2009 y diciembre de 2018. Resultados: El tratamiento más efectivo para lesiones en estadios TF1 y TF2 fue aclaramiento dental con peróxido de carbamida a 15% o peróxido de hidrógeno a 35% durante tres sesiones de 15 minutos cada una, reforzado con peróxido de carbamida a 10%. Para estadios TF3 y TF4 fue microabrasión con ácido clorhídrico al 6% y carburo de silicio y/o con aclaramiento dental. Para lesioneTF5 fue la técnica combinada de macro y microabrasión con ácido fosfórico a 37% o ácido clorhídrico a 6%, 15% y 18%, aclaramiento y aplicación de resina infiltrante. Conclusión: Existen bases científicas que indican que el tratamiento de la Fluorosis es directamente proporcional al estadio de la lesión.

ABSTRACT Introduction: The clinical management of dental lesions caused by dental fluorosis is carried out through various techniques that are very aggressive and with poor aesthetic results. For these reasons, the aim is to determine the minimally invasive and aesthetic treatment for dental fluorosis in stages of 1 to 5 according to the Thylstrup and Fejerskov index, described in the literature. Methodology: Systematic review of 2,299 articles, from four databases: PubMed, Embase, Science Direct and EBSCO; the search was carried out with eight MeSHterms and three Boolean connectors for a final selection of 22 articles in English, Spanish and Portuguese, published between January 2009 and December2018. Results: The most effective treatment for lesions in stages TF1 and TF2 was dental clearance with carbamide peroxide at 15% or hydrogen peroxide at 35% for three sessions of 15 minutes each, reinforced with 10% carbamide peroxide. For stages TF3 and TF4 it was microabrasion with 6% hydrochloric acid and silicon carbide and / or with dental clearance. For lesioneTF5 was the combined technique of macro and microabrasion with phosphoric acid at 37% or hydrochloric acid at 6%, 15% and 18%, clearance and application of infiltrating resin. Conclusion: There are scientific bases that indicate that the treatment of Fluorosis is directly proportional to the stage of the lesion.

https://doi.org/10.4321/s0213-12852021000200005

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Glossary and search help

You can enrich your search in a very simple way. Use the search indexes combined with the connectors (AND or OR) and specify more your search.

For example, if you want to search for articles about
cases of dengue in Brasil in 2015, use:
ti:dengue and publication_year:2015 and aff_country:Brasil

See below the complete list of search indexes that can be used:

Index code	Element
ti	article title
au	author
kw	article keywords
subject	subject (title words, abstract and keywords)
ab	abstract
ta	journal short title (e.g. Cad. Saúde Pública)
journal_title	journal full title (e.g. Cadernos de Saúde Pública)
la	publication language code (e.g. pt - Portuguese, es - Spanish)
type	document type
pid	publication identifier
publication_year	publication year of publication
sponsor	sponsor
aff_country	country code of the author's affiliation
aff_institution	author affiliation institution
volume	article volume
issue	article issue
elocation	elocation
doi	DOI number
issn	journal ISSN
in	SciELO colection code (e.g. scl - Brasil, col - Colômbia)
use_license	article usage license code

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