We investigated the factors associated with no dental visit within the last two years by adolescents in the state of São Paulo, Brazil, by using data from the Oral Health Conditions of São Paulo state population Project (SBSP-2015) conducted in 2015. This was a cross-sectional epidemiological study with a representative sample of adolescents aged 15 to higher years residing in São Paulo State. The examiners were calibrated and dental visits were measured categorically as 1- Less than 1 year, 2- One to two years, 3 - Three years or more, 4- I have never visited the dentist. Based on the literature we dichotomized the outcome in two groups: response 1 plus 2 against response 3 plus 4. Then, Multilevel Poisson Regression (MPR) was used to estimate the prevalence ratios of last dental visit three years or had never been to a dentist by adolescents compared with those who had visited the dentist within the past two years, with contextual variables as the distal level; sociodemographic variables, mesial; and individual variables, proximal level. A high percentage of adolescents (84.9%) reported visiting the dentist in the last 2 years. Whereas, 626 (11.6%) had not visited the dentist for over 3 years and 188 (3.4%) had never been. A significantly higher proportion of females than males reported visiting the dentist in the past 2 years (p = 0.003). The oral and dental condition was reported as satisfactory by 4,350 respondents (80.6%), and when they accessed the health service, 2,286 (42.3%) went to the public service. Lower mean family income (1.62PR;95%CI;1.36–1.94); ≥ 1,000 inhabitant/Dental Surgeons (1.25PR;95%IC;1.03–1.56);male (1.26PR;95%CI; 1.11–1.43) non-Caucasian ethnicity (Mulatto:1.30PR;95%CI;1.13–1.50 and Black:1.58PR;95%CI;1.29–1.93); dissatisfaction with the oral health condition (1.20PR;95%CI;1.01–1.45),last visit to the public service versus private service (2.26PR; 95%CI;1.91–2.65) and presenting with periodontal disease in the form of dental calculus as the worst situation (1.38PR; 95%CI; 1.16–1.53) were associated with last visit to the dentist. A high proportion of adolescents had visited the dentist in the last two years. No dental visit within the last two years by adolescents were associated with contextual, health care system, sociodemographic, personal and oral health status, demonstrating that this is a complex phenomenon. Actions to promote regular dental visits by adolescents in Brazil should take these factors into consideration.

No Brasil, o direito à saúde tem previsão constitucional e universal. No entanto, a via judicial tem sido muito utilizada para acesso a bens e serviços de saúde. Assim, o objetivo deste artigo foi revisar a literatura sobre a judicialização da saúde entre 2004 e 2017. A partir de pergunta estruturada, foram revisadas as bases de dados PubMed/MEDLINE, Lilacs, SciELO, Scopus e Bireme/BVS. A maioria das ações refere-se a medicamentos. Houve consenso quanto à característica individual das litigações, à preponderância da prescrição médica e à constitucionalidade da saúde integral. Há divergências em relação a possíveis interferências das decisões judiciais na gestão e na efetivação das políticas públicas e do direito à saúde. Estudos apontam falhas na gestão e disfunções nos sistemas de saúde. Os perfis das demandas de saúde levados à justiça podem auxiliar os gestores de saúde na reorientação das práticas assistenciais.

Recent studies have shown a high number of deaths from oral and oropharyngeal cancer worldwide, Brazil included. For this study, the deaths data (ICD-10, chapter II, categories C00 to C14) was obtained from Mortality Information System (SIM) and standardized by gender and population for each of the 554 Microregions of Brazil. The raw mortality rates were adopted as the standard and compared to the application of smoothing by the Bayesian model. In order to describe the geographical pattern of the occurrence of oral cancer, thematic maps were constructed, based on the distributions of mortality rates for Microregions and gender. Results: There were 7882 deaths registered due to oral and oropharyngeal cancer in Brazil, of which 6291 (79.81%) were male and 1591 (20.19%) female. The Empirical Bayesian Model presented greater scattering with mosaic appearance throughout the country, depicting high rates in Southeast and South regions interpolated with geographic voids of low rates in Midwest and North regions. For males, it was possible to identify expressive clusters in the Southeast and South regions. Conclusion: The Empirical Bayesian Model allowed an alternative interpretation of the oral and oropharynx cancer mortality mapping in Brazil.

Resumo O objetivo deste artigo é analisar os fatores associados ao uso dos serviços odontológicos públicos por adultos. Estudo transversal com amostra representativa de adultos de 35 a 44 anos, com dados do Levantamento Epidemiológico das Condições de Saúde Bucal da População do Estado de São Paulo (SBSP-2015). Utilizou-se análise de regressão logística multivariada, baseada em modelo proposto por Andersen para predizer o acesso aos serviços odontológicos públicos. Visitaram o serviço privado 3.421 (59,9%) adultos e 2.288 (40,1%), o público. Os serviços odontológicos públicos foram mais acessados por mulheres (41,8%) e menos escolarizados (50,2%). Indivíduos não brancos (OR = 1,32; IC95%:1,16; 1,50), menor renda familiar (OR = 2,37; IC95%:2,11; 2,65), histórico de dor de dente (OR = 1,60; IC95%:1,39; 1,83) e necessidade de tratamento endodôntico (OR = 1,44; IC95%:1,12; 1,85) foram associados ao uso dos serviços odontológicos públicos. Fatores contextuais, individuais e necessidade de tratamento foram associados à utilização dos serviços odontológicos públicos por adultos residentes no estado de São Paulo, em 2015.

Objective: This study assessed maternal mortality (MM) and related factors in a large-sized municipality in the Southeastern region of Brazil (Campinas, São Paulo) during the period 2000-2015. Methods: This study consisted of two phases: 1. An analytical nested case-control phase that assessed the impact of individual and contextual variables on MM; and 2. an ecological phase designed to contextualize maternal deaths by means of spatial analysis. The case group consisted of all maternal deaths (n = 87) and the control group consisted of 348 women who gave birth during the same period. Data analysis included descriptive statistics, association, and multiple logistic regression (MLR) tests at p < 0.05 as well as spatial analysis. Results: Maternal Mortality Ratio was 37 deaths per 100.000 live births. Deaths were dispersed throughout the urban territory and no formation of cluster was observed. MLR showed that pregnant women aged ≥ 35 years old (OR = 2.63) or those with cesarean delivery (OR = 2.51) were more prone to maternal death. Conclusion: Maternal deaths were distributed dispersedly among the different socioeconomic levels and more prone to occur among older women or those undergoing cesarean deliveries.

O objetivo deste estudo foi identificar os fatores associados ao não comparecimento dos usuários ao tratamento ortodôntico, em três centros de especialidades odontológicas regionais (CEO-R) localizados no estado do Ceará. Metodologia: Os dados foram extraídos de prontuários de pacientes que concluíram o tratamento ortodôntico. Foi calculada a taxa de ausências, com o objetivo de estabelecer um coeficiente de faltas entre os municípios. A fim de descrever o padrão geográfico da ocorrência, foram construídos mapas temáticos baseados nas distribuições. Para as associações entre a variável desfecho (falta ao tratamento) e as independentes (sexo, idade, quebra de aparelho, mudança de profissional, renda e local de residência do usuário), utilizou-se a análise de regressão logística múltipla com p ≤ 0,05. Resultados: Foram examinados 237 prontuários em 20 municípios, com 8.283 consultas ortodônticas realizadas e 2.665 (32,17%) faltas. Apresentou diferença estatisticamente significativa a variável mudança de profissional. Conclusão: O maior número de faltas foi associado à mudança de profissional.