A exodontia dentre as atividades executadas pelos odontólogos, representa uma prática invasiva, de alta complexidade técnica-científica e de alta ocorrência. Este estudo descritivo-exploratório tem como propósito avaliar a manutenção de um ambiente odontológico biologicamente seguro na exodontia com vistas a propor um protocolo de assistência com ênfase nos riscos biológicos. Inicialmente foi elaborado e validado um roteiro do procedimento de exodontia, e posteriormente, utilizado como guia de observação não-participante em Unidades Básicas de Saúde do município de Londrina – PR. Assim, o roteiro foi estruturado tipo check-list contendo 26-itens distribuídos em 3 fases (pré, trans e pós-exodontia). No total observou-se 15 procedimentos de exodontia realizadas por diferentes odontólogos. O instrumento elaborado é considerado adequado e útil na avaliação dos riscos biológicos na exodontia, e, consequentemente, permitirá a apontar os possíveis fatores de risco à infecção exógena. Os resultados da observação estruturada apontaram uma variabilidade de condutas as quais podem predispor a diferentes riscos. Com relação aos escores de acertos totais segundo as fases pré, trans e pós exodontia correspondeu a uma média de 63,8, mediana de 57,7 e desvio padrão de 12, 6. E, os escores de acerto de acordo com tempo de atuação, superior a 16 anos demonstrou os melhores resultados (69,2 média; 73,1 mediana e 10,2 desvio padrão). Os dados obtidos reforçam a necessidade rever o ensino e a assistência odontológica no sentido de intensificar as atividades que promovam as mudanças de comportamento em prol da manutenção de ambiente de saúde biologicamente seguro. / The extration among the activities executed by the dentists, it represents the invasive practice, of high technique-scientific complexity and of high occurrence. This descriptive-exploratory study has purpose you evaluate the maintenance of an atmosphere dentristy biologically disembarasses in the extration with views you the propose protocol of attendance with emphasis in the biological risks. Initially it was elaborated and validated route of the exodontia procedure, and to later, used guide of no-participant observation in beginner's all-purpose symbolic instruction code Units of municipal Health of the district of London - PR. Like this, the route was structured type check-list containing 26-items distributed in 3 phases (daily pay, trans and powder-extation). Total In the it was observed 15 exodontia procedures accomplished by different dentists. The elaborated instrument is considered appropriate and useful in the evaluation of the biological risks in the extration, and, consequently, it will allow you point the possible risk factors you the infection out off. The results of the structured observation pointed variability of conducts which can predispose you different risks. With relationship you the scores of total successes according you the phases daily pay, trans and powders extation corresponded her/it an average of 63,8, medium of 57,7 and I divert pattern of 12, 6. AND, the success scores in agreement with teams of performance, superior you the 16 years it demonstrated the best results (69,2 average; 73,1 medium and 10,2 deviation pattern). The obtained dates reinforce the need you review the teaching and the attendance dentristy in the sense of intensifying the activities that promote the changes of behavior biologically on behalf of the maintenance of atmosphere of health disembarasses

A exodontia dentre as atividades executadas pelos odontólogos, representa uma prática invasiva, de alta complexidade técnica-científica e de alta ocorrência. Este estudo descritivo-exploratório tem como propósito avaliar a manutenção de um ambiente odontológico biologicamente seguro na exodontia com vistas a propor um protocolo de assistência com ênfase nos riscos biológicos. Inicialmente foi elaborado e validado um roteiro do procedimento de exodontia, e posteriormente, utilizado como guia de observação não-participante em Unidades Básicas de Saúde do município de Londrina – PR. Assim, o roteiro foi estruturado tipo check-list contendo 26-itens distribuídos em 3 fases (pré, trans e pós-exodontia). No total observou-se 15 procedimentos de exodontia realizadas por diferentes odontólogos. O instrumento elaborado é considerado adequado e útil na avaliação dos riscos biológicos na exodontia, e, consequentemente, permitirá a apontar os possíveis fatores de risco à infecção exógena. Os resultados da observação estruturada apontaram uma variabilidade de condutas as quais podem predispor a diferentes riscos. Com relação aos escores de acertos totais segundo as fases pré, trans e pós exodontia correspondeu a uma média de 63,8, mediana de 57,7 e desvio padrão de 12, 6. E, os escores de acerto de acordo com tempo de atuação, superior a 16 anos demonstrou os melhores resultados (69,2 média; 73,1 mediana e 10,2 desvio padrão). Os dados obtidos reforçam a necessidade rever o ensino e a assistência odontológica no sentido de intensificar as atividades que promovam as mudanças de comportamento em prol da manutenção de ambiente de saúde biologicamente seguro. / The extration among the activities executed by the dentists, it represents the invasive practice, of high technique-scientific complexity and of high occurrence. This descriptive-exploratory study has purpose you evaluate the maintenance of an atmosphere dentristy biologically disembarasses in the extration with views you the propose protocol of attendance with emphasis in the biological risks. Initially it was elaborated and validated route of the exodontia procedure, and to later, used guide of no-participant observation in beginner's all-purpose symbolic instruction code Units of municipal Health of the district of London - PR. Like this, the route was structured type check-list containing 26-items distributed in 3 phases (daily pay, trans and powder-extation). Total In the it was observed 15 exodontia procedures accomplished by different dentists. The elaborated instrument is considered appropriate and useful in the evaluation of the biological risks in the extration, and, consequently, it will allow you point the possible risk factors you the infection out off. The results of the structured observation pointed variability of conducts which can predispose you different risks. With relationship you the scores of total successes according you the phases daily pay, trans and powders extation corresponded her/it an average of 63,8, medium of 57,7 and I divert pattern of 12, 6. AND, the success scores in agreement with teams of performance, superior you the 16 years it demonstrated the best results (69,2 average; 73,1 medium and 10,2 deviation pattern). The obtained dates reinforce the need you review the teaching and the attendance dentristy in the sense of intensifying the activities that promote the changes of behavior biologically on behalf of the maintenance of atmosphere of health disembarasses

La recherche de facteurs génétiques de susceptibilité aux infections virale dans des populations générales exhaustives endémiques est une approche originale en épidémiologie génétique. Nos travaux de thèse nous ont permis d’établir, dans une population endémique pour deux virus oncogènes MCPyV et HHV-8 au Cameroun et dans une population endémique pour le VHC en Egypte, plusieurs arguments forts en faveur d’une susceptibilité génétique aux infections par les virus oncogènes humains définies par la séropositivité/ séronégativité vis-à-vis du virus impliqué. Concernant l’infection par le MCPyV, dont les modes de transmission sont peu connus, nous avons mis en évidence l’existence de fortes corrélations familiales mère-enfant et entre enfants pour la séropositivité au virus, en faveur d’une transmission virale par contacts proches. Ces résultats sont similaires à ceux observés pour l’HHV-8, dans la même population, virus pour lequel la transmission par voie salivaire est l’hypothèse la plus forte. Concernant l’infection par l’HHV-8, nous avons identifié un locus majeur de prédisposition à l’infection par une analyse de ségrégation mettant un gène majeur mendélien autosomique récessif prédisposant à l’infection, suivie d’une analyse de liaison paramétrique utilisant le modèle de l’analyse de ségrégation. Concernant l’infection par le VHC, nous avons identifié par une analyse de liaison génétique un locus majeur de prédisposition à l’infection. Nous avons ensuite identifié, par une analyse d’association en génome entier sur une grande cohorte de plus de 6500 individus, trois signaux associés avec l’infection par le VHC. Par ailleurs, nous avons également réalisé une étude fine des variants du locus du gène IL28B, associés à la clairance du VHC, cohérente avec les résultats publiés au cours de nos travaux. L’identification de facteurs génétiques impliqués dans la susceptibilité aux infections virales oncogènes et aux cancers associés permettra de mieux comprendre la physiopathologie de la réponse à ces infections et les mécanismes intervenant depuis l’exposition virale jusqu’au développement de cancers. / The identification of genetic variants predisposing to viral infection in highly endemic general populations is an original approach in genetic epidemiology. Our work suggests a genetic control of the susceptibility to human oncogenic viruses infection, in a population in Cameroon in which MCPyV and HHV-8 are highly endemic and in an Egyptian population in which HCV is endemic. MCPyV is thought to be the etiological agent of Merkel cell carcinoma, but little is known about its distribution and modes of transmission. We provided evidence for familial aggregation of MCPyV infection status suggesting that MCPyV infection is acquired through close contact, possibly involving saliva and/or the skin, especially between young siblings and between mothers and their children. Infection with HHV-8 has been shown to display strong familial aggregation, in countries in which HHV-8 infection is endemic. Our segregation analysis provided strong evidence for a recessive major gene conferring predisposition to HHV-8 infection. The following linkage analysis identified a single region on chromosome 3p22 significantly linked to HHV-8 infection. This study provides the first evidence that HHV-8 infection in children in endemic areas has a strong genetic basis. Concerning HCV infection, we performed a linkage analysis that mapped a major locus predisposing to HCV infection in an Egyptian cohort. We then performed a genome-wide association study in more than 6500 individuals, identifying three signals associated with HCV infection. Finally we investigated the role of several IL28B SNPs in HCV spontaneous clearance in an Egyptian population. The results confirm the major role of IL28B variants in the spontaneous clearance of HCV genotype 4 infection in an Egyptian population. The identification of genetic variants predisposing to viral infection should greatly improve our understanding of the molecular mechanisms involved in the response to these infections and may also unravel new pathways for investigation in viruses-associated diseases, such as cancer.