Inflammatory response to bioceramic and epoxy resin-based endodontic sealers implanted in mice subcutaneous tissue: An in vivo study.

To evaluate the inflammatory tissue response to BioRoot™ RCS (BR) and AH Plus Jet (AHPJ) sealers implanted in mice subcutaneous tissue. It was hypothesized that the inflammatory tissue response to BR would be milder than to AHPJ. An in vivo study was carried out using isogenic mice. The sealers were implanted during standardized surgical procedures. The inflammatory response was evaluated by microscopic analysis and von Kossa reaction in the reactionary tissue around the specimens after 7, 21, and 63 days. For comparisons, a zinc oxide and eugenol sealer (ZOE) was used as a positive control, in addition to a negative control without a sealer (n = 10 per group/period). All statistical analyses considered a significance level of 5%. All endodontic sealers triggered an inflammatory tissue response after 7 days. BR had a higher inflammatory cell count and a thicker fibrous capsule when compared with AHPJ, but both were less inflammatory than ZOE (p < .001). After 21 days, BR continued to trigger an intense inflammatory tissue response, higher in both microscopic parameters compared to AHPJ, and a thicker fibrous capsule than ZOE (p < .001). After 63 days, the inflammatory tissue response decreased in BR, matching the fibrous capsule thickness with AHPJ and ZOE. BR promoted intense calcium precipitation in all study periods. After 63 days, AHPJ and BR sealers were more biocompatible to subcutaneous mice tissue, but AHPJ present better early inflammatory response, as well as BR showed potential bioactivity. RESEARCH HIGHLIGHTS: The inflammatory tissue response triggered by a bioceramic endodontic sealer (BR) was not milder than that triggered by an epoxy-resin based endodontic sealer (AHPJ) during the first 3 weeks, considering the microscopic analysis of the reactionary tissue.

Outpatient and inpatient dental care for patients with disabilities in Brazil's public healthcare system: A population-based approach from 2014 to 2023.

AIM: The aim of this study was to evaluate outpatient and inpatient dental care for patients with disabilities from 2014 to 2023. MATERIAL AND METHODS: A time series analysis was carried out with data from Brazil's public healthcare system, considering the outpatient productivity of Special Needs Dentistry specialists and hospitalizations (inpatient admissions) of patients with disabilities for dental procedures, both normalized to every 100,000 inhabitants (incidence). The significance level was set at 5%. RESULTS: In the last 10 years, 22,420,859 procedures were carried out and 89,380 hospitalizations were approved. Trend analysis showed no significant temporal variation in the incidence of both variables. Regarding the procedures, the majority were low-complexity (82.1%, p < .001) and clinical (71.2%, p < .001). Periodontal (19.9%) and restorative (19.5%) procedures were the most frequent. Considering the hospitalizations, almost (R$) 40 million was allocated, and the majority were classified as elective (71.9%, p = .002) and of short duration (less than a day). CONCLUSION: Dental care for patients with disabilities presented patterns related to the types of procedures, complexity and circumstance, in addition to not showing significant temporal variation over the last 10 years.

Territorial Disparities in Dental Care for Disabled Persons and Oral Health-Related Indicators: A Population-Level Approach in Brazil's Public Healthcare System from 2014 to 2023.

This study evaluated territorial disparities in dental care for disabled persons in Brazil's public healthcare system from 2014 to 2023. The person-year incidence of outpatient dental procedures carried out by special care dentistry specialists and hospitalizations for dental procedures for disabled persons were compared across different regions and against the national estimate. In addition, productivity was correlated with oral health-related indicators. The significance level was set at 5%. The northern region exhibited the highest outpatient productivity, while the southern region showed lower productivity compared to the national estimate (both p-value < 0.05). This pattern was reversed in inpatient productivity (both p-value < 0.05), with the northeastern and central-western regions also below average (both p-value < 0.05). There were no significant correlations between the indicators and inpatient productivity, but outpatient productivity was positively correlated with the proportions of inhabitants who self-rated their general and oral health as "poor" or "very poor", who have never visited a dentist, and who visited a dentist for tooth extraction (all p-values < 0.05). Territorial disparities in dental care for disabled persons were observed within Brazil's public healthcare system, and they were correlated with unfavorable oral health-related indicators at the population level.

The effects of NLRP3 inflammasome inhibition or knockout in experimental apical periodontitis induced in mice.

OBJECTIVE: To evaluate the effects of NLRP3 inflammasome inhibition or knockout in experimental apical periodontitis (AP) induced in mice. METHODS: The experimental AP was induced by pulpal exposure. To evaluate NLRP3-specific inhibitor medication (MCC950), WT mice received intraperitoneal injections, while the control received PBS (n = 10). In addition, to evaluate NLRP3 knockout, 35 wild-type (WT) and 35 NLRP3-/- mice were divided into a control group (without pulpal exposure, n = 5) and three experimental groups: after 2, 14 and 42 days after pulpal exposure (n = 10). Microscopic and molecular analyzes were carried out using a significance level of 5%. RESULTS: Exposure to MCC950 did not affect the periapical lesion size after 14 days (P = 0.584). However, exposed mice had a lower expression of IL-1ß, IL-18 and caspase-1 (P = 0.010, 0.016 and 0.002, respectively). Moreover, NLRP3-/- mice showed a smaller periapical lesion after 14 and 42 days (P = 0.023 and 0.031, respectively), as well as a lower expression of IL-1ß after 42 days (P < 0.001), of IL-18 and caspase-1 after 14 (P < 0.001 and 0.035, respectively) and 42 days (P = 0.002 and 0.002, respectively). NLRP3-/- mice also showed a lower mRNA for Il-1ß, Il-18 and Casp1 after 2 (P = 0.002, 0.036 and 0.001, respectively) and 14 days (P = 0.002, 0.002 and 0.001, respectively). CONCLUSIONS: NLRP3 inflammasome inhibition or knockout can attenuate the inflammatory events that result in the periapical lesion (AP) formation after pulpal exposure in mice. CLINICAL RELEVANCE: The NLRP3 inflammasome may be a therapeutic target for AP, and new approaches may verify the impact of its inhibition (through intracanal medications or filling materials) on the bone repair process and treatment success.

Root canal conicity determination of primary second molars using nanotomography: An in vitro study.

BACKGROUND: The conicity of the root canals of primary teeth is an important measure for endodontic therapies. However, determining this conicity depends on the methods employed, which requires further investigation. AIM: The aim of this study was to determine the conicity of the root canals of the upper and lower primary second molars using nanotomography (nCT). DESIGN: An in vitro study was performed using nine primary second molars, both upper and lower, subjected to nCT. Comparisons between the diameters of root canals were performed between the thirds (cervical-D0, middle-D5, and apical-D7). The conicity (%) was determined for each root canal from cervical to apical. Data were statistically analyzed with a significance level of 5%. RESULTS: The conicity ranged from 2% to 8% for the upper primary second molars. Significant differences in root canal diameter between the thirds (D0, D5, and D7 points) were observed in the mesio- and distobuccal roots (p < .05), but not in the palatal roots (p > .05). For the lower primary second molars, the conicity ranged from 2% to 17%, as well as significant differences in root canal diameter between the thirds (D0, D5, and D7 points) were observed in all roots (distal, mesiobuccal, and mesiolingual; p < .05). CONCLUSION: The conicity of the upper primary second molars was different from that of the lower ones, which showed a greater variability.

Caries-related hospital morbidity in the Brazilian Unified Health System from 2008 to 2022.

Dental caries is an important Public Health issue. However, the treatment of this disease in tertiary dental care requires further investigation. Therefore, the objective of this study was to evaluate caries-related hospital morbidity in the Brazilian Unified Health System (SUS) from 2008 to 2022. An ecological study was conducted with secondary data on caries-related Hospital Admission Authorizations (AIH) and in-hospital dental procedures (IDP). Data were collected nationwide and statistical analysis was performed with a significance level (p) of 5%. In the last 15 years, 3,474 caries-related AIH and 63,657 IDP were approved within SUS. There was a significant upward trend in the number of caries-related AIH (p = 0.018) and a stationary trend in the number of caries-related IDP (p = 0.841). Moreover, from 2008 to 2022, R$ 1,160,843.09 was allocated for caries-related AIH. Hospital mortality was 0.29% (10 deaths), and 75.1% were elective inpatient admissions. Among SUS users, adults constituted the majority (49%), with a higher frequency of males (59.8%) and whites (46.2%). The most frequent type of caries-related IDP was restoration of permanent teeth (55.3%). Nonetheless, during the COVID-19 pandemic years, significant reductions in caries-related AIH and IDP within the SUS were observed (all p <0.05). Thus, within the SUS, caries-related tertiary dental care has shown a specific pattern over the last 15 years, including an increase in hospitalizations and a high number of in-hospital dental procedures, especially before the COVID-19 pandemic onset.

Activation of gelatinases in permanent human teeth after different experimental radiotherapy protocols.

The objective of this study was to compare the activation of gelatinases in dentin-enamel junction (DEJ) and underlying dentin of permanent teeth after experimental radiotherapy in conventional and hypofractionated modalities. Newly extracted third molars (n = 15) were divided into three experimental radiotherapy groups: control, conventional (CR), and hypofractionated (HR) (n = 5 per group). After in vitro exposure to ionizing radiation, following standardized protocols for each modality, a gelatinous substrate was incubated on the tooth slices (n = 10 per group). Activation of gelatinases was measured by in situ zymography, expressed in arbitrary fluorescence units (mm2) from three tooth regions: cervical, cuspal, and pit. Fluorescence intensity was compared among radiotherapy protocols and tooth regions in each protocol, considering a significance level of 5%. Considering all tooth regions, the fluorescence intensity of the CR group was higher than the HR and control groups, both in DEJ and underlying dentin (p <0.001). In addition, the fluorescence intensity was higher in underlying dentin when compared to DEJ in all groups (p <0.001). Considering each tooth region, a statistically significant difference between CR and HR was only observed in the pit region of underlying dentin (p <0.001). Significant and positive correlations between fluorescence intensities in DEJ and underlying dentin were also observed (p <0.001). Experimental radiotherapy influenced the activation of gelatinases, as well as exposure to the conventional protocol can trigger a higher activation of gelatinases when compared to hypofractionated, both in DEJ and underlying dentin.

Activation of gelatinases in permanent human teeth after different experimental radiotherapy protocols

Abstract The objective of this study was to compare the activation of gelatinases in dentin-enamel junction (DEJ) and underlying dentin of permanent teeth after experimental radiotherapy in conventional and hypofractionated modalities. Newly extracted third molars (n = 15) were divided into three experimental radiotherapy groups: control, conventional (CR), and hypofractionated (HR) (n = 5 per group). After in vitro exposure to ionizing radiation, following standardized protocols for each modality, a gelatinous substrate was incubated on the tooth slices (n = 10 per group). Activation of gelatinases was measured by in situ zymography, expressed in arbitrary fluorescence units (mm2) from three tooth regions: cervical, cuspal, and pit. Fluorescence intensity was compared among radiotherapy protocols and tooth regions in each protocol, considering a significance level of 5%. Considering all tooth regions, the fluorescence intensity of the CR group was higher than the HR and control groups, both in DEJ and underlying dentin (p <0.001). In addition, the fluorescence intensity was higher in underlying dentin when compared to DEJ in all groups (p <0.001). Considering each tooth region, a statistically significant difference between CR and HR was only observed in the pit region of underlying dentin (p <0.001). Significant and positive correlations between fluorescence intensities in DEJ and underlying dentin were also observed (p <0.001). Experimental radiotherapy influenced the activation of gelatinases, as well as exposure to the conventional protocol can trigger a higher activation of gelatinases when compared to hypofractionated, both in DEJ and underlying dentin.

Resumo O objetivo deste estudo foi comparar a ativação de gelatinases na junção dentina-esmalte (DEJ) e na dentina subjacente de dentes permanentes após a radioterapia experimental nas modalidades convencional e hipofracionada. Os terceiros molares recém-extraídos (n = 15) foram divididos em três grupos de radioterapia experimental: controle, convencional (CR) e hipofracionada (HR) (n = 5 por grupo). Após a exposição in vitro à radiação ionizante, seguindo protocolos padronizados para cada modalidade, um substrato gelatinoso foi incubado nas fatias de dente (n = 10 por grupo). A ativação das gelatinases foi medida por zimografia in situ, expressa em unidades arbitrárias de fluorescência (mm2) de três regiões do dente: cervical, cúspide e fossa. A intensidade da fluorescência foi comparada entre os protocolos de radioterapia e as regiões do dente em cada protocolo, considerando um nível de significância de 5%. Considerando todas as regiões do dente, a intensidade de fluorescência do grupo CR foi maior do que a dos grupos HR e controle, tanto no DEJ quanto na dentina subjacente (p <0,001). Além disso, a intensidade da fluorescência foi maior na dentina subjacente quando comparada à DEJ em todos os grupos (p <0,001). Considerando cada região do dente, uma diferença estatisticamente significativa entre CR e HR foi observada apenas na região da fossa da dentina subjacente (p <0,001). Também foram observadas correlações significativas e positivas entre as intensidades de fluorescência no DEJ e na dentina subjacente (p <0,001). A radioterapia experimental influenciou a ativação das gelatinases, assim como a exposição ao protocolo convencional pode desencadear uma maior ativação das gelatinases quando comparada ao hipofracionamento, tanto no DEJ quanto na dentina subjacente.

Caries-related hospital morbidity in the Brazilian Unified Health System from 2008 to 2022

Abstract Dental caries is an important Public Health issue. However, the treatment of this disease in tertiary dental care requires further investigation. Therefore, the objective of this study was to evaluate caries-related hospital morbidity in the Brazilian Unified Health System (SUS) from 2008 to 2022. An ecological study was conducted with secondary data on caries-related Hospital Admission Authorizations (AIH) and in-hospital dental procedures (IDP). Data were collected nationwide and statistical analysis was performed with a significance level (p) of 5%. In the last 15 years, 3,474 caries-related AIH and 63,657 IDP were approved within SUS. There was a significant upward trend in the number of caries-related AIH (p = 0.018) and a stationary trend in the number of caries-related IDP (p = 0.841). Moreover, from 2008 to 2022, R$ 1,160,843.09 was allocated for caries-related AIH. Hospital mortality was 0.29% (10 deaths), and 75.1% were elective inpatient admissions. Among SUS users, adults constituted the majority (49%), with a higher frequency of males (59.8%) and whites (46.2%). The most frequent type of caries-related IDP was restoration of permanent teeth (55.3%). Nonetheless, during the COVID-19 pandemic years, significant reductions in caries-related AIH and IDP within the SUS were observed (all p <0.05). Thus, within the SUS, caries-related tertiary dental care has shown a specific pattern over the last 15 years, including an increase in hospitalizations and a high number of in-hospital dental procedures, especially before the COVID-19 pandemic onset.

Internet Search Trends on Breast Cancer Between 2017 and 2021 in Brazil: an Infoveillance Investigation / Tendências de Pesquisa na Internet sobre Câncer de Mama entre 2017 e 2021 no Brasil: uma Investigação de Infovigilância / Tendencias de Búsqueda en Internet sobre Cáncer de Mama entre 2017 y 2021 en Brasil: una Investigación de Infovigilancia

Introduction: Internet users frequently search for information on health issues. The behavior of Internet users may be related to health contexts experienced in their communities, reflecting unmet demands. Objective: To analyze the interest of Internet users on breast cancer in Brazil between 2017 and 2021. Method: An infodemiological study was carried out using the relative search volume (ranging from 0 to 100) for the term "câncer de mama" (breast cancer) in Brazil, retrieved from the Google Trends tool. The annual relative search volume was compared with a non-parametric approach and significance value (p) of 5%. Results: Except between 2019 and 2020 (p-value>0.05), there was a significant increase in Internet searches for the term "câncer de mama" in Brazil (all p-values <0.05). The peak of interest (relative search volume=100) was found in October 2020. Internet users who searched for the term "câncer de mama" often searched for signs and symptoms of breast cancer. Conclusion: The interest of Internet users on breast cancer has increased in recent years in Brazil.

Introdução: Os usuários da Internet frequentemente buscam informações sobre questões de saúde. O comportamento desses usuários pode estar relacionado com contextos de saúde vivenciados em suas comunidades, refletindo demandas não supridas. Objetivo: Examinar o interesse dos usuários da Internet sobre o câncer de mama no Brasil, considerando o período entre 2017 e 2021. Método: Estudo infodemiológico utilizando o volume relativo de busca (variando entre 0 e 100) para o termo "câncer de mama" no Brasil, recuperado da ferramenta Google Trends. O volume relativo de busca entre os anos foi comparado com abordagem não paramétrica e valor de significância (p) de 5%. Resultados: Exceto entre 2019 e 2020 (p-valor>0,05), houve um aumento significativo nas buscas na Internet pelo termo "câncer de mama" no Brasil (todos os valores de p<0,05). O pico de interesse (volume relativo de busca=100) foi observado no mês de outubro de 2020. Os usuários da Internet que buscaram pelo termo "câncer de mama" frequentemente procuravam por sinais e sintomas do câncer de mama. Conclusão: Observou-se que o interesse desses usuários sobre câncer de mama aumentou nos últimos anos no Brasil.

Introducción: Los internautas suelen buscar información sobre temas de salud. El comportamiento de los internautas puede estar relacionado con contextos de salud vividos en sus comunidades, reflejando demandas insatisfechas. Objetivo: Examinar el interés de los internautas sobre el cáncer de mama en Brasil, considerando el período comprendido entre 2017 y 2021. Método: Estudio infodemiológico utilizando el volumen relativo de búsqueda (que va de 0 a 100) para el término "câncer de mama" en Brasil, obtenido de la herramienta Google Trends. El volumen relativo de búsqueda entre los años se comparó con un enfoque no paramétrico y un valor de significación (p) del 5%. Resultados: Excepto entre 2019 y 2020 (p-valor>0,05), hubo un aumento significativo en las búsquedas en Internet del término "câncer de mama" en Brasil (todos los valores p<0,05). El pico de interés (volumen relativo de búsqueda=100) se observó en el mes de octubre de 2020. Los usuarios de Internet que buscaban el término "câncer de mama" a menudo buscaban signos y síntomas de cáncer de mama. Conclusión: Se observó que el interés de los internautas por el cáncer de mama ha aumentado en los últimos años en Brasil.

Internet searches for Invisalign® orthodontic aligner: an infodemiological study using google trends tool / Buscas na internet sobre alinhador orodôntico Invisalign®: um estudo infodemiológico usando ferramenta google trends

Aim: to evaluate the internet searches for Invisalign® in Brazil and worldwide between 2018 and 2021, using the Google Trends tool. Methods: An infodemiological study was carried out. The relative search volume (RSV) for the term "invisalign" in Google platform was retrieved for each year of study, both in Brazil and worldwide, using a standard procedure. Results and Conclusion: Both in Brazil and worldwide, there was a statistically significant increase in RSV between 2018 and 2021 (all p <0.05), indicating progressively more interest in Invisalign® clear aligner on the internet.

Objetivo: avaliar as buscas na internet por Invisalign® no Brasil e no mundo entre 2018 e 2021, utilizando a ferramenta Google Trends. Métodos: Foi realizado um estudo infodemiológico. O volume relativo de busca (RSV) para o termo "invisalign" na plataforma Google foi recuperado para cada ano de estudo, tanto no Brasil quanto no mundo, utilizando um procedimento padrão. Resultados e Conclusão: Tanto no Brasil quanto no mundo, houve um aumento estatisticamente significativo do RSV entre 2018 e 2021 (todos p <0.05), indicando progressivamente mais interesse pelo alinhador transparente Invisalign® na internet.

Self-reported oral hygiene habits and gingival bleeding in women with breast cancer: evidence from an observational and prospective study / Hábitos de higiene oral e sangramento gengival autorrelatados em mulheres com câncer de mama: evidência de um estudo observacional e prospectivo

Objectives: to describe and examine oral hygiene habits and self-reported gingival bleeding in women with breast cancer undergoing chemotherapy. Methods: in an observational and prospective study, 140 women were evaluated during chemotherapy between 2017 and 2019. Results and Conclusion: more than 40% of participants reported gingival bleeding at some point during chemotherapy. Flossing was unsatisfactory at baseline and in the intermediate cycle as well as did not affect self-reported gingival bleeding. The amount of tooth brushing per day was a predictor of self-reported gingival bleeding at the end of chemotherapy.

Objetivos: descrever e examinar os hábitos de higiene bucal e o autorrelato de sangramento gengival em mulheres com câncer de mama em quimioterapia. Métodos: em um estudo observacional prospectivo, foram avaliadas 140 mulheres ao longo da quimioterapia, entre 2017 e 2019. Resultados e Conclusão: mais de 40% das participantes relataram sangramento gengival em algum momento da quimioterapia. O uso de fio dental foi insatisfatório no baseline e ciclo intermediário, bem como não afetou o autorrelato de sangramento gengival. A quantidade de escovação dentária por dia foi um preditor para o autorrelato de sangramento gengival ao fim da quimioterapia.

Toxicidades sistêmicas simultâneas relacionadas à quimioterapia do câncer de mama: um relato observacional e prospectivo / Concurrent chemotherapy-related systemic toxicities during breast cancer treatment: an observational and prospective report / Toxicidades sistémicas relacionada con la quimioterapia concurrente durante el tratamiento del cáncer de mama: un informe observacional y prospectivo

Objetivo: avaliar quantitativamente um clusterde toxicidades sistêmicas relacionadas à quimioterapia em mulheres com câncer de mama ao longo do tratamento.Métodos: foi realizado um estudo observacional e prospectivo, de natureza quantitativa, envolvendo 140 mulheres com câncer de mama expostas à quimioterapia como modalidade de tratamento. A ocorrência de 14 toxicidades sistêmicas (baseadas noCommon Terminology Criteria for Adverse Events, versão 4.03) foi avaliada nos prontuários médicos em dois segmentos: no ciclo intermediário e ao fim da quimioterapia. As frequências foram comparadas entre os dois segmentos do estudo, associando separadamente cada toxicidade e agrupando a quantidade de toxicidades simultâneas de cada paciente, considerando o nível de significância (p) de 5%. Resultados:observou-se que a maioria das toxicidades sistêmicas foram associadas entre os segmentos do estudo, bem como a maioria se manifestou com maior frequência ao final da quimioterapia. As toxicidades mais frequentes (considerando ambos os segmentos) foram vômito (90.7%), cefaleia (88.6%) e astenia (87.9%). As mais incomuns foram leucopenia (7.1%), neutropenia (13.6%) e parestesia (32.1%).Ao comparar a quantidade de toxicidades sistêmicas simultâneas entre os segmentos, observou-se um aumento significativo ao final da quimioterapia em relação ao ciclo intermediário (p <0.001). Conclusão: as mulheres com câncer de mama experimentaram umaquantidade maior de toxicidade sistêmicas simultâneas ao final da quimioterapia, bem como uma alta frequência de toxicidades sistêmicas ao longo do tratamento foi observada.

Objective: to quantitatively evaluate a cluster of chemotherapy-related systemic toxicities in women with breast cancer throughout treatment.Method: an observational, prospective andquantitative study was carried out, involving 140 women with breast cancer exposed to chemotherapy as a treatment modality. The occurrence of 14 systemic toxicities (based on the Common Terminology Criteria for Adverse Events, version 4.03) was evaluated in the medical charts in two segments: in the intermediate cycle and at the end of chemotherapy. The frequencies were compared between the two study segments, associating each toxicity separately and grouping the amount of simultaneous toxicities of each patient, considering the significance level (p) of 5%. Results: it was observed that most systemic toxicities were associated between the segments of the study, as well as most manifested more frequently at the end of chemotherapy. The most frequent toxicities (considering both segments) were vomiting (90.7%), headache (88.6%) and asthenia (87.9%). The most uncommon were leukopenia (7.1%), neutropenia (13.6%) and paresthesia (32.1%). When comparing the amount of concurrent systemic toxicities between the segments, a significant increase was observed at the end of chemotherapy in relation to the intermediate cycle (p<.001).Conclusion: women with breast cancer experienced a greater amount of concurrent systemic toxicities at the end of chemotherapy, as well as a high frequency of systemic toxicities throughout treatment was observed.

Objetivo: evaluar cuantitativamente un grupo de toxicidades sistémicas relacionadas con la quimioterapia en mujeres con cáncer de mama durante el tratamiento.Métodos: se realizó un estudio observacional y prospectivo de carácter cuantitativo, en el que participaron140 mujeres con cáncer de mama expuestas a quimioterapia como modalidad de tratamiento. Se evaluó la ocurrencia de 14 toxicidades sistémicas (con base en Common Terminology Criteria for Adverse Events, versión 4.03) en las historias clínicas en dos segmentos: en el ciclo intermedio y al final de la quimioterapia. Se compararon las frecuencias entre los dos segmentos del estudio, asociando cada toxicidad por separado y agrupando la cantidad de toxicidades simultáneas de cada paciente, considerando el nivel de significancia (p) del 5%.Resultados: se observó que la mayoría de las toxicidades sistémicas se asociaron entre los segmentos del estudio, así como la mayoría se manifestó con mayor frecuencia al final de la quimioterapia. Las toxicidades más frecuentes (considerando ambos segmentos) fueron vómitos (90.7%), cefalea (88.6%) y astenia (87.9%). Las más infrecuentes fueron leucopenia (7.1%), neutropenia (13.6%) y parestesia (32.1%). Al comparar la cantidad de toxicidades sistémicas concurrentes entre los segmentos, se observó un aumento significativo al final de la quimioterapia en relación al ciclo intermedio (p<.001).Conclusión: las mujeres con cáncer de mama experimentaron una mayor cantidad de toxicidad sistémica concurrente al final de la quimioterapia, así como también se observó una alta frecuencia de toxicidades sistémicas a lo largo del tratamiento.

Online teaching, quality of life and anxiety of Brazilian dental professors during the COVID-19 outbreak.

The COVID-19 pandemic led to changes in academic teaching and dental education, but the impact on dental professors' mental health and quality of life remains poorly understood. Thus, the objective of this study was to evaluate the impacts of social distancing and online teaching related to COVID-19 on the quality of life and anxiety of Brazilian dental professors. This was a cross-sectional study conducted from August 2020 to October 2020. Three instruments were used in an online version: a questionnaire about personal data, academic information and online teaching activities, the Generalized Anxiety Disorders 7 (GAD7) scale, and the Abbreviated World Health Organization Quality of Life (WHOQOL-bref) scale. All instruments were sent by e-mail, social media, and messaging apps to private and public universities and professors. Of the 318 responses, 187 (58.8%) were from female professors. Moreover, lack of good internet access and adequate place for online teaching, difficulties in producing teaching materials, and housework roles had a significant impact on the quality of life and anxiety scores (all p-values < 0.05). Also, Brazilian dental professors who declared that they would make greater efforts if the activities were face-to-face had significantly worse quality of life and anxiety scores, and female professors had significantly higher anxiety scores (all p-values < 0.05). These results provide evidence of a negative effect of social distancing and online teaching activities related to COVID-19 outbreak on the health-related quality of life and mental health of Brazilian dental professors.

Disseminated dermatophytosis and acquired immunodeficiency syndrome: literature review and presentation of clinical experience / Dermatofitose disseminada e síndrome da imunodeficiência adquirida: revisão de literatura e apresentação de experiência clínica

Introduction: Dermatophytosis are very common fungal infections caused by the fungal species Microsporum, Epidermophyton or Trichophyton, which mostly affect the skin, the interdigital region, groin and scalp. Although they do not cause serious diseases, in patients with the human immunodeficiency virus the infection manifests itself and evolves exuberantly, usually with extensive and disseminated lesions. Objective: To review the literature on dermatophytosis in people living with human immunodeficiency virus and to present the experience in clinical care in a patient living with human immunodeficiency virus with extensive and disseminated dermatophytosis. Methods: A literature review on the topic was carried out in the PubMed/National Library of Medicine ­ USA databases, using the keywords dermatophytosis, or dermatophytosis associated with the words AIDS, human immunodeficiency virus or immunodeficiency, from 1988­2022. The clinical experience showed a patient living with human immunodeficiency virus developing AIDS and presenting with disseminated skin lesions. Samples of the lesion were collected by scraping, which were submitted to culture and there was growth of fungi of the Trichophyton sp genus. A biopsy of the lesion was also performed using the Grocott-Gomori's Methenamine Silver stain. Results: We found 1,014 articles, of which only 34 presented a direct correlation with our paper, and were used to discuss the main themes narrated in this article. We present clinical experience in the management of a patient with human immunodeficiency virus/AIDS and low adherence to antiretroviral treatment, showing extensive and disseminated erythematous-squamous lesions with a clinical diagnosis of tinea corporis, manifesting with a clinical picture usually not found in immunocompetent patients. The diagnosis was confirmed by laboratory tests with isolation of the Trichophyton sp fungus. The patient was treated with oral fluconazole, with complete remission of the clinical picture after two months. She was also thoroughly encouraged to use the prescribed antiretroviral medication correctly. Conclusion: Dermatophytosis in patients living with human immunodeficiency virus can present extensive and disseminated forms. The antifungal treatment is quite effective, with remission of the condition. Antiretroviral therapy is an important adjuvant for better recovery of the sickness.

Introdução: Dermatofitoses são infecções comuns, causadas pelas espécies fúngicas Microsporum, Epidermophyton ou Trichophyton, que acometem preferencialmente a pele da região interdigital, da virilha e do couro cabeludo. Apesar de não causar doenças graves, em pacientes portadores do vírus da imunodeficiência humana, a infecção se manifesta e evolui de forma exuberante, normalmente com lesões extensas e disseminadas. Objetivo: Fazer revisão de literatura sobre dermatofitose em pessoas vivendo com vírus da imunodeficiência humana e apresentar a experiência na atenção clínica em uma paciente vivendo com o vírus e dermatofitose extensa e disseminada. Métodos: A revisão de literatura sobre o tema baseou-se nos dados do Pubmed/National Library of Medicine, dos Estados Unidos, utilizando-se as palavras-chave dermatofitose, dermatofitose e AIDS, dermatofitose e vírus da imunodeficiência humana, e dermatofitose e imunodeficiência, de 1988­2022. Descreveu-se a experiência clínica na abordagem de uma paciente vivendo com vírus da imunodeficiência humana, a qual desenvolveu AIDS e apresentou lesões cutâneas disseminadas. Por raspado, foram coletadas amostras da lesão e submetidas à cultura, e constatou-se crescimento de fungos do gênero Trichophyton sp. Realizou-se também biópsia da lesão, corada pelo método da metenamina de prata de Grocott-Gomori. Resultados: Foram encontrados 1.014 artigos, dos quais apenas 34 apresentaram correlação direta com nosso trabalho, e foram utilizados para discorrer sobre os principais temas narrados neste artigo. Apresentou-se experiência clínica na abordagem de uma paciente com vírus da imunodeficiência humana/AIDS e baixa adesão ao tratamento antirretroviral, exibindo lacerações eritematoescamosas extensas e disseminadas, com diagnóstico clínico de Tinea corporis, manifestando-se com quadro clínico usualmente não encontrado em pacientes imunocompetentes. O diagnóstico foi confirmado por exames laboratoriais com isolamento do fungo Trichophyton sp. Tratada com fluconazol via oral, a paciente apresentou remissão parcial das infecções aos dois meses e completa aos seis meses. Também foi exaustivamente estimulada a usar corretamente a medicação antirretroviral prescrita. Conclusão: A dermatofitose em pacientes com vírus da imunodeficiência humana pode se apresentar de forma extensa e disseminada. O tratamento antifúngico é eficaz, com remissão do quadro. A terapia antirretroviral é importante adjuvante para melhor recuperação dos enfermos

Online teaching, quality of life and anxiety of Brazilian dental professors during the COVID-19 outbreak

Abstract: The COVID-19 pandemic led to changes in academic teaching and dental education, but the impact on dental professors' mental health and quality of life remains poorly understood. Thus, the objective of this study was to evaluate the impacts of social distancing and online teaching related to COVID-19 on the quality of life and anxiety of Brazilian dental professors. This was a cross-sectional study conducted from August 2020 to October 2020. Three instruments were used in an online version: a questionnaire about personal data, academic information and online teaching activities, the Generalized Anxiety Disorders 7 (GAD7) scale, and the Abbreviated World Health Organization Quality of Life (WHOQOL-bref) scale. All instruments were sent by e-mail, social media, and messaging apps to private and public universities and professors. Of the 318 responses, 187 (58.8%) were from female professors. Moreover, lack of good internet access and adequate place for online teaching, difficulties in producing teaching materials, and housework roles had a significant impact on the quality of life and anxiety scores (all p-values < 0.05). Also, Brazilian dental professors who declared that they would make greater efforts if the activities were face-to-face had significantly worse quality of life and anxiety scores, and female professors had significantly higher anxiety scores (all p-values < 0.05). These results provide evidence of a negative effect of social distancing and online teaching activities related to COVID-19 outbreak on the health-related quality of life and mental health of Brazilian dental professors.

Clinical-Epidemiological Profile and Health-Related Quality of Life of Women with Breast Cancer During Chemotherapy Treatment: Observational Study / Perfil Clínico-Epidemiológico e Qualidade de Vida Relacionada à Saúde de Mulheres com Câncer de Mama durante Tratamento Quimioterápico: Estudo Observacionall / Perfil Clínico-Epidemiológico y Calidad de Vida Relacionada con la Salud de Mujeres con Cáncer de Mama en Tratamiento Quimioterápico: Estudio Observaciona

Introduction: Breast cancer may affect different profiles of women worldwide. In addition, chemotherapy to treat breast neoplasms directly affects health-related quality of life. Objective: To describe the clinical-epidemiological profile and to compare the general and specific health-related quality of life of women with breast cancer during chemotherapy. Method: In an observational and prospective study, 140 women with breast cancer in northeastern Brazil were evaluated in the intermediate cycle and at the end of chemotherapy. Quality of life was assessed using a general instrument (EORTC-QLQ-C30) and a specific module (EORTC-QLQ-BR23). Data were compared with a paired non-parametric test, with a significance level of 5%. Results: Regarding the clinical-epidemiological profile, the median age was 50 years, 82.9% were black or mixed-race, and 95% lived in Sergipe, Brazil. In addition, 50.7% had no occupation, the median family income was one minimum wage, as well as the median of education was eight years of study and only 40.7% have completed high school. Considering the data from the C30 and BR23 questionnaires, it was observed that most items and scales worsened at the end of chemotherapy when compared to the intermediate cycle. Among the items and scales with significant differences, most had moderate or high effect sizes. Conclusion: It is possible to conclude that the clinical-epidemiological profile was unfavorable and chemotherapy reduced several aspects of the health-related quality of life of women with breast cancer

Introdução: O câncer de mama pode acometer diferentes perfis de mulheres ao redor do mundo. Além disso, a quimioterapia para tratar neoplasias mamárias afeta diretamente a qualidade de vida relacionada à saúde. Objetivo: Descrever o perfil clínico-epidemiológico e comparar a qualidade de vida relacionada à saúde geral e específica de mulheres com câncer de mama durante a quimioterapia. Método: Estudo observacional e prospectivo com 140 mulheres com câncer de mama no Nordeste do Brasil avaliadas no ciclo intermediário e ao final da quimioterapia. A qualidade de vida foi avaliada por um instrumento geral (EORTC-QLQ-C30) e um módulo específico (EORTC-QLQ-BR23). Os dados foram comparados com teste não paramétrico pareado, com nível de significância de 5%. Resultados: Em relação ao perfil clínico-epidemiológico, a mediana da idade foi de 50 anos, 82,9% eram pretas ou pardas e 95% moravam em Sergipe, Brasil. Além disso, 50,7% não possuíam ocupação, a mediana da renda familiar foi de um salário-mínimo, bem como a mediana da escolaridade foi de oito anos de estudo, e somente 40,7% tinham ensino médio completo. Considerando os dados dos questionários C30 e BR23, observou-se que a maior parte dos itens e escalas piorou ao final da quimioterapia quando comparados ao ciclo intermediário. Entre os itens e escalas com diferenças significativas, a maioria apresentou tamanho de efeito moderado ou alto. Conclusão: É possível concluir que o perfil clínico-epidemiológico foi desfavorável, e a quimioterapia reduziu diversos aspectos da qualidade de vida relacionada à saúde de mulheres com câncer de mama

Introducción: El cáncer de mama puede afectar a diferentes perfiles de mujeres en todo el mundo. Además, la quimioterapia para tratar las neoplasias de mama afecta directamente la calidad de vida relacionada con la salud. Objetivo: Describir el perfil clínico-epidemiológico y comparar la calidad de vida relacionada con la salud general y específica de mujeres con cáncer de mama durante quimioterapia. Método: Estudio observacional y prospectivo con 140 mujeres con cáncer de mama en el Noreste de Brasil evaluadas en la mitad del ciclo y al final de la quimioterapia. La calidad de vida se evaluó mediante un instrumento general (EORTC-QLQ-C30) y un módulo específico (EORTC-QLQ-BR23). Los datos se compararon con una prueba pareada no paramétrica, con un nivel de significación del 5%. Resultados: En cuanto al perfil clínico-epidemiológico, la mediana de edad fue de 50 años, el 82,9% eran negros o mestizos y el 95% vivían en Sergipe, Brasil. Además, el 50,7 % no tenía ocupación, la renta familiar mediana era de un salario mínimo, así como el nivel educativo medio era de ocho años de estudio y solo el 40,7 % tenían la secundaria completa. Considerando los datos de los cuestionarios C30 y BR23, se observó que la mayoría de los ítems y escalas empeoró al final de la quimioterapia en comparación con el ciclo intermedio. Entre los ítems y escalas con diferencias significativas, la mayoría tuvo tamaños del efecto moderados o altos. Conclusión: Es posible concluir que el perfil clínico-epidemiológico fue desfavorable y la quimioterapia redujo varios aspectos de la calidad de vida relacionada con la salud de las mujeres con cáncer de mama

Molluscum Contagiosum Associated with Acquired Immunodeficiency Syndrome: Experience in HIV outpatient care and literature review / Molusco contagioso associado à síndrome da imunodeficiência adquirida: experiência no atendimento em ambulatório de HIV e revisão da literatura

Introduction: Molluscum contagiosum is a dermatosis caused by a DNA virus of the family Poxvirus and genus Molluscipoxvirus, affecting mainly children, sexually active adults, atopic individuals and immunocompromised patients, especially those with human immunodeficiency virus (HIV) infection. Objective: To describe our experience in caring for patients living with HIV who presented with extensive and severe Molluscum contagiosum, and to conduct a literature review on the subject as well. Methods: An electronic search was carried out in the MEDLINE/PubMed and SciELO databases and in the books: ATLAIDS and AZULAY limited to the period of January 2017 to June 2021. Results: Four clinical cases are reported in people living with HIV with extensive lesions normally not found in immunocompetent patients. The treatment performed in the cases reported in this article was the punctual application of 90% trichloroacetic acid (TCA) to each lesion, with complete remission of the clinical presentation in two patients over a period of three and six months. The other two patients did not receive treatment for molluscum contagiosum as they died because of pulmonary complications. Conclusion: Infection with Molluscum contagiosum in people living with HIV has disseminated forms with large-volume lesions, with substantial stigmatizing aesthetic impairment, and treatment with 100% TCA is quite effective.

Introdução: Molusco contagioso é uma dermatose causada por um vírus de DNA da família poxvírus e do gênero Molluscipoxvirus. Afeta principalmente crianças, adultos sexualmente ativos, indivíduos atópicos e pacientes imunodeprimidos, especialmente aqueles com infecção pelo vírus da imunodeficiência humana (HIV). Objetivo: Descrever a experiência no atendimento de pacientes vivendo com HIV que apresentaram quadro de molusco contagioso extenso e grave, além de realizar uma revisão da literatura sobre o tema. Métodos: Foi realizada uma pesquisa eletrônica nas bases de dados MEDLINE/PubMed e SciELO e nos livros ATLAIDS e AZULAY, limitada ao período de janeiro de 2017 a junho de 2021. Resultados: São relatados quatro casos clínicos em pessoas que vivem com HIV com lesões extensas normalmente não encontradas em pacientes imunocompetentes O tratamento realizado nos casos relatados nesse artigo foi a aplicação pontual de ácido tricloroacético (ATC) 100% em cada lesão, com a remissão completa do quadro clínico em dois pacientes em um período de tempo entre três e seis meses. Os outros dois pacientes não receberam tratamento para o vírus do molusco contagioso pois evoluíram para óbito em razão de complicações pulmonares. Conclusão: A infecção pelo molusco contagioso em pessoas vivendo com HIV apresenta formas disseminadas com lesões de grande volume, com comprometimento estético estigmatizante importante, e o tratamento com ATC 90% é bastante eficaz.