O impacto da pandemia da Covid-19 na saúde mental de estudantes universitários / The impact of the Covid-19 pandemic on the mental health of university students / El impacto de la pandemia de Covid-19 en la salud mental de los estudiantes universitarios

A pandemia pelo SARS-CoV-2 é um dos maiores desafios sanitários em escala global. Devido estado de emergência, uma série de medidas de controle e prevenção foram adotadas, como distanciamento social e redução das reuniões públicas. Nesse cenário, buscou-se avaliar a saúde mental de estudantes de uma instituição privada de Ensino Superior diante da pandemia. Esta pesquisa trata-se de um estudo transversal descritivo desenvolvido na Faculdade do Vale do Jaguaribe, localizada em Aracati-CE. A coleta de dados ocorreu de dezembro de 2020 a fevereiro de 2021, utilizando formulário eletrônico contendo variáveis sociodemográficas, epidemiológicas e relativas aos diferentes aspectos da saúde mental do estudante frente a pandemia da COVID-19. A análise foi baseada no cálculo de frequências absolutas e relativas das variáveis além de medidas de tendência central e dispersão. Dos 333 discentes que participaram do estudo, a média de idade foi 25, com variação entre 18 e 56 anos, sendo maioria do sexo feminino (72,7%), autodenominação de cor/etnia parda (72,7%) e não estarem trabalhando (53,8%). A taxa de positividade entre os graduandos para COVID-19 foi de 9% (30). Ao serem questionados sobre como a pandemia alterou seus níveis de estresse ou saúde mental, 75,5% responderam que houve piora. Dentre os sintomas mais relatados no período da quarentena, estavam medo e ansiedade (ambos com 74,2%), seguidos por insegurança (69,7%). Baseados nos achados deste estudo, recomenda-se a incorporação de ações multiprofissionais na atenção aos estudantes dentro da academia. Sugere-se a implantação de um serviço qualificado buscando desenvolver um olhar holístico para os discentes.

The SARS-CoV-2 pandemic has presented itself as one of the greatest health challenges on a global scale. Given the state of public health emergency, a series of control and prevention measures have been adopted, such as social distancing and reduction of public meetings, as in universities. Faced with this scenario, we sought to evaluate the mental health of students from a private institution of Higher Education in the face of the COVID-19 pandemic. Thus, this research was a descriptive cross-sectional study developed at the Faculdade do Vale do Jaguaribe, located in the City of Aracati- CE. Data collection occurred from December 2020 to February 2021, using an electronic form containing sociodemographic and epidemiological variables, as well as variables related to the repercussions in different aspects of the student's mental health when facing the pandemic of COVID-19. The analysis was based on the calculation of absolute and relative frequencies of the variables, as well as measures of central tendency and dispersion. Of the 333 students who participated in the study, the mean age was 25 years, with ages ranging from 18 to 56 years, the majority being female (72.7%), self- denominated as Brown (72.7%), not working when answering the form (53.8%). The positivity rate among undergraduates for COVID-19 was 9% (30/333). When asked how the pandemic altered their stress levels or mental health, 75.5% responded that it had worsened. Among the symptoms most reported by students during the quarantine period were fear and anxiety (both 74.2%), followed by insecurity (69.7%). It is suggested the implementation of a qualified approach service seeking to develop a holistic look for the students.

La pandemia por SARS-CoV-2 es uno de los mayores desafíos sanitarios a escala global. Debido al estado de emergencia, se han adoptado una serie de medidas de control y prevención, como el distanciamiento social y la reducción de reuniones públicas. En este escenario, se buscó evaluar la salud mental de los estudiantes de una institución privada de educación superior frente a la pandemia. Esta investigación es un estudio descriptivo transversal desarrollado en la Facultad de Valle de Jaguaribe, ubicada en Aracati-CE. La recopilación de datos se llevó a cabo de diciembre de 2020 a febrero de 2021, utilizando un formulario electrónico que contiene variables sociodemográficas, epidemiológicas y relacionadas con los diferentes aspectos de la salud mental del estudiante frente a la pandemia de COVID-19. El análisis se basó en el cálculo de frecuencias absolutas y relativas de las variables, además de medidas de tendencia central y dispersión. De los 333 estudiantes que participaron en el estudio, la media de edad fue de 25 años, con variación entre 18 y 56 años, siendo la mayoría del sexo femenino (72,7%), autodenominación de la raza / etnia morena (72,7%) y no trabajando (53,8%). La tasa de positividad entre los estudiantes de pregrado para COVID-19 fue del 9% (30). Cuando se les preguntó cómo la pandemia había alterado su nivel de estrés o salud mental, el 75,5% respondió que había empeorado. Entre los síntomas más comunes durante el período de cuarentena, se encontraban el miedo y la ansiedad (ambos con un 74,2%), seguidos de la inseguridad (69,7%). Basados en los resultados de este estudio, se recomienda la incorporación de acciones multiprofesionales en la atención a los estudiantes dentro de la academia. Se sugiere la implementación de un servicio calificado que busque desarrollar una mirada holística hacia los estudiantes.

Religiosidade/espiritualidade entre a população brasileira diante da pandemia Covid-19 e a correlação com a qualidade de vida / Religiosity/spirituality among the brazilian population in the face of the Covid-19 pandemic and the correlation with quality of life / Religiosidad/espiritualidad en la población brasileña frente a la pandemia de Covid-19 y la correlación con la calidad de vida

A pandemia causada pelo SARS-CoV-2 (COVID-19) trouxe inúmeros impactos na vida cotidiana, tanto nos aspectos econômicos, como nos emocionais, psicológicos e sociais. Em situações difíceis, as pessoas, muitas vezes, recorrem à espiritualidade ou à religiosidade. O objetivo deste estudo foi investigar a presença da religiosidade/espiritualidade entre a população brasileira diante da pandemia da COVID- 19, correlacionado com a qualidade de vida. É um estudo quantitativo, descritivo e transversal, realizado nos últimos meses de 2020. Os dados foram coletados por meio de respostas aos instrumentos WHOQOL-Bref e o WHOQOL-SRPB, de forma online, por meio do Google Forms®. Utilizou-se o método de amostragem não probabilístico do tipo snowball sampling, totalizando 948 respostas. Os dados foram tabulados por meio do software Microsoft Excel (2019) e analisados estatisticamente, considerando significativo p<0,05. Os dados apresentados mostram de forma enfática como os participantes que pertencem a alguma religião, apresentaram melhor relação nos domínios saúde psicológica, independência, meio ambiente e espiritualidade/religião/crenças pessoais em comparação àqueles que declaram não pertencer a uma religião. No entanto, não houve diferença estatisticamente significativa para os domínios saúde física e relações sociais. Conclui-se que o pertencimento a uma religião pode contribuir para a melhoria da qualidade de vida e auxiliar o enfrentamento das situações desfavoráveis durante a pandemia COVID-19. Diante disso, destaca-se a importância do desenvolvimento de novos estudos sobre o tema, para compreender com mais veemência e detalhamento, a relação dessas variáveis em contextos de crise que possam alterar a rotina de vida das pessoas.

The pandemic caused by SARS-CoV-2 (COVID-19) has brought numerous impacts on daily life, both in economic, emotional, psychological, and social aspects. In difficult situations, people often turn to spirituality or religiosity. The objective of this study was to investigate the presence of religiosity/spirituality among the Brazilian population facing the pandemic of COVID-19, correlated with quality of life. Quantitative, descriptive, cross-sectional study conducted in the last months of 2020. Data were collected by means of responses to the WHOQOL-Bref and the WHOQOL-SRPB instruments, online, through Google Forms®. The non-probabilistic snowball sampling method was used, totaling 948 answers. Data were tabulated using Microsoft Excel software (2019) and statistically analyzed, considering p<0.05 significant. The data presented emphatically show how the participants, who belong to some religion, presented a better relationship in the domains psychological health, independence, and environment and spirituality/religion/personal beliefs compared to those who do not have a religion. However, there was no statistically significant difference for the physical health and social relationships domains. It is concluded that belonging to a religion can contribute to improved quality of life and assist in coping with unfavorable situations during the COVID-19 pandemic. Therefore, the importance of developing new studies on the subject is highlighted, in order to understand more vehemently the relationship of these variables in crisis contexts that can change the routine of people's lives.

La pandemia causada por el SARS-CoV-2 (COVID-19) ha traído numerosos impactos en la vida cotidiana, tanto en los aspectos económicos, emocionales, psicológicos y sociales. En situaciones difíciles, las personas suelen recurrir a la espiritualidad o la religiosidad. El objetivo de este estudio fue investigar la presencia de religiosidad/espiritualidad en la población brasileña que enfrenta la pandemia de COVID- 19, correlacionada con la calidad de vida. Estudio cuantitativo, descriptivo, transversal, realizado en los últimos meses de 2020. Los datos fueron recolectados por medio de respuestas a los instrumentos WHOQOL-Bref y WHOQOL-SRPB, en línea, a través de Google Forms®. Se utilizó el método de muestreo no probabilístico de bola de nieve, totalizando 948 respuestas. Los datos fueron tabulados utilizando el software Microsoft Excel (2019) y analizados estadísticamente, considerando p<0,05 significativa. Los datos presentados muestran enfáticamente cómo los participantes, que pertenecen a alguna religión, presentaron una mejor relación en los dominios salud psicológica, independencia y entorno y espiritualidad/religión/creencias personales en comparación con aquellos que no tienen religión. Sin embargo, no hubo diferencias estadísticamente significativas para los dominios salud física y relaciones sociales. Se concluye que la pertenencia a una religión puede contribuir a mejorar la calidad de vida y ayudar a afrontar situaciones desfavorables durante la pandemia de COVID-19. Por lo tanto, se destaca la importancia de desarrollar nuevos estudios sobre el tema, para comprender con más vehemencia la relación de estas variables en contextos de crisis que pueden cambiar la rutina de vida de las personas.

Percepção de residentes de curso multiprofissional em saúde em relação à importância de cuidados odontológicos no hospital / Percepción de residentes de un curso multidisciplinario de salud sobre la importancia de la atención odontológica en el hospitalResumen / Perception of residents of a multiprofessionalresidency program in hospital care regarding the importance of oral careAbstract

O estudo objetivou conhecer a percepção de residentes multiprofissionais de um hospital público sobre a importância dos cuidados odontológicos no cenário hospitalar. Foi realizado um estudo do tipo transversal, observacional, descritivo com amostra por conveniência, composta por 63 residentes do Programa de Residência Multiprofissional Integral de Saúde Hospitalar (RIMUSH) do Hospital Universitário Lauro Wanderley. O instrumento de coleta de dados foi um questionário adaptado contendo sete perguntas. Para análise, os residentes foram divididos em dois grupos, o grupo 1 (G1) possui cirurgião-dentista (CD) na equipe multiprofissional e o grupo 2 (G2) não possui CD na equipe. A maioria dos residentes respondeu que avaliação odontológica nos pacientes hospitalizados é muito importante, que condições sistêmicas, medicações e condição de saúde bucal impactam na recuperação. Porém, os residentes do G1 compreenderam melhor as atribuições do CD na equipe, assim como quando indicar um pedido de consulta odontológica comparados aos do G2. Conclui-se que os residentes das demais áreas da saúde percebem a importância da Odontologia Hospitalar e que a presença do CD nas equipes de residência contribui para a capacitação desses profissionais, para a troca de saberes interprofissionais e para a promoção de assistência integral (AU).

El estudio tuvo como objetivo conocer la percepción de los residentes multidisciplinarios de un hospital público sobre la importancia de la atención odontológica en el ámbito hospitalario. Se realizó un estudio transversal, observacional, descriptivo, con una muestra de conveniencia, conformada por 63 residentes del Programa de Residencia Multiprofesional Integral en Salud Hospitalaria (RIMUSH) del Hospital Universitario Lauro Wanderley. El instrumento de recolección de datos fue un cuestionario adaptado que contenía siete preguntas. Para el análisis, los residentes fueron divididos en dos grupos, el grupo 1 (G1) tiene un cirujano dentista (CD) en el equipo multidisciplinario y el grupo 2 (G2) no tiene un dentista en el equipo. La mayoría de los residentes respondieron que la evaluación dental en pacientes hospitalizados es muy importante, que las condiciones sistémicas, los medicamentos y la condición de salud oral impactan en la recuperación. Sin embargo, los residentes de G1 entendieron mejor las funciones del CD en el equipo, así como cuándo indicar una solicitud de cita dental en comparación con G2. Los residentes de otras áreas de salud se dan cuenta de la importancia de la Odontología Hospitalaria y la presencia de CD en los equipos de residencia contribuye a la formación de estos profesionales, al intercambio de conocimientos interprofesionales y a la promoción de la atención integral (AU).

This study aimed to investigate the perception of multiprofessional residents of a public hospital about the importance of oral care in the hospital setting. A cross-sectional, observational study of descriptive design was conducted with a convenience sample, including 63 residents of the Multiprofessional Integrated Residency Program in Hospital Care (RIMUSH) at the University Hospital Lauro Wanderley. The instrument used for data collection was an adapted questionnaire containing seven questions. For the analysis, residents were divided into two groups: group 1 (G1) included a dental surgeon (DS) in the multiprofessional team, and group 2 (G2) did not include a DS in the team. Most residents answered that dental evaluation of hospitalized patients was very important, and that systemic conditions, medications and oral health had a significant impact on recovery. However, G1 residents had better understanding of the duties of the DS in the team and of timely referral of hospitalized patients for a dental consultation, compared to G2. Residents of other Health Care courses realize the importance of Hospital Dentistry and understand that the presence of DSs in residency teams is acontributing factor to the qualification of these professionals, exchange of interprofessional knowledge and promotion of comprehensive care (AU).

Percepção dos docentes de um curso de Odontologia sobre a terapia a laserde baixa intensidade / Perception of the professors of a Dentistry School about low intensity laser therapy

A tendência da Odontologia é a incorporação de métodos menos invasivos.Por isso, acredita-se que a terapia a laserde baixa intensidade (TLBI) seja uma opção de tratamento, na medida em que apresenta efeitos benéficos comprovados. O presente estudo tem o objetivo de traçar o padrão de ensino e a percepção dosprofessores sobre o uso de terapia a laserde baixa intensidade no curso degraduação em Odontologia da Universidade Federal do Espírito Santo.Além disso, busca analisar a presença da disciplina de laserterapia nos cursos de Odontologia brasileiros.A pesquisa foi realizada a partir de um estudo analítico, transversal e descritivo, com a aplicação de um questionário a44 professores da Odontologiada Universidade Federal do Espírito Santo. A partir deste estudo obteve-se que 9% de todo corpo docente afirmou utilizar o laserem alguma das atividades das disciplinasque ministram, sendo que esta baixa porcentagem foi justificada pelos professores devido à falta de recurso financeiro para obtenção dos aparelhos. Foi observado que a maior parte do corpo docente já teve conhecimento sobre o laser, sendo 45,4% durante a pós-graduação. Quando avaliada a estrutura curricular das 461instituições de ensino superior brasileiras de Odontologia em atividade, 13 oferecem a disciplina de laserterapia em sua matriz curricular.Pode-se concluir que existe um considerável nível de conhecimento sobre o laserentre os docentes. Porém, nota-se pouca disseminação de informação nas diferentes disciplinas do curso estudado (AU).

There is a tendency in Dentistry to incorporate less invasive methods of treatment. Therefore, since it has proven beneficial effects, it is believed that low-intensity laser therapy (LILT) can be a treatment option. The objective of this study is to outline the teaching pattern and perception of professors about their knowledge in the use of low -intensity laser therapy in Dentistry at the Federal University of Espírito Santo. In addition, it seeks to analyze the presence of Laser Therapy programs in the Dentistry Schools in Brazil. The research was carried out from an analytical, transversal and descriptive study. A questionnaire was applied to 44 professors of the course of Dentistry at the Federal University of Espírito Santo. From this study, it was found that 9% of all professors claimed to use the laser in some of the teaching activities. This percentage was justified by then due to the lack of financial resources to obtain the devices. It was observed that most of the professors had knowledge about the laser. According to 45.4% of then, this knowledge was acquired during the post-graduation. When evaluating the curricular structure of the courses of Dentistry at Brazilian Universities it was found that from the 461 in activity, 13 offer the disciplineof laser therapy. It can be concluded that there is a considerable level of knowledge about the laser among professors. However, there is little knowledge transmission in the different disciplines of the course studied (AU).

Imunoexpressão da Yes-Associated Protein (YAP) em hiperceratoses e displasias epiteliais orais / Immunoexpression of Yes-Associated Protein (YAP) in hyperkeratosis and oral epithelial dysplasia

A busca por um biomarcador que auxilie na predição de risco de transformação maligna das desordens orais potencialmente malignas (DOPMs) representa um grande desafio, já que pode auxiliar no manejo precoce e adequado dos pacientes. Este estudo avaliou a imunoexpressão da Yes-Associated Protein (YAP) em lesões intraorais leucoplásicas, eritroplásicas ou leucoeritroplásicas, com diagnóstico histopatológico de hiperceratose ou displasia epitelial oral (DEO), correlacionando essa imunoexpressão com o grau de severidade morfológica dessas lesões. A amostra foi composta por 20 casos de hiperceratoses e 53 casos de DEOs, além de 10 casos de mucosa oral normal (grupo controle). Para a avaliação do grau de displasia, foram utilizadas as gradações da OMS (EL-NAGGAR et al., 2017) e o Sistema Binário (KUJAN et al., 2006), sendo o perfil imunoistoquímico da proteína YAP avaliado por meio de escores, que variaram entre 0 e 3, com base em sua localização intracelular (citoplasmática ou nuclear) e por sua distribuição no tecido epitelial. Para a análise entre os parâmetros estudados foram realizados os testes estatísticos Qui-quadrado de Pearson, Exato de Fisher, além de testes não paramétricos, (nível de significância de 95%). Displasias leves foram enquadradas (100%) no baixo risco de transformação maligna, enquanto as moderadas dividiram-se entre baixo (47%) e alto risco (53%), sendo as displasias severas, em sua maior parte (71%), classificadas como de alto risco (p < 0,001). O grupo controle exibiu imunomarcação de escore 0 (80%), as hiperceratoses e displasias leves (em 80% das vezes) exibiram escore 1, já nas displasias moderadas (63%) e severas (79%), foram predominantes os escores 2 e 3; com padrão de imunomarcação nuclear associado ao alto risco de transformação maligna sugerido pelo Sistema binário (p = 0,002). A imunoexpressão da YAP foi semelhante entre hiperceratoses e displasias leves, o que deve suscitar maior atenção dos profissionais frente aos casos de hiperceratose, além disto a expressão da YAP aparenta dicotomizar as DOPMs entre as lesões com baixo risco de transformação maligna e as lesões com alto risco, o que pode sugerir no futuro, sua utilização como potencial marcador preditivo de progressão destas lesões (AU).

The search for a biomarker that helps to predict the risk of malignant transformation of oral potentially malignant disorders (OPMDs) represents a great challenge, as it can help in the early and adequate management of patients. This study evaluated the immunoexpression of Yes-Associated Protein (YAP) in intraoral leukoplastic, erythroplastic or leukoerythroplastic lesions, with histopathological diagnosis of hyperkeratosis or oral epithelial dysplasia (OED), correlating this immunoexpression with the degree of morphological severity of these lesions. The sample consisted of 20 cases of hyperkeratosis and 53 cases of OED, in addition to 10 cases of normal oral mucosa (control group). To assess the degree of dysplasia, the WHO grading (EL-NAGGAR et al., 2017) and the Binary System (KUJAN et al., 2006) were used, and the immunohistochemical profile of the YAP protein was evaluated through scores, which ranged from 0 to 3, based on their intracellular location (cytoplasmic or nuclear) and their distribution in the epithelial tissue. For the analysis of the studied parameters, Pearson's Chi-square and Fisher's Exact statistical tests were performed, in addition to non-parametric tests (significance level of 95%). Mild dysplasias were classified (100%) in the low risk of malignant transformation, while the moderate ones were divided between low (47%) and high risk (53%), with severe dysplasias, for the most part (71%), classified as high risk (p < 0.001). The control group exhibited score 0 of immunostaining (80%), hyperkeratosis and mild dysplasias (80% of booth) exhibit score 1, whereas in moderate (63%) and severe dysplasia (79%), the predominant scores was 2 and 3; with a pattern of nuclear immunostaining associated with the high risk of malignant transformation suggested by the Binary System (p = 0.002). The immunoexpression of YAP was similar between hyperkeratosis and mild dysplasias, which should attract greater attention from professionals in cases of hyperkeratosis. Furthermore, the expression of YAP appears to dichotomize OPMDs between lesions with low risk of malignant transformation and lesions with high risk, which may suggest, in the future, its use as a potential predictive marker of the progression for these lesions (AU).

Hot-Water Bathing Improves Symptoms in Patients with Cyclic Vomiting Syndrome and Is Modulated by Chronic Cannabis Use.

BACKGROUND: Cyclic vomiting syndrome (CVS) is a chronic functional GI disorder; a characteristic compulsive "hot-water bathing" pattern is reported to alleviate symptoms during an acute episode. There is limited data on this bathing pattern: proposed mechanisms include core temperature increase via effects on cannabinoid type 1 receptors in the brain, skin transient receptor potential vanilloid 1 receptor stimulation, and blood flow shift from viscera to skin. AIMS: We thus sought to characterize the hot-water bathing pattern in patients with CVS and identify differences between heavy cannabis users in comparison to occasional and non-users. METHODS: We conducted a cross-sectional study of 111 patients with CVS at a single tertiary referral center. Questionnaires regarding clinical characteristics, hot-water bathing, and cannabis use were administered. Patients were classified based on cannabis usage into regular cannabis users (≥ 4 times/week), and occasional + non-users (< 4 times/week and no current use). RESULTS: A total of 81 (73%) respondents reported the hot-water bathing behavior during an episode. The majority (> 80%) noted a marked improvement in nausea, vomiting, abdominal pain and symptoms associated with panic. Regular cannabis users were more likely to use "very-hot" water (50% vs. 16%, p = 0.01) and time to relief of symptoms was longer (> 10 min) in this group, compared to the rest of the cohort. CONCLUSIONS: Hot-water bathing relieves both GI and symptoms related to panic in most patients which appear to be modulated by chronic cannabis use. These findings can help inform future physiologic studies in CVS pathogenesis.

Assessment of Hypnosis Knowledge Among Dentists: A Cross-Sectional Study

ABSTRACT Objective: To assess the attitudes, experiences, training levels, and interest in future education regarding the use of hypnosis by dentists working in Dental Clinic of Monastir, Tunisia. Material and Methods: A cross-sectional study was conducted among 330 dentists working in Dental Clinic of Monastir in November 2019. Students, internship, residents, and professors were randomly selected. This was a survey with a structured questionnaire mailed to all dentists. The questionnaire was pre-fabricated, simple, and close-ended. Data were analyzed using SPSS 24.0 statistical software. Results: A total of 202 dentists respond to this survey. 54% of the participants were interns with a female predominance (66.5%). Findings revealed that beliefs toward hypnosis in the sample were generally positive. Using a visual analogue scale, dentists reported having moderate acknowledge in hypnosis (3.4). 60% of the participants in our study consider that hypnosis is useful in dentistry and, more particularly, in pediatric dentistry. 78.2% of respondents want to follow training courses in hypnosis. Conclusion: Our survey highlights the weak knowledge of participants in hypnosis and reveals certain misconceptions about this procedure. More efforts are required to better educate dentists about hypnosis's benefits in their practice.

Dental Status of Firefighters of Rio de Janeiro State and Comparison with Brazilian Oral Health Surveys

ABSTRACT Objective: This cross-sectional study aimed to assess clinical dental status in military firefighters of Rio de Janeiro State and compare data with Brazilian National and Regional oral health surveys. Material and Methods: A sample of 926 military firefighters was examined using the visible biofilm index, the DMFT index and the Community Periodontal Index (CPI). Clinical exams were performed by 15 trained dentists. The Kruskal-Wallis test and Mann-Whitney test with Bonferroni correction were used. Results: Higher biofilm accumulation was associated with increased age. The mean DMFT index for the whole sample of this study was 12.74 (±7.03), and the 'filled' component was the most prevalent (69.9%), whereas the 'decayed' and 'missing' components were, respectively, 8.4% and 21.7%. There was a higher prevalence of periodontal diseases with increasing age, ranging from 57.1% in firefighters of 34 years or less to 70.5% in the ones between 35 and 44 years old and 75.4% in participants at age 45 years or older. Clinical dental status of the military firefighters who belonged to the age group 35-44 was better than the one observed for the Brazilian population at the same age range. However, pathological conditions that can be solved with health promotion strategies associated with dental procedures of low complexity still persist. Conclusion: These results suggest that the availability of dental health care services itself does not represent the most effective approach to the oral health problems found in the studied population.

Periodontal Comparison on Systemic Lupus Erythematosus Patients and Healthy Subjects: A Cross-Sectional Study

ABSTRACT Objective: To analyze periodontal comparison between Systemic Lupus Erythematosus (SLE) subject and healthy control. Material and Methods: This descriptive cross-sectional study included 122 subjects, 61 SLE patients and 61 healthy subjects who visited the Rheumatology Department, Dr. Saiful Anwar General Hospital, Malang, during 2017-2018. Clinical examination of SLE was using Mexican SLE Disease Activity Index and oral cavity conditions were assessed using the periodontal index, gingival index, calculus index, bleeding on probing, clinical attachment loss and mobility teeth. Results: The age of SLE patients ranged from 18-55 years old with the mean age of 29.50 ± 9.57 years old. Periodontitis was higher in SLE patients (88.5%) than healthy subjects (22.95%). In addition, periodontitis occurrence in SLE (2.66 ± 1.02) was significantly different (p<0.001) compared to healthy subjects (0.51 ± 0.81). Conclusion: This study found higher rates of periodontitis, gingivitis, bleeding on probing, clinical attachment loss, and mobility tooth among SLE patients compared to healthy subjects. Periodontitis was also found to be higher along with more severe SLE group.

3D CT Soft Tissue Craniofacial Analysis and Lip Morphology

ABSTRACT Objctive: To assess the soft tissue characteristics of Bangladeshi adults to formulate soft tissue 3D CT standards using Holdaway's (HA) and lip morphology (LM) analyses. Another aim of this study was to assess the gender dimorphism of Bangladeshi population. Material and Methods: One hundred and seventeen (Eighty-five men and Thirty-two women) Bangladeshi adults have obtained their computed tomography (CT) scan at the Radiology Department for normal diagnosis. Craniofacial deformities were undetected in all cases. The CT images were prepared by a 3D imaging programming software (Mimics 11.02 Materialise). Parameters from the identified landmark points were measured in 3D through this software. Results: Upper lip thickness (ULT) (vermillion UL-A point) measurement was significant in HA and in LM analyses, upper lip protrusion (ULP) (Ls to Sn-SPog) measurement has demonstrated significant difference among both genders, where p-value was less than 0.05. Mean measurements of Bangladeshi adults were relatively comparable except the face convexity (FC) when compared with the HA cephalometric soft tissue values. Conclusion: By using HA and LM analyses, 3D CT soft tissue standards were established for Bangladeshi adults. Measurements for all parameters have remained equivalent with the HA standard data apart from the FC measurement. This consequently may demonstrate that the Bangladeshi population retains a convex shape with a slight protrusive lip or retruded chin.

Diagnostic Validity of Self-Perceived Dental Caries in Indonesian Young Adolescents Aged 12-15 Years

Objective: To compare self-perceived information and clinically diagnosed dental caries status among Indonesian children aged 12­15 years. Material and Methods: In this cross-sectional study, a questionnaire was used to obtain self-perceived information. Clinical examinations were conducted to determine the mean number of decayed, missing or filled teeth (DMFT) and the presence of severely decayed teeth with visible pulpal involvement, ulceration caused by dislocated tooth fragments, fistula, and abscess (PUFA). The study included 494 children aged 12­15 years recruited from six junior high schools in Jakarta, Indonesia. The clinical examination results and responses to the self-perceived assessment questionnaire were compared to determine the sensitivity and specificity. Results: The proportions of children with dental caries and clinical consequences of untreated dental caries in this study were 69.4% and 17.6%, respectively, with mean DMFT and PUFA index scores of 2.4 and 0.2, respectively. For the DMFT index, the self-perceived need for oral treatment had the highest sensitivity (86%), while the dental pain had the highest specificity (89%). For the PUFA index, the self perceived oral health condition had the highest sensitivity (92%), while the self-perceived dental pain had the highest specificity (82%). However, none of the self-perceived variables had both high sensitivity and specificity. Conclusion: Self-perceived information obtained from the questionnaire can not properly evaluate the clinical status of dental caries.

Salivary Transferrin Levels in Patients with Oral Lichen Planus

Objective: To compare salivary transferrin levels between patients with oral lichen planus (OLP) and healthy subjects. Material and Methods: In this descriptive, analytical, crosssectional study, 11 patients with OLP and 22 healthy subjects were selected after matching in terms of age and gender. OLP was confirmed by two oral medicine specialists based on clinical and histopathological criteria. Salivary samples were collected by spitting. The patients were asked to collect their saliva in their oral cavity and then evacuate it into sterilized Falcon tubes. The procedure was repeated every 60 seconds for 5-15 minutes. A total of 5 mL of saliva was collected using this method. The samples were collected from 8 to 9 in the morning in a fasting state to avoid circadian changes. The collected salivary samples were immediately placed next to ice and transferred to the laboratory to be centrifuged at 4°C at 800 g to isolate squamous cells and cellular debris. Then the samples were frozen at -80°C until the samples were prepared. An ELISA kit was used to determine salivary transferrin levels. Data were analyzed with descriptive statistics (means and standard deviations) and t-test for independent groups using SPSS 17. Statistical significance was set at p<0.05. Results: The mean salivary transferrin concentrations in patients with OLP and healthy subjects were 0.9055±0.28229 and 1.5932±0.80041 mg/dL, respectively (p<0.05). Conclusion: The salivary transferrin levels in patients with OLP were significantly lower than those in healthy subjects.

Translation, Transcultural Adaptation and Validation of the Halitosis Associated Life-Quality Test for Use in Brazilian Adolescents

Objective: To perform the transcultural adaptation to Brazil and validation of the Halitosis Associated Life-quality Test (HALT) for use in adolescents. Material and Methods: Students aged 12 to 15 years, of both sexes, with healthy permanent dentition, attending public schools in Piracicaba, Brazil, were selected for this study. The HALT was translated, backtranslated, reviewed by an expert committee and submitted to a pre-test. In the first phase (n = 13), 15% of the sample did not understand items 2, 12 and 15; therefore, these items were reformulated and resubmitted to 13 adolescents. The version with a sociocultural adaptation was self-applied by 56 adolescents (64% females, 13.4 ± 1.0 years), of whom 25 participated in the test-retest. The presence of visible biofilm, gingival bleeding, calculus and tongue coating, was evaluated. Selfperception of halitosis after exhalation/breathing was assessed by a single question. Results: The HALT score ranged from 0 to 62 points (mean = 10.1±13.4) and the floor effect was 5.4%. Internal consistency was excellent (Cronbach's alpha = 0.92) and reproducibility was moderate (Intraclass Correlation Coefficient = 0.59). Individuals with "excessive" tongue coating had a higher HALT score than those with mild and/or moderate coating (p<0.001). Multiple linear regression analysis indicated that only the male sex was related to a higher HALT score (p<0.05). Conclusion: The Brazilian Portuguese version of the HALT was easily understood by adolescents. Those with greater tongue coating accumulation reported more frequently the presence of halitosis, which was only associated to male sex.

Influence of Photodynamic Therapy in the Control of Postoperative Pain in Endodontic Treatment: A Cross-Sectional Randomized Clinical Trial

Objective: To evaluate the postoperative pain at different times after endodontic treatment with and without the use of photodynamic therapy (PDT) of asymptomatic teeth with apical periodontitis. Material and Methods: In this cross-sectional randomized clinical trial, the treatment was performed in a single visit with and without the use of photodynamic therapy. The sample consisted of 10 patients with two teeth in the same jaw, but on different sides (splitmouth), subjected to the same endodontic treatment with reciprocating instrumentation in the apical foramen instrumentation limit. The teeth from each patient were randomly divided into two groups: G1 (Control): endodontic treatment without photodynamic therapy and G2 (PDT): received methylene blue 0.005% and irradiation with a low-level laser. The fillings were performed with a Touch'n Heat technical device and Ah Plus sealer. The treatments of G1 and G2 in the same patient were performed in an interval of 3 weeks between them and the blinding study was ensured during all long treatment. Postoperative pain was recorded using an adapted VAS scale in times of 6, 12, 24, 36, 48, and 72 hours. Results: In both groups, the highest value recorded at the VAS scale was 2 mm (no pain), and there were no statistically significant differences in postoperative pain between the groups at any observation times (p<0.05). Conclusion: The photodynamic therapy did not have advantages to control postoperative pain in endodontic treatments of asymptomatic teeth with apical periodontitis, since both groups showed low levels of pain in all patients evaluated.

Tratamiento sistémico de la psoriasis moderada-grave en edad pediátrica en Galicia: estudio descriptivo / Systemic Treatment of Moderate to Severe Psoriasis in Pediatric Patients in Galicia, Spain: A Descriptive Study

ANTECEDENTES Y OBJETIVO: Los trabajos sobre el tratamiento sistémico de la psoriasis en edad pediátrica son escasos. El objetivo principal de este trabajo consistió en describir qué tratamientos sistémicos se emplean en práctica clínica en psoriasis moderada-grave en edad pediátrica. Secundariamente se describió la efectividad y perfil de seguridad de dichos tratamientos. MATERIALES Y MÉTODOS: Estudio descriptivo transversal multicéntrico, de los pacientes con psoriasis moderada-grave, que siendo menores de 18 años estuviesen recibiendo o hubieran recibido tratamiento sistémico (clásico o biológico) o fototerapia. Se recogieron datos clínico-demográficos, tipo de tratamiento recibido, y tolerancia, efectos indeseables y respuesta al mismo. RESULTADOS: Se obtuvieron datos de 40 pacientes (60% sexo femenino, edad media 13 años), que realizaron 63 ciclos de tratamiento. Teniendo en cuenta el primer tratamiento (n = 40), la fototerapia fue la opción más frecuente (68%), seguida de acitretino (15%). Considerando el total de ciclos de tratamiento (n = 63), el tratamiento más frecuentemente empleado fue la fototerapia (57%), seguida de metotrexato (16%). En la semana 12 (incluye evaluación de fototerapia), el 66% y el 22% fueron buenos respondedores o respondedores parciales, respectivamente. En la semana 24 (datos exclusivos sobre fármacos sistémicos), el 36% y el 32% continuaron con respuestas buenas y parciales. Los tratamientos fueron bien tolerados (97%) y los efectos indeseables escasos (11%), sin que en ningún caso motivasen la suspensión del fármaco. CONCLUSIONES: En la población menor de 18 años con psoriasis moderada-grave evaluada la fototerapia fue el tratamiento más utilizado, seguida de metotrexato. Los tratamientos consiguieron porcentajes de buenos respondedores del 66% en la semana 12 (incluida fototerapia), y del 36% en la semana 24 (fármacos sistémicos sin fototerapia), presentando un buen perfil de seguridad

BACKGROUND AND OBJECTIVE: Studies on the use of systemic therapy for psoriasis in pediatric patients are scarce. The main aim of this study was to describe the systemic treatments used for moderate to severe psoriasis in pediatric clinical settings. The second aim was to describe the effectiveness and safety of these treatments. MATERIAL AND METHODS: Descriptive, cross-sectional, multicenter study of patients under 18 years of age with moderate to severe psoriasis who were being treated or had been treated with a systemic drug (conventional or biologic) or phototherapy. We recorded demographic and clinical information, treatments received, tolerance, adverse effects, and response to treatment. RESULTS: Data were collected for 40 patients (60% female; mean age, 13 years) who had received 63 treatments in total. The most common first treatment (n = 40) was phototherapy (administered to 68% of patients), followed by acitretin (15%). The most common treatments overall (n =63) were phototherapy (57%) and methotrexate (16%). At week 12 (evaluation of systemic treatment and phototherapy), 66% of the patients were classified as good responders and 22% as partial responders. The respective rates for week 24 (evaluation of systemic treatment only) were 36% and 32%. The treatments were well tolerated (97%) and adverse effects were reported in just 11% of cases. There were no treatment discontinuations because of adverse effects. CONCLUSIONS: Phototherapy, followed by methotrexate, was the most common treatment for moderate to severe psoriasis in this series of patients under 18 years. The treatments showed a favorable safety profile and were associated with a good response rate of 66% at week 12 (systemic treatment and phototherapy) and 36% at week 24 (systemic treatment only)

Hipertrigliceridemia grave. Características clínicas y manejo terapéutico / Severe hypertriglyceridemia. Clinical characteristics and therapeutic management

Introducción: El manejo terapéutico de la hipertrigliceridemia grave representa un desafío clínico. Objetivos: 1) Identificar las características clínicas de los pacientes con hipertrigliceridemia grave; 2) Analizar el tratamiento instaurado por el médico en cada caso. Métodos: Se realizó un estudio de corte transversal a partir de la historia clínica electrónica. Se incluyeron todos los pacientes > 18 años con una determinación en sangre de triglicéridos ≥ 1.000mg/dL entre el 01/01/2011 y el 31/12/2016. Se identificaron variables clínicas y de laboratorio. Se analizó la conducta de los médicos tratantes en los 6 meses posteriores al hallazgo lipídico. Resultados: Se incluyeron 420 pacientes (edad media 49,1 ± 11,4 años, varones el 78,8%). La mediana de triglicéridos fue 1.329mg/dL (rango intercuartílico 1.174-1.658). En el 34,1% de los pacientes no se encontraron causas secundarias. Las causas secundarias más frecuentes fueron la obesidad (38,6%) y la diabetes (28,1%). Se recomendó realizar actividad física y se derivó a un nutricionista en el 49,1% y el 44,2% de los pacientes respectivamente. Las causas secundarias se identificaron y se intentaron corregir en el 40,7% de los casos. Los esquemas terapéuticos más indicados fueron fenofibrato 200 mg/día (26,5%) y gemfibrozil 900 mg/día (19,3%). Pocos pacientes recibieron la indicación de ácidos grasos omega 3 o niacina. Conclusión: Nuestro trabajo mostró por primera vez en nuestro país las características de una población con hipertrigliceridemia grave. Las medidas terapéuticas instauradas por los médicos fueron insuficientes. Conocer las características en este particular escenario clínico podría mejorar el abordaje actual de estos pacientes

Introduction: The therapeutic management of severe hypertriglyceridaemia represents a clinical challenge. Objectives: The objectives of this study were 1) to identify the clinical characteristics of patients with severe hypertriglyceridaemia, and 2) to analyse the treatment established by the physicians in each case. Methods: A cross-sectional study was carried out using the computerised medical records of all patients > 18 years of age with a blood triglyceride level ≥ 1,000 mg/dL between 1 January 2011 and 31 December 2016. Clinical and laboratory variables were collected. The behaviour of the physicians in the 6 months after the lipid finding was analysed. Results: A total of 420 patients were included (mean age 49.1±11.4 years, males 78.8%). The median of triglycerides was 1,329 mg/dL (interquartile range 1,174 - 1,658). No secondary causes were found in 34.1% of the patients. The most frequent secondary causes were obesity (38.6%) and diabetes (28.1%). Physical activity was recommended and a nutritionist was referred to in 49.1% and 44.2% of the patients, respectively. Secondary causes were identified and attempts were made to correct them in 40.7% of cases. The most indicated pharmacological treatments were fenofibrate 200 mg/day (26.5%) and gemfibrozil 900 mg/day (19.3%). Few patients received the indication of omega 3 fatty acids or niacin. Conclusion: This study showed, for the first time in our country, the characteristics of a population with severe hypertriglyceridaemia. The therapeutic measures instituted by the physicians were insufficient. Knowing the characteristics in this particular clinical scenario could improve the current approach of these patients

Percepção dos internos de uma faculdade de medicina sobre o câncer de mama e reconstrução mamária / Perception of breast cancer and breast reconstruction in medical school students

Introdução: O câncer de mama é o tipo mais comum entre as mulheres no mundo e no Brasil, depois do câncer de pele não melanoma. O objetivo é avaliar a percepção dos estudantes de medicina sobre o câncer de mama e reconstrução mamária. Métodos: Trata-se de estudo transversal piloto composto por alunos do 5º e 6º ano de curso de medicina, realizado de maio de 2016. Resultados: Foi questionado se há possibilidade de reconstrução mamária após a mastectomia, sendo que de forma unânime 100% foi sim. Para melhor caracterização, foi perguntado se a reconstrução pode ser feita no mesmo momento da mastectomia, 69 (57,5%) estudantes marcaram sim e 51 (42,5%) negaram. Em análise aos conhecimentos cirúrgicos, foi perguntado se os mesmos conhecem alguma técnica de reconstrução mamária, sendo que 49 (40,83%) responderam que sim e 71 (59,16%) negaram conhecer. Em relação ao encaminhamento à especialidade médica mais preparada para acompanhar e realizar a reconstrução mamária, 93 (77,5%) discentes elegeram a cirurgia plástica e 26 (21,66%) a mastologia. Quanto à possibilidade de reconstrução de mama em pacientes que farão radioterapia adjuvante, 66 (55%) responderam sim, 51 (42,5%) não e 3 (2,5%) não souberam responder. Quanto a esta possibilidade mesmo em pacientes com implantes de silicone, 59 (49,16%) responderam sim, 3 (2,5%) responderam não e 58 (48,33%) afirmaram não saber sobre o assunto. Conclusão: Observou-se que a Mastologia vem ganhando espaço na reconstrução de mama, inclusive no meio acadêmico, devido ao alto percentual de resposta de que a mesma seria mais preparada do que a Cirurgia Plástica para reconstrução mamária.

Introduction: Breast cancer is the most common type of cancer among women in the world and in Brazil, after non-melanoma skin cancer. Our objective was to evaluate the medical students' perception of breast cancer and breast reconstruction. Methods: This is a cross-sectional pilot study composed of students from the fifth and sixth year of medical school, in May 2016. Results: We questioned whether there is a possibility of breast reconstruction after mastectomy, and the response was unanimous (100%). For a better characterization, we asked if the reconstruction could be done at the same time as the mastectomy, and 69 (57.5%) students said yes and 51 (42.5%) denied. In the analysis of surgical knowledge, we asked whether they knew any breast reconstruction technique, and 49 (40.83%) answered yes and 71 (59.16%) denied knowing. With regard to referral to a medical specialist who was better prepared to follow and perform breast reconstruction, 93 (77.5%) students chose plastic surgery and 26 (21.66%) chose mastology. Regarding the possibility of breast reconstruction in patients who need to undergo adjuvant radiotherapy, 66 (55%) answered yes, 51 (42.5%) did not answer, and three (2.5%) did not know how to respond. Regarding this possibility in patients with silicone implants, 59 (49.16%) answered yes, three (2.5%) answered no, and 58 (48.33%) said they did not know about the subject. Conclusion: We conclude that mastology has been gaining immense interest in the field of breast reconstruction, including in the academic world, based on the high percentage of respondents who stated that they are better prepared for this procedure than for plastic surgery for breast reconstruction.

Knowledge and Practical Attitudes of Surgeons-Dentists of Bamako District Facing the Septum Syndrome

Objective: To determine the knowledge and attitude of dental surgeons in Bamako regarding the management of septal syndromes. Material and Methods: It was a crosssectional and descriptive study conducted in the Bamako District, Mali. The following variables were collected: sociodemographic, training, knowledge of septal syndrome, therapeutic decisions and treatment. The data was collected from a survey sheet and processed by Epi-info Software version 3.5.3 and by the language R. Results: A total of 67 professionals participated in this study, of which 88.1% were men. Seventy-six point one percent of the Dental Surgeons have recognized septum syndrome as an emergency. The management of the emergency, followed by the completion of the comprehensive care later represents the attitude of 71.6% of the dentists. Sixty-four point two percent of dentists remove irritating elements under gingival, 80.6% prescribe an antiinflammatory, 38.8% prescribe chlorhexidine gel and 26.9% reconstruct the point of contact. Conclusion: This study demonstrates that Dental Surgeons in general have adequate average knowledge and attitude for their management of septal syndrome.

Exploring Knowledge, Attitudes, and Practice Associated With Meditation Among Patients With Melanoma.

AIM: To explore the knowledge, attitudes, and practices associated with meditation among people with melanoma and investigate the relationship between perceived stress, trait mindfulness, and meditation. Factors associated with interest to participate in an online meditation program were also explored. METHODS: A survey-based cross-sectional study of 291 patients attending a melanoma outpatient clinic assessed knowledge of meditation, attitudes toward meditation using Determinants of Meditation Practice Inventory (DMPI), and meditation experience. Perceived stress and trait mindfulness were measured using the Perceived Stressed Scale and Cognitive and Affective Mindfulness Scale, respectively. RESULTS: Participants who had tried meditation (43%) were likely to be younger, female, and have completed higher education or be employed. Perceived stress score was higher among women, younger participants, and those treated in the past year but did not differ by melanoma stage. Participants reported a good understanding of the potential benefits of meditation, but even among people with meditation experience, common misconceptions prevailed. The main barrier to meditation was a perceived lack of knowledge about meditation . Higher DMPI scores were associated with lower education, moderate to low access to service centers, or living in disadvantaged neighborhoods . Participants practicing meditation that involved self-reflection reported less stress and higher trait mindfulness compared with participants practicing another type of meditation. People interested in participating in an online meditation-based program reported higher perceived stress than those not interested. CONCLUSION: A meditation-based intervention teaching self-reflective practices, targeted at people with melanoma, may have the potential to assist them with managing their stress.

Rendimiento y optimización de la herramienta trigger en la detección de eventos adversos en pacientes adultos hospitalizados / Performance and optimisation of a trigger tool for the detection of adverse events in hospitalised adult patients

Objetivo: Caracterizar el rendimiento de los triggers utilizados en la detección de eventos adversos (EA) de pacientes adultos hospitalizados y definir un panel de triggers simplificado suficientemente sensible y específico, para la detección de EA. Método: Estudio transversal de altas de pacientes de un servicio de medicina interna para la detección de EA mediante revisión sistemática de la historia clínica y la identificación de 41 triggers (evento clínico relacionado frecuentemente con EA), determinando si hubo EA según el contexto en que apareció el trigger. Una vez identificado el EA, se procedió a la caracterización de los triggers que lo detectaron. Se aplicó regresión logística para la selección de los triggers con mayor capacidad de detección de EA. Resultados: Se revisaron 291 historias clínicas y se detectaron 562 triggers en 103 pacientes, de los cuales 163 estuvieron implicados en la detección de un EA. Los triggers que detectaron más EA fueron «A.1. Úlcera por presión» (9,82%), «B.5. Laxante o enema» (8,59%), «A.8. Agitación» (8,59%), «A.9. Sobresedación» (7,98%), «A.7. Hemorragia» (6,75%) y «B.4. Antipsicótico» (6,75%). Se obtuvo un modelo simplificado de triggers que incluyó la variable «Número de fármacos» y los triggers «Sobresedación», «Sondaje», «Reingreso en 30 días», «Laxante o enema» y «Cese brusco de la medicación». Este modelo obtuvo una probabilidad del 81% de clasificar correctamente las historias con EA y sin EA (p <0,001; intervalo de confianza del 95%: 0,763-0,871). Conclusiones: Un número elevado de triggers estuvieron asociados a EA. El modelo resumido permite detectar una gran cantidad de EA con un mínimo de elementos (AU)

Objective: To characterise the performance of the triggers used in the detection of adverse events (AE) of hospitalised adult patients and to define a simplified panel of triggers to facilitate the detection of AE. Method: Cross-sectional study of charts of patients from a service of internal medicine to detect EA through systematic review of the charts and identification of triggers (clinical event often related to AE), determining if there was AE as the context in which it appeared the trigger. Once the EA was detected, we proceeded to the characterization of the triggers that detected it. Logistic regression was applied to select the triggers with greater AE detection capability. Results: A total of 291 charts were reviewed, with a total of 562 triggers in 103 patients, of which 163 were involved in detecting an AE. The triggers that detected the most AE were 'A.1. Pressure ulcer' (9.82%), 'B.5. Laxative or enema' (8.59%), 'A.8. Agitation' (8.59%), 'A.9. Over-sedation' (7.98%), 'A.7. Haemorrhage' (6.75%) and 'B.4. Antipsychotic' (6.75%). A simplified model was obtained using logistic regression, and included the variable 'Number of drugs' and the triggers 'Over-sedation', 'Urinary catheterisation', 'Readmission in 30 days', 'Laxative or enema' and 'Abrupt medication stop'. This model showed a probability of 81% to correctly classify charts with EA or without EA (p <0.001; 95% confidence interval: 0.763-0.871). Conclusions: A high number of triggers were associated with AE. The summary model is capable of detecting a large amount of AE, with a minimum of elements (AU)