Assessment of Pain and Satisfaction After Orofacial Harmonization Procedures.

AIMS: This long-term study assessed satisfaction and pain levels following facial aesthetic procedures. The study also aimed to correlate expectations, and psychological and social well-being immediately and after one month, describe perceived age, and assess differences in satisfaction between injectable fillers and other Orofacial Harmonization procedures such as hyaluronic acid treatments (for dark circles, nasolabial fold lips, malar, jaw), botulinum toxin injections, enzymatic lipolysis of the double chin, micro-needling, and PDO threads. METHODS: Data were collected immediately after the procedures and then again 30 days later. Among the participants, 159 (92.4%) were females and 13 (7.6%) were males, who completed FACE-Q questionnaires addressing perceived age, expectations, psychological and social well-being, satisfaction, and facial appearance, as well as the visual pain scale. RESULTS: The average age of the patients treated in the Dental Clinics in Brazil was 40.4 years (SD± 12.7), with 48.8% of participants perceiving themselves as older immediately after the procedures, decreasing to 47.7% after 30 days, and pain intensity was reported as low. The total number of Orofacial Harmonization procedures performed was 256. Satisfaction after 30 days was high, especially among those who received fillers. The psychological and social function scales were positively correlated with satisfaction with the decision, result, and appearance scales. Fillers showed a significant improvement in perceived age appearance, with half of the patients feeling younger after 30 days. The patients exhibited high satisfaction levels in one-month post-aesthetic orofacial harmonization procedures. Despite initially high expectations, patients reported enhanced psychological and social well-being, along with minimal pain during interventions CONCLUSION: Positive correlations were observed between satisfaction, decision-making, result perception, and appearance. Injectable fillers notably improved perceived aging, with a significant portion of patients initially perceiving themselves as older than their actual age, but later feeling younger post-procedure. Fillers also yielded superior satisfaction and pain relief compared to alternative interventions. LEVEL OF EVIDENCE II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Postoperative Pain in Endodontically Treated Teeth: A Cross-sectional Study of Retrospective Data.

AIM: This study aimed to assess the occurrence of postoperative pain and associated factors in patients treated endodontically at a Postgraduate Center in Endodontics in Southern Brazil. MATERIALS AND METHODS: The evaluation was performed using the medical records of 658 patients. Pulp conditions, postoperative pain, pain intensity, edema, number of sessions (single or multiple), and medication administration in the postoperative period were analyzed. For data analysis, descriptive analyses and univariate and multiple regressions were performed. In the multiple analyses, odds ratios (OR) and their respective 95% confidence intervals were estimated, crude and adjusted for exposure variables in a binary logistic regression model (p-value < 0.05). RESULTS: To perform the adjusted logistic regression, all variables associated with p-value <0.10: gender, edema, and pulp condition (bio- and necropulpectomy) entered the crude model. After the multivariate analysis, a statistically significant association was found between the outcome variable of the presence of postoperative pain and the independent variable of pulp condition, and the presence of pain was associated with patients who underwent endodontics on teeth with live pulp and edema with greater chances of postoperative pain. CONCLUSION: It was concluded that the pulp condition and edema affected postoperative pain. CLINICAL SIGNIFICANCE: The occurrence of postoperative pain was around 30% in both single and multiple sessions, and it was considered relevant for the dental clinic. Pulp condition affected postoperative pain, and the presence of pain was associated with patients who underwent endodontics on teeth with live pulp.

Oral colonization by Candida spp. in liver transplant patients: Molecular identification and antifungal susceptibilityOral colonization by Candida spp. in liver transplant.

Candida species are commensal to normal oral microbiota; however, they can cause infections if immune functions are reduced. The aim of this study was to investigate oral colonization, identify species, and test the susceptibility profile to antifungals. A descriptive study included 97 liver transplant patients who attended the transplant center of a referral hospital in southern Brazil. Two oral swab collections were performed, with a 6-month gap between collections. The samples were identified by sequencing the internal transcribed spacer ITS region of the ribosomal DNA. The sensitivity test was performed with fluconazole, amphotericin B, and micafungin using a broth microdilution method recommended by Clinical and Laboratory Standards Institute document M27-A4. Eighty-two patients were investigated and 15 were excluded for presenting clinical infection. The identification of yeasts showed colonization in 66% and 61.9% in collections A and B, respectively. Candida albicans was the most prevalent species in both collections (n = 29/50 and n = 27/49, respectively). In 31 (62%) patients, the yeast species remained the same for 6 months, and in 19 (38%) the colonizing species was substituted. Thirty-two isolates from collection A were sensitive (S) to Fluconazole, 13 sensitive dose-dependent (SDD), and five resistant (R). In collection B, 32 were S, 12 SDD, and 5 R. For amphotericin B and micafungin, all isolates were sensitive. With knowledge of the species and identification of strains resistant to fluconazole, useful information can be alerts about the emergence of antifungal resistance strains. LAY SUMMARY: Study of great importance because it is the first investigation that identifies Candida in the oral cavity of liver transplant patients, allowing an understanding of epidemiology and contributing to the knowledge about strains resistant to fluconazole.

Assessment of Apical Extrusion using Rotary and Reciprocating Systems during Root Canal Retreatment.

AIM: The objective of this study was to assess apical extrusion after filling material removal using two systems, one rotary and one reciprocating. MATERIALS AND METHODS: A total of 34 extracted mandibular premolars with single roots were selected and, posteriorly, prepared and filled. Following material aging for 60 days, teeth were divided into two groups, according to the method used to remove root filling material: group I, ProTaper® Universal Retreatment instruments plus refining with the Hero 642® sequence and group II, WaveOne® instruments. The teeth were fixed in an apparatus designed to collect the extruded material during removal procedure. Data on the amount of debris extruded (mg/weight) were analyzed using the Student's t test with a significance level of 5%. RESULTS: No significant differences were found between the groups with regard to the amount of material extruded during root canal retreatment. CONCLUSION: The present findings suggest that the extrusion of debris during apical root canal retreatment does not depend on the instrument design or the protocol employed. CLINICAL SIGNIFICANCE: Regardless of root canal clearance techniques, debris extrusion eventually occurs during endodontic retreatment and may be related to postoperative pain.

Emotional, physical and sexual violence against female students undergoing medical, dental and psychology courses in South Brazil.

Violence against women is a hot topic in the spotlight of contemporary science. In the academy, most of the courses are structured in a hierarchical system, in which students-especially female-become potentially vulnerable to emotional, physical and even sexual harm. This study aimed to describe the prevalence and the study-associated factors of emotional, physical and sexual violence against female students in medical, dental and psychological courses in South Brazil. A questionnaire-based survey was performed combining two previously validated tools for the investigation of workplace violence. The questionnaires were digitally provided to women undergoing medicine, dentistry and psychology courses in South Brazil. The study was conducted between April and July, 2018. The final sample consisted of 241 students (57 medical students; 91 dental students and 93 psychology students). Reports of general violence reached a prevalence rate of 45.2%. In particular, emotional violence reached 78.9% of the cases, whilst physical and sexual violence reached 4.6% and 8.3%, respectively. Amongst the identified offenders, professors figured as the most prevalent (18.4%). Alarming rates of violence against women were detected in this study. Institutional preventive strategies must be designed to protect female students in their study/workplace and enable a safe routine of academic activities.

Implementation of dental specialty centers: a descriptive analysis of the current status in the Brazilian territory.

This study aimed to assess the current implementation status of Dental Specialty Centers (Centros de Especialidades Odontológicas - CEO) in Brazil. The sample included CEOs implemented up to November 2015 in the 27 Brazilian federative units. Data were obtained directly from the database of the Informatics Department of the Brazilian Unified Health System, according to the National Registry of Health Facilities (NRHF) of Dental Specialty Centers of all Brazilian regions. Primary care data were also collected from the cities with implemented CEOs, including coverage status of the Family Health Strategy (FHS) and number of Oral Health Teams (OHT) I and II, at 2 collection periods (January 2006 and November 2015). There were 1019 CEOs implemented in Brazil, which were unequally distributed among the Brazilian states, with prevalence of implementation of CEOs type II (n=503, 49.4%). The statistical analysis showed significant difference between the three types of CEO (I, II, and III) and the variables of coverage rate (FHS) and number of teams (OHT I, OHT II) at both data collection periods. Although presenting an evolutionary aspect in the implementation of CEOs, the implementation of medium-complexity care in Brazil is disorganized.

Identification and management of elder physical abuse in the routine of dentistry - a systematic review.

OBJECTIVE: To perform a systematic search in the literature in order to verify whether the dentists are able to identify and manage cases elder physical abuse. BACKGROUND: Dentists may play an important legal role contributing to the management of abused patients through the identification of injuries in their face, head and neck. MATERIALS AND METHODS: The present systematic review was performed following the PRISMA Statement and was registered in the PROSPERO database. A search was conducted in the following electronic databases: PubMed, LILACS, SciELO, Embase, Web of Science, OpenGrey, Google Scholar. Specifically, the last two databases were used to search the 'grey literature'. The research question was based on the PVO strategy for systematic exploratory review. Two examiners determined the eligibility criteria for selecting the studies and performed all the research steps. RESULTS: The initial search resulted in 842 studies, from which eight were considered eligible. Six studies used questionnaires to assess the perception, knowledge and attitudes of dentists towards the identification and management of cases of elder abuse, while two studies assessed this information through personal interviews. Two studies were rated as high quality, while six studies reached moderate quality. Male and female dentists were assessed separately in six studies. Only three studies specified the aggressor. CONCLUSION: The dentists revealed insufficient knowledge on elder abuse. Most of the dentists are not able to identify and manage these cases in the clinical routine.

Oral candidiasis in liver transplant patients: species identification and antifungal susceptibility profile.

OBJECTIVE: This study aimed to verify oral candidiasis, identify the causative species, and investigate the antifungal susceptibility of yeasts isolated from liver transplant patients. METHODS: A descriptive analysis of 97 patients who underwent liver transplantation was conducted at a hospital. Two clinical examinations (Collections A and B) of the oral cavity were performed. Oral material was collected from all patients, inoculated in Sabouraud Dextrose Agar, and incubated at 35℃ for 48 hours. Samples were identified by molecular sequencing of the internal trascribed space region of rDNA. RESULTS: An antifungal susceptibility test with fluconazole, amphotericin B, and micafungin was performed using the Clinical and Laboratory Standards Institute yeast broth microdilution method. Among the patients, 15 presented with oral candidiasis: eight in Collection A and seven in Collection B. The primary type of candidiasis was atrophic, followed by pseudomembranous candidiasis. The most prevalent species was Candida albicans (nine), followed by Candida glabrata (three), Candida tropicalis (two), and Candida dubliniensis (one). Regarding susceptibility to fluconazole, of the 15 samples, 11 were susceptible, three were susceptible in a dose-dependent manner, and one was resistant. CONCLUSION: The most commonly identified type of candidiasis was atrophic, with C. albicans and C. glabrata being the most prevalent causative species. One fluconazole-resistant isolate each of C. tropicalis and C. albicans were identified.

Is drug use associated with the presence of periodontitis and oral lesions? A meta-analysis.

PURPOSE: This systematic review investigated whether drug use is associated with the presence of oral lesions and periodontitis. METHODS: A search was performed for studies that analyzed the presence of periodontitis and/or oral lesions in users of crack, cocaine, and/or marijuana in the PubMed, Scopus, and Web of Science databases. Observational studies in English, Spanish, or Portuguese, without limitation of year, age, and sex, were included. Studies that did not evaluate periodontitis and oral lesions according to the eligibility criteria were excluded. Two authors independently performed study selection and data extraction using a standardized form. The risk of bias of studies included in the meta-analysis was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. The meta-analysis included studies that investigated the association of drug use with the outcome. RESULTS: The initial search resulted in 9,279 articles, from which 16 studies with 15,434 participants were included in the review and 8 studies were included in the meta-analysis. Most studies that evaluated periodontitis in drug users and non-users found a positive association in users. Most studies that analyzed oral lesions reported a higher prevalence, association, or risk of oral lesions in drug users than in non-users. A critical evaluation identified a need to improve the control and reporting of confounding factors in studies on this topic. An association was found between periodontitis and the use of crack, cocaine, and/or marijuana (odds ratio [OR], 1.84; 95% confidence interval [CI], 1.04-3.27; P=0.04) and between oral lesions and the use of these drugs (OR, 2.13; 95% CI, 1.58-2.86; P<0.001). CONCLUSIONS: Drug users are more likely to develop oral lesions and periodontitis than non-users. However, the results should be interpreted with caution, considering the heterogeneity and quality of the studies included in the analysis.

Untreated caries and serum vitamin D levels in children and youth of the United States: NHANES 2013-2014.

This study aimed to investigate the association between serum vitamin D levels and untreated caries and determining factors in children and youth. METHODOLOGY: This cross-sectional study used data from the National Health and Nutrition Examination Survey (2013-2014). In total, 3,072 participants with ages ranging from 1 to 19 years were included in our sample. The main dependent variable, untreated caries, was defined as having at least one untreated carious surface in any tooth. Serum concentration of 25-hydroxyvitamin D [25(OH)D] was categorized into four groups: ≥75 nmol/ml, 50-74.9 nmol/ml, 25-49.9 nmol/ml, and <25 nmol/ml. Data were analyzed using a binary logistic regression. RESULTS: For children aged 1-5 years, age (OR = 1.68, 95% confidence intervals (95% CI) 1.38-2.04) and low levels of vitamin D (25-49.9 nmol/ml, and <25 nmol/ml: OR = 2.55, 95% CI 1.06-6.13) were associated with untreated caries. For children aged 6-11 years, low levels of vitamin D (50-74.9 nmol/ml: OR=1.45, 95% CI 1.16-1.82) remained associated with untreated caries. No associations were found in those between 12 and 19 years of age. CONCLUSION: Our findings show an association between low levels of 25(OH)D and untreated caries in children between 1 and 11 years of age, suggesting that this nutrient might interfere in the caries process.

Prevalence of dental implant positioning errors: A cross-sectional study.

Purpose: This study evaluated the prevalence of dental implant positioning errors and the most frequently affected oral regions. Materials and Methods: A sample was obtained of CBCT images of 590 dental implants from 230 individuals who underwent diagnosis at a radiology center using cone-beam computed tomography from 2017 to 2020. The following variables were considered: thread exposure, violation of the minimum distance between 2 adjacent implants and between the implant and tooth, and implant contact with anatomical structures. Descriptive data analysis and the Pearson chi-square test (P<0.05) were performed to compare findings according to mouth regions. Results: Most (74.4%) of the 590 implants were poorly positioned, with the posterior region of the maxilla being the region most frequently affected by errors. Among the variables analyzed, the most prevalent was thread exposure (54.7%), followed by implant contact with anatomical structures, violation of the recommended distance between 2 implants and violation of the recommended distance between the implant and teeth. Thread exposure was significantly associated with the anterior region of the mandible (P<0.05). The anterior region of the maxilla was associated with violation of the recommended tooth-implant distance (P<0.05) and the recommended distance between 2 adjacent implants (P<0.05). Implant contact with anatomical structures was significantly more likely to occur in the posterior region of the maxilla (P<0.05). Conclusion: Many implants were poorly positioned in the posterior region of the maxilla. Thread exposure was particularly frequent and was significantly associated with the anterior region of the mandible.

Prevalence of xerostomia and its association with systemic diseases and medications in the elderly: a cross-sectional study.

BACKGROUND: Dry mouth syndrome or xerostomia is defined as decreased salivary flow or hypofunction of salivary glands. Its origins are multicausal and might be the result of a change in the salivary glands or a systemic imbalance. OBJECTIVE: To ascertain the prevalence of self-reported xerostomia and to identify associated factors. DESIGN AND SETTING: Cross-sectional study on the entire population of 293 elderly people over 60 years of age living in a Brazilian municipality. METHODS: Data were gathered from a questionnaire that asked about demographic data, chronic diseases and use of continuous medications, and which used the Xerostomia Inventory (XI) to evaluate dry mouth sensation. Our analysis consisted of multivariate regression and estimation of odds ratios (OR) and their respective 95% confidence intervals (CI) in binary logistic regression models. RESULTS: The prevalence of self-reported xerostomia was 19.1%. Elderly people with diabetes had higher odds of having self-reported xerostomia (OR: 3.59; 95% CI: 1.48-8.68; P < 0.001) as did those who had chronic diseases and used continuous medication (OR: 2.3; 95% CI: 1.19-4.67; P = 0.009). Elderly people who used continuous medication for the gastrointestinal tract were more likely to have xerostomia (OR: 2.14; 95% CI: 1.03-1.44; P = 0.030). CONCLUSIONS: Elderly people with diabetes and chronic diseases who were using continuous medication were more likely to have dry mouth. Use of continuous medications for the gastrointestinal tract led to a greater chance of having self-reported xerostomia.

Emotional distress in patients with type 1 diabetes mellitus.

AIM: This study aimed to analyze the association between emotional distress and glycated hemoglobin (HbA1c) values in adolescents and young adults with type 1 diabetes mellitus (T1DM), with respect to dental anxiety, microvascular diabetes chronic complications, demographic conditions. METHOD: The cross-sectional study design included 100 adolescents and young adults with T1DM, from regional diabetes reference center. The clinical and laboratory data were obtained from medical records. Distress and dental anxiety scales were produced from questionnaires that were validated for emotional distress (DDS) and dental anxiety (Corah Scale). Multiple analyses estimated odds ratios and their respective 95% confidence intervals using a binary logistic regression model (P < .05). RESULTS: The mean participants age was 20.7 ± 5.5 years, and 52% were female. Of the patients, 19% presented with chronic microvascular diabetes complications (nephropathy, retinopathy, neuropathy). Regarding the distress scale, 53% of the patients presented with high DDS and 83% had little to slight anxiety with dental procedures. There were statistically significant differences when variables were adjusted in the model, such as that of microvascular diabetes chronic complications and female gender with emotional distress. CONCLUSIONS: Our results showed that female sex and microvascular diabetes chronic complications are associated with greater emotional distress in patients with T1DM.

Academic performance and use of psychoactive drugs among healthcare students at a university in southern Brazil: cross-sectional study.

BACKGROUND: People have been using psychoactive substances for a long time. Over the last few years, this practice has spread among university students, who use these substances to improve their academic performance, relieve stress and increase concentration and memory. OBJECTIVES: To estimate the use of psychoactive drugs among healthcare students at a higher education institution in the city of Passo Fundo (RS), Brazil, and to ascertain the associated demographic and lifestyle factors. DESIGN AND SETTING: Cross-sectional study in a higher education institution. METHODS: We included 287 undergraduate medicine and dentistry students in this study. They answered a self-administered questionnaire regarding sociodemographic, lifestyle and health variables. The statistical analysis used univariate and bivariate analyses with Pearson's chi-square test (P-value < 0.05). -Multivariate analyses were used to estimate odds ratios (OR) and their respective 95% confidence intervals. The SPSS software, version 20.0, was used. RESULTS: The prevalence of use of psychoactive substances among the students was 24.7%. Among these students, high frequencies of psychoactive drugs had been prescribed by physicians (95.8%) and for the purpose of relaxation or stress relief (73.2%). Women, medical students (compared with dental students) and participants with lower academic performance were more likely to use psychoactive drugs. After the multivariate adjustment, the "course" and "academic performance" remained associated with use of psychoactive drugs. CONCLUSION: There was high prevalence of psychoactive drug use among the students at the higher education institution investigated. Some variables (female sex, medical students and low academic performance) were associated with the outcome.

Prevalence of Oral Lesions Diagnosed at a Pathology Institute: A Four-year Analysis

Abstract Objective: To identify the most prevalent oral lesions based on reports from a pathology institute's reports and associations between malignant and oral potentially malignant disorders with patient's demographic variables and the anatomical location. Material and Methods: All 1,298 histopathological reports of oral lesions recorded in the database were reviewed. Demographic variables, anatomical location of the lesion, histopathological diagnosis of the lesions, and their biological behavior were analyzed. Results: Regarding the biological behavior of the identified lesions, benign lesions were predominant (70%), followed by lesions of undetermined behavior (14.3%), malignant lesions (14.2%), absence of histological alteration (1.2%), and finally, oral potentially malignant disorders (0.5%). The anatomical locations of the most prevalent oral lesions potentially malignant disorders and malignant were in the following structures of the oral cavity: gums, buccal mucosa, floor of the mouth and hard palate (p=49.2%), and tongue (p=48.7%). Conclusion: The probability of malignant and premalignant lesions was higher among males (PR= 4.21; 95% CI 2.08-6.22), the increase in age (PR = 1.06; 95% CI 1.05-1.08), and in the tongue region (PR = 5.48; 95% CI 1.67; 17.92). Identification of malignant and potentially malignant oral conditions is higher in older men and in tongue specimens.

Evaluation of anxiety levels and their characteristics in dental care: Cross-sectional study.

CONTEXT: Anxiety is defined as an emotion produced by a set of feelings and physical changes. Many patients are afraid of some procedures involved in dental therapy. AIM: The objective of this study was to verify the anxiety of patients regarding the visits to dental clinics of a higher education institution, as well as to observe the moment of greatest anxiety. SETTINGS AND DESIGN: It is a cross-sectional observational study including 94 patients from the dental clinics of an educational institution in a city of southern Brazil. MATERIALS AND METHODS: The Corah Dental Anxiety Scale, composed of four questions, was used to evaluate the dental anxiety levels of all patients. The sample universe included registered patients under treatment in the clinics of the studied institution, from August to November of 2016. We included only healthy patients over 18-year old who were subjected to surgical and nonsurgical procedures. STATISTICAL ANALYSIS: The data were analyzed through descriptive statistic to verify the frequency distribution of all variables. Pearson's Chi-square test, at 5% significance level and 95% confidence interval, was used to evaluate the association between the dependent variable (dental treatment anxiety) and the independent variables (demographics), aided by the SPSS software 20.0. Results: It was found that most of the participants were not anxious (69.1%) and the moment of greatest anxiety reported was before local anesthesia. In addition, statistics showed no correlation among gender, age group, and type of procedure performed. It was possible to conclude that the level of anxiety of the patients regarding the dental care performed in the clinics of the studied institution was low for both surgical and nonsurgical procedures. CONCLUSION: This survey revealed that the moment of greatest anxiety for the patients was before the anesthetic procedure, and gender, age, and type of procedure did not influence the level of anxiety felt by the patient.

Periodontal conditions in adolescents and young Brazilians and associated factors: Cross-sectional study with data from the Brazilian oral health survey, 2010.

BACKGROUND: Diseases of the gingival tissues are considered a global public health problem concern. These diseases show great differences in their distribution and prevalence in the different localities investigated. This study aimed to estimate the prevalence of the periodontal conditions of gingival bleeding and dental calculus in Brazilian adolescents and young people, as well as to verify the associated factors. MATERIALS AND METHODS: This is a cross-sectional population-based study that used secondary data from the National Oral Health Survey (SB Brazil 2010) performed by the Ministry of Health. This study assessed 7328 adolescents aged 12 years and 5445 young people aged 15-19 years. The characteristics of the periodontal conditions were obtained by the community periodontal index, which provided the outcome variables of gingival bleeding and dental calculus. The predictor variables were demographic, socioeconomic, and oral clinical data. RESULTS: The results showed a high prevalence of gingival bleeding (32%) and dental calculus (33.1%) in the individuals assessed. In addition, as observed after adjusting to the Poisson regression model, the variables of 12 years of age, no tooth loss, fewer household residents, >6 years of education, and no need for dental treatment were considered protective factors for gingival bleeding and dental calculus. CONCLUSIONS: The variables of nonwhite skin color, certain regions of the country, and low monthly household income were considered risk factors for the outcomes. Boys presented a higher prevalence of dental calculus than girls.

Quality of Prenatal Care in Brazil: National Health Research 2013. / Qualidade do Pré-Natal no Brasil: Pesquisa Nacional de Saúde 2013.

This study aimed to assess the adequacy of prenatal care in Brazil associated with sociodemographic determinants. The study included a data analysis from the National Health Research performed in Brazil in 2013. Two outcomes on the adequacy of prenatal care were assessed: the Kessner index modified by Takeda index that, in addition to the former, assessed whether blood pressure and weight were measured in all appointments, as well as the performance of blood and urine tests and ultrasound. Both quality indicators were assessed for Brazil and for its macro-regions. According to Outcome 1, 80.6% of women received adequate prenatal care. When adding the performance of tests (Outcome 2), the rate dropped to 71.4%. Adequate prenatal care was more frequent among white women who performed prenatal care in the private health sector. The northern region had the lowest rate of adequate prenatal care, while the southeast region showed the highest rates. Despite the extensive coverage, prenatal care in Brazil still presents inequities and low service quality, especially for women from the poorest regions of the country.

O objetivo deste estudo foi avaliar a adequação do cuidado pré-natal no Brasil associado a determinantes sociodemográficos. A pesquisa consistiu em uma análise dos dados da Pesquisa Nacional de Saúde realizada no Brasil em 2013. Foram avaliados dois desfechos sobre a adequação do pré-natal, o índice de Kessner modificado por Takeda que, além de levar em consideração esse índice, avaliou se houve aferição da pressão arterial e do peso em todas as consultas, realização de algum exame de sangue e urina e ultrassom. Ambos indicadores de qualidade foram avaliados para o Brasil e também pelas macrorregiões do país. De acordo com o desfecho 1, 80,6% das mulheres realizaram o pré-natal adequado. Ao adicionarmos a realização de exames (Desfecho 2) o percentual foi 71,4%. O pré-natal adequado foi mais frequente entre as mulheres de cor branca e que realizaram o pré-natal na rede privada. A região norte apresentou as menores frequências de pré-natal adequado, enquanto a região sudeste as maiores. Apesar da ampla cobertura, o pré-natal no Brasil ainda apresenta iniquidades e baixa qualidade no atendimento, especialmente entre mulheres das regiões mais pobre do país.

Oral candidiasis in liver transplant patients: species identification and antifungal susceptibility profile

ABSTRACT Objective This study aimed to verify oral candidiasis, identify the causative species, and investigate the antifungal susceptibility of yeasts isolated from liver transplant patients. Methods A descriptive analysis of 97 patients who underwent liver transplantation was conducted at a hospital. Two clinical examinations (Collections A and B) of the oral cavity were performed. Oral material was collected from all patients, inoculated in Sabouraud Dextrose Agar, and incubated at 35℃ for 48 hours. Samples were identified by molecular sequencing of the internal trascribed space region of rDNA. Results An antifungal susceptibility test with fluconazole, amphotericin B, and micafungin was performed using the Clinical and Laboratory Standards Institute yeast broth microdilution method. Among the patients, 15 presented with oral candidiasis: eight in Collection A and seven in Collection B. The primary type of candidiasis was atrophic, followed by pseudomembranous candidiasis. The most prevalent species was Candida albicans (nine), followed by Candida glabrata (three), Candida tropicalis (two), and Candida dubliniensis (one). Regarding susceptibility to fluconazole, of the 15 samples, 11 were susceptible, three were susceptible in a dose-dependent manner, and one was resistant. Conclusion The most commonly identified type of candidiasis was atrophic, with C. albicans and C. glabrata being the most prevalent causative species. One fluconazole-resistant isolate each of C. tropicalis and C. albicans were identified.

Untreated caries and serum vitamin D levels in children and youth of the United States: NHANES 2013-2014

Abstract This study aimed to investigate the association between serum vitamin D levels and untreated caries and determining factors in children and youth. Methodology: This cross-sectional study used data from the National Health and Nutrition Examination Survey (2013-2014). In total, 3,072 participants with ages ranging from 1 to 19 years were included in our sample. The main dependent variable, untreated caries, was defined as having at least one untreated carious surface in any tooth. Serum concentration of 25-hydroxyvitamin D [25(OH)D] was categorized into four groups: ≥75 nmol/ml, 50-74.9 nmol/ml, 25-49.9 nmol/ml, and <25 nmol/ml. Data were analyzed using a binary logistic regression. Results: For children aged 1-5 years, age (OR = 1.68, 95% confidence intervals (95% CI) 1.38-2.04) and low levels of vitamin D (25-49.9 nmol/ml, and <25 nmol/ml: OR = 2.55, 95% CI 1.06-6.13) were associated with untreated caries. For children aged 6-11 years, low levels of vitamin D (50-74.9 nmol/ml: OR=1.45, 95% CI 1.16-1.82) remained associated with untreated caries. No associations were found in those between 12 and 19 years of age. Conclusion: Our findings show an association between low levels of 25(OH)D and untreated caries in children between 1 and 11 years of age, suggesting that this nutrient might interfere in the caries process.

Resumo Este estudo teve como objetivo investigar a associação entre os níveis séricos de vitamina D e cárie dentária não-tratada e fatores determinantes em crianças e jovens. Metodologia: Este estudo transversal utilizou dados da Pesquisa Nacional de Saúde e Nutrição (2013-2014). No total, 3.072 participantes com idades entre 1 e 19 anos foram incluídos em nossa amostra. A principal variável dependente, cárie não-tratada, foi definida como pelo menos uma superfície de cárie não-tratada em qualquer dente. A concentração sérica de 25-hidroxivitamina D [25(OH)D] foi categorizada em quatro grupos: ≥75 nmol/ml, 50-74,9 nmol/ml, 25-49,9 nmol/ml e <25 nmol/ml. Os dados foram analisados ​​por meio de regressão logística binária. Resultados: Para crianças de 1 a 5 anos, idade (OR = 1,68, intervalo de confiança de 95% (IC 95%) 1,38 a 2,04) e baixos níveis de vitamina D (25 a 49,9 nmol/ml e <25 nmol/ml: OR = 2,55, IC 95% 1,06-6,13) foram associados a cárie não-tratada. Para crianças de 6 a 11 anos, baixos níveis de vitamina D (50 a 74,9 nmol/ml: OR = 1,45, IC 95% 1,16 a 1,82) permaneceram associados à cárie não-tratada. Não foram encontradas associações naqueles entre 12 e 19 anos de idade. Conclusão: Nossos achados mostram uma associação entre baixos níveis de 25(OH)D e cárie não-tratada em crianças de 1 a 11 anos, sugerindo que este nutriente pode interferir no processo da cárie dentária .