Efficacy of antibiotic prophylaxis to preventing brucellosis in accidental exposure: A systematic review.

BACKGROUND: Antibiotic prophylaxis to prevent brucellosis after accidental exposure to Brucella is an important topic in public health. This study aimed to systematically review the efficacy of antibiotic prophylaxis following accidental exposure to Brucella in preventing human brucellosis disease. METHODS: The study protocol was registered in PROSPERO (CRD42023456812). The outcomes included the incidence of brucellosis disease, adverse events rate, and antibiotic prophylaxis adherence. A comprehensive literature search, conducted until 20 November, 2023, involved Medline, Embase, Cochrane Library, and LILACS databases. Descriptive analysis and meta-analysis using R software were performed, risk of bias was assessed using JBI Critical appraisal tools, and certainty of evidence was assessed using the GRADE tool. RESULTS: Among 3102 initially identified records, eight studies involving 97 individuals accidentally exposed, all focused on high-risk accidental exposure to Brucella in laboratory settings, were included in the review. All studies reported the prophylactic treatment comprising doxycycline at a dosage of 100 mg twice daily, combined with rifampicin at 600 mg, both administered over 21 days. Prophylaxis adherence was reported in 86% of cases, and incidence of brucellosis post-treatment was 0.01. Adverse events, mainly gastrointestinal, occurred in 26% of cases. Critical appraisal revealed limitations in reporting demographics and clinical information. The certainty of evidence was rated as 'very low,' emphasising the need for caution in interpreting the observed outcomes due to study design constraints and the absence of comparative groups. CONCLUSIONS: PEP is an alternative practice reported in the literature, used in accidents with high-risk exposure to Brucella. The currently available evidence of the efficacy of antibiotic prophylaxis is insufficient to support a recommendation for or against the widespread use of antibiotic prophylaxis, so caution is needed in interpreting results due to the very low certainty of evidence, primarily stemming from case series and lack of comparative groups.

Efficacy and safety of therapeutic strategies for human brucellosis: A systematic review and network meta-analysis.

BACKGROUND: Human brucellosis is a neglected, re-emerging, and endemic zoonosis in many countries. The debilitating and disabling potential of the disease is a warning about its morbidity, generating socioeconomic impact. This review aims to update the current evidence on the efficacy and safety of therapeutic options for human brucellosis using the network meta-analysis (NMA). METHODOLOGY: A systematic search was conducted in four different databases by independent reviewers to assess overall therapy failure, adverse events, and time to defervescence associated with different therapies. Randomized clinical trials (RCTs) evaluating any therapeutic drug intervention were selected, excluding non-original studies or studies related to localized forms of the disease or with less than 10 participants. Data were analyzed by frequentist statistics through NMA by random effects model. The risk of bias and certainty of evidence was assessed, this review was registered at PROSPERO. RESULTS: Thirty-one (31) RCTs involving 4167 patients were included. Three networks of evidence were identified to evaluate the outcomes of interest. Triple therapy with doxycycline + streptomycin + hydroxychloroquine for 42 days (RR: 0.08; CI 95% 0.01-0.76) had a lower failure risk than the doxycycline + streptomycin regimen. Doxycycline + rifampicin had a higher risk of failure than doxycycline + streptomycin (RR: 1.96; CI 95% 1.27-3.01). No significant difference was observed between the regimens when analyzing the incidence of adverse events and time to defervescence. In general, most studies had a high risk of bias, and the results had a very low certainty of evidence. CONCLUSIONS: This review confirmed the superiority of drugs already indicated for treating human brucellosis, such as the combination of doxycycline and aminoglycosides. The association of hydroxychloroquine to the dual regimen was identified as a potential strategy to prevent overall therapy failure, which is subject to confirmation in future studies.

Complementary and alternative therapies for managing postoperative pain after lower third molar surgery: a systematic review and network meta-analysis.

OBJECTIVE: The objective of this study was to evaluate the impact of complementary and alternative treatments on postoperative pain following lower third molar surgeries. METHODS: A comprehensive search of Electronic databases (Embase, MEDLINE via PubMed, and Cochrane Library) and grey literature was conducted up until May 2022. Randomized clinical trials investigating the effect of acupuncture, ozone therapy, laser (LLLT), drainage tube, kinesio-taping, ice therapy, and compressions on pain after LTM surgeries were included. The estimated mean differences (MD) for alternative therapies were pooled using the frequentist approach to random-model network meta-analysis NMA. RESULTS: Eighty-two papers were included in the qualitative analysis; 33 of them were included in the quantitative analyzes. NMA revealed that drainage tube and kinesio-taping were superior in controlling pain 24-hours postoperatively than no-treatment. At 48-hours follow-up, kinesio-taping and LLLT more effective than placebo and drainage tube; and kinesio-taping and LLLT were superior to no treatment. At 72 h postoperatively, ozone therapy was superior to placebo; and drainage tube, kinesio-taping, and LLLT were better than no treatment. At 7-days follow-up, ozone and LLLT were superior to placebo; and LLLT and kinesio-taping were superior to no treatment. The SUCRA-ranking placed drainage tube as top-ranking intervention at 48-hours (98.2%) and 72-hours (96%) follow-ups, and ozone (83.5%) at 7-days follow-up. CONCLUSION: The study findings suggest that these alternative and complementary therapies may be useful in reducing postoperative pain after LTM surgeries, and may offer advantages when combined to traditional pain management methods. CLINICAL RELEVANCE: Non-pharmacological therapies are gaining popularity among healthcare professionals and patients. This study found that some of these therapies, specifically kinesio-taping and drainage tube were effective in controlling postoperative pain after third molar surgeries. These findings have important implications for clinical practice, as they highlight the potential benefits of incorporating these therapies into postoperative pain management plans.

Quality of life of patients with cutaneous leishmaniasis: A comparative analysis of the EQ-5D-3L and CLIQ questionnaires.

PURPOSE: To evaluate the performance of the Cutaneous Leishmaniasis Impact Questionnaire (CLIQ) using the EuroQol-5 Dimension (EQ-5D-3L) as a reference standard (criterion validation); to evaluate the responsiveness of the instruments and estimate a cut-off point for the CLIQ to be able to discriminate between high and low impacts of cutaneous leishmaniasis on patients. METHODS: Between 2020 and 2022, a longitudinal validation study was conducted at a reference centre for leishmaniasis in Brazil. The EQ-5D-3L and CLIQ questionnaires were administered before, during and after treatment for cutaneous leishmaniasis. The correlation between the instruments was assessed using Spearman's correlation coefficient, responsiveness was assessed using the Wilcoxon test, and CLIQ cut-off points were proposed based on results of the EQ-5Q-3L, dichotomized between patients reporting no problems' and 'some or extreme problems'. RESULTS: There were satisfactory correlation coefficients between the two instruments before (-0.596) and during treatment (-0.551) and a low correlation between the instruments after the end of treatment (-0.389). In general, the responsiveness of the instruments was satisfactory. The CLIC scores that maximized sensitivity and specificity for recognizing impaired health status before and during treatment were 7 points and 17 points, respectively. However, at the end of treatment, based on the results for the EQ-5D-3L, the CLIC was not able to discriminate between individuals with high and low impacts of the disease. CONCLUSION: The CLIQ corresponds well with the EQ-5D-3L when applied before and during treatment but does not seem to be appropriate for follow-up evaluations after the end of treatment.

Comparison of suture and sutureless techniques on postoperative complications after third molar surgery: a systematic review.

OBJECTIVE: To compare, among patients undergoing third molar surgeries, whether the use or omission of sutures improves postoperative clinical parameters. METHOD: A systematic literature review was conducted to identify randomized clinical trials in humans. The steps of this review were conducted following the PRISMA protocol. The risk of bias assessment was performed using the revised Cochrane tool (RoB 2). The RevMan software was employed for meta-analyses, and the quality of evidence was evaluated using GRADE. RESULT: A total of seven articles were included in the systematic review; however, only one article quantitatively measured bleeding, rendering meta-analysis for this outcome unfeasible. The group of patients in whom sutures were not used presented lower pain and edema on the first day (respectively: MD - 1.08; 95% CI - 1.35 to - 0.81; MD - 1.23; 95% CI - 2.34 to - 0.11) and second day (respectively: MD - 0.50; 95% CI - 0.83 to - 0.17; MD - 10.66; 95% CI - 1.16 to - 0.16) postoperatively, compared to the group where sutures were employed. The group of patients who received sutures exhibited increased trismus on the first day postoperatively (MD 1.04; 95% CI 0.67 to 1.41). CONCLUSION: The omission of postoperative sutures in third molar surgeries appears to favor pain and edema outcomes within the first 24 h after the procedure, as well as trismus within the same timeframe. CLINICAL RELEVANCE: Despite the suture being the standard conduct in tooth extractions. The omission of sutures in third molar extractions may favor inflammatory outcomes of pain, edema, and trismus in the immediate postoperative period.

Does cyanoacrylate have the best postoperative outcomes after third molar extractions when compared to conventional sutures? A systematic review and meta-analysis.

Purpose: Tissue synthesis is extremely important for the attenuation of postoperative discomforts, as it keeps the tissues coapted, accelerates the healing process, and reduces the bleeding period of the surgical wound. Thus, this study aimed to systematically review the results of clinical trials that compared the use of cyanoacrylate with conventional sutures after third molars extraction. Materials and methods: Searches were conducted on MEDLINE (via PubMed), Cochrane Central Registry of Controlled Trials (CENTRAL), Virtual Health Library (VHL), and Web of Science. Articles published up to February 20, 2022, were included. No restrictions were imposed on data or language of publication. Results: A total of 8 studies (5 randomized controlled trials and 3 non-randomized comparative clinical studies) were included in this review and five studies were included in the meta-analysis, comprising 440 patients. The use of cyanoacrylate promoted better results in pain reduction in the first postoperative day when compared to the use of conventional suture (SMD: -1.01; 95%CI -1.90 to -0.12). Cyanoacrylate group promoted significant but borderline edema reduction compared to conventional sutures in the 7th postoperative day (SMD: -0.24, 95%CI -0.46 to -0.01, I2 = 0 %). For the trismus outcome, in all periods evaluated no differences were found between the groups. Conclusion: Although promising results, there is no high-quality evidence to suggest the use of cyanoacrylate was better than conventional sutures.

Erich arch bars vs intermaxillary fixation screws for mandibular fracture reduction during ORIF: a randomized clinical trial.

OBJECTIVE: This randomized clinical trial aimed to compare the efficacy of Erich arch bars (EAB) and intermaxillary fixation (IMF) screws in reducing mandibular fractures during open reduction and internal fixation (ORIF). METHODS: A total of 28 patients with mandibular fractures were randomly allocated to either the EAB group or the IMF screws group. The study evaluated various parameters including occlusal stability, complications, duration of application, oral hygiene status, quality of life, and patient characteristics. RESULTS: The study found no significant differences in occlusal stability between the EAB and IMF screw groups. However, the application and removal times were longer for EAB compared to IMF screws. The EAB group showed a higher presence of biofilm on teeth, indicating poorer oral hygiene status compared to the IMF screws group. In terms of quality of life, patients in the EAB group reported worse results in the "handicap" domain at the 15th postoperative day. No significant differences were observed in other quality-of-life parameters. Patient characteristics were well distributed between the two groups, enhancing the reliability of the results. CONCLUSION: Both EAB and IMF screws demonstrated comparable occlusal stability for minimally displaced mandibular fractures. However, IMF screws offered advantages such as shorter application and removal times, better oral hygiene maintenance, and potentially improved quality of life in the "handicap" domain. Further studies with larger sample sizes are necessary to validate these findings and explore the stability of IMF methods in cases requiring postoperative malocclusion correction or prolonged IMF.

Top 100 Most-Cited Articles on Mandibular Fractures: A Bibliometric Analysis.

PURPOSE: This study aimed to compile a list of the 100 most cited articles on mandibular fractures and to glean key insights from these articles via a bibliometric analysis. METHODS: This bibliometric analysis was performed using the Web of Science Core Collection database. The search was performed through January 2022. The bibliometric parameters extracted included title, number of citations, citation density (number of citations per year), first author's country, year of publication, study design, and subject. The software program VOSviewer was used to create graphical bibliometric maps. RESULTS: The articles were ranked by the total number of citations, which ranged from 64 to 374, with 32 articles being cited more than 100 times. The included articles were published from 1952 to 2015, mainly in maxillofacial surgery journals. The most frequent of these were the Journal of Oral and Maxillofacial Surgery (54%) and the International Journal of Oral and Maxillofacial Surgery (14%). The studies were from 29 different countries, with the United States of America (42%) contributing substantially more than others, with the next ranked nation being Germany (9%). The most frequently used keywords were osteosynthesis (25), open reduction (18), and fixation (16). CONCLUSIONS: The country that contributed most to mandibular fracture research was the United States of America. This conclusion was based on the number of published articles by nation of origin and the origin of the Journal of Oral and Maxillofacial Surgery, in which the majority were published. Osteosynthesis was the most cited field of research among the articles in the sample set.

Oral and maxillofacial trauma in women assaulted by men: Systematic review and meta-analysis.

BACKGROUND: Violence against women represents an urgent public health problem and has been an increasingly important topic in society's discussions and concerns. Although studies report a high prevalence of injuries to the face and head of women victims of intentional violence, this physical damage has never been investigated by grouped studies. Thus, the objective of this systematic review was to research the characteristics and the overall prevalence of oral-maxillofacial trauma in women victims of physical violence caused by men. METHODS: Searches were carried out on Medline (via PubMed) and Lilacs (via Virtual Health Library) and on gray literature until June 16, 2020 (updated on February 12, 2021) without restriction on the year of publication or language. RESULTS: A total of 27 studies involving 9,318 women victims of aggression by men and 3,738 oral-maxillofacial traumas were included. The prevalence of oral-maxillofacial trauma among all injuries in women was 51% (95% CI 28% - 74%). There was no significant difference in the chance of occurrence between soft tissue injuries (bruises, lacerations, abrasions, edema, erythema, and epistaxis) and hard tissue injuries (OR: 1.44, 95% CI: 0.43 - 4.80). The relationship between the victims and the aggressors was mainly that of intimate partners and relatives. CONCLUSIONS: These results highlight the need for political and ethical reflection to prevent oral-maxillofacial trauma and ensure women's health and human rights.

Association between asthma and oral conditions in children and adolescents: a systematic review with meta-analysis.

OBJECTIVE: To investigate the association between asthma and oral conditions in children and adolescents. MATERIAL AND METHODS: Observational studies that evaluated the association between asthma and oral conditions in children and/or adolescents were retrieved from five databases, grey literature and reference lists up to April 7th, 2022. Meta-analyses were performed, and I2 statistics were calculated. The mean difference was used as a measure of effect for continuous variables. Event frequencies were evaluated to determine odds ratios for dichotomous variables. Publication bias was investigated using Egger's test. The methodological quality (JBI) and certainty of the evidence (GRADE) were assessed. RESULTS: Forty-two studies were eligible, and sixteen were included in the meta-analysis. Mean dmft (MD: 1.11, 95%CI: 0.48-1.73), DMFT (MD: 1.01, 95% CI: 0.45-1.56), dmfs (MD: 3.62, 95%CI: 2.60-4.63) and DMFS (MD: 4.47, 95%CI: 0.98-7.96) indices were significantly higher in asthmatic children and adolescents compared to those without asthma. In the analysis of biofilm, asthmatic children and adolescents had a higher Plaque Index compared to those without asthma (MD: 0.18, 95%CI: 0.03-0.33). CONCLUSION: Asthmatic children and adolescents may be more likely to develop tooth decay and build up biofilm compared to those without asthma. It is suggested that there are no differences between asthmatic and non-asthmatic children and adolescents regarding gingivitis, developmental defects of enamel or erosive tooth wear. The certainty of the evidence was classified as 'very low'. CLINICAL RELEVANCE: Knowledge of the risks that asthma and asthma medications for oral health can assist in counselling families of children and adolescents with this condition in terms of control and prevention measures for oral problems.

Does watching an informative video reduce the anxiety in patients undergoing third molar surgery: a systematic review of randomized controlled trials.

PURPOSE: Dental anxiety (DA) is characterized by the expression of tension, stress, apprehension, irritation, anger, and frustration experienced by patients during dental appointment. The objective of this study was to systematically review the literature to assess the effectiveness of the use of informative videos in reducing DA in patients undergoing 3 M surgeries. METHODS: Searches were carried out on MEDLINE (via PubMed), the Cochrane Central Registry of Controlled Trials (CENTRAL), the Virtual Health Library (VHL), and the Web of Science. Articles published until November 20, 2021, were included. There were no restrictions on the data or language of publication. RESULTS: A total of 9 randomized clinical trials were included in this review, and five studies were included in the meta-analysis, comprising 529 patients. There was no significant difference in DA between the groups in the baseline when it was evaluated by any of the tools, indicating sample balancing at the beginning of the study. After intervention (video vs. verbal and/or written orientation) in the preoperative period, DA was assessed again; however, there was no difference in DA between the groups when assessed by the MDAS or STAI-S tools. After 3 M removals, the DA was still not significantly different between the groups when measured by the different considered tools. CONCLUSION: Informative videos addressing 3 M removal surgeries used in the preoperative period did not show an influence on the reduction of pre- and postoperative DA when compared to the verbal and/or written informative presentation.

Associação entre a via de parto e o perfil obstétrico de parturientes / Association between the birth route and the obstetric profile of pregnant women / Asociación entre la ruta de nacimiento y el perfil obstétrico de las mujeres embarazadas

Objetivo: Verificar a associação entre via de parto e perfil obstétrico das parturientes atendidas em uma unidade hospitalar referência em ginecologia e obstetrícia. Métodos: Estudo transversal, exploratório e descritivo, com dados secundários provenientes dos livros de registros de partos realizados em um hospital referência para os municípios do alto Vale do Jequitinhonha, Minas Gerais, no ano de 2017. Foram realizadas análises descritiva e inferencial. Resultados: Dos 1326 partos registrados, 740 (55,8%) foram por via vaginal e 586 (44,2%) por via cesárea. Houve maior prevalência de partos vaginais entre as parturientes assistidas pelo Sistema Único de Saúde (SUS) quando comparado àquelas assistidas por convênio particular (p<0,001). A prevalência de partos cirúrgicos foi maior entre mulheres com idade superior a 30 anos (p<0,001) e entre gestantes de alto risco (p<0,006). Dos partos vaginais, 364 (49,2%) foram na posição semi-sentada e realizaram-se episiotomias em 124 (16,8%) parturientes. Houve maior prevalência de cesariana entre recémnascidos com peso superior a 4000g (p=0,001) e maior prevalência de parto vaginal entre recém-nascidos com peso entre 2500 a 2999 g (p=0,001). Conclusão: Condições materno-infantis influenciaram significativamente a via de parto entre as mulheres incluídas neste estudo. (AU)

Objective: To verify the association between the mode of delivery and the obstetric profile of the parturients attended at a hospital that is a reference in gynecology and obstetrics. Methods: Cross-sectional, exploratory and descriptive study, with secondary data from the records of births performed in a reference hospital for the municipalities of the upper Vale do Jequitinhonha, Minas Gerais, in 2017. Descriptive and inferential analyzes were performed. Results: Of the 1326 registered births, 740 (55.8%) were vaginal and 586 (44.2%) cesarean sections. There was a higher prevalence of vaginal births among women assisted by the Unified Health System (SUS) when compared to those assisted by private agreement (p<0.001). The prevalence of surgical deliveries was higher among women over 30 years of age (p<0.001) and among high-risk pregnant women (p<0.006). Of vaginal deliveries, 364 (49.2%) were in the semi-sitting position and episiotomies were performed in 124 (16.8%) pregnant women. There was a higher prevalence of cesarean section among newborns weighing more than 4000g (p=0.001) and a higher prevalence of vaginal delivery among newborns weighing between 2500 and 2999 g (p=0.001). Conclusion: Maternal and childbirth conditions significantly influenced the birth route among the women included in this study. (AU)

Objectivo: Verificar la asociación entre el modo de parto y el perfil obstétrico de las parturientas atendidas en un hospital de referencia en ginecología y obstetricia. Métodos: Estudio transversal, exploratorio y descriptivo, con datos secundarios de los registros de nacimientos realizados en un hospital de referencia para los municipios del alto Vale do Jequitinhonha, Minas Gerais, en 2017. Se realizaron análisis descriptivos e inferenciales. Resultados: De los 1326 partos registrados, 740 (55,8%) fueron vaginales y 586 (44,2%) cesáreas. Hubo una mayor prevalencia de los partos vaginales entre las mujeres asistidas por el Sistema Único de Salud (SUS) en comparación con las asistidas por acuerdo privado (p<0,001). La prevalencia de los partos quirúrgicos fue mayor entre las mujeres de más de 30 años de edad (p<0,001) y entre las embarazadas de alto riesgo (p<0,006). De los partos vaginales, 364 (49,2%) se produjeron en posición semisentada y se realizaron episiotomías en 124 (16,8%) mujeres embarazadas. Hubo una mayor prevalencia de la cesárea entre los recién nacidos que pesaban más de 4000 g (p=0,001) y una mayor prevalencia del parto vaginal entre los recién nacidos que pesaban entre 2500 y 2999 g (p=0,001). Conclusión: Las condiciones de la maternidad y el parto influyeron significativamente en la ruta de nacimiento de las mujeres incluidas en este estudio. (AU)

Gestação de alto risco: perfil epidemiológico e fatores associados com o encaminhamento para serviço especializado / Embarazo de alto riesgo: perfil epidemiológico y factores asociados a la referencia a servicio especializado / High risk pregnancy: epidemiological profile and factors associated with referral to specialized servisse

Objetivo: Verificar o perfil epidemiológico das gestantes e os fatores associados com o encaminhamento de gestantes para um serviço especializado. Método: Estudo transversal retrospectivo, realizado nos prontuários de gestantes classificadas em alto risco, período de janeiro a dezembro de 2019. Realizou-se análise descritiva, bivariada e multivariada. Resultados: Dos 405 prontuários, a média de idade foi 29 anos, 19% eram hipertensas crônicas,14,2% desenvolveram diabetes gestacional. A diferença média entre a data da primeira consulta e a data do encaminhamento pela atenção primária foi de 4 semanas. A regressão logística mostrou que: gestantes de outros municípios, com baixa renda econômica e diferença no tempo de encaminhamento possuem interferência no início do pré-natal. Conclusão: As análises realizadas poderão contribuir para a elaboração de políticas intersetoriais em busca da promoção da saúdede gestantes.

Objective: To verify the epidemiological profile of pregnant women and the factors associated with referring pregnant women to a specialized service. Method: Retrospective cross-sectional study, carried out on the medical records of pregnant women classified as high risk, from January to December 2019. A descriptive, bivariate and multivariate analysis was performed. Results: Of the 405 medical records, mean age was 29 years, 19% were chronic hypertensive patients, 14.2% developed gestational diabetes. The average difference between the date of the first consultation and the date of referral by primary care was 4 weeks. The logistic regression showed that: pregnant women from other cities, withlow economic income and difference in referral time have interference in the beginning of prenatal care. Conclusion: The analyzes carried out may contribute to the development of intersectoral policies in search of health promotion for pregnant women.

Objetivo: Verificar el perfil epidemiológico de la gestante y los factores asociados a la derivación de gestantes a un servicio especializado. Método: Estudio retrospectivo, transversal, realizado sobre las historias clínicas de gestantes clasificadas como de alto riesgo, de enero a diciembre de 2019. Se realizó un análisis descriptivo, bivariado y multivariado. Resultados: De las 405 historias clínicas, la edad promedio fue de 29 años, el 19% eran hipertensos crónicos, el 14,2% desarrolló diabetes gestacional. La diferencia media entre la fecha de la primera consulta y la fecha de derivación por atención primaria fue de 4 semanas. La regresión logística mostró que: mujeres embarazadas de otras ciudades, con bajos ingresos económicos e diferencia en el tiempo de derivación tienen interferencia en el inicio de la atención prenatal. Conclusión: Los análisis realizados pueden contribuir a la elaboración de políticas intersectoriales en busca de promoción de la salud de la gestante.

Top 100 cited publications in the field of third molar surgery: A bibliometric analysis.

PURPOSE: This study aimed to identify and rank the top 100 cited papers related to third molar surgery METHODS: This bibliometric analysis was performed through the Clarivate Analytics' Web of Science database intended to find the top 100 most cited papers. The search was conducted on 18th November 2021 with MeSH terms related to the third molar surgery. Extracted Data included title, main author, institution, publication year, a total of citations, citation average per year, country, the journal paper was published, journal impact factor, the number of citations of the three most-cited journals, study design, and field related to third molar surgery RESULTS: The top-cited paper was a retrospective cohort related to complications after the third molars surgery, published in 2003 in the Journal of Oral and Maxillofacial Surgery. The total number of citations was 9026. Thirty-nine percent of the papers included were randomized clinical trials. The USA is the main country responsible for the best publications in the field of third molar surgery. European researchers had the main expressive citation score, and "surgery" related to the third molar was the most critical field of research CONCLUSIONS: 1) The United States of America was the leading country that contributed to third molar field research 2) The Universities of Barcelona and the University of North Carolina were the most productive institutions regarding this research field; 3) Complications after third molar surgery was the most researched field. Compared to the other fields in dentistry such as Oral pathology and Cariology, the number of citations regarding third molar surgery was low.

Development and validation of a tool for competence assessment of the insert of the intrauterine device / Desenvolvimento e validação de uma ferramenta para avaliação por competência da inserção do dispositivo intrauterino

Abstract Objectives:. to develop and validate an instrument to assess the professional competence of nurses in the insertion of the intrauterine device (IUD) Methods: methodological study, developed in three stages: 1) tool development (Theoretical procedures); 2) evaluation of the tool by experts and judgment of the initially proposed items (Appearance validation and content validation); 3) test of the version resulting from the assessment by experts and assessment of internal consistency (Analytical procedures). Ten judges participated in the face and content validation, among obstetric nurses and gynecologists/obstetricians from the Sofa Feldman Hospital in Belo Horizonte (MG), while 38 nursing residency students were evaluated using the test tool, in the last stage of the study. Calculations of the Content Validity Index (CVI) and Cronbach's alpha coefficient were performed as psychometric measures. Results: the initial tool covered 39 items. No item obtained CVI<0.8; however, through suggestions from the judges, items were merged, totaling 34 items. The total Cronbach's alpha coefficient for this version was 0.828. Conclusion: the tool developed is valid and reliable. It is believed that the implementation of this tool will contribute to the training of professionals and the improvement of knowledge, behaviors, and skills in nursing consultations with a focus on reproductive planning with an emphasis on the insertion of the IUD.

Resumo Objetivos:. desenvolver e validar um instrumento de avaliação da competência profissional do enfermeiro na inserção do dispositivo intrauterino (DIU) Métodos: estudo metodológico, desenvolvido em três etapas: 1) desenvolvimento da ferramenta (Procedimentos teóricos); 2) avaliação da ferramenta por especialistas e julgamento dos itens inicialmente propostos (Validação aparente e validação de conteúdo); 3) teste da versão resultante da avaliação pelos especialistas e avaliação da consistência interna (Procedimentos analíticos). Participaram da validação aparente e de conteúdo 10 juízes, dentre enfermeiros obstétricos e médicos ginecologistas/obstetras do Hospital Sofa Feldman em Belo Horizonte (MG), enquanto 38 alunos da residência em enfermagem foram avaliados por meio da ferramenta em teste, na última etapa do estudo. Foram realizados cálculos do Índice de Validade de Conteúdo (IVC) e do coeficiente alfa de Cronbach como medidas psicométricas. Resultados: a ferramenta inicial abrangeu 39 itens. Nenhum item obteve IVC<0,8; contudo, através de sugestões dos juízes, itens foram fundidos, totalizando 34 itens. O coeficiente alfa de Cronbach total desta versão foi de 0,828. Conclusão: a ferramenta desenvolvida apresenta-se válida e confável. Acredita-se que a implantação dessa ferramenta contribuirá para a formação de profissionais e para o aprimoramento dos conhecimentos, comportamentos e habilidades na consulta de enfermagem com foco no planejamento reprodutivo com ênfase na inserção do DIU.

Top 100 Cited Publications in the Field of Temporomandibular Disorders: A Bibliometric Analysis.

Background: The aim of this bibliometric research was to identify and analyze the top 100 cited publications in the field of temporomandibular disorders (TMD) in order to guide any professional level with interest in this topic by mapping the current trends in the field of TMD. Materials and Methods: The Clarivate Analytics' Web of Science database was used to find the top 100 most cited papers in the field of TMD, published from the year 2000 to November 18, 2021, with MeSH terms in the search strategy. Data extracted were ranking, title, main author, institution, publication year, a total of citations, citation average per year, the journal the study was published, journal impact factor, and the number of studies that each journal published. Further, also the percentage of the different study designs, the number of studies regarding a specific area within the field of TMD, and the number of studies per country were also calculated. A ranking of authors was also performed. Results: The top cited paper was a study on diagnostic criteria for TMD, with 1,287 citations published in 2014 in the Journal of Oral and Facial Pain and Headache which also had most of the top 100 cited publications. Eighty-one percent of the most cited studies were from the USA and Europe and 33% of the included studies were review articles. Conclusion: Taken together, since all papers were considered classic, one can draw the conclusion that researchers in 2000 onward in the field of TMD are interested in (a) diagnostic criteria, (b) TMD symptoms and mainly pain-related symptoms, (c) etiology and risk factors of TMD and mainly bruxism, and (d) treatment of TMD. However, topics such as imaging, occlusion, tissue engineering, and disk displacements are presently not as popular.

Impact of the presence of partially erupted third molars on the local radiographic bone condition.

The decision on retaining or prophylactically removing asymptomatic lower third molars is still discussed in the literature. This study aimed to verify the association between asymptomatic lower third molars and local bone conditions through periapical radiographs. Based on sample size calculations, 288 radiographs were required. Dependent variables were alveolar bone crest status and radiolucency between the distal aspect of the third molar crown and the ascending mandibular ramus. Independent variables were sex, age, Pell and Gregory and Winter's classification, angulation and distance between second and third molars, third molar side. Advanced ages (OR 1.15; CI 1.08-1.24; p < 0.001) and greater third molar angulations (OR 1.03; CI 1.01-1.04; p < 0.001) significantly increased the chance of radiographic alterations in the bone crest between second and third molars. Radiolucency distal to third molars was solely impacted by patient's age (OR 1.05; CI 1.01-1.11; p = 0.036). Older patients and lower third molars with greater angulations about adjacent second molar should be evaluated for third molar removal because of the increased chance of alveolar bone crest alterations. Older patients should also be monitored for wider radiolucent pericoronal spaces distal to lower third molars and its consequences.

Does kinesio taping reduce pain, swelling, and trismus after mandibular third molar surgery? A systematic review and meta-analysis.

The aim of this study is to provide an evidence-based conclusion regarding the effectiveness of kinesio taping (KT) in reducing postsurgical discomforts after mandibular third molar surgery and critically appraise the available literature. Eligible clinical trials evaluating patients older than 18 years who were treated with any type of KT compared to no taping in which pain, swelling, or trismus scores were reported were included. An electronic literature search was carried out in the following databases to identify relevant papers up to May 30, 2021: Medline, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus. The risk of bias was assessed using the Cochrane risk-of-bias tool for randomized trials (RoB 2.0). The effect sizes were calculated using mean difference (MD) and standardized mean difference (SMD). The heterogeneity analysis was conducted using (I2) statistic at alpha = 0.10 (PROSPERO; CRD42021252670). Nine randomized clinical trials with 444 participants were included in the qualitative analysis and eight in the quantitative analysis. The results of the meta-analysis revealed a statistically significant reduction in pain and swelling scores before the 7th postoperative day. On the 7th postoperative day, no significant difference was observed between KT and control groups in terms of pain and swelling. Additionally, KT led to an increase in patients' maximum mouth opening of more than 3 mm in postoperative intervals. KT is effective in reducing postoperative pain within the first 48 h after surgery and improving mouth opening during all postoperative intervals with moderate to high certainty of evidence.

Top 100 cited systematic reviews and meta-analyses in the major journals of oral and maxillofacial surgery: a bibliometric analysis.

The aim of this bibliometric research was to identify and analyze the top 100 cited systematic reviews in the field of oral and maxillofacial surgery in order to guide any professional level with interest in this topic and to map the current trends the field of oral and maxillofacial surgery. Using the Web of Science database without restrictions on publication year or language, a bibliometric analysis was performed for the five major journals of oral and maxillofacial surgery: International Journal of Oral and Maxillofacial Surgery (IJOMS), Journal of Oral and Maxillofacial Surgery (JOMS), Journal of Cranio-maxillofacial Surgery (JCMS), British Journal of Oral & Maxillofacial Surgery (BJOMS), and Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology (Triple-O). The most top-cited systematic review was published in 2015 with a total of 200 citations on survival and success rates of dental implants, consistent with the finding that "pre- and peri-implant surgery and dental implantology," and "craniomaxillofacial deformities and cosmetic surgery" were the most frequently cited topics (22% each). The majority of top cited papers were published in IJOMS (43%), followed by JOMS (34%), Triple-O (8%), JCMS(8%) and BJOMS(7%). The highest number of contributions was from the Netherlands, followed by Italy and USA. The outcome of this article can be used as a source of information and to guide not just researchers but also clinicians and students to which areas are trending in the field of oral and maxillofacial surgery, thus also having a large impact on the field of oral and maxillofacial surgery. However, this article cannot reflect the quality of the included systematic reviews.

Can high-flow nasal cannula reduce the risk of bronchopulmonary dysplasia compared with CPAP in preterm infants? A systematic review and meta-analysis.

BACKGROUND: Bronchopulmonary dysplasia (BPD) is a chronic lung disease that affects the premature lung, and to reduce its incidence has been used non-invasive ventilatory support, such as continuous positive airway (CPAP) and high-flow nasal cannula (HFNC). Thus, the objective of this review was to assess whether the use of high flow nasal cannula (HFNC) compared to continuous positive airway pressure (CPAP) decreases the risk of bronchopulmonary dysplasia (BPD) in premature newborns. METHODS: The protocol was registered (Prospero: CRD42019136631) and the search was conducted in the MEDLINE, PEDro, Cochrane Library, CINAHL, Embase, and LILACS databases, and in the clinical trials registries, until July 2020. We included randomized clinical trials comparing HFNC versus CPAP use in premature infants born at less than 37 weeks of gestational age. The main outcome measures were the development of BPD, air leak syndrome, and nasal injury. The methodological quality of the included studies was assessed using the Cochrane risk of bias tool and the GRADE system was used to summarize the evidence recommendations. Meta-analyses were performed using software R. RESULTS: No difference was found between HFNC or CPAP for the risk of BPD (RR: 1.10; 95% CI: 0.90-1.34), air leak syndrome (RR: 1.06; 95% CI: 0.52-2.14), and nasal trauma (RR: 2.00; 95% CI: 0.64-6.25), with a very low level of evidence. CONCLUSION(S): The HFNC showed similar results when compared to CPAP in relation to the risk of BPD, air leak syndrome, and nasal injury. In the literature, no randomized clinical trial has been found with BPD as the primary outcome to support possible outcomes.