Preemptive use of ibuprofen and desensitizer decreases immediate tooth sensitivity after in-office bleaching: A triple-blind, randomized, placebo-controlled clinical trial.

BACKGROUND: The authors evaluated the synergistic analgesic effect of preemptive administration of 400 mg of ibuprofen (IBU) and potassium fluoride 2% (KF2), both in isolation or combination, on the painful perception of tooth sensitivity after tooth bleaching. METHODS: Fifteen patients participated in this triple-blind, randomized, placebo-controlled clinical trial. The study used a crossover design for drug administration and a split-mouth design for desensitizer agent. Four paired groups were formed: IBU plus KF2 (IBU + KF2); IBU (IBU + placebo KF); KF2 (placebo IBU + KF2), and placebo (placebo IBU + placebo KF). The outcome measure was the perception of tooth sensitivity, assessed using a visual analog scale. Data were collected at 4 different times: immediately after tooth bleaching (baseline) and after 6, 30, and 54 hours. Statistical analysis was performed using the Friedman test and relative risk. RESULTS: IBU plus KF2 was found to be more effective in reducing tooth sensitivity immediately after bleaching (baseline) compared with the placebo group (P < .05). The risk of experiencing moderate or severe tooth sensitivity was approximately 4 times higher in the placebo group than in the IBU plus KF2 group (relative risk, 4.00; 95% CI, 1.01 to 15.81; P = .025). CONCLUSIONS: The combined use of 400 mg of IBU and KF2 appears to be beneficial in managing postbleaching tooth sensitivity. It provides a superior analgesic effect compared with placebo. PRACTICAL IMPLICATIONS: The preemptive administration of IBU plus KF2 reduces tooth sensitivity after tooth whitening when compared with placebo. This clinical trial was registered in the Brazilian Clinical Trials Registry Platform. The registration number is U1111-1249-8191.

Antibiotic Resistance Profile of Clinical Strains of Enterococci from Secondary/Persistent Endodontic Infections: What do We Know? A Systematic Review of Clinical Studies.

INTRODUCTION: Enterococcus faecalis is the most common enterococcal species associated with infective endocarditis and 1 of the most commonly detected bacteria in cases of secondary/persistent endodontic infection (SPEI). Antimicrobial resistance is a global public health concern. This review aimed to answer the following research question: "Is there a change in the antibiotic resistance profile in clinical strains of E. faecalis over the years?". P (population) - patients with SPEI, I (intervention) -endodontic retreatment, C (comparison) -not included, O (outcome) - profile of Enterococci resistance and susceptibility to systemic antibiotics used. METHODS: Two authors independently performed study selection, data extraction, and risk of bias assessment. The literature search was conducted using the following electronic databases: PubMed, Scopus, EMBASE, Web of Science, and Medline. Clinical studies in which Enterococci strains were isolated to assess their antimicrobial resistance were included. RESULTS: Eleven clinical trials were included. Overall, E. faecalis isolated from teeth with SPEI presented an intermediate resistance to 16 antibiotics. In recent years, E. faecalis showed a little resistance to amoxicillin (without clavulanate) and benzylpenicillin. Erythromycin and rifampicin presented an increase in the intermediate-resistance status between the first and the last studies. E. faecium presented intermediate-resistance results. CONCLUSION: The most effective drugs remain the combination of amoxicillin and clavulanate, followed by amoxicillin and benzylpenicillin. In patients allergic to penicillin derivatives, moxifloxacin and azithromycin may be indicated with caution. The antibiotics with the highest pattern of resistance against E. faecalis are clindamycin, gentamicin, metronidazole, and rifampicin and are therefore, contraindicated in cases of SPEI. Very few clinical studies using a microbiological approach in teeth with endodontic failure have been carried out to improve the efficacy of prophylactic regimens. However, as bacteria periodically develop resistance to the main drugs used, regular studies should be carried out on the action of these drugs in infection control.

Access to dental services in an elder population of African descent in Brazil.

OBJECTIVES: We investigated access to dental services and associated factors in a community of Quilombola older people. BACKGROUND: Quilombola populations are groups of individuals descended from black Africans subjected to slavery during part of Brazilian history. As marginalised and neglected individuals, they have high rates of negative indicators and require further attention to the social determinants that affect their health reality. MATERIALS AND METHODS: A cross-sectional quantitative study was conducted in the Quilombola community of Castainho, in the Northeast region of Brazil. In this community, 34 older people aged between 65 and 74 resided. We collected self-report data on sociodemographic and economic characteristics, along with oral examinations by the researchers. The primary dependent variable was regular access to dental services. Statistical analysis used Fisher's exact test (P = .05). RESULTS: Among the 32 participants in the final sample, 18.8% (n = 6) reported accessing dental services in the previous 6 months. Self-declared individuals of mixed race, with positive self-assessment of oral health, and those who did not self-perceive the need for treatment had lower rates of regular access to dental services (P < .05). CONCLUSION: Use of dental services by older Quilombola people is low, and there are differences by ethnicity and individual perception of oral health.

Analysis of professional training in Multiprofessional Health Residency Programs in Brazil from the perspective of residents. / Análise da formação em Programas de Residência Multiprofissional em Saúde no Brasil: perspectiva dos egressos.

The aim of this study was to analyze professional training in multiprofessional health residency programs (MHRPs) in primary care from the perspective of residents from 20 programs who had completed residency in the period 2015-2019. We undertook a cross-sectional study analyzing criteria in the dimensions Pedagogical Approach and In-Service Education Settings responded using a 10-point Likert scale. The study sample consisted of 365 graduates from MHRPs in 12 Brazilian states. The highest-scoring criteria in the dimension Pedagogical Approach (Cronbach's α=0.94) were broad concept of care and professional training oriented towards comprehensive care (P50=10). The lowest scoring criteria were those involving preceptorship (P50=7). With regard to the In-Service Education Settings dimension (Cronbach's α=0.90), the main strength was group educational activities (P50=9) and the main weaknesses were adequacy of the physical structure of health facilities (P50=6), participation of residents in local health committees (P50=6), and coordination with medical residency programs (P50=5). The findings show that professional training in MHRPs is aligned with the principles and guidelines underpinning Brazil's public health system, with emphasis on comprehensiveness and prevention. However, efforts are needed to improve preceptor training and address weaknesses in practice settings.

Objetivou-se analisar a formação em Programas de Residência Multiprofissional em Atenção Básica (PRMAB) no Brasil a partir dos egressos de 20 Programas no período de 2015 a 2019. Trata-se de um estudo transversal que analisou as dimensões Abordagem Pedagógica (AP) e Cenários de Educação em Serviço (CES) com escala do tipo Likert. Participaram do estudo 365 egressos de programas instalados em 12 estados da federação. Na dimensão AP (α de Cronbach=0,94) destacaram-se os critérios sobre a concepção ampliada do cuidado e formação pautada em cuidado integral (P50=10), enquanto os com pior desempenho se relacionavam à preceptoria (P50=7). Quanto aos CES (α de Cronbach=0,90), foram reveladas potencialidades para as atividades educativas em grupo (P50=9) e fragilidades para critérios relativos à suficiência de espaço físico nas unidades de saúde (P50=6), participação dos residentes em Conselhos (P50=6) e articulação com Programas de Residência Médica (P50=5). A formação nos PRMAB mostra-se sintonizada com os atuais paradigmas da atenção à saúde, com ênfase na integralidade e prevenção. Contudo, os Programas carecem de investimento na formação de preceptores e melhoria de fragilidades no âmbito dos cenários de prática.

Análise da formação em Programas de Residência Multiprofissional em Saúde no Brasil: perspectiva dos egressos / Analysis of professional training in Multiprofessional Health Residency Programs in Brazil from the perspective of residents

Resumo Objetivou-se analisar a formação em Programas de Residência Multiprofissional em Atenção Básica (PRMAB) no Brasil a partir dos egressos de 20 Programas no período de 2015 a 2019. Trata-se de um estudo transversal que analisou as dimensões Abordagem Pedagógica (AP) e Cenários de Educação em Serviço (CES) com escala do tipo Likert. Participaram do estudo 365 egressos de programas instalados em 12 estados da federação. Na dimensão AP (α de Cronbach=0,94) destacaram-se os critérios sobre a concepção ampliada do cuidado e formação pautada em cuidado integral (P50=10), enquanto os com pior desempenho se relacionavam à preceptoria (P50=7). Quanto aos CES (α de Cronbach=0,90), foram reveladas potencialidades para as atividades educativas em grupo (P50=9) e fragilidades para critérios relativos à suficiência de espaço físico nas unidades de saúde (P50=6), participação dos residentes em Conselhos (P50=6) e articulação com Programas de Residência Médica (P50=5). A formação nos PRMAB mostra-se sintonizada com os atuais paradigmas da atenção à saúde, com ênfase na integralidade e prevenção. Contudo, os Programas carecem de investimento na formação de preceptores e melhoria de fragilidades no âmbito dos cenários de prática.

Abstract The aim of this study was to analyze professional training in multiprofessional health residency programs (MHRPs) in primary care from the perspective of residents from 20 programs who had completed residency in the period 2015-2019. We undertook a cross-sectional study analyzing criteria in the dimensions Pedagogical Approach and In-Service Education Settings responded using a 10-point Likert scale. The study sample consisted of 365 graduates from MHRPs in 12 Brazilian states. The highest-scoring criteria in the dimension Pedagogical Approach (Cronbach's α=0.94) were broad concept of care and professional training oriented towards comprehensive care (P50=10). The lowest scoring criteria were those involving preceptorship (P50=7). With regard to the In-Service Education Settings dimension (Cronbach's α=0.90), the main strength was group educational activities (P50=9) and the main weaknesses were adequacy of the physical structure of health facilities (P50=6), participation of residents in local health committees (P50=6), and coordination with medical residency programs (P50=5). The findings show that professional training in MHRPs is aligned with the principles and guidelines underpinning Brazil's public health system, with emphasis on comprehensiveness and prevention. However, efforts are needed to improve preceptor training and address weaknesses in practice settings.

Might Zika virus-associated microcephaly's severity impact deciduous tooth eruption and orofacial structures?

OBJECTIVE: to investigate the impact of the severity of microcephaly caused by the Zika virus (MCZ) on tooth eruption and orofacial structures of children. DESIGN: This case series study developed the research at the Mens Sana Rehabilitation Center, Arcoverde, Brazil. The study included 27 children diagnosed with MCZ. We performed the data collection in June 2018 through a questionnaire answered by the legal guardians, followed by a clinical examination of the children. The data were analyzed by the Mann-Whitney and Fisher's exact tests (p = 0.05). RESULTS: The final sample was composed of 20 children. Of these, 13 (35.0%) had severe microcephaly, 5 (30.0%) had altered sequence of tooth eruption, 10 (50.0%) had delayed eruption, and the mean number of decayed teeth was 2.3. The most identified orofacial changes were teeth grinding habit (65.0%), difficult chewing (50.0%), and non-nutritive sucking (50.0%). The Mann-Whitney test showed that the severity of microcephaly did not affect tooth eruption (p = 0.581). The Fisher's exact test showed that the severity of microcephaly was not associated with orofacial changes (p > 0.05). CONCLUSIONS: The severity of MCZ does not seem to influence changes in deciduous tooth eruption and the presence of orofacial anomalies.

Agravos de saúde bucal na população quilombola brasileira: uma revisão de escopo

[RESUMO]. Objetivo. Delinear o panorama atual acerca dos agravos de saúde bucal da população quilombola no Brasil. Métodos. Uma busca foi realizada nas bases de dados Biblioteca Virtual em Saúde (BVS), PubMed, EMBASE, Scopus, Web of Science, Science Direct e SciELO, além de busca manual no Google Scholar, sem restrições de período. Foram incluídos artigos publicados em inglês, português ou espanhol descrevendo pesquisas realizadas no Brasil sobre saúde bucal em indivíduos que se autodeclararam quilombolas de comunidades reconhecidas pelo poder público. Analisou-se ainda a qualidade da evidência nos estudos incluídos. Resultados. Foram selecionados 14 estudos, todos com desenho transversal e classificados como nível IV de evidência científica (evidência proveniente de estudos descritivos ou estudos com abordagem qualita- tiva), ou seja, qualidade moderada-baixa. Seis estudos foram desenvolvidos na região Nordeste do Brasil e nove foram publicados entre 2016 e 2021. Sobre os agravos de saúde bucal, houve alta frequência de cárie dentária e altos índices de experiência da doença. O edentulismo e a doença periodontal também foram frequentes, afetando indivíduos jovens, adultos e idosos. Conclusão. Foi alta a prevalência de cárie dentária, edentulismo e doenças periodontais descrita na literatura sobre quilombolas no Brasil, demonstrando a necessidade de melhorar a assistência odontológica nesse grupo populacional.

[ABSTRACT]. Objective. To describe the current scenario of oral health in quilombola communities in Brazil. Methods. A search was performed in the Virtual Health Library (VHL), PubMed, EMBASE, Scopus, Web of Science, Science Direct, and SciELO, without date limits. Articles published in English, Portuguese, or Spanish were included if they described research performed in Brazil to investigate oral health in individuals self- declared as belonging to officially recognized quilombola communities. The quality of evidence of included studies was analyzed. Results. Fourteen studies were selected for inclusion, all with cross-sectional design and classified as level IV scientific evidence (evidence from descriptive studies or studies with a qualitative approach), i.e., moderate- low quality. Six were developed in the Northeast region of Brazil and nine were published between 2016 and 2021. Regarding oral health problems, a high frequency was detected for dental caries, with high indices of disease experience. Edentulism and periodontal disease were also frequent, affecting youth, adults, and older individuals. Conclusion. A high prevalence of dental caries, edentulism, and periodontal disease was observed, suppor- ting the need to improve dental care in this population group.

[RESUMEN]. Objetivo. Describir el panorama actual de los trastornos de salud bucodental de la población quilombola de Brasil. Métodos. Se realizó una búsqueda en las bases de datos de la Biblioteca Virtual en Salud (BVS), PubMed, EMBASE, Scopus, Web of Science, Science Direct y SciELO, además de una búsqueda manual en Google Scholar, sin restricciones del período. Se incluyeron artículos publicados en español, inglés o portugués descriptivos de investigaciones realizadas en Brasil sobre la salud bucodental de personas que se autode- nominan quilombolas pertenecientes a comunidades reconocidas por el poder público. También se analizó la calidad de la evidencia científica de los estudios incluidos. Resultados. Se seleccionaron 14 estudios, todos con un diseño transversal y clasificados en el nivel IV de evidencia científica (evidencia proveniente de estudios descriptivos o estudios con un enfoque cualitativo), es decir, de mediana y baja calidad. Se realizaron seis estudios en la región nordeste de Brasil y se publi- caron nueve en el período 2016-2021. En cuanto a los trastornos de salud bucodental, se observó una alta frecuencia de caries dental y altas tasas de prevalencia de esa enfermedad. El edentulismo y la enfermedad periodontal también fueron frecuentes y afectaron a jóvenes, adultos y personas mayores. Conclusión. Se observó una alta prevalencia de caries dental, edentulismo y enfermedades periodontales descritas en la literatura científica sobre la población quilombola de Brasil, lo que demuestra la necesidad de mejorar la atención dental prestada a ese grupo de la población.

Access to information on oral hygiene and mothers' practices of children with microcephaly caused by Zika virus.

OBJECTIVE: To verify whether access to information about oral hygiene influenced the practices of caregivers of children with microcephaly caused by Zika virus (ZIKV). METHODS: A case series study was developed at the Mens Sana Rehabilitation Center, in the municipality of Arcoverde, Pernambuco, Brazil. The study universe included the mothers of 32 children with microcephaly caused by Zika virus. Data collection took place in June 2018 and was carried out through a structured questionnaire. The variables studied comprised socioeconomic issues, habits, diet, and knowledge about oral hygiene. Fisher's Exact and Pearson's Chi-square tests were used with a significance level of 5%. RESULTS: Out of 32 individuals eligible to participate in the study, only 27 were selected. Most mothers reported receiving information about oral hygiene from their infants (63.0%). Fisher's Exact and Pearson's Chi-square tests showed that access to oral hygiene information was associated with mother's education, family income, regular visits to the dentist, frequency of tooth brushing, age at which the infant started brushing, and brushing time (p < 0.05). CONCLUSION: Access to information about oral hygiene positively influenced the oral health care of mothers with their children with microcephaly caused by ZIKV.

Schinopsis brasiliensis Engler-Phytochemical Properties, Biological Activities, and Ethnomedicinal Use: A Scoping Review.

Brazil has the most incredible biodiversity globally and has a vast storehouse of molecules to be discovered. However, there are no pharmacological and phytochemical studies on most native plants. Parts of Schinopsis brasiliensis Engler, a tree from the Anacardiaceae family, are used by several traditional communities to treat injuries and health problems. The objective of this scoping review was to summarize the pharmacological information about S. brasiliensis, from ethnobotanical to phytochemical and biological studies. Data collection concerning the geographical distribution of S. brasiliensis specimens was achieved through the Reflora Virtual Herbarium. The study's protocol was drafted using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The search strategy used the keyword "Schinopsis brasiliensis" in the databases: PUBMED, EMBASE, SCOPUS, Science Direct, Web of Science, SciFinder, and SciELO. Rayyan was used for the selection of eligible studies. In total, 35 studies were included in the paper. The most recurrent therapeutic indications were for general pain, flu and inflammation. The bark was the most studied part of the plant. The most used preparation method was decoction and infusion, followed by syrup. Phytochemical investigations indicate the presence of tannins, flavonoids, phenols, and polyphenols. Most of the substances were found in the plant's leaf and bark. Important biological activities were reported, such as antimicrobial, antioxidant, and anti-inflammatory. S. brasiliensis is used mainly by communities in the semi-arid region of northeastern Brazil to treat several diseases. Pharmacological and phytochemical studies together provide scientific support for the popular knowledge of the medicinal use of S. brasiliensis. In vitro and in vivo analyses reported antimicrobial, antioxidant, anti-inflammatory, antinociceptive, cytotoxic, photoprotective, preservative, molluscicidal, larvicidal, and pupicidal effects. It is essential to highlight the need for future studies that elucidate the mechanisms of action of these phytocompounds.

[Training in Multi-Professional Primary Health Care Residency Programs: a systematic review of the literature]. / Formação na Residência Multiprofissional em Atenção Básica: revisão sistemática da literatura.

The scope of this study is to investigate how the training of health professionals has been provided in Multi-professional Primary Health Care Residency Programs in Brazil. A systematic review was conducted on Scielo, BVS and PubMed databases in 2019, under registration number CRD42019134350. The search was carried out using key words related to Multi-Professional Residency Programs and Primary Health Care, including empirical research on the theme with a low-level risk of bias. Of the 700 studies identified, 13 articles were included in this review. All the studies adopted a qualitative approach predominantly performed in São Paulo with a low risk of bias (69%). The main results were categorized as: Contribution of measures for occupational training; Definition of professional training strategies; Potential of Multi-Professional Primary Health Care Residency Programs for health professional training and difficulties experienced during the training process. Professional training on programs studied has provided a new profile of health providers, despite limitations in the training process. Investments in the qualification of the personnel involved in training were perceived as being necessary, since it was one of the main weaknesses reported.

Este estudo tem como objetivo investigar a formação de profissionais de saúde em programas de Residência Multiprofissional em Saúde (RMS) direcionados à atenção básica no Brasil. Trata-se de uma revisão sistemática da literatura conduzida nas bases de dados SciELO, BVS e PubMed no ano de 2019, registrada sob número CRD42019134350. A busca ocorreu utilizando descritores relacionados à RMS e à atenção básica, sendo incluídas pesquisas empíricas sobre o tema sem alto risco de viés. Dos 700 registros recuperados no processo de busca, 13 artigos foram incluídos na revisão. Todos os estudos apresentaram abordagem qualitativa, predominando estudos realizados no estado de São Paulo e com baixo risco de viés (69%). Os principais resultados foram categorizados em: contribuição de dispositivos para a formação pelo trabalho; estratégias balizadoras da formação; potencialidades da residência para a formação em saúde; e dificuldades experienciadas no processo de formação. A formação nos programas estudados tem proporcionado um novo perfil de profissional de saúde, apesar das limitações vivenciadas no processo. Torna-se necessário investimento na qualificação dos atores envolvidos na formação, uma vez que essa foi uma das principais dificuldades relatadas.

Use of WhatsApp in Dental Education: a Scoping Review.

Purpose/Objective: This study aimed to perform a critical appraisal of WhatsApp use by undergraduate students in dental education. Methods: A PRISMA-Scoping Review was carried out to explain (i) how has WhatsApp been used as a learning tool in dental education? and (ii) how has WhatsApp been evaluated as a learning tool in dental education? Inclusion criteria are specified as the population (dental students), concept (use of WhatsApp), context (institutions/universities of dental education), and types of sources of evidence (peer-reviewed publication). Results: Nine studies published between 2016 and 2020 were included in this scoping review. Mostly had a cross-sectional design. Conclusion: WhatsApp is used in dental education to facilitate communication and improve learning through discussions via the app.

Formação na Residência Multiprofissional em Atenção Básica: revisão sistemática da literatura / Training in Multi-Professional Primary Health Care Residency Programs: a systematic review of the literature

Resumo Este estudo tem como objetivo investigar a formação de profissionais de saúde em programas de Residência Multiprofissional em Saúde (RMS) direcionados à atenção básica no Brasil. Trata-se de uma revisão sistemática da literatura conduzida nas bases de dados SciELO, BVS e PubMed no ano de 2019, registrada sob número CRD42019134350. A busca ocorreu utilizando descritores relacionados à RMS e à atenção básica, sendo incluídas pesquisas empíricas sobre o tema sem alto risco de viés. Dos 700 registros recuperados no processo de busca, 13 artigos foram incluídos na revisão. Todos os estudos apresentaram abordagem qualitativa, predominando estudos realizados no estado de São Paulo e com baixo risco de viés (69%). Os principais resultados foram categorizados em: contribuição de dispositivos para a formação pelo trabalho; estratégias balizadoras da formação; potencialidades da residência para a formação em saúde; e dificuldades experienciadas no processo de formação. A formação nos programas estudados tem proporcionado um novo perfil de profissional de saúde, apesar das limitações vivenciadas no processo. Torna-se necessário investimento na qualificação dos atores envolvidos na formação, uma vez que essa foi uma das principais dificuldades relatadas.

Abstract The scope of this study is to investigate how the training of health professionals has been provided in Multi-professional Primary Health Care Residency Programs in Brazil. A systematic review was conducted on Scielo, BVS and PubMed databases in 2019, under registration number CRD42019134350. The search was carried out using key words related to Multi-Professional Residency Programs and Primary Health Care, including empirical research on the theme with a low-level risk of bias. Of the 700 studies identified, 13 articles were included in this review. All the studies adopted a qualitative approach predominantly performed in São Paulo with a low risk of bias (69%). The main results were categorized as: Contribution of measures for occupational training; Definition of professional training strategies; Potential of Multi-Professional Primary Health Care Residency Programs for health professional training and difficulties experienced during the training process. Professional training on programs studied has provided a new profile of health providers, despite limitations in the training process. Investments in the qualification of the personnel involved in training were perceived as being necessary, since it was one of the main weaknesses reported.

Effect of handling, time of use and photoactivation on the contamination of dental composite resins

This study evaluated the effect of contamination of composite resins (CRs) handled by undergraduate students during restorative procedures, varying the time (baseline, 30 days and 60 days) and experimental condition (before and after handling, contamination with saliva [positive control] and photoactivation). Eight CR tubes were randomly distributed at the dental clinic and the samples were organized into four groups: CR fragments collected before (GB) and after (GA) the restorative procedure; CR fragments contaminated with saliva (GS) and photoactivated (GP) both collected after the procedure. These 4 groups were evaluated in 3 different times: baseline (after sealing), 30 days and 60 days of use of the CR. Samples that had positive turbidity in Brain HeartInfusion (BHI) broth were sown in BHI and Sabouraud Dextrose (SB) agars for subsequent counting of Colony Forming Units (CFU mL-1). The results showed that the handling was responsible for increasing contamination (p < 0.05) at the baseline (GB [n = 0] and GA [n = 3]), as well as after 30 (GB [n = 1] and GA [n = 6]) and 60 (GB [n = 1] and GA [n = 5]) days of use. Photoactivation was responsible for the reduction for microorganisms in T0 and T60. Additionally, the time use and conservation did not influencethe contamination of CRs. Handling was responsible for the increase of contamination of CR, the photoactivation seems to reduce the number of viable microorganisms and the time of use seems not to potentiate the effect of tube contamination.

Orofacial features in children with microcephaly associated with Zika virus: A scoping review.

OBJECTIVE: To analyze published scientific evidence about the most common orofacial disorders in children with microcephaly associated with ZIKV infection. METHODS: Through a scoping review, we respond to the search question was formulated: "What are the orofacial alterations in children with microcephaly associated with ZIKV?" It was performed a search in PubMed, EMBASE, Scopus, and Health Virtual Library. It was selected papers wrote in English, Portuguese, or Spanish. An evidence quality analysis was performed using the Agency for Healthcare Research and Quality classification. RESULTS: It was included 11 studies performed in the Brazilian Northeast region. The studies were carried out between 2018 and 2020. The main related alterations were delay in the tooth-eruption and deformation in the oral structures. CONCLUSION: The results observed in our work show moderate scientific evidence regarding the association of ZIKV with orofacial alterations in children with microcephaly due to the classifications of the quality of evidence of each one of the included studies. The main changes reported were in the chronology of tooth eruption, alteration in teeth, and oral structures.

Admission of alumni from Multiprofessional Residency Programs into the SUS.

INTRODUCTION: The Multiprofessional Health Residency Programs (PRMS) were set up as a strategy for training workforce for the Brazilian Unified Health System (SUS). OBJECTIVE: To investigate the proportion of alumni from Primary Health Care Multiprofessional Residency Programs admitted into the SUS and associated factors. METHODS: This is a sectional study developed with alumni from Primary Health Care Multiprofessional Residency Programs from all over Brazil, encompassing the period from 2015 to 2019. Participants answered an online questionnaire with general personal information, admission into stricto sensu graduate school, the labor market and, specifically, the SUS. We applied Pearson's chi-square test for bivariate analyses and Poisson's regression for multiple analysis. RESULTS: A total of 365 alumni from Programs from all Brazilian regions participated in the study. Of those, 80.2% reported entry into the labor market and 47.9% reported being employed in the SUS. Admission into the SUS has been associated with the professions that make up the Reference Team for Primary Health Care (PHC) (PR = 1.87; 95% CI 1.54-2.28) and non-admission into stricto sensu graduate programs (PR = 0.77; 95% CI 0.61-0.97). Regarding admission characteristics, the PHC scenario (47.4%) and work focused on health care (84.9%) were prevalent. Almost 40% of alumni who entered the SUS are working with unstable contracts. Besides, being a residency alumnus is often undervalued in recruitment (56.9%). Among those admitted into the SUS, 8.7% reported being selected to work in the Covid-19 pandemic effort. CONCLUSIONS: The results of this study reinforce the need for a policy to encourage the maintenance, creation and valorization of the PRMS. They also warn about the possibility that admission into the SUS for workers is increasingly difficult due to the current underfunding of the health system.

Two phytocompounds from Schinopsis brasiliensis show promising antiviral activity with multiples targets in Influenza A virus.

Influenza A virus, the main flu agent, affects billions of people worldwide. Conventional treatments still present limitations related to drug-resistance and severe side effects. As a result, natural product-derived molecules have been increasingly investigated as prospect drug candidates. Therefore, the aim of this study was to investigate the possible anti-flu activity and to evaluate the toxicity and pharmacokinetic parameters, by in silico approaches, of the Schinopsis brasiliensis Engl. phytochemical compounds. Nine phytocompounds and six antiviral drugs (Amantadine, Umifenovir, Favipiravir, Nitazoxanide, Oseltamivir, Zanamivir) were selected for the analyses against four Influenza A proteins: neuraminidase, polymerase basic protein 2, hemagglutinin and M2 ion channel protein. The molecular docking, the predicted antiviral activity, the predicted toxicity and the pharmacokinetics investigations were conducted. The obtained results demonstrated that Syringaresinol and Cycloartenone display promising in silico antiviral activity (binding energy < 5.0 and ≥ 9.0 kcal/mol) and safety (low toxicity than commercial anti-flu drugs). Overall, this study corroborated the hypothesis that S. brasiliensis barks extract has a biological activity against Influenza A virus. Additionally, Syringaresinol and Cycloartenone have multiple targets in Influenza A virus and showed themselves as the most promising phytocompounds to be isolated and considered for the therapeutic arsenal against the flu.

Identification of docosahexaenoic and eicosapentaenoic acids multiple targets facing periodontopathogens.

The eicosapentaenoic (EPA) and docosahexaenoic acid (DHA) play a substantial role in Periodontal Disease (PD) due to their antimicrobial and immunomodulatory actions. However, their antimicrobial mechanism of action against bacteria involved in PD remains unclear. We aimed to estimate the probable targets of EPA and DHA against the seven periodontopathogens. Through in silico analyses, the protein-acids interactions, protein characterization, and molecular docking were performed. We identified 165 proteins from periodontopathogens that may interact with EPA and DHA. Fusobacterium nucleatum has the highest number of predicted proteins among analyzed bacteria (n = 43, 26.06%). The EPA shows more interactions than DHA. The EPA and DHA interact mainly with proteins involved in the metabolism (n = 69, 41.81%). Also, the EPA and DHA interact with proteins located in any subcellular location. The affinities between acids and pathogenic proteins were moderate (binding energy was lower than -4.0 kcal/mol). The interactions between EPA and DHA and periodontopathogens occur in multiples proteins. There is not a predilection about the functional class of pathogenic proteins targeting EPA and DHA. However, there are moderate binding affinities between EPA or DHA and essential pathogenic proteins (TolC, CRISPR, FusA).

Dental workers in front-line of COVID-19: an in silico evaluation targeting their prevention.

OBJECTIVE: SARS-CoV-2 has high human-human transmission rate. The aerosols and saliva droplets are the main contamination source. Thus, it is crucial to point out that dental practitioners become a high-risk group of contagion by SARS-CoV-2. Based on this, protocols have been recommended to avoid cross-contamination during dental care; however, appropriate evidence has not yet been established. Our study sought to make a screening, by in silico analysis, of the potential of mouth rinses used in dental practices to prevent the dental workers' contamination by SARS-CoV-2. METHODOLOGY: Multiple sequence comparisons and construction of the phylogenetic tree were conducted using the FASTA code. Therefore, molecular docking investigation between SARS-CoV-2 proteins (Main Protease, Spike Glycoprotein, Non-structure Protein, and Papain-like Protease) and molecules used in dental practices (chlorhexidine digluconate, hydrogen peroxide, cetylpyridinium chloride, povidone-iodine, gallic acid, ß-cyclodextrin, catechin, and quercetin) was performed using AutoDock Vina. Moreover, 2D interactions of the complex protein-ligand structure were analyzed by Ligplot+. RESULTS: The obtained results showed a remarkable affinity between SARS-CoV-2 proteins and all tested compounds. The chlorhexidine digluconate, catechin, and quercetin presented a higher affinity with SARS-CoV-2. CONCLUSIONS: The overall results allowed us to suggest that chlorhexidine is the most suitable active compound in reducing the SARS-CoV-2 salivary load due to its better binding energy. However, in vivo studies should be conducted to confirm their clinical use.

Dental workers in front-line of COVID-19: an in silico evaluation targeting their prevention

Abstract SARS-CoV-2 has high human-human transmission rate. The aerosols and saliva droplets are the main contamination source. Thus, it is crucial to point out that dental practitioners become a high-risk group of contagion by SARS-CoV-2. Based on this, protocols have been recommended to avoid cross-contamination during dental care; however, appropriate evidence has not yet been established. Objective Our study sought to make a screening, by in silico analysis, of the potential of mouth rinses used in dental practices to prevent the dental workers' contamination by SARS-CoV-2. Methodology Multiple sequence comparisons and construction of the phylogenetic tree were conducted using the FASTA code. Therefore, molecular docking investigation between SARS-CoV-2 proteins (Main Protease, Spike Glycoprotein, Non-structure Protein, and Papain-like Protease) and molecules used in dental practices (chlorhexidine digluconate, hydrogen peroxide, cetylpyridinium chloride, povidone-iodine, gallic acid, β-cyclodextrin, catechin, and quercetin) was performed using AutoDock Vina. Moreover, 2D interactions of the complex protein-ligand structure were analyzed by Ligplot+. Results The obtained results showed a remarkable affinity between SARS-CoV-2 proteins and all tested compounds. The chlorhexidine digluconate, catechin, and quercetin presented a higher affinity with SARS-CoV-2. Conclusions The overall results allowed us to suggest that chlorhexidine is the most suitable active compound in reducing the SARS-CoV-2 salivary load due to its better binding energy. However, in vivo studies should be conducted to confirm their clinical use.