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Early clinical trials investigating antiPD(L)-1 agents rarely reached a maximum tolerated dose (MTD), and efficacy signals were observed even at the lowest dose levels. Most extended treatment intervals investigated indicated that these drugs do not follow a direct dose-toxicity or dose-efficacy relationship. Within this context and considering the high cost of antiPD(L)-1 agents, there is a significant debate on whether lower doses or the administration of such agents at an extended interval should be prospectively evaluated in already-approved agents, or at least be considered in novel combination trials involving antiPD(L)-1 drugs. Herein, we review the dosing, overall response rates, and incidence of treatment-related adverse events of antiPD(L)-1 agents in early dose-escalation trials and discuss the appropriateness of recommended Phase 2 dose selection as well as the final regulatory approved doses of such agents. Efficacy and safety data from randomized dose-range Phase 2 trials and real-world data (RWD) on the usage of lower doses and/or non-standard extended treatment intervals are also examined. As the accumulating evidence suggests lower doses or extended dosing intervals of antiPD(L)-1 may achieve a similar clinical benefit in comparison to the currently approved doses, we address the clinical and financial toxicity implications of using potentially higher doses than necessary. Last, we discuss ways to resolve the current dosing conundrum of antiPD-(L)1 agents such as performing near-equivalence studies and propose a framework for future development of immunotherapeutics to find the lowest efficacious dose instead of MTD.

Objective The aim of the present study was to carry out a systematic review of available data regarding case reports and case series of oral and maxillofacial benign fibrous histiocytoma (BFH). Study Design A search strategy was performed using the PubMed, Web of Science, Scopus, and EMBASE electronic databases. Results Male individuals (56.89%) were more affected, with a mean age of 34.55 ± 20 years. The buccal mucosa (20.33%) represented the most common site, with the clinical presentation of a painless (86.95%) nodule (98.03%). The clinical hypothesis of a fibroma was reported in most cases (31.57%). Radiographic presentation of intraosseous lesions showed multilocular radiolucent images (55.55%). Regarding the histopathologic features, the biphasic population of fibroblastic and histiocytic cells was seen in 21 cases (39.62%), and a spindle-shaped fibroblastic cell population organized into a storiform pattern was observed in 25 cases (47.16%). CD68 (n = 26) and vimentin (n = 25) showed immunoreactivity in all BFH cases in which they were used. All cases were treated with a surgical resection, and 8.10% recurred. Conclusions The current systematic review demonstrated that BFH represents a rare lesion that mainly affects the buccal mucosa of male individuals, and the treatment is mainly surgical with a good prognosis.

Hearing loss is one of the most common sensory defects, affecting 5.5% of the worldwide population and significantly impacting health and social life. It is mainly attributed to genetic causes, but their relative contribution reflects the geographical region’s socio-economic development. Extreme genetic heterogeneity with hundreds of deafness genes involved poses challenges for molecular diagnosis. Here we report the investigation of 542 hearing-impaired subjects from all Brazilian regions to search for genetic causes. Biallelic GJB2/GJB6 causative variants were identified in 12.9% (the lowest frequency was found in the Northern region, 7.7%), 0.4% carried GJB2 dominant variants, and 0.6% had the m.1555A > G variant (one aminoglycoside-related). In addition, other genetic screenings, employed in selected probands according to clinical presentation and presumptive inheritance patterns, identified causative variants in 2.4%. Ear malformations and auditory neuropathy were diagnosed in 10.8% and 3.5% of probands, respectively. In 3.8% of prelingual/perilingual cases, Waardenburg syndrome was clinically diagnosed, and in 71.4%, these diagnoses were confirmed with pathogenic variants revealed; seven out of them were novel, including one CNV. All these genetic screening strategies revealed causative variants in 16.2% of the cases. Based on causative variants in the molecular diagnosis and genealogy analyses, a probable genetic etiology was found in ~ 50% of the cases. The present study highlights the relevance of GJB2/GJB6 as a cause of hearing loss in all Brazilian regions and the importance of screening unselected samples for estimating frequencies. Moreover, when a comprehensive screening is not available, molecular diagnosis can be enhanced by selecting probands for specific screenings.

Purpose The objective was to assess the continuation and satisfaction of women who had copper IUDs inserted during caesarean delivery, in addition to possible factors associated with device positioning. Materials and methods A prospective, observational study was carried out involving 158 women who underwent copper IUD insertion during caesarean delivery in Fortaleza, Brazil. The women were followed up 6 weeks and 6 months after insertion of the IUD, at which time they completed a satisfaction questionnaire. We performed speculum and ultrasound examination. Results IUD continuation rates after 6 weeks and 6 months were 92% and 71.5%, respectively. Approximately 85% and 76% of the women were satisfied with the method after 6 weeks and 6 months, respectively. The rate of poor positioning on ultrasound was 5% and the rate of visible thread after 6 weeks was 29.1%, both without association with age, parity, gestational age or active labour. There were 2 cases of infection (1.3%) and no cases of perforation or pregnancy. Conclusions There was a good rate of continuation and satisfaction with the immediate post-caesarean IUD. There was no association between IUD malpositioning and age, parity, gestational age or active labour.

Objective The aim of this study was to report the clinicopathologic features of 62 cases of central odontogenic fibroma (COdF). Study Design Clinical and radiographic data were collected from the records of 13 oral pathology laboratories. All cases were microscopically reviewed, considering the current World Health Organization classification of tumors and were classified according to histopathologic features. Results There were 43 females and 19 males (average age 33.9 years; range 8–63 years). Clinically, COdF lesions appeared as asymptomatic swellings, occurring similarly in the maxilla (n = 33) and the mandible (n = 29); 9 cases exhibited palatal depression. Imaging revealed well-defined, interradicular unilocular (n = 27), and multilocular (n = 12) radiolucencies, with displacement of contiguous teeth (55%) and root resorption (46.4%). Microscopically, classic features of epithelial-rich (n = 33), amyloid (n = 10), associated giant cell lesion (n = 7), ossifying (n = 6), epithelial-poor (n = 3), and granular cell (n = 3) variants were seen. Langerhans cells were highlighted by CD1a staining in 17 cases. Most patients underwent conservative surgical treatments, with 1 patient experiencing recurrence. Conclusions To the best of our knowledge, this study represents the largest clinicopathologic study of COdF. Most cases appeared as locally aggressive lesions located in tooth-bearing areas in middle-aged women. Inactive-appearing odontogenic epithelium is usually observed within a fibrous/fibromyxoid stroma, occasionally exhibiting amyloid deposits, multinucleated giant cells, or granular cells.

Objective: This living systematic review aims to integrate the morphological and tissue-based molecular caracterization of oral lesions occurring in individuals infected by COVID-19 (OLICs). Materials and Design: This study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Web of Science, Scopus, Ovid, Embase, and LILACS were searched to identify reports on OLICs with morphological and/or tissue-based molecular data. Results: Four studies reporting five cases were included. Three patients were male, and the mean age of the individuals was 47.6 years. The most reported anatomical location was the palate (n = 4), whereas ulcers were the most frequent clinical presentation (n = 3). Histopathologically, all cases revealed cell vacuolization and exocytosis in the epithelial layer. In the mesenchymal layer, inflammatory cell infiltrate and thrombi/microvascular thrombosis were observed in three cases. Immunohistochemical reactions were performed in two cases. Both cases were negative for HHV-1, HHV-2, and CMV. One case revealed positivity for SARS-CoV-2 spike protein. No other molecular tests were found for the characterization of OLIC. Conclusions: The pathological characteristics of OLICs are still unspecific. However, with the ongoing COVID-19 pandemic and well-documented new cases, whether OLICs are due to coinfections or has a primary origin can be determined.

OBJECTIVE To systematically integrate the available data published in the literature on oral pigmented lesions (OPL) associated with syndromes, summarizing the clinical and demographic features of the individuals. MATERIALS AND METHODS An electronic search was undertaken in six databases. Eligibility criteria were articles in English, Spanish, and Portuguese describing case reports or case series of OPL associated with syndromes. Data were aggregated and statistically evaluated. RESULTS About 108 articles reporting 149 cases of individuals with syndromes were identified. Among the affected individuals, nine syndromes were reported. The mean age at diagnosis was 35.93 years (0.41 to 83 years), with a predilection for white (n = 85/85.86%) female (n = 102/68.46%) individuals. As regards the number of lesions, 109 (73.15%) were multiple and 40 (26.85%) were single. Lip represented the anatomical location more affected (122 cases/38.01%), followed by the buccal mucosa (100 cases/31.15%). Brownish lesions accounted for 82 (69.49%) cases. The mean time of evolution was 10.52 years (0.16 to 56 years). OPL preceding diagnosis of the syndrome was observed in 111 (74.50%) cases. CONCLUSIONS Although these syndromes are uncommon, dentists should be able to recognize their manifestations, since oral manifestations can represent an important aspect in early diagnosis.

In professional soccer, increasing amounts of data are collected that harness great potential when it comes to analysing tactical behaviour. Unlocking this potential is difficult as big data challenges the data management and analytics methods commonly employed in sports. By joining forces with computer science, solutions to these challenges could be achieved, helping sports science to find new insights, as is happening in other scientific domains. We aim to bring multiple domains together in the context of analysing tactical behaviour in soccer using position tracking data. A systematic literature search for studies employing position tracking data to study tactical behaviour in soccer was conducted in seven electronic databases, resulting in 2338 identified studies and finally the inclusion of 73 papers. Each domain clearly contributes to the analysis of tactical behaviour, albeit in - sometimes radically - different ways. Accordingly, we present a multidisciplinary framework where each domain's contributions to feature construction, modelling and interpretation can be situated. We discuss a set of key challenges concerning the data analytics process, specifically feature construction, spatial and temporal aggregation. Moreover, we discuss how these challenges could be resolved through multidisciplinary collaboration, which is pivotal in unlocking the potential of position tracking data in sports analytics.Highlights Over the recent years, there has been a considerable growth in studies on tactical behaviour using position tracking data, especially in the domains of sports science and computer science. Yet both domains have contributed distinctly different studies, with the first being more focused on developing theories and practical implications, and the latter more on developing techniques.Considerable opportunities exist for collaboration between sports science and computer science in the study of tactics in soccer, especially when using position tracking data.Collaborations between the domains of sports science and computer science benefit from a stronger dialogue yielding a cyclical collaboration.We have proposed a framework that could serve as the foundation for the combination of sports science and computer science expertise in tactical analysis in soccer.

The latest Brazilian Guidelines on ambulatory blood pressure monitoring (ABPM) consider an exam as a useful tool during pregnancy, especially during the first half of pregnancy. They also indicate that white coat hypertension as well as masked hypertension may occur in up to one-third of pregnancies. As white coat hypertension has a more favorable diagnosis than gestational hypertension, it remains associated with 50% of pregnancies and is not associated with complications. Elsewhere, 40% of pregnant women develop gestational hypertension. As per the guidelines, the guidance values should be the same for the general population. The aim of this study was to verify the blood pressure behavior after birth in pregnant women who underwent ABPM and whether ABPM in pregnant women may serve as a predictor of preeclampsia and abnormalities in newborns. Between 01 January 2017 and 31 December 2019, 117 ABPM routines in pregnant women were performed at Unicordis. Among them, 40 were requested for the diagnosis of hypertension, and 77 were requested for antihypertensive therapeutic assessment. The study population comprised pregnant women who underwent ABPM for the diagnosis of hypertension. We assessed a population that comprised 31 subjects who underwent ABPM, 17 of whom had normal results and 14 of whom had abnormal results. Of the 14 pregnant women with abnormal blood pressure behavior, only three (21%) had a physiological drop in blood pressure, seven had attenuated descent, and four did not have blood arterial descent. The age of the pregnant women ranged from 21 to 42 years. The gestational age at the beginning of ABPM ranged from 6 to 37 weeks. In the group with normal ABPM, two pregnant women (11.7%) developed preeclampsia during pregnancy. Additionally, in the group with abnormal ABPM, seven pregnant women (50%) developed preeclampsia during pregnancy. In the group with normal ABPM, three newborns had abnormalities (17.6%); in the group with abnormal ABPM, four newborns had abnormalities (28.5%). In the group with normal ABPM, two subjects developed hypertension after birth (11.7%). In the group with abnormal ABPM, ten subjects (71%) remained hypertensive following birth (Table 1). Conclusions: (1) the results show that the proportion of patients who presented with preeclampsia was higher among individuals with abnormal ABPM than that among individuals with normal ABPM. (2) The proportion of subjects with hypertension following birth was higher among individuals with abnormal ABPM than that among individuals with normal ABPM.

Objectives The purpose of this systematic review was to incorporate the information published on metastatic lesions in the in the oral and maxillofacial region into a comprehensive analysis of their demographic, clinical, and imaginological features and survival rate. Materials and methods An electronic search was undertaken in the subsequent databases: PubMed, Web of Science, Scopus, EMBASE, and LILACS. All papers included were case reports or case series. Absolute and relative frequencies were obtained by descriptive analysis. Overall survival was defined by the Kaplan-Meier method. Results This systematic review identified 217 studies from 33 countries, comprising 348 cases. Male individuals were more affected (n = 199/57.68%) in the 5th to 7th decades of life. The most usual primary site was the lung in men (n = 49/14.08%) and the breast in women (n = 40/11.49%). Jawbones were affected in 183 cases (53.19%), with the posterior mandible (n = 96/66.66%) representing the preferred site. In soft tissues, the gingiva (n = 80/23.25%) was more affected. Clinical presentation was a nodular mass with or without ulceration (n = 280/85.89%). Imaginological examinations revealed radiolucent/hypodense lesions (n = 115/59.28%). The mean survival time was eight months. Conclusion Despite the rare occurrence of metastatic lesions in the oral and maxillofacial region, the current systematic review offers substantial data that could assist clinicians and surgeons.

We present the frequency of cases of isolated odontogenic keratocysts submitted to microscopic examination at 10 Brazilian referral centres in Oral and Maxillofacial Pathology. In a retrospective (1953-2017) analysis, data on clinicoradiographic features and treatment of these lesions were collected and analysed descriptively. Among the 258,867 cases retrieved, 2,497 (0.96%) were isolated odontogenic keratocysts. In summary, an overview of individuals affected with isolated odontogenic keratocysts is reported herein. This lesion showed predilection for the posterior mandible of young adult men.

The aim of this study was to verify and compare the effects of electromyostimulation training (EMS), strength training (ST), and both combined (STEMS), through the analysis of the elbow flexors muscle thickness. Forty subjects (24.45 ± 3.53 years), were randomly divided equally in 4 groups: 3 experimental groups and 1 control group. Each experimental group was submitted to one of three interventions, either an ST protocol, an EMS protocol, or a STEMS protocol. The control group (CG) did not perform any type of physical activity. Ultrasonography (US) was used to measure muscle thickness (MT) at 50 and 60% of the distance between the acromion and the olecranon. The results showed a significant difference in the elbow flexors muscle thickness after 8 weeks, both in the STG, EMSG, and STEMSG, but not in the CG. However, no significant differences were observed between the intervention protocols. It seems that an increase in MT can be obtained using either with ST, EMS, or both combined, however, the results doesn’t support the overlap of one method in relation to the others. EMS can be another interesting tool to induce muscle hypertrophy, but not necessarily better.

The aim of this study was to determine the presence of immature CD1a+ and mature CD83+ dendritic cells in oral squamous cell carcinoma, to compare immunoreactivity between smokers and nonsmokers, and to correlate the results with histopathological grading. In this observational study, twenty-eight paraffin-embedded biopsies of oral squamous cell carcinoma were retrospectively retrieved and submitted to immunohistochemistry for immature CD1a+ and mature CD83+. Descriptive and statistical analyses were performed. The sample consisted of 18 man (64.3%) and 10 women (35.7%), with a mean age of 64.6 years in the nonsmoker group and 53.2 years in the smoker group. The tongue (11 cases, 39.2%) was the most commonly affected anatomical site, followed by gingiva (6 cases, 21.4%). Histopathological grading revealed 7 low-grade and 7 high-grade malignancy cases in each group, and no correlation with the number of positive DCs. The number of immature CD1a+ was not significantly different between smoker and nonsmoker groups, while a lower number of mature CD83+ was detected in the smoker group (p = 0.001). Smoking changes the oral immune system and decreases the ability to activate and mature dendritic cells, which may influence the development and progression of oral squamous cell carcinoma.

to determine salivary electrolyte concentration of oral potentially malignant disorders (OPMD) and oral squamous cell carcinoma (OSCC) patients. A related systematic review was performed.Observational study. Unstimulated saliva from 18 patients with OSCC, 18 with OPMD, and 18 without oral lesions was collected. A biochemical analysis was performed to evaluate the salivary concentrations of potassium (K), phosphorus (P), sodium (Na), calcium (Ca), magnesium (Mg), zinc (Zn), copper (Cu), and iron (Fe). Kruskal-Wallis test was performed, and p0.05 was interpreted as statistically significant. The literature search for the systematic review retrieved 9 studies that associated salivary electrolyte levels with presence and progression of OSCC.A highly significant increase was found in the salivary Mg levels in the OPMD group (5.41 µg/mL) in comparison with the OSCC (3.71µg/mL) and control group (3.51 µg/mL) (p = 0.041). No differences were observed in other salivary levels elements. The results of the systematic review revealed that one article indicated a decrease, and three papers reported an increase in salivary Na levels in patients with OPMD and OSCC. Two articles indicated a decrease in salivary K levels in OSCC, and the other two reported high Mg levels in OPMD and OSCC.High salivary Mg levels can be a potential biomarker indicating the presence of OPMD, however, the evidence is still contradictory and more studies are required.

To evaluate the impact of the COVID-19 pandemic on the number of diagnoses of oral and maxillofacial lesions in public laboratories after one year of COVID-19 outbreak in Brazil.This is a cross-sectional study. Biopsies submitted to histopathologic examination from March 2019 to February 2020 (pre-pandemic period) and from April 2020 to March 2021 (pandemic period) in nine Brazilian public oral pathology laboratories were retrieved and the number of diagnoses, types of lesion, and percentage changes during both periods were analyzed.There were 7389 diagnoses in the pre-pandemic period and 2728 in the pandemic era, indicating a reduction of 63.08%. The reduction was 64.23% for benign lesions and 49.48% for malignant lesions, with a 50.64% reduction in squamous cell carcinoma. The largest decreases were observed in April 2020 and January 2021.An important reduction in the diagnoses of benign and malignant lesions was noted in the Brazilian public oral pathology laboratories during the first year of the COVID-19 pandemic.

Background: The present study investigated the influence of body dissatisfaction (BD) on the self-esteem of Brazilian adolescents. Methods: A cross-sectional study was carried out with 1011 students at public and private schools in the city of Fortaleza, Brazil. The body shape questionnaire and the Rosenberg self-esteem scale were applied. Chi-square test, Student&rsquo, s t-test, Pearson&rsquo, s correlation, the odds ratio and binary logistic regression were used. Results: The rate of low self-esteem was 33.8% in the adolescents, 27.8% of the adolescents presented some degree of BD, with severe BD in 5.8%. A significant low negative correlation was found between self-esteem and BD in all the adolescents. In the Odds Ratio analysis, it was observed that the odds of having low self-esteem increased in adolescents with BD as compared to adolescents without BD, being 3.85 times higher in females (CI 95%, 2.12&ndash, 6.99), 2.83 times higher in males (CI 95%, 1.22&ndash, 6.58), 5.79 times higher in adolescents attending public schools (CI 95% 2.06&ndash, 16.26), and 2.96 times higher in adolescents attending private schools (CI 95%, 1.79&ndash, 4.88). Conclusions: Low self-esteem affected one-third of the adolescents, both male and female. BD and education in public schools are predictor variables of low self-esteem in adolescents.

Background The aim was to analyze the frequency, clinical and demographic features of solitary and multiple/diffuse oral pigmented lesions submitted to histopathological examination, and to summarize the features that guide the clinical differential diagnosis. Methods Clinical and demographic data were retrieved from biopsy records and descriptive statistics were performed. Results Nine hundred and five (0.51%) oral pigmented lesions were retrieved among 177 356 specimens, being 95.9% solitary and 4.1% multiple/diffuse lesions. Regardless the overlapping clinical presentation, age, site, association with amalgam restoration, and a nodular appearance may help in the clinical differential diagnosis of solitary oral pigmentations. Patient's habits, site, and systemic signs and symptoms are helpful in the clinical differential diagnosis of multiple/diffuse lesions. Conclusions Oral pigmented lesions are a rare diagnosis in oral pathology and solitary lesions are more commonly submitted to biopsy. Some key features help in the differential diagnosis, though biopsy can be warranted in doubtful cases.

To integrate the available data published on malignant peripheral nerve sheath tumours (MPNST) of the oral and maxillofacial region. Searches in Embase, PubMed, Web of Science and Scopus were conducted for the identification of case reports/case series in English language. The risk of bias was assessed using the Joanna Briggs Institute tool. Outcomes were evaluated by Cox regression and Kaplan-Meier methods. A total of 306 articles were retrieved, 50 of which reporting 57 MPNST were included. The lesion showed a predilection for the mandible (n = 18/31.57%) of middle-aged adults (~40.5 years) with a male/female ratio of 1.1:1. The individuals were mostly symptomatic with a mean evolution time of 9.6 months. Surgical removal plus adjuvant therapy (especially radiotherapy) was the main approach (51.86%). Recurrence was reported in 39.62% of cases. Nodal and distant metastases were identified in 28.26% and 26.66% of cases, respectively. The 2-year cumulative survival rate was 55%. Independent predictors of poor survival were the presence of neurofibromatosis type 1 (p = 0.04) and distant metastases (p = 0.004). The diagnosis of MPNST is challenging due to the variety of its clinical and histopathological presentations. Local aggressiveness and the potential for metastases are common outcomes of this neoplasm.

Rifampicin is used in both phases of treatment for tuberculosis. In chronic use, the short half-life and the self-induction of metabolism can decrease the levels of the drug below the minimal inhibitory concentration. The aim of the study was to investigate whether plasma concentrations of rifampicin are sustained above 0.5 μg/mL in patients with tuberculosis using 600 mg/day. Rifampicin was measured in plasma by high-performance liquid chromatography and a sputum smear microscopy was performed in all days of the study. A total of 44 male patients completed the study. On days 31, 61 and 91, the mean plasma concentrations of rifampicin were 0.6 (0.5) μg/mL, 0.55 (0.5) μg/mL and 0.46 (0.4) μg/mL. There was a high variation of rifampicin levels leading to a high percentage of samples with concentrations below 0.5 μg/mL. There was no significant association between the frequency of samples with drug levels below 0.5 μg/mL with the conversion of the sputum microscopy. These data suggest that pre-doses samples offer limited information on the exposure of M. tuberculosis to rifampicin. Keywords: Infectious disease, Tuberculosis, Rifampicin

Made available in DSpace on 2019-10-05T10:15:53Z (GMT). No. of bitstreams: 0 Previous issue date: 2019-02-01 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Introduction: This study evaluated the efficacy of photodynamic inactivation (PDI) with hematoporphyrin IX (H) and modified hematoporphyrin IX (MH) at 10 mu mol/L, using a blue light-emitting diode (LED), fluence of 75 J/cm,(2) over planktonic cultures and biofilm of Streptococcus mutans (UA 159). Methods: Suspensions containing 107 cells/mL were tested under different experimental conditions: a) H and LED (H+L+), b) MH and LED (MH+L+), c) only LED (P-L+), d) only H (H+L-), e) only MH (MH+L-), and f) control group, no LED or photosensitizer treatment (P-L-). The study also evaluated the effect of PDI on S mutans biofilm on metallic or ceramic brackets bonded on specimens of human teeth. The strains were seeded onto Mitis safivarius-bacitracin-sacarose agar to determine the number of colony-forming units. Results: H and MH under LED irradiation were effective on planktonic cultures (P

Chikungunya virus (CHIKV) infection is an acute febrile illness with polyarthralgia and arthritis. There are few data about CHIKV infection in kidney transplant recipients (KTR). We report the largest case series of CHIKV infection in this population.We retrospectively analyzed 32 cases of CHIKV infection in KTR between January 2016 and December 2017 at Hospital Universitário Walter Cantídio of Federal University of Ceará.All patients had been in endemic areas before the beginning of the symptoms. All presented arthralgia, 15 (46.9%) with joint inflammatory symptoms and 14 (43.8%) evolved to chronic arthralgia. Seven (21.9%) showed acute kidney injury (AKI) by Kidney Disease: Improving Global Outcomes criteria during the acute phase. Acute kidney injury was not related to prednisone use (odds ratio [OR], 0.3; 95% confidence interval [CI], 0.04-2.61, P = 0.3) nor chronic arthralgia (OR, 1.2; 95% CI, 0.2-8.4, P = 0.8) as well as male sex, chronic kidney disease and older than 60 years (OR, 1.7; 95% CI, 0.3-10.3, P = 0.58; OR, 0.4; 95% CI, 0.1-2.7, P = 0.4; and OR, 2.1; 95% CI, 0.3-14.9, P = 0.45, respectively). Hospitalization was associated to AKI (OR, 44.0; 95% CI, 3.8-503.1; P = 0.002), probably due to diarrhea or dehydration. One patient died throughout the study, possibly unassociated with CHIKV infection.KTR with CHIKV infection have a clinical presentation and evolution similar to those seen in the general population. Kidney function is generally well preserved, with transitory graft dysfunction without negative impact after 3 months from the beginning of the symptoms. Previous costicosteroids use did not relate with AKI or chronic arthralgia.

Background and aim This study aimed to describe the clinical, genetic, and epidemiological features of Charcot-Marie-Tooth disease (CMT) in Brazilian patients from a tertiary center, and to compare our data with previously published findings. Methods This retrospective observational study conducted between February 2015 and July 2020 evaluated 503 patients (94 families and 192 unrelated individuals), diagnosed with CMT. Clinical and neurophysiological data were obtained from electronic medical records and blood samples were used for genetic analyses. Multiplex ligation-dependent probe amplification was used to assess duplications/deletions in PMP22. Sanger sequencing of GJB1 was performed in cases of suspected demyelinating CMT. Targeted gene panel sequencing was used for the remaining negative demyelinating cases and all axonal CMT cases. Results The first decade of life was the most common period of disease onset. In all, 353 patients had demyelinating CMT, 39 had intermediate CMT, and 111 had axonal CMT. Pathogenic or likely pathogenic variants were identified in 197 index cases. The most common causative genes among probands were PMP22 (duplication) (n=116, 58.88%), GJB1 (n=23, 11.67%), MFN2 (n=12, 6.09%), GDAP1 (n=7, 3.55%), MPZ (n=6, 3.05%), PMP22 (point mutation) (n=6, 3.05%), NEFL (n=3, 1.52%), SBF2 (n=3, 1.52%), and SH3TC2 (n=3, 1.52%). Other identified variants were ≤1% of index cases. Interpretation This study provides further data on the frequency of CMT subtypes in a Brazilian clinical-based population and highlights the importance of rarer and previously undiagnosed variants in clinical practice. This article is protected by copyright. All rights reserved.

Neuroimaging findings in people at either genetic risk or at clinical high-risk for psychosis (CHR-P) or bipolar disorder (CHR-B) remain unclear. A meta-analytic review of whole-brain voxel-based morphometry (VBM) and functional magnetic resonance imaging (fMRI) studies in individuals with genetic risk or CHR-P or CHR-B and controls identified 94 datasets (N = 7942). Notwithstanding no significant findings were observed following adjustment for multiple comparisons, several findings were noted at a more liberal threshold. Subjects at genetic risk for schizophrenia or bipolar disorder or at CHR-P exhibited lower gray matter (GM) volumes in the gyrus rectus (Hedges' g = −0.19). Genetic risk for psychosis was associated with GM reductions in the right cerebellum and left amygdala. CHR-P was associated with decreased GM volumes in the frontal superior gyrus and hypoactivation in the right precuneus, the superior frontal gyrus and the right inferior frontal gyrus. Genetic and CHR-P were associated with small structural and functional alterations involving regions implicated in psychosis. Further neuroimaging studies in individuals with genetic or CHR-B are warranted.

Objective: To analyze the effects of the ice popsicle on vasopressin, osmolality, thirst intensity, and thirst discomfort. Method: This is a quasi-experimental, pre- and post-test study conducted in a laboratory. The sample consisted of nine healthy male volunteers, who received 2% hypertonic saline solution. Results: Popsicle intake did not result in a statistically significant reduction in vasopressin levels (F=0.876 and p=0.428). However, there was a reduction in the hormonal physiological profile of vasopressin from 7.1 pg/ml to 5.8 pg/ml after the first two interventions. Osmolality concentration changed from 270.65 to 286.51 mOsm/kg, with no statistical difference (F=2.207; p=0.09). Ice popsicles significantly reduced thirst intensity (F=10.00; p=0.001) and thirst discomfort (F=10.528; p

Background: Domestic violence is a traumatic experience that can lead to physical consequences, mental disorders and financial damage. Over 18 cases per 100,000 inhabitants were reported in Brazil between 2013 and 2014. The ministry of health poses a mandatory notification of all cases of domestic violence, which is essential, bearing in mind its systemic relation to various social issues and the extensive regional differences and high socioeconomic inequalities present in Brazil.Aim: To analyze the characteristics of the notification rates of domestic violence and investigate the correlation of these with health and socioeconomic characteristics of large Brazilian cities.Methods: Retrospective data on notifications of domestic violence was collected from the National Information System for Notifiable Diseases for Brazil, 2017. Dependent variables were collected from the Brazilian Institute of Geography and Statistics and Ministry of Citizenship. Inclusion criteria were: cities larger than 100.000 habitants and that had at least 20 reports, totaling 68.313 reports in 259 cities. These were stratified by age, race and sex of victim, type of violence used, violence perpetrator, place of occurrence and means of aggression. Proportional number of notified cases was calculated for each city to expose different characteristics of reports. A multiple linear regression model was used to investigate the correlation between report rates and different socioeconomic and health variables.Results: The analysis showed a high proportion of repeated violence, use of body strength and over 50% were perpetrated by a partner or boyfriend. Report rates were higher for women, black individuals and children under four, highlighting subgroups of the population that were more vulnerable. Indeed, these groups were correlated differently with socioeconomic variables. Poverty, assessed as Bolsa Família investment, was correlated with domestic violence report rates across vulnerable groups.Conclusion: The study showed that black women and children are more vulnerable to domestic violence, highlighting deleterious effects of patriarchy and structural racism within Brazilian society. Altogether, we suggest that reducing poverty, patriarchy and structural racism could lead to fewer cases of domestic violence.

Magnetic nanocomposites were synthesized for the targeted delivery of hydrophilic bioactives through guidance generated by a magnetic field. Superparamagnetic iron oxide nanoparticles (SPIONs) were used to generate hydroxyethyl starch magnetic nanocapsules (HES MNCs). This synthesis allowed the co-encapsulation of oncocalyxone A (onco A) and surface-modified magnetite nanoparticles (Fe3O4@citrate) into the same nanostructure. The synthesized nanocapsules exhibited a core-shell morphology, with an average diameter of 143 nm. This nanocomposite showed potential anticancer activity (IC50) against four human tumor cell lines: glioblastoma SNB-19 (1.010 μgmL−1), colon carcinoma HCT-116 (2.675 μgmL−1), prostate PC3 (4.868 μgmL−1), and leukemia HL-60 (2.166 μgmL−1). Additionally, in vivo toxicity and locomotor activity were evaluated in a zebrafish (Danio rerio) model. The nanocomposite exhibited in vitro cytotoxicity, prolonged drug release profile and also responded to an applied magnetic field, representing a versatile compound with perspectives for highest concentration of different hydrophilic bioactives in a target tissue through magnetic vectorization.

Objective: to analyze the association of skin-to-skin contact and social determinants of health. Methods: this is a cross-sectional study with 187 medical records of newborns from a reference rooming in in northeastern Brazil. An instrument with maternal and neonatal data was used. Analysis was descriptive and inferential statistics. For the associations, a chi-square test was used to measure strength, an Odds Ratio was calculated, with a 95% confidence interval. Results: 62% of newborns who made skin-to-skin contact at birth were eutrophic, full-term, Apgar > 7, mothers with prenatal care and without abortion. The determinants associated with non-skin-to-skin contact were preterm (CR=3.2;95%CI: 2.72-18.98); 1st minute Apgar < 7 (CR:2.9;95%CI: 2.38-3.06), cesarean section (CR:8.4;95%CI: 4.29-16.57), and unhealthy NB (CR 12.7;95%CI: 4.9-32.67). We used STROBE guidelines. Conclusion: skin-to-skin contact was influenced by gestational age, Apgar, delivery, and newborn health.

Ricardo Pereira Nogueira,1,2 Jose Deuzimar Uchoa,3,4 Fanny Hilario,2 Gabriela de Fátima Santana-Melo,5 Luana Marotta Reis de Vasconcellos,5 Fernanda Roberta Marciano,6 Virginie Roche,2 Alberto Moreira Jorge Junior,2,7 Anderson Oliveira Lobo4 1Chemical Engineering Department, Khalifa University of Science and Technology, Abu Dhabi 127788, United Arab Emirates; 2Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, GrenobleINP*LEPMI, Grenoble 38000, France; 3Federal Institute of Education, Science and Technology of Piauí, Teresina 64053-390, Brazil; 4Interdisciplinary Laboratory for Advanced Materials, BioMatLab Group, Materials Science and Engineering Graduate Program, UFPI – Federal University of Piaui, Teresina 64049-550 Brazil; 5Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, Sao Paulo State University, Sao José dos Campos 12245-000, Brazil; 6Department of Physics, Federal University of Piaui, Teresina PI 64049-550 Brazil; 7Department of Materials Engineering, Federal University of São Carlos, São Carlos 13565-905, BrazilCorrespondence: Anderson Oliveira LoboCampus Universitário Ministro Petrônio Portella, Av. Universitária, s/n, Centro de Tecnologia, Laboratório Interdisciplinar de Materiais Avançados, Ininga, Teresina, PI 64049-550, BrazilTel +55 86 32371057Email lobo@ufpi.edu.brBackground: Nanostructured surface modifications of Ti-based biomaterials are moving up from a highly-promising to a successfully-implemented approach to developing safe and reliable implants.Methods: The study’s main objective is to help consolidate the knowledge and identify the more suitable experimental strategies related to TiO2 nanotubes-modified surfaces. In this sense, it proposes the thorough investigation of two optimized nanotubes morphologies in terms of their biological activity (cell cytotoxicity, alkaline phosphatase activity, alizarin red mineralization test, and cellular adhesion) and their electrochemical behavior in simulated body fluid (SBF) electrolyte. Layers of small-short and large-long nanotubes were prepared and investigated in their amorphous and crystallized states and compared to non-anodized samples.Results: Results show that much more than the surface area development associated with the nanotubes’ growth; it is the heat treatment-induced change from amorphous to crystalline anatase-rutile structures that ensure enhanced biological activity coupled to high corrosion resistance.Conclusion: Compared to both non-anodized and amorphous nanotubes layers, the crystallized nano-structures’ outstanding bioactivity was related to the remarkable increase in their hydrophilic behavior, while the enhanced electrochemical stability was ascribed to the thickening of the dense rutile barrier layer at the Ti surface beneath the nanotubes.Keywords: surface modification, TiO2 nanotubes, commercially pure titanium, bioactivity

Media influence may lead adolescents to internalize patterns of physical beauty, resulting in dissatisfaction with their own bodies when they are unable to match up to these patterns. In the constant search for an &lsquo, ideal body&rsquo, adolescents may begin to develop risk behaviors for the development of eating disorders (ED). The object of this study was to analyze the influence of the mass media on body dissatisfaction (BD) and on ED in adolescents, comparing genders. We also analyzed the influence of BD on the risk of developing unsuitable eating behaviors, with risk of ED, comparing genders. A cross-sectional study was carried out with 1011 adolescents: 527 girls and 484 boys. The BMI of each adolescent was determined, and the instruments EAT-26, Sociocultural Attitudes towards Appearance Questionnaire-3 (SATAQ-3), and body shape questionnaire (BSQ), were applied. For statistical analysis, we used Student&rsquo, s t-test, the chi-square test, Pearson&rsquo, s correlation test, the odds ratio, and hierarchical multiple linear regression. The influence of the mass media is associated with a greater probability of adolescents presenting BD. An increase in BD is associated with an increased risk of developing ED in adolescents of both genders but is greater in girls than in boys. Furthermore, the influence of the MM and BMI are predictors of BD in both genders, and BD is a predictor of ED risk in both girls and boys.

Occurrences of rare oral complications following herpes zoster (HZ) infection have been reported. In the present case, a 57-year-old man was referred for periodontal evaluation due to gingival bleeding. His medical history included diagnoses of chronic lymphocytic leukemia and HZ infection. Intraoral examination revealed necrosis and alveolar bone exposure around the mandibular left lateral incisor, and the patient reported spontaneous exfoliation of the maxillary and mandibular left central incisors. Conservative surgical and antibiotic therapies were provided to the patient, and a diagnosis of osteonecrosis of the jaw following HZ infection was established. There were no signs of recurrence in 17 months of follow-up. Clinicians should be aware of unusual complications related to a previous HZ infection.

Define factors for proper diagnosis and treatment of small intestinal injury during procedures with percutaneous renal access, thus optimizing favorable outcomes and avoiding complications and death during conservative or surgical approaches. Bibliographic review of case reports available in the literature and presentation of data from an additional case have been carried out. Percutaneous nephrolithotripsy was the procedure that most frequently caused injury of the small intestine. Time for diagnosis of the lesion took up to 5 days after the intraoperative phase. When occurring in the intraoperative phase, perforation was identified by direct endoscopic visualization; a catheter was then placed inside the intestinal lumen and a conservative approach to the derived fistula was adopted, which led to successful outcomes in all cases. Abdominal pain was the most common symptom in cases diagnosed during the postoperative phase (75%). In the presence of signs of peritonitis, surgical intervention was performed, with favorable evolution in all cases. Conservative management of small intestine injuries is possible when there is no peritoneal contamination. Its success factors include intraoperative diagnosis and non-transfixing lesions, which is more common in duodenal involvement. Laparotomy to clean the cavity associated with a corrective approach (enterorrhaphy or enterectomy with primary anastomosis) was successfully indicated in cases of late diagnosis with signs of peritonitis, a situation that is most commonly found in transfixing lesions of ileum and jejunum.

The aim of this study was to determine the effects of probiotics on peri-implant diseases.PubMed-MEDLINE, Scopus, Literature in the Health Sciences in Latin America and the Caribbean (LILACS) and Science Direct were searched until September 2019. Three authors independently carried out this search, using the following search algorithm to explore databases using Boolean operators ("peri-implant diseases" OR "dental implants") AND ("probiotics" OR "lactobacillus"). Randomized clinical trials were included. No limits were applied to the year and articles were restricted to those in the English, Spanish and Portuguese languages. Review articles, reports of clinical cases and works without mention of the topic were excluded.Five randomized clinical trials were analyzed in the final review process. For the primary outcomes - Periodontal probing depth (PPD) and bleeding on probing (BOP); and for the secondary outcames - plaque index, gingival index, gingival crevicular fluid and microbiological tests - no significant clinical effects of probiotics were observed.Probiotics could be used during the treatment of peri-implant diseases. However, the most appropriate form of probiotic administration or the effectiveness of this approach are still unclear. There is currently insufficient evidence to demonstrate the benefits of the use of probiotics as an adjunctive therapy in patients with peri-implant diseases.

Background intravascular papillary endothelial hyperplasia is an unusual vascular lesion characterized by the proliferation of endothelial cells. The aim of this study was to determine the frequency and general features of this lesion. Methods biopsy records of three oral pathology services were reviewed for intravascular papillary endothelial hyperplasia cases from 1959 to 2020. In addition, a systematic review of case reports and case series was carried out in eight electronic databases. Results of the 65,205 retrieved cases, 20 (0.03%) were diagnosed as intravascular papillary endothelial hyperplasia. Mean patient age was 46.55 years, and females (12 cases/60%) were more affected. The lower lip (9 cases/47.36%) was the most commonly affected site, and the lesions were generally asymptomatic (7 cases/63.63%). Clinically, 90% of the lesions presented (18 cases) as a nodule, with a mean size of 1.13cm. The clinical diagnostic hypotheses most frequently raised were mucocele (6 cases/37.50%) and hemangioma (5 cases/31.25%). An excisional biopsy was chosen in all cases for treatment. Forty-nine studies of the systematic review were included, yielding 105 cases. The literature showed similarity in all variables. Conclusion despite the uncommon frequency, clinicians and oral pathologists should familiarize themselves with the similarities between intravascular papillary endothelial hyperplasia and some other lesions in terms of clinical and histological features.

Background Cardiovascular complications associated with thoracic surgery increase morbidity, mortality, and treatment costs. Elevated cardiac troponin level represents a predictor of complications after non-cardiac surgeries, but its role after thoracic surgeries remains undetermined. The objective of this study was to analyze the relationship between troponin I elevation and morbidity and mortality after one year in patients undergoing lung resection surgery. Methods This prospective cohort study evaluated 151 consecutive patients subjected to elective lung resection procedures using conventional and video-assisted thoracoscopic techniques at a University Hospital in Brazil, from July 2012 to November 2015. Preoperative risk stratification was performed using the scores obtained by the American College of Physicians (ACP) and the Society of Cardiology of the state of São Paulo (EMAPO) scoring systems. Troponin I levels were measured in the immediate postoperative period (POi) and on the first and second postoperative days. Results Most patients had a low risk for complications according to the ACP (96.7%) and EMAPO (82.8%) scores. Approximately 49% of the patients exhibited increased troponin I (≥0.16 ng/ml), at least once, and 22 (14.6%) died in one year. Multivariate analysis showed that the elevation of troponin I, on the first postoperative day, correlated with a 12-fold increase in mortality risk within one year (HR 12.02, 95% CI: 1.82–79.5; p = 0.01). Conclusions In patients undergoing lung resection surgery, with a low risk of complications according to the preoperative evaluation scores, an increase in troponin I levels above 0.16 ng/ml in the first postoperative period correlated with an increase in mortality within one year.

Introduction Malignant nonendodontic periapical lesions represent a rare diagnosis, in which few case have been reported about this condition. Due to the low occurrence and little exploration of this subject, serious errors of diagnosis are observed in the oral medicine services. In this sense, the purpose of the present review was to integrate the information on the record published on malignant lesions that mimic endodontic pathoses into a comprehensive analysis of their clinical, radiologic, and histopathologic features. Methods An online search was made in March 2020 in the following databases: Pubmed, Web of Science, and Scopus. Eligibility criteria included publications having enough clinical, radiologic, and histopathologic information to confirm the diagnosis. Data were assessed descriptively. Results Forty-nine publications from 16 countries comprising 60 cases were included. There is a nearly equal occurrence rate between males and females (male/female ratio is 49.15%/50.84%) with a mean age of 46.56 years. The lesions were more prevalent in the posterior mandibles (40.69%), and, radiographically, they were unilocular radiolucent. Histopathologic analysis showed metastasis (26.67%) as the most prevalent lesion followed by salivary gland malignant disease (25%). Conclusions The present systematic review revealed several histologic types of malignant periapical lesions that could be mimicking endodontic pathoses. Because these lesions usually do not show clinical or radiologic features of malignant alteration, clinicians should consider these hypotheses in their routine.

This study aimed to investigate the association between maternal psychological distress and impairment in mother-child relationship in a sample from a Northeast capital city in Brazil with a low Human Development Index, using directed acyclic graphs (DAG). A total of 3,215 women were evaluated for the presence of psychological distress through the Self Reporting Questionnaire instrument and for the mother-child relationship by the first factor of Postpartum Bonding Questionnaire, considered the most appropriate in the literature. Demographic and socioeconomic variables were used to construct a theoretical model and, after this, multivariate logistic regression was performed using variables suggested by Directed Acyclic Graphs (DAG). Psychological distress was present in 22.7% of the women and 12.6% of them presented impaired mother-child relationships. After adjustment, the variable ‘maternal mental distress' remained associated with impaired mother-child relationship (RR=3.03), and among the explanatory variables only ‘primary school level' (RR=1.48) was associated as a risk factor to this outcome. The results indicated that, in this population, women with psychological distress and lower schooling are more likely to present impaired mother-child relationships.

BACKGROUND: The role of Helicobacter pylori infection on eosinophilic infiltration in duodenal mucosa is poorly studied. An increase in the number of eosinophils in duodenum has been associated with functional dyspepsia. OBJECTIVE: To evaluate the influence of H. pylori infection on duodenal eosinophil count and the role of eosinophilic infiltrate of duodenum in functional dyspepsia. METHODS: Positive and negative H. pylori individuals were included. Both functional dyspeptic patients according to Rome III criteria (cases) and individuals without gastrointestinal symptoms (controls) were enrolled. They were submitted to upper endoscopy and H. pylori infection was verified by gastric histopathology and urease test. Eosinophils in the duodenal mucosa were counted in five high-power fields, randomly selected on slides of endoscopic biopsies. RESULTS: Thirty-nine H. pylori positive (mean age 40.5 and 69.2% women) and 24 negative patients (mean age 37.3 and 75% women) were included. The influence of the infection was observed in the duodenal eosinophil count, which was higher in infected individuals: median 13.2 vs 8.1 in non-infected individuals (P=0.005). When we analyzed patients according to symptoms, cases - mean age 39.6; 71.4% women - and controls - mean age 38.7; 71.4% women - had similar duodenal eosinophil count: median 11.9 and 12.6 respectively (P=0.19). CONCLUSIONS: We did not demonstrate association of duodenal eosinophil count with functional dyspepsia but found association with H. pylori infection. RESUMO CONTEXTO: O papel de infecção por Helicobacter pylori no infiltrado eosinofílico duodenal ainda é pouco compreendido. Um aumento no número de eosinófilos duodenais tem sido associado a dispepsia funcional. OBJETIVO: Avaliar a influência do H. pylori na contagem de eosinófilos duodenais e o papel do infiltrado eosinofílico duodenal na dispepsia funcional. MÉTODOS: Indivíduos H. pylori positivo e negativo foram incluídos. Ambos os grupos, compreendendo dispépticos funcionais pelos critérios de Roma III (casos) e indivíduos sem sintomas gastrointestinais (controles), foram submetidos à endoscopia digestiva alta para pesquisa de H. pylori, efetuada por histopatologia e teste de urease. Eosinófilos na mucosa duodenal foram contabilizados em cinco campos de maior aumento, selecionados randomicamente nas lâminas de biópsia endoscópicas. RESULTADOS: Trinta e nove indivíduos H. pylori positivo (média de idade 40,5 e 69,2% mulheres) e 24 H. pylori negativos (média de idade 37,3 e 75% mulheres) foram incluídos. A influência da infecção por H. pylori foi observada na contagem de eosinófilos, que foi maior nos positivos: mediana 13,2 vs 8,1 (P=0,005). Quando analisados pacientes de acordo com sintomas, os casos (média de idade 39,6 e 71,4% mulheres) e controles (média de idade 38,7 e 71,4% mulheres), apresentaram semelhante contagem de eosinófilos duodenais: mediana 11,9 e 12,6, respectivamente (P=0,19). CONCLUSÃO: Não demonstramos associação da contagem de eosinófilos duodenais com dispepsia duodenal, mas encontramos associação com infecção por H. pylori.

Made available in DSpace on 2020-12-12T01:58:39Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-02-19 Background: Pelvic floor muscles (PFM) and rectus abdominis muscles (RAM) of pregnant diabetic rats exhibit atrophy, co-localization of fast and slow fibers and an increased collagen type I/III ratio. However, the role of similar PFM or RAM hyperglycemic-related myopathy in women with gestational diabetes mellitus (GDM) remains poorly investigated. This study aims to assess the frequency of pelvic floor muscle disorders and pregnancy-specific urinary incontinence (PS-UI) 12 months after the Cesarean (C) section in women with GDM. Specifically, differences in PFM/RAM hyperglycemic myopathy will be evaluated. Methods: The Diamater is an ongoing cohort study of four groups of 59 pregnant women each from the Perinatal Diabetes Research Centre (PDRC), Botucatu Medical School (FMB)-UNESP (São Paulo State University), Brazil. Diagnosis of GDM and PS-UI will be made at 24-26 weeks, with a follow-up at 34-38 weeks of gestation. Inclusion in the study will occur at the time of C-section, and patients will be followed at 24-48 h, 6 weeks and 6 and 12 months postpartum. Study groups will be classified as (1) GDM plus PS-UI; (2) GDM without PS-UI; (3) Non-GDM plus PS-UI; and (4) Non-GDM without PS-UI. We will analyze relationships between GDM, PS-UI and hyperglycemic myopathy at 12 months after C-section. The mediator variables to be evaluated include digital palpation, vaginal squeeze pressure, 3D pelvic floor ultrasound, and 3D RAM ultrasound. RAM samples obtained during C-section will be analyzed for ex-vivo contractility, morphological, molecular and OMICS profiles to further characterize the hyperglycemic myopathy. Additional variables to be evaluated include maternal age, socioeconomic status, educational level, ethnicity, body mass index, weight gain during pregnancy, quality of glycemic control and insulin therapy. Discussion: To our knowledge, this will be the first study to provide data on the prevalence of PS-UI and RAM and PFM physical and biomolecular muscle profiles after C-section in mothers with GDM. The longitudinal design allows for the assessment of cause-effect relationships between GDM, PS-UI, and PFMs and RAMs myopathy. The findings may reveal previously undetermined consequences of GDM. Department of Gynecology and Obstetrics Botucatu Medical School (FMB) São Paulo State University (UNESP) Physics Department Institute of Biosciences Letters and Exact Sciences Multiuser Center for Biomolecular Innovation UNESP-São Paulo State University Physiotherapy Department Faculdades Integradas de Bauru FIB Universidade Do Sagrado Coração (USC), Jardim Brasil Department of Health Research Methods Evidence and Impact McMaster University Biostatistics Unit Father Sean o'Sullivan Research Centre St Joseph's Healthcare-Hamilton Department of Obstetrics and Gynecology Weill Cornell Medicine Institute of Tropical Medicine University of Sao Paulo Medical School School of Philosophy and Sciences Department of Physiotherapy and Occupational Therapy UNESP-São Paulo State University Department of Gynecology and Obstetrics Botucatu Medical School (FMB) São Paulo State University (UNESP) Physics Department Institute of Biosciences Letters and Exact Sciences Multiuser Center for Biomolecular Innovation UNESP-São Paulo State University School of Philosophy and Sciences Department of Physiotherapy and Occupational Therapy UNESP-São Paulo State University

Objectives To analyse the occurrence of calcifying epithelial odontogenic tumours (CEOT) based on biopsy records from different Brazilian geographic regions and to contrast the data with a review of the literature. Materials and methods A 2-step study was conducted. Step 1 consisted of a collaborative study of biopsies obtained from 1953 to 2017 at six Brazilian oral and maxillofacial pathology centres. Evaluation of 86,268 biopsy records was performed. Demographic and histopathological diagnosis data were assessed. In Step 2, a review of the literature of case reports and cases series of CEOT identified across five electronic databases was conducted. Results In the collaborative study, 32 cases of CEOT were evaluated. This figure represented 0.03% of the oral and maxillofacial lesions and 1.7% of all odontogenic tumours across the centres. Women in the fourth decade of life were more affected. CEOT occurred more in the mandible than in the maxilla (ratio 1.9:1). The review of the literature showed that Asian individuals were more affected by this neoplasm. Conclusions Useful knowledge on the epidemiology, treatment and follow-up of CEOT has been provided. Demographic data and clinical features of the cases presented in this collaborative study were quite similar to those of studies reported worldwide.

Objective The aim of this study was to investigate the frequency and some characteristics of odontogenic tumours, odontogenic cysts and non-odontogenic cysts in an elderly population (≥60 years). Background Few studies describe the distribution of oral lesions in older people. Materials and methods A retrospective descriptive cross-sectional study was performed. Biopsy records were obtained from the archives of four Brazilian referral centres between 2000 and 2016. Data such as gender, age, anatomical location, symptomatology and histopathological diagnosis were collected and categorised. Statistical analyses were performed adopting a P-value of ≤.05 and a 95% confidence interval. Results A total of 7259 biopsy records of elderly participants were analysed; 642 cases were cystic lesions and odontogenic tumours, 491 of which being classified as odontogenic cysts (76.5%), 75 as odontogenic tumours (11.7%) and 76 as non-odontogenic cysts (11.8%). The most frequent lesions in each group were radicular cyst (n = 268), ameloblastoma (n = 51) and salivary duct cyst (n = 21), respectively. Overall, women were more affected (n = 351, mean age: 68 years). Intraosseous lesions were more common in the mandible (n = 342), and soft tissue cysts occurred more in the lip (n = 13). Conclusion Odontogenic cysts were relatively common, whereas odontogenic tumours and non-odontogenic cysts were rarer among the older people studied in the present investigation.

Summary Background The sepsis burden on acute care services in middle-income countries is a cause for concern. We estimated incidence, prevalence, and mortality of sepsis in adult Brazilian intensive care units (ICUs) and association of ICU organisational factors with outcome. Methods We did a 1-day point prevalence study with follow-up of patients in ICU with sepsis in a nationally representative pseudo-random sample. We produced a sampling frame initially stratified by geographical region. Each stratum was then stratified by hospitals' main source of income (serving general public vs privately insured individuals) and ICU size (ten or fewer beds vs more than ten beds), finally generating 40 strata. In each stratum we selected a random sample of ICUs so as to enrol the total required beds in 1690 Brazilian adult ICUs. We followed up patients until hospital discharge censored at 60 days, estimated incidence from prevalence and length of stay, and generated national estimates. We assessed mortality prognostic factors using random-effects logistic regression models. Findings On Feb 27, 2014, 227 (72%) of 317 ICUs that were randomly selected provided data on 2632 patients, of whom 794 had sepsis (30·2 septic patients per 100 ICU beds, 95% CI 28·4–31·9). The ICU sepsis incidence was 36·3 per 1000 patient-days (95% CI 29·8–44·0) and mortality was observed in 439 (55·7%) of 788 patients (95% CI 52·2–59·2). Low availability of resources (odds ratio [OR] 1·67, 95% CI 1·02–2·75, p=0·045) and adequacy of treatment (OR 0·56, 0·37–0·84, p=0·006) were independently associated with mortality. The projected incidence rate is 290 per 100 000 population (95% CI 237·9–351·2) of adult cases of ICU-treated sepsis per year, which yields about 420 000 cases annually, of whom 230 000 die in hospital. Interpretation The incidence, prevalence, and mortality of ICU-treated sepsis is high in Brazil. Outcome varies considerably, and is associated with access to adequate resources and treatment. Our results show the burden of sepsis in resource-limited settings, highlighting the need to establish programmes aiming for sepsis prevention, early diagnosis, and adequate treatment. Funding Fundacao de Apoio a Pesquisa do Estado de Sao Paulo (FAPESP).

Background Odontogenic myxoma (OM) is an uncommon neoplasm of the jaws. Considering the importance of defining the relative incidence and demographic profile of these lesions in South America, the aim of this study was to analyze the clinical and imagiological features of OM from three South American oral pathology services and to discuss these findings in light of the literature. Methods Data regarding age, gender, anatomic site and imagiological features from 85 cases of OM were collected. Additionally, we did a review of OM studies published in three electronic databases. Results Among 63,450 oral biopsies, 1,178 (1.85%) were odontogenic tumors (World Health Organization - 2017), of which 85 (7.21%) met the criteria of OM. The mean age was 30.7 years (range: 10-61 years; SD: 12.22). Forty-five (52.9%) cases occurred in females and 40 (47.1%) in males (ratio: 1:1.12). Maxilla was affected in 44 cases (53%) and mandible in 39 (47%). Of the 41 informed cases (48.2%), all of them were radiolucent lesions. The literature review indicated a majority of mean ages in third decade and a predilection for females, mandible and multilocular radiolucent lesions. Conclusions The features of OM samples have strong similarity to that reported in studies from other continents. It is possible to infer that geographic variation does not help to explain some differences observed in the clinical features of OM. This article is protected by copyright. All rights reserved.

The aim of this study was to evaluate the demographic and clinical profile of the oral squamous cells carcinoma (OSCC) cases registered in a center of oral diagnosis in southern Brazil. Eight hundred and six individuals with OSCC from 1959 to 2012 were included in this study. The variables recorded were: sex, age, occupation according to workplace, alcohol and tobacco consumption, skin color, tumor location, histological type, clinical appearance, size, evolution time, presence of pain and lymph node metastasis. Descriptive analysis was performed and the associations between variables were assessed using the chi-square and Fisher’s exact test, with a confidence level of 5%. OSSC was more common in males (76.6%) aged between 51 to 70 years (53.9%). The most frequent sites were lower lip vermilion (23.3%), tongue (20.2%) and gingiva/alveolar ridge (18.1%). There was a strong association between outdoor occupation and white skin color with lip squamous cell carcinoma (LSCC). OSCC intraoral lesions were commonly more painful, larger than 2 cm and presented lymphatic metastasis. In conclusion, most of the results confirm the data from literature about sex, age, tumor location and occupation. Moreover, the positive correlations between LSCC and occupation, between LSCC and white skin color, and between bigger lesions and presence of pain/cervical metastasis also corroborate the literature data.