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Sisal fibers were employed as cost-effective adsorbent material to remove methylene blue (MB) and reactive black 5 (RB5) dyes from aqueous solutions. The fibers were characterized and the effects of adsorbent dosage and pH were investigated. Kinetic, equilibrium, and thermodynamics were analyzed. Desorption studies were performed and simulated textile effluents were treated with the fibers. The results revealed that the homogeneous surface diffusion model (HSDM) for cylindrical geometry was able to explain the adsorption kinetics, being the diffusion coefficients (DS) of 3.45 and 1.94 × 10−14 cm2 s−1 for MB and RB5, respectively. The BET model was adequate to represent the equilibrium data for MB and RB5. Adsorption capacities reached 553.4 and 310.2 mg g−1 for MB and RB5, respectively. Adsorption was spontaneous and favorable. Chemisorption was involved in the MB adsorption, while, physisorption was dominant for RB5 adsorption. Sisal fibers were efficient to decolorize a simulated effluent, reaching color removal percentage of 85%. It can be concluded that sisal fibers are a promising adsorbent to treat colored effluents, since has low cost, require little processing and possess high adsorption capacity for anionic and cationic dyes. [ABSTRACT FROM AUTHOR]

This meta-research sought to evaluate the conduct, reporting, and main characteristics of published randomized controlled trials (RCTs) in dentistry. A search was performed on PubMed for RCTs in dentistry indexed from 31 December 2016 to 31 December 2021. Two reviewers independently screened the studies for the presence of eligibility criteria. Only studies in English were considered. Journal and author data, subject, citation and publishing metrics, reporting, and details of study conduct were collected. A descriptive analysis of the data, a map depicting the number of RCTs per country, and a network graph of scientific collaboration among different countries were presented. We included 844 articles. The main research area was periodontics (16.35%). The highest number of RCTs was attributed to Brazil (16.59%). Authors from the USA established the most links with other countries. Most studies did not report the use of CONSORT (67.89%), the type of randomization (69.31%), or the mechanism used to implement the random allocation sequence (52.37%). However, most studies included "randomized" in the title (71.92%) and reported the method for generating a random allocation sequence (65.88%) and blinding (74.88%). RCTs are the basis for clinical decision-making. Our results provide a better view of current RCTs and identify areas that require improvement. Brazil was the country that produced the most RCTs, and the USA was the main collaborator. We emphasize the variability of reporting characteristics and study conduct.

This study aimed to assess the fatigue resistance of molars lacking a coronary remnant, using zero, one, two, or three fiberglass posts. Forty caries/crack-free human molars with coronal portions removed at the pulp chamber floor were randomly allocated into four groups (n=10). Following endodontic treatment, posts (Whitepost DC/DC.E 0.5, 1.0, FGM) were silanized (silane agent, Angelus) and cemented with a resin cement (RelyX U200, 3M ESPE). Resin composite cores (Z350, 3M ESPE) were built, and metal crowns were fabricated and cemented using the same luting system. Samples underwent cyclic fatigue testing at 45°, applying load in the occlusal surface at 10 Hz and 100 N initial load for 10,000 cycles, with 50 N increments every 10,000 cycles until failure. Fatigue failure load and cycles for failure data were recorded and subjected to survival analysis through Kaplan-Meier and Mantel-Cox post hoc tests, and Weibull analysis. Fractography patterns of failed crowns were qualitatively analyzed. The group without posts exhibited the lowest fatigue performance (p < 0.05) for both fatigue failure load and cycles to failure. Superior fatigue performance was observed in the three-post group, followed by groups with one or two posts, corroborated by the Weibull characteristic strength parameter. Weibull moduli were similar among conditions. All specimens exhibited failure involving detachment of the restorative set (posts/core/crown) with a portion of the dental remnant, without tooth fracture. Thus, when restoring mandibular molars without crown remnants, the use of fiberglass posts promotes greater fatigue resistance to oblique loads.

Background: To evaluate transparency practices in randomized controlled trials (RCTs) in dentistry., Methods: This meta-research study included RCTs in dentistry regardless of topic, methods, or level of detail reported. Only studies in English were considered. We searched PubMed for RCTs in dentistry published in English from December 31, 2016, to December 31, 2021. The screening was performed in duplicate, and data extracted included journal and author details, dental specialty, protocol registration, data and code sharing, conflict of interest declaration, and funding information. A descriptive analysis of the data was performed. We generated maps illustrating the reporting of transparency items by country of the corresponding author and a heat table reflecting reporting levels by dental specialty., Results: A total of 844 RCTs were included. Only 12.86% of studies reported any information about data and code sharing. Protocol registration was reported for 50.36% of RCTs. Conflict of interest (83.41%) and funding (71.68%) declarations were present in most studies. Conflicts of interest and funding were consistently reported regardless of country or specialty, while data and code sharing had a low level of reporting across specialties, as well as low dissemination across the world. Protocol registration exhibited considerable variability., Conclusions: Considering the importance of RCTs for evidence-based dentistry, it is crucial that everyone who participates in the scientific production and dissemination process actively and consistently promotes adherence to transparent scientific standards, particularly registration of protocols, and sharing of data and code., (© 2024. The Author(s).)

Statement of Problem: How best to restore endodontically treated teeth is still unclear because many types of material and techniques are involved., Purpose: The purpose of this overview of systematic reviews of clinical studies was to assess the available evidence-based literature on the influence of associated clinical factors on the clinical performance (survival, failure rate, or success) of restored endodontically treated teeth., Material and Methods: PubMed, Scopus, and Web of Science were searched from inception until September 27, 2021, to identify systematic reviews. Two reviewers independently screened titles, abstracts, and full-text articles, and each reviewer extracted the data of half of the included studies. A single reviewer with an independent verifier completed the quality appraisal. A descriptive analysis of the collected data was made., Results: A total of 36 systematic reviews fulfilled the inclusion criteria. The factors most assessed were the type of coronal restorative technique (n=22) and type of post (n=22). The results indicated that metal and fiber posts seem to present similar clinical performance, 1-piece endodontic crowns could be a suitable restorative option, there is no evidence to confirm whether single crowns are better or worse than direct restoration, the maintenance of the coronal structure is a fundamental factor, and the ferrule effect is still a controversial topic. Most of the studies (n=30, 81%) presented a final Grading of Recommendations, Assessment, Development and Evaluations (GRADE) rating of "critically low.", Conclusions: The post type does not appear to influence the clinical performance of restored endodontically treated teeth. However, conclusive evidence to suggest how different materials or techniques for restoring coronal tooth structure affect the clinical performance of such restorations, as well as the impact of the ferrule effect, is still lacking., (Copyright © 2022 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Objectives: This study evaluates the endorsement of open science practices by dental journals., Materials and Methods: This was a meta-research study that included journals listed in the 2021 Journal Citation Reports under Dentistry. A comprehensive evaluation was performed by accessing journal websites to ascertain the availability of publicly accessible instructions to authors in Portuguese, English, or Spanish. A researcher extracted information from the "Instructions for Authors" section, encompassing the journal's impact factor, mention of any reporting guidelines, details on data sharing, acceptance of articles in preprint format, and information regarding study protocol registration. Descriptive data analysis was conducted using the Stata 14.0 program, and an Open Science Score (OSS) (ranging from 0 to 100 %) was calculated for each journal by considering five open science practices. Pearson's correlation test was conducted to determine the relationship between the OSS score and journal impact factor., Results: Ninety journals were included in the study. Most journals (70 %) indicated the mandatory use of reporting guidelines, while 60 % recommended data sharing. Conversely, 46.7 % did not provide information on study protocol registration, and 44.4 % stipulated them as mandatory for authors. Regarding preprints, 50 % of the journals did not provide any information, but 46.7 % confirmed their acceptance. The mean OSS was 52.9 % (standard deviation 26.2). There was a weak correlation (Pearson's correlation coefficient of 0.221) between the journal impact factor and OSS (P-value=0.036)., Conclusion: This study found varying degrees of endorsement of open science practices among dental journals., Clinical Significance: Dental practitioners rely on high-quality, evidence-based research for informed decision-making. By assessing the endorsement of open science practices, our study contributes to improving the quality and reliability of dental research, ultimately enhancing the evidence base for clinical practice., Competing Interests: Declaration of competing interest The authors declare there is no conflict of interests., (Copyright © 2024. Published by Elsevier Ltd.)

Background and Objectives: This study aimed to assess the gender gap in randomized controlled trials (RCTs) in dentistry in terms of authorship, collaborations, metrics, funding and reporting of good research practice and transparecy., Methods: The search was performed in PubMed for RCTs restricted to English texts in the dental field, indexed from 12/31/2016 to 12/31/2021. Two reviewers screened the studies in line with the eligibility criteria. A total of 844 articles were included. The name and gender of authors, citation metrics, funding, reporting of characteristics of good research practice and transparency were extracted. We considered "collaboration between authors" when the corresponding author was different from the first author., Results: The proportion of women as first authors was 46.56% and 40.12% for corresponding authors. The analysis showed that when a woman is the corresponding author, the probability of the first author also being a woman is 57% higher compared to the first author being a man. For "protocol registration" and "data sharing," the prevalence of reporting was higher when women were first authors., Conclusion: A gender gap in dentistry RCTs was identified and related to the participation of women as first and corresponding authors and the collaboration between authors., Competing Interests: Declaration of Competing Interest The authors declare that they have no competing interests., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Background: The study aimed to explore reporting characteristics of scoping reviews in dental public health and the impact of some factors on the reporting quality., Methods: This study searched for dental public health scoping reviews in PubMed and Scopus without year restrictions and restricted to English-language publications. Study selection was undertaken by two reviewers independently. One reviewer, after training, extracted data from included studies considering general study characteristics and reporting characteristics. The impact of PRISMA-ScR publication, journal endorsement, and use of study protocol on the reporting was explored., Results: Eighty-one scoping reviews were included. Five items presented rates of appropriate reporting higher than 80% considering the overall percentage. Related to the impact of PRISMA-ScR publication, six items were found more often in scoping reviews published after the publication of PRISMA-ScR than in scoping reviews published before the publication of PRISMA-ScR. With regards to journals endorsement, only two reporting characteristics were found more often in scoping reviews published in journals that endorse the PRISMA-ScR statement than in scoping reviews published in non-endorsers journals. Last, regarding the use of the pre-specified protocol, five reporting characteristics presented differences in studies reporting the use of pre-specified protocol than in studies that did not mention the use of a protocol. All differences were statistically significant., Conclusions: Important information is missing in the included scoping reviews demonstrating crucial reporting problems., (© 2023. The Author(s).)

Objective: To evaluate the reporting of authors' justifications for choosing the scoping review methodology in oral health., Study Selection, Data and Source: This is a meta-research study about scoping reviews in dentistry. This study searched for reviews in PubMed and Scopus without year restrictions and restricted to English-language publications. Study selection was undertaken by two reviewers independently. Each of these reviewers extracted data from half of the included studies considering general study characteristics and scoping reviews objectives, as well as data about whether or not the authors clearly explained why they chose the scoping review framework., Results: We included 184 articles. Ninety-seven of the reports did not provide a rationale as to why they chose the scoping review method (52.7%). Regarding the reported aims of the studies, 29.9% (n = 29/87) of the scoping reviews presented more than one. When comparing studies reporting the use of the PRISMA-ScR to those not reporting the PRISMA-ScR, there is no difference in the reporting of a clear explanation of why the authors used a scoping review method., Conclusion: There is room for improvement in how authors report their justifications for choosing the scoping review method., Clinical Significance: Scoping reviews may be used by researchers who are unaware of this method. Educational initiatives should thus be encouraged., (Copyright © 2022. Published by Elsevier Ltd.)

Statement of Problem: The best protocol to restore endodontically treated teeth is still unclear, with many factors to be considered, including the selection and necessity of a post, the type of coronal restoration, the amount of remaining coronal structure, and the type of luting agent., Purpose: The purpose of this systematic review was to assess the restorative preferences for endodontically treated teeth between dentists and dental students., Material and Methods: Survey studies, written in English, of dentists and dental students, which evaluated the use of intracanal posts and other restorative options for endodontically treated teeth, were selected. Searches were performed in the PubMed and SCOPUS databases without time restriction. Screening and data extraction were performed by 2 researchers independently. A standardized outline was used to extract the data (questions related to the theme and the response rate of each question on the survey), and the risk of bias was assessed. Descriptive analysis was performed of the collected information., Results: Twenty-five articles were included. Most dentists who answered the surveys reported the time since graduation as 1 to 20 years (40%), and 44% were specialists. The most reported choices concerning the type of posts used were prefabricated posts (45.8%), cast metal posts (16.7%), and both posts (16.7%). The cast metal posts were cited more frequently in surveys published between 1994 and 2010, whereas prefabricated posts, both metal and glass fiber ones, were cited between 2006 and 2019. The preferred luting agent for intracanal posts was resin-based (47%). These choices seem to have been influenced by time and by the level of postgraduate training., Conclusions: Restorative preferences related to posts have changed over time, from the use of cast posts to prefabricated ones or the use of both posts and seem to be influenced by experience and postgraduate training., (Copyright © 2020 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Statement of Problem: Severely discolored substrates have been shown to limit the use of computer-aided design and computer-aided manufacturing (CAD-CAM) ceramic blocks because they provide insufficient color masking., Purpose: The purpose of the in vitro study was to evaluate the effect of a layer of high-value opaque composite resin over discolored substrates to determine its masking ability with CAD-CAM ceramics., Material and Methods: Six ceramic groups (n=10) were tested. A bilayer group of zirconia and porcelain served as the control. The CAD-CAM monolithic groups were translucent zirconia, zirconia-reinforced lithium silicate, lithium disilicate, leucite-reinforced glass-ceramic, and feldspathic ceramic. Five substrates were used: A1 (used as reference), A3.5, C4, and coppery and silvery metals. The substrates were separated as nonlayered or layered (with flowable or restorative opaque composite resins). The tested luting agents were white, opaque, and A1. Color differences (ΔE 00 ) were assessed with the CIEDE2000 formula. A 2-way ANOVA (α=.05) was used to detect significant differences in ΔE 00 among the groups for each substrate. The results were compared with acceptability (1.77) and perceptibility (0.81) thresholds., Results: The flowable composite resin layer associated with A1 luting agent ensured ΔE 00 lesser the than perceptibility thresholdwith the use of CAD-CAM monolithic ceramics, with the lowest values for zirconia-reinforced lithium silicate in substrates A3.5 (0.53) and C4 (0.32) and for leucite-reinforced glass-ceramic for coppery (0.49) and silvery (0.81) substrates (P<.001). The same benefit was observed when zirconia and porcelain was tested over the silvery substrate. The absence of substrate treatment only provided ΔE 00 lesser than the acceptability threshold with CAD-CAM ceramics for the A3.5 background., Conclusions: The application of a flowable opaque composite resin and the use of a shaded luting agent ensure masking with CAD-CAM monolithic ceramics., (Copyright © 2021 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

This scoping review study aimed to map the evidence about solvents' use for gutta-percha dissolution and removal during endodontic retreatments. The study protocol followed the Joanna Briggs Institute guidelines, available online (https://osf.io/5vy8n/). Reporting was based on PRISMA Extension for Scoping Reviews. We selected dentistry studies that considered the effectiveness of solvents in gutta-percha dissolution in endodontic retreatments and compared their performance to the use of instrumentation techniques without solvents. The search and study screening were performed in PubMed and Scopus databases by two independent researchers. A descriptive analysis considered the study design, method/technique used for obturation, method/technique used for instrumentation during retreatment, solvent solutions tested, exposure time, and main findings. A total of 41 studies were included. Despite that, most studies suggested that solvents' use may complicate root canal cleanliness, regardless of the type of instrumentation used, and facilitate the presence of gutta-percha remnants in the root surface. Thus, the use of solvents should be avoided and its use should only be considered if the previous working length was not possible to access without it. Despite that, high heterogeneity was observed, further studies are still encouraged comparing the performance and effects of different solvents in different clinical scenarios., (© 2020 Wiley Periodicals LLC.)

Objective: This study aimed to assess the characteristics of different designs of systematic reviews (SRs) registered in the International Prospective Register of Systematic Reviews (PROSPERO) about COVID-19., Methods: The search was performed in the PROSPERO database using the strategy proposed by the database and considered only human studies. The last date of the search was April 27, 2020. Full text of all records was accessed, and data were extracted by a single researcher, which was further double-checked by another researcher. A descriptive analysis was performed considering record characteristics using tables., Results: We included 564 records from which the vast majority were registered as SRs (n = 513, 91%). In general, we found poor reporting and missing or confusing information, since 84% of the records (n = 474) did not report the full search that would be adopted, 16% (n = 90) did not report clearly the databases that would be used, and 49.1% (n = 277) did not report the number of primary outcomes. The main focus of most of the records involved clinical, epidemiological, complication, and laboratory characteristics (n = 173, 30.7%) or the treatment of COVID-19 (n = 138, 24.5%)., Conclusion: A large number of SRs about COVID-19 have been conducted, and many of the assessed records were poorly reported and would be difficult to replicate. Besides, collected data points to an epidemic of redundant reviews on COVID-19., (© 2021 Chinese Cochrane Center, West China Hospital of Sichuan University and John Wiley & Sons Australia, Ltd.)

Objectives: This scoping review aimed to map and compile the available evidence regarding the effectiveness of decontaminating N95 respirators against the novel coronavirus (SARS-CoV-2)., Data: We selected studies written in English assessing or discussing the decontamination strategies of N95 respirators against SARS-CoV-2. Two independent researchers performed the search and study screening. A descriptive analysis was carried out considering the study design of the included studies., Sources: PubMed, SCOPUS, and Preprint platforms (bioRxiv and medRxiv)., Study Selection: We included 55 reports from PubMed and SCOPUS. Nine articles were letters to the editors, 21 were in vitro studies, 16 were literature reviews, and 9 were classified as other study designs. We included 37 preprints. Two articles were letters to the editors, 24 were in vitro studies, 3 were literature reviews, and 8 were classified as other study designs. In general, vaporized hydrogen peroxide and ultraviolet irradiation were the strategies most cited and most promising. However, there is a lack of evidence and consensus related to the best method of N95 respirator decontamination., Conclusion: The evidence regarding decontamination strategies of N95 respirators against SARS-CoV-2 remains scarce. Vaporized hydrogen peroxide and ultraviolet irradiation seem to be the current standard for N95 respirator decontamination., Clinical Significance: Vaporized hydrogen peroxide and ultraviolet irradiation appear to be the most promising methods for N95 respirator decontamination., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Aims: To describe all cases of gestational diabetes mellitus (GDM) managed at the Italian Hospital of San Daniele del Friuli from 2006 to 2018, after the establishment of a dedicated multidisciplinary team., Methods: Data on mothers, pregnancies, and newborns have been recorded since the team establishment. The associations of maternal, pregnancy, and delivery characteristics with complications of pregnancy and delivery and adverse birth outcomes were assessed., Results: 894 cases of GDM were observed, representing 6.8% of all deliveries. More than 20% of women were non-Italian, 5.3% had a previous macrosomic child, 12.5% previous diabetes or GDM, 27.3% family history of diabetes. On average, women had 4 visits at the clinic; mean glycated hemoglobin was 5.3%; starting body mass index (BMI) 26.2 and weight gain 10.3 kg. Cesarean sections were 21.8%. Pre-eclampsia was the most common pregnancy complication (4.7%). 6.0% of newborns were macrosomic and there were 3 fetal deaths. Only 26.3% of women had a post-partum oral glucose tolerance test. Initial BMI, weight gain, nationality, family history of diabetes or previous diabetes-related pregnancy complications were associated with pregnancy complications or adverse outcomes., Conclusions: We identified factors to be targeted for preventing GDM complications. Further efforts should be directed at post-partum., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier B.V. All rights reserved.)

The effect of root canal preparation technique on microcrack initiation is a controversial issue. This systematic review aimed to assess the role of root canal preparation techniques with different kinematics (manual, rotary, reciprocating, adaptive, self-adjusting file) on microcrack initiation. In vitro and in situ studies comparing the influence of at least two different root canal preparation techniques on the initiation of dentin microcracks were searched in PubMed/MEDLINE and SCOPUS up to June 5, 2018 without language and period restriction. Two authors independently reviewed all identified titles and abstracts for eligibility. Tables were generated to summarize the included studies, and the included studies were assessed for bias. Fifty-four (n=54) articles met the eligibility criteria. The results were classified according to the method used for microcrack evaluation, and most studies that used micro-computed tomography showed no formation of new cracks after root canal preparation. In general, the instrumentation techniques induced microcrack formation when the methods were destructive, irrespective of kinematics. In relation to the apex region, when the preparation working length was set as the root canal length subtracted of 1 mm, the risk of microcrack initiation reduces. The majority of the included studies had low risk of bias for all assessed domains. Our results seem to indicate that the various root canal preparation techniques considered in this study will not cause damage to the dental structure when adequately employed and the proper methodology is applied.

Introduction: The aim of this study was to identify through a scoping review whether root canal irrigants influence the mechanical properties of endodontically treated teeth, and which properties could be affected. The protocol of this study, available online (https://osf.io/yc9nb/), followed the Joana Briggs Institute guidelines. Reporting was based on PRISMA Extension for Scoping Reviews., Methods: We selected studies written in English that evaluated the effect of at least one irrigant on the mechanical properties of endodontically treated teeth. The search and study screening were performed in PubMed and Scopus databases by 2 independent researchers. A descriptive analysis was performed to consider the study design, the characteristics of the irrigants, and the properties tested., Results: The initial search yielded 608 citations, of which 66 were included. On the basis of the collected data, the most commonly used solutions were 17% EDTA, 2.5% or 5% sodium hypochlorite, and 2% chlorhexidine, and the most common tested properties were hardness and strength. Alterations in the modulus of elasticity, stress and strain concentration during preparation, and roughness were also assessed., Conclusions: The majority of studies corroborated a negative effect of all solutions on the mechanical properties of endodontically treated teeth. Furthermore, increases in the concentration of the solution and in the time of exposure were found to intensify deleterious effects. However, disinfection of the canal is also a crucial factor in endodontic success. Thus, clinicians should consider these factors to mitigate the effects without interfering with antibacterial properties, customizing the choice of the solution to the case in hand., (Copyright © 2020 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Objective: This study aimed to evaluate whether a master and PhD thesis in Brazilian graduate programs in dentistry can be based on a systematic review (SR)., Methods: In this cross-sectional study, we surveyed the coordinators of Brazilian graduate programs in dentistry using a self-administered questionnaire including questions about whether an SR meets requirements for approval of a master or PhD thesis, instructions regarding how to use an SR as the method for a master or PhD thesis, and reasons and barriers that SRs were not recognized as acceptable for a master or PhD thesis. The responses were analyzed descriptively, and tables and graphs were created to summarize the data., Results: Among 101 graduate programs invited to participate in the study, 38 (37.6%) returned the questionnaire. Over three-quarters of surveyed programs (n = 30, 78.1%) answered that SRs, in whole or in part, meet the criteria for a master or PhD thesis. Likewise, most programs answered that a master or PhD thesis could be exclusively based on an SR (n = 28, 73.7%). The same number of programs pointed out that one possible reason for not recognizing SRs as a master or PhD thesis is either the lack of SR expertise among committee members (n = 28, 73.7%) or the lack of adequate training of candidates in SR methodology (n = 26, 68.4%)., Conclusions: SRs are well accepted as a master or PhD thesis by Brazilian graduate programs in dentistry. Educational initiatives should be encouraged to promote understanding of SR methodology and increase acceptance among graduate programs worldwide., (© 2020 Chinese Cochrane Center, West China Hospital of Sichuan University and John Wiley & Sons Australia, Ltd.)

Objective: the objective was to analyze trends in the dental surgeon workforce in Brazil between 2007 and 2014., Methods: this is a time series study using data from the Brazilian National Register of Health Establishments and the Brazilian National Institute of Geography and Statistics. Prais-Winsten generalized linear regression was used to estimate time trends and to calculate the annual percent change in the dental surgeon workforce over the period., Results: the number of dental surgeons working as general practitioners and as specialists grew on average by 12.7% and 17.3% per annum, respectively; dental surgeon workforce expansion in relation to general practitioners (0.5%) and specialists (11.6%) was lower in the public sector, compared to the private sector (24.5% and 30.3%, respectively)., Conclusion: the number of dental surgeons in Brazil is high, although they are not equally distributed between both sectors. This may imply barriers to dental care access in Brazil.

Objectives: To evaluate the relationships between alcohol intake and serum lipoprotein(a) [Lp(a)], a powerful predictor of organ damage, in patients with essential hypertension with a wide range of alcohol intake, and to investigate whether the association between alcohol intake and serum Lp(a) concentrations occurs over the entire spectrum of apo(a) phenotypes., Design: Cross-sectional study of a case series., Setting: University medical centre., Patients: Four hundred and two patients with untreated essential hypertension recruited at a hypertension clinic., Main Outcome Measures: Serum Lp(a) concentrations, apo(a) isoforms, alcohol consumption, smoking habits and cardiovascular status., Results: No difference in Lp(a) concentrations was observed between teetotalers and occasional drinkers. Light drinkers (1-20 g/day ethanol), moderate drinkers (21-50 g/day), and heavy drinkers (> 50 g/day) had, respectively, 21, 26 and 57% lower median Lp(a) concentrations than teetotalers and occasional drinkers. Similar findings were obtained when male and female patients were analysed separately. Log Lp(a) concentrations were inversely and independently correlated with alcohol consumption in both men and women with hypertension. The frequency distributions of apo(a) isoforms and liver function parameters were comparable across the different alcohol intake groups. Patients with evidence of cardiovascular damage had greater concentrations of serum Lp(a) and higher frequency of low-molecular weight apo(a) isoforms as compared with patients without such evidence., Conclusions: Serum Lp(a) is inversely and dose-dependently related with alcohol intake in patients with hypertension, and this relationship is independent of the size distribution of apo(a) isoforms. Reduction of Lp(a) concentrations by regular consumption of alcohol might favourably affect the atherosclerotic risk profile of patients with hypertension and thereby decrease cardiovascular morbidity.

Appropriate correction of cardiovascular risk factors is a mainstay of the treatment of patients that have developed or might develop cardiovascular disease. In addition to classical risk factors, such as hypertension, smoking, dyslipidemia, diabetes, obesity, and sedentary life, epidemiological research has identified a number of additional conditions that are associated with a greater risk of cardiovascular disease. In fact, a substantial percentage of patients who develop cardiovascular events do not have any of the classical risk factors. Over the past thirty years, effective intervention in the treatment of hypertension, dyslipidemia, and diabetes has reduced remarkably cardiovascular morbidity and mortality, but the incidence of coronary artery disease and stroke remains unacceptably high and cardiovascular diseases are still the leading cause of death in the Western world. New cardiovascular risk factors are likely to give substantial contribution to this scenario and it could be easily anticipated that this contribution will become more evident in the upcoming years. This is why physicians who operate in the field of cardiovascular medicine and deal with problems related to cardiovascular prevention should be aware of these emergent risk factors, evaluate them accurately in their patients, and treat them appropriately. This review will summarize the literature supporting the role of lipoprotein(a), homocysteine, and fibrinogen as cardiovascular risk factors.

Learning and memory can be impaired by sleep loss during specific vulnerable "windows" for several days after new tasks have been learned. Different types of tasks are differentially vulnerable to the loss of different stages of sleep. Memory required to perform cognitive procedural tasks is affected by the loss of rapid-eye-movement (REM) sleep on the first night after learning occurs and again on the third night after learning. REM-sleep deprivation on the second night after learning does not produce memory deficits. Declarative memory, which is used for the recall of specific facts, is not similarly affected by REM-sleep loss. The learning of procedural motor tasks, including those required in many sports, is impaired by the loss of stage 2 sleep, which occurs primarily in the early hours of the morning. These findings have implications for the academic and athletic performance of students and for anyone whose work involves ongoing learning and demands high standards of performance.

Hundred-forty-eight pregnancies in immigrants from South-east Asia were analyzed. A high number of such patients underwent legal abortion; in the women who carried on pregnancy, the authors considered the course of pregnancy, delivery and puerperium and some neonatal parameters. The results have shown that pregnancy in immigrants presents a certain amount of risk.