Abstract This study analyzes the characteristics of the top 100 most-cited papers related to tooth bleaching. A literature search was performed on the Web of Science up to March 2022. The number of citations was cross-matched with the citation count on Scopus and Google Scholar. The following data were collected: number and density of citations; authorship; year and journal of publication; study design and thematic; keywords; institution and country of origin. Spearman’s correlation and Poisson regression were used to determine associations between the number of citations and study characteristics. The VOSviewer software was used to generate collaborative network maps for the authors and keywords. The number of citations ranged from 66 to 450. Papers were published between 1981 and 2020. The most frequent study design and topic were laboratory-based studies and ‘interaction of the bleaching agent with dental tissues’, respectively. Cochran M, Loguercio AD, Matis B, Reis A, and Suliman M were the authors with the highest number of papers. The countries with the most papers were the United States of America (USA) (28%) and Brazil (20%). Indiana University and State University of Ponta Grossa were the institutions with the most papers (6% each). There was a very strong correlation among the number of citations of the three databases. The 100 most-cited papers related to tooth bleaching were mainly published by the USA and Brazil, with laboratory-based studies addressing topics related to the effects of bleaching agents on tooth structure being the most prevalent.

Resumo Este estudo analisa as características dos 100 artigos mais citados relacionados ao clareamento dental. Uma pesquisa bibliográfica foi realizada na Web of Science até março de 2022. O número de citações foi cruzado com a contagem de citações na Scopus e na Google Scholar. Foram coletados os seguintes dados: número e densidade de citações; autoria; ano e periódico de publicação; desenho do estudo e temática; palavras-chave; instituição e país de origem. A correlação de Spearman e a regressão de Poisson foram usadas para determinar associações entre o número de citações e as características do estudo. O software VOSviewer foi utilizado para gerar mapas de rede colaborativa para os autores e palavras-chave. O número de citações variou de 66 a 450. Os artigos foram publicados entre 1981 e 2020. O desenho e o tópico de estudo mais frequentes foram estudos laboratoriais e interação do agente clareador com tecidos dentários, respectivamente. Cochran M, Loguercio AD, Matis B, Reis A e Suliman M foram os autores com maior número de artigos. Os países com mais artigos foram os Estados Unidos da América (EUA) (28%) e o Brasil (20%). A Universidade de Indiana e a Universidade Estadual de Ponta Grossa foram as instituições com mais artigos (6% cada). Houve uma correlação muito forte entre o número de citações das três bases de dados. Os 100 artigos mais citados relacionados ao clareamento dentário foram publicados principalmente pelos EUA e Brasil, sendo os estudos laboratoriais que abordaram tópicos relacionados aos efeitos dos agentes clareadores na estrutura dentária os mais prevalentes.

Abstract Efficient working length determination is essential for a successful endodontic treatment. The purpose of the present study was to evaluate whether the method for determining the working length of root canals (radiographic or electronic) influences the obturation level of primary molars. Thus, a controlled, triple-blind, randomized clinical trial was conducted. Sixty-four children aged 6 to 9 years with an indication for primary molar pulpectomy were included. Participants were divided into two groups according to the method used to determine the working length of the root canals: (G1) radiographic and (G2) using an electronic apex locator. The study had 3 operators: #1 performed the clinical procedures, except the electronic measurement; #2 performed radiographic measurement and final evaluation of obturation level; and #3 performed eligibility criteria and electronic measurement. Adequacy of obturation level was evaluated based on the final conventional radiography and it was recorded as acceptable or unacceptable (short or overfilled). Data were analyzed with repeated measures logistic regression. There was no difference between the obturation level of primary molars measured by radiographic and electronic methods (p > 0.05). The other investigated variables (age, tooth type, dental arch position, last instrumentation file, and canal location) also did not influence the obturation level (p > 0.05). In conclusion, both measurement methods resulted in similar adequacy of obturation level in primary molars after pulpectomy.

RESUMO Objetivo: Investigar a prevalência de problemas para dormir por motivos dentários autorrelatado e sua associação com condições orais adversas em escolares. Métodos: Estudo transversal com amostra representativa de 1589 escolares de 8 a 10 anos matriculados em escolas públicas de Florianópolis, Brasil. Os dados não clínicos incluíram um questionário sobre indicadores socioeconômicos respondidos pelos pais/cuidadores. As crianças foram questionadas se tinham problemas para dormir por motivos dentários e sobre episódios anteriores de dor de dente. Foram realizados exames clínicos orais para avaliar: cárie dentária - Índice de Dentes Cariados, Perdidos e Obturados (índice CPO-D/ceo-d) - e suas consequências clínicas (índice PUFA/pufa - presença de envolvimento pulpar (P/p); ulceração (U/u); fístula (F/f); e abscessos (A/a) e traumatismo dental (TD). Foram realizados análise descritiva e modelos ajustados de regressão logística (p<0,05; IC95%). Resultados: A prevalência de problemas para dormir por motivos dentários foi de 28%. Crianças com cárie dentária não tratada (OR 1,32; IC95% 1,05-1,67) e presença de índice PUFA/pufa (OR 1,89; IC95% 1,45-2,46) apresentaram maiores chances de relatar problemas para dormir devido a razões dentárias. Conclusões: Aproximadamente, um terço das crianças apresentou problemas para dormir devido a razões dentárias. Cárie dentária não tratada e suas consequências clínicas foram associadas a problemas autorrelatados para dormir por motivos dentários em escolares.

ABSTRACT Objective: To investigate the prevalence of self-reported trouble sleeping due to dental problems and its association with oral conditions in schoolchildren. Methods: This is a cross-sectional study carried out with a representative sample of 1,589 schoolchildren aged 8-10 years enrolled in public schools from Florianópolis, Santa Catarina, Brazil. Non-clinical data included a questionnaire about socioeconomic indicators answered by parents/guardians. Children were questioned about whether they had trouble sleeping due to dental problems and about previous history of toothache. Clinical oral examinations were performed to evaluate dental caries - Decayed, Missing, and Filled Teeth Index (DMFT/dmft index) and its clinical consequences [PUFA/pufa index: considering the presence of pulpal involvement (P/p); ulceration of tissues due to tooth fragments from decayed crowns (U/u); fistula (F/f); and abscesses (A/a), and traumatic dental injuries (TDI)]. We conducted a descriptive analysis and used adjusted logistic regression models (p<0.05; 95%CI). Results: The prevalence of trouble sleeping due to dental problems was 28%. Children with untreated dental caries (OR 1.32; 95%CI 1.05-1.67) and clinical consequences from the PUFA/pufa index (OR 1.89; 95%CI 1.45-2.46) had higher chances of reporting trouble sleeping due to dental problems. Conclusions: Approximately one-third of the children declared having trouble sleeping due to dental problems. Untreated dental caries and its clinical consequences were associated with self-reported trouble sleeping due to dental problems in schoolchildren.

Abstract The exact calculations of the stress and strain distributions based on the controlling equations for a forming process with large deformation are often difficult. To circumvent such difficulties, some analytical methods such upper-bound analysis and slip-line field theory have been established by making a number of simplifying assumptions regarding the material properties and deformation modes. In this work an analytical model based on the upper-bound theory was successfully developed to predict material flow pattern and maximum process loads for an Equal Channel Angular Pressing (ECAP) die with circular cross-section and an intersecting channel angle of 120°. Based on the model, the power dissipated on all frictional and velocity discontinuity surfaces were determined and optimized in order predict the maximum process force as function of the channel geometry and the material plastic behavior. To validate the developed model, the ECAP die were produced and used to determine experimental load-displacement curves of AA6061-T6 specimens with different lengths. A good correlation between theoretical and experimental results was observed. In addition, the constant friction factor demonstrated to have a strong effect on the relative extrusion pressure.

ABSTRACT Soils in the Depressão Central and Campanha Gaúcha in Rio Grande do Sul State, Brazil, developed from sedimentary rocks are mainly Alfisols (Luvissolos, Planossolos and Plintossolos) and Ultisols (Argissolos) with high textural contrast between A and/or E horizons and clayey B horizons. Red Ultisols dominate in well-drained areas in the summit. But many soils present redoximorphic features on the backslope and footslope, with mottled and/or nodules similar to plinthite due to the oscillating of the water table above the rock or poorly permeable saprolite. Identifying morphological features, mineralogical and chemical properties, and parent material differences are essential to identify the main processes responsible for their genesis. Knowledge of the relative distribution of different forms of iron in the soil is also of particular interest when interpreting pedogenesis. This study aimed to evaluated the main process responsible for the high textural contrast in soils developed from different sedimentary lithologies, and how the redoximorphic features observed in some soils may be related to genesis of plinthites and ferrolysis processes. The study area is located in the hydrographic basin of Rio Santa Maria, in the city of Rosário do Sul – RS, Brazil (30° 15’ 28” S and 54° 54’ 50” W), average altitude of 132 m and Cfa-type climate. Topolithosequences were defined based on soils developed from lithogies of Piramboia and Sanga-do-Cabral geological formations, by choosing soil profiles according to the source material, variations in relief, altitude and hydrological conditions. Morphological descriptions, particle size determinations, chemical analysis, mineralogy of the clay fraction by XRD analysis, determination of the main forms of iron, tests to identify plinthite were performed. Argiluviation, ferrolysis and plinthization were the most active processes identified in the genesis of most studied soils. The high textural contrast on these soils was not solely due to clay illuviation processes but also ferrolysis and lithological discontinuities in some soils, indicating polygenetic origin. Redoximorphic features in most soil revealed that iron segregation in most soils occurs like mottles and not plinthite, since they did not remain aggregated after the various wetting and drying cycles.

Introduction: Dematiaceous fungi are characterized by the presence of brown melanine or melanine like pigments in their cell wall. They are generally distributed worldwide, being more common in tropical and subtropical climates. The clinical syndromes are often cutaneous and subcutaneous infections, but can be also responsible of allergic diseases, pneumonias, cerebral abscesses or disseminated infections. Clinical Case: We present the case of a patient with a diagnosis of rectal adenocarcinoma intervening surgically and with an incidental finding of Meckel’s Diverticulum. The anatomopathological study revealed the presence of a dematiaceous fungi.

Resumen Introducción: Los hongos dematiáceos se caracterizan por la presencia de abundante melanina en su pared celular. Presentan una distribución mundial, siendo más comunes en climas tropicales y subtropicales. Producen infecciones cutáneas y subcutáneas, además de enfermedades alérgicas, neumonías, abscesos cerebrales o infecciones diseminadas. Caso Clínico: Presentamos el caso de un paciente con adenocarcinoma de recto intervenido quirúrgicamente con hallazgo incidental de divertículo de Meckel y en el cual en el estudio anatomopatológico reveló la presencia de un hongo dematiáceo

Resumo A partir de uma perspectiva comparada e de uma reflexão de cunho foucaultiano, este artigo1 tem como propósito analisar as construções discursivas sobre (in)segurança internacional, produzidas pelas reportagens jornalísticas da British Broadcasting Corporation (BBC) e pela Dabiq Magazine, de modo a desestabiliza-las. Ressalta-se que o fato histórico investigado corresponde aos ataques em Paris de 13 de novembro de 2015, tendo em vista a audiência midiática então produzida. Assim, o artigo busca refletir sobre a seguinte pergunta: como a BBC e a Dabiq Magazine construíram seus discursos sobre a (in)segurança internacional a partir da temática do terrorismo? Em face desse questionamento, temos como reflexão que as construções discursivas das mídias online ocorrem segundo duas questões. De um lado, existe a transmissão de ideias e valores mediante a lógica de “segurança”, “solidariedade” e retorno à “normalidade”; por sua vez, a partir de outro espectro, há a construção da sensação de insegurança, de tragédias e de desespero. Nesse sentido, de modo a empreender este estudo, metodologicamente foram utilizadas referências bibliográficas acerca do tema sobre os estudos críticos de (in)segurança internacional, terrorismos, análises de discurso. Desse modo, foi realizado um estudo pormenorizado que comparou as capas das mídias online, uma vez que ambas são calcadas em seus respectivos regimes de verdade, poder e conhecimento.

Abstract From a comparative perspective and a Foucauldian reflection, this article1 aims to analyze the discursive constructions about international (in)security, produced by the British Broadcasting Corporation (BBC) and Dabiq Magazine journalistic reports, in a way that it destabilizes itself. It is worth noting that the historical fact investigated corresponds to the November 13, 2015 attacks in Paris, in view of the media audience then produced. Thus, the article seeks to reflect on the following question: how did the BBC and Dabiq Magazine construct their discourses on international (in)security on the subject of terrorism? In face of this questioning, we have, as a reflection, that the discursive constructions of the online media occur according to two questions. On one hand, there is the transmission of ideas and values through the logic of “security”, “solidarity” and return to “normality”; In turn, from another spectrum, there is the construction of a sense of insecurity, tragedy and despair. In this sense, in order to undertake this study, methodologically were used bibliographical references on the topic of critical studies of international (in)security, terrorisms, discourse analysis. Thus, a detailed study was conducted comparing the layers of the online media, since both are based on their respective regimes of truth, power and knowledge.

Resumen A partir de una perspectiva comparada y de una reflexión de cuño foucaultiano, este artículo tiene como propósito analizar las construcciones discursivas sobre (in)seguridad internacional, producidas por los reportajes periodísticos de la British Broadcasting Corporation (BBC) y la Dabiq Magazine, para desestabilizar-las. Se resalta que el hecho histórico investigado corresponde a los ataques en París del 13 de noviembre de 2015, teniendo en vista la audiencia mediática entonces producida. Así, el artículo busca reflexionar sobre la siguiente pregunta: ¿cómo la BBC y la Dabiq Magazine construyeron sus discursos sobre la (in)seguridad internacional a partir de la temática del terrorismo ?. En vista de este cuestionamiento, tenemos como reflexión que las construcciones discursivas de los medios online ocurren según dos cuestiones. De un lado, existe la transmisión de ideas y valores mediante la lógica de “seguridad”, “solidaridad” y retorno a la “normalidad”; a su vez, a partir de otro espectro, hay la construcción de la sensación de inseguridad, de tragedias y de desesperación. En este sentido, y de modo a emprender este estudio, metodológicamente se utilizaron referencias bibliográficas acerca del tema sobre los estudios críticos de (in)seguridad internacional, terrorismo, análisis de discurso. De este modo, se realizó un estudio detallado que comparó las capas de los medios online, ya que ambas se calcaban en sus respectivos regímenes de verdad, poder y conocimiento.

Resumo As Euphorbiaceae da tribo Hippomaneae são complexas e pouco estudadas taxonomicamente em decorrência de possuírem flores diminutas e homogêneas. Com base em coletas mensais desde 2011, análise de coleções de herbários e de literatura específica, foi realizado o tratamento taxonômico de Hippomaneae no Parque Nacional Chapada dos Veadeiros, área cuja flora é rica e pouco conhecida. Foram encontradas 15 espécies pertencentes a cinco gêneros: Microstachys e Sapium, os mais diversos, com nove e três espécies respectivamente, seguidos por Gymnanthes, Maprounea e Sebastiania com uma espécie cada. Sapium haematospermum é uma nova ocorrência no estado de Goiás. São apresentadas uma chave de identificação para as espécies, descrições e comentários taxonômicos, além da transferência de Sebastiania anisodonta e S. salicifolia para o gênero Microstachys, e uma lectotipificação.

Abstract The Euphorbiaceae of the tribe Hippomaneae are complex and poorly studied taxonomically due to having small and homogeneous flowers. Based on monthly collections since 2011, analysis of herbarium collections and specific literature was performed the taxonomic treatment to the Hippomaneae present in the Chapada dos Veadeiros National Park, an area whose flora is rich and little known. Fifteen species belonging to five genera were found: Microstachys and Sapium, the most diverse, with nine and three species respectively, followed by Gymnanthes, Maprounea and Sebastiania with one species each. Sapium haematospermum is firstly recorded in the state of Goiás. Species identification key, species descriptions with comments and illustrations, besides the transference of Sebastiania anisodonta and S. salicifolia to the genus Microstachys and a lectotipification.

ABSTRACT The exploitation of valuable native timber species in forest restoration projects has emerged as a promising strategy to make restoration financially viable. There are few studies regarding the quality of timber from restoration plantations. The aim of this study was to analyze growth stresses by determining the longitudinal residual strain (LRS) and evaluate their correlation with the growth variables in the species Peltophorum dubium (Spreng.) Taub in a 14-year old restoration plantation. Eighteen individuals were evaluated, determining the following variables: diameter at breast height (DBH), bark thickness, average annual growth in diameter (IMA) and annual periodic growth in diameter (IPA 2012-2015 ). The LRS was determined by the extensometer (CIRAD-Forêt), on DBH height and in the north-south direction of each tree. The LRS average was 0.072 mm, within the range of expected wood values for sawmilling. There was a significant positive correlation between the LRS, DBH and IMA.

Introduction: The Department of Basic Biomedical Sciences at the Universidad Europea de Madrid is committed to design activities that foster an environment of active and inclusive student-centered learning and contextualized in a professional environment. The aim is to ensure, through an integrated assimilation of fundamental concepts, the student motivation to learn and facilitate the extracurricular knowledge. Subjects and methods: Within our added-value activities, we have designed a play-based activity with students from the first course of the degrees of Medicine, Pharmacy and the double degree Pharmacy-Biotechnology. Using a clinical case related to a cardiovascular disease as a thread, a gymkhana was designed following a workstations working model. The correct resolution of all tasks included in each workstation without delay was finally rewarded. Results: Respondents found the integrated sessions more useful than the traditional seminars and also remarked that they bring up a variety of contents from different subjects successfully (54% positive answers). 58% of the survey participants expressed that the activity approached them new content not covered through the traditional master class. Conclusions: We have ensured that students develop skills required to take their future roles as members of multidisciplinary teams, thanks to the participation of students from different degrees. Moreover, the activity managed to increase motivation and the interest for the most basic concepts of Biomedical Sciences through real integration and direct application to a real clinical case. The experience was evaluated as very positive by all participants.

Introducción: Desde el Departamento de Ciencias Biomédicas Básicas de la Universidad Europea de Madrid optamos por el diseño de actividades que fomenten un entorno de aprendizaje activo e integrador, centrado en el alumno y contextualizado en un entorno profesional. El objetivo es favorecer la asimilación de conceptos fundamentales, motivando al alumno y facilitando el aprendizaje extracurricular. Sujetos y métodos: Dentro de nuestras actividades de valor añadido hemos diseñado una dinámica a través del juego con estudiantes de los primeros cursos de los grados de Medicina, Farmacia y la doble titulación de Farmacia-Biotecnología. Utilizando como hilo conductor un caso clínico relacionado con una enfermedad cardiovascular, se diseñó una yincana con un carácter integrador de disciplinas básicas con diferentes estaciones de trabajo. Se premió la correcta resolución de las tareas incluidas en las estaciones de trabajo en un tiempo establecido. Resultados: Los estudiantes encuestados mostraron su satisfacción con la utilidad de estas sesiones integradas frente a las no integradas, así como con la inclusión de contenidos de diferentes materias (el 54% respondió favorablemente). El 58% de los grupos participantes afirmó que la actividad les acercó a contenidos nuevos. Conclusiones: Con esta actividad se ha aumentado el interés y la motivación de los alumnos por los conceptos más básicos de las ciencias biomédicas, a través de la integración real y la aplicación directa a un caso clínico auténtico. Asimismo, hemos conseguido que los alumnos trabajen competencias necesarias para asumir sus futuros roles como integrantes de equipos multidisciplinares, gracias a la participación de alumnos de grados distintos.

ABSTRACT The source material is one of the factors that most influence soil genesis and the mainly responsible for the nature, composition, and behavior of the soil. Given the geological complexity of the Santa Maria River basin, the objective of this study was to investigate whether the new lithologies described recently may be responsible for a greater variation in soil properties, as well as in the soil taxonomy itself. The study area is located in the municipality of Rosário do Sul, RS, Brazil at 30° 15’ 28” S and 54° 54’ 50” W, with average altitude of 132 m and climate type Cfa. This study was supported by a cartographic base composed of topographic charts, geological maps, satellite images, digital elevation models, and maps of geomorphometric variables, with the support of GPS receivers and GIS. Topolithosequences were defined from soils developed from the Pirambóia, Sanga-do-Cabral, and Guará Formations, and soil profiles were chosen based on types of source materials, variations in relief, and altitude. A classical model of slope compartmentalization was applied for correlation of the geomorphic surfaces with pedogenesis. Soil profiles were described in a general and morphological manner, and soil samples were collected for analysis. The physical and chemical properties determined were particle size, active and potential acidity, organic C content, Ca2+, Mg2+, K+, and Al3+. The sum of bases, CEC, flocculation activity and degree of flocculation of the clay fraction, and base (V), aluminum (m), and sodium saturation were calculated. Soil properties were evaluated through factor analysis and grouping, which allowed profiles to be grouped based on their variables and identification of which variables were preponderant in distinguishing them. Furthermore, multivariate analysis allowed statistical differentiation of the profiles in the same lithostratigraphic unit and in different relief positions, and also differentiation of soils developed from different source materials and occupying similar positions in the pedo-landscape, through the formation of homogeneous groups of profiles linked by their degree of similarity.

ABSTRACT Quali-quantitative and crystallographic characterizations of the different minerals of a soil are essential for the best evaluation of its genesis, degree of weathering, active pedogenetic processes, physical and chemical properties, and its potential reserve of mineral nutrients. This study presents the results of mineralogical investigations carried out to verify the influence of the different lithologies of three geological formations of a sedimentary nature on the mineralogical composition of the soils and the relation of this mineralogical composition to soil chemical properties. The study area is located in the physiographic region of the Santa Maria River basin in the municipality of Rosário do Sul, RS, Brazil, at 30° 15’ 28” S and 54° 54’ 50” W, with average altitude of 132 m and Cfa climate type. Topolithosequences were defined from soils developed from the lithology of the Pirambóia, Sanga-do-Cabral and Guará Formations, choosing representative soil profiles based on types of parent materials and variations in relief and altitude. A general and morphological description of the profiles was carried out, and soil samples were collected for analysis. The properties determined were texture, active and potential acidity, organic C, exchangeable Al, sum of bases, CEC at pH7, and base saturation. Mineralogical characterization of the clay fraction was performed by an X-ray diffractometer (XRD). In most of the profiles, kaolinite was the predominant clay, along with a significant contribution from 2:1 clay minerals and the presence of interstratified minerals in combination with kaolinite, which were related to the chemical properties of the soils. The crystallographic parameters of the kaolinite (full width at half maximum - FWHM, layer-d spacing, mean crystallite size - D, and mean number of layers - NL) varied, revealing a distinct pedogenetic evolution, which can be attributed to different degrees of weathering, as well as differences in the source material. Large and asymmetrical reflexes related to the d001 and 002 planes of kaolinite indicated that they are due to the presence of kaolinite-smectite strata in association with pure kaolinites.

Abstract: This study aimed to systematically review the literature to address the question regarding the influence of different materials in the clinical and radiographic success of indirect pulp treatment in primary teeth. A literature search was carried out for articles published prior to January 2017 in PubMed/MEDLINE, CENTRAL, Scopus, TRIP and ClinicalTrials databases; relevant articles included randomized clinical trials that compared materials used for indirect pulp treatment in primary teeth. Two reviewers independently selected the studies and extracted the data. The effects of each material on the outcome (clinical and radiographic failures) were analyzed using a mixed treatment comparisons meta-analysis. The ranking of treatments according to their probability of being the best choice was also calculated. From 1,088 potentially eligible studies, 11 were selected for full-text analysis, and 4 were included in the meta-analysis. In all papers, calcium hydroxide liner was used as the control group versus an adhesive system, resin-modified glass ionomer cement or placebo. The follow-up period ranged from 24 to 48 months, with dropout rates of 0-25.7%. The material type did not significantly affect the risk of failure of the indirect pulp treatment. However, calcium hydroxide presented a higher probability of failure. In conclusion, there is no scientific evidence showing the superiority of any material used for indirect pulp treatment in primary teeth.

RESUMO OBJETIVO: Identificar, caracterizar e medir a associação de fatores relacionados à qualidade de vida (QV) de pacientes asmáticos sob a perspectiva da farmacoterapia. MÉTODOS: Estudo de corte transversal com 49 pacientes (≥ 18 anos) portadores de asma grave não controlada ou asma refratária, atendidos em um ambulatório especializado do Sistema Único de Saúde, em uso regular de altas doses de corticoides inalatórios (CIs) e/ou de diversos medicamentos e com comorbidades. Obtiveram-se as medidas de QV através da aplicação do questionário Asthma Quality of Life Questionnaire (AQLQ) num único momento. O escore global e dos domínios do AQLQ foram relacionados com variáveis demográficas (gênero e idade), escore do Asthma Control Questionnaire, terapia medicamentosa (dose inicial de CI, dispositivos inalatórios e politerapia) e comorbidades. RESULTADOS: Melhores escores do AQLQ associaram-se com asma controlada - escore global (OR = 0,38; IC95%: 0,004-0,341; p < 0,001) e domínios "sintomas" (OR = 0,086; IC95%: 0,016-0,476; p = 0,001) e "função emocional" (OR = 0,086; IC95%: 0,016-0,476; p = 0,001) - e com dose de CI ≤ 800 µg - domínio "limitação de atividades" (OR = 0,249; IC95%: 0,070-0,885; p = 0,029). Piores escores do AQLQ correlacionaram-se com politerapia - domínio "limitação de atividades" (OR = 3,651; IC95%: 1,061-12,561; p = 0,036) - e com número de comorbidades ≤ 5 - domínio "estímulo ambiental" (OR = 5,042; IC95%: 1,316-19,317; p = 0,015). CONCLUSÕES: Nossos resultados, a importância do tema, e a escassez de estudos sob a perspectiva da farmacoterapia apontam a necessidade da realização de estudos longitudinais para se estabelecer uma relação de causalidade entre os fatores identificados e a QV em pacientes com asma.

ABSTRACT OBJECTIVE: To identify, characterize, and quantify associations of various factors with quality of life (QoL) in patients with asthma, according to the pharmacotherapy employed. METHODS: This was a cross-sectional study involving 49 patients (≥ 18 years of age) with severe uncontrolled or refractory asthma treated at a specialized outpatient clinic of the Brazilian Unified Health Care System, regularly using high doses of inhaled corticosteroids (ICs) or other medications, and presenting comorbidities. At a single time point, QoL was assessed with the Asthma Quality of Life Questionnaire (AQLQ). The overall AQLQ score and those of its domains were correlated with demographic variables (gender and age); Asthma Control Questionnaire score; pharmacotherapy (initial IC dose, inhaler devices, and polytherapy); and comorbidities. RESULTS: Better AQLQ scores were associated with asthma control-overall (OR = 0.38; 95% CI: 0.004-0.341; p < 0.001), "symptoms" domain (OR = 0.086; 95% CI: 0.016-0.476; p = 0.001), and "emotional function" domain (OR = 0.086; 95% CI: 0.016-0.476; p = 0.001)-and with IC dose ≤ 800 µg-"activity limitation" domain (OR = 0.249; 95% CI: 0.070-0.885; p = 0.029). Worse AQLQ scores were associated with polytherapy-"activity limitation" domain (OR = 3.651; 95% CI: 1.061-12.561; p = 0.036)-and number of comorbidities ≤ 5-"environmental stimuli" domain (OR = 5.042; 95% CI: 1.316-19.317; p = 0.015). CONCLUSIONS: Our results, the importance of this issue, and the lack of studies taking pharmacotherapy into consideration warrant longitudinal studies to establish a causal relationship between the identified factors and QoL in asthma patients.

AbstractHere, we describe a case of acute disseminated encephalomyelitis (ADEM) that occurred during a plausible risk interval following inactivated influenza vaccination in a previously healthy 27-year-old man from Manaus, Brazil. He was treated with intravenous methylprednisolone and immunoglobulin. One-month follow-up revealed resolution of the brain lesions, but not of the spinal cord lesions. No recurrence or progression of the main neurological symptoms was observed. After two years of monitoring, the patient continues to experience weak lower limbs and urinary retention. Thus, we recommend that ADEM should be considered in a patient presenting with neurological symptoms after influenza vaccination.