ABSTRACT Introduction/framework/objectives The legislation gives the possibility for pregnant women with jobs where there are night shifts, to avoid doing them during this stage. However, sometimes the workers themselves question whether this has concrete scientific validity and what this could entail for themselves and their descendants. Not being a topic with much published literature, this review allows to consult a summary of the most up-to-date records at this level, in order to make assertive and scientific decisions regarding conditioning, as well as whether these should be mandatory or optional. Methodology This is a Bibliographic Review, initiated through a search carried out in May 2023 in the databases “CINALH plus with full text, Medline with full text, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: comprehensive, MedicLatina and RCAAP”. Content Night shifts during pregnancy may be associated with greater family-work conflict, tiredness and sleep disturbance; as well as cancers, weight gain, diabetes, high blood pressure and other cardiovascular diseases; in addition to preterm delivery, low birth weight and congenital anomalies. Discussion and Conclusions Night shifts during pregnancy, especially if numerous and/or consecutive, seem to allow for some alterations, whose pathophysiology is reasonably explained/theorized. However, the probability and eventual severity of these issues must be considered by the pregnant woman herself, so that she (duly informed with regard to current medical knowledge on the subject) choose whether she wishes to continue to do some night shifts and, if so, how; since anxiety and disruption of routines can also be harmful, especially on an emotional and/or economic level (more prominently in companies where the pregnant woman has empathy with the tasks, the work team and/or I have a shared transport). It should be decided on a case-by-case basis, as a team, taking into account pregnant´s opinion. It would be interesting for professionals working in a hospital environment, in an institution that has Obstetric service, to focus a little on the topic, portraying the national reality and publishing their research in a magazine in the area, to disseminate knowledge. and national level, with international extrapolation.

RESUMO Introdução/enquadramento/objetivos A legislação consagra a possibilidade de as grávidas com postos de trabalho em que existam turnos noturnos, os evitem durante esta etapa. Contudo, por vezes, as próprias trabalhadoras questionam a validade científica concreta dessa medida e o que isso poderá acarretar para si e para a descendência. Não sendo um tema com muita bibliografia publicada, esta revisão permite consultar uma síntese do que mais atualizado se registou a este nível, de forma a se tomarem decisões assertivas e científicas em relação a condicionamentos, bem como se estes devem ser obrigatórios ou opcionais. Metodologia Trata-se de uma Revisão Bibliográfica, iniciada através de uma pesquisa realizada em maio de 2023, nas bases de dados “CINALH plus with full text, Medline with full text, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: comprehensive, MedicLatina e RCAAP”. Conteúdo Os turnos noturnos durante a gravidez poderão associar-se a maior conflito família-trabalho, cansaço e perturbação do sono; bem como cancros, aumento de peso, diabetes, hipertensão arterial e outras doenças cardiovasculares; para além de parto pré-termo, baixo peso ao nascer e anomalias congénitas. Discussão e Conclusões Os turnos noturnos durante a gravidez, sobretudo se numerosos e/ou seguidos, parecem possibilitar algumas alterações, cuja fisiopatologia se encontra razoavelmente explicitada/teorizada. Contudo, a probabilidade e eventual gravidade dessas questões devem ser ponderadas pela própria grávida (devidamente informada relativamente aos conhecimentos médicos atuais), para que possa optar se deseja continuar a fazer alguns turnos noturnos e, em caso positivo, de que forma; uma vez que a ansiedade e perturbação de rotinas pode ser também perniciosa, sobretudo a nível emocional e/ou económico (com maior destaque em empresas onde a grávida tenha empatia com as tarefas e com a equipa de trabalho e/ou tenha meio de transporte partilhado). Caberá decidir caso a caso, em equipa, considerando a opinião da própria. Seria aliciante que profissionais a exercer em ambiente hospitalar, em instituição que tenha serviço de Obstetrícia, se debruçassem um pouco sobre o tema, retratando a realidade nacional e publicando a sua investigação em revista da área, para difusão de conhecimentos e nível nacional, com extrapolação internacional.

RESUMEN Introducción: Los profesionales de la salud, para mantenerse actualizados y aportar nuevos conocimientos, deben valorar adecuadamente toda la información aparejada al desarrollo científico actual. Objetivo: Modificar los conocimientos de los estomatólogos sobre las acciones para prevenir las malformaciones congénitas bucomaxilofaciales según la guía seleccionada. Métodos: Se realizó un estudio cuasiexperimental, de intervención educativa sin asignación aleatoria, a través de un curso desde el aula virtual de salud de Santiago de Cuba, durante el periodo abril-mayo de 2021, para el cual fue seleccionada una muestra aleatoria de 90 estomatólogos de diferentes provincias del país. Las variables analizadas fueron provincia, años de graduado, nivel de especialización, grado académico, categoría docente y nivel de conocimientos sobre malformaciones congénitas bucomaxilofaciales. Se aplicaron la encuesta y la entrevista grupal. Resultados: Hubo mayor representatividad de los estomatólogos de Matanzas (22,2 %). Predominaron aquellos con más de 10 años de graduados (35,6 %) y las féminas (84,4 %). De manera general, el nivel de conocimientos al inicio fue inadecuado (90,0 %); sin embargo, al finalizar el curso dichos conocimientos resultaron ser adecuados en igual proporción (90,0 %). Conclusiones: El nivel de conocimientos de los estomatólogos sobre las acciones a realizar en cada nivel de prevención fue modificado de manera ostensible.

ABSTRACT Introduction: Health professionals should value all the information concerning the current scientific development to stay up-to-date and contribute new knowledge. Objective: To modify the knowledge of dentists on the actions to prevent the buccal maxillofacial congenital malformations according to the selected guide. Methods: A quasi-experiment study of educational intervention without random assignment was carried out, through a course from the health virtual classroom in Santiago de Cuba, during the period April-May, 2021, for which a random sample of 90 dentists of different provinces of the country was selected. The analyzed variables were province, time of graduation, specialization level, academic degree, teaching category and level of knowledge on buccal maxillofacial congenital malformations. The survey and group interview were applied. Results: There was higher representation of the dentists from Matanzas (22.2 %). There was a prevalence of dentists with more than 10 years of graduation (35.6 %) and females (84.4 %). In general, the level of knowledge at the beginning was inadequate (90.0 %); however, when concluding the course that knowledge was adequate in the same proportion (90.0 %). Conclusions: Dentists level of knowledge on the actions to carry out in each level of prevention had an evident modification.

ABSTRACT Introduction: Class II malocclusion is one of the anomalies that affect facial aesthetics, which is why it is one of the most frequent in the Orthodontic Consultation. Objective: to design an integrated classification for patients with Class II malocclusion that allows efficient diagnosis and treatment. Methods: a descriptive cross-sectional investigation with a mixed approach was carried out in the Department of Clinical Sciences of the Faculty of Stomatology of the University of Medical Sciences of Villa Clara in the period between 2020 and 2023. We worked with a sample not probabilistic that was made up of seven experts to whom three surveys were administered. The number of experts was determined using criteria based on the binomial probability distribution. The competence of the experts was determined by the competence coefficient, which was calculated according to the expert's opinion about his level of knowledge about the problem and with the sources that allowed him to argue his criteria. Results: the reviewed documentation provided valuable information and the specialists issued different criteria on the classification and diagnosis of Class II malocclusion. The experts established the invariable elements for their classification. Conclusions: the classification of malocclusion was carried out based on a diagnostic taxonomy that included invariable elements in order to achieve more comprehensive and efficient attention to malocclusion.

RESUMEN Introducción: la maloclusión de Clase II es una de las anomalías que afectan la estética facial, por lo que es una de las más frecuentes en la Consulta de Ortodoncia. Objetivo: diseñar una clasificación integrada para pacientes con maloclusión de Clase II que permita el diagnóstico y el tratamiento eficiente. Métodos: se realizó una investigación descriptiva de corte transversal con enfoque mixto en el Departamento de Ciencias Clínicas de la Facultad de Estomatología de la Universidad de Ciencias Médicas de Villa Clara en el período comprendido entre los años 2020 y 2023. Se trabajó con una muestra no probabilística que estuvo constituida por siete expertos a los que se les aplicaron tres encuestas. La determinación del número de expertos se realizó utilizando criterios basados en la distribución binomial de probabilidad. La competencia de los expertos se determinó por el coeficiente de competencia, el que se calculó de acuerdo con la opinión del experto sobre su nivel de conocimiento acerca del problema y con las fuentes que permitieron argumentar sus criterios. Resultados: la documentación revisada aportó información valiosa y los especialistas emitieron diferentes criterios sobre la clasificación y el diagnóstico de la maloclusión de Clase II. Los expertos establecieron los elementos invariables para su clasificación. Conclusiones: se realizó la clasificación de la maloclusión a partir de una taxonomía de diagnóstico que incluyó los elementos invariables con el fin de lograr una atención más integral y eficiente de la maloclusión.

SUMMARY OBJECTIVE: This study aimed to investigate the effects of weight gain and maternal anemia on postpartum depression. METHODS: This is a prospective, single-center, case-control study. We recorded the demographic characteristics, blood ferritin level, and weight gain during the pregnancy. This study was planned between April 2023 and June 2023 in the Obstetrics and Gynecology Clinic of Ankara Etlik City Hospital. A total of 109 patients were enrolled in the study. Patients were assessed with the Edinburgh Postpartum Depression Scale. Weight gain, nutritional education, educational level, mode of delivery, and pregnancy history were asked in person. Ferritin levels at the onset of labor were determined to detect anemia. Twin births, births due to fetal anomalies or intrauterine stillbirths, patients with systemic infections, and patients diagnosed with a psychiatric disorder in the past 6 months whose records were not accessible were excluded from the study. RESULTS: Pregnancy weight gain and percentage of pregnancy weight gain were higher. Serum ferritin levels and nutritional education during pregnancy were lower in the postpartum depression group (p<0.001). These parameters with statistical significance were identified as risk factors in the regression analysis for postpartum depression (p<0.05). In receiver operating characteristics analysis, >15 kg for weight gain, >28.8 for percentage of weight gain in pregnancy, and <19 ng/dL for serum ferritin level were identified as cutoff values (p<0.001). CONCLUSION: Nutritional education and vitamin supplementation should be recommended to pregnant women during routine examinations. OBJECTIVE METHODS prospective singlecenter, singlecenter single center, center single-center casecontrol case control 202 Hospital 10 Scale delivery person stillbirths infections RESULTS higher p<0.001. p0001 p p<0.001 . 0 001 (p<0.001) p<0.05. p005 p<0.05 05 (p<0.05) 15 >1 288 28 8 >28. 19 <1 ngdL ng dL CONCLUSION examinations 20 1 p000 p<0.00 00 (p<0.001 p00 p<0.0 (p<0.05 > 2 >28 < (p<0.00 p0 p<0. (p<0.0 >2 p<0 (p<0. p< (p<0 (p< (p

Abstract Objectives The aim was to describe the spectrum of inner ear malformations in CHARGE syndrome and propose a Computed Tomography (CT) detailed scan evaluation methodology. The secondary aim was to correlate the CT findings with hearing thresholds. Methods Twenty ears of ten patients diagnosed with CHARGE syndrome were subjected to CT analysis focusing on the inner ear and internal acoustic canal. The protocol used is presented in detail. ASSR results were analyzed and correlated with inner ear malformations. Results Cochlear hypoplasia type III was the most common malformation found in 12 ears (60%). Cochlear hypoplasia type II, aplasia with a dilated vestibule, and rudimentary otocyst were also identified. In 20%, no cochlear anomaly was found. The lateral Semicircular Canal (SCC) absence affected 100% of ears, the absence of the posterior SCC 95%, and the superior SCC 65%. Better development of cochlea structures and IAC correlated significantly with the lower hearing thresholds. Conclusion This study demonstrated that rudimentary SCC or a complete absence of these SCCs was universally observed in all patients diagnosed with CHARGE syndrome. This finding supports the idea that inner ear anomalies are a hallmark feature of the CHARGE, contributing to its distinct clinical profile. The presence of inner ear malformations has substantial clinical implications. Audiological assessments are crucial for CHARGE syndrome, as hearing loss is common. Early detection of these malformations can guide appropriate interventions, such as hearing aids or cochlear implants, which may significantly improve developmental outcomes and communication for affected individuals. Recognizing inner ear malformations as a diagnostic criterion presents implications beyond clinical diagnosis. A better understanding of these malformations can advance the knowledge of CHARGE pathophysiology. It may also help guide future research into targeted therapies to mitigate the impact of inner ear anomalies on hearing and balance function. Level of evidence: 4. (CT methodology thresholds canal detail 1 60%. 60 60% . (60%) II vestibule identified 20 20% (SCC 100 95 95% 65 65% profile interventions implants individuals diagnosis pathophysiology function evidence 4 6 (60% 2 10 9 (60 (6 (

Abstract Objective To determine the prevalence, epidemiological profile, and clinical characteristics of Oral or Oropharyngeal Mucosal Lesions (OOPML) in patients attended at the Otorhinolaryngology Service of the Evandro Chagas National Institute of Infectious Diseases (INI-FIOCRUZ) from 2005 to 2017. Methods Statistical analysis of descriptive data from medical records (gender, age, education level, skin color, origin, smoking, alcoholism, HIV co-infection, time of disease evolution, first symptom, and OOPML location) was performed. Results Of 7551 patients attended at the service, 620 (8.2%) were included in the study. OOPML were classified into developmental anomalies (n = 3), infectious diseases (non-granulomatous n = 220; granulomatous n = 155), autoimmune diseases (n = 24), neoplasms (benign n = 13; malignant, n = 103), and unclassified epithelial/soft tissue diseases (n = 102). OOPML of infectious diseases (60.5%) and neoplasms (18.7%) were the most frequent. The predominant demographics of patients with OOPML were: males (63.5%), white (53.5%), and those in the fifth to sixth decades of life (43.3%). Local pain (18.1%) and odynophagia (15%) were the most reported first symptoms, and the most frequent OOPML sites were the palatine tonsil (28.5%), hard palate (22.7%), and tongue (20.3%). The median evolution time was three months. Conclusions Infectious OOPML were the most frequent, as expected in a reference center for infectious diseases, and thus, they are likely to be less frequent in general care and/or dental services. Underreporting of OOPML is possible, as oral/oropharyngeal examination is often not included in the routine medical examination. Oral cavity/oropharynx examination should be performed by specialists, such as dentists and otorhinolaryngologists, who have the expertise in identifying OOPML, even in incipient/asymptomatic cases. Given the numerous diseases in which OOPML can present, diagnosis could be facilitated by multidisciplinary teams, potentially enabling the early treatment of diseases, and thus, reduce morbidity and improve prognosis. The use of standardized medical records for oral/oropharyngeal systematic examination could provide relevant tools for differential diagnoses and information for new clinical-epidemiological studies. Level of evidence: Level 3. prevalence profile (OOPML INIFIOCRUZ INI FIOCRUZ (INI-FIOCRUZ 200 2017 gender, gender (gender age level color origin smoking alcoholism coinfection, coinfection co infection, infection co-infection symptom location 755 service 62 8.2% 82 8 2 (8.2% study 3, 3 , 3) nongranulomatous non 220 155, 155 155) 24, 24 24) benign 13 malignant 103, 103 103) epithelialsoft epithelial soft 102. 102 . 102) 60.5% 605 60 5 (60.5% 18.7% 187 18 7 (18.7% 63.5%, 635 63.5% 63 (63.5%) 53.5%, 535 53.5% 53 (53.5%) 43.3%. 433 43.3% 43 (43.3%) 18.1% 181 1 (18.1% 15% 15 (15% symptoms 28.5%, 285 28.5% 28 (28.5%) 22.7%, 227 22.7% 22 (22.7%) 20.3%. 203 20.3% 20 (20.3%) months thus andor services possible oraloropharyngeal oral oropharyngeal cavityoropharynx cavity oropharynx specialists otorhinolaryngologists incipientasymptomatic incipient asymptomatic cases present teams prognosis clinicalepidemiological studies evidence 201 75 6 8.2 (8.2 10 60.5 (60.5 18.7 (18.7 63.5 (63.5% 53.5 (53.5% 43.3 4 (43.3% 18.1 (18.1 (15 28.5 (28.5% 22.7 (22.7% 20.3 (20.3% 8. (8. 60. (60. 18. (18. 63. (63.5 53. (53.5 43. (43.3 (1 28. (28.5 22. (22.7 20. (20.3 (8 (60 (18 (63. (53. (43. ( (28. (22. (20. (6 (63 (53 (43 (28 (22 (20 (5 (4 (2

RESUMEN Introducción: La asfixia perinatal es un síndrome caracterizado por la suspensión o grave disminución del intercambio gaseoso a nivel de la placenta o de los pulmones. Objetivo: Caracterizar los neonatos con asfixia perinatal durante el trabajo de parto con la introducción de la gasometría de la arteria umbilical. Materiales y métodos: Se realizó un estudio descriptivo, transversal, de octubre de 2016 a diciembre de 2021. Se trabajó con la totalidad del universo: 75 neonatos asfícticos. Las variables fueron: edad materna, edad gestacional al nacimiento, enfermedades asociadas y dependientes del embarazo, tipo y tiempo de trabajo de parto, características del líquido amniótico, anomalías de la placenta y cordón umbilical, pH de la gasometría de la arteria del cordón, evolución clínica del recién nacido. Los datos se almacenaron y procesaron en una hoja de cálculo de Microsoft Excel, utilizando la estadística descriptiva. Resultados: Predominaron pacientes con edad materna menor de 20 años (56 %), y edad gestacional al nacimiento de 28 a 33,6 semanas (77,3 %). La hipertensión arterial fue la comorbilidad más común, así como la preeclampsia, entre las enfermedades dependiente del embarazo (30,7 %); 61,3 % tuvieron parto eutócico, con líquido amniótico claro (65,3 %), placenta previa (38,7 %) y circulares en cordón umbilical (30,7 %). En el 86,7 % el pH de la gasometría fue menor que 7, y el 92 % presentó evolución clínica favorable. Conclusiones: La asfixia perinatal estuvo predominantemente asociada a madres adolescentes, con tiempo gestacional entre 28 y 36 semanas, preeclampsia, placenta previa, circulares del cordón umbilical y predominio de gasometría con pH menor que 7.

ABSTRACT Introduction: Perinatal asphyxia is a syndrome characterized by the suspension or severe decrease in gas exchange at the level of the placenta or lungs. Objective: To characterize neonates with perinatal asphyxia during labor with the introduction of umbilical arterial blood gas test. Materials and methods: A descriptive, cross-sectional study was carried out from October 2016 to December 2021. It dealt with the entire universe, 75 asphyxiated neonates. The variables were: maternal age, gestational age at birth, associated and pregnancy-dependent diseases, type and time of labor, characteristics of the amniotic fluid, anomalies of the placenta and umbilical cord, pH of the cord arterial blood gas test, clinical evolution of the newborn. The data were stored and processed in a Microsoft Excel spreadsheet, using descriptive statistics. Results: Patients with maternal age below 20 years (56%), and gestational age at birth from 28 to 33.6 weeks (77.3%) predominated. Arterial hypertension was the most common comorbidity, as well as preeclampsia, among pregnancy-dependent diseases (30.7%); 61.3% had eutocic delivery, with clear amniotic fluid (65.3%), previous placenta (38.7%) and umbilical cord circulars (30.7%). In 86.7%, the blood gas pH was less than 7 and 92% had a favorable clinical evolution. Conclusions: Perinatal asphyxia was predominantly associated with adolescent mothers, with gestational time between 28-36 weeks; preeclampsia, placenta previa, umbilical cord circulars, and blood gases pH lower than 7.

Abstract The geotechnical monitoring of tailings dams combined with a suitable application of geophysical electrical methods can improve their structure evaluation, allowing several correlations between direct analyses and the resistivity anomaly pattern. Considering this synergy, twenty-three electrical resistivity sections (ERT) were acquired along the beach, abutments, and central part of a dam, totalizing 10,776 m of dataset. After the interpretation of each ERT section, comparing the anomaly ranges with the water level meters measurements, three resistivity zones were defined: Zones of low resistivity (<64 ohm-m), correlated to regions of high humidity; zones of high resistivity (> 357 ohm-m), interpreted as dry zones, and regions with intermediate resistivity values, located between these limits. The groundwater surface generated from the interpretation of the electrical resistivity dataset and the groundwater surface acquired from the water level gauges were almost coincident. On the right abutment, the conductive anomalies showed remarkable continuity, suggesting a high moisture content in this region with strong gradients (200 mV) directed towards the zone of low resistivity values identified in the sections. The analysis showed a robust correlation of the ERT data with localized physical geotechnical measurements, valuable for monitoring dam integrity, overseeing the structure's response to climate and operational changes, and ultimately mitigating the risks of failure. The results of this study support the adoption of a seasonal 4D electrical resistivity survey as an effective tool to monitor and manage surface and high humidity zones, key indicators of dam integrity throughout the entire structure. evaluation pattern synergy twentythree twenty (ERT beach abutments 10776 10 776 10,77 section measurements defined <64 64 (<6 ohmm, ohmm ohm , ohm-m) > ( 35 limits coincident abutment continuity 200 (20 mV structures s changes failure D 1077 1 77 10,7 <6 6 (< ohm-m 3 20 (2 107 7 10, < 2

Abstract Objective: To compare the measurements of the lumbar safety triangle (Kambin’s triangle) and the invasion of the dorsal root ganglion in the triangle in coronal and coronal oblique planes. Materials and Methods: A cross-sectional study, in which 210 3.0-T magnetic resonance images of L2-L5 were analyzed in coronal and coronal oblique planes. Exams with lumbar spine anomalies were excluded. Demographic (sex and age) and radiological variables were recorded by a single evaluator. Results: Most sample was female (57.1%), mean age 45.5 ± 13.3 (18–98 years). The measurements average, as well as the areas, gradually increased from L2 to L5. The dorsal root ganglion invaded the triangle in all images. The safety triangle average area was smaller in the coronal oblique plane than in the coronal plane. Of the seven dimensions of safety triangle obtained for each level of the lumbar spine, six were significantly smaller in the coronal oblique plane than in the coronal plane. The only dimension that showed no difference was the smallest ganglion dimension. Conclusion: The dimensions and areas investigated were smaller in coronal oblique plane, especially the area (difference > 1 mm). The analysis of the triangular zone in this plane becomes important in the preoperative assessment of minimally invasive procedures. Objective Kambins Kambin s planes Methods crosssectional cross sectional study 21 3.0T 30T T 3.0 3 0 L2L5 LL L5 L L2-L excluded sex evaluator Results 57.1%, 571 57.1% , 57 (57.1%) 455 45 5 45. 133 13 13. 18–98 1898 18 98 (18–9 years. years . years) Conclusion mm. mm mm) procedures 2 0T 30 3. L2L 57.1 (57.1% 4 18–9 189 9 (18– 57. (57.1 18– (18 (57. (1 (57 ( (5

Resumo Objetivo: Comparar as medidas do triângulo de segurança lombar (triângulo de Kambin) e invasão do gânglio da raiz dorsal no triângulo nas incidências coronal e coronal oblíqua. Materiais e Métodos: Estudo transversal, em que foram analisadas 210 imagens de ressonância magnética 3.0-T de L2-L5 nos planos coronal e coronal oblíquo. Foram excluídos exames com anomalias da coluna lombar. Variáveis demográficas (sexo e idade) e radiológicas foram registradas por um único avaliador. Resultados: A maioria da amostra era do sexo feminino (57,1%), com idade média de 45,5 ± 13,3 (18–98 anos). A média das medidas, assim como as áreas, aumentaram gradativamente de L2 a L5. O gânglio da raiz dorsal invadiu o triângulo em todas as imagens. A área média do triângulo de segurança foi menor na incidência coronal oblíqua do que na incidência coronal. Das sete dimensões do triângulo de segurança obtidas para cada nível da coluna lombar, seis foram significativamente menores no plano coronal oblíquo do que no plano coronal. Única dimensão que não apresentou diferença foi a menor dimensão do gânglio. Conclusão: As dimensões e áreas investigadas foram menores na incidência coronal oblíqua, especialmente a área (diferença > 1 mm). A análise da zona triangular nesta incidência torna-se importante na avaliação pré-operatória de procedimentos minimamente invasivos. Objetivo Kambin Métodos transversal 21 3.0T 30T T 3.0 3 0 L2L5 LL L5 L L2-L avaliador Resultados 57,1%, 571 57,1% , 57 (57,1%) 455 45 5 45, 133 13 13, 18–98 1898 18 98 (18–9 anos. anos . anos) Conclusão mm. mm mm) tornase torna se préoperatória pré operatória invasivos 2 0T 30 3. L2L 57,1 (57,1% 4 18–9 189 9 (18– 57, (57,1 18– (18 (57, (1 (57 ( (5

ABSTRACT Sleep-disordered breathing (SDB) is a group of disorders associated with breathing anomalies during sleep. Easily detectable by sound, snoring is one of the most common manifestations and the main sign of SDB. Snoring is characteristic of breathing sound during sleep, without apnea, hypoventilation, or interrupted sleep. It may reduce the percentage of sleep and increase microarousals due to breathing effort or gas exchange. A range of questionnaires have been validated and adapted to the pediatric population to screen for patients who require laboratory testing. The Pediatric Sleep Questionnaire (PSQ) screens for SDB and identifies primary signs such as snoring. RoncoLab is a mobile application that records and measures snoring intensity and frequency Aim To compare the RoncoLab app and the PSQ regarding how efficiently they diagnose snoring Materials and Method This was an observational, analytical study of 31 children aged 7 to 11 years who visited the pediatric dental clinic at Benemérita Universidad Autónoma de Puebla, Mexico (BUAP). The PSQ was applied to diagnose SDB. Guardians were then instructed on how to download and use the mobile application to record data while the child was sleeping at home. Agreement between RoncoLab and the PSQ was analyzed statistically by Cohen’s Kappa index at 95% confidence level Results The Kappa index for identification of primary snoring was 0.743 (p<0.05). App sensitivity was 0.92, and specificity 0.82 Conclusion There is good agreement between PSQ and RoncoLab for diagnosing primary snoring, with acceptable sensitivity and specificity.

RESUMEN Los trastornos respiratorios del sueño (TRS) son un grupo de padecimientos asociados con anormalidades respiratorias del sueño. Una de las manifestaciones más comunes es el ronquido; signo fácil de detectar por el ruido que emite y se considera como el signo principal. Este trastorno es característico del ruido respiratorio durante el sueño, sin apneas, hipoventilación, ni interrupciones del sueño. Este puede ocasionar disminución del porcentaje del sueño y aumentar los microdespertares, esto debido al esfuerzo respiratorio o al intercambio de gases. En la actualidad existen cuestionarios validados y adaptados para la población pediátrica útiles como herramienta clínica para el tamizaje y selección de pacientes que requieran pruebas de laboratorio. El Pediatric Sleep Questionnaire (PSQ) permite el cribado de TRS e identificación de signos primarios como el ronquido. RoncoLab es una aplicación móvil que registra y mide la intensidad y frecuencia del ronquido. Objetivo Comparar la eficacia del diagnóstico del ronquido por medio del RoncoLab contrastado con el PSQ Materiales y Método Estudio observacional, analítico, en el cual se incluyeron 31 niños de 7 a 11 años, que acudieron a la clínica de odontopediatría de la Benemérita Universidad Autónoma de Puebla, México (BUAP) Se aplicó el PSQ a los 31 niños para el diagnóstico de TRS, después se le instruyó al tutor como descargar y utilizar la aplicación móvil para registrar los datos obtenidos en las horas de sueño en casa. El análisis estadístico de concordancia entre los instrumentos diagnósticos se realizó con el Índice Kappa de Cohen a un nivel de confianza del 95% Resultados El Índice de Kappa para la identificación de los ronquidos primarios fue de 0.743 (p<0.05). La sensibilidad de la aplicación fue de 0.92, mientras la especificidad fue de 0.82 Conclusión Existe buena concordancia entre el PSQ y el RoncoLab en el diagnóstico de ronquido primario, con sensibilidad y especificidad aceptable.

ABSTRACT Objectives: This study aims to determine the prevalence of tooth agenesis and supernumerary teeth and characterize both anomalies in a Portuguese pediatric population. Methods: Clinical records of patients attending Pediatric Dentistry appointments in the Faculty of Dental Medicine of the University of Porto were consulted. Appointments from September 2020 to December 2021 were analyzed. For each patient, sex and age were recorded, along with any relevant data in their clinical history. Statistical analysis of the results was conducted using chi-square tests with a significance level of 0.05. The sample included 144 patients. Results: This study found a prevalence for tooth agenesis of 20.83% (11.81% excluding the third molars) and a prevalence for supernumerary teeth of 1.39%. The prevalence of agenesis was 26.1% for males and 16% for females. No association was established in this regard (p>0.05). The most affected teeth were the third molars, followed by the second premolars. The mandible had 52.63% of agenesis cases, but no association was found (p>0.05). Two cases of supernumerary teeth were found, both in male patients and in the second quadrant. No differences were inferred regarding sex (p>0.05). Conclusions: The results of this study contributed to the existing data regarding the prevalence of dental anomalies of number within a Portuguese population. (Rev Port Estomatol Med Dent Cir Maxilofac. 2023;64(3):99-104)

RESUMO Objetivos: Este estudo pretende determinar a prevalência da agenesia dentária e de dentes supranumerários e caracterizar as duas anomalias numa população pediátrica portuguesa. Métodos: Os registos clínicos dos pacientes pediátricos consultados na Faculdade de Medicina Dentária da Universidade do Porto foram consultados. Foram analisadas consultas desde setembro de 2020 até dezembro de 2021. O sexo e a idade de cada paciente foram registados, assim como quaisquer dados relevantes constantes na história clínica. Foi realizada a análise estatística dos resultados com recurso a testes do Qui-Quadrado, com um nível de significância de 0,05. Foram incluídos 144 pacientes na amostra. Resultados: Este estudo encontrou uma prevalência de agenesias dentárias de 20,83% (11,81% excluindo os terceiros molares) e uma prevalência de dentes supranumerários de 1,39%. A prevalência de agenesias foi 26.1% no sexo masculino e 16% no feminino. Nenhuma associação foi estabelecida a este respeito (p>0,05). Os dentes mais afetados foram os terceiros molares, seguido dos segundos pré-molares. 52.63% das agenesias encontravam-se na mandíbula, mas nenhuma associação foi encontrada (p>0,05). Foram encontrados dois casos de dentes supranumerários, ambos no sexo masculino e no segundo quadrante. Não foram encontradas diferenças quanto ao sexo. (p>0,05). Conclusões: Os resultados deste estudo contribuíram para os dados existentes quanto à prevalência das anomalias dentárias de número na população portuguesa

Resumen Presentamos un raro caso de nacimiento anómalo de arteria coronaria izquierda en el seno de Valsalva contralateral. Se trata de un hombre de 63 años que consultó al servicio de emergencias de nuestro centro por disnea progresiva de una semana de evolución, con signos clínicos de insuficiencia cardíaca, aso ciado a signos de congestión en la radiografía de tórax, y valores de NT-proBNP elevados (2000 pg/ml; valor normal <150). El ecocardiograma Doppler evidenció dilatación grave de la aurícula y del ventrículo izquierdo, con deterioro grave de la función sistólica (fracción de eyección de 26%), hipoquinesia global e insuficiencia mitral moderada con jet central. Se realizó una cinecoronariografía que evidenció el nacimiento anómalo del tronco de arteria coronaria izquierda desde el seno coronario derecho, con una lesión cercana al 50%. Una angiotomografía coronaria confirmó el origen anómalo del vaso coronario, con trayecto intramiocárdico a nivel del septum interventricular asociado a compresión extrínseca moderada. Para determinar el grado de isquemia funcional que presentaba la lesión del tronco coronario izquierdo se evaluó la reserva de flujo fraccional, que arrojó un resultado de 0.75 el cual se consideró significativo, prosiguiendo a angioplastia con implante de stent liberador de droga (con Everolimus) a dicha lesión. El paciente evolucionó favorablemente durante la internación en el hospital, egresando de la institución para continuar seguimiento ambulatorio. Persistió asintomático en los controles realizados al mes y a los 6 meses, sin evidencia de isquemia en la evaluación funcional no invasiva.

Abstract We present an unusual case of an anomalous left coronary artery arising from the contralateral sinus of Valsalva: a 63-year-old male patient who consulted to our emergency department with 1-week history of progressive dyspnea on exertion with clinical signs of heart failure, associated with lung congestion on the chest X ray and elevated NT-proBNP levels (2000 pg/ml; normal value <150). Doppler echocardiography showed severe dilation of both left atrium and left ventricle, with severe deterioration of LV systolic function (Ejection fraction of 26%), global hypokinesia and a moderate mitral regurgitation with central jet. A cardiac cath eterization was performed, which evidenced an anomalous origin of the left main coronary artery from the right coronary sinus with a proximal lesion of nearly 50%. A coronary computed tomographic angiography confirmed the diagnosis of an anomalous origin with an intramyocardial path at the level of the interventricular septum, as sociated with moderate extrinsic compression. To determine the degree of functional ischemia presented by the left main coronary artery lesion we performed a fractional flow reserve evaluation, resulting in 0.75, which was ranked as significant. An angioplasty with implantation of a drug-eluting stent (with Everolimus) was performed successfully to the target lesion. The patient evolved favorably during hospitalization and was discharged from the medical center to continue outpatient follow-up. Patient remained asymptomatic at 1-month and 6 months, during clinical evaluation, without evidence of ischemia on noninvasive functional assessment.

Resumen Introducción: Con poca frecuencia se ha reportado el entrenamiento necesario para realizar ultrasonido (US) obstétrico. El objetivo de este estudio fue determinar si el entrenamiento del ultrasonografista influye en la certeza del diagnóstico prenatal de algunas malformaciones congénitas. Métodos: Se llevó a cabo una evaluación retrospectiva de los hallazgos ultrasonográficos prenatales de neonatos que tuvieron malformaciones congénitas en un hospital de referencia pediátrico de tercer nivel. Se realizó al ingreso de neonatos consecutivos en un hospital de referencia de tercer nivel. Se recolectaron y analizaron datos del embarazo y alumbramiento, así como los de los ultrasonidos prenatales (USP) correlacionando con el diagnóstico final. Resultados: Se incluyeron 67 neonatos. Todos tuvieron USP con media de 4.6. Se realizó diagnóstico prenatal en 24 casos (35.8%). Se detectaron 13 malformaciones congénitas, predominando malformación anorectal gastrosquisis. La certeza del USP se asoció con el entrenamiento del individuo que realizó el US y la mayor certeza se encontró cuando lo realizaron ginecólogos y especialistas materno-fetales contra radiólogos y médicos generales (p = 0.005). Los pacientes sin diagnóstico prenatal certero tuvieron mayor riesgo de presentar comorbilidades (riesgo relativo [RR]: 1.65, p = < 0.001, 95% intervalo de confianza [CI]: 1.299-2.106). Conclusiones: En nuestro medio, el diagnóstico prenatal de estas malformaciones está determinado directamente por el entrenamiento de la persona que realiza el ultrasonido.

Abstract Background: The training needed for doing obstetric ultrasounds is rarely reported. The aim of this study was to determine whether the training of the ultrasonographer influences the prenatal diagnostic certainty of some congenital malformations. Methods: We conducted a retrospective evaluation of antepartum sonographic findings of newborn infants found ultimately to have a congenital anomaly in a tertiary level pediatric reference center. Data were collected on admission for consecutive patients at a tertiary-level pediatric reference center. The mother´s pregnancy and birth demographic variables and those of the prenatal ultrasound (PUS) were analyzed and correlated with the final diagnosis. Results: Sixty-seven neonates were included. All cases underwent PUS with a mean of 4.6. Prenatal diagnosis was established in 24 cases (35.8%). Thirteen surgical anomalies were detected, particularly anorectal malformation and gastroschisis. The accuracy of PUS was associated with the training of the physician performing the PUS, whereby PUS with the greatest accuracy were performed by gynecologists and maternal-fetal specialists against radiologists and general practitioners (p = 0.005). Patients without an accurate prenatal diagnosis had a greater risk of presenting comorbidities (relative risk [RR]: 1.65, p = < 0.001, 95% confidence interval [CI]: 1.299-2.106). Conclusions: In our setting, prenatal diagnosis of these malformations is directly determined by the training of the person performing the ultrasound.

Abstract Although variation between observers in the assessment of the Apgar score, it remains a useful indicator of the general conditions of the newborn. This is a cross-sectional study based on population of live births in Brazil in 1999 and biennium 2018-2019. All declarations of live births (DNV) obtained from the Live Births System database were accessed. Frequencies were compared between groups using Pearson’s chi-square test and multivariate logistic regression analysis was performed. A statistical significance level of 0.05 was considered. We included 9.050.521 DNVs in our research. We found that 2,1% of newborns had 5th minute Apgar < 7 in 1999 compared with 0,9% in 2018-2019. Multivariate analysis shows that twins and teenage pregnancy are no longer risk factors. Among risk factors, we observed an increase in prematurity, low birth weight and congenital anomalies. An improvement in maternal markers was observed, especially increase in the number of prenatal consultations and schooling. Such findings demonstrate the importance access and adequate prenatal care and improved socioeconomic conditions as effective strategy to reduce neonatal morbidity and mortality. score newborn crosssectional cross sectional 199 20182019. 20182019 2018 2019. 2019 2018-2019 DNV (DNV accessed Pearsons Pearson s chisquare chi square performed 005 0 05 0.0 considered 9050521 9 050 521 9.050.52 research 21 2 1 2,1 th 09 0,9 factors prematurity anomalies schooling mortality 19 2018201 201 2018-201 00 0. 905052 52 9.050.5 2, 0, 201820 20 2018-20 90505 5 9.050. 20182 2018-2 9050 9.050 2018- 905 9.05 90 9.0 9.

Resumo Apesar da variação entre observadores na avaliação do escore de Apgar, ele permanece um indicador útil das condições gerais do recém-nascido. O presente trabalho é um estudo de corte transversal baseado na população de nascidos vivos no Brasil no ano de 1999 e no biênio 2018-2019. Foram avaliadas todas as declarações de nascidos vivos (DNV) obtidas a partir do banco de dados do Sistema de Informações sobre Nascidos Vivos. As frequências foram comparadas entre os grupos por meio do teste qui-quadrado de Pearson e foi realizada análise de regressão logística multivariada. Adotou-se nível de significância estatística de 0,05. Foram analisadas 9.050.521 DNVs em nossa pesquisa. Constatamos que 2,1% dos recém-nascidos tiveram Apgar de 5º minuto < 7 em 1999, em comparação com 0,9% em 2018-2019. A análise multivariada indicou que gemelidade e gravidez na adolescência deixaram de ser fatores de risco para Apgar de 5º minuto < 7. Entre os fatores de risco, nota-se aumento da prematuridade, baixo peso ao nascer e anomalias congênitas. Observou-se melhoria de marcadores maternos, em especial o aumento do número de consultas pré-natais e escolaridade. Tais achados mostram a importância de acesso e seguimento pré-natal adequado e investimento em melhores condições socioeconômicas como estratégia eficaz para redução de morbimortalidade neonatal. recémnascido. recémnascido recém nascido. nascido recém-nascido 199 20182019. 20182019 2018 2019. 2019 2018-2019 DNV (DNV Vivos quiquadrado qui quadrado Adotouse Adotou se 005 0 05 0,05 9050521 9 050 521 9.050.52 pesquisa 21 2 1 2,1 recémnascidos º 09 0,9 notase nota prematuridade congênitas Observouse Observou maternos prénatais pré natais escolaridade prénatal natal neonatal 19 2018201 201 2018-201 00 0,0 905052 52 9.050.5 2, 0, 201820 20 2018-20 90505 5 9.050. 20182 2018-2 9050 9.050 2018- 905 9.05 90 9.0 9.

Abstract Background Cardiac anomalies are the most prevalent congenital malformations among live births in the world. In Brazil, it is estimated that nearly 25,757 new cases occur each year, and the Southeast region presents the highest prevalence, with 10 new cases/1,000 live births. Objective The aim of this study is to evaluate the epidemiology of congenital heart disease (CHD) in the state of São Paulo. Methods This is a cross-sectional and time-series observational study with data from the Brazilian Information System on Live Births. Heart-related cardiac malformation cases — International Classification of Diseases (ICD) 10th revision Q20.0 to Q24.9 — were selected from January 2010 to December 2018, in the state of São Paulo, Brazil. This study analyzed rates of malformations per year and investigated associated factors, using single and multiple logistic regression models. The significance level adopted in this study was 5%. Results The highest cardiac malformation rate was in the São Paulo metropolitan region (2.84:1000), while the lowest was found in the region of Franca (0.3:1000). The most frequent defect was interatrial communication (38.2%). The main associated factors observed in this study were prematurity of 22 to 27 weeks (OR=4,401 95% CI: 3,796-5,104) — CI: Confidence Interval; OR: Odds ratio —, mother’s age between 35 and 49 years of age (OR=1,602 95% CI: 1,525-1,682), yellow race (OR=1,481 95% CI: 1,235-1,775), triple or more pregnancy (OR=1,438 95% CI: 1,004-2,060), and history of a dead child (OR=1,213 95% CI: 1,152-1,277). Conclusion The main factors associated with this outcome, which are part of the obstetric history of mothers, should be addressed and considered when pregnancy is a planned event. world Brazil 25757 25 757 25,75 prevalence 1 cases1000 000 cases/1,00 CHD (CHD crosssectional cross sectional timeseries time series Births Heartrelated Heart related ICD (ICD th Q200 Q Q20 0 Q20. Q249 Q24 9 Q24. 201 2018 models 5 5% 2.841000, 2841000 2.84 1000 , 2 84 (2.84:1000) 0.31000. 031000 0.3 . 3 (0.3:1000) 38.2%. 382 38.2% 38 (38.2%) OR=4,401 OR4401 OR 4 401 (OR=4,40 95 CI 3,7965,104 37965104 3,796 5,104 796 104 3,796-5,104 Interval mothers mother s OR=1,602 OR1602 602 (OR=1,60 1,5251,682, 15251682 1,525 1,682 525 682 1,525-1,682) OR=1,481 OR1481 481 (OR=1,48 1,2351,775, 12351775 1,235 1,775 235 775 1,235-1,775) OR=1,438 OR1438 438 (OR=1,43 1,0042,060, 10042060 1,004 2,060 004 060 1,004-2,060) OR=1,213 OR1213 213 (OR=1,21 1,1521,277. 11521277 1,152 1,277 152 277 1,152-1,277) outcome event 2575 75 25,7 cases100 00 cases/1,0 Q2 20 841000 2.841000 284100 284 2.8 100 8 (2.84:1000 31000 0.31000 03100 03 0. (0.3:1000 38.2 (38.2% OR=4,40 OR440 40 (OR=4,4 7965 3,7965,10 3796510 3796 3,79 5104 5,10 79 3,796-5,10 OR=1,60 OR160 60 (OR=1,6 5251 1,5251,682 1525168 1525 1,52 1682 1,68 52 68 1,525-1,682 OR=1,48 OR148 48 (OR=1,4 2351 1,2351,775 1235177 1235 1,23 1775 1,77 23 77 1,235-1,775 OR=1,43 OR143 43 0042 1,0042,060 1004206 1004 1,00 2060 2,06 06 1,004-2,060 OR=1,21 OR121 21 (OR=1,2 1521 1,1521,277 1152127 1152 1,15 1277 1,27 15 1,152-1,277 257 7 25, cases10 cases/1, 84100 2.84100 28410 28 2. (2.84:100 3100 0.3100 0310 (0.3:100 38. (38.2 OR=4,4 OR44 (OR=4, 3,7965,1 379651 379 3,7 510 5,1 3,796-5,1 OR=1,6 OR16 6 (OR=1, 1,5251,68 152516 1,5 168 1,6 1,525-1,68 OR=1,4 OR14 1,2351,77 123517 123 1,2 177 1,7 1,235-1,77 1,0042,06 100420 1,0 206 2,0 1,004-2,06 OR=1,2 OR12 1,1521,27 115212 115 1,1 127 1,152-1,27 cases1 cases/1 8410 2.8410 2841 (2.84:10 310 0.310 031 (0.3:10 (38. OR=4, OR4 (OR=4 3,7965, 37965 37 3, 51 5, 3,796-5, OR=1, OR1 (OR=1 1,5251,6 15251 1, 16 1,525-1,6 1,2351,7 12351 12 17 1,235-1,7 1,0042,0 10042 2, 1,004-2,0 1,1521,2 11521 11 1,152-1,2 cases/ 841 2.841 (2.84:1 31 0.31 (0.3:1 (38 OR=4 (OR= 3,7965 3,796-5 OR=1 1,5251, 1,525-1, 1,2351, 1,235-1, 1,0042, 1,004-2, 1,1521, 1,152-1, (2.84: (0.3: (3 OR= (OR 3,796- 1,5251 1,525-1 1,2351 1,235-1 1,0042 1,004-2 1,1521 1,152-1 (2.84 (0.3 ( 1,525- 1,235- 1,004- 1,152- (2.8 (0. (2. (0 (2