ABSTRACT Objective: To determine the prevalence and risk factors associated with dental caries in Brazilian preschool children aged 2 to 5 years. Material and Methods: The following independent variables were evaluated: dental caries, dental trauma, and malocclusions. Data were analyzed using the Mann-Whitney test and Poisson regression (p<0.05). Results: The prevalence of dental caries in preschoolers was 55.1%. Child age, family income, maternal education, and tooth color alteration from trauma were significantly associated with dental caries (p<0.05). The final adjusted multivariate model showed a significant association between maternal education and dental caries; children of mothers with low education were 1.89 times more likely to have caries (PR: 1.89; 95%CI: 1.40-2.55) (p<0.01). Children with tooth color change from trauma were more likely to have dental caries (PR: 1.69; 95%CI: 1.22-2.34 (p=0.001). Conclusion: Child age, family income, maternal education, tooth discoloration and discoloration color are risk factors for the development of caries disease in children. Also, children of mothers with low educational levels have a higher chance of developing dental caries. Objective years Methods evaluated malocclusions MannWhitney Mann Whitney p<0.05. p005 p p<0.05 . 0 05 (p<0.05) Results 551 55 1 55.1% age income 189 89 1.8 PR (PR 95%CI 95CI CI 95 1.402.55 140255 1.40 2.55 40 1.40-2.55 p<0.01. p001 p<0.01 01 (p<0.01) 1.69 169 69 1.222.34 122234 1.22 2.34 22 34 1.22-2.3 p=0.001. p0001 p=0.001 001 (p=0.001) Conclusion Also p00 p<0.0 (p<0.05 55.1 18 8 1. 9 402 1.402.5 14025 140 1.4 255 2.5 4 1.40-2.5 (p<0.01 1.6 16 6 222 1.222.3 12223 122 1.2 234 2.3 3 1.22-2. p000 p=0.00 00 (p=0.001 p0 p<0. (p<0.0 55. 1.402. 1402 14 25 2. 1.40-2. 1.222. 1222 12 23 1.22-2 p=0.0 (p=0.00 p<0 (p<0. 1.402 1.40-2 1.222 1.22- p=0. (p=0.0 p< (p<0 1.40- p=0 (p=0. (p< p= (p=0 (p (p=

RESUMO Objetivo: Esta revisão sistemática teve como objetivo analisar a literatura sobre alterações em biomarcadores salivares endógenos de dor, ansiedade, estresse e inflamação relacionados à movimentação dentária durante tratamento ortodôntico de crianças e adolescentes. Material e Métodos: Foram realizadas buscas eletrônicas em nove bases de dados para identificar estudos quase-experimentais sobre o tema, sem restrições de idioma e ano de publicação. Dois revisores extraíram os dados e avaliaram o risco individual de viés usando as ferramentas JBI, e a certeza da evidência usando a ferramenta GRADE. Resultados: A busca eletrônica encontrou 7.038 registros, dos quais 12 atenderam aos critérios de elegibilidade e foram incluídos na síntese qualitativa. A maioria dos estudos apresentou baixo risco de viés. Os biomarcadores foram agrupados em cinco categorias: eletrólitos, enzimas, hormônios, imunoglobulinas e mediadores. Os eletrólitos apresentaram diminuição dos níveis de Ca2+, Pi3+ e K+ e aumento dos níveis de Na+ e Cl-. Todas as enzimas (ALP, LDH, MMP8 e MMP9) aumentaram ao longo do tempo. Os hormônios apresentaram diminuição da leptina e algumas oscilações nos níveis diários de cortisol. As imunoglobulinas (IgA, IgG, IgM, IgD e IgE) não tiveram alterações significativas, e a IgA salivar apresentou resultados divergentes entre os estudos. Os mediadores (sRANKL, OPG, IL-1β e PGE2) apresentaram flutuações nas diferentes fases do tratamento, principalmente após a ativação ortodôntica. Conclusões: Com base em um nível de certeza muito baixo, a movimentação dentária ortodôntica teve pouco ou nenhum efeito sobre biomarcadores salivares endógenos. Objetivo dor ansiedade adolescentes Métodos quaseexperimentais quase experimentais tema publicação JBI GRADE Resultados 7038 7 038 7.03 registros 1 qualitativa categorias Ca2 Ca Ca2+ Pi3 Pi K Na Cl. Cl . Cl- ALP, ALP (ALP LDH MMP MMP9 tempo cortisol IgA, (IgA IgG IgM IgE significativas sRANKL, sRANKL (sRANKL OPG IL1β ILβ IL 1β β PGE2 PGE Conclusões 703 03 7.0 70 0 7.

ABSTRACT Objective: This systematic review aimed to analyze the literature on changes in endogenous salivary biomarkers of pain, anxiety, stress, and inflammation related to tooth movement during orthodontic treatment of children and adolescents. Material and Methods: An electronic search was performed in nine databases to identify quasi-experimental studies, without restricting publication language and year. Two reviewers extracted the data and assessed the individual risk of bias using the JBI tools, and the certainty of evidence using the GRADE tool. Results: The electronic search found 7,038 records, of which 12 met the eligibility criteria and were included in the qualitative synthesis. Most studies had a low risk of bias. Biomarkers were grouped into five categories: electrolytes, enzymes, hormones, immunoglobulins, and mediators. Electrolytes showed decreased Ca2+, Pi3+ and K+ levels, and increased Na+ and Cl- levels. All enzymes (ALP, LDH, MMP8, and MMP9) increased over time. Hormones presented a decrease in leptin and some fluctuations in daily cortisol levels. Immunoglobulins (IgA, IgG, IgM, IgD, and IgE) had no significant changes, and salivary IgA showed divergent results among studies. Mediators (sRANKL, OPG, IL‐1β, and PGE2) showed fluctuations at different treatment stages, mainly after orthodontic activation. Conclusions: Based on a very low certainty level, orthodontic tooth movement had little to no effect on endogenous salivary biomarkers. Objective pain anxiety stress adolescents Methods quasiexperimental quasi experimental year tools tool Results 7038 7 038 7,03 records 1 synthesis categories electrolytes hormones immunoglobulins mediators Ca2 Ca Ca2+ Pi3 Pi K levels Na Cl ALP, ALP (ALP LDH MMP8 MMP MMP9 time IgA, (IgA IgG IgM IgD IgE sRANKL, sRANKL (sRANKL OPG IL1β ILβ IL 1β β IL‐1β PGE2 PGE stages activation Conclusions level 703 03 7,0 70 0 7,

ABSTRACT Purpose: to present a method to enhance enzymatic hydrolysis of biomass, hydrothermal treatment. Methods: It was used Teflon bomb, fed with rice straw and water, to extract reducing sugars by hydrothermal treatment. Conditions were analysed using design of experiment procedure and ANOVA. The hydrothermal conditions were 140 and 200 °C, 20 and 60 min and 62,5 and 71,42 g straw per kilogram of water. The straw was filtered, dried and submitted to enzymatic hydrolysis; the conditions were 24 and 72 h, solid/liquid ratio were 0,625 and 2,50 % w/v and enzyme loading 16,5 and 66 FPU · g-1. Results: It was observed best yields of Reducing Sugars when submitting the Teflon bomb to 200 °C temperature for 60 min and 62,5 g straw per kg of water (pressure of 15,5 atm). The conditions for the enzymatic hydrolysis were 72 h and enzyme loading of 66 FPU · g-1. The enzymatic yield was 42,72 %.

RESUMEN Propósito: presentar un método para potenciar la hidrólisis enzimática de biomasa, tratamiento hidrotermal. Métodos: Se utilizó bomba de teflón, alimentada con paja de arroz y agua, para extraer azúcares reductores por tratamiento hidrotermal. Las condiciones se analizaron usando el procedimiento de diseño de experimento y ANOVA. Las condiciones hidrotermales fueron 140 y 200 °C, 20 y 60 min; y 62,5, y 71,42 g de paja por kg de agua. La paja fue filtrada, secada y sometida a hidrólisis enzimática; las condiciones fueron 24 y 72 h, relación sólido/líquida 0,625 y 2,50 % p/v y carga de enzima 16,5 y 66 FPU · g-1. Resultados: Se observaron mejores rendimientos de azúcares reductores al someter la bomba de teflón a una temperatura de 200 °C durante 60 min y 62,5 g de paja por kg de agua (presión de 15,5 atm). Las condiciones para la hidrólisis enzimática fueron 72 h y carga enzimática de 66 FPU · g-1. El rendimiento enzimático fue del 42,72 %.

ABSTRACT Objective To describe and compare the clinical characteristics and outcomes of patients admitted to intensive care units during the first and second waves of the COVID-19 pandemic. Methods In this retrospective single-center cohort study, data were retrieved from the Epimed Monitor System; all adult patients admitted to the intensive care unit between March 4, 2020, and October 1, 2021, were included in the study. We compared the clinical characteristics and outcomes of patients admitted to the intensive care unit of a quaternary private hospital in São Paulo, Brazil, during the first (May 1, 2020, to August 31, 2020) and second (March 1, 2021, to June 30, 2021) waves of the COVID-19 pandemic. Results In total, 1,427 patients with COVID-19 were admitted to the intensive care unit during the first (421 patients) and second (1,006 patients) waves. Compared with the first wave group [median (IQR)], the second wave group was younger [57 (46-70) versus 67 (52-80) years; p<0.001], had a lower SAPS 3 Score [45 (42-52) versus 49 (43-57); p<0.001], lower SOFA Score on intensive care unit admission [3 (1-6) versus 4 (2-6); p=0.018], lower Charlson Comorbidity Index [0 (0-1) versus 1 (0-2); p<0.001], and were less frequently frail (10.4% versus 18.1%; p<0.001). The second wave group used more noninvasive ventilation (81.3% versus 53.4%; p<0.001) and high-flow nasal cannula (63.2% versus 23.0%; p<0.001) during their intensive care unit stay. The intensive care unit (11.3% versus 10.5%; p=0.696) and in-hospital mortality (12.3% versus 12.1%; p=0.998) rates did not differ between both waves. Conclusion In the first and second waves, patients with severe COVID-19 exhibited similar mortality rates and need for invasive organ support, despite the second wave group being younger and less severely ill at the time of intensive care unit admission. COVID19 COVID 19 COVID-1 pandemic singlecenter single center study System 2020 2021 Paulo Brazil May 31 30 total 1427 427 1,42 421 (42 1,006 1006 006 (1,00 median IQR, IQR , (IQR)] 57 [5 4670 46 70 (46-70 6 5280 52 80 (52-80 years p<0.001, p0001 p p<0.001 0 001 p<0.001] 45 [4 4252 42 (42-52 4357 43 (43-57) [ 16 (1-6 26 2 (2-6) p=0.018, p0018 p=0.018 018 p=0.018] 01 (0-1 02 (0-2) 10.4% 104 10 (10.4 18.1% 181 18 p<0.001. . 81.3% 813 81 (81.3 53.4% 534 53 highflow high flow 63.2% 632 63 (63.2 23.0% 230 23 stay 11.3% 113 11 (11.3 10.5% 105 5 p=0.696 p0696 696 inhospital 12.3% 123 12 (12.3 12.1% 121 p=0.998 p0998 998 support COVID1 COVID- 202 142 1,4 (4 1,00 100 00 (1,0 (IQR) 467 7 (46-7 528 8 (52-8 p000 p<0.00 425 (42-5 435 (43-57 (1- (2-6 p001 p=0.01 (0- (0-2 10.4 (10. 18.1 81.3 (81. 53.4 63.2 (63. 23.0 11.3 (11. 10.5 p=0.69 p069 69 12.3 (12. 12.1 p=0.99 p099 99 20 14 ( 1,0 (1, (IQR (46- (52- p00 p<0.0 (42- (43-5 (1 (2- p=0.0 (0 10. (10 18. 81. (81 53. 63. (63 23. 11. (11 p=0.6 p06 12. (12 p=0.9 p09 9 (46 (52 p0 p<0. (43- (2 p=0. (8 (6 (5 p<0 (43 p=0 p< p=

RESUMO O objetivo deste estudo foi verificar a associação entre o grau de sabedoria e o nível de atividade física de lazer (AF) de alunos de uma escola pública federal do sul do Brasil. Estudo observacional de corte transversal com 462 jovens de ambos os sexos entre 15 e 18 anos de idade. A coleta de dados foi realizada por meio de um questionário autoaplicável na plataforma REDCap. A variável independente foi o “nível de AF de lazer” (inativo, insuficientemente ativo e ativo fisicamente) e o desfecho foi a “grau de sabedoria” avaliados por meio de questionários validados. Observou-se tendência linear de aumento do escore de sabedoria conforme o nível de AF. Essa tendência e associação significativa se manteve na análise ajustada, com os ativos tendo em média 1.84 pontos a mais no escore de sabedoria em comparação aos inativos. Em conclusão, os jovens mais sábios também são os jovens mais ativos fisicamente. Tendo em vista os potenciais efeitos benéficos, os estudos atuais podem considerar a sabedoria como um possível mediador da AF com desfechos em saúde. (AF Brasil 46 1 idade REDCap inativo, inativo (inativo fisicamente validados Observouse Observou ajustada 184 84 1.8 inativos conclusão benéficos saúde 4 8 1.

ABSTRACT The aim of this study was to verify the association between the degree of wisdom and the level of leisure-time physical activity (PA) of students from a federal public school in southern Brazil. Observational cross-sectional study with 462 young people of both sexes between 15 and 18 years old. Data collection was performed using a self-administered questionnaire on the REDCap platform. The independent variable was the “level of leisure PA” (inactive, insufficiently active, and physically active) and the outcome was the “degree of wisdom” evaluated through a validated questionnaire (SD-WISE7). There was a linear trend towards an increase in the wisdom score according to the level of PA. This trend and significant association continued in the adjusted analysis, with active students averaging 1.84 points more in the wisdom score compared to inactive students. In conclusion, the wisest young people are also the most physically active young people. In view of the potential beneficial effects, current studies may consider wisdom as a possible mediator of PA with health outcomes. leisuretime time (PA Brazil crosssectional cross sectional 46 1 old selfadministered self administered platform inactive, (inactive SDWISE7. SDWISE7 SDWISE SD WISE7 . WISE (SD-WISE7) analysis 184 84 1.8 conclusion effects outcomes 4 (SD-WISE7 8 1. (SD-WISE

Resumo Este estudo avalia a capacidade da política fiscal em suavizar o ciclo econômico brasileiro. Para tanto, são estimados multiplicadores para variáveis fiscais desagregadas. Considerando os impactos positivos da política fiscal sobre a atividade econômica, as respostas do produto aos choques diferem entre as fases recessivas e expansivas do ciclo durante o período de 1997 a 2018. Em termos de condução de política econômica, os resultados revelam que os estímulos à demanda agregada são mais adequados em um contexto recessivo. Por fim, os autores mostram que a inclusão da dívida líquida nas equações do modelo não altera o comportamento dos choques no SVAR. Contudo, embora modifique alguns resultados do MS-VAR, não se trata de uma variável predominante para a magnitude do multiplicador fiscal, pois as flutuações cíclicas prevalecem sobre o tamanho do impulso fiscal.

Abstract This study evaluates the capacity of fiscal policy to smooth the Brazilian economic cycle. Therefore, multipliers are estimated for disaggregated fiscal variables. Considering the positive impacts of fiscal policy on economic activity, production responses to shocks differs between the recessive and expansive phases of the cycle from 1997 to 2018. In terms of economic policy management, the results reveal that aggregate demand stimuli are more appropriate in the context of a recession. Finally, the authors show that the inclusion of net debt in the model’s equations does not affect how shocks behaver in the SVAR. However, although it modifies some of the MS-VAR results, it is not a predominant variable for the magnitude of the fiscal multiplier, since cyclical fluctuations prevail over the size of the fiscal impulse.

Resumo: Introdução: A semiologia é a base da prática clínica e seu ensino é essencial no curso de Medicina. Este estudo foi desenvolvido por haver uma lacuna no conhecimento sobre sua distribuição no Brasil. Objetivo: Este estudo teve como objetivo analisar a distribuição da semiologia do adulto nas escolas médicas brasileiras. Método: Trata-se de um estudo transversal descritivo realizado com 226 escolas médicas brasileiras que disponibilizavam a distribuição de semiologia na internet entre as 335 ativas, em dezembro de 2020 (67,5%). As variáveis estudadas foram região geográfica, administração, gratuidade e tempo de existência da escola, carga horária do curso, do internato e de semiologia, e ano(s) ou semestre(s) em que a semiologia era ofertada no currículo. A análise dos dados foi descritiva, e analisaram-se as associações com os testes: t de Student, análise de variância, qui-quadrado de Pearson, U de Mann-Whitney, Kruskal-Wallis e Wilcoxon. Admitiu-se um nível de significância de p < 0,05. Resultado: A semiologia foi mais frequentemente ofertada apenas no quarto semestre (n = 40), seguida por sua oferta em dois semestres: quarto e quinto e terceiro e quarto. Entre as 226 escolas, 142 integravam os conteúdos em módulos ou eixos (62,8%). Entre 117 escolas que forneciam a carga horária de semiologia, mediana foi de 240,0 horas (P25-75 = 165,4 - 338,2), sem diferença estatística por região geográfica, administração, gratuidade e tempo de existência da escola. A mediana da carga teórica de semiologia [77,5 horas (P25-75 = 51,7 - 123,5)] foi menor do que a carga prática [147,0 horas (P25-75 = 64,5 - 180,0)], Z = -3,99, p < 0,01. A mediana da porcentagem da carga horária de semiologia no curso foi de 2,9% (P25-75 = 2,0 - 4,0). Conclusão: A semiologia é mais frequentemente ofertada no quarto semestre, e sua carga horária não difere por características geográficas, de administração e tempo de existência das escolas estudadas.

Abstract: Introduction: Semiology is the basis of clinical practice and its teaching is essential in the medical course. This study was developed to fill a gap in the knowledge about its distribution in Brazil. Objective: To analyze the distribution of adult semiology in Brazilian medical schools. Method: Cross-sectional descriptive study with 226 Brazilian medical schools that provided the distribution of semiology on the Internet among the 335 active schools in December 2020 (67.5%) The variables studied were school geographic region, administration and free tuition, time of existence of the course, course load of the regular course, clerkship and semiology, and year(s) or semester(s) in which semiology was offered in the curriculum. Data analysis was descriptive and the associations were analyzed using: Student’s t, Chi-square, Analysis of Variance, Mann-Whitney-U, Kruskal Wallis and Wilcoxon tests. The significance level was set at p < 0.05. Result: Semiology was more frequently offered only in the 4th semester (n = 40), followed by its offer in two semesters, the 4th and 5th and 3rd and 4th. Among the 226 schools, 142 integrated semiology into modules or axes (62.8%). Among the 117 schools that provided the semiology course load, its median was 240.0 hours (P25-75 = 165.4 - 338.2), with no statistical difference by geographic region, type of administration and time of existence of the course. The median of the theoretical course load [77.5 hours (P25-75 = 51.7 - 123.5)] was lower than the practical course load [147.0 hours (P25-75 = 64.5 - 180.0)], Z = - 3,99, p < 0,01. The median of the percentage of semiology course load during the course was 2.9% (P25-75 = 2.0 - 4.0). Conclusion: Semiology is more frequently offered in the 4th semester and its median course load is similar in Brazilian geographic regions and by school administration type and time of existence of the assessed schools.

ABSTRACT Background: This study aimed to evaluate IgG and IgM levels in COVID-19 recurrence. Methods: The serum antibody levels and clinical data from 73 healthcare workers with SARS-CoV-2 divided into seroconverted (n=51) and non-seroconverted (n=22) groups were assessed. The presence of specific anti-nucleocapsid (anti-N) IgM and IgG for SARS-CoV-2 was evaluated. IgG antibodies to the SARS-CoV-2 spike receptor-binding domain were used to confirm non-seroconversion in all negative anti-N. Results: Four recurrent cases displayed mild symptoms and were non-seroconverted until the recurrence of symptoms. Conclusions: Undetectable anti-nucleocapsid IgM and IgG levels may be correlated with symptomatic COVID-19 recurrence.

ABSTRACT The air traffic environment is a complex system that involves several players. Between the air navigation service provider (ANPS) and the final client, many different organizations act with different purposes but are strongly interfaced. Changes and modifications in terms of technology, predefined process, or personnel are constantly needed, requiring coordination among the stakeholders. However, due to the high level of interaction between the players, any change in a complex system like the air traffic environment requires risk management. This paper demonstrates the suitability and advantages of the System-Theoretic Accident Model and Processes/Systems-Theoretic Process Analysis (STAMP/STPA) method to be applied to the risk assessment of an operational air traffic modification. The method, which had never been used on an air traffic problem in Brazil before, was applied considering the implementation of segregated simultaneous operation at the Guarulhos International Airport. The results were proven to be effective in terms of deriving useful safety requirements. From such demonstration, STAMP/STPA can be considered as a feasible alternative to the brainstorming method currently applied for risk assessment and generation of safety requirements regarding modifications in the structure of the air traffic services (ATS) in Brazil.

Resumo: Introdução: O processo de ensino-aprendizagem passou por grandes mudanças tecnológicas ao longo das décadas, com importante impacto nos cursos de Medicina. Uma dessas mudanças foi o uso dos ambientes virtuais de aprendizagem (AVA). Objetivo: Este estudo teve como objetivo avaliar a qualidade do processo de ensino-aprendizagem remoto no curso de Medicina durante a pandemia da Covid-19. Método: É um estudo de caráter descritivo com abordagem quantitativa e qualitativa. Seu desenvolvimento foi dividido em quatro fases: revisão da literatura, desenvolvimento do protocolo de avaliação, coleta e análise dos dados. A coleta de dados foi realizada por meio de um formulário on-line, e a análise dos dados, por análise estatística em três eixos: a avaliação do perfil tecnológico, a avaliação da aceitação da tecnologia e a experiência do usuário. Resultado: Foi constatado que a maioria dos estudantes (65%) e docentes (88.2%) possuía infraestrutura para participar do semestre suplementar. A maior parte dos alunos relatou sentir segurança em utilizar as ferramentas tecnológicas e estava satisfeita com o ensino remoto, porém 53% dos alunos relataram não ter um rendimento tão grande quanto teriam em um período presencial comum, além de terem mencionado dificuldades na adaptação ao ensino remoto, e 40,2% citaram uma alta taxa de problemas psicológicos entre eles. Os docentes em sua maioria se sentiam seguros em lecionar on-line e também tiveram uma avaliação em geral bastante positiva do semestre remoto, tendo apenas algumas discordâncias em relação ao tempo para preparação das aulas e da criação de materiais didáticos para seus alunos. Conclusão: Os diversos fatores relacionados à tecnologia, organização e saúde mental dos estudantes e docentes devem ser levados em consideração no planejamento dos próximos semestres, pois, até que a situação de saúde volte ao normal, os próximos semestres letivos terão todos os componentes teóricos do curso de Medicina trabalhados remotamente, ao menos com a maioria na modalidade híbrida. É provável que alunos e professores desenvolvam uma curva de aprendizagem e consequente adaptação, o que pode atenuar algumas das dificuldades observadas. É preciso que o processo de adaptação seja catalisado por normas, orientações e também inovações da universidade.

Abstract: Introduction: Introduction: The teaching-learning process has undergone major technological changes over the decades, with a significant impact on medical courses. One of these changes has been the use of virtual learning environments (VLEs). Objective: to evaluate the quality of the remote teaching-learning process in the medical course during the COVID-19 pandemic. Method: This is a descriptive study with a quantitative and qualitative approach. Its development was divided into 4 phases: literature review, development of the assessment protocol, data collection and analysis. Data collection was through an online form and data analysis was by statistical analysis on three axes: assessment of the technological profile, assessment of the acceptance of the technology and the user experience. Result: It was found that most students (65%) and teachers (88.2%) had the infrastructure to participate in the supplementary semester. Most students reported feeling safe in using technological tools and were satisfied with the remote teaching, however, 53% of students reported underachievement in relation to their performance in an ordinary classroom period and reported difficulties in adapting to remote learning, and 40.2% reported a high rate of psychological problems. Most teachers felt secure in teaching online and had a very positive overall evaluation of the remote semester, with only a few disagreements regarding the time to prepare classes and create teaching materials for their students. Conclusion: The various factors related to technology, organization and mental health of students and teachers must be taken into account in the planning of the next semesters, because until the health situation returns to normal, the forthcoming academic semesters will provide all the theoretical components of the medical course remotely, or at least the majority provided in a hybrid modality. It is likely that students and teachers will develop a learning curve and consequent adaptation, which may alleviate some of the difficulties observed. The adaptation process needs to be catalyzed by standards, guidelines and innovations from the university.

Resumo Um cisto odontogénico calcificante pode estar associado a tumores odontogénicos, particularmente odontomas. No entanto, a associação entre cisto odontogénico calcificante e cistos odontogénicos é rara. O objetivo deste estudo é relatar o primeiro caso de um cisto odontogénico calcificante associado a um pseudocisto antral. Um paciente do sexo masculino apresentou lesão tumoral em rebordo alveolar superior direito após 6 meses de evolução e quadro doloroso. A radiografia panorâmica indicou lesão radiolúcida entre os dentes 13 a 15 e velamento do seio maxilar. Foi realizada biópsia excisional e realizado diagnóstico histopatológico de cisto odontogénico calcificante associado a pseudocisto antral. O tratamento de escolha foi a enucleação das lesões e curetagem. A paciente está em acompanhamento há cerca de 3 anos sem recidiva da lesão, caracterizando comportamento indolente do cisto odontogénico calcificante.

Abstract A calcifying odontogenic cyst may be associated with odontogenic tumors, particularly odontomas. However, the association between calcifying odontogenic cysts and odontogenic cysts is rare. This study aims to report the first case of a calcifying odontogenic cyst associated with an antral pseudocyst. A male patient presented a tumor lesion in his right maxillary alveolar ridge with 6 months of evolution and painful symptoms . An excisional biopsy was performed, and a histopathological diagnosis of calcifying odontogenic cyst associated with an antral pseudocyst was issued. The treatment of choice was lesion enucleation and curettage. The patient has been under follow-up for about 3 years without lesion recurrence, which is typical indolent calcifying odontogenic cyst behavior.

ABSTRACT: The aim of this work was to trace an epidemiological and clinical profile of oral squamous cell carcinoma (SCC) cases diagnosed as lip and tongue SCC from June 2001 to 2018 at a pathology anatomy service located in Northeastern Brazil. Age, sex, duration, location, growth type, staining, metastasis, etiologic agents and lesion size data were obtained fr om patient clinical files and histopathological reports. A total of 124 cases were recorded, with tongue SCC being the most preval ent. The common characteristics of both assessed SCCs included higher frequency in men, mean age of 60 years old, evidence mostly of exophytic lesions and maximum size of 4 cm, predominantly diagnosed after a maximum of 1 year of appearance. Regarding divergent findings, lip SCC occurred mostly in the lower portion of the lip, presenting a predominantly leukoplastic color, with regular smoking habits and sunlight identified as the main etiological agents, and no strong relation to metastasis. On the other hand, tongue SCC mostly exhibiting predominantly erythroleukoplastic staining, with a greater relationship to alcohol - associated smoking and regular smoking habits. The highest percentage of patients with metastasis presented tongue SCC. Although lip and tongue SCC display a male preference, an increasing amount of female involvement has been noted over the years, due to the adoption of deleterious habits such as smoking and alcoholism. Tongue SCC presented a greater relationship with metastasis and clinical leukoeritroplastic evidence. This greater aggressiveness could be related to the unfavorable locat ion of these lesions in relation to lip SCC, sometimes making it difficult to identify in their early development stages.

RESUMEN: El objetivo de este trabajo fue rastrear un perfil epidemiológico y clínico de los casos de carcinoma oral de células escamosas (CCE) diagnosticados como CCE de labios y lengua entre junio de 2001 y 2018 en un servicio de anatomía patológica ubicado en el Noreste de Brasil. Los datos de edad, sexo, duración, ubicación, tipo de crecimiento, tinción, metástasis, agentes etiológicos y tamaño de la lesión se obtuvieron de los archivos clínicos de los pacientes y los informes histopatológicos. Se revisaron un total de 124 casos, siendo el CCE de lengua el más prevalente. Las características comunes de ambos CCE evaluados incluyeron mayor frecuencia en hombres, edad promedio de 60 años, evidencia mayoritariamente de lesiones exofíticas y tamaño máximo de 4 cm, diagnosticado predominantemente después de un máximo de 1 año de aparición. En cuanto a los hallazgos divergentes, el CCE labial se presentó mayoritariamente en la porción inferior del labio, presentando un color predominantemente leucoplásico, con el hábito de fumar habitualmente y la luz solar identificados como los principales agentes etiológicos, sin una fuerte relación con las metástasis. Por otro lado, el CEC de la lengua presenta en su mayoría tinción predominantemente eritroleucoplásica, con una mayor relación con el tabaquismo asociado con el alcohol y con los hábitos habituales de tabaquismo. El mayor porcentaje de pacientes con metástasis presentó CCE de lengua. Aunque el CCE de labios y lengua muestra una preferencia en hombres, se ha observado una cantidad cada vez mayor prevalencia en mujeres a lo largo de los años, debido a la adopción de hábitos nocivos como el tabaquismo y el alcoholismo. El CCE de lengua presentó una mayor relación con la metástasis y la evidencia clínica leucoeritroplásica. Esta mayor agresividad podría estar relacionada con la ubicación desfavorable de estas lesiones en relación al CCE labial, dificultando en ocasiones su identificación en sus primeras etapas de desarrollo.

RESUMO CONTEXTO: Um local comum de tumores neuroendócrinos (TNEs) é o reto. A técnica mais utilizada é a ressecção endoscópica da mucosa com injeção de solução salina. No entanto, as margens profundas costumam ser difíceis de ressecar porque a invasão da submucosa é comum. A ressecção endoscópica sob imersão d’água (RESI) é uma técnica em que o lúmen intestinal é preenchido com água em vez de ar, evitando a necessidade de elevação submucosa. OBJETIVO: Este estudo teve como objetivo avaliar a eficácia e segurança da RESI para a remoção de pequenos TNEs retais (rTNEs). MÉTODOS: Estudo retrospectivo com pacientes que realizaram RESI em dois centros. RESI foi realizada usando um colonoscópio padrão. Nenhuma injeção submucosa foi realizada. Patologistas certificados conduziram avaliação histopatológica. RESULTADOS: RESI foi realizada para pequenos rTNEs em 11 pacientes (nove mulheres) com média de idade de 55,8 anos e 11 lesões (tamanho médio de 7 mm, variando de 3-12 mm). Havia 9 (81%) pacientes com G1 rTNEs e dois pacientes com G2, sendo que todos os tumores invadiam a submucosa sendo apenas um restrito a mucosa. Nenhum caso mostrou invasão vascular ou perineural. Todas as lesões foram removidas em bloco. Nove (81%) ressecções tiveram margens livres. Dois pacientes tiveram envolvimento de margens profundas; um teve biópsias negativas por meio de vigilância endoscópica e o outro perdeu o acompanhamento. Não ocorreram perfurações ou sangramento tardios. CONCLUSÃO: A RESI parece ser uma alternativa eficaz e segura para o tratamento de pequenos rTNEs sem eventos adversos e com altas taxas de ressecção em bloco e R0. Mais estudos prospectivos são necessários para comparar as intervenções endoscópicas disponíveis e para elucidar a técnica endoscópica mais adequada para ressecção de rTNEs.

ABSTRACT BACKGROUND: A common site of neuroendocrine tumors (NETs) is the rectum. The technique most often used is endoscopic mucosal resection with saline injection. However, deep margins are often difficult to obtain because submucosal invasion is common. Underwater endoscopic mucosal resection (UEMR) is a technique in which the bowel lumen is filled with water rather than air, precluding the need for submucosal lifting. OBJECTIVE: This study aimed to evaluate the efficacy and safety of UEMR for removing small rectal neuroendocrine tumors (rNETs). METHODS: Retrospective study with patients who underwent UEMR in two centers. UEMR was performed using a standard colonoscope. No submucosal injection was performed. Board-certified pathologists conducted histopathologic assessment. RESULTS: UEMR for small rNET was performed on 11 patients (nine female) with a mean age of 55.8 years and 11 lesions (mean size 7 mm, range 3-12 mm). There were 9 (81%) patients with G1 rNET and two patients with G2, and all tumors invaded the submucosa with only one restricted to the mucosa. None case showed vascular or perineural invasion. All lesions were removed en bloc. Nine (81%) resections had free margins. Two patients had deep margin involvement; one had negative biopsies via endoscopic surveillance, and the other was lost to follow-up. No perforations or delayed bleeding occurred. CONCLUSION: UEMR appeared to be an effective and safe alternative for treatment of small rNETs without adverse events and with high en bloc and R0 resection rates. Further prospective studies are needed to compare available endoscopic interventions and to elucidate the most appropriate endoscopic technique for resection of rNETs.