Abstract Background 5-Fluorouracil (5-FU) is a first-line drug to treat cutaneous field cancerization (CFC). There are few clinical trials with topical colchicine (COL). Objective To evaluate the effectiveness of 0.5% COL cream versus 5% 5-FU cream in the treatment of CFC. Method This was a randomized, open, self-controlled clinical trial. Forty-five patients (90 forearms), with three to ten actinic keratoses (AK) on each forearm, used 0.5% COL cream 2×/day for seven days on one forearm, and 5% 5-FU cream 2× /day, for 21 days, on the other forearm. The dosages were defined based on previous clinical trials for each drug. Adverse effects were evaluated after 14 days and outcomes after 90 days of inclusion. The primary outcome was complete AK clearance and the secondary outcomes were: partial clearance (≥50%), reduction in AK count, assessment of the Forearm Photoaging Scale (FPS), AK Severity Score (AKSS), and adverse effects. Results After 90 days, there was complete clearance of AK in 37% (95% CI 24%-49%) and partial clearance in 85% (95% CI 76%-93%) of the forearms treated with 5-FU,versus 17% (95% CI 7%-27%) and 78% (95% CI 66%-88%) for COL (p > 0.07). There was a percentage reduction of 75% in the AK count of the forearms treated with 5-FU (95% CI 66%-83%) and 64% in those treated with COL (95% CI 55%-72%). Regarding FPS and AKSS, there was improvement in both groups, with no difference regarding FPS (p = 0.654), and 5-FU superiority for AKSS (p = 0.012). Study limitations Single-center study. Conclusions 5-FU and COL are effective for treating CFC, with neither showing superiority regarding the reduction in AK counts. 5Fluorouracil Fluorouracil 5 5FU FU (5-FU firstline first line CFC . (CFC) COL. (COL) 05 0 0.5 randomized open selfcontrolled self controlled trial Fortyfive Forty five (9 forearms, , forearms) (AK forearm 2day day 2 /day 1 9 inclusion ≥50%, 50 ≥50% (≥50%) FPS, (FPS) (AKSS) 37 95% 95 (95 24%49% 2449 24% 49% 24 49 24%-49% 85 76%93% 7693 76% 93% 76 93 76%-93% 5FU,versus 5FUversus FUversus FU,versus 17 7%27% 727 7% 27% 7 27 7%-27% 78 66%88% 6688 66% 88% 66 88 66%-88% p 0.07. 007 0.07 07 0.07) 75 66%83% 6683 83% 83 66%-83% 64 55%72%. 5572 55% 72% 55 72 55%-72%) groups 0.654, 0654 0.654 654 0.654) 0.012. 0012 0.012 012 0.012) Singlecenter Single center study counts (CFC (COL 0. ( ≥50 (≥50% (FPS (AKSS 3 24%49 244 4 24%-49 8 76%93 769 76%-93 7%27 7%-27 66%88 668 6 66%-88 00 0.0 66%83 66%-83 55%72% 557 55%-72% 065 0.65 65 001 0.01 01 ≥5 (≥50 24%4 24%-4 76%9 76%-9 7%2 7%-2 66%8 66%-8 55%72 55%-72 06 0.6 ≥ (≥5 24%- 76%- 7%- 66%- 55%7 55%-7 (≥ 55%-

Resumo Um macho de Pteronura brasiliensis (Carnivora: Mustelidae) foi encontrado morto às margens do Rio Negro, no Pantanal do estado de Mato Grosso do Sul, município de Aquidauana. Dois carrapatos encontrados aderidos à sua pele foram identificados, morfologicamente, como uma ninfa de segundo ínstar de Ornithodoros rostratus (Argasidae) e um macho de Amblyomma sculptum (Ixodidae). Para complementar a identificação morfológica, esses espécimes de carrapatos foram submetidos à extração de DNA e testados por meio de ensaios de PCR, para confirmar a identidade molecular dos espécimes. Além disso, os extraídos dos carrapatos foram testados e revelaram-se negativos nos ensaios de PCR para todos os patógenos testados. Também foram examinados 30 lotes, compostos por 174 indivíduos de O. rostratus, depositados na Coleção Acari do Instituto Butantan, e encontramos material de quatro estados brasileiros, incluindo-se um lote contendo 2 machos e 2 fêmeas de Aquidauana, estado de Mato Grosso do Sul (MS), coletado do solo. Este foi, portanto, o primeiro registro de O. rostratus parasitando P. brasiliensis e o primeiro registro de localidade (Aquidauana). Da mesma forma, A. sculptum é comumente encontrado no Pantanal e relatado aqui, pela segunda vez, parasitando a ariranha, hospedeiro pouco estudado em relação a ectoparasitas. Carnivora (Carnivora Mustelidae Negro Aquidauana identificados morfologicamente Argasidae (Argasidae Ixodidae. Ixodidae . (Ixodidae) morfológica disso revelaramse revelaram se 3 lotes 17 O Butantan brasileiros incluindose incluindo MS, MS , (MS) solo portanto P (Aquidauana) forma A aqui vez ariranha ectoparasitas (Ixodidae 1 (MS (Aquidauana

Abstract A male of Pteronura brasiliensis (Carnivora: Mustelidae) was found dead on the banks of the Rio Negro, in the Pantanal wetlands of Mato Grosso do Sul state, Aquidauana municipality. Two ticks found attached to its skin were morphologically identified as a second-instar nymph of Ornithodoros rostratus (Argasidae) and a male of Amblyomma sculptum (Ixodidae). In order to complement the morphological identification, these tick specimens were subjected to DNA extraction, and tested using PCR assays to confirm the molecular identity the specimens. Also, the tick DNA samples were tested and were negative in the PCR assays for all the pathogens tested. We also examined 30 batches, consisting of 174 individuals of O. rostratus deposited in the Acari Collection of the Butantan Institute, and we found material from four Brazilian states, including one batch containing 2 males and 2 females from Aquidauana, of Mato Grosso do Sul state, collected from the soil. This was therefore the first record of O. rostratus parasitizing P. brasiliensis and the first locality record (Aquidauana). Likewise, A. sculptum is commonly found in the Pantanal and is reported here for the second time parasitizing the giant otter, which is a host little studied regarding the ectoparasites. Carnivora (Carnivora Mustelidae Negro state municipality secondinstar instar Argasidae (Argasidae Ixodidae. Ixodidae . (Ixodidae) identification extraction Also 3 batches 17 O Institute states soil P Aquidauana. (Aquidauana) Likewise otter ectoparasites (Ixodidae 1 (Aquidauana

ABSTRACT Objective: To assess the methodological quality and characteristics of systematic reviews (SRs) of interventional studies in orthodontics and assess how the certainty of the evidence is reported using the GRADE approach. Material and Methods: Six electronic databases were searched, followed by a hand search of the reference lists of eligible studies (PROSPERO #CRD42020180852). The required study design was randomized and nonrandomized studies of interventions published between January 2019 and May 2020. The Assessing the Methodological Quality of Systematic Reviews (AMSTAR 2) tool was used for the quality appraisal of the included SRs. Paired reviewers independently screened the studies, extracted data, and appraised the methodological quality. Results: The study included 46 SRs; 19.5% had moderate to high methodological quality, and the remaining had low to critically low methodological quality. Fifty-four percent of the reviews assessed the certainty of evidence using the GRADE approach, and 34.8% followed all GRADE criteria. Conclusion: Most reviews had a good judgment of the AMSTAR2 items, although some critical items contributed to decreased overall quality. Half of the reviews used the GRADE approach to assess the certainty of the evidence, and this approach should be included in future systematic reviews of interventions. Objective SRs (SRs Methods searched PROSPERO #CRD42020180852. CRD42020180852 CRD #CRD42020180852 . #CRD42020180852) 201 2020 AMSTAR 2 data Results 4 195 19 5 19.5 Fiftyfour Fifty four 348 34 8 34.8 criteria Conclusion CRD4202018085 #CRD4202018085 20 202 1 19. 3 34. CRD420201808 #CRD420201808 CRD42020180 #CRD42020180 CRD4202018 #CRD4202018 CRD420201 #CRD420201 CRD42020 #CRD42020 CRD4202 #CRD4202 CRD420 #CRD420 CRD42 #CRD42 CRD4 #CRD4 #CRD

RESUMO JUSTIFICATIVA E OBJETIVOS: O impacto do ciclo menstrual na percepção da dor é um foco importante de estudo, sendo necessária uma maior elucidação na disfunção temporomandibular (DTM). Assim, este estudo transversal avaliou limiares de dor experimental, características psicossociais e relatos de dor em mulheres com DTM ao longo do ciclo menstrual, comparadas com controles saudáveis. MÉTODOS: 220 prontuários de mulheres foram analisados, sendo 80 selecionados para os grupos de controle (saudáveis, n=40) e DTM (dor miofascial, n=40). Nas fases do ciclo menstrual, as pacientes foram divididas nas categorias Pré-Luteal e Luteal. Os instrumentos Escala de Estresse Percebido (PSS), Escala de Pensamentos Catastróficos (PCS), Limiar de Dor Mecânica (MPT), Wind-up Ratio (WUR), Limiar de Dor à Pressão (PPT), Modulação Condicionada da Dor (CPM) e Escala analógica visual (EAV) foram analisados com nível de significância de 5%, pelos testes ANOVA de dois fatores e Tukey post hoc. RESULTADOS: As escalas PSS e PCS foram significativamente diferentes entre os grupos DTM e controle (p<0,001), independentemente do ciclo menstrual. Indivíduos saudáveis na fase luteal apresentaram MPT maior em comparação com outras fases (p,0,001). O PPT mostrou diferença significativa entre as fases menstruais (p=0,022), sem diferença nas comparações múltiplas. Os valores da EAV não apresentaram diferença entre as fases menstruais (p=376). CONCLUSÃO: Indivíduos saudáveis na fase luteal têm MPT e PPTl maior na região orofacial. Os relatos de dor em pacientes com DTM não mostraram diferença ao longo do ciclo menstrual, indicando que pequenas alterações nos limiares experimentais podem ser clinicamente relevantes. A presença de dor crônica parece estar mais relacionada com características psicossociais do que com flutuações hormonais. OBJETIVOS DTM. . (DTM) Assim experimental MÉTODOS 22 8 saudáveis, (saudáveis n=40 n40 n 40 miofascial n=40. PréLuteal Pré Luteal PSS, , (PSS) PCS, (PCS) MPT, (MPT) Windup Wind up WUR, WUR (WUR) PPT, (PPT) CPM (CPM (EAV 5 5% hoc RESULTADOS p<0,001, p0001 p p<0,001 0 001 (p<0,001) p,0,001. p,0,001 (p,0,001) p=0,022, p0022 p=0,022 022 (p=0,022) múltiplas p=376. p376 p=376 376 (p=376) CONCLUSÃO orofacial relevantes hormonais (DTM 2 n=4 n4 4 (PSS (PCS (MPT (WUR (PPT p000 p<0,00 00 (p<0,001 p,0,00 (p,0,001 p002 p=0,02 02 (p=0,022 p37 p=37 37 (p=376 n= p00 p<0,0 (p<0,00 p,0,0 (p,0,00 p=0,0 (p=0,02 p3 p=3 3 (p=37 p0 p<0, (p<0,0 p,0, (p,0,0 p=0, (p=0,0 p= (p=3 p<0 (p<0, p,0 (p,0, p=0 (p=0, (p= p< (p<0 p, (p,0 (p=0 (p (p< (p,

ABSTRACT BACKGROUND AND OBJECTIVES: The hormonal impact on pain perception during the menstrual cycle is a major focus of study, and further elucidation in temporomandibular disorders (TMD) field is necessary. Thus, this cross-sectional study evaluated experimental pain thresholds, psychosocial features, and clinical pain report on TMD women across menstrual cycle versus healthy controls. METHODS: A total of 220 women’s clinical files were screened, with 80 selected and divided into control group (healthy individuals, n=40) and TMD group (myofascial pain, n=40). Regarding the menstrual cycle phases, the files were divided into Pre-Luteal and Luteal. The Perceived Stress Scale (PSS), Pain Catastrophizing Scale (PCS), Mechanical Pain Threshold (MPT), Wind-up (WUR), Pressure Pain Threshold (PPT), Conditioned Pain Modulation (CPM) and Visual Analogue Scale (VAS) were analyzed at a 5% significance level, by Two-Way ANOVA test and post hoc Tukey test. RESULTS: PSS and PCS were significantly different between TMD and control group (p<0.001), regardless of menstrual cycle. Healthy individuals in the Luteal phase presented higher MPT values compared to the other phases (p<0.001). PPT showed significant difference across menstrual phases (p=0.022), but no differences in multiple comparisons. VAS values showed no difference between menstrual cycle phases (p=0.376). CONCLUSION: Finally, healthy individuals in the Luteal phase have higher MPT and PPT values on the orofacial region. Pain report in patients with TMD showed no difference throughout the menstrual cycle, showing that small alterations on experimental pain thresholds may not be clinically relevant. The presence of chronic pain seems to be more related to psychosocial features than hormonal fluctuations. OBJECTIVES (TMD necessary Thus crosssectional cross sectional controls METHODS 22 womens s screened 8 n=40 n40 n 40 myofascial n=40. . PreLuteal Pre PSS, , (PSS) PCS, (PCS) MPT, (MPT) Windup Wind up WUR, WUR (WUR) PPT, (PPT) CPM (CPM (VAS 5 level TwoWay Two Way RESULTS p<0.001, p0001 p p<0.001 0 001 (p<0.001) p<0.001. p=0.022, p0022 p=0.022 022 (p=0.022) comparisons p=0.376. p0376 p=0.376 376 (p=0.376) CONCLUSION Finally region relevant fluctuations 2 n=4 n4 4 (PSS (PCS (MPT (WUR (PPT p000 p<0.00 00 (p<0.001 p002 p=0.02 02 (p=0.022 p037 p=0.37 37 (p=0.376 n= p00 p<0.0 (p<0.00 p=0.0 (p=0.02 p03 p=0.3 3 (p=0.37 p0 p<0. (p<0.0 p=0. (p=0.0 (p=0.3 p<0 (p<0. p=0 (p=0. p< (p<0 p= (p=0 (p< (p= (p

RESUMO Objetivo: Comparar pacientes com pneumonite de hipersensibilidade crônica (PHc) e controles com espirometria normal quanto às características do sono, bem como estabelecer a prevalência de apneia obstrutiva do sono (AOS) e hipoxemia noturna. Os objetivos secundários foram identificar fatores associados à AOS e hipoxemia noturna; correlacionar a hipoxemia noturna com o índice de apneias e hipopneias (IAH), função pulmonar, SpO2 em repouso, SpO2 em vigília e SpO2 durante o exercício; e avaliar o poder discriminatório de questionários do sono para predizer AOS. Métodos: Um total de 40 pacientes com PHc (casos) foram emparelhados por sexo, idade e IMC com 80 controles (2:1). O questionário STOP-Bang, a Escala de Sonolência de Epworth (ESE), o Índice de Qualidade do Sono de Pittsburgh, o questionário de Berlim e o escore Neck circumference, obesity, Snoring, Age, and Sex (NoSAS, circunferência do pescoço, obesidade, ronco, idade e sexo) foram aplicados a todos os casos, e ambos os grupos foram submetidos a polissonografia de noite inteira. Resultados: Os pacientes com PHc apresentaram maior latência do sono, menor eficiência do sono, menor IAH, menor índice de distúrbio respiratório, menos apneias centrais, menos apneias mistas e menos hipopneias do que os controles. Os pacientes com PHc apresentaram SpO2 noturna significativamente menor; a porcentagem do tempo total de sono com SpO2 < 90% foi maior que nos controles (mediana = 4,2; IIQ: 0,4-32,1 vs. mediana = 1,0; IIQ: 0,1-5,8; p = 0,01). Não houve diferenças significativas entre os casos com e sem AOS quanto à pontuação no questionário STOP-Bang, no NoSAS e na ESE. Conclusões: A prevalência de AOS em pacientes com PHc (casos) foi alta, embora não tenha sido maior que a observada em controles com espirometria normal. Além disso, os casos apresentaram mais hipoxemia durante o sono do que os controles. Nossos resultados sugerem que os questionários do sono não têm poder discriminatório suficiente para identificar AOS em pacientes com PHc. Objetivo (PHc (AOS IAH , (IAH) pulmonar SpO repouso exercício Métodos 4 (casos sexo 8 21. 21 2 1 . (2:1) STOPBang, STOPBang STOP Bang, Bang STOP-Bang ESE, ESE (ESE) Pittsburgh circumference obesity Snoring Age NoSAS, (NoSAS pescoço obesidade ronco inteira Resultados respiratório centrais 90 4,2 42 IIQ 0,432,1 04321 0,4 32,1 0 32 0,4-32, vs 1,0 10 0,15,8 0158 0,1 5,8 5 0,1-5,8 0,01. 001 0,01 01 0,01) Conclusões alta disso (IAH (2:1 (ESE 9 4, 432 0,432, 0432 04 0, 321 32, 3 0,4-32 1, 15 0,15, 015 58 5, 0,1-5, 00 0,0 (2: 43 0,432 043 0,4-3 0,15 0,1-5 (2 0,43 0,4- 0,1- (

ABSTRACT Objective: To compare patients with chronic hypersensitivity pneumonitis (cHP) and controls with normal spirometry in terms of their sleep characteristics, as well as to establish the prevalence of obstructive sleep apnea (OSA) and nocturnal hypoxemia. Secondary objectives were to identify factors associated with OSA and nocturnal hypoxemia; to correlate nocturnal hypoxemia with the apnea-hypopnea index (AHI) and lung function, as well as with resting SpO2, awake SpO2, and SpO2 during exercise; and to evaluate the discriminatory power of sleep questionnaires to predict OSA. Methods: A total of 40 patients with cHP (cases) were matched for sex, age, and BMI with 80 controls, the ratio of controls to cases therefore being = 2:1. The STOP-Bang questionnaire, the Epworth Sleepiness Scale (ESS), the Pittsburgh Sleep Quality Index, the Berlin questionnaire and the Neck circumference, obesity, Snoring, Age, and Sex (NoSAS) score were applied to all cases, and both groups underwent full-night polysomnography. Results: The patients with cHP had longer sleep latency, lower sleep efficiency, a lower AHI, a lower respiratory disturbance index, fewer central apneas, fewer mixed apneas, and fewer hypopneas than did the controls. The patients with cHP had significantly lower nocturnal SpO2 values, the percentage of total sleep time spent below an SpO2 of 90% being higher than in controls (median = 4.2; IQR, 0.4-32.1 vs. median = 1.0; IQR, 0.1-5.8; p = 0.01). There were no significant differences between cases with and without OSA regarding the STOP-Bang questionnaire, NoSAS, and ESS scores. Conclusions: The prevalence of OSA in cHP patients (cases) was high, although not higher than that in controls with normal spirometry. In addition, cases had more hypoxemia during sleep than did controls. Our results suggest that sleep questionnaires do not have sufficient discriminatory power to identify OSA in cHP patients. Objective (cHP characteristics (OSA apneahypopnea hypopnea AHI (AHI function SpO exercise Methods 4 (cases sex age 8 21. 21 2 1. 1 2:1 STOPBang STOP Bang ESS, , (ESS) Index circumference obesity Snoring Age NoSAS (NoSAS fullnight full night polysomnography Results latency efficiency apneas values 90 4.2 42 IQR 0.432.1 04321 0.4 32.1 0 32 0.4-32. vs 1.0 10 0.15.8 0158 0.1 5.8 5 0.1-5.8 0.01. 001 0.01 . 01 0.01) scores Conclusions high addition 2: (ESS 9 4. 432 0.432. 0432 04 0. 321 32. 3 0.4-32 15 0.15. 015 58 5. 0.1-5. 00 0.0 43 0.432 043 0.4-3 0.15 0.1-5 0.43 0.4- 0.1-

Abstract Background Data on post-acute COVID-19 in autoimmune rheumatic diseases (ARD) are scarce, focusing on a single disease, with variable definitions of this condition and time of vaccination. The aim of this study was to evaluate the frequency and pattern of post-acute COVID-19 in vaccinated patients with ARD using established diagnosis criteria. Methods Retrospective evaluation of a prospective cohort of 108 ARD patients and 32 non-ARD controls, diagnosed with SARS-CoV-2 infection (RT-PCR/antigen test) after the third dose of the CoronaVac vaccine. Post-acute COVID-19 (≥ 4 weeks and > 12 weeks of SARS-CoV-2 symptoms) were registered according to the established international criteria. Results ARD patients and non-ARD controls, balanced for age and sex, had high and comparable frequencies of ≥ 4 weeks post-acute COVID-19 (58.3% vs. 53.1%, p = 0.6854) and > 12 weeks post-acute COVID-19 (39.8% vs. 46.9%, p = 0.5419). Regarding ≥ 4 weeks post-acute COVID-19, frequencies of ≥ 3 symptoms were similar in ARD and non-ARD controls (54% vs. 41.2%, p = 0.7886), and this was also similar in > 12 weeks post-acute COVID-19 (68.3% vs. 88.2%, p = 0.1322). Further analysis of the risk factors for ≥ 4 weeks post-acute COVID-19 in ARD patients revealed that age, sex, clinical severity of COVID-19, reinfection, and autoimmune diseases were not associated with this condition (p > 0.05). The clinical manifestations of post-acute COVID-19 were similar in both groups (p > 0.05), with fatigue and memory loss being the most frequent manifestations. Conclusion We provide novel data demonstrating that immune/inflammatory ARD disturbances after third dose vaccination do not seem to be a major determinant of post-acute COVID-19 since its pattern is very similar to that of the general population. Clinical Trials platform (NCT04754698). postacute post acute COVID19 COVID 19 COVID-1 (ARD scarce disease criteria 10 nonARD non SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- RTPCR/antigen RTPCRantigen RT PCR/antigen PCR antigen test vaccine Postacute Post ( 1 sex 58.3% 583 58 (58.3 vs 531 53 53.1% 0.6854 06854 0 6854 39.8% 398 39 8 (39.8 469 46 9 46.9% 0.5419. 05419 0.5419 . 5419 0.5419) COVID19, 19, 54% 54 (54 412 41 41.2% 0.7886, 07886 0.7886 , 7886 0.7886) 68.3% 683 68 (68.3 882 88 88.2% 0.1322. 01322 0.1322 1322 0.1322) reinfection 0.05. 005 0.05 05 0.05) 0.05, immuneinflammatory immune inflammatory population NCT04754698. NCT04754698 NCT (NCT04754698) COVID1 COVID- SARS-CoV RTPCR PCRantigen 58.3 5 (58. 53.1 0.685 0685 685 39.8 (39. 46.9 0541 0.541 541 (5 41.2 0788 0.788 788 68.3 6 (68. 88.2 0132 0.132 132 00 0.0 NCT0475469 (NCT04754698 58. (58 53. 0.68 068 39. (39 46. 054 0.54 41. 078 0.78 78 68. (68 88. 013 0.13 13 0. NCT047546 (NCT0475469 0.6 06 (3 0.5 07 0.7 7 (6 01 0.1 NCT04754 (NCT047546 NCT0475 (NCT04754 NCT047 (NCT0475 NCT04 (NCT047 NCT0 (NCT04 (NCT0 (NCT

Abstract Background Takayasu's arteritis (TA) is a vasculitis that affects the aorta and its branches and causes stenosis, occlusion, and aneurysms. Up to 60% of TA patients are associated with cardiac involvement which confers a poor prognosis. Global longitudinal strain (GLS) analysis is an echocardiographic technique that can detect the presence of subclinical systolic dysfunction. Hence, this study aimed to describe the prevalence of subclinical systolic dysfunction in patients with TA using the GLS method and to correlate this finding with disease activity using the ITAS-2010 (Indian Takayasu Activity Score). Methods Thirty patients over 18 years of age who met the American College of Rheumatology (ACR) 1990 criteria for TA were included. The sample was submitted for medical record review, clinical and echocardiographic evaluation, and application of ITAS-2010. The cutoff for systolic dysfunction was GLS > - 20%. Results Of the 30 patients analyzed, 25 (83.3%) were female, and the mean age was 42.6 years (± 13.2). The median time since diagnosis was 7.5 years [range, 3-16.6 years], and the type V angiographic classification was the most prevalent (56.7%). Regarding echocardiographic findings, the median ejection fraction (EF) was 66% [61-71%] and the GLS was - 19.5% [-21.3 to -15.8%]. Although half of the participants had reduced GLS, only two had reduced EF. Eleven patients (33.%) met the criteria for activity. An association was found between disease activity and reduced GLS in eight patients (P = 0.02) using the chi-square test. Conclusion GLS seems to be an instrument capable of the early detection of systolic dysfunction in TA. The association between GLS and disease activity in this study should be confirmed in a study with a larger sample size. Takayasus s (TA stenosis occlusion aneurysms 60 prognosis (GLS Hence ITAS2010 ITAS 2010 ITAS-201 Indian Score. Score . Score) 1 ACR (ACR 199 included review evaluation ITAS2010. 2010. 20 20% 3 analyzed 2 83.3% 833 83 (83.3% female 426 42 6 42. ± ( 13.2. 132 13.2 13 13.2) 75 7 5 7. range, range [range 316.6 3166 16.6 16 3-16. years, , years] 56.7%. 567 56.7% 56 (56.7%) findings EF (EF 66 6171% 6171 61 71% 71 [61-71% 195 19 19.5 21.3 213 21 [-21. 15.8%. 158 15.8% 15 8 -15.8%] 33.% 33 (33.% P 0.02 002 0 02 chisquare chi square test size ITAS201 201 ITAS-20 83.3 (83.3 4 13. 316 316. 166 16. 3-16 56.7 (56.7% 617 [61-71 19. 21. [-21 15.8 -15.8% 33. (33. 0.0 00 ITAS20 ITAS-2 83. (83. 31 3-1 56. (56.7 [61-7 [-2 15. -15.8 (33 0. ITAS2 ITAS- (83 3- (56. [61- [- -15. (3 (8 (56 [61 [ -15 (5 [6 -1

Abstract The current study aims to assess the effectiveness of e-learning in compliance with the new biosafety recommendations in dentistry in the context of COVID-19 applied to the clinical staff of a dental school in Brazil. A quasi-experimental epidemiological study was carried out by means of a structured, pre-tested online questionnaire, applied before and after an educational intervention, using an e-learning format. After data collection, statistical tests were performed. A total of 549 members of the clinical staff participated in the study in the two collection phases, with a return rate of 26.9%. After the e-learning stage, a reduction was found in the reported use of disposable gloves, protective goggles, and surgical masks. The course had no impact on the staff’s knowledge concerning the proper sequence for donning PPE and showed 100% effectiveness regarding proper PPE doffing sequence. Knowledge about avoiding procedures that generate aerosols in the clinical setting was improved. Despite the low rate of return, it can be concluded that online intervention alone was ineffective in significantly improving learning about the new clinical biosafety guidelines. Therefore, the use of hybrid teaching and repetitive training is highly recommended. elearning e COVID19 COVID 19 COVID-1 Brazil quasiexperimental quasi experimental structured pretested pre tested questionnaire format performed 54 phases 269 26 9 26.9% stage gloves goggles masks staffs s 100 improved guidelines Therefore recommended COVID1 1 COVID- 5 2 26.9 10 26.

RESUMO: A toracoscopia está substituindo as biópsias pulmonares abertas por ser menos invasiva. Usualmente a técnica é feita utilizando três portais e ligaduras feitas intra corporalmente. O objetivo deste estudo foi descrever a viabilidade e eficácia de uma nova ligadura com alça pré-amarrada e propor uma estratégia de acesso toracoscópico com dois portais para realizar biópsia pulmonar em pacientes com menos de 5kg. Dez coelhos foram posicionados em decúbito dorsal. A biópsia pulmonar por toracoscopia total foi feita pela abordagem combinada transdiafragmática e abordagem intercostal direita. Uma nova ligadura pré-amarrada foi colocada para realizar uma biópsia do lobo pulmonar caudal. Não foi realizada insuflação da cavidade torácica. O tempo total de cirurgia foi de 41,4 ± 14,5 min. Os procedimentos foram realizados sem complicações que impedissem o escorregamento ou aperto do nó ou que o soltassem após a biópsia pulmonar; não houve nenhuma intercorrência grave durante o procedimento cirúrgico. As amostras coletadas tinham tamanho médio 1x0,64x0,45 cm e foram consideradas satisfatórias de acordo com a avaliação histopatológica. As radiografias de tórax feitas antes e depois das cirurgias foram comparadas e não mostraram pneumotórax ou hemotórax. A necropsia confirmou que não ocorreu falha do nó no local da biópsia. Conclui-se que uso da nova ligadura com alça pré-amarrada é uma técnica segura e eficaz, evitando problemas com o tamanho limitado da cavidade torácica em pacientes pequenos. RESUMO invasiva corporalmente préamarrada pré amarrada 5kg kg dorsal direita caudal 414 41 4 41, 145 14 5 14, min cirúrgico 1x064x045 xx 1x0 64x0 45 x 1x0,64x0,4 histopatológica hemotórax Concluise Conclui se eficaz pequenos 1 1x064x04 1x 64x 1x0,64x0, 1x064x0 1x0,64x0 1x064x 1x0,64x

ABSTRACT: Thoracoscopy is replacing open lung biopsies because it is less invasive, usually the technique is done using three portals and intracorporeal suture technique. This study described the feasibility and efficacy of a novel pre tied loop ligature and to propose a thoracoscopic access strategy with two portals to perform lung biopsy in patients under 5 kg. Ten rabbits were positioned in dorsal recumbency. Total thoracoscopic lung biopsy was performed using a combined transdiaphragmatic approach and a right intercostal approach. A pre tied loop ligature was placed to perform a caudal lung lobe biopsy. Insufflation of the thoracic cavity was not performed. The total surgery time was 41.4 ± 14.5 min. The procedure was carried out free of complications that prevented slippage or tightening the knot or that made it come loose after the lung biopsy; there was no serious complication during the surgical procedure. The samples obtained averaged 1x0.64x0.45 cm (Length, Width, Depth) and were considered satisfactory according to the histopathologic evaluation. Thorax radiographs taken before and after the surgeries were compared and showed no pneumothorax or hemothorax. Necropsy confirmed no knot failure occurred at the biopsy site. The use of the novel pre tied loop ligature is a safe and effective technique, avoiding problems with the limited size of the thoracic cavity in small patients. ABSTRACT invasive kg recumbency 414 41 4 41. 145 14 14. min 1x064x045 xx 1x0 64x0 45 x 1x0.64x0.4 Length, Length (Length Width Depth evaluation hemothorax site 1 1x064x04 1x 64x 1x0.64x0. 1x064x0 1x0.64x0 1x064x 1x0.64x

ABSTRACT Introduction: Combined solid organ transplantation is infrequently performed in Brazil. The objective of this article is to present our initial experience with combined heart and kidney transplantation. Methods: From January 2007 to December 2019, four patients were submitted to combined heart and kidney transplantation. Their mean age was 55.7±4.4 years, and three (75%) patients were males. All patients had Chagas cardiomyopathy, two were hospitalized and inotrope dependent, and all patients were on preoperative dialysis (median of 12 months prior to transplant). Results: All patients survived and were in New York Heart Association functional class I at the latest follow-up (mean 34.7±17.5 months). Mean retarded kidney graft function was 22.9±9.7 days. One patient lost the kidney graft two years after the transplant due to Polyomavirus infection. Conclusion: Our initial experience of combined heart and kidney transplantation was favorable in selected patients with advanced heart failure and end-stage kidney disease. It requires involvement of a dedicated multispecialty team throughout all the diagnostics and treatment steps.

SUMMARY Thyroid cancer is the most common endocrine malignancy, and papillary thyroid carcinoma (PTC) is the main subtype. The cribriform morular variant is a histological phenotype of PTC characterized by its relationship with familial adenomatous polyposis (FAP). Description of the case: We report the genetic assessment of a 20-year-old female patient diagnosed with a cribriform-morular variant of PTC and FAP. We aimed to assess the genetic background of the reported patient, looking for variants that would help us explain the predisposition to tumorigenesis. Genomic DNA was extracted from peripheral blood lymphocytes, and whole exome sequencing was performed. We applied an overrepresentation and gene-set enrichment analysis to look for an accumulation of effects of variants in multiple genes at the genome. We found an overrepresentation of single nucleotide variants (SNVs) in extracellular matrix interactions and cell adhesion genes. Underrepresentation of SNVs in genes related to the regulation of autophagy and cell cycle control was also observed. We hypothesize that the package of alterations of our patient may help to explain why she presented colonic manifestations and thyroid cancer. Our findings suggest that multiple variants with minor impact, when considered together, may be helpful to characterize one particular clinical condition.

Abstract Objective: To assess the incidence of caries in a two-year period among low birth weight (LBW), very low birth weight (VLBW), and extremely low birth weight (ELBW) children considering socioeconomic indicators, dietary factors and oral hygiene. Material and Methods: A convenience sample was formed of 42 low birth weight children aged two to five years at baseline. Two examiners diagnosed caries using the World Health Organization criteria. Birth weight, socioeconomic indicators and diet were collected from medical records and questionnaires. Binomial models were used to estimate unadjusted and adjusted rate ratios (RR) and respective 95% confidence intervals for the factors evaluated. Results: Thirty-six children were re-examined after two years. The incidence of dental caries was 36.7%. The dmft index was 0.44 (±1.25) at baseline and increased to 1.36 (±3.85) at follow-up. VLBW children (1,000 to 1,500 g) (RR=0.23; 95%CI: 0.08-0.72) and LBW children (1,500 to 2,500 g) (RR=0.06; 0.01-0.55) had fewer carious lesions compared to ELBW children (<1,000 g). Carious lesions were more frequent among children with a lower income (RR=6.05; 1.05-34.84) and less frequent among those who did not consume sweetened juice, tea or yogurt (RR: 0.21; 0.07-0.62). Conclusion: An inverse dose-response relation was found between birth weight and the incidence of caries. A lower income and the consumption of sweetened beverages were risk factors for the development of caries.

ABSTRACT Objective To evaluate knowledge and attitudes towards biosafety recommendations during the COVID-19 pandemic at a Brazilian dental school. Material and Methods A cross-sectional study was performed in 2020 with the clinical staff of a Brazilian dental school. The whole clinical staff was sent pre-tested self-administered online questionnaires about knowledge and attitudes towards the recommendations for biosafety in dental settings in the context of the COVID-19 pandemic. Descriptive statistical analyses were carried out for proportion calculation. Results Disposable head covering caps, isolation gowns, and gloves were the most frequently reported personal protective equipment (PPE). The rates ranged from 52.9% to 88.5% for N95 respirators, from 68.6% to 92.6% for face shields, from 47.4% to 67.5% for conventional eye protection shields, and 45.1% to 77.4% for eye protection with solid side shields. Chlorhexidine gluconate was the most frequent mouthwash indicated before clinical dental care. The percentage of agreement to provide clinical care to patients with suspected COVID-19 varied from 23.5% to 50.0%. The percentage of respondents who agreed that bioaerosol-generating procedures should be avoided was higher than 74.5%. Less than 50% knew the correct sequence for doffing of PPE. Conclusion This study revealed important gaps in knowledge and attitudes towards prevention and control measures against infection in dental environments in the context of COVID-19, indicating the need for improvements.

Abstract Objective: This study aimed to review evidence from randomized controlled trials (RCTs) to describe: 1) the active ingredients and desensitizing toothpaste brands; 2) the evaluation of these active ingredients over time, and 3) the fluoride and abrasive content in the formulations designed to treat dentin hypersensitivity (DH). Methodology: In total, 138 RCTs and their tested toothpastes were included. Searches were updated up to August 19, 2021. Formulations, reported brands, active ingredients over time, and type of fluoride (ionizable or ionic fluoride) and abrasive (calcium or silica-based) were analyzed (PROSPERO #CRD42018086815). Results: Our trials assessed 368 toothpaste formulations, including 34 placebo (9%), 98 control toothpastes with fluoride (27%), and 236 (64%) with active ingredients to treat DH. We tested the following active ingredients: potassium compounds (n=68, 19%), calcium sodium phosphosilicate (CSP) (n=37, 10%), strontium compounds (n=28, 8%), arginine (n=29, 8%), stannous fluoride (SnF2) (n=21, 6%), hydroxyapatite (n=9, 2%), potassium combined with another active ingredient (n=19, 5%), inorganic salt compounds (n=11, 3%), citrate (n=5, 1%), formaldehyde (n=3, 1%), herbal (n=4, 1%), copolymer (n=1, 0.5%), and trichlorophosphate (TCP) (n=1, 0.5%). The number of toothpaste formulations increased since 1968, with the greatest increment after 2010. Most toothpastes described their type of fluoride as sodium monofluorphosphate (MFP) (n=105, 29%) and NaF (n=82, 22%), with silica-based (n=84, 23%) and calcium-based (n=64, 17%) abrasives. Conclusion: Patients and dentists enjoy an increasing number of brands and active ingredients to decide what desensitizing toothpaste to use. The most common types of fluoride are MFP and NaF.