ABSTRACT Objective: To evaluate the possible renal and hepatic alteration by root canal filling pastes in mice. Material and Methods: Fifty-four mice were divided into nine groups and received one polyethylene tube implant containing two filling pastes (CTZ or calcium hydroxide pastes). Empty polyethylene tubes were used as a negative control. All tubes were implanted subcutaneously in the back of the mice. After time intervals of 7, 21, and 63 days, 1.5 mL of blood was collected by cardiac puncture, and serum samples were used for serological testing. Urea, creatinine, aspartate transferase (AST), alanine transferase (ALT), alkaline phosphatase (ALP), and gamma-glutamyltransferase (GGT) were evaluated. Data were analyzed by 2-way ANOVA (p<0.05). Results: When comparing CTZ and calcium hydroxide pastes and empty tubes and experimental time intervals, no significant differences in the results were found for any of the biochemical parameters analyzed (p>0.05). No differences were observed in the interactions (material*experimental time intervals) and the biochemical parameters analyzed (p>0.05). Conclusion: CTZ and calcium hydroxide pastes did not cause hepatic and renal alterations in mice, demonstrating the pastes' safety. Objective Methods Fiftyfour Fifty four pastes. . pastes) control 7 21 6 days 15 1 5 1. puncture testing Urea creatinine AST, AST , (AST) ALT, ALT (ALT) ALP, ALP (ALP) gammaglutamyltransferase gamma glutamyltransferase GGT (GGT evaluated 2way way 2 p<0.05. p005 p p<0.05 0 05 (p<0.05) Results p>0.05. p>0.05 (p>0.05) material*experimental materialexperimental material Conclusion safety (AST (ALT (ALP p00 p<0.0 (p<0.05 p>0.0 (p>0.05 p0 p<0. (p<0.0 p>0. (p>0.0 p<0 (p<0. p>0 (p>0. p< (p<0 p> (p>0 (p< (p> (p

Resumen En este artículo, desarrollamos modelos matemáticos sucesivos para describir la primera y la segunda ola de COVID-19 en Brasil, incluida la cepa original, las dos variantes de mayor circulación (variantes Gamma y Delta) y la vacunación de la población. Partimos de un modelo inicial simple y utilizando técnicas de modelado matemático y la función escalón de Heaviside, lo mejoramos según las necesidades de describir el comportamiento de la enfermedad, tanto considerando las nuevas variantes como la vacunación. En todos los casos, realizamos simulaciones informáticas y comparamos la curva obtenida con datos reales de los casos activos, lo que reforzó la eficiencia del modelo para describir el comportamiento de la pandemia y destacó la importancia de la vacunación de la población para describir la dinámica de los contagios y reducir los casos.

Abstract In this paper, we develop successive mathematical models for describing the first and second waves of COVID-19 in Brazil, including the original strain, the two variants with the highest circulation (Gamma and Delta variants) and population vaccination. We started with a a simple initial model and using mathematical modelling techniques and the Heaviside step function, we improved it according to the necessities of describing the disease’s behaviour, both considering the new variants or vaccination. In all cases, we performed computer simulations and compared the obtained curve with real data from the active cases, which reinforced the model’s efficiency in describing the behaviour of the pandemic and highlighted the importance of population vaccination in describing the dynamics of the infections and reducing cases.

Abstract This study aimed to describe potentially inappropriate medication (PIM) use according to the Beers criteria among older adults followed in a comprehensive medication management (CMM) service, the pharmacists´ interventions, and the clinical outcomes of PIM use. All older adults in a CMM service delivered in the Brazilian public primary care system were included in the study (n = 389). Two methodological approaches were developed: (I) cross-sectional - prevalence of PIM use and associated factors were identified (univariate analysis - Pearson’s chi-square; multivariate - logistic regression); (II) documental analysis of the negative clinical outcomes potentially associated with PIM use and pharmacists’ interventions. The prevalence of PIM use was 48.3%, and it was independently and positively associated with the use of ≥ 5 drugs. For 21.3% of PIMs, a potential negative clinical outcome was identified. The most common negative clinical outcome was hypotension (35.1% of the negative outcomes), fractures or diagnosis of osteoporosis (21.1%), and hypoglycemia (14.0%). For most of them (78.9%), an intervention was performed to mitigate harm or discontinue use. A high prevalence of PIM was detected and was associated with polypharmacy. A significant proportion of PIM showed potential negative clinical outcomes that were identified by clinical pharmacists, and the majority of pharmacists’ interventions aimed at its mitigation or deprescription. Overall, our findings reinforce the potential of CMM services for reducing PIM use and the occurrence of negative outcomes.

Abstract Pharmaceutical education should enable the development of competences for community pharmacy practice, which is an important field for the pharmacist workforce. The aim of this study was to evaluate the competences perceived by pharmacy interns from a Brazilian pharmacy school for community pharmacy practice. This study adopted a combined quantitative and qualitative approach. The study cohort included undergraduate students who undertook internships in community pharmacy in the final year of the pharmacy course. Students responded to an 11-item structured questionnaire according to a five-point Likert scale that included perceptions of their competences for community pharmacy practice. Among the 693 possible answers, 605 (87.3%) agreed that the course promoted the development of competences for professional practice in community pharmacy. Less than 70% of students perceived themselves as prepared to respond to symptoms and provide non-prescription medicines. Qualitative analysis of the comments revealed three themes: the need to improve patient information skills, improve practice as a member of a health care team, and improve dispensing according to legal requirements. These findings may support improvements in undergraduate pharmacy programs, such as the inclusion of experiential learning, active learning methods, interprofessional education, and development of clinical skills.

Abstract The aim of this study was to evaluate the clinical efficacy of varnish and neutral fluoride gel in the management of early childhood caries (ECC). A randomized clinical trial was conducted to compare two strategies for ECC management: topical application of neutral fluoride gel (NFG group) and varnish (FV group) every four months for a period of one year. The sample consisted of children between the ages of three and four years, enrolled in public daycare centers. The incidence of ECC between the groups was compared by assessing values (new dmfs) at two levels: d2 when enamel/dentin were affected and d3 when dentin affected. Pearson’s Chi-square, Fisher’s Exact, Kolmogorov-Smirnov and Mann-Whitney tests were used to compare the incidence and increment of caries between the NFG and FV groups (p<0.05). A total of 240 children were included in this study and 213 children (88.7%) were followed up for 12 months. The incidence of ECC was 24.1% in the GF and 21.0% in the FV groups (p=0.586). The increment of caries in d2mfs was 1.36 (95% CI = 0.83 – 1.89) in the NFG and 1.33 (95% CI = 0.75 – 1.89) in FV (p=0.756) groups. Increment of caries in d3mfs was 1.60 (95% CI = 0.95 – 2.25) in NFG and 1.40 (95% CI = 0.75 – 2.04) in FV (p=0.468). Neutral fluoride gel and fluoride varnish exhibited similar efficacy in the management of ECC after 12 months of follow-up.

RESUMO Objetivo: Avaliar a prevalência dos fenótipos eosinofílico e alérgico da asma grave no Brasil e investigar as características clínicas dos pacientes com asma grave no país. Métodos: Estudo transversal com pacientes adultos com diagnóstico de asma grave atendidos em centros especializados no Brasil. O estudo foi realizado em 2019. Resultados: Foram incluídos no estudo 385 pacientes. Destes, 154 apresentavam contagem de eosinófilos no sangue > 300 células/mm3 e 231 apresentavam contagem de eosinófilos no sangue ≤ 300 células/mm3. A mediana da idade foi de 54,0 anos, e a maioria dos pacientes era do sexo feminino, com IMC de 29,0 kg/m2 e história de alergia (81,6%). A prevalência de pacientes com contagem de eosinófilos no sangue > 300 células/mm3 foi de 40,0% (IC95%: 35,1-44,9), e a daqueles com contagem de eosinófilos no sangue > 300 células/mm3 e história de alergia foi de 31,9% (IC95%: 27,3-36,6). A idade e o IMC apresentaram associações positivas com contagem de eosinófilos no sangue > 300 células/mm3 (OR = 0,97, p < 0,0001 e OR = 0,96, p = 0,0233, respectivamente), ao passo que o tempo decorrido desde o início dos sintomas de asma apresentou associação aumentada com contagem de eosinófilos no sangue > 300 células/mm3 (OR = 1,02, p = 0,0011). Conclusões: Este estudo possibilitou a caracterização da população de pacientes com asma grave no Brasil, mostrando a prevalência do fenótipo eosinofílico (em 40% da amostra). Nossos resultados revelam a relevância do fenótipo eosinofílico da asma grave em nível nacional, contribuindo para aumentar a eficácia no manejo da doença e na implantação de estratégias de saúde pública.

ABSTRACT Objective: To assess the prevalence of the eosinophilic and allergic phenotypes of severe asthma in Brazil, as well as to investigate the clinical characteristics of severe asthma patients in the country. Methods: This was a cross-sectional study of adult patients diagnosed with severe asthma and managed at specialized centers in Brazil. The study was conducted in 2019. Results: A total of 385 patients were included in the study. Of those, 154 had a blood eosinophil count > 300 cells/mm3 and 231 had a blood eosinophil count of ≤ 300 cells/mm3. The median age was 54.0 years, and most of the patients were female, with a BMI of 29.0 kg/m2 and a history of allergy (81.6%). The prevalence of patients with a blood eosinophil count > 300 cells/mm3 was 40.0% (95% CI: 35.1-44.9), and that of those with a blood eosinophil count > 300 cells/mm3 and a history of allergy was 31.9% (95% CI: 27.3-36.6). Age and BMI showed positive associations with a blood eosinophil count > 300 cells/mm3 (OR = 0.97, p < 0.0001; and OR = 0.96, p = 0.0233, respectively), whereas the time elapsed since the onset of asthma symptoms showed an increased association with a blood eosinophil count > 300 cells/mm3 (OR = 1.02, p = 0.0011). Conclusions: This study allowed us to characterize the population of severe asthma patients in Brazil, showing the prevalence of the eosinophilic phenotype (in 40% of the sample). Our results reveal the relevance of the eosinophilic phenotype of severe asthma at a national level, contributing to increased effectiveness in managing the disease and implementing public health strategies.

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.

Resumo Introdução: A incontinência urinária (IU) causa considerável impacto negativo na qualidade de vida, ocasionando prejuízo psicossocial, emocional e higiênico, além de alto custo para o sistema de saúde e limitações nas atividades de vida diária. Objetivo: Descrever a proporção de mulheres com IU e o seu impacto na qualidade de vida, bem como investigar os fatores associados a essa condição de saúde entre usuárias de Unidades de Atenção Primária à Saúde (UAPS) do município de Governador Valadares, MG. Métodos: Estudo transversal realizado entre mulheres usuárias de UAPS do município. Um questionário elaborado pelas pesquisadoras foi utilizado para coleta de dados. As participantes que relataram queixa de perda urinária em qualquer situação responderam ao International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF). Resultados: Participaram do estudo 201 mulheres. A proporção de mulheres com incontinência urinária foi de 36,32% e entre essas o escore do ICIQ-SF teve mediana igual a 7 pontos, indicando impacto moderado na qualidade de vida. A incontinência urinária associou-se à idade, renda, índice de massa corporal e paridade. Conclusão: A proporção de mulheres com IU está de acordo com a prevalência descrita pela International Continence Society (ICS), impactando moderadamente na qualidade de vida, o que indica uma normalização do problema. Ademais, a IU esteve associada à idade, renda, IMC e número de gestações. Assim, estratégias de educação em saúde para esse grupo são necessárias, a fim de prevenir e tratar a IU nas UAPS, bem como ações intersetoriais para melhorar a renda da população, no sentido de controlar os fatores de risco que são modificáveis.

Abstract Introduction: Urinary incontinence (UI) has a considerable negative impact on quality of life, resulting in psychosocial, emotional and health impairment, high costs to the health system and limited activities of daily living. Objective: To describe the proportion of women with UI and its impact on quality of life (QOL), and investigate the factors associated with this condition among users of Primary Health Care Units (PHCUs) in the municipality of Governador Valadares, Minas Gerais state (MG), Brazil. Methods: Cross-sectional study with female users of the municipal PHCUs. A questionnaire compiled by the researchers was used for data collection. Participants who reported urine leakage in any situation completed the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF). Results: A total of 201 women took part in the study, 36.32% of whom had UI and obtained a score of 7, indicating a moderate impact on their QOL. Urinary incontinence was associated with age, income, body mass index and parity. Conclusion: The proportion of women with UI corroborates the prevalence described by the International Continence Society (ICS), moderately impacting quality of life and indicating normalization of the problem. Urinary incontinence was also correlated with age, income, BMI and number of pregnancies. This demonstrates the need for health education strategies at PHCUs to prevent and treat UI in this group, as well as intersectoral activities to improve the income of the population in order to control modifiable risk factors.

Resumo Introdução Crianças com defeitos de desenvolvimento de esmalte (DDE) são mais suscetíveis à hipersensibilidade dentinária, maloclusões e dificuldades relativas à adesão de materiais restauradores. O conhecimento sobre a prevalência de DDE e seus fatores associados permite aos profissionais obter maior compreensão desse problema de saúde bucal, minimizando, dessa forma, as sequelas e melhorando a saúde bucal e a qualidade de vida dos indivíduos afetados. Objetivo Determinar a prevalência de DDE e seus fatores associados na dentição decídua. Método Trata-se de estudo transversal com amostra probabilística de 566 pré-escolares de 5 anos de idade, matriculados em creches públicas e privadas de Teresina, Piauí, Brasil. Foi aplicado questionário socioeconômico e de história médica da criança aos responsáveis. Os exames clínicos foram conduzidos por um único examinador (kappa = 0,93 para DDE e 0,86 para cárie) que utilizou os índices DDE modificado e ceo-d. Foi realizada a análise descritiva dos dados, além dos testes qui-quadrado e exato de Fisher e a regressão de Poisson, considerando como significativo p ≤ 0,05. Resultados A prevalência de DDE foi de 33,7%. A média de dentes com DDE por criança foi de 3,12 ± 2,23. O tipo mais prevalente de DDE foi opacidade demarcada (9,5%). Os segundos molares superiores foram os dentes mais afetados (11,9%). Houve associação entre DDE e estudar em creche pública (p = 0,026) e cárie (p = 0,012). Crianças com experiência de cárie apresentaram maior prevalência de DDE (RP: 1,29; IC95%: 1,01-1,64). Conclusão A prevalência de DDE na dentição decídua foi de 33,7% e se mostrou associada à experiência de cárie.

Abstract Background Children with Developmental Defects of Enamel (DDE) are more susceptible to dentin hypersensitivity, malocclusions, and difficulties related to the adhesion of restorative materials. Knowledge about the prevalence and factors associated with DDE allows professionals to gain a greater understanding of this oral health problem, minimizing sequelae, improving oral health and quality of life of affected individuals. Objective To determine the prevalence and factors associated with DDE in primary dentition. Method This is a cross-sectional study assessing a random sample of 566 preschool five-year-old children, enrolled in public and private preschools in Teresina, Piauí, Brazil. It was applied the socioeconomic and medical history of the child questionnaire for the parents or guardians. Clinical examinations were conducted by a single examiner (kappa = 0.93 for DDE and 0.86 for caries) that used the modified DDE index and dmft. Descriptive analysis, chi-square and Fisher's exact tests, and Poisson regression were performed, considering significant p ≤ 0.05. Results the prevalence of DDE was 33.7%. The mean DDE teeth per child was 3.12 ± 2.23. The most prevalent type of DDE was demarcated opacity (9.5%). The second molars were the most affected teeth (11.9%). There was an association between DDE and study at public preschool (p = 0.026) and dental caries (p = 0.012). Children with experience of caries were more likely to DDE (PR: 1.29; 95% CI: 1.01 to 1.64). Conclusion prevalence of DDE in the primary dentition was 33.7% and was associated with caries experience.

Resumo Dentes com defeitos de desenvolvimento do esmalte (DDE) apresentam porosidades e/ou irregularidades que os tornam suscetíveis a acúmulo de biofilme e predisposição à cárie e doenças periodontais. O objetivo deste artigo é determinar a prevalência de DDE e fatores associados em crianças e adolescentes residentes em comunidade quilombola. A população foi censitária e composta por indivíduos na faixa etária de 3 a 14 anos. Os responsáveis responderam a questionário contendo dados socioeconômicos demográficos e histórico de agravos durante a gravidez e infância. Foi aplicado o Índice DDE modificado. Foram realizadas análise descritiva e regressão de Poisson com variância robusta (p<0,05). Foram examinados 406 indivíduos. A prevalência de DDE foi de 80,5%, sendo que em dentes decíduos foi de 42,2% e permanentes 61,1%. Houve associação entre DDE e maior idade da criança (RP=1,09; IC95%=1,01-1,17), uso de antibiótico na gravidez (RP=1,14; IC95%=1,07-1,22) e relato de desnutrição durante a primeira infância (RP=1,12; IC95%=1,03-1,22). A prevalência de DDE em crianças e adolecentes da comunidade quilombola foi alta. E os fatores associados foram maior idade da criança, uso de antibióticos na gravidez e desnutrição durante a primeira infância.

Abstract Teeth with developmental defects of enamel (DDE) have porous and/or uneven enamel, making them more susceptible to the build-up of oral biofilm and development of caries and periodontal diseases. The aim of this cross-sectional study was to determine the prevalence of DDE and associated factors among children and adolescents living in a Quilombola community in the Northeast of Brazil. The study population was census-based and comprised individuals aged three to 14 years. The children’s parents/guardians answered a questionnaire devised to collect information on socioeconomic and demographic characteristics, health problems during pregnancy and illnesses during early childhood. DDE was diagnosed using the modified DDE index. The data were analyzed using descriptive statistics and Poisson regression with robust standard errors (p<0.05). A total of 406 individuals were examined. DDE prevalence was 80.5%: 42.2% in deciduous teeth and 61.1% in permanent teeth. There was an association between presence of DDE and age (PR=1.09, 95% CI=1.01-1.17), use of antibiotics during pregnancy (PR=1.14, 95% CI=1.07-1.22) and reported malnutrition during early childhood (PR=1.12; 95% CI=1.03-1.22). The findings reveal high prevalence of DDE among children and adolescents living in the Quilombola community. Associated factors were older age, use of antibiotics during pregnancy and malnutrition during early childhood.

Resumo Este estudo transversal avaliou a prevalência e severidade de cárie dentária e fluorose em crianças de 5 anos e adolescentes de 12 anos usuários de dentifrício fluoretado, em áreas com e sem água fluoretada. Os responsáveis pelas crianças e adolescentes responderam questionários para determinação de características socioeconômicas e demográficas e hábitos relacionados à saúde. Os indivíduos foram examinados e a cárie e a fluorose foram mensuradas pelos índices ceo-d / CPOD e TF, respectivamente. Foram realizadas análises descritivas, bivariadas e de regressão logística (p <0,05). Dos 692 participantes, 47,7% tinham 5 anos e 52,3% tinham 12 anos. A média de ceod / CPOD em crianças de 5/12 anos dos grupos de exposto e não exposto à água fluoretada foi 1,53 (± 2,47) e 3,54 (± 4,10) / 1,53 (± 1,81) e 3,54 (± 3,82), respectivamente. Crianças (OR = 2,86, IC 95% = 1,71-4,75) e adolescentes (OR = 1,95, IC 95% = 1,24-3,05) que não consumiram água fluoretada tiveram maior experiência de cárie. Entre os adolescentes, houve associação entre a água fluoretada e a prevalência de fluorose muito leve / leve (OR = 5,45, IC 95%: 3,23-9,19) e fluorose moderada (OR = 11,11, IC 95% = 4,43-27,87). Crianças e adolescentes que consumiram água fluoretada apresentaram menor prevalência e severidade de cárie dentária em comparação com aqueles que usaram apenas dentifrício fluoretado como fonte de flúor. Houve uma associação entre a fluoretação da água e fluorose muito leve / leve e moderada em adolescentes.

Abstract This cross-sectional study evaluated the prevalence and severity of dental caries and fluorosis in children and adolescents using fluoridated toothpaste, from areas with and without fluoridated water. Parents of 5-year-old children and 12-year-old adolescents from neighbourhoods that are supplied with and without fluoridated water answered questionnaires for determining socio-economic and demographic characteristics and habits related to oral health. The individuals were examined, and dental caries and fluorosis were measured by dmft/DMFT and TF indexes, respectively. Descriptive, bivariate and logistic regression analyses were performed (p < 0.05). Of 692 participants, 47.7% were 5-year-olds and 52.3% were 12-year-olds. The mean dmft/DMFT in the 5-year-olds/ 12-year-olds from Exposed and Not Exposed fluoridated water groups was 1.53 (± 2.47) and 3.54 (± 4.10) / 1.53 (± 1.81) and 3.54 (± 3.82), respectively. Children (OR = 2.86, 95% CI = 1.71-4.75) and adolescents (OR = 1.95, 95% CI = 1.24-3.05), who did not consume fluoridated water, had greater caries experience. Among adolescents, there was an association between fluoridated water and the prevalence of very mild/mild fluorosis (OR = 5.45, 95% CI: 3.23-9.19) and moderate fluorosis (OR = 11.11, 95% CI = 4.43-27.87). Children and adolescents, who consumed fluoridated water, presented lower prevalence and severity of dental caries compared to those who used only fluoridated toothpaste as the source of fluoride. There is an association between water fluoridation and very mild/mild and moderate fluorosis in adolescents.

Resumo Introdução A ingestão de açúcar é um importante fator relacionado à cárie dentária. O contato com alimentos açucarados em idade precoce pode representar risco para a saúde bucal de crianças em idade pré-escolar. Objetivo Avaliar o momento de introdução do açúcar na dieta de pré-escolares e sua associação com a cárie na primeira infância. Material e método Estudo transversal de base populacional com 888 pré-escolares de cinco anos de escolas públicas e privadas. Os pais responderam questionário sobre dados sociodemográficos, hábitos alimentares e saúde bucal. As variáveis tempo de introdução do açúcar (> 1 ano e ≤1 ano) e experiência de cárie dentária foram dicotomizadas e os dados foram analisados por meio de estatística descritiva e regressão de Poisson (p <0,05). Resultado A introdução do açúcar na dieta ocorreu nos primeiros doze meses de vida para 73,8% dos pré-escolares. Não houve associação entre o momento de introdução do açúcar e a cárie na primeira infância (p> 0,05). A interrupção do aleitamento materno exclusivo e a baixa renda familiar aumentaram a prevalência de pré-escolares com contato precoce com açúcar em 32% e 23%, respectivamente (p <0,05). A prevalência de cárie na primeira infância foi de 42,3% e esteve associada à menor escolaridade materna, baixa renda, maior frequência de ingestão de doces e uso de dentifrício não fluoretado (p <0,05). Conclusão A introdução de açúcar na dieta ocorreu durante o primeiro ano de vida na maioria dos pré-escolares e não houve associação com cárie na primeira infância.

Abstract Introduction Sugar ingestion is the most important isolated factor related to dental caries. Contact with sugary foods at an early age may represent a risk to the oral health of preschool children. Objective To evaluate the timing of the introduction of sugar in the diet of preschoolers and its association with early childhood caries. Material and method Cross-sectional population-based study with 888 five-year-old preschoolers from public and private schools. Parents answered a questionnaire on sociodemographic data, eating habits and oral health. The variables timing of sugar introduction (>1 year and ≤1 year) and dental caries experience were dichotomized and data were analyzed using descriptive statistics and Poisson regression (p<0.05). Result The introduction of sugar in the diet occurred during the first twelve months of life for 73.8% of preschoolers. There was no association between the timing of sugar introduction and early childhood caries (p>0.05). The interruption of exclusive breastfeeding and low family income increased the prevalence of preschoolers having early contact with sugar by 32% and 23%, respectively (p<0.05). The prevalence of early childhood caries was 42.3% and was associated with a lower level of maternal education, low income, increased frequency of ingestion of candy and the use of nonfluoridated toothpaste (p<0.05). Conclusion The introduction of sugar in the diet occurred during the first year of life in most preschoolers and there was no association with early childhood caries.

OBJECTIVES: Coronavirus disease 2019 (COVID-19) may be associated with prolonged symptoms and post-recovery health impairment. This study aimed to evaluate the persistence of symptoms, lung function, and pulmonary diffusion for carbon monoxide (DLCO) in patients between 15 and 30 days after hospital discharge after admission for severe COVID-19. METHODS: The evaluation consisted of 1) comparative analysis between the initial symptoms and symptoms still present at the post-discharge evaluation 2) analysis of the chest images obtained during hospitalization, and 3) conducting spirometry, plethysmography, and DLCO assessment. RESULTS: Forty-one patients who were hospitalized for 16±8 days with severe COVID-19 were included. Patients were predominantly men (73%) and had a mean age of 51±14 years. The most frequent comorbidities were arterial hypertension (51%) and diabetes mellitus (37%). Pulmonary evaluation was performed a mean of 36 days after the onset of symptoms, with the most frequent persistent symptoms being dyspnea (83%) and coughing (54%). Approximately 93% of patients still had at least one symptom, and 20% had more than five symptoms. Chest imaging revealed a typical pattern of COVID-19 on X-ray (93%) and computer tomography (95%). Lung function test results showed a restrictive pattern with a reduction in forced vital capacity (FVC) in 54% of individuals, with an average FVC of 78±14%. A reduction in DLCO was observed in 79% of patients. CONCLUSIONS: We observed a high prevalence of symptoms, in addition to a significant change in lung function and DLCO, in the post-discharge assessment of patients requiring hospitalization after admission for COVID-19.

Resumo Dentes com defeitos de desenvolvimento do esmalte (DDE) apresentam porosidades e/ou irregularidades que os tornam suscetíveis a acúmulo de biofilme e predisposição à cárie e doenças periodontais. O objetivo deste artigo é determinar a prevalência de DDE e fatores associados em crianças e adolescentes residentes em comunidade quilombola. A população foi censitária e composta por indivíduos na faixa etária de 3 a 14 anos. Os responsáveis responderam a questionário contendo dados socioeconômicos demográficos e histórico de agravos durante a gravidez e infância. Foi aplicado o Índice DDE modificado. Foram realizadas análise descritiva e regressão de Poisson com variância robusta (p<0,05). Foram examinados 406 indivíduos. A prevalência de DDE foi de 80,5%, sendo que em dentes decíduos foi de 42,2% e permanentes 61,1%. Houve associação entre DDE e maior idade da criança (RP=1,09; IC95%=1,01-1,17), uso de antibiótico na gravidez (RP=1,14; IC95%=1,07-1,22) e relato de desnutrição durante a primeira infância (RP=1,12; IC95%=1,03-1,22). A prevalência de DDE em crianças e adolecentes da comunidade quilombola foi alta. E os fatores associados foram maior idade da criança, uso de antibióticos na gravidez e desnutrição durante a primeira infância.

Abstract Teeth with developmental defects of enamel (DDE) have porous and/or uneven enamel, making them more susceptible to the build-up of oral biofilm and development of caries and periodontal diseases. The aim of this cross-sectional study was to determine the prevalence of DDE and associated factors among children and adolescents living in a Quilombola community in the Northeast of Brazil. The study population was census-based and comprised individuals aged three to 14 years. The children’s parents/guardians answered a questionnaire devised to collect information on socioeconomic and demographic characteristics, health problems during pregnancy and illnesses during early childhood. DDE was diagnosed using the modified DDE index. The data were analyzed using descriptive statistics and Poisson regression with robust standard errors (p<0.05). A total of 406 individuals were examined. DDE prevalence was 80.5%: 42.2% in deciduous teeth and 61.1% in permanent teeth. There was an association between presence of DDE and age (PR=1.09, 95% CI=1.01-1.17), use of antibiotics during pregnancy (PR=1.14, 95% CI=1.07-1.22) and reported malnutrition during early childhood (PR=1.12; 95% CI=1.03-1.22). The findings reveal high prevalence of DDE among children and adolescents living in the Quilombola community. Associated factors were older age, use of antibiotics during pregnancy and malnutrition during early childhood.

ABSTRACT Objective: To determine in vitro the frequency, shape, type, diameter, and patency of accessory canals in the primary molars pulp chamber floor. Material and Methods: Sixteen healthy primary molars were evaluated by micro-computed tomography and scanning electron microscopy. Descriptive analyses of the frequency, shape (round, oval, or irregular), type (blind, true, or hidden), patency and diameter of the accessory canals were performed. Results: Half of the teeth presented accessory canals, 62.5% of which were located in the upper molars and 37.5% in the lower molars. The most frequent shape was irregular. In three-dimensional analysis, blind accessory canals (12.5%) and with patency (18.7%) of the teeth were observed. The average accessory canal diameter was 51.97 µm (± 26.03 µm). Conclusion: Upper molars showed a higher frequency of accessory canals with larger diameters. The irregular shape was the most frequent. 18.7% of accessory channels showed patency.