RESUMO A determinação do sexo é um dado importante para a identificação post-mortem de um indivíduo ou de restos mortais humanos. Uma maneira de adquirir dados quanto ao sexo é utilizar mensurações de estruturas como a mandíbula. O objetivo principal deste estudo é avaliar a utilização de índices radiomorfométricos de mandíbulas para a identificação de dimorfismo sexual, através de radiografias panorâmicas. O estudo foi realizado em exames radiográficos panorâmicos de 300 indivíduos entre 51 e 80 anos, residentes do Nordeste brasileiro. Foram analisadas quatro medidas lineares e três índices numéricos no software Inkscape® versão 1.0.1 para Windows, por dois avaliadores cegos. Após análise estatística, os resultados demostraram que as medidas lineares obtidas se configuram como um método seguro para a identificação sexual. Entretanto, os índices obtidos através destas medidas demostraram menor eficiência para o mesmo fim. Logo, as radiografias panorâmicas podem ser utilizadas como método eficaz para a obtenção da caracterização sexual através da mandíbula. postmortem post mortem humanos mandíbula 30 5 8 anos brasileiro Inkscape 101 1 0 1.0. Windows cegos estatística Entretanto fim Logo 3 10 1.0 1.

ABSTRACT Sex determination plays a crucial role in the post-mortem identification of human remains. One effective approach for obtaining sex-related data is to use measurements of anatomical structures such as the mandible. This study aimed to evaluate the potential of mandibular radiomorphometric indices from panoramic radiographs (PRs) for the identification of sexual dimorphism. The study sample included 300 PRs of individuals aged 51 to 80 years from the northeastern region of Brazil. Four linear measures and three numerical indices were analyzed with Inkscape® version 1.0.1 for Windows by two blinded evaluators. After statistical analysis, the results showed that the linear measurements obtained from PRs are a reliable method for sex identification. However, the calculated indices of these measurements exhibited lower efficacy for the same purpose. Therefore, PRs proved to be a valuable method for sexual identification through mandibular assessment. postmortem post mortem remains sexrelated related mandible (PRs dimorphism 30 5 8 Brazil Inkscape 101 1 0 1.0. evaluators analysis However purpose Therefore assessment 3 10 1.0 1.

Abstract Objective To evaluate the immunoexpression profile for CD8, CD3, CD20 and CD68 in the process and carcinogenesis of Carcinoma of the vermilion lip. Methods Average cell count with positive expression for CD3, CD8, CD20 and CD68. The CD8/CD3 ratio calculated in the region was based on the percentage of positive cells in a total of malignant cells. Kruska-Wallis/Dunn, Mann-Whitney and Spearman correlation tests (SPSS, p< 0.05) were used. Results In the Aquitic Cheilitis samples, there was an increase in intraepithelial CD8+ and CD68+. In LSCCs, there was an increase in peritumoral and intratumoral CD3+, CD8+, CD20+ and CD68+ cells. In peritumoral LSCC, CD3+ and CD8+ showed a direct correlation (p= 0.004), and CD68+ and CD8+ (p= 0.017). In the intraepithelial region, CD8+ correlated with CD20+ (p= 0.014) and CD68+ (p= 0.013). In the CAs, CD3 (p< 0.001) and CD8 (p= 0.025) correlated intraepithelial and subepithelial. In LSCC CD3+ (p= 0.002), CD8+ (p= 0.001) and CD68+ (p= 0.030) had intra and peritumoral correlation. Conclusion CD68+ is the first interacting cell with the greatest capacity to migrate to the tumor and interact with CD3, CD8 and CD20. Apparently, CD20 affects perineural invasion. Level of evidence: Level 2. CD CD2 CD6 lip CD8CD3 CDCD CD8/CD KruskaWallis/Dunn, KruskaWallisDunn Kruska Wallis/Dunn, Wallis Dunn Kruska-Wallis/Dunn MannWhitney Mann Whitney SPSS, SPSS (SPSS p 0.05 005 0 05 used samples LSCCs p= (p 0.004, 0004 0.004 , 004 0.004) 0.017. 0017 0.017 . 017 0.017) 0.014 0014 014 0.013. 0013 0.013 013 0.013) CAs 0.001 0001 001 0.025 0025 025 subepithelial 0.002, 0002 0.002 002 0.002) 0.030 0030 030 Apparently invasion evidence 2 CD8CD KruskaWallis KruskaWallis/Dunn WallisDunn Wallis/Dunn 0.0 00 000 0.00 0.01 01 0.02 02 0.03 003 03 0.

Abstract This cross-sectional study evaluated the association between salivary immunoglobulins, plaque index, and gingival index in Brazilian children with and without type 1 diabetes mellitus (DM1). The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for the reporting of observational studies was followed. The DM1 group had 38 children, and an equal number of volunteers matched by sex and age were recruited as controls. Clinical examination was performed for plaque index and gingival index determination. Non-stimulated whole saliva was collected. Concentrations of IgA, IgG, and IgM were determined by ELISA test. Data were tested by the Kolmogorov-Smirnov, Mann-Whitney, and Spearman tests and a multiple linear regression model (p<0.05) was performed. Gingival index was higher in the Control (DM1: 0.16±0.17; Control: 0.24±0.23, p=0.040). In DM1, there was a correlation between IgA and age (rho=0.371, p=0.024), IgM and IgG (rho=0.459, p=0.007), and IgM and gingival index (rho=0.394, p=0.014). In DM1, multiple linear regression showed that age (p=0.041; β=0.363), gingival index (p=0.041; β=0.398), and plaque index (p=0.008; β=-0.506) were good predictors of IgA levels in saliva. Thus, IgA was the only researched immunoglobulin that was directly associated with plaque and gingival indices in Brazilian children with DM1, but not in control subjects. crosssectional cross sectional immunoglobulins DM1. DM . (DM1) STROBE (STROBE followed 3 controls determination Nonstimulated Non stimulated collected test KolmogorovSmirnov, KolmogorovSmirnov Kolmogorov Smirnov, Smirnov Kolmogorov-Smirnov MannWhitney, MannWhitney Mann Whitney, Whitney Mann-Whitney p<0.05 p005 p 0 05 (p<0.05 (DM1 0.16±0.17 016017 16 17 024023 24 23 0.24±0.23 p=0.040. p0040 p=0.040 040 p=0.040) rho=0.371, rho0371 rho 371 (rho=0.371 p=0.024, p0024 p=0.024 , 024 p=0.024) rho=0.459, rho0459 459 (rho=0.459 p=0.007, p0007 p=0.007 007 p=0.007) rho=0.394, rho0394 394 (rho=0.394 p=0.014. p0014 p=0.014 014 p=0.014) p=0.041 p0041 041 (p=0.041 β=0.363, β0363 β β=0.363 363 β=0.363) β=0.398, β0398 β=0.398 398 β=0.398) p=0.008 p0008 008 (p=0.008 β=0.506 β0506 β= 0.506 506 β=-0.506 Thus subjects p<0.0 p00 (p<0.0 (DM 0.16±0.1 01601 02402 2 0.24±0.2 p004 p=0.04 04 rho=0.371 rho037 37 (rho=0.37 p002 p=0.02 02 rho=0.459 rho045 45 (rho=0.45 p000 p=0.00 00 rho=0.394 rho039 39 (rho=0.39 p001 p=0.01 01 (p=0.04 β036 β=0.36 36 β039 β=0.39 (p=0.00 β=0.50 β050 0506 0.50 50 β=-0.50 p<0. p0 (p<0. 0.16±0. 0160 0240 0.24±0. p=0.0 rho=0.37 rho03 (rho=0.3 rho=0.45 rho04 4 (rho=0.4 rho=0.39 (p=0.0 β03 β=0.3 β=0.5 β05 050 0.5 5 β=-0.5 p<0 (p<0 0.16±0 016 0.24±0 p=0. rho=0.3 rho0 (rho=0. rho=0.4 (p=0. β0 β=0. 0. β=-0. p< (p< 0.16± 0.24± p=0 rho=0. (rho=0 (p=0 β=0 β=-0 (p 0.16 0.24 p= rho=0 (rho= (p= β=- 0.1 0.2 rho= (rho

Abstract This study explored the effects of L-PRF on pain, soft tissue healing, periodontal condition, and post-extraction bone repair of mandibular third molars (3Ms). A randomized, prospective, triple-blind, split-mouth clinical trial was conducted with 34 volunteers. Eligible patients were randomly allocated into two treatments: G1 (without L-PRF), G2 (alveoli filled with L-PRF), in which the removal of bilateral 3Ms was performed at the same surgical time. Outcomes were assessed according to a visual analogue scale (pain), soft tissue scoring system (wound healing), periodontal probing of mandibular second molar. Bone repair was determined by volumetric analysis (ITK-SNAP software) and fractal analysis (ImageJ software). An intention-to-treat approach to Statistical analysis was used. L-PRF reduced pain in the 7-day postoperative follow-up (p = 0.019) and not only improved soft tissue healing after 1 month of follow-up (p = 0.021), but also probing depth (distal face) in 3 months postoperatively (p = 0.011). Significant alveolar reduction occurred in 3 months after surgery in both treatments (p < 0.05), however, this was more significant in G1 (p = 0.016). The fractal dimension showed no statistical differences. L-PRF improved postoperative clinical parameters of pain, soft tissue healing, and periodontal condition, suggesting that it has a beneficial effect on preserving the alveolar ridge and accelerating the initial repair process. LPRF L PRF condition postextraction post extraction 3Ms. Ms . (3Ms) randomized prospective tripleblind, tripleblind triple blind, blind triple-blind splitmouth split mouth volunteers G without LPRF, , L-PRF) alveoli time (pain) wound healing) molar ITKSNAP ITK SNAP software ImageJ software. intentiontotreat intention treat used 7day day 7 followup follow up p 0.019 0019 0 019 0.021, 0021 0.021 021 0.021) distal face 0.011. 0011 0.011 011 0.011) 0.05, 005 0.05 05 0.05) however 0.016. 0016 0.016 016 0.016) differences process (3Ms (pain 0.01 001 01 002 0.02 02 00 0.0 0.

Resumo Este estudo visou avaliar a capacidade de reparação de tecidos de quatro cimentos endodônticos biocerâmicos através da quantificação de fibras colágenas de tipo I e III. Foram testados os seguintes cimentos: EndoSequence BC Sealer (Brasseler, Brasseler, Savannah, EUA), Bio C Sealer (Angelus, Londrina, Brasil), Bioroot RCS (Septodont, Santa Catarina, Brasil), e Sealer Plus BC (MKLife, Porto Alegre, Brasil). Foram implantados tubos de polietileno de 1,5 mm de diâmetro e 1 cm de comprimento contendo os cimentos endodônticos no tecido subcutâneo de cinco ratos (Rattus norvegicus albinus, linhagem Wistar). Após 14 dias, os animais foram eutanasiados e as fibras colágenas foram quantificadas a partir de cortes histológicos do tecido. Diante de uma distribuição não-normal dos dados, uma regressão gama com função de ligação log, implementada por meio do módulo de modelos lineares generalizados, foi empregada para testar se havia diferença significativa entre os cimentos. A comparação dois a dois foi realizada utilizando Least significant difference. Houve diferença significativa entre os cimentos para os colágenos tipo I (p=0,001), tipo III (p=0,023) e colágeno total (p=0,002). No geral, o cimento Bioroot foi estatisticamente superior aos demais cimentos, com exceção na análise do colágeno tipo III na qual não houve diferença entre o cimento Bioroot e o cimento Bio C Sealer e o grupo controle (p>0,05). O cimento endodôntico biocerâmico Bioroot RCS foi capaz de estimular uma maior produção de colágeno. Brasseler (Brasseler Savannah EUA, EUA , EUA) Angelus, Angelus (Angelus Londrina Brasil, Brasil Brasil) Septodont, Septodont (Septodont Catarina MKLife, MKLife (MKLife Alegre Brasil. . 15 5 1, Rattus albinus Wistar. Wistar Wistar) dias nãonormal normal dados log generalizados difference p=0,001, p0001 p p=0,001 0 001 (p=0,001) p=0,023 p0023 023 (p=0,023 p=0,002. p0002 p=0,002 002 (p=0,002) geral p>0,05. p005 p>0,05 05 (p>0,05) p000 p=0,00 00 (p=0,001 p=0,02 p002 02 (p=0,02 (p=0,002 p00 p>0,0 (p>0,05 p=0,0 (p=0,00 (p=0,0 p0 p>0, (p>0,0 p=0, (p=0, p>0 (p>0, p=0 (p=0 p> (p>0 p= (p= (p> (p

Abstract This study aimed to evaluate the tissue repair capacity of four bioceramic endodontic sealers by quantifying type I and III collagen fibers. The following sealers were tested: EndoSequence BC Sealer (Brasseler, Brasseler, Savannah, USA), Bio C Sealer (Angelus, Londrina, Brazil), Bioroot RCS (Septodont, Santa Catarina, Brazil), and Sealer Plus BC (MKLife, Porto Alegre, Brazil). Polyethylene tubes 1.5 mm in diameter and 1 cm in length containing the endodontic sealers were implanted in the subcutaneous tissue of five rats (Rattus norvegicus albinus, Wistar lineage). After 14 days, the animals were euthanized, and collagen fibers were quantified from the histological tissue sections. Given a non-normal distribution of the data, a gamma regression with log link function was employed and implemented through the generalized linear models module, was used to test whether there was a significant difference between the sealers. The pairwise comparison was performed using Least significant difference. There were significant differences between the sealers for type I (p=0.001), type III (p=0.023), and total collagen (p=0.002). Overall, Bioroot sealer was statistically superior to the other sealers, except in the analysis of type III collagen, in which there was no difference between the Bioroot sealer and Bio C Sealer sealer and the control group (p>0.05). Bioroot RCS bioceramic endodontic sealer stimulates a greater production of collagen. tested Brasseler (Brasseler Savannah USA, USA , USA) Angelus, Angelus (Angelus Londrina Brazil, Brazil Brazil) Septodont, Septodont (Septodont Catarina MKLife, MKLife (MKLife Alegre Brazil. . 15 5 1. Rattus albinus lineage. lineage lineage) days euthanized sections nonnormal non normal data module p=0.001, p0001 p p=0.001 0 001 (p=0.001) p=0.023, p0023 p=0.023 023 (p=0.023) p=0.002. p0002 p=0.002 002 (p=0.002) Overall p>0.05. p005 p>0.05 05 (p>0.05) p000 p=0.00 00 (p=0.001 p002 p=0.02 02 (p=0.023 (p=0.002 p00 p>0.0 (p>0.05 p=0.0 (p=0.00 (p=0.02 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: Este estudio tuvo como objetivo evaluar los aspectos morfológicos craneofaciales de los pacientes con síndrome de Sheehan (SHS). Se realizó un estudio observacional con 19 mujeres diagnosticadas con SHS y 19 controles asociados por edad y sexo. Se obtuvieron radiografías cefalométricas laterales y se analizaron 30 medidas lineales y angulares mediante el software Radiocef Studio 2. La edad media de los pacientes fue de 65,47 ± 10,19 años. Los principales hallazgos fueron proposición maxilar (52,63 %) y mandíbula (52,63 %) con respecto a la base del cráneo, prognatismo mandibular en 73,68 %, patrón de crecimiento profundo en 42,1 %, aumento del plano mandibular en 36,84 % y reducción de la altura facial anterior. El grupo SHS mostró diferencias estadísticamente significativas en SNB (p=0,026), N-Me (p=0,006), longitud del paladar blando (p=0,011) y Ena-Me (p<0,001) en comparación con los controles. El análisis de la puntuación de la desviación estándar reveló valores alterados en relación con las longitudes maxilares y mandibulares totales. El SHS mostró una morfología craneofacial alterada, caracterizada por prognatismo maxilomandibular, tipo braquifacial, aumento del plano mandibular y reducción de la longitud del velo del paladar. Este estudio informa hallazgos novedosos en SHS.

ABSTRACT: This study aimed to assess the craniofacial morphologic aspects of Sheehan’s syndrome (SHS) patients.An observational study was performed with 19 women diagnosed with SHS and 19 controls matched by age and sex. Lateral cephalometric radiographs were obtained, and 30 linear and angular measurements were analyzed using the Radiocef Studio 2 software. The mean age of patients was 65.47 ± 10.19 years. The main findings were propositioned maxilla (52.63 %) and mandible (52.63 %) relative to the cranial base, mandibular prognathism in 73.68 %, deep growth pattern in 42.1 %, increased mandibular plane in 36.84 %, and reduction in anterior facial height. The SHS group showed statistically significant differences in SNB (p=0.026), N-Me (p=0.006), soft palate length (p=0.011), and Ena-Me (p<0.001) in comparison with controls. The standard deviation score analysis revealed altered values in relation to total maxillary and mandibular lengths. SHS showed altered craniofacial morphology, characterized by maxillo- mandibular prognathism, brachyfacial type, increased mandibular plane, and reduction in soft palate length. This study reports novel findings in SHS.

RESUMEN Objetivos: identificar factores asociados al conocimiento, actitud y práctica de los ancianos en relación a la prevención del cáncer de piel. Métodos: estudio transversal, realizado con 120 ancianos de una Unidad Básica de Salud de Quixadá, Ceará, de septiembre a noviembre de 2018. Resultados: los individuos de 60 a 69 años y que trabajaban se asociaron estadísticamente con conocimientos adecuados (p=0,038). Tener piel, ojos y cabello claros se asoció con una actitud adecuada (p=0,030). Tener problemas en la piel, como heridas sangrantes, se asoció con una práctica adecuada (p=0,016). Sobre conductas inapropiadas para la prevención del cáncer de piel, hubo asociación estadísticamente significativa entre trabajar o haber trabajado bajo exposición directa al sol, conocimientos inadecuados (p=0,036), actitud inadecuada (p=0,010), tener instrucción primaria incompleta y práctica inadecuada (p<0,001). Conclusiones: los factores sociodemográficos y clínicos influyen en el conocimiento, la actitud y la práctica de los ancianos respecto a la prevención del cáncer de piel. Objetivos conocimiento piel Métodos transversal 12 Quixadá Ceará 2018 Resultados 6 p=0,038. p0038 p p=0,038 . 0 038 (p=0,038) p=0,030. p0030 p=0,030 030 (p=0,030) sangrantes p=0,016. p0016 p=0,016 016 (p=0,016) sol p=0,036, p0036 p=0,036 , 036 (p=0,036) p=0,010, p0010 p=0,010 010 (p=0,010) p<0,001. p0001 p<0,001 001 (p<0,001) Conclusiones 1 201 p003 p=0,03 03 (p=0,038 (p=0,030 p001 p=0,01 01 (p=0,016 (p=0,036 (p=0,010 p000 p<0,00 00 (p<0,001 20 p00 p=0,0 (p=0,03 (p=0,01 p<0,0 (p<0,00 2 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

ABSTRACT Objectives: to identify factors associated with older adults’ knowledge, attitude and practice regarding skin cancer prevention. Methods: this is a cross-sectional study, carried out with 120 older adults from a Basic Health Unit in Quixadá, Ceará, from September to November 2018. Results: individuals aged 60 to 69 years and working were statistically associated with adequate knowledge (p=0.038). Having light skin, eyes and hair was associated with adequate attitude (p=0.030). Having skin problems, such as bleeding wounds, was associated with adequate practice (p=0.016). With regard to inappropriate behavior for skin cancer prevention, there was a statistically significant association between working or having worked under direct exposure to the sun, inadequate knowledge (p=0.036), inadequate attitude (p=0.010) and having incomplete primary education and inadequate practice (p<0.001). Conclusions: sociodemographic and clinical factors influence older adults’ knowledge, attitude and practice regarding skin cancer prevention. Objectives prevention Methods crosssectional cross sectional study 12 Quixadá Ceará 2018 Results 6 p=0.038. p0038 p p=0.038 . 0 038 (p=0.038) p=0.030. p0030 p=0.030 030 (p=0.030) problems wounds p=0.016. p0016 p=0.016 016 (p=0.016) sun p=0.036, p0036 p=0.036 , 036 (p=0.036) p=0.010 p0010 010 (p=0.010 p<0.001. p0001 p<0.001 001 (p<0.001) Conclusions 1 201 p003 p=0.03 03 (p=0.038 (p=0.030 p001 p=0.01 01 (p=0.016 (p=0.036 (p=0.01 p000 p<0.00 00 (p<0.001 20 p00 p=0.0 (p=0.03 (p=0.0 p<0.0 (p<0.00 2 p0 p=0. (p=0. p<0. (p<0.0 p=0 (p=0 p<0 (p<0. p= (p= p< (p<0 (p (p<

RESUMO Objetivos: identificar fatores associados a conhecimento, atitude e prática de idosos sobre a prevenção do câncer de pele. Métodos: estudo transversal, realizado com 120 idosos de uma Unidade Básica de Saúde em Quixadá, Ceará, de setembro a novembro de 2018. Resultados: indivíduos na faixa etária de 60 a 69 anos e trabalhando estiveram associados estatisticamente ao conhecimento adequado (p=0,038). O fato de ter pele, olhos e cabelos claros estava associado à atitude adequada (p=0,030). Ter problemas de pele, do tipo ferida sangrante, estava associado à prática adequada (p=0,016). Acerca das condutas inadequadas para a prevenção do câncer de pele, observou-se associação estatisticamente significante entre trabalhar ou já ter trabalhado sob exposição direta ao sol, conhecimento inadequado (p=0,036), atitude inadequada (p=0,010), ter o ensino fundamental incompleto e prática inadequada (p<0,001). Conclusões: fatores sociodemográficos e clínicos influenciam no conhecimento, atitude e prática de idosos sobre a prevenção do câncer de pele. Objetivos pele Métodos transversal 12 Quixadá Ceará 2018 Resultados 6 p=0,038. p0038 p p=0,038 . 0 038 (p=0,038) p=0,030. p0030 p=0,030 030 (p=0,030) sangrante p=0,016. p0016 p=0,016 016 (p=0,016) observouse observou se sol p=0,036, p0036 p=0,036 , 036 (p=0,036) p=0,010, p0010 p=0,010 010 (p=0,010) p<0,001. p0001 p<0,001 001 (p<0,001) Conclusões 1 201 p003 p=0,03 03 (p=0,038 (p=0,030 p001 p=0,01 01 (p=0,016 (p=0,036 (p=0,010 p000 p<0,00 00 (p<0,001 20 p00 p=0,0 (p=0,03 (p=0,01 p<0,0 (p<0,00 2 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

Resumo: Introdução: A utilização de protocolos de ultrassonografia revolucionou o atendimento na medicina de emergência e pode auxiliar no diagnóstico de insuficiência respiratória no pronto atendimento. Assim, torna-se importante o treinamento médico para a utilização desses protocolos. Já foi demonstrado também que os aplicativos de smartphone médico têm resultados positivos na prática diária, além de serem uma ferramenta educacional potencialmente valiosa. Objetivo: Dessa forma, o objetivo deste estudo foi desenvolver um aplicativo em ultrassonografia pulmonar de emergência. O BLUE SIM é um aplicativo de celular que simula atendimentos de casos clínicos utilizando o protocolo Bedside Lung Ultrasound in Emergency, o qual pode auxiliar alunos e profissionais da área da saúde a usar a ultrassonografia pulmonar no atendimento da insuficiência respiratória aguda. A hipótese é que o BLUE SIM será um aplicativo usável e aceitável entre os usuários. Método: Após desenvolvido, avaliou-se o aplicativo com 36 voluntários: 18 fisioterapeutas, um médico, sete enfermeiros e dez acadêmicos de Medicina. Analisaram-se a usabilidade e a utilidade de uma aplicação móvel para o sistema iOS, utilizando como referências a escala de usabilidade System Utility Score (SUS) e o modelo de aceitação Technology Acceptance Model (TAM). Os dados obtidos foram tabulados e analisados pelo teste exato de Fisher ou Mann-Whitney. Resultado: Pela aplicação do questionário SUS (usabilidade), o aplicativo obteve um escore de 76,8%. Exclusivamente entre os fisioterapeutas, obteve-se um escore de 75%, não havendo diferença estatística entre o grupo geral de todos os profissionais emergencistas e o grupo somente de fisioterapeutas (p = 0,239). Segundo a análise de percepção de utilidade, 93,9% dos profissionais emergencistas responderam positivamente, enquanto, entre os fisioterapeutas, obteve-se um escore de 88,9% (p = 0,04). Conclusão: O aplicativo desenvolvido foi classificado de utilidade na aprendizagem do diagnóstico de insuficiência respiratória entre os profissionais, contudo eles consideraram que é necessário um treinamento para o uso da ferramenta. Resumo Introdução Assim tornase torna se diária valiosa Objetivo forma Emergency aguda usuários Método Apos Apo s avaliouse avaliou 3 voluntários 1 Medicina Analisaramse Analisaram aplicacao aplicac movel mo vel iOS referencias refere ncias (SUS aceitacao aceitac TAM. TAM . (TAM) MannWhitney. MannWhitney Mann Whitney. Whitney Mann-Whitney Resultado questionario questiona rio usabilidade, , (usabilidade) 768 76 8 76,8% obtevese 75 75% p 0,239. 0239 0,239 0 239 0,239) 939 93 9 93,9 positivamente enquanto 889 88 88,9 0,04. 004 0,04 04 0,04) Conclusão (TAM (usabilidade 7 76,8 023 0,23 23 93, 88, 00 0,0 76, 02 0,2 2 0,

Abstract: Introduction: The use of ultrasound protocols has revolutionized care in emergency medicine and can help in the diagnosis of respiratory failure in emergency care; therefore, medical training for the use of these protocols has become important. It has also been demonstrated that medical smartphone apps have positive results in daily practice, in addition to being a potentially valuable educational tool. Objective: Thus, the objective was to develop an emergency pulmonary ultrasound application. The “BLUE SIM” is a cell phone application that simulates clinical cases using the “Bedside Lung Ultrasound in Emergency” protocol, which can help students and health professionals regarding the use of pulmonary ultrasound in the care of acute respiratory failure. The hypothesis is that the “BLUE SIM” will be a usable and acceptable application among users. Method: After the development, the application was evaluated with a group of 36 volunteers, which included 18 physical therapists and 18 other professionals consisting of physicians, nurses and medical students. The usability and usefulness of a mobile application for the iOS system was analyzed, using the System Utility Score (SUS) usability scale and the Technology Acceptance Model (TAM) as references. The obtained data were tabulated and analyzed using Fisher’s exact test or Mann-Whitney test. Result: When applying the SUS questionnaire (usability), the application obtained a score of 76.8%. A score of 75% was obtained exclusively among physical therapists, with no statistical difference between the general group of all emergency professionals and the group of physical therapists only (p=0.239). According to the usefulness perception analysis, 93.9% of the emergency professionals had a positive response, while a score of 88.9% was obtained among physical therapists (p=0.04). Conclusion: It was concluded that the developed application was classified as useful in learning the diagnosis of respiratory failure among health professionals; however, they considered that training is necessary for its use. Abstract Introduction therefore important practice tool Objective Thus BLUE SIM Bedside Emergency protocol users Method development 3 volunteers 1 physicians (SUS TAM (TAM references Fishers Fisher s MannWhitney Mann Whitney Result usability, , (usability) 768 76 8 76.8% 75 p=0.239. p0239 p p=0.239 . 0 239 (p=0.239) analysis 939 93 9 93.9 response 889 88 88.9 p=0.04. p004 p=0.04 04 (p=0.04) Conclusion however (usability 7 76.8 p023 p=0.23 23 (p=0.239 93. 88. p00 p=0.0 (p=0.04 76. p02 p=0.2 2 (p=0.23 p0 p=0. (p=0.0 (p=0.2 p=0 (p=0. p= (p=0 (p= (p

Abstract Objective To evaluate the influence of RORγT inhibition by digoxin on inflammatory changes related to interleukin-17 (IL-17) in the pulp of rats treated with zoledronate (ZOL). Methodology Forty male Wistar rats were divided into a negative control group (NCG) treated with saline solution, a positive control group (PCG) treated with ZOL (0.20 mg/kg), and three groups treated with ZOL and co-treated with digoxin 1, 2, or 4 mg/kg (DG1, 2, and 4). After four intravenous administrations of ZOL or saline solution in a 70-day protocol, the right molars were evaluated by histomorphometry (number of blood vessels, blood vessels/µm2, cells/µm2, total blood vessel area, and average blood vessel area) and immunohistochemistry (IL-17, TNF-α, IL-6, and TGF-β). The Kruskal-Wallis/Dunn test was used for statistical analysis. Results PCG showed an increase in total blood vessel area (p=0.008) and average blood vessel area (p=0.014), and digoxin treatment reversed these changes. DG4 showed a reduction in blood vessels/µm2 (p<0.001). In PCG odontoblasts, there was an increase in IL-17 (p=0.002) and TNF-α (p=0.002) immunostaining, and in DG4, these changes were reversed. Odontoblasts in the digoxin-treated groups also showed an increase in IL-6 immunostaining (p<0.001) and a reduction in TGF-β immunostaining (p=0.002), and all ZOL-treated groups showed an increase in IL-17 (p=0.011) and TNF-α (p=0.017) in non-odontoblasts cells. Conclusion ZOL induces TNF-α- and IL-17-dependent vasodilation and ectasia, and the classical Th17 response activation pathway does not seem to participate in this process. interleukin17 interleukin 17 interleukin-1 IL17 IL (IL-17 ZOL. . (ZOL) NCG (NCG (PCG 0.20 020 0 20 (0.2 mg/kg, mgkg , mg kg mg/kg) cotreated co 1 2 DG1, DG1 DG (DG1 4. 4) 70day day 70 protocol number vessels vesselsµm2 vesselsµm µm2 µm cellsµm2 cellsµm cells cells/µm2 IL17, 17, TNFα, TNFα TNF α, α IL6, IL6 6, 6 TGFβ. TGFβ TGF β TGF-β) KruskalWallis/Dunn KruskalWallisDunn Kruskal Wallis/Dunn Wallis Dunn analysis p=0.008 p0008 p 008 (p=0.008 p=0.014, p0014 p=0.014 014 (p=0.014) vessels/µm p<0.001. p0001 p<0.001 001 odontoblasts IL-1 p=0.002 p0002 002 (p=0.002 digoxintreated IL- (p<0.001 p=0.002, ZOLtreated p=0.011 p0011 011 (p=0.011 p=0.017 p0017 017 (p=0.017 nonodontoblasts non IL17dependent ILdependent dependent ectasia Th Th1 process interleukin1 interleukin- IL1 (IL-1 (ZOL 0.2 02 (0. (DG 7 cells/µm KruskalWallis WallisDunn p=0.00 p000 00 (p=0.00 p001 p=0.01 01 (p=0.014 p<0.00 (p<0.00 (p=0.01 (IL- 0. (0 p=0.0 p00 (p=0.0 p<0.0 (p<0.0 (IL ( p=0. p0 (p=0. p<0. (p<0. p=0 (p=0 p<0 (p<0 p= (p= p< (p< (p

ABSTRACT Objective: To evaluate the prevalence of dental caries in children aged five years in a Northeast Brazilian Capital (Fortaleza, CE) and its association with sociodemographic conditions, presence of malocclusion, and gingival bleeding. Material and Methods: This is a quantitative, descriptive, observational, and cross-sectional study carried out in a representative sample of 3,582 children aged five years in the city of Fortaleza-CE. Data was collected in public and private schools distributed in the city's Regional Health Coordination (CORES). Each of the six CORES worked with five field teams, participating in inter-examiner training and calibration with a final KAPPA coefficient of 0.87. Data were collected using a clinical form adapted from the SB Brasil 2010 questionnaire on sociodemographic conditions. The indices of dmft, need for treatment, malocclusion, and gingival bleeding were used for oral health conditions. The data were submitted to Pearson's Chi-square or Fisher's Exact tests, and the variables that show values of p<0.05 were submitted to a multinomial logistic regression model (forward stepwise model). Results: 57.1% of children were caries-free, and the mean dmft-d was 1.65 (1.65±2.65). CORES I and VI were the ones that presented the most significant association with caries attacks in all primary molars. The highest percentage of caries in the 2nd upper molar (60.6%), 1st lower molar (59%), and 2nd lower molar (58.8%) were found in children with normal occlusion. There was a significant association between gingival bleeding and caries in all molars and the need for treatment. Conclusion: These results allow us to observe that the prevalence of dental caries in 5-year-old children in Fortaleza is low, although with a tendency to increase. Objective Fortaleza, (Fortaleza CE conditions malocclusion Methods quantitative descriptive observational crosssectional cross sectional 3582 3 582 3,58 FortalezaCE. FortalezaCE CE. Fortaleza-CE citys s CORES. . (CORES) teams interexaminer inter examiner 087 0 87 0.87 201 dmft treatment Pearsons Pearson Chisquare Chi square Fishers Fisher tests p005 p 05 p<0.0 forward model. model) Results 571 57 1 57.1 cariesfree, cariesfree free, free caries-free dmftd d 165 65 1.6 1.65±2.65. 165265 1.65±2.65 2 (1.65±2.65) nd 60.6%, 606 60.6% , 60 6 (60.6%) st 59%, 59 59% (59%) 58.8% 588 58 8 (58.8% occlusion Conclusion 5yearold yearold 5 year old low increase 358 3,5 (CORES 08 0.8 20 p00 p<0. 57. 16 1. 16526 1.65±2.6 (1.65±2.65 60.6 (60.6% (59% 58.8 (58.8 35 3, 0. p0 p<0 1652 1.65±2. (1.65±2.6 60. (60.6 (59 58. (58. p< 1.65±2 (1.65±2. (60. (5 (58 1.65± (1.65±2 (60 ( (1.65± (6 (1.65 (1.6 (1. (1

Resumo O objetivo deste estudo foi desenvolver e validar um aplicativo para identificação de fatores de risco para câncer bucal. Para tanto, desenvolvemos um aplicativo (OCS: Oral Cancer Screening) com preditores de Câncer Oral (CO) e montagem de algoritmo para estimar o risco de seu desenvolvimento. Metodologia: Casos clínicos simulados foram projetados para que 40 profissionais com expertise em diagnóstico oral pudessem validar o algoritmo e testar sua usabilidade (SUS: System Usabilidade Score) e aceitabilidade (TAM: Technology Acceptance Model). O coeficiente alfa de Cronbach, os testes de Friedman/Dunn e a correlação de Spearman avaliaram as escalas SUS e TAM. A curva ROC foi traçada para estimar o ponto de corte do algoritmo ao sugerir um alto risco para OCS dos casos simulados. Os testes do qui-quadrado e exato de Fisher foram usados adicionalmente (p<0,05, SPSS v20.0). Resultados: Profissionais com expertise em diagnóstico oral tiveram usabilidade de 84,63±10,66 e aceitabilidade de 84,75±10,62, que se correlacionaram positivamente (p<0,001, r=0,647). Atuar em áreas clínicas da odontologia (p=0,034) e histórico de realização de CO orientação de fator de risco (p=0,048) aumentaram a aceitabilidade enquanto atuar no ensino superior aumentou a usabilidade (p=0,011). O ponto de corte sugerido pelo App após validação dos casos clínicos simulados apresentou alta sensibilidade de 84,8% e baixa especificidade de 58,4%. Conclusão: O OCS foi eficaz e com sensibilidade, usabilidade e aceitabilidade adequadas e pode contribuir para a detecção de lesões orais precoces.

Abstract The objective of this study was to develop and validate an App for identifying risk factors for oral cancer. To this end, we developed an App (OCS: Oral Cancer Screening) with predictors of Oral Cancer (OC) and algorithm assembly to estimate the risk of its development. Methodology: Simulated clinical cases were designed so that 40 professionals with expertise in oral diagnostics could validate the algorithm and test its usability (SUS: System Usability Score) and acceptability (TAM: Technology Acceptance Model). Cronbach's alpha coefficient, Friedman/Dunn tests, and Spearman correlation evaluated the SUS and TAM scales. ROC curve was plotted to estimate the cutoff point of the algorithm in suggesting a high risk for OCS of the simulated cases. Chi-square and Fisher's exact tests were additionally used (p<0.05, SPSS v20.0). Results: Professionals with expertise in oral diagnosis had usability of 84.63±10.66 and acceptability of 84.75±10.62, which correlated positively (p<0.001, r=0.647). Acting in clinical areas of dentistry (p=0.034) and history of performing OC risk factor orientation (p=0.048) increased acceptability while acting in higher education increased usability (p=0.011). The cutoff point suggested by the App after validation of the simulated clinical cases showed high sensitivity of 84.8% and lower specificity of 58.4%. Conclusion: The OCS was effective and with adequate sensitivity, usability, and acceptability and may contribute to the detection of early oral lesions.

Resumo Introdução Os tumores malignos das glândulas salivares são entidades patológicas incomuns, representam menos de 5% das neoplasias de cabeça e pescoço. O prognóstico dos pacientes com tumores malignos das glândulas salivares é altamente variável e alguns fatores clínicos podem influenciar significativamente a sobrevida global. Objetivo Analisar as características clinicopatológicas e sociodemográficas que influenciam a sobrevida em pacientes com tumores malignos das glândulas salivares. Método Este estudo retrospectivo analisou sexo, idade, etnia, nível de escolaridade, localização do tumor, tamanho do tumor, envolvimento linfonodal, metástase distante, margens, tipo de tratamento, estado civil, método de acesso à assistência médica e sobrevida global em 15 anos de 193 pacientes com tumores malignos das glândulas salivares. Foram usados os testes X2, log-rank Mantel-Cox, regressão multinomial e regressão logística de Cox (SPSS 20.0, p < 0,05). Resultados Os tipos histológicos mais comuns foram adenocarcinoma (32,1%), carcinoma adenoide cístico (31,1%) e carcinoma mucoepidermoide (18,7%). A taxa de sobrevida global em 15 anos foi de 67,4%, com média de 116 ± 6 meses. A análise univariada revelou que sexo masculino (p = 0,026), idade > 50 anos (p = 0,001), origem de referência do sistema público de saúde (p = 0,011), estádio T (p = 0,007), estádio M (p < 0,001)), estágio clínico (p < 0,001), margens cirúrgicas comprometidas (p = 0,013) e quimioterapia (p < 0,001) foram associados a um prognóstico ruim. As análises multivariadas também mostraram que a idade > 50 anos foi associada independentemente a um prognóstico ruim (p = 0,016). O nível de escolaridade foi o único fator mais prevalente em pacientes idosos (p = 0,011). Conclusão Pacientes com tumores malignos das glândulas salivares acima de 50 anos apresentam pior prognóstico e associação independente com baixo nível de escolaridade.

Abstract Introduction Malignant tumors of the salivary glands are uncommon pathological entities, representing less than 5% of head and neck neoplasms. The prognosis of patients with malignant tumors of the salivary glands is highly variable and certain clinical factors can significantly influence overall survival. Objective To analyze the clinicopathologic and sociodemographic characteristics that influence survival in patients with malignant tumors of the salivary glands Methods This retrospective study analyzed sex, age, race, education level, tumor location, tumor size, lymph node involvement, distant metastasis, margin status, treatment type, marital status, method of health care access and 15-year overall survival in 193 patients with malignant tumors of the salivary glands. The X², log-rank Mantel-Cox, multinomial regression and Cox logistic regression tests were used (SPSS 20.0,p < 0.05). Results The most common histological types were adenocarcinoma (32.1%), adenoid cystic carcinoma (31.1%) and mucoepidermoid carcinoma (18.7%). The 15-year overall survival rate was 67.4%, with a mean of 116 ± 6 months. The univariate analysis revealed that male sex (p = 0.026), age > 50 years (p = 0.001), referral origin from the public health system (p = 0.011), T stage (p = 0.007), M stage (p < 0.001), clinical stage (p < 0.001), compromised surgical margins (p = 0.013), and chemotherapy (p < 0.001) were associated with a poor prognosis. Multivariate analyses also showed that age > 50 years was independently associated with a poor prognosis (p = 0.016). The level of education was the only factor more prevalent in older patients (p = 0.011). Conclusion Patients with malignant tumors of the salivary glands older than 50 years have a worse prognosis and an independent association with a low education level.

RESUMO Objetivo: Avaliar os óbitos causados por câncer ocular durante os anos de 2010 a 2019 no Brasil. Métodos: Os dados foram selecionados na plataforma do Departamento de Informática do SUS do Ministério da Saúde, incluindo declarações de óbito, durante os anos de 2010 a 2019, de todos os estados brasileiros e do Distrito Federal, filtrando os códigos C69.0 a C69.9 como causa básica de óbito, de acordo com a Classificação Internacional de Doenças e Problemas Relacionados à Saúde – 10ᵃ Revisão. Resultados: Houve 1.859 óbitos por neoplasia maligna de olho e anexos (C69), no Brasil, no período de 2010 a 2019, acometendo 1.062 (57,1%) homens. O sítio da neoplasia não foi especificado (C69.9) em 719 casos, representando a etiologia mais frequente no grupo C69 (38,67%). A neoplasia maligna da órbita (C69.6) foi a segunda causa mais comum de óbito (22,59%), seguida pela neoplasia maligna da retina (C69.2) (14,73%). Conclusão: O número de óbitos por neoplasia maligna de olho e anexos aumentou discretamente ao longo dos anos de 2010 a 2019, no Brasil.

ABSTRACT Objective: To assess the deaths caused by eye cancer from 2010 to 2019 in Brazil. Methods: Data were selected from SUS’ Computer Department platform at the Ministry of Health, including death certificates, from 2010 to 2019, from all Brazilian states and the Federal District, filtering the codes C69.0 to C69.9 as the cause of death, according to the International Classification of Diseases, Tenth Revision. Results: There were 1,859 deaths from malignant neoplasm of eye and adnexa (C69), in Brazil, from 2010 to 2019, affecting 1,062 (57.1%) men. The site of neoplasm was unspecified (C69.9) in 719 cases, representing the most frequent etiology in the C69 group (38.67%). The malignant neoplasm of the orbit (C69.6) was the second most common cause of death (22.59%), followed by malignant neoplasm of retina (C69.2) (14.73%). Conclusion: The number of deaths due to malignant neoplasm of eye and adnexa slightly increased through the years of 2010 to 2019, in Brazil.

ABSTRACT Purpose: To evaluate the effect of a selective cyclooxygenase 2 (COX-2) inhibitor on trigeminal ganglion changes and orofacial discomfort/nociception in rats submitted to an experimental model of dental occlusal interference (DOI). Methods: Female Wistar rats (180-200 g) were divided into five groups: a sham group (without DOI) (n=15); and four experimental groups with DOI treated daily with 0.1 mL/kg saline (DOI+SAL), 8, 16, or 32 mg/kg celecoxib (DOI+cel -8, -16, -32) (n=30/group). The animals were euthanized after one, three, and seven days. The bilateral trigeminal ganglia were analyzed histomorphometrically (neuron cell body area) and immunohistochemically (COX-2, nuclear factor-kappa B [NFkB], and peroxisome proliferator-activated receptor-y [PPARy]). A bilateral nociception assay of the masseter muscle was performed. The number of bites/scratches, weight, and grimace scale scores were determined daily. One-way/two-way analysis of variance (ANOVA)/Bonferroni post hoc tests were used (P < .05, GraphPad Prism 5.0). Results: DOI+SAL showed a reduction in neuron cell body area bilaterally, whereas DOI+cel-32 exhibited a significative increase in neuron cell body area compared with DOI+SAL group (P < 0.05). The ipsilateral (P=0.007 and P=0.039) and contralateral (P < 0.001 and P=0.005) overexpression of COX-2 and NFkB and downregulation of PPARy (P=0.016 and P < 0.001) occurred in DOI+SAL, but DOI+cel-32 reverted this alteration. DOI+SAL showed increase in isplateral (P < 0.001) and contralateral (P < 0.001) nociception, an increased number of bites (P=0.010), scratches (P < 0.001), and grimace scores (P=0.032). In the group of DOI+cel-32, these parameters were reduced. Conclusions: Celecoxib attenuated DOI-induced transitory nociception/orofacial discomfort resulting from trigeminal COX-2 overexpression.

Resumen La fluoración de los suministros públicos de agua es una medida importante para prevenir la caries dental y está vinculada al objetivo 6 del desarrollo sostenible. El objetivo del estudio fue promover una evaluación estatal del contenido de fluoruro en el agua. Para eso, el análisis de datos secundarios del SISAGUA (ciudad, año, fecha, origen y punto de colecta; forma de abastecimiento; sistema de abastecimiento; concentraciones de cloro y flúor) y del IBGE (IDH, población, índice de desarrollo municipal FIRJAN y población estimada) para distribución espacial y análisis de factores de riesgo. De las 26.390 muestras recolectadas, solo el 17,8% presentó un contenido ideal de flúor, con mayor prevalencia en las recolectas realizadas en 2016, en áreas urbanas aisladas, en sistemas de abastecimiento de agua y con presencia de cloro por encima del óptimo (p < 0,001). De los 182 municipios evaluados, solo el 16,7% tuvo la mayoría de muestras recolectadas con contenido ideal de flúor. En un análisis multivariado, los municipios con población menor de 30 mil habitantes tuvieron una prevalencia de contenido inadecuado de flúor (por debajo o por encima del ideal) 2,12 (IC95%=1,92-4,88) veces mayor que los municipios con gran población. Se concluye que menos de la quinta parte de la población de Ceará está expuesta a niveles adecuados de fluoruro en el suministro público de agua y las ciudades con población inferior a 30 mil habitantes son las más afectadas. sostenible eso ciudad, ciudad (ciudad año fecha colecta IDH, IDH (IDH estimada riesgo 26390 26 390 26.39 178 17 8 17,8 2016 aisladas p 0,001. 0001 0,001 . 0 001 0,001) 18 evaluados 167 16 7 16,7 multivariado 3 212 2 12 2,1 IC95%=1,924,88 IC95192488 IC IC95%=1,92 4,88 IC95 1 92 4 88 (IC95%=1,92-4,88 afectadas 2639 39 26.3 17, 201 000 0,00 00 16, 21 2, 924 IC95%=1,924,8 IC9519248 IC95192 IC95%=1,9 488 4,8 IC9 9 (IC95%=1,92-4,8 263 26. 20 0,0 IC95%=1,924, IC951924 IC9519 IC95%=1, 48 4, (IC95%=1,92-4, 0, IC95%=1,924 IC951 IC95%=1 (IC95%=1,92-4 IC95%= (IC95%=1,92- IC95% (IC95%=1,92 (IC95%=1,9 (IC95%=1, (IC95%=1 (IC95%= (IC95% (IC95 (IC9 (IC

Abstract Fluoridation of public water supplies is an important measure to prevent dental caries and is linked to Sustainable Development Objective 6. This study aimed to evaluate the fluoride content of Ceará's municipalities. The research used secondary data from SISAGUA (municipality; year, date, source and point of collection; form of supply; supply system; chlorine and fluoride concentrations) and the IBGE (HDI, population, FIRJAN Municipal Development Index, and estimated population) for spatial distribution and the analysis of fluoride risk factors. Of the 26,390 samples collected, only 17.8% had ideal fluoride content, with a higher prevalence in samples collected in 2016, in isolated urban areas, in water supply systems, and in chlorine levels above the ideal. Of the 182 municipalities evaluated, 16.7% had most of the samples with ideal fluoride content. In a multivariate analysis, municipalities with a population below 30 thousand inhabitants had a prevalence of inadequate fluoride content (below or above the ideal) 2.12 (95% CI = 1.92-4.88) times higher than municipalities with large populations. It is concluded that less than a fifth of Ceará's population is exposed to adequate public water fluoride levels, and cities with fewer than 30,000 inhabitants are the most affected. 6 Cearás Ceará s municipality (municipality year date collection system concentrations HDI, HDI (HDI Index factors 26390 26 390 26,39 178 17 8 17.8 2016 areas systems 18 evaluated 167 16 7 16.7 3 212 2 12 2.1 95% 95 (95 1.924.88 192488 1.92 4.88 1 92 4 88 1.92-4.88 populations 30000 000 30,00 affected 2639 39 26,3 17. 201 16. 21 2. 9 (9 924 1.924.8 19248 192 1.9 488 4.8 1.92-4.8 3000 00 30,0 263 26, 20 ( 1.924. 1924 19 1. 48 4. 1.92-4. 300 0 30, 1.924 1.92-4 1.92-

Resumo Fluoretação das águas de abastecimento público é uma importante medida de prevenção da cárie dentária e está vinculada ao objetivo 6 do desenvolvimento sustentável. O estudo objetiva avaliar o teor de flúor nas águas de abastecimento em âmbito estadual. Utilizou-se dados secundários do SISAGUA (município; ano, data, procedência e ponto de coleta; forma de abastecimento; sistema de abastecimento; concentrações de cloro e fluoreto) e do IBGE (IDH, Índice FIRJAN de desenvolvimento municipal e população estimada) para analisar distribuição espacial e fatores de risco da fluoretação. Das 26.390 amostras, apenas 17,8% apresentavam teor de flúor ideal, com maior prevalência nas coletas realizadas em 2016, em áreas urbanas isoladas, em sistemas de abastecimento de água, e com presença de cloro acima do ideal (p < 0,001). Dos 182 municípios avaliados, apenas 16,7% apresentaram maioria das amostras com teor ideal de flúor. Municípios com população inferior a 30 mil habitantes apresentaram prevalência de teor de flúor inadequado (abaixo ou acima do ideal) 2,12 (IC95%=1,92-4,88) vezes superior aos municípios com grandes populações (análise multivariada). Conclui-se que menos de 1/5 da população cearense está exposta a teores adequados de flúor nas águas de abastecimento público e cidades com população inferior a 30 mil habitantes são mais afetadas. sustentável estadual Utilizouse Utilizou se município (município ano data coleta fluoreto IDH, IDH (IDH estimada fluoretação 26390 26 390 26.39 178 17 8 17,8 2016 isoladas água p 0,001. 0001 0,001 . 0 001 0,001) 18 avaliados 167 16 7 16,7 3 abaixo 212 2 12 2,1 IC95%=1,924,88 IC95192488 IC IC95%=1,92 4,88 IC95 1 92 4 88 (IC95%=1,92-4,88 análise multivariada. multivariada multivariada) Concluise Conclui 15 5 1/ afetadas 2639 39 26.3 17, 201 000 0,00 00 16, 21 2, 924 IC95%=1,924,8 IC9519248 IC95192 IC95%=1,9 488 4,8 IC9 9 (IC95%=1,92-4,8 263 26. 20 0,0 IC95%=1,924, IC951924 IC9519 IC95%=1, 48 4, (IC95%=1,92-4, 0, IC95%=1,924 IC951 IC95%=1 (IC95%=1,92-4 IC95%= (IC95%=1,92- IC95% (IC95%=1,92 (IC95%=1,9 (IC95%=1, (IC95%=1 (IC95%= (IC95% (IC95 (IC9 (IC