Abstract We evaluated the accuracy of radiomorphometric indices (RI) and fractal dimension (FD) for screening bone mineral density (BMD) in postmenopausal patients who had breast cancer and were using aromatase inhibitors (AI). The sample consisted of 40 participants. Digital panoramic radiography (DPR) and cone beam computed tomography (CBCT) were evaluated along with dual-energy X-ray absorptiometry (DXA), which is the gold standard for detecting low BMD. According to the T-scores of DXA, the subjects were assigned into two groups: with normal BMD and with low BMD (osteopenia and osteoporosis). The area under the curve (AUC), sensitivity, and specificity with their respective confidence intervals were determined for DPR and CBCT. For DPR indices, AUC ranged from 52.6 to 75.8%. The mandibular cortical width (MCW) had the highest AUC. For FD, the total trabecular index had the highest sensitivity, while the index anterior to the mental foramen (MF) had the highest specificity. In CBCT, the AUC ranged from 51.8 to 62.0%. The indices with the highest AUC were the molar (M) and anterior (A). The symphysis (S) index had the highest sensitivity and the posterior (P) index had the highest specificity. Sensitivity and specificity were adequate for the computed tomography index (Inferior; CTI [I]). Therefore, MCW, FD of the mandible angle, and total trabecular ROI in DPR and the CTI (I), M, P, and A indices in CBCT proved to be promising tools in distinguishing individuals with low BMD. Cutoff point for these indices could be a useful tool to investigate low BMD in postmenopausal women taking AI.

Abstract The coronavirus disease (COVID-19) has been prioritized in relation to other illnesses considered critical, such as cancer, cardiovascular diseases/stroke, diabetes, and autoimmune diseases. The management of patients with these diseases involves dental care to reduce systemic complications caused by odontogenic infections, and/or to treat oral manifestations of systemic comorbidities. In this regard, the dental care of these individuals must be guaranteed during the pandemic. Although a high risk of exposure to and catching of COVID-19 is expected to befall dental professionals, biosafety guidelines reduce the likelihood of infection. Thus, the current scenario poses challenges, and offers decision-making approaches and tools that facilitate the management of individuals with oral manifestations of chronic and/or critical diseases, using hospital-based services. This article presents an overview for hospital service providers who are at the forefront of COVID-19 care, including a secure protocol, and clinical guidelines based on the experience of the Hospital das Clínicas in Belo Horizonte, a public referral service, supported by the Brazilian National Health System.

Ventilator-associated pneumonia (VAP) is one of the most prevalent infections in hospital intensive care unit (ICU). Among the risk factors highlight the microaspiration of oropharyngeal microorganisms. The strategy for prevention of VAP bundle was the creation of ventilation. However, not all strategies are included in the bundle, for example, the oral hygiene. This study aimed to assess the oral hygiene procedures to prevent VAP. We conducted a review of secondary data from the infection control committee of the hospital between 2008 to 2011 presented by frequency of occurrence. We also evaluated the perception of health professionals in the ICU on the implementation of the protocol of oral hygiene. After signing the informed consent a questionnaire was administered. Pneumonia was the primary cause of infection in the ICU from 2008 to 2010. In 2011 after deploying the bundle fails to lead to pneumonia as the most frequent. Percentage reduction in numbers of pneumonia after the deployment bundle to the incorporation of oral hygiene protocol ranged from 33.3% to 3.5%. About the perception of professionals about the insertion of dental professionals in the ICU 56 respondents, citing oral hygiene as the second most important measure. 100% of professionals said to be favorable to the dentist's inclusion in the ICU. The vast literature demonstrates the efficiency of the protocol of oral hygiene in the prevention of VAP, so it is recommended the inclusion of this measure in the bundle.

La neumonía asociada a ventilación mecânica (NAVM) es una de las infecciones más prevalentes en unidades de cuidados intensivos (UCI). Entre los factores de riesgo se destacan la microaspiración de bacterias colonizantes de la orofaringe. La estratega para prevención de la NAV fue la creación del bundle de la ventilación. Sin embargo, no todas las estrategias se incluyen en el paquete de medidas como, por ejemplo, la higiene bucal. Este estudio tuvo como objetivo evaluar los procedimientos de higiene oral para prevenir la NAVM. Se realizó una revisión de datos secundarios de la comisión de control de infecciones del hospital entre 2008 a 2011 según la frecuencia de incidencia. También se evaluó la percepción de los profesionales de la salud en la UCI sobre la aplicación del protocolo de higiene bucal. Después de firmar el consentimiento informado se aplicó un cuestionario. La neumonía fue la principal causa de infecciones en la UCI desde 2008 hasta 2010. En 2011, después de implementar el paquete, la neumonía dejó de ser la más frecuente. En porcentaje, la reducción de la neumonía después de la puesta en práctica del bundle hasta la incorporación del protocolo de higiene bucal varió entre 33,3% y 3,5%. Acerca de la percepción de los profesionales de la inserción de la odontología en la UCI, 56 profesionales encuestados citaron la higiene bucal como la segunda medida más importante. El cien por ciento de los profesionales es favorable a la inclusión del dentista en la UCI. La vasta literatura demuestra la eficacia del protocolo de higiene bucal en la prevención de la NAVM. Se recomienda, entonces, la inclusión de esta medida en el paquete.

A pneumonia associada à ventilação mecânica (PAVM) é uma das infecções hospitalares mais prevalentes na Unidade de Tratamento Intensivo (UTI). Dentre os fatores de risco, destacam-se as microaspirações de microrganismos da orofaringe. A estratégia para prevenção da PAVM foi a criação do bundle da ventilação. Nem todas as estratégias, porém, estão incluídas no bundle - por exemplo, a higiene bucal. O objetivo com este trabalho foi avaliar os procedimentos de higiene bucal na prevenção da PAVM. Foram avaliados os dados secundários da comissão de controle de infecção hospitalar entre 2008 e 2011, apresentados por frequência de ocorrência, bem como a percepção dos profissionais de saúde na UTI sobre a implantação do protocolo de higiene bucal. Após assinar o Termo de Consentimento Livre e Esclarecido (TCLE), foi aplicado um questionário. A pneumonia foi a principal causa de infecção no CTI, de 2008 a 2010. Em 2011, após a implantação do bundle, a pneumonia deixou de liderar como a mais frequente. Em números percentuais, a redução de pneumonia após a implantação do bundle até a incorporação do protocolo de higiene bucal variou de 33,3% para 3,5%. Sobre a percepção dos profissionais sobre a inserção da odontologia na UTI, 56 profissionais responderam ao questionário, citando a higiene bucal como a segunda medida mais importante. Cem por cento dos profissionais responderam que eram favoráveis à inserção do dentista na UTI. A vasta literatura existente evidencia a eficiência do protocolo de higiene bucal na prevenção de PAVM. Recomenda-se, portanto, a inserção dessa medida no bundle.