Abstract Introduction Pregnancy and diabetes mellitus promote several musculoskeletal changes predisposing this population to complaints of Lower Back (LB) and Pelvic Pain (PP). Objective To assess the frequency of LB and PP and associated factors in type 1 Diabetic (DM1) pregnant women. Method: An observational analytical cross-sectional study. Thirty-six pregnant women with DM1 were evaluated through a postural assessment with a focus on pelvic positioning and what patients reported. The associated factors were assessed using the State-Trait Anxiety Inventory (STAI), the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), and the Female Sexual Function Index (FSFI). Results The frequency of LB and PP was 55.6 % and 30.6 %, respectively. The presence of anxiety was not associated with a higher prevalence of pain. The incidence of sexual dysfunctions was higher in the GD. DM1 duration had a mean of 14.9 years (± 8.2 SD) in the GD and 9.0 years (± 6.9 SD) in the GSD, which was statistically significant (p ≤ 0.050). In the multiple binary regression analysis for the occurrence of pain, the independent factor was DM1 duration ≥ 17 years (OR = 11.2; 95 % CI = 1.02‒124.75). The association between DM1 duration ≥ 17 years and being overweight showed a probability of 95 % for the studied population in the analysis of the probabilities of occurrence of the pain event. Conclusion There was a high frequency of LB and PP related to pregnancy in DM1 pregnant women in the second trimester of pregnancy. The incidence of sexual dysfunction and DM1 duration ≥ 17 years increases the chance that DM1 pregnant women will experience pain. There was no association between anxiety. urinary incontinence and pain in DM1 pregnant women. (LB PP. . (PP) DM (DM1 Method crosssectional cross sectional study Thirtysix Thirty six reported StateTrait State Trait STAI, STAI , (STAI) ICIQSF, ICIQSF ICIQ SF (ICIQ-SF) FSFI. FSFI (FSFI) 556 55 6 55. 306 30 30. respectively 149 14 9 14. ± ( 82 8 2 8. SD 90 0 9. 69 6. GSD p 0.050. 0050 0.050 050 0.050) OR 11.2 112 11 1.02‒124.75. 10212475 1.02‒124.75 02 124 75 1.02‒124.75) event (PP (DM (STAI (ICIQ-SF (FSFI 5 3 005 0.05 05 11. 1021247 1.02‒124.7 12 7 00 0.0 102124 1.02‒124. 0. 10212 1.02‒124 1021 1.02‒12 102 1.02‒1 10 1.02‒ 1.02 1.0 1.

Abstract Objectives To compare the efficacy and safety of larotrectinib with those of infigratinib in adult glioma patients with tyrosine kinase alterations. Methods Patients received oral infigratinib 125 mg (IN cohort, n = 125) or oral larotrectinib (LB cohort, n = 105) until unacceptable toxicity or disease progression. Results Duration of treatment was longer in the LB cohort than in the IN cohort (8 [9.5-6.25] months vs. 5.5 [6-5.25] months, p < 0.0001). Patients with partial responses (p = 0.0424) and overall survival (p = 0.03) were higher in the IN cohort than those in the LB cohort. The number of patients with disease progression was higher in the LB cohort (p = 0.0015). All the patients reported diarrhea, fatigue, vomiting, constipation, and decreased appetite. Patients in the IN cohort reported hyperphosphatemia, hyperlipasemia, stomatitis, dry skin, alopecia, dyspepsia, onycholysis, palmar-plantar erythrodysesthesia, nail disorders, and dry eyes. Patients in the LB cohort reported upper respiratory tract infections, pyrexia, cough, anemia, bacterial/viral infections, conjunctivitis, urinary tract infections, headaches, ataxia, dizziness, and muscle tremors. A total of 30 (24 %) and 40 (38 %) patients from the IN and the LB cohorts died at the follow-up of 18 months (p = 0.03). Patients who received bevacizumab initial therapy had higher overall survival (p = 0.048). Conclusions Infigratinib has higher efficacy and overall survival than larotrectinib but has higher adverse effects in the management of both glioma and tyrosine kinase alterations after failure of initial therapies. Initial bevacizumab therapy is associated with a higher overall survival. 12 105 8 ( 9.56.25 95625 9.5 6.25 9 5 6 25 [9.5-6.25 vs 55 5. 65.25 6525 5.25 [6-5.25 0.0001. 00001 0.0001 . 0 0001 0.0001) 0.0424 00424 0424 0.03 003 03 0.0015. 00015 0.0015 0015 0.0015) diarrhea fatigue vomiting constipation appetite hyperphosphatemia hyperlipasemia stomatitis skin alopecia dyspepsia onycholysis palmarplantar palmar plantar erythrodysesthesia disorders eyes infections pyrexia cough anemia bacterialviral bacterial viral conjunctivitis headaches ataxia dizziness tremors 3 24 (2 % 4 38 (3 followup follow up 1 0.03. 0.048. 0048 0.048 048 0.048) therapies 10 56 9.56.2 9562 95 9. 625 6.2 2 [9.5-6.2 65 65.2 652 525 5.2 [6-5.2 0000 0.000 000 0.042 0042 042 0.0 00 0.001 001 004 0.04 04 9.56. 956 62 6. [9.5-6. 65. 52 [6-5. 0.00 0. 9.56 [9.5-6 [6-5 [9.5- [6- [9.5 [6 [9. [ [9

Abstract Objective Summarize the evidence on drug therapies for obstructive sleep apnea. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. PubMed, Embase, Scopus, Web of Science, SciELO, LILACS, Scopus, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov were searched on February 17th, 2023. A search strategy retrieved randomized clinical trials comparing the Apnea-Hypopnea Index (AHI) in pharmacotherapies. Studies were selected and data was extracted by two authors independently. The risk of bias was assessed using the Cochrane Risk of Bias tool. RevMan 5.4. was used for data synthesis. Results 4930 articles were obtained, 68 met inclusion criteria, and 29 studies (involving 11 drugs) were combined in a meta-analysis. Atomoxetine plus oxybutynin vs placebo in AHI mean difference of -7.71 (-10.59, -4.83) [Fixed, 95 % CI, I2 = 50 %, overall effect: Z = 5.25, p < 0.001]. Donepezil vs placebo in AHI mean difference of -8.56 (-15.78, -1.33) [Fixed, 95 % CI, I2 = 21 %, overall effect: Z = 2.32, p = 0.02]. Sodium oxybate vs placebo in AHI mean difference of -5.50 (-9.28, -1.73) [Fixed, 95 % CI, I2 = 32 %, overall effect: Z = 2.86, p = 0.004]. Trazodone vs placebo in AHI mean difference of -12.75 (-21.30, -4.19) [Fixed, 95 % CI, I2 = 0 %, overall effect: Z = 2.92, p = 0.003]. Conclusion The combination of noradrenergic and antimuscarinic drugs shows promising results. Identifying endotypes may be the key to future drug therapies for obstructive sleep apnea. Moreover, studies with longer follow-up assessing the safety and sustained effects of these treatments are needed. PROSPERO registration number CRD42022362639. apnea MetaAnalyses Meta Analyses PRISMA (PRISMA followed PubMed Embase Scopus Science SciELO LILACS Trials ClinicalTrialsgov ClinicalTrials gov 17th th 2023 ApneaHypopnea Apnea Hypopnea (AHI pharmacotherapies independently tool 54 5 4 5.4 synthesis 493 obtained 6 criteria 2 involving 1 metaanalysis. metaanalysis meta analysis. analysis meta-analysis 7.71 771 7 71 -7.7 10.59, 1059 10 59 (-10.59 4.83 483 83 -4.83 Fixed, Fixed [Fixed 9 CI I effect 525 25 5.25 0.001. 0001 0.001 . 001 0.001] 8.56 856 8 56 -8.5 15.78, 1578 15 78 (-15.78 1.33 133 33 -1.33 232 2.32 0.02. 002 0.02 02 0.02] 5.50 550 -5.5 9.28, 928 28 (-9.28 1.73 173 73 -1.73 3 286 86 2.86 0.004. 0004 0.004 004 0.004] 12.75 1275 12 75 -12.7 21.30, 2130 30 (-21.30 4.19 419 19 -4.19 292 92 2.92 0.003. 0003 0.003 003 0.003] results Moreover followup follow up needed CRD42022362639 CRD 202 5. 49 7.7 77 -7. 10.59 105 (-10.5 4.8 48 -4.8 52 5.2 000 0.00 00 8.5 85 -8. 15.78 157 (-15.7 1.3 13 -1.3 23 2.3 0.0 5.5 55 -5. 9.28 (-9.2 1.7 17 -1.7 2.8 12.7 127 -12. 21.30 213 (-21.3 4.1 41 -4.1 2.9 CRD4202236263 20 7. -7 10.5 (-10. 4. -4. 8. -8 15.7 (-15. 1. -1. 2. 0. -5 9.2 (-9. 12. -12 21.3 (-21. CRD420223626 - 10. (-10 -4 15. (-15 -1 9. (-9 21. (-21 CRD42022362 (-1 (- (-2 CRD4202236 ( CRD420223 CRD42022 CRD4202 CRD420 CRD42 CRD4

ABSTRACT Introduction Instruments to manage adverse effects of endocrine therapy with Aromatase inhibitors (AI) may improve adherence and persistence to treatment and Health-Related Quality of Life (HRQL). The 31-item Cervantes Scale (CS-31) is an HRQL questionnaire with particularities of the perimenopausal and postmenopausal period that could be an appropriate instrument to assess HRQL in Breast Cancer (BC) survivors. Objective This study aimed to perform additional validation of the CS-31 for BC survivors undergoing adjuvant endocrine therapy. Methods This prospective study was performed at three time points named T0, T1, and T2: initial, intermediate, and final follow-up period, respectively, totaling 24 months of follow-up. At each time point, the participants completed the CS-31, Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F), and Hospital Anxiety and Depression Scale (HADS). The internal consistency, construct validity, responsiveness analyses, and known-group validity of CS-31 were evaluated. Results This study included 89 postmenopausal women diagnosed with hormone receptor-positive early BC in adjuvant endocrine therapy with AI. The internal consistency was good (Cronbach's alpha = 0.89). Construct validity received a positive rating, with 100% of results consistent with prior hypotheses. A prospective improvement in HRQL was identified for the CS-31 Global Score and FACIT-F Total Score and for most of their domains. Furthermore, women with anxiety and depression by HADS presented worse HRQL by CS-31. Conclusion The authors identified that the CS-31 seems to be appropriate for use in oncology medical routine and may help to monitor adverse effects and HRQL of BC survivors during adjuvant endocrine therapy. AI (AI HealthRelated Health Related HRQL. . (HRQL) 31item item 31 CS31 CS (CS-31 (BC CS-3 T0 T T1 T2 initial intermediate followup follow up respectively 2 followup. up. point CS31, 31, FACITF, FACITF FACIT F , (FACIT-F) HADS. (HADS) analyses knowngroup known group evaluated 8 receptorpositive receptor Cronbachs Cronbach s 0.89. 089 0.89 0 0.89) rating 100 hypotheses domains Furthermore CS31. 31. (HRQL 3 CS3 (CS-3 CS- (FACIT-F (HADS 08 0.8 10 (CS- 0. 1 (CS

Abstract Aim miR-141-5p expression in patients with Early Spontaneous Abortion (ESA) and its correlation with hormone levels during pregnancy were investigated. Methods A total of 70 pregnant women with ESA were selected as the research group, and 70 normal pregnant women who chose abortion for non-medical reasons were selected as the Con group. Serum β-HCG, Progesterone (P), and Estrogen (E2) were detected by enzyme-linked immunosorbent assay. Differentially expressed miRNAs were screened by miRNA microarray analysis. miR-141-5p expression was detected by RT-qPCR, and its correlation with serum β-HCG, P, and E2 levels was analyzed. The diagnostic value of miR-141-5p for ESA was evaluated by the ROC curve. Results Serum β-HCG, P, and E2 were decreased and serum miR-141-5p was increased in patients with ESA. Pearson correlation analysis showed that serum β-HCG, P, and E2 levels were negatively correlated with miR-141-5p expression levels. ROC curve showed that miR-141-5p had a diagnostic value for ESA. Conclusions miR-141-5p is related to hormone levels during pregnancy and is expected to become a new candidate diagnostic marker for ESA. miR1415p miRp miR 141 5p p (ESA investigated 7 group nonmedical non medical βHCG, βHCG β HCG, HCG β-HCG P , (P) E (E2 enzymelinked enzyme linked assay RTqPCR, RTqPCR RT qPCR, qPCR RT-qPCR analyzed 14 (P (E 1

Abstract Introduction Advanced Glycation End-Products (AGEs) are a diverse group of highly reactive molecules that play a vital role in the development of neurodegenerative disorders, such as Parkinson's Disease (PD), leading to a decline in functional and cognitive capacity. The objective of this study was to assess the intake and quantification of AGEs in individuals with PD and to correlate them with their functional and cognitive abilities. Methods This was a cross-sectional study involving 20 PD patients and 20 non-PD individuals as the Control group (C). The autofluorescence reader was used to evaluate skin AGEs, while food recall was used to quantify AGEs consumed for three different days. The Montreal Cognitive Assessment, Short Physical Performance Battery, and handgrip tests were used. PD patients demonstrated greater impairment in functional capacity compared to the control group. Results Dominant Handgrip (p = 0.02) and motor performance, in the sit and stand test (p = 0.01) and Short Physical Performance Battery (SPPB) (p = 0.01) were inferior in PD patients than the control group. Although PD patients tended to consume less AGEs than the control group, AGE intake was negatively correlated with handgrip strength in individuals with PD (r = -0.59; p < 0.05). Conclusion PD patients had lower strength and functional capacity, suggesting that the effects of AGEs might be exacerbated during chronic diseases like Parkinson's. EndProducts End Products (AGEs disorders Parkinsons Parkinson s PD, , (PD) abilities crosssectional cross sectional 2 nonPD non C. C . (C) days Assessment 0.02 002 0 02 performance 0.01 001 01 SPPB (SPPB r 0.59 059 59 -0.59 0.05. 005 0.05 05 0.05) Parkinsons. s. (PD (C 0.0 00 0.5 5 -0.5 0. -0. -0 -

Abstract Background The oral cavity is a link between of external environment with gastrointestinal tract. Studies are controversial on the presence of Periodontal Disease (PD) and its association with Gastric Adenocarcinoma (GAC). Methods The authors performed a systematic review and meta-analysis to verify the association between PD and GAC. Six electronic databases were evaluated between 1961 and 2022. Titles and abstracts were reviewed independently according to the eligibility criteria, assessing full texts of selected studies. The quality of the included research was verified using the Newcastle-Ottawa Scale for case-control and cohort studies. Statistical analyses were performed based on fixed and/or random effects models to calculate the summarized Relative Risk (RR) and its 95 % Confidence Interval (95 % CI). Results There were 639 studies, of which nine articles were included (3 case-controls and 6 cohorts). Overall, the authors identified 1,253 cases of GAC 2,501 controls in case-control studies, and 1,631 patients with GAC enrolled in cohort studies. Patients presenting PD increased the risk of developing GAC by 17 % (RR=1.17; 95 % CI 1.03‒1.32), which remained regardless of the diagnostic method for PD, i.e., clinical examination (RR = 1.19; 95 % CI 1.14‒1.24) and self-report (RR = 1.34; 95 % CI 1.06‒1.69). Moreover, Asian patients (RR=1.17; 95 % CI 1.00‒1.36) with PD had a higher risk of having GAC than American and European patients (RR = 1.18; 95 % CI 0.84‒1.66). Conclusions The presence of PD the risk of GAC suggesting that its infectious-inflammatory process of PD may be related to GAC development. Further investigations on the oral-gastric microbiota and its role in the carcinogenesis of gastric cancer should be carried out, and the screening of patients with potential risk for GAC should be considered in the clinical practice of dentists. tract (PD . (GAC) metaanalysis meta analysis 196 2022 criteria studies NewcastleOttawa Newcastle Ottawa casecontrol case control andor or RR 9 (9 CI. CI) 63 3 ( casecontrols cohorts. cohorts cohorts) Overall 1253 1 253 1,25 2501 2 501 2,50 1631 631 1,63 RR=1.17 RR117 (RR=1.17 1.03‒1.32, 103132 1.03‒1.32 , 03 32 1.03‒1.32) ie i e i.e. 1.19 119 19 1.14‒1.24 114124 14 24 selfreport self report 1.34 134 34 1.06‒1.69. 106169 1.06‒1.69 06 69 1.06‒1.69) Moreover 1.00‒1.36 100136 00 36 1.18 118 18 0.84‒1.66. 084166 0.84‒1.66 0 84 66 0.84‒1.66) infectiousinflammatory infectious inflammatory development oralgastric out dentists (GAC 202 125 25 1,2 250 50 2,5 163 1,6 RR=1.1 RR11 (RR=1.1 10313 1.03‒1.3 i.e 1.1 11 1.14‒1.2 11412 1.3 13 10616 1.06‒1.6 1.00‒1.3 10013 08416 0.84‒1.6 8 20 12 1, 5 2, 16 RR=1. RR1 (RR=1. 1031 1.03‒1. 1. 1.14‒1. 1141 1061 1.06‒1. 1.00‒1. 1001 0841 0.84‒1. RR=1 (RR=1 103 1.03‒1 1.14‒1 114 106 1.06‒1 1.00‒1 100 084 0.84‒1 RR= (RR= 10 1.03‒ 1.14‒ 1.06‒ 1.00‒ 08 0.84‒ 1.03 1.14 1.06 1.00 0.84 1.0 0.8 0.

Abstract Background Varicocele is an abnormal expansion of the pampininias venous plexus in the scrotum, resulting in impaired sperm production and reduced sperm quality. The exact pathophysiological mechanism leading to varicocele-related infertility has not been fully elucidated. Although treatable, varicocele may lead to male infertility. Objective To investigate the relationship between semen parameters, serum InhB and INSL-3 levels, and the degree of varicocele in male patients. Methods Serum InhB and INSL-3 were detected. To evaluate the relationship between semen parameters and serum InhB and INSL-3 levels. To evaluate the value of semen parameters and serum InhB and INSL-3 levels in distinguishing disease severity in patients with varicocele. Results Serum INSL-3 in patients with varicocele decreased with the severity of the disease. Serum INSL-3 was positively correlated with total sperm count and frequency of normal sperm morphology. There was a weak correlation between serum InhB and semen volume, concentration, and total sperm. Patients with different disease severity were similar within the groups, with partial overlap or similarity between varicocele Grade I and Grade II, and significant differences between Grade III and Grade I and II. Semen volume, concentration, total sperm, normal sperm morphology, and serum InhB and INSL-3 levels could distinguish the degree of varicocele. Conclusion Semen parameters and the combination of serum InhB and INSL-3 levels in patients with varicocele are closely related to the severity of the disease. Serum INSL-3 is expected to be a potential biomarker for early clinical intervention. scrotum quality varicocelerelated elucidated treatable INSL3 INSL 3 INSL- detected morphology volume concentration groups II intervention

Abstract Introduction Almost 20 % of patients with Non-Seminomatous Germinative Cell Tumors (NSGCT) will require intrathoracic metastasectomy after chemotherapy. The authors aim to determine their long-term survival rates. Methods Retrospective study including patients with NSGCT and intrathoracic metastasis after systemic therapy from January 2011 to June 2022. Treatment outcomes and overall survival were analyzed with the Kaplan-Meier method. Results Thirty-seven male patients were included with a median age of 31.8 years. Six presented with synchronous mediastinum and lung metastasis, nine had only lung, and 22 had mediastinal metastasis. Over half had retroperitoneal lymph node metastasis. Twenty-two had dissimilar pathologies, with a discordance rate of 62 %. Teratoma and embryonal carcinoma were the prevalent primary tumor types, 40.5 % each, while teratoma was predominant (70.3 %) in the metastasis group. Thoracotomy was the main surgical approach (39.2 %) followed by VATS (37.2 %), cervico-sternotomy (9.8 %), sternotomy (5.8 %), and clamshell (3.9 %). Lung resection was performed in 40.5 % of cases. Overall, 10-year survival rates were 94.3 % with no surgical-related mortality. Conclusion Multimodality treatment with systemic therapy followed by radical surgery offers a high cure rate to patients with intrathoracic metastatic testicular germ cell tumors. 2 NonSeminomatous Non Seminomatous (NSGCT chemotherapy longterm long term 201 2022 KaplanMeier Kaplan Meier method Thirtyseven Thirty seven 318 31 8 31. years Twentytwo Twenty two pathologies 6 types 405 40 5 40. each 70.3 703 70 3 (70. group 39.2 392 39 (39. 37.2 372 37 (37. %, , cervicosternotomy cervico 9.8 98 9 (9. 5.8 58 (5. 3.9 (3. . cases Overall 10year year 10 943 94 94. surgicalrelated related mortality tumors 202 4 70. 7 (70 39. (39 37. (37 9. (9 5. (5 3. (3 1 (7 (

Abstract Background Xuebijing (XBJ) is widely applied in the treatment of Acute Lung Injury (ALI). This study focused on the potential mechanism of XBJ in Lipopolysaccharide (LPS)-induced ALI. Methods The rat ALI model was established by injection of LPS (10 mg/kg) and pretreated with XBJ (4 mL/kg) three days before LPS injection. BEAS-2B cell line was stimulated with LPS (1 μg/mL) and ATP (5 mM) to induce pyroptosis, and XBJ (2 g/L) was pretreated 24h before induction. The improvement effects of XBJ on pulmonary edema, morphological changes, and apoptosis in ALI lung tissue were evaluated by lung wet/dry weight ratio, HE-staining, and TUNEL staining. Inflammatory cytokines in lung tissue and cell supernatant were determined by ELISA. pyroptosis was detected by flow cytometry. Meanwhile, the expressions of miR-181d-5p, SPP1, p-p65, NLRP3, ASC, caspase-1, p20, and GSDMD-N in tissues and cells were assessed by RT-qPCR and immunoblotting. The relationship between miR-181d-5p and SPP1 in experimental inflammation was reported by dual luciferase assay. Results XBJ could improve inflammation and pyroptosis of ALI by inhibiting contents of inflammatory cytokines, and levels of inflammation- and pyroptosis-related proteins. Mechanistically, XBJ could up-regulate miR-181d-5p and inhibit SPP1 in ALI. miR-181d-5p can target the regulation of SPP1. Depressing miR-181d-5p compensated for the ameliorative effect of XBJ on ALI, and overexpressing SPP1 suppressed the attenuating effect of XBJ on LPS-induced inflammation and pyroptosis. Conclusion XBJ can regulate the miR-181d-5p/SPP1 axis to improve inflammatory response and pyroptosis in ALI. (XBJ . (ALI) LPSinduced induced 10 mg/kg mgkg mg kg 4 ( mL/kg mLkg mL BEAS2B BEASB BEAS 2B B 1 μg/mL μgmL μg 5 mM 2 g/L gL g L h induction edema changes wetdry wet dry ratio HEstaining, HEstaining HE staining, staining HE-staining ELISA cytometry Meanwhile miR181d5p, miR181d5p miRdp miR 181d 5p, 5p d p SPP pp65, pp65 pp p65, p65 p-p65 NLRP3 NLRP ASC caspase1, caspase1 caspase 1, caspase-1 p20 GSDMDN GSDMD N RTqPCR RT qPCR immunoblotting assay pyroptosisrelated related proteins Mechanistically upregulate up miR181d5p/SPP1 miR181d5pSPP1 miRdpSPP 5p/SPP1 miR-181d-5p/SPP (ALI pp6 p6 p-p6 caspase- p2 miR181d5p/SPP pSPP miR181d5pSPP 5pSPP1 5p/SPP p-p 5pSPP

Abstract Introduction The maternal mortality rate in developing countries, such as Brazil, has significantly increased since 2020. Obstetric Emergencies (OE) account for 72.5% of these deaths. A national survey was conducted in Brazil to evaluate how gynecologists and obstetricians deal with OE and identify the main difficulties regarding theoretical/practical knowledge and structural resources. Methods An electronic questionnaire assessing resource availability, health teams, institutional protocols, and provision of OE training courses was completed by Brazilian obstetricians. Results More than 90 % of the questionnaire respondents reported treating a pregnant and/or puerperal patient with severe morbidity and that their health network has human resources, trained professionals, and structural resources required for this type of care. However, few respondents participate in continuing education programs (36 %) or specific training for the medical team (61.41 %). The implementation rates of obstetric risk identification protocols (33.09 %), a rapid response team (46.54 %), and boxes and emergency cart assembly teams (71.68 %) were determined. Conclusion A high Maternal Mortality Ratio (MMR) may be related to disorganized healthcare systems, low implementation of risk classification protocols for the care of severe maternal and fetal conditions, and lack of access to continued/specific training programs. The Brazilian MMR is multifactorial. According to obstetricians, Brazilian health services include care teams, essential medications, obstetric centers, and clinical analysis laboratories, though they lack systematized processes and permanent professional training for qualified care of OE. countries 2020 (OE 725 72 5 72.5 deaths theoreticalpractical theoretical practical availability 9 andor professionals However 36 (3 61.41 6141 61 41 (61.4 %. . 33.09 3309 33 09 (33.0 %, , 46.54 4654 46 54 (46.5 71.68 7168 71 68 (71.6 determined (MMR systems conditions continuedspecific continued multifactorial medications centers laboratories 202 7 72. 3 ( 61.4 614 6 4 (61. 33.0 330 0 (33. 46.5 465 (46. 71.6 716 (71. 20 61. (61 33. (33 46. (46 71. (71 2 (6 (4 (7

Abstract Background Local anesthetic puncture is often related to the experience of pain. This study aimed to systematically analyze the literature on changes in pain perception during the anesthetic puncture of dental local anesthesia after Photobiomodulation Therapy (PBMT). Material and methods An electronic search was performed in eight primary databases (Embase, LILACS, BBO, LIVIVO, MedLine via PubMed, SciELO, Scopus, and Web of Science) and three additional ones (EASY, Google Scholar, and OATD) to partially capture the “gray literature”. The PICO strategy was used to identify randomized clinical trials evaluating the analgesic effect of PBMT in the anesthetic puncture site of dental local anesthesia compared to placebo or control groups, without restrictions on publication language and year. Two reviewers extracted the data and assessed the individual risk of bias of the eligible studies using the Cochrane Collaboration Risk of Bias Tool version 2.0. Results The electronic search found 3,485 records, of which eight met the eligibility criteria and were included in the qualitative synthesis. The studies were published from 2011 to 2022. None of the included studies had a low risk of bias. PBMT groups showed no significant difference in pain scores compared to placebo and control groups of most studies. Conclusion Based on a low to very low certainty of evidence, PBMT seems to have no effect on pain perception during anesthetic puncture in patients undergoing dental local anesthesia. PBMT. . (PBMT) Embase, Embase (Embase LILACS BBO LIVIVO PubMed SciELO Scopus Science EASY, EASY (EASY Scholar OATD gray literature. literature” year 20 2 0 2.0 3485 3 485 3,48 records synthesis 201 2022 evidence (PBMT 2. 348 48 3,4 202 34 4 3,

Abstract Aims Very Low Birthweight (VLBW) infants with neonatal Chronic Lung Disease (CLD) have been found to have functional impairment of the brainstem auditory pathway at term. This study investigated the functional status of the brainstem auditory pathway in VLBW infants with CLD after term for any abnormality. Methods Fifty-two VLBW infants were recruited at 50 weeks of Postconceptional Age: 25 with neonatal CLD and 27 without CLD. None had any other major complications to minimize confounding effects. Brainstem Auditory Evoked Responses were studied at 21‒91/s click rates. Results Compared with those without CLD, VLBW infants with CLD had relatively shorter latencies of BAER waves I and III, associated with a slightly lower BAER threshold. Wave V latency and I‒V interpeak interval did not differ significantly between the two groups of infants. The I‒III interval in infants with CLD was shorter than in those without CLD at 91/s clicks. However, the III‒V interval was significantly longer than in those without CLD at all click rates (all p < 0.05). There were no significant differences in the amplitudes of BAER wave components between the two groups of infants. Conclusions The main BAER abnormality in VLBW infants with CLD was a prolonged III‒V interval. Auditory conduction is delayed or impaired at more central regions of the brainstem in CLD infants. After term central auditory function is adversely affected by neonatal CLD. Monitoring post-term change is required to provide valuable information for post-term care of CLD infants. (VLBW (CLD Fiftytwo Fifty 5 Age 2 effects 2191s s 21 91 III threshold IV IIII 91s clicks However IIIV 0.05. 005 0.05 . 0 05 0.05) postterm post 9 00 0.0 0.