Ankyloglossia and malocclusion: A systematic review and meta-analysis.

BACKGROUND: Ankyloglossia is a congenital alteration that affects the tongue's mobility, influencing craniofacial development; however, its association with malocclusion is still unclear. This systematic review and meta-analysis investigated the association between ankyloglossia and malocclusion in patients. TYPES OF STUDIES REVIEWED: The authors conducted a systematic review and meta-analysis of observational studies that investigated the association between malocclusion and the presence of ankyloglossia in any age group, used any assessment tool to diagnose ankyloglossia, and considered all types of malocclusion. The authors conducted searches in 8 electronic databases through July 1, 2022. They used Joanna Briggs Institute appraisal tools to assess the methodological quality and the Grading of Recommendations, Assessment, Development and Evaluations approach to assess the certainty of the evidence. RESULTS: Eleven studies (5 cross-sectional, 6 case-control) included 2,904 patients and over 13 occlusal alterations. The certainty of the evidence ranged from low through very low. Patients with Angle Class III malocclusion had similar or more inserted lingual frenula than patients with Class I malocclusion (standard mean difference, 0.37; 95% CI, -0.50 to 1.25) and Class II malocclusion (standard mean difference, 0.55; 95% CI, -0.52 to 1.63). Patients with Class III malocclusion had clinically significant increased mouth opening reduction compared with patients with Class I malocclusion (mean difference, 6.67; 95% CI, 4.01 to 9.33) and Class II malocclusion (mean difference, 5.04; 95% CI, 2.35 to 7.72) patients. PRACTICAL IMPLICATIONS: There is uncertain evidence that ankyloglossia may be associated with the development of occlusal alterations. Ankyloglossia did not influence the Angle classification. Clinicians should closely follow children with ankyloglossia to evaluate whether this condition interferes with the occlusion. Future research should prospectively follow up on the long-term association between ankyloglossia and malocclusion. The protocol was registered a priori in the PROSPERO database (CRD42021248034). No amendments were deemed necessary after the registration of the protocol. Some subgroup analyses planned a priori were not possible, such as the severity of ankyloglossia, sex, and age, due to the lack of studies reporting data for these subgroups.

Association Between Vocal Symptoms, Communication, Work Environment, and Sense of Coherence in Hospital Health Professionals.

OBJECTIVE: This study aimed to associate the presence of vocal symptoms with sociodemographic and occupational data, work environment self-perception, oral communication wearing a face mask, and the sense of coherence (SOC). METHOD: This cross-sectional analytical observational study included 66 health professionals from a Brazilian hospital. They answered an online questionnaire on sociodemographic aspects, self-perception of the physical work environment, and oral communication at work. The Voice Symptom Scale (VoiSS) and Sense of Coherence Scale (SOC-13) were also applied. The significance level was set at 5% for the statistical analysis. RESULTS: The self-perception of vocal symptoms was 62%. Professionals who considered the noise in their work environment unsatisfactory had more vocal symptoms (P = 0.005), especially in the limitation (P = 0.013) and physical (P = 0.028) domains of the VoiSS. Professionals with higher self-perceived vocal symptoms also reported incoordination between breathing, speech, and articulation (P = 0.041) and self-perceived difficulty being heard with a protective mask (P = 0.033). Professionals with a higher self-perceived score in the limitation domain of the VoiSS also had a higher self-perceived effort to speak with a mask (P = 0.035) and a higher self-perception that other people find it difficult to hear them with a face mask (P = 0.050). There was a weak negative correlation between VoiSS and SOC (P < 0.05) and between its domains (P < 0.05). CONCLUSION: Self-perception of voice symptoms is high among health professionals in a Brazilian public hospital. The presence of these symptoms is related to the perception of a noisy work environment and communication difficulties due to the use of a face mask. The lower the ability to cope with stressful situations, the larger the presence of voice symptoms among health professionals.

Bacteremia following different oral procedures: Systematic review and meta-analysis.

To evaluate the timing, duration and incidence of bacteremia following invasive dental procedures (IDPs) or activities of daily living (ADL). Eight databases were searched for randomized (RCTs) and nonrandomized controlled trials (nRCTs) evaluating bacteremia before and after IDPs or ADL in healthy individuals. The risk of bias was assessed by RoB 2.0 and ROBINS-I. For the meta-analysis, the primary outcomes were the timing and duration of bacteremia. The secondary outcome was the incidence of bacteremia, measuring the proportion of patients with bacteremia within 5 min after the end of the procedure compared with baseline. We included 64 nRCTs and 25 RCTs. Peak bacteremia occurred within 5 min after the procedure and then decreased over time. Dental extractions showed the highest incidence of bacteremia (62%-66%), followed by scaling and root planing (SRP) (44%-36%) and oral health procedures (OHP) (e.g., dental prophylaxis and dental probing without SRP) (27%-28%). Other ADL (flossing and chewing) (16%) and toothbrushing (8%-26%) resulted in bacteremia as well. The majority of studies had some concerns RCTs or moderate risk of bias nRCTs. Dental extractions, SRP and OHP, are associated with the highest frequency of bacteremia. Toothbrushing, flossing, and chewing also caused bacteremia in lower frequency.

Relationships Between Sense of Coherence, Self-perception of Voice and Work Environment Among Teachers.

OBJECTIVE: to analyze the relationship between sense of coherence and sociodemographic data, remote physical work environment, and self-perception of symptoms, vocal handicap and vocal fatigue in teachers. METHODS: Seventy eight teachers pertaining to the municipal education network of a Brazilian capital city participated in the study, during the period of social isolation by COVID-19. An online questionnaire was applied with sociodemographic and physical remote work environment questions, the Sense of Coherence Scale (SOC-13), the Brazilian Dysphonia Screening Tool (Br-DST), the Vocal Fatigue Index (VFI), and the Vocal Handicap Index (VHI-10). Descriptive analysis, bivariate and multivariate Logistic regression models were performed to check the proportion of teachers with high and low SOC among the different categories of independent variables. Student's t test and Mann Whitney test were used to compare SOC, IDV, and VFI scores between the groups, and Hedge's g test was used to access the effect size. The total scores of SOC, VHI and VFI were correlated using Pearson's Correlation Coefficient. All tests adopted a 5% significance level. RESULTS: Male teachers and those over 45 years old were, respectively, 6.79 (95%CI = 1.16-39.58) and 5.27 (95%CI = 1.40-19.76) times more likely to present a high SOC. The variables associated with a lower chance of presenting high SOC were vocal restriction (OR = 0.21; 95%CI = 0.06-0.79) and voice-related physical discomfort (OR = 0.13; 95%CI = 0.02-0.78). Regarding the remote work environment, in bivariate analysis, teachers who were dissatisfied with air quality (OR = 0.08; 95%CI = 0.01-0.65), temperature (OR = 0.11; 95%CI = 0.01-0.92), and noise (OR = 0.25; 95%CI = 0.61-0.99) were less likely to have high SOC. Higher values of SOC are associated with lower self-perception of vocal fatigue and voice handicap (P < 0,001). CONCLUSION: The way individuals face stressful situations interferes with the self-perception of their voice and their work environment. The relationship between the sense of coherence and voice perception is relevant to favor programs to promote vocal health and stress management in teachers.

Prevalence of ankyloglossia according to different assessment tools: A meta-analysis.

BACKGROUND: Prevalence of ankyloglossia may vary depending on the assessment tool. This systematic review aimed to evaluate the prevalence of ankyloglossia in distinct age groups according to different assessment tools. TYPES OF STUDIES REVIEWED: Nine electronic databases were searched from inception through November 2021 without restrictions of language or year of publication. Paired independent reviewers selected cross-sectional and cohort studies reporting the diagnosis of ankyloglossia, extracted data, and assessed methodological quality. The number of patients with ankyloglossia and the sample were extracted to calculate the overall prevalence of ankyloglossia and 95% CI. The authors calculated the prevalence of ankyloglossia per assessment tool, age group, and sex. They assessed the certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation approach. RESULTS: Seventy-one studies were included. Seven different diagnostic tools were used. The overall prevalence of ankyloglossia was 5% (95% CI, 4.0% to 5.0%) and ranged from 2% (using an unspecific tool) to 20% (Coryllos classification). The prevalence per age group was higher in infants (7%). The prevalence ratio was 1.34 (95% CI, 1.17 to 1.54) for boys, with very low certainty of evidence. PRACTICAL IMPLICATIONS: The prevalence of ankyloglossia is higher among infants and differs depending on the assessment tool used for the diagnosis. It is uncertain whether boys are more affected by ankyloglossia than girls.

A saúde infantil frente ao fechamento de escolas na pandemia de covid-19 / Children's health in the face of school closures in the covid-19 pandemic / La salud infantil frente al cierre escolar en la pandemia covid-19

Objetivo: Investigar as repercussões do fechamento das escolas na saúde infantil, diante da pandemia de COVID-19. Métodos: Revisão de escopo, com busca eletrônica nas bases de dados National Library of Medicine and National Institutes of Health (MEDLINE/PubMed), Cumulative Index to Nursing and Allied Health Literature (CINAHL) e Scopus. Resultados: Ao total, 21 artigos foram incluídos no estudo e categorizados por domínios, de acordo com a taxonomia NANDA-I, elencando-se Nutrição, Atividade/repouso, Enfrentamento/tolerância ao estresse, Segurança/proteção e Percepção/cognição. Conclusão: O fechamento das escolas durante a pandemia de COVID-19 gerou aumento do risco de obesidade e sedentarismo, insegurança alimentar, estresse, transtornos de humor e ansiedade como repercussões na saúde infantil. (AU)

Objective: To investigate the repercussions of school closures on children's health in the face of the COVID-19 pandemic. Methods: Scoping review, with electronic search in the databases National Library of Medicine and National Institutes of Health (MEDLINE/PubMed), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Scopus. Results: In total, 21 articles were included in the study and categorized by domains, according to the NANDA-I taxonomy, listing Nutrition, Activity/Residence, Stress Confrontation/Protection and Perception/Cognition. Conclusion: The closure of schools during the COVID-19 pandemic generated increased risk of obesity and sedentariness, food insecurity, stress, mood disorders and anxiety as repercussions on children's health. (AU)

Objetivo: Investigar las repercusiones del cierre de escuelas en la salud de los niños ante la pandemia de COVID-19. Métodos: Examen del alcance, con búsqueda electrónica en las bases de datos de la Biblioteca Nacional de Medicina y los Institutos Nacionales de Salud (MEDLINE/PubMed), el Índice Acumulativo de Literatura de Enfermería y Salud Aliada (CINAHL) y Scopus. Resultados: En total, se incluyeron 21 artículos en el estudio y se categorizaron por dominios, según la taxonomía NANDA-I, enumerando Nutrición, Actividad/Residencia, Confrontación/Protección del Estrés y Percepción/Cognición. Conclusión: El cierre de las escuelas durante la pandemia de VOCID-19 generó un mayor riesgo de obesidad y sedentarismo, inseguridad alimentaria, estrés, trastornos del estado de ánimo y ansiedad como repercusiones en la salud de los niños. (AU)

Análise comparativa das características demográficas, sintomatologia e comorbidades de adultos e idosos notificados e confirmados com covid-19 nas capitais brasileiras / Análisis comparativo de las características demográficas, la sintomatología y las comorbilidades de los adultos y ancianos notificados y confirmados con covid-19 en las capitales brasileñas / Comparative analysis of demographic characteristics, symptoms and comorbidities of adults and elderly people notified and confirmed with covid-19 in brazilian capitals

RESUMO Objetivo: comparar o perfil demográfico, a sintomatologia e as comorbidades de adultos e idosos notificados com COVID-19 nas capitais brasileiras e no Distrito Federal - DF. Métodos: estudo ecológico desenvolvido a partir dos dados da plataforma online e-SUS Notifica, preenchidos até dia 4 de janeiro de 2021, com amostra constituída por 1.416.252 indivíduos, utilizando como critérios de inclusão: ter idade > 20 anos; residir nas capitais brasileiras ou no Distrito Federal - DF; e apresentar resultado do teste positivo para COVID-19. A análise descritiva contou com a exposição das frequências absoluta e relativa e medidas de tendência central. Para a análise inferencial, aplicou-se o teste qui-quadrado de Pearson, considerando diferença significativa para valores de p<0,05. Resultados: predominou sexo masculino (52%), com média de idade de 43,29 ± 14,85 anos. Os indivíduos apresentaram tosse (45,4%), febre (38,8%) e outros sintomas (83,1%). As comorbidades mais prevalentes foram: doenças cardíacas (7,1%) e diabetes (4,5%). Houve diferença significativa (p<0,001) entre as regiões brasileiras, ao comparar sexo, idade, ser profissional da saúde, sintomas e comorbidades. Conclusão: os dados contribuíram para o conhecimento acerca do processo epidêmico de COVID-19 no Brasil no primeiro ano de pandemia e demonstraram a distribuição dos casos e as relações existentes entre perfil demográfico, sintomatologia e doenças preexistentes com os agrupados das capitais brasileiras.

RESUMEN Objetivo: comparar el perfil demográfico, la sintomatología y las comorbilidades de los adultos y ancianos notificados con COVID-19 en las capitales brasileñas y el Distrito Federal - DF. Métodos: estudio ecológico, desarrollado a partir de los datos de la plataforma online e-SUS Notifica, completados hasta el 4 de enero de 2021, con una muestra compuesta por 1.416.252 individuos, utilizando como criterios de inclusión: edad > 20 años; residir en capitales brasileñas o en el Distrito Federal - DF; y presentar un resultado positivo en la prueba de COVID-19. El análisis descriptivo incluyó la presentación de frecuencias absolutas y relativas y medidas de tendencia central. Para el análisis inferencial, se aplicó la prueba de chi-cuadrado de Pearson, considerando la diferencia significativa para valores p <0,05. Resultados: predominó el sexo masculino (52%), con una edad media de 43,29 ± 14,85 años. Los individuos presentaron tos (45,4%), fiebre (38,8%) y otros síntomas (83,1%). Las comorbilidades más prevalentes fueron las cardiopatías (7,1%) y la diabetes (4,5%). Hubo una diferencia significativa (p<0,001) entre las regiones brasileñas al comparar el género, la edad, ser profesional de la salud, los síntomas y las comorbilidades. Conclusión: los datos contribuyeron al conocimiento del proceso epidémico del COVID-19 en Brasil, en el primer año de pandemia, y demostraron la distribución de los casos y las relaciones existentes entre el perfil demográfico, la sintomatología y las enfermedades preexistentes con los agrupados de las capitales brasileñas.

ABSTRACT Objective: to compare the demographic profile, symptoms and comorbidities of adults and elderly people notified with COVID-19 in Brazilian capitals and the Distrito Federal - DF. Methods: ecological study developed from data from the online platform e-SUS Notifica, completed until January 4, 2021, with a sample consisting of 1,416,252 individuals, using as inclusion criteria: being > 20 years old; reside in Brazilian capitals or the Distrito Federal - DF; and present a positive test result for COVID-19. The descriptive analysis included the exposure of absolute and relative frequencies and measures of central tendency. For the inferential analysis, Pearson's chi-square test was applied, considering a significant difference for values of p<0.05. Results: males predominated (52%), with a mean age of 43.29 ± 14.85 years. Subjects had cough (45.4%), fever (38.8%) and other symptoms (83.1%). The most prevalent comorbidities were: heart disease (7.1%) and diabetes (4.5%). There was a significant difference (p<0.001) between Brazilian regions, when comparing sex, age, being a health professional, symptoms and comorbidities. Conclusion: the data contributed to the knowledge about the epidemic process of COVID-19 in Brazil in the first year of the pandemic and demonstrated the distribution of cases and the relationships between demographic profile, symptoms and pre-existing diseases with the groups of Brazilian capitals.

Sense of Coherence and Coping Strategies in Patients With Dysphonia.

AIM: To analyze sense of coherence (SOC) of dysphonic individuals considering the type and degree of dysphonia, coping strategies, and sociodemographic variables. METHODS: This cross-sectional study was performed with 50 dysphonic individuals under follow-up at a Brazilian Speech-Language Pathology Clinic. They answered a questionnaire with sociodemographic information, the PEED-10 (Brazilian Voice Disability Coping Questionnaire) and the Brazilian version of Sense of Coherence scale. The SOC was categorized as high or low using Cluster analysis. After descriptive analysis, data were analyzed through both the bivariate and multivariate logistic regression model method and the Spearman's correlation test (P< 0.05). RESULTS: Most individuals presented a high SOC (60%). Individuals with mild dysphonia were 7.00 times more likely to present high SOC (95% CI = 1.24-39.38).  Individuals between 45 and 70 years old were 5.03 times more likely to present high SOC (95% CI = 1.25-20.28). In addition, the higher SOC, as well as the scores of manageability domain, the lower the use of strategies focused on emotion. CONCLUSION: Patients with mild dysphonia are more likely to have a high SOC. The same goes for individuals over the fourth decade of life. Also, the greater the SOC, the fewer emotional strategies are used to cope with dysphonia.

The importance of full text screening when judging eligibility criteria in a systematic review: a systematic survey / A importância da avaliação do texto completo ao julgar os critérios de elegibilidade em uma revisão sistemática: uma revisão de métodos

Aim: To evaluate if statistically significant results are more likely to be reported in title/abstracts compared to non-significant outcomes. Methods: In this methodological survey, we reanalyzed 59 observational studies from a previous systematic review. The PECO question was: Patient (P): children with primary teeth; Exposure (E): low birth weight and/or preterm; Comparison (C): normal birth weight and/or full-term; Outcome (O): dental caries. We analyzed the presence of key terms in the titles and abstracts, such as gestational age, preterm, full-term, birth weight, low/normal birth weight. Full texts were analyzed for "positive outcomes" (statistically significant association, p < 0.05 or 95% CI not crossing the null effect line) related to the association between the outcome and the exposure; and "negative outcomes" (when the outcome had statistically similar occurrence between the exposure and the comparison group). The odds ratio (OR) was calculated between the presence of key terms in titles/abstracts and the type of outcome (positive or negative). Results: Of 59 studies, 66% cited the key terms in titles/abstracts, and 75% reported negative outcomes. Studies with positive outcomes were more likely to report key terms in the titles/abstracts compared to studies with negative outcomes (OR: 4.5; 95% CI: 0.9-22.4; Chi-square test: p = 0.06). Studies with statistically significant outcomes, favoring the exposure or the comparison, were more likely to report these data in the titles/abstracts. Conclusion: When conducting a systematic review, the final decision related to the inclusion of a study must be based on a full-text level.

Objetivo: Avaliar se os resultados estatisticamente significativos são mais prováveis de serem relatados nos títulos/resumos dos artigos do que os resultados não significativos. Métodos: Neste levantamento metodológico, foram reanalisados 59 estudos observacionais de uma revisão sistemática anterior. A questão PECO foi: Paciente (P): crianças com dentes decíduos; Exposição (E): baixo peso ao nascer e/ou pré-termo; Comparação (C): peso normal ao nascer e/ou a termo; Resultado (O): cárie dentária. Foi analisada a presença de termos-chave nos títulos/resumos, como idade gestacional, pré-termo, a termo, peso ao nascer, baixo/peso normal ao nascer. Textos completos foram analisados para "desfechos positivos" (associação estatisticamente significativa, p < 0,05 ou IC 95% não cruzando a linha de efeito nulo) relacionados à associação entre o desfecho e a exposição; e "desfechos negativos" (quando o desfecho teve ocorrência estatisticamente semelhante entre a exposição e o grupo de comparação). Foi calculada a odds ratio (OR) entre a presença de termos-chave nos títulos/resumos e o tipo de resultado (positivo ou negativo). Resultados: Dos 59 estudos, 66% citaram os termos-chave nos títulos/resumos e 75% relataram resultados negativos. Estudos com resultados positivos foram mais propensos a relatar os termos-chave nos títulos/resumos em comparação com estudos com resultados negativos (OR: 4,5; IC 95%: 0,9-22,4; teste do qui-quadrado: p = 0,06). Estudos com significância estatística os desfechos, favorecendo a exposição ou a comparação, foram mais propensos a relatar esses dados nos títulos/resumos. Conclusão: Ao realizar uma revisão sistemática, a decisão final quanto à inclusão de um estudo deve ser baseada por meio da análise do texto completo.

Sense of Coherence and the fear of public speaking in university students. / Senso de Coerência e o medo de falar em público em universitários.

PURPOSE: To test the association between the Sense of Coherence (SOC) and the fear of public speaking in university students. METHOD: Cross-sectional study was carried out with a sample of 1124 undergraduate students of a Brazilian public university. An online questionnaire was used divided into three blocks: the first evaluated the sociodemographic data and the somatic symptoms of the fear of public speaking; the second evaluated the SOC, through the SOC-13 questionnaire; and the third was composed by the Scale for Self-Assessment in Public Speaking (SSPS), with questions that point out cognitive aspects of this activity. The students were divided into two groups (high SOC and low SOC) through the Two-step Cluster analysis. Data were analyzed descriptively and by the Mann-Whitney test and bi and multivariate logistic regression models, with significance set at 5%. RESULTS: The students who reported not being afraid to speak in public were more likely to belong to the high SOC group (OR = 3.19, 95% CI = 2.30-4.42). Students from the high SOC group self-assessed more positively on the SSPS scale (p <0.001). CONCLUSION: College students over 30 years old, on the second half of graduation, with breathing discomfort, who do not report fear of public speaking and who perceive themselves more positively for public speaking, they have the highest SOC. Thus, it is observed the importance of considering the SOC as an important coping resource, given the great interference of emotional aspects in public speech.

OBJETIVO: Testar a associação entre o Senso de Coerência (SOC) e o medo de falar em público em universitários. MÉTODO: Estudo transversal, com amostra de 1.124 estudantes de cursos de graduação de uma universidade pública brasileira. Foi utilizado questionário online dividido em três blocos: o primeiro avaliou os dados sociodemográficos e os sintomas somáticos do medo de falar em público; o segundo avaliou o SOC, por meio do questionário SOC-13; e o terceiro foi composto pela Escala para Autoavaliação ao Falar em Público (SSPS), que norteia aspectos cognitivos dessa atividade. Os universitários foram divididos em dois grupos (SOC alto e SOC baixo) por meio da análise de Cluster de dois passos. Os dados foram analisados de forma descritiva e por meio do teste de Mann-Whitney e modelos de regressão logística bi e multivariado, com significância de 5%. RESULTADOS: Os universitários que relataram não ter medo de falar em público apresentaram mais chance de pertencer ao grupo SOC alto (OR=3,19, IC95%=2,30-4,42). Os universitários do grupo SOC alto se autoavaliaram mais positivamente na escala SSPS (p<0.001). CONCLUSÃO: Universitários com mais de 30 anos, na segunda metade da graduação, das áreas da Saúde e Exatas, com sintoma de respiração ofegante, que não relatam medo de falar em público e que se autopercebem mais positivamente para falar em público, apresentam o SOC mais alto. Diante do estudo, observa-se a importância de se considerar o SOC como um recurso de enfrentamento importante, tendo em vista a grande interferência dos aspectos emocionais na fala em público.

Prevalence of Oral Inclusion Cysts in a Brazilian Neonatal Population.

Purpose: To evaluate oral inclusion cysts in newborns and their association with birth weight, preterm birth, newborn health, maternal health, prenatal factors, and socio-economic factors.
Methods: The sample consisted of 411 pairs of mothers and their newborns born at a university hospital in Brazil. The oral inclusion cysts, diagnosed by clinical examination, were Epstein pearls, Bohn's nodules, and dental lamina cysts. Medical records and a questionnaire were used to collect data related to newborns and mothers. Data were analyzed using the chi-square, linear by linear, and Fisher's exact tests for bivariate analysis, while Poisson regression with robust variance was used for multivariate analysis (α =five percent).
Results: The prevalence of inclusion cysts was 56.7 percent. A total of 42 (62.7 percent) low birth weight (LBW) newborns, 192 (56.0 percent) normal weight newborns, 38 (63.3 percent) preterm newborns, and 187 (56.7 percent) full-term newborn had inclusion cysts. Epstein pearls (n=164, 39.9 percent) were more prevalent and associated with prematurity (P =0.025), LBW newborns (P =0.033), and mothers who worked during pregnancy (P =0.019). Bohn's nodules (n=80, 19.9 percent) were more prevalent in newborns of mothers who did not receive welfare support (P =0.004). Dental lamina cysts occurred in 5.6 percent (N=23) of the sample and were not associated with independent variables.
Conclusion: Epstein pearls were more common in LBW and preterm infants.

Prevalence of dental caries in preschool children born preterm and/or with low birth weight: A systematic review with meta-analysis of prevalence data.

The aim of the present systematic review and meta-analysis was to evaluate the prevalence of dental caries among preschool children who had been born preterm and/or with low birth weight (LBW) compared with those who had been born full term and/or with normal birth weight (NBW). Eight electronic databases were searched from interception up to November 2018 with no restrictions imposed regarding the date of publication or language. Two independent reviewers screened studies, extracted data, and assessed the risk of bias. A random-effects meta-analysis was run to pool the crude prevalence of dental caries according to gestational age and birth weight. We performed a narrative synthesis and assessed the certainty of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). Fifty-nine observational studies were included (55 in the meta-analysis). The prevalence of dental caries was 39% among preterm children, 30% among full-term children, 40% among LBW children, and 33% among NBW children (I2 :97%-99%). The majority of studies reported that dental caries was not associated with gestational age or birth weight, with very low certainty of evidence. Preschool children born preterm or with LBW have similar dental caries experience as those born full term or with NBW, with very low certainty of evidence (PROSPERO #CDR42018118086).

Senso de Coerência e o medo de falar em público em universitários / Sense of Coherence and the fear of public speaking in university students

RESUMO Objetivo: Testar a associação entre o Senso de Coerência (SOC) e o medo de falar em público em universitários. Método: Estudo transversal, com amostra de 1.124 estudantes de cursos de graduação de uma universidade pública brasileira. Foi utilizado questionário online dividido em três blocos: o primeiro avaliou os dados sociodemográficos e os sintomas somáticos do medo de falar em público; o segundo avaliou o SOC, por meio do questionário SOC-13; e o terceiro foi composto pela Escala para Autoavaliação ao Falar em Público (SSPS), que norteia aspectos cognitivos dessa atividade. Os universitários foram divididos em dois grupos (SOC alto e SOC baixo) por meio da análise de Cluster de dois passos. Os dados foram analisados de forma descritiva e por meio do teste de Mann-Whitney e modelos de regressão logística bi e multivariado, com significância de 5%. Resultados: Os universitários que relataram não ter medo de falar em público apresentaram mais chance de pertencer ao grupo SOC alto (OR=3,19, IC95%=2,30-4,42). Os universitários do grupo SOC alto se autoavaliaram mais positivamente na escala SSPS (p<0.001). Conclusão: Universitários com mais de 30 anos, na segunda metade da graduação, das áreas da Saúde e Exatas, com sintoma de respiração ofegante, que não relatam medo de falar em público e que se autopercebem mais positivamente para falar em público, apresentam o SOC mais alto. Diante do estudo, observa-se a importância de se considerar o SOC como um recurso de enfrentamento importante, tendo em vista a grande interferência dos aspectos emocionais na fala em público.

ABSTRACT Purpose: To test the association between the Sense of Coherence (SOC) and the fear of public speaking in university students. Method: Cross-sectional study was carried out with a sample of 1124 undergraduate students of a Brazilian public university. An online questionnaire was used divided into three blocks: the first evaluated the sociodemographic data and the somatic symptoms of the fear of public speaking; the second evaluated the SOC, through the SOC-13 questionnaire; and the third was composed by the Scale for Self-Assessment in Public Speaking (SSPS), with questions that point out cognitive aspects of this activity. The students were divided into two groups (high SOC and low SOC) through the Two-step Cluster analysis. Data were analyzed descriptively and by the Mann-Whitney test and bi and multivariate logistic regression models, with significance set at 5%. Results: The students who reported not being afraid to speak in public were more likely to belong to the high SOC group (OR = 3.19, 95% CI = 2.30-4.42). Students from the high SOC group self-assessed more positively on the SSPS scale (p <0.001). Conclusion: College students over 30 years old, on the second half of graduation, with breathing discomfort, who do not report fear of public speaking and who perceive themselves more positively for public speaking, they have the highest SOC. Thus, it is observed the importance of considering the SOC as an important coping resource, given the great interference of emotional aspects in public speech.

Senso de coerência materno no período puerpério imediato baseado no peso ao nascer do recém-nascido / Maternal sense of coherence in immediate postpartum period according newborn's birth weight

O baixo peso ao nascer é considerado um fator estressante para as mães, por representar um maior risco de mortalidade. O Senso de Coerência (SOC) é a capacidade adaptativa frente à fatores estressantes. Diante de determinadas situações, como o nascimento de um filho, o SOC pode sofrer alterações. Este estudo transversal pareado teve por objetivo verificar a associação do SOC materno de acordo com o peso do filho ao nascer com aspectos relacionados ao nascimento, gestação, e fatores socioeconômicos no puerpério imediato. Após aprovação no comitê de ética, foram convidadas a participar do estudo as mães que estavam dentro do período puerpério imediato (até 10 dias de pós-parto) e cujos filhos nasceram no Hospital das Clínicas da Universidade Federal de Minas Gerais. Foram excluídas as mães que não sabiam ler ou escrever, que não conseguiram completar algum dos questionários, diagnosticadas com depressão, e cujos filhos fossem gemelares ou nascidos com más-formações e/ou síndromes. Os recém-nascidos poderiam estar tanto no Alojamento Conjunto (AC) quanto na Unidade Neonatal de Cuidados Progressivos (UNCP), e todas as mães avaliadas estavam no AC. As mães foram divididas em dois grupos, pareados na proporção de 1:1 por faixa etária: Grupo BP - mães de crianças com baixo peso ao nascer; e Grupo PN - mães de crianças nascidas com peso normal. A variável dependente deste estudo foi o SOC, obtido através da versão curta da escala de SOC (SOC-13), e dicotomizado em "alto SOC" e "baixo SOC" em cada grupo através da análise de cluster de dois passos. As variáveis independentes relacionadas ao recém-nascido foram: idade gestacional, necessidade de UNCP ou incubadora e sexo. As variáveis independentes maternas foram: idade, fatores socioeconômicos (trabalho na gestação, renda mensal familiar, anos de estudo, religião e morar com o pai do recém-nascido), fatores relacionados a saúde (alterações sistêmicas, pré-eclâmpsia, medicamentos, tabaco e aborto), e fatores relacionados a gestação (paridade, gestação planejada, tipo de parto, tempo de pósparto e amamentação). Estas variáveis foram obtidas através dos prontuários médicos e de um questionário semiestruturado aplicado às mães, contendo 40 questões divididas em 5 seções: identificação; educação materna; condição socioeconômica; saúde materna; parto e aleitamento. Após análise descritiva, os dados foram analisados pelos modelos de Regressão Logística bivariada e multivariada, com nível de significância de 5%. A média de idade das 158 mães avaliadas foi de 27,8 anos (±7,2). No grupo BP, as mães com renda mensal familiar acima de 2 salários mínimos tiveram mais chances de ter alto SOC (OR=3,57, IC 95%=1,15-11,10). Em contrapartida, no grupo PN, as mães que moravam com o pai do recém-nascido (OR=3,88, IC 95%=1,12-13,52) e aquelas cujos filhos não precisaram de incubadora (OR=5,38, IC 95%-1,14-25,32) tiveram mais chances de apresentar SOC alto. O SOC materno no puerpério imediato se associou com fatores distintos considerando o peso do filho ao nascer. Reconhecer estes fatores pode auxiliar estratégias específicas para a diminuição dos fatores estressantes no puerpério imediato.

Low birth weight is considered a stressful factor for mothers, since it represents a higher risk of mortality. The Sense of Coherence (SOC) is the adaptive capacity to deal with stress. In certain situations, such as the birth of a child, the SOC may change. This paired cross-sectional study aimed to verify the association of maternal SOC according to the newborn's birth weight with birth outcomes, as well as socioeconomic factors in the immediate postpartum. After approval by the ethics committee, the mothers who were in immediate postpartum (up to 10 days of postpartum) and gave birth at the Public University Clinical Hospital of the Federal University of Minas Gerais were invited to participate. Women who could not read or write, unable to complete any of the questionnaires, diagnosed with depression, or whose children were twin or born with malformations or syndromes. The newborns could be at the Rooming-in or at the Intensive Care Unit (ICU), and all mothers assessed were in the Rooming-in. Mothers were divided into two groups, paired in a 1:1 ratio by their range age: Group BP - mothers whose children were born with low birth weight; and Group PN - mothers whose children were born with normal weight. The dependent variable in this study was the SOC, obtained through the short version of the SOC scale (SOC-13), and dichotomized in "high SOC" and "low SOC" in each group through two-step cluster analysis. The independent variables related to the newborns were: gestational age, the need to stay in ICU or incubator and sex. The mother's variables addressed the age, socioeconomic factors (work during pregnancy, monthly family income, years of schooling, religiosity and to live with newborn's father), health related factors (systemic alterations, pre-eclampsia, medications, tobacco use and abortion history), and pregnancy variables (parity, planned pregnancy, type of childbirth, postpartum time, and breastfeeding). These variables were obtained through medical records and a semi-structured questionnaire applied to mothers, containing 40 questions divided into 5 sections: identification; maternal education; socioeconomic status; maternal health; childbirth and breastfeeding. After descriptive analysis, the data were analyzed by bi and multivariate Logistic Regression models, with significance level set at 0.05. The mean age of the 158 mothers evaluated was 27.8 years (± 7.2). In the BP group, mothers with monthly family income above 2 Brazilian minimum wages were more likely to present high SOC (OR = 3.57, 95% CI = 1.15-11.10). On the other hand, in the PN group, mothers who lived with the newborn's father (OR = 3.88; 95% CI = 1.12­ 13.52) and whose newborns did not need an incubator (OR = 5.38; 95% CI = 1.14­ 25.32) were more likely to present with high SOC. The maternal SOC in the immediate postpartum period is associated with distinct factors considering the birth weight. Recognizing these factors can help specific strategies for reducing stressors in the immediate postpartum.

Evaluation of photosensitizer penetration into sound and decayed dentin: A photoacoustic spectroscopy study.

BACKGROUND: Photodynamic therapy (PDT) may have topical indications. In those cases it is important for a topical photosensitizer to penetrate into the tissue to which it has been applied. This study aimed to compare the penetration of two different concentrations of erythrosine into intact and in vitro decayed dentin samples. METHODS: This in vitro study evaluated erythrosine (0.3 and 5%) penetration into sound (intact) and decayed dentin. A total of 11 dentin discs were prepared and divided into two equal halves, in order to keep one half sound while the other half was submitted to sterilization and an in vitro demineralization model for 5 days. Before erythrosine application, the organic and inorganic composition of all samples was evaluated by Fourier Transform Raman spectroscopy, and after erythrosine application for 30 min, the penetration depth was determined by Photoacoustic spectroscopy technique. RESULTS: The results indicated that 0.3% erythrosine showed a higher penetration depth into sound dentin (p = 0.002); and 5% erythrosine higher penetration into decayed dentin (p < 0.001). However considering clinical parameters, no statistically significant difference was found between any of the conditions tested. CONCLUSIONS: Erythrosine demonstrated ability to penetrate into dentin, irrespective of sound or decayed condition. Photoacoustic spectroscopy can be considered a method for estimating the penetration into hard tissues, and in conjunction with Raman spectroscopy, these are effective methods for evaluating the spectral response of dentin. Considering that erythrosine is capable of penetrating into decayed dentin, clinical trials are needed to test the effectiveness of this photosensitizer in Photodynamic therapy and Antimicrobial Photodynamic therapy.

Standard or accelerated methotrexate, vinblastine, doxorubicin and cisplatin as neoadjuvant chemotherapy for locally advanced urothelial bladder cancer: Does dose intensity matter?

BACKGROUND: There is continuing controversy regarding the optimal regimen for neoadjuvant chemotherapy (NAC) in bladder cancer. PATIENTS AND METHODS: We performed a retrospective analysis of 241 consecutive bladder cancer patients who received a combination of methotrexate, vinblastine, doxorubicin and cisplatin (MVAC) using a standard (52 patients) or an accelerated schedule (189 patients) as NAC before radical cystectomy in 17 centres of the French GEnito-urinary TUmour Group from March 2004-May 2013. RESULTS: The median age was 62 years. As expected, the median number of cycles, the median total dose of cisplatin and the median cisplatin dose intensity were higher in patients treated with the accelerated regimen. Conversely, the median duration of chemotherapy was shorter. Regarding toxicity, grade III/IV neutropenia, grade III thrombocytopenia and grade III anaemia as well were more frequently observed in patients treated with the standard regimen. Among 211 (88%) patients who proceeded to cystectomy, 75 (35%) patients achieved an ypT0 pN0 status (no pathologic residual tumour cells) with no significant difference according to the MVAC schedule. Three-year overall survival rates were 66.5% (95% confidence interval [CI], 56-79) and 72% (95% CI, 59.5-88) in the standard and accelerated cohorts, respectively. In the multivariate analysis, two independent prognostic parameters were retained: the ypT0 stage and the ypN0 stage. Heterogeneity test did not show any interaction with NAC regimens. CONCLUSION: Similar pathological response and survival rates were observed whatever the chemotherapy regimen used. Haematological toxicity was greater in patients who received standard MVAC.