Risk of meningomyelocele mediated by the common 22q11.2 deletion.

Meningomyelocele is one of the most severe forms of neural tube defects (NTDs) and the most frequent structural birth defect of the central nervous system. We assembled the Spina Bifida Sequencing Consortium to identify causes. Exome and genome sequencing of 715 parent-offspring trios identified six patients with chromosomal 22q11.2 deletions, suggesting a 23-fold increased risk compared with the general population. Furthermore, analysis of a separate 22q11.2 deletion cohort suggested a 12- to 15-fold increased NTD risk of meningomyelocele. The loss of Crkl, one of several neural tube-expressed genes within the minimal deletion interval, was sufficient to replicate NTDs in mice, where both penetrance and expressivity were exacerbated by maternal folate deficiency. Thus, the common 22q11.2 deletion confers substantial meningomyelocele risk, which is partially alleviated by folate supplementation.

Mobile app for pelvic floor muscle training for urinary incontinence during the coronavirus disease 2019 pandemic: clinical trial.

OBJECTIVE: The objective of this study was to evaluate the effects of home-based pelvic floor muscle training in women with urinary incontinence, addressing the difficulties arising from social isolation due to the coronavirus disease 2019 pandemic by utilizing a specialized mobile app. METHODS: This randomized, single-group clinical trial aimed to assess the efficacy of pelvic floor muscle training guided by a mobile app (Diario Saúde) in women with stress urinary incontinence. Participants were instructed via telephone to engage in pelvic floor muscle training exercises twice a day for 30 days. Pre- and post-treatment, participants completed validated questionnaires regarding urinary symptoms and quality of life through telephone interviews. Additionally, treatment adherence was evaluated. RESULTS: A total of 156 women were enrolled in the study, with a mean age of 49.3±14.2 years. Significant improvements in urinary incontinence symptoms and quality of life were observed following pelvic floor muscle training guided by the mobile app (p<0.001). Notably, 74.3% of the participants reported performing the exercises with appropriate frequency. Of the participants, 62% reported either complete or substantial improvement in urinary symptoms post-treatment. CONCLUSION: This study revealed notable enhancements in stress urinary incontinence, urinary storage, and overall quality of life subsequent to pelvic floor muscle training guided by a mobile app, particularly during the coronavirus disease 2019 pandemic. The mobile app demonstrated robust acceptance and adherence among women experiencing urinary incontinence.

Use of a Mobile Application for Pelvic Floor Muscle Training in Women With Urinary Incontinence: a Randomized Control Trial.

INTRODUCTION AND HYPOTHESIS: This study was aimed at evaluating the impact of a mobile app-guided pelvic floor muscle training (PFMT) program on urinary symptoms and quality of life in women suffering from urinary incontinence. METHODS: The study included women with stress urinary incontinence (SUI), who underwent a structured interview and completed validated questionnaires, including the Questionnaire for Urinary Incontinence Diagnosis (QUID), the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF), and the Incontinence Quality of Life Questionnaire (I-QOL). These women were randomly assigned to one of two groups: the app group, which received a visual depiction on the expected contraction pattern through a mobile app to support their PFMT exercises, and the control (paper) group. Both groups were instructed to perform PFMT exercises twice daily for 30 days. Data were collected at baseline and at 30, 60, 90, and 120 days after completing the exercises. RESULTS: A total of 154 women participated, with 76 in the app group and 78 in the paper group. The mean ages were 61 (± 6.1) and 60.6 (± 6.8) in the app and paper groups respectively (p = 0.644). Both groups showed significant improvements in QUID SUI scores (p < 0.001), overactive bladder (OAB; p < 0.001), ICIQ-SF scores (p < 0.001), and quality-of-life scores (p < 0.001). When comparing the two groups, the app group exhibited a more substantial reduction in OAB (p = 0.017) as assessed by QUID and total (p = 0.042), psychosocial (p = 0.032) and social embarrassment (p = 0.006) I-QOL scores. CONCLUSIONS: The study findings suggest that PFMT guided by a mobile app with visual guidance leads to greater improvements in storage symptoms and quality of life than the home-based PFMT guidance.

Resenha: A Pandemia e o Trabalho em Saúde - Vozes do Cotidiano

Trata-se da resenha do livro A Pandemia e o Trabalho em Saúde - Vozes do Cotidiano, publicado em dezembro de 2022 pela Rede Unida. A obra é um compêndio de textos sobre as consequências da pandemia da doença COVID-19 na vida dos trabalhadores da saúde brasileiros.

Polyvinyl Alcohol Nanofibers Blends as Drug Delivery System in Tissue Regeneration.

Nanofibers have shown promising clinical results in the process of tissue regeneration since they provide a similar structure to the extracellular matrix of different tissues, high surface-to-volume ratio and porosity, flexibility, and gas permeation, offering topographical features that stimulate cell adhesion and proliferation. Electrospinning is one of the most used techniques for manufacturing nanomaterials due to its simplicity and low cost. In this review, we highlight the use of nanofibers produced with polyvinyl alcohol and polymeric associations (PVA/blends) as a matrix for release capable of modifying the pharmacokinetic profile of different active ingredients in the regeneration of connective, epithelial, muscular, and nervous tissues. Articles were selected by three independent reviewers by analyzing the databases, such as Web of Science, PubMed, Science Direct, and Google Scholar (last 10 years). Descriptors used were "nanofibers", "poly (vinyl alcohol)", "muscle tissue", "connective tissue", "epithelial tissue", and "neural tissue engineering". The guiding question was: How do different compositions of polyvinyl alcohol polymeric nanofibers modify the pharmacokinetics of active ingredients in different tissue regeneration processes? The results demonstrated the versatility of the production of PVA nanofibers by solution blow technique with different actives (lipo/hydrophilic) and with pore sizes varying between 60 and 450 nm depending on the polymers used in the mixture, which influences the drug release that can be controlled for hours or days. The tissue regeneration showed better cellular organization and greater cell proliferation compared to the treatment with the control group, regardless of the tissue analyzed. We highlight that, among all blends, the combinations PVA/PCL and PVA/CS showed good compatibility and slow degradation, indicating their use in prolonged times of biodegradation, thus benefiting tissue regeneration in bone and cartilage connective tissues, acting as a physical barrier that results in guided regeneration, and preventing the invasion of cells from other tissues with increased proliferation rate.

Comparative genomic damage among three shark species with different habits: Sublethal impacts of human origin in a protected island environment in the South Atlantic.

Elasmobranchs can bioaccumulate and biomagnify pollutants. However, few studies are directed to the effects of pollutants on the health of these animals, and in most cases, are limited to the analysis of biochemical markers. Thus, the incidence of genomic damage among shark species inhabiting a protected ocean island in the South Atlantic was investigated in association with the analysis of pollutants in seawater sample. High levels of genomic damage were identified, especially in Negaprion brevirostris and Galeocerdo cuvier, in addition to interspecific variations that may be related to characteristics such as animal size, metabolism and habits. High concentrations of Surfactants were observed in seawater sample, in addition to low concentrations of Cadmium, Lead, Copper, Chromium, Zinc, Manganese, and Mercury. The results evidenced the potential of shark species as a bioindicator of environmental quality and allowed assessing the anthropic impact on the archipelago, which currently drives its economy through tourism.

Current Practices in Brazil on Diagnosis and Management of Women With Vulvodynia.

OBJECTIVE: Vulvodynia (VVD) is a frequent and harrowing condition for which diagnosis and management remain insufficient. Our study aimed to describe and compare vulvovaginal signs and symptoms of Brazilian women with VVD and controls and describe previous medical assessment, past treatments, and vulvar pain relief among women with VVD. METHODS: This cross-sectional descriptive study included Brazilian women with (n = 151) and without VVD (n = 106). All women were assessed for vaginal infection, vulvar pain intensity by means of a cotton swab test based on a numerical rate scale, and answered the Female Sexual Function Index questionnaire and a structured instrument about current vulvar symptoms. Previous treatments were assessed in the VVD group, and vulvar pain relief achieved with previous treatments was qualified through a 4-point Likert scale. RESULTS: Volunteers were mainly White, with mean age of 30 years. Vulvovaginal signs and symptoms were significantly more frequent in women with VVD (p < .05), and vulvar pain duration was 5.8 (±4) years. More than 50% consulted with three or more physicians, and 49% remained without a conclusive diagnosis. Previous diagnosis and treatment of vulvovaginal infection were often reported by women with VVD. Most of the tried prescriptions were self-reported as providing only low vulvar pain relief. CONCLUSIONS: Prolonged duration of vulvar pain, multiple visits to health care professionals, and poor relief of pain are common aspects in the clinical history of women with VVD. In addition to pain, vulvar fissure, edema, erythema, vaginal discharge, and foul odor are common and should be considered to avoid misdiagnosis. Appropriate treatments to VVD are still poorly reported.

Effect of diazinon (organophosphate) on the composition and succession of Calliphoridae assemblages in rabbit carcasses in the Eastern Amazon.

Fatal poisonings with diazinon may occur both accidentally or intentionally in suicide cases. Forensic entomotoxicology can aid in understanding these deaths by detecting and analyzing the interference of toxic substances in the biology of necrophagous insects. Hence, this study sought to evaluate diazinon's effect on the composition and succession of calliphorid species in the tropical savannas of the Amazon. Nine rabbit carcasses were divided into three groups: one control and two diazinon treatments (100 mg/kg and 300 mg/kg); each group had three replicates. Three fragments of the Amazon tropical savanna were selected for the experiments. Daily collections of adult and immature calliphorids were performed. Five decomposition stages were observed: fresh, bloated, active decay co-occurring, advanced decay, and dry. Eight species of Calliphoridae were identified among the collected adults: Chloroprocta idioidea (0.1%), Chrysomya albiceps (58.3%), Chrysomya megacephala (14.2%), Chrysomya putoria (2.6%), Cochliomyia hominivorax (1.3%), Cochliomyia macellaria (0.5%), Lucilia eximia (19.8%), and Paralucilia paraensis (3.3%). The adult specimens in the control group with the highest abundance were observed only from the advanced decay stage onward. In the dry stage, abundance was higher in control than in treated carcasses. From the sampled 941 Calliphorid immatures, three species were identified: C. albiceps (76,3%), C. putoria (1%), and L. eximia (22,7). The number of immatures was higher in control than in treated carcasses. Therefore, diazinon interferes with the putrefaction timeframe in carcasses, slowing the decomposition stages and affecting their colonization by immature forms of Calliphoridae.

Phytochemical Characterization of Cannabis sativa L. Roots from Northeastern Brazil.

This article describes the phytochemical study of Cannabis sativa roots from northeastern Brazil. The dried plant material was pulverized and subjected to exhaustive maceration with ethanol at room temperature, obtaining the crude ethanolic extract (Cs-EEBR). The volatile compounds were analyzed by gas chromatography coupled with mass spectrometry (GC/MS), which allowed to identify 22 compounds by comparing the linear retention index (LRI), the similarity index (SI) and the fragmentation pattern of the constituents with the literature. By this technique the major compounds identified were: friedelan-3-one and ß-sitosterol. In addition, two fractions were obtained from Cs-EEBR by classical column chromatography and preparative thin layer chromatography. These fractions were analyzed by NMR and IR and together with the mass spectrometry data allowed to identify the compounds: epifriedelanol, friedelan-3-one, ß-sitosterol and stigmasterol. The study contributed to the phytochemical knowledge of Cannabis sativa, specifically the roots, as there are few reports on the chemical constituents of this part of the plant.

New ent-kaurene-type nor-diterpene and other compounds isolated from Annona vepretorum Mart. (Annonaceae).

A new nor-ent-kaurene diterpene and ten other compounds were isolated from Annona vepretorum stems, including four kaurene diterpenes, three alkamides, one sesquiterpene and two steroids. Their chemical structures were elucidated using spectroscopic methods, including 1D-, 2D-NMR, and HRESIMS. The absolute configuration of compounds 1, 5, 8, 9 and 10 was confirmed by CD experiments. Compounds 1-5 and 8-10 were evaluated for cytotoxic activity using (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) MTT method, against three human carcinoma cell lines: human colon (HCT-116), glioblastoma (SF295) and prostate (PC3). However, all isolated compounds exhibited low cytotoxic activity.

Aplicação das metodologias ativas para ensino de enfermagem em meio à pandemia de COVID-19 / Application of active methodologies for nursing teaching in the midst of the COVID-19 pandemic

Objetivo:Relatar a aplicação das metodologias ativas para o ensino em enfermagem em meio à pandemia de COVID-19.Métodos:Trata-se de um relato de experiênciadas vivências na disciplina de Laboratório de Fundamentos de Enfermagem de uma Universidade Pública em Fortaleza-CE.Resultados:Utilizou-se multimétodos, como aulas e jogos online, estudosde caso, simulação realística, elaboração de portfólio e vídeos com os procedimentos de Enfermagem abordados na disciplina.As diversas estratégias foram necessárias para colaborar com a construção do conhecimento durante a pandemia, uma vez que se utilizou do modelo híbrido de ensino.Conclusão:Constata-se que os vários métodos tecnológicos,como sala virtual, o WhatsAppcomo ferramenta de comunicação rápida, a elaboração do portfólio e a utilização de vídeos e jogos online, os estudos de caso e a simulação realística,foram utilizados de forma complementar e integrada, tornando-se favoráveis para os alunos, pois eles fazem parte de uma geração que tem maior facilidade em utilizartecnologias e são receptivos a multimétodos de aprendizagem

Objective: To report the application of active methodologies for nursing teaching in the midst of the COVID-19 pandemic. Methods: This is an experience report of lived situations in the Nursing Fundamentals Laboratory discipline at a Public University in Fortaleza-CE.Results: Multi-methods were used, such as online classesand games, case studies, realistic simulation, portfolio development and videos with the Nursing procedures addressed in the course. The various strategies were necessary to collaborate with the construction of knowledge during the pandemic, since the hybrid teaching model was used. Conclusion: It appears that the various technological methods, such as the virtual room, WhatsApp as a quick communication tool, the elaboration of the portfolio and the use of videos and online games, case studies and realistic simulation, were used in a complementary and integrated way, becoming favorable for students, as they are part of a generation that is more comfortable using technologies and are receptive to multi-method learning

Influência da religiosidade/espiritualidade em cuidadores informais de crianças com leucemia / Influence of religiosity/spirituality on informal caregivers of children with leukemia / Influencia de la religiosidad/espiritualidad en cuidadores informales de niños con leucemia

Resumo Perante diagnóstico e tratamento de doença grave em crianças, incluindo a oncológica, os pais, em especial as mães, tendem a assumir integralmente as demandas de cuidados, necessitando desenvolver estratégias de enfrentamento situacional. Nesse sentido, este estudo descritivo e transversal objetivou identificar o uso do coping religioso/espiritual em cuidadores informais de crianças com leucemia linfoide aguda mediante aplicação da escala de coping religioso/espiritual breve. Participaram 30 cuidadores informais, que apresentaram coping religioso/espiritual alto (média=3,90; Dp=0,34) na modalidade positiva (média=3,67; Dp=0,48). Por fim, identificou-se que as mães utilizam coping religioso/espiritual para lidar com a demanda de cuidados a elas imposta, vinculada à condição de saúde da criança. Com isso, reforça-se a possibilidade de utilizar a espiritualidade e/ou a religiosidade como indicadores de bem-estar físico e mental, visto que a qualidade dos cuidados prestados está intimamente relacionada à saúde de quem cuida.

Abstract Faced with diagnosis and treatment of serious illness in children, including oncology, parents, especially mothers, tend to fully assume the demands of care and, consequently, must develop situational coping strategies. In this regard, this descriptive and cross-sectional study sought to identify the use of religious/spiritual coping by informal caregivers of children with acute lymphoid leukemia via the Brief Religious/Spiritual Coping (SRCOPE) scale. A total of 30 informal caregivers participated in the study, presenting high religious/spiritual coping (mean=3.90; SD=0.34) regarding positive methods (mean=3.67; SD=0.48). Finally, results show that mothers use religious/spiritual coping deal with the imposed demands for care, linked to the child's health condition. This reinforces the possibility of using spirituality and or religiosity as indicators of physical and mental well-being, since the quality of care is closely related to the caregivers' health.

Resumen Ante el diagnóstico y tratamiento de una enfermedad grave en niños como el cáncer, los padres, sobre todo las madres, tienden a asumir plenamente las demandas de cuidado, por lo que necesitan desarrollar estrategias de afrontamiento de la situación. Este estudio descriptivo y transversal tuvo por objetivo identificar el uso de coping religioso/espiritual en los cuidadores informales de niños con leucemia linfocítica aguda mediante la aplicación de la escala de coping religioso/espiritual breve. Participaron 30 cuidadores informales, quienes presentaron un alto coping religioso/espiritual (media=3,90; DE=0,34) en la modalidad positiva (media=3,67; DE=0,48). Se identificó que las madres utilizan coping religioso/espiritual para hacer frente a la demanda de cuidados que realizan, relacionada al estado de salud del niño. Esto refuerza la posibilidad de utilizar la espiritualidad y/o la religiosidad como indicadores de bienestar físico y mental, ya que la calidad de la asistencia prestada está relacionada directamente con la salud del cuidador.

Different levels of adherence to the Mediterranean diet that do not change the risk of breast cancer in western women

Breast cancer (BC) is the most common neoplasm in women globally. Healthy eating, a characteristic of the Mediterranean diet (MD), has been associated with a lower risk of developing BC, although this relationship remains inconclusive. This study aimed to analyse the relationship between MD adherence and the risk of BC development. A case-control study was carried out with 181 women divided into two groups: with BC (n= 90) and without breast cancer (WBC) (n= 91). Clinical and reproductive aspects were investigated through interviews, and food consumption was assessed through a food frequency questionnaire (FFQ). Adherence to the MD was evaluated using the MD score. Statistical analysis was performed using SPSS® software, with p<0.05. The results showed that the main type of breast carcinoma was invasive ductal carcinoma, positive for oestrogen or progesterone receptors. The mean MD score was 4.08 ± 1.61 and 4.22 ± 1.69 among women with BC and without BC, respectively, with no difference between the groups. The risk assessment of BC with respect to adherence to MD showed no significant difference after adjustments were made in the logistic regression models. In conclusion, this study showed that women with and without breast cancer had "medium adherence" to MD, with no difference between the groups. In the group of women investigated, adherence to MD did not affect the risk of developing the disease.

El cáncer de mama (CM) es la neoplasia más frecuente entre las mujeres del mundo, y la alimentación saludable, característica del patrón de la dieta mediterránea (DM), se ha asociado con un menor riesgo de desarrollar CM, aunque esta relación sigue sin ser concluyente. El objetivo del estudio fue analizar la relación entre la adherencia a la DM y el riesgo para el desarrollo de CM. Estudio de casos y controles realizados con 181 mujeres divididas en dos grupos: con cáncer de mama (n=90) y sin cáncer de mama (SCM; n= 91). Los aspectos clínicos y reproductivos se evaluaron a través de una entrevista; consumo de alimentos a través del cuestionario de frecuencia alimentaria (FFQ) y adherencia a la dieta mediterránea evaluada según la puntuación de DM. El análisis estadístico se realizó mediante el software SPSS®, considerando valores significativos de p<0,05. Los resultados mostraron que el principal tipo de carcinoma de mama fue el carcinoma ductal invasivo, positivo para el receptor de estrógenos y progesterona. La puntuación media de DM fue de 4,08 ± 1,61 entre las mujeres con CM y de 4,22 ± 1,69 entre las que no tenían la enfermedad, sin diferencia entre los grupos. La evaluación del riesgo de CM en relación con la adherencia a la DM mostró que, después de ajustes en los modelos de regresión logística, no hubo diferencia significativa. En conclusión, el estudio muestra que las mujeres con y sin CM tuvieron "adherencia media" a la DM, sin diferencia entre los grupos. También mostró que, en el grupo de mujeres investigadas, la adherencia a la DM no influyó en el riesgo para el desarrollo de la enfermedad.

Gestantes e puérperas: manejo e assistência no contexto da pandemia de Covid-19

Trata-se da resenha crítica do Manual de recomendações para a assistência à gestante e puérpera frente à pandemia de Covid-19, publicado em 2021.

Effect of a Hygiene Protocol on Denture-Related Stomatitis Remission, Local Inflammatory Factors, and Hemodynamic Responses by Arterial Pressure.

Denture-related stomatitis (DRS) is frequent oral inflammation in complete denture wearers. This study evaluated the effect of a hygiene protocol on DRS remission, local inflammatory factors, and hemodynamic responses. Thirty-three individuals were enrolled in the study. The outcomes were measured before and after 10 days of a hygiene protocol treatment consisting of brushing the palate with a soft brush and water and denture brushing with a denture-specific brush and mild soap, as well as immersion of the denture for 20 min in a 0.25% sodium hypochlorite solution. Data were analyzed by paired Wilcoxon for biofilm removal and CFU count of microorganisms. The paired T test was used to assess salivary MUC 1, cytokines, and arterial pressure (p < 0.05). A significant difference was found in the DRS degree (p < 0.001), biofilm (p < 0.001), microbial load of Candida spp. (p < 0.001), Gram-negative (p < 0.004), Staphylococcus spp. (p < 0.001), and S. mutans (p < 0.001) of the denture, and S. mutans (p < 0.001) of the palate after use of the protocol. The salivary flow (p = 0.2) and pH (p = 0.97) did not change; there was an increase of MUC 1 (p = 0.049) and a decrease in IL-6 (p = 0.038), IL-2 (p = 0.04), IL-10 (p = 0.041), and IFNγ (p = 0.04). There was also a decrease in systolic (p = 0.012) and mean arterial pressure (p = 0.02). The current hygiene protocol reduced the inflammation degree of DRS and promoted an improvement of local inflammatory factors and a reduction in the systolic arterial pressure of the patients.

Effect of Denture Hygiene Protocols on Patient Satisfaction, Oral Health-Related Quality of Life, and Salivary Parameters: A Randomized Clinical Trial.

PURPOSE: This randomized controlled trial compared four denture hygiene protocols in terms of patient satisfaction, oral health-related quality of life (OHRQoL), and salivary parameters in complete denture wearers with denture stomatitis. MATERIAL AND METHODS: For this randomized, double-blind, controlled clinical trial, 108 participants were assigned to soak their dentures in one of the following solutions: (1) 0.25% sodium hypochlorite (positive control), (2) 0.15% Triclosan, (3) denture disinfecting tablets, or (4) denture disinfecting tablets plus palatine mucosa brushing solution. The outcomes of patient satisfaction, OHRQoL, and salivary parameters (salivary flow rate and pH) were measured at baseline and after 10 days. The Kruskal-Wallis and Dunn tests (between groups), and Wilcoxon test (between times) were used to compare the results. (α = 0.05). RESULTS: After the hygiene protocols, and when compared with baseline, the overall patient satisfaction, maxillary denture satisfaction, maxillary denture comfort, and maxillary denture retention were ameliorated. A significant improvement was noted in OHRQoL in 3 of 4 domains evaluated (orofacial pain and discomfort, masticatory discomfort and disability, and psychological disability and discomfort). The salivary flow rate (unstimulated and stimulated) and salivary pH were not significantly affected at the times evaluated. CONCLUSIONS: Complete denture wearers may feel more satisfied with their complete dentures when treated for denture stomatitis. The tested treatments lead to similar improvement in terms of patient satisfaction and OHRQoL.

Habits of Genital Hygiene and Sexual Activity among Women with Bacterial Vaginosis and/or Vulvovaginal Candidiasis.

OBJECTIVE: To evaluate genital hygiene among women with and without bacterial vaginosis (BV) and/or vulvovaginal candidiasis (VVC). METHODS: A cross-sectional study of reproductive-aged women who underwent gynecological and laboratory tests and fulfilled a genital hygiene questionnaire. RESULTS: This study evaluated 166 healthy controls and 141 women diagnosed with either BV (n = 72), VVC (n = 61), or both (n = 8). The use of intimate soap and moist wipes after urination was more frequent among healthy women (p = 0.042 and 0.032, respectively). Compared to controls, bactericidal soap was more used by women with BV (p = 0.05). CONCLUSION: Some hygiene habits were associated to BV and/or VVC. Clinical trials should address this important issue in women's health.

OBJETIVO: Avaliar a higiene genital de mulheres com e sem vaginose bacteriana (VB) e/ou candidíase vulvovaginal (CVV). MéTODOS: Estudo transversal com mulheres em idade reprodutiva submetidas a exames ginecológicos e laboratoriais e preenchimento de questionário de higiene genital. RESULTADOS: Este estudo avaliou 166 controles saudáveis e 141 mulheres com diagnóstico de VB (n = 72), VVC (n = 61) ou ambas (n = 8). O uso de sabonete íntimo e lenços umedecidos após a micção foram hábitos mais frequentes entre mulheres saudáveis (p = 0,042 e 0,032, respectivamente). Em comparação com os controles, o sabonete bactericida foi mais usado por mulheres com VB (p = 0,05). CONCLUSãO: Alguns hábitos de higiene foram associados à VB e/ou VVC. Os ensaios clínicos devem abordar esta questão importante na saúde da mulher.

Effect of local hygiene protocols on denture-related stomatitis, biofilm, microbial load, and odor: A randomized controlled trial.

STATEMENT OF PROBLEM: Denture stomatitis affects complete denture wearers and is frequently treated with antifungals drugs, as well as treating the denture with sodium hypochlorite. Whether the limitations of these treatments can be overcome with local hygiene protocols that do not damage the denture materials or adversely affect the patient is unclear. PURPOSE: The purpose of this randomized controlled trial was to evaluate the effect of denture hygiene protocols on complete denture wearers with denture stomatitis. MATERIAL AND METHODS: For this randomized, double-blind controlled clinical trial, 108 participants were assigned to parallel groups: 0.25% sodium hypochlorite (positive control) 0.15% Triclosan, denture cleaning tablets, or denture cleaning tablets plus gingival cleaning tablets. The participants were instructed to brush the dentures and the palate and immerse the denture in the solutions. The outcomes of denture stomatitis remission, biofilm removal, decrease of microbial load (colony-forming units), and odor level of the mouth and denture were measured at baseline and after 10 days. Descriptive analyses were used for sociodemographic characterization of the participants; the Pearson chi-square test was used to compare participant frequency with different degrees of denture stomatitis. The data were not normally distributed (Shapiro-Wilks test) or homogeneous (Levene test). So, the Kruskal-Wallis and Dunn post hoc tests and Wilcoxon test were used to compare the effects of solutions and time on the variables (α=.05). RESULTS: The frequency of the highest to lowest denture stomatitis scores was significantly different for the 0.15% Triclosan and denture cleaning tablets groups. No significant difference was found among the groups in terms of denture stomatitis scores, biofilm, or colony-forming unit count of Candida spp. or C. albicans and S. mutans; a significant reduction was found in these parameters. The 0.25% sodium hypochlorite and 0.15% Triclosan treatments caused a significant reduction in Gram-negative microorganisms; these 2 protocols, and the denture cleaning tablets showed a significant reduction in Staphylococcus spp.; all protocols had similar effects. Only the S. mutans count of the palate decreased after 10 days. The odor level of the mouth and the denture was not significantly different (P=.778). CONCLUSIONS: The evaluated protocols can be recommended for the hygiene of complete dentures, since they were effective for all the variables studied.