Injury Risk Estimation in Mandible-Related Surgical Procedures: A CBCT Study Based on Vital Interforaminal Anatomical Structures.

The mandibular interforaminal region has been considered safe for surgical procedures; nevertheless, the risk of injury to neurovascular structures, such as the mental foramen (MF) and its related structures (anterior loop [AL] and lingual foramina [LF]) should not be overlooked. The study aimed to evaluate the relative risk of injury to these structures during surgical procedures in the anterior region of the mandible based on cone-beam computed tomography (CBCT) scans. A retrospective cross-sectional and observational study was performed on 250 CBCTs from adults (18-69 years) with dentate jaws. Linear measurements of the MF, AL, and LF were evaluated to estimate the risk of injury to these structures during chin-related surgical procedures. The most frequent distance between the base of the mandible (BM) and MF was 8 mm (30.2%). In addition, 20.4% of the CTs had 6 mm from the vestibular cortical bone to the LF. The commonly found measurement from LF to the apex of the nearest tooth was 7 mm (24.0%); 64.2% of the CTs showed a 2-mm distance between the most distal point of the dental implant site to the most anterior point of the AL. Safety distances for genioplasty techniques (MF to mandible base > 6 mm, 96.6% [CI 95%, 95.0%-98.2%]) were observed. Considering the 5-mm cut-off point between the lower limit of a hypothetical bone graft and the chin, 65.4% (CI 95%, 58.9%-71.9%) of CTs were within this distance. Regarding the safety margin of 8 mm, 85.6% (CI 95%, 80.8%-90.4%) were up to this value. This study found safety margins for genioplasty and chin bone grafting surgical techniques that adopt a 5-mm cut-off point. Further similar studies assessing other surgical methods and employing larger samples from different geographical origins may contribute to this field of investigation.

Salivary immunoglobulin levels and periodontal indices in Brazilian children with and without type 1 diabetes.

This cross-sectional study evaluated the association between salivary immunoglobulins, plaque index, and gingival index in Brazilian children with and without type 1 diabetes mellitus (DM1). The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for the reporting of observational studies was followed. The DM1 group had 38 children, and an equal number of volunteers matched by sex and age were recruited as controls. Clinical examination was performed for plaque index and gingival index determination. Non-stimulated whole saliva was collected. Concentrations of IgA, IgG, and IgM were determined by ELISA test. Data were tested by the Kolmogorov-Smirnov, Mann-Whitney, and Spearman tests and a multiple linear regression model (p<0.05) was performed. Gingival index was higher in the Control (DM1: 0.16±0.17; Control: 0.24±0.23, p=0.040). In DM1, there was a correlation between IgA and age (rho=0.371, p=0.024), IgM and IgG (rho=0.459, p=0.007), and IgM and gingival index (rho=0.394, p=0.014). In DM1, multiple linear regression showed that age (p=0.041; ß=0.363), gingival index (p=0.041; ß=0.398), and plaque index (p=0.008; ß=-0.506) were good predictors of IgA levels in saliva. Thus, IgA was the only researched immunoglobulin that was directly associated with plaque and gingival indices in Brazilian children with DM1, but not in control subjects.

Chemotherapy increases the prevalence of radiotherapy-related trismus in head and neck cancer patients: A systematic review and meta-analysis.

Background: To evaluate the influence of chemotherapy on the prevalence of trismus in irradiated head and neck cancer patients. Material and Methods: This systematic review guided by PRISMA-2020 and registered in PROSPERO (CRD42021255377) screened 963 articles in 7 scientific-databases (PubMed, Lilacs, Livivo, Scopus, Embase, Web of Science, EBSCO) and 3 grey-literature databases (Open Grey, Google Scholar, ProQuest) and eight articles were included for qualitative synthesis, meta-analysis (combined odds ratio, inverse variance method plus random effects), heterogeneity analysis (I² and Tau²), one-of-out evaluation and publication bias analysis (Eggs' and Begg's tests) (RevMan®, p<0.05). The Newcastle-Ottawa Quality Assessment Scale Cohort Studies was used to assess the risk of bias (RoB). The classification assessment, development, and recommendations (GRADE) approach was used to assess the certainty of evidence. Results: The eight articles evaluated 1474 patients treated with chemoradiotherapy and 858 patients treated with radiotherapy. Five articles had low RoB, and three had high RoB. Chemoradiotherapy significantly (p=0.0003) increased the prevalence of trismus (OR=2.55, 95% CI = 1.53-4.23) compared to radiotherapy, with significant (p=0.010) but low heterogeneity (I²=59%;Tau²=0.29). There was no significant risk of publication bias, one-out analysis showed no significant difference between studies, and GRADE showed a moderate level of evidence. Trismus was directly associated to worse quality of life. Conclusions: The incidence of trismus increases when chemotherapy is combined with radiotherapy for head and neck cancer, which negatively impacts the quality of life. Key words:Radiotherapy, Chemoradiotherapy, Head and Neck Neoplasms, Trismus, Quality of Life.

Does the use of universal adhesive systems improve the durability of the bond strength of orthodontic brackets to enamel?

Background: Universal adhesive systems used for restorative clinical procedures are like orthodontics and may be a viable option. This study evaluated the effectiveness of universal adhesive systems in enhancing the durability of the shear bond strength (SBS) and adhesive remnant index (ARI) of orthodontic brackets to enamel. Material and Methods: 100 bovine incisors were divided into five groups (n=20), according to the applied adhesive systems: Primer Transbond XT; Ambar; Ambar Universal; Single Bond Universal; Adper Single Bond 2. Bracket from each tooth were submitted to SBS test after 24 hours, and 12 months later. The amount of remaining adhesive was evaluated through ARI. Results: After 24 hours, there was no difference in BS between the control and the other groups (p>0.05). However, there were difference between TOTALETCHING1 group and the Ambar Universal (p=0.015) and Single Bond Universal groups (p=0.011). After 12 months, Primer Transbond XT, Ambar, Ambar Universal and Adper Single Bond 2 showed no differences in the SBS (p>0.05). Nonetheless, Single Bond Universal presented superior result when compared to Primer Transbond XT (p=0.046) and Ambar (p=0.011) groups. The SBS of all groups reduced significantly after 12 months (p<0.05). There was no difference between ARI scores in each individually assessed group (p>0.05), for both periods. Following 24 hours, a difference was observed between the groups (p=0.043), fact that didn't occur after 12 months (p=0.109). Conclusions: Adhesive systems, such as Ambar Universal and Single Bond Universal are efficient in bonding orthodontic brackets to enamel when associated with Transbond XT adhesive paste. Key words:Bond strength; Primer Transbond XT, orthodontic brackets, adhesive systems.

Risk factors for oral mucositis in patients with solid tumorsunder treatment with cetuximab: a retrospective cross-sectional study

Background: This study retrospectively analyzed the risk factors for oral mucositis (OM) during cetuximab treatment. Material and Methods: We screened patients using cetuximab and retrospectively evaluated the presence of OM based on medical records. We collected information from 2 years of evaluations. Patient medical records were reviewed to obtain data on chemotherapy cycle and dose, sex, age, primary tumor, TNM stage, and head and neck radiotherapy (HNR) history. The X2 test and multinomial logistic regression were used for statistical analysis (SPSS 20.0, p < 0.05). Results: Among 1831 patients, OM was showed in 750 in any grade (41%), during cetuximab treatment. Most patients were female (n=944, 51.6%), <70years-old (n=1149, 62.8%), had larynx cancer (n=789, 43.1%) in T4 (n=579, 47.7%), N0 (n=509, 52.6%) stages. Primary tumor surgery was performed in 1476 (80.6%) patients, radiotherapy in 606 (33.1%) patients and cetuximab protocols most used involved up to four cycles (n=1072, 58.5%) of <400mg (n=996, 54.4%) cetuximab doses. Female (OR [odds ratio] = 2.17, CI95% = 1.26-3.75), >70 years-old patients (OR = 16.02, CI95% = 11.99-21.41), with HHNR (OR = 1.84, 1.41-2.40), treated with >4 cycles (OR = 1.52, CI95% = 1.16-2.01) and high doses of cetuximab (OR = 3.80, CI95% = 2.52-5.71) are the greatest risk factors for OM. Conclusions: Since the clinical benefit of cetuximab in the treatment of older patients is limited and there is a high OM, especially in women with head and neck treated with radiotherapy, high doses and a high number of cetuximab cycles must be administered with caution. (AU)

Role of collagen and immunostaining for TGF-β in the clinical andmicroscopic findings of pyogenic granuloma and peripheral ossifying fibroma

Background: Collagen is a component of Pyogenic Granuloma (PG) and Peripheral Ossifying Fibroma (POF) and performs different functions in these lesions. The objective of this study is to evaluate the role of collagen and immunostaining for Transforming Growth Factor beta (TGF-β) in the clinical and microscopic findings of PG and POF. Material and Methods: PG (n=20) and POF (n=20) were selected for clinical evaluation (sex, age, localization, size and evolution time) and microscopic analysis (picrosirius red staining for collagen analysis and immunohistochemistry for TGF-β) performed in the superficial and deep areas of the two lesions. ANOVA/Bonferroni and t-test, Pearson correlation and χ2 were used to compare the sites and parameters analyzed (p<0.05, GraphPad Prism 5.0). Results: The depth of PG presented the highest amount of collagen (p<0.001), and its surface showed the lowest amount of type 1 collagen (yellow-red strong birefringence). Type 1 collagen gradually increased in depth of PG, surface and depth of POF (p<0.001). The number of TGF-β+ cells was lower on the surface of PG compared with the depth of PG and the two areas of POF (p<0.001). Sex and localization did not affect these parameters, but the profile of collagen and immunostaining for TGF-β suffered from modifications by the time of evolution and the size of the lesion. Conclusions: Although PG and POF are reactive gingival lesions, the expression of TGF-β and its role in collagen showed different biological behaviors in these lesions, suggesting different biological origins for its components. (AU)

Prevalência de anomalias dentárias e outros achados orais em radiografias panorâmicas de brasileiros com fissura labiopalatal: um estudo retrospectivo / Prevalence of dental anomalies and other oral findings on panoramic radiographs of Brazilian with cleft lip and palate: a retrospective study

Objetivo: avaliar a prevalência de anomalias dentárias (AD) e outros achados orais em radiografias panorâmicas de pacientes com fissuras labiopalatais (FLP) nascidos no Nordeste brasileiro. Métodos: a amostra foi composta por 69 pacientes com fissuras labiopalatais unilateral (FLPu) (n = 51) e bilateral (FLPb) (n = 18), não sindrômicos, de ambos os sexos, idade de 6 a 17 anos, nascidos no Nordeste brasileiro. Foram analisados prontuários e radiografias panorâmicas de pacientes atendidos de janeiro/2020 a julho/2022. Os dados categóricos foram expressos em forma de frequência absoluta e percentual e comparados por teste exato de Fisher ou qui-quadrado de Pearson (SPSS, p < 0,05). Resultados: entre os achados orais, destacaram-se as anomalias de número e as ausências dentárias por trauma, cárie ou doença periodontal. As AD foram identificadas em 34 pacientes (49,3%). As anomalias de número apresentaram maior prevalência, com diferença estatística significativa para pacientes FLPb do sexo masculino (p = 0,047). A agenesia foi a AD mais frequente (n = 24; 34,8%). As ausências dentárias por trauma, cárie ou doença periodontal foram observadas em 44 pacientes (n = 63,8%), com uma diferença estatística significativa entre os grupos FLPu e FLPb (p = 0,018). Conclusões: as AD e as ausências dentárias por trauma, cárie ou doença periodontal apresentaram uma alta prevalência entre pacientes brasileiros com FLP e devem ser consideradas durante o planejamento ortodôntico-cirúrgico desses indivíduos.

Aim: this study aimed to assess the prevalence of dental anomalies (DA) and other oral findings in panoramic radiographs of patients with cleft lip and palate (CLP) born in the Northeast region of Brazil. Methods: the sample consisted of 69 patients with unilateral cleft lip and palate (UCLP) (n = 51) and bilateral cleft lip and palate (BCLP) (n = 18), non-syndromic, of both genders, aged 6 to 17 years, born in the Brazilian Northeast. Patient records and panoramic radiographs from those treated between January 2020 and July 2022 were analyzed. Categorical data were expressed as absolute frequency and percentage and compared using Fisher's exact test or Pearson's chi-square test (SPSS, p < 0.05). Results: among oral findings, anomalies in number and tooth absences due to trauma, caries, or periodontal disease stood out. DAs were identified in 34 patients (49.3%). Anomalies in number showed higher prevalence, with a statistically significant difference for male BCLP patients (p = 0.047). Agenesis was the most frequent DA (n = 24; 34.8%). Tooth absences due to trauma, caries, or periodontal disease were observed in 44 patients (63.8%), with a statistically significant difference between the UCLP and BCLP groups (p = 0.018). Conclusions: DAs and tooth absences due to trauma, caries, or periodontal disease showed a high prevalence among Brazilian patients with CLP and should be considered during the orthodontic-surgical planning for these individuals.

Photoanthropometric craniofacial parameters in individuals with osteogenesis imperfecta / Parámetros craneofaciales fotoantropométricos en personas con osteogénesis imperfecta

Background: This study aimed to evaluate facial photoanthropometric parameters in patients with OI.Material and Methods: We selected 20 Brazilian patients diagnosed with OI treated at the Extension Service forMinors in Need of Specialized Treatment of the Dentistry Course at the Federal University of Ceará (Fortaleza,Brazil), of both sexes, without age restriction, and able to understand and sign the informed consent form (ICF).As a control group, 38 non-syndromic Brazilian individuals, categorized as ASA I, able to understand and sign theICF, matched by sex, age, and Legan and Burstone facial profile were selected. The exclusion criteria were: previ-ous orthodontic treatment, craniofacial trauma and/or surgery, and the presence of any other systemic diseases.Photoanthropometric analysis of the 18 facial parameters proposed by Stengel-Rutkowski et al. (1984), previouslyestablished in the literature for craniofacial syndromes, were conducted. A single examiner digitally performedall effective and angular measurements with the CorelDRAWX7® software.Results: Horizontally shortened ears (p<0.001) but larger in height in relation to the face (p=0.012) were shownto be alterations belonging to individuals with OI.Conclusions: OI patients present distinct photoanthropometric parameters inherent in this condition.(AU)

Deficiency in infiltration of CD8/CD3 positive lymphocytes and macrophages plays a role in lip carcinogenesis: an immunohistochemical study.

OBJECTIVE: To evaluate the immunoexpression profile for CD8, CD3, CD20 and CD68 in the process and carcinogenesis of Carcinoma of the vermilion lip. METHODS: Average cell count with positive expression for CD3, CD8, CD20 and CD68. The CD8/CD3 ratio calculated in the region was based on the percentage of positive cells in a total of malignant cells. Kruska-Wallis/Dunn, Mann-Whitney and Spearman correlation tests (SPSS, p < 0.05) were used. RESULTS: In the Aquitic Cheilitis samples, there was an increase in intraepithelial CD8+ and CD68+. In LSCCs, there was an increase in peritumoral and intratumoral CD3+, CD8+, CD20+ and CD68+ cells. In peritumoral LSCC, CD3+ and CD8+ showed a direct correlation (p = 0.004), and CD68+ and CD8+ (p = 0.017). In the intraepithelial region, CD8+ correlated with CD20+ (p = 0.014) and CD68+ (p = 0.013). In the CAs, CD3 (p < 0.001) and CD8 (p = 0.025) correlated intraepithelial and subepithelial. In LSCC CD3+ (p = 0.002), CD8+ (p = 0.001) and CD68+ (p = 0.030) had intra and peritumoral correlation. CONCLUSION: CD68+ is the first interacting cell with the greatest capacity to migrate to the tumor and interact with CD3, CD8 and CD20. Apparently, CD20 affects perineural invasion. LEVEL OF EVIDENCE: Level 2.

Through the fingers: Use of plastinated anatomical specimens for visually impaired students.

The plastination technique produces non-toxic human tissues, ensuring their safe handling in educational settings. This investigation aimed to understand if visually impaired students profit from the use of plastinated anatomical specimens in learning the anatomy of the nervous system. For this purpose, their learning performance was compared to sighted and blindfolded students recruited from three primary schools in Fortaleza city, in the state of Ceará. Initially, a questionnaire was applied before carrying out the pedagogical practice, followed by an anatomy lecture with practical components with the use of plastinated anatomical specimens and synthetic anatomical models of the nervous system. After these steps, the students answered the questionnaire previously applied. Our results showed that the tactile perception of the visually impaired participants was significantly more developed compared to sighted (p < 0.001) and the blindfolded (p < 0.0001) students. The average of correct answers in the reapplied questionnaire was higher in the groups that used plastinated specimens (p < 0.05). In conclusion, the use of plastinated specimens has proven to be an effective tool in promoting a better understanding of anatomical structures, mainly for students with or without visual impairments, making it a valuable asset in anatomy teaching.

Deficiency in infiltration of CD8/CD3 positive lymphocytes and macrophages plays a role in lip carcinogenesis: an immunohistochemical study

Abstract Objective To evaluate the immunoexpression profile for CD8, CD3, CD20 and CD68 in the process and carcinogenesis of Carcinoma of the vermilion lip. Methods Average cell count with positive expression for CD3, CD8, CD20 and CD68. The CD8/CD3 ratio calculated in the region was based on the percentage of positive cells in a total of malignant cells. Kruska-Wallis/Dunn, Mann-Whitney and Spearman correlation tests (SPSS, p< 0.05) were used. Results In the Aquitic Cheilitis samples, there was an increase in intraepithelial CD8+ and CD68+. In LSCCs, there was an increase in peritumoral and intratumoral CD3+, CD8+, CD20+ and CD68+ cells. In peritumoral LSCC, CD3+ and CD8+ showed a direct correlation (p= 0.004), and CD68+ and CD8+ (p= 0.017). In the intraepithelial region, CD8+ correlated with CD20+ (p= 0.014) and CD68+ (p= 0.013). In the CAs, CD3 (p< 0.001) and CD8 (p= 0.025) correlated intraepithelial and subepithelial. In LSCC CD3+ (p= 0.002), CD8+ (p= 0.001) and CD68+ (p= 0.030) had intra and peritumoral correlation. Conclusion CD68+ is the first interacting cell with the greatest capacity to migrate to the tumor and interact with CD3, CD8 and CD20. Apparently, CD20 affects perineural invasion. Level of evidence: Level 2.

Salivary immunoglobulin levels and periodontal indices in Brazilian children with and without type 1 diabetes

Abstract This cross-sectional study evaluated the association between salivary immunoglobulins, plaque index, and gingival index in Brazilian children with and without type 1 diabetes mellitus (DM1). The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for the reporting of observational studies was followed. The DM1 group had 38 children, and an equal number of volunteers matched by sex and age were recruited as controls. Clinical examination was performed for plaque index and gingival index determination. Non-stimulated whole saliva was collected. Concentrations of IgA, IgG, and IgM were determined by ELISA test. Data were tested by the Kolmogorov-Smirnov, Mann-Whitney, and Spearman tests and a multiple linear regression model (p<0.05) was performed. Gingival index was higher in the Control (DM1: 0.16±0.17; Control: 0.24±0.23, p=0.040). In DM1, there was a correlation between IgA and age (rho=0.371, p=0.024), IgM and IgG (rho=0.459, p=0.007), and IgM and gingival index (rho=0.394, p=0.014). In DM1, multiple linear regression showed that age (p=0.041; β=0.363), gingival index (p=0.041; β=0.398), and plaque index (p=0.008; β=-0.506) were good predictors of IgA levels in saliva. Thus, IgA was the only researched immunoglobulin that was directly associated with plaque and gingival indices in Brazilian children with DM1, but not in control subjects.

Mandibular assessment of panoramic radiographs for sex identification / Análise do dimorfismo sexual através de índices radiomorfométricos em radiografias panorâmicas

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

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

Desenvolvimento de uma plataforma móvel de apoio ao ensino de infectologia para alunos de graduação em medicina de um centro universitário em fortaleza/ce / Development of a mobile platform to support the teaching of infectiology for undergraduate medicine students at a university center in fortaleza/ce / Desarrollo de una plataforma móvil de apoyo a la enseñanza de infectiología para estudiantes de grado de medicina en un centro universitario de fortaleza/ce

O rápido avanço tecnológico na área da saúde tem impacto relevante e positivo na educação médica. O amplo uso de recursos digitais teve crescimento com a pandemia de Covid-19 e impulsionou a disponibilidade de novas formas de desenvolver o ensino por meio de plataformas digitais, para o ensino híbrido e EaD. Nesse sentido, o objetivo deste estudo foi elaborar uma plataforma móvel de suporte educacional em Infectologia para graduação em Medicina. Foi avaliada a aplicabilidade e usabilidade do sistema, o seu impacto na facilitação do ensino e o grau de satisfação do usuário com a nova ferramenta. Trata-se de um estudo quantitativo, experimental, descritivo, em que a plataforma desenvolvida foi avaliada por 42 estudantes de Medicina do quarto semestre do Centro Universitário Christus (Unichristus), por meio de questionários, visando estimar a repercussão nos diferentes cenários educacionais e o grau de satisfação com esse instrumento. Quanto à sua eficácia, foi aplicada a Escala de Usabilidade de Sistema (System Usabillity Scale - SUS). Como resultado, foi analisado que a plataforma apresentou o escore SUS de 84,64, com desvio-padrão de 13,8, sendo evidenciada uma correlação de Spearman estatisticamente significativa (p<0,05). Conclui-se que a plataforma móvel em infectologia é uma ferramenta com boa aceitabilidade e facilidade na utilização, permitindo uma alternativa de abordagem eficaz de ensino na graduação de medicina.

The rapid technological advancement in the field of healthcare has a significant and positive impact on medical education. The widespread use of digital resources has seen growth with the Covid-19 pandemic and has driven the availability of new ways to deliver education through digital platforms for hybrid and distance learning. In this regard, the objective of this study was to develop a mobile educational support platform in Infectious Diseases for undergraduate medical education. The applicability and usability of the system, its impact on facilitating education, and the user satisfaction with the new tool were evaluated. This was a quantitative, experimental, descriptive study in which the developed platform was assessed by 42 fourth-semester medical students at Christus University Center (Unichristus) through questionnaires to estimate its impact on various educational scenarios and the level of satisfaction with this tool. In terms of its effectiveness, the System Usability Scale (SUS) was applied. As a result, it was found that the platform scored an SUS score of 84.64 with a standard deviation of 13.8, and a statistically significant Spearman correlation (p<0.05) was evident. It is concluded that the mobile platform in Infectious Diseases is a tool with good acceptability and ease of use, allowing for an effective alternative approach to medical education at the undergraduate level.

El rápido avance tecnológico en el campo de la salud tiene un impacto significativo y positivo en la educación médica. El uso generalizado de recursos digitales ha experimentado un crecimiento con la pandemia de Covid-19 y ha impulsado la disponibilidad de nuevas formas de brindar educación a través de plataformas digitales para la enseñanza híbrida y a distancia. En este sentido, el objetivo de este estudio fue desarrollar una plataforma de apoyo educativo móvil en Enfermedades Infecciosas para la educación médica de pregrado. Se evaluó la aplicabilidad y la usabilidad del sistema, su impacto en facilitar la educación y el nivel de satisfacción del usuario con la nueva herramienta. Este fue un estudio cuantitativo, experimental y descriptivo en el que la plataforma desarrollada fue evaluada por 42 estudiantes de medicina en su cuarto semestre en el Centro Universitario Christus (Unichristus) a través de cuestionarios para estimar su impacto en diversos escenarios educativos y el nivel de satisfacción con esta herramienta. En términos de su eficacia, se aplicó la Escala de Usabilidad del Sistema (SUS). Como resultado, se encontró que la plataforma obtuvo una puntuación de SUS de 84.64 con una desviación estándar de 13.8, y se evidenció una correlación de Spearman estadísticamente significativa (p<0.05). Se concluye que la plataforma móvil en Enfermedades Infecciosas es una herramienta con buena aceptabilidad y facilidad de uso, que permite un enfoque alternativo efectivo para la educación médica a nivel de pregrado.

Management of Cancer Therapy-Induced Oral Mucositis Using Photobiomodulation Therapy: An Overview of Systematic Reviews.

Objective: To systematically summarize the evidence for photobiomodulation therapy (PBMT) in the prevention and treatment of oral mucositis (OM) in patients undergoing cancer treatment. An electronic search was conducted in 8 databases and grey literature. Background: PBMT is recommended for the management of OM resulting from cancer treatment, with several systematic reviews (SRs) being published in recent years on this topic. Methods: Only SRs with outcomes from clinical trials were included, with no language or year restriction. The AMSTAR 2 tool was used to assess the methodological quality of the SRs. Results: Five thousand eight hundred fifty-six references were found, and 16 were selected for this review. OM prevention and treatment were favorable for PBMT in most studies, with a significant reduction in OM severity. Most studies obtained moderate confidence. Conclusions: PBMT represents an effective strategy in the management of OM, and this evidence is supported by studies with acceptable methodological quality.

Factors associated with older adults' knowledge, attitude and practice on skin cancer prevention.

OBJECTIVES: to identify factors associated with older adults' knowledge, attitude and practice regarding skin cancer prevention. METHODS: this is a cross-sectional study, carried out with 120 older adults from a Basic Health Unit in Quixadá, Ceará, from September to November 2018. RESULTS: individuals aged 60 to 69 years and working were statistically associated with adequate knowledge (p=0.038). Having light skin, eyes and hair was associated with adequate attitude (p=0.030). Having skin problems, such as bleeding wounds, was associated with adequate practice (p=0.016). With regard to inappropriate behavior for skin cancer prevention, there was a statistically significant association between working or having worked under direct exposure to the sun, inadequate knowledge (p=0.036), inadequate attitude (p=0.010) and having incomplete primary education and inadequate practice (p<0.001). CONCLUSIONS: sociodemographic and clinical factors influence older adults' knowledge, attitude and practice regarding skin cancer prevention.

Interleukin-17 plays a role in dental pulp inflammation mediated by zoledronic acid: a mechanism unrelated to the Th17 immune response?

OBJECTIVE: To evaluate the influence of RORγT inhibition by digoxin on inflammatory changes related to interleukin-17 (IL-17) in the pulp of rats treated with zoledronate (ZOL). METHODOLOGY: Forty male Wistar rats were divided into a negative control group (NCG) treated with saline solution, a positive control group (PCG) treated with ZOL (0.20 mg/kg), and three groups treated with ZOL and co-treated with digoxin 1, 2, or 4 mg/kg (DG1, 2, and 4). After four intravenous administrations of ZOL or saline solution in a 70-day protocol, the right molars were evaluated by histomorphometry (number of blood vessels, blood vessels/µm2, cells/µm2, total blood vessel area, and average blood vessel area) and immunohistochemistry (IL-17, TNF-α, IL-6, and TGF-ß). The Kruskal-Wallis/Dunn test was used for statistical analysis. RESULTS: PCG showed an increase in total blood vessel area (p=0.008) and average blood vessel area (p=0.014), and digoxin treatment reversed these changes. DG4 showed a reduction in blood vessels/µm2 (p<0.001). In PCG odontoblasts, there was an increase in IL-17 (p=0.002) and TNF-α (p=0.002) immunostaining, and in DG4, these changes were reversed. Odontoblasts in the digoxin-treated groups also showed an increase in IL-6 immunostaining (p<0.001) and a reduction in TGF-ß immunostaining (p=0.002), and all ZOL-treated groups showed an increase in IL-17 (p=0.011) and TNF-α (p=0.017) in non-odontoblasts cells. CONCLUSION: ZOL induces TNF-α- and IL-17-dependent vasodilation and ectasia, and the classical Th17 response activation pathway does not seem to participate in this process.

Tissue repair capacity of bioceramic endodontic sealers in rat subcutaneous tissue.

This study aimed to evaluate the tissue repair capacity of four bioceramic endodontic sealers by quantifying type I and III collagen fibers. The following sealers were tested: EndoSequence BC Sealer (Brasseler, Brasseler, Savannah, USA), Bio C Sealer (Angelus, Londrina, Brazil), Bioroot RCS (Septodont, Santa Catarina, Brazil), and Sealer Plus BC (MKLife, Porto Alegre, Brazil). Polyethylene tubes 1.5 mm in diameter and 1 cm in length containing the endodontic sealers were implanted in the subcutaneous tissue of five rats (Rattus norvegicus albinus, Wistar lineage). After 14 days, the animals were euthanized, and collagen fibers were quantified from the histological tissue sections. Given a non-normal distribution of the data, a gamma regression with log link function was employed and implemented through the generalized linear models module, was used to test whether there was a significant difference between the sealers. The pairwise comparison was performed using Least significant difference. There were significant differences between the sealers for type I (p=0.001), type III (p=0.023), and total collagen (p=0.002). Overall, Bioroot sealer was statistically superior to the other sealers, except in the analysis of type III collagen, in which there was no difference between the Bioroot sealer and Bio C Sealer sealer and the control group (p>0.05). Bioroot RCS bioceramic endodontic sealer stimulates a greater production of collagen.