Diagnostic accuracy of a set of clinical and radiological criteria for screening of COVID-19 using RT-PCR as the reference standard

BACKGROUND

The gold-standard method for establishing a microbiological diagnosis of COVID-19 is reverse-transcriptase polymerase chain reaction (RT-PCR). This study aimed to evaluate the accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of a set of clinical-radiological criteria for COVID-19 screening in patients with severe acute respiratory failure (SARF) admitted to intensive care units (ICUs), using reverse-transcriptase polymerase chain reaction (RT-PCR) as the reference standard.

METHODS

Diagnostic accuracy study including a historical cohort of 1009 patients consecutively admitted to ICUs across six hospitals in Curitiba (Brazil) from March to September, 2020. The sample was stratified into groups by the strength of suspicion for COVID-19 (strong versus weak) using parameters based on three clinical and radiological (chest computed tomography) criteria. The diagnosis of COVID-19 was confirmed by RT-PCR (referent).

RESULTS

With respect to RT-PCR, the proposed criteria had 98.5% (95% confidence interval [95% CI] 97.5-99.5%) sensitivity, 70% (95% CI 65.8-74.2%) specificity, 85.5% (95% CI 83.4-87.7%) accuracy, PPV of 79.7% (95% CI 76.6-82.7%) and NPV of 97.6% (95% CI 95.9-99.2%). Similar performance was observed when evaluated in the subgroups of patients admitted with mild/moderate respiratory disfunction, and severe respiratory disfunction.

CONCLUSION

The proposed set of clinical-radiological criteria were accurate in identifying patients with strong versus weak suspicion for COVID-19 and had high sensitivity and considerable specificity with respect to RT-PCR. These criteria may be useful for screening COVID-19 in patients presenting with SARF.

Treatments for Burning Mouth Syndrome: A Network Meta-analysis

The aim of this systematic review and network meta-analysis (NMA) of randomized controlled trials was to evaluate the effectiveness of treatments for pain relief of burning mouth syndrome (BMS). Five databases and gray literature were searched. Independent reviewers selected studies, extracted data, and assessed the risk of bias. The primary outcome was pain relief or burning sensation, and the secondary outcomes were side effects, quality of life, salivary flow, and TNF-α and interleukin 6 levels. Four comparable interventions were grouped into different network geometries to ensure the transitivity assumption for pain: photobiomodulation therapy, alpha-lipoic acid, phytotherapics, and anxiolytics/antidepressants. Mean difference (MD) and 95% CI were calculated for continuous outcomes. The minimal important difference to consider a therapy beneficial against placebo was an MD of at least -1 for relief of pain. To interpret the results, the GRADE approach for NMA was used with a minimally contextualized framework and the magnitude of the effect. Forty-four trials were included (24 in the NMA). The anxiolytic (clonazepam) probably reduces the pain of BMS when compared with placebo (MD, -1.88; 95% CI, -2.61 to -1.16; moderate certainty). Photobiomodulation therapy (MD, -1.90; 95% CI, -3.58 to -0.21) and pregabalin (MD, -2.40; 95% CI, -3.49 to -1.32) achieved the minimal important difference of a beneficial effect with low or very low certainty. Among all tested treatments, only clonazepam is likely to reduce the pain of BMS when compared with placebo. The majority of the other treatments had low and very low certainty, mainly due to imprecision, indirectness, and intransitivity. More randomized controlled trials comparing treatments against placebo are encouraged to confirm the evidence and test possible alternative treatments (PROSPERO CRD42021255039).

Desensitizing Toothpastes for Dentin Hypersensitivity: A Network Meta-analysis

The goal of this systematic review and network meta-analysis was to compare the relative effects of toothpaste formulations for dentin hypersensitivity (DH), tested in randomized controlled trials (RCTs). We searched 7 databases to February 2019. Paired reviewers independently screened studies, extracted data, and performed risk of bias assessment. The outcome of interest was painful response measured through tactile, cold, and air stimuli. We conducted a random-effects Bayesian network meta-analysis using standardized mean difference (SMD) and their credible intervals (CIs) as the measure of effect for each pain stimuli. We assessed certainty of evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. We included 125 RCTs (12,541 patients). For tactile stimulus, the following active ingredients showed large beneficial effects compared to fluoride with moderate certainty of evidence (SMD; 95% CI): potassium + stannous fluoride (SnF₂) (3.05; 1.69-4.41), calcium sodium phosphosilicate (CSP) (2.14; 0.75-3.53), SnF₂ (2.02; 1.06-2.99), potassium + hydroxyapatite (2.47; 0.3-4.64), strontium (1.43; 0.46-2.41), and potassium (1.23; 0.48-1.98). For cold stimulus, CSP showed large beneficial effects compared to fluoride (3.93; 0.34-7.53) with moderate certainty; for air stimulus, arginine (2.22; 1.45-2.99), potassium + hydroxyapatite (2.44; 0.33-4.55), potassium + SnF₂ (2.28; 0.87-3.69), CSP (1.98; 0.99-2.98), and SnF₂ (1.9; 1.03-2.77) showed large beneficial effects compared to fluoride with moderate to high certainty. Most toothpaste formulations showed evidence of superiority against placebo or fluorides (amine fluoride, sodium monofluorophosphate, or sodium fluoride). CSP was most beneficial for all 3 stimuli with high to moderate certainty. SnF₂ alone and potassium combined with SnF₂ or hydroxyapatite were beneficial for tactile and air stimulus with high to moderate certainty. Arginine was beneficial for air stimulus, and strontium and potassium were beneficial for tactile stimulus, with moderate certainty.

Mediterranean diet is associated with bone mineral density and muscle mass in postmenopausal women

PURPOSE

This study aimed to investigate the association between the Mediterranean diet (MD), body composition, and bone mineral density (BMD) in postmenopausal women.

METHODS

In this cross-sectional study, 105 apparently healthy postmenopausal women aged between 45 and 65 years were included. BMD, percentage body fat, and appendicular lean mass index (ALMI, appendicular lean mass/height squared) were assessed by dual-energy X-ray absorptiometry. Dietary intake was assessed by a validated food frequency questionnaire. Assessment of MD adherence was based on intake of cereals, vegetables, fruits, meats, dairy products, fish, red wine, and olive oil, and expressed as the Mediterranean diet score (MDS).

RESULTS

Women with higher adherence to the MD had higher ALMI (6.6 ± 0.8 kg/m² vs. 6.3 ± 0.7 kg/m²; p = 0.039) and lumbar spine BMD (1.076 ± 0.149 vs. 0.997 ± 0.143 g/cm²; p = 0.007) compared to those with lower MDS. Linear regression analysis adjusted for previous hormone therapy, previous smoking behavior, and habitual physical activity showed an independent positive contribution of MDS to lumbar spine BMD (mean difference 0.088 g/cm², 95% confidence interval 0.028-0.147; p = 0.004) and ALMI (mean difference 0.296 kg/m², 95% confidence interval 0.020-0.591; p = 0.049).

CONCLUSION

Bone mineral density at the lumbar spine and ALMI were positively associated with the MDS in a sample of postmenopausal women from a non-Mediterranean region.

Alterations of cytochrome P450 and the occurrence of persistent organic pollutants in tilapia caged in the reservoirs of the Iguaçu River

Environmental chemicals originating from human activities, such as persistent organic pollutants (POPs), may interfere with the endocrine system of aquatic organisms. The effect of these chemicals on biota and human populations is of high public concern but remains poorly understood, especially in aquatic environments of South America. The aim of this study was to investigate the bioavailability of POPs and the related effects in caged male tilapia (Oreochromis niloticus) in four cascading reservoirs of the Iguaçu River, Southern Brazil. POPs including organochlorine pesticides (OCPs), polychlorinated biphenyl (PCBs), and polybrominated diphenyl ethers (PBDEs) were determined in the reservoir water and tissue samples of tilapia after two months of exposure. The PCB levels in water (14.7 ng L^-1) were 14 times higher than the limits permitted by the Brazilian legislation in the Salto Santiago (SS) reservoir. Similarly, concentrations of aldrin and its metabolites (6.05 ng L^-1) detected in the water sample of the Salto Osório (SO) reservoir were also above the permitted limits. RT-qPCR analysis revealed different transcript levels of cytochrome P450 enzymes (CYP1A and CYP3A) in the liver among the four groups, with induced activity in tilapia from the SS reservoir. Quantification of the CYP3A mRNA expression and catalytic activity showed higher values for fish caged at the SS reservoir. The fish from this site also had a higher number of eosinophils observed in the testes. Although overt measurements of endocrine disruption were not observed in caged fish, alteration of CYP enzymes with co-occurrence of organochlorine contaminants in water may suggest bioavailability of contaminants from agricultural sources to biota. Additional studies with feral or caged animals for a longer duration may be necessary to evaluate the risks of the waterways to humans and wildlife.

Association between malocclusion and dental caries in adolescents: a systematic review and meta-analysis

AIM

To evaluate the scientific evidence regarding the association between malocclusion and dental caries in adolescents.

METHODS

Searches were conducted of six electronic databases, complemented by manual searching of the reference lists of the selected articles and grey literature. Two independent reviewers performed the selection of the articles, data extraction and the evaluation of the risks of bias through an assessment of methodological quality. Meta-analysis was performed considering the mean decayed, missing and filled teeth (DMFT) index for caries and the Dental Aesthetic Index (DAI) for malocclusion. Heterogeneity was tested using the I² statistic and a random effect model was employed. Summary effect measures were calculated as differences in means.

RESULTS

The initial search retrieved 2644 studies, only 15 of which were selected for full-text analysis. Four cross-sectional studies were included in the qualitative systematic review. Only one of these studies found no association between malocclusion and dental caries. The meta-analysis of three studies demonstrated that a lower DAI value was significantly associated with a lower mean DMFT index, except for the comparison of DAI 26-30 vs. 31-35.

CONCLUSIONS

Based on the studies analysed, the scientific evidence indicates an association between malocclusion and dental caries.

Use of antidepressants in dentistry: A systematic review

OBJECTIVE

Previous research has suggested that antidepressants can be used in oral health care. The aim of this systematic review was to search for scientific evidence of the efficacy of the use of antidepressants in dentistry.

MATERIALS AND METHODS

The clinical question was as follows (PICO question): dentistry patients (Patients); antidepressants (Intervention); no use or placebo or other drug (Comparison); and efficacy in oral health problems (Outcome). An electronic search was conducted in seven databases, as well as a manual search without restriction regarding language and date of publication. Two independent reviewers selected studies based on eligibility criteria, extracted data and assessed methodological quality based on the PEDro scale. The PROSPERO record is number CRD42016037442.

RESULTS

A total of 15 randomized controlled trials were associated with the use of antidepressants to control chronic or acute pain in dentistry, among other conditions such as bruxism and burning mouth syndrome. The most commonly used drug in clinical trials was amitriptyline (more than 50% of studies).

CONCLUSIONS

Antidepressants may be effective in dentistry for acute and chronic pain, but there is a large amount of methodological heterogeneity among the evaluated studies. In summary, there is rationality for the indication of this class of medicine in dentistry in specific clinical situations.

Canonical correlations between agronomic traits and seed physiological quality in segregating soybean populations

The objective of this study was to evaluate the relationship between agronomic traits and physiological traits of seeds in segregating soybean populations by canonical correlation analysis. Seven populations and two commercial cultivars in three generations were used: F3 plants and F4 seeds; F4 plants and F5 seeds, and F4 seeds and plants. The following agronomic traits (group I) were evaluated: number of days to maturity, plant height at maturity, insertion height of first pod, number of pods, grain yield, and oil content. The physiological quality of seeds (group II) was evaluated using germination, accelerated aging, emergence, and emergence rate index tests. The results showed that agronomic traits and physiological traits of seeds are not independent. Intergroup associations were established by the first canonical pair for the generation of F3 plants and F4 seeds, especially between more productive plants with a larger pod number and high oil content and seeds with a high germination percentage and emergence rate. For the generation of F4 plants and F5 seeds, the first canonical pair indicated an association between reduced maturity cycle, seeds with a high emergence percentage and a high percentage of normal seedlings after accelerated aging. According to the second canonical pair, more productive and taller plants were associated with seed vigor. For the generation of F4 seeds and plants, the associations established by the first canonical pair occurred between seed vigor and more productive plants with high oil content and reduced maturity cycle, and those established by the second canonical pair between seeds of high physiological quality and tall plants.

Influence of third molars in mandibular fractures. Part 2: mandibular condyle-a meta-analysis

The aim of this systematic review was to investigate the influence of the presence and position of mandibular third molars in mandibular condyle fractures. An electronic search was conducted in PubMed, Scopus, Web of Science, Cochrane Library, and VHL, through January 2016. The eligibility criteria included observational studies. The search strategy resulted in 704 articles. Following the selection process, 13 studies were included in the systematic review and 11 in the meta-analysis. In terms of the risk of bias analysis, six studies presented ≤6 stars in the Newcastle-Ottawa scale assessment. The presence of a mandibular third molar decreased the probability of condylar fracture (cross-sectional and case-control studies: odds ratio (OR) 0.26, 95% confidence interval (CI) 0.17-0.40, I²=87.8%; case-control studies: OR 0.30, 95% CI 0.16-0.58, I²=91.6%). The third molar positions most favourable to condylar fracture according to the Pell and Gregory classification are class A (OR 1.32, 95% CI 1.09-1.61, I²=0%) and class I (OR 1.37, 95% CI 1.05-1.77, I²=32.8%). Class B (OR 0.69, 95% CI 0.49-0.97, I²=56.0%) and class II (OR 0.71, 95% CI 0.57-0.87, I²=0%) act as protective factors for condylar fracture. The results suggest that the presence of a mandibular third molar decreases the chance of condylar fracture and that the positions of the third molar most favourable for condylar fracture are classes A and I, with classes B and II acting as protective factors.

Impact of periodontal disease on quality of life: a systematic review

The diagnosis of periodontal disease is commonly based on objective evaluations of the patient's medical/dental history as well as clinical and radiographic examinations. However, periodontal disease should also be evaluated subjectively through measures that quantify its impact on oral health-related quality of life. The aim of this study was to evaluate the impact of periodontal disease on quality of life among adolescents, adults and older adults. A systematic search of the literature was performed for scientific articles published up to July 2015 using electronic databases and a manual search. Two independent reviewers performed the selection of the studies, extracted the data and assessed the methodological quality. Thirty-four cross-sectional studies involving any age group, except children, and the use of questionnaires for the assessment of the impact of periodontal disease on quality of life were included. Twenty-five studies demonstrated that periodontal disease was associated with a negative impact on quality of life, with severe periodontitis exerting the most significant impact by compromising aspects related to function and esthetics. Unlike periodontitis, gingivitis was associated with pain as well as difficulties performing oral hygiene and wearing dentures. Gingivitis was also negatively correlated with comfort. The results indicate that periodontal disease may exert an impact on quality of life of individuals, with greater severity of the disease related to greater impact. Longitudinal studies with representative samples are needed to ensure validity of the findings.

Exercise Training positively modulates the Ectonucleotidase Enzymes in Lymphocytes of Metabolic Syndrome Patients

In this study, we investigated the cardiovascular risk factors as well as ectonucleotidase activities in lymphocytes of metabolic syndrome (MetS) patients before and after an exercise intervention. 20 MetS patients, who performed regular concurrent exercise training for 30 weeks, 3 times/week, were studied. Anthropometric, biochemical, inflammatory and hepatic parameters and hydrolysis of adenine nucleotides and nucleoside in lymphocytes were collected from patients before and after 15 and 30 weeks of the exercise intervention as well as from participants of the control group. An increase in the hydrolysis of ATP and ADP, and a decrease in adenosine deamination in lymphocytes of MetS patients before the exercise intervention were observed (P<0.001). However, these alterations were reversed by exercise training after 30 weeks of intervention. Additionally, exercise training reduced the inflammatory and hepatic markers to baseline levels after 30 weeks of exercise. Our results clearly indicated alteration in ectonucleotidase enzymes in lymphocytes in the MetS, whereas regular exercise training had a protective effect on the enzymatic alterations and on inflammatory and hepatic parameters, especially if it is performed regularly and for a long period.

Effect of plant extracts and a disinfectant on biological parameters and pathogenicity of the fungus Beauveria bassiana (Bals.) Vuill. (Ascomycota: Cordycipitaceae)

The fungus Beauveria bassiana is naturally found in poultry houses and causes high rates of mortality in Alphitobius diaperinus. Laboratory and field experiments have shown the potential of this fungus as an insect control agent. However, in poultry houses, bacteria as Salmonella, can be found and have been studied alternative control methods for this pathogen. Thus, this study aimed to evaluate the effect of plant extracts and a disinfectant on the fungus Beauveria bassiana (strain Unioeste 4). Conidial viability, colony-forming unit (CFU) counts, vegetative growth, conidia production, insecticidal activity of the fungus and compatibility were used as parameters in the evaluation of the effect of these products on the fungus. Alcoholic and aqueous extracts of jabuticaba (Myrciaria cauliflora (Mart.), guava (Psidium guajava (L.)), and jambolan (Syzygium cumini (L.), at concentrations of 10% as well as the commercial disinfectant, Peroxitane® 1512 AL, were evaluated at the recommended concentrations (RC), 1:200 (RC), 0.5 RC and 2 RC. There was a negative influence of alcoholic and aqueous extracts of jabuticaba, guava and three dilutions of Peroxitane on the viability of conidia. The CFUs and vegetative growth of the fungus were affected only by the Peroxitane (all dilutions). For conidial production, the aqueous extract of guava had a positive effect, increasing production, while the Peroxitane at the R and RC concentrations resulted in a negative influence. The mortality of A. diaperinus, caused by the fungus after exposure to these products, was 60% for the peracetic acid at 0.5 RC, and above 80% for the extracts. Thus, the results showed that all the extracts and Peroxitane at RC 0.5 are compatible with the fungus B. bassiana Unioeste 4, however only the extracts had a low impact on inoculum potential.

Complex spatial and temporal variation of subtropical benthic macrofauna under sewage impact

To better understand variation in sewage-impacted benthic macrofauna from subtropical tidal flats over time and space, we applied a five-factor linear model at a hierarchy of spatial (Condition - Contaminated or Non-Contaminated, Tidal Flat and Plot) and temporal scales (Season and Fortnight). The Contaminated site showed high levels of coprostanol and the presence of Paranais cf frici as markers or indicators of organic enrichment. Differences between Seasons were more pronounced for the faunal variation patterns than for the other parameters, with lower species richness and abundance in summer. There were significant interactions between Fortnight and Tidal Flat for most variables, reflecting marked heterogeneity within Tidal Flats. Benthic community has significantly changed over short periods of time. These rapid changes may lead to erroneous interpretations and mask the true sources of variation. Our results clearly demonstrate the need to better understand benthic temporal variability even at small scales.

Association between oral conditions and functional limitations in childhood

The aim of this study was to evaluate the impact of oral conditions on functional limitations among preschoolers. A preschool-based, cross-sectional study was carried out with 843 preschoolers in Campina Grande, Brazil. Parents/caregivers answered a questionnaire addressing socio-demographic characteristics and perceptions regarding the general/oral health of their children as well as the Brazilian version of the Early Childhood Oral Health Impact Scale. The nonparametric Kruskal-Wallis test followed by Mann-Whitney test (α = 5%) was used to compare mean children's quality-of-life scores for each independent variable. Poisson regression analysis was used to test associations between the independent and dependent variables (difficulties eating, drinking and speaking) (α = 5%). The multivariate regression model involved a hierarchical approach with four levels (distal to proximal determinants): (i) socio-demographic aspects; (ii) health perceptions; (iii) oral conditions; and (iv) pain conditions. The prevalence of negative impact on function was 24.7% for eating/drinking and 8.0% for speaking. Significant associations were found between toothache and negative impact on eating/drinking (PR = 5.38; 95%CI: 3.20-9.02) as well as between high severity dental caries and negative impact on speaking (PR = 14.91; 95%CI: 1.98-112.32). Dental caries, traumatic dental injury and malocclusion were not significantly associated with a negative impact on eating or drinking. However, toothache was an indicator of negative impact on eating/drinking and dental caries severity was an indicator of negative impact on speaking.

Effects of quercetin on oxidative stress biomarkers in methimazole - induced hypothyroid rats

The objective of the present study was to evaluate the effect of quercetin on oxidative stress biomarkers in methimazole (MMI) - induced hypothyroidism male rats. Hypothyroidism was induced by administering MMI at 20 mg/100 ml in the drinking water, for 1 month. After achieved hypothyroidism, rats received orally 10 or 25 mg/kg of quercetin (QT) for 8 weeks. 60 male wistar rats were randomly divided into 6 groups (group I, control; group II, QT10; group III, QT25; group IV, hypothyroid; group V, hypothyroid+QT10; group VI, hypothyroid+QT25). Liver, kidney and serum TBARS levels significantly increased in hypothyroid rats when compared to controls, along with increased protein carbonyl (PCO) in liver and increased ROS levels in liver and kidney tissues. QT10 and QT25 were effective in decreasing TBARS levels in serum and kidney, PCO levels in liver and ROS generation in liver and kidney. MMI - induced hypothyroidism also increased TBARS levels in cerebral cortex and hippocampus that in turn were decreased in rats treated with QT25. Moreover, the administration of QT25 to hypothyroid rats resulted in decreased SOD activities in liver and whole blood and increased liver CAT activity. Liver and kidney ascorbic acid levels were restored with quercetin supplementation at both concentrations. QT10 and QT25 also significantly increased total oxidative scavenging capacity in liver and kidney tissues from hypothyroid rats. These findings suggest that MMI - induced hypothyroidism increases oxidative stress parameters and quercetin administration could exert beneficial effects against redox imbalance in hypothyroid status.

Alterations in the cholinesterase and adenosine deaminase activities and inflammation biomarker levels in patients with multiple sclerosis

Multiple sclerosis (MS) is one of the main chronic inflammatory diseases of the CNS that cause functional disability in young adults. It has unknown etiology characterized by the infiltration of lymphocytes and macrophages into the brain. The aim of this study was to evaluate the acetylcholinesterase (AChE) activity in lymphocytes and whole blood, as well as butyrylcholinesterase (BChE) and adenosine deaminase (ADA) activities in serum. We also checked the levels of nucleotides, nucleosides, biomarkers of inflammation such as cytokines (interleukin (IL)-1, IL-6, interferon (IFN)-γ, tumor necrosis factor-alpha (TNF-α) and IL-10) and C-reactive protein (CRP) in serum from 29 patients with the relapsing-remitting form of MS (RRMS) and 29 healthy subjects as the control group. Results showed that AChE in lymphocytes and whole blood as well as BChE, and ADA activities in serum were significantly increased in RRMS patients when compared to the control group (P<0.05). In addition, we observed a decrease in ATP levels and a significant increase in the levels of ADP, AMP, adenosine and inosine in serum from RRMS patients in relation to the healthy subjects (P<0.05). Results also demonstrated an increase in the IFN-γ, TNF-α, IL-1, IL-6 and CRP (P<0.05) and a significant decrease in the IL-10 (P<0.0001) in RRMS patients when compared to control. Our results suggest that alterations in the biomarkers of inflammation and hydrolysis of nucleotides and nucleosides may contribute to the understanding of the neurological dysfunction of RRMS patients.

Acute effects of resistance exercise and intermittent intense aerobic exercise on blood cell count and oxidative stress in trained middle-aged women

The aim of this study was to compare the effect of an intermittent intense aerobic exercise session and a resistance exercise session on blood cell counts and oxidative stress parameters in middle-aged women. Thirty-four women were selected and divided into three groups: RE group (performing 60 min of resistance exercises, N = 12), spinning group (performing 60 min of spinning, N = 12), and control group (not exercising regularly, N = 10). In both exercise groups, lymphocytes and monocytes decreased after 1-h recuperation (post-exercise) compared to immediately after exercise (P < 0.05). Immediately after exercise, in both exercised groups, a significant increase in TBARS (from 16.5 ± 2 to 25 ± 2 for the spinning group and from 18.6 ± 1 to 28.2 ± 3 nmol MDA/mL serum for the RE group) and protein carbonyl (from 1.0 ± 0.3 to 1.6 ± 0.2 for the spinning group and from 0.9 ± 0.2 to 1.5 ± 0.2 nmol/mg protein for the RE group) was observed (P < 0.05). A decrease in antioxidant activities (non-protein sulfhydryl, superoxide dismutase, catalase) was also demonstrated with a negative correlation between damage markers and antioxidant body defenses (P < 0.05). These results indicate that an acute bout of intermittent or anaerobic exercise induces immune suppression and increases the production of reactive oxygen species, causing oxidative stress in middle-aged and trained women. Furthermore, we demonstrated that trained women show improved antioxidant capacity and lower oxidative damage than sedentary ones, demonstrating the benefits of chronic regular physical activity.

Parents' perceptions of oral health conditions depicted in photographs of anterior permanent teeth

AIM

The aim of this study was to evaluate parents' perceptions of dental fluorosis and other oral health conditions depicted in photographs of anterior teeth.

MATERIALS AND METHODS

The sample comprised 120 parents (average age 39.3 years) whose children were undergoing dental treatment at the School of Dentistry of the Federal University of Minas Gerais. Seven photographs were selected: P1, open bite; P2, dental fluorosis TF 1 associated with open bite; P3, dental fluorosis TF 1; P4, midline deviation and crowding; P5, dental hypoplasia; P6, teeth without oral problems; P7, dental fluorosis TF 3. All photographs were randomly shown to all the parents, who classified the conditions observed based on a numeric scale: 0-19 (very unsatisfactory), 20-39 (unsatisfactory), 40-59 (neutral), 60-79 satisfactory and 80-100 (very satisfactory). The reasons for dissatisfaction and the possible treatment choice were examined.

RESULTS

P6 (normal teeth) was the most satisfactory photograph according to the parents (mean 61.2), and all photographs were statistically significantly different from one another (Mann-Whitney test, p ≤ 0.05), except the following pairs: P1 (mean 52.9) and P7 (mean 50.2) (p 0.537); P2 (mean 32.6) and P3 (mean 39.0) (p 0.073); and P5 (mean 18.9) and P4 (mean 18.4) (p 0.923). Alignment and crowding were considered the most prevalent problem in all cases (27.5 to 90.8% of parents) and orthodontic treatment was the most frequently cited option for treating all conditions (34.2 to 89.2% of parents).

CONCLUSION

In general, parents were dissatisfied with the oral conditions depicted in all photographs. Midline deviation associated to crowding (P4) and dental hypoplasia (P5) were considered the most unsatisfactory conditions. The most frequently cited oral problems by the parents were alignment and crowding. Orthodontic treatment was considered the best option by the majority of parents.

Prospective study of the association between fluoride intake and dental fluorosis in permanent teeth

OBJECTIVE

To evaluate the relationship between fluoride intake and dental fluorosis in permanent central incisors and first molars.

METHODS

Fluoride intake (mg F/kg body weight/day) from diet, dentifrice and both combined was determined on a single occasion in 1998 among children aged 19-39 months living in two fluoridated Brazilian communities (0.6-0.8 ppm F). Six years later, when the permanent teeth of these children had erupted (central incisors and first molars), 49 children aged 7-9 years [20 girls (40.8%) and 29 boys (58.2%)] were evaluated for dental fluorosis. To test the association between fluorosis and fluoride intake, children were dichotomized into two groups, cases (children with dental fluorosis on at least two teeth, TFI > or =1) and noncases (children without dental fluorosis, TFI = 0).

RESULTS

Among the case group (n = 29), median fluoride doses from diet, dentifrice and combined were 0.031, 0.050 and 0.083 mg F/kg/day, respectively. Among the noncase group (n = 20), median fluoride doses were 0.029, 0.049, 0.084 mg F/kg/day, respectively. There was no association between dental fluorosis in permanent teeth and fluoride intake from diet, dentifrice and combined (p > 0.05).

CONCLUSIONS

There was no difference between children with and without fluorosis in the permanent central incisors and first molars regarding fluoride intake. However, this study has limitations that must be recognized: fluoride intake was only measured once, and there were no children in the sample with severe degrees of dental fluorosis.

[Angiosarcoma of the spleen]

Primitive splenic tumors are extremely rare. We report a case, the first at S. José-Hospitais Civis de Lisboa, of a 70 year old woman who presented splenomegaly. She had pelvic irradiation in her past history. MRI revealed a splenic mass characterized as vascular on angiography. She is doing well 12 months after splenectomy. We have found 61 reported cases of this rare tumor whose etiopathogeny is unknown. Early splenectomy should be the first therapeutical approach, since spontaneous rupture is very common and was the feature presented in 34% of patients in the series by Autry et al. As far as cytostatic chemotherapy is concerned, the rarity of this tumor precludes any conclusion about its efficacy, but in metastasized forms it seems that chemotherapy for soft tissue sarcomas may be effective.

Dermatophilus congolensis human infection

Four cases of human dermatophilosis observed in Rio de Janeiro, Brazil, are reported. Data that suggest nail infection by Dermatophilus congolensis are presented. The clinical spectrum of the disease ranged from an asymptomatic infection to a pustular eruption. Our findings suggest that epidermal Langerhans cells play a role in the pathogenesis of the infection.

[Undifferentiated sarcoma of the liver in the adult]

A case of undifferentiated sarcoma of the liver with heart, lung and liver metastases, is reported. We emphasised the role of ultrasound for the early diagnosis of cardiac metastases. As far as we know there is no other report on this tumour in portuguese literature.