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OBJECTIVE: This study aims to evaluate the effectiveness and safety of adalimumab (ADA) compared with leflunomide (LEF) in patients with Takayasu arteritis (TAK). METHOD: A retrospective cohort study was performed with the following inclusion criteria: the fulfilment of the 2022 American College Classification/European Alliance of Associations for Rheumatology criteria for TAK, age ≥18 years, and written informed consent. Forty-four patients were treated with LEF (n=28) or ADA (n=16) therapy due to relapsing/refractory disease or toxicity from previous therapy. Patients were evaluated at baseline (T0), at a median of 7.0 months (T1) and at 15.0 months of follow-up (T2). Data regarding disease activity, daily dose of prednisone, side effects and angiographic progression were analysed. RESULTS: LEF and ADA groups had similar features on the baseline visit. However, intravenous methylprednisolone was more frequently prescribed for the ADA group (p=0.019). On T1 and T2 visits, complete response rates were similar for ADA and LEF groups (75.0% and 88.5%; p=0.397 and 62.5% vs 78.3%; p=0.307), respectively. The differences remained non-significant after adjusting for baseline variables by propensity score matching. Although the ADA group had a higher median daily prednisone on visit T1 (p=0.004), it was similar on visit T2 (p=0.595). Similar rates of angiographic progression were observed in ADA and LEF groups (40% vs 25%; p=0.467). Mild-to-moderate adverse events were observed only in the LEF group (17.9%). CONCLUSION: LEF and ADA had comparable outcomes after a median of 15.0 months of follow-up. However, withdrawal from therapy and mild-to-moderate adverse events were only observed in the LEF group.

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Aim: This study aims to report the perioperative management of a patient with von Willebrand disease (vWd) who underwent orthognathic surgery. The report follows the guidelines of the Case Report Guidelines (CARE) and focuses on the steps taken to prevent bleeding during the surgical procedure. Methods: A 39-year-old female patient with skeletal Class III was treated with maxillary advancement and mandibular setback. Despite normal test results for ristocetin cofactor activity, measures were taken to prevent bleeding, including atraumatic surgical techniques, use of antifibrinolytic medication, induced hypotension during anesthesia, and preparation of blood products for transfusion during trans and postoperative periods if needed. In the end, these measures were not required. Results: The patient did not experience any bleeding during the surgical procedure or postoperative period, demonstrating the effectiveness of the measures taken to manage their blood dyscrasia. Two years after the surgery, the patient had satisfactory aesthetic and functional results and no evidence of relapse. Conclusion: Thus, this case report demonstrates that vWd does not prevent largescale oral and maxillofacial surgeries such as orthognathic surgery as long as proper precautions are taken pre-, intraand postoperatively

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Dentre as Doenças Cardiovasculares, o infarto agudo do miocárdio (IAM) é a principal causa de hospitalizações no Brasil. A educação do paciente é fundamental para uma alta segura por meio do envolvimento do paciente, da família e do cuidador e as tecnologias educacionais são as estratégias para mediar esses processos de ensino e aprendizado para troca de experiências e desenvolvimento de habilidades. Percebe-se uma lacuna relacionada a estudos que avaliam o efeito de intervenções validadas no Brasil que orientem pacientes para a alta hospitalar após o IAM. Assim, esse estudo teve por objetivo avaliar efeito de uma intervenção por cenário simulado no conhecimento de pacientes acometidos por IAM sobre cuidados após alta hospitalar. Trata-se de um estudo composto por duas etapas: estudo metodológico de elaboração e validação de conteúdo de cenário simulado para pacientes acometidos por IAM e estudo quase experimental, do tipo antes e depois de avaliação do efeito da intervenção por cenário simulado no conhecimento sobre cuidados após alta hospitalar em pacientes acometidos por IAM desenvolvido em um hospital de cuidado terciário, público e de grande porte, referência em Cardiologia da cidade de Belo Horizonte, Minas Gerais. A amostra foi composta por 58 pacientes com idade maior ou igual a 18 anos, acometidos por IAM, com ou sem supradesnivelamento do segmento ST submetidos a tratamento clínico ou Intervenção Coronária Percutânea com quadro clínico estável, orientados no tempo e espaço, e em condições de responder ao instrumento de coleta. O estudo foi desenvolvido em três fases, sendo: 1­Avaliação do conhecimento do paciente antes da intervenção; 2­Intervenção com cenário simulado e 3­Avaliação do conhecimento do paciente após a intervenção. Os dados foram submetidos a análise estatística quantitativa com os testes teste t-student e Teste de Shapiro- Wilk. Para validação de conteúdo do cenário simulado foram avaliados itens relacionados à: clareza de linguagem, pertinência prática e relevância teórica. O índice de validação de conteúdo global foi satisfatório para a análise geral do cenário pelos especialistas apresentando o valor de 100%. Em relação aos pacientes, predominou o sexo masculino (60,3%), com mediana de idade de 60 anos. O principal diagnóstico foi IAM sem supra de ST ou IAM de localização não especificada (75%) e hipertensão (70,7%) e diabetes (32,8%) como comorbidades mais prevalentes. Quanto à avaliação do conhecimento após aplicação do cenário simulado, observou- se que os domínios com melhores desempenhos foram 'Clínico', 'Exercícios', 'Dieta' e "Psicossocial" apresentando diferença significativa com valor de p=0,012; 0,028;<0,001 e 0,026, respectivamente. Na análise da média global observou-se diferença significativa (p<0,001), ou seja, houve melhora do conhecimento dos pacientes em relação aos cuidados após alta para prevenção de novos eventos coronarianos. A intervenção por cenário simulado para orientação de alta hospitalar de pacientes pós-IAM mostrou-se efetiva e modificou o conhecimento dos pacientes participantes. Ressalta-se que o planejamento da alta deve fornecer informações claras, oportunas e pautadas em evidências científicas para a garantia de uma transição suave do ambiente hospitalar para o cuidado em casa.

Among Cardiovascular Diseases, acute myocardial infarction (AMI) is the leading cause of hospitalizations in Brazil. Patient education is crucial for a safe discharge through the involvement of the patient, family, and caregiver, and educational technologies are the strategies to mediate these teaching and learning processes for the exchange of experiences and skills development. There is a gap in studies evaluating the effect of validated interventions in Brazil guiding patients for hospital discharge after AMI. Thus, this study aimed to evaluate the effect of an intervention through simulated scenarios on the knowledge of patients affected by AMI regarding post-hospital discharge care. This study consists of two stages: a methodological study for the development and validation of content in a simulated scenario for patients affected by AMI, and a quasi-experimental study, before and after the assessment of the effect of the simulated scenario intervention on knowledge about post-hospital discharge care in patients affected by AMI. The study was conducted at a large, public, tertiary care hospital, a reference in Cardiology in the city of Belo Horizonte, Minas Gerais.The sample included 58 patients aged 18 or older, affected by AMI, with or without ST-segment elevation, undergoing clinical treatment or Percutaneous Coronary Intervention with a stable clinical condition, oriented in time and space, and able to respond to the data collection instrument. The study was developed in three phases: 1 ­ Evaluation of patient knowledge before the intervention; 2 ­ Intervention with simulated scenarios; and 3 ­ Evaluation of patient knowledge after the intervention. Data were subjected to quantitative statistical analysis using the t-student test and Shapiro-Wilk test. For content validation of the simulated scenario, items related to language clarity, practical relevance, and theoretical significance were evaluated. The overall content validation index was satisfactory for the overall scenario analysis by experts, with a value of 100%. Regarding patients, males predominated (60.3%), with a median age of 60 years. The main diagnosis was AMI without ST elevation or AMI of unspecified location (75%), with hypertension (70.7%) and diabetes (32.8%) as the most prevalent comorbidities. Concerning the evaluation of knowledge after the application of the simulated scenario, it was observed that the domains with the best performances were 'Clinical,' 'Exercise,' 'Diet,' and 'Psychosocial,' showing a significant difference with values of p=0.012, 0.028, <0.001, and 0.026, respectively. In the analysis of the overall mean, a significant difference was observed (p<0.001), indicating an improvement in patients' knowledge regarding post-discharge care to prevent new coronary events. The intervention through simulated scenarios for post-AMI hospital discharge guidance proved to be effective and modified the knowledge of participating patients. It is emphasized that discharge planning should provide clear, timely information based on scientific evidence to ensure a smooth transition from the hospital environment to home care.

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OBJECTIVES: To evaluate the incorporation of repairing capsules containing different monomers and polymerization modulators on the self-healing efficiency of an experimental photopolymerizable resin-based composite. METHODS: Self-healing capsules containing different monomers and polymerization modulators were prepared by emulsion polymerization: TCDHEPT (TEGDMA and DHEPT), BTCDHEPT (Bis-GMA, TEGDMA, and DHEPT), and BTCBPO (Bis-GMA, TEGDMA, and BPO). The capsules were analyzed through Fourier transform infrared spectroscopy and scanning electron microscopy. The capsules were added into experimental photopolymerizable resin composites establishing the following groups: ER (Control without capsules), ER+BPO, ER+BPO+TCDHEPT, and ER+BTCBPO+BTCDHEPT. Filtek Z350 resin composite (3 M ESPE) was used as a commercial reference. The materials were tested for degree of conversion (DC), flexural strength (σf), elastic modulus (Ef), fracture toughness (virgin KIC), self-healing efficiency (healed KIC), and roughness. For statistical analysis, the significance value was established at an a = 0.05 level. RESULTS: When compared to the control material, the incorporation of repairing capsules did not affect DC, σf, and Ef. Fracture toughness was statistically similar between the experimental groups (p ≤ 0.05). Healed KIC was statistically different between the groups ER+TCDHEP and ER+BTCBPO+BTCDHEPT; the self-healing efficiency was higher for ER+TCDHEPT. Surface roughness was statistically similar among all groups. CONCLUSIONS: The use of self-healing capsules promoted repair of the material. Studies with material aging after the self-healing process are necessary to better demonstrate the effectiveness of this system. CLINICAL SIGNIFICANCE: The self-healing system seemed to be a promising technology to be used in self-repaired restorative materials, which may prevent restoration fractures.

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The sealing and bonding characteristics of luting cements may be affected by the application of desensitizers containing ingredients that induce chemical interaction with dentin organic matrix. This study evaluated the effect of different desensitizers on the immediate and long-term shear bond strength (SBS) of a self-adhesive resin cement (SARC) to dentin. Healthy bovine dentin specimens were used for the study. Gluma® Desensitizer, Desensibilize Nano P®, and Soothe® desensitizer were used in study groups, while the control group did not receive any treatment. Next, SARC (RelyXTM U200) in cylindrical mold was applied to the sample surface. All specimens were stored at 37 °C for 24 h or six months and tested for SBS. Additionally, water contact angle was measured using an optical tensiometer. Results were analyzed by analysis of variance and Student-t tests (p ˂ 0.05). Application of the different types of desensitizers had no significant influence on immediate or long-term SBS of SARC to dentin (p > 0.05). Differences for water contact angle were not statistically significant among the tested groups (p = 0.450). Within the limitations of the present study, it can be concluded that the application of the different types of desensitizers had no significant influence on the SBS of a SARC to dentin.

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Introdução: Os instrumentos de avaliação podem permitir a mensuração de déficits funcionais, corroborando para um diagnóstico mais assertivo. Objetivo: Investigar o conhecimento e a aplicação de instrumentos/testes de avaliação em fisioterapia neonatal e pediátrica. Métodos: Observacional, descritivo, de corte transversal, realizado entre dezembro de 2020 e abril de 2021. Foram avaliados o conhecimento e a aplicação de instrumentos/testes de avaliação por fisioterapeutas que atuam em pediatria e/ou neonatologia na cidade de Salvador/BA. A coleta foi realizada através de um formulário online, produzido pelas autoras, e composto por 24 questões. Resultados: A amostra foi composta por 70 participantes, idade média de 32,5 ± 6,6 anos, 95,7% feminino, 32,9% com pós-graduação Lato Sensu, 51,4% atuavam no regime público, 30% trabalhavam em até dois setores. A mensuração da força muscular respiratória foi o teste mais conhecido (94,3%) e a Escala de Estado Funcional Pediátrica (FSS) o instrumento menos conhecido (41,4%) pelos fisioterapeutas. O instrumento/teste mais e menos aplicados na prática clínica foram, respectivamente, a mensuração da força muscular respiratória (47,1%) e o Denver II (71,4%). Conclusão: Apesar de haver maior frequência de fisioterapeutas que relataram conhecer os instrumentos/testes analisados, houve predominância da não aplicação destes na prática clínica.

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BACKGROUND: Burning mouth syndrome (BMS) it is characterized by burning and uncomfortable sensations with no clinical alterations or laboratory findings. The evaluation of the salivary characteristics of people with BMS can help the understanding of the pathogenesis of this condition. This case-control study aimed to trace the salivary profile of women with burning mouth syndrome (BMS). MATERIAL AND METHODS: 40 women with BMS and 40 control women were recruited. Unstimulated salivary flow rate (uSFR), pH, salivary cortisol levels, salivary viscosity, and oral health impact profile (OHIP-14 questioner) were determined. P< 0.05 was considered statistically significant. RESULTS: For uSFR, mean values obtained for BMS and for control group respectively were 0.35 and 0.61 mL/min; for pH, 7.23 and 7.34; for cortisol levels, 0.36 and 0.15 µg/dL; for viscosity values, 31.1 and 45.01 mPas and for OHIP-14 scores, 21.7 and 5.7. To uSFR, cortisol levels, viscosity values and OHIP-14 scores, differences were statistically significant. Salivary cortisol levels and OHIP-14 scores were correlated positively (rho = 0.624; p< 0.05). CONCLUSIONS: BMS women have lower uSFR and salivary viscosity and higher salivary cortisol levels that were associated with worse quality of life, compared with the control group. Key words:Xerostomia, Burning mouth syndrome, Viscosity.

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Objetivo: Avaliar o efeito do envelhecimento térmico por termociclagem na estabilidade de cor e rugosidade superficial de duas resinas compostas, avaliar grau de conversão (GC), sorção (SO), solubilidade (SL) e microdureza. Material e método: Foram confeccionados 10 espécimes (6 mm x 1 mm) para cada resina: Filtek Z350 XT (Z350XT) e Estelite Sigma Quick (ES). Foram avaliados: GC, utilizando um espectrofotômetro no infravermelho, SO e SL. A avaliação da microdureza Vickers (MV) e densidade de ligações cruzadas foi realizada antes e após a imersão em etanol por 24 h. A rugosidade superficial e a estabilidade de cor (CIEDE2000) foram avaliadas antes e após envelhecimento térmico por 2000 ciclos, alternando 30 s a 5°, 37° e 55° C. A estabilidade de cor e translucidez foram avaliadas com um espectrofotômetro. Os dados foram submetidos ao teste t (α=0,05). Resultados: ES apresentou resultados de GC maiores (62,5% ± 3,7) que Z350XT (48,7% ± 6,9) (p=0,004). Ambas resinas apresentaram resultados de SO e SL similares. A MV final da ES diminuiu 13% com relação a inicial (p=0,115). Z350XT apresentou diminuição de 17% (p=0,004). ES apresentou aumento de 115% na rugosidade superficial após a termociclagem (p=0,001), enquanto a Z350XT apresentou diminuição de 35% (p=0,299). ES apresentou menor alteração de cor (0,280 ± 0,093), quando comparada a Z350XT (0,549 ± 0,183). A translucidez foi similar para ambos materiais (ES=30,80; Z350XT=30,35). Conclusão: A termociclagem influenciou na alteração de cor e rugosidade superficial das resinas compostas, demonstrando que podem ser alteradas pela degradação na matriz polimérica.

Objective: To evaluate the thermocycling effect on color stability and surface roughness of two resin composites and also evaluate the degree of conversion (GC), sorption (SO), solubility (SL) and microhardness. Material and method: 10 specimens (6 mm x 1 mm) were made for each resin: Filtek Z350 XT (Z350XT) and Estelite Sigma Quick (ES). The following were evaluated: GC, using an infrared spectroscopy, SO and SL. Vickers microhardness (MV) and cross-link density evaluation was performed before and after immersion in ethanol for 24 hours. Surface roughness and color stability (CIEDE2000) were evaluated before and after thermal aging for 2000 cycles, alternating between 30 s at 5°, 37° and 55° C. Color stability and translucency were assessed with a spectrophotometer. Data were submitted to t test (α= 0.05). Results: ES presented higher GC results (62.5% ± 3.7) than Z350XT (48.7% ± 6.9) (p= 0.004). Both resins showed similar SO and SL results. The final MV of ES decreased 13% in relation to the initial (p= 0.115). Z350XT decreased by 17% (p= 0.004). ES showed a 115% increase in surface roughness after thermocycling (p= 0.001), while the Z350XT showed a 35% decrease (p= 0.299). ES showed less color change (0.280 ± 0.093) when compared to Z350XT (0.549 ± 0.183). The translucency was similar for both materials (ES= 30.80; Z350XT= 30.35). Conclusion: Thermocycling influenced the change in color stability and surface roughness of composite resins, demonstrating that they may be altered by degradation in the polymer matrix.

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The purpose of this study was to evaluate aortic wall thickness after periodontal disease and/or obesity induction in a Wistar rat model.Sixty male Wistar rats were randomly divided into four groups: control (CT), periodontal disease (PD), obesity (OB), and obesity plus periodontal disease (OB+PD). Groups OB and OB+PD received cafeteria diet for 17 weeks. After they had acquired obesity (week 12), periodontal disease was induced by placing a silk ligature on the maxillary right second molar of groups PD and OB+PD. During the experimental period, body weight and Lee index were assessed. Mean alveolar bone loss (ABL) was evaluated, and aortas were prepared for histometric analysis of the aortic wall by ImageJ software. Body weight and Lee index increased in rats exposed to cafeteria diet. Mean ABL was higher in Groups PD and OB+PD than in control and OB (p<0.05). ABL was 18% higher in Group OB+PD than in Group PD, with statistically significant difference (p<0.001). Aortas were thicker in Groups OB and OB+PD than in control and PD groups, respectively (2.31mm ± 0.28 and 2.33 ± 0.29 vs. 2.18 ± 0.26 and 2.14 ± 0.27). Group OB differed significantly from the control group (p=0.036), and OB+PD and OB differed significantly from PD (p=0.004 and p= 0.001, respectively). Obesity alters aortic wall thickness in Wistar rats. However, the presence of periodontal disease did not affect the aortic wall thickness under the conditions of the present study.

O objetivo deste estudo foi avaliar a espessura da parede da aorta após modelos de indução de doença periodontal e/ou obesidade em ratos Wistar. Sessenta ratos Wistar machos foram aleatoriamente divididos em quatro grupos: controle (CT), doença periodontal (DP), obesidade (OB), obesidade mais doença periodontal (OB+DP). Os grupos OB e OB+DP rece beram dieta de cafeteria por 17 semanas. Após de adquirirem obesidade, (semana 12), doença periodontal foi induzido pela colocação de ligaduras de seda no segundo molar superior direito dos grupos DP e OB+DP. Durante o período experi mental, o peso corporal e índice de Lee foram obtidos. Média de perda óssea alveolar (POA) foi avaliada e as aortas preparadas para análise histométrica da parede aórtica (em mm) pelo software ImageJ. Ratos expostos a dieta de cafeteria demonstraram um aumento do peso corporal e do índice de Lee. Uma POA media maior foi observada nos grupos DP e OB+DP comparado aos grupos controle e OB (p<0.05). O grupo OB+DP, quando comparado ao grupo DP, apresentou POA 18% maior e essa diferença foi estatisticamente significativa (p<0.001). Os grupos OB e OB+DP exibiram uma espessura de aorta maior comparado aos grupos DP e controle, respectivamente (2.31 ± 0.28 e 2.33 ± 0.29 vs. 2.18 ± 0.26 e 2.14 ± 0.27). Diferenças significativas foram observadas nas comparações dos grupos OB e controle (p=0,036), e OB+DP e OB comparado ao grupo DP (p=0.004 e p= 0.001, respectivamente). A obesidade parece afetar a espessura da parede da aorta em ratos Wistar. Entretanto, a presença de doença periodontal não afetou a espessura da parede da aorta sob as condições do presente estudo.

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ABSTRACT The purpose of this study was to evaluate aortic wall thickness after periodontal disease and/or obesity induction in a Wistar rat model. Sixty male Wistar rats were randomly divided into four groups: control (CT), periodontal disease (PD), obesity (OB), and obesity plus periodontal disease (OB+PD). Groups OB and OB+PD received cafeteria diet for 17 weeks. After they had acquired obesity (week 12), periodontal disease was induced by placing a silk ligature on the maxillary right second molar of groups PD and OB+PD. During the experimental period, body weight and Lee index were assessed. Mean alveolar bone loss (ABL) was evaluated, and aortas were prepared for histometric analysis of the aortic wall by ImageJ software. Body weight and Lee index increased in rats exposed to cafeteria diet. Mean ABL was higher in Groups PD and OB+PD than in control and OB (p<0.05). ABL was 18% higher in Group OB+PD than in Group PD, with statistically significant difference (p<0.001). Aortas were thicker in Groups OB and OB+PD than in control and PD groups, respectively (2.31mm ± 0.28 and 2.33 ± 0.29 vs. 2.18 ± 0.26 and 2.14 ± 0.27). Group OB differed significantly from the control group (p=0.036), and OB+PD and OB differed significantly from PD (p=0.004 and p= 0.001, respectively). Obesity alters aortic wall thickness in Wistar rats. However, the presence of periodontal disease did not affect the aortic wall thickness under the conditions of the present study.

RESUMO O objetivo deste estudo foi avaliar a espessura da parede da aorta após modelos de indução de doença periodontal e/ou obesidade em ratos Wistar. Sessenta ratos Wistar machos foram aleatoria mente divididos em quatro grupos: controle (CT), doença periodontal (DP), obesidade (OB), obesidade mais doença periodontal (OB+DP). Os grupos OB e OB+DP rece beram dieta de cafeteria por 17 semanas. Após de adquirirem obesidade, (semana 12), doença periodontal foi induzido pela colocação de ligaduras de seda no segundo molar superior direito dos grupos DP e OB+DP. Durante o período experi mental, o peso corporal e índice de Lee foram obtidos. Média de perda óssea alveolar (POA) foi avaliada e as aortas preparadas para análise histométrica da parede aórtica (em mm) pelo software ImageJ. Ratos expostos a dieta de cafeteria demonstraram um aumento do peso corporal e do índice de Lee. Uma POA media maior foi observada nos grupos DP e OB+DP comparado aos grupos controle e OB (p<0.05). O grupo OB+DP, quando comparado ao grupo DP, apresentou POA 18% maior e essa diferença foi estatisticamente significativa (p<0.001). Os grupos OB e OB+DP exibiram uma espessura de aorta maior comparado aos grupos DP e controle, respectivamente (2.31 ± 0.28 e 2.33 ± 0.29 vs. 2.18 ± 0.26 e 2.14 ± 0.27). Diferenças significativas foram observadas nas comparações dos grupos OB e controle (p=0,036), e OB+DP e OB comparado ao grupo DP (p=0.004 e p= 0.001, respectivamente). A obesidade parece afetar a espessura da parede da aorta em ratos Wistar. Entretanto, a presença de doença periodontal não afetou a espessura da parede da aorta sob as condições do presente estudo.

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