Rare Diseases and COVID-19: How are the Patients?

Dear Editor, When searching the scientific literature COVID-19-associated syndromes in addition to syndromes middle eastern respiratory syndrome (MERS), severe acute respiratory syndrome (SARS), some cardiovascular syndromes and post intensive care syndrome [1,2], we found the syndromes of Guillain-Barré, Miller Fisher, polyneuritis cranialis, Kawasaki, Inflammatory multisystem syndrome, and syndrome of inappropriate antidiuretic hormone secretion [3-29]. Of these, only Guillain-Barré syndrome and Miller Fisher syndrome, Kawasaki diseases and Inflammatory multisystem syndrome have currently present cranio-facial manifestation (Table 1), but possibly others will become know when the damage of COVID-19 becomes known.Although there is no standardized definition of rare diseases, the classification of rare diseases is closely related to a definition according to point prevalence in the current political and legislative context, and such definitions are based on a prevalence threshold directly or implied. According to the World Health Organization (WOS) and adopted by the Ministry of Health of Brazil, a rare disease affects up to 65 per 100,000 individuals [30]. Each rare disease, taken separately, affects a limited number of people. Considering, however, that there are up to 8,000 types of rare diseases worldwide, when grouped under a single category, their epidemiological impact may become quite significant. About 80% of those are caused by genetic factors, and the rest by other factors, such as environmental, infectious and immunologicalones [31]. Thus, rare diseases are a global challenge that must be overcome. A multi-professional and interdisciplinary team, including pediatric dentistry, oral medicine and pathology, is essential for success throughout the process

Impacto da pandemia Covid-19 na formação de acadêmicos de odontologia da Univerdade Prof. Edson Antônio Velano - Unifenas - Campus Alfenas

O Brasil, assim como o mundo todo, enfrentou um período delicado devido à pandemia da COVID-19, que tornou necessárias diversas restrições visando prevenir o contágio do vírus, situação essa que afetou diretamente os métodos de ensino durante a pandemia, sobretudo no curso de Odontologia. Uma das principais mudanças na área de educação foi a transição da modalidade de ensino presencial para o ensino à distância ou remoto, permitindo cursos que antes não podiam ser administrados online, fossem autorizados pelo Ministério da Educação a atuarem nessa modalidade. O grande desafio dessa transição para a Odontologia foi a diminuição das aulas práticas de laboratório e no ambiente clínico, além da possível falta de infraestrutura das instituições de ensino para administrar o curso nessa modalidade de ensino. Essa situação pode ter impactado tanto positivamente, quanto negativamente na formação dos acadêmicos dessa área, portanto, o objetivo deste trabalho, é apresentar dados qualitativos a respeito do impacto da pandemia do COVID-19 na formação acadêmica dos estudantes de odontologia, e, desta forma, apontar o nível de aproveitamento dos acadêmicos no ensino remoto e suas respectivas reposições de atividades práticas. Foi feito um estudo campo, observacional transversal, qualitativo, por meio de um questionário eletrônico na plataforma Google Forms, aplicado aos alunos do quarto, quinto, sexto, sétimo e oitavo período matriculados no curso de odontologia no ano letivo de 2022 na Universidade José do Rosário Vellano – Unifenas – Câmpus Alfenas. O questionário e o termo de consentimento foram enviados aos alunos de acordo com seu período por meio de aplicativos de mensagens como o WhatsApp, devido ao cenário pandêmico atual. Assim, após a coleta dos dados foi feita a estatística descritiva apresentando os resultados qualitativos da pesquisa

Low-intensity resistance exercise does not affect cardiac autonomic modulation in patients with peripheral artery disease

OBJECTIVE: To analyze the effect of a single bout of resistance exercise on cardiac autonomic modulation in patients with peripheral artery disease. METHODS: Fifteen patients with peripheral artery disease (age: 58.3±4.0 years) underwent the following sessions in a random order: resistance exercise (three sets of 10 repetitions of the six resistance exercises with a workload of 5-7 in the OMNI-RES scale) and control (similar to the resistance session; however, the resistance exercises were performed with no load). The frequency domain (low frequency, high frequency and sympathovagal balance) and symbolic analysis (0V, 1V and 2V patterns) of heart rate variability were obtained before and until one hour after the interventions. RESULTS: After the resistance exercise and control sessions, similar increases were observed in the consecutive heartbeat intervals (control: 720.8±28.6 vs. 790.9±34.4 ms; resistance exercise: 712.9±30.1 vs. 756.8±37.9 ms;

Guidance on mucositis assessment from the MASCC Mucositis Study Group and ISOO: an international Delphi studyResearch in context

Summary: Background: Mucositis is a common and highly impactful side effect of conventional and emerging cancer therapy and thus the subject of intense investigation. Although common practice, mucositis assessment is heterogeneously adopted and poorly guided, impacting evidence synthesis and translation. The Multinational Association of Supportive Care in Cancer (MASCC) Mucositis Study Group (MSG) therefore aimed to establish expert recommendations for how existing mucositis assessment tools should be used, in clinical care and trials contexts, to improve the consistency of mucositis assessment. Methods: This study was conducted over two stages (January 2022–July 2023). The first phase involved a survey to MASCC-MSG members (January 2022–May 2022), capturing current practices, challenges and preferences. These then informed the second phase, in which a set of initial recommendations were prepared and refined using the Delphi method (February 2023–May 2023). Consensus was defined as agreement on a parameter by >80% of respondents. Findings: Seventy-two MASCC-MSG members completed the first phase of the study (37 females, 34 males, mainly oral care specialists). High variability was noted in the use of mucositis assessment tools, with a high reliance on clinician assessment compared to patient reported outcome measures (PROMs, 47% vs 3%, 37% used a combination). The World Health Organization (WHO) and Common Terminology Criteria for Adverse Events (CTCAE) scales were most commonly used to assess mucositis across multiple settings. Initial recommendations were reviewed by experienced MSG members and following two rounds of Delphi survey consensus was achieved in 91 of 100 recommendations. For example, in patients receiving chemotherapy, the recommended tool for clinician assessment in clinical practice is WHO for oral mucositis (89.5% consensus), and WHO or CTCAE for gastrointestinal mucositis (85.7% consensus). The recommended PROM in clinical trials is OMD/WQ for oral mucositis (93.3% consensus), and PRO-CTCAE for gastrointestinal mucositis (83.3% consensus). Interpretation: These new recommendations provide much needed guidance on mucositis assessment and may be applied in both clinical practice and research to streamline comparison and synthesis of global data sets, thus accelerating translation of new knowledge into clinical practice. Funding: No funding was received