Purpose: To investigate the relationship between sleep quality and quantity and injuries in elite soccer players and to compare sleep–wake variables and injury characteristics. Methods: The current investigation was a prospective cohort study of 23 elite male soccer players competing for 2 teams over 6 mo in the highest-level Brazilian competition. The players’ sleep behavior was monitored for 10 d in the preseason using self-reporting sleep diaries and wrist activity monitors to determine sleep duration and quality. Furthermore, injuries were recorded by the respective club’s medical teams into a specific database. Details of injuries recorded included the type, location, and severity of each injury. The results were expressed as descriptive statistics, and the significance level was set at 5%. The Mann–Whitney U test was performed to compare the sleep variables between groups. Spearman correlation coefficient and linear-regression analysis were used. Results: The results indicated a moderate negative correlation between sleep efficiency and particular injury characteristics, including absence time, injury severity, and amount of injuries. The linear-regression analysis indicated that 44% of the total variance in the number of injuries can be explained by sleep efficiency, 24% of the total variance in the absence time after injury (days) can be explained by sleep efficiency, and 47% of the total variance in the injury severity can be explained by sleep efficiency. Conclusions: Soccer players who exhibit lower sleep quality or nonrestorative sleep show associations with increased number and severity of musculoskeletal injuries.

BackgroundThe aim of this systematic review with meta-analysis was to analyze the effects of intra-pregnancy nonsurgical periodontal therapy on periodontal inflammatory biomarkers and adverse pregnancy outcomes.MethodsOn June 5, 2017, we searched PubMed, Cochrane, SCOPUS, Web of Science, LILACS, ProQuest, Open Grey, and Google Scholar databases. Randomized clinical trials in which pregnant women with chronic periodontitis underwent nonsurgical periodontal therapy, compared with an untreated group, tested for inflammatory biomarkers, and followed till delivery were included. Primary outcomes were preterm birth, low birth weight, and preeclampsia. Meta-analysis was performed with 5.3.5 version of Review Manager software.ResultsWe found 565 references in the databases, 326 after duplicates removal, 28 met criteria for full text reading, and 4 met eligibility criteria for quantitative and qualitative synthesis. Intra-pregnancy nonsurgical periodontal therapy improved periodontal clinical parameters (periodontal pocket depth, clinical attachment level, and bleeding on probing) and reduced biomarker level from gingival crevicular fluid (GCF), and some from blood serum; however, it did not influence biomarker level from umbilical cord blood. Meta-analysis showed tendency for reduction of the risk of preterm birth before 37 weeks for treated group (risk ratio (RR) = 0.54, 95% CI 0.38–0.77; p = 0.0007; inconsistency indexes (I2) 32%) but did not show any difference for low birth weight occurrence (RR = 0.78, 95%CI 0.50–1.21; p = 0.27; I2 41%). No included study considered preeclampsia as a gestational outcome.ConclusionsThese results demonstrated that the intra-pregnancy nonsurgical periodontal therapy decreased periodontal inflammatory biomarker levels from gingival crevicular fluid and some from serum blood, with no influence on inflammatory biomarker level from cord blood, and it did not consistently reduce adverse gestational adverse outcome occurrence.Systematic review registrationPROSPERO CRD42015027750 Electronic supplementary materialThe online version of this article (10.1186/s13643-017-0587-3) contains supplementary material, which is available to authorized users.

Objectives To assess the occurrence of coronal and root caries in adults with diabetes mellitus (DM).Materials and methods This study was performed accordingly to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. A search strategy was adapted for six databases, as well as gray literature. The risk of bias was assessed using the Joanna Briggs Institute critical appraisal tools for observational studies. Revman 5.3 was used to conduct five metaanalyses. The quality of evidence of meta-analysis was evaluated by GRADE. Results From 4047 titles retrieved, 29 studies were included in qualitative synthesis and 20 in quantitative synthesis. Findings showed a higher mean of DMFT in DM individuals compared with healthy controls (mean difference = 1.71; 95% CI 1.08-2.33; p < 0.01; I 2 = 55%). Individuals with type 2 DM were three times more likely to have root caries in comparison with non-DM individuals (OR = 3.17; 95% CI 1.19-8.49; p = 0.02; I 2 = 70%). Individuals with uncontrolled glycemic levels within the population with DM had higher prevalence of caries than individuals with controlled DM (OR = 3.82; 95% CI 1.12-13.07; p < 0.01; I 2 = 89%; DMFT index mean difference = 2.61; 95% CI 1.14-4.08; p < 0.01; I 2 = 75%). Conclusions Diabetes mellitus may increase the occurrence of coronal and root caries in adults. Poor glycemic control turned diabetic individuals more likely to have caries. Clinical relevance Dental caries can be an oral sign to indicate poor glycemic control in individuals with DM. Strategies to prevent root caries should be adopted in individuals with type 2 DM. Besides, dental and medical treatments should synergistically explore whether dietary habits are healthy for controlling both, DM and caries.

Resumo Trata-se de estudo transversal, com o objetivo de analisar a satisfação de usuários em relação ao atendimento em unidades de Atenção Primária à Saúde do Distrito Federal e fatores associados. Foram incluídos 4.476 usuários das 62 equipes da ESF existentes na Região de Saúde Leste; utilizou-se questionário testado previamente com perguntas abertas e fechadas. Quanto ao nível geral de satisfação, encontrou-se 54,9% dos usuários Satisfeitos e 23,0% Muito Satisfeitos. Para este desfecho Nível Geral de Satisfação houve menor satisfação nos casos que o usuário não conseguiu ser atendido (OR 12,1 p=0,01); não recebeu visita domiciliar (OR 1,7 p=0,01); é do sexo feminino (OR 1,2 p=0,01) e declarou cor/etnia não branco (OR 0,77 p=0,021). Já a “Chance do Usuário Recomendar a UBS” foi: Alta (43,4%) e Muito Alta (17,7%). De modo similar, a menor chance de recomendar foi associada a casos de não atendimento (OR 5,1 p=0,01) e ausência de visita domiciliar (OR 1,5 p=0,01); não houve associação com variáveis sociodemográficas. Evidencia-se a percepção que os serviços são satisfatórios para a maioria dos usuários. O estudo também trouxe evidências para a importância de contar com a equipe ESF completa e de expandir a visita domiciliar.

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