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Objectives: To assess the level of knowledge and attitudes regarding prenatal and infant oral health in a sample of pregnant women from Coimbra, Portugal. Methods: A self-applied questionnaire was administered to randomly selected pregnant women who attended prenatal check-ups at two public health institutions in Coimbra. Collected data included sociodemographic information, oral health knowledge and practices in pregnancy, and knowledge on oral health in children. All ethical requirements were met. Statistical analysis was conducted using descriptive and inferential methods. Variables were tested for independence using a chi-square test with a 95% confidence interval. Results: A total of 120 women enrolled in the study. Although 68.9% of participants brushed their teeth twice daily, 36.4% reported not using floss, with a statistically significant association with age (p=0.004). Half of the respondents had not attended a dental appointment before pregnancy, and 59.2% believed pregnancy could be harmful to oral health. Findings showed limited knowledge of the possible consequences of gingivitis and periodontitis to the course of pregnancy and the importance of diet in oral health. Moreover, a low level of understanding was noted regarding the existence and prevention of early childhood caries. Conclusions: Oral health-related knowledge and practices of surveyed women were in general deficient. Considering pregnancy is a period of particular interest for acquiring knowledge and good oral health practices, which are decisive for both the expectant mother and the child, our results highlight an urgent need to implement prenatal oral health care programs in this study population.

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Adenomatoid odontogenic tumor (AOT) is a benign encapsulated epithelial odontogenic tumor that shows indolent clinical behavior and predilection for young individuals. We have recently reported in a few AOT cases mutations in KRAS, which is a proto-oncogene frequently mutated in cancer types such as lung, pancreas and colorectal adenocarcinomas. We aimed to assess KRAS mutations in the hotspot codons 12, 13 and 61 in a large cohort of AOT samples and to test the association of these mutations with clinical (patients’ age, tumor site, tumor size, follicular or extrafollicular subtypes) and histopathological parameters. A convenience sample of 38 central AOT cases was included in the study. KRAS codon 12 mutations were assessed by TaqMan allele-specific qPCR (p.G12V/R) and/or Sanger sequencing, and codon 13 and 61 mutations were screened by Sanger. Histological tumor capsule thickness was evaluated by morphometric analysis. In addition, the phosphorylated form of the MAPK downstream effector ERK1/2 was investigated. Statistical analysis was carried out to test the association of KRAS mutations with clinicopathological parameters. KRAS c.35G>T mutation, leading to p.G12V, was detected in 15 cases. A novel mutation in AOT, c.34G>C, leading to p.G12R, was detected in 12 cases and the other 11 were wild-type. Codon 12 mutations were not associated with the clinicopathological parameters tested. RAS mutations are known to activate the MAPK pathway and we show AOTs express phosphorylated ERK1/2. In conclusion, a high proportion of AOT (27/38, 71%) have KRAS codon 12 mutations, which occur independently of the clinicopathological features evaluated. Collectively, these findings indicate that KRAS mutations and MAPK pathway activation is a common feature of AOT and some cancer types. Although it is unclear why different codon 12 alleles occur in different disease contexts and the complex interactions between tumor genotype-phenotype need clarification, on the basis of our results the presence of KRAS p.G12V or p.G12R can favor the AOT diagnosis in challenging oral neoplasm cases.Acknowledgements: This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brazil (CAPES) - Finance Code 001 and CNPq/Brazil. Citation Format: Carolina C. Gomes, Bruna P. Coura, Vanessa F. Bernardes, Silvia F. de Sousa, Josiane A. França, Nubia B. Pereira, Helder A. Pontes, Aline C. Batista, Danyel E. Perez, Ricardo C. Albuquerque, Lelia B. de Souza, Manoela D. Martins, Marina G. Diniz, Ricardo S. Gomez. KRAS mutations drive adenomatoid odontogenic tumor and are independent of clinicopathological features [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 4663.

Long noncoding RNAs (lncRNAs) are transcribed RNA molecules that can interact with DNA or RNA, transcription factors, histones and other chromatin modifying proteins, affecting the expression level of a broad spectrum of genes. Because of their tissue-specific expression characteristics, lncRNAs hold strong promise as novel biomarkers and therapeutic targets for diseases. High-density whole-genome microarray analysis in ameloblastomas, an aggressive odontogenic tumor, and in adenomatoid odontogenic tumor (AOT), an indolent one, showed a high frequency of copy number alteration at chromosome band 14q32.33, which encompasses the lncRNA gene KIAA0125. To understand molecular mechanisms associated with their biological behavior and considering the copy-number gains observed at 14q32.33, we aimed to investigate the expression levels of the lncRNA KIAA0125 in ameloblastomas and in AOTs. The University Ethics Committee approved this study and patients signed informed consent. Thirteen frozen samples were included: five solid/multicystic ameloblastomas, four AOT, and four dental follicles. qPCR reactions were performed in triplicates and the relative changes in gene expression were obtained using the 2^-ΔΔCt formula. The reference gene HPRT1 was used for normalization and the human keratinocyte HaCat cell line was used as calibrator. Differences in the relative changes in gene expression between two groups of samples were assessed and the significance level was set at 0.05. All samples expressed more KIAA0125 than the calibrator. The ameloblastoma group showed higher expression levels of KIAA0125 when compared to dental follicles (p=0.042), while there was no difference between the expression in ameloblastomas and AOT (p>0.05). The expression levels of KIAA0125 in AOT were not different from that of the dental follicle. Our findings suggest that lncRNA KIAA0125 is likely involved in ameloblastoma pathobiology. LncRNAs hold strong promise as therapeutic targets, and experimental validation of this lncRNA functions may lead to tailored therapies targeting KIAA0125 in extensive and recurrent ameloblastomas. Citation Format: Silvia F. Sousa, Marina G. Diniz, Josiane A. França, Fabricio A. Vilas-Boas, Fabricio T. Souza, George A. Calin, Ricardo S. Gomez, Carolina C. Gomes. The long noncoding RNA KIAA0125 is aberrantly expressed in ameloblastomas [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 1811.

Background: Cervical incompetence occasionally results in mid-trimester pregnancy loss, preterm labour and increased foetal morbimortality. History-indicated cerclage is proposed when obstetric history suggests cervical incompetence. The aim of this study was to evaluate the maternal-foetal outcomes following prophylactic cervical cerclage.Methods: Retrospective study reviewing data of all women undergoing transvaginal history-indicated cerclage from January 1st, 2008 to December 31th, 2017 at Centro Hospitalar Universitário do Algarve - Faro. Primary outcome: gestational age <37weeks at birth. Secondary outcomes: neonatal morbimortality and intensive care unit (NICU) admission and maternal morbidity. Data were analyzed with IBM SPSS Statistics 23.Results: A total of 12 history-indicated cerclages were performed (9 women). At first cerclage, mean maternal age, gestity, parity and live children were 27.6, 2.44, 1.11 and 0.78 (87.7% preterm), respectively. At cerclage placement, mean gestational age and cervical length were 16.1 weeks and 27.5mm. Average hospital admission was 10.7 days. In all cases McDonald technique was performed. Four hospital readmissions occurred for threatened labour. Mean gestational age at cerclage removal was 36.9 weeks (83.3% in ambulatory) and 38.9 at delivery. Average time between cerclage removal and labour was 14.5 days. Spontaneous onset of labour occurred in 75% and vaginal delivery in 83.4%. There were no reports of preterm birth, foetal admission to NICU or maternal complications. Mean number of live children after procedure was 1.58.Conclusions: Prophylactic cervical cerclage seems to improve pregnancy outcome with minimal maternal risks. However, our data suggest over inclusion of women, with unnecessary procedures, emphasizing the importance of re-evaluating inclusion criteria.

Spontaneous hemoperitoneum in pregnancy is a rare complication resulting in high maternal and fetal morbidity and mortality. The authors describe the case of a pregnant woman presenting at 32 weeks of gestation with abdominal pain and free abdominal fluid on ultrasound. Laparotomy revealed a hemoperitoneum resulting from a suspected ruptured varices on the uterine posterior surface. A live newborn was delivered by cesarean-section, and hemorrhage was controlled with sutures and compression. Clinicians should be aware of this diagnosis when a pregnant woman presents with abdominal pain, anemia or hypovolemic shock. Early intervention will avoid poor outcomes for both the mother and the fetus.