Summary: This observational study assessed the frequency and risk factors of dental damage after classic direct laryngoscopy for tracheal intubation in 536 adult patients. The patients' sex, age, height, weight, dental condition, dental mobility, Mallampati class, interincisor gap, thyromental distance, neck circumference, and head and neck extension were recorded. From anaesthesia records, the difficulty of intubation, the number of attempts, type of neuromuscular blocking agent used and duration of anaesthesia were recorded. After anaesthesia, examination revealed that 134 patients (25.0%) had dental damage affecting 162 teeth (147 maxillary; 15 mandibular). Enamel fracture was the commonest injury. In tooth number 21, the interincisor gap (OR 2.5 (95% CI 1.0–5.9)) and in tooth number 22, the number of intubation attempts ( OR 5.3 (95% CI 1.3–22.0)) were considered a risk factor for dental injury. Conventional direct laryngoscopy is associated with a strikingly high incidence of dental damage, although specific risk factors remain unclear.

Introduction: The transition from secondary to higher education is a challenging and demanding period for medical students. The ability to manage study time effectively and to be a self-regulated learner is essential to cope with the exponential growth of knowledge in medical education. Thus, the purpose of our study was to measure self-regulated learning skills and self-study across secondary higher education transition and to explore its effect on academic burnout in the first year of medical school.Material and Methods: We collected data from 102 (43%) freshman medical students on self-regulated learning, academic achievement, and hours of self-study/week relative to last year of secondary school (at the beginning of academic year) and the first year of medical school (at the end of academic year). Burnout data was collected at the end of academic year.Results: Among the 102 participants, 12% were at risk of burnout. Self-directedness at secondary school and higher education, and strategies for learning and assessment at higher education were protective factors against academic burnout. However, secondary selfdirectedness has an indirect effect on academic burnout mediated by self-directedness in the first year of medical school. In addition, self-study during class period was a risk factor for burnout.Conclusion: Our results support the premise that students experience mental health problems from an early stage at medical school. Empowering medical students to develop strategies for learning assessment and self-direction will help them manage their learning and, consequently, promote their well-being. Finally, we found that it is not academic performance that influences burnout but the time dedicated to study.

Background Facial fractures are infrequent in children and adolescents, and there are only few reports that review a significant number of patients. The objective of this study was to analyze the pattern of maxillofacial fractures in pediatric patients of Portugal. Study Design We reviewed the clinical records of a series of 1416 patients 18 years or younger with facial fractures, treated by the Department of Plastic Reconstructive, Aesthetic and of Maxillofacial Surgery of São João Hospital, Porto, Portugal, between 1993 and 2012. The following parameters were evaluated: age; sex; cause of the accident; hour, day, and month of hospital admission; location and type of fractures; presence and location of associated injuries; treatment methods; length of in-hospital stay; and complications. Results A total of 2071 fractures were treated. The ratio of boys to girls was 3.1:1. Patients between 16 and 18 years old were the major group (43.9%). Motor vehicle accident was the most common cause of injuries (48.7% of patients). Mandibular fractures were the most common (44.4%). Associated injuries occurred in 1015 patients (71.7%). Conclusions Pediatric facial fractures are usually associated with severe trauma. There has been a highly significant decrease (P < 0.001) in pediatric facial fractures in Portugal for the past 20 years.

Purpose: Maladaptive personality traits and some psychological functioning indicators have been linked to academic misbehaviour; yet their role is still poorly explored in medical students. This study aims to assess associations of academic misconduct with dark personality traits and psychological well-being. Methods: Five hundred and ninety-one medical students attending the first, third and fifth-year at one Portuguese medical school replied to the Dark Triad Dirty Dozen, Ryff’s Psychological Well-Being Scales and an original Academic Misconduct Questionnaire, using a cross-sectional design. Multiple linear regression was performed to assess associations. Results: Fifth-year medical students who scored higher in Machiavellianism and psychological well-being and perceived greater peer fraud and lower penalty for cheating reported more academic misconduct. The explanatory power of the model was 16.6%. Machiavellianism showed the strongest associations with cheating, while sex and age were not significant predictors. Conclusion: This study offers relevant insights into how maladaptive personalities influence academic misconduct in medical students, and how this relationship is moulded by psychological and contextual factors. These findings can help guide institutional actions to foster academic integrity in future physicians.