ESTUDO EPIDEMIOLÓGICO DE LESÕES BUCAIS NO AMBULATÓRIO DE ESTOMATOLOGIA DO HOSPITAL GERAL DE CURITIBA

Os autores apresentam o primeiro levantamento estatístico do Ambulatório de Estomatologia do HGeC (biênio 2005/2007). Além do atendimento ambulatorial, a equipe examina pacientes no leito, e participa de campanhas de prevenção do Câncer Bucal durante as Ações Cívico-Sociais do Exército Brasileiro. Nesse período foram atendidos 60 pacientes, com média de idade de 51 anos, 42 do sexo feminino e 18 do sexo masculino. Realizaram 39 biópsias.  A partir da análise dos prontuários e dos laudos dos exames histopatológico, avaliou-se a prevalência das lesões bucais de tecidos moles. As alterações observadas foram classificadas como: 1)processos proliferativos não neoplásicos - 26,6% (16/60), 2)lesões pigmentadas (negras) - 6,6% (4/60), 3)doenças infecciosas (estomatite protética) - 10,0% (6/60); 4)tumores benignos (tecido mole) - 6,6% (4/60), 5)glândulas salivares (mucocele) - 8,3% (5/60), 6)lesões e condições cancerizáveis - 25,0% (15/60) e 7)outras - 16,6% (10/60). Os resultados demonstraram um predomínio das lesões proliferativas não neoplásicas  e também lesões e condições cancerizáveis.  Lesões raras como cisto linfoepitelial bucal e fibromatose gengival hereditária também foram diagnosticadas. Concluem que maiores cuidados no diagnóstico preciso das lesões bucais são necessários, considerando-se o alto número de lesões proliferativas relacionadas freqüentemente a iatrogenias, além da importância do diagnóstico precoce do câncer bucal

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries