FRAGILITIES AND POTENTIALITIES IN THE ASSISTANCE NETWORK FOR PATIENTS WITH ORAL CANCER IN PALMAS, TOCANTINS, BRAZIL

O presente trabalho teve por objetivo verificar o conhecimento dos cirurgiões dentistas da rede de atenção primária, secundária e terciária do município de Palmas, Tocantins, acerca do fluxo de assistência aos pacientes com diagnóstico de câncer bucal no Sistema Único de Saúde, desde o início do tratamento até a sua conclusão. Para isso, foi aplicado um questionário semiestruturado aos grupos de profissionais envolvidos diretamente com a rede de atenção, avaliando o nível de entendimento dos cirurgiões dentistas sobre o fluxo de atendimento. Foram feitas as análises qualitativa e quantitativa. Os resultados da análise quantitativa mostraram que houve diferenças no entendimento dos profissionais dos grupos envolvidos na pesquisa em relação ao conteúdo abordado no questionário. Conclui-se que, no município de Palmas, existe a necessidade de uma maior integração entre os cirurgiões dentistas envolvidos na rede de atenção ao paciente com câncer de boca, e que a introdução de um programa de cooperação interinstitucional voltado a esses pacientes poderia contribuir com o fluxo de acompanhamento e com a qualidade de vida do doente durante e após o tratamento oncológico.   Palavras-chave: Neoplasias Bucais; Sistema Único de Saúde; Atenção à Saúde. ABSTRACT The objective of this study was to verify the knowledge of dental surgeons in the primary, secondary and tertiary care network of the city of Palmas, Tocantins, Brazil, about the care of patients with oral cancer diagnosis in the Unified Health System, from the beginning of the treatment to completion. A semi-structured questionnaire was applied to the groups of professionals directly involved in the care network, evaluating the level of understanding of the dentists about the care. Qualitative and quantitative analyzes were performed. The results of the quantitative analysis showed that there were differences in the understanding of the professionals of the groups involved in the research, in relation to the content addressed in the questionnaire. It is concluded that, in the city of Palmas, there is a need for greater integration among dental surgeons involved in the care network for patients with oral cancer, and that the introduction of an inter- institutional cooperation program for  these patients could contribute to the follow-up flow and the quality of life during and after cancer treatment. Keywords: Mouth Neoplasms; Unified Health System; Health Care.The objective of this study was to verify the knowledge of dental surgeons in the primary, secondary and tertiary care network of the city of Palmas, Tocantins, Brazil, about the care of patients with oral cancer diagnosis in the Unified Health System, from the beginning of the treatment to completion. A semi-structured questionnaire was applied to the groups of professionals directly involved in the care network, evaluating the level of understanding of the dentists about the care. Qualitative and quantitative analyzes were performed. The results of the quantitative analysis showed that there were differences in the understanding of the professionals of the groups involved in the research, in relation to the content addressed in the questionnaire. It is concluded that, in the city of Palmas, there is a need for greater integration among dental surgeons involved in the care network for patients with oral cancer, and that the introduction of an inter- institutional cooperation program for  these patients could contribute to the follow-up flow and the quality of life during and after cancer treatment

Carcinoma epidermoide intraoral em Palmas, Tocantins: uma análise de incidência

  O carcinoma epidermoide oral (CE) é um neoplasma com diferenciação escamosa originado no epitélio das mucosas da cavidade bucal, além de ser a neoplasia maligna de cabeça e pescoço mais comum, excluindo-se os carcinomas de pele não-melanomas. Os Registros de Câncer de Base Populacional (RCBP) são sistemas de informações relacionados ao Instituto Nacional do Câncer (INCA), específicos para a oncologia, que coletam, classificam e analisam os casos novos de câncer diagnosticados em moradores de uma área geográfica específica, permitindo conhecer a incidência de câncer daquela área. O presente trabalho objetivou realizar uma análise do RCBP da cidade de Palmas, Tocantins, Brasil, em um período de seis anos (2008-2013), comparado com o número de casos diagnosticados em um único serviço de atendimento municipal (Centro de Especialidades Odontológicas- CEO), no mesmo intervalo de tempo (2014-2019). Em ambos os casos, houve prevalência entre homens acima de 50 anos, o que confirma os dados epidemiológicos da OMS e do INCA relacionados ao CE. Em relação à raça, no RCBP houve predomínio da raça parda, enquanto no CEO houve predomínio da raça branca, possivelmente pelo maior número de casos em CE de lábio. Em relação à localização das lesões, no RCBP houve predomínio de CE em base de língua, enquanto no CEO houve predomínio de lesões em outras localizações. Diante destes resultados, acredita-se que (1) embora o RCBP seja um meio confiável de registro de câncer, os dados referentes à incidência de CE na população de Palmas podem estar subestimados, já que, em um mesmo intervalo de tempo, um único serviço da cidade (CEO) registrou o mesmo número de casos notificados no último RCBP; ou (2) houve um aumento real incidência de CE na população de Palmas, o que poderá ser evidenciado com a próxima divulgação de dados de registro do RCBP no período correspondente aos registros do CEO (2014-2019). Desta forma, ressalta-se a importância dos exames anatomopatológicos para a confirmação diagnóstica e a necessidade da notificação da doença pelos profissionais aos setores responsáveis, o que permite uma ampla coleta de dados epidemiológicos para o desenvolvimento de ações que minimizem os riscos do CE. &nbsp

Odontogenic myxoma in childhood

Odontogenic myxoma is a benign odontogenic tumor of ectomesenchymal origin. In adults, it is the third most frequent odontogenic tumor, but in children, this tumor is uncommon. This paper aims to report an uncommon case of an odontogenic myxoma in a 10-year-old girl. The patient was referred to a children's hospital presenting with asymptomatic facial asymmetry, noticed six months earlier. Intraoral examination showed a tumoral lesion in the right posterior maxillary region, with an expansion of the buccal bone plate, without ulceration or mucosal color change. Computed tomography revealed a hypodense lesion with extensive bone involvement in the right maxillary region, with the displacement of the tooth germ of the upper right third molar, involving the maxillary sinus, orbital floor, and nasal cavity. An incisional biopsy was performed. Gross examination revealed a grayish-white lesion, with a firm-elastic consistency. The histological sections revealed a non-encapsulated neoplasm formed by spherical and spindle-shaped cells, with a stellate arrangement in a myxoid stroma with variable amounts of collagen. There was no evidence of odontogenic epithelium. The diagnosis was odontogenic myxoma. An enucleation with vigorous curettage of the margins of the lesion was performed, and no recurrence was observed in two years of postoperative follow-up

Guidelines for the use and interpretation of assays for monitoring autophagy

In 2008 we published the first set of guidelines for standardizing research in autophagy. Since then, research on this topic has continued to accelerate, and many new scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Accordingly, it is important to update these guidelines for monitoring autophagy in different organisms. Various reviews have described the range of assays that have been used for this purpose. Nevertheless, there continues to be confusion regarding acceptable methods to measure autophagy, especially in multicellular eukaryotes. A key point that needs to be emphasized is that there is a difference between measurements that monitor the numbers or volume of autophagic elements (e.g., autophagosomes or autolysosomes) at any stage of the autophagic process vs. those that measure flux through the autophagy pathway (i.e., the complete process); thus, a block in macroautophagy that results in autophagosome accumulation needs to be differentiated from stimuli that result in increased autophagic activity, defined as increased autophagy induction coupled with increased delivery to, and degradation within, lysosomes (in most higher eukaryotes and some protists such as Dictyostelium) or the vacuole (in plants and fungi). In other words, it is especially important that investigators new to the field understand that the appearance of more autophagosomes does not necessarily equate with more autophagy. In fact, in many cases, autophagosomes accumulate because of a block in trafficking to lysosomes without a concomitant change in autophagosome biogenesis, whereas an increase in autolysosomes may reflect a reduction in degradative activity. Here, we present a set of guidelines for the selection and interpretation of methods for use by investigators who aim to examine macroautophagy and related processes, as well as for reviewers who need to provide realistic and reasonable critiques of papers that are focused on these processes. These guidelines are not meant to be a formulaic set of rules, because the appropriate assays depend in part on the question being asked and the system being used. In addition, we emphasize that no individual assay is guaranteed to be the most appropriate one in every situation, and we strongly recommend the use of multiple assays to monitor autophagy. In these guidelines, we consider these various methods of assessing autophagy and what information can, or cannot, be obtained from them. Finally, by discussing the merits and limits of particular autophagy assays, we hope to encourage technical innovation in the field

Guidelines for the use and interpretation of assays for monitoring autophagy

In 2008 we published the first set of guidelines for standardizing research in autophagy. Since then, research on this topic has continued to accelerate, and many new scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Accordingly, it is important to update these guidelines for monitoring autophagy in different organisms. Various reviews have described the range of assays that have been used for this purpose. Nevertheless, there continues to be confusion regarding acceptable methods to measure autophagy, especially in multicellular eukaryotes. A key point that needs to be emphasized is that there is a difference between measurements that monitor the numbers or volume of autophagic elements (e.g., autophagosomes or autolysosomes) at any stage of the autophagic process vs. those that measure flux through the autophagy pathway (i.e., the complete process); thus, a block in macroautophagy that results in autophagosome accumulation needs to be differentiated from stimuli that result in increased autophagic activity, defined as increased autophagy induction coupled with increased delivery to, and degradation within, lysosomes (in most higher eukaryotes and some protists such as Dictyostelium) or the vacuole (in plants and fungi). In other words, it is especially important that investigators new to the field understand that the appearance of more autophagosomes does not necessarily equate with more autophagy. In fact, in many cases, autophagosomes accumulate because of a block in trafficking to lysosomes without a concomitant change in autophagosome biogenesis, whereas an increase in autolysosomes may reflect a reduction in degradative activity. Here, we present a set of guidelines for the selection and interpretation of methods for use by investigators who aim to examine macroautophagy and related processes, as well as for reviewers who need to provide realistic and reasonable critiques of papers that are focused on these processes. These guidelines are not meant to be a formulaic set of rules, because the appropriate assays depend in part on the question being asked and the system being used. In addition, we emphasize that no individual assay is guaranteed to be the most appropriate one in every situation, and we strongly recommend the use of multiple assays to monitor autophagy. In these guidelines, we consider these various methods of assessing autophagy and what information can, or cannot, be obtained from them. Finally, by discussing the merits and limits of particular autophagy assays, we hope to encourage technical innovation in the field

Guidelines for the use and interpretation of assays for monitoring autophagy

In 2008 we published the first set of guidelines for standardizing research in autophagy. Since then, research on this topic has continued to accelerate, and many new scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Accordingly, it is important to update these guidelines for monitoring autophagy in different organisms. Various reviews have described the range of assays that have been used for this purpose. Nevertheless, there continues to be confusion regarding acceptable methods to measure autophagy, especially in multicellular eukaryotes. A key point that needs to be emphasized is that there is a difference between measurements that monitor the numbers or volume of autophagic elements (e.g., autophagosomes or autolysosomes) at any stage of the autophagic process vs. those that measure flux through the autophagy pathway (i.e., the complete process); thus, a block in macroautophagy that results in autophagosome accumulation needs to be differentiated from stimuli that result in increased autophagic activity, defined as increased autophagy induction coupled with increased delivery to, and degradation within, lysosomes (in most higher eukaryotes and some protists such as Dictyostelium) or the vacuole (in plants and fungi). In other words, it is especially important that investigators new to the field understand that the appearance of more autophagosomes does not necessarily equate with more autophagy. In fact, in many cases, autophagosomes accumulate because of a block in trafficking to lysosomes without a concomitant change in autophagosome biogenesis, whereas an increase in autolysosomes may reflect a reduction in degradative activity. Here, we present a set of guidelines for the selection and interpretation of methods for use by investigators who aim to examine macroautophagy and related processes, as well as for reviewers who need to provide realistic and reasonable critiques of papers that are focused on these processes. These guidelines are not meant to be a formulaic set of rules, because the appropriate assays depend in part on the question being asked and the system being used. In addition, we emphasize that no individual assay is guaranteed to be the most appropriate one in every situation, and we strongly recommend the use of multiple assays to monitor autophagy. In these guidelines, we consider these various methods of assessing autophagy and what information can, or cannot, be obtained from them. Finally, by discussing the merits and limits of particular autophagy assays, we hope to encourage technical innovation in the field

Strategies and performance of the CMS silicon tracker alignment during LHC Run 2

The strategies for and the performance of the CMS silicon tracking system alignment during the 2015–2018 data-taking period of the LHC are described. The alignment procedures during and after data taking are explained. Alignment scenarios are also derived for use in the simulation of the detector response. Systematic effects, related to intrinsic symmetries of the alignment task or to external constraints, are discussed and illustrated for different scenarios

Guidelines for the use and interpretation of assays for monitoring autophagy

In 2008 we published the first set of guidelines for standardizing research in autophagy. Since then, research on this topic has continued to accelerate, and many new scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Accordingly, it is important to update these guidelines for monitoring autophagy in different organisms. Various reviews have described the range of assays that have been used for this purpose. Nevertheless, there continues to be confusion regarding acceptable methods to measure autophagy, especially in multicellular eukaryotes. A key point that needs to be emphasized is that there is a difference between measurements that monitor the numbers or volume of autophagic elements (e.g., autophagosomes or autolysosomes) at any stage of the autophagic process vs. those that measure flux through the autophagy pathway (i.e., the complete process); thus, a block in macroautophagy that results in autophagosome accumulation needs to be differentiated from stimuli that result in increased autophagic activity, defined as increased autophagy induction coupled with increased delivery to, and degradation within, lysosomes (in most higher eukaryotes and some protists such as Dictyostelium) or the vacuole (in plants and fungi). In other words, it is especially important that investigators new to the field understand that the appearance of more autophagosomes does not necessarily equate with more autophagy. In fact, in many cases, autophagosomes accumulate because of a block in trafficking to lysosomes without a concomitant change in autophagosome biogenesis, whereas an increase in autolysosomes may reflect a reduction in degradative activity. Here, we present a set of guidelines for the selection and interpretation of methods for use by investigators who aim to examine macroautophagy and related processes, as well as for reviewers who need to provide realistic and reasonable critiques of papers that are focused on these processes. These guidelines are not meant to be a formulaic set of rules, because the appropriate assays depend in part on the question being asked and the system being used. In addition, we emphasize that no individual assay is guaranteed to be the most appropriate one in every situation, and we strongly recommend the use of multiple assays to monitor autophagy. In these guidelines, we consider these various methods of assessing autophagy and what information can, or cannot, be obtained from them. Finally, by discussing the merits and limits of particular autophagy assays, we hope to encourage technical innovation in the field