Inter-relação cirurgião dentista e radiologista: sucesso no diagnóstico odontológico

The present study to objective to evaluated the professional relation between dentist and the odontological radiologist to the efficiency on treatment of patient who needs image for diagnostics exams to right clinical conduction. The final informations were obtained from a 176 questionnaires that were answered only by dentist surgeons. The radiologist was excluded of this study. These informations were statistically analyzed by Epi Info 6.04/2000 computer program. A total of 54% of the professionais has a specialist proficiency degree. The standart of proficiency more frequent was dentistry witer (23,3%) and orthodontia witer (17,5%). About the place that the radiographic exams were performed, 72,9% of the professionals refered to specialized sites. The most of the professionals (70,7%) informed that has a good professional relation with the radiologist. There is a distance on a technical language used daily by a radiologists and the dentist language. The effectiveness of the radiographic exam used as a way to greater the diagnosis could be better if the professional relation radiologist/dentist and the other professionals of the odontological class.O presente estudo teve como objetivo avaliar a relação cirurgião-dentista e radiologista-odontólogo, visando à eficácia no atendimento ao paciente que necessita de exames por imagem para o diagnóstico e planejamento da conduta clínica. Os dados coletados de 176 questionários distribuídos a cirurgiões-dentistas, excluindo-se os radiologistas, foram tabulados e analisados estatisticamente pelo programa Epi Info 6.04/2000. Dos profissionais entrevistados 54% tinham título de especialista, sendo as especialidades mais freqüentes dentística (23,3%) e ortodontia (17,5%). Quanto ao local de realização do exame radiográfico, 72,9% encaminham para centros especializados. A maioria dos entrevistados (70,7%) afirma possuir um bom relacionamento profissional com o radiologista. Existe um distanciamento dos cirurgiões-dentistas em relação à linguagem técnica utilizada no cotidiano do radiologista, sendo que a eficácia do exame radiográfico como auxiliar de diagnóstico pode ser maior quando existe uma adequada relação entre o profissional radiologista-odontólogo e os demais profissionais da classe odontológica

Detecção do papilomavírus humano (HPV) em carcinoma epidermóide de lábio através da nested PCR e sua correlação com os fatores de risco, características clínicas, anatomopatológicas e de sobrevida

O papilomavírus humano (HPV) está associado à um amplo espectro de lesões em humanos e tem sido associado à carcinogênese oral. Uma das metodologias mais sensíveis e especifica para sua detecção é a reação em cadeia de polimerase (PCR). O objetivo deste estudo foi investigar a presença do DNA do HPV em carcinoma epidermóide de lábio e correlacioná-la com fatores de risco, características clínicas, anatomopatológicas e sobrevida dos pacientes estudados. A presença do DNA do HPV foi investigada através da nested PCR em 30 amostras parafinadas de carcinoma epidermóide de lábio. O DNA viral foi detectado em 43,33% (13/30) das amostras. A presença do DNA do vírus foi relacionada com: idade, sexo, etnia, graduação histológica, etilismo, tabagismo, exposição freqüente à radiação solar, estadiamento clínico e sobrevida livre de doença e nenhuma correlação entre a presença do DNA viral e os parâmetros avaliados foi observada. Estes resultados sugerem que HPV não teve participação no processo de carcinogênese dos carcinomas epidermóides de lábio estudados.Human papillomavirus (HPV) is associated with a wide spectrum of lesions in humans and has been related to the oral carcinogenesis. The most sensitive and specific methodology for its detection is the polymerase chain reaction (PCR). The aim of this study was to investigate HPV DNA presence in lip squamous cell carcinoma and to correlate it with demographic, clinicalpathologic characteristics and survival data. HPV DNA was investigated by nested PCR in 30 paraffin-embedded tissues of lip squamous cell carcinomas. HPV DNA was detected in 43,33% (13/30) of samples. Presence of viral DNA was not associated with the following factors: age, sex, race, histologic grade, etilism, tabagism, history of solar radiation exposition, clinical staging and survival of the patients. This results suggest that HPV is not related to the lip squamous cell carcinomas carcinogenesis

Oral drugs for hypertensive urgencies: systematic review and meta-analysis

CONTEXTO E OBJETIVO: Urgências hipertensivas são definidas como elevações graves na pressão arterial sem evidência de danos agudos ou progressivos a órgãos-alvo. A necessidade de tratamento é considerada urgente, mas permite um controle gradual, utilizando-se drogas orais ou sublinguais. Se o aumento na pressão arterial não está associado a risco de vida ou danos a órgãos alvo, o controle pressórico deve ser feito lentamente durante 24 horas. em relação às urgências hipertensivas, não é conhecida qual a classe de drogas anti-hipertensivas que promove os melhores resultados e há controvérsia em relação a quando e quais as drogas devem ser utilizadas nestas situações. O objetivo desta revisão foi avaliar a efetividade e a segurança de drogas orais para urgências hipertensivas. METODOS: Esta revisão sistemática da literatura foi desenvolvida no Centro Cochrane do Brasil, e na Disciplina de Medicina de Urgência e Medicina Baseada em Evidências da Universidade Federal de São Paulo (UNIFESP) - Escola Paulista de Medicina (Unifesp-EPM), de acordo com a metodologia da Colaboração Cochrane. RESULTADOS: Os 16 ensaios clínicos aleatórios selecionados incluíram 769 participantes e demonstraram um efeito superior dos inibidores da enzima conversora de angiotensina no tratamento da urgência hipertensiva, avaliada em 223 participantes. Os efeitos adversos mais frequentes para os bloqueadores de canal de cálcio foram cefaleia (35/206), rubor (17/172) e alterações do ritmo cardíaco (14/189); para os inibidores da enzima conversora de angiotensina, o efeito colateral mais frequente foi disgeusia (25/38). CONCLUSÕES: Há evidências importantes a favor do uso de inibidores da enzima conversora da angiotensina para o tratamento de urgências hipertensivas, quando comparados aos bloqueadores dos canais de cálcio, devido a maior efetividade e à menor frequência de efeitos adversos, como cefaléia e rubor facial.CONTEXT and OBJECTIVE: Hypertensive urgencies are defined as severe elevations in blood pressure without evidence of acute or progressive target-organ damage. The need for treatment is considered urgent but allows for slow control using oral or sublingual drugs. If the increase in blood pressure is not associated with risk to life or acute target-organ damage, blood pressure control must be implemented slowly over 24 hours. For hypertensive urgencies, it is not known which class of antihypertensive drug provides the best results and there is controversy regarding when to use antihypertensive drugs and which ones to use in these situations. The aim of this review was to assess the effectiveness and safety of oral drugs for hypertensive urgencies. METHODS: This systematic review of the literature was developed at the Brazilian Cochrane Center, and in the Discipline of Emergency Medicine and Evidence-Based Medicine at the Universidade Federal de São Paulo (UNIFESP) - Escola Paulista de Medicina (Unifesp-EPM), in accordance with the methodology of the Cochrane Collaboration. RESULTS: Sixteen randomized clinical trials including 769 participants were selected. They showed that angiotensin-converting enzyme inhibitors had a superior effect in treating hypertensive urgencies, evaluated among 223 participants. The commonest adverse event for calcium channel blockers were headache (35/206), flushing (17/172) and palpitations (14/189). For angiotensin-converting enzyme inhibitors, the principal side effect was bad taste (25/38). CONCLUSIONS: There is important evidence in favor of the use of angiotensin-converting enzyme inhibitors for treating hypertensive urgencies, compared with calcium channel blockers, considering the better effectiveness and the lower frequency of adverse effects (like headache and flushing)

O tabaco é um dos principais fatores etiológicos do câncer bucal: conceitos atuais

Neoplasm, tumor or cancer generic synonymies are used to designate a group of diseases that affect any part of the body.Their main common feature is the abnormal cell proliferation, usually rapid, uncontrolled and unrestrained. According to World HealthOrganization (WHO) cancer is the leading cause of death worldwide. In 2005, a total of 58 million deaths, 7.6 million (or 13%) of all of them were cancer. Among the factors that favor its development, the tobacco is considered one of the main villains. Therefore, this article, we will discuss the basics and updates about oral cancer and tobacco consumption.Neoplasia, câncer ou tumor são sinonímias genéricas, usadas para designar um grupo composto de doenças que afetam qualquer parte do organismo e têm como principal característica comum a proliferação celular anormal, geralmente rápida, desordenada e desenfreada. Segundo dados da Organização Mundial da Saúde (OMS) o câncer é a principal causa de morte mundial. Em 2005, de um total de 58 milhões de mortes, 7.6 milhões (ou 13%) de todas elas foram por câncer. Dentre os fatores que favorecem seu desenvolvimento, o tabagismo é considerado um dos principais vilões. Assim sendo, neste artigo, discorreremos sobre os conceitos básicos e atualidades a cerca do câncer bucal e o consumo do tabaco

Absence of HPV Infection Is Associated with Smoker Patients with Squamous Cell Carcinoma of the Oropharynx

The purpose of this study was to evaluate the survival of patients with SCC of the oropharynx, according to the presence of HPV and tobacco consumption. A total of 37 patients were followed up for at least 5 years after being diagnosed with SCC of the oropharynx. The biopsy tissue was submitted to the polymerase chain reaction (PCR) and in situ hybridization (ISH) methods for broad determination of HPV presence, to identify the presence of high-risk viruses (16 and 18). 12 of the 37 (32.4%) samples were HPV positive, whereas the two specific types of virus were identified in two samples for HPV-16 and in no samples for HPV-18. We observed no significant effect of the virus in survival analysis, irrespective of tobacco consumption. The level of tobacco consumption was significantly higher in the group of HPV-negative patients (P=0.0283), in which all the patients in this group were smokers. Therefore, HPV did not change the survival of patients with SCC of the oropharynx in this study, indicating that factors other than tobacco need to be studied in conjunction with it, and the level of tobacco consumption is significantly higher in the group of HPV-negative patients

Oral drugs for hypertensive urgencies: systematic review and meta-analysis

CONTEXT AND OBJECTIVE: Hypertensive urgencies are defined as severe elevations in blood pressure without evidence of acute or progressive target-organ damage. The need for treatment is considered urgent but allows for slow control using oral or sublingual drugs. If the increase in blood pressure is not associated with risk to life or acute target-organ damage, blood pressure control must be implemented slowly over 24 hours. For hypertensive urgencies, it is not known which class of antihypertensive drug provides the best results and there is controversy regarding when to use antihypertensive drugs and which ones to use in these situations. The aim of this review was to assess the effectiveness and safety of oral drugs for hypertensive urgencies. METHODS: This systematic review of the literature was developed at the Brazilian Cochrane Center, and in the Discipline of Emergency Medicine and Evidence-Based Medicine at the Universidade Federal de São Paulo - Escola Paulista de Medicina (Unifesp-EPM), in accordance with the methodology of the Cochrane Collaboration. RESULTS: Sixteen randomized clinical trials including 769 participants were selected. They showed that angiotensin-converting enzyme inhibitors had a superior effect in treating hypertensive urgencies, evaluated among 223 participants. The commonest adverse event for calcium channel blockers were headache (35/206), flushing (17/172) and palpitations (14/189). For angiotensin-converting enzyme inhibitors, the principal side effect was bad taste (25/38). CONCLUSIONS: There is important evidence in favor of the use of angiotensin-converting enzyme inhibitors for treating hypertensive urgencies, compared with calcium channel blockers, considering the better effectiveness and the lower frequency of adverse effects (like headache and flushing)

MANIFESTACIÓN BUCAL DE PARACOCCIDIOIDOMICOSIS ASOCIADA A ASPERGILOSIS. PRESENTACIÓN DE CASO

Paracoccidioidomicosis y Aspergilosis son micosis causadas respectivamente por los hongos Paracoccidioides brasiliensis y Aspergillus fumigatus, que afectan con mayor frecuencia los pulmones y posteriormente se propagan para otras regiones del cuerpo. La asociación de estas dos micosis en pacientes que no presentaban inmunosupresión es poco común. Descripción de caso clínico resaltadas: Paciente de sexo masculino de 49 años, presentó lesión en el paladar, orofaringe y región retromolar. Los exámenes histológicos, citopatológicos y microbiológicos confirmaron el diagnóstico de paracoccidioidomicosis asociada a aspergilosis. Históricamente los hongos se han considerado como la causa de infecciones de relativa significancia; sin embargo, en los últimos años se ha visto un aumento importante de las enfermedades que causan. El reconocimiento del agente etiológico en cultivos es importante para poder implementar el tratamiento adecuado, ya que éstos pueden producir daños irreversibles o llevar a la muerte del paciente. El objetivo de este trabajo fue mostrar por medio del caso clínico de un paciente que presentaba las dos mucosis asociadas em mucosa bucal y orofaringe la necesidad de exámenes complementares para el diagnóstico de las enfermedades bucales cuando los exámenes de laboratorioABSTRACTParacoccidioidomycosis and aspergillosis are, respectively, mycosis caused by Paracoccidioides brasiliensis and Aspergillus fumigatus fungi, which, most frequently, attack the lungs and later spread to other body regions. The association between both mycosis is rare in patients that do not present immunosuppression. A 49-year-old man presented with oral lesion, besides lesions on palatum, retromolar and oropharyngeal regions. Histopathological and microbiological exams confirmed the diagnosis of paracoccidioidomycosis associated to aspergillosis. Historically, fungi have been considered as the cause of relatively important infections, but, in the last years, a significant increase of diseases caused by fungi is evidenced. The recognition of the etiological agent in culture is important for the suitable treatment, once these fungi can cause irreversible damages or even death. The purpose of this study was to demonstrate, through the case of a patient who presented both mycosis associated, the need of complementary exams for the diagnosis of oral diseases, when routine laboratorial exams indicate the presence of another disease associated. de rutina indican la presencia de enfermedades asociadas