Oral Medicine and Pharmacology Teleconsulting Sessions of the Telehealth Program in one Southeastern State of Brazil

Objective: To evaluate questions concerning oral medicine- and pharmacology-related specialties of asynchronous dental teleconsulting sessions of the Telehealth Brazil Networks Program. Material and Methods: Data were collected from secondary databases of asynchronous dental teleconsulting sessions of the telehealth centers of Minas Gerais from July 2015 to July 2017. The variables for dental underlying fields and the types of questions were evaluated. Descriptive analysis was performed with the SPSS v.22.0 program. Results: 3,920 teleconsulting sessions were referred to the telehealth centers of Minas Gerais during the study period. Regarding oral medicine-related questions (n=745), most (n=469; 62.95%) addressed diagnosis, whereas the underlying field questions mostly regarded fungal, viral, and bacterial infections (17.3%), biopsies (16.4%), developmental defects and dental abnormalities (9.9%), and soft tissue tumors (9.4%). Pharmacology-related questions (n=738) mostly addressed general approaches (n=672; 91.06%), and the most common questions were about underlying fields\u27 prescriptions (44.7%), anesthetics (17.6%), adverse effects of medications and anesthetics (10.2%), and selection of anesthetics for patients with systemic conditions (9.8%). Conclusion: Most teleconsulting sessions regarded conditions or procedures common in primary health care and essential for diagnosis and treatment planning at all care levels, which suggests a need for more academic learning processes for healthcare professionals, especially in dentistry primary fields

Salivary and Serum Biochemical Analysis from Patients with Chronic Renal Failure in Hemodialysis: A Cross-Sectional Study

Objective: To compare salivary and serum biochemical levels in patients with chronic renal failure undergoing hemodialysis. Material and Methods: The sample was composed of 57 patients treated in Hemodialysis Reference Centers, from a state of Northeastern Brazilian, with age ≥21 years old with at least 3 months of hemodialysis treatment time. Serum data were obtained from records. Unstimulated and stimulated saliva were collected. Flow rate (mL/min) was measured. Spectrophotometry was performed for the measurement of salivary levels of calcium (570 nm), urea (340 nm), and creatinine (510 nm). Statistical analysis used Mann Whitney and Kruskal-Wallis tests (p<0.05). Results: Unstimulated and stimulated salivary flow rates were 0.43 mL/min and 1.69 mL/min, respectively. There was significant difference (p<0.001) of levels of calcium (5.41 mg/dL and 9.70 mg/dL), urea (118.03 mg/dL and 183.22 mg/dL) and creatinine (0.59 mg/dL and 9.20 mg/dL) between saliva and serum, respectively. Concerning the time of hemodialysis, salivary and serum calcium not exhibited significant association; however, serum urea (p=0.012) and serum creatinine (p=0.025) showed significant association to the time of hemodialysis. Conclusion: Salivary biochemical levels of urea, creatinine and calcium can indicate the presence of a possible chronic renal failure and the saliva demonstrated to be a potential auxiliary biofluid for clinical monitoring renal alterations

Mucinose oral focal: descrição de um caso clínico

The aim of this article is to report the case of a 23-year-old female patient that sought dental service for examination of an asymptomatic slow-growing large lump in the mandibular gingiva causing displacement of the right first molar. Excisional biopsy, histopathological analysis, Alcian blue/periodic acid-Schiff (PAS) staining and immunohistochemistry analysis for S-100 were performed. The diagnosis established was oral focal mucinosis. After three years, the patient is still under follow-up, without any recurrences. Although cases of oral focal mucinosis of this particular size are rare, this entity should be considered in the differential diagnosis of oral lesions located in the gingiva5015456O objetivo deste artigo é relatar o caso de uma paciente de 23 anos de idade que procurou o serviço odontológico para exame de um grande nódulo de crescimento lento, assintomático, na gengiva mandibular, o que causou deslocamento do primeiro molar direito. Foram realizadas biópsia excisional, análise histopatológica, coloração Alcian blue/periodic acid-Schiff (PAS) e análise imuno-histoquímica para S-100. O diagnóstico de mucinose oral focal foi estabelecido. A paciente ainda está sob acompanhamento, sem recorrência, após três anos. Embora os casos de mucinose oral focal com esse tamanho sejam raros, esta entidade deve ser considerada no diagnóstico diferencial das lesões orais localizadas em gengivasem informaçã

Unusual epithelial-myoepithelial carcinoma in palate: case report and immunohistochemical study

Ephitelial-myoepithelial carcinoma (EMC) is a neoplasm of salivary gland extremely rare and low-grade malig- nant, exhibiting predilection for major salivary gland, especially parotid gland. This paper described a case of EMC localized in soft palate. The initial clinical diagnosis were mucoepidermoid and adenoid cystic carcinoma. A incisional biopsy was performed, and the histological diagnosis was adenocarcinoma not otherwise specified. The patient underwent excisional biopsy, where was realized immunohistochemical analysis, staining the duct-like structures, where the inner layer of epithelial cells positively for CK 14, whereas outer layer of myoepithelial cells stained positively for smooth muscle actin (SMA) and vimentin antibodies. Based on these findings, the final histological diagnosis was EMC. The patient was submitted 30 sessions of radiotherapy, and she is being follow-up about 2 years without evidence recurrences

Clinical findings and risk factors to oral squamous cell carcinoma in young patients: a 12-year retrospective analysis

Background: In recent years have been observed an increased incidence of OSCC in young individuals. Based on this, the aim this study was to describe the clinical characteristics of all cases of OSCC in younger patients, diagnosed in two oncology referral hospitals, at the northeast region of Brazil within a 12-year period. Material and Methods: Data regarding general characteristics of patients (age, gender and tobacco and/or alcohol habits) and information about the lesions (tumor location, size, regional lymph node metastasis, distant metastasis and clinical stage) were submitted to descriptive and inferential analysis. Statistical analysis included Chi-square and Fisher’s exact tests (P<0.05). Results: Out of 2311 registered cases of OSCC, 76 (3.3%) corresponded to OSCC in patients under 45 years old. Most of them were male (n=62, 81.6%) and tobacco and/or alcohol users (n=40, 52.8%). The most frequent site was the tongue (n=31, 40.8%), with predominance of cases classified at advanced clinical stage (III and IV, n = 46, 60.5%). The advanced stage of OSCC (III and IV) was statistically associated with male gender (P=0.035), lower education level (P=0.007), intraoral sites (P<0.001), presence of pain symptomatology (P=0.006), and consumption of tobacco and/or alcohol (P=0.001). Conclusions: The profile of OSCC in young patients resembles to the commonly characteristics reported for overall population. The late diagnosis in young patients usually results in poor prognosis, associated with gender, harmful habits and tumor location. Although prevalence is low, stimulus to prevention and to early diagnosis should be addressed to young individuals exposed to risk factor

Relações genotípicas entre componentes da resistência pós-colheita em tomate cereja e salada

Este trabalho objetivou avaliar a necessidade de realizar análise de trilha individualizada para tomates tipo Salada (L. esculentum) e Cereja (L. esculentum var. cerasiforme), visando obter informações sobre quais variáveis estão relacionadas com a resistência pós-colheita (RPC), e orientar a seleção de materiais para programas de melhoramento. Realizaram-se análises de variâncias, correlações genotípicas, diagnóstico de multicolinearidade e o desdobramento das correlações genotípicas por meio de análise de trilha. As variáveis mais explicativas da RPC em tomates tipo Salada foram o diâmetro da cicatriz do pedúnculo (DCP) e o diâmetro médio do fruto (DMF); a espessura do mesocarpo (ESP) e o peso médio dos frutos (PMF) em tipo Cereja. Em tomates Cereja, ganhos podem ser obtidos na RPC por meio de seleção indireta via ESP. Estes serão maiores se dentre os frutos de maior ESP forem selecionados os de menor PMF. No caso de Salada, deve-se selecionar indiretamente os frutos de menor DCP e dentre estes os de maior DMF. A análise de trilha deve ser realizada considerando cada tipo de tomate, visto que as variáveis explicativas diferem entre estes

Survival and prognostic factors in patients with oral squamous cell carcinoma

This study aimed to evaluate sociodemographic and clinical factors influencing overall survival (OS) in patients with oral squamous cell carcinoma (OSCC). Medical charts of 547 patients with OSCC from a public hospital in northeastern Brazil seen between 1999 and 2013 were evaluated. Survival analysis was performed using the Kaplan-Meier method. The influence of age, sex, ethnicity, clinical stage, anatomical location, type of treatment, and comorbidities on the patients? prognosis was evaluated. Cox proportional hazards regression model was used to identify independent prognostic factors. The 5-year OS was 39%. Multivariate analysis showed that age < 40 years (HR = 2.20; 95%CI: 1.02-4.72) and a single treatment modality (HR = 1.91; 95%CI: 1.37-2.67) were associated with a poor prognosis, while early clinical stage resulted in better outcomes (HR = 0.38; 95%CI: 0.25-0.58). OSCC patients in advanced clinical stages, diagnosed at a younger age, and submitted to a single therapeutic modality have a poorer prognosis

Critérios brasileiros de elegibilidade à doação de sangue para pacientes dermatológicos

A focused and commented review on the impact of dermatologic diseases and interventions in the solidary act of donating blood is presented to dermatologists to better advise their patients. This is a review of current Brazilian technical regulations on hemotherapeutic procedures as determined by Ministerial Directive #1353/2011 by the Ministry of Health and current internal regulations of the Hemotherapy Center of Ribeirão Preto, a regional reference center in hemotherapeutic procedures. Criteria for permanent inaptitude: autoimmune diseases (>1 organ involved), personal history of cancer other than basal cell carcinoma, severe atopic dermatitis or psoriasis, pemphigus foliaceus, porphyrias, filariasis, leprosy, extra pulmonary tuberculosis or paracoccidioidomycosis, and previous use of etretinate. Drugs that impose temporary ineligibility: other systemic retinoids, systemic corticosteroids, 5-alpha-reductase inhibitors, vaccines, methotrexate, beta-blockers, minoxidil, anti-epileptic, and anti-psychotic drugs. Other conditions that impose temporary ineligibility: occupational accident with biologic material, piercing, tattoo, sexually transmitted diseases, herpes, and bacterial infections, among others. Discussion: Thalidomide is currently missing in the teratogenic drugs list. Although finasteride was previously considered a drug that imposed permanent inaptitude, according to its short halflife current restriction of 1 month is still too long. Dermatologists should be able to advise their patients about proper timing to donate blood, and discuss the impact of drug withdrawal on treatment outcomes and to respect the designated washout periods