Oral potentially malignant disorders : clinical-pathological study of 684 cases diagnosed in a Brazilian population

The frequency and distribution of oral potentially malignant disorders (OPMD) may vary among different populations. The aim of the present study was to evaluate the clinical-pathological characteristics of OPMD diagnosed in a Brazilian oral pathology laboratory over a period of 11 years. All cases diagnosed as leukoplakia, speckled leukoplakia, erythroplakia, and actinic cheilitis from 2005 to 2015 were analyzed. Clinical information was obtained from laboratory forms and histological information was obtained from histological slides stained with hematoxylin and eosin. the final sample was comprised of 684 cases, of which 292 were males and 392 were females. The mean age was 58 years. The anatomical site most often involved was the lateral border of the tongue (23%), followed by the lower lip (20%), and by the buccal mucosa/vestibule (18%). Leukoplakia accounted for 82% of the sample (564 cases). The mean size of the leukoplakia and speckled leukoplakia lesions was 13 mm (ranging from 1 to 100 mm) and 15 mm (ranging from 5 to 30 mm), respectively (p=0.460). Males reported smoking and drinking alcohol more frequently than females (p=0.001 and p <0.0001, respectively). In half of the cases, dysplasia was not histologically detected, while slight dysplasia was detected in 28% of the cases. The lesions from patients aged from 41 to 80 years presented moderate and severe dysplasia more often than lesions from patients in other age groups. OPMD were more common in females in their sixties. Females were more frequently affected in all anatomical sites, except for the lips. Leukoplakia lesions were the most common OPMD, followed by actinic cheilitis. The lateral border of the tongue was the most affected anatomical site. OPMD located in the floor of the mouth/sublingual mucosa and lesions from older patients presented severe epithelial dysplasia with greater frequency

Caracterização epidemiológica e sociodemográfica da Leishmaniose tegumentar americanano na região franco-brasileira

A leishmaniose tegumentar americana (LTA) é uma doença parasitária, endêmica em 88 países com mais de 12 milhões de pessoas infectadas, caracterizando-se, desta maneira, como um grave problema de saúde pública. Neste contexto, esta pesquisa buscou caracterizar o perfil epidemiológico e sociodemográfico de casos notificados e atendidos de LTA no município do Oiapoque-Amapá, durante os anos de 2013 a 2016. Trata-se de uma pesquisa descritiva, retrospectiva e documental, com abordagem quantitativa. O levantamento dos dados foi realizado por meio das fichas de notificação compulsória do Sistema de Informação de Agravos e de Notificação de janeiro de 2013 a dezembro de 2016. No período estudado foram notificados 491 casos de LTA, o ano de maior notificação foi 2014 com 40,1% dos casos. Observou-se, também que o ano de 2014 redarguiu com os maiores valores de incidência e prevalência (6,34 e 8,33 casos por 1000 mil habitantes, respectivamente). Após análise dos resultados foi perceptível que o perfil sociodemográfico da LTA no munícipio do Oiapoque compreende o sexo masculino, com cor autodeclarada parda, baixa escolaridade, ocupação por atividades de garimpagem e procedentes da zona urbana

Comparative effectiveness of adalimumab and etanercept for rheumatoid arthritis in the Brazilian Public Health System

Aim: Biological disease-modifying antirheumatic drugs (bDMARDs) are used to treat rheumatoid arthritis (RA) with adalimumab and etanercept the most used bDMARDs in Brazil. This open prospective cohort study evaluated their effectiveness and safety among RA patients in the Brazilian Public Health System given their costs. Methods: The Clinical Disease Activity Index was primarily used to assess their effectiveness after 6 and 12 months of follow-up. The Health Assessment Questionnaire and EuroQol-5D were also used. Results: A total of 266 RA patients started treatment with adalimumab or etanercept. Adalimumab was the most widely used bDMARD (70%). In total, 46% achieved remission or low-disease activity at 12 months with no difference in effectiveness between them (p = 0.306). bDMARDs were more effective in patients who had better functionality at treatment onset and had spent longer in education. Conclusion: This real-world study demonstrated that adalimumab and etanercept are equal alternatives for RA treatment and both were well tolerated

Fatty acid synthase as a potential new therapeutic target for cervical cancer

Fatty acid synthase (FASN) is the rate-limiting enzyme for the de novo synthesis of fatty acids in the cytoplasm of tumour cells. Many tumour cells express high levels of FASN, and its expression is associated with a poorer prognosis. Cervical cancer is a major public health problem, representing the fourth most common cancer affecting women worldwide. To date, only a few in silico studies have correlated FASN expression with cervical cancer. This study aimed to investigate in vitro FASN expression in premalignant lesions and cervical cancer samples and the effects of a FASN inhibitor on cervical cancer cells. FASN expression was observed in all cervical cancer samples with increased expression at more advanced cervical cancer stages. The FASN inhibitor (orlistat) reduced the in vitro cell viability of cervical cancer cells (C-33A, ME-180, HeLa and SiHa) in a time-dependent manner and triggered apoptosis. FASN inhibitor also led to cell cycle arrest and autophagy. FASN may be a potential therapeutic target for cervical cancer, and medicinal chemists, pharmaceutical researchers and formulators should consider this fi nding in the development of new treatment approaches for this cancer type

Profile of patients with rheumatic diseases undergoing treatment with anti-TNF agents in the Brazilian Public Health System (SUS), Belo Horizonte - MG

The aim of this study was to describe the baseline demographic and clinical characteristics as well as the functional status of a prospective cohort of patients with rheumatic diseases assisted by the Brazilian Public Health System (SUS). Data for 302 patients receiving tumor necrosis factor α inhibitors (anti-TNF agents) was collected through a standard form. Among patients, 229 (75.8%) were female and 155 (51.3%) were Caucasian; the mean age was 50.3 ± 12.8 years, and the mean disease duration was 9.9 ± 8.7 years. Among them 214 patients (70.9%) received adalimumab, 72 (23.8%) etanercept, and 16 (5.3%) infliximab. Mean Health Assessment Questionnaire-Disability Index (HAQ-DI) was 1.37 ± 0.67 for all participants. Poor functional response was associated with female gender, married patients and with a score of &lt; 0.6 on the EuroQoL-5 dimensions (EQ-5D). Significant correlation was found between the HAQ-DI values, disease activity and quality of life (QOL). The results obtained in this study contribute to a better understanding of the clinical and demographic characteristics of patients with rheumatic diseases at the beginning of anti-TNF-agent treatment by SUS. Furthermore, our findings are consistent with another Brazilian and foreign cross-sectional investigations. This knowledge can be of great importance for further studies evaluating the effectiveness of biological agents, as well as, to contribute to improve the well-being of the patients with rheumatic diseases.O objetivo do estudo foi descrever as características demográficas e clínicas iniciais, bem como o estado funcional de uma coorte de pacientes com doenças reumáticas tratados pelo Sistema Único de Saúde (SUS). Dados de 302 pacientes em uso de inibidores do fator de necrose tumoral (agentes anti-TNF) foram coletados por formulário padronizado. Desses, 229 (75.8%) eram mulheres e 155 (51.3%) eram brancos; a idade média foi 50,3 ± 12,8 anos, e a duração média da doença foi de 9,9 ± 8,7 anos. Entre os pacientes 214 (70,9%) usaram adalimumabe, 72 (23,8%) etanercepte e 16 (5,3%) infliximabe. A média do Health Assessment Questionnaire-Disability Index (HAQ-DI) foi 1,37 ± 0,67 para a população total. Pior resposta funcional estava associada com mulheres, pacientes casados e com um valor de EuroQoL-5 dimensions (EQ-5D) < 0.6. Correlação significativa foi obtida entre os valores de HAQ-DI, atividade das doenças e qualidade de vida. Os resultados obtidos no estudo contribuem para o melhor entendimento das características clínicas e demográficas de pacientes com doenças reumáticas iniciando a terapia com agentes anti-TNF pelo SUS. Além disso, nossos achados são consistentes com resultados obtidos em outros estudos transversais nacionais e estrangeiros. Este conhecimento pode ser de grande importância para estudos futuros que avaliem a eficácia de agentes biológicos, assim como, para contribuir para a melhoria do bem-estar das pessoas com doenças reumáticas

Experiência em Simulação Realística na formação em Urgência e Emergência

Este relato tem por objetivo apresentar as experiências da criação e desenvolvimento de uma simulação realística executada pela Liga Acadêmica de Medicina de Urgência e Emergência da Universidade Federal do Sul da Bahia para acadêmicos dos cursos de saúde do Campus Paulo Freire da instituição. A simulação realística aconteceu posteriormente ao curso de capacitação teórico-prático em urgência e emergência, ambos realizados em dois dias e guiados por profissionais do Serviço de Atendimento Móvel de Urgência e do Grupamento de Bombeiros Militares de Teixeira de Freitas (BA), com participação de 23 acadêmicos dos cursos de graduação da área da saúde da instituição. Percebeu-se a importância e a necessidade da constante atualização dos conhecimentos. Como dificuldade, destaca-se a relação entre número de participantes e quantidade de materiais. Acredita-se que a experiência durante a simulação realística foi de fundamental importância no que tange a aquisição de habilidades que em momentos posteriores serão executadas, além do uso de conhecimentos prévios e consolidação efetiva da teoria e a troca de experiências. Os impactos alcançados com a execução desta ação contribuem para melhoria da prevenção de agravos e consequente promoção da saúde. A repetição simulada de casos em diversos níveis de gravidade e, também, em cenários de morte,  é uma grande vantagem do método de ensino e a utilização de simulação de alta fidelidade é extremamente relevante na formação em urgência e emergência

Electrochemical mediated oxidation of phenol using Ti/IrO2 and Ti/Pt-SnO2-Sb2O5 electrodes

The indirect electrochemical oxidation of phenol was studied at Ti/IrO2 and Ti/Pt-SnO2-Sb2O5 electrodes by bulk electrolysis experiments under galvanostatic control. The obtained results clearly shown that the electrode material was an impor­tant para­me­ter for the optimization of such processes determining their mecha­nism and oxidation products. Different current efficiencies were obtained at Ti/IrO2 and Ti/Pt-SnO2-Sb2O5, depending on the applied current density in the range from 10, 20 and 30 mA cm−2. The effect of the amount of dissolved NaCl was studied also. It was observed that the electrochemical processes (direct/indirect) favor specific oxidation pathways depending on electrocatalytic material. Phenol degradation generates several intermediates eventually leading to complete mineralization, as indicated by the results obtained with the High-performance liquid chromatography (HPLC) technique

DRAMATIZAÇÃO PARA PROMOÇÃO EM SAÚDE E SUA RELAÇÃO COM OS INSTRUMENTOS BÁSICOS PARA O CUIDAR

In the scope of health care, nursing has autonomy with active participation in promotion and prevention, requiring the graduate a theoretical-practical foundation that can be acquired by different teaching methodologies. Aiming to describe the experience of students and teachers of the undergraduate nursing course, in a health promotion activity to relate it to the Basic Care Instruments, through an experience report and through the role play, it was possible to experience the application of the instruments basic concepts of nursing recommended by Wanda Horta, used in the professional practice of nurses. It is believed that the use of dramatization as an active methodology is an important tool in the caring process.No âmbito da assistência à saúde, a enfermagem possui autonomia com participação ativa na promoção e prevenção, exigindo do graduando um embasamento teórico-prático que pode ser adquirido por diferentes metodologias de ensino. Objetivando descrever a experiência de discentes e docentes do curso de graduação em enfermagem, em uma atividade de promoção de saúde relacioná-la com os Instrumentos Básicos do Cuidar, através de relato de experiência e por meio da dramatização, foi possível vivenciar a aplicação dos instrumentos básicos de enfermagem preconizados por Wanda Horta, utilizados no exercício profissional do enfermeiro. Acredita-se que o uso da dramatização como metodologia ativa é importante instrumento no processo do cuidar