Healing bio compound for the treatment of fissures in the diabetic foot / Biocomposto cicatrizante para o tratamento de fissuras no pé diabético

Xerosis cutis in Mellitus diabetes is a common complication that if not treated can cause fissures, infections, ulcer and its prevention is fundamental. Herbal medicine has been contributing for the improvement of the healing process. The objective of this study was to analyze the therapeutic efficacy of a bio compound of essential oils for the treatment of xerosis cutis and fissures in the feet of diabetic patients in order to prevent upcoming complications. The studies were developed in Nova Friburgo, Brazil, with 47 diabetic adult patients with xerosis cutis and fissures in their feet, they were divided into two groups: CG (control n=22) treated with urea cream 10% and SG (study n=25) treated with the bio compound. The fissures were measured (length X width) and photographed every week. Measurement of the glycated hemoglobin: in the beginning of the treatment and 60 days later. Therapeutic efficacy: decreased measures of the fissures; lack of complications (pain, bleeding and increase of the fissure area); healing time. The average of the decrease of the fissure area was alike. The complete healing of the fissure occurred: 52.9% in SG and 47.1% in CG. There was no significant difference in the decrease of the fissure in the patients with total healing. Time for healing: SG took in average 11.6 weeks and CG 12 weeks (non-significant difference). Product efficacy: 60% in SG and 36.4% in CG reported some recovery right in the first seven days. All patients reported recovery in the healing of the fissures and xerosis cutis. In SG all reported no pain, itch, burn sensation or edema in their legs or feet after the treatment with the bio compound, and in CG only 33.3% of them reported some recovery in local pain and no one of them reported any recovery in the edema in their legs or feet. The bio compound was efficient for the treatment of fissures and xerosis cutis in the feet of diabetic patients, providing hydration, skin recovery, absence of pain, itch, and decrease of edema, being indicated as an advantage for the treatment of fissures and xerosis cutis, regardlessly the glycemic level

Cardiovascular adverse effects associated with the use of anti-HER2 in breast cancer treatment

Background: Cancer represents an important public health problem with increasing incidence, prevalence, and mortality, affecting the entire Western population, especially in developed and developing countries. The use of monoclonal antibodies has revolutionized the treatment of cancer, but this treatment can cause adverse cardiovascular effects (AE).Objective: The objective of this paper is to identify and classify AE in breast cancer patients in the use of Trastuzumab in two health institutions.Methods: Retrospective study of medical records of patients with breast cancer Her 2+ submitted the therapy with trastuzumab in early and advanced stage of the disease. Review conducted in a university hospital and a private clinic, both located in Rio de Janeiro State, Brazil.Results: Cardiovascular events were late for trastuzumab, with predominance of moderate reactions. There was a predominance of dyspnea, increased blood pressure, fatigue and reduced left ventricular ejection.Conclusion: The results resemble similarities in the pattern of the institutions’ reactions. Identify possible AE and know the toxicity profile of trastuzumab can contribute to a safer therapy

Odontogenic tumors : a retrospective study of four Brazilian diagnostic pathology centers

Objective: This article presents the results of a retrospective study of the frequency and classification of odontogenic tumors recorded at four centers of diagnostic pathology in Rio de Janeiro, Brazil. Study Design: All medical records and microscopic slides of odontogenic tumor specimens for the years 1997 to 2007 were retrieved from the files of four services of diagnostic pathology in Rio de Janeiro City. Diagnoses were re-evaluated and the tumors classified according to the latest (2005) World Health Organization Classification of Tumors. Results: A total of 201 odontogenic tumors were found among 15,758 oral biopsies (1.3%). The frequencies of these tumors at the four centers ranged from 0.5% at the National Cancer Institute to 3.3% in a private laboratory. Chi-square analysis revealed statistically significant differences (p<0.05) between the proportions of odontogenic tumors in the studied centers. Of these, 94.5% were benign and 5.5% were malignant. Keratocystic odontogenic tumor (32.3%) was the most frequent lesion, followed by ameloblastoma (29.8%) and odontoma (18.4%). Conclusions: Odontogenic tumors are uncommon in Brazil. Different pathology laboratories reported divergent frequencies of odontogenic tumors, which may reflect institutional specializations and the patient populations served

Immunoexpression of cleaved caspase-3 shows lower apoptotic area indices in lip carcinomas than in intraoral cancer

Objective This study aimed to evaluate apoptosis by assessing cleaved caspase-3 immunoexpression in hyperplastic, potentially malignant disorder (PMD), and malignant tumors in intraoral and lower lip sites. Material and Methods A retrospective study using paraffin blocks with tissues from patients with inflammatory fibrous hyperplasia (IFH), actinic cheilitis, oral leukoplakia, lower lip and intraoral squamous cell carcinoma (SCC) was performed. The tissues were evaluated by immunohistochemical analysis with anti-cleaved caspase-3 antibody. Apoptotic area index was then correlated with lesion type. Results From 120 lesions assessed, 55 (46%) were cleaved caspase-3-positive. The SCC samples (n=40) had the highest apoptotic area indices (n=35; 87.5%). Significant differences were detected between SCCs and PMDs (p=0.0003), as well as SCCs and IFHs (p=0.001), regarding caspase-3 immunopositivity. Carcinomas of the lower lip had lower apoptotic area indices than intraoral cancer (p=0.0015). Conclusions Cleaved caspase-3 immunoexpression showed differences in oral SCCs and PMDs and demonstrated a distinct role of apoptosis in carcinogenesis of intraoral and lower lip cancer. In future, the expression of cleaved caspase-3 with other target molecules in oral cancer may be helpful in delineating the prognosis and treatment of these tumors

Craniomaxillofacial morphology alterations in children, adolescents and adults with neurofibromatosis 1 : a cone beam computed tomography analysis of a Brazilian sample

Oral manifestations are common in neurofibromatosis 1 (NF1), and include jaws and teeth alterations. Our aim was to investigate the craniomaxillofacial morphology of Brazilian children, adolescents and adults with NF1 using cone beam computed tomography. This study was conducted with 36 Brazilian individuals with NF1 with ages ranging from 4 to 75. The participants were submitted to anamnesis, extra and intraoral exam and cephalometric analysis using cone beam computed tomography. Height of the NF1 individuals was compared to the length of jaws and skull base. The results of the cephalometric measurements of the NF1 group were compared with a control group paired by age, gender and skin color. Individuals with NF1 had lower maxillary length (p<0.0001), lower mandibular length (p<0.0001), lower skull base length (p<0.0001). In children and adolescents, the mandible was more posteriorly positioned (p=0.01), when compared with the control group. There was no association between jaws and skull base length with the height of the individuals with NF1. Brazilian children, adolescents and adults with NF1 have short mandible, maxilla and skull base. Moreover, children and adolescents present mandibular retrusion

Estudo do perfil lipídico em crianças e jovens do ambulatório pediátrico do Hospital Universitário Antônio Pedro associado ao risco de dislipidemias

O processo de formação da placa aterosclerótica inicia-se na infância e progride lentamente até a vida adulta, quando ocorrerão as manifestações clínicas da doença. O objetivo deste trabalho foi realizar um estudo da concentração plasmática de colesterol total (CT), colesterol da lipoproteína de baixa densidade (LDL-C), triglicéride (TG) e colesterol da lipoproteína de alta densidade (HDL-C) numa população na faixa etária de 2 a 19 anos, de ambos os sexos, atendida no ambulatório do Hospital Universitário Antônio Pedro (HUAP). Os dados dos prontuários foram obtidos entre dezembro/2004 e janeiro/2006 e as concentrações plasmáticas foram correlacionadas com os fatores de risco para dislipidemia. As dosagens foram feitas no Laboratório de Bioquímica Clínica do HUAP. Os níveis plasmáticos do CT, LDL-C, TG e HDL-c foram maiores no sexo feminino do que no masculino e este fato é compatível com a literatura. A média dos valores de TG, CT, LDL-C e HDL-C observada na população estudada mostrou-se elevada para esses parâmetros, principalmente em pacientes que apresentam doenças, como síndrome nefrótica, lúpus eritematoso sistêmico (LES) e diabetes mellitus (DM). Este trabalho reforça a tese da necessidade de utilização, no Brasil, de estudos sobre os intervalos de valores de referência do perfil lipídico nesta faixa etária e também sobre o perfil dos níveis desses lípides na população considerada sadia

Concordance between cytopathology and incisional biopsy in the diagnosis of oral squamous cell carcinoma

Oral cytopathology is a simple, non-invasive technique that could be used for early detection of oral premalignant and malignant lesions, but the effectiveness of this diagnostic approach remains controversial. The aim of this study was to evaluate the sensitivity, specificity, positive and negative predictive values, and accuracy of cytopathology for diagnosing oral squamous cell carcinoma (OSCC) and the diagnostic concordance between cytopathological and histopathological diagnoses. The study enrolled 172 patients at outpatient clinics who presented with oral lesions suspicious of malignancy. All patients underwent oral cytological scrapes followed by an incisional biopsy. Of 148 cases that were histopathologically diagnosed with OSCC, the cytopathological method diagnosed 123 positive cases and resulted in a suspicion of OSCC in 16 patients. Based on these data, the sensitivity was 83.1%, the specificity was 100.0%, the positive predictive value was 100.0%, the negative predictive value was 49.0%, and the accuracy was 85.5%. The diagnostic concordance between histopathological and cytopathological examinations was 83.1% for OSCC and 85.7% for non-neoplastic lesions. The results indicate that cytopathological diagnosis had good concordance with histopathological diagnosis and showed high sensitivity, specificity, positive predictive value, and accuracy. We conclude that the sensitivity of oral cytopathology is sufficient to justify its use as a diagnostic screening test and to confirm the malignant nature of epithelial cells, mainly for the classification of OSCC. Therefore, cytopathology may be a reliable method for referring patients who require diagnosis of suspected oral cancer for starting treatment