Bulimia nervosa as a risk factor for voice disorders: literature review

A bulimia nervosa é um tipo de transtorno alimentar que tem início na adolescência e que apresenta uma variedade de sintomas, dentre estes, os episódios recorrentes de vômitos que acometem a cavidade oral, podendo alcançar a laringe de forma semelhante ao refluxo gastroesofágico, ocasionando alterações laríngeas e distúrbios na voz. OBJETIVO: Este trabalho teve como objetivo investigar através da revista da literatura os estudos que relacionassem a BN como fator de risco para os distúrbios da voz. RESULTADOS: Dos noventa e três artigos levantados, vinte e três foram usados como base para esta revisão, dentre os quais, apenas três referem-se à BN com fator etiológico de alterações na voz em mulheres adultas, não sendo encontrado nenhum trabalho referindo esta relação em adolescentes bulímicos. CONCLUSÃO: Faz-se necessária a observância de sinais e sintomas laríngeos e vocais que possam estar relacionados à BN, em especial nos adolescentes cuja voz passa por significativas mudanças quando do período da muda vocal.Bulimia nervosa (BN) is a type of feeding disorder that starts in adolescence and presents a variety of symptoms, recurrent vomiting in the oral cavity that may reach down to the larynx - similarly to gastro-esophageal reflux, causing laryngeal and voice disorder alterations. AIM: These studies aimed at surveying the literature and investigate the studies that considered BN a risk factor for voice disorders. RESULTS: of the ninety three papers we found, twenty-three were used as a basis for this review, among them, only three discuss BN as an etiology factor associated with voice changes in adult women, and we did not find any paper associating this with bulimic teenagers. CONCLUSION: It is necessary to observe laryngeal and vocal signs and symptoms associated with BN, especially in teenagers whose voices are going through a period of change

Prognostic and Predictive Significance of MYC and KRAS Alterations in Breast Cancer from Women Treated with Neoadjuvant Chemotherapy

Breast cancer is a complex disease, with heterogeneous clinical evolution. Several analyses have been performed to identify the risk factors for breast cancer progression and the patients who respond best to a specific treatment. We aimed to evaluate whether the hormone receptor expression, HER2 and MYC genes and their protein status, and KRAS codon 12 mutations may be prognostic or predictive biomarkers of breast cancer. Protein, gene and mutation status were concomitantly evaluated in 116 breast tumors from women who underwent neoadjuvant chemotherapy with doxorubicin plus cyclophosphamide. We observed that MYC expression was associated with luminal B and HER2 overexpression phenotypes compared to luminal A (p= 2.5 was a protective factor for chemotherapy resistance. On the other hand, age and grade 2 tumors were a risk factor. Additionally, luminal B, HER2 overexpression, and triple-negative tumors presented increased odds of being resistant to chemotherapy relative to luminal A tumors. Thus, breast tumors with KRAS codon 12 mutations seem to present a worse prognosis. Additionally, MYC amplification may help in the identification of tumors that are sensitive to doxorubicin plus cyclophosphamide treatment. If confirmed in a large set of samples, these markers may be useful for clinical stratification and prognosis.Fundacao Amazonia Paraense de Amparo a PesquisaConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Ophir Loyola Hosp, Mastol Unit, Belem, PA, BrazilUniversidade Federal de São Paulo, Dept Orthopaed & Traumatol, São Paulo, BrazilFed Univ Para, Inst Biol Sci, Human Cytogenet Lab, BR-66059 Belem, PA, BrazilHosp Univ La Paz, Res Unit Unidad Invest, Madrid, SpainFed Univ Para, Nucleu Res Oncol, Joao de Barros Barreto Univ Hosp, BR-66059 Belem, PA, BrazilUniv Fed Piaui, Dept Biomed, Parnaiba, PI, BrazilUniversidade Federal de São Paulo, Div Genet, Dept Morphol & Genet, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Orthopaed & Traumatol, São Paulo, BrazilUniversidade Federal de São Paulo, Div Genet, Dept Morphol & Genet, São Paulo, BrazilFundacao Amazonia Paraense de Amparo a Pesquisa: FAPESPA/PPSUS 247/2009Fundacao Amazonia Paraense de Amparo a Pesquisa: 300240/2009Web of Scienc

Sound localization and occupational noise

OBJECTIVE: the aim of this study was to determine the effects of occupational noise on sound localization in different spatial planes and frequencies among normal hearing firefighters.METHOD: A total of 29 adults with pure-tone hearing thresholds below 25 dB took part in the study. the participants were divided into a group of 19 firefighters exposed to occupational noise and a control group of 10 adults who were not exposed to such noise. All subjects were assigned a sound localization task involving 117 stimuli from 13 sound sources that were spatially distributed in horizontal, vertical, midsagittal and transverse planes. the three stimuli, which were square waves with fundamental frequencies of 500, 2,000 and 4,000 Hz, were presented at a sound level of 70 dB and were randomly repeated three times from each sound source. the angle between the speaker's axis in the same plane was 45, and the distance to the subject was 1 m.RESULT: the results demonstrate that the sound localization ability of the firefighters was significantly lower (p < 0.01) than that of the control group.CONCLUSION: Exposure to occupational noise, even when not resulting in hearing loss, may lead to a diminished ability to locate a sound source.Research Support Foundation of Alagoas State (FAPEAL)Univ Estadual Ciencias Saude Alagoas UNCISAL, Acoust Instrumentat Lab, Maceio, AL, BrazilUniv Fed Pernambuco UFPE, Dept Fonoaudiol, Recife, PE, BrazilEscola Paulista Med UNIFESP, Dept Fonoaudiol, São Paulo, BrazilEscola Paulista Med UNIFESP, Dept Fonoaudiol, São Paulo, BrazilWeb of Scienc

PROPRIEDADES MECÂNICAS DE MATERIAIS RESINOSOS UTILIZADOS PARA RESTAURAÇÕES DE LESÕES CERVICAIS / MECHANICAL PROPERTIES OF RESIN MATERIALS USED IN CERVICAL LESIONS RESTORATIONS

Introdução: Desordens oclusais complexas podem ocasionar a fratura de tecido dentário e o aparecimento de hipersensibilidade dentinária, levando o profissional a difícil escolha do material restaurador. Objetivo: Comparar as propriedades mecânicas (resistência flexural e módulo de elasticidade) de cinco materiais utilizados para restauração de lesões cervicais com a dentina bovina. Métodos: Foram utilizadas duas resinas compostas comerciais de baixa viscosidade: Opallis Flow (OL) e Natural Flow (NF); duas resinas composta comerciais de viscosidade média: Z-100 (Z100) e Opallis (OP); e um cimento de ionômero de vidro modificado por resina Riva Light Cure (RL). Para a confecção dos corpos-de-prova, o material foi inserido uma matriz de silicone e fotoativado (n=12). Para a confecção dos corpos-de-prova de dentina, raízes de dentes bovinos foram utilizadas. As raízes foram seccionadas em uma máquina de corte (Isomet 1000) e lixados para obtenção dos palitos de dentina (10x1x1mm). Após, os corpos-de-prova foram levados a uma máquina de ensaio universal (Instron 3342) sob uma velocidade de 0,5 mm/min para o ensaio de resistência flexural e módulo de elasticidade. Os dados foram submetidos ANOVA um fator e Tukey (α=0.05). Resultados: Houve diferença significativa entre os grupos experimentais testados (p<0,05). A dentina bovina apresentou valores superiores de resistência flexural (169,30 ± 19,60 MPa) e os menores valores de módulo de elasticidade (4,48 ± 0,32 GPa). Conclusão: Nenhum material utilizado na pesquisa apresenta características mecânicas próximas daquelas encontradas na dentina bovina.Palavras-chave: Módulo de Elasticidade. Materiais Dentários. Dentina.AbstractIntroduction: Complex occlusal disorders can lead to tissue tooth fracture and may cause dentin hypersensitivity, thus dental professional have difficult to choose the ideal restorative material Objective: To compare flexural strength and modulus of elasticity, of five materials used for restoration of cervical lesions with bovine dentin. Methods: Two low viscosity resins: Opallis Flow (OL) and Natural Flow (NF), two medium viscosity resins: Z-100 (Z100) and Opallis (OP), and ionomer resin modified glass Riva Light Cure (RL) were tested materials. The specimens were made by silicon matrix and halogen light curing unit (Optilux 501) (n = 12). For dentin specimens, twelve bovine teeth without coronal portion were used. The roots were cut using a cutting machine (Isomet 1000) to obtain dentin sticks (10x1x1mm). Flexural strength test was conducted on a universal testing machine (Instron 3342) at a crosshead speed of 0.5 mm/min. Data were submmited to ANOVA (one variation factor) and Tukey (α=0.05). Results: There were significant differences between experimental groups tested (p < 0.05). Bovine dentin showed higher flexural strength values, which were statistically significant (169.30 ± 19.60 MPa). Bovine dentin showed lower modulus values (4.48 ± 0.32 GPa). Conclusion: No material used in this study showed similar mechanical properties from those found in bovine dentin.Keywords: Elastic Modulus. Dental Materials. Dentin

Occurrence of Helicobacter pylori and Epstein-Barr virus infection in endoscopic and gastric cancer patients from Northern Brazil

Background: Helicobacter pylori (HP) and Epstein-Barr virus (EBV) have been associated with cancer development. We evaluated the prevalence of HP, HP CagA(+) and EBV infection in gastric cancer (GC) samples from adults and in gastric tissues from patients who underwent upper endoscopy (UE).Methods: Samples from UE and GC were collected to investigate the presence of HP infection and the HP virulence factor CagA by a urease test and PCR. the presence of EBV was detected by Eber-1 in situ hybridization.Results: in UE, 85.5% of juvenile patients showed some degree of gastritis (45.3% of patients with mild gastritis and 54.7% with moderate/severe gastritis) and patients with mild gastritis were younger than patients with moderate/severe gastritis. Among adults, 48.7% presented mild gastritis and 51.3% moderate/severe gastritis. HP infection was detected in 0% of normal mucosa, 58.5% of juvenile gastritis patients, 69.2% of adult gastritis patients and 88% of GC patients. in these same groups, HP CagA(+) was detected in 0%, 37.7%, 61.5% and 67.2% of tissue samples, respectively. in juvenile patients, HP infection was more common in those with gastritis than in normal samples (p = 0.004). the patients with either HP or HP CagA(+) were older than patients without these pathogens (p < 0.05). in juvenile patients, HP infection was more frequent in cases of moderate/severe gastritis than in cases of mild gastritis (p = 0.026). Moreover, in patients with GC, HP infection was more frequent in males than in females (p = 0.023). GC patients with HP CagA(+) were older than patients with HP CagA-(p = 0.027). HP CagA(+) was more common in intestinal-type than diffuse-type GC (p = 0.012). HP CagA(+) was also associated with lymph-node (p = 0.024) and distal (p = 0.005) metastasis. No association between EBV infection and HP infection or any clinicopathological variable was detected.Conclusions: Our results suggest that HP is involved in the pathophysiology of severe gastric lesions and in the development of GC, particularly when CagA(+) is present. EBV was not the primary pathogenic factor in our samples.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Fed Univ Para, Inst Ciencias Biol, Lab Citogenet Humana, BR-66075110 Belem, PA, BrazilFed Univ Para, Inst Ciencias Saude, BR-66075110 Belem, PA, BrazilCtr Univ Para, Belem, PA, BrazilUniversidade Federal de São Paulo, Dept Ortopedia & Traumatol, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Morfol & Genet, Disciplina Genet, São Paulo, BrazilFed Univ Para, BR-66075110 Belem, PA, BrazilUniv Fed Ceara, Fac Odontol, Dept Oral Pathol, Fortaleza, CE, BrazilUniversidade Federal de São Paulo, Dept Ortopedia & Traumatol, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Morfol & Genet, Disciplina Genet, São Paulo, BrazilWeb of Scienc

O papel do enfermeiro no cuidado à mulher com depressão puerperal / The role of the nurse in the care of women with puerperal depression

Objetivo – Analisar o cuidado de enfermagem a puérpera com depressão. Método – O método utilizado foi revisão integrativa da literatura com abordagem qualitativo-descritivo na base de dados da Biblioteca Virtual de Saúde, com os descritores abaixo, recorte temporal entre 2012 a 2018, artigos disponíveis online, com assunto principal: prevenção da depressão pós-parto, cuidado pós-natal, foram excluídos os que não tiveram aderências a tema proposto, sendo selecionadas 17 publicações para análise. Resultados – Há uma enorme importância da assistência de enfermagem à mulher durante o período de gestação ao puerpério, favorecendo a detecção o mais precocemente possível dos sintomas da depressão durante o ciclo gravídico puerperal. Considerações Finais – Conclui-se que a depressão no puerpério incorre na possibilidade de desamparo do recém-nascido e no abandono de si, pode ser minimizado com a construção da sistematização da assistência com um plano de cuidados que contemple o pós-alta também. 

Mortality reduction with use of oral beta-blockers in patients with acute coronary syndrome

OBJECTIVES: Recent studies have revealed a relationship between beta-blocker use and worse prognosis in acute coronary syndrome, mainly due to a higher incidence of cardiogenic shock. However, the relevance of this relationship in the reperfusion era is unknown. The aim of this study was to analyze the outcomes of patients with acute coronary syndrome that started oral beta-blockers within the first 24 hours of hospital admission (group I) compared to patients who did not use oral beta-blockers in this timeframe (group II). METHODS: This was an observational, retrospective and multicentric study with 2,553 patients (2,212 in group I and 341 in group II). Data regarding demographic characteristics, coronary treatment and medication use in the hospital were obtained. The primary endpoint was in-hospital all-cause mortality. The groups were compared by ANOVA and the chi-square test. Multivariate analysis was conducted by logistic regression and results were considered significant when

Preliminary comparision between phalangeal quantitative ultrassonography and bone densitometry for bone mass evaluation in adolescents

OBJECTIVE: To evaluate the association between quantitative ultrasonography at hand phalanges (QUS) and dual energy X-ray absorptiometry (DXA), and between these methods with food intake and history of bone fractures. SUBJECTS AND METHODS:After two years of follow up of 270 schoolchildren, 10 of them, who showed bone mass below - 2 SD in QUS, were included in the present study. Laboratory results and DXA data were analyzed. RESULTS: Bone mass evaluated by DXA at L1-L4 ranged from -2.8 to -1.1 SDS, and whole body bone mass, from -2.9 to -1.2 SDS. Three children had history of non-pathological bone fractures. Dietary assessment showed low intake of calcium in 10 cases, of phosphorus in 6, and of vitamin D in 8 cases. There were no differences among the cases of bone mass below-2 SD in any of the three used methods. There was no association between history of bone fractures and food intake, and between these evaluations and bone mass. CONCLUSION: In this small group of schoolchildren there was an association between the methods QUS and DXA. However, there was no association between bone mass and the history of bone fractures, or calcium, phosphorus and vitamin D intake.OBJETIVO: Avaliar associação entre ultrassonografia quantitativa de falanges da mão (QUS) e a densitometria por absorção de raio-X de dupla energia (DXA) e desses com os históricos alimentar e de fraturas. SUJEITOS E MÉTODOS: Após dois anos de acompanhamento de 270 escolares, 10 com massa óssea por QUS abaixo de -2 DP foram incluídos no estudo e avaliados com DXA. RESULTADOS: A massa óssea por DXA de L1-L4 variou de -2,8 a -1,1 DP e de corpo inteiro -2,9 e -1,2. Três estudantes apresentaram fraturas. Baixa ingestão de cálcio foi observada nos 10 casos, de fósforo em 6 e de vitamina D em 8. Não houve diferença entre os casos com massa abaixo de -2 DP nos três métodos de avaliação. Não foi observada associação entre as fraturas e o histórico alimentar, nem com os valores de massa óssea. CONCLUSÃO: Neste pequeno grupo de adolescentes houve associação entre QUS e DXA, porém sem associação entre essas avaliações e as fraturas e a ingestão de cálcio, fósforo e vitamina D.1924Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES

Choosing Wisely Portugal – Escolhas Criteriosas em Saúde

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