Tumores de células granulares na língua: relato de 2 casos

ResumoO tumor de células granulares é uma neoplasia benigna incomum com forte predileção pela cavidade oral, com um maior número de casos afetando a região da língua. Apresenta-se geralmente como um nódulo solitário, assintomático, de base séssil, com crescimento lento (meses ou anos) e coloração variável. Apesar da sua etiologia incerta, há estudos que apontam para uma origem neural para a lesão. O presente artigo tem como objetivo apresentar 2 casos clínicos cuja queixa principal era um nódulo submucoso no dorso da língua, com evolução lenta e superfície epitelial hígida. Em ambos os casos, o diagnóstico definitivo foi realizado após a análise histológica e imuno-histoquímica e o tratamento realizado através de excisão cirúrgica conservadora. Também são discutidos os aspetos clínicos, histológicos e imuno-histoquímicos do tumor de células granulares.AbstractThe granular cell tumor is an uncommon benign neoplasm with a strong predilection for the oral cavity, with a greater number of cases affecting the tongue. It typically presents as a solitary nodule, asymptomatic, sessile base, with slow growth (months or years) and variable color. Despite its uncertain etiology, studies suggest a neural origin for the lesion. The aim of this article is to present two clinical cases whose main complaint was a submucosal nodules in the dorsum of the tongue, with slow evolution and healthy surface. In both cases, definitive diagnosis was made after histological and immunohistochemical analysis and the treatment was made with conservative surgical excision. It is also discussed clinical, histological and immunohistochemical features of granular cell tumor

Vitamin D Food Fortification and Nutritional Status in Children: A Systematic Review of Randomized Controlled Trials

Children are in the risk group for developing hypovitaminosis D. Several strategies are used to reduce this risk. Among these, fortification of foods with vitamin D (25(OH)D) has contributed to the achievement of nutritional needs. This systematic review aims to discuss food fortification as a strategy for maintenance or recovery of nutritional status related to vitamin D in children. The work was developed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and registered in the International prospective register of systematic reviews (PROSPERO) database (CRD42018052974). Randomized clinical trials with children up to 11 years old, who were offered vitamin D-fortified foods, and who presented 25(OH)D concentrations were used as eligibility criteria. After the selection stages, five studies were included, totaling 792 children of both sexes and aged between two and 11 years. Interventions offered 300–880 IU of vitamin D per day, for a period of 1.6–9 months, using fortified dairy products. In four of the five studies, there was an increase in the serum concentrations of 25(OH)D with the consumption of these foods; additionally, most children reached or maintained su ciency status. Moreover, the consumption of vitamin D-fortified foods proved to be safe, with no concentrations of 25(OH)D > 250 nmol/L. Based on the above, the fortification of foods with vitamin D can help maintain or recover the nutritional status of this vitamin in children aged 2–11 years. However, it is necessary to perform additional randomized clinical trials in order to establish optimal doses of fortification, according to the peculiarities of each region.This research was funded by the National Council for Scientific and Technological Development (CNPq/MS/SCTIE/DECIT/DAB/CGAN), grant number 440809/2017-7. In part by the Coordination of Improvement of Higher Education Personnel—Brazil (CAPES)—Finance Code 001. And by Unidad Científica de Excelencia Ejercicio y Salud (UCEES), University of Granada, Spain

Anthropometry and lifestyle of children and adolescent in inland of Northeastern Brazil

Introduction: Brazil is going through a nutritional transition, which is observed decrease in malnutrition and increased excess weight.Objective: To evaluate the nutritional status and lifestyle of school children and adolescents from 4 to 17 years old resident in the interior of the Brazilian Northeast.Methods: This is a longitudinal study performed in two stages. The first stage took place during the School Health Program and anthropometric data were collected from 975 schoolchildren. In the second stage, it was used a questionnaire to assess lifestyle and diet. Participants were classified into “not overweight” and “overweight”. The significant level for the statistical tests was set at 5%.Results: In the first stage, less than 2% of students had low height for age. The prevalence of overweight and malnutrition was 22.15% and 5.23%, respectively.  Of the 134 participants of the second stage, 47.76% were not overweight and 52.24% overweight. Regarding the lifestyle, the not overweight group had a higher percentage of insufficiently active members (p = 0.017) and a lower intake of vegetables and salads (p=0.015).Conclusions: The results revealed low short stature in the population studied and overweight was more prevalent than malnutrition. Children and adolescents had sedentary habits that associated with inappropriate dietary practices favor the occurrence of overweight.

Postoperative pain in patients submitted to elective craniotomy

Artigo disponível em português e inglêsJUSTIFICATIVA E OBJETIVOS: A dor é uma experiência subjetiva e multidimensional, comum em pacientes submetidos a operações. Os objetivos do estudo foram identificar a intensidade e verificar o registro da dor em prontuário, de pacientes submetidos à craniotomia eletiva. MÉTODO: Estudo descritivo, quantitativo. Foram estudados 100 pacientes submetidos à craniotomia. As variáveis pesquisadas foram idade, sexo, tipo de operação, presença e intensidade da dor, registro da dor e uso de analgésicos no pós-operatório. Realizou-se a análise descritiva das variáveis estudadas, utilizando-se medidas de tendência central, dispersão e análise de proporções. RESULTADOS: Os dados deste estudo demonstram que 59% dos pacientes submetidos à craniotomia eram do sexo feminino, com média de idade 44,6 ± 14,5 anos, 57% eram solteiros, e tiveram uma média de internação na unidade de terapia intensiva (UTI) e no hospital de 2,8 ± 2,4 e 21,8 ± 16,9 dias, respectivamente. Em 55% dos casos o diagnóstico médico foi de tumor cerebral, e o tipo de operação foi supratentorial em 90% dos pacientes. A cefaleia foi a principal queixa no pós-operatório, classificada na maioria das vezes como moderada, do tipo contínua. A maioria dos pacientes não recebeu qualquer tipo de medicação analgésica. Na maior parte dos prontuários não havia registro da dor pela equipe de saúde. CONCLUSÃO: Os dados demonstram a necessidade de aperfeiçoamento dos profissionais da saúde para o tratamento e a avaliação da dor de maneira sistemática._________________________________________________________________________________________ ABSTRACT: BACKGROUND AND OBJECTIVES: Pain is subjective and multidimensional and is common in the postoperative period. This study aimed at identifying intensity and at checking pain records of patients submitted to elective craniotomy. METHOD: This is a descriptive and quantitative study involving 100 patients submitted to craniotomy. Studied variables were age, gender, type of surgery, pain and pain intensity, pain records and the use of analgesics in the postoperative period. Studied variables were submitted to descriptive analysis using central trend measurements, dispersion and ratio analysis. RESULTS: Our study has shown that 59% of patients submitted to craniotomy were females, with mean age of 44.6 ± 14.5 years, 57% were single and had mean ICU and hospital stay of 2.8 ± 2.4 e 21.8 ± 16.9 days, respectively. Brain tumor was diagnosed in 55% of cases and surgery was supratentorial in 90% of patients. Headache was the major postoperative complaint, classified as moderate and continuous by most patients. Most patients had no analgesic medication. Most medical records had no pain recorded by the health team. CONCLUSION: Data show the need for health professionals' improvement to systematically treat and evaluate pain

Postoperative pain in patients submitted to elective craniotomy

Artigo disponível em português e inglêsJUSTIFICATIVA E OBJETIVOS: A dor é uma experiência subjetiva e multidimensional, comum em pacientes submetidos a operações. Os objetivos do estudo foram identificar a intensidade e verificar o registro da dor em prontuário, de pacientes submetidos à craniotomia eletiva. MÉTODO: Estudo descritivo, quantitativo. Foram estudados 100 pacientes submetidos à craniotomia. As variáveis pesquisadas foram idade, sexo, tipo de operação, presença e intensidade da dor, registro da dor e uso de analgésicos no pós-operatório. Realizou-se a análise descritiva das variáveis estudadas, utilizando-se medidas de tendência central, dispersão e análise de proporções. RESULTADOS: Os dados deste estudo demonstram que 59% dos pacientes submetidos à craniotomia eram do sexo feminino, com média de idade 44,6 ± 14,5 anos, 57% eram solteiros, e tiveram uma média de internação na unidade de terapia intensiva (UTI) e no hospital de 2,8 ± 2,4 e 21,8 ± 16,9 dias, respectivamente. Em 55% dos casos o diagnóstico médico foi de tumor cerebral, e o tipo de operação foi supratentorial em 90% dos pacientes. A cefaleia foi a principal queixa no pós-operatório, classificada na maioria das vezes como moderada, do tipo contínua. A maioria dos pacientes não recebeu qualquer tipo de medicação analgésica. Na maior parte dos prontuários não havia registro da dor pela equipe de saúde. CONCLUSÃO: Os dados demonstram a necessidade de aperfeiçoamento dos profissionais da saúde para o tratamento e a avaliação da dor de maneira sistemática._________________________________________________________________________________________ ABSTRACT: BACKGROUND AND OBJECTIVES: Pain is subjective and multidimensional and is common in the postoperative period. This study aimed at identifying intensity and at checking pain records of patients submitted to elective craniotomy. METHOD: This is a descriptive and quantitative study involving 100 patients submitted to craniotomy. Studied variables were age, gender, type of surgery, pain and pain intensity, pain records and the use of analgesics in the postoperative period. Studied variables were submitted to descriptive analysis using central trend measurements, dispersion and ratio analysis. RESULTS: Our study has shown that 59% of patients submitted to craniotomy were females, with mean age of 44.6 ± 14.5 years, 57% were single and had mean ICU and hospital stay of 2.8 ± 2.4 e 21.8 ± 16.9 days, respectively. Brain tumor was diagnosed in 55% of cases and surgery was supratentorial in 90% of patients. Headache was the major postoperative complaint, classified as moderate and continuous by most patients. Most patients had no analgesic medication. Most medical records had no pain recorded by the health team. CONCLUSION: Data show the need for health professionals' improvement to systematically treat and evaluate pain

High-concentration carbamide peroxide can reduce the sensitivity caused by in-office tooth bleaching: a single-blinded randomized controlled trial

Objectives: A single-blinded, randomized, parallel clinical trial evaluated the use of 37% carbamide peroxide (CP) on bleaching effectiveness and tooth sensitivity reported by patients undergoing in-office tooth bleaching, in comparison with the results of using 35% hydrogen peroxide. Material and Methods:Forty patients were allocated to receive two sessions of in-office tooth bleaching using either 35% hydrogen peroxide (HP) or 37% CP. Each patient’s sensitivity level was evaluated during and up to 24 h after bleaching. The effectiveness of the bleaching procedures was evaluated with a spectrophotometer one week after each session and 30 days after the last session. The impact of tooth bleaching on the patients’ perceptions regarding smile changes, in addition to the bleaching procedures and their results, were also recorded. Absolute and relative sensitivity risks were calculated. Data on sensitivity level were analyzed using the Mann-Whitney or T-test, and data from the color evaluation were subjected to 2-way repeated measures ANOVA. Results: The use of CP reduced the risk and level of tooth sensitivity to values close to zero, whereas the difference between the bleaching agents disappeared after 24 h. An increased bleaching effect was observed for HP, mainly due to an improved reduction of redness and yellowness. Participants perceived improved tooth bleaching for HP and reduced sensitivity for CP, but no differences regarding the comfort of the techniques were noted. Conclusions: In our study, 37% CP resulted in reduced tooth sensitivity but decreased the tooth bleaching effectiveness. However, both bleaching agents resulted in high levels of patient satisfaction