Accuracy, sensitivity and specificity of fine needle aspiration biopsy in salivary gland tumours : a retrospective study

Objective: The aim of this study was to evaluate the diagnostic accuracy, sensitivity and specificity of fine needle aspiration biopsies (FNAB) of salivary gland tumours performed at the Erasto Gaertner Hospital over the course of a four year period. Study design: A retrospective study was carried out between 2001-2005 to review the cases of patients with salivary gland tumours who had undergone pre-operative FNAB and had been diagnosed during post-operative histopathology examination. Results: A total of 106 cases of salivary gland tumours were considered for this study, but 27 cases (25.5%) of the samples were considered unsatisfactory for analysis. The sensitivity, specificity and accuracy were calculated considering only the 79 benign and malignant cases in which FNAB provided sufficient samples for analysis. Based on these data, the value of sensitivity was 68.2% (15/22), specificity was 87.7% (50/57), accuracy was 82.3% (65/79), positive predictive value was 68.2% (15/22) and negative predictive value was 87.7% (50/57). Conclusions: Despite the high rate of inadequate samples obtained in the FNAB in this study, the technique offers high specificity, accuracy and acceptable sensitivity

Design of a geospatial model applied to Health management

ABSTRACT Objective: To identify geographically the beneficiaries categorized as prone to Type 2 Diabetes Mellitus, using the recognition of patterns in a database of a health plan operator, through data mining. Method: The following steps were developed: the initial step, the information survey. Development, construction of the process of extraction, transformation, and loading of the database. Deployment, presentation of the geographical information through a georeferencing tool. Results: As a result, the mapping of Paraná according to its health care network and the concentration of Type 2 Diabetes Mellitus is presented, enabling the identification of cause-and-effect relationships. Conclusion: It is concluded that the analysis of georeferenced information, linked to health information obtained through the data mining technique, can be an excellent tool for the health management of a health plan operator, contributing to the decision-making process in Health

Comparative study of tissue reactivity to n-butyl-2-cyanoacrylate and nylon monofilament thread on pericranium-cutaneous flaps in rats

PURPOSE:To study the repair of pericranium-cutaneous flaps fixed with suture anchored in a skull bone tunnel or N-butyl-2-cyanoacrylate adhesive in Wistar rats with emphasis on the cellular inflammatory response and the production of types I and III collagen. METHODS:The operated region in the cephalic region of Wistar rats was removed minutes before euthanasia, fixed in formalin, and subjected to histological preparation. Slides were stained with hematoxylin-eosin and Picrosirius. Standardized counts of polymorphonuclear and mononuclear cells, fibroblasts, and macrophages were performed, and the percentages of types I and III collagen were determined. Data collection occurred on days 3, 7, 14, 21, and 45 postoperatively. A value of p<0.05 was considered statistically significant. RESULTS:Quantitative analysis of the data showed more fibroblasts in the surgical adhesive group than in the nylon monofilament thread groups (p=0.0211). Qualitative analysis showed higher reactivity in the adhesive group, with a predominance of polymorphonuclear cells from days 3-45 and macrophages from days 3-7. The amount of type I collagen exceeded 80% in the treated and control groups at the end of the experiment. CONCLUSIONS:Subperiosteal detachment triggers a cellular inflammatory response that is amplified using soft tissue fixation methods. The adhesive n-butyl-2-cyanoacrylate was more reactive than the nylon monofilament thread anchored in the skull bone tunnel.26126

O processo de cicatrização influenciado pelo hipotireoidismo e pelo envelhecimento: estudo da cicatrização de anastomoses intestinais, em ratos The healing inffluenced by hypotireoidism and elderly: study of intestinal anastomosis healing in rats

OBJETIVO: O envelhecimento da população tem feito crescer o número de intervenções em pacientes idosos, sendo o hipotireoidismo, ainda que sub-clínico, é uma situação bastante comum nestes doentes. O presente estudo busca conhecer a influência do hipotireoidismo no processo de cicatrização de anastomoses colônicas em ratos idosos. MÉTODO: Utilizaram-se 96 ratos Wistar, machos; 48 deles jovens e 48 velhos. Metade dos animais jovens e metade dos velhos eram eutireoideanos e metade eram hipotireoideanos. Conseguiu-se o hipotireoidismo por meio de tireoidectomia total. Após 30 dias, fez-se uma laparotomia mediana seguida de colotomia transversa de cólon esquerdo com anastomose término-terminal e laparorrafia. No 3.º, 7.º e 14.º dias de pós-operatório, sorteados, 6 animais de cada grupo, que foram submetidos à eutanásia. Fez-se a análise macroscópica das anastomoses, da resistência e estudo histopatológico. RESULTADOS: Não se detectaram deiscências e o ganho de resistência e a evolução histológica geral, considerando epitelização e reação inflamatória foi semelhante em todos os grupos. A análise do conteúdo total de colágeno revelou, no 3.º dia, que as anastomoses de jovens e velhos tinham o mesmo comportamento, porém via-se menos colágeno nas anastomoses dos animais com hipotireoidismo (JN x JH p=0,0000; VN x VH p=0,0000). Este comportamento se manteve no 7.º e no 14.º dia. A presença de colágeno I era menor nas anastomoses dos animais hipotireoideanos no 3.º dia (JN x JH p=0,0015; VN x VH p=0,0000), no 7.º dia (JN x JH p=0,0006; VN x VH p=0,0001) e no 14.º dia (JN x JH p=0,0181; VN x VH p=0,0057) o mesmo acontecendo com o colágeno III, no 3.º dia (x JH p=0,0007; VN x VH p=0,0260), no 7.º dia (JN x JH p=0,0160; VN x VH p=0,2670) e no 14.º dia (JN x JH p=0,0000; VN x VH p=0,0030). CONCLUSÃO: A análise dos resultados permite concluir que existe diminuição da concentração de colágeno decorrente da baixa da síntese e retardo de maturação das cicatrizes das anastomoses muito mais às custas do hipotireoidismo do que do envelhecimento.<br>TURPOSE: The aging of the population has led to an increased number of interventions in elderly patients, with hypothyroidism, even at the subclinical level, being a common situation among these patients. The objective of the present study was to determine the influence of hypothyroidism on the healing process of colon anastomoses in aged rats. METHODS: 96 male Wistar rats were used, 48 of them young and 48 old. Half the young animals and half the old ones were euthyroid and half were hypothyroid. Hypothyroidism was obtained by total thyroidectomy. Thirty days after surgery the animals were submitted to median laparotomy followed by transverse colotomy of the left colon with end-to-end anastomosis and laparorrhaphy. Six animals from each group were submitted to euthanasia by drawing lots on the 3rd, 7th and 14th postoperative day and submitted to macroscopic, resistance, and histopathological analysis of the anastomoses. RESULTS: No dehiscence was observed and the gain of resistance and the general histological evolution in terms of epithelialization and inflammatory reaction was similar in all groups. Analysis of total collagen content revealed that the anastomoses of young and old animals showed the same behavior on the 3rd day, although less collagen was observed in hypothyroid animals (YN x YH p=0.0000; ON x OH p=0.0000). This behavior persisted on the 7th and 14th day. Less collagen I was present in the anastomoses of hypothyroid animals on the 3rd (YN x YH p=0.0015; ON x OH p=0.0000), 7th (YN x YH p=0.0006; ON x OH p=0.0001) and 14th day (YN x YH p=0.0181; ON x OH p=0.0057), the same occurring for collagen III on the 3rd (x YH p=0.0007; ON x OH p=0.0260), 7th (YN x YH p=0.0160; ON x OH p=0.2670) and 14th day (YN x YH p=0.0000; ON x OH p=0.0030). CONCLUSION: Analysis of the results permitted us to conclude that lower collagen concentration due to low synthesis and delayed scar maturation in the anastomoses occurred and was much more due to hypothyroidism than to aging

Epithelial-mesenchymal markers and their correlation with clinical aspects in odontogenic keratocysts

ABSTRACT Objective: Odontogenic keratocysts have a high recurrence rate and aggressive clinical behavior. The event called epithelial-mesenchymal transition is a process in which the epithelial cell loses its epithelial characteristics and acquires properties typical of mesenchymal cells. Studies have already demonstrated that odontogenic keratocysts has expression of tumor markers, but the lack of clarification about its development mechanism and molecular composition makes the therapeutic options remain limited. The aim of this study is to evaluate the expression of epithelial-mesenchymal transition marker proteins in these lesions, correlating the expression of these proteins with clinical aspects of each case. Methods: Patients with odontogenic keratocysts diagnoses, treated by the Department of Oral and Maxillofacial Surgery of the Erasto Gaertner Hospital, Curitiba, Brazil in the period between 2016 and 2019 were evaluated by immunohistochemical analysis, to assess the expression of epithelial-mesenchymal transition markers (Vimentin, beta-catenin and E-cadherin) by qualitative analysis. Results: Eighteen patients were included, with a mean age of 43 years, and most of them were male. The mandible was more affected than the maxilla. No association between the clinical characteristics of the cysts and the immunohistochemical profile for epithelial-mesenchymal transition proteins was observed. Conclusion: The positivity of E-cadherin and negativity of vimentin demonstrates that its function is preserved. Loss of function of E-cadherin is associated with worse prognosis. The identification of the epithelial-mesenchymal transition process as a prognostic marker for odontogenic cysts and tumors could be an important tool for defining treatment