ABSTRACT
Introdução: Pacientes com câncer necessitam de atendimento odontológico personalizado em virtude das terapias antineoplásicas para minimizar a ocorrência ou a gravidade dos efeitos adversos causados por essas terapias nos tecidos bucais. Objetivo: Traçar o perfil epidemiológico e odontológico de pacientes oncológicos acompanhados em um serviço de referência em odontologia do Estado do Ceará. Método: Estudo retrospectivo observacional transversal, baseado em prontuários de pacientes com necessidades especiais atendidos ambulatorialmente entre 2017 e 2021. Tais variáveis foram analisadas utilizando os testes exato de Fisher ou qui-quadrado de Pearson, adotando um nível de confiança de 95% com o software SPSS versão 20.0 para Windows. Resultados: A maioria dos pacientes avaliados era do sexo masculino (55,8%), com idade entre 51 e 60 anos (39,0%), sendo o câncer de cabeça e pescoço o mais prevalente (37,7%). Os principais motivos de procura por atendimento odontológico foram adequação bucal pré-tratamento de câncer (36,4%), tratamento pós-câncer (22,05%) e dor (15,6%), a maioria em fase pós-quimioterapia (42,9%) e pós-radioterapia (39,0%). Os procedimentos odontológicos mais realizados entre os pacientes foram dentística (64,9%), periodontia (59,7%) e cirurgia (48,1%). Em relação à higiene bucal, 49,2% escovavam os dentes uma vez ao dia e 54,5% não utilizavam fio dental; 47,8% desses pacientes apresentaram índice CPO-D (dentes permanentes cariados, perdidos e obturados) superior a 20. Conclusão: Aproximadamente metade dos pacientes procurou atendimento odontológico para adequação pré-tratamento oncológico, entretanto, a maior parte deles buscou atendimento após o fim da quimioterapia e radioterapia, o que pode estar associado ao elevado índice de CPO-D
Introduction: Cancer patients need personalized dental care due to antineoplastic therapies to minimize the occurrence or severity of adverse effects caused on oral tissues. Objective: Design the epidemiological and dental profile of cancer patients followed up at a reference dentistry service in the State of Ceará. Method: Cross-sectional observational retrospective study, based on medical records of patients with special needs followed up at an outpatient clinic from 2017 to 2021. The variables were tabulated using Fisher's or Pearson's chi-square tests, with a confidence level of 95% with the software SPSS version 20.0 for Windows. Results: The majority of patients evaluated were males (55.8%), aged between 51 and 60 years (39.0%) with head and neck cancer as the most prevalent (37.7%). The main reasons for seeking dental care were oral adequacy pre-cancer treatment (36.4%), post-cancer treatment (22.05%) and pain (15.6%), with the majority in post-chemotherapy phase (42.9%) and after radiotherapy (39.0%). Restorative dentistry (64.9%), periodontics (59.7%) and surgery (48.1%) were the dental procedures most performed. Regarding oral hygiene, 49.2% brushed their teeth once a day and 54.5% did not use dental floss, 47.8% of these patients had a DMFT Index (decayed, missing, filled teeth) greater than 20. Conclusion: Approximately half of the patients sought dental care for pre-oncological treatment adjustment, however, the majority sought care post-chemotherapy and radiotherapy, which may be associated with high DMFT index
Introducción: Los pacientes oncológicos necesitan una atención odontológica personalizada debido a las terapias antineoplásicas, con el objetivo de minimizar la aparición o severidad de los efectos adversos que estas terapias provocan en los tejidos orales. Objetivo: Trazar el perfil epidemiológico y odontológico de pacientes oncológicos seguidos en un servicio de referencia en odontología en el estado de Ceará. Método: Estudio retrospectivo observacional transversal, basado en historias clínicas de pacientes atendidos ambulatoriamente para pacientes con necesidades especiales de 2017 a 2021. Dichas variables se tabularon mediante las pruebas de Fisher o ji-cuadrada de Pearson, adoptando un nivel de confianza del 95% en el software SPSS v20.0 para Windows. Resultados: La mayoría de los pacientes evaluados fueron del sexo masculino (55,8 %), con edad entre 51 y 60 años (39,0 %), siendo el cáncer más prevalente entre ellos, los de cabeza y cuello (37,7%). Los principales motivos de búsqueda de atención odontológica fueron tratamiento precanceroso de adecuación oral (36,4%), tratamiento poscanceroso (22,05%) y dolor (15,6%), siendo la mayoría en fase posquimioterapia (42,9%) y después radioterapia (39,0%). Los procedimientos odontológicos más realizados entre los pacientes fueron odontología restauradora (64,9%), periodoncia (59,7%) y cirugía (48,1%). En cuanto a la higiene bucal, el 49,2% se cepillaba los dientes una vez al día y el 54,5% no utilizaba hilo dental, donde el 47,8% de estos pacientes presentaba un índice de CPOD (dientes permanentes, con caries, perdidos y curados) superior a 20. Conclusión: Aproximadamente la mitad de los pacientes buscó atención odontológica para ajustar el tratamiento preoncológico, sin embargo, la mayoría de los pacientes buscó atención después del final de la quimioterapia y radioterapia, lo que puede estar asociado con la alta tasa de CPOD
Subject(s)
Humans , Male , Female , Patient Care Team , Oral Health , Dental Care for Chronically IllABSTRACT
Ventilator-associated pneumonia (VAP) is one of the most prevalent healthcare-associated infections (HAI) and causes of death in intensive care units (ICUs), and studies have shown its relation to oral health. Aim: To report the impact of the incorporation of dental professionals into multidisciplinary ICU staff on the incidence of VAP. Methods: A retrospective observational study was carried out to collect and analyze health indicators of patients in the ICUs from 2011 to 2018 and to differentiate these indicators between the periods before and after the participation of dental staff in the ICU. This study was approved by the Research Ethics Committee. Results:The average number of monthly ICU admissions was 105.89 ± 169.72, and the discharge was 105.21 ± 168.96, with a monthly average number of deaths within 24 h of 38.61 ± 62.27. The average number of monthly HAI-related deaths decreased from 2011 to 2018, followed by a reduction in cases of HAI per month. The average monthly number of HAIs related to mechanical ventilation (MV) decreased, and the same was observed for the infection density of HAIs related to MV (p < 0.001). In multivariate analysis, there was a significant decrease in the number of HAIs related to MV (p = 0.005). Conclusion: Although a reduction in the number of admissions or complexity of cases was not observed in the study period, multidisciplinary staff practices were essential for controlling HAIs and the presence of dental professionals can assist in the control of HAIs related to MV