Sialendoscopy for treatment of major salivary glands diseases: a comprehensive analysis of published systematic reviews and meta-analyses

Abstract Objectives: Sialendoscopy is a minimally invasive procedure used to diagnose and treat obstructive salivary gland diseases. Previous studies in the topic have shown mixed results. The present study aimed to evaluate the efficacy and safety of sialendoscopy through previous systematic reviews for different outcomes of several diseases. We also aimed to assess studies' methodological quality and heterogeneity. Methods: We conducted a comprehensive systematic literature search of Pubmed, Embase, Lilacs and Cochrane Library. We included systematic reviews and meta-analyses that used sialendoscopy to treat both lithiasic and alithiasic salivary glands diseases. Data extraction included studies' characteristics and results. We assessed studies' methodological quality using the AMSTAR-2 (A Measurement Tool to Assess systematic Reviews 2) tool. Results: 13 studies were included in the review, being 9 in adult populations and 4 in pediatric populations. Sialendoscopy proved to be effective at the treatment of different lithiasic and other obstructive diseases, but with important heterogeneity. The technique was also considered highly safe in most studies. However, studies had a critically low quality of evidence. Conclusions: Most studies demonstrated high efficacy and safety of sialendoscopy, but with critically low quality of evidence. We still lack randomized studies in this field, and future systematic reviews on the topic should follow current guidelines to improve conduction and reporting.

Cancer in the head and neck region and its face under the perspective of users of a public reference hospital in Recife, state of Pernambuco, Brazil

Introduction: In Brazil, cancer is a public health problem because of its epidemiological, social, and economic amplitude. Objective: This study aimed to identify and analyze the difficulties experienced by head and neck (H&N) cancer patients, who are users of the Brazilian public health system (SUS), from their perspective of diagnosis to post-treatment. Methods: Qualitative case series carried out using individual semistructured interviews. Data were collected from October 2019 to March 2020 and interpreted by content analysis. Results: Three categories emerged from the analysis: "difficulties in the diagnosis phase", "conflicts experienced during treatment" and "post-treatment difficulties/sequelae". Corroborating the literature, it was found that the difficulties faced by cancer patients are present in all stages of the disease: from access to prevention health services and diagnosis to post-treatment, influenced by late diagnosis, treatment side effects, and disease comorbidities. Conclusion: It is essential to carry out studies addressing changes in the family, professional and personal scope of cancer patients, aiming to provide them with comprehensive care and health professionals with understanding about what this disease represents in the life of these individuals.

Conhecimentos, atitudes e práticas sobre câncer de boca da comunidade atendida pelo PSF de São Sebastião do Umbuzeiro/PB / Oral cancer knowledge, attitudes and practices of the community assisted by PSF of São Sebastião do Umbuzeiro/PB

Introdução: Diante dos dados de aumento da incidência e da taxa de mortalidade por câncer de boca no Brasil e dos índices que demonstram inadequações das ações de prevenção, diagnóstico e tratamento, buscou-se verificar os conhecimentos, atitudes e práticas da comunidade atendida pelo PSF de São Sebastião do Umbuzeiro/PB a respeito dessa neoplasia. Objetivo: Avaliar o grau de conhecimento dos usuários quanto aos fatores de risco, formas de prevenção e tratamento e conseqüências para o paciente acometido pelo câncer bucal. Métodos: A amostra foi totalizada em 50 questionários aplicados aos pacientes que estavam realizando sua primeira consulta odontológica na Unidade de Saúde da Família. Resultados: Observou-se que, com relação ao perfil sócio-econômico, 48% dos pacientes são pardos, 72% são do gênero feminino e moram na zona urbana, 40% possuem de um a quatro anos de estudo concluídos e 46% são agricultores e possuem renda familiar menor que um salário mínimo. Quanto aos fatores de risco para o câncer de boca, 37% são fumantes e 50% consomem bebida alcoólica em uma freqüência menor que três vezes por semana. Sobre o grau de conhecimento a respeito da doença, 56% consideram possuir conhecimento insuficiente e a quase totalidade (98%) demonstra interesse em aprender mais. Conclusão: Esse grupo populacional está submetido a condições precárias de vida e trabalho e não possui um grau de conhecimento que possibilite a tomada de atitudes e práticas preventivas, mas encontra-se interessado neste aprendizado.

Introduction: Considering the increase of oral cancer occurrence and mortality rates in Brazil and the data that demonstrate unsuitable actions of prevention, diagnosis and treatment, it was intended to check the knowledge, attitudes and practices concerning that disease in the community assisted at PSF of São Sebastião do Umbuzeiro/PB. Objctive: this T evaluate the level of knowledge of the users concerning the risk factors, ways of prevention and treatment and also consequences for the patient with oral carcinoma. Methods: The sample had a total of 50 questionnaires applied to patients that were attending their first dental appointment at the Unidade de Saúde da Família. Results: It could be seen that, concerning their social and economic profile, 48% of the patients are dark colored fellows, 72% are women and live in a urban zone, 40% have studied from 1 to 4 years and 46% are agricultural workers and have a less than minimum wage income. As to the risk factors for oral cancer, 37% smoke and 50% drink alcohol less than 3 times a week. On the degree of knowledge regarding the illness, 56% consider having insufficient knowledge and almost all of them (98%) show interest in learning more. Conclusion: This population has been submitted to poor life and work conditions and does not have enough knowledge to act in a preventive way. However, they are interested in learning.

Fungos associados a tumores de cabeça e pescoço / Fungal association with head and neck tumors

Introdução: Fungos podem infectar secundariamente carcinoma de cabeça e pescoço, diante da imunossupressão local e de tratamentos invasivos. Objetivo: Detectar fungos em tumor de cabeça e pescoço. Métodos: Foram submetidos à biópsia 81 pacientes, atendidos no ambulatório de cirurgia de cabeça e pescoço do Hospital do Câncer de Pernambuco, obtendo-se 83 amostras teciduais, segmentadas para exame histopatológico e micológico. Foram preparados exames diretos com KOH a 20% e cultura em ágar infusão de cérebro e coração e ágar Sabouraud, adicionados de cloranfenicol mantidos em duplicata a 30°C e 37°C, respectivamente. Resultados: Foram detectadas leveduras e/ou pseudomicélio com isolamento de Candida albicans (três), C. tropicalis (uma), C. parapsilosis (quatro), C. guillermondii (duas) acometendo áreas de cavidade bucal, lábio e pele na região da cabeça e pescoço. No diagnóstico histológico, foi confirmado que 60% dos pacientes apresentavam carcinoma de células escamosas. Os tumores malignos ocorreram no estádio I em 50%, seguido de estádio II e IV. Em apenas um caso foi verificado tumor de língua benígno. Conclusão: Fungos ocorrem em tumores de cabeça e pescoço e, devido à gravidade de seus danos, torna-se indispensável o diagnóstico preciso e precoce.

Introduction: Fungi can secondarily infect head and neck carcinoma, due to the local immunosuppression and invasive treatments. Objective: To detect fungi in head and neck tumor. Methods: 81 patients had been submitted to biopsy, attended the clinic of surgery of head and neck of the Cancer Hospital of Pernambuco getting 83 clinical specimens, which had been fragmented, for histopathologic and mycological examination. They were prepared for direct examination with potassium hydroxide solution 20% and culture in agar brain heart infusion and Sabouraud agar added with cloranphenicol, kept at 30°C and 37°C. Results: Yeasts were detected and/or pseudomicelium with isolation of Candida albicans (3), C. tropicalis (1), C. parapsilosis (4), C. guillermondii (2) affecting areas of the oral cavity, lip and skin in the head and neck region. On histological diagnosis it was confirmed that 60% of the patients presented squamous cells carcinoma. The malignant tumors occurred in stadium I in 50%, followed by stadium II and IV. Only one case of tongue benign tumor was verified. Conclusion: Fungi occur in head and neck tumors and, due to the severity of his injury, it is essential to the accurate early diagnosis.

Carcinoma metastático de mama para couro cabeludo / Breast carcinoma metastatic to the scalp

Apesar de as neoplasias metastáticas para a cabeça e pescoço serem raras quando comparadas com as neoplasias primárias, o carcinoma metastático de mama tem sido descrito em diversos sítios da cabeça e pescoço. Este é um caso de uma paciente com adenocarcinoma de mama que evoluiu com metástase para couro cabeludo.

Although the metastasis to head and neck are rare when compared with primary neoplasms, metastatic carcinoma from breast has been described in many sites of head and neck. This is a case of a patient with adenocarcinoma of breast that developed metastasis to the scalp.

Expressão das proteínas Ki-67 e endoglina (CD 105) no carcinoma epidermóide de língua oral e assoalho de boca estádios I e II: associação com fatores demográficos, clínicos e histopatológicos: análise prognóstica / Expression of ki-67 and endoglin (CD105) proteins in stages I and II, squamous cell carcinoma of oral tongue and floor of the mouth: association with demographic, clinical and histopathological factors: prognostic analysis

A seleção do tratamento mais apropriado para cada paciente portador de carcinoma epidermóide é uma busca constante em oncologia. Essa opção terapêutica ainda é baseada no sistema TNM, que não inclui avaliação da biologia molecular dos tumores e nem de aspectos histopatológicos, critérios estes que podem alterar o curso da doença e motivar um tratamento mais agressivo. O objetivo deste estudo retrospectivo, com 53 pacientes portadores de carcinoma epidermóide de língua oral e assoalho de boca, tratados no Hospital de Câncer de Pernambuco, entre maio de 1996 a fevereiro de 2002, foi analisar o impacto de fatores demográficos, clínicos, histopatológicos, moleculares (KI-67 e endoglina) e o estadiamento sobre o comportamento biológico dos tumores / The election of the ideal and most appropriate treatment and for each patient with squamous cell carcinoma is a constant search in oncology. This therapeutical option is still based on system TNM, that does not include evaluation of the molecular biology of the tumors and nor of histopathological aspects, criterions that can modify the course of the illness, and could motivate a more aggressive treatment. The objective of this retrospective study, with 53 patients with squamous cell carcinoma of oral tongue and floor of mouth, treated in the Hospital do Cancer de Pernambuco, between May 1996 and February 2002, was to analyze the impact of demographic, clinical, histopathological, molecular (KI-67 and endoglin) factors and the stage on the biological behavior of the...