Diagnostic and therapeutic features associated with modification of quality-of-life's outcomes between one and six months after major surgery for head and neck cancer / Características terapêuticas e diagnósticas associadas a modificações nos resultados da qualidade de vida entre um e seis meses após cirurgia de grande porte para câncer de cabeça e pescoço

ABSTRACT INTRODUCTION: Treatments used in head and neck cancer greatly impact the physical, psychological and functional state of patients. Evaluation of quality of life has become an integral part of the treatment. OBJECTIVE: This retrospective study evaluates features involved in changes in quality of life after major surgery for head and neck cancer within six months, according to self-reported outcomes. METHODS: One hundred and thirty patients completed the University of Washington Quality of Life questionnaire one and six months after major surgery for head and neck cancer. A multivariate model was used to evaluate which diagnostic and therapeutic features were related to improvement of quality of life within a six-month period. RESULTS: Significant improvement in most features related to quality of life was already recognizable at six months. Patients submitted to more invasive treatment had the biggest improvement in quality of life between time-points, as well as those patients with bigger tumors. CONCLUSION: After major surgery, patients may undergo fast recovery, with overall quality of life likely to improve in the short-term. Clinicians must be aware of the importance of dealing with treatment-related issues immediately after surgery, with hopeful possibility of on-the-upgrade results.

Resumo Introdução: Os tratamentos adotados em câncer de cabeça e pescoço causam grande impacto nos estados físico, psicológico e funcional dos pacientes. A avaliação da qualidade de vida tornou-se parte integrante do tratamento. Objetivo: Este estudo retrospectivo avaliou os aspectos envolvidos nas mudanças da qualidade de vida pós-cirurgia de grande porte para câncer de cabeça e pescoço no período de seis meses, de acordo com os resultados autorrelatados. Método: Cento e trinta pacientes responderam ao Questionário de Avaliação de Qualidade de Vida da Universidade de Washington, um e seis meses após cirurgia de grande porte para câncer de cabeça e pescoço. Um modelo multivariado foi usado para avaliar quais características terapêuticas e diagnósticas estavam relacionadas à melhora da qualidade de vida no período de seis meses. Resultados: Melhora significativa na maioria dos aspectos relacionados à qualidade de vida já podia ser percebida em seis meses. Os pacientes submetidos a um tratamento mais invasivo apresentaram os melhores avanços na qualidade de vida entre os tempos de avaliação, bem como os pacientes portadores de tumores maiores. Conclusão: Após uma cirurgia de grande porte, os pacientes podem ter recuperação rápida, com melhora da qualidade de vida global em pouco tempo. Os médicos devem estar cientes da importância de lidar com questões relacionadas ao tratamento imediatamente após a cirurgia, devido à possibilidade de resultados melhores.

Dental malocclusion and body posture in young subjects: a multiple regression study

OBJECTIVES: Controversial results have been reported on potential correlations between the stomatognathic system and body posture. We investigated whether malocclusal traits correlate with body posture alterations in young subjects to determine possible clinical applications. METHODS: A total of 122 subjects, including 86 males and 36 females (age range of 10.8-16.3 years), were enrolled. All subjects tested negative for temporomandibular disorders or other conditions affecting the stomatognathic systems, except malocclusion. A dental occlusion assessment included phase of dentition, molar class, overjet, overbite, anterior and posterior crossbite, scissorbite, mandibular crowding and dental midline deviation. In addition, body posture was recorded through static posturography using a vertical force platform. Recordings were performed under two conditions, namely, i) mandibular rest position (RP) and ii) dental intercuspidal position (ICP). Posturographic parameters included the projected sway area and velocity and the antero-posterior and right-left load differences. Multiple regression models were run for both recording conditions to evaluate associations between each malocclusal trait and posturographic parameters. RESULTS: All of the posturographic parameters had large variability and were very similar between the two recording conditions. Moreover, a limited number of weakly significant correlations were observed, mainly for overbite and dentition phase, when using multivariate models. CONCLUSION: Our current findings, particularly with regard to the use of posturography as a diagnostic aid for subjects affected by dental malocclusion, do not support existence of clinically relevant correlations between malocclusal traits and body posture