Religiosidade e espiritualidade no cuidado da saúde e o impacto na vida de pessoas com doenças crônicas / Religiosity and spirituality in health care and the impact on life / Religiosidad y espiritualidad en el cuidado de la salud y elimpacto en la vida

Objetivo: Descrever a influência da religiosidade e espiritualidade no cuidado da saúde, com ênfase nas seguintes doenças crônicas: diabetes, doença pulmonar obstrutiva crônica, doenças cardiovasculares e renais. Método:Revisão sistemática realizada nas bases de dados Latindex, Pubmed e SciELO. As palavras-chave utilizadas foram: "religiosidade" OR "espiritualidade" AND "cuidados da saúde" AND "doenças crônicas" e seus equivalentes no idioma inglês: "religiosity" OR "spirituality" AND "health care" AND "Chronic disease". Foram selecionados artigos nos idiomas português e inglês, publicados nos últimos dez anos. Resultados:Foram encontrados 3.686 artigos. Após leitura e análise criteriosa foram selecionados 14 artigos finais. Os benefícios que aparecem nos estudos estão relacionados com mudanças no estilo de vida, redução de depressão, ansiedade e estresse, que o diagnóstico de doença crônica carrega, estimulando o maior enfrentamento as doenças e maior adesão aos tratamentos, contribuindo de forma geral para o bem-estar e melhora da saúde desta população. Conclusão:Indivíduos portadores de doenças crônicas que usam a R/E no enfrentamento da doença, apresentam um impacto positivo no cuidado das mesmas e melhor qualidade de vida.

Objective: To describe the influence of religiosity and spirituality in health care, with emphasis on the following chronic diseases: diabetes, chronic obstructive pulmonary disease, cardiovascular and renal diseases. Method:Systematic review performed in the databases Latindex, Pubmed and SciELO. The keywords used were: "religiosity" OR "spirituality" AND "health care" AND "chronic diseases" and their equivalents in the English language: "religiosity" OR "spirituality" AND "health care" AND "Chronic disease". Articles in Portuguese and English, published in the last ten years, were selected. Results: A total of 3,686 articles were found. After careful reading and analysis, 14 final articles were selected. The benefits that appear in the studies are related to changes in lifestyle, reduction of depression, anxiety and stress, which the diagnosis of chronic disease carries, stimulating greater coping with diseases and greater adherence to treatments, contributing in a general way to the well-being and improvement of the health of this population. Conclusion:Individuals with chronic diseases who use R/E in coping with the disease have a positive impact on their care and better quality of life

Objetivo: Describir la influencia de la religiosidad y la espiritualidad en el cuidado de la salud, con énfasis en las siguientes enfermedades crónicas: diabetes, enfermedad pulmonar obstructiva crónica, enfermedades cardiovasculares y renales. Método:Revisión sistemática realizada en las bases de datos Latindex, Pubmed y SciELO. Las palabras clave utilizadas fueron: "religiosidad" O "espiritualidad" Y "cuidado de la salud" Y "enfermedades crónicas" y sus equivalentes en el idioma inglés: "religiosidad" O "espiritualidad" Y "atención médica" Y "enfermedad crónica". Se seleccionaron artículos en portugués e inglés, publicados en los últimos diez años.Resultados:Se encontraron un total de 3.686 artículos. Después de una cuidadosa lectura y análisis, se seleccionaron 14 artículos finales. Los beneficios que aparecen en los estudios están relacionados con cambios en el estilo de vida, reducción de la depresión, ansiedad y estrés, que conlleva el diagnóstico de enfermedad crónica, estimulando un mayor afrontamiento de las enfermedades y una mayor adherencia a los tratamientos, contribuyendo de manera general al bienestar y mejora de la salud de esta población. Conclusión:Los individuos con enfermedades crónicas que utilizan R/E en el afrontamiento de la enfermedad tienen un impacto positivo en su cuidado y una mejor calidad de vida.

Molecular breast imaging and background uptake of fibroglandular tissue as tools to predict neoplasms in dense breasts

The sensitivity of mammography as a screening method is low in dense breasts, which are associated with a high risk of developing tumors. Thus, molecular breast imaging (MBI) with background uptake (BPU) of fibroglandular tissue can be used as a complementary method. The aim of this review was to synthesize the existing evidence on these important diagnostic imaging tools. Three electronic databases were searched to identify original articles, including publications dating from September 2010 and September 2020, in English, conducted in any location, and addressing at least one aspect related to dense breasts and Breast-specific gamma-imaging (BSGI). In total, 22 studies were reviewed. Several advantages of MBI and BPU as complementary methods of screening for dense breasts were found. Among them, we can mention the increase in breast cancer detection rate, easy implementation in clinical practice, high patient satisfaction, low cost and good reproducibility. In view of the good results found in our review, we can conclude that the implementation of MBI, especially with BPU, can be a promising complementary tool for screening of dense breasts.

Does the number of sets in a resistance exercise session affect the fast and slow phases of post-exercise cardiac autonomic recovery?

Abstract Aims: The purpose of this study was to evaluate the acute effects of different resistance exercise (RE) volumes on postexercise cardiac autonomic modulation in men. Methods: Ten young men (25.5 ± 4.9 years, 24.8 ± 2.1 kg/m2) performed 3 trials of RE with 1, 2 or 3 sets (48-72 h between each trial) of 10-12 repetitions (70% of the one-maximum repetition) of bench press, leg press, and barbell row. Heart rate variability (HRV) was assessed at the 1st and 5th minutes of recovery (fast phase) and 3 consecutive 5-minute intervals from the 5th to 20th minute of recovery (slow phase). Parasympathetic and global modulations were assessed using the SD1 and SD2 indices of HRV, respectively. The comparison of the interventions was performed using the Friedman and Wilcoxon tests (p<0.05). Results: Lower parasympathetic modulation was identified after 2 and 3 sets compared to 1 set in both the fast and slow recovery phases (p= 0.004-0.05). Lower global modulation was identified after 3 sets compared to 1 set in both fast and slow recovery phases (p= 0.005-0.01). No differences in post-exercise parasympathetic and global modulation were observed between 2 and 3 sets. Conclusion: We concluded that 2 and 3 sets of RE compared to 1 set promoted higher autonomic reduction on the post-exercise phase, which should be considered by coaches when prescribing an RE program for untrained participants or intend to manipulate the postexercise organic recovery.

Cognitive impairment in bipolar disorder Neuroprogression or behavioral variant frontotemporal dementia? / Comprometimento cognitivo no transtorno bipolar: neuroprogressão ou variante comportamental da demência frontotemporal?

ABSTRACT Patients with Bipolar Disorder (BD) usually display cognitive deficits with aging. However, the correlation between BD and dementia syndromes is inconclusive, despite the similarity with behavioral variant frontotemporal dementia. We report a 78-year-old female patient who had bipolar type 1 disorder since adolescence. Her symptoms ranged from apathy to psychotic mania. She had had three hospitalizations, and since her last stay 10 years ago, her symptoms had remained stable. However, in the past 2 years, she displayed different symptoms, such as irritability manifested as verbal and physical aggression, cognitive impairment, repetitive pattern of behavior, perambulation, persecutory delusions, disorientation, and hyporexia. Treatment with anticholinesterases or mood stabilizers promoted no improvement. She scored 17/30 points on the Mini-Mental State Examination. Neuropsychological assessment suggested deficits in executive function, attention, and memory. Neuroimaging tests revealed frontotemporal degeneration and hypoperfusion. Diagnostic and therapeutic approaches for this type of patient represent a significant challenge for clinicians.

RESUMO Pacientes com Transtorno Bipolar (TB) costumam apresentardéficits cognitivosao envelhecer. No entanto, a correlação com síndromes demenciais é inconclusiva, apesar da similaridade com a variante comportamental da demência frontotemporal (bvFTD). Nósrelatamos uma paciente de 78 anos de idade com TB tipo 1 desde a adolescência. Seus sintomas variavam de apatia a mania psicótica. A paciente passou por 3 internações, sendo a última há 10 anos, seguida de estabilização clínica. No entanto, nos últimos 2 anos, ela apresentou sintomas diferentes, como irritabilidade expressada por agressões verbal e física, comprometimento cognitivo, padrão repetitivo de comportamento, perambulação, delírios persecutórios, desorientação e hiporexia. O tratamento com anticolinesterásicos ou estabilizadores de humor não revelou melhora. Apresentou 17/30 pontos no miniexame do estado mental, a avaliação neuropsicológica sugeriu déficit de função executiva, atenção e memória. Os exames de neuroimagem demonstraram atrofia e hipoperfusão fronto-temporal. Abordagens diagnósticas e terapêuticas para este tipo de paciente representam um desafio significativo para os clínicos.

Nova face de um velho problema: o autoplágio no cenário da produção científica / A new side of an old problem: self-plagiarism in scientific publications

Este artigo é parte de uma série especial que foi desenvolvida para auxiliar autores no processo da redação científica e comunicação. No cenário da produção científica, dentre as várias infrações éticas, está cada vez mais comum a ocorrência do plágio. Define-se plágio como a apresentação de uma obra contendo partes que pertençam a outra pessoa, sem o devido crédito. Um tipo de plágio que tem ganhado destaque nos últimos anos é o autoplágio, no qual o próprio autor reutiliza seus trabalhos anteriores sem a devida referência. Entretanto, há discussões na comunidade científica sobre esse tipo de plágio, estendendo o termo a algumas má-condutas específicas em publicações científicas. Isso acaba gerando artigos inautênticos e prejudicando a integridade da ciência. O presente artigo tem por objetivo abordar de forma mais detalhada o que é autoplágio, seus motivos e consequências para a comunidade científica. Para tanto, realizou-se uma pesquisa não sistemática da literatura, a fim de também apresentar os principais tipos de autoplágio, o que pode ser feito para evitá-lo e como proceder quando o mesmo é detectado.

This article is part of a special series that was designed to assist authors in the process of scientific writing and communication. Among the various forms of ethical misconduct in scientific publishing, plagiarism is increasingly common. Plagiarism is defined as the presentation of a work containing parts authored by another person without due credit. One type of plagiarism that has gained prominence in recent years is self-plagiarism, in which authors themselves reuse their previous work without proper referencing. However, active discussion remains in the scientific community about this type of plagiarism, with the term being extended to some specific forms of misconduct in scientific publication. This practice leads to inauthentic work and ultimately undermines the integrity of science. The purpose of this article is to address in depth the definition of self-plagiarism, the underlying motives for this practice and its consequences for the scientific community. To do so, a non-systematic review of the literature was conducted. Guidance is provided on the major types of self-plagiarism, what can be done to avoid it and how to proceed when it is detected.

When to indicate radiotherapy after nipple-sparing mastectomy? Systematic review / Quando indicar radioterapia após mastectomia nipple-sparing? Revisão sistemática

Introduction: Nipple-sparing mastectomy (NSM) and preservation of the nipple-areola complex (NAC) represent a therapeutic option of breast cancer with a better aesthetic result, a positive impact on body image and more satisfaction than the reconstruction of the NAC. It is questioned the indication of radiotherapy when the NAC is maintained and its potential aesthetic impairment. Objective: To examine the indication of radiotherapy in NSM and, secondarily, the incidence of NAC involvement and local recurrence rates. Methods: Systematic review carried out in the PubMed database with the terms ("breast neoplasm" [Mesh] OR "breast cancer") AND ("radiotherapy" OR "radiation therapy") AND ("nipple sparing mastectomy" OR "mastectomies" OR "subcutaneous mastectomies"). The selection of the studies, the evaluation of its quality and data extraction were carried out independently by four reviewers. Results: The indications for radiotherapy after NSM were: positive axilla, tumors over 5 cm and retroareolar tissue remaining greater than 5 mm. The NAC involvement occurred in 5 to 26.1% in the definitive anatomopathological study. NAC recurrence occurred from 2.59 to 10%. NAC necrosis occurred in 2.2 to 43.4%. Conclusions: The radiotherapy indications for NSM seem to follow the same classical indications for radiotherapy after mastectomy. The relapse index in NAC was not shown to be larger and without difference for the type of radiotherapy used. Radiotherapy should be based on factors that suggest a high risk for NAC involvement

Introdução: A mastectomia nipple-sparing (MNS) e a conservação do complexo aréolo-papilar (CAP) representam uma manobra terapêutica do câncer de mama com melhor resultado estético, impacto positivo na imagem corporal e mais satisfação do que a reconstrução do CAP. Questiona-se a indicação de radioterapia quando da manutenção do CAP e seu potencial prejuízo estético. Objetivo: Examinar a indicação de radioterapia em MNS e, secundariamente, a incidência do envolvimento do CAP e as taxas de recorrência local. Métodos: Revisão sistemática realizada na base de dados do PubMed com os termos ("breast neoplasm" [Mesh] OR "breast cancer") AND ("radiotherapy" OR "radiation therapy") AND ("nipple sparing mastectomy" OR "mastectomies" OR "subcutaneous mastectomies"). A seleção dos estudos, a avaliação da qualidade do estudo e a extração de dados foram realizadas de forma independente por quatro revisores. Resultados: As indicações para radioterapia após MNS foram: axila positiva, tumores acima de 5 cm e tecido retroareolar remanescente maior que 5 mm. O envolvimento do CAP ocorreu em 5 a 26,1% no anatomopatológico definitivo. A recorrência no CAP ocorreu de 2,59 a 10%. A necrose do CAP ocorreu em 2,2 a 43,4%. Conclusão: As indicações de radioterapia para MNS parecem seguir as mesmas indicações clássicas para radioterapia após mastectomia. O índice de recidiva no CAP não mostrou ser maior com uso de radioterapia nem ter diferença quanto ao seu tipo. A decisão de realizar a radioterapia deve se basear em fatores que sugerem alto risco para envolvimento do CAP

Case report and ca se series: is there room for them? / Relato de caso e série de casos: há espaço para eles?

This article is part of a special series developed to assist authors in the process of scientific writing and communication. The purpose of the study was to underscore the importance of publishing case reports and case series in the medical and health sciences and to provide insights to guide the authors who wish to submit these types of study. A non-systematic review was conducted to present a brief historical overview on reports published in the literature and to provide data on the main difficulties faced by authors trying to publish in the current scenario and on the contributions of case reports and case series to scientific progress. Finally, we address the current paradox of the simultaneous depreciation of this type of publication and reinforcement of the importance of publishing emblematic cases with major impact on the progress of medical science.

Este artigo é parte de uma série especial que foi desenvolvida para auxiliar autores no processo da redação científica e comunicação. O presente artigo visa ratificar a importância das publicações científicas de relatos e série de casos nas ciências médicas e da saúde. O estudo teve o objetivo de fornecer insights para orientar os autores que pretendem submeter esse tipo de estudo. Realizou-se uma pesquisa não sistemática, trazendo uma breve abordagem histórica sobre os relatos da literatura científica, um levantamento de dados sobre as principais dificuldades para publicações no cenário atual e, as contribuições dos relatos e série de casos para a ciência. Por fim, aborda-se o atual paradoxo entre a subvalorização deste tipo de publicação e a importância dos casos emblemáticos publicados com grande impacto na evolução da ciência.

Assessment of the accuracy of portable monitors for halitosis evaluation in subjects without malodor complaint. Are they reliable for clinical practice?

Abstract Halitosis is defined as a foul odor emanated from the oral cavity, with great impact in quality of life and social restraints. Recently, the use of Breath Alert™ in research increased significantly. Halimeter™, another portable device, is often used in clinical practice. Nevertheless, not many studies have verified the accuracy and compared the results of both devices simultaneously. Objective: To verify the accuracy of Breath Alert™ and Halimeter™ in patients without chief complaint of halitosis, using the organoleptic test (OT) as "gold standard." The second aim was to verify whether their concomitant use could enhance the diagnostic accuracy of halitosis. Material and Methods: A cross-sectional analytical study was performed. The quality of expired air of 34 subjects without chief complaint of halitosis was assessed. Two experienced examiners carried out the OT. Afterward, a third blinded examiner performed Halimeter™ (HT) and Breath Alert™ (BA) tests. Results: The OT identified halitosis in 21 subjects (62%). The area under the ROC curve (95% confidence interval) was 0.67 (0.48-0.85) and 0.54 (0.34-0.75) for HT and BA, respectively. The accuracy for HT and BA was 59% and 47%, respectively. The combined usage of HT and BA provided 11 positive results, being 9 subjects (43%) out of the total of 21 positive cases. Conclusions: Halimeter™ and Breath Alert™ were not able to diagnose halitosis in non-complainer subjects at the same level as the organoleptic examination, since their accuracy were low. Our results suggest that such portable devices are not reliable tools to assess halitosis and may neglect or misdiagnose a considerable number of patients in clinical practice.

Scientific communication: the art of preparing and presenting scientific results / Comunicação científica: a arte de preparar e apresentar resultados científicos

This article is part of a special series designed to help authors in the process of scientific writing and communication. The objective of the study was to provide tools and strategies to prepare and achieve effective forms of oral communication, especially related to posters and oral presentations. A non-systematic literature research (PubMed/Web of Science) was performed to retrieve relevant data about how to prepare posters, oral presentation and how to control anxiety caused by oral speeches. In addition, a brief overview of innovative and recent digital tools is also provided. The scientific literature proves some interesting recommendations for preparing a good poster or a slide show and to avoid public speech anxiety as well. A list of available digital tools for such preparation was also disclosed. The rules for oral or poster communication differ from those related to manuscript writing. The quality of oral scientific communication can be improved by following such rules.

Este artigo é parte de uma série especial que foi desenvolvida para auxiliar autores no processo da redação científica e comunicação. O estudo teve o objetivo de fornecer ferramentas e estratégias para preparar e alcançar formas efetivas de comunicação oral, especialmente para pôsteres e apresentações orais. Realizou-se uma pesquisa não-sistemática da literatura (PubMed/Web of Science) para levantar dados relevantes sobre como preparar pôsteres, apresentação oral e como controlar a ansiedade causada por apresentações em público. Além disso, também é fornecido um breve resumo de inovações e ferramentas digitais recentes. As regras para a comunicação oral ou pôster diferem daquelas relacionadas à escrita do manuscrito. A qualidade da comunicação científica oral pode ser melhorada seguindo tais regras.

Improving reproducibility and external validity. The role of standardization and data reporting of laboratory rat husbandry and housing

Abstract Purpose: To identify the most relevant flaws in standardization in husbandry practices and lack of transparency to report them. This review proposes some measures in order to improve transparency, reproducibility and eventually external validity in experimental surgery experiments with rat model. Methods: We performed a search of scientific articles in PUBMED data base. The survey was conducted from august 2016 to January 2017. The keywords used were "reproducibility", "external validity", "rat model", "rat husbandry", "rat housing", and the time frame was up to January 2017. Articles discarded were the ones which the abstract or the key words did not imply that the authors would discuss any relationship of husbandry and housing with the reproducibility and transparency of reporting animal experiment. Reviews and papers that discussed specifically reproducibility and data reporting transparency were laboriously explored, including references for other articles that could fulfil the inclusion criteria. A total of 246 articles were initially found but only 44 were selected. Results: Lack of transparency is the rule and not the exception when reporting results with rat model. This results in poor reproducibility and low external validity with the consequence of considerable loss of time and financial resources. There are still much to be done to improve compliance and adherence of researchers, editors and reviewers to adopt guidelines to mitigate some of the challenges that can impair reproducibility and external validity. Conclusions: Authors and reviewers should avoid pitfalls of absent, insufficient or inaccurate description of relevant information the rat model used. This information should be correctly published or reported on another source easily available for readers. Environmental conditions are well known by laboratory animal personnel and are well controlled in housing facilities, but usually neglected in experimental laboratories when the rat model is a novelty for the researcher.

Pesquisa qualitativa: conceitos importantes e breve revisão de sua aplicação à geriatria/gerontologia / Qualitative research: key concepts and a brief overview of its application in geriatrics/gerontology

Introdução: Este artigo faz parte de uma série especial destinada a contribuir para o desenvolvimento de projetos de pesquisa de profi ssionais de saúde. A proposta é rever a importância, a metodologia e a aplicabilidade da pesquisa qualitativa. Objetivo: Discutir a metodologia de pesquisa qualitativa, seus critérios de validade, seu rigor científi co e sua aplicabilidade na área de saúde, com enfoque na geriatria/gerontologia. Métodos: Foi realizada uma revisão não sistemática da literatura (PubMed.gov ­U.S. National Library of Medicine/National Institute of Health) no intuito de detectar artigos relevantes na temática proposta. Resultados: A pesquisa qualitativa tem crescido bastante na área de saúde devido à sua capacidade única de explorar de forma sistemática e completa questões a serem estudadas. Ela proporciona um conhecimento mais profundo para a interpretação de fenômenos, experiências e comportamentos e o signifi cado deles na vida das pessoas estudadas ­ elementos esses não explorados nos métodos quantitativos. Conclusão: A abordagem qualitativa possui rigor científi co similar à pesquisa quantitativa e consegue aprofundar o entendimento do comportamento do participante de forma mais holística ­ o que é extremamente relevante na área de geriatria/gerontologia.

Introduction: This paper is part of a special series designed to help health professionals to develop a research project. It reviews the importance, methodology, and applicability of qualitative research. Objective: To discuss the methodology of qualitative research presenting validity criteria and emphasizing the scientific rigor, with focus in healthcare area, especially in geriatrics/gerontology. Methods: The authors performed a non-systematic literature review (PubMed.gov ­ U.S. National Library of Medicine/National Institute of Health) and included articles that clarified the main themes. Results: Qualitative research has grown considerably in the area of healthcare due to its ability to broaden the knowledge and interpretation of phenomena, experiences, behaviors, and their meaning in the lives of the people studied ­ elements not explored in quantitative methods. Conclusion: Qualitative approach has scientific rigor similar to quantitative research and manages to broaden understanding of participant behavior in a more holistic approach ­ which is extremely relevant in the area of geriatrics/gerontology.

The in vivo effect of L-arginine on skin elasticity in mice

ABSTRACT The human skin aging process is a complex mechanism that can be induced both by intrinsic and extrinsic factors. Observations include a decrease in the biosynthetic and proliferative capacity of cells, increased expression of matrix metalloproteinases, reduction in collagen type I expression, and the progressive disappearance of elastic tissue in the papillary dermis. L-arginine, the substrate of nitric oxide synthesis, is involved in angiogenesis and cell proliferation, as well as an indirect precursor of collagen synthesis via the proline pathway. The aim of this study was to examine the tensile strength, histology, and immunohistochemistry of female and male mice skin receiving different concentrations of topically applied L-arginine, in order to evaluate the possibility of using L-arginine as an active cosmetic ingredient in antiaging products. The results suggest that the application of L-arginine improves the mechanical resistance of skin from older female mice (20 weeks old) and promotes the formation of a larger amount of collagen and elastic fibers in the skin when applied at a concentration of 15%.

Aggressive ameloblastic fibrosarcoma in maxilla: case report and new perspectives based on the current literature / Fibrossarcoma ameloblástico agressivo em maxila: relato de caso e novas perspectivas com base na literatura atual

ABSTRACT Ameloblastic fibrosarcoma (AFS) is a rare malignant tumor characterized by benign epithelial component within a malignant fibrous stroma. It occurs as a de novo lesion or from a previous ameloblastic fibroma. The aim of this paper is to report an aggressive and recurrent case of AFS in the maxilla of a 38-year-old patient. Histopathological diagnosis can be challenging, especially when it is based on incisional biopsy specimens. Hence, this report highlights not only the importance of the histological features for diagnosis but also the clinical behavior of AFS based on current literature evidence.

RESUMO O fibrossarcoma ameloblástico (FSA) é um tumor maligno raro caracterizado pela presença de componente epitelial benigno em um tecido conjuntivo fibroso maligno. Pode desenvolver-se a partir de um fibroma ameloblástico ou como uma lesão nova. O objetivo deste estudo é relatar um caso de um FSA agressivo e recorrente em maxila em um paciente de 38 anos. O diagnóstico histopatológico desse tumor pode ser difícil, principalmente a partir de biópsias incisionais. Este trabalho também discute fatores em relação aos aspectos histopatológicos para o seu diagnóstico, assim como seu comportamento clínico, com base em revisão atual da literatura.

What rheumatologists should know about orofacial manifestations of autoimmune rheumatic diseases / O que o reumatologista deve saber sobre as manifestações orofaciais das doenças reumáticas autoimunes

ABSTRACT Orofacial manifestations occur frequently in rheumatic diseases and usually represent early signs of disease or of its activity that are still neglected in clinical practice. Among the autoimmune rheumatic diseases with potential for oral manifestations, rheumatoid arthritis (RA), inflammatory myopathies (IM), systemic sclerosis (SSc), systemic lupus erythematosus (SLE), relapsing polychondritis (RP) and Sjögren's syndrome (SS) can be cited. Signs and symptoms such as oral hyposalivation, xerostomia, temporomandibular joint disorders, lesions of the oral mucosa, periodontal disease, dysphagia, and dysphonia may be the first expression of these rheumatic diseases. This article reviews the main orofacial manifestations of rheumatic diseases that may be of interest to the rheumatologist for diagnosis and monitoring of autoimmune rheumatic diseases.

RESUMO Manifestações orofaciais ocorrem com frequência nas doenças reumáticas e, comumente, representam sinais iniciais ou de atividade da doença que ainda são negligenciados na prática clínica. Entre as doenças reumáticas autoimunes com possíveis manifestações orais, incluem-se a artrite reumatoide (AR), miopatias inflamatórias (MI), esclerose sistêmica (ES), lúpus eritematoso sistêmico (LES), policondrite recidivante (PR) e síndrome de Sjögren (SS). Sinais e sintomas orofaciais como hipossalivação, xerostomia, disfunções temporomandibulares, lesões na mucosa bucal, doença periodontal, disfagia e disfonia podem ser a primeira expressão dessas doenças reumáticas. Esse artigo revisa as principais manifestações orofaciais das doenças reumáticas que podem ser de interesse do reumatologista, para diagnóstico e acompanhamento das doenças reumáticas autoimunes.

Percepções de pacientes sobre a relação entre diabetes mellitus e saúde oral: um estudo transversal / Patients perceptions towards diabetes mellitus and oral health: a cross-sectional study

Purpose: To evaluate the knowledge of diabetic patients towards the connection between diabetes mellitus (DM) and oral diseases. Oral status was also assessed in order to evaluate the correlation among patients' perception and their oral health. Material and Methods: A sample of 132 diabetic subjects answered a questionnaire containing 12 questions addressing their knowledge, attitudes and practices related to oral health. Oral examination accessed the presence of cavity carious lesions, residual roots, dental biofilm, calculus, gingivitis, tooth mobility and gingival recession. Results: Fifty-four percent of the sample had never been instructed by their health professionals that DM could cause oral diseases. However, 66% presumed being more vulnerable to develop oral illnesses and 57.5% answered that they assumed having no oral disturbances at that moment. In contrast, intraoral clinical examination showed that 99% presented at least one oral injury such as caries lesions, plaque/calculus, gingival inflammation, tooth mobility, residual root and xerostomia. Conclusions: Health care professionals usually neglect oral status in diabetic patients. Above all, there is a huge gap between patients' perceptions towards oral health and their real oral status. This study highlights the need of developing new models of prevention that properly address the important clinical relation between oral diseases and DM.(AU)

Squamous odontogenic tumor: report of a case of unusual involvement / Tumor odontogênico escamoso: relato de um caso de envolvimento incomum

ABSTRACT The squamous odontogenic tumor (SOT) is defined as a very rare benign neoplasm, locally infiltrative and can extend to neighboring structures. This study aimed to report a case of SOT unusual involvement. A female patient, 56-year-old, smoker showed mild swelling in the chin region in the portion between the left canine and right first premolar. Axial, coronal and sagittal images showed expansive hypodense lesion in the mandibular symphysis and parasymphysis. Partial removal of the lesion was performed, which led to the diagnosis of SOT. The patient presented no recurrence during 4 years and 2 months follow-up.

RESUMO O tumor odontogênico escamoso (TOE) é definido como uma neoplasia benigna rara, localmente infiltrativa, podendo estender-se a estruturas vizinhas. Objetivou-se relatar um caso de TOE de acometimento incomum. Paciente do sexo feminino, 56 anos de idade, fumante, demonstrou leve aumento de volume na região do mento na porção compreendida entre o canino esquerdo e o primeiro pré-molar direito. Imagens axial, coronal e sagital demonstraram lesão expansiva hipodensa na sínfise e na linha média mandibular. Fez-se a remoção parcial da lesão, o que levou ao diagnóstico de TOE. A paciente não apresentou recidiva durante quatro anos e dois meses de acompanhamento.

In situ carcinoma developed over oral lichen planus: a case report with analysis of BUB3, p16, p53, Ki67 and SOX4 expression

AbstractOral lichen planus (OLP) represents a common mucocutaneous disease. Various authors have suggested that OLP has malignant potential; however, the mechanisms involved in malignant transformation have not yet been elucidated. A 79-year-old man presented a white lesion for five months in the buccal mucosa diagnosed as OLP. After two months using 0.05% clobetasol ointment for treatment, the lesion became ulcerated. A new biopsy of the same lesion was performed, and histological analysis showed an in situ oral carcinoma (ISOC). An immunohistochemistry panel was performed, and p16 expression was negative in OLP, however, it showed weak cytoplasmic staining in ISOC. There was strong nuclear BUB3 staining in both OLP and ISOC areas. p53 showed less intense nuclear staining in both regions. Ki67 was negative in OLP area, but showed nuclear staining in the ISOC. SOX4 was negative in both studied areas. BUB3 expression, first reported in this case, and the p16 expression may suggest some influence of these genes on pathogenesis or malignant potential of OLP.

The effect of simvastatin on relapse of tooth movement and bone mineral density in rats measured by a new method using microtomography

PURPOSE: To evaluate the effect of simvastatin on relapse of tooth movement in rats using microtomography (micro CT), as well as the correlation of bone density with the orthodontic relapse. METHODS: Twenty-five adult male Wistar rats, divided into two groups, had stainless steel springs installed on left maxillary first molar. The molars were moved for 18 days, and after removing the springs, were applied by oral gavage, 5mg/kg of simvastatin in the experimental group for 20 days. Tooth relapse was assessed with a micro CT scanner, and the images chosen through the Data Viewer software 1.5.0.0 had their measurement guides made and checked by the software Image ProR plus 5.1, and compared by Mann-Whitney test. After rats were sacrificed, bone mineral density was evaluated by micro CT through the software CT Analyzer 1.13 and compared by independent T-test, as well as by Spearman correlation test. RESULTS: Relapse and bone mineral density (BMD) was lower in the experimental group than in the control group, however without a statistically significant difference. CONCLUSION: Simvastatin did not inhibit the relapse of tooth movement in rats, and there was no correlation between bone density and orthodontic relapse. .