Pre-emptive effect of dexamethasone and methylprednisolone on pain, swelling, and trismus after third molar surgery: a split-mouth randomized triple-blind clinical trial.

The aim of this study was to compare the effect of dexamethasone 8 mg and methylprednisolone 40 mg for the control of pain, swelling, and trismus following the extraction of impacted third molars. Sixteen healthy patients with a mean age of 20.3 (standard deviation 1.25) years received a single oral dose of either drug 1 h prior to each surgical procedure (left and right teeth). At 24, 48, and 72 h and 7 days following surgery, swelling was determined using linear measurements on the face and trismus was determined by maximal mouth opening. Postoperative pain was self-recorded by the patients using a visual analogue scale at 8-h intervals for a period of 72 h. Data analysis involved descriptive statistics and the Wilcoxon, and paired t tests (P < 0.05). Dexamethasone controlled swelling better than methylprednisolone at all postoperative evaluations (P < 0.02) and led to greater mouth opening 48 h after surgery (P = 0.029). No statistically significant difference was found between drugs with regard to pain. In conclusion, pre-emptive dexamethasone 8 mg demonstrated better control of swelling and limited mouth opening in comparison to methylprednisolone 40 mg, with no differences between drugs regarding pain control.

Impact of early childhood caries on the oral health-related quality of life of preschool children and their parents.

The aim of the present population study was to evaluate the impact of early childhood caries (ECC) on the oral health-related quality of life (OHRQoL) of preschool children and their parents/caregivers. A random sample of 638 children (aged 2-5 years) underwent a clinical oral examination to assess ECC, and their parents were invited to answer two questionnaires: one on the OHRQoL of the child, the Early Childhood Oral Health Impact Scale, and another on the characteristics and sociodemographic conditions of the child. Descriptive analysis, χ(2) test, Mann-Whitney test, Kruskal-Wallis test, and hierarchically adjusted Poisson regression models were used. The prevalence of ECC was 52.2%. The number of teeth with decay ranged from 1 (n = 42; 6.6%) to 20 (n = 5; 0.8%), averaging 2.86 (SD = 4.04). There was a significant difference between the severity of ECC and OHRQoL in terms of the impact on both child and family (p < 0.001). An increase in the severity of ECC resulted in an increased negative impact on the quality of life of the child (rate ratio, RR = 5.32; 95% confidence interval, CI: 3.67-7.71). Greater age of the mother had a positive impact on the OHRQoL of preschool children (RR = 0.72; 95% CI: 0.54-0.97). Increased age resulted in an increased negative impact on the quality of life of the child (RR = 2.97; 95% CI: 1.61-5.47). ECC has a negative impact on the OHRQoL of children aged 2-5 years and their parents. Mothers aged 30 or older reported better OHRQoL, independent of the presence of ECC and the age of the child.

Epidemiological profile of individuals with American cutaneous leishmaniasis in Jequitinhonha Valley, Brazil

This study aimed to characterize the epidemiological profile of patients with American cutaneous leishmaniasis [ACL] in 34 municipalities in Jequitinhonha Valley, Minas Gerais, Brazil, registered from 2005 to 2010 with the Regional Health Superintendence, using data from the Brazilian Disease Notification Information System. Among 281 cases, 156 [55.5%] were included in the study. A statistically significant difference was found in ACL among men between 21 and 60 years of age [P = 0.034] in relation to women and other age groups. Analysing the male sample, a significant association was found between ACL and occupation [P = 0.04]. The cutaneous form occurred in 87.3% of cases. The medication most often employed was pentavalent antimony [87.3%], with cure achieved in 91.1% of cases. The epidemiological profile of ACL in the Jequitinhonha Valley is similar to that reported for other regions of Brazil, exhibiting a rural occupational nature and affecting men with low levels of schooling within the productive age

Internal hemipelvectomy in the treatment of recurrent carcinoma of the colon: report of a case.

PURPOSE: Although extended surgery has been established as an effective method for the treatment of advanced carcinoma of the colon, there are no reports in the literature of en bloc resection of the tumor together with the iliac bone. We report herein a 46-year-old woman with a second local recurrence after right colectomy, with the main objective of showing the possibility of indicating this type of surgery in selected cases. METHODS: In view of the lack of therapeutic options for the case and the absence of metastases, extended curative surgery for recurrent carcinoma of the colon was performed, with en bloc resection of the right iliac bone and of the crural nerve (Type I internal hemipelvectomy). RESULTS: After a 27-month follow-up, the patient is asymptomatic, with no signs of local recurrence or metastases. CONCLUSIONS: In selected cases, recurrent carcinoma of the colon can be treated by extended and aggressive surgery, including bone resection, to obtain an appropriate safety margins.