ABSTRACT
OBJECTIVE: To identify predictors of sarcopenia (demographical, anthropometric measurements, tumor-related clinical characteristics, performance status, and serum C-reactive protein (CRP) and albumin levels in individuals with head and neck squamous cell carcinoma (HNSCC). MATERIAL AND METHODS: This cross-sectional study selected diagnosed with HNSCC (n = 125). Sarcopenia was defined as low muscle strength and low physical performance. Association between sarcopenia and anthropometric assessments (weight, height, body mass index, triceps skinfold, mid-upper arm circumference [MUAC], mid-upper arm muscle circumference, mid-upper arm fat area [UFA], mid-upper arm bone free muscle area, calf circumference, and appendicular skeletal muscle mass and index), tumor clinical characteristics (anatomical site, tumor size, and cervical metastasis), performance status scale (Eastern Cooperative Oncology Group Performance Status [ECOG-PS]), and CRP and albumin levels was analyzed using binary logistic regression models. RESULTS: The diagnosis of sarcopenia was identified in 28 (22.4%) individuals with HNSCC. Being an older adult increases the odds of association with sarcopenia in individuals with HNSCC (odds ratio [OR] = 1.05). Increments in MUAC measurement reduce the odds of association with sarcopenia (OR = 0.69), while the increase in the UFA measurement increases the odds of association with sarcopenia (OR = 1.33). Poor ECOG-PS scores increase the odds of association with sarcopenia in individuals with HNSCC (OR = 5.54). CONCLUSION: Early identification of easy-to-perform, cost-effective predictors of sarcopenia tends to favor the implementation of personalized therapeutic and supportive interventions in individuals with HNSCC.
Subject(s)
Head and Neck Neoplasms , Sarcopenia , Humans , Aged , Sarcopenia/epidemiology , Sarcopenia/etiology , Squamous Cell Carcinoma of Head and Neck , Cross-Sectional Studies , C-Reactive Protein , Head and Neck Neoplasms/complicationsABSTRACT
Objetivo: Avaliar a expectativa e satisfação dos pais/responsáveis de usuários da Associação dos Pais e Amigos dos Excepcionais (APAE) atendidos na Clínica de Pacientes Especiais do curso de Odontologia da Unimontes, MG, durante o ano de 2004 e 1º semestre letivo de 2005. Método: Na primeira consulta, 46 pessoas foram avaliadas quanto à expectativa acerca do atendimento e, no final do tratamento, 89,0% dessas pessoas responderam o questionário de satisfação. Para análise estatística foram realizados os testes Qui-quadrado de Pearson e Exato de Fisher (p< 0,05). Resultados: A maioria dos pacientes (84,8%) já havia sido atendida na Clínica da Unimontes, 84,8% desconhecem a assistência fisioterápica e 78,4% a fonoaudiológica, na clínica. Quanto à expectativa, 71,7% esperavam restaurações, 65,2% profilaxia, 45,7% tratamento fonoaudiológico, 41,3% tratamento fisioterápico, 37,0% exodontias e 23,9% tratar dor de dente. Quanto à satisfação, 78,1% acharam ótimo o atendimento odontológico e 21,9% bom. As orientações dos professores aos alunos, na clínica, foram classificadas como ótimo para 75,6% dos entrevistados. Em relação às orientações profissionais, 97,5% consideraram importantes aquelas feitas pelo cirurgião-dentista, 56,1% da fonoaudiologia e 56,1% da fisioterapia. Conclusão: As expectativas mais relatadas envolveram o atendimento odontológico cirúrgico e restaurador. Os pesquisados estavam muito satisfeitos com o atendimento odontológico. Uma importante parcela dos usuários da APAE não foi atendida pela Fisioterapia e Fonoaudiologia, tendo, como conseqüência, um baixo percentual de avaliação desses serviços.
Purpose: To evaluate the expectations and satisfaction of theparents/guardians of APAE (Association of Parents and Friends ofSpecial Needs Individuals) users treated at the Clinic of Special Needs Patients of the Dental Course of Unimontes, MG, during the year 2004 and the first academic semester of 2005.Method: In the first clinical visit, 46 patients were evaluated with respect to their expectations regarding the dental care and, at the end of the treatment, 89% of the individuals answered a satisfaction questionnaire. Pearson's chi-square test and Fisher's exact testwere used for statistical analysis (p<0.05).Results: Most patients (84.8%) have already been treated at the Unimontes Clinic. 84.8% were not aware that physical therapy assistance was offered at the clinic and 78.4% did not know that speech therapy was available. Regarding their expectations, 71.7% expected restorations, 65.2% prophylaxis, 45.7% speech therapy treatment, 41.3% physical therapy treatment, 37% extractions and 23.9% toothache treatment. Regarding satisfaction, 78.1% found the dental care excellent and 21.9% rated it as good. The instructions of the professors to the students at the clinic were considered as excellent for 75.6% of the interviewees. Regarding the professional instructions, 97.5% considered as important those given by thedentist, 56.1% considered those given by speech therapist and 56.1% those given by the physical therapist.Conclusions: The most frequently reported expectations were those referring to the surgical and restorative dental care. The respondents were very satisfied with the dental treatment. A large number of APAE users did not receive speech therapy and physical therapy assistance, and, as a consequence, there was a low percentage of evaluation by these services.
