Task force of the Brazilian Society of Otology - evaluation and management of peripheral facial palsy.

OBJECTIVE: To review key evidence-based recommendations for the diagnosis and treatment of peripheral facial palsy in children and adults. METHODS: Task force members were educated on knowledge synthesis methods, including electronic database search, review and selection of relevant citations, and critical appraisal of selected studies. Articles written in English or Portuguese on peripheral facial palsy were eligible for inclusion. The American College of Physicians' guideline grading system and the American Thyroid Association's guideline criteria were used for critical appraisal of evidence and recommendations for therapeutic interventions. RESULTS: The topics were divided into 2 main parts: (1) Evaluation and diagnosis of facial palsy: electrophysiologic tests, idiopathic facial palsy, Ramsay Hunt syndrome, traumatic peripheral facial palsy, recurrent peripheral facial palsy, facial nerve tumors, and peripheral facial palsy in children; and (2) Rehabilitation procedures: surgical decompression of the facial nerve, facial nerve grafting, surgical treatment of long-term peripheral facial palsy, and non-surgical rehabilitation of the facial nerve. CONCLUSIONS: Peripheral facial palsy is a condition of diverse etiology. Treatment should be individualized according to the cause of facial nerve dysfunction, but the literature presents better evidence-based recommendations for systemic corticosteroid therapy.

Long-term outcomes of neoadjuvant immunotherapy plus chemotherapy in patients with early-stage triple-negative breast cancer: an extracted individual patient data and trial-level meta-analysis.

BACKGROUND: Neoadjuvant immunotherapy (nIO) has emerged as a treatment option for stage II-III triple-negative breast cancer (TNBC). While randomised clinical trials (RCTs) demonstrated pathological complete response rate benefit to nIO added to chemotherapy, additional data on long-term outcomes is warranted. We performed this analysis to evaluate long-term efficacy outcomes of nIO in TNBC. METHODS: We searched databases for RCTs evaluating nIO in early-stage TNBC. A meta-analysis of extracted individual patient data (EIPD) was performed to evaluate EFS and OS, with data from reported Kaplan-Meier plots. Additionally, we conducted a trial-level meta-analysis using fixed and random effects models. RESULTS: The literature search resulted in four included RCTs with available EFS or OS (KEYNOTE-522, IMpassion031, I-SPY2 and GeparNuevo). EIPD showed that the addition of nIO to chemotherapy provides statistically significant benefits in EFS (HR 0.62, 0.50-0.76; p < 0.001) and OS (HR 0.62, 0.46-0.82, p < 0.001). Number needed to treat to avoid one EFS or OS event in 4 years was 9 and 14, respectively. Trial-level meta-analysis yielded similar results (EFS: HR 0.64, 0.51-0.79; OS: 0.57, 0.37-0.89). CONCLUSIONS: Results show that nIO combined with chemotherapy can provide significant EFS and OS benefits, supporting its use as standard treatment for early-stage TNBC.

Activity of capecitabine for central nervous system metastases from breast cancer.

Purpose: Central nervous system (CNS) metastases are a significant burden in breast cancer (BC). Capecitabine is a frequent choice in this scenario, but data supporting its single-agent activity are scarce. We aimed to evaluate the intracranial efficacy of capecitabine in CNS metastases from BC. Methods: This retrospective cohort included patients with CNS metastases from BC treated with capecitabine at a single centre. Study endpoints were intracranial CNS objective response rate (CNS-ORR), intracranial CNS disease control rate (CNS-DCR), intracranial CNS progression-free survival (CNS-PFS) and overall survival (OS). Results: 209 patients were included; 41.6% hormone receptor-positive HER2-negative (HR + HER2-), 33.9% human epidermal growth factor receptor 2 positive (HER2+), and 26.4% triple-negative breast cancer (TNBC). Radiotherapy was performed in 90.4% and CNS surgery in 27.5%. Among patients accessible for intracranial response, 3-month CNS-ORR and CNS-DCR were 41.6% and 81.2%. CNS-ORR was numerically higher among TNBC (61% versus 38% in HR + HER2-BC and 35% in HER2 + BC) (p = 0.194). When considering patients who were not evaluable at 3-month as non-responders, the 3-month CNS-ORR was 19.1% (18.4% in HR + HER2-, 18.3% in HER2+, and 21.6% in TNBC). Nevertheless, TNBC was associated with lower CNS-PFS (p < 0.001) and OS (p < 0.001). Median PFS was 8.3 months in HR + HER2-, 5.0 months in HER2+, and 3.0 months in TNBC. Median OS was 8.7, 9.1 and 4.5 months, respectively. Conclusion: Among patients with BC and CNS metastases accessible for intracranial response at 3 months, intracranial activity was observed with capecitabine. These patients have a poor prognosis regardless of the BC subtype, especially in scenarios where newer therapeutic options are unavailable.

Comparison of Oropharyngeal Dysphagia in Brazilian Children with Prenatal Exposure to Zika Virus, With and Without Microcephaly.

Severe brain damage associated with Zika-related microcephaly (ZRM) have been reported to result in oropharyngeal dysphagia (OPD); however, it is unknown if OPD presents in children with prenatal Zika virus (ZIKV) exposure but only mild or undetectable abnormalities. The aims of this study were: to compare the frequency and characteristics of OPD in children with ZRM and in children without microcephaly born to mothers who tested polymerase chain reaction positive (PCR+) for ZIKV during pregnancy; and to investigate the concordance of caregiver reports of OPD with the diagnosis from the clinical swallowing assessment (CSA). Between Mar/2017 and May/2018, we evaluated 116 children (n = 58 with microcephaly, n = 58 children without microcephaly born to ZIKV PCR + mothers) participating in the Microcephaly Epidemic Research Group (MERG) cohort of children born during the 2015-2016 ZIKV epidemic in Pernambuco, Brazil. To assess OPD we used: a CSA; a clinical assessment of the stomatognathic system; and a questionnaire administered to caregivers. The frequency of OPD was markedly higher in children with ZRM (79.3%) than in the exposed but normocephalic group (8.6%). The children with microcephaly also presented more frequently with anatomic and functional abnormalities in the stomatognathic system. There was a high degree of agreement between the caregiver reports of OPD and the CSA (κ = 0.92). In conclusion, our findings confirm that OPD is a feature of Congenital Zika Syndrome that primarily occurs in children with microcephaly and provide support for policies in which children are referred for rehabilitation with an OPD diagnosis based on caregiver report.

Study of the brainstem auditory evoked potential with speech stimulus in the pediatric population with and without oral language disorders: a systematic review / Estudo do potencial evocado auditivo de tronco encefálico com estímulo de fala na população pediátrica com e sem transtornos de linguagem oral: uma revisão sistemática

Abstract Introduction: The brainstem auditory evoked potential with speech stimulus, BAEP-speech, has been applied to observe how speech sounds are manifested in the brainstem. This tool can be used in children to assess central auditory processing, allowing preventive and early interventions. Objective: To assess the results found in the brainstem auditory evoked potential with speech stimulus in the pediatric population with and without oral language disorders, through a systematic literature review. Methods: The search was carried out in the scientific databases Portal BVS, Pubmed, Lilacs, Medline, Scielo and Web of Science, OpenGrey.eu, DissOnline, OpenDoar, OAIster and The New York Academy of Medicine. A systematic literature review was performed using the descriptors: auditory evoked potentials, children and their synonyms, combined by the Boolean operators AND and OR. The search filter "age: child" was used. The studies were independently read by peers and, in case of disagreement regarding the inclusion of studies, a third researcher was consulted. Original case-control articles that performed BAEP-speech without competitive noise, carried out in the pediatric population without and with oral language disorders, were included. Result: 14 articles published between 2008 and 2019 were included in this review. Methodological variability was observed in the exam, with the syllable / da / being the most frequently used as the stimulus. When performing the average of the groups, it was observed that the population with specific language disorders showed greater latency delays in the sustained portion, lower amplitude values and VA complex slope. The group with phonological disorders had higher values in the transient portion of the responses. Conclusion: Children with language disorders of different etiologies have different patterns of BAEP-speech responses when compared to children with typical development.

Resumo Introdução: O potencial evocado auditivo de tronco encefálico com estímulo de fala (PEATE-fala) tem sido aplicado para observar como os sons da fala se manifestam no tronco encefálico. Essa ferramenta pode ser usada em crianças na avaliação do processamento auditivo central, permite intervenções preventivas e precoces. Objetivo: Conhecer os resultados encontrados no potencial evocado auditivo de tronco encefálico com estímulo de fala na população pediátrica com e sem transtornos de linguagem oral, por meio de revisão sistemática da literatura. Método: As buscas foram feitas nas bases de dados científicos Portal BVS, Pubmed, Lilacs, Medline, Scielo e Web of Science, OpenGrey.eu, DissOnline, OpenDoar, OAIster e The New York Academy of Medicine. Foi feita revisão sistemática da literatura, com os descritores auditory evoked potentials, children e seus sinônimos, combinados pelos operadores booleanos AND e OR. Foi usado o filtro de pesquisa "idade: criança". A leitura dos estudos foi feita por pares de forma independente e em caso de discordância na inclusão de estudos um terceiro pesquisador foi consultado. Foram incluídos artigos originais do tipo caso-controle que fizeram o PEATE-fala sem ruído competitivo na população pediátrica sem e com transtornos de linguagem oral. Resultado: Foram incluídos 14 artigos publicados entre 2008 e 2019 na presente revisão. Foi observada variabilidade metodológica na realização do exame, a sílaba /da/ foi a mais usada para estimulação. Ao se fazerem médias dos grupos, observou-se que a população com distúrbio específico de linguagem apresentou maiores atrasos de latência na porção sustentada, menores valores de amplitude e slope do complexo VA. O grupo com transtorno fonológico obteve maiores valores na porção transiente das respostas. Conclusão: Crianças com alterações de linguagem de diferentes etiologias apresentam padrões de respostas do PEATE-fala distintos quando comparadas às crianças com desenvolvimento típico.

Study of the brainstem auditory evoked potential with speech stimulus in the pediatric population with and without oral language disorders: a systematic review.

INTRODUCTION: The brainstem auditory evoked potential with speech stimulus, BAEP-speech, has been applied to observe how speech sounds are manifested in the brainstem. This tool can be used in children to assess central auditory processing, allowing preventive and early interventions. OBJECTIVE: To assess the results found in the brainstem auditory evoked potential with speech stimulus in the pediatric population with and without oral language disorders, through a systematic literature review. METHOD: The search was carried out in the scientific databases Portal BVS, Pubmed, Lilacs, Medline, Scielo and Web of Science, OpenGrey.eu, DissOnline, OpenDoar, OAIster and The New York Academy of Medicine. A systematic literature review was performed using the descriptors: auditory evoked potentials, children and their synonyms, combined by the Boolean operators AND and OR. The search filter "age: child" was used. The studies were independently read by peers and, in case of disagreement regarding the inclusion of studies, a third researcher was consulted. Original case-control articles that performed BAEP-speech without competitive noise, carried out in the pediatric population without and with oral language disorders, were included. RESULT: 14 articles published between 2008 and 2019 were included in this review. Methodological variability was observed in the exam, with the syllable / da / being the most frequently used as the stimulus. When performing the average of the groups, it was observed that the population with specific language disorders showed greater latency delays in the sustained portion, lower amplitude values and VA complex slope. The group with phonological disorders had higher values in the transient portion of the responses. CONCLUSION: Children with language disorders of different etiologies have different patterns of BAEP-speech responses when compared to children with typical development.

Irisin and troponin I expression in dialysis patients submitted to remote ischemic preconditioning: a pilot study / Expressão de irisina e troponina I em pacientes em diálise submetidos a pré-condicionamento isquêmico remoto: um estudo piloto

ABSTRACT Background: Renal replacement therapy continues to be related to high hospitalization rates and poor quality of life. All-cause morbidity and mortality in renal replacement therapy in greater than 20% per year, being 44 times greater when diabetes is present, and over 10 times that of the general population. Regardless of treatment, the 5-year survival is 40%, surpassing many types of cancers. Irisin is a hormone that converts white adipose tissue into beige adipose tissue, aggregating positive effects like fat mass control, glucose tolerance, insulin resistance, prevention of muscle loss, and reduction in systemic inflammation. Objectives: To determine the serum levels of troponin I in hemodialysis patients submitted to remote ischemic preconditioning (RIPC) associated with irisin expression. Methods: This was a prospective, randomized, double-blind clinical trial with patients with chronic kidney disease submitted to hemodialysis for a 6-month period. Troponin I, IL-6, urea, TNF-α, and creatinine levels were determined from blood samples. The expressions of irisin, thioredoxin, Nf-kb, GPX4, selenoprotein and GADPH were also evaluated by RT-PCR. Results: Samples from 14 hypertensive patients were analyzed, 9 (64.3%) of whom were type 2 diabetics, aged 44-64 years, and 50% of each sex. The difference between pre- and post-intervention levels of troponin I was not significant. No differences were verified between the RIPC and control groups, except for IL-6, although a significant correlation was observed between irisin and troponin I. Conclusion: Remote ischemic preconditioning did not modify irisin or troponin I expression, independent of the time of collection.

RESUMO Introdução: A terapia de substituição renal continua associada a altas taxas de hospitalização e baixa qualidade de vida. A morbimortalidade por todas as causas na terapia de substituição renal é superior a 20% ao ano, sendo 44 vezes maior quando a diabetes está presente e mais de 10 vezes a da população em geral. Independentemente do tratamento, a sobrevida em 5 anos é de 40%, superando muitos tipos de câncer. A irisina é um hormônio que converte tecido adiposo branco em tecido adiposo bege, agregando efeitos positivos como o controle de massa gorda, tolerância à glicose, resistência à insulina, prevenção de perda muscular e redução da inflamação sistêmica. Objetivos: Determinar os níveis séricos de troponina I em pacientes em hemodiálise submetidos ao pré-condicionamento isquêmico remoto (PCIR) associado à expressão da irisina. Métodos: Estudo clínico prospectivo, randomizado, duplo-cego, com pacientes com doença renal crônica submetidos à hemodiálise por um período de 6 meses. Os níveis de troponina I, IL-6, uréia, TNF-α e creatinina foram determinados a partir de amostras de sangue. As expressões de irisina, tioredoxina, Nf-kb, GPX4, selenoproteína e GADPH foram também avaliadas por RT-PCR. Resultados: Foram analisadas amostras de 14 pacientes hipertensos, 9 (64,3%) dos quais eram diabéticos tipo 2, com idades entre 44 e 64 anos e 50% de cada gênero. A diferença entre os níveis pré e pós-intervenção de troponina I não foi significativa. Não houve diferenças entre os grupos PCIR e controle, exceto pela IL-6, embora tenha sido observada correlação significativa entre irisina e troponina I. Conclusão: O pré-condicionamento isquêmico remoto não modificou a expressão de irisina ou troponina I, independentemente do tempo de coleta.

Irisin and troponin I expression in dialysis patients submitted to remote ischemic preconditioning: a pilot study.

BACKGROUND: Renal replacement therapy continues to be related to high hospitalization rates and poor quality of life. All-cause morbidity and mortality in renal replacement therapy in greater than 20% per year, being 44 times greater when diabetes is present, and over 10 times that of the general population. Regardless of treatment, the 5-year survival is 40%, surpassing many types of cancers. Irisin is a hormone that converts white adipose tissue into beige adipose tissue, aggregating positive effects like fat mass control, glucose tolerance, insulin resistance, prevention of muscle loss, and reduction in systemic inflammation. OBJECTIVES: To determine the serum levels of troponin I in hemodialysis patients submitted to remote ischemic preconditioning (RIPC) associated with irisin expression. METHODS: This was a prospective, randomized, double-blind clinical trial with patients with chronic kidney disease submitted to hemodialysis for a 6-month period. Troponin I, IL-6, urea, TNF-α, and creatinine levels were determined from blood samples. The expressions of irisin, thioredoxin, Nf-kb, GPX4, selenoprotein and GADPH were also evaluated by RT-PCR. RESULTS: Samples from 14 hypertensive patients were analyzed, 9 (64.3%) of whom were type 2 diabetics, aged 44-64 years, and 50% of each sex. The difference between pre- and post-intervention levels of troponin I was not significant. No differences were verified between the RIPC and control groups, except for IL-6, although a significant correlation was observed between irisin and troponin I. CONCLUSION: Remote ischemic preconditioning did not modify irisin or troponin I expression, independent of the time of collection.

Análise do acolhimento com classificação de risco em unidades de pronto-atendimento / Embracement analysis of the risk classification in the emergency units / Análisis de la atención según la clasificación de riesgo en puestos de emergencias

OBJETIVO: avaliar os serviços de acolhimento com classificação de risco realizados em unidades de pronto-atendimento. MÉTODO: trata-se de um estudo transversal e quantitativo, realizado com 63 enfermeiros que atuam nas unidades de pronto-atendimento de João Pessoa, Paraíba, Brasil. Os dados foram coletados por meio de entrevistas individuais realizadas no ambiente de trabalho dos enfermeiros, mediante a utilização de um questionário semiestruturado e do instrumento de avaliação do acolhimento com classificação de risco, sendo analisados por meio de estatística descritiva. RESULTADOS: mediante a avaliação das dimensões do instrumento de acolhimento com classificação de risco observou-se que a maioria dos enfermeiros classificou a "estrutura" como precária (47,6%), o "processo" como satisfatório (47,6%) e o "resultado" como igualmente satisfatório e precário (42,9%). A análise individual de cada serviço evidenciou que apenas uma unidade de pronto-atendimento classificou a "estrutura" como precária e as demais questões foram tidas como satisfatórias nas outras dimensões donabedianas: processo e resultado. CONCLUSÃO: o acolhimento com classificação de risco tem cumprido um dos seus principais objetivos, que é atender o usuário conforme a gravidade do caso e não por ordem de chegada.(AU)

Objective: to evaluate the embracement services in the risk classification performed in emergency units. Method: this is a cross-sectional and quantitative study, carried out with 63 nurses who work in the emergency units of João Pessoa, Paraíba, Brazil. Data were collected through individual interviews conducted in the nurses' work environment, using a semi-structured questionnaire and the embracement of the risk classification analysis instrument, analyzed using descriptive statistics. Results: by assessing the dimensions of embracement of the risk classification instrument, it was observed that most nurses classified the "structure" as precarious (47.6%), the "process" as satisfactory (47.6%) and the "result" as equally satisfactory and precarious (42.9%). The individual analysis of each service showed that only one emergency unit classified the "structure" as precarious, and the other questions were considered satisfactory in the other Donabedian dimensions: process and result. Conclusion: embracement in the risk classification has fulfilled one of its main objectives, assisting the patient according to the severity of the case and not of his arrival order.(AU)

Objetivo: evaluar los servicios de atención con clasificación de riesgo en puestos de emergencias. Método: se trata de un estudio cuantitativo transversal llevado a cabo con 63 enfermeros de puestos de emergencias de João Pessoa, estado de Paraiba, Brasil. Los datos se recogieron mediante entrevistas individuales realizadas en el entorno laboral de los enfermeros, utilizando un cuestionario semiestructurado y el instrumento de evaluación de la atención de pacientes según la clasificación de riesgo. Los datos se analizaron mediante estadísticas descriptivas. Resultados: al evaluar las dimensiones del instrumento de atención según la clasificación de riesgo, se observó que la mayoría de los enfermeros clasificó la estructura como precaria (47,6%), el proceso como satisfactorio (47,6%) y el resultado como igualmente precario y satisfactorio (42,9%). El análisis individual de cada puesto mostró que sólo uno de ellos clasificó la estructura como precaria y que las respuestas sobre las otras dimensiones fueron consideradas satisfactorias: proceso y resultado. Conclusión: la atención de pacientes según la clasificación de riesgo cumple uno de sus principales objetivos: atender al usuario según la gravedad del caso y no por orden de llegada. (AU)

Aleitamento materno exclusivo: empecilhos apresentados por primíparas / Exclusive breastfeeding: obstacles presented by primiparous women

Objetivo: identificar os empecilhos apresentados pelas primíparas das Unidades Básicas de Saúde, em relação à amamentação exclusiva dos filhos nos primeiros 6 meses de vida. Método: trata-se de estudo quantitativo, de campo, exploratório e descritivo, por meio da aplicação de um questionário semiestruturado com 30 participantes. Utilizou-se o pacote de recursos e técnicas estatísticas do programa Microsoft Excel 2010 para a análise dos dados, a frequência e proporção, apresentando-os por meio de figuras. Resultados: apresentaram-se como principais empecilhos: os ambientes, as crenças, o leite materno dito fraco, o trabalho ou a ocupação da mulher, a falta de tempo, as mamas endurecidas, a pega incorreta e o bebê agitado. Conclusão: torna-se relevante esta pesquisa pela exposição das dificuldades da mulher no processo de amamentação exclusiva, ainda mais aquela que enfrenta o percurso gravídico-puerperal pela primeira vez. Mostram-se que, com tais empecilhos abordados, podem-se elaborar intervenções e métodos estratégicos para auxiliar a mulher no momento da amamentação.(AU)

Percepção dos acompanhantes das crianças hospitalizadas acerca do brinquedo terapêutico / Perception of the hospitalized child's companion in relation to therapeutic toys

Objetivo: identificar a percepção dos acompanhantes das crianças hospitalizadas com relação às atividades lúdicas. Método: trata-se de estudo qualitativo, de campo, descrito e exploratório, com dez acompanhantes, uutilizando-se a ferramenta Brinquedo terapêutico. Coletaram-se os dados por meio de entrevista com roteiro semiestruturado. Empregou-se a técnica de Análise de Conteúdo na modalidade Análise Categorial para análise dos dados. Resultados: elegeram-se, a partir da leitura e releitura das entrevistas, quatro categorias: << A brinquedoteca como auxílio no tratamento pediátrico >>, << Utilização do Brinquedo Terapêutico na realização dos procedimentos >>; << O brinquedo terapêutico como suporte da assistência de Enfermagem >>, << O brinquedo e a aproximação entre o profissional e a criança >>. Conclusão: considerou-se primordial que os profissionais atuantes na Pediatria desenvolvam estratégias para a utilização do brinquedo terapêutico, melhorando a assistência oferecida e como contribuição, proporcionando o atendimento mais humano e qualificado na área.(AU)

Effectiveness and satisfaction evaluation of patients submitted to TMJ arthrocenthesis: a case series.

The aim of this study was to evaluate the effectiveness and level of satisfaction of patients who underwent TMJ arthrocentesis under local anesthesia by considering the following parameters: joint pain, mouth opening, mastication, and satisfaction. Fourteen patients (13 women and one man; mean age, 37.6 years with TMJ arthralgia were selected. The patients underwent arthrocentesis under local anesthesia, and pain intensity was measured before, during, and 1 year after treatment using a visual analog pain scale (VAS 0-100 mm). A Likert scale was used to assess patients' opinion regarding the improvement of mouth opening and mastication. After treatment, patients were questioned on levels of satisfaction provided by arthrocentesis in regard to their quality of life. At the end of 1 year, patients showed a marked improvement in their pain clinical picture (p < 0.0001). Mouth opening and mastication, evaluated separately and then correlated (R2 = 0.925, p < 0.0001), also showed a marked improvement. When questioned, all patients reported being satisfied with the treatment outcome.

Effectiveness and satisfaction evaluation of patients submitted to TMJ arthrocenthesis: a case series

The aim of this study was to evaluate the effectiveness and level of satisfaction of patients who underwent TMJ arthrocentesis under local anesthesia by considering the following parameters: joint pain, mouth opening, mastication, and satisfaction. Fourteen patients (13 women and one man; mean age, 37.6 years with TMJ arthralgia were selected. The patients underwent arthrocentesis under local anesthesia, and pain intensity was measured before, during, and 1 year after treatment using a visual analog pain scale (VAS 0–100 mm). A Likert scale was used to assess patients’ opinion regarding the improvement of mouth opening and mastication. After treatment, patients were questioned on levels of satisfaction provided by arthrocentesis in regard to their quality of life. At the end of 1 year, patients showed a marked improvement in their pain clinical picture (p < 0.0001). Mouth opening and mastication, evaluated separately and then correlated (R2 = 0.925, p < 0.0001), also showed a marked improvement. When questioned, all patients reported being satisfied with the treatment outcome.

Tumor odontogênico adenomatoide: relato de caso / Adenomatoide Odontogenic Tumor: Case Report

O Tumor Odontogênico Adenomatoide (TOA) é uma rara lesão benigna, que acomete, mais comumente, pacientes do sexo feminino (2:1) e jovens. A maxila é o local de maior ocorrência, com predileção pela região anterior com envolvimento do canino permanente. Clinicamente apresenta-se com um crescimento lento, progressivo e indolor, de consistência firme, que geralmente não atinge grandes proporções. Essa lesão é comumente descoberta em exames radiográficos de rotina. O TOA apresenta três variantes clínicopatológicas: folicular, extrafolicular e a forma periférica. As características radiográficas do TOA podem variar de acordo com o tipo da lesão. O presente artigo objetiva fazer o relato de um tumor odontogênico adenomatoide, presente na região anterior da maxila de uma paciente, apresentando suas características clínicas, radiográficas e histopatológicas assim como a terapêutica empregada... (AU)

The Adenomatoid Odontogenic Tumor (AOT) is a rare benign lesion, that is common in young females patients (2:1). This injury is more frequent in anterior jaw, generally involves the permanent canine. Clinically, this tumor presents slow, painless and progressive growth, firm consistency, that in general doesn't grows to large proportions. This lesion is detected in routine radiographic exams. AOT presents three clinic-pathologic nuances: follicular, extra follicular and peripheral. This paper presents an adenomatoid odontogenic tumor of a female patient aged 30 years old in the region of the right maxilla presenting their clinical, radiographic, histopathologic and therapy used. This article aims to report an adenomatoid odontogenic tumor present in the anterior maxilla of a female patient, presenting their clinical, radiological and histopathological features as well as the therapy employed... (AU)

Verificação do conhecimento da população Pernambucana acerca do câncer de boca e dos fatores de risco - Brasil / Knowledge of the population of the state of Pernambuco - Brazil about oral cancer and risk factors

Objetivo: Verificar o conhecimento da população pernambucana acerca do câncer de boca bem como identificar indivíduos expostos aos fatores de risco já comprovados na literatura. Metodologia: Estudo de corte transversal realizado com população de 54 municípios pernambucanos, no período de janeiro de 2005 a dezembro de 2009. A população foi visitada em suas casas, escolas, associações, conselhos, empresas públicas e privadas, ambulatórios, e, após concordar em participar deste estudo, mediante assinatura do Termo de Consentimento Livre e Esclarecido (TCLE), foi aplicado questionário. Em seguida, houve um compartilhamento de informações acerca da doença, dos fatores de risco, prevenção e autoexame. Em paralelo, foram realizados cursos de atualização/ capacitação para prevenção e diagnóstico diferencial e precoce do câncer bucal com as equipes de saúde bucal desses municípios pernambucanos. Os dados obtidos foram submetidos à análise descritiva e estatística por meio teste do qui-quadrado (Programa BioEstat 3.0). Resultados: Constituíram a amostra 43.200 (100%) pessoas que, responderam ao questionário e compartilharam das atividades educativas/ preventivas, sendo 25.488(59%) do sexo feminino e 17.712 (41%) masculino. A média das idades observada foi 42,3, sendo a mínima=07 e a máxima= 103 anos. 25.920 (60%) das pessoas já tinham ouvido falar sobre a doença, porém não souberam associar corretamente os fatores de risco, embora 24.192 (56%) estivessem expostos a estes. O sexo masculino está exposto de forma mais significativa aos fatores de risco do que as mulheres, o que foi evidenciado através do teste de qui-quadrado (alfa= 0,05; p menor que 0,01). Foi observado nesta pesquisa que, a despeito da perda dentária, a reabilitação protética não é usual. Conclusões: Parte da população conhece os fatores de risco para o câncer de boca, embora muitos desconheçam mesmo estando expostos a estes. O tabagismo, etilismo e a exposição ao sol foram identificados como os fatores de risco preponderantes nessa amostra.

Objective: To verify the knowledge of the population of the State of Pernambuco about oral cancer and identify individuals exposed to risk factors recognized in the literature. Method: A cross-sectional study was conducted with the population of 54 cities of the State of Pernambuco between January 2005 and December 2009. People were visited at their homes, schools, associations, councils, public and private companies and outpatient health services. After agreeing to participate in the study and signing an informed consent form, a questionnaire was applied to the subjects. Information was collected to assess their knowledge about the disease, risk factors, prevention and self-exam. In parallel, refreshing/capacitation courses for the prevention and differential and early diagnosis of oral cancer were offered to the oral health teams of the cities involved in the study. Data were subjected to descriptive and statistical analyses using the chi-square test (BioEstat 3.0 software). Results: A sample of 43,200 (100%) people filled out the questionnaire and took part in educative/preventive activities, being 25,488(59%) females and 17,712 (41%) males. The mean age was 42.3 years (range: 7 to 103 years). As much as 25,920 (60%) people had already heard about the disease, but they were not able to associate the risk factors correctly, although 24,192 (56%) were exposed to them. Male individuals were found to be more significantly exposed to the risk factors that females, as shown by the chi-square test (alpha= 0.05; p less than 0.01). It was observed in the present study that, despite tooth loss, prosthetic rehabilitation is not usual. Conclusion: Part of population recognizes the risk factors associated with oral cancer, although many people are not aware of them even being exposed to them. Smoking, alcoholism and direct sunlight exposure were identified as predominant risk factors in this sample.

Amaurose secundária a mucocele esfenoidal / Amaurosis secondary to sphenoid mucocele

INTRODUÇÃO: A mucocele do seio esfenoidal é uma lesão rara e benigna. Essas lesões são provavelmente diagnosticadas tardiamente por serem assintomáticas ou causarem sintomas não específicos. As características clínicas dependem de sua localização e podem incluir dor fronto-orbitária, paralisia do nervo oculomotor, diminuição da acuidade visual, exoftalmia e anosmia. Os achados da tomografia computadorizada (TC) e ressonância nuclear magnética (RNM) de nariz e seios paranasais aumentaram a precisão do diagnóstico. O tratamento consiste na marsupialização e drenagem da mucocele por via endoscópica nasossinusal. O prognóstico em relação à visão depende da duração da perda da acuidade visual pré-operatória. OBJETIVO: Relatar um caso de mucocele esfenoidal de grandes dimensões. RELATO DE CASO: Os autores relatam um caso de mucocele do seio esfenoidal em um paciente masculino de 48 anos de idade que apresentou amaurose subitamente. COMENTÁRIOS FINAIS: As características da mucocele esfenoidal são revistas com especial atenção para os seus achados clínicos e radiológicos, bem como o tratamento cirúrgico.

INTRODUCTION: The mucocele of the sphenoide sinus its a benign rare lesion. Those lesions are probably diagnosed late because they are asymptomatic or cause non-specific symptoms. The clinical characteristics depend on its location and can include fronto-orbital pain, oculomotor nerve palsy, decrease of visual acuity, exophthalmos and olfaction disorders. The findings of the CT and the MRI of nose and paranasal sinuses have increased the diagnostic accuracy. The treatment consists of marsupialization and drainage of the mucocele via endoscopic sinus. The prognosis for vision depends on the length loss of the visual acuity preoperative. OBJECTIVE: Report a case of sphenoid mucocele of big dimensions. CASE REPORT: The authors report a case of sphenoid sinus mucocele in a male patient of 48 years old, that has suddenly presented amaurosis. FINAL COMMENTS: The caracteristics of the sphenoid mucocele are reviewed with special attention for the clinical and radiological findings, as well as the surgical treatment.

Auditory processing performance in blind people.

UNLABELLED: Hearing has an important role in human development and social adaptation in blind people. OBJECTIVE: To evaluate the performance of temporal auditory processing in blind people; to characterize the temporal resolution ability; to characterize the temporal ordinance ability and to compare the performance of the study population in the applied tests. METHODS: Fifteen blind adults participated in this study. A cross-sectional study was undertaken; approval was obtained from the Pernambuco Catholic University Ethics Committee, no. 003/2008. RESULTS: Temporal auditory processing was excellent--the average composed threshold in the original RGDT version was 4. 98 ms; it was 50 ms for all frequencies in the expanded version. PPS and DPS results ranged from 95% to 100%. There were no quantitative differences in the comparison of tests; but oral reports suggested that the original RGDT original version was more difficult. CONCLUSIONS: The study sample performed well in temporal auditory processing; it also performed well in temporal resolution and ordinance abilities.

Auditory processing performance in blind people / Desempenho do processamento auditivo temporal em uma população de cegos

Hearing has an important role in human development and social adaptation in blind people. OBJECTIVE: To evaluate the performance of temporal auditory processing in blind people; to characterize the temporal resolution ability; to characterize the temporal ordinance ability and to compare the performance of the study population in the applied tests. METHODS: Fifteen blind adults participated in this study. A cross-sectional study was undertaken; approval was obtained from the Pernambuco Catholic University Ethics Committee, no. 003/2008. RESULTS: Temporal auditory processing was excellent - the average composed threshold in the original RGDT version was 4. 98 ms; it was 50 ms for all frequencies in the expanded version. PPS and DPS results ranged from 95 percent to 100 percent. There were no quantitative differences in the comparison of tests; but oral reports suggested that the original RGDT original version was more difficult. CONCLUSIONS: The study sample performed well in temporal auditory processing; it also performed well in temporal resolution and ordinance abilities.

A audição exerce um papel importantíssimo no desenvolvimento e adaptação social dos pacientes cegos. OBJETIVOS: Avaliar o desempenho do processamento temporal de cegos; caracterizar a habilidade de resolução temporal, segundo tempo e frequência; a ordenação temporal de cegos usando o teste de padrão de frequência e comparar o desempenho da população estudada para os testes de processamento aplicados. METODOLOGIA: Participaram do estudo 12 adultos portadores de cegueira. O estudo foi do tipo transversal, aprovado pelo Comitê de Ética da Universidade Católica de Pernambuco sob nº 003/2008. Para a coleta de dados, foi utilizado o RGDT em suas duas versões e os testes de padrão de duração (TPD) e de frequência (TPF). RESULTADOS: Foi evidenciado excelente desempenho para o processamento temporal, média de 4,98 para o limiar composto na versão original do RGDT e 50 ms de reposta para todas as frequências na versão expandida. Os resultados do TPD e TPF variaram de 95 por cento a 100 por cento de acertos. Não houve diferença quantitativa quando comparados os testes avaliados, mas relatos verbais apontam o RGDT original como o mais difícil. CONCLUSÃO: A amostra avaliada apresentou bom desempenho do processamento temporal, bom desempenho para as habilidades de resolução temporal e ordenação temporal.