Rare clear cell odontogenic carcinoma associated with impacted tooth in a young patient: case report and literature review.

Clear cell odontogenic carcinoma (CCOC) is a rare malignant odontogenic tumor. It is characterized by showing, on histopathological examination, clusters of vacuolated and clear tumor cells with epithelial differentiation surrounded by fibrocollagenous stroma and fibroblasts. The present study presents a rare clinical case of mandibular CCOC associated with an impacted tooth in a 26-year-old woman surgically treated with mandibulectomy and reconstruction with iliac crest bone graft. The patient has been followed up for 22 months without signs of recurrence. A search for case report/case series was carried out in the PUBMED database, as well as in the references of relevant previously published literature reviews. Ninety-six publications were identified, totaling 136 distinct cases reported. Female sex was the most affected (63.1%) with 63.3% of cases occurring in patients in the fifth, sixth, or seventh decades of life. The mandible was more affected than the maxilla (74.2%). Association of CCOC with impacted teeth was found in 2.4% of cases, thus rendering it a rare occurrence. The present case report corroborates the results of the survey regarding sex and anatomical location of the tumor; however, it contradicts the findings regarding age predilection. The case described is the fourth known occurrence of tooth impaction associated with the tumor and the first in a female. In conclusion, CCOC should be considered, as well as other malignancies, as a possible diagnosis of maxillary or mandibular intraosseous lesions even in unusual circumstances such as in association with impacted teeth and in young patients.

Resection of a juvenile nasoangiofibroma by Le Fort I osteotomy: Experience with 40 cases.

PURPOSE: The aim of this study was to determine the rate of success and complications of juvenile nasoangiofibroma resection by Le Fort I osteotomy. MATERIAL AND METHODS: Data were obtained from the medical records of 40 patients with a diagnosis of juvenile nasoangiofibroma confirmed by anatomopathological examination. All tumors were resected by Le Fort I osteotomy between 1983 and 2010. The data obtained were gender, age, symptoms, sites of invasion, preoperative embolization, routes of surgical access, duration of surgery, complications, need for transfusion, relapses, and follow-up time. RESULTS: All patients were male, ranging in age from 7 to 27 years. The most common symptom was nasal obstruction, and central nervous system (CNS) invasion was present in 27.5% of cases. Craniotomy was associated with Le Fort I osteotomy in only one case. The mean duration of surgery was 216 min. Complications occurred in 15% of cases, with intraoperative bleeding being the most frequent one. Relapses occurred in 5% of cases. The mean follow-up was 48.8 months. CONCLUSION: Exclusively surgical treatment by Le Fort I access proved to be a safe and effective method for the treatment of nasoangiofibromas, permitting the removal of tumors even in patients with extension to the CNS, with a low rate of complications and relapses.

Management of neck metastases in T2N0 lip squamous cell carcinoma.

BACKGROUND: Prophylactic neck dissection (PND) is indicated when the chance of occult lymph node metastases from head and neck tumors is significant. There is no consensus regarding which tumor size PND would be indicated in cases of lip cancer. METHODS: A total of 139 patients with surgically treated lip cancer were selected. The size of the lesion (T) and the presence of lymph node metastases (N) were assessed by examining the medical records. For analysis purposes, the T2 group was divided into T2a (2 to 3 cm) and T2b (3 to 4 cm). RESULTS: The following distribution of incidence of neck metastases was observed in the study groups: 11.7% in T1, 9% in T2a, 43.7% in T2b, and 52.2% in T3+T4. Statistical comparison of the groups (p) revealed the following results: T2aXT2b=0.03; T2aXT3+T4=0.001. CONCLUSION: PND is indicated for tumors larger than 3 cm.

Utilização de medicamentos entre usuários de um ambulatório de diabetes: um estudo descritivo / El consumo de drogas entre los usuarios de um dispensário de diabetes: um estúdio descriptivo / Utilization of drugs among users of ambulatory’s diabetes: a descriptive study

Identificar como sujeitos com diabetes mellitus tipo 2 utilizam medicamentos para o controle da sua doença. Método: Foram entrevistados 239 sujeitos com diabetes mellitus tipo 2, atendidos num ambulatório de diabetes de Fortaleza-Brasil em 2006. Resultados: Os resultados mostram que 39,3% utilizam os antidiabéticos orais. A maioria diariamente obedece a prescrição médica, 83,3% adquirem os medicamentos na rede pública de saúde. Aproximadamente 66% e 35% realizam a auto-administração e necessitam de apoio familiar na utilização dos medicamentos, respectivamente. Dentre os principais problemas, foi verificado que 37,2% diferenciam os medicamentos apenas pelo nome na embalagem e que os efeitos adversos mais referidos foram os sintomas gastrintestinais. Conclusões: Há ainda a necessidade de reorganização dos serviços de atenção às pessoas com DM que assegure além do fornecimento dos medicamentos, a sua utilização de forma correta para obtenção do efeito terapêutico desejado.

Objective: To identify how subjects with diabetes mellitus type 2 diabetes using medications to control their disease. Method: 239 subjects with diabetes mellitus type 2 diabetes attending a ambulatory’s diabetes in Fortaleza, Brazil were interviewed in 2006. Results: The results show that 39.3% used oral antidiabetics. Most daily follows the prescription, 83.3% purchased drugs in public health. Approximately 66% and 35% perform self-administration and they need family support in the use of drugs, respectively. Among the main problems, it was found that 37.2% of medicines differ only by name on the packaging and that the most reported adverse events were gastrointestinal symptoms. Conclusions: There is still a need for reorganization of health care services to people with DM than ensuring the supply of drugs, their use of correct form to obtain the desired therapeutic effect.

Determinar la forma en sujetos con diabetes tipo 2 el uso de medicamentos para controlar su enfermedad. Método: Se entrevistaron 239 sujetos con diabetes mellitus tipo 2 diabetes asistidos en undispensario de diabetes de Fortaleza, Brasil en 2006. Resultados: Los resultados muestran que 39,3% utilizan antidiabéticos orales. La mayoría de diarios sigue la receta, el 83,3% comprar drogas en la salud pública. Aproximadamente el 66% y el 35% realizan auto-administración y que necesitan apoyo de la familia en el uso de drogas, respectivamente. Entre los principales problemas, se encontró que 37,2% de los medicamentos sólo se diferencian por su nombre en el envase y que los efectos adversos más reportados fueron síntomas gastrointestinales. Conclusiones: existe todavía una necesidad de reorganización de los servicios de salud a las personas con diabetes, así como para garantizar el suministro de medicamentos a ser utilizados correctamentepara lograr el efecto terapéutico deseado.