Clinicopathological characteristics of odontogenic carcinosarcoma: A systematic review.

BACKGROUND: The aim of the present systematic review was to summarize evidence on odontogenic carcinosarcoma, analyzing clinical, epidemiological, imaging, histopathological, immunohistochemical, therapeutic, and prognostic features of this tumor. MATERIALS AND METHODS: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Searches were performed in the Ovid MEDLINE (Wolters Kluwer), PubMed (National Library of Medicine), Web of Science (Thomson Reuters), Scopus (Elsevier), and LILACS (Latin American and Caribbean Center on Health Sciences Information) databases, without publication date or language restrictions. Case reports or case series of OCS reporting clinical, radiological, and histopathological data that confirmed the diagnosis were selected. The Joanna Briggs Institute-University of Adelaide tool was used for critical appraisal of the included articles. RESULTS: Odontogenic carcinosarcoma is a rare, aggressive tumor associated with high mortality; however, the metastasis rate is low. The tumor has a male predilection. The mean patient age is 40 years, but there is no predilection for age. The left posterior mandible is the most affected site, but no specific radiographic features have been reported. CONCLUSION: Given its rarity, dentists, oral-maxillofacial surgeons, and physicians need to be aware of odontogenic carcinosarcoma in order to increase the diagnostic potential, preventing delays in diagnosis and treatment and thus contributing to lower morbidity of the tumor.

Effect of simvastatin topical use on alveolar bone after tooth extraction: a scoping review.

OBJECTIVES: Conducting a scoping review (SR) to assess scientific evidence for topical simvastatin's impact on alveolar bone regeneration and determine its level of support for clinical applications. MATERIALS AND METHODS: This SR followed the PRISMA-ScR and OSF registries protocol; systematic searching was conducted on MEDLINE/PubMed, Cochrane, Embase, Scopus, Web of Science, and LILACS, to identify relevant articles until June 2023. Inclusion criteria covered clinical trials, case series, prospective and retrospective studies, along with in vivo investigations, involving participants of any sex and age. RESULTS: Out of 1312 identified studies, 20 (9 in vivo, 11 RCTs) met inclusion criteria. RCTs focused on third molar extraction, in vivo on mandibular incisor surgery. The majority of RCTs employed a collagen sponge and a simvastatin concentration of 10mg; conversely, most in vivo studies favored polylactide-co-glycolide and a 2 mg simvastatin concentration. RCTs had 3-month follow-ups; in vivo, studies extended to 8 weeks. Seven RCTs assessed pain outcomes, simvastatin did not significantly affect pain in six studies. Among four RCTs on postoperative swelling, only two observed a significant increase in the simvastatin group. In general, positive bone formation and the absence of adverse effects directly linked to topical simvastatin were observed across the study models. CONCLUSIONS: Intra-alveolar simvastatin post-tooth extraction has been to be shown to be effective and safe for preserving alveolar bone, with varied concentrations and carriers, with no significant adverse effects. CLINICAL RELEVANCE: This review provides critical insights into the effects of simvastatin on alveolar bone regeneration, informing potential benefits and possible challenges associated with its post-extraction application. OSF REGISTRY PROTOCOL: osf.io/q3bnf.

Evaluation of the effects of pregabalin and dexamethasone coadministration on preemptive multimodal analgesia and anxiety in third molar surgeries: a triple-blind randomized clinical trial.

OBJECTIVE: To evaluate the efficacy of pregabalin and dexamethasone coadministration in preemptive analgesia and anxiety control in lower third molar surgery. MATERIALS AND METHODS: A triple-blind, split-mouth clinical trial conducted with patients divided into two groups: control group, receiving placebo and dexamethasone, and test group, receiving pregabalin and dexamethasone preoperatively. The evaluated variables were pain, measured by the Visual Analog Scale (VAS), anxiety assessed through the State-Trait Anxiety Inventory (STAI) questionnaires, hemodynamic parameters [Blood Pressure (BP), Heart Rate (HR), Oxygen Saturation (SpO2)], and sedation assessed by the Ramsay scale. RESULTS: A total of 31 patients were included. The test group exhibited a significant reduction in pain at 2,4,6,8,12,16,24, and 48 h after surgery and in the consumption of rescue analgesics. Anxiety, evaluated by STAI and VAS, showed a significant decrease in the test group (p < 0.001). Additionally, there was a significant decrease in BP at most of the assessed time points (p < 0.05) and a significant reduction in HR at two different time intervals (p = 0.003 and p = 0.009), indicating a positive effect in the test group. There was no significant difference in SpO2 between the groups. Sedation assessment revealed a significant difference at all time points favoring the test group (p < 0.05). There were no significant postoperative adverse effects. CONCLUSIONS: Pregabalin coadministered with dexamethasone demonstrated significant efficacy in controlling postoperative pain and anxiety, as well as a sedative effect. CLINICAL RELEVANCE: The coadministration of pregabalin with dexamethasone may presents potential advantages in both pain modulation and psychological well-being of individuals undergoing third molar surgeries. TRIAL REGISTRATION: Brazilian Clinical Trials Registry (REBEC), No. RBR-378h6t6.

Extensive osteonecrosis of the maxilla caused by bisphosphonates: Report of a rare case.

Bisphosphonates are drugs indicated for the treatment of bone metabolic diseases or malignant hypercalcemia. They are generally well-tolerated drugs, however, recent reports have described osteonecrosis of the jaw bones as a potentially serious complication related to the long-term use of these drugs. We report a case of severe osteonecrosis in a 52-years-old white woman that was taking bisphosphonates (zoledronic acid and alendronate) for the management of osteoporosis. Following a long exposure to these drugs and after being subjected to multiples exodontias, developed bisphosphonate-related osteonecrosis of the jaw compromising the whole maxilla and that extended toward the base of skull. Due to the extent of osteonecrosis, total maxillectomy and removal of all adjacent necrotic bone were planned guided by ultraviolet light. fluorescence. This case illustrates that if not treated correctly, bisphosphonate-related osteonecrosis of the jaw may cause significant morbidity, affect the quality of life and can eventually produce significant morbidity with the dissemination to noble structures and potentially causing life-threatening complications. Key words:Osteonecrosis, bisphosphonate, bisphosphonate-associated osteonecrosis of the jaw, maxilla, osteoporosis.

Translation and cultural adaptation of the King's Brief Interstitial Lung Disease health status questionnaire for use in Brazil.

OBJECTIVE: To translate the King's Brief Interstitial Lung Disease (K-BILD) questionnaire to Portuguese and culturally adapt it for use in Brazil. The K-BILD quantifies the health status of patients with ILD. METHODS: The process involved the following steps: authorization from the author of the original (English-language) questionnaire; translation of the questionnaire to Portuguese by three translators, working independently; merging of the translations by a committee of specialists; back-translation of the questionnaire to English; revision and readjustment of the back-translation by the committee of specialists; evaluation by the original author; revision of the back-translation; cognitive debriefing (verification of the clarity and acceptability of the Portuguese-language version in the target population-i.e., patients with ILD); and finalization of the Portuguese-language version. RESULTS: In the cognitive debriefing step, 20 patients with ILD were interviewed. After the interviews, the clarity and acceptability index of each question was ≥ 0.8, which is considered acceptable. CONCLUSIONS: The Portuguese-language version of K-BILD appears to be easily administered to and understood by patients with ILD in Brazil. To our knowledge, this is the only instrument in Brazilian Portuguese that is designed to evaluate the impact that ILD has on the various aspects of the lives of those it affects.

Distrofia muscular congênita merosina negativa: um relato de caso / Congenital muscular dystrophy merosin negative: a case report

A Distrofia muscular laminin subunit alpha 2 (DM LAMA2) é caracterizada pela deficiência da proteína da cadeia laminina α2, apresentando sintomas distróficos que progridem na infância. Objetivo: Apresentar dados da avaliação fisioterapêutica de uma criança com DM LAMA2 em acompanhamento ambulatorial. Métodos: Pesquisou-se em prontuário dados referentes às avaliações fisioterapêuticas de uma criança de 12 anos com diagnóstico de DM LAMA2 atendida em ambulatório especializado. A avaliação caracterizou-se por ausculta pulmonar, espirometria, verificação de parâmetros cardiorrespiratórios, análise do pico de fluxo de tosse (PFT), força muscular respiratória (FMR) e avaliação motora através da escala MFM-32. Resultados: Realizou-se três avaliações durante 9 meses. A paciente possui doença pulmonar restritiva, na primeira avaliação apresentou VEF1= 29% na espirometria e, comparando com a terceira avaliação obteve aumento de 1%, também houve aumento de 2% na relação VEF1/CVF, 5% no PEF e 11% no FEF25-75%. Na FMR, obteve-se valores de PImáx= 17,9% e PEmáx= 7,13% na primeira avaliação com aumento de 16,85% e 5,34% respectivamente, entre primeira e terceira avaliação. O PFT manteve-se em 0L/min em todas avaliações. Na primeira avaliação motora pontuou 25% no escore total da escala MFM-32, aumentando 3,12% na terceira avaliação. Ao longo do acompanhamento iniciou-se o uso da VNI noturna e introduzida a técnica de AS, buscando correção da hipoxemia, apneias noturnas, aumento do PFT e FMR. Conclusão: Paciente apresentou manutenção de parâmetros espirométricos, aumento de variáveis de FMR e função motora, sem piora do quadro. Possíveis resultados decorridos do acompanhamento multiprofissional e especializado.

Laminin subunit alpha 2 muscular dystrophy (DMLAMA2) is characterized by a deficiency of the α2 laminin chain protein, presenting dystrophic symptoms that progress in childhood. Objective: To present data from the physical therapy evaluation of a child with DMLAMA2 in outpatient follow-up. Methods: Medical records were searched for data referring to the physiotherapeutic evaluations of a 12-year-old child diagnosed with DMLAMA2 treated at a specialized outpatient clinic. The evaluation was characterized by pulmonary auscultation, spirometry, verification of cardiorespiratory parameters, analysis of peak cough flow (PFT), respiratory muscle strength (FMR) and motor evaluation using the MFM-32 scale. Results: Three evaluations were carried out during 9 months. The patient has restrictive disease, in the first evaluation she had FEV1= 29% in spirometry, compared to the third evaluation, she had an increase of 1%, there was also an increase of 2% in the FEV1/FVC ratio, 5% in the PEF and 11% in the FEF25-75%. In the FMR, values of MIP=17.9% and MEP= 7.13% were obtained in the first assessment, with an increase of 16.85% and 5.34%, respectively, between the first and third assessments. The PFT remained at 0L/min in all evaluations. In the first motor evaluation, it scored 25% in the total score of the MFM-32 scale, increasing 3.12% in the third evaluation. During the follow-up, the use of nocturnal NIV started and AS technique was introduced, seeking correction of hypoxemia, night apneas, increased PFT and FMR. Conclusion: Patient presented maintenance of spirometric parameters, increased FMR variables and motor function, without worsening the condition. Possible results from the multidisciplinary and specialized monitoring.

Comunicação Aumentativa e Alternativa e Habilidades de Linguagem de Crianças com Paralisia Cerebral: uma Revisão Sistemática / Augmentative and Alternative Communication and Language Skills of Children with Cerebral Palsy: a Systematic Review

RESUMO: O objetivo deste artigo foi identificar quais os sistemas de comunicação aumentativa e alternativa interferem nas habilidades de linguagem de crianças com paralisia cerebral. A questão norteadora foi: Quais os métodos de comunicação aumentativa e alternativa interferem nas habilidades de linguagem de crianças com paralisia cerebral? A população foi delimitada como crianças com diagnóstico médico de paralisia cerebral. Considerou-se comunicação aumentativa e/ou alternativa como intervenção. Habilidades comunicativas foram consideradas o desfecho. Foram selecionados artigos nas bases Medline, The Cochrane Central Register of Controlled Trials e EMBASE e em bases secundárias, por meio dos termos "Cerebral Palsy" e "Infant" e "Communication Aids for Disabled" e "Language Development". Os termos foram incluídos com seus entretermos e na língua indicada e requerida por cada base de dados. Não houve restrição de idioma, independentemente do ano de publicação até abril de 2019, que apresentassem, no título, resumo ou corpo do artigo, relação com o objetivo da pesquisa e os critérios de elegibilidade. Após a extração dos dados, as medidas foram transformadas em percentagem e descritas em uma síntese qualitativa. Foram encontrados 427 artigos nas bases de dados, sendo incluídos, após análises, seis artigos. As pranchas manuais foram as mais utilizadas pelos estudos encontrados, apesar de suas construções serem realizadas por meio de sistema simbólico computadorizado. Em todos os estudos encontrados, foram identificadas melhoras das habilidades comunicativas das crianças, independentemente do recurso e do modo de acesso utilizados. Todos os métodos de comunicação aumentativa e/ou alternativa utilizados nos estudos, apresentaram benefícios para as habilidades comunicativas de crianças com paralisia cerebral

ABSTRACT: The aim of this paper was to identify which augmentative and alternative communication systems interfere with the language skills of children with cerebral palsy. The guiding question was: What augmentative and alternative communication methods interfere with the language skills of children with cerebral palsy? The population was defined as children with a medical diagnosis of cerebral palsy. Augmentative and/or alternative communication was considered as an intervention. Communicative skills were considered the outcome. Papers were selected in Medline, The Cochrane Central Register of Controlled Trials and EMBASE and in secondary databases, using the terms "Cerebral Palsy" and "Infant" and "Communication Aids for Disabled" and "Language Development". The terms were included with their related terms and in the language indicated and required by each database. There was no language restriction, regardless of the year of publication until April 2019, which presented in the title, abstract or body of the article a relation with the research objective and the eligibility criteria. After data extraction, the measurements were transformed into percentages and described in a qualitative synthesis. Four hundred and twenty-seven articles were found in the databases, and after analysis 6 articles were included. The hand planks were the most used by the studies found, although their constructions were made through a computerized symbolic system. In all studies found, improvements in children's communication skills were identified, regardless of the resource and mode of access used. All augmentative and/or alternative communication methods used in the studies showed benefits for the communicative skills of children with cerebral palsy.

Terapia miofuncional orofacial na reabilitação das queimaduras de face em crianças e adolescentes: Uma revisão sistemática / Orofacial myofunctional therapy in the rehabilitation of face burns in children and adolescents: A systematic review

OBJETIVO: Identificar e analisar os achados da literatura referentes a terapia miofuncional orofacial em crianças e adolescentes que sofreram queimaduras de cabeça e/ou pescoço. MÉTODO: Revisão sistemática na qual foram incluídos estudos com desenho analítico observacional, sem restrição de idioma ou data de publicação, com a população de crianças de ambos os sexos, faixa etária de 0 a 18 anos, expostas à queimadura de cabeça e/ou pescoço e como desfecho, que tivessem realizado alguma modalidade de terapia miofuncional orofacial. As bases de dados utilizadas para a busca de artigos científicos foram PubMed, Cochrane CENTRAL, LILACS, CidSaude, PAHO, REPIDISCA, BDENF, MedCarib, WHOLIS, IBECS e SciELO, incluindo estudos indexados até dezembro de 2019. A estratégia de busca foi adaptada para cada base de dados. A seleção dos resumos, seleção dos artigos incluídos, extração de dados e análise de viés foi realizada por três pesquisadores separadamente. RESULTADOS: Foram encontrados 311 artigos nas bases de dados e, desses, quatro foram selecionados para compor o estudo. Identificaram-se diferentes intervenções nos pacientes, variando o tempo e o número de sessões realizadas durante o tratamento de acordo com o tipo de queimadura de exposição, incluindo terapia por pressão, aplicação de silicone, massagem e exercício facial, massagens e uso de aparelhos (placas) associados. CONCLUSÃO: Há falta de evidências sobre a terapia miofuncional orofacial como forma de tratamento para pacientes pediátricos com queimaduras de cabeça e/ou pescoço.

OBJECTIVE: To identify and to analyze the findings in the literature regarding an orofacial myofunctional therapy in children and adolescents who suffered head andor neck burns. METHODS: Systematic review which included studies with observational analytical design, with no restriction on language or publication data, with a population of children of both sexes, aged 0 to 18 years, exposure to head and/or neck burns and as an outcome, they had undergone some modality of orofacial myofunctional therapy. The databases used to search for scientific articles were PubMed, Cochrane CENTRAL, LILACS, CidSaude, PAHO, REPIDISCA, BDENF, MedCarib, WHOLIS, IBECS and SciELO, including studies indexed until December 2019. The search strategy was adapted for each database. The selection of abstracts, selection of included articles, data extraction and bias analysis was performed by three researchers separately. RESULTS: 311 articles were found in the databases, and four were selected to compose the study. Different treatments were identified in patients, varying the time and number of combinations during treatment according to the type of exposure burn, including pressure therapy, silicone application, massage and facial exercise, massage and use of devices (plates) associates. CONCLUSION: There is a lack of evidence on orofacial myofunctional therapy as a form of treatment for pediatric patients with head and/or neck burns.

Translation and cultural adaptation of the King's Brief Interstitial Lung Disease health status questionnaire for use in Brazil / Tradução e adaptação cultural do King's Brief Interstitial Lung Disease health status questionnaire

ABSTRACT Objective: To translate the King's Brief Interstitial Lung Disease (K-BILD) questionnaire to Portuguese and culturally adapt it for use in Brazil. The K-BILD quantifies the health status of patients with ILD. Methods: The process involved the following steps: authorization from the author of the original (English-language) questionnaire; translation of the questionnaire to Portuguese by three translators, working independently; merging of the translations by a committee of specialists; back-translation of the questionnaire to English; revision and readjustment of the back-translation by the committee of specialists; evaluation by the original author; revision of the back-translation; cognitive debriefing (verification of the clarity and acceptability of the Portuguese-language version in the target population-i.e., patients with ILD); and finalization of the Portuguese-language version. Results: In the cognitive debriefing step, 20 patients with ILD were interviewed. After the interviews, the clarity and acceptability index of each question was ≥ 0.8, which is considered acceptable. Conclusions: The Portuguese-language version of K-BILD appears to be easily administered to and understood by patients with ILD in Brazil. To our knowledge, this is the only instrument in Brazilian Portuguese that is designed to evaluate the impact that ILD has on the various aspects of the lives of those it affects.

RESUMO Objetivo: Traduzir e adaptar culturalmente o King's Brief Interstitial Lung Disease (K-BILD) health status questionnaire, utilizado para mensurar o estado de saúde em pacientes com doença pulmonar intersticial (DPI), para a língua portuguesa falada no Brasil. Métodos: As seguintes etapas foram realizadas: autorização do autor do instrumento original; preparação; tradução do K-BILD da língua inglesa para a língua portuguesa falada no Brasil por três tradutores independentes; unificação das traduções por um comitê de especialistas; retradução do português para o inglês; revisão e readequação da retradução pelo comitê de especialistas; avaliação do autor do original; revisão da versão em inglês; desdobramento cognitivo (observação da clareza e aceitabilidade do questionário traduzido na população-alvo); e elaboração da versão final em português. Resultados: Na etapa de desdobramento cognitivo foram entrevistados 20 pacientes com DPI. Após todas as entrevistas, o índice de clareza e aceitabilidade das questões foi igual ou maior que 0,8, indicando um índice de clareza aceitável para todas as questões. Conclusões: A versão do K-BILD mostrou ser compreensível e de fácil aplicação. Até onde sabemos, esse é atualmente o único instrumento disponível em português falado no Brasil dirigido à avaliação do impacto da DPI em vários aspectos da vida desses pacientes.

Tratamento cirúrgico de lipoma: relato de dois casos / Surgical Treatment of Lipoma: Report of two cases

O lipoma é um tumor mesenquimal benigno, considerado um dos mais comuns dos tecidos moles. Ocorre, principalmente, no tronco, nas porções proximais das extremidades do corpo e na região de cabeça e pescoço, com incidência de 15 a 20% dos casos. Quando apresentado em região oral e maxilofacial, é relativamente raro, tendo uma incidência relativa de 1% - 4% dos tumores que acometem essa região. Clinicamente a lesão intraoral apresenta-se como aumento de volume nodular, assintomática, bem-circunscrita, de crescimento lento, com superfície lisa e consistência macia, que pode ser séssil ou pedunculada, de tamanho diverso, com coloração variando de amarelo discreto, em lesões superficiais, a rosa, semelhante à mucosa em lesões mais profundas. O trabalho tem como objetivo relatar dois casos de lipomas em regiões maxilofaciais, tratados cirurgicamente sob anestesia local e geral. Os pacientes encontram-se em acompanhamento, sem sinais de recidiva. É importante o correto diagnóstico clínico e anatomopatológico da lesão, para que seja definido o tratamento ideal e um bom prognóstico, já que essa lesão apresenta uma baixa taxa de recidiva... (AU)

Lipoma is a benign mesenchymal tumor, considered one of the most common one in soft tissues. They mainly occur in the trunk, in the proximal portions of the extremities of the body and in the region of the head and the neck, with incidence of 15 to 20% of cases. When present in the oral and maxillofacial regions, it is relatively rare, with a relative incidence of 1% -4% of the tumors affecting this region. Clinically, the intraoral lesion presents as a nodular volume increase, asymptomatic, well-circumscribed, slow-growing, with smooth surface and soft consistency - which may be sessile or pedunculated - of different size, with a coloration ranging from discrete yellow in superficial lesions to a mucosa-like pink in deeper lesions. The aim of this study is to report two cases of lipomas in maxillofacial regions surgically treated under local and general anesthesia. Patients are being followed up without signs of relapse. The appropriate clinical and pathological diagnosis of the lesion is important to define the ideal treatment and a good prognosis, since this lesion presents a low rate of recurrence... (AU)

Nosographic profile of soccer injuries according to the age group / Perfil nosográfico de lesões desportivas no futebol segundo faixa etária

Soccer is one of the world's most popular team sports and corresponds to one of the leading causes of sports injuries (SI). This study aimed to analyze the nosographic profile of the sports injuries common to soccer, according to the age group: childhood, youth and adulthood. We selected 209 soccer players, from amateurs to professional players of a sports club from Campo Grande/MS. Participants were divided into four age groups: G1 (childhood), G2 (juvenile), G3 (teenagers) and G4 (adults). To obtain information about the injuries, we used a morbidity survey. Generally, 74 athletes reported sports injuries, with register of 92 SI. Concerning injury types, muscle injuries totalized 43.47%, followed by joint damage (34.78%) and tendon injury (14.13%), respectively (p<0.05). The affected anatomical sites were predominantly lower limbs (91.3%). Contact was the main etiologic mechanism of injuries, integrating almost half of the cases (47.82%), followed by technique (20.65%) and running (19.56%). Training consisted in the main situation of occurrence of SI (74.3%) in G2 and G4; in other groups, occurrence of SI was similar between training and competition situations (p> 0.05). A higher proportion of registers involved medical-therapeutic approach and asymptomatic return. The evidence shows a higher rate of muscle and joint injuries by contact in the lower limbs in soccer practitioners, regardless of age group. The practice of training seems to be the main cause of injuries in adolescents and adults.

O futebol é a modalidade desportiva mais popular no mundo e responde pelos principais índices de lesões desportivas (ld). O objetivo deste trabalho foi traçar o perfil nosográfico de lesões músculo-esqueléticas típicas do futebol, relacionando-as com a faixa etária de desenvolvimento: infância, adolescência e adultez. A casuística contemplou 209 praticantes de futebol, procedentes das equipes de base profissionalizante e profissional de um clube desportivo da cidade de campo grande/ms. os participantes foram distribuídos em quatro grupos etários: g1 (infância), g2 (infanto-juvenil), g3 (adolescentes) e g4 (adultos). Para a tomada de informações sobre lesões, utilizou-se de um inquérito de morbidade referida. No geral, 74 atletas relataram lesões, com registro de 92 ld. Quanto à natureza, 43,47% configuraram agravos musculares, seguidos por lesões articulares (34,78%) e tendíneas (14,13%), respectivamente (p<0,05). Os locais anatômicos predominantemente acometidos foram membros inferiores (91,3%). Como mecanismo de ld, o contato desportivo integrou quase metade dos casos (47,82%), seguidos pela técnica (20,65%) e corrida (19,56%). As situações de treino consistiram na principal forma de ocorrência (74,3%) nos grupos g2 e g4; nos demais grupos, denotou-se um equilíbrio entre situações de treino e competição (p>0,05). A maior proporção de registros envolveu abordagem médico-terapêutica e retorno assintomático. As evidências comprovam um maior índice de lesões musculares e articulares por contato em membros inferiores, em praticantes de futebol, independente de faixa etária. quanto à situação de ocorrência, a prática de treino é a principal circunstância de origem de lesões em jovens e adultos.