Critical period of exposure to mercury and the diagnostic of autism spectrum disorder: A systematic review.

Autism spectrum disorder (ASD) is characterized by repetitive behaviors and deficits in social interaction. Its etiology is not completely clear, but both genetic and environmental factors contribute to and influence its development and course. The increased number of autism cases in recent years has been strongly associated with increased exposure to heavy metals. Mercury (Hg) has gained prominence in the scientific literature as a result of its presence as an urban pollutant and well-described neurotoxicity. This review assessed the relationship between Hg exposure in the pre- and post-natal period and ASD. The systematic review identified observational clinical studies and pre-clinical trials in journals indexed in the PubMed, Embase, ProQuest, and LILACS databases. The aim of this study was to investigate the association between exposure to Hg and ASD and to define the critical period of exposure. A total of 57 articles were selected for this review, with 35 articles (61.40%) identifying a positive association between ASD and Hg, while 22 articles (38.60%) did not find the same outcome. The biological samples most used to analyze Hg body burdens were hair (36.84%) and blood (36.84%). Most case-control studies found an increase in Hg levels in individuals with ASD who were exposed to a polluted environment in the post-natal period. Taken together, the studies suggest that these patients have a deficient detoxification system, and this could worsen the symptoms of the disorder. However, new studies addressing the influence of Hg on the post-natal nervous system and its relationship with ASD should be carried out.

Vitamin D3 as adjuvant in the treatment of type 2 diabetes mellitus: modulation of genomic and biochemical instability.

Type 2 diabetes mellitus has undergone a worldwide growth in incidence in the world and has now acquired epidemic status. There is a strong link between type 2 diabetes and vitamin D deficiency. Because vitamin D has beneficial effects on glucose homeostasis, the aim of this study was to evaluate the influence of vitamin D3 supplementation on the modulation of glycaemic control and other metabolic effects, as well as modulation of genomic instability in patients with type 2 diabetes. We evaluated 75 patients with type 2 diabetes, registered in the Integrated Clinics of the University of Southern Santa Catarina. Participants received 4000 IU of vitamin D3 (25(OH)D) supplementation daily for 8 weeks. Blood samples were collected at the beginning and at the end of the supplementation, and 4 weeks after the end of supplementation. The glycidic and lipid profiles [total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein and triglycerides], oxidative stress, DNA damage and 25(OH)D levels were evaluated. Vitamin D3 supplementation for 8 weeks showed enough to significantly increase blood levels of 25(OH)D. A significant difference in lipid profile was observed only in non-HDL cholesterol. Significant changes were observed in glucose homeostasis (fasting glucose and serum insulin) and, in addition, a reduction in the parameters of oxidative stress and DNA damage. There was a significant reduction in the values of 25(OH)D 4 weeks after the end of the supplementation, but levels still remained above baseline. Use of vitamin D supplementation can be an ally in the health modulation of patients with type 2 diabetes mellitus.

Use of Data Mining to Predict the Risk Factors Associated With Osteoporosis and Osteopenia in Women.

Osteoporosis has recently been acknowledged as a major public health issue in developed countries because of the decrease in the quality of life of the affected person and the increase in public costs due to complete or partial physical disability. The aim of this study was to use the J48 algorithm as a classification task for data from women exhibiting changes in bone densitometry. The study population included all patients treated at the diagnostic center for bone densitometry since 2010. Census sample data collection was conducted as all elements of the population were included in the sample. The service in question provides care to patients via the Brazilian Unified Health System and private plans. The results of the classification task were analyzed using the J48 algorithm, and among the dichotomized variables associated with a diagnosis of osteoporosis, the mean accuracy was 74.0 (95% confidence interval [CI], 61.0-68.0) and the mean area under the curve of the receiver operating characteristic (ROC) curve was 0.65 (95% CI, 0.64-0.66), with a mean sensitivity of 76.0 (95% CI, 76.0-76.0) and a mean specificity of 48.0 (95% CI, 46.0-49.0). The analyzed results showed higher values of sensitivity, accuracy, and curve of the ROC area in experiments conducted with individuals with osteoporosis. Most of the generated rules were consistent with the literature, and the few differences might serve as hypotheses for further studies.

[The quality and characteristics of sleep of hypertensive patients]. / Características e qualidade do sono de pacientes hipertensos.

OBJECTIVE: Analyzing the quality of sleep of hypertensive patients registered in the national registration system and monitoring of hypertensive patients. METHODS: A cross-sectional study of quantitative and descriptive analyses with 280 hypertensive patients registered in the National Program of Hypertension and Diabetes of the Federal Government in the months from August to October 2011. Questionnaires were used which allowed for tracking sociodemographic data on hypertension and Pittsburgh Sleep Quality Index (PSQI). RESULTS: The prevalence of poor sleep quality among respondents (156 hypertensive patients) and high rates of using medication for sleeping (106 hypertensive patients) was observed. Other relevant data refers to the quality of sleep among hypertensive patients using sleep medication compared to those who do not use it (p≤0.01). CONCLUSION: Individuals with high blood pressure have a negative association with sleep quality.

The effects of academic unprofessional behaviour on disciplinary action by medical boards: Systematic review and meta-analysis.

OBJECTIVE: The objective of this study is to evaluate the association of disciplinary actions by regulatory councils and unprofessional behaviour during medical graduation. METHODS: A search strategy was developed using the terms: 'physicians', 'disciplinary action', 'education', 'medical', 'undergraduate' and their synonyms, subsequently applied to the electronic databases MEDLINE, Embase, Cochrane Library, LILACs and grey literature, with searches up to November 2023. The risk of bias was assessed using the Newcastle-Ottawa scale and statistical analysis was performed using the RevMan software. RESULTS: A total of 400 studies were found in the databases, and 15 studies were selected for full-texting reading. Four studies met the inclusion criteria and were included, bringing together a total of 3341 evaluated physicians. Three studies were included in the meta-analysis, showing a greater chance of disciplinary actions among physicians who exhibited unprofessional behaviour during medical graduation (OR: 2.54; 95%CI: 1.87-3.44; I2: 0%; P < 0.0001; 3077 participants; physicians with disciplinary action: 107/323; control physicians: 222/2754). CONCLUSIONS: There is a statistically significant association between unprofessional behaviour during medical undergraduate study and subsequent disciplinary actions by Medical Councils. The tools for periodic assessments of student behaviour during undergraduate studies can be a perspective for future studies aimed at reducing disciplinary actions among physicians.

Environmental degradation, climate change and health from the perspective of Brazilian Indigenous stakeholders: a qualitative study.

BACKGROUND: The WHO identifies climate change as the most significant threat to global health systems. Indigenous peoples, whose lives are deeply intertwined with nature, are particularly vulnerable to the impacts of these changes. OBJECTIVE: This study aimed to understand the perspectives of Indigenous stakeholders and public services managers on the interconnectedness of climate change and Indigenous health. DESIGN: A qualitative study with 22 Indigenous stakeholders and public service managers on climate change and perceived impact on Indigenous health. SETTING AND PARTICIPANTS: Indigenous stakeholders and public service managers on climate change and perceived impact on Indigenous health from Brazil. Data was collected through interviews incorporating two vignette videos depicting environmental and health scenarios. Thematic content analysis was used to analyse the data. RESULTS: The analytical process yielded six subcategories that were further grouped into three overarching thematic macro-categories: environmental degradation and climate change in the context of Indigenous peoples; environment, vulnerability and impact on Indigenous mental health; and actions and public health policies for Indigenous peoples. CONCLUSION: The perspectives of Indigenous stakeholders and public service managers on the interconnectedness of climate change and Indigenous health were deeply entrenched in their lived experiences of loss of their lands from deforestation and environmental degradation. They argued strongly for the strengthening of public health policies aimed at the Indigenous peoples, to face many challenges, especially suicide, and to have a voice in decision-making. A sensitive approach that values Indigenous peoples' connections with nature is fundamental to promote their health and well-being.

Prevalence of cognitive impairment and associated factors in older people.

BACKGROUND: Older people are the fastest-growing age group, with the highest risk of cognitive impairment. This study assessed the prevalence and associated factors with cognitive impairment in community-dwelling older people. METHODS: Older people were interviewed and accomplished through sociodemographic and health questionnaires. The quantitative variables were described by mean and standard deviation or median and interquartile range. The significance level adopted was 5 % (p < 0.05). The association between the quantitative variables was evaluated using the Pearson or Spearman correlation coefficients. RESULTS: The research population comprised 165 long-lived adults aged ≥80. The youngest one was 80, and the oldest one was 94 years old. The participants were 84.8 ± 3.6 years old, female (63 %) with a mean of education of 2.9 ± 1.8 years. A poor performance in the Mini-Mental State Examination (MMSE) was found in 58 (35.2 %) individuals when adjusted for educational level. After adjustment for confounding factors, body mass index (BMI) (p = 0.09), total older adults' income (up to 1 minimum wage [mw], p = 0.023; over 1 to 2 mw, p = 0.023), functional disability (Moderate dependence 75 %, p = 0.038; Moderate dependence 50 %, p = 0.081; Moderate dependence 25 %, p = 0.054), and the anxiety scale (p = 0.032), remained associated with cognitive impairment. CONCLUSIONS: This study showed that BMI, total older adults' income, functional disability, and anxiety are related to cognitive impairment in long-lived adults. This study has some limitations, such as the fact that it is a cross-sectional study, the reduced number of individuals, and the fact that there were no comparisons among different ages and populations.

Gut and Vaginal Microbiota in the Endometriosis: Systematic Review and Meta-Analysis.

Background: Endometriosis is a clinical condition associated with genetic, endocrine, and immunological factors, present in 6 to 10% of women of reproductive age. Currently, the human microbiota has been studied and associated with the evolution of diseases due to its influence on pathogenesis, indicating that changes in the colonization of microorganisms in the genitourinary and gastrointestinal systems can promote physiological changes that can trigger inflammatory and immunological processes and hormonal dysregulation, which can be linked to endometriosis. Thus, this systematic review and meta-analysis evaluated microbiota changes in women with endometriosis. Methods: The following electronic databases were searched up to April 2022: Medline, Embase, Web of Science, Cochrane Library, and gray literature (Google Scholar), using the keywords "dysbiosis", "microbiome" and "endometriosis", combined with their synonyms. The observational studies conducted with women diagnosed with endometriosis and women without endometriosis as controls were included. For the analyses, a standard mean difference with a 95% confidence interval was used using RevMan software (version 5.4), and for methodological quality assessment, the Newcastle-Ottawa scale was used. Results: A total of 16 studies were found in the literature assessing the composition of the microbiota in women with endometriosis, and no significant difference were found for changes in alpha diversity analysis in gut microbiota (SMD = -0.28; 95% CI = -0.70 to 0.14; P = 0.19; I2 = 52%; four studies, 357 participants) or vaginal microbiota (SMD = -0.68; 95% CI = -1.72 to 0.35; P = 0.19; I2 = 66%; two studies, 49 participants). Conclusion: In intestinal and vaginal samples from women with endometriosis, alpha-diversity did not present a significant difference when compared to the control population. However, each study individually showed a possible relationship between the female microbiota and endometriosis. This trial is registered with CRD42021260972.

Green tea promotes weight loss in women with polycystic ovary syndrome: Systematic review and meta-analysis.

Among the main consequences of polycystic ovary syndrome (PCOS) are menstrual dysfunction, infertility, hyperandrogenism, insulin resistance, and weight gain; in aggravated cases, it can become a risk factor for the development of metabolic syndrome and cardiovascular disease. We hypothesized that green tea can be an option to complement the treatment of PCOS. Thus, this systematic review aims to evaluate the effects of green tea supplementation in women with PCOS. We searched for randomized controlled trials (RCTs) that evaluated women with PCOS who received green tea compared with placebo in electronic databases: MEDLINE via PubMed, EMBASE via Elsevier, Cochrane Library, LILACS via BVS, and Web of Science using the terms: "polycystic ovary syndrome," "green tea," "Camellia sinensis," "epigallocatechin gallate." The outcomes listed in the study protocol were body weight, fasting insulin, body mass index, body fat percentage, daily caloric intake, waist circumference, hip circumference, and waist/hip ratio. Four double-blind RCTs were included, with a total of 169 women: 85 in the green tea group and 84 in the placebo group. We found a significantly lower body weight (kg) for green tea group (mean difference, -2.80; 95% confidence interval, -5.25 to -0.35; P = .03; I² = 0%; 4 studies, 169 participants, very low-quality evidence). Green tea has potential positive effects for the reduction of weight, and future studies will be needed to confirm the estimated effect size; we reasonably expect this to be an option of adjuvant treatment in PCOS clinical management. Registration number: CRD42021226296.

A systematic review and meta-analysis of the accuracy of SARS-COV-2 IGM and IGG tests in individuals with COVID-19.

INTRODUCTION: Active SARS-CoV-2 infection is confirmed mainly through the detection of viral nucleic acid via the reverse transcriptase polymerase chain reaction (RT-PCR) technique. Methods to assess humoral responses contribute to the monitoring of the disease and confirmation of exposure to the virus. OBJECTIVE: To evaluate the accuracy of tests for IgM and IgG antibodies for SARS-CoV-2 infection confirmed by RT-PCR and utility as complementary data for immunosurveillance. METHODS: Literature research was performed by searching the terms "COVID-19", "COVID-19 diagnostic testing" and "test" in the databases MEDLINE, EMBASE, Cochrane Library, Web of Science and Cumulative Index to Nursing and Allied Health Literature to search for potentially eligible observational studies without language restrictions published up to September 2020. RESULTS: The pooled sensitivity and specificity, regardless of collection moment, was 80.0% (CI 95% 72.0-86.0) and 97.0% (CI 95% 94.0-98.0) for "IgM and/or IgG", respectively. Serology considering immunoglobulins M and G together had a high accuracy performance on "fifteenth day and after": sensitivity and specificity was 91.0% (CI 95% 85.0-94.0) and 98.0% (CI 95% 95.0-99.0) respectively, DOR 461 and AUC 0.98. CONCLUSION: This study shows that serology is a group of tests with high accuracy, mainly following the second week after infection.

Meta-Analysis of the Sensitivity of Decision Support Systems in Diagnosing Diabetic Retinopathy.

Diabetic Retinopathy (DR) is one of the most common microvascular complications presenting by patients diagnosticated with diabetic diseases. Uncontrolled hyperglycemia may manifest as visual impairment and blindness. The early detection of DR is essential to minimize the risk and consequence of visual diminishing. The standard gold diagnoses tool relies on different imaging modalities and requires a judgment of expert photographers, which are not available in most of the primary care centers or remote location. In that scenario, an automate or semiautomated DR screening systems can contribute to improving the accuracy of the diagnostic. Thus, we performed a Systematic Review and Meta-Analysis to evaluate the Decision Support Systems (DSS) in diagnosing DR. The overall Diagnostic Odds Ratio was 73.15 (95%CI: 37.54-142.50), sensitivity was 97.70 (95%CI: 97.50-97.90) and specificity was 90.30 (95%CI: 90.00-90.60). Our results corroborate with the concept of usefulness of DSSs in early diagnosis, screening and preliminary evaluation of suspicious images of DR.

Detection of the Hepatitis C virus in a population of adults.

UNLABELLED: The objective of this study was to determine the prevalence of Hepatitis C virus (HCV) in adults from Criciuma-SC and to search factors associated with the viral transmission. METHODS: During a health campaign, a questionnaire about factors associated to HCV transmission and tests to detect HCV were applied. A representative sample of the population was considered with 300 voluntaries. Fisher's Exact test, Mann-Whitney and Kappa tests were performed (p values < 0.05 were considered significant). RESULTS: HCV was detected in 7/ 457 (1.53 %) voluntaries. Subjects with positive HCV had a mean of 5.7 (+/- 4.1 SD) sexual partners in the last 10 years, which was significantly higher than those with negative anti-HCV (mean sexual partners 2 +/- 2.5 SD) (p= 0.01). CONCLUSION: The prevalence of HCV in a voluntary population of adults from Criciuma-SC was high and there was significant association between positive anti-HCV and higher number of sexual partners.

Acolhimento de pessoas com deficiência auditiva na Atenção Primária à Saúde no município de Criciúma, Santa Catarina / Reception of the hearing impaired in Primary Health Care in the municipality of Criciúma, Santa Catarina

As pessoas com deficiência auditiva (DA) possuem barreiras a serem descontruídas quando o assunto é acesso aos serviços de saúde. Estas se dão devido à dificuldade na comunicação, falta de profissionais qualificados, ausência de intérprete da Língua Brasileira de Sinais (LIBRAS) dentre outros aspectos. O objetivo deste trabalho é analisar o acolhimento dos indivíduos com surdez na Atenção Primária em Saúde (APS). Trata-se de um estudo de métodos mistos com triangulação concomitante por meio de um estudo descritivo e quantitativo. O estudo foi realizado nas Unidades Básicas de Saúde (UBS) do município de Criciúma ­ Santa Catarina, participaram os gerentes das unidades de saúde, cirurgiões dentistas, enfermeiros e médicos. Foram entrevistados 43 profissionais de saúde de 44 UBS diferentes do município, dos quais os resultados apontaram frágeis condições de acolhimento e atendimento humanizado das pessoas com DA que procuram as unidades básicas de saúde. A comunicação predominante é de forma verbal e na maioria das vezes, conta com a presença de um familiar durante as consultas para facilitar essa comunicação. Alguns profissionais afirmaram que o DA não possui atendimento humanizado, inclusivo e resolutivo, e que os programas de capacitação deixariam os atendimentos mais humanizados. Em suma, existem inúmeras barreiras no acolhimento dos pacientes com DA na APS, sendo necessária a aprimoração das práticas para que seja desenvolvido um atendimento inclusivo, humanizado, acolhedor e integral.

The person with hearing loss (AD) has barriers to be deconstructed regarding access to health services. These are due to the difficulty in communication, lack of qualified professionals, and absence of interpreters of Brazilian Sign Language, among other aspects. This study aims to analyze the reception of individuals with deafness in Primary Health Care (PHC). This is a mixed methods study with concomitant triangulation through descriptive and quantitative analysis. The study was conducted in the Basic Health Units (BHU) of the municipality of Criciúma - Santa Catarina, with the participation of managers of health units, dental surgeons, nurses, and physicians. Participants were 43 health professionals from 44 different BHUs in the city, of which the results showed fragile conditions of reception and humanized care of people with AD who seek basic health units. The predominant communication is verbal and, in most cases, relies on the presence of a family member during the consultations to facilitate this communication. Some professionals stated that the DA lacks humanized, inclusive and resolutive care and that the training programs would make the care more humanized. In short, there are numerous barriers in the reception of patients with AD in PHC, and it is necessary to improve practices so that inclusive, humanized, welcoming, and integral care is developed.

Mental health in underground coal miners.

As mental health goes beyond the simple absence of mental disorders, this paper characterized mental health components in 89 underground coal miners in southern Brazil. This is a cross-sectional study, that detected a low prevalence of depression; light or moderate anxiety in 13% of the workers; self-perception of good health; life quality and good psychological capacity in most of the participants; poor sleep quality in half of them; reverse correlations between anxiety and life quality, and anxiety and psychological capital; positive correlations between psychological capital and life quality; associations between self-perception of health, time, and sleep quality; associations between anxiety and sleep duration and quality; and between alcohol consumption and location at work (front, rear, or variable). The results suggest vulnerabilities regarding anxiety and sleep quality. However, there is a potential coping of determinants that impact on mental health.

Accuracy of Decision Support Systems for Breast Cancer - Initial Results.

The aim of this study was to evaluate the accuracy of decision support systems in the diagnosis of breast cancer by means of a systematic review and meta-analysis of studies of diagnostic accuracy. The first step of the research, which consisted of the initial research of abstracts and titles identified from the research strategy in the databases was performed by two researchers independently. In this stage, 622 references were retrieved in the databases and, through a consensus meeting, 183 articles were selected for full reading.

Centrais de Regulação e Consórcios Intermunicipais de Saúde: a Percepção de Gestores Catarinenses

Objetivo: Analisar a percepção dos gestores dos consórcios intermunicipais de saúde e das comissões intergestores regionais do sul de Santa Catarina sobre a incorporação das centrais de regulação nos procedimentos eletivos de média e alta complexidade, inseridos nos consórcios intermunicipais de saúde do estado. Métodos: Trata-se de um estudo descritivo como abordagem mista, realizado com representantes legais de consórcios intermunicipais de saúde e gestores municipais representantes da Comissão Intergestores Regional do sul de Santa Catarina, totalizando 6 participantes. A coleta de dados se deu através de entrevista semiestruturada. A análise ocorreu por método de condensação de significados com auxílio do programa SPSS versão 23.0. Resultados: Foi possível obter a percepção dos representantes legais e gestores acerca dos mecanismos de regulação, legislação vigente, sua eficácia e seu conhecimento prévio a respeito dos mesmos. Além disso, conseguiu-se traçar as características do perfil profissional dos respectivos indivíduos. Conclusões: Os resultados obtidos apontam uma percepção positiva dos gestores acercada regulação e o auxílio que a mesma trouxe aos municípios em relação à continuidade na linha de cuidado e a garantia do acesso aos pacientes com critérios clínicos mais graves. Evidenciou-se também a necessidade de melhorias na eficiência e fiscalização das legislações vigentes, além da necessidade dos gestores receberem capacitações acerca de características pontuais dos mecanismos legais.

Integração ensino-serviço: possibilidades de uma Universidade Comunitária em meio à pandemia da covid-19

O cenário da pandemia da COVID-19 convoca à rápidas mudanças no modo de trabalho, as Instituições de Ensino Superior (IES), além de potencializar as ações no campo da pesquisa reafirmam seu papel para a comunidade, especialmente quando se trata de Universidades comunitárias. Este artigo caracteriza-se como relato de experiência sobre as ações utilizadas para o enfrentamento da COVID-19 pela Universidade do Extremo Sul Catarinense (UNESC), do município de Criciúma ­ SC, uma Universidade comunitária. As ações da UNESC foram intensificadas durante o cenário pandêmico, trazendo ações inovadoras como implantação de Sala de Situação Covid-19, teleatendimentos como SOS UNESC Covid-19 e Acolher UNESC Covid-19, Programa de Rastreamento do Coronavírus, Comitê e Análise de Gestão da Covid-19 e várias ações realizadas para além dos espaços da IES. Este artigo marca o importante papel das Universidades comunitárias e seu compromisso com o desenvolvimento regional, ações, intervenções e parcerias com impacto direto na saúde da população local. A UNESC, enquanto Universidade comunitária, desenvolve ações pautadas nas melhores evidências científicas e valoriza o cuidado com a vida das pessoas. Palavra-chave: Coronavírus, Epidemiologia, Gestão de Riscos, Vigilância em Saúde Pública, Instituições de Ensino Superior.

Data Mining Applied to Analysis of Contraceptive Methods Among College Students.

The aim of this study was to use the Data Mining to analyze the profile of the use of contraceptive methods in a university population. We used a database about sexuality performed on a university population in southern Brazil. The results obtained by the generated rules are largely in line with the literature and epidemiology worldwide, showing significant points of vulnerability in the university population. Validation measures of the study, as such, accuracy, sensitivity, specificity, and area under the ROC curve were higher or at least similar as compared to recent studies using the same methodology.

Meta-analysis of magnetic resonance imaging accuracy for diagnosis of oral cancer.

OBJECTIVE: To establish the diagnostic accuracy of magnetic resonance imaging (MRI) as an auxiliary means for the diagnosis of oral cancer through a systematic review and meta-analysis. METHODS: An exhaustive search of publications from 1986 to 2016 was performed of Medline, Embase and Cochrane (and related databases), including grey literature. Primary diagnostic accuracy studies that assessed oral cancer (target condition) using MRI (index test) were included. Diagnostic threshold, sensitivity and meta-regression analyses were performed. A meta-analysis was performed using Meta-DiSc® v. 1.4 software. RESULTS: A total of 24 primary studies were assessed, comprising 1,403 oral cancer lesions. Nine studies used diffusion-weighted MRI, with a diagnostic odds ratio (DOR) of 30.7 (95% confidence interval [CI]: 12.7-74.3) and area under the curve (AUC) of 0.917 (95% CI: 0.915-0.918); seven studies used dynamic contrast-enhanced MRI, with a DOR of 48.1 (95%CI: 22.4-103.2) and AUC of 0.936 (95% CI: 0.934-0.937); and 13 studies used traditional MRI, with a DOR of 23.9 (95%CI: 13.2-43.3) and AUC of 0.894 (95% CI: 0.894-0.895). Meta-regression analysis indicated that the magnetic field strength may have influenced the heterogeneity of the results obtained (p = 0.0233) using traditional MRI. Sensitivity analysis revealed a discrete reduction of inconsistency in some subgroups. CONCLUSION: The three types of MRI assessed exhibited satisfactory accuracy compared to biopsy. Considering the relevance of early treatment and screening and that better health care results in improved survival rates and quality of life for oral cancer patients, we suggest the use of MRI as a part of the pre-treatment and monitoring protocol at public health services.