HPV Prevalence and Predictive Biomarkers for Oropharyngeal Squamous Cell Carcinoma in Mexican Patients.

BACKGROUND: Worldwide prevalence of Oropharyngeal Squamous Cell Carcinoma (OPSCC) has increased, affecting mostly young males. OPSCC associated with Human Papillomavirus (HPV) infection exhibits particular characteristics in terms of response to treatment, hence HPV has been proposed as a prognostic factor. The impact of HPV positivity and associated biomarkers on OPSCC in the Mexican population has not been addressed. Therefore, the analysis of OPSCC prognostic markers in the Mexican population is necessary. METHODS: Retrolective study in Mexican OPSCC patients, where HPV prevalence, p16 and EGFR levels were assessed using INNO-LiPA and immunohistochemistry. RESULTS: We found an HPV prevalence of 57.6% in OPSCC cases treated at a reference center in Mexico. HPV and p16 positivity, as well as EGFR, associate with better outcomes in OPSCC patients, and they also promote reduced death risk. Notably, HPV presence and p16 positivity showed a significant association with disease-free survival (DFS), with a HR of 0.15 (p = 0.006) and a HR of 0.17 (p = 0.012), respectively, indicating a possible role as predictive biomarkers in Mexican OPSCC patients. CONCLUSIONS: Our results reflect the clinical utility of p16 analysis to improve overall survival (OS) and to predict recurrence in oropharyngeal cancer. These results position p16 and HPV as predictive biomarkers for OPSCC.

Pega na mentira: notas antropológicas sobre tempos inquietantes / Catch the lie: anthropological notes on unsettling times / Atrapa la mentira: apuntes antropológicos sobre tiempos inquietantes

O artigo emprega o método etnográfico e comparativo por contraste, fundado em observação direta, participante e entrevistas no campo no Brasil, na França e nos EUA. O objetivo do mesmo consiste em analisar a produção de narrativas contraditórias no mundo contemporâneo que se arrogam a qualidade de verdades legítimas para aqueles que acreditam nelas. Como resultado demonstramos como tais narrativas se articulam a uma generalizada quebra de 'confiança' (trust), característica presumida nas interações das sociedades de mercado, por uma desconfiança generalizada, mais especificamente caracterizada na língua portuguesa como 'a cisma'. O principal problema é o renascimento do ethos inquisitorial na sociedade contemporânea e suas implicações nas formas de produção da verdade. A intersecção entre a cisma e o ethos inquisitorial de suspeição sistemática sobre todas as interações sociais na sociedade contemporânea parece estar intimamente relacionada com os efeitos das redes sociais nas práticas e dinâmicas sociais, em particular no que diz respeito à rachadura produzida por estes instrumentos na construção de consensos, das concepções do "comum" da ideia da verdade, da inclinação ao debate e à crítica, etc.

The article employs the ethnographic and comparative method by contrast, based on direct and participant observation, and field interviews in Brazil, France and the USA. Its purpose is to analyze the production of contradictory narratives in the contemporary world that claim to be legitimate truths for those who believe them. As a result, we show how such narratives are articulated to a generalized breakdown of 'trust', a presumed characteristic in the interactions of market societies, by a generalized distrust, more specifically characterized in Portuguese as 'a cisma'. The main problem is the revival of the inquisitorial ethos in contemporary society and its implications for the forms of truth production. The intersection between schism and the inquisitorial ethos of systematic suspicion about all social interactions in contemporary society seems to be closely related to the effects of social networks on social practices and dynamics, in particular with regard to the cracking produced by these instruments in the construction of consensus, of the conceptions of the 'common' idea of truth, of the inclination to debate and criticism, etc.

El artículo utiliza el método etnográfico y comparativo por contraste, basándose en la observación directa y participante y en entrevistas sobre el terreno en Brasil, Francia y Estados Unidos. Su objetivo es analizar la producción de narrativas contradictorias en el mundo contemporáneo que pretenden ser verdades legítimas para quienes las creen. Como resultado, demostramos cómo tales narrativas se articulan a una ruptura generalizada de la 'confianza', una presunta característica en las interacciones de las sociedades de mercado, por una desconfianza generalizada, más específicamente caracterizada en el idioma portugués como 'a cisma'. El problema principal es el resurgimiento del ethos inquisitorial en la sociedad contemporánea y sus implicaciones para las formas de producción de la verdad. La intersección entre el cisma y el ethos inquisitorial de sospecha sistemática sobre todas las interacciones sociales en la sociedad contemporánea parece estar estrechamente relacionada con los efectos de las redes sociales en las prácticas y dinámicas sociales, en particular en lo que se refiere a la fisura producida por estos instrumentos en la construcción del consenso, de las concepciones de lo 'común' de la idea de verdad, de la inclinación al debate y la crítica, etc.

Effectiveness of Concomitant Chemoradiotherapy with Gemcitabine in Locally Advanced Cervical Cancer Patients with Comorbidities.

PURPOSE: The standard treatment for locally advanced cervical cancer (LACC) is concomitant chemoradiotherapy with cisplatin (CDDP) followed by brachytherapy. The presence of comorbidities are risk factors for nephrotoxicity and are associated with lower survival. Gemcitabine is a radiosensitizing drug that has shown efficacy and safety in this context. The effectiveness of concomitant chemoradiotherapy with gemcitabine was evaluated versus cisplatin in LACC patients with comorbidities and preserved renal function. MATERIALS AND METHODS: An observational, longitudinal and paired study was carried out that included patients treated between February 2003 and December 2015. The primary objectives were to evaluate response rates, progression-free survival, and overall survival; the secondary objectives were to evaluate toxicity and renal function. RESULTS: Sixty-three patients treated with gemcitabine at 300 mg/m2 weekly and 126 patients treated with CDDP 40 mg/m2 weekly were included. There were no significant differences in response rates and survival rates. Treatment with cisplatin presented a higher frequency of hematological toxicities, while gemcitabine presented a higher frequency of gastrointestinal toxicities. A decrease in glomerular filtration rate (GFR; baseline vs. 1-year post-treatment) was observed in the cisplatin group (p=0.002), while not in the gemcitabine group (p=0.667). In a multivariate analysis, it is observed that only CDDP correlates with the decrease in GFR (hazard ratio, 2.42; p=0.012). CONCLUSION: In LACC patients with comorbidities, gemcitabine and CDDP show the same efficacy, with different toxicity profiles. Treatment with cisplatin is associated with a significant decrease in GFR during follow-up, compared to treatment with gemcitabine that does not decrease it.

HPV oral and oropharynx infection dynamics in young population.

The incidence of human papillomavirus (HPV)-associated cancers, especially those from the head and neck region, has increased. The relatively early age of presentation of HPV-positive head and neck cancer (HNC) indicates that viral infection might be acquired early in life. Persistent HPV infection has been recognized as the main risk factor for cancer development, but most studies have focused on evaluating HPV persistence in the genital region. Thus, in this work, we aimed to evaluate the prevalence of HPV in oral cavity and oropharynx in a young population, as well as the possible persistence of the infection after 12 months. Our results indicate that almost half (46.8%) of the analyzed population harbors an HPV infection either in the oral cavity or in the oropharynx. Furthermore, after 1 year of initial identification, half of them eliminated the infection, and only one person (5.26%) exhibited persistence. Interestingly, 50% of the individuals who successfully eliminated the infection acquired a new viral type, indicating that even when the primary infection is effectively eliminated by the immune system, there is a dynamic circulation of HR-HPV types that produce reinfection. This dynamic HPV infection among young individuals could influence the future establishment of cancer in some proportion of the cases.

Validation of the QLQ-CX24 questionnaire for the assessment of quality of life in Mexican women with cervical cancer.

OBJECTIVE: Cervical cancer is the fourth most frequent neoplasm among women in terms of incidence and mortality. Health-related quality of life (HRQL) is an important outcome in oncology. The QLQ-CX24 instrument was developed to measure HRQL in patients with cervical cancer, and its Mexican-Spanish version had not been validated. METHODS: Between March 2018 and May 2019, Mexican women older than 18, with any-stage cervical cancer were invited to participate in the study. Patients answered the QLQ-C30 and QLQ-CX24 questionnaires. Current tests for psychometric and clinical validation were performed. RESULTS: Three hundred and thirty patients with cervical cancer were included in this study. All women invited to participate accepted and were included. The QLQ-CX24 internal consistency test demonstrated adequate convergent (Spearman correlation coefficient 0.001-0.847) and divergent validity (Spearman correlation coefficient <0.0001-0.45). Cronbach's alpha coefficients of the three multi-item scales were >0.7 (minimum 0.76, maximum 0.89). Four scales of the QLQ-CX24 distinguished patients in different clinical stages. The evaluation of responsiveness demonstrated that the peripheral neuropathy scale was sensitive to change over time during chemo-radiation therapy. Six scales of the QLQ-CX24 instrument were associated with survival. CONCLUSION: The Mexican-Spanish version of the QLQ-CX24 questionnaire is reliable and valid for the assessment of HRQL in patients with cervical cancer.

Body composition and nutritional status according to clinical stage in patients with locally advanced cervical cancer.

The objective was to evaluate body composition and nutritional status in women with locally advanced cervical cancer (LACC) before receiving oncologic treatment. Women with cervical cancer diagnoses in clinical stage IB2 to IIIB were studied. Body composition was measured with bioimpedance, sarcopenia determined according to the European Consensus, and nutritional status according to the Patient-Generated Subjective Global Assessment. A total of 155 women with age 50.4 ± 13.7, 29 clinical stage I, 82 II, and 44 III, were studied. Patients in advanced clinical stage III, compared with patients in stage II and stage I, lower phase angle (III: 5.2 ± 0.98 vs. II: 5.7 ± 1.9 and I: 5.8 ± 0.69, p = 0.007). Impedance vector distribution was different in patients in clinical stage III vs. those in clinical stage II (p = 0.014) and I (p = 0.039). LACC patients in advanced stages had worse body composition and nutritional status before treatment.

IMMUNOLOGY OF CERVICAL CANCER.

Optimal function of the immune system allows the recognition and elimination of infected and tumor cells. However, these cells can develop mechanisms to evade the cellular immune response. In human papillomavirus (HPV) infection, dysregulation of major histocompatibility complex Class I molecules and other components of the innate immune system promote the survival of infected cells by allowing the infection to persist which, in turn, favors the development of cancer. Further, tumor cells possess inherent mechanisms designed to block the recognition and activation of cytotoxic lymphocytes: particularly, HPV proteins such as E1 and E2 and oncoproteins E5, E6, and E7 that inhibit immune mechanisms and/or stimulate the expression of immunosuppressive cytokines. These mechanisms include a decrease in receptor activation and costimulating molecules on the surface of immune cells, as well as the constitutive expression of molecules that inhibit their function, which allow HPV persistence and tumor progression. Immunotherapy-based therapeutic options are positioned as excellent candidates for the treatment of cervical cancer.

IMMUNOTHERAPY TREATMENT AGAINST CERVICAL CANCER.

Cervical cancer (CC) is one of the most common gynecological tumors and an important health problem, especially in developing countries. The vast majority of patients in early stages are cured of the disease with surgical treatment and with concomitant chemoradiotherapy in locally advanced stages. However, in patients with recurrent, persistent, or metastatic cervical CC, the effectiveness of treatment is limited, except for the combination of chemotherapy based on platinum doublets plus bevacizumab, the treatment that has achieved the best results to date. Programmed cell death-1/PD ligand-1 (PD-1/PD-L1) inhibitors could be a novel and cutting-edge therapeutic option to improve clinical outcomes in this group of patients. Thus far, there are a few Phase I/II clinical trials that have assessed the usefulness of pembrolizumab and nivolumab in this group of patients; these include the KEYNOTE 028, KEYNOTE 158, and CHECKMATE 358 trials, in which clinical benefit has been proven with PD-1/PD-L1 inhibitors in recurrent, persistent, or metastatic CC, as second-line treatment. There are also some ongoing trials that could provide further evidence on the PD-1/PD-L1 pathway as a therapeutic target in CC. In this review, we will focus on the usefulness of these PD-1/PDL1 inhibitors in CC, as well as on trials that are still in the recruitment phase, to confirm their effectiveness in this clinical setting.

Immunology of cervical cancer

ABSTRACT Optimal function of the immune system allows the recognition and elimination of infected and tumor cells. However, these cells can develop mechanisms to evade the cellular immune response. In human papillomavirus (HPV) infection, dysregulation of major histocompatibility complex Class I molecules and other components of the innate immune system promote the survival of infected cells by allowing the infection to persist which, in turn, favors the development of cancer. Further, tumor cells possess inherent mechanisms designed to block the recognition and activation of cytotoxic lymphocytes: particularly, HPV proteins such as E1 and E2 and oncoproteins E5, E6, and E7 that inhibit immune mechanisms and/or stimulate the expression of immunosuppressive cytokines. These mechanisms include a decrease in receptor activation and costimulating molecules on the surface of immune cells, as well as the constitutive expression of molecules that inhibit their function, which allow HPV persistence and tumor progression. Immunotherapy-based therapeutic options are positioned as excellent candidates for the treatment of cervical cancer.

Immunotherapy treatment against cervical cancer

ABSTRACT Cervical cancer (CC) is one of the most common gynecological tumors and an important health problem, especially in developing countries. The vast majority of patients in early stages are cured of the disease with surgical treatment and with concomitant chemoradiotherapy in locally advanced stages. However, in patients with recurrent, persistent, or metastatic cervical CC, the effectiveness of treatment is limited, except for the combination of chemotherapy based on platinum doublets plus bevacizumab, the treatment that has achieved the best results to date. Programmed cell death-1/PD ligand-1 (PD-1/PD-L1) inhibitors could be a novel and cutting-edge therapeutic option to improve clinical outcomes in this group of patients. Thus far, there are a few Phase I/II clinical trials that have assessed the usefulness of pembrolizumab and nivolumab in this group of patients; these include the KEYNOTE 028, KEYNOTE 158, and CHECKMATE 358 trials, in which clinical benefit has been proven with PD-1/PD-L1 inhibitors in recurrent, persistent, or metastatic CC, as second-line treatment. There are also some ongoing trials that could provide further evidence on the PD-1/PD-L1 pathway as a therapeutic target in CC. In this review, we will focus on the usefulness of these PD-1/PDL1 inhibitors in CC, as well as on trials that are still in the recruitment phase, to confirm their effectiveness in this clinical setting.

Habilidades informacionales: un requisito de alta demanda en la formación doctoral / Information skills: a crucial requirement in doctoral training

El imponente uso de las tecnologías de la información y la comunicación en el entorno investigativo trae consigo un constante crecimiento y divulgación de la información, lo que demanda la necesidad del dominio de las habilidades para el acceso y el uso adecuado de este recurso. El objetivo de este artículo fue identificar las habilidades informacionales que los doctorandos necesitan desarrollar, basándose en el uso de la información científica para la solución de las tareas de investigación en el proceso de formación doctoral. Para el desarrollo de este trabajo se realizó la revisión bibliográfica, el análisis de la información y del modelado, y se utilizó el software EndNote y Bizagi para el análisis y la discusión de los resultados. El trabajo de investigación se centró en las particularidades del sistema de Educación Superior en Cuba, específicamente en la educación doctoral de posgrado. Se examinaron las etapas de la formación doctoral, con mayor énfasis en las actividades relacionadas con el uso de la información científica. Finalmente se describen las habilidades informacionales que los doctorandos deben dominar para el uso de la información científica, teniendo en cuenta la proyección internacional de la comunidad científica que trabaja la alfabetización informacional(AU)

The impressive use of information and communications technologies in the field of research has resulted in permanent growth and dissemination of information, leading to the need to master the skills involved in the access and adequate use of this resource. The purpose of the study was to identify the information skills that aspiring PhDs need to develop in terms of the use of scientific information to solve research tasks throughout the process of doctoral training. The study was based on a bibliographic review as well as analysis and modeling of the information. EndNote and Bizagi software was used for the analysis and discussion of results. The research focused on the specific features of the Higher Education System in Cuba, particularly as concerns graduate doctoral education. Examination was performed of the doctoral training stages, with greater emphasis on activities related to the use of scientific information. A description is provided of the information skills that aspiring PhDs should master to use scientific information, bearing in mind the international projection of the scientific community involved in information literacy(AU)

Food Intervention with Folate Reduces TNF-α and Interleukin Levels in Overweight and Obese Women with the MTHFR C677T Polymorphism: A Randomized Trial.

Methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism associated with body fat accumulation could possibly trigger an inflammatory process by elevating homocysteine levels and increasing cytokine production, causing several diseases. This study aimed to evaluate the effects of food intervention, and not folate supplements, on the levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-1ß (IL-1ß) in overweight and obese women with the MTHFR C677T polymorphism. A randomized, double-blind eight-week clinical trial of 48 overweight and obese women was conducted. Participants were randomly assigned into two groups. They received 300 g of vegetables daily for eight weeks containing different doses of folate: 95 µg/day for Group 1 and 191 µg/day for Group 2. MTHFR C677T polymorphism genotyping was assessed by digestion with HinfI enzyme and on 12% polyacrylamide gels. Anthropometric measurements, 24-h dietary recall, and biochemical analysis (blood folic acid, vitamin B12, homocysteine (Hcy), TNF-α, IL-1ß, and IL-6) were determined at the beginning and end of the study. Group 2 had a significant increase in folate intake (p < 0.001) and plasma folic acid (p < 0.05) for individuals with the cytosine-cytosine (CC), cytosine-thymine (CT), and thymine-thymine (TT) genotypes. However, only individuals with the TT genotype presented reduced levels of Hcy, TNF-α, IL-6, and IL-1ß (p < 0.001). Group 1 showed significant differences in folate consumption (p < 0.001) and folic acid levels (p < 0.05) for individuals with the CT and TT genotypes. Food intervention with folate from vegetables increased folic acid levels and reduced interleukins, TNF-α, and Hcy levels, mainly for individuals with the TT genotype.

Variations in concerns reported on the patient concerns inventory in patients with head and neck cancer from different health settings across the world.

BACKGROUND: The aim was to collate and contrast patient concerns from a range of different head and neck cancer follow-up clinics around the world. Also, we sought to explore the relationship, if any, between responses to the patient concerns inventory (PCI) and overall quality of life (QOL). METHODS: Nineteen units participated with intention of including 100 patients per site as close to a consecutive series as possible in order to minimize selection bias. RESULTS: There were 2136 patients with a median total number of PCI items selected of 5 (2-10). "Fear of the cancer returning" (39%) and "dry mouth" (37%) were most common. Twenty-five percent (524) reported less than good QOL. CONCLUSION: There was considerable variation between units in the number of items selected and in overall QOL, even after allowing for case-mix variables. There was a strong progressive association between the number of PCI items and QOL.

A saúde bucal no contexto da prevenção de absenteísmo e presenteísmo no trabalho / Oral health in the context of prevention of absenteeism and presenteeism in the workplace

A saúde bucal é um importante fator de morbidade humana mundial, mas frequentemente negligenciada em saúde ocupacional, apesar do impacto direto na qualidade de vida e na saúde do trabalhador. O objetivo deste artigo foi discutir o papel da saúde bucal como fator de absenteísmo e presenteísmo e nos processos de desenvolvimento e eficiência laboral por parte de governos, empresas e pelos próprios trabalhadores. Realizou-se revisão da literatura com artigos na íntegra, em inglês ou português, dos últimos 10 anos, nas bases científicas relacionando-se os temas saúde bucal, saúde ocupacional, absenteísmo e presenteísmo. Doenças bucais variaram como causas de absenteísmo entre 9 e 27%, mas de 28 a 50% como de presenteísmo. Dores dentárias e de ATM são as causas mais comuns. Entre 9 e 56% dos trabalhadores buscaram tratamentos em rede pública, e de 40 a 45%, em rede privada. Nas empresas que oferecem atendimento odontológico, 49% dos funcionários optaram pelo ambulatório da empresa, contra 40% da rede pública e 11% de outros tipos. A elevada prevalência de doenças bucais e de dor orofacial não é causa de elevados índices de absenteísmo, mas principalmente de presenteísmo. O trabalhador não se afasta, trabalha de forma deficitária e com propensão a maiores adoecimentos futuros. A saúde bucal tem importância não dissociada da saúde geral e ocupacional e, como tal, precisa ser incentivada e acompanhada de forma integrada. Políticas públicas e ações do setor privado efetivas e abrangentes na promoção e prevenção em saúde bucal no ambiente laboral podem ofertar melhor qualidade de vida aos trabalhadores.

Background: Oral health is an important factor of human morbidity worldwide. Yet is often neglected in occupational health despite its direct impact on the quality of life and health of workers. Objective: To discuss the role of oral health in sickness absence and presenteeism, as well as in development and work efficiency improvement processes involving governments, companies and the workers themselves. Methods: Review of full-text articles on oral health, occupational health, sickness absence and presenteeism published in English or Portuguese in the last 10 years and included in scientific databases. Results: Oral problems accounted for 9 to 27% cases of sickness absence and 28 to 50% of presenteeism, with toothache and temporomandibular joint pain as the most frequent reasons. About 50% of workers prefer company-provided dental care, while 40% visit public and 10% other types of facilities. Despite high, the prevalence of oral diseases and orofacial pain was not associated with high rates of absenteeism, but mainly with presenteeism, this is to say, workers do not tend to miss work days, but their performance is reduced and become susceptible to more serious health problems in the future. Conclusion: Oral health is not dissociated from general and occupational health, and as such it must be enhanced and duly promoted in an integrated manner. Effective and comprehensive oral health promotion and prevention public policies and private sector actions in the workplace can enhance the quality of life of workers.

Presence of Papillomavirus DNA sequences in the canine transmissible venereal tumor (CTVT).

BACKGROUND: The canine transmissible venereal tumor (CTVT) or Sticker's sarcoma is a neoplastic disease affecting dogs. This disease is presented as a tumoral mass in the genital organs of both, male and female individuals. Up to date, there is no clear evidence indicating a viral agent as the causative mediator for CTVT development. PURPOSE: The present work aims to analyze 21 samples from canines with CTVT for molecular identification of Papillomavirus DNA sequences. In addition, microbiological analysis, cytologic and histopathologic evaluations were also performed. RESULTS: All patients showed no biochemical and microbiological alterations. Molecular analysis demonstrated the viral DNA presence in the samples using different primer sets. The MY primers amplified a 450 bp band in seven out of 21 samples (33%). The PVF and Fap64 primer set, targeting the L1 sequence of Canine Papillomavirus (CPV), showed positivity in 16 out of 21 samples (76%). CONCLUSION: These results support the possible causative association between CPV and CTVT; nevertheless, additional studies are required to uphold such statement. This work presents evidence indicating that a viral agent might be involved in the pathogenesis of CTVT and set the bases for a better understanding of the CTVT pathobiology.

Relato da experiência da realização de pequenos procedimentos em dermatologia em Hospital Universitário / Report of the experience of small procedures in dermatology at University Hospital

Modelo do estudo: Cohort. Objetivos: Relatar a experiência do setor de Pequenos Procedimentos em Dermatologia do Hospital Universitário Gaffrée e Guinle, determinando os diagnósticos, tipos de tratamentos e resolutividade. Metodologia: Trata-se de estudo prospectivo, observacional, por meio da coleta de dados dos pacientes do Programa de Saúde da Família da Secretaria Municipal de Saúde do Rio de Janeiro encaminhados para a realização de pequenos procedimentos em dermatologia, durante um período de 31 semanas. Resultados: Foram atendidos 884 pacientes. As lesões benignas representaram 77,5% dos diagnósticos clínicos e as malignas 22,5%. Os diagnósticos mais frequentes foram de cisto (133) e carcinoma basocelular (128). Os procedimentos mais realizados foram a excisão e sutura simples (337) e a retirada de lesão por shaving mais eletrocoagulação (161). No total, 98,3% dos procedimentos foram de cirurgia dermatológica básica e 1,7% dos casos necessitaram de procedimentos avançados. Além disso, 90,8% dos pacientes foram operados no dia do primeiro atendimento e 3,7% precisaram ser encaminhados para outras especialidades cirúrgicas. Conclusão: Um serviço de cirurgia dermatológica estruturado para a realização de pequenos procedimentos, em caráter ambulatorial, permite prover atendimento resolutivo à grande maioria dos pacientes com essa necessidade. (AU)

Study design: Cohort study. Objectives: To report the experience of the Small Procedures Division, Dermatology Department, at Gaffrée and Guinle University Hospital, including a description of diagnoses, types of treatment, and efficacy. Methods: This is a prospective, observational study that consisted of data compilation of patients referred from the primary Family Health Program, Local Health Department, to an University Hospital for the performance of small dermatological procedures, encompassing a period of 31 weeks. Results: Overall, 884 patients underwent procedures. Benign lesions comprised 77.5% of the clinical diagnoses, while malignant lesions constituted 22.5%. The most frequent diagnoses were cyst (133) and basal cell carcinoma (128). The most commonly performed procedures were simple excision and suture (337) and lesion removal through shaving plus electrocoagulation (161). 98.3% of the procedures consisted of basic dermatological surgeries and 1.7% of the cases required advanced procedures. In addition, 90.8% of the patients were operated on the first day of care, on the other hand 3.7% were referred to other surgical specialties. Conclusion: A Dermatologic Surgery Department structured to perform small outpatient procedures provides efficacious care to the vast majority of referred patients (AU)

Assessment of quality of life in patients with advanced oral cancer who underwent mandibulectomy with or without bone reconstruction

INTRODUCTION Malignant neoplasms of the head and neck, due to its anatomical location, can cause significant alterations in vital functions related to feeding, communication and social interaction of the affected patients. Objective To analyze the quality of life of patients with advanced malignant neoplasms of the oral cavity and submitted to radical operations with curative intent. Material and methods 47 patients with oral cavity squamous cell carcinoma (SCC), in stages III and IV, underwent surgical treatment with segmental mandibulectomy and complementary radiotherapy. The patients were submitted to the quality of life questionnaires after a minimum time of six months after the surgical treatment. Results Of the 183 patients, only 47 (25.7%) were able to answer the questionnaire and were included as the sample of the study. The majority of patients selected were male (39; 82.9%). The mean age was 64.4 years. The majority of the patients presented clinical stage IV (83%) and were submitted to adjuvant radiotherapy (95.4%). The mean score obtained after the questionnaires were applied was 64.6. The worst scores were found in swallowing and chewing. Conclusion There were no statistically significant differences in the domains of quality of life between the two groups studied (with bone reconstruction versus no bone reconstruction). Patients interviewed 2 years or more after treatment presented higher scores (p = 0.02).

RESUMO INTRODUÇÃO As neoplasias malignas de cabeça e pescoço, pela própria localização anatômica, podem acarretar alterações significativas em funções vitais relacionadas à alimentação, comunicação e interação social dos indivíduos afetados. OBJETIVO Analisar a qualidade de vida dos pacientes com neoplasias malignas avançadas de cavidade oral, submetidos a operações radicais com intenção curativa. MATERIAL E MÉTODOS 47 pacientes portadores de carcinoma espinocelular de cavidade oral, em estádios III e IV, foram submetidos ao tratamento cirúrgico com mandibulectomia segmentar e radioterapia complementar. Os pacientes foram submetidos ao teste de qualidade de vida após o tempo mínimo de seis meses do tratamento cirúrgico. RESULTADOS Dos 183 pacientes, com apenas 47 (25,7%) foi possível a realização da entrevista, compondo estes a amostra para o estudo. A maioria dos pacientes do grupo selecionado era do sexo masculino, total de 39 homens (82,9%). A idade média foi de 64,4 anos. A maioria dos pacientes apresentava estadiamento clínico IV (83%), sendo submetidos à radioterapia adjuvante (95,4%). A média do escore obtido após a avaliação dos questionários foi de 64,6. Os piores escores foram encontrados nos quesitos deglutição e mastigação. CONCLUSÃO Não houve diferenças estatisticamente significativas nos domínios de qualidade de vida entre os dois grupos estudados (com reconstrução óssea versus sem reconstrução óssea). Pacientes entrevistados dois anos ou mais após o tratamento apresentaram escores superiores (p=0,02).

Epidemiological Profile, Gastrointestinal Toxicity, and Treatment of Pelvic Cancers in Patients Managed with Radiotherapy to the Abdominal Pelvic Area.

Mexico has seen an increase in cancer prevalence in its entire population as well as particular age ranges, predominantly the older segment. The most frequently reported pelvic cancers in Mexico are cervical, endometrial, bladder, prostate, rectum, and anal canal. Approximately 80% of the population diagnosed with pelvic cancers present with locally advanced tumors and require concomitant chemoradiotherapy, sequential chemoradiotherapy, or radiotherapy alone. The toxicity of any of these treatment modalities may be manifested as intestinal injury, a significant problem that can compromise the response to treatment, the patient's nutritional state, quality of life, and survival. In this article, we will approach key aspects in nutrition as well as the epidemiological characteristics and toxicities in patients affected by these pelvic tumors.