Outcomes of a Community of Practice on Quebec Speech Language Pathologists' Voice Assessment Practices and Professional Identity

In a context where different protocols for recommended practices in clinical voice assessment exist, while there are gaps in the literature regarding the evidence base supporting assessment procedures and measures, clinicians from regions where a strong community holding expertise in clinical and scientific voice practices lack can struggle to confidently develop their voice assessment practices. In an effort to improve voice assessment practices and strengthen professional identity among speech-language pathologists in Quebec, Canada, a community of practice (CoP) was established, with the aim of promoting knowledge sharing, implementing change in clinical practice, and improving professional identity. Thirty-nine participants took part in the CoP activities conducted over a four-month period, including virtual meetings and in-person workshops. Participants had a high rate of attendance (> 74% participation rate in virtual meetings), and were highly satisfied with their participation and intended to remain involved after the project's end. Statistically significant changes in voice assessment practices were observed post-CoP, regarding probability of performing assessments (p < .001), and perceived importance of assessment for evaluative purposes (p <.001), as well as improvements in assessment specific confidence, specifically for procedure of auditory-perceptual assessment (p < .001) and purpose of aerodynamic assessment (p = .05). Moreover, there was an increase in professional identity post-CoP (p < .001) and participants felt they made significant learnings. The present study highlighted the need to involve SLPs in future research to identify assessments that are relevant to the specific evaluative objectives of SLPs working with voice, and suggests CoPs are an efficient tool for that purpose.

En un contexto en el que existen diferentes protocolos para las prácticas recomendadas en la evaluación vocal clínica, y en el que se presentan vacíos en la literatura respecto a la base de evidencia que respalda los procedimientos y medidas de evaluación, los profesionales de regiones donde no hay una comunidad sólida con experiencia en prácticas vocales clínicas y científicas pueden enfrentar dificultades para desarrollar con confianza sus prácticas de evaluación vocal. Con el propósito de mejorar las prácticas de evaluación vocal y fortalecer la identidad profesional entre los logopedas de Quebec, Canadá, se estableció una comunidad de práctica (CdP). Esta tenía como objetivo fomentar el intercambio de conocimientos, implementar cambios en la práctica clínica y mejorar la identidad profesional. Un total de treinta y nueve participantes se involucraron en las actividades de la CdP, llevadas a cabo durante un período de cuatro meses, que incluyeron reuniones virtuales y talleres presenciales. Los participantes tuvieron una alta tasa de asistencia (> 74% de participación en las reuniones virtuales) y expresaron un alto grado de satisfacción con su participación, manifestando su intención de continuar involucrados después de la finalización del proyecto. Se observaron cambios estadísticamente significativos en las prácticas de evaluación vocal posterior a la CdP, en lo que respecta a la probabilidad de llevar a cabo evaluaciones (p < .001) y la percepción de la importancia de la evaluación con fines evaluativos (p < .001), así como mejoras en la confianza específica en la evaluación, particularmente en el procedimiento de evaluación auditivo-perceptual (p < .001) y el propósito de la evaluación aerodinámica (p = .05). Además, se registró un aumento en la identidad profesional posterior a la CdP (p < .001) y los participantes sintieron que obtuvieron aprendizajes significativos. El presente estudio destacó la necesidad de involucrar a los logopedas en investigaciones futuras, para identificar evaluaciones pertinentes a los objetivos evaluativos específicos de los logopedas que trabajan con la voz, y sugiere que las CdP son una herramienta eficiente con ese propósito.

Biópsia excisional de lipoma em fundo de vestíbulo mandibular: um relato de caso / Excisional biopsy of lipoma in the buccal mandibular vestibule: a case report

Introdução: os lipomas são as neoplasias benignas de origem mesenquimal mais comum, podendo acometer diversas partes do corpo, sendo a região maxilofacial, de fato, uma das menos frequentes. Clinicamente, manifestam-se como aumentos de volume de crescimento lento e circunscrito, de base séssil ou pediculada, superfície lisa e consistência macia e coloração amarelada. Os sítios intra-orais mais acometidos são a mucosa jugal e o vestíbulo bucal.Dentre suas variantes microscópicas mais comuns, estão o fibrolipoma, composto de um componente fibroso. No entanto, tais variações não afetam o prognóstico do seu tratamento, que deve ser realizado através da excisão conservadora da lesão. OBJETIVO: O presente trabalho tem como objetivo relatar um caso atípico de lipoma intra-oral. DESCRIÇÃO DO CASO: Paciente do sexo feminino, 67 anos, apresentou-se com aumento de volume em região de fundo de vestíbulo mandibular com evolução de, aproximadamente, 10 meses, indolor, com queixas de dificuldade no posicionamento da prótese dentária inferior. O diagnóstico inicial foi de lipoma, confirmado por análise anatomopatológica através de biópsia excisional da peça. Considerações finais: O tratamento de lipomas intra-orais preconizado pela literatura é a excisão local, obtida por meio da biópsia excisional, sendo uma solução eficaz e de baixa morbidade ao paciente(AU)

Introduction: lipomas are the most common benign neoplasms of mesenchymal origin, which can affect different parts of the body, with the maxillofacial region, in fact, one of the least frequent. Clinically, they manifest as slow-growing, circumscribed swellings, with a sessile or pedunculated base, smooth surface, soft consistency and yellowish color. The most affected intraoral sites are the buccal mucosa and the buccal vestibule. Among its most common microscopic variants are the fibrolipoma, composed of a fibrous component. However, such variations do not affect the prognosis of its treatment, which must be carried out through conservative excision of the lesion. OBJECTIVE: This study aims to report an atypical case of intraoral lipoma. CASE DESCRIPTION: A 67-yearold female patient presented with swelling in the bottom region of the mandibular vestibule with an evolution of approximately 10 months, painless, with complaints of difficulty in positioning the lower dental prosthesis. The initial diagnosis was lipoma, confirmed by anatomopathological analysis through excisional biopsy of the specimen. Final considerations: The treatment of intraoral lipomas recommended by the literature is local excision, obtained through excisional biopsy, being an effective solution with low morbidity for the patient(AU)

Displasia dentinaria tipo I: Manejo clínico y estudio histológico a propósito de dos casos

La displasia dentinaria tipo I (DD-I) corresponde a una alteración dentinaria de heterogeneidad genética y penetrancia completa, en donde se presenta un defecto en el desarrollo de las raíces de los dientes tanto temporales como definitivos. Clínicamente se observan dientes con extrema movilidad junto con antecedentes de exfoliación prematura o espontánea. Los defectos estructurales de los tejidos dentarios, tales como DD-I; implican un desafío ya que son pocos los casos documentados en la literatura que hablan de esta condición. Además implican un tratamiento multidisciplinario y altamente invasivo. El objetivo de este artículo es presentar dos casos de DD-I, enfatizando en su tratamiento y características histopatológicas.

Dentin Dysplasia Type I (DD-I) consists of a pathological dentinary alteration with genetic heterogeneity that results in a defectuous development of dental roots both in primary and secondary dentition. Clinically we can appreciate teeth with extreme pathological mobility and premature or spontaneous exfoliation. Alterations within normal dental structure, such as DD-I imply a challenge for the common practitioner, because of the scarce number of case reports with in the scientific literature regarding this condition and also, because of the need for a highly invasive and multidisciplinary approach they require. The aim of this article is to present two DD-I cases, emphasizing on their treatment and histopathological features.

Congruencia Diagnóstica Clínica-Histopatológica de Lesiones en Cavidad Oral, en la Faculta de Odontología, Universidad de Costa Rica, en el Período 2016-2019

El conocimiento de la patología oral, y su correcto diagnóstico es fundamental en Odontología, puesto que un diagnóstico tardío, particularmente en casos de lesiones premalignas o malignas, pueden conducir a serias consecuencias para el paciente. El objetivo de este trabajo fue establecer la congruencia diagnóstica clínica - histopatológica de lesiones en cavidad oral en pacientes que asistieron a la Facultad de Odontología, Universidad de Costa Rica, y a quienes se les realizó biopsia de la lesión, durante el período 2016-2019. El estudio fue descriptivo y retrospectivo, basado en datos de reportes histopatológicos en la población mencionada, por presentar alguna lesión, de tejidos blandos o duros, en cavidad oral. La muestra estadística fue por conveniencia, no probabilística y no aleatoria. Las técnicas estadísticas utilizadas fueron descriptivas para el análisis de la información, el cual se basó en la distribución de frecuencias y cruce de variables. El procesamiento estadístico de los datos se diseñó en una base de datos creada en Excel. La muestra comprendió 160 reportes histopatológicos de los cuales se excluyeron 14. La edad promedio de los pacientes fue 42 años (rango 2 - 78 años). La proporción hombre: mujer correspondió 1:1.4, predominado el sexo femenino en 58,9 %. La congruencia del diagnóstico histopatológico con el diagnóstico clínico correspondió a 55,8 %. La congruencia de los diagnósticos demuestra el conocimiento del profesional en identificar la lesión clínicamente de forma correcta, lo que permite actuar en el momento preciso y confirmar la impresión clínica diagnóstica de una patología mediante el estudio histopatológico, el cual es el estándar oro. El problema radica en aquellos casos en que hay discrepancia diagnóstica, pues exige conocer los factores responsables de esta discrepancia, exige la búsqueda de soluciones y exige reforzar y redireccionar la formación académica del profesional y de los estudiantes para reconocer y describir estas lesiones.

Knowledge of oral pathology and its correct diagnosis is fundamental in Dentistry, since a late diagnosis, particularly in cases of premalignant or malignant lesions, can lead to serious consequences for the patient. The objective of this study was to establish the clinical- histopathological diagnostic consistency of lesions in the oral cavity in patients who attended the Faculty of Dentistry, Universidad de Costa Rica, and who underwent a biopsy of the lesion, during the period 2016-2019. The study was descriptive and retrospective, based on data from histopathological reports in the mentioned population, due to presenting some lesion, soft or hard tissue, in the oral cavity. The statistical sample was for convenience, non- probabilistic nor random. The statistical techniques used were descriptive for the analysis of the information, which was based on frequency distribution and crossing of variables. The statistical processing of the data was designed in a database created in Excel. The sample collects 160 histopathological reports, of which 14 were excluded. The average age of the patients was 42 years (range between 2 - 78 years old).The male:female ratio corresponded to 1:1.4, with a predominance of the female sex at 58.9 %.The congruence of the histopathological diagnosis with the clinical diagnosis corresponded to 55.8 %. Diagnostic consistency demonstrates knowledge of the professional in correctly identifying the lesion clinically, which allows acting at the precise moment and confirming the diagnostic clinical impression of the pathology via histopathological study which is the gold standard. The problem lies in those cases in which there is a diagnostic discrepancy, since it requires having knowledge of the underlying factors and therefore, requires searching for solutions, reinforcing and redirecting the academic training of professionals and students to recognize and describe these lesions.

Prevalencia de lesiones en mucosa bucal y su relación con condición sistémica, edad y sexo / Prevalence of lesions in the oral mucosa and its relationship with systemic condition, age and gender

Este estudio tiene la finalidad de analizar la prevalencia de variantes de la normalidad y patología en la mucosa de la cavidad bucal por zona anatómica, de una población controlada en una clínica estomatológica universitaria de pregrado en el Estado de México. Se trata de un estudio transversal, descriptivo y observacional de 542 pacientes, de los cuales el 62.7% (340) pertenecen al sexo femenino y 37.3% (202) al masculino; la edad se distribuyó en un rango de dos a 85 años con una media de 28 años y fue categorizada en cinco grupos etarios: 2 a 12, 13 a 18, 19 a 35, 36 a 69 y > 70 años. En este estudio participaron una especialista en patología bucal, un especialista en odontopediatría y una pasante de la licenciatura de estomatología quien fungió como ayudante de investigación. Fueron identificadas 13 variantes de la normalidad y 52 lesiones en total, mismas que son reportadas por zona anatómica, por rangos de edad y por sexo. El número de condiciones y lesiones diagnosticadas por paciente varió de una a cinco en 87.27% y en el restante 12.73% no se detectó ninguna. Las variantes de la normalidad o condiciones más frecuentes fueron lengua fisurada con 12.17%, apéndice mucoso en frenillo vestibular con 11.25% y gránulos de Fordyce con 10.88%. Las lesiones más prevalentes por zona anatómica fueron: nevo intradérmico con 2.39% en labio externo superior e inferior; queilitis simple con 11.43% en la interfase de piel y mucosa de los labios (borde bermellón); úlcera traumática con 3.87% en mucosa labial; absceso de origen dental con 1.42 en encía; frenillo con inserción baja 1.84% en frenillos; úlcera traumática con 5.53% en mucosa bucal; candidiasis atrófica crónica con 5.53% en paladar; amígdalas hipertróficas con 8.11% en zona amigdalina; lengua pilosa con 1.66% en lengua; úlcera traumática con 3.69% en piso de boca; granuloma piógeno con 0.18% en proceso alveolar; y por último, hipertrofia de glándulas salivales labiales con 0.55% asociadas a presencia de aparatología ortodóntica. Finalmente se llevó a cabo una prueba de χ2 de Pearson para establecer correlación entre variables dependientes e independientes, encontrando significancia estadística de p < 0.000 entre lesiones de lengua y condición sistémica y edad en relación a lesiones de lengua, paladar y labios con p < 0.000 (AU)

The purpose of this study is to analyze the prevalence of variants of normality and pathology in the mucosa of the oral cavity by anatomical area in a controlled population in a university undergraduate stomatological clinic in the state of Mexico. This is a cross-sectional, descriptive and observational study of 542 patients, of which 62.7% (340) belonged to the female gender and 37.3% (202) to the male gender, the age was distributed in a range of two to 85 years with a mean of 28 years and was categorized in five age groups: 2 to 12, 13 to 18, 19 to 35, 36 to 69 and > 70 years. A specialist in oral pathology, a specialist in pediatric dentistry and an intern in stomatology who served as a research assistant participated in this study. Thirteen variants of normality and 52 lesions in total were identified and reported by anatomical area, age range and gender. The number of conditions and lesions diagnosed per patient ranged from one to five in 87.27% and none were detected in 12.73% of the population studied. The most frequent variants of normality or conditions were fissured tongue with 12.17%, mucous appendage in the vestibular frenulum with 11.25% and Fordyce granules with 10.88%. The most prevalent lesions by anatomical area were: intradermal nevus with 2.39% in upper and lower external lip; simple cheilitis with 11.43% in the interphase interface of skin and mucosa of the lips (vermilion border); traumatic ulcer with 3.87% in labial mucosa; abscess of dental origin with 1.42 in gingiva; frenulum with low insertion 1.84% in frenulum; traumatic ulcer with 5. 53% in buccal mucosa; chronic atrophic candidiasis with 5.53% in palate; hypertrophic tonsils with 8.11% in tonsillar area; hairy tongue with 1.66% in tongue; traumatic ulcer with 3.69% in floor of mouth; pyogenic granuloma with 0.18% in alveolar process and finally; hypertrophy of labial salivary glands with 0.55% associated with the presence of orthodontic appliances. Finally, a Pearson's χ2 test was carried out to establish correlation between dependent and independent variables, finding statistical significance of p < 0.000 between tongue lesions and systemic condition and age in relation to tongue, palate and lip lesions with a p < 0.000 (AU)

Mucositis oral como efecto adverso al uso del metotrexato en el tratamiento de la artritis reumatoide: una revisión sistematizada de casos / Oral mucositis as an adverse effect of the use of methotrexate in the treatment of rheumatoid arthritis: a systematized review of cases

Introducción: el metotrexato se usa ampliamente para el tratamiento de una variedad de enfermedades neoplásicas y autoinmunes. Sin embargo, como todo fármaco, su eficacia viene marcada por cierto grado de toxicidad debido a la farmacocinética del medicamento. El metotrexato se creó como un fármaco anticancerígeno; sin embargo, se ha convertido en el tratamiento de elección contra la artritis reumatoide. Principalmente, el metotrexato causa inflamación de las mucosas epiteliales. La mayoría de los efectos secundarios del metotrexato se pueden detectar de forma temprana y son reversibles. La mucositis del tracto alimentario es el principal efecto secundario de la quimioterapia contra el cáncer. Se le conoce colectivamente como lesión de la mucosa inducida por quimioterapia, afecta todo el canal alimentario desde la boca hasta el ano, ocasionando la mucositis oral y la mucositis intestinal. Material y métodos: se buscaron casos clínicos en los que se reporte mucositis causada por metotrexato en tratamiento de artritis reumatoide. Se empleó un diagrama de flujo, PRISMA modificado para la búsqueda de artículos. Finalmente, se cotejó que los casos clínicos cumplieran con los fundamentos de la CARE guide, para manejar una correcta estructura y bajo riesgo a sesgo. Conclusiones: una correcta anamnesis y exploración clínica oral es lo más importante de la medicina oral. Es relevante indagar sobre las enfermedades que presentan los pacientes, así como la historia de medicamentos que se administren, especialmente en pacientes mayores, con mayores padecimientos de enfermedades sistémicas (AU)

Introduction: methotrexate is widely used for the treatment of a variety of neoplastic and autoimmune diseases. However, like all drugs its efficacy is marked by a certain degree of toxicity due to the pharmacokinetics of the drug. Methotrexate was developed as an anticancer drug, however, it has become the treatment of choice for rheumatoid arthritis. Methotrexate primarily causes inflammation of the epithelial mucous membranes. Most of the side effects of methotrexate can be detected early and are reversible. Mucositis of the alimentary tract is the main side effect of cancer chemotherapy. It is collectively known as chemotherapy-induced mucosal injury, affecting the entire alimentary canal from the mouth to the anus, where oral mucositis and intestinal mucositis are both common. Material and methods: we searched for clinical cases reporting mucositis caused by methotrexate in the treatment of rheumatoid arthritis, using a modified PRISMA flowchart to search for articles. Finally, the clinical cases were checked for compliance with the fundamentals of the CARE guide, in order to manage a correct approach to oral medicine. It is important to inquire about the diseases the patients present, as well as the history of medications administered, especially in older patients, with more systemic disease conditions, structure, and low risk of bias. Conclusion: a correct anamnesis and oral clinical examination is the most important aspect of oral medicine. It is important to inquire about the diseases that the patients present, as well as the history of medications that are administered, especially in older patients with major systemic diseases (AU)

Caracterización histológica del melanoma cutáneo en reportes de patología en la ciudad de Cali, 2016-2021 / Histological characterization of cutaneous melanoma in pathology reports in the city of Cali, 2016-2021

Introducción. El melanoma es la proliferación maligna de melanocitos asociado a un comportamiento agresivo. El objetivo de este estudio fue determinar las variables histológicas del melanoma cutáneo. Métodos. Estudio observacional retrospectivo, transversal descriptivo, realizado con reportes de patologías de pacientes con diagnóstico de melanoma cutáneo en un laboratorio de patología en Cali, Colombia, entre 2016-2021. Se incluyeron las variables edad, sexo, localización, subtipo, espesor de Breslow, ulceración, márgenes, mitosis, invasión linfovascular, neurotrofismo, regresión tumoral, nivel de Clark e infiltración tumoral por linfocitos. Resultados. Se obtuvieron 106 reportes y fueron excluidos 54 por duplicación. Se incluyeron 52 registros, la media de edad fue de 61 años, con una mayor frecuencia de mujeres (55,8 %). De los 33 casos donde se especificó el subtipo histológico, el más frecuente fue el de extensión superficial (66,6 %), seguido del acral lentiginoso (18,1 %) y nodular con (15,2 %). La localización más frecuente fue en extremidades (61,5 %). El espesor de Breslow más común fue IV (34,6 %) y el nivel de Clark más frecuente fue IV (34,6 %). La ulceración estuvo en el 40,4 %. El subtipo nodular fue el de presentación más agresiva, donde el 100 % presentaron espesor de Breslow IV. Conclusiones. El subtipo de melanoma más común en nuestra población fue el de extensión superficial; el segundo en frecuencia fue el subtipo acral lentiginoso, que se localizó siempre en extremidades. Más del 50 % de los melanomas tenían espesor de Breslow mayor o igual a III, lo que impacta en el pronóstico.

Background. Melanoma is the malignant proliferation of melanocytes associated with aggressive behavior. The objective of this study was to determine the histological variables of cutaneous melanoma. Methods. Observational, cross-sectional, descriptive, retrospective study carried out with reports of pathologies with a diagnosis of cutaneous melanoma in a pathology laboratory in Cali between 2016-2021. The variables were age, sex, location, subtype, Breslow thickness, ulceration, margins, mitosis, lymphovascular invasion, neurotropism, tumoral regression, Clark level and tumor infiltration by lymphocytes. Results. One hundred and six reports were obtained and 54 were excluded due to duplication. A descriptive analysis was made on the 52 records that were included, the mean age was 61 years, with a higher frequency in women with 55.8%. Of the 33 cases where the histological subtype was specified, the most frequent was superficial extension with 66.6%, followed by acral lentiginous with 18.1% and nodular with 15.2%. The most frequent location was in the extremities (61.5%); the most common Breslow was IV (34.6%), and the most frequent Clark was IV (34.6%). Ulceration was in 40.4%. The nodular subtype was the most aggressive presentation where 100% presented Breslow IV. Conclusions. The most common subtype of melanoma was that of superficial extension. In our population, the second most frequent was the acral lentiginous subtype, which was always located on the extremities. More than 50% of the melanomas had Breslow greater than or equal to III, which affects the prognosis.

Teratoma mesentérico maduro en una mujer adulta: reporte de caso y revisión de la literatura / Mature mesenteric teratoma in an adult women: Case report and literature

Introducción. Los teratomas son neoplasias que surgen a partir de células germinales pluripotenciales y derivan de dos o más capas de células. Se clasifican en tumores maduros, que contienen tejidos bien diferenciados, o inmaduros, que contienen estructuras inmaduras y embrionarias. Su localización más frecuente son las gónadas; la ubicación mesentérica es infrecuente y se han descrito aproximadamente 40 casos en la literatura mundial. Dentro del abordaje diagnóstico y terapéutico, se emplea la tomografía computarizada y la resonancia magnética nuclear para caracterizar la lesión, evaluar la extensión intraabdominal y la relación con otras estructuras. El diagnóstico debe confirmarse mediante el examen histopatológico. Caso clínico. Paciente femenina de 56 años, con antecedente de carcinoma ductal infiltrante de mama izquierda en remisión, en estudios de seguimiento con hallazgo incidental en tomografía de abdomen de lesión abdominopélvica dependiente del mesenterio, contornos lisos y nivel grasa-líquido. Estudios de extensión con marcadores tumorales negativos. Resultados. Por la alta sospecha clínica e imagenológica de teratoma, fue llevada a resección quirúrgica de la lesión. El examen histopatológico confirmó el diagnóstico de teratoma quístico maduro del mesenterio. Conclusión. El teratoma mesentérico es una entidad clínica rara, que debe ser considerado como uno de los diagnósticos diferenciales de una masa abdominal con efecto compresivo. El diagnóstico se basa principalmente en el examen clínico y los hallazgos imagenológicos. La escisión quirúrgica temprana es el pilar del tratamiento; el abordaje laparoscópico o abierto depende de las características clínicas y la experiencia del cirujano.

Background. Teratomas are neoplasms that arise from pluripotent germ cells, derived from two or more layers of germ cells. They are classified as mature tumors (cystic or solid), which contain well-differentiated tissues, or as immature tumors, which contain immature and embryonic structures. Its most frequent location is the female and male gonads; the mesenteric location is rare and approximately 40 cases have been described in the world literature. Within the diagnostic and therapeutic approach, computed tomography and magnetic resonance imaging are used to characterize the lesion, assess intra-abdominal extension and the relationship with other structures. The diagnosis must be confirmed by histopathological examination. Clinical case. A 56-year-old female patient with a history of infiltrating ductal carcinoma of the left breast in remission. In follow-up studies, incidental abdominal tomography finding of an abdominopelvic lesion dependent on the mesentery at the level of the mesogastrium, smooth contours with fat-liquid level. Extension studies with negative tumor markers. Results. Due to high clinical and imaging suspicion of teratoma, the patient was taken to resection of the lesion. Histopathological examination confirmed the diagnosis of mature cystic teratoma of the mesentery. Conclusion. Mesenteric teratoma is a rare clinical entity and is considered one of the differential diagnoses of an abdominal mass with a compressive effect. Diagnosis is mainly based on clinical examination and imaging findings. Early surgical excision is the mainstay of treatment; laparoscopic or open approach depends on the clinical characteristics and the experience of the surgeon.

Longitudinal evaluation of RTVue optical coherence tomography in patients with glaucoma and suspected glaucoma and stable visual fields / Avaliação longitudinal da tomografia de coerência óptica RTVue em pacientes glaucomatosos e suspeitos de glaucoma com campos visuais estáveis

ABSTRACT Purpose: To longitudinally compare isolated structural parameters obtained using RTVue optical coherence tomography in patients with glaucoma and suspected glaucoma with stable visual fields. Methods: All patients were required to have a reliable SITA Standard 24-2 Humphrey Visual Field test. Visual field stability was defined as having <5 points with p<5% and/or having no points with p<1% and/or p<0.05% in the glaucoma progression analysis comparison graph. Furthermore, the glaucoma assessment strategy was used in optical coherence tomography. Results: The study included 75 eyes from 75 patients, 43 of which had glaucoma and 32 had suspected glaucoma. The mean visual field intervals were 29.57 ± 9.65 months between the first and third tests. No visual field parameter variations (mean deviation, pattern standard deviation, and visual field index) and no retinal nerve fiber layer or optic disk parameter variations between the first and third tests were observed (p>0.05 for all), and no retinal nerve fiber layer parameter variations throughout the study were observed, except for optic disk parameters presenting with cup volume changes (p=0.004). However, ganglion complex cells presented a progressively decreased average ganglion cell complex parameter, with a variability of -0.98% ± 3.71% (p=0.04) between the first and third tests. By contrast, the global loss volume progressively increased throughout the study, with a variability of 14.71% ± 44.52% (p=0.04) between the first and third tests. The inferior ganglion cell complex parameter was significantly decreased between the first and third tests (p=0.02). Conclusion: The present findings suggest that patients with glaucoma or suspected glaucoma with stable visual fields may present structural ganglion complex cell progression as assessed using RTVue optical coherence tomography.

RESUMO Objetivo: Comparar longitudinalmente os parâmetros estruturais isolados obtidos através da tomografia de coerência óptica RTVue em pacientes glaucomatosos e suspeitos de glaucoma com campos visuais estáveis. Métodos: Todos os incluídos deveriam ter Campimetria Computadorizada Humphrey Sita Standard 24-2 confiáveis. A estabilidade campimétrica foi definida se apresentassem menos de cinco pontos com p<5% e/ou nenhum ponto com p<1% e/ou p<0,05% no gráfico de comparação do Glaucoma Progression Analysis. Para a tomografia de coerência óptica, foi utilizado a estratégia de avaliação para glaucoma. Resultados: Foram incluídos 75 olhos de 75 pacientes: 43 com glaucoma e 32 suspeitos. A média dos intervalos do campo visual entre o 1o e 3o exame, foi de 29,57 ± 9,65 meses. Não houve variação para os parâmetros do campo visual (desvio médio, desvio padrão e índice da função visual) entre o primeiro e o último exame (p>0,05 para todos). Não houve variação dos parâmetros da camada de fibras nervosas da retina ao longo do estudo, enquanto que para os parâmetros do disco óptico, apenas cup volume apresentou mudança (p=0,004). Em relação à camada de células ganglionares da retina, notou-se uma redução progressiva na espessura média da Ganglionar Complex Cells com uma variabilidade entre o primeiro e último exame de -0,98 ± 3,71% (p=0,04). Quanto ao Global loss volume, houve um aumento progressivo ao longo do estudo com uma variabilidade entre o primeiro e último exame de 14,71 ± 44,52% (p=0,04). O parâmetro inferior do Ganglionar Complex Cells também reduziu significativamente entre o 1o e 3o exames (p=0,02). Os demais parâmetros da tomografia de coerência óptica RTVue se mantiveram estáveis entre o 1o e 3o exames. Conclusão: Os presentes achados sugerem que pacientes glaucomatosos ou com suspeita de glaucoma e com campos visuais estáveis, podem apresentar progressão estrutural na camada de células ganglionares da retina avaliada por meio da tomografia de coerência óptica RTVue.

Corneal ectasia following photorefractive keratectomy: a confocal microscopic case report and literature review / Ectasia corneana após ceratectomia fotorrefrativa: relato de caso de microscopia confocal e revisão da literatura

ABSTRACT The occurrence of corneal ectasia after photorefractive keratectomy is a rare but serious complication of refractive surgery. Possible risk factors are not well assessed, but a probable reason is the failure to detect keratoconus preoperatively. In this report, we describe a case of corneal ectasia after photorefractive keratectomy in a patient who presented a suspicious tomography pattern preoperatively but had no degenerative alterations associated with pathologic keratoconus, as revealed by in vivo corneal confocal microscopy. We also review eligible case reports of post-photorefractive keratectomy ectasia to find similar characteristics.

RESUMO A ocorrência de ectasia corneana após ceratectomia fotorrefrativa é uma complicação rara, porém grave, em cirurgia refrativa. Os possíveis fatores de risco não são bem avaliados, mas a opinião atual é que a falha na detecção de ceratocone pré-operatório possa ser o principal motivo. Neste relato, descrevemos um caso de ectasia corneana após ceratectomia fotorrefrativa em paciente apresentando padrão tomográfico suspeito no pré-operatório, mas sem alterações degenerativas associadas a ceratocone patológico, conforme revelado por microscopia confocal in vivo da córnea. Além disso, revisamos, na literatura, relatos de casos elegíveis de ectasia pós-ceratectomia fotorrefrativa para encontrar características semelhantes.

Treatment of orbital lymphatic malformation with oral sirolimus: a case report / Malformação linfática orbital tratada com sirolimo oral: relato de caso

ABSTRACT It is estimated that lymphatic malformations in children account for 6% of all benign vascular malformations. New medical therapies have been developed for the management of lymphatic orbital disease. The purpose of this article was to describe a clinical case of orbital venolymphatic malformation in a 10-year-old boy, causing proptosis and palpebral edema. The lesion was initially treated with local sclerotherapy. However, the lesion relapsed, and was successfully treated with oral sirolimus. Prospective studies are warranted to determine the appropriate dose and extend the indications of sirolimus in these patients.

RESUMO A incidência de malformações linfáticas em crianças é estimada em 6% de todas as malformações vasculares benignas. Têm sido desenvolvidos novos tratamento para doenças linfáticas orbitárias. Nosso objetivo é descrever um caso clínico de malformação venolinfática orbitária em um menino de 10 anos de idade, causando proptose e edema palpebral. A lesão foi tratada inicialmente com escleroterapia local. No entanto, a lesão teve recidiva e foi tratada com sucesso com sirolimo oral. Ainda são necessários estudos prospectivos para estabelecer a dose apropriada e a duração do tratamento com sirolimo nesses pacientes.

Inactivation of isolated fungi on Erythrina velutina Willd. seeds through atmospheric plasma / Inativação de fungos isolados em sementes de Erythrina velutina Willd. por meio do plasma atmosférico

Abstract This study aimed to evaluate the effect of atmospheric plasma application on the inactivation of fungi on the surface of Erythrina velutina seeds and on isolated fungal colonies. Two experiments were conducted using a completely randomized design. First, plasma was applied to the surface of the seeds using helium gas and atmospheric plasma for 3, 6, and 9 min in addition to the control (untreated seeds), constituting seven treatments with five repetitions each. In the second experiment, Petri dishes containing the inoculum of different fungi were treated with atmospheric air plasma for 3, 6, and 9 min (Air-3, Air-6, and Air-9) and were compared with untreated fungi in Petri dishes without treatment (control), totaling four treatments and five repetitions each. We found that the application of atmospheric air plasma to E. velutina seeds for 9 min had an antimicrobial effect on the fungi Aspergillus niger, Aspergillus flavus, Fusarium sp., Brachysporium sp., and Rhizopus sp. The formation of fungal colonies isolated from E. velutina seeds was also inhibited by 3 min of exposure to atmospheric air plasma, except for A. niger, whose inhibition occurred after 6 min of exposure to atmospheric plasma.

Resumo Este trabalho teve como objetivo avaliar o efeito da aplicação de plasma atmosférico na inativação de fungos na superfície de sementes de Erythrina velutina e em colônias fúngicas isoladas. Dois experimentos foram realizados em delineamento inteiramente casualizado: no primeiro, o plasma foi aplicado na superfície das sementes usando gás hélio e plasma atmosférico por três, seis e nove minutos, além do controle (sementes sem tratamento), constituindo sete tratamentos com cinco repetições cada; no segundo experimento, placas de Petri contendo o inóculo de diferentes fungos foram tratadas com plasma atmosférico por três, seis e nove minutos (Air-3, Air-6 e Air-9) e comparadas com fungos não tratados em placas de Petri sem tratamento (controle), totalizando quatro tratamentos e cinco repetições cada. Descobrimos que a aplicação de plasma atmosférico nas sementes de E. velutina por nove minutos teve efeito antimicrobiano sobre os fungos Aspergillus niger, Aspergillus flavus, Fusarium sp., Brachysporium sp. e Rhizopus sp. A formação de colônias fúngicas isoladas de sementes de E. velutina também foi inibida por três minutos de exposição à aplicação de plasma atmosférico, exceto para A. niger, cuja inibição ocorreu a partir de 6 minutos de exposição à aplicação de plasma atmosférico.

Inactivation of isolated fungi on Erythrina velutina Willd. seeds through atmospheric plasma

Abstract This study aimed to evaluate the effect of atmospheric plasma application on the inactivation of fungi on the surface of Erythrina velutina seeds and on isolated fungal colonies. Two experiments were conducted using a completely randomized design. First, plasma was applied to the surface of the seeds using helium gas and atmospheric plasma for 3, 6, and 9 min in addition to the control (untreated seeds), constituting seven treatments with five repetitions each. In the second experiment, Petri dishes containing the inoculum of different fungi were treated with atmospheric air plasma for 3, 6, and 9 min (Air-3, Air-6, and Air-9) and were compared with untreated fungi in Petri dishes without treatment (control), totaling four treatments and five repetitions each. We found that the application of atmospheric air plasma to E. velutina seeds for 9 min had an antimicrobial effect on the fungi Aspergillus niger, Aspergillus flavus, Fusarium sp., Brachysporium sp., and Rhizopus sp. The formation of fungal colonies isolated from E. velutina seeds was also inhibited by 3 min of exposure to atmospheric air plasma, except for A. niger, whose inhibition occurred after 6 min of exposure to atmospheric plasma.

Resumo Este trabalho teve como objetivo avaliar o efeito da aplicação de plasma atmosférico na inativação de fungos na superfície de sementes de Erythrina velutina e em colônias fúngicas isoladas. Dois experimentos foram realizados em delineamento inteiramente casualizado: no primeiro, o plasma foi aplicado na superfície das sementes usando gás hélio e plasma atmosférico por três, seis e nove minutos, além do controle (sementes sem tratamento), constituindo sete tratamentos com cinco repetições cada; no segundo experimento, placas de Petri contendo o inóculo de diferentes fungos foram tratadas com plasma atmosférico por três, seis e nove minutos (Air-3, Air-6 e Air-9) e comparadas com fungos não tratados em placas de Petri sem tratamento (controle), totalizando quatro tratamentos e cinco repetições cada. Descobrimos que a aplicação de plasma atmosférico nas sementes de E. velutina por nove minutos teve efeito antimicrobiano sobre os fungos Aspergillus niger, Aspergillus flavus, Fusarium sp., Brachysporium sp. e Rhizopus sp. A formação de colônias fúngicas isoladas de sementes de E. velutina também foi inibida por três minutos de exposição à aplicação de plasma atmosférico, exceto para A. niger, cuja inibição ocorreu a partir de 6 minutos de exposição à aplicação de plasma atmosférico.

Prevalencia de hipofunción vestibular en el vértigo postural paroxístico benigno post traumatismo craneoencefálico

Introducción: El traumatismo craneoencefálico (TCE) puede generar vértigo, mareo e inestabilidad. Posibles causas otorrinolaringológicas son el vértigo postural paroxístico benigno (VPPB) que constituye el diagnóstico más frecuente, y la hipofunción vestibular. Objetivo: Describir la prevalencia de hipofunción vestibular en un grupo de pacientes con VPPB asociado a TCE. Material y Método: Estudio retrospectivo de pacientes con VPPB asociado a TCE que requirieron maniobra de reposición (MRP) entre los años 2017 y 2021. La información clínica, características clínico-demográficas, hallazgos en pruebas de función vestibular y número de MRP fueron evaluados. Resultados: Se incluyeron 48 pacientes con una edad promedio de 60,8 ± 16,5 años, siendo un 52% mujeres. La prevalencia de pacientes con paresia vestibular concomitante correspondió al 35,4%. Al comparar al grupo con y sin paresia se observó: (1) en el grupo con paresia fue, significativamente, más frecuente presentar contusión cerebral asociada, 47,1% vs 12,9%; (2) el sexo masculino fue, significativamente, más frecuente en el grupo con paresia, 70,59% vs 35,5%; (3) en ambos grupos, la mediana de MRP fue 1. Conclusión: La presencia de paresia vestibular en pacientes con VPPB secundario a TCE, no es un hallazgo infrecuente, en nuestro estudio, correspondió a un 35,4%, siendo este más frecuente en hombres. Adicionalmente, la contusión cerebral asociada es más frecuente en el grupo con paresia.

Introduction: Head trauma can generate vertigo, dizziness and instability. Possible otorhinolaryngologic causes are benign paroxysmal postural vertigo (BPPV), which is the most frequent diagnosis, and vestibular hypofunction. Aim: To describe the prevalence of vestibular hypofunction in a group of patients with BPPV associated with head trauma. We studied the clinical characteristics, vestibular function test findings and the number of (PRM). Material and Method: Retrospective study of patients with BPPV associated with head trauma who underwent particle repositioning maneuvers (PRM) during the years 2017 to 2021. Clinical characteristics, vestibular function test findings and the number of PRM were evaluated. Results: 48 patents were included. The mean age was 60.8 ± 16.5 years old, 52% were women. The prevalence of patients with concomitant vestibular paresis was 35.4%. When comparing the groups with and without paresis the following was observed: (1) associated brain contusions were significatively more frequent in the paresis group, 47.1% vs 12.9%; (2) male sex was significatively more frequent in the paresis group, 70.59% vs 35.5%; (3) in both groups, the median of needed PRM was 1. Conclusion: The presence of vestibular paresis in patients with BPPV secondary to head trauma is not an infrequent finding. In our study, its prevalence was 35.4%, being significatively more frequent in men. Also, associated brain contusions were significatively more frequent in the paresis group.

Relationship between Smoking and Vocal Self-perception of Trans Women

Objective: To verify the relationship between smoking, age, schooling, and the vocal self-perception of trans women. Methods: Cross-sectional observational quantitative study conducted with 24 trans women over 18 years old, living in their affirmed gender for a minimum of 6 months. Data collection involved selected questions from the translated and authorized Portuguese version of the Trans Woman Voice Questionnaire (TWVQ) and information regarding age, education, occupation, and smoking status. All variables were analyzed descriptively, and the association with smoking was assessed using Pearson's Chi-square, Fisher's Exact, Student's T, and Mann-Whitney tests, with a significance level of 5%. Results: The mean age of trans women was 28.2 +/- 6.5 years (range: 21 - 48). Most participants (41.6%) had completed their high school education and pursued diverse careers. Regarding smoking habits, 58.3% of women were either current smokers or had smoked at least 100 cigarettes in their lifetime. A statistically significant association was found between smoking and age (p = 0.001), with smokers having a lower average age (24.9 years) compared to nonsmokers (32.9 years). However, no statistical significance was observed between smoking, education, and self-perception of vocal femininity. Only 9 (37.5%) trans women perceived their voices as feminine, while 17 (70.7%) desired a more feminine-sounding voice. Limitation: The limited sample size in this study may have constrained the ability to detect significant differences between the analyzed groups using statistical tests. Conclusion: The smoking prevalence was notably high among younger trans women. However, there was no statistically significant difference in vocal self-perception between those who smoked and those who did not. The majority of trans women expressed a desire for their voices to sound more feminine, particularly among smokers.

Objetivo: Verificar la relación entre el tabaquismo, edad, escolaridad y la autopercepción vocal de mujeres trans. Métodos: Estudio observacional transversal cuantitativo realizado con 24 mujeres trans mayores de 18 años, que viven en su género afirmado durante 6 meses. Para la recolección de datos se utilizaron preguntas seleccionadas de la versión portuguesa traducida y autorizada del Trans Woman Voice Questionnaire (TWVQ) y datos sobre edad, educación, ocupación y tabaquismo. Todas las variables se analizaron descriptivamente y la asociación con el tabaquismo se realizó mediante las pruebas Chi-cuadrado de Pearson, Exacta de Fisher, T de Student y Mann Whitney, con un nivel de significación del 5%. Resultados: La edad promedio de las mujeres trans fue de 28,2 +/- 6,5 (rango 21 - 48). La mayoría de las participantes (41,6%) había terminado la escuela secundaria con carreras muy diversas. Respecto al tabaquismo, el 58,3% de las mujeres fuman actualmente o han fumado al menos 100 cigarrillos en su vida. Hubo una asociación estadísticamente significativa entre el tabaquismo y la edad (p = 0,001), en la que la edad promedio entre los fumadores (24,9 años) fue menor que la de los no fumadores (32,9 años). No hubo significación estadística entre el tabaquismo, la educación y la autopercepción vocal. Solo 9 (37,5%) mujeres trans actualmente consideran su voz femenina y 17 (70,7%) dijeron que la voz ideal podría sonar más femenina. Limitación: La pequeña casuística puede haber limitado la identificación de diferencias entre los grupos analizados a través de pruebas estadísticas. Conclusión: El tabaquismo fue alto entre las mujeres trans, especialmente las más jóvenes. La autopercepción vocal no fue estadísticamente diferente entre los grupos de fumadores y no fumadores. La mayoría de las mujeres trans dijeron que sus voces podrían sonar más femeninas, especialmente las fumadoras.

Advances in diffuse glial tumors diagnosis / Avanços no diagnóstico dos gliomas difusos

Abstract In recent decades, there have been significant advances in the diagnosis of diffuse gliomas, driven by the integration of novel technologies. These advancements have deepened our understanding of tumor oncogenesis, enabling a more refined stratification of the biological behavior of these neoplasms. This progress culminated in the fifth edition of the WHO classification of central nervous system (CNS) tumors in 2021. This comprehensive review article aims to elucidate these advances within a multidisciplinary framework, contextualized within the backdrop of the new classification. This article will explore morphologic pathology and molecular/genetics techniques (immunohistochemistry, genetic sequencing, and methylation profiling), which are pivotal in diagnosis, besides the correlation of structural neuroimaging radiophenotypes to pathology and genetics. It briefly reviews the usefulness of tractography and functional neuroimaging in surgical planning. Additionally, the article addresses the value of other functional imaging techniques such as perfusion MRI, spectroscopy, and nuclear medicine in distinguishing tumor progression from treatment-related changes. Furthermore, it discusses the advantages of evolving diagnostic techniques in classifying these tumors, as well as their limitations in terms of availability and utilization. Moreover, the expanding domains of data processing, artificial intelligence, radiomics, and radiogenomics hold great promise and may soon exert a substantial influence on glioma diagnosis. These innovative technologies have the potential to revolutionize our approach to these tumors. Ultimately, this review underscores the fundamental importance of multidisciplinary collaboration in employing recent diagnostic advancements, thereby hoping to translate them into improved quality of life and extended survival for glioma patients.

Resumo Nas últimas décadas, houve avanços significativos no diagnóstico de gliomas difusos, impulsionados pela integração de novas tecnologias. Esses avanços aprofundaram nossa compreensão da oncogênese tumoral, permitindo uma estratificação mais refinada do comportamento biológico dessas neoplasias. Esse progresso culminou na quinta edição da classificação da OMS de tumores do sistema nervoso central (SNC) em 2021. Esta revisão abrangente tem como objetivo elucidar esses avanços de forma multidisciplinar, no contexto da nova classificação. Este artigo irá explorar a patologia morfológica e as técnicas moleculares/genéticas (imuno-histoquímica, sequenciamento genético e perfil de metilação), que são fundamentais no diagnóstico, além da correlação dos radiofenótipos da neuroimagem estrutural com a patologia e a genética. Aborda sucintamente a utilidade da tractografia e da neuroimagem funcional no planejamento cirúrgico. Destacaremos o valor de outras técnicas de imagem funcional, como ressonância magnética de perfusão, espectroscopia e medicina nuclear, na distinção entre a progressão do tumor e as alterações relacionadas ao tratamento. Discutiremos as vantagens das diferentes técnicas de diagnóstico na classificação desses tumores, bem como suas limitações em termos de disponibilidade e utilização. Além disso, os crescentes avanços no processamento de dados, inteligência artificial, radiômica e radiogenômica têm grande potencial e podem em breve exercer uma influência substancial no diagnóstico de gliomas. Essas tecnologias inovadoras têm o potencial de revolucionar nossa abordagem a esses tumores. Em última análise, esta revisão destaca a importância fundamental da colaboração multidisciplinar na utilização dos recentes avanços diagnósticos, com a esperança de traduzi-los em uma melhor qualidade de vida e uma maior sobrevida.

Actualización en el Diagnóstico y Tratamiento del Fibroma Ameloblástico: Revisión Sistemática

El fibroma ameloblástico (FA) es una neoplasia benigna con potencial de recurrencia y transformación maligna que afecta los huesos maxilofaciales. Se analizaron casos recientes de FA para describir sus características clínicas y opciones de tratamiento. El objetivo de este estudio es mejorar la comprensión de esta enfermedad poco común y brindar información relevante para el diagnóstico y manejo de los pacientes. Se realizó una revisión de la literatura en busca de reportes de caso de FA publicados en los últimos 5 años. Después de eliminar duplicados, se seleccionaron 16 estudios para su análisis. Se recopilaron datos sociodemográficos, ubicación de la lesión, signos clínicos, hallazgos radiográficos y opciones de tratamiento. Los estudios incluidos en el análisis reportaron casos de FA en pacientes con edades entre 4 y 21 años. Se observó una ligera predominancia en hombres. La ubicación más común de la lesión fue la mandíbula posterior. Los signos clínicos más frecuentes fueron el aumento de volumen óseo y el dolor. Radiográficamente, se encontraron principalmente lesiones radiolúcidas multiloculares. El tratamiento más común fue la enucleación de la lesión. No se observaron recurrencias durante el seguimiento de los casos reportados. Los resultados coinciden con la literatura reciente, proporcionando información actualizada sobre el perfil clínico y radiográfico del FA. La enucleación se muestra como una opción efectiva de tratamiento. Estos hallazgos contribuyen al diagnóstico preciso y al manejo adecuado de los pacientes con FA, resaltando la importancia de comprender las características clínicas de esta neoplasia.

Ameloblastic fibroma (AF) is a benign neoplasm with the potential for recurrence and malignant transformation that affects the maxillofacial bones. Recent cases of AF were analyzed to describe their clinical characteristics and treatment options. The objective of this study is to enhance understanding of this rare disease and provide relevant information for the diagnosis and management of patients. A literature review was conducted to identify case reports of AF published in the past 5 years. After removing duplicates, 16 studies were selected for analysis. Sociodemographic data, lesion location, clinical signs, radiographic findings, and treatment options were collected. The included studies reported cases of AF in patients aged between 4 and 21 years. There was a slight male predominance. The most common location of the lesion was the posterior mandible. The most frequent clinical signs were increased bone volume and pain. Radiographically, predominantly multilocular radiolucent lesions were found. The most common treatment was lesion enucleation. No recurrences were observed during the follow-up of the reported cases. The results align with recent literature, providing updated information on the clinical and radiographic profile of AF. Enucleation emerges as an effective treatment option. These findings contribute to accurate diagnosis and appropriate management of patients with AF, highlighting the importance of understanding the clinical characteristics of this neoplasm.

Characterization of Salivary Gland Pain: A Review of the Literature / Caracterización del Dolor de Glándulas Salivales: Revisión de la Literatura

SUMMARY: The salivary glands in pathological conditions produce countless different clinical presentations, and due to their complex neuroanatomy, their pain symptoms vary widely. However, in the literature to date, few studies characterize salivary gland pain. The aim of this study was to conduct a literature review concerning the clinical characteristics of pain in various salivary gland pathologies. A literature review was done through a systematic search of scientific articles in the Web of Science (WoS), MEDLINE, Scopus, and Elton B. Stephens Company (EBSCO) databases. The free terms "salivary gland", "parotid gland", "submaxillary gland", "sublingual gland", and "pain" were used along with the Boolean operators OR and AND. The search yielded a total of 1896 articles, of which 60 fulfilled the inclusion criteria and were ultimately included in this review. It is described that pain is a nonspecific symptom of a glandular pathology and is characterized mainly by the location of the pain, which is correlated with the anatomical location of the affected salivary gland. Among the painful salivary gland pathologies, we found inflammatory disorders, including infections, obstructions, disorders secondary to hyposalivation; systemic autoimmune diseases; neoplasms, and neuropathic pain disorders. The diagnosis and management of salivary gland pain require knowledge of the causes and mechanisms of the pain, and it is to recognize the signs and symptoms of salivary gland disorders to be able to diagnose and treat them.

Las glándulas salivales en condiciones patológicas producen un sinfín de presentaciones clínicas diferentes, y debido a su compleja neuroanatomía generan variaciones en su sintomatología dolorosa. Sin embargo, en la literatura hasta ahora son escasos los estudios que caracterizan el dolor de glándulas salivales. El objetivo de este estudio fue realizar una revisión de la literatura respecto a las características clínicas del dolor en diversas patologías de glándulas salivales. Se realizó una revisión de la literatura, a través de la búsqueda sistemática de artículos científicos en las bases de datos Web of Science (WoS), MEDLINE, Scopus y Elton B. Stephens Company (EBSCO). A través de los términos libres: "salivary gland", "parotid gland", "submaxillary gland", "sublingual gland", "pain", junto con los operadores booleanos OR y AND. La búsqueda arrojó un total de 1896 artículos, de los cuales 60 cumplieron los criterios de inclusión y fueron finalmente incluidos en esta revisión. Se describe que el dolor es un síntoma poco específico para la patología glandular y está caracterizado principalmente por la localización del dolor, el cual se correlaciona con la ubicación anatómica de la glándula salival afectada. Dentro de las patologías dolorosas de glándulas salivales encontramos los trastornos inflamatorios, incluidas infecciones, obstrucciones, trastornos secundarios a hiposalivación; enfermedades sistémicas autoinmunes; neoplasias y trastornos de dolor neuropático. El diagnóstico y manejo del dolor de glándulas salivales requiere del conocimiento de las causas y mecanismos del dolor, siendo necesario reconocer los signos y síntomas de los trastornos de glándulas salivales para ser capaces de diagnosticarlos y tratarlos.

A relação entre a oralidade e escrita e sua implicação na clínica fonoaudiológica sob diferentes perspectivas teóricas: revisão integrativa / The relationship between orality and writing and its implication in the speech therapy from different theoretical perspectives: integrative review / La relación entre oralidad y escritura y su implicación en la clínica logopédica desde diferentes perspectivas teóricas: revisión integradora

Introdução: Este trabalho diferencia três abordagens teóricas que, comumente, sustentam a prática fonoaudiológica na área da linguagem. O foco é a relação entre oralidade e escrita e sua implicação nos procedimentos clínicos nos distúrbios ou dificuldades de leitura e escrita. Objetivo: apresentar e analisar a relação entre a oralidade e a escrita e discutir como a clínica fonoaudiológica conduz o tratamento ou o acompanhamento de crianças com distúrbios na linguagem escrita em diferentes perspectivas teóricas. Método: Trata-se de uma revisão integrativa da literatura. Foram selecionados dezesseis artigos que respondem às questões de pesquisa nas seguintes abordagens: Cognitivo-Linguística, Enunciativo-Discursiva e Clínica de Linguagem (Linguístico-Discursiva). Resultados: Nota-se diferentes interpretações clínicas para a prevenção, os critérios diagnósticos, nomenclatura e método de tratamento. Conclusão: As diferentes posições teóricas definem modelos de clínicas distintos, considerando como a oralidade pode afetar a escrita. (AU)

Introduction: This work differentiates three theoretical approaches about language that are used by Brazilian speech therapists. The focus is the relationship between orality and writing and its implication in clinical procedures in disorders or difficulties in reading and writing. Objective: to produce and analyze the relationship between orality and writing and to discuss how the speech therapy clinic conducts the treatment or follow-up of children with written language disorders in different theoretical perspectives. Method: This is an integrative literature review. Sixteen articles were selected that answer the research questions in the following approaches: Cognitive-Linguistic, Enunciative-Discursive and Language Clinic (Linguistic-Discursive). Results: There are different clinical interpretations for prevention, nomenclature, diagnosis, and treatment method. Conclusion: The different theoretical positions define different clinical models, considering how orality can affect writing. (AU)

Introducción: Este trabajo diferencia tres enfoques teóricos que comúnmente sustentan la práctica de la patología del habla y el lenguaje en el área del lenguaje. El enfoque es la relación entre la oralidad y la escritura y su implicación en los procedimientos clínicos en los trastornos o dificultades en la lectura y la escritura. Objetivo: presentar y analizar la relación entre la oralidad y la escritura y discutir cómo la clínica de logopedia realiza el tratamiento o seguimiento de niños con trastornos del lenguaje escrito en diferentes perspectivas teóricas. Método: Esta es una revisión integradora de la literatura. Se seleccionaron dieciséis artículos que responden a las preguntas de investigación en los siguientes enfoques: Cognitivo-Lingüístico, Enunciativo-Discursivo y Clínica del Lenguaje (Lingüístico-Discursivo). Resultados:Existen diferentes interpretaciones clínicas para la prevención, criterios diagnósticos, nomenclatura y método de tratamiento. Conclusión: Las diferentes posiciones teóricas definen diferentes modelos clínicos, considerando cómo la oralidad puede afectar la escritura. (AU)