Performance of multiple therapeutic approaches for palatal wound healing after soft tissue graft removal - an overview of systematic reviews.

OBJECTIVE: To overview the literature to answer the following question: "What is the performance of different therapies on wound healing and postoperative discomfort after palatal ASTG removal?" METHODS: SRs that evaluated the wound healing (WH), postoperative pain, bleeding, and analgesic consumption of patients submitted to de-epithelialized/free gingival grafts (FGG) or subepithelial connective tissue grafts (SCTG) removed from the palate were included. The searches were conducted on six white and two gray databases up to December 2023. Methodological quality was evaluated through AMSTAR 2. The synthesis of results was described as a narrative analysis. RESULTS: Ten SRs (involving 25 randomized clinical trials) related to low-level laser therapy (LLLT) (3), platelet-rich fibrin (PRF) (4), cyanoacrylate tissue adhesives (CTA) (2), and ozone therapy (OT) (1) were included in this overview. All techniques demonstrated improvements in WH. LLT, PRF, and CTA reduced pain and analgesic consumption. PRF and CTA reduced bleeding. Regarding methodological quality, the SRs were classified as critically low (2), low (5), moderate (2), or high quality (1). CONCLUSIONS: In SRs related to LLLT, PRF, CTA, and OT, the use of different therapies after palatal ASTG removal improved WH and postoperative discomfort. Due to the studies' low methodological quality and high heterogeneity, data should be interpreted with caution. CLINICAL RELEVANCE: The present overview compiles the evidence of SRs related to different therapies for WH and patients' postoperative experience and reveals that different treatments can significantly improve the clinical outcomes of patients who require ASTG removal for periodontal or peri-implant surgeries. REGISTRATION: PROSPERO registration number: CRD42022301257.

Catastrophic Antiphospholipid Syndrome and Renal Failure: An Unexpected Recovery After Three Years on Dialysis.

Catastrophic antiphospholipid syndrome (CAPS) is a rare and life-threatening disorder characterised by arterial or venous thrombotic events, involving three or more organs in a short period of time, in the presence of persistent antiphospholipid antibodies. Long-term anticoagulation with warfarin is the standard of care to prevent recurrent vascular events. Besides supportive care, optimal management of CAPS is unclear and consensus among experts is lacking. We describe a patient with primary antiphospholipid syndrome who experienced probable CAPS after receiving rivaroxaban, resulting in extensive cutaneous ulceration, acute coronary syndrome and dialysis-dependent renal failure. Anticoagulation, glucocorticoids and plasmapheresis were started. In the haemodialysis period, he maintained treatment with long-term vitamin K antagonist. The international normalized ratio target was optimized to 3.5-4. This strategy was associated with the healing of skin lesions, regression of cardiac lesions and recovery of renal function after three years on dialysis.

Neurotoxicidades apresentadas por pacientes submetidos ao transplante de células-tronco hematopoéticas: uma revisão de escopo / Neurotoxicidades en pacientes sometidos al trasplante de células madre hematopoyéticas: una revisión de alcance / Neurotoxicity presented by patients undergoing hematopoietic stem cell transplantation: a scoping review

Resumo Objetivo Mapear os tipos de neurotoxicidades apresentadas por pacientes submetidos ao Transplante de Células-Tronco Hematopoéticas. Métodos Trata-se de uma Scoping Review, orientada a partir do método proposto pelo Joanna Briggs Institute, e seguiu as recomendações do Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. A busca pelos estudos foi realizada entre os meses de julho e agosto de 2020 e ocorreu nas bases de dados e em portais de teses e dissertações nacionais e internacionais. Resultados A amostra final foi composta por 71 artigos científicos, todos na língua Inglesa. Houve destaque para o ano de 2018 com 14 (19%) publicações. Observou-se prevalência de estudos realizados nos Estados Unidos da América com 29 (40,8%). No tocante a população, todos (100%) os artigos são sobre pacientes submetidos ao transplante de células-tronco hematopoéticas que apresentaram neurotoxicidades. Acerca dos quimioterápicos utilizados no regime de condicionamento pré-transplante de células-tronco hematopoéticas sete (9,8%) utilizaram a combinação de Fludarabina e Ciclofosfamida, seguida da Ciclosporina e Tacrolimus em seis (8,4%), ciclosporina em quatro (5,6%), Fludarabina em três (4,2%). Quanto às neurotoxicidades apresentadas em pacientes submetidos ao transplante, evidenciou-se a síndrome de encefalopatia reversível posterior em 19 (26,7%) estudos. Cabe ressaltar que outros estudos identificaram essa síndrome, porém relataram sintomas diferentes. Conclusão As neurotoxicidades apresentadas por pacientes submetidos ao transplante de células-tronco hematopoéticas, são encefalopatia reversível posterior, leucoencefalopatia reversível posterior, encefalopatia de Wernicke, encefalopatia hipertensiva, encefalopatia metabólica, encefalopatia límbica, complicações hemorrágicas e convulsões.

Resumen Objetivo Mapear los tipos de neurotoxicidades en pacientes sometidos al trasplante de células madre hematopoyéticas. Métodos Se trata de una Scoping Review, orientada a partir del método propuesto por el Joanna Briggs Institute, que siguió las recomendaciones del Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. La búsqueda de los estudios se realizó entre los meses de julio y agosto de 2020 y ocurrió en las bases de datos y en portales de tesis de doctorado y maestría nacionales e internacionales. Resultados La muestra final estuvo compuesta por 71 artículos científicos, todos en lengua inglesa. Se destacó el año 2018 con 14 publicaciones (19 %). Se observó una prevalencia de estudios realizados en Estados Unidos de América con 29 (40,8 %). En lo que se refiere a la población, todos los artículos (100 %) tratan sobre pacientes sometidos al trasplante de células madre hematopoyéticas que presentaron neurotoxicidades. Sobre los quimioterápicos utilizados en el régimen de acondicionamiento previo al trasplante de células madre hematopoyéticas, siete (9,8 %) utilizaron la combinación de Fludarabina y Ciclofosfamida, seguida de la Ciclosporina y Tacrolimus en seis (8,4 %), ciclosporina en cuatro (5,6 %), Fludarabina en tres (4,2 %). Con relación a las neurotoxicidades en pacientes sometidos al trasplante, se evidenció el síndrome de encefalopatía reversible posterior en 19 estudios (26,7 %). Cabe destacar que otros estudios identificaron ese síndrome, pero refirieron síntomas distintos. Conclusión Las neurotoxicidades presentadas por pacientes sometidos al trasplante de células madre hematopoyéticas son encefalopatía reversible posterior, leuco encefalopatía reversible posterior, encefalopatía de Wernicke, encefalopatía hipertensiva, encefalopatía metabólica, encefalopatía límbica, complicaciones hemorrágicas y convulsiones.

Abstract Objective To map the types of neurotoxicity presented by patients undergoing Hematopoietic Stem Cell Transplantation. Methods This is a scoping review, guided by the method proposed by the Joanna Briggs Institute, and followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews recommendations. The search for studies was carried out between the months of July and August 2020 and took place in databases and in national and international theses and dissertations portals. Results The final sample consisted of 71 scientific articles, all in English. There was a highlight for the year 2018 with 14 (19%) publications. There was a prevalence of studies carried out in the United States of America with 29 (40.8%). Regarding the population, all (100%) articles are about patients undergoing hematopoietic stem cell transplantation who presented neurotoxicity. Regarding the chemotherapeutic agents used in the pre-transplantation regimen of hematopoietic stem cells, seven (9.8%) used the combination of Fludarabine and Cyclophosphamide, followed by Cyclosporine and Tacrolimus in six (8.4%), Cyclosporine in four (5.6%), Fludarabine in three (4.2%). As for the neurotoxicity presented in patients undergoing transplantation, the posterior reversible encephalopathy syndrome was evidenced in 19 (26.7%) studies. It should be noted that other studies have identified this syndrome, but have reported different symptoms. Conclusion The neurotoxicity presented by patients undergoing hematopoietic stem cell transplantation are posterior reversible encephalopathy, posterior reversible leukoencephalopathy, Wernicke's encephalopathy, hypertensive encephalopathy, metabolic encephalopathy, limbic encephalopathy, hemorrhagic complications and seizures.

Metastatic Renal Cell Carcinoma to the Oral Cavity.

Metastases to the oral cavity are extremely rare events, representing less than 1% of all malignant oral tumors. Renal cell carcinoma constitutes about 3% of solid tumors in adults, and it is the most frequent kidney neoplasm, representing about 90% of kidney malignancies. Due to the silent growth of this neoplasm, most patients have no symptoms and the diagnosis is belated, usually after metastases. The present study reports an additional patient of metastatic renal cell carcinoma to the oral cavity regarding the clinical and pathologic features.

Tumor odontogênico adenomatoide folicular em maxila: relato de caso / Follicular adenomatoid odontogenic tumor in maxilla: case report

Tumor odontogênico adenomatoide (TOA) é uma lesão benigna incomum de origem odontogênica, caracterizado pelo crescimento lento, progressivo, indolor, de consistência firme, cujo tamanho, normalmente não atinge grandes proporções. Há predileção pela região anterior de maxila e o envolvimento de um dente impactado; geralmente o canino, é recorrente, caracterizando a variante folicular. O TOA apresenta três variantes: folicular, extrafolicular e periférica, que não se distinguem microscopicamente, porém são diferenciadas com achados clínicos ou imaginológicos. O presente trabalho descreve um caso de tumor odontogênico adenomatoide folicular, presente em maxila tratado por enucleação e curetagem. O paciente encontra-se em acompanhamento pós-cirúrgico de 30 meses, sem quaisquer sinais clínicos e radiográficos de recidivas da lesão... (AU)

Adenomatoid odontogenic tumor (AOT) is an uncommon benign lesion of odontogenic origin, characterized by slow growth, progressive painless, firm consistency, with size that normally does not reach large proportions. There is a predilection for the anterior maxilla and the involvement of an impacted tooth, usually the canine, is recurrent, featuring follicular variant. The TOA have three variants: follicular, extrafollicular and peripheral, which are not distinguishable microscopically, but clinically or imaging. This paperdescribes a case of follicular adenomatoid odontogenic tumor present in the maxilla, treated by enucleation and curettage with 30 months follow-up without clinical and radiographic signs of injury recurrence... (AU)

Por uma estética tátil: sobre a adaptação de obras de artes plásticas para deficientes visuais / Towards a tactile aesthetics: on the adaptation of works of plastic art for the visually disabled

Analisamos três estratégias comuns para se fornecer acesso às artes plásticas para deficientes visuais: adaptação via alto-relevo, uso representacional de texturas e seleção de esculturas. Lançando mão de estudos de psicologia cognitiva sobre tato (como GIBSON, 1962; LEDERMAN, 1997; HATWELL; MARTINEZ-SAROCCHI, 2000) discutimos tanto a adequação destas estratégias ao tato quanto seu alcance estético. Mostramos que a maioria das "versões táteis" nada possui de tátil: ignorando as propriedades cognitivas e a dimensão expressiva do tato, acabam por reproduzir padrões visuais. Concluímos que o acesso às artes plásticas deve ser pensado em termos da invenção de uma estética verdadeiramente tátil.(AU)

Three common strategies for providing the visually disabled with access to plastic arts are analyzed: adapting works of art via raised-line techniques, using representational textures and selecting sculptures. We draw upon studies in the cognitive psychology of touch (such as GIBSON, 1962; LEDERMAN, 1997; HATWELL; MARTINEZ-SAROCCHI, 2000), in order to discuss both the adequacy of these strategies vis-à-vis the modality of touch and their aesthetic reach. We show that most "tactile versions" are by no means tactile: by ignoring both the cognitive properties and the expressive dimension of touch, they end up reproducing visual standards. We suggest that access to the plastic arts should be understood in terms of the invention of a truly tactile aesthetics.(AU)

O aprendizado da utilização da substituição sensorial visuo-tátil por pessoas com deficiência visual: primeiras experiências e estratégias metodológicas / The learning of the use of the tactile-vision sensory substitution by people with visual disability: first experiences and methodological strategies

O sistema de substituição tátil-visual (TVSS) é uma tecnologia assistiva criada para ajudar deficientes visuais a perceberem aspectos visuais de seu ambiente através do tato e contribuir para sua inclusão social. Para melhor entender o processo de aprendizagem dessa tecnologia, quatro participantes cegos foram treinados com o Brainport®, a última versão do TVSS, onde imagens visuais transformadas são exploradas pela língua. O artigo objetiva de investigar o estágio inicial desse processo de aprendizagem, em termos tanto do desempenho dos participantes quanto da qualidade de sua experiência. O treinamento, conduzido de acordo com um método clínico-pedagógico, produziu dados em terceira pessoa e em primeira pessoa. Os dados foram obtidos através de registros de desempenho e de entrevistas de explicitação. Os resultados mostram que as maiores dificuldades surgidas foram relativas ao acoplamento sensório-motor, aos movimentos do corpo e da cabeça e à dissonância entre as expectativas e a qualidade da experiência perceptiva.

The tactile-vision-substitution-system (TVSS) is an assistive technology designed to aid the visually impaired in perceiving visual aspects of their environment located beyond touch. In order to better understand the learning process of that assistive aid, we trained four blind participants with the Brainport®, the last version of the TVSS, where the transformed visual images are explored by the tongue. More specifically, this article aims to investigate the initial stage of this learning process, in terms both of participants' performance and their qualitative experience. The training, conducted according to the clinical-pedagogic method, produced data both from the first-person and the third-person point of view. Data were gathered through records of participants' performance and explanation interviews. Results show that the main difficulties arising during the process concerned sensory-motor coupling, body and head movement, and the gap between actual and expected quality of the perceptual experience.