Ultrasonography in the Assessment of Tumors of the Cheek: Water Mouth Distension Technique.

PURPOSE: To describe a new B-mode ultrasound examination technique to assess cheek tumors. MATERIALS AND METHODS: 30 cheek oral cavity lesions of different histological types (11 benign and 19 malignant) from 23 patients (11 women and 12 men, 7-82 years old, mean age of 49.5 years) were analyzed. Transcutaneous oral B-mode ultrasound (5-12 MHz transducer) was carried out in two stages. Initially it was performed conventionally with an empty mouth. Next, the patient was asked to keep their oral cavity filled with water (like when using a mouthwash) during imaging for the new test examination technique. The anatomical layers of this region and the characteristics of the tumors were evaluated. Lesions were classified as ill defined, partially defined, or defined. Conventional findings were compared to those of the new technique using the Wilcoxon signed-rank test. Ultrasound results were compared to histological findings analyzed by an independent team. RESULTS: The conventional empty mouth technique was able to confidently define lesion extension in only 6 of the 30 lesions, while the water-filled mouth technique was able to confidently define lesion extension in 29 of the 30 lesions (p<0.00001). CONCLUSION: We present a novel technique that dramatically improves ultrasound staging of cheek oral cavity tumors. In addition to the increase in ultrasound accuracy, this technique does not require any special equipment or extra cost, is very well tolerated by patients, and thus should be considered in the evaluation of every patient undergoing transcutaneous cheek ultrasound for oral cavity lesion characterization.

Unveiling the hidden threat of microplastics to coral reefs in remote South Atlantic islands.

The widespread presence of marine microplastics (< 5 mm) is a significant concern, as it may harm marine biodiversity and ocean ecosystems. Corals' capacity to ingest microplastics has emerged as a significant threat to reef ecosystems, owing to the detrimental physiological and ecological effects it can trigger. The extent of the impact of microplastics on Brazilian corals remains unclear and this study aimed to investigate its distribution and characteristics in four coral species: Favia gravida, Mussismilia hispida, Montastrea cavernosa, and Siderastrea stellata, found in the Trindade and Martim Vaz Islands - the most isolated archipelago of Brazil, located about 1200 km (680 miles) east of the coast. This study aims to reveal the extent of microplastic distribution in the coral reef environment, assess the amount of microplastics in different coral species, and compare each species' capacity to adhere and accumulate microplastics. A high concentration of ingested and adhered microplastics was detected in all coral species evaluated in the present study. No significant differences were observed in the sampling points which indicates that although the sampling points are located at different distances from the coast, the microplastic pollution is equally distributed in the region. Polyethylene (PE), polyvinyl chloride (PVC), polypropylene (PP), poly(methyl methacrylate) (PMMA), Rayon, and Nylon particles were detected, with a predominance of PE (45.5 %). No significant differences in microplastic concentration were detected among the various species and locations studied. Our research presents findings that demonstrate the extensive occurrence of microplastic contamination in coral colonies located on remote islands.

New record and a new species of Lissosabinea Christoffersen, 1988 (Decapoda: Caridea: Crangonidae) from Brazil.

Lissosabinea tridentata (Pequegnat, 1970) known hitherto from the Gulf of Mexico off Florida (24N) and only western Atlantic representative of the genus, is reported here for the first time from much further south, Brazil off the coast of Esprito Santo, Vitria-Trindade Seamount Chain, Montague Bank (20S), between 310 and 391 m. A second western Atlantic species, Lissosabinea christofferseni sp. nov., is described here as new from material collected in the Abrolhos Bank, at depth between 340360 m. One exuviae and one damaged specimen, reported in 1988 from off the coast of Chu, Brazil (34S) (at that time mistakenly referred to as Uruguay) and attributed to Lissosabinea cf. tridentata are herein referred to the new species. It has been clarified that Lissosabinea christofferseni sp. nov. and L. tridentata have a transverse row of teeth adjacent to the posterior margin of the sixth pleonal sternite; in crangonids, such a feature is so far known only in Placopsicrangron formosa Komai Chan, 2009.

Characteristics and prevalence of orofacial pain as an initial symptom of oral and oropharyngeal cancer and its impact on the patient's functionality and quality of life.

OBJECTIVE: To evaluate the prevalence and characteristics of orofacial pain in oral and oropharyngeal cancer (OOC), at diagnosis. MATERIAL AND METHODS: a) Study group (SG; n = 74) patients with cancer were divided into 2 subgroups: oral cancer (OC) and oropharyngeal cancer (OPC); b) control group (CG; n = 74) patients within dental care. STUDY DESIGN: An Orofacial Pain Assessment, verbal descriptive scale, Helkimo dysfunction index, Quality of Life questionnaire, and Karnofsky performance status (KPS) was used for evaluation. RESULTS: The mean age was 58.46 years (79.7% male) in SG, 58.61 years (20.3% male) in CG. The pain within the SG was indicated by the following: prevalence = 91.9% (21.6% in stages 0, I, or II; 70.3% in III or IV); reason for seeking care = 50.1%; main complaint = 55.4%; most important issue in the past 7 days = 74.3%; breakthrough-like pain = 64.9%; main features: chewing or swallowing as triggering factors, wake up patient, variable duration, independent of daytime, multiple descriptors, and earache. The following indexes were worse within the SG: clinical dysfunction, quality of life, and KPS. In addition, the OC subgroup reported toothache-like pain and burning; whereas the OPC subgroup reported heavy swallowing as triggering factor, throat as location, and a bilateral earache. CONCLUSION: At diagnosis, orofacial pain, including breakthrough-like pain, was prevalent in patients with OOC, and the pattern was heterogeneous. Predominantly, the pain was moderate to severe, related to stage of cancer, and already compromising the patients' quality of life and functionality.

Two new species of Psolus Oken from Brazil (Holothuroidea: Psolidae), with neotype designation and redescription of Psolus vitoriae Tommasi, 1971, and a key to the southwestern Atlantic and Magellanic species.

The taxonomy of the southeastern Brazilian species of Psolus is reviewed and two new species described. Additionally, P. vitoriae is redescribed based on a newly designated neotype and supplemental material from the type locality and nearby regions. The synonymy of P. marcusi with P. patagonicus is called into question. The calcareous ring is useful for distinguishing between some Psolus species. Psolus tommasi sp. nov. is characterized by having five oral valves, an anus covered by a variable number of small, irregular anal valves, oral and anal valves distinct from body wall scales, calcareous ring interradial plates entire, calcareous ring simple, without posterior processes; radial and interradial plates entire, dorsal ossicles spheroid bodies and sole ossicles knobbed and smooth perforated plates. Psolus thandari sp. nov. is characterized by granules on body scales; mouth surrounded by five to seven triangular valves of equal size; anus surrounded by a variable number of small and irregular anal valves that grade into surrounding scales; calcareous ring with interradial plates entire. Six species of Psolus are known from the southwestern Atlantic and Magellanic region: P. vitoriae (São Paulo, Brazil); P. patagonicus (Mar del Plata to Tierra del Fuego, Argentina; Strait of Magellan and Cape Horn); P. segregatus (Patagonia, Argentina; Strait of Magellan, Chile; Hikurangi Margin and Chatham Rise, New Zealand); P. antarcticus (Magellanic region; South Georgia Island, southern Atlantic Ocean; Macquarie Island and Ridge, New Zealand); P. lawrencei (Mar del Plata, Argentina) and Psolus murrayi Théel, 1886 (Montevideo, Uruguay). A key to the species of Psolus from the southwestern Atlantic and Magellanic region, and a synoptic table to all southern Atlantic Psolus species is provided.

Two new species of Sclerothyone from the southwestern Atlantic Ocean, with a key to genera and species of Sclerothyoninae (Holothuroidea: Dendrochirotida: Sclerodactylidae).

Sclerothyone Thandar, 1989, currently restricted to two South African species, is here expanded to include two new species from off coast of Brazil. These new species expand the distribution of the genus to the southwestern Atlantic Ocean. Sclerothyone reichi sp. nov. is characterized by having body wall with multilocular two pillared tables with multiperforate disc and short spire, ending in a narrow crown of teeth; tentacles with rods and introvert with two pillared tables and rosettes; tube feet with only end plates. Sclerothyone oloughlini sp. nov. is distinctive in having a body wall with multilocular, two pillared tables; handles present and multilocular two-pillared tables; circular disc without handle; and plates (near the anus). The new species resemble each other in the tentacles with rods. However, Sclerothyone oloughlini sp. nov. stands apart from S. reichi sp. nov. in the introvert with rosettes; tube feet with two pillared supporting tables, arched plates and end plates. The possible assignment of Cucumaria nozawai Mitsukuri, 1912 and Thyone adinopoda Pawson Miller, 1981 to Sclerothyone, and the position of Thyone neofusus Deichmann, 1941 in Temparena Thandar, 1989, are briefly discussed. A key to all genera and species of Sclerodactylinae is provided.

Clinical and epidemiological features of oral cancer in a medical school teaching hospital from 1994 to 2002: increasing incidence in women, predominance of advanced local disease, and low incidence of neck metastases.

PURPOSE: Description of clinical and epidemiological characteristics of patients who underwent surgery for oral cancer in a Medical School Teaching Hospital, and determination of differences with respect to other institutions and/or periods of time. METHOD: The charts of patients undergoing surgery for oral cancer from 1994 to 2002 were reviewed. Data were collected in a spreadsheet in order to analyze clinical and epidemiological features.. RESULTS: A total of 374 patients having undergone 406 operations was identified. Their ages varied from 14 to 94 years (mean = 57.4 years), with 255 men (68.2%), and 295 out 366 Caucasian (80.6%). A majority had tumors of the tongue and/or floor of mouth (55.6%), while 20.3% had lip cancer. Squamous cell carcinoma was found in 90.3%, and glandular carcinoma in 4%. T4 tumors in 39.6%, Tis or T1 lesions in 15.2% of all patients. Nearly 62% had no regional metastases, and the relative incidence in young patients (40 years or younger) reached 8.6%. CONCLUSION: In spite of the predominance of locally advanced tumors, a majority of patients had no neck metastases. The 31.8% incidence in females indicates an increasing incidence of oral cavity cancer among women when compared to previous periods at the same institution.

Fat food habitual intake and risk of oral cancer.

This case-control study evaluated fat food habitual intake in the context of the Brazilian diet as a risk factor for oral cancer. A food frequency questionnaire was applied to 70 patients with oral carcinoma and an equal number of controls treated in the same hospital for acute non-neoplastic conditions. Participants were paired for age, gender and smoking status, and matched by frequency for the use of dental prostheses and length of smoking history. Conditional logistic regression for multivariate analysis indicated as risk factors the habitual intake of foods rich in animal and saturated fat: pork meat, soup, cheese, bacon and fried food. The multivariate model also indicated the protective effect of non-cooked butter or margarine, probably the most effective vehicle for vitamin A ingestion in the Brazilian diet. These findings suggest that there is a non-negligible scope for the prevention of oral cancer through the improvement of diet.

Foregut morphology of Macrobrachium carcinus (Crustacea, Decapoda, Palaemonidae) / Morfologia do estômago do camarão Macrobrachium carcinus (Crustacea, Decapoda, Palaemonidae)

Macrobrachium carcinus is a Brazilian native prawn with recognized potential for use in aquaculture activities. The aim of this study was to describe and illustrate in detail the morphology of the M. carcinus foregut. The foregut comprises the mouth, esophagus and stomach. It is lined by a simple cylindrical epithelium overlain by chitinous cuticle. The cardiac chamber is well supplied with muscles and lined with chitin thickened in places to form a complex, articulating set of ossicles. The ossicles and setae inside the cardiac chamber seem to direct the food movement through the cardiac chamber and sort the food according to particle size as digestion takes place. Twenty-one basic ossicles were observed in the stomach ofM. carcinus and are divided into seven categories, reflecting their presumed functional roles. The significance of these morphological features is discussed in terms of its implication in feeding management that can support future commercial farms of this important fishery resource.

Macrobrachium carcinus é uma espécie nativa com reconhecido potencial para uso em cultivos aquícolas, porém com poucas informações sobre suas estratégias alimentares. O objetivo deste estudo foi descrever e ilustrar em detalhes a morfologia do estômago de M. carcinus e fazer uma breve associação com seu hábito alimentar. O trato digestivo compreende a boca, esôfago e estômago (câmara cardiáca e câmara pilórica) o qual é revestido por um epitélio cilíndrico simples recoberta por uma fina cutícula quitinosa. A câmara cardíaca é bem provida de músculos e margeada por quitina espessada em áreas formando um conjunto complexo de ossículos articulados. Os ossículos e cerdas no interior da câmara cardíaca parecem dirigir a circulação de alimentos através da câmara cardíaca e triar o alimento de acordo com o tamanho de partícula no decorrer da digestão. Um total de 21 ossículos básicos fazem parte do estômago de M. carcinus e estão divididos em sete categorias de acordo com suas funções presumíveis. O significado destas características morfológicas é discutido em termos de sua implicação no manejo alimentar que podem apoiar futuras explorações comerciais deste importante recurso pesqueiro.

Prevenção e Detecção Precoce do Câncer de Boca: Screening em Populações de Risco / Prevention and Early Detection of Oral Cancer: Screening in Risk Populations

Objetivo: Avaliar a viabilidade de programa de prevenção e diagnóstico precoce do câncer de boca direcionado a grupos considerados de risco para esta enfermidade, como tabagistas e etilistas crônicos.Método: No período entre junho de 2000 e julho de 2002, o programa foi realizado em pacientes do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP) e grupos de apoio comunitários, estruturado em palestras periódicas, exame bucal dos interessados e encaminhamento quando necessário para exames complementares e tratamento.Resultados: Foram examinadas 509 pessoas, das quais 215 pertenciam ao sexo masculino (42,2%), 59,7% eram brancos e com média de idade de 49,8 anos. Destas, 131 apresentaram lesão fundamental na boca, que foram encaminhadas à Faculdade de Odontologia da Universidade de São Paulo (FOUSP), para realização de exame complementar. Dos 48 (38,7%) pacientes que compareceram ao ambulatório, 11 foram submetidos à biópsia. Os achados das biópsias foram de hiperqueratose em 3, hiperplasia papilomatosa em 2, hiperplasia fibrosa em 3, um caso de displasia leve, um adenocarcinoma e um carcinoma epidermóide. À citologia esfoliativa, 5 pacientes tiveram o diagnóstico de classe I e 11 como classe II de Papanicolau.Conclusão: O elevado número de lesões fundamentais diagnosticadas demonstra ser de extrema importância o exame oral periódico de pacientes de risco, entretanto o método proposto, como deslocamento de equipes específicas para o rastreamento dos pacientes, mostrou-se bastante trabalhoso e oneroso para ser efetivamente incorporado em serviços de atenção à saúde. Por outro lado, serviços de atenção permanente em conjunto à atuação periódica de campanhas de esclarecimento a população, foram considerados os métodos de maior resultado para o diagnóstico precoce do câncer de boca

Objective: To evaluate a viability of a program for prevention and early diagnosis of oral cancer directed to groups considered at risk for this disease, such as chronic smokers and alcoholics.Method: The program was conducted between June 2000 and July 2002 with patients of the University Hospital of the Medical School of the University of São Paulo (HCFMUSP) and communitarian support groups, structured in the form of periodic lectures, oral exam for those who had interest, and, if necessary, referral for complementary exams and treatment.Results: 509 people were examined, of which 215 (42.2%) were males and 59.7% were Whites with mean age of 49.8 years. From these, 131 presented a fundamental lesion in the mouth and were referred to School of Dentistry of the University of São Paulo (FOUSP) for a complimentary exam. From the 48 (38.7%) patients that attended the University outpatient service, 11 were subjected to biopsy. Results of the biopsies were hyperkeratosis in 3 cases, papillomatous hyperplasia in 2, fibrous hyperplasia in 3, mild dysplasia in 1, adenocarcinoma in 1 and epidermoid carcinoma in 1. Based on the results of exfoliative cytology, 5 patients had diagnosis of Papanicolau class I and 11 of Papanicolau class II.Conclusion: The large number of fundamental lesions diagnosed demonstrates that periodic oral exam of high-risk patients is of paramount importance. However, the method proposed in this study, involving the transport of specific teams for screening of patients, appeared to be too demanding and costly to be effectively incorporated in public health attention services. On the other hand, permanent attention services together with periodic informative campaigns to the population were considered the methods with better results for the early diagnosis of oral cancer

Endoscopia de contato (microestomatoscopia) nas lesões da boca e do lábio: avaliação do método / Contact endoscopy (microstomatoscopy) in oral lesions: evaluation of the method

OBJETIVO: Descrever as dificuldades da endoscopia de contato aplicada à boca e ao lábio (microestomatoscopia de contato) e aplicar nas lesões do lábio os critérios usados na endoscopia de contato de outras topografias. MÉTODO: Estudo prospectivo utilizando o endoscópio de contato Storz 8715A e o corante azul de toluidina. Vinte exames foram feitos para aprendizado da técnica e depois mais 31 (21 lesões do lábio e 10 da boca), todos exames in vivo. Os critérios avaliados foram: Celularidade, Arquitetura, Estratificação e Morfologia. RESULTADOS: A falta de nitidez, os tremores finos e o deslizamento do aparelho dificultaram o procedimento em 100 por cento dos casos, mas permitiram um exame adequado. Os 13 diagnósticos de malignidade das lesões do lábio apresentaram todos os critérios alterados. CONCLUSÃO: as dificuldades encontradas foram o contato do aparelho com a superfície anatômica, o deslizamento do aparelho, os tremores finos e a falta de nitidez da imagem, que não inviabilizaram a realização e a interpretação do exame. Os critérios são aplicáveis às lesões da boca e do lábio inferior.

BACKGROUND: 1- To describe difficulties of contact endoscopy related to mouth and lip (contact microstomatoscopy) and 2- apply the criteria used in contact endoscopy of other topographies when lip lesions are diagnosed. METHODS: A prospective study was performed with the contact endoscope Storz 8715A and toluidine blue was used. Twenty examinations were accomplished in order to learn the technique; after that, other 31 were included (21 lip lesions and 10 oral lesions), all in vivo examinations. The criteria assessed were: cellularity, architecture, stratification and morphology. RESULTS: Lack of image clearness, slight tremors and sliding of the equipment made the procedure difficult in 100 percent of the cases; even though, accomplishment of proper examination was obtained. The 13 cases of lip malignancy lesions had the criteria altered as a whole. CoNCLUSION: Difficulties found were the contact of the equipment with anatomic surface, the sliding of the equipment, the slight tremors, and the lack of image clearness. Nevertheless, such elements did not interrupt the accomplishment and the examination analysis. The criteria are applied to oral and lower lip lesions.

Clinical and epidemiological features of oral cancer in a medical school teaching hospital from 1994 to 2002: increasing incidence in women, predominance of advanced local disease, and low incidence of neck metastases

OBJETIVO: Caracterizar epidemiológica e clinicamente a população atendida por câncer de boca em hospital-escola de atenção terciária e quaternária e verificar variações em relação a outras casuísticas e períodos. MÉTODO: Procedeu-se à revisão dos prontuários dos operados por câncer oral de 1994 a 2002. As características clínicas e epidemiológicas foram colocadas em planilhas e analisadas. RESULTADOS: Foram identificados 374 portadores de câncer da boca que foram submetidos a 406 operações. A idade dos doentes variou de 14 a 94 anos (média = 57,4 anos). Duzentos e cinqüenta e cinco eram do gênero masculino (68,2%). Duzentos e noventa e cinco entre 366 doentes eram caucasianos (80,6%). A maioria era portadora de tumores da língua e/ou do soalho da boca (194 entre 349 doentes; 55,6%), e 71 (20,3%) tinham tumores dos lábios. O carcinoma epidermóide foi encontrado em 90,3% e carcinomas glandulares em 4%. Os tumores T4 estavam presentes em 39,6% dos doentes; 15,2% tinham lesões Tis ou T1. Quase 62% dos pacientes não tinham metástases cervicais. A incidência relativa em jovens (com até 40 anos de idade) atingiu 8,6%. CONCLUSÃO: Apesar dos achados freqüentemente referidos na literatura terem se confirmado (como o predomínio de lesões avançadas localmente), a maioria dos doentes não apresentava metástases cervicais. Acima do observado em outras casuísticas, os 31,8% de mulheres na presente casuística indica a preocupante e crescente incidência no gênero feminino.

Metástase linfática cervical no carcinoma espinocelular de vias aerodigestivas superiores: análise crítica de fatores preditivos, pelo modelo de regressão logística / Lymph node metastasis from squamous cell carcinoma of the upper aerodigestive tract: individual risk prediction by logistic regression model

Introdução: a dissecção cervical no carcinoma espinocelular (CEC) de vias aerodigestivas superiores (VADS) é preconizada com base no risco epidemiológico de metástase linfática. A indicação do esvaziamento eletivo, porém, ainda é controversa. Determinar o risco individual de metástase auxilia na escolha do tratamento mais adequado. Objetivo: verificar a possibilidade de calcular o risco individual de metástase segundo os resultados da comparação de características clínicas e anátomo-patológicas entre os doentes com e sem metástase linfática cervical do CEC de VADS. Pacientes e Método: estudo retrospectivo longitudinal de caso-controle de 209 operados no período de agosto de 2002 a janeiro de 2007, distribuídos em dois grupos: 128 casos com e 81 sem metástase (estes seguidos por mais de 12 meses). Variáveis passíveis de serem preditivas do risco de metástase linfática foram comparadas entre os grupos e analisadas pelo modelo de regressão logística. Resultados: No grupo com metástase, o CEC apresentou maior freqüência de invasão sangüínea, linfática, perineural, margem comprometida e infiltrado inflamatório escasso. Maior diâmetro e grau de diferenciação foram variáveis independentes preditivas do risco (razão de chances) de desenvolver metástase linfática respectivamente de: 4,8 vezes para o CEC moderadamente diferenciado; e 1,5 vezes para cada centímetro de aumento no diâmetro do carcinoma primário. Maior espessura e invasão sangüínea foram co-variáveis dependentes. O cálculo do risco individual revelou que tanto para o CEC T1/T2 de língua oral e soalho, bem diferenciado e com espessura a partir de 1cm, assim como para o CEC de laringe (não glótico) com diâmetro acima de 1,3cm, o risco de metástase foi maior de 20%, para esta casuística. Conclusão: O grau de diferenciação e o maior diâmetro do CEC de VADS foram variáveis independentes preditivas da ocorrência de metástase linfática cervical. O risco individual de metástase pôde ser calculado em função dessas características, segundo o modelo logístico.

Introduction: the elective neck dissection is indicated for head and neck squamous cell carcinoma (SCC) with metastasis risk higher than 20% in epidemiological investigations, but it remains controversial in some situations. To determine the individual risk to develop node metastasis would allow the surgeons to offer a more adequate treatment case by case. Objective: to verify if it is possible to obtain an individual risk prediction model based on clinical and pathological features presented by patients with SCC of the upper aerodigestive tract. Patients and methods: retrospective longitudinal case-control study of 209 patients treated from August 2002 to January 2007, divided into two groups: 128 cases with and 81 without node metastasis followed up more than 12 months. The clinical and pathological characteristics of the primary tumor were compared between the groups and analyzed by the logistic regression model. Results: Diameter and histological grade were independent predictive variables of node metastasis risk (odds ratio = 4.8 for moderately, compared to well differentiated carcinoma; 1.5 per centimeter of primary carcinoma diameter). Thickness and vascular invasion were covariates related to them. The logistic prediction model revealed that the risk of node metastasis was higher than 20% for T1/T2 well differentiated SCC of the oral tongue and floor of mouth with thickness larger than 1.0cm. Laryngeal SCC (except glottic) with diameter smaller than 1.3cm presented less than 20% of risk. Conclusion: histological grade and diameter of the upper aerodigestive tract SCC were independent predictive variables of the neck node metastasis. The individual risk could be calculated in function of these factors by the logistic regression model.

Hemiagenesia de tireóide: relato de quatro casos / Thyroidal hemiagenesis: report of four cases

Há pouco mais de 130 casos de hemiagenesia de tireóide na literatura. Mais quatro säo relatados no presente artigo: todos eram mulheres sem alteraçöes hormonais, duas tinham discreto aumento no volume do pescoço. A suspeita foi levantada ao mapeamento com iodo radiativo e confirmada com o estímulo pelo TSH exógeno e a ultra-sonografia, que mostraram ausência do lobo esquerdo em três dos casos e, do lobo direito no caso restante. Näo havia alteraçöes patológicas no lobo remanescente e todas se encontram assintomáticas até o momento

Tres anos de atividades da liga de prevencao e controle do cancer da cavidade oral / Three years of activities of the league for prevention and control of oral cavity cancer

A Liga de Prevencao e Controle do Cancer da Cavidade Oral foi criada em 1995 na Faculdade de Medicina da Universidade de Sao Paulo com objetivo de divulgar informacoes sobre cancer de boca, incentivar o exame da cavidade oral entre os profissionais da saude e promover o diagnostico em fases mais precoces dos tumores da regiao. E formada por academicos do terceiro ao sexto anos da FMUSP e por professores e medicos da Disciplina de Cirurgia de Cabeca e Pescoco da FMUSP. Nesses tres anos de atividade foram atendidos 160 individuos (675 consultas) portadores de cancer de boca e outras afeccoes benignas e malignas da regiao cervicofacial. As atividades de 1998 da Liga se concentraram no desenvolvimento de programas de incentivo ao diagnostico precoce dos tumores da cavidade oral

Avaliação odontológica de pacientes com câncer de boca pré e pós tratamento oncológico - uma proposta de protocolo / Dental management of oral cancer patients before and after radiation trerapy a protocol purpose

Muitas complicações orais podem ser observadas em pacientes que receberam radioterapia no tratamento do câncer bucal. O cirurgião-dentista deve estar familiarizado com os protocolos disponíveis para o manejo destes pacientes,prevenindo suas futuras complicações e deterioração bucal. O objetivo deste trabalho foi identificar as possíveis complicações bucais em pacientes vitimas de câncer da cavidade bucal eorofaringe submetidos a radioterapia, e assim propor um protocolo de prevenção e controle destas seqüelas. Trinta indivíduos com carcinoma epidermóide foram incluídos. Doze destes pacientes receberam radioterapia e foram clinicamente avaliados tendo seus resultados comparados com 18 pacientes ainda não tratados. Os achados clínicos incluíram cáries,doença periodontal, fatores traumáticos, mucosite, trismo eosteorradionecrose. Os pacientes irradiados foram acompanhados por seis meses e seus fluxos e pH salivares foram determinados e comparados com o outro grupo. Os resultados mostraram que a ausência do fluxo salivar esteve presente em 17 por cento dos pacientes irradiados e ainda que a médiade fluxo salivar destes pacientes era bem mais baixa(0,2ml/min) que os não irradiados (1,4ml/min). A média do pH salivar dos pacientes irradiados foi de 6,03 não sendo considerado diferente estatisticamente do pH do grupo não irradiado (pH= 5.96). Quatro pacientes irradiados exibiram cárie de radiação (33por cento), nove desenvolveram trismo (75 porcento) eoito mucosite (67 porcento). Apenas um caso de osteorradionecrose foiverificado sei meses após a radioterapia. Assim, foi verificado que os efeitos da radiação são mais significantes com relação ao fluxo salivar do que com a alteração do pH; 1/3 dos pacientes irradiados apresentaram alterações importantes logo após a radioterapia e a osteorradionecrose, apesar de poder surgir logo após o tratamento, é normalmente observado um ano apósa radioterapia. A condição oral dos pacientes irradiados requerum tratamento multidisciplinar

Implante de dura-mater homóloga em cavidade oral: estudo experimental em cäes / Homologous dura-mater implant em oral cavity: experimental study in dogs

O revistimento e reconstrucao em cirurgia oncologica de cabeca e pescoco e uma das preocupacoes dos cirurgioes que fazem esta especialidade. A dura-mater homologa conservada em glicerina e um dos recursos aventados para esta finalidade. Os AA realizaram implante deste material como substituto de mucosa no palato-duro de caes. Os mesmos foram sacrificados em grupos de tres no 2.,4.,6.,10.,15. dias de pos-operatorio. As pecas retiradas foram analisadas a luz de microscopia optica. Verificando-se que este material nao se incorpora ao hospedeiro. Ele foi destruido por processo inflamatorio agudo que iniciou-se no 2. dia pos-operatorio e terminou no 10. dia, com dificil identificacao do mesmo local do implante.

Fatores prognósticos em carcinoma espinocelular de lábio inferior: estudo retrospectivo / Prognostic factors in squamous cell carcinoma of the lower lip: retrospective study

Análise retrospectiva de 58 prontuários de portadores de carcinoma espinocelular do lábio inferior, atendidos no período de janeiro de 1980 a dezembro de 1989, no Hospital das Clínicas da Faculdade de Medicina da Universidade de Säo Paulo. Além dos dados demográficos, foram considerados o uso de álcool, fumo e a exposiçäo solar, assim como o estado clínico na época da cirurgia, as características macroscópicas dos tumores, o tipo de tratamento instituído e as observaçöes do seguimento pós-operatório. Os espécimens cirúrgicos foram submetidos a minuciosa revisäo anátomo-patológica com análise do grau de diferenciaçäo histológica, espessura máxima tumoral, elastose solar, invasöes perineural, vascular e muscular, margens cirúrgicas, infiltrado inflamatório peritumoral e acometimento glanglionar, com ou sem rotura capsular. A análise da sobrevida global em 5 anos demonstrou valor prognóstico significativo para as seguintes variáveis: espessura tumoral, tamanho da neoplasia (T) e acometimento ganglionar