Racial disparity and prognosis in patients with mouth and oropharynx cancer in Brazil.

BACKGROUND: Oral and oropharyngeal cancer (OPC) is an important cause of morbidity and mortality worldwide. Populations in situations of social vulnerability tend to have higher incidences of cancer, a higher proportion of late diagnosis, greater difficulties in accessing health services, and, consequently, worse prognosis. The aim of this study was to evaluate the relationship between race/skin color and OPC prognosis in Brazil. MATERIAL AND METHODS: This is a cross-sectional epidemiological study using OPC data from the National Cancer Institute between the years 2000 and 2019. The selected variables were: gender, race/skin color, age, education, smoking and alcohol consumption, stage of the disease and disease status at the end of the 1st treatment. RESULTS: 154,214 cases were recorded. Black men, in the 6th decade of life, were the most affected population. Blacks had a lower level of education when compared to non-blacks (p<0.001). Blacks were more exposed to smoking and alcohol consumption (p<0.001). At the time of diagnosis, the black population was at the most advanced stage when compared to non-blacks (p<0.001). At the end of the 1st treatment, more black patients had disease in progression, as well as more black patients died (p<0.001). CONCLUSIONS: Blacks had a worse prognosis for OPC in Brazil. Despite the limitations, these results are important to elucidate the scenario of health disparities in relation to the race/skin color of the Brazilian population.

[Percutaneous neuromodulation with pulsating radiofrequency vs cryoablation for the treatment of patients with lumbar facet syndrome]. / Neuromodulación percutánea utilizando radiofrecuencia pulsada versus crioablación en pacientes con síndrome facetario lumbar.

INTRODUCTION: lumbar spine pain affects a high percentage of the population and has a significant socioeconomic impact. Lumbar facet syndrome has a prevalence between 15-31% with lifetime incidence of up to 52% in some series. Due to the use of different types of treatment and different patient selection criteria, the success rate varies in the literature. OBJECTIVE: to compare results of treatment with rhizolysis applying pulsed radiofrequency versus cryoablation in patients diagnosed with lumbar facet syndrome. MATERIAL AND METHODS: from January 2019 to November 2019, eight patients were randomly divided into two groups: group A treated with pulsed radiofrequency and group B treated with cryoablation. Pain was assessed with the visual analogue scale and the Oswestry low back pain disability index at four weeks, in addition to three and six months. RESULTS: follow-up was six months. Immediately the eight patients (100%) reported improvement in symptoms and pain. Of the four patients who were in intense functional limitation, one of them became without functional limitation, and two of them went to minimum functional limitation and one to moderate functional limitation at the first month, statistically significant differences were reported. CONCLUSIONS: both treatments control pain in the short term; there is also an improvement in physical abilities. The morbidity accompanying neurolysis either radiofrequency or cryoablation is very low.

INTRODUCCIÓN: el dolor en columna lumbar afecta a un alto porcentaje de la población y presenta un significativo impacto socioeconómico. El síndrome facetario lumbar tiene una prevalencia entre 15-31% con incidencia a lo largo de la vida de hasta 52% en algunas series. Debido al empleo de distintos tipos de tratamiento y diversos criterios de selección de los pacientes, la tasa de éxito varía en la literatura. OBJETIVO: comparar resultados de tratamiento con rizólisis aplicando radiofrecuencia pulsada versus crioablación en pacientes con diagnóstico de síndrome facetario lumbar. MATERIAL Y MÉTODOS: de Enero de 2019 a Noviembre de 2019, ocho pacientes fueron divididos aleatoriamente en dos grupos: el grupo A tratados con radiofrecuencia pulsada y el grupo B tratados con crioablación. Se evaluó el dolor con la escala visual análoga y el índice de discapacidad de dolor lumbar de Oswestry a las cuatro semanas, además de tres y seis meses. RESULTADOS: el seguimiento fue de seis meses. De forma inmediata los ocho pacientes (100%) refirieron mejoría de los síntomas y del dolor. De los cuatro pacientes que se encontraban en limitación funcional intensa, uno pasó a estar sin limitación funcional, dos de ellos pasaron a limitación funcional mínima y uno a limitación funcional moderada al primer mes; se reportaron diferencias estadísticamente significativas. CONCLUSIONES: ambos tratamientos controlan el dolor en el corto plazo; también hay una mejoría de las capacidades físicas. La morbilidad que acompaña a la neurólisis, ya sea radiofrecuencia o crioablación, es muy baja.

High prevalence of oral potentially malignant disorders and risk factors in a semi-urban brazilian city: a population-based cross-sectional study.

BACKGROUND: Oral Potentially Malignant Disorders (OPMDs) are defined as lesions with a greater likelihood of progressing to cancer. Population-based studies that evaluate the prevalence of OPMDs are scarce in Brazil. The aim of the present study was to determine the prevalence of OPMDs and associated risk factors in a semi-urban Brazilian population. MATERIAL AND METHODS: This is a cross-sectional study, whose universe included individuals aged 40 years or older residing in a medium-sized city of northeastern Brazil. Data collection was divided into two steps: interview and oral examination. The outcome variable was the presence of OPMDs. The predictor variables were sociodemographic characteristics and risk habits. The bivariate analysis was performed through chi-square test. The crude prevalence ratios (PR) and its respective 95% confidence intervals (CI) were calculated. Poisson regression analysis with robust variance was used to calculate adjusted PRs and 95% CI. RESULTS: Three hundred fourteen individuals were included in the study. When asked about risk habits, 58.9% reported being current smokers or ex-smokers and 62.2% reported being current drinkers or ex-drinkers. The prevalence of OPMDs was 7.6% and was significantly higher among individuals with black skin color (p < 0.001), alcohol users (p = 0.017), and individuals with both tobacco and alcohol habits (p = 0.012). CONCLUSIONS: Therefore, the population in the present study had a high frequency of risk habits associated with PMDs of the oral cavity.

Avaliaçäo da contagem diferencial de células sangüíneas por metodologia automatizada e microscopia / Diferential blood cells counting evaluation by automated methodology and optical microscopy

O hemograma é uma importante análise laboratorial de triagem na avaliaçäo dos fatores estimuladores e diferenciadores dos precursores hemopoiéticos medulares. Em condiçöes fisiológicas há equilíbrio entre a produçäo e a destruiçäo das células sangüíneas, realizada através de microscopia óptica e/ou automatizada, pode revelar possíveis variaçöes fisiológicas ou mesmo situaçöes patológicas. O objetivo deste estudo foi comparar os resultados da contagem de células sangüínas, empregando-se metodologia automatizada, com aqueles obtidos através da avaliaçäo diferencial por microscopia óptica. As análises das células sangüíneas de 558 pacientes atendidos no Hospital Universitário foram realizadas no setor de Hematologia do Laboratório de Análises Clínicas. Os resultados deste estudo demonstram que através da metodologia automatizada determinou-se número significamente maior de neutrófilos (p<0,05) e de monócitos (p<0,0001), em relaçäo àqueles determinados por microscopia óptica. Nas determinaçöes de plaquetas, linfócitos, eosinófilos e basófilos, näo foram observadas variaçöes significativas entre os métodos avaliados (p>0,05). Esses dados sugerem que apesar da agilidade dos métodos automatizados, quando o aparelho apresentar alarmes específicos em sua leitura, a análise por microscopia óptica, ainda é indispensável afim de minimizar as limitaçöes na contagem diferencial das células sangüíneas realizadas em aparelhos automatizados, e assim garantir a qualidade do resultado