The incidence of severe oral mucositis and its occurrence sites in pediatric oncologic patients.

BACKGROUND: Childhood cancer is one of the main causes of child mortality and its treatment has debilitating effects on the oral cavity. Several oral mucositis (SOM) is one of the most common and may cause undesirable symptoms such as pain and risk of systemic infection. MATERIAL AND METHODS: This was a longitudinal, retrospective, and observational study determining the incidence of severe oral mucositis (SOM) and its occurrence sites in pediatric oncologic patients, in João Pessoa, Brazil, between 2013 and 2018. Data from 56 patients aged 1 to 18 years were collected from their medical records and through an oral mucosa examination, from the 1st to 5th week of chemotherapy treatment (CT) using the modified Oral Assessment Guide, by previously calibrated examiners (Kappa index > 0.7). The data were analyzed by the Chi-square test, and Odds Ratios were calculated. RESULTS: Most patients were females (54.5%), aged 8.8 years (± 4.8), with hematologic tumors (73.2%), predominantly Acute Lymphoid Leukemia (50.0%). An increase in the occurrence of SOM was observed throughout the CT (P = 0.05), ranging from 12.5% in the 1st to 35.7% in the 5th CT week. In the 1st CT week, there was a predominance of alterations in the lips (5.5%) and saliva (5.5%), while in the 5th, the jugal / palate mucosa (21.4%) remained the most affected site by SOM. Differences in the severity of SOM in the jugal / palate mucosa (P = 0.01) and labial mucosa (P = 0.04) were observed over time. In the 5th CT week, the likelihood of developing SOM was 13.3-fold higher (95% CI: 1.5 - 105.6) in patients with hematologic tumors. CONCLUSIONS: The incidence of SOM was higher in the 5th CT week, most commonly affecting the jugal / palate mucosa, and patients with hematologic tumors were more prone to develop SOM.

Trend of hospitalized cases of oral cancer in Brazil and its relationship with oral health coverage in public health system between 2009 and 2017.

BACKGROUND: This study aimed to analyze the trend in the number of hospitalized cases of oral cancer in Brazil, according to the coverage of oral health services in public health system, and also investigate the influence of healthcare and clinical characteristics on the severity of oral cancer cases. MATERIAL AND METHODS: This retrospective study considered the period between 2009 and 2017. Data from the Hospital Registry of Cancer from the National Cancer Institute were used, considering the primary locations C00 to C06. Detailed information including sex, age, alcohol and tobacco use, year of first consultation, and the clinical stage of the cases were also collected. The frequency of hospitalized cases was correlated with the coverage of Primary Care Oral Health Teams (ESB) and the number of Dental Specialty Centers (CEO). It was also estimated the chance of advanced oral cancer cases, according to healthcare and clinical characteristics. Data were analyzed using Tweedie's multiple regression and multiple binary logistic regression (α<0.05). RESULTS: There was an increasing trend in the number of hospitalized cases of oral cancer in Brazil between 2009 and 2017 (B=0.043, p<0.001, PR=1.044). The increase in ESB coverage was associated with small increase in the number of hospitalized cases of oral cancer (B=0.001, p=0.003, PR=1.001). The increase in the number of CEO was associated with decrease in the number of hospitalized cases of oral cancer (B=-0.085, p<0.001, PR =0.918). The increase of ESB (OR=0.998) and CEO (OR=0.974) contributed for reducing the number of stage IV cases, whilst the history of alcohol and tobacco use (OR=1.574) was associated with an increase in the number of stage IV cases. CONCLUSIONS: Although an increasing trend was detected, the expansion of the public health system reduced the number of hospitalized cases and the frequency of advanced oral cancer cases in Brazil.

Evaluation of patients undergoing placement of zygomatic implants using sinus slot technique.

BACKGROUND: This study aimed to evaluate patients undergoing placement of zygomatic implants by Stella and Warner's technique, considering the survival rate of conventional and zygomatic implants, and assess the health of the maxillary sinuses and the level of patient satisfaction. METHODS: In this retrospective cohort study, 28 patients had received a combination of conventional and zygomatic implants (group I) and 14 were rehabilitated with only conventional implants (group II). RESULTS: The results showed that Stella and Warner's technique, thought to minimize the presence of the implant into the maxillary sinus, improving the emergence of the implant, proved to be effective, allowing a high survival rate of conventional and zygomatic implants (100 %). The follow-up period ranged from a minimum of 15 months to a maximum of 53 months after prosthetic rehabilitation (average of 34 months). No pathological changes were found on the periimplant tissues. Radiographs showed satisfactory bone levels in conventional implants of oral rehabilitation with zygomatic implants and a good positioning of the apex of the zygomatic implants in relation to the zygomatic bone. The tomographic findings revealed no characteristics of sinus disease. There were no cases of obstruction of the maxillary sinus ostium. CONCLUSIONS: The placement of zygomatic implants by Stella and Warner's technique proved to be a predictable technique with high implant survival rate in patients with atrophic maxilla and was not associated with sinus disease in the sample analyzed. However, a long-term follow-up is necessary to confirm the initial findings of this study.

Characterization of nine transferred SSR markers in the tropical tree species Enterolobium contortisiliquum (Fabaceae).

Transfer of molecular markers is widely used in conservation genetic studies. We investigated the transferability of simple sequence repeat (SSR) markers developed for Enterolobium cyclocarpum to E. contortisiliquum, a tropical tree widely distributed in dry forests. A set of 9 evaluated SSR markers were amplified in E. contortisiliquum and the degree of polymorphism was assessed in 8 trees sampled from each of 5 populations from central Brazil. All loci were polymorphic and the mean number of alleles for all loci was 6. In addition, all pairs of SSR markers were in linkage equilibrium. For most loci, the observed heterozygosity was higher than the expected heterozygosity under Hardy-Weinberg equilibrium, with fixation indices not significantly different from zero. The combined probability of paternity exclusion was high and the probability of identity was very low. We conclude that these SSR markers developed for E. cyclocarpum are applicable for genetic studies of E. contortisiliquum.

Variation of the antimicrobial susceptibility profiles of Burkholderia cepacia complex clonal isolates obtained from chronically infected cystic fibrosis patients: a five-year survey in the major Portuguese treatment center.

The treatment of cystic fibrosis (CF) patients chronically infected with Burkholderia cepacia complex (Bcc) bacteria requires extensive and aggressive antibiotics therapy, exposing these bacteria to prolonged antibiotics-selective pressure. In the present study, we have compared the susceptibility patterns to 13 antimicrobials of 94 Bcc isolates obtained from 15 Portuguese CF patients in the course of chronic infection during a five-year survey. These isolates were previously genotyped and represent 11 different strains of the species B. cenocepacia (subgroups A and B), B. cepacia, B. multivorans, and B. stabilis. The results are consistent with the notion that CF Bcc isolates are resistant to the most clinically relevant antimicrobials and suggest an uneven distribution of resistance rates among the different species, with B. cenocepacia subgroup A isolates being the most resistant. Phenotypic variants exhibiting differences in the antimicrobial susceptibility patterns were obtained from the sputum samples of clinically deteriorated CF patients during chronic lung infection. The isolation of resistant variants coincided with periods of pulmonary exacerbation and antibiotics therapy.

Passive fit of frameworks in titanium and palladium-silver alloy submitted the laser welding.

This study evaluated the precision of fit of implant frameworks cast in titanium (cp Ti) and palladium-silver alloy (Pd-Ag), made by the one-piece cast and laser welding techniques. From a metal matrix with five implants, 20 master casts were obtained, to which replicas of implants were incorporated. On these masters 10 frameworks were made for each type of material (cp Ti and Pd-Ag alloy). Half of these were made by the one-piece cast technique and the other half by the laser welding technique. The implant/prosthesis interface was analysed and measured in the vestibular and lingual regions of the central and distal implants with the help of a measuring microscope. The results indicated that in the central cylinders, the Tukey test (P<0.0005) showed a significant difference in the passive fit between the laser-welded frameworks (34.73 microm) and those one-piece cast frameworks (151.39 microm), and as regards materials, the palladium-silver alloy (66.30 microm) showed better results than the titanium (119.83 microm). In the distal cylinders there was no significant difference between the frameworks cast in titanium and palladium-silver by the one-piece technique. However, after laser welding, there was a significant difference for the frameworks cast in titanium (31.37 microm) and palladium-silver (106.59 microm).