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Objective: This article concerns evaluation of the sensitivity, specificity and accuracy of FNAB for pre-surgical diagnosis of benign and malignant lesions of major and minor salivary glands of patients treated in the Department of Head and Neck Surgery of Erasto Gartner Hospital. Methods: This retrospective study analyzed medical records from January 2006 to December 2011 from patients with salivary gland lesions who underwent preoperative FNAB and, after surgical excision of the lesion, histopathological examination. Results: The study had a cohort of 130 cases, but 34 cases (26.2%) were considered unsatisfactory regarding cytology analyses. Based on the data, sensitivity was 66.7% (6/9), specificity was 81.6% (71/87), accuracy was 80.2% (77/96), the positive predictive value was 66,7% (6/9) and the negative predictive value was 81.6% (71/87). Conclusion: Despite the high rate of inadequate samples obtained in the FNAB in this study the technique offers high specificity, accuracy and acceptable sensitivity.
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BACKGROUND: Functional decline in Brazilian patients with head and neck squamous cell carcinoma (HNSCC) is associated with impaired recovery, quality of life, and health care costs. METHODS: Sixty patients enrolled at the regional oncology center in Curitiba, Brazil, were assessed over 6 months for toxicities, nutritional status, anthropometry, fatigue, stress, and functionality. RESULTS: Severe mid-arm and mid-calf circumference depletion accompanied weight loss. Total fatigue score increased 64% (p < .001), as did perceived stress and serum cortisol (p = .01). Instrumental activities of daily living (IADL) dependence doubled, and activities of daily living (ADL) dependence quadrupled (p < .001). Difficulty chewing or swallowing, weight loss, fatigue, perceived stress, and IADL dependence accounted for 48.2% of ADL dependence. CONCLUSIONS: The physical and psychological impact of HNSCC and its treatment are universally experienced; yet, screening and intervention for symptoms such as fatigue and stress are not typical clinical practice. Moreover, assessment of functional status is usually limited to chewing and swallowing. This study identified symptoms that require systematic intervention and randomized trials with functional independence as the outcome.
Subject(s)
Activities of Daily Living , Carcinoma, Squamous Cell/therapy , Head and Neck Neoplasms/therapy , Quality of Life , Weight Loss , Adaptation, Physiological , Aged , Brazil , Carcinoma, Squamous Cell/mortality , Carcinoma, Squamous Cell/pathology , Cohort Studies , Combined Modality Therapy , Fatigue/epidemiology , Female , Head and Neck Neoplasms/mortality , Head and Neck Neoplasms/pathology , Humans , Linear Models , Male , Middle Aged , Multivariate Analysis , Neck Dissection/methods , Nutritional Status , Oncology Service, Hospital , Postoperative Complications/physiopathology , Predictive Value of Tests , Risk Assessment , Stress, Psychological , Time FactorsABSTRACT
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.
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OBJECTIVE: To assess the prognostic significance of several factors in oropharyngeal squamous cell carcinoma treated with radiotherapy alone or in combination with chemotherapy. DESIGN: Retrospective study. SETTING: Erasto Gaertner Hospital, Curitiba, Brazil, and A. C. Camargo Hospital, São Paulo, Brazil. PATIENTS: A total of 361 patients treated for squamous cell carcinoma from January 1, 1990, to December 31, 2001. INTERVENTIONS: Radiotherapy alone or with chemotherapy. MAIN OUTCOME MEASURES: Disease-free survival, overall survival, and treatment response. RESULTS: Most tumors were located at the tonsil (46.8%) or base of the tongue (28.0%) and were at clinical stage III or IV (92.8%). Treatment response was associated with Zubrod scale score, weight loss, number of comorbidities, symptom-severity and Piccirillo stages, hemoglobin level, tumor site, macroscopic appearance of the tumor, and clinical stage. The 5-year overall survival rate was 17.6% and disease-free survival rate was 16.2%. The significant prognostic variables were age; Zubrod scale score; weight loss; comorbidities; Berg, Piccirillo, and symptom-severity staging; involvement of adjacent soft-tissue areas and bone; lymph node mobility; clinical stage; and radiotherapy doses. The multivariate analysis showed Zubrod scale score, symptom-severity staging system, Berg staging system, comorbidities, and radiotherapy dose as independent prognostic factors. CONCLUSION: A combination of clinical factors, such as symptoms, patients' general status, weight loss, and comorbidities, leads to a relevant stage of clinical severity that can be associated with the TNM stage as predictors of survival in oropharyngeal carcinoma.
Subject(s)
Carcinoma, Squamous Cell/drug therapy , Carcinoma, Squamous Cell/radiotherapy , Oropharyngeal Neoplasms/drug therapy , Oropharyngeal Neoplasms/radiotherapy , Adult , Aged , Aged, 80 and over , Carcinoma, Squamous Cell/mortality , Carcinoma, Squamous Cell/pathology , Chemotherapy, Adjuvant , Combined Modality Therapy , Disease-Free Survival , Female , Humans , Male , Middle Aged , Neoplasm Staging , Oropharyngeal Neoplasms/mortality , Oropharyngeal Neoplasms/pathology , Prognosis , Radiotherapy Dosage , Retrospective Studies , Tongue Neoplasms/drug therapy , Tongue Neoplasms/mortality , Tongue Neoplasms/pathology , Tongue Neoplasms/radiotherapy , Tonsillar Neoplasms/drug therapy , Tonsillar Neoplasms/mortality , Tonsillar Neoplasms/pathology , Tonsillar Neoplasms/radiotherapyABSTRACT
É apresentado relato de quatro pacientes tratados com oxigenação hiperbárica: dois pacientes pós-TRI em cabeça e pescoço que desenvolveram ORN e foram tratados com OH e outros dois pacientes, previamente irradiados, necessitando de procedimentos cirúrgicos (exodontias), que foram tratados com OH profilaticamente
Subject(s)
Hyperbaric Oxygenation , Mouth , Mouth Mucosa , Osteoradionecrosis , Radiotherapy , Surgery, Oral , Tooth Extraction , TrismusABSTRACT
Realizado um levantamento de todos os pacientes com diagnóstico de mixoma odontogênicos tratados em duas instituiçöes: Hospital Erasto Gaertner (HEG), Curitiba, PR e Universidade Estadual de Säo Paulo. Foi revisado a idade, sexo, raça, topografia, sensibilidade, freqüência e tratamento desta neoplasia benigna na regiäo bucomaxilofacial
Subject(s)
Bone Transplantation , Maxilla , MyxomaABSTRACT
Devido à importância do câncer de boca na regiäo de Curitiba, correspondendo ao sexto tumor de maior freqüência nos homens e oitavo nas mulheres, associado ao fato de que 60 por cento de todos os casos säo diagnosticados em estágios avançacos, foi criado o Centro de Diagnóstico de Lesöes Bucais - CDLB pela Secretaria Municipal da Saúde (SMS) de Curitiba. Este estudo apresenta os resultados iniciais das atividades deste centro
Subject(s)
Mouth , Mouth Neoplasms , Wounds and InjuriesABSTRACT
Foi revisada a experiência multi-institucional dos autores nessa doença rara, enfatizando seu tratamento e resultado
