Actinomycosis in the maxilla of a young asymptomatic patient: unusual case report / Actinomicose em maxila de um paciente jovem assintomático: relato de caso incomum

ABSTRACT The aim of this study is to report an unusual case of actinomycosis in the maxilla region of an asymptomatic patient. A 21-year-old white man was referred for the analysis of panoramic radiography and cone beam computed tomography, where it was observed the presence of a hypodense lesion on the left side of the maxilla, which extended from the maxillary left central incisor to the region of the maxillary left second premolar. During intraoral examination, a depression was observed in the hard palate mucosa, as well as a fistula in the alveolar mucosa close to maxillary left central incisor, which had pulp vitality confirmed by thermal tests. A fistulography was performed, with periapical radiography, where it was found that the fistulous path did not originate from the tooth mentioned above. An incisional biopsy was performed for diagnostic purposes. However, given the inconclusive microscopic findings, four months later, a new biopsy was performed. The histopathological examination revealed the presence of a colony of microoganisms with filamentous pattern of radiated rosette, surrounded by polymorphonuclear inflammatory cells. Based on the morphological characteristics, the diagnosis of actinomycosis was established. The treatment was based on antibiotic therapy. Six months after treatment of the infection, no signs of recurrence were observed, and the patient remains in follow-up. Actinomycosis in the maxilla is an uncommon infection with a predilection for males between the ages of 20 and 60, whose treatment is antibiotic therapy associated or not with surgical excision.

RESUMO O objetivo deste estudo é relatar um caso incomum de actinomicose em região de maxila de um paciente assintomático. Um homem de 21 anos, branco, foi encaminhado para análise de radiografia panorâmica e tomografia computadorizada de feixe cônico, onde foi observada a presença de lesão hipodensa do lado esquerdo da maxila, que se estendia da região do incisivo central superior esquerdo ao segundo pré-molar superior esquerdo. Ao exame intrabucal, observou-se depressão na mucosa do palato duro, bem como fístula na mucosa alveolar próxima ao incisivo central superior esquerdo, no qual tinha vitalidade pulpar confirmada pelos testes térmicos. Uma fistulografia com radiografia periapical foi realizada, onde foi observado que o trajeto fistuloso não era originado do dente mencionado anteriormente. Foi realizada biópsia incisional para fins diagnósticos. Porém, diante dos achados microscópicos inconclusivos, quatro meses depois, uma nova biópsia foi realizada. O exame histopatológico revelou a presença de colônia de microrganismos com padrão filamentoso de roseta irradiada, circundado por células inflamatórias polimorfonucleares. Com base nas características morfológicas, foi estabelecido o diagnóstico de actinomicose. O tratamento foi baseado em antibioticoterapia. Seis meses após o tratamento da infecção, não foram observados sinais de recidiva e o paciente permanece em acompanhamento. A actinomicose da maxila é uma infecção incomum, com predileção por pacientes do sexo masculino com idade entre 20 e 60 anos, cujo tratamento é antibioticoterapia associada ou não à excisão cirúrgica.

Treatment of recurrent herpes of the lower lip skin region with photodynamic therapy and photobiomodulation: case report.

The aim of the present study is to describe a case report on the treatment of recurrent herpes using Photodynamic therapy (PDT) and Photobiomodulation as the treatments of choice. A 21-year-old white man checked in in the clinic for evaluation of vesicles arranged in the lower lip skin region. The clinical diagnosis was recurrent herpes and, for treatment, PDT was chosen, using 0.1% methylene blue as a photosensitizer and a pre-irradiation time of five minutes. The Therapy XT laser was used, with a wavelength of 660 nm, power of 100 mW, in a spot area of 0.028 cm², using 4 J energy per point, having been applied on 4 points, one in the center of the lesion and three on its laterals, so that it involved the entire extension of the lesion, totaling 16 J. After 24 hours after the application of the PDT, the patient returned for photobiomodulation with a low-power laser with a wavelength of 660 nm, power of 100 mW, using energy of 1 J per point, for 10 s, being applied on 4 points, totaling 4 J. It was possible to observe complete healing after 10 days of treatment, and the patient remains in follow-up for eight months without any recurrences.

Pleomorphic adenoma of buccal mucosa: a case report and review of the literature.

BACKGROUND: Salivary gland neoplasms are rare, accounting for 3% to 5% of all head and neck tumors, and involvement of the minor salivary glands is uncommon. Pleomorphic adenoma (PA) is the most common benign neoplasm, which mainly affects the parotid gland. However, involvement of the cheek mucosa is very rare. OBJECTIVE: This study reports a case of PA in the cheek mucosa. In addition, the etiopathogenesis, clinical and morphological features and differential diagnoses of PA are discussed, emphasizing the importance of knowledge about the characteristics of this tumor for a correct diagnosis. CASE REPORT: A 50-year-old woman presented with a nodular lesion of endophytic growth in the left cheek mucosa. The lesion was small and well-delimited and had a normal mucosa color and intact surface. An excisional biopsy of the lesion was performed, and the diagnosis was PA. CONCLUSION: Although the occurrence of PA in the minor salivary glands of the cheek mucosa is uncommon, the early establishment of a correct diagnosis and initiation of appropriate treatment are important because they permit effective management of the condition and improvement in the prognosis of patients.

Prototyping for the treatment of late zygomatic-orbital fracture: A case report.

INTRODUCTION: Zygomatic-orbital complex fractures are the most common facial traumas that can result in severe esthetic and functional sequelae. Surgical correction of these fractures is a delicate approach and prototyping is an excellent tool to facilitate this procedure. PRESENTATION OF CASE: A 27-year-old man, a motorcycle accident victim, was hospitalized in the intensive care unit for 30days. After this period, facial fractures were treated surgically, leaving sequelae such as enophthalmos, dystopia and loss of projection of the zygomatic arch. A second intervention was planned after one year for reconstruction of the orbit with the help of prototyping. Better outcomes were achieved than in the first intervention. DISCUSSION: This report permits to compare the result of conventional surgery and the use of a prototype in the same patient. Noticeably better outcomes were achieved with the second approach. Prototyping made the surgical procedure more predictable and reduced operative time because of the possibility of using preshaped titanium plates. CONCLUSIONS: Prototyping was found to be an excellent option to overcome the deficiencies of the conventional technique, recovering the functional and esthetic characteristics of the patient's face and ensuring a markedly satisfactory outcome.

Prevenção primária de saúde em residencial do projeto "Minha Casa, Minha Vida": relato de experiência / Primary health prevention in residential of the project "My House, My Life": case studies / Prevención primaria de salud enresidencialdel proyecto "Mi Casa, Mi Vida": estudios de caso

Objetivo: relatar os cuidados de prevenção primária à saúde realizados pela equipe de Saúde da Família Veneza V com a implantação do Residencial Jardim Veneza. Método: estudo qualitativo visando à compreensão vivenciada pelos integrantes do projeto "Minha Casa, Minha Vida",através de relato de caso das atividades realizadas no Residencial pela Unidade Básica de Saúde Veneza V. Resultados:os primeiros meses de implantação foram marcados pela apresentação dos serviços de saúde da Equipe de Saúde da Família Veneza, cadastramento populacional, ações educativas com temas sobre higiene pessoal e ambiental, nutrição e saúde bucal. As visitas domiciliares foram sistematizadas com agendamento prévio, priorizando-se os cuidados domiciliares a pessoas acamadas e acidentadas. Conclusão: a efetivação de uma assistência primária em saúde que contemple os princípios e diretrizes do Sistema Único de Saúde deve ser fundamentada através do conhecimento da população específica.(AU)

Objective: reporting the health of primary preventive care performed by Family Health Team Venice V with the implementation of the Residential Jardim Veneza. Method: a qualitative study aimed at the understanding of the experience lived by members of the project "My House, My Life", through case report of activities carried out at the Residential for Basic Health Unit Veneza V. Results: the first months of implementation were marked by the presentation of health services of the Family Health Team Veneza, population registration, educational activities with themes about personal and environmental hygiene, nutrition and oral health. Home visits were systematized with prior appointment, giving priority to home care to bedridden and accident victims. Conclusion: the effectuation of a primary health care that addresses the principles and guidelines of the Unified Health System must be based through specific population knowledge.(AU)

Objetivo: presentar la atención de prevención primaria de la saludrealizada por el Equipo de Salud de la Familia Veneza V, con la implementación del Residencial Jardim Veneza. Método: un estudio cualitativo dirigido a la comprensión experimentada por los miembros de la "Mi Casa, Mi Vida" a través de informe de caso de las actividades llevadas a cabo enel Residencial por la Unidad Básica de Salud Veneza V. Resultados: los primeros meses de implementación fueron marcados por la presentación de servicios de salud del Equipo de Salud de la Familia Veneza, registro de población, actividades educativas con temas de higiene personal y ambiental, la nutrición y la salud oral. Las visitas domiciliarias se sistematizaron con cita previa, dando prioridad a la atención domiciliaria a las personas postradas en cama y a las víctimas de accidentes. Conclusión: la ejecución de una atención primaria a la salud que se ocupa de los principios y directrices del Sistema Único de Salud deberá ser basada por el conocimiento de la población específica.(AU)

Violência de Gênero Contra a Mulher: Perfil de Registros Periciais da Gerência Executiva de Medicina e Odontologia Legal (GEMOL) – João Pessoa/PB / Gender violence against women: Profile of forensic records in the ExecutiveCenter for Medical and Forensic Dentistry (GEMOL) - João Pessoa / PB

Objetivo: Traçar o perfil dos registros periciais envolvendomulheres vítimas de violência de gênero. Material e Método:Estudo quantitativo, documental, analítico, transversal paraa análise dos laudos realizados, durante o ano de 2009, naGerência de Medicina e Odontologia Legal (GEMOL) doInstituto de Polícia Científica (IPC) em João Pessoa – Paraíba.Resultados: A maioria das periciadas apresentou idade entre19 e 24 anos (21,7%) e eram economicamente inativas (“dolar” e estudantes) (39,4%). Houve predomínio de mulheressolteiras (55,9%) e agredidas em residências (38,4%). Assituações de violência foram perpetradas por companheirosdas vítimas (33,4%) e por indivíduos sem padrão íntimo(policiais, vizinhos e terceiros) (28,8%) com as agredidas. Apresença de lesões foi descrita frequentemente nos laudosexaminados (96,6%), resultantes de agressões nãoinstrumentalizadas (34,2%) principalmente em região decabeça e pescoço (42,5%), prevalecendo contusões dostipos equimose (37,1%) e escoriações (30,2%). Mediante asrespostas aos quesitos oficiais, verificou-se largapredominância de lesões classificadas sugestivamente comoleves (97,4%) de acordo com o Artigo 129 do Código PenalBrasileiro. Conclusão: Legitima-se que a violência de gênerocontextua-se relevante problemática contemporânea,frequente em adultas jovens com menor nível de escolaridadee sem ocupação funcional, agredidas em residências. Asmesmas apresentavam lesões corporais atingindo regiõescomo face, sendo necessária uma maior atenção por parte dos profissionais de saúde para o engajamento em atividadesvoltadas para políticas de prevenção e controle do fenômeno...

Objective: To outline the profile of forensic records involvingwomen victims of gender violence. Material and Methods:This was a quantitative, documental, analytical, crosssectionalstudy carried out to outline the profile of forensicrecords involving women victims of gender violence in 2009,registered at the Gerência de Medicina e Odontologia Legal(GEMOL) [Executive Center for Medical and ForensicDentistry] of the Scientific Police Institute (IPC), in João Pessoa,Paraíba. Results: Most of the examined individuals were aged19 to 24 years (21.7%), economically inactive (housewifeand students) (39.4%). There was a predominance of singlewomen (55.9%) attacked in their residences (38.4%). Theepisodes of violence were perpetrated by the victims’companions (33.4%) and by individuals with no closerelationship (police, neighbors and others) (28.8%). Thepresence of lesions was frequently described in the records(96.6%), and resulted from non-instrumentalized aggressions(34.2%) mainly in the head and neck area (42.5%), withpredominance of ecchymosis (37.1%) and abrasions(30.2%). The majority of lesions were classified suggestivelyas mild (97.4%) according to article no. 129 of the BrazilianPenal Code. Conclusions: Gender violence is considered tobe a contemporary issue affecting young female adults withlow education and without functional occupation.Aggressions were mostly held in their residences. Victimspresented with body injuries, particularly in the face,evidencing the need for attention on the part of healthprofessionals for their engagement in activities focused onpreventive and control measurements...