Profile and speech-language rehabilitation of patients with laryngeal cancer. / Perfil e reabilitação fonoaudiológica de pacientes com câncer de laringe.

PURPOSE: to describe the clinical and sociodemographic profile and analyze the voice rehabilitation outcomes of patients with laryngeal cancer. METHODS: cross-sectional study with 204 individuals with laryngeal cancer treated between 1989 and 2015. The variables describing the patients' profile were presented in absolute values (n) and percentage (%). The association between the speech-language therapy outcome and the sociodemographic and clinical characterization variables was verified by means of uni- and multivariate techniques. RESULTS: 95.1% of the patients are male; 53.43% are aged 60 or more; 77.37% have elementary education; 44.12% are in the service industry; 81.63% smoke and consume alcohol; 30.4% are stage T3. Absence of nodules was found in 72.00%, and of metastasis, in 85.6% of patients. The most frequent therapeutic procedure was complete or partial laryngectomy (69.61%). There was an association among education, disease stage, habits, and therapeutic outcome with speech-language therapy (p<0.001). CONCLUSION: Several causes can affect the prognosis of vocal rehabilitation in patients with laryngeal cancer. Optimization and diversification of new therapeutic procedures are challenges for these patients' speech-language rehabilitation.

OBJETIVO: descrever o perfil clínico e sociodemográfico e o desfecho da reabilitação fonoaudiológica de pacientes com câncer de laringe. MÉTODO: estudo transversal com 204 pessoas atendidas entre 1989 e 2015. A associação entre desfecho da fonoterapia e variáveis de caracterização sociodemográfica e clínicas foi verificada por técnicas univariadas e multivariadas. RESULTADOS: prevalência do gênero masculino (95,10%), 60 anos ou mais (53,43%), ensino fundamental (77,37%), setor de serviços (44,12), tabagistas e etilistas (81,63%); estágio T3 (30,4%), ausência de nódulos (72,00%) e de metástase (85,6%). O procedimento terapêutico mais frequente foi a laringectomia total ou parcial (69,61%). Houve associação da escolaridade, estágio da doença, hábitos e procedimento terapêutico com desfecho da fonoterapia (p<0,001). CONCLUSÃO: fatores sociodemográficos e clínicos podem interferir no prognóstico da reabilitação vocal de pessoas com câncer de laringe. A otimização e diversificação de novos procedimentos terapêuticos são desafios na reabilitação fonoaudiológica destas pessoas.

Polymorphisms in MTHFR, MTR, RFC1 and CßS genes involved in folate metabolism and thyroid cancer: a case-control study.

INTRODUCTION: Polymorphisms in genes coding enzymes involved in folate metabolism may cause alterations in this metabolic pathway and contribute to carcinogenesis, because folate is essential for DNA synthesis, methylation and repair. The objective of this study was to investigate the association of MTHFR 677C>T (rs1801133), MTR 2756A>G (rs1805087), RFC1 80A>G (rs1051266) and CßS 844ins(68) (no rs#) polymorphisms and thyroid cancer development. The association of these polymorphisms with demographic risk factors and clinical histopathological parameters was also evaluated. MATERIAL AND METHODS: The study is a case-control analysis with a total of 462 individuals (151 patients and 311 controls). Polymerase chain reaction-restriction fragment length polymorphism technique was used for genotyping. The χ2 and multiple logistic regression were utilized for statistical analysis. RESULTS: The polymorphisms analysis revealed an association between the MTHFR 677C>T polymorphism (OR = 2.87, 95% CI: 1.50-5.48, p < 0.01, codominant model), (OR = 1.76, 95% CI: 1.18-2.64, p < 0.01, dominant model), (OR = 2.37, 95% CI: 1.28-4.39, p < 0.01, recessive model) and thyroid cancer. RFC1 80A>G polymorphism also was associated with thyroid cancer under recessive mode of inheritance (OR = 1.55; 95% CI: 1.02-2.38; p = 0.04); however, this polymorphism showed Hardy-Weinberg disequilibrium in the control group (χ2 = 24.71, p < 0.001). Furthermore, alcohol (OR = 1.56, 95% CI: 1.36-1.89, p < 0.01) and tobacco consumption (OR = 1.97, 95% CI: 1.28-3.04, p < 0.01) were associated with increased risk for thyroid cancer. The MTR 2756A>G polymorphism showed an association with tumor extent (OR = 2.69, 95% CI: 1.27-5.71, p < 0.01) and aggressiveness (OR = 4.51, 95% CI: 1.67-12.1, p < 0.01). CONCLUSIONS: MTHFR 677C>T is significantly associated with increased risk for thyroid cancer and MTR 2756A>G is associated with tumor extent and aggressiveness. In addition, alcohol and tobacco consumption were associated with increased risk of thyroid cancer. These results may contribute to a better prognosis for thyroid cancer.

Perfil e reabilitação fonoaudiológica de pacientes com câncer de laringe / Profile and speech-language rehabilitation of patients with laryngeal cancer

RESUMO Objetivo descrever o perfil clínico e sociodemográfico e o desfecho da reabilitação fonoaudiológica de pacientes com câncer de laringe. Método estudo transversal com 204 pessoas atendidas entre 1989 e 2015. A associação entre desfecho da fonoterapia e variáveis de caracterização sociodemográfica e clínicas foi verificada por técnicas univariadas e multivariadas. Resultados prevalência do gênero masculino (95,10%), 60 anos ou mais (53,43%), ensino fundamental (77,37%), setor de serviços (44,12), tabagistas e etilistas (81,63%); estágio T3 (30,4%), ausência de nódulos (72,00%) e de metástase (85,6%). O procedimento terapêutico mais frequente foi a laringectomia total ou parcial (69,61%). Houve associação da escolaridade, estágio da doença, hábitos e procedimento terapêutico com desfecho da fonoterapia (p<0,001). Conclusão fatores sociodemográficos e clínicos podem interferir no prognóstico da reabilitação vocal de pessoas com câncer de laringe. A otimização e diversificação de novos procedimentos terapêuticos são desafios na reabilitação fonoaudiológica destas pessoas.

ABSTRACT Purpose to describe the clinical and sociodemographic profile and analyze the voice rehabilitation outcomes of patients with laryngeal cancer. Methods cross-sectional study with 204 individuals with laryngeal cancer treated between 1989 and 2015. The variables describing the patients' profile were presented in absolute values (n) and percentage (%). The association between the speech-language therapy outcome and the sociodemographic and clinical characterization variables was verified by means of uni- and multivariate techniques. Results 95.1% of the patients are male; 53.43% are aged 60 or more; 77.37% have elementary education; 44.12% are in the service industry; 81.63% smoke and consume alcohol; 30.4% are stage T3. Absence of nodules was found in 72.00%, and of metastasis, in 85.6% of patients. The most frequent therapeutic procedure was complete or partial laryngectomy (69.61%). There was an association among education, disease stage, habits, and therapeutic outcome with speech-language therapy (p<0.001). Conclusion Several causes can affect the prognosis of vocal rehabilitation in patients with laryngeal cancer. Optimization and diversification of new therapeutic procedures are challenges for these patients' speech-language rehabilitation.

Head and neck cancer: causes, prevention and treatment.

UNLABELLED: Although head and neck carcinoma ranks fifth among cancer types, patient survival rates have not changed significantly over the past years. OBJECTIVE: To determine the risk factors, causes, therapies, and prevention measures for head and neck cancer. METHOD: Risk factors, causes, therapies, and preventive measures for this disease were searched on databases PUBMED, MEDLINE, and SCIELO. RESULTS: Alcohol and tobacco are still atop risk factors. Other factors may influence the development of head and neck carcinoma. Surgery is the main treatment option, and the addition of radiotherapy following surgery is frequent for patients in the early stages of the disease. Other therapies target specific genetic molecular components connected to tumor development. Disease preventive measures include smoking cessation, limiting alcohol intake, preventing exposure to tobacco smoke and environmental carcinogenic agents, early detection of infection by HPV, maintaining oral health, good eating habits, and managing stress. CONCLUSION: Additional research is needed for a more thorough understanding of the development of head and neck carcinomas and to shed light on new ways to improve therapeutic approaches and interventions.

Câncer de cabeça e pescoço: causas, prevenção e tratamento / Head and neck cancer: causes, prevention and treatment

Câncer de cabeça e pescoço é o quinto tipo de câncer mais comum e a taxa de sobrevivência não tem mudado nos últimos anos. OBJETIVO: Determinar os fatores de risco, causas, tratamento e prevenção do câncer de cabeça e pescoço. MÉTODO: Nós detalhamos os fatores de risco, causas, tratamento e prevenção da doença por meio de pesquisa nos bancos de dados PUBMED, MEDLINE e SciELO. RESULTADOS: Álcool e fumo ainda são os principais fatores de risco. Outros fatores podem influenciar o desenvolvimento do carcinoma de cabeça e pescoço. A opção de tratamento principal é terapia cirúrgica e sua utilização seguida por radioterapia é uma prática comum de tratamento em fases iniciais da doença. Existem terapias que visam agir em componentes moleculares genéticos específicos para o desenvolvimento do tumor. A cessação do cigarro, limitação de ingestão de álcool, evitar a exposição à fumaça do cigarro, a carcinogênicos ambientais, detecção precoce de infecção por HPV, manutenção da saúde bucal, bons hábitos alimentares e controle do stress podem ser medidas de prevenção da doença. CONCLUSÃO: Investigações adicionais são necessárias para completa compreensão do desenvolvimento do carcinoma de cabeça e pescoço e isso irá fornecer novos caminhos e melhora na intervenção e abordagens terapêuticas.

Although head and neck carcinoma ranks fifth among cancer types, patient survival rates have not changed significantly over the past years. OBJECTIVE: To determine the risk factors, causes, therapies, and prevention measures for head and neck cancer. METHOD: Risk factors, causes, therapies, and preventive measures for this disease were searched on databases PUBMED, MEDLINE, and SCIELO. RESULTS: Alcohol and tobacco are still atop risk factors. Other factors may influence the development of head and neck carcinoma. Surgery is the main treatment option, and the addition of radiotherapy following surgery is frequent for patients in the early stages of the disease. Other therapies target specific genetic molecular components connected to tumor development. Disease preventive measures include smoking cessation, limiting alcohol intake, preventing exposure to tobacco smoke and environmental carcinogenic agents, early detection of infection by HPV, maintaining oral health, good eating habits, and managing stress. CONCLUSION: Additional research is needed for a more thorough understanding of the development of head and neck carcinomas and to shed light on new ways to improve therapeutic approaches and interventions.

Study of the Nuclear Volume of Testicular Cells of Rats Receiving Ofloxacin Through Lactation / Estudio del Volumen Nuclear de Células Testiculares de Ratas que Recibieron Ofloxacin Durante la Lactancia

Ofloxacin presents an ample spectrum of antimicrobial action, including combating Mycobacterium leprae, and is currently employed as a substitute when the use of rifampicin is impossible. The objective of this work was to study alterations in testicular cell nuclei of suckling rats, whose dams were submitted to oral application of ofloxacin, and respective control groups. The method utilized was morphometry by the karyometric technique. The main structures observed in histological preparations of the testicles were interstitial cells, spermatogonias, and sustentacular cells. 10 Wistar rats were utilized, four treated and five controls, in the period of the first 25 days of life, whose dams received ofloxacin 12 mg/ Kg of body weight / day orally, before being killed on the 25th day after birth. The karyometric study of interstitial cells and spermatogonias revealed that there were no changes in the form of their nuclei (p > 0.05). Since sustentacular cell nuclei presented increased major diameter, minor diameter, mean geometric diameter, volume, area, volume/area ratio and perimeter, as well as an augmented and statistically different eccentricity (p < 0.05) in suckling pups whose dams were administered ofloxacin, the nuclei presented larger size and more elongated form. It was concluded that the sustentacular cells were more sensitive to the ofloxacin effect at the administered dose.

El ofloxacin presenta un amplio espectro de acción antimicrobiana, incluyendo el combate a.Mycobacterium leprae, y es frecuentemente empleado como un sustituto cuando el uso de la rifampicina es imposible. El objetivo del trabajo fue estudiar las alteraciones en el núcleo de las células testiculares en ratas que se encontraban amamantando y que fueron sometidas a la aplicación oral de ofloxacin. El método utilizado fue la técnica morfométrica de la cariometría. Las principales estructuras observadas en las preparaciones histológicas fueron las células intersticiales, espermatogenias y células sustentaculares. Se utilizaron 10 ratas Wistar, cinco fueron el grupo control y cinco sometidas al tratamiento, cuyas madres recibieron ofloxacin en dosis oral diaria de 12 mg/Kg de peso corporal los primeros 25 días de vida, para luego ser sacrificadas al día 25 después del nacimiento. El estudio cariométrico de las células intersticiales y de la espermatogénesis revelaron que no hubo cambios en la forma de sus núcleos (p > 0,05). Las células sustentaculares presentaron un incremento en su diámetro mayor, diámetro menor, diámetro geométrico promedio, volumen, área, razón volumen/área y perímetro, también hubo aumento con una diferencia de la excentricidad estadísticamente significativa (p < 0,05) en las crías amamantadas, a las cuales se les administró ofloxacin. Los núcleos presentaron un gran tamaño y una forma más alargada. Esto concluye que las células sustentaculares son más sensibles al efecto de la administración de ofloxacin.

Value of Morphometry in the Prognosis of Laryngeal Neoplasms / Valores de Morfometría en el Pronóstico de Neoplasmas Laríngeos

Laryngeal neoplasms represent 2% of all human cancers. They befall mainly the male sex, especially between 50 and 70 years of age, but exceptionally may occur in infancy or extreme old age. Their occurrence has increased considerably inclusively due to progressive population again. The present work aims at establishing a relation between this infirmity and its prognosis in patients submitted to the treatment recommended by Departament of Otolaryngology and Head Neck Surgery of the School of Medicine of São José do Rio Preto. To this effect, by means of karyometric optical microscopy, cell nuclei in the glottic region of 20 individuals, divided into groups according to their tumor stage and time of survival, were evaluated. Following comparation with a control group and statistical analsis, it became possible to verify that the lesser diameter of nuclei is of prognostic value for initial tumors in this region.

Los neoplasmas laríngeos representan el 2% de todos los cánceres humanos. Ellos ocurren principalmente en el sexo masculino, especialmente entre los 50 y 70 años de edad, pero excepcionalmente pueden producirse en la infancia o en la ancianidad. Esta ocurrencia se ha incrementado considerablemente haciéndose progresiva en la población. El presente trabajo tiene como objetivo establecer una relación entre esta enfermedad y su pronóstico, en pacientes sometidos al tratamiento recomendado por el Departamento de Otorrinolaringología y Cirugía de Cabeza y Cuello de la Escuela de Medicina de São José do Rio Preto, Brasil. Para estos efectos, fueron evaluados, por mediciones cariométricas de microscopía óptica, núcleos celulares, en la región glótica de 20 individuos, divididos en grupos de acuerdo al estado del tumor y tiempo de sobrevida. Se establecieron comparaciones con un grupo control y se efectuaron análisis estadísticos, verficándose que el menor diámetro de los núcleos es de valor pronóstico para tumores iniciales en esta región.

Protocolo de abordagem terapêutica para mucosite radioinduzida / A protocol for therapeutic approach on radiation-induced mucosite

Entre as condutas terapêuticas para o tratamento de neoplasias de cabeça e pescoço destaca-se a radioterapia. Entretanto, por causar toxicidade aos tecidos normais adjacentes à neoplasia, leva ao aparecimento de vários efeitos colaterais, incluindo a mucosite.Neste trabalho apresentamos um protocolo para a prevenção e controle da mucosite radioinduzida empregado no Serviço de Cirurgia Bucomaxilofacial do Hospital de Base de São José do Rio Preto-SP

Proptose: diagnóstico diferencial / Proptosis: differential diagnostic

Os autores relatam quatro casos de proptose ocorridos na disciplina de Otorrinolaringologia e serviços de Cirurgia de Cabeça e Pescoço e Fonoaudiologia da Faculdade de Medicina de São José do Rio Preto - SP, no período de janeiro de 1994 a setembro de 1995, dando ênfase à investigação diagnóstica. A proptose é um sinal clínico não freqüente em nossa clínica, porém que implica em patologias que devem ser investigadas com rapidez, devido à possibilidade de neoplasia e comprometimento de estruturas nobres

Tumores do espaço parafaríngeo: diagnóstico, prognóstico e tratamento / Parapharyngeal space tumors: diagnostic, prognostic and treatment

Os tumores do espaço parafaríngeo sao raros, sendo os quatro maiores tumores primários as massas do lóbulo profundo da parótida, lesoes de glândulas salivares menores, neuromas e tumores glômicos. O espaço parafaríngeo é virtual, em forma de pirâmide invertida, com seu assoalho na base do crânio e seu ápice no corpo maior do osso hióide. Os exames complementares mais importantes sao: punçao aspirática, tomografia computadorizada, ressonância magnética e arteriografia. Sao apresentados 9 casos típicos.

Carcinoma adenóide-cístico da laringe: diagnóstico, prognóstico e tratamento / Laryngeal adenoid cistic carcinoma: diagnosis, prognosis and treatment

Carcinoma adenóide-cístico da laringe é uma patologia rara, com origem em glândulas salivares menores, cujo diagnóstico geralmente é tardio e as metástases distantes säo frequentes. O tratamento é cirúrgico, com radioterapia complementar. O prognóstico é reservado, ocorrendo as recorrências locais ou metástases distantes, precoces ou tardiamente.