Peripheral T-cell non-Hodgkin lymphoma manifesting as a primary lesion on the lip: A rare case report.

Primary manifestations of extraganglion non-Hodgkin lymphoma (NHL) from T-cells in the oral cavity are rare and often difficult to diagnose. Herein, we describe a case of T-cell NHL with a primary lesion on the lip diagnosed with a 25-year-old woman. The patient reported the appearance of the initial lesion on the upper lip, which advanced to the hard palate and oral mucosa. Histological examination and immunohistochemistry were compatible with peripheral T-cell NHL without further specifications. The proposed treatment consisted of six cycles of multiagent chemotherapy. The patient died from complications of the disease before the third cycle of chemotherapy. Understanding the clinical signs of lymphoma is important for the early diagnosis of this disease to avoid aggressive and potentially fatal behavior.

Conhecimentos, atitudes e práticas de pessoas com doença de parkinson sobre um programa terapêutico domiciliar com orientação em grupo / Knowledge, attitudes and practices of people with parkinson's disease about a home-based therapeutic program with group guidance

Introdução: Exercícios domiciliares são uma opção terapêutica acessível para pacientes com doença de Parkinson que apresentam dificuldade de locomoção. Serviços de fisioterapia utilizam palestras e manuais como forma de orientar a prática destes exercícios, mas carecem de avaliar o que está de fato sendo compreendido pelo paciente. Objetivo: Investigar conhecimentos, atitudes e práticas de pessoas com doença de Parkinson sobre um programa de exercícios terapêuticos domiciliares autossupervisionados com orientação em grupo. Métodos: Trata-se de um estudo transversal realizado com pessoas com doença de Parkinson idiopática leve e moderada, em um Programa de referência em um hospital universitário do nordeste do Brasil. Palestras e manual são disponibilizados pelo Programa desde 2012. Foram coletados: dados sociodemográficos, da doença, assistência e hábitos (ficha geral); conhecimentos, atitudes e práticas sobre exercícios fisioterapêuticos do manual (Inquérito Conhecimentos, Atitudes e Práticas) e barreiras associadas à prática (questionário estruturado). Utilizou-se o software BioEstat 5.0 para estatística descritiva e testes de associação, p ≤ 0,05. Resultados: Foram avaliados 28 pacientes (63 ± 7,4 anos) com tempo de diagnóstico médio de 4,5 (± 2,1) anos e maior prevalência do estágio HY 2 (71,4%). A maioria frequentava o Programa há pelo menos 1 ano (85,7%), era sedentária (60,7%) e relatava como principais entraves para a realização de sessões de fisioterapia a dificuldade financeira (92,8%) e de locomoção (53,6%). A adesão às palestras de fisioterapia foi de 60,7%. A maioria apresentou conhecimentos (60,7%) e atitudes (96,4%) adequados, entretanto, práticas inadequadas (53,6%) acerca dos exercícios terapêuticos domiciliares autossupervisionados orientados em grupo. Conclusão: Programa autossupervisionado requer maior disciplina dos pacientes e apenas orientar em grupo e distribuir manual podem não ser suficientes. Estratégias de acompanhamento semanal para motivação e suporte às dúvidas podem ser necessárias. (AU)

Introduction: Home-based exercises are an accessible therapeutic option for patients with Parkinson's disease who have locomotion difficulty. Physiotherapy services use lectures and manuals as a way of guiding the practice of these exercises, but they lack to evaluate what is in fact being understood by the patient. Purpose: To investigate knowledge, attitudes and practices of people with Parkinson's disease about a self-supervised home exercise program with a guidance group. Methods: This is a cross-sectional study carried out with people with mild and moderate idiopathic Parkinson's disease, in a reference program at a university hospital in northeastern Brazil. Lectures and manuals have been made available by the Program since 2012. Sociodemographic, disease, assistance and habits data were collected (general file); knowledge, attitudes and practices about physical therapy exercises in the manual (Knowledge, Attitudes and Practices Survey) and barriers associated with practice (structured questionnaire). BioEstat 5.0 software was used for descriptive statistics and association tests, p ≤ 0.05. Results: We evaluated 28 patients (63 ± 7.4 years) with an average diagnosis time of 4.5 (± 2.1) years and a higher prevalence of the HY 2 stage (71.4%). Most of them attended the Program for at least one year (85.7%), were sedentary (60.7%) and reported financial (92.8%) and locomotion (53.6%) difficulties as the main obstacles to physical therapy sessions. Adherence to physiotherapy lectures was 60.7%. The majority presented adequate knowledge (60.7%) and attitudes (96.4%), however, inadequate practices (53.6%) about a home therapy program with a group guidance. Conclusion: Self-supervised program requires greater discipline of the patients and only guiding in a group and distributing a manual may not be enough. Weekly follow-up strategies for motivation and support for questions may be needed. (AU)

Factors associated with the utilization of dental health services by the pediatric population: an integrative review. / Fatores associados à utilização dos serviços de saúde bucal pela população pediátrica: uma revisão integrativa.

This integrative literature review aimed to analyze studies about factors associated with the utilization of dental health services by the pediatric population between zero and 15 years old, published between 2006 and 2016 and available in Portuguese, English or Spanish. A survey of articles in the Lilacs and Medline databases was carried out, using the search strategy: ("dental care/utilization" OR "dental health services/utilization") AND ("child" OR "child, preschool") AND NOT adult. To analyze the methodological quality, the adapted Critical Appraisal Skill Programme (CASP) and the Agency for Healthcare and Research and Quality (AHRQ) were used. The following predictors of use of dental health services stood out: factors associated with children or adolescents (age, frequency of tooth brushing, chronic conditions), caregivers (schooling, perception of child's dental health, perceived oral health needs), dentists (availability at night and on the weekends) and follow up of oral health by the family health team. These are inherent factors for the planning of oral health policies or programs for the pediatric population. However, these factors vary according to the context, and therefore, a contextual analysis should be conducted.

O objetivo desta revisão integrativa da literatura foi analisar estudos publicados entre 2006-2016, disponibilizados em português, inglês ou espanhol, sobre fatores associados à utilização dos serviços de saúde bucal pela população pediátrica entre 0 e 15 anos. Foi realizado um levantamento nas bases de dados Lilacs e Medline, utilizando a estratégia de busca: ("dental care/utilization" OR "dental health services/utilization") AND (child OR "child, preschool") AND NOT adult. Para análise da qualidade metodológica, utilizou-se o Critical Appraisal Skill Programme (CASP) adaptado e o Agency for Healthcare and Research and Quality (AHRQ). Destacam-se como preditores do uso: fatores da criança ou adolescente (idade, frequência de escovação, condições crônicas), do cuidador (escolaridade, percepção da saúde bucal do filho, necessidades bucais referidas), do dentista (disponibilidade à noite e nos finais de semana) e o acompanhamento da saúde bucal pela equipe de saúde da família. Estes fatores são inerentes ao planejamento de políticas ou programas em saúde bucal na população pediátrica, entretanto, variam de acordo com o contexto em que se inserem. Portanto, uma análise contextual é necessária.

Fatores associados à utilização dos serviços de saúde bucal pela população pediátrica: uma revisão integrativa / Factors associated with the utilization of dental health services by the pediatric population: an integrative review

Resumo O objetivo desta revisão integrativa da literatura foi analisar estudos publicados entre 2006-2016, disponibilizados em português, inglês ou espanhol, sobre fatores associados à utilização dos serviços de saúde bucal pela população pediátrica entre 0 e 15 anos. Foi realizado um levantamento nas bases de dados Lilacs e Medline, utilizando a estratégia de busca: ("dental care/utilization" OR "dental health services/utilization") AND (child OR "child, preschool") AND NOT adult. Para análise da qualidade metodológica, utilizou-se o Critical Appraisal Skill Programme (CASP) adaptado e o Agency for Healthcare and Research and Quality (AHRQ). Destacam-se como preditores do uso: fatores da criança ou adolescente (idade, frequência de escovação, condições crônicas), do cuidador (escolaridade, percepção da saúde bucal do filho, necessidades bucais referidas), do dentista (disponibilidade à noite e nos finais de semana) e o acompanhamento da saúde bucal pela equipe de saúde da família. Estes fatores são inerentes ao planejamento de políticas ou programas em saúde bucal na população pediátrica, entretanto, variam de acordo com o contexto em que se inserem. Portanto, uma análise contextual é necessária.

Abstract This integrative literature review aimed to analyze studies about factors associated with the utilization of dental health services by the pediatric population between zero and 15 years old, published between 2006 and 2016 and available in Portuguese, English or Spanish. A survey of articles in the Lilacs and Medline databases was carried out, using the search strategy: ("dental care/utilization" OR "dental health services/utilization") AND ("child" OR "child, preschool") AND NOT adult. To analyze the methodological quality, the adapted Critical Appraisal Skill Programme (CASP) and the Agency for Healthcare and Research and Quality (AHRQ) were used. The following predictors of use of dental health services stood out: factors associated with children or adolescents (age, frequency of tooth brushing, chronic conditions), caregivers (schooling, perception of child's dental health, perceived oral health needs), dentists (availability at night and on the weekends) and follow up of oral health by the family health team. These are inherent factors for the planning of oral health policies or programs for the pediatric population. However, these factors vary according to the context, and therefore, a contextual analysis should be conducted.

Utilization of oral health services network among children and adolescents with leukemia.

AIM: To evaluate the use of the network of oral health services by children and adolescents with leukemia, according to the phase of cancer treatment, type of dental treatment received, and access barriers. METHODS AND RESULTS: An exploratory cross-sectional study carried out in a referral hospital in cancer in northeast of Brazil, with all children and adolescents (3-16 years old) with leukemia who used dental services and who attended the medical consultation in the outpatient clinic between March and August 2016. The analysis of the medical records and a structured interview with caregivers were performed. The majority who used only the specialized network were in a single phase of cancer treatment (49.1%), had oral mucositis treatment (79.2%), and had a time of displacement for oral health services greater than 40 minutes (92.6%). In addition, dental care was centered in the specialized network (76.8%) and during hospitalization (37.7%). CONCLUSIONS: The findings suggest that the oral health care of these individuals is centered on tertiary care, reflecting a deficiency in communication between the network services, as well as the nonrecognition of the basic network as a caregiver source by its users. Despite this, more research is needed.

Efficacy of imidazolquinoline on treatment of condyloma acuminatum of the buccal mucosa.

The condylomata acuminata is a benign epithelial neoplasm induced by papillomavirus, and it is characterized by the proliferation of stratified squamous epithelial tissue that affects the anogenital and oral mucosa. It is considered to be a sexually transmitted disease and has a higher prevalence in individuals infected with human immunodeficiency virus. Various therapies have been used for the removal of lesions, such as cryotherapy, surgical laser and surgical excision, which are painful and scarring. These techniques, however, do not eliminate the virus and relapses are common shortly after treatment. The use of immunomodulators has been proposed to be an alternative treatment, as imidazolquinoline has been shown to be effective in the treatment of lesions in the anogenital region. However, its use in the oral cavity has been the subject of few reports in the literature. Thus, the objective of this study is to describe a case of warts in the labial mucosa of an HIV positive patient using imidazolquinoline 5%.