What haematopoietic stem cell transplant patients think about health and oral care: A qualitative study in a Brazilian health service.

Differences in the perceptions of treatment between healthcare team and patients should be identified, aiming to provide a more humanised health care. We sought to understand and evaluate the concepts regarding oral health and dental care among haematopoietic stem cell transplant patients. Individual semi-structured interviews were conducted with patients, from both sexes, in the post-haematopoietic stem cell transplant stage, who underwent dental treatment. All interviews were recorded and transcribed, respecting the spelling and syntax used by the interviewees. A thematic content analysis was performed, and three themes were assessed: what is oral health, why was pre-transplant dental treatment performed, and what was the relevance of dental treatment for the haematopoietic stem cell transplant. Oral health was understood as the act of dental care through oral hygiene. The reason for performing prior dental treatment involves strict guidelines for transplants, and when questioned as to the importance of the dental treatment for transplants, the interviewed subjects' statements focused on the prevention of infections during the low-immunity stage. The individuals saw dental treatment as a step towards a successful transplant; their main concerns were not to re-establish their oral health, but rather to end the dental treatment as quickly as possible.

Criteria for indication of breast reconstruction.

Breast reconstruction has been affirmed as part of the treatment for locally advanced breast tumor, and the development of new techniques has been providing better results and widening surgical indications. The objective of this work was to establish and discuss the different criteria that are related to this indication, mainly in what refers to the timing for the procedure. Oncological, clinical and psychological aspects are evaluated according to experience accumulated in recent years, with immediate and delayed reconstruction, carried out in the most diverse specialized centers. The authors conclude that, in reference to the safety and benefits of immediate reconstruction, it would be indicated for any patient who wants it and presents favorable clinical and psychological conditions, without having any absolute contraindication from the oncological point of view.