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2.
Dentomaxillofac Radiol ; 49(3): 20190275, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31714151

RESUMO

OBJECTIVES: In paediatric cancer survivors treated with chemotherapy and radiotherapy therapy, late effects on dental development are quite common. Oral radiologists are not familiar with the radiographic images of these specific dental consequences of chemotherapy and radiotherapy. With the goal of educating colleagues, to raise awareness of the needs of survivors, and to identify directions for future research, we present dental radiographs of survivors treated for head and neck rhabdomyosarcoma with chemotherapy and radiotherapy. Also, based on the survivors reviewed, a radiographic inventory of commonly found late dental developmental effects seen in conjunction with treatment is presented. METHODS: Panoramic radiographic findings of five illustrative cases are presented, from a group of 42 survivors of head and neck rhabdomyosarcoma treated at the Academic Medical Center Amsterdam, The Netherlands over the past 25 years. RESULTS: Five cases showing dental developmental disorders are presented. These cases show an association of the location of the radiation field and the developmental stage of the teeth with the severity of the effect on dental development. We also report an inventory of severe and moderate effects of chemotherapy and radiotherapy on the development of molars and anterior teeth. CONCLUSIONS: This paper presents five cases and a radiographic inventory to illustrate disturbances of dental development associated with chemotherapy and radiotherapy in children. Medical and dental professionals involved in the treatment of cancer survivors are relatively unaware of the dental consequences of radiation therapy and the age dependency of specific regional effects. These effects can be severe, with great impact on quality of life. Further research in this area could help improve planning of radiation therapy for children, potentially preventing or limiting dental or maxillofacial sequelae.


Assuntos
Neoplasias de Cabeça e Pescoço , Odontogênese , Odontopatias , Criança , Neoplasias de Cabeça e Pescoço/complicações , Humanos , Qualidade de Vida , Sobreviventes , Odontopatias/etiologia
3.
Clin Oral Investig ; 24(1): 455-463, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31111283

RESUMO

OBJECTIVES: The study aimed to investigate the timeline association with specific dental therapy and osteoradionecrosis (ORN) in oral cancer patients. MATERIALS AND METHODS: A total of 7394 oral cancer patients, including 198 ORN subjects, were retrieved from a Longitudinal Health Insurance Database for Catastrophic Illness Patients of Taiwan and were analyzed with the Cox proportional hazard regression to compare the ORN risk of individual dental treatments under different dental treatments. RESULTS: The initial dental treatment time significantly impacted on the risk of ORN in oral cancer patients (P<0.05). Pre-radiotherapy endodontic treatment and post-radiotherapy scaling or subgingival curettage increased ORN prevalence (hazard ratio [HR], 2.28 and 1.77, respectively). Endodontic treatment within 2 weeks to 1 month prior to radiotherapy increased the ORN risk by 5.83-fold. Dental scaling or subgingival curettage initialized from three to 6 months post-radiotherapy raised the ORN prevalence by 2.2-fold. Exodontia initialized within 2 weeks before radiotherapy (HR=1.49) or 1 to 3 months after radiotherapy (HR=2.63) greatly increased ORN prevalence. To perform oral surgery from 3 months pre-radiotherapy to 6 months after radiotherapy increased the 1.85-fold ORN risk. The chemotherapy combined oral surgery increased the ORN prevalence by 2.55-fold. CONCLUSIONS: Timing of dental treatment, including pre-radiotherapy endodontic treatment, post-radiotherapy scaling or subgingival curettage, and oral surgery or exodontia before and after radiotherapy, could closely relate to ORN development in oral cancer patients. CLINICAL RELEVANCE: Choosing right time to perform appropriate dental treatment could effectively reduce oral infection and ORN risk.


Assuntos
Neoplasias de Cabeça e Pescoço , Osteorradionecrose , Estudos de Coortes , Assistência Odontológica , Feminino , Neoplasias de Cabeça e Pescoço/complicações , Humanos , Masculino , Osteorradionecrose/complicações , Osteorradionecrose/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Taiwan/epidemiologia
4.
Support Care Cancer ; 28(1): 341-349, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31044309

RESUMO

PURPOSE: This study analysed nutritional parameters (baseline body mass index (BMI), weight changes and enteral nutrition (EN) use, and their association with hospital admissions during radiotherapy in patients with head and neck cancer (HNC)). METHODS: A retrospective review of patients diagnosed with HNC and treated with radiotherapy between October 2012 and April 2014 was conducted. Data on each subject's diagnosis, age, sex, chemotherapy, previous surgery, EN use, weight changes, and BMI were examined for their association with hospital admissions during treatment. RESULTS: Eighty-three patients were included, mean age (±standard deviation) = 61 (± 11 years). Thirty-four percent had self-reported weight loss at diagnosis, and mean BMI was 26.2 ± 5.3 kg/m2. Mean weight change during treatment was - 5.1 ± 6.2%. Ten patients used EN, with mean weight stabilisation during EN use (0.3 ± 5.1%). Higher presenting BMI, younger age, and definitive radiotherapy ± chemotherapy predicted greater weight loss (p < 0.05). Critical weight loss ≥ 5% was associated with a higher number of hospital admissions for nutrition reasons (n = 10) (p = 0.011) compared with those without critical weight loss (n = 2). EN use was associated with a higher number of nutrition-related admissions; however, it did not predict length of stay among those admitted. CONCLUSION: Critical weight loss during radiotherapy was associated with unplanned nutrition-related hospital admissions. Higher BMI was associated with greater weight loss during radiotherapy, whilst EN use assisted in weight preservation. Further research around patient selection for nutritional interventions aimed at preventing critical weight loss and unplanned hospital admissions is needed.


Assuntos
Nutrição Enteral/estatística & dados numéricos , Neoplasias de Cabeça e Pescoço/epidemiologia , Neoplasias de Cabeça e Pescoço/terapia , Estado Nutricional/fisiologia , Admissão do Paciente/estatística & dados numéricos , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Austrália/epidemiologia , Índice de Massa Corporal , Caquexia/epidemiologia , Caquexia/etiologia , Caquexia/terapia , Nutrição Enteral/efeitos adversos , Feminino , Neoplasias de Cabeça e Pescoço/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Radioterapia/efeitos adversos , Radioterapia/métodos , Radioterapia/estatística & dados numéricos , Estudos Retrospectivos , Perda de Peso/fisiologia
5.
Support Care Cancer ; 28(1): 9-11, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31701267

RESUMO

PURPOSE: To compare the effects of two stretching devices, the TheraBite® Jaw Motion Rehabilitation System™ and the Dynasplint Trismus System®, on maximal mouth opening in head and neck cancer patients. METHODS: Patients were randomly assigned to one of two exercise groups: the TheraBite® Jaw Motion Rehabilitation System™ group or the Dynasplint Trismus System® group. Patients performed stretching exercises for 3 months. During the three study visits, maximal mouth opening was measured and the patients completed questionnaires on mandibular function and quality of life. RESULTS: In our study population (n = 27), five patients did not start the exercise protocol, eight patients discontinued exercises, and two patients were lost to follow-up. No significant differences regarding the change in mouth opening between the two devices were found. Patients had an increase in MMO of 3.0 mm (IQR - 2.0; 4.0) using the TheraBite® Jaw Motion Rehabilitation System™ and 1.5 mm (IQR 1.0; 3.0) using the Dynasplint Trismus System®. Exercising with either stretching device was challenging for the patients due to the intensive exercise protocol, pain during the exercises, fitting problems with the stretching device, and overall deterioration of their medical condition. CONCLUSIONS: The effects of the two stretching devices did not differ significantly in our study population. The factors described, influencing the progression of stretching exercises, need to be taken into account when prescribing a similar stretching regimen for trismus in head and neck cancer patients. TRIAL REGISTRATION: NTR - Dutch Trial Register number: 5589.


Assuntos
Equipamentos e Provisões , Terapia por Exercício/instrumentação , Neoplasias de Cabeça e Pescoço/terapia , Exercícios de Alongamento Muscular/instrumentação , Trismo/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Desenho de Equipamento , Exercício/fisiologia , Terapia por Exercício/métodos , Feminino , Neoplasias de Cabeça e Pescoço/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Exercícios de Alongamento Muscular/métodos , Qualidade de Vida , Amplitude de Movimento Articular/fisiologia , Inquéritos e Questionários , Trismo/etiologia , Adulto Jovem
7.
Kathmandu Univ Med J (KUMJ) ; 17(65): 61-65, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31734681

RESUMO

Background Radiation-induced oral mucositis is one of the major ionizing radiation toxicities and normal tissue injuries resulting from radiotherapy. It occurs in up to 80% of head and neck cancer irradiated patients, reaching up to 100% in patients with altered fractionation. Objective To assess the grade of Radiation induced oral mucositis as per World Health Organization grading system among post-radiotherapy patients of Head and Neck cancer. Method World Health Organization grading for oral mucositis was done in patients reporting to Department of Radiation oncology for radiotherapy at BP Koirala Memorial Cancer Hospital, Bharatpur. A total of 71 patients in 1 month duration were included. Result Grade 2 mucositis was most common, 52.11% followed by grade 1 (22.5%), grade 3 (18.3%) and grade 4 (7.04%). There were no post-radiotherapy patients who presented without mucositis. Conclusion Radiation induced oral mucositis is a common adverse reaction of radiotherapy. With increase in dose and duration of radiotherapy, grade of mucositis was increasing.


Assuntos
Neoplasias de Cabeça e Pescoço/complicações , Radioterapia/efeitos adversos , Estomatite/diagnóstico , Idoso , Feminino , Neoplasias de Cabeça e Pescoço/radioterapia , Humanos , Masculino , Pessoa de Meia-Idade , Lesões por Radiação/diagnóstico , Lesões por Radiação/etiologia , Estomatite/etiologia , Organização Mundial da Saúde
9.
Ned Tijdschr Tandheelkd ; 126(10): 507-511, 2019 Oct.
Artigo em Holandês | MEDLINE | ID: mdl-31613279

RESUMO

A side effect of radiotherapy in the head and neck area is a reduction of the capillary blood flow and with it, a reduction in local defenses. Depending on the duration and intensity of the radiation, hypoxia, hypocellularity and hypovascularity, may occur, resulting in an increased risk of infection. Hyposalivation, a commonly occurring phenomenon after radiotherapy, leads to a higher caries sensitivity. To keep oral health at an acceptable level as much as possible, teeth are checked by a dentist prior to radiotherapy. Non-essential teeth and teeth with pathology are extracted, in order to prevent future problems. Dental treatment in the area treated with radiation will nevertheless sometimes be necessary after radiotherapy. Because the risk of infection is high and may result in the loss of part of the jaw, antibiotic prophylaxis is started prior to invasive treatment. In general, amoxicillin 500 mg 3dd 1 is chosen for 14 days. After treatment, wound healing should be checked by the specialist.


Assuntos
Antibacterianos/administração & dosagem , Antibioticoprofilaxia , Cárie Dentária/prevenção & controle , Neoplasias de Cabeça e Pescoço , Neoplasias de Cabeça e Pescoço/complicações , Neoplasias de Cabeça e Pescoço/radioterapia , Humanos , Xerostomia/etiologia
10.
Infez Med ; 27(3): 340-344, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31545781

RESUMO

Human autochthonous myiasis is uncommonly reported in Europe. This report describes a case of myiasis of a wound caused by Sarcophaga spp. Suffering from cutaneous lymphoma, the patient showed, at the level of his scalp lesions, the presence of larvae that were removed during curettage surgery; they were subsequently identified as belonging to the genus Sarcophaga. Preservation of these larvae in 10% formalin did not allow identification at the species level using molecular methods.


Assuntos
Neoplasias de Cabeça e Pescoço/complicações , Linfoma não Hodgkin/complicações , Miíase/parasitologia , Sarcofagídeos , Dermatoses do Couro Cabeludo/parasitologia , Neoplasias Cutâneas/complicações , Adulto , Animais , Evolução Fatal , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Linfoma não Hodgkin/patologia , Masculino , Miíase/patologia , Dermatoses do Couro Cabeludo/patologia , Neoplasias Cutâneas/patologia
11.
Mo Med ; 116(3): 198-200, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31527941

RESUMO

Initial clinical uses of hyperbaric oxygen (HBO2) capitalized upon physical effects to drive offending gases back into solution and deliver more oxygen to tissues in early treatments of decompression sickness. HBO2 has a myriad of other effects, including stimulating angiogenesis and new cellular in growth for healing.


Assuntos
Neoplasias de Cabeça e Pescoço/complicações , Neoplasias de Cabeça e Pescoço/radioterapia , Oxigenação Hiperbárica , Lesões por Radiação/terapia , Humanos
12.
Int J Pediatr Otorhinolaryngol ; 127: 109642, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31479918

RESUMO

OBJECTIVE: Currently no established criteria exist to guide use of ex utero intrapartum treatment (EXIT) for fetal neck mass management. This study aims to correlate prenatal radiographic findings with incidence of ex utero intrapartum treatment and necessity of airway intervention at delivery. METHODS: We reviewed our EXIT experience between 2012 and 17. Furthermore, we performed a literature review of articles reporting incidences of fetal neck masses considered for EXIT. Articles that were included (1) discussed prenatal radiographic findings such as size, features, and evidence of compression and (2) reported extractable data on delivery outcomes and airway status. RESULTS: Ten cases at our institution were reviewed. Another 137 cases across 81 studies met inclusion criteria. These studies showed aerodigestive tract compression to be significantly associated with neck masses undergoing EXIT. Additionally, there was significantly higher incidence of airway intervention in cases where polyhydramnios, anatomic compression, and solid masses were seen on prenatal diagnostic imaging, while mass location and size did not correlate with airway intervention. CONCLUSION: With this data, we propose that any neck mass with anatomic compression on fetal imaging in the 3rd trimester should be considered for EXIT. When radiographic findings do not show compression but do display polyhydramnios or a solid neck mass (regardless of polyhydramnios), an airway surgeon should be available for perinatal airway assistance.


Assuntos
Obstrução das Vias Respiratórias/cirurgia , Doenças Fetais/cirurgia , Neoplasias de Cabeça e Pescoço/cirurgia , Obstrução das Vias Respiratórias/diagnóstico por imagem , Obstrução das Vias Respiratórias/etiologia , Feminino , Doenças Fetais/diagnóstico por imagem , Doenças Fetais/etiologia , Neoplasias de Cabeça e Pescoço/complicações , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética , Período Periparto , Gravidez , Centros de Atenção Terciária , Ultrassonografia Pré-Natal
13.
In Vivo ; 33(5): 1645-1651, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31471418

RESUMO

BACKGROUND: Unfavorable changes in body composition are frequent among patients with head and neck cancer (HNC). Unfortunately, in daily clinical practice, there is a lack of reliable diagnostic tools for predicting changes in body composition in individuals following radiotherapy (RT). Among non-invasive tools, bioelectrical impedance analysis (BIA) seems to be most promising. One BIA parameter, the phase angle (PA), reflects condition of various body cells and their mass in detail. MATERIALS AND METHODS: Using BIA, the body composition was measured prior to and after RT in 52 male patients with HNC. PA derived from BIA prior to RT was tested as a predictor of body composition changes developing during RT. RESULTS: Patients with low PA had a greater than 9.3-fold higher chance of body mass index (BMI) reduction below 18.5 kg/m2 and over 5.9-fold and 4.2-fold higher chance of lean mass and fat mass reduction after therapy end compared with patients with a high PA value. PA values demonstrated significant diagnostic accuracy for detection of fat-free mass, lean mass and BMI reduction in the study group [area under the curve (AUC)=0.781, 0.774 and 0.786, respectively]. CONCLUSION: PA prior to RT is a useful marker for selection of individuals with HNC who are at a high risk of unfavorable changes in body composition.


Assuntos
Composição Corporal/efeitos da radiação , Neoplasias de Cabeça e Pescoço/radioterapia , Radioterapia/efeitos adversos , Adiposidade/efeitos da radiação , Adulto , Idoso , Idoso de 80 Anos ou mais , Área Sob a Curva , Impedância Elétrica , Neoplasias de Cabeça e Pescoço/complicações , Neoplasias de Cabeça e Pescoço/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Curva ROC , Radioterapia/métodos , Fatores de Risco , Fatores Sexuais
14.
Z Gastroenterol ; 57(8): 971-976, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31398768

RESUMO

BACKGROUND: Neopharyngeal obstruction after therapy of head and neck cancer is a frequent and clinically challenging problem without evidence-based guideline recommendations. CASE: We present two cases of complete esophageal obstruction after treatment for head and neck cancer. Due to complete obstruction of long distance stricture standard dilatation procedures were impossible to perform. In both cases, recanalization was achieved by combining an antegrade with a retrograde maneuver. In one patient endoscopic cutting with a papillotome was needed. CONCLUSION: Even in complex cases of post-therapeutic stenosis an endoscopic approach may offer a feasible alternative to surgical therapy, especially in the subset of frail patients.


Assuntos
Estenose Esofágica/terapia , Esofagoscopia/métodos , Neoplasias de Cabeça e Pescoço/complicações , Neoplasias de Cabeça e Pescoço/terapia , Idoso , Dilatação , Estenose Esofágica/etiologia , Feminino , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Resultado do Tratamento
15.
Biomed Res Int ; 2019: 2401743, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31380414

RESUMO

Objective: This study aimed to analyze the effects of comprehensive protection of bilateral parotid glands (PG-T), contralateral submandibular gland (cSMG), and accessory salivary glands in the oral cavity (OC) by helical tomotherapy for head-and-neck cancer patients. Methods: Totally 175 patients with histologically confirmed head-and-neck cancer treated with helical tomotherapy were recruited. The doses delivered to PG-T, cSMG, and OC were constrained to be as low as possible in treatment planning. The saliva flow rates and xerostomia questionnaire were evaluated. Correlation between xerostomia and other clinical factors were assessed using univariate and multivariate models. The impact of salivary gland dose on locoregional (LR) recurrence was assessed by Cox analysis. ROC curve was used to determine the threshold of mean dose for each gland. Results: The median follow-up was 25 (19-36) months. The OC mean dose, PG-T mean dose, cSMG mean dose, age, clinical stage (II and III versus IV), and both unstimulated and stimulated saliva flow rates were significantly correlated with xerostomia. The OC mean dose, cSMG mean dose, age, and clinical stage were predictors of xerostomia after adjusting PG-T mean dose, and unstimulated and stimulated saliva flow rates. Xerostomia was significantly decreased when the mean doses of PG-T, cSMG, and OC were kept below 29.12Gy, 29.29Gy, and 31.44Gy, respectively. At 18 months after radiation therapy, early LR recurrence rate was only 4%. Conclusion: Comprehensive protection of salivary glands minimized xerostomia in head-and-neck cancer patients treated by helical tomotherapy, without increasing early LR recurrence risk.


Assuntos
Neoplasias de Cabeça e Pescoço/radioterapia , Recidiva Local de Neoplasia/radioterapia , Glândulas Salivares/efeitos da radiação , Xerostomia/prevenção & controle , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Neoplasias de Cabeça e Pescoço/complicações , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/complicações , Recidiva Local de Neoplasia/patologia , Glândula Parótida/patologia , Glândula Parótida/efeitos da radiação , Dosagem Radioterapêutica , Radioterapia de Intensidade Modulada/efeitos adversos , Glândulas Salivares/patologia , Glândula Submandibular/patologia , Glândula Submandibular/efeitos da radiação , Xerostomia/complicações , Xerostomia/patologia , Adulto Jovem
16.
Rev Lat Am Enfermagem ; 27: e3168, 2019 Aug 19.
Artigo em Português, Inglês, Espanhol | MEDLINE | ID: mdl-31432921

RESUMO

OBJECTIVE: to identify the frequency of fatigue and domains affected in patients with head and neck cancer undergoing radiation therapy, at the beginning, middle and end of treatment. METHOD: longitudinal and prospective study of quasi-experimental design, involving 60 patients with head and neck cancer. It should be highlighted that this article will address only the data of the Control Group. The dependent variables were collected through interview, using the revised Piper Fatigue Scale, which is a multidimensional instrument that assesses global, behavioral, affective and sensory/psychological domains. Data analysis was based on absolute and relative frequencies. RESULTS: there was a predominance of males, age group between 41-60 years, low level of education and in regular use of alcohol and cigarettes. All domains in the fatigue scale had their scores increased, presenting median values of greater magnitude in Time 2 and Time 3, when compared to the Time 1 values, indicating an increase in fatigue levels during radiation therapy. CONCLUSION: fatigue increased in the course of the radiation therapy, having all domains affected. Therefore, its evaluation throughout the treatment is important, as fatigue is a common and debilitating symptom on cancer patients.


Assuntos
Carcinoma de Células Escamosas/radioterapia , Fadiga/etiologia , Neoplasias de Cabeça e Pescoço/radioterapia , Radioterapia/efeitos adversos , Adulto , Brasil , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/psicologia , Fadiga/psicologia , Feminino , Neoplasias de Cabeça e Pescoço/complicações , Neoplasias de Cabeça e Pescoço/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Escalas de Graduação Psiquiátrica , Qualidade de Vida , Radioterapia/psicologia , Fatores Socioeconômicos , Inquéritos e Questionários
17.
Acta Otolaryngol ; 139(10): 930-933, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31452413

RESUMO

Background: Head and neck paragangliomas are slowly growing benign tumors and they originate from specialized neural crest cells. Aims/objectives: This study aimed to express the safety of paraganglioma surgery regarding complications, treatment, and outcomes of patients with head and neck glomus tumors. Materials and methods: Medical records of patients who were operated because of head and neck paraganglioma between 2006 and 2016 were reviewed. Results: The study group consisted of 49 patients (M/F: 6/43). The patients were distributed as follows: 22 glomus caroticum (GC) (44.8%), 8 glomus jugulare (GJ) (16.3%), 10 glomus tympanicum (GT) (20.4%), 4 glomus vagale (GV) (8.1%), 2 GC + GV (4%), 2 bilateral GC (4%) and 1 thyroidal glomus tumor (2%). All GC and GV tumors were resected via cervical approach. Three of GJ tumors were resected through transmastoid approach while five of them were resected through both transmastoid and cervical approach. Nine GT tumors were resected via transmastoid approach. One patient received cyberknife. Thyroid paraganglioma was diagnosed incidentally after total thyroidectomy. Mean follow-up period was 61.92 ± 35.11 months (1-124 m). Conclusions and significance: The choice of treatment depends on the size, location and biologic activity of tumor as well as the physical condition of the patient. Our results show that glomus tumors can be resected with low mortality and morbidity rates due to developing imaging and microsurgical methods.


Assuntos
Tumor Glômico/diagnóstico , Tumor Glômico/cirurgia , Neoplasias de Cabeça e Pescoço/diagnóstico , Neoplasias de Cabeça e Pescoço/cirurgia , Adulto , Feminino , Tumor Glômico/complicações , Neoplasias de Cabeça e Pescoço/complicações , Humanos , Masculino , Microcirurgia , Pessoa de Meia-Idade , Estudos Retrospectivos , Avaliação de Sintomas , Resultado do Tratamento
18.
Rev Gaucha Enferm ; 40: e20180483, 2019 Aug 05.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31389479

RESUMO

OBJECTIVE: To recognize how educational technologies are not up-to-date and do not care about head and neck oncology. METHODS: Qualitative, exploratory-descriptive research. Held with 12 nurses, at a cancer reference center in the south of the country, in July/2017. Through a semi-structured interview and data analyzed by Minayo Thematic Analysis. RESULTS: Results of two categories: "The techniques of updating the nurse" and "The use of educational technologies in the nurses' daily life". In this context, a version of the present in the training of students stands out, since the data of secondary education are permanent, evidencing a small use of technological resources for this purpose. CONCLUSION: It is suggested to integrate the use of technologies with lifelong education in order to become popular in professional practice.


Assuntos
Educação Continuada em Enfermagem/métodos , Tecnologia Educacional , Neoplasias de Cabeça e Pescoço/enfermagem , Enfermagem Oncológica/educação , Ferimentos e Lesões/enfermagem , Adulto , Institutos de Câncer , Feminino , Neoplasias de Cabeça e Pescoço/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Ferimentos e Lesões/etiologia
19.
BMJ Case Rep ; 12(8)2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31439570

RESUMO

A constellation of newly diagnosed benign tumours and glioblastoma is an uncommon occurrence in a single individual. We present a case of a patient with a history of skin lipomas who presented with seizures and was found to have a left frontotemporal multifocal enhancing mass on MRI. Work-up for metastatic disease revealed a benign lung carcinoid tumour, a cervical schwannoma, adrenal masses, a growth hormone-secreting pituitary adenoma, and lastly a glioblastoma following brain biopsy.


Assuntos
Neoplasias Encefálicas/diagnóstico , Tumor Carcinoide/diagnóstico , Glioblastoma/diagnóstico , Adenoma Hipofisário Secretor de Hormônio do Crescimento/diagnóstico , Neoplasias de Cabeça e Pescoço/diagnóstico , Neoplasias Pulmonares/diagnóstico , Neoplasias Primárias Múltiplas/diagnóstico , Neurilemoma/diagnóstico , Idoso , Neoplasias Encefálicas/complicações , Neoplasias Encefálicas/diagnóstico por imagem , Tumor Carcinoide/complicações , Tumor Carcinoide/diagnóstico por imagem , Vértebras Cervicais , Evolução Fatal , Lobo Frontal , Glioblastoma/complicações , Glioblastoma/diagnóstico por imagem , Adenoma Hipofisário Secretor de Hormônio do Crescimento/complicações , Adenoma Hipofisário Secretor de Hormônio do Crescimento/diagnóstico por imagem , Neoplasias de Cabeça e Pescoço/complicações , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Humanos , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/diagnóstico por imagem , Imagem por Ressonância Magnética , Masculino , Neoplasias Primárias Múltiplas/complicações , Neoplasias Primárias Múltiplas/diagnóstico por imagem , Neurilemoma/complicações , Neurilemoma/diagnóstico por imagem , Convulsões/etiologia , Tomografia Computadorizada por Raios X
20.
Eur Arch Otorhinolaryngol ; 276(10): 2881-2886, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31289851

RESUMO

PURPOSE: It is aimed to present endovascular treatment of carotid blowout syndrome (CBS) in patients with head and neck cancer. METHODS: A retrospective review was performed on patients with carotid blowout syndrome between 2012 and 2018 in our hospital. A total of ten patients with prior history of head and neck cancer surgery and radiation therapy were investigated with clinical, postoperative and follow-up findings as well as technical outcome. Digital subtraction angiography of the carotid arteries was performed in all the cases for the diagnosis of the source of bleeding. Detachable coils and covered stents were used in endovascular treatment of carotid blowout syndrome. After the procedures, all patients were admitted to the intensive care unit for the follow-up of both hemodynamic and neurologic conditions. RESULTS: Thirteen diagnostic and endovascular treatment sessions were performed in 10 patients. Seven patients had major surgery for head and neck cancer and all patients were treated with chemoradiotherapy. Head and neck cancers in seven of the ten patients were persistent and pharyngocutaneous fistula developed in five patients. Two patients had impending CBS and eight patients had acute CBS. A total number of 19 vascular lesions in 10 patients were detected and 4 patients had multiple lesions. In three patients, additional endovascular treatment of stent-graft deployment had required due to recurrent hemorrhage after a mean time of 5.33 days (range 1-11 days). CONCLUSIONS: As a conclusion, covered stent application with or without coil embolization is a safe and efficient technique in treatment of CBS secondary to head and neck cancers.


Assuntos
Doenças das Artérias Carótidas , Procedimentos Endovasculares , Neoplasias de Cabeça e Pescoço , Angiografia Digital/métodos , Doenças das Artérias Carótidas/diagnóstico , Doenças das Artérias Carótidas/etiologia , Doenças das Artérias Carótidas/cirurgia , Procedimentos Endovasculares/efeitos adversos , Procedimentos Endovasculares/instrumentação , Procedimentos Endovasculares/métodos , Feminino , Neoplasias de Cabeça e Pescoço/complicações , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Ruptura Espontânea/diagnóstico , Ruptura Espontânea/etiologia , Ruptura Espontânea/cirurgia , Turquia
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