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1.
Rev. Odontol. Araçatuba (Impr.) ; 42(3): 21-24, set.-dez. 2021. ilus
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1284111

RESUMO

Introdução: os cistos radiculares são as lesões císticas mais comuns nos maxilares. Eles surgem dos Restos Epiteliais de Malassez, presos no ligamento periodontal e podem ser ativados por um processo inflamatório na região pulpar. Geralmente são descobertos em exames radiográficos de rotina, apresentando-se como uma imagem radiolúcida, bem delimitada, envolvendo o periápice de um ou mais dentes. Objetivo: apresentar o tratamento de um extenso cisto radicular, em região de maxila, com acompanhamento de 18 meses. Relato do caso: Paciente do sexo feminino, 49 anos, foi encaminhada para avaliação e tratamento na Clínica Odontológica da Faculdade Sete Lagoas (FACSETE), apresentando lesão extensa em região maxilar anterior direita ao exame radiográfico. Ao exame clínico, observou-se leve assimetria facial e ausência de sintomas dolorosos. Tomografia computadorizada, punção aspirativa e biópsia incisional foram utilizadas para se chegar ao diagnóstico compatível com cisto radicular. Optou-se por uma técnica conservadora, em que foi realizada a descompressão da lesão. Após 05 meses de tratamento, um novo procedimento cirúrgico foi realizado para enuclear o restante da patologia. Conclusão: a descompressão, com utilização de cânula, é um tratamento auxiliar fácil, conservador, eficaz e reduz a morbidade causada por diferentes cistos odontogênicos(AU)


Introduction: root cysts are the most common cystic lesions in the jaw. They arise from the Epithelial Remains of Malassez, trapped in the periodontal ligament and can be activated by an inflammatory process in the pulp region. They are usually discovered in routine radiographic examinations, presenting as a well-defined radiolucent image involving the periapex of one or more teeth. Objective: to present the treatment of an extensive root cyst, in the maxillary region, with a follow-up of 18 months. Case report: A 49-year-old female patient was referred for evaluation and treatment at the Dental Clinic of Faculdade Sete Lagoas (FACSETE), with an extensive lesion in the right anterior maxillary region on radiographic examination. On clinical examination, mild facial asymmetry and absence of painful symptoms were observed. Computed tomography, aspiration puncture and incisional biopsy were used to reach a diagnosis compatible with radicular cyst. We opted for a conservative technique, in which the lesion was decompressed. After 05 months of treatment, a new surgical procedure was performed to enucleate the rest of the pathology. Conclusion: decompression, using a cannula, is an easy, conservative, effective auxiliary treatment and reduces the morbidity caused by different odontogenic cysts.


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Cisto Radicular , Descompressão , Ligamento Periodontal , Cistos Odontogênicos , Cisto Radicular/cirurgia , Cisto Radicular/diagnóstico , Cisto Radicular/terapia , Cisto Radicular/diagnóstico por imagem
2.
Magy Onkol ; 65(3): 223-230, 2021 Oct 06.
Artigo em Húngaro | MEDLINE | ID: mdl-34614043

RESUMO

In an increasingly aging Western society, the treatment of the malignant diseases became the greatest challenge of medicine in the 21st century. Among these, pancreatic ductal adenocarcinoma (PDAC) is of particular interest which, in spite of modern oncology treatments, is a malignancy with an unfavorable prognosis. Underlying the poor survival rates, relatively late-stage recognition, limitations of surgical removal, and ineffective oncological treatments can be mentioned. Its importance is further enhanced by its growing incidence. As a consequence of these reasons, there is an increasing effort for the early detection of invasive tumors, the central part of which is the detection and clinical addressing of precancerous conditions in the pancreas. Of these, intraductal papillary mucinous neoplasia (IPMN) has a paramount importance. In this review, we present the latest evidence-based knowledge of the etiological factors, epidemiological features, pathomorphological manifestations, most up-to-date diagnosis and treatment of IPMN.


Assuntos
Neoplasias Pancreáticas , Humanos , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/terapia
3.
Magy Onkol ; 65(3): 250-256, 2021 Oct 06.
Artigo em Húngaro | MEDLINE | ID: mdl-34614046

RESUMO

This review provides an overview about the role of endoscopy in the care of patients suffering from pancreatic cancer. In the field of diagnostics the role of endoscopic ultrasound is highlighted in both solid and cystous pancreatic tumors. The decreasing diagnostic relevance of endoscopic retrograde cholangiopancreatography (ERCP) is also discussed. The issue of preoperative biliary drainage in case of obstruction is negotiated in detail, while palliative settings are appointed thoroughly. Besides conventional enteral stenting in case of gastric outlet syndrome caused by local spreading of pancreatic tumor, some new innovative endoscopic solutions are summarized. Several endoscopic ultrasound-guided antitumor interventions that are mainly in clinical trial phase are referred in the article. The diagnostics and treatment of pancreatic neuroendocrine tumors are discussed separately due to their different biological behavior. The review emphasizes the need for multidisciplinary approach of the patients suffering from malignant pancreatic tumors.


Assuntos
Endoscopia , Neoplasias Pancreáticas , Humanos , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/terapia
4.
Rev Bras Enferm ; 75(1): e20201093, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34614075

RESUMO

OBJECTIVE: to analyze the mobile apps on heart failure available in the main operating systems and their usability. METHODS: benchmarking of mobile applications, systematic research, comprising 38 mobile applications for analysis of general information, functionalities and usability. Usability was assessed using System Usability Scale and Smartphone Usability Questionnaire, followed by the calculation of the agreement index and the exact binomial distribution test, with a significance level of p> 0.05 and a proportion of 0.90. RESULTS: mobile applications had English as the predominant language (73.7%), were directed to patients (71.1%) and the predominant theme was disease knowledge (34.2%). Functionalities ranged from general features to the need for an internet connection. In assessing usability, heart failure was shown to be 92.1% -94.7% and p <0.05. FINAL CONSIDERATIONS: the mobile apps on heart failure have varied content and adequate usability. However, there is a need to develop more comprehensive mobile applications.


Assuntos
Insuficiência Cardíaca , Aplicativos Móveis , Benchmarking , Insuficiência Cardíaca/terapia , Humanos
5.
Rev Bras Enferm ; 75(1): e20201257, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34614076

RESUMO

OBJECTIVE: To analyze the self-care activities of elderly people with diabetes mellitus and its correlation with the nurse-patient interpersonal relationship. METHODS: Cross-sectional quantitative study, with 144 elderly people followed up in Family Health Units, with data collected by the Diabetes Self-Care Activities Questionnaire and Interpersonal Relationship Questionnaire in Nursing Care, being analyzed by descriptive and inferential statistics. RESULTS: There was a greater accomplishment of the activities Take insulin injections as recommended (6.74), Take diabetes medications as recommended (6.55) and Take the indicated number of diabetes pills (6.52). The interpersonal relationship showed moderate effectiveness (80.6%). The correlation between self-care with diabetes and interpersonal relationships showed a positive and significant value in the dimension Specific feeding. CONCLUSION: The effectiveness of the interpersonal relationship in nursing care resulted in greater compliance with activities related to specific food.


Assuntos
Diabetes Mellitus , Autocuidado , Idoso , Estudos Transversais , Diabetes Mellitus/terapia , Humanos
6.
Rev Bras Enferm ; 75(2): e20210146, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34614105

RESUMO

OBJECTIVE: to know health professionals' perceptions about care actions provided to children with Congenital Zika Virus Syndrome and their families. METHODS: this is a qualitative study, carried out in a capital of center-western Brazil, based on the Unified Health System theoretical precepts. Data were collected in September and October 2020, through audio-recorded interviews with 12 health professionals from a specialized service and submitted to analysis of content, thematic modality. RESULTS: the implementation of care actions with these children occurs through multidimensional assessment of children and their families, use of the Unique Therapeutic Project, therapeutic interventions for the development of children and the communication and exchange of interprofessional and family experiences, in addition to considering professionals' prior knowledge and their search for it. FINAL CONSIDERATIONS: children with CZS and their families need individualized, frequent, integrated and continuous care.


Assuntos
Infecção por Zika virus , Zika virus , Brasil , Criança , Programas Governamentais , Humanos , Infecção por Zika virus/terapia
7.
Rev Bras Enferm ; 75(2): e20210196, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34614108

RESUMO

OBJECTIVE: to develop an ICNP® terminology subset for the care of people with heart failure. METHODS: this is a methodological study, which used the theoretical framework of the Mid-Range Nursing Theory for Cardiovascular Rehabilitation, with the steps: Construction of nursing diagnoses/outcomes and interventions statements and Cross-mapping of statements constructed. RESULTS: forty-two diagnosis/outcome statements and 179 nursing intervention statements were constructed, organized based on five theory concepts, with a higher prevalence of statements related to "Rehabilitative care", "Psychosocial support for patients and families" and "Supervised cardiovascular rehabilitation program". FINAL CONSIDERATIONS: it was possible to build nursing diagnosis/outcome and intervention statements for developing a terminology subset for the care of people with heart failure, based on the chosen theory.


Assuntos
Insuficiência Cardíaca , Insuficiência Cardíaca/terapia , Humanos
8.
Rev Med Suisse ; 17(753): 1690-1693, 2021 Oct 06.
Artigo em Francês | MEDLINE | ID: mdl-34614309

RESUMO

Acute tonsillitis is a common disease. The tonsillar infection can be uni- or bilateral with a high rate of spontaneous recovery. In some cases, a peritonsillar cellulitis or abscess can occur, characterized by an inflammatory reaction of the peritonsillar space. The red flags consist of a gradually worsening odynodysphagia, an ipsilateral swelling of the soft palate, a trismus (infrequent in children) and in some cases a change of voice (« hot potato voice ¼). A needle puncture of the swollen soft palate is then required. If pus is found, a surgical drainage by either hot tonsillectomy or incision under local anesthesia with an appropriate antibiotic therapy must be carried out.


Assuntos
Abscesso Peritonsilar , Criança , Humanos , Abscesso Peritonsilar/diagnóstico , Abscesso Peritonsilar/terapia
9.
Rev Med Suisse ; 17(753): 1694-1700, 2021 Oct 06.
Artigo em Francês | MEDLINE | ID: mdl-34614310

RESUMO

This article proposes, through a literature review, an updated summary of the initial evaluation, treatment and follow-up of sudden sensorineural hearing loss (SSNHL) based on current guidelines. SSNHL occurs within 72h with at least 30dBHL loss over 3 consecutive frequencies. Diagnosis is medical in the emergency setting, the etiological workup aims at treating known causes, while different pathophysiological hypotheses exist for idiopathic SSNHL. Controversy exists regarding optimal management due to frequent spontaneous recovery. However, corticotherapy remains widely accepted. Prognosis depends on initial severity, age, associated vertigo and shape of the audiometric curve. Hearing rehabilitation in proposed for significant residual hearing loss.


Assuntos
Perda Auditiva Neurossensorial , Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Neurossensorial/terapia , Humanos
10.
Brain Nerve ; 73(10): 1067-1074, 2021 Oct.
Artigo em Japonês | MEDLINE | ID: mdl-34615743

RESUMO

What are desirable roles of general neurologists in the diagnosis and treatment of primary central nervous system lymphoma (PCNSL)? These issues were discussed 7 years back in the special feature articles of this journal. In the last 7 years genome analyses using liquid biopsy specimens have progressed and are becoming popular in the management of PCNSL, thereby enabling neurosurgeons to avoid invasive brain biopsy. The role of general neurologists in this country is not to be directly engaged in the PCNSL management, but to make an early diagnosis of PCNSL and to refer patients with PCNSL to specialists for a combination of chemotherapy and irradiation therapy.


Assuntos
Linfoma , Neurologistas , Sistema Nervoso Central , Humanos , Linfoma/diagnóstico , Linfoma/terapia
11.
Brain Nerve ; 73(10): 1107-1114, 2021 Oct.
Artigo em Japonês | MEDLINE | ID: mdl-34615748

RESUMO

Management of primary central nervous system lymphoma (PCNSL) includes induction and consolidation therapies in newly diagnosed patients, as well as second-line therapy in relapsed or refractory patients. The current standard-of-care induction therapy involves methotrexate (MTX)-based multi-agent immunochemotherapy with rituximab, methotrexate, procarbazine, and vincristine. Deferral or dose reduction of radiation therapy is considered in consolidation therapy, especially in elderly patients who carry a high risk of radiation-induced delayed neurotoxicity. Since elderly patients comprise the main population of PCNSL, minimally toxic treatments that are effective and feasible for them are strongly needed. For second-line therapy, rechallenge using MTX-based chemotherapy (in patients with a prior durable response to MTX-based chemotherapy) or radiation therapy is considered. Bruton's tyrosine kinase inhibitor tirabrutinib (for relapsed and refractory PCNSL) and high-dose chemotherapy with autologous stem cell transplantation support using thiotepa and busulfan (BuTT) were approved by the Japanese Ministry of Health and Welfare in March 2020 and has recently become available for clinical practice. While these novel treatments seem promising, the optimal use of these treatments along with the standard-of-care therapy of PCNSL should be defined and investigated in clinical trials.


Assuntos
Transplante de Células-Tronco Hematopoéticas , Linfoma , Idoso , Sistema Nervoso Central , Humanos , Japão , Linfoma/terapia , Transplante Autólogo
12.
No Shinkei Geka ; 49(5): 922-933, 2021 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-34615752

RESUMO

To avoid preventable trauma death(PTD), initial management, including resuscitation, is crucial in traumatic brain injury(TBI)care. PTD is defined as a case in which the percentage of probability of survival exceeds 50%, but the patient unfortunately dies without appropriate treatment. To diminish cases of PTD, a standardized approach has been established with several training courses and guidelines. However, 20% of all patients with TBI experience PTD. In our study, PTD cases accounted for 26.2% of all cases of so-called "talk and deterioration." Additionally, anti-coagulation/anti-platelet users comprised 26.8% of all PTD cases. Thus, to eliminate PTD, measures against anti-coagulants are important. Moreover, quick decision making regarding treatments preceding the rapid-changing pathophysiology is also essential in TBI care. In addition to securing airway management, providing oxygen support, and stabilizing circulation, timely administration of a neutralizer for anti-coagulative drugs and use of tranexamic acid(a drug for anti-fibrinolysis)is crucial. In this chapter, the pearls of initial TBI management are mentioned, with focus on the "first hour" of treatment.


Assuntos
Lesões Encefálicas Traumáticas , Lesões Encefálicas Traumáticas/diagnóstico , Lesões Encefálicas Traumáticas/terapia , Humanos
13.
No Shinkei Geka ; 49(5): 955-963, 2021 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-34615755

RESUMO

The main objectives of critical care of severe traumatic brain injury(TBI)are the prevention and treatment of intracranial hypertension and secondary brain insults, preservation of cerebral perfusion pressure, and optimization of cerebral oxygenation. The critical care management of severe TBI will be discussed with a focus on the monitoring and avoidance or minimization of secondary brain insults, with emphasis on understanding the underlying physiology and pathophysiology. The evolution of critical care of severe traumatic brain injury will also be discussed along with the accumulating knowledge and experience.


Assuntos
Lesões Encefálicas Traumáticas , Lesões Encefálicas Traumáticas/diagnóstico , Lesões Encefálicas Traumáticas/terapia , Humanos
14.
No Shinkei Geka ; 49(5): 1032-1039, 2021 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-34615763

RESUMO

All the statements regarding sports-related concussion(SRC)in our guidelines are generally simple but somewhat unfavorable. SRC is diagnosed solely by symptoms, without any definitive diagnostic measures. Various pathophysiologies are suspected to underlie SRC, making single diagnostic biomarker or neuroimaging unreliable. It is widely acknowledged that casualties of SRC should return to play gradually in a stepwise fashion; however, effective treatment and rehabilitation need to be determined. Although the pathological findings of chronic traumatic encephalopathy(CTE), possibly the result of repetitive injuries, have been elucidated, further research is needed to establish a clinical diagnosis and testing modalities for CTE.


Assuntos
Traumatismos Craniocerebrais , Esportes , Traumatismos Craniocerebrais/diagnóstico por imagem , Traumatismos Craniocerebrais/terapia , Humanos , Japão/epidemiologia
15.
No Shinkei Geka ; 49(5): 1056-1065, 2021 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-34615765

RESUMO

Since the 2000s, "intracranial hypotension syndrome associated with trauma" has become a social problem in relation to litigation and compensation issues in Japan. To address this problem, guidelines for correct diagnosis have been developed. The basic pathogenesis of this disease is cerebrospinal fluid leakage caused by fragile tissue injury due to trauma. In order to improve the treatment outcome of this disease, it is important to prove the CSF leakage directly, using diagnostic imaging based on the guidelines, rather than diagnosing it based on clinical manifestations alone. For management, an epidural blood patch(EBP)should be used only after careful consideration. As such, rest and adequate fluid replacement should generally be given first. However, in cases with concomitant subdural hematoma, the order of hematoma irrigation and EBP should be determined according to the condition and urgency of each patient. In addition, it is necessary to standardize the formal name of this condition in papers to ensure rigorous academic discussion.


Assuntos
Hipotensão Intracraniana , Humanos , Hipotensão Intracraniana/diagnóstico por imagem , Hipotensão Intracraniana/terapia , Japão/epidemiologia
16.
Rinsho Ketsueki ; 62(9): 1388-1392, 2021.
Artigo em Japonês | MEDLINE | ID: mdl-34615798

RESUMO

We interviewed the adult and pediatric hematologists in the Chugoku and Shikoku regions in order to determine their opinions and attitudes about fertility preservation in 2020. A questionnaire on fertility preservation practices was sent to 59 doctors in 46 adult and pediatric hematology-oncology hospitals, out of which 52 doctors (88.1%) responded. Forty doctors (76.9%) had no rules about the explanation and 37 doctors (71.2%) answered that the attending physicians provided the explanation alone in their hospitals. Many doctors had no rules about the target age group of patients. Only few hospitals were able to complete the treatment of hematological malignancies and fertility preservation within their own infrastructure. Several doctors referred to neighboring hospitals for fertility preservation; however, five hospitals were unable to provide fertility preservation and had no relationship with other hospitals. Doctors should give fertility preservation options to all patients at risk of infertility because of their cancer treatment. It is suggested that the local networks should be utilized and relationships with neighboring hospitals strengthened.


Assuntos
Preservação da Fertilidade , Neoplasias Hematológicas , Criança , Neoplasias Hematológicas/terapia , Humanos , Inquéritos e Questionários
17.
Am J Psychiatry ; 178(10): 896-902, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34592843

RESUMO

Sleep disturbances and depression are closely linked and share a bidirectional relationship. These interconnections can inform the pathophysiology underlying each condition. Insomnia is an established and modifiable risk factor for depression, the treatment of which offers the critical opportunity to prevent major depressive episodes, a paradigm-shifting model for psychiatry. Identification of occult sleep disorders may also improve outcomes in treatment-resistant depression. Sleep alterations and manipulations may additionally clarify the mechanisms that underlie rapid-acting antidepressant therapies. Both sleep disturbance and depression are heterogeneous processes, and evolving standards in psychiatric research that consider the transdiagnostic components of each are more likely to lead to translational progress at their nexus. Emerging tools to objectively quantify sleep and its disturbances in the home environment offer great potential to advance clinical care and research, but nascent technologies require further advances and validation prior to widespread application at the interface of sleep and depression.


Assuntos
Depressão , Transtornos Intrínsecos do Sono , Depressão/fisiopatologia , Depressão/terapia , Humanos , Administração dos Cuidados ao Paciente/métodos , Administração dos Cuidados ao Paciente/tendências , Psicopatologia/métodos , Sono/fisiologia , Transtornos Intrínsecos do Sono/psicologia , Transtornos Intrínsecos do Sono/terapia
19.
Anticancer Res ; 41(10): 5089-5096, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34593459

RESUMO

BACKGROUND/AIM: Distinguishing true oligometastatic disease from early polymetastatic disease is vital in patients with soft tissue sarcoma as contemporary treatment strategies differ significantly. Clinical factors such as tumour biology, organ involved, number of lesions, and patient fitness influence clinical decisions. PATIENTS AND METHODS: A retrospective search of a prospective database identified patients with new distant relapse, treated between 2009 and 2012. RESULTS: A total of 223 patients were included, and oligometastases were diagnosed in 81 (36%) patients, which were pulmonary in just over half of cases. These were treated with local therapy in 66 of 89 cases, and 7 patients received subsequent treatment for additional oligometastases. Metastasectomy was the most common treatment modality. A total of 16/66 patients (24%) underwent active surveillance for >6 months prior to local therapy. CONCLUSION: Patients with oligometastatic disease can experience durable disease control with timely multimodality treatment approaches for evolving metastatic disease, where disease biology allows.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Metastasectomia/mortalidade , Sarcoma/mortalidade , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Terapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Estudos Retrospectivos , Sarcoma/patologia , Sarcoma/terapia , Taxa de Sobrevida , Adulto Jovem
20.
Anticancer Res ; 41(10): 5107-5116, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34593461

RESUMO

BACKGROUND/AIM: We evaluated local control and toxicity in patients receiving radiotherapy associated with immune check point inhibitors and analyzed which oligometastatic disease setting benefits the most from local ablation in terms of advantage in overall survival. PATIENTS AND METHODS: We retrospectively identified 60 oligoprogressive patients treated with a PD-1 inhibitor in association with radiotherapy on the site of progression (119 lesions). RESULTS: After a median follow-up of 11.7 months (range=1-39 months), we observed complete response (CR) in 45/119, partial response (RP) in 42/119, and stable disease (SD) in 30/119 patients. Nine radionecrotic events occurred. Two patients experienced grade 3 toxicities and 32 patients reported grade 2 toxicities. The number of radiologically evident metastatic organs in patients who received concomitant PD-1 inhibitors and radiotherapy showed a significant increase in survival (respectively, 73% after 12 months and 47% after 24 months) in patients with 0-3 metastatic organs compared to those with more than 3 organ sites involved (p<0.0001). CONCLUSION: Radiotherapy associated with PD-1 inhibitors is overall safe and efficacious. Patients eligible for intensification of local treatments should have less or equal to 3 metastatic organ sites.


Assuntos
Inibidores de Checkpoint Imunológico/uso terapêutico , Recidiva Local de Neoplasia/mortalidade , Neoplasias/mortalidade , Radiocirurgia/mortalidade , Terapia Combinada , Progressão da Doença , Feminino , Seguimentos , Humanos , Masculino , Metástase Neoplásica , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/terapia , Neoplasias/patologia , Neoplasias/terapia , Prognóstico , Hipofracionamento da Dose de Radiação , Estudos Retrospectivos , Taxa de Sobrevida , Testes de Toxicidade
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