Laryngeal Cancer Attributable Factors and the Influence on Survival Rates: A Single Brazilian Institution Experience

Abstract Introduction Epidemiological studies focused on prognostic factors associated with laryngeal cancer in the Brazilian population are poorly reported in the literature. Objective To evaluate the influence of certain risk factors on the survival rates of patients with squamous cell carcinoma (SCC) of the larynx. Methods This retrospective study was conducted on adult patients who were admitted to the outpatient clinic of the head and neck department in a tertiary care hospital. Evaluation of the influence of risk factors on the survival rates of patients registered in the hospital with laryngeal SCC was performed based on age, sex, initial stage, time of evolution, habits, educational levels and relapse and death. Overall survival (OS), disease-free survival (DFS) and clinical-demographic data were analyzed using the Kaplan-Meier method, Log-rank test and Cox regression. Results A total of 107 patients with a mean age of 59.8 years (range 19-81) were included in this study. Stages III and IV were associated with decreased DFS (p = 0.02) and OS (p = 0.02). Smoking patients had a greater period of disease evolution than non-smoking patients (p = 0.003). Alcohol consumption in smokers increased the risk of death by 2.8 (p = 0.002) compared with non-drinking smokers. Male patients presented lower DFS average when compared with female patients (p = 0.04). Conclusion Our study confirms that male gender, smoking habit combined with alcohol consumption, and advanced stages were strongly associated with poor prognosis.

Quantitative ultrasound at the hand phalanges in patients with bisphosphonate-related osteonecrosis of the jaws

Patients with bisphosphonate-related osteonecrosis of the jaws (BRONJ) who received intravenous or oral bisphosphonates (BP) were selected for determination of their bone microarchitecture as a risk predictor of BRONJ development. The diagnosis of BRONJ was made based on clinical and radiographic findings. The control group consisted of healthy patients. All patients underwent quantitative and qualitative ultrasound measurements of bone at the hand phalanges carried out using the DBM Sonic BP. Ultrasound bone profile index (UBPI), amplitude-dependent speed of sound (AD-SoS), bone biophysics profile (BBP), and bone transmission time (BTT) were measured. The BRONJ group consisted of 17 patients (62 ± 4.24; range: 45-82); 10 (58.8%) were male and seven (41.1%) were female, of whom 11 (64.7%) suffered from multiple myeloma, three (17.6%) from osteoporosis, one (5.8%) from prostate cancer, one (5.8%) from kidney cancer, and one (5.8%) from leukemia. Fourteen (82.3%) of them received intravenous BP whereas three (17.6%) received oral BP. Nine (9/17; 52.9%) patients developed bone exposure: two in the maxilla and seven in the mandible. Regarding quantitative parameters, Ad-SoS was low in the BRONJ group, but not significant. The UBPI score was significantly reduced in BRONJ patients with exposed bone when compared to controls (0.47 ± 0.12 vs. 0.70 ± 0.15; p = 0.004). The present study demonstrated that quantitative ultrasound was able to show bone microarchitecture alterations in BRONJ patients, and suggests that these analyses may be an important tool for early detection of bone degeneration associated with BRONJ.

Levantamento do grau de instruções e dos materiais e métodos de higiene utilizados por usuários de próteses totais / Rising of the instructions degree and of materials and methods of hygiene used by complete dentures users

O objetivo desse trabalho foi realizar um estudo longitudinal a respeito dosmateriais e métodos de higiene utilizados por usuários de próteses totais, bem como avaliar ograu de instruções dos mesmos. O levantamento dos dados foi realizado por meio da aplicaçãode questionário e posterior tabulação dos dados. Foram entrevistados 98 usuários de prótesestotais no ano de 1989 e 100, no ano de 2004 atendidos na Faculdade de Odontologia de RibeirãoPreto-USP. Os resultados foram analisados por meio da comparação dos dados e pelo Teste dasProporções. Em 1989, 93,87% dos entrevistados relataram utilizar escova dental e dentifrício parahigiene de próteses totais. No ano de 2004, 95% dos usuários relataram utilizar o mesmo métodode higiene. Quanto ao grau de instrução, mais de 80% dos pacientes não receberam orientaçãoquanto à higienização ou quanto à necessidade de visita periódica ao cirurgião-dentista no ano de1989, mas em 2004 pôde-se notar que houve uma melhora significativa nesse quadro, uma vezque 52% dos pacientes não receberam orientação quanto à higienização e 77% não receberamorientação quanto à visita periódica ao cirurgião-dentista. Por meio deste estudo verificou-se queo método mais utilizado consiste no método mecânico, uma vez que são aqueles regularmenteencontrados no mercado, porém, estes não são específicos para higienização de próteses totais.Embora o grau de instrução tenha melhorado ao longo dos anos, a higiene oral de usuários deprótese total ainda é precária, havendo necessidade de maior atenção ao idoso, não somente porparte do cirurgião-dentista, mas também de indústrias de produtos de higiene oral, para que osdesdentados totais tenham acesso aos produtos específicos para este fim, podendo assim, controlarde forma adequada sua saúde oral.

The goal of this work was to accomplish a longitudinal study concerning aboutof the materials and methods of hygiene used by complete dentures users, as well as to evaluatethe instructions degree of the same. The rising of the data was accomplished by means of thequestionnaire and posterior table application of the data. They were interviewed 98 completedentures users in year of 1989 and 100, in year of 2004 attended in to Odontology Faculty ofRibeirão Preto. The results were analyzed by means of the comparison of the data and by theProportions Test. In 1989, 93.87% of the interviewees related use dental brush and toothpastefor complete denture hygiene. In year of 2004, 95% of the users related use the same hygienemethod. Regarding the instruction degree, more than 80% of the patients did not receive orientationregarding cleansers or regarding the need to periodic visit to the surgeon-dentist in year of 1989,but in 2004 could notice that there was a significant improvement in this picture, once that 52% of the patients did not receive orientation regarding cleansers and 77% did not receive orientationregarding the periodic visit to the surgeon-dentist. For half of this study it verified that the usedmethod consists in mechanical method, once that are those methods are not regularly found in themarket, however, these are not specific for denture complete hygiene. Although the instructiondegree has improved along years, the users' oral complete denture hygiene is precarious, therebeing need to larger attention to the senior, not only by the surgeon-dentist, but also of productsindustries of oral hygiene, so that the total toothless have access to the specific products for thisend, could this way, control of adequate your form oral health.