El pH salival como marcador biológico en pacientes diagnosticados con carcinoma epidermoide oral de Guantánamo / Salivary pH as diagnostic biomarker in patients diagnosed with oral squamous cells carcinoma in Guantanamo / pH salivar como marcador biológico em pacientes diagnosticados com carcinoma epidermóide oral de Guantánamo

RESUMEN Introducción: El cáncer bucal constituye un problema de salud de connotación mundial. Objetivo: Comparar las variaciones del pH salival entre pacientes con carcinoma epidermoide recién diagnosticados, después del tratamiento oncoespecífico y sujetos aparentemente sanos de la provincia Guantánamo, Cuba, en el período noviembre 2019- enero 2022. Método: Se realizó un estudio descriptivo, comparativo, transversal, en pacientes ambulatorios de la consulta de Cirugía Maxilofacial del Hospital General Docente "Dr. Agostinho Neto". El grupo de estudio estuvo conformado por 200 pacientes divididos en 3 subgrupos: subgrupo I (50 pacientes recién diagnosticados con carcinoma epidermoide oral, con diagnóstico concomitante de caries dental y periodontitis crónica del adulto); subgrupo II (50 pacientes con la referida patología después de tratamiento oncoespecífico, tratados por las enfermedades bucales antes citadas) y subgrupo III (100 pacientes controles aparentemente sanos). Se estudiaron las variables: edad, sexo, tipo de dieta y pH salival. Resultados: La edad media fue de 59,8 años, 70 % fueron hombres. Se asoció la dieta consumida y cada subgrupo (p=0,001). El pH salival de los pacientes con carcinoma epidermoide recién diagnosticados afectados por ambas enfermedades bucales fue ácido (6,25±0,37) en comparación a los otros subgrupos. El 98,6 % de los pacientes con pH salival ácido presentaron una dieta usual a base de carbohidratos y grasas (p=0,000). Conclusiones: Se evidenció que el pH salival de los pacientes con carcinoma epidermoide recién diagnosticados fue ácido en comparación a los otros subgrupos, por lo que este parámetro puede usarse como un marcador biológico de la enfermedad.

ABSTRACT Introduction: Oral cancer is a common health problem worldwide. Objective: Compare the salivary pH range changes among patients diagnosed recently with oral squamous cells carcinoma after receiving oncospecific treatment and subjects apparently healthy, Guantanamo, Cuba, period time November 2019 -January 2022. Method: A descriptive, comparative, cross-sectional study was carried out in outpatients of the Maxillofacial Surgery Consultation room at the Hospital General Docente "Dr. Agostinho Neto". The study group consisted of 200 patients divided into 3 subgroups: subgroup I (50 newly diagnosed patients with oral squamous cell carcinoma, with concomitant diagnosis of dental caries and chronic adult periodontitis); subgroup II (50 patients with the aforementioned pathology after oncospecific treatment, treated for the aforementioned oral diseases) and subgroup III (100 apparently healthy control patients). The following variables were studied: age, sex, type of diet and salivary pH. Results: Average age was 59.8 years, 70% were men. There was an association between the diet consumed and each subgroup (p= 0.001). The salivary pH of newly diagnosed squamous cell carcinoma patients affected by both oral diseases was acidic (6.25±0.37) compared to the other subgroups. The 98.6% of patients with acid salivary pH presented a usual diet based on carbohydrates and fats (p=0.000). Conclusions: It was shown that the salivary pH of newly diagnosed patients with squamous cell carcinoma was acidic compared to the other subgroups. Therefore, this parameter can be used as a biological marker of the disease.

RESUMO Introdução: O câncer bucal é um problema de saúde global. Objetivo: Comparar as variações do pH salivar entre pacientes com carcinoma espinocelular recém-diagnosticado, após tratamento oncoespecífico, e indivíduos aparentemente saudáveis da província de Guantánamo, Cuba, no período de novembro de 2019 a janeiro de 2022. Método: Estudo descritivo, comparativo, cruzado seccional, em pacientes ambulatoriais da consulta de Cirurgia Bucomaxilofacial do Hospital General Docente "Dr. Agostinho Neto". O grupo de estudo foi composto por 200 pacientes divididos em 3 subgrupos: subgrupo I (50 pacientes recém-diagnosticados com carcinoma espinocelular oral, com diagnóstico concomitante de cárie dentária e periodontite crônica do adulto); subgrupo II (50 pacientes com a patologia supracitada após tratamento oncoespecífico, tratados para as doenças bucais supracitadas) e subgrupo III (100 pacientes controles aparentemente saudáveis). As variáveis estudadas foram: idade, sexo, tipo de dieta e pH salivar. Resultados: A média de idade foi de 59,8 anos, 70% eram homens. A dieta consumida e cada subgrupo foram associados (p=0,001). O pH salivar de pacientes recém-diagnosticados com carcinoma espinocelular afetados por ambas as doenças bucais foi ácido (6,25±0,37) em comparação com os outros subgrupos. 98,6% dos pacientes com pH salivar ácido apresentaram dieta habitual baseada em carboidratos e gorduras (p=0,000). Conclusões: Evidenciou-se que o pH salivar dos pacientes com carcinoma espinocelular recém-diagnosticado foi ácido em relação aos demais subgrupos. Portanto, esse parâmetro pode ser utilizado como marcador biológico da doença.

Nivel de información sobre el cáncer bucal en población mayor de 60 años / Level of information on oral cancer in the population over sixty years of age

RESUMEN Fundamentación: Los adultos mayores presentan factores de riesgo de naturaleza diversa asociados a la probabilidad de que desarrollen cáncer bucal. Objetivo: Determinar el nivel de información sobre el cáncer bucal de los adultos mayores de 60 años del consultorio 5 de Casilda. Metodología: Se realizó un estudio observacional descriptivo de corte transversal de noviembre del 2019 a abril del 2021. La muestra se obtuvo mediante muestreo aleatorio simple, estuvo constituida por 85 mayores de 60 años del consultorio 5 de Casilda. Se analizó la variable de respuesta principal: Nivel de información sobre el cáncer bucal. Se aplicó un cuestionario sobre cáncer bucal y una guía de observación del autoexamen bucal. Resultados: Se observó una edad promedio cercana a los 67 años; el 55.3 % de los adultos mayores fue del sexo femenino, predominó el nivel escolar primario con 38.8 %. Se constató un nivel de información bajo en el 89.4 % de la muestra estudiada. Conclusiones: El nivel de información sobre el cáncer bucal fue bajo en más de la tercera parte de los adultos mayores.

ABSTRACT Background: Older adults present risk factors of a diverse nature associated with the probability of developing oral cancer. Objective: To determine the level of information about oral cancer in adults older than 60 years in Casilda Doctor´s office 5. Methodology: A cross-sectional descriptive observational study of November 2019 to April 2021. The sample was obtained by simple random sampling, it was made up of 85 people over 60 years of age from the Casilda Doctor´s 5. It was analyzed main response variable: Level of information about oral cancer. A was applied an oral cancer questionnaire and an oral self-examination observation guide. Results: An average age close to 67 years was observed; 55.3% of adults older was female, the primary school level prevailed with 38.8%. It was found a low level of information in 89.4% of the studied sample. Conclusions: The level of information about oral cancer was low in more than the third part of older adults.

Avaliação do conhecimento de pacientes idosos acerca do câncer bucal / Assessment of elderly patients' knowledge about oral cancer

O objetivo deste estudo foi avaliar o conhecimento de pacientes do Centro Universitário da Serra Gaúcha acerca do câncer oral. Foram aplicados questionários para idosos (n=60) de ambos os gêneros, diferentes etnias e graus de escolaridade. A análise dos dados foi realizada por meio do teste qui-quadrado com nível de confiança de 95%. Não houve relação estatisticamente significativa (p>0,05) entre gênero, estado civil e escolaridade. A presença de lesões bucais, ausência de dentes, visitas frequentes ao dentista, e uso de bebida alcoólica e tabagismo não influenciaram quanto ao conhecimento acerca do câncer bucal. Embora a maioria dos pacientes (85%) já tenha ouvido falar em câncer bucal, apenas a minoria relatou saber se prevenir (23%) e possuir o hábito de examinar a boca em casa (35%). Além disso, apesar de 55% dos pacientes visitarem regularmente o dentista, apenas 28,3% relatou ter recebido informações sobre o câncer bucal. Pôde-se concluir que mesmo sabendo da existência do câncer bucal, a população idosa não possui informações suficientes para o correto diagnóstico e prevenção da doença, sendo necessário melhorias nas orientações fornecidas pelos profissionais da área da saúde com relação a este tema(AU)

The aim of this study was to evaluate the knowledge of patients at Serra Gaucha University Center about oral cancer. Questionnaires were applied to the elderly (n = 60) of both genders, different ethnicities and educational levels. Data analysis was performed using the chi-square test with a 95% confidence level. There was no statistically significant relationship (p> 0.05) between gender, marital status and education. The presence of oral lesions, absence of teeth, frequent visits to the dentist, and the use of alcohol and smoking did not influence the knowledge about oral cancer. Although most patients (85%) have heard of oral cancer, only a minority reported knowing whether to prevent it (23%) and having the habit of examining their mouth at home (35%). In addition, although 55% of patients regularly visit the dentist, only 28.3% reported receiving oral cancer information. It can be concluded that even knowing the existence of oral cancer, the elderly population does not have enough information for the correct diagnosis and prevention of the disease, being necessary improvements in the guidance provided by health professionals regarding this theme(AU)

Nivel de conocimientos sobre el tabaquismo y su relación con la cavidad bucal / Level of knowledge about smoking and its relationship with the oral cavity

Introducción: El tabaquismo es una enfermedad adictiva crónica la cual constituye la causa de muerte prevenible más importante en los países desarrollados y la de mayor morbilidad y mortalidad antes que cualquier otra enfermedad crónica (hipertensión arterial, diabetes mellitus). Se considera una epidemia de carácter universal y es una gravosa carga para el individuo, la familia y la sociedad. Objetivo: Determinar el nivel de conocimientos sobre el hábito de fumar, relacionado con la cavidad bucal en adultos fumadores. Métodos: Se realizó un estudio descriptivo transversal con 55 pacientes fumadores de ambos sexos. Se aplicó un cuestionario para realizar un diagnóstico de conocimientos sobre el daño que ocasiona el tabaquismo en la cavidad bucal. Resultados: El 76,33 por ciento de los sujetos presentaron un nivel de conocimiento insuficiente, el 92,72 por ciento conocían la relación con el cáncer bucal, el 72,72 por ciento los beneficios de abandonar el hábito y el 53,36 por ciento la relación con los dientes, sin embargo el 83,63 por ciento presentó un nivel de conocimiento insuficiente en relación con los tejidos periodontales. Conclusiones: El nivel de conocimientos en la población estudiada fue insuficiente(AU)

Introduction: Smoking is a chronic addictive disease which is the most important preventable cause of death in developed countries and the one with the highest morbidity and mortality before any other chronic disease (hypertension, diabetes mellitus). It is considered an epidemic of universal character and is a burden for the individual, the family and society. Objective: To determine the level of knowledge about smoking habit, related to the oral cavity in adult smokers. Methods: A cross-sectional descriptive study was conducted with 55 smokers patients of both sexes. A questionnaire was applied to make a diagnosis of knowledge about the damage caused by smoking in the oral cavity. Results: 76.33 percent of the subjects presented an insufficient level of knowledge, 92.72 percent knew the relationship with oral cancer, 72.72 percent the benefits of quitting and 53.36 percent the relationship with teeth, however, 83.63 percent presented an insufficient level of knowledge in relation to periodontal tissues. Conclusions: The level of knowledge in the population studied was insufficient(AU)

Conocimientos, Actitudes y prácticas de prevención de riesgo del cáncer bucal en población mayor de 15 años. Panamá. / [Knowledge, attitudes and practices of prevention of oral cancer risk in popul oral cancer risk in population over 15 years old. Panama.

Introducción: El Cáncer Bucal es una enfermedad de importancia en Salud Pública. En Panamá, se desconoce la incidencia y prevalencia de la enfermedad y no se dispone de información por tipo de patología, lesión, localización, ni estudios de conocimientos, ac­ titudes y prácticas, relacionados a los factores de riesgo. Objetivo General: analizar los conocimientos, actitudes y prácticas de prevención de Cáncer Bucal en la población mayor de 15 años. Materiales y Método: estudio descriptivo transversal, realizado en las Regiones Sanitarias de San Miguelito, Metropolitana y Panamá Oeste. Se realizó un muestreo por conveniencia en 42 instalaciones de salud del primer nivel de atención, a la población que acudió al servicio odontológico durante cuatro meses. Se aplicó una encuesta de Conocimiento, Actitudes y Prácticas de prevención de factores de riesgo al cáncer bucal, considerando variables de estilo de vida. Para el análisis estadístico, se utilizaron los programas Epi Info versión 7.2 y XLSTAT 2019 y presentados los datos en medidas paramétricas y no paramétricas. Resultados: se encuestó un total de 3,832 personas mayores de 15 años. La mayor proporción fueron mujeres en edades de 25 y 34 años. En relación al conocimiento, el 81% desconoce los factores de riesgo de cáncer bucal y según la actitud, el 63% no asiste al control odontológico periódicamente. Las prácticas reflejaron hábitos relaciona­ dos al consumo de tabaco y alcohol. Conclusión: La población mayor de 15 años del estudio, desconoce los factores de riesgo del cáncer bucal y manifiesta limitada actitud de práctica preventiva.

Introduction: Oral Cancer is an importance disease in Public Health. In Panama, the in­ cidence and prevalence of the disease is unknown and there is no information available by type of pathology, injury, location, or studies of knowledge, attitudes and practices re­ lated to risk factors. General Objective: to analyze the knowledge, attitudes and practi­ ces of prevention of Oral Cancer in the population over 15 years old. Materials and Methods: cross­sectional descriptive study, carried out in San Miguelito, Metropolitan and Panamá Oeste Health Regions. Sampling was carried out for convenience in 42 health facilities of the first level of health care, to the population that attended the dental service during four months. A survey of Knowledge, Attitudes and Practices of preven­ tion of risk factors to oral cancer was applied, considering Lifestyle variables. For the statistical analysis, the Epi Info version 7.2 and XLSTAT 2019 programs were used and the data presented in parametric and non­parametric measurements. Results: a total of 3,832 people over 15 years of age were surveyed. The highest propor­ tions were women between the ages of 25 and 34. In relation to knowledge, 81% do not know the risk factors for oral cancer and according to the attitude, 63%, do not attend pe­ riodically to a dental control. The practices reflected habits related to consumption of to­ bacco and alcohol. Conclusion: The population over 15 years old of the study ignores the risk factors of oral cancer and manifests a limited attitude of preventive practice.

O câncer bucal no estado do rio grande do norte: um estudo ecológico / Oral Cancer in the state of Rio Grande do Norte: an ecological study / Cáncer Oral en el estado de RíoGrande do Norte: un estudio ecológico

Introdução:As neoplasias malignas ocupam o segundo lugar em causa de mortalidade no Brasil. Embora o país detenha grande número de dentistas em relação aos outros países, estudos apontam que o diagnóstico é feito tardiamente, levando assim, o câncer de boca como o oitavo câncer mais letal. Objetivo:Descrever a epidemiologia do câncer bucal no estado do Rio Grande do Norte. Método:Estudo epidemiológico descritivo do tipo ecológico realizado a partir dos casos diagnosticados de câncer bucal nos anos de 2000 a 2014. Resultados:Foram notificados 1.198 casos, sendo 714 óbitos; a região da língua e base de língua foi a mais acometida (33,63%), com predominância de 63,18% do sexo masculino. Conclusões:O câncer bucal está ganhando destaque e estudos como este poderão subsidiar a proposição de políticas públicas e o planejamento de ações mais efetivas, para o diagnóstico precoce e o tratamento nos estágios iniciais da doença (AU).

Introduction:Malignant neoplasms are the second leading cause of death in Brazil. Although the country has a large number of dentists compared to other countries, studies indicate that the diagnosis is made late, thus leading to oral cancer as the eighth most lethal cancer.Objective:To describe the epidemiology of oral cancer in the state of Rio Grande do Norte.Methods:A descriptive epidemiological study of the ecological type carried out from the diagnosed cases of oral cancer in the years 2000 to 2014. Results:A total of 1198 cases were reported, of which 714 were deaths; The region of the tongue and tongue base was the most affected (33.63%), with a predominance of 63.18% of males.Conclusions:Oral cancer is gaining prominence and studies such as this may support the proposal of public policies and the planning of more effective actions for the early diagnosis and treatment in the early stages of the disease (AU).

Introducción:las neoplasias malignas son la segunda causa de mortalidad en Brasil. Aunque el país tiene una gran cantidad de dentistas en relación con otros países, los estudios muestran que el diagnóstico se hace tarde, por lo qu el cáncer de boca es el octavo cáncer más letal.Objetivo:Describir la epidemiología del cáncer oral en el estado de Rio Grande do Norte. Método:Estudio epidemiológico descriptivo del tipo ecológico realizado en base a los casos diagnosticados de cáncer oral en los años 2000 a 2014. Resultados:se reportaron 1.198 casos, de los cuales 714 fueron muertes; la región de la lengua y la base de la lengua fue la más afectada (33,63%), con un predominio del 63,18% de varones. Conclusiones: el cáncer oral está ganando protagonismo y estudios como este pueden respaldar la propuesta de políticas públicas y la planificación de acciones más efectivas para el diagnóstico y tratamiento tempranos en las primeras etapas de la enfermedad (AU).

Lesiones bucales en adultos mayores y factores de riesgo. Policlínico "Dr. Tomás Romay", La Habana, Cuba / Buccal lesions in older adults, and risk factors. Dr. Tomás Romay Polyclinic, Havana, Cuba

Introducción: Las lesiones en la mucosa bucal son frecuentes en la población de adultos mayores, lo cual repercute en la aparición del cáncer bucal. Objetivo: Caracterizar las lesiones en las mucosas bucales y su relación con los factores de riesgo presentes en una población geriátrica, del Policlínico Dr. Tomás Romay, Habana Vieja. Material y Métodos: Estudio descriptivo en los 137 adultos mayores de ambos sexos del consultorio 2 del Policlínico Dr. Tomás Romay, Habana Vieja, entre 2015-2016. A todos se les solicitó su consentimiento de participación, se les realizó un interrogatorio y el examen bucal. Se tuvieron en cuenta las variables edad, sexo, tipo de lesión y la localización de las mismas; además de los factores de riesgo de lesiones bucales. Resultados: El 62,8 por ciento fueron mujeres, 24,8 por ciento tenía entre 60-69 años y 45,3 por ciento presentó lesiones, con mayor frecuencia las del paladar duro (62,9 por ciento) y la mucosa del carrillo (20,9 por ciento). Se identificaron siete tipos de lesiones bucales, con una primacía de la estomatitis subprótesis (62,9 por ciento). La ingestión de alimentos calientes o muy condimentados alcanzó el mayor porcentaje (85,5 por ciento) y le siguió las prótesis desajustadas (75,8 por ciento). Conclusiones: En la población geriátrica estudiada, las mujeres son las más afectadas y los que presentan 70 años y más. Son más frecuentes las lesiones en el paladar duro y la estomatitis subprótesis, observándose mayor riesgo en los pacientes con prótesis dentales desajustadas, en los que ingieren alimentos calientes y muy condimentados, y en los fumadores(AU)

Introduction: Lesions of the buccal mucosa are frequent in older adults, which has an effect on the appearance of buccal cancer. Objective: To characterize lesions in the buccal mucosa, and their relation to risk factors in a geriatric population in Dr. Tomás Romay Polyclinic, Old Havana. Material and methods: A descriptive study was conducted using data from 137 older adults of both sexes treated in doctor´s office No. 2 of Dr. Tomás Romay Polyclinic in Old Havana, from 2015-2016. A consent for participation was asked to all of them, a questionnaire was applied, and buccal examinations were done. Variables such as age, sex, kind of lesion, and location of the lesions were taken into account, as well as the risk factors for buccal lesions. Results: The 62,8 percent of the participants in the study were women, 24,8 percent aged 60-69 years, and 45,3 percent presented lesions which were more frequently observed in the hard palate (62,9 percent) and the mucosa of the cheek (20,9 percent). Seven kinds of buccal lesions were identified, with a priority of subprosthesis stomatitis (62,9 percent). The ingestion of hot or very spiced food reached the highest percentage (85,5 percent), followed by prosthesis loosen (75,8 percent). Conclusions: In the geriatric population studied, the most affected people are women and those people who are 70 years old or older. The most frequent lesions are the ones that appear in the hard palate and subprosthesis stomatitis, observing a highest risk in those patients with loosening of dental prosthesis, in those people who ingest hot and very spicy food, and in smokers(AU)

Nivel de conocimiento sobre cáncer bucal en un sector de la población / Level of knowledge on oral cancer in a sector of the population

Introducción: el conocimiento por parte de la población del cáncer bucal es de vital importancia para actuar sobre los factores de riesgo a padecer cáncer bucal y disminuir su incidencia. Objetivo: evaluar el nivel de conocimiento de la población objeto de estudio sobre los factores de riesgo del cáncer bucal, los factores protectores para prevenir el cáncer bucal y los signos bucales de alarma relacionados con el cáncer bucal. Materiales y Métodos: se realizó un estudio experimental de intervención educativa para aumentar el nivel de conocimiento y la percepción del riesgo ante el cáncer bucal, en el territorio atendido por el Hospital General Docente “Julio Aristegui Villamil” de Cárdenas. Resultados: se diagnosticó bajo nivel de conocimiento en el 78,5 % de la población estudiada sobre el cáncer bucal, se diseñó y ejecutó una estrategia de intervención educativa para aumentar la percepción del riesgo ante el cáncer bucal en la población según las necesidades de aprendizaje. El nivel de conocimiento luego de la intervención educativa resultó satisfactorio en el 94,2 % de la población. Conclusiones: el nivel de conocimiento sobre cáncer bucal inicial resultó ser insatisfactorio en la mayoría, mientras que luego de aplicar la intervención educativa fue satisfactorio en casi su totalidad. La intervención educativa resultó ser un método idóneo de la educación para la salud respecto al cáncer bucal en la población estudiada (AU).

Introduction: knowledge of oral cancer in all the population is very important, that permit to act over factors of risk to suffer Oral cancer and to diminish the morbidity in this illness. Objective: to describe the level knowledge about factors of risk of Oral cancer in the population studied, the protective factors to prevent the Oral cancer and the alarm signs related with the Oral cancer; as well as to evaluate the level of knowledge before and after the application of the educational strategy to the population. Materials and methods: was carried out an experimental study of educational intervention to increase the perception of risk about Oral cancer, in the territory assisted by the General Hospital "Julio Aristegui Villamil" of Cárdenas. The level of knowledge about Oral cancer was studied in 450 patients. Results: low level of knowledge was diagnosed in population´s studied (78,5 %). Then was designed and executed a Strategy of Educational Intervention to increase the perception of the risk about Oral cancer in the population according to the learning necessities. The level of knowledge after the educational intervention was Satisfactory in the 94,2 % of the population. Conclusions: at first most of population have a not satisfactory level of knowledge about Oral cancer, but it turned out to be Satisfactory in almost totally, after applying the educational intervention. This educational intervention turned out to be a suitable method for the health´s education regarding Oral cancer in the studied population (AU).

Caracterización del Cáncer Bucal. Estudio de 15 años / Characterization of oral cancer. Study of 15 years

Introducción: La región bucal es una de las diez localizaciones más frecuentes de incidencia del cáncer en Cuba y en el mundo, su estudio en nuestro medio es de vital importancia para mejorar su prevención y curación. Objetivo: identificar distribución de morbilidad por año del cáncer bucal en el territorio de Cárdenas y su tasa por 100 000 habitantes, características sociodemográficas de los pacientes diagnosticados con cáncer bucal en la región y periodo objetos de estudio y determinar el comportamiento del cáncer bucal según localización anatómica y presencia de factores de riesgo. Materiales y Métodos: se realizó un estudio descriptivo retrospectivo de 15 años en pacientes con diagnóstico histopatológico de cáncer bucal atendidos en el Hospital General Docente ¨Julio M Aristegui Villamil¨ de Cárdenas, en el periodo comprendido entre enero de 2000 y diciembre de 2014. Resultados: se pudo constatar un incremento de pacientes afectados en el referido territorio al elevarse la tasa de 4,5 X 100 000 habitantes en el 2000 a 15,4 en el 2013 y 12,5 en el 2014. Hubo mayor incidencia en el grupo de edad de 51-60 años (24,6 %), el sexo masculino (78,5 %), el color de piel blanca (94,1 %), el labio inferior (44,5 %). Los factores de riesgo con mayores valores fueron el tabaquismo (94,6 %) y alcoholismo (64,8 %). Conclusiones: El cáncer bucal tiene una tendencia al incremento en el municipio estudiado, predominando en individuos masculinos, de piel blanca y con adicciones como tabaquismo y alcoholismo. Es necesario realizar actividades de promoción de salud y prevención del cáncer bucal por el incremento de esta enfermedad (AU).

Introduction: oral region is one of the ten more frequent localizations of the cancer in our country and in the world, so to study oral cancer in our context is very important to improve prevention and cure. Objective: describing the distribution of the morbidity for year of the Oral cancer in Cárdenas and their rate for 100 000 inhabitants, as well as the demographic characteristics of the patients diagnosed with Oral cancer in the anatomical region and period studied and factors of risk in those patients. Materials and methods: was carried out a descriptive and retrospective study of 15 year in patient with histopathologic diagnosis of Oral cancer assisted in the General Hospital ¨Julio M Aristegui Villamil¨ of Cárdenas, since January, 2000 to December, 2014. Results: was verified an increase of patients affected by Oral cancer in the referred territory and was raising the rate of since 4,5 X 100 000 inhabitants in the 2000 to 15,4 in the 2013 and 12,5 in the 2014. There was bigger incidence in the group of 51-60 year-old age (24,6 %), the masculine sex (78,5 %), the white skin color (94,1 %) and the inferior lip area (44,5 %). The higher factors of risk were Tabaco addiction (94,6 %) and alcoholism (64,8 %). Conclusions: it becomes necessary to carry out activities of promotion of health and prevention of Oral cancer because the growth of this illness in our context (AU).

Knowledge of oral cancer among the community served during the stomatological lesion prevention campaign conducted at Universidad Catolica de Santiago de Guayaquil - Ecuador

The aim of this study was to evaluate the level of knowledge on oral cancer and level of preventive care among the population. A descriptive crosssectional study was performed to evaluate 408 individuals through a facetoface survey at Universidad Católica de Santiago de Guayaquil during the 2016 academic year. Sixtyone percent (61%) of respondents said they knew of the existence of oral cancer, but 56.1% did not know that 'white spots' in the oral cavity could become malignant, and 50.7% did not know that 'lumps' could be oral cancer. Moreover, 81.8% said they had never undergone screening for oral cancer. This shows the continued need to implement preventive measures such as educating patients in selfexamination of the oral cavity, intensifying prevention campaigns and raising awareness among dentists regarding their responsibility in early detection (AU)

Este estudio tuvo como objetivo evaluar el nivel de cono cimiento de la población sobre el cáncer bucal y evaluar el nivel de atención preventiva. Se realizó un estudio descriptivo y de corte transversal que evaluó 408 individuos a través de una encuesta de forma personal. El estudio se realizó en la Universidad Católica de Santiago de Guayaquil durante el periodo lectivo 2016. El 61% de los encuestados indicaron conocer la existencia del cáncer bucal, sin embargo 56,1% ignoraban que las "manchas blancas" en cavidad bucal podrían malignizar; 50,7% desconocían que los "bultos" podrían ser un cáncer bucal. Por otra parte, el 81,8% respondieron nunca haber sido sometidos a un examen de prevención contra el cáncer bucal. Esto nos muestra que es necesario continuar estableciendo medidas preventivas tales como educar a los pacientes en la realización de un autoexamen de la cavidad bucal, intensificar las campañas de prevención y concientizar a los odontólogos en cuanto a su responsabilidad en la detec ción precoz (AU)

Maior acesso à informação sobre como prevenir o câncer bucal entre idosos assistidos na atenção primária à saúde / Greater access to information on how to prevent oral cancer among elderly using primary health care

Resumo Na promoção de saúde, as ações educativas são prioridade na Estratégia de Saúde da Família (ESF). Evidencia-se a eficácia dessas ações na adesão a comportamentos saudáveis e na redução nas taxas de morbimortalidade por câncer bucal. Objetivou-se identificar se o acesso a informações sobre como prevenir o câncer bucal é maior entre idosos residentes em domicílios cadastrados na ESF. Utilizou-se o SPSS® na obtenção de estimativas corrigidas pelo efeito do desenho amostral, considerando as magnitudes das associações do acesso a tais informações com os determinantes pessoais, uso dos serviços/custos com a saúde, comportamentos relacionados à saúde e desfechos da saúde. Dentre os 492 idosos, 58,9% relataram ter tido acesso a tais informações. Verificaramse maiores chances de acesso entre residentes em domicílios cadastrados na ESF; com maior renda per capita (2,01/1,18-3,43); não tabagistas (2,00/1,16-3,46); que realizaram autoexame bucal (6,35/3,46-11,64); e que não autoperceberam incômodo na boca, cabeça ou pescoço (2,06/1,024,17). O acesso foi maior entre os residentes em domicílios cadastrados na ESF. Determinantes pessoais, comportamentos relacionados à saúde e desfechos de saúde sofrem influência ou influenciam a oferta e o acesso a essas informações.

Abstract Educative actions are an important component of health promotion in Brazil's primary healthcare program, the Family Health Strategy (FHS). The efficacy of these actions is evidenced by compliance with healthy behaviors and in the reduction of rates of mortality and morbidity. The objective of this study was to identify whether access to information regarding the prevention of oral cancer is greater among elders whose residences are registered with the FHS. SPSS® was utilized to obtain estimates that were corrected for sample design, considering the magnitude of the associations between access to such information with personal determinants, the use and cost of healthcare, health-related behaviors and health outcomes. 58.9% of the 492 participating elders reported having access to such information. We verified that there was a greater chance for access among residents of houses registered by the FHS; those with greater per capita income (2.01/1.183.43); non-smokers (2.00/1.16-3.46); those that realized oral self-examination (6.35/3.46-11.64); and those that did not perceive discomfort in the mouth, head or neck (2.06/1.02-4.17). Access was greater among residents of homes registered by the FHS. Personal determinants of health, health-related behaviors and health outcomes are influenced or influence access to information regarding the prevention and management of oral diseases.

Perfil epidemiológico dos pacientes com câncer bucal em um CEO / Epidemiologic Profile of the Patients with Oral Cancer in a CEO

Foi realizado um estudo retrospectivo com o objetivo de verificar o perfil epidemiológico dos pacientes com câncer bucal, diagnosticados por biópsia e exame histopatológico, registrados nos arquivos de um Centro de Especialidades Odontológicas (CEO), no período de outubro de 2006 a fevereiro de 2013. Observou-se a prevalência relacionada entre os tipos de tumores, suas localizações, relação com tabagismo, diferenças entre os sexos, doenças sistêmicas associadas, grupos etários e tempo de evolução. Foram avaliados os dados obtidos de 1816 prontuários, dos quais 73 tiveram diagnóstico histopatológico de lesões malignas da boca. O tipo histológico mais frequente de câncer bucal encontrado neste estudo foi o carcinoma espino-celular, com 76,71% dos casos, estando diretamente relacionado ao tabagismo, acometendo principalmente pacientes em uma faixa etária de 50 a 59 anos... (AU)

The aim of this retrospective study is to verify the epidemiological profile of patients with oral cancer, diagnosed by biopsy and histopathology exam. It was evaluated the prevalence related to tumor type, their locations, and compared with smoking, gender, systemic diseases, age groups and time elapsed, registered in the archives of a Dental Specialty Center (CEO) in the period between October 2006 to February 2013. It was evaluated the data obtained from medical records of 1816 patients, of which 73 had histopathologic diagnosis of malignant lesions of the mouth. The most frequent type of oral cancer in this study was the squamous cell carcinoma, with 76.71% of cases, which was directly related to smoking, affecting mainly patients in an age range from 50 to 59 years... (AU)

Informação e comportamento preventivo de pacientes do Programa de Saúde da Família de Aracaju a respeito de câncer bucal / Level of information and preventive behavior of patients attending the Family Health Program of Aracaju-SE regarding oral cancer

Objetivo: Identificar o nível de informação e de comportamento preventivo que os pacientes do Programa Saúde da Família de Aracaju-SE possuem a respeito de câncer bucal. Métodos: Realizou-se estudo transversal, através de entrevistas estruturadas com 489 usuários das Unidades Básicas de Saúde do Programa Saúde da Família. Atribuiu-se um ponto para respostas adequadas e zero para as inadequadas. A partir da análise das respostas, os participantes do estudo foram classificados de acordo com um escore em baixo, médio e alto nível de informação e de comportamento preventivo. Os testes estatísticos utilizados foram o qui-quadrado e exato de Fisher. Resultados: A maioria dos pacientes entrevistados era do sexo feminino (78,3%), donas de casa (33%), com idades entre 18 e 71 anos (média de 33,7 anos) e utilizavam algum tipo de prótese dentária (78,3%). Cerca de 52% apresentaram médio nível de informação e 66% demonstraram alto nível de comportamento preventivo sobre câncer bucal. Eles evitavam fatores de risco como tabagismo e etilismo; consultavam regularmente profissional de saúde; não demorariam a buscar auxílio profissional caso notassem alterações bucais e já examinaram a própria boca em busca de lesões. Eles desconheciam ou possuíam informações inadequadas sobre auto-exame de boca, fatores de risco e apresentação clínica do câncer bucal. Conclusão: Com base nestes dados, os usuários das unidades básicas de saúde do Programa Saúde da Família de Aracaju apresentaram médio nível de informação e demonstraram alto nível de comportamento preventivo sobre câncer bucal.

Objective: To identify the level of information and preventive behavior of patients attending the Family Health Program of Aracaju-SE about oral cancer. Method: A cross-sectional study was performed by means of structured interviews with 489 users of public basic health units belonging to the Family Health Program. One point was attributed to adequate answers and zero to inadequate answers. From the analysis of the responses, the participants were classified according to a scoring system as having low, medium and high level of information and preventive behavior. Chi-square and Fisher's Exact tests were used for the statistical analysis. Results: The majority of the interviewed patients were females (78.3%), housewives (33%), aged between 18 and 71 years (mean age: 33.7 years) and used some type of denture (78.3%). Around 52% of them presented medium level of information and 66% showed a high level of preventive behavior about oral cancer. They avoided risk factors, such as smoking and alcoholism; visited a health professional regularly; would not take long to seek professional assistance if they noticed oral alterations; and had already examined their own mouth for the presence of lesions. However, they did not know or had inadequate knowledge of self-exam of the mouth, risk factors and clinical presentation of oral cancer. Conclusion: Based on these findings, the users of the public basic health units belonging to the Family Health Program of Aracaju-SE presented medium level of information and high level of preventive behavior about oral cancer.

Verificação do conhecimento da população Pernambucana acerca do câncer de boca e dos fatores de risco - Brasil / Knowledge of the population of the state of Pernambuco - Brazil about oral cancer and risk factors

Objetivo: Verificar o conhecimento da população pernambucana acerca do câncer de boca bem como identificar indivíduos expostos aos fatores de risco já comprovados na literatura. Metodologia: Estudo de corte transversal realizado com população de 54 municípios pernambucanos, no período de janeiro de 2005 a dezembro de 2009. A população foi visitada em suas casas, escolas, associações, conselhos, empresas públicas e privadas, ambulatórios, e, após concordar em participar deste estudo, mediante assinatura do Termo de Consentimento Livre e Esclarecido (TCLE), foi aplicado questionário. Em seguida, houve um compartilhamento de informações acerca da doença, dos fatores de risco, prevenção e autoexame. Em paralelo, foram realizados cursos de atualização/ capacitação para prevenção e diagnóstico diferencial e precoce do câncer bucal com as equipes de saúde bucal desses municípios pernambucanos. Os dados obtidos foram submetidos à análise descritiva e estatística por meio teste do qui-quadrado (Programa BioEstat 3.0). Resultados: Constituíram a amostra 43.200 (100%) pessoas que, responderam ao questionário e compartilharam das atividades educativas/ preventivas, sendo 25.488(59%) do sexo feminino e 17.712 (41%) masculino. A média das idades observada foi 42,3, sendo a mínima=07 e a máxima= 103 anos. 25.920 (60%) das pessoas já tinham ouvido falar sobre a doença, porém não souberam associar corretamente os fatores de risco, embora 24.192 (56%) estivessem expostos a estes. O sexo masculino está exposto de forma mais significativa aos fatores de risco do que as mulheres, o que foi evidenciado através do teste de qui-quadrado (alfa= 0,05; p menor que 0,01). Foi observado nesta pesquisa que, a despeito da perda dentária, a reabilitação protética não é usual. Conclusões: Parte da população conhece os fatores de risco para o câncer de boca, embora muitos desconheçam mesmo estando expostos a estes. O tabagismo, etilismo e a exposição ao sol foram identificados como os fatores de risco preponderantes nessa amostra.

Objective: To verify the knowledge of the population of the State of Pernambuco about oral cancer and identify individuals exposed to risk factors recognized in the literature. Method: A cross-sectional study was conducted with the population of 54 cities of the State of Pernambuco between January 2005 and December 2009. People were visited at their homes, schools, associations, councils, public and private companies and outpatient health services. After agreeing to participate in the study and signing an informed consent form, a questionnaire was applied to the subjects. Information was collected to assess their knowledge about the disease, risk factors, prevention and self-exam. In parallel, refreshing/capacitation courses for the prevention and differential and early diagnosis of oral cancer were offered to the oral health teams of the cities involved in the study. Data were subjected to descriptive and statistical analyses using the chi-square test (BioEstat 3.0 software). Results: A sample of 43,200 (100%) people filled out the questionnaire and took part in educative/preventive activities, being 25,488(59%) females and 17,712 (41%) males. The mean age was 42.3 years (range: 7 to 103 years). As much as 25,920 (60%) people had already heard about the disease, but they were not able to associate the risk factors correctly, although 24,192 (56%) were exposed to them. Male individuals were found to be more significantly exposed to the risk factors that females, as shown by the chi-square test (alpha= 0.05; p less than 0.01). It was observed in the present study that, despite tooth loss, prosthetic rehabilitation is not usual. Conclusion: Part of population recognizes the risk factors associated with oral cancer, although many people are not aware of them even being exposed to them. Smoking, alcoholism and direct sunlight exposure were identified as predominant risk factors in this sample.

Tratamento Conservador de Osteorradionecrose de Mandíbula: Equidade e Racionalização de Recursos / Conservative Treatment of Mandibular Osteoradionecrosis: Equity and Rationalization of Resources

Relatar uma experiência de tratamento conservadore controle da ORN mandibular. Material e Métodos: Seis casosde ORN foram tratados com aplicação tópica diária desolução aquosa de gluconato de clorexidine à 0,12%, higienebucal rigorosa e eliminação de fatores irritantes à mucosa.As lesões orais de ORN tinham até 2cm no maior eixo. Oacompanhamento clínico foi realizado semanalmente até iníciode resposta ao tratamento e mensalmente após este período.A resposta à terapia foi classificada em: remissão total eparcial, aumento da lesão e ausência de resposta.Resultados: Dos seis pacientes, dois eram do sexo femininoe quatro do sexo masculino, com idades entre 39 a 78 anos.Todos os casos apresentaram resposta positiva tratamento,com três pacientes apresentando remissão parcial e trêscom remissão total. Após uma semana e meia, todos ospacientes relaram remissão total dos sinais prodrômicos daORN (dor e secreção purulenta). O tempo médio de tratamentofoi de 16,6 meses. Conclusão: Houve redução ou cura dosquadros clínicos dos casos acompanhados, e considera-seque esta evolução evitou o encaminhamento dos pacientespara câmara hiperbárica ou ainda a ressecção cirúrgica,deste modo, o tratamento relatado contribuiu para menormorbidade e racionalização de recursos do Sistema Únicode Saúde...

To report the results obtained in the conservativetreatment and control of mandibular ORN. Material andMethods: Six cases of ORN were treated with daily aqueoussolution of chlorhexidine gluconate 0.12% mouthwash,rigorous oral hygiene and removal of irritants to the mucosa.The oral lesions of ORN had up to 2 cm in greatest diameter.Clinical follow-up was conducted weekly until early responseto treatment and monthly, after that period. Response totherapy was classified as: total and partial remission,increased injury and absence of response. Results: Two ofthe six patients were female and four were male. Ages rangedfrom 39 to 78 years old. All cases showed some positiveresponse to the treatment, three patients had partial remissionand three patients had complete remission. In a week and ahalf, all patients presented total remission of ORN prodromalsigns (pain and purulent secretion). The average time oftreatment was 16.6 months. Conclusion: Reduction or totalheal of all ORN cases were achieved. It was noticeable thatthese results avoided indication of both hyperbaric oxygentherapy and surgical resection. Thus, thetreatment reported resulted in less morbidity to patients andrationalization of resources for the Public Health System...

Characteristics of oral squamous cell carcinoma in users or non users of tobacco and alcohol / Características do carcinoma bucal de células escamosas em usuários ou não usuários de tabaco e álcool

Tobacco and alcohol are the main extrinsic etiological factors for the genesis of oral squamous cell carcinoma (SCC), but it is still not clear if the presence of these factors interfere with clinical, pathologic and molecular characteristics or with the prognosis of the disease. In the present study, these characteristics were reviewed, establishing comparisons between the lesions of patients exposed and not exposed to tobacco and alcohol. We observed that oral SCC in non smokers and non alcohol drinkers occur mainly in female patients, under 50 or over 70 years old. The lesions tend to be less aggressive in this group of patients and have a better prognosis. The molecular characteristics of these malignant tumors also appear to be influenced by the presence of these habits, once mutations of p53 have been associated with tobacco and alcohol use. The understanding of the differences between the neoplasms of these two groups of patients can contribute to the management of this cancer, which could lead to advances in the determination of more appropriate therapeutic measures.

O tabaco e o álcool são os principais fatores etiológicos extrínsecos associados à gênese do carcinoma bucal de células escamosas (CCE), mas não está claro se estes fatores interferem nas características clínico-patológicas, moleculares ou no prognóstico da doença. No presente estudo, essas características foram revisadas, estabelecendo-se comparações entre as lesões de pacientes usuários ou não de tabaco e álcool. Observou-se que carcinomas bucais de não fumantes e não etilistas ocorrem, preferencialmente, em pacientes do sexo feminino, em faixa etária inferior a 50 ou superior 70 anos. Neste grupo de indivíduos, as lesões tendem a ser menos agressivas e apresentam melhor prognóstico. O tabagismo e o etilismo também parecem influenciar as características moleculares do carcinoma bucal, uma vez que mutações da proteína p53 nas lesões têm sido associadas a esses fatores de risco. A compreensão das diferenças entre os CCE bucais desses dois grupos de pacientes pode contribuir para uma melhor abordagem e avanços no desenvolvimento de medidas terapêuticas mais adequadas frente a esta neoplasia.

Necesidades de aprendizaje relacionados con el cáncer bucal en un círculo de abuelos de Ciudad de La Habana / Learning needs related to oral cancer in Isla Azul grandparents home, Plaza de la Revolución Municipality: 2007

El envejecimiento en las personas està asociado a la aparición o aumento de afecciones estomatológicas, entre ellas las alteraciones periodontales, disfunción masticatoria y el càncer bucal, esta última enfermedad es la de mayor incidencia en la población adulta mayor y su prevención ocupa un lugar importante en la atención primaria de salud, por ello se realizó una investigación cuyo objetivo fue determinar las necesidades de aprendizaje relacionadas con el càncer bucal en el Círculo de Abuelos Isla Azul en el año 2007. Se realizó una investigación de desarrollo tecnológico, descriptiva, de corte transversal para el diagnóstico educativo. Se aplicó una encuesta a 26 ancianos y se determinaron las necesidades de aprendizaje mediante el modelo de David Leyva. El 73 por ciento de los encuestados obtuvo calificación deficiente. Se encontró bajo nivel de conocimiento de los factores de riesgo del càncer bucal, deficiencias en las vías de información educativa, desconocimiento de los síntomas y signos de alarma ante el càncer bucal. No realizaban adecuadamente el autoexamen bucal, por lo que consideramos que existieron necesidades de aprendizaje sobre prevención del càncer bucal en todos los aspectos explorados(AU)

Aging in persons it is associated with appearance or increase of stomatologic affections including the periodontal alterations, mastication dysfunction and oral cancer, this entity with the great incidence in elderlies and its prevention is a priority in Health Primary Care, thus, we conducted a research in elderlies linked to a grandparent home whose objective was to determine the learning needs related to oral hygiene in above mentioned home in 2007. A technological development, descriptive and cross-sectional research to an educational diagnosis. A survey was applied in 26 elderlies determining the learning needs by David Leyva Form. The 73 percent of person polled had a qualification of deficient. In he above mentioned home we found a knowledge low level on oral cancer risk factors, the deficiencies in ways of educational information, lack of knowledge on alarming symptoms and signs in face of or oral cancer and that they not underwent the oral examination, thus considering that there are learning needs on oral cancer prevention in all features explored(AU)

Prácticas de salud bucal y características sociodemográficas / Oral hygiene practices and sociodemographic characteristics

Describir la frecuencia y distribución de la realización de actividades preventivas relacionadas con el cáncer bucal y otras periodontopatías según edad, sexo, nivel educacional y lugar de residencia. Se realizó un estudio transversal con diseño muestral complejo, estratificado y por conglomerados polietápicos. El universo estuvo constituido por la población cubana urbana de 15 años y más, tomándose una muestra representativa por provincias que abarcó a 22 851 personas. Se practicó una entrevista en el hogar donde se recogieron datos sobre características sociodemográficas, así como la realización de algunas conductas y acciones preventivas. 96,6 por ciento de los encuestados refiere realizar el cepillado dental diario, 34,7 por ciento alude que el personal de salud le enseñó cómo efectuar el autoexamen bucal, mientras que 33,9 por ciento efectúa ese procedimiento. Al 38,7 por ciento se les practicó el examen bucal, siendo el porcentaje de estas actividades mayor en las mujeres y en edades jóvenes. Estos resultados demuestran la necesidad de aumentar las actividades preventivas en el sistema nacional de salud con una capacitación, implementación y control, para prever tempranamente el cáncer bucal y otros trastornos periodontales.

To describe the frequency and distribution of the carrying out of preventive activities related to oral cancer and other periodontal diseases according to age, sex, educational level, and residence place. A cross-sectional study with a complex sampling design, stratified by polystage groups, was conducted. The universe included the urban Cuban population aged 15 and over. A representative sample was taken by province for a total of 22 851 subjects. Home interviews were made to collect data on sociodemographic characteristics and on some behaviors and preventive actions. 96,6 percent of the surveyed referred that they brushed their teeth daily; 34,7 percent said that the health staff tougth them how to perform the oral self-examination, whereas 33,9 percent carried out this procedure. 38,7 percent underwent oral examination. The percentage of these activities was greater in females and at young ages. These results showed the need to increase the preventive activities in the National Health System by means of training, implementation and control for the early prevention of oral cancer and other periodontal disorders.