A criança disfônica: diagnóstico, tratamento e evolução clínica

Os nódulos vocais são causas freqüentes de disfonias infantis, porém, através das vídeoendoscopias, outras lesões têm sido diagnosticadas na laringe infantil, como os cistos, sulcos, pontes e micromembranas, denominadas de lesões estruturais mínimas. OBJETIVO: Avaliar, em 71 crianças com disfonia agendadas nos ambulatórios de Foniatria da Faculdade de Medicina de Botucatu (Unesp) nos últimos cinco anos: sexo, idade, diagnósticos, tratamentos e evolução clínica. FORMA DE ESTUDO: Clínico retrospectivo. CASUÍSTICA E MÉTODO: Realizou-se estudo retrospectivo das avaliações otorrinolaringológicas e endoscópicas de 71 crianças com queixas de disfonia e idade entre 3 a 13 anos (45 meninos e 26 meninas). As crianças haviam sido submetidas a exame endoscópico com telescópio rígido ou nasofibroscópio flexível. Foram excluídas as crianças com disfonias funcionais ou com queixas de obstrução respiratória. RESULTADOS: Os principais diagnósticos foram: nódulo vocal (47 casos; 66,2%), cisto epidérmico (7 casos; 9,9%), cisto aberto fistulizado (6 casos; 8,4%), sulco vocal (5 casos; 7,1%), ponte + cisto (2 casos; 2,8%), micromembrana anterior (2 casos; 2,8%) e pólipo vocal (2 casos; 2,8%). As disfonias foram mais freqüentes entre os meninos (63,3%). A fonoterapia isolada foi o tratamento de escolha nos casos de nódulo vocal (evolução favorável), sulco vocal (evolução desfavorável) e micro-membrana (evolução desfavorável). Nas demais lesões (cistos, pontes e pólipos) o tratamento de escolha foi a cirurgia associada à fonoterapia, com resultados satisfatórios, exceto nos casos que recusaram a cirurgia. CONCLUSÃO: Os nódulos vocais são as principais causas de disfonias em crianças, porém as lesões estruturais mínimas mostraram-se também freqüentes, exigindo exame minucioso para o diagnóstico.

Bleomycin sensitivity in patients with familial and sporadic polyposis: a pilot study

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Expression of betacatenin in carcinoma in pleomorphic adenoma, pleomorphic adenoma and normal salivary gland: an immunohistochemical study

OBJECTIVES: Pleomorphic adenomas are the most frequent type of epithelial salivary gland neoplasms, and their malignant counterpart, the carcinoma in pleomorphic adenomas, is much less common. Beta-catenin is a cell adhesion molecule associated with the invasion and metastasis of carcinomas of the head and neck, esophagus. The objective of this study was to detect the expression of beta-catenin in pleomorphic adenomas, carcinomas in pleomorphic adenomas and normal salivary glands to discuss its role in the development of these two lesions. STUDY DESIGN: The expression of beta-catenin (BD Transduction Laboratories) was analyzed by immunohistochemistry in formalin-fixed, paraffin embedded specimens by the avidin-biotin-peroxidase complex method in 16 pleomorphic adenomas (12 from minor salivary glands), 3 carcinomas in pleomorphic adenomas (all from palate) and 10 normal salivary glands as control group (5 from major and 5 from minor salivary glands). RESULTS: All cases of glands, adenomas and carcinomas in pleomorphic adenomas have membranous and cytoplasmic immunostaining. Nuclear beta-catenin immunostaining was not observed. The antibody presented a fine granular arrangement in the cytoplasm and cellular membrane of duct and acinic cells. Higher beta-catenin index rates were seen mainly in salivary gland ducts and in ductal structures in the adenomas and carcinomas in pleomorphic adenomas. There was protein loss in pleomorphic adenomas and cytoplasmic accumulation in carcinoma in pleomorphic adenomas. CONCLUSIONS: The present study showed participation of the loss of beta-catenin adhesion molecule in the development of pleomorphic adenoma, and that the cytoplasmic accumulation of the molecule takes part in the malignant transformation of the pleomorphic adenoma into carcinoma in pleomorphic adenoma.

Avaliação clínica, videolaringoscópica e vocal perceptivo-auditiva e acústica de professores disfônicos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Transtorno de déficit de atenção e hiperatividade: a medicalização e a coação no desenvolvimento moral

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Tratamiento Quirúrgico de Mesiodens en Odontopediatría

Supernumerary teeth are a relatively frequent disorder of odontogenesis that can interfere with the development of the germs teeth. This pathology is most common in the maxillary anterior area, called mesiodens, and their prevalence is generally reported to occur more frequently in male than female, in a ratio of 2:1. The aim of this article was to report the clinical procedures performed in the Clinic of Pediatric Dentistry at the Araraquara School of Dentistry when the presence of two mesiodens, radiographically shown, caused retention of permanent anterior teeth, resulting in esthetic and funcional disturb. All the surgical procedures, etiology and the importancy of the early diagnostic for the appropriate treatment was detailed described.

Tratamiento quirúrgico de mesiodents en odontopediatría

Supernumerary teeth are a relatively frequent disorder of odontogenesis that can interfere with the development of the germs teeth. This pathology is most common in the maxillary anterior area, called mesiodens, and their prevalence is generally reported to occur more frequently in male than female, in a ratio of 2:1. The aim of this article was to report the clinical procedures performed in the Clinic of Pediatric Dentistry at the Araraquara School of Dentistry when the presence of two mesiodens, radiographically shown, caused retention of permanent anterior teeth, resulting in esthetic and funcional disturb. All the surgical procedures, etiology and the importancy of the early diagnostic for the appropriate treatment was detailed described.

Osteomielitis crónica con periostitis proliferativa

Chronic osteomyelitis with proliferative periostitis is a kind of osteomyelitis that is characterized by a great periosteal reaction resulting of low grade stimulation, usually a caries lesion associated a periapical pathology. It affects especially children and young adults, with the mandible as the most common site, usually in the inferior aspect. Clinically presents as a painless hard swelling intra and/or extra-oral. Radiographic aspects include bone layers new formed, parallel to each other and to the underlying cortical surface, giving the characteristic appearance of "onion skin". Treatment includes elimination of the cause, with or without antibiotics, being restored the facial symmetry of patient. The present article is a clinical case report of chronic osteomyelitis with proliferative periostitis affecting a female 11 year old patient, caused by a caries lesion in the left permanent first molar, that was submissed to a exodontia and the facial symmetry of the patient was restored with management.

Imagen de hipertrofia bilateral del proceso coronoides mandibular a través de la tomografía computarizada cone-beam

The hypertrophy of the mandibular coronoid process is a rare condition, progressive and of unknown etiology, characterized by the over development of the coronoid process determining their size increased, resulting in progressive and painful limitation of mouth opening. The mandibular hypomobility is a present symptom in several diseases and associates it to a specific cause requires detailed clinical and imaginologic examination. The cone-beam computed tomography has the potential to provide complementary informations above than conventional radiography. It also has the advantage of eliminate overlaps, provide high resolution image, helping not only in diagnosis, but also in planning the surgical procedure. Here we report a case of male patient, who appeared at the clinic for an evaluation of a trismus. He had no pain, only discomfort for progressive limitation of mouth opening. On physical examination, only a limited mouth opening has been found. Although the movements of laterality and protrusión were posible, they were very limited. Cone-beam computed tomography examination was performed, that showed an image compatible with bilateral hypertrophy of the mandibular coronoid process.

Brinquedoteca móvel: o brincar interativo na hospitalização infantil

The hospitalization process can cause significant changes in the children’s everyday life because, besides the suffering caused by the disease, there are the invasive processes which bring them sorrow. Thus, aiming to make this state of sorrow lower and to contribute for the treatment process we developed in a hospital the Mobile Toy Library project which develops interactive activities through playing, trying to make the staying of these kids at the hospital easier. The team is formed by Psychology professors and students, who daily visit the children with a trolley full of toys in order to interact and play with them. We wait on 500 patients a year. We concluded the Mobile Toy Library provides ways for kids to elaborate their psychological conflicts, lowering their sorrow as well as their negative feelings of staying in hospital, and this helps them deal with the disease, family and medical team all together.

Pemphigus vulgaris in adolescence: a case report

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Tratamento cirúrgico de ameloblastoma mandibular

Ameloblastomas are benign, invasive locally and highly recurrent. It is an odontogenic tumor, characterized by the proliferation of epithelial ameloblastic in a fibrous stroma. This paper reports a case of mandibular ameloblastoma, in patients 27 years of age without pain with developments around 4 years, with about 20 mm at its greatest extent, sessile base and surface coatings full. The treatment of choice was the surgical conservative

Ectopic third molar as a cause of sinusitis

Ectopic third molar teeth are those that are impacted in unusual positions, or that have been displaced and are at a distance from their normal anatomic location. Ectopic eruption of a tooth within the oral cavity is common, but rare in other sites. Ectopic eruption can be associated with developmental disturbances, pathologic processes or iatrogenic activity. Male, 19- years old, with an upper left ectopic third molar located in the maxillary sinus-infraorbital region. The patient reported a bad taste and recurrent sinusitis that had been resistant to treatment. Surgical excision was carried out of the third molar tooth using the Caldwell-Luc approach.

Osteotomia ventral da bula timpânica em gatos: revisão de literatura

Otite média e pólipos são as principais afecções da orelha média em gatos. A otite média geralmente é decorrente de otite externa crônica, enquanto os pólipos se formam a partir de um processo inflamatório crônico presente na orelha média. Quando o pólipo sai da cavidade timpânica pela tuba auditiva, aparecendo na nasofaringe, é denominado pólipo nasofaríngeo. Outra possibilidade é o pólipo romper a membrana do tímpano e surgir no meato acústico externo. O tratamento indicado para essas afecções é a osteotomia ventral da bula timpânica, procedimento cirúrgico cuja finalidade é remover exsudatos inflamatórios presentes na cavidade timpânica. Apesar de possíveis complicações, como síndrome de Horner e lesão na orelha interna, essa cirurgia proporciona resultados muito satisfatórios. O objetivo da presente revisão é relatar essas afecções da orelha média em gatos e descrever a técnica cirúrgica de osteotomia ventral da bula timpânica.