Os significados do tabagismo construídos na dinâmica social

The present study has the purpose of catching the significances of smoking in the social dinamics based on the Theory of Social Representations. It was developed among adults with ages from 20 to 59 years, low social and economic conditions, at Natal RN, Brazil. The Free-words Association Test was applied as the instrument of data collection and a semi-structured interview with the smokers and non-smokers, besides a structured interview with smokers, non-smokers and ex-smokers. All data was analyzed by the descriptive statistics using the Analysis of Content Technique of the thematic kind and by the softwares ALCESTE and EVOC 2000. Elaborations about smoking were marked by social, cultural and historical dimension, however they showed sensibility to changes and revealed positive and negative aspects of the habit. The analysis of the semi-structured interviews showed the following categories and under-categories respectively: Initiation of the habit (Friends and Family and Appreciation and Beauty); Psychosocial Implications of smoking (Personal relationship, Work and Financial); Behavior when facing smoking (Positive, Negative and Neutral); Smoking Effects (Smokers´ health and the other people health); Description about oral diseases ( Bad breath, Oral cancer and Dental problems); Smoking treatment (Physician and psychological, Supernatural and Difficulties). ALCESTE analysis presented 4 classes: Ambivalence between pleasure and get ill, Smoking as a trouble and danger to society, Social discrimination of smokers and Mouth as a place of reaffirmation of the discrimination. Those helped us to understand the psychosocial repercussion of the habit. On the social representation structure we identified as a probable central nucleus of the smoker group the categories Pleasure and Bad to the health and as peripheral elements Alcoholic Drink, Financial damage and Nervousness. For the non-smoker group the category Bad to the health comes first and Stop Smoking comes as a peripheral element. Finally, we hope that the knowledge of these representations can contribute to plan and/or to rethink over the professional practices and public policies related to smoking. Besides that, for an amplified comprehension of the study object the discussions over the identified representations should be deepen and amplified to other population and social groups

Atividades preventivas realizadas pelos cirurgiões-dentistas do PSF de Natal-RN

Family Health Program (FHP) presents itself as a restructured model on basic cares besides having prevention practices and promotion in health as essential parts. According to that, the purpose of this study is to perceive which prevention practices in oral health are accomplished by the dentists from the FHP of Natal-RN as well as the way they have been developed, the knowledge basis to execute the procedure and the use of evaluation instruments by the dentists and by the Oral Health Co-Ordinator. A list of dentists participating on the FHP of Natal in March, 2006 (n= 91) was obtained so it was possible to formulate a structured interview. After excluding those with less than six months attending to the program, and considering the loss, eighty dentists got to be interviewed. It had questions about individual and group preventive procedures, sources of basement to develop the activities and to verify the impact and evaluation instruments. Besides that, an interview was made with the Oral Health Co-Ordinator about the evaluating process and the existence of a protocol as well as about document analysis in the Ambulatory Informations System Unique Health System (AIS-UHS), Information of Basic Care System and Pact of Recorder. The main individual activities consist on Oral Hygiene Orientation (87,5%) and Fluoridization (95%). Group activities remain at scholar groups acts(91,25%) being fluoridization done by 91,25% and educative activities by 86,25% mainly through speeches (61,25%).Orientations about oral cancer were detached on the aged group (39,96%)and hypertensive and diabetic group (19,51%), as well as integration with the health team was respectively 21,93% and 39,02%. Speeches and talk rounds are the main activities for aged, hypertensive and diabetics, and are also expressive to pregnant women. For pregnant women and babies group predominate hygiene and diet orientation. About the evaluation instruments 73,75% of the dentists do not consider their existence, despite 73,75% consider that actions have impact specially due to a increase of hygiene and decrease of caries index on the children. The main sources of basement are clinical experience (42,5%) and preparative courses (33,75%), only 7,5% mentioned population need and local reality. The Oral Health Co-Ordinator related the Attention Pact Recorder and records from the AIS - UHS as evaluation source but also detached the lack of epidemiologic surveying. She mentioned the increase of supervised brushing as a positive result and detached the hardness of the professional to act inside the family and as a team. The AIS-UHS records showed that fluoridization is more used individually and the supervised brushing is predominant as a group action, besides that educative activities at the Health Establishment predominate due to actions at the community. Facing the results, it was verified the act in different groups, special attention given to scholars, as well as focus the activities on caries giving less emphasis to other oral problems. Despite that, there was no epidemiologic instruments or data of the local reality to guide the actions and to be part of the planning and evaluation process

Associação entre polimorfismos funcionais nos genes da MMP-7 e MMP-9 e o perfil clinicopatológico do carcinoma epidermóide de língua

Matrix metalloproteinase-7 (MMP-7) and -9 (MMP-9) modulate important functions strictly related to the development, invasion and metastasis of several human cancers among them the squamous cell carcinoma of the tongue (SCCT). However, individual genetic factors such as the functional single nucleotide polymorphisms (SNPs) influence the pattern of protein expression of these MMPs and thus may be related to the variability observed in the clinical behavior of patients with SCCT. In this context, the present cross-sectional study aimed to evaluate the association between the frequency of the functional SNPs MMP-7 -181 A/G and MMP-9 -1562 C/T and the clinical (age, gender and metastasis) and pathological (malignancy histological grading and immunohistochemistry expression) features of SCCT cases. Genotyping of these SNPs were performed by PCR-RFLP on DNA samples from 71 cases of SCCT and 60 individuals without cancer who constitute the control group. Among the results of this research, it was observed that the frequency of the polymorphic alleles MMP-7 -181 G and MMP-9 -1562 T in SCCT patients was 28% and 12%, respectively, and the frequency of the heterozygotes A/G (PR = 2.00; p < 0.001) and C/T (PR = 1.54; p = 0.014) were significantly higher in the patient group than in the controls. The prevalence of patients carrying the combination of SNPs studied was significantly associated with SCCT cases (PR = 2.00; p = 0.011) and metastasis (PR = 2.00; p < 0.001). Furthermore, with the frequency of SNPs analyzed, the age, gender, histological grading and immunoreactivity of MMP-7 and MMP-9 formed clinical and pathological parameters relevant to the identification of population subgroups more related to the development of SCCT and metastasis. Based on these results, it is suggested that the protein expression levels of MMP-7 and -9 substantially influence the balance between their pro- and anticancer biological functions and hence the clinicopathological profile of the squamous cell carcinoma of the tongue

Imbalance of Tumor Suppression Genes Expression Following Rat Tongue Carcinogenesis Induced by 4-Nitroquinoline 1-Oxide

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

Comparação entre dois métodos de detecção de DNA de papilomavírus humano em carcinoma epidermoide de lábio

Introdução: Recentemente o papilomavírus humano (HPV) tem sido associado à carcinogênese oral. A metodologia empregada na detecção do vírus é uma das maiores causas observadas da grande variabilidade nas taxas de detecção do HPV. Objetivo: Este estudo comparou a sensibilidade de detecção do DNA do HPV em casos de carcinoma epidermoide de lábio utilizando a amplificação do DNA viral por reação em cadeia da polimerase (PCR) ou nPCR. Material e método: Foram utilizadas 33 amostras provenientes de casos de carcinoma epidermoide de lábio. Para as extrações do DNA utilizou-se o sistema QIAamp DNA Mini Kit. Como controle interno utilizou-se o gene da b-globina. Das 33 amostras iniciais, 30 foram positivas para o gene b-globina, sendo utilizadas para detectar o DNA viral. Comparou-se a amplificação do DNA viral pelos métodos da PCR com os oligonucleotídeos MY09/MY11 e nPCR, empregando-se os pares de oligonucleotídeos iniciadores MY09/MY11 e, na segunda etapa, o par GP5+/GP6+. O controle positivo para a presença do DNA do HPV utilizado foi a linhagem de células HeLa e, como controle negativo, a mistura de amplificação sem DNA. A análise dos produtos de PCR e nPCR para HPV foi realizada por eletroforese em gel de poliacrilamida a 8%. Resultados: Utilizando-se o método da PCR, a amplificação do DNA do HPV foi constatada em dois casos. Com a nPCR foi verificada presença de DNA viral em 13 das 30 amostras. Conclusão: Com a utilização da nPCR, a detecção do HPV nos casos estudados aumentou mais de seis vezes.

Epidemiologia do câncer de boca em laboratório público do Estado de Mato Grosso, Brasil

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Surgical treatment of squamous cell carcinoma of tongue with carbon dioxide laser radiation (CO2)

In this clinical study, we proposed to observe the efficacy of the treatment of squamous cell carcinoma of the tongue (SCCT) by carbon dioxide (CO2) laser surgery. Twelve patients with SCCT were treated with excisional surgery using the CO2 laser with a spot size of 0.8 mm, 10 W, power density of 2.5 W/cm(2) in continuous mode, and under constant vacuum removal of the plume. The post surgical clinical evaluations were done every day until the sutures were removed and then every 7 days up to 1 month postoperatively. Subjects were re-examined quarterly until the fifth year post surgery. After 5 yr of follow-up for all subjects, there was no recurrence of the SCCT at the involved sites. The functional and aesthetic results observed were excellent. It is concluded that CO2 laser ablation of SCCT is an extremely useful surgical technique that can provide a clean field and is capable of providing surgical results consistent with accepted principles of oncological surgery. (C) 2012 Laser Institute of America.

Fluorescence spectroscopy for the detection of tongue carcinoma - validation in an animal model

The efficacy of fluorescence spectroscopy to detect squamous cell carcinoma is evaluated in an animal model following laser excitation at 442 and 532 nm. Lesions are chemically induced with a topical DMBA application at the left lateral tongue of Golden Syrian hamsters. The animals are investigated every 2 weeks after the 4th week of induction until a total of 26 weeks. The right lateral tongue of each animal is considered as a control site (normal contralateral tissue) and the induced lesions are analyzed as a set of points covering the entire clinically detectable area. Based on fluorescence spectral differences, four indices are determined to discriminate normal and carcinoma tissues, based on intraspectral analysis. The spectral data are also analyzed using a multivariate data analysis and the results are compared with histology as the diagnostic gold standard. The best result achieved is for blue excitation using the KNN (K-nearest neighbor, a interspectral analysis) algorithm with a sensitivity of 95.7% and a specificity of 91.6%. These high indices indicate that fluorescence spectroscopy may constitute a fast noninvasive auxiliary tool for diagnostic of cancer within the oral cavity. (C) 2008 Society of Photo-Optical Instrumentation Engineers.

Abnormal expression of bcl-2 and bax in rat tongue mucosa during the development of squamous cell carcinoma induced by 4-nitroquinoline 1-oxide

4-Nitroquinoline 1-oxide (4NQO)-induced rat tongue carcinogenesis is a useful model for studying oral squamous cell carcinoma. The aim of this study was to investigate the expression of bcl-2 and bax during tongue carcinogenesis induced by 4NQO. Male Wistar rats were distributed into three groups of 10 animals each and treated with 50 ppm 4NQO solution through their drinking water for 4, 12 or 20 weeks. Ten animals were used as negative control. Although no histological changes were induced in the epithelium after 4 weeks of carcinogen exposure, bcl-2 and bax were over-expressed (P < 0.01) in all layers of the 'normal' epithelium. The expression levels were the same in all layers of epithelium for both the antibodies used (bcl-2 or bax). In dysplastic lesions at 12 weeks following carcinogen administration, the levels of bcl-2 and bax expression did not increase when compared to negative control with the immunoreactivity for bcl-2 being restricted to the superficial layer of epithelium. In well-differentiated squamous cell carcinoma induced after 20 weeks of treatment with 4NQO, bcl-2 was expressed in some cells of tumour islands. on the other hand, immunostaining for bax was widely observed at the tumour nests. The labelling index for bcl-2 and bax showed an increase (P < 0.05) after only 4 weeks of 4NQO administration. In conclusion, our results suggest that abnormalities in the apoptosis pathways are associated with the development of persistent clones of mutated-epithelial cells in the oral mucosa. Bcl-2 and bax expression appears to be associated with a risk factor in the progression of oral cancer.

Surgical treatment of erythroleukoplakia in lower lip with carbon dioxide laser radiation

Erythroplakia is considered to represent a premalignant condition and is felt to be at high risk to progress to oral cancer development. When the lesion presents with red and white mucosal alterations concomitantly, the term erythroleukoplakia is used. However, in erythroleukoplakia lesions, the red or erythroplakia areas have been shown to be most likely to demonstrate dysplastic changes compared to the white hyperkeratotic areas. We present a case of patient with erythroleukoplakia involving the lower lip that was treating with carbon dioxide laser radiation (CO2) with 0.8 mm focus, 5 W, power density of 2.5 W/cm(2) in continuous. After the surgery, the vaporized surface was protected with a fibrinolisine + chloramphenicol cream. To date, after 6 months, there has been no clinically evident recurrence on the vermilion area. The functional and esthetic results observed were judged to be excellent.

Placental glutathione S-transferase correlates with cellular proliferation during rat tonguie carcinogenesis induced by 4-nitroquinoline 1-oxide

Taking into consideration that glutatione S-transferase (GST) and cellular proliferation play a crucial role during carcinogenesis, the goal of this study was to investigate the expression of placental GST, called GST-P, and proliferating cellular nuclear antigen (PCNA) by means of immunohistochemistry during rat tongue carcinogenesis induced by 4-nitroquinoline 1-oxide (4NQO). This is a useful model for studying oral squamous cell carcinoma phase by phase. Male Wistar rats were distributed into three groups of 10 animals each and treated with 50 ppm 4NQO solution by drinking water for 4, 12 or 20 weeks. Ten animals were used as negative control. GST-P positive foci were detected in non-neoplastic oral cells at 4 weeks of 4NQO administration. In the same way, GST-P positive cells were detected in pre-neoplastic lesions and squamous cell carcinomas induced after 12 and 20 weeks-treatment, respectively. None of the control animals expressed GST-P positive cells. Regarding cellular proliferation, PCNA positive nuclei were higher at 12 and 20 weeks following 4NQO exposure (p < 0.05) when compared to negative control. These results suggest that the expression of GST-P is correlated with cellular proliferation, in which GST-P is associated with risk and progression of oral cancer, whereas PCNA is closely involved during neoplastic conversion. (c) 2007 Published by Elsevier GmbH.

Medium-term tongue carcinogenesis assays: A comparative study between 4-nitroquinoline 1-oxide (4NQO)-induced rat and dimethylbenzanthracene (DMBA)-induced hamster carcinogenesis

The most used animal models in oral cancer research are the hamster treated by dimethylbenzanthracene (DMBA), and the rat treated by 4-nitroquinoline 1-oxide (4NQO). The purpose of this study was to compare the DMBA-induced hamster tongue carcinogenesis and 4NQO-induced rat tongue carcinogenesis by means of morphological analysis. Male Wistar rats were distributed into three groups of ten animals each and treated with 50 ppm 4NQO solution by drinking water for 4, 12 or 20 weeks. A total of 18 Syrian golden hamsters were submitted to 0.5% DMBA (dissolved in acetone) topical application three times/week for 4, 12 and 20 weeks. The primary histopathological change i.e., hyperplasia and hyperkeratosis, was evidenced after 4 weeks treatment with DMBA. Regarding 12 weeks treatment, 4NQO and DMBA were able to induce morphological changes as depicted by hyperplasia and dysplasia. At 20 weeks, squamous cell carcinoma was found in the majority of animals for both carcinogens used. Taken together, our results suggest that the hamster experimental model disclosed aspects related with tongue carcinogenesis in lesser time than rats. Probably, such discrepancies depend strongly on route of administration and the susceptibility with respect to animal species. © 2006 Elsevier GmbH. All rights reserved.

Estudo clínico, morfológico e imunoistoquímico de carcinomas espinocelulares em boca: análise comparativa entre pacientes jovens e idosos

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

Elaboração, padronização e aplicação de questionário para avaliação de conhecimento sobre câncer bucal validado pela teoria de resposta ao item

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Atenção ao câncer de boca no estado de Mato Grosso

Pós-graduação em Odontologia Preventiva e Social - FOA