Carcinoma escamoso oral: análise retrospectiva de 185 casos

The squamous cell carcinoma is the most common malignancy in the oral cavity, representing over 90% of cancers in this region. This study aimed to conduct an epidemiological study of oral squamous carcinoma cases diagnosed by the Department of Pathology, Department of Pathology and Clinical Propaedeutics in the Dentistry Faculty of Araçatuba - UNESP, in the period between 1995 and 2005. 185 cases were studied, it was observed that the oral floor and tongue were the sites most affected, with predominance in males, white race and aged between 41 and 60 years, noting that the majority of patients were smokers. Knowledge of these data is important for the dental surgeon to act preventively, contributing to early diagnosis of cancer.

Análise retrospectiva de 61 casos de paracoccidioidomicose diagnosticados na Faculdade de Odontologia de Araçatuba/ UNESP

Paracoccidioidomycosis is a systemic mycosis which requires prolonged treatment. It is highest prevalence in Latin America, with different endemic areas in Brazil. In this study the aim was to characterize clients suffering from mucocutaneous paracoccidioidomycosis by analysis of histopathological examinations of 61 adult patients diagnosed with mucocutaneous paracoccidioidomycosis treated at the Dental School of Araçatuba, from January 1989 to December 2004. It was observed that the disease occurred in 91.81% (56) men and 8.19% (5) women, more prevalent (78.68%) in whites, aged 40 to 59 years (62.9%) and the profession linked to agriculture in 17 patients (27.86%). All patients had oral manifestations, in multiple sites, but it was most prevalent in the oral mucosa (31.42%) and alveolar ridge (17.14%). The dentist as an integral member of the health services, must know the clinical manifestations of paracoccidioidomycosis to achieve early diagnosis and thereby to improve the quality of life of patients.

Expressão diferencial de microRNAs no câncer de próstata

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

Análise integrada entre dados de expressão global de transcritos codificadores e de miRNAs em carcinomas de células escamosas de laringe

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Aspectos sociodemográficos e epidemiológicos dos casos de hanseníase em uma área endêmica: conhecimentos e experiências de cirurgiões-dentistas

Pós-graduação em Odontologia Preventiva e Social - FOA

Fatores de risco relacionados à pré-eclâmpsia

Introduction: Preeclampsia is a major cause of maternal and perinatal morbidity and mortality in Brazil and worldwide. It is a heterogeneous disorder, multifactorial, with no clear etiology and pathophysiology. The identification of risk factors for its development can assist in prevention and early diagnosis of the clinical onset of the disease Objective: To identify risk factors related to the development of preeclampsia aimed at identifying pregnant women at risk for early disease and to offer specialized treatment to them Methodology: A bibliographic survey of scientific articles indexed in the following databases: CAPES (Ovid external Link), Scientific Eletronic Library Online (SciELO), Latin American and Caribbean Health Sciences Literature (LILACS), and Medical Literature Analysis and Retrieval System Online (Medline) of the National Library of Medicine over the last tem years (2001-2011) was carried out with the addition of certain classic and priority references.

Prevalência de infecções sexualmente transmissíveis e de alterações da microbiota vaginal e fatores associados em mulheres que fazem sexo com mulheres

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

APR e FMEA em trocador de calor de bomba

The modernization of the world made the speed, accuracy and reliability of all existing processes become increasingly necessary. For this evolution to occur every day, the evolution of the equipment was strategic, but not as much as needed. It is necessary for such equipment to ensure its function and, in case of failure, an early diagnosis to prevent loss. Therefore the evolution of maintainability and reliability in equipment is also paramount. Thus, the growth of forms of maintenance was driven by this scenario, forming maintenance philosophies. Among many, there is the RCM, which have its focus on the identification, parameters development and performance preview. One of those methodologies from this idea is the FMEA, process that has been studied and implemented this work, aiming the anticipation of failure modes and guidance for the use of a heat exchanger and a pump. This implementation has the aid of another process of RCM, the PHA, which was also shown and implemented, these results being used to start the FMEA process. The results show the activities with the highest chance of failure, presenting also the measures to be taken to avoid or minimize them. It is shown, in this paper, concern with the valves because they maintain control and system security, and its flaws related to accidents with possible danger to people and the whole system, emphasizing the priority of action

APR e FMEA em trocador de calor de bomba

The modernization of the world made the speed, accuracy and reliability of all existing processes become increasingly necessary. For this evolution to occur every day, the evolution of the equipment was strategic, but not as much as needed. It is necessary for such equipment to ensure its function and, in case of failure, an early diagnosis to prevent loss. Therefore the evolution of maintainability and reliability in equipment is also paramount. Thus, the growth of forms of maintenance was driven by this scenario, forming maintenance philosophies. Among many, there is the RCM, which have its focus on the identification, parameters development and performance preview. One of those methodologies from this idea is the FMEA, process that has been studied and implemented this work, aiming the anticipation of failure modes and guidance for the use of a heat exchanger and a pump. This implementation has the aid of another process of RCM, the PHA, which was also shown and implemented, these results being used to start the FMEA process. The results show the activities with the highest chance of failure, presenting also the measures to be taken to avoid or minimize them. It is shown, in this paper, concern with the valves because they maintain control and system security, and its flaws related to accidents with possible danger to people and the whole system, emphasizing the priority of action

Post-operative mediastinitis in a Heart Hospital of Recife: contributions for nursing care

The objective of this study was to determine the prevalence of post-operative mediastinitis with the purpose to contribute to nursing care knowledge. To do this, an analysis was performed on 896 medical records of patients who underwent heart surgery involving sternotomy at the Cardiology Emergency Room of Recife-PE, in the period between June 2007 and June 2009. The following variables were considered: gender, age, type of surgery, personal history, length of stay, use of antibiotics, and culture of the surgical wound. A high death rate from mediastinitis was observed (33.3%). Several risk factors were identified, including: systemic arterial hypertension (80.9%); smoking (61.9%); diabetes mellitus (42.8%); and obesity (33.3%), most of which (76.2%) were identified in patients who underwent surgery for myocardial revascularization. It is concluded that mediastinitis is a serious infection that needs continuous nursing supervision and preventive measures to assure an early diagnosis and, thus, reduce mortality.

Invasive aspergillosis: a severe infection in juvenile systemic lupus erythematosus patients

Infections are an important cause of morbidity and mortality in juvenile systemic lupus erythematosus (JSLE). Among them, invasive aspergillosis (IA), which is usually related to immunosuppressed patients, has been rarely reported in JSLE. From 1983 to 2011, 5604 patients were followed at our institution and 283 (5%) met the American College of Rheumatology (ACR) classification criteria for SLE. Six (2.1%) of our JSLE patients had IA. One of them was previously reported and five will be described herein. Four of them were female. The median age at JSLE diagnosis was 12 years (8-16) and the median interval between diagnosis of JSLE and IA was 6 months (1-38). All had pulmonary involvement and three of them had systemic involvement. The median Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) was 19 (7-22). Diagnosis of IA was performed by isolation of Aspergillus spp., two in bronchoalveolar lavage culture and by way of autopsy in the others. All of them were treated with corticosteroids and/or immunosuppressive drugs at IA diagnosis (azathioprine and/or intravenous cyclophosphamide). They all required treatment in the pediatric intensive care unit with mechanical ventilation and antifungal therapy (fluconazole, amphotericin B, itraconazole and/or voriconazole); nonetheless, none of them survived. In conclusion, this was the first report that evaluated the prevalence of IA in a large population of JSLE patients from a tertiary pediatric hospital, and clearly showed the severity of the outcome, especially in patients with active disease and treated with immunosuppressive agents. This study reinforces the importance of early diagnosis and treatment with certain antifungals, especially in critically ill patients. Lupus (2012) 21, 1011-1016.

Reduced platelet amyloid precursor protein ratio (APP ratio) predicts conversion from mild cognitive impairment to Alzheimer's disease

Studies have shown that platelet APP ratio (representing the percentage of 120-130 kDa to 110 kDa isoforms of the amyloid precursor protein) is reduced in patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD). In the present study, we sought to determine if baseline APP ratio predicts the conversion from MCI to AD dementia after 4 years of longitudinal assessment. Fifty-five older adults with varying degrees of cognitive impairment (34 with MCI and 21 with AD) were assessed at baseline and after 4 years. MCI patients were re-classified according to the conversion status upon follow-up: 25 individuals retained the diagnostic status of MCI and were considered as stable cases (MCI-MCI); conversely, in nine cases the diagnosis of dementia due to AD was ascertained. The APP ratio (APPr) was determined by the Western blot method in samples of platelets collected at baseline. We found a significant reduction of APPr in MCI patients who converted to dementia upon follow-up. These individuals had baseline APPr values similar to those of demented AD patients. The overall accuracy of APPr to identify subjects with MCI who will progress to AD was 0.74 +/- A 0.10, p = 0.05. The cut-off of 1.12 yielded a sensitivity of 75 % and a specificity of 75 %. Platelet APPr may be a surrogate marker of the disease process in AD, with potential implications for the assessment of abnormalities in the APP metabolism in patients with and at risk for dementia. However, diagnostic accuracy was relatively low. Therefore, studies in larger samples are needed to determine whether APPr may warrant its use as a biomarker to support the early diagnosis of AD.

Disseminated histoplasmosis in a juvenile lupus erythematosus patient

Introduction: Histoplasmosis is an infection caused by dimorphic fungus, Histoplasma capsulatum, and it has not been reported in juvenile systemic lupus erythematosus (JSLE) patients, particularly progressive disseminated histoplasmosis (PDH) subtype. Case report: We reported herein a 14-year old girl who was diagnosed with JSLE. Six months later, she had abdominal distension and received prednisone, hydroxychloroquine and azathioprine. Computer tomography evidenced hepatosplenomegaly and multiple mesenteric, mediastinal and retroperitoneal enlarged lymph nodes, forming large conglomerates at the mesentery, suggestive of lymphoproliferative disorder. After 10 days, she had acute surgical abdominal, and underwent a laparotomy and intestinal perforation and conglomerates of lymph nodes were observed. The jejunum biopsy showed perforated acute enteritis with hemorrhage and necrosis, and Grocott staining identified Histoplasma sp. and the culture showed a heavy growth of Histoplasma capsulatum. At that moment liposomal amphotericin B (1.0 mg/Kg/day) was introduced. Despite this treatment she died due to septic shock eight days later. Diffuse Histoplasma capsulatum was evidenced at autopsy. Conclusion: We reported a severe opportunistic infection in JSLE patient with adenopathy and multiple intestinal perforations. This study reinforces the importance of early diagnosis and antifungal therapy, especially in patients with these uncommon clinical manifestations.

Differential Proteomic Analysis of Noncardia Gastric Cancer from Individuals of Northern Brazil

Gastric cancer is the second leading cause of cancer-related death worldwide. The identification of new cancer biomarkers is necessary to reduce the mortality rates through the development of new screening assays and early diagnosis, as well as new target therapies. In this study, we performed a proteomic analysis of noncardia gastric neoplasias of individuals from Northern Brazil. The proteins were analyzed by two-dimensional electrophoresis and mass spectrometry. For the identification of differentially expressed proteins, we used statistical tests with bootstrapping resampling to control the type I error in the multiple comparison analyses. We identified 111 proteins involved in gastric carcinogenesis. The computational analysis revealed several proteins involved in the energy production processes and reinforced the Warburg effect in gastric cancer. ENO1 and HSPB1 expression were further evaluated. ENO1 was selected due to its role in aerobic glycolysis that may contribute to the Warburg effect. Although we observed two up-regulated spots of ENO1 in the proteomic analysis, the mean expression of ENO1 was reduced in gastric tumors by western blot. However, mean ENO1 expression seems to increase in more invasive tumors. This lack of correlation between proteomic and western blot analyses may be due to the presence of other ENO1 spots that present a slightly reduced expression, but with a high impact in the mean protein expression. In neoplasias, HSPB1 is induced by cellular stress to protect cells against apoptosis. In the present study, HSPB1 presented an elevated protein and mRNA expression in a subset of gastric cancer samples. However, no association was observed between HSPB1 expression and clinicopathological characteristics. Here, we identified several possible biomarkers of gastric cancer in individuals from Northern Brazil. These biomarkers may be useful for the assessment of prognosis and stratification for therapy if validated in larger clinical study sets.

De Novo Thrombotic Microangiopathy After Kidney Transplantation: Clinical Features, Treatment, and Long-Term Patient and Graft Survival

Introduction. Posttransplant thrombotic microangiopathy (TMA)/hemolytic uremic syndrome (HUS) can occur as a recurrent or de novo disease. Methods. A retrospective single-center observational study was applied in order to examine the incidence and outcomes of de novo TMA/HUS among transplantations performed between 2000 and 2010. Recurrent HUS or antibody-mediated rejections were excluded. Results. Seventeen (1.1%) among 1549 kidney transplant recipients fulfilled criteria for de novo TMA. The mean follow-up was 572 days (range, 69-1769). Maintenance immunosuppression was prednisone, tacrolimus (TAC), and mycophenolic acid in 14 (82%) patients. Mean age at onset was 40 +/- 15 years, and serum creatinine was 6.1 +/- 4.1 mg/dL. TMA occurred at a median of 25 days (range, 1-1755) after transplantation. Nine (53%) patients developed TMA within 1 month of transplantation and only 12% after 1 year. Clinical features were anemia (hemoglobin < 10 g/dL) in 9 (53%) patients, thrombocytopenia in 7 (41%), and increased lactate dehydrogenase in 12 (70%). Decreased haptoglobin was observed in 64% and schistocytes in 35%. Calcineurin inhibitor (CM) withdrawal or reduction was the first step in the management of 10/15 (66%) patients, and 6 (35%) received fresh frozen plasma (FFP) and/or plasmapheresis. TAC was successfully reintroduced in six patients after a median of 17 days. Eight (47%) patients needed dialytic support after TMA diagnosis and 75% remained on dialysis. At 4 years of follow-up, death-censored graft survival was worse for TMA group (43.0% versus 85.6%, log-rank = 0.001; hazard ratio = 3.74) and there was no difference in patient survival (53.1% versus 82.2%, log-rank = 0.24). Conclusion. De novo TMA after kidney transplantation is a rare but severe condition with poor graft outcomes. This syndrome may not be fully manifested, and clinical suspicion is essential for early diagnosis and treatment, based mainly in CM withdrawal and FFP infusions and/or plasmapheresis.