Referral letters in oral medicine: an approach for the general dental practitioner

The aim of this study was to analyze the contents of referral letters related to clinical history and reason for consultation. A total of 236 consecutive referral letters were evaluated. Analysis of the referral letters was based on key items concerning patient identification. chief complaint, previous consultation. laboratory investigation and use of drugs for the chief complaint. A database was organized (Epinfo 6.04) and the chi (2) test (a = 0.05) was applied to the results. of the 800 files examined. only 30%, (236) had a referral letter. of the 236 referral letters. 67% were from dentists, 22% from physicians and 11% from unidentified professionals. Patient age did not appear in 70%, of the letters and the chief complaint was mentioned only in 55%. The letters had no details such as description of the oral lesion (80%), anatomical site (34%), size (99%), symptoms (83%), or period of evolution (92%). Clinical diagnosis was not included in 84% of the letters. Less than 5% of the referral letters contained information about previous consultation and laboratory investigation. The chi (2) test showed significant differences for ail items of the referral letter. Referral letters did not satisfy minimal requirements about clinical history or reason for consultation. leading to failed communication among professionals. Based on this study, we suggest that standard letters are important to improve the quality of the letters, reducing the rate of omission of relevant items.

Subclinical abnormalities of glucose metabolism in Brazilian women with a history of gestational diabetes mellitus

Background. To evaluate insulin release and insulin sensitivity in women with prior gestational diabetes mellitus (GDM) to gain a better understanding of type 2 diabetes pathogenesis.Methods. GDM women were individually matched for age, body mass index, and waist/hip ratio with those who were normal glucose tolerant in a previous pregnancy (NGT). All women presented with normal glucose tolerance. Twenty pairs were submitted to the oral glucose tolerance test (OGTT) with plasma glucose, insulin, and C-peptide determinations. of the 20 pairs, 18 participated in hyperglycemic (10.0 mmol/l) clamp experiments with frequent plasma glucose and insulin determinations, allowing us to calculate first- and second-phase insulin release and the insulin sensitivity index. GDM and NGT women were compared using Student's t-test, the Mann-Whitney U-test, Friedman's non-parametric test, and the two proportion test for independent groups.Results. GDM women showed higher glycosylated hemoglobin values; at OGTT, they showed late insulin peak with increased plasma insulin levels only during the second hour, and a similar plasma C-peptide response despite a higher plasma glucose curve; during hyperglycemic clamp procedures, they showed similar biphasic insulin release and insulin sensitivity index. Considering that a woman with previous GDM had a defect in insulin release and/or insulin sensitivity, if its magnitude was at least 25% lower than that of the matched NGT woman, 43.8% showed impairment of first-phase insulin release and 55.6% insulin resistance.Conclusions. GDM women showed some degree of glucose intolerance. It is therefore necessary to follow them for a longer time.

Management of Osteonecrosis of the Jaws in Patients With History of Bisphosphonates Therapy

Bisphosphonates are compounds used in the treatment of various metabolic and malignant bone diseases. The relation between the use of bisphosphonates and ostenonecrosis of the jaws as an adverse effect of the drug has been intensely discussed during the last few years, and up to this moment, there is no consensus concerning an ideal treatment modality for this condition. Nevertheless, there is an agreement among researchers that the standard goal for controlling jaw osteonecrosis is to prevent it. Otherwise, the rationale for a randomized controlled trial is that current treatment has proven to be suboptimal, and no consensus has been reached yet on the best strategies to repair the exposed bone once bone necrosis is developed. This article is focused on reporting a case of moderate osteonecrosis of the upper jaw induced by bisphosphonates and discusses a possible role for surgical debridement associated to platelet-rich plasma, hyperbaric oxygen therapy, and the cessation of the bisphosphonate use in managing this type of lesion. Moreover, the dentist, the oral surgeon, and the oncologist need to work together to reach better outcomes.

Caries and its association with infant feeding and oral health-related behaviours in 3-4-year-old Brazilian children

Objectives: To investigate the relationships between socio-demographic factors, infant feeding habits, oral hygiene and the prevalence and patterns of caries in Brazilian 3-4-year-olds. Methods: Systematic random sampling was used to select children enrolled in municipal nurseries in Araraquara, Brazil, in 1998. Clinical examinations were carried out by one examiner using dmft and dmfs indices and WHO criteria. Questionnaires for information related to the socio-demographic background, oral hygiene and dietary history of the children were completed by their mothers. Results: Caries was seen in 46% of the children; 17% of them had the more extensive pattern involving molars and incisors. Social class, mother's education, and age at which breast-feeding terminated showed statistically significant associations with caries. Feeding bottles with added sugars were still being given to 80% of the children. When the significant variables were taken into account only age at which breast-feeding terminated showed a significant relationship to the pattern of disease. Children who were never breast-fed or were breast-fed beyond the age of 24 months had a higher prevalence of the more extensive pattern of caries. Conclusions: The association between the length of time a mother breast-feeds and extensive caries should be a consideration in any local infant feeding policies or health promotion strategies. The duration for appropriate breast- or bottle-feeding should be emphasised.

Unusual presentation of oral squamous cell carcinoma in a young woman

Oral squamous cell carcinoma (OSCC) is the most common oral malignant neoplasm, mainly affecting individuals over 50 years old with a history of tobacco and alcohol use. The occurrence of this oral cancer in individuals under 40 years old is unusual and, when it does occur, shows a weaker relation to those risk factors and a more aggressive clinical course. Due to the paucity of reports in this population, it is difficult to prove its increasing trend. A case of oral squamous cell carcinoma in a 39-year-old woman with no history of tobacco or alcohol use is reported. Clinical and histopathological findings, aetiology, and treatment are discussed. The increasing trend of oral squamous cell carcinoma in young women without known risk factors highlights the need for clinicians to be prepared to diagnose this lesion quickly and precisely, providing a better prognosis, chance of survival, and quality of life for the patient.

Oral granuloma formation after injection of cosmetic filler

The increased use of orofacial fillers in cosmetic procedures has led to new diagnostic challenges for dentists and oral pathologists. Here, we describe a case with multiple oral foreign body granulomas, which were formed after a polymethylmetacrylate injection for cosmetic purposes. © 2011 European Association for Cranio-Maxillo-Facial Surgery.

High dosage folic acid supplementation, oral cleft recurrence and fetal growth

Objectives: To evaluate the effects of folic acid supplementation on isolated oral cleft recurrence and fetal growth. Patients and Methods: The study included 2,508 women who were at-risk for oral cleft recurrence and randomized into two folic acid supplementation groups: 0.4 and 4 mg per day before pregnancy and throughout the first trimester. The infant outcome data were based on 234 live births. In addition to oral cleft recurrence, several secondary outcomes were compared between the two folic acid groups. Cleft recurrence rates were also compared to historic recurrence rates. Results: The oral cleft recurrence rates were 2.9% and 2.5% in the 0.4 and 4 mg groups, respectively. The recurrence rates in the two folic acid groups both separately and combined were significantly different from the 6.3% historic recurrence rate post the folic acid fortification program for this population (p = 0.0009 when combining the two folic acid groups). The rate of cleft lip with palate recurrence was 2.9% in the 0.4 mg group and 0.8% in the 4 mg group. There were no elevated fetal growth complications in the 4 mg group compared to the 0.4 mg group. Conclusions: The study is the first double-blinded randomized clinical trial (RCT) to study the effect of high dosage folic acid supplementation on isolated oral cleft recurrence. The recurrence rates were similar between the two folic acid groups. However, the results are suggestive of a decrease in oral cleft recurrence compared to the historic recurrence rate. A RCT is still needed to identify the effect of folic acid on oral cleft recurrence given these suggestive results and the supportive results from previous interventional and observational studies, and the study offers suggestions for such future studies. The results also suggest that high dosage folic acid does not compromise fetal growth. © 2013 by the authors; licensee MDPI, Basel, Switzerland.

The Panama Canal turns 100: history and possible future scenarios

This issue of the FAL Bulletin sets out a brief history of the Panama Canal, its construction and its social and political impact on Panama, within the context of international trade at the time. This issue also reviews the recovery of the canal by the Republic of Panama and subsequent major events, including the decision to expand the canal and the start-up of work on the expansion project.

Mediação oral da literatura: a voz do bibliotecário lendo ou narrando

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Desempenho oral em português para falantes de outras línguas: da avaliação à aprendizagem de línguas estrangeiras em contexto online

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Estado nutricional relacionado à vitamina K de pacientes portadores de doença vascular em tratamento anticoagulante oral ambulatorial com varfarina sódica

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

A tradição oral no ensino de línguas indígenas: uma proposta para o povo Parkatêjê

Esta dissertação tem como objetivo principal “apresentar uma proposta para o ensino da língua parkatêjê apoiada na tradição oral do povo de mesma denominação, com vistas a sua implantação na Escola Indígena Pẽmptykre Parkatêjê”, da aldeia Parkatêjê, localizada na Terra Indígena Mãe Maria, à altura do quilômetro 30 da rodovia BR 222, no município Bom Jesus do Tocantins. Com base em Severino (2007), caracteriza-se como uma pesquisa etnográfica, por visar compreender a cotidianidade da aludida escola, no que se refere ao ensino e aprendizagem da língua tradicional, e também como pesquisa bibliográfica, tendo em vista a natureza das fontes utilizadas para sua tessitura. A pesquisa está vinculada à Linguística Aplicada, uma área da INdisciplina ou transdisciplinar, segundo Moita Lopes (2006), pautada na democracia cognitiva por uma educação emancipadora, conforme Petraglia (2013). O texto está estruturado em quatro partes, além da introdução e das considerações finais. A primeira parte apresenta considerações gerais sobre os Parkatêjê. A segunda parte trata de uma abordagem histórica acerca do desenvolvimento da linguística indígena no contexto educacional brasileiro, com base nos acontecimentos observados desde o ano de 1540 até os dias atuais. A terceira parte reúne algumas características de sociedades reguladas pela tradição oral, ou principalmente por meio dessa tradição, e, a partir de uma definição de cultura, apresenta reflexões sobre cultura oral e cultura escrita. A quarta parte trata do histórico da educação formal na aldeia parkatêjê e aborda informações referentes ao protagonismo do povo de mesma denominação no momento contemporâneo da mencionada escola. Ainda nesta última parte, a aludida proposta de ensino, que se intitula “A tradição oral no ensino da língua parkatêjê”, é apresentada, com o apoio de Queiroz e Pereira (2013), Belintane (2007; 2008), Calvet (2011) e de outros estudos levados a efeito por autores favoráveis à pujança da oralidade no ensino de língua. A pesquisa destaca os velhos da aldeia, índios de primeira geração, como atores importantes no processo de ensino e aprendizagem da língua tradicional na educação formal.

Environmental sensitivity index (ESI) mapping of oil spill in the amazon coastal zone: the PIATAM Mar project

A importância do monitoramento ambiental é medida pelos vários casos de derramamentos de óleo ocorridos no mundo durante as últimas três décadas. Isto tem incentivado as empresas e órgãos do governo envolvidos na prevenção e combate a estes acidentes a aperfeiçoarem cada vez mais os métodos, tanto preventivos como corretivos, para a minimização dos danos gerados por acidentes com derramamento de óleo. Este trabalho objetiva contextualizar de forma histórica como os acidentes com derramamento de óleo propiciaram o desenvolvimento de pesquisa tecnológica a partir de parcerias entre empresas de petróleo, agências de governo, universidades e institutos de pesquisa no Brasil, em especial na zona costeira Amazônica. Como resultado, índices de sensibilidade ambiental ao derramamento de óleo (ISA) foram definidos especialmente para a Amazônia costeira, onde processos fluviais e marinhos se encontram na foz do maior rio do mundo, o rio Amazonas. Perspectivas de pesquisa e respostas de emergência a acidentes são apresentadas, a fim de se conservar a diversidade socioambiental da mais importante região tropical do planeta.

Larvae of proceratophrys melanopogon (amphibia: anura), with emphasis on internal oral morphology and comparisons with p. cururu and p. moratoi

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)