Fernanda Guglielmi Faustini Sônego

Meta-analysis of magnetic resonance imaging accuracy for diagnosis of oral cancer

Objective To establish the diagnostic accuracy of magnetic resonance imaging (MRI) as an auxiliary means for the diagnosis of oral cancer through a systematic review and meta-analysis. Methods An exhaustive search of publications from 1986 to 2016 was performed of Medline, Embase and Cochrane (and related databases), including grey literature. Primary diagnostic accuracy studies that assessed oral cancer (target condition) using MRI (index test) were included. Diagnostic threshold, sensitivity and meta-regression analyses were performed. A meta-analysis was performed using Meta-DiSc® v. 1.4 software. Results A total of 24 primary studies were assessed, comprising 1,403 oral cancer lesions. Nine studies used diffusion-weighted MRI, with a diagnostic odds ratio (DOR) of 30.7 (95% confidence interval [CI]: 12.7–74.3) and area under the curve (AUC) of 0.917 (95% CI: 0.915–0.918); seven studies used dynamic contrast-enhanced MRI, with a DOR of 48.1 (95%CI: 22.4–103.2) and AUC of 0.936 (95% CI: 0.934–0.937); and 13 studies used traditional MRI, with a DOR of 23.9 (95%CI: 13.2–43.3) and AUC of 0.894 (95% CI: 0.894–0.895). Meta-regression analysis indicated that the magnetic field strength may have influenced the heterogeneity of the results obtained (p = 0.0233) using traditional MRI. Sensitivity analysis revealed a discrete reduction of inconsistency in some subgroups. Conclusion The three types of MRI assessed exhibited satisfactory accuracy compared to biopsy. Considering the relevance of early treatment and screening and that better health care results in improved survival rates and quality of life for oral cancer patients, we suggest the use of MRI as a part of the pre-treatment and monitoring protocol at public health services.

Condição de saúde bucal, estado nutricional e perfil socioeconômico de pacientes com necessidades especiais

Introdução: A abordagem odontológica precoce dos pacientes com deficiência é importante para determinar a sua qualidade de higiene bucal, estimular a realização de higiene periódica e capacitar o núcleo familiar, que será o responsável por tal tarefa. Uma relação entre saúde bucal e estado nutricional existe, mas ainda não se encontram na literatura muitos estudos que fundamentem essa afirmação adequadamente. Objetivo: Avaliar e relacionar a idade, o sexo, a condição de saúde bucal, o estado nutricional e o perfil socioeconômico dos pacientes com necessidades especiais da Associação de Pais e Amigos dos Excepcionais (APAE), de um município gaúcho. Método: Trata-se de um estudo observacional, transversal, de análise descritiva, realizado no Centro Ocupacional Santa Rita de Cássia em Caxias do Sul RS, relacionando variáveis como dados obtidos com aplicação do índice CPO-D (dentes cariados, perdidos e obturados) na

Meta-Analysis of Prevalence of Xerostomia in Diabetes Mellitus

Background: As with other complications of diabetes mellitus, the occurrence of dry mouth can lead to a poor quality of life. Therefore, this study aimed to identify the prevalence of xerostomia in patients with diabetes mellitus through a systematic review and meta-analysis. Method: Systematic review and meta-analysis. Results: After the screening process, 23 studies were included in the meta-analysis. Overall, the incidence of dry mouth was investigated in 1979 people with diabetes (cases) and 1225 controls. The global prevalence of diabetes in xerostomia was 42.22% (95% CI: 33.97%-50.92%). In the analysis by specific subtype, the overall prevalence was 37.42% (95% CI: 22.33%-55.44%) among individuals with Type 1 diabetes and 46.09% (95% CI: 23.99%-69.85%) among those with type 2 diabetes. The prevalence of xerostomia found in Asia (49.01%; 95% CI: 32.08%-66.16%) was higher than that found in Europe (40.04%; 95% CI: 29.58%-51.50%) and America (38.39%; 95% CI: 23.63%-55.65%). Analysis of the case-control studies showed a statistically significant association between xerostomia and diabetes mellitus (OR=3.15; 95% CI: 2.11-4.70; p<0.001). Conclusion: Through the data collected, we can infer that the prevalence of xerostomia in individuals affected by diabetes mellitus types 1 and 2 was high and independent of geographic location.