Isabella Lima Arrais Ribeiro

Factors associated with lip and oral cavity cancer

PURPOSE This study aimed to identify factors associated with the occurrence of primary cancer of the lip and oral cavity regions compared to other types of head and neck cancers according to demographic, socioeconomic data and lifestyle, in Brazil, from 2000 to 2011. METHODS A study was conducted using Hospital Cancer Records (Instituto Nacional do Câncer), from 2000 to 2011, totaling 23,153 cases. Data were analyzed by binary logistic regression (response category: primary cancers located in the lip and oral cavity; comparison category; other types of primary cancer in the head and neck, which does not affect the lip and oral cavity) at a significance level α = 5%. RESULTS The study showed factors associated with higher incidence of cancer in the lip and oral cavity: being of advanced age (OR = 1.16), not having a family history of cancer (OR = 2.38), alcohol consumption (OR = 1.17); former tobacco use (OR = 1.51) or current tobacco use (OR = 1.65); having a previous diagnosis of cancer without treatment (OR =1.66). Being female (OR = 0.92), having completed basic (OR = 0.71) and higher (OR = 0.46) education and having previous diagnosis of cancer with treatment (OR = 0.74) constituted factors associated with lower prevalence of cancer of the lip and oral cavity. CONCLUSION Age, absence of family history of cancer, smoking habits and alcohol consumption, and previous diagnosis of cancer without treatment were associated with a higher incidence of cancer of the lip and oral cavity.

Factors associated with health-related quality of life among children with cancer from the standpoint of patients and caregivers

BackgroundThe quality of life for childhood cancer patients is impaired by this disease and its treatment. Knowing the factors that contribute most to this framework allows identifying the greatest needs, subsidized preventive strategies. The objective of the study was assessing the factors associated with health-related quality of life among children with cancer from the standpoint of patients and caregivers.MethodsA cross-sectional study was conducted with sample consisted of 71 patients between the ages of 5 and 18 as well as their caregivers. Two forms (clinical examination and interview) from the National Oral Health Survey, the Modified Oral Assessment Guide and the Pediatric Quality of Life Inventory (PedsQLTM) version 3.0 were used as data collection instruments.ResultsFrom the standpoint of the caregivers, having fewer cognitive difficulties (OR = 0.92), fewer pain symptoms and hurt (OR = 0.94) and lower procedure anxiety (OR = 0.93) were associated with higher quality of life scores; by contrast, being female (OR = 9.49), the number of household members (OR = 1.94) and smiling with embarrassment (OR = 13.82) were associated with lower quality of life score. From the standpoint of patients, having fewer cognitive difficulties (OR = 0.94) and positive perception of physical appearance (OR = 0.94) were associated with higher quality of life scores; by contrast, smiling with embarrassment (OR = 11.56) and toothaches (OR = 7.37) were associated with lower quality of life score.ConclusionsThe patient and caregiver symptom reports yielded distinct results, although cognitive difficulties and smiling with embarrassment were significantly associated with impaired quality of life on both types of reports.

Oral Mucositis in Pediatric Patients in Treatment for Acute Lymphoblastic Leukemia

Oral mucositis in oncologic patients is the most undesirable event of the chemotherapeutic treatment. This study aimed to identify damage to the oral cavity resulting from chemotherapy in pediatric patients with acute lymphoblastic leukemia (ALL). This is a prospective study with a sample of 42 children and adolescents evaluated for 10 consecutive weeks after diagnosis. The modified Oral Assessment Guide (OAG) was used, and data were analyzed by Spearman’s rank correlation coefficient (α = 5%). Changes to the normal lips and saliva were positively related to an increase in the OAG score during all 10 weeks of evaluation. Alterations to the labial mucosa were correlated with an increase in the OAG score from the 2nd to 10th week, which was also found for changes in the tongue and in the swallowing function in Weeks 1, 6, 8, 9, and 10 and for gum changes from the 5th to 7th week. No significant vocal changes were correlated with the total OAG score at any point during the monitoring period. Changes in lips, cheek and/or palatal mucosa, labial mucosa, and gum areas and in swallowing function were positively correlated with an increase in the severity of oral mucositis in patients with ALL after beginning chemotherapeutic treatment.

Quality of Life of Paediatric Oncology Patients

Objective: To evaluate the indicators of quality of life (QoL) of children and adolescents with cancer and to evaluate the QoL of participants regarding oral health. Material and Methods: The modified Autoquestionnaire Qualite de Vie Enfant Image (AUQEI), with scores ranging from 0 to 78 and a cut-off value of 48, was the instrument used in this study. Questions were added regarding oral health, with scores ranging from 0 to 18. The study consisted of two groups: group 1 (case) consisted of 24 children and adolescents with cancer, and group 2 (control) consisted of 30 healthy children and adolescents aged 6 to 15 years old. A chi-square test was performed using the SPSS program, version 18.0, to determine whether health conditions were related to QoL. Results: We observed that 69.25% of participants had scores representing a satisfactory QoL, with a mean score of 54.3 (51.7 for the group of children and adolescents with cancer and 56.5 for the healthy group). The results of the present study showed a value of p =0.016, suggesting that the disease condition is related to lower QoL scores. The Mann-Whitney test showed that the healthy group showed significantly better indicators in the oral health domain. Conclusion: The children and adolescents under study showed satisfactory overall QoL standards; however, when comparing the cancer group to the healthy group, we observed that cancer is associated with lower QoL indicators.

Factors Contributing to the Duration of Chemotherapy-Induced Severe Oral Mucositis in Oncopediatric Patients

This study analyzes the factors contributing to the duration of severe oral mucositis in oncopediatric patients. A longitudinal study was conducted in the pediatric department of a cancer referral hospital between 2013 and 2017. Seventy-three patients diagnosed with cancer undergoing chemotherapy protocols were analyzed. Oral evaluations were performed using the Modified Oral Assessment Guide criteria, and the data were collected from the patients’ records. The Kaplan-Meier method was used to estimate survival curves. Most patients were males (52.1%), of mixed race (“pardo”) (49.3%), with a mean age of 7.56 years (±5.34). There was a predominance of patients diagnosed with solid tumors (52.1%), with no metastasis (86.3%), using natural product chemotherapeutics (56.2%), who had not undergone a bone marrow transplant (97.3%); amputation was observed in 35.6% of patients, while death rates were as high as 8.2%. The survival analysis estimated a mean time of 30.6 days until complete remission of severe oral mucositis. The regression analysis showed that patients over 10 years old had a median mucositis duration 1.4 times greater than those at the age of 10 years or younger. Patients without metastasis had a median mucositis duration 1.7 times greater than those with metastasis (p-value ≤ 0.10). Increasing age and the absence of metastasis were conditions that prolonged the duration of severe oral mucositis.

Susceptibility of cariogenic microorganisms to phytoconstituents

This study aimed to evaluate the in vitro antibacterial activity of the phytochemicals thymol, linalool, and citronellol against Streptococcus mutans, Streptococcus salivarius and Streptococcus oralis. Disk diffusion screening on solid medium and measurement of the diameter of the bacterial growth inhibition halos was the technique utilized. The Minimum Inhibitory Concentration (MIC) of the substances was determined using serial substance dilutions and microdilution technique in Brain Heart Infusion culture medium. After incubation for 24 hours in an oven at 37 °C, plate reading was completed and confirmed by visual method using 2,3,5 triphenyl tetrazolium chloride dye. The Minimum Bactericidal Concentration (MBC) was determined from MIC subcultures. Assays were performed in triplicate, and chlorhexidine was used as a positive control. The diameters in mm of the growth inhibition halos ranged between 7.3 and 10.7 for S. mutans, 7.3 and 10.0 for S. oralis, and 8.2 and 9.8 for S. salivarius. The MIC and MBC values obtained converged, ranging from maximum values in the presence of Linalool (1,250.0 mg/mL, 2,500.0 mg/mL and 2,500.0 mg/mL, respectively, for S. mutans, S. oralis, and S. salivarius); and minimum values with Thymol (312.5 μg/ml, 156.2 μg/mL and 156.2 μg/ml, respectively for S. mutans, S. oralis, and S. salivarius). All the tested phytochemicals displayed antibacterial activity, thus representing substances with potential applications in preventing tooth decay.

Embryonal rhabdomyosarcoma in the maxillary sinus with orbital involvement in a pediatric patient: Case report

This report presents a case of embryonal rhabdomyosarcoma (eRMS) located in the left maxillary sinus and invading the orbital cavity in a ten-year-old male patient who was treated at a referral hospital. The images provided from the computed tomography showed a heterogeneous mass with soft-tissue density, occupying part of the left half of the face inside the maxillary sinus, and infiltrating and destroying the bone structure of the maxillary sinus, left orbit, ethmoidal cells, nasal cavity, and sphenoid sinus. An analysis of the histological sections revealed an undifferentiated malignant neoplasm infiltrating the skeletal muscle tissue. The immunohistochemical analysis was positive for the antigens: MyoD1, myogenin, desmin, and Ki67 (100% positivity in neoplastic cells), allowing the identification of the tumour as an eRMS. The treatment protocol included initial chemotherapy followed by radiotherapy and finally surgery. The total time of the treatment was nine months, and in 18-mo of follow-up period did not show no local recurrences and a lack of visual impairment.

Prevalência de traumatismos dentários em pacientes com distúrbio neuropsicomotor: estudo controlado

Introduction: Traumatic dental injuries are distressing experiences in children, which promote both physical, emotional and psychological changes. Objective: To evaluate the prevalence of dental trauma in patients with neuropsychomotor disorder and to compare to normoreactive individuals. Material and method: 120 individuals, 60 neuropsychomotor changes (study group) and 60 normorreatives (control group), of both sexes, from 2 to 15 years old, assisted in the Foundation of Support to the Disabled of the Government of the State of Paraíba. Data were collected through a structured questionnaire and clinical examination. Descriptive and inferential analysis (t-student test; Fisher’s exact test) was performed, adopting a significance level of 5%. Result: The prevalence of dental trauma observed in patients with neuropsychomotor disorder was 20.0%, whereas in the control group it was 16.6% (p>0.05); in the control group the occurrence was higher in males. The groups differed according to the type of activity at the moment of the trauma (p<0.05) in relation to the etiology (p<0.05), and in relation to the place of occurrence (p<0.05). For both groups, the most affected teeth were the maxillary central incisors. Enamel fractures, followed by enamel and dentin fractures without pulp exposure were the most common lesions in both groups. Conclusion: The prevalence of dental trauma in individuals with neuropsychomotor alterations is similar to that of normorreative individuals, with a higher occurrence in females, in preteen phase, during routine activities. Descriptors: Tooth injuries; brain; neurological diagnostic. Galvão, Ribeiro, Cabral et al. Rev Odontol UNESP. 2017 Nov-Dec; 46(6): 351-356 352

Predictors for oral cancer in Brazil

Introduction: The incidence of lip, oral cavity and oropharynx cancer in Brazil is one of the highest worldwide. Objective: This study aimed to identify predictors for oral cancer in Brazil between 2010 and 2013. Method: Through a time series study in which 14,959 primary head and neck cancer diagnoses were evaluated. The variables of interest were gender, age, race, education level, family history of cancer, alcohol consumption, smoking, and previous cancer diagnosis. The outcome variable was divided into “oral cancer” and “cancer of other head and neck regions.” The data were analysed by multiple binary logistic regression; α=5%. Result: The protective factor was: approximately 12 years of education (OR = 0.85). The risk factors were: being an ex-consumer (OR=1.19) or consumer (OR=1.11) of alcohol, tobacco use (OR=1.35) and a prior diagnosis of cancer that went untreated (OR=1.21). Conclusion: Was concluded that the oral cancer had the following predictors compared to other types of head and neck cancer during the same period: approximately 12 years of education (protective factor) and ex-consumer or consumer of alcohol, smoking and previous diagnosis of cancer that went untreated (risk factors). Descriptors: Cancer; public health; social determinants; epidemiology.

Perfil socioeconômico, educacional e de acesso aos serviços ofertados pelos Centros de Especialidades Odontológicas de João Pessoa-Paraíba, Brasil

This is an epidemiological and quantitative study, using an inductive approach and a direct intensive observation of the users of the Specialty Centers of Joao Pessoa-PB, aiming at identifying the profile of the users and the use of the services offered in such centers. 590 users of the Odontology Specialty Centers (OSCs) from Torre and Jaguaribe were evaluated, from August 2012 to August 2013, all chosen at random according to daily availability, and interviewed in the centers. The data were analyzed through the Chi-square test (=0,05) in the software SPSS (20.0). It was noted that 64.2% of the users were female, had completed high school (29.2%), and the minority were unemployed — they were either freelance or registered workers (53.9%). Among the specialties offered at the OSC, Endodontics was the one with the most attendances (43.89%), while, on the other hand, health prevention and promotion practices were not present. Most users are referred to the OSCs from a Primary Health Unit.