Background The assessment of pain as the fifth vital sign (P5VS) is of paramount importance since... more Background The assessment of pain as the fifth vital sign (P5VS) is of paramount importance since it leads to the management of undertreated pain, consequently reducing suffering, readmissions and emergency department visits after hospital discharge. Objective To evaluate the implementation of P5VS in public and private hospitals. Methods Data analysis on validated questionnaires was sent to all 171 Portuguese hospitals via an official letter. Results When compared to private hospitals, public hospitals presented a higher adherence to the process related to the P5VS. It has demonstrated superiority in the charts properly placed to record P5VS, in the number of emergency departments recording P5VS, in the regularity of audits, and in the existence of guidelines and staff training on pain assessment and management. Conclusion The standardization of both evaluation and recording of pain intensity constitutes a measure of good clinical practice. Public hospitals demonstrated better comm...
This study aimed to compare the performance of intra-oral autologous bone grafts versus porcine x... more This study aimed to compare the performance of intra-oral autologous bone grafts versus porcine xenografts in a two-step lateral window sinus lift. This split-mouth randomised controlled trial sequentially enrolled 12 patients with a 6-month follow-up. For each patient, a simultaneous randomised bilateral maxillary sinus lift was performed and filled with autologous bone from the mandible (control) or a porcine xenograft (test). A bone biopsy sample was collected during the implant placement for histological and histomorphometric analysis. CT scans were performed at the beginning and at the end of the trial to assess radiological evolution. A comparison of initial and six-month CT scans indicated statistically significant increases in bone level for both materials (7.8 ± 2.4 mm for autologous and 8.7 ± 2.2 mm for xenograft, p < 0.05), and there were no significant differences between the performance of the two materials over time (p = 0.26). The histological analysis showed vario...
Introduction: Non-small cell lung cancer (NSCLC) is the second most common cancer globally. The m... more Introduction: Non-small cell lung cancer (NSCLC) is the second most common cancer globally. The mesenchymal-epithelial transition (MET) proto-oncogene can be targeted in NSCLC patients. Methods: We performed a literature search on PubMed in December 2019 for studies on MET inhibitors and NSCLC. Phase II and III clinical trials published in English between 2014 and 2019 were selected. Results: Data on MET inhibitors (tivantinib, cabozantinib, and crizotinib) and anti-MET antibodies (emibetuzumab and onartuzumab) are reported in the text. Conclusion: Emibetuzumab could be used for NSCLC cases with high MET expression. Further, studies on onartuzumab failed to prove its efficacy, while the results of tivantinib trials were clinically but not statistically significant. Additionally, cabozantinib was effective, but adverse reactions were common, and crizotinib was generally well-tolerated.
Technological advances have increased the rate of success of dental procedures. In periradicular ... more Technological advances have increased the rate of success of dental procedures. In periradicular surgery, the use of ultrasonic tips ensures high-quality root-end cavity preparations, enables the performance of a 90-degree apicoectomy, and removes larger amounts of contaminated material. The authors reviewed in vitro and in vivo studies in the literature and evaluated root-end cavities prepared with burs or ultrasonic tips using scanning electron microscopy.
American Society of Clinical Oncology educational book. American Society of Clinical Oncology. Annual Meeting, Jan 23, 2018
Esophageal cancer and gastric cancer are aggressive diseases for which treatment approaches are f... more Esophageal cancer and gastric cancer are aggressive diseases for which treatment approaches are facing a new era. Some molecular pathways, such as VEGF, EGFR, fibroblast growth factor receptor, PIK3CA, and PARP-1, have been studied, and novel targeted drugs are presumed to be developed in the near future. From The Cancer Genome Atlas report, 80% of Epstein-Barr virus tumors and 42% of tumors with microsatellite instability have PIK3CA mutations, suggesting that this pathway could be reevaluated as a possible target for new systemic treatment of gastric cancer. Notably, higher PARP-1 expression can be found in gastric cancer, which might be related to more advanced disease and worse prognosis. In addition, PD-L1 expression, high microsatellite instability, and mismatch repair deficiency can be found in gastric cancer, thus suggesting that immunotherapy may also play a role in those patients. We discuss trends related to the potential of novel therapies for patients with esophageal an...
Journal of clinical and experimental dentistry, 2018
The search for the ideal, healthy and reproducible position of the condyles is of utmost importan... more The search for the ideal, healthy and reproducible position of the condyles is of utmost importance for dental diagnosis and treatment. Thus, the objective of this laboratory cross-sectional study was to verify the relationship between the posterior joint space and the mandibular lateral movements. Dental casts from 15 women and 15 men with normal mastication, 28 natural teeth and no history of temporomandibular disorders or pain, were fabricated and mounted on a fully adjustable articulator. From the maximum intercuspal position, condylar displacement was evaluated and measured on the working and nonworking sides during mandibular lateral movement, both to the right and left sides. The correlation between the measures of interest was assessed with the Pearson correlation coefficient (α=.05). Condylar displacement on the working side and nonworking side condyle was 0.88±0.71 mm and 3.57±1.11 mm (right mandibular lateral movement); and 0.91±0.58 mm and 3.51±0.78mm (left mandibular la...
The global burden of lung cancer has been increasing over the past years, and is still a major th... more The global burden of lung cancer has been increasing over the past years, and is still a major threat to public health worldwide, leading to disabilities and premature mortality. Despite multifactorial cause, smoking remains as the major etiological factor, followed by occupational exposure to carcinogens, genetic predisposition and other concomitant diseases. In order to reduce the individual and social burden due to the direct and indirect costs related to the lung cancer treatment, accurate methods of screening are needed. Among those, x-ray with cytological analysis of sputum was first proposed. Nowadays, more sensitive methods such as low-dose computed tomography are being used to improve the early detection. In the future, molecular biomarkers may complement low-dose computed tomography and improve the robustness of early lung cancer detection.
Clinical implant dentistry and related research, Jan 3, 2017
Findings in regenerative medicine applied to the sinus lift procedures. Evaluate the effectivenes... more Findings in regenerative medicine applied to the sinus lift procedures. Evaluate the effectiveness of regenerative medicine in sinus lift. An extensive search for manuscripts were performed by using different combinations of keywords and MeSH terms (Pub-med; Embase; Scopus; Web of Science Core Collection; Medline; Current Contents Connect; Derwent Innovations Index; Scielo Citation Index; Cochrane library). The full text selected articles are written in English, Portuguese, Spanish, Italian, German, or French, and published until 28 of November 2016. Inclusion criteria were: implant osteointegration, radiographic, histologic, and/or histomorphometric analysis, clinical studies in humans using of regenerative medicine. This systematic review was performed by selecting only randomized controlled clinical trials and controlled clinical trials. Eighteen published studies (11 CT and 7 RCT) were considered eligible for inclusion in the present systematic review. These studies demonstrated...
ABSTRACT Background: Retinoblastoma (Rb) and p53 gene play a fundamental role in cell cycle mecha... more ABSTRACT Background: Retinoblastoma (Rb) and p53 gene play a fundamental role in cell cycle mechanisms, and their deregulation is related to many steps of oral cancer carcinogenesis. This study was conducted to evaluate the expression of p53 and Rb proteins in malignant and pre-malignant oral cavity lesions. Methods: Design: Retrospective study from 1990 to 2004. Setting: Federal University of Bahia, Salvador, Brazil, and Molecular Biology Laboratory of the Otorhinolaringology Department of the University of Heidelberg, Germany. Protocol: Forty five excisional biopsy samples of oral cavities were collected from patients with suspect oral lesions, including 15 squamous cell carcinoma, 15 leukoplakia, and 15 actinic cheilitis. The samples were processed by imunohistochemistry to be classified by a semi-quantitative score: samples &lt; 10% positivity (-) was considered without expression; from 11 to 50% of positivity (+), moderate expression; 50% (++), high expression. Data was analyzed according to descriptive statistics with Statistical Package for Social Science (SPSS), Chicago, version 18.0, software. Results: Actinic cheilitis presented higher expression frequency (100%) +/++ to p53 protein; squamous cell carcinoma, 46%; and leukoplakia, 23%. However, squamous cell carcinoma showed higher frequency (93.3%) expression +/++ to Rb protein; actinic cheilitis, 80%; and leukoplakia 73.3% respectively. Conclusions: Despite the small number of samples, the expression of these cell cycle biomarkers (p53 and Rb protein) in excisional biopsies may suggest that molecular lesion assessment could determine premalignant lesions, and its use may improve clinical and surgical approach in early lesions. Thus, the p53 expression may be related with early steps of carcinogenesis in oral cavity squamous cell carcinoma. Higher Rb expression was observed in malignant lesions. Further studies with a higher number of samples are warranted to reach statistical significance.
Lung cancer (LC) is a serious public health problem responsible for the majority of cancer deaths... more Lung cancer (LC) is a serious public health problem responsible for the majority of cancer deaths and comorbidities in developed countries. Tobacco smoking is considered the main risk factor for LC; however, only a few smokers will be affected by this cancer. Current screening methods are focused on identifying the early stages of this malignancy. Thus, new data concerning the roles of microRNA alterations in inflammation, epithelial-mesenchymal transition and lung disease have increased hope about LC pathogenesis, diagnosis, treatment and prognosis. MicroRNA mechanisms include angiogenesis promotion, cell cycle regulation by modulating cellular proliferation and apoptosis, and migration and invasion inhibition. In this context, this manuscript reviews the current information about many important microRNAs as they relate to the initiation and progression of LC.
Due to the bite force importance in functionality of the masticatory system, this study aimed to ... more Due to the bite force importance in functionality of the masticatory system, this study aimed to characterize it in dolichofacial and brachyfacial individuals. A sample comprised by 190 patients was divided into two groups: 90 severe dolichofacial, and 100 severe brachyfacial individuals classified according to the VERT index and the face height ratio (Jarabak quotient). Bite force was measured by using an adjusted digital dynamometer and proper methodology. The sample met the parametric assumptions and presented statistical significance when right and left sides of dolichofacial and brachyfacial individuals were compared. However, within the same group, no differences between the left and right sides were found. Generally, bite force was higher for male, left masticator, age between 41-50 years, weighing over 100kg and between 1.81 and 1.90m tall. Based on the results of this cross-sectional study, it was possible to conclude that the bite force in severe brachyfacial individuals w...
s, EACMFS XIX Congress Swelling was the most frequent chief complaint (39%), followed by pain (22... more s, EACMFS XIX Congress Swelling was the most frequent chief complaint (39%), followed by pain (22%). However, 18% of the cases were symptomless. Among 171 surgically treated odontogenic tumors, enucleation with or without curettage was performed in 125 cases (65.1%). At least 5 cases of ameloblastoma and 4 cases of keratocystic odontogenic tumor recurred.
Technological advances have increased the rate of success of dental procedures. In periradicular ... more Technological advances have increased the rate of success of dental procedures. In periradicular surgery, the use of ultrasonic tips ensures high-quality root-end cavity preparations, enables the performance of a 90-degree apicoectomy, and removes larger amounts of contaminated material. The authors reviewed in vitro and in vivo studies in the literature and evaluated root-end cavities prepared with burs or ultrasonic tips
Page 1. ANÁLISE COMPARATIVA ENTRE DUAS METODOLOGIAS PARA AFERIÇÃO DE INFILTRAÇÃO POR CORANTE EM A... more Page 1. ANÁLISE COMPARATIVA ENTRE DUAS METODOLOGIAS PARA AFERIÇÃO DE INFILTRAÇÃO POR CORANTE EM APICOPLASTIAS COM RETROBTURAÇÕES 505 ANÁLISE COMPARATIVA ENTRE DUAS METODOLOGIAS PARA AFERIÇÃO DE ...
Background The assessment of pain as the fifth vital sign (P5VS) is of paramount importance since... more Background The assessment of pain as the fifth vital sign (P5VS) is of paramount importance since it leads to the management of undertreated pain, consequently reducing suffering, readmissions and emergency department visits after hospital discharge. Objective To evaluate the implementation of P5VS in public and private hospitals. Methods Data analysis on validated questionnaires was sent to all 171 Portuguese hospitals via an official letter. Results When compared to private hospitals, public hospitals presented a higher adherence to the process related to the P5VS. It has demonstrated superiority in the charts properly placed to record P5VS, in the number of emergency departments recording P5VS, in the regularity of audits, and in the existence of guidelines and staff training on pain assessment and management. Conclusion The standardization of both evaluation and recording of pain intensity constitutes a measure of good clinical practice. Public hospitals demonstrated better comm...
This study aimed to compare the performance of intra-oral autologous bone grafts versus porcine x... more This study aimed to compare the performance of intra-oral autologous bone grafts versus porcine xenografts in a two-step lateral window sinus lift. This split-mouth randomised controlled trial sequentially enrolled 12 patients with a 6-month follow-up. For each patient, a simultaneous randomised bilateral maxillary sinus lift was performed and filled with autologous bone from the mandible (control) or a porcine xenograft (test). A bone biopsy sample was collected during the implant placement for histological and histomorphometric analysis. CT scans were performed at the beginning and at the end of the trial to assess radiological evolution. A comparison of initial and six-month CT scans indicated statistically significant increases in bone level for both materials (7.8 ± 2.4 mm for autologous and 8.7 ± 2.2 mm for xenograft, p < 0.05), and there were no significant differences between the performance of the two materials over time (p = 0.26). The histological analysis showed vario...
Introduction: Non-small cell lung cancer (NSCLC) is the second most common cancer globally. The m... more Introduction: Non-small cell lung cancer (NSCLC) is the second most common cancer globally. The mesenchymal-epithelial transition (MET) proto-oncogene can be targeted in NSCLC patients. Methods: We performed a literature search on PubMed in December 2019 for studies on MET inhibitors and NSCLC. Phase II and III clinical trials published in English between 2014 and 2019 were selected. Results: Data on MET inhibitors (tivantinib, cabozantinib, and crizotinib) and anti-MET antibodies (emibetuzumab and onartuzumab) are reported in the text. Conclusion: Emibetuzumab could be used for NSCLC cases with high MET expression. Further, studies on onartuzumab failed to prove its efficacy, while the results of tivantinib trials were clinically but not statistically significant. Additionally, cabozantinib was effective, but adverse reactions were common, and crizotinib was generally well-tolerated.
Technological advances have increased the rate of success of dental procedures. In periradicular ... more Technological advances have increased the rate of success of dental procedures. In periradicular surgery, the use of ultrasonic tips ensures high-quality root-end cavity preparations, enables the performance of a 90-degree apicoectomy, and removes larger amounts of contaminated material. The authors reviewed in vitro and in vivo studies in the literature and evaluated root-end cavities prepared with burs or ultrasonic tips using scanning electron microscopy.
American Society of Clinical Oncology educational book. American Society of Clinical Oncology. Annual Meeting, Jan 23, 2018
Esophageal cancer and gastric cancer are aggressive diseases for which treatment approaches are f... more Esophageal cancer and gastric cancer are aggressive diseases for which treatment approaches are facing a new era. Some molecular pathways, such as VEGF, EGFR, fibroblast growth factor receptor, PIK3CA, and PARP-1, have been studied, and novel targeted drugs are presumed to be developed in the near future. From The Cancer Genome Atlas report, 80% of Epstein-Barr virus tumors and 42% of tumors with microsatellite instability have PIK3CA mutations, suggesting that this pathway could be reevaluated as a possible target for new systemic treatment of gastric cancer. Notably, higher PARP-1 expression can be found in gastric cancer, which might be related to more advanced disease and worse prognosis. In addition, PD-L1 expression, high microsatellite instability, and mismatch repair deficiency can be found in gastric cancer, thus suggesting that immunotherapy may also play a role in those patients. We discuss trends related to the potential of novel therapies for patients with esophageal an...
Journal of clinical and experimental dentistry, 2018
The search for the ideal, healthy and reproducible position of the condyles is of utmost importan... more The search for the ideal, healthy and reproducible position of the condyles is of utmost importance for dental diagnosis and treatment. Thus, the objective of this laboratory cross-sectional study was to verify the relationship between the posterior joint space and the mandibular lateral movements. Dental casts from 15 women and 15 men with normal mastication, 28 natural teeth and no history of temporomandibular disorders or pain, were fabricated and mounted on a fully adjustable articulator. From the maximum intercuspal position, condylar displacement was evaluated and measured on the working and nonworking sides during mandibular lateral movement, both to the right and left sides. The correlation between the measures of interest was assessed with the Pearson correlation coefficient (α=.05). Condylar displacement on the working side and nonworking side condyle was 0.88±0.71 mm and 3.57±1.11 mm (right mandibular lateral movement); and 0.91±0.58 mm and 3.51±0.78mm (left mandibular la...
The global burden of lung cancer has been increasing over the past years, and is still a major th... more The global burden of lung cancer has been increasing over the past years, and is still a major threat to public health worldwide, leading to disabilities and premature mortality. Despite multifactorial cause, smoking remains as the major etiological factor, followed by occupational exposure to carcinogens, genetic predisposition and other concomitant diseases. In order to reduce the individual and social burden due to the direct and indirect costs related to the lung cancer treatment, accurate methods of screening are needed. Among those, x-ray with cytological analysis of sputum was first proposed. Nowadays, more sensitive methods such as low-dose computed tomography are being used to improve the early detection. In the future, molecular biomarkers may complement low-dose computed tomography and improve the robustness of early lung cancer detection.
Clinical implant dentistry and related research, Jan 3, 2017
Findings in regenerative medicine applied to the sinus lift procedures. Evaluate the effectivenes... more Findings in regenerative medicine applied to the sinus lift procedures. Evaluate the effectiveness of regenerative medicine in sinus lift. An extensive search for manuscripts were performed by using different combinations of keywords and MeSH terms (Pub-med; Embase; Scopus; Web of Science Core Collection; Medline; Current Contents Connect; Derwent Innovations Index; Scielo Citation Index; Cochrane library). The full text selected articles are written in English, Portuguese, Spanish, Italian, German, or French, and published until 28 of November 2016. Inclusion criteria were: implant osteointegration, radiographic, histologic, and/or histomorphometric analysis, clinical studies in humans using of regenerative medicine. This systematic review was performed by selecting only randomized controlled clinical trials and controlled clinical trials. Eighteen published studies (11 CT and 7 RCT) were considered eligible for inclusion in the present systematic review. These studies demonstrated...
ABSTRACT Background: Retinoblastoma (Rb) and p53 gene play a fundamental role in cell cycle mecha... more ABSTRACT Background: Retinoblastoma (Rb) and p53 gene play a fundamental role in cell cycle mechanisms, and their deregulation is related to many steps of oral cancer carcinogenesis. This study was conducted to evaluate the expression of p53 and Rb proteins in malignant and pre-malignant oral cavity lesions. Methods: Design: Retrospective study from 1990 to 2004. Setting: Federal University of Bahia, Salvador, Brazil, and Molecular Biology Laboratory of the Otorhinolaringology Department of the University of Heidelberg, Germany. Protocol: Forty five excisional biopsy samples of oral cavities were collected from patients with suspect oral lesions, including 15 squamous cell carcinoma, 15 leukoplakia, and 15 actinic cheilitis. The samples were processed by imunohistochemistry to be classified by a semi-quantitative score: samples &lt; 10% positivity (-) was considered without expression; from 11 to 50% of positivity (+), moderate expression; 50% (++), high expression. Data was analyzed according to descriptive statistics with Statistical Package for Social Science (SPSS), Chicago, version 18.0, software. Results: Actinic cheilitis presented higher expression frequency (100%) +/++ to p53 protein; squamous cell carcinoma, 46%; and leukoplakia, 23%. However, squamous cell carcinoma showed higher frequency (93.3%) expression +/++ to Rb protein; actinic cheilitis, 80%; and leukoplakia 73.3% respectively. Conclusions: Despite the small number of samples, the expression of these cell cycle biomarkers (p53 and Rb protein) in excisional biopsies may suggest that molecular lesion assessment could determine premalignant lesions, and its use may improve clinical and surgical approach in early lesions. Thus, the p53 expression may be related with early steps of carcinogenesis in oral cavity squamous cell carcinoma. Higher Rb expression was observed in malignant lesions. Further studies with a higher number of samples are warranted to reach statistical significance.
Lung cancer (LC) is a serious public health problem responsible for the majority of cancer deaths... more Lung cancer (LC) is a serious public health problem responsible for the majority of cancer deaths and comorbidities in developed countries. Tobacco smoking is considered the main risk factor for LC; however, only a few smokers will be affected by this cancer. Current screening methods are focused on identifying the early stages of this malignancy. Thus, new data concerning the roles of microRNA alterations in inflammation, epithelial-mesenchymal transition and lung disease have increased hope about LC pathogenesis, diagnosis, treatment and prognosis. MicroRNA mechanisms include angiogenesis promotion, cell cycle regulation by modulating cellular proliferation and apoptosis, and migration and invasion inhibition. In this context, this manuscript reviews the current information about many important microRNAs as they relate to the initiation and progression of LC.
Due to the bite force importance in functionality of the masticatory system, this study aimed to ... more Due to the bite force importance in functionality of the masticatory system, this study aimed to characterize it in dolichofacial and brachyfacial individuals. A sample comprised by 190 patients was divided into two groups: 90 severe dolichofacial, and 100 severe brachyfacial individuals classified according to the VERT index and the face height ratio (Jarabak quotient). Bite force was measured by using an adjusted digital dynamometer and proper methodology. The sample met the parametric assumptions and presented statistical significance when right and left sides of dolichofacial and brachyfacial individuals were compared. However, within the same group, no differences between the left and right sides were found. Generally, bite force was higher for male, left masticator, age between 41-50 years, weighing over 100kg and between 1.81 and 1.90m tall. Based on the results of this cross-sectional study, it was possible to conclude that the bite force in severe brachyfacial individuals w...
s, EACMFS XIX Congress Swelling was the most frequent chief complaint (39%), followed by pain (22... more s, EACMFS XIX Congress Swelling was the most frequent chief complaint (39%), followed by pain (22%). However, 18% of the cases were symptomless. Among 171 surgically treated odontogenic tumors, enucleation with or without curettage was performed in 125 cases (65.1%). At least 5 cases of ameloblastoma and 4 cases of keratocystic odontogenic tumor recurred.
Technological advances have increased the rate of success of dental procedures. In periradicular ... more Technological advances have increased the rate of success of dental procedures. In periradicular surgery, the use of ultrasonic tips ensures high-quality root-end cavity preparations, enables the performance of a 90-degree apicoectomy, and removes larger amounts of contaminated material. The authors reviewed in vitro and in vivo studies in the literature and evaluated root-end cavities prepared with burs or ultrasonic tips
Page 1. ANÁLISE COMPARATIVA ENTRE DUAS METODOLOGIAS PARA AFERIÇÃO DE INFILTRAÇÃO POR CORANTE EM A... more Page 1. ANÁLISE COMPARATIVA ENTRE DUAS METODOLOGIAS PARA AFERIÇÃO DE INFILTRAÇÃO POR CORANTE EM APICOPLASTIAS COM RETROBTURAÇÕES 505 ANÁLISE COMPARATIVA ENTRE DUAS METODOLOGIAS PARA AFERIÇÃO DE ...
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