BackgroundThe frequencies of molecular breast cancer subtypes vary among different human populations. The Northeastern region of Brazil has a mixed population of African, Indigenous and European ancestry. This retrospective study investigated breast cancer subtypes and applied therapies in a public hospital of Northeastern Brazil.MethodsData of 633 patients with invasive breast cancer from 2005 to 2011 were obtained from medical records. Status of hormone receptor (HR), HER2 and Ki67 expression index of 269 out of 633 patients were used to define subtypes of Luminal A and B, HER2 and triple negative (TN) breast cancer. Expression index of Ki67 ≥ 14% was applied to distinguish Luminal A from Luminal B subtypes.ResultsOverall, 185 (68.77%) and 132 (49.07%) patients showed positive hormone receptor (HR+) and positive HER2 (HER2+) tumors. The mean age ranged from 53.33 to 58.25 years for patients with tumors of Luminal B and Luminal A subtypes, respectively (p = 0.0182). In general, 67.39% of patients with TN tumors aged over 50 and 19.57% aged between 31 and 40 years (p = 0.0046). The rate of small tumors (T1: ≤ 2.0 cm) varied from 22.73% to 52.46% for TN and Luminal A subtypes (p = 0.0088). The rate of high graded (G3) tumors was increased for HER2 and TN subtypes (35.29% and 34.28%) compared to Luminal A and Luminal B subtypes (3.92% and 12.62%), respectively (p < 0.0001). The five-year survival rate ranged from 92.86% to 75.00%, for Luminal A, HER2 and TN subtypes, respectively (HR: 0.260 to 1.015; 95% CI: 0.043 to 3.594; p = 0.2589). Patients with HER2 positive (HER2+) breast tumors did not receive immunotherapy and chemotherapy application varied from 54.84% to 86.49% for Luminal A and HER2 subtypes, respectively (p = 0.0131).ConclusionsThe results of this study revealed a high percentage of HER2+ breast tumors and an increased rate of patients with TN tumors aged over 50 years. This emphasizes the need for establishing immunotherapy as an additional therapeutic option to improve clinical outcomes for patients with HER2+ tumors and to investigate the risk factors of TN breast cancer.
RESUMOA utilização da prototipagem rápida na área médico-odontológica consiste na obtenção de modelos tridimensionais através de sistemas Computer Aided Design (CAD) e Computer Aided Manufacturing (CAM). Tais sistemas incidem especificamente sobre ferramentas de visualização aprimoradas 3D, que fornecem ao profissional a oportunidade de planejamento pré-operatório preciso através da impressão tridimensional. O objetivo deste trabalho é descrever as principais etapas na fabricação de biomodelos utilizando uma impressora 3D Objet (CONNEX 350), cuja matéria prima é uma resina fotopolimerizável. As etapas descritas são adotadas pelos pesquisadores do Laboratório de Tecnologias Tridimensionais (LT3D) do Núcleo de Tecnologias Estratégicas em Saúde, da Universidade Estadual da Paraíba, e iniciam-se com a aquisição das imagens tomográficas que são processadas por meio do softwares específicos e exportadas para o formato Stereolitography (STL). A técnica de manufatura aditiva utilizada é a estereolitografia, que consiste na construção do biomodelo por fotopolimerização de uma resina epoxy líquida usando radiação ultravioleta. O biomodelo resultante deste processo é levado à máquina pressurizadora para remoção da resina de suporte através de lavagem por jatos de água. Após esta etapa o mesmo é enviado ao profissional de saúde responsável. O uso de biomodelos constitui um grande avanço para a área da Odontologia, permitindo a realização de diagnósticos mais precisos por parte do profissional; simulação e planejamento cirúrgico; adaptação prévia de biomateriais e órteses; bem como a comunicação entre o cirurgião e o paciente, obtendo assim, resultados estéticos mais satisfatórios e diminuição do tempo cirúrgico.Termos de indexação: Assistência à saúde. Odontologia. Impressão tridimensional.
ResumoIntrodução: A população mundial está envelhecendo e já é possível observar um maior número de pacientes idosos sendo atendido em consultórios odontológicos, o que torna cada vez mais necessário que o cirurgião-dentista entenda quais são as condições comumente associadas à terceira idade. Objetivo: Este estudo objetivou analisar a situação de ensino da Odontogeriatria nos cursos de Odontologia da região Nordeste do Brasil. Material e método: Tratou-se de uma pesquisa transversal, descritiva e com abordagem quantitativa, realizada em outubro de 2016. O universo foi composto por todas as faculdades de Odontologia brasileiras situadas na região Nordeste, em atividade, segundo relação do Conselho Federal de Odontologia (CFO), totalizando 43 instituições. Foi realizada uma consulta às grades curriculares dos cursos e às ementas da disciplina de Odontogeriatria e de disciplinas que envolvessem o conteúdo referente à Odontogeriatria, disponíveis nos sites da internet de cada faculdade. Resultados: Apenas 16 oferecem o ensino da Odontogeriatria em seus currículos e dessas, 10 são em faculdades privadas, 10 ofertam a disciplina de forma obrigatória e somente 6 instituições abordam o conteúdo com atividades práticas. Conclusão: Diante do exposto, a Odontogeriatria nos cursos de Odontologia da região Nordeste do Brasil apresenta-se como uma disciplina que ainda não é unanimidade em todos os currículos, evidenciando assim a necessidade de sua implementação para uma formação profissional voltada a atender satisfatoriamente as necessidades da população idosa. Descritores: Odontologia Geriátrica; Educação em Odontologia; Idoso; Currículo. AbstractIntroduction: The world population is aging and it is already possible to observe a greater number of elderly patients being attended in dental office, which makes it increasingly necessary for the dentist to understand the conditions commonly associated with the elderly. Objective: This study aimed to analyze the teaching situation of Odontogeriatry in dentistry courses in the Northeastern region of Brazil. Material and method: It was a cross-sectional, descriptive and quantitative research carried out in October 2016. The universe was composed of all Brazilian dentistry faculties located in the northeast region, in activity, according to the Federal Council of Dentistry (CFO), totaling 43 institutions. A consultation was carried out with the curriculum grades of the courses and the subjects of the Odontogeriatrics course and subjects involving the content related to Odontogeriatry, available on the websites of each faculty. Results: Only 16 offer the teaching of Odontogeriatrics in their curriculum and of these, 10 are in private colleges and 10 offer the discipline in a mandatory way and only 6 institutions approach the content of the discipline with practical activities. Conclusion: In view of the above, Odontogeriatrics in dentistry courses in the northeastern region of Brazil presents itself as a discipline that is not yet unanimous in all curriculum, thus evidencing the ne...
Introduction There have been concerns that longstanding oral dryness secondary to Sjogren's syndrome may increase the risk of failure of dental implants. Aims The aim of the present study was to determine the level of methodological quality of systematic reviews that evaluated the effectiveness of dental implants in patients diagnosed with Sjogren's syndrome. Methods and results Databases of PubMed/Medline, LILACS, Science Direct and Dare Cochrane to October 2020 were evaluated. A total of 833 articles were initially identified but following use of appropriate inclusion and exclusion criteria 4 papers were identified for detailed analysis. An eventual study sample comprised 722 implants placed in 189 patients with a 95.22% success rate, the minimum follow‐up time was 45.2 ± 23.8 months and the maximum 125.5 months. The studies were assessed for their methodological quality by the AMSTAR 2 tool, in which 3 had critically low quality and one low quality. Conclusion Oral rehabilitation with dental implants in patients with Sjogren's syndrome seems to have a high success rate; however, the low quality of relevant reports highlights the need for primary and secondary studies with better methodological design in order to reduce bias and provide reassurance for this treatment option.
ObjectiveThe objective of this overview is to evaluate the effectiveness of dental implants placed in patients who underwent radiotherapy for the treatment of head and neck cancer, as well as to assess the methodological quality of the included systematic reviews.MethodsThe study was conducted in four PubMed, Lilacs, Dare Cochrane and Google Scholar databases until July 2022, using the descriptors “Radiotherapy,” “Dental implants,” and “Head and Neck Cancer.” Results: 958 studies were found in the initial search and after applying the inclusion and exclusion criteria, fifteen systematic reviews were selected to compose this overview and had their methodological quality evaluated by the AMSTAR 2 tool.Results24,996 implants in 5487 patients were evaluated with a rate of success rate of 86.2% in patients who underwent radiotherapy and 95.2% in patients who did not undergo radiotherapy. Only one of the systematic reviews was of high quality according to AMSTAR 2.ConclusionOral rehabilitation with dental implants in patients with a history of head and neck cancer undergoing radiotherapy is a valid therapy. However, given the level of evidence found, further studies with better design are necessary to provide greater confidence in the clinical decision.
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