The objective of this study was to verify the incidence of phlebitis in a clinical medical unit. A prospective cohort study was conducted using nonparticipatory observations guided by a structured questionnaire, with 100 patients admitted to the clinical medical unit, in whom 234 peripheral venous accesses were used. Phlebitis was identified in 60% of patients and in 55.6% of the peripheral venous accesses, and most of them remained intact for more than 72 hours (53%). The presence of phlebitis per patient was associated with longer hospitalization on the clinical unit (p=0.002) and a greater number of accesses per patient (p<0.001). Length of retention of venous access for more than 72 hours was also associated with the presence of phlebitis (p<0.001). Phlebitis occurred in the majority of the patients and peripheral venous accesses analyzed. Therefore, it is necessary to intensify the training protocols for nursing staff in order to reduce the rates of phlebitis.

No abstract

An algorithm based on breast size in relation to tumor location and extension of resection can be followed to determine the best approach to reconstruction. The authors' results have demonstrated that the complications were similar to those in other clinical series. Success depends on patient selection, coordinated planning with the oncologic surgeon, and careful intraoperative management.

The aim of this study was to investigate the density of mast cells and microvessels in minor salivary gland tumors. Forty-one cases of minor salivary gland tumors (pleomorphic adenoma, n = 10; adenoid cystic carcinoma, n = 11; mucoepidermoid carcinoma, n = 10; and polymorphous low-grade adenocarcinoma) were investigated using immunohistochemistry for mast cell tryptase and von-Willebrand factor. Density of mast cells was higher in mucoepidermoid carcinoma; however, no differences in the number of these cells were observed between the different types of tumors (p > 0.05). The number of mast cells was higher in periparenchymal areas in all tumors, but the difference was not significant (p > 0.05). Mucoepidermoid carcinoma showed the largest number of periparenchymal mast cells, whereas pleomorphic adenomas showed the smallest number of intraparenchymal mast cells (p > 0.05). The highest microvessel density was observed in mucoepidermoid carcinomas, being this difference statistically significant when mucoepidermoid carcinoma was compared to pleomorphic adenoma (p = 0.0034) and polymorphous low-grade adenocarcinoma (p = 0.004). Microvessel density was significantly higher in adenoid cystic carcinoma when compared to pleomorphic adenoma (p = 0.0406) and polymorphous low-grade adenocarcinoma (p = 0.0123). Comparison of mast cells and microvessel densities showed no significant difference between tumors. A quantitative difference in mast cells and microvessels was observed, particularly in mucoepidermoid carcinoma, a finding supporting the aggressive behavior of malignant salivary gland tumors without myoepithelial differentiation. Further studies are needed to determine the role of mast cells in angiogenesis, as well as in the development and biological behavior of these tumors.

No abstract

The objective of this study is to describe the surgical planning of the inferior dermoglandular pedicle (IDP) technique and its outcome following partial mastectomy reconstruction. A total of 26 patients with breast cancer underwent immediate IDP reconstruction. IDP was indicated to reconstruct superior/central breast defects. Postoperative complications were evaluated and information on esthetic result and satisfaction were collected. About 57.6 percent had tumors measuring 2cm or less (T1). Immediate complications occurred in 34.2 percent with skin necrosis in 11.4 and dehiscence in 7.6 percent. Late complications were observed in 11.4 percent. The cosmetic result was considered to be good or very good in 88.4 percent and the majority of patients were satisfied. All complications were treated by conservative approach. IDP is a reliable technique and should be given consideration in cases of superior/central quadrant reconstruction. The success of the procedure depends on patient selection and careful intra-operative management.

The use of violet LED was recently introduced as a new alternative technique to perform tooth bleaching, associated or not with bleaching agents. This paper shows a tooth bleaching clinical case report performed in a 26-year-old woman, using a violet LED with 10% carbamide peroxide (CP). The tooth bleaching protocol was performed in 3 sessions. Fifteen irradiations using a violet light system (BMW, MMoptics, São Carlos, SP, Brazil) were done during 30 s (on) and 60 s (off) without bleaching gel, and more 5 irradiations associated to 10% CP. Upper and lower arches were irradiated separately. The total procedure time was 30 min. Subjective and objective color assessments were performed using Vitapan Classical shade guide and VITA Easyshade spectrophotometer, respectively. Dentin sensitivity was measured using a visual analogue scale. The use of violet LED associated to a low concentration carbamide peroxide successfully promoted tooth bleaching and no side effects i.e. dentin sensitivity during and post treatment was observed.

OBJECTIVE: To identify the clinical pathways of women with breast cancer treated in public hospitals, and to analyze the factors that influence the time interval between the first appointment and the start of therapy. METHODS: A cross-sectional study was conducted with 600 women with breast cancer treated in nine public hospitals in the Brazilian Federal District. Patients were interviewed between September 2012 and September 2014. Simple and multiple logistic regression models were adjusted to evaluate the variables associated with the time interval studied. The most frequent pathway was the one that started in primary care with following care in the therapy service (28.9%). In the multiple adjustment, factors associated to a longer time interval between the first appointment and therapy were: lower family income (OR = 1.89; 95%CI 1.32–2.68), the first appointment in public services (OR = 1.78; 95%CI 1.20–2.64), care in more than two health services in the clinical pathway (OR = 1.71; 95%CI 1.19–2.44); and obtaining the anatomopathological analysis of the biopsy in public services instead of private health services (OR = 1.87; 95%CI 1.29–2.71). Independently, the implementation of specialist appointment scheduling, with care regulation, was associated with a shorter time interval between first appointment and therapy (OR = 0.33; 95%CI 0.16–0.65). CONCLUSIONS: We observed that multiple pathways were covered by women with breast cancer treated in public services of the Federal District. Socioeconomic iniquities and several aspectos of the pathways covered were associated with a longer time interval between the first appointment and the start of breast cancer therapy.