BackgroundNosocomial pneumonia has correlated to dental plaque and to oropharynx colonization in patients receiving mechanical ventilation. The interruption of this process, by preventing colonization of pathogenic bacteria, represents a potential procedure for the prevention of ventilator-associated pneumonia (VAP).MethodsThe study design was a prospective, randomized trial to verify if oral hygiene through toothbrushing plus chlorhexidine in gel at 0.12% reduces the incidence of ventilatior-associated pneumonia, the duration of mechanical ventilation, the length of hospital stay and the mortality rate in ICUs, when compared to oral hygiene only with chlorhexidine, solution of 0.12%, without toothbrushing, in adult individuals under mechanical ventilation, hospitalized in Clinical/Surgical and Cardiology Intensive Care Units (ICU). The study protocol was approved by the Ethical Committee of Research of the Health Sciences Center of the Federal University of Pernambuco – Certificate of Ethical Committee Approval (CAAE) 04300012500005208. Because it was a randomized trial, the research used CONSORT 2010 checklist criteria.ResultsSeven hundred sixteen patients were admitted into the ICU; 219 fulfilled the criteria for inclusion and 213 patients were included; 108 were randomized to control group and 105 to intervention group. Toothbrushing plus 0.12% chlorhexidine gel demonstrated a lower incidence of VAP throughout the follow up period, although the difference was not statistically significant (p = 0.084). There was a significant reduction of the mean time of mechanical ventilation in the toothbrushing group (p = 0.018). Regarding the length of hospital stay in the ICU and mortality rates, the difference was not statistically significant (p = 0.064).ConclusionsThe results obtained showed that, among patients undergoing toothbrushing there was a significant reduction in duration of mechanical ventilation, and a tendency to reduce the incidence of VAP and length of ICU stay, although without statistical significance.Trial registrationRetrospectively registered in the Brazilian Clinical Trials Registry (Registro Brasileiro de Ensaios Clínicos) - RBR-4TWH4M (4 September 2016).

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The authors set out in this study to verify the presence of low-and high-risk DNA of human papillomavirus (HPV) in oral cancer by means of the hybrid capture Digene ® test (São Paulo-SP, Brazil) in smears from exfoliative cytology and also to compare the findings with those of conventional light microscopy (hematoxylin-eosin (HE)/Papanicolaou). Forty individuals gave their written informed consent to participate in the study and also had their clinical data analyzed. The 40 exfoliative cytology examinations performed to date produced the following results: 29 (72.5%) negative for low-and high-risk HPV-DNA; nine (22.5%) positive for low-and high-risk HPV-DNA; one (2.5%) positive for low-risk HPV-DNA; and one (2.5%) positive for high-risk HPV-DNA. There was agreement among the findings for the presence of DNA-HPV for both exfoliative cytology (smear to hybrid capture Digene ® test and the cytological smear readings made by conventional light microscopy). It was therefore concluded that the HPV virus may be a cocarcinogen of the mouth cancer as it is in the cervix cancer. Oral cancer HPV Exfoliative cytology Hybrid capture resumo Os autores buscaram verificar, neste estudo, a presença do papilomavírus humano (HPV) de baixo e de alto risco em carcinomas orais através do teste de captura híbrida Digene ® (São Paulo-SP, Brasil) em amostras colhidas pela citologia esfoliativa bucal e, ainda, avaliar comparativamente as referidas leituras com alterações celulares indicativas deste vírus obtidas com a interpretação citológica óptica convencional (hematoxilinaeosina (HE)/Papanicolaou). Quarenta indivíduos concordaram, espontaneamente, através de assinatura do termo de consentimento livre e esclarecido, em participar da pesquisa, e seus dados clínicos foram analisados. Entre as 40 amostras provenientes da citologia esfoliativa 29 (72,5%) mostraram-se negativas para presença de HPV-DNA de baixo e de alto risco; nove (22,5%) foram positivas para o HPV-DNA de baixo e de alto risco; uma (2,5%) foi positiva apenas para o HPV de baixo risco; e também uma (2,5%) foi positiva apenas para o HPV de alto risco. Houve concordância entre todos os resultados positivos para presença de HPV-DNA nas amostras citológicas submetidas ao teste de captura híbrida Digene ® e na leitura de esfregaço citológico ao microscópio óptico convencional. Desta forma, conclui-se que o vírus HPV pode comportar-se como mais um co-carcinógeno para o câncer de boca, à semelhança do carcinoma uterino.

To assess the knowledge of elementary and high school students about oral cancer, risk factors, self-examinati on, preventi on, diagnosis and treatment. Method: The study comprised 826 students from public elementary and high school in the citi es of Arcoverde, Caraíbas and Venturosa in the State of Pernambuco, Brazil. Aft er explaining the scope of the study, the authors/researchers interviewed the students by the applicati on of a questi onnaire in the schools. Immediately aft er data collecti on, educati onal/ preventi ve acti viti es were developed (Durati on: 4 hours class in each class of up to 30 students) to explain about the disease, risk factors, preventi on and self-examinati on. At the end, the parti cipants were asked to give a feedback about the performed acti viti es. The data were analyzed stati sti cally by descripti ve stati sti cs. Results: The students presented a similar knowledge profi le in all three citi es. There was a predominance of women with incomplete elementary educati on and a mean age of 16 years (55%). Although 60% of the interviewees affi rmed having heard about the disease, they could not associate correctly the risk factors. Smoking, alcohol and the sun were identi fi ed as risk factors by 20% of the sample. Self-examinati on was unknown by 96% and 80% stated not knowing what to do if a lesion was discovered, while 6% said they would visit a denti st. Their own general and oral health was considered good by 53% and 22% said they were undergoing dental treatment. Almost all (99%) said that they enjoyed the acti viti es, learned about the risk factors, acquired new knowledge, warranted that they would take bett er care of themselves and would transmit the obtained informati on to other people and learned about selfexaminati on. Conclusion: The results reaffi rmed the need of orientati on/ educati on/preventi on. Objeti vo: Verifi car o conhecimento de escolares de ensino médio e fundamental acerca do câncer de boca, fatores de risco, auto-exame, prevenção, diagnósti co e tratamento. Método: Estudo realizado com 826 alunos de escolas públicas de ensino médio e fundamental, do Sertão (Arcoverde, Caraíbas, Venturosa) Pernambuco, Brasil. Após a explicação sobre o projeto, foi aplicado um questi onário prévio, através de entrevista pessoal, realizada pelos pesquisadores/autores, deste trabalho, nas escolas, e, imediatamente, após a obtenção dos dados foram desenvolvidas ati vidades educati vas/preventi vas (CH= 4 h/a em cada turma de até 30 alunos) de esclarecimento aos escolares sobre a doença, fatores de risco, de prevenção e auto-exame e, ao fi nal, foram coletados depoimentos sobre as ati vidades realizadas. Foi realizada análise estatí sti ca descriti va dos dados. Resultados: Os escolares apresentaram um perfi l de conhecimento semelhante nos três locais estudados. Houve predomínio do 55% do sexo feminino, com ensino fundamental incompleto, idade média de 16 anos. Embora 60% tenham afi rmado haver ouvido falar sobre a doença, não souberam associar corretamente os fatores de ris...

The oral cancer is responsible for approximately 3 % of cases of cancer in Brazil. Epidemiological studies have associated low folate intake with an increased risk of epithelial cancers, including oral cancer. Folic acid has a key role in DNA synthesis, repair, methylation and this is the basis of explanations for a putative role for folic acid in cancer prevention. The role of folic acid in carcinogenesis may be modulated by polymorphism C677T in MTHFR and tandem repeats 2R/3R in the promoter site of TYMS gene that are related to decreased enzymatic activity and quantity and availability of the enzyme, respectively. These events cause a decrease in the synthesis, repair and DNA methylation, which can lead to a disruption in the expression of tumor suppressor genes as TP53. The objective of this study was investigate the distribution of polymorphisms C677T and tandem repeats 2R/3R associated with the development of oral squamous cell carcinoma (OSCC). 53 paraffin-embedded samples from patients who underwent surgery but are no longer at the institution and 43 samples collected by method of oral exfoliation by cytobrush were selected. 132 healthy subjects were selected by specialists at the dental clinics of the Faculdade de Odontologia de Pernambuco-FOP. The MTHFR genotyping was performed by PCR-RFLP, and the TYMS genotyping was performed by conventional PCR. Fisher's Exact test at significant level of 5 %. Odds ratios (ORs) and 95 % confidence intervals (CIs) were used to measure the strength of association between genotype frequency and OSCC development. The results were statistically significant for the tandem repeats of the TYMS gene (p = 0.015). The TYMS 2R3R genotype was significantly associated with the development of OSCC (OR = 3.582; 95 % CI 1.240-10.348; p = 0.0262) and also the genotype 3R3R (OR = 3.553; 95 % CI 1.293-9.760; p = 0.0345). When analyzed together, the TYMS 2R3R + 3R3R genotypes also showed association (OR = 3.518; 95 % CI 11.188-10.348; p = 0.0177). No differences for the MTHFR C677T polymorphisms distribution were found between the oral cancer patients and controls subjects in our study (p = 0.499). Therefore, these data suggest that determination of TYMS tandem repeats could provide information on the comprehension of the risk factors and prevention of the OSCC.

ABTRACT Hospital dental care is an educational and health care strategy whose purpose is to intervene, in a multidisciplinary way, in the health-disease process of vulnerable individuals, as unsatisfactory oral health is a risk factor for local and systemic infections. Patients in cancer treatment usually present oral manifestations because of the antineoplastic therapies to which they are submitted. Chemotherapy, radiation and cancer surgery, when the latter held in the head and neck region, have the potential to generate side effects in the oral cavity. These oral manifestations can be serious and interfere with the results of medical therapy, leading to important systemic complications, which can increase hospital stay, treatment costs, and affect the quality of life. In view of this reality, the incorporation of the dentist into the multiprofessional team in oncology is essential to guarantee the patient’s integral care in all stages of therapy. This article then proposes to report a series of cases of patients attended at the Dentistry Service of the Oncology Center of the Oswaldo Cruz University Hospital of the University of Pernambuco, that exemplify the dental surgeon performance in a hospital environment, participating as an active member of a multidisciplinary team in oncology.

Objetivo: Verificar o conhecimento da população pernambucana acerca do câncer de boca bem como identificar indivíduos expostos aos fatores de risco já comprovados na literatura. Metodologia: Estudo de corte transversal realizado com população de 54 municípios pernambucanos, no período de janeiro de 2005 a dezembro de 2009. A população foi visitada em suas casas, escolas, associações, conselhos, empresas públicas e privadas, ambulatórios, e, após concordar em participar deste estudo, mediante assinatura do Termo de Consentimento Livre e Esclarecido (TCLE), foi aplicado questionário. Em seguida, houve um compartilhamento de informações acerca da doença, dos fatores de risco, prevenção e autoexame. Em paralelo, foram realizados cursos de atualização/ capacitação para prevenção e diagnóstico diferencial e precoce do câncer bucal com as equipes de saúde bucal desses municípios pernambucanos. Os dados obtidos foram submetidos à análise descritiva e estatística por meio teste do qui-quadrado (Programa BioEstat 3.0). Resultados: Constituíram a amostra 43.200 (100%) pessoas que, responderam ao questionário e compartilharam das atividades educativas/ preventivas, sendo 25.488(59%) do sexo feminino e 17.712 (41%) masculino. A média das idades observada foi 42,3, sendo a mínima=07 e a máxima= 103 anos. 25.920 (60%) das pessoas já tinham ouvido falar sobre a doença, porém não souberam associar corretamente os fatores de risco, embora 24.192 (56%) estivessem expostos a estes. O sexo masculino está exposto de forma mais significativa aos fatores de risco do que as mulheres, o que foi evidenciado através do teste de qui-quadrado (α= 0,05; p<0,01). Foi observado nesta pesquisa que, a despeito da perda dentária, a reabilitação protética não é usual. Conclusões: Parte da população conhece os fatores de risco para o câncer de boca, embora muitos desconheçam mesmo estando expostos a estes. O tabagismo, etilismo e a exposição ao sol foram identificados como os fatores de risco preponderantes nessa amostra.Câncer Bucal; Fatores de Risco; Educação; Prevenção; Epidemiologia.Objective: To verify the knowledge of the population of the State of Pernambuco about oral cancer and identify individuals exposed to risk factors recognized in the literature. Method: A cross-sectional study was conducted with the population of 54 cities of the State of Pernambuco between January 2005 and December 2009. People were visited at their homes, schools, associations, councils, public and private companies and outpatient health services. After agreeing to participate in the study and signing an informed consent form, a questionnaire was applied to the subjects. Information was collected to assess their knowledge about the disease, risk factors, prevention and self-exam. In parallel, refreshing/capacitation courses for the prevention and differential and early diagnosis of oral cancer were offered to the oral health teams of the cities involved in the study. Data were subjected to descriptive and statistical analyses using the chi-square test (BioEstat 3.0 ...

MDS may present limiting oral repercussions interfering in patients' quality of life. The aPDT is presented as an adjuvant therapeutic modality in oral infections with satisfactory results.