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Bonissoni, Maressa Daniela Anghinoni;

Alves, Fernanda Mara;

Almeida, Rafaella Frederico;

Smaniotto, Lucca;

Berny, Maria Paula De Andrade;

Silva, Victor Pereira Da;

Fiuza, Brenda Stephanie;

Rodrigues, Guilherme Cirino;

Neres, Eloisa Maria;

Kern, Rodrigo;

Santos, Carlos Victor Pereira Dos;

Souza, Janoário Athanazio De;

Rech, Daniel;

Panis, Carolina;

ABSTRACT Purpose: Approximately 10% of breast cancer patients with localized operable disease experience recurrence. This study aimed to evaluate patients with early-stage breast cancer (TNM I and II) who underwent surgery without the need for neoadjuvant therapy. Methods: The total of 117 patients was included in the study: 104 without recurrence and 13 with recurrence. We analyzed various clinicopathological parameters, including body mass index, age at diagnosis, menopausal status, pesticide exposure, and tumor characteristics such as HER2 amplification, Ki67 index, molecular subtype, and histological grade. Results: Two primary subsets were identified as being associated with disease recurrence. The first subset (PC1) was characterized by HER2 amplification and metastatic disease, while the second subset (PC2) comprised premenopausal young women exposed to pesticides who had triple-negative tumors. While some of these factors are well-documented in the literature, pesticide exposure emerged as a notable regional factor contributing to poor outcomes in breast cancer patients. Conclusion: These findings underscored the significance of identifying local and regional risk factors when assessing recurrence risk in women with breast cancer, particularly in cases in which surgery is the primary treatment approach.

Viana, Sofia Wagemaker;

Gerk, Ayla;

Schlindwein, Sofia Schmitt;

Marrazzo, Enzzo;

Feres, Brenda;

Ribeiro, Lívia;

Carroll, Madeleine;

Mooney, David Patrick;

Schnitman, Gabriel;

Camargo, Cristina Pires;

ABSTRACT Purpose: To assess the cost of traffic accidents in Brazil and the impact of age/location. Methods: All patients admitted to a Brazilian hospital due to traffic accidents from January 2012 to December 2022 and cost of hospital services were obtained from the Department of Information Technology of the Unified Health System. Demographic data were collected in the Brazilian Institute of Geography and Statistics database. Parametric and nonparametric data were analyzed. The Kruskal-Wallis’ test and a post-hoc test were used for data comparison. The ARIMA linear regression method for trend estimation. Results: In Brazil, 1.6 million individuals were involved in traffic accidents between 2012–2022, resulting in a cumulative hospital expenditure of US$ 38 million. The average hospital admission cost during this time was US$ 239.66, but no correlation was found between the cost per capita and driver population density increase. Hospitalization in the Midwest/South was higher. Conclusion: The economic impact of traffic accidents on the Brazilian public health system is significant. With a high number of victims admitted annually and evident regional and age-related disparities, there is a clear need for comprehensive and cost-effective healthcare strategies.

Moraes, Michelle Bianchi-De;

Costa, Natália Caroline Queiroz;

Silva, Gabriella Yasmim Santos Da;

Costa, André Luiz Ferreira;

Costa, Fernanda Calvo;

Raldi, Fernando Vagner;

Lopes, Sérgio Lúcio Pereira De Castro;

ABSTRACT Purpose: The degenerative joint disease is a temporomandibular disorder. By analysing texture parameters, it becomes possible to characterize and differentiate various tissues, based on their textural properties according to cone-beam computed tomography (CBCT). This study evaluated degenerative diseases in the temporomandibular joint through texture analysis. Methods: Eighty images of the jaw condyle with three types of degenerative diseases, flattening, osteophytes, erosion and control group were analysed, obtained through CBCT. The analyses were carried out through texture analysis with three regions of interest (ROIs) corresponding to specific bone sites. The scans were exported to MaZda software, in which the ROIs were delimited following previously marked contours, and the co-occurrence matrix values were calculated for selected texture analysis parameters. Results: The erosion group showed a significantly different behaviour from the other groups for all analysed parameters. Conclusion: This study highlights the potential of texture analysis in characterizing medullary bone changes in condyles affected by erosion. Texture analysis allows for a more comprehensive assessment of bone condition on CBCT images. These results have implications for early detection and monitoring of degenerative changes in the temporomandibular joint, thus allowing preventive intervention and personalized treatment planning, improving the prognosis of the disease.

Saad, Sarhan Sydney;

Forones, Nora;

Lopes Filho, Gaspar;

Waisberg, Jaques;

Caetano Júnior, Elesiario;

Artigiani-Neto, Ricardo;

Matos, Delcio;

ABSTRACT Purpose: To identify the prognostic variables related to the survival of patients operated on for adenocarcinoma of the rectum who underwent preoperative radiochemotherapy (RCT). Methods: We studied 70 patients from the Discipline of Surgical Gastroenterology at Escola Paulista de Medicina from 2000 to 2019, with rectal cancer located up to 10 cm from the anal verge and with stages II or III, submitted to preoperative RCT and curative surgery (R0) and with follow-up of at least 12 months. Clinical restaging was performed four to six weeks after the end of neoadjuvant treatment to characterize the degree of clinical tumor regression. Surgery by laparotomy or videolaparoscopy was performed six to 12 weeks after RCT. Primary endpoint were: overall survival (OS), disease-free survival (DFS), metastasis-free survival (MSS), and neoplasm-specific survival (SEN). These were compared with gender, age, carcinoembryonic antigen (CEA) dosage, distance from the tumor to the anal verge, radiation dose, radiotherapy-surgery interval, clinical regression, type of surgery, pT and pN TNM stage tumor, number of nodes, circumferential resection margin, and complete pathological response. Survival was assessed by Kaplan-Meier curves. Univariate and multivariate Cox analyses were calculated to identify factors associated with survival outcomes. Results: The mean follow-up time was 62 months. The pathological complete response rate was 18.6%. Univariate cox regression showed a significant relationship of CEA equal to or greater than 4 ng/mL with DFS and MFS, pT3/pT4 staging with DFS, MFS and SEN, pN1/N2 with DFS, MFS and SEN and stages II and III with DFS and MFS. Multivariate regression found that CEA, pT, and pN staging are independent prognostic factors for DFS, MFS, and SEN. Conclusion: Carcinoembryonic antigen level prior to radiotherapy, pT staging and pN staging were independent prognostic factors for survival in patients with rectal adenocarcinoma who are treated with preoperative radiochemotherapy.

Sales, Paulo Victor Alves De;

Godói, Isabella Piassi Dias;

Brito, Gerly Anne De Castro;

Leitão, Renata Carvalho;

Araújo, Aurigena Antunes De;

Medeiros, Caroline Addison Carvalho Xavier De;

ABSTRACT Purpose: To conduct a systematic review of the mechanisms of photobiomodulation therapy (PBMT) for treating or preventing oral mucositis (OM) caused by antineoplastic therapy. Methods: Following PRISMA 2020 guidelines, a search was conducted in Medline, Latin American and Caribbean Health Sciences Literature (LILACS), Scientific Electronic Library Online (SciELO), and Bibliografia Brasileira de Odontologia from August to September 2023 using descriptors related to OM and laser therapy. Studies on the mechanisms of photobiomodulation in OM were included. Randomized (RCTs) or non-randomized trials from the past 10 years were reviewed. Risk of bias was assessed using RoB 2.0 and ROBINS-I tools. Results: A total of 355 studies was identified. After the screening, seven met the eligibility criteria. The RCTs showed a low risk of bias. PBMT reduced OM incidence in patients undergoing chemotherapy/radiotherapy. PBMT decreased pro-inflammatory cytokines (interleukin-6, tumor necrosis factor-α) and increased anti-inflammatory cytokines (interleukin-4, interleukin-10). It also modulated inflammatory mediators, enhancing the antioxidant enzyme superoxide dismutase and overexpressing genes for keratinocyte differentiation, aiding injury repair. Conclusion: The findings suggested that the mechanism of action of PBMT in OM involves modulation of the inflammatory response, balancing oxygen reactive species generation, and expression of factors related to healing or repair. Further studies are needed to elucidate these mechanisms and optimize treatment protocols.

Flumignan, Victor Kalil;

Sircili, Marcelo De Palma;

Franzolin, Marcia Regina;

Tavassi, Ana Marisa Chudzinski;

Germano, Lígia Garcia;

Souza, Ana Vitória Dos Santos;

Silva, Nicole Fernandes;

Fukumasu, Newton Kiyoshi;

Anjos, Raphaela Marques Dos;

Otoch, Jose Pinhata;

Artifon, Everson Luiz De Almeida;

ABSTRACT Purpose: Plastic biliary stents are a cost-effective treatment for biliary obstruction. Unfortunately, they have low patency, related to intraluminal biofilm formation. Silver nanoparticles (AgNPs) have been increasingly used in biomedicine because of its antibacterial properties. This study aimed to compare biofilm formation on stents with and without silver nanoparticle coatings when in contact with different bacterial culture medium. Methods: Different types of silver coatings were tested on plastic biliary stents. Two groups of stents were analyzed: one group with various types of silver nanoparticle coatings, and a negative control group with no coating. The stents were placed in different bacterial culture media and assessed for biofilm formation. Analysis was performed using confocal microscopy and direct colony-forming unit (CFU/cm2). Results: Quantitative analysis showed promising results with C16 coating, as Escherichia coli ATCC and Pseudomonas aeruginosa ATCC exhibited reduced growth in the AgNP-coated group (p < 0.05). However, when mixed samples, including clinical strains and Staphylococcus aureus, were tested, the AgNP coating did not inhibit bacterial growth. Conclusion: AgNP-coated stents are effective against certain strains, such as E. coli ATCC and P. aeruginosa. Further research is needed to explore potential improvements in the coating mechanism.